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Objective: Pharmacotherapeutic Follow-up is the Professional Pharmaceutical Care Service aimed at detecting Drug-Related Problems for the prevention and resolution of negative medicine outcomes. The Dader Method is considered a clear and simple tool to develop Pharmacotherapeutic Follow-up. This research aims to analyze the evolution of the international scientific production related to Pharmacotherapeutic Follow-up and the Dader Method to show the current situation of this Professional Pharmacy Assistance Service. In addition, from the data obtained, we give a critical perspective on the implementation of the Dader Method in Community Pharmacy, considering its advantages and disadvantages based on the published scientific literature. Methods: Using bibliometrics tools, indicators were obtained to analyze the international production of scientific articles on Pharmacotherapeutic Followup and the Dader Method during the period (1999-2022) through the Scopus database. Results: The results showed a growth in the international scientific production of publications on Pharmacotherapeutic Follow-up, obtaining 30,287 papers, placing the United States, the United Kingdom, Australia, Canada and Spain as the five most productive countries. The publication of 83 papers on the Dader Method places Spain with the highest number of publications, followed by other Spanish or Portuguese speaking countries, among which Brazil and Colombia have the most prominent number of published papers in Latin America. The most frequent international journal covering the topic of Pharmacotherapeutic Follow-up was the American Journal of Health- Pharmacy (12.4%), while on the Dader Method, the journal Pharmaceutical Care Spain (21.7%) is in the first position, followed by Farmacia Hospitalaria (8.4%). Conclusion: The publications on the Dader method highlighs the greater productivity of the University of Granada and the author María José Faus Dáder. The inclusion of patients in the PTF service using the Dader Method, is more frequent in the hospital context, and is based on the presence of defined chronic pathologies (mainly diabetes), polymedication or specialized care follow-up, with elderly population being the most represented in all cases.(AU)

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Adenosine regulates multiple physiological processes through the activation of four receptor subtypes, of which the A2B adenosine receptor (A2BAR) has the lowest affinity for adenosine. Being the adenosine receptor subtype most prominently expressed in epidermis, we recently described the antiproliferative and anti-inflammatory effect of the selective A2BAR agonist BAY60-6583 (BAY) in human keratinocytes stimulated with 12-O-tetradecanoylphorbol-13-acetate (TPA), so we sought to establish the effect of topical application of BAY in a model of murine epidermal hyperplasia. Topical application of BAY (1 or 10 µg/site) prevented the inflammatory reaction and skin lesions induced by TPA, minimizing hyperproliferation and acanthosis, as well as the expression of specific markers of proliferative keratinocytes. On the other hand, pre-treatment with the selective A2BAR antagonist, PSB-1115 (PSB, 5 or 50 µg/site) reversed these beneficial effects. Additionally, BAY application normalized the expression of epidermal barrier proteins, whose integrity is altered in inflammatory skin diseases, while treatment with the antagonist alone worsened it. Our results, besides confirming the anti-inflammatory and antiproliferative effects of the A2BAR agonist, further demonstrate a role of A2BAR activation to preserve the epidermal barrier. Therefore, the activation of A2BAR may constitute a possible new pharmacological target for the treatment of skin inflammatory diseases such as psoriasis.

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RESUMEN Antecedentes: los colgajos perforantes perimamarios son de gran utilidad en la reconstrucción mamaria inmediata en cirugía conservadora. Objetivo: describir los resultados del empleo de un algoritmo sobre colgajos perforantes perimamarios en la reconstrucción mamaria inmediata después de cirugía conservadora por cáncer de mama. Material y métodos: se llevó a cabo un estudio retrospectivo descriptivo. Se revisaron las historias clínicas de las pacientes operadas entre enero de 2020 y diciembre de 2022 por carcinoma de mama con cirugía conservadora y que requirieron reconstrucción con colgajos perimamarios. Las indicaciones incluyeron déficit de volumen, defecto de contorno y asimetría. Se evaluó el pedículo vascular del colgajo mediante Doppler color en todos los casos, lo que permitió seguir un algoritmo para la selección de la mejor opción de colgajo. Resultados: se realizaron 20 colgajos en 19 pacientes. Promedio de edad: 52 años ± 11 (rango 30-76). No existieron complicaciones intraoperatorias. Una paciente requirió reoperación por compresión del pedículo vascular del colgajo por hematoma, con la pérdida parcial, y otro colgajo sufrió epidermólisis superficial. No hubo pérdidas totales de ningún colgajo. Todas recibieron radioterapia posoperatoria y no experimentaron pérdida de volumen ni retracciones. Con un promedio de seguimiento de 15 meses, las pacientes valoraron los resultados a 6 meses como excelente en 7, bueno en 11 y regular en 2. Conclusión: la selección de colgajos perforantes locales para corregir defectos mamarios después de cirugía conservadora, mediante el examen con Doppler color preoperatorio para la identificación del pedículo vascular y un algoritmo específico, permitió obtener resultados estéticos satisfactorios sin requerir elementos aloplásticos ni revisiones posteriores.

ABSTRACT Background: Chest wall perforator flaps are a good option for immediate breast reconstruction after conservative surgery. Objective: The aim of this study was to describe the clinical results of an algorithm for using chest wall perforator flaps for breast reconstruction after breast-conserving surgery for breast cancer. Material and methods: We conducted a descriptive and retrospective study. The information was retrieved from the medical records of the patients diagnosed with breast cancer who underwent breast-conserving surgery and required reconstruction using chest wall perforator flaps between January 2020 and March 2022. The indications included volume deficit, contour defect and asymmetry. The vascular pedicle of the flap was evaluated by color Doppler ultrasound in all cases, which allowed us to follow an algorithm for selecting the best flap option. Results: Twenty flaps were made in 19 patients. Mean age: 52 years ± 11 (range 30-76). There were no intraoperative complications. One patient required reoperation due to a hematoma with compression of the vascular pedicle of the flap with partial flap loss, and another flap presented superficial epidermolysis. There were no cases of complete flap loss. All the patients underwent postoperative radiation therapy without loss of volume or retractions. Mean follow-up was 15 months. At 6 months, patients rated the results as excellent, good, and fair in 7, 11, and 2 cases, respectively. Conclusion: The selection of local perforator flaps to correct breast defects after conservative surgery, using preoperative color Doppler ultrasound to identify the vascular pedicle and a specific algorithm, allowed us to obtain satisfactory aesthetic results without the need for alloplastic elements or subsequent revisions.

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INTRODUCCIÓN: los Centros de Información de Medicamento (CIM) tienen como objetivo servir a los farmacéuticos como fuente de información técnica, científica y actualizada de los medicamentos y productos sanitarios para promover el uso racional de estos y mejorar el cuidado y la salud del paciente. El farmacéutico ha de disponer de la mejor información sobre el medicamento para dar un buen servicio profesional.OBJETIVO: elaboración, implantación y validación de un protocolo de respuestas a las consultas recibidas en el CIM que permita el registro normalizado de las preguntas recibidas, así como un modelo optimizado de respuestas basado en la recuperación eficiente de información en las bases de datos especializadas.MATERIALES Y MÉTODOS: estudio observacional retrospectivo de las consultas recibidas y desarrollo de una base de datos propia para el registro de las consultas generadas (CAC). Las consultas se clasificaron siguiendo criterios de categorización a través de 25 ejes (comercialización, indicación, seguridad, posología, etc.), fármaco consultado y grupo ATC al que pertenece. Una vez procesadas las consultas de 7 meses, se procedió a la implantación del protocolo normalizado de resolución de consultas para evaluar su eficiencia.RESULTADOS Y DISCUSIÓN: durante el periodo de tiempo comprendido entre junio de 2021 y enero de 2022 se han registrado 248 consultas, que se han categorizado en base al tipo de consulta y fármaco consultado. En febrero, tras iniciar la validación, se recibieron 38 consultas de las cuales se repitieron 9 fármacos consultados (3,21 %), 10 grupos ATC (3,57 %) y se repitieron las mismas consultas 4 veces (1,43 %). Estos resultados permitieron responder de forma rápida y efectiva a las consultas que se repitieron durante el primer mes de validación. (AU)

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BACKGROUND: To evaluate the influence of the disease activity on radiographic progression in axial spondyloarthritis (axSpA) patients treated with TNF inhibitors (TNFi). METHODS: The study included 101 axSpA patients from the Spanish Register of Biological Therapy in Spondyloarthritides (REGISPONSERBIO), which had clinical data and radiographic assessment available. Patients were classified into 2 groups based on the duration of TNFi treatment at baseline: (i) long-term treatment (≥4 years) and (ii) no long-term treatment (< 4 years). Radiographs were scored by two readers according to the modified Stoke Ankylosing Spondylitis Spine Score (mSASSS) with known chronology. Disease activity differences between patients' groups at each time point were assessed using a linear mixed-effect model. RESULTS: Radiographic progression was defined as an increase in ≥2 mSASSS units. At inclusion, approximately half of the patients (45.5%) were receiving long-term treatment with TNFi (≥4 years). In this group of subjects, a significant difference in averaged Ankylosing Spondylitis disease Activity Score (ASDAS) across follow-up was found between progressors and non-progressors (2.33 vs 1.76, p=0.027, respectively). In patients not under long-term TNFi treatment (54.5%) though, no significant ASDAS differences were observed between progressors and non-progressors until the third year of follow-up. Furthermore, no significant differences were found in progression status, when disease activity was measured by Bath Ankylosing spondylitis Disease Activity Index (BASDAI) and C reactive protein (CRP). CONCLUSIONS: Patients on long-term TNFi treatment with a mean sustained low disease activity measures by ASDAS presented lower radiographic progression than those with active disease.

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Adenosine A2A receptor mediates the promotion of wound healing and revascularization of injured tissue, in healthy and animals with impaired wound healing, through a mechanism depending upon tissue plasminogen activator (tPA), a component of the fibrinolytic system. In order to evaluate the contribution of plasmin generation in the proangiogenic effect of adenosine A2A receptor activation, we determined the expression and secretion of t-PA, urokinase plasminogen activator (uPA), plasminogen activator inhibitor-1 (PAI-1) and annexin A2 by human dermal microvascular endothelial cells stimulated by the selective agonist CGS-21680. The plasmin generation was assayed through an enzymatic assay and the proangiogenic effect was studied using an endothelial tube formation assay in Matrigel. Adenosine A2A receptor activation in endothelial cells diminished the release of PAI-1 and promoted the production of annexin A2, which acts as a cell membrane co-receptor for plasminogen and its activator tPA. Annexin A2 mediated the increased cell membrane-associated plasmin generation in adenosine A2A receptor agonist treated human dermal microvascular endothelial cells and is required for tube formation in an in vitro model of angiogenesis. These results suggest a novel mechanism by which adenosine A2A receptor activation promotes angiogenesis: increased endothelial expression of annexin A2, which, in turn, promotes fibrinolysis by binding tPA and plasminogen to the cell surface.

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Atopic dermatitis (AD) and psoriasis are the most common chronic inflammatory skin disorders, which importantly affect the quality of life of patients who suffer them. Among other causes, nitric oxide has been reported as part of the triggering factors in the pathogenesis of both conditions. Cyanocobalamin (vitamin B12) has shown efficacy as a nitric oxide scavenger and some clinical trials have given positive outcomes in its use for treating skin pathologies. Passive skin diffusion is possible only for drugs with low molecular weights and intermediate lipophilicity. Unfortunately, the molecular weight and hydrophilicity of vitamin B12 do not predict its effective diffusion through the skin. The aim of this work was to design new lipid vesicles to encapsulate the vitamin B12 to enhance its skin penetration. Nine prototypes of vesicles were generated and characterized in terms of size, polydispersity, surface charge, drug encapsulation, flexibility, and stability with positive results. Additionally, their ability to release the drug content in a controlled manner was demonstrated. Finally, we found that these lipid vesicle formulations facilitated the penetration of cyanocobalamin to the deeper layers of the skin. The present work shows a promising system to effectively administer vitamin B12 topically, which could be of interest in the treatment of skin diseases such as AD and psoriasis.

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Con este artículo se presenta al grupo “Cuidados Enfermeros Avanzados ENFERAVANZA”, integrado en el Instituto Murciano de Investigación Biosanitaria (IMIB-Arrixaca) como grupo de investigación enfermera del instituto, independiente de otras disciplinas de Ciencias de la Salud. En el texto se exponen las líneas de investigación, alianzas institucionales, proyectos y producción científica desde sus inicios hasta la actualidad. Se considera que la oportunidad de investigar desde los institutos de investigación acreditados visibiliza el trabajo que se está realizando por las enfermeras desde el seno de la disciplina, a la vez que se fomenta y se fortalece la investigación clínica en cuidados, considerando que lleva implícito no solo un beneficio sanitario, sino social y económico, y entendiendo la investigación como un valor fundamental en la mejora de la sanidad.(AU)

This article introduces the “Advanced Nursing Care ENFERAVANZA” group, integrated in the Murcia BioHealth Research Institute (IMIB-Arrixaca) as a nursing research group from the institute, independent from other disciplines of Health Sciences. The text presents its lines of research, institutional alliances, projects, and scientific output from their beginning until today. The opportunity to conduct research from accredited research institutes is considered to make visible the work done by nurses within the discipline, and at the same time it encourages and strengthens clinical research on care, considering that it entails not only a benefit in terms of healthcare but also social and economic, and understanding research as an essential value in terms of healthcare improvement.(AU)

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Microneedle arrays (MNA) are considered as one of the most promising resources to achieve systemic effects by transdermal delivery of drugs. They are designed as a minimally invasive, painless system which can bypass the stratum corneum, overcoming the potential drawbacks of subcutaneous injections and other transdermal delivery systems such as chemical enhancers, nano and microparticles, or physical treatments. As a trendy field in pharmaceutical and biomedical research, its applications are constantly evolving, even though they are based on very well-established techniques. The number of molecules administered by MNA are also increasing, with insulin and vaccines administration being the most investigated. Furthermore, MNA are being used to deliver cells and applied in other organs and tissues like the eyes and buccal mucosae. This review intends to offer a general overview of the current state of MNA research, focusing on the strategies, applications, and types of molecules delivered recently by these systems. In addition, some information about the materials and manufacturing processes is presented and safety data is discussed.

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Background: Biologics for moderate-to-severe psoriasis are expensive and treatment substitutions may vastly increase cost. Moreover, administration regimens in routine practice may differ from recommended guidelines.Objectives: To evaluate long-term effectiveness, regimen, drug-survival, and efficiency of self-administered biologics in clinical practice.Methods: We performed a 5-year retrospective study in 72 patients (44 ± 14 years old) with moderate-to-severe psoriasis at the University Hospital La Plana (Vila-real, Spain), treated with subcutaneous biologics. We determined the effectiveness (PASI 75 or PASI < 5), and drug-survival using Kaplan-Meier estimates, and analyzed reasons for treatment interruption, drug substitution patterns, and costs.Results: Etanercept was less effective (45%) than ustekinumab (85%) and adalimumab (71%). In 15% of patients, optimal responses were maintained despite dose intervals lengthening. Drug-survival was significantly lower for etanercept than for the other biologics (p < .005). Most adalimumab and etanercept discontinuations were due to adverse events or lack of effectiveness; for ustekinumab the causes were unrelated to drug effects. Ustekinumab was 100% effective as a secondary biologic.Conclusion: Ustekinumab was the safest and most efficient treatment. Etanercept showed the highest treatment failure rate, incurring higher costs. Dosage individualization according to patient needs improves the therapy efficiency, reducing therapeutic failure and derived costs.

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OBJECTIVES: Hiliar (pN1) and mediastinal lymph (pN2) nodal upstaging after surgery for early stage (

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Procedures to characterize drugs that can be obtained from plant extracts or combinatorial chemistry are tedious, and they consume considerable resources (e.g., animals) and time. Thus, we have looked for a way to streamline this process. We describe here a novel system for the pre-characterization of drugs based on liquid chromatography coupled to biological detection using perifused or perfused organs. This novel system allows the on-line detection of pharmacologically active substances in hydrosoluble mixtures from vegetal extracts or combinatorial chemistry libraries. Depending on the volume of drug solution and concentration of the samples, the procedure can work through either medium pressure liquid chromatography or HPLC, and it enables the fingerprints of drugs to be assessed based on their contractile activity on combinations of different isolated tissues. As an example, we show how the system can identify active fractions from an extract of Stevia rebaudiana Bertoni, an activity that was later associated with rebaudioside N. Coupling liquid chromatography to biological detection offers a rapid way to focus attention on active products in complex samples, mostly from hydrosoluble species, helping to considerably reduce the time and cost of the pre-characterization of drugs.

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BACKGROUND: The shortage of organs has made it necessary to look for new alternatives as xenotransplantation. The objective of this study was to analyze the attitudes of Polish nursing students toward organ donation of nonhuman origin, and to determine the factors that affect them. METHODS: Year 2011-2012. Nursing students of the University of Poland. Sampling points in 5 compulsory-attendance nursing courses with a completion rate of fulfillment of 80%. Validated questionnaire (PCID-XenoTx Rios) filled out anonymously and self-administered. RESULTS: The completion rate was 81% (325/402): 55% in favor (n = 179), 7% (n = 24) against, and 38% (n = 122) do not know. There were significant associations between: 1) the academic year, with 1st-year students presenting the more favorable attitude than those in the 3rd year (68% vs 41%; P = .039); 2) discuss the topic with friends (59% vs 41%; P = .043); 3) being in favor of cadaver organ donation (64% vs 41%; P < .001); and 4) consider the option of needing a transplant in the future (63%) compared with those who do not consider this option (40%; P = .040). In multivariate analysis, the relationship with being in favor of cadaver organ donation remained (odds ratio, 2.577; 95% confidence interval, 4.081-1.631; P < .001). CONCLUSIONS: Almost one-half of the nursing students had an unfavorable attitude toward xenotransplantation.

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BACKGROUND: Nursing students, as future professionals, have an enormous impact on the opinion of the rest of the population on topics of organ donation and transplantation (ODT). The objective of this study was to analyze the attitudes of nursing students at the University of Bialystok toward ODT, and to determine the factors that affect ithemt. METHODS: Academic year 2011-2012. STUDY POPULATION: nursing students at the University of Bialystok. Type of sampling: sampling points during 5 compulsory-attendance nursing courses with >80% fulfillment. Measuring instrument: validated questionnaire (PCID-ODT Rios) filled out anonymously and self-administered. RESULTS: Completion rate of 90% (331/367): 58% (n = 191) in favor, 35% (n = 118) undecided, and 7% (n = 22) against. The most important variables were: being in the 1st year (odds ratio [OR], 4.444; 95% confidence interval [CI], 11.627-1.700; P = .002); not knowing any donor (OR, 12.048; 95% CI, 55.555-2.57; P = .018); being in favor of organ donation by a relative (OR, 6.25; 95% CI, 14.705-2.666; P < .001); discussing the topic with friends (OR, 2,785; 95% CI, 5.347-1.447; P = .002); not worried about the possible mutilation of the body after donation (OR, 3.039; 95% CI, 5.882-1.569; P = .001); favorable attitude toward ODT of mother (OR, 3.676 (0.881-1.814; P < .001); accepting other treatment options, such as inhumation (OR, 3.436; 95% CI, 7.092-1.655; P = .001); accepting autopsy after death (OR, 2.141; 95% CI, 4.065-1.126; P = .020); and professing the Catholic religion (OR, 3.436; 95% CI, 8.333-1.410; P = .007). CONCLUSIONS: More than 42% of the nursing students were not in favor of organ donation, their attitudes influenced by various psychosocial factors.

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BACKGROUND: The knowledge and acceptance of the concept of brain death among future health professionals is essential. The objective of this study was to analyze the knowledge of the concept of brain death among nursing students at the Medical University of Warsaw and determine the factors that affect it. METHODS: Academic year 2011-2012, nursing students of the University of Poland. Sampling points in 5 compulsory-attendance nursing courses with a completion rate >80%. Validated questionnaire (PCID-DTO Rios), anonymous and self-administered. RESULTS: The completion rate was 96% (793/828); 71% (n = 561) knew the concept of brain death, 22% (n = 178) did not know it, and 7% (n = 54) did not know that it implies the death of the patient. Variables related to the correct knowledge: 1) to be studying in 4th year compared with 1st year (85% vs 60%; P ≤ .001); 2) discuss the subject with family (76% vs 61%; P ≤ .001); 3) discuss with friends (73% vs 63%; P = .009); and 4) having a favorable attitude toward organ donation (74% vs 65%; P = .011). In the multivariate analysis, the variables that remained independent were studying in 4th year (odds ratio [OR], 3.809; 95% confidence interval [CI], 2.006-5.823; P ≤ .001) and discussed with family concerning donation and transplantation (OR, 1.718; 95% CI, 1.241-2.381; P ≤ .001). CONCLUSIONS: One-third of the nursing students were unfamiliar with the concept of brain death.

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BACKGROUND: Liver transplantation from living donors (LLD) has become a viable and important source of liver grafts. The objective of this study was to analyze the attitude of nursing students at the Pomeranian Medical University in Poland on donation of live liver, and to determine the factors that affect it. METHODS: Academic year 2011-2012, nursing students at a university in Poland, sampling points in 5 compulsory-attendance nursing courses with a completion rate of 80%, validated questionnaire (PCID-DVH Rios) filled out anonymously and self-administered. RESULTS: The completion rate was 89% (227/254). Of the 227 students surveyed, 92% (n = 209) were in favor, 6% (n = 14) undecided, and 2% (n = 4) against. When the LLD is not related, 44% (n = 100) of respondents would be in favor. With a positive attitude toward this type of donation, we associated the following variables: 1) age, with the youngest showing a more favorable attitude (P = .006); 2) attitude in favor of living kidney donation (98% vs 85%; odds ratio, 4.950; 95% confidence interval, 9.259-2.652; P = .002); 3) attitude in favor of accepting a family LLD (96% vs 81%; P = .003); 4) discussing donation and transplantation with family (95% vs 87%; P = .043). CONCLUSIONS: Ninety-two percent of nursing students at the Pomeranian Medical University in Poland were in favor of live organ donation, an attitude conditioned by various psychosocial factors.

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The sprouting of new vessels is greatly influenced by the procedure chosen. We sought to optimize the experimental conditions of the angiogenic growth of fresh and cryopreserved vessels cultured in Matrigel with the aim to use this system to analyze the pharmacological modulation of the process. Segments of second-order branches of rat mesenteric resistance arteries, thoracic aorta of rat or mouse, and cryopreserved rat aorta and human femoral arteries were cultured in Matrigel for 7-21 days in different mediums, as well as in the absence of endothelial or adventitia layer. Quantification of the angiogenic growth was performed by either direct measurement of the mean length of the neovessels or by calcein AM staining and determination of fluorescence intensity and area. Fresh and cryopreserved arterial rings incubated in Matrigel exhibited a spontaneous angiogenic response that was strongly accelerated by fetal calf serum. Addition of vascular endothelial growth factor, fibroblast growth factor, endothelial growth factor, or recombinant insulin-like growth factor failed to increase aortic sprouting, unless all were added together. Removal of adventitia, but not the endothelial layer, abrogated the angiogenic response of aortic rings. Determination of the mean neovessel length is an easy and accurate method to quantify the angiogenic growth devoid of confounding factors, such as inclusion of other cellular types surrounding the neovessels. Activity of a α1-adrenoceptor agonist (phenylephrine) and its inhibition by a selective antagonist (prazosin) were analyzed to prove the usefulness of the Matrigel system to evaluate the pharmacological modulation of the angiogenic growth.

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Dendritic cell (DC) cancer vaccines have shown limited clinical benefit. Thus, the identification of signals and molecular pathways that potentiate the immunogenicity of DCs has become a major challenge in cancer research. Our studies demonstrate that triiodothyronine endows DCs with enhanced ability to stimulate cytotoxic T-cell responses with implications in DC-based immunotherapy.

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BACKGROUND: The objective of the present study was to analyze the knowledge and acceptance of the brain death (BD) concept among nursing students. METHODS: The study was undertaken in the academic year of 2011 to 2012 in nursing students from the University of the South of Poland. The sample was carried out in compulsory sessions, in the 5 years of the nursing degree study, with a completion rate of 80%. The questionnaire was validated (PCID-DTO Ríos), self-administered, and completed anonymously. RESULTS: The completion rate was 93% (492 of 530). Of the students surveyed, 75% (n = 369) knew the concept of BD and considered it to mean a person's death. Of the rest, 19% (n = 93) did not know it, and the remaining 6% (n = 30) believed that it did not mean that a person was dead. The following variables were significantly related with the correct knowledge of the BD concept: 1) age (22 ± 2 years; P ≤ .001); 2) academic year (P ≤ .001); 3) discussion with friends about organ donation and transplantation (ODT) (P = .035); 4) partner's favorable attitude toward donation and transplantation (P = .009); and 5) being Catholic (P = .031). In the multivariate analysis, the following variables persisted as independent variables related to the BD concept: a) age [OR = 1.468 (1.247-1.697); P ≤ .001] and b) partner's opinion of ODT [OR = 2.248 (1.255-4.025); P = .006]. No association was found with attitude toward ODT. CONCLUSIONS: More than 25% of the students from the Jagiellonian University of Kraków did not know or accept the concept of brain death.

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