Characteristics and clinical correlates of white matter changes in brain magnetic resonance of migraine females

Objective: White matter hyperintensities (WMHs) were often found in migraine patients. The aim of study was to characterize WMHs, assess their prevalence, determine relationship to clinical symptoms and homocysteine levels in migraine females. Methods: 69 women 38 with migraine without aura (MO), 31 with migraine with aura (MA) who underwent brain MRI with 1.5T scanner were enrolled. TheWMHsnumber, location and size in FLAIR sequence were evaluated. Migraine severity was measured by pain intensity, number of attacks per month and MIDAS scale. Results: WMHs were found in 39.1% females. There was no WMHs and migraine typecorrelation. The total WMHs number was higher in MO ( p = 0.027). Patients with WMHswere older ( p = 0.025), have higher BMI ( p = 0.042), suffered longer ( p = 0.001), more often had positive pregnancy history ( p = 0.010) and less frequent prodromal symptoms. The age of onset, migraine's severity and homocysteine did not correlate with WMHs. No effect of antimigraine medication and oral contraceptive pills (OCP) was found. Both in MO and MA groupsWMHswere located only supratentorially. In MO femalesWMHswere mainly located in one cerebral hemisphere ( p = 0.024) whereas in MA were found bilaterally. WMHs were most commonly located in the frontal lobes. In MOlesions were small ≤3 mmand present in almost all MO patients ( p = 0.027).Conclusion: WMHs are present in more than one third of migraine females, regardless of aura. WHMs are located supratentorially, subcortically and in the frontal lobes. Older age, longer disease's duration, obesity and positive history of pregnancy are main risk factors for WMHs. Symptomatology and migraine severity, hyperhomocysteinemia, OCP and antimigraine medications do not increase WMHs

Salt caves as simulation of natural environment and significance of halotherapy

Introduction. Human activity usually leads to a deterioration in air quality; therefore, searching for places that simulate an environment without pollution is important. Artificial salt caves play crucial role, as a kind of therapy, known as halotherapy, based on treatment in a controlled air medium that simulates a natural salt cave microclimate. Objective. Evaluation of awareness about the existence of salt caves, basic knowledge about the purpose for their presence among people who bought salt caves sessions, and checking their subjective estimation of salt caves influence on their well-being. Material & Methods. 303 inhabitants (18–51-years-old) of 3 randomly chosen cities of southern Poland were surveyed using a validated author’s questionnaire. Both genders were represented in comparable numbers. Results. It was be observed that knowledge about the existence of salt-caves is common – 94% of respondents. 96 persons bought at least 3 salt caves sessions. The majority of women, did this for therapeutic reasons (57%), and men for both therapeutic and relaxation reasons (both 39%). Both among women and men, the dysfunctions intended to be cured by sessions included problems with throat, larynx or sinus. Depression as a reason for buying sessions was mentioned only by women. In general, those who attended felt better after sessions in salt caves. Conclusion. Besides the health benefits, people do not have free time for rest and activities in clean air; moreover, stress is inseparable from everyday life, and for that reasons salt caves become places that help to support a proper lifestyle

Prostate cancer in patients from rural and suburban areas : PSA value, Gleason score and presence of metastases in bone scan

Introduction. Prostate cancer is the second most common neoplasm among men both worldwide and in Poland. In prostate cancer, bone metastasis is related to a poorer prognosis. A diagnosis of metastatic bone disease is important in prostate cancer patients prior to therapy. Prostate specific antigen (PSA) serum value is used both as a screening tool and for staging of prostate cancer. Aim. To evaluate whether there is a link between symptoms presented by patients, pain in particular, and the presence, number and location of bone metastases as assessed by bone scan scintigraphy in concordance with PSA values and Gleason scores. Material. A group of 186 patients (aged: 68.38±6.16) diagnosed with prostate cancer, from rural and suburban areas of Małopolska province, that was directed for bone scan scintigraphy to the Nuclear Medicine Dept, John Paul II Hospital in Kraków. Methods. Analysis of all laboratory findings (including PSA value) and a biopsy were performed. Then, bone scan scintigraphy was done with the use of methylene disphosphonate (MDP) labeled with Tc-99m. Results. In patients with a Gleason value ≤7 and a PSA value ≤20 ng/ml, the cutoff value for a negative bone scan with a confidence interval of 0.95 was established at a PSA value below 10 ng/ml (p<0.01). Correlations were established between PSA value and presence of metastases in bone scan (r=0.45, p=0.05), the number of metastases (r=0.66, p<0.01), and their presence in particular body regions. Conclusions. The correlation between PSA value and both presence and number of metastases confirms the usefulness of bone scan scintigraphy in prostate cancer staging. The cutoff value for negative bone scan with a 95% confidence interval was established at PSA = 10 ng/ml

Cardiac rehabilitation : a good measure to improve quality of life in peri- and postmenopausal women with microvascular angina

Cardiac Syndrome X (CSX) was considered a stable coronary syndrome, yet due to its nature, CSX symptoms often have a great impact on patients’ Quality of Life (QoL). According to ESC 2013 stable coronary artery disease criteria, CSX was replaced by Microvascular Angina (MA).Unfortunately, most CSX or MA patients, after classical angina (involving main coronary vessels) has been ruled out, often do not receive proper treatment. Indications for pharmacological treatment of MA patients were introduced only recently. Another problematic issue is that scientists describing the pathophysiology of both CSX and MA stress a lack of a deeper insight into the multifactorial etiology of the source of pain associated with this disease. In the presented article we have attempted to study the influence of cardiac rehabilitation (3 months programme) on the QoL of patients recognized as suffering from MA, as well as to check if changes in myocardial perfusion in these patients at baseline and after completion of cardiac rehabilitation match changes in their QoL. Therefore, after screening 436 women for MA, we studied 55 of them who were confirmed as having MA and who agreed to participate in the study. Exercise tests, Myocardial Perfusion Imaging, and QoL questionnaires were studied at baseline and after completing 3 months period of cardiac rehabilitation. Results were subsequently compared, which showed a link between improved perfusion score in SPECT study and improved overall physical capacity, on one hand, and improved QoL score on the other. These results confirm that cardiac rehabilitation is a very useful treatment option for MA patients. It seems that training during cardiac rehabilitation is a very important factor (improved physical efficiency –&amp;amp;gt; increase in self-belief), and that taking into consideration the multifactor pathophysiology of pain, it is connected with a better quality of life for MA patients

Assessment of patients' level of satisfaction with nursing care during hospitalisation in the General Surgery Ward

Quality of nursing care shows the extent to which nursing care contributes to reach the desired effects of nursing. To measure the quality of medical services one should examine patient satisfaction of the given services. The aim of this study was to evaluate the level of patient satisfaction of nursing care during hospitalisation at the Department of General Surgery in the Saint Lucas Provincial Hospital in Tarnow. The study was conducted among a group of 100 patients hospitalised at the Department of General Surgery in the Saint Lucas Provincial Hospital in Tarnow, who were subject to a planned surgery. This group consisted of 47 women and 53 men. This research was based on a diagnostic opinion poll. The Newcastle Satisfaction with Nursing Scale (NSNS) – an instrument for assessment of quality of nursing care – was used as the research tool. The research tool consisted of three parts containing 48 closed questions, one open-ended question, and the respondents' characteristics. The nursing care was most commonly (53%) evaluated by patients as very good, by 30% of them as good, and by 15% as fair enough. Only a few individuals considered it bad or very bad. The average level of satisfaction reached 78.67 points (SD = 18.19) on a scale from 0 to 100 points. The results varied from 7.89 up to 100 points. Half the people did not exceed 82.89 points. According to 28% of patients there are means to improve nursing care, but 24% of respondents claim that there is no possibility for improvement. 48% of patients did not have any opinion about that. The research results’ analysis shows that the nursing care at the Department of General Surgery was rated as very good or good by the majority of patients. Additionally, along with the increase of the rate of satisfaction with nursing care, satisfaction with other aspects of care grew as well. Patients who had been hospitalised at the Department of General Surgery for a longer time were more satisfied with nursing care. Few respondents gave examples of improvement of the quality of nursing care

Dietary acrylamide exposure in chosen population of South Poland

Introduction: Acrylamide is used for wide range of industry purposes and it is produced in food during heating process. Foods with high acrylamide concentration include French fries, chips, bread crust, cereal, different baked goods. The electrophilic nature of acrylamide allows to interact with biological molecules. It is easily absorbed via the ingestion, inhalation or through the skin. Objective: Evaluation of dietary exposure to acrylamide in chosen population with respect to different age groups in South Poland and assessment of health risk. Material and Methods: Food consumption survey was conducted among 3 southern provinces in Poland. Studies involved 1470 participants. A semi-Quantitative Food Frequency Questionnaire was used. Consumption data of individuals were calculated into μg/kg bw/day. Statistics was calculated for both whole group and different age groups. MOE values were calculated. Results: Average acrylamide intake was 0.85 ± 0.82 μgacrylamide/kgbw per day and calculated 95th percentile was 1.70 μgacrylamide/kgbw/day. In general total dietary exposure decreased with age from 1.51 μgacrylamide/kgbw/day for the youngest group (6–12 years old) to 0.67 μgacrylamide/kgbw/day for the oldest one (42–60 years old). The main contributor of acrylamide in diet in all age groups are bakery products. The MOE values calculated for average acrylamide exposure in diet was 212 and 365 for BMDL100.18 and 0.31 mg/kgbw/day. Conclusions: Young population consume the highest amount of acrylamide thus any efforts should be done to rise their nutritional knowledge and to decrease intake of high acrylamide products (crisps and French fries). The need for promotion of knowledge how to decrease acrylamide level especially in home-made food regardless of age is necessary

Wpływ wybranych czynników socjodemografi cznych na jakość życia chorych na stwardnienie rozsiane

Wstęp. Stwardnienie rozsiane (sclerosis multiplex - SM) jest przewlekłą chorobą demielinizacyjną o licznych objawach klinicznych, takich jak: zaburzenia koordynacji i równowagi, zaburzenia widzenia, niedowłady, nasilone zmęczenie, zaburzenia nastroju, spastyczność czy parestezje. Cel. Analiza wpływu czynników socjodemograficznych na jakość życia chorych na stwardnienie rozsiane. Materiał i metody. Badanie przeprowadzono wśród 105 pacjentów Szpitala Wojewódzkiego im. św. Łukasza oraz członków Stowarzyszenia Stwardnienia Rozsianego w Tarnowie w 2015 roku. Kryterium włączenia było rozpoznanie SM oraz dobrowolna zgoda chorego na udział w badaniu. W badaniu posłużono się Skalą EQ-5D (Health related quality of life questionnaire), Skalą EQ-VAS (EuroQol-visual analogue scales), Rozszerzoną Skalą Niewydolności Ruchowej Kurtzkego (EDSS) oraz kwestionariuszem ankiety własnego autorstwa. Wyniki. Wysoką samoocenę własnego stanu zdrowia oraz wyższą jakość życia we wszystkich wymiarach miały częściej osoby w pełni wydolne funkcjonalnie (p < 0,0001). Analiza badań wykazała, że 65,7% osób nie zgłaszało problemów w zakresie samoopieki. Osoby młodsze istotnie częściej nie miały problemów z mobilnością (p = 0,0006), samoopieką (p = 0,0328). Rzadziej występował u nich również niepokój czy przygnębienie (p = 0,0022). Osoby z wykształceniem wyższym rzadziej odczuwały ból/dyskomfort (60,9%). Wnioski. Samoocena jakości życia badanych zależy istotnie od wieku badanych, stanu cywilnego, wykształcenia oraz źródła utrzymania.Introduction. Multiple sclerosis (MS) is a chronic demyelinising disease with numerous clinical signs, such as: balance and coordination disorders, visual disturbances, muscle weakness, paresis, feeling of chronic fatigue, mood disorders, genitourinary dysfunction, spasticity and paresthesias. Aim. Analysis of the infl uence of sociodemographic factors on the quality of life of patients with multiple sclerosis. Material and methods. The research covered 105 patients and was conducted at St. Luke´s Regional Hospital and in the Multiple Sclerosis Association in Tarnow in 2015. The criterion for inclusion was medical diagnosis of multiple sclerosis and the voluntary consent of the patient to participate in the research. The study used: the EQ-5D (Health related quality of life questionnaire), the EQ-VAS (EuroQol-visual analogue scale), the EDSS (Kurtzke Expanded Disability Status Scale ) and the authors’ original questionnaire. Results. High self-esteem regarding their own health condition and higher quality of life in all dimensions were shown more often by people with full functional efficiency (p <0.0001). The research analysis showed that 65.7% of the people reported no problems in terms of self-care. Younger people significantly more frequently had no problems with mobility (p = 0.0006), self-care (p = 0.0328). Also, anxiety or depression were less frequent among them (p =0.0022). People with higher education were less likely to feel pain / discomfort (60.9%). Conclusions. Self-assessment of the quality of life of the respondents depends significantly on age, marital status, education and the source of livelihood

Comparison of the efficiency of two commercial kits – ELFA and Western blot in estimating the phase of <i>Toxoplasma gondii</i> infection in pregnant women

Sera of 89 pregnant women were selected according to the results of ELFA IgM, IgG and avidity IgG, and tested with commercial tests IgM, IgG and avidity IgG Western Blot (WB) to compare the efficacy of both techniques in determining the phase of T. gondii infection. In total, 81 of 89 tested sera (91.0%) were classified as positive, both in the ELFA and WB tests for the presence of anti- Toxoplasma antibodies of class IgG, indicating a past infection, while the prevalence of anti- Toxoplasma positive reactions associated with the antibodies of class IgM indicating a recent infection was much lower – 31.5% and 20.2%, respectively. Sera of 81 women were also tested in the ELFA and WB tests for avidity, e.g. ability of forming high-molecular IgG antibody complexes. Low or medium results in these tests (in this study all classified as low), indicating a recent infection, were detected by ELFA and WB in 22.2% and 45.7% of the total examined samples, respectively. The Spearman’s rank test for correlation, performed for recognition of quantitative data of the ELFA and WB tests (index, units or points), revealed a highly significant correlation between the ELFA and WB tests for homologous classes of antibodies, both for IgM and IgG (p0.05), except for the WB test for IgM antibodies, which showed a significant correlation with the ELFA test for IgG antibodies (p<0.01). A highly significant negative correlation between the ELFA and WB test for IgM antibodies and ELFA and WB tests for IgG avidity was demonstrated (p<0.01), except for a relationship between the WB test for IgM and WB for avidity, which was not significant. Such negative correlations are theoretically expected, as strong complexes with the participation of IgG antibodies are absent in the early phase of toxoplasmosis when early antibodies of IgM class are present. Summarizing, this study indicates the high usefulness of the commercial ELFA and WB tests in serodiagnostics of toxoplasmosis in pregnant women. Special attention should be paid to parallel detection of IgM antibodies and low values in the ELFA and WB tests for IgG avidity, which indicates a recent infection which may be associated with a clinical form of congenital toxoplasmosis and damage to the foetus