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Klak A.,Medical University of Warsaw | Minko M.,Medical University of WarsawWarsaw | Siwczynska D.,Warsaw School of Economics | Samolinski B.,Medical University of Warsaw
Postepy Dermatologii i Alergologii | Year: 2015

The scientific literature is full of numerous reports dealing with the quality of life of patients suffering from different diseases. The aim of the study is to present a set of questionnaires, which are used to study the quality of the patient's life, the questionnaires, which are the most popular in Poland and all over the world as well as those which concern the children's allergy. Increasingly, the research deals with the objective and subjective feelings of patients about their condition. Currently, the European Union's priority is to improve the quality of life of patients suffering from chronic non-communicable diseases. The studies on the quality of life are an interdisciplinary area, combining the clinical significance and the psychological aspects of medical care. Source

Karlinska A.G.,Institute of Psychiatry and Neurology | Gromadzka G.,Institute of Psychiatry and Neurology | Karlinski M.A.,Institute of Psychiatry and Neurology | Czlonkowska A.,Institute of Psychiatry and Neurology | Czlonkowska A.,Medical University of WarsawWarsaw
Journal of Stroke and Cerebrovascular Diseases | Year: 2015

Background: It has been suggested that stroke in patients with cancer may differ from the conventional pattern. The aim of this study was to evaluate the burden of vascular risk factors, stroke etiology, and short-term outcome in patients with active and nonactive malignancy compared with patients without cancer. Methods: This is a prospective cohort study of consecutive acute stroke patients admitted to our department between September 2006 and September 2011. We distinguished between the following: (1) patients with active malignancy (AM, diagnosed not earlier than 12 months before stroke); (2) patients with nonactive malignancy (non-AM); and (3) cancer-free (CF) patients, used as a reference. Results: Pre-existing cancer was found in 90 of 1558 patients, including 41 (2.6%) cases with AM and 49 (3.1%) cases with non-AM. Compared with CF patients, AM patients less frequently had a history of previous stroke (2.4% versus 17.9%, P =.018) and more frequently experienced ischemic strokes of undetermined etiology (62.5% versus 38.3%, P = .002). Non-AM patients did not differ in the distribution of vascular risk factors but more often experienced stroke caused by small vessel occlusion (20.0% versus 8.0%, P = .004). Inflammatory blood markers were elevated especially in patients with AM. Short-term prognosis was similar across all groups. Conclusions: Stroke pattern in patients with non-AM appears very similar to that observed in the CF patients. However, our findings support the thesis that cancer-specific prothrombotic mechanisms play an important role in stroke patients with AM, which may be related to active inflammatory and immune processes. Malignancy does not influence short-term prognosis of stroke. © 2015 by National Stroke Association. Source

Stuckey H.L.,Pennsylvania State University | Vallis M.,Dalhousie University | Kovacs Burns K.,University of Alberta | Mullan-Jensen C.B.,Novo Nordisk AS | And 6 more authors.
Clinical Therapeutics | Year: 2015

Purpose The aim of this study was to describe the perspectives of diabetes care professionals regarding the roles and responsibilities of people with diabetes (PWD), health care professionals (HCPs), and the larger society to improve the provision of person-centered diabetes care. Methods The survey contained open-ended items about challenges of, successes of, and wishes for improvements in treating adults with diabetes. All responses were systematically coded using a schema developed and validated through multinational collaboration. Findings Participants were 4785 diabetes care professionals (physicians, nurses, and dietitians) from 17 countries. The data contained 2 distinct themes. One theme reflected the fact that the roles and responsibilities of HCPs are transitioning from those of one who "tells" to one who "listens" to PWD. Some ways that HCPs can "listen" to PWD and family members is to involve them in goals and to encourage self-management for the improvement of treatment. The second theme identified barriers to successful diabetes care, which include a lack of time and collaboration from HCPs, a lack of availability of resources for treatment, and a lack of psychosocial support. Implications The views of diabetes care professionals are in transition from a conventional hierarchic approach to a PCC approach. Further adoption of this approach would be facilitated by additional psychosocial training and educational/psychological resources, increased teamwork, and societal changes that would make it easier for people to live successfully with diabetes. © 2015 The Authors. Source

Januszkiewicz L.,Harvard University | Januszkiewicz L.,Medical University of WarsawWarsaw | Vegh E.,Harvard University | Borgquist R.,Harvard University | And 6 more authors.
Heart Rhythm | Year: 2015

Background Prolongation of the baseline ECG PR interval is frequently encountered among cardiac resynchronization therapy (CRT) recipients. There are conflicting data regarding the association of a prolonged PR interval with long-term clinical outcome in this patient group. Objective The purpose of this study was to compare clinical outcomes and response to CRT in patients with normal (<200 ms) vs prolonged (≥200 ms) baseline PR interval. Methods In this study, 283 patients (normal PR interval: n = 158; prolonged PR interval: n = 125) with documented baseline intrinsic PR interval were followed for 3 years after CRT implantation. The study population consisted of 24.7% women (mean age 66 ± 13 years, left ventricular ejection fraction 24% ± 7%). Results A Cox proportional hazard model identified baseline PR interval as a predictor of the composite end-point (all-cause mortality, heart failure hospitalization, left ventricular assist device implantation, and heart transplantation) in univariate analysis (hazard ratio [HR] 1.49, 95% confidence interval [CI] 1.02-2.17, P =.04) but not in multivariate analysis. It also predicted heart failure hospitalization in univariate (HR 1.6, 95% CI 1.1-2.4, P =.02) and multivariate analysis (HR 1.6, 95% CI 1.0-2.3, P =.03). A prolonged PR interval was associated with lower probability of reverse remodeling defined as ≥10% improvement in ejection fraction (64% vs 77%, P =.057), especially in patients with non-left bundle branch block ECG morphology (41% vs 68%, P =.03). Conclusion Among patients with CRT, a prolonged baseline PR interval is an independent predictor of worse prognosis and lower probability of reverse remodeling, especially for patients with non-left bundle branch block morphology on ECG. © 2015 Heart Rhythm Society. Source

Pawelec K.,Medical University of Warsaw | Salamonowicz M.,Medical University of Warsaw | Panasiuk A.,Medical University of BialystokBialystok | Demkow U.,Medical University of WarsawWarsaw | And 20 more authors.
Advances in Experimental Medicine and Biology | Year: 2015

Immunosuppressive therapy is the treatment of choice in children with acquired severe aplastic anemia (AA) and no HLA-matched family donor. The paper presents results of a multicenter study of 63 children with AA treated with rabbit antithymocyte globulin (r-ATG) and cyclosporine A as the first line treatment in the years 1996-2012. Therapeutic effects were evaluated at Days 112, 180, and 360. At Day 112, remission was achieved in 28 out of the 63 patients (44.4 %), complete remission in 10 patients (15.9 %), and partial remission in 18 (28.5 %). At Day 180, 31 patients (49.2 %) were in remission including 15 cases in complete (23.8 %), and 16 cases in partial remission (25.4 %). One year after therapy onset, 34 patients (64.9 %) were in remission including 24 patients (38.0 %) in complete and 10 (15.9 %) in partial remission. Relapse occurred in 4 patients, from 8 months up to 2 years and 2 months after remission. One child, 5 years after remission, was diagnosed with paroxysmal nocturnal hemoglobinuria. The estimated 10-year overall survival rate and 10-year event-free survival rate were 67 % and 57 %, respectively. © Springer International Publishing Switzerland 2014. Source

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