53 research outputs found
Varicella — a potential threat to maternal and fetal health
Objectives: The aim of the study was to evaluate the following: i) number of midwives and nurses at risk for contracting varicella; ii) effectiveness of infectious disease prevention among healthcare personnel; iii) attitude of healthcare personnel towards immunization.
Material and methods: A total of 524 midwives and nurses from obstetric, neonatal, and pediatric wards were investigated. Quantitative data analysis was performed.
Results: Overall, 14.7% potentially seronegative respondents were identified. Out of those with a positive history of varicella, 6.56% contracted the disease after starting work, and > 70% had contact with the varicella-zoster virus. Overall, 9.54% of the respondents had a history of varicella, 3.12% were informed about the possibility of immunization, and 1.56% of those with a negative history of the disease were offered a state-funded vaccine. In the same group, the number of vaccinated people amounted to 13.28%, and 26.13% would accept a state-funded vaccine.
Conclusions: Varicella may constitute a significant threat to maternal and fetal health at obstetric, neonatal, and pediatric wards, which must be considered when providing care to women in the reproductive age. Occupational health physicians should confirm the immunity status of the patients and suggest immunization to seronegative subjects. Regular workshops are necessary to update the knowledge of medical professionals and patients in order to shape their attitudes and beliefs about immunization
Influence of hormonal therapy on growth rate and bone age progression in patients with Turner syndrome
Celem pracy była ocena skuteczności leczenia hormonalnego u pacjentek z zespołem Turnera (TS) poprzez analizę tempa wzrastania i progresji wieku kostnego w trakcie stosowania hormonu wzrostu (GH), oxandrolonu (Ox) i estrogenów (E). 62 pacjentki z TS w zależności od rodzaju zastosowanej terapii podzielono na pięć grup: grupę GH (n=11); GH+Ox (n=18); GH+Ox+E (n=7); Ox+E (n=6) oraz grupę 0, którą stanowiły pacjentki nie leczone. Wzrost pacjentek wyrażano w wartościach standaryzowanych obliczonych według siatek dla TS (hSDST), a wiek kostny (BA) oceniano metodą Greulich-Pyle. Wyniki: Średnie wartości ∆hSDST uzyskane w poszczególnych grupach w pierwszym i drugim roku terapii różniły się znamiennie, co wynikało z istotnie wyższych wartości ∆hSDST w grupie GH+Ox. Na podstawie analizy regresji pomiędzy przyrostem wieku metrykalnego w trakcie terapii (∆CA) a przyrostem wieku kostnego w tym czasie (∆BA) uzyskano w poszczególnych grupach współczynniki kierunkowe α równania ∆BA=α x ∆CA, które różniły się istotnie, co wynikło ze znamiennie wyższych ich wartości w grupie GH niż w grupie 0 i GH+Ox. Tylko w grupie GH+Ox stwierdzono ujemną korelację pomiędzy początkowych CA a ∆BA. Wnioski: Wszystkie formy terapii przyczyniły się do poprawy tempa wzrastania u naszych pacjentek, jednak największy przyrost wzrostu przy najmniejszej progresji wieku kostnego obserwowano w grupie GH+Ox.The efficacy of growth promoting hormonal therapy is assessed on the basis of growth rate as well as bone age progression until the patients reach their final height. The aim of our study was to investigate which hormonal therapy influences in most appropriate way height velocity and bone age progression in patients with Turner syndrome (TS) and to establish the optimal age to initiate treatment. Patients were divided into five groups according to the type of hormonal therapy:1) 11 patients treated with growth hormone (GH); 2) 18 patients treated with GH and oxandrolone (Ox); 3) 7 patients treated with GH, Ox and estrogens (E); 4) 6 patients treated with OX and E; and the control group (Group 0) of 62 untreated patients. The patients height was expressed in hSDS calculated on the basis of growth chart for patients with TS (hSDST). Bone age (BA) was assessed according to Greulich-Pyle method. Results: The mean values of ∆hSDST in the first and second year of therapy in individual groups were significantly different. The difference resulted from significantly higher value of ∆hSDST in group treated with GH+Ox. Analysis of regression between ∆CA and ∆BA revealed regression coefficients α of equation ∆BA= α x ∆CA: in group 0: 0.817; group GH: 1.233; group GH+Ox: 0.861; group GH+Ox+E: 0.997; group Ox+E: 1.141. There was significant difference between regression coefficients in studied groups. It resulted from significantly higher value of α in group treated with GH than in a group 0 and treated with GH+Ox. Only group treated with GH+Ox showed a significant negative correlation between baseline CA and ∆BA during the therapy. We can conclude that all regimens of hormonal therapy improved height in our patients but the highest increase of height during the therapy and the smallest progression of the bone age in the same time were observed in patients treated with GH+Ox
Submassive pulmonary embolism as a mask of acute coronary syndrome
The paper presents a case of a 77-year-old man, who was admitted to hospital suffering from
chest pain. The ECG showed horizontal ST segment depression in the V4-V6 leads. Non-ST
segment elevation acute coronary syndrome was diagnosed. However, transthoracic
echocardiography revealed signs of pulmonary embolism. The present case indicates the need to
consider pulmonary embolism in the differential diagnosis of acute coronary syndromes and
underlines the role of echocardiography, which should be performed at the earliest possible stage.
(Cardiol J 2007; 14: 402-406
Submassive pulmonary embolism as a mask of acute coronary syndrome
The paper presents a case of a 77-year-old man, who was admitted to hospital suffering from chest pain. The ECG showed horizontal ST segment depression in the V4-V6 leads. Non-ST segment elevation acute coronary syndrome was diagnosed. However, transthoracic echocardiography revealed signs of pulmonary embolism. The present case indicates the need to consider pulmonary embolism in the differential diagnosis of acute coronary syndromes and underlines the role of echocardiography, which should be performed at the earliest possible stage
Complex treatment including participation in the psychological support group in adolescents with Diabetes Mellitus Type 1
Prevalence of overweight and obesity in preschool children from Rzeszow region
WSTĘP. Celem pracy było określenie częstości występowania nadwagi
i otyłości u dzieci w wieku przedszkolnym z regionu rzeszowskiego.
MATERIAŁ I METODY. Zważono i zmierzono 576 dzieci przedszkolnych
z regionu rzeszowskiego, w tym 302 dziewczęta i 274 chłopców
w wieku 4,82 roku ± 1,10 odchylenia standardowego (SD,
standard deviation). Na podstawie uzyskanych pomiarów obliczono
ich wskaźnik masy ciała (BMI, body mass index). Nadwagę
i otyłość określono na podstawie kryteriów IOTF.
WYNIKI. Nadwagę stwierdzono u 9,1% dziewcząt i 9,9% chłopców.
Otyłość stwierdzono u 7,2% dziewcząt i 8,4% chłopców. Nadwaga
występowała znamiennie częściej u chłopców 3-letnich, podczas
gdy w tej samej grupie wiekowej otyłość statystycznie częściej
stwierdzono u dziewcząt. W grupie badanych 5- i 6-letnich
chłopców stwierdzono znamiennie częstsze występowanie otyłości
niż w badanej grupie dziewcząt w tym wieku.
WNIOSKI. Nadwaga i otyłość u dzieci w wieku przedszkolnym stanowią
duży problem zdrowia publicznego. Wyniki badań autorów
niniejszej pracy wskazują na konieczność pilnego podjęcia działań
profilaktycznych i leczniczych otyłości u dzieci przedszkolnych.INTRODUCTION. The aim of the study was to assess the prevalence
of overweight and obesity in preschool children from Rzeszow
region.
MATERIAL AND METHODS. Weight and height were measured in
576 preschool children (302 girls and 274 boys) in the mean age
4.82 years ± 1.10 SD from Rzeszow region, and their body mass
index (BMI) was calculated. Overweight and obesity were diagnosed
according to the International Obesity Task Force criteria.
RESULTS. Overweight was present in 9.1% of girls and 9.9% of boys.
The prevalence of obesity was 7.2% and 8.4%s respectively. Three
years old boys were significantly more overweight than the girls in
the same age. However obesity was significantly more prevalent in
3 years old girls than boys and in 5-6 years old boys than girls.
CONCLUSIONS. Overweight and obesity in preschool children are
an emerging problem of the public health. The study results indicate
that obesity prevention and treatment should be focused already
at the preschool children
Przyczyny przedwczesnego dojrzewania dzieci kierowanych do diagnostyki w warunkach szpitalnych
Introduction: Symptoms of precocious puberty (PP) in children always arouse anxiety in their parents. Many children
with PP are being hospitalized for the detailed diagnostic work-up. The aim of our study was to analyze the frequency of
the variants of PP in children referred to our department.
Material: Retrospective analysis of 119 children (103 girls and 16 boys) referred for hospitalization in the years 2003-2005
due to signs of precocious puberty was performed.
Results: Premature thelarche, benign variant of puberty, was diagnosed in 62 (53%) girls, in the mean age of 3.39 (± 2.33)
years. Their mean height was within 0.7 ± 1.1 SD. Premature pubarche was diagnosed 30 (25%) children - 22 girls and
8 boys in the mean age was 7.24 (± 0.81) years. Their mean height was 1.3 ± 1.0 SD and was significantly higher than
normal (p < 0.0001). Premature menarche was diagnosed in 8 (7%) girls in the mean age 4.81 ±2.26 years. Mean height in this group was normal for age (0.9±0.8 SD). PP was diagnosed in 19 (16%) children (11 girls and 8 boys0 in the mean age
5.91 ± 1.63 years. Mean height in this group was 1.6 ± 0.7 SD, and was significantly higher than the mean for age (pWstęp: Wystąpienie objawów przedwczesnego dojrzewania u dzieci budzi zrozumiały niepokój rodziców. Dzieci te są
często kierowane do hospitalizacji celem wykonania badań diagnostycznych. Celem pracy była analiza częstości występowania
wariantów przedwczesnego dojrzewania u pacjentów naszej kliniki.
Materiał: Przeprowadzono retrospektywną analizę 119 dzieci (103 dziewczynek i 16 chłopców) skierowanych do hospitalizacji
w latach 2003-2005 z powodu objawów przedwczesnego dojrzewania.
Wyniki: W grupie dziewcząt przeważały łagodne warianty dojrzewania. Przedwczesne powiększenie gruczołów piersiowych
(thelarche praecox) rozpoznano u 62 (53%) dziewczynek, których średni wiek wynosił 3,39 (± 2,33) lat, a wzrost mieścił
się w 0.7 ± 1.1 SD. Przedwczesne owłosienie płciowe (pubarche praecox) rozpoznano u 30 (25%) dzieci w tym u 22 dziewcząt
i 8 chłopców w średnim wieku 7,24 (± 0,81) lat. Średni wzrost pacjentów w tej grupie wynosił 1,3 ± 1,0 SD i był istotnie
wyższy od średniej dla wieku (p < 0,0001). Przedwczesne krwawienia miesięczne (menarche praecox) rozpoznano
u 8 (7%) dziewczynek w średnim wieku 4,81 (± 2,26) lat. Ich wzrost mieścił się w 0.9±0.8 SD. Przedwczesne dojrzewanie
rozpoznano u 19 (16%) dzieci w wieku 5,91 (± 1,63) lat, w tym u 15 dzieci było to dojrzewanie typu centralnego (GnRH-zależne). Miało ono charakter idiopatyczny u 9 dziewczynek i 1 chłopca. U pozostałych 5 chorych (4 chłopców i 1 dziewczynki)
stwierdzono patologię ośrodkowego układu nerwowego. Przedwczesne dojrzewanie GnRH-niezależne rozpoznano
u 3 dzieci z wrodzonym przerostem nadnerczy i u 1 chłopca z guzem jądra (Leydigioma). Średni wzrost pacjentów
tej grupy wyrażony w SD wynosił 1,6 ± 0,7 i był istotnie wyższy niż średni wzrost dla wieku (p < 0,0005).
Wnioski: Brak przyspieszenia tempa wzrastania u dziewcząt z izolowanym powiększeniem gruczołów piersiowych świadczy
o łagodnym wariancie dojrzewania i wymaga jedynie okresowej kontroli. Chłopcy z objawami przedwczesnego dojrzewania
wymagają diagnostyki klinicznej ze względu na częstszą przyczynę organiczną
Submasywna zatorowość płucna przebiegająca pod postacią ostrego zespołu wieńcowego
W niniejszej pracy przedstawiono przypadek 77-letniego mężczyzny, którego przyjęto do szpitala
z powodu bólu w klatce piersiowej. W EKG zaobserwowano poziome obniżenia odcinka ST
w odprowadzeniach V4-V6. Rozpoznano ostry zespół wieńcowy bez uniesienia odcinka ST.
W badaniu echokardiograficznym uwidoczniono jednak cechy sugerujące zatorowość płucną.
Przypadek ten dobrze ilustruje konieczność uwzględnienia zatorowości płucnej w rozpoznaniu
różnicowym ostrych zespołów wieńcowych, a także podkreśla rolę badania echokardiograficznego,
które należy wykonać najszybciej jak to możliwe. (Folia Cardiologica Excerpta 2007; 2: 560-564
Treatment of severe primary IGF-1 deficiency using rhIGF-1 preparation — first three years of Polish experience
Introduction: The objective of this study was to analyse the effects of the first three years of treatment with recombinant human insulinlike growth factor 1 (rhIGF-1) in patients from the Polish population.
Material and methods: Twenty-seven children (22 boys and five girls) aged 2.8 to 16.0 years old were qualified for treatment with rhIGF-1 (mecasermin) in different treatment centres, according to Polish criteria: body height below –3.0 SD and IGF-1 concentration below percentile 2.5 with normal growth hormone (GH) levels. Mecasermin initial dose was 40 μg/kg bw twice a day and was subsequently increased to an average of 100 μg/kg bw twice a day. Body height, height velocity, weight, body mass index (BMI), and adverse events were measured.
Results: Mecasermin treatment resulted in a statistically significant increase in body height (1.45 ± 1.06 SD; p < 0.01) and height velocity in comparison with pre-treatment values. The biggest change in height velocity happened during the first year and diminished during subsequent years. Body weight and BMI also increased significantly after treatment (1.16 ± 0.76 SD and 0.86 ± 0.75 SD, respectively; p < 0.01). Eight patients reported adverse events. These were mild and temporary and did not require treatment modification except in two patients.
Conclusions: Treatment with rhIGF-1 was effective and safe in Polish patients with primary IGF-1 deficiency. It had a clear beneficial effect on the height of the patients and significantly accelerated the height velocity, particularly in the first year of treatment
The impact of COVID-19 on the lives of community- dwelling people with dementia and informal carers in the context of using the social and medical services – a qualitative study
Background: Older people with dementia are particularly at risk of COVID-19, whilst still little is known about the indirect impact of the Pandemic on the lives of those living with and caring for someone with dementia. The aim of this study was to investigate the impact of the Pandemic on the lives of people with dementia and their informal carers in the context of using social and medical services in Poland. Methods: A qualitative thematic analysis of semi-structured interviews with people with dementia (n = 5) and informal carers (n = 21) was performed. Interviews were collected between June and August 2020 via phone after the first wave of COVID-19 in Poland. Data were analysed using NVivo software by four team members. Results: Three overarching themes emerged: (1) Care re-organization; (2) Psychological responses; (3) Emerging needs. The factor underlying all these elements were a reliance on other people. Regardless of the type of support (informal or formal), a sense of presence of others and maintaining mutual contacts displayed as crucial elements influencing the well-being of people with dementia and informal carers. Conclusions: Social support and engagement are vital to the ongoing health and wellbeing of people living with dementia and their informal carers. Services need sustaining to provide ongoing provision to those living with dementia to reach pre-pandemic levels, if not better. Within the post-pandemic environment people with dementia and their informal carers need reassurance that they can rely on external institutional and social support able to meet their need
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