Health education for stroke patient carers: does it affect functional status improvement in patients after ischemic stroke?

AIM: The aim of the prospective cohort study was to assess the impact of the conducted carer training on functional status improvement in patients after stroke. BACKGROUND: In recent years, the role of family in unprofessional care provision for patients in their home environment has been emphasized. METHODS: The cohort comprised 157 patients after ischemic stroke. The study group consisted of 81 patients and their carers who participated in the education program, and the control group included 76 patients. We used a repeated measures design: the patients' functional status was assessed on the day of hospital discharge and after 3 and 12 months at home. RESULTS: After 12 months the patients' functional status according to Barthel Index and Modified Rankin Scale significantly improved in both groups, but no difference between the groups was noted in the degree of improvement achieved. CONCLUSIONS: The carers' participation in the education program did not significantly affect the patients' functional improvement.

[Evaluation of selected epidemiological risk factors for cancer of the lower gastrointestinal tract in middle Pomerania]. / Ocena wybranych epidemiologicznych czynników ryzyka chorób nowotworowych dolnego odcinka przewodu pokarmowego na terenie Pomorza Srodkowego.

INTRODUCTION: Cancer now represents the basic problem that modern medicine has difficulties dealing with both in Poland and around the world. In spite of the continuous development of science, more and better diagnostic techniques and new therapies based on the drugs acting selectively on cancer cells, the malignant cancer continues to be the first in women and the second in men, after heart disease, most common cause of death. According to data from the International Agency for Reserch of Cancer about 10 million people suffers from malignant cancer and the number of deaths due to this type of cancer has exceeded 6 million. If current trends do not change, until 2020 these figures can double. In a properly functioning organism the balance is maintained between the formation of new cells and tissues and apoptosis, a genetically programmed atrophy of cells. The formation of cancerous changes is the uncontrolled formation of new cells which anatomically should not occur in a particular location. These cells form tumours which can be divided into benign and malignant. Within the group of benign tumours, characteristic is that their cells are similar to the cells of a certain organ which has been affected by them. Organs are surrounded by connective tissue sac, and the cancers resulting from them mostly do not spread and their growth is slow. What is important for the patient is that they rarely are an imminent danger to life and they can be removed. Some types of benign tumours can become malignant. RESULTS AND CONCLUSIONS: Scientific studies have shown that colon cancer often derives from benign polyps and an early diagnosis and removal of pathological changes may prevent further mutations and the onset of cancer. Other studies have found a link between the incidence of cancer and smoking, physical activity, limiting alcohol consumption, or the use of certain drugs. Currently, it is believed that a high-fibre diet reduces the risk of developing cancer. The development of modern oncology, introduction and development of modern methods of genetic and imaging diagnosis as well as treatment (chemotherapy), have resulted in the need for an accurate determination of the biological structure of colon cancer. The introduction of modern diagnostic techniques in pathological anatomy, and, in particular, immunohistochemistry, has a significant impact on the understanding of new factors specific to cancer, considered as prognostic or predictive factors. Further development of medical science, including genetics and molecular biology, leads to a better understanding of the epidemiology of the colon cancer. The introduction of genetic DNA Microarray screening significantly affects the determination of the genetic profile of the specific population, which can cause the increased susceptibility to colon cancer. In the future this should allow the use of significantly more sensitive screening methods to separate the persons who are more susceptible to being affected (predictive diagnostics), and subsequently the introduction of efficient conduct associated with the introduction of a proper diet and the rules for promoting a healthy lifestyle, treatment methods in the occurrence of pathological lesions or early cancerous changes.

[Elevated blood pressure as cardiovascular risk factor]. / Podwyzszone cisnienie titnicze jako czynnik ryzyka sercowo-naczyniowego.

Cardiovascular diseases for decades have been and still are the main and current health problem of the Polish society and there are many reasons for these diseases. Hypertension is one of the major risk factors for developing cardiovascular disease. The factors significantly increasing risk the of cardiovascular disease are in addition to high blood pressure, smoking (also passive), high blood fats (cholesterol and its HDL, LDL fractions as well as triglyceride levels, obesity, lack of exercise, diabetes and hereditary features. Other important factors which play an important role are external factors such as e.g. environmental pollution, lifestyle, stress. Prediction of cardiovascular disease should start from the evaluation of the fetal period because low birth weight may be a risk of coronary heart disease, hypertension, obesity or diabetes in adulthood. The authors of the referred tests showed that the level of blood pressure observed during childhood is closely associated with the level of blood pressure in adults and is also dependent on the body weight. Since the issue of the effects of high pressure on the cardiovascular system is inherent in the issue of the metabolic syndrome, it should be mentioned also that another causative factor may be an irregularity in the removal of urine from the body and the amount of insulin. The control of hypertension is a complex problem, at least in view of the wide range of adverse factors affecting the human body: hypertension is often either a constituent of other lesions. Therefore, it is difficult to treat high blood pressure in the strict sense; more often it is a combination therapy based on pharmacology caused for other reasons.

[Biochemical risk factors for cardiovascular disease in children]. / Wplyw biochemicznych czynników ryzyka na rozwój chorób serca i naczyn u dzieci.

The problem of finding the biochemical markers for determining cardiovascular risk is complex, difficult and multidisciplinary. Even in a simple biochemical blood test the number of possible variables significant for indicating the negative changes in the cardiovascular system is high. The image created from a variety of factors is fuzzy, inconclusive and sometimes difficult to define and explain. Contemporary cardiology uses fixed operative levels and the presence of biochemical factors as the basis for patient diagnosis. Even a thorough and multi-biochemical analysis can not give conclusive results. Many precautions are needed in using the results of biochemical analysis. Ambiguous results may be misleading, disrupt the analytical process, or suggest probable, but not necessarily the correct, solutions. This biochemical analysis presented points to the most important prognostic factors and biochemical information used in the cardiological treatment of children and adolescents.