Annales Academiae Medicae Stetinensis最新文献

In proceedings relating to patients suffering from cancer, an important step is predicting response and toxicity to treatment. Depending on the type of cancer, physicians use the generally accepted schema of treatment, for example pharmacotherapy. 5-fluorouracil (5-FU) is the most widely used anticancer drug in chemotherapy for colon, breast, and head and neck cancer. Patients with dihydropyrimidine dehydrogenase (DPD) deficiency, which is responsible for the metabolism of 5-FU, may experience severe side effects during treatment, and even death. In many publications the need for determining the activity of DPD is discussed, which would protect the patient from the numerous side effects of treatment. However, in practice these assays are not done routinely, despite the high demand. In most cases, a genetic test is used to detect changes in the gene encoding DPD (such as in the USA), but because of the large number of mutations the genetic test cannot be used as a screening test. Dihydropyrimidine dehydrogenase activity has been shown to have high variability among the general population, with an estimated proportion of at least 3-5% of individuals showing low or deficient DPD activity. In this publication we presents data about average dihydropirymidine dehydrogenase activity in various populations of the world (e.g. Japan, Ghana, Great Britain) including gender differences and collected information about the possibility of determination of DPD activity in different countries. Detection of reduced DPD activity in patients with planned chemotherapy will allow a lower dosage of 5-FU or alternative treatment without exposing them to adverse reactions.

Introduction: Polish law forbids persons to drive under the influence of intoxicating substances, and those after the use of substances producing effects similar to alcohol. Therefore, there is a need to give an opinion based on a blood test, to establish whether or not the person from whom the blood was taken was under the influence of an intoxicating substance or after use of the drug while driving. Some authors reported that the final opinion should take into account chemical and toxicology test results identifying the parent compound and/or the metabolite only, but also the sampling time of the material to be analyzed in relation to the driving time, the result of the medical examination conducted prior to the collection of material for analysis, and the results of screening tests executed at the scene. Circumstances relating to the event, the findings and observations of third parties, and the testimony of the suspect are also relevant. The aim of this study was to evaluate the results of the medical examination in the evaluation of cases concerning driving by persons who were potentially under the influence of amphetamine and its analogs, or delta9-tetrahydrocannabinol, (delta9-THC) and conformity assessment of these results with the results of blood tests. An additional aim was to determine the factors considered by doctors when making their evaluation of patient's condition.

Material and methods: The study group consisted of 350 persons suspected of driving while under the influence of amphetamine and its analogs, and/or delta9-THC, from whom blood samples were taken to test amphetamine content or its analogues and/or delta9-tetrahydrocannabinol. Blood tests were carried out according to the existing procedure developed by the department. Blood samples were initially analyzed with immunochemical methods. Positive preliminary results were verified by gas chromatography-mass spectrometry. Statistical analysis was conducted with independent tests for multi-way tables, i.e. the Pearson chi2 test and the 2 x 2 tables Yates' correction was used for the low numbers. Comparison of mean concentrations of amphetamine and delta9-THC in the blood was performed using the U Mann-Whitney test.

Results: The analysis revealed a significant correlation between the symptoms and the results of the chemical-toxicological blood tests for mood only. There was no significant correlation between the results of toxicological and physical elements contained in the protocol of blood collection as the skin's appearance, speech, heart rate, pupil, pupil reaction to light, walking, lifting objects off the ground, the Romberg test, the finger-to-nose test and orientation in the space time environment. In the analysis of the relationship between the medical assessment and physical elements significant relationships with the assessment of mood, pupils, pupil reaction to light and gait were found. A signific

It is estimated that over one third of the human population is now exposed or has been exposed in the past to Mycobacterium tuberculosis, and new infections occur in the world at a rate of one per second. The history of tuberculosis is long and very interesting, because before the isolation of mycobacteria and the finding of a cure, the disease mercilessly killed thousands of people and deprived doctors of hope. Robert Koch's momentous discovery was a major breakthrough in the fight against tuberculosis. Unfortunately, the disease has never been fully controlled. Tuberculosis is a chronic infectious disease localized in 90-95% of cases in the lungs, and therefore it is extremely difficult to diagnose unequivocally in paleopathological material. Only the form of osteo-arthritis leaves traces in archaeological material. The earliest evidence of tuberculosis (the location of the spine, Pott's disease) in the form of fossils is dated to before 8000 BC. Another very old trace is considered to be human remains from the Neolithic period (ca 5000 BC), found near Heidelberg, where changes in the thoracic spine are typical for spondylitis in tuberculosa. Constant growth in the incidence of new cases in the world can be observed today. Not everyone infected will develop the full-blown disease. The infection may remain dormant. However, one in ten latent infections will subsequently be activated, leading, if not treated, to the death of almost half of the patients.

Introduction: This work is aimed at comparing the self-concept of individuals suffering from somatic diseases differing in the severity of symptoms and their visibility.

Material and methods: The study was carried out in three groups of subjects aged 30 to 65 years, with an even proportion of males and females: 160 dermatological patients, 160 patients after first heart attack and 160 healthy individuals. The structure and content of self-concept were measured with The Wheel Questionnaire by Ben Shalit.

Conclusions: Somatically ill individuals revealed lower levels of self-acceptance and motivation for psychological change than healthy individuals, and they also possessed less self-knowledge then healthy subjects. These qualities of self-concept can diminish the adaptive abilities of ill persons. Therefore, the aims of psychological work with these patients should include enhancing their self-acceptance and willingness to change, as well as widening their self-awareness by encouraging reflection and exploration of various areas of experiencing and functioning.

The victim of a motorcycle frontal crash was treated in a high reference teaching hospital for disruption of the right lobe of the liver (IV grade AAST/Moore). Primary packing, secondary biloma and abscess treatment including papillotomy and biliary stent, led, after 8 months, to cicatrisation of a damaged liver parenchyma. In conclusion, the authors stress that such injuries should be treated in highest level reference centres where all modern noninvasive interventional modalities are available, and that surgical resection is not always the operation of best choice.

Introduction: For the purposes of this research attachment theory was incorporated into the concept of emotional intelligence.

Material and method: The methodological starting point of this study was the assumption that the level of emotional intelligence and social competence is related to a steady feature, namely the type of attachment. Standardized questionnaires available in the Laboratory of Psychological Tests of the Polish Psychological Association were chosen to measure the level of emotional intelligence. However, the type of attachment was studied by Bartholomew's Self Description Test in my own translation. The study involved two groups of students, who were compared: 147 people from the Faculty of Health Sciences/Faculty of Nursing (nursing, midwifery, health promotion, cosmetology, emergency medicine, dietetics), and 181 people from the Faculty of Medicine (medicine), students in their second and third years of studies. A total of 328 people, aged 19-24, were tested.

Results: On the basis of the results it was stated that students of the Faculty of Health Sciences/Faculty of Nursing, as compared to students of the Faculty of Medicine, received significantly higher scores on the scale of the social competence scale, which investigated the efficiency of their behaviour in intimate situations. Moreover, statistical analysis proved that students of the Faculty of Health Sciences showed significantly higher scores than those studying at the Faculty of Medicine in the following fields: KKS-I subscale assessing social competencies in--conditioning effective behaviour in intimate situations, emotional intelligence measured with the INTE questionnaire,--awareness of their own emotional states and understanding their causes (DINEMO-I),--ability to recognize emotions in other people and understanding the reasons for the reactions expressed by them (DINEMO-Others)--emotional intelligence measured with the DINEMO questionnaire (DINEMO-general score). Women from both faculties showed higher social competence than men in the KKS-I, and higher emotional intelligence according to the INTE questionnaire and DINEMO: the overall result, DINEMO-Others and DINEMO-I (in the last scale, at level 0.065). Male students, from both faculties, showed significantly higher social competence in conditioning effectiveness of behaviour in situations requiring assertiveness (KKS-A).

Conclusion: Taking into consideration the results of this study, the answer to the question of whether it is reasonable and necessary to develop skills among the examined students seems to be obvious. Indeed, assertive behaviours should be trained for at the Faculty of Health Sciences. At the same time skills related to EI--such as perceiving and processing emotional information, awareness of one's own and others' emotions, and associated social competencies in conditioning effective behaviours in inti

Introduction: The aim of the study was to assess the quality of life in patients with multiple sclerosis who underwent complex rehabilitation, and to identify the aspect (psychological, physical or social) in which most improvement was achieved with respect to quality of life after complex rehabilitation.

Materials and methods: The study was carried out from July to September 2010 at the Centre for the Rehabilitation of Patients with Multiple Sclerosis in Borne Sulinowo. The study group included 30 subjects with diagnosed multiple sclerosis. The study was based on a diagnostic survey--a questionnaire for direct survey. We used the reintegration to normal living index scale (RNLI) and expanded disability status scale.

Results: We found a statistically significant improvement in the assessment of the quality of life in patients who underwent complex rehabilitation (p = 0.000000). The analysis of individual aspects of the quality of life revealed a statistically significant improvement in all aspects: psychological (p = 0.000027), physical (p = 0.000090) and social (p = 0.000026). The difference in the assessment of the quality of life in the social aspect was 1.21, in the physical aspect - 1.16, and in the psychological aspect - 0.86. The greatest difference in the assessment of the quality of life was found for the social aspect, and the lowest in the psychological aspects.

Conclusions: Complex rehabilitation improves the self--reported quality of life in patients with multiple sclerosis in all its aspects. After complex rehabilitation the highest scores were found for the assessment of the quality of life in the psychological aspect, but the greatest improvement in the quality of life was in the social aspect, proving the positive effects of sociotherapy.

During the last decade there has been a striking growth in interest in ethical issues arising from the development of neurosciences. It was as late as 2002 that the new discipline, called neuroethics, started. It was intended to be a new area of interdisciplinary discourse on moral dilemmas connected with recent advances in, broadly understood, neurosciences. Ten years after its launch neuroethics possesses a distinct body of knowledge and an institutional basis for its further development. As a very young discipline, however, neuroethics is still in a state offlux. Two essential theoretical concepts of how this discipline is to be built on are emerging. Both are discussed in this article. According to the first of them (i.e. ethics of neurosciences), neuroethics is basically understood as a sub--discipline of bioethics. Although there are some reasons for distinguishing several branches or sub-disciplines of bioethics (genethics, neuroethics, nanoethics, etc.), there are sound arguments against such a tendency for the proliferation of biomedical ethics. The second approach to neuroethics (neuroscience of ethics), which aims at studying neuronal correlates of the well-known ethical concepts (e.g. free-will, moral responsibility, etc.), seems to be much more promising. Neuroethics understood in this way (and only in this way) can be considered as a truly new opportunity for collaboration between neuroscientists and ethicists.