Although not conclusive because of the small sample and short observation period, the study suggests that telehome monitoring is an effective tool in controlling type 2 diabetes in a primary care setting.
A telemedicine support system for diabetes management was compared with standard monitoring of patients with diabetes. The telemedicine system was composed of two modules: a Patient Unit and a Medical Unit connected by the telecommunication network. The study involved 60 patients of family doctors' practices in the Lower Silesia Region who were diagnosed with diabetes. There was no significant difference in haemoglobin A(1c) between telemonitoring and the traditional group of diabetic patients during the survey. The patients' quality of life slightly improved in the telemonitoring (mean score 3.4) and the traditionally monitored group (mean score 3.2), but there was no significant difference between them. Most of the telemonitoring patients (75%) expressed the desire to continue with telemedicine support and nearly 60% of patients monitored with traditional methods wanted to be included in the telemedicine group. The system seems to be reliable, simple to use and friendly for the patients.
Heterozygous familial hypercholesterolemia (HFH) affects on average 1 in 500 individuals in European countries, and it is estimated that HeFH in Poland may affect more than 80,000 people. Cardiovascular mortality in individuals with FH between 20 and 39 years of age is 100 times higher than in the general population. HFH is a relatively common lipid disorder, but usually still remaining undiagnosed and untreated. A very high risk of cardiovascular diseases and a shortened lifespan in patients with this condition require early diagnosis and intensive treatment. The aim of the position paper was to present the importance and scale of this problem in Poland, which has not been raised enough so far, as well as the recommendations of diagnosis, treatment and prevention methods.
Chronic renal failure and dialysis belong to contraindications to vaccination with live vaccines. The objective of this study was to evaluate the humoral response to influenza vaccination consisting of the formation of antibodies against hemagglutinin and neuraminidase in patients undergoing chronic hemodialysis due to chronic renal failure. The study included 173 patients treated at a dialysis station in the Silesian region in Poland. The patients were assigned to the following groups: Group A-71 hemodialysis patients, mean age 65.4 ± 14.5 years; mean time of dialysis therapy 38.9 ± 31.7 months, vaccinated against influenza; Group B-39 hemodialysis patients, mean age 64 ± 13.5 years; mean time of dialysis therapy 45.0 ± 45.2 months, not vaccinated against influenza; and Group C-63 healthy patients, mean age 44.1 ± 21.2 years, vaccinated against influenza - control group. The vaccinated patients (Groups A & C) received a single dose of Agrippal influenza vaccine (Novartis) containing hemagglutinin from three strains of the influenza virus: A/Brisbane/59/2007 (H1N1), A/Brisbane/10/2007 (H3N2), and B/Brisbane/60/2008. The serological response to vaccination was assessed from antihemagglutinin (anti-HA) and antineuraminidase antibody assays (anti-NA). We found that the protection level of antibodies (protection rate) against H1 was only 40% among the vaccinated hemodialysis patients, as opposed to 65% in controls. The level of anti-H3 antibodies was similar in both groups of vaccines; 68% in dialysis patients and 75% in controls. The level of anti-HB antibodies was higher in the dialysis patient than in controls; 70% vs. 38%, respectively. The response rate to H1 antigen a month after vaccination was almost twice lower in the hemodialysis patients than in healthy controls vaccinated against influenza; 37% vs. 65%, respectively. We conclude that there is a rather insufficient serological response in the group of hemodialysis patients vaccinated with a single dose of influenza vaccine.
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