Ewa Barczykowska

Tissue Factor and Tissue Factor Pathway Inhibitor in the Wound-Healing Process After Neurosurgery:

Objectives: The aim of the study was to assess the concentrations of tissue factor (TF) and tissue factor pathway inhibitor (TFPI) in the blood of patients with a postoperative wound after neurosurgery. Method: Participants included 20 adult patients who underwent neurosurgery because of degenerative spine changes. The concentration of TF and TFPI in the patients’ blood serum was measured 3 times: before surgery, during the first 24 hr after surgery, and between the 5th and 7th days after surgery. The control group comprised 20 healthy volunteers similar to the patient group with respect to gender and age. Results: A statistically significant difference was observed between TF concentration at all three measurement time points in the research group and TF concentration in the control group (p = .018, p = .010, p = .001). A statistically significant difference was found between TFPI concentration at the second time point in the research group and TFPI concentration in the control group (p = .041). No statistically significant within-subject difference was found between TF concentrations before and after surgery. A statistically significant within-subject difference was found between TFPI concentrations within 24 hr after surgery and 5–7 days after surgery (p = .004). Conclusion: High perioperative concentrations of TF indicate not only the presence of thrombophilia but also the importance of TF in the wound-healing process. Perioperative changes in TFPI concentrations are related to its compensatory influence on hemostasis in thrombophilic conditions.

Measuring scales used for assessment of patients with traumatic brain injury: multicenter studies

Background Application of adequate numeric scales is essential for assessment of a patient’s condition. The scales most commonly used by the therapeutic team for assessment of a patient with traumatic brain injury (TBI) include deficit scales, functional scales, and scales assessing quality of life. The purpose of this study was to establish the relationships between the particular scales used for assessment of patients with TBI. Methods This multicenter study included 159 patients with TBI. The direct observation technique was used. Two measurements were made (at hospital admission and discharge) using standardized assessment scales, ie, the Glasgow Coma Scale (GCS), the Functional Capacity Scale (FCS), the Functional Index “Repty” (FIR), and the Glasgow Outcome Scale. Results Patients with mild impairment of consciousness were most numerous in the examined group at both admission and discharge, ie, 118 (78.8%) and 134 patients (89.3%), respectively. The mean score for functional capacity measured with the FCS was 34.41 points (71.7%) on the day of admission and 41.87 points (87.2%) on the day of discharge from hospital. A significant correlation was found between results obtained using the GCS and results on the FIR, on both the day of admission [R t(n-2) =7.612=0.530; P=0.00] and the day of discharge [R t(n-2) =8.998=0.595; P=0.00]. Further, a high correlation was found between the FCS and the FIR (rs= −0.854 on day of admission and rs= −0.840 on day of discharge). Conclusion The majority of examined patients had mild impairment of consciousness. A moderate correlation was found between the GCS and the scales assessing activities of daily living. A high correlation was found between FCS and FIR, which may result from the similarities between the analyzed tools in the scope of their construction and application.

The Quality of Life of a Teenager with Rasmussen’s Encephalitis — Case Report

Introduction. Rasmussen’s Syndrome (RE), is a rare type of chronic focal encephalitis (CFE) of unexplained etiology and progressive course. It is characterized by resistant to treatment epileptic seizures. Mainly, these are epilepsy partialis continua (EPC) seizures. In the course of the disease, regress of cognitive function and progressive neurological deficits follow, primarily, hemiparesis. Quality of life examination is an expression of a holistic approach towards the patient. These studies are really important in the chronic diseases. Apart from the time of survival, they may be the dependent variable in the models of, treatment effectiveness of and care assessment. Case Report. The case study concerns a 15year-old sick girl, whose neurological condition, has been steadily deteriorating — aphasia and dementia dominate, hemiparesis is low. The assessment of the quality of the patient’s life was assessed by the pediatric quality of life questionnaire (PedsQL 4.0). Discussion. Subjective assessment of the quality of life assessed by the patient, is a source of information, which is often different from the assessment made by the girl’s mother. Furthermore, subjective evaluation suggests for existence of patient’s needs that are imperceptible, which require professional care and assistance outside the hospital environment. Conclusions. The patient with RE is characterized by complexity and a multitude of health problems. According to the assessment made by the girl the quality of her life is lower compared to the answers given by the mother. (JNNN 2018;7(1):33–39)

Evaluation of the frequency of childhood hospitalization due to thermal injuries in the Provincial Polyclinical Hospital in Toruń, Poland, 2007–2011

INTRODUCTION Burns constitute the most common and severe injuries suffered in childhood. OBJECTIVE The study was aimed at providing a retrospective analysis of the etiology, location, extent and depth of burns, as well as treatment methods and length of hospital stay. MATERIAL AND METHODS A retrospective analysis of 508 cases of children treated due to a thermal injury between 1 January 2007 31 December 2011 was conducted at the Department of Paediatrics, Urology and Paediatric Surgery, Childrens Hospital, L. Rydygier Provincial Hospital in Toruń, Poland. RESULTS The sample group included more boys (58.9%) than girls (41.1%). The most numerous group comprised children aged 1-2 years (44.5%). Burns were largely suffered at home (91.9%). Injuries were largely caused by thermal burns (99.2%). Half of the children sustained injury to one body area (51.4%), while every third sufferer (37.9%) was affected by burns to body parts prone to trigger shock. Burns up to 5% of the Total Body Surface Area (TBSA) were suffered by half (51.2%) of the children. Most of the patients underwent conservative treatment (89.4%). CONCLUSIONS Burns were mostly suffered by children at 1-2 years of age, with boys prevailing over girls. Injuries were largely suffered at the childs family home, in the afternoon or evening, while the child was in the care of the parents. Scalds, caused by hot liquid, constituted the most frequent type of injury. The most numerous group of affected children comprised burns to limb areas, and thorax with limbs, with the TBSA of up to 5%. The great majority of the patients underwent conservative treatment, with a hospitalization period of up to 3 days.

Kliniczne, terapeutyczne i opiekuńcze aspekty padaczki w wieku rozwojowym

Epilepsy is a neurological disorder characterized by the occurrence of seizures of distinct nature. At the developmental age it occurs in 0.5% of people. Diagnostic and therapeutic process is complex. In the treatment, pharmacological, surgical, and dietetic methods are used. In the handling of a child affected by epilepsy, we should take into account the impact of the disease on the quality of patient’s life and on that of their families’. The aim of the work is to present the current clinical knowledge on the subject of epilepsy at the age of development and the problems, which the children and their parents must face. (JNNN 2016;5(1):31–35)

Morphological-functional considerations of neonatals’ and early children’s skin care

Skin of children, especially neonates and infants, shows profound anatomic and functional differences compared to an adults skin. Skins immaturity and lack of fully developed natural protective qualities, results in its immense fragility, tenderness and irritability. Due to these factors, it is crucial to use procedures considering the morphological and functional state of the skin in nursing. Based on data analysis from medical literature, up-todate recommendations for skin, hair and nail care have been presented, for both infants and early children. Special attention has been given to navel, ‘diaper’ area and dry skin care.

Sposoby opisywania stopnia niepełnosprawności motorycznej, klasyfikacji umiejętności codziennej komunikacji oraz oceny jakości życia dzieci z mózgowym porażeniem dziecięcym

Cerebral palsy (CP) is a chronic and incurable disease, in which there is high possibility to significantly improve the patient’s condition. The formation of ways of describing the degree of physical impairment, the classification of everyday life communication skills or scales thanks to which there is high possibility to measure the quality of life in that specific group of patients, allows for thorough understanding of the needs, as well as systematic evaluation of therapeutic actions taken with respect to the patient with cerebral palsy. This work aims to provide the ways of describing a degree of physical impairment, the classification of everyday communication skills and the specific scales used to describe the quality of life patients with cerebral palsy. Research in the group of patients with ICP allows to learn the needs of patients and may be useful in channeling into development of the patients’ life quality from both clinical and social aspects. (JNNN 2014;3(4):183–187)

Assessment of selected quality fields of nursing care in neurosurgical wards: a prospective study of 530 people - multicenter studies.

Background One of the elements influencing the assessment of nursing care quality is the assessment of the nurse’s functions that determine the nurse’s particular tasks. The aim of this work was to assess selected tasks involved in the nurse’s caring function, which influence nursing care quality on neurosurgical wards, on the basis of patients’ and nursing staff’s opinions. Materials and methods The research was carried out on neurosurgical wards in Poland on a group of 455 patients and 75 nurses. In order to assess nursing care quality, an author’s original questionnaire (Questionnaire – Patient Satisfaction) was used. Results Statistically significant differences concerned particular groups (both patients and nurses) in the assessment of selected issues: providing information about performed activities and operations (P=0.000 and P=0.040), respecting personal dignity and assuring discretion during the operations (P=0.000 and P=0.001), speed of response to patient’s requests (P=0.000 and P=0.000), time availability of nurses for the patient (P=0.000 and P=0.000), providing information about further self-care at home (P=0.032, P=0.008), and nurses’ attitude (kindness, courtesy, tenderness, care) to patients (patient’s assessment only P=0.000). Conclusion Selected tasks in the field of the caring function of nurses were assessed differently by particular groups. There were no statistically significant differences in the assessment of particular tasks in the opinions of patients and nurses, which means that both examined groups similarly assessed tasks involved in the nurse’s caring function, which influence nursing care quality.