The Impact of Early Rehabilitation and the Acceptance of the Disease on the Quality of Life of Patients after Hip Arthroplasty: An Observational Study.

Background: The early introduction of physiotherapy significantly shortens the time required for a patient to regain full mobility after hip arthroplasty. Obtaining the expected result is determined by cooperation with a physiotherapist and the patient's involvement in the rehabilitation process. The aim of this study was to assess the quality of life, life satisfaction, and motor ability of patients after hip arthroplasty. Methods: This study included 147 patients who underwent hip arthroplasty at the Orthopedic and Trauma Department. The research material was collected using questionnaires, and the study used the Barthel Index (BI), Harris Hip Score (HHS), Visual Analogue Scale (VAS), Acceptance of Illness Scale (AIS), and Quality of Life Assessment Questionnaire (WHOQOL-BREF). In the studied group of patients, the Excia cementless endoprosthesis was primarily used (69.39%), as well as the Metha Short Hip prosthesis (15.65%), AM hip prosthesis (10.20%), and bipolar hip prosthesis (4.76%). Results: The analyzed group of patients included 95 women (64.63%) and 52 men (35.37%); the average age was 67 years. Six weeks after hip arthroplasty, mild disability occurred in 53.74% of the patients, while the remaining 46.26% had no disability, and 95.24% of the patients achieved a high level of acceptance of the disease and quality of life. Conclusions: Early improvement after hip replacement surgery contributes to eliminating the disability of the hip joint in the following areas: pain sensation, functionality, lack of deformation, and range of motion. Each subsequent stage of treatment increased the level of acceptance of the disease in the study group. The applied surgical treatment increased satisfaction with overall health and quality of life.

The Effect of Serum Leptin Concentration and Leptin Receptor Expression on Colorectal Cancer.

INTRODUCTION: The level of leptin in the blood shows a positive, strong correlation with the mass of adipose tissue. Being overweight and having metabolic disorders increase the risk of developing colorectal cancer. AIM OF THE PAPER: The aim of the study was to assess the concentration of leptin in the blood serum as well as the expression of the leptin receptor in colorectal cancer cells. In addition, the effect of serum leptin concentration and leptin receptor expression on clinical and pathological parameters such as BMI, obesity, TNM, and tumor size was assessed. METHODS: The study included 61 patients diagnosed with colorectal cancer and treated with surgery. RESULTS: Strong leptin receptor expression and the prevalence of overweight and obesity are factors influencing the occurrence of excessive leptin concentrations. CONCLUSION: Leptin may be involved in the development and progression of colorectal cancer. More research is needed to better elucidate the role of leptin in the development and progression of the disease.

Quality of Life after Bariatric Surgery-A Systematic Review.

BACKGROUND: Most studies analyzing the health-related quality of life (HRQOL) after bariatric treatment ceased at five years post-surgery or even earlier, and it is unclear whether the HRQOL benefit persists for a longer time. This paper reviews sparse evidence regarding HRQOL in patients who underwent bariatric surgery at least nine years prior. MATERIALS AND METHODS: A of PubMed, Scopus and Google Scholar between 2007-2021 was carried out for the studies investigating HRQOL as an outcome measure in patients after bariatric surgery of any type and having at least a 9-year follow-up. Inconsistent reporting of weight loss or postgraduate study results unrelated to QoL were not included in the study. The study used the PICO procedure. RESULTS: The review of 18 identified publications demonstrated that bariatric treatment seems to provide a persistent benefit in terms of HRQOL, especially its physical component score. Due to psychological predispositions, some patients appear to be less likely to benefit from bariatric treatment, whether in terms of HRQOL or bodyweight reduction. Inconsistent and imprecise studies may limit the evidence included in a review. CONCLUSIONS: The early identification of such patients and providing them with holistic care, including psychological intervention, would likely further improve the outcomes of bariatric treatment.

Role of Preoperative Esophagogastroduodenoscopy (EGD) in Bariatric Treatment.

Background: The recommendations for routine preoperative esophagogastroduodenoscopy (EGD) in patients qualified for bariatric surgeries are still a matter of debate. The aim of this study was to analyze the pathologies on preoperative EGD in patients qualified for bariatric surgeries. Materials and Methods: This study included 222 patients, divided into two groups. The obesity group consisted of patients with obesity (BMI ≥ 40 kg/m2), for whom EGD was a routine part of the preparation for laparoscopic sleeve gastrectomy (LSG). The control group of patients with normal body weight (BMI) qualified for EGD because of gastrointestinal ailments. Results: Regarding preoperative EGD in patients qualified for bariatric surgeries, we analyzed the prevalence of endoscopic pathologies in various gastrointestinal tract segments. Patients with obesity were shown to present with esophageal pathologies significantly more often than persons in the control group (n = 23, 20.91% vs. n = 12, 10.91%, p = 0.042). The odds ratio of esophageal pathologies in patients with obesity versus the control group equaled 2.15 (95%CI: 1.01-4.59). In turn, the odds ratio of duodenal pathologies in patients from the control group was 3.31 (95%Cl: 1.16-9.47), which means that persons from this group were approximately three times more likely to be diagnosed with those pathologies compared to obese patients. Moreover, patient sex was a significant predictor of duodenal pathologies, with an odds ratio of 4.03 (95%CI: 1.53-10.61). Conclusions: Preoperative EGD can identify a broad spectrum of pathologies in obese patients, which suggests a routine examination before bariatric surgery.

The Impact of an Individual Educational Program on the Quality of Life and Severity of Symptoms of Patients with Irritable Bowel Syndrome.

BACKGROUND: Irritable bowel syndrome (IBS) is one of the most common functional diseases of the gastrointestinal tract. A typical symptom is changed bowel patterns: diarrhea, constipation, or alternation of the two. Abdominal pains vary in intensity and location, with periods of exacerbation and remission, causing disorganization in everyday life and work. Educational intervention could be one strategy to improve the well-being of IBS patients. Only a few trials have examined this hypothesis. The aim of this study was to examine the effect of an educational program combined with elements of behavioral therapy, individualized for each patient, on quality of life (QOL) and severity of pain of patients with IBS. METHODS: In total, 150 IBS patients and 100 healthy persons in the control group were included. QOL (36-Item Short Form Health Survey, SF-36) and pain severity (Visual Analogue Scale) were measured at baseline and six months after education of IBS patients. RESULTS: At baseline, patients with IBS showed highly significantly worse QOL. In the IBS group, significantly higher physical component summary (PCS) and mental component summary (MCS) scores were noted for 35- to 50-year-old patients compared to other patients. Six months after education and behavioral therapy, significant improvement in QOL and a significant decrease in the subjective perception of pain severity were noted compared to values before therapeutic education. CONCLUSION: An educational program combined with elements of behavioral therapy, individualized for patients with IBS, is an important part of therapy for these patients.

Assessment of education effects on patient involvement and bariatric treatment outcome: an observational study.

INTRODUCTION: As a result of the growing number of people with obesity, the popularity of bariatric surgery has been systematically increasing. It has not yet been explored whether individual education of the patient can contribute to long-term success in weight reduction after bariatric treatment. AIM: To implement and compare the effects of different education methods, versus receiving one-time written information in the form of a guidebook, on patient involvement in abiding by lifestyle recommendations after laparoscopic sleeve gastrectomy (LSG) bariatric treatment. MATERIAL AND METHODS: The study included 160 patients with morbid obesity. The education session study participants were 100 patients after sleeve gastrectomy, with whom three education sessions were planned, and who were enrolled in the study. The control group consisted of 60 patients who underwent sleeve gastrectomy, and before discharge from the department, they received one-time written recommendations in the form of a guidebook. RESULTS: We confirmed that the three education sessions we conducted with the study group after LSG had a significant impact on weight loss. The control group, which received only written information, achieved weight loss and abided by the written recommendations, although to a lesser extent than the study group. The differences were evident particularly in motivation to adhere to recommendations and check-ups, which was significantly lower (p < 0.001) after a year of observation in the control group. CONCLUSIONS: This study results should encourage the establishment of education as a permanent element of the LSG procedure.

Evaluation of Pain Management after Surgery: An Observational Study.

Background and Objectives: Choosing a pain management strategy is essential for improving recovery after surgery. Effective pain management reduces the stress response, facilitates mobilization, and improves the quality of the postoperative period. The aim of the study was to assess the effectiveness of pain management in patients after surgery. Materials and Methods: The study included 216 patients operated on in the following surgical wards: the Department of Cardiosurgery and the Department of General and Endocrine Surgery. Patients were hospitalized on average for 6 ± 4.5 days. Patients were randomly selected for the study using a questionnaire technique with a numerical rating scale. Results: Immediately after surgery, pre-emptive analgesia, multimodal analgesia, and analgosedation were used significantly more frequently than other methods (p < 0.001). In the subsequent postoperative days, the method of administering drugs on demand was used most often. Patients with confirmed complications during postoperative wound healing required significantly more frequent use of drugs from Steps 2 and 3 of the World Health Organization (WHO) analgesic ladder compared with patients without complications. Conclusion: The mode of patient admission for surgery significantly affected the level of pain perception. Different pain management methods were used and not every method was effective.

Psychosocial Work-Related Hazards and Their Relationship to the Quality of Life of Nurses-a Cross-Sectional Study.

BACKGROUND: Nursing requires a commitment to work and care for the well-being of the patient, which is a great mental and physical burden for the nurse. As a result of exposure to adverse psychosocial work conditions and experiencing the resulting work-related stress, the problem of burnout is becoming more common. The aim of the study was to assess the psychosocial work conditions and their relationship to quality of life in the studied group of nurses. METHODS: A cross-sectional study was carried out on 523 randomly selected professionally active registered nurses. The study was based on a diagnostic survey using standardized psychometric questionnaires: The Psychosocial Working Conditions Questionnaire and the quality of life WHOQOL-Bref. RESULTS: Respondents with a better education assessed the level of demands at work to be higher (p = 0.000); however, they were also more satisfied in the well-being category (p = 0.020). Shift work was associated with a worse perception of psychosocial work conditions in almost all considered domains. The strongest correlations were between the scale of well-being and the assessment of quality of life in the somatic and psychological domains. CONCLUSION: Nurses doing shift work assessed working conditions as being worse in all domains. They felt the mental and physical burden the most. Psychosocial work conditions were assessed to be better by nurses working in management positions. The strongest correlations were between the scale of well-being and the assessment of quality of life in the somatic and psychological domains.

The Relationship between Mental Health and the Quality of Life of Polish Nurses with Many Years of Experience in the Profession: A Cross-Sectional Study.

BACKGROUND: In their professional work, nurses struggle repeatedly with difficult situations that are causes of stress. Another issue is the low prestige of the nursing profession compared with other professions, which results in dissatisfaction, increased frustration, and lack of precision when performing professional tasks. The aim of this study was to assess the relationship between mental health and quality of life and satisfaction with life in nurses with many years of experience in the profession. METHODS: The study was conducted in a group of 523 randomly selected professionally active nurses aged over 40 years old from the Podlaskie Voivodeship. Standardized questionnaires were used, including WHOQOL-BREF, a short version of a questionnaire assessing quality of life, the general health questionnaire (GHQ-28), and the satisfaction with life scale (SWLS). RESULTS: The mental health component was found to be significantly affected by financial situation (p = 0.005). Among respondents describing their financial status as bad, the assessment of negative mental health symptoms was higher. The remaining studied variables-work experience, nature of work, place of residence, age, material status, having a partner, and having children-did not affect the respondents' mental health status. The co-occurrence of chronic diseases affected (p = 0.008) the intensification of negative mental health symptoms such as somatic symptoms, anxiety, insomnia, and social dysfunction. The intensification of negative mental health symptoms was not connected with absence from work. CONCLUSIONS: The financial situation of the respondents significantly determined their quality of life as well as influencing mental health components. Nurses' satisfaction with life was correlated with all studied domains of quality of life.

Effect of BMI on quality of life and depression levels after bariatric surgery.

BACKGROUND: Studies conducted in Poland have found that 1% (~300,000) of Polish adults are obese. The degree of weight loss and reduction of discomfort associated with severe obesity are used to evaluate bariatric surgery outcomes. From the patient's point of view, QoL and mental health are the most important determinants of successful surgery, which is why interest in QoL assessment has increased. OBJECTIVES: To assess the effect of BMI on quality of life and depression levels depending on the type of bariatric surgery. MATERIAL AND METHODS: The group included 57 women and 43 men aged 20-60 years (mean age 40 years) with BMI from 36 to 40 (31%) and > 40 (69%). Twelve patients (12%) underwent laparoscopic adjustable gastric binding (LAGB), 58 (58%) sleeve gastrectomy, and 30 (30%) Roux-en-Y Gastric Bypass (RYGB). The Bariatric Analysis and Reporting Outcome System (BAROS) was used to assess QoL. The severity of mood disorders was assessed using the Self-Rating Scale of Depression and Anxiety. RESULTS: Six months or 1 year after bariatric surgery, the number of patients with BMI > 40 had decreased from 69 to 14%. We found that the time since bariatric surgery contributed to a significant (p < 0.01) difference in BAROS outcomes. In the long-term perspective, we observed better quality of life. CONCLUSIONS: MA-QoL II is a useful tool in assessing bariatric surgery, including quality of life. Long-term monitoring will be essential in determining psychological changes and the degree of weight loss.

The effect of bariatric procedures on selected laboratory parameters of patients from rural areas in Poland.

BACKGROUND: Rural areas in Poland are inhabited by over 15 million people, i.e. 39.5% of Polish population, including about 5 million rural residents in the Podlaskie province. The incidence of obesity is associated with increased prevalence of obesity-related conditions. Studies that have been conducted do not confirm the efficacy of conservative treatment of obesity, but show that bariatric procedures produce the best longterm results. OBJECTIVES: The aim of the study was to present the effects of bariatric obesity treatments (laparoscopic adjustable gastric banding [LAGB], sleeve gastrectomy [SG], Roux-en-Y gastric bypass [RYGB]) on body mass index (BMI), selected diabetes control parameters, dyslipidemia, hepatic and renal enzymes, blood count and hypertension control. MATERIAL AND METHODS: The study group comprised a total of 100 consecutive patients from rural areas qualified for bariatric procedures. Most of the patients (69.07%) underwent SG; 11.34% underwent LAGB; and 19.59% underwent RYGB. Comorbidities included hypertension (35%), type 2 diabetes (52%) and hyperlipidemia (15%). Glucose, insulin, HbA1C, alanine and aspartate aminotransferase, bilirubin, total and fraction cholesterol, creatinine, urea, uric acid and CRP levels, as well as blood count and blood pressure values, were assessed prior to surgery and during follow-up visits 3 and 6 months after the procedures. BMI, percentage of excess weight loss (%EWL) and percentage of excess body mass index loss (%EBMIL) were assessed. RESULTS: Consistent, significant decreases in BMI were observed 3 months (39.31 ± 4.70) and 6 months (35.74 ± 4.52) after surgery. The largest BMI reduction at the 6-month follow up was observed for SG (12.29%), and the smallest was observed for LAGB (9.02%). CONCLUSIONS: Improvements in the general health status of the patients were observed, as well as normalization of metabolic parameters (glucose, cholesterol, triglycerides, hepatic enzymes).

[Acceptance of own disease by patients with diagnosed glaucoma]. / Akceptacja wlasnej choroby przez pacjentów z rozpoznana jaskra.

UNLABELLED: The notion of glaucoma comprises a number of diseases which are all characterized by optic nerve damage. It was estimated that nearly 70 million people all over the world suffer from glaucoma and 10% of them have lost their sight because of glaucomatous optic nerve atrophy. The aim of this paper is to determine the acceptance level of the condition by patients with primary glaucoma as well as to study the relations between the acceptance level and the parameters influencing it directly or indirectly. MATERIAL AND METHODS: The study included 50 patients (40 women and 10 men) aged between 20 and 90 with recognized primary open-angle glaucoma. A questionnaire and a standardized Acceptance of Illness Scale (AIS) were used to evaluate the study material. The observed differences and relation levels were subjected to statistical analysis with the use of the Student's t test as well as the chi2 test, and the statistical significance level was established at p < 0.05. RESULTS: Within the studied group, people between the ages of 61 and 70 (38%), with secondary education (48%), were the most numerous. The most frequent therapeutic method was local treatment (application of eye drops). Prescribed medication was taken on a regular basis by 86% of patients, lack of regularity was declared by 14% of them. The 26% of patients realize their duties less accurately than before and 12% of them declared the need of frequent breaks in their work. The analysis showed a statistically significant relation (p = 0.0005) between the acceptance level of the condition and refraining from various forms of activity. The low acceptance of patients' illness determined the increase of they resignation from all forms of physical activity. CONCLUSIONS: The consecutive degrees of disease acceptance (low, medium, high) are comprised in glaucoma patients in the same proportion, i.e. each degree comprises around 30% of patients the most serious problems accepting the illness. This means that the tolerance of the disease is observed in 1/3 of patients with glaucoma. The most serious problems in disease acceptance were determined in elderly people and those with elementary or vocational education.