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1.
J Clin Med ; 13(2)2024 Jan 19.
Artigo em Inglês | MEDLINE | ID: mdl-38276078

RESUMO

Alcohol addiction is characterized by extensive alcohol consumption that dominates other behaviours previously important to a patient. According to data from The State Agency for Prevention of Alcohol-Related Problems, up to 900,000 people in Poland are addicted to alcohol. On average, approximately 9.7 L of pure alcohol per capita was consumed in 2021. Alcohol addiction may cause severe health problems and is one the key risk factors for various diseases. Stress plays an important role in the process of alcohol addiction and is also a predictor for lower enjoyment in life. On the other hand, sense of coherence may be a stronger protective factor. The aim of our study was to verify the relation between the level of perceived stress among patients with alcohol addiction and satisfaction with life. Because sense of coherence is a disposition that allows for managing stress effectively, the latter should be reflected in the results of multivariate analyses that take both the level of stress and sense of coherence into account. In the present study, sense of coherence and perceived stress were negatively correlated; therefore, strengthening internal resources for managing difficult and stressful situations is recommended.

2.
J Clin Med ; 12(15)2023 Jul 28.
Artigo em Inglês | MEDLINE | ID: mdl-37568360

RESUMO

Alcohol consumption is linked to over 200 diseases and injuries. It is also classified as a risk factor for several types of neoplasms as well as infectious diseases (i.e., HIV and tuberculosis). In 2019, among people aged 25 to 49, alcohol use was the leading risk factor for attributable burden of disease. There are many factors that affect alcohol drinking patterns such as social and economic status, social norms, cultural customs, availability of alcohol, etc. Stress also plays a significant role in the process of developing alcohol addiction. The aim of our study was to examine health patterns and stress levels among patients undergoing alcohol addiction treatment. The study sample consisted of 104 patients who were treated in a hospital ward due to alcohol dependence. Three standardized questionnaire tools were used to measure the sense of coherence and the level of stress among those patients. The main results suggest that the level of perceived stress correlated negatively with all dimensions of sense of coherence and all indicators of health behaviors, however, age was positively correlated with positive mental attitude, proper eating habits, and health behaviors. In conclusion, it is worth noting that developing patterns for positive health behaviors will make it possible to avoid alcohol dependence or reinforce the treatment results if alcohol dependence syndrome occurs.

3.
J Clin Med ; 12(14)2023 Jul 19.
Artigo em Inglês | MEDLINE | ID: mdl-37510882

RESUMO

(1) Background: Acceptance of illness is a process in which a person with an illness accepts its presence and treats it as an integral part of their life. With regard to alcoholism, acceptance of illness is one of the important elements of the healing process. (2) Methods: The study group consisted of 104 residents in an addiction treatment ward. Questionnaires SOC-29, AIS and PSS-10 were used to check levels of coherence, stress and acceptance of illness. The analysis was based on regression analysis. Patient age was analysed as a moderator of correlations between perceived indicators. Moderation analysis was based on the simple moderation model. (3) Results: The level of perceived stress correlated negatively with all areas of the sense of coherence and with acceptance of illness. All areas of the sense of coherence correlated with acceptance of illness positively. (4) Conclusions: The acceptance of illness by the patient is a factor that can be motivating for further treatment, through a positive approach to illness and strengthening the sense of control in experiencing it. The combination of strengthening behavioural, cognitive and motivational resources can be used in the treatment of people experiencing the challenges of addiction to alcohol.

4.
Artigo em Inglês | MEDLINE | ID: mdl-36078499

RESUMO

The financial burden of adverse healthcare outcomes in Poland still remains unknown. The objective of the study was to estimate the cost of adverse healthcare outcomes in the Polish healthcare system. Cost calculation was performed on the basis of civil cases completed in Polish courts against doctors and healthcare entities. The research material consisted of 183 civil cases completed by a final judgment in 2011-2013. The case study was conducted in five out of forty-five district courts across the country. Out of 183 reviewed cases, 73 complaints ended up with favorable judgments (39.9%). The average value of the subject matter of the dispute was USD 78,675. The total expected value of lawsuits in the 183 reviewed cases was USD 11,299,020. The total amount awarded in 73 judgments from medical facilities to injured patients was USD 2,653,595, which on average means USD 36,351 per case. The average amount of awarded compensation was USD 33,317 per case. The average compensation amount in the analyzed cases was USD 11,724. The average one-time annuity for a patient was USD 11,788. The estimated costs of negative healthcare outcomes amounted to USD 8,000,000 per year.


Assuntos
Atenção à Saúde , Instalações de Saúde , Humanos , Polônia
5.
Artigo em Inglês | MEDLINE | ID: mdl-35886502

RESUMO

INTRODUCTION: Alcohol dependence is one of the world's major health challenges. The salutogenic concept of health developed by Antonovsky focuses on the search for resources and factors supporting health. Its basic concept of the sense of coherence (SOC) focuses on strengthening the global orientation of the patient, and creating permanent internal resources that translate into the improvement of pro-health behavior, including the fight against alcoholism. OBJECTIVE: The objective of this study was to determine the correlation between individual factors and the SOC as well as the influence of the SOC concept on pro-health behavior of people addicted to alcohol. MATERIALS AND METHODS: The study group consisted of 110 men undergoing treatment in an addiction treatment ward. To check the level of the SOC, two standardized questionnaires, Antonovsky's "SOC-29 Life Orientation Questionnaire" and Juczynski's "Health Behaviour Inventory", were used. The correlation coefficient between the sociodemographic variables was checked using the Pearson's r test. RESULTS: A positive correlation was found with the intensity of pro-health behaviors for three sociodemographic variables. In people aged 43-65 (r = 0.299; p = 0.030), people with primary/vocational education (r = 0.276; p = 0.015), and respondents living in rural areas (r = 0.303; p = 0.028) a greater SOC was associated with pro-health behaviors. CONCLUSIONS: Individuals addicted to alcohol are characterized by a low SOC and a low level of pro-health behaviors. Strengthening the internal level of the SOC can constitute an element of addiction therapy when introducing health education to prepare the patient for independent life in sobriety.


Assuntos
Alcoolismo , Senso de Coerência , Comportamentos Relacionados com a Saúde , Humanos , Masculino , Inquéritos e Questionários
6.
Ann Agric Environ Med ; 29(2): 269-273, 2022 Jun 24.
Artigo em Inglês | MEDLINE | ID: mdl-35767762

RESUMO

INTRODUCTION AND OBJECTIVE: Cancer triggers many negative emotions in patients which affect the quality of life and low acceptance of the illness. The level of acceptance of illness is related to the level of pain and the degree of compliance with medical recommendations. The aim of the study is evaluation of the use of the Acceptance of Illness Scale (AIS) among people with cancer. MATERIAL AND METHODS: The study involved 1,187 patients (666 women aged 21-96 (M=58.17; SD=12.88) and 521 men aged 22-96 (M=67.12; SD=13.75) diagnosed with malignant cancer under outpatient care of the Maria Sklodowska-Curie Institute - Oncology Center in Warsaw. An acceptance of illness questionnaire developed by B. J. Felton, T. A. Revensson and G. A. Hinrichsen was used. RESULTS: Socio-economic (education, place of residence, income, professional status) and medical (occurrence of metastases, type of treatment used) factors affect the level of acceptance of illness by patients. Stent standards were developed to determine the level of acceptance of illness in the low-average-high categories. CONCLUSIONS: The Acceptance of Illness Scale (AIS) should be used in the case of cancer patients. Assessment of the patient's acceptance of illness, as well as the factors affecting acceptance, will allow for the planning of appropriate treatment and psychotherapeutic support for specific patients, whose level of acceptance of illnes is the lowest.


Assuntos
Neoplasias , Qualidade de Vida , Feminino , Humanos , Masculino , Neoplasias/terapia , Dor/psicologia , Manejo da Dor , Inquéritos e Questionários
7.
Med Sci Monit ; 28: e936547, 2022 May 27.
Artigo em Inglês | MEDLINE | ID: mdl-35619331

RESUMO

BACKGROUND During the current Coronavirus Disease 2019 (COVID-19) pandemic, falls have been identified as a potential presenting symptom in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection; however, data on factors increasing fall risk in this patient population are limited. This study aimed to examine the factors that may predispose hospitalized COVID-19 disease patients to falls. MATERIAL AND METHODS In this retrospective observational study, hospitalized COVID-19 disease patients were examined for fall incidence, as well as demographics, comorbidities, and clinical and laboratory data. Patients were stratified according to their fall status and their characteristics were compared using Fisher's exact test or Mann-Whitney U test. A total of 312 hospitalized COVID-19 disease patients were enrolled (median age, 75 years; males, 51.3%), of whom 11 (3.5%) fell. RESULTS There was a greater prevalence of falls among patients who experienced arrhythmias than those that did not (28.6% vs 1.7%; P<0.001). Additionally, a significantly greater proportion of those that were discharged to the internal ward and to the intensive care unit fell (10.3% and 10.0%, respectively) compared to those that were discharged home (1.6%, P=0.008). Thyroid-stimulating hormone (TSH) was significantly elevated in patients who fell (5.3 vs 0.97 µIU/mL, P=0.013), while alanine aminotransferase (ALT) was significantly lower in those who fell (17.1 vs 33.5 IU/L, P=0.041). CONCLUSIONS Arrhythmias may be an important predisposing factor for falls in COVID-19 disease patients and fall prevention programs should prioritize interventions directed at this vulnerable patient population.


Assuntos
Acidentes por Quedas , COVID-19 , Acidentes por Quedas/prevenção & controle , Idoso , Hospitalização , Humanos , Masculino , Estudos Retrospectivos , SARS-CoV-2
8.
Disaster Med Public Health Prep ; 17: e139, 2022 03 04.
Artigo em Inglês | MEDLINE | ID: mdl-35241209

RESUMO

The manifestation of a new pathogen, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), constitutes a new problem for modern health care systems. Developing updated standards for all emergency services working at an accident site during the pandemic has been a continuous challenge. The principal method of preventing the transmission of the SARS-CoV-2 virus is the use of personal protective equipment, such as protective suits, masks and goggles, or face shields. The study aims to present the recommended on-site procedures during the coronavirus pandemic based on the description of an accident of an ambulance transporting a patient with confirmed SARS-CoV-2 infection, emphasizing the actions taken by the emergency services sent to the accident site.


Assuntos
COVID-19 , SARS-CoV-2 , Humanos , Ambulâncias , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Equipamento de Proteção Individual , Acidentes
9.
Artigo em Inglês | MEDLINE | ID: mdl-34831905

RESUMO

BACKGROUND: Breast, ovarian, and endometrial cancer are among the most common causes of morbidity and mortality of women in Poland. In 2016, breast cancer was the most common cause of morbidity and the second leading cause of cancer deaths in women, endometrial cancer was the third most common cause of morbidity and the seventh leading cause of death, and ovarian cancer was the fifth most common cause of morbidity and the fourth leading cause of cancer deaths in women. The aim of the study was to assess the strategy of pain control, acceptance of the cancer and adjustment to life with disease in women with ovarian cancer, endometrial and breast cancer. This study shows how level of pain control, acceptance, and adjustment can differ among patients with the three kinds of cancer and which factors have the most influence on patients' adjustment to the disease. METHODS: The study was carried out with 481 patients diagnosed with ovarian cancer, endometrial and breast cancer. In the study BPCQ, CSQ, AIS and Mini-MAC questionnaires were used. RESULTS: In the BPCQ questionnaire the highest result was acquired in the scope of the impact of doctors (M = 16.45, SD = 4.30), differentiated by cancer location and socio-economic variables. In the CSQ test, the highest result was achieved by praying/hoping, differentiated by cancer location and socio-economic variables. The average AIS acceptance score was M = 27.48 (SD = 7.68). The highest result of the Mini-Mac scale was obtained by patients in the area of fighting spirit (M = 22.94, SD = 3.62), and these results depended on socio-economic and treatment-related variables but were not differentiated by cancer location. CONCLUSIONS: Patients attribute the highest importance in the disease to the influence of physicians, praying/hoping, and fighting spirit. The awareness of the pain management strategies of patients with cancer allows appropriate psychological support to be designed for specific groups of patients.


Assuntos
Neoplasias da Mama , Neoplasias do Endométrio , Neoplasias Ovarianas , Adaptação Psicológica , Neoplasias da Mama/epidemiologia , Neoplasias do Endométrio/epidemiologia , Feminino , Humanos , Dor , Manejo da Dor , Polônia/epidemiologia , Inquéritos e Questionários
10.
Ann Agric Environ Med ; 28(3): 391-396, 2021 Sep 16.
Artigo em Inglês | MEDLINE | ID: mdl-34558259

RESUMO

INTRODUCTION: Although falls occur extremely frequently, they are still one of the least investigated causes of death. According to the World Health Organization, around 37.3 million falls occur globally every year resulting in the deaths of over 660,000 adults and almost 30,000 children. OBJECTIVE: The aim of this review is to evaluate the most up-to-date and comprehensive knowledge on falls and their consequences, especially in populations at the highest risk of fatal falls. BRIEF DESCRIPTION OF STATE OF KNOWLEDGE: Currently, there is a limited amount of literature which analyzes falls. Falls affect all age groups, but their location, cause, and severity vary among different populations. Individuals who are particularly at risk of falling at home include younger children and the elderly. Research indicates that falls are one of the main causes of work-related injuries and deaths, especially those occurring at significant heights. Falls in the home environment are the second most common cause of death in over 33% of accidents and the main cause of injury in 41.2% of accidents. During patient hospitalizations, falls generate additional burdens and costs on the healthcare system. CONCLUSIONS: This review elaborated on the nature of falls in different populations and analyzed the influence falls have on the healthcare system, in society, and on the economy. This knowledge is particularly important in an aging society, which will inevitably face increasing problems due to falls in the near future. As the emphasis on falls increases, leaders and lawmakers will be pushed to establish individualized prevention measures, as described in this review, for specific risk groups to effectively prevent falls and their consequences.


Assuntos
Acidentes por Quedas/economia , Acidentes por Quedas/prevenção & controle , Acidentes por Quedas/mortalidade , Acidentes por Quedas/estatística & dados numéricos , Hospitalização/economia , Humanos , Fatores Socioeconômicos
11.
Artigo em Inglês | MEDLINE | ID: mdl-34360462

RESUMO

BACKGROUND: Inpatient falls are common hospital adverse events. We aimed to determine inpatient fall rates in an urban public hospital and analyzed their characteristics across clinical departments. METHODS: The study was conducted in a 350-bed urban, multi-specialty public hospital in the 2013-2019 period. Patient data were retrieved from the hospital's standardized falls reporting system. Descriptive statistics and statistical tests: chi2 and ANOVA tests with multiple comparison tests (post-hoc analysis) were used. For fall incidence estimation a joint-point regression was applied. p-value of 0.05 was considered as statistically significant for all the calculations. RESULTS: The highest prevalence of falls was reported in the rehabilitation and internal medicine wards (1.915% and 1.181%, respectively), the lowest in the orthopedic (0.145%) and rheumatology wards (0.213%) (p < 0.001). The vast majority of falls took place in the late evening and during the night (56.711%) and were classified as bed falls (55.858%). The crude incidence rate (cIR) of falls was 6.484 per one thousand hospitalizations. In the 2013-2017 period, an increase in total cIR was observed, reaching the peak value in 2016; it was followed by a slight decline from 2017 to 2019, however, differences in changes were observed between the wards. CONCLUSION: Fall rates and trends as well as circumstances of inpatient falls varied significantly among clinical departments, probably due to differences in patient characteristics.


Assuntos
Acidentes por Quedas , Pacientes Internados , Hospitalização , Hospitais Urbanos , Humanos , Incidência , Fatores de Risco
12.
Pediatr Dev Pathol ; 24(6): 504-512, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34176349

RESUMO

BACKGROUND: Granulomatous lymphocytic interstitial lung disease (GLILD) has been increasingly recognized in children affected with primary immunodeficiencies (PIDs). In this study, we aimed to better characterize the spectrum of pediatric PIDs coexisting with GLILD including clinical and immunological predictors, thoracic imaging findings, and histopathologic features. METHODS: We respectively reviewed records of six representative cases of children, three of them affected with common variable immunodeficiency (CVID) and three with syndromic immunodeficiencies, in whom a diagnosis of GLILD was established based on clinical, radiological, and histopathologic findings. Clinical and immunological predictors for GLILD were also analyzed in the patients studied. RESULTS: All the children with GLILD had a history of autoimmune phenomena, organ-specific immunopathology, and immune dysregulation. Defective B-cell maturation and deficiency of memory B cells were found in all the children with GLILD. The radiological and histopathological features consistent with the diagnosis of GLILD, granulomatous disease, and lymphoid hyperplasia, were accompanied by chronic airway disease with bronchiectasis in children with CVID and syndromic PIDs. CONCLUSIONS: Our study shows that both CVID and syndromic PIDs may be complicated with GLILD. Further studies are required to understand the predictive value of coexisting autoimmunity and immune dysregulation in the recognition of GLILD in children with PIDs.


Assuntos
Imunodeficiência de Variável Comum , Doenças Pulmonares Intersticiais , Criança , Imunodeficiência de Variável Comum/complicações , Imunodeficiência de Variável Comum/diagnóstico , Granuloma , Humanos , Doenças Pulmonares Intersticiais/diagnóstico , Doenças Pulmonares Intersticiais/etiologia , Células B de Memória , Radiografia
13.
Postepy Kardiol Interwencyjnej ; 17(1): 39-45, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33868416

RESUMO

INTRODUCTION: Currently, invasive cardiology techniques are the preferred method of treatment for patients with ST-elevation myocardial infarction (STEMI). Improving the care of patients with STEMI is possible by minimizing the time that elapses from the onset of pain to the start of treatment. As studies indicate, early pharmacotherapy, especially with antiplatelet and anticoagulant medications, allows for their early effectiveness. AIM: To assess the influence of early administration of antiplatelet (clopidogrel) and anticoagulant medications in the pre-hospital period in patients with ST-elevated myocardial infarction on the frequency of in-hospital deaths and on the left ventricular ejection fraction evaluated at hospital discharge. MATERIAL AND METHODS: In this study, a retrospective analysis of 573 patients hospitalized due to ST-segment elevation myocardial infarction in one of Krakow's hospitals from January 2011 to December 2015 (excluding the whole of 2013) was used as a research method. RESULTS: As many as 97% of patients received pre-hospital pharmacotherapy, but only 46.0% of respondents received unfractionated heparin, and 19.2% received clopidogrel. The in-hospital mortality rate was 6.7%, but among patients prehospitally treated with clopidogrel and unfractionated heparin, the in-hospital mortality rate was 1.1%. Prehospital administration of clopidogrel significantly decreased the possibility of reduced left ventricular ejection fraction (OR = 0.27; 95% CI: 0.09-0.90). CONCLUSIONS: Among pre-hospital procedures, only administration of a second antiplatelet drug (clopidogrel) significantly decreased the risk of reduced left ventricular ejection fraction, and administration of clopidogrel or heparin, or a combination of both, significantly decreased the risk of in-hospital death in patients with STEMI.

15.
Pol Arch Intern Med ; 131(4): 369-376, 2021 04 29.
Artigo em Inglês | MEDLINE | ID: mdl-33629828

RESUMO

Falls are associated with increased morbidity and mortality, rising hospital readmission rates, decreased patient independence, and strained healthcare resources. In aged populations and individuals with multimorbidity, cardiovascular conditions may contribute towards an increased propensity to fall. The prevalence of cardiovascular conditions generally increases with age, and understanding potential fall risk factors may help to minimize the risk of falls and develop preventive interventions. Acting on even one such risk factor or introducing an appropriate intervention may reduce the overall propensity for a patient to fall. Further prevention strategies primed towards cardiovascular ailments should be elucidated and trialed.


Assuntos
Acidentes por Quedas , Doenças Cardiovasculares , Acidentes por Quedas/prevenção & controle , Idoso , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Humanos , Prevalência , Fatores de Risco
16.
Clin Respir J ; 14(12): 1201-1207, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32790902

RESUMO

INTRODUCTION: Viral respiratory tract infections are the leading cause of acute wheezing in children with a significant risk of hospital admission, risk of recurrence and subsequent asthma. Human respiratory syncytial virus (RSV) and human rhinovirus (RV) in childhood wheezing are widely studied; however, accessible PCR assays enabled diagnosis of other pathogens, including bocavirus (hBOV) and metapneumovirus (hMPV). OBJECTIVES: The aim of the study was to evaluate the prevalence of respiratory viruses in children hospitalized for acute wheezing along with demographic and clinical data. METHODS: We enrolled 101 children, n = 50 (49.5%) with wheezy bronchitis, n = 34 (33.7%) with acute bronchiolitis and n = 17 (16.8%) with exacerbation of asthma; (median age 1.41 ± 2.84 years). Multiplex real-time PCR assay was used for virus detection. RESULTS: One or more viruses were detected in 83.2% subjects: RSV in 44.6%, followed by RV (23.8%), hBOV and hMPV (both 11.9%); other viruses were less frequent (<8%). Viral coinfection was found in 38 (37.6%) of children. ANCOVA analysis revealed significantly higher total IgE concentrations in the hMPV-positive subgroup compared to RSV (34 kU/L vs 12.7 kU/L; P = .009) and RV (13.3 kU/L, P = .022). For both hMPV and hBOV an association with atopic dermatitis (AD) was observed: aOR for hMPV and AD was 5.6 (95%CI: 1.4-22.7; P = .016) and 4.7 for hBOV and AD (95%CI: 1.3-18; P = .024). CONCLUSION: Viral detection ratio in wheezy respiratory tract infections in Polish children is high (83.2%), with both hBOV and hMPV at 11.9% The results also suggest possible relationship of hBOV wheezy infection with nonspecific markers of atopy in children.


Assuntos
Bocavirus Humano , Metapneumovirus , Infecções por Parvoviridae , Infecções por Vírus Respiratório Sincicial , Infecções Respiratórias , Criança , Bocavirus Humano/genética , Humanos , Lactente , Metapneumovirus/genética , Infecções por Parvoviridae/complicações , Infecções por Parvoviridae/epidemiologia , Sons Respiratórios/etiologia , Infecções por Vírus Respiratório Sincicial/complicações , Infecções por Vírus Respiratório Sincicial/diagnóstico , Infecções por Vírus Respiratório Sincicial/epidemiologia , Infecções Respiratórias/diagnóstico , Infecções Respiratórias/epidemiologia
17.
Ann Agric Environ Med ; 27(2): 306-309, 2020 Jun 19.
Artigo em Inglês | MEDLINE | ID: mdl-32588611

RESUMO

INTRODUCTION: An adverse event is an incident induced while providing health care services or resulting from it, not related to the natural course of a given disease or health condition, which causes or is likely to cause negative consequences for the patient, including their death, a threat to life, the necessity of hospitalisation or its prolongation, permanent or considerable health detriment; or is a foetal disease, congenital defect or the result of foetal damage. OBJECTIVE: The aim of this analysis is to explore the problem of the occurrence of adverse events from the perspective of doctors and ward nurses who manage wards. MATERIAL AND METHODS: The research on the occurrence of adverse events among doctors and nurses (the management staff) was conducted with the use of a postal survey. RESULTS: It was ascertained that 86.5% of the medical personnel had taken part in an adverse event, of which 20.2% took part in an occurrence associated with pharmacotherapy, 16.2% - in an event related to diagnostics and diagnosis, or an infection - 15.7%. 14.2% of respondents were involved in an occurrence linked to a medical device malfunction, and 14.1% - in an adverse event related to an operation. CONCLUSIONS: The adverse events most often identified in the nursing professional group are occurrences associated with pharmacotherapy, and in the doctors' professional group - occurrences related to diagnostics and diagnosis. The research established that the most frequent reason for not informing patients about the occurrence of an adverse event is fear of their filing a complaint. Medical management staff show high acceptance of an adverse event reporting system as a tool for improving patient safety.


Assuntos
Atitude do Pessoal de Saúde , Erros Médicos/estatística & dados numéricos , Recursos Humanos de Enfermagem/estatística & dados numéricos , Médicos/estatística & dados numéricos , Hospitais , Polônia
18.
Med Sci Monit ; 26: e921862, 2020 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-32292180

RESUMO

BACKGROUND The aim of our study was to investigate the risk factors for falls in the rheumatoid arthritis (RA) patient population in Poland. This would be a major step towards the development of new fall prevention programs. MATERIAL AND METHODS There were 450 RA patients who met the criteria of the American College of Rheumatology who participated in this study. The average age of patient participants was 54.2 years; the average RA duration was 15.1 years. All patients filled out the study questionnaire regarding falls, medications, and diseases, and they filled out the Polish version of the Health Assessment Questionnaire (HAQ). RESULTS Of the 400 patients, 203 patients (51%) experienced falls. Out of the 268 falls experienced by study patients, 113 falls (42%) were due to an environmental cause, the remainder 155 falls were caused by health conditions. The number of falls positively correlated with HAQ scores (r=0.42, P<0.01) and the duration of RA (r=0.39, P<0.05). For individuals who had fallen 3 or more times, there was a stronger positive correlation between the number of falls and the total HAQ score (r=0.61, P<0.01). The main risk factors for falls in the study group were dizziness (odds ratio [OR]=3.42), the use of hypotensive medication (OR=2.82), foot deformities (OR=4.09), and a high HAQ score (OR=2.59). Other factors such as drug use (e.g., glucocorticoids), pain, and duration of RA were measured using a visual analogue scale, and were found not to have increased the risk for falls and fractures (P>0.05). CONCLUSIONS Knowledge about risk factors can help identify high-risk patients to help decrease their risk of falling, thus preventing fall-related injuries.


Assuntos
Acidentes por Quedas , Artrite Reumatoide , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Polônia , Fatores de Risco
19.
Ann Agric Environ Med ; 27(1): 123-128, 2020 Mar 17.
Artigo em Inglês | MEDLINE | ID: mdl-32208590

RESUMO

INTRODUCTION AND OBJECTIVE: Lymph node involvement is a strong predictor of disease recurrence and patient survival in vulvar cancer. The aim of the study was to evaluate the feasibility of sentinel lymph node (SLN) screening, the incidence of skip metastases, and lymph node lymphangiogenesis. MATERIAL AND METHODS: Fifty-five patients participated in this prospective, single centre study. A double SLN screening method was employed using radiocolloid (technetium-99 sulfur colloid) and 1.0% Isosulfan Blue. Immunohistochemistry, using a mouse monoclonal antibody against D2-40, was used to evaluate lymphatic vessel density (LVD). All calculations were performed using STATISTICA software v. 10 (StatSoft, USA, 2011); p < 0.05 was considered significant. RESULTS: Using both methods of SLN detection, 100% accuracy was achieved, and skip metastases were diagnosed in only one woman (1.82%). Peri-tumour median LVD was significantly increased compared with matched intra-tumour samples (p < 0.001), while median LVD was significantly lower in negative, compared with positive SLN, regardless of whether matched non-SLN were negative (p < 0.001) or positive (p = 0.005). Metastatic SLN exhibited significantly higher median LVD compared with matched negative non-SLN (p = 0.015), while no significant difference in median LVD was detected between positive SLN and matched positive non-SLN. However, negative SLN had a significantly higher median LVD compared with matched negative non-SLN (p = 0.012). CONCLUSIONS: SLN detection is a safe and feasible procedure in vulvar cancer. In patients without nodular involvement, SLN, compared with non-SLN, exhibited significantly higher median LVD, which may be an indication of its preparation to host metastases, and thus requires further investigation.


Assuntos
Carcinoma de Células Escamosas/diagnóstico , Linfangiogênese , Metástase Linfática/diagnóstico , Linfonodo Sentinela/patologia , Neoplasias Vulvares/diagnóstico , Idoso , Animais , Anticorpos Monoclonais Murinos , Carcinoma de Células Escamosas/patologia , Feminino , Virilha , Humanos , Imuno-Histoquímica , Camundongos , Estadiamento de Neoplasias , Estudos Prospectivos , Corantes de Rosanilina , Coloide de Enxofre Marcado com Tecnécio Tc 99m , Neoplasias Vulvares/patologia
20.
World Neurosurg ; 133: e401-e411, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31536812

RESUMO

BACKGROUND: The primitive trigeminal artery (PTA) is the most common and the largest persistent carotid-basilar anastomosis. Primitive trigeminal artery variants (PTAVs) are anastomoses between the internal carotid artery and cerebellar arteries. These vessels pose a risk of hemorrhagic or ischemic complications during neurosurgical procedures in the parasellar and intrasellar regions. The aim of this study was to determine the prevalence of both PTA and PTAVs and their clinically important anatomic features. METHODS: Major electronic databases were thoroughly searched for studies on PTA and PTAV. References in the included articles were also evaluated. Data regarding prevalence, laterality, origin, course patterns, and associated anomalies were extracted and pooled into a meta-analysis. RESULTS: A total of 39 studies (110,866 patients) were included in the meta-analysis. The total pooled prevalence estimate of PTA and PTAVs combined was 0.4% (95% confidence interval [CI], 0.3-0.5). Individually, PTA was present in 0.3% of patients and PTAV in 0.2%. Both arteries most often originated from the C4 internal carotid artery and took a course lateral to the dorsum sellae. The anterior inferior cerebellar artery type was the predominant PTAV (72.1%). Basilar artery hypoplasia was found in 42.5% of patients with a PTA. CONCLUSIONS: PTA and PTAVs are rare vessels, but they are clinically important because they can contribute to trigeminal neuralgia. Knowledge of the potential course of these arteries is essential in neuroradiology and neurosurgery, especially in minimally invasive procedures such as the endoscopic endonasal transsphenoidal approach to the pituitary gland and the percutaneous gasserian ganglion procedure.


Assuntos
Malformações Vasculares do Sistema Nervoso Central/epidemiologia , Artérias Cerebrais/anormalidades , Artéria Basilar/embriologia , Variação Biológica Individual , Artéria Carótida Interna/embriologia , Malformações Vasculares do Sistema Nervoso Central/complicações , Malformações Vasculares do Sistema Nervoso Central/patologia , Cerebelo/irrigação sanguínea , Artérias Cerebrais/embriologia , Humanos , Aneurisma Intracraniano/etiologia , Prevalência
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