Background: The changes in the period of ventricular repolarization, i.e., QT interval, QTp (Q-Tpeak) and TpTe interval (Tpeak–Tend), make it possible to assess the electrical instability of the heart muscle, which may lead to the development of life-threatening ventricular arrhythmia. The aim of the study was to determine and evaluate the use of differences in T-wave morphology and durations of repolarization period parameters (QT, TpTe) in resting ECGs for children with ventricular arrhythmias. Methods: The retrospective analysis was made of the disease histories of 80 examined children with resting ECGs, which were admitted to the Children’s Cardiology Department. The study group consisted of 46 children aged 4 to 18 with ventricular arrhythmias and the control group consisted of 34 healthy children between 4 and 18 years of age, with no arrhythmias. Results: The duration of the TpTe interval was significantly (p < 0.001) longer in the group of children with ventricular arrhythmia with abnormal T-wave (bactrian/bifid, humid/biphasic) compared to the TpTe interval in children with ventricular arrhythmia with the normal repolarization period. The duration of the TpTe (p < 0.001), QTcB (p < 0.001) and QTcF (p < 0.001) intervals were significantly longer in the group of children with ventricular arrhythmias and with abnormal T-wave compared to the values of the TpTe, QTcB, and QTcF intervals of the control group with normal morphology of the repolarization period. Only the duration of the TpTe interval was significantly (p = 0.020) longer in the group of children with ventricular arrhythmia without clinical symptoms. Conclusions: Children with benign ventricular arrhythmias recorded on a standard ECG with prolonged TpTe and QT intervals and abnormal T-wave morphology require systematic and frequent cardiac check up with long term ECG recordings due to the possibility of future more severe ventricular arrhythmias. Further follow-up studies in even larger groups of patients are necessary to confirm the values of these repolarization parameters in clinical practice.
Introduction. One of the most common causes of death, permanent disability in people aged over 40 is a stroke. The effective rehabilitation of stroke patients is affected by proper nursing care, as well as by assistance, presence and support for families of patients. Aim. The aim of this study was to obtain nurses' opinion about the problems in the nursing care of patients after stroke. Material and Methods. The study was conducted with the participation of 60 respondents aged 23-58 years (average age: 38.1) including 4 men and 56 women. The respondents were of practitioners nurses at surgical and conservative wards in a healthcare facility in Silesia. The research tool was a questionnaire completed voluntarily by respondents, ensuring anonymity. Results. According to 85% of the respondents the most common problems that emerged during the nursing care of patients after stroke consisted of mental disorders occurring in patients. Then, performance of the toilet of the whole body of the patient (21.6%), education of the patients and their families (21.6%) and taking actions against anti-bedsore (18.3%). The fewest problems in nursing care accounted for oral feeding of patients (6.6%) and the situation in which the patient experienced pain (3.3%). Whereas feeding the patient through the tube and participation in pharmacotherapy was not the reason for problems that arise in the care of patients after stroke. Conclusions. 1) Working conditions of nurses at profile conservative and surgical wards, where hospitalized patients are of III and IV category of care contribute to the formation of significant physical and psychological burdens of this professional group, which reduces efficiency and thus reduces job satisfaction. 2) For the study group, the greatest problems of nursing are patients with mental disorders, education of the patients and their families and the performance of the patient's whole body toilet. They hinder the care of the patient after a stroke.3) The occurrence of adverse events did not constitute, according to the study group, a problem in patient care, so this perception of the study group points to the emerging syndrome of 'burnout'. This may entail negative consequences in patient's care, who need appropriate and comprehensive care after stroke. (JNNN 2017;6(2):73-80)
The aim of the paper is to characterize hippotherapy as an effective method supporting rehabilitation of disabled people in the biopsycho-social area. The analysis is based on a review of the literature and previous studies of this form of therapy.
WstępAnomalie sercowo-naczyniowe, w tym przetrwały otwór owalny, są przyczyną 40% udarów kryptogennych. Przetrwały otwór owalny jest wadą serca, które zwykle nie daje objawów klinicznych. Jest rozpoznawalny u młodych udarowych pacjentów (przed 55 rokiem życia – r.ż.) przy braku innych przyczyn udaru mózgu. Celem pracy była ocena częstości występowania przetrwałego otworu owalnego w grupie młodych pacjentów z udarem przed 55 r.ż. z migrenowymi bólami głowy.Materiał i metodyBadaniami objęto 50 młodych, udarowych pacjentów przed 55 r.ż. (średnia wieku 48, ♀: 21, ♂: 29). Pacjenci byli hospitalizowani w okresie od 1 stycznia 2012 do 31 grudnia 2012 roku w pododdziale udarowym na oddziale neurologicznym. Analizowano historie chorób, uzyskując dane odnośnie do płci, wieku, objawów przy przyjęciu, wyników przeprowadzonych badań diagnostycznych oraz zastosowanej terapii.WynikiW badanej grupie młodych udarowych pacjentów (przed 55 r.ż.) przetrwały otwór owalny był stwierdzony u 16% pacjentów. Częstość występowania PFO była szczególnie wysoka (83%) w grupie młodych udarowych pacjentów z migrenowymi bólami głowy, stanowiącej 12% całej grupy badanej.WnioskiCzęste występowanie przetrwałego otworu owalnego, jako jedynej zidentyfikowanej przyczyny udaru mózgu u młodych pacjentów przed 55 r.ż., skłania do podjęcia odpowiednich działań profilaktycznych z diagnostyką echokardiograficzną, szczególnie u osób z migrenowymi bólami głowy i np. w czasie badań bilansowych u młodzieży.
Introduction. Syncope is defined as a state of short-term loss of consciousness with reduction of muscle tone due to insufficient hypoxic brain. It is characterized by a sudden onset and spontaneous, complete subsiding. Approximately 30-40% of all syncopes of unclear origin represent vasovagal syncope which are the most common type among children, young people (75-85%) and in people in old age. Syncope is a common condition, and any loss of consciousness always causes concern the patient and his/her relatives. A strong sense of the disease and the risk of even life-threatening situations accompanying syncope reduces comfort and quality of life. The leading method of treatment of vasovagal syncope is to educate the patients and their families. Good education of the patient helps to avoid situations that lead to the development of a vasovagal reaction and also helps to learn the proper procedure when dealing with prodromal symptoms. A nurse has a great role in the education, therefore it is so important for her to know the basic rules of syncope prevention. Aim. The aim of the study was to assess the knowledge of learners of medical sciences on dealing with syncope. Material and Methods. The survey involved 133 patients, including 66 (49.6%) first-year students of the second degree in nursing (12 -part-time students and 54 -full-time students), 39 (29.3%) first-year students studying the second degree in midwifery (21 full-time students and 18 -part-time) and 28 (21.1%) trainees studing to be a medical caretaker. The applied research method was a diagnostic study conducted with the use of an anonymous survey questionnaire, which contained only closed questions. Results. 75% of the study group has witnessed syncope and a vast majority (97.7%) declare they know how to help the person who fainted, and who presents prodrome symptoms (98.5%). In order to assist the person who fainted most respondents indicated the answer: "opening a window" (95.4%) and "lifting the legs up" (92.4%), whereas 29 respondents said that the person who fainted should be given a glass of water (21.8%). In the event of syncope symptoms most respondents would recommend leaving the stuffy air (93.9%), change in body position to lying or sitting and lifting the lower limbs (75.93%). The smallest number of the answers obtained referred to cough provoking (18.0%), trotting (9.02%), abdominal flexion (9.77%) and clenching the fists (5.26%). Conclusions. The study group was characterized by a good general knowledge of the proceedings in syncope, with a better knowledge shown by people with higher education. More rarely the respondents demonstrated the knowledge on behavior in the case of prodromal symptoms, such as the use of cough, tripping and arms and wrists straining. (JNNN 2016;5(2):40-45) Wstęp. Omdlenie określane jest jako stan krótkotrwałej utraty świadomości wraz z obniżeniem tonusu mięśniowego w wyniku niedostatecznego niedotlenienia mózgu. Charakteryzuje się gwałtownym początkiem i samoistnym, całkowitym ustąpieniem. Około 30-40% wszystkich...
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