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Uwulopalatoplastyka z użyciem lasera Nd:YAG (LAUP) u chorych z zespołem obturacyjnych bezdechów podczas snu

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Babiński D., Stankiewicz C., Kowalska B., Majkowicz M.
Polish Journal of Otolaryngology
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2007
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vol. 61
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issue 3
295-300
EN
Introduction. Surgical treatment of OSAS is focused on removal of narrowing that increase airway resistance in upper respiratory tract. Nd:YAG laser beam penetrates deeper into tissue than CO2 laser followed by superior scarification ability. In this study we investigate efficacy of surgery with Nd:YAG laser assisted uvuloplasty (LAUP). Material and methods. The subject was 51 patients with OSAS treated in Department of Otolaryngology, Medical University of Gdansk during the 2004–2005 period. All patients underwent all-night PSG and the ESS (Epworth Sleepiness Scale) score was used to assess the daytime sleepiness. Surgery treatment was performed and all patients underwent LAUP and additionally lingual base laser vaporization, tonsillectomy and nasal surgery where needed. The postoperative control ENT examination including ESS and all-night PSG was performed after 6 months. Results. Success was found in 29 patients, they achieved AHI<10 and ESS<12. In another 22 patients improvement at PSG parameters and ESS score were evaluated but they were still beyond normal range. Success was obtained in 14/16 patients with preoperative AHI I degree, 10/19 AHI II, and 4/16 AHI III. Nasal surgery for enlargement of airway passage was performed more frequently (25/32) in the group with success then in the group with partial improvement (9/19). Preoperative PSG parameters were better in patients with nasal obstruction. Patients with BMI≥30 succeeded rarely (10/22) in compare with patients with BMI<30 (success in 24/29). Preoperative PSG parameters were better in patients with BMI<30. Conclusion. LAUP with Nd:YAG laser wit additional tonsillectomy, lingual base surgery and nasal surgery were needed is successful method for surgery at light and medium stage of OSAS in nonobese patients.
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Pain ailments and the quality of life and requisition on nursing care patients with neoplasmic disease

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Jałtuszewska S., Basiński A., Majkowicz M.
Ból
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2010
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vol. 11
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issue 4
EN
The aim of this work was to examine the dependence between pain complaints and quality of life or need for nursing care in patients diagnosed with neoplastic disease, and to establish which measures of the studied quality of life were influenced by pain ailments to the greatest degree. Five hundred patients diagnosed with different types of cancer and receiving analgesic treatment were admitted to the study. The data were collected from June 2008 till December 2009. The examination was carried out at patients’ homes. The patients were inhabitants of small cities and villages of the Pomeranian province. The study group comprised 250 women and 250 men in the age from 25 to 90 years (average 61 years). The quality of life was evaluated according to the questionnaire EORTC QLQ-C3O, while pain intensity was estimated based on the Visual Analogue Score. The Cantril’s ladder served to assess general satisfaction from life and the Barthel Scale was used to define the need for nursing care in the opinion of the patients. The general quality of life, and also its individual measures in the studied group were quite low and averaged 35.99 %. Only cognitive functions the patients rated above 50 % and estimated them comparatively well. The patients also complained of coexistence of many different problems worsening their quality of life: 69.9 % suffered from intensification of fatigue, 58.1 % from sleep disorders and 58 % from deranged appetite. The results showed statistically significant relationships between intensity of pain and increased need for nursing care.
PL
Celem pracy była próba oceny zależności pomiędzy dolegliwościami bólowymi a jakością życia i stopniem zapotrzebowania na opiekę pielęgniarską chorych z rozpoznaną chorobą nowotworową oraz ustalenie, na które z obszarów badanej jakości życia największy wpływ mają dolegliwości bólowe. Do badania włączono 500 pacjentów leczonych przeciwbólowo z rozpoznaną chorobą nowotworową, o zróżnicowanej diagnozie. Dane gromadzono od czerwca 2008 roku do grudnia 2009 roku. Badania przeprowadzano w domu pacjentów, mieszkańców małych miast i wsi województwa pomorskiego. W badanej grupie było 250 kobiet i 250 mężczyzn w wieku od 25 do 90 lat (średnia 61 lat). Do oceny jakości życia zastosowano kwestionariusz opracowany przez Grupę Badania Jakości Życia powstałą przy Europejskiej Organizacji Badania i Leczenia Raka EORTC QLQ-C3O (wersja 3.0), Skalę wzrokowo-analogowo VAS (Visual AnalogueScore) służącą do pomiaru stopnia natężenia bólu, Drabinę Cantrila, która posłużyła do oceny ogólnej satysfakcji z życia oraz Skalę Barthel określającą stopień zapotrzebowania na opiekę pielęgniarską w ocenie badanej grupy chorych. Ogólna jakość życia i jej poszczególne obszary w badanej grupie respondentów jest dość niska. Średnia ogólna jakość życia wynosiła 35,99%. Wartość powyżej 50 punktów badani pacjenci przypisują jedynie funkcjonowaniu poznawczemu, które oceniają stosunkowo dobrze. Badani pacjenci wskazywali także na współistnienie wielu innych dolegliwości, zdecydowanie pogarszających ich jakość życia, szczególne znaczenie przypisywali nasileniu zmęczenia 69,9% i zaburzeniom snu 58,1% oraz zaburzeniom łaknienia 58%. Uzyskane wyniki wskazują na istotne statystycznie zależności pomiędzy stopniem natężenia dolegliwości bólowych a zwiększeniem zapotrzebowania na opiekę pielęgniarską.
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Influence of megestrol acetate on nutrition and inflammation in dialysis patients - preliminary results

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Gołębiewska J., Lichodziejewska-Niemierko M., Aleksandrowicz E., Majkowicz M., Łysiak-Szydłowska W., Rutkowski B.
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issue 4
733-737
EN
Malnutrition is a common clinical problem in dialysis patients. So far the management of malnutrition in this population has not been fully successful. The aim of the study was to evaluate the efficacy and safety of use of megestrol acetate suspension in malnourished dialysis patients. Twenty-six hypoalbuminemic (albumin ≤ 3.8 g/dl) dialysis patients took 160 mg of megestrol acetate daily for a period of two months. Anthropometry (dry weight, body mass index) and biochemical measurements of nutrition (serum albumin, triglycerides, total cholesterol) and inflammation (hsCRP, IL-1β, IL-6) were performed on a monthly basis. The treatment led to a statistically significant increase (P < 0.05) in anthropometry and albumin concentration, with no statistically significant changes in total cholesterol, triglycerides and indices of inflammation. Side effects included overhydration, diarrhoea and hyperglycaemia. Thus, megestrol acetate may be an effective therapeutic agent in improving the nutritional status of carefully selected dialysis patients, while it might not mitigate inflammation. Because of the prevalent side effects it must be monitored closely.
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