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1.
Sci Total Environ ; 752: 141787, 2021 Jan 15.
Artículo en Inglés | MEDLINE | ID: mdl-32889266

RESUMEN

European ash (Fraxinus excelsior L.) dieback affects both overstory trees and natural regeneration. The decline of ash caused by severe crown defoliation and branch mortality has a high impact on ash natural regeneration. The site factors affecting the disease symptoms vary significantly and are not fully understood. Hence, we aimed to assess the joined effects of soil fertility and moisture (expressed by soil pH, CaCO3 content, and summer groundwater table level), herbivory, and health conditions connected with Hymenoscyphus fraxineus (T. Kowalski) Baral, Queloz, and Hosoya infestation on natural regeneration of F. excelsior. We examined 32 ash stands in Western Poland across soil fertility gradient. We established randomly selected circular plots (400 m2) in forests with ≥60% of ash in overstory species composition. We assessed natural regeneration density, the proportion of browsed trees, and trees damaged by ash dieback using generalized mixed-effects models. We found a higher proportion of damaged trees in neutral and base soils than in acid soils. Moreover, we found a low proportion of damaged trees in sites with low groundwater table levels. High CaCO3 content decreased the proportion of browsed trees, similarly as high shrub cover. The density of F. excelsior natural regeneration depended on groundwater table level, canopy cover, and proportion of damaged trees. We also found a positive relationship between density and deer browsing. The factor responsible for the higher infestation of saplings (low groundwater table level) also influenced natural regeneration density. This way, our study revealed how soil properties influence ash natural regeneration directly and indirectly. We showed that ash dieback will have a more severe impact on ash regeneration in ash typical sites. This is essential for predicting forest recovery and the ability to resilience after disturbances caused by H. fraxineus. CAPSULE: Joined effects of ash dieback, soil pH, and CaCO3 content, together with soil moisture, as well as deer browsing, affect ash regeneration.


Asunto(s)
Ciervos , Fraxinus , Animales , Enfermedades de las Plantas , Polonia , Suelo
2.
Sci Total Environ ; 751: 142335, 2021 Jan 10.
Artículo en Inglés | MEDLINE | ID: mdl-33181979

RESUMEN

Forest soils are being exposed to nutrient deficiency and acidification at increasing rates as a result of intensive management. Mineral fertilization, however, provides a way to improve soil nutrient balance. The aim of this study is to present the effects of mineral fertilization on the properties of forest soil 11 years after fertilization. Our research investigated the effects of dolomite, magnesite and serpentinite fertilization on the physicochemical properties of the soil, soil biological activity, and fungal diversity. We also determined the condition of a new generation of fir trees after mineral fertilization. In autumn, 2008, fertilizers (dolomite, magnesite and serpentinite, specifically) in the amount of 4000 kg.ha-1 were added to plots in the Wisla Forest District in Poland; one area was left unfertilized to act as the control area for this research. Our results reveal that all fertilization improved the selected soil's physicochemical properties (pH, Ca and Mg content) and accordingly, its biochemical activity; in particular, we found that dolomite (4000 kg.ha-1) contributed heavily to soil improvement. The findings also showed that soil pH and calcium content were strongly dependent on enzymatic activity, while dolomite fertilization resulted in a significant increase in biomass size in the fir trees included in this study. In addition to being associated with the highest plant biomass and amounts of enzymatic activity, dolomite-fertilized soil also had the highest number of fungal operational taxonomic units (OTUs): 403, compared to 322 OTUs in the control soil. Finally, the fungal communities in the control soil varied significantly from the fungal communities in soils fertilized with dolomite and serpentinite. The results of this research support mineral fertilization, and in particular, fertilization using dolomite in amounts of 4000 kg.ha-1, to improve soil nutrient supply and to shape the biological activity expressed by the enzymatic activity of forest soils.


Asunto(s)
Ecosistema , Suelo , Bosques , Polonia , Microbiología del Suelo , Árboles
3.
Sci Total Environ ; 750: 142266, 2021 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-33182211

RESUMEN

Urbanization and population growth have created considerable sanitation challenges in cities and communities in many parts of Europe and the world. As such, it is imperative to identify the most environmentally-harmful microbiological and chemical sources of pollution, these being wastewater treatment plants (WWTPs) which release wastewater of low quality. In the present manuscript, an extensive study was performed of the sanitary conditions of river water and treated wastewater from seventeen WWTPs of various sizes along the Pilica River catchment in central Poland, with the aim of identifying "hot spots" in terms of most serious sources of sanitary hazards. The bacteriological risk for the river, including fecal indicator bacteria (FIB) such as coliforms, E.coli, enterococci, C. perfringens, and carbapenem-resistant Acinetobacter spp. (CRA) were assessed using classical microbiological methods, and the physicochemical parameters were also tested. The WWTPs, particularly the small ones (<2000 people equivalent, PE) demonstrated significant variation regarding the physicochemical parameters. Carbapenem-resistant Acinetobacter spp. bacteria growing at 42 °C were found in the effluent wastewaters of all tested municipal WWTPs, and in most of the Pilica River water samples, presenting a potential hazard to public health. A positive correlation was identified between E. coli and CRA abundance in treated wastewater; however, no such relationship was found in river water. It was found that seven small treatment plants discharged wastewater with very different microbiological parameters. Moreover, three small treatment plants serving only 0.56% of the population in the studied area continuously released extremely high microbiological contamination, constituting as much as 54-82% of fecal indicator bacteria loads in the area studied. Our findings show that this type of comprehensive analysis may enable assessment of the use of the entire catchment area, thus identifying the most serious threats to surface water quality and guiding the actions needed to improve the worst operating WWTPs.


Asunto(s)
Acinetobacter , Aguas Residuales , Carbapenémicos , Ciudades , Monitoreo del Ambiente , Escherichia coli , Europa (Continente) , Heces/química , Humanos , Polonia , Ríos , Aguas Residuales/análisis , Agua , Microbiología del Agua
4.
Pol Merkur Lekarski ; 48(287): 375-378, 2020 Oct 23.
Artículo en Inglés | MEDLINE | ID: mdl-33130803

RESUMEN

Poland is a country with an increasing number of claims based on medical errors, especially in the following surgical disciplines: obstetrics and gynaecology, orthopaedics and emergency medicine, general surgery. This problem raises the need to seek out-of-court dispute solutions beneficial to the physician, the patient and the national health care system. Mediation - a procedure commonly used and well-established in Polish law, however, not widespread, as far as medical claims are concerned - creates this opportunity. The purpose of this article is to summarize international experiences in mediation in physician-patient disputes, and to try to popularize them in Poland. An analysis of foreign literature has provided evidence that mediation is an effective tool to resolve disputes by compromise, while reducing the costs and time of proceedings, and preventing burnout among physicians and the patients' loss of trust in medical care.


Asunto(s)
Disentimientos y Disputas , Médicos , Femenino , Humanos , Negociación , Relaciones Médico-Paciente , Polonia , Embarazo
5.
Wiad Lek ; 73(9 cz. 2): 1904-1908, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33148832

RESUMEN

OBJECTIVE: Introduction: Lifestyle modification, including changing eating habits, plays an essential role in the prevention of stroke. The aim: The study aimed to assess the nutritional prevention of cerebrovascular diseases in adult inhabitants of Poland. PATIENTS AND METHODS: Material and Methods: The study was conducted using the author's questionnaire among 145 women and 76 men, aged 18 - 30 (53.9%) and 50 - 70 (46.1%) years. RESULTS: Results: The following stroke risk factors were found in the examined group: overweight or obesity (46.6%), lack of regular physical activity (48%), smoking (33%), hypertension (22.1%), dyslipidemia (8.6%), diabetes (5.9%), and cardiac arrhythmias (6.3%). The younger subjects compared to older ones more often declared the daily consumption of whole-grain cereal products and vegetables, fish at least once a week, and they preferred vegetable oils. On the other hand, older subjects declared the consumption of sweets, sweet drinks, salt, and fast food less frequently than younger ones. Also, fruits were more often chosen by older people. Both groups declared similar moderate consumption of milk and dairy products with reduced fat content, lean meat, and alcohol. Only 38% of respondents considered their eating habits to be appropriate. CONCLUSION: Conclusions: The eating habits of examined adults only partially met the recommendations regarding the nutritional prevention of stroke. In some elements, younger people were more likely to follow appropriate dietary recommendations, while older people were more appropriate in others. The education regarding the principles of the nutritional prevention of cerebrovascular diseases is still necessary and should be age-appropriate.


Asunto(s)
Conducta Alimentaria , Accidente Cerebrovascular , Adulto , Anciano , Anciano de 80 o más Años , Dieta , Femenino , Humanos , Masculino , Persona de Mediana Edad , Polonia , Accidente Cerebrovascular/prevención & control , Encuestas y Cuestionarios , Verduras
6.
Wiad Lek ; 73(9 cz. 2): 2076-2079, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33148863

RESUMEN

OBJECTIVE: Positron emission tomography (PET/CT) is a non-invasive molecular imaging technique using isotopes with a short half-life usually in combination with chemical compounds. The most commonly used PET/CT tracer is 2-fluoro-2-deoxy-D-glucose labeled with fluorine (18-FDG). It is used mainly in oncological diagnostics as well as myocardial viability, epilepsy and inflammatory diagnostics. The tracer less commonly used in PET/CT could be carbon-labeled methionine (11C-MET). It is mainly used in the diagnosis of focal lesions in the central nervous system. There are also reports of the use of this tracer in diagnostics of the primary, secondary and tertiary hyperparathyroidism as well as multiple myeloma. This tracer may also be used in the diagnosis of lymphoproliferative diseases and solid tumors, although there is no clear evidence of its advantage over 18-FDG. CONCLUSION: Conclusion: Significant difficulties in the production and transport of this tracer and lack of reimbursement of this type of procedure in Poland limits the use of this tracer for scientific research.


Asunto(s)
Medicina Nuclear , Tomografía Computarizada por Tomografía de Emisión de Positrones , Radioisótopos de Carbono , Metionina , Polonia , Tomografía de Emisión de Positrones
9.
Artículo en Inglés | MEDLINE | ID: mdl-33187315

RESUMEN

(1) Background: The SARS-CoV-2 pandemic has changed the functioning of Polish health systems. Telemedicine has been developed and access to prescription drugs (Rx) has been facilitated. This study examined whether these changes and the imposition of a three-month lockdown caused Polish people to engage in more self-medication-related behaviors. (2) Method: After the fourth (final) stage of defrosting the Polish economy, an online survey of a quota sample of 1013 Polish respondents was conducted. (3) Results: Almost half of the respondents (45.6%) indicated that they had engaged in at least one behavior associated with inappropriate self-medication during the lockdown (e.g., 16.6% took medication as a precaution, and 16.8% took an Rx formulation without consultation). Some of these people had never engaged in such behaviors prior to the lockdown. Linear regression showed that higher values of a composite ("lockdown") index of self-medication-related behaviors occurring during lockdown were predicted by greater religiosity and the presence of children in a household. Also, independent samples t-tests showed that people who were afraid for their financial future and people who feared for their health obtained higher lockdown index scores than people not having such worries. (4) Conclusions: Self-medication-related behaviors were more common among Poles before lockdown than during the lockdown (which is unsurprising given that the lengths of the periods compared were hugely different), worryingly, many people exhibited such behaviors for the first time during the lockdown.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Neumonía Viral/epidemiología , Automedicación/tendencias , Betacoronavirus , Infecciones por Coronavirus/prevención & control , Humanos , Pandemias/prevención & control , Neumonía Viral/prevención & control , Polonia , Aislamiento Social
10.
Artículo en Inglés | MEDLINE | ID: mdl-33198124

RESUMEN

The older population is one of the most vulnerable to experience adverse outcomes of COVID-19. Exploring different clinical features that may act as detrimental to this population's survival is pivotal for recognizing the highest risk individuals for poor outcome. We thus aimed to characterize the clinical differences between 60-day survivors and non-survivors, as well as analyze variables influencing survival in the first older adults hospitalized in Poznan, Poland, with COVID-19. Symptoms, comorbidities, complications, laboratory results, and functional capacity regarding the first 50 older patients (≥60 years) hospitalized due to COVID-19 were retrospectively studied. Functional status before admission (dependent/independent) was determined based on medical history. The 60-day survivors (n = 30/50) and non-survivors (n = 20/50) were compared across clinical parameters. The patients had a mean age of 74.8 ± 9.4 years. Overall, 20/50 patients died during hospitalization, with no further fatal outcomes reported during the 60-day period. The non-survivors were on average older (78.3 ± 9.7 years), more commonly experienced concurrent heart disease (75%), and displayed functional dependence (65%) (p < 0.05). When assessing the variables influencing survival (age, heart disease, and functional dependence), using a multivariate proportional hazards regression, functional dependence (requiring assistance in core activities of daily living) was the main factor affecting 60-day survival (HR, 3.34; 95% CI: 1.29-8.63; p = 0.01). In our study, functional dependence was the most important prognostic factor associated with mortality. Elderly with COVID-19 who required assistance in core activities of daily living prior to hospitalization had a three times increased risk to experience mortality, as compared to those with complete independence. Exploring geriatric approaches, such as assessment of functional capacity, may assist in constructing comprehensive survival prognosis in the elderly COVID-19 population.


Asunto(s)
Actividades Cotidianas , Infecciones por Coronavirus/mortalidad , Neumonía Viral/mortalidad , Anciano , Anciano de 80 o más Años , Betacoronavirus , Hospitalización , Humanos , Pandemias , Polonia/epidemiología , Estudios Retrospectivos , Factores de Riesgo , Análisis de Supervivencia , Sobrevivientes
11.
Psychiatr Pol ; 54(3): 421-436, 2020 Jun 30.
Artículo en Inglés, Polaco | MEDLINE | ID: mdl-33038878

RESUMEN

SARS-CoV-2 poses a particular risk to the elderly and people with many comorbidities. In the case of people with dementia, the compliance with sanitary recommendations and the necessary physical isolation can have far-reaching negative consequences in terms of limiting the continuation of tailored care, support and treatment. The recommendations related to the SARS-CoV-2 pandemic must take into account not only the medical consequences of lack of access to medical care, but also their long-term effects and the disease progression in accordance with the concept of social health. A plan of action for the psychoeducation of informal carers, adapted to the elderly group (including people with dementia), is also necessary. Prepared under the auspices of the Polish Psychiatric Association, the recommendations for people living alone, with their family and in long-term care facilities are intended to draw attention to key epidemiological issues that can be planned by medical staff within the organization of patient care. However, mental and social needs of patients, whose fulfilment is particularly significant in times of restrictions related to everyday activities, are of equal importance. Further monitoring of the epidemiological situation and scientific reports related to the SARS-CoV-2 pandemic are necessary to verify and update the guidelines.


Asunto(s)
Betacoronavirus , Cuidadores/estadística & datos numéricos , Infecciones por Coronavirus/terapia , Demencia/terapia , Neumonía Viral/terapia , Actividades Cotidianas , Anciano , Cuidadores/educación , Infecciones por Coronavirus/epidemiología , Humanos , Pandemias , Neumonía Viral/epidemiología , Polonia , Guías de Práctica Clínica como Asunto , Medición de Riesgo , Aislamiento Social , Sociedades Médicas
12.
Sci Total Environ ; 747: 142084, 2020 Dec 10.
Artículo en Inglés | MEDLINE | ID: mdl-33076212

RESUMEN

Forest habitats change significantly under the influence of global warming. It is important to predict the effects of these changes, especially in primeval forests which currently represent a small percentage of temperate forests. Such changes often manifest themselves in an acceleration of the frequency of mass seeding of trees, which causes cascading effects in various organisms. We evaluated changes in: tree masts (oak Quercus robur and hornbeam Carpinus betulus), rodent abundance (yellow-necked mouse Apodemus flavicollis), folivorous caterpillar abundance (winter moth Operophtera brumata), and the breeding success of a cavity-nesting songbird (collared flycatcher Ficedula albicollis) in over a 30-year period in the Bialowieza Forest (E Poland). We also analysed temperature, precipitation and snow cover to determine the effects of weather on each trophic level. Previous studies have exposed the indirect effect of tree masting on songbirds breeding in open nests. Our study uniquely highlights the relationships between trees, rodents, caterpillars, and a cavity-nesting bird. Precipitation was positively correlated with the fructification of trees, abundance of caterpillars, and the breeding losses of flycatchers (in July, August, October in the previous year, in May in the current year, respectively). We found that along with the changing climate, the frequency of mast years of oak increased, which caused an increasing frequency of rodent outbreaks. The abundance of mice was positively correlated with the predation on flycatcher broods (current year) and negatively - with the abundance of caterpillars (following year). We predict that current global trends in climate change will have a negative impact on the flycatcher due to the cascading effects from the above species. Bearing in mind that F. albicollis is one of the most numerous bird species, it can be assumed that more frequent masting will result in substantial changes in the entire bird assemblage, and presumably also other groups of animals.


Asunto(s)
Pájaros Cantores , Árboles , Animales , Cruzamiento , Cambio Climático , Bosques , Ratones , Polonia
13.
Wiad Lek ; 73(8): 1641-1649, 2020.
Artículo en Polaco | MEDLINE | ID: mdl-33055326

RESUMEN

OBJECTIVE: Introduction: Current information suggests the existence of two main transmission routes for SARS-CoV-2. This is the drip trajectory and contact transmission. The order to cover the mouth and nose in the public space has been introduced as one of the preventive measures to limit the spread of some virus-induced respiratory diseases, including COVID-19. Both medical and non-medical masks have become the most popular tool. Is there any evidence of their effectiveness? What can be the disadvantages of using them? The aim: To analyze social behaviour towards the order to cover the nose and mouth during the SARS-CoV-2 pandemic and to confront them with the results of research on the effectiveness of medical and non-medical masks. PATIENTS AND METHODS: Material and methods: The study involved a group of 2512 respondents from all over Poland. The research tool was an original questionnaire containing 24 questions. RESULTS: Results: 76.1% of the respondents declare that they always obey the current order. 83% use a material mask and 26.9% wear a surgical mask. 35.2% of respondents think that the order to cover their nose and mouth is not justified. CONCLUSION: Conclusions: The authors confronted the results of the questionnaire with the scientific research mentioned above. There is limited evidence to resolve the question - "Masks - protection or danger?" However, it is worth noting the small harmfulness and indirect evidence of benefits, which together have precedence over the lack of clear arguments supporting the use of masks by Polish society in times of epidemics.


Asunto(s)
Infecciones por Coronavirus , Máscaras , Boca , Pandemias , Neumonía Viral , Actitud , Betacoronavirus , Humanos , Polonia
14.
Wiad Lek ; 73(8): 1659-1662, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33055329

RESUMEN

OBJECTIVE: Introduction: The SARS-CoV-2 virus was recognized in December 2019 in China. From that moment it has quickly spread around the whole world. It causes COVID-19 disease manifested by breathlessness, coughing and high temperature. The COVID-19 pandemic has become a great challenge for humanity. The aim: To analyze interventions of emergency medical teams during the SAR-CoV-2 pandemic, and to compare obtained data with the same periods in 2018-2019. PATIENTS AND METHODS: Material and methods: The study retrospectively analyzed interventions of emergency medical teams in the period from 15.03 to 15.05 in 2018 - 2020. 1,479,530 interventions of emergency medical teams were included in the study. The number of interventions, reasons for calls, and diagnoses made by heads of the emergency medical teams during the SARS-CoV-2 pandemic were compared to the same period in 2018-2019. RESULTS: Results: Authors observed the decline in the number of interventions performed by emergency medical teams during the pandemic in relation to earlier years by approximately 25%. The big decline concerned interventions that were the reason for calls to public places, such as "traffic accident" and "collapse". In the case of diagnoses made by the head of the emergency medical team, the diagnoses regarding stroke or sudden cardiac arrest remained at the similar level. Others showed a marked decline. CONCLUSION: Conclusions: Reduced social activity contributed to a reduced number of interventions by emergency medical teams in public places. The societal fear of the unknown also contributed to the decrease in the number of interventions performed by emergency medical teams. People began to avoid contact with other people.


Asunto(s)
Infecciones por Coronavirus , Servicios Médicos de Urgencia , Pandemias , Neumonía Viral , Betacoronavirus , China/epidemiología , Humanos , Polonia/epidemiología , Estudios Retrospectivos
15.
Wiad Lek ; 73(8): 1756-1760, 2020.
Artículo en Polaco | MEDLINE | ID: mdl-33055347

RESUMEN

The article presents the life and work of dr. Mieczyslaw Biernacki, a Polish doctor of medicine, freemason, social, economic and political activist unknown to the younger generation of Polish doctors, who was born in 1862, Throughout his life, he actively worked to raise the level of education and health of Lublin's inhabitants. He held managerial positions in numerous associations, economic institutions, local government and political organizations. Above all, he was a doctor who effectively fought against infectious diseases, venereal diseases and tuberculosis. As an editor and publicist, he took the floor by writing on medical, economic and literary subjects. He died in 1948, at the age of eighty-eight.


Asunto(s)
Enfermedades Transmisibles , Médicos , Enfermedades Transmisibles/terapia , Historia del Siglo XIX , Humanos , Masculino , Polonia , Política
16.
Wiad Lek ; 73(8): 1593-1599, 2020.
Artículo en Polaco | MEDLINE | ID: mdl-33055317

RESUMEN

Allergic alveolitis (AA) is a group of diseases with an immunologic background evoked by chronic antigen inhalation. The diagnosis is difficult due to the diversity and non-specific character of symptoms and different clinical severity. AA is the third most often interstitial-lung-disease, comprising 4-15% of all interstitial diseases. It's often related to professional exposure. Farmer's lung, a hypersensitivity pneumonitis is the most common AA. By binding precipitins to form immunologic complexes, antigens trigger an early phase acute reaction in the lung tissue thus initiating disease's progression. In the chronic phase endolobular fibrosis located in the upper lobes prevails. Disease differs in course depending the type and time of antigen exposition. Thus, avoiding antigen exposition is the first-line-therapy. Acute form is characterized by fever, chills, dyspnea, and cough. It usually starts 4-8 hours after intensive exposure. Early diagnosis leads to a good prognosis. When the exposition to the antigen stops, acute form of AA usually self-limits within 24-48 hours. Only in severe cases 0.5-1.0 mg/kg/d (up 60 mg/d) can be required for 1-2 weeks with a subsequent dose reduction. Long-term usually leads to chronic form with more serious deteriorations, including severe dyspnea and chronic cough (it takes months-years for them to develop, however). There is no effective therapy, in rapidly progressing cases 40-60 mg/g of prednisone repeated in 4-week-cycles can be recommended. Usually it does not stop the progression, and pulmonary fibrosis followed by respiratory insufficiency develop. Symptoms duration at diagnosis and effectiveness of antigen elimination are the known prognostic factors.


Asunto(s)
Alveolitis Alérgica Extrínseca , Alveolitis Alérgica Extrínseca/diagnóstico , Alveolitis Alérgica Extrínseca/tratamiento farmacológico , Alveolitis Alérgica Extrínseca/etiología , Enfermedad Crónica , Humanos , Polonia
17.
Wiad Lek ; 73(8): 1632-1636, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33055324

RESUMEN

OBJECTIVE: The aim: The aim of this study was to characterize the general characteristics of the completed interventions by the Voivodeship Rescue Service of Katowice in the time period from 1st January 2018 to 31 December 2018. PATIENTS AND METHODS: Material and methods: Analysis of the characteristics of the trips was done based on the information contained in the dispatch order cards and medical emergency services cards. In the statistical analysis the Chi-Square (p<0.05) test was utilized. RESULTS: Results: The total number of interventions was 211,548 cases. It is also worth observing, that the general number of interventions out of town amounted to 20,344 interventions, whereas, in town, there were 191,204 interventions. It can be observed that the most common decision made by the Emergency Medical Team was the decision to directly transported and received by the emergency department (126,553 cases; p<0.05). The definite most common reason for symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (ICD-10 code : R; p<0.05). CONCLUSION: Conclusion: The largest number of interventions completed by the Voivodeship Rescue Service in Katowice in 2018 was due to injuries and poisonings, symptoms, diseases features and incorrect results of diagnostic tests, and in third place were cardiovascular diseases.


Asunto(s)
Servicios Médicos de Urgencia , Servicio de Urgencia en Hospital , Polonia , Estudios Retrospectivos
18.
Wiad Lek ; 73(8): 1771-1779, 2020.
Artículo en Polaco | MEDLINE | ID: mdl-33055350

RESUMEN

Nurses are the largest group of Polish medical staff. There are currently approximately 230,000 nurses employed in Poland. There is a statutory profession for many years. Nurses provide health services on the basis of a medical order or on their own. As a result of changes in the law, the scope of their professional competences has been increasing for several years, including to independently administer medicines and issue prescriptions. The purpose of the article is to present and analyze legal norms determining the status of a nurse in the Polish health care system. In addition, the definition of the statutory principles of cooperation between doctors and nurses. The analysis shows that changes in law in recent years have significantly influenced the increase in the role of nurses in the health care system and they are also relevant to the practice of the medical profession.


Asunto(s)
Prestación de Atención de Salud , Médicos , Humanos , Polonia , Competencia Profesional
19.
BMC Infect Dis ; 20(1): 761, 2020 Oct 16.
Artículo en Inglés | MEDLINE | ID: mdl-33066740

RESUMEN

BACKGROUND: Device-associated health care-associated infections (DA-HAIs) in intensive care unit (ICU) patients constitute a major therapeutic issue complicating the regular hospitalisation process and having influence on patients' condition, length of hospitalisation, mortality and therapy cost. METHODS: The study involved all patients treated > 48 h at ICU of the Medical University Teaching Hospital (Poland) from 1.01.2015 to 31.12.2017. The study showed the surveillance and prevention of DA-HAIs on International Nosocomial Infection Control Consortium (INICC) Surveillance Online System (ISOS) 3 online platform according to methodology of the INICC multidimensional approach (IMA). RESULTS: During study period 252 HAIs were found in 1353 (549F/804M) patients and 14,700 patient-days of hospitalisation. The crude infections rate and incidence density of DA-HAIs was 18.69% and 17.49 ± 2.56 /1000 patient-days. Incidence density of ventilator-associated pneumonia (VAP), central line-associated bloodstream infection (CLA-BSI) and catheter-associated urinary tract infection (CA-UTI) per 1000 device-days were 12.63 ± 1.49, 1.83 ± 0.65 and 6.5 ± 1.2, respectively. VAP(137) constituted 54.4% of HAIs, whereas CA-UTI(91) 36%, CLA-BSI(24) 9.6%.The most common pathogens in VAP and CA-UTI was multidrug-resistant (MDR) Acinetobacter baumannii (57 and 31%), and methicillin-resistant Staphylococcus epidermidis (MRSE) in CLA-BSI (45%). MDR Gram negative bacteria (GNB) 159 were responsible for 63.09% of HAIs. The length of hospitalisation of patients with a single DA-HAI at ICU was 21(14-33) days, while without infections it was 6.0 (3-11) days; p = 0.0001. The mortality rates in the hospital-acquired infection group and no infection group were 26.1% vs 26.9%; p = 0.838; OR 0.9633;95% CI (0.6733-1.3782). Extra cost of therapy caused by one ICU acquired HAI was US$ 11,475/Euro 10,035. Hand hygiene standards compliance rate was 64.7%, while VAP, CLA-BSI bundles compliance ranges were 96.2-76.8 and 29-100, respectively. CONCLUSIONS: DA-HAIs was diagnosed at nearly 1/5 of patients. They were more frequent than in European Centre Disease Control report (except for CLA-BSI), more frequent than the USA CDC report, yet less frequent than in limited-resource countries (except for CA-UTI). They prolonged the hospitalisation period at ICU and generated substantial additional costs of treatment with no influence on mortality. The Acinetobacter baumannii MDR infections were the most problematic therapeutic issue. DA-HAIs preventive methods compliance rate needs improvement.


Asunto(s)
Infecciones por Acinetobacter/epidemiología , Acinetobacter baumannii/genética , Infecciones Relacionadas con Catéteres/epidemiología , Hospitales Universitarios/economía , Control de Infecciones/métodos , Unidades de Cuidados Intensivos/economía , Staphylococcus aureus Resistente a Meticilina/genética , Neumonía Asociada al Ventilador/epidemiología , Infecciones Estafilocócicas/epidemiología , Infecciones Urinarias/epidemiología , Infecciones por Acinetobacter/economía , Infecciones por Acinetobacter/microbiología , Infecciones por Acinetobacter/prevención & control , Adulto , Anciano , Anciano de 80 o más Años , Infecciones Relacionadas con Catéteres/economía , Infecciones Relacionadas con Catéteres/microbiología , Infecciones Relacionadas con Catéteres/prevención & control , Farmacorresistencia Bacteriana Múltiple , Femenino , Higiene de las Manos/normas , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Neumonía Asociada al Ventilador/economía , Neumonía Asociada al Ventilador/microbiología , Neumonía Asociada al Ventilador/prevención & control , Polonia/epidemiología , Reacción en Cadena de la Polimerasa , Estudios Prospectivos , Infecciones Estafilocócicas/economía , Infecciones Estafilocócicas/microbiología , Infecciones Estafilocócicas/prevención & control , Infecciones Urinarias/economía , Infecciones Urinarias/microbiología , Infecciones Urinarias/prevención & control
20.
Wiad Lek ; 73(9 cz. 1): 1829-1834, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33099524

RESUMEN

OBJECTIVE: Introduction: Cardiovascular diseases are one of the most important causes of the morbidity and mortality in the Polish and European population, accounting for nearly half of the causes of death. Prevention and treatment of cardiovascular diseases, especially in view of the predicted increase in mortality rate as a result of these diseases in the aging populations is crucial. The aim: To characterize selected psychological risk factors that predispose to the development of cardiovascular disease. RESULTS: Review and disscusion: Numerous scientific studies indicate the importance of mental and psychosocial factors in the prevention, treatment and rehabilitation patients with cardiovascular diseases. In this article the most important psychological risk factors, such as Type A and D personality, stress, depression and depressed mood, anxiety, social support and lifestyle are presented. CONCLUSION: Conclusions: Population-focused programs devoted to health promotion and informing the general public about the risk factors for cardiovascular diseases should mainly aim at improving people's lifestyle, in particular with regard to nutrition, smoking, alcohol consumption, physical activity and mental well-being.


Asunto(s)
Enfermedades Cardiovasculares , Envejecimiento , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/etiología , Humanos , Estilo de Vida , Polonia/epidemiología , Factores de Riesgo
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