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Search Results: 1 - 10 of 1429 matches for " Jerzy Leppert "
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Type D personality is a risk factor for psychosomatic symptoms and musculoskeletal pain among adolescents: a cross-sectional study of a large population-based cohort of Swedish adolescents
Emelie Condén, Jerzy Leppert, Lisa Ekselius, Cecilia ?slund
BMC Pediatrics , 2013, DOI: 10.1186/1471-2431-13-11
Abstract: A population-based, self-reported cross-sectional study conducted in V?stmanland, Sweden with a cohort of 5012 students in the age between 15–18 years old. The participants completed the anonymous questionnaire Survey of Adolescent Life in V?stmanland 2008 during class hour. Psychosomatic symptoms and musculoskeletal pain were measured through index measuring the presence of symptoms and how common they were. DS14 and its two component subscales of negative affectivity (NA) and social inhibition (SI) were measured as well.There was a difference depending on sex, where 10.4% among boys and 14.6% among girls (p?=?< 0.001) were defined as Type D personality. Boys and girls with a Type D personality had an approximately 2-fold increased odds of musculoskeletal pain and a 5-fold increased odds of psychosomatic symptoms. The subscale NA explained most of the relationship between Type D personality and psychosomatic symptoms and musculoskeletal pain. No interaction effect of NA and SI was found.There was a strong association between Type D personality and both psychosomatic symptoms and musculoskeletal pain where adolescent with a type D personality reported more symptoms. The present study contributes to the mapping of the influence of Type D on psychosomatic symptoms and musculoskeletal pain among adolescents.The high prevalence of musculoskeletal and psychosomatic symptoms among adolescents in the western world is a problem involving significant costs for both individuals and societies [1,2]. Musculoskeletal pain and psychosomatic symptoms that appear during adolescence often persist into adulthood and may partly be explained by psychosocial and lifestyle factors [3-5]. Pain among adolescents has been identified as an important public health problem. Roth-Isigkeit found that 83% of children and adolescents had experienced pain during the preceding three months, with headache, abdominal, limb and back pain being the most prevalent types. Pain caused the respondents of th
Psychosomatic complaints and sense of coherence among adolescents in a county in Sweden: a cross-sectional school survey
Bo Simonsson, Kent W Nilsson, Jerzy Leppert, Vinod K Diwan
BioPsychoSocial Medicine , 2008, DOI: 10.1186/1751-0759-2-4
Abstract: A cross-sectional school survey in the county of V?stmanland, Sweden. All 16- and 19-year old adolescents present at school on the day of the survey were asked to complete a questionnaire in their classrooms during a one-lesson hour session under the supervision of their teachers. Totally 3,998 students in both private and public schools, studying in ninth grade elementary school or third grade secondary school participated.The results from our study show that there is a statistically significant relation between PSC and SOC among adolescents. It also shows that adolescents with a weak SOC score have more symptoms of PSC.Our study indicates that SOC can help the adolescents to choose a coping strategy that is appropriate for the situation and thereby may prevent them from developing PSC. However, additional studies are needed to confirm our findings.The major causes of mortality and morbidity among adolescents have, during the last decades, shifted from infectious to behavioural aetiologies [1]. This shift is mostly due to risk taking behaviours among adolescents that lead to, among others, injuries and drug and alcohol misuse [2]. Mental health problems are also common among young people. The mental health problems can range from fully developed psychiatric diseases to learning disabilities, behavioural problems in school, speech- and language problems and psychosomatic complaints (PSC) [3]. To better understand the development of psychosomatic complaints among adolescents, it was decided to perform a population-based study, which is to our knowledge, the first to examine the relation between PSC and sense of coherence (SOC) among adolescents.The symptoms of psychosomatic disorders usually begin during adolescence or early adulthood and are characterised by many vague physical complaints. Any part of the body may be affected, although the symptoms and their frequencies vary. Common symptoms among adolescents are headaches, nausea and vomiting, abdominal pain, diarr
Hospital employees' theoretical knowledge on what to do in an in-hospital cardiac arrest
Marie-Louise K?llestedt, Andreas Rosenblad, Jerzy Leppert, Johan Herlitz, Mats Enlund
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine , 2010, DOI: 10.1186/1757-7241-18-43
Abstract: The aim of this study was to investigate how much theoretical knowledge in CPR would increase among all categories of health care professionals lacking training in CPR, in an intervention hospital, after a systematic standardised training. Their results were compared with the staff at a control hospital with an ongoing annual CPR training programme.Health care professionals at two hospitals, with a total of 3144 employees, answered a multiple-choice questionnaire before and after training in CPR. Bootstrapped chi-square tests and Fisher's exact test were used for the statistical analyses.In the intervention hospital, physicians had the highest knowledge pre-test, but other health care professionals including nurses and assistant nurses reached a relatively high level post-test. Improvement was inversely related to the level of previous knowledge and was thus most marked among other health care professionals and least marked among physicians.The staff at the control hospital had a significantly higher level of knowledge pre-test than the intervention hospital, whereas the opposite was found post-test.Overall theoretical knowledge increased after systematic standardised training in CPR. The increase was more pronounced for those without previous training and for those staff categories with the least medical education.The survival rate after cardiac arrest depends on the quality of cardiopulmonary resuscitation (CPR), alarm response time, and time to defibrillation [1,2]. All health care professionals should be able to perform CPR with competence [3]. Studies have investigated and compared different ways of teaching CPR with the aim to find a gold standard, maximising the best retention of knowledge [4-6]. Some studies have also suggested that too much emphasis is placed upon verbal information and too little on practical skills during training [5,7,8].In the year 2000, CPR guidelines recommended that health care professionals should use an AED as soon as possible duri
The impact of CPR and AED training on healthcare professionals' self-perceived attitudes to performing resuscitation
Marie-Louise K?llestedt, Anders Berglund, Johan Herlitz, Jerzy Leppert, Mats Enlund
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine , 2012, DOI: 10.1186/1757-7241-20-26
Abstract: To examine whether there were any changes in the attitudes among healthcare professionals to performing CPR from before to after training.Healthcare professionals from two Swedish hospitals were asked to answer a questionnaire before and after training. The questions were relating to physical and mental discomfort and attitudes to CPR. Statistical analysis used was generalized McNemar's test.Overall, there was significant improvement in 10 of 11 items, reflecting various aspects of attitudes to CPR.All groups of health care professionals (physicians, nurses, assistant nurses, and "others" = physiotherapists, occupational therapists, social welfare officers, psychologists, biomedical analysts) felt more secure in CPR knowledge after education. In other aspects, such as anxiety prior to a possible cardiac arrest, only nurses and assistant nurses improved.The concern about being infected, when performing mouth to mouth ventilation, was reduced with the most marked reduction in physicians (75%; P < 0.001).In this hospital-based setting, we found a positive outcome of education and training in CPR concerning healthcare professionals' attitudes to perform CPR. They felt more secure in their knowledge of cardiopulmonary resuscitation. In some aspects of attitudes to resuscitation nurses and assistant nurses appeared to be the groups that were most markedly influenced. The concern of being infected by a disease was low.Cardiac arrest may occur anywhere in a hospital, and be discovered by any healthcare professional [1]. Although being difficult to prove, it is not unlikely that the attitude towards cardiopulmonary resuscitation (CPR) among health care professionals is of importance for the chance of survival after cardiac arrest. Some of these professionals may be concerned about of the potential risks to themselves of starting CPR. To our knowledge, there has been no previous study on the effects of CPR training and education to attitudes in cardiopulmonary resuscitation,
Role of intranasal fentanyl in breakthrough pain management in cancer patients
Wojciech Leppert
Cancer Management and Research , 2010, DOI: http://dx.doi.org/10.2147/CMAR.S7926
Abstract: le of intranasal fentanyl in breakthrough pain management in cancer patients Review (6033) Total Article Views Authors: Wojciech Leppert Published Date September 2010 Volume 2010:2 Pages 225 - 232 DOI: http://dx.doi.org/10.2147/CMAR.S7926 Wojciech Leppert Department of Palliative Medicine, Poznan University of Medical Sciences, Poznan, Poland Abstract: Fentanyl is a strong opioid analgesic, which is commonly used in the form of a transdermal patch for the treatment of chronic cancer pain. An intranasal route of fentanyl administration is a novel treatment for breakthrough cancer pain (BTCP). The prevalence, assessment, and management of BTCP is outlined in this paper, and basic pharmacodynamic and pharmacokinetic properties, dosing guidelines, and clinical experience with the use of intranasal fentanyl in this indication are discussed. Intranasal fentanyl is an attractive and convenient mode of BTCP treatment in opioid-tolerant patients due to its quick onset and short duration of action, noninvasive administration route, high bioavailability, and avoidance of a hepatic first-pass effect. Until now, few clinical trials have been conducted with intranasal fentanyl, but all have confirmed its usefulness and acceptability in BTCP treatment. Intranasal fentanyl may be used in opioid-tolerant patients without nasal pathologies. The dose should be titrated in each patient regardless of the regular opioid dose administered. Future studies should compare intranasal fentanyl with other fentanyl formulations used for BTCP management, and with analgesia, adverse effects, and quality of life taken into consideration.
Jako ycia chorych na zaawansowanego raka p uca obj tych opiek paliatywn stacjonarn i domow
Wojciech Leppert
Medycyna Paliatywna , 2010,
Abstract: Wst p: Ocena jako ci ycia (J ) u chorych na zaawansowanego raka p uca (ZRP) stanowi wa nezagadnienie w opiece paliatywnej. Celem badania by a ocena zmian J i stanu sprawno ci u chorychna ZRP w opiece paliatywnej stacjonarnej i domowej. Materia i metody: Przeprowadzono badanie prospektywne 50 chorych leczonych objawowow hospicjum domowym (HD, 25 osób) i na oddziale medycyny paliatywnej (OMP, 25 osób).Aktywno chorych oceniano wg skali Karnofsky’ego (KPS), J kwestionariuszem EORTCQLQ-C30. Wykonano dwa pomiary J co 10 dni. W obu grupach chorych rozpoznano niedrobnokomórkowegoi drobnokomórkowego raka p uca. Wyniki: W ocenie J , w skali funkcjonowania fizycznego i problemach finansowych nie stwierdzonoistotnych zmian w obu grupach chorych. W zakresie funkcjonowania w rolach, w obu grupachobserwowano wi ksze ograniczenie w realizowaniu hobby. Funkcjonowanie spo eczne uleg opogorszeniu w HD ( ycie rodzinne), nie stwierdzono zmian na OMP. Funkcjonowanieemocjonalne uleg o pogorszeniu u chorych HD (zmartwienie), nie stwierdzono zmian w grupieOMP. Funkcjonowanie poznawcze uleg o pogorszeniu wy cznie w grupie OMP (trudno ciw koncentracji i w zapami tywaniu). Ogólna J (OJ ) i ogólny stan zdrowia (OSZ) uleg y pogorszeniuu chorych OMP, pozosta y bez zmian u pacjentów HD. Aktywno wg KPS uleg a pogorszeniuu chorych HD, nie uleg a zmianie u pacjentów OMP. Wnioski: Zaobserwowano niskie warto ci OJ (1,5–2), OSZ (2–2,5) i KPS (3–4) w obu grupachchorych. W wi kszo ci skal funkcjonowania J i aktywno ci obserwowano pogorszenie w drugiejocenie przynajmniej w jednej z badanych grup chorych. Przyczyn obserwowanych zmian by oprawdopodobnie wi ksze nasilenie objawów somatycznych zwi zane z post pem choroby.
Ocena objawów u chorych na zaawansowanego raka p uca w opiece paliatywnej stacjonarnej i domowej
Wojciech Leppert
Medycyna Paliatywna , 2010,
Abstract: Wprowadzenie: Ocena objawów u chorych z zaawansowanym rakiem p uca (ZRP) stanowi wa nezagadnienie w opiece paliatywnej. Celem badania by a ocena nat enia bólu i innych objawówu chorych z ZRP w opiece paliatywnej stacjonarnej i domowej. Materia i metody: Badanie prospektywne 50 chorych leczonych objawowo na oddziale medycynypaliatywnej (OMP, 25 chorych) i w domu, pod opiek hospicjum domowego (HD, 25 chorych).Nat enie bólu oceniano skal wzrokowo-analogow (visual analogue scale – VAS), do ocenyinnych objawów zastosowano kwestionariusz EORTC QLQ C 30 i modu dla raka p uca LC 13.Wobydwu grupach chorych wykonano dwa pomiary jako ci ycia (J ), co 10 dni. W obu grupachchorych podobnie cz sto rozpoznawano niedrobnokomórkowego (NDRP) i drobnokomórkowego(DRP) raka p uca. Wyniki: Najcz ciej wyst puj ce objawy w obydwu grupach chorych to: duszno (ponad 90%chorych), zm czenie (90%), os abienie (80%), zaparcie stolca (60%) i utrata apetytu (50%). W drugiejocenie os abienie uleg o nasileniu na OMP, duszno i duszno w spoczynku by y bardziejnasilone w HD, nasilenie krwioplucia zmniejszy o sie na OMP. Nat enie objawów ze stronyuk adu pokarmowego nie uleg o zmianie w obydwu grupach chorych, przy czym utrata apetytuby a bardziej nasilona w HD. Nat enie bólu uleg o zwi kszeniu w grupie chorych OMP (warto ci rednie VAS odpowiednio 6,4 i 7,12) i pozosta o stabilne w grupie chorych HD (warto ci rednieVAS odpowiednio 5,44 i 5,72). Wnioski: Nat enie bólu by o znaczne w obu grupach chorych i uleg o zwi kszeniu w grupieOMP. Post powanie objawowe u chorych na ZRP powinno w wi kszym stopniu uwzgl dnia intensywne leczenie duszno ci, zm czenia, os abienia, zaparcia stolca i utraty apetytu, a zw aszczadolegliwo ci bólowych.
Nudno ci i wymioty u chorych w medycynie paliatywnej
Wojciech Leppert
Medycyna Paliatywna , 2011,
Abstract: Nudno ci i wymioty nale do najcz ciej wyst puj cych objawów ze strony uk adu pokarmowegou chorych w medycynie paliatywnej. Przewlek e nudno ci i wymioty wywo ane s najcz ciej rozwojem choroby nowotworowej, zaburzeniami metabolicznymi, stosowanym leczeniemonkologicznym, zw aszcza cytostatykami, podawaniem opioidów i innych leków. Szczególnietrudne jest leczenie tych obajwów u chorych z nieoperacyjn niedro no ci jelit. W artykuleomówiono patomechanizm oraz leczenie nudno ci i wymiotów, które powinno by oparte naszczegó owej ocenie przyczyn i stanu klinicznego, co pozwala na wdro enie skutecznego leczeniai w efekcie popraw jako ci ycia chorych.
Sprawozdanie z 12. Kongresu Europejskiego Towarzystwa Opieki Paliatywnej
Wojciech Leppert
Medycyna Paliatywna , 2011,
Abstract: 18–21 maja 2011 r. w Lizbonie odby si 12. KongresEuropejskiego Towarzystwa Opieki Paliatywnej(European Association for Palliative Care – EAPC).Warto podkre li , e EAPC jest stowarzyszeniem,którego cz onkami oprócz lekarzy s tak e piel g -niarki i przedstawiciele zawodów niemedycznych.Spotkanie zgromadzi o du liczb uczestników –zarejestrowano ponad 2700 osób reprezentuj cychwszystkie kontynenty, przedstawiono blisko 1100prezentacji plakatowych i liczne prezentacje ustne.Tegoroczne wydarzenie odby o si pod has em Palliativecare reaching out, sta o si wi c tak naprawd wiatowym spotkaniem osób zainteresowanychopiek paliatywn . W ród uczestników znalaz y si osoby reprezentuj ce rodowisko medycyny paliatywnejz Polski, przy czym byli my najliczniejsz reprezentacj spo ród krajów Europy rodkowo--Wschodniej – zarejestrowano 55 uczestnikówz naszego kraju.
Role of intranasal fentanyl in breakthrough pain management in cancer patients
Wojciech Leppert
Cancer Management and Research , 2010,
Abstract: Wojciech LeppertDepartment of Palliative Medicine, Poznan University of Medical Sciences, Poznan, PolandAbstract: Fentanyl is a strong opioid analgesic, which is commonly used in the form of a transdermal patch for the treatment of chronic cancer pain. An intranasal route of fentanyl administration is a novel treatment for breakthrough cancer pain (BTCP). The prevalence, assessment, and management of BTCP is outlined in this paper, and basic pharmacodynamic and pharmacokinetic properties, dosing guidelines, and clinical experience with the use of intranasal fentanyl in this indication are discussed. Intranasal fentanyl is an attractive and convenient mode of BTCP treatment in opioid-tolerant patients due to its quick onset and short duration of action, noninvasive administration route, high bioavailability, and avoidance of a hepatic first-pass effect. Until now, few clinical trials have been conducted with intranasal fentanyl, but all have confirmed its usefulness and acceptability in BTCP treatment. Intranasal fentanyl may be used in opioid-tolerant patients without nasal pathologies. The dose should be titrated in each patient regardless of the regular opioid dose administered. Future studies should compare intranasal fentanyl with other fentanyl formulations used for BTCP management, and with analgesia, adverse effects, and quality of life taken into consideration.Keywords: adverse effects, analgesia, breakthrough pain, intranasal fentanyl, opioid analgesics, treatment
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