Marek Sobolewski

Laboratory-based scoring system for prediction of hepatic inflammatory activity in patients with autoimmune hepatitis

In autoimmune hepatitis (AIH), inflammation is closely related to fibrosis. Although transaminase levels are commonly used to assess hepatic inflammation, they may not relate directly to the histology. We developed a noninvasive diagnostic score as an alternative to liver biopsy to help optimize treatment for AIH and monitor disease progress.

Counterfeit medicines in Poland: opinions of primary healthcare physicians, nurses and lay persons

AIMS AND OBJECTIVES To gain information concerning disparities in the understanding of the counterfeit medicines phenomenon between healthcare workers and lay persons. BACKGROUND Central-eastern Europe is facing significant challenges in combating a multi-billion euro, and often lethal, trade in counterfeit medicines. It is a major challenge especially for primary healthcare workers to expand the understanding of counterfeit medicines to the benefit of patients. DESIGN Use of questionnaires. Two separate questionnaires were distributed, one for healthcare professionals and the other for lay persons. METHODS Conducted between September 2009-May 2010. One thousand and seventy-eight primary healthcare professionals and 377 lay persons were surveyed. RESULTS Findings revealed less awareness among healthcare professionals than lay persons about the danger of purchasing illegal medicines or dietary supplements outside pharmacies. Healthcare professionals have lower levels of awareness about the scale of counterfeit medicines as well as threats of counterfeit medicines to health than lay persons. The majority of medical workers do not know the procedure for reporting suspicious medicine and do not warn their patients against purchasing medicine from unknown sources. CONCLUSIONS Primary healthcare workers have less awareness of the scale of the counterfeit medicines phenomenon than lay persons. RELEVANCE TO CLINICAL PRACTICE Nurses and physician need to become aware of the counterfeit medicines phenomenon. Nurses are well positioned to assume the active role in educating patients about the threat of the presence of counterfeit medicines so as to enhance safety for their patients. However, to accomplish that aim, these findings suggest that healthcare professionals need to become better educated about counterfeit medicines and need to be trained in skills to identify counterfeit medicines.

Acceptance of illness and satisfaction with life among malaria patients in rivers state, Nigeria

BackgroundHealth condition is one of the basic factors affecting satisfaction with life, and the level of illness acceptance. The purpose of the study was to analyse the level of illness acceptance, the level of satisfaction with life among malaria patients, and the level of trust placed in the physician and the nurse.MethodsThe study employs the method of diagnostic survey based on standardised AIS and SWLS scales, as well as Anderson and Dedrick’s PPTS and PNTS scales.ResultsThe average AIS level was 12 points, while the average level of SwL at the SWLS scale was 16.5 points. The average level of trust in the physician and the nurse amounted to 50.6 points and 51.4 points, respectively. The correlation between the level of illness acceptance and self-evaluated satisfaction with life was statistically significant, with R = 0.56. The marital status influenced the level of illness acceptance with p < 0.05 and the level of satisfaction with life with p < 0.05. The employment status affected the level of satisfaction with life with p < 0.05 and the level of illness acceptance with p < 0.05.ConclusionsThe majority of malaria patients did not accept their illness, while the level of satisfaction with life was low. The majority of respondents trusted their physician and nurse. There is a statistically significant correlation between the level of illness acceptance and the self-evaluated satisfaction with life. The marital status had a statistically significant effect on the acceptance of illness and the satisfaction with life. The individuals who had a job demonstrated higher levels of quality of life and illness acceptance.

Changes in Gait Symmetry After Training on a Treadmill with Biofeedback in Chronic Stroke Patients: A 6-Month Follow-Up From a Randomized Controlled Trial

Background One of the most significant challenges for patients who survive a stroke is relearning basic motor tasks such as walking. The goal of this study was to evaluate whether training on a treadmill with visual biofeedback improves gait symmetry, as well as spatiotemporal and kinematic gait parameters, in stroke patients. Material/Methods Thirty patients in the chronic phase after a stroke were randomly allocated into groups with a rehabilitation program of treadmill training with or without visual biofeedback. The training program lasted 10 days. Spatiotemporal and kinematic gait parameters were evaluated. For all parameters analyzed, a symmetrical index was calculated. Follow-up studies were performed 6 months after completion of the program. Results The symmetrical index had significantly normalized in terms of the step length (p=0.006), stance phase time, and inter-limb ratio in the intervention group. After 6 months, the improvement in the symmetry of the step length had been maintained. In the control group, no statistically significant change was observed in any of the parameters tested. There was no significant difference between the intervention group and the control group on completion of the program or at 6 months following the completion of the program. Conclusions Training on a treadmill has a significant effect on the improvement of spatiotemporal parameters and symmetry of gait in patients with chronic stroke. In the group with the treadmill training using visual biofeedback, no significantly greater improvement was observed.

Evaluation of the impact of exercise of gait on a treadmill on balance of people who suffered from cerebral stroke.

PURPOSE The aim of the study is to define the impact of exercise on a treadmill on static balance and stability of posture in a group of patients after cerebral stroke rehabilitated in a late period, with an application of a treadmill with the function of visual biofeedback. METHODS The examination was carried out in a group of 46 people in a late period after ischemic cerebral stroke. The patients examined were randomly put to a group with intervention (n = 23), in which a rehabilitation programme with an application of a treadmill with the visual feedback function was realized and to a control group (n = 23). They evaluated balance in standing on both feet by means of a force plate, symmetry of load of lower limbs and dynamic balance in Up & Go test. RESULTS A statistically significant change of stabilometric parameters was observed only in the area of postural sways of the centre of pressure (COP). A significant improvement of the symmetry of load of lower limbs in standing (p = 0.0266) was diagnosed in the examined group after the end of the programme. After the end of the programme no significant difference between the group with intervention and the control group as for a change of balance of the examined patients was found. CONCLUSIONS In the examined group in the chronic period after cs no significant improvement of stabilometrically evaluated balance was obtained, but improvement of the symmetry of load of lower limbs as well as improvement of dynamic balance were observed.

The Influence of Upper Level NUTS on Lower Level Classification of EU Regions

The Nomenclature of Territorial Units for Statistics or Nomenclature of Units for Territorial Statistics (NUTS) is a geocode standard for referencing the subdivision of countries for statistical purposes. It covers the member states of the European Union. For each EU member country, a hierarchy of three levels is established by Eurostat. In 27 EU countries we have 97 regions at NUTS1, 271 regions at NUTS2 and 1,303 regions at NUTS3. They are subject of many statistical analysis involving clustering methods. Having a partition of units on a given level, we can ask the question, whether this partition has been influenced by the upper level division of Europe. For example, after finding groups of homogeneous levels of NUTS 2 regions we would like to know if the partition has been influenced by differences between countries. In the paper we propose a procedure for testing the statistical significance of influence of upper level units on a given partition. If there is no such influence, we can expect that the number of between-groups borders which are also country borders should have a proper probability distribution. A simulation procedure for finding this distribution and its critical values for testing significance is proposed in this paper. The real data analysis shown as an example deals with the innovativeness of German districts and the influence of government regions on innovation processes.

Leisure time physical activity of young women from the Carpathian Euroregion in relation to the Body Mass Index

Carpathian Euroregion gathers the population of 5 countries, including Poland, Slovakia, Hungary and Romania- the European Union members, as well as Ukraine. Young women are statistically less involved in high-intensity physical activity than young men. The objective of this work was to assess the relation between physical activity of young women aged 18-21 years old and BMI and conditioning factors. The study was conducted between 2010 and 2011 among 2339 women. The Minnesota Leisure Time Physical Activity Questionnarie (MLTPAQ) was applied. It results from the study that 74,2% of young women is considered to have the proper BMI rate (18,5-24,9). As many as 16,2% is considered underweight and almost 10% have higher BMI rate and are overweight. More than one third of respondents did not gain the level of physical activity of 1000 kcal/week, and that is the minimum recommended amount of leisure physical activity time per week. In case of women with low level of physical activity (<1000 kcal), as many as 52% of week activity considered low-intensity activity EEPAlight. The character of changes of the BMI index with reference to the level of physical activity is very similar in the women from towns/cities and the women from villages. An increase of BMI along with the total physical activity was related among all to the increase of free fat mass FFM despite of the level of physical.

The prevalence of underweight, overweight and obesity in children and adolescents from Ukraine

The aim of this study was to evaluate the prevalence of overweight, obesity and underweight in children from Ukraine. A cross-sectional study was performed on data collected from a representative sample of Ukraine children (13,739 children (boys 48%, girls 52%) aged 6.0–18.9 years). The measurement of body weight was performed with medical scales and height was measured using a stadiometer. Based on the results obtained, body mass index (BMI) was calculated. Three criteria were used to define childhood underweight, overweight and obesity: The International Obesity Task Force (IOTF) reference, World Health Organization (WHO) child growth standard and The US Center for Disease Control and Prevention (CDC). The combined prevalence of obesity and overweight among children aged 6–18 years old was 12.1%, 17.6%, and 12.6% based on the IOTF reference, WHO growth standard, and the CDC, respectively. Obesity was 2.1%, 4.2%, and 3.6% respectively. Significantly more girls were underweight than boys. Furthermore, a higher prevalence of overweight and obesity was diagnosed in younger that older Ukrainian population.

The paediatric version of Wisconsin gait scale, adaptation for children with hemiplegic cerebral palsy: a prospective observational study

BackgroundIn clinical practice there is a need for a specific scale enabling detailed and multifactorial assessment of gait in children with spastic hemiplegic cerebral palsy. The practical value of the present study is linked with the attempts to find a new, affordable, easy-to-use tool for gait assessment in children with spastic hemiplegic cerebral palsy. The objective of the study is to evaluate the Wisconsin Gait Scale (WGS) in terms of its inter- and intra-rater reliability in observational assessment of walking in children with hemiplegic cerebral palsy.MethodsThe study was conducted in a group of 34 patients with hemiplegic cerebral palsy. At the first stage, the original version of the ordinal WGS was used. The WGS, consisting of four subscales, evaluates fourteen gait parameters which can be observed during consecutive gait phases. At the second stage, a modification was introduced in the kinematics description of the knee and weight shift, in relation to the original scale. The same video recordings were rescored using the new, paediatric version of the WGS. Three independent examiners performed the assessment twice. Inter and intra-observer reliability of the modified WGS were determined.ResultsThe findings show very high inter- and intra-observer reliability of the modified WGS. This was reflected by a lack of systematically oriented differences between the repeated measurements, very high value of Spearman’s rank correlation coefficient 0.9 ≤ |R| < 1, very high value of ICC > 0.9, and low value of CV < 2.5% for the specific physical therapists.ConclusionsThe new, ordinal, paediatric version of WGS, proposed by the authors, seems to be useful as an additional tool that can be used in qualitative observational gait assessment of children with spastic hemiplegic cerebral palsy. Practical dimension of the study lies in the fact that it proposes a simple, easy-to-use tool for a global gait assessment in children with spastic hemiplegic cerebral palsy. However, further research is needed to validate the modified WGS by comparing it to other observational scales and objective 3-dimensional spatiotemporal and kinematic gait parameters.Trial registrationanzctr.org.au, ID: ACTRN12617000436370. Registered 24 March 2017.

The quality of life in parents raising children with an autism spectrum disorder from Poland, Belarus and France

__________________________________________________________________________________________ Purpose: To assess the health-related quality of life (HRQL) in parents of children with autism spectrum disorder (ASD). Materials and methods: The sample consisted of 83 families with children with ASD, including 30 families from Poland, 25 from Belarus, and 28 from France. Parental HRQL was surveyed with the World Health Organization Quality of Life–BREF (WHOQOL–BREF) and KINDLR questionnaires. Results: This study showed that Polish parents reported the lowest quality of life according to the WHOQOL–BREF. Parents from Belarus reported slightly worse HRQL than parents from France, though other aspects of quality of life (e.g, social sphere, somatic sphere) did not differ significantly between these parents. Parents from Poland also reported lower HQOL according to the KINDLR questionnaire, while parents from Belarus had a higher HQRL in the mental, physical, and selfesteem domains compared to parents from Poland and France. Conclusion: Parents from Poland with children with ASD reported lower HRQL both on the WHOQOL–BREF and KINDL R questionnaires compared to parents from Belarus and France.