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1.
Ann Agric Environ Med ; 26(3): 479-482, 2019 Sep 19.
Artigo em Inglês | MEDLINE | ID: mdl-31559807

RESUMO

INTRODUCTION: Trauma is the third cause of death among the general population in Poland, and the first in people aged 1-44 years. Trauma centers are hospitals dedicated to treating patients with multiple organ injuries, in a complex way that endeavours to ensure a lower mortality rate, shorter hospital stay and better outcomes if the patients are transferred to such a center. Worldwide, there are many models on how to treat a trauma patient, but them to be qualified for the procedure, the selection of potential patients is crucial. OBJECTIVE: The aim of the study was to compare the Polish model for qualification to a trauma center and American Guidelines for Field Triage. MATERIAL AND METHODS: Retrospective analysis of medical documentation recorded between 1 January 2014 - 31 December 2014 was undertaken. The study concerned trauma patients admitted to the Emergency Department of the Regional Trauma Center at the Copernicus Memorial Hospital in Lódz, Poland. Inclusion criterion was initial diagnosis 'multiple-organ injury' among patients transported by the Emergency Medical Service (EMS). RESULTS: In the period indicated, 3,173 patients were admitted to the Emergency Department at the Copernicus Memorial Hospital. From among them, 159 patients were included in the study. Only 13.2% of the patients fulfilled the Polish Qualification Criteria to Trauma Center in comparison to 87.4% who fulfilled the American Guidelines for Field Triage. CONCLUSIONS: Polish qualification criteria do not consider the large group of patients with severe injuries (ISS>15), but indicate patients with minimal chance of survival. Polish criteria do not consider the mechanism of injury, which is a relevant predictive indicator of severe or extremely severe injuries (ISS>15). Further studies should be undertaken to improve the qualification and treatment of trauma patients in Poland.


Assuntos
Centros de Traumatologia/normas , Triagem/normas , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Guias como Assunto , Humanos , Lactente , Tempo de Internação , Masculino , Polônia , Estudos Retrospectivos , Estados Unidos , Ferimentos e Lesões/mortalidade , Ferimentos e Lesões/terapia , Adulto Jovem
2.
Wiad Lek ; 71(5): 966-973, 2018.
Artigo em Polonês | MEDLINE | ID: mdl-30176624

RESUMO

OBJECTIVE: Introduction: Under the Act on State Emergency Medicine System, an emergency medical team consists of at least two members, including a specialist system nurse or paramedic, who have the license to perform medical rescue activities. However, this does not exclude the possibility of expanding the team. In practice, however, it appears that in most cases a head of healthcare institution decides to have teams with a number of members limited to two persons in which a paramedic or nurse also fulfil the function of a driver. PATIENTS AND METHODS: Materials rial and methods: An originally designed questionnaire was used to collect data. The sample group included 138 employees working in two-person emergency medical teams at the Regional Ambulance Station in Poznan. RESULTS: Results: Over half of the subjects (N=90; 65,2%) rarely requests assistance from another emergency medical team as support in intervention, however, when transporting patients such teams are often assisted by patients' families (N=129; 93,5%). The patient's weight is one of the most frequently cited reasons for using such assistance. Every third respondent knows standards on weight limits for manual transport. 77,5 % of respondents believe that the Act on State Emergency Medicine should be amended by increasing the minimum number of members in primary care emergency medical teams from two to three. CONCLUSION: Conclusions: It may be concluded that formation of two-person teams constitutes an infringement of occupational health and safety regulations on manual transport, which increases the risk of injury occurrence.


Assuntos
Serviços Médicos de Emergência , Atenção Primária à Saúde , Segurança , Pessoal Técnico de Saúde , Feminino , Humanos , Masculino , Enfermeiras e Enfermeiros , Polônia , Inquéritos e Questionários
3.
Arch Med Sci ; 14(4): 865-870, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30002706

RESUMO

Introduction: The Revised Trauma Score (RTS) accurately identifies trauma patients at high risk of adverse events or death. Less is known about its usefulness in the general population and non-trauma recipients of Helicopter Emergency Medical Service (HEMS). The RTS is a simple tool and omits a lot of other data obtained during clinical evaluation. The aim was to assess the role of the RTS to identify patients at risk of major complications (death, cardiopulmonary resuscitation, defibrillation, intubation) in the general population of HEMS patients. Clinical factors beyond the RTS were analyzed to identify additional prognostic factors for predicting major complications. Material and methods: A retrospective analysis of medical records of adult patients routinely collected during HEMS missions in the years 2011-2014 was performed. Results: The analysis included 19 554 HEMS missions. Patients were 55 ±20 years old and 68% were male. The most common indication for HEMS was diseases of the circulatory system - 41%. Major complications occurred in 2072 (10.6%) cases. In the general population of HEMS patients, the RTS accurately identified individuals at risk of major complications at a cut-off value of 10.5 and area under the curve (AUC) of 93.5%. In multivariate analysis, additional clinical data derived from clinical examination (ECG; skin, pupil and breathing examination) significantly but marginally improved the accuracy of RTS assessment: AUC 95.6% (p < 0.001 for the difference). Conclusions: The Revised Trauma Score accurately identifies individuals at risk of major complications during HEMS missions regardless of the indication. Additional clinical data significantly but marginally improved the accuracy of RTS in the general population of HEMS patients.

4.
Cardiol J ; 25(3): 291-300, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29671864

RESUMO

A group of Polish experts in cardiology and emergency medicine, encouraged by the European Society of Cardiology (ESC) guidelines, have recently published common recommendations for medical emergency teams regarding the pre-hospital management of patients with acute coronary syndrome. Due to the recent publication of the 2017 ESC guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation and 2017 focused update on dual antiplatelet therapy in coronary artery disease the current panel of experts decided to update the previous standpoint. Moreover, new data coming from studies presented after the previous document was issued were also taken into consideration.


Assuntos
Síndrome Coronariana Aguda/tratamento farmacológico , Cardiologia , Serviços Médicos de Emergência/normas , Prova Pericial , Inibidores da Agregação de Plaquetas/uso terapêutico , Guias de Prática Clínica como Assunto , Sociedades Médicas , Humanos , Polônia
5.
Adv Clin Exp Med ; 26(8): 1225-1231, 2017 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-29264879

RESUMO

BACKGROUND: Carotid endarterectomy (CEA) is a surgical procedure used in ischemic brain stroke prevention in patients with symptomatic and asymptomatic severe carotid artery stenosis. OBJECTIVES: This study compares perioperative stroke or death rate after carotid endarterectomy (CEA) in male and female patients, and determines risk factors for perioperative incidents in women and men. MATERIAL AND METHODS: The outcome of surgical treatment of 269 consecutive symptomatic patients (181 men and 88 women) treated from January 2004 to August 2008 in the Department of Vascular, General and Oncologic Surgery was analyzed. RESULTS: Perioperative stroke-death rate (within 30 days after the surgery) in women was 6.8% (6/88) and 3.3% (6/181) in men (p > 0.05). In the female group, none of the analyzed risk factors were associated with a higher risk of periprocedural incident, while in men, only hypercholesterolemia was a significant predictor of perioperative stroke (TC > 240 vs 240 vs 200-240: OR = 6.59; 95% CI: 1.12-38.97; p = 0.0375). CONCLUSIONS: In men, hypercholesterolemia significantly increased the risk of perioperative stroke or death, while in females, none of the analyzed factors were determined as the predictors of the incident. The fact that plaque type VI by AHA was significantly more frequent in women and men more frequently were suffering from ischemic heart disease and peripheral artery occlusive disease appeared not to influence the outcome of CEA.


Assuntos
Estenose das Carótidas/cirurgia , Endarterectomia das Carótidas/efeitos adversos , Acidente Vascular Cerebral/etiologia , Adulto , Idoso , Feminino , Humanos , Hipercolesterolemia/complicações , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/etiologia , Fatores de Risco , Caracteres Sexuais , Acidente Vascular Cerebral/mortalidade
7.
Wiad Lek ; 70(6 pt 1): 1088-1095, 2017.
Artigo em Polonês | MEDLINE | ID: mdl-29478984

RESUMO

OBJECTIVE: Objective: Assessment of execution time and tissue damage during providing percutaneous airway access using four ready-to-use sets: Quicktrach I (Q1) and II (Q2), Portex Cricothyroidothomy Kit (PCK) and Surgicric I (SC). PATIENTS AND METHODS: Material and methods:Prospective laboratory test. Each of 54 participants carried out 1 puncture on porcine larynx preparation for each of 4 sets, which resulted in a total of 216 trials. Efficacy was defined as placing a cannula in the tracheal lumen ensuring adequate ventilation. Safety was assessed based on the size and type of laryngeal damage, improper placement of the cannula, perforation of the esophagus and extensive destruction of surrounding tissues. RESULTS: Results: The percentage of effective procedures for respective sets was: PCK - 94.4%; Q1 - 100.0%; Q2 - 96.3%; SC - 96.3%. Differences were not statistically significant. There were significant differences in duration of the procedure: PCK - 59.20 s (20.0-188.0 s, SD ± 35.25), Q1 - 21.76 s (6.0-61.0 s; SD ± 10.62), Q2 - 28.36 s (5.0-71.0 s, SD ± 14.86), SC - 48.71 s (29.0-9.0 s, SD ± 15.07). The size of the lesions of anterior and posterior walls of the larynx and trachea were significantly different. The mean (SD) lesions of the anterior laryngeal wall for respective sets were: PCK - 11.18 mm ± 5.11; Q1 - 6.59 mm ± 2.22; Q2 - 7.71 mm ± 1.87; SC - 19.85 mm ± 5.72, and for the posterior wall of the trachea: PCK - 8.29 ± ± 8.43; Q1 - 0.44 mm ± 1.22; Q2 - 0.92 mm ± 3.79; SC - 0.08 mm ± 0.27. Percentage of additional damages for respective sets: PCK - 18.5%, Q1 - no damages; Q2 - 5.6% and SC - 3.7%. CONCLUSION: Conclusions: There were no differences in the efficacy of particular sets. Significant differences were demonstrated for the duration and safety of the procedure. The average time as well as the size of posterior wall damage and the amount of additional damage was the highest for PCK and the lowest in case of Q1.


Assuntos
Manuseio das Vias Aéreas/métodos , Cartilagem Cricoide/patologia , Cartilagem Cricoide/cirurgia , Tratamento de Emergência/métodos , Intubação Intratraqueal/métodos , Traqueotomia/métodos , Manuseio das Vias Aéreas/efeitos adversos , Animais , Serviços Médicos de Emergência , Tratamento de Emergência/efeitos adversos , Modelos Animais , Polônia , Estudos Prospectivos , Respiração Artificial/métodos , Suínos
8.
Medicine (Baltimore) ; 95(52): e5777, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-28033300

RESUMO

The intubation difficulties in obese patients are not a new problem. They may result from an accumulation of fat in the oral cavity and cheeks. A thick tongue is also a significant factor. The literature reports that some tests to determine the intubation difficulties in obese people may be unreliable. The observed predictors of difficult intubation were the thyromental and sternomental distance and the intubation difficulty scale: FRONT score.The aim of this study was to assess the degree of difficult intubation in obese patients by the parameters such as the thyromental and sternomental distance. The authors also tried to evaluate the frequency of the guidewire usage and the number of intubation attempts in obese patients in the research sample.The study included the group of 153 patients intubated in prehospital conditions. The research was conducted in 3 clinical centers receiving patients from prehospital care. Among the members of the research sample, obese patients with body mass index >35 were selected and evaluated for various predictors of intubation difficulties. Quantitative analysis of differences in the incidence of the variables was assessed using the chi-squared test for P < 0.05. Analyses were performed in STATISTICA.Complications such as postintubation hematomas were more frequent in obese patients of the research sample. The frequency of the guidewire usage observed in that group was also higher. As anticipated by the adopted predictors, most of the obese patients were classified as difficult to intubate.There is a correlation between the occurrence of injuries and the prevalence of obesity in the research sample and the same dependency has been demonstrated in the issue concerning the use of the guidewire. Although the majority of predictors indicated patients with intubation difficulties, many predictors could show falsely positive results. The greater amount of intubation attempts was observed in obese patients. Further studies devoted to explain those correlations would be needed.


Assuntos
Hematoma/etiologia , Intubação Intratraqueal/efeitos adversos , Obesidade/complicações , Pontos de Referência Anatômicos , Estudos de Casos e Controles , Queixo/anatomia & histologia , Humanos , Esterno/anatomia & histologia , Glândula Tireoide/anatomia & histologia
9.
Ann Agric Environ Med ; 23(2): 350-6, 2016 Jun 02.
Artigo em Inglês | MEDLINE | ID: mdl-27294646

RESUMO

OBJECTIVE: The aim of this study is to investigate the morbidity rate due to Rheumatoid Arthritis (RA) in the Polish population during 2008-2012, calculated per 1,000 inhabitants, and taking into account the differences between provincess, area of residence (urban or rural) and gender. MATERIALS AND METHOD: From the NFZ IT systems, PESEL number information was obtained for all 17 types of services contracted in 2008-2012, for patients whose main diagnosis in the report was the ICD-10 disease code: M05.X - seropositive rheumatoid arthritis, or M06.X - other rheumatoid arthritis. The number of patients, gender and age were calculated based on the PESEL number provided in the statistical reports of the patient with the analysed ICD-10 diagnosis. Urban and rural cases were compared using commune zip codes. The basis for classifying the patient as a member of an urban or rural population was the Zip Code of the declared place of residence. Urban and rural areas are classified based on administrative criteria provided by the Central Statistical Office: the National Official Register of Territorial Division of the Country (TERYT). RESULTS: During the studied period the number of RA patients increased from 173,844-230,892. In urban areas, the most patients were recorded in the Slaskie Province, the least in Lubuskie Province. Patients from rural areas were approx. 1/3(rd) of the total population of patients in Poland. In rural areas, the most patients were recorded in the Mazowieckie Province, the least in Lubuskie Province. The morbidity rate in cities was 5.08 in 2008 and increased to 8.14 in 2012 in rural areas, respectively, it was 3.74 and increased to 3.98. Regardless of the place of residence the women fell ill 3.5 times more frequently. The lowest morbidity rate, both in rural and urban areas, was recorded in the Lubuskie Province, the largest in Swietokrzyskie Province. The the most probable explanation of the highest morbidity rate in the latter province is a worse access to a rheumatologist: in this province there is the lowest number of inhabitants per one employed rheumatologist. CONCLUSION: In Poland, the number of RA sufferers is increasing, which is probably a result of increasing life expectancy. In Poland, also exists a differences in morbidity between urban and rural inhabitants. Differences may also derive from undiagnosed cases of the disease.


Assuntos
Artrite Reumatoide/epidemiologia , Saúde da População Rural/estatística & dados numéricos , Saúde da População Urbana/estatística & dados numéricos , Adulto , Idoso , Artrite Reumatoide/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Morbidade , Polônia/epidemiologia
10.
Pol Przegl Chir ; 88(1): 48-53, 2016 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-27096775

RESUMO

Number of deaths related with injuries suffered as a result of experienced traumas is increasing. Penetrating traumas of the facial skeleton occur relatively rarely and much more often concern rather children than adults. Epidemiology relating this kind of trauma differs depending on the region of the world. In Poland, gunshot injuries as well as traumas caused by explosions of firecrackers or fireworks amount only to a slight percentage among all facial skeleton traumas, and the most common reason for penetrating traumas lies in accidents or assault with the use of sharp, narrow and long objects that easily enter bones of the facial skeleton. The present study reported the case of 50-year-old man who suffered from trauma of the facial skeleton, which resulted from foreign body (pickaxe) penetration into the subtemporal area, zygomatic arch and the right orbital cavity. The surgical treatment method and final outcome was presented and discussed.


Assuntos
Ossos Faciais/lesões , Ossos Faciais/cirurgia , Traumatismos Faciais/cirurgia , Armas , Ferimentos Penetrantes/diagnóstico , Ferimentos Perfurantes/cirurgia , Acidentes Domésticos , Humanos , Masculino , Maxila/lesões , Maxila/cirurgia , Pessoa de Meia-Idade , Ferimentos Perfurantes/diagnóstico
11.
Disaster Med Public Health Prep ; 10(1): 38-41, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26456325

RESUMO

OBJECTIVE: The aim of the study was to verify the effectiveness of short text messages (short message service, or SMS) as an additional notification tool in case of fire or a mass casualty incident in a hospital. METHODS: A total of 2242 SMS text messages were sent to 59 hospital workers divided into 3 groups (n=21, n=19, n=19). Messages were sent from a Samsung GT-S8500 Wave cell phone and Orange Poland was chosen as the telecommunication provider. During a 3-month trial period, messages were sent between 3:35 PM and midnight with no regular pattern. Employees were asked to respond by telling how much time it would take them to reach the hospital in case of a mass casualty incident. RESULTS: The mean reaction time (SMS reply) was 36.41 minutes. The mean declared time of arrival to the hospital was 100.5 minutes. After excluding 10% of extreme values for declared arrival time, the mean arrival time was estimated as 38.35 minutes. CONCLUSIONS: Short text messages (SMS) can be considered an additional tool for notifying medical staff in case of a mass casualty incident.


Assuntos
Comunicação , Incidentes com Feridos em Massa , Recursos Humanos em Hospital/tendências , Mensagem de Texto , Planejamento em Desastres/métodos , Planejamento em Desastres/estatística & dados numéricos , Humanos , Recursos Humanos em Hospital/estatística & dados numéricos , Polônia , Fatores de Tempo
13.
J Clin Monit Comput ; 30(4): 379-87, 2016 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-26120020

RESUMO

Currently, there are plenty of videolaryngoscopes that appear on the market. They have different specifications. Some of these features favor the fact that they are more suited for educational purposes of future operators and others can be characterized with an excellent clinical use. In this study we compared four types of videolaryngoscopes. The aim of the study was to compare the technical specifications of the above-mentioned devices for usefulness in clinical practice and correlate these parameters with the subjective evaluation of these videolaryngoscopes usage performed in practice by an experienced medical staff. All devices considered in this study participated in another multicenter clinical study on the basis of which we completed the subjective evaluation of the operators. In order to examine the technical parameters of the equipment we established the cooperation with the Department of Microelectronics at Technical University of Lodz. Mechanical and optical parameters and the endoscopic tube current were taken into consideration. The C-MAC has a camera with the widest viewing angle (the OX axis-63.1, the axis OY-47.8), which in combination with the largest diagonal size of the display enables the operator to see the details relevant to clinical practice. It has also the strongest lamp intensity of the devices mentioned in this comparison (7800 Lx). In comparison of the clinical use in almost all compared parameters the Cmac D-blade is a winner, although for clinical education purpose we consider the Vividtrac a better device.


Assuntos
Intubação Intratraqueal/instrumentação , Intubação Intratraqueal/métodos , Laringoscópios , Endoscópios , Desenho de Equipamento , Humanos , Laringoscopia , Óptica e Fotônica , Reprodutibilidade dos Testes , Estresse Mecânico , Gravação em Vídeo
14.
Ther Clin Risk Manag ; 11: 1489-96, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26491335

RESUMO

BACKGROUND: Intubation is still one of the best methods to secure the airway. In the case of prehospital or early hospital conditions when factors such as urgency, stress, or inaccuracy of the undertaken activities are involved, the risk of causing complications, for instance, edema or postintubation injuries, increases, especially while dealing with a difficult intubation. The risk of improper inflation of the endotracheal tube cuff also increases, which is considered in this study. OBJECTIVE: The aim of this study was to evaluate the prevalence of postintubation complications, such as postintubation injuries or edema, in a research sample, and to examine whether such complications occur more often, for example, while using a guidewire. In this study, we also evaluated the injuries associated with the inflation of the endotracheal tube cuff. MATERIALS AND METHODS: This study was performed on a group of 153 patients intubated in prehospital conditions. The tests were carried out in three clinical sites that received patients from prehospital care. Postintubation injuries were revealed and photographed using videolar-yngoscope, such as the C-MAC and the McGrath series 5. The endotracheal tube cuff pressure was measured using a pressure gage manual (VBM Medizintechnik GmbH). The quantitative analyses of differences between incidence of variables were assessed using χ (2) test for P<0.05. Analyses have been carried out using the Statistica software. RESULTS: In the group of 153 patients, postintubation injuries occurred in 17% of cases. The dependency between using the guidewire and the occurrence of the hematomas and loss of mucosa was statistically significant (P<0.01). In nearly half (42%) of the patients the endotracheal tube cuff pressure was excessively inflated over 30 cm H2O, and in two cases, endotracheal tube displacement was observed on account of poor cuff inflation (<20 cm H2O). CONCLUSION: The highest percentage of overfilled cuffs were observed in the admission room. In the other wards, it was observed in 25% of cases. Even though only six cases of poor cuff inflation were noticed, the relationship between the leakage and the clinical conditions of patients is worth examining. The results would help in taking additional measures to reduce the risk of complications.

15.
Cardiol J ; 22(6): 675-82, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26412603

RESUMO

BACKGROUND: Basic medical rescue teams (BMRTs) administer aid in the pre-hospital phase to people in a life-threatening condition. A tele-transmission and teleconsultation system (TTaTC) supports the team without a physician. The aim of the presented study was to evaluate the application and spectrum of use of a 12-lead ECG TTaTC in BMRT operations. METHODS: Medical records of BMRTs in Warsaw from September 2009 to August 2013 regarding TTaTC were checked. Successful TTaTC, electrocardiography (ECG) results, sex, age, consultant advice, and decisions of BMRT leaders were analyzed. RESULTS: BMRTs performed 28,557 12-lead ECG transmissions within the analyzed period. The teams recorded 26,208 (91.8%) successful tele-transmissions, while 2,349 tests (8.2%) failed to reach the TC. The average TTaTC time was 6 min 12 s. The most common reason for using the ECG TTaTC was chest pain. ST-segment elevation myocardial infarction (STEMI) was diagnosed in 2.1% of the cases, and non-ST segment elevation myocardial infarction - NSTEMI - in 3.8%. Cardiac arrhythmia was recorded in 20.5% of the events. TTaTC proved to be useful when making decisions on transporting patients to appropriate hospitals. One hundred percent of STEMI cases - all confirmed by TC - were transported directly to cardiac centers. CONCLUSIONS: 1. TTaTC constitutes an increasing support in BMRT everyday operations and is widely used. 2. Standard ECG TTaTC with a physician improved BMRT diagnostic capaci-ties and exerted a beneficial impact on cardiovascular patient segregation and target hospital selection. 3. It seems possible to expand the scope of operations performed by BMRT members based on TTaTC.


Assuntos
Doenças Cardiovasculares/diagnóstico , Diagnóstico Precoce , Eletrocardiografia/métodos , Serviços Médicos de Emergência/métodos , Telemedicina/métodos , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Polônia , Reprodutibilidade dos Testes , Estudos Retrospectivos , Fatores de Tempo
16.
Int J Occup Med Environ Health ; 28(3): 499-505, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26190726

RESUMO

OBJECTIVES: To analyze perforation rate in sterile gloves used by surgeons in the operating theatre of the Department of Endocrinological and General Surgery of Medical University of Lodz. MATERIAL AND METHODS: Randomized and controlled trial. This study analyses the incidents of tears in sterile surgical gloves used by surgeons during operations on 3 types of thyroid diseases according to the 10th revision of International Statistical Classification of Diseases and Related Health Problems (ICD-10) codes. Nine hundred seventy-two pairs (sets) of gloves were collected from 321 surgical procedures. All gloves were tested immediately following surgery using the water leak test (EN455-1) to detect leakage. RESULTS: Glove perforation was detected in 89 of 972 glove sets (9.2%). Statistically relevant more often glove tears occurred in operator than the 1st assistant (p < 0.001). The sites of perforation were localized mostly on the middle finger of the non-dominant hand (22.5%), and the non-dominant ring finger (17.9%). CONCLUSIONS: This study has proved that the role performed by the surgeon during the procedure (operator, 1st assistant) has significant influence on the risk of glove perforations. Nearly 90% of glove perforations are unnoticed during surgery.


Assuntos
Procedimentos Cirúrgicos Eletivos/instrumentação , Luvas Cirúrgicas/normas , Exposição Ocupacional/efeitos adversos , Medição de Risco/métodos , Cirurgiões , Glândula Tireoide/cirurgia , Tireoidectomia/instrumentação , Falha de Equipamento , Seguimentos , Humanos , Estudos Prospectivos
17.
Pol Przegl Chir ; 87(4): 166-73, 2015 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26146115

RESUMO

UNLABELLED: Complications after blood components still constitute an important clinical problem and serve as limitation of liberal-transfusion strategy. The aim of the study was to present the 5-year incidence of early blood transfusions complications and to assess their relation to the type of the transfused blood components. MATERIAL AND METHODS: 58,505 transfusions of blood components performed in the years 2006-2010 were retrospectively analyzed. Data concerning the amount of the transfused blood components and the numbers of adverse transfusion reactions reported to the Regional Blood Donation and Treatment Center (RBDTC) was collected. RESULTS: 95 adverse transfusion reactions were reportedto RBDTC 0.16% of alldonations (95/58 505) - 58 after PRBC transfusions, 28 after platelet concentrate transfusions and 9 after FFP transfusion. Febrile nonhemolytic and allergic reactions constitute respectively 36.8% and 30.5% of all complications. CONCLUSION: Nonhemolyticand allergic reactions are the most common complications of blood components transfusion and they are more common after platelet concentrate transfusions in comparison to PRBC and FFP donations.


Assuntos
Transfusão de Componentes Sanguíneos/efeitos adversos , Hipersensibilidade/etiologia , Reação Transfusional/etiologia , Doença Aguda , Transfusão de Componentes Sanguíneos/estatística & dados numéricos , Humanos , Hipersensibilidade/epidemiologia , Incidência , Transfusão de Plaquetas/efeitos adversos , Polônia/epidemiologia , Estudos Retrospectivos , Fatores de Risco , Reação Transfusional/epidemiologia
18.
Emergencias (St. Vicenç dels Horts) ; 27(3): 193-196, jun. 2015. tab
Artigo em Espanhol | IBECS | ID: ibc-139128

RESUMO

Objetivo. El objetivo de este estudio transversal es analizar los transportes en helicóptero de pacientes con ictus isquémico en Polonia durante los años 2011-12. Se procuró evaluar el papel del servicio médico de helicópteros en reducir tiempos prehospitalarios y analizar la evolución de los pacientes durante el transporte. Método. Estudio retrospectivo de todas las atenciones realizadas por el servicio polaco de helicópteros medicalizados durante un periodo de dos años. Los datos recogidos de cada atención y paciente incluyeron el tiempo desde la activación hasta la llegada al lugar de atención, tiempo en el lugar de la atención, tiempo de transporte, escala del National Advisory Committee for Aeronautics (NACA), ETR (Escala de Trauma Revisada) y ECG (Escala de Coma de Glasgow) en el lugar de atención y en el momento de transferencia del paciente a los servicios de emergencias o al hospital. Resultados. Se analizaron 1.191 atenciones. Los valores medios de las escalas ETR y ECG en el lugar de atención eran 11,1 (DE 1,36) y de 11,8 (DE 3,39). Después del transporte en helicóptero medicalizado, los valores medios eran: 11,0 (1,5) y 11,7 (3,5), respectivamente. Se observó que el tiempo de transporte no influyó en el estado del paciente, mientras que más tiempo en el lugar de atención produce una disminución estadísticamente significativa en los valores medios de las escalas. Conclusiones. El helicóptero es un modo seguro de transporte para pacientes con ictus y asegura su transferencia al hospital/ambulancia más cercano en el tiempo apropiado para la iniciación de tratamiento. La atención en el lugar de atención en caso de ictus debería ser tan corta como sea posible (AU)


Objective. The aim of this cross-sectional study was to analyze transport by helicopter emergency medical services (HEMS) in cases of ischemic cerebral stroke in Poland in 2011 and 2012. We assessed the role of the HEMS in reducing prehospital times and analyzed changes in patients’ status during transport. Methods. Retrospective study of all missions flown by the Polish HEMS to attend stroke patients over the 2-year period. The following data were collected for each mission and patient: time from activation of the HEMS until arrival at the scene, time spent at the scene; and scores on the National Advisory Committee for Aeronautics scale, the Revised Trauma Scale (ETR), and the Glasgow Coma Scale (ECG) at the scene and on transfer of the patient to the hospital or ambulance. Results. A total of 1191 patients were analyzed. The mean (SD) ETR and ECG scores on the scene were 11.1 (1.36) and 11.8 (3.39), respectively. After HEMS transport the means were 11.0 (1.5) and 11.7 (3.5). In-flight transport did not affect the patient’s condition, but more time spent at the scene was associated with significantly lower scores on the scales. Conclusions. Helicopter transport of these patients is safe and ensures their transfer to the nearest hospital or ambulance within the treatment time window. Time spent on care at the scene of the emergency should probably be as short as posible (AU)


Assuntos
Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Serviços Médicos de Emergência/métodos , Serviços Médicos de Emergência , Acidente Vascular Cerebral/epidemiologia , Serviços Pré-Hospitalares , Evolução Clínica/métodos , Evolução Clínica , Serviços Médicos de Emergência/tendências , Estudos Transversais/métodos , Estudos Transversais/tendências , Aeronaves/normas , Resgate Aéreo , Estudos Retrospectivos
19.
Psychiatr Pol ; 49(1): 145-57, 2015.
Artigo em Polonês | MEDLINE | ID: mdl-25844417

RESUMO

AIM: Disgust is one of the principal emotions, typically triggered by a variety of biological and social stimuli. Several questionnaire tools have been used to assess disgust. The aim of the study was to assess psychometric properties of the Polish version of the Questionnaire for the Assessment of Disgust Sensitivity (QADS), adapted from the tool prepared by the German researchers. METHODS: Eight hundred twenty subjects (631, 77% females and 189, 23% males) aged 18-69 (mean - 28 years) participated in the study. There are 3 subscale in the questionnaire: Core Disgust, Animal Reminder and Contamination. The tool consists of 37 items, the intensity of feeling of disgust is assessed based on 5-point Likert scale. RESULTS: Confirmatory factor analysis confirmed the adequacy of grouping of items in the three subscales: Core Disgust, Animal-Reminder, and Contamination-Interpersonal. In our sample, females had higher levels of disgust than males. Several other psychometric variables - high degree of correlations between the subscales, and high reliability -were in agreement with parameters of the original version. The Polish version compared favourably with the original, with Cronbach's alpha of 0.94 for the whole questionnaire and 0.85 - 0.90 for the subscales. CONCLUSIONS: The psychometric properties of the Polish version of QADS are sufficient to recommend this tool for diagnostic and research use.


Assuntos
Autoavaliação Diagnóstica , Transtorno Obsessivo-Compulsivo/diagnóstico , Transtorno Obsessivo-Compulsivo/psicologia , Inquéritos e Questionários/normas , Adolescente , Adulto , Idoso , Emoções , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtorno Obsessivo-Compulsivo/classificação , Polônia , Psicometria , Reprodutibilidade dos Testes , Adulto Jovem
20.
Emergencias ; 27(3): 193-196, 2015 Jun.
Artigo em Espanhol | MEDLINE | ID: mdl-29077314

RESUMO

OBJECTIVES: The aim of this cross-sectional study was to analyze transport by helicopter emergency medical services (HEMS) in cases of ischemic cerebral stroke in Poland in 2011 and 2012. We assessed the role of the HEMS in reducing prehospital times and analyzed changes in patients' status during transport. MATERIAL AND METHODS: Retrospective study of all missions flown by the Polish HEMS to attend stroke patients over the 2-year period. The following data were collected for each mission and patient: time from activation of the HEMS until arrival at the scene, time spent at the scene; and scores on the National Advisory Committee for Aeronautics scale, the Revised Trauma Scale (ETR), and the Glasgow Coma Scale (ECG) at the scene and on transfer of the patient to the hospital or ambulance. RESULTS: A total of 1191 patients were analyzed. The mean (SD) ETR and ECG scores on the scene were 11.1 (1.36) and 11.8 (3.39), respectively. After HEMS transport the means were 11.0 (1.5) and 11.7 (3.5). In-flight transport did not affect the patient's condition, but more time spent at the scene was associated with significantly lower scores on the scales. CONCLUSION: Helicopter transport of these patients is safe and ensures their transfer to the nearest hospital or ambulance within the treatment time window. Time spent on care at the scene of the emergency should probably be as short as possible.

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