Knowledge about carbon monoxide poisoning among medical and non-medical students living in Kraków - questionnaire study.

O b j e c t i v e s: Accidental exposure to non-fire related carbon monoxide (CO) in young people is largely unquantified. Our aim was to estimate the possibility of exposure to CO and the awareness of intoxication in the population of students living in Kraków, one of the largest academic cities in Poland. M e t h o d s: Anonymous questionnaires about CO poisoning were distributed among medical and non-medical students living in Kraków. R e s u l t s: 1081 questionnaires were collected - 16% of study participants knew a person who had been poisoned with carbon monoxide, 51.2% of students using a bathroom water heater believed that they had no risk of CO poisoning. Medical students gained significantly higher scores in the CO-poisoning knowledge test than non-medical ones. C o n c l u s i o n s: There is still unsatisfactory awareness of CO poisoning among non-medical students in Kraków.

Cardiological aspects of carbon monoxide poisoning.

AIM: The aim of this study was to assess cardiological manifestations of carbon monoxide (CO) poisoning. Background/introduction: Carbon monoxide intoxication is one of the most important toxicological causes of morbidity and mortality worldwide. Early clinical manifestation of CO poisoning is cardiotoxicity. MATERIALS AND METHODS: We enrolled 75 patients (34 males and 41 females, mean age 37.6 ± 17.7 y/o) hospitalized due to CO poisoning. Laboratory tests including troponin I, blood pressure measurements, HR and electrocardiograms (ECG) were collected. Pach's scale scoring and grading system was used to establish severity of poisoning. RESULTS: Grade of poisoning is positively correlated with troponin I levels and systolic blood pressure. Moreover, troponin levels are significantly correlated with exposition time, lactates and are higher in tachycardiac, hypertensive and positive ECG subpopulations. COHb levels are indicative of exposure but do not correlate with grade of poisoning. The main cause of CO poisoning were bathroom heaters - 83%, only 11% of examined intoxicated population were equipped with CO detectors. CONCLUSIONS: Complex cardiological screening covering troponin levels, ECG, blood pressure and heart rate measurements as well as complete blood count with particular attention to platelet parameters should be performed in each case where CO intoxication is suspected. More emphasis on education on CO poisoning is needed.

Assessment of stress load and its causes among dental students. / Pomiar poziomu stresu i czynników go wywolujacych wsród studentów kierunku lekarsko-dentystycznego.

OBJECTIVES: The aim of this study was thus to assess the stress level among dental students, characterizing the factors that induce it and describing which students are most susceptible. METHODS: Two international, independent and validated to polish language and environment stress questionnaires were used: the Perceived Stress Scale (PSS-10) and the Perceived Medical School Stress Instrument (PMSS). The present study received approval from the Jagiellonian University Bioethical Committee (no. 1072.6120.290.2020). RESULTS: A total of 272 students from all five years of the dental undergraduate degree at Jagiellonian University Medical College were enrolled to the study, including 197 female and 75 male respondents. The overall response rate was 85%. The PSS-10 score for all dental students was 22.14±6.65. A total of 182 (66.91%) respondents had high levels of stress. Female students had significantly higher stress levels than male students, accordingly 22,9±6,51 and 20,12±6,69. Moreover, first and fifth year students had the highest stress level. In the case of PMSS the total score for all dental students was 36.84±8.65. CONCLUSIONS: Perceived stress among Polish dental students is generally high. These findings suggest that support services should be made widely available to all dental students. Such services should be targeted to the specific needs of male and female students as well as to those in specific years of study.

Personality traits and hypertension-mediated organ damage. / Cechy osobowosci a powiklania narzadowe nadcisnienia tetniczego.

OBJECTIVES: Arterial hypertension may lead to the development of organ changes. This study compares different personality traits in hypertensive patients with and without left ventricular hypertrophy and arterial stiffness. METHODS: The study group consisted of 93 subjects (47 males and 46 females) with primary hypertension. Left ventricular mass index (LVMI) and pulse wave velocity (PWV) were evaluated and used as markers of cardiac and vascular damage. Personality traits of each patient were assessed using three psychometric tools: NEO-FFI, DS14 and EAS. RESULTS: Patients with increased PWV scored significantly lower than individuals with normal PWVin the following scales: NEO-FFI Neuroticism (18 vs. 27.5; p = 0.018), DS14 Negative affectivity (11.5 vs. 17; p = 0.035) and EAS Fear (10 vs. 13; p = 0.004). Subjects with left ventricular hypertrophy (increased LVMI values) presented lower levels of openness to experience (measured by the NEO-FFI) than persons with normal LVMI values (23 vs. 26; p = 0.027). CONCLUSIONS: These findings suggest that there are significant differences in personality traits between hypertensive patients with and without vascular and cardiac damage.

Sense of coherence and hypertensive target organ damage. / Poczucie koherencji a powiklania narzadowe nadcisnienia tetniczego.

OBJECTIVES: This study was designed to compare the level of sense of coherence in hypertensive patients with arterial stiffness or leftventricular hypertrophy and in hypertensive individuals without such health complications. METHODS: The study group consisted of 93 participants. All of them were asked to undergo the following procedures: clinical assessment, echocardiography (to diagnose hypertensive cardiac damage), pulse wave velocity measurement (to assess vascular damage) and psychological testing (to measure their level of comprehensibility, manageability, meaningfulness, and sense of coherence). RESULTS: Patients with hypertensive vascular damage (high pulse wave velocity) had higher levels of comprehensibility and sense of coherence than other hypertensive subjects. At the same time, there were no significant differences in the level of sense of coherence (and all of its dimensions) between individuals with and people without hypertensive left ventricular hypertrophy. CONCLUSIONS: The findings of this study suggest, that the sense of coherence may not be strongly associated with good somatic health. They may also contribute to the discussion about diagnostic usefulness of the SOC-29 method as a single tool. We believe that the level of sense of coherence should be taken into consideration in further studies on the development of hypertensive TOD.

Neurotic personality and pseudo-cardiac symptoms in a day hospital patients diagnosed at pretreatment between 2004 and 2014.

AIM: Assessment of associations between occurrence of pseudocardiac symptoms in patients qualified for psychotherapy, with intensity and picture of their neurotic personality disorder. MATERIAL AND METHODS: Case records of 2450 patients from years 2004-2014 were analysed in terms of associations between symptoms reported by means of symptom checklist and global neurotic symptom scores (OWK), global neurotic personality level (XKON) and elevated scores of 24 scales of KON-2006 personality inventory. Associations expressed by OR coefficients with 95% confidence intervals were estimated with logistic regression analyses. RESULTS: Presence of pseudocardiac symptoms seems to be linked to significantly higher neuroticism described both as global neurotic symptom level (OWK) as well as by global neurotic personality desintegration (XKON), and most of 24 scales of KON-2006 inventory. CONCLUSIONS: 1. Personality background examined with the use of KON-2006 seems to be an important risk factors of pseudo-cardiac symptoms being part of or accompanying neurotic syndromes. 2. In women especially strong appeared associations of tachycardia and Sense of being in danger, Exaltation, Asthenia and Conviction of own resourselessness. 3. In men pain in heart area was substantially associated with Sense of being overloaded. Probably pseudocardiac symptom cure may be attained by psychotherapeutic treatment aimed at its background - at elimination of neurotic personality dysfunctions.

Complaints of neurotic patients that are of interest for a cardiologist.

BACKGROUND: Patients in various areas of medicine report symptoms that are unexplained by other medical reasons than psychological/psychiatric. Some of them urgently seek treatment due to cardiovascular complaints, mostly rapid heart rate, palpitations and chest pain. Typical cardiac investigations, usually showing no organic reasons for these conditions, bring little information about stressful life events and psychological predispositions of these patients. Identification of coexistence of "cardiac" symptoms with other symptoms typical for neurotic disorders and difficult life circumstances may facilitate not only psychiatric diagnosis but also evaluation by cardiologists, primary care physicians, and other specialists. AIM: To determine the psychosocial context of psychogenic "pseudocardiac" symptoms and their coexistence with other symptoms in patients with neurotic disorders. METHODS: Medical records of patients from the years 1980-2002 that included self-administered questionnaires transformed into an anonymised database were examined. An analysis of the relationship between symptoms reported in the Symptom Checklist and biographical circumstances described in the Life Inventory before admission to a psychotherapy day clinic for patients with neurotic disorders was performed using simple logistic regression with estimation of odds ratios and their 95% confidence intervals. RESULTS: The symptoms of tachycardia/palpitations and chest pain were very common, present in most subjects, and were significantly associated with such circumstances as suboptimal conflict solving by passive aggression or quarrels, uncertainty in the relationship, a sense of being inferior to the partner, and poor financial situation. In addition, these "pseudocardiac" symptoms were also associated with such childhood reminiscences as origin from a large low income family, feeling that the family of origin was inferior to others, and experience of parental hostility or lack of support. CONCLUSIONS: Physicians of all specialties who deal with patients experiencing pseudocardiac symptoms should expect their psychological background and perform a simple interview to identify the presence of adverse biographical circumstances described above. Identification and discussing these difficult experiences with the patients may help to convince them to seek psychological support or psychotherapy.

The crossroads of gastroenterology and psychiatry - what benefits can psychiatry provide for the treatment of patients suffering from gastrointestinal symptoms.

INTRODUCTION: Gastrointestinal symptoms are very common in the general population. Many of them coincide with mental disorders (especially with neuroses, stress-related disorders, somatisation disorders, autonomic dysfunction, and anxiety) that are associated with psychological trauma, conflicts, and difficulties with interpersonal relationships. AIM: Assessment of the association between gastrointestinal complaints and stressful situations in relationships, among patients admitted to day hospital for neurotic and behavioural disorders. MATERIAL AND METHODS: Analysis of the likelihood of co-occurrence of abdominal symptoms and stressful situations, reported by patients before admission, in a large group of subjects treated with psychotherapy. RESULTS: Gastrointestinal symptoms were highly prevalent in the studied group (they were reported by 40-50% of patients). The most common complaints in women were: loss of appetite (52%), nausea (49%), and constipation and flatulence (45%). In men the most prevalent symptoms were: loss of appetite (47%), heartburn (44%), and flatulence (43%). Functional gastrointestinal symptoms (especially vomiting in cases of nervousness in females or heartburn in males) were significantly associated with greater likelihood of current difficulties in interpersonal relationships, such as conflicts with partner/spouse or parent. CONCLUSIONS: The results suggest that in many cases symptoms of anxiety disorders or somatisation disorders coexisted with irritable bowel syndrome and functional dyspepsia.