Numer 17 (4) 2021
Redaktor: Eligiusz Madejski
Spis treści
Strony
Pobierz
Thomas Küpper,
Steven Rutten,
Audry Morrison,
Volker Schöffl
Femoral neck stress fracture during sport climbing
DOI: https://doi.org/10.5604/01.3001.0015.5750
1 – 5
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Słowa kluczowe

physiotherapy |injury |rehabilitation |sport climbing |diagnosis |occult fracture

Streszczenie

While the epiphyseal stress fracture of the finger’s middle phalanx is a known sport-specific injury occurring only in adolescent climbers, and in other locations it’s rare, no femoral neck stress fracture (FNSF) in sports climbing has yet been reported. An experienced female sport climber (37y, 160 cm, 45 kg, BMI 17.5) suffered from pain in the left inguinal region while climbing, and later, also required a stick to walk. Routine radiography missed the FNSF and it was many weeks before a MRI accurately provided that diagnosis. The time between the X-ray and MRI should have been minimized as it resulted in a delayed diagnosis, unnecessary pain and delayed healing. In this situation the initial clinical investigation, the patient’s history and the X-ray did not lead to a clear diagnosis, and the initial treatment was ineffective. Further investigation by MRI and / or CT scans should have taken place sooner and would have been essential.


INFORMACJE O AUTORACH


Thomas Küpper
Politechnika w Akwizgranie (Rheinisch-Westfälische Technische Hochschule Aachen), Niemcy
Komisja Medyczna Międzynarodowej Federacji Wspinaczki i Alpinizmu (UIAA MedCom), Szwajcaria

Steven Rutten
Therapeuticum Aachen-Laurensberg, Aachen, Niemcy

Audry Morrison
Komisja Medyczna Międzynarodowej Federacji Wspinaczki i Alpinizmu (UIAA MedCom), Szwajcaria
Royal Free London NHS Foundation Trust, UK

Volker Schöffl
Royal Free London NHS Foundation Trust, UK
Klinikum Bamberg, Niemcy
Uniwersytet Fryderyka Aleksandra w Erlangen i Norymberdze (Friedrich-Alexander-Universität Erlangen-Nürnberg), Niemcy
Micaela Tobler,
Christos T. Nakas,
Matthias P. Hilty,
Andreas Huber,
Tobias M. Merz,
Jacqueline Pichler Hefti
Plasmatic hemostasis at very high altitude — a thrombelastometric approach
DOI: https://doi.org/10.5604/01.3001.0015.5749
6 – 17
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Słowa kluczowe

hypobaric hypoxia |thrombelastometry |coagulation

Streszczenie

Introduction: Changes in blood coagulation during exposure to high altitude are not well understood and studies of activation and consumption of specific coagulation factors in hypoxic humans have yielded conflicting results. In this study we used thrombelastometry (TEM) which allows a global evaluation of clot formation and lysis process to study blood coagulation profiles in volunteers exposed to prolonged hypobaric hypoxia at extreme altitudes.

Material and methods: We conducted a prospective observational study in 39 healthy volunteers during a research expedition up to an altitude of 7050 m. Plasma based thrombelastometric measurements and standard coagulation parameters were performed at different altitudes.

Results: TEM measurements showed an increase in clotting time (CT) and maximum clot firmness (MCF) at high altitudes, paralleled by an increase in international normalized ratio (INR) and activated partial thromboplastin time (aPTT). Fibrinogen concentration increased until 6022 m. D-Dimer and Thrombin-Antithrombin complex (TAT) increased with time exposed to severe hypoxia. For both measurements high-est levels were found at 4844 m after acclimatization; in contrast, lower values were observed again at 7050m in the group of summiteers. Activated protein C resistance (APC-R) was slightly lowered at all altitudes.

Conclusion: Our results suggest that activation of the coagulation and fibrinolytic system occurs with increasing hypobaric hypoxia with concurrent use of coagulation factors indicating the occurrence of a consumption-coagulopathy phenotype.


INFORMACJE O AUTORACH


Micaela Tobler
Szpital Uniwersytecki w Bernie (Universitätsspital Bern), Szwajcaria
Uniwersytet w Bernie (Universität Bern), Szwajcaria


Christos T. Nakas
Szpital Uniwersytecki w Bernie (Universitätsspital Bern), Szwajcaria
Uniwersytet w Bernie (Universität Bern), Szwajcaria
Uniwersytet w Tesalii (Πανεπιστήμιο Θεσσαλίας), Grecja

Matthias P. Hilty
Uniwersytet Zuryski, Szwajcaria
Szpital Uniwersytecki w Zurychu (Universitätsspital Zürich), Szwajcaria


Andreas Huber
Prywatny Uniwersytet w Księstwie Liechtenstein (Private Universität im fürstentum Liechtenstein)
Kantonsspital Aarau, Szwajcaria

Tobias M. Merz
Szpital Uniwersytecki w Bernie (Universitätsspital Bern), Szwajcaria
Auckland City Hospital, Nowa Zelandia


Jacqueline Pichler Hefti
Szpital Uniwersytecki w Bernie (Universitätsspital Bern), Szwajcaria
Swiss Sportclinic, Szwajcaria

Mirco Gindulis,
Nikolaus C. Netzer,
Martin Burtscher,
Hannes Gatterer,
Christian K.M. Schmidt,
Audry Morrison,
Thomas Küpper
Extreme sleep fragmentation for 11 consecutive days and nights does not significantly alter total sleep time, and sleep stage distribution, during the continuous alpine downhill skiing world record
DOI: https://doi.org/10.5604/01.3001.0015.6743
18 – 24
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Słowa kluczowe

sport |continuous exercise |recovery |resilience |sleep stages |sleep deprivation |sleep fragmentation |expeditions

Streszczenie

Introduction: Extreme levels of sleep deprivation, fragmentation and management, are major problems in many sportive disciplines, ultramarathons, polar or extreme altitude expeditions, and in space operations.

Material and methods: Polysomnographic (PSG) data was continuously recorded (total sleep time and sleep stage distribution) in a 34-year-old male whilst performing the new world record in long-term downhill skiing. He napped only during the short ski lift rides for 11 days and nights.

Results: After an initial period of complete sleep deprivation for 24 hours, total sleep time and the total times of non-REM and REM achieved during the lift rides returned to standard values on the second day. PSG data revealed an average sleep time per 24 hours of 6 hours and 6 minutes. During daylight sleep was rarely registered. The subject experienced only two minor falls without injury and immediately resumed skiing.

Conclusion: In a healthy, trained, elite male athlete, sleep fragmentation over 11 consecutive days did not significantly impair the sleep, motor or cognitive skills required to perform a continuous downhill skiing world record after an initial adaptation phase.


INFORMACJE O AUTORACH


Mirco Gindulis
Politechnika w Akwizgranie (Rheinisch-Westfälische Technische Hochschule Aachen), Niemcy

Nikolaus C. Netzer
Uniwersytet Leopolda i Franciszka w Innsbrucku (Universität Innsbruck), Austria


Martin Burtscher
Uniwersytet Leopolda i Franciszka w Innsbrucku (Universität Innsbruck), Austria


Hannes Gatterer
Uniwersytet Leopolda i Franciszka w Innsbrucku (Universität Innsbruck), Austria


Christian K.M. Schmidt
Klinikum Landsberg am Lech, Landsberg, Niemcy

Audry Morrison
Komisja Medyczna Międzynarodowej Federacji Wspinaczki i Alpinizmu (UIAA MedCom), Szwajcaria
Royal Free London NHS Foundation Trust, UK

Thomas Küpper
Politechnika w Akwizgranie (Rheinisch-Westfälische Technische Hochschule Aachen), Niemcy
Komisja Medyczna Międzynarodowej Federacji Wspinaczki i Alpinizmu (UIAA MedCom), Szwajcaria
Weronika Gieniec,
Beata Jurkiewicz
Patient satisfaction with tele-advice during the COVID-19 pandemic
DOI: https://doi.org/10.5604/01.3001.0015.5520
25 – 29
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Słowa kluczowe

telemedicine |tele-visit |care quality |Covid-19 pandemic

Streszczenie

Introduction: The coronavirus pandemic has shed a whole new light on telehealth, which has become an alternative for diagnosis, monitoring, treatment and support without physical contact between patient and healthcare professional. The aim of this study was to examine patient satisfaction with medical services provided with tele-advice during the Covid-19 pandemic.

Material and methods: The study was conducted using our own questionnaire via Google Form that was correctly completed by 133 individuals between the ages of 18 and 76 years (mean 33.1 ± 13.1 years) who received medical services via tele-advice.

Results: Patients with chronic conditions were statistically more likely to seek specialist services via tele-advice (p = 0.003). Slightly less than one-third of respondents (n = 39; 29.3%) were asked during the tele-advice to attend the clinic / office in person to complete the visit with a physical examination. The vast majority of subjects (n = 95; 71.4%) responded that their health status had not changed since the pandemic and the introduction of tele-advice. Nearly half (n = 64; 48.1%) believed that their health problem had been solved via tele-advice. Only 4.5% of the respondents (n = 6) strongly agreed with the statement that “tele-advice enables proper diagnosis and matching of effective treatment”, 18.0% (n = 24) tended to agree. The vast majority of respondents believed that everyone should be able to choose between tele-advice and a traditional medical visit (n = 121; 91.0%).

Conclusions: The majority of people surveyed did not perceive a difference in their health since the pandemic and the introduction of tele-advice. Nearly half of respondents believed that their health problem had been resolved with a telemedicine consultation, with even fewer people convinced that “tele-advice allows for proper diagnosis and matching of effective treatment.” Patients would mostly like to have a choice between tele-visit and in-person visits, with no clear indication of the superiority of one or the other. Continuous improvement of current solutions will certainly contribute to increased patient satisfaction with the medical services provided.


INFORMACJE O AUTORACH


Weronika Gieniec
Akademia Tarnowska

Beata Jurkiewicz
Akademia Tarnowska
Sławomir Kozioł,
Piotr Wróbel,
Adrian Kozioł,
Joanna Witkoś
Professional competence of health educators with special consideration of physiotherapists
DOI: https://doi.org/10.5604/01.3001.0015.6742
30 – 36
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Słowa kluczowe

professional competence |health education |physiotherapists

Streszczenie

Health education consists in developing human knowledge, attitudes and skills and abilities, as well as in affecting human conduct in order to maintain or improve their state of health, whereas health promotion comprises propagation of a fit and healthy lifestyle including implementation of some prophylactic measures preventing the development of complaints, illnesses or diseases. Physiotherapists, who become health educators, play a significant role in attaining those objectives through undertaking some preventive measures; they also play a key part in encouraging their clients/patients to change their lifestyle and implement pro-health attitude towards life.


INFORMACJE O AUTORACH


Sławomir Kozioł
Krakowska Akademia im. Andrzeja Frycza Modrzewskiego


Piotr Wróbel
Krakowska Akademia im. Andrzeja Frycza Modrzewskiego


Adrian Kozioł
Krakowska Akademia im. Andrzeja Frycza Modrzewskiego

Joanna Witkoś
Krakowska Akademia im. Andrzeja Frycza Modrzewskiego

Akademia Tarnowska
ul. Mickiewicza 8
e-ISSN 2544-9117
33-100 Tarnów, Poland