Catholic Teaching: A Middle Ground and Guide for End-of-Life Care and Decision-Making and an Antidote for Dying Badly in America.

Dying in the United States is characterized as: medicalized, depersonalized, high technology, fragmented with frequent transitions among care settings, burdensome to patients and families, driven by efficiency and effectiveness, and lacking in key areas, for example, access to palliative care and adequate pain and symptom treatment. Patients and families are often left with a choice of two extremes: vitalism or utilitarian pessimism (utilitarianism). The Catholic Church, however, rejects both of these extremes, and Catholic social teaching (CST) at end of life focuses on ordinary-extraordinary treatments/means, a culture of life and human dignity, accompaniment and community, and caring for whole persons through the end of life.

Obesity in rheumatological practice.

Obesity is a chronic disease that leads to the development of secondary metabolic disturbances and diseases and strongly contributes to increased morbidity and mortality. On the other hand, musculoskeletal disorders are currently the main cause of disability and the second most frequent reason for visits to the doctor. Many studies clearly show that excessive body weight adversely affects the course of almost all musculoskeletal system diseases, from osteoarthritis, through metabolic, systemic connective tissue, to rarely diagnosed diseases.

Thyroid autoimmunity and its negative impact on female fertility and maternal pregnancy outcomes.

Thyroid autoimmunity (TAI) is commonly defined as the presence of thyroperoxidase antibodies (TPOAbs) and/or thyroglobulin antibodies (TgAbs), which predisposes an individual to hypothyroidism. TAI affects nearly 10% of women of reproductive age and evokes great interest from clinicians because of its potentially negative impact on female fertility and pregnancy course. In this mini-review, we review the current literature concerning the influence of TPOAb or TPOAb/TgAb positivity without thyroid dysfunction on reproduction.

The effects of testosterone replacement therapy in men with age-dependent hypogonadism on body composition, and serum levels of leptin, adiponectin, and C-reactive protein.

Introduction: Age-related hypogonadism in men leads to abnormal body composition development and overproduction of inflammatory cytokines, and thus has atherogenic and potentially cancer promoting effects. The aim of the study was to assess the effect of agedependent testosterone deficiency replacement in men on body composition, serum leptin, adiponectin, and C-reactive protein levels.

Material And Methods: Men aged 50-65 years (56.

Gastric Contractility Modulation - a novel method for the treatment of type 2 diabetes mellitus and obesity.

Because the majority of antidiabetic medications are of limited efficacy and patient compliance with treatment is usually poor, new therapies are still being searched for. In the review a newly developed system for treatment of subjects with type 2 diabetes and concomitant overweight/obesity is described. The system consists of an implantable pulse generator that delivers electrical stimuli through leads implanted in the sero-muscular layer of the stomach.

Late-onset hypogonadism.

In Poland, the number of men over the age of 50 years exceeds 6 million. It is estimated that about 2-6% of this population develops symptoms of late-onset hypogonadism (LOH). In men, testosterone deficiency increases slightly with age.

Gastric electrical stimulation treatment of type 2 diabetes: effects of implantation versus meal-mediated stimulation. A randomized blinded cross-over trial.

Gastric electrical stimulation with the implanted DIAMOND device has been shown to improve glycemic control and decrease weight and systolic blood pressure in patients with type 2 diabetes inadequately controlled with oral antidiabetic agents. The objective of this study was to determine if device implantation alone (placebo effect) contributes to the long-term metabolic benefits of DIAMOND(®) meal-mediated gastric electrical stimulation in patients with type 2 diabetes. The study was a 48 week randomized, blinded, cross-over trial in university centers comparing glycemic improvement of DIAMOND(®) implanted patients with type 2 diabetic with no activation of the electrical stimulation (placebo) versus meal-mediated activation of the electrical signal.

The DIAMOND system in the treatment of type 2 diabetes mellitus in an obese patient.

Obesity and type 2 diabetes mellitus have reached epidemic proportions worldwide. As the majority of antidiabetic medications are of limited efficacy and patient adherence to long-term therapy is one of the main limiting factors of effective blood glucose and body weight control, new therapies are still looked for. The DIAMOND system seems to be one of the most promising among them.

Associations of vitamin D concentration with metabolic and hormonal indices in women with polycystic ovary syndrome presenting abdominal and gynoidal type of obesity.

Goal: The aim of the study was to estimate potential associations of vitamin D concentration with metabolic and hormonal indices in women with polycystic ovary syndrome (PCOS) presenting abdominal and gynoidal type of obesity.

Material And Methods: Twenty-six women with PCOS (19-49 years old, BMI: 26.8-53.

Fetuin-A levels in lean and obese women with polycystic ovary syndrome.

Introduction: The aim of this study was to estimate serum fetuin-A levels in lean and obese women with polycystic ovary syndrome (PCOS) and to find possible relationships between fetuin-A, metabolic factors and androgens in these patients.

Material And Methods: In 25 lean (18-38 years, BMI 17.5-25.

Body composition, glucose metabolism markers and serum androgens - association in women with polycystic ovary syndrome.

Introduction: To evaluate the association between abdominal and gynoid fat, glucose and lipid metabolism markers, and serum androgens in women with polycystic ovary syndrome (PCOS).

Material And Methods: Anthropometric measurements were performed in 40 women with PCOS aged 19-49 years with body mass index (BMI) 18.7-53.

The high prevalence of testosterone deficiency in population of Polish men over 65 years with erectile dysfunctions.

Objectives: Erectile dysfunctions (EDs) are in part caused by hormonal causes; but in men over 65 years of age, testosterone deficiency seems to play an important role. However, in population of Polish men over 65 years of age with relative poor health status, the prevalence of testosterone deficiency in patients with ED is unknown.

Material And Methods: 286 men over 65 years of age with EDs were invited to complete an erectile function questionnaire (IIEF-5), as a diagnostic tool for EDs.

Ghrelin - growth hormone releasing and orexigenic hormone in men declines with age, insulin and with decrease in testosterone concentration.

Objectives: Ghrelin, a natural ligand of the growth-hormone secretagouges receptor is the peptide known because of its growth hormone (GH)-releasing as well as orexigenic actions. THE AIM of the study was to examine the relationship between ghrelin levels and age, weight, glucose metabolism markers, GH, IGF-1 and androgens in men.

Patients And Methods: The study included 19 healthy men aged 16-73 yrs, mean 46,8 +/-18,5 (mean +/- SD).

[The relationship between testosterone and dehydroepiandrosterone sulfate concentrations, insulin resistance and visceral obesity in elderly men].

Introduction: Sex hormones deficiency--hypotestosteronemia (20-30% of men) and dehydroepian-drosterone sulfate deficiency (60-70% of men) are often observed in elderly men. In these men also changes of body composition (visceral obesity, increasing of fat mass), and metabolic disturbances (hypercholesterolemia, hyperinsulinism and insulin resistance) are common disorders. Visceral obesity and insulin resistance may be either reasons or effects of testosterone deficiency.

[Lowered ghrelin levels in acromegaly—normalization after treatment].

Unlabelled: Ghrelin has been found as a natural ligand of growth hormone secretagouges receptors (GHSR-1a) that exerts a marked stimulatory effect on growth hormone (GH) secretion. It is also thought to be involved of eating behavior and control of energy homeostasis. However, still little is known about the physiology of ghrelin secretion in acromegaly.

[The beneficial effects of growth hormone replacement therapy on elderly men].

Unlabelled: The relationship of growth hormone (GH) to the ageing process is currently subject of considerably interest. The study was designed to investigate the effects of replacement therapy with growth hormone on quality of life, serum lipids and body composition (fat free mass and fat mass) in elderly men.

Material: 18 healthy men 60.

[The effect of growth hormone replacement therapy on markers of bone formation and bone mineral density in elderly men].

Objective: Decline in growth hormone (GH) secretion and serum levels of insulin-like growth factor-1 (IGF-1) during ageing may be a causal factor in the development of osteopenia. The purpose of this study was to test the effects of GH-replacement therapy on bone metabolism and mineral density in healthy men over 40 years old.

Material: 18 healthy men aged 60.

The nurse as the knowledge worker. A management challenge.

The purpose of health care institutions is to provide quality patient care. Who renders quality patient care for these institutions? Nurses do. Without nurses, health care institutions would be unable to provide essential services; therefore, administrators need to attract and retain nurses who are knowledge workers and manage their environments effectively.