Hemophagocytic lymphohistiocytosis in children

Hemophagocytic lymphohistiocytosis (HLH) is a heterogenic syndrome characterized by an acute, life-threatening inflammation due to a highly stimulated but ineffective immune response. Depending on the etiology, HLH is divided into primary (genetic) and secondary (acquired) forms. Primary HLH can be divided into familial HLH and HLH associated with other genetic disorders. Secondary HLH usually occurs in the context of a severe infection, rheumatic disease, or malignancy. HLH in children is a rare condition characterized by nonspecific symptoms and poor prognosis. Novel diagnostic tools and therapeutic methods give hope to improve the survival of the patients

Genetic aberrations in children with acute lymphoblastic leukaemia, their clinical and therapeutic significance

Acute lymphoblastic leukaemia (ALL) is the most common paediatric malignancy. Despite the fact that the outcome of treatment of ALL in children has improved in the last decades, still as many as 20% of children will undergo treatment failure. Over the last years, there have been great efforts to characterize the genetic alterations of leukaemic cells, which could affect the clinical course of the disease and become new markers that may be targeted with novel therapies. Genomic profiling and sequencing studies have not only identified new subtypes of ALL (e.g. Philadelphia chromosome-like ALL, early T-cell precursor ALL) but also helped to understand the genetic basis of leukaemogenesis and predict treatment failure. Those efforts contributed not only to better risk stratification of children with ALL, but also to development of new tailored therapeutic strategies. So far, improvements in survival of children with Ph+ ALL (Philadelphia positive ALL) have been demonstrated due to combination of intensive chemotherapy with tyrosine kinase (TK) inhibitor (imatinib). There are also some pre- and clinical testing of other inhibitors (TK, FLT3, PI3K/mTOR, MEK) and specific antibodies (CD19 and CD22). Widespread use of modern diagnostic techniques at the early stage of the disease would enable rapid identification of children with a high-risk leukaemia and use of more intensive and tailored therapy

Motor skills among high school adolescents : effect of the exercise program

To assess the basic motor skills and the effects of physical training improvement program in a group of adolescents. The study group comprised 133 students (92 women and 41 men) aged 17 to 19 years. First, the subjects' motor skills were tested using the Eurofit Fitness Testing Battery. Second, the general improving program of physical training was implemented during the same school year. Third, the Eurofit test was repeated at one year after the initial one. The SPSS 15.0 software was used to analyse the data. At the first measurement, only 2/133 students performed all the Eurofit tests on satisfactory (above the national sample 50%) level. In four of nine domains the results were below representative national sample. A year later, after completion of the training program, 37/133 students (27.1%) performed all Eurofit domains above the 50th percentile (P<0.001), the improvements were registered in previously deficit Eurofit Test constituencies. A low level of physical fitness has been observed in majority of adolescents. A general program of physical training leads to improvement of motor skills in a significant number of adolescents and the performance in the Eurofit test domains

Physical fitness and the occurrence of frailty among older people

Wstęp. Zespół słabości, wynikający z obniżonej wydolności układów fi zjologicznych, charakteryzuje się zmniejszoną rezerwą czynnościową i brakiem odporności na czynniki stresogenne w organizmie osób starszych. Cel pracy. Analiza oraz ocena związku sprawności fi zycznej osób w wieku starszym z potencjalnym wystąpieniem zespołu słabości. Grupa badana i metody. Badania przeprowadzono w grupie 104 pacjentów w wieku 60–101 lat. Sprawność fi zyczną oceniono, dokonując pomiarów kryteriów zespołu słabości, tj.: osłabienie siły mięśniowej (w odniesieniu do BMI i płci badanych osób), spowolnienie chodu, niezamierzone zmniejszenie masy ciała, wyczerpanie, obniżona aktywność fi zyczna. W ocenie siły mięśniowej posłużono się: pomiarem siły maksymalnego uścisku dłoni oraz wskaźnikiem masy ciała (BMI). Wyniki badań. Wraz z wiekiem maleje udział procentowy osób sprawnych fi zycznie, a wyraźnie rośnie udział procentowy osób niesprawnych. Wśród mężczyzn największy jest udział procentowy osób niesprawnych fi zycznie (39%), a u kobiet – osób osłabionych fi zycznie (51%). W grupie osób osłabionych i niesprawnych fi zycznie – u 26 (25%) nie wykazano zespołu słabości (not-frail), u 23 osób (22,12%) stwierdzono stan przed wystąpieniem zespołu słabości (pre-frail), u 37 (35,58%) stwierdzono zaś wystąpienie zespołu słabości (frail).Introduction. Frailty resulting from the reduced effi ciency of physiological systems, ischaracterized by reduced functional reserve and lack of resistance to stressors in thebody of the elderly.Aim. Analysis and assessment of the relationship between physical fi tness of olderpeople and the potential occurrence of frailty.Study group and methods. The study was conducted in a group of 104 patients aged60–101 years. Physical fi tness was assessed by measuring the criteria of the frailty, i.e.weakening of muscle strength (in relation to BMI and sex of the subjects), slowed gait,unintentional weight loss, exhaustion, reduced physical activity. In assessing muscularstrength, the following measures were used: maximum handshake and body massindex (BMI).Results. Following the progress of ageing the percentage of people physically fi t decreases and the percentage of disabled people evidently increases. The percentageof physically disabled people is the highest (39%) among men whereas it is the percentage of physically weakened people (51%) that occurs among women. 26 people(25%) were not-frail in the group of the weakened and disabled physically, 23 people(22.12%) were pre-frail and 37 people (35.58%) were frail.Conclusions. The higher frequency of frailty in older people is connected with females and with the institutionalized. There is a close connection between the darkening of one’s mood or depression and the loss of physical fi tness in old age. The loss ofphysical fi tness may be a warning sign of the progress of frailty

Coaching in the professional and personal development of nurses

Wprowadzenie . Deficyt pielęgniarek obserwowany w UE (Unii Europejskiej) może mieć różne przyczyny m. in.: mało atrakcyjne warunki pracy, niepodejmowanie pracy w tej profesji (pomimo posiadanego wykształcenia) oraz wysoki wskaźnik wypalenia zawodowego. Wyzwaniem dla pracodawców oraz instytucji zajmujących się problemami współczesnego pielęgniarstwa pozostaje problem zachęcenia adeptów kierunku do podjęcia pracy w zawodzie i pozostania w nim na dłużej. Także duże znaczenie ma nauczenie pielęgniarek jak chronić się przed wypaleniem zawodowym, łączyć ambicje zawodowe z potrzebami rodziny a przede wszystkim osobistą satysfakcją z życia. Pośród potencjalnych rozwiązań wspomagających świadome zaplanowanie życia osobistego i dalszego rozwoju zawodowego, warto rozważyć wsparcie coacha, podobnie jak to ma miejsce w innych zawodach. Cel. Analiza sytuacji zawodowej pielęgniarek w kontekście potrzeby indywidualnego rozwoju z zastosowaniem metody coachingu. Metodyka. Zastosowano metodę analizy i krytyki piśmiennictwa naukowego. Podsumowanie i wnioski. Wykorzystanie elementów coachingu stwarza szansę, by pielęgniarka/pielęgniarz w sposób świadomy i planowy projektowali przebieg swojego rozwoju zawodowego synchronicznie z potrzebami i oczekiwaniami w życiu osobistym, rodzinnym i społecznym. Dodatkowymi korzyściami z zastosowania tej formy wsparcia są umiejętność lepszego radzenia sobie ze stresem, zachowanie równowagi pomiędzy pracą a życiem osobistym (tzw. work-life balance) oraz prewencja wypalenia zawodowego.Introduction . Shortage of nurses reported in the EU (European Union) among other causes is related to: non-attractive work conditions, lack of willingness to take up job as a nurse (despite their education), and high risk of professional burnout. Encouraging graduates to take up a job in the profession and remain is a challenge for employers and institutions involved in the problems of modern nursing. Teaching nurses how to: protect themselves from professional burnout, how to combine career ambitions, family needs and above all personal satisfaction is of utmost importance. Amongst possible solutions which enhance planning of career and personal development in a deliberate manner, as is the case in other professions, it may be worth considering the support of a coach. Aim. Analysis of the professional situation of nurses in the context of need for individual development using the coaching method. Method. A method of analysis and criticism of the literature was used. Conclusions and results. Coaching gives an op po rtun ity for conscious planning process of nurse professional development in synchrony with needs and expectations for personal, family and social life. Better stress management, maintaining work-life balance and professional burnout prevention are benefits provided by this approach

Adverse events in professional practice of nurses working in anaesthetic and intensive care units

The main goal of modern health protection systems is to provide such a high quality level of medical services including patients' safety. Because of their specific both anaesthetics and intensive care medicine increase the risk of many dangers, especially adverse events. Analysis of adverse events occurrence during nurses’ work experience, focusing on nurses who work in intensive care or anaesthetics. Recognition of adverse events' incidence and reasons. Research was done on 83 nurses working in intensive care and anaesthetics; the majority of them were women (approx 96.4%). An average age of examined ones was 35.6 years (SD = 8.2). Researchers used authorial questionnaire that had been based on literature analysis and research instrument: Hospital Survey on Patient Safety Culture. 32.5% of examined persons declared occurrence of an adverse event during doing a professional activity. Prominent plurality of them said as well that the number of nurses in employment was insufficient (p = 0.018) or work at night hours caused the risk of adverse events (p = 0.022). Among persons who declared occurrence of an adverse event 51.9% had not reported this fact to their supervisors. An adverse event that happened the most often was accidental removal of either endotracheal or feeding tube (68.7%). The following conclusions were made: 1. Every third respondent declared occurrence of an adverse event during performing work. 2. Prominent majority of examined persons found reporting adverse events as a duty of every worker but only every other of those who declared occurrence of an adverse event notified a supervisor about it. 3. The incidence of adverse events depended on the respondents' opinion about working conditions. Sociodemographic aspects did not influence the incidence of mistakes