Medycyna pracy最新文献

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.

Background: Anxiety disorders can be an independent risk factor of many somatic conditions and complication of various organic states leading to the unfavourable course of the primary disease and poor prognosis. The main goal of the study was to evaluate anxiety reactions with regard to the disturbances of homeostatic processes within respiratory system, from which various somatic symptoms were reported.

Material and methods: The study group I comprised 50 subjects (aged M±SD 62.5±2.29 years) presenting with generalized anxiety disorders, and 60 normal subjects (aged M±SD 61.94±2.32 years), volunteers as a reference group II. In all the study subjects spirometry and pulse oxymetry were performed. A level of declared dyspnoea was assessed using the 0-10 Borg scale. Moreover, all persons were subjected to physical examination after taking medical history.

Results: In the group I, hyperventilation was reported in the chronic form, and a declared dyspnoea level was relatively low, despite the proper oxygen saturation (SaO₂) of arterial blood. The objective analysis of the Tiffeneau index showed obturative ventilation disturbances, and evaluation of forced expiratory volume in 1 sec (FEV₁) correspondet to obturation of a mild type (FEV₁ = 80.88% of normal value) and a significant decrease in inspiration vs. expiration parameters (e.g., forced inspiratory vital capacity to forced expiratory vital capacity) that indicated the inspiration type of ventilation impairment. In turn, the analysis of the maximal expiratory flow values showed that obturation in all persons from the group I was located mainly in the upper respiratory tract. The statistically significant correlations between the declared dyspnoea level and spirometry parameters in the group I were also noted. In contrast, subjects from group II did not declare dyspnea.

Conclusions: It was shown that anxiety disorders affect not only a breathing pattern but also can induce the objective changes of spirometric parameters like in the organic diseases. As the result of erroneous interpretation of afferent stimuli in the respiratory centre, the normal SaO₂ can be a stimulus triggering dyspnoea. The characteristics accompanying a feeling of dyspnoea suggested the psychogenic background of the symptoms. Med Pr Work Health Saf. 2025;76(3):167-177.

Background: The development of research on exercise physiology in the last several years has allowed to better understand mechanisms affecting exercise performance in athletes. Despite this, the causes of exercise intolerance in athletes are not fully elucidated. The exercise performance is a complex process and regardless of the proper functioning of the cardiovascular system may be subject to significant changes under the influence of nervous system and thermoregulatory mechanisms. The purpose of this work is to assess the relationship between psychomotor performance (sprawność psychomotoryczna - SP), core body temperature (Tc) and exercise performance parameters as measured by spiroergometry (cardiopulmonary exercise testing - CPX) and the diagnostic accuracy of neurothermometabolic index (NTMI) as a new marker of exercise performance in athletes.

Material and methods: Forty-four healthy athletes participated in the study. Each of the examined athletes underwent CPX for the assessment of ventilatory parameters (maximal oxygen consumption - VO₂max, minute ventilation - VE, ventilatory equivalent for carbon dioxide at anaerobic threshold - VECO2AT, maximal carbon dioxide output - VCO₂ and anaerobic threshold), SP tests (average reaction time to light stimulus, the number of correctly received light stimuli, number of missed light stimuli) before and immediately after CPX. In addition, Tc was continually measured during CPX. Followingly, NTMI was calculated using Tc during the maximum exercise, oxygen consumption at anaerobic threshold and average reaction time to light stimulus as measured after CPX.

Results: A significant relationship was found between Tc during the maximum effort in CPX and SP after CPX. A significant relationship between SP before CPX and VECO₂AT during CPX was also confirmed. Psychomotor performance shortly after CPX was also significantly related to VCO₂. In addition, NTMI was significantly associated with CPX parameters.

Conclusions: The study results confirmed the relevant relationship between SP, Tc during the maximum exercise and ventilatory parameters as measured by CPX in athletes. Neurothermometabolic index is a reliable marker of exercise performance in athletes. Med Pr Work Health Saf. 2025;76(3):179-192.

Background: The aim of this study was to assess whether and to what extent the coronavirus disease (COVID-19) pandemic affected the lifestyle and body weight of military flying personnel.

Material and methods: The study involved 930 Polish soldiers - members of aircrew. The study was conducted by using a survey designed by the author, as part of the implementation of the National Health Programme 2021-2025. The survey used the research technique computer assisted web interview.

Results: Approximately half of the soldiers surveyed (49%) declared that they did not contract COVID-19. Analysis of the results on the frequency of consumption of selected food items showed that most food items respondents consumed at similar levels during the pandemic, compared to the pre-pandemic period. There was a positive increase in the frequency of consumption of nuts, fresh fruit and vegetables in 14.8%, 15.9% and 19% of respondents, respectively. More than 20% of those surveyed declared that they consumed less restaurant meals, fast food, sweets and sugary drinks. The vast majority of the respondents (77.6%) answered that they did not feel more negative emotions compared to the pre-pandemic period COVID-19 and emotions did not affect their diet. The frequency of physical activity remained the same for 71.9% of soldiers, while 14.9% respondents said they played sport less often than before the pandemic. Overweight was diagnosed in 50.2% of respondents, while 12.8% were obese. More than half of the respondents (56%) declared that their weight had not changed during the COVID-19 pandemic, 25.1% declared that their weight had increased and 8.9% that it had decreased.

Conclusions: The COVID-19 pandemic condition did not disrupt the existing lifestyles of most military flying personnel. More than half of the military flying personnel surveyed reported no effect of the COVID-19 pandemic on weight change. A quarter of soldiers reported weight gain, which was associated with negative changes in diet and physical activity. Med Pr Work Health Saf. 2025;76(2):101-121.