Advances in medical sciences
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The metabolic syndrome refers to the clustering of upper body obesity, atherogenic dyslipidemia, insulin resistance and elevated blood pressure. Both, obesity and metabolic syndrome, have the potential to influence on the incidence and severity of cardiovascular disease with serious implications for worldwide health care systems. Obesity plays a central role in the development of insulin resistance and dyslipidemia through the mediation of a pro-inflammatory and pro-thrombotic state. ⋯ Those bioactive molecules participate in regulation of apetite and energy homeostasis, lipid metabolism (tumour necrosis factor alpha--TNF-alpha), insulin sensitivity (TNF-alpha, adiponectin, resistin, visfatin) immunity (monocyte chemoattractant protein-1--MCP-1, TNF-alpha, IL-6), angiogenesis, blood pressure and hemostasis (plasminogen activator inhibitor--PAI-1). The effects of major pro-/anti-inflammatory and pro-thrombotic adipokines on several physiological processes will be discussed in this review. Also, an evidence-based approach to the laboratory diagnosis and treatment of metabolic syndrome will be presented.
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Multicenter Study
Estimation of the declared knowledge of anaesthesiology nurses concerning some chosen procedures and actions being within the scope of professional competence.
Together with introducing legal regulations as well as modem standards of postgraduate education, the professional position of a nurse has strengthened and also her responsibility for professional activity has increased. Performing the profession of an anaesthesiology nurse involves necessity of possessing some adequate professional qualifications. The aim of the study was an attempt to answer the question on how the knowledge of an anaesthesiology nurse concerning the activities being within her professional qualifications shapes. ⋯ Obtaining competence in anaesthesiology nursing involves the necessity of continual raising of qualifications by nurses, especially being on specialization level; 3. A necessity of differentiation between particular competence levels of anaesthesiology nurses during different forms of education should be underlined; 4. Possibility of realization of their competences on a particular level by anaesthesiology nurses is connected with the necessity of improving whole therapeutic team work.
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The extremely rare case of 83-year old woman with rupture of the gallbladder due to blunt abdominal trauma is presented. Patient's general condition was complicated because of coagulopathy caused by oral anticoagulant what has contributed to intra-abdominal haemorrhage. ⋯ The treatment of choice in rupture of the gallbladder is cholecystectomy. In patients after abdominal trauma, beside damage of parenchymatous organs, the injury to other organs should be taken into consideration, even if they occur very rarely.
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To evaluate the frequency, source and type of aggression towards doctors, depending on their place of work and position. ⋯ Workplace aggression towards doctors may be inflicted both by patients and colleagues. The aggression in the medical environment can take on different forms and create a threat in the workplace. Doctors working in hospital wards (psychiatry, surgery, neurology) are the ones who are the most exposed to aggression.
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Small intestinal bacterial overgrowth (SIBO) may coexist with irritable bowel syndrome (IBS) and eradication therapy has been reported as effective in reducing IBS symptoms. Aims of this study were to: (1) Assess the clinical profiles of IBS patients, who underwent breath testing with a glucose substrate--glucose breath test (GBT); (2) Evaluate hydrogen and methane parameters in various IBS groups; (3) Assess the role of inhibition of gastric acid in contributing to SIBO; (4) Investigate efficacy and safety of non-absorbable antibiotic rifamixin for eradication and symptom relief. ⋯ (1) SIBO was present in nearly half of this large cohort of IBS patients based on the results of GBT; (2) Chronic PPI use was not associated with SIBO; (3) Methane formers on the GBT are more likely to be constipated; (4) Rifaximin is effective in treatment of SIBO in IBS and controlled trials are warranted.