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Chronic vein insufficiency (CVI) is a disease which, when it develops, leads to varicose veins of the lower limbs. As approximately 25% to 50% of people suffer from it, it should be recognised as a public disease. The treatment of chronic vein insufficiency is based on a surgical approach. The aim of the operation is to remove (strip) the insufficient major saphenous vein (MSV), the main cause of the disease. The major saphenous vein drains into the femoral vein and forms the sapheno-femoral junction, which is located in the hiatus saphenous within the femoral triangle. We conducted 94 varicose vein operations by the Babcock method on patients suffering from chronic vein insufficiency. This surgical treatment was performed in “Therapy”, a private clinic for peripheral vessel disease. We operated on 52 left lower limbs and 42 right lower limbs. The patients were qualified for the operation procedure after physical examination and Doppler ultrasonography imaging. We identified 5 types of major saphenous vein tributary drainage. The most common was Type I, in which there were 3 tributaries draining directly into the major saphenous vein. This type consisted of 45 cases (47.87%). We distinguished here 3 modifications. In Type II, however, there were 4 direct tributaries that drained into the major saphenous vein in 23 cases (24.46%). In this group of patients also 3 modifications were distinguished. Type III occurred in 14 cases (14.89%). We identified here 2 direct tributaries that drained into the saphenous vein and divided this type into 2 modifications. Type IV occurred in 8 cases (8.51%). Here we found 5 or 6 direct tributaries depending on the number of the external pudendal veins. Type V turned out to be very rare, occurring in only 4 cases (4.25%). Among all the types mentioned a thin tributary 1–2 mm wide was found in 10 cases (10.63%). This ran from under the fascia cribrosa into the saphenofemoral junction in the hiatus saphenous. This may be one of the causes of the recurrences of chronic vein insufficiency. There is also the possibility that a tributary will be overlooked or ignored during the operation, particularly when Type IV appears with 5 or 6 direct collaterals.
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Since the mid-eighties, the Polish society has witnessed a steady increase in the 65+ population. This demographic trend calls for a change in the organisation of health services and healthcare for this segment of the society. Old age is a difficult period in human life, especially if one has not been prepared for it. Individuals experience a number of health restrictions, while the quality of life at that stage of life depends mostly on the accuracy of identifying health needs, their types and the quality of the available solutions. The following paper aims to present literature on the most common health problems amongst the elderly in Poland. Numerous scientific centres in Poland (and abroad) which work with seniors have confirmed that the health situation of this age group is highly unsatisfactory. Seniors often face problems which affect their functioning, independence and self-care. Impairment may be caused by geriatric disorders, which include cardiovascular diseases (the most common cause of death in Poland among persons aged 65+), cancer, diabetes, balance disorders, impaired mobility, falling down, dementia, depression, insomnia, incontinence, soiling, impaired vision and hearing, lower limb muscle cramps at night, and bedsores. The rapid ageing of the society poses numerous challenges for healthcare organisers, educators and doctors with regard to educating, preventing and treating seniors in Poland.
Introduction. Fibromyalgia syndrome (FMS) and myofascial pain syndrome (MFPS) can be ranked among disease entities being difficult to diagnose clinically, manifesting themselves mainly through pain in specific hypersensitivity points. Aim. To present the current state of medical knowledge about pain spots appearing on hypersensitive points of soft tissue in the context of selected disease entities. Summary of the knowledge. MFPS is defined as sensory, motor and autonomic complaints, caused by the occurrence of trigger points (TrP). Yet the FMS is stated during the anamnesis on the basis of generalized pain, and pressure achiness of at least 11 out of 18 tender points (TP) of precisely determined location. Patients with FMS report numerous additional complaints – apart from the above mentioned ones; these are however highly non-specific and are not confirmed during routine medical check-ups. There are also no laboratory tests that can confirm presence of TrP being characteristic to MFPS and differentiating it from other muscles’ disease entities. Such points are identified only with the use of palpation. Unfortunately while examining a patient this way TrP – being symptoms of MFPS – can be quite easily confused with TP – being symptoms of FMS. Patients with MFPS which is developing in consequence of long-lasting global disorder of muscle tension balance and sensitivity of nociceptors as a result of chronically remaining pain, frequently suffer from achiness fulfilling the criteria of generalized pain. Moreover – in effect of static overload of soft tissues (especially of tonic muscles) – there occur hypersensitive palpable areas (points). Stimulating them cause lively reaction of the patient. Described symptoms can suggest a suspicion of FMS – the more so that making a diagnosis of MFPS does not exclude its coexistence. Having this in mind, there is a pretty large group of authors who raise a supposition that the differential diagnosis between TrP and TP should be observed in the quantitative rather than in the qualitative categories, despite the still binding definition and nomenclature. Recapitulation. Looking at the MFPS and at the FMS from the perspective of evolution of knowledge about them and from the point of view of period when scientific researches were conducted and their results published, it must be stated that during last years a considerable progress has been obtained in scope of better understanding of pathogenesis and pathophysiology of pain in specified points of soft tissue hypersensitivity, and the parallel clinical studies – confirming the hypotheses that were made – clearly increased the diagnostic and therapeutic capabilities of clinical practice.
A 25-year-old female patient with a history of oral contraceptive use was admitted to hospital because of exertional dyspnoea, palpitations, chest discomfort and weakness. Since the clinical presentation was suggestive of some heart disease the patient underwent echocardiography which revealed indirect signs of acute pulmonary embolism. The diagnosis was confirmed with multisliced computed tomography of the pulmonary arteries. Blood test results raised suspicion of antithrombin III deficiency. Enoxaparin and warfarin were used as treatment regimen with good effect and the patient was discharged home without significant symptoms, signs, and with normal echocardiography.
Background. The study aims to evaluate the effect of the pelotherapy in the treatment of patients with lumbar discopathy treated with low-frequency magnetic field and kinesitherapy. Material and methods. The study involved 79 persons randomly divided into 2 groups. The patients from group I (39 individuals) were subjected to pelvic therapy, low-frequency magnetic field and kinesitherapy. Those in the other group (40 individuals) were exposed to low-frequency magnetic field and kinesitherapy. To compare and assess the changes in both samples, the VAS pain scale and the Roland-Morris Disability Index were used, as well as the fingers-floor test to examine the range of mobility. Results. There were no statistically significant differences between the examined groups (p> 0.05). Both groups benefited from the therapy. In the first one, there was a reduction in pain − Me = 1.0 point in the VAS scale and, according to the Roland-Morris Questionnaire, the degree of disability was reduced by Me = 1.0 point. A more significant increase in the range of motion of the lumbar spine was observed in group II, in which the range of mobility increased by Me = 2.0 cm in the fingers-to-floor test. Conclusions. I ncorporation o f a pelotherapy i nto t he t reatment w hich c onsisted o f l owfrequency magnetic field and kinesitherapy did not significantly result in achieving a better therapeutic outcome.
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Type 2 diabetes risk factors among the unemployed

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Unemployment is a significant social problem which has numerous negative health consequences. Findings of numerous researches provide  data on the range of the consequences of unemployment with risk of health deterioration being one of the most important. Unemployment remains an area of interest for the following fields of science: psychology, economics, sociology. More and more researches prove that there is a link between the increase of disease occurrence and death rate and long-term unemployment. Both in Poland and all over the world a steady increase in the incidence of type 2 diabetes is being observed. World Health Organization (WHO) estimates that, taking into consideration present dynamics of changes, in 2025 there will be 300 million people diagnosed with diabetes. That is why a diabetes epidemic is such a topical issue, and according to some epidemic data this epidemic is starting to reach Poland as well. Data provided by IDF (International Diabetes Federation) show that in Poland the percentage of diabetes patients is 9,1% of the whole population and it is a little higher than the European average (8,6%). It is predicted that by 2015 the percentage will rise to 11%. Identification of adverse health behaviors and introducing actions promoting health in a given population group can prove to be beneficial for the present condition of members of a given group as well as decrease the risk connected with the occurrence of diseases associated with the progress of civilization in the future. The aim of the article is to indicate type 2 diabetes risk factors among the unemployed in Poland.
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Etiopathogenesis of allergic diseases

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Allergic diseases are the most common chronic diseases, particularly widely spread among children, adolescents and young adults. The problem is that there is an increasing incidence of allergic diseases. The causes of such a sudden increase of incidence rate are not well known. Complex interactions of environmental factors seem to play their role in the phenomenon. These include: change in the dietary and hygienic habits, progressing industrialization and increased use of numerous chemical agents. It was shown that inhabitants of highly industrialised nations, as compared to those from the developing countries, suffer from allergic diseases more frequently (most often in USA, Australia, Great Britain, Ireland and New Zealand, least frequently in Eastern Europe, Russia, China, India and Ethiopia), inhabitants of cities rather than those of rural areas, children who have no siblings rather than those from large families [1]. Knowledge of the factors that cause or influence the course of allergy is significant as it can help prevent and properly treat this disorder. It seems especially vital as in some patients allergy can manifest itself in the form of severe anaphylactic reactions, including an anaphylactic shock burdened with high risk of death.
Background. The study aimed to evaluate the scope and level of rural residents’ knowledge on the prevention of Lyme borreliosis and how this knowledge is used by residents of some selected rural areas of Lublin Province. Material and methods. A survey methodology was conducted with a sample of respondents of the Firlej and Kock communes (Lubartów County) and Borki commune (Radzyń Podlaski County). The study group involved 100 rural residents aged 18-67 years (mean 43; SD 0.14). Results. Among rural residents participating in the study, 35% are engaged in agriculture, and 61% have backyard gardens. 14% of the respondents have experienced a single tick bite, while 26% multiple bites. Out of those respondents who have experienced tick bites, only 12.5% have undergone diagnostic tests for the presence of Lyme borreliosis. The reported bite sites were found mostly in the lower limb (55%), stomach (40%), upper limb (30%), and the observed symptoms included first of all: muscle pain (50%), headache (37.5%), impaired concentration (20%), fever (17.5%), bone and joint pain (12.5%). A total of 30% farmers and rural residents consider their knowledge on the prevention of tick-borne diseases as minimal. Conclusions. It is necessary to undertake educational activities that would not only contribute to an increase in the level of knowledge of countryside residents on the prevention of tick-borne diseases but also lead to taking appropriate measures when bites occur.
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Background. Breast cancer is the most common malignant tumour in women in Poland. To reduce the risk of breast cancer, appropriate prevention is necessary. Numerous studies conducted over many years in Poland and throughout the world have demonstrated a significant effect of selenium on prevention of disease, including breast cancer in women. The following paper aims to present the literature on effects of selenium (Se) on prevention of breast cancer in women. Material and methods. Based on national and international literature, the paper presents information on the role of selenium (Se) in prevention of breast cancer in women. Results. Numerous studies conducted in research centres in Poland and abroad have shown that female patients with breast cancer and individuals with gastrointestinal cancer have significantly lower selenium concentration in their blood serum and whole blood, as well as significantly lower GSH - Px activity in plasma and red blood cells, compared to healthy women. Low selenium concentration may indicate an increased risk of breast cancer. Selenium is an essential co-factor in the production of antioxidant enzymes and may affect the development of cancer. Clinical trials which assessed selenium content in food showed that its supplementation reduced cancer mortality. Conclusions. Results of numerous national and prospective international studies indicate that low selenium intake and/or concentration in serum/plasma/nails is a high-risk marker of the majority of cancers, including breast cancer in women.
Background. Superior mesenteric artery syndrome (SMAS) is a rare disease caused by the acute angle of branching of the superior mesenteric artery from the aorta. Material and methods. There were 63 patients (56 women and 7 men) with low body weight, who reported recurrent persistent abdominal pain, nausea, post-prandial vomiting, significant weight loss. All of them had abdominal ultrasonography performed with measurement of the angle of branching of SMA from the aorta. CBC, total bilirubin, AST, ALT, GT, ALP, amylase, lipase, albumins, iron, sodium, potassium, GFR, lipid profile, TSH, urinalysis were ordered. Additionally, esophagogastroduodenoscopy with Hp. test and esophageal impedance measurement in correlation with the reported ailments was performed. Results. Acid reflux impedance was diagnosed in 10 patients. There were >55 acid reflux episodes per day and a positive reflux sign (SI) for heartburn and nausea. Abnormal impedance recording of acid reflux was diagnosed in 17 patients. They had >21 episodes of non-acid reflux per day. Positive reflux sign (SI) was not confirmed for any non-acid reflux-related symptoms. Conclusions. It is justified to perform impedance pH monitoring in this group of patients as it allows to modify the therapy. The most important dietary recommendations are weight gain and understanding the cause of the disease.
Present study aimed at analysing the set of epidemiologic, clinical and serological data in appraisal of trichinellosis focus in little towns near Poznań. It was stressed, that parasitic testing of the consumed meat associated with biological appraisal of Trichinella spiralis represent valuable criteria, which are helpful in interpretation mild clinical signs and symptoms, serological data and in establishing management of patients.
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