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Volume 124 (2014): Issue 1 (March 2014)

Journal Details
Format
Journal
eISSN
2083-4829
First Published
23 Apr 2014
Publication timeframe
1 time per year
Languages
English

Search

Volume 124 (2014): Issue 1 (March 2014)

Journal Details
Format
Journal
eISSN
2083-4829
First Published
23 Apr 2014
Publication timeframe
1 time per year
Languages
English

Search

12 Articles
Open Access

Acceptance of the illness and the quality of life of patients with breast cancer

Published Online: 23 Apr 2014
Page range: 5 - 9

Abstract

Abstract

Introduction. Breast cancer is the most frequent cancer diagnosed in women. Its treatment is a combined therapy and the sequence and time are established according to the accepted standards in Poland. Consequences posed by this disease include disorder in the physical, mental and social spheres in women. Adapting to cancer is very important for the process of treatment, and the acceptance of the disease is the determinant. Aim. The aim of the study was to determine and compare the degree of acceptance of the illness and the assessment of quality of life among breast cancer patients during cancer treatment. Material and methods. The survey included 85 ill people treated in a conserving way and 94 ill people treated by breast amputation. Patients after the surgical procedure were subjected to adjuvant treatment involving chemotherapy (90 women) and/or endocrine therapy (87 women). The study used standardized questionnaires EORTC (European Organisation for Research and Treatment of Cancer): QLQC-30 and the scale (AIS Approval IIIness Scale). Results. The highest level of acceptance of the disease, so the best ability to adapt to cancer have those women who have undergone radical mastectomy and adjuvant hormone therapy during the treatment. The lowest level of acceptance of the illness, expressed as a negative assessment was observed in women after BCT and during chemotherapy treatment. The use of the EORTC QLQC-30 to assess the overall health and quality of life of patients allowed us to capture statistically significant differences in the percentages stating good health, with the relatively highest negative response rates which were observed in the subgroups treated with chemotherapy and hormone therapy. With regard to the highest quality of life, the percentage of negative responses was observed in subgroups treated with the use of hormone therapy and after mastectomy. Conclusions. Good acceptance of the disease was obtained by women treated for breast cancer who have undergone mastectomy in the course of adjuvant endocrine therapy. The assessment of general health and quality of life was influenced by oncological treatment. Patients during chemotherapy and hormone therapy showed a negative impact of this form of treatment on overall well-being and functioning.Patients after mastectomy and during hormone therapy treatment showed a comparatively lower quality of life compared to a group of patients after BCT and during treatment with chemotherapy

Keywords

  • breast cancer
  • acceptance of the illness
  • quality of life
Open Access

The evaluation of health-related behaviours between the physically active and non-active women

Published Online: 23 Apr 2014
Page range: 10 - 13

Abstract

Abstract

Introduction. In the face of the more and more general threat with civilization diseases the promotion of healthy lifestyle should be one of main activities of educational and medical institutions. Aim. The aim of the work was comparison of chosen elements of healthy lifestyle between the young physically active women and non-sports ones. Material and methods. The survey was carried out on 156 women aged 18-35 years, divided into two groups. Persons physically active were classified into Group 1 (n=72), whereas into Group 2 - non-active ones (n=84). The investigative tool was the Inventory of Health-Related Behaviours by Juczyński (where health-related behaviours were rated in four categories: proper nutrition habits, prophylaxis behaviours, and positive attitude and health practices). Differences between the data were qualified with the t-student test for independent groups; level p≤0.05 was accepted as of minimum significance. Results. The results show that physically active persons pay greater attention to healthy lifestyle than non-sports people. The general indicator of health-related behaviours was noticeably higher in Group 1 (p=0.007). Greatest differences (p=0.008) were noted within the range of nutritional habits, and the least significant ones - in positive attitude (p=0.546). Conclusion. The positive influence of the physical activity on other aspects of the healthy lifestyle has been proven. It seems legitimate to promote physical activity among women of every age

Keywords

  • physical activity
  • health behaviours
  • lifestyle
  • women
Open Access

Assessment of medical personnel knowledge about the function of transplant coordinator with reference to current Polish legislation

Published Online: 23 Apr 2014
Page range: 14 - 20

Abstract

Abstract

Introduction. Initially, a transplant coordinator assisted in the process of removal and transplantation of organs. The most important rule in the Polish legislation is the Act of July 17th, 2009, amending the Act on removal, preservation, and transplantation of cells, tissues, and organs. Professional qualifications of a transplant coordinator are specified by the Regulation of the Minister of Health of December 4th, 2009 on detailed conditions of removal, preservation, and transplantation of cells, tissues, and organs. Aim. The study aimed to assess the knowledge of medical personnel about the function of a transplant coordinator with reference to the current Polish legislation. Material and methods. The study was conducted in April 2013 among 100 selected health professionals (25 physicians, 62 nurses, and 13 persons representing other medical professions) with the use of a questionnaire comprising 42 close-ended simple choice questions and one multiple-choice question. They were referring to various aspects associated with the legal axiology of transplantation, procedure of organ donation, and tasks of a donation coordinator, as well as one open-ended question about the age of respondents. Results. Statistically significant differences between the occupational groups were found in relation to questions about legal and medical aspects. As many as 21 nurses (34%), 26 physicians (92%), and 6 persons representing other medical professions (46%) (p<0.000) provided the correct answer to a question referring to determination of death, and 19 nurses (31%), 7 physicians (28%), and 5 persons representing other medical professions (p<0.021) answered correctly to a question about the key premise to determine brain death. Conclusions. 1. The knowledge of medical personnel about the function of a transplant coordinator and the legal provisions concerning brain death determination needs to be supplemented. 2. There is a need of constantly supplementing knowledge of medical personnel about the clinical aspects of transplantation

Keywords

  • transplant coordinator
  • transplantation
  • law
  • knowledge
  • nurses
  • physicians
Open Access

Assessment of knowledge of midwives about the scope of professional responsibility under the amended provisions of law

Published Online: 23 Apr 2014
Page range: 21 - 25

Abstract

Abstract

Introduction. To work safely, knowledge of law is crucial for midwives who should be familiar with the midwife’s rights and duties as well as their professional responsibility. Aim. Assessment of knowledge of midwives about their professional responsibility. Material and methods. A total of 103 MA Midwifery students of the Medical University of Warsaw, including 55 working and 48 not working as midwives. A diagnostic poll, original anonymous questionnaire, 25 close-ended questions, 8 openended questions. Statistical analysis: STATISTICA 10.0, Mann-Whitney U test, p<0.05. Results. Seventy-one percent of the study participants had knowledge of the binding provisions of law and 83% considered this kind of knowledge as necessary in their professional activity. Twenty-four percent of the total did not know any legal regulations. Thirty percent was not familiar with the Nurses and Midwives Act. Only 52% of the study participants were knowledgeable about the legal protection of midwives and indicated the protection established for public officers. Forty-six percent of the total said that the Act on Professional Self-Government of Nurses and Midwives of July 1st, 2011 regulates the issue of self-governance. As many as 30 study participants knew that membership in the self-governing body of midwives is obligatory. Conclusions. Knowledge of nurses about professional responsibility under amended provisions of law is insufficient and does not improve with experience as a midwife. Due to the fact that new acts on professional responsibility of midwives were implemented in Poland beginning in January 1st, 2012, it is advisable to extend qualifications and knowledge of midwives in order to improve their knowledge of professional issues. Midwives should constantly update their knowledge of legal regulations on their profession

Keywords

  • midwifery
  • professional responsibility
  • provisions of law
Open Access

Type of financing dental care and frequency of dental visits among patients treated with implants

Published Online: 23 Apr 2014
Page range: 26 - 28

Abstract

Abstract

Introduction. Many factors affect the oral health of the population. These include individual factors, the effectiveness of dental care, life styles and political, economic and environmental factors. Aim. The aim of the study was to evaluate the type of financing dental care and frequency of dental visits among patients treated with implants because of missing teeth. Material and methods. The survey was conducted among 464 patients of both genders aged 20-74 years, treated with dental implants at the Non-Public Healthcare Centre “Dental” in Tomaszów Mazowiecki. The patients answered questions included in anonymous questionnaire. The questions concerned age, education, type of dental care financing and frequency of dental visits. Results. Results of the survey indicate that among patients treated with implants there were over 14-times more people benefiting from dental care in private clinics providing preventive and restorative treatments at full cost, compared with people using dental services funded by the National Health Fund. Just over 16% of the surveyed patients frequently enough, i.e. at least once in 6 months reported to the dentist. The frequency of dental visits increased with the education level - people with vocational and secondary education most often visited a dentist irregularly, when necessary, while those with higher education - once a year. Patients below 60 years reported to the dentist 1-2 times a year, whereas older - irregularly, when necessary. Conclusion. In preparing the patient for the treatment of missing teeth with implants one should be aware of his need for paying special attention to oral health and regular, sufficiently frequent follow-up visits which has a substantial impact on the course and therapeutic success in the implant prosthetic treatment

Keywords

  • dental implants
  • dental care
  • demographic factors
Open Access

The structure of dental procedures under general anaesthesia in children and adolescents with epilepsy

Published Online: 23 Apr 2014
Page range: 29 - 32

Abstract

Abstract

Introduction. One of the indications for dental treatment in general anaesthesia of children and adolescents is the patients’ refusal to cooperate with the dentist; this concerns especially the so-called special care patients, and among them, those suffering from epilepsy. Aim. The aim of the study was to evaluate the structure of treatment procedures in conservative dentistry and dental surgery performed under general anaesthesia in children and adolescents with epilepsy. Material and methods. The analysis covered case histories of 109 patients with epilepsy, aged 3-18 years, who received dental treatment under general anaesthesia. The patients were divided into three age groups, according to the dentition type: patients with deciduous dentition - 3-5 years of age; with mixed dentition - 6-12 years, and with permanent dentition - 13-18 years. The analysis concerned the procedures on both deciduous and permanent teeth. Results. An average number of extractions in a child with full deciduous dentition was 3.9 teeth, while in a child with mixed dentition - 2.7 teeth. The greatest number of deciduous teeth extractions concerned first and second molars. Carious cavities in the occlusal surfaces of permanent teeth, due to deep caries, were the most frequently treated lesions. Conclusions. In patients with epilepsy treated under general anaesthesia, extensive treatment needs, resulting from prophylactic and therapeutic neglect in dental care, were found. Conservative and surgical treatment, combined with prophylactic procedures, performed under general anaesthesia seems one of the necessary elements of a complex dental care in uncooperative children and adolescents

Keywords

  • epilepsy
  • children
  • adolescents
  • dental treatment
  • general anaesthesia
Open Access

The evaluation of kindergarten teachers’ preparation to promote oral health among children

Published Online: 23 Apr 2014
Page range: 33 - 37

Abstract

Abstract

Introduction. The problem of high caries prevalence among preschool children has been widely discussed in Poland. Studies show unsatisfactory level of children’s oral health. A reason of this situation could be insufficient health education. Aim. The aim of the study was to evaluate kindergarten teachers’ preparation to promote oral health among children. Material and methods. Ninety-seven preschool teachers from Lublin (96 women and 1 man) participated in the study. Teachers were asked to fill survey forms concerning: oral health education campaigns launched in the kindergarten, meals consumed by kids and basic issues of oral hygiene. Results and discussion. The majority of examined teachers (96.91%) confirmed that oral health education campaigns were executed at their workplace. Significantly less people confirmed execution of fluoridation programs. Half of the subjects (53.61%) rated their knowledge of oral health diseases prevention as good. Passing on the knowledge about oral hygiene during lessons with children was confirmed by 96.91% subjects. A great proportion of the subjects (71.13%) think that launching regular oral health education campaigns among teachers would help to improve oral health level of children. Conclusions. Kindergarten teachers have general, but not expert knowledge of oral health. Trained teachers could play an important role in raising children health status

Keywords

  • caries prophylaxis
  • kindergarten children
  • kindergarten teachers
  • oral health promotion
Open Access

The gene expression of class III inhibitors of apoptosis in arteriosclerotic disease

Published Online: 23 Apr 2014
Page range: 38 - 41

Abstract

Abstract

Introduction. Recent research shows that programmed cell death has great importance in the pathomechanism of atherosclerosis. The BIRC5 and BIRC6 genes belong to Class III IAPs with the anti-apoptotic effect. The proteins display multidirectional action. According to the available literature, in addition to the effect of apoptosis inhibition they also display other properties. It is suggested that they play an important role in the processes of proliferation and cellular differentiation. Aim. The aim of the study was to assess the expression of the BIRC5 and BIRC6 genes in normal peripheral blood lymphocytes and in peripheral blood lymphocytes of patients diagnosed with atherosclerosis. Material and methods. The analysis was carried out on RNA samples obtained from peripheral blood lymphocytes of 21 patients with diagnosed atherosclerosis. The specific fragment of the analysed gene was obtained through amplification with the use of cDNA synthesised in the reaction of reverse transcription. The test of expression was conducted with the use of the Real-Time PCR method. In the studied cases, the level of expression of the analysed gene was compared to the level of expression of the reference gene, B2M. Results. The study showed that mRNA of the BIRC5 and BIRC6 genes is present in the cells of patients with atherosclerosis, as well as in the cells of healthy individuals. The cells taken from the patients with atherosclerosis were mainly characterized by an increased gene expression in comparison to the normal cells. Conclusion. Increased BIRC6 and BIRC5 gene expression in the cells of the patients with atherosclerosis can suggest an increased amount of the inhibitor protein BRUCE and survivin, and also decreased sensitivity of cells to apoptosis. In the case of the patients who had significantly higher expression of the BIRC6 gene in lymphocytes compared to the norm, hypertension and diabetes mellitus were more common

Keywords

  • apoptosis
  • atherosclerosis
  • IAP
  • BIRC5 gene
  • BIRC6 gene
Open Access

Influence of prednisone on serum level of tumor necrosis factor alpha, interferon gamma and interleukin-1 beta, in active pulmonary tuberculosis

Published Online: 23 Apr 2014
Page range: 42 - 45

Abstract

Abstract

Introduction. Tumor necrosis factor alpha, interferon gamma and interleukin-1 beta modulate the interaction between T-cells and macrophages and play the key role in immune defense in Mycobacterium tuberculosis infection. Several studies have demonstrated that corticosteroids may improve clinical conditions of patients with active pulmonary tuberculosis. Aim. The aim of the study was a potential impact of prednisone on the early immune response in HIV-negative young adults with active pulmonary tuberculosis, during the first four weeks of treatment. Material and methods. The study included 38 adults, aged 18-39 years, with active pulmonary tuberculosis. The first group of patients received only anti-tuberculosis chemotherapy whereas the second group of patients was administered antituberculosis chemotherapy and 20 mg prednisone, once daily. Serum levels of tumor necrosis factor-alpha, interferon-gamma and interleukin 1-beta were measured using ELISA kits before treatment initiation as well after two and four weeks of treatment, in both study groups. Results. The highest serum levels of evaluated cytokines were observed before treatment initiation. Serum levels of cytokines were significantly decreased in patients who received anti-tuberculosis drugs and prednisone, compare to those not treated with prednisone (p<0.001), in all study periods. Conclusions. Adjunctive therapy, like 20 mg prednisone daily, remarkably inhibited the secretion of inflammatory cytokines during the early stage of active pulmonary tuberculosis in HIV-negative young adults, which is likely to be beneficial for this group of patients

Keywords

  • pulmonary tuberculosis
  • TNF-alpha
  • IFN-gamma
  • IL-1 beta
  • immune defense mechanism
  • prednisone
Open Access

Potential anti-inflammatory activity of low molecular weight heparin in patients with exacerbations of COPD – short report

Published Online: 23 Apr 2014
Page range: 46 - 48

Abstract

Abstract

Introduction. Anti-inflammatory, separate from anti-thrombotic activity of low molecular weight heparin, is still not well documented. Aim. We estimated the influence of enoxaparin on serum levels of tumor necrosis factor alpha, as the pro-inflammatory cytokine, and interleukin-12, as the heparin-binding, anti-inflammatory cytokine, in patients with exacerbations of chronic obstructive pulmonary disease. Material and methods. Seventy-three consecutive patients (48 males, 25 females) aged 56-75 years without thromboembolic history, were enrolled into the study. They were randomized to group who received enoxaparin in one daily dose 40 mg, or to group who did not receive it. Patients receiving oral anti-coagulants were excluded from the study. Using ELISA approach, we evaluated serum levels of tumor necrosis factor-alpha and interleukin-12 at the following periods: before the first dose of enoxaparin, after 7 days of treatment and 14 days of treatment. Serum level of the C-reactive protein was evaluated simultaneously. Results. In enoxaparin recipients statistically significant (p<0.01) decreasing of TNF-alpha serum levels (from 168.33 pg/ml in admission, to 85.67 pg/ml in the end of study) to compare enoxaparine non-recipients, was observed. Interleukin-12 serum levels were significantly higher in enoxaparine recipients both after 7 days (67.46 pg/ml) and 14 days (89.32 pg/ml) of the study (p<0.05). C-reactive proteins serum levels were significantly higher in enoxaparine non-recipients than recipients (p<0.05) in all study period. Conclusions. Enoxaparin in daily dose 40 mg, significantly depressed serum levels of TNF-alpha and promote serum levels of interleukin-12. Enoxaparin administration may be beneficial for the patients with COPD exacerbation during the first 14 days of treatment

Keywords

  • low molecular weight heparin
  • chronic obstructive pulmonary disease exacerbation
  • IL-12
  • TNF-alpha
  • inflammation
Open Access

The future of internal medicine in the United States and Poland

Published Online: 23 Apr 2014
Page range: 49 - 54

Abstract

Abstract

Internal medicine physicians are critical to the health of the population. Internal medicine doctors also bring cost savings in health care because they treat many systems in the body and treat the patients in a holistic manner. However, the popularity of the specialty of internal medicine is declining. This is due to the decreased compensation that internal medicine doctors obtain when compared to their colleagues who specialize in other fields. The decline in number of physicians specializing in internal medicine causes a decrease in the health of the population. Governments and policy makers must look for ways to reverse the trend of doctors not specializing in internal medicine

Keywords

  • internal medicine
  • specialization
Open Access

The role of Th17 lymphocytes in pathogenesis of autoimmune arthritides

Published Online: 23 Apr 2014
Page range: 55 - 58

Abstract

Abstract

Th17 cells are newly described population of lymphoctyes, that recruits neutrophils to the site of inflammation and activate inflammatory phenotype of various tissues. They also play a pivotal role in autoimmune diseases and cancers. These cells secrete mainly different isoforms of IL-17, but also IL-21 and IL-22. Rheumatoid arthritis and juvenile idiopathic arthritis are the most common autoimmune joints’ inflammatory disease, affecting respectively adults and children. For a long time the immunopathogenesis of autoimmune diseases has been associated with Th1 lymphocytes. This hypothesis has changed after the discovery of Th17 cells, which are thought to be key mediators of autoimmune arthritides

Keywords

  • rheumatoid arthritis
  • juvenile idiopathic arthritis
  • Th17 lymphocytes
12 Articles
Open Access

Acceptance of the illness and the quality of life of patients with breast cancer

Published Online: 23 Apr 2014
Page range: 5 - 9

Abstract

Abstract

Introduction. Breast cancer is the most frequent cancer diagnosed in women. Its treatment is a combined therapy and the sequence and time are established according to the accepted standards in Poland. Consequences posed by this disease include disorder in the physical, mental and social spheres in women. Adapting to cancer is very important for the process of treatment, and the acceptance of the disease is the determinant. Aim. The aim of the study was to determine and compare the degree of acceptance of the illness and the assessment of quality of life among breast cancer patients during cancer treatment. Material and methods. The survey included 85 ill people treated in a conserving way and 94 ill people treated by breast amputation. Patients after the surgical procedure were subjected to adjuvant treatment involving chemotherapy (90 women) and/or endocrine therapy (87 women). The study used standardized questionnaires EORTC (European Organisation for Research and Treatment of Cancer): QLQC-30 and the scale (AIS Approval IIIness Scale). Results. The highest level of acceptance of the disease, so the best ability to adapt to cancer have those women who have undergone radical mastectomy and adjuvant hormone therapy during the treatment. The lowest level of acceptance of the illness, expressed as a negative assessment was observed in women after BCT and during chemotherapy treatment. The use of the EORTC QLQC-30 to assess the overall health and quality of life of patients allowed us to capture statistically significant differences in the percentages stating good health, with the relatively highest negative response rates which were observed in the subgroups treated with chemotherapy and hormone therapy. With regard to the highest quality of life, the percentage of negative responses was observed in subgroups treated with the use of hormone therapy and after mastectomy. Conclusions. Good acceptance of the disease was obtained by women treated for breast cancer who have undergone mastectomy in the course of adjuvant endocrine therapy. The assessment of general health and quality of life was influenced by oncological treatment. Patients during chemotherapy and hormone therapy showed a negative impact of this form of treatment on overall well-being and functioning.Patients after mastectomy and during hormone therapy treatment showed a comparatively lower quality of life compared to a group of patients after BCT and during treatment with chemotherapy

Keywords

  • breast cancer
  • acceptance of the illness
  • quality of life
Open Access

The evaluation of health-related behaviours between the physically active and non-active women

Published Online: 23 Apr 2014
Page range: 10 - 13

Abstract

Abstract

Introduction. In the face of the more and more general threat with civilization diseases the promotion of healthy lifestyle should be one of main activities of educational and medical institutions. Aim. The aim of the work was comparison of chosen elements of healthy lifestyle between the young physically active women and non-sports ones. Material and methods. The survey was carried out on 156 women aged 18-35 years, divided into two groups. Persons physically active were classified into Group 1 (n=72), whereas into Group 2 - non-active ones (n=84). The investigative tool was the Inventory of Health-Related Behaviours by Juczyński (where health-related behaviours were rated in four categories: proper nutrition habits, prophylaxis behaviours, and positive attitude and health practices). Differences between the data were qualified with the t-student test for independent groups; level p≤0.05 was accepted as of minimum significance. Results. The results show that physically active persons pay greater attention to healthy lifestyle than non-sports people. The general indicator of health-related behaviours was noticeably higher in Group 1 (p=0.007). Greatest differences (p=0.008) were noted within the range of nutritional habits, and the least significant ones - in positive attitude (p=0.546). Conclusion. The positive influence of the physical activity on other aspects of the healthy lifestyle has been proven. It seems legitimate to promote physical activity among women of every age

Keywords

  • physical activity
  • health behaviours
  • lifestyle
  • women
Open Access

Assessment of medical personnel knowledge about the function of transplant coordinator with reference to current Polish legislation

Published Online: 23 Apr 2014
Page range: 14 - 20

Abstract

Abstract

Introduction. Initially, a transplant coordinator assisted in the process of removal and transplantation of organs. The most important rule in the Polish legislation is the Act of July 17th, 2009, amending the Act on removal, preservation, and transplantation of cells, tissues, and organs. Professional qualifications of a transplant coordinator are specified by the Regulation of the Minister of Health of December 4th, 2009 on detailed conditions of removal, preservation, and transplantation of cells, tissues, and organs. Aim. The study aimed to assess the knowledge of medical personnel about the function of a transplant coordinator with reference to the current Polish legislation. Material and methods. The study was conducted in April 2013 among 100 selected health professionals (25 physicians, 62 nurses, and 13 persons representing other medical professions) with the use of a questionnaire comprising 42 close-ended simple choice questions and one multiple-choice question. They were referring to various aspects associated with the legal axiology of transplantation, procedure of organ donation, and tasks of a donation coordinator, as well as one open-ended question about the age of respondents. Results. Statistically significant differences between the occupational groups were found in relation to questions about legal and medical aspects. As many as 21 nurses (34%), 26 physicians (92%), and 6 persons representing other medical professions (46%) (p<0.000) provided the correct answer to a question referring to determination of death, and 19 nurses (31%), 7 physicians (28%), and 5 persons representing other medical professions (p<0.021) answered correctly to a question about the key premise to determine brain death. Conclusions. 1. The knowledge of medical personnel about the function of a transplant coordinator and the legal provisions concerning brain death determination needs to be supplemented. 2. There is a need of constantly supplementing knowledge of medical personnel about the clinical aspects of transplantation

Keywords

  • transplant coordinator
  • transplantation
  • law
  • knowledge
  • nurses
  • physicians
Open Access

Assessment of knowledge of midwives about the scope of professional responsibility under the amended provisions of law

Published Online: 23 Apr 2014
Page range: 21 - 25

Abstract

Abstract

Introduction. To work safely, knowledge of law is crucial for midwives who should be familiar with the midwife’s rights and duties as well as their professional responsibility. Aim. Assessment of knowledge of midwives about their professional responsibility. Material and methods. A total of 103 MA Midwifery students of the Medical University of Warsaw, including 55 working and 48 not working as midwives. A diagnostic poll, original anonymous questionnaire, 25 close-ended questions, 8 openended questions. Statistical analysis: STATISTICA 10.0, Mann-Whitney U test, p<0.05. Results. Seventy-one percent of the study participants had knowledge of the binding provisions of law and 83% considered this kind of knowledge as necessary in their professional activity. Twenty-four percent of the total did not know any legal regulations. Thirty percent was not familiar with the Nurses and Midwives Act. Only 52% of the study participants were knowledgeable about the legal protection of midwives and indicated the protection established for public officers. Forty-six percent of the total said that the Act on Professional Self-Government of Nurses and Midwives of July 1st, 2011 regulates the issue of self-governance. As many as 30 study participants knew that membership in the self-governing body of midwives is obligatory. Conclusions. Knowledge of nurses about professional responsibility under amended provisions of law is insufficient and does not improve with experience as a midwife. Due to the fact that new acts on professional responsibility of midwives were implemented in Poland beginning in January 1st, 2012, it is advisable to extend qualifications and knowledge of midwives in order to improve their knowledge of professional issues. Midwives should constantly update their knowledge of legal regulations on their profession

Keywords

  • midwifery
  • professional responsibility
  • provisions of law
Open Access

Type of financing dental care and frequency of dental visits among patients treated with implants

Published Online: 23 Apr 2014
Page range: 26 - 28

Abstract

Abstract

Introduction. Many factors affect the oral health of the population. These include individual factors, the effectiveness of dental care, life styles and political, economic and environmental factors. Aim. The aim of the study was to evaluate the type of financing dental care and frequency of dental visits among patients treated with implants because of missing teeth. Material and methods. The survey was conducted among 464 patients of both genders aged 20-74 years, treated with dental implants at the Non-Public Healthcare Centre “Dental” in Tomaszów Mazowiecki. The patients answered questions included in anonymous questionnaire. The questions concerned age, education, type of dental care financing and frequency of dental visits. Results. Results of the survey indicate that among patients treated with implants there were over 14-times more people benefiting from dental care in private clinics providing preventive and restorative treatments at full cost, compared with people using dental services funded by the National Health Fund. Just over 16% of the surveyed patients frequently enough, i.e. at least once in 6 months reported to the dentist. The frequency of dental visits increased with the education level - people with vocational and secondary education most often visited a dentist irregularly, when necessary, while those with higher education - once a year. Patients below 60 years reported to the dentist 1-2 times a year, whereas older - irregularly, when necessary. Conclusion. In preparing the patient for the treatment of missing teeth with implants one should be aware of his need for paying special attention to oral health and regular, sufficiently frequent follow-up visits which has a substantial impact on the course and therapeutic success in the implant prosthetic treatment

Keywords

  • dental implants
  • dental care
  • demographic factors
Open Access

The structure of dental procedures under general anaesthesia in children and adolescents with epilepsy

Published Online: 23 Apr 2014
Page range: 29 - 32

Abstract

Abstract

Introduction. One of the indications for dental treatment in general anaesthesia of children and adolescents is the patients’ refusal to cooperate with the dentist; this concerns especially the so-called special care patients, and among them, those suffering from epilepsy. Aim. The aim of the study was to evaluate the structure of treatment procedures in conservative dentistry and dental surgery performed under general anaesthesia in children and adolescents with epilepsy. Material and methods. The analysis covered case histories of 109 patients with epilepsy, aged 3-18 years, who received dental treatment under general anaesthesia. The patients were divided into three age groups, according to the dentition type: patients with deciduous dentition - 3-5 years of age; with mixed dentition - 6-12 years, and with permanent dentition - 13-18 years. The analysis concerned the procedures on both deciduous and permanent teeth. Results. An average number of extractions in a child with full deciduous dentition was 3.9 teeth, while in a child with mixed dentition - 2.7 teeth. The greatest number of deciduous teeth extractions concerned first and second molars. Carious cavities in the occlusal surfaces of permanent teeth, due to deep caries, were the most frequently treated lesions. Conclusions. In patients with epilepsy treated under general anaesthesia, extensive treatment needs, resulting from prophylactic and therapeutic neglect in dental care, were found. Conservative and surgical treatment, combined with prophylactic procedures, performed under general anaesthesia seems one of the necessary elements of a complex dental care in uncooperative children and adolescents

Keywords

  • epilepsy
  • children
  • adolescents
  • dental treatment
  • general anaesthesia
Open Access

The evaluation of kindergarten teachers’ preparation to promote oral health among children

Published Online: 23 Apr 2014
Page range: 33 - 37

Abstract

Abstract

Introduction. The problem of high caries prevalence among preschool children has been widely discussed in Poland. Studies show unsatisfactory level of children’s oral health. A reason of this situation could be insufficient health education. Aim. The aim of the study was to evaluate kindergarten teachers’ preparation to promote oral health among children. Material and methods. Ninety-seven preschool teachers from Lublin (96 women and 1 man) participated in the study. Teachers were asked to fill survey forms concerning: oral health education campaigns launched in the kindergarten, meals consumed by kids and basic issues of oral hygiene. Results and discussion. The majority of examined teachers (96.91%) confirmed that oral health education campaigns were executed at their workplace. Significantly less people confirmed execution of fluoridation programs. Half of the subjects (53.61%) rated their knowledge of oral health diseases prevention as good. Passing on the knowledge about oral hygiene during lessons with children was confirmed by 96.91% subjects. A great proportion of the subjects (71.13%) think that launching regular oral health education campaigns among teachers would help to improve oral health level of children. Conclusions. Kindergarten teachers have general, but not expert knowledge of oral health. Trained teachers could play an important role in raising children health status

Keywords

  • caries prophylaxis
  • kindergarten children
  • kindergarten teachers
  • oral health promotion
Open Access

The gene expression of class III inhibitors of apoptosis in arteriosclerotic disease

Published Online: 23 Apr 2014
Page range: 38 - 41

Abstract

Abstract

Introduction. Recent research shows that programmed cell death has great importance in the pathomechanism of atherosclerosis. The BIRC5 and BIRC6 genes belong to Class III IAPs with the anti-apoptotic effect. The proteins display multidirectional action. According to the available literature, in addition to the effect of apoptosis inhibition they also display other properties. It is suggested that they play an important role in the processes of proliferation and cellular differentiation. Aim. The aim of the study was to assess the expression of the BIRC5 and BIRC6 genes in normal peripheral blood lymphocytes and in peripheral blood lymphocytes of patients diagnosed with atherosclerosis. Material and methods. The analysis was carried out on RNA samples obtained from peripheral blood lymphocytes of 21 patients with diagnosed atherosclerosis. The specific fragment of the analysed gene was obtained through amplification with the use of cDNA synthesised in the reaction of reverse transcription. The test of expression was conducted with the use of the Real-Time PCR method. In the studied cases, the level of expression of the analysed gene was compared to the level of expression of the reference gene, B2M. Results. The study showed that mRNA of the BIRC5 and BIRC6 genes is present in the cells of patients with atherosclerosis, as well as in the cells of healthy individuals. The cells taken from the patients with atherosclerosis were mainly characterized by an increased gene expression in comparison to the normal cells. Conclusion. Increased BIRC6 and BIRC5 gene expression in the cells of the patients with atherosclerosis can suggest an increased amount of the inhibitor protein BRUCE and survivin, and also decreased sensitivity of cells to apoptosis. In the case of the patients who had significantly higher expression of the BIRC6 gene in lymphocytes compared to the norm, hypertension and diabetes mellitus were more common

Keywords

  • apoptosis
  • atherosclerosis
  • IAP
  • BIRC5 gene
  • BIRC6 gene
Open Access

Influence of prednisone on serum level of tumor necrosis factor alpha, interferon gamma and interleukin-1 beta, in active pulmonary tuberculosis

Published Online: 23 Apr 2014
Page range: 42 - 45

Abstract

Abstract

Introduction. Tumor necrosis factor alpha, interferon gamma and interleukin-1 beta modulate the interaction between T-cells and macrophages and play the key role in immune defense in Mycobacterium tuberculosis infection. Several studies have demonstrated that corticosteroids may improve clinical conditions of patients with active pulmonary tuberculosis. Aim. The aim of the study was a potential impact of prednisone on the early immune response in HIV-negative young adults with active pulmonary tuberculosis, during the first four weeks of treatment. Material and methods. The study included 38 adults, aged 18-39 years, with active pulmonary tuberculosis. The first group of patients received only anti-tuberculosis chemotherapy whereas the second group of patients was administered antituberculosis chemotherapy and 20 mg prednisone, once daily. Serum levels of tumor necrosis factor-alpha, interferon-gamma and interleukin 1-beta were measured using ELISA kits before treatment initiation as well after two and four weeks of treatment, in both study groups. Results. The highest serum levels of evaluated cytokines were observed before treatment initiation. Serum levels of cytokines were significantly decreased in patients who received anti-tuberculosis drugs and prednisone, compare to those not treated with prednisone (p<0.001), in all study periods. Conclusions. Adjunctive therapy, like 20 mg prednisone daily, remarkably inhibited the secretion of inflammatory cytokines during the early stage of active pulmonary tuberculosis in HIV-negative young adults, which is likely to be beneficial for this group of patients

Keywords

  • pulmonary tuberculosis
  • TNF-alpha
  • IFN-gamma
  • IL-1 beta
  • immune defense mechanism
  • prednisone
Open Access

Potential anti-inflammatory activity of low molecular weight heparin in patients with exacerbations of COPD – short report

Published Online: 23 Apr 2014
Page range: 46 - 48

Abstract

Abstract

Introduction. Anti-inflammatory, separate from anti-thrombotic activity of low molecular weight heparin, is still not well documented. Aim. We estimated the influence of enoxaparin on serum levels of tumor necrosis factor alpha, as the pro-inflammatory cytokine, and interleukin-12, as the heparin-binding, anti-inflammatory cytokine, in patients with exacerbations of chronic obstructive pulmonary disease. Material and methods. Seventy-three consecutive patients (48 males, 25 females) aged 56-75 years without thromboembolic history, were enrolled into the study. They were randomized to group who received enoxaparin in one daily dose 40 mg, or to group who did not receive it. Patients receiving oral anti-coagulants were excluded from the study. Using ELISA approach, we evaluated serum levels of tumor necrosis factor-alpha and interleukin-12 at the following periods: before the first dose of enoxaparin, after 7 days of treatment and 14 days of treatment. Serum level of the C-reactive protein was evaluated simultaneously. Results. In enoxaparin recipients statistically significant (p<0.01) decreasing of TNF-alpha serum levels (from 168.33 pg/ml in admission, to 85.67 pg/ml in the end of study) to compare enoxaparine non-recipients, was observed. Interleukin-12 serum levels were significantly higher in enoxaparine recipients both after 7 days (67.46 pg/ml) and 14 days (89.32 pg/ml) of the study (p<0.05). C-reactive proteins serum levels were significantly higher in enoxaparine non-recipients than recipients (p<0.05) in all study period. Conclusions. Enoxaparin in daily dose 40 mg, significantly depressed serum levels of TNF-alpha and promote serum levels of interleukin-12. Enoxaparin administration may be beneficial for the patients with COPD exacerbation during the first 14 days of treatment

Keywords

  • low molecular weight heparin
  • chronic obstructive pulmonary disease exacerbation
  • IL-12
  • TNF-alpha
  • inflammation
Open Access

The future of internal medicine in the United States and Poland

Published Online: 23 Apr 2014
Page range: 49 - 54

Abstract

Abstract

Internal medicine physicians are critical to the health of the population. Internal medicine doctors also bring cost savings in health care because they treat many systems in the body and treat the patients in a holistic manner. However, the popularity of the specialty of internal medicine is declining. This is due to the decreased compensation that internal medicine doctors obtain when compared to their colleagues who specialize in other fields. The decline in number of physicians specializing in internal medicine causes a decrease in the health of the population. Governments and policy makers must look for ways to reverse the trend of doctors not specializing in internal medicine

Keywords

  • internal medicine
  • specialization
Open Access

The role of Th17 lymphocytes in pathogenesis of autoimmune arthritides

Published Online: 23 Apr 2014
Page range: 55 - 58

Abstract

Abstract

Th17 cells are newly described population of lymphoctyes, that recruits neutrophils to the site of inflammation and activate inflammatory phenotype of various tissues. They also play a pivotal role in autoimmune diseases and cancers. These cells secrete mainly different isoforms of IL-17, but also IL-21 and IL-22. Rheumatoid arthritis and juvenile idiopathic arthritis are the most common autoimmune joints’ inflammatory disease, affecting respectively adults and children. For a long time the immunopathogenesis of autoimmune diseases has been associated with Th1 lymphocytes. This hypothesis has changed after the discovery of Th17 cells, which are thought to be key mediators of autoimmune arthritides

Keywords

  • rheumatoid arthritis
  • juvenile idiopathic arthritis
  • Th17 lymphocytes

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