Przeglad lekarski最新文献

Introduction: The World HealthOrganization has taken actions atinternational level in order to reducethe tobacco epidemic. ThereforeFramework Convention on TobaccoControl and MPOWER package weredeveloped. The strategies containedin these documents are consideredto be the most effective and efficient.Compliance with these guidelinesand broad public support for the implementedsolutions has positive effectson the population level, and alsoat the local level, eg. voivodeship ordistrict.The aim of the study was to investigatethe attitudes and opinionsof employees of schools on selectedelements of tobacco control policiesand strategies for tobacco control.

Material and methods: During the period from November 2014 and May2015 employees working in 60 schoolsin Piotrkowski county were examined.Conducting a survey among the personnelemployed in schools an anonymousquestionnare adopted fromthe study Global School PersonnelSurvey (GSPS) was applied.

Results: Among all surveyed everythird respondent believes thatsmoking bans in the workplace helpsmokers to stop smoking. Among allrespondents, half of the respondentsbelieve that smoking bans in theworkplace help former smokers tomaintain tobacco abstinence. Amongall respondents 37.4% declared theirsupport for raising taxes on tobaccoproducts.

Conclusions: Effective implementationof smoking ban in publicplaces and the introduction of otherprovisions of the Act on the protectionof health against consequencesof tobacco use and tobacco productsrequire broad information campaignsto increase support to tobacco controlactivities.

Introduction: Smoking is the mostcommon addiction in the world. Coexistenceof smoking and obesitylead to a significant increase in therisk of cardiovascular diseases. It isalso known that both the tobacco andexcessive weight have a negative impacton oral health.

Aim: Assessment of the frequencyof smoking, hygienic habits andhealthy behaviors in people with obesity.

Material and methods: The studyincluded 125 people, of both sexes,aged from 20 to 65 years. The studygroup consisted of patients Clinic ofInternal Medicine, Metabolic and Nutrition,Poznań University of MedicalSciences with a BMI> 25 kg/m2, controlgroup - patients Clinic of ConservativeDentistry and Periodontology,Poznań University of MedicalSciences of normal weight (BMI <25kg/m2). All participants were asked tocomplete a short survey on smoking,frequency of dental checkups and hygienehabits associated with the oralcavity.

Results: In both groups of patients,obese and normal weight, wefound similar percentages of smokers:25 and 24.24%. Both groupsshowed a similar time of brushing,however, we found statistically significantdifferences in the frequencyof tooth brushing.

Conclusion: Despite the similarresults obtained during the survey inboth groups of patients, it seems necessaryto take patients with obesityparticularly dental care, enhancementof preventive measures as well as incitementto refrain from smoking.

Allergies of the respiratory systemare very often at children andare a global problem and still increasing.Passive smoking may predisposeto allergies. Assuming thatanti-smoking education conductedamong of the children’s parents duringeach control visit to the AllergyClinic affects the behavior of theparents, we decided to analyze itseffectiveness.

Materials and methods: The studycomprised parents of 946 childrenat the Allergy Clinic, who were diagnosedand treated in years 2005-2014.The anti-nicotine education was appliedby whole period of observationduring routine medical visits. The outcomeof an anti-smoking educationachieved nearly 70 % efficiency.

Results: Anti-nicotine educationof the children’s parents diseased onchronic allergic diseases of respiratorysystem is very good restrictiveagent their exposition on smokingthe tobacco. Contemporaneouslyin eftective way influences on decisionsof adults about cessationsmoking and the healthy style ot lifepromotes.

Honey bee venom (Apis mellifera)is a mixture of many components,both amines, peptides enzymes andtoxins. Most of the enzymes are allergenswith different allergenic potential.It may affect not only to thesymptoms, it may also contribute tothe success of immunotherapy. Insome cases the problem of a bee venomallergy diagnosis is difficult dueto the imperfection of the classicaldiagnostic methods. In the presentwork reports in the literature regardingthe bee venom allergy diagnosison the basis of identification of thevenom allergen sIgE to componentsare summarized.The use of recombinant allergenshas allowed for the study of sIgEagainst the allergenic components,and thus determination of the individualprofile of allergy. Extending thetest panel of bee venom componentsto rApi m10 and rApi m3 comparedto rApi m1 increases the diagnosticsensitivity by identifying new allergensthat are not always present inthe available preparations used in immunotherapy.

Clinical observations indicatethe frequently reported food hypersensitivityamong patients, sensitiveto airborne allergens. Symptomsof food hypersensitivity inthis group of patients are often exacerbatedduring the pollen season.These reactions may be the resultsof cross-reactions between pollenand food allergens or food and pollenallergy coexisting. The aim ofthe study was to determine the incidenceof food hypersensitivity inpatients allergic to airborne allergens,the type of clinical manifestationsand a kind of food frequentlycausing the symptoms. Retrospectiveanalyses of case records of 55randomly selected patients with airborneallergy aged from 18 to 72 yrs(mean 55 yrs), including 28 womenranging in age from 18 years to 62yrs (mean 36 yrs) and 27 men agedfrom 18 to 72 yrs (mean 34 yrs) werecarried out. All patients underwentskin prick tests with the following allergens:grass, rye, birch, alder, hazel,mugwort, plantain, Dermatophagoidesfarinae, Dermatophagoidespteronyssinus, skin dog, cat dander,Alternaria alternata, Cladosporiumherbarum. We assessed the typeof clinical manifestations of pollenallergy and evaluated the type ofclinical manifestations of food hypersensitivityand the type of foodsthat caused it. In the examined 55patients, 15 individuals reportedfood hypersensitivity (27.2%), themost frequently after consumptionof apples, carrots, cherry, peach,hazelnut, walnut, celery and nectarines.Clinical manifestation of foodhypersensitivity was mainly oral allergysyndrome (OAS). Hypersensitivityto food above all was reportedby patients with allergic rhinitis,sensitive to grass and tree pollen.Due to the high prevalence of foodhypersensitivity in patients allergicto airborne allergens, it seems advisableto consider avoiding eatingsome foods, such as apple, carrots,cherries, peach, particularly frequentlycross-reacting with grassand trees allergens. This dietary restrictioncan prevent about 30% of patients with inhalantallergy against onset of oral allergy.

The evaluation of expectationsof patients is one of the elements ofevaluation of patient’s satisfactionfrom the received medical services.The degree to which these expectationsare met determinates the levelof patient’s motivation to completedoctor’s orders and undertake actionsaiming the diagnostic and therapeuticprocess.Cancers as diseases of affluenceare a significant clinical and social issue.In the context of holistic patientcare the research of cancer patient’sexpectations are of special importance.The aim of the work is to presentdefinitions and types of expectationsthat the cancer patients have of theirdoctors and the methodology ofresearch in this field. The work wasperformed on basis of analysis of publicationsfound in MEDLINE , EMBASE,PsycINFO, Web of Science databasesand concerning results of researchof patient’s expectations. First part ofthe article discusses the definitionsand type of patient’s expectations ofdoctors. Then the begins of researchon the expectations of patients weredescribed, including the input of Polishauthors in this field. Then we movedon to discuss research evaluating theexpectations of cancer patients.In comparing the different researcheswe conclude, that the cancer patientsdeclare their need of support and expectinformation regarding their treatment.What those expectations requirefrom the doctors, is the development ofcommunication skills that are adjustedto the situation on every stage of thediagnostic and therapeutic processesas well as knowledge of the ways thepatients can cope with their disease.

Background: Children born with extremely low birth weight (ELBW) have more respiratory tract complications during childhood. Little is known about respiratory and allergy problems in ELBW children at the threshold of adolescence.

Materials and methods: A follow-up study was conducted at the age of 11 among ELBW children (n=65) and age-matched controls (n=36). The primary outcomes in the study were the occurrence of respiratory and allergy problems and the rate of hospitalization due to respiratory complications at the age of 11 years, assessed with a questionnaire. Secondary outcome variables were serum levels of immunoglobulin classes.

Results: ELBW children had more respiratory tract infections (31 vs.11%, p = 0.03), but less allergies (3 vs. 22%, p < 0.01) compared with controls and had lower level of serum tIgE (geometric mean: 46.5 vs. 89.3 kU/l, p = 0.02). The risk factors for the occurrence of respiratory tract disorders in the ELBW group were: low gestational age, need for surfactant therapy and length of ventilatory support in the neonatal period.

Conclusions: ELBW children have more frequent respiratory tract complications, but fewer allergies at the age of 11 years compared with children born at term. Lower respiratory tract problems decrease in ELBW children with age. Respiratory tract infections are not connected with deficiency in humoral immunity.

Since first performed coronary angiography it was noticed that many patients with chest pain, abnormal rest electrocardiogram and positive stress test have normal result of coronary angiogram. The cause of this wasn't known. For the first time this disorder was named cardiac syndrome X by Harvey Kemp in 1973. In the new 2013 European Society of Cardiology guidelines regarding diagnosis and treatment of stable coronary artery disease, term cardiac syndrome X was substituted by "angina with normal coronary arteries". This article elaborates epidemiology, diagnostics, ethiopatoghenesis, prognosis and treatment of patients with diagnosis of term cardiac syndrome X in the light of the latest studies and guidelines.

Introduction: Acute kidney injury (AKI) is a frequent and serious complication in patients with cardiovascular disease. The aim of the study was to evaluate the risk of death in patients with AKI complicating severe cardiovascular diseases.

Material and methods: A retrospective analysis of 246 patients surveys (157 men and 89 women aged 67.9 ± 14.8 years) with AKI in the course of severe cardiovascular diseases, hospitalized in intensive care units and words of nephrological profile in years 2000-2011 were performed.

Results: The majority of patients (95.9%) with AKI required hemodialysis treatment. The mortality rate in the study group was high and amounted to 69.5% and the recovery of renal function was observed in 39 patients (27.3%). Kidney disease before the onset of AKI was observed in 116 patients (47.2%). Patients with arterial hypertension have more frequently oligoanuria (p = 0.001), needs more hemodialysis sessions (p = 0.029) and stay longer in hospital (p = 0.012). In multivariate analysis, the occurrence of death depend on such factors as: the lack of recovery of renal function, bleeding from gastrointestinal tract, urinary tract infections, and other infectious and noninfectious complications.

Conclusions: No recovery of renal function and comorbidity while AKI in the course of severe cardiovascular diseases increase the risk of death.

In the last decades a few new physical methods based on the electromagnetic head stimulation were subjected to the clinical research. To them belong:--vagus nerve stimulation (VNS),--magnetic seizure therapy/magnetoconvulsive therapy (MST/MCT),--deep stimulation of the brain (DBS) and--transcranial direct current stimulation (tDCS). The paper presents a description of mentioned techniques (nature, advantages, defects, restrictions), which were compared to the applied electroconvulsive treatment ECT, earlier described transcranial magnetic stimulation TMS and the pharmacotherapy (the basis of the psychiatric treatment).