Oskar Sierka

Introduction Continuous progress in medicine generates new ethical challenges faced by members of the healthcare system. The use of persistent therapy is referred to when the methods and measures used in treatment do not offer a realistic chance of recovery or significant improvement of the patient’s condition. Aim The aim of the study was to analyse adults’ knowledge about the use of persistent therapy. Material and methods The study involved 200 (100%) adults, the vast majority of whom were women (160; 80.00%). An original online survey questionnaire was used to conduct the study, consisting of questions covering the topic in question and regarding the sociodemographic data of the respondents. The study was completely anonymous and voluntary, and all respondents gave their informed consent to participate. Results and discussion The most common procedures included in the persistent therapy, according to the respondents, were mechanical circulatory support (124; 62.00%) and mechanical ventilation (90; 45.00%). Among the most frequently cited factors influencing the decision to discontinue persistent therapy, respondents mentioned the patient’s statement of intent (146; 37.00%). There was also a statistically significant result (P = 0.002) indicating large differences in the level of knowledge between those declaring a conenction with patient care and those who did not declare such connection. Conclusions Among participants, knowledge regarding persistent therapy was incomplete, especially among non-medical respondents. Informational activities should therefore be undertaken to raise public awareness about end-life decisions and treatment options in the last hours of one’s life.

The most common cause of heart failure (HF) is coronary artery disease (CAD). The aim of this study was to evaluate the transcriptional activity of the metalloproteinase 9 (MMP-9) and tissue metalloproteinase inhibitor 1 (TIMP-1) genes in a study group of patients with HF due to CAD and in the control group, as well as assess the transcriptional activity of the examined genes, taking into account the number of affected coronary arteries and the severity of heart failure. The study group consisted of a total of 150 (100%) patients. The material for the study was peripheral blood, and molecular tests were performed using the quantitative QRT-PCR technique. The transcriptional activity of the MMP-9 gene was significantly higher in the group of patients with CAD and HF. It was also significantly higher with the progression of heart failure. TIMP-1 gene transcriptional activity was significantly lower with the advancement of heart failure. The transcriptional activity of the MMP-9 and TIMP-1 genes differentiated the examined patients. The severity of HF, and a significant increase in the QRT-PCR transcriptional activity of the MMP-9 gene with a simultaneous decrease in the activity of the TIMP-1 gene, makes them useful diagnostic and prognostic markers in clinical practice.