Allergic and nonallergic rhinitis in schoolchildren: part II : relationship to spirometric parameters, bronchial hyperresponsiveness and biomarkers of allergic inflammation

In recent years, with the increasing prevalence of allergic rhinitis (AR), a higher incidence of nonallergic rhinitis (NAR) has been observed. Aim: The aim of the study was the comparison of pulmonary function tests and the degree of bronchial hyperresponsiveness (BHR) in children with AR and NAR, evaluation of the biomarker for clinical AR or BHR diagnosis. Material and methods: Pulmonary function tests and BHR in the exercise tests were done in 139 schoolchildren (8-14 years of age) with symptoms of non-infectious rhinitis. The analyzed biomarkers included exhaled nitric oxide (FeNO), total IgE (tIgE), serum IL-4, serum tumour necrosis factor α (TNF-α), absolute eosinophils count in blood (Eos). Positive prick tests with 10 aeroallergens identified children with AR. Results: Spirometric parameters and values of BHR were not different in AR (n = 73) and NAR (n = 66) groups. The risk of BHR was higher in children with AR than those with NAR (OR = 2.768; p = 0.051). In the logistic regression analysis, none of the analyzed biomarkers was related to BHR. Differences in the area under the ROC curve (AUC) for: tIgE and FeNO (AUC tIgE-AUC FeNO = 0.102; p = 0.042), FeNO and Eos (AUC FeNO-AUDEos = 0.07; p = 0.219), tIgE and Eos (AUC tIgE-AUC Eos = 0.172; p = 0.002) showed that measurements of tIgE level were the best diagnostic tool for AR (sensitivity = 78.9%, specificity = 79.4% for tIgE = 68 kU/l). Conclusions: There were no differences in pulmonary function test parameters between groups of children with AR and NAR. Bronchial hyperresponsiveness was more often observed in AR than in NAR. Any biomarker of allergic inflammation predicts BHR in children with rhinitis. The accuracy of diagnostic AR testing with tIgE measurement (cut-off level = 68 kU/l) was moderately good in schoolchildren

Difficult situations and ways of managing them in paediatric nurses' practise

Paediatric nurses are continuously subject to difficult situations because they are responsible for the most important values such as health and life of a child. The aim of the study was to recognise difficult situations in paediatric nurses' practise, and ways of solving problems in nursing care. Study group comprised of 108 nurses employed in paediatric departments in Malopolska Province. The study used home-made survey questionnaire, CISS questionnaire for examination of reactions on difficult situations and KWEP questionnaire for measurement of emotional support received because of problems originating from professional work. Results show that there are many difficult situations in paediatric nurses' practise. Those situations result from the nature of the work, its organization and interpersonal relationships

Quality of nursing´s care at cardiologic department

Assurance of nursing in accordance with actual knowledge and which fulfill expectations of patients require not only the professionalism in execution of duties from the nursing stuff but also an activity towards quality, an activity which base element should be constant measuring and evaluation. Diagnosis of weak and strong sides of nursing at cardiological department. 113 people were involved in research, 41 nurses and 72 randomly selceted patients. In assembling of opinion about nursing’s care quality the Interviewer questionnaire was applied. Strong side of nursing's care is efiicency in carring out the nursing activities, interpersonal relationships between nurse and patient, seeing patients, subjectiv treatment of patient, informing. Weak sides are education, existent need satisfactory and hotel conditions

Risk factors for retinopathy in the premature newborns

Retinopathy of prematurity (ROP) is one of the basic medical problems that have a negative impact on the development of children born prematurely. The aim of the study was to estimate ROP frequency and to identify factors related to this disease. One hundred forty nine premature newborns, treated at the Department of Pathology and Neonatal Intensive Care at the University Children's Hospital in Krakow in 2008-2009 years, were analyzed. Inclusion criteria were: gestation age less than 32 weeks and birth weight equal or less than 2000 g. Material was collected using computer data base with individual patient’s disease course and paper files. Relationship of analyzed factors was established using analysis of variance, Pearson correlation coefficient and $Chi^{2}test$, level of significance was p < 0,05. ROP was diagnosed in 35% (52/149) premature babies and distribution of the level of retinopathy was following: I grade - 10% (5/52); II grade - 17% (9/52); III grade - 73% (38/52). Factors significantly related to the occurrence and the level of ROP were: low gestational age, extremely low birth weight (< 750 g), sepsis, perinatal asphyxia, long period of mechanical ventilation and oxygen therapy, frequent blood transfusions, formation of posthemorrhagic encephalopathy or bronchopulmonary dysplasia. ROP is a quite often disease in premature babies. Moreover, there is significant relationship between the level of ROP and low gestational age and intensive medical interventions