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Open access

Davorina Petek, Marija Petek-Ster and Ksenija Tusek-Bunc

Abstract

Background

Health-related quality of life (HRQoL) is measuring a patient’s experience of his health status and represents an outcome of medical interventions. Existing data proves that a healthy lifestyle is positively associated with HRQoL in all age groups. Patients with a high risk for cardiovascular disease typically led an unhealthy lifestyle combined with risk diseases. We aimed to analyse these characteristics and their reflection in HRQoL.

Methods

A cross-sectional study in 36 family practices, stratified by location and size. Each practice invited 30 high-risk patients from the register. Data were obtained from medical records and patient questionnaire. The EQ-5D questionnaire and the VAS scale were used for measuring the patient’s HRQoL as an independent variable.

Results

871 patients (80.6% response rate) were included in the analysis. 60.0% had 3-4 uncontrolled risk factors for CVD. The average VAS scale was 63.2 (SD 19.4). The correlation of EQ-5D was found in the number of visits in the practice (r=-0.31, p<0.001), the socioeconomic status (r=-0.25, p=0.001), age (r=-0.27, p=0.001) and healthy diet (r=0.20, p=0.006). In a multivariate model, only physical activity among lifestyle characteristics was an independent predictor of HRQoL (p=0.001, t=3.3), along with the frequency of visits (p<0.001, t=-5.3) and age (p=0.025, t=-2.2).

Conclusion

This study has been performed on a specific group of patients, not being “really sick”, but having less optimal lifestyle in many cases. Encouragement to improve or keep healthy lifestyle, especially physical activity, is important, not only to lower the risk for CVD, but also to improve HRQoL.

Open access

Valentina Prevolnik Rupel, Renata Erker and Marko Divjak

Abstract

Introduction

The purpose of this study is to analyse and present the causes of the differences in crude utilization rate in cardiac implantation electronic devices, specifically pacemakers and automatic implantable cardioverter-defibrillators, across 5 European countries, with a specific emphasis on Slovenia.

Methods

Based on the results of the analysis of the uptake of cardiac implantation electronic devices across countries studied in MedtecHTA project, the targeted interviews were conducted to explain the factors that impact the differences and explain data in Slovenia.

Results

The reasons for the differences in crude utilization rate across 5 European countries were multiple: the first group of differences refers to the coding system and linkages between coding and financing of health care. The second group of reasons can be qualitatively ascribed to the economic situation, financial situation in health care, and its impact on decision-making. The last reason is the non-existence of the golden rule for optimal crude utilisation rate.

Conclusions

It is evident that the differences in the uptake of cardiac implantation electronic devices among the countries are of organisational nature: they refer to the system of coding, the importance attached to correct coding practices, the link between coding and financing of health care as well as the availability of private clinics and private insurance. According to the interviews, the economic development of the country also impacts those differences, whereas the differences in clinical practice and guidelines are claimed not to play a role in the explanation of the differences.

Open access

Maciej Jerzemowski, Zbigniew Dąbrowiecki, Romuald Olszański, Piotr Siermontowski and Janusz Jerzemowski

Abstract

Research shows a potential threat from external environmental factors which might be the cause of upper and lower gastrointestinal diseases in tourists, or soldiers engaged in tropical peacekeeping missions. The research includes infections which due to their spread are also present in their home countries such as Helicobacter pylori infections, viral hepatitis as well as infections which might cause symptoms of upper and lower gastrointestinal tract diseases as a result of poor sanitary and unhygienic conditions. Contact with diseases typical of the tropical climate, especially during longer stays, increases the chances of bringing some tropical diseases back to Poland, which can be problematic for the domestic health care service.

Open access

Jarosław Paprocki, Marta Pawłowska, Paweł Sutkowy, Jacek Piechocki and Alina Woźniak

Abstract

The activity of selected antioxidant enzymes: superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx) in erythrocytes, and the concentration of thiobarbituric acid reactive substances (TBARS) in blood plasma and erythrocytes, were determined in people subjected to hyperbaric oxygen (HBO) therapy due to sudden sensorineural hearing loss (SSNHL). Venous blood samples were taken immediately before entering the hyperbaric chamber and 5 min after leaving it. In the study group, two age subgroups were distinguished: group I consisting of subjects under 35 and group II consisting of subjects over 50. The obtained values were analysed statistically using Student’s t-test. Differences were considered as statistically significant at p < 0.05. A statistically significant decrease in the CAT activity was shown 5 min after leaving the hyperbaric chamber in pooled subjects (p < 0.01) and group I (p < 0.05). Furthermore, a statistically significant decrease in the erythrocyte TBARS concentration was observed in group II (p < 0.05). It was demonstrated that a single exposure to hyperbaric oxygen affects the oxidant-antioxidant equilibrium as evidenced by, e.g., a statistically significant decrease in the activity of catalase in erythrocytes. It is possible that the antioxidant response to HBO depends on the age of subjects.

Open access

Magdalena Zawadzka, Maria Dziedziczak-Buczyńska, Andrzej Buczyński and Gabriela Henrykowska

Abstract

Frequent consumption of large amounts of alcohol usually does not correspond to regular physical activity. However, regular physical activity can lead to an improved well-being and greater satisfaction with life. The aim of the study was to determine the level of physical activity in the group of patients diagnosed with alcohol dependence syndrome and examine the correlation between these variables. The study was conducted among a selected group of individuals of both sexes, aged 22-65 and undergoing treatment. Our study indicated an absence of a correlation between gender and the level of physical activity among people addicted to alcohol. Moreover, no statistically significant relationship was found between alcohol dependence and physical activity undertaken in the researched group.

Open access

Kazimierz Ulewicz

Abstract

Knowledge of the impact of hyperbaric conditions, especially hyperbaric oxygen, on human and animal organisms, is of great theoretical and practical importance, particularly in reference to the increased application of hyperbaric oxygen for therapeutic purposes. It must be said that unfortunately our knowledge on the impact of hyperbaria, including oxygen hyperbaria, on the immunological response of the animal and human organisms is still not sufficient and is incomplete. The Institute of the Naval Medicine of the Naval Academy in Gdynia has been carrying out tests in this field for some years now. The tests have been carried out on animals (rabbits, guinea pigs) as well as on humans (commercial divers, scuba divers, and candidates to these activities) within immunology investigations. The impact of hyperbaric oxygen at pressures ranging between 2.8 and 3.1 ata, in single or multiple expositions, have been tested as well as the relations between hyperbaria in air and the different conditions of the exposure.The study revealed important shifts in the immunological response of both the animals and humans.

Open access

Magdalena Bryndza, Grzegorz Filip, Krzysztof Bartuś, Anna Chrapusta, Ewa Kobielska, Bogusław Kapelak and Radosław Litwinowicz

Abstract

We hereby present the case of a female patient with recurrent aortic aneurysms. In order to treat aneurysms of the ascending aorta, aortic arch and aneurysms of the aortic arch branches, the debranching procedure was used. Following the surgery, a deep sternal wound infection occurred characterised by impaired healing. The infection was treated with targeted antibiotic therapy and hyperbaric oxygen therapy.

Open access

Piotr Siermontowski, Beata Janas and Romuald Olszański

Abstract

This two-part article reviews the current legal situation of specialist staff performing hyperbaric procedures for purposes not related to diving. Numerous discrepancies between the applicable legal acts and the lack of legal regulations concerning procedures not financed from the state budget have been noted. The first significant problem consisted in the lack of a correlation between various Regulations of the Minister of Health concerning hyperbaric oxygenation, as well as inconsistencies with the programmes of medical specialisation effective in Poland. The second problem is the lack of determination requirements of medical personnel other than doctors and nurses in the documents of the Ministry of Health. It was also found that medical hyperbaric centres which do not apply for funding from the budget (National Health Fund), do not even meet the minimum requirements defined as to the qualifications of the staff working there. Moreover, there is a lack of knowledge of the requirements set out in legal acts other than those concerning medicine.

Open access

Augustyn Dolatkowski, Tadeusz Doboszyński and Bogdan Łokucijewski

Abstract

Numerous research works indicate that staying in a hyperbaric environment is a stressor. We have undertaken studies using an animal model to determine the effect of hyperbaria on adrenocortical secretion and the level of adrenal ascorbic acid (a.a.a.). The research was conducted on 70 male hooded rats, which were divided into groups and subjected to hyperbaric air and oxygen at an overpressure of 1 and 3 atn, with some of the animals being additionally burdened with physical effort (swimming). It was found that short-term exposures (30 minutes) of rats to hyperbaric conditions caused a decrease in the content of a.a.a. With a prolonged (3-hour) exposure to 3 atm air the a.a.a. content returns to a normal level. A reduction in the a.a.a. content indicates the presence of stress in hyperbaric conditions in the rat, however, it does not allow to determine its intensity with the method used in the study.

Open access

Sławomir Kujawski, Joanna Słomko, Monika Zawadka-Kunikowska, Mariusz Kozakiewicz, Jacek J. Klawe, Małgorzata Tafil-Klawe and Paweł Zalewski

Abstract

Introduction Among experienced divers, dive adaptation is seen as a modified pattern of physiological changes. This is reflected, inter alia, in the change in cardiovascular responses, therefore there is need to examine the role of the autonomic nervous system in cardiovascular response modulation after hyperbaric exposure. Material and methods Ten experienced divers took part in the study. The effects of hyperbaric exposure at 30 and 60 meters and interaction (depth x time) were measured. Changes in HR, RRI, CI and HRV values have been taken into analysis. Results Hyperbaric exposure at 30 meters significantly affected HFnu-RRI elevation and decrease of LFnu-RRI (F = 42.92, p <0.00001), without significant affecting the HR, RRI and CI. Exposure to hyperbaric 60 m increased HR and CI (F = 7.64, p = 0.01 and F = 4.89, p = 0.04 respectively) and RRI (F = 7.69, p = 0.01), without significant impact on other variables. The influence of interaction (depth x time) was significant in all measured variables. Conclusions The results indicate that hyperbaric exposure at 60 meters affected HR, RRI, CI parameters, that were not significantly affected by hyperbaric exposure at 30 meters. On the other hand, the exposure at 30 meters showed a significant effect on the LFnu and HFnu HRV, which were not significantly affected by the exposure at 60 meters. Significant effect of time and depth interaction in each of the analyzed variables was observed.