Medicinal Leeches to Aid in Post-procedural Hematoma Evacuation.

Patients presenting with a post-invasive procedure hematoma can be treated with medicinal leeches to evacuate the hematoma. Our patient, a postmenopausal woman in her 60s, with a past medical history of hypothyroidism, presented to the outpatient clinic with pain, redness, warmth, and swelling on her right thigh. Ten days prior, the patient had undergone a subcutaneous pellet implant procedure in the right thigh for hormonal replacement therapy. The patient developed post-procedure cellulitis and soft tissue infection and was treated with antibiotics. The patient developed a progressively enlarged hematoma at the implant site. The hematoma was treated with medicinal leeches. Two weeks after treatment, the implant area healed. The patient had a family history of von Willebrand disease and a history of prolonged bleeding during childbirth, menstruation, and dental procedures. A von Willebrand panel was obtained, and the results were consistent with a new diagnosis of von Willebrand disease.

Coverage and Influencing Determinants of Influenza Vaccination in Elderly Patients in a Country with a Poor Vaccination Implementation.

The seasonal influenza vaccination uptake of the elderly in Poland is one of the lowest in Europe. Objective: to assess the vaccination coverage and influencing determinants in patients ≥65 years of age. METHODS: A cross-sectional study was conducted (November 2015-April 2016) among consecutive patients admitted to a municipal hospital located in the city of Szczecin, North-west Poland. Patients completed researcher-administered, anonymous questionnaires on socio- demographic data/factors related to the vaccination. Results: The response rate: 92.0%. Among 230 patients (79.6% women, median of age 69 years, range 65-89) who agreed to participate, 34.8% (95% Confidence Interval: 28.6-41.0%) were vaccinated. About 15.7% of respondents had not previously heard about the vaccination; 41.3% of those who stated they were vaccinated or planned on being vaccinated the following year, compared to 19.3% of respondents who stated they were not currently vaccinated (p < 0.001). A multivariable regression analysis revealed that patient factors, such as younger age (Odds Ratio, OR = 7.69), living in the urban area (OR = 7.69), having comorbidities (OR = 2.70), having a vaccinated family member (OR = 3.57), and being informed about vaccination (OR = 5.00) were each associated with greater odds of being immunized. Willingness for vaccination the next year was strongly associated (OR = 8.59) with vaccination status. Conclusions: The influenza vaccination uptake in the elderly population in Poland is disturbingly low. Improved education strategies are needed to increase the uptake. Vaccinated respondents are more likely to plan on being vaccinated the following year. Future interventions related to maximizing vaccination coverage should be more tailored, focusing especially on older patients living in rural areas.

Attitudes of patients and staff towards tobacco smoking in hospital.

The aim of this paper was to establish the frequency and intensity of smoking by the patients and hospital staff and to define the attitudes of the polled persons towards smoking tobacco on the premises of the hospital and their opinions about the limitations in force. The examination in the form of a distributed questionnaire, comprised 101 patients and 127 staff members of Henryk Klimontowicz Specialist Hospital in Gorlice (province of Malopolska /Little Poland/). Both mobile and bed-ridden patients participated in the study. The personnel was represented by physicians, nurses, ward attendants, psychologists, secretaries, Medical University students doing their apprenticeships on the premises of the hospital, employees of technical and administrative departments. The study was carried out by means of a diagnostic sounding with the use of a distributed questionnaire technique in the period from September 2002 to July 2003. The questionnaire contained 38 questions, including closed, open, half-open and multiple-choice questions. In our poll we used the Fagerstrom test, which determined the type of addiction to smoking tobacco (physical or psychological), and which was completed by tobacco-smokers. The statistical analysis was carried out by means of the Chi2 test for independence, assuming the significance level of 0.05. The obtained results were analyzed according to the sex of the polled persons and their functions in the premises of the hospital (patient, staff member). The results of the obtained analysis show that 13.9% of the polled patients of the Specialist Hospital in Gorlice smoked cigarettes every day. The percentage of everyday smokers among the staff of this hospital was significantly higher and equalled 18.1%. Half of the polled persons were exposed to passive smoking on the premises of the hospital, the staff more than the patients. The patients supported the restrictions concerning smoking on the premises of the hospital to a greater extent than the personnel. Most of the smokers claimed that they were trying to cut down on smoking on the premises of the hospital. Despite these declarations, tobacco-smokers smoked cigarettes in the area of the hospital anyway, and one fifth of the smokers smoked also outside the places designed for that purpose.