Ocena kompetencji zawodowych lekarzy

Introduction: Competences are a combination of knowledge in a specific area, skills and attitudes. The professional group most often assessed in this regard are doctors. After leaving the office, patients assess the competences of a healthcare professional in relation to their own observations. Aim of the study: Presentation of the society's assessment of physicians' competences. Material and methods: The research was carried out using an original questionnaire. 210 questionnaires were collected and analyzed. Discussion of the results: Men (29%) and women (71%) participated in the study. The analysis showed that, according to a quarter of the respondents, doctors are not competent. Only 45.72% of people indicated positive feelings about the doctor's appointment. The respondents expressed their opinion in a similar way regarding the lack of time regarding the survey (48.10%). Almost 40% of them did not show trust in the health care system, as opposed to trust in a specialist, which is not displayed by 13% of respondents. Conclusions: The data suggest that doctors in their work are assessed quite well by patients, especially specialist doctors. However, there is controversy over how the health service is to be delivered.Wstęp: Kompetencje to połączenie wiedzy z konkretnego zakresu, umiejętności i postaw. Grupą zawodową najczęściej podlegającą ocenie w tej kwestii są lekarze. Pacjenci po wyjściu z gabinetu dokonują oceny kompetencji pracownika służby zdrowia w odniesieniu do własnych spostrzeżeń. Cel pracy: Przedstawienie oceny kompetencji lekarzy przez społeczeństwo. Materiał i metody: Badania przeprowadzono za pomocą autorskiej ankiety. Zebrano 210 kwestionariuszy i poddano analizie. Omówienie wyników: W badaniu wzięli udział mężczyźni (29%) oraz kobiety (71%). Analiza wykazała, że według ¼ respondentów, lekarze nie odznaczają się kompetentnością. Zaledwie 45,72% osób wskazało na pozytywne odczucia dotyczące wizyty lekarskiej. Ankietowani w podobny sposób opowiedzieli się w kwestii braku czasu odnośnie przeprowadzenia badania (48,10%). Prawie 40% z nich nie wykazała zaufania do systemu służby zdrowia w odróżnieniu do ufności wobec specjalisty, której nie przejawia 13% respondentów. Wnioski: Dane sugerują, że lekarze w swojej pracy są dość dobrze oceniani przez pacjentów, szczególnie lekarze specjaliści. Istnieją jednak kontrowersje w kwestii sposobu realizacji świadczenia zdrowotnego

The role of shopping in human life in 2021

Introduction: Society today is overly overwhelmed with advertisements for attractive products and ways to purchase them. The population is becoming richer and richer, which means they can spend more money on entertainment and their own pleasures.   Purpose: To present the role of shopping in human life in 2021 from the perspective of consumers. Material and method: The study was carried out using the author's questionnaire. 260 questionnaires were collected and analyzed. Results: Men (52.3%) and women (47.7%) participated in the study. More than half of them (53.8%) were employed and more than 30% were studying.  One in three respondents earned cash income greater than the minimum national gross rate. Nearly 60% rated their material situation as good. The analysis showed knowledge of the term "consumerism" by 83.1% of people. The study showed that the respondents shopped several times a week (69.2%) and even daily (18.5%). In order to buy food products, they usually visited supermarkets (64.6%), and in buying products they were most often guided by quality (47.7%). They are most encouraged by sales (50.8%), as well as recommendations from friends (18.5%) and product ingredients (12.6%). The data shows that as many as 58.5% of respondents used shopping to improve their mood. They were also induced to buy products by advertisements in the media (49.2%). Conclusions: For consumers, apart from the price, the quality of the products is of primary importance. They buy mainly in large supermarkets and via the Internet. The advertisements in media, promotions and the desire to improve one’s mood are the reasons of increasing phenomenon of consumerism

Women’s knowledge about pregnancy complicated by breast cancer and the attitude towards the implementation of anti-cancer therapy

Introduction and purpose: Breast cancer is the most commonly diagnosed cancer during pregnancy. Women can treat it, but pregnancy has a significant impact on the types and duration of using treatment. Purpose is to present the opinions of women about pregnancy complicated by breast cancer. Material and methods: 206 women participated in the study. We used a survey on the Internet. The average age of the respondents was 31.2. To establish whether an observed frequency distribution differs from a theoretical distribution the chi2 test of goodness-of-fit was used, to estimate relation we use the chi2 test of independence. Results: There were statistically significant differences between the number of women who believe that breast cancer is benign vs. malignant. Most often indicated as a safe method of diagnosis in pregnant women were: biopsy, mammography with lead shield, ultrasound, there was also a relationship between the place of residence and the choice of biopsy and ultrasound. A significant difference was noted between the number of women declaring an attitude forward delay vs starting treatment in pregnancy. There was a significant relationship between the pregnancy experience and the declared decision on the time of beginning of the therapy. Conclusions: The results suggest that women are aware of the malignancy of breast cancer. Many of them incorrectly differentiate the effects of this cancer in pregnant women and not pregnant. Biopsy, mammography with lead shield, ultrasound are perceived as the safest methods of diagnosis. Significantly more respondents claim that they would postpone the therapy until the end of pregnancy. Women who have never been pregnant more often declare that they would decide to postpone treatment. Key words: breast cancer; pregnancy; attitude; knowledge

Perception of the media image of health care in society

Introduction and purpose: The mass media deal with, among others creating the image of health care. Most often, information published in the media is negative because it aims to show sensation and increase the interest of recipients. To present the perception of the media image of health care in society.Material and method: The research was carried out using the author's questionnaire. 210 responses were collected and analyzed.Results: The study involved men (29%) and women (71%). Majority (89.52%) of respondents were in favor of an unfavorable or neutral overall image of health care created by the media. Information reached almost 70% of respondents on long queues for visits to specialists,  half a year or more. The respondents (83.81%) also drew attention to references spreading in publishers about the lack of staff among medical workers. However, most people (69.52%) did not share the healthcare model shaped by the "fourth authority" based on their experience.Conclusions: Based on the analysis, a negative media impact on the healthcare picture was confirmed. The data suggests that society does not quite agree with the media image of healthcare

Aktywność fizyczna społeczeństwa

Introduction: Physical activity is defined as human body movement performed by skeletal muscles. It is part of a healthy lifestyle and is linked to goals such as health and happiness. It shows beneficial effects on the human body as well as on the human mental state. Aim: To present the public's opinion on physical activity. Material and methods: The study was conducted by using the author's questionnaire. 198 questionnaires were obtained and then analyzed. Results: Women (76.8%) and men (23.2%) participated in the study. The average height of women was 169.5 cm, while that of men was 178.3 cm. The average weight of women was 65.7 kg and men 79.2 kg. The analysis shows that 61.1% of the respondents engage in regular physical activity every day. Seasonal activity is different, with only 29.3% of respondents engaging in it. The most popular sport was cycling, chosen by almost 1/3 of the respondents. Also popular was the gym (29.8%). In winter the respondents most often went skiing (19.7%) and skating (19.2%), while in summer they went roller-skating (18.6%). Men more often opted for activities that contribute to good physical condition, while women preferred body shaping exercises. The analysis also showed that for 34.0% of the respondents health is the most important goal. They also focused on staying fit (24.2%) and silhouette (23.2%). Almost all respondents described their motivation as high (88.9%) and believe that they will achieve their physical activity goal (81.8%).  Conclusions: The majority of the population knows the importance of physical activity on a daily basis and is motivated to do so. The type of activity varies according to gender, season and individual preference. However, most people say that the main purpose of being active is to stay healthy.Wstęp: Aktywność fizyczną definiuje się jako ruch ciała człowieka wykonywany przez mięśnie szkieletowe. Stanowi ona element zdrowego stylu życia i jest związana z celami takimi jak rozwój, zdrowie i dobre samopoczucie. Wykazuje korzystny wpływ na ciało człowieka, jak również jego psychikę. Cel pracy: Przedstawienie opinii społeczeństwa na temat aktywności fizycznej. Materiał i metody: Badania przeprowadzono za pomocą autorskiej ankiety. Uzyskano 198 kwestionariuszy a następnie przeanalizowano. Omówienie wyników: W badaniu wzięli udział kobiety (76,8%) oraz mężczyźni (23,2%). Średni wzrost kobiet wyniósł 169,5 cm, zaś mężczyzn 178,3 cm. Natomiast średnia waga kobiet wynosiła 65,7 kg a mężczyzn 79,2 kg. Z analizy wynika, że codzienną regularną aktywność fizyczną uprawia 61,1% ankietowanych. W odmienny sposób przedstawia się aktywność sezonowa, gdyż jedynie 29,3% badanych ją podejmuje. Najpopularniejszy sport stanowiła jazda na rowerze, którą wybrała blisko 1/3 respondentów. Również popularna była siłownia (29,8%). W sezonie zimowym badani najczęściej jeździli na nartach  (19,7%) i łyżwach (19,2%), zaś latem na rolkach (18,6%). Mężczyźni częściej wybierali aktywności wpływające na dobrą kondycję fizyczną, zaś kobiety wolały ćwiczenia kształtujące sylwetkę. Analiza wykazała również, że dla 34,0% respondentów najważniejszym celem jest zdrowie. Stawiali także na sprawność (24,2%) i sylwetkę (23,2%). Prawie wszyscy badani określali swoją motywację jako wysoką (88,9%) oraz wierzą, że osiągną swój cel aktywności fizycznej (81,8%).  Wnioski: Dane sugerują, że większość społeczeństwa wie jak ważna jest aktywność fizyczna na co dzień. Rodzaj sportu jest zróżnicowany w zależności od płci, pory roku oraz indywidualnych preferencji. Głównym celem aktywności jest utrzymanie zdrowia

The importance of CAD and DECT in CT colonography

IntroductionAccording to the American College of Radiology and the American Cancer Society, CTC has been recognized as a valuable screening method for detecting CRC in people at medium risk as an alternative to endoscopic colonoscopy. The condition for the proper interpretation of this procedure is the patient’s preparation for the examination. The evaluation of the test includes: topogram, transverse images (as reference images), multifaceted reconstructions and three-dimensional images (3D navigator). Materials and methods                            The literature on the use of CTC in the diagnosis of CRC was analyzed. A review of the scientific literature indexed in the PUBMED database from the last 10 years was carried out. Results The introduction of dual energy computed tomography (DECT) clearly improved the diagnostic accuracy of CTC. The main advantage of DECT is the possibility of obtaining iodine maps and VNC (virtual non-contrast) – a ’’virtual’’ native image (without the use of contrast). DECT allows you to monitor the results and extent of iodine capture on VNC and iodine map images, respectively, without using pre-recorded tomographic images. Pilot tests showed that DECT is an effective tool in CT colonography diagnostics and electronic colon loop cleaning after barium labeling. The use of the Computer Aided Diagnosis (CAD) algorithm in high energy tomography helps in the diagnosis and detection of intestinal tumors. ConclusionsThe development of modern technologies used in CT colonography proves that it is a safe and acceptable technique for patients. Lack of invasiveness, low radiation dose and high diagnostic efficiency of CTC may encourage more people to undergo colorectal cancer screening in the future

Stem cells migration during skeletal muscle regeneration - the role of Sdf-1/Cxcr4 and Sdf-1/ Cxcr7 axis

The skeletal muscle regeneration occurs due to the presence of tissue specific stem cells - satellite cells. These cells, localized between sarcolemma and basal lamina, are bound to muscle fibers and remain quiescent until their activation upon muscle injury. Due to pathological conditions, such as extensive injury or dystrophy, skeletal muscle regeneration is diminished. Among the therapies aiming to ameliorate skeletal muscle diseases are transplantations of the stem cells. In our previous studies we showed that Sdf-1 (stromal derived factor ¡1) increased migration of stem cells and their fusion with myoblasts in vitro. Importantly, we identified that Sdf-1 caused an increase in the expression of tetraspanin CD9 - adhesion protein involved in myoblasts fusion. In the current study we aimed to uncover the details of molecular mechanism of Sdf-1 action. We focused at the Sdf-1 receptors - Cxcr4 and Cxcr7, as well as signaling pathways induced by these molecules in primary myoblasts, as well as various stem cells - mesenchymal stem cells and embryonic stem cells, i.e. the cells of different migration and myogenic potential. We showed that Sdf-1 altered actin organization via FAK (focal adhesion kinase), Cdc42 (cell division control protein 42), and Rac-1 (Ras- Related C3 Botulinum Toxin Substrate 1). Moreover, we showed that Sdf-1 modified the transcription profile of genes encoding factors engaged in cells adhesion and migration. As the result, cells such as primary myoblasts or embryonic stem cells, became characterized by more effective migration when transplanted into regenerating muscle

Wielomiesięczny czas wolny od progresji u chorej z uogólnionym nowotworem neuroendokrynnym jelita cienkiego po leczeniu skojarzonym oktreotydem LAR i terapią izotopową

Long-acting somatostatin analogs are considered as a first line of treatment in well-differentiated metastatic gastroenteropancreatic neuroendocrine neoplasms with symptoms of carcinoid syndrome, because of relief symptoms and antiproliferative effect. According to the results of PROMID study (Placebo-Controlled, Double-Blind, Prospective, Randomized Study on the Effect of Octreotide LAR in the control of Tumor Growth in Patients With Metastatic Neuroendocrine Midgut Tumors), median time to progression is 14.3 months during treatment with octreotide. In this case report we presented 46-year-old woman with primary diagnosis of hepatocellular carci­noma, treated with palliative chemiotherapy (doxorubicin, dexamethasone, cyclophosphamide) with hematologic side effects and after that in follow-up. Because of uncommon course of HCC, histopathology examination was reviewed. The new diagnosis was metastases of well-differentiated neuroendocrine tumor (G1 in WHO 2010 clas­sification). During diagnostic imaging (computed tomography of chest and abdomen, Gallium-68-DOTA-TATE PET/CT) primary tumor in small intestine was found. The final diagnosis was well-differentiated neuroendocrine neoplasm of small intestine with distant metastasis and carcinoid syndrome. Improvement of general condition and 26 months stabilization of the disease was observed after concomitant treatment with long-acting octreotide and peptide receptor radionuclide therapy.Leczeniem farmakologicznym z wyboru w nowotworach neuroendokrynnych przewodu pokarmowego przebiega­jących z objawami zespołu rakowiaka są długodziałające analogi somatostatyny, redukujące objawy aktywności hormonalnej guzów oraz mające działanie antyproliferacyjne. Według danych badania PROMID średni czas wolny od progresji podczas leczenia długodziałającym oktreotydem wynosi 14,3 miesiąca. Prezentowany przy­padek dotyczy 46-letniej kobiety z rozpoznanym początkowo rakiem wątrobowokomórkowym (HCC), leczonym chemioterapią paliatywną (doksorubicyna, deksametazon, cyklofosfamid), a następnie z powodu powikłań hematologicznych pozostawionym w obserwacji. Ze względu na nietypowy przebieg HCC poddano weryfikacji badanie histopatologiczne, rozpoznając przerzut wysokozróżnicowanego nowotworu neuroendokrynnego (G1 wg WHO 2010). W wykonanych badaniach obrazowych (tomografia komputerowa klatki piersiowej i jamy brzusznej, 68Ga-DOTA-TATE-PET/CT) uwidoczniono zmianę w jelicie cienkim, mogącą odpowiadać ognisku pierwotnemu. Rozpoznano wysokozróżnicowany nowotwór neuroendokrynny jelita cienkiego w fazie uogólnienia przebiegający z objawami zespołu rakowiaka. Po zastosowanym leczeniu skojarzonym długodziałającym analogiem somato­styny — oktreotydem LAR oraz terapią znakowanymi izotopowo analogami somatostatyny 90Y/177Lu-DOTA-TATE uzyskano poprawę sprawności chorej o 2 stopnie w skali ECOG/WHO oraz 26-miesięczną stabilizację choroby

Transient Elastography for Detection of Liver Fibrosis in Children With Autosomal Recessive Polycystic Kidney Disease

Introduction: Congenital hepatic fibrosis (CHF) is invariably present in all patients with autosomal recessive polycystic kidney disease (ARPKD) but is usually clinically asymptomatic. The portal hypertension in the course of CHF develops and progresses over time, so an early detection of liver fibrosis remains crucial.Aim: The aim of the study was to evaluate a predictive value of transient elastography for evaluating liver disease progress in pediatric ARPKD patients.Material and Methods: The study group encompassed 21 pediatric patients with ARPKD and 20 healthy children (control group) from The Children's Memorial Health Institute in Warsaw, Poland. Liver fibrosis was determined by assessing the liver stiffness (LS) with transient elastography (FibroScan®, FS) using size-appropriate probes. In ARPKD group the laboratory findings, results of an abdominal ultrasound examination, and an endoscopic gastroduodenoscopy were also analyzed.Results: Compared with healthy controls, patients with ARPKD had significantly increased median LS values (22 vs. 4.25 kPa, p < 0.0001). Based on FS results, ARPKD group was divided into two subgroups: patients (n = 5) with LS results suggestive of no fibrosis or minimal fibrosis (LS < 6.9 kPa, METAVIR fibrosis stage 0–1) and patients (n = 16) with LS results suggestive of at least significant liver fibrosis (LS ≥ 6.9 kPa, METAVIR fibrosis stage 2–4). In the first subgroup (no fibrosis or minimal fibrosis), all patients had no signs of portal hypertension. In the subgroup with at least significant liver fibrosis, splenomegaly was observed in 87.5% of patients and thrombocytopenia in 69% of patients. An endoscopic gastroduodenoscopy was performed in 15 out of 21 ARPKD patients, nine patients (60%) had esophageal varices. All of these patients had LS results suggestive of at least significant liver fibrosis.Conclusions: TE by FibroScan can be used as an additional method for evaluating liver disease progress in pediatric ARPKD patients

Cell cycle regulation of embryonic stem cells and mouse embryonic fibroblasts lacking functional Pax7

The transcription factor Pax7 plays a key role during embryonic myogenesis and in adult organisms in that it sustains the proper function of satellite cells, which serve as adult skeletal muscle stem cells. Recently we have shown that lack of Pax7 does not prevent the myogenic differentiation of pluripotent stem cells. In the current work we show that the absence of functional Pax7 in differentiating embryonic stem cells modulates cell cycle facilitating their proliferation. Surprisingly, deregulation of Pax7 function also positively impacts at the proliferation of mouse embryonic fibroblasts. Such phenotypes seem to be executed by modulating the expression of positive cell cycle regulators, such as cyclin E