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Exercise‐Based Cardiac Rehabilitation with and without Neuromuscular Electrical Stimulation and its Effect on Exercise Tolerance and Life Quality of Persons with Chronic Heart Failure

-systolic and end-diastolic diameters (LVESD and LVEDD, respectively). The procedure was carried out before the rehabilitation program and then repeated at week 3. Quality of life assessment (QL) . Participants completed the Minnesota Living with Heart Failure Questionnaires (MLHFQ; license no. SKU Z94019A; Toy et al., 2000 ) measuring life quality in CHF patients at entry to the cardiac rehabilitation program and at week 4. To ensure the reliability of their answers, explanations were provided whenever questions required clarification. Outcomes Primary outcome . The

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Burned Out Or Just Frustrated? Reasons Why Physical Education Teachers Leave Their Profession

Abstract

This work focuses on the reasons why physical education (PE) teachers leave their profession. The study included 80 individuals who decided to leave a teaching profession in 2013. A diagnostic poll method with the use of the QWL (Quality of Work Life) index was employed in the study. It was observed that there are usually a number of reasons why they give up their job, the most important being financial reasons. Their decision is influenced by the accumulation of professional and personal problems as well as their inability to solve them. The findings showed that teachers‘ departure from the profession is generally associated with the issue of burnout; however, financial reasons are most frequently ones that directly affect this decision.

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Primary Total Knee Arthroplasty (TKA) with revision Total Stabilizer Prosthesis in a 66-year-old patient with secondary knee osteoarthritis and valgus deformity. Case Report

Abstract

Knee osteoarthritis (gonarthrosis) is the most prevalent knee pathology encountered nowadays in the third age population, leading to severe disability and reduced life quality. Secondary gonarthrosis may be caused by a traumatic event, which subjects the knee joint to a transitory highly increased mechanical stress, initiating a rapidly progressive degrading process of the articular cartilage and subjacent bone tissue. TKA is intended to replace all the intra-articular components with artificial parts, in order to relieve pain, compensate for ligament instability, correct deformities, and restore proper joint functionality. Semi-constrained, non-hinged implants are usually used for revision TKA, in knees that already had a primary TKA but sustained complications. Nevertheless, here we reported the case of a 66-year-old female patient diagnosed with posttraumatic gonarthrosis who underwent TKA with a revision total stabilizer implant as primary treatment due to severe joint instability and high grade valgus deviation. The outcome of the surgical procedure was positive, with significant pain relief and increased knee stability. The valgus angle was reduced from 37° to 4° and the KSS score increased from 3 to 87 points. Therefore, revision semi-constrained prosthesis may be used as a primary implant with promising result in severe cases.

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Treading on tricky ground: reconstructive approaches to Charcot neuropathic arthropathy of the foot

Abstract

Introduction and purpose:Charcot neuroarthropathy defines a cluster of progressive lesions affecting the joints and bones, as well as the soft tissues of the foot in the context of diabetes, a pivotal role being attributed to peripheral neuropathy. Loss of sensation and proprioception, subsequent repeated trauma, muscle and autonomic nervous system impairment contribute to the alteration of the foot’s architecture and distribution of pressure, ultimately triggering ulceration and gangrene. The urge to avoid amputation has fueled the development of conservative and reconstructive techniques capable of delaying, if not preventing such negative outcomes. The purpose of this review was to present the most frequently used reconstruction procedures and the challenges arising in adapting them to particular foot morphologies and lesion stages. Methods:Literature search was conducted using PubMed, resulting in around 90 articles, multicenter studies and reviews, 26 of which were considered most relevant in providing the guidelines for orthopedic reconstruction and postoperative care in Charcot foot patients with diabetic neuropathy prevailing over arteriopathy. Results:The tarsometatarsal and metatarsophalangeal joints are most frequently affected. Closed reduction, arthrodesis, and tendon lengthening are key features of an efficient correction, alternatively accompanied by resections and tenotomies. Ulceration and callus debridement may also be necessary, while prolonged casting and immobilization remain obligatory. Conclusions:Most authors agree that stabilizing the deformities, optimizing the pressure on the soft tissues, and promoting the healing of potential lesions are the main purposes of the interventions. Prompt recognition and correction of Charcot foot deformities improve life quality and minimize the prospects of amputation.

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Health Status of Healthcare Professionals Working in an Institute for Chronically Ill Psychiatric Patients

Abstract

Several research works in the related international literature on sociology and health sciences deal with the state of health in one selected population. In these studies, the chosen sample is often connected with special jobs, especially with healthcare professionals and their working conditions. These studies predominantly examine the self-rated subjective health status using questionnaires. There are others that assess the state of health based not only on self-rated subjective indicators, but also using objective data gained by measuring. Considering the international experiences, we chose a special population in our research – healthcare professionals working in an institute for chronically ill psychiatric patients. Our choice was influenced by the fact that we wanted to include their unique working conditions when exploring and assessing their health status. Moreover, our approach was to assess the objective state of health alongside the subjective factors, as our hypothesis was that the majority of the indicators presumably coincided. The data were collected with the help of three questionnaires and some indicators of the objective health statuses were measured. The findings were processed using the SPSS 17.0 mathematical-statistical software package. Following the descriptive statistics, we applied hierarchic cluster-analysis based on results of the WHOQOLD-BREF26 life-quality questionnaire, the WHO WBI-5 Well Being Index, and on the body composition analysis. The results show the objective and subjective health status of population and the factors that influenced it; the working conditions and the interpersonal contacts in the workplace. The conclusion was that in the examined population the subjective and objective health status doesn’t coincide.

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Prevalence of Stress Urinary Incontinence in Elite Female Endurance Athletes

Dancers. Int. Urogynecology J, 2002; 13(1): 15-17 Uebersax JS, Wyman JF, Shumaker SA, McClish DK, Fantl JA. Short forms to assess life quality and symptoms distress for urinary incontinence in woman: the Incontinence Impact Questionnaire and the Urogenital Distress Inventory. Neurourol. Urodyn, 1995; 14: 131-139

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Effect of a MAST Exercise Program on Anthropometric Parameters, Physical Fitness, and Serum Lipid Levels in Obese Postmenopausal Women

Normality (Complete Samples). Biometrika, 1965; 52(3/4): 591-611 Tornqvist L, Vartia P, Vartia YO. How Should Relative Changes Be Measured. American Statistician, 1985; 39(1): 43-46 Uthman O, Aremu O. Comparison of physical activity level between overweight/obese and normal weight individuals: A systematic review. The Internet Journal of Nutrition and Wellness, 2007; 5(1) Wiacek M, Hagner W, Hagner-Derengowska M, Bluj B, Czereba J, Drozd M, Zubrzycki IZ. Deterioration of basic coordinative parameters defines life quality of elderly. Arch

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New Prospect for Improving University Students’ Quality of Life

Medicine, 13, 327-343. Edvy, L. (2012). A Pannon Egyetem hallgatóinak fittségét megalapozó egészségtudata és az egészséggel kapcsolatos életminőség mutatói /The indicators of health in relation of life quality of students at Pannon University, in connection with basing the fitness of the health consciousness/. Hungarian Review of Sport Science, 49, 4-10. Edvy, L. (2013a). Quality of Life Indicators of University Students in Hungary. Physical Culture and Sport. Studies and Research, 58(1), 53-60. Edvy, L. (2013b). Egészségtudatot formáló kurzus

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Inflammatory Biomarkers in Chronic Obstructive Pulmonary Disease

Abstract

Chronic obstructive lung disease (COPD) is a severe progressive disease associated with high morbidity and mortality. Early diagnosis and correct treatment improve the symptoms, quality of life and survival in COPD. Exacerbations of the disease are acute events that cause worsening of COPD symptoms (dyspnea, cough and/or sputum) and may require modification of stable COPD therapy. COPD exacerbations add inflammation, damage the quality of life, deteriorate the lung function, increase mortality and associate high socio-economic costs. Accurate early prediction of exacerbation and mortality risk facilitates patient selection upon risk, in order to provide appropriately targeted early treatment. The risk of having frequent exacerbations is clearly demonstrated by recognized studies in patients with specific criteria: previous exacerbation in the last year, decrease in FEV1s, increase in the score of St. George Questionnaire (life quality decline), high levels of several inflammatory biomarkers, such as neutrophils, C-reactive protein (CRP), fibrinogen, pro-calcitonin, eosinophils, IL-6, IL-8, chemokine ligand 18 (CCL-18/PARC), surfactant protein D (SP-D). Simultaneously elevated levels of CRP, fibrinogen and leukocyte count in COPD patients were associated with an increased risk for exacerbations. At the same time, elevated levels of the three biomarkers are associated with an increased risk of major comorbidities in COPD. Biomarker detection may be an additional tool for assessment and management of COPD comorbidities. Detection of pathologic levels of inflammatory biomarkers improves the ability to predict the risk mortality in COPD alongside with BODE index (BMI, obstruction in lung function, dyspnea scale, 6-minute walk test) and may provide a targeted treatment.

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Limited Cutaneous Scleroderma-Related Pulmonary Arterial Hypertension — a Case Report

Abstract

Background: Pulmonary hypertension (PH), defined by mean pulmonary arterial pressure (PAPm) ≥25 mm Hg, can lead to increasing pulmonary vascular resistance, which eventually results in right ventricle failure. Scleroderma, as an autoimmune connective tissue disease, is associated with PH as a sub-group according to the 2015 ESC/ERS PH classification. Pulmonary arterial hypertension (PAH) associated with scleroderma (SSc-PAH) can often result in poor prognosis with increased mortality. Early diagnosis and specific treatment of PH can significantly improve the prognosis of these patients.

Case report: We present the case of a 50 year-old male, with no relevant family history, with a 2-year history of echocardiography-based diagnosis of PH (PAPm 78 mmHg). Physical examination revealed limited hand and forearm areas of non-folding thick skin, vital signs in the normal range and peripheral oxygen saturation of 96%. Severity and risk assessment were performed based on clinical and imaging tests, and hemodynamics. 12-lead rest ECG revealed sinus tachycardia and right bundle branch block, the six-minute walk test confirmed limited exertion capacity, Borg scale 9. Transthoracic echocardiography pointed to dilated right heart cavities and moderate pericardial effusion. Right heart catheterization confirmed the PAH (PAPm: 36 mmHg), and pulmonary CT angiography excluded massive pulmonary embolism. Rheumatologic examination and immune serology identified a scleroderma subset, limited cutaneous sclerosis form (lcSSc) with early onset PH. Combined specific PH drug therapy was initiated, followed by clinical and functional improvement in clinical status, prognosis and life quality.

Conclusions: In clinical group 1 of PH, the subgroup etiology of PAH associated with connective tissue disease (1.4.1) often goes undiagnosed, mainly due to the diminish of lung involvement symptoms in early CTD stages. Multidisciplinary approach is essential in order to refine the diagnosis and set out the treatment algorithm.

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