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EN
The 12-lead surface electrocardiogram adjacent QTc dispersion, which is the maximum difference of corrected QT interval between two adjacent leads, is a simple method to determine regional variation in repolarization and refractoriness. The aim of this study is to evaluate adjacent QTc dispersion as a marker of susceptibility to ventricular arrhythmias after myocardial infarction. A total of 135 consecutive patients with acute myocardial infarction were enrolled in the study. Adjacent QTc, measured by lens magnifier, was calculated on the first, second and third days after acute myocardial infarction. On the second day after acute myocardial infarction, adjacent QTc dispersion was significantly greater in patients with ventricular arrhythmias (P < 0.001). Adjacent QTc dispersion on the first and fifth day after acute myocardial infarction was not associated with development of ventricular arrhythmias. On the second day after acute myocardial infarction, adjacent QTc dispersion is a simple and feasible method for prediction of ventricular arrhythmias.
EN
Introduction. In recent times, patient outcome measurement has developed from being narrowly focussed upon levels of symptomatology and service use, to being a broader assessment of the impact of illness and treatment on the individual. Thus, it can be said that quality of life has become as significant as life expectance. This has brought about a transition in the assessment of treatment. Quality of life (QOL) is a multidimensional concept that usually includes subjective evaluations of both positive and negative aspects of life as it is being led. With regard to healthcare, a cross-sectional comparison of palliative care needs is crucial in understanding differences in the patients' quality of life. Hence, an analysis of programme implementation within different types of healthcare institutions is significant in evaluating current medical care standards. Our study analyzed the satisfaction level and quality of life of patients with Chronic Obstructive Pulmonary Disease (COPD), and after myocardial infarction (MI). Different types of healthcare institutions were evaluated. Aim. To evaluate patients' satisfaction and quality of life in selected healthcare institutions in southern-eastern Poland. Material and methods. The quality of life of patients with Chronic Obstructive Pulmonary Disease (COPD) was analyzed through the medical documentation obtained from different types of healthcare institutions. Among these are the pulmonary outpatient department in Moczary, as well as a GP Practice and a Nursing Home in this location. The quality of life of patients after myocardial infraction was analyzed through a survey study conducted at “Polonia” hospital spa in Rymanów Zdrój (the cardiology department). Results and conclusions. The post-myocardial infarction incident patients had began to care more about their health condition and the quality of life they led. Moreover, their satisfaction level from received treatment and medical care indicated that the cardiological services implemented in southern-eastern Poland has proceeded in a good direction. Of note, these patients were systematically under specialist control. In contrast, among patients with COPD, only those under everyday care in the Nursing Home in Moczary received a similar systematic treatment, thus, COPD patients in Moczary lead a poor quality of life. This indicates a need to re-evaluate the current programmes and services provided by health care institutions in this region.
EN
The purpose of this study was to present the outcomes of treatment of cardiogenic shock (CS) complicating acute myocardial infarction (AMI) among patients hospitalized from 1999 through 2006. The study enrolled 1003 patients. Group 1 comprised 87 patients presenting with AMI complicated with CS, whereas Group 2 comprised 916 patients presenting with AMI without CS symptoms. Determination of invasive treatment was according to standard guidelines. The endpoint comprised death, stroke, and reocclusion/reinfarction. Follow-up was confined to the intra-hospital period. CS was observed more frequently in cases of ST-elevation MI (STEMI) and right ventricular MI. The transportation and door-to-needle time were shorter in Group 1. CS patients were characterized by a more severe coronary artery disease, higher maximal creatinine kinase levels, lower global ejection fractions, and increased incidence of atrioventricular conduction disorders. The efficacy of percutaneous coronary intervention (PCI) was 82.26% in Group 1 and 95.03% in Group 2. Death occurred in 33.3% of CS patients and in 3.6% of AMI patients (p<0.0001). Our study proved that in a short-term follow-up, PCI is a procedure of high efficacy in CS patients. The short-term follow-up precluded a conclusion of statistically significant benefits from the shortening of the transportation and door-to-needle time.
EN
Post-communist Bulgaria has experienced the full impact of a socioeconomic disaster. Under prolonged and powerful stress the human body may exhaust its adaptive potential and a variety of pathophysiological symptoms may occur. The cardiovascular system is most vulnerable to stress. The aim of this study is to analyze the role of psychological factors correlating with Acute Myocardial Infarction (AMI) during the transition period in post-communist Bulgaria. A case-control epidemiological study was performed. 306 cases of acute myocardial infarction (AMI) and 210 controls were studied. Analysis of patients’ records was made and a direct face-to-face interview was carried out. The study covers a 15-year transition period lasting from 1989 until 2005. The interview questions are based on W. Zung’s standardized self-evaluation tests of anxiety and depression (Self Rating Depression Scale - SDS, 1965, SAS-Self Rating Anxiety Scale, 1976) and on a test of aggression, as a part of the Minnesota Multiphase personality inventory, adapted from A.A. Krilov and F. Korozi’s FPI test. Average levels of anxiety and depression appear to be higher among patients suffering from coronary heart diseases than in control group members. Levels of aggression do not show a direct correlation with coronary heart disease. Both groups demonstrate symptoms of psychological disturbances caused, most probably, by the socio-economic instability of the transition period. In conclusion, certain socioeconomic factors significantly increase the level of anxiety and depression in the respondents. The AMI patients are considerably more anxious and depressed than the controls. The results provide evidence that high levels of anxiety and depression may correlate to and be interpreted as a potential risk factor for coronary heart disease.
PL
Wstęp: Sposób w jaki człowiek troszczy się o swoje życie, jego jakość i kształt uzależniony jest od wielu czynników. Analizując ich wpływ na zachowania jednostki względem własnego zdrowia nietrudno dostrzec, że istotne znaczenie mają tak podstawowe własności podmiotu jak wiek, płeć, wykształcenie czy też poziom dochodów jednostki. Przyjmując, że troska o siebie stanowi główny czynnik kształtujący poziom aktywności własnej jednostki w procesie rehabilitacji, zasadnym wydaje się założenie, że powyższe czynniki wpływać będą także na poziom troszczenia się o siebie. Ustalenie tych zależności było głównym celem niniejszego opracowania.Materiał i metody: Badaniami objętych zostało 127 osób, które przeszły zawał serca po raz pierwszy i nie miały innych poważnych chorób towarzyszących. Przebadanych zostało 28 kobiet i 99 mężczyzn. Badanie polegało na wypełnieniu kwestionariusza KTS mierzącego poziom troski o siebie oraz metryczki pozwalającej ustalić wiek, płeć, wykształcenie oraz poziom dochodu na jednego członka rodziny badanego.Wyniki: Uzyskane wyniki badań, pozwalają stwierdzić, iż nie ma istotnego związku między wiekiem i poziomem dochodu a troską o siebie i jej rodzajami. Istnieje związek na poziomie istotności 0,01 między poziomem wykształcenia a poziomem i rodzajami troski o siebie. Badania nie wykazały związku między płcią a ogólnym poziomem troski o siebie. Istnieje natomiast związek na poziomie istotności 0,05 między płcią a troską o funkcjonowanie psychiczne. Wnioski: Z przeprowadzonych badań wynika, że wraz z poziomem wykształcenia wzrasta poziom troski o siebie. Tym samym edukacja pacjenta w rehabilitacji kardiologicznej, może być jednym z podstawowych i najprostszych środków oddziaływania, zwiększających jego poziom troszczenia się o siebie. Wiek i poziom dochodów okazały się nie mieć istotnego znaczenia dla troski o siebie jednak w przypadkach obu zmiennych daje się zaobserwować pewne tendencje, które skłaniać powinny do dalszych analiz. Płeć nie ma znaczenia dla ogólnego poziomu troski o siebie, jednak kobiety istotnie bardziej troszczą się o swoje funkcjonowanie psychiczne niż mężczyźni.
EN
Introduction: The low level of participation in cardiac rehabilitation of patients after myocardial infarction is one of the most important problems in cardiology. Participation in the cardiac rehabilitation process depends on many diverse factors and one of the fundamental ones is a self-care attitude. It is very important to find predictors which can effectively influence this attitude. If we can understand some of the self-care attitude predictors, we might be better prepared to lead a more effective and much faster form of rehabilitation. The presented studies relate to the above mentioned issues.Material and methods: The studies were performed on a group of 127 patients, 28 women and 99 men, after myocardial infarction, who were subjected to cardiac rehabilitation. The studies comprised filling out a questionnaire that appraises self-care and personal data. The results were then subjected to statistical analysis and discussion.Results: The study found that there is no correlation between the self care, age and socioeconomic status of the patients after myocardial infarction. There is a correlation between educational level and self care (0.01) and mental self care and gender (0.05). There is no correlation between general self care and gender.Conclusion: It resulted from the studies that along with the level of education the level of self care increases. Results suggest that the education of the patients after myocardial infarction can be an important factor influencing people’s self care. Results also indicate that women have a higher level of mental self care than men do. Although there was no relation between self care, age and socioeconomic status, the results show that there is a trend in this connection that might be important. Further research into this problem should be encouraged.
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