Given the fact that physical exertion leads to blood glucose fluctuations, type one diabetes mellitus (T1D) may potentially constitute a barrier for obtaining a sufficient amount of exercise. The main purpose of the study was to compare the level of physical activity between children with T1D (n = 215) and healthy controls (n = 115) and to assess the physical activity of the study group in relation to the applied method of insulin therapy, i.e., the use of insulin pen vs. insulin pump. The level of physical activity was assessed with a hip-worn tri-axial accelerometer (ActiGraph GT3X+) used by the subjects for an uninterrupted period of seven days. Children with T1D had significantly lower median values of total time of moderate (213.3 vs. 272.1 min), vigorous (135.3 vs. 19.6 min) and moderate-to-vigorous (347.4 vs. 467.4 min) physical activity compared to healthy peers respectively, (p < 0.001) in all cases. In addition, the total median number of steps was significantly lower (53,631 vs. 67,542 steps), (p < 0.001). The method of insulin therapy was not associated with significant differences in physical activity level (p > 0.001). The level of physical activity in children and adolescents with T1D is lower than in their healthy peers and does not depend on the insulin therapy method.
Tissue engineering is an interdisciplinary field of science that has developed very intensively in recent years. The first part of this review describes materials with medical and dental applications from the following groups: metals, polymers, ceramics, and composites. Both positive and negative sides of their application are presented from the point of view of medical application and mechanical properties. A variety of techniques for the manufacture of biomedical components are presented in this review. The main focus of this work is on additive manufacturing and 3D printing, as these modern techniques have been evaluated to be the best methods for the manufacture of medical and dental devices. The second part presents devices for skull bone reconstruction. The materials from which they are made and the possibilities offered by 3D printing in this field are also described. The last part concerns dental transitional implants (scaffolds) for guided bone regeneration, focusing on polylactide–hydroxyapatite nanocomposite due to its unique properties. This section summarises the current knowledge of scaffolds, focusing on the material, mechanical and biological requirements, the effects of these devices on the human body, and their great potential for applications.
Background: The Clinical Learning Environment, Supervision and Nurse Teacher Scale(CLES+T) instrument is internationally used for the evaluation of clinical learning environment in undergraduate nursing education. However, no evidence is available on the possible applications of this instrument in the context of postgraduate nursing education.Purpose: To examine the basic psychometric properties of CLES+T in the context of clinical postgraduate nursing education in Poland.Methods: Study among a sample of 417 nurses participating in the clinical postgraduate training in Poland.Results: Cronbach’s alpha for the total scale was 0.97. A five-factor structure was confirmed in accordance with the assumptions adopted by the authors of the original version of the scale. Cronbach’s alpha coefficient for the Polish version of the CLES+T subscales ranged from 0.83 (Nursing care on the ward) to 0.95 (The content of supervisory relationship). The mean results for individual subscales ranged from 4.52 ± 0.63 fornursing care on the wardto 4.73 ± 0.45 forrole of the nurse teacher.Conclusions: Having shown satisfactory psychometric properties, CLES+T can be considered a useful instrument to assess those elements of clinical learning environment which are important for the assurance of education quality at the postgraduate level.
2 October 2018 in Advances in Clinical and Experimental Medicine
Malignant cancers of the eyelid skin and the periocular area comprise 5-10% of facial skin malignant cancers. Basal cell carcinomas (BCCs) dominate, comprising approx. 80-90% of cancers of this area of the face. Considerably less often, in 9-14% of cases, squamous cell carcinomas (SCCs) are observed. The aim of this study is to provide an epidemiological-clinical assessment of patients treated over the period 2006-2015 for primary malignant cancers of the eyelid skin considering histological diagnosis and clinical staging. This study was based on an analysis of the medical records of 262 patients. Demographic data, age, sex, size and location of lesions, histological types, and clinical staging were assessed. In the analyzed group of 262 patients, most were over the age of 60 years. Primary cancers were most frequently located in the area of the medial canthus of the eye and in the lower eyelid skin. They were mainly lesions of 6-10 mm and 16-20 mm with histologically diagnosed basal cell carcinoma of nodular and cystic types. The most represented group was that of patients aged 60-70 years with primary cancers located in the medial canthus of the eye (47.3%) and in the lower eyelid. Basal cell carcinoma was diagnosed, mainly nodular and cystic types.
Background: Patients using antiplatelet drugs following infarctions, acute coronary syndrome or stroke pose a significant clinical problem if it is necessary to perform surgery, including dental surgery, since they are at risk of prolonged or secondary post-extraction bleeding. Discontinuation of this therapy is associated with a high risk of serious thromboembolic complications. The purpose of this study was to assess the effectiveness of TachoSil fibrin-collagen patches in stopping and preventing of secondary post-extraction bleeding in patients undergoing chronic antiplatelet therapy.Methods: The study was conducted through retrospective examination of the medical records of 153 patients using chronic antiplatelet therapy and those qualified for tooth extraction. The largest group comprised 74 patients using aspirin and clopidogrel as dual platelet antiaggregation therapy; in this group 75 tooth extractions were carried out. In all of the patients TachoSil fibrin-collagen patches and stiches were applied to the wounds resulting from tooth removal.Results: Following tooth extraction, primary bleeding was stopped in all the patients and their wounds closed via coagulation within 20–30 min. In eight cases, accounting for 4.9% of the patients, secondary bleeding occurred and was successfully stopped only by applying a pressure dressing soaked in tranexamic acid. Secondary bleeding occurred in three patients on the second day and in five patients on the third day following tooth removal.Conclusion: Topical application of TachoSil patches following tooth removal in patients using single or dual antiplatelet therapy effectively stopped bleeding and prevented secondary bleeding after tooth extraction.
Background. Post-traumatic craniofacial injuries associated with bone fractures lead to serious morphological, functional and aesthetic complications which may negatively affect the physical and mental condition of the patient throughout the recovery period. Objectives. The aim of this study was the evaluation of complaints and well-being in patients during the short-and long-term period following injury to the lower face, as well as an assessment of the effects of age and sex in the examined parameters. Material and methods. The research group included 42 patients with injury to the lower face. The patients' well-being and the most common functional problems following treatment were assessed using Oral Health Impact Profile-14 (OHIP-14). Statistical analyses were performed using the Mann-Whitney U test and Spearman's rank correlation coefficient, with significance level assumed at p < 0.05. Results. A period of 8 months following injury of the lower face was sufficient for the patients to achieve significant improvement in the quality of life. Improvement in well-being, according to OHIP-14, by approx. 11.9 points +/- 11.7 points, was highly significant (p < 0.001). The most frequent complaints included pain in the maxillofacial area, difficulties with consumption of food and dissatisfaction due to the necessary change of diet. The factors of age (p = 0.2839) and sex (p = 0.6047) did not significantly affect improvement in well-being. Conclusions. During both the short-and long-term period following injury of the lower face, the most frequent complaints included pain in the maxillofacial region, problems with eating food and dissatisfaction due to change in diet. The study has shown that during the period of 8 months after the injury, there was a significant improvement in the quality of life assessed with OHIP-14. Age and gender do not significantly affect the quality of life after injury to the lower face.