Vaccination against COVID-19 in Poland

Introduction. Due to the still difficult and worsening epidemic situation in Poland, related to the second wave of the coronavirus pandemic (COVID-19), it turned out to be necessary to develop, prepare and conduct additional training on the work of medical personnel during the pandemic. Preventive vaccinations and their skilful implementation play a very important role.Aim. The aim of the systematic review is to present the general principles, procedures and competences of nurses in the pandemic era, this work can be used to conduct a comparative meta-analysis.Disscusion. The vaccine protects against the symptoms of COVID-19, which has been proven in clinical trials. For both the Comirnaty vaccine and the Moderna vaccine, the European Medicines Agency website states that the effect of vaccination on the transmission of the virus is unknown and whether vaccinated people can transmit SARS-CoV-2. Clinical trials are scheduled for 2 years and, as part of conditional approval, companies will complete the data after subsequent periodic evaluations.Conclusion. Over 1.5 million people worldwide have died since the outbreak of the COVID-19 epidemic. Each vaccinated person is potentially from a few to a dozen or so people protected against infection. Already 50% of the vaccinated population will significantly reduce the risk of spreading the coronavirus in it. Vaccines are the most effective method of protection against infection with various diseases. Humanity has been successfully using this achievement of civilization for several hundred years

Adverse reaction after transfusion of Red Blood Cells in a patient aged 97 years - case report

During hospitalization 97 years old patient had blood transfusion. This procedure lead to overload of cardiovascular system. Pharmacotherapy gradually improved the general condition of the patient. The patient was discharged in a stable state. Doubts arise; when blood should be transfused, in which cases should a blood transfusion be discontinued, what should be the recommendation for a blood transfusion for older people over the age of 90. There is a need for further research in geriatrics regarding the transfusion of blood and its components

Masywne przerzuty do skóry jako pierwszy objaw raka piersi — opis przypadku

Introduction: Metastases to the skin are relatively rare, but they are an important diagnostic and therapeutic challenge. In women skin metastases are the most commonly associated with breast cancer. In the men they are often associated with lung cancer. Skin metastasis most often are in form of blue-purple nodules and tumours with tendency of necrosis. Aim: The aim of this paper is to present the case of a patient with diagnosed breast cancer with skin involvement. Case report: The 48-years old female patient was admitted to The Department of Dermatology for diagnosis and treatment of dermal lesions in form of numerous blue-purple nodules and ulcerations localised on the skin of the chest. The ultrasound examination suggested a primary malignant lesion in the left breast spreading to the right side and numerous satellite nodules. A whole nodule was collected for histopathological and immunohistochemical examinations in order to make the final diagnosis. Histopathology tests confirmed the diagnosis of tumour metastases of the skin and positive immunohistochemical reactions for cytokeratin 7 (CK7) and for oestrogen receptors (ER) pointed mammary glands as the primary site. The patient was urgently referred to the Oncology Centre. Conclusions: The occurrence of skin metastasis in all tumour processes significantly worsens the prognosis of the patient. These changes should be quickly recognized by the oncologist or dermatologist. Sometimes the localization of primary tumour is not possible to determine without taking the biopsy for histopathological and immunohistochemistry assays. Rapid treatment of appropriate chemotherapy or radiotherapy can prolong life and reduce pain.Wstęp: Przerzuty nowotworów do skóry stanowią istotny problem diagnostyczy i terapeutyczny, chociaż występują stosunkowo rzadko. Przerzuty do skóry obserwowane są najczęściej w przebiegu raka sutka u kobiet i raka płuca w przypadku mężczyzn. Zazwyczaj mają one postać sinofioletowych guzków i guzów, niekiedy z tendencją do rozpadu. Cel pracy: Celem pracy jest przedstawienie przypadku pacjentki z rozpoznanym nowotworem piersi przebiegającym z zajęciem skóry. Opis przypadku: 48-letnia pacjentka została przyjęta do Kliniki Dermatologii w celu diagnostyki i leczenia zmian skórnych o charakterze licznych sinofioletowych guzków z tendencją do rozpadu oraz owrzodzeń zlokalizowanych na skórze gładkiej klatki piersiowej. W badaniu USG piersi całość obrazu przemawiała za procesem nowotworowym pierwotnie wywodzącym się z piersi lewej, z progresją zmian na stronę prawą, z licznymi guzkami satelitarnymi. Pobrano w całości guzek do badania histopatologicznego oraz immunohistochemicznego w celu ustalenia rozpoznania ostatecznego. Wynik badania histopatologicznego potwierdził rozpoznanie przerzutów nowotworowych do skóry, dodatnie odczyny immunohistochemiczne dla cytokeratyny 7 (CK 7) i receptorów estrogenowych (ER) wskazywały na sutek jako miejsce guza pierwotnego. Pacjentka została w trybie pilnym skierowana do Centrum Onkologii. Wnioski: Wystąpienie przerzutów do skóry w przypadku wszystkich procesów nowotworowych znacznie pogarsza rokowanie pacjenta. Zmiany te powinny być szybko rozpoznane przez prowadzącego onkologa lub dermatologa. Czasem punkt wyjścia nowotworu nie jest możliwy do ustalenia bez pobrania materiału do badania histopatologicznego i immunohistochemicznego. Szybkie wdrożenie odpowiedniej chemioterapii lub radioterapii pozwala przedłużyć życie chorych oraz zmniejszyć dolegliwości bólowe.

Systemic sclerosis – review of current data and latest reports

Introduction: Systemic scleroderma (SSc) is an autoimmune disease characterized by fibrosis of the skin and internal organs, vasculopathy and dysregulation of the immune system. It has the highest mortality rate among rheumatologic diseases. SSc causes high economic and social costs. Aim of the study: The purpose of this review is to present the current state of knowledge and recent reports on the pathophysiology, clinical manifestation and treatment of SSc. Materials and methods: A search was conducted using PubMed and GoogleScholar databases. Articles were searched in English using the following keywords: "systemic sclerosis", "scleroderma", "treatment", "symptoms", "pathophysiology". Conclusions: Although the prognosis of SSc remains poor, optimized patient diagnosis along with ongoing advances in therapy could significantly impact the effectiveness of disease management in the near future. It is anticipated that there will be a growing need for further development of combination therapies to better treat this complex disease

Management of blood infection caused by colonization of the vascular port with klebsiella variicola in case of patient treated with palliative chemotherapy

Klebsiella variicola is a bacterial species that was originally identified as a mild endosymbiont in plants, it occurs in humans and cattle. It is a bacterium that has been discovered relatively recently and research on the broader understanding of the pathogen is still underway. Vascular catheters are very often used to receive chemotherapy by patients. The purpose of this work was to present the management of blood infection caused by colonization of the vascular port with klebsiella varicola. The material described can be used to conduct patient pharmacotherapy. Care for a patient with a vascular port should be developed. There is a need to conduct staff training on: proper care and use of the vascular port and Huber needle for pharmacotherapy. Huber needles could be standard material in the list of required equipment in hospital wards to improve patient care with a vascular port

Assessment of physical activity of residents of Bydgoszcz using the international physical activity questionnaire IPAQ

Introduction: Currently, we live in the age of promoting a healthy lifestyle and encouraging physical activity, which justifies conducting a survey on the level of physical activity of the population living in Bydgoszcz. The results of the observation carried out will allow for the analysis of changes in physical activity of Bydgoszcz residents over the years in the future. Material and methods: 199 people living in Bydgoszcz, 97 women and 102 men participated in the study. The mean age of the respondents is 37.7 years, mean BMI: 25.84. The study was conducted using the Polish version of the IPAQ - Long version. Results: 84.42% (n = 168) of respondents were physically active, 12.06% (n = 24) of respondents were sufficiently physically active, and 3.52% (n = 7) were insufficiently physically active. Conclusions: The physical activity of the inhabitants of Bydgoszcz is at a high level, but the in-depth analysis of the results encourages the education in the aim to increase the level even more and to conduct more research

Imaging in a rare case of neuroendocrine tumour with skin metastases

Purpose: Disseminated malignancies are a diagnostic and therapeutic challenge that is often encountered in radiology. Finding the primary tumour is crucial for planning proper surgical and oncological treatment. Computed tomography (CT) of the thorax and abdomen is typically the initial examination. However, abdominal magnetic resonance imaging (MRI) or positron emission tomography (PET/CT) or PET/MRI are often subsequently performed. Histopathological examination of metastatic tumours is performed as well, followed by immunohistochemistry. The aim of the report was to present diagnostic workup in a rare case of skin metastases. Case report: A 72-year-old patient was admitted to a dermatology ward because of skin lesions - violaceous nodules localised on the hair-covered skin of the head. On abdominal CT, a generalised neoplastic process with metastases in the liver, pancreas, adrenal glands, lymph nodes, bones, thoracic wall, and a suspected metastasis in the right breast was revealed. Histopathology of the skin nodules confirmed a neuroendocrine tumour. Metastases of a pancreatic neuroendocrine tumour or small-cell lung cancer were suspected on immunohistochemistry. The patient died before we were able to localise the primary source of the tumour and provide treatment. Conclusions: Skin metastases are relatively rare, aggravate the prognosis, and usually indicate spread of the neoplastic process in the internal organs. It is not always possible to localise the primary tumour using radiological imaging. In such cases, co-operation with the pathologist is crucial as are the results of histopathological and immunohistochemical examinations

The case of a patient of 80 years old with epilepsy and neurocognitive disorders

Background. Epilepsy is a very widespread disease in the world. It is one of the most common neurological diseases of old age. However, older age is also associated with multi-morbidity and cognitive decline. This will result in a decrease or loss of the possibility of being independent of other people in the scope of basic everyday activities such as: moving, nutrition, sphincter control and maintaining personal hygiene. Disorders occurring in such a wide range in people with dementia often translate into disability in everyday life. Improving the quality of life of patients consists primarily in maintaining autonomy in self-service for as long as possible. Therefore, one of the most important elements of improving the quality of life of an elderly person is the early detection of neurocognitive disorders, rehabilitation of the patient and performing prescribed screening tests. Case report. A 80- year-old patient admitted to the Clinic of Geriatric in urgent matter due to dizziness and falls. Patient living with family, dependent in daily life, financially self-sustaining. Patient takes medicines from different groups due to multiple diseases. Patient's symptoms: dizziness and frequent falls. Because of the last complain, consulted in the department of emergency medicine, head tomography was conducted. The test showed no signs of fresh bleeding. The patient suffers from epilepsy. Patient has condition after treatment of subdural hematoma, in the state after heart attacks in 2001, 2003, 2004. In 2003 coronary angioplasty was performed. Patient is also suffering from hypertension, type 2 diabetes and chronic kidney disease. No use of drugs, alcohol and cigarettes. Result. The risk of functional limitations increases with the number of diseases present and is particularly large in people over 80 years of age. Multiple diseases is a serious problem in rehabilitation, therefore geriatric rehabilitation should be carried out on many levels. A comprehensive geriatric assessment helps diagnose the problem and develop a plan to improve the patient's quality of life. In addition, vitamin supplementation should be implemented in the elderly. Also medications used by the elderly and behavioral changes should be controlled. Patients should follow the recommendations of health care workers and attend both laboratory and neuropsychological monitoring tests

Challenges of modern medicine – a case study of a patient with ALS after age 60

Background. Amyotrophic lateral sclerosis is a degenerative disease of the nervous system, neurodegenerative cerebral cortex, pad and spinal cord due to damage to the upper and lower motor neurons, with progressive course, various symptoms with varying intensity and duration (from several months to even 10 years), extremely unfavorable prognosis. As an incurable and progressive disease, due to the deterioration of mobility it leads to complete stopping of muscles, including respiratory ones, with the intellectual ability of the patients fully preserved Case report. A 65-year-old patient was hospitalized in Geriatrics Clinic in University Hospital A. Jurasza in Bydgoszcz. Patient with shortness of breath, present paradoxical chest movement, impaired chest mobility, present whirring, wheezing during auscultation examination. The patient was admitted to the ward because of pneumonia. Amyotrophic lateral sclerosis, chronic respiratory failure, hypertension, and hyperthyroidism were diagnosed. In the medical history she had swallowing problems, abdominal pain, insufficient cough reflex, dysphagia, increased body temperature, difficulty falling asleep, depressed mood. The patient did not consent to a tracheotomy for aspiration of secretions from the respiratory tract. The patient required suctioning of excessively accumulating secretions in the mouth. The patient was patted. Patient's skin without pathological changes. During the night, the patient requires non-invasive mechanical ventilation - BIPAP respirator. Patient under the care of the Palliative Medicine Clinic. Patient fed an industrial diet (Isosource Protein) for PEG (percutaneous endoscopic gastrostomy) - self-service. Results. Although the disease is incurable, many of its symptoms can be alleviated, and the goal of therapy should be to improve the quality of life and maintain patient independence for as long as possible. SLA patients and their relatives often experience depression, feelings of despair and anxiety. Therefore, psychological help is recommended for patients and their relatives. The continuous development of medicine remains a hope for this disease. There is a need to continue research into the search for an effective cure for amyotrophic lateral sclerosis

Case report of a patient with acute renal failure and cardiovascular disease after 65 years of age

Introduction. Acute kidney injury (AKI) is a clinical syndrome with high mortality. It is a clinical syndrome consisting in rapid impairment of kidney function. The result is retention of metabolic products in the body and the inability to maintain normal water-electrolyte and acid-base homeostasis. Chronic heart failure is a significant clinical, economic and social problem, and despite the continuous development of medicine, the incidence of this disease is still increasing. A weakened inefficient heart is not able to supply the organs with the right amount of blood, oxygen and nutrients. The effect is fast fatigue, weakness of muscle strength and dizziness. Kidney and cardiovascular diseases affect each other and increase their course, which worsens the patient's condition. Periodic monitoring of renal function in patients with cardiovascular disease is very important because it has been proven that the occurrence of kidney disease in these patients increases the risk of death. Case report. Patient, 78 years old, hospitalized many times in the Geriatrics Clinic, Cardiology Clinic, Nephrology Clinic due to shortness of breath, chronic myocardial insufficiency, edema of the lower limbs. The degree of independence is limited, the patient walks with assistance, lives with a family / significant other. Main ailments of the patient: increasing swelling of the lower limbs, left foot pain, nausea, vomiting, palpitations, effortlessness and rest dyspnea without stenocardial complaints. Comorbidities: Type 2 insulin-dependent diabetes mellitus (with unspecified complications), obesity, generalized atherosclerosis, hypertension, chronic NYHA type II heart failure. Cardiac defect in the form of mitral and tricuspid regurgitation, pulmonary hypertension, paroxysmal atrial fibrillation, myocardial infarction. The patient was qualified for hemodialysis treatment, then returned to conservative treatment, followed a strict diet. The applied treatment improved the general condition of the patient and was discharged from the hospital in a stable general condition. Results. Frequent and regular examination of a patient's condition with cardiac-renal syndrome, disease progression and ability to tolerate treatment can be helpful in treating and prolonging the patient's life. It is important to monitor kidney function in people with cardiovascular disease