Association between cyberchondria and the use of complementary and alternative medicine (CAM) - a cross-sectional study.

INTRODUCTION AND OBJECTIVE: Cyberchondria has been described relatively recently as a behaviour characterized by excessive Internet searching for medical information related to increasing levels of health anxiety. Complementary and alternative medicine (CAM) refers to a broad set of health care practices that are not part of a country's traditional or conventional medicine, and are not fully integrated into the dominant health care system The aim of this study is to evaluate the relationship between cyberchondria and the use of complementary and alternative medicine. MATERIAL AND METHODS: A cross-sectional study was conducted from 25 April - 25 December 2022. A computer-assisted web interviewing (CAWI) survey technique was used. The study population consisted of 626 respondents who took part in the study. RESULTS: The severity of cyberchondria is associated with 'a greater number of CAM products used' (beta = 0.101; p = 0.043), 'a greater number of self-help techniques used' (beta = 0.210; p<0.001), searching for knowledge about CAM on the Internet (beta-0.199; p<0.001), using sources other than books (beta = -0.114; p = 0.025), younger age (beta = -0.170; p<0.001) and worse education (beta = -0.101; p = 0.033). CONCLUSIONS: The research results indicate that there is a link between cyberchondria and the use of CAM. However, since some components of the CSS-PL scale and self-rated health were not associated with more frequent use of CAM, it is likely that these results may not be fully reliable. The association between cyberchondria and CAM use should be investigated in further studies using comprehensive medical interviews.

Links between COVID-19 and Alzheimer's Disease-What Do We Already Know?

Alzheimer's disease (AD) is a life-changing condition whose etiology is explained by several hypotheses. Recently, a new virus contributed to the evidence of viral involvement in AD: the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes the COVID-19 coronavirus disease. AD was found to be one of the most common COVID-19 comorbidities, and it was found to increase mortality from this disease as well. Moreover, AD patients were observed to present with the distinct clinical features of COVID-19, with delirium being prevalent in this group. The SARS-CoV-2 virus enters host cells through the angiotensin-converting enzyme 2 (ACE2) receptor. ACE2 is overexpressed in brains with AD, which thus increases the viral invasion. Furthermore, the inhibition of the ACE2 receptor by the SARS-CoV-2 virus may also decrease the brain-derived neurotrophic factor (BDNF), contributing to neurodegeneration. The ApoE ε4 allele, which increases the risk of AD, was found to facilitate the SARS-CoV-2 entry into cells. Furthermore, the neuroinflammation and oxidative stress existing in AD patients enhance the inflammatory response associated with COVID-19. Moreover, pandemic and associated social distancing measures negatively affected the mental health, cognitive function, and neuro-psychiatric symptoms of AD patients. This review comprehensively covers the links between COVID-19 and Alzheimer's disease, including clinical presentation, molecular mechanisms, and the effects of social distancing.

Endothelial Progenitor Cells in Neurovascular Disorders-A Comprehensive Overview of the Current State of Knowledge.

Endothelial progenitor cells (EPCs) are a population of cells that circulate in the blood looking for areas of endothelial or vascular injury in order to repair them. Endothelial dysfunction is an important component of disorders with neurovascular involvement. Thus, the subject of involvement of EPCs in such conditions has been gaining increasing scientific interest in recent years. Overall, decreased levels of EPCs are associated with worse disease outcome. Moreover, their functionalities appear to decline with severity of disease. These findings inspired the application of EPCs as therapeutic targets and agents. So far, EPCs appear safe and promising based on the results of pre-clinical studies conducted on their use in the treatment of Alzheimer's disease and ischemic stroke. In the case of the latter, human clinical trials have recently started to be performed in this subject and provided optimistic results thus far. Whereas in the case of migraine, existing findings pave the way for testing EPCs in in vitro studies. This review aims to thoroughly summarize current knowledge on the role EPCs in four disorders with neurovascular involvement, which are Alzheimer's disease, cerebral small vessel disease, ischemic stroke and migraine, with a particular focus on the potential practical use of these cells as a treatment remedy.

Use of complementary and alternative medicine in patients with cancer and their relationship with health behaviours - Cross-sectional study.

INTRODUCTION AND OBJECTIVE: Although the use of complementary and alternative medicine (CAM) is common with Polish cancer patients, little is known about cancer patients' methods of using CAM and how it correlates with their health behaviour. The aim of the study was to determine the scope of application of complementary and alternative medicine methods among patients treated by oncology and to compare the health behaviours of patients who use alternative medicine with those who do not use these methods. MATERIAL AND METHODS: The studies were conducted from August 2019 - January 2020 in an Oncology Centre in south-eastern Poland. A cross-sectional study was conducted in a group of 208 oncological patients. The authors' own questionnaire and the standardized Health Behaviour Inventory were used. RESULTS: Most of the patients (85.09%) declared that they used complementary and alternative medicine methods. 45.19% of the respondents had a high rate of health behaviours. It was observed that there was no communication related to the use of CAM among the patients and healthcare staff. Patients using CAM demonstrated more positive health behaviours than those who were not using these methods (p<0.001). CONCLUSIONS: The majority of the surveyed patients suffering from cancer used complementary and alternative medicine and declared that it was very or slightly effective in strengthening the immune system and helpful in fighting cancer. The patients who used CAM exhibited a higher level of health behaviours than those who did not use these methods.

The Relationship Between the Metabolic Syndrome and the Place of Residence in the Local Community on the Example of the Janów Lubelski District in Eastern Poland: A Population-Based Study.

PURPOSE: The aim of this study was to estimate the incidence concerning metabolic syndrome (MetS) in a local community with a low socioeconomic status and a medium and high cardiovascular risk on the example of residents of Janów Lubelski district, eastern Poland. The second goal of the research was to analyze the relationship between residence and the occurrence of MetS. METHODS: We conducted a cross-sectional study of 4040 people living in eastern Poland. A group of 3046 people with medium and high cardiovascular risk was selected among the respondents and included in further analyzes. The research adopted the definition criteria proposed by the National Cholesterol Education Program - Third Adult Treatment Panel (NCEP ATP III) to implement diagnostic evaluation of MetS. RESULTS: It was observed that metabolic syndrome was significantly more frequent among the inhabitants of rural areas (40.56%; n=810) compared to those living in the city (35.27%; n=370) p=0.005. Among the inhabitants of rural areas, the percentage of people with elevated glucose levels was significantly higher, fasting blood glucose (FGB) p<0.001, elevated blood pressure (HBP) p<0.001, elevated serum triglycerides (TGs) p=0.01, and abnormal waist circumference (WC) p=0.003 compared to urban inhabitants. After adjusting for potential confounding variables (age, education, smoking, marital status, and level of physical activity), in both women and men, the odds of developing metabolic syndrome were approximately 30% higher in rural areas compared to urban residents (women: odds ratio (OR)=1.25, 95% confidence intervals (CI)=1.01-1.56; men: OR=1.30, 95% CI=1.01-1.67). CONCLUSION AND RECOMMENDATIONS: A higher incidence of metabolic syndrome was observed among respondents living in rural areas than those living in cities. Similarly, across the gender strata, metabolic syndrome is more commonly diagnosed among men and women living in rural areas. Healthcare workers, especially in rural areas, should engage in education, prevention, and the promotion of a healthy lifestyle.

Oxidative/Antioxidative Status in Patients after Myocardial Infarction and in Those without Cardiovascular Event Depending on Anthropometric Factors Defining Body Weight.

Obesity is one of the factors leading to the development of atherosclerosis. This metabolic disorder is associated with an increased production of reactive oxygen species, which affect the oxidative stress levels. The aim of this study was to evaluate oxidative/antioxidative status and to investigate the correlation between redox markers and anthropometric parameters and body composition in adult patients after myocardial infarction and in individuals without a cardiovascular event in the past. Descriptive data on socio-demographic, clinical, and anthropometric features and blood samples were collected and categorized into two equal groups: after myocardial infarction (study group (SG), n = 80) and without a cardiovascular event (control group (CG), n = 80). The oxidative/antioxidative status was assessed in plasma on the basis of total oxidative/capacitive status (PerOx), total antioxidative status/capacity (ImAnOx), and oxidized low-density lipoprotein (oxLDL). The oxLDL was significantly higher in the CG group compared to the SG group (p = 0.02). No significant differences were found with regard to PerOx and ImAnOx values between the groups studied. A significant positive correlation between PerOx and percentage of adipose tissue (FM%) and body adiposity index (BAI) was found in the two studied groups. ImAnOx significantly positively correlated with visceral adiposity indexes(VAIs) in SG and FM% in CG. OxLDL negatively correlated with body mass index and waist to hip circumference ratio in CG. The total oxidative/antioxidative status is related to the amount of adipose tissue and the BAIs of the subjects. It was observed that it correlates more frequently with the visceral distribution of body fat.

Level of vitamin 25 (OH) D and B group vitamins and functional efficiency among the chronically ill elderly in domiciliary care - a pilot study.

INTRODUCTION AND OBJECTIVE: Deficits of vitamin resources constitute a significant public health problem, especially among the elderly population. The aim of the research was to determine the level of vitamin 25 (OH) D and vitamins from group B in the chronically ill elderly in domiciliary care, depending on functional capacity and coexisting diseases. MATERIAL AND METHODS: The pilot study included 137 patients staying in long-term domiciliary care. Samples of the participants' venous blood was obtained for laboratory tests. Centrifuged serum was used to determine the level of the following biochemical parameters: vitamin 25 (OH)D, B12, folic acid and total protein, albumin, triglycerides, total cholesterol and HDL cholesterol. Assessment of the functional status of patients was made by using the Barthel scale. RESULTS: More than ¾ of the patients with functional deficit (according to Barthel's score 0-85 points) were deficient in vitamin 25 (OH)D, while folic acid values were below the reference values in more than half of the patients. Respondents with lower functional efficiency were characterised by a reduced average value of vitamin 25 (OH)D and folic acid. CONCLUSIONS: The studied group of the chronically ill elderly was characterised by a deficiency of vitamin D3 and folic acid. Subjects with a functional impairment deficit show a reduced mean value of vitamin 25 (OH)D and folic acid in the blood serum, compared to the group of patients with higher mobility.

Analysis of Health Behaviors and Personal Values of Childless Women, Pregnant Women and Women Who Recently Delivered.

Preconception lifestyle modifications and reduction of several known risk factors may have an influence on future pregnancy outcomes. The aim of the study was to analyze health behaviors and personal values as well as to assess the relationship between these factors in women without children, in pregnant women and in women who had already delivered babies. The questionnaire survey included the Health Behavior Inventory (HBI), the Personal Value List (PVL) and sociodemographic data and was conducted in 538 women. These women were divided into three groups: women who had recently delivered (n = 235), pregnant women (n = 121) and childless women (n = 182). Pregnant women demonstrated a significantly higher level of declared health behaviors, and also, they rated higher on the subscales values "positive mental attitude" and "health practices", in comparison to women who had recently delivered and to childless women. In all tested groups, the highest rated personal value was "a successful family life", while the most appreciated symbol of happiness was "love and friendship". Our results suggest that the system of values and the perception of happiness symbols may influence women's health behaviors. Positioning "health" in the hierarchy of personal values as the most important one may facilitate the introduction of healthy behaviors. This, in turn, could reduce several adverse pregnancy outcomes that are potentially modifiable with changing preconception health attitudes. Our results also identify several unanswered questions and highlight areas where new research is needed.

Nursing Activities in the Prevention and Treatment of Perioperative Complications After Airway Foreign Body Removal in Pediatric Patients.

PURPOSE: 1) To evaluate postanesthesia complications after bronchoscopy performed for a suspected foreign body (FB) in the pediatric population and 2) To propose an algorithm of nursing activities for management of this problem. DESIGN: A retrospective descriptive design was used. METHODS: A chart review of 155 children who underwent rigid bronchoscopy for FB removal was conducted. FINDING: Complications occurred in 78% of children: 43% of them experienced desaturation below 90% requiring oxygen therapy. Therapy ranged from oxygen administration via blow-by nasal cannula or face mask (89%) to positive pressure ventilation via bag-mask (23%). Seven percent of the population required intubation and admission to intensive care unit (all were less than 2 years of age). CONCLUSIONS: Our results suggest special attention to the children less than 2 years of age as serious respiratory failure may occur after FB removal. The algorithm for nurses was created to manage children after bronchoscopy.

Are there any differences in medical emergency team interventions between rural and urban areas? A single-centre cohort study.

OBJECTIVE: To compare interventions of medical emergency teams in urban and rural areas with particular emphasis on response time and on-site medical rescue activities. DESIGN: A retrospective analysis of ambulance call reports from two emergency medical service substations: one in the city and the other in a rural area. SETTING: Two emergency medical service substations: one in the city and the other in a rural area. PARTICIPANTS: Medical emergency teams. RESULTS: Interventions in the city were associated with a substantially shorter response time in comparison to rural areas. In the city, the distances were generally less than 10 km. In the rural area, however, such short distances accounted for only 7.2% of events, while 33.8% were over 30 km. Medical emergency teams more often acted exclusively on-site or ceased any interventions in rural areas. Compared with the city, actions in the rural setting were associated with significantly increased use of cervical collars and decreased use of intravenous access. The presence of a physician in the team raised the probability of pharmacotherapy. CONCLUSION: The relationship between medical emergency teams activities and the location of intervention shows the real diversity of the functioning of emergency medical service within a city and rural areas. Further research should aim to improve the generalisability of these findings.

A comparison of ambulance responses to incidents of Medical Emergency Teams led by nurses and paramedics--A retrospective single-center study.

BACKGROUND: In Poland there are currently two main types of Medical Emergency Team: basic, run by nurses or paramedics, and specialist, led by physicians. They differ not only in professional qualifications but also in their terms of reference. OBJECTIVES: We compared the responses to incidents of Medical Emergency Teams led by nurses and paramedics, in terms of the frequency of pharmacotherapy use and medical rescue activities. STUDY DESIGN: Ambulance call reports. SETTINGS: Medical Emergency Teams in Eastern Poland. PARTICIPANTS: Medical Emergency Teams led by nurses or paramedics. Exclusion criteria were cancelation of calls by the dispatcher, calls with no patient on the scene, and neonatal and interhospital transportation. METHODS: A retrospective analysis of ambulance call reports. A comparison of actions of nurses and paramedics taken in the field, and decisions concerning transportation of the patient to a hospital or leaving the home were collected. RESULTS: Of 1115 Medical Emergency Teams calls, those led by paramedics (60.5%) were more common. Paramedics, more often than nurses, provided aid solely in the field-27.5% and 16.0%, respectively-and less frequently transported patients to the hospital-38.5% and 50.7%, respectively. Significant differences in administration of oxygen therapy and analgesics were identified; paramedics used them more often than nurses. Paramedics used cervical collars, 3.6% and 1.1% (p=0.01), respectively, and performed 12-lead electrocardiograms, 4.7% and 1.4% (p=0.002), respectively, significantly more frequently than did nurses. CONCLUSIONS: Despite the comparable competency of paramedics and emergency nurses in Poland, Medical Emergency Teams' activities varied depending on whether a nurse or a paramedic was the team leader. It is recommended that further in-depth research is conducted in this area.

Esophageal foreign bodies in pediatric patients: a thirteen-year retrospective study.

We discuss clinical symptoms and radiological findings of variable esophageal foreign bodies as well as therapeutic procedures in Caucasian pediatric patients. A retrospective study of 192 cases of suspected esophageal foreign bodies between 1998 and 2010 was conducted. Data were statistically analyzed by chi-square test. A foreign body was removed from a digestive tract of 163 children aged 6 months to 15 years (mean age 4.9). Most objects were located within cricopharyngeal sphincter. Dysphagia occurred in 43%, followed by vomiting (29%) and drooling (28%). The most common objects were coins. Plain chest X-rays demonstrated aberrations in 132 cases, and in doubtful situations an esophagram test was ordered. In the group of thirty-seven patients whose radiograms were normal, esophagoscopy revealed fifteen more objects, which were eventually successfully removed. No major complications occurred. Esophagram should be a second X-ray examination if an object is not detected in plain chest X-ray. We recommend a rigid esophagoscopy under general anesthesia in doubtful cases as a safe treatment for pediatric patients.

[The ethics of resuscitation]. / Eytka resuscytacji.

Resuscitation should always be attempted in a patient who has at least a theoretical chance of survival. This assumes that there are patent cerebral, coronary and pulmonary vessels, a reasonable time from cardiac arrest has not been exceeded, and cardiac arrest did not occur as a result of a terminal condition caused by an untreatable disease. During resuscitation, medical personnel may face two dilemmas: when to start CPR, and when (and how) to stop it. Apart from various medical conditions, possible outcome and will of a victim has to be taken into consideration. CPR is frequently started without an adequate knowledge of the patient's medical status. As soon as the latter is obtained, a decision about continuing CPR should be reconsidered. CPR and/or life-prolonging treatment can be stopped in several situations, i.e. lack of cardiovascular response or recognition of a life-limiting condition. The decision should be made by a team leader, acting in accordance with national or house guidelines. In terminal patients, a DNR order should be issued well in advance, usually by an attending physician. After that, the patient should be provided with palliative care, consisting of pain therapy, and treatment of dyspnoea, congestive cardiac failure, etc. In their review, the authors discuss various medical and ethical aspects of resuscitation, concluding that hospital ethics committees could be of great value in solving complicated questions relating to limitation of resuscitation and life-prolonging treatment.

Analysis of health-promoting behaviours of 14-year-olds of selected schools of Lublin.

The health of an individual and of the community depends on many interrelated factors, including health behaviours which are one of the most important of these factors. The aim of the paper was to analyze the selected pro-health behaviours of 14-year old students. The research was carried out by means of a self-made questionnaire. The survey was conducted in the city of Lublin among 250 students of Lublin schools selected at random. The results of the survey were the basis for the following conclusions: self-evaluation of health and physical activity is perceived as good or very good; analysis of pro-health behaviours revealed insufficient knowledge among the majority of students; proper pro-health education and health promotion plays an essential role in changing such negative behaviours.

The type of relationship in marriages of patients with neurosis disorders.

Conjugal relationships are an integral part of spouses' bonds. The only pattern of relationships in the marriages of patients with neurosis disorders was a type based on a dependence mechanism, i.e. subordinating one partner to another, whereas in the control group the pattern is based on a sense of mutual confidence, self-control, and the need to understand oneself and other people as well.

The valuation of satisfaction from the conjugal life of patients with neurosis.

The experience of emotional bonds created by spouses through mutual relationship is significant for reaching the state of satisfaction and fulfilling personal needs. Neurosis disorders of one spouse have a significant influence on conjugal situation in many aspects, such as: the level of satisfaction from marriage and social contacts of a family.

Psychosocial functioning of the people with delusional disorders under forensic psychiatric observation in the ward of forensic psychiatry in 1998-2002.

In the literature on the subject frequency and kind of deeds committed by people with mental illness in relation to individual clinical diagnoses are analyzed mainly, whereas little attention is paid to the issue of their psychosocial functioning. Intellectual functioning of the people manifesting delusional disorders in the course of committing attributed deeds, was on an average level. The patients' social functioning was on a low level.

Frequency of self-monitoring and its effect on metabolic control in patients with type 2 diabetes.

The aim of the study was to investigate the frequency of self-monitoring of blood glucose in patients with type 2 diabetes and to determine its effect on metabolic control measured as glycosylated hemoglobin level. The study involved 218 patients with type 2 diabetes (68.8% of females and 31.19% of males) who reported to the Outpatient Department for Diabetes at the Institute of Agricultural Medicine in Lublin. All patients were asked to complete a questionnaire form containing questions concerning, among other things, demographic data, course of diabetes, method of treatment, ability to adjust insulin doses and frequency of self-monitoring of blood glucose level. The levels of glycosylated emoglobin were obtained based on medical records. The analysis of the data showed that 59.22% of patients tested their blood glucose levels at home > or = 1/day, 21.36% of them tested their blood glucose > or = 1/week, whereas 8.74% of patients tested glucose < or = 1/week. 10.68% of patients stated that they never racticed SMBG. Statistical differences were observed in the level of education. Among the group of patients who exercised self-monitoring the most dominant were those with secondary school or university level of education (60.66%), while among patients who did not maintain self-monitoring the greatest number had only elementary or vocational education (72.73) (p = 0.01). The greatest number of patients who most often maintained self-monitoring were office workers (52.46%), whereas among those who did not exercise self-monitoring, those employed in agriculture dominated (45.45%) (p < 0.01). Urban inhabitants exercised self-monitoring more frequently than urban inhabitants (p < 0.01). The frequency of self-monitoring did not affect glycemia control. Urban inhabitants with secondary school or university education level and those who perform office work are more keen on frequent home monitoring of glycemia. In patients with type 2 diabetes the intensity of self-monitoring does not exert any effect on diabetes control evaluated by means of glycosylated hemoglobin level.