Roczniki Akademii Medycznej w Bialymstoku (1995)最新文献

Purpose: Evaluation of the level of the family readiness to look after a person suffering from the Alzheimer's disease.

Material and methods: In the research an authorized questionnaire was used, which comprised knowledge concerning the disease, coping with the situation, looking after a patient and an open test.

Results: It was shown that the level of knowledge about Alzheimer's disease corresponds to the level of education (p < 0.05). Most families 67% look after the patient in their own houses, although they don't belong to any support group. Adapting to a new situation is difficult for people, although, most of them devote most of their energy to the patient with the support of the other members of the family. Family support and the level of knowledge aren't related with the patient acceptance (p < 0.05).

Conclusions: Family support and the level of knowledge aren't related with the patient acceptance. There is a relation, however, between the education and the level of knowledge about the Alzheimer's disease.

Purpose: The aim of the study was to evaluate quality of life and to assess frequency and severity of depressive and anxiety symptoms in hyperthyroid patients.

Material and methods: Forty-seven hyperthyroid patients (38 female, 9 male, mean age 51.4 +/- 13.0; 25-Graves disease, 22 - nodular goitre) and fifty-eight sex- and age-matched controls (40 female, 18 male, mean age 49.6 +/- 16.0) were studied. Quality of life was assessed by means of WHO QuoL Questionnaire. Psychometric evaluation included assessment of depressive symptoms (Hamilton Depression Rating Scale and Beck Depression Inventory) and anxiety level (State and Trait Anxiety Inventory--STAI).

Results: Patients presented significantly decreased perception of quality of life and health state, and scored worse in physical domain and global score of WHO QuoL. Nineteen patients showed depressive symptoms, remaining 28 were euthymic. Level of anxiety did not differ significantly between the patients group and controls. Free thyroxine plasma level correlated with psychological domain of QuoL. Depression severity correlated with anxiety (STAI 2). Anxiety as a state marker influenced psychological and environmental domains and global score of quality of life questionnaire.

Conclusions: The influence of hyperthyroidism on the quality of life was observed. Depressive symptoms are frequent in hyperthyroidism, occurring in 40% hyperthyroid patients. We found also the association between the anxiety level and the quality of life.

In the years 1987-1998 we conducted examined a group of 556 men three times. The nutritional status was evaluated as well as total cholesterol, HDL- and LDL-cholesterol and triglycerides concentration in blood serum and it allowed to evaluate the influence of nutrition on lipid status. The relationships between diet composition and lipid levels in the whole period of 9 years were evaluated using multidimensional linear regression analysis. Among examined men, depending on the period of the study, values of serum total cholesterol (C <200 mg/dk) favourable from the standpoint of arteriosclerosis prevention were noted in only 36-39%, with LDL-cholesterol below 130 mg/dl in 35-48%, HDL-cholesterol over 35 mg/dl in 87-94% and triglyceride levels below 200 mg/dl in 81-83% of the studied men. Among 6 basic nutrients of the diet, only plant fat was significantly influencing the concentration of triglycerides in blood serum--an increase of its consumption caused the decrease of triglyceride level. It has been proven that increasing amount of alcohol in the diet led to the increase of HDL-cholesterol in blood serum. Blood serum lipids were significantly influenced by BMI. Increased body mass index significantly influenced the concentration of total cholesterol, LDL-cholesterol and triglycerides in blood serum. In examined men with the increase of body mass index the HDL-cholesterol concentration was decreasing. Summing it up-it has been shown that the diet of examined men directly and significantly influenced lipid concentration in blood serum, and it also had an indirect influence on lipid concentration, through body mass regulation, which significantly influenced its concentration.

Pulmonary hypertension (PH) is one the most fatal complications of systemic sclerosis (SSc). The aim of the present study was to investigate the occurrence of PH in SSc patients hospitalized in Department of Rheumatology and Internal Diseases University Hospital of Bialystok in years 2003-2004. PH was defined as pulmonary artery systolic pressure (PASP) higher than 35 mmHg as evaluated by ECHO-Doppler. We found PH in 23 out of 53 (43%) SSc patients included in the study. In the majority of patients 20/23 (87%) PH coexisted with the presence of scleroderma lung disease as evaluated by high resolution computed tomography of the lungs. In the remaining 3/23 (13%) patients isolated (arterial) PH was detected. Patients with isolated PH tend to have higher values of PASP (82 +/- 39.0 mmHg) than those with PH and interstitial lung disease (42.5 +/- 6.4 mmHg). The results of our study indicate that PH is a frequent complication of SSc.

Purpose: The aim of this study was the assessment of the quality of life of children and adolescents with tension headaches in comparison with healthy peers.

Material and methods: The study was conducted on 135 middle school and high school students in Poznań and on 86 children with tension headaches, that were treated in the out-patient clinic of The Chair and Clinic of Development Age Neurology of Karol Marcinkowski University of Medical Sciences in Poznań. The research tool for both groups was Pediatric Quality of Life Inventory, version 4.0 (PedsQL 4.0) questionnaire.

Results: In the analysed groups dominated 14- and 16-year-old children. Among children with tension headaches, the ailments usually appeared once or twice a week in 39 (45%) of them. With the use of the PedsQL 4.0 questionnaire the following fields of activity were analyzed: biological, emotional, social functioning and mood.

Conclusions: The biggest discrepancies between the group of healthy children and those with headaches were noted in the field of emotional functioning and mood. Adolescents with tension headaches more frequently reported the feeling of fear and sleep disorders in comparison to healthy students. Children with headaches look at the future in a more pessimistic way and are less satisfied with their lives.

Purpose: The aim of the work is to rate different factors specifying quality of life after surgical treatment of thyroid gland diseases.

Material and methods: Research was carried out on 93 people with recognition of nodular goitre treated surgically during the period 2000-2003 in 2nd Department of General and Oncological Surgery in Wrocław. 83 women and 10 men aged approximately 48 took part in the research. The research was carried out with a help of analysis of medical documentation as well as QL questionnaire including 25 features (clinical, emotional, social). The results of the QL research were prepared on the basis of "SyntMed" Computer Medical Diagnostics programme (Krefft method). Every patient was given a certain QL quantity in the 0-1 range together with the importance of diagnostic features, indicating the strength of influence of the feature on QL quantity.

Results: The strongest influence on QL index had the following diagnostic features: subjective opinion of the quality of life (0.674), sensation of fear in connection with the health condition (0.631), physical efficiency (0.565). Among clinical features the strongest influence had a feeling of palpitation (0.405). It was certified that together with the extension of the post-operation period medium value of QL index increases. The most frequent clinical problems mentioned by the tested patients were: sleeping disorder (66.6%), nervousness (37.6%), sweating (36.5%), palpitation (24.7%). 36.6% of the tested patients are afraid of a setback and 77.4 % of them are worried about their health condition. The treatment did not have an influence on planning the future, sexuality and social life. 59.1% of the tested patients defined their present health condition as satisfactory.

The simultaneous presence of many disorders (physical, psychological, and social) and unmet health care needs in elderly people require a more complex assessment then just a routine diagnostic examination. The involvement of comprehensive geriatric assessment provides a health care model that integrates medical and nursing care with social support. A geriatric assessment could be carried out in a wide variety of settings including: acute hospital units, long-term care, out-patient dispensaries and home visits. A holistic and comprehensive geriatric approach should cover physical, functional and mental assessments as well as the caregiver's strain. For preventive care, effort should be placed on the aspect of health promotion, diseases prevention, and disability postponement. Rehabilitation is an important area for older people, as a majority of them requires a temporary rehabilitation after a major illness before they could regain independence in the community. In order to provide a cross comparison among different patients in different settings, a standardized methodology or instruments will enable to make comparisons better then subjective investigation. To provide a holistic and interdisciplinary health care for the elderly, training doctors, nurses and other health care professionals in geriatrics and gerontology is essential.

A study was conducted to identify pertaining to the care of HIV infected patients among nurses in the County of West Pomerania. Most of the respondents (43.2%) were working in municipal hospitals, 38.7% in hospitals located in the country and 18% in academic hospitals. The responding nurses ranged in age from 20 to 58 (median 38 years). Median of work experience was 16 (1-28) years. The respondents were divided into 3 groups: A--the nurses who expressed serious concern about HIV infection, 62.9%; B--some degree of concern, 31.3%; C--not concerned, 4.3%. An HIV/AIDS workshop was attended by 74.6% of respondents from group A and 76.6% from group B (p > 0.85). The occupational exposure reported 49.5% nurses from group A, 39.9% from group B and 42.4% from group C (p > 0.3). The gloves were "always" used by 82.5% respondents from group A, 87.8% from group B and 76.9% from group C (p > 0.07). 79.9% of nurses from group A, 53.2% from group B and 42.3% (p < 0.0001) favored HIV antibodies testing of all patients.

Purpose: The aim of our study was to evaluate the prevalence of anticardiolipin and anti-beta2-glikoprotein I (anti-beta2GPI) antibodies in patients with systemic sclerosis (SSc) and to correlate the presence of these antibodies with clinical and serological features of the disease.

Material and methods: 22 patients (21 women and 1 man) fulfilling the ACR classification criteria of SSc were included into the study. In all SSc patients a detailed clinical evaluation including skin and internal organ involvement was performed. Moreover, the measurements of antitopoisomerase I (anti-Scl-70) and anticentromere (ACA) antibodies were done in all patients studied. Anticardiolipin antibodies in IgM and IgG class and anti-beta2GPI antibodies in IgM, IgG and IgA class were evaluated using ELISA kits (Hycor Biomedical and DiaSorin).

Results: Anticardiolipin antibodies were found in 10/22 (45.5%) patients with SSc, in 6/12 (50%) with diffuse SSc and in 4/10 (40%) with the limited SSc. Anticardiolipin antibodies in the IgG class were observed in 4/22 (18.2%) patients, and in the IgM class in 9/22 (40.9%) subjects. Anti-beta2GPI antibodies were found in 9/22 patients (40.9%), of which 3/22 (13.6%) had antibodies in IgG class, 4/22 (18.2%) in IgM class and 3/22 (13.6%) in the IgA class. Anti-beta2GPI antibodies were found exclusively in the patients in whom the anticardiolipin antibodies were also present. An association between the presence of antiphospholipid antibodies and internal organ involvement (pulmonary fibrosis, pulmonary hypertension and the alterations of oesophageal function) was not significant. No significant correlation was found between the presence of anticardiolipin or anti-beta2GPI antibodies and the presence of anti-Scl-70 or ACA antibodies.

Conclusions: The results of our study indicate that the prevalence of anticardiolipin antibodies and anti-beta2GPI antibodies is relatively high in patients with SSc. A more detailed assessment of the relationship between the presence of antiphospholipid antibodies and the clinical and serological features of SSc requires further studies on the larger group of patients and a several years of follow-up.

Purpose: The aim of the study was to determine the level of knowledge concerning risk factors for the development of asthma and worsening of the course of the disease among patients, as well as achieving a better understanding of the educational role of the nurse in improving the quality of life of patients suffering from the disease.

Materials and methods: The study was a questionnaire study involving 100 patients suffering from asthma. 59 of them were diagnosed as having an allergic and 41 a nonallergic asthma. In the main they were patients suffering from moderate to severe asthma, who had attended the outpatient allergology clinic for many years.

Results: Analysis of the results obtained demonstrated the significant effects of asthma for the lives and health of the patients questioned. This was reflected in the high number of people registered as unable to work and receiving invalidity benefits, and influenced the activity of the majority patients in various spheres of life. A number of respondents demonstrated poor knowledge of the risk factors for asthma and ways of eliminating the illness. The majority of patients had a good knowledge of the names, doses and ways in which they should take their prescribed medication as well as showing an understanding of the principles of taking additional medicines as necessary. Their knowledge of the principles of anti-inflammatory treatment, which is a basic factor in the treatment of patients with asthma was, however very poor.

Conclusions: Among patients suffering from asthma there is a great need for health information. The majority of respondents expressed a willingness to take part in training sessions to be run by nursing staff. The focus of these educational sessions should be on improving the patients' knowledge about asthma as a chronic inflammatory disease, helping to eliminate and limit risk factors for the disease, treatment principles and avoiding the side-effects of prescribed medication.