Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 68
Filtrar
1.
Viruses ; 15(10)2023 10 09.
Artigo em Inglês | MEDLINE | ID: mdl-37896844

RESUMO

INTRODUCTION: Eradication of HCV in the global population remains one of the greatest challenges faced by the WHO. An insufficient level of knowledge and the lack of a national screening test strategy are obstacles to HCV eradication. AIM: This work aimed to summarize surveys assessing risk factors and awareness of the respondents regarding the prevention and course of HCV infection. The summary also includes the most important European and global attempts at eliminating HCV. MATERIALS AND METHODS: A cross-sectional, population-based study was conducted in the Mazowieckie district in Poland using anonymous surveys and conducted on people who willingly reported for a test. RESULTS: In the study cohort of n = 7397 adults, there were 5412 women (73.16%). The analysis of the quota sample (n = 1303) reflected the actual proportions in the population of the Mazowieckie Voivodeship. CONCLUSIONS: Insufficient knowledge about HCV decreases the probability of higher detection of infections, fast diagnostics, and treatment. According to the WHO model, assuming a 90% detection rate and treatment of 80% of infected by 2030, and taking into account 120-150 thousand infected persons in Poland, the number of detections of HCV should be increased 4-5 times and all diagnosed persons should be offered antiviral treatment.


Assuntos
Objetivos , Hepatite C , Adulto , Humanos , Feminino , Polônia/epidemiologia , Estudos Transversais , Antivirais/uso terapêutico , Hepatite C/diagnóstico , Hepatite C/epidemiologia , Hepatite C/prevenção & controle , Hepacivirus
2.
Int J Public Health ; 68: 1606139, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37732329

RESUMO

Objectives: The full-scale Russian invasion of Ukraine resulted in a refugee crisis. The terms of employment of Ukrainian Refugee background Medical Professionals (UKR-MPs) in the Polish healthcare system were liberalised. The aim of the study was to identify challenges in job seeking and the integration of Ukrainian war refugee healthcare workers into the Polish healthcare system. Methods: A qualitative, descriptive study based on content thematic analysis of Facebook content. We analyzed 1,700 posts published on two public Facebook groups intended for UKR-MPs. Results: The most common problems encountered by UKR-MPs were: 1) lack of easy-to-understand information about the list of documents necessary to apply for a work permit, 2) lack of feedback from those responsible for handling individual cases, and 3) long waiting time for the decision issued by the Ministry of Health. Conclusion: Despite the promptly implemented solutions enabling access to the job market by UKR-MPs, the refugees have encountered considerable administrative difficulties, as well as those arising from insufficient knowledge of the regulations on working as medical professionals in Poland under the EU law.


Assuntos
Refugiados , Mídias Sociais , Humanos , Polônia , Emprego , Pessoal de Saúde
3.
Clin Exp Hepatol ; 9(1): 1-8, 2023 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-37064834

RESUMO

The recommendations define the principles of diagnosis and treatment of hepatitis C virus (HCV) infection according to the latest knowledge. The main goal of the treatment of HCV infection is to eliminate the virus from the body, which in turn leads to stopping the progression or causes the regression of previously formed changes in the liver. The current version of the guidelines prioritizes pangenotypic regimens and includes guidelines for special patient populations such as children, patients with cirrhosis, human immunodeficiency virus (HIV) and hepatitis B virus (HBV) infection, patients with renal failure, liver failure and lack of response to previous therapies as well as patients in the peri-transplant period.

4.
Artigo em Inglês | MEDLINE | ID: mdl-36497862

RESUMO

INTRODUCTION: Nurses became the largest medical group exposed to direct contact with the SARS-CoV-2 virus. In this study, we aimed to assess the readiness and motivation for vaccination, as well as the use of sources of information and attitudes toward vaccination depending on the psychological profile. MATERIAL AND METHODS: A cross-sectional online survey study was conducted. The study included 145 novice nurses from 8 medical universities who completed 3-year undergraduate studies. Women constituted 97.2% of the respondents (N = 141). The Generalized Anxiety Disorder 7-Item Scale, General Self-Efficacy Scale, Brief Resilient Coping Scale, and an original questionnaire were used. Variables were analyzed with descriptive statistics methods. A p-value of <0.05 was considered statistically significant. RESULTS: Among the participants, 73.1% had already been vaccinated against COVID-19 (N = 106). The participants were divided into two groups: G1 (N = 98), characterized by a lower level of anxiety with higher self-efficacy and resilient coping, and G2 (N = 47), with a higher level of anxiety with poorer self-efficacy and resilient coping. The analysis of the potential correlation of psychological pattern with the decision to vaccinate was not statistically significant (p = 0.166). CONCLUSION: Psychological variables may be correlating with motivation, attitudes toward vaccination, and the choice of reliable sources of information about vaccination. Our study demonstrates the key role of two psychological variables, self-efficacy and resilient coping, in this context.


Assuntos
Vacinas contra COVID-19 , COVID-19 , Humanos , Feminino , Estudos Transversais , COVID-19/prevenção & controle , SARS-CoV-2 , Vacinação , Adaptação Psicológica
5.
Ann Transplant ; 27: e936949, 2022 Sep 16.
Artigo em Inglês | MEDLINE | ID: mdl-36110033

RESUMO

The introduction of vaccines preventing a severe course of COVID-19 disease is particularly important in immunocompromised patients, among whom organ recipients and patients awaiting transplantation constitute a large group. The article is a critical review of 68 recent publications on the impact of the SARS-CoV-2 pandemic on transplantology worldwide. The study discusses research results concerning various aspects of SARS-CoV-2 vaccination in transplant patients; it also lists important factors influencing vaccination effectiveness. A suboptimal immune response to 2 doses of vaccine in this group of patients is a major challenge prompting further research. Therefore, this review aims to provide an update on the humoral and cellular immune responses to SARS-CoV-2 vaccination following solid organ transplantation.


Assuntos
Vacinas contra COVID-19 , COVID-19 , Transplante de Órgãos , COVID-19/prevenção & controle , Vacinas contra COVID-19/efeitos adversos , Humanos , Imunidade Celular , Transplante de Órgãos/efeitos adversos , SARS-CoV-2 , Vacinação , Vacinas Virais
6.
Ann Transplant ; 27: e934924, 2022 Jan 26.
Artigo em Inglês | MEDLINE | ID: mdl-35078965

RESUMO

Liver transplantation (LTx) is the best treatment for patients with early-stage hepatocellular carcinoma (HCC). The Milan criteria positively influenced results of liver transplantation and were adopted by the majority of cancer centers, becoming the criterion standard treatment for early-stage HCC. Despite the use of restrictive criteria, recurrence is still high, affecting between 8% and 20% of cases, and is a significant predictor of survival after LTx. The diagnosis of both micro-and macro-invasion of vessels, which are significant factors in determining the frequency of recurrence and overall survival, significantly decreases the success of transplantation, causing an increase in mortality of 50% in comparison to recipients with no vascular invasion. The risk of recurrence depends on several factors, which are discussed in this review. The authors also discuss the clinical presentation and treatment methods of recurrence and its prognosis. In addition, the role of different models developed to identify groups of patients with high versus low risk of recurrence is discussed, enabling the planning of recommendations and screening protocols after transplantation to help early diagnosis and guide effective treatment. In the era of an increasing numbers of liver transplants due to HCC, the need to create robust screening tools is urgent.


Assuntos
Carcinoma Hepatocelular , Neoplasias Hepáticas , Transplante de Fígado , Carcinoma Hepatocelular/cirurgia , Humanos , Neoplasias Hepáticas/cirurgia , Transplante de Fígado/efeitos adversos , Recidiva Local de Neoplasia , Estudos Retrospectivos , Fatores de Risco
7.
Med Sci Monit ; 27: e932025, 2021 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-34480012

RESUMO

The coronavirus disease 2019 (COVID-19) pandemic, due to infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which began in March 2020, affected organ donor acceptance and rates of heart, lung, kidney, and liver transplants worldwide. According to data reported to POLTRANSPLANT, the number of solid organ transplants decreased by over 35% and the number of patients enlisted de novo for organ transplantation was reduced to 70% of its pre-COVID-19 volume in Poland. Most transplant centers in Western Europe and the USA have also drastically reduced their activity when compared to the pre-pandemic era. Areas of high SARS-CoV-2 infection incidence, like Italy, Spain, and France, were most affected. Significant decreases in organ donation and number of transplant procedures and increase in waitlist deaths have been noted due to overload of the healthcare system as well as uncertainty of donor SARS-CoV-2 status. Intensive care unit bed shortages and less intensive care resources available for donor management are major factors limiting access to organ procurement. The impact of the COVID-19 outbreak on transplant activities was not so adverse in Asia, as a result of a strategy based on experience gained during a previous SARS pandemic. This review aims to compare the effects of the COVID-19 pandemic on solid organ transplantation during 2020 in Poland with countries in Western Europe, North America, and Asia.


Assuntos
COVID-19/epidemiologia , Seleção do Doador/organização & administração , Transplante de Órgãos/estatística & dados numéricos , Pandemias , Ásia , Europa (Continente) , Humanos , América do Norte , Polônia
8.
Med Sci Monit ; 27: e931856, 2021 Aug 31.
Artigo em Inglês | MEDLINE | ID: mdl-34462415

RESUMO

BACKGROUND The mortality caused by hepatocellular carcinoma is expected to rise in the upcoming decade. Sorafenib has become the preferred systemic treatment option in patients with unresectable HCC. This study aimed to present the median overall survival (OS) in a group of patients with advanced HCC, treated with sorafenib in Poland between 2011 and 2019. MATERIAL AND METHODS The analyzed group of patients was qualified for treatment with sorafenib, financed by the National Health Fund, based on the guidelines of the Polish Drug Program. Kaplan-Meier method was used to plot the OS curves, and the log-rank test was used for testing. Multivariate assessment of factors (sex and age) related to the time to death of the patient was done using Cox regression. RESULTS Of the 2072 treated patients, 75% were men (1556) and 25% were women (516). The minimum age of patients in the trial group was 18 years and the maximum age was 90 years. Among the 1556 analyzed cases in males, 27.44% (427) did not end with death (by the date of completing the analysis). The percentage of one-year survival for this population was 58.16%, and the 2-, 3-, and 5-year survival rates were 34.45%, 21.81%, and 9.72%, respectively. The percentage of censored cases in the 516 females was 25.78% (133). The 1-2-, 3-, and 5-year survival for this population was 59.30%, 36.27%, 22.47%, and 11.34%, respectively. Statistical tests did not reveal a significant difference in the curve profiles by sex. There were no associations between OS and age. CONCLUSIONS Systemic treatment with sorafenib in accordance with the presented criteria allows for very good results, comparable to the results of selected groups of patients presented by other authors.


Assuntos
Antineoplásicos/uso terapêutico , Carcinoma Hepatocelular/tratamento farmacológico , Neoplasias Hepáticas/tratamento farmacológico , Sorafenibe/uso terapêutico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma Hepatocelular/mortalidade , Feminino , Humanos , Neoplasias Hepáticas/mortalidade , Masculino , Pessoa de Meia-Idade , Polônia , Estudos Retrospectivos , Análise de Sobrevida , Adulto Jovem
9.
Transplant Proc ; 53(6): 1784-1791, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33888347

RESUMO

BACKGROUND: Hematopoietic stem cell transplantation is a method of treatment in many diseases, including oncology. For a large group of patients, such a therapy is a procedure that saves their health and life. Most of the transplants come from unrelated donors, which are still insufficient in comparison to the recipients in need. The purpose of the study to assess the knowledge, opinions, and attitudes of students of Warsaw universities toward hematopoietic stem cell transplantation. METHODS: The survey was conducted among 351 students of Warsaw universities. The research method was a diagnostic survey, and the tool was the author's questionnaire. The statistical analysis was performed using the StatSoft Statistica 13.1 PL statistical package and Microsoft Office package. RESULTS: The respondents answered correctly on an average 59% of the analyzed issues. Medical students older than 25 and women had a higher level of knowledge; 41.6% of respondents were registered in the donor database, and this more often referred to medical students (P < .0001). The motivation for registering (97.3%) was the willingness to help another person. The unregistered reported that their lack of a decision on registration, among others, was because their general health condition made it impossible to become a donor (34.6%) or they had insufficient knowledge (31.7%)-this more often referred to nonmedical students (P < .0001). In addition, 55% of students would be interested in attending a meeting/lecture at their university about being a potential donor (including 63.1% of medical and 44.9% of nonmedical students). CONCLUSIONS: The knowledge of the surveyed students was at an average level, and the opinions and attitudes were mostly favorable. It seems that the organization of meetings on bone marrow donation at universities could enable a larger number of undecided students to decide to enter into the donor register.


Assuntos
Transplante de Células-Tronco Hematopoéticas , Estudantes de Medicina , Adulto , Atitude , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Conhecimento , Inquéritos e Questionários , Obtenção de Tecidos e Órgãos , Universidades
10.
Clin Exp Hepatol ; 6(3): 163-169, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33145422

RESUMO

The recommendations set out the principles of diagnosis and treatment of hepatitis C virus (HCV) infections according to the most recent knowledge. The main goal of therapy for HCV infection is to eliminate the virus from the body, which consequently leads to arrest of progress or regression of changes in the liver. Current version of the recommendations prioritise pangenotypic regimens and provide guidelines in special populations of patients, such as children, cirrhotics, human immunodeficiency virus (HIV) and hepatitis B virus (HBV) coinfected, those with renal failure, hepatic decompensation and non-responders to previous therapies.

11.
Clin Exp Hepatol ; 6(3): 170-175, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33145423

RESUMO

In recent years, rapid growth of incidence of metabolic syndrome, obesity and diabetes has been noted worldwide. Concurrent non-alcoholic steatohepatitis (NASH) has become a dominant factor of hepatic cirrhosis and hepatocellular carcinoma (HCC). The most important risk factors of transition from NASH to HCC are the degree of liver fibrosis, diabetes, obesity, age and male gender. Body mass index (BMI) reduction and increase of physical activity limit the risk of occurrence of HCC. Also, treatment of diabetes with metformin and application of statins have potential anticancer effects. Patients with HCC due to NASH should be treated in line with BCLC staging. Distant results of HCC therapy in the course of non-alcoholic fatty liver disease (NAFLD) are similar to the results of cancer of different aetiologies. However, patients with the metabolic syndrome are at high perioperative risk, and thus require accurate preparation, especially cardiological, in order to avoid that risk.

12.
PLoS One ; 15(7): e0235764, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32645071

RESUMO

INTRODUCTION: Chronic hepatitis C (HCV), considered by the World Health Organization as one of the greatest epidemiological health hazards, often with asymptomatic clinical course and one which, due to scanty knowledge, remains a crucial risk factor of serious chronic HCV infection complications. The purpose of this study is to validate the psychometric properties of the Polish version of the validated Brief Hepatitis C Knowledge Scale (BHCKS_PL), developed by Balfour in 2009. METHODS: The study, conducted from May to July 2018, included 246 persons (68,69% females), divided into four subgroups: patients (n = 86), nursing students (n = 74), medical students (n = 28), healthcare workers (nurses and doctors; n = 58). The 19-items questionnaire contained questions designed to assess general knowledge regarding hepatitis C and the transmission risk factors. RESULTS: An evaluation by means of multiple comparisons in pairs showed that there were significant differences in the knowledge level between the group of patients and the group of nursing students (Mdn: 14.0 vs 11.0, z = 7.713, P<0.001), and between students of medicine (Mdn: 16.0 vs 11.0, z = 0.339, P<0.001) and healthcare workers (17.0 vs 11.0, z = 11.447, P<0.001). Moreover, significant differences were observed between the groups of students of nursing and medicine (Mdn: 14.0 vs 16.0, z = 3.646, P = 0.002) and healthcare workers (Mdn: 14.0 vs 17.0, z = 4.117, P<0.001). No significant differences in the knowledge level between the students of medicine and healthcare workers were observed (z = 0.377, P = 1.000). CONCLUSIONS: The completed validation suggests good BHCKS_P psychometric characteristics with the internal consistency convergent and known-groups validity. The questionnaire can be used in educational practice. The obtained results of the measurement provide information about the studied person based on the total score.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Hepatite C , Inquéritos e Questionários , Adulto , Feminino , Pessoal de Saúde , Hepatite C/diagnóstico , Hepatite C/transmissão , Hepatite C Crônica/diagnóstico , Hepatite C Crônica/transmissão , Humanos , Masculino , Pessoa de Meia-Idade , Pacientes , Polônia , Psicometria/métodos , Estudantes de Medicina , Estudantes de Enfermagem
13.
Clin Exp Hepatol ; 6(2): 74-76, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32728622

RESUMO

AIM OF THE STUDY: The purpose of the study was to select the optimal target population for a possible national hepatitis C virus (HCV) screening program in Poland, based on the most recent available data. MATERIAL AND METHODS: The analysis included 723,654 participants from different populations screened for anti-HCV. Testing was performed in the whole blood using rapid anti-HCV kits. Presence of HCV RNA was additionally demonstrated in some anti-HCV positive patients with the real-time polymerase chain reaction method. RESULTS: Altogether 3,548 anti-HCV positive individuals were identified, so the prevalence rate in the whole studied population was 0.5%. The highest percentage (1.2%) was shown by diagnostic laboratories, which offered rapid testing for patients visiting their offices during the HCV awareness campaign. Relatively high anti-HCV prevalence of 0.6-0.7% was noted in hospitals and in private medical centers, as well as during music concerts. Surprisingly, the lowest prevalence (0.2%) was observed in general practitioners' offices. Among 502 anti-HCV positive individuals tested additionally for HCV RNA, viremic presence was demonstrated in 40%. CONCLUSIONS: Anti-HCV testing in Poland should be carried out using rapid anti-HCV kits at the patients' admission to the hospitals and should also be offered to patients during their visits for any purpose in diagnostic laboratories or private medical centers.

14.
Transplant Proc ; 52(8): 2497-2502, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32362463

RESUMO

AIM: The aim of the study was a single-center assessment of occurrence of surgical site infections (SSI) in patients after liver transplantation and an attempt to determine factors that may contribute to this complication. PATIENTS AND METHODS: Analysis of medical records of 60 adult patients, who underwent first transplantation in 2016 and 2017 was conducted. Selected pre-, intra-, and postoperative factors were assessed. Statistical analysis was performed with StatSoft Statistica 13.1 PL package. RESULTS: SSI occurred in 25% of liver recipients, with average timing of diagnosis on the 14th day after surgery. Mean duration of hospitalization was significantly longer in patients who experienced SSI than in patients without this complication (35.8 ± 8.9 days vs 25.2 ± 6 days, P < .0001). SSI occurred a little more frequently in men and older recipients, as well as in overweight and underweight patients (not significant). An indication for transplantation did not have an impact on SSI occurrence. The complication was more likely in patients with diabetes and renal failure prior to transplantation (P > .05). Duration of the procedure, blood loss and prolonged drainage did not have any impact on SSIs. SSI was significantly more common in recipients with lower total protein value (P < .0002) and anemia (P < .0002) in early postoperative period. CONCLUSION: Among the studied population, a high incidence of SSI was noted, and that some of the identified risk factors differ from those described in the literature.


Assuntos
Transplante de Fígado/efeitos adversos , Infecção da Ferida Cirúrgica/epidemiologia , Adulto , Idoso , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Fatores de Risco
15.
Transplant Proc ; 52(7): 2001-2006, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32359827

RESUMO

BACKGROUND: In recent years a systematic decrease in donation activity in Poland (15.4 vs 13.0) has been observed. A significant reduction has been noticed in Warsaw (36.2 vs 19.2) as well. METHODS: Data on deaths of patients admitted to intensive care units (ICUs) of Warsaw hospitals in from 2014 to 2018 were analyzed. Analysis was conducted in compliance with the Helsinki Congress and the Istanbul Declaration. Population of the city during this period averaged 1,753,480, although specialized capital hospitals service substantially bigger area than Warsaw alone. There are 18,500 to 18,600 deaths affecting this population every year. A total of 333 patients diagnosed as having brain death were included in analysis. RESULTS: In 42 cases (12.7%) data collection was given up because of lack of authorization. In all donors, death was diagnosed according to neurologic criteria. The most common causes were vascular brain diseases (64.1%) and craniocerebral trauma (21.4%). In 14.5% brain death occurred from other reasons. There are 20 hospitals with ICUs in Warsaw, which totals 318 intensive care beds. Program of identification of deceased organ donors was active in only 14 hospitals. A total of 243 potential donors (73%) were identified in the 3 most active hospitals. CONCLUSION: Analysis of ICU deaths of Warsaw hospitals showed a gradual decrease in the number of reported donors (from 75 in 2014 to 46 in 2018), although the number of all deaths did not decrease (the number of deaths in ICUs was on average 2.571/y).


Assuntos
Unidades de Terapia Intensiva/estatística & dados numéricos , Doadores de Tecidos/provisão & distribuição , Doadores de Tecidos/estatística & dados numéricos , Obtenção de Tecidos e Órgãos/provisão & distribuição , Obtenção de Tecidos e Órgãos/estatística & dados numéricos , Adulto , Morte Encefálica , Feminino , Hospitais , Humanos , Polônia
16.
Ann Transplant ; 25: e920232, 2020 Mar 03.
Artigo em Inglês | MEDLINE | ID: mdl-32123153

RESUMO

BACKGROUND The aim of this study was to evaluate the feasibility of using intravoxel incoherent motion (IVIM) imaging for noninvasive assessment of pathologic changes in chronic kidney disease (CKD). MATERIAL AND METHODS Thirty-four patients with CKD and 20 healthy volunteers were examined on a 1.5 T magnetic resonance imaging (MRI) unit. The examination consisted of morphologic sequences and diffusion-weighted echo-planar sequence with 10 b values. Diffusion parameters were calculated with the use of mono- (apparent diffusion coefficient, ADC) and bi-exponential model: pure diffusion coefficient (D) and perfusion fraction (Fp). Blood samples to assess the serum creatinine level were taken immediately before examination. Ultrasound guided biopsies were performed in less than 30 days from MRI and were scored by an experienced nephropathologist. Parametrical unpaired t-test and ROC curve analysis were used to investigate differences in diffusion parameters in relation to estimated glomerular filtration rate (eGFR). Pearson's correlation coefficients were calculated to assess relationship between diffusion parameters and laboratory and histopathological markers of renal damage. P-value <0.05 indicated statistical significance. RESULTS Both ADC and D correlated positively with eGFR (respective r 0.74 and 0.72), however D showed a more significant correlation with histopathology: while D correlated negatively with parameters reflecting chronic glomerular (r -0.48) and tubulo-interstitial changes (r -0.47), ADC correlated only with interstitial infiltrations (r -0.44). Flow-related diffusion parameters showed high standard deviation. CONCLUSIONS IVIM imaging is sensitive to functional and morphologic changes in CKD. The separation of influence of Fp from true diffusion improves the assessment of chronic changes in renal parenchyma.


Assuntos
Rim/diagnóstico por imagem , Insuficiência Renal Crônica/diagnóstico por imagem , Adulto , Imagem de Difusão por Ressonância Magnética , Feminino , Taxa de Filtração Glomerular/fisiologia , Humanos , Rim/fisiopatologia , Masculino , Pessoa de Meia-Idade , Insuficiência Renal Crônica/fisiopatologia
17.
Artif Organs ; 44(1): 91-99, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31267563

RESUMO

Acute-on-chronic liver failure (ACLF) requiring intensive medical care and associated with acute kidney injury (AKI) has a mortality rate as high as 90% due to the lack of effective therapies. In this study, we assessed the effects of intermittent high-flux single-pass albumin dialysis (SPAD) coupled with continuous venovenous hemodialysis (CVVHD) on 28-day and 90-day survival and an array of clinical and laboratory parameters in patients with severe ACLF and renal insufficiency. Sixteen patients were studied. The diagnosis of ACLF and AKI was made in accordance with current EASL Clinical Practice Guidelines, including the recommendations of the International Club of Ascites. All patients received SPAD/CVVHD treatments as the blood purification therapy to support liver, kidneys, and other organs. Five patients were transplanted and 11 were not listed for transplantation because of active alcoholism. Data at the initiation of SPAD/CVVHD were compared with early morning data after the termination of the extracorporeal treatment phase. All patients had ACLF and renal insufficiency with 13/16 additionally fulfilling the AKI criteria. A total of 37 SPAD/CVVHD treatments were performed [2.3 ± 1.4]. The baseline MELD-Na score was 37.6 ± 6.6 and decreased to 33.4 ± 8.7 after SPAD/CVVHD (P < 0.001). In parallel, the CLIF-C ACLF grade and OF score, estimated at 28- and 90-day mortality, AKI stage, hepatic encephalopathy grade, and liver function tests were lowered (P = 0.001-0.032). The 28- and 90-day survivals were 56.2% overall and 53.8% in AKI. Survival in patients not transplanted (n = 11) was 45.4%. In patients with severe ACLF and AKI, the renal replacement therapy coupled with high-performance albumin dialysis improved estimated 28- and 90-day survival and several key clinical and laboratory parameters. It is postulated that these results may be further improved with earlier intervention and more SPAD treatments per patient. High-performance albumin dialysis improves survival and key clinical and laboratory parameters in severe ACLF and AKI.


Assuntos
Injúria Renal Aguda/terapia , Insuficiência Hepática Crônica Agudizada/terapia , Terapia de Substituição Renal Contínua/métodos , Albumina Sérica Humana/uso terapêutico , Injúria Renal Aguda/complicações , Insuficiência Hepática Crônica Agudizada/complicações , Adulto , Idoso , Feminino , Humanos , Transplante de Fígado , Masculino , Pessoa de Meia-Idade , Diálise Renal/métodos
18.
Am J Mens Health ; 13(4): 1557988319860970, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31268395

RESUMO

The objective of the study was the realistic evaluation of the prevalence of eating disorders (ED) among Polish men who sought treatment through the National Health Fund (NFZ) in the years 2010-2017. According to ICD-10, four types of ED were analyzed: anorexia nervosa-AN (F50.0), atypical anorexia nervosa (F50.1), bulimia nervosa-BN (F50.2), and atypical bulimia nervosa (F50.3). The NFZ database was used. The ED groups were defined according to ICD-10 codes. Demographic data were collected from the web page of Statistics Poland (GUS). The annual prevalence of EDs was estimated, and the age groups were categorized into nine groups. For the incidence of EDs in male patients in the years 2010-2017, relative risk (RR) with 95% confidence interval (95% CI) was calculated. The frequency trend of AN in males remains relatively stable. AN occurred mainly in young men (between 11 and 30 years). It was noted that AN affected approximately 100 men in each year of observation, while atypical anorexia nervosa affected about 40 men. In 2017, the RR for EDs in young males was 0.041 (95% CI [0.033, 0.051]). Bulimia was relatively rare (about 35 males each year). The incidence of EDs in males is a relatively constant phenomenon. The real number of male patients with EDs may be higher. The current conceptualizations of ED pathology should be modified and better adapted to men. Clinical guidelines for specialists working with males with EDs should be developed.


Assuntos
Índice de Massa Corporal , Transtornos da Alimentação e da Ingestão de Alimentos/epidemiologia , Saúde do Homem/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Adolescente , Adulto , Transtornos da Alimentação e da Ingestão de Alimentos/terapia , Seguimentos , Humanos , Masculino , Polônia , Prevalência , Qualidade de Vida , Adulto Jovem
19.
Ann Transplant ; 24: 312-318, 2019 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-31147531

RESUMO

BACKGROUND Hepatitis B and C viruses have been recognized as undoubtedly carcinogenic to humans. In the Polish population, where most people are protected by HBV vaccinations, hepatocellular carcinoma (HCC) and its main cause, persistent HCV infection, significantly affect the demand for liver transplantations. MATERIAL AND METHODS The purpose of this study was to categorize the number of primary liver transplantations in Poland in the years 2001-2017 by cause and to analyze changes in LTx indications during this period. Data were sourced from POLTRANSPLANT, the Organization and Coordination Center for Transplantation in Poland. Additionally, we compared the numbers of HCC cases and hepatitis B and C cases during this period. RESULTS In the analyzed period, in Poland, 3332 primary liver transplantations were performed. Overall, 44% (1456) of LTx cases were combined with HBV and/or HCV and/or HCC. In this group, transplants in patients with only 1 specific factor - HCV - formed the largest cohort, accounting for about 40% (581) of cases. Transplants in patients who only had HBV and in those who only had HCC accounted for 12% (185) and 5% (69), respectively. CONCLUSIONS The analyzed data suggest that HCV infections are a significant public health problem in Poland, as is also reflected by the growing number of LTx performed due to HCC. To limit the numbers of HCV and HCC cases, immediate implementation of a Polish National Program against HCV should be considered.


Assuntos
Carcinoma Hepatocelular/cirurgia , Hepatite B/cirurgia , Hepatite C/cirurgia , Neoplasias Hepáticas/cirurgia , Transplante de Fígado , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma Hepatocelular/etiologia , Carcinoma Hepatocelular/patologia , Feminino , Hepatite B/complicações , Hepatite B/patologia , Hepatite C/complicações , Hepatite C/patologia , Humanos , Neoplasias Hepáticas/etiologia , Neoplasias Hepáticas/patologia , Masculino , Pessoa de Meia-Idade , Polônia , Fatores de Risco , Adulto Jovem
20.
Biomed Res Int ; 2019: 2474839, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31080812

RESUMO

Cystic echinococcosis is considered as an emerging zoonosis that can develop asymptomatically for years, clinically nonpathognomic. The disease is of public health importance due to often late, difficult diagnostics, uncertain results of treatment, the need to remove hydatid cysts surgically in advanced cases, and poor prognosis in untreated patients. Six Polish female patients with diagnosed cystic echinococcosis (CE) were examined. DNA extracted from the liver and lung samples served for amplification of mitochondrial nad1 gene fragment. Sequence alignments of 5 isolates showed identity with the pig strain, Echinococcus canadensis G7. One case was in 100% identical with Echinococcus ortleppi G5, the cattle strain. These data demonstrate first report of E. ortleppi, regarded as extinct species, causing human cystic echinococcosis in Poland, where the most frequent causative agent of human CE is E. canadensis.


Assuntos
Cistos/parasitologia , Echinococcus/isolamento & purificação , Adulto , Animais , Bovinos , Doenças dos Bovinos/genética , Doenças dos Bovinos/parasitologia , Cistos/genética , DNA Mitocondrial/genética , Equinococose/genética , Equinococose/parasitologia , Feminino , Genótipo , Humanos , Fígado/parasitologia , Pulmão/parasitologia , Pessoa de Meia-Idade , Mitocôndrias/genética , Mitocôndrias/parasitologia , Polônia , Suínos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...