Sleep Disturbances as a Consequence of Long COVID-19: Insights from Actigraphy and Clinimetric Examinations-An Uncontrolled Prospective Observational Pilot Study.

The COVID-19 pandemic represents a global health and social challenge. However, the impact of a SARS-CoV-2 infection itself on mental health and sleep quality remains poorly understood. The purpose of the present uncontrolled prospective observational pilot study was to evaluate the impact of past COVID-19 disease on the incidence of quantitative and qualitative sleep disturbances. A group of 61 subjects (37 female, 24 male) reported sleep disturbances that had lasted for at least one month and had started after recovery from COVID-19. The study used self-reported instruments: the Epworth Sleepiness Scale (ESS) and Insomnia Severity Index (ISI), as well as an objective method-actigraphy-for quantitative analysis of sleep architecture. It was shown that sleep disturbances most commonly started after recovery (68.3%, n = 41) and lasted for more than one month (83.6%, n = 51). ESS scores of 7.8 ± 5.0 points indicate moderate daytime sleepiness, and ISI scores of 16.3 ± 5.8 points denote moderate insomnia. ESS scores were negatively correlated with total time in bed (r = -0.3780, p = 0.003), total sleep time (r = -0.2969, p = 0.020), and wakefulness after sleep onset (r = -0.2654, p = 0.039). In addition, ESS scores were correlated negatively with the respondents' age (B = -0.17, p = 0.000) and time from COVID-19 onset. A positive correlation was found between wakefulness after sleep onset and ESS scores (B = -0.05, p = 0.039). ISI scores were positively correlated with time in bed (r = 0.3275, p = 0.010). Female gender was found to be a significant predictor of insomnia's severity (B = 2.159, t = 3.04, p = 0.004). In conclusion, patients with a history of COVID-19 report long-lasting sleep disturbances that do not subside spontaneously. In the patient group studied, moderate levels of daytime sleepiness and insomnia were found. The most frequently reported problems included irregular sleep, frequent awakenings, and difficulty maintaining sleep, while normal sleep duration was preserved. These findings underscore the need for continued attention to the long-term consequences of COVID-19 on sleep health and emphasize the importance of targeted interventions to address these enduring sleep disturbances in affected individuals.

Compliance and satisfaction with treatment as a success of therapy effectiveness in the group of patients with ischemic heart disease: a cross-sectional study.

OBJECTIVES: Non-adherence and non-compliance to pharmaceutical treatment is one of the most common causes of not effective management of patients suffering from ischemic heart disease (IHD). It is crucial to understand the reasons behind it but studies on this subject performed in the Polish population are still lacking. MATERIAL AND METHODS: The 329 patients (160 male and 169 female) diagnosed with IHD who reported for follow-up appointments are examined. The following standardized questionnaires were used: Treatment Satisfaction with Medicines Questionnaire (SATMED-Q) and Adherence to Refills and Medication Scale (ARMS), which evaluates the patient's compliance and adherence level, respectively. RESULTS: Patients with IHD showed moderate compliance with pharmacological recommendations and average satisfaction with treatment. Anemia, drugs side effects, and SATMED-Q total score were significant predictors of the overall ARMS score in the univariate analysis, whereas the male gender and satisfaction with treatment improves this results. In multivariate analysis, significant predictors of lower adherence included family history of IHD, anemia and drugs side effects, while higher education and SATMED-Q overall score increased adherence. CONCLUSIONS: Treatment satisfaction is a significant predictor of increased overall treatment adherence as well as adherence in terms of drug intake and drug and prescription refills. Raising patient awareness should be an important goal of future educational activities. Int J Occup Med Environ Health. 2023;36(4):465-76.

An epidemiological and retrospective study in a cohort qualified for SARS-CoV-2 vaccination in the region of Lower Silesia, Poland.

BACKGROUND: Since the beginning of the coronavirus disease (COVID-19) pandemic, numerous infections have been observed with various symptoms and degrees of severity. Not all patients have had a confirmation of infection made using reverse transcription polymerase chain reaction (RT-PCR) or antigen tests. It has been observed that some people, including convalescents or those without knowledge of a past infection, perform serological tests to detect anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies. OBJECTIVES: We aimed to evaluate the levels of anti-SARS-CoV-2 immunoglobulin G (IgG) antibodies in a cohort of convalescents and in individuals not previously infected, who were willing to get vaccinated. We also aimed to assess several socio-clinical factors associated with participants' humoral responses. MATERIAL AND METHODS: We recruited 298 individuals from the region of Lower Silesia who were willing to get vaccinated for SARS-CoV-2. The participants were divided into 2 groups: convalescents (group I) and participants without a past infection (group II). Several seropositive individuals in group II were identified, and they were transferred to group I, resulting in a final distribution of 171 individuals in group I and 127 individuals in group II. For serological testing, the QuantiVac anti-SARS-CoV-2 (IgG) enzyme-linked immunosorbent assay (ELISA) was used. RESULTS: The results showed the presence of anti-SARS-CoV-2 IgG antibodies in participants from group I, with an average number of 190.3 IU/mL. Twenty-three participants (13.45%) did not have a detectable level of antibodies despite a previous SARS-CoV-2 infection. In 21 participants (12.28%), antibodies were detected despite no previous symptoms of infection (average level: 145.0 IU/mL). CONCLUSION: Older participants were more likely to experience a symptomatic SARS-CoV-2 infection, and the severity of the symptoms was related to higher antibody titers seen later after COVID-19. Numerous individuals from group II were unaware of past SARS-CoV-2 infections. In several participants, antibodies were not detected despite a previous infection.

Reply to Mathieu et al. Omega 3 Fatty Acids Intake Does Not Decrease the Risk of Rheumatoid Arthritis Occurrence: A Meta-Analysis. Comment on "Tanski et al. The Relationship between Fatty Acids and the Development, Course and Treatment of Rheumatoid Arthritis. Nutrients 2022, 14, 1030".

In response to the comment [...].

Assessment of The Effect of Stress, Sociodemographic Variables and Work-Related Factors on Rationing of Nursing Care.

(1) Rationing of nursing care is withholding, limiting or not fulfilling the necessary nursing activities for patients. It may have a negative effect on patient safety and the quality of care. The aim of the present paper is the assessment of the effect of stress on the rationing of nursing care. (2) The current research has a cross-sectional, observational design. The study sample comprised 567 nurses. The following questionnaires were used in the study PIRNCA and PSS-10. (3) It was demonstrated that nurses with a high level of perceived stress rationed nursing care to a greater extent and showed lower assessment of nursing care and lower job satisfaction in comparison with nurses with average and low levels of perceived stress. (4) 1. Stress in nurses has a negative effect on rationing of nursing care and job satisfaction. It is recommended that actions aimed at developing effective stress coping skills be implemented as early as at the stage of training to become a nurse. 2. Factors such as marital status, sex, form of employment, place of employment and the level of professional burnout syndrome may have an influence on the level of experienced stress. In turn, the level of experienced stress, marital status, education, place of work as well as the place of residence may have an effect on rationing of nursing care and, consequently, affect the quality of care.

THE FRAMEWORK OF THE PILOT PROJECT FOR TESTING A TELEMEDICINE MODEL IN THE FIELD OF GERIATRICS - HEALTH CHALLENGES AND JUSTIFICATION OF THE PROJECT IMPLEMENTATION.

OBJECTIVE: Aim: To present the essentials of the pilot project for testing a telemedicine model in the field of geriatrics, along with a snapshot of the health challenges. PATIENTS AND METHODS: Materials and Methods: This review paper use the synthetic method summarizing the main objectives of the telemedicine project in the field of geriatrics. The described project involving telemedical care of patients with geriatric complexes in the area of frailty syndrome, sarcopenia and malnutrition, according to the proposed model addresses the aforementioned problems. The project provides a holistic model of home and outpatient care, which will allow concerting on 3 groups of the above-mentioned geriatric syndromes. The project will have a pilot character and is aimed at clinical verification through the introduction (implementation) of the new method and accompanying organizational and technological solutions (platform, equipment) in an area where current models and schemes of therapeutic and diagnostic support were insufficient. CONCLUSION: Conclusions: The implementation of telemedicine solutions creates an opportunity for geriatric patients and their families by improving access to specialized medical care. This project will support patients, but also caregivers, who (through training and telemedicine) will be better able to provide care services with the ability to reconcile them with their own work.

THE FRAMEWORK OF THE PILOT PROJECT FOR TESTING A TELEMEDICINE MODEL IN THE FIELD OF CHRONIC DISEASES - HEALTH CHALLENGES AND JUSTIFICATION OF THE PROJECT IMPLEMENTATION.

OBJECTIVE: Aim: To present the essentials of the pilot project for testing a telemedicine model in the field of chronic diseases, along with a snapshot of the health challenges. PATIENTS AND METHODS: Materials and Methods: This review paper use the synthetic method summarizing the main objectives of the telemedicine project in the field of chronic diseases with a focus on COPD. The described project will have a pilot character and is aimed at clinical verification through the implementation of a new method and accompanying organizational and technological solutions (platform, devices) in an area where current models and schemes of therapeutic and diagnostic support were insufficient. The main (primary) outcome will be the leveling of social inequalities in health by reducing the residence and income factor in access to screening and medical services through the use of telemedicine. CONCLUSION: Conclusions: Implementation of telemedicine solutions creates an opportunity for patients diagnosed with COPD and their families by improving access to specialized medical care. With early detection of COPD exacerbation symptoms (deterioration of remotely monitored spirometric parameters), it will be possible to introduce appropriate preventive measures for these patients offsetting the adverse consequences.

Fatigue, Depression, and Anxiety in Patients with COPD, Asthma and Asthma-COPD Overlap.

INTRODUCTION: Asthma and COPD are extremely common respiratory diseases that have a serious impact on people's lives around the world. A disease characterized by symptoms characteristic for asthma and COPD is called asthma-COPD overlap (ACO). Fatigue and certain psychological disorders such as anxiety and depression are important comorbidities in these diseases. The purpose of this study was to assess the prevalence of fatigue, anxiety, and depression in patients with asthma, COPD, and ACO and to also consider their mutual correlations. MATERIAL AND METHODS: A total of 325 patients were enrolled in the study. There were 159 women and 166 men and their mean age was 63. Two standardized questionnaires were used: the Modified Fatigue Impact Scale (MFIS) and the Hospital Anxiety and Depression Scale (HADS). RESULTS: The mean total MFIS score for all patients was 33.03. Patients with asthma generally scored lower than patients with COPD and ACO. There were no statistical differences in the HADS for anxiety between the groups, although around half of the patients registered a score indicating some level of disorder. Patients with COPD and ACO were proven to suffer more from depression than patients with asthma. The HADS and MFIS scores were found to correlate significantly and positively. CONCLUSIONS: Our study showed that patients with COPD, asthma, and ACO generally suffered from an increased level of fatigue and depression. Anxiety was high in all groups, but it was at a similar level for patients suffering from each of the three diseases under consideration. It is important to treat the physical symptoms as well as the psychological disorders since they greatly impact on the patient outcomes.

Analysis of Mortality in Unvaccinated Patients with COVID-19 and Cardiovascular Risk.

COVID-19 is a contagious disease that has spread globally, killing millions of people around the world. In order to reduce the likelihood of in-hospital death due to COVID-19, it is reasonable to select a group of patients with a low probability of survival and to implement measures in advance to minimize the risk of death. One way to do this is to establish cut-off values for the most commonly performed blood laboratory tests, above or below which the likelihood of death increases significantly. The aim of the study was to determine the basic laboratory parameters among unvaccinated patients hospitalized for COVID-19 with concomitant cardiovascular disease, which are the predictors of in-hospital death. Out of 1234 patients, 446 people who met the specific inclusion criteria were enrolled in the study. The multivariate regression analysis has shown that the independent predictors of death are: troponin levels of at least 0.033 µg/L (OR = 2.04 [1.10; 3.79]), creatinine of at least 1.88 mg/dL (OR = 2.88 [1.57; 5.30]), D-dimers of at least 0.97 g/L (OR = 2.04 [1.02; 4.07]), and C-reactive protein minimum of 0.89 mg/L (OR = 2.28 [1.24; 4.18]).

Treatment Adherence in Patients with Obstructive Pulmonary Diseases.

COPD is the third most common cause of death globally. Adherence rates in patients with obstructive pulmonary diseases usually range between 10% and 40%. The aim of the study was to evaluate the level of treatment adherence to inhaled therapy in patients with obstructive pulmonary diseases. A total of 325 patients, of mean age 63.04 ± 11.29, with COPD or asthma, were included into the study between 2020 and 2021. The following questionnaires were used: Beliefs about Medicines Questionnaire, Test of Adherence to Inhalers and Adherence to Refills and Medications Scale. The respondents tended to be convinced of the necessity of their medication (3.87 points per question). The patients reported moderate levels of overall adherence (21.15 ± 6.23). A total of 74% of patients demonstrated sporadic non-compliance. We conclude that patients with obstructive pulmonary diseases are moderately adherent to their medication. Beliefs about medicines have a significant impact on adherence to medications. Being unemployed, being a non-smoker and belief in the necessity of medication are independent determinants of better medication adherence. The number of hospital admissions due to exacerbations of the disease over the last year and belief that medicines are harmful are independent determinants of poorer medication adherence.

How Humoral Response and Side Effects Depend on the Type of Vaccine and Past SARS-CoV-2 Infection.

Since the end of December 2020, it has been possible to vaccinate against COVID-19. Our aim was to evaluate and compare the effectiveness of the vaccines available at the time of the mass vaccination program in Poland and also to look into the most common adverse side effects. Patients' anti-SARS-CoV-2 antibodies levels were checked before vaccination and after the first and after the second/last dose by the anti-SARS-CoV-2 QuantiVac ELISA (IgG) (EUROIMMUN MedicinischeLabordiagnostica AG; Luebeck; Germany) test. Before each blood collection, all patients filled out a questionnaire regarding experienced side effects. We observed that 100% of patients responded to the vaccinations. After the first dose, convalescents had much higher levels of anti-SARS-CoV-2 antibodies than naive patients, although after the second dose, 61 out of 162 convalescents (37.7%) had lower results than before. The comparison of immunological responses in the convalescents group after the first dose and in the naive group after the second dose showed that convalescents had higher antibody titers, which may suggest the possibility of changing the vaccination schedule for convalescents. The highest antibody titers after both the first and second doses were observed after Moderna shots. Fever was identified as a significant factor regarding higher levels of antibodies after the first and second doses of the vaccine.

Attitude of Health Care Workers and Medical Students towards Vaccination against COVID-19.

The role of medical personnel in promoting vaccination and pro-health attitudes seems to be of key importance for protection against COVID-19. The aim of the study was to assess the attitudes of health care workers and students of medical faculties towards preventive vaccinations against COVID-19. A cross-sectional online self-administered survey was conducted among 497 people. The questions concerned attitudes towards vaccination as well as concerns about the side effects of the vaccine and contracting COVID-19. A positive attitude to vaccination was observed in 82% of the respondents. More than 54% respondents were concerned about side effects after COVID-19 vaccination. Medical students under 26 years had a more positive attitude towards COVID-19 vaccination, twice as high as among health care workers OR (95%Cl): 2.20 (1.03-4.66) vs. 4.06 (2.54-6.48), respectively. Students were more concerned than nurses about adverse effects of COVID-19 vaccine 3.8 (3.2-4.1) vs. 3.0 (2.7-3.5) and contracting the virus (1.7 (1.2-2.5) vs. 1.2 (1.0-2.0). Medical students had a more positive attitude toward vaccination than nursing students 4.2 (3.9-4.3) vs. 3.7 (3.3-4.3). In conclusion, predictors of positive attitudes toward vaccination were medical student status and young age.

Medical students' knowledge about COVID-19 and evaluation of the effectiveness of the applied preventive strategies.

BACKGROUND: SARS-CoV-2 is a novel coronavirus which has caused a global pandemic. Due to the lack of available treatment for COVID-19 infections, prevention plays the most important role in combating the virus. Educational programs among students of medical faculties is necessary, because in the future they will act as health educators in the healthcare system. The aim of the study is to assess the students' knowledge as an initial stage to the implementation of further preventive strategies against the spread of SARS-CoV-2 virus infections and to the evaluation of the effectiveness of the implemented preventive measures by continuous monitoring of the number of implemented administrative procedures. METHODS: The study involved 482 students of medical faculties. Participants completed a questionnaire based on knowledge about the SARS-CoV-2 virus. Additionally, a number of preventive measures were introduced, including vaccination against COVID-19. During the entire period of the study, the number of administrative procedures (isolation and quarantine) were monitored. RESULTS: The results of the knowledge test about COVID-19 were generally low and amounted to 11.0 (SD = 2.2). Significant differences in knowledge about COVID-19 between students of particular medical faculties were found. The most appropriate answers to questions about the incubation time of the SARS-CoV-2 virus were given by students of medicine (55%), followed by nursing (42.14%) and pharmacy (26%) students. Nursing students were the most correct in identifying the 3 main symptoms of COVID-19 (91.07%), followed by students of medicine (85.83%), and finally dentistry (77.27%) and pharmacy (76.67%) students. The Median (IQR) of students quarantined or isolating during steps 1, 2, 3, and 4 was 117,5 (142); 40 (43); 38, (20); and 9,5 (15), respectively. CONCLUSION: Students of certain faculties showed a low level of knowledge about transmission routes and procedures for dealing with a person suspected of being infected with SARS-CoV-2 or who has tested positive for COVID-19. Additional educational programs were conducted among medical students, along with other prevention strategies, which contributed to a decrease in the number of applied administrative procedures (isolation or quarantine).

Illness Perception and Quality of Life in Patients with Breast Cancer.

INTRODUCTION: In 2020, breast cancer was the most frequently diagnosed malignancy worldwide. The QoL level plays a role in assessing the effectiveness of the diagnosis and therapy and is a significant prognostic factor. The subject that is relatively less often addressed in the literature is the impact of psycho-social factors and health-related beliefs on QoL in breast cancer patients. The aim of the study was to assess the association of illness perception, the sense of coherence, and illness acceptance with QoL in breast cancer patients. METHODS: The study included 202 women (mean age 53.0 ± 10.3) treated surgically for breast cancer at the Lower Silesian Oncology Centre. The following standardized questionnaires were used: Acceptance of Illness Scale (AIS), Mental Adjustment to Cancer (Mini-MAC), Quality of Life Questionnaires (EORTC QLQ-C30 and QLQ-BR23), The Multidimensional Essence of Disease and Illness Scale (MEDIS), and Life Orientation Test (LOT-R). RESULTS: There is a statistically significant association between illness acceptance and QoL. There is a statistically significant association between the sense of coherence (life optimism-LOT-R) and QoL among breast cancer patients. There is a statistically significant association between illness perception and QoL. There was a statistically significant correlation between the increasing importance of illness as a dysfunction, decreasing QoL, and increasing intensity of symptoms and complaints. CONCLUSIONS: Patients with a high level of illness acceptance, with an optimistic disposition, and with a positive illness perception have better QoL within all the functional domains and experience lower intensity of cancer- and treatment-related symptoms as compared to those with low level of illness acceptance, with moderate optimism or a pessimistic disposition, and with neutral or negative illness perception.

The Relationship between Fatty Acids and the Development, Course and Treatment of Rheumatoid Arthritis.

For this systematic review, a search of the relevant literature was conducted in the EMBASE and PubMed databases. We used the following terms: 'rheumatoid arthritis' in conjunction with 'fatty acid'. The following inclusion criteria had to be satisfied for the studies to be included in the analysis: an RCT/observational/cohort study published in English. A total of seventy-one studies were analysed. The presented systematic review of the available data indicates that increased consumption of omega-3 fatty acids (FAs) may have a beneficial effect on human health by decreasing pain and disease activity in patients with RA. The beneficial effect of unsaturated FA on the clinical parameters of RA was demonstrated in all 71 studies analysed. The content of omega-3 FAs in the diet and the consumption of fish, which are their main source, may contribute to a reduced incidence of RA. FAs are an essential component in the synthesis of eicosanoids that exhibit anti-inflammatory properties. Due to the documented positive influence of unsaturated FAs on treatment outcomes, the use of a diet rich in long-chain unsaturated FAs should be the standard of care, along with pharmacotherapy, in the treatment of RA patients. An important element in the control of the treatment process should be the routine assessment of the quality of life of RA patients.

Psychometric Properties of the Treatment Satisfaction with Medicines Questionnaire (SATMED-Q) in Patients with Diabetes, Arterial Hypertension and Heart Failure.

BACKGROUND: Satisfaction with medicines is crucial in indicating patient experiences with the treatment which impact medicine adherence and compliance. AIM: The aim of this research was to adopt a general measure of patients' satisfaction with medicines, the Treatment Satisfaction with Medicines Questionnaire (SATMED-Q), to the Polish language (BMQ-PL). MATERIALS AND METHODS: A total of 197 patients qualified for the research, with the following diagnoses: type 2 diabetes (n = 42), hypertension (n = 55) and heart failure (n = 100), aged 64.73 (SD = 13.27). The criterion-related validity was determined with the use of a Polish version of the Adherence to Refills and Medications Scale. Confirmatory and exploratory factor analyses were used. RESULTS: The respondents' mean score was 73.63 (SD = 18.42). Cronbach's alpha for the entire instrument was 0.847. All items of the questionnaire were found to have a positive item-total correlation. A multifactorial linear regression model showed that a significant (p ˂ 0.05) independent variable increasing the SATMED-Q score for the whole group was educational level (vocational education R = 14.576; secondary education R = 14.055; higher education R = 19.372) and low adherence (R = -1.384) was a decreasing variable. CONCLUSIONS: The present findings indicate a high level of reliability and validity of the translated SATMED-Q questionnaire, fully comparable to that of the original. The questionnaire can be used for the assessment of satisfaction with medicines among Polish patients.

Polish Nurses' Knowledge of Heart Failure Self-Management Principles.

BACKGROUND: Only comprehensive care and structured education can have a significant impact on the effectiveness of treatment and prepare patients for self-care. Unfortunately, Polish nurses are not ready to perform comprehensive heart failure (HF) care tasks without careful preparation.The purpose of the study was to evaluate nurses' knowledge of patient education in general and topic-specific perceptions of basic information important for HF self-care, and also to determine the variables (workplace, education, internship) that may affect the implementation of educational tasks in the care of patients with HF. METHODS: The study involved 304 nurses who were surveyed using the Nurses' Knowledge of Heart Failure Education Principles. RESULTS: Cardiology nurses' knowledge regarding patient education for self-care is insufficient. The overall knowledge score was the highest among nurses in provincial specialist hospitals and university hospitals and the lowest in regional hospitals in small towns (14.98 vs. 14.35 vs. 12.83 vs. 11.89, respectively). Nurses who completed a cardiological specialty demonstrated significantly more extensive knowledge than those who had completed other specialties (15.52 vs. 13.71). CONCLUSIONS: Cardiology nurses' knowledge of HF self-care principles regarding patient education is satisfactory, but not with all mandatory issues, especially in the recognition of disease symptoms, exacerbations, and pharmacotherapy.

Risk of Falls in Patients Aged Over 65 in the Context of the Treatment Facility.

This study assessed the risk of falls, the incidence of frailty, cognition, and nutritional status in people aged over 65 in the context of the treatment facility. To this end, we compared a group of 99 non-hospitalized patients treated in primary healthcare facilities with a group of 100 patients hospitalized in a geriatric ward. It was a survey-type study based on the following questionnaires: Mini-Mental State Examination, Tilburg Frailty Indicator, Mini Nutritional Assessment, and the Tinetti Balance and Gait Assessment. We found significant differences between non-hospitalized and hospitalized patients to the advantage of the former. A risk of falls was 56.6% vs. 85% (p < 0.001), the incidence of frailty was 51% vs. 71% (p = 0.005), and cognitive decline was 35% vs. 61% (p = 0.120), respectively. Additionally, nutritional detriment also was less expressed in outpatients. A distinctly worse overall health performance, with increased risk of falls, was confirmed in multifactorial regression analysis in hospitalized patients. We conclude that geriatric hospital setting is an independent risk factor aggravating the risk of falls, frailty, and cognitive weakness in senior persons.