Analysis of the Increase of Vascular Cell Adhesion Molecule-1 (VCAM-1) Expression and the Effect of Exposure in a Hyperbaric Chamber on VCAM-1 in Human Blood Serum: A Cross-Sectional Study.

Background and Objectives: Vascular cell adhesion molecule-1 (VCAM-1) was identified as a cell adhesion molecule that helps to regulate inflammation-associated vascular adhesion and the transendothelial migration of leukocytes, such as macrophages and T cells. VCAM-1 is expressed by the vascular system and can be induced by reactive oxygen species, interleukin 1 beta (IL-1ß) or tumor necrosis factor alpha (TNFα), which are produced by many cell types. The newest data suggest that VCAM-1 is associated with the progression of numerous immunological disorders, such as rheumatoid arthritis, asthma, transplant rejection and cancer. The aim of this study was to analyze the increase in VCAM-1 expression and the impact of exposure in a hyperbaric chamber to VCAM-1 levels in human blood serum. Materials and Methods: The study included 92 volunteers. Blood for the tests was taken in the morning, from the basilic vein of fasting individuals, in accordance with the applicable procedure for blood collection for morphological tests. In both groups of volunteers, blood was collected before and after exposure, in heparinized tubes to obtain plasma and hemolysate, and in clot tubes to obtain serum. The level of VCAM-1 was determined using the immunoenzymatic ELISA method. Results: The study showed that the difference between the distribution of VCAM-1 before and after exposure corresponding to diving at a depth of 30 m was at the limit of statistical significance in the divers group and that, in most people, VCAM-1 was higher after exposure. Diving to a greater depth had a much more pronounced impact on changes in VCAM-1 values, as the changes observed in the VCAM-1 level as a result of diving to a depth of 60 m were statistically highly significant (p = 0.0002). The study showed an increase in VCAM-1 in relation to the baseline value, which reached as much as 80%, i.e., VCAM-1 after diving was almost twice as high in some people. There were statistically significant differences between the results obtained after exposure to diving conditions at a depth of 60 m and the values measured for the non-divers group. The leukocyte level increased statistically after exposure to 60 m. In contrast, hemoglobin levels decreased in most divers after exposure to diving at a depth of 30 m (p = 0.0098). Conclusions: Exposure in the hyperbaric chamber had an effect on serum VCAM-1 in the divers group and non-divers group. There is a correlation between the tested morphological parameters and the VCAM-1 level before and after exposure in the divers group and the non-divers group. Exposure may result in activation of the endothelium.

Preferences and attitudes of older adults of Bialystok, Poland toward the use of over-the-counter drugs.

PURPOSE: The aim of the study was to assess preferences and attitudes toward the use of over-the-counter (OTC) drugs among residents of Bialystok aged 60 or older. PATIENTS AND METHODS: The study included 170 people, inhabitants of Bialystok aged over 60: 85 students of the University of a Healthy Senior and the University of Psychogeriatric Prophylaxis, and 85 students of the University of the Third Age in Bialystok. The study made use of a diagnostic survey conducted via a questionnaire prepared by the authors. RESULTS: The vast majority of respondents bought OTC drugs for own use. About one-third of the respondents from each analyzed group bought OTC drugs less often than once every 3 months. Over half of the respondents bought OTC drugs due to a cold. A majority of the respondents were of the opinion that OTC drugs should be sold only in pharmacies. Over 40% of seniors took 1 OTC drug regularly. Most respondents also took vitamins and supplements. The main sources of information on OTC drugs for the studied seniors were their doctor and pharmacist. Respondents did not always consult the treatment method with a doctor or pharmacist. Over half of the respondents familiarized themselves with the contents of the OTC drug package leaflet. Over three-quarters of the respondents were familiar with drug disposal methods; however, despite declarations of being familiar with these principles, a significant percentage did not bring back medication to a pharmacy or clinic, or threw the drugs into the trash. CONCLUSION: Our study found that in our sample there were many OTC drug consumers who did not always demonstrate responsible attitudes toward using this group of drugs. Thus, older people should be educated on the possible adverse effects of taking OTC drugs without consulting a doctor or pharmacist as well as basic drug disposal principles. Furthermore, legislation should be introduced that will limit the wide availability of OTC drugs, particularly to the elderly; and thus, lower the costs of hospitalization and outpatient treatment of this age group. Also, a wider-reaching study should be conducted. It should include a larger group of elderly people as well as information on intake of prescribed medications in order to be able to determine the frequency of drug consumption in this population, as well as seniors' preferences and attitudes in this regard.

Patient aggression towards different professional groups of healthcare workers.

INTRODUCTION: Patient aggression affects healthcare quality and, in extreme situations, may even lead to medical malpractice. Little is known, however, about the specific distribution of health care professionals' exposure to patient aggression in various countries. OBJECTIVE: The aim of this study was to assess the exposure of various professional groups of healthcare personnel to patient aggression, and to identify potential determinants (medical profession, age, gender, professional experience and employment at outpatient/inpatient healthcare units) of this exposure. METHODS: The study was performed between January 2008 - December 2009 in northeastern Poland, and included 1,624 healthcare workers (493 nurses, 504 midwives, 501 physicians and 126 medical rescue workers). Exposure to eight forms of patient aggression was assessed using the MDM Mobbing Questionnaire. RESULTS: Using a raised voice was the most frequently observed form of aggression in all groups, whereas the least frequent form of aggression encountered was the use of direct physical violence. In inpatient healthcare units, the intensity of patient aggression was encountered most by nurses and medical rescue workers, followed by physicians and midwives. In outpatient healthcare units, medical rescue workers experienced significantly higher levels of aggression when compared to other professional groups. Significant differences in mean aggression intensity experienced in inpatient and outpatient healthcare units were observed only in nurses and physicians. Furthermore, no significant effects of gender were observed on the intensity of patient aggression. CONCLUSION: Nurses are most exposed to different forms of patient aggression, with verbal attacks being most prevalent. Nurses employed at inpatient healthcare units experienced aggression more frequently than those working in outpatient healthcare units.

Preferred health behaviors and quality of life of the elderly people in Poland.

PURPOSE: The aim of this study was to assess possible differences between a group of residents of public nursing homes (PNH) and a group of members of Universities of the Third Age (UTA) measured using standard psychometric scales. MATERIALS AND METHODS: The research was conducted between January 3, 2013 and February 15, 2014 on a group of 200 residents of PNH and 200 members of the UTA using five psychometric scales: Standardized Satisfaction with Life Scale (SWLS), Standardized Health Behavior Inventory (HBI), Standardized Social Support Scale (SSS), Standardized General Self-efficacy Scale (GSES), and Standardized Multiple Health Locus of Control Scale (MHLC). RESULTS: The average point total in the Standardized Satisfaction with Life Scale (SWLS) in the group of residents of PNH was 18.03 (Me =19) and was significantly higher (P=0.047) in comparison with the group of UTA members (17.08). Similar to residents of PNH, a vast majority of UTA members assessed the support received from the UTA as good, which significantly influenced their satisfaction from life (P=0.028) and their feeling of self-efficacy (P=0.048). An observed dependence states that the greater the level of satisfaction from life, the greater the level of various types of support from family. CONCLUSION: This study indicates that biopsychosocial problems decrease quality of life in elderly people. The elderly people require a comprehensive, holistic approach to a variety of problems that occur with aging. In future, extended interdisciplinary research should be carried out on aspects of quality of life in order to optimize comprehensive geriatric assessment.

Comparison of the level of aggression towards healthcare workers within Podlaskie Voivodeship.

OBJECTIVES: The aim of this study was to estimate the level of exposure and average intensity of aggression towards particular professional groups of healthcare workers. MATERIALS AND METHODS: Study participants (n = 1498) were employed at open and closed healthcare units within Podlaskie Voivodeship: 493 nurses, 504 midwives and 501 physicians. The MDM Questionnaire was applied. RESULTS: Aggression originating from patients was experienced by 92% of nurses, 86% of doctors, and 74% of midwives examined. Aggressive behavior of co-working physicians concerned 55% of midwives, 54% of nurses and 40% of physicians. The highest average levels of patient aggression, ranging between 2.20 and 3.31, were reported by nurses. CONCLUSIONS: Nurses are the group most exposed to most aggression forms and sources. Physicians are least exposed to aggression, except for aggression manifested by patients.

[Quality of life in rheumatoid arthritis. Methods of measurement]. / Jakosc zycia w reumatoidalnym zapaleniu stawów. metody pomiaru.

Interest in quality of life in the medical sciences arises out of a holistic conception of the medical model. Taking into account the whole patient, concentrating efforts not only on extending his/her life in a biological sense, but also on increasing activities whose aim it is to create an active life, similar to the lives of healthy people. A chronic condition, which reduces the quality of life in illness is rheumatoid arthritis (RA). The illness leads to impairment in motor function, changes in excess of those caused by joint damage, and systemic complications, leading in consequence to a lowering in levels of health and living standards for the patient. The quality of life for a patient with RA depends on the individual patient's own skills in overcoming difficulties, on his/her ability to adapt and on psychological and social health resources. The aim of this paper is to present instruments for the measurement of quality of life and health problems of a psychological and social nature in those suffering from chronic and damaging RA. A multidimensional therapeutic approach should aim not only to reduce the difficulties associated with the illness, but also to improve the patient's functioning, and consequently his/her quality of life.