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Streszczenie:
Abstract: BackgroundDiet-related diseases remain leading causes of death in most developed countries around the world. The aim of the study was to compare opinions of patients and family physicians on receiving and providing recommendations about physical activity, diet and use of medication. Methods: The questionnaire study was conducted among patients of 36 primary health care clinics in Poland between September 2018 and February 2019. Patients and physicians were interviewed separately by trained researchers. Data from 509 patients and 167 family doctors were analyzed. Results: The median age of patients was 44 years (interquartile range: 29–55) and 70% were women. The majority of physicians were women (59%) and the median age was 37 years (IQR: 31–50). There was a significant difference between physicians’ declarations on providing recommendations on diet (92% vs. 39%) and activity (90% vs. 37%) versus patients’ declarations on receiving them. Conclusions: The results indicate that there is significant room for improvement in providing patients with proper recommendations on diet and physical activity by their family physicians. Primary care physicians should put more emphasis on clear communication of recommendations on diet and physical activity.

Słowa kluczowe:
diet

Streszczenie:
Background. Blood flow-mediated dilation (FMD) is a noninvasive assessment of vascular endothelial function in humans. The study of the FMD in hypertensive (HT) patients is an important factor supporting the recognition of the early mechanisms of cardiovascular pathologies, and also of the pathogenesis related to hypertension. Objectives. To investigate whether FMD measured on the radial artery (FMD-RA) using high-requency ultrasounds can be used asan alternative to FMD assessed with the lower frequency system onthe brachial artery in patients with HT. Materials and methods. The simultaneous measurements of FMD-RA and FMD measurements in the brachial artery (FMD-BA) were performed on 76 HT patients using 20 MHz and 7–12 MHz linear array probes, and were compared to the FMD measured in healthy groups. All quantitative data are presented as mean ± standard deviation (SD); the p-values of the normality and tests for variables comparisons are listed. The agreement of the FMD-RA and FMD-BA in HT patients was assessed with the Bland–Altman method, and using the intraclass correlation coefficient (ICC). In some statistical calculations, the FMD-RA values were rescaled by dividing them by a factor of 2. Results. The mean FMD-RA and FMD-BA in HT patients were 5.16 ±2.18% (95% confidence interval (95% CI): [4.50%, 5.82%]) and 2.13 ±1.12% (95% CI: [1.76%, 2.49%]), respectively. The FMD-RA and FMD-BA values of HT patients were significantly different than those in respective control groups. The p-values of Mann–Whitney–Wilcoxon tests were less than 0.05. The Bland–Altman coefficient for both measurement methods, FMD-RA and FMD-BA, was 3%, and the ICC was 0.69. Conclusions. Our findings show that FMD-RA, supplementary to FMD-BA measurements, can be used to assess endothelial dysfunction in the group of HT patients. In addition, the FMD-RA measurements met the criteria of high concordance with the FMD-BA measurements.

Słowa kluczowe:
hypertension, brachial artery, radial artery, endothelial function

Streszczenie:
Cardiovascular disease (CVD) is one of the major causes of perioperative complications. Screening of patients referred to major surgery is a costly and time and resources- consuming process. The study aimed to assess the usefulness of an electronic stethoscope with dedicated analytical software operated by a nurse for detecting heart disease in patients prepared for major orthopedic surgery. The study group consisted of 137 patients aged (46 – 91) with defined cardiovascular diseases qualified for hip or knee replacement surgery and 94 healthy age-matched volunteers. Heart auscultation with Littmann lectronic stethoscope using Littmann® StethAssist™ Heart and Lung Sound Visualization Software software was conducted and analyzed by a trained nurse. The signal recorded was analyzed by the blinded researcher using dedicated custom- made algorithm. Finally, 91 signals (52 CVD (+) patients, 39 CVD (-) patients) were analyzed. Eventually a classifier with a sensitivity of 92% and a specificity of 97% was obtained in a group. The global accuracy of the classifier was 95%. Heart auscultation by nursing staff using Littmann® StethAssist™ Heart and Lung Sound Visualization Software with dedicated custom- made can be cheap and noninvasive method of identifying patients with cardiovascular disease made algorithm for arthroplasty.

Słowa kluczowe:
electronic stethoscope, heart auscultation, nurse, arthroplasty, cardiovascular disease

Streszczenie:
Układ oddechowy pacjenta jest początkowo diagnozowany przy zastosowaniu stetoskopu. Osłuchowa interpretacja zjawisk fizycznych jest skomplikowana i wymaga od lekarza doświadczenia oraz predyspozycji. W niniejszym artykule zaprezentowano system pomiarowy i oprogramowanie badawcze, a także proces generacji cech dystynktywnych szmerów oddechowych różnicujących przypadki chorobowe od zdrowych. Wybrane reprezentacje stanowią obiecującą podstawę do opracowania systemu klasyfikującego wspierającego proces diagnostyczny

Słowa kluczowe:
szmery oddechowe, klasyfikacja, cyfrowe przetwarzanie sygnałów

Streszczenie:
Wprowadzenie i cel pracy. Rozwój technologii informacyjno-komunikacyjnej może doprowadzić do poprawy sytuacji w służbie zdrowia. Telepielęgniarstwo pozwoli na rozszerzenie praktyki pielęgniarskiej oraz wielu funkcji takich jak: opiekuńczo-pielęgnacyjna, profilaktyczna, diagnostyczna, rehabilitacyjna i związana z promocją zdrowia. Celem pracy jest ukazanie telepielęgniarstwa w ortopedii, a także zaprezentowanie wielu korzyści, jakie niesie zarówno dla pacjenta, jak i dla personelu medycznego. Skrócony opis stanu wiedzy. Starzejące się społeczeństwo potrzebuje zarówno wykwalifikowanego personelu pielęgniarskiego, jak i możliwości uzyskania szybkiej konsultacji lekarskiej i pielęgniarskiej. Udzielanie wskazówek, porad i opieki pielęgniarskiej przez pielęgniarki specjalistki w swej profesji m.in. za pomocą wideokonferencji przysporzy znaczących korzyści zarówno pacjentom, lekarzom, pielęgniarkom, jak i rehabilitantom. Podsumowanie. Wdrożenie wirtualnych wizyt może doprowadzić do poprawy sytuacji w ochronie zdrowia. Telepielęgniarstwo rozszerzyłoby kompetencje pielęgniarki, a także podniosłoby jakość świadczonych przez nie usług. Być może zatrzymałoby również emigrację zarobkową pielęgniarek w Polsce.

Słowa kluczowe:
telepielęgniarstwo, ortopedia, edukacja pacjenta, nowe technologie, kształcenie, niedobór personelu pielęgniarskiego

Streszczenie:
Under the influence of pathological changes, the blood coagulates inside the blood vessel, creating a thrombus. The thrombus dissolution process is called thrombolysis. The aim of the study is to evaluate the thrombolysis process by the interaction of the thrombolitic drug and ultrasound. The clot dissolution process was analyzed in a specially designed, transparent for ultrasound parallel plate flow chamber. Inside, a freshly coagulated human blood sample was exposed to ultrasound. A liquid containing the tissue plasminogen activator drug in a concentration of 10 μg/ml passed around the sample. The liquid flow was forced by a peristaltic pump. The source of ultrasound was a 1 MHz flat ultrasonic transducer with a 25 mm diameter. The transducer radiated a 1000 periods burst, repeated every 2500 periods and space averaged time averaged intensities of 0.2-1.6 W/cm2. The efficacy of thrombus dissolution was observed by means of a designed parallel plate flow chamber and the time of thrombus complete dissolution was measured. The best result for the 1 MHz frequency and space averaged time averaged intensity of 1.6 W/cm2 was recorded, where the thrombus was dissolved within 5.5 minutes.

Słowa kluczowe:
ultrasound, blood, thrombus, thrombolysis, parallel plate flow chamber

Streszczenie:
Parallel plate flow chambers are widely used for cell research in conditions of constant or pulsatile liquid flow. They are also used to analyze the formation of thrombi. The authors designed a flow chamber that is transparent to ultrasound, thus enabling the microscopic observation of the thrombus dissolution process by interaction of drug, microbubbles and ultrasound in real time, in-vitro. Sonothrombolysis was performed at 1 MHz and 3.3 MHz ultrasound frequencies, at space-averaged and time-averaged intensities ISATA of 0.2 – 1.6 W/cm2. 1 mm thick slices of the human blood clots were exposed to ultrasound in the presence of the Actilyse tissue plasminogen activator at a concentration of 10 μg/ml flowing around the sample. Next, the effect of SonoVue microbubbles at a concentration of 5x105/ml on the dissolution of the thrombus was investigated. Thrombus size changes were observed under a 4x magnification microscope and were recorded as a function of time. The best result was achieved for the Actilyse tissue plasminogen activator at the 1 MHz and 1.6 W/cm2 ISATA, the thrombus was sonolysed within 5.5 minutes. The noticeable effect of the SonoVue microbubbles on the thrombolysis process appeared at 3.3 MHz, the thrombus was sonolysed in 12 min at ISATA = 1.6 W/cm2.

Słowa kluczowe:
ultrasound, blood, thrombus, thrombolysis, parallel plate flow chamber