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Litvinova O, Hammerle FP, Stoyanov J, Ksepka N, Matin M, Ławiński M, Atanasov AG, Willschke H. Patent and Bibliometric Analysis of the Scientific Landscape of the Use of Pulse Oximeters and Their Prospects in the Field of Digital Medicine. Healthcare (Basel) 2023; 11:3003. [PMID: 37998496 PMCID: PMC10671755 DOI: 10.3390/healthcare11223003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 11/02/2023] [Accepted: 11/11/2023] [Indexed: 11/25/2023] Open
Abstract
This study conducted a comprehensive patent and bibliometric analysis to elucidate the evolving scientific landscape surrounding the development and application of pulse oximeters, including in the field of digital medicine. Utilizing data from the Lens database for the period of 2000-2023, we identified the United States, China, the Republic of Korea, Japan, Canada, Australia, Taiwan, and the United Kingdom as the predominant countries in patent issuance for pulse oximeter technology. Our bibliometric analysis revealed a consistent temporal trend in both the volume of publications and citations, underscoring the growing importance of pulse oximeters in digitally-enabled medical practice. Using the VOSviewer software(version 1.6.18), we discerned six primary research clusters: (1) measurement accuracy; (2) integration with the Internet of Things; (3) applicability across diverse pathologies; (4) telemedicine and mobile applications; (5) artificial intelligence and deep learning; and (6) utilization in anesthesiology, resuscitation, and intensive care departments. The findings of this study indicate the prospects for leveraging digital technologies in the use of pulse oximetry in various fields of medicine, with implications for advancing the understanding, diagnosis, prevention, and treatment of cardio-respiratory pathologies. The conducted patent and bibliometric analysis allowed the identification of technical solutions to reduce the risks associated with pulse oximetry: improving precision and validity, technically improved clinical diagnostic use, and the use of machine learning.
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Affiliation(s)
- Olena Litvinova
- Department of Management and Quality Assurance in Pharmacy, National University of Pharmacy, Ministry of Health of Ukraine, 61002 Kharkiv, Ukraine
- Ludwig Boltzmann Institute Digital Health and Patient Safety, Medical University of Vienna, 1090 Vienna, Austria;
| | - Fabian Peter Hammerle
- Ludwig Boltzmann Institute Digital Health and Patient Safety, Medical University of Vienna, 1090 Vienna, Austria;
- Department of Anesthesia, General Intensiv Care and Pain Management, Medical University of Vienna, 1090 Vienna, Austria
| | | | - Natalia Ksepka
- Institute of Genetics and Animal Biotechnology of the Polish Academy of Sciences, 05-552 Magdalenka, Poland; (N.K.); (M.M.); (M.Ł.)
| | - Maima Matin
- Institute of Genetics and Animal Biotechnology of the Polish Academy of Sciences, 05-552 Magdalenka, Poland; (N.K.); (M.M.); (M.Ł.)
| | - Michał Ławiński
- Institute of Genetics and Animal Biotechnology of the Polish Academy of Sciences, 05-552 Magdalenka, Poland; (N.K.); (M.M.); (M.Ł.)
- Department of General, Gastroenterologic and Oncologic Surgery, Medical University of Warsaw, 02-097 Warsaw, Poland
| | - Atanas G. Atanasov
- Ludwig Boltzmann Institute Digital Health and Patient Safety, Medical University of Vienna, 1090 Vienna, Austria;
- Institute of Genetics and Animal Biotechnology of the Polish Academy of Sciences, 05-552 Magdalenka, Poland; (N.K.); (M.M.); (M.Ł.)
| | - Harald Willschke
- Ludwig Boltzmann Institute Digital Health and Patient Safety, Medical University of Vienna, 1090 Vienna, Austria;
- Department of Anesthesia, General Intensiv Care and Pain Management, Medical University of Vienna, 1090 Vienna, Austria
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Kubick N, Paszkiewicz J, Bieńkowska I, Ławiński M, Horbańczuk JO, Sacharczuk M, Mickael ME. Investigation of Mutated in Colorectal Cancer (MCC) Gene Family Evolution History Indicates a Putative Role in Th17/Treg Differentiation. Int J Mol Sci 2023; 24:11940. [PMID: 37569317 PMCID: PMC10418881 DOI: 10.3390/ijms241511940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 07/14/2023] [Accepted: 07/21/2023] [Indexed: 08/13/2023] Open
Abstract
The MCC family of genes plays a role in colorectal cancer development through various immunological pathways, including the Th17/Treg axis. We have previously shown that MCC1 but not MCC2 plays a role in Treg differentiation. Our understanding of the genetic divergence patterns and evolutionary history of the MCC family in relation to its function, in general, and the Th17/Treg axis, in particular, remains incomplete. In this investigation, we explored 12 species' genomes to study the phylogenetic origin, structure, and functional specificity of this family. In vertebrates, both MCC1 and MCC2 homologs have been discovered, while invertebrates have a single MCC homolog. We found MCC homologs as early as Cnidarians and Trichoplax, suggesting that the MCC family first appeared 741 million years ago (Ma), whereas MCC divergence into the MCC1 and MCC2 families occurred at 540 Ma. In general, we did not detect significant positive selection regulating MCC evolution. Our investigation, based on MCC1 structural similarity, suggests that they may play a role in the evolutionary changes in Tregs' emergence towards complexity, including the ability to utilize calcium for differentiation through the use of the EFH calcium-binding domain. We also found that the motif NPSTGE was highly conserved in MCC1, but not in MCC2. The NPSTGE motif binds KEAP1 with high affinity, suggesting an Nrf2-mediated function for MCC1. In the case of MCC2, we found that the "modifier of rudimentary" motif is highly conserved. This motif contributes to the regulation of alternative splicing. Overall, our study sheds light on how the evolution of the MCC family is connected to its function in regulating the Th17/Treg axis.
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Affiliation(s)
- Norwin Kubick
- Department of Biology, Institute of Plant Science and Microbiology, Univeristy of Hamburg, Ohnhorststr. 18, 22609 Hamburg, Germany;
| | - Justyna Paszkiewicz
- Department of Health, John Paul II University of Applied Sciences in Biala Podlaska, Sidorska 95/97, 21-500 Biała Podlaska, Poland;
| | - Irmina Bieńkowska
- Institute of Animal Biotechnology and Genetics, Polish Academy of Science, Postępu 36A, 05-552 Jastrzębiec, Poland; (I.B.); (M.Ł.); (J.O.H.)
| | - Michał Ławiński
- Institute of Animal Biotechnology and Genetics, Polish Academy of Science, Postępu 36A, 05-552 Jastrzębiec, Poland; (I.B.); (M.Ł.); (J.O.H.)
- Department of General Surgery, Gastroenterology and Oncology, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Jarosław Olav Horbańczuk
- Institute of Animal Biotechnology and Genetics, Polish Academy of Science, Postępu 36A, 05-552 Jastrzębiec, Poland; (I.B.); (M.Ł.); (J.O.H.)
| | - Mariusz Sacharczuk
- Institute of Animal Biotechnology and Genetics, Polish Academy of Science, Postępu 36A, 05-552 Jastrzębiec, Poland; (I.B.); (M.Ł.); (J.O.H.)
- Department of Pharmacodynamics, Faculty of Pharmacy, Medical University of Warsaw, l Banacha 1, 02-697 Warsaw, Poland
| | - Michel Edwar Mickael
- Institute of Animal Biotechnology and Genetics, Polish Academy of Science, Postępu 36A, 05-552 Jastrzębiec, Poland; (I.B.); (M.Ł.); (J.O.H.)
- PM Research Center, Väpnaregatan 22, 58649 Linköping, Sweden
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Rudziński M, Ławiński M, Gradowski Ł, Antoniewicz AA, Słodkowski M, Bedyńska S, Kostro J, Singer P. Kidney stones are common in patients with short-bowel syndrome receiving long-term parenteral nutrition: A predictive model for urolithiasis. JPEN J Parenter Enteral Nutr 2022; 46:671-677. [PMID: 33938015 DOI: 10.1002/jpen.2133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND In short-bowel syndrome (SBS) treated with parenteral nutrition (PN), multiple complications can occur. The etiology of kidney stones may be linked to the underlying disease thrombosis, surgical complications, complications of therapy for cancer, Crohn's disease, metabolic abnormalities resulting from morphological and functional changes in the gastrointestinal tract, and to treatment used. We analyzed all these parameters in a large cohort of patients receiving home PN (HPN), to define the incidence of stones and groups of patients particularly at risk of stone formation. One of the objectiveswas to develop a predictive model of urolithiasis. METHODS This observational retrospective study included 459 patients with SBS recieving HPN in a single center. Patient records were evaluated for demographics, SBS etiology, and underlying disease, anatomy of the gastrointestinal tract, intestinal failure classification, nutrition regimen, and presence of urolithiasis. RESULTS Kidney stones were diagnosed in 24% of patients. Nodifferences in incidence were noted between the various etiologic groups. The incidence in patients with a colon in continuity and those with an end stoma was similar. The length of residual small bowel did not play a role in stone formation. There were no differences between patients according to the severity of intestinal failure. In patients treated with PN and limited oral feeding, the risk of urolithiasis was twice as high as in patients receiving PN only. CONCLUSIONS Patients developed urolithiasis with no relation to the SBS etiology. The risk of kidney stone formation was higher in patients recieving PN with oral feeding.
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Affiliation(s)
- Marcin Rudziński
- Department of Urology, Multidisciplinary Hospital Międzylesie, Warsaw, Poland
| | - Michał Ławiński
- Department of General Surgery, Gastroenterology and Oncology, Medical University of Warsaw, Warsaw, Poland
- Institute of Genetics and Animal Biotechnology Polish Academy of Sciences, Jastrzębiec, Poland
| | - Łukasz Gradowski
- SWPS University of Social Sciences and Humanities, Warsaw, Poland
| | - Artur A Antoniewicz
- Department of Urology, Multidisciplinary Hospital Międzylesie, Warsaw, Poland
| | - Maciej Słodkowski
- Department of General Surgery, Gastroenterology and Oncology, Medical University of Warsaw, Warsaw, Poland
| | - Sylwia Bedyńska
- SWPS University of Social Sciences and Humanities, Warsaw, Poland
| | - Justyna Kostro
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdańsk, Gdańsk, Poland
| | - Pierre Singer
- Department of General Intensive Care and Institute for Nutrition Research, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Tel Aviv University, Tel Aviv, Israel
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Kot D, Ławiński M, Słodkowski M, Kagan I, Hellerman M, Theilla M. Effects of Sexual Function, Social Media Use, and Self-Efficacy on Quality of Life Among Home Parenteral Nutrition Patients. JPEN J Parenter Enteral Nutr 2020; 45:991-998. [PMID: 32700380 DOI: 10.1002/jpen.1969] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 07/12/2020] [Accepted: 07/16/2020] [Indexed: 01/04/2023]
Abstract
BACKGROUND Quality of life (QOL) of home parenteral nutrition (HPN) patients is a critical issue for functioning and survival. This study evaluates the roles of sexual function (SF), self-efficacy (SE), and the use of social media (USM) in the QOL of HPN patients. MATERIALS AND METHODS The study model investigates the independent variables USM and SF and the dependent variable QOL, and SE is a mediator variable between SF and USM. RESULTS We included 203 participants with HPN who completed self-administered, validated questionnaires for QOL, SF, SE, and USM. Statistical analysis included a t-test, Sobel test, bootstrapping method, and Pearson correlations between variances. The mean HPN duration was 10.5 ± 8 years. Results show a significant correlation between QOL scores and SF (P = .001). USM was positively correlated with SE (P = .001). SE as a mediator between USM and SF was supported by significant results in the Sobel test. Patients with a stoma were significantly less sexually active and had lower SE ratings than those without a stoma. CONCLUSION Physical changes that affect SE and boost social relationships by allowing emotional support through social networks are important factors for QOL improvement. These findings may guide health professionals in the management of HPN patients.
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Affiliation(s)
- Dominika Kot
- Department of General, Gastroenterological and Oncological Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Michał Ławiński
- Department of General, Gastroenterological and Oncological Surgery, Medical University of Warsaw, Warsaw, Poland
- Institute of Genetics and Animal Biotechnology of the Polish Academy of Sciences, Warsaw, Mazowieckie, Poland
| | - Maciej Słodkowski
- Department of General, Gastroenterological and Oncological Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Ilya Kagan
- Department of General Intensive Care and Institute for Nutrition Research, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Affiliated with the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Moran Hellerman
- Department of General Intensive Care and Institute for Nutrition Research, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Affiliated with the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Miriam Theilla
- Department of General Intensive Care and Institute for Nutrition Research, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Affiliated with the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Nursing Department, Steyer School of Health Professions, Sackler School of Medicine, Tel Aviv University, Israel
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Ławiński M, Skroński M, Ukleja A, Andrzejewska M, Nyckowski P, Słodkowski M, Theilla M, Singer P. MON-PO600: Indirect Calorimetry in Oncological Surgery Liver Patients – Comparison of Resting Energy Expenditure with Prediction Equations. Clin Nutr 2019. [DOI: 10.1016/s0261-5614(19)32433-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Theilla M, Ławiński M, Kot D, Słodkowski M, Kagan I, Singer P. MON-PO433: Examine the Role of Health Perception, Self-Efficacy and Use of Social Media on QOL of Home Parenteral Nutrition (HPN) Patients in Poland and Israel. Clin Nutr 2019. [DOI: 10.1016/s0261-5614(19)32266-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Ukleja A, Andrzejewska M, Skroński MK, Ławiński M, Włodarek D, Korba M, Nyckowski P, Słodkowski M. Assessment of resting energy demand and body composition in oncological patients undergoing partial resections of the liver. Prz Gastroenterol 2019; 14:62-68. [PMID: 30944679 PMCID: PMC6444109 DOI: 10.5114/pg.2019.83427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Accepted: 11/12/2018] [Indexed: 12/04/2022]
Abstract
INTRODUCTION The metabolism of the body is a complicated process. The most important organ of the organism that affects the intensity of changes is the liver. An effective treatment method of primary and metastatic tumours is a partial resection of the organ. The analysis of changes in the body composition of patients undergoing this type of treatment allows identification of problems coexisting with the underlying disease. AIM To evaluate changes in the parameters of body composition and the amount of resting metabolism. MATERIAL AND METHODS The study group consisted of 87 patients who underwent resection of changes in the liver or thermoablation of focal lesions during hospitalisation. RESULTS Analysis of the data showed that the surgical intervention contributes to a statistically significant (p < 0.05) decrease in the value of the phase angle. A significant increase was noted within the extra cellular water content. The amount of resting metabolism in the postoperative period did not differ significantly; however, there was an upward trend in women and a downward trend in men. CONCLUSIONS Surgical resection of lesions aimed at extending the survival of patients are performed more and more often, while the consequences of these operations are not sufficiently known. The adverse effect of resection treatments on body composition parameters, mainly imaged by decreasing the phase angle value, should be minimised. Effects on metabolism remain ambiguous because no significant changes have been demonstrated in the postoperative period.
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Affiliation(s)
- Anna Ukleja
- Department of Clinical Dietetics, Medical University of Warsaw, Warsaw, Poland
| | - Marta Andrzejewska
- Department of General, Gastroenterological, and Oncological Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Michał K. Skroński
- Department of General, Gastroenterological, and Oncological Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Michał Ławiński
- Department of General, Gastroenterological, and Oncological Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Dariusz Włodarek
- Department of Dietetics, Warsaw University of Life Sciences, Warsaw, Poland
| | - Michał Korba
- Department of General, Gastroenterological, and Oncological Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Paweł Nyckowski
- Department of General, Gastroenterological, and Oncological Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Maciej Słodkowski
- Department of General, Gastroenterological, and Oncological Surgery, Medical University of Warsaw, Warsaw, Poland
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Skroński M, Andrzejewska M, Fedosiejew M, Ławiński M, Włodarek D, Ukleja A, Nyckowski P, Słodkowski M. Assessment of changes in the body composition in patients qualified for the operational treatment of the primary and metastatic liver tumors with the use of bioelectric impedance. Pol Przegl Chir 2018; 90:1-5. [PMID: 30652693 DOI: 10.5604/01.3001.0012.4719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Resection is an optimal way of treatment of hepatic tumors and metastasis from another organ. The operational injury may influence on patients body composition examined by bioelectrical impedance (BIA). Analysis of parameters may be helpful in identifying early changes indicating of deterioration in nutritional status. THE AIM OF THE STUDY was to assess changes in body composition of patients before and after resection of liver tumors and potential radiofrequency ablation of lesions. MATERIAL AND METHODS The study included a group of 50 patients of the Department of General, Gastroenterological and Oncological Surgery, Medical University of Warsaw, who were qualified for radical surgical treatment of tumors within the liver. Data on water content, fat, muscle and cell mass were analyzed. RESULTS Comparing data obtained from patients before and after intervention in the liver, statistically significant (p <0.05) loss of intracellular water, muscle mass, cell mass, as well as adipose tissue, was demonstrated. The phase angle value in these patients also significantly changed, decreasing by an average of 0.61°. On the other hand, the increase in content was noted in the case of extracellular water. CONCLUSIONS Surgical intervention within the liver causes noticeable, unfavorable changes in the body composition, as evidenced by the reduction in the value of muscle mass, as well as cellular mass, resulting in a decrease in the phase angle. Bioelectric impedance is a suitable method for assessing changes in body composition of patients undergoing liver resection and is useful in clinical practice. It is advisable to conduct further research in the group of patients undergoing invasive treatment of the liver due to: an increasing number of such operations and centers where this type of surgical intervention is performed.
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Affiliation(s)
- Michał Skroński
- Warszawski Uniwersytet Medyczny I Wydział Lekarski Katedra i Klinika Chirurgii Ogólnej, Gastroenterologicznej i Onkologicznej
| | - Marta Andrzejewska
- Warszawski Uniwersytet Medyczny I Wydział Lekarski Katedra i Klinika Chirurgii Ogólnej, Gastroenterologicznej i Onkologicznej
| | - Małgorzata Fedosiejew
- Warszawski Uniwersytet Medyczny I Wydział Lekarski Katedra i Klinika Chirurgii Ogólnej, Gastroenterologicznej i Onkologicznej
| | - Michał Ławiński
- Warszawski Uniwersytet Medyczny I Wydział Lekarski Katedra i Klinika Chirurgii Ogólnej, Gastroenterologicznej i Onkologicznej
| | - Dariusz Włodarek
- Szkoła Główna Gospodarstwa Wiejskiego Wydział Nauk o Żywieniu Człowieka i Konsumpcji Zakład Dietetyki
| | - Anna Ukleja
- Warszawski Uniwersytet Medyczny Wydział Nauki o Zdrowiu Zakład Dietetyki Klinicznej
| | - Paweł Nyckowski
- Warszawski Uniwersytet Medyczny I Wydział Lekarski Katedra i Klinika Chirurgii Ogólnej, Gastroenterologicznej i Onkologicznej
| | - Maciej Słodkowski
- Warszawski Uniwersytet Medyczny I Wydział Lekarski Katedra i Klinika Chirurgii Ogólnej, Gastroenterologicznej i Onkologicznej
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Ławiński M, Kot-Mielczarska E, Gradowska A. Quality of life of patients on chronic parenteral nutrition before and after gastrointestinal tract continuity restoration. Pol Przegl Chir 2017; 87:153-9. [PMID: 26146113 DOI: 10.1515/pjs-2015-0037] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Indexed: 11/15/2022]
Abstract
UNLABELLED The issue of the quality of life considering patients with a temporary or permanent intestinal stoma, as well as the necessity for chronic parenteral nutrition at home remain a poorly understood problem. Daily care of the intestinal stoma and the need to comply with sterile procedures required for parenteral nutrition require such patients to commit their time, which secondarily is associated with the broad aspects of social and personal life. The aim of the study was to analyse the quality of life considering patients with intestinal stomas subjected to chronic parenteral nutrition, before and after gastrointestinal tract continuity restoration. MATERIAL AND METHODS The survey was conducted between May and July, 2014 on a group of 71 patients (33 female and 38 male) who were under the care of the Department of General Surgery and Clinical Nutrition, Warsaw Medical University, operated during the period between 2007 and July, 2014 with a present stoma (32 patients - 45%), as well as after stoma closure (39 patients - 55%). The analysed questionnaire contained 31 questions, and the SF-36 questionnaire was additionally used, determining the quality of life. RESULTS Analysis of the study material showed differences in the quality of life, considering three most important determinants. Significantly worse assessment of the quality of life was reported by patients with a stoma and subject to intravenous nutrition (83.2±30.5), as compared to those after stoma closure subject to normal nutrition (52.3±33.8). Based on the SF-36 questionnaire differences between patients with a stoma and those without amounted to t(69)=2.84 (p=0.006) demonstrating that those with a stoma reported a lower quality of life. Analysis between younger and older patients, based on the SF-36 questionnaire (t(62.87)=2.49; p=0.016) showed that younger patients achieved lower results, considering dissatisfaction with life (61.55±27.5), as compared to the elderly (80.8±36.9). CONCLUSIONS The group of patients without a stoma seem to be more independent- the vast majority do not use the help of family members (43.6%), or friends (64.1%). Patients with a stoma more often withdraw from social life. The factor that mostly reduces the quality of life is the presence of a stoma, which impairs daily functioning a lot more than the sterile procedures associated with parenteral nutrition. All patients after stoma closure consider that their overall functioning has significantly improved.
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Theilla M, Ławiński M, Cohen J, Hadar E, Kagan I, Perkewick M, Singer P. Safety of home parenteral nutrition during pregnancy. Clin Nutr 2015; 36:288-292. [PMID: 26708728 DOI: 10.1016/j.clnu.2015.12.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Revised: 11/24/2015] [Accepted: 12/01/2015] [Indexed: 11/18/2022]
Abstract
BACKGROUND & AIMS Few studies have examined the effect of total parenteral nutrition which is lipid-based given throughout pregnancy to patients unable to obtain adequate nutrition by the oral route. In this study we examined the use of lipid-based home parenteral nutrition (HPN) in 7 pregnant women, commenced either before or during pregnancy, and their intra-pregnant course as well as a 2-year follow-up of their offspring is described. METHODS HPN was formulated on an individual basis and protein administered in a dose of 0.8-1.1 g/kg during the three trimesters. Lipid emulsions included long chain triglycerides or olive-oil based formulae and all patients received trace elements. Data were collected during the course of pregnancy and at birth while infants were followed for a period of between 6 months and 2 years using medical records and questionnaires. RESULTS In total, we studied 9 pregnancies (in 7 women). HPN was administered for a median of 9 months (range 3-9 months). The mean energy provided during the 1st, 2nd and 3rd trimester was 9297 ± 2797 kcal/week, 9148 ± 2629 kcal/week and 8564 ± 4059 kcal/week resp. The mean increase in weight during the pregnancy was 9 ± 5 Kg. The only complications noted during the pregnancy consisted of 3 episodes of catheter-related infections which were successfully treated by antibiotics. The infants were born after a mean of 38.00 ± 1.55 weeks of gestation, with a mean first minute Apgar score of 8.7 ± 1.8 which increased to 9.8 ± 0.4 after 10 min. The mean infant birth weight was 2.45 ± 0.37 kg. No complications were noted at birth apart from one infant who suffered from torticollis which resolved spontaneously. During follow up, a decrease in hemoglobin related to low iron levels was noted in 1 infant, 2 infants were noted to be allergic to pollen and one underwent a scrotal hernia reduction. No developmental problems have been observed, neither physiological nor psychomotor, over the 2-year follow-up period. CONCLUSIONS The authors suggest, based on, the current study, that lipid-based HPN for pregnant women is a safe method for meeting the nutritional demands of both mother and fetus, and may be administered throughout the pregnancy.
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Affiliation(s)
- Miriam Theilla
- Department of General Intensive Care and Institute for Nutrition Research, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Affiliated to the Sackler School of Medicine, Tel Aviv University, Israel; Nursing Department, Steyer School of Health Professions, Sackler School of Medicine, Tel Aviv University, Israel
| | - Michał Ławiński
- Department of General Surgery and Clinical Nutrition, Medical University of Warsaw, Poland
| | - Jonathan Cohen
- Department of General Intensive Care and Institute for Nutrition Research, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Affiliated to the Sackler School of Medicine, Tel Aviv University, Israel
| | - Eran Hadar
- Department of Maternal Fetal Medicine Unit, Helen Shneider Hospital for Women, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Affiliated to the Sackler School of Medicine, Tel Aviv University, Israel
| | - Ilya Kagan
- Department of General Intensive Care and Institute for Nutrition Research, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Affiliated to the Sackler School of Medicine, Tel Aviv University, Israel
| | - Marek Perkewick
- Department of General Surgery and Clinical Nutrition, Medical University of Warsaw, Poland
| | - Pierre Singer
- Department of General Intensive Care and Institute for Nutrition Research, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Affiliated to the Sackler School of Medicine, Tel Aviv University, Israel.
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Ławiński M, Majewska K, Gradowski Ł, Fołtyn I, Singer P. A comparison of two methods of treatment for catheter-related bloodstream infections in patients on home parenteral nutrition. Clin Nutr 2015; 34:918-22. [DOI: 10.1016/j.clnu.2014.09.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Revised: 09/04/2014] [Accepted: 09/22/2014] [Indexed: 10/24/2022]
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Ławiński M, Majewska K, Fołtyn I, Gradowska A. The efficacy of alcohol-antibiotic lock therapy for treatment of catheter related bloodstream infections in patients receiving home parenteral nutrition. Pol Przegl Chir 2015; 86:563-8. [PMID: 25803055 DOI: 10.1515/pjs-2015-0002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Indexed: 11/15/2022]
Abstract
UNLABELLED In patients with chronic gastrointestinal tract failure, requiring access to the venous system, the subsequent catheter re-insertion are leading to large veins thrombosis impeding or preventing the insertion of another catheter and exposing patients to the risk of complications. Understanding the pathophysiology of catheter-related infections, enabled to use methods allowing to eradicate the source of infection without removal and replacement of central catheter with a new one. In our center, for many years we have been using an alternative method involving implementation of the alcohol-antibiotic lock in the treatment of infections. This method is based on the assumption that the destruction of biofilm with concentrated alcohol will enable antibiotic penetration and killing other microorganisms. Treatment with alcohol-antibiotic lock lasts from 8 to 10 days and involves filling the catheter with 96% alcohol followed by a solution of the antibiotic of high concentration. The aim of the study was to evaluate the efficacy of treatment of catheter-related bloodstream infections with two methods (catheter replacement with a new one and the alcohol-antibiotic lock therapy) in patients receiving home parenteral nutrition (HPN). MATERIAL AND METHODS 428 HPN in the period from 1 January 2005 to 31 December 2010. Among which 240 (56%) of women with an average age of 56.5 ± 16 years and 188 (44%) of men with an average age of 54 ± 17 years. The indications to HPN were as follows: short bowel syndrome in 298 (70%) patients, multilevel obstruction of the gastrointestinal tract in 52 (12%), postoperative gastrointestinal fistulas in 48 (11.2%), malabsorption syndrome in 17 (4%), motility disorders in 6, cachexia in 4 and radiation enteritis in 3 patients. RESULTS In 247 (57.5%) from 428 patients, no episode of catheter-related bloodstream infection was found, while 181 were diagnosed with 352 episodes of catheter-related bloodstream infections. In 40 (9.4%) from 428 patients, 168 (47.8%) episodes have been found - almost a half. The mean duration of treatment of patients receiving home parenteral nutrition, starting from the first episode of catheter-related bloodstream infection, in 48 patients treated with the lock was equal to 1053+748 days, and in 133 patients treated with catheter replacement was equal to 952+709 days (t-test p = 0.62). CONCLUSIONS The survival time of patients treated with alcohol-antibiotic lock is the same as in patients treated with the catheter removal and insertion of the new one. The use of alcohol-antibiotic lock to treat catheter-related bloodstream infections in order to eradicate selected microorganisms that colonize the lumen and cause an infection, is as effective as catheter replacement with a new one.
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Błasiak R, Ławiński M, Majewska K, Gradowska A. Damage of Central Catheters in Home Parenteral Nutrition Patients. Polish Journal of Surgery 2015; 87:579-86. [DOI: 10.1515/pjs-2016-0006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Indexed: 11/15/2022]
Abstract
AbstractAccording to the ESPEN and ASPEN guidelines, in the case of a long-term (>3-month) parenteral nutrition should be administered via a subcutaneous central venous catheter (CVC). There are three types of mechanical complications of tunnelled central catheter: catheter rupture, occlusion by TPN depositing and thrombofibrotic occlusion.was to analyse the incidence of complications central catheter in a group of patients receiving HPN.Between January 2010 and June 2014, HPN was conducted in 584 patients (306 women and 278 men), ninety-nine patients were enrolled in the study: 67 women and 32 men in whom mechanical complications of central catheters were found.Among 99 patients, 71 used the tunnelled Broviac catheter. Groshong catheters were placed only in patients receiving parenteral nutrition due to cancer. Analyses have shown differences between the older and younger in the number of mechanical complications. Younger patients were found to have a larger number of catheter complications (1.6 ± 1.1) in comparison with older patients (1.3 ± 0.7). The catheter that was most commonly damaged was the Broviac catheter 76.8%. The most frequent type of mechanical complications was catheter rupture 64.81%.Mechanical complications of tunnelled central catheters in HPN patients can be repaired in an outpatient setting in half of the cases, which enables continuation of parenteral nutrition without the need to hospitalise the patient. The centres that conduct HPN should offer 24-hour care and help in case of problems with the central venous line to the patients.
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Niemyjska S, Ukleja A, Ławiński M. Evaluation Of Irritable Bowel Syndrome Symptoms Amongst Warsaw University Students. Polish Journal of Surgery 2015; 87:252-9. [DOI: 10.1515/pjs-2015-0050] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Indexed: 11/15/2022]
Abstract
AbstractIrritable bowel syndrome (IBS) belongs to functional gastrointestinal disorders and is characterized by abdominal pain and change in stool consistency and/or bowel habits. Etiological factors include gastrointestinal peristalsis disturbances, visceral hypersensitivity, chronic inflammation of the mucous membrane, dysbacteremia, intestinal infections, psychosomatic and nutritional factors. Gastrointestinal motility disturbances in case of IBS are manifested by the inhibition of the intestinal passage, which favors the development of constipation or occurrence of diarrhea.was to evaluate IBS symptoms and demonstrate the relationship between physical activity and place of residence amongst Warsaw University students.The study was conducted in march, 2014 using a specific questionnaire, amongst Warsaw University students. The study group comprised 120 female patients, aged between 19 and 27 years (M=23.43; SD=1.29). The chi-square test was used for analysis, p<0.05 was considered as statistically significant.The BMI of investigated patients ranged between 16.30-31.22 kg/mIBS symptoms are common amongst Warsaw University students. In case of respondents with low physical activity, abdominal pain or discomfort occurred more often. It has been demonstrated that diet and stress might contribute to the occurrence of abdominal symptoms, being evidence of IBS.
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Adryjanek R, Majewska K, Fołtyn I, Ławiński M, Pertkiewicz M. PP174-SUN ETHANOL CONSUMPTION AND CONSEQUENCES IN HPN PATIENTS. Clin Nutr 2013. [DOI: 10.1016/s0261-5614(13)60219-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Koper I, Majewska K, Ławiński M, Fołtyn I, Śliwka J, Kaczanowska J, Pertkiewicz M. PP211-MON RESULTS OF HOME ENTERAL NUTRITION. Clin Nutr 2013. [DOI: 10.1016/s0261-5614(13)60521-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Majewska K, Kociszewska D, Pałuba J, Fołtyn J, Adryjanek R, Omidi M, Ławiński M, Pertkiewicz M. PP182-MON CATHETER RELATED BLOOD STREAM INFECTIONS (CRBSI) IN HPN PATIENTS – OCCURRENCE AND OUTCOME. Clin Nutr 2013. [DOI: 10.1016/s0261-5614(13)60493-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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