Thirty years' follow-up of depressive adolescents : a preliminary report

Aims and Objectives: The purpose of the study was to describe the consequences of adolescent depression in adults. The history of health problems and the choice of career were selected as indicators of the nature of depressive syndromes experienced in adolescence. Since the 1970s, adolescent depression is seen as related to a developmental crisis or a form of affective disorder. Materials and Methods: The method employed for this baseline study was screening school-age children. A sample of children from different schools and different backgrounds were screened with the Krakow Depression Inventory (KID) in 1985. A follow-up study was performed 15 years later and a second follow-up study 30 years later. The follow-up questionnaires were devised by authors of the original study and sent out to the baseline sample by post. A preliminary analysis of the responses to the second follow-up study is presented. Results: The results showed that there were no significant differences between adults who had depression in adolescence and their non-depressive peers. Discussion: Conducting the follow-up assessments remotely by post was found to have limitations, as there was a small number of replies received, which has limited the significance of our findings. Nevertheless, it was found that the differences between life health histories of the group studied and that of a non depressive peer group were negligible or none. Conclusions: The results of this long-term prospective study support the hypothesis of a developmental character of adolescent depression

Electrocardiography and cardiac magnetic resonance imaging in the detection of left ventricular hypertrophy : the impact of indexing methods

Background: Discrepancies between increased left ventricular mass (LVM) and electrocardiographic (ECG) criteria for the diagnosis of left ventricular hypertrophy (LVH) are described in the literature. Aims: This study aimed to evaluate the usefulness of ECG criteria in the diagnosis of LVH, as determined by cardiac magnetic resonance (CMR) imaging, using various LVM indexing methods. Methods: We included 53 patients who underwent CMR imaging and had electrocardiograms of appropriate quality available in their medical records. The majority of the study patients had cardiovascular diseases. We defined CMR‑LVH as increased LVM, also assessed after LVM indexing to body surface area (LVM/BSA), height1.7, height2.7, or as the percentage of predicted LVM (%pLVM). To determine ECG‑LVH, 10 different ECG-LVH criteria were used. Results: The prevalence of CMR‑LVH ranged from 11% (for %pLVM) to 72% (for LVM/BSA). At the same time, for a single criterion, the prevalence of ECG‑LVH ranged between 1.9% (for R wave amplitude in lead V5 / V6 greater than 2.6 mV, Sokolow–Lyon product, and Gubner–Ungerleider criterion) and 45.3% (for Peguero–Lo Presti criterion), showing high sensitivity, from 55.3% (95% CI, 38.3–71.4) to 100% (95% CI, 54.1–100). The sensitivity of ECG‑LVH criteria when all criteria were applied together ranged from 57.9% (95% CI, 40.8–73.7) to 100% (95% CI, 63.1–100). The best performance regarding the endpoint of CMR‑LVH diagnosis after LVM indexing was achieved by the Peguero–Lo Presti and Cornell criteria (area under the curve, 0.621–0.876; P, 0.001–0.17). Conclusions: Thediagnosis of LVH strongly depends on ECG- and CMR‑based definitions. ThePeguero–Lo Presti criterion and the Cornell criteria, which are sex‑specific, may provide the highest level of diagnostic accuracy and should be considered when screening patients with cardiovascular diseases for LVH

Air pollution and asthma-related hospitalizations in the Malopolska region

Introduction: Asthma is one of the most frequent chronic disease worldwide. Its prevalence has grown rapidly over last years, however the differences between countries are significant. Aim: The purpose of this study was to assess the relation between the number of urgent asthma-related hospital admissions and air pollution in the Malopolska region. Material and methods: We used data collected in the frame of the project “Hospitalization” – the Polish Survey on Overall Hospital Morbidity in Poland. We analyzed hospital records for Malopolska region with primary cause of hospital admission defined as bronchial asthma or status asthmaticus (code J45.* or J46 according to ICD-10) for years 2005–2009. Air pollution data were collected from monitoring station in Malopolska. Poisson regression model was used to assess the impact of air pollution level on number of hospital admissions with adjustment for the daily mean of temperature. Results: During the years 2005–2009 overall 6942 urgent asthma-related hospital admissions were observed. The level of air pollution during this period was high, for example, mean daily PM10 air pollution level was higher than 50 µg/m3 for more than 30% of days in most monitoring settings. The highest PM10 level was observed to be more than 350 µg/m3. Out of the analyzed pollutant the most important predictor was found to be SO2 with RR41,039 (95%CI: 1,014–1,064) and PM10 with RR41,018 (95%CI: 1.008–1.029) for 10 µg/m3 increase of pollutant. We have also examined the effect of air pollution during the previous days on asthma hospitalizations. The effect of air pollution by sulfur dioxide on number of hospital admissions from asthma was also observed with RR41,051 (95%CI: 1,028–1,075) and by PM10 with RR41,016 (95%CI: 1,007–1,025) for a seven days delay. In our study we have also observed the relation between air pollution by NO2 in previous days and asthma-related hospital admissions. Conclusions: The number of asthma hospitalizations, especially those unplanned, probably because of exacerbation of asthma episodes can be reduced by lowering air pollution level

The "Wholesome Contact" non-pharmacological, volunteer-delivered multidisciplinary programme to prevent hospital delirium in elderly patients : study protocol for a randomised controlled trial

Background: In hospital settings, delirium affects as many as 50% of older patients, aggravating their symptoms and worsening their condition, and therefore increasing the risk of in-hospital complications and death. The aim of this study is to assess the efficacy of structured, non-pharmacological care, delivered to older hospitalised patients by trained volunteers (students of medical fields), on the reduction of incidence of adverse health-related outcomes. Methods/design: This trial will be a randomised, investigator-blind, controlled trial conducted in an internal medicine and geriatric ward in Poland. We aim to include 416 patients who are 70 years of age and have been hospitalised for medical reasons. Eligible patients will be randomised 1:1 to receive structured, non-pharmacological care delivered by students of medicine, psychology and nursing, together with standard medical treatment or standard medical care alone. The protocol of interventions has been designed to cover nine main risk factors for delirium, with the scope of multidisciplinary interventions being individualised and tailored. The protocol will be aimed at immobilisation, vision and hearing impairment, cognitive impairment and disorientation, stress and anxiety, sleep–wake cycle disturbances, dehydration and malnutrition, and pain. A structured evaluation of patients’ cognition, mood, anxiety and functional performance is planned to be carried out twice, on the day of group allocation and at discharge; structured screening assessment for delirium will be conducted daily using the Confusion Assessment Method. The primary outcome will be the incidence of delirium in hospital; secondary outcomes will be in-hospital changes in cognition, mood and anxiety, and functional status, occurrence of falls and death. Discussion: Delirium prevention programmes are being introduced worldwide. A particular novelty of our project, however, is that invitations for voluntary work with older patients at risk for delirium will be addressed to medical students. With the use of the service learning method, the students will shape their attitudes, increase their knowledge and understanding of hospital care, and master competencies to work within interdisciplinary teams, which establishes the originality and practicality of the project