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Background: The early introduction of physiotherapy significantly shortens the time required for a patient to regain full mobility after hip arthroplasty. Obtaining the expected result is determined by cooperation with a physiotherapist and the patient's involvement in the rehabilitation process. The aim of this study was to assess the quality of life, life satisfaction, and motor ability of patients after hip arthroplasty. Methods: This study included 147 patients who underwent hip arthroplasty at the Orthopedic and Trauma Department. The research material was collected using questionnaires, and the study used the Barthel Index (BI), Harris Hip Score (HHS), Visual Analogue Scale (VAS), Acceptance of Illness Scale (AIS), and Quality of Life Assessment Questionnaire (WHOQOL-BREF). In the studied group of patients, the Excia cementless endoprosthesis was primarily used (69.39%), as well as the Metha Short Hip prosthesis (15.65%), AM hip prosthesis (10.20%), and bipolar hip prosthesis (4.76%). Results: The analyzed group of patients included 95 women (64.63%) and 52 men (35.37%); the average age was 67 years. Six weeks after hip arthroplasty, mild disability occurred in 53.74% of the patients, while the remaining 46.26% had no disability, and 95.24% of the patients achieved a high level of acceptance of the disease and quality of life. Conclusions: Early improvement after hip replacement surgery contributes to eliminating the disability of the hip joint in the following areas: pain sensation, functionality, lack of deformation, and range of motion. Each subsequent stage of treatment increased the level of acceptance of the disease in the study group. The applied surgical treatment increased satisfaction with overall health and quality of life.

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Introduction: Alcohol is the most common psychoactive substance among young people. The use of psychoactive substances gives rise to a number of health, social, moral and economic problems. The aim of the study was to characterise the symptoms reported by children and adolescents presenting with psychoactive substance intoxication on admission to hospital. Methods: The study included a group of 303 patients aged 0 to 18 years, diagnosed with psychoactive substance intoxication. This retrospective study assessed medical records of patients hospitalised at the Provincial Specialist Children's Hospital in Olsztyn between 2016 and 2018. Results: Body temperature on admission varied depending on the type of psychoactive substance taken (χ2 = 14.12, p < 0.006). Girls were more likely to have an increased heart rate than boys. An analysis of the symptoms of intoxication over the years 2016-2018 showed significant differences in the incidence of the following symptoms: disturbed consciousness (χ2 = 8.75, p < 0.01), visual disorders (χ2 = 8.02, p < 0.02), loss of consciousness (χ2 = 37.71, p < 0.000001), drowsiness (χ2 = 7.33, p < 0.03), hypothermia (χ2 = 18.95, p < 0.00008) and gait disturbances (χ2 = 13.08, p < 0.002). Conclusions: Girls are more likely to use stimulants such as alcohol and cigarettes, while boys are more likely to opt for designer drugs. The number of patients hospitalised more than once increases every year. Gastrointestinal intoxication with psychoactive substances was most common. The most severe intoxication was associated with alcohol intake, while the most intense pain was reported by patients poisoned with other psychoactive substances.

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Introduction: The use of a validated scale, Spirituality and Spiritual Care Rating Scale (SSCRS) to measure nurses' perceptions of spirituality and spiritual care. Aim: The purpose of this study was to analyse selected psychometric properties of the Polish version of the SSCRS, among them the applicability of the dimensions of spiritual care in nursing, ie, spirituality, spiritual care, religiosity and personalized care, to Polish conditions. Methods: Poland-wide multicentre study with a cross-sectional validation design. The study was conducted between March and June 2019. Seven Polish Nursing Faculties accepted the invitation to participate in the study. A representative sample of 853 nurses enrolled in MSc (postgraduate) programs in nursing participated. After translation and cultural adaption of the SSCRS, the instrument underwent a full psychometric evaluation of its construct validity using (exploratory and confirmatory factor analysis), internal consistency (Cronbach's alpha and correlation analysis), reliability (test-retest analysis), known-group validity (Student's t-test) analysis. Results: The exploratory and confirmatory factor analysis demonstrated that the Polish version of the SSCRS was a three-factor model with "Activity-centred spiritual care" (9 items), "Emotional support-centred spiritual care" (5 items) and "Religiosity" (3 items) domains. The Cronbach's alpha coefficient for the whole scale was 0.902, and the alpha values for the individual domains were 0.898, 0.873 and 0.563, respectively. The three domains mentioned above seemed to provide a comprehensive understanding of spiritual care perceived subjectively by Polish MSc in nursing students. Conclusion: This study demonstrated a substantial degree of similarity in the selected psychometric characteristics of the Polish version of SSCRS and the original scale.

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INTRODUCTION: The level of leptin in the blood shows a positive, strong correlation with the mass of adipose tissue. Being overweight and having metabolic disorders increase the risk of developing colorectal cancer. AIM OF THE PAPER: The aim of the study was to assess the concentration of leptin in the blood serum as well as the expression of the leptin receptor in colorectal cancer cells. In addition, the effect of serum leptin concentration and leptin receptor expression on clinical and pathological parameters such as BMI, obesity, TNM, and tumor size was assessed. METHODS: The study included 61 patients diagnosed with colorectal cancer and treated with surgery. RESULTS: Strong leptin receptor expression and the prevalence of overweight and obesity are factors influencing the occurrence of excessive leptin concentrations. CONCLUSION: Leptin may be involved in the development and progression of colorectal cancer. More research is needed to better elucidate the role of leptin in the development and progression of the disease.

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INTRODUCTION: Nurses became the largest medical group exposed to direct contact with the SARS-CoV-2 virus. In this study, we aimed to assess the readiness and motivation for vaccination, as well as the use of sources of information and attitudes toward vaccination depending on the psychological profile. MATERIAL AND METHODS: A cross-sectional online survey study was conducted. The study included 145 novice nurses from 8 medical universities who completed 3-year undergraduate studies. Women constituted 97.2% of the respondents (N = 141). The Generalized Anxiety Disorder 7-Item Scale, General Self-Efficacy Scale, Brief Resilient Coping Scale, and an original questionnaire were used. Variables were analyzed with descriptive statistics methods. A p-value of <0.05 was considered statistically significant. RESULTS: Among the participants, 73.1% had already been vaccinated against COVID-19 (N = 106). The participants were divided into two groups: G1 (N = 98), characterized by a lower level of anxiety with higher self-efficacy and resilient coping, and G2 (N = 47), with a higher level of anxiety with poorer self-efficacy and resilient coping. The analysis of the potential correlation of psychological pattern with the decision to vaccinate was not statistically significant (p = 0.166). CONCLUSION: Psychological variables may be correlating with motivation, attitudes toward vaccination, and the choice of reliable sources of information about vaccination. Our study demonstrates the key role of two psychological variables, self-efficacy and resilient coping, in this context.

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BACKGROUND: Most studies analyzing the health-related quality of life (HRQOL) after bariatric treatment ceased at five years post-surgery or even earlier, and it is unclear whether the HRQOL benefit persists for a longer time. This paper reviews sparse evidence regarding HRQOL in patients who underwent bariatric surgery at least nine years prior. MATERIALS AND METHODS: A of PubMed, Scopus and Google Scholar between 2007-2021 was carried out for the studies investigating HRQOL as an outcome measure in patients after bariatric surgery of any type and having at least a 9-year follow-up. Inconsistent reporting of weight loss or postgraduate study results unrelated to QoL were not included in the study. The study used the PICO procedure. RESULTS: The review of 18 identified publications demonstrated that bariatric treatment seems to provide a persistent benefit in terms of HRQOL, especially its physical component score. Due to psychological predispositions, some patients appear to be less likely to benefit from bariatric treatment, whether in terms of HRQOL or bodyweight reduction. Inconsistent and imprecise studies may limit the evidence included in a review. CONCLUSIONS: The early identification of such patients and providing them with holistic care, including psychological intervention, would likely further improve the outcomes of bariatric treatment.

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COVID-19 vaccination raises numerous concerns among the public, and also among medical personnel including nurses. As nurses play a crucial role in the process of vaccination, it is important to recognize the attitudes of students of nursing, nurses in spe, toward COVID-19 vaccination, as well as to define the factors influencing students' pro-vaccine choices. The study was conducted between March and April 2021 at all medical universities in Poland educating nurses in spe. The study included 793 first-degree students from 12 universities. The results revealed that the vast majority of students of nursing (77.2%) were vaccinated against COVID-19, as 61.2% received an mRNA vaccine and 16% a viral vector vaccine. Every other person in the non-vaccinated group declared their intention to get a vaccination. A trend was observed whereby people co-living with persons from the risk group, who are at risk of a severe form of COVID-19, showed greater willingness to get a vaccine. The study results identified the role of universities in increasing the vaccination rate among students, both in terms of education about vaccinations and in shaping pro-vaccine attitudes among students, as well as organizing vaccinations on university campuses to facilitate the process.

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Background: The recommendations for routine preoperative esophagogastroduodenoscopy (EGD) in patients qualified for bariatric surgeries are still a matter of debate. The aim of this study was to analyze the pathologies on preoperative EGD in patients qualified for bariatric surgeries. Materials and Methods: This study included 222 patients, divided into two groups. The obesity group consisted of patients with obesity (BMI ≥ 40 kg/m2), for whom EGD was a routine part of the preparation for laparoscopic sleeve gastrectomy (LSG). The control group of patients with normal body weight (BMI) qualified for EGD because of gastrointestinal ailments. Results: Regarding preoperative EGD in patients qualified for bariatric surgeries, we analyzed the prevalence of endoscopic pathologies in various gastrointestinal tract segments. Patients with obesity were shown to present with esophageal pathologies significantly more often than persons in the control group (n = 23, 20.91% vs. n = 12, 10.91%, p = 0.042). The odds ratio of esophageal pathologies in patients with obesity versus the control group equaled 2.15 (95%CI: 1.01-4.59). In turn, the odds ratio of duodenal pathologies in patients from the control group was 3.31 (95%Cl: 1.16-9.47), which means that persons from this group were approximately three times more likely to be diagnosed with those pathologies compared to obese patients. Moreover, patient sex was a significant predictor of duodenal pathologies, with an odds ratio of 4.03 (95%CI: 1.53-10.61). Conclusions: Preoperative EGD can identify a broad spectrum of pathologies in obese patients, which suggests a routine examination before bariatric surgery.

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BACKGROUND: Currently, as the number of vaccinated children in Poland and throughout Europe is decreasing. Many factors impact on the rate vaccination and parents' health behaviours may affect the frequency of vaccinations. The aim of the study was to assess the association of parents' health behaviors with children's vaccinations. METHODS: A cross-sectional survey was conducted from July 2015 to June 2016 to assess to assess the association of parents' health behaviors with children's vaccinations in Bialystok city, Poland. We used the the Inventory of Health Behaviours and an original questionnaire including demographic data and questions about vaccination. Three hundred parents were recruited from the Pro Medica Family Medica Center in Bialystok, Poland. RESULTS: Only 3.7% of respondents did not vaccinate their children. The level of health behaviours was average in 42.3% of the respondents, low in 33%, and high in 24.7%. Significant differences in health behaviours, mainly the level of normal eating habits (p = 0.038) and positive mental attitude (p = 0.022), were found in relation to views on the toxicity of vaccines. Participants who reported that vaccines can cause autism engaged in a higher level of prophylactic behaviours. Respondents who vaccinated their children with combined vaccines had a significantly higher level of health practices. CONCLUSIONS: Parents preferred health behaviours did not effect on children vaccination. Parents who believed in the toxicity of vaccines were more concerned about proper nutrition, had a positive mental attitude, and engaged in a higher level of preventive behaviours and health practices. Parents who did not vaccinate their children had lower levels of normal eating habits. Parents who vaccinated their children with combined vaccines had a higher level of health behaviours, especially in terms of health practices.

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BACKGROUND: Irritable bowel syndrome (IBS) is one of the most common functional diseases of the gastrointestinal tract. A typical symptom is changed bowel patterns: diarrhea, constipation, or alternation of the two. Abdominal pains vary in intensity and location, with periods of exacerbation and remission, causing disorganization in everyday life and work. Educational intervention could be one strategy to improve the well-being of IBS patients. Only a few trials have examined this hypothesis. The aim of this study was to examine the effect of an educational program combined with elements of behavioral therapy, individualized for each patient, on quality of life (QOL) and severity of pain of patients with IBS. METHODS: In total, 150 IBS patients and 100 healthy persons in the control group were included. QOL (36-Item Short Form Health Survey, SF-36) and pain severity (Visual Analogue Scale) were measured at baseline and six months after education of IBS patients. RESULTS: At baseline, patients with IBS showed highly significantly worse QOL. In the IBS group, significantly higher physical component summary (PCS) and mental component summary (MCS) scores were noted for 35- to 50-year-old patients compared to other patients. Six months after education and behavioral therapy, significant improvement in QOL and a significant decrease in the subjective perception of pain severity were noted compared to values before therapeutic education. CONCLUSION: An educational program combined with elements of behavioral therapy, individualized for patients with IBS, is an important part of therapy for these patients.

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INTRODUCTION: As a result of the growing number of people with obesity, the popularity of bariatric surgery has been systematically increasing. It has not yet been explored whether individual education of the patient can contribute to long-term success in weight reduction after bariatric treatment. AIM: To implement and compare the effects of different education methods, versus receiving one-time written information in the form of a guidebook, on patient involvement in abiding by lifestyle recommendations after laparoscopic sleeve gastrectomy (LSG) bariatric treatment. MATERIAL AND METHODS: The study included 160 patients with morbid obesity. The education session study participants were 100 patients after sleeve gastrectomy, with whom three education sessions were planned, and who were enrolled in the study. The control group consisted of 60 patients who underwent sleeve gastrectomy, and before discharge from the department, they received one-time written recommendations in the form of a guidebook. RESULTS: We confirmed that the three education sessions we conducted with the study group after LSG had a significant impact on weight loss. The control group, which received only written information, achieved weight loss and abided by the written recommendations, although to a lesser extent than the study group. The differences were evident particularly in motivation to adhere to recommendations and check-ups, which was significantly lower (p < 0.001) after a year of observation in the control group. CONCLUSIONS: This study results should encourage the establishment of education as a permanent element of the LSG procedure.

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BACKGROUND: Achieving high quality care through full use of potential stemming from the use of the principles of evidence based practice (EBP) requires adequate shaping of student attitudes toward EBP already at an early stage of education, as well as teaching in the scope of knowledge and skills essential to apply EBP in future professional work. Therefore, nursing educators need a tool to assess competency in EBP. This study aims to present the adaptation of the psychometric test and setting norms to the Polish version of the Evidence Based Practice Competence Questionnaire (EBP-COQ_P). METHODS: Poland-wide multicentre study, cross-sectional validation design, a representative sample of 1636 nursing students. The EBP-COQ_P was validated in terms of content validity through an expert review. The EBP-COQ_P was administered to evaluate test reliability and validity. Settings norms for the Polish nurse population were also done. RESULTS: Confirmatory factor analysis demonstrated that 25 items are grouped into three categories which define competences related to EBP: attitude, knowledge, and skills. Cronbach's alpha was 0.856 for the entire questionnaire. EBP-COQ_P had good parameters of absolute stability. EBP-COQ_P was also characterized with external construct validity. Measurement with the use of EBP-COQ_P allowed for a good differentiation of the respondents in terms of their expertise in EBP (known-groups validity). CONCLUSIONS: In terms of reliability and validity, EBP-COQ_P is compared with its original version. EBP-COQ_P may be used in educational practice (graduate and postgraduate education). Polish norms set for a representative group of nursing students may serve as a benchmark for the results obtained from individual and group measurements.

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Background and Objectives: Choosing a pain management strategy is essential for improving recovery after surgery. Effective pain management reduces the stress response, facilitates mobilization, and improves the quality of the postoperative period. The aim of the study was to assess the effectiveness of pain management in patients after surgery. Materials and Methods: The study included 216 patients operated on in the following surgical wards: the Department of Cardiosurgery and the Department of General and Endocrine Surgery. Patients were hospitalized on average for 6 ± 4.5 days. Patients were randomly selected for the study using a questionnaire technique with a numerical rating scale. Results: Immediately after surgery, pre-emptive analgesia, multimodal analgesia, and analgosedation were used significantly more frequently than other methods (p < 0.001). In the subsequent postoperative days, the method of administering drugs on demand was used most often. Patients with confirmed complications during postoperative wound healing required significantly more frequent use of drugs from Steps 2 and 3 of the World Health Organization (WHO) analgesic ladder compared with patients without complications. Conclusion: The mode of patient admission for surgery significantly affected the level of pain perception. Different pain management methods were used and not every method was effective.

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BACKGROUND: Nursing requires a commitment to work and care for the well-being of the patient, which is a great mental and physical burden for the nurse. As a result of exposure to adverse psychosocial work conditions and experiencing the resulting work-related stress, the problem of burnout is becoming more common. The aim of the study was to assess the psychosocial work conditions and their relationship to quality of life in the studied group of nurses. METHODS: A cross-sectional study was carried out on 523 randomly selected professionally active registered nurses. The study was based on a diagnostic survey using standardized psychometric questionnaires: The Psychosocial Working Conditions Questionnaire and the quality of life WHOQOL-Bref. RESULTS: Respondents with a better education assessed the level of demands at work to be higher (p = 0.000); however, they were also more satisfied in the well-being category (p = 0.020). Shift work was associated with a worse perception of psychosocial work conditions in almost all considered domains. The strongest correlations were between the scale of well-being and the assessment of quality of life in the somatic and psychological domains. CONCLUSION: Nurses doing shift work assessed working conditions as being worse in all domains. They felt the mental and physical burden the most. Psychosocial work conditions were assessed to be better by nurses working in management positions. The strongest correlations were between the scale of well-being and the assessment of quality of life in the somatic and psychological domains.

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Obesity is a new risk factor, to which more and more research is devoted, related to the development of cancer. Many studies of recent years have drawn attention to the role of adipose tissue as an important internal endocrine organ. In the adipose tissue proteins are produced, referred to by the common name as adipokines. In the case of obesity, the neoplasm cells are constantly stimulated by pro-inflammatory cytokines and adipokines, among which leptin dominates. The studies show that leptin can affect the cancer cells through numerous phenomena, e.g. inflammation, cell proliferation, suppression of apoptosis and angiogenesis. In this literature review we examined the role of leptin in the development of the individual cancers: breast cancer, colorectal cancer, prostate cancer, ovarian cancer, endometrial cancer and brain neoplasms: glioma and meningioma. However, leptin has very complicated mechanisms of action which require better understanding in certain types of cancer.

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INTRODUCTION: Nursing care is one of the most important areas of health services, taking place in direct contact with the patient, constituting a subsystem deciding about the general level of services. AIM: The aim of the study was to construct the Trust in Nurse Scale on the basis of the standardized Trust in Physician Scale by Anderson and Dedrick. METHODS: The study included a group of 1,200 people selected at random, 600 each from surgical and medical treatment wards. Patients did not report any problems with understanding the statements on the scale. RESULTS: The internal accuracy scores were excellent, all Cronbach's a values were well above 0.70. The Spearman's rank correlation coefficient values were highly statistically significant (p <0.001), and correlation strength was very high (for most items r s > 0.90). CONCLUSION: We suggest that The Trust in Nurse Scale, developed on the basis of the standardized Trust in Physician Scale by Anderson and Dedrick, can be used in studies on patient satisfaction with nursing care.

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BACKGROUND: In their professional work, nurses struggle repeatedly with difficult situations that are causes of stress. Another issue is the low prestige of the nursing profession compared with other professions, which results in dissatisfaction, increased frustration, and lack of precision when performing professional tasks. The aim of this study was to assess the relationship between mental health and quality of life and satisfaction with life in nurses with many years of experience in the profession. METHODS: The study was conducted in a group of 523 randomly selected professionally active nurses aged over 40 years old from the Podlaskie Voivodeship. Standardized questionnaires were used, including WHOQOL-BREF, a short version of a questionnaire assessing quality of life, the general health questionnaire (GHQ-28), and the satisfaction with life scale (SWLS). RESULTS: The mental health component was found to be significantly affected by financial situation (p = 0.005). Among respondents describing their financial status as bad, the assessment of negative mental health symptoms was higher. The remaining studied variables-work experience, nature of work, place of residence, age, material status, having a partner, and having children-did not affect the respondents' mental health status. The co-occurrence of chronic diseases affected (p = 0.008) the intensification of negative mental health symptoms such as somatic symptoms, anxiety, insomnia, and social dysfunction. The intensification of negative mental health symptoms was not connected with absence from work. CONCLUSIONS: The financial situation of the respondents significantly determined their quality of life as well as influencing mental health components. Nurses' satisfaction with life was correlated with all studied domains of quality of life.

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BACKGROUND: Studies conducted in Poland have found that 1% (~300,000) of Polish adults are obese. The degree of weight loss and reduction of discomfort associated with severe obesity are used to evaluate bariatric surgery outcomes. From the patient's point of view, QoL and mental health are the most important determinants of successful surgery, which is why interest in QoL assessment has increased. OBJECTIVES: To assess the effect of BMI on quality of life and depression levels depending on the type of bariatric surgery. MATERIAL AND METHODS: The group included 57 women and 43 men aged 20-60 years (mean age 40 years) with BMI from 36 to 40 (31%) and > 40 (69%). Twelve patients (12%) underwent laparoscopic adjustable gastric binding (LAGB), 58 (58%) sleeve gastrectomy, and 30 (30%) Roux-en-Y Gastric Bypass (RYGB). The Bariatric Analysis and Reporting Outcome System (BAROS) was used to assess QoL. The severity of mood disorders was assessed using the Self-Rating Scale of Depression and Anxiety. RESULTS: Six months or 1 year after bariatric surgery, the number of patients with BMI > 40 had decreased from 69 to 14%. We found that the time since bariatric surgery contributed to a significant (p < 0.01) difference in BAROS outcomes. In the long-term perspective, we observed better quality of life. CONCLUSIONS: MA-QoL II is a useful tool in assessing bariatric surgery, including quality of life. Long-term monitoring will be essential in determining psychological changes and the degree of weight loss.

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BACKGROUND: Rural areas in Poland are inhabited by over 15 million people, i.e. 39.5% of Polish population, including about 5 million rural residents in the Podlaskie province. The incidence of obesity is associated with increased prevalence of obesity-related conditions. Studies that have been conducted do not confirm the efficacy of conservative treatment of obesity, but show that bariatric procedures produce the best longterm results. OBJECTIVES: The aim of the study was to present the effects of bariatric obesity treatments (laparoscopic adjustable gastric banding [LAGB], sleeve gastrectomy [SG], Roux-en-Y gastric bypass [RYGB]) on body mass index (BMI), selected diabetes control parameters, dyslipidemia, hepatic and renal enzymes, blood count and hypertension control. MATERIAL AND METHODS: The study group comprised a total of 100 consecutive patients from rural areas qualified for bariatric procedures. Most of the patients (69.07%) underwent SG; 11.34% underwent LAGB; and 19.59% underwent RYGB. Comorbidities included hypertension (35%), type 2 diabetes (52%) and hyperlipidemia (15%). Glucose, insulin, HbA1C, alanine and aspartate aminotransferase, bilirubin, total and fraction cholesterol, creatinine, urea, uric acid and CRP levels, as well as blood count and blood pressure values, were assessed prior to surgery and during follow-up visits 3 and 6 months after the procedures. BMI, percentage of excess weight loss (%EWL) and percentage of excess body mass index loss (%EBMIL) were assessed. RESULTS: Consistent, significant decreases in BMI were observed 3 months (39.31 ± 4.70) and 6 months (35.74 ± 4.52) after surgery. The largest BMI reduction at the 6-month follow up was observed for SG (12.29%), and the smallest was observed for LAGB (9.02%). CONCLUSIONS: Improvements in the general health status of the patients were observed, as well as normalization of metabolic parameters (glucose, cholesterol, triglycerides, hepatic enzymes).

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INTRODUCTION: While chronic cigarette smoking can lead to increased risk of stroke, the acute effects of smoking have not been established. We studied the changes in blood flow parameters in the major cerebral arteries caused by smoking one cigarette. METHOD: Using transcranial color-coded sonography (TCCS), we studied the anterior cerebral artery (ACA), middle cerebral artery (MCA), posterior cerebral artery (PCA), and the internal carotid artery (ICA) of 36 healthy male volunteers before and after they smoked one cigarette. RESULTS: Blood flow velocity increased to a different degree in all but one of the arteries examined after participants smoked a single cigarette: The end diastolic velocity increased significantly by 7.8% in the PCA, 8% in the ACA, and 14.4% in the MCA. The peak systolic velocity increased significantly by 7.5% in the MCA. Blood flow velocity remained unchanged in the ICA only. Blood pressure and heart rate increased as did the flow velocity ratio for the MCA/ICA. The pulsatility index decreased after smoking from 0.92 ± 0.13 to 0.87 ± 0.14 in the MCA, 0.93 ± 0.15 to 0.87 ± 0.13 in the ACA, and 0.95 ± 0.17 to 0.89 ± 0.16 in the PCA. CONCLUSIONS: The results suggest that the direct effect of smoking on cerebral circulation includes peripheral vasodilatation with possible constriction of the main trunk of the basal cerebral arteries.

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