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Quality of life is an interdisciplinary concept. It is broadly defined and understood by representatives of many sciences, including medical and humanities. This is because the quality of life can directly affect human behavior, decisions made by him and affect the life situation, including health.The aim of the study was to assess the quality of life of patients hospitalized in the Department of Trauma and Orthopedics Surgery.The study included 105 people hospitalized in the Department of Surgery with the Trauma and Orthopedic Sub-Unit of the Healthcare Complex in Strzyżów. The diagnostic survey method was used. The research techniques that were used in the work are surveys.Both, the quality of life and the level of satisfaction with health, were assessed by the respondents as good. Quality of life in the physical field is ranked the lowest. It has been noticed that the quality of life of patients decreases with age. Pain sensation diminishes the quality of life in the physical domain. On the other hand, patients who are in a relationship have a much higher assessment of the quality of life in the psychological field. Education and age do not affect the quality of life and health satisfaction.Most of the patients assessed their quality of life as good or very good (83.8% of all respondents). Among the examined areas of quality of life, the respondents rated the physical domain as the lowest and the social domain the highest.

Background. Supracondylar humerus fractures are a serious problem in children. The complicated anatomy of the elbow joint necessitates careful assessment of the damage before individually adapting treatment methods. The aim of the study was to evaluate the effectiveness of comprehensive treatment of children in Group A in relation to children in Group B. Moreover, the impact of rehabilitation on the function of the affected elbow joint was examined. Materials and methods. The study enrolled 40 children divided into two groups: Group A and Group B. In Group A, the dominant method of treatment was percutaneous K-wire stabilization. The results demonstrate that the use of this treatment method and the implementation of systematic rehabilitation made it possible to achieve very good results. In Group B, stabilization was performed in less than half of the children and rehabilitation was carried out at home. The initial and follow-up examinations were carried out in both groups according to a medical test card. In Group A, the initial examination was performed on the day the rehabilitation commenced, and the follow-up examination after the completion of a 10-day rehabilitation cycle. In Group B, the initial examination was carried out after immobilization was removed and a follow-up examination was performed after 3 weeks of home-based rehabilitation. Results. The treatment model used in Group A was more effective than the model used in Group B. Conclusions. 1. Correct repositioning, the use of percutaneous K-wire stabilization and elbow rehabilitation performed at the earliest possible time give very good functional results. 2. The use of percutaneous stabilization shortens the hospitalization period, which is of great importance in the treatment of young patients.

OliwkoElżbieta, Babuśka–Roczniak Magdalena, Wojtanowska–Kaczka Magdalena,LyubinetsOleh, Roczniak Wojciech. Physiotherapeutic recommendations for patients with cystic fibrosis.Journal of Education, Health and Sport.2020;10(11):96-103. eISSN 2391-8306. DOIhttp://dx.doi.org/10.12775/JEHS.2020.10.11.010 https://apcz.umk.pl/czasopisma/index.php/JEHS/article/view/JEHS.2020.10.11.010 https://zenodo.org/record/4278924 The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019. © The Authors 2020; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 03.11.2020. Revised: 11.11.2020. Accepted: 18.11.2020. Physiotherapeutic recommendations for patients with cystic fibrosis Elżbieta Oliwko1, Magdalena Babuśka–Roczniak1, Magdalena Wojtanowska–Kaczka1, OlehLyubinets², Wojciech Roczniak1 1The Jan Grodek State University in Sanok, Medical Institute, Poland ²Danylo Halytsky Lviv National Medical University, Lviv, Ukraine Abstract Cystic fibrosis is a genetically determined disease. The development of medicine has resulted in an improvement and prolongation of life. Numerous scientific studies support the thesis that maintaining physical performance is a key element of complex treatment. The basis of treatment should be: parallel pharmacological treatment and physiotherapeutic. The aim of this work was to present the physiotherapeutic techniques used in this disease. The main methods of physiotherapeutic treatment include positional drainage, forced exhalation technique, active breathing cycle technique, autogenous drainage, variable bronchial pressure technique and increased respiratory pressure technique. Physiotherapy of the respiratory system is of major importance, the main aim of which is to prevent the deterioration of the already existing respiratory failure. Each of the presented methods of physiotherapy was created thanks to constant search for the perfect technique to cleanse the bronchial tree. This disease has a different clinical course and each technique should be adapted to the individual needs of the patient and the basis of effective therapy is systematic, daily cleansing of the bronchial mucus from the bronchial tree. Physiotherapy applied earlyIn the thoracic region, it is the treatment of choice for patients with cystic fibrosis, improves the quality of life and prolongs the patient's age. Conclusions: 1. There is no effective, causal treatment for cystic fibrosis, and drug treatment comes down to treating complications and often has side effects. 2. Comprehensive physiotherapy is the golden mean in the treatment of cystic fibrosis and significantly prolongs the life of patients. 3. The effectiveness of physiotherapy depends on the time of commencement, regularity and personalization of treatments. Keywords:cystic fibrosis, treatment methods, physiotherapy.

Introduction: Speed of movement refers to the max. speed of moves that an individual is able to perform, associated with the optimal activation of muscle fibers. It increases until the age of 15 in girls and 18 in boys, with the fastest rate 6–14 years of age. In boys, 2 periods of a particularly intense increase in speed are observed: 7–10 and 13–15 years of age. The aim of the study was to assess the level of speed in girls and boys aged 9–10-years-old from school groups with an extended physical education program and those from regular groups. Materials and methods: This study, performed every year 2003–2013, involved 470 children aged 9–10 years, finishing the 3rd year of the primary school. A 30 m run and long jump were used to test the speed of the children. The study method was based on the selected elements of the Denisiuk test. Results: The tests showed that boys were faster than girls. Every year, they obtained better average score for the 30 m run and tests. The lowest difference between sexes was noted in 2013. We also demonstrated that almost in all years the candidates for cross-country skiers were faster than the students assigned to groups with no extra sports classes. Conclusions: Our study confirmed higher speed in 9–10-year-old boys than in girls, especially in long jump tests. Children with higher fitness level were faster than their less active peers. The deterioration of speed test results in the subsequent years of the study is an unfavorable trend that requires further long-term research.

Introduction. Cross-country skiing is a sport discipline with different applications in the modern world. It is used in recreation, rehabilitation, tourism and sport as a phycical movement. Objective of the work. The aim of the study was to estimate physical fitness of children aged 10 - 11 years attending sports classes (cross-country skiing profile) with the results of the efficiency grade among students attending unsportsmanlike classes in Sports Primary School in Suprasl. Material and methods. The study involved 50 children attending the Sports School in Suprasl - class 4 students. Each student was supposed to take part in the International Physical Fitness Test. There were the following attempts: 50 metres run, long jump, sitting position from lying down during 30 seconds, the trunkbend in front and 600 metres run. The results of completed studies are presented in tables and figures below. Results. The analysis show that girls practising cross-country skiing are characterized by higher efficiency motor skill compared to their peers, as well as it is easier for them to acquire new motor skills than for boys of their class. For boys the differences that occurred between sports and unsportsmanlike classes was insignificant. Perhaps, it may change in future. Conclusions. Children attending sports classes (cross country-skiing profile) have better motor abilities and acquire new motor skills faster than pupils in unsportsmanlike classes.

Background: Changes in adipokine secretion may be involved in the anti-epileptic effect of a ketogenic diet (KD) in drug-resistant epilepsy (DRE). Objectives: The assessment of the influence of KD on serum adiponectin, omentin-1, and vaspin in children with DRE. Methods: Anthropometric measurements (weight, height, BMI, and waist-to-hip circumference ratio) were performed in 72 children aged 3–9 years, divided into 3 groups: 24 children with DRE treated with KD, 26—treated with valproic acid (VPA), and a control group of 22 children. Biochemical tests included fasting glucose, insulin, beta-hydroxybutyric acid, lipid profile, aminotransferases activities, and blood gasometry. Serum levels of adiponectin, omentin-1 and vaspin were assayed using commercially available ELISA tests. Results: Serum levels of adiponectin and omentin-1 in the KD group were significantly higher and vaspin—lower in comparison to patients receiving VPA and the control group. In all examined children, serum adiponectin and omentin-1 correlated negatively with WHR and serum triglycerides, insulin, fasting glucose, and HOMA-IR. Vaspin levels correlated negatively with serum triglycerides and positively with body weight, BMI, fasting glucose, insulin, and HOMA-IR. Conclusion: One of the potential mechanisms of KD in children with drug-resistant epilepsy may be a modulation of metabolically beneficial and anti-inflammatory adipokine levels.

The mineral structure of bones is never static, it is a living structure, reacting and adapting to load and having the ability to remodel. Skeletal cells work continuously to maintain the remodelling process therefore they are in a constant state of dynamic balance both in the sense of composition and structure, and they react to external mechanical forces. The remodelling processes that occur in the bone tissue allow for a proper functioning of this tissue, as well as for inclusion of additional elements, toxic ones included, in the remodelled bone, and they affect the metabolic processes occurring therein. This may result in disturbances in the osteoarticular system, manifested by changes in the bone tissue and within other organs. The influence of tobacco smoking on the content of strontium, lead, calcium, phosphorus, sodium and magnesium has not been confirmed. Non-smokers showed a high iron content in knee joint tissues compared to smokers. There were no statistically significant differences in the content of cadmium, nickel, copper and zinc in women and men in the studied knee joint components. With age, an increase in the content of chromium in knee joint tissues was observed, while gender, place of residence and occupational exposure had no effect.

Objectives: To assess pancreatic exocrine function in patients with anorexia nervosa using a breath test with 13C-labeled mixed triglycerides (MTG-BT) and to determine the relationship between the test results and selected biochemical and hormonal parameters. Material and methods: Anthropometric measurements, biochemical and hormonal parameters (serum leptin, soluble leptin receptor (sLR), acylated and desacylated ghrelin, free leptin index (FLI)), and MTG-BT were performed in a group of 31 girls with the restrictive type of AN, as well as 38 healthy girls (C). Results: The average cumulative dose of 13C-triglycerides recovered with exhaled air (%CD) was similar in both study groups, while the average time from 13C-triglycerides administration to peak 13CO2 excretion in expired air (time to peak (TTP)) was significantly longer in patients with AN compared to C. In both groups, %CD correlated negatively with FLI. TTP correlated negatively with sLR and FLI in the AN and with serum insulin and HOMA-IR values in the C. Conclusions: In girls with AN, the pancreatic efficiency of lipase secretion was found to be normal, while the kinetics of this enzyme secretion were disturbed. These changes may result from disorders in the functioning of the adipose–insular and islet–acinar axes.

Introduction Carbon monoxide is known as the ‘silent killer’. It may lead to a direct threat to people’ s life. In the statistics, carbon monoxide poisoning is in the third place after drugs and alcohol. Its victims are not only the result of accidents, but also because of deliberate action (suicide). There are many emergency medical interventions in cases of carbon monoxide poisoning. Objective The aim of the study was to determine the appropriate scheme for medical rescue teams attending to the victim poisoned by carbon monoxide. Material and Methods The research material was obtained from the analysis of medical record cards of rescue actions and the order of departure medical rescue team, which were directed to 70-year-old man due to carbon monoxide poisoning as a result of intentional action – a suicide attempt. The case study method was used. Results Most important for the medical person assisting in a case of poisoned by carbon monoxide is the immediate interruption of exposure to the toxic gas by evacuation of the victim, and quick implementation of a high rate of oxygen flow. In such a situation, each minute is very precious. The longer the exposure to the fumes, the less likely the victim is to survive. Conclusions The medical rescue team acted in accordance with the guidelines in a case of carbon monoxide poisoning. They properly implemented the medical rescue operation, but this does not always guarantee success.

Background: Interleukin 15 (IL-15) plays a key role in the muscle-fat interaction, reducing adipose tissue mass without changes in the lean body mass and reduction of food intake. Here we assess serum IL-15 levels in girls with anorexia nervosa (AN) relative to obese and normal weight female adolescents.Methods: Serum IL-15 concentrations were evaluated using a commercially available ELISA kit in 32 Polish girls with restrictive AN, 29 girls with obesity (O), and 21 healthy controls (C). Anthropometric measurements (weight, height, BMI) and laboratory assays (serum fasting glucose, insulin, HOMA-IR, total cholesterol, HDL, LDL, triglycerides, and C-reactive protein (CRP)) were performed.Results: Mean serum IL-15 in the AN group was significantly higher than in C, but lower than in O. In all examined girls, significant positive correlations between IL-15 and body weight, BMI, insulin, HOMA, LDL, triglycerides and CRP were noted. We also observed an inverse relationship between IL-15 and HDL.Conclusions: Our study demonstrated that serum IL-15 concentrations in adolescent girls with AN and obesity are significantly elevated in comparison to normal weight controls. However, the role of IL-15 in the pathogenesis of AN and obesity remains still unclear.

Introduction: Ovarian cancer is most frequently detected in the advanced stage. Although its pathogenesis is not fully elucidated, it is assumed that body susceptibility and hormonal disorders are responsible. The role of some cytokines as predictors in the treatment process is still investigated. The aim of the study was to determine the relationship of adiponectin and leptin with the disease severity and response to chemotherapy. Material and methods: Forty-three ovarian cancer patients were treated by systemic treatment. Patients received 5–7 cycles of chemotherapy — paclitaxel/carboplatin with or without bevacizumab. Using standard ELISA kits before and after chemotherapy, adiponectin and leptin concentrations were determined in the blood serum. Results: The average adiponectin concentration before chemotherapy was found to be 8.83 ± 3.19 μg/ml, as compared to 10.37 ± 4.18 μg/ml (increase by 17.44%, p < 0.001) after treatment. Mean pre-treatment leptin concentration was 16.89 ± 15.54 ng/ml, and 21.77 ± 14.69 ng/ml after chemotherapy (increase by 28.89%, p < 0.01). A positive correlation was found between leptin concentration and age and BMI. There was no relationship of the disease severity with the response to treatment and the concentration of the adipokines. The leptin/adiponectin ratio (L/A) before treatment correlated with better response to chemotherapy. Conclusions: Adiponectin and leptin did not correlate with the stage of ovarian cancer and response to chemotherapy. The L/A ratio may be considered a predictor of clinical response to treatment.

Roczniak Wojciech, Skalik Marta, Brodziak–Dopierała Barbara, Płaziak Robert, Marek Hubert, Motyka Marcin, Sośnicki Krzysztof, Wojtanowska-Kaczka Magdalena. Atrial fibrillation as a frequent reason for calls by Emergency Medical Teams. Journal of Education, Health and Sport. 2021;11(01):82-93. eISSN 2391-8306. DOI http://dx.doi.org/10.12775/JEHS.2021.11.01.009 https://apcz.umk.pl/czasopisma/index.php/JEHS/article/view/JEHS.2021.11.01.009 https://zenodo.org/record/4456061 The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019. © The Authors 2021; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 01.01.2021. Revised: 10.01.2021. Accepted: 21.01.2021. Atrial fibrillation as a frequent reason for calls by Emergency Medical Teams Wojciech Roczniak¹, Marta Skalik², Barbara Brodziak–Dopierała³, Robert Płaziak⁴, HubertMarek¹, Marcin Motyka¹, Krzysztof Sośnicki¹, Magdalena Wojtanowska-Kaczka¹ ¹The Jan Grodek State University in Sanok, Medical Institute ²Nicolaus Copernicus University in Toruń, Ludwik Rydygier Collegium Medicum in Bydgoszcz ³Department of Toxicology and Bioanalysis, School of Pharmacy with the Division of Laboratory Medicine, Medical University of Silesia ⁴SP ZOZ in Lesko Summary Introduction Atrial fibrillation is the most common supraventricular arrhythmia which is also a frequent cause of calls by Emergency Medical Services Teams. The purpose of the work was presentation of the conduct of the Medical Rescue Teams in about patients with atrial fibrillation. Research methodology The study included an 86-year-old woman who was called by the Medical Rescue Team due to increasing weakness accompanied by chest pain and dyspnoea. At the patient after a thorough medical history and physical examination, the first episode of atrial fibrillation was found. An individual case study method was used. The study was conducted on the basis of a medical rescue cardthose. Conclusions There is no one size fits all regimen for the management of patients with atrial fibrillation. There are algorithms that facilitate the implementation of appropriate treatment. The rescue operation must always be tailored to the individualthe patient's health status and modified as necessary. Thanks to this procedure, paramedics minimize the chances of making a mistake and improve the patient's health. Key words: atrial fibrillation, arrhythmia, Syndrome Medical Rescue, emergency procedures

Introduction: Mercury is one of the elements that are commonly found in nature. This element is highly toxic, mainly affecting the nervous system, kidneys and lungs. Mercury ions can accumulate in bone and cartilage and build up behind calcium ions in carbonates and hydroxyapatites. High mercury concentrations in the spongy bone compared to the compacted bone were found. Aim: The aim of the manuscript was to assess the mercury content in tibial and femoral tissue taken from patients undergoing knee arthroplasty. Material and methods: Samples were taken from 17 patients (tibial and femoral bone samples), collected from patients who underwent knee arthroplasty. The tested samples were homogenized and determined by atomic absorption spectrometry and the AMA 254 amalgamation technique. Studies have shown mercury presence in all samples tested. Results and discussion: The range of mercury content in the tested samples was 3.3–19.18 μg/kg. The average for the examined bone tissue samples was 8.71 μg/kg, while for the tibia it was slightly higher (9.08 μg/kg), compared to the femur (8.34 μg/kg). There was a high mercury content in men’s bone tissue (10.05 μg/kg), compared to women (8.15 μg/kg). In both sexes, higher levels of mercury in the tibia were found in men (11.08 μg/kg in men, and 8.24 μg/kg in women). Conclusions: The dependence between mercury concentration in bone tissue and the patient’s age, weight and BMI, the number of cigarettes smoked and the consumption of fish and seafood were checked. There were no statistically significant correlations between these indicators.

Babuska RoczniakMagdalena, Wojtanowska KaczkaMagdalena, Racz Oliwer, Marek Hubert, Sośnicki Krzysztof, RoczniakWojciech. Proceedings of an emergency medical team (paramedics) with a patient in anaphylaxis. Journal of Education, Health and Sport. 2020;10(6):108-116. eISSN 2391-8306. DOIhttp://dx.doi.org/10.12775/JEHS.2020.10.06.012 https://apcz.umk.pl/czasopisma/index.php/JEHS/article/view/JEHS.2020.10.06.012 https://zenodo.org/record/3895085 The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019. © The Authors 2020; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 01.06.2020. Revised: 15.06.2020. Accepted: 16.06.2020. Proceedings of an emergency medical team (paramedics) with a patient in anaphylaxis Magdalena Babuska Roczniak1, Magdalena Wojtanowska Kaczka1, Oliwer Racz2, Hubert Marek1, Krzysztof Sośnicki1, Wojciech Roczniak1 1 The Jan Grodek State University in Sanok, Medical Institute, Sanok, Poland 2University of Pavol Jozef Safarik Kosice, Kosice, Slovakia ABSTRACT Introduction:Anaphylactic shock is an acute allergic body reaction to allergens. This condition threatens the patient's life and health. Anaphylaxis can be caused by intolerance to many nutrients, medications or hymenoptera stings. Aim of the manuscript:The aim of the manuscript was to determine the pattern of proceedings of emergency medical teams with patients in anaphylactic shock. Material and methods: The individual case method of a patient stung by a Hymenoptera insect, for whom a medical rescue team was dispatched, was used. The research material was obtained thanks to the analysis of medical rescue operations and dispatch orders. Results: The analysis of medical records of the injured person depicted an appropriate algorithm of proceedings with a patient in anaphylactic shock. In anaphylaxis, it is important to gather information as soon as possible, make an accurate and prompt diagnosis, and provide immediate pharmacotherapy. In this case, the first-line drug is Adrenaline, which prevents the release of histamine and reverses the effects of shock. Further treatment requires oxygen, fluids and second-line pharmacotherapy. Conclusions: The emergency medical team followed the applicable algorithms and current knowledge. It implemented appropriate medical rescue operations, thanks to which the condition of the injured was stabilized. The first step is to stop the exposure to the allergen. Keywords: anaphylaxis, shock, emergency medical team, rescue procedure.

Irritable bowel syndrome (IBS) is one of the most common functional gastrointestinal disorders (FGID), characterized by abdominal pain and a change in stool form that cannot be explained by structural abnormalities. Its prevalence ranges from 9 to 23% of the worldwide population. The pathophysiology of IBS is diverse and not well understood. Biopsychosocial concept assumes that the disease is a product of psychosocial factors and altered at multiple levels of gut physiology interactions. Some aetiological factors have been identified, yet. One of the most important is the disruption of brain-gut mutual communication that leads to visceral hypersensitivity. Also genetic and epigenetic factors are involved. Chronic stress may predispose to IBS as well as exacerbate its symptoms. Both quantitative and qualitative disorders of the gut microbiota are observed. There is also a relationship between the IBS symptoms and the intake of a specific type of food products. In the diarrhoea type of IBS the role of previous gastrointestinal infection is demonstrated. Recent studies have suggested that visceral hypersensitivity in patients with IBS may be secondary to the activation of the immune cells and low-grade inflammation. Clinical symptoms of IBS include abdominal pain and change in bowel habits as well as somatic and psychiatric comorbidities. IBS is diagnosed on the basis of Rome Diagnostic Criteria. Recently, their newest version (Rome IV) has been presented. The aim of this review is to summarize the past decade progress in IBS diagnosis, main pathophysiological aspects and therapeutic management strategy.

Growth hormone (GH) is a naturally occurring polypeptide hormone produced by somatotropic cells in the anterior pituitary. The main function of somatotropin is stimulation of linear growth, but it also affects carbohydrate metabolism, increases bone mass and has potent lipolytic, antinatriuretic and antidiuretic effects. Growth hormone deficiency (GHD) may occur both in children and in adults. At the moment there is no gold standard for the diagnosis of GHD, and the diagnosis should take into account clinical, auxological, biochemical and radiological changes and, if necessary, genetic testing. Recent studies have highlighted that the biochemical diagnosis of GH deficiency is still imperfect. Stimuli used in the tests are non-physiological, and various substances are characterized by a different mechanism of action and potency. A few years ago it was thought that GHD treatment in children must be completed at the end of linear growth. Studies performed in the last two decades have shown that GHD deficiency in adults may result in complex clinical problems, and if untreated shortens the life expectancy and worsens its comfort. Discontinuation of GH therapy after the final height has been reached in fact negatively impacts the physiological processes associated with the transition phase, which is the period of human life between achieving the final height and 25-30 years of age. Given the adverse metabolic effects of GH treatment interruption after linear growth has been completed, the latest recommendations propose reassessment of GH secretion in the period at least one month after cessation of treatment and continuation of the therapy in case of persistent deficit.

Introduction: Breast cancer is the most common malignancy in women. Due to the large number of women living with breast cancer and the increasing incidence of this cancer, it is very important to understand the factors determining the quality of life (QOL) of patients. The aim of the study. The aim of the study was to determine the impact of time to initiation of treatment on the quality of life of women with breast cancer. Materials and methods. The study involved 324 women with breast cancer, treated at the Podkarpackie Oncology Centre in Brzoz&oacute, w, Poland. The study was conducted using a diagnostic survey, using a standardised questionnaire to measure the quality of life of women treated for breast cancer, i.e., the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC) QLQ-C30 and the QLQ-BR23 module, as well as a proprietary survey questionnaire. Statistical analysis was performed using the Statistica 10.0 software (StatSoft Inc., 2011). A p value of &lt, 0.05 was considered statistically significant. Results: The examined women had a reduced overall quality of life and health (M = 53.88). The quality of life was higher in women who consulted a doctor the earliest after noticing initial symptoms of the disease, i.e., up to one week (M = 57.58), compared to patients who delayed the decision (over four weeks, M = 47.8) (p = 0.002). The quality of life was also considered higher by women who received treatment within two weeks of diagnosis (M = 56.79) and was lower for patients who waited for treatment for more than two months (M = 43.68). Statistically significant relationships were demonstrated for functional scales and disease intensity. Conclusions: Women diagnosed with breast cancer had a considerably lower overall quality of life. A relatively higher quality of life was experienced by patients who consulted a doctor the earliest after discovering symptoms of the disease and those whose waiting time for treatment was shorter. In a systematic manner, the individual stages of diagnosis should be maximally reduced and breast cancer treatment initiated without delay.

Introduction In women diagnosed with breast cancer one of the methods most commonly applied in therapy is surgical treatment, which consists in a breast conserving surgery or total removal of the breast. The applied type of surgical treatment may exert an effect on the satisfaction with life of the women. Objective The aim of the study was evaluation of the satisfaction with life among women surgically treated for breast cancer, according to the type of surgery on the breast, and the time elapsed since its performance. Material and methods The study included 121 patients of the Sub-Carpathian Oncology Centre in Brzozów, south-east Poland, who had undergone surgical treatment due to breast cancer. The women expressed their informed consent to participate in the study. The method of a diagnostic survey was applied. Results The women obtained a mediocre result in satisfaction with life – 5.64 sten scores. Patients who had undergone mastectomy had a considerably lower level of satisfaction with life, compared to those after breast-conserving surgery (4.73 sten scores vs. 6.30 sten scores). Evaluations of the satisfaction with life in the examined group significantly differed according to the time elapsed since performance of surgery. Conclusions There is a need for undertaking actions directed to women who have undergone surgical treatment for breast cancer within the period from 2–5 years, aimed at improving the satisfaction with life in this group of patients. In addition, special support should be provided for women who have undergone mastectomy, especially during the period of more than 1 and up to 2 years.

OBJECTIVE The aim of the study was evaluation of satisfaction with life among women ill with breast cancer, with consideration of selected demographic and social factors. MATERIAL AND METHODS In the study participated 121 patients from the Sub-Carpathian Oncology Centre in Brzozow, Poland, who had undergone surgical treatment due to breast cancer. The method of a diagnostic survey was used. The research instruments were an author-constructed questionnaire and the Satisfaction with Life Scale. RESULTS Women who received surgical treatment due to breast cancer evaluated their satisfaction with life on a mediocre level. Younger patients had a lower satisfaction with life than those who were older. Women living in urban areas evaluated their satisfaction with life in more positive terms than rural women. In turn, education level, marital status and material standard had no effect on the level of satisfaction with life among the women in the study. CONCLUSIONS According to the SWLS, women with the diagnosis of breast cancer obtained a mean result of 5.64 sten scores Younger women evaluated their satisfaction with life in more positive terms than those who were older. Women who lived in urban areas obtained a considerably higher result according to the SWLS, compared to rural inhabitants. Marital status, education level, material standard and occupational activity of the women were insignificant in the respondents' evaluation of satisfaction with life.

Chromium is an essential microelement in the human body. It exerts an effect on bones by modulating their biochemical parameters: alkaline phosphatase (ALP) and tartrate-resistant acid phosphatase (TRAP). With considerable accumulation of chromium in the skeleton, the activity of alkaline phosphatase was found to decrease, which affected bone formation rate. The study objective was to analyze chromium content in the knee tissues. Tissues for analysis were obtained during endoprosthesoplasty of the knee joint and included tibia, femur, and meniscus tissues. Samples were collected from 50 patients, including 36 women and 14 men. The analysis was performed using the inductively coupled plasma atomic emission spectroscopy (ICP-AES) method, by means of a Varian 710-ES apparatus. The results revealed no significant differences in the content of chromium in the knee joint tissues between women and men. The highest level of chromium was found in the femoral bone of the knee joint, then in the meniscus, and was lowest in the tibia, although the differences were statistically insignificant. Chromium content increased with age.

Background Iron as a cofactor of enzymes takes part in the synthesis of the bone matrix. Severe deficiency of iron reduces the strength and mineral density of bones, whereas its excess may increase oxidative stress. In this context, it is essential to determine the iron content in knee joint tissues. Objectives The study objective was to determine the level of iron in the tissues of the knee joint, i.e., in the femoral bone, tibia and meniscus. Material and methods Material for analysis was obtained during endoprosthetic surgery of the knee joint. Within the knee joint, the tibia, femur and meniscus were analyzed. Samples were collected from 50 patients, including 36 women and 14 men. The determination of iron content was performed with the ICP-AES method, using Varian 710-ES. Results The lowest iron content was in the tibia (27.04 μg/g), then in the meniscus (38.68 μg/g) and the highest in the femur (41.93 μg/g). Statistically significant differences were noted in the content of iron in knee joint tissues. Conclusions In patients who underwent endoprosthesoplasty of the knee joint, statistically significant differences were found in the levels of iron in various components of the knee joint. The highest iron content was found in the femoral bone of the knee joint and then in the meniscus, the lowest in the tibia. The differences in iron content in the knee joint between women and men were not statistically significant.

Introduction Since little has been known about the effect of the central noradrenergic system on the reactivity of serotonin 5-HT 3 receptors, the aim of the current study was to find out whether this reactivity could be altered by chemical damage to the system in adult rats in early developmental stage. Materials and methods Adult male Wistar rats with central noradrenergic lesion induced by DSP-4 on day 1 and 3 of life were injected with analgesic model substance – morphine, serotoninergic 5-HT 3 receptor agonist (1-phenylbiguanide, PBG), 5-HT 3 receptor antagonist (ondansetron) or both compounds jointly followed by decarboxylase inhibitor of aromatic amino acids (NSD-1050). After 30 min following NSD-1050 injection, the animals were decapitated using a guillotine. Chosen cerebral structures were dissected, and the contents of 5-hydroxytryptofan (5-HTP) and l -dihydroxyphenylalanine ( l -DOPA) were determined using high-pressure liquid chromatography with electrochemical detection (HPLC/ED). Results Neither PBG nor morphine affected l -DOPA contents in the hippocampus in control rats; however, DSP-4 lesion caused a significant decrease in the synthesis rate of DA in this structure. Hippocampal contents of 5-HTP increased after morphine or PBG administration, and central noradrenergic lesion attenuated this effect. Morphine or PBG decreased cerebellar DA synthesis rate in control rats and DSP-4 lesion did not modify it. Cerebellar levels of 5-HTP increased after morphine or PBG challenge in control rats. DSP-4 lesion intensified the effect of morphine and attenuated that of PBG. Ondansetron abolished the effects mediated by PBG. We did not observe any impact of PBG or ondansetron on DA and 5-HT synthesis in the striatum. Conclusion Damage to the central noradrenergic system in rat newborns, through altered reactivity of central 5-HT 3 receptors, results in permanent disorders in serotoninergic transmission in hippocampus and cerebellum as well as dopaminergic transmission in hippocampus, which may attenuate the activity of the descending pathways that derive from these structures.

Many elements are responsible for the balance in bone tissue, including those which constitute a substantial proportion of bone mass, i.e., calcium, phosphorus and magnesium, as well as minor elements such as strontium. In addition, toxic elements acquired via occupational and environmental exposure, e.g., Pb, are included in the basic bone tissue composition. The study objective was to determine the content of strontium, lead, calcium, phosphorus, sodium and magnesium in chosen components of the knee joint, i.e., tibia, femur and meniscus. The levels of Sr, Pb, Ca, P, Na and Mg were the highest in the tibia in both men and women, whereas the lowest in the meniscus. It should be noted that the levels of these elements were by far higher in the tibia and femur as compared to the meniscus. In the components of the knee joint, the level of strontium showed the greatest variation. Significant statistical differences were found between men and women only in the content of lead.

Fibroblast growth factor 21 (FGF21) is a hepatokine, myokine and adipokine of a potent influence to energy homeostasis. Data according its serum concentrations in AN are contradictory.Analysis of serum FGF21 in girls with acute anorexia nervosa and comparison the results with normal weight and obese female adolescents considering their nutritional status, carbohydrate and lipid metabolism.Serum FGF21 concentrations were evaluated using commercially available ELISA kit in 32 Polish girls with restrictive AN (AN), 29 girls with obesity (O) and 21 healthy controls (C). Anthropometric measurements (weight, height, BMI) and laboratory assays (serum fasting glucose, insulin, HOMA-IR, total cholesterol, HDL, LDL, triglycerides, C-reactive protein) were performed.Mean serum FGF-21 in the AN group was significantly lower, whereas in the O group it was significantly higher than in healthy controls. In all examined girls significant positive correlations between FGF21 and BMI were noted. We also observed significant positive relationships between serum FGF21 levels and fasting glucose, triglycerides, CRP, insulin and HOMA-IR. In all examined girls serum concentrations of this hormone correlated negatively with age and HDL-cholesterol levels.1) Serum FGF21 concentrations are decreased in AN and elevated in obesity. They are independently and positively related to BMI and insulin resistance; 2) Decreased serum FGF21 in AN may support the maintenance of normal blood glucose through adjustment the insulin levels and insulin sensitivity; 3) Elevated FGF21 levels in obesity may be considered adaptive mechanism preventing insulin resistance and its metabolic consequences.

Adiponectin (APN) is adipose tissue-derived hormone influencing energy metabolism. Growth hormone deficiency (GHD) may contribute to the development of disturbances in the hormonal function of adipose tissue (AT), and many disorders observed in untreated patients with GHD coincides with these contributed to low serum APN levels.The assessment of serum adiponectin levels in adolescents and young adults with severe or partial GHD and analysis of relationships between serum APN and GH/IGF-1 axis function impairment as well as cardiometabolic risk factors.Based on the results of insulin tolerance test (ITT) patients were qualified for one of the following groups: 1) severe GHD - SGHD (26 patients; 8 women and 18 men); 2) partial GHD - PGHD (22 patients, 7 women and 15 men); 3) normal GH status - NGHS (28 patients, 9 women and 19 men). The fourth examined group consisted of healthy individuals - H (46 participants; 15 women, 31 men). Anthropometric measurements (height, weight, BMI), analysis of body composition and serum glucose, lipids, insulin, IGF-1 and APN assays were performed in all participants.There were no significant differences in the concentrations of APN between groups. After calculation of the total APN content in extracellular fluids per unit of fat tissue mass (TAPN/FM), these values were significantly lower in the SGHD (p0.001) and correlated with the degree of impairment of the GH/IGF-1 axis functioning. In patients with GHD positive correlations between APN and serum HDL cholesterol (r=0.39, p0.05) have been demonstrated. In the subjects with normal GH secretion serum APN correlated positively with serum HDL cholesterol (r=0.28; p0.05), and negatively with fasting blood glucose (r=-0.31; p0.05).Severe, but not partial growth hormone deficiency impairs adiponectin production in the adipose tissue that is compensated by the increase of fat mass. The degree of GH/IGF-1 axis disruption is related to the TAPN/FM. This parameter may be potentially useful in diagnosing severe growth hormone deficiency in the adults.