Franciszek Szatko

Observance of hand washing procedures performed by the medical personnel after the patient contact. Part II

ObjectivesThe Centers for Disease Control and Prevention (CDC) as well as the World Health Organization (WHO) state that adequate hand hygiene maintained by medical personnel is an indispensable prerequisite for controlling nosocomial infections. The recommendations of CDC and WHO emphasize the obligation to wash hands after each contact with a patient, after the exposure to a potentially infectious material or upon the contact with objects surrounding the patient.Materials and MethodsThe study was performed by quasi-observation among the group of 188 medical staff members (nurses and physicians) working in three selected hospitals of the Łódź Province. The procedure of hand washing/disinfection performed directly after the patient contact according to the recommendations of CDC and WHO was observed. The results were subject to statistical analysis (p < 0.05).ResultsDuring 1544 h of observations, 4101 activities requiring hand washing were recorded. The medical personnel followed the hand hygiene procedures after the patient contact in 26.4% of the situations that require hygiene according to the guidelines. The level of observance of the hand washing procedures depended significantly on the type of performed activity, profession, degree of workload, index of activity, and time of duty hours. The mean time of hand washing after patient contact was 9.2 s for physicians and 6.7 s for nurses.ConclusionBoth the level of observance of hygienic procedures after the contact with patients as well as the time of hand washing are insufficient. There is an urgent need to work out educational programs on maintaining proper hand hygiene for medical personnel.

Masseter muscle tension, chewing ability, and selected parameters of physical fitness in elderly care home residents in Lodz, Poland

Background Maintaining good physical fitness and oral function in old age is an important element of good quality of life. Disability-related impairment of oral function contributes to a deterioration of the diet of older people and to the reduction of their social activity. Objectives Investigate the association between masseter muscle tension, dental status, and physical fitness parameters. Materials and methods Two hundred fifty-nine elderly care home residents (97 men, 162 women; mean age, 75.3±8.9 years) were involved in this cross-sectional study. Their chewing ability was evaluated by masseter muscle tension palpation, differences of masseter muscle thickness, self-reported chewing ability, number of present and functional teeth, and number of posterior tooth pairs. Masseter muscle thickness was measured by ultrasonography. To assess physical fitness, hand grip strength and the timed up-and-go test were performed. Nutritional status was assessed using body mass index and body cell mass index (BCMI), calculated on the basis of electrical bioimpedance measurements. Medical records were used to collect information on systemic diseases and the number of prescribed medications. Subjects were also evaluated for their ability to perform ten activities of daily living. Results Ninety-seven percent of the subjects suffered from systemic diseases. The three most prevalent illnesses were cardiac/circulatory 64.5%, musculoskeletal 37.3%, and endocrine/metabolic/nutritional 29.3%. Of the participants, 1.5% were underweight and more than one third (34.4%) were overweight. Malnutrition (BCMI below normal) was found in almost half (45.2%) of the subjects. Only 5.8% had a sufficient number of functional natural teeth. Statistically significant correlations were found between palpation of masseter muscle tension and perceived chewing ability, number of present teeth, number of functional teeth, number of posterior tooth pairs, timed up-and-go, hand grip strength, body mass index, BCMI, and activities of daily living. In a multivariate model, after adjusting for age, sex, and education, subjects with higher BCMI, higher hand grip strength, and more present teeth had a significantly higher chance of strong masseter muscle tension. Conclusion There is a relationship between chewing ability and physical fitness in elderly people. Efficiency of masseter muscles is related to physical fitness in the elderly. Masseter muscle tension examined by palpation can be used in public dentistry as one of the indicators of quality of life.

Lower Plasma Levels of Antioxidant Vitamins in Patients with Metabolic Syndrome: A Case Control Study

BACKGROUND Metabolic syndrome (MS) is a coexistence of metabolic risk factors affecting the development of cardiovascular diseases. Reactive oxygen species, which are excessively produced in MS, participate in its pathogenesis. Vitamins A, C and E are an important part of the non-enzymatic antioxidative barrier in humans. OBJECTIVES The aim of the study was to estimate plasma vitamin A, C and E levels and the intake of these vitamins from the diet in patients with MS. MATERIAL AND METHODS The study included 182 patients with MS, 94 men and 88 women, aged 30-65 years (mean 57.31 ± 8.28 years). The control group was comprised of 91 subjects, 56 men and 35 women, aged 41-65 years (mean 57.75 ± 5.84 years). The MS diagnosis was based on IDF criteria. The determination of the serum level of vitamin A, C and E was performed using the spectrophotometric method. The food intake was assessed by 24-h dietary recall. RESULTS The mean plasma vitamin A, C and E levels were significantly lower in MS patients than in the controls (p = 0.05). No correlation was found between vitamin A, C and E intake from the diet and their plasma concentrations in MS patients. Plasma vitamin A, C and E deficiency was observed significantly more often in MS patients than in the control group (15.38% vs. 2.19%, 79.12% vs. 8.79% and 60.45% vs. 5.49%, p < 0.0001, respectively). BMI was the one factor significantly affecting the mean value of vitamin A, C and E levels in MS patients. CONCLUSIONS MS patients demonstrated significantly lower plasma levels of vitamin A, C and E compared to the healthy subjects. Lower plasma levels of antioxidant vitamins with their high intake from the diet indicate antioxidant barrier impairment in MS patients.

Oral health status, dental treatment needs, and barriers to dental care of elderly care home residents in Lodz, Poland

Objectives To determine oral health status, dental treatment needs, and to identify barriers that prevent easy access to dental care by elderly care home residents in Lodz. Background Studies in many countries show that oral health status of elderly care home residents is poor and there is an urgent need to improve it. Methods The study included 259 care home residents, aged 65 years and older. The oral examination was performed. In face-to-face interviews, subjects were asked about frequency of cleaning teeth and/or dentures, whether they needed assistance, and whether the assistance was available; they were also asked about the perceived dental needs, and about the time since their last visit to a dentist and the purpose of the visit. If they had not visited the dentist in the past 12 months, they were asked about reasons for failing to visit the dentist. Results Forty-six percent of the subjects were edentulous. Only 5.8% of all participants had a sufficient number of functional natural teeth. Dental treatment was found to be necessary in 59.8% of the respondents. One in four subjects reported reduced ability of correctly cleaning teeth and dentures themselves, of whom only one-third were helped by others. An insufficient level of hygiene was found in every other subject. About 42% of residents had not visited a dentist for over 5 years, mainly due to organizational reasons. Conclusion Expanding the current scope of medical care for the elderly care home residents to include dental care would improve their currently poor oral health status.

Thirty years of evolution of oral health behaviours and dental caries in urban and rural areas in Poland

INTRODUCTION AND OBJECTIVE 34 years ago, children living in rural areas had almost 2 more teeth affected by decay than those living in cities. Environmental differences are being reduced along with Polands civilization development. The aim of the study is to assess the extent to which the differences in the intensity of caries and oral health behaviours between the urban rural environment have been reduced have been reduced in the past 3 decades. MATERIALS AND METHODS The data from 9 national surveys of 14,338 children aged 12 years and 5,425 adults aged 35-44 who lived in the city and in the countryside were analysed. Mean number of decayed (D), missing (M) and filled (F) teeth (DMFT) was determined during the examination, as well as oral health behaviours. RESULTS During the past 3 decades, in the statistical 12-year-old Polish child, tooth decay has been reduced from 7.3 to 3.6 teeth, and the environmental difference between the town and village children is now almost 5 times smaller. A similar trend is observed in childrens dental behaviours. Improving the oral health status and levelling of the environmental differences in the population aged 35-44 is much slower than in children. CONCLUSIONS In the last three decades, the level of tooth decay has been reduced by half, but it is still 3 times higher than in other European countries. Environmental differences have been reduced particularly in children. Both the oral health status and urban/rural environment differences in the intensity of tooth decay may be regarded as one of the many measures of Polands social and civilization development. However, the analysed process is not monotonic; instead, it has some turning points.

The use of protective gloves by medical personnel

IntroductionTo minimize the risk of cross-infection between the patient and the medical staff, it is necessary to use individual protective measures such as gloves. According to the recommendations of the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO), protective gloves should always be used upon contact with blood, mucosa, injured skin or other potentially infectious material.Materials and MethodsThe aim of the study was to evaluate, through quasi-observation, the use of protective gloves by medical staff according to the guidelines issued by the CDC and WHO. The results were subject to statistical analysis (p < 0.05).ResultsDuring 1544 hours of observations, 3498 situations were recorded in which wearing protective gloves is demanded from the medical staff. The overall percentage of the observance of using gloves was 50%. The use of gloves depended significantly on the type of ward, profession, performed activity, number of situations that require wearing gloves during the observation unit and the real workload. During the entire study, as many as 718 contacts with patients were observed in which the same gloves were used several times.ConclusionWearing disposable protective gloves by the medical staff is insufficient.

Life Satisfaction and Work-Related Satisfaction among Anesthesiologists in Poland

The aim of the study was to assess the level of life and job satisfaction of Polish anesthesiologists and to explore the impact of extrinsic-hygiene and intrinsic-motivating determinants. Materials and Methods. A cross-sectional questionnaire study was conducted among consultant anesthesiologists in Lodz region. The questionnaire concerned patient care, burden, income, personal rewards, professional relations, job satisfaction in general, and life satisfaction. Respondents were asked to rate their level of satisfaction for each item on a seven-point Likert scale (1: extremely dissatisfied; 7: extremely satisfied). Results. 86.03% of anesthesiologists were satisfied with their economic status, 77.94% found their health status satisfactory, and 52.21% viewed their personal future optimistically. In general, 71.32% of anesthesiologists were satisfied with their current job situation. Among the less satisfying job aspects were work-related stress (2.49; SD = 1.23), administrative burden (2.85; SD = 1.47), workload (3.63; SD = 1.56), and leisure time (3.09; SD = 1.44). Conclusions. Considerable work-related stress leads to job dissatisfaction among anesthesiologists. There is an association between job satisfaction and health status, social life, and economic status. Working for long hours by anesthesiologists results in a high risk of burnout.

Dietary Vitamin C, E and β-Carotene Intake Does Not Significantly Affect Plasma or Salivary Antioxidant Indices and Salivary C-Reactive Protein in Older Subjects

It is not clear whether habitual dietary intake influences the antioxidant or inflammatory status. The aim of the present study was to assess the impact of antioxidative vitamins C, E, and β-carotene obtained from daily food rations on plasma and salivary Total Antioxidant Capacity (TAC), uric acid and salivary C-reactive protein (CRP). The study involved 80 older subjects (66.9 ± 4.3 years), divided into two groups: group 1 (n = 43) with lower and group 2 (n = 37) with higher combined vitamins C, E and β-carotene intake. A 24-h dietary recall was obtained from each individual. TAC was assessed simultaneously with two methods in plasma (Ferric Reducing Ability of Plasma—FRAP, 2.2-diphenyl-1-picryl-hydrazyl—DPPH) and in saliva (FRAS and DPPHS test). Lower vitamin C intake corresponded to higher FRAS. There were no other correlations between vitamins C, E or β-carotene intake and antioxidant indices. Salivary CRP was not related to any antioxidant indices. FRAS was decreased in group 2 (p < 0.01) but no other group differences for salivary or for plasma antioxidant parameters and salivary CRP were found. Habitual, not extra supplemented dietary intake does not significantly affect plasma or salivary TAC and salivary CRP.

Assessment of 25(OH)D vitamin concentration in plasma of residents of Lodz with metabolic syndrome in pre- and postmenopausal period

Introduction Vitamin D deficiency is a risk factor for metabolic syndrome disorders and the occurrence of these disorders greatly contributes to the deficiency of vitamin D. Postmenopausal women are particularly prone to that deficiency. Aim The aim of the study was to assess vitamin D concentration in the plasma of pre- and postmenopausal women, with or without metabolic syndrome. Material and methods The study included 141 women aged 26-77 (the mean age 58.74 years old), divided into 4 groups depending on the pre- or postmenopausal period and diagnosed or not with metabolic syndrome according to the International Diabetes Federation criteria (2005). Vitamin D concentration was assessed by LIAISON® test using chemiluminescent immunoassay (CLIA) technology. Results The mean vitamin D concentration was the highest among premenopausal women without metabolic syndrome (24.32 ng/ml), it was insignificantly higher than in postmenopausal women without metabolic syndrome (23.52 ng/ml) and significantly higher than in both groups with metabolic syndrome – premenopausal (19.86 ng/ml) and postmenopausal women (9.32 ng/ml). The recommended plasma 25(OH)D concentration was not found in any of postmenopausal women with diagnosed metabolic syndrome. Conclusions Postmenopausal women with metabolic syndrome had a significantly lower 25(OH)D vitamin concentration in plasma than postmenopausal women without metabolic syndrome. The frequency of vitamin D deficiency in women with metabolic syndrome was very high, significantly higher than in women without metabolic syndrome.

Knowledge and Attitudes of Dentists with Respect to the Risks of Blood-Borne Pathogens—A Cross-Sectional Study in Poland

Background: To analyze dentists’ knowledge of blood-borne infections, their attitudes towards infected patients, and to determine the frequency of the contact with infectious material; Methods: We surveyed 192 dentists using an anonymous questionnaire. Results: Only a quarter of dentists responded correctly to all questions. 96% of the examined dentists confirmed that they were more cautious during treatment of patients with HBV, HCV and HIV. 25% of all respondents refuse to help infected patients due to concerns about their own health. The dentists occasionally removed protective clothing to make it “easier” to perform specific procedures. The dentists experienced contact with infectious material most frequently by splashes onto the conjunctiva or as a result of superficial injuries. The risk of injury by a medical tool increased with the years of employment. Re-capping needles was associated with an increased risk of injury; Conclusions: Despite the widespread tolerance of people infected with blood-borne viruses and the well-proven low infection risk to medical personnel, dentists continue to be prejudiced and concerned about their own health and may refuse to treat infected patients. It may be assumed that the proportion of refusing treatment is even greater. This attitude should imply the implementation of training in the field of pathogen transmission and the real risk of infection.