Wioletta Samolińska, Bożena Kiczorowska and Renata Klebaniuk
Introduction. The rate of aging and the possible coexistence of diet-related diseases are largely determined by the nutrition and lifestyle of the elderly. Therefore, it is important to assess the degree of coverage of organism demand for such nutrients as calcium and vitamin D in the elderly population.
Aim. The aim of the study was to determine the impact of age on calcium and vitamin D supply in daily alimentary rations of the elderly as well as their nutritional behaviour in terms of consumption of products which are the source of these nutrients.
Material and methods. The study involved 42 subjects aged from 60 to 85 years. The vitamin D and calcium content in daily food rations was assessed with the method of a 24-hour dietary interview carried out in triplicate.
Results. The nutrition of the elderly turned out to be inappropriate in terms of supplying the organism with calcium and vitamin D, and this was not age dependent. The average calcium and vitamin D supply in the daily food rations was estimated at 455.53 mg/day and 2.31 μg/day, respectively. The demand for calcium was covered in the range of 31-60% of RDA in over 60% of the elderly and the vitamin D demand was met in 30% of AI in over 80% of the subjects.
Conclusions. The assessment of the daily food rations indicates a necessity for increasing the intake of calcium- and vitamin D-rich food products and dietary supplementation with these components.
Katarzyna Szczekala, Krzysztof Wiktor, Katarzyna Kanadys and Henryk Wiktor
Motivational Interviewing (MI) is a collaborative, goal-oriented and focused on change, style of communication. It is characterised by the MI provider’s empathy, understanding, mental and emotional attitudes towards the patient. This non-judgemental conversation is aimed at strengthening inner motivation and commitment to attain the goal and is based solely on the individual’s reasons for change. The initial application of MI in clinical psychology has been modified appropriately to allow for its use in health care, rehabilitation, public health, social work, dentistry, social rehabilitation, coaching and education. It is recommended for introducing new behaviours, lifestyles and therapeutic adherence. The application of MI contributes to the enhancement of patient-healthcare worker communication, the patient’s concordance and compliance. On the other hand, learning and adopting this method in counselling is useful for healthcare professionals. In treatment, greater patient awareness and obedience lead to more conscientious responsibility for treatment and health, which in turn, produces better therapy outcomes that serve as confirmation of the merit of the therapy prescribed. The application of MI contributes to health professionals’ greater success, satisfaction, self-confidence and a sense of self-efficacy.
The aim of this work is to present the essential features of MI as well as some interesting examples of research showing the benefits of using MI and ideas for training it. Non-systematic literature review of the years 2005-2018 on the use of MI in health promotion in PubMed provided evidence of wide use of MI by healthcare professionals.
Ionizing radiation are classified as Class I carcinogens. The exposure to this factor increases the risk of developing cancer, and researchers aim to establish the relationship between the exposure and the risk levels, as well as guidelines which would limit exposure to it. The risks were assessed through studies related to the atomic bomb survivors, to the populations exposed to radiation for the purpose of diagnosis or therapy and to the professionally exposed populations – radiologists, radiotherapists, workers in uranium mines, operatives in the nuclear industry. The population of Japanese survivors of the atomic bombs is the largest population exposed and studied with an extremely wide age range (from the irradiation in utero to old people). This population, made up of 93.000 people, represents a major source of information used to determine the potential risk of low dose radiation exposure. Health professionals working with ionizing radiation have been studied ever since the 1890’s. After the implementation of a radiation protection system, the doses received decreased only to increase again with the technical development and its use in a wide variety of specialties. Two recent studies on large cohorts and during long periods of time brought information about the cancer risk due to occupational exposure to ionizing radiation and shed light on the need to monitor exposed staff and re-evaluate radiological safety standards. This review is focused on recent literature concerning the radiation exposure of medical professionals.
Context. It has been decades since the circadian variation of the secretion of the thyroid stimulating hormone (TSH) was proven in humans. Even so, there are few studies on human beings that explored the relationship existing between night shift circadian rhythm deregulation and thyroid disorders.
Methods. We have revised the occupational medicine files of all employees in a single speciality hospital to conduct an observational study on the prevalence of thyroid disorders in night shift compared to day shift workers. Age, gender, occupational history, body mass index and specialist diagnosed thyroid disorders were recorded. Numerical variables were compared with ANOVA test, and categorical ones with chi test (StatPlus for Mac version v6).
Results. Obesity was slightly more prevalent in night shift workers, but not statistically significant. Instead, we found a significant increase in the prevalence of thyroid disorders in night shift workers (X= 7.424, p = 0.006). As this is a mere observational study, our results only contribute to the pool of data concerning the relationship between thyroid dysfunction and night shifts.
Conclusions: These results should raise awareness, particularly among occupational physicians and endocrinologists, about the influence of sleep and circadian rhythm deregulation on the raising incidence of thyroid disorders.
Case presentation and literature review of the TB diagnosis in silicosis
Patricia Petculescu, Andrei Năstase, Ana-Maria Mănescu and Marina Ruxandra Oțelea
Romania is recognized as the European country with the highest tuberculosis rate in Europe. The association of tuberculosis with silicosis determines synergistic immunosuppression of the alveolar macrophages resulting in a higher grade of pulmonary parenchymal destruction and consequently respiratory failure. The case report approaches a patient with third stage of silicosis and associated active secondary pulmonary tuberculosis disease with positive smears. The impact of the Mycobacterium tuberculosis (MTB) infection’s activation is known to be severe, worsening the prognosis of silicosis and reducing the patient’s quality of life. Regarding the high morbidity rate of tuberculosis, an early diagnosis of tuberculosis in patients with silicosis is paramount, and sometimes cannot be achieved by usual bacteriological tests. Therefore, a better strategy is to be considered in silicotuberculosis, namely to prevent the progression of the latent tuberculosis foci by testing the positive predictive value of up-to-date tests such as IFN-γ inducible protein 10 biomarker, which may allow early detection and treatment.
Bartłomiej Krynicki, Monika Guszkowska, Ewa Kozdroń, Ewa Niedzielska, Joanna Piotrowska and Anna Leś
Introduction. We tested how female University of the Third Age (U3A) attendees evaluated their health, physical fitness, and satisfaction with health. We also examined various factors potentially underlying those self-assessments, that is objective indicators of health and physical fitness, their potential determinants (age and financial situation), and potential modifiers of self-assessment (mood, perceptive ability, and education).
Material and methods. A total of 116 female participants attending U3A classes in Warsaw aged 50-88 years evaluated their health and fitness on a 100-level visual scale and their satisfaction with their health on a five-level Likert scale. Each participant completed the UWIST mood adjective checklist (UMACL) by Matthews, Chamberlain, and Jones and Yesavage’s geriatric depression scale, underwent the Fullerton fitness test, a hand grip strength test, Romberg’s test, and Ciechanowicz and Stanczyk’s attention and perception test, as well as filling out a specially designed questionnaire.
Results. Self-assessments of health were found to correlate with aggravated symptoms of depression and certain components of physical fitness, but not with age or financial situation. Self-assessments of physical fitness, in turn, were strongly correlated with objective indicators of physical health and depression and less strongly with dexterity test results. General satisfaction levels, in turn, were found to be associated with long-term conditions, aggravated symptoms of depression, and financial situation.
Conclusions. Overall, our results confirm that self-assessments are a moderately accurate indicator of the general health and physical fitness of elderly people: they correlated to a certain degree with more objective indicators of health/fitness but were influenced by modifying factors, particularly cognitive ones.
Maria Pyda-Karwicka, Malwina Karwicka, Janusz Kopczyński, Magdalena Orłowska, Mariusz Krata, Andrzej Skrzyński, Jolanta Masiak, Yee Kong Chow and Agnieszka Pedrycz
Prostate adenocarcinoma, remaining among top most common cancers, is a heterogeneous group of tumors with a diverse morphological structure. Basing on the histological architecture of cancer tissue, individual cases can be classified into different therapeutic groups. Current diagnosis of prostate cancer brings many challenges. The major problem is the lack of effective and accessible diagnostic methods that would eliminate incidences of overdiagnosis and prevent unnecessary treatments of many patients. There are many efforts to determine favorable and unfavorable molecular prognostic factors. The basic marker currently used in this field is prostate-specific antigen (PSA). Increased level of PSA may suggest the presence of prostate cancer although its level is not specific for the disease and can be elevated also in certain benign hyperplastic or inflammatory conditions as well as after irritation or rectal examination. Clinical symptoms such as dysuria or hematuria are often uncharacteristic and benign prostatic diseases which cannot be confirmed on the basis of physical examination alone. Also, we often deal with the situation of false negative results of prostate needle biopsy, which require many tests to determine the final correct diagnosis. Moreover, prostate cancer can also be present in patients with non-elevated serum PSA level. Due to such difficulties, the search for new molecular markers that could be used for diagnostic purposes is underway. Evaluation of survivin level in prostate cancer tissue may serve as a new diagnostic indicator of prostate cancer progression. Other useful molecular biomarkers with good potential in prostate cancer diagnosis are AMACR (Alpha Methyl Acyl Coenzyme A Racemase), p-63 or Ki-67 or microRNAs present in body fluids.
Piotr Tabor, Czesław Urbanik and Andrzej Mastalerz
Introduction. The aim of this study was to determine the correlations between the direction and velocity of the ball in volleyball spike. We adopted the hypothesis that the direction of an attack is dependent upon the arrangement of the pectoral girdles in the phase of flight.
Material and methods. The research was carried out for four different types of attacks: from the left side of the court down the line (A) and in the cross-court direction (B) and from the right side in the same directions (C and D). Sixteen young volleyball players from a Sports Championship School run by the Polish Volleyball Federation were examined.
Results. The analysis of the results showed different ball velocities in different attacks. The velocity was the lowest in attack B and the highest in attack D.
Conclusions. The direction of attack was produced by hitting the ball in a non-central manner and by aligning the glenohumeral joints diagonally to the net.
Iulia-Rahela Marcu, Ion Toma and Adrian Costin Bighea
Quality of life studies in patients with knee osteoarthritis (OA) attest to the significant impact of the disease on day-to-day activities and social interactions. The aim of this study was to assess the efficacy of a physical exercise program on functional status and quality of life in patients with work-related knee osteoarthritis. The present study included 144 participants with knee osteoarthritis, 72% women, mean age (SD) 47.2 (11.1) years. The patients were randomly assigned in two lots based on the type of kinetic treatment: lot A-with knee OA and medication (72 patients) and lot B- with knee OA, medication and exercise program (72 patients). They followed for 12 days ambulatory exercise programs based on increasing knee flexion, muscular strength and endurance, improving balance, coordination, and respiratory exercises. The patients in the control group continued their daily living activities. The evaluation was made at the beginning of the study (T0), after 2 weeks (T1) and 8 weeks after the 12 days of exercise program (T2) and was based on the following parameters: knee mobility (knee flexion), muscular strength, pain assessment on a Visual Analogue Scale (VAS), functional status (Western Ontario &McMaster Universities Osteoarthritis Index - WOMAC) and quality of life evaluation using SF-36 Questionnaire (36-Item Short Form Survey). Out of 144 participants who completed the initial evaluation, 138 also completed the 2 weeks and the 8 weeks follow-up assessments: 70 patients from the control lot and 68 patients from the exercise lot. The benefits of the kinetic programs were shown by a significant improvement in knee mobility and muscular strength for knee extensors (quadriceps muscle) and knee flexor muscles. Testing the linear correlations between the SF-36 score and the VAS (r=0.71, p<0.05) and WOMAC (r=0.83, p<0.05) indicators demonstrates a highly positive relationship between the quality of life expression, the pain assessment score and the functional status score in patients with knee OA. The physical exercise program improves both functional status and quality of life in patients with work-related knee osteoarthritis by increasing the range of motion and muscular strength and by reducing pain.
Magdalena Czarkowska, Tomasz Saran, Anna Mazur and Lech Panasiuk
Introduction. The provision of adequate health care for a successively growing group of geriatric patients requires taking into account many factors in order to preserve and/or improve their overall health and the related functional capacity. Its crucial aspects include the ability to safely change position and locomotion, as well as the severity of discomfort from the osteoarticular system.
Aim. The objective of the present study was to assess the impact of comprehensive ambulatory rehabilitation including tailored endurance training, preceded by an ergospirometry test, on indicators showing the risk of falls and the severity of pain symptoms of patients aged 60 and over, receiving health services at the Outpatient Healthcare Home (DDOM).
Material and methods. The study involved 60 seniors during their rehabilitation cycle implemented as part of the services provided to patients at DDOM of the W. Chodźko Institute of Rural Health in Lublin. The tests were carried out in the test-retest model on the first and last day of the kinesiotherapy cycle. The Tinetti scale of the risk of falls, balance and walk and Visual Analogue Scale of the severity of pain sensations (VAS) were utilized in the research. The patient rehabilitation program at the DDOM included adapted systemic kinesiotherapy (endurance training with a load determined according to individual exercise capacity, as determined on the basis of the ergospirometry test) and local kinesiotherapy as well as physical therapy adapted to the needs resulting from the condition of the musculoskeletal system.
Results. After completing the rehabilitation cycle, the patients obtained higher scores, compared to the tests carried out before the beginning of the rehabilitation cycle, in the scales of Tinetti Questionnaire. There were also lower results of the respondents in VAS scale used to assess the severity of pain sensations.
Conclusions. As a result of the rehabilitation program applied, DDOM patients simultaneously obtained the desired changes in minimizing the risk of falls, improving the ability to maintain balance and fitness while walking, as well as reducing the severity of pain sensation.