New onset diabetes after transplantation (NODAT) : scientific data review

New onset diabetes after transplantation (NODAT) is one of the most common and serious complications of solid organ transplantation. The incidence of NODAT is estimated to range from 2% to 53%. Patients who develop new onset diabetes after transplantation are significantly more frequently exposed to a higher risk of death and cardiovascular incidents as well as other adverse effects, such as decreased patient survival, higher infection rates and early graft loss. Identifying high-risk patients, undertaking preventive action and applying appropriate treatment can limit the development of new onset diabetes after transplantation and improve a patient’s long-term prognosis

Promotion of healthy nutrition of seafarers

Nutrition disorders arise from various interacting factors: cultural, environmental, genetic, physiological, and psychological. Excessive consumption of highly processed food, sugar, salt, alcohol, and saturated fats is a problem nowadays, and consumption of fish, vegetables, and fruit is insufficient. Overeating and an unbalanced diet are often accompanied by stress and a lack of physical activity. This is intensified by easy access to “comfort food”, “fast food”, and “junk food”. The number of people suffering from overweight and obesity, so-called diseases of civilization, is increasing. Not only is being overweight a risk factor for the development many other metabolic diseases, but it also significantly worsens the quality of life. This also concerns people working at sea. Obesity is favoured by emotional eating disorders (EED), uncontrolled/compulsive eating - binge eating disorders (BED), and night eating disorders (NED). Most frequently, eating is a reaction to stress or boredom. It alleviates tension and improves the mood, also of seafarers

Wybrane aspekty oceny funkcjonowania pacjentów geriatrycznych

Introduction. As time passes by and the aging proceeds, the state of one’s health also changes. Chronic, progressive illnesses appear and limit one’s self-reliance. The aim of this study was to evaluate chosen functional fitness factors in geriatric patients and to analyze problems in caring.Material and methods. The study was conducted in 2010 among 109 patients from the Department and Clinic of Geriatrics. Research tools included: the Care Dependency Scale questionnaire (the CDS); Polish version, Katz Activities of Daily Living Scale (ADL) questionnaire, Lawton Instrumental Activities of Daily Living (IADL) Scale questionnaire.Results. Everyday and instrumental activities in the surveyed group were estimated at medium to high level. The majority of the patients surveyed were found to be at medium to low level of care dependency in CDS scale. The correlation between values tested for in ADL scale and the dependency on care tested for with CDS scale has been confirmed.Conclusions. Among the patients surveyed, the most prominent problems included the difficulties in adjusting the proper body position, mobility limitations and limitations in participating in recreational activities outside without help. The remaining needs were met at a medium level. The general assessment of functional capability was estimated at a medium to high level.Wstęp. Wraz z upływem czasu oraz postępem procesu starzenia zmienia się stan zdrowia, pojawiają się schorzenia o charakterze przewlekłym i postępującym, które ograniczają samodzielne funkcjonowanie.Celem badań było ocena wybranych parametrów sprawności funkcjonalnej pacjentów geriatrycznych oraz analiza problemów pielęgnacyjnych.Materiał i metody. Badania przeprowadzono w 2010 roku wśród pacjentów Katedry i Kliniki Geriatrii w liczbie 109 osób. Narzędziami badawczymi były: kwestionariusz (CDS) Care Dependency Scale - wersja polska; kwestionariusz oceny sprawności codziennej (ADL) na podstawie skali Katza, kwestionariusz oceny złożonych czynności życia codziennego (IADL) na podstawie skali Lawtona.Wyniki. Czynności dnia codziennego oraz czynności instrumentalne w badanej grupie kształtowały się na średnim i wysokim poziomie. Większość badanych pacjentów znajdowała się na średnim i niskim poziomie zależności od opieki w skali CDS. Potwierdzono istnienie korelacji między wartościami badanymi w skali sprawności funkcjonalnej ADL a zależnością od opieki badaną skalą CDS.Wnioski. U badanych pacjentów najważniejszymi problemami były trudności w realizacji potrzeb przyjęcia odpowiedniej pozycji ciała, ograniczenia w poruszaniu się oraz ograniczenia w uczestniczeniu w zajęciach rekreacyjnych poza domem bez niczyjej pomocy. Pozostałe potrzeby były zaspokajane na średnim poziomie. Ogólna sprawność funkcjonalna była oceniona na średnim i wysokim poziomie

The selected aspects of geriatric patients’ functioning evaluation

Introduction. As time passes by and the aging proceeds, the state of one’s health also changes. Chronic, progressive illnesses appear and limit one’s self-reliance. The aim of this study was to evaluate chosen functional fitness factors in geriatric patients and to analyze problems in caring. Material and methods. The study was conducted in 2010 among 109 patients from the Department and Clinic of Geriatrics. Research tools included: the Care Dependency Scale questionnaire (the CDS); Polish version, Katz Activities of Daily Living Scale (ADL) questionnaire, Lawton Instrumental Activities of Daily Living (IADL) Scale questionnaire. Results. Everyday and instrumental activities in the surveyed group were estimated at medium to high level. The majority of the patients surveyed were found to be at medium to low level of care dependency in CDS scale. The correlation between values tested for in ADL scale and the dependency on care tested for with CDS scale has been confirmed. Conclusions. Among the patients surveyed, the most prominent problems included the difficulties in adjusting the proper body position, mobility limitations and limitations in participating in recreational activities outside without help. The remaining needs were met at a medium level. The general assessment of functional capability was estimated at a medium to high level.Wstęp. Wraz z upływem czasu oraz postępem procesu starzenia zmienia się stan zdrowia, pojawiają się schorzenia o charakterze przewlekłym i postępującym, które ograniczają samodzielne funkcjonowanie. Celem badań było ocena wybranych parametrów sprawności funkcjonalnej pacjentów geriatrycznych oraz analiza problemów pielęgnacyjnych. Materiał i metody. Badania przeprowadzono w 2010 roku wśród pacjentów Katedry i Kliniki Geriatrii w liczbie 109 osób. Narzędziami badawczymi były: kwestionariusz (CDS) Care Dependency Scale - wersja polska; kwestionariusz oceny sprawności codziennej (ADL) na podstawie skali Katza, kwestionariusz oceny złożonych czynności życia codziennego (IADL) na podstawie skali Lawtona. Wyniki. Czynności dnia codziennego oraz czynności instrumentalne w badanej grupie kształtowały się na średnim i wysokim poziomie. Większość badanych pacjentów znajdowała się na średnim i niskim poziomie zależności od opieki w skali CDS. Potwierdzono istnienie korelacji między wartościami badanymi w skali sprawności funkcjonalnej ADL a zależnością od opieki badaną skalą CDS. Wnioski. U badanych pacjentów najważniejszymi problemami były trudności w realizacji potrzeb przyjęcia odpowiedniej pozycji ciała, ograniczenia w poruszaniu się oraz ograniczenia w uczestniczeniu w zajęciach rekreacyjnych poza domem bez niczyjej pomocy. Pozostałe potrzeby były zaspokajane na średnim poziomie. Ogólna sprawność funkcjonalna była oceniona na średnim i wysokim poziomie

The Framework of Leader’s Skills in Lean Manufacturing in the Chinese Automotive Industry – Empirical Results

Background. China is one of the most attractive investment destinations for the biggest global automotive players, and Lean Manufacturing (LM) is their most established business improvement methodology enhancing the automotive industry's performance. Despite intensive investments in LM, the automotive industry is still not able to employ Lean philosophy effectively at Chinese locations. Research aims. Theoretical and empirical questions arise on how to improve the situation in terms of Lean Manufacturing performance at Chinese locations. Thus, in the paper, we pose that if we assume leadership is the crucial enabler in LM implementation, there is an urgent need to address the conditions of Chinese leadership. Method. Basing on the content analysis of existing job offers we estimated the alignments of demands of the job posed by the unique context of Chinese culture with the profiles of candidates that are mostly wanted. Key findings. The content analysis revealed that in job offers there is an underestimation of cultural intelligence skills. The aforementioned analysis led us to the proposition of how to improve leadership in China by introducing a model of Chinese leadership center development denoted as a “China Lean Center”. The Center can be used by practitioners to develop in-house skillful and culturally aware leaders in order to enable successful implementation of LM at Chinese locations

The global risk of pressure ulcers among elderly patients: initial diagnosis

Background. Prevention is the most effective method of reducing the risk of pressure ulcers. Prophylaxisinvolves several actions and procedures that can decrease the risk and aid implementation of rapidtreatment if pressure ulcers develop.Aim. To evaluate the risk of pressure ulcers in elderly patients.Material and methods. The study group involved patients hospitalized at the Department and Clinic ofGeriatric Medicine in Bydgoszcz: 82 females and 34 males (116 in total). The study used a diagnostic pollmethod with the application of an ADL (Activities of Daily Living) questionnaire to assess daily efficiencyon the basis of the Katz Scale, CDS (Care Dependency Scale) questionnaire to measure the level of caredependency and human needs, and a risk scale for pressure ulcer development devised by D. Norton.Results. The risk of pressure ulcers was observed in approximately one third of the study subjects (30.2%).Almost a half of the patient group had multiple morbidities. Problems concerning the care of patientswith a high risk of pressure ulcers were usually connected with a lack of independence in changing bodyposition, movement, dressing, and sphincter dysfunction.Conclusion. There is a correlation between the level of functional capability and the risk of pressureulcers. The accumulation of problems related to the lack of independence in fulfilling the patients’ ownneeds significantly increased the risk of pressure ulcers in the study group.Background. Prevention is the most effective method of reducing the risk of pressure ulcers. Prophylaxisinvolves several actions and procedures that can decrease the risk and aid implementation of rapidtreatment if pressure ulcers develop.Aim. To evaluate the risk of pressure ulcers in elderly patients.Material and methods. The study group involved patients hospitalized at the Department and Clinic ofGeriatric Medicine in Bydgoszcz: 82 females and 34 males (116 in total). The study used a diagnostic pollmethod with the application of an ADL (Activities of Daily Living) questionnaire to assess daily efficiencyon the basis of the Katz Scale, CDS (Care Dependency Scale) questionnaire to measure the level of caredependency and human needs, and a risk scale for pressure ulcer development devised by D. Norton.Results. The risk of pressure ulcers was observed in approximately one third of the study subjects (30.2%).Almost a half of the patient group had multiple morbidities. Problems concerning the care of patientswith a high risk of pressure ulcers were usually connected with a lack of independence in changing bodyposition, movement, dressing, and sphincter dysfunction.Conclusion. There is a correlation between the level of functional capability and the risk of pressureulcers. The accumulation of problems related to the lack of independence in fulfilling the patients’ ownneeds significantly increased the risk of pressure ulcers in the study group

Effects of creatine supplementation on brain in the healthy population

Introduction and purpose:  Creatine supplementation is playing an increasingly important role not only in sports, but is beneficial in the context of brain health (e.g., cognitive processing, brain function and recovery from injury). This is a growing field of research, and the purpose of this brief review is to provide an update on the effects of creatine supplementation on brain health in healthy people. Description of the state of knowledge: Creatine, is an organic compound produced mainly by the liver and kidneys. From the liver, kidneys and gastrointestinal tract, creatine enters through the bloodstream into skeletal muscle, where a total of about 95% of the body's total creatine is stored. It is stored in the muscles, heart and brain. Summary: There is potential for creatine supplementation to improve cognitive processing, especially in conditions characterized by creatine deficits in the brain, which can be triggered by acute stress factors (e.g., exercise, lack of sleep) or chronic, pathological conditions (e.g., creatine synthesis enzyme deficiencies, mild traumatic brain injury, aging, Alzheimer's disease). People with depression, the elderly, people with diseases associated with certain genetic defects (where creatine production and storage in the brain is impaired) are just some of the groups of people in whom creatine supplementation may be helpful. More research is needed to determine the clinical impact of long-term creatine supplementation dosing strategies on brain function and health

Antibiotic resistance among Escherichia coli urinary isolates and their susceptibility to clove essential oil

Escherichia coli is a Gram-negative, facultatively anaerobic, rod-shaped, coliform bacterium, which is a primary cause of urinary tract infections. Resistance to antibiotics has become a particular problem in recent decades. Consequently, there is an unmet need for new therapeutic options. It has been observed that essential oils have bactericidal effects. The antimicrobial susceptibility testing for Escherichia coli isolates obtained from urine of patients with urinary tract infections was determined via disk diffusion method according to the European Committee on Antimicrobial Susceptibility Testing (EUCAST, 2015). Essential oil from clove – Syzygium aromaticum (L.) Merill et L.M. (Myrtaceae) was analyzed by GC-FID-MS. Minimal Inhibitory Concentration (MIC) and Minimal Bactericidal Concentration (MBC) were detected by using the micro-dilution broth method. Escherichia coli clinical isolates are characterized by high resistance to ampicillin, amoxicillin with clavulanic acid, norfloxacin, trimethoprim/sulfamethoxazole, tetracycline, tobramycin and ticarcillin. Clove oil possesses strong inhibiting and killing properties against E. coli isolates, among them the ones resistant to recommended antibiotics. The results of this study highlight the need for testing the efficacy of new agents to inactivate bacteria in clinical settings

Kardiologiczne, niekardiologiczne powikłania i czynniki predykcyjne przedłużonej hospitalizacji u pacjentów bez cukrzycy z zawałem serca leczonych pierwotną przezskórną angioplastyką wieńcową

Introduction. Prolonged patient stay after acute myocardial infarction (MI) results in higher costs. This study evaluated factors prolonging hospitalization after admission due to MI. Complications which also influence on longer hospital stay: both cardiac (CC) and non-cardiac (NCC), were analysed. Material and methods. The authors included prospectively 131 patients with MI undergoing primary percutaneous intervention. Following factors were collected: demographic and anthropomorphic data, types of infarction, 12-lead electrocardiography (ECG), echocardiography, standard blood tests including admission blood glucose level, fasting glycaemia, oral glucose tolerance test (OGTT) at discharge as well as renal filtration and lipid parameters. Length of hospital stay of < 6 days or longer, the occurrence of CC and NCC were analysed. Results. The mean age of patients was 62 ± 10.9 years, 71.8% were male. Factors which correlated significantly with longer hospitalisation were: older age (R = 0.47, p = 0.001), higher fasting glycaemia (R = 0.25, p = 0.027), reduced left ventricular ejection fraction (LVEF) (R = –0.36, p = 0.04), occurrence of ST-elevation MI (p = 0.0166), presence of CC (p = 0.0007) and NCC (p = 0.0001). Age, high blood glucose in OGTT and LVEF remained significant in a multivariate model predicting the duration of stay (R2 = 0.32). Factors predicting hospital stay ≥ 6 days in the multivariate model were: older age (p = 0.000), hip circumference (p = 0.014), anterior wall MI (p = 0.026) and usage of glycoprotein IIb/IIIa inhibitors (p = 0.022) with and area under the receiver operating characteristic curve (ROC): 0.792 [95% confidence interval (CI) 0.71–0.87] with specificity 71% and sensitivity 79%. Factors influencing CC occurrence in the multivariate model were: estimated glomerular filtration rate (p = 0.009), LVEF (p = 0.003) with ROC 0.735 (95% CI 0.65–0.82) with specificity 76% and sensitivity 60%. Factors influencing the occurrence of NCC were hyperlipidaemia (p = 0.021), and LVEF (p = 0.004) with an ROC: 0.792 (95% CI 0.71–0.87) with specificity 55% and sensitivity 90%. Conclusions. LVEF, age and blood glucose levels significantly prolonged hospital stay. The major factor associated with an increased risk of both CCs and NCCs was LVEF.Wstęp. Przedłużony czas hospitalizacji po zawale serca (MI) skutkuje dodatkowymi kosztami. W opisanym badaniu oceniono czynniki wydłużające czas hospitalizacji po przyjęciu do szpitala z powodu MI. Do powikłań, które także wpływają na dłuższy okres hospitalizacji, należą zarówno kardiologiczne (CC), jak i niekardiologiczne (NCC); poddano je analizie. Materiał i metody. Prospektywnie zakwalifikowano 131 pacjentów z MI leczonych pierwotną przezskórną angioplastyką. Zebrano następujące dane: demograficzne, antropomorficzne, rodzaj zawału, 12-odprowadzeniowe badanie elektrokardiograficzne, echokardiograficzne, standardowe badania laboratoryjne, włączając oznaczenie glukozy przy przyjęciu, glukozę na czczo, doustny test tolerancji glukozy (OGTT) przy wypisaniu, a także filtrację kłębuszkową oraz parametry lipidowe. Czas hospitalizacji wynosił poniżej 6 dni lub dłużej, natomiast analizie poddano powikłania zarówno CC, jak i NCC. Wyniki. Średni wiek pacjentów wynosił 62 ± 10,9 roku, 71,8% stanowili mężczyźni. Do czynników, które znacząco korelowały z dłuższym czasem hospitalizacji, zaliczono: starszy wiek (R = 0,47; p = 0,001), wyższe stężenie glukozy na czczo (R = 0,25; p = 0,027), obniżoną frakcję wyrzutową lewej komory (LVEF) (R = –0,36; p = 0,04), występowanie zawału serca z uniesieniem odcinka ST (p = 0,0166), obecność powikłań CC (p = 0,0007) i NCC (p = 0,0001). Wiek, wysokie stężenie glukozy w OGTT przy wypisaniu oraz LVEF pozostawały znaczące w wieloczynnikowym modelu służącym przewidywaniu czasu hospitalizacji (R2 = 0,32). Do czynników służących przewidywaniu czasu hospitalizacji ponad 6 dni w modelu wieloczynnikowym należały: starszy wiek (p = 0,000), obwód w biodrach (p = 0,014), przednia ściana MI (p = 0,026), zastosowanie inhibitora glikoprotein IIb/IIIa (p = 0,022) z polem powierzchni pod krzywą (ROC): 0,792 (95-proc. przedział ufności [CI] 0,71–0,87) ze specyficznością 71% i czułością 79%. Czynnikami wpływającymi na występowanie powikłań CC w wieloczynnikowym modelu były szacowany współczynnik filtracji kłębuszkowej (eGFR) (p = 0,009), LVEF (p = 0,003) z ROC 0,735 (95% CI 0,65–0,82) ze specyficznością 76% i czułością 60%. Do czynników wpływających na wystąpienie NCC należały: hiperlipidemia (p = 0,021) i LVEF (p = 0,004) z ROC 0,792 (95% CI 0,71–0,87) ze specyficznością 55% i czułością 90%. Wnioski. Wartość LVEF, wiek oraz stężenie glukozy znacząco przedłużają czas hospitalizacji. Głównym czynnikiem związanym ze zwiększonym ryzykiem wystąpienia zarówno CC, jak i NCC była LVEF