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Kazimierz Filip Wize (1873-1953) was a Polish multidisciplinary scholar, a microbiologist, a lepidopterologist, a psychiatrist, and a philosopher. He was an avid promoter of care of the mentally ill. After defending a Ph.D. in medicine in Munich (Germany) in 1899, Wize specialized in bacteriology at the Pasteur Institute in Paris. In 1907 he defended his second Ph.D. in philosophy in Leipzig. Soon, Wize became an internationally active scholar and a prolific writer, working especially on esthetics and the philosophy of medicine. For Wize, philosophy of action was a bridge between abstract academic philosophy, practical ethics, and the philosophy of medicine understood as an art and a science. Later in his life, Wize moved back to practicing medicine, and in the 1930s he specialized in psychiatry. The new field enabled him to apply his esthetic concepts to the treatment of patients and become a pioneer of art therapy. Music, painting, and dance, Wize argued, are a means to achieve serenity and freedom and play an important part in the process of recovery. Much later, Wize witnessed the extermination of psychiatric patients in Poland during a Nazi T4 action.
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Ética Médica/historia , Psiquiatría/historia , Psicología/historia , Historia del Siglo XIX , Historia del Siglo XX , Humanos , PoloniaRESUMEN
PURPOSE: This cohort study aimed to determine the frequency of overweight and obesity in classical phenylketonuria children and to identify the possible influence of metabolic control on the BMI of the studied patients. PATIENTS AND METHODS: The study group included 63 classical phenylketonuria patients (40 girls and 23 boys; aged 5-16 years). Their z-score BMI, metabolic control, educational level of parents and socioeconomic status were determined. RESULTS: Twenty children were overweight or obese and only three were underweight. The percentages of overweight and obese children were 31.7% for the whole group, 21.7% (5 out of 23) for boys and 37.5% (15 out of 40) for girls. Overweight and obesity in these phenylketonuria patients was statistically significantly more frequent when compared to national reference studies (p = 0.0031). The five-year index of dietary control and the percentage of spikes exceeding 6 and 12 mg/dl (Spikes 6 and 12) indicated better metabolic control in the case of normal weight children than those who were overweight and obese (p < 0.049, p < 0.041 and p < 0.011, respectively). The odds ratio of being overweight or obese for those having poorer metabolic control (values higher vs lower than mean) was statistically significantly higher than for the remaining patients (for Spikes 12: 6.926 < 95%CI: 2.011-23.854 > ; p < 0.002). These results strongly suggest a link between overweight and diet non-compliance. CONCLUSIONS: Children with classical phenylketonuria presented higher odds of being overweight or obese as compared with reference national studies, with girls only having a higher frequency of overweight.
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Fenilcetonurias/fisiopatología , Adolescente , Índice de Masa Corporal , Peso Corporal/fisiología , Niño , Preescolar , Femenino , Humanos , Masculino , Obesidad/fisiopatología , Oportunidad Relativa , Sobrepeso/fisiopatología , Fenilalanina/metabolismo , Fenilcetonurias/metabolismo , Estudios Retrospectivos , Clase SocialRESUMEN
BACKGROUND: Phenylketonuria (PKU) is a metabolic disease. It is manifested by a complete or partial inability to convert phenylalanine (Phe) to tyrosine and leads to increased concentrations of Phe in the blood and in other tissues, including the brain, causing irreversible neurological damage if left untreated. Low-phenylalanine diet is a key component of classical PKU therapy. OBJECTIVES: The objective of this study was to assess the effectiveness of classical phenylketonuria therapy and compliance with doctors' recommendations in the first 5 years of life. MATERIAL AND METHODS: Data was collected from all diagnosed and treated patients (n = 57) born 1999-2010. Phenylalanine blood levels, the number of visits to a specialist outpatients' center, the number of blood tests, as well as socioeconomic status (SES) and parents' education level have been analyzed, and potential relationships have been assessed. RESULTS: In the 1st year of life patients visited their doctors (odds ratio (OR) = 6.8267; 95% confidence interval (95% CI) = 2.827-16.5163; p < 0.0001) and had their blood collected (OR = 2.7875; 95% CI = 1.0467-7.4234; p < 0.0402) significantly more frequently than in the 2nd year. This tendency persisted into subsequent years. Similarly, in infancy they had statistically significantly lower odds of exceeding more than 40% of their Phe levels over therapeutic range than 1 year later (OR = 3.6078; 95% CI = 1.4859-8.7599; p < 0.0046). No PKU child had more than 70% of Phe levels over the therapeutic range in the 1st year of life, whereas 4 years later there were 18 such children. Phe levels were correlated with the number of visits to a specialist (ρ = 0.39) and the number of Phe blood tests with index of dietary control (ρ = -0.33). The effectiveness of therapy and compliance with the doctor's recommendations seem to depend neither on the level of education of the patient's parents nor on their SES. CONCLUSIONS: Therapy effectiveness and patients' compliance in PKU is very good in infancy. However, both deteriorate in subsequent years. Moreover, they do not seem to depend on the family background.
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Cooperación del Paciente , Fenilalanina/sangre , Fenilcetonurias/dietoterapia , Preescolar , Estudios de Cohortes , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Oportunidad Relativa , Fenilcetonurias/sangreRESUMEN
PURPOSE: Patients with end stage renal failure (ESRD) report low quality of life and inflammation may be one of the contributing factors. We studied if the hemodialysis induced inflammation correlates with the patients quality of life. METHODS: Study was performed in 76 (35 males and 41 females) ESRD patients treated with hemodialysis. Effect of one dialysis session on blood concentration of Vascular Endothelial Growth Factor (VEGF), Hepatocyte Growth Factor (HGF), Interleukin 6 (IL6) and Monocyte Chemoattractant Protein-1 (MCP-1) was studied. Results were correlated with answers given by patients to a short questionnaire composed of questions from Kidney Disease Quality of Life Short Form (KDQoL-SF) questionnaire. RESULTS: Hemodialysis induced increase of serum level of HGF (+117%) and IL-6 (+17%). Declared by patients health status correlated with their age, GFR, kt/V and hemodialysis induced change in serum IL6 and HGF level (R(2) = 0469, P < 0.001). Physical activity correlated with age, serum IL-6 and hemodialysis induced change in serum HGF and VEGF (R(2) = 0.362, P < 0.001). Presence of social/mental problems during previous 4 weeks correlated with age, serum HGF and hemodialysis induced changes in serum HGF and VEGF levels (R(2) = 0.333, P < 0.001). Interference of the kidney disease with daily life activities correlated with age, serum VEGF and hemodialysis induced change in serum HGF and IL6 levels (R(2) = 0.422, P < 0.001). CONCLUSION: Inflammation correlates with reduced quality of life in ESRD. Low hemodialysis-induced release of the anti-inflammatory cytokine HGF correlates with impaired quality of life in that group of patients.
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Factor de Crecimiento de Hepatocito/sangre , Inflamación/sangre , Inflamación/etiología , Calidad de Vida , Diálisis Renal/efectos adversos , Adulto , Anciano , Ensayo de Inmunoadsorción Enzimática , Femenino , Humanos , Interleucina-6/sangre , Fallo Renal Crónico/sangre , Fallo Renal Crónico/terapia , Masculino , Persona de Mediana Edad , Encuestas y Cuestionarios , Factor A de Crecimiento Endotelial Vascular/sangreRESUMEN
INTRODUCTION AND OBJECTIVES: Human's life as well as medical professions consist of many moral dilemmas. The aim of our study was to evaluate moral competences of midwifery students during their whole university education (3 year course) based on their moral competences C-index. MATERIAL AND METHOD: We performed randomized single blinded 3-year follow-up trial of 72 midwifery students. Standard Moral Judgment Test (MJT) By Georg Lind was used accompanied by own questionnaire. Moral competences were calculated (C-index) according to Lind's methodology. Subjects were also divided into active and passive ethics training to search for differences. RESULTS: C-index varied during studies insignificant (p=0.14). Randomized groups were equal at the beginning point, no significant differences were noticed. Active ethics teaching did not increase C-index compared to controls in all measuring points (P1-P4, respectively p=0,41 and p=0,38). CONCLUSIONS: During 3 year studies at medical university moral competences measured by C-index varied insignificantly, but simultaneously the change in C-index was dependent on its value at the beginning of the trial. There was not statistically significant influence of active ethic's teaching compared to controls. Among social factors parents have strongest influence on students' morality, but growing role of Medical University in this hierarchy raises hopes for improvement in effectiveness of training in ethics.
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Ética Médica/educación , Partería/educación , Principios Morales , Estudiantes de Medicina/psicología , Femenino , Estudios de Seguimiento , Humanos , Juicio , Método Simple Ciego , Encuestas y Cuestionarios , Adulto JovenRESUMEN
The work presents the ideas and assumptions of eugenics, a social philosophy established in 1883 by Francis Galton, which affected the social policies of numerous European countries in the first half of the 20th century. The work shows the effect of eugenics on the literary standards of European prose in the previous century. Two outstanding dystopian novels of the 20th century, The Brave New World by Aldous Huxley and 1984 by George Orwell, situate eugenics as a permanent element of the literary plot of dystopia. Apart from the typical features of this type of novel, for example: personal narration with a trace of irony, a totalitarian state and Newspeak, eugenics is an important element of the literary plot with is aim to exclude and marginalise certain social groups. Eugenics is also one of the main social ideas criticised by both the writers.