Analysis of Changes in the Selected Nutritional Parameters of Patients within a Year from the Admission to the Enteral Nutrition Clinic.

(1) The following research question was formulated: What are the relationships between enteral nutrition and selected anthropometric and blood biochemical parameters? The aim of this study was to provide an assessment of the nutritional status of patients within one year from their admission to the Enteral Nutrition Clinic. (2) The study group included 103 participants. For the purpose of analysing their nutritional status, the Subjective Global Assessment (SGA) and Nutritional Risk Score (NRS) scales were used, anthropometric measurements were taken, and blood laboratory tests were performed. The assessment of changes in the indicated parameters was conducted at three time intervals: upon admission (T0) and 6 and 12 months after admission (T6 and T12, respectively). (3) The study group showed a significant improvement in the circumference of their upper and lower limbs. Nutrition therapy had an effect on the levels of erythrocytes, iron concentration, the activity of liver enzymes, and C-reactive protein levels. (4) The enrolment of patients into the Nutritional Therapy Programme had a positive effect on the selected results. 1. Twelve months after the introduction of nutritional intervention, an increase in erythrocyte count was particularly marked, and there was a decrease in the CRP (C Reactive Protein) level as well as the activity of liver enzymes. There was no significant effect of enteral nutrition on albumin and protein values. 2. To ensure the greatest efficiency of enteral nutritional therapy, it is to be continued for more than six months. 3. Nutritional interventions resulted in a significant increase in upper and lower limb circumferences among the study group. 4. For the purpose of identifying patients at risk of malnutrition, medical personnel should systematically raise their qualifications, and educational measures on this issue should be implemented at the stage of medical training at medical universities.

The Relationship between Social Support and Mental Health Problems of Peri- and Postmenopausal Women during the SARS-CoV-2 Pandemic.

The COVID-19 pandemic affects women's mental health, because they are more predisposed to vulnerabilities and adverse impacts. Therefore, is important to find strategies for preventing and treating these mental health consequences in the female population. The main purposes of our study were to determine the level of social support received by peri- and postmenopausal women during the SARS-CoV-2 pandemic, as well as factors related to this level with reference to health status and sociodemographic variables. A total of 218 women in peri- and postmenopausal status participated in the study. The study assessed depression (Beck Depression Inventory), anxiety (the Spielberg State-Trait Anxiety Scale), climacteric symptoms (the Blatt-Kupperman Index), social support (the Inventory of Social Supportive Behaviors). The majority of the respondents had a moderate level of anxiety as a state (40.8%), a low level of anxiety as a trait (51.4%), no depressive symptoms (75.2%) and no climacteric symptoms (52.3%). Age was found to significantly correlate with anxiety as a state (p = 0.036). The anxiety as state was significantly stronger in people with higher education than in people with secondary education (p = 0.019). Professionally inactive women had more emotional (p = 0.05) and appraisal (p = 0.014) support than women who work. The analysis demonstrated no statistically significant correlation between social support and depression, anxiety or climacteric symptoms (p > 0.05). The majority of peri- and postmenopausal women had no depressive symptoms and/or anxiety symptoms. Professionally inactive women had more emotional and appraisal support than women who work. The analysis demonstrated no statistically significant correlation between social support and depression, anxiety or climacteric symptoms.

Analysis of Factors Related to Mental Health, Suppression of Emotions, and Personality Influencing Coping with Stress among Nurses.

(1) The specificity of a nurse's work, apart from performing medical procedures, is characterized by intensive contacts with other people. Stress is an inevitable part of a nurse's job and can affect their physical and mental health. Thus, strategies for coping with stress play an important role in improving health or well-being by reducing the level of stress. (2) The aim of the study was to evaluate the impact of coping strategies in predicting the overall health of nurses. The study also assessed the impact of personality traits and emotional control (anger, depression, anxiety) on the choice of coping with stress among nurses. (3) The study included 811 nurses from the West Pomeranian Voivodeship, with an average age of 40 (SD = 9.8), working mainly in hospitals (82%). The research was carried out with a diagnostic survey method, using the Coping Inventory for Stressful Situations questionnaire, NEO-Five Factor Inventor, Courtland Emotional Control Care Scale, General Health Questionnaire 30, and a demographic questionnaire. (4) Among the surveyed nurses, the dominant style of coping with stress was the style focused on emotions (MT 0.43), followed by the style focused on avoidance (MT 0.42). There were mental problems among 46.1% of the respondents. Nurses with mental problems according to GHQ-30 were characterized by a high intensity of coping styles focused on emotions (30.2%), avoiding (18.7%), and engaging in alternative activities (32.3%) (p = 0.000). (5) Most of the surveyed nurses have a tendency to cope with stress through an emotional-focused style, which may be associated with a higher level of occupational stress.

Assessment of Psychosocial Functioning of Polish Nurses during COVID-19 Pandemic.

(1) The COVID-19 pandemic has significantly affected the psychological well-being of people around the world. The aim of this study was to assess the levels of psychological distress of nurses (anxiety, depression, stress, insomnia) in relation to sociodemographic variables and psychosocial variables: self-assessment of health, quarantine, psychological support, presence of chronic diseases and the Impact of Events Scale (IES-R). (2) A total of 207 nurses working with COVID-19 patients at the Independent Public Clinical Hospital No. 1 of the Pomeranian Medical University in Szczecin participated in the study. The study was conducted with the diagnostic survey method, using the Athens Insomnia Scale, the Generalized Anxiety Disorder questionnaire, the Impact of Event Scale-Revised, the Patient Health Questionnaire-9, The Perceived Stress Scale and a questionnaire of our authorship. (3) Among the respondents, 40.58% suffered sleep disturbance, 36.71% had mild anxiety, 71.95% had high stress according to the PSS-10 and 31.88% had depression according to the PHQ-9. The study observed that the chances of insomnia decreased with the age of the respondents. Moreover, the form of employment of nurses significantly affected the levels of depression, anxiety and stress. (4) Education, gender and age were variables that significantly affected the severity of anxiety, depression and insomnia in the surveyed nurses working with patients with COVID-19.

The Severity of Changes in Cardiovascular Risk Factors in Adults Over a Five-Year Interval.

PURPOSE: The aim of this study was to analyze the severity of changes in cardiovascular risk factors (hypertension, overweight and obesity, carbohydrate metabolism disorders, burdened family history) and to assess the risk of a cardiovascular incident according to the Systematic Coronary Risk Evaluation (SCORE) algorithm in the same group of patients over a five-year interval. PATIENTS AND METHODS: The research method was analysis of medical records of patients from the area of West Pomeranian Province, Poland, included in the Cardiovascular Disease Prevention Program of the National Health Fund five years after the first examination (2012/2013 vs 2017/2018). We collected data on changes in the levels of selected cardiovascular risk factors over five years and calculated the SCORE values. RESULTS: In the second measurement (after five years), the odds of obesity were about 2.5 times higher. The repeated BMI measurement showed that after five years more respondents were classified as overweight and obese compared with the first measurement (p = 0.000; η2 = 0.056). The repeated SCORE measurement indicated that after five years the SCORE values significantly increased compared with the first measurement (p = 0.000; η2 = 0.588). Statistically significant differences (p < 0.05) were also found between the first and the second measurements of arm circumference, waist circumference, BMI, diastolic blood pressure, heart rate, and triglycerides. The risk of visceral obesity was statistically significantly higher for men than for women (RHM = 1.47). CONCLUSION: In the group of patients examined twice over five years, the incidence of obesity, including abdominal obesity, significantly increased. Furthermore, five years after the last examination, the risk of a cardiovascular incident significantly increased. The participants had higher values of such parameters as: arm circumference, waist circumference, BMI, diastolic blood pressure, heart rate, and triglycerides.

Seeking genetic determinants of selected metabolic disorders in women aged 45-60.

INTRODUCTION AND OBJECTIVE: The biochemical and anthropometric consequences of metabolic disorders exert an enormous effect on the functioning of people worldwide. The aim of this study is to assess relationships between biochemical and anthropometric parameters associated with metabolic syndrome, and the presence of the PPAR-γ rs1801282, the FTO rs9939609, and the MC4R rs17782313 polymorphisms in women aged 45-60. MATERIAL AND METHODS: The study included 425 women, aged 45-59 years, from the general population of the West Pomeranian Province in north-west Poland. The research procedure involved a structured interview, anthropometric and blood pressure measurements, biochemical analysis of serum, and genetic analysis. RESULTS: The carriers of the A/A genotype of the FTO polymorphism had higher LDL levels than their counterparts with the T/T genotype (p = 0.01). The carriers of the T/T genotype of the MC4R polymorphism had lower non-HDL levels than those with the C/C and C/T genotypes (p = 0.019). Weight was related to the C/C and the C/G + G/G genotypes of the PPAR-γ gene polymorphism (p = 0.046). The model of inheritance for the MC4R polymorphism had a significant effect on TG (p = 0.039) and non-HDL (p = 0.05) levels. CONCLUSIONS: The genotypes analyzed in the study had only a slight direct effect on the biochemical and anthropometric abnormalities typical of metabolic disorders. Nonetheless, the risk alleles (A allele of the FTO rs9939609 and the C allele of the MC4R rs17782313) were found to be related to lipid metabolism disorders in 45-60-year-old women.

The Relationship between the IFNG (rs2430561) Polymorphism and Metabolic Syndrome in Perimenopausal Women.

Background and Objectives: Metabolic syndrome (MetS) is a multiple risk factor for atherosclerosis, cardiovascular disease, type 2 diabetes and strokes. One-third of middle-age women are at risk of MetS, which predisposes them to type 2 diabetes and cardiovascular disease. Changes in the regulation of anti-inflammatory cytokines-which play an important role in pathologic processes-may contribute to inflammatory disorders. Cytokine polymorphisms are known to have an impact on gene expression. The purpose of this study was to search for the relationship between the IFNG polymorphisms and the levels of proinflammatory cytokines. Materials and Methods: This study, conducted in West Pomeranian Voivodeship, Poland, involved 416 women. Of these women, 33.6% of them had primary education, 44.8% lived in cities with a population of over 100,000, and 82.7% were married. Of the participants, 28.4% met the criteria for MetS. The study involved: interview performed to collect sociodemographic and medical data, anthropometric measurements, as well as venous blood collection for biochemical analysis, genetic testing and the measurement of inflammatory markers. Results: The link between the IFNG (rs2430561) polymorphism and serum PIC (proinflammatory cytokines) levels was tested with regard to MetS. In the MetS+ subgroup, the T/T and A/T genotypes of the IFNG gene were accompanied by higher IL-6 levels than in the MetS- subgroup. Conclusion: Our study has not confirmed a direct link between the IFNG polymorphisms and the levels of inflammatory biomarkers. Nevertheless, the T/T and A/T genotypes of the IFNG gene may predispose to elevated IL-6 levels.

The Effect of Whole Blood Lead (Pb-B) Levels on Changes in Peripheral Blood Morphology and Selected Biochemical Parameters, and the Severity of Depression in Peri-Menopausal Women at Risk of Metabolic Syndrome or with Metabolic Syndrome.

The aim of our study was to assess the impact of whole blood lead (Pb-B) levels on changes in peripheral blood morphology and selected biochemical parameters, and the severity of depression in peri-menopausal women at risk of metabolic syndrome (pre-MetS) or with metabolic syndrome (MetS). The study involved 233 women from the general population of the West Pomeranian Province (Poland) aged 44-65 years. The intensity of menopausal symptoms and the severity of depression was examined using the Blatt-Kupperman Index (KI) and the Beck Depression Inventory (BDI). C-reactive protein (CRP), insulin, glucose, glycated hemoglobin (HbA1C), high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol, triglyceride levels (TG), cortisol, morphology of blood cells and homeostasis model assessment for insulin resistance (HOMA-IR) and Pb-B was measured. Women with MetS had higher levels of glucose, HbA1C, HDL, LDL, TG, cortisol, insulin and higher HOMA-IR. No significant differences in Pb-B were observed between pre-MetS and the control group, and between pre-MetS and the MetS group. A significant correlation was noticed between Pb-B vs. the percentage of monocytes in blood, and blood cortisol levels in women with MetS; Pb-B vs. lymphocyte count and HbA1C in the pre-MetS group, as well as in the BDI scores between the MetS and pre-MetS group. We cannot clearly state that exposure to Pb is an environmental factor that can be considered as a risk factor for MetS in this studied group.

Cardiovascular Risk Distribution in a Contemporary Polish Collective.

The aim of this study was to assess the prevalence of selected risk factors for cardiovascular disease (hypertension, overweight, obesity, carbohydrate metabolism disorders, a positive family history, a lack of physical activity), and to estimate the risk of a cardiovascular incident according to the Systematic Coronary Risk Evaluation (SCORE) algorithm for patients aged 35, 40, 45, 50, and 55 years, included in a primary-care prevention program, with regard to selected variables (sex and age brackets). The study sample consisted of 2009 subjects, 63% of whom were women. The largest group was the group of 35-year-olds (27%). The research method was the analysis of medical documentation of primary-care patients living in West Pomerania included in the Program of Prevention and Early Detection of Cardiovascular Disease of the National Health Fund. We collected data concerning risk factors for cardiovascular disease, blood pressure, anthropometric measurements (arm circumference, waist circumference, height, weight), body mass index (BMI), and the levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), and fasting glucose, as well as the SCORE results. Men more often than women were overweight and obese, had hyperglycemia, and had elevated levels of total cholesterol, LDL cholesterol, and triglycerides (p < 0.001). There was also a statistically significant difference in the odds of a cardiovascular incident (p < 0.001)-the SCORE results obtained by men were higher. Men require special preventive measures in order to reduce their risk factors for cardiovascular disease, especially hypertension, dyslipidemia, diabetes, overweight, obesity, smoking, and a positive family history.

Depression, changes in peripheral blood cell count, and changes in selected biochemical parameters related to lead concentration in whole blood (Pb-B) of women in the menopausal period.

THE AIM: The aim of this study was to assess the severity of depression, vasomotor symptoms, changes in peripheral blood cell count, and selected biochemical parameters in relation to the concentration of lead in whole blood of women in the perimenopausal period. METHODS: The study sample consisted of 233 women from the general population of the West Pomeranian Province (Poland) in age between 44-65 years. The intensity of menopausal symptoms was examined using the Blatt-Kupperman Index, and the severity of depression using the Beck Depression Inventory. The following biochemical data were evaluated: concentrations of glucose, triglycerides, HDL, C-reactive protein, glycated haemoglobin, cortisol, insulin, blood cell count, and lead concentration in whole blood (Pb-B). RESULTS: A whole blood Pb concentration below 5 µg/dl was found in 55 subjects (23.61 %), in 142 women (60.94 %) it ranged from 5 to 10 µg/dl, while in 36 women (15.45 %) was higher than 10 µg/dl. There was a strong positive correlation between Pb concentration in the blood of the examined women and the severity of depressive symptoms (Rs=+0.60, p = 0.001). The lowest mean values for total leukocytes (5.07 ±â€¯1.22 thousand/µl) and neutrophils (2.76 ±â€¯0.86 thousand/µl) were found in women with Pb concentration above 10 µg/dl (p < 0.05). There was a significant negative correlation between the number of total leukocytes (r=-0.45, p = 0.002) and neutrophils (r=-0.50, p = 0.001) and blood Pb concentration. Analysis showed statistically significant differences in glucose concentration (p < 0.05) between groups. Blood glucose was higher in women with Pb-B <5 and between 5-10 µg/dl than in women with Pb-B >10 µg/dl. CONCLUSION: Exposure to Pb may be a factor playing a significant role in the development of depressive symptoms in menopausal women. It may also be associated with glucose metabolism disorders and immunosuppression in women during this period of life.

Effects of socio-demographic, personality and medical factors on quality of life of postmenopausal women.

UNLABELLED: Numerous studies show that changes occurring in a woman's organism during menopause may lower her quality of life. This study involved 630 healthy postmenopausal women from Poland. Its purpose was to assess their quality of life in relation to socio-demographic variables, medical data and personality profiles. The authors used the Short Form Health Survey (SF-36) to assess quality of life, the NEO-Five Factor Inventory to measure personality traits, and the Blatt-Kupperman Menopausal Index to estimate severity of climacteric symptoms. The study demonstrated significant relationships between quality of life and variables such as: age, education, employment status, and the use of menopausal hormone therapy. An analysis of personality traits revealed correlations between the openness to experience scores and the quality of life within physical functioning, vitality, and mental health. Neuroticism, agreeableness and extroversion significantly correlated with all quality of life domains. CONCLUSIONS: (1) Age, education and employment status have significant effects on the selected quality of life domains after menopause. (2) Quality of life within the general health domain was assessed lower by MHT-users (Menopausal hormone theraphy (MHT)). (3) Health-related quality of life is also influenced by personality traits, which are relatively stable throughout life.

[Monitoring of hospital infections in cardiac surgery ward]. / Monitorowanie zakazen szpitalnych na oddziale kardiochirurgii.

INTRODUCTION: The development of techniques applied in cardiac surgery changed the profile of operated patients. Patients with small lesions within the cardiovascular system are treated using invasive cardiology. The occurrence of infections is directly related to the type of surgery and the implanted material. Many hospitals, even in the developed countries, contend with hospital infections, which are the source of serious clinical and economic problems. Paradoxically, problems associated with hospital infections have grown worse along with advances in medicine and the implementation of new invasive diagnostic methods. Cardiac surgery wards are specialist units, where infections among patients are quite common. Hospital infections are dangerous for patients' health and even life. They also contribute to the failure of therapy. Therefore, the awareness of infections and their reasons, which may help to control and eliminate this problem, is so important. The aim of this study was an annual forward-looking analysis of hospital infections in the cardiac surgery ward, which included: patients' profiles, clinical forms of infections, aetiological factors and infection risk factors in patients with various types of cardiac surgical procedures. MATERIAL AND METHODS: This forward-looking study involved all patients hospitalised in the Cardiac Surgery Clinic, the Pomeranian Medical University of Szczecin in the period 1.01-31.12.2008. The total number of participants was 1127, including 804 (71.3%) men and 323 (28.7%) women. analysis of procedures used in cardiac surgery wards so far and the offer of optimal prevention measures. Each patient had his/her own infection registration card. The material for microbiological tests was taken in accordance with a routine procedure once a week or in cases of suspected infections. CONCLUSIONS: 1. Infections were detected in 7.2% of patients. 2. Death rates among patients with infections was higher in women than in men (46.2% vs 33.3%). 3. The most common clinical forms of infection were pneumonia (44.4%), sepsis (42.0%) and surgical site infection (33.3%), however every infected patient had 1-4 clinical forms. 4. The most common aetiological factors of infection, irrespective of a clinical form, were Gram-negative rods with the prevalence of Enterobacter cloacae and Pseudomonas aeruginosa. 5. Patient-related infection risk factors included overweight and womens' age > 72, while a statistically significant increase in the incidence of infections was found in patients who had not received anti-thrombosis treatment. 6. Infection risk factors associated with treatment and specificity of the cardiac surgery ward were mainly: artificial ventilation > 24 h, the necessity for reoperation, a blood transfusion, pressor administration, treatment complications, as well as not using extracorporeal circulation and surgical site drainage. 7. Risk factors related to treatment complications included mainly: circulatory problems, renal insufficiency, respiratory insufficiency, low cardiac output syndrome and ischaemic cerebral stroke. 8. There were no correlations between infections and the course of surgery, the type of a prosthesis (mechanical/biological) or catheterization of vessels and the bladder. 9. The presented results enable the analysis of procedures used in cardiac surgery wards so far and the offer of optimal prevention measures.