14 research outputs found
Why do Polish medical students resign from pursuing surgical careers? A survey study
Background: In recent years, the interest of Polish medical students in choosing a career in surgical subspecialties has been declining. In the face of a growing demand for surgical procedures it seems essential to find the reasons responsible for that situation. Aim: The aim of the study was to evaluate the level of interest in pursuing surgical careers among Polish medical students and to identify factors that may influence their decision. Material and methods: An anonymous questionnaire was distributed electronically among students from 11 different Polish medical universities. Results: We surveyed 595 individuals (190 male and 405 female). 48% of them declared interest in choosing surgical subspecialty as a career. The percentage of students who considered it before medical school was higher and reached almost 65%. Slight or no interest in surgery as a field of study (OR = 20.6), self-assessment of surgical predispositions as unsatisfactory (OR = 14.3), feeling unable to enter and accomplish surgical specialty (OR = 5.2), being discouraged by the partner (OR = 3.4), negative past experience with the surgical environment (OR = 3.2), not having a surgeon as a mentor (OR = 2.6), no authorship of journal articles or congress presentations (OR = 1.9) and first contact with the operating theatre >2nd year of study (OR = 1.9) were found to be the independent risk factors of abandoning a surgical career. Conclusions: Most medical students are interested in pursuing a surgical specialty at some time during their education. However, being discouraged by lifestyle issues, surgical training quality or experiencing gender discrimination, they often resign from such a career path
Oncogeriatrics (part 5.). The role of comorbidities in older patients with cancer
Comorbidity is defined as the presence of one or more additional conditions co-occurring with primary indices. Comorbidity is common in older cancer patients. Its prevalence, however, is difficult to determine and varies by cancer site. There is no single reason for which comorbidity and cancer coexist, but chronic diseases and cancer are both common in older age and share many risk factors.
There is no consensus on how should comorbidity be measured. Even though many comorbidity indices have been developed so far, no unified, widely used instrument exists.
Patients with comorbidities have worse outcomes compared to those with no such conditions. They may experience diagnostic and therapeutic delay and be disqualified from radical treatment more often. Moreover, they are more likely to suffer from treatment-related complications and have worse overall survival.
It seems important to assess the comorbidity status as a part of individualised oncologic treatment planning. However, as data regarding its significance are insufficient and in many cases conflicting, patients with comorbidity should not be routinely considered as not fit enough for a radical treatment. Therefore, to adequately address all of the concerns that have been raised, a broader participation of older, comorbid patients in clinical trials is needed.Comorbidity is defined as the presence of one or more additional conditions co-occurring with primary indices. Comorbidity is common in older cancer patients. Its prevalence, however, is difficult to determine and varies by cancer site. There is no single reason for which comorbidity and cancer coexist, but chronic diseases and cancer are both common in older age and share many risk factors.
There is no consensus on how should comorbidity be measured. Even though many comorbidity indices have been developed so far, no unified, widely used instrument exists.
Patients with comorbidities have worse outcomes compared to those with no such conditions. They may experience diagnostic and therapeutic delay and be disqualified from radical treatment more often. Moreover, they are more likely to suffer from treatment-related complications and have worse overall survival.
It seems important to assess the comorbidity status as a part of individualised oncologic treatment planning. However, as data regarding its significance are insufficient and in many cases conflicting, patients with comorbidity should not be routinely considered as not fit enough for a radical treatment. Therefore, to adequately address all of the concerns that have been raised, a broader participation of older, comorbid patients in clinical trials is needed.
Oncogeriatrics (part 5.). The role of comorbidities in older patients with cancer
Comorbidity is defined as the presence of one or more additional conditions co-occurring with primary indices. Comorbidity is common in older cancer patients. Its prevalence, however, is difficult to determine and varies by cancer site. There is no single reason for which comorbidity and cancer coexist, but chronic diseases and cancer are both common in older age and share many risk factors.
There is no consensus on how should comorbidity be measured. Even though many comorbidity indices have been developed so far, no unified, widely used instrument exists.
Patients with comorbidities have worse outcomes compared to those with no such conditions. They may experience diagnostic and therapeutic delay and be disqualified from radical treatment more often. Moreover, they are more likely to suffer from treatment-related complications and have worse overall survival.
It seems important to assess the comorbidity status as a part of individualised oncologic treatment planning. However, as data regarding its significance are insufficient and in many cases conflicting, patients with comorbidity should not be routinely considered as not fit enough for a radical treatment. Therefore, to adequately address all of the concerns that have been raised, a broader participation of older, comorbid patients in clinical trials is needed.Comorbidity is defined as the presence of one or more additional conditions co-occurring with primary indices. Comorbidity is common in older cancer patients. Its prevalence, however, is difficult to determine and varies by cancer site. There is no single reason for which comorbidity and cancer coexist, but chronic diseases and cancer are both common in older age and share many risk factors.
There is no consensus on how should comorbidity be measured. Even though many comorbidity indices have been developed so far, no unified, widely used instrument exists.
Patients with comorbidities have worse outcomes compared to those with no such conditions. They may experience diagnostic and therapeutic delay and be disqualified from radical treatment more often. Moreover, they are more likely to suffer from treatment-related complications and have worse overall survival.
It seems important to assess the comorbidity status as a part of individualised oncologic treatment planning. However, as data regarding its significance are insufficient and in many cases conflicting, patients with comorbidity should not be routinely considered as not fit enough for a radical treatment. Therefore, to adequately address all of the concerns that have been raised, a broader participation of older, comorbid patients in clinical trials is needed.
The significance of comorbidity burden among older patients undergoing abdominal emergency or elective surgery
IgG4-related disease manifesting as an isolated gastric lesion- a literature review
Introduction: IgG4-related disease (IgG4-RD) is a newly recognised disorder of unknown etiology and pathogenesis, characterised by dense IgG4+ cells infiltration and fibrosis. IgG4-RD can affect various organs, but gastrointestinal tract involvement is rare. First case of isolated gastric IgG4-RD reported in polish population was diagnosed in our Clinic and became the reason for conducting a literature review. Materials and methods: A literature review was performed using PubMed database. Eight studies of isolated gastric IgG4-RD, published between 2011 and 2017, and a case diagnosed by the authors were included. Results: Three out of nine analysed patients had gastrointestinal complaints. In other cases lesions were detected accidentally. The majority of them were submucosal tumors while only one was a gastric ulcer. The most commonly affected was the stomach body. In all cases malignancy had been suspected, and the lesions were surgically removed. Diagnosis was based on the histopathology image and immunohistochemical staining. Only one patient had elevated IgG4 serum level. No case of recurrence or other organ involvement was reported. Conclusion: IgG4-related disease may manifest as an isolated gastric lesion and should be taken in consideration in differential diagnosis. Making an ultimate diagnosis without histopathological specimen examination seems to be difficult and can lead to misdiagnosis followed by inappropriate treatment. IgG4-RD responds well to steroid therapy. However, on this matter further studies are needed
Choroba IgG4 zależna manifestująca się jako izolowana zmiana w obrębie żołądka– przegląd literatury
Wstęp: Choroba IgG4-zależna (IgG4-RD) jest niedawno opisaną jednostką chorobową o nieustalonej etiologii i patogenezie charakteryzującą się występowaniem bogatych w komórki IgG4 dodatnie nacieków tkankowych z włóknieniem. Zmiany w jej przebiegu lokalizują się w różnych narządach, jednak w obrębie przewodu pokarmowego występują rzadko. Rozpoznany w naszej Klinice przypadek izolowanego zajęcia żołądka przez IgG4-RD stał się punktem wyjścia do wykonania przeglądu aktualnej literatury w celu przybliżenia lekarzom tej nowej jednostki chorobowej. Materiały i metody: Przeglądu literatury dokonano w oparciu o bazę PubMed. Do przeglądu włączono 8 prac dotyczących choroby IgG4-zależnej ograniczonej do żołądka opublikowanych w latach 2001–2017 oraz przypadek IgG-RD rozpoznany przez autorów pracy. Wyniki: U 3 z 9 chorych występowały objawy ze strony przewodu pokarmowego, w innych przypadkach zmiany zostały wykryte przypadkowo. U większości pacjentów miały one charakter guza podśluzówkowego. Tylko w jednym przypadku zaobserwowano zmianę w postaci owrzodzenia. Najczęstszą lokalizacją zmiany był trzon żołądka. Wszystkie zmiany zostały usunięte chirurgicznie z powodu podejrzenia nowotworu złośliwego, a diagnozę postawiono na podstawie typowego obrazu choroby w badaniu histologicznym i immunohistochemicznym. Podwyższony poziom IgG4+ w surowicy stwierdzono u jednej pacjentki. W żadnym przypadku nie zaobserwowano wznowy ani pojawienia się innych zmian o typie IgG4-RD. Wnioski: Choroba IgG4-zależna może manifestować się w postaci zmian ograniczonych do żołądka i powinna być brana pod uwagę w diagnostyce różnicowej. Postawienie ostatecznego rozpoznania przed wykonaniem badania histopatologicznego jest trudne, co przekłada się na pomyłki diagnostyczne i terapeutyczne. IgG4-RD charakteryzuje się dobrą odpowiedzią na glikokortykosteroidy. W tym aspekcie konieczne są jednak dalsze badania
Indications for emergency abdominal surgeries in older patients : 7-year experience of a single centre
Dlaczego polscy studenci medycyny rezygnują z podejmowania specjalizacji zabiegowych? Badanie ankietowe
Wstęp: Zainteresowanie podejmowaniem specjalizacji zabiegowych przez polskich studentów spadło w ostatnich latach. W obliczu wzrastającego zapotrzebowania na zabiegi chirurgiczne, istotne jest poszukiwanie czynników odpowiedzialnych za tę sytuację. Cel: Celem badania było przeprowadzenie oceny poziomu zainteresowania podejmowaniem specjalizacji zabiegowych przez polskich studentów medycyny oraz identyfikacja czynników wpływających na ich decyzje. Materiał i metody: Anonimowe kwestionariusze ankiety zostały rozesłane drogą elektroniczną do studentów kierunku lekarskiego z 11 polskich uczelni medycznych. Wyniki: Do badania włączono 595 uczestników (190 mężczyzn i 405 kobiet). 48% z nich zadeklarowało chęć wyboru specjalizacji zabiegowej po ukończeniu studiów. Procent studentów, którzy rozważali taką karierę w przeszłości, był jednak większy i wyniósł 65%. Niewielkie zainteresowanie chirurgią jako dziedziną nauki (OR = 20.6), własna ocena predyspozycji chirurgicznych jako niesatysfakcjonujących (OR = 14.3), przekonanie, że nie jest się w stanie dostać i ukończyć szkolenia specjalizacyjnego z chirurgii (OR = 5.2), odradzanie kariery chirurga przez partnera (OR = 3.4), negatywne wcześniejsze doświadczenia ze środowiskiem chirurgicznym (OR = 2.6), brak dorobku naukowego (współautorstwa artykułów lub prezentacji na konferencjach naukowych) (OR = 1.9), pierwszy kontakt z blokiem operacyjnym po drugim roku studiów (OR = 1.9) zostały zidentyfikowane jako niezależne czynniki ryzyka rezygnacji z podejmowania kariery w specjalizacjach zabiegowych. Wnioski: Na przestrzeni lat studiów większość studentów medycyny rozważa podjęcie specjalizacji zabiegowej. Zniechęcani przez czynniki dotyczące stylu życia, niski poziom szkolenia chirurgicznego lub doświadczając dyskryminacji ze względu na płeć, często rezygnują z tej ścieżki kariery