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Transfusion of blood and blood components is one of the widely used medical procedures. The responsibility for provision of blood and blood components lies with Polish blood transfusion centers (CKiK) substantively supervised by the Institute of Hematology and Transfusion Medicine. Hospital based blood banks, hospital wards, immunohematology laboratories are supervised by CKiK. Every year approximately 600 thousand people donate blood, more than 75% of which are regular donors. The annual number of donations is maintained at a constant level of about 1.3 million. The aim of this position paper is to present the current status, achievements and advancement in collection, preparation and testing procedures and methods used to obtain the best possible quality blood components dedicated for clinical use. The aim is also to show the structure of blood transfusion service in Poland. Collaboration of all organizational units involved in transfusion medicine is crucial for providing high quality health care for patients. Polish transfusiologists and blood transfusion officers have largely contributed to transfusion science with numerous publications and significant research work. The implementation of novel methods and ongoing research positions Polish blood transfusion service among those of highly developed countries.

Background: In this study we evaluated the basic aspects of the activity of the Polish Blood Transfusion Service (hereinafter referred to as Centers) in 2019. Materials and methods: Retrospective analysis of the 2019-data supplied by the Centers. Results: In 2019, blood and blood components were collected in 21 Polish Centers and 129 local collection sites as well as during 13 048 mobile collections. The overall number of blood donors was estimated at 590 893, the majority of which were non-remunerated donors (590 280 — including 40 738 responders to donation appeals), as well as 57 remunerated donors and 556 autologous donors. Most frequent were whole blood collections (1 202 079) and least frequent — granulocyte concentrate collections (94) and RBCs collections by apheresis (48 donations). Whole blood was collected mostly in local collection sites (45.25%), in Centers (28.75%) and mobile collection sites (26%). Most frequently prepared blood components were RBCs — 1 180 333 units) and fresh frozen plasma (FFP — 1 344 092 units, 21.42% dedicated for clinical use). Platelet concentrates (PCs) collected by apheresis amounted to 53 379 units and 81 905 were whole blood-derived. Additional processing methods (leukocyte depletion, irradiation) were more frequently applied to PCs (43.34% leukocyte-depleted, 0.04% irradiated, 54.63% both leukocyte-depleted and irradiated) than to RBCs (18.71% leukocyte-depleted, 0.06% irradiated, 9.17% both leukocytedepleted and irradiated). Pathogen reduction technologies were applied to 20.76% of FFP units issued for clinical use (transfusion) and 11.87% of PCs. In 2019 — for a variety of reasons — 14 013 units of whole blood, 32 798 units of RBCs, 49 285 units of FFP, 1334 units of cryoprecipitate, 4778 units of pooled PCs and 1279 of apheresis PCs were wasted. Conclusions: Our study data may be considered as starting point for assessment of the tendencies observed in the Polish blood transfusion service and may serve practical-benchmarking with benefit to the transfusion community as a whole.

Background: The five antigens of the Yt blood group system are located on the membrane GPI‐linked erythrocyte acetylcholinesterase (AChE‐E), which is implicated in a range of clinical issues, including sleep apnoea and neurotoxin poisoning. Conformational changes associated with different Yt antigens, as well as the storage of red cells, may affect AChE‐E activity. Direct analysis of AChE‐E presents unique challenges that may be overcome by electrochemical measurement using low‐cost electron‐mediated screen‐printed carbon electrodes (SPCEs) under suitable amperometric conditions. Aims: We present the electrochemical analysis of AChE‐E activity of five different Yt phenotypes, the effect on AChE‐E of red cell refrigeration over a four‐week timeframe and storage by freezing. The efficacy of electron‐mediated SPCEs is examined in relation to the potential interferences and electrode‐fouling. Methods: SPCEs containing the electron mediator (cobalt phthalocyanine) were manufactured on a plastic substrate, each in association with a screen‐printed Ag/AgCl counter/reference electrode in a two‐electrode format. Whole blood samples were initially washed to remove butyrylcholinesterase and resuspended in PBS. AChE‐E activity was assessed at 37⁰C using chronoamperometry at + 0 mV following the addition of acetylthiocholine chloride to the cell suspension. Ten Yt(a+b‐) and four Yt(a‐b+) donor samples were tested after collection and at two and four weeks storage at 4⁰C. Five Yt(a+b‐) and twenty Yt(a‐b+) were tested following freezing in liquid nitrogen. Samples with confirmed rare Yt phenotypes were evaluated to determine if the phenotype effected AChE‐E activity. The assay longevity and electrode viability were examined using eight of the samples representing the different Yt phenotypes over an extended duration of measurement. Results: SPCEs gave a consistent response in all samples tested without evidence of interference or fouling by the adherence of the cells to the electrode surface. The sensors were shown to operate continuously for a minimum of 60 minutes until the substrate became limiting. The reproducibility of the sensors (six replicates each of five samples) was 14% (RSD), which is typical for SPCEs in biological samples. An optimal assay duration of 120 seconds was selected. Compared to fresh samples, storage by freezing resulted in a loss of approximately 40% AChE‐E activity in Yt(a+b‐), whereas Yt(a‐b+) samples showed a 40% increase in enzyme activity. These differences occurred despite the almost identical conformation of the Yta and Ytb AChE‐E structure as studied by molecular dynamic calculations. Samples stored at 4⁰C showed a significant deterioration in AChE‐E activity within the first 14 days; a reduction of 35% for Yt(a+b‐) and 28% for Yt(a‐b+) (P < 0.01), followed by no significant change between 14 and 28 days of storage. The effect of rare Yt phenotypes was examined using stored frozen samples. AChE‐E activity differed markedly when compared to Yt(a+b‐); 82% higher in Yt(a‐b+) samples, 39% in YTLI– and 210% in YTOT–. An exception was YTEG–, which remained comparable to Yt(a+b‐). Summary/Conclusions: Mediated SPCEs were used effectively in the electrochemical measurement of AChE‐E activity, showing their potential for rapid low‐cost analysis of red cells. We showed that the activity of the enzyme was reduced with refrigeration, although the consequences of freezing were more varied in terms of Yt phenotype.

Quality assurance and safety of hematopoietic stem cells (HSC) with special emphasis on bacterial and fungal contamination is the prerequisite for any transplantation procedure. The aim was to determine the incidence rate of such contamination during processing of transplantation material with regard to HSC source: peripheral blood stem cell (PBSC), bone marrow (BM), or cord blood (CB). Analysis involved autologous and allogenic products dedicated for patients and comprised in all 4135 donations, including 112 BM (2.70%), 3787 PBSC (91.60%), and 236 CB (5.70%) processed in cell bank over the period 1996–2016. Aerobic and anaerobic contamination was determined.Analysis of the 20-year data revealed 42 contaminated products: 25 PBSC (0.66% of tested units) and 17 CB (7.20% of tested units). No microbial contamination of BM products was detected. Overall percentage of contaminated products was 1.01%, mostly with Staphylococcus epidermidis (61.36%). Bacterial contamination rate at cell bank is relatively low and processing in a closed system does not seem as crucial as might be expected. This is particularly true for BM components. Equally important are evaluation of donor’s medical status and condition of the puncture site for collection of source material. Implementation of appropriate sample collection procedures should help minimize the risk of false-positive results due to environmental contamination.

Background: Assessment of the basic aspects of the activity of the Polish Regional Blood Transfusion Centers (hereinafter referred to as Centers) in 2018. Materials and methods: Retrospective analysis of the 2018-data supplied by the Centers. Results: In 2018, blood and blood components were collected in 21 Centers and 132 local collection sites as well as during 13 189 mobile collections. The overall number of blood donors was estimated at 590 470; the majority were non-remunerated donors (589 897 — including 37 824 responders to donation appeals), 73 remunerated donors and 500 autologous donors. Most frequent were whole blood collections (1 184 311), least frequent — granulocyte concentrate collections (116) and red blood cell (RBC) collection by apheresis (31 donations). Whole blood was collected mostly in local collection sites (44.85%), less frequently in Centers (28.47%) and at mobile collection sites (26.67%). Most frequently prepared blood components were RBC — 1 161 600 units) and fresh frozen plasma (FFP — 1 298 216 units; 20.93% dedicated for clinical use). Platelet concentrates (PCs) collected by apheresis amounted to 50 255 units and 83 598 were whole blood-derived. Additional processing methods such as leukocyte depletion and irradiation were more frequently applied to PCs (32.56% leukocyte depleted, 1.37% irradiated, 58.07% both leukocyte depleted and irradiated) than to RBCs (17.29% leukocyte depleted, 0.31% irradiated, 8.94% both leukocyte depleted and irradiated). Pathogen reduction technologies were applied to 11.74% of PCs and 10.23% units of FFP issued for transfusion. In 2018 — for various reasons — 14 067 units of whole blood, 30 521 units of RBC, 49 979 units of FFP, 1376 units of cryoprecipitate, 5186 units of pooled PCs and 1625 of apheresis PCs were wasted. Conclusions: The study data may contribute to evaluation of the tendencies observed in Centers and may serve practical-benchmarking which in turn may prove beneficial to the transfusion community as a whole.

Many countries currently witness a decline in the number of blood donors and, consequently, a decrease in supply of blood and blood components dedicated for clinical use. To improve the situation one of the measures taken is to qualify for blood donation people with diagnosed hereditary hemochromatosis (HH) — a genetic disorder that leads to iron overload, most effectively treated by frequent bloodletting to eliminate the excess of iron. Blood from therapeutic phlebotomy is often discarded. Reservations and doubts related to the clinical use of this blood are primarily related to additional factors that affect its safety. However, there is currently no convincing evidence that blood from HH donors exposes recipients to higher risk. Reservations are also raised regarding organizational challenge and costs as well as ethical concerns regarding the voluntary nature of donations. In Poland — according to current regulations — HH individuals are deferred from donating blood during the onset of disease symptoms or in the course of treatment other than phlebotomy. The decision regarding blood donation as well as frequency of subsequent donations is made by the physician in the unit of the public health service in cooperation with the doctor responsible for therapy of hemochromatosis. Guidelines regarding this group of potential blood donors markedly differ from country to country therefore numerous publications emphasize the need to develop a set of uniform, optimal regulations based on the outcome of available research.

Background The quality of platelet concentrates (PCs) is affected by preparation, storage, the type of container, and pathogen reduction technology (PRT). The Mirasol® Pathogen Reduction Technology (PRT) system (Terumo BCT Inc., Lakewood, USA), which uses riboflavin and ultraviolet (UV) light, has recently been proven effective against bacteria, viruses, parasites, and leukocytes. Objectives The aim of the study was to evaluate the effect of the Mirasol® PRT system, based on riboflavin and UV light exposure, on the most common in vitro platelet quality parameters of PCs prepared from whole blood-derived buffy coats. Material and methods The study included 15 trials (n = 15). For each trial, 2 PCs were used: 1 for treatment with the Mirasol® PRT system (M) and 1 for a control (C). In the M group, PCs were illuminated. In the C group, saline solution was added. PCs from groups M and C were stored at 20-24°C, with agitation. Samples were collected on days 1, 3 and 5 to determine platelet concentration, total platelet count/unit, mean platelet volume (MPV), power of hydrogen (pH), glucose and beta-thromboglobulin concentration (BTG), hypotonic shock response (HSR), aggregation, CD42b and CD62P expression, pCO2, and pO2. Results No significant differences in HSR or CD42b expression were observed between groups M and C. All pH values were stable during the whole storage period (7.1-7.5). On storage day 1, CD62P expression in group C was significantly higher than in group M. In the Mirasol® group, significantly higher glucose consumption was noted on storage days 3 and 5. On day 5, a 2-3-fold increase in BTG was observed in both groups as compared to day 1; on day 5, BTG concentration was 32% higher in group M than in group C. On all storage days, pCO2 was comparable in groups M and C; lower pO2 values were reported for group M. Conclusions In vitro results demonstrated that pH, HSR, aggregation, CD42b antigen expression, and MPV and platelet count parameters were comparable in groups M and C.

Anna Rosiek,1,2 Aleksandra Rosiek-Kryszewska,3 Łukasz Leksowski,4 Tomasz Kornatowski,2 Krzysztof Leksowski2,5 1Ross-Medica, 2Faculty of Health Sciences, Public Health Department, Nicolaus Copernicus University, 3Faculty of Pharmacy, Department ofInorganic and Analytical Chemistry, Nicolaus Copernicus University, 4Faculty of Health Sciences, Department of Rehabilitation, Nicolaus Copernicus University, 5Department of General Thoracic and Vascular Surgery, Military Clinical Hospital in Bydgoszcz, Bydgoszcz, Poland Background: Increasing the engagement of employees in the treatment process of patients may benefit a hospital and employee productivity and may result in better patient care and satisfaction with medical services. Given this, the first step in improving the quality of patientcare is better availability of doctors for patients in a hospital ward.Methods: The research for this paper was conducted in six healthcare units in the Kuyavian-Pomeranian province in Poland. The research assessed how the elements relating to employees’ behavior and things characteristic to medical service influence patients’ willingness to recommend a hospital.Results: Patients’ perception of services is linked with the behavior of medical employees and their engagement in the treatment process.Conclusion: Our research indicates that individual employee recognition and collective recognition of hospital employees as a whole were identified as the most important factors in employee engagement in the treatment process (employee productivity) and patients’ satisfaction with medical service. Keywords: employee’s productivity, workplace interventions to enhance health, hospitals, organizational health, medical staff, public health

Anna Rosiek,1 Tomasz Kornatowski,1 Natalia Frąckowiak-Maciejewska,1 Aleksandra Rosiek-Kryszewska,2 Przemysław Wyżgowski,3 Krzysztof Leksowski1,3 1Department of Public Health, Faculty of Health Science, Nicolaus Copernicus University in Toruń, 2Department of Inorganic and Analytical Chemistry, Faculty of Pharmacy, Nicolaus Copernicus University in Toruń, 3Department of General Surgery, 10th Military Hospital, Bydgoszcz, Poland Background: The diagnosis of type 2 diabetes mellitus (T2DM) carries with it a number of changes to the patient’s lifestyle. A healthy lifestyle, health and preventive behaviors, as well as healthy nutrition habits play a key role in treating T2DM as well as limiting its complications.Materials and methods: The aim of this study was the analysis of the correlation of T2DM patients’ health behaviors and their influence on the patients’ quality of life. The study was performed on a group of 50 patients from the Kuyavian–Pomeranian Voivodeship. In this study, the Health Behavior Inventory and the Satisfaction with Life Scale were used. The results were statistically analyzed. The study was approved by the ethics committee.Results: The intensity of severity of health behavior and satisfaction with life of T2DM patients depends on the gender of the patient (P

Introduction. The stress related to patient’s stay in a hospital increases when it is necessary to perform a surgery. Therefore, the study of the phenomenon of stress intensity in hospitalized patients has become an important issue for public health.Material and Method. The study was conducted in University Hospital No. 1 in the cardiosurgery clinic. The study involved 58 patients who were admitted as planned to the hospital. The study used a standardized questionnaire measuring intensity of the stress and also deepened interviews with patients about stress and anxiety felt before the surgery.Results. The greater the patient’s anxiety resulting from his state of health, the greater the intensity of stress in the preoperative period. This relationship is linear. The results of the study also made it possible to see intrapersonal factors (pain, illness, and suffering) and extrapersonal factors (anesthesia, surgery, and complications after surgery), which are causes of anxiety before surgery.Conclusion. The research showed high (negative) results of anxiety and stress associated with the disease, surgery, and complications after cardiac surgery. Active involvement in hospitalization elements, such as patient education before surgery, psychological support, and medical care organization taking into account patient’s preferences, reduces the impact of stressors.

The epidemic nature of obesity in industrialized countries is a serious health and social concern. The number of obese people has significantly increased in the past 20 years. In Poland excess weight and obesity are a serious epidemiological concern. In terms of the number of overweight people, Poland is a leader in Europe. Therefore, indicating many serious health concerns that are the natural consequences of this phenomenon has become important from the point of view of public health. This work identifies numerous diseases which are a direct consequence of obesity due to bad eating habits and lack of physical exercise among Poles. It discusses the negative effect of television and food commercials contributing to an increase in obesity, not only among adults but also among children. This is an overview forming grounds for further studies into ways of preventing the development of diseases due to obesity, both in Poland and in the world.

Background: The rapid international expansion of telemedicine reflects the growth of technological innovations. This technological advancement is transforming the way in which patients can receive health care. Materials and Methods: The study was conducted in Poland, at the Department of Cardiology of the Regional Hospital of Louis Rydygier in Torun. The researchers analyzed the delay in the treatment of patients with acute coronary syndrome. The study was conducted as a survey and examined 67 consecutively admitted patients treated invasively in a two-stage transport system. Data were analyzed statistically. Results: Two-stage transportation does not meet the timeframe guidelines for the treatment of patients with acute myocardial infarction. Intervals for the analyzed group of patients were statistically significant (p &lt, 0.0001). Conclusions: Direct transportation of the patient to a reference center with interventional cardiology laboratory has a significant impact on reducing in-hospital delay in case of patients with acute coronary syndrome. Perspectives: This article presents the results of two-stage transportation of the patient with acute coronary syndrome. This measure could help clinicians who seek to assess time needed for intervention. It also shows how time from the beginning of pain in chest is important and may contribute to patient disability, death or well-being.

The risk of transfusion-related infectious diseases, the markers for which are routinely tested, is extremely low. Recently, however, blood transfusion service faces the challenge from emerging infectious diseases (EIDs), mainly zoonotic origin. Pathogens are microorganisms, mostly viruses, that usually require vectors for their transmission to humans. The relation of some EIDs to transfusion has been proved, in other cases it is considered likely. The paper presents views on EIDs etiology and spread and explains the epidemiologic basic terminology. It describes the principles and methods of EIDs risk assessment as well as prioritization of EIDs with regard to transfusion risk. It outlines the principles of international cooperation and rapid response to newly emerging threats. More attention is devoted to such diseases as West Nile fever, malaria, dengue and chikungunya which are recently a real epidemiological threat. Preventive measures to reduce the threat of EIDs transmission have also been discussed as well as their impact on the safety and supply of blood and blood components.

Background Increasing the engagement of employees in the treatment process of patients may benefit a hospital and employee productivity and may result in better patient care and satisfaction with medical services. Given this, the first step in improving the quality of patient care is better availability of doctors for patients in a hospital ward. Methods The research for this paper was conducted in six health care units in the Kuyavian-Pomeranian province in Poland. The research assessed how the elements relating to employees’ behavior and things characteristic to medical service influence patients’ willingness to recommend a hospital. Results Patients’ perception of services is linked with the behavior of medical employees and their engagement in the treatment process. Conclusion Our research indicates that individual employee recognition and collective recognition of hospital employees as a whole were identified as the most important factors in employee engagement in the treatment process (employee productivity) and patients’ satisfaction with medical service., Video abstract

Introduction: The subject of chronic stress and ways of dealing with it are very broad. The aim of this study was to analyze stress and anxiety and their influence on suicidal thinking among medical students. Materials and Methods: The study was conducted in the years 2014 to 2015 in Poland, at the Medical University—Nicolaus Copernicus University, Collegium Medicum. The objective of this study was to assess chronic stress and suicidal thinking among students and how students cope with this huge problem. Descriptive statistics and chi-square analyses were conducted to detect differences. Results: Analyses showed that students’ life is full of stressors. Students toward the end of their education cope better with stress than students starting their university studies. Chronic stress has a strong impact on mental health and suicidal thinking among students. Conclusions: The results of the study confirmed that chronic stress and anxiety have a negative influence on mental health and also confirm a relation to suicidal thinking in medical students. Students cope with stress by listening to music, talking to relatives or people close to them, resting or engaging in sports, with cycling, running and swimming being the most common methods used to affect suicidal thinking.

The risk of transfusion-related infectious diseases, the markers for which are routinely tested, is extremely low. Recently, however, blood transfusion service faces the challenge from emerging infectious diseases (EIDs), mainly zoonotic origin. Pathogens are microorganisms, mostly viruses, that usually require vectors for their transmission to humans. The relation of some EIDs to transfusion has been proved, in other cases it is considered likely. The paper presents views on EIDs etiology and spread and explains the epidemiologic basic terminology. It describes the principles and methods of EIDs risk assessment as well as prioritization of EIDs with regard to transfusion risk. It outlines the principles of international cooperation and rapid response to newly emerging threats. More attention is devoted to such diseases as West Nile fever, malaria, dengue and chikungunya which are recently a real epidemiological threat. Preventive measures to reduce the threat of EIDs transmission have also been discussed as well as their impact on the safety and supply of blood and blood components.