Medycyna pracy最新文献

Background: Due to the expanding population aging phenomenon, public spaces must be redesigned architecturally to make them accessible to the elderly. Motivating people to engage in physical activity is crucial because outdoor exercise positively impacts seniors' well-being. Outdoor gyms, which serve as meeting spots, places to work out, and locations for daily walks, play a significant role in this context. This article aimed to analyze existing outdoor gyms as public spaces available to the oldest residents of Gdańsk, Poland.

Material and methods: The study analyzed outdoor gyms located in Gdańsk. It assessed accessibility within the city structure (distance from the nearest residential building and public transportation stops) and architectural solutions used in implementing the facilities (the degree of shading of the area where the gym is located, the presence of artificial lighting at the gym, the type of surface, and the number and type of exercise equipment).

Results: Seventy four gyms were surveyed as part of the fieldwork carried out.

Conclusions: Existing gyms require correction in terms of adaptation to older people's needs and consider a broader spectrum of their needs. Med Pr Work Health Saf. 2025;76(4):249-257.

Regardless of the advancement of civilization, humanity remains a part of nature and can derive various benefits from this coexistence. Numerous studies prove that contact with living nature affects human mental and physical stability. Systematic exposure to nature has been shown to be an excellent prophylaxis for mood and cognitive disorders, as well as protecting against the development of civilization diseases and improving physical fitness. Exposure to the natural environment also has a positive effect on immunity and optimizes responses to stress or pain. Contact with nature can be realized in many ways - being in the woods, walking in the park and around flowerbeds, gardening, including touching plants, or contemplating landscapes. The purpose of this paper is to present selected studies showing the positive impact of nature on human well-being regardless of their age, as well as to promote various beneficial forms of exposure to the natural environment. The presented research justifies the inclusion of green areas in urban planning. Med Pr Work Health Saf. 2025;76(4):341-346.

With the increasing number of stroke cases worldwide, there is a growing demand for more and more effective rehabilitation methods. Having suffered a stroke is associated with significant functional and motor limitations, which directly translates into a decrease in quality of life. Over the past decades, researchers have become increasingly interested in the impact of therapies using multimedia tools, such as video games, virtual reality or robots that support the movements of specific body parts, on the effectiveness of rehabilitation and the patient's return to maximum fitness. One such tool is MusicGloves, a dynamic form of post-stroke rehabilitation using movement therapy, video games, music therapy and biofeedback. In this literature review, available peer-reviewed research papers from 2011-2020 were used. The purpose of the review article was to gather existing knowledge on the benefits and risks of using MusicGloves therapy as a form of rehabilitation for patients, with upper limb disorders, after stroke. Based on selected research papers, the effectiveness of MusicGloves therapy is described in comparison with other therapies available in neurological rehabilitation departments. MusicGloves therapy, as a fairly new therapy method, is a promising rehabilitation tool, with a simple and transparent way of working, not requiring the presence of a therapist during the entire therapy process, and significantly motivating patients to undertake newer and more difficult motor tasks. The effectiveness of MusicGloves therapy is still poorly understood, current research is based on low numbers of study groups and the sheer number of available studies is negligible. Improving the recommendations, regarding MusicGloves therapy, may allow patients to recover faster and achieve a standard of living similar to that before the stroke. Med Pr Work Health Saf. 2025;76(3):193-197.

Urinary continence requires the coordination of all components of the urinary system. This review aimed to clarify contemporary views on the nature of micturition disorders and to try to determine which amenities might be useful for older people with micturition disorders. PubMed and Google Scholar search engines were used to search for English-language full-text articles using the keywords: "micturition disorders," "bladder changes," "neurological disorders," "hypoactive detrusor," "improvements," "technology," "quality of life improvement," "elderly," "accessibility," "public toilets," "interior design". Forty-one articles were selected for the final analysis. With age the structure of the bladder walls changes. At the same time, there are physiological changes in the nervous system that make ideal control of continence and micturition difficult. In older men, benign prostate hypertrophy is a common urinary tract disorder, in women there is pelvic organ prolapse and mucosal atrophy due to hypoestrogenism, and in both sexes an increase in infections. Older people are more likely to have diseases of other systems that affect urinary function (stroke, Parkinson's disease, dementia, circulatory failure, diabetes). Urinary incontinence, is a major social problem that significantly affects the quality of life of seniors. E-visits, medical chatbots, medical apps, and examinations performed at the patient's home or in the general practitioner's outpatient clinic can facilitate access to medical services for these patients. There is a need to improve accessibility to specialists, rehabilitation, medication, hygiene products as well as easy access to toilets at home and in the urban environment. The development of electronic devices, mobile applications and use of artificial intelligence, can improve the quality of life of seniors also regarding urinary disorders. Med Pr Work Health Saf. 2025;76(3):199-207.

The aging population has led to an increasing number of patients with urological conditions, such as urinary tract infections, prostate and bladder cancer, and nephrolithiasis. These diseases often require regular medical visits, posing challenges for elderly patients with usually limited mobility, as well as for the burdened healthcare system. Telemedicine, through remote consultations and telemonitoring tools, can improve the care of urological patients, which require further analysis. A literature review in Polish and English was conducted using the PubMed, Scopus, and Web of Science databases with the keywords: "telemedicine in urology," "telehealth in urology," "telehealth," "telementoring," and "telemedicine." Articles meeting the criteria, standards of practice according to the current guidelines, and relevant content related to the listed keywords were included. The authors evaluated the publications, excluding outdated information. Telemedicine facilitates early diagnosis, treatment, and monitoring of patients, reducing transport. Remote consultations allow for the assessment of laboratory and imaging results, monitoring of cancer treatment, and planning of surgical and pharmacological treatments. In andrology, telemedicine supports hormonal therapy and infertility diagnostics. The use of virtual rounds and surgical telementoring enhances the effectiveness of surgical treatment. Although studies indicate high acceptance and adaptation rates of telemedicine among patients and physicians, significant barriers to its implementation remain. These include limited technological proficiency among elderly patients, lack of formal training and standardization of telemedical procedures, and concerns regarding data security and confidentiality in teleconsultations. Not all procedures in urology can be effectively managed remotely and further research, including the optimal scope of telemedicine, is necessary. Telemedicine is an effective tool in geriatric urological care, improving access to specialists, reducing costs, and enhancing patients' quality of life. However, its successful integration into modern urology requires addressing technological, organizational, legal and ethical challenges. Med Pr Work Health Saf. 2025;76(3):223-231.

This scientific paper analyzes surgical treatment methods for benign prostatic hyperplasia (BPH). It discusses traditional procedures such as transurethral resection of the prostate (TURP) and modern, minimally invasive techniques, including holmium laser enucleation of the prostate (HoLEP), transurethral incision of the prostate (TUIP), prostatic urethral lift (PUL), and prostatic artery embolization (PAE). The authors emphasize that technological advancements and individualized patient approaches increase therapy's safety and effectiveness. A literature review was conducted in both Polish and English, using databases such as PubMed, Scopus, and Web of Science, with keywords including: "prostatic hyperplasia," "TURP," "HoLEP," "BPH" and "BPO" (benign prostatic obstruction). Articles meeting the established criteria, per current treatment guidelines from urological societies, were analyzed. Additionally, relevant content concerning the effectiveness, applications, limitations, and challenges of using telemedicine in the geriatric population was included. The publications were evaluated by the authors, and sources containing potentially outdated information were excluded. Currently, the choice of surgical method for treating BPH is vast, and none of the available options can be considered absolutely the best. Key to treatment is an individualized approach to the patient, taking various factors into account when selecting the optimal therapy. Different treatment methods may have similar effectiveness but differ in cost, duration of action, and potential side effects. Some offer quick results, but their durability is limited, while others require greater financial investment and time but provide long-term benefits. The final choice depends on the patient's individual needs and available resources. The development of minimally invasive procedures has expanded treatment options, reducing the risk of complications and shortening hospitalization and recovery times. Ongoing research and technological innovations continue to improve surgical methods, leading to better urodynamic outcomes and more effective therapy. Med Pr Work Health Saf. 2025;76(3):217-222.

Postoperative delirium (POD) is a disorder of attention and consciousness accompanied by cognitive impairment as a direct consequence of a medical condition, the action (or discontinuation) of a drug, toxin, psychoactive substance or the simultaneous action of several factors. To describe the current state of knowledge on delirium, the Medline PubMed database was searched for full-text articles from the years 2000-2025 using the keywords: "postoperative delirium," "prediction" and "elderly." Fifty-six articles were selected for the final analysis. Risk factors for POD are: older age, sensory impairment, alcohol consumption, pre-existing disorders (cognitive, psychomotor activity, sleep-wake rhythm, emotional) and depression. The risk of developing POD can be assessed using questionnaires. Conditions associated with an elevated risk of developing POD include hypertension, history of myocardial infarction and other cardiovascular diseases, anaemia, diabetes, renal failure, urinary incontinence and other micturition disorders. The development of perioperative risk assessment questionnaires (American Society of Anesthesiologists Physical Status Classification System, Charlson Comorbidity Score) is based on the presence of comorbidities. In addition to conventional analysis, machine learning and artificial intelligence has emerged as a novel approach to POD risk factors analysis. Markers of delirium are: inflammatory markers (interleukin 6, neutrophil to limphocyte ratio [NLR] ≥3.5, platelet to lymphocyte ratio [PLR] >139, high CRP concentration), markers of brain tissue damage (D-ribose, plasminogen activator inhibitor-1, tau protein, S100A12 protein, uric acid), markers of blood-brain barrier damage (urinary albumin, fasting glucose), and many others. The risk of POD can be estimated by ultrasound or computed tomography scan (the cross-sectional diameter of the quadriceps or lumbar muscle) and by electroencephalography. Trigger factors may include major surgery, hypotonia, intraoperative blood transfusion, and the need for intra-aortic counterpulsation. There is no procedure to determine the certain development of delirium. The search for better methods should continue. Recognising the risk of delirium allows earlier preventive measures to be taken and its consequences to be reduced. Med Pr Work Health Saf. 2025;76(3):209-215.

Bladder cancer is one of the most commonly diagnosed cancers, especially in older people. Bladder cancer belongs to urothelial carcinomas, which can also occur in other parts of the urinary tract (also at the same time). The most common symptom of bladder cancer is hematuria. Bladder cancer treatment is largely based on surgery. Not all patients (due to comorbidities) will benefit from surgical treatment (especially in the case of radical cystectomy). Appropriate geriatric assessment of patients is crucial when qualifying for surgery. The aim of this article was to indicate the best management of a multimorbid geriatric patient with bladder cancer. The authors presented current knowledge and discussed interdisciplinary approach. The literature review included scientific articles that form the new standards and current guidelines of the European Association of Urology. Geriatric patients with bladder cancer require greater specialist involvement and multidisciplinary care. During qualification for treatment, close cooperation between urologist, oncologist, geriatrician, and other specialists is necessary. Due to the complex therapeutic process, not all patients will be able to follow all recommendations. Personalized medicine allows for the selection of the most appropriate therapeutic option. Further research is also needed on less invasive treatments, such as trimodal therapy, which includes transurethral resection of the bladder tumor, systemic chemotherapy, and external beam radiation therapy - especially for patients who are not eligible for radical treatment. Med Pr Work Health Saf. 2025;76(3):233-239.