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Malnutrition is known to impair the wound healing process, contributing to wound chronicity. Venous leg ulcers (VLU) represent the most common chronic leg wounds and become epidemiologically relevant in an ageing society.This study investigated the effects of a complex treatment, including a specialized oral nutritional supplementation, on the dynamics of the VLU healing.This 12-week prospective study included 35 individuals with VLU. The patients received professional wound care including specialized dressings. To ensure an optimal nutritional status for wound healing, the patients were asked to drink three times per day 200 ml of an energy-dense protein-rich formula containing arginine, zinc, and vitamins. The healing dynamics were assessed by planimetry.Complete wound healing was achieved in 6 patients, and the median ulcer area decreased from 26.5 cmThis study shows that a complex intervention involving nutritional support contributes to a significant progress in VLU healing and promotes the well-being of affected individuals.

Quality of life is an important aspect in the fields of medicine and health sciences. It is presented as a complex concept. Therefore, it is presented in various ways. Its interpretation and definition depends mainly on the discipline and area of study. Very often, the quality of life is also defined in the context of the well-being that a person experiences during his life. It depends on the state of health. It can take into account a wide variety of problems, because neurological diseases bring about such unwanted effects as pain, the need for medical and rehabilitation stays, social isolation, and one of the worst consequences, i.e. shortening life expectancy. Therefore, it is important to conduct research on the quality of life among neurological patients. The results obtained from the conducted and continued research on large groups of patients could constitute a specific compendium of knowledge about the situation of patients, their needs and the perceived quality of life. Therefore, the aim of this study is to present research on the assessment of quality of life and its predictors among neurological patients. (JNNN 2020;9(3): 114–118) Key Words: neurology disease, patients, predictors, quality of life

This study investigated the status of job burnout, work-related depression and job satisfaction among neurological and neurosurgical nurses in Poland.A cross-sectional and multicentre study.The sample consisted of 206 neurological and neurosurgical nurses, all of whom completed a self-report questionnaire designed by the authors.The results revealed a work-related burnout incidence of 32%, colleague-related burnout incidence of 44.2% and patient-related burnout incidence of 22.8%. Nurses working in neurological departments were statistically over three times more likely to struggle with colleague-related burnout than nurses working in neurosurgical departments were. Further, work-related burnout was higher in people aged above 54 years than those in the youngest age category. Nonetheless, 71.8% of the nurses expressed satisfaction with their work. In sum, our results indicated that job burnout is common among registered nurses and that personal (age) and workplace (type of ward, distance to work, experience and shift work) factors contributed to symptoms of burnout.

Venous leg ulcers are complex, and their multifactorial etiology make successful treatment a difficult and long process. Nonhealing ulcers are the greatest challenge because they are resistant to standard therapies. In this study, we analyzed whether monitoring the temperature of the ulcered limb wound area could benefit the diagnosis of the wound's tendency to heal (estimating the presence of a healing or nonhealing wound) in patients with two-sided venous leg ulcers. This prospective, 12-week observational study included 57 adult individuals with chronic venous leg ulcers. The dynamics of wound healing was assessed by planimetry and infrared thermography every two weeks. We analyzed temperatures measured at three marked areas-the wound, the periwound skin, and the reference area. An initial wound area larger than 1 cm2 was associated with a temperature increase of 0.027 °C in the periwound skin. A 1-cm2 decrease in the wound area was associated with a 0.04 °C decrease in the temperature difference between the periwound skin and wound. A strong positive relationship was identified for both the bacteriology variables (the presence of bacteria: temperature increase in the periwound skin of 0.4 °C, p < 0.001; the number of bacterial species in a wound, temperature increase of 0.95 °C, p < 0.001). The temperature in the reference area was significantly correlated with the failure of the superficial and perforating veins (temperature increase of 0.69 °C, p = 0.04). This study reports that the assessment of the temperature a limb may be beneficial in predicting whether an ulcer is a healing or a nonhealing ulcer. The decrease in the temperature differences between the areas referred to as healing wounds was the only beneficial prognostic marker. Other temperature differences in the periwound skin were caused by disorders, such as multibacterial wound infections and superficial venous inflammation.

Structural and chemical alterations in living tissue are reflected in electrical impedance changes. However, due to the complexity of skin structure, the relation between electrical parameters and physiological/pathological conditions is difficult to establish. The impedance dispersion reflects the clinical status of the examined skin tissue and, therefore, it is frequently used in a non-invasive evaluation of exposing skin to various factors. The method has been used to assess the effect of the fish collagen on the skin of patients suffering from the leg ulcer. Therefore, from a number of different approaches to skin electrical impedance dispersion, the one considered to be safe was selected and applied. This paper presents a short review of different technical approaches to in vivo electrical impedance measurements, as well as an analysis of the results and the effect of fish collagen locally administered on human skin.

Venous ulcers are difficult to heal chronic wounds. Most challenging are the non-healing and recurrent ulcers, because of which we are seeking for therapies that stimulate and support their healing.To assess the efficacy of fish collagen and its impact on the process of healing of venous leg ulcers.This 12-week randomized single-centre study included a total of 97 adults with venous leg ulcer, randomized into two groups: the study group (We observed a greater number of complete ulcer healing in the study group (week 12: 29.2% vs. 22.4%; week 24: 52.1% vs. 36.7%). Faster healing time in the study group was observed in both big and small ulcers. The thermographic analysis showed statistically significant reduction in periwound inflammation among patients from the study group (Thermographic analysis showed better wound healing effects in the group using tropocollagen. Significant impact of collagen on the healing process was observed only after 8 weeks of application.

The development of the field related to the treatment of wounds has resulted in the appearance of new antimicrobial active ingredients.To analyse, evaluate and systematize the available scientific evidence of the effectiveness and safety of antiseptic preparations intended for the treatment of chronic wounds.We conducted a literature review using the advanced search engine in the PubMed database. We used a combination of two English keywords, i.e.: "antiseptic" and "chronic wound". We have selected only clinical, randomized controlled trials.We obtained a total of 825 items (674 full-text works). We included 29 studies in the review. The most frequently evaluated preparation was octenidine dihydrochloride and povidone iodine (pharmacological drugs). Preparations containing polyhexanide, products based on hypochlorite, reactive oxygen species, 1% acetic acid, and specialized antibacterial dressings were also assessed. The new generation of antimicrobial preparations were highly effective, both in the prevention and treatment of infections, and were well tolerated by the tissues and do not interfere with the healing process. The best tolerated and most effective antiseptic was OCT/PE. For cleaning, we recommend OCT-based irrigation fluids, PHMB, or hypochlorite. The maintenance of the antimicrobial effect during the therapy was ensured by a compatible dressing.An antiseptic alone is not effective enough and the therapeutic effect depends to the greatest extent on properly selected causal therapy, preceded by thorough diagnostics.

Background: The aim of the study was to analyze the dynamics of pain severity and its predictors in a group of patients with chronic venous leg ulcers. Methods: A 12-week longitudinal study included 754 patients with chronic venous leg ulcers. Subjective severity of pain was measured at weekly intervals with an 11-point visual analogue scale (VAS). Results: A significant decrease in VAS scores has been observed throughout the entire analyzed period. Higher severity of pain during follow-up was independently predicted by the presence of pus and/or unpleasant smell from the ulceration during the first visit, as well as by the occurrence of posterior and/or circumferential ulcers. The presence of ulcer redness during the first visit was associated with lesser pain severity, also, a significant interaction effect between the ulceration redness and warmth was observed. Conclusions: Implementation of complex holistic care may contribute to a substantial decrease in the occurrence and severity of pain in a patient with venous leg ulcers. Pain control seems to depend primarily on clinical parameters and topography of venous ulcers. The predictors of pain severity identified in this study might be considered during the planning of tailored care for patients with venous leg ulcers.

Epidemiological data regarding venous leg ulcers, specifically low healing rates and frequent recurrences (occurring in 20-70% of the cases), seems surprising regarding recent progress in the management of this complication. The aim of this review is to present the current state of knowledge on venous leg ulcer management, especially compression therapy. Treatment of venous ulcers should be comprehensive and wellorganized, based on modern standards and up-to-date, and should involve elaborated treatment strategies. A thorough diagnostic process followed by adequate treatment may result in marked improvement of the outcomes, with up to 67% healing rate at 12 weeks and up to 81% within 24 weeks. Continuation of therapeutic activities after the ulceration has been healed is reflected by a marked decrease in the recurrence rates, down to 16% whenever the patient is actively involved in the therapeutic process. Furthermore, early diagnosis and appropriate causal treatment may prevent progression of the illness.

Introduction : The results of previous studies suggest that the quality of life in patients with lower limb ulcerations is markedly poorer than in the general population – with regard to physical, mental and social spheres. This complex character of that parameter necessitates comprehensive analyses of its specific aspects, including the level of the acceptance of illness and associated pain symptoms. Aim : To compare the quality of life and its specific dimensions in patients with lower limb ulcerations of various etiology. Material and methods : Patients with the ulcerations resulting from venous (n = 101) or arterial pathologies (n = 98), or having mixed etiology (n = 99) were examined with the: 1) Skindex-29 instrument, 2) Acceptance of Illness Scale, 3) Beliefs about Pain Control Questionnaire, and 4) Coping Strategy Questionnaire. Results : The average quality of life related to physical symptoms was significantly higher in patients with venous ulcerations. Patients with ulcerations of arterial etiology more frequently used catastrophizing, and less often ignored pain sensations, used coping self-statements, and increased their activity levels; they were characterized by lower levels of control and poorer ability to decrease the pain. The internal locus of pain control increased proportionally to the global quality of life scores and levels of illness acceptance. Control over pain and ability to decrease the pain were more effective in individuals who used ignoring pain sensations, increasing the activity level, coping self-statements, and reinterpreting pain than in those using catastrophizing or praying and hoping strategies. Conclusions : Physical complaints seem to be the basic determinant of the quality of life in patients with the lower limb ulceration, irrespective of its etiology.

BACKGROUND While data on the long-term (e.g., 1 year and subsequent years) outcomes of intracranial aneurysms treatment is relatively well-documented mainly in the clinical aspect (comparability of treatment, mortality, and complications), little is known about the early results, in terms of the functional outcome. OBJECTIVES The aim of the study was to analyze the use of Functional Capacity Scale (FCS) in the evaluation of patients in the early period after endovascular treatment of intracranial aneurysms. MATERIAL AND METHODS The study was conducted in the Neurosurgery Clinic, University Hospital Collegium Medicum in Bydgoszcz, on a group of 118 consecutively admitted patients with the diagnosis of intracranial aneurysm, qualified for treatment using the endovascular method (embolization). The assessment was performed twice. In the clinical assessment the Glasgow Coma Scale (GCS) was used to evaluate the level of consciousness and the Hunt and Hess Scale (H&H) to assess the patient's condition. To assess the final outcome and early functional capacity Glasgow Outcome Scale (GOS), Barthel Index (BI), Modified Rankin Scale (mRS) and the new Functional Capacity Scale were used. RESULTS The assessment performed with the FCS was comparable to the assessment conducted with standardized tools such as BI, mRS or GOS. The clinical condition assessed with the GCS (p < 0.001) and H&H (p < 0.001) differentiates the functional condition assessed using the FCS. Statistically significant correlations were found between FCS and BI (r = -0.78), GOS (r = -0.69) and mRS (r = 0.68). CONCLUSIONS The study indicates that the FCS correlates with other scales used in the assessment of patients with intracranial aneurysm, which means that the proposed tool can be applied successfully in practice. However, further randomized multicenter studies are necessary in order to clarify the final conclusion.

Intermittent claudication is a symptom of atherosclerosis of the lower limbs (peripheral arterial disease (PAD)) and is characterized by pain and cramps of lower limb muscles during exercise. Claudication leads to a reduction in physical activity of patients. PAD is a systemic disease. Atherosclerotic lesions located in the arteries of the lower limbs not only pose the risk of the ischemic limb loss, but above all, they are an important prognostic factor. Patients with claudication are at significant risk of cardiovascular complications such as infarcts or strokes. Comprehensive rehabilitation of patients with intermittent claudication based on the current TASC II (Inter-Society Consensus for the Management of Peripheral Arterial Disease) guidelines, ESC (European Society of Cardiology) guidelines, and AHA (American Heart Association) guidelines includes supervised treadmill training, training on a bicycle ergometer, Nordic Walking, resistance exercises of lower limb muscles, and exercises of upper limbs. A trained, educated, and motivated patient has a chance to improve life quality as well as life expectancy.

TWstęp: Wskaźnik kostka–ramię (ABI) wyraża stosunek ciśnienia skurczowego w tętnicach zlokalizowanych na podudziach, tj. tętnicy piszczelowej tylnej bądź tętnicy grzbietowej stopy, do ciśnienia panującego w tętnicy ramiennej.Celem niniejszej pracy było porównanie wartości ABI mierzonego za pomocą detektora dopplerowskiego fali ciągłej (DDFC) oraz urządzenia BOSO ABI-SYSTEM 100 (ABIs) u seniorów, a także próba określenia czynników determinujących wyniki badań w porównaniu z pacjentami młodszymi.Materiały i metody: Przedmiotem przeprowadzonego badania był pomiar ABI przy użyciu DDFC oraz urządzenia ABIs wśród pacjentów z przewlekłą niewydolnością żylną, niedokrwieniem kończyn dolnych oraz cukrzycą. Badania przeprowadzono po uzyskaniu zgody Komisji Bioetycznej nr KB 523/2016 z dnia 28.06.2017 r. przy Uniwersytecie Mikołaja Kopernika w Toruniu, Collegium Medicum w Bydgoszczy w okresie 28.06.2016–6.04.2017 r. Miejscem realizacji badań była Poradnia Leczenia Ran Przewlekłych w Szpitalu Uniwersyteckim nr 1 im. Ludwika Rydygiera w Bydgoszczy.Wyniki: Średnia wartość ABI wśród wszystkich badanych wyniosła w kończynach: prawej – 0,999 (DDFC), 0,954 (ABIs), lewej – 0,980 (DDFC) i 0,945 (ABIs); z odchyleniem standardowym 32,9% (DDFC), 30,1% (ABIs) dla kończyny prawej i 34,2% (DDFC), 32,1% (ABIs) dla kończyny lewej wartości średniej, co świadczy o dużym zróżnicowaniu wyników. Średnio najwyższy wskaźnik uzyskali pacjenci z cukrzycą (1,163 DDFC – dla kończyny prawej, 1,196 DDFC – dla kończyny lewej), a najniższy – badani z miażdżycą (0,750 – kończyna prawa, 0,684 – kończyna lewa DDFC).Wnioski: Wyniki pomiaru ABI za pomocą DDFC oraz ABIs nie wykazują istotnych statystycznie różnic mogących wpływać na postawienie diagnozy. Płeć, wiek, wykształcenie i analiza kliniczna pacjentów częściowo określiły wyniki testu ABI. Pacjenci w wieku 61–70 lat i najstarsi mieli najniższe wartości ABI.