Knowledge of medical personel on the Standard of “Practice of the raped person” in medical units

Wstęp. Celem niniejszego artykułu jest ocena znajomości „Procedury postępowania z osobą zgwałconą” w jednostkach medycznych, przez personel medyczny. Materiał i metody. Przeprowadzono badanie pilotażowe wstępne. W badaniu ankietowym wzięło udział 38 osób, metodę badawczą stanowił anonimowy kwestionariusz własnego autorstwa. Wyniki. Procedurę postępowania z ofiarą przemocy seksualnej zna 54,5% lekarzy, 26,9% ankietowanych położnych. Wnioski. Z badania wynika, że pomoc oferowana kobietom, które stały się ofiarami przemocy seksualnej, jest fragmentaryczna, a tym samym niesatysfakcjonująca kobiety, które doświadczyły gwałtu.Introduction. The purpose of this article is to access the knowledge of “Procedures of contact with person that was raped“ by personnel of medical institutions. Material and methods. The preliminary pilot study had a form of questionnaire, that has been completed by 38 persons. Methodology was based on self written anonymous questionnaire. Results. 54.5% of doctors and 26.9% of midwifes know the Procedure of contact with victims of sexual abuse. Conclusions. The research showed that help which is offered to victims of sexual abuse is rare and unsatisfactory for most of raped women

The role of serological testing for <i>Chlamydia trachomatis</i> in differential diagnosis of pelvic pain

Introduction Pelvic pain is typically associated with pelvic inflammatory disease (PID). The most common cause of PID is Chlamydia trachomatis . The aim of this study was to verify the role of serological testing for Chlamydia trachomatis in patients with suspected PID. Material and Methods The retrospective study included 185 patients with pelvic pain hospitalized at the Department of Obstetrics and Gynecology in 2003 and 2004. Titers of anti- Chlamydia trachomatis IgG and IgA were measured by means ELISA immunoassays. Erythrocyte sedimentation rate (ESR), serum concentration of C-reactive protein (CRP) and leukocyte count (WBC) were also determined. Final diagnosis was established on the basis of laparoscopic examination. Results The presence of anti- Chlamydia trachomatis antibodies correlated significantly with abnormal values of ESR, WBC and CRP. The most common laparoscopic pathology were pelvic adhesions, typically found in women with elevated titers of anti- Chlamydia trachomatis IgG. Conclusions Serological examination for Chlamydia trachomatis is helpful in evaluation of patients with suspected PID. Elevated titers of anti- Chlamydia trachomatis antibodies are frequently associated with laparoscopic evidence of pelvic adhesions and inflammation

Immunoexpression of aromatase cytochrome P450 and 17β-hydroxysteroid dehydrogenase in women’s ovaries after menopause

BACKGROUND: Menopause results in a lack of regular menstrual cycles, leading to the reduction of estrogen production. On the other hand, ovarian androgen synthesis is still present at reduced levels and requires expression of several steroidogenic enzymes. METHODS: This study was performed on 104 postmenopausal women hospitalized due to uterine leiomyomas, endometriosis, and/or a prolapsed uterus. Patients were divided into three groups depending on the time from menopause. Group A patients experienced menopause 1–5 years before enrollment in the study (42 women). Group B included women who had their last menstruation 5–10 years before the study (40 women). Group C consisted of 22 women who were more than 10 years past menopause. Hysterectomy or removal of the uterine corpus with adnexa was performed during laparotomy. We evaluated the expression of aromatase cytochrome P450 (CYP 19) and 17β-hydroxysteroid dehydrogenase (17β HSD) by employing immunohistochemistry. RESULTS: Activity of 17β-HSD and CYP19 was demonstrated in the cytoplasm of stromal cells of postmenopausal ovaries, epithelium cells coating the ovaries, vascular endothelial cells, and epithelial inclusion cysts. However, overall expression of both 17β-HSD and CYP 19 decreased with time after menopause. CONCLUSION: Demonstration of the activity of the key enzymes of ovarian steroidogenesis, CYP 19 and 17β-HSD, confirms steroidogenic activity in the ovaries of postmenopausal women. Nevertheless, ovarian steroidogenic activity decreases with time, and its significant decrease occurs 10 years after menopause

Ocena jakości życia u pacjentów z chorobą Gravesa-Basedowa i postępującą naciekową oftalmopatią tarczycową w trakcie skojarzonego leczenia metyloprednizolonem i radioterapią przestrzeni pozagałkowych

Wstęp: Celem pracy była ocena jakości życia u chorych z naciekową postacią oftalmopatii tarczycowej (GO, Graves&#8217; opthalmopathy) w trakcie pulsacyjnego leczenia metylprednizolonem w połączeniu z radioterapią oczodołów oraz próba odniesienia wyników leczenia oftalamopatii do zmian w jakości życia. Materiał i metody: Badaniem objęto grupę 29 pacjentów w wieku 25-74 lat (śr. wieku: 52 &#177; 6 lat) z naciekową GO. Podstawą kwalifikacji chorych do leczenia oftalmopatii było uzyskanie eutyreozy, postępujący charakter zmian ocznych, stopień zaawansowania zmian ocznych oceniany w oparciu o klasyfikację NO SPECS mieszczący się przynajmniej w klasie 3c, indeks oftalmopatii według Donaldson &#8805; 4 punktów. Za aktywną postać GO przyjmowano wartości klinicznego wskaźnika aktywności (CAS, clinical activity score) &#8805; 4. Podczas leczenia, u chorych zastosowano 6 cykli soli sodowej metyloprednizolonu w dawce 1,0 g/dobę podczas jednogodzinnych wlewów dożylnych, przez kolejne trzy dni w tygodniu. Między 2. a 4. cyklem Solu-Medrolu prowadzono radioterapię tkanek pozagałkowych promieniami X o energii 10 MeV. Grupę kontrolną utworzono ze zdrowych ochotników, dobranych w stosunku do grupy badanej pod względem płci, wieku, posiadanego wykształcenia i uzależnienia od nikotyny. Składała się ona z 53 osób, w wieku 21-75 lat (śr. wieku: 52,4 &#177; 14 lat). Badania jakości życia przeprowadzano, opierając się na kwestionariuszu MOS SF-36. Wyniki: Pacjenci z GO gorzej oceniali jakość życia w stosunku do osób zdrowych w zakresie ogólnej sprawności, ograniczeń fizycznych i emocjonalnych w pełnieniu funkcji, stanu zdrowia, witalności, funkcjonowania społecznego, zdrowia psychicznego oraz występowania i nasilenia bólu. Nie wykazano korelacji pomiędzy jakością życia a wiekiem, płcią, czasem trwania choroby Gravesa-Basedowa i oftalmopatii. Podobnie nie stwierdzono zależności pomiędzy aktywnością i zaawansowaniem klinicznym zmian ocznych a jakością życia. Zastosowanie skojarzonej terapii GO spowodowało znamienne zmniejszenie stopnia zaawansowania zmian ocznych i obniżenie aktywności choroby. Po leczeniu pacjenci wskazali na poprawę jakości życia w zakresie ograniczeń fizycznych w odgrywaniu ról, występowania i nasilenia bólu oraz witalności. Pozostałe parametry jakości życia nie różniły się istotnie statystycznie. Wnioski: Oftalamopatia tarczycowa powoduje znaczne pogorszenie jakości życia. Stopień zaawansowania klinicznego i aktywność oftalmopatii nie wykazują związku z jakością życia. Skuteczności leczenia oftalmopatii nie można oceniać, kierując się zmianami w jakości życia pacjentów.Introduction: The aim of the study was to assess quality of life (QoL) in patients with infiltrative form of Graves&#8217; ophthalmopathy (GO) during the combined pulse treatment with methylprednisolone and orbital radiotherapy, and also to search for the relation between the results of ophthalmopathy treatment and changes in QoL. Material and methods: The study involved 29 patients aged 25-74 (the mean age: 52 &#177; 6 years) with infiltrative form of GO. They were classified for ophthalmopathy treatment on the basis of the following factors: the obtained euthyreosis, progressive character of eye changes, the level of eye changes determined on the basis of NO SPECS classification (at least class 3c), ophthalmopathy index (OI) according to Donaldson &#8805; 4. GO was diagnosed as active if CAS (clinical activity score) &#8805; 4. During the treatment, the patients received 6 cycles of methylprednisolone sodium succinate in doses of 1,0 g/24 h given as one-hour-long intravenous infusions for three successive days in a week. Between the 2nd and 4th cycle of Solu-Medrol, orbital radiotherapy with 10 MeV X-rays was performed. The control group was made up of healthy volunteers selected with regard to sex, age, educational background and nicotine addiction so as they corresponded with the study group. It involved 53 individuals aged 21-75 (the mean age: 52,4 &#177; 14 years). QoL was assessed by means of the MOS SF-36 questionnaire. Results: Patients with GO evaluated their QoL lower than healthy individuals, which referred to physical functioning, physical and emotional role functioning, general health, vitality, social functioning, mental health and bodily pain. No correlation was found between quality of life and such factors as age, sex, or duration time of Graves disease and ophthalmopathy. Analogically, no relation was observed between the activity and stage of clinical development of eye changes and QoL. The use of the combined GO therapy contributed to a considerable decrease in the development of eye changes and the disease activity. After treatment, the patients&#8217; QoL improved which referred to physical role functioning, bodily pain, and vitality. Other QoL parameters did not statistically significantly differ. Conclusions: GO causes a considerable worsening of QoL. The stage of clinical development and activity of GO find no reflection in QoL. Effectiveness of treatment for GO cannot be evaluated on the basis of changes in QoL

Osteoarthritis of the knee - a condemnation of a prosthesis for a young person? ATLAS Knee System as an effective method of relieving the medial compartment of the knee

Introduction: Osteoarthritis of the knee is one of the more common causes of disability in the elderly. In the United States, one in four adults suffers from the condition, half of whom are under the age of 65. The most commonly affected joint is the knee. A significant proportion of people in the 35-65 age range have degeneration in one compartment of the knee joint. Among the younger population, when non-operative methods are already failing and it is too early for surgery, there is a place for the ATLAS Knee System. Aim of the study:  The purpose of our work is to present a new and innovative form of treatment for single-compartment osteoarthritis of the knee. Based on the available literature, to show the advantages, disadvantages and results of treatment with the ATLAS Knee System. Methods and materials: A literature review was conducted in the PubMed database, using the keywords: "Atlas Knee System"; "osteoarthritis"; "knee osteoarthritis". Results: The ATLAS system is built with an absorber that, as the knee is stretched, absorbs the forces acting on the medial compartment, while not putting stress on the rest of the knee joint. After patients use the implant, a significant reduction in pain and improvement in knee function is observed. Conclusion: Osteoarthritis is a significant health problem increasingly prevalent even among the younger population. The ATLAS system provides an alternative for younger people in whom conservative treatment has failed, while more invasive methods such as osteotomies and total or single-unit prosthetics are impossible or rejected by the patient. More studies are needed, on a larger number of people to accurately evaluate this system

Acceptance of cancer by women after mastectomy in Western Pomerania region – preliminary studies

Background. Breast cancer is the most common cancer that women can suffer from. Most often it develops between 50 and 80 year of life. Many women adapt to the new situation, but a large group cannot adapt and reconcile with the disease. The bigger acceptation of a disease, the better adaptation and smaller feeling of discomfort. Objectives. The aim of this thesis was to check the degree of acceptance of cancer among women after mastectomy. Material and methods . The study was conducted among 60 women after mastectomy in Western Pomerania. The study was entirely voluntary and anonymous, the authors obtained the written, informed consent from each person to participate in the studies and each person was informed of the aim. The study used an anonymous questionnaire containing questions about demographics and The Scale of Disease Acceptance in adaptation of Z. Juczyński. The study was made after acceptance of Bioethics Commission of Westpomeranian Medical University, getting number KB-0012/97/14. Results . The average age of women is 62.3 years. 25 (42%) of the women received a high level of acceptance of the disease, 18 (30%) the average, and 17 (28%) of women low level of acceptance. 22 (37%) of the respondents have no problem adapting to the limitations imposed by the disease. 24 (40%) women feel needed, 30 (50%) of respondents believe that they are not a problem to family and friends. 19 (32%) amazons feel a full-fledged human being despite the illness. Conclusions . Analysis of the research material revealed that nearly half of the respondents achieved a high level of acceptance of the disease, which creates a sense of security and control over their lives

The influence of socio-demographic and environmental factors on the fall rate in geriatric patients in primary health care

Background . A fall is defined as an event which results in a person coming to rest inadvertently on the ground or floor or other lower level. Falls are the leading cause of injuries among geriatrics and a factor which significantly lowers their quality of life. Objectives. The aim of this study was to identify fall risk factors in the elderly with regard to their environmental situation and sociodemographic data. Material and methods. This epidemiological population-based study involved 304 patients from selected outpatient clinics. The median age was 79 years. Our study employed a diagnostic survey-based method using an environmental inquiry of our devising, as well as the Tinetti Test (TT). Results . A statistically significant correlation was found between the number of falls and such variables as age, the family structure and family care efficiency (p 0.05). Regardless of whether the respondents experienced falls or not, a vast majority of them showed a need for information support concerning the reduction of fall risk in the future. Conclusions . 1. Risk factors for falls among geriatric patients include age, falls in the medical history, solitude as an adverse social situation and the unpreparedness of the family for taking non-professional care of their elderly relatives. 2. According to the respondents, information support may improve their knowledge of fall prevention and ways of handling the situation with increasingly limited self- -reliance, and the preparation of their families for taking care of them may reduce the risk of falls

Fall Risk Factors in Community-Dwelling Elderly Depending on Their Physical Function, Cognitive Status and Symptoms of Depression

Falls are the leading cause of unintentional injuries and injury-related disability, morbidity and mortality in the geriatric population. Therefore, they may also lower quality of life. The aim of this study was to analyze the fall risk factors in the community-dwelling elderly depending on their physical function, cognitive status and symptoms of depression. The study involved 304 individuals aged 65–100 years with a mean age of 78.6 ± 7.4. This survey-based study was conducted using the Geriatric Environmental Inquiry, the Barthel Scale (BS), the Abbreviated Mental Test Score (AMTS), the Geriatric Depression Scale (GDS) and the Tinetti Test (TT). There was a statistically significant correlation between the BS, the TT and the incidence of falls (p &lt; 0.05). The number of falls correlated significantly with the results of the BS (R = −0.39), the GDS (R = 0.18), and the TT (R = −0.40). A statistically significant correlation was also noted between the TT results and the results of the BS (R = 0.77), the AMTS (R = 0.40) and the GDS (R = −0.37). The incidence of falls may significantly increase in people with a lower functional status, which may be related to cognitive process disturbances and lower affective functioning. A comprehensive geriatric assessment, related to all aspects of advanced-age patients’ efficiency, is recommended. Fall prevention strategies should include actions undertaken to evaluate and treat depression and cognitive disturbances