Symptoms of sexuality-related disorders in the group of overweight and obese women. / Objawy zaburzen zwiazanych z seksualnoscia w grupie kobiet z nadwaga i otyloscia.

OBJECTIVES: The aim of the study was to assess the presence of symptoms of sexuality-related disorders (S-RD) in a group of overweight and obese women and the relationship of these symptoms with maladaptive attitudes and beliefs about food, the severity of anxiety and depressive symptoms, alcohol consumption, difficulties in emotional regulation, and the general quality of life. METHODS: The study group (SG) consisted of 44 overweight/obese women, the control group (CG) consisted of 51 women with normal body weight, all aged 18-40 years. The following were used: Sexological Questionnaire, Eating Attitude Test, Eating Beliefs Questionnaire, Alcohol Use Disorder Identification Test, Hospital Anxiety and Depression Scale, and the Quality of Life Questionnaire. RESULTS: SG showed more severe S-RD symptoms, including sexual dysfunctions and sexual preferences disorders, as compared to CG. In the SG there were more significant correlations between S-RD and the studied variables, especially in the area of difficulties with emotional regulation. Negative and permissive dietary beliefs were significant for S-RD in SG, while positive beliefs were significant in CG. Additionally, the number of S-RD symptoms predicted the quality of life. CONCLUSIONS: e results indicate a relationship between excessive body weight and greater severity of S-RD symptoms, as well as a relationship between the symptoms of S-RD with clinical variables and with the quality of life. Further research exploring the mechanisms of the observed relationships is necessary.

Whole-body cryotherapy as a treatment for chronic medical conditions?

INTRODUCTION: Whole-body cryotherapy (WBC) is a controlled exposure of the whole body to cold to gain health benefits. In recent years, data on potential applications of WBC in multiple clinical settings have emerged. SOURCES OF DATA: PubMed, EBSCO and Clinical Key search using keywords including terms 'whole body', 'cryotherapy' and 'cryostimulation'. AREAS OF AGREEMENT: WBC could be applied as adjuvant therapy in multiple conditions involving chronic inflammation because of its potent anti-inflammatory effects. Those might include systemic inflammation as in rheumatoid arthritis. In addition, WBC could serve as adjuvant therapy for chronic inflammation in some patients with obesity. AREAS OF CONTROVERSY: WBC probably might be applied as an adjuvant treatment in patients with chronic brain disorders including mild cognitive impairment and general anxiety disorder and in patients with depressive episodes and neuroinflammation reduction as in multiple sclerosis. WBC effects in metabolic disorder treatment are yet to be determined. WBC presumably exerts pleiotropic effects and therefore might serve as adjuvant therapy in multi-systemic disorders, including myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). GROWING POINTS: The quality of studies on the effects of WBC in the clinical setting is in general low; hence, randomized controlled trials with adequate sample size and longer follow-up periods are needed. AREAS ARE TIMELY FOR DEVELOPING RESEARCH: Further studies should examine the mechanism underlying the clinical efficacy of WBC. Multiple conditions might involve chronic inflammation, which in turn could be a potential target of WBC. Further research on the application of WBC in neurodegenerative disorders, neuropsychiatric disorders and ME/CFS should be conducted.

Association of Higher Rates of Type 2 Diabetes (T2DM) Complications with Psychological and Demographic Variables: Results of a Cross-Sectional Study.

Introduction: The aim of this study was to assess the relationship between the occurrence and number of T2DM complications with sociodemographic (age, sex, habitation, education), clinical (duration of diabetes, HbA1c (%), BMI) and psychological (well-being, sense of influence on the diabetes course, coping styles) variables. Methods: A total of 2574 adult patients were assessed using The Sense of Influence on the Diabetes Course Scale, WHO-5 Well-Being Index, and the Brief Method of Evaluating Coping with Disease. Hierarchical Regression Analysis was conducted with number of complications as the dependent variable and three sets of variables entered in sequential steps: (a) sociodemographic; (b) clinical and (c) psychological factors. Logistic regression analysis was used to examine the association of these variables with diabetes complications' occurrence. Results: A higher number of complications and higher odds ratios of occurrence of complications were associated with sociodemographic and clinical variables, poor well-being, low perception of influence on the diabetes course, and an emotion-oriented coping style. The logistic regression indicated that participants with HbA1c >7% (in comparison with HbA1c ≤ 7%) and with high risk of depression (in comparison with no risk of depression) had respectively 68% and 86% higher odds of developing complications. Discussion: The number of complications has weak but statistically significant relations with psychological and clinical factors. Conclusion: The results support the rationale of including the psychosocial factors in the context of diabetes management.

Relations of Well-Being, Coping Styles, Perception of Self-Influence on the Diabetes Course and Sociodemographic Characteristics with HbA1c and BMI Among People with Advanced Type 2 Diabetes Mellitus.

PURPOSE: Assessment of the relationship between psychological and sociodemographic factors with the levels of glycated hemoglobin (HbA1c) and Body Mass Index (BMI) among people with advanced type 2 diabetes mellitus (T2DM). PATIENTS AND METHODS: A total of 2574 persons, among them 1381 (53.7%) women, with type 2 diabetes, during the period of switching from biphasic mixtures of human insulin to insulin analogues. The age of participants ranged from 22 to 94 years (M = 63.5; SD = 9.58), and their treatment period was in the time frame from 2 years to 43 years (M = 10.2; SD = 6.1). Participants filled out a Scale for Perception of Self-Influence on the Diabetes Course, Well-Being Index WHO-5, two questions from the Brief Method of Evaluating Coping with a Disease. RESULTS: Statistically significant correlations were found between the HbA1c levels and (1) disease duration (rs=0.067; p < 0.001); (2) number of complications (rs = 0.191, p < 0.001) (3) the perception of self-influence on the diabetes course (rs=- 0.16; p < 0.001); (4) well-being (risk of depression) (rs=- 0.10; p < 0.001). The regression analysis showed that 7% of HbA1c variability is explained by age, a perception of self-influence on the diabetes course, the number of complications, place of residence, education, BMI. The most important findings concerning BMI were found in regression analysis, which indicated a week relationship between BMI and a number of complications, perception of self-influence on the diabetes course and coping styles (3% of the resultes' variability). The group at high risk of depression had the highest levels of HbA1c. CONCLUSION: Sociodemographic and psychological factors show weak but statistically significant relationships with the current levels of HbA1c and BMI.

The craniofacial necrotizing fasciitis after a minor trauma in an elderly white woman.

The term necrotizing fasciitis /NF/ was probably first described by Jones in 1871 as "hospital gangrene". NF, with its fast spreading from the local infection to massive necrosis of the underlying tissues, ie. superficial fascia and subcutaneous layers, is a potentially fatal disease, unless diagnosed early and properly treated. NF is more frequent in frail patients with chronic debilitating illnesses, immune deficiencies or from a poor social background. Sixty percent of NF cases occur in females. Here we present a case of necrotizing fasciitis of the head and neck region after a minor trauma (phenol blocks due to severe neuropathic pain) in an 82-year-old female with the history of trigeminal neuralgia. Key words:Necrotizing fasciitis, craniofacial infection, tissue necrosis.

Psychometric properties of the Polish version of the Multidimensional Fatigue Inventory-20 in cancer patients.

CONTEXT: Multidimensional questionnaires estimating cancer-related fatigue (CRF) as a symptom cluster or a clinical syndrome primarily have been used and validated in English-speaking populations. However, cultural issues and language peculiarities can affect CRF assessment OBJECTIVES: The main aims of this study were to evaluate the psychometric properties of the Polish version of the Multidimensional Fatigue Inventory-20 (MFI-20) and to deliver to clinicians a multidimensional tool for CRF assessment in Polish-speaking patients with cancer. METHODS: After forward-backward translation procedures, the Polish version of MFI-20 was administered to 340 cancer patients. The Polish MFI-20 was appraised in terms of acceptability, reliability, and validity. Internal consistency was assessed by calculating Cronbach's alpha coefficients. Structural validity was evaluated with confirmatory factor analysis. RESULTS: The translated MFI-20 was well accepted; 90% of subjects fully completed the questionnaire. The overall Cronbach's alpha coefficient was 0.9, ranging from 0.57 to 0.81. All correlation coefficients among Numeric Rating Scale-fatigue, fatigue-related items from the European Organization for Research and Treatment of Cancer Quality of Life Core-30 questionnaire, and the MFI--20 were statistically significant (P < 0.001). Confirmatory factor analysis demonstrated good structural validity and revealed only three dimensions in the Polish version of the MFI-20-physical and mental fatigue as well as reduced motivation. CONCLUSION: The Polish version of the MFI-20 is well accepted by patients, reliable, and a valid instrument to assess CRF in Polish cancer patients.

Strategy of coping with end-stage disease and cancer-related fatigue in terminally ill patients.

UNLABELLED: The aim was to investigate whether there is a relationship between strategy of coping with end-stage disease and cancer-related fatigue. The study was conducted using the Rotterdam Symptom Checklist, Brief Fatigue Inventory, and Mini-Mental Adjustment to Cancer scale to specify patient's strategy of coping. Finally, 51 hospice care patients with cancer were analyzed. MAIN FINDINGS: The majority of responders adopted 1 of the 2 styles; avoidance (belongs to adaptive coping) or anxious preoccupation (destructive or maladaptive). Less often moderate fatalism and helpless/hopeless (H/H) or fighting spirit were observed. Significant correlation has been found between H/H or fatalism strategy and fatigue. CONCLUSIONS: High level of fatigue had a negative impact on almost all aspects of daily living among people with H/H or fatalism strategy.

Kinesitherapy alleviates fatigue in terminal hospice cancer patients-an experimental, controlled study.

PURPOSE: The study was focused on the influence of the kinesitherapy on fatigue and the quality of life in the terminal hospice cancer patients. PATIENTS AND METHODS: Forty-nine patients were included into the study and divided into experimental group A (with kinesitherapy) with 30 subjects and control group B (without kinesitherapy) with 19 subjects. Patients from group A did the exercises three times a week, for 20-30 min, for the period of 3-4 weeks. The exercises were individually supervised by a physiotherapist, following a carefully worked out pattern. In both groups, the changes in the intensity of fatigue and the quality of life were observed by means of using Rotterdam symptom checklist, brief fatigue inventory, and visual analogue fatigue scale. RESULTS: In group A, the intensity of fatigue decreased significantly after 3 weeks of kinesitherapy. In group B, fatigue deteriorated significantly in comparison with the initial measurement. The intensity of physical symptoms in group A decreased significantly after 2 weeks of kinesitherapy, whereas in group B, increased after 2 weeks of observation. The quality of life in group A remained stable throughout the study. A tendency towards the deterioration of the quality of life with the time passing in group B was noticeable. CONCLUSION: Our analysis showed that, on average, after 3 weeks of kinesitherapy, a significant decrease of the intensity of fatigue was observed, while in the control group, it increased after 2 weeks of observation. The obtained results provide evidence that a planned set of exercises decreases cancer-related fatigue effectively.

[Quality of life in elderly, terminally ill cancer patients]. / Ocena jakosci zycia osób w wieku podeszlym w terminalnym okresie choroby nowotworowej.

In the last few years many researches have emerged in which quality of life of terminally ill patients has been a main focus of attention. Some evaluation methods have been used in elderly population too. Our paper presents results of a study concerning the problem of QL of patients in the terminal state in institutional care for elderly people. The terminally ill over the age 65 were compared with those of the same aged men and women without cancer and those aged 64 and younger suffering from cancer too. Self-assessment of health and QL was compared with objective evaluation of the health state. We hope this study will give the opportunity to make the QL of our patients better and quality of care more effective.

The religiousness as a way of coping with anxiety in women with breast cancer at different disease stages.

BACKGROUND: Anxiety is an unpleasant emotion affecting patients with cancer, and there are various ways of coping with it. Little is known about the relationship between the anxiety level and physical, somatic or spiritual (e.g. religiousness) factors in breast cancer patients at different stages of the disease. OBJECTIVES: The purpose of the study was to assess the intensity of anxiety at different stages of breast cancer, to define the relationship between religiousness and physical (somatic) condition and anxiety in the study subjects and to find out if religiousness is an effective coping strategy at any breast cancer stage. MATERIALS AND METHODS: The study involved 180 women aged between 28 and 77, who were qualified to one of five study groups, according to their disease stage. The following research instruments were used: the State-Trait Anxiety Inventory (STAI), Scale of Personal Religiousness, the Rotterdam Symptom Checklist as well as medical history and data from patients' medical records. RESULTS: There is a significant correlation between state anxiety and trait anxiety measured by STAI in study groups. Breast cancer stage differentiates the study groups in respect of revealed anxiety level. Somatic condition has no significant impact on the intensity of anxiety in terminal breast cancer patients. Amongst the studied variables, only religiousness is an important factor that influences the anxiety level of end-stage cancer patients. CONCLUSIONS: The obtained results allow us to conclude that: (a) religiousness is an effective factor of coping with anxiety only of the end-stage breast cancer patients; (b) cancer stage is a differentiating factor in respect of revealed anxiety level in study subjects; (c) exacerbation of somatic symptoms does not influence the anxiety level in terminal cancer patients and at disease-free period.

[Palliative care in chronic obstructive pulmonary disease]. / Opieka paliatywna w przewleklej chorobie obturacyjnej pluc (POChP).

Traditionally focusing on terminally ill cancer patients, palliative care services have recently attempted to involve patients with other chronic, life - threatening diseases, e.g. chronic obstructive pulmonary disease (COPD). In this group of patients both quality of life and life expectancy is poor. Unfortunately, patients with COPD don't receive adequate special medical service, although this progressive disease causes almost as many deaths as lung cancer. The suffering of patients dying from COPD is not smaller than cancer patients. The major symptoms are usually dyspnoe, cough, fatigue, depression, emotional and psychosocial problems. In fact, their needs are really palliative, so we try to pay attention to the quality of life of people suffering from COPD. It is important to underline that medical palliation of these patients falls not only to the management of the main clinical symptoms, but also to adopt a holistic, multiprofessional approach and working with their families and caregivers.

[Cancer-related fatigue. II. Causes and management of the problem]. / Zmeczenie w chorobie nowotworowej. II. Przyczyny i sposoby zwalczania.

Fatigue is often related to cancer, and is related to its treatment. Fatigue is the most commonly reported side effect of cancer treatment. It differs from fatigue induced by other causes, because doesn't decrease after period of rest. The fatigue reported by cancer patients is usually described as an unusual, excessive, whole-body experience that is disproportionate or unrelated to activity or exertion and is not relieved by rest or sleep. Cancer related fatigue is multidimensional, subjective experience that has profoundly negative effect on patients' quality of life. Fatigue today is the most commonly reported symptom, for some patients the most unpleasant symptom, and the most distressing side-effect in connection with cancer and/or its treatment. The prevalence of fatigue in patients receiving anti-cancer treatment has been estimated to be more than 80 per cent. The fatigue can be pervasive: patients report that fatigue begins with treatment, continues during the course of chemotherapy or radiation treatment, and declines somewhat--but frequently sustains at a higher-than-baseline rate- after treatment is over. It may also persist for several years even in patients with no apparent disease. Despite of the prevalence of fatigue and its profoundly negative effect on patients quality of life, little is known about the specific mechanisms that underline fatigue in cancer patients or how to prevent it and treat it effectively.

[Cancer related fatigue. I. Prevalence and attempt to define the problem]. / Zmeczenie w chorobie nowotworowej. I. Czestosc wystepowania i próba zdefiniowania problemu.

Fatigue is often related to cancer, and is related to its treatment. Fatigue is the most commonly reported side effect of cancer treatment. It differs from fatigue induced by other causes, because doesn't decrease after period of rest. The fatigue reported by cancer patients is usually described as an unusual, excessive, whole-body experience that is disproportionate or unrelated to activity or exertion and is not relieved by rest or sleep. Cancer related fatigue is multidimensional, subjective experience that has profoundly negative effect on patients' quality of life. Fatigue today is the most commonly reported symptom, for some patients the most unpleasant symptom, and the most side-effect in connection with cancer and/or its treatment. The prevalence of fatigue in patients receiving anti-cancer treatment has been estimated to be more than 80 per cent. The fatigue can be pervasive: patients report that fatigue begins with treatment, continues during the course of chemotherapy or radiation treatment, and declines somewhat--but frequently sustains at a higher-than-baseline rate-after treatment is over. It may also persist for several years even in patients with no apparent disease. Despite of the prevalence of fatigue and its profoundly negative effect on patients quality of life, little is known about the specific mechanisms that underline fatigue in cancer patients or how to prevent it and treat it effectively.

[Clinical and metabolic effects of recombinant human growth hormone in cardiac insufficiency]. / Kliniczne i metaboliczne efekty dzialania rekombinowanego ludzkiego hormonu wzrostu u chorych z niewydolnoscia serca.

Growth hormone (GH) acting through locally produced insulin--like growth factors stimulates myocardial hypertrophy and increases myocyte contractility. Many people with growth hormone deficiency (GHD) present a lower left ventricular mass, reduced ejection fraction and lower exercise tolerance. Recombinant human growth hormone (rhGH) administration gives a chance to correct these disturbances. On the other hand excessive levels of GH (for example in acromegaly) may induce heart failure too. Initially, cardiac hypertrophy is an adaptive response, but with time, in untreated cases, it leads to congestive heart failure. Mentioned information inclined many authors to undertake researches on rhGH application in severe heart failure in patient with idiopathic dilated cardiomyopathy and coronary disease. RhGH improved treatment let these patients reach heart transplantation.