Search

Aim of the study: The aim of study was to determine the level and influence of fatigue and general stress levels among emergency department staff. Material and methods: Team research in a group of 119 people employed in three Hospital Rescue Departments in the Podkarpackie Voivodeship. The Fatigue Assessment Scale and the Perceived Stress Scale-10 standardised research scales and the author's questionnaire for subjective assessment of the quality of performed operations were used. The method of diagnostic survey and estimation was used in the work. Results: The research was carried out among 119 people actively working in Emergency Departments in Podkarpackie Voivodeship. Sixty-seven of them are nurses, 38 of whom are paramedics and 14 are doctors. The results indicate a direct correlation between stress levels and fatigue among hospital staff. The correlation between sex and type of work carried out was also presented. In subjective evaluation of the quality of medical service provided, the relationship between patient and staff and work satisfaction was high among employees. Conclusions: The fatigue levels of test subjects were on an average level. The age and type of work done by them had no direct effect on the fatigue levels. The stress level in the tested group was also on an average level. The highest level was presented by women (nurses' group), a lower level was presented by paramedics, and the lowest by doctors. The respondents who highly rated services undertaken and were satisfied with their work presented a lower level of stress and fatigue. [ABSTRACT FROM AUTHOR]

Introduction. By means of an X-ray diffractometer, it is possible to very precisely determine the composition of examined stones while identifying each kind of crystal. The objective of this paper is to make an in vitro assessment of the crystalline composition of urinary stones obtained during surgeries or those spontaneously excreted by the patients treated in the I and II Clinic of Urology of the Medical University in Lódź. Material and method. The research was conducted with the use of X-ray diffractometers: Dron - 1 or D 5000 Siemens. One hundred eighty-eight urinary stones obtained from patients treated in the clinics were examined. Results. The following crystals were found in the examined urinary stones: whewellite occurs in 97 (51.6%) stones, weddellite in 45 (23.9%), struvite in 82 (43.6%), apatite in 70 (37.2%), newberyite in 40 (21.2%), brushite in 34 (18.1%), bobierrite in 14 (7.4%), vitlokite in 7 (3.7%), uric acid in 12 (6.4%), ammonium acid urate in 1 (0.5%), calcium carbonate in 3 (1.6%), cystine and other sporadically occurring crystals were found in 0.6% to 1% of cases. Stones made of pure calcium oxalate constituted 18.1%. Oxalic stones with the additive of other crystals, although not containing any struvite, were found in 20.2% of cases, which in total makes 38% of the analyzed stones. Pure struvite stones constituted 5.3% and the ones with the additive of other phosphate crystals - 27.7%, which makes 33.0% in total. Uric acid stones constituted 5.3%, whereas with the additive of other crystals - 1.1%, which makes 6.4% in total. Cystine stones were found in 0.6% of cases. Mixed stones containing all kinds of crystals constituted 22.0%. Conclusions. Diffractometric studies allow very precise determination of the composition of urinary stones. While using the crystalline structure as a criterion for dividing urinary stones, one cannot create any homogenous groups. On the basis of the conducted research, we divided urinary stones into oxalic, phosphate, uric acid, cystine, and mixed ones, the latter containing all possible kinds of crystals. The largest group is made of mixed stones, which constitute 55% of the deposits and combine infected stones without calcium oxalate and stones that are a mixture of struvite and calcium oxalate as well as other crystals. Another numerous group is made of oxalic stones - 38.3% of cases. Uric acid stones (6.4%) and cystine stones (0.6%) are less frequent. Based on the observations conducted it can be concluded that along with the increase in the number of crystals contained in a uric stone, the number of uric acid deposits decreases and the number of stones made of phosphate and mixed oxalic and phosphate crystals, often with the additive of struvite, grows. [ABSTRACT FROM AUTHOR]

Introduction: Difficult-to-heal injuries are an increasing problem for today's healthcare systems. Patients claim that limitations in self-care, lack of specialised knowledge, absence of support from others perceived subjectively, and low self-esteem are the most common factors affecting the quality of their lives. Pain, exudation, and unpleasant smell increase medical treatment expenses and have a destructive influence on patients' functionality in terms of complications and frequent hospitalization. Aim of the research: Assessment of selected determinants conditioning the functioning of patients qualified for the Comprehensive Treatment of Chronic Wounds Program (KLRP-1). Material and methods: Thirty-one adults meeting the inclusion criteria were selected for the program. A prospective-observational study with the use of estimation and observation methods was conducted on the basis of the developed research protocol containing wound assessment tools, gathering data concerning pain perception, the functioning of patients in everyday life, and their subjective opinions of their life. The study was conducted during the first and the last visit of patients to the Surgery Clinic of Podkarpackie voivodeship, which implements protocols of Ambulatory Specialised Care (pl. AOS) and of the Comprehensive Chronic Wound Treatment Programme (KLRP-1). Results: The most common negative symptoms were excessive exudation (83.9%), pain (77.3%), and unpleasant smell (3.2%). In spite of the self-care capabilities declared by patients, most of them were not able to treat their wounds independently and needed the help of other persons (96.8%). The more intense the pain, the lower the subjective assessment of quality of life. Conclusions: Wound aetiology, degree of damage, or self-care ability do not affect the everyday physical functionality in patients. [ABSTRACT FROM AUTHOR]

Type 2 diabetes is a progressive disease and its consequence is the gradual decrease of endogenous insulin secretion to a very low level. Beyond this point, without insulin it is not possible to achieve proper metabolic compensation. The authors are trying to explain why the insulin therapy is often delayed in type 2 diabetic patients despite existing guidelines about its initiation and continuation. The causes of delay can be divided into two groups. One is the fear and disagreement of the patients (psychological insulin resistance - PIR) arising from different cognitive, emotional and other reasons. The second is the "clinical inertia", when the physicians are not able to explain in an effective and persuasive way the rationale and necessity of insulin treatment to their patients. The common background of both causes is the lack of sufficient knowledge about the pathogenesis of type 2 diabetes and the rationale of insulin treatment together with an insufficient level of communication between doctor and patient. The authors see the solution in the improvement of pre- and postgradual education of doctors and other health care providers (nurses, educators, psychologists), in their mutual cooperation and the translation of their knowledge towards a system of successful patient education. Orv Hetil. 2019; 160(3): 93-97.