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Rehabilitation Procedure in People with Degeneration of the Intervertebral Disc 椎间盘退变患者的康复治疗
Pub Date : 2021-03-01 DOI: 10.36145/jhsm2021.02
Marlena Krawczyk-Suszek, A. Makara, Justyna Materna
Abstract Introduction The International Association for the Study of Pain (IASP) defines pain as a subjective sensory and emotional sensation resulting from the action of stimuli that disturb the tissue. Pain significantly impacts the quality of our lives, mainly if it concerns the spine. In Poland, more than half of the population experiences pain in the spine, while as much as 44% of spine disorders concern the lower segment. Back pain is currently one of the most common reasons for contacting a GP, which makes it a medical and socio-economic problem. Purpose of the study Subjective evaluation of the effectiveness of rehabilitation in people with degeneration of the intervertebral disc. Material and methods The study was carried out in a group of 153 patients. A self-constructed questionnaire was the study tool. Results and conclusions The patients were asked to carry out activities of daily living. At the beginning, they reported the occurrence of pain, and thus the ordered activities were carried out by them carefully and slowly. At the end of rehabilitation, a control analysis was carried out, which showed an improvement in the quality of life of the patients (the pain rating on the scale decreased from 3.33 points to 2.36 points). The activities were carried out naturally. Properly selected and conducted rehabilitation causes both the improvement of the patients’ quality of life and the reduction of pain associated with degenerative spine disease.
国际疼痛研究协会(IASP)将疼痛定义为由干扰组织的刺激作用引起的主观感觉和情绪感觉。疼痛会显著影响我们的生活质量,尤其是当它涉及到脊柱时。在波兰,超过一半的人经历过脊柱疼痛,而多达44%的脊柱疾病涉及脊柱下部。背痛是目前人们去看全科医生最常见的原因之一,这使它成为一个医学和社会经济问题。目的:对椎间盘退变患者的康复效果进行主观评价。材料与方法本研究在153例患者中进行。研究工具为自编问卷。结果与结论要求患者进行日常生活活动。一开始,他们报告疼痛的发生,因此有序的活动由他们小心缓慢地进行。康复结束时进行对照分析,患者的生活质量得到改善(量表上的疼痛评分从3.33分下降到2.36分)。活动进行得很自然。正确选择和实施康复治疗既能改善患者的生活质量,又能减轻退行性脊柱疾病相关的疼痛。
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引用次数: 0
Onasemnogene Abeparvovec as New Gene Therapy in Patients with Spinal Muscular Atrophy – a Review of the Literature Onasemnogene abparvovec作为治疗脊髓性肌萎缩症的新基因疗法——文献综述
Pub Date : 2021-03-01 DOI: 10.36145/jhsm2021.05
G. Ręka, Angelika Pawlak, Halina Piecewicz-Szczęsna
Abstract Introduction Spinal muscular atrophy is an autosomal recessive neurodegenerative disease that mainly affects children. It is caused by mutation in the SMN1 gene, which results in degeneration and loss of alpha motor neurons innervating skeletal muscles. Without any intervention, spinal muscular atrophy progresses and leads to disability or even early death. Material and methods The latest available literature accessible on the Pub-Med database was reviewed. Thirty papers, which were published in English, available as full-text publications, and published since 2015, were selected for analysis. Results Depending on the level of motor development and the age of onset, spinal muscular atrophy is divided into 4 or 5 subtypes. Onasemnogene abeparvovec is a gene replacement therapy and consists of a vector of the serotype 9 adeno-associated virus, which delivers a functional copy of the SMN1 gene to the cells of the motor neuron. Important advantage of the drug is single administration via an intravenous route. The limitation is the high price and the lack of studies in older children. Several studies confirmed the efficacy and safety of using onesamnogene abeparvovec in children who afterward made progress in respiratory functions, swallowing, and motor milestones, like head control and sitting independently. Conclusions Onasemnogene abeparvovec is an innovative and effective drug with great potential for present and future use. Therapy in spinal muscular atrophy should be implemented as early as possible to avoid muscle cell loss. It is important to conduct universal screening tests of newborns to detect the disease before the first symptoms appear.
摘要简介脊髓性肌萎缩症是一种常染色体隐性神经退行性疾病,主要发病于儿童。它是由SMN1基因突变引起的,导致支配骨骼肌的α运动神经元变性和丧失。在没有任何干预的情况下,脊髓性肌萎缩会恶化并导致残疾甚至过早死亡。材料和方法回顾了Pub-Med数据库中可获得的最新文献。选取2015年以来发表的30篇英文全文论文进行分析。结果脊髓性肌萎缩症根据运动发育程度和发病年龄可分为4 ~ 5个亚型。Onasemnogene abeparvovec是一种基因替代疗法,由血清型9腺相关病毒载体组成,该载体将SMN1基因的功能拷贝传递到运动神经元细胞。该药的重要优点是单次静脉给药。限制是价格高,缺乏对年龄较大的儿童的研究。几项研究证实了在呼吸功能、吞咽和运动里程碑(如头部控制和独立坐下)取得进展的儿童中使用单胺基因阿伯帕韦的有效性和安全性。结论Onasemnogene abparvovec是一种创新有效的药物,具有广阔的应用前景。治疗脊髓性肌萎缩应尽早实施,以避免肌肉细胞损失。重要的是对新生儿进行普遍筛查试验,以便在出现最初症状之前发现疾病。
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引用次数: 0
EN ISO 9001:2015 Quality Management System for Health Care Sector in Accordance with PN-EN 15224:2017-02 Standard and Accreditation Standards of the Minister of Health – Comparative Analysis EN ISO 9001:2015卫生保健部门质量管理体系符合PN-EN 15224:2017-02标准和卫生部长认证标准-比较分析
Pub Date : 2021-03-01 DOI: 10.36145/jhsm2021.03
Ewa Kaniecka, D. Timler, Agata Białas, Małgorzata Timler, Monika Białas, A. Staszewska, Edyta Skibińska, Anna Rybarczyk-Szwajkowska
Abstract The aim The aim of this article is to indicate similarities and differences between EN ISO 9001:2015 quality management system in accordance with PN-EN 15224:2017-02 standard and the accreditation standards of the Minister of Health. Material and methods A comparative analysis of two documents describing requirements of the quality management system EN ISO 9001:2015 in accordance with PN-EN 15224:2017-02 and accreditation standards of the Minister of Health issued by the Quality Monitoring Centre was performed. Results This comparative analysis concerns individual aspects/quality requirements of the PN-EN 15224-02 standard with reference to thematically analogous accreditation standards. According to the following analysis designation of both the PN-EN 15224:2017-02 standard and accreditation for health care sector causes natural, very high convergence and similarity between both systems. For specialist and expert on discussed subject, there is no bigger problem with connecting mutual reference of requirements of individual quality aspects described in the standard and accreditation standards. The PN-EN 15224:2017-02 standard, similarly to accreditation standards, pays particular attention to obligation to manage clinical risk during planning, implementation and control of individual process which becomes the key element of quality management system for clinical activities. In both cases, data related to significant events connected with hospitalization should be analyzed and assessed, and conclusions and observations should be used to conduct improvement projects in important health care areas in accordance with the E. Deming quality improvement methodology (PDCA cycle). However, they can’t be said to be identical. Differences result from the very structure of the documents. Accreditation standards are divided into 15 subject areas, gathering a total of 221 standards. The PN-EN 15224:2017-02 standard, in accordance with the ISO/ IEC Directives, Part 1, Consolidated ISO Supplement, Annex SL, contains common, consistent structure of new revised management system standards. Another difference between discussed systems concerns scope of both documents, the standard has international dimension and the set of standards is definitely national. There are, of course, many more similarities as well as differences, which this article deals with in full. Conclusions Carried out analysis shows clearly that, despite formal differences, there are numerous connections and analogies between requirements of individual quality aspects of the PN-EN 15224:2017-02 standard and requirements of the accreditation standards. Effective implementation of both requirements of the ISO standard in question and accreditation standards can constitute the basis for creating a single, consistent and effective management system for treatment entity as a whole.
摘要:本文的目的是指出符合PN-EN 15224:2017-02标准的EN ISO 9001:2015质量管理体系与卫生部认可标准的异同。根据PN-EN 15224:2017-02和质量监测中心发布的卫生部认证标准,对描述质量管理体系EN ISO 9001:2015要求的两份文件进行了对比分析。对比分析了PN-EN 15224-02标准的各个方面/质量要求,并参考了主题类似的认可标准。根据以下分析,PN-EN 15224:2017-02标准的指定和医疗保健部门的认可导致两个系统之间自然的,非常高的趋同和相似性。对于所讨论主题的专家和专家来说,将标准和认可标准中描述的各个质量方面的要求相互参考联系起来并不是更大的问题。与认可标准类似,PN-EN 15224:2017-02标准特别关注在计划,实施和控制单个过程期间管理临床风险的义务,这成为临床活动质量管理体系的关键要素。在这两种情况下,应分析和评估与住院有关的重大事件的数据,并根据E. Deming质量改进方法(PDCA循环)利用结论和观察结果在重要的保健领域开展改进项目。然而,它们不能说是完全相同的。这些差异是由文档的结构本身造成的。认证标准分为15个学科领域,共收集221项标准。PN-EN 15224:2017-02标准,根据ISO/ IEC指令,第1部分,综合ISO补充,附录SL,包含新修订的管理体系标准的共同,一致的结构。所讨论的体系之间的另一个区别涉及两个文件的范围,标准具有国际维度,而标准集肯定是国家的。当然,两者之间有更多的相似之处,也有更多的不同之处,本文将对此进行全面讨论。分析清楚地表明,尽管形式上存在差异,但PN-EN 15224:2017-02标准的各个质量方面的要求与认可标准的要求之间存在许多联系和相似之处。有效实施相关ISO标准和认可标准的要求,可以为整个处理实体建立单一、一致和有效的管理体系奠定基础。
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引用次数: 2
Implementation of Smoke Free-homes Rules in the Homes of Smokers with Low Socioeconomic Status 社会经济地位低的吸烟者家庭实施无烟家庭规则
Pub Date : 2021-03-01 DOI: 10.36145/jhsm2021.01
M. Znyk, D. Kaleta
Abstract Introduction Private places such as homes are common places of exposure to secondhand smoke. Currently, more and more attention is being paid to reducing general and residential exposure to ETS (environmental tobacco smoke). The voluntary introduction of smoke-free homes (SFH) is a promising preventive measure in this regard. Most smoking households don’t implement comprehensive anti-smoking policies, and exposure to secondhand smoke (SHS) is still common among low socioeconomic populations and children. Aim The aim of the study was to assess exposure to passive smoking and to assess compliance with the rules of a smoke-free home in the homes of smokers with low socioeconomic status. Material and methods 117 smokers in Piotrków County were examined in 2015. The research tool was a questionnaire. The study received a positive opinion from the Bioethics Committee of the Medical University of Lodz (RNN/243/15/KE). Results People who respect the implementation of smoke free-homes rules in their homes accounted for 48.7% of the total number of respondents, of which 58% were women and 42% were men. They were mostly people aged 50 and more (54.3%), married (60%), with secondary education (33.3%), employed persons (70.2%), living at home with one adult (43.8%). 68.4% of the respondents advocating smoke-free homes have ever tried to quit, usually 1–2 times (38.6%). Fear of the disease (36.8%) and the wish of the family (29.8%) were the most frequently mentioned reasons that prompted the respondents to quit smoking in tobacco-free homes. In smoke-free homes, 82.5% of the guests complied with the accepted rules for smoking. Conclusions There is a need for interventions to encourage a smoking ban in homes. Primary care interventions, public health programs, and media campaigns should promote the health benefits of having a smoke-free home.
家庭等私人场所是暴露于二手烟的常见场所。目前,人们越来越重视减少一般和居住环境中烟草烟雾的暴露。在这方面,自愿推行无烟家居是一项很有希望的预防措施。大多数吸烟家庭没有实施全面的禁烟政策,二手烟暴露在低社会经济人群和儿童中仍然很普遍。目的本研究的目的是评估被动吸烟的暴露情况,以及评估社会经济地位低的吸烟者对无烟家庭规则的遵守情况。材料与方法对2015年Piotrków县117名吸烟者进行调查。研究工具是问卷调查。这项研究得到了罗兹医科大学生物伦理委员会(RNN/243/15/KE)的积极评价。结果尊重家中无烟规定执行情况的受访者占受访者总数的48.7%,其中女性占58%,男性占42%。他们大多年龄在50岁或以上(54.3%),已婚(60%),受过中等教育(33.3%),有工作(70.2%),与一名成年人同住(43.8%)。68.4%倡导无烟家庭的受访者曾尝试戒烟,通常为1-2次(38.6%)。对疾病的恐惧(36.8%)和家人的愿望(29.8%)是促使受访者在无烟家庭中戒烟的最常见原因。在无烟家庭中,82.5%的客人遵守了公认的吸烟规定。结论:有必要采取干预措施鼓励家庭禁烟。初级保健干预措施、公共卫生计划和媒体宣传活动应促进无烟家庭对健康的益处。
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引用次数: 0
Cognitive Screening Tests as an Early Method of Detecting Cognitive Dysfunctions 认知筛选测试作为早期检测认知功能障碍的方法
Pub Date : 2021-03-01 DOI: 10.36145/jhsm2021.04
Małgorzata Kwiatkowska, Weronika Hajec, N. Skierkowska, M. Muszalik
Abstract Cognitive impairment is an increasingly common problem in aging societies. With age, cognitive functions are naturally weakened. However, this process may lead to more serious deficits such as mild cognitive impairment (MCI) and dementia. Identification of patients at high risk, early diagnosis of cognitive impairment and monitoring of the patient’s condition, as well as taking appropriate action is very important. Cognitive impairment is detected using neuropsychological screening tests that enable the detection of cognitive impairment in the early stages. The most commonly used tools for the initial assessment of cognitive functioning are: Mini Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Clock Drawing Test (CDT), Addenbrooke’s Cognitive Examination (ACE III). Early detection of MCI gives the opportunity to quickly implement appropriate interventions, which can slow down or limit the development of cognitive impairment. Early diagnosis allows to find the cause and reduce the adverse effects of modifiable factors that contribute to the development of dementia. Among these factors, there are: reduced levels of folic acid, diabetes and depression. Early diagnosis also gives the opportunity to plan the patient’s care appropriately, including the patient’s conscious participation in making such decisions. Cognitive screening tests are also used to monitor the progress of the disease, which allows you to respond appropriately and modify the treatment plan adequately to the patient’s condition and cognitive deficits.
认知障碍是老龄化社会中日益普遍的问题。随着年龄的增长,认知功能自然会减弱。然而,这一过程可能导致更严重的缺陷,如轻度认知障碍(MCI)和痴呆。识别高危患者,早期诊断认知障碍,监测患者病情,并采取适当的行动是非常重要的。认知障碍是通过神经心理学筛选测试来检测的,这种测试能够在早期阶段发现认知障碍。最常用的认知功能初步评估工具有:迷你精神状态检查(MMSE)、蒙特利尔认知评估(MoCA)、时钟绘制测试(CDT)、阿登布鲁克认知检查(ACE III)。早期发现MCI可以快速实施适当的干预措施,从而减缓或限制认知功能障碍的发展。早期诊断可以找到原因并减少导致痴呆症发展的可改变因素的不利影响。这些因素包括:叶酸水平降低、糖尿病和抑郁症。早期诊断还提供了适当规划患者护理的机会,包括患者有意识地参与做出此类决定。认知筛查测试也用于监测疾病的进展,这使您能够根据患者的病情和认知缺陷适当地做出反应并修改治疗计划。
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引用次数: 0
Small Intestinal Bacterial Overgrowth: Diagnosis, Pathophysiology and Treatment Methods 小肠细菌过度生长:诊断、病理生理及治疗方法
Pub Date : 2021-03-01 DOI: 10.36145/jhsm2021.06
Patrycja Maliszewska
Abstract Small intestinal bacterial overgrowth (SIBO) is the excessive abundance of nonpatogenic microbes in the small bowel, which are characteristic to the large intestine. It is often referred to as dysbiosis. Typical symptoms include: immoderate flatulence, abdominal pain, steatorrhea or micronutrient deficiencies that may cause conditions like anemia or general fatigue associated with it. The dysfunction of the intestinal mucosal barrier and chronic inflammation, caused by SIBO, are the causes of many diseases, for example fatty liver disease and autoimmune diseases, which also act as predispositions to bacterial overgrowth. The diagnosis is based mainly on the breathing tests. The therapy is comprehensive and relies on pharmacological treatment, adequate diet (usually low-FODMAP diet is recommended) as well as preventive measures in order to avoid the relapse. The key to complete recovery is correct identification of the core cause and its removal, which is often not so clear as SIBO manifests itself with many nonspecific symptoms and therefore, may be misidentified as irritable bowel syndrome, celiac disease or other GI tract diseases. This article reviews and summarizes the current state of knowledge about the bacterial overgrowth in the small intestine.
摘要小肠细菌过度生长(Small intestinal bacterial overgrowth, SIBO)是指小肠内非致病性微生物数量过多,以大肠为特征。它通常被称为生态失调。典型症状包括:过度胀气、腹痛、脂肪漏或微量营养素缺乏,这些症状可能导致贫血或与之相关的全身疲劳。SIBO引起的肠黏膜屏障功能障碍和慢性炎症是许多疾病的病因,例如脂肪肝和自身免疫性疾病,这些疾病也容易导致细菌过度生长。诊断主要基于呼吸测试。治疗是综合的,依靠药物治疗,适当的饮食(通常推荐低fodmap饮食)以及预防措施,以避免复发。完全康复的关键是正确识别核心病因并将其清除,由于SIBO表现为许多非特异性症状,因此往往不那么明确,因此可能被误诊为肠易激综合征、乳糜泻或其他胃肠道疾病。本文综述了目前有关小肠细菌过度生长的研究现状。
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引用次数: 0
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Journal of Health Study and Medicine
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