Predyktory objawów depresyjnych u pacjentów po udarze mózgu – obserwacja trzymiesięczna

Background and purpose Depression is one of the most common post-stroke complications, which could impair rehabilitation outcome and quality of life, and could also increase mortality after stroke. The aim of the present study was to assess the association between demographic, socioeconomic and clinical (stroke risk factors, type of stroke, location of vascular lesion, cognitive functions) factors on the presence and severity of post-stroke depressive symptoms in patients after first ever stroke as well as on their social functioning. Material and methods A prospective, cohort study with a three-month observation period was performed in seven centres. Severity of depressive symptoms was assessed with the help of a short, 15-item version of the Geriatric Depression Scale (GDS), 3 months after stroke onset. Results On the basis of GDS (GDS ≤ 5 points or > 5 points) patients were allocated to a group without (n = 160) or with symptoms suggestive of depression (n = 82). The study groups did not differ with respect to age, sex or place of residence. Univariate logistic regression analysis showed that independent predictors for the presence of symptoms suggestive of depression at 3 months after stroke were: low level of education, low income, greater severity of stroke, worse functional status, self-reported problems with daily-living activities and need of help in daily living activities. More than 60% of patients with depressive symptoms limited their social contacts. Patients with depressive symptoms were unsatisfied with their relations with life partners and friends. Conclusions Our study showed a complex aetiology of post-stroke depressive symptoms with an important role of socioeconomic factors. Depressive symptoms after stroke worsen existing health, social and economic problems, and cause social isolation of patients.Wstęp i cel pracy Depresja jest jednym z najczęstszych powikłań udaru mózgu, które znacząco wpływa zarówno na postęp rehabilitacji po udarze, jakość życia pacjentów, jak i umieralność. Celem badania była ocena wpływu czynników demograficznych oraz klinicznych związanych z udarem (czynniki ryzyka udaru mózgu, typ udaru, lokalizacja ogniska naczynio-pochodnego, nasilenie deficytu neurologicznego, funkcje poznawcze) na występowanie i nasilenie objawów depresyjnych u pacjentów po pierwszym w życiu udarze mózgu. Oceniano również funkcjonowanie społeczne pacjentów po udarze mózgu w zależności od nasilenia objawów depresyjnych. Materiał i metody Prospektywne, kohortowe badanie z 3-miesięcznym okresem obserwacji prowadzono w 7 ośrodkach. Nasilenie objawów depresyjnych po 3 miesiącach od udaru oceniano w 15-punktowej wersji Geriatrycznej Skali Depresji (Geriatric Depression Scale – GDS). Wyniki Na podstawie wyników uzyskanych w skali GDS (GDS ≤ 5 lub > 5 punktów) wyodrębniono grupę pacjentów bez depresji (n = 160) i z objawami sugerującymi depresję (n = 82). Chorzy z obu grup nie różnili się pod względem wieku, płci i miejsca zamieszkania. Znaczącymi predyk-torami występowania nasilonych objawów depresyjnych u pacjentów po udarze mózgu były: niższy poziom wykształcenia, niższe dochody, gorszy stan neurologiczny i funkcjonalny oraz trudności w życiu codziennym i potrzeba pomocy. Ponad 60% pacjentów z objawami depresyjnymi ograniczyło po udarze kontakty społeczne. Chorzy z objawami sugerującymi depresję oceniali gorzej swoje kontakty z rodziną i przyjaciółmi. Wnioski Badanie pokazuje złożoność przyczyn występowania objawów depresyjnych po udarze mózgu, wśród których istotną rolę odgrywają również czynniki społeczno-ekonomiczne. Występowanie objawów depresyjnych po udarze mózgu powoduje dodatkowo narastanie istniejących problemów oraz izolację społeczną chorych

Predyktory objawów depresyjnych u pacjentów po udarze mózgu : obserwacja trzymiesięczna

Background and purpose Depression is one of the most common post-stroke complications, which could impair rehabilitation outcome and quality of life, and could also increase mortality after stroke. The aim of the present study was to assess the association between demographic, socioeconomic and clinical (stroke risk factors, type of stroke, location of vascular lesion, cognitive functions) factors on the presence and severity of post-stroke depressive symptoms in patients after first ever stroke as well as on their social functioning. Material and methods A prospective, cohort study with a three-month observation period was performed in seven centres. Severity of depressive symptoms was assessed with the help of a short, 15-item version of the Geriatric Depression Scale (GDS), 3 months after stroke onset. Results On the basis of GDS (GDS ≤ 5 points or > 5 points) patients were allocated to a group without (n = 160) or with symptoms suggestive of depression (n = 82). The study groups did not differ with respect to age, sex or place of residence. Univariate logistic regression analysis showed that independent predictors for the presence of symptoms suggestive of depression at 3 months after stroke were: low level of education, low income, greater severity of stroke, worse functional status, self-reported problems with daily-living activities and need of help in daily living activities. More than 60% of patients with depressive symptoms limited their social contacts. Patients with depressive symptoms were unsatisfied with their relations with life partners and friends. Conclusions Our study showed a complex aetiology of post-stroke depressive symptoms with an important role of socioeconomic factors. Depressive symptoms after stroke worsen existing health, social and economic problems, and cause social isolation of patients

Co-occurrence of Artemisia and Ambrosia pollen seasons against the background of the synoptic situations in Poland

The Asteraceae family is one of the largest families, comprising 67 genera and 264 species in Poland. However, only a few genera, including Artemisia and Ambrosia are potential allergenic sources. The aim of the study was to estimate how often and to what degree Artemisia and Ambrosia pollen seasons co-occur intensifying human health risk, and how synoptic situations influence frequency of days with high pollen concentrations of both taxa. Artemisia and Ambrosia pollen data were collected, using the volumetric method, at 8 sites in Poland. Daily concentrations of Artemisia pollen equal to 30 grains or more and Ambrosia pollen equal to 10 grains or more were accepted as high values. Concentrations of more than 10 pollen grains were defined as high in the case of Ambrosia because its allergenicity is considered higher. High concentrations were confronted with synoptic situations. Analysis was performed on the basis of two calendars on circulation types of atmosphere in Poland (Niedźwiedź, 2006, 2015). Co-occurrence of Artemisia and Ambrosia pollen seasons is being found most often, when Ambrosia pollen season starts in the first half of August. If it happens in the last 10 days of August high pollen concentrations of Artemisia and Ambrosia do not occur at the same days. At three sites (Sosnowiec, Rzeszów, Lublin) high Ambrosia pollen concentrations during the Artemisia pollen season appear more often than in other sites under question. The high Artemisia pollen concentrations occur, when continental or polar maritime old air masses inflow into Poland. The impact of air masses on high Ambrosia pollen concentrations depends on site localizations. It is likely, that in the south-eastern part of Poland high Ambrosia pollen concentrations result from the pollen transport from east-south-south-westerly directions and the local sources. Co-occurrence of both taxa pollen seasons depends on the air masses inflow and appears more often in a southeastern part of Poland

Fenologiczne fazy kwitnienia i sezony pyłkowe wybranych taksonów drzew w Krakowie w latach 2009-2011 na tle warunków meteorologicznych

Celem badań było porównanie faz fenologicznych ze stężeniem pyłku wybranych drzew wczesnowiosennych. Szczególną uwagę zwrócono na panujące wówczas warunki meteorologiczne sprzyjające lub nie kwitnieniu i uwalnianiu pyłku. W tym celu wykorzystano obserwacje fenologiczne, stężenie pyłku i dane meteorologiczne w 5 stanowiskach w centrum Krakowa w latach 2009–2011. Analizie poddano 5 faz fenologicznych 4 gatunków drzew: Alnus glutinosa, Alnus incana, Corylus avellana i Betula pendula. Stwierdzono, że w przypadku Alnus glutinosa sezon pyłkowy często poprzedzał fazę kwitnienia podczas gdy u Alnus incana te dwa okresy były bardziej skorelowane. W przypadku Corylus avellana początek sezonu pyłkowego i fazy kwitnienia były równoczesne. Niemniej jednak ziarna pyłku występowały dłużej nawet o kilkanaście dni. Zarówno fenologiczne fazy kwitnienia jak i sezony pyłkowe były uzależnione od warunków meteorologicznych. Zastosowano analizę Spearmana do stwierdzenia czy istnieje związek między stężeniem pyłku i warunkami meteorologicznymi. Wysokie stężenie pyłku Alnus i Corylus występowało w dniach słonecznych z maksymalną temperaturą powyżej 10°C bez opadów i po zaniku pokrywy śnieżnej. W przypadku Betula fenologiczne fazy kwitnienia pokrywały się zazwyczaj z wysokim stężeniem pyłku. Jednak pyłek Betula pojawia się czasami wcześniej i pozostaje dłużej w powietrzu niż okres kwitnienia lokalnych drzew w najbliższej okolicy, co wskazuje na daleki transport lub redepozycję.The aim of the study was to compare phenological observations of pollen seasons of selected early spring trees. Special attention was paid to meteorological conditions which favored or did not favor tree flowering and pollen release. For this reason, we used phenological observation, pollen counts, and meteorological data in five sites in the center of Kraków in the period 2009–2011. Phenological phases (5) of four tree species: Alnus glutinosa, Alnus incana, Corylus avellana, and Betula pendula, were analyzed. It was found that in case of A. glutinosa the pollen season often preceded the flowering period, while for A. incana those two phenomena were more correlated. As regards Corylus avellana, the beginning of the pollen season and phenological phases was simultaneous. However, pollen grains occurred in the air longer, even by a dozen or so days. The phenological phases and pollen seasons of Alnus and Corylus were dependent on meteorological conditions. To give the definition of the relationship between pollen concentration and weather conditions, Spearman rank correlation analysis was applied. High Alnus and Corylus pollen concentrations were found on sunny days with a maximum temperature over 10°C and no precipitation, and when the snow cover was gone. In case of Betula, the phenological phases of the full pollination period usually coincided with the periods of high pollen concentrations. However, Betula pollen sometimes appears earlier and stays in the air longer than the flowering period of local trees in the nearest vicinity. This situation indicates long-distance transport or secondary deposition

STD care: variations in clinical care associated with provider sex, patient sex, patients' self-reported symptoms or high-risk behaviors, partner STD history

Sexually transmitted diseases in the United States are frequently diagnosed by private, as well as public, physicians. However, we know little about the decision processes that physicians employ when faced with people who may or may not be infected. To address this gap, we compared physicians' responses to different patient vignettes to assess how variations in patients' presentations affect physicians' clinical behavior. We systematically varied reported symptoms, behavioral risk, partner STD, and sex of patients in 16 different vignettes, with one vignette randomly presented to each physician in a national survey. Physicians rated the likelihood of 12 clinical management actions they might take with the patient vignette presented. Responses varied with self-reported symptoms, high-risk behavior, and report of an STD infected partner such that female physicians were more attentive to sexual health, and all physicians were more likely to treat female patients aggressively, relative to their male patients. Overall behavior was broadly congruent with sound medical practice, although we discuss several caveats to this general statement.STD care Sexual health Physician decision-making USA