Monika Biercewicz

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.

Functional capacity scale in assessment of patients with intracranial aneurysms: reliability and validity.

ABSTRACT The aim of the study was to investigate the use of the Functional Capacity Scale (FCS) to measure functional outcome of patients who had undergone surgical removal of an intracranial aneurysm in the early postoperative period. Reliability and validity of the tool were tested as well as its utility in nursing practice. The study included 120 patients, operated on for intracranial aneurysm. Phase I included 23 patients. Reliability of FCS and the amount of time used for the assessment were tested using observation and direct measurement methods. Phase II included 97 patients, and the tool was administered along with standard outcome assessment tools (Barthel Index, Functional Index “Repty,” Glasgow Outcome Score, and Rankin Scale) to determine concurrent validity. Kendall’s coefficients of concordance (W) between particular care markers of FCS ranged from 0.910 to 1.000. Mean amount of time used for assessment was 90 seconds. Differences between time used for measurements by individual examiners were insignificant (p > .05). Correlation of FCS with the following scales was statistically significant: Functional Index “Repty” (p < .001), Glasgow Outcome Score (p < .01), Rankin Scale (p < .01), and Barthel Index (p < .001). The FCS appears to be a reliable, valid, and practical assessment tool for neuroscience nurses to use with patients who have undergone surgical removal of an intracranial aneurysm.

Ocena stanu umysłowego — wybrane narzędzia pomiarowe w neurogeriatrii

Complete Cerebral Assessment (CGA) involves the assessment of a neurological patient in four basic areas where performance capacity, physical health, mental health, as well social and environmental factors are taken into account. Specially prepared research tools (scales, questionnaires) can be used to assess individual CGA components, which significantly facilitate it and influence its credibility. In addition, they allow to verify changes in patient’s condition over time, in the category of improvement or deterioration, and also help in the exchange of quantitative (clinical) information between health care providers. Based on the literature, there have been discussed the most frequently applied scales used to assess the mental state of neurogeriatric patients. There have been presented data of metrics such as Mini-Mental State Examination (MMSE), Abbreviated Mental Test Score (AMTS), Clock Drawing Test (CDT), Geriatric Depression Scale (GDS), Hamilton Depression Rating Scale (HDRS), and Beck Depression Inventory (BDI). ( JNNN 2017;6(3):130–133 )

Application of the functional capacity scale in the early assessment of functional efficiency in patients after aneurysm embolization: Preliminary reports

BACKGROUND While data on the long-term (e.g., 1 year and subsequent years) outcomes of intracranial aneurysms treatment is relatively well-documented mainly in the clinical aspect (comparability of treatment, mortality, and complications), little is known about the early results, in terms of the functional outcome. OBJECTIVES The aim of the study was to analyze the use of Functional Capacity Scale (FCS) in the evaluation of patients in the early period after endovascular treatment of intracranial aneurysms. MATERIAL AND METHODS The study was conducted in the Neurosurgery Clinic, University Hospital Collegium Medicum in Bydgoszcz, on a group of 118 consecutively admitted patients with the diagnosis of intracranial aneurysm, qualified for treatment using the endovascular method (embolization). The assessment was performed twice. In the clinical assessment the Glasgow Coma Scale (GCS) was used to evaluate the level of consciousness and the Hunt and Hess Scale (H&H) to assess the patients condition. To assess the final outcome and early functional capacity Glasgow Outcome Scale (GOS), Barthel Index (BI), Modified Rankin Scale (mRS) and the new Functional Capacity Scale were used. RESULTS The assessment performed with the FCS was comparable to the assessment conducted with standardized tools such as BI, mRS or GOS. The clinical condition assessed with the GCS (p < 0.001) and H&H (p < 0.001) differentiates the functional condition assessed using the FCS. Statistically significant correlations were found between FCS and BI (r = -0.78), GOS (r = -0.69) and mRS (r = 0.68). CONCLUSIONS The study indicates that the FCS correlates with other scales used in the assessment of patients with intracranial aneurysm, which means that the proposed tool can be applied successfully in practice. However, further randomized multicenter studies are necessary in order to clarify the final conclusion.

Problemy pielęgnacyjne pacjentów z chorobą Parkinsona — opis przypadku

Introduction . Parkinson’s disease is considered to be one of degenerative disorders of the central nervous system. It is classified as an incurable, progressive disease leading to significant deficits in self-care. It is regarded, just after Alzheimer’s disease, as a disease of the elderly, which relates to the central nervous system (CNS). The mechanisms being the basis of this disease have not been completely understood. Case Report . The case study refers to a 72-year-old woman diagnosed with Parkinson’s disease and comorbid dizziness. This work has presented nursing diagnosis and the nursing process. There have been defined patient’s problems, the purpose of the care and its implementation by planning activities. There has been also made an assessment, which is a comparison of the results of the care obtained with the objectives assumed. This work is a description of the case of a theoretical patient. Discussion . One of the most important persons taking care of a patient with PD is the nurse. In the proces of hospital treatment hospital nurse becomes the closest person to the patient. Therefore, she is required to maintain a professional therapeutic contact with the patient. The role of the nurse is primarily to motivate the patient to take actions which will lead to a slowdown in the progress of the disease (ie. encouragement to participate in activities with a therapist, to talk to a psychologist, exercise with a physiotherapist). The patient described has a problem with low self-esteem and a critical attitude towards herself. It is difficult for her to establish contacts and maintain relationship with another person. Such signals should be noticed by the nurse. The nurse is required to respond adequately to the aforementioned symptoms. Conclusions . Parkinson’s disease is defined as a primary degenerative process of the extrapyramidal system. In its course it is characterised by a slow and degenerative process. The patient described by us is fully aware of her state of health as well as of the nature of the disease. This involves a significant decrease of mood, apathy and fear. She cannot accept her condition and the developing deficit of self-care resulting from the progress of the disease. In the case of our patient after discharge from hospital there was recommended further therapy with a psychologist and participation in classes conducted by an occupational therapist and a physiotherapist. (JNNN 2016;5(4):156–161)

Problemy pielęgnacyjne pacjentów z chorobą Alzheimera — opis przypadku

Introduction . Alzheimer’s disease is a syndrome caused by brain disease, usually chronic or of progressive course characterised by clinically numerous disorders of higher cortical functions. It is an incurable disease leading to a complete disability in the advanced stage. An latent initial phase of Alzheimer’s disease results in the disease being diagnosed in a more advanced stage. Case Report . The case study refers to a 67 woman diagnosed with Alzheimer’s disease. The disease was diagnosed 1.5 years ago. The paper presents selected needs and problems observed in a patient diagnosed with Alzheimer’s disease. The work is a description of a case of a hypothetical patient. Discussion . Care and looking after the patient with Alzheimer’s disease is a complex process. It is characterised by total engagement and the necessary specialistic knowledge on the part of all members of the care team taking care of the patient. Taking care of a patient with cognitive impairment is a difficult challenge for his family and relatives. It requires patience, calm and dedication. Nursing interventions are focused on the performance of professional diagnostic procedures, as well as assisting in everyday activities, supporting and educating the patients and their family. Conclusions . Alzheimer’s disease is a chronic disease that leads to disturbances of functional and cognitive functions. In the presented case the patient is aware of the essence of her disease, which significantly reduces her current quality of life. With a decline in physical performance there can be observed deterioration of patient’s physical condition. A significant role in the care of a patient with AD is fulfilled by assistance in everyday activities. (JNNN 2016;5(3):117–122)

Witamina D a wybrane schorzenia układu nerwowego

nterest in the role of vitamin D in the human body has greatly increased in the last decade. Many scientific studies provide the evidence of vitamin D deficiency, which is considered to be one of the most serious health problems in children, young people as well as those middle-aged and older people. The effects of vitamin D deficiency in the prenatally period can affect the health condition at later age, and can be related to diseases of chronic and progressive nature. Nowadays, vitamin D is seen rather as a hormone and is said to have pleiotropic effect. Apart from its classical effect on calcium and phosphate metabolism, vitamin D is also applied in the prophylaxis and treatment of the cardiovascular system and metabolic diseases, cancer or autoimmune diseases. Taking into account scientific reports on certain diseases of the nervous system, there is an indication regarding a relationship between their occurrence and the deficit of vitamin D. Therefore, this vitamin can be seen as a potential “candidate” to support the prevention as well as treatment of these diseases. It should be emphasized however, that not everything in this matter is absolutely certain and clear; further studies are still required in this area. (JNNN 2015;4(2):85–90)

Rola pielęgniarki w leczeniu zespołów bólowych kręgosłupa

The development of civilization has led to the increasing prevalence of spinal problems. Lifestyle in the form of long hours of sitting or standing significantly affect the reduction in spinal mobility and promotes complaint back pain. Its structure is closely related to the functioning of the human being. Back pains are varied in terms of pathogenesis uprising. A common feature is pain that occurs in the lumbar area — the cross and the cross — the hip, with varied backgrounds and character. Treatment is based on conservative methods, such as drug treatment and rehabilitation, and surgery. An important role is played by prevention of backaches distributed among learners and workers. This article aims to highlight the role of nurses over patients with spinal pain syndromes in various stages of treatment. The nurse must take care individually and holistically. It is based mainly on alleviating pain and help the patient because of the temporary reduction in physical activity, which impedes the proper functioning. It is aimed at the comprehensive preparation of the patient and his family for self-care. (JNNN 2014;3(1):39–43)

Evaluation of Patients with Dysfunction of the Extra-Pyramidal System — Selection of Measuring Tools in Neurogeriatria

Summary The group of diseases with extra-pyramidal disorders includes inter alia Parkinson’s disease. It is one of the most common progressive, degenerative diseases of the central nervous system occurring in mature and older people. First symptoms of the disease occur in most cases after fifty years of age. The disease is generated by the loss of dopaminergic cells in the substantia nigra manifested clinically in the mobility slowdown, muscle rigidity and tremor at rest. The clinical use of various measuring tools (scales, indexes, indicators, tests, etc.) for the diagnosis of patients with dysfunction of the extra-pyramidal system has been increasingly applied. Based on the literature there were discussed scales most commonly used in the assessment of patients with dysfunction of the extra-pyramidal system including mainly those with Parkinson’s disease. There were presented data regarding such measuring scales as: Hoehn and Yahra’s (HY Scale), Webster’s (Webster Rating Scale — WRS), Unified Parkinson’s Disease Rating Scale (UPDRS), Northwestern University scale (Northwestern University Disability Scale — NUDS), Columbia University scale (Columbia University Rating Scale — CURS), Schwab and England’s independence scale (Schwab and England ADL Scale — S-E ADL), the short scale of Parkinson’s disease evaluation (Short Parkinson’s Evaluation Scale — SPES), the scale of daily activities in Parkinson’s disease (Parkinson’s Disease Activities of Daily Living Scale — PDADL) as well as life quality scales, including the PDQL (Parkinson’s Disease Quality of Life Questionnaire) and PDQ-39 (Parkinson’s Disease Questionnaire). (JNNN 2014;3(2):88–92)