Mental adjustment to cancer in patients with colorectal cancer

Introduction.Exploration of the psychological aspects of cancer may play a key role in the disease’s progression. Active mental strategies have been associated with a better prognosis. Due to these associations, the aim of this study is to assess the prevalence and elucidate determinants influencing mental adjustment in patients with colorectal cancer. Material and methods.A cross-sectional study identifying 200 patients with colorectal cancer. The mental state of pa­tients was measured with an adaptation the of mini-MAC questionnaire. Results.Constructive determinants influencing the occurrence of mental adaptation to colorectal cancer are the presence of the disease in the family, fitness status and smoking status. Education level is an important destructive determinant influencing the occurrence of mental adaptation to colorectal disease. Conclusions.Among the patients with colorectal cancer, the destructive and constructive style of mental adaptation occurs with a similar frequency (26.5% and 22.5%).

Mental adjustment to cancer in patients with colorectal cancer

Introduction. Exploration of the psychological aspects of cancer may play a key role in the disease’s progression. Active mental strategies have been associated with a better prognosis. Due to these associations, the aim of this study is to assess the prevalence and elucidate determinants influencing mental adjustment in patients with colorectal cancer. Material and methods. A cross-sectional study identifying 200 patients with colorectal cancer. The mental state of patients was measured with an adaptation the of Mini-MAC questionnaire. Results. Constructive determinants influencing the occurrence of mental adaptation to colorectal cancer are the presence of the disease in the family, fitness status, and smoking status.   Education level is an important destructive determinant influencing the occurrence of mental adaptation to colorectal disease. Conclusions. Among the patients with colorectal cancer, the destructive and constructive style of mental adaptation occurs with a similar frequency (26.5% and 22.5%)

Components of the metabolic syndrome in girls with Turner syndrome treated with growth hormone in a long term prospective study

BackgroundComponents of the metabolic syndrome are more common in patients with Turner syndrome (TS) than in the general population. Long-term growth hormone (GH) treatment also affects the parameters of carbohydrate metabolism. Therefore, all these factors should be monitored in girls with TS.ObjectiveTo assess the occurrence of metabolic syndrome components in TS girls before GH treatment and to monitor changes in metabolic parameters throughout GH therapy.Patients and method89 TS patients were enrolled in the study. Clinical and laboratory data after the 1st (V1), 3rd (V3), 5th (V5) and 10th (V10) year of GH therapy was available respectively in 60, 76, 50 and 22 patients. The patients’ biochemical phenotypes were determined by glucose 0’, 120’, insulin 0’, 120’, HOMA-IR, Ins/Glu ratio, HDL-cholesterol and triglycerides (TG) concentration.ResultsObesity was found during V0 in 7.9% of patients,V1 - 5%, V3 - 3.9%, V5 - 2%, V10 – 0%. No patient met diagnostic criteria for diabetes. A significant increase in the basal plasma glucose 0’ was found in the first five years of therapy (pV0-V1 < 0.001; pV0-V3 = 0.006; pV0-V5 < 0.001). V10 glucose 120’ values were significantly lower than at the onset of GH treatment (pV0-V10 = 0.046). The serum insulin 0’ and 120’ concentrations as well as insulin resistance increased during treatment. No statistically significant differences in serum TG and HDL-cholesterol levels during GH therapy were found.ConclusionThe development of insulin resistance and carbohydrate metabolism impairment have the greatest manifestations during GH therapy in girls with TS. Monitoring the basic parameters of carbohydrate-lipid metabolism in girls with TS seems particularly important

Parental Declaration of Adverse Event Following Immunization in a Cross-Sectional Study in Poland

Vaccines are a well-known and effective preventive measure in communicable diseases. However, like any medical product, vaccines can cause some adverse effects. With increasing population awareness, the number of reported events related to vaccination has increased. Aim: The aim of the study was to assess the frequency and type of reported adverse events following childhood immunization (AEFI), and to recognize the determinant of their occurrence related with a socio-demographic situation, parental knowledge, and/or opinions on vaccinations. Material and Methods: The self-administrated questionnaire was distributed to a group of 3000 random parents or legal guardians living in the Silesian Voivodship (the southern part of Poland) in 2016. The response rate was eventually 41.3% from 1239 participants. Both, the number of children and the percentage of vaccinations given in the studied region, was representative for Poland as a whole. Results: Approximately one-third (32%) of surveyed parents declared the occurrence of AEFI in their children. The most frequently declared AEFIs were: redness, pain, swelling at the injection site (27%), and fever (24.9%). The frequency of reported AEFI was associated with a higher level of parental education and the number of vaccinations given. A negative attitude toward vaccination and the belief that vaccination is unsafe were associated with a higher number of reported AEFI. Conclusions: The results obtained confirmed that the number of declared mild and moderate AEFI is related to a lower parental educational level and is associated with a better experience as a consequence of a higher number of vaccinations given. Frequent AEFI reporters represent negative attitudes toward vaccinations. Further investigation with the exact surveillance system is needed to improve parental trust in vaccination safety

Predictive Value of Fractional Exhaled Nitric Oxide (FeNO) in the Diagnosis of Asthma for Epidemiological Purposes—An 8-Year Follow-Up Study

At the population level, respiratory symptoms in children can be estimated cross-sectionally. However, such methods require additional objective support parameters, such as the measurement of fractional exhaled nitric oxide (FeNO). The aim of the present study was to analyze if the FeNO value measured at baseline can have a predictive value for asthma-like symptoms after 8 years of measurement. Methods: The follow-up included 128 (out of 447) children, 70 girls and 58 boys. The FeNO was measured at baseline only. The prevalence of asthma-like symptoms was measured with the adopted version of the ISAAC questionnaire. Results: After 8 years of FeNO measurement, 5 new cases of asthma, 2 cases of attacks of dyspnoea, 1 case of wheezy in the chest, and 18 cases of allergic rhinitis occurred. The FeNO values, measured at the baseline of the study, for new cases of the above diseases were 53.4 ± 75.9 ppb, 11 ± 1.5 ppb, 12.0 ppb, and 16.3 ± 12.4 ppb, respectively. The best diagnostic accuracy parameters were found in the new cases of asthma, where the sensitivity was 40.0%, the specificity was 98.6%, and the AUC was 66.6%. The diagnostic odds ratio was 46.9 when considering the FeNO cut-off >35 ppb. Conclusions: The FeNO measurement is a fair method for asthma prognosis in early school-aged children with asthma-like symptoms measured on the population level but requires further confirmation at the clinical level with more accurate diagnostic tools

The Accuracy of a Screening Tool in Epidemiological Studies—An Example of Exhaled Nitric Oxide in Paediatric Asthma

Diagnostic tests are widely used in medicine, especially in the clinical setting. The doctor’s decision regarding the treatment process is mostly based on the result of the diagnostic test. The value of the test is expressed by its accuracy. It is easier to verify the accuracy of a diagnostic test in a clinical setting in comparison to an epidemiological setting. Moreover, a very good test may not work in epidemiological settings in the same effective way as in a clinical setting, especially because the accuracy is affected by the prevalence of the disease. The aim of the study is to assess the accuracy of FeNO measurement in different respiratory disorders or symptoms, including their prevalence, in a childhood population. The secondary aim is to suggest the optimal FeNO cut-off for epidemiological screening for respiratory diseases and symptoms. Methods: The cross-sectional study included 447 children (50.8% boys and 49.2% girls) aged 6–9 years. An adapted version of the ISAAC questionnaire was used for the assessment of the respiratory status. FeNO was measured with an electrochemical device (Niox Mino) according to ERS/ATS recommendations. For interpretation, the FeNO cut-off values of 20 parts per billion (ppb), 25 ppb and 35 ppb were applied taking the real-life prevalence of the disease or symptoms into consideration and also for simulated prevalences of 20%, 30%, 40%, 50% for the interpretation of the accuracy of the test. The accuracy was calculated according to the following formula: Accuracy = (Prevalence) (Sensitivity) + (1- Prevalence) (Specificity). The area under the curve was calculated based on logistic regression. Results: For all respiratory outcomes, FeNO accuracy decreased with increasing prevalence, and in general the area under the curve (AUC) was low. The highest FeNO accuracy was found for any asthma diagnosis (with possible coexisting diseases/symptoms), i.e., 78.6%, 92.8% and 88.5% for FeNO cut-offs >19 ppb, >24 ppb and >34 ppb, respectively. The AUC was 0.628. For the same FeNO cut-offs, the accuracy of an asthma diagnosis without any coexisting diseases and symptoms was 81.2%, 87.5%, 92.9%, respectively, with an AUC of 0.757. Conclusion: FeNO accuracy decreases with increasing prevalence of the respiratory disease and symptoms. The best accuracy for the FeNO cut-off in the screening of asthma for epidemiological purposes is 35 ppb. For isolated asthma, the best accuracy for FeNO was 92.9%

The Effect of Obesity on Fractional Exhaled Nitric Oxide in School-Aged Children

Background: Fractional exhaled nitric oxide (FeNO) is recognized as a biomarker of eosinophilic inflammation. Current literature shows evidence that FeNO is influenced by many factors. Obesity is a chronic inflammatory state. In this study, we considered obesity as a potential factor that influences FeNO levels. The aim of the study was to analyze the association between body mass index (BMI, body mass (kg)/height (m)2) and FeNO levels in a young group of children. Methods: The participants in the study were 506 school-aged children who were randomly selected from primary schools located in Silesian Voivodship (Poland). The modified version of the Study of Asthma and Allergies in Childhood (ISAAC) questionnaire was used to assess the respiratory system status of children. FeNO was measured in 447 children according to European Respiratory Society and America Thoracic Society (ERS/ATS) recommendations. Body mass and height were measured by a medical body composition analyzer. BMI was defined and interpreted with Palczewska’s percentile charts. Results: In the study group there were 49.9% (n = 223) boys and 50.1% (n = 224) girls. The frequency of normal BMI was 76.8% (n = 172), overweight 13.7% (n = 31) and obesity 9.4% (n = 21) in girls, while the normal BMI was found in 71.3% (n = 159), overweight 11.6% (n = 26) and obesity 17% (n = 38) in boys, the differences not statistically significant (p = 0.05). The mean FeNO value in children with obesity was 16.1 ± 12.5 ppb, in children with normal BMI 15.8 ± 15.5 ppb and the lowest FeNO values were in children with overweight 15.3 ± 13.0 ppb; p = 0.9. The FeNO values after adjusting for age, sex, BMI and symptoms from respiratory system were depended on age and respiratory symptoms only. Conclusions: In 6–9 year old school children, FeNO levels are associated with age and health in relation to the respiratory system. The BMI should not be included when considering reference values for FeNO

The incidence of tuberculosis in the Silesian voivodeship among children and adolescents between 2002–2013

Introduction. Tuberculosis is still a public health problem despite the steadily declining incidence rate in the wider Polish population. Effective prevention requires a good diagnosis of the problem on a regional scale, particularly among the younger population. Therefore, analysis of the incidence in the Silesian population with analysis of temporary differences in this trend among children and adolescents to 19 years of age was made. Material and methods. The incidence rate and standardized incidence were calculated on data based from Central Statistical Office reports and data from Provincial Sanitary Epidemiological Station in Katowice. Data were analyzed with consideration of counties as a place of residence. Results. The standardized incidence rate of tuberculosis (n/100,000) in Silesian population between 2002–2013 amounted to: 25.5; 21.8; 22.1; 21.1; 17.3; 18.5; 17.1; 18.8; 19.8; 22.0; 19.9; 19.5. Percentage incidence in children and adolescents aged 0–19 years in subsequent years: 1.4%; 1.5%; 0.9%; 2.4%; 1.7%; 1.8%; 1.4%; 2.7%; 2.0%; 3.0%; 2.3%; 3.7%. The highest temporary differences of trend in children and adolescents are reported in Lubliniec county (0–35.2/100,000). Conclusions. Varied incidence of tuberculosis noted in the years 2002–2013 in Silesian area is followed by low percentage of tuberculosis cases in children and adolescents aged 0–19 years. The epidemiological situation of tuberculosis in most counties is stable. However, the increasing incidence in the youngest segment of the Silesian population in the last three years should be noted.Wstęp. Gruźlica nadal pozostaje aktualnym problemem zdrowia publicznego pomimo spadającego współczynnika zapadalności w populacji polskiej. Skuteczne działania profilaktyczne wymagają dobrego rozpoznania problemu w skali regionalnej, zwłaszcza w odniesieniu do najmłodszej populacji. W związku z tym przeprowadzono analizę zachorowalności na gruźlicę w populacji woj. śląskiego, z oceną zróżnicowania czasowego trendu w tym zakresie wśród dzieci i młodzieży do 19 roku życia. Materiał i metody. Surowe i standaryzowane współczynniki zapadalności (lata 2002–2013) obliczono na podstawie danych zawartych w raportach Głównego Urzędu Statystycznego oraz na podstawie danych udostępnionych przez Wojewódzką Stację Sanitarno-Epidemiologiczną w Katowicach. Dane analizowano z uwzględnieniem powiatów jako miejsca zamieszkania. Wyniki. Standaryzowane współczynniki zapadalność na gruźlicę (n/100000) w całej populacji woj. śląskiego w latach 2002–2013 wyniosły odpowiednio: 25,5; 21,8; 22,1; 21,1; 17,3; 18,5; 17,1; 18,8; 19,8; 22,0; 19,9; 19,5. Odsetkowy udział zapadalności w wieku 0–19 lat w całkowitej zapadalności wyniosły, w kolejnych latach, odpowiednio: 1,4%; 1,5%; 0,9%; 2,4%; 1,7%; 1,8%; 1,4%; 2,7%; 2,0%; 3,0%; 2,3%; 3,7% Największe czasowe zróżnicowanie, wśród dzieci i młodzieży odnotowano w powiecie lublinieckim (0–35,2/100000). Wnioski. W latach 2002–2013 zróżnicowanej zapadalności na gruźlicę na terenie województwa śląskiego towarzyszy niski odsetek przypadków gruźlicy u dzieci i młodzieży do 19 roku życia. Sytuacja epidemiologiczna gruźlicy w większości powiatów jest stabilna, jednakże należy zwrócić uwagę na wzrost zapadalności w najmłodszym segmencie wiekowym populacji woj. śląskiego w ostatnich trzech latach obserwacji