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Pozycja Risk factors for cancer development in type 2 diabetes. A retrospective case-control study.(2016-08-19) Dąbrowski, Mariusz; Szymańska-Garbacz, Elektra; Miszczyszyn, Zofia; Dereziński, Tadeusz; Czupryniak, LeszekAbstract Background. The risk of several types of cancer is increased in type 2 diabetes mellitus. The earliest possible diagnosis of cancer – difficult within regular outpatient diabetes care - is of utmost importance for patients’ survival. The aim of this multicenter, retrospective (years 1998-2015), case-control study was to identify risk factors associated with malignancy in subjects with diabetes treated in a typical outpatient setting. Methods. In the databases of 3 diabetic and 1 primary care clinics 203 patients (115 women) with type 2 diabetes mellitus who developed malignancy while treated for diabetes were identified. The control group consisted of 203 strictly age- and gender matched subjects with type 2 diabetes without cancer. Factors associated with diabetes: disease duration, antidiabetic medications use and metabolic control of diabetes were analyzed. Also other variables: BMI (body mass index), smoking habits, place of residence and comorbidities were included into analysis. Results. The most prevalent malignancies in men and women together were breast cancer (20.7%) and colorectal cancer (16.3%). HbA1c (hemoglobin A1c) level ≥8.5%, obesity and insulin treatment in dose-dependent and time-varying manner demonstrated significant association with increased risk of malignancy, while metformin use was associated with a lower risk of cancer. Diabetes duration, comorbidities, smoking habits, place of residence and aspirin use did not show significant association with risk of malignancy. Conclusions. In the outpatient setting the obese patients with poorly controlled insulin treated type 2 diabetes mellitus should be rigorously assessed towards malignancies, particularly breast cancer in women and colorectal cancer in men.Pozycja The paediatric version of Wisconsin Gait Scale, adaptation for children with hemiplegic cerebral palsy: a prospective observational study(2017) Guzik, Agnieszka; Drużbicki, Mariusz; Kwolek, Andrzej; Przysada, Grzegorz; Bazarnik-Mucha, Katarzyna; Szczepanik, Magdalena; Wolan-Nieroda, Andżelina; Sobolewski, MarekIn 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 objective of the study is to assess the Wisconsin Gait Scale (WGS) in terms of its inter- and intra-observer reliability in observational gait analysis of children with hemiplegic cerebral palsy. The study was conducted in a group of 34 patients with hemiplegic cerebral palsy. At the first stage the original version of WGS was used to assess gait. At the second stage a modified WGS was introduced and the same video recordings were rescored using the new, paediatric version of WGS. Three independent examiners performed the assessment twice (two weeks apart). Inter and intra-observer reliability of the modified WGS were determined. The 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. The new, paediatric version of WGS is a promising tool to be used in qualitative observational gait assessment of children with spastic hemiplegic cerebral palsy. The findings of the study have practical value as they show feasibility of the new, affordable, easy-to-use tool for gait assessment to be used in clinical practice specifically for children with spastic hemiplegic cerebral palsy.Pozycja Gniewkowo Women Study(2017) Dereziński, Tadeusz; Zozulińska-Ziółkiewicz, Dorota; Uruska, Aleksandra; Dąbrowski, MariuszPozycja Association between hearing organ and renal function in young adult type 1 diabetic patients. A cross-sectional study.(2018) Dąbrowski, Mariusz; Mielnik-Niedzielska, Grażyna; Nowakowski, AndrzejBackground: Type 1 diabetes can lead to impaired function of many organs and tissues. The aim of this study was to evaluate associations between hearing and kidney function in young adult type 1 diabetic patients. Methods: 31 patients (9 women) with type 1 diabetes, aged <45, with disease duration <10 years were included. Blood and urine samples for laboratory tests and urinary albumin excretion (UAE) assessment were obtained. eGFR was calculated with CKD-EPI formula. In all patients pure-tone audiometry, transient evoked otoacoustic emissions and auditory brainstem responses were evaluated, also eye fundus was examined. Results: Mean patients’ age was 29.5±7.0 years and disease duration 4.6±2.6 years. All patients had eGFR >60.0 ml/min/1.73 m2. In one case microalbuminuria and in 3 patients early retinopathy were revealed. Linear correlation between eGFR and hearing threshold at 4, 6, 8 and 12 kHz was found. Patients with hearing impairment (n=7) had lower eGFR 108.8 vs. 121.7 ml/min/1.73 m2, p=0.047 compared to normal-hearing subjects. Also patients with absence of otoacoustic emissions in at least one ear had lower eGFR, 103.1 vs. 123.3 ml/min/1.73 m2, p<0.001, compared to the remaining group. In auditory brainstem responses we found significant linear correlation between eGFR and wave III and interval I-III latencies, and between UAE and waves III, V and interval I-III latencies. Conclusions: This study indicate possible relationship between hearing and kidney function in type 1 diabetic patients. Pathways directly linking hearing and renal function are unknown. Larger studies are necessary to further analyze these relationships.Pozycja Range of motion in the cervical spine after odontoid fracture treated with anterior screw fixation.(2018) Wolan-Nieroda, Andżelina; Maciejczak, Andrzej; Guzik, Agnieszka; Przysada, Grzegorz; Szeliga, Ewa; Drużbicki, MariuszABSTRACT Introduction It is believed that direct odontoid screw fixation preserves the physiological cervical range of motion following surgery. However, there are no clinical studies confirming the motion sparing value of this technique. Objective. (1) to assess active cervical range of motion following type II and type III odontoid fracture, successfully treated with anterior odontoid screw fixation, (2) to examine the relationship between the range of motion of the head and: (i) duration of collar usage, (ii) neck pain, (iii) quality of life, and (iv) patients’ age. Material and method. The study involved 41 patients subjected to a procedure of direct osteosynthesis of the dens with lag screw. Following the operation all the patients had to wear a cervical collar to protect the osteosynthesis. The control group consisted of 41 individuals with no clinical diagnosis of any cervical spine disorders. Spinal motion was assessed using Multi-Cervical Unit, taking into account bending/extension, left and right lateral flexion, as well as left and right axial rotation. The ranges of motion in the study group were compared to the corresponding control data. Results. Compared to the controls, the study group presented significantly lower ranges of cervical movement (p<0.001). In the study group spine mobility correlated with the duration of hard collar usage following the operation, with a longer duration corresponding to poorer spine mobility at the end of the treatment. Statistically significant correlation was observed in the case of extension (p<0.021) and axial rotation (p<0.007). In the study group there was a negative correlation between the range of motion and the patients’ age, i.e. the older the patient the poorer his/her spinal mobility (p<0.001). The strongest correlation between age and range of motion was identified in the case of lateral flexion and axial rotation (p<0.001). The findings also showed a correlation between intensity of neck pain and range of motion (most significantly in lateral flexion p<0.005) where lower range of motion corresponded to greater neck pain. Conclusions. Active cervical range of motion in patients following direct osteosynthesis of the dens, augmented with hard collar, was significantly lower than in the control population and it correlated negatively with the duration of collar usage, the patients’ age and intensity of spinal pain.Pozycja Assessment of the effects of a multi-component individualized physiotherapy program in patients in a home hospice(2019) Ćwirlej-Sozańska, Agnieszka; Wójcicka, Agnieszka; Kluska, Edyta; Stachoń, Anna; Żmuda, AnnaIntroduction: Hospice care is aimed at chronically and terminally ill patients. It includes symptomatic treatment as standard, but the interest in physiotherapy programs for hospice patients is increasing in order to improve their functioning and quality of life. Aim of the study: The aim of the study is to assess the impact of a multi-component individualized physiotherapy program on the functional and mental condition and quality of life of patients in a home hospice. Material and method: The study included 60 patients (mean 66.3 years) in a home hospice living in southern Poland. Functional status was assessed twice: before and after intervention. The program was performed for 6 weeks (12 trainings) and was managed on the basis of the World Health Organization (WHO) Rehab-Cycle The International Classification of Functioning, Disability and Health (IC)F. The program was individually tailored to the patient, but structured according to the same scheme, i.e. breathing, strengthening, transfer, balance and functional exercisesas well as functional ergonomics. Patients participated in setting particular objectives of the program. The study used: Katz (ADL) and Lawton (IADL) scales, Tinetti test, Visual Analogue Scale (VAS) pain scale, WHOQOL – BREF, Yesavage Geriatric Depression Scale (GDS). A set of ICF categories in terms of function, activity and participation was selected for the studied areas. Results: The average functional level of ADL (mean 2.87) and IADL (mean 11.92) as well as quality of life (WHOQL mean 46.43) of researched patients before the intervention were low, whereas the intensity of pain (VAS mean 5.82) , the risk of falling (Tinetti mean 8.20) and depression (GDS mean 16.65) were recorded high. After the completion of the intervention program, a significant improvement was found in all assessed areas, in particular in the scope of performing basic everyday activities(ADL mean 3.95), risk of falling (Tinetti mean 12.25) and QOL (mean 52.58). Conclusions: The physiotherapeutic intervention presented here has a significant impact on improving the performance of basic and complex activities of everyday life as well as the emotional state and quality of life of patients in a home hospice. The results of our research confirm the great need for physiotherapy in hospice patients and for comprehensive assessment by means of ICF.Pozycja Determinants of ADL and IADL disability in older adults in southeastern Poland(2019) Ćwirlej-Sozańska, Agnieszka; Wiśniowska-Szurlej, Agnieszka; Wilmowska-Pietruszyńska, Anna; Sozański, BernardBackground: The extension of the life span has led to an increase in the number of older people and an increase in the prevalence of disability in people over 60 years of age. The aim of this study was to assess the prevalence of ADL and IADL disability and to analyze its determinants among people aged 60 and older living in southeastern Poland. Methods: This cross-sectional study was carried out among a randomly selected, representative population of people aged 60 and older living in southeastern Poland. Disability was assessed using the Katz Index of Independence in Basic Activities of Daily Living and Instrumental Activities of Daily Living. Logistic regression models were used to identify the factors related to ADLs and IADLs. For the variables that were included in the above models, their clustered influence on the increase in the odds ratio for the occurrence of an ADL or IADL limitation was also examined. Results: The research results show that 35.75% of the participants reported at least one problem with IADLs. At least one problem with ADLs was reported by 17.13% of the participants. The most significant modifiable factors influencing the occurrence of disability were the presence of barriers in the participant’s environment, poor relations with relatives, a lack of social contacts, multimorbidity and pain. A multiple increase in the odds ratio of disability was found with the presence of pairs of analyzed factors. The highest odds ratio of at least one ADL limitation was observed for the combination of barriers in the participant’s environment with multimorbidity (OR 74.07). With regard to IADL disability, the highest odds ratio was observed for the combination of pain on the VAS scale ≥ 3 points with older age (OR 19.47). Conclusions: The study showed a high prevalence of ADL and IADL disability in older people living in southeastern Poland. It also indicated the extent to which modifiable factors influenced the occurrence of disability and the extent to which the risk of disability increased with the presence of pairs of factors, especially those that included environmental barriers in the participant’s environment.Pozycja Factors Associated with Disability and Quality of Life among the oldest-old in Poland: a cross selection study(2019-03-04) Ćwirlej-Sozańska, Agnieszka; Wiśniowska-Szurlej, Agnieszka; Wilmowska-Pietruszyńska, Anna; Sozański, BernardPozycja A study of the psychometric properties of 12-item World Health Organization Disability Assessment Schedule 2.0 in adults living in Poland(2019-11-13) Ćwirlej-Sozańka, Agnieszka; Sozański, Bernard; Kotarski, Hubert; Wilmowska-Pietruszyńska, Anna; Wiśniowska-Szurlej, AgnieszkaBackground: Assessment of population disability is an important part of public health management. This article presents the psychometric properties of the World Health Organization Disability Assessment Schedule 2.0 12-item version (WHODAS 2.0 v 12) assessing adults living in Poland. Methods: The analysis comprised 584 adult urban residents. The study used WHODAS 2.0 v 12 and WHOQL-BREF. Basic sociodemographic and selected health assessment (pain, depressive moods) data were also collected. Results: A high internal consistency was found in the general population for the entire tool (α-Cronbach=0.90) and for individual domains (α-Cronbach in the range of 0.76 - 0.79). The similar situation was of dispersion groups (with pain, depressive moods). Satisfactory values of fit indices were obtained: CFI = 0.999, TLI = 0.999, and RMSEA = 0.004, SRMR = 0.043, p = 0.454. A good consistency was noted over time (correlation coefficient = 0.88). A high validity of the tool was found, including satisfactory discriminant validity of people with different health status and a good convergent validity in correlation with the WHOQOL-BREF questionnaire. Conclusions: The results allow WHODAS 2.0 v 12 to be considered as a high-quality tool for measuring health status, functioning and disability of a general and particular population.Pozycja Short- and long-term effects of physical exercises and verbal stimulation on functional efficiency and use of free time in an older population under institutional care: A randomized controlled trial.(2019-12-18) Wiśniowska-Szurlej, Agnieszka; Ćwirlej-Sozańska, Agnieszka; Wołoszyn, Natalia; Sozański, Bernard; Wilmowska-Pietruszyńska, AnnaBackground: Older people covered by institutional care are mostly physically inactive and uninvolved in interacting with each other and medical staff. Therefore, reducing sedentary behaviour is a new, important, modifiable variable of lifestyle that can improve the health of elderly people. The aim of the project was to assess the degree of improvement in functional performance and the possibility of changing habitual ways of spending free time among elderly people under institutional care, by applying physical training with verbal stimulation. Methods: The study covered older people aged 65-85 years, who are living a sedentary lifestyle in care homes in south-eastern Poland. Those who meet the eligibility criteria and are enrolled in the study was assigned at random to one of four parallel groups: basic exercises (BE), basic exercises combined with verbal stimulation (BE + VS), functional exercise training (FET) and functional exercise training with verbal stimulation (FET + VS). Data were collected at baseline and at 12 and 24 weeks following completion of the program. Results: In the FET + VS group, the greatest positive long-term impact of intervention was demonstrated in terms of functional fitness, gait speed (improved by 0.18m/s), hand grip strength (by over 3.5 kg), and upper limb flexibility (by 10 cm). There was also a significant increase in the level of physical activity spent in free time and an improvement in the quality of life especially expressed in the domain of overall physical functioning. Conclusion: Our study showed that a functional exercise program combined with verbal stimulation is effective in improving physical fitness and raising the level of physical activity spent in free time.Pozycja Cultural adaptation and validation of the Polish version of the Physical Activity Scale for the older people living in community(2020-02-18) Wiśniowska-Szurlej, Agnieszka; Ćwirlej-Sozańska, Agnieszka; Wołoszyn, Natalia; Sozański, Bernard; Wilmowska-Pietruszyńska, Anna; Washburn, RichardObjective: The purpose of this study was cultural adaptation and validation of the Polish version of the Physical Activity Scale for Elderly (PASE) and an assessment of its accuracy and reliability among older people living in south-eastern Poland. Method: This cross-sectional study was carried out among 115 older adults living in southeastern Poland. The original version of the scale has been translated into Polish language following standardized translation procedures. Validity was evaluated by Pearson's rank correlation coefficients between PASE-P and Test Up and Go normal and with cognitive task (TUG; TUGcog), grip strength, basic and instrumental activities of daily living (ADL; IADL), 5 times sit-to-stand test (5x STS), 10-meter walk test (10MWT) and Berg Balance scale (BBS) and International Physical Activity Questionnaire (IPAQ). Results: The mean PASE-P was equal to 91.54 (SD 71.15). Sufficient reliability of the test-retest of the PASE-P questionnaire components was found between the trials. The ICC test was strong and ranged from 0.988 to 0.778 for major domains and total scale score. A significant correlation was found between the total PASE-P score and shorter TUG, TUG cog (r = -0.514, p <0.001; r = -0.481, p <0.001) and 10MWT (r = 0.472, p <0.001). The total PASE-P score was also positively correlated with ADL and IADL (r = 0.337, p <0.001; r = 0.415 p <0.001), BBS (r = 0.537, p <0.001) and 5xSTS (r = 0.558, p < 0.001). Discussion: The results obtained in the study confirm that the Polish version of the PASE scale is a valid and reliable tool for assessing the level of physical activity in older adults living in community.Pozycja Data set of Covid-19 social media monitoring(2020-03-25) Burzyńska, JoannaPozycja Assessment of body mass index in a pediatric population aged 7-17 from Ukraine according to various international criteria – a cross-sectional study. Raw date(2020-12-10) Dereń, Katarzyna; Wyszyńska, Justyna; Nyankovskyy, Serhiy; Nyankovska, Olena; Yatsula, Marta; Łuszczki, Edyta; Sobolewski, Marek; Mazur, ArturPozycja The use of static posturography cut-off scores to predict the risk of falling in older adults.(2021) Wiśniowska-Szurlej, Agnieszka; Ćwirlej-Sozańska, Agnieszka; Sozański, Bernard; Wilmowska-Pietruszyńska, AnnaBackground: Falling is the most common accident that occurs in daily living and the second leading cause of unintentional injury death worldwide. The complexity of the risk factors associated with falling makes older people at risk of falling difficult to identify. Research question: The aim of the study was to identify the cut-off scores of standing posturography measures that can be used to predict the risk of falling in older adults. Methods: This observational study involved 267 elderly people aged 65 to 85 years (73.99 SD 7.51) living in south-eastern Poland. The subjects were divided into two groups: a group with a high risk of falling (HRF) and a group without risk of falling (WRF). Postural stability was assessed during eyes-open (EO) and eyes-closed (EC) trials using the two-plate stability platform CQ Stab 2P. Results and Significance: The best accuracy, sensitivity and specificity were observed for sway path, anterior-posterior sway path and medial-lateral sway path with EO and EC. The clinical cut-off score to predict the risk of falling was 350.63 for sway path with EO, 272.64 for anterior-posterior sway path with EO and 159.63 for medial-lateral sway path. The clinical cut-off score for sway path with EC was 436.11. Such screenings in clinical practice may also be useful for detecting typical balance changes in older adults.Pozycja The impact of physical exercises with elements of dance movement therapy on upper limb and functional fitness of elderly wheelchair users living in nursing homes – randomized control trial(2021-01-18) Wołoszyn, Natalia; Wiśniowska-Szurlej, Agnieszka; Grzegorczyk, Joanna; Kwolek, AndrzejIntroduction: Over the last decades the quality of care and the quality of life of NH home resi-dents has significantly improved but low physical activity and social involvement still represent a huge challenge in modern nursing facilities. The research aims at evaluating the impact of physical exercises with elements of dance movement therapy (DMT) on the indicators related to upper limb fitness and overall functional fitness of elderly wheelchair users, as compared to standard exercise program. Method: The study participants were persons aged 68-85 who live in nursing homes and use manual wheelchair as the primary means of mobility. Persons meeting the inclusion criteria were assigned to one of the three groups: Group 1 – Basic exercises/BE group (n=55), Group 2 – Physical exercises with elements of dance movement therapy/PED group (n=55); Group 3 – No Interven-tion/CO group (n=55): control, routine care. The data were collected at the beginning of the study as well as at the 12 week and 24 week mark. Results: Prior to the start of the exercise programmes, all the groups tested were homogeneous. The most positive changes after 12 weeks of intervention were shown in the PED group: handgrip strength, manual dexterity, joint mobility, lung capacity, body flexibility, functional fitness in everyday life. The positive change with regard to the parameters tested lasted beyond 24 weeks. Conclusion: The study demonstrated that DTM appear to be effective in improving upper ex-tremity fitness and physical fitness.Pozycja Psychological Responses and Associated Factors during the Initial Stage of the Coronavirus Disease (COVID-19) Epidemic among the Population in Poland - a cross-sectional study(2021-04-14) Sozański, Bernard; Ćwirlej-Sozańska, Agnieszka; Wiśniowska-Szurlej, Agnieszka; Jurek, Krystian; Górniak, Patryk; Górski, Karol; Englert-Bator, Anna; Perenc, LidiaPozycja Beneficial effect of DASH diet combined with regular physical activity on fat mass, anthropometric and metabolic parameters in people with overweight and obesity. DATASET(2023-08-06) Soroń, Małgorzata,; Więch, Paweł; Dąbrowski, MariuszAbstract Introduction. Obesity and overweight prevalence has reached pandemic level and became a growing health-related issue worldwide. Excess of fat mass is associated with increased risk of cardiovascular disease, diabetes, musculoskeletal disorders, neuropsychological disturbances, cancer and premature death. The aim of our study was to assess the effect of DASH diet combined with regular physical activity on fat mass, anthropometric and metabolic parameters in overweight and obese subjects. Methods. One hundred people (85 women) with overweight and obesity were included in the study. Mean age of study participants was 48.8±12.1 years and half of them had hypertension. In all study participants anthropometric measurements and laboratory tests were assessed and anthropometric as well as metabolic indices were calculated at baseline and after three months of treatment. Results. A significant decrease in body weight, BMI, waist circumference, fat mass, uric acid level and metabolic indices as well as significant improvement in lipid profile with exception of HDL cholesterol level were found. The effect of DASH diet and physical activity was beneficial irrespective of age, gender and baseline presence of hypertension. Conclusion. Implementation of healthy lifestyle was associated with significant improvement in anthropometric and metabolic parameters. It seems necessary to increase the public awareness of the role of behavioral changes to improve the health-related outcomes.Pozycja Comparative analysis of the musculoskeletal health of the populations of Poland and Spain: a cross-sectional study using the International Classification of Functioning, Disability and Health(2024) Wiśniowska-Szurlej, Agnieszka; Sozańska, Agnieszka; Jiménez del Barrio, Sandra; Sozański, Bernard; Ceballos Laita, Luis; Hernández Lázaro, Héctor