Anomalous origin of the right coronary artery from the pulmonary artery in a Staffordshire Bull Terrier

An asymptomatic 17-month-old, 18.5-kg, male Staffordshire Bull Terrier was referred due to a heart murmur. Examination revealed a grade 3/6 left apical systolic and right apical 3/6 heart murmur. Echocardiography showed volume overload of the left ventricle and mild systolic dysfunction with a left-right flow over the interventricular septal region. Cardiac gated computed tomography revealed anomalous origin of the right coronary artery from the pulmonary artery, an extensive network of collateral blood vessels connected the right and left coronary arteries, with bronchial and left intercostal arteries also connected to the network of collateral blood vessels, markedly enlarged right and left coronary arteries and left coronary sinus. With varied presentation, coronary anomalies are difficult to recognise and classify and to the best of our knowledge this is the first case of anomalous origin of the right coronary artery from the pulmonary artery diagnosis in the dog.

Indirect and Direct 65+ Patient Reporting of Non-Steroidal Anti-Inflammatory Drug-Induced Adverse Drug Reactions as a Source of Information on Polypharmacy and Polypharmacy-Related Risk

Background and Objectives: Non-steroidal anti-inflammatory drugs (NSAIDs), which have anti-inflammatory and analgesic properties, are commonly used in the treatment of various, particularly frequent, as well as chronic, conditions in older patients. Due to common polypragmasia in these patients and a high risk of adverse drug reactions (ADRs) and drug interactions, pain management poses a therapeutic challenge. This study describes the importance of ADR reports in the identification of polypharmacy and the ensuing interactions. Materials and Methods: Both healthcare professionals (HPs) and non-healthcare professionals (non-HPs) reports collected in the EudraVigilance database of NSAIDs, including most commonly co-reported medications and reported reactions, were analysed and differences between HPs and non-HPs reports were identified. Results: In the analysed period and group, non-HPs reported more reactions but indicated fewer drugs as suspect or concomitant. The outcomes of our analysis indicate more HP engagement and more detailed reports of serious ADRs when compared to non-serious individual case safety reports (ICSRs) by non-HPs, which appeared more detailed. Such reactions as kidney failure and increased risk of bleeding are known adverse reactions to NSAIDs and common symptoms of their interactions, which were described in the available literature. They were much more frequently reported by HPs than by non-HPs. Non-HPs more frequently reported reactions that may have been considered less significant by HPs. Conclusions: The differences between healthcare professionals' (HPs) and non-healthcare professionals' (non-HPs) reports may result from the fact that the reports from patients and their caregivers require a professional medical diagnosis based on symptoms described by the patient or additional diagnostic tests. This means that when appropriately classified, medically verified, and statistically analysed, the data may provide new evidence for the risks of medication use or drug interactions.

Increased Accessibility to Primary Healthcare Due to Nurse Prescribing of Medicines

Since January 2016, nurses and midwives in Poland have had the right, with some restrictions, to prescribe medicines. Consequently, Polish patients received the same opportunity as in other countries worldwide: easier access to certain health services, i.e., medical prescribing. The aim of this study was to assess the impact of structural changes which increased the nurses' competences on the accessibility to prescription visits for patients receiving primary healthcare on the example of Medical and Diagnostic Centre (MDC), and to discuss the general trend of legal changes in nursing profession regulations. We performed a detailed analysis of the data on the MDC patient population in Siedlce who received at least one prescription written by a general practitioner and/or a nurse/midwife in the years 2017-2019.The largest number of prescription visits made by nurses concerned patients aged 50-70 years, as this age range includes the largest number of patients with chronic diseases who need continued pharmacological treatment originally administered by doctors. An increasing tendency for prescription visits made by nurses was recorded, with a simultaneous downward trend in the same type of visits undertaken by doctors at MDC. Nurses' involvement in prescribing medications as a continued pharmacotherapy during holiday seasons results in patients having continuous access to medication. An upward trend was also observed in the number of medications prescribed by nurses per patient. Structural changes in the legal regulations of the nursing profession improve patients' access to prescription visits under primary healthcare. Further research is recommended to evaluate the dynamics of these trends and the impact of newly introduced nursing competences on the accessibility of prescription visits for patients.

Risk Factors of Early Adolescence in the Criminal Career of Polish Offenders in the Light of Life Course Theory

Life course theory (LCT) diagnoses childhood and adolescent factors that determine an individual’s involvement in crime in the future. Farrington lists eight key correlates identified by empirical analyses of criminal careers. In this paper, we seek to discuss the inconsistencies with LCT that we observed in our three empirical studies of the criminal careers of Polish offenders. During 12 years of qualitative research, we conducted direct observations and in-depth interviews in juvenile correction institutions (21) and prisons (8) across the country. We gained access to incarcerated (102) and released (30) juvenile offenders, as well as to incarcerated (68) and released (28) adult offenders. We also conducted in-depth interviews (92) with experts working with young and adult offenders. We similarly accessed some offenders’ criminal records and psychological opinions. Our study revealed the strong presence of family and neighborhood influences on early criminality. Contrary to LCT assumptions, state-dependent institutions (military, work, family) were not strong enough determinants of delinquency. Polish offenders generally experience criminal onset later than LCT-oriented criminologists indicate. Based on our data, we also agree with the thesis that the onset of crime should be discussed as different age-related periods rather than just a general onset.

[Vitex agnus castus extract in the treatment of luteal phase defects due to latent hyperprolactinemia. Results of a randomized placebo-controlled double-blind study]

The efficacy of a Vitex agnus castus preparation (Strotan capsules) was investigated in a randomized double blind study vs. placebo. This clinical study involved 52 women with luteal phase defects due to latent hyperprolactinaemia. The daily dose was one capsule (20 mg) Vitex agnus castus preparation and placebo, respectively. Aim of the study was to prove whether the elevated pituitary prolactin reserve can be reduced and deficits in luteal phase length and luteal phase progesterone synthesis be normalized. Blood for hormonal analysis was taken at days 5-8 and day 20 of the menstrual cycle before and after three month of therapy. Latent hyperprolactinaemia was analysed by monitoring the prolactin release 15 and 30 min after i.v. injection of 200 micrograms TRH. 37 complete case reports (placebo: n = 20, verum: n = 17) after 3 month of therapy were statistically evaluated. The prolactin release was reduced after 3 months, shortened luteal phases were normalised and deficits in the luteal progesterone synthesis were eliminated. These changes were significant and occurred only in the verum group. All other hormonal parameters did not change with the exception of 17 beta-estradiol which rouse up in the luteal phase in patients receiving verum. Side effects were not seen, two women treated with the Vitex agnus castus preparation got pregnant. The tested preparation is thought to be an efficient medication in the treatment of luteal phase defects due to latent hyperprolactinaemia.