Wojciech M Orzechowski, Bartosz Fiderkiewicz, Paweł Żebrowski, Andrzej Rydzewski, Andrzej Kokoszka
{"title":"[Brief measure to assess patient perception of self-influence on the disease course-version for hemodialysis].","authors":"Wojciech M Orzechowski, Bartosz Fiderkiewicz, Paweł Żebrowski, Andrzej Rydzewski, Andrzej Kokoszka","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Self-influence on the disease course has a significant impact on coping with disease and adherence to medical recommendations.</p><p><strong>Aim: </strong>Elaboration of a brief scale for screening of patient perception of self-influence on the course of disease among hemodialysis, which could be used during usual medical practice.</p><p><strong>Methods: </strong>In the first stage of the study, based on a group focus interview with 6 hemodialysis (mean age 65.2 ± 14.8 year)--5 women (83%) and 1 men (17%), mean time of dialysis 43.8 ± 38 months, a list of 51 characteristics of patients with low (LP) and high perception (HP) of self-influence on the curse of disease, was constructed. In the second stage 99 patients (mean age 66.1 ± 14.7 year)--51 men (52%) and 48 women (48%), mean time of dialysis 48.7 ± 48.1 months, assessed scale reliability. They were selected by their nephrologists to groups with LP and HP. Based on the results 11 items had the strongest power of discrimination of those two groups. 15 (13.2%) hemodialysis refused to participate at this part of study. In a third step 70 (mean age 68 ± 13.3 year) patients--40 men (57.1%) and 30 women (42.9%), mean time of dialysis 48.1 ± 45.6 months, assessed validity of the tool.</p><p><strong>Results: </strong>The reliability alfa-Cronbach = 0.9 and validity tau-Kendall = 0.6.</p><p><strong>Conclusions: </strong>Scale has a very high reliability and satisfactory validity. It can be used for those of hemodialysis who have problems with adherence to medical recommendations or have difficulty in contact with the medical staff or other patients.</p>","PeriodicalId":21148,"journal":{"name":"Przeglad lekarski","volume":"73 1","pages":"20-4"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34436201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Maria Ignacak, Natalia Celejewska-Wójcik, Krzysztof Wójcik, Kinga Sałapa, Ewa Konduracka, Marek Sanak, Katarzyna Tyrak, Krzysztof Sładek, Jacek Musiał, Lucyna Mastalerz
{"title":"[Induced sputum supernatant prostaglandin E2 during oral aspirin challenge of asthmatic patients with and without aspirin hypersensitivity and healthy controls--pilot study].","authors":"Maria Ignacak, Natalia Celejewska-Wójcik, Krzysztof Wójcik, Kinga Sałapa, Ewa Konduracka, Marek Sanak, Katarzyna Tyrak, Krzysztof Sładek, Jacek Musiał, Lucyna Mastalerz","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The aim of this pilot study was to evaluate changes in the concentration of prostaglandin E2 (PGE2) in induced sputum supernatant in 3 groups: sub- jects with NSAID-exacerbated respira- tory disease (NERD), aspirin tolerant asthma (ATA) and healthy controls (HC), before and after oral aspirin chal- lenge test. The study was conducted in the years 2014-2015 at the Clinical Department of the Pulmonology Clinic at the University Hospital in Cracow. 43 patients were enrolled in the study (NERD - n = 15, ATA - n = 15 and HC - n = 13). All of them underwent a placebo-controlled oral aspirin challenge. Sputum was induced 24 hours before the challenge and immediately after the test. Induced sputum was processed in order to obtain cystospin slides to depict inflammatory cell patterns and supernatants, in which PGE2 was measured. The concentration of PGE2 was determined using mass spectrometry coupled with gas chromatography (gas chromatography/mass spectrometry - GC/MS). After aspirin challenge, the concentration of PGE2 in induced sputum supernatant decreased in both asthmatics hypersensitive to aspirin (p = 0.01) and those who tolerated aspirin well (p = 0.17). The change in the healthy control group was not statistically significant. These results support the cyclooxygenase theory of PGE2 inhibition by aspirin. However, the mechanism of bronchoconstriction after aspirin administration alone in patients with NSAID-exacerbated respiratory disease remains unclear.</p>","PeriodicalId":21148,"journal":{"name":"Przeglad lekarski","volume":"73 2","pages":"93-6"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34498651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sławomir Kroczka, Katarzyna Stasiak, Marek Kaciński
{"title":"[Neurophysiological parameters in myasthena gravis in children in diagnostic and therapeutic view].","authors":"Sławomir Kroczka, Katarzyna Stasiak, Marek Kaciński","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Myasthenia gravis (MG) is an autoimmunologic disorder. It is characterized by various clinical symptoms and their dependency upon the exertion and the rest as well.</p><p><strong>Material and methods: </strong>Between 2002-20014 in the Neurophysiology Laboratory at the Chair of Pediatric and Adolescent Neurology, Jagiellonian University in Krakow, the electrophysiological repetitive nerve stimulation study were performed in 44 children. The clinical picture and positive electrophysiological test were the ground to diagnose MG in 19 of them (12 girls and 7 boys). The mean age at onset of MG in the examined group was 12.8 years. In 5 patients the diagnosis was completed using edrophonium test. In 14patients the titer of AchRAb was also tested. In 18 patients with MG the radiological examinations of the chest were performed. In 14/19 patients with MG the control electrophysiological testing was performed 2 to 8 months after the first one.</p><p><strong>Results: </strong>The gen-ralized MG was diagnosed in 14 patients, and ocular in 2 of them. The amplitude of electro-physiological testing was normal during the first response in all patients, but the decrement of amplitude 4:1 in patients with MG was 26% to 88%. In 3 patients with MG the persisted thymus, while in 7 hypertrophy of thymus, in 2 thymoma nad inl thyinflammation of the thymus was detected. In 5 children the result of chest examination was normal. Among 5/8 patients (62.5%) with positive AChRAb, in one ocular MG was diagnosed, in the other 7 generalized MG. The titer of AChRAb was between 0.4 and 30.8 nmol/l (mean 9.44 nmol/l), and the decrement of amplitude 4:1 was 22% to 58%.. In the treatment pirydostygmine bromide (Mestinon) was used in all children, however in 4 of them together with azathioprine, and in 7 with steroids. In the treatment of myasthenic crisis in 5 patients plasmapheresis was performed. In 42% of patients thymectomy was performed during the first year after diagnosis. The clinical remission was succeed in 90,9% patients. The electrophysiological control examination detected the decrement of amplitude 4:1 in 1% to 80% (mean 36%). The electrophysiological remission, correlating with clinical remission was achieved in 2 patients. In 6/10 patients with clinical remission, the decrement of amplitude 4:1 in electrophysiological examination continued to be at the level similar to initial examination. In 1 patient remission was complete allowing significant reduction of doses of Mestinon, even though in the electrophysiological test the decrement was 80%.</p><p><strong>Conclusions: </strong>(1) Among hospitalized children, the generalized myasthenia was the most common. (2) Neurophysiological studies plays still fundamental role in diagnostic methods in the diagnosis of myasthenia gravis in children. (3) The correlation of the clinical state and electrophysiological results was not established.</p>","PeriodicalId":21148,"journal":{"name":"Przeglad lekarski","volume":"73 3","pages":"119-23"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34613772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jacek Zawierucha, Jolanta Małyszko, Jacek Małyszko, Teresa Dryl-Rydzyńska, Tomasz Prystacki, Wojciech Marcinkowski
{"title":"[Treatment of secondary hyperparathyroidism in hemodialysed patients--paricalcitol with or without cinacalcet].","authors":"Jacek Zawierucha, Jolanta Małyszko, Jacek Małyszko, Teresa Dryl-Rydzyńska, Tomasz Prystacki, Wojciech Marcinkowski","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Secondary hyperparathyroidism (sHPT) is a common complication being a consequence of metabolic disorders associated with chronic kidney disease (CKD). Treatment of the sHPT should lead to calcium-phosphate management stabilization and parathyroid hormone levels reduction. The phosphate binders, synthetic vitamin D analogs and calcimimetics are used in sHPT treatment. In this paper we analyzed the results of three month paricalcitol treatment of 36 hemodialysis patients with sHPT (serum iPTH> 500 pg/ml). 11 patients have additionally received cinacalcet. Analysis of the results showes a statistically significant reduction in iPTH and alkaline phosphatase. Paricalcitol is effecitve in the tratment of SHPT with favourable profile of side effects. Alcaline phosphatase reduction may be a desirable additional therapeuctic effect. However, it appears that combined therapy with paricalcitol and cinacalcet shoud be offered to selected population of patients i.e. with hypocalcemia after calcimimetics.</p>","PeriodicalId":21148,"journal":{"name":"Przeglad lekarski","volume":"73 4","pages":"229-32"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34309046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Myocardial infarction in the course of digoxin and\u0000theophylline poisoning].","authors":"Kamil Zaleski, Agnieszka Górska, Malgorzata Kołodziej, Agnieszka Witkowska, Anna Kujawa, Zuzanna Przykaza, Jaroslaw Szponar","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The aim of this paper is to present\u0000a case of the patient who was hospitalized\u0000in the Toxicology and Cardiology\u0000Department because of suicidal digoxin\u0000and theophylline intoxication. Both\u0000drugs have complicated mechanism\u0000of action and affect cardiovascular\u0000system differently, but both predispose\u0000to ventricular and supraventricular\u0000arrhythmias. In the presented patient\u0000conduction disorders, cardiac muscle\u0000repolarization disorders and ventricular\u0000arrhythmias typical to digoxin\u0000poisoning were observed. During hospitalization\u0000the patient experienced the\u0000ECG and biochemical abnormalities\u0000resulting from myocardial infarction.\u0000In our paper we have analyzed digoxin\u0000and theophylline mechanisms of action\u0000and possible impact of each of\u0000these drugs on the clinical symptoms\u0000that our patient presented.</p>","PeriodicalId":21148,"journal":{"name":"Przeglad lekarski","volume":"73 8","pages":"599-603"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36027650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}