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Background Identifying prognostic factors that are predictive of in-hospital mortality for patients in surgical units may help in identifying high-risk patients and developing an approach to reduce mortality. This study analyzed mortality predictors based on outcomes obtained from a national database of adult patients. Materials and methods This retrospective study design collected data obtained from the National Health Fund in Poland comprised of 2,800,069 hospitalizations of adult patients in surgical wards during one calendar year. Predictors of mortality which were analyzed included: the patient’s gender and age, diagnosis-related group category assigned to the hospitalization, length of the hospitalization, hospital type, admission type, and day of admission. Results The overall mortality rate was 0.8%, and the highest rate was seen in trauma admissions (24.5%). There was an exponential growth in mortality with respect to the patient’s age, and male gender was associated with a higher risk of death. Compared to elective admissions, the mortality was 6.9-fold and 15.69-fold greater for urgent and emergency admissions (p Conclusion Age, male gender, emergency admission, and admission on the weekend or a bank holiday are factors associated with greater mortality in surgical units.

Introduction and objective Using the concepts of Ulrich's theory of supportive design and Malkin's healing environment, an eye tracking experiment was designed in order to measure respondents' reactions while looking at visualisations of various interiors, with the aim of verifying whether certain parameters of an interior are related to emotional reactions in terms of positive stimulation, and the sense of security and comfort. Material and methods 12 boards were designed, incorporating standard features of an interior, i.e. (1) proportions, (2) lighting, (3) colour scheme of a room, as well as (4) the colours and spatial arrangement of furnishings. Respondents' reactions were recorded with an eye tracker Tobii TX300 and supplemented by self-descriptions of emotional reactions. Results The results showed that the varying spatial and colour arrangements presented in the interior visualisations provoked different emotional responses, confirmed by pupil reaction parameters, as measured by the eye tracking device. Conclusions Architectural space can have a diverse emotional significance and impact on an individual's emotional state. This is an important conclusion from the point of view of optimising and creating the so-called supportive and healing environment. The results have implications for the interpretation of the pupil diameter as an index of emotional reactions to different architectural space visualisations. Testing the eye tracker as a method helpful in diagnosing the emotional reactions to features of the interior is justified, and can provide an effective tool for early diagnosis of the impact of architectural space on the well-being of individuals. It can also be a good form of testing the emotional significance of architectural designs before they are implemented.

Nursing graduates are required to have both excellent theoretical and practical skills that should be used during stressful emergency interventions. Since the received knowledge should be practiced to gain skills and trained to achieve competences, simulation exercises can be beneficial to even reduce the stress that each individual may face during emergency management of patients. A total of 146 first-year nursing students participated in the study, including 124 women and 22 men aged between 19 and 50 years, with a mean age of 32 years. The objective method estimated psychophysiological parameters (serum cortisol). Objective and subjective methods were used. The subjective method assessed stress experienced by students based on the standardized Stress Appraisal Questionnaire Version B for dispositional assessment. The study was conducted in the Monoprofile Medical Simulation Centre at the University of Economics and Innovation in Lublin, Poland and was approved by the University Research Ethics Committee. Both participants under and over 25 years of age showed increased levels of stress after low and high-fidelity simulations, with statistically significantly higher stress levels found for the low fidelity method. Low-fidelity simulation methods generated a greater increase in cortisol levels, indicating a higher stress level than the high-fidelity methods. The analysis of the scores obtained in the Stress Appraisal Questionnaire (KOS-B) showed that higher cortisol levels after the low-fidelity simulation reduced the subjective perception of a threat, while higher cortisol levels before the high-fidelity simulation promoted higher intellectual activity among the students. Levels of stress in the education of nursing students using low and high-fidelity methods can limit the sense of threat and activate professional task performance. The use of low and high-fidelity simulation does not generate destructive stress levels.

In‑hospital mortality is a relevant outcome of hospital admissions.This study aimed to identify predictors independently associated with in‑hospital mortality in nonsurgical departments.In 2014, the Polish National Health Fund database provided data on 2 855 029 hospitalizations of adults, which were not related with surgical procedures. Patients' age and sex, diagnosis‑related group category assigned to the hospitalization, length of stay, types of hospital and admission, and day of the week and month of admission were analyzed as mortality predictors.The mean (SD) in‑hospital mortality rate was 4.1% (0.01%). Odds ratios for in‑hospital death increased with patients' age. The female sex was associated with lower odds ratios of death than the male sex. Among the diagnosis‑related groups assigned to hospitalizations, the highest mortality was found in patients with vascular diseases (11.95%). Considering the length of stay, the lowest mortality occurred during 5- to 7‑day (2.63%). Compared with teaching hospitals, the odds ratio of death was 1.31‑fold higher for regional hospitals, 1.35‑fold higher for private hospitals, and 1.48‑fold higher for district and city hospitals; 92% of all in‑hospital deaths occurred after urgent and emergency admissions. Hospital admissions at weekends or on other nonworking days (public holidays) were significant predictors of in‑hospital mortality. Differences in mortality rates were found between particular months, but no seasonal relationship was established.Age, male sex, emergency admission, admission at the weekend or on another nonworking day (during public holidays), and hospitalization in a district, city, private, or regional hospital (compared with a university hospital) were factors associated with higher mortality in nonsurgical departments.

Objective. The aim of the study was investigation of the correlations between medical indicators of the course of illness and psychological factors, treated as generalised resistance resources, according to the Salutogenic Model by A.Antonovsky. The salutogenic orientation is one of the more viable paradigms for health promotion research and practice, and is offered as a useful theory for taking a salutogenic approach to health research. Materials and methods. Data was used of 67 patients at Institute of Rural Health in Lublin, Poland, suffering from Osteoarthritis. Using psychological test methods: SOC-29, CISS, AIS, IZZ, KNS, GSES, BDI and The Index of Severity for Osteoarthritis of the Hip or the Knee and The Low Back Pain Rating Scale as medical indicators of the course of the illness. Results. Analysis showed significance correlations between some psychosocial (sense of coherence, stress coping strategies, acceptance of illness, health behaviour, hope for success, self-efficacy and depression) and medical variables (intensity of the degenerative disease and low back spine). Conclusions. Results of analysis showed that psychological factors within the meaning of psychosocial resources may be potential pathways for improving or disturbing the treatment effects in the course of hip and knee osteoarthritis treatment, and/or the patient’s condition.

Osteitis has been proven to play important role in patophysiology of chronic rhinosinusitis (CRS). Computed tomography (CT), a standard diagnostic technique used to evaluate the extent of the sinus disease, fails to show the bone involvement in patients with CRS. In contrast single-photon emission tomography (SPECT) yields adequate information on remodeling and bone turnover. Persistent osteitis may be one of the reasons of failure of adequate medical and surgical therapy for CRS and discrepancies between extent of the disease as evaluated by CT and symptom scores.is to evaluate correlation between the results of CT and SPECT in patients with CRS.29 patients with CRS (15 with nasal polyps and 14 without nasal polyps) were evaluated with CT and SPECT. The mucosal involvement of CRS graded on Lund-Mackay Scale (LMS) was compared to degree of bone involvement evaluated by SPECT with the use of modified LMS.The mean LMS grade was 13,3 for CT and 9,8 for SCPECT (modified LMS). A positive correlation between the results of two imaging methods was found r = 0.72 (p0.0001).The bone involvement as evaluated by SPECT correlates with the degree of mucosal changes showed by CT.

Lichen planus still remains a disease of unclear etiology. Inconclusive reports exist on the role of stress the pathophysiological mechanisms involved in this disease. The objective of this study was to find associations between levels of stress and indices of the endocrine and immune response in patients with lichen planus.A total of 57 patients with lichen planus and 27 healthy control volunteers took part in the study. All participants completed questionnaires measuring the frequency of stressful life events. Blood samples were collected and analyzed for levels of endocrine and immune parameters: neopterin, cortisol, interleukin (IL)-2, IL-6, IL-18, soluble IL-2 receptor (sIL-2R), sIL-6R, sFasL, T lymphocyte antigens CD3, CD4, CD8, CD25, CD69, HLA-DR, CD16/56, CD45RO and CD45RA.Patients differed significantly from the controls in the levels of neopterin (but not cortisol), expression of CD25, CD16, CD8, and CD45RA antigens on T lymphocytes. Patients had also significantly higher levels of sIL-2R, sFasL, sIL-6R and IL-18 than healthy controls. Patients and controls did not differ in the overall frequency of stressful life events experienced over 1 year prior to the study. However, two subgroups of patients with various stress levels differed significantly in the expression of CD25, HLA-DR, CD45RO, and CD45RA on T lymphocytes.Our findings suggest that stress may alter numerous parameters of endocrine and immune response in lichen planus, which provides support for its role in the etiopathogenesis of this disease.

In the period 1973/74-1995 a prospective observation was carried out on 4420 diabetic patients (1990 males and 2430 females) aged 30-68 years, with type 2 (non-insulin dependent diabetes) of 1-10 years duration. During the 22-year period nearly 80% of the initial cohort died. The risk of death was 2-times higher in diabetes than in the samples of general population observed at the same time. The death risk from cardiovascular diseases was over 3.0 times higher than in general population. The relevant risk ratio was found over 5-times higher for coronary heart disease, which was unlike to result from the differences in death ascertainment between diabetics and the city dwellers. The all-causes ratio of death and cardiovascular diseases was the same for women and men but it was selectively higher for females than males group for coronary heart disease and cerebrovascular diseases, and for males 50% higher for atherosclerosis and other heart diseases. The highest cumulation of risk factors was observed for deaths from cardiovascular diseases, and coronary heart disease. There were risk factors typical for cardiovascular disease and typical for poor metabolic control of diabetes (hyperglycaemia, glucosuria) and presence of complications of diabetes (nephropathy).

From the follow-up examination of 1329 out of 4420 type 2 (non-insulin-dependent) diabetes followed for 17 years, the incidence of micro and macrovascular complications (proteinuria and nephropathy, symptoms of leg vascular disease, ischemic heart disease, and cerebrovascular events, was estimated and related to the levels of baseline-risk variables using logistic regression. For new cases of proteinuria and heavy proteinuria, hyperglycemia was the common predictor (alongside diastolic hypertension, smoking and overweight); hyperglycemia and glycosuria were among significant predictors of leg vascular disease (with duration of diabetes, smoking, male sex, diastolic hypertension, and proteinuria). On the other hand, systolic hypertension and male sex prevailed among factors predicting both ischemic heart disease (with high cholesterol and overweight), and stroke. The data confirm the higher involvement of diabetic milieu in micro than macrovascular incidents, with diabetic foot disease placed in between.

In the period 1973/74-1995 a prospective observation was carried out on 4420 diabetic patients (1990 males and 2430 females) aged 30-68 years, with type 2 (non-insulin dependent diabetes) of 1-10 years duration. During the 22-years period nearly 80% of initial cohort died. The risk of death were 2-times higher in diabetes than in the samples of general population observed at the same time. The death risk from cardiovascular disease were over 3-times higher than in general population. The relevant risk ratio has been found over 5-times higher for coronary heart disease, which were unlike to results from the differences in death ascertainment between diabetics and the city dwellers. The all-causes ratio of death and cardiovascular diseases were the same for women and men but it was selectively higher for females then males group for coronary heart disease and cerebrovascular diseases. Among diabetic cohort the risk of death was also higher for neoplasms, especially in women.

During the follow-up 1973/74-1995 years 171 subjects with type 1 (insulin dependent diabetes) (105 males and 66 females) aged 18-30 years died 31.6% (32.4% males and 30.3% females). The relative risk of mortality for all causes in the compared to the general population was 5.0 (3.5 for men and 7.5 for women). Almost 30% deaths were from renal disease, 17% from ischemic heart disease, and 3 death in women from carcinoma of breast.