Features of clinical, biochemical, and sonographic parameters in patients with chronic viral hepatitis C with concomitant non-alcoholic fatty liver disease.

INTRODUCTION AND OBJECTIVE: Introduction. Difficulties encountered in treating patients with chronic viral hepatitis C (CHC) are associated with the presence of concomitant liver pathology, namely fatty degeneration, which contributes to the progression of HCV infection. The above circumstances prompted the authorsled to thoroughly examine of this category of patients for further development of a new pathogenetically directed course of treatment. Objective. To study clinical, biochemical, and instrumental features of the course of liver disease in CHC patients with concomitant non-alcoholic fatty liver disease (NAFLD). MATERIAL AND METHODS: Tested 339 patients with chronic hepatitis C with concomitant NAFLD; and 175 patients with СНС. Methodology: anamnestic, anthropometric and clinical, general clinical, biochemical, serological, and molecular genetic (markers of hepatitis C virus, HCV RNA PCR (qualitative and quantitative determination, genotyping), enzyme-linked immunosorbent assay, ultrasonographic examination of digestive organs, statistical methods. RESULTS: Conducted clinical, instrumental, and laboratory studies have shown that CHC patients with concomitant NAFLD are characterized by various disorders - a violation of the functional state of the liver, a violation of carbohydrate and lipid metabolism, an imbalance of the cytokine system, the presence of histological and non-inflammatory activity in the liver. CONCLUSIONS: The presence of concomitant NAFLD in patients with CHC aggravates the clinical picture, manifesting itself in a significant lipid metabolism disorder that provokes the rapid formation of liver fibrosis. An additional complicating factor is the development of insulin resistance, leading to persistent morphological changes in the liver parenchyma.

Evaluation of work conditions of nurses employed in a shift system in hospital wards during the COVID-19 pandemic.

BACKGROUND: Nurses work in a shift system that determines the provision of round-the-clock care of a patient in hospital conditions; however, it entails health consequences. OBJECTIVE: The aim of the study was the evaluation of work conditions of nurses engaged in shift work in hospital wards during the COVID-19 pandemic. METHODS: The study was conducted in 2020, and included 108 nurses working in a shift system in hospital wards. The research method was a diagnostic survey, using an author-constructed questionnaire. RESULTS: 88.9% nurses reported a negative effect of shift work on their physical health: 'musculoskeletal pain', 'elevated arterial blood pressure', and 'hormonal disorders' - 54.5% of respondents used pharmacological treatment. The causes of physical disorders were: 'microclimate', 'physical effort', 'noise', and 'forced body position'. Shift work exerted a negative effect on psychological health of the majority of respondents (75.0%): 'deconcentration', 'sleep disorders', 'feeling of occupational burnout' - treatment in 38.9% of respondents. Psychological health disorders were caused by: 'circadian rhythms disturbance by shift work', 'chronic stresses', and 'conflicts at work'. 69.7% of respondents reported that their shift work was disturbed by organizational factors, including: a 'badly planned work schedule', 'enhanced pace of work due to staff shortage', 'ambiguous division of duties, rights, responsibilities', 'shortages of equipment at the workplace'. CONCLUSION: The examined nurses experienced a negative effect of shift work on their physical and psychological health which, for some of them, was the cause of pharmacological treatment. Many organizational factors hindered the work of nurses in a shift system in hospital wards.

Assessment of the degree of illness acceptance in patients diagnosed with hepatitis C.

INTRODUCTION: In Poland, approximately 730,000 people are infected with the hepatitis C virus (HCV). Acceptance of a chronic illness may positively motivate patients in the process of treatment. The higher the degree of illness acceptance, the lower the feeling of psychological discomfort and a lower intensity of negative emotions. OBJECTIVE: The aim of the study was assessment of illness acceptance among patients with chronic hepatitis C, and determination of the level of the relationship between social and demographic variables, and the degree of illness acceptance. MATERIAL AND METHODS: The study included 220 patients with a diagnosis of chronic hepatitis C. The research method was a diagnostic survey, while the instruments used were the Acceptance of Illness Scale (AIS) and an author-constructed questionnaire. RESULTS: Respondents most frequently accepted their illness to the mean degree (30 scores), and a low category or even the lack of acceptance (<20 scores) of respondents. Urban inhabitants significantly more often accepted their illness to a high degree, compared to rural inhabitants. Disability pensioners and retired pensioners significantly more frequently accepted their disease in the category - low degree. The remaining independent variables: gender, age, education, marital status, number of years of illness, had no significant effect on the degree of acceptance of hepatitis C. CONCLUSIONS: The majority of patients diagnosed with chronic hepatitis C accept their illness to the mean degree. Patients with hepatitis C should be covered with psychological assistance in order to change the way of perception and evaluation of their health situation in more positive terms.

Concept of Health in Opinions of Patients Diagnosed with Hepatitis C.

Objectives:The aim of this study was assessment of the value of health in opinions of patients with chronic hepatitis C. Methods: The study was conducted among 220 patients infected with HCV by the diagnostic survey method using the Health Criteria List (LHC) and the proprietary questionnaire. Results: Patients infected with HCV evaluated their health status mainly as mediocre - 50.9%. Older respondents significantly more rarely defined being healthy as "being employed, having various interests," and "feeling well." For males, health meant "eating properly," whereas for females - it was "experiencing no physical complaints." Respondents who had higher education understood health mainly as "having skills of solving own problems." Those married significantly more often mentioned "experiencing no physical complaints." Rural inhabitants significantly more frequently considered that being healthy meant "being able to associate well with others," compared to urban inhabitants. Conclusions: Valuation of health by patients infected with HCV depends on age, gender, level of education, place of residence, marital status, and duration of the disease. Arrangement according to rank allowed establishing what 'being healthy' means for patients with hepatitis C, and to what extent health is identified with goal, state, feature, and process.