Introduction:The implementation of guidelines on cardiovascular disease (CVD) prevention in patients at high risk of developing CVD was assessed in the EUROASPIRE V registry.Aim of the study: This study was designed to compare a simple self-reported quantitative assessment of adherence to medication using the Medication Adherence Questionnaire (MAQ) with a qualitative evaluation based on the Adherence in Chronic Disease Scale (ACDS) in the Polish cohort of the EUROSPIRE V registry. Material and methods:The study was performed in 200 patients (133 women and 67 men) with an average age of 51.49 (13.63) years and a history of hypertension, hypercholesterolemia or diabetes, but without prior cardiovascular events. Pharmacological treatment was applied in 127 patients (63.5%) with hypertension, 90 (45%) with hypercholesterolemia, and 31 (15.5%) with diabetes.Results: According to the MAQ, high adherence to medication (100% or 90%) was declared by 67.7% of patients, while medium (75% or 50%) and low adherence (< 50% or 0%) by 9.7% and 22.6%, respectively. The adherence assessed with the ACDS, was high in 38.7%, medium in 44.8%, and low in 16.5% of patients. A remarkable inconsistency between ACDS and MAQ responses was found. The MAQ and the ACDS rendered consistent results in 44.8% of patients (111 out of 148), while in the remaining 55.2% (137 out of 248) of patients the results were discordant. Conclusions:The assessment of medication adherence based on patient declarations used in the EU-ROASPIRE V registry is likely to overestimate the frequency of high adherence.
Parathyroid hyperactivity is the state of over-production and PTH secretion [1]. The most common cause of primary hyperparathyroidism is parathyriod adenoma - about 80% of cases, the remaining are parathyroid hyperplasia around 15%cases [2] [3], and in 1-5% of cases, cancer [2] [3] [4] [5]. The disease is diagnosed inabout 40 people in 100,000 [5] [6] [3] [7]. The most common cause of adenoma is the mutation in gene MEN 1. Less than 5% of cases are chronichyperparathyroidism, which is a component of the MEN 1 MEN 2a endocrine adenocarcinoma syndrome [1]. Excess PTH in the body leads to increased mobilization of calcium from the bones, and henceincreased osteolysis, what also increases the absorption of calcium from thedigestive system, as well as an increased amount of phosphate excretion in the urine. Clinical picture of the disease is multiform and often runs in a latent form. Most often the diseaseoccurs in the form of osteoporosis, chronic recurrent kidney stones, and is also commonpyelonephritis on the basis of urolithiasis. The disease may be accompanied by: dysphagia, abdominal pain, metallic taste in the mouth, persistent constipation. In addition, from the systemnervous: dizziness and headaches, disturbances of consciousness. Arrhythmia the form of additional contractions and paroxysmal tachycardia. Osteolysis, osteoporosis and pathological fractures [1]. The purpose of this article is to bring closer to the reader case of 33 years old woman with primary hyperparathyroidism on the adenoma.
Introduction. The study compared the effects of surgical treatment of grade III and IV haemorrhoids achieved with a conventional operative technique and by using a thermal tissue fusion instrument based on offset electrode technology. A total of 60 patients with grade III and IV haemorrhoids were operated on in the Department of General and Oncologic Surgery, Municipal Hospital in Siemianowice Śląskie, and in the On-Clinic Medical Centre in Chorzów, between October 2011 and September 2015. Aim. The aim of the study was to compare the outcomes of treatment of haemorrhoidal disease using KLS Martin maXium marClamp® CUT IQ thermal tissue fusion instrument based on offset electrode technology and the Milligan-Morgan surgical procedure with bipolar coagulation for the excision of grade III and IV haemorrhoids. Material and methods. The patients were divided into two groups: Group 1 – patients operated on using KLS Martin maXium marClamp® CUT IQ thermal tissue fusion instrument based on offset electrode technology. Group 2 – patients operated on using the conventional Milligan-Morgan technique with electrocoagulation. The evaluated parameters included the length of hospital stay after surgery, duration of the surgical procedure, level of pain on the postoperative days 1 and 2 rated on a 10-point VAS scale, and postoperative wound healing time. Results. A reduction in postoperative pain, shorter procedure duration and hospital stay, and more rapid postoperative wound healing were observed in Group 1 compared to Group 2. Conclusions. In our study material, the application of a thermal tissue fusion instrument using offset electrode technology in surgeries to remove grade III and IV haemorrhoids, compared to the conventional Milligan-Morgan procedure with electrocoagulation, brought the following results: – less postoperative pain, – shorter duration of surgical procedure, – reduced length of hospital stay, – faster healing of postoperative wound.
Wprowadzenie i cel pracy. Światowa epidemia otyłości przyczyniła się do rozwoju badań mających na celu dokładne poznanie budowy i zrozumienie procesów zachodzących w tkance tłuszczowej, której nadmiar jest głównym wyznacznikiem tej choroby. Obecnie wiadomo, że tkanka tłuszczowa dzięki wytwarzanym adipokinom może być jedną z przyczyn zaburzeń związanych z otyłością. Celem pracy jest przedstawienie budowy i funkcji tkanki tłuszczowej, ze szczególnym uwzględnieniem jej aktywności hormonalnej. Skrócony opis stanu wiedzy. Adipokiny wytwarzane przez tkankę tłuszczową działają nie tylko lokalnie (autokrynnie i parakrynnie), ale także na narządy odległe (działanie endokrynne). Regulują one metabolizm komórkowy, angiogenezę, ciśnienie krwi, procesy immunologiczne i zapalne, utrzymują równowagę energetyczną czy też odpowiadają za uczucie łaknienia i procesy związane z płodnością. Obecnie zidentyfikowano kilkaset adipokin, zróżnicowanych zarówno pod względem budowy, jak i pełnionej funkcji. W pracy opisano wybrane adipokiny o szczególnym znaczeniu dla organizmu. Podsumowanie. Tkanka tłuszczowa wpływa na funkcjonowanie całego organizmu i może odgrywać fundamentalną rolę w rozwoju wielu chorób, zwłaszcza metabolicznych. Biorąc pod uwagę szerokie spektrum działania adipokin, należy stwierdzić, że szczególnie ważne staje się dokładne poznanie wpływu tych związków na procesy życiowe, co w przyszłości może umożliwić ich zastosowanie kliniczne w farmakoterapii czy w diagnostyce chorób.
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