It is our intention to present in this work indications, contraindications and benefits regarding the application of therapeutic hypothermia in patients after cardiac arrest. Therapeutic hypothermia means lowering the internal temperature of the human body to 32-34 degree Celsius. It is a safe and efficient method increasing the patients’ chances of survival and their neurological prognosis, especially if the arrest was caused by cellular rhythm disorders. The efficiency of this treatment is confirmed by the American Heart Association and the European Resuscitation Board, which included it in the resuscitation guidelines for adults. We also describe the place of this treatment in valid resuscitation guidelines and pay attention to its mostly unknown potentialities and a few controversies.
The aim of this thesis was to evaluate if the students of universities of Bydgoszcz know the principles of proper nutrition and whether or not they follow them.The study was conducted on a group of 100 students of the universities of Bydgoszcz, 77 women and 23 men between the ages of 19 and 25. The study was carried out in the first half of 2014 using a survey method.Conclusions. Knowledge of rational nutrition and the principles of healthy eating among students of Bydgoszcz universities is quite varied and depends on the field of study. The best eating habits are characterized by technical and art faculties. Students of medical faculties and health sciences are not leaders in this field. More irregularities relating to the quality of diet is observed among students of humanities and social sciences.
Introduction. Emotional status of a patient who underwent a surgery is an important element in the recovery process. The aim of the study was to assess changes in positive and negative emotions in patients subjected to endovascular procedure due to chronic ischemia of the lower limbs and the determination of the factors affecting that process.Materials and methods. 63 patients subjected to endovascular surgery due to chronic ischemia participated in the study. The study group included persons aged 46 to 87 (median 65 years). The following tools were used: a questionnaire on demographic and medical data, Larsen & Diener Affect Intensity Measure Scale, modified Charles Carver's MiniCOPE (situational version) Inventory of coping with stress measurement, Berlin social support scale and Multidimensional Health Locus of Control Scale. Medical data on the hospitalization time, type of anesthesia and the type of a surgery procedure was also used in the study.Results. Statistically significant increase of the positive emotions intensity was observed in the studied group of patients Me=9 (min. 0, max. 23) before the surgery and Me=13 (min. 4, max. 27) after surgery and reduced level of negative emotions from Me=10 (min. 1, max. 24) to Me=3 (min. 0, max. 15).Conclusions. In patients treated for chronic ischemia of the lower limbs an endovascular intervention (revascularization of lower limbs) decreased the negative emotions level and increased the positive ones. Health locus of control does not influence the emotional status change in the studied subjects. Patients with higher levels of perceived social, emotional and instrumental support are characterized by smaller increase of positive emotions intensity after endovascular surgery. Patients with lower levels of perceived instrumental support are characterized by smaller decrease of negative emotions intensity after endovascular surgery. Strategies used to cope with stress related to surgery do not affect the emotional condition change in persons subjected to endovascular surgery. Number of symptoms following endovascular surgery is a predictor of the level of negative emotions.
Background. Currently, the average amputation free survival in patients with critical limb ischemia (CLI) amounts to 76% after one year of follow-up. Such poor prognosis raises the question: is revascularization in patients with CLI cost-effective? The aim of this study was to conduct a cost analysis of vascular care in patients with CLI.The aim of this study was to conduct a cost analysis of vascular care in patients with CLI.Patients and methods. A retrospective cost analysis of in-hospital endovascular treatment in 37 patients with CLI who underwent secondary leg amputation between January 2012 and June 2015.Results. The average length of time between the first endovascular procedure due to CLI and leg amputation amounted to 214 days (range 8-1088 days). The total cost of hospitalizations before leg amputation amounted to 687 603.13 PLN, which is, on average, 18 583.87 PLN per patient, and 86.84 PLN per person per day for living with the preserved lower limb. The total costs associated with the patients who had undergone leg amputation amounted to 404 883.24 PLN, which is an average of 10 942.79 PLN per patient. Previous endovascular procedures accounted for 58.9% of this sum and 37.1% to total management costs for the patients.Conclusions. The cost per day of endovascular treatment that makes it possible to live with two lower limbs did not exceed the established cost-effectiveness threshold. Lower limb amputation increases the costs of in-hospital patient care by 59%, represents financial wastage for the hospital, and incurs other costs not easily measured.
Managers willingly use performance as the key element in the motivation of employees, evaluation of their work, as well as an important indicator in the bonus system. The measurement of performance allows not only the explanation of the cause of the occurrence of a deviation in the efficiency of nurses’ work, but also facilitates the implementation of actions improving the quality of performance of occupational activities. The objective of the study was analysis of literature concerning the structure and principles of the application of instruments used for the assessment of performance of nurses. The review of literature pertaining to the tools for the evaluation of efficiency of performance of nurses showed a large number of international reports; however, there is a total lack in the Polish literature. Analysis of literature allowed the formulation of the following conclusions: in Poland, there is a lack of studies concerning the measurement of performance of nurses. The performance of nurses should be measured by the tool which enables its evaluation in a multi-aspect context, and possesses a high reliability and validity.
Background. High-dose therapy (HDT) with autologous stem cell rescue has been recently applied in very-poor-risk pediatric solid tumors. Promising data have become available with the use of high-dose busulfan in neuroblastoma (NBL) and Ewing sarcoma (ES), and with high-dose treosulfan in ES. HDT approach resulted in an encouraging outcome without toxic mortality for high-risk patients.Objective. The objective of this study is to present transplant outcomes, that is disease-free-survival and overall survival in children with high-risk NBL and ES undergoing auto-HSCT.Patients and methods. A total number of 47 NBL and 20 ES auto-HSCT performed between 2004 and 2016 in a single transplant center were included in this analysis.Results. Probability of 3-years pOS was 0.79±0.06 and 0.46±0.14 for NBL and ES patients, respectively. Relapse incidence at 3 years after HSCT was 0.37±0.08 and 0.26±0.11 for NBL and ES patients, respectively. The number of relapses at 3 years after HSCT was 15/47 in NBL and 6/20 in ES. Busulfan-based vs treosulfan-based conditioning in ES patients resulted in lower relapse and death rates. NBL and ES patients transplanted in complete remission (CR1) had lower relapse rates and lower death rates than patients at CR>1.Conclusion. Obtained results of auto-HSCT confirm the therapeutic benefit for children with NBL and ES. Recent reports on current practice of HSCT in Europe indicate HDT with auto-HSCT as a standard of care in pediatric patients with high risk or relapsed NBL and ES.
Wheelchair plays two important roles from the physical point of view: increased mobility and body support. Two main areas of children’ development: motor and cognitive are interrelated. Thus, wheelchair supported mobility in children may also prevent many severe problems in the area of social and cognitive development.This paper aims at presentation of current state of the art and own concept concerning the role of the wheelchair-based mobility in cognitive development of children with motor deficit.
Thanks to recent advances in health care an increased number of patients may recover from severe brain injuries, but some of them are still assessed as non-responsive. Reliance on behavioural measures in communication with DoC patients seems be too prone to errors. There is need for solutions providing more objective attempts of bidirectional communication (intentional questions/commands and adequate related responses) in patients with DoC using significant processed by the patient stimuli and novel technologies (EEG-, fMRI-, BCI-based, etc.) based on recent scientific and clinical evidences. Such communication may be fulfilled even in the absence of behavior.This article aims at assessment the extent to which current possibilities in the area of devices for extended communication has been exploited, including own experiences within InteRDoCTor project.
Background : The study is aimed at classifying the Body mass index (BMI) of Igbo women resident in Maiduguri and correlating between their BMI and hip circumference. Materials and Methods : The study was conducted on 150 Igbo women between 25-40 years resident in Maiduguri. The height, weight, upper arm circumference, hip circumference, abdominal and upper arm skin folds of subjects were measured. BMI was calculated by dividing the weight (kg) by the height (m²). One way analysis of variance was used to determine the mean difference between groups while Pearson’s linear correlation was used to determine correlation co-efficient. Data were expressed as Mean±Standard Deviation (SD) and P <0.05 was considered statistically significant. Results: The result showed that Igbo women in Maiduguri have an upper arm circumference, hip circumference, height and weight of 26.24±0.590 cm, 34.26±3.96 cm, 2.49±0.22 m² and 74.50±13.34 kg respectively with an upper arm and abdominal skin fold of 7.50±1.75 kcal and 8.10±1.25 kcal respectively. From the subjects studied, (0.6%) were underweight, (15%) were normal, while 73.3% were overweight/obese. The result also showed a correlation co-efficient (r) of 0.1951 between upper arm and hip circumference, 0.1758 between upper arm circumference and weight, 0.0001 between weight and hip circumference and 0.2368 between hip circumference and BMI. Conclusion: From the sample studied, 83.3% were overweight/obese placing them at risk of coronary heart disease, diabetes and hypertension which are more common in obese persons. Hip circumference is not a predictor of BMI in Igbo women resident in Maiduguri. Keywords : Body Mass Index, Fat composition, hip circumference and abdominal skinfold.
Nowadays obesity is one of the most important problems in the developed countries. It is characterized by the excess increase of fat tissue. The main causes of obesity are insufficient amount of physical activity and overdosing of energy delivered with food.The purpose of this paper is the assessment of skinfold thickness and the percentage of fat tissue content in women between 50 and 80 years of age.1215 female inhabitants of Kujawsko-Pomorskie Voivodeship participated in the study and were divided into 6 age groups in 5-year divisions. The skinfold thickness was assessed and the percentage of fat tissue content was calculated. The measurements were made with the skinfold caliper.All tested women in the respective age groups, according to BMI index, were overweight, whereas the percentage of fat tissue content was over 40% in all groups. In 65-69 age bracket there is an increase of all tested parameters, whereas in women above 70 years of age a visible decrease of measured skinfold thickness values is observed as well as reduction of proportional fat tissue content.
Malfunctioning of environmental, immunologic or genetic mechanisms brings about a disorder of system homeostasis, which results in the development of diseases of arduous course. Inflammatory bowel diseases are a group of disorders which house a pathological inflammation of the wall of the gastrointestinal tract. It is postulated that one reason for the resulting changes may be free radical reactions. As a result of the ongoing inflammation under the course of the disease an influx of neutrophils into the lumen begins. Although endoscopic examination constitutes an irreplaceable method in the evaluation of the resulting changes, laboratory tests are an essential tool in the diagnostic process. In recent years it has been proven that the role of faecal calprotectin as a non-invasive test can be used to differentiate organic and functional gastrointestinal diseases, and evaluate remission or exacerbation of inflammatory bowel disease [6,28]. It has also been noted that there is a need to seek other new markers that would facilitate the diagnosis.
The analysis of the epidemiology of breast cancer in Kujawsko-Pomorskie voivodship in 2006 – 2010 in terms of the number of cases and deaths, and selected epidemiological indicators. Kujawsko-Pomorskie is the region with a great epidemiology risk in Poland. The number of cancers detected in this period was 4402, majority among the people between the ages of 50 and 69. 20% of cases were detected in cancer screening. The number of breast cancers detected in the pre-invasive stage is growing. The 5 year cure rate in the cases of breast cancer has risen.
The aim of the study was to assess the severity of mood disorders in women in the first and sixth week postpartum and to determine the incidence of baby blues depending on selected risk factors. Material and methods. 285 postpartum women were enrolled in the study. The research project was divided into two stages (first and sixth week postpartum). The Edinburgh Postnatal Depression Scale (EPDS) was used to assess the severity of mood disorders. The indicator of the presence of disorders was set at ≥ 12 points on the 30-point EPDS scale. In order to determine the impact of selected independent variables on the dichotomous dependent variable (baby blues), a logistic regression model was used based on the formula. Results. In the first week postpartum, baby blues was found in 23.2% of the postpartum women. The risk for postnatal depression after six weeks postpartum was determined in 17.3% of the women. The odds ratio for baby blues correlated with: unfavorable financial situation of the women (OR=2.56), a family history of mental disorders (OR=3.87), and dissatisfaction with medical care received during childbirth (OR=5.24). Conclusions Cases of baby blues were determined in every fourth woman from the sample group. The risk for postnatal depression was found in 17.3% of women after six weeks postpartum. The odds ratio for baby blues was affected by the following statistically significant factors: unfavorable financial situation of the women, genetic predispositions and dissatisfaction with perinatal medical care.
O b j e c t i v e s . The aim of the study was to establish if the social support received by primiparae in the 3rd trimester of pregnancy and in the postpartum period differs significantly from the social support received by multiparae, and if there are any differences in the satisfaction with life among the women involved in the study. M e t h o d s . The Berlin Social Support Scales (BSSS) as well as the Satisfaction with Life Scale (SWLS) were used in the study. A total of 199 women in the third trimester of pregnancy and after physiological birth or caesarean section (only 188) took part in the study. R e s u l t s . In the 3rd trimester of pregnancy the primiparae received significantly more emotional and instrumental support than the multiparae. In the postpartum period no difference was found between the social support received by the primiparae and the one received by the multiparae. There is no difference in life satisfaction between primiparae and multiparae in the gestation and postpartum period. C o n c l u s i o n s . Study of received social support and life satisfaction is necessary in order to define what assistance programmes should be created for women and their families while they are in the perinatal period.
Novel technologies such as 3D printing (additive manufacturing), 3D scanning and reverse engineering may significantly improve application of the principles of medicine in current clinical practice. This paper aims at presentation of the own concept of the repository of medical images based on 3D printing and reverse engineering technology. The proposed concept of the repository can constitute a beginning of the novel family of commercial techniques needed for development and optimization of reverse engineering toward printing the fully clinically functional solutions.
I n t r o d u c t i o n . Adolescence is a very important period for young people as it is the time when the patterns of health behaviour stabilize and in such form may be adopted for the rest of one’s life. This age group is also most prone to behaviour posing a risk to health and lacking behaviour good for health. The period of education is the most suitable to make teenagers aware of how much depends on themselves. Adolescence is often the time of rebellion and independent decision making which influence both the diet, way of spending fee time, personal and mental hygiene as well as abusing dangerous substance. The aim of the study was to assess the health behaviour of lower secondary school attendees in the scope of diet and physical activity by means of a questionnaire. The materials were based on research regarding health behaviour. The study group consisted of 90 students (60% male, 40% female). A questionnaire was chosen as the study method. The study was performed in 2012, from May until September. The results were comparable with HBSC results from 2006 in which 64.4% of the adolescents did not achieve the recommended physical activity minimum. The research has shown that adolescents prefer passive ways of spending their free time. Studies which monitor the state of behaviour linked with the health of the youth are carried out both internationally, nationally and locally. Poland achieves poor results in comparison to other countries when it comes to level of physical activity and amount of time spent on passive leisure.
I n t r o d u c t i o n . Advances in technology and the increasing experience of surgeons have made the thoracoscopic approach possible in diagnostic process in pediatric oncology. The objective of this paper is the retrospective analysis of efficacy and safety of thoracoscopic lung biopsy in diagnosis of malignancy in children.M a t e r i a l a n d m e t h o d s . Between 2010-2012 thoracoscopy with lung biopsy was performed in 12 cases in 10 children, including 5 boys and 5 girls, aged 2-17 years.R e s u l t s . In 11 out of 12 cases the result was conclusive. In 5 cases the lung biopsy was done due to problems with initial diagnosis, and in 7 cases due to suspicion of relapse of malignant disease. In 3 cases the diagnosis of malignancy was confirmed as: Hodgkin lymphoma, non-Hodgkin lymphoma and soft tissue sarcoma. In the group of children diagnosed due to relapse suspicion, the lung biopsy was performed 3-33 months after initial diagnosis. Results were conclusive in all 7 cases. In 3 cases malignancy was confirmed as Ewing sarcoma twice or neuroblastoma, and in 4 cases malignancy was not confirmed, including one case of diagnosis of invasive fungal infection. None of the children, who were excluded from malignant disease, experienced relapse during at least 2-year follow-up. The procedure of thoracoscopy with lung biopsy was safe. In the postoperative period only one patient required short-time Intensive Care Unit hospitalization because of respiratory insufficiency. In 5 cases only minor problems occurred including 4 cases of small subcutaneous emphysema. Median time of pleural drainage was 2 days (0-5 days). There were no periand postoperative deaths.C o n c l u s i o n s . Thoracoscopy with lung biopsy is a safe, effective approach for the evaluation and resection of pulmonary pathologic changes. The diagnostic yield of this method is very high in children.
Wstep. Transplantacja komorek krwiotworczych (HSCT) jest wazną metodą terapeutyczną w wielu wrodzonych i nabytych chorobach, w tym nowotworowych, zespolach niewydolności szpiku oraz zaburzeniach immunologicznych i metabolicznych. Celem pracy jest analiza wynikow HSCT w pojedynczym ośrodku pediatrycznym w okresie 12 lat. Pacjenci i metodyka. Analizie poddano wyniki przeszczepien wykonanych w latach 2003-2015 w Klinice Pediatrii, Hematologii i Onkologii w Bydgoszczy. Transplantacje analizowano w trzech przedzialach czasowych: 2004-2007, 2008-2011 oraz 2012-2015. Wyniki. Wykonano 318 HSCT, w tym 186 alloge-nicznych (68 zgodnych rodzinnych i 118 od dawcow alternatywnych) oraz 132 autologiczne. Średnie przezycie po HSCT, wyznaczone metodą Kaplana-Meiera wynioslo 8,1 lat. Calkowite prawdopodobienstwo przezycia (pOS) wynioslo 0,64±0,03; pOS po allo-HSCT wynosi 0,62±0,04, a po auto-HSCT 0,67±0,05. Nie wykazano znamiennych roznic w pOS zarowno po allo-HSCT, jak i po auto-HSCT pomiedzy drugim (2008-2011) i trzecim (2012-2015) analizowanym okresie. Jednakze, pOS bylo wyzsze w dru-gim i trzecim okresie w stosunku do okresu pierwszego (2004-2007), zarowno dla wszystkich pacjentow, jak i u pacjentow po auto-HSCT. W grupie pacjentow allo-HSCT, uzyskano wzrost pOS o ponad 20% (43% vs 66% vs 64% w kolejnych przedzialach czasu; ns). Wnioski. Wyniki HSCT uzyskiwane aktualnie w na-szym ośrodku są porownywalne z wynikami podawanymi w miedzynarodowych rejestrach.
Objectives. Leg ischemia is the third leading cause of atherosclerotic cardiovascular morbidity, concerning about 20-30% of the elderly population. Recognition of its risk factors helps in early diagnosis and patient management. The aim of this study was to determine the prevalence of respective atherosclerosis risk factors among patients with peripheral artery disease (PAD) referred for lower limb endovascular revascularization and compare their prevalence with the data obtained in large epidemiological investigations and in patients with atherosclerosis manifestation in coronary and cerebral vascular beds.Material and methods. Medical documentation for 73 male patients with PAD after a first endovascular intervention was evaluated retrospectively, and the prevalence of atherosclerosis risk factors found was compared with historical control groups from the literature.Results. The patients studied presented significantly greater prevalence of a current smoking habit and diabetes mellitus than in the POLSCREEN, WOBASZ and NATPOL PLUS studies, significantly greater prevalence of hypertension than in WOBASZ and NATPOL PLUS, significantly greater prevalence of dyslipidemia than in POLSCREEN and NATPOL PLUS, significantly lower prevalence of BMI ≥ 25 kg/m2 than in POLSCREEN, and greater than in NATPOL PLUS. In comparison to patients with coronary artery disease (CAD), individuals with PAD had a lower prevalence of hypertension and overweight and/or obesity, but greater occurrence of a current smoking habit and dyslipidemia.Conclusions. Patients with PAD who were qualified for endovascular therapy presented greater prevalence of atherosclerosis risk factors and multisite vascular disease manifestation than various general Polish populations and subjects with CAD, which suggests the need for the improved management of these patients.
Introduction. The aim of this study is to analyze the characteristics of patients in whom leg amputation was performed due to critical limb ischemia (CLI).Material and methods. Retrospective analysis of the characteristics of patients who underwent leg amputation between 2012 and 2014 in our center.Results. Between 2012 and 2014, 39 amputations of 37 limbs were performed on 32 patients treated due to CLI. Amputations amounted to 39/1282 (3.2%) of all vascular procedures performed on the lower limbs. They concerned, respectively: forefoot – 49%, calf – 15%, and thigh – 36%. In 85% of patients, the amputations were preceded by vascular procedures. The median length of time between the first revascularization procedure and amputation amounted to 99 ± 8-1088 days. Patients who underwent primary amputation (n = 6, 15%) compared to the individuals with secondary amputation were treated less frequently with aspirin (67% vs. 97%; p = 0.01) and statins (50% vs. 94%, p = 0.002). Patients who underwent amputation at thigh level compared with subjects with forefoot amputation were hospitalized for a significantly longer period of time, diagnosed more often with chronic heart failure (CHF) and chronic kidney disease (CKD), and were more often tobacco smokers.Conclusions. The main factors determining the need for amputation, its level and time between the first revascularization procedure and leg amputation were: the number of preceding procedures and stent implantations, comorbidity of CHF and CKD, smoking habit, inadequate pharmacotherapy (probably due to delayed diagnosis), severity of angiographic lesions, and higher MPV and INR values.
