The Myasthenia Gravis-specific Activities of Daily Living scale as a useful outcome measure and in routine clinical management in Polish patients

Introduction The Myasthenia Gravis-Activities of Daily Living scale (MG-ADL) is a short, and easy to use disease-specific quality of life during daily routine tool in myasthenia gravis. Objectives The purpose of our work was to evaluate neurological condition patients with myasthenia gravis using the form MG-ADL in order to enable the introduction in common use of an instrument which allows for the assessment of patients with myasthenia gravis. Patients and Methods The total number of 50 patients with MG were qualified for the examination. Each patient underwent neurological examination and completed the quality of life evaluation questionnaire MQ-ADL. Additionally, each patient was asked to evaluate the quality of his/her life by means of questionnaire MG-QOL 15 and MG Composite in Polish language version. Results Our analysis showed a positive correlation with other scales used - MG-QOL 15, MGFA, MG Composite. The intensification of neurological symptoms showed significant relation with obtained higher number of points in MG-ADL questionnaire. The MG-ADL was found to have high internal consistency, test–retest reliability, and concurrent validity. Conclusion We confirmed reliability and dependability of the questionnaire in the the test-retest assessment. The MG-ADL is accepted to be a reliable and valuable tool for measuring disease-specific QOL in Polish patients with MG

Validity and reliability of the Polish version of myasthenia gravis – Quality of life questionnaire – 15 item

Aim The myasthenia gravis-quality of life questionnaire 15 item (MG-QOL15) is a short, and easy to use disease-specific quality of life (QOL) tool in myasthenia gravis. The aim of this study was to validate and adapt the Polish version of the MG-QOL15. Materials and methods The total number of 50 patients with MG were qualified for the examination. Each patient underwent neurological examination and completed the quality of life evaluation questionnaire MQ-QOL 15 after translation and back-translation. Additionally, each patient was asked to evaluate the quality of his/her life by means of questionnaire SF-36 in Polish language version. Results The MG-QOL15 was found to have high internal consistency, test–retest reliability, and concurrent validity. Conclusion The MG-QOL15 is accepted to be a valid, reliable, valuable tool for measuring disease-specific QOL in Polish patients with MG

ASSESSMENT OF FIRST AID KNOWLEDGE AMONG MEDICAL AND NON-MEDICAL UNIVERSITY STUDENTS

   INTRODUCTION: Cardiovascular diseases and the associated sudden cardiac arrest (SCA) are the main cause of death in Poland and around the world. The immediate reaction of bystanders to the event increases the survivor’s chances of survival. The aim of this study was to assess the knowledge and declared skills of medical and non-medical students regarding the methods and techniques of first aid. METHODS: During the period April–May 2017 at Collegium Mazovia Innovative University in Siedlce (Poland), a study was carried out using the anonymous questionnaire of author’s design on the principles of first aid. The survey was addressed to 200 part-time students of medical (medical emergency, nursing, physiotherapy) and non-medical (finance and construction) degrees. RESULTS: There were statistically significant differences between the self-assessment of knowledge about first aid and the field of study (p < 0.001). The question “How do you evaluate your knowledge about first aid” by comparing the medical, financial and construction fields of study showed that a level assessed as very good was indicated by: 38% vs. 7% vs. 8% students, respectively. A good level was indicated by 51% vs. 37% vs. 24% of students respectively while an average level was shown by: 11% vs. 49% vs. 64% of students respectively. In addition, a lack of knowledge was displayed by: 0% vs. 7% vs. 4% of students, respectively. CONCLUSIONS: Our data indicates that: (1) the state of non-medical students’ knowledge concerning first aid was unsatisfactory; (2) it is advisable to promote knowledge about current CPR guidelines in the non-medical student population

Elective lung resection increases spatial QRS-T angle and QTc interval

Background: Lung resection changes intra-thoracic anatomy, which may affect electrocardiographic results. While postoperative cardiac arrhythmias have been recognized after lung resection, no study has documented changes in vectorcardiographic variables in patients undergoing this surgery. The purpose of this study was to analyse changes in spatial QRS-T angle (spQRS-T) and corrected QT interval (QTc) after lung resection.Methods: Adult patients undergoing elective lung resection under general anaesthesia were studied. The patients were allocated into four groups: those undergoing (1) left lobectomy (LL); (2) left pneumonectomy (LP); (3) right lobectomy (RL); and (4) right pneumonectomy (RP). The spQRS-T angle and QTc interval were measured one day before surgery (baseline) and 24, 48 and 72 h after surgery.Results: Seventy-one adult patients (47 men and 24 women) aged 47–80 (65 ± 7) years were studied. In the study group as a whole, lung resection was associated with significant increases in spQRS-T (p < 0.001) and QTc (p < 0.05 at 24 and 48 h and p < 0.01 at 72 h). The greatest changes were noted in patients undergoing LP. Postoperative atrial fibrillation (AF) was noted in 6.4% of patients studied, in whom the widest spQRS-T angle and the most prolonged QTc intervals were also noted.Conclusions: Lung resection widens the spQRS-T angle and prolongs the QTc interval, especially in patients undergoing LP. While postoperative AF was a relatively rare complication after lung resection in this study, it was associated with the widest spQRS-T angles and most prolonged QTc intervals

EMPATHY AND BURNOUT SYNDROME IN THE PRACTICE OF EMERGENCY SERVICES — PILOT STUDY

  INTRODUCTION: The burnout syndrome is a result of stress on the work situation and most often concerns pro­fessions requiring emotional and direct contact with another human being. The level of empathy is closely related to the phenomenon of occupational burnout. The aim of the study was to determine the impact of socio-demo­graphic factors of emergency services employees on the level of empathy. METHOD: In the period January–March 2018, a survey was conducted using a questionnaire — Emphatic Sensi­tiveness Scale (ESC) and an anonymous author’s questionnaire containing questions regarding sex, age, length of employment, occupation, marital status and number of hours worked per month. The survey was addressed to 81 employees of emergency services: paramedics (n = 17) and firefighters (n = 23). The control group consisted of 16 nurses and 25 people performing non–medical professions. RESULTS: The average number of hours worked per month by the respondents was 189 ± 49. There were 50 fe­males (62%) and 31 males (38%). The questionnaire showed statistically significant differences in perspective taking domain between the control group composed of people working in non-medical professions (25.6 ± 4.3) and emergency services professionals: firefighter (28.7 ± 3.6) vs. paramedic (29.9 ± 3.5) vs. nurse (31.2 ± 3.0), p < 0.001. It has been shown a statistically significant effect of sex on personal distress domain: male (21.4 ± 4.2) vs. female (24.3 ± 4.7), p = 0.005. CONCLUSIONS: In conclusion, our data indicates that: (1) Nurses were characterised by the highest level of empathy amongst the surveyed professional groups; (2) Females were characterised by a higher level of personal distress; (3) Variables such as sex, age, and length of employment did not affect the level of empathy

An assessment of the effectiveness of regional analgesia after VATS measured by an objective method for assessing testosterone, cortisol, α-amylase, sIgA, and β-endorphin levels — a randomised controlled trial

Introduction: Thoracic surgeries are associated with intense postoperative pain. General opioid analgesia is still the main anaesthetic method. Due to the large number of opioid-induced side effects, alternative methods of pain relief are sought. One of them is the use of balanced analgesia, which consists of regional analgesia, non-opioid painkillers, and small doses of opioids. Material and methods: The objective of this study was to assess the effectiveness of preoperative thoracic paravertebral block (ThPVB) in the treatment of postoperative pain after video-assisted thoracic surgery (VATS) by measuring hormone levels in blood serum or saliva. It was a randomised, open-label study conducted in a single university hospital setting between May 2018 and September 2019. In total, 119 patients were scheduled for elective video-assisted thoracic surgery. Performed interventions included: preoperative thoracic paravertebral block with 0.5% bupivacaine, followed by postoperative oxycodone combined with nonopioid analgesics. Follow-up period comprised first 24 hours and one, two, and six months after surgery. Main outcomes were measured by pain intensity assessed using the Numerical Rating Scale (NRS) and the levels of the following hormones: testosterone, cortisol, α-amylase activity, sIgA, and β-endorphin. Results: A total of 119 patients were randomised into two groups and, of these, 49 were subsequently excluded from the analysis. The final analysis included 37 patients from the study group and 33 from the control group. There were no statistically significant differences in the analysed parameters the relative change T1–T0. There was a tendency towards statistical significance in the relative change T2–T0 in testosterone levels. At rest, no statistically significant differences were found between groups and time in the percentage of patients with NRS ≥ 1. During cough, the percentage of patients with NRS ≥ 1 was higher at T1 and T2 time points in the ThPVB group. Of the factors considered, only α-amylase levels statistically significantly increased the chance for higher NRS score after a month [OR = 1.013; 95% PU: 1.001–1.025; p < 0.01]. Conclusions: ThPVB is effective and safe for patients undergoing VATS. It can be an effective alternative for general anaesthesia using high doses of opioids