ABSTRACT
INTRODUCTION: The purpose of this study was to describe rural and urban disparities in quality of life and health-related behaviors among chronically ill patients. Additionally, effects of health status and health-related behaviors on healthcare utilization were investigated. METHODS: The study included 1239 chronically ill patients from primary care centers in rural areas (eligible patients; response rate: 62.0%). The analyzed group was compared with the urban group, homogeneous in respect of gender and age (n=1886). Quality of life (QoL) was measured using the World Health Organization Quality of Life Instrument Short Form (WHOQoL-Bref). The authors also used the Health Behavior Inventory (HBI). RESULTS: Only the results in Domain 4 (Environmental) were higher among patients from rural areas (13.6 vs 13.4, p=0.015) within the WHOQoL-Bref. Differences between rural and urban areas in the contributors to lower QoL referred to such variables as gender, height, body mass, BMI and level of healthcare utilization. Results of HBI were higher in patients from urban areas (85.0 vs 83.1, p<0.001). The differences in factors potentially contributing to lower levels of health behavior concerned gender, age, height, body mass, BMI, having a partner, number of chronic diseases and level of healthcare utilization. The authors observed among the rural patients fewer visits of district nurses (12.1 vs 15.3, p=0.003). Odds ratio (OR) for QoL in the case of place of residence (rural vs urban) was OR=1.341 (95% CI: 1.067-1.687). CONCLUSIONS: Higher quality of life may reduce the level of healthcare utilization among residents of rural and urban areas. Educational programs, promoting health behaviors, should be primarily addressed to rural patients, men, younger individuals, patients with a lower number of chronic diseases, and those using healthcare services less often.
Subject(s)
Chronic Disease , Health Behavior , Health Status , Quality of Life , Rural Population/statistics & numerical data , Urban Population/statistics & numerical data , Adolescent , Adult , Age Factors , Aged , Aged, 80 and over , Body Mass Index , Environment , Female , Health Status Disparities , Humans , Male , Mental Health , Middle Aged , Sex Factors , Social Support , Socioeconomic Factors , Young AdultABSTRACT
There is a growing interest in using proteins as therapeutics agents. Unfortunately, they suffer from limited stability and bioavailability. We aimed to develop a new delivery system for proteins. ALP, a model protein, was successfully encapsulated in the physically cross-linked sodium alginate/hydroxypropylcellulose (ALG-HPC) hydrogel microparticles. The obtained objects had regular, spherical shape and a diameter of â¼4 µm, as confirmed by optical microscopy and SEM analysis. The properties of the obtained microbeads could be controlled by temperature and additional coating or crosslinking procedures. The slow, sustained release of ALP in its active form with no initial burst effect was observed for chitosan-coated microspheres at pH = 7.4 and 37 °C. Activity of ALP released from ALG/HPC microspheres was confirmed by the occurance of effectively induced mineralization. SEM and AFM images revealed formation of the interpenetrated three-dimensional network of mineral, originating from the microbeads' surfaces. FTIR and XRD analyses confirmed formation of hydroxyapatite.
Subject(s)
Alginates/chemistry , Alkaline Phosphatase/chemistry , Cellulose/analogs & derivatives , Enzymes, Immobilized/chemistry , Hydrogels/chemistry , Microspheres , Cellulose/chemistry , Delayed-Action Preparations/chemistry , Glucuronic Acid/chemistry , Hexuronic Acids/chemistryABSTRACT
The purpose of this study was to analyze health behaviors of patients with chronic respiratory disease and the correlations between health behaviors (HB) and quality of life (QoL). The study involved 256 adult patients (135 women and 121 men), mean age was 62.6 ± 16.1 years, with chronic respiratory disease. The research tools consisted of the Health Behavior Inventory (HBI) and the World Health Organization Quality of Life Instrument Short Form. The mean general score for HB was 85.6 ± 17.8. Most patients (74 persons) obtained high scores (7-10 stens). The strongest correlations between QoL and HB were as follows: Psychological Domain correlated with positive mental attitude (r = 0.308, p < 0.001), healthy eating habits (r = 0.224, p = 0.001), and with the level of health behaviors (r = 0.222, p = 0.003); Social Relationship Domain correlated with positive mental attitude (r = 0.282, p < 0.001) and healthy eating habits (r = 0.238, p < 0.001). We conclude that QoL in patients with chronic respiratory diseases is significantly shaped by their health behaviors.
Subject(s)
Respiratory Tract Diseases/physiopathology , Respiratory Tract Diseases/psychology , Aged , Chronic Disease , Female , Health Behavior , Humans , Male , Middle Aged , Quality of Life , Residence Characteristics , Sex FactorsABSTRACT
The purpose of this study was to analyze correlations between quality of life (QoL), acceptance of illness (AI), and health behaviors (HB) demonstrated by chronically ill patients of advanced age. The study was comprised of 1974 chronically ill primary care patients (mean age 71.60±7.98 years) recruited from 131 primary care practices. QoL was assessed with the World Health Organization Quality of Life Instrument Short Form. The patients' AI with the Acceptance of Illness Scale (AIS) and the Health Behavior Inventory (HBI) measured four categories of HB: healthy eating habits (HEH), preventive behaviors (PB), positive mental attitudes (PMA) and health practices (HP). The Spearman rank correlation test was used to check correlations between the variables and analysis of multiple regression was used in order to examine the impact of explanatory variables on the response variable. The highest scores were obtained in the Social Relationship Domain of QoL (M=13.68±2.75) and the lowest in the Psychological Domain of QoL (M=12.38±2.66) of the patients. The low AI was noted in 65.68% (1221). Lower level of QoL and AI were observed in patients with a larger number of chronic diseases and higher health care utilization. The lowest HB scores were obtained in the category of PMA (M=3.61±0.73) and HEH (M=3.36±0.84). The AI level correlated strongest with: Physical Domain of QoL (r(S)=0.49, p<0.0001) and PMA (r(S)=0.23, p<0.0001). HB correlated strongest with Psychological Domain of QoL (r(S)=0.33, p<0.0001). Health behavior programs for chronically ill patients of advanced age should stimulate health behavior categories such as PMA and HEH, and raise the AI level. This would result in a higher QoL and, consequently, a lower health care utilization.
Subject(s)
Aging/psychology , Attitude to Health , Chronic Disease/psychology , Health Behavior , Quality of Life , Aged , Female , Humans , Male , Middle Aged , Psychometrics , Surveys and QuestionnairesABSTRACT
The authors present 6 cases of adenoma pleomorphum localized out of salivary glands-2 of them on palate, 1 in external auditory canal, 1 in larynx, 1 in lacrimal gland and 1 in parapharyngeal space. All patients were treated surgically.
Subject(s)
Adenoma, Pleomorphic/diagnosis , Salivary Gland Neoplasms/diagnosis , Salivary Glands, Minor , Adenoma, Pleomorphic/surgery , Adult , Aged , Aged, 80 and over , Female , Head and Neck Neoplasms/diagnosis , Head and Neck Neoplasms/surgery , Humans , Male , Middle Aged , Salivary Gland Neoplasms/surgeryABSTRACT
Primary tumours of orbital cavity are a difficult diagnostic and therapeutic problem from a borderline of ophthalmology, laryngology and neurosurgery. Particular anatomical relations of orbital cavity surrounded by paranasal sinuses, cranial cavity cause that it has become an interdisciplinary region and the best method of therapy is multispecialistic surgical treatment ("team approach"). In this article the classification and general symptomatology of orbital cavity primary tumours were presented. 37 patients suffering from primary orbital tumours were treated surgically in the ENT Department of Silesian Medical Academy in Katowice. The patients were aged from 23 (woman with neurosarcoma) to 73 (man with melanoma). All patients were treated surgically: 15 of them by orbital exenteration, 10 by lateral orbitotomy m. Kronlein-Reese-Berk, and 12 by canthotomy. Special attention was paid to possible postoperative complications.
Subject(s)
Orbital Neoplasms/surgery , Academic Medical Centers , Adult , Aged , Catchment Area, Health , Female , Humans , Male , Middle Aged , Orbital Neoplasms/diagnosis , Otolaryngology , Patient Care Team , Poland , Postoperative Complications , Tomography, X-Ray ComputedABSTRACT
The author present a clinical analysis of 23 cases of Warthin's tumor treated in the I Clinic of Otolaryngology Silesian Medical Academy in years 1982-1991. In 16 cases the tumor was localised in the superficial part of the parotid gland, in 3 cases a multifocus tumor was found. The Warthin's tumor in 3 patients was localised in the deep part of the parotid gland. In one patient the tumor was beyond the parotid gland.
Subject(s)
Adenolymphoma/diagnosis , Adenolymphoma/pathology , Salivary Gland Neoplasms/diagnosis , Salivary Gland Neoplasms/pathology , Salivary Glands/pathology , Adenolymphoma/surgery , Aged , Cranial Nerve Diseases/etiology , Cranial Nerve Diseases/physiopathology , Facial Nerve/physiopathology , Female , Humans , Male , Middle Aged , Postoperative Complications , Retrospective Studies , Salivary Gland Neoplasms/surgery , Sex FactorsABSTRACT
The authors present a rare case of lingual ectopic thyroid in 22 year--old--woman. A massive bleeding from the tumor occurred several times and required an urgent surgical treatment. A tracheostomy and ligation of the right external carotid artery were performed prior the removal of the tumor which was removed by medial pharyngotomy. No complications were observed. A substitutive hormonal therapy was administered. Six months after the tracheostomy tube was removed.
Subject(s)
Choristoma/pathology , Choristoma/surgery , Thyroid Neoplasms/pathology , Thyroid Neoplasms/surgery , Tongue Neoplasms/secondary , Tongue Neoplasms/surgery , Tongue/pathology , Adult , Carotid Arteries/surgery , Female , Humans , Neoplasm Invasiveness , Pharynx/pathology , Pharynx/surgery , Tomography, X-Ray Computed , Tongue Neoplasms/diagnosis , Trachea/pathology , Trachea/surgery , TracheostomyABSTRACT
The authors present the results of fine needle aspiration biopsy in 58 patients with tumors of head and neck. Cytological and pathomorphological correlation was evaluated in all patients. The highest accuracy of cyto-pathomorphological was obtained in parotid gland tumors, both benign and malign, and in lymph nodes of the neck. The lowest accuracy was obtained in tumors of the orbit.
Subject(s)
Head and Neck Neoplasms/pathology , Biopsy, Needle , Female , Humans , Lymph Nodes/pathology , Lymphatic Metastasis , Male , Neck , Orbital Neoplasms/pathology , Parotid Neoplasms/pathology , Predictive Value of Tests , Sensitivity and SpecificityABSTRACT
14 patients suffering from primary orbital tumours were treated surgically in the Otolaryngological Department in Silesian Medical Academy in Katowice in the years 1992-1995. The patients were aged from 23 (woman with neurosarcoma) to 67 (woman with haemangioma). All patients were treated surgically: 8 of them by lateral orbitotomy m. Krönlein-Reese-Berk, 3 of them by orbital exenteration, and 3 of them by canthotomy. The author analysed 3 very rare cases of primary orbital malignant neoplasms: neurosarcoma, rhabdomyosarcoma and additionally I case with fibrosarcoma, osteosarcoma and chondrosarcoma simultaneously.
Subject(s)
Orbital Neoplasms/surgery , Adult , Aged , Female , Humans , Middle Aged , Sarcoma/surgeryABSTRACT
Considering rareness of primary multiple neoplasms of head and neck region, the authors present 5 cases of different histopathological structure. The authors refer to etiopathogenetic factors and to treatment problems connected with the fact that next recognized neoplasms are, generally, more clinically advanced.
Subject(s)
Head and Neck Neoplasms/etiology , Neoplasms, Multiple Primary/etiology , Adult , Aged , Female , Head and Neck Neoplasms/pathology , Head and Neck Neoplasms/therapy , Humans , Male , Middle Aged , Neoplasms, Multiple Primary/pathology , Neoplasms, Multiple Primary/therapy , Risk FactorsABSTRACT
The authors present a case of a large, noncapsulated pharyngeal lipoma. Surgical extirpation followed the tracheostomy and ligature of the external carotid artery.
