Zasady stosowania silnie działających opioidów u pacjentów z bólem przewlekłym pochodzenia nienowotworowego – przegląd piśmiennictwa i zalecenia Polskiego Towarzystwa Badania Bólu, Polskiego Towarzystwa Neurologicznego i Polskiego Towarzystwa Medycyny Rodzinnej

Dobrogowski, Jan; Wordliczek, Jerzy; Szczudlik, Andrzej; Stępień, Adam; Drobnik, Jarosław; Leppert, Wojciech; Krajnik, Małgorzata; Woroń, Jarosław; Zajączkowska, Renata; Kocot-Kępska, Magdalena; Przeklasa-Muszyńska, Anna; Jakowicka-Wordliczek, Joanna; Kołłątaj, Marta; Janecki, Marcin; Pyszkowska, Jadwiga; Boczar, Krystyna; Suchorzewski, Marek; Susło, Robert; Mordarski, Sylwester; Malec-Milewska, Małgorzata

doi:10.5604/1640324x.1178726

Cited by 10 publications

(9 citation statements)

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“…in Poland, mental status alteration quite often results from acute or chronic ethanol abuse [24], acute drug abuse [25], and drug dependency [26]. on the other hand, paradoxically, physicians whose patients suffer from chronic pain need to be encouraged to introduce opioids into the treatment schemes, as they are often are overcautious or fear narcotic dependency or respiratory insufficiency [27]. Hypoxia is a well-known factor that severely alters mental status, causing deep confusion and hallucinations [28], which are now often seen as iatrogenic in origin [29] -the cause being accidental overdose or a failure in doctor-patient communication [30].…”

Section: Guidelines For Primary Care Physiciansmentioning

confidence: 99%

The role of primary care physicians in enabling validation of a patient’s ability to make legal statements and express a last will

Trnka¹,

Drobnik²,

Susło³

2017

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A -study Design, B -Data Collection, C -statistical analysis, D -Data interpretation, E -Manuscript Preparation, F -Literature search, G -Funds Collection the expression of a last will is legally invalid when the will-maker was in a state preventing him or her from making a decision, or expressing will, in a conscious or independent way; this could occur due to psychiatric disorders, mental retardation, or any other mental activity disturbance, even temporary. there are many problems with medical opinions concerning the validity of last wills. Medical staff play an important and law-rooted role in providing valuable evidence in such cases. the forensic medical literature was searched for topics related to evaluations of last will and testament. Forensic opinions issued by the Forensic Medicine Department, wrocław Medical university, Poland, in years 2006-2016 were also examined for cases illustrating the role of physicians and medical files in the legal evaluation of contested wills. this allowed us to conclude that mental status alterations that prevent patients from making last wills in a legally valid way can result from psychiatric or somatic disorders that negatively influencing the level of consciousness. Medical files are a highly valuable and trustworthy source of evidence -especially in the parts authored by medical staff in frequent contact with patients, which includes primary and palliative care physicians or nurses. it is necessary that these files contain remarks on the patient's behavior and ability to function in a home environment, as well as information shared by the patient's relatives. it is crucial that any drugs prescribed and their doses are recorded, and that the actual drugs administered to the patient are also noted. Key words: forensic psychiatry, forensic medicine, medical records, family medicine, last will.

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Section: Guidelines For Primary Care Physiciansmentioning

confidence: 99%

The role of primary care physicians in enabling validation of a patient’s ability to make legal statements and express a last will

Trnka¹,

Drobnik²,

Susło³

2017

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“…Because of its potent and highly addictive psychoactive effect, it is often used as a recreational narcotic [4]. Morphine can be administered orally, intravenously, subcutaneously, in transdermal form or by inhalation [5]. It is widely used as a medication, most often in chronic pain treatment [5], hemorrhagic shock [6], or acute heart failure accompanied by pulmonary edema with severe dyspnea [7].…”

Section: Introductionmentioning

confidence: 99%

Cardiogenic shock induced by a high dose of intravenous morphine

Anand¹,

Korolkiewicz²,

Anand³

2021

Int J Occup Med Environ Health

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“…Conditions involving chronic pain are in particular much more common and involve on average more sites in the elderly than in younger people; they thus frequently increase healthcare use [13]. At the same time, paradoxically, the healthcare system in Poland is still not suited to efficiently manage pain in older patients [14], even though proper permissive medical guidelines for the use of analgesics exist [15]. Old age is an independent perioperative factor in death risk in the case of some surgical procedures [16], and prolonged hospitalization may have additional detrimental health effects, increasing mortality and shortening survival time, as does any additional factor which strips an ill elderly person of his or her sense of control over life [17].…”

Section: Introductionmentioning

confidence: 99%

An analysis of the costs of treating aged patients in a large clinical hospital in Poland under the pressure of recent demographic trends

Pobrotyn¹,

Susło

Witczak

et al. 2020

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Introduction: The aging of modern societies increases the general healthcare burden due to the growing demand for inpatient services, which lack adequate financing. Material and methods: Data concerning the costs of 312,250 hospitalizations at University Clinical Hospital in Wrocław, Poland in the years 2012-2015 were analyzed according to the age of the patients: below 65 years and 65 years and older, with subgroups (65-74, 75-84 and 85 years and older). Results: The mean length of stay (LOS) differed significantly for patients below 65 years and for patients 65 years old or older (3.5 vs. 4.7 person-days); over the 4 years covered by our data, these increased by 0.4 person-days, mostly among patients 85 years and older (by 0.7 person-days). The mean direct cost of hospitalization differed significantly for patients below 65 years and those 65 years or older (PLN 4,907.12 vs. PLN 6,357.15). The mean cost of laboratory tests and radiologic diagnostics was significantly higher among those in the 65+ group, and the difference had a rising trend. The differences between age groups in cost-related hospitalization characteristics and direct hospitalization costs that have been suggested by the medical literature have also been confirmed in Poland. Conclusions: The mean hospitalization costs of patients aged 65 years and older in Poland are higher than for younger patients due to longer LOS and more complex and expensive treatment, especially laboratory and radiologic diagnostics, which is increasingly common in the oldest age groups. This demands an urgent systemic solution, especially in terms of adjusted financing of elderly patients' hospital treatment.

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Zasady stosowania silnie działających opioidów u pacjentów z bólem przewlekłym pochodzenia nienowotworowego – przegląd piśmiennictwa i zalecenia Polskiego Towarzystwa Badania Bólu, Polskiego Towarzystwa Neurologicznego i Polskiego Towarzystwa Medycyny Rodzinnej

Cited by 10 publications

References 0 publications

The role of primary care physicians in enabling validation of a patient’s ability to make legal statements and express a last will

The role of primary care physicians in enabling validation of a patient’s ability to make legal statements and express a last will

Cardiogenic shock induced by a high dose of intravenous morphine

An analysis of the costs of treating aged patients in a large clinical hospital in Poland under the pressure of recent demographic trends

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