Showing papers in "Family Medicine & Primary Care Review in 2016"

FOCUS: Frailty Management Optimisation through EIPAHA Commitments and Utilisation of Stakeholders’ Input – an innovative European Project in elderly care*

Abstract: The goal of FOCUS, which stands for Frailty Management Optimization through EIPAHA Commitments and Utilization of Stakeholders’ Input, is to reduce the burden of frailty in Europe The partners are working on advancing knowledge of frailty detection, assessment, and management, including biological, clinical, cognitive and psychosocial markers, in order to change the paradigm of frailty care from acute intervention to prevention FOCUS partners are working on ways to integrate the best available evidence from frailty-related screening tools, epidemiological and interventional studies into the care of frail people and their quality of life Frail citizens in Italy, Poland and the UK and their caregivers are being called to express their views and their experiences with treatments and interventions aimed at improving quality of life The FOCUS Consortium is developing pathways to leverage the knowledge available and to put it in the service of frail citizens In order to reach out to the broadest audience possible, the FOCUS Platform for Knowledge Exchange and the platform for Scaling Up are being developed with the collaboration of stakeholders The FOCUS project is a development of the work being done by the European Innovation Partnership on Active and Healthy Ageing (EIPAHA), which aims to increase the average healthy lifespan in Europe by 2020 while fostering sustainability of health/social care systems and innovation in Europe The knowledge and tools developed by the FOCUS project, with input from stakeholders, will be deployed to all EIPAHA participants dealing with frail older citizens to support activities and optimize performance

Natural cold pressed oils as cosmetic products

Abstract: Background. it seems that patients may ask general practitioners about natural cosmetics applied on the skin regarding their safety and suitability. Objectives. the aim of the study was to analyze natural cold pressed oils as potential cosmetic products. Material and methods. cold pressed oils obtained from selected seeds and fruit stones were analyzed, including: chokeberry seed oil, blackcurrant seed oil, elderberry seed oil, raspberry seed oil, apricot seed oil, tomato seed oil, strawberry seed oil, broccoli seed oil, Nigella sativa seed oil, hemp oil, safflower seed oil, Silybum marianum seed oil and coconut oil. 80 adult volunteers assessed the cosmetic properties of the analyzed oils. each of the volunteers tested 2 to 4 different oils, by applying them on the skin. in addition, patch tests with all analyzed oils were performed on 23 individuals. Results. the majority of tested oils were positively evaluated by the participants: in the opinion of the participants, oil extracted from safflower had the best appearance (100% positive opinions), coconut oil had the best smell (70% positive opinions), while black currant seed oil showed the best absorbency (85% positive opinions). no irritation was observed within the analyzed product group, albeit one allergic reaction to apricot seed oil was observed with patch testing. Conclusions. based on the achieved results, it could be suggested that natural cold pressed oils can be applied to the skin as cosmetics. our observations may be helpful for general practitioners when choosing natural cosmetics.

Influence of ionizing radiation on human body

Abstract: W niniejszej pracy przedstawiono zagadnienia dotyczące negatywnego i pozytywnego wpływu promieniowania jonizującego na organizm człowieka. Promieniowanie jonizujące we współczesnej medycynie wykorzystywane jest w leczeniu, diagnostyce i radiologii zabiegowej i z tego powodu stanowi ważny aspekt w praktyce klinicznej zarówno dla lekarza, jak i pacjenta. W związku z interdyscyplinarną i powszechną naturą zjawiska ważne wydaje się poznanie skutków promieniowania jonizującego. obowiązujące zasady i ograniczenia dotyczące stosowania promieniowania jonizującego w medycynie umożliwiają zoptymalizowanie dawki pochłanianej przez organizm i tym samym ograniczają nadmierną ekspozycję na promieniowanie, z jednoczesnym ograniczeniem negatywnych skutków. Wśród koncepcji dotyczących wpływu promieniowania jonizującego na organizm ludzki wyróżnia się powszechnie akceptowaną teorię liniową: progową i bezprogową, a także zupełnie jej przeciwstawną hormezę radiacyjną. Pomimo faktu, iż obowiązujące standardy ochrony radiologicznej oparte są na teorii liniowej, to hormeza radiacyjna wzbudza coraz większe zainteresowanie i podejmowane są liczne próby dowiedzenia jej prawdziwości. kolejne badania naukowe poszerzające wiedzę na temat hormezy radiacyjnej mogą zmienić oblicze przyszłości. Być może badania te otworzą nowe możliwości zastosowania promieniowania jonizującego, jak i umożliwią obliczenie optymalnej i spersonalizowanej dawki dla pacjenta, pozwalając nam na wyznaczenie nowego „złotego środka” dla promieniowania jonizującego. W związku z tym uważamy, że przed zastosowaniem tych metod jest duża przyszłość, niemniej powinno się mieć na uwadze głównie dobro pacjenta. Słowa kluczowe: promieniowanie jonizujące, radiologia zabiegowa, hormeza radiacyjna.

Primary health care tasks in implementing the main operations of public health

Abstract: Public health and primary health care are complementary strategies for sustaining the health of a society. There are many analyses in the literature on the subject that deal with the possibility of mutual support between public health and primary health care. There reports from many countries include studies of scientific institutions, presentations of specific solutions used by health protection administrations and self-government bodies, programs of study, and courses. However, this issue is rarely raised in Poland. The aim of this article is to present an up-to-date list of public health operations and to where there is room for primary health care activities. a binding list of public health operations was defined by the World Health organisation (WHo) in 2012 under the name of essential Public Health operations (ePHos). in order to define public health operations more precisely in this article, a questionnaire self-assessment tool for the evaluation of essential public health operations in the WHo european Region was used. Primary health care plays a significant role in the performance of public health operations (ePHos), whereas the public health operations connected with health protection (ePHo 3), health promotion (ePHo 4) and disease prevention (ePHo 5), are mostly attributed to primary health care. Primary health care provides the information necessary for the performance of public health operations in the field of monitoring population health and well-being – in particular infectious and chronic diseases (ePHo 1), and for health care management and improvement of health care quality (ePHo 6).

Effects of regular physical activity on pain, anxiety, and depression in patients with treatment-resistant arterial hypertension

Abstract: Background. Medical experts and professional societies commonly recommend regular physical activity to patients with arterial hypertension. However there is little evidence of the influence of physical exercise on treatment-resistant arterial hypertension. Objectives. the aim of the study was to analyze the influence of physical activity, intensified with additional training support, and followed up with SMS reminders regarding pain, anxiety, and depression in patients with resistant hypertension. Material and methods. the study group consisted of 53 patients, including 27 who fulfilled the criteria for resistant hypertension, and a control group of 26 patients with well-controlled blood pressure. initially, 24-hour monitoring of blood pressure, anthropometric measurements, and measurements of body composition by means of electric bioimpedance were conducted after the third and sixth month, and a mobile activity profile was defined by means of accelerometric measurements conducted for subsequent 72 hours. The patients completed the hospital anxiety and Depression Scale (haDS) and the Roland and Morris Disability Questionnaire (RMDQ). The patients were advised to perform regular aerobic physical activity in accordance with the guidelines of the american Heart association. Results. after 6 months, the back pain score as assessed with RMDQ had reduced from 8.2 ± 7.5 to 6 ± 5.9 (p = 0.01) in subjects with treatment-resistant hypertension. Similar results applied to anxiety (score 8.2 ± 4 vs. 9.3 ± 4.4 at baseline; p = 0.02) and depression as measured with haDS (5.3 ± 3 vs. 6.9 ± 3.7 at baseline; p = 0.01). There was a significant positive correlation between the changes in the pain score (RMDQ) and the changes in the 24 h and nighttime systolic blood pressure, pulse pressure, and anxiety. Conclusions. regular physical activity may have a beneficial effect on anxiety, depression, and pain in patients with treatmentresistant hypertension.

Significance of education and self-management support forpatients with chronic heart failure in family physician practice

Abstract: Background. Chronic heart failure (CHF) is a disease that requires self-management by the patient, thus it is understood that when they are diagnosed, they need access to relevant information about their disease. Objectives. The purpose of this paper was to ascertain the sources and content of education for patients with CHF and evaluate the use of patient education for self-management support of patients with CHF in primary care. Material and methods. Patients were identified from a patient registry and physician referrals. 371 individuals responded to the questionnaire, and we estimated the effectiveness of patient education. Results. Whilst 91% of patients reported receiving education at the time of diagnosis, it is a concern that 9% say they were not provided information. Only a few patients said they had received education from hospital consultants. After the training, the percentage of patients who kept a diary of introspection increased almost three-fold, the percentage of patients measuring blood pressure and heart rate increased four-fold and measuring body mass increased six-fold. Conclusions. CHF education was mainly delivered in primary care by family physicians. While there have been a growing number of efficacious interventions for patients with CHF, their effectiveness will be limited without self-management support to assist patients in adopting behaviors that contribute to improved health.

Management of subclinical hypothyroidism in pregnancy and in children

Abstract: subkliniczna niedoczynność tarczycy (subclinical hypothyroidism – sCH) występuje u około 2% ciężarnych i u 2% dzieci. rozpoznanie opiera się na stwierdzeniu podwyższonego stężenia tyreotropiny (tsH) przy prawidłowych stężeniach hormonów tarczycy, podczas gdy objawy kliniczne hipotyreozy są słabo wyrażone lub w ogóle nie występują. w ciąży za górną granicę prawidłowego stężenia tsH uznaje się 2,5 miu/l w pierwszym trymestrze, w drugim – 3,0 miu/l, a w trzecim – 3,5 miu/l. u dzieci stężenie tsH zależy od wieku. wystąpienie sCH w ciąży może sprzyjać powikłaniom położniczym, a szczególnie poronieniu, przedwczesnemu porodowi, cukrzycy ciążowej lub innym. Znaczenie sCH u dzieci wynika z możliwego wpływu na zaburzenia neuropsychologiczne, zarówno w przypadku pojawienia się jej w okresie płodowym, jak i w pierwszych latach życia. u wszystkich ciężarnych z sCH zaleca się leczenie substytucyjne, którego celem jest osiągnięcie optymalnego stężenia tsH. postępowanie u dzieci z sCH jest kontrowersyjne, ponieważ często podwyższone stężenie tsH ulega samoistnej normalizacji i nie ma jednoznacznych dowodów wskazujących na korzyści z leczenia. terapię u dzieci zaleca się wtedy, gdy stężenie tsH przekracza 10 miu/l i nie ulega samoistnej normalizacji, gdy obecne jest wole lub kliniczne symptomy hipotyreozy lub występują choroby sprzyjające współistnieniu hipotypozy, np. zespół downa. lekiem z wyboru u ciężarnych i u dzieci jest l-tyroksyna. nadal nie rozstrzygnięto jednoznacznie kwestii obowiązkowego wykonywania badań przesiewowych stężenia tsH u ciężarnych. nie ma takich zaleceń, choć propagują je niektóre towarzystwa endokrynologiczne i często zlecane są przez lekarzy praktyków. obowiązkowym badaniem przesiewowym stężenia tsH objęte są wszystkie noworodki. Słowa kluczowe: subkliniczna hipotyreoza, ciąża, dzieci, leczenie subklinicznej niedoczynności tarczycy.

The prevalence of depression symptoms and other mental disorders among patients aged 65 years and older – screening in the rural community

Abstract: Background. mental disorders, especially depression, are common problems among the elderly. Objectives. to determine the prevalence of symptoms of mental disorders, with emphasis on symptoms of depressive disorders, in patients aged 65 years and older. Material and methods. The study involved 93 patients (59 women, 34 men, median age 70). The Primary care evaluation of mental Disorders Patient health Questionnaire (Prime-mD PhQ) was used for the preliminary diagnosis of mental disorders. The Patient health Questionnaire (PhQ-9) was used to assess the severity of depressive symptoms. Results. symptoms of mental disorders were detected in 59 patients (63.4%). Thirty six (42.3%) patients reported symptoms of depressive syndrome, 13 (14%) – symptoms of anxiety, 3 (3.2%) declared alcohol overuse. sleep disorders were reported by 58 (62%) patients. in the group of patients who reported depressive syndrome the prevalence of somatic complaints was significantly higher. The positive correlation between the number and severity of somatic complaints and symptoms of depressive disorders was revealed. in this group sleep disorders and anxiety were also reported significantly more frequent. Among the 59 patients who presented with symptoms of mental disorders 18 (30.5%) were treated pharmacologically due to psychiatric reasons. in 18 patients (19.3%) screening revealed symptoms of posttraumatic stress disorder. Conclusions. 1. in the studied group symptoms of sleep disorders and depressive disorders were the most frequent problems. 2. The severity of symptoms of depressive disorders correlated positively with the number and severity of somatic complaints. 3. only 1/3 of the patients presenting symptoms of mental disorders were treated with pharmacotherapy. 4. Depression screening should be carried out among the elderly who report somatic problems and sleep disorders.

Defining rural, remote and isolated practices: the example of Slovenia

Abstract: There is no single definition of rural practice available. Definitions vary from one country to another, as countries differ in geography and have different health care systems with varying organizational specificities, even within the same country. In spite of increased urbanization and the specific health-related problems it brings with it, a large proportion of the world population still dwells in rural, remote, and isolated areas. In fact, there are many countries in the world with extensive rural areas. Rural areas are unique in organization, demographics, and infrastructure, and so are the specific health-related problems of people living in them. Healthcare in such areas is generally provided by general practitioners or by physicians specialized in family medicine. One of the basic challenges in rural health is defining which areas are rural and finding the characteristics that define “rural”. There are several criteria and combinations of criteria that can be used to define rural areas. Their use mostly depends on the purpose for which the definition is used, and can thus vary from application to application. This paper addresses issues in rural family practice and criteria that may be used to define such practices. It also presents the use of criteria for defining rural practices in a small European country, on the example of Slovenia.

Health-Related Quality of Life or Quality of Medical Service? Current challenges for family doctors

Abstract: Maximizing Health-Related Quality of Life (HRQoL) is one of the most important goals in the work of the family doctor. Providing a high quality of medical services (QMS) should be among the most important challenges in primary health care organizations (PHCOs). In practice, these two areas of activity require continuous improvement, and can complement each other and enhance their mutual impact on the health of patients. The objective of this article is to present selected areas of HRQoL and QMS improvement in the practice of a family doctor, which might contribute to patients’ health, to cost reduction, and to a beneficial reposition of a health center within the medical service market. The paper presents proposals for improving HRQoL and QMS through the use of data from questionnaires filled out by patients, through the cooperation of all the people involved in the delivery of medical services, through adaptation of the IT infrastructure to meet the needs of PHCOs, and through improvements in quality as the result of a process model. QMS is of great importance, especially for both consumers and providers of medical services, including PHCOs. Improvement in quality should be considered as operating on both HRQoL and QMS. This paper presents strategies for selected areas that may contribute to improving QMS, both with respect to the opinions of patients and the functioning of PHCOs.

Occupational burnout among nursing personel

Abstract: Wstęp. stres zawodowy i związany z tym zespół wypalenia zawodowego jest jednym z wyzwań dla zdrowia publicznego. Cel pracy. identyfikacja wypalenia zawodowego wśród pielęgniarek. Materiał i metody. W badaniach brało udział 408 pielęgniarek/pielęgniarzy czynnych zawodowo, pracujących na terenie województwa zachodniopomorskiego. W ocenie wypalenia zawodowego zastosowano standaryzowany kwestionariusz Wypalenia zawodowego Maslach. Wyniki. Średnie wartości poziomu wypalenia zawodowego dla badanej grupy wynosiły 39,3 ± 30,9 dla wyczerpania emocjonalnego, 30,64 ± 27,89 dla podskali depersonalizacja oraz 66,26 ± 27,94 w obniżonej satysfakcji zawodowej. Wnioski. 1. Badany personel pielęgniarski przejawiał objawy wypalenia zawodowego w każdym wymiarze syndromu, tj. wysokiego poziomu dla wyczerpania emocjonalnego i depersonalizacji oraz niskiej satysfakcji zawodowej. 2. osoby z wyższym wykształceniem uzyskały niższe wyniki w skali wyczerpania emocjonalnego. 3. na wyczerpanie emocjonalne wpływ ma miejsce i stanowisko pracy. Słowa kluczowe: wypalenie zawodowe, pielęgniarstwo, ochrona zdrowia.

Anxiety following cardiac surgery – an important aspect of health status assessment

Abstract: Background. Patient-reported outcomes (Pros), including psychological factors, have become an important aspect of both health research and clinical practice. Patients who have undergone cardiac surgery can constitute a large subgroup of the patients of a family physician. Postoperative distress has been observed in up to 40% of patients. Objectives. the study aimed to evaluate anxiety levels among patients who had undergone cardiac surgery, and to explore the correlations between anxiety and depression and subjective health status. Material and methods. the research group consisted of 70 patients (48 men, mean age: 65.9 years; ± 8.5). the study was conducted during consultations three months after surgery. the Hospital anxiety and depression Scale (HadS), including question regarding suicidal thoughts, was used. a four-point likert scale was used to evaluate subjective effectiveness of the surgery and the Visual analogue Scale (VaS) was used to assess subjective health status. Results. an increased level of anxiety was observed in 23 patients (32.9%), and depression was seen in 12 (17.1%). 13 patients (18.6%) indicated that they had had suicidal thoughts. Patients with suicidal ideation had significantly higher level of anxiety. Significant positive correlations were noted between levels of anxiety and depression. anxiety level correlated negatively with subjective health status and assessment of surgery effectiveness. no significant connections were observed between level of anxiety and sex, age, or the type of surgery. Conclusions. 1. increased levels of anxiety were observed in a significant percentage of patients who had undergone cardiac surgery. 2. increased anxiety level is concomitant with depression, suicidal thoughts, and lower subjective health status assessment. 3. Health status assessment following cardiac surgery should also include the evaluation of mental health.

Coexistence of insomnia and chronic diseases in over 60 years olds

Abstract: Background. The coexistence of several chronic physical illness worsens and the body burden older people, causing both poor health and lower quality of life. Multidisease has a significant impact on the incidence of sleep disorders, including insomnia. Objectives. The aim of this study was to determine how selected chronic diseases are related to insomnia and its severity in over 60 year old members of the University of the Third age in stargard. Material and methods. The research was conducted among 131 persons aged 60 years and above, including 72.52% (n = 95) women and 27.48% (n = 36) men. The mean age was 68.12 ± 6.63. The survey was used with elements of athens insomnia scale (ais), insomnia severity index (isi) and author’s own questionnaire with questions about taking sleeping pills. Results. The most respondents was a arterial hypertension 53.43% (n = 70) including 68.57% in women (n = 48), and 31.43% (n = 22) in men. The indicator of multidisease was a 1,25 per respondent. insomnia was reported in persons with arterial hypertension (chi2 = 6.256; p = 0.043), asthma and chronic obstructive (chi2 = 22.79; p = 0.0001), atherosclerosis (chi2 = 8.368; p = 0.015) and depression (chi2 = 20.94; p = 0.0002). Conclusions. insomnia in the group of members of the University of the Third age in stargard coexists with chronic diseases, such as hypertension, asthma/coPD, atherosclerosis and depression.

Impact of climacteric and depressive symptoms on the quality of life of postmenopausal women

Abstract: Background. Quality of life consists of many elements that affect the creation of the level of Qol. Women with postmenopausal may experience a phenomenon of loneliness. This phenomenon can be caused by the effects they had on menopausal symptoms and depression from private and professional life. Objectives. The aim of the study was to determine the effect of menopausal symptoms and depression on quality of life in postmenopausal women. Material and methods. The survey was performed among 128 women after menopause. The mean age was 64.20 ± 8.61, median 65 years. The study used a questionnaire consisting of the sF-36, kupperman index, Beck Depression scale and the author’s questionnaire. Results. The sense of mental health – MH women found at most, which was equal to 69.47. Meanwhile, the general level of health – HP was rated the lowest of only 46.68. of the 128 respondents revealed menopausal symptoms at 32.81% (n = 42) of surveyed women. it has been shown statistically significant relationship between the index of climacteric, and the assessment of Qol in the sF-36 domains: rlM (emotional role functioning) – (χ2 = 24.33; p = 0.003), MH (mental health) – (χ2 = 27.27; p = 0.001), eV (vitality) – (χ2 = 24.28; p = 0.003), P (pain) – (χ2 = 25.89; p = 0.002), and the Beck Depression inventory, and the assessment of Qol by sF-36. Conclusions. Menopausal symptoms, the presence of depression and age have a significant impact on the quality of life of women in postmenopausal period.

Social competence of physicians and medical students – a preliminary report

Abstract: Background. efficient functioning at work and in the environment depends on social and emotional competence, understood as complex skills that determine the effectiveness of behaviors in various professional and social situations. Objectives. The aim of this study was to determine the social competence of physicians and medical students with regard to the sociodemographic contributors which shape social competence. Material and methods. The study was conducted in 2015 and 2016 and it involved 90 physicians, including 25 GPs (27.8%) and 53 medical students of PMu in szczecin. The median age of the physicians and the students was 32 and 25, respectively. The social competencies Questionnaire (scQ) by anna Matczak and a self-developed survey questionnaire were employed. Results. The ability of physicians to achieve medium and high levels of social competence increases by 8.5% with every year of seniority. Membership in scientific societies increases the odds of a high level of social competence fivefold in the es scale and fourfold in the a scale. Physicians involved in the education of medical students were less likely to obtain medium and high scores (5 stens) in the a scale. an increase in seniority in the last workplace is accompanied by a 0.93 times lower probability of obtaining a high competence score in the a scale. similarly, third cycle degree studies increase the odds of achieving high competence level by 7.48 times in the a scale. Conclusions. low levels of competence can be expected from physicians with less seniority, not belonging to scientific societies, not involved in students’ education, working in only one place, and not participating in third cycle degree studies. This group should be provided with social competence training.

The incidence of falls among geriatric outpatients in relation to the number and types of drugs taken

Abstract: Background. Causes of falls among people over 65 are complex because of age-related involutional changes, comorbidity and polypragmasy that exert negative influence on physical mobility. Objectives. The purpose of this study is to assess the incidence of falls in geriatric outpatients in relation to the number and type of drugs taken. Material and methods. The study involved 304 subjects aged 65–100 years, using ambulatory care services. The mean age of the respondents was 78.6 ± 7.4. women constituted 77.3% of those analyzed, men – 22.7%. This survey-based study was performed using the geriatric environmental inquiry. Results. a higher number of drugs corresponded with more frequent falls (χ2 test; p < 0.05). gender was not proved to influence the number of falls (χ2 test; p > 0.05). gender was proved to influence the number of drugs (χ2 test; p < 0.05). There was a statistically significant relationship between the number of falls and taking hypotensive, anxiolytic and oral antidiabetic drugs (χ2; p < 0.05). Conclusions. 1. The use of a higher number of drugs, irrespective of their pharmacological group, contributes to a higher number of falls, which may be associated with an interaction between particular drugs or be a consequence of a multitude of diseases predisposing to falls. 2. Polypharmacotherapy is a fall risk factor, however it is difficult to say which pharmacology group, discussed in the study, contributes most to the incidence of falls. 3. it is suggested that geriatric pharmacotherapy should be individualized to minimize the incidence of the iatrogenic geriatric syndrome, which predisposes to falls.

Acceptance of cancer by women after mastectomy in Western Pomerania region – preliminary studies

Abstract: Wstęp. rak piersi jest najczęstszym nowotworem złośliwym u kobiet. na ogół rozwija się między 50. a 80. rokiem życia. Wiele kobiet przystosowuje się do nowej sytuacji, jednak liczna grupa nie potrafi zaadaptować się i pogodzić z chorobą. Im większa akceptacja choroby, tym lepsze przystosowanie i mniejsze poczucie dyskomfortu psychicznego. Cel pracy. Ocena stopnia akceptacji choroby nowotworowej przez kobiety po mastektomii. Materiał i metody. W badaniach posłużono się Skalą akceptacji choroby aIS, w adaptacji z. Juczyńskiego oraz ankietą dotyczącą danych demograficznych. Badania przeprowadzano wśród 60 kobiet po mastektomii w województwie zachodniopomorskim. Badania były całkowicie dobrowolne i anonimowe, uzyskano pisemną zgodę od każdej respondentki, a uczestniczące w nich kobiety zostały poinformowane o ich celu. Badania ankietowe przeprowadzono po uzyskaniu zgody od Komisji Bioetycznej PUM w Szczecinie, nr KB-0012/97/14. Wyniki. Średnia wieku badanych kobiet to 62,3 lat. 25 (42%) kobiet uzyskało wysoki poziom akceptacji choroby, 18 (30%) – średni, a 17 (28%) – niski poziom akceptacji. 22 (37%) respondentek nie ma problemu z przystosowaniem się do ograniczeń narzuconych przez chorobę. 24 (40%) kobiety czują się potrzebne, 30 (50%) badanych uważa, że nie jest ciężarem dla rodziny i przyjaciół. Pełnowartościowym człowiekiem, pomimo swojej choroby, czuje się 19 (32%) amazonek. Wnioski. analiza materiału badawczego pozwoliła stwierdzić, że blisko połowa respondentek uzyskała wysoki poziom akceptacji choroby, co stwarza poczucie bezpieczeństwa i kontroli nad własnym życiem. Słowa kluczowe: mastektomia, nowotwory piersi, jakość życia.

Prolonged consumption of energy drinks does not affect the processes of memory, and increases the activity of transaminases, and cholesterol concentration – animal model study results

Abstract: Background. the consumption of energy drinks (ed) is popular among young people. there are concerns that it could be harmful for their health. Objectives. the aim of the study was to analyze the influence of ed consumption on animals for 30 subsequent days on memory, weight gain and biochemical parameters (alanine transaminase-aLt, asparagine transaminase-ast, creatinine, cholesterol and glycated hemoglobin-Hba1c). Material and methods. the study was conducted on 32 mice (16 females and 16 males). the mice received standard feed for rodents ad libitum. the animals were randomly assigned to four groups (8 animals each): i – female controls provided with water ad libitum, ii – females provided with ED ad libitum, iii – male controls provided with water, and iV – males provided with ed. every 7 days memory retention in a passive avoidance task, and fresh spatial memory in a Y-maze were checked. the results were analyzed with statistica 10.0. p < 0.05 was considered statistically significant. Results. the consumption of ed did not affect fresh spatial memory or memory retention in the experiment. Males drinking ed gained weight at a faster rate than control males. ed significantly increased the activity of ast in the blood sera of females and, to a lesser degree, of aLt in both males and females drinking ed. ed did not significantly affect the concentration of creatinine or Hba1c, but significantly increased the concentration of cholesterol in the blood of males from group iV. Conclusions. the prolonged consumption of ed does not affect memory processes, but increases the activity of transaminases and cholesterol concentration in blood sera in the mice model.

In which group of children and adolescents should a family doctor look for metabolic syndrome

Abstract: Background. the asymptomatic course, early genesis, multifactorial onset, and the lack of a single definition of metabolic syndrome in children and adolescents make it difficult to assess its prevalence. Metabolic syndrome developed in childhood increases cardiovascular risk in adulthood. Objectives. the evaluation of the prevalence of metabolic syndrome based on age, sex, weight and abdominal obesity in a population of children and adolescents in a family doctor’s practice. Material and methods. the study group comprised 325 children and adolescents (177♀, 148♂) aged 7, 13 and 16 years. anthropometric measurements (height, weight, waist circumference) were made, along with the determination of blood pressure, fasting glucose and lipid levels. overweight states and obesity were assessed according to the Iotf criteria. abdominal obesity and hypertension were evaluated using growth charts appropriate for the age, gender and height of the children of lodz. Metabolic syndrome was diagnosed based on the nCeP/atP III criteria. Results. Metabolic syndrome was diagnosed in 6.5% of the subjects. In children aged 13 and 16 years – 7.6% (p > 0.05 vs. 7 years), aged 7 years – 3.9% (p > 0.05 vs. 13, 16 years), boys (8.8%; p > 0.05), girls (4.5%; p > 0.05). among children with excessive body weight, metabolic syndrome was observed in every fourth child (25.4%), more often in those with obesity (44.1%) than with abdominal obesity (32%) and those who were overweight (19.2%), respectively (p < 0.001 vs. metabolic syndrome). the number of components of metabolic syndrome elevated with increasing body weight (p < 0.001). abdominal obesity was observed in 17.5% of the subjects. Children with abdominal obesity had higher levels of triglycerides (p < 0.05) and lower Hdl cholesterol (p < 0.001). the most common cardiovascular risk factors were ldl-c > 110 mg/dl in 85 (26.1%) and excessive body weight in 71 subjects (21.8%). Conclusions. the presence of metabolic syndrome correlated with overweight state, obesity and abdominal obesity in the group of children and adolescents. the evaluation of cardiovascular risk performed in obese children by a family doctor allows for the early implementation of prevention.

Intermittent pneumatic compression in patients with postmastectomy lymphedema

Abstract: Background. Postmastectomy lymphedema frequently affecting young patients constitutes a personal, family and social problem. For this reason, primary care physicians often consult both patients and their families. Objectives. the aim of this study was to evaluate the effects of intermittent pneumatic compression (iPC) alone or in combination with exercises on upper limbs circumference and hand function. Material and methods. the study population consisted of 21 patients with breast cancer-related lymphedema. in group a, the treatment consisted of 20 IPc sessions (45 minutes a day at 60 mm Hg, 5 times weekly) and physical exercises (combination therapy). group B only received 20 iPC sessions. Prior to and after intermittent pneumatic compression, all patients had arm circumference measurements at 6 sites on the mastectomy side. hand function was assessed with the Carpal tunnel syndrome Functional status scale. Results. Both groups exhibited a reduction in upper limb circumferences after the therapy in comparison to the initial values. However, a comparison of percentage circumference changes did not show any advantage of the combination therapy on the magnitude of the edema and hand function. Conclusions. Pneumatic compression is an effective method of reducing upper limb edema in postmastectomy patients. the exercises did not have a significant effect on function of hand.

A physical activity assessment of Wroclaw Medical University students with IPAQ – long questionnaire: a cross sectional study

Abstract: Background. Polish society is characterized with low physical activity. medical university students, as future doctors, should not only understand the importance of physical activity, but also do all they can to actively propagate it. Objectives. the aim of conducted research was to assess the level of physical activity among students of the final study year of medical and Dentistry Faculties of wroclaw medical university. Material and methods. study group included 211 people. in term of age and gender students of both faculties were a homogenous group. the study was conducted in summer term of 2011/2012 academic year, auditory method, ensuring anonymity. the study tool was international Questioner of Physical activity (iPaQ) – long form. based on mets values the authors distinguished three levels of total physical activity – intense, moderate and low. Results. the level of students’ physical activity is comparable between the faculties with slightly higher values for students of Dentistry Faculty. Distributions of three levels of physical activity were similar between the faculties. Conclusions. the present study showed a need of health promotion in contests of physical activity among students of both faculties. the lowest activity of them (both male and female) is in the domain of work-related, during academic year. it creates a need for modifications of the study curriculum by adding additional sport classes and promoting attitudes of undertaking physical activity during other than study related activities.

Opinions and behavior of family doctors concerning vaccinating against influenza

Abstract: Background. influenza is a severe respiratory disease caused by influenza virus. according to estimates from the world Health organisation (wHo), 5–15% of the world’s population, or 330–1575 million people, suffer from influenza each year. the vaccination of patients and health professionals plays an important role in the prevention of infections. Objectives. to describe family doctors’ opinions and behavior concerning influenza vaccination. Material and methods. an online survey was filled out by 77 family physicians, of whom women accounted for 53.5%. the age mean of the doctors surveyed was 44.6 ± 11.7 years. the questionnaire contained 14 questions. Results. 63.6% (49 people) of the respondents were worried about flu, and 84.4% (65 people) were concerned about the possibility of their family members being infected. 77.9% (60 people) approve of vaccination. 51.5% (40 people) of the doctors received the vaccination in the current (2015/2016) influenza season. 18.2% (14) of the respondents were vaccinated within the last five seasons. the respondents recommended vaccination against influenza to their families sometimes (50.6%, 39) or frequently (41.6%, 32). they recommended the vaccination to their patients frequently (41.6%, 32) or sometimes (53.2%, 41). only 18.2% (14) of the respondents were covered by the free vaccination program in their workplace. as many as 76.6% (59) of the doctors would recommend the vaccination more often if it were free, and 44.2% (32) would be more willing to recommend the vaccination if they received additional payment for it. when doctors were asked why they thought patients did not have themselves vaccinated, the reasons most frequently given were: patients’ lack of time and awareness of the disease consequences and complications (57.1%, 44), patients’ fear of postvaccination reactions (44.2%, 34), inconvenience associated with vaccination, including the cost of the vaccine (42.9%, 33), patients’ belief that vaccination is ineffectiveness, that the risk of infection is low, or that they do not belong to a risk infection group (28.6%, 22) and, finally, inconvenient vaccination hours (7.8%, 6). Conclusions. 1. Family doctors are fully aware of the importance of vaccinating against influenza. However, this awareness is not reflected in the immunization rates among medical personnel. 2. More than half of the practitioners recommend vaccination to their patients. 3. the fear of supposed complications and financial problems are the most often indicated reasons for not being vaccinated against influenza.