Usefulness of three-dimensional echocardiography for the assessment of ventricular function in children: Comparison with cardiac magnetic resonance, with a focus on patients with arrhythmia

Background: Focusing on patients with arrhythmia, the aims of this study was to assess ventricular function in children using three-dimensional echocardiography (3D-ECHO) and to compare the results to those obtained with cardiac magnetic resonance (CMR).Methods: The study group consisted of 43 children in whom 3D-ECHO and CMR were performed. Twenty-five patients had a ventricular arrhythmia, 7 left ventricular cardiomyopathies, 9 proved to be healthy. In all children, 3D-ECHO (offline analysis) was used to assess ventricular ejection fraction (EF). The results were compared to CMR using the Bland-Altman analysis and linear regression. The Student paired T-test was used to compare of means between both modalities.Results: The relation between the results derived from both methods is linear (for left ventricle: estimated slope = 1.031, p < 0.0001, R-squared = 0.998; for right ventricle: estimated slope = 0.993, p < 0.0001, R-squared = 0.998). In spite of minimal mean differences between results for both ventricles and narrow 95% confidence intervals, the paired t-test proved those differences not to be significant (p > 0.05) for the right ventricle but statistically significant (p < 0.05) for the left ventricle, for which the left ventricular EF calculated in 3D-ECHO was systematically underestimated with a mean difference of –1.8% ± 2.6% (p < 0.0001).Conclusions: Three-dimensional echocardiography assessment of both left and right ventricular EF in children showed high significant correlation and agreement with CMR. 3D-ECHO could be a valuable tool in follow-up of children with arrhythmic disorders requiring regular assessment of ventricular function

Evaluation of symptoms of anxiety and depression in women with breast cancer after breast amputation or conservation treated with adjuvant chemotherapy

Introduction Evaluation of the presence of symptoms of anxiety and depression in women treated for breast cancer who underwent surgical procedure using one of two alternative methods, either radical mastectomy or breast conserving treatment (BCT). Material and Methods A questionnaire survey involved 85 patients treated in a conservative way and 94 patients after breast amputation. Hospital Anxiety and Depression Scale (HADS), Beck Depression Inventory (BDI) and depression degree evaluation questionnaire were used in the study. The patients’ responses were statistically analyzed. Results Based on the HADS questionnaire, the total anxiety level in the group of women treated with BCT was 6.96 points, while in the group of patients who had undergone mastectomy the value was 7.8 points. The observed results were statistically significant. In the case of depression, the following values were found: patients after amputation had 8.04 scale value points, and those after BCT had 6.8 scale value points. The observed differences were statistically significant. Negative correlation was found between the level of anxiety and depression. The total level of depression evaluated using the Beck scale was 16.3 points in the BCT group, which means that they suffered from mild depression, while in the mastectomy group the level was 19.6 points, which corresponds to moderate depression. Conclusions The level of anxiety and depression among women with breast cancer was influenced by the type of the applied surgical procedure and adjuvant chemotherapy. Demographic variables did not influence the level of anxiety and depression

Life quality of women with breast cancer after mastectomy or breast conserving therapy treated with adjuvant chemotherapy

Introduction Breast cancer is the most frequent malignant neoplasm in women. The evaluation of the quality of life has become a treatment parameter as important as survival. Objective The aim of the study was evaluation of the quality of life among women treated for breast cancer who underwent surgical procedures using two alternative methods: mastectomy or breast conserving therapy (BCT). Material and Methods 85 patients treated with BCT and 94 patients who underwent mastectomy were evaluated. Standard questionnaires for the evaluation of the quality of life of cancer patients were used – QLQ-C30 (Quality of life questionnaire – core 30) with QLQ-BR23 (Breast Cancer Module). The Hospital Anxiety and Depression Scale was also applied. Results Social and demographic factors (age, education, marital status) influenced the evaluation of the life quality among both groups. Obtained data was also dependent on the type of surgical procedure and chemical treatment. The level of anxiety and depression also influenced the general quality of life and was higher in women who underwent mastectomy. Conclusions Quality of life plays an important role in the treatment process. Women after BCT declared a higher quality of life compared to patients after mastectomy. The process of making the decision concerning the planned surgical procedure should take into consideration the influence of the intervention on the quality of patients’ future life

Quality of life and occurrence of depression under chemotherapy in patients suffering from lung carcinoma

[b]introduction and objective[/b]. In Poland, lung carcinoma is the most frequent malignant neoplasm in men and the third most frequent in women. The neoplastic disease causes enormous psychic stress and may lead to depressive reactions. The purpose of this research was to assess the quality of life and the occurrence of depression in patients suffering from lung neoplasms and undergoing chemotherapy. [b]materials and method[/b]. The research covered 102 patients (test group TG) with lung carcinoma and undergoing chemotherapy. In the research, standardised questionnaires: EORTC-QLQ-C30, Beck Depression Inventory and a matrix developed by the researcher were applied. The control group (CG) consisted of 60 healthy people who were examined by the Beck Depression Inventory. [b]results[/b]. A highly statistically significant dependency was found (p<0.01) between the general quality of life and the occurrence of depression. 51.5% of those examined with a very low level of general quality of life had the symptoms of severe depression. Those examined who had a very high level of general quality of life did not have features of severe depression. A statistically significant dependency (p<0.01) was ascertained between the occurrence of depression and the health condition of those examined. [b]conclusions[/b]. Depression symptoms occur more frequently and with greater intensity in patients suffering from lung neoplasm, compared to the group of healthy people (p<0.01). A statistically significant connection between marital status, place of residence, and assessment of quality of life was found out (p<0.05)

Difficult situations for nursing students during the first practical classes at the hospital

Nursing students during the first practical classes are in contact with the new environment, take on new roles which is associated with difficult situations. The aim of the study was to analyze difficult situations faced by nursing students during the first practical classes. The study included 105 first-year students of nursing Jagiellonian University Collegium Medicum in Krakow. The method of diagnostic survey and estimation were used. The Generalized Self-Efficacy Scale by Schwarzer and Jerusalem, in the adaptation of Z. Juczyńskiego (GSES) and author's questionnaire have been used. Statistical analysis was performed chi2 test, the level of significance was set at p < 0.05. Almost half of those surveyed nursing students admitted that during the implementation of the first practical classes in the hospital very often experienced difficult situations. Such situations significantly less experienced students younger age (p = 0.00219; chi2 = 11.6908). Most often difficult situations related to contact with the patient. Their causes were: lack of experience (47.5%), lack of knowledge (18.8%) and lack of support (15%). The most common way to deal with such situations was to seek emotional support (49.2%). Knowledge about the prevalence of stressful situations during the first practical classes for students, in addition to cognitive objectives, it may also fulfill a preventive function

Zagrożenia zdrowotne wśród dzieci i młodzieży. T. 1

Praca recenzowana / Peer-reviewed pape

The level of the professional prestige of nurses taking into account the opinions of selected groups

Wstęp. Prestiż zawodowy zależy w dużej mierze od tego, jak widziany jest przez społeczeństwo. Zależy również od jego przydatności dla społeczeństwa, co oznacza, że prestiż zawodowy zależy także od prestiżu społecznego danej grupy zawodowej. Można więc oczekiwać, że wraz z postępującymi zmianami społecznymi pojawiają się też zmiany w kryteriach, według których dokonuje się oceny prestiżu zawodowego. Cel pracy. Głównym celem pracy była ocena poziomu prestiżu i pozycji zawodowej pielęgniarek według opinii wybranych grup oraz odpowiedź na pytanie: jakie czynniki wpływają na te oceny? Materiał i metody. Materiał badawczy stanowiła grupa 114 osób, wśród których było 57 studentów Elbląskiej Uczelni Humanistyczno- -Ekonomicznej i Państwowej Wyższej Szkoły Zawodowej w Elblągu oraz 57 słuchaczy Uniwersytetu III Wieku EUH-E. W badaniach zastosowano metodę sondażu diagnostycznego. Narzędzie stanowił autorski kwestionariusz ankiety. Wyniki i wnioski. Poziom prestiżu zawodowego pielęgniarek oceniono jako średni, niezależnie od grupy. Ocena czynników wpływających na prestiż zawodu pielęgniarki zależy od badanej grupy. Wśród studentów dominuje pogląd, że na prestiż zawodowy pielęgniarek wpływa głównie czynnik ekonomiczny, a wśród słuchaczy Uniwersytetu III wieku pogląd, że czynnik humanistyczny. Według studentów pozycja społeczno-zawodowa pielęgniarek zależy od ich wykształcenia i poziomu wynagrodzeń. Słuchacze Uniwersytetu III wieku uważają, że jest to kształcenie zawodowe i działalność naukowa. Symbole zawodowe są oceniane przez studentów, w przeciwieństwie do seniorów, jako nieistotne dla kształtowania wizerunku pielęgniarek.Introduction. The professional prestige depends largely on how a particular society perceives a given profession. It also depends on its usefulness for the society so it means that a professional prestige depends on the social prestige of a particular profession. One may assume that social changes occur simultaneously with the changes concerning the criteria according to which the professional level may be assessed. Aim of the study. The focal aim of the paper is to assess the level of professional prestige and the professional position of nurses taking into account the opinions of selected groups answering the question on the factors that determine their assessment. Materials and methods. The group of 114 people constituted the research material. There were 57 students of Elblag University of Humanities and Economy and the State School of Higher Professional Education and 57 participants of the University of the Third Age at Elblag University of Humanities and Economy. The method of an interview has been used. The questionnaire prepared by the author constitutes the tool. Results and conclusions. Regardless of the group, the level of the professional prestige of nurses has been assessed as an average one. The assessment of the factors that influence the professional prestige of nurses depends on the group that is questioned. The students maintain that the economic factor determine the professional prestige of nurses, whereas the participants of the University of the Third Age claim that is a humanistic factor. The students think that the social and professional position of nurses depends on their education and the level of remuneration. The participants of the University of the Third Age hold that vocational education and scientific activities play important roles. The professional symbols are assessed by the students, as opposed to what the participants of the University of the Third Age, as insignificant for forming the image of a nurse

Deontology of the communication process the oncologist and the patient

&lt;p&gt;The research objective the authors have set themselves is to discuss ethical aspects relating to&lt;/p&gt;&lt;p&gt;&nbsp;&lt;/p&gt;&lt;p&gt;the oncologist-patient relationship in the context of cancer treatment. The authors consider the problem of ethical aspects such as the autonomy of the patient, i.e. his/her right to self-determination and to decide on his/her treatment, and trust, which is the foundation of the doctor-patient relationship. Issues relating to the doctor's independence and his or her loyalty to the patient are also referred to. The authors helpfully refer to principles derived from the SPIKES protocol to help overcome basic communication difficulties. Indeed, communicating unhelpful information should be a basic skill of the oncology physician and should be based on deontological principles, moral values, and a proper communication process, all of which are indispensable in the context of effective cancer treatment, while, of course, complying with current legislation. As a result of the research, it was noted that the area of cancer treatment is a particularly difficult area of interface between current legislation, deontological norms and the treatment process. It is therefore crucial to find a so-called 'third way' that, while respecting the applicable law, will allow the patient to feel treated with dignity, with the highest possible ethical standards.&lt;/p&gt;&lt;p&gt;&nbsp;&lt;/p&gt;&lt;p&gt;This article is a starting point for further research work around aspects of patient rights, particularly in the context of the right to information, in the context of a specific category of people undergoing cancer treatment. This issue is extremely complex, multifaceted, interdisciplinary and, due to its topicality, deserves an in-depth study. In conducting the research, a method of analysis was used which included current studies, reports relating to the issue of communication between the oncologist and the patient. In addition, a formal and dogmatic method was used to identify legal issues.&nbsp;&lt;/p&gt

The assessment of the longitudinal arch of the foot in deaf and hearing children aged 9 to 11 years Hodnocení podélné klenby nohy u hluchých a slyšících dětí ve věku od 9 do 11 let

The aim of the study was to establish the condition of the foot arch in deaf and hearing children and to determine whether there are differences in the foot arch between children with impaired hearing and healthy children aged 9–11 years. A group of 19 deaf children and 33 hearing children, including 23 girls and 29 boys aged 9 to 11 years were studied. Their average age was 9.9 years. The examination of the longitudinal arch of the feet was carried out in an nonloaded (in a sitting position) and in a loaded (standing) position, using a Podoskop (POSMED, Poland). In the preparation of impressions of the soles of the feet, a line method according to Wejsflog was used with the specification of an index of the longitudinal arch of the foot. It was noted that there was a statistically significant difference between the arch of the left and the right feet in loading in healthy children (p < 0.05). However, no statistically significant differences were noted between the studied groups of children in terms of the indicator of the arch of the foot in both an unloaded and loaded posture. It was noted however, that the condition of the arch of the foot in deaf children was characterised by a lower effectiveness of the muscular and ligament systems, which was confirmed by the values of the foot parameters of deaf children. The results of the Wejsflog index indicate that in deaf children a typical area of variables (the right foot in loading 20.55–39.85) was greater than in healthy children (the right foot in loading 17.05–34.75). Moreover, in both groups of girls greater differences were noted in the degree of foot arching than in boys. This confirms the tendency to generally a more labile body posture in girls and in the muscular and ligament system of the feet. In conclusion, no statistically significant differences were noted between the studied groups of children in terms of the index of the arch of the foot in both a loaded and an unloaded posture. Cílem studie bylo zjistit stav klenby nohy u hluchých a slyšících dětí a určit, zda existují rozdíly mezi klenbou nohy u dětí s poškozením sluchu a u zdravých dětí ve věku 9–11 let. Studie proběhla na skupině 19 hluchých dětí a 33 slyšících dětí, z nichž bylo 23 dívek a 29 chlapců ve věku 9 až 11 let. Jejich průměrný věk byl 9,9 let. Vyšetření podélné klenby nohy bylo provedeno v poloze nezatížené (v sedě) a zatížené (ve stoje), za použití podoskopu (POSMED, Polsko). Při přípravě otisků chodidel byla použita lineární metoda dle Wejsfloga se specifikací ukazatele podélné klenby nohy. Byl zjištěn statisticky významný rozdíl mezi klenbou levé a pravé nohy v zatížené poloze u zdravých dětí (p < 0,05). Nebyly ovšem zjištěny žádné statisticky významné rozdíly mezi zkoumanými skupinami dětí, pokud jde o ukazatele klenby v nezatížené i zatížené poloze. Nicméně bylo zjištěno, že stav klenby nohy u hluchých dětí byl charakterizován nižší efektivitou svalového a vazivového systému, což potvrdily hodnoty parametrů nohou u hluchých dětí. Výsledky Wejsflogova ukazatele svědčí o tom, že u hluchých dětí byla typická oblast proměnných (pravá noha v zatíženém stavu 20,55–39,85) větší než u zdravých dětí (pravá noha v zatíženém stavu 17,05–34,75). Navíc byly u obou skupin dívek zjištěny větší rozdíly ve stupni klenutí nohy než u chlapců. Toto potvrzuje tendenci k všeobecně labilnějšímu držení těla u dívek a ve svalovém a vazivovém systému nohy. Závěr: nebyly zjištěny žádné statisticky významné rozdíly mezi zkoumanými skupinami dětí, pokud jde o ukazatele klenby v nezatížené i zatížené poloze