Analysis of Postural Stability Following the Application of Myofascial Release Techniques for Low Back Pain-A Randomized-Controlled Trial.

INTRODUCTION: Low back pain (LBP) is one of the most frequently observed disorders of the musculoskeletal system in the modern population. It is suggested that myofascial disorders in the highly innervated thoracolumbar fascia (TLF), reported in patients with LBP, may be an underlying cause of the ailment. Research also confirms that patients with LBP demonstrate poorer postural stability compared with individuals without the condition. Myofascial release techniques (MFR) are additional therapeutic options that complement existing therapies and help provide a more holistic treatment for chronic LBP (CLBP). OBJECTIVE: Evaluation of changes in postural stability following one MFR intervention applied to CLBP subjects immediately after manual therapy and after a month. It was hypothesized that postural stability is going to aggravate immediately after the MFR intervention and improve one month after treatment compared with the baseline results before the treatment. METHODS: 113 patients with CLBP participated in a randomized-controlled trial. The experimental group (n = 59) received one MFR intervention, whereas the control group (n = 54) did not receive any therapeutic intervention. Posturography was performed to determine experimental group's immediate response to the therapy and to evaluate the experimental and control groups' responses to the therapy one month after the intervention. RESULTS: Only 2 out of 12 comparisons of stabilometric parameters demonstrated reliable effects that are in line with our research hypotheses. Even though both comparisons were observed for therapy outcomes within the experimental group, no reliable differences between the groups were found. CONCLUSIONS: A single MFR treatment in the TLF did not affect postural stability in CLBP patients in the experimental group. Further studies are needed to extend the findings by performing a series of holistic MFR treatments applied to a larger area of the body surface that would induce more general tissue changes and thus having a greater impact on postural stability.

The use of amantadine in the prevention of progression and treatment of COVID-19 symptoms in patients infected with the SARS-CoV-2 virus (COV-PREVENT): Study rationale and design.

BACKGROUND: COVID-19, a disease caused by infection with the SARS-CoV-2 virus, is asymptomatic or mildly symptomatic in most cases. Some patients, usually burdened with risk factors develop acute respiratory failure and other organ dysfunction. In such cases, the mortality rate is very high despite the use of intensive therapy. Amantadine has complex activity including antiviral, antiinflammatory and dopaminergic effects. This clinical trial will assess the efficacy and safety of amantadine in the prevention of COVID-19 progression toward acute respiratory failure and neurological complications. METHODS AND RESULTS: The trial will enroll 200 patients who are positive for SARS-CoV-2 infection and have one or more risk factors for worsening the disease. These patients will be included as hospitalized or ambulatory subjects for early treatment of illness. The recruitment will take place in 8 centers covering different regions of Poland. For 14 days they will be given either 200 mg of amantadine a day or placebo. Our hypothesis is a considerable reduction in the number of patients with progression toward respiratory insufficiency or neurological complications thanks to the treatment of amantadine. CONCLUSIONS: Demonstrating the efficacy and safety of amantadine treatment in improving the clinical condition of patients diagnosed with COVID-19 is of great importance in combating the effects of the pandemic. It has potential to influence on the severity and course of neurological complications, which are very common and persist long after the infection as long-COVID syndrome. CLINICAL TRIAL REGISTRATION: www. CLINICALTRIALS: gov identification no. NCT04854759; Eudra CT number: 2021-001144-98 (dated 27 February 2021).

Influence of Classical Massage on Biochemical Markers of Oxidative Stress in Humans: Pilot Study.

Classical massage is one of the most popular forms of conservative treatment in various diseases. Despite the wide scope of research, the mechanisms of massage are not fully known and understood. Apart from the well-described effects on individual body systems, there are few scientific reports on the effects of massage on the human body at the subcellular level. The study was designed to assess changes in oxidative stress parameters in healthy volunteers after a single session of classical massage. 29 healthy volunteers aged 22.24 ± 3.64 participated in the study. Before and 30 minutes after the massage procedures, blood samples were taken by experienced personnel. Biochemical markers of oxidative homeostasis were assessed with highly specific methods for each parameter: oxidase ceruloplasmin, glutathione, malondialdehyde, glutathione peroxidase, glutathione S-transferase, and superoxide dismutase. The study demonstrates that massage therapy caused statistically significant decrease in the concentration of glutathione peroxidase (red blood cells) and increase in the level of glutathione peroxidase (plasma), superoxide dismutase, and malondialdehyde. In contrast, statistically significant changes in the hematocrit, glutathione, NO2-/NO3-, and oxidase ceruloplasmin were not observed. The results show that complex influence of classical massage therapy on human organism may be reflected in parameters of the oxidative stress. To understand this mechanism clearly, further research is needed.

Analysis of Muscle Activity Following the Application of Myofascial Release Techniques for Low-Back Pain-A Randomized-Controlled Trial.

INTRODUCTION: Lumbosacral dysfunctions and the resulting pain syndromes, such as low-back pain (LBP), are one of the most common musculoskeletal problems being faced by society around the world. So far, a contributory role of thoracolumbar fascia (TLF) dysfunction in some cases of LBP has been suggested. Research also confirms that muscle resting activity level in the TLF area is increased in people with LBP. Myofascial release (MFR) is a therapeutic option offered to patients with chronic low-back pain (CLBP). The therapy aims to improve flexibility and sliding between layers of soft tissue, and thus decrease muscle activity, reduce pain intensity, and improve functional performance. OBJECTIVE: This study aims to assess changes in resting activity of selected muscles within the TLF in a group of patients with CLBP immediately after a single MFR treatment and one month after the intervention. METHODS: A total of 113 patients with CLBP completed the study. Simple randomization was applied to assign subjects to study groups. The experimental group (n = 59) underwent a single session of MFR therapy. No therapeutic intervention was applied to the control group (n = 54). Surface electromyography was used to evaluate positive treatment effects in patients immediately after receiving the therapy (experimental group) and after one month (experimental and control group). RESULTS: A statistically reliable decrease in the activity of erector spinae (ES) and multifidus muscles (MF) was observed after a single session of MFR therapy. Effects of the treatment were present immediately after receiving the therapy and one month after the intervention. CONCLUSIONS: A single MFR treatment in patients with CLBP immediately reduces the resting activity levels of ES and MF. Results of measurements carried out one month after the treatment confirm that the therapeutic effects were maintained.

Randomized-Controlled Trial Examining the Effect of Pelvic Floor Muscle Training in the Treatment of Stress Urinary Incontinence in Men after a Laparoscopic Radical Prostatectomy Pilot Study.

AIM: The aim of this study was to assess the impact of pelvic floor muscle training (PMFT) in the treatment of stress urinary incontinence (SUI) in men after they received radical prostatectomy (RP). METHODS: From November 2018 to September 2019, patients who underwent radical prostatectomy were assessed for eligibility. A total of 37 men were then randomly assigned to the experimental group (EG) and the control group (CG). The EG group received supervised exercise twice a week for 12 weeks, and the CG did not receive any intervention. To objectify the results obtained in both groups before and after the intervention, the authors assessed myostatin concentration. Moreover, the Expanded Prostate Cancer Index Composite (EPIC-26) was applied to assess the quality of life, and Beck's Depression Inventory (BDI-II) was used to measure depression severity. RESULTS: Study results demonstrated a statistically significant reduction of myostatin concentration in the EG following the treatment and no statistically significant differences in this parameter in the CG. In addition, a comparison of the EPIC-26 scores in the EG at the initial and final assessments revealed a statistically significant improvement in the quality of life in each domain. A comparison of the EPIC-26 scores in the CG at the initial and final assessments showed there is a statistically significant decline in quality of life in the "overall urinary problem" and "sexual" domain. A comparison of the BDI-II scores at the initial and final assessments showed a statistically significant decline in depressive symptoms in the EG and no statistically significant differences in the CG. CONCLUSIONS: PFMT is an effective treatment for urinary incontinence (UI) in men who received radical prostatectomy.

Quality of Life in Women Subjected to Surgical Treatment of Breast Cancer Depending on the Procedure Performed within the Breast and Axillary Fossa-A Single-Center, One Year Prospective Analysis.

The aim of this study was to evaluate the quality of life of patients undergoing surgical treatment of breast cancer depending on the type of procedure involving the breast (mastectomy vs. breast conserving treatment) and axillary fossa (sentinel lymph node biopsy vs. axillary lymph node dissection). The prospective study was carried out in a group of 338 females undergoing breast cancer treatment. Study variables were assessed by means of a diagnostic survey using standardized QLQ C30 and BR23 questionnaires as well as the Acceptance of Illness Scale and Mini-MAC scales. The quality of life was assessed at threetime points: on the day before the surgical procedure (I assessment) as well as three and 12 months after surgery (II and III assessment). Statistically significant differences between study groups were observed in the overall quality of life subscale (I, II, III-p < 0.0001), physical functioning (I-p < 0.0001; II-p = 0.0413; III-p < 0.0001), role functioning (I-p = 0.0002; III-p < 0.0001), emotional functioning (III-p = 0.0082), cognitive functioning (I-p = 0.0112; III-p < 0.0001), social functioning (III-p < 0.0001), body image (I, II, III-p < 0.0001), and sexual functioning (I-p = 0.0233; III-p = 0.0011). In most symptomatic scales, significant (p < 0.05) differences were also noted. Mastectomy and limfadenectomy patients were significantly (p < 0.0001) more prone to present with destructive coping strategies one year after surgery. Breast conserving therapy is associated with better quality of life outcomes as compared to mastectomy. Sentinel lymph node biopsy is associated with a lower intensity of adverse changes in multiple dimensions of patients' functioning.

Assessment of Postural Balance in Women Treated for Breast Cancer.

Background and objectives: Surgery is the primary and most effective treatment of breast cancer. Unilateral mastectomy disrupts the distribution of muscle tension between the right and the left sides of the body. The aim of the study was to evaluate postural balance in patients treated for breast cancer by mastectomy. Materials and methods: A controlled clinical study was conducted on 90 patients who have undergone surgical treatment for breast cancer (mastectomy) 5-6 years prior (Breast Group-BG). The control group (CG) consisted of 74 healthy female volunteers. Analysis of balance was performed using the Alfa stabilography platform. A static test (Romberg's test) with open and closed eyes was used to assess balance. The following balance parameters were analyzed: path length, statokinesigram area, parameters of deflection and velocity of the foot pressure center. Results: The study demonstrated that patients from BG (5-6 years after surgery) obtained worse results in both tests with open (maximum back deviation, maximum forward deviation, average Y deviation, average Y velocity, path length and path surface area) (p < 0.05) as well as with closed eyes (maximum backward deviation, maximum forward deviation, mean Y deviation and path length) (p < 0.05). Conclusions: Our study demonstrated that women 5-6 years after surgery for breast cancer have impaired balance compared to healthy women, despite physiotherapy.

Sexual functioning and self-esteem in women after mastectomy - a single-centre, non-randomised, cross-sectional study.

AIM OF THE STUDY: The goal of our study was to assess the sexual functioning of patients undergoing mastectomy, five years after surgery, compared to a control group. MATERIAL AND METHODS: A cross-sectional study included 170 patients five years post mastectomy (group A1) and 149 healthy women (group A2) who had never been diagnosed with breast cancer. The study was conducted at the Oncology Centre in Bydgoszcz, at the Amazon Clubs, and at the University of the Third Age by the University of Economy in Bydgoszcz. Standardised questionnaires: the Female Sexual Function Index (FSFI) and Rosenberg's SES (self-esteem scale) were used. RESULTS: Our study results show significantly worse sexual functioning in the domains pertaining to desire (p = 0.0015), arousal (p = 0.0052), lubrication (p = 0.0026), ability to reach orgasm (p = 0.0417), sexual satisfaction (p = 0.0142), and the presence of clinically significant sexual dysfunction (p = 0.0028) among patients after amputation of the mammary gland. On the scale of pain relating to sexuality, there were no significant differences between the two groups (p> 0.05). The overall score in the FSFI questionnaire was also lower (p = 0.0066) among women after mastectomy. Highly statistically significant (p < 0.0001) differences in self-esteem were also noted between the two groups, with worse results observed in patients after mastectomy. CONCLUSIONS: Diagnosis of sexual dysfunction in patients treated for breast cancer allows timely implementation of counselling and interventional therapy depending on the causal factors and individual preferences of patients.

Assessment of the Effectiveness of Pelvic Floor Muscle Training (PFMT) and Extracorporeal Magnetic Innervation (ExMI) in Treatment of Stress Urinary Incontinence in Women: A Randomized Controlled Trial.

OBJECTIVE: The purpose of this study is to assess the effectiveness of pelvic floor muscle training and extracorporeal magnetic innervation in treatment of urinary incontinence in women with stress urinary incontinence. METHODS: The randomized controlled trial enrolled 128 women with stress urinary incontinence who were randomly allocated to either one out of two experimental groups (EG1 or EG2) or the control group (CG). Subjects in the experimental group 1 (EG1) received 12 sessions of pelvic floor muscle training, whereas subjects in the experimental group 2 (EG2) received 12 sessions of extracorporeal magnetic innervation. Subjects in the control group (CG) did not receive any therapeutic intervention. The following instruments were used to measure results in all study groups at the initial and final assessments: Revised Urinary Incontinence Scale (RUIS), Beck Depression Inventory (BDI-II), General Self-Efficacy Scale (GSES), and King's Health Questionnaire (KHQ). RESULTS: In both experimental groups, a statistically significant decline in depressive symptoms (BDI-II) and an improvement in urinary incontinence severity (RUIS) and quality of life (KHQ) were found in the following domains: "social limitations," "emotions," "severity measures," and "symptom severity scale." Moreover, self-efficacy beliefs (GSES) improved in the experimental group that received ExMI (EG2). No statistically significant differences were found between all measured variables in the control group. Comparative analysis of the three study groups showed statistically significant differences at the final assessment in the quality of life in the following domains: "physical limitations," "social limitations," "personal relationships," and "emotions." Conclusion. Pelvic floor muscle training and extracorporeal magnetic innervation proved to be effective treatment methods for stress urinary incontinence in women. The authors observed an improvement in both the physical and psychosocial aspects.

The Impact Of Pelvic Floor Muscle Training On Urinary Incontinence In Men After Radical Prostatectomy (RP) - A Systematic Review.

PURPOSE: The purpose of this study was to determine the efficacy of pelvic floor muscle training (PFMT) in the treatment of urinary incontinence (UI) in men after radical prostatectomy (RP). METHODS: PubMed, ScienceDirect, and Cochrane Library databases were searched for studies published in years 2000-2019. We included randomized controlled trials in English which compare clinic-based vs home-based PFMT, preoperative and postoperative PFMT, supervised vs unsupervised PFMT, and PFMT alone vs no treatment at all. RESULTS: Eight articles were included in the final review. There was a total of 1078 patients aged 45-75 in all study groups. The study participants received radical retropubic prostatectomy or radical prostatectomy. Included studies assessed the following interventions: preoperative and postoperative PFMT, supervised vs home-based PFMT, unsupervised PFMT vs no treatment at all, and PFMT combined with resistance and flexibility exercises vs PFMT alone. CONCLUSION: PFMT is an effective treatment for urinary incontinence in men after radical prostatectomy. PFMT improves not only physical parameters but also the quality of life of men after RP.

Rehabilitation of infants after transtibial amputation due to thrombosis in the perinatal period. Case report.

Congenital thrombosis and amputation in infancy is not common. Therefore, the existing literature lacks sufficient evidence regarding this subject. Available research primarily focuses on treatment and causes of thrombosis in children. The paper describes a case of preterm infant after transtibial amputation due to common iliac artery thrombosis during the perinatal period. The girl began neurodevelopmental therapy based on normal development patterns of infants, which was provided three times a week for 45 minutes. The rehabilitation process also included prosthesis and surgical interventions. The assessment of motor development of the child was carried out at the age of 6, 9, 12, 18 and 20 months, using the motor scale of the Albert Infants Motor Scale (AIMS). Case analysis allows to state that infant rehabilitation after transtibial amputation should be individualized, and focus on supporting normal motor development, based on the correct movement sequences of infants. Additionally, the AIMS scale can be used to assess the gross motor development in infants after amputation and is useful in formulating early therapeutic intervention. A prosthetist should perform prosthesis revisions as often as needed, i.e., in infants that is usually every 4 months. What is more, successful outcomes can be achieved by implementing proper surgical procedures regarding the appositional overgrowth of the residual limb in growing children.

[Assessment of irisin concentration in women with stress urinary incontinence after using exracorporeal magnetic innervation (EXMI) - pilot study].

OBJECTIVE: Introduction: In Poland, urinary incontinence (UI) is the ninth in frequency of reported health problem, which occurs in 15.4% of women over 60 years of age (data of the Central Statistical Office of 2016). The search for optimal treatment methods for this disease and objective methods for assessing the effectiveness of therapy is a challenge for an interdisciplinary team of specialists. The aim: To examine the effect of Extracorporeal Magnetic Innervation (ExMI) on the Irisin concentration in women with stress urinary incontinence. PATIENTS AND METHODS: Materials and methods: A total of 52 women were included in the analysis: 28 participants were allocated to the experimental group (EG) and 24 to the control group (CG). EG patients completed ExMI therapy, whereas no therapeutic intervention was applied to the CG. Irisin concentration, severity of urinary incontinence (RUIS) were measured in all women at the initial and final assessments. RESULTS: Results: By comparing the initial and final assessment results we have been able to demonstrate a statistically significant differences in the measured variables in the EG. No statistically significant differences in the measured variables were reported for the CG at the initial and final assessments. No correlation was observed between the Irisin concentration results and severity of urinary incontinence in the EG at the final assessment. CONCLUSION: Conclusions: There is a need for further studies of biochemical parameters in the assessment of pelvic floor muscle dysfunction.

A randomised-controlled trial pilot study examining the effect of pelvic floor muscle training on steroid hormone concentrations in elderly women with stress urinary incontinence.

INTRODUCTION: In this study, we attempted to examine the effect of pelvic floor muscle training on testosterone and cortisol concentrations in elderly women with stress urinary incontinence. MATERIAL AND METHODS: The number of participants included in the analysis was 59: 30 women in the experimental group (EG) and 29 women in the control group (CG). The EG underwent pelvic floor muscle training, whereas the CG did not receive any therapeutic intervention. In the present study the authors measured testosterone and cortisol concentrations as well as body mass index (BMI) in all study participants at the initial and final assessments. RESULTS: The initial and final assessment results were compared and showed a statistically significant decrease in cortisol concentration and an increase in testosterone concentration in the EG. However, no statistically significant differences in the measured variables were observed in the CG at the initial and final assessments. The authors did not report any statistically significant correlations between testosterone and cortisol concentrations and the BMI score in the EG and CG. Also, statistically significant correlations between testosterone and cortisol concentrations in the EG were not apparent. CONCLUSIONS: Determination of the concentration of testosterone and cortisol is a method that may help to objectify pelvic floor muscle training outcomes in elderly women with stress urinary incontinence.

A randomized-controlled trial pilot study examining the effect of extracorporeal magnetic innervation in the treatment of stress urinary incontinence in women.

INTRODUCTION: Peri- and postmenopausal women frequently suffer from urinary incontinence (UI). Generally, UI becomes more severe with age. It impacts physical, mental, and social functioning as well as the quality of life, often leading to depression. Extracorporeal magnetic innervation (ExMI) is a relatively new conservative treatment method for UI. OBJECTIVE: The aim of the study was to assess the effectiveness of ExMI in the treatment of stress UI in women. METHODS: A total of 52 women were included in the analysis: 28 participants were allocated to the experimental group (EG) and 24 to the control group (CG). The average age was 65.41 years (±SD 4.08). EG patients completed ExMI therapy. The treatment sessions lasted for 15 minutes, and occurred three times a week, for 4 weeks. No therapeutic intervention was applied to the CG. To objectify the treatment outcomes in both groups before and after the treatment, we measured myostatin concentration and performed the UI severity assessment (The Revised Urinary Incontinence Scale), perceived self-efficacy assessment (General Self-Efficacy Scale), and depression severity assessment (Beck Depression Inventory). RESULTS: The authors compared the EG results at the initial and final assessments and found a statistically significant improvement in severity of UI (P=0.001) and depression severity (P=0.006), and a decrease in myostatin concentration (P≤0.001). The authors did not find any statistically significant differences between all measured variables for the CG at the initial and final assessments. Furthermore, there were no statistically significant differences between all measured variables for the EG and the CG at the final assessment. CONCLUSION: Further trials are needed to determine optimal treatment protocols for various UI types and to evaluate long-term outcomes of the ExMI treatment.

The impact of pelvic floor muscle training on the myostatin concentration and severity of urinary incontinence in elderly women with stress urinary incontinence - a pilot study.

OBJECTIVE: The aim of the study was to assess the myostatin concentration and an improvement in the severity of urinary incontinence (UI) after pelvic floor muscle training (PFMT) in a group of elderly women with stress UI. METHODS: A total of 74 participants were included in the analysis: 40 participants in the experimental group (EG) and 34 participants in the control group (CG). The EG underwent PFMT, whereas no therapeutic intervention was applied to the CG. Myostatin concentration and UI severity (Revised Urinary Incontinence Scale [RUIS]) were assessed in all women before and after the treatment. RESULTS: By comparing the results before and after the treatment, we have been able to demonstrate a statistically significant decrease in myostatin concentration (P<0.0001) and an improvement in the severity of UI (RUIS) (P<0.0001) in the EG. No statistically significant differences in all measured variables were reported before and after the treatment in the CG. A lower myostatin concentration (P=0.0084) and an improvement in the severity of UI (RUIS) (P=0.0008) were observed after the treatment in the EG compared to that in the CG. CONCLUSION: Effective PFMT causes downregulation of myostatin concentration and an improvement in the severity of UI in elderly women with stress UI. Further trials on a larger EG and an assessment of long-term treatment outcomes are required.

Treatment of patients with acute coronary syndrome: Recommendations for medical emergency teams: Focus on antiplatelet therapies. Updated experts' standpoint.

A group of Polish experts in cardiology and emergency medicine, encouraged by the European Society of Cardiology (ESC) guidelines, have recently published common recommendations for medical emergency teams regarding the pre-hospital management of patients with acute coronary syndrome. Due to the recent publication of the 2017 ESC guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation and 2017 focused update on dual antiplatelet therapy in coronary artery disease the current panel of experts decided to update the previous standpoint. Moreover, new data coming from studies presented after the previous document was issued were also taken into consideration.

Association of vitamin D status and clinical and radiological outcomes in a treated MS population in Poland.

BACKGROUND: Vitamin D influences the immune system significantly. Previous studies have found that vitamin D deficiency in adolescence can play a significant role in increasing the risk of developing autoimmune diseases including multiple sclerosis. The aim of this study was to investigate the relationship between the vitamin D status in serum and clinical and radiological outcomes in a treated population in Poland. METHODS: Inclusion criteria met 83 adult patients aged 20-61 years with diagnosis of relapsing-remitting multiple sclerosis, who underwent immunomodulatory treatment which lasted at least 12 months. Levels of serum 25-hydroxyvitamin D were determined using radio-immuno assay. Magnetic resonance imaging of the brain and cervical part of a spinal cord was performed each time after 12 months of the treatment. Patients were assessed neurologically after 12 months of treatment, the level of disability was also assessed using Extended Disability Status Scale. RESULTS: The largest group (63.8%) showed significant vitamin D deficiency (<20 ng/ml), 21.7% showed the suboptimal level of vitamin D (20-30 ng/ml). The normal level of 25(OH)D (>30 ng/ml) was observed in 14.5% of the patients. Statistically significant correlation was observed between the vitamin D status and frequency of relapses. CONCLUSIONS: Our findings confirm that deficiency of vitamin D in patients with MS is correlated with clinical and radiological course of the disease.

[Emotional self-control, coping with stress and psycho-physical well-being of prison officers]. / Samokontrola emocjonalna, radzenie sobie ze stresem a samopoczucie psychofizyczne funkcjonariuszy sluzby wieziennej.

BACKGROUND: Mental and physical health status is closely associated with the specific character of work in the structures of the uniformed services. The aim of the study was to examine how self-control, revealed strategies of coping with stress, sociodemographic factors differentiate the level of psychological and physical well-being of prison officers, and what is the predictor of psychological and physical well-being in this occupational group. MATERIAL AND METHODS: A questionnaire survey was conducted in a group of 75 prison officers working in the Prison Potulice Security Department. In the study the following tools were used: the questionnaire on "Psychosocial working conditions", popular questionnaire on emotional intelligence (Popularny Kwestionariusz Inteligencji Emocjonalnej--PKIE), Measure Coping Strategies with Stress (Mini-COPE) and the questionnaire on sociodemographic variables. RESULTS: A higher level of mental and physical well-being of the subjects was accompanied by a higher level of declared active coping and a lower level in the range of helplessness, avoidance, turn to religion and sense of humor. Regression analysis showed that the levels of emotional control, helplessness strategy and support seeking strategies are important predictors of physical well-being of the dependent variable. As regards the psychological well-being, significant predictors are: the levels of emotional control, sense of humor and support seeking. The value of the results is limited due to the methodology used to collect questionnaires. In our study a random trial was not used as the questionnaires were completed only by individuals interested in the subject under study. CONCLUSIONS: Knowledge about the specificity of the psychophysical characteristics of prison officers should be taken into account when designing the tools of occupational health promotion. Studies show an average low level of perceived well-being with a high level of self-control.

Intracoronary versus intravenous abciximab administration in STEMI patients: overview of current status and open questions.

OBJECTIVES: To perform a systematic review to provide rationale for intracoronary (IC) abciximab administration in patients with ST-segment elevation myocardial infarction (STEMI), to summarize recent studies comparing IC vs. intravenous (IV) abciximab administration in this setting and to define questions that need to be answered in future trials determining the optimal abciximab regimen. METHODS: A search covering the period from January 1993 to June 2011 was conducted by two independent investigators using MEDLINE, CENTRAL and Google Scholar databases. Proceedings from the scientific sessions of ACC, AHA, ESC, TCT and EuroPCR were also considered. RESULTS: IC administration allows one to obtain a much higher concentration of abciximab than IV injection at the culprit lesion. Therefore it is hypothesized that IC abciximab administration provides more efficient GP IIb/IIIa receptor inhibition and more pronounced additional dose-dependent antiplatelet, antithrombotic, and anti-inflammatory effects when compared to the IV route. Numerous observational and randomized studies comparing IC vs. IV abciximab in STEMI patients indicated improvement in different surrogate end points (infarct size, obstruction of coronary microcirculation, ST segment resolution, inflammatory mediators and markers of platelet activation) related to IC administration. The evidence supporting clinical benefits associated with IC injection of abciximab comes from one randomized and several non-randomized trials as most of the studies were underpowered to assess clinical outcomes. No difference in bleeding complications was observed between IC and IV regimens. Issues that need to be addressed in future studies include: the use of IC abciximab in combination with thrombectomy, the role of selective delivery systems, and the necessity of a prolonged IV infusion of abciximab after IC bolus administration. CONCLUSIONS: An accumulating body of evidence suggests the superiority of IC over IV abciximab administration in STEMI patients. However, further trials are warranted to establish the optimal strategy of abciximab treatment in this setting.