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Pain ailments and the quality of life and requisition on nursing care patients with neoplasmic disease

100%
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.
2
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CT negative subarachnoid hemorrhage in emergency department

88%
Szypenbejl J., Siemiński M., Szurowska E., Szmuda T., Basiński A.
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EN
Background: Subarachnoid hemorrhage (SAH) is rare but potentially life-threatening cause of acute headache. First diagnostic test performed in the Emergency Department (ED) for acute “thunderclap” headache is computed tomography of the head (CT) without contrast enhancement. Negative non-contrast head CT may be erroneously interpreted as an exclusion of SAH and lead to ED discharge. The consequences of overlooking SAH are of special interest to the Emergency Physician. The aim of this study was to assess prevalence and clinical picture of CT-negative cases of SAH admitted to the ED. Material and methods: Retrospective analysis of charts of patients admitted to the ED and diagnosed with SAH during 18 consecutive months. Results: Our data gives information about clinical picture of patients with CT-negative SAH and their further clinical course. Out of 126 patients diagnosed with SAH, 5 (4.0%) were diagnosed with SAH despite negative non-contrast head CT scan. All cases were diagnosed by means of lumbar puncture and analysis of cerebrospinal fluid. In all patients with CT-negative SAH computed tomographic angiography (CTA) was performed and no vascular abnormalities were found. In one case digital subtraction angiography was performed due to equivocal CTA picture and it demonstrated small unruptured aneurysm of the medial cerebral artery. All patients with CT-negative SAH were admitted to a neurological ward and later discharged from the hospital without neurological deficit. There were no episodes of clinical deterioration and none of the patients required an urgent neurosurgical intervention. Conclusions: Although lumbar puncture remains a gold standard in exclusion of SAH, head CT scan without contrast enhancement appears to be a satisfying diagnostic tool in ED.
3
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CT negative subarachnoid hemorrhage in emergency department

88%
Szypenbejl J., Siemiński M., Szurowska E., Szmuda T., Basiński A.
European Journal of Translational and Clinical Medicine
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2020
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vol. 3
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issue 1
43-48
EN
Background Subarachnoid hemorrhage (SAH) is rare but potentially life-threatening cause of acute headache. First diagnostic test performed in the Emergency Department (ED) for acute “thunderclap” headache is computed tomography of the head (CT) without contrast enhancement. Negative non-contrast head CT may be erroneously interpreted as an exclusion of SAH and lead to ED discharge. The consequences of overlooking SAH are of special interest to the Emergency Physician. The aim of this study was to assess prevalence and clinical picture of CT-negative cases of SAH admitted to the ED. Material and methods Retrospective analysis of charts of patients admitted to the ED and diagnosed with SAH during 18 consecutive months. Results Our data gives information about clinical picture of patients with CT-negative SAH and their further clinical course. Out of 126 patients diagnosed with SAH, 5 (4.0%) were diagnosed with SAH despite negative non-contrast head CT scan. All cases were diagnosed by means of lumbar puncture and analysis of cerebrospinal fluid. In all patients with CT-negative SAH computed tomographic angiography (CTA) was performed and no vascular abnormalities were found. In one case digital subtraction angiography was performed due to equivocal CTA picture and it demonstrated small unruptured aneurysm of the medial cerebral artery. All patients with CT-negative SAH were admitted to a neurological ward and later discharged from the hospital without neurological deficit. There were no episodes of clinical deterioration and none of the patients required an urgent neurosurgical intervention. Conclusions Although lumbar puncture remains a gold standard in exclusion of SAH, head CT scan without contrast enhancement appears to be a satisfying diagnostic tool in ED.
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Videothoracoscopic Simultaneous Bilateral Posterior Splanchnicectomy - Initial Report

52%
Stefaniak T., Reszetow J., Żemojtel Ł., Kobiela J. a., Makarewicz W., Kaska Ł., Krajewski J., Proczko-Markuszewska M., Kwiecińska B., Łachiński A., Basiński A., Śledziński Z.
Polish Journal of Surgery
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2007
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vol. 79
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issue 1
42-46
EN
Chronic pain syndrome (CPS), accompanying pancreatic diseases, especially chronic pancreatitis and pancreatic cancer requires the strongest analgesic agents and is considered difficult to manage. Conservative methods are unsatisfactory and their side effects lead to serious somatic and mental comorbidities.The aim of the study was to perform an initial evaluation of videothoracoscopic bilateral splanchnicectomy using the posterior approach, as the method of treatment in cases of advanced pancreatic cancer.Material and methods. During the period between May and July 2005 there were 10 simultaneous bilateral videothoracoscopic splanchnicectomies (BVSPL) performed in patients with chronic pain syndrome, due to advanced pancreatic cancer, at the Department of General, Endocrinological and Transplant Surgery, Medical University of Gdańsk.Results. All patients were discharged from the hospital on the second postoperative day. Subjective pain measured by the VAS scale changed from 84.3±7.6% before the operation to 25.3±5.3% during the first and second postoperative days. The median follow-up of patients was approximately 4 months (ranging between 2 and 6 months). The intensity of pain 2, 6, and 12 weeks after the procedure was 28.7±4.7%, 30.3±5.4% and 36.2±4.7%, respectively.Conclusions. This is the first description of this safe and feasible method in the Polish surgical literature. The surgical procedure can be safely performed in most surgical departments equipped with videoscopic instruments. Moreover, the short learning curve enables surgeons to perform this procedure well after a short training period. In combination with good results concerning subjective pain reduction, it can be concluded that BVSPL should be incorporated into the spectrum of surgical procedures in most surgical departments in Poland.
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