Pharmaceuticals, microplastics, and oil spills are the most hazardous contaminants in aquatic environments. The COVID-19 pandemic enhanced pharmaceutical and microplastic contamination in aquatic environments. The present study aimed to investigate the prevalence of pharmaceutical and microplastic pollution on a global scale. This study assessed the results of pharmaceutical contamination in 25 countries and microplastic pollution in 13 countries. The findings show that pharmaceutical residues were detected in surface water, groundwater, and wastewater influents and effluents. In total, 43 types of pharmaceutical products were detected in 25 countries. Caffeine, acetaminophen, ibuprofen, sulfamethoxazole, and carbamazepine were the most abundant. In total, 32 types of polymers were detected in 13 countries. In the case of microplastics, polypropylene, polyethylene, polystyrene, and polyethylene terephthalate were the more abundant polymers. Particles with a size of 1–2.5 mm and 2.5–5 mm accounted for half of the microplastics present in 13 countries. This study provides new evidence of the importance of emerging pollutants in aquatic environments before and during the COVID-19 pandemic.
Occupational psychosocial stress can increase the risk of several cardiometabolic diseases. Healthcare workers worldwide experience exceptionally high levels of occupational stress, leading to serious individual, organizational, and societal problems. This narrative review seeks to provide information about the overall consequences of having over-stressed healthcare workers and ascertain how it eventually holds back the advancement of healthcare. In addition, we present a review of the concept, study, and theories related to stress management in order to deeply understand this issue, providing a theoretical perspective of stress management and the subtle concepts of stress, stress management, healthcare structure, and organization in Nigeria. The current literature has shown that Nigerian healthcare workers are more stressed due to long working hours, caregiving responsibilities, and psychological contact with patients. Healthcare workers are more likely to experience stress and burnout than other professions. The level of stress in the healthcare sector has garnered a lot of attention in this regard because of the negative impact of stress on both staff and patients. However, health policies and better working conditions need to be adopted. Collaborative efforts from policymakers, healthcare institutions, and other stakeholders are necessary to prioritize the well-being and productivity of healthcare professionals in the journey toward a more robust and equitable healthcare system.
Background: Recently, the leptin/adiponectin (L/A) ratio has been suggested as a novel predictor of cardio-metabolic and other chronic diseases. Aim: To evaluate the ability of leptin (L), adiponectin (A), and the L/A ratio in identifying high risk of insulin resistance IR in adolescents, adjusted by cardiorespiratory fitness, adherence to the Mediterranean diet, and body fat percentage. Subjects and methods: This is a cross-sectional analysis with 529 adolescents aged 12–18 years-old. Blood samples were taken to analyze glucose, insulin, leptin, and adiponectin levels. IR (homeostasis model assessment of insulin resistance (HOMA-IR) was estimated from fasting serum insulin and glucose). Results: Adiponectin, leptin, and L/A ratio were accurate to predict IR among adolescents. The optimal L/A cut-off value to indicate risk of IR development was >0.35 in boys and >0.97 in girls. Logistic analyses showed that the suggested cut-off points for adiponectin (girls: OR: 2.87 (1.26–6.53); p = 0.012); leptin (boys: OR: 5.23 (1.16–7.14) p = 0.006; girls: OR: 2.99 (1.10–8.09) p = 0.031), and the L/A ratio (boys: OR: 8.38 (2.6–26.8) p < 0.001; girls: OR: 6.1 (2.1–17.0) p < 0.001), were significant predictors of IR, after adjustments for age, pubertal stage, adherence to the Mediterranean diet, cardiorespiratory fitness, and body fat percentage. Conclusion: Leptin and L/A ratio were associated with IR risk, after adjustments for confounders in both sexes and adiponectin in girls. The L/A ratio seems to have a higher diagnostic accuracy to identify IR risk than adiponectin or leptin, in both sexes.
Introduction: Limited information is available on trends in hepatitis C virus (HCV) infection, particularly in Central Europe. To address this knowledge gap, we analyzed HCV epidemiology in Poland, considering socio-demographic characteristics, changing patterns over time, and the impact of the COVID-19 pandemic. Material and Methods: We examined HCV cases (diagnosis and deaths) reported by national registries and used joinpoint analysis to estimate time trajectories. Results: Between 2009 and 2021, there were changes in the trends of HCV, shifting from positive to negative in Poland. Among men, there was a significant increase initially in diagnosis rate of HCV in rural areas (annual percent change, APC2009–2016 +11.50%) and urban areas (APC2009–2016 +11.44%) by 2016. In subsequent years until 2019, the trend changed direction, but the reduction was weak (Ptrend > 0.05) in rural areas (−8.66%) and urban areas (−13.63%). During the COVID-19 pandemic, the diagnosis rate of HCV dramatically decreased in rural areas (APC2019–2021 −41.47%) and urban areas (APC2019–2021 −40.88%). Among women, changes in the diagnosis rate of HCV were less pronounced. In rural areas, there was a significant increase (APC2009–2015 +20.53%) followed by no significant change, whereas changes occurred later in urban areas (APC2017–2021 −33.58%). Trend changes in total mortality due to HCV were mainly among men, with a significant decrease in rural (−17.17%) and urban (−21.55%) areas from 2014/2015. Conclusions: The COVID-19 pandemic reduced HCV diagnosis rates in Poland, especially for diagnosed cases. However, further monitoring of HCV trends is necessary, along with national screening programs and improved linkage to care.
Cutaneous melanoma, an aggressive malignancy, has undergone significant transformation in clinical management with the introduction of immune checkpoint inhibitors (ICIs) and targeted therapies. Current monitoring methods, such as imaging scans, present limitations, prompting exploration of alternative biomarkers. This review comprehensively explores the role of circulating tumor DNA (ctDNA) in advanced melanoma, covering technical aspects, detection methods, and its prognostic and predictive value. Recent findings underscore ctDNA’s potential applications and implications in clinical practice. This review emphasizes the need for precise and dynamic biomarkers in melanoma care, positioning ctDNA as a promising blood-based tool for prognosis, treatment response, and resistance mechanisms. The technical nuances of ctDNA detection, association with melanoma mutations, and its role in guiding therapeutic decisions for immunotherapy and targeted therapy underscore its multifaceted utility, marking a paradigm shift in clinical decision-making and offering a promising trajectory for personalized and informed care in advanced melanoma.
Physical activity is an important factor for primary and secondary stroke prevention. The process of stroke rehabilitation includes early and late physical activity and exercise, which prevents further stoke and improve patients’ quality of life. MY WAY project, an ERASMUS+ SPORT program, is aimed at analyzing and developing or transferring best innovative practices related to physical activity and exercise enhancing health in poststroke patients. The aim of the study was to identify, analyze, and present the good practices and strategies to encourage participation in sport and physical activity and engage and motivate chronic stroke patients to perform physical activity changing their lifestyle and to maintain a high adherence to long‐term exercise‐based rehabilitation programs. Our results demonstrated that unified European stroke long‐term exercise‐based rehabilitation guidelines do not exist. It seems that low training frequency with high aerobic exercise intensity may be optimal for improved physical performance and quality of life in combination with a high adherence. It is important to optimize the training protocols suitable for each patient. The continuous education and training of the specialized professionals in this field and the presence of adequate structures and cooperation between different healthcare centers are important contributors. The clear objective for each country should be to systematically make the necessary steps to enhance overall exercise‐based stroke rehabilitation attendance in the long term. Long‐term interventions to support the importance of physical exercise and lifelong exercise‐based rehabilitation in chronic stroke patients should be created, what coincides with the goal of the MY WAY project.