[Temperament risk factor for mental health disturbances in the judiciary staff]. / Temperamentalny czynnik ryzyka zaburzen stanu zdrowia pracowników sadownictwa.

BACKGROUND: The aim of this paper was to examine how temperament might moderate the health impact of psychosocial hazards at work and thus to attempt to identify the temperament risk factor in the judiciary staff. MATERIAL AND METHODS: The data were collected from 355 court employees, including judges, judicial assistants, court clerks and service workers from criminal, civil, commercial as well as from labor and social insurance divisions. The psychosocial work environment was measured with the Psychosocial Working Conditions Questionnaire by Cieslak and Widerszal-Bazyl, temperament with Cloninger's Temperament and Character Inventory adopted by Hornowska and employee health status was screened with Goldberg's General Health Questionnaire- 28 (GHQ-28) adopted by Makowska and Merecz. The health impact of job strain with moderating effects of temperament traits was estimated with logistic regression (forward stepwise selection based on the likelihood ratio for the model). RESULTS: The analyses confirmed the moderating role of temperament in the health consequences of work-related stress. High score in novelty seeking was identified as independent temperament risk factor for mental health disturbances in judiciary staff facing at least medium job demands. The job control was a protective factor while relative risk of negative health outcomes was also elevated due to female gender. CONCLUSIONS: Temperament may control sensitivity to the environmental exposure to psychosocial hazards at work and its health consequences. Further research is needed to explore and understand better the moderating role of temperament in the relation between job stress (strain) and health in different vocational groups and workplaces. Med Pr 2017;68(3):375-390.

Quality of life in heart failure patients undergoing home-based telerehabilitation versus outpatient rehabilitation--a randomized controlled study.

BACKGROUND: The most common manifestation of heart failure is physical capacity impairment resulting in dyspnoea and fatigue. The disease deteriorates the quality of life (QoL). Its consequences restrict not only functioning in the physical aspect of QoL but also patients' emotional condition. OBJECTIVE: The study is aimed to assess QoL changes in HF patients after home-based telemonitored cardiac rehabilitation (HTCR Group) versus outpatient-based standard cardiac rehabilitation (SCR Group). METHODS: The study comprised 131 heart failure patients (aged 56.4±10.9 years; II/III NYHA) rehabilitated for eight weeks in two random groups: HTCR Group (n=75), participating in home-based rehabilitation supervised telemedically based on walking training; SCR Group (n=56), participating in traditional outpatient-based rehabilitation (cycloergometer training). QoL parameters were assessed with a Polish version of the Medical Outcomes Study Short Form 36 Health Survey Questionnaire (SF-36). RESULTS: After rehabilitation, both groups achieved a significant QoL improvement, both physically and mentally. HTCR Group patients improved in QoL physical categories in one subscale (physical function), and in two subscales in the mental categories (mental health, vitality). In SCR Group, three physical subscales improved (physical function, role limitation caused by physical problems, bodily pain). In the mental categories, also three subscales improved (social function, mental health, vitality). CONCLUSIONS: The study demonstrated that in heart failure patients HTCR provided a similar improvement in total QoL index as SCR. Yet it differed in QoL subscales. Patients who underwent home-based telerehabilitation observed an improvement mainly in the mental categories. Patients in SCR Group improved their general physical well-being.

[Difficult questions for family physicians concerning hypertension--questionnaire results]. / Trudne pytania dla lekarzy rodzinnych dotyczace nadcisnienia tetniczego.

UNLABELLED: Epidemiological studies shows high percent of hypertension cases are not covered as well as level of hypertension control is not satisfactory. The aim of this study was assessment of basic level of knowledge concerning hypertension in group of basic health care physicians. MATERIAL AND METHODS: 846 practice family physicians were included in this study. The questionnaire (own creation) was used for investigation. Before training course, four questions were asked to physicians about: 1/ Hypertension diagnosis in different age groups of people, 2/ Frequency of essential hypertension among of adult population, 3/ Blood pressure in first half period of normal pregnancy comparison to pre-pregnancy blood pressure, 4/ Groups of antihypertensive drugs certainly non administered in pregnancy period. RESULTS: 14% responders correctly answered for first question, 19%for second question, 10%-for third and 6% for fourth question. CONCLUSIONS: 1. Investigated physicians presented low level of knowledge about hypertension. 2. It is necessary to elaborate more effective strategy for education of family physicians.

[Quality of life in patients after the Ross operation for aortic stenosis]. / Jakosc zycia u pacjentów po korekcji lewego ujscia tetniczego metoda Rossa.

The pulmonary autograft provides ideal conditions regarding hemodynamics. Its additional value is durability and low thromboembolic hazard. We postulated that the Ross technique results in minimal restrictions on patient's lifestyle as compared to normal controls and we expected the patients to have good quality of life (QoL). On the other hand QoL may be affected by the risk of the homograft degeneration and the need of reoperation in the future. The aim of the study was to assess the QoL of patients after Ross operation because of aortic valve stenosis. Postoperative condition of the patients was judged by resting transthoracic echo, 24 hour ECG recording, maximal exercise test on bicycle ergometer. The mean age of patients was 31.1 (N=50; 18 female, 32 male). The mean follow-up was 3.6 years. We applied the Short Form Health Survey Questionnaire (SF-36) for assessment of QoL. The results of psychological tests were compared with age, gender and education matched control group without underlying cardiac disease. Overall QoL (QoL index) did not vary between patients and control group. The only significant difference concerned physical sum score and subtests of physical functioning (scale 1) and general health perception (scale 8). There were no differences in psychological health sum score. We concluded that in general, patients after the Ross operation enjoy a normal life style. The results of our study are consistent with well known advantages of Ross procedure. This study also implies the need for more detailed information concerning patient's lifestyle after the operation. Patient's family and doctors who are to take care of the patient after leaving hospital ought to be instructed as well. Education should specify patient's ability to perform different everyday abilities, especially physical ones. The aim of the education is to eliminate negative self-assessment of patient's own physical abilities which probably originate from preoperative period and stress connected with operation.

[Placebo: its hypotensive effect and influence on certain psychological parameters and dependency on dosage prescribed to patients]. / Placebo--jego dzialanie hipotensyjne oraz wplyw na wybrane parametry psychologiczne w zaleznosci od podawanej pacjentowi liczby tabletek.

The main purpose of this study is to estimate the influence of taking a number of placebo tablets to obtain hypotensive effects and some psychological parameters with essential hypertension. 197 patients (102F/95M) aged between 18-80 years (average age 52.3) with essential hypertension were included in the research in two outpatients clinics. The patients who participated in research, stayed for at least seven days without any pharmacological treatment. They had a diastolic pressure (DBP) between 95-114 mm Hg and systolic pressure (SBP) up to 200 mm Hg. 92 patients had taken one tablet a day and 105 patients had taken two tablets in the morning. This was before the placebo was included and two weeks after their blood pressure had been taken by standard methods (sphygmomanometer). They were monitored daily throughout the period using traditional methods and ABPM (SpaceLabs 90121). The patients completed two psychological tests. 97 records (52F/45M) qualified for statistical analysis (80% of measurements were undertaken properly, and the time between measurements was less than two hours). Psychological questionnaires were correctly completed by 92 patients. The visible results of decreasing systolic and diastolic value of blood pressure were obtained after using one (group 1) and two (group 2) placebo tablets. They were monitored by a standard method and recorded by ABPM. In group 1 SBP decreased from 164 +/- 11.4 mm Hg to 158 +/- 8.8 mm Hg (p < 0.01, on standard method) and from 149.5 +/- 17.8 to 144.5 +/- 8.3 mm Hg daily (p < 0.05, ABPM). DBP in this examined group decreased from 106.2 +/- 2.8 to 102 +/- 3.9 mm Hg (p < 0.01, stand. method), and from 103.2 +/- 2.6 to 98.6 +/- 1.2 mm Hg daily (p < 0.05, ABPM). In the second group SBP decreased from 169 +/- 12.8 to 157.6 +/- 17.9 mm Hg (p < 0.001, stand. method), and in ABPM from 148.5 +/- 15.8 to 139.6 +/- 16.2 mm Hg (p < 0.01). In this same group, DBP decreased from 104.4 +/- 2.6 to 98 +/- 3.4 mm hG (p < 0.001, stand. method), and from 107.4 +/- 5.8 mm Hg to 95.5 +/- 4.2 mm Hg-daily (p < 0.001, ABPM). There were no differences between heart rate in all groups of patients. In both groups there were significant statistical differences in negative symptoms, physical symptoms and anexity, but a more optimistic mood was observed by group 2. More effective hypertensive treatment was observed within the group which was treated with two placebo tablets. This group was characterized by more optimistic mood compared to the group which was treated with one placebo tablet a day.

[Mental stress test in patients with stable coronary artery disease]. / Test prowokacji stresem psychicznym u chorych ze stabilna choroba wiencowa.

UNLABELLED: Myocardial ischemia may be triggered by exercise and non-exercise stimuli. THE PURPOSE: Of this study was to determine the usefulness of laboratory mental stress (MS) in inducing myocardial ischemia and/or cardiac arrhythmia in patients (pts) post myocardial infarction, with stable coronary artery disease. Sixty four men, mean age 45 +/- 6 years underwent: 15 min mental stress test during 24 h Holter monitoring and exercise stress testing. RESULTS: Only 8 pts (13%) had positive mental stress test (MS+). Five of them had ST segment depression > 1.0 mm (STD), and the remaining 3 pts had cardiac arrhythmias. All episodes were silent. MS+ pts had higher heart rate (HR) during the mental test than those with negative stress test (MS-) (120/min vs 105/min, p < 0.05). In contrast, at least one episode of daily life ischemia (DLI) was recorded in 23 pts (36%) on Holter monitoring. In MS+ pts average duration of DLI (17 min) and mean HR during ischemia (124/min) were greater than in MS-pts (respectively 10.5 min and 94/min, p < 0.05). Exercise induced ischemia (STD > 1.0 mm) was observed in 29 of 64 pts (45%). However, in MS+ pts exercise duration (708 +/- 132 s), time to 1 mm STD (432 +/- 108 s) were significantly shorter and double product at 1 mm STD (13,400 +/- 2913 mm Hg/min) was lower than in MS- pts (respectively 924 +/- 174 s, p < 0.01; 624 +/- 162 s, p < 0.01; 14,800 +/- 3321 mmHg/min, p < 0.05). CONCLUSIONS: Mental stress test is a weak inducer of ischemia and arrhythmia in patients with stable coronary artery disease. Patients with mental stress-induced ischemia are more likely to display ischemia during daily life and exercise stress testing.

[Socio-economical status, state of health, menstrual cycle, sexual relation--how they influence girls' self-evaluation in surrounding conditions?]. / Warunki socjalno-bytowe, stan zdrowia, cykl miesiaczkowy, wspólzycie seksualne--co pomaga a co przeszkadza dziewczetom w postrzeganiu siebie w otaczajacej rzeczywistosci?

School and home environment may deeply affect adolescent girls' behavior. This investigation included 1371 girls (mean age 16 +/- 0.49 years) from different schools in Warsaw who were inquired about their living conditions, health, menstrual cycle disturbances, sexual relations and knowledge of family planning. Their self-evaluation and susceptibility to depression were estimated. The girls' mean age of menarche was 12.8 +/- 0.39 yrs. Majority of the subjects (70.9%) had regular cycles and 65.6% suffered from menstrual pain two years after menarche. 18% of adolescents started intercourse up to the age of eighteen. Relation between parents, their divorce or death did not affect the girls' self-evaluation. Type of school, day and phase of menstrual cycle or hormonal contraception did not influence their psychological indices. Presence of a partner markedly increased adolescents' self-evaluation.