Cel pracyZbadano związek stylu radzenia sobie ze stresem i motywacji do spożycia alkoholu w kontekście ryzyka uzależnienia od alkoholu u studentów kierunków medycznych.MetodaBadaniem objęto 268 studentów kierunków medycznych W badaniach wykorzystano Test AUDIT (Alcohol Use Disorders Identyfication Test), Kwestionariusz Radzenia Sobie w Sytuacjach Stresowych (CISS), oraz autorską ankietę badającą poza danymi demograficznymi także motywację do picia alkoholu i sytuacje, w jakich badani sięgają po alkohol.WynikiW badanej grupie 94% osób spożywało alkohol w okresie ostatnich dwunastu miesięcy. W badanej grupie 16% studentów kierunku medycznego i 20% studentów stomatologii pije w sposób ryzykowny lub szkodliwy. W 2% przypadków zaobserwowano duże ryzyko uzależnienia od alkoholu Ponad połowa respondentów sięga po alkohol w celu radzenia sobie ze stresem. Dane dotyczące stylu radzenia sobie ze stresem nie wykazują różnic istotnych statystycznie w zakresie głównego stylu radzenia sobie ze stresem: skoncentrowanego na zadaniu, skoncentrowanego na emocjach, skoncentrowanego na unikaniu. Studenci kierunku lekarskiego istotnie częściej niż studenci stomatologii radzili sobie ze stresem w sposób unikowy (poszukiwanie kontaktów towarzyskich). Nie wykazano istotnego związku między stylem radzenia sobie ze stresem, motywacją do picia i ryzykiem uzależniania od alkoholu.WnioskiBrak związków między badanymi zmiennymi może wskazywać na stosowanie przez badanych innych czynności niż sięganie po alkohol w radzeniu sobie ze stresem. Ważna jest profilaktyka i stworzenie warunków sprzyjających rozwojowi strategii radzenia sobie ze stresem w grupie studentów kierunków medycznych.
The purpose of this postmarket surveillance registry was to document the efficacy of a vascular prosthesis coated with metallic silver in high-risk patients undergoing vascular reconstructions. Patency (primary endpoint) and freedom from graft infection (secondary endpoint) data were assessed at a minimum of 12 months in patients with significant co-morbidity and/or confirmed graft infections or infected native vessels. Between November 2006 and December 2009, 230 patients with high-risk factors underwent aortic,peripheral and/or extra-anatomic reconstructions with Silver Graft® (SG) in six German, one French and one Polish vascular center.All participating centers used the metallic silver-coated polyester graft (SG) in various diameters and lengths including tubular and bifurcate vascular grafts. Doppler ultrasound follow-ups to determine graft patency were planned at 12 months or done at an earlier time in case the patient became symptomatic. A total of 230 patients were studied. Ten of these 230 patients had graft infections at baseline whereas the remaining 220 subjects had significant risk factors such as coronary artery disease (62.7%, 138/220), vascular access in scar tissue (27.3%, 60/220), Fontaine III/IV (38.2%, 84/220), chronic renal insufficiency (26.8%, 59/220) and diabetes (21.0%,46/220). The long-term follow-up at 15.5 ± 8.3 months revealed a secondary patency rate of 93.2% (205/220) and an ‘all cause’ mortality rate of 18.6% (41/220). There was a freedom from de novo graft infection rate of 95.9% (211/220) in the high-risk group without graft infections at baseline. One regraft infection occurred distal of the revisional reconstruction in the 10 patients with graft infection at baseline. The presence of perigraft fluid at follow-up and Fontaine III/IV at baseline were found to be predictors for graft patency whereas perigraft fluid presence was the only predictor for de novo graft infections. This registry revealed favorable patency and freedom from de novo infections rates in a ‘high-risk’ population with significant co-morbidities.
Peripheral arterial disease (PAD), caused by atherosclerotic processes, is allied with an increased risk of ischemic events, limb loss, and death. Recently, the use of a solid-state laser at 355 nm within a hybrid catheter was suggested for that purpose. In this work, short nanosecond pulses of a solid-state laser at 355 nm delivered through a hybrid catheter, composed of optical fibers and a blunt mechanical blade, are used to conduct a pre-clinical study and two clinical cases. The pre-clinical study consisted of an atherosclerotic calcified cadaveric leg and a porcine in vivo trial within the iliac artery, respectively. The clinical cases include chronic total occlusions with a calcified lesion. The occluded cadaveric leg is recanalized successfully and no evidence of thermal necrosis is indicated in the histopathology analysis of the porcine study. No arterial wall damage is demonstrated on the animals' treated arteries and no significant impact on blood count and biochemistry analysis is noted in the animal trial. Successful recanalization of the occluded arteries followed by balloon angioplasty is obtained in both clinical cases. Our work constitutes a proof of concept for using a solid-state pulsed laser at 355 nm in atherectomy.
Endovascular implantation of a stent graft in the abdominal aorta (endovascular aneurysm repair – EVAR) is a widely accepted alternative to open surgery in treatment of abdominal aortic aneurysms. Although EVAR is connected with a significant reduction in the risk of peri- and post-operative complications, it does not eliminate them totally. Long-term surveillance of post-EVAR patients is aimed at early detection of and fast reaction to a group of complications called endovascular leaks. Currently, the gold standard in leak diagnostics is computed tomography angiography (CTA). The other methods are ultrasonography, magnetic resonance (MR) angiography, intra-aneurysm sac pressure measurement, X-ray, and digital subtraction angiography (DSA). Despite many analyses based on long-term research, emphasising the high value and competitiveness of less invasive tests such as US or X-ray compared to CTA, it is still difficult for them to win the trust and acceptance of clinicians. The persisting view is that computed tomography is the test that finally resolves any inaccuracies. Consequently, a patient with a number of concurrent diseases is subject to absurdly high radiation exposure and effects of a radiocontrast agent within a short time. It is therefore logical to acknowledge that the EVAR-related risk is catching up with the open surgery risk, while the endovascular procedure is much more costly. Nevertheless, the status of CTA as the gold standard ultimately seems to be unthreatened. This paper presents a description of the diagnostic imaging tests that make it possible to detect any vascular leaks and to develop strategies for therapeutic processes.
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