The most common factors hindering the independent functioning of the elderly at home by age and sex.

OBJECTIVE: Changes occurring with increased age as well progressive illnesses can negatively affect the independent functioning of older people. The goal of this study was to identify the most common problems that make independent life at home more difficult for the elderly and to try and present their relation with age and gender. PATIENTS AND METHODS: A total of 506 persons over 60 years of age took part in the study. They were residents of Poznan, Poland and surrounding areas. The research instruments were the Abbreviated Mental Test Score and EASY-Care Standard 2010 questionnaire which makes it possible to analyze patient's functioning in seven areas and includes three risk scales: Independence score, Risk of breakdown in care, Risk of falls. RESULTS: In the group studied the greatest difficulties included performing complex activities of everyday life connected with moving around (III area), difficulties with performing household tasks (50.8%), shopping (39.7%) and falls (35.0%). The most frequently reported symptom that was a cause of worry was pain (68.2%). Other health problems reported included sleep disorders (58.9%), incorrect body weight (52.6%), low tolerance of physical effort (48.4%), urethral sphincter functioning disorder (42.7%) and forgetfulness (40.5%). The feeling of being lonely was found in 45.8% of older people. CONCLUSIONS: Significant differences in functioning between the genders were found in the areas of meal preparation, falls, mobility outside the home, not feeling safe, lack of physical activity, low tolerance of physical effort and almost all of area VII - Mental health and well-being. The main determinants of risk scores with the Independence Score, Risk of breakdown in care and Risk of fall domains were age and subjective feelings of pain.

Functioning of people with colorectal cancer during chemotherapy. Demographic and clinical determinants of quality of life of patients with colorectal cancer receiving chemotherapy. Pilot study.

Cancer of the colon is one of the most common malignant tumours in both genders. Thanks to the development of diagnostic techniques, lesions can be detected early fostering full patient's recovery. The aim of this study was to investigate factors affecting quality of life of patients with colorectal cancer (CRC) during chemotherapy. The research tool was a questionnaire of our own design that allows collecting demographic and clinical data and Functional Assessment of Cancer Therapy Scale-Colorectal (FACT-C). The study included 90 patients. The analysis confirmed the difference between Social-Family Well-Being (SWB) and Emotional Well-Being (EWB) and in the overall assessment of quality of life and age. Taking into account the presence of stoma, a statistically significant difference was found only in the Colorectal Cancer Subscale (CCS p = .01321). Regarding the number of cycles of chemotherapy, a statistically significant difference was shown in the overall evaluation (p = .0459) and the SWB (p = .0463) area. In patients with CRC in the general assessment of quality of life, which is at a medium level, non-modifiable factors like age and gender play a minor role when compared with the group of variables related to the process and treatment of the disease.

Angiogenesis and fibroblast proliferation precede formation of recurrent tumors after radiation therapy in nude mice.

Recently, the combination of ionizing radiation with inhibitors of angiogenesis has been reported to improve tumor eradication compared to treatment with irradiation alone. However, the mechanisms of this effect have not been defined. For this purpose [corrected] we established a non-small cell lung cancer model in nude mice. Tumor vascularization was visualized in vivo by MRI using gadolinium-DTPA as contrast agent. Further, cryosections were produced as close as possible to the MRI slice positions. Since we were interested in examining the formation of a recurrent tumor, irradiation was performed with a single fraction of 4 Gy. This dose caused a partial remission followed by recurrent tumor growth 25 to 35 days after therapy. The process of partial remission as well as formation of the recurrent tumor was examined in 28 nude mice analysing the following parameters: (i) contrast agent enhancement using high-resolution MRI, (ii) proliferation of tumor cells and fibroblasts using Ki-67 immunohistochemistry and (iii) formation of microvessels using CD31 immunohistochemistry. The latter analyses led to differentiation of three stages. Stage 1 (day 1 to day 15 after irradiation) was characterized by increasing areas of dead cell mass in hematoxylin-eosin-stained slides that corresponded to a decrease in tumor cell proliferation as well as contrast agent enhancement in MRI. The percentage of Ki-67-positive tumor cells decreased from initially 45.1% +/- 6.0% (mean +/- standard deviation) to 1.4% +/- 1.2% (mean +/- standard deviation) on day 15. Stage 2 (day 6 to day 20 after irradiation; overlapping with stage 1) was characterized by proliferation of fibroblasts leading to formation of fibrotic septae with abundant microvessels. Already during late stage 2, MRI identified new contrast agent enhancing areas. Stage 3 (day 20 to day 40 after irradiation) was characterized by new tumor cell proliferation. Interestingly, tumor cells almost exclusively proliferated in the direct neighbourhood of the fibrotic septae that had been formed in stage 2. Obviously, proliferation of fibroblasts and blood vessels was a condition prior to formation of recurrent tumor tissue. Thus, our results are in contrast with the view that tumors or recurrent tumors begin as avascular masses that later induce neovascularization. With respect to clinical practice, our results suggest that: (i) adjuvant anti-angiogenic therapy should not be limited to the day of irradiation but should cover a critical period until day 5 to day 20 after radiotherapy, (ii) adjuvant therapy should also include inhibition of fibroblast proliferation and (iii) MRI can identify a recurrent tumor 10 to 15 days before occurrence of new tumor growth.

[Ozone therapy and viscosity of blood and plasma, distance of intermittent claudication and certain biochemical components in patients with diabetes type II and ischemia of the lower extremities]. / Ozonoterapia a lepkosc krwi i osocza, dystans chromania przestankowego oraz niektóre skladniki biochemiczne krwi u chorych na cukrzyce typu II z choroba niedokrwienna konczyn dolnych.

Blood and plasma viscosity, total blood lipids, triglycerides, total cholesterol, free fatty acids, fibrinogen, hematocrit, and lipidogram were determined in patients with diabetes mellitus type II and coexisting symptoms of the obliterative arteriosclerosis of the lower limbs. Intermittent claudication distance has been measured parallel. The same tests have been carried out after ozone therapy. A significant improvement in the intermittent claudication and reduction in blood and plasma viscosity have been noted. There was statistically significant correlation between intermittent claudication decrease and blood viscosity reduction following ozone therapy.

[Blood and plasma viscosity and the distance of intermittent claudication in patients with type II diabetes and thrombophlebitis]. / Lepkosc krwi i osocza a dystans chromania przestankowego u chorych na cukrzyce typu II z choroba niedokrwienna konczyn dolnych.

In 49 patients with insulin-resistant diabetes, with ischaemia of the lower extremities blood viscosity was measured at low coagulation rates and plasma viscosity was determined also. Moreover plasma measurements were done of total lipids, alpha-, pre-beta-, and beta lipoproteins, triglycerides, total cholesterol, free fatty acids, and, besides that, the hematocrit was measured. Immediately after blood sampling for rheological and biochemical investigations the distance of intermittent claudication was measured. A rather considerable increase of blood and plasma viscosity was noted in the patients in comparison with controls, other findings included disturbances of lipid metabolism, increased fibrinogen level, and a negative correlation between the distance of intermittent claudication and blood and plasma viscosity.