Management of blood infection caused by colonization of the vascular port with klebsiella variicola in case of patient treated with palliative chemotherapy

Klebsiella variicola is a bacterial species that was originally identified as a mild endosymbiont in plants, it occurs in humans and cattle. It is a bacterium that has been discovered relatively recently and research on the broader understanding of the pathogen is still underway. Vascular catheters are very often used to receive chemotherapy by patients. The purpose of this work was to present the management of blood infection caused by colonization of the vascular port with klebsiella varicola. The material described can be used to conduct patient pharmacotherapy. Care for a patient with a vascular port should be developed. There is a need to conduct staff training on: proper care and use of the vascular port and Huber needle for pharmacotherapy. Huber needles could be standard material in the list of required equipment in hospital wards to improve patient care with a vascular port

Assessment of physical activity of residents of Bydgoszcz using the international physical activity questionnaire IPAQ

Introduction: Currently, we live in the age of promoting a healthy lifestyle and encouraging physical activity, which justifies conducting a survey on the level of physical activity of the population living in Bydgoszcz. The results of the observation carried out will allow for the analysis of changes in physical activity of Bydgoszcz residents over the years in the future. Material and methods: 199 people living in Bydgoszcz, 97 women and 102 men participated in the study. The mean age of the respondents is 37.7 years, mean BMI: 25.84. The study was conducted using the Polish version of the IPAQ - Long version. Results: 84.42% (n = 168) of respondents were physically active, 12.06% (n = 24) of respondents were sufficiently physically active, and 3.52% (n = 7) were insufficiently physically active. Conclusions: The physical activity of the inhabitants of Bydgoszcz is at a high level, but the in-depth analysis of the results encourages the education in the aim to increase the level even more and to conduct more research

The case of a patient of 80 years old with epilepsy and neurocognitive disorders

Background. Epilepsy is a very widespread disease in the world. It is one of the most common neurological diseases of old age. However, older age is also associated with multi-morbidity and cognitive decline. This will result in a decrease or loss of the possibility of being independent of other people in the scope of basic everyday activities such as: moving, nutrition, sphincter control and maintaining personal hygiene. Disorders occurring in such a wide range in people with dementia often translate into disability in everyday life. Improving the quality of life of patients consists primarily in maintaining autonomy in self-service for as long as possible. Therefore, one of the most important elements of improving the quality of life of an elderly person is the early detection of neurocognitive disorders, rehabilitation of the patient and performing prescribed screening tests. Case report. A 80- year-old patient admitted to the Clinic of Geriatric in urgent matter due to dizziness and falls. Patient living with family, dependent in daily life, financially self-sustaining. Patient takes medicines from different groups due to multiple diseases. Patient's symptoms: dizziness and frequent falls. Because of the last complain, consulted in the department of emergency medicine, head tomography was conducted. The test showed no signs of fresh bleeding. The patient suffers from epilepsy. Patient has condition after treatment of subdural hematoma, in the state after heart attacks in 2001, 2003, 2004. In 2003 coronary angioplasty was performed. Patient is also suffering from hypertension, type 2 diabetes and chronic kidney disease. No use of drugs, alcohol and cigarettes. Result. The risk of functional limitations increases with the number of diseases present and is particularly large in people over 80 years of age. Multiple diseases is a serious problem in rehabilitation, therefore geriatric rehabilitation should be carried out on many levels. A comprehensive geriatric assessment helps diagnose the problem and develop a plan to improve the patient's quality of life. In addition, vitamin supplementation should be implemented in the elderly. Also medications used by the elderly and behavioral changes should be controlled. Patients should follow the recommendations of health care workers and attend both laboratory and neuropsychological monitoring tests

Challenges of modern medicine – a case study of a patient with ALS after age 60

Background. Amyotrophic lateral sclerosis is a degenerative disease of the nervous system, neurodegenerative cerebral cortex, pad and spinal cord due to damage to the upper and lower motor neurons, with progressive course, various symptoms with varying intensity and duration (from several months to even 10 years), extremely unfavorable prognosis. As an incurable and progressive disease, due to the deterioration of mobility it leads to complete stopping of muscles, including respiratory ones, with the intellectual ability of the patients fully preserved Case report. A 65-year-old patient was hospitalized in Geriatrics Clinic in University Hospital A. Jurasza in Bydgoszcz. Patient with shortness of breath, present paradoxical chest movement, impaired chest mobility, present whirring, wheezing during auscultation examination. The patient was admitted to the ward because of pneumonia. Amyotrophic lateral sclerosis, chronic respiratory failure, hypertension, and hyperthyroidism were diagnosed. In the medical history she had swallowing problems, abdominal pain, insufficient cough reflex, dysphagia, increased body temperature, difficulty falling asleep, depressed mood. The patient did not consent to a tracheotomy for aspiration of secretions from the respiratory tract. The patient required suctioning of excessively accumulating secretions in the mouth. The patient was patted. Patient's skin without pathological changes. During the night, the patient requires non-invasive mechanical ventilation - BIPAP respirator. Patient under the care of the Palliative Medicine Clinic. Patient fed an industrial diet (Isosource Protein) for PEG (percutaneous endoscopic gastrostomy) - self-service. Results. Although the disease is incurable, many of its symptoms can be alleviated, and the goal of therapy should be to improve the quality of life and maintain patient independence for as long as possible. SLA patients and their relatives often experience depression, feelings of despair and anxiety. Therefore, psychological help is recommended for patients and their relatives. The continuous development of medicine remains a hope for this disease. There is a need to continue research into the search for an effective cure for amyotrophic lateral sclerosis

Case report of a patient with acute renal failure and cardiovascular disease after 65 years of age

Introduction. Acute kidney injury (AKI) is a clinical syndrome with high mortality. It is a clinical syndrome consisting in rapid impairment of kidney function. The result is retention of metabolic products in the body and the inability to maintain normal water-electrolyte and acid-base homeostasis. Chronic heart failure is a significant clinical, economic and social problem, and despite the continuous development of medicine, the incidence of this disease is still increasing. A weakened inefficient heart is not able to supply the organs with the right amount of blood, oxygen and nutrients. The effect is fast fatigue, weakness of muscle strength and dizziness. Kidney and cardiovascular diseases affect each other and increase their course, which worsens the patient's condition. Periodic monitoring of renal function in patients with cardiovascular disease is very important because it has been proven that the occurrence of kidney disease in these patients increases the risk of death. Case report. Patient, 78 years old, hospitalized many times in the Geriatrics Clinic, Cardiology Clinic, Nephrology Clinic due to shortness of breath, chronic myocardial insufficiency, edema of the lower limbs. The degree of independence is limited, the patient walks with assistance, lives with a family / significant other. Main ailments of the patient: increasing swelling of the lower limbs, left foot pain, nausea, vomiting, palpitations, effortlessness and rest dyspnea without stenocardial complaints. Comorbidities: Type 2 insulin-dependent diabetes mellitus (with unspecified complications), obesity, generalized atherosclerosis, hypertension, chronic NYHA type II heart failure. Cardiac defect in the form of mitral and tricuspid regurgitation, pulmonary hypertension, paroxysmal atrial fibrillation, myocardial infarction. The patient was qualified for hemodialysis treatment, then returned to conservative treatment, followed a strict diet. The applied treatment improved the general condition of the patient and was discharged from the hospital in a stable general condition. Results. Frequent and regular examination of a patient's condition with cardiac-renal syndrome, disease progression and ability to tolerate treatment can be helpful in treating and prolonging the patient's life. It is important to monitor kidney function in people with cardiovascular disease

Effect of restoration of euthyroidism on visfatin concentrations and body composition in women

Dysregulation of thyroid function has known impact on body metabolism, however, data regarding metabolic outcome after restoration of thyroid function is limited. Therefore, the aim of the study was to investigate the effect of restoration of euthyroidism on serum visfatin, and its associations with insulin resistance and body composition. This is an observational study with consecutive enrollment. Forty-nine hyperthyroid (median age of 34 years) and 44 hypothyroid women (median age of 46 years) completed the study. Laboratory parameters and body composition analysis were assessed before and after the therapy. In the hyperthyroid group, visfatin concentrations increased (P \u3c 0.0001), while glucose concentrations decreased (P \u3c 0.0001). Total body mass and fat mass in the trunk and limbs significantly increased during the treatment. In the hypothyroid group, significant weight loss resulted from decrease of fat and muscle masses in trunk and limbs. Visfatin serum concentrations positively correlated with total fat mass (r = 0.19, P = 0.01) and insulin concentrations (r = 0.17, P = 0.018). In conclusion, restoration of thyroid function is not associated with beneficial changes in body composition, especially among hyperthyroid females

The case of myelodysplastic syndrome after 65 years old

Background. The etiology of MDS syndromes (myelodysplastic syndromes) is unknown. MDS is a disease of the elderly, mostly affects people over 50 years of age. Elderly patients with MDS are diagnosed at an earlier stage of the disease compared to younger people. Therapeutic options in MDS include treatment with high-dose chemotherapy with / without hematopoietic stem cell transplantation, treatment with low-dose chemotherapy, supportive care and symptomatic treatment. Transfusion of RBC (Red Blood Cells) concentrate and platelet concentrate is used in the majority of patients with MDS and it is the only form of therapy recommended for both patients with good and bad prognosis. Case report. A 77-year-old patient repeatedly hospitalized in the Clinic of Geriatrics for symptomatic anemia in myelodysplastic syndrome. Independent patient in the field of self-care, living alone. Patient take many medicines from different groups. Patient with multidisease. Symptoms of the patient: weakness, depressed mood, reduced tolerance of physical exercise, dizziness, palpitations associated with slight physical effort, symptoms of gastrointestinal bleeding, stenocardial complaints in 2017. A bone marrow biopsy was performed - in the myelogram MDS was diagnosed with features of low-grade triplicate dysplasia. Patient repeatedly hospitalized for transfusion of Irradiated Leukocyte-Depleted RBC Concentrate (since the beginning of 2018 11 times - average 1 x / month). From October 2012 to November 2018, a total of 49 Irradiated Leukocyte-Depleted RBC Concentrates units were transfused, reducing only the symptoms of the disease. Results. A careful assessment of the functional status, ability to tolerate treatment, disease progression and overall health can be helpful in determining treatment. To improve access to treatment, emphasis should be placed on oral drug therapies that can be easily administered on an outpatient basis to minimize transfusion. Palliative care and environmental care are important aspects of improving the health and quality of life of MDS patients

Assessment of knowledge about body postural defects among parents

Introduction: Postural defects became in recent decades significant problem, both medical and social. Many examinations show that faulty posture affect about 60-80 per cent of children. The rapid development of technology has led to limiting of physical activity which manifests itself by massive occurrence of faulty posture. Therefore it is extremely important to increase the parents knowledge and awareness of the prevention and correction of faulty posture as well as benefit from physical activity. Aim: The aim of the present study was estimation parents knowledge about faulty posture and verification who knows more – parents who have children with correct posture or these who have children with postural defects as well as parents who encourage children to exercise or these who don’t do this. Materials and methods: A survey was conducted in a group of 60 parents. First group: 30 parents of children attending The Postural Defect Clinic, second group: 30 parents of children attending School Complex No. 8 in Bydgoszcz. The original questionnaire was used for the study. Questionnaire to the estimation of parents knowledge consisted of 19 questions: metric questions and knowledge test. The results were analyzed statistically (p<0,05). Results: Parents who enroll children for extra sports are more knowledgeable than parents who do not. Parents whose children have postural problems have no higher knowledge than parents whose children have a correct posture. Parents with higher education have more knowledge about posture defects. Conclusion: Parents knowledge on the prevention and correction of faulty posture is sufficient (mean: 56 per cent correct answers). Nowadays, knowledge should be at a higher level by looking at the frequency of postural defects

Impact of the percentage of muscle and fat tissue and muscle strength on the quality of life of people over 60 years of age

Introduction: Physical activity is crucial in a person’s life. It has an impact on health, motor and mental fitness. Implementation of physical activity affects the percentage of human body tissues. The aim of the study is to conduct an analysis influence of the percentage of muscle and fatty tissue and muscle strength on the quality of life of people over 60 years of age.Material and methods: The study was conducted among 86 patients (the average age was: 72) from Geriatrics Clinic, qualified for Geriatric Comprehensive Assessment in scheduled mode. Measurements of anthropometric parameters were performed: 1) for body composition was used TANITA weight; 2) for muscle strength measurement of the upper limbs was used a hand dynamometer; 3) quality of life measurement by the FACIT scale.Results: In case of the higher percentage of adipose tissue, the lower muscular strength of the patients. Incase of the higher percentage of muscle mass, the higher muscular strength of the patients. Correlation of muscle strength (kg) with the quality of life (4 domains measured by FACIT scale) was significant and amounted respectively: physical domain R = 0.34 (p &lt; 0.001), social domain R = 0.25 (p = 0.031), emotional domain R = 0.27 (p = 0.021), functional domain R = 0.35 (p &lt; 0.001).Conclusions: The results clearly present that the higher muscle strength of older people has an influence on a higher level of quality of life. It is necessary to aware carers of the elderly people that physical activity maintain as much muscle mass and strength as possible which contributes to ensuring the best quality of life for the elderly