Medical appointment and its influence on patients' confidence

IntroductionPatient’s confidence is very important in patient – doctor communication. It is very vital when we talk about efficient medical care because it can improve this care significently. It is particularly important for people who can not contact with it easily. Thanks to watching relations between patient and doctor we can get to know the way the patient judges references of the doctor during his professional activities.The aim of the thesisThe aim of these studies was to estimate the level of patient’s confidence after the last medical appointment. The studies were made with the help of Anderson and Dedrick scale. ResultsPatients were satisfied after the appointment when during the examination they could see a telephone and a computer on the desk, medical equipment and other medical things. The doctor was closer than 61 cm from them and patients could not see any physical barriers. During the examination the position of the doctor was open, he used gestures and he was sitting face to face to the patient (angle 180° or 90°). His eyes were at the same level as patient’s eyes. ConclusionsThe ability of proper communication with the patient is a very important element of medical care. However, it is often underestimated. But efficiency of therapy and efficiency of diagnostics depend on these factors

Anti-Müllerian hormone: a critical factor for female fertility and reproductive health

Anti-Müllerian hormone (AMH) is a glycoprotein produced by the granulosa cells of preantral and small antral follicles. AMH concentrations reflect ovarian physiology with high precision, thus serving as a more sensitive marker of the ovarian re­serve than chronological age. This hormone plays a role in the pathogenesis of menstrual disorders and fertility in both obesity and polycystic ovary syndrome. The evaluation of AMH may also be useful in diagnosing or monitoring therapy of granulosa cell ovarian tumors

Expression of tumor necrosis factor-α (TNF-α) on peritoneal fluid mononuclear cells in women with endometriosis

Objectives: Tumor necrosis factor-α (TNF-α) plays a key role in the processes underlying the development of pelvic endometriosis. TNF-α acts on target cells via two receptors: TNFR1(p55) and TNFR2(p75). Depending on cell type and its activation state, ligand binding to TNF-α may induce activation and proliferation of the cells or promote apoptosis. The aim of our study has been to evaluate the expression of TNFR1 and TNFR2 on peritoneal fluid macrophages and T lymphocytes derived from women with endometriosis. Material and methods: The study group consisted of 22 patients with endometriosis (stage I and II rAFS). 14 patients with benign, non-inflammatory ovarian tumors composed the reference group. Mononuclear cells have been isolated from peritoneal fluid, obtained during laparoscopy. The expression of TNFR1 and TNFR2 proteins has been evaluated by means of flow cytometry, using monoclonal antibodies against CD120a, CD120b, CD3 and CD14. Results: The percentage of peritoneal fluid macrophages revealing the expression of TNFR1 and TNFR2 proteins has been higher in patients with endometriosis, in comparison with control group (22.6+/-5.3% vs. 6.8+/-1,8%; p=0.03 and 29.3+/-2.3% vs. 8.8+/-1.8%; p=0.01, respectively). The percentage of T lymphocytes with the expression of TNFR1 and TNFR2 has been similar in endometriosis and control group. Conclusion: Higher percentage of peritoneal fluid macrophages expressing TNFR1 and TNFR2 proteins in endometriosis suggests dependence of these cells on TNF-α stimulation. Changes in TNF receptors distribution on PF macrophages, but not lymphocyte, may play its role in the pathogenesis of endometriosis

health behaviour of postmenopausal women after mastectomy preliminary study

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The evaluation of patients satisfaction with nursery care in Medical Care Centre in Jaroslaw

THE AIM OF THE THESIS The aim of research was determining the evaluation of nursery care according to patients and the impact of age, sex and education on these opinions. Material and method: The research was made among 100 patients in Medical Care Centra in Jarosław in non-surgery section in 2007/2008. For the research it was used satisfaction scale from the following nursery: The Newcastle Satisfaction with Nursing Scale. RESULTS 1. General evaluation of the patients’ experience and satisfaction from nursery care in an analysed care center is very high. (suitably 76,8%, 87,3%) 2. Social-demographic factors such as: age, sex, the level of education among the patients don’t generally influence the patients’ satisfaction. CONCLUSIONS The researches of the level of the patients’ satisfaction during their stay in the hospital have a very important sense. Systematic researches and their precise analysis made in a very short time are the key to a real success. On the basis of conducted researches it has been noticed that the patients highly evaluate nursery care. It seems necessary to improve only researching tools.CEL PRACY Celem badań było ustalenie, jaka jest ocena opieki pielęgniarskiej w opinii pacjentów oraz wpływu wieku, płci i wykształcenia na te opinie. Materiał i metoda: Badania przeprowadzono w Centrum Opieki Medycznej w Jarosławiu w oddziale niezabiegowym w 2007/2008 roku wśród 100 pacjentów. Do badań wykorzystano skalę zadowolenia z pielęgnacji The Newcastle Satisfaction with Nursing Scale. WYNIKI: 1. Ogólna ocena doświadczeń pacjenta ze świadczonej opieki pielęgniarskiej w badanym ośrodku jak również satysfakcja pacjenta z opieki pielęgniarskiej jest bardzo dobra (odpowiednio 76,8%, 87,3%). 2. Czynniki socjodemograficzne takie jak: wiek, płeć i wykształcenie ankietowanych nie wpływają w sposób znaczący na satysfakcję pacjentów z opieki pielęgniarskiej sprawowanej w badanym ośrodku. WNIOSKI: Badania poziomu satysfakcji pacjenta podczas pobytu w szpitalu mają istotne znaczenie. Kluczem do sukcesu jest systematyczne przeprowadzanie takich badań i bezwzględna ich analiza dokonywana w krótkim czasie. Na podstawie przeprowadzonych badań zauważono, że pacjenci wysoko oceniają opiekę pielęgniarską. Koniecznym jednak wydaje się doskonalenie narzędzi badawczych

A Modified Method of Insulin Producing Cells’ Generation from Bone Marrow-Derived Mesenchymal Stem Cells

Type 1 diabetes mellitus is a result of autoimmune destruction of pancreatic insulin producing β-cells and so far it can be cured only by insulin injection, by pancreas transplantation, or by pancreatic islet cells’ transplantation. The methods are, however, imperfect and have a lot of disadvantages. Therefore new solutions are needed. The best one would be the use of differentiated mesenchymal stem cells (MSCs). In the present study, we investigated the potential of the bone marrow-derived MSCs line for in vitro differentiation into insulin producing cells (IPSs). We applied an 18-day protocol to differentiate MSCs. Differentiating cells formed cell clusters some of which resembled pancreatic islet-like cells. Using dithizone we confirmed the presence of insulin in the cells. What is more, the expression of proinsulin C-peptide in differentiated IPCs was analyzed by flow cytometry. For the first time, we investigated the influence of growth factors’ concentration on IPCs differentiation efficiency. We have found that an increase in the concentration of growth factors up to 60 ng/mL of β-FGF/EGF and 30 ng/mL of activin A/β-cellulin increases the percentage of IPCs. Further increase of growth factors does not show any increase of the percentage of differentiated cells. Our findings suggest that the presented protocol can be adapted for differentiation of insulin producing cells from stem cells

Komórki macierzyste w leczeniu złamań towarzyszących osteoporozie – medyczne science fiction czy metoda terapii w przyszłości?

Osteoporosis is typically a disease of the elderly, and with population aging it has become one of themost frequent and relevant health problems in this age bracket, especially among women. The greatest lossof bone mass occurs in women during perimenopause and is associated with oestrogen deficiency. The agerelateddecrease in bone mass could also reflect decreased osteoblasts secondary to an age-related loss ofosteoprogenitors.The risk of fractures increases as women pass through the menopause. Osteoporotic fractures are associatedwith a profound temporary, and sometimes permanent, impairment of function and quality of life.Despite the rapid evolution of implant technologies and bone grafting techniques, there is still a greatdemand for novel bone replacement strategies. Cell replacement therapies represent an alternative solution. The potenuseof mature cells such as osteoblasts is associated with several disadvantages such as the limited availability,donor site morbidity, dedifferentiation, and restricted proliferation potential. Bone marrow or adipose tissuederivedmesenchymal stem cells, which are the developmental progenitors for osteoblasts and for several othercell types, have been discovered for bone regeneration purposes.This review presents the possible applications of mesenchymal stem cells in the treatment of osteoporoticfractures

Anti-Müllerian hormone: structure, properties and appliance

Anti-Müllerian hormone (AMH) is a glycoprotein produced by the granulosa cells of preantral and small antral follicles. AMH concentrations reflect ovarian physiology with high precision, thus serving as a more sensitive marker of the ovarian reserve than the chronological age. This hormone plays a role in the pathogenesis of menstrual disorders and fertility in obesity and polycystic ovary syndrome. The evaluation of AMH may also be useful in the diagnosis or the monitoring therapy of granulosa cells ovarian tumors