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Polak A, Pawlikowska-Łagód K, Zagaja A, Grzybowski A. The history of louse-borne typhus and geomedizine. Clin Dermatol 2023; 41:767-771. [PMID: 37741590 DOI: 10.1016/j.clindermatol.2023.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/25/2023]
Abstract
The experience of World War I made popular the concept of medical geography (geomedicine in English, geomedizine in German), which became part of Nazism's philosophy of national welfare, safety, and solidarity. The Nazis used it to create propaganda to show some groups as rats, vermin, and Untermenschen (subhumans). In this way, more than 10 million people were killed under the Nazi regime: 6 million Jews, plus more than 5 million Gypsies, Jehovah's Witnesses, and other individuals who were not part of the German theory of "master race." The Germans' fear of typhus that spread in the Wehrmacht was so immense that during the occupation, Polish doctors used this phobia to organize a resistance movement. Contemporarily, the scope of geographic medicine encompasses the following research areas: spatial differentiation of disease incidents and the process of disease diffusion, geographic inequalities in the population's health level, and morbidity determinants among the inhabitants of developing countries. In the first half of the 19th century, it played an essential role in the activities aimed against epidemics of infectious diseases, including louse-borne typhus (epidemic typhus), cholera, and typhoid, linking these diseases to cultural determinants. Under the influence of this idea, the concept of doctor-hygienist emerged, and social medicine began to evolve.
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Affiliation(s)
- Agnieszka Polak
- Department of Humanities and Social Medicine, Medical University of Lublin, Poland.
| | | | - Anna Zagaja
- Department of Humanities and Social Medicine, Medical University of Lublin, Poland
| | - Andrzej Grzybowski
- Department of Ophthalmology, University of Warmia and Mazury, Olsztyn, Poland; Institute for Research in Ophthalmology, Poznan, Poland
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Patryn R, Zagaja A, Drozd M. Donor Safety, Discrepancies Between Practice and Theory: Analysis of the Polish Supreme Audit Office's Report. Appl Clin Genet 2023; 16:1-10. [PMID: 36713959 PMCID: PMC9880020 DOI: 10.2147/tacg.s376251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 11/21/2022] [Indexed: 01/21/2023] Open
Abstract
The introduction and development of genetic testing has caused the emergence of numerous dilemmas, which pertain to the performed tests, their results, and the influence they have on an individual person. To minimize potential doubts, it is crucial to ensure compliance with established procedures and to fulfill all test-associated formalities. In 2018, a report of the Polish Supreme Audit's Office (a governmental control agency) on the quality of genetic tests revealed that there is much to be done in the field of laboratory diagnostics in Poland. The inspection of six selected laboratories performing genetic tests identified shortcomings in terms of formalities accompanying the process of performing laboratory tests, keeping patient documentation and personal data protection. Although the observed shortcomings pertained to legal aspects of genetic tests, and not the quality of the tests themselves, the aforementioned may be detrimental to the individual person and the society (eg, lack of consent undermines the concept of biological material ownership), may cause legal liability to the laboratory personnel and even undermine public trust in genetic testing.
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Affiliation(s)
- Rafał Patryn
- Department of Humanities and Social Medicine, Medical University of Lublin, Lublin, Poland
| | - Anna Zagaja
- Department of Humanities and Social Medicine, Medical University of Lublin, Lublin, Poland
| | - Mariola Drozd
- Department of Humanities and Social Medicine, Medical University of Lublin, Lublin, Poland,Correspondence: Mariola Drozd, Department of Humanities and Social Medicine, Medical University of Lublin, 1, Raclawickie str 20-059, Lublin, Poland, Tel +48 448 68 50, Email
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Polak A, Pawlikowska-Łagód K, Zagaja A, Grzybowski A. Typhus works of Rudolf Weigl, PhD, Ludwik Fleck, MD, and Eugeniusz Łazowski, MD, against the Nazis. Clin Dermatol 2022; 40:567-572. [PMID: 35182710 DOI: 10.1016/j.clindermatol.2022.02.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Typhus has been present in Central Europe and Russia since the 19th century, but it was not until 1918 that it became an epidemic problem in Poland. Poverty, general devastation, unsanitary living conditions, and the extensive spread of the disease forced the Polish government to organize effective measures to improve the population's health. One such measure was the establishment of a typhus research center in Lviv. The center was led by Rudolf Weigl, who in the 1930s succeeded in elaborating a clinically effective vaccine. In September 1939, when the Germans invaded Poland, the problem of typhus returned, primarily due to the ghettos where the Nazis confined Jews in poor, crowded, and unsanitary conditions. Later, in 1941 when Nazis tried to invade the Soviet Union (where typhus was endemic), the typhus vaccine-the work of Weigl and Ludwik Fleck (also an employee of the Lviv institute)-was in high demand. The Germans feared typhus due to its persistence and speed of spread. The Nazi typhus phobia was also used by some Polish doctors who took advantage of this disease to protect their patients from being deported or located in camps. An example of such a doctor was Eugeniusz Łazowski, who even organized a "false pandemic" to save the local population.
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Affiliation(s)
- Agnieszka Polak
- Department of Humanities and Social Medicine, Medical University of Lublin, Lublin, Poland.
| | | | - Anna Zagaja
- Department of Humanities and Social Medicine, Medical University of Lublin, Lublin, Poland
| | - Andrzej Grzybowski
- Department of Ophthalmology, University of Warmia and Mazury, Olsztyn, Poland; Institute for Research in Ophthalmology, Poznań, Poland
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Zagaja M, Zagaja A, Szala-Rycaj J, Szewczyk A, Lemieszek MK, Raszewski G, Andres-Mach M. Influence of Umbelliferone on the Anticonvulsant and Neuroprotective Activity of Selected Antiepileptic Drugs: An In Vivo and In Vitro Study. Int J Mol Sci 2022; 23:ijms23073492. [PMID: 35408852 PMCID: PMC8999126 DOI: 10.3390/ijms23073492] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 03/17/2022] [Accepted: 03/21/2022] [Indexed: 02/04/2023] Open
Abstract
Umbelliferone (7-hydroxycoumarin; UMB) is a coumarin with many biological properties, including antiepileptic activity. This study evaluated the effect of UMB on the ability of classical and novel antiepileptic drugs (e.g., lacosamide (LCM), levetiracetam (LEV), phenobarbital (PB) and valproate (VPA)) to prevent seizures evoked by the 6-Hz corneal-stimulation-induced seizure model. The study also evaluated the influence of this coumarin on the neuroprotective properties of these drugs in two in vitro models of neurodegeneration, including trophic stress and excitotoxicity. The results indicate that UMB (100 mg/kg, i.p.) significantly enhanced the anticonvulsant action of PB (p < 0.01) and VPA (p < 0.05), but not that of LCM orLEV, in the 6-Hz test. Whether alone or in combination with other anticonvulsant drugs (at their ED50 values from the 6-Hz test), UMB (100 mg/kg) did not affect motor coordination; skeletal muscular strength and long-term memory, as determined in the chimney; grip strength; or passive avoidance tests, respectively. Pharmacokinetic characterization revealed that UMB had no impact on total brain concentrations of PB or VPA in mice. The in vitro study indicated that UMB has neuroprotective properties. Administration of UMB (1 µg/mL), together with antiepileptic drugs, mitigated their negative impact on neuronal viability. Under trophic stress (serum deprivation) conditions, UMB enhanced the neurotrophic abilities of all the drugs used. Moreover, this coumarin statistically enhanced the neuroprotective effects of PB (p < 0.05) and VPA (p < 0.001) in the excitotoxicity model of neurodegeneration. The obtained results clearly indicate a positive effect of UMB on the anticonvulsant and neuroprotective properties of the selected drugs.
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Affiliation(s)
- Mirosław Zagaja
- Isobolographic Analysis Laboratory, Institute of Rural Health, Jaczewskiego 2, 20-090 Lublin, Poland; (J.S.-R.); (A.S.); (M.A.-M.)
- Correspondence: (M.Z.); (A.Z.); Tel.: +48-81-718-4549 (M.Z.); +48-81-448-6850 (A.Z.)
| | - Anna Zagaja
- Chair and Department of Humanities and Social Medicine, Medical University of Lublin, Chodźki 7, 20-090 Lublin, Poland
- Correspondence: (M.Z.); (A.Z.); Tel.: +48-81-718-4549 (M.Z.); +48-81-448-6850 (A.Z.)
| | - Joanna Szala-Rycaj
- Isobolographic Analysis Laboratory, Institute of Rural Health, Jaczewskiego 2, 20-090 Lublin, Poland; (J.S.-R.); (A.S.); (M.A.-M.)
| | - Aleksandra Szewczyk
- Isobolographic Analysis Laboratory, Institute of Rural Health, Jaczewskiego 2, 20-090 Lublin, Poland; (J.S.-R.); (A.S.); (M.A.-M.)
| | - Marta Kinga Lemieszek
- Department of Medical Biology, Institute of Rural Health, Jaczewskiego 2, 20-090 Lublin, Poland;
| | - Grzegorz Raszewski
- Department of Toxicology and Food Protection, Institute of Rural Health, Jaczewskiego 2, 20-950 Lublin, Poland;
| | - Marta Andres-Mach
- Isobolographic Analysis Laboratory, Institute of Rural Health, Jaczewskiego 2, 20-090 Lublin, Poland; (J.S.-R.); (A.S.); (M.A.-M.)
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Ostrowska M, Drozd M, Patryn R, Zagaja A. Prescriptions as quality indicators of pharmaceutical services in Polish community pharmacies. BMC Health Serv Res 2022; 22:373. [PMID: 35317797 PMCID: PMC8939172 DOI: 10.1186/s12913-022-07772-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 02/09/2022] [Indexed: 11/10/2022] Open
Abstract
Background Assessment of community pharmacies’ quality of service is a very difficult task, resulting from the multiplicity and variety of provided services as well as patient-related factors (i.e. their health condition, expectations, education level or cultural and social background). Although proceedings of pharmaceutical professionals are to a great extend legally determined and described in various acts and regulations, work diligence should be one of the most characteristic traits of a professional pharmacy employee. Many publications addressing the quality of services provided by pharmaceutical employees focus on patient satisfaction, here the authors focused on more objective methods i.e. prescription analysis. Objective The main aim of the study was to assess whether post-inspection National Health Fund reports would constitute a reliable source of quality assessment of pharmaceutical services provided by community pharmacies. Methods The study is an in-depth quality and quantity analysis of 28 post-inspection quarterly reports conducted by the National Health Fund between 2013 and 2019. Results Vast majority of inspections ended in stating a variety of irregularities. Conclusions The analysis of irregularities contained in the National Health Fund’s post-inspection reports does not seem an appropriate indicator of assessing the quality of pharmaceutical services provided in community pharmacies, because of its targeted character. Inappropriate performance of professional duties by staff members is the main source of irregularities in the implementation of prescriptions for reimbursable medications. There is a need to improve staffs’ professional competence and ultimately the quality of pharmaceutical services.
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Affiliation(s)
- Marlena Ostrowska
- Department of Humanities and Social Medicine, Medical University of Lublin, ul. Chodźki 7, 20-093, Lublin, Poland
| | - Mariola Drozd
- Department of Humanities and Social Medicine, Medical University of Lublin, ul. Chodźki 7, 20-093, Lublin, Poland
| | - Rafał Patryn
- Department of Humanities and Social Medicine, Medical University of Lublin, ul. Chodźki 7, 20-093, Lublin, Poland
| | - Anna Zagaja
- Department of Humanities and Social Medicine, Medical University of Lublin, ul. Chodźki 7, 20-093, Lublin, Poland.
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Patryn R, Zagaja A, Drozd M. Safety of Medical Devices in Poland - Analysis of Withdrawn and Suspended Certificates of Compliance. Med Devices (Auckl) 2021; 14:239-247. [PMID: 34345188 PMCID: PMC8323850 DOI: 10.2147/mder.s316473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 06/22/2021] [Indexed: 11/29/2022] Open
Abstract
Introduction In the European Union, the process of controlling currently used medical devices is carried out and determined by legal provisions. The law stipulates that each entity responsible for using medical equipment must confirm its safety with an appropriate certificate issued by a notifying body. In Poland, the entity responsible for keeping records as to the withdrawn and suspended certificates, is the Office for Registration of Medicinal Products, Medical Devices, and Biocidal Products (URPL). Certification is required for all medical devices prior to their introduction onto the market and during their use. Purpose The article presents data concerning the number of medical devices that failed to meet the certification criteria. Methods The research method is an analysis of available subject literature and a report on withdrawn and suspended certificates of medical devices in Poland. Results In the years 2014–2020, the notified bodies withdrew and suspended 13,354 certificates for medical devices, of which 9792 certificates were withdrawn, 2852 suspended and one falsified. Conclusion The suspension or withdrawal of a certificate for medical devices due to the inefficiency, obsolescence, imprecision, or safety of the devices is an action that improves the safety of patients. Such action reduces the number of medical damages and the obligation to pay compensation to those injured.
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Affiliation(s)
- Rafał Patryn
- Chair and Department of Humanities and Social Medicine, Medical University of Lublin, Lublin, Poland
| | - Anna Zagaja
- Chair and Department of Humanities and Social Medicine, Medical University of Lublin, Lublin, Poland
| | - Mariola Drozd
- Chair and Department of Humanities and Social Medicine, Medical University of Lublin, Lublin, Poland
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Patryn R, Zagaja A. Value of substitute consent and autonomy of research participants in Regulation (EU) No 536/2014. J Pre Clin Clin Res 2020. [DOI: 10.26444/jpccr/131221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Zagaja A. Quality of informed consent in clinical trials. J Pre Clin Clin Res 2020. [DOI: 10.26444/jpccr/119621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Abstract
Vaccinations cause controversies for numerous reasons: medical, religious, and even personal. The following paper focuses on one more, underestimated conflict between individual autonomy and public health in regard to obligatory childhood vaccinations. Every medical intervention should be preceded by informed consent; however, informed consent in the case of obligatory vaccinations cannot be voluntary and valid. Moreover, asking parents to sign an informed consent form is paradoxical in a situation where not signing it will lead to legal consequences. Our paper tries to accentuate the issue of involuntariness and invalidity of informed consent in the case of obligatory vaccination and tries to propose a solution that acknowledges requirements for vaccinations and makes parents feel safer coming in and out of a vaccination visit.
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Affiliation(s)
- Anna Zagaja
- Department of Ethics and Human Philosophy, Medical University of Lublin, Lublin, Poland
| | - Rafał Patryn
- Department of Ethics and Human Philosophy, Medical University of Lublin, Lublin, Poland
| | - Jakub Pawlikowski
- Independent Medical Sociology Unit, Medical University of Lublin, Lublin, Poland
| | - Jarosław Sak
- Department of Ethics and Human Philosophy, Medical University of Lublin, Lublin, Poland
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Abstract
The article presents vaccination obligation in relation to the existing or newly enacted legislation. Mass vaccinations and a wave of criticism they cause, forces us to reflect on the limits of medical intervention in the human body and the boundaries granted to individual's freedom and autonomy. This problem is universal and exists mainly in countries without mandatory vaccinations. Analyzing recent years, it must be underlined that a process in some legislatures has been introduced to enforce various forms of vaccination coercion. Although, refusing vaccinations has been treated liberally, the last wave of epidemics in the United States and Europe forced the creation of a different approach. Gradually in the USA, a duty (not a 'coercion') of vaccination is being enforced. Occurring epidemics, (e.g. measles) and dangers resulting from them, force authorities to violate the principle of autonomy and restrict individuals' freedoms regarding their own body. The article presents legal solutions relating to vaccinations in the United States and Europe i.e. administrative decisions imposing vaccinations, solutions conditioning social existence and financial penalties for not complying with this obligation and proposes a solution based on financial liability that will balance out patients' autonomy and public security.
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Affiliation(s)
- Andrzej Grzybowski
- a Department of Ophthalmology , Poznan City Hospital , Poznan , Poland.,b Department of Ophthalmology , University of Warmia and Mazury , Olsztyn , Poland
| | - Rafał K Patryn
- c Department of Ethics and Human Philosophy , Medical University of Lublin , Lublin , Poland
| | - Jarosław Sak
- c Department of Ethics and Human Philosophy , Medical University of Lublin , Lublin , Poland
| | - Anna Zagaja
- c Department of Ethics and Human Philosophy , Medical University of Lublin , Lublin , Poland
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Grzybowski A, Patryn R, Sak J, Zagaja A, Włoszczak-Szubzda A. Surgical Safety Checklist. Procedure for the safety of procedures. Int J Surg 2017; 41:174-175. [PMID: 28390991 DOI: 10.1016/j.ijsu.2017.03.087] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Revised: 03/28/2017] [Accepted: 03/30/2017] [Indexed: 11/16/2022]
Affiliation(s)
- Andrzej Grzybowski
- Department of Ophthalmology, Poznan City Hospital, Poznan, Poland; Department of Ophthalmology, University of Warmia and Mazury, Olsztyn, Poland
| | - Rafał Patryn
- Department of Ethics and Human Philosophy Medical University, Lublin, Poland
| | - Jarosław Sak
- Department of Ethics and Human Philosophy Medical University, Lublin, Poland
| | - Anna Zagaja
- Department of Ethics and Human Philosophy Medical University, Lublin, Poland
| | - Anna Włoszczak-Szubzda
- Department of Health Informatics and Statistics, Institute of Rural Health, Lublin, Poland; Faculty of Health Sciences, University of Economics and Innovation, Lublin, Poland.
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Patryn RK, Grzybowski K, Sak J, Rymgayłło-Jankowska B, Zagaja A. Epidemiology and the legal basis for corneal transplants in Poland. Ophthalmology J 2017. [DOI: 10.5603/oj.2016.0026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Abstract
Dynamically changing social situation associated with migrations, increasing freedom rights, popularity of anti-vaccine movements and the resulting from that decrease in herd immunity, forces the medical society and the governments of various countries to reflect on the attitude toward vaccinations. Issues of freedoms and self-determination frequently do not accept any medical coercion in case of prophylactic vaccinations, however, recent waves of epidemics revealed that there is a necessity for undertaking strict legal actions to encourage vaccinations. After analyzing various legal approaches toward vaccinations we believe that personal coercion in case of vaccination refusal has too far reaching sanctions and propose the possibility of balancing the right to autonomy and the medical coercion. We postulate that vaccination refusal should be equivalent with covering frequently high medical costs in case of infection, The threat of financing medical treatment should influence the decision making process of those opposing vaccinations simultaneously respecting their rights not too get vaccinated.
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Affiliation(s)
- Rafał K Patryn
- a Department of Ethics and Human Philosophy , Medical University of Lublin , Lublin , Poland.,b Provincial Committee for Adjudication on Medical Events , Lublin , Poland
| | - Anna Zagaja
- a Department of Ethics and Human Philosophy , Medical University of Lublin , Lublin , Poland
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Affiliation(s)
- Rafał Kamil Patryn
- Department of Ethics and Human Philosophy, Medical University of Lublin, Lublin, Poland.,Provincial Committee for Adjudication on Medical Events, Lublin, Poland
| | - Anna Zagaja
- Department of Ethics and Human Philosophy, Medical University of Lublin, Lublin, Poland
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Zagaja A, Patryn RK. Letter to the Editor: Medicolegal Sidebar: Informed Consent in the Information Age. Clin Orthop Relat Res 2016; 474:861. [PMID: 26676116 PMCID: PMC4746155 DOI: 10.1007/s11999-015-4665-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Accepted: 11/30/2015] [Indexed: 01/31/2023]
Affiliation(s)
- Anna Zagaja
- />Department of Ethics and Human Philosophy, Medical University of Lublin, S. Staszica 4/6, 20-059 Lublin, Poland
| | - Rafał K. Patryn
- />Department of Ethics and Human Philosophy, Medical University of Lublin, S. Staszica 4/6, 20-059 Lublin, Poland , />Provincial Committee for Adjudication on Medical Events, Czechowska 15, 20-072 Lublin, Poland
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Jarzyński A, Nowotnik J, Zagaja A, Pachnia D, Polz-Dacewicz M. Reactivation of BKV and AdV infections during
post-transplant immunosuppressive therapy. J Pre Clin Clin Res 2014. [DOI: 10.26444/jpccr/71445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Mroczek M, Wróbel A, Korzeniowska M, Zagaja A. History of pharmacies, healthcare and famous physicians and pharmacists from Urzędów. Curr Issues Pharm Med Sci 2012. [DOI: 10.12923/j.2084-980x/25.1/a.25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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