Kozioł K, Owczarek D, Cibor D
… +1 more, Zwolińska-Wcisło M
Folia Med Cracov
· 2023 Oct · PMID 38310527
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OBJECTIVE: Evaluation of serum lactadherin level, its correlation with disease activity and certain biochemical parameters in IBD patients. METHODS: The study involved adult IBD patients, comprising 50 with ulcerative co...OBJECTIVE: Evaluation of serum lactadherin level, its correlation with disease activity and certain biochemical parameters in IBD patients. METHODS: The study involved adult IBD patients, comprising 50 with ulcerative colitis (UC), 68 with Crohn's disease (CD), and 29 healthy controls. RESULTS: The MFGE8 median concentration was significantly higher in UC versus controls (1914.54 vs. 1392.21; p = 0.017), but not in CD. The median MFGE8 levels in UC and CD patient groups didn't significantly differ. There was a significant inverse correlation between MFGE8 and CRP (r = -0.283; p = 0.044) and fibrinogen (r = -0.362, p = 0.017) in UC. In active UC, MFGE8 median concentration was higher versus controls (1974.36 vs. 1392.21; p = 0.04) and negatively correlated with CRP (r = -0.482; p = 0.005), WBC (r = -0.391; p = 0.027), and fibrinogen (r = -0.473; p = 0.015). Inactive UC showed negative correlation only with fibrinogen (r = -0.567; p = 0.018). No correlations were found with disease activity measured using appropriate scales, age, BMI, or gender. CONCLUSIONS: Active UC patients show higher MFGE8 levels. These increase inversely with inflammatory markers (CRP, WBC, fibrinogen) in active UC, but not in CD.
Folia Med Cracov
· 2023 Oct · PMID 38310526
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Publisher ↗
The venous plexus of Rektorzik is a network of small veins, which enlace outside the wall of the internal carotid artery while it traverses the petrous part of the temporal bone. The anatomical and clinical issues relate...The venous plexus of Rektorzik is a network of small veins, which enlace outside the wall of the internal carotid artery while it traverses the petrous part of the temporal bone. The anatomical and clinical issues related to the communication between the plexus of Rektorzik and other cranial venous structures were discussed in this paper.
Prevalence of metabolic syndrome (MetS) and its components is a growing issue, including pediatric populations. However, because of many definitions used, it is difficult to assess the true frequency of these problems. T...Prevalence of metabolic syndrome (MetS) and its components is a growing issue, including pediatric populations. However, because of many definitions used, it is difficult to assess the true frequency of these problems. The aim of this study was to assess the prevalence of MetS and its components as well as the frequency of problems with inadequate nutritional status among adolescents. One hundred ninety-six teenagers aged 15-18 years, living in Krakow and its vicinity were examined including measurement of blood pressure, anthropometric parameters and blood levels of cholesterol and glucose. The prevalence of MetS was low and varied from 0.5% to 2.0% depending on the definition. Based on Cook's definition of MetS, the most common components were hypertension (12.8%) and hypertriglyceridemia (12.8%). Improper body weight (based on BMI) was found in 23.5% of adolescents, including 5.1% underweight, and 18.4% overweight or obese. According to the body fat percentage (BF%), 45.8% of the boys were underfat and 6.3% had too much body fat, while only 4% of the girls were below the BF% reference values and 15% above. All girls and 86.5% of boys had too low total body water. In conclusion, the prevalence of metabolic syndrome in population of Krakow adolescents was relatively low, but more than 12% of the adolescents had a hypertension or hypertriglyceridemia. Based on BMI most of adolescents were found to have adequate body weight, but examination of fat content in the body high prevalence of underfat was observed, especially among boys.
QF-PCR is a widely used molecular biology method. To name just a few of its uses, it is considered to be useful in paternity tests, identification tests or prenatal diagnostics. Therefore, there is a good chance that med...QF-PCR is a widely used molecular biology method. To name just a few of its uses, it is considered to be useful in paternity tests, identification tests or prenatal diagnostics. Therefore, there is a good chance that medical faculty students would come into contact with this technology - directly or indirectly - during their professional work. The following article proposes a teaching classes scenario conducted in the problem-based learning manner, which aims to familiarize students with the QF-PCR technique. In addition, other modern methods of molecular genetics are among topics that students can learn during the problem-based learning modules. The classes are divided into three parts. In the first part, students learn about the possible usage of QF-PCR in paternity tests. The second part focuses on learning about the advantages and limitations of QF-PCR in prenatal diagnosis. Learning activities in the last part are designed to show the limitations of the diagnostic properties of the method - students analyze the case study, in which QF-PCR must be replaced by other modern methods of molecular genetics. By analyzing three independent stories, students learn about usage, advantages and limitations of QF-PCR, and additionally gain knowledge in basic, pre-clinical and clinical sciences. This course is designated as an elective course for final year medical students who have completed either: a basic genetics course, a molecular genetics course, a biochemistry course or a molecular biology course. The focus of the classes is to draw students' attention to the possible application and rapid development of molecular biology techniques, which is the base for modern therapeutic and diagnostic strategies.
Drug-abuse detection tests are becoming increasingly commonplace in patient care today and provide a rapid and effective method for identifying illicit substances. Occasionally, they may yield a positive result, indicati...Drug-abuse detection tests are becoming increasingly commonplace in patient care today and provide a rapid and effective method for identifying illicit substances. Occasionally, they may yield a positive result, indicating the presence of a substance, even though the individual has not consumed the suspected drug what sometimes can significantly impact both medical and legal decisions. The study outlines the substances that can lead to false-positive drug test results for amphetamines, cannabinoids, and benzodiazepines. The study's findings have revealed pivotal insights for patients receiving chronic treatment and their primary care physicians. Notably, amphetamine assays appear to be most prone to cross-reactivity with other substances. The beta-blocker group of medications, confirmed by various studies to interfere with amphetamine assays, could pose a substantial challenge in drug screening given its widespread use. Efavirenz also warrants mention, as it frequently triggers positive results for both benzodiazepine and cannabinoid assays among its users. This research helps highlight new areas for further investigation and aims to guide clinicians in their daily practice, especially when interpreting questionable positive drug-abuse test results. This comprehensive review serves as a valuable resource for clinicians to navigate false-positive scenarios effectively and maintain the highest standard of patient care.
Melanoma is a highly malignant neoplasm with the most typical primary locations in the skin and eyeball and rarely reported in the other organs, including the gallbladder. More commonly metastases of melanoma of various...Melanoma is a highly malignant neoplasm with the most typical primary locations in the skin and eyeball and rarely reported in the other organs, including the gallbladder. More commonly metastases of melanoma of various primary sites to the gallbladder are observed. However, generally melanoma of the gallbladder is a rare entity with only 217 cases reported in the literature up to date. The paper summarizes knowledge on epidemiology, symptoms, laboratory and imaging findings, morphology, treatment options, and outcome of patients with both primary and metastatic melanoma to the gallbladder.
Pelvic venous disorder (PeVD) is a prevalent chronic condition characterized by the presence of varicose veins in the pelvis, leading to the development of chronic pelvic pain. Despite the growing interest in assessing q...Pelvic venous disorder (PeVD) is a prevalent chronic condition characterized by the presence of varicose veins in the pelvis, leading to the development of chronic pelvic pain. Despite the growing interest in assessing quality of life in PeVD, well-designed and validated disease-specific questionnaires are missing. The objective of this study was a linguistic and clinical validation of the Symptom Questionnaire (SQ) in a cohort of Polish females with pelvic vein incompetence. The Polish version of SQ was developed using a standardized validation process that involved a back-and- forth translation protocol. A total of 58 female patients diagnosed with pelvic varicose veins, representing diverse educational back- grounds, participated in the study. Multiple issues were observed during linguistic validation, primarily originating from disparities between the Polish and British healthcare systems, as well as differing levels of sexual health education of those two populations. Cronbach α was calculated separately for each part of the questionnaire with results exceeded 0.6 for each section. Test-retest analysis indicated most Pearson correlation coefficients surpassing 0.70. The absolute agreement consistency between pretest and post-test measures, evaluated using the Intra Class Correlation (ICC), exceeded 0.8 in three sections and 0.7 in the remaining three sections. However, the clinical validation failed due to the lack of standardized score calculation proposed by the authors of the questionnaire and inaccurately assigned values in the answer key for five questions. Consequently, the practical utility of SQ in daily clinical settings remains uncertain, highlighting the urgent need for the development of a new, user-friendly questionnaire specifically tailored to assess the quality of life in individuals with PeVD.
Scar development in the children's renal cortex with vesicoureteral reflux (VUR) is one of the most important parameters of prognosis. It can develop regardless of the chosen treatment, even after the regression of VUR....Scar development in the children's renal cortex with vesicoureteral reflux (VUR) is one of the most important parameters of prognosis. It can develop regardless of the chosen treatment, even after the regression of VUR. The shape of the renal papillae, the ascending urinary tract infection, the greater than third-degree VUR, and finally the increased intra-calyceal pressure, induce the formation of renal scarring in the renal parenchyma. Renal scarring may complicate VUR independently of the therapeutic strategy (conservative or operative) and its regression. For restitution of this entity, many scientific terms have been used and the most common of them is intrarenal reflux (IRR). The effects of VUR on future renal function result from the limited ability of the affected kidney to grow (failure of renal growth) due to the existence of scars in the renal cortex, the worsening of these scars, or finally the creation of new scars. With the present study, we intend to clarify the etiology and the pathophysiology of IRR and the relation of VUR prognosis to newer biomarkers such as N-acetyl-beta-glycosaminidase, beta-2 microglobulin, Pen- traxin- 3 and Liver-type fatty-acid-binding protein.
Inflammatory bowel diseases (IBD), including Crohn's disease and ulcerative colitis, despite the increasing incidence, still do not have a specific etiology. Diet seems to be an important factor, modifying the occurrence...Inflammatory bowel diseases (IBD), including Crohn's disease and ulcerative colitis, despite the increasing incidence, still do not have a specific etiology. Diet seems to be an important factor, modifying the occurrence of the disease and its course. Diet can affect the symptoms of IBD both directly, e.g., by alleviating diarrhea, bloating and constipation, and indirectly by shaping the microbiota. Bacterial metabolites produced under the influence of supplied nutrients may contribute to the modulation of pro- and anti-inflammatory pathways, depending on the diet used. So far, IBD has been associated with weight loss and malnutrition. In recent years, a trend of sarcopenic obesity with concomitant malnutrition has been observed. The new phenomenon is called malnubesity. This work aims to review the most commonly used diets in IBD in order to evaluate them in terms of alleviating ailments, but also maintaining proper nutritional status and lack of obesity. Low-fiber, low FODMAPs, Mediterranean diet and Crohn's Disease Exclusion Diet diet were considered. We assume that diet is modifiable factor that is related to nutritional status and healthy body weight. In addition, the current knowledge on the relationship between nutrition strategies, obesity and IBD will be demonstrated.
Atopic dermatitis (AD) is a chronic, recurrent inflammatory dermatosis. The most characteristic symptoms of the disease include itch, eczematous eruptions and excessive dryness of the skin. Elderly patients with AD repre...Atopic dermatitis (AD) is a chronic, recurrent inflammatory dermatosis. The most characteristic symptoms of the disease include itch, eczematous eruptions and excessive dryness of the skin. Elderly patients with AD represent a poorly characterized population because the physiological ageing, possible comorbidity and polypharmacy modify the clinical presentation typically observed in the younger age groups. The aim of the study is to comprehensively assess the clinical characteristics of elderly patients (>60 years old) with AD. Data were collected from 26 AD patients treated in the Department of Dermatology of the University Hospital in Krakow. Late-onset AD with generalized/prurigo lesions was the most predominant phenotype. Skin biopsy was required in 15 (58%) patients in the differential diagnosis process. Allergic rhinitis, a positive family history of atopy and xerosis were associated with a higher number of hospitalizations during the year prior to the last admission (p = 0.034, p = 0.046 and p = 0.036, respectively). Xerosis was more prevalent among subjects with polypharmacy (p = 0.046) and higher serum total IgE concentration (p = 0.048). AD in elderly patients is a new phenotype of the disease that requires careful differential diagnosis. Aged patients with an individual or family history of atopy, due to the increased incidence of severe exacerbations of AD, may benefit from the introduction of proactive therapy.
The aim of this cross-sectional study is to examine if neglect is associated with self-rated health (SRH) and if neglect mediates the association between selected factors and self-rated health, among older men and women....The aim of this cross-sectional study is to examine if neglect is associated with self-rated health (SRH) and if neglect mediates the association between selected factors and self-rated health, among older men and women. The analyses were based on face-to-face computer-assisted personal interviews conducted with 1632 randomly selected community-dwelling individuals aged 65 years and more from among the general population of Lesser Poland. The regression models' analysis revealed that elder neglect was associated with self-rated health, and the mediation analysis demonstrated that neglect mediates the association between frequency of church attendance and SRH, as well as between marital status (being a widower vs being married) and SRH, among men. These observations can be helpful in better under- standing of the broad context of elder neglect in order to develop instruments for an efficient improvement of older adults' health and quality of life. In addition to this, the study underlines the role of social networks and social engagement as factors which might protect against neglect, and thus improve self- rated health of older people.
B a c k g r o u n d: Medical education has changed in response to scientific advances and social needs. A i m: The aim of the study was to examine curricula of medical schools around the world and to observe the trends t...B a c k g r o u n d: Medical education has changed in response to scientific advances and social needs. A i m: The aim of the study was to examine curricula of medical schools around the world and to observe the trends that currently dominate in medical education. M e t h o d: We have collected information on the current curricula of various medical schools using their official websites. When necessary, we supplemented the information using published articles describing the curriculum of a given medical school. R e s u l t s: Our findings reveal that medical schools demonstrate the need for constant reforms and adaptation to changing conditions worldwide. Generally, there is a tendency to integrate basic and clinical fields, to sooner establish bedside teaching, to provide less theoretical and more practical approaches to teaching, to implement more communication skills, and provide students with research training. C o n c l u s i o n s: Medical education has evolved and will continue to change with time. Medical schools introduce modifications to their curricula and share their experiences.
The epidemic process of COVID-19 in the world developed rapidly. The situation with morbidity, despite the establishment of quarantine, the introduction of restrictive anti-epidemic measures, and vaccination, remains dif...The epidemic process of COVID-19 in the world developed rapidly. The situation with morbidity, despite the establishment of quarantine, the introduction of restrictive anti-epidemic measures, and vaccination, remains difficult. The results of research on the influence of meteorological factors on the dynamics of the incidence of COVID-19, hospitalization, and mortality are ambiguous and contradictory. The purpose of this study is to analyze the indicators of morbidity, hospitalization, and mortality from COVID-19 in Ukraine, and to establish the level of influence of meteorological factors on them. A high variation in morbidity, hospitalization, and mortality rates was observed in Ukraine, in 2020-2021. A total of 3 waves of disease growth were established. The curve of hospitalization indicators of patients with COVID-19 had a correlation dependence on the incidence curve r = 0.766 (р <0.05), the maximum rates of hospitalization and mortality were registered in September-December 2021. A direct strong correlation was established between the frequency of registration of cases of COVID-19 and mortality - r = 0.899 (р <0.05). Most cases of COVID-19 were registered in the cold season, the least in June-August. Inverse correlations of moderate strength were established between the indicators of morbidity, hospitalization, and mortality and air temperature levels (-0.370< r <-0.461). Direct correlations of average strength (0.538< r <0.632) were established with the levels of relative air humidity.
Atopic dermatitis (AD) is the most common inflammatory skin disease. However, recent reports concerning the simple clinical aspects of treatment with topical glucocorticosteroids (TCS) and calcineurin inhibitors (TCI) ar...Atopic dermatitis (AD) is the most common inflammatory skin disease. However, recent reports concerning the simple clinical aspects of treatment with topical glucocorticosteroids (TCS) and calcineurin inhibitors (TCI) are lacking. The objective of this study is providing an update on these characteristics of AD management. A group of 150 adults suffering from AD treated with TCS during last year was asked to fill an anonymous questionnaire. The course of topical treatment was analyzed in the context of the severity of symptoms and the knowledge of the patients about therapy. During the last year, the majority of patients (66%) were treated with class IV TCS; however, in the last two weeks, class I TCS was used the most frequently (35%). Only 11% were familiar with the concept of intermittent therapy and 4% used the fingertip unit (FTU). In total, 77% of them used TCI. Most of the patients used the same class of TCS permanently. Unfortunately, patients are unaware of simple approaches (like intermittent therapy or FTU) that increase both the effectiveness and safety of the treatment. Practicians should be aware of these problems to identify and eliminate them, primarily through the education of patients.
The Buschke-Löwenstein tumor is a rare disease associated with human papillomavirus infection. The condition manifests with an ulcerative, exophytic tumor localized in the perineal area. Generally considered as non-cance...The Buschke-Löwenstein tumor is a rare disease associated with human papillomavirus infection. The condition manifests with an ulcerative, exophytic tumor localized in the perineal area. Generally considered as non-cancerous, the growth may develop malignant transformation. Our manuscript highlights the importance of early diagnosis with histopathological analysis.
UNLABELLED: A i m: Assessment of the effectiveness and efficiency of three mobile (portable) rescue aspirators models in the opinion of state fire service officers. Comparison with the use of the medical simulation eleme...UNLABELLED: A i m: Assessment of the effectiveness and efficiency of three mobile (portable) rescue aspirators models in the opinion of state fire service officers. Comparison with the use of the medical simulation element. MATERIAL AND METHODS: The study was conducted in organizational units of the State Fire Service (24-hour officers). The research consisted in carrying out the task with the use of three models of mobile rescue aspirators (manual, hand-foot, battery). Each participating firefighter had the task of sucking up an equal amount of fluid (100 ml, respectively) with each model of an aspirator. The test fluid was water at room temperature in a homogeneous 1:1 mixture with sugar (increased viscosity and density, simulated real conditions). Immediately after three suction attempts (with measured suction time), each officer completed a questionnaire on the three models used. Descriptive statistics were used to characterize the variables. The following measures were calculated for the variables: mean (M) and standard deviation (SD), minimum, maximum. The following measures were calculated for categorical variables: number (n) and frequency (%). RESULTS: 184 officers (182 M and 2 F) took part in the study, including commanders 18.43%, rescuers 65.22%, drivers 16.30%. In the study area 1,609 officers serve in the combat division as at the end of 2021. The studied group accounts for 11.43%. Age of respondents M 34.04 SD 8.24 Min 21 Max 52, length of service M 8.48, SD 7.20 Min 1, Max 25. The longest mean time of completing the task was recorded for model 2 (hand-foot) and it was 6.77 sec. CONCLUSIONS: SFS officers highly appreciated the usefulness and effectiveness of the battery-operated automatic aspirator. This assessment may contribute to the widespread introduction of such a model to rescue sets in the SFS. Time of performing the task by mode 1 was significantly longer by elderly people. People with experience with the model 1 during rescue and firefighting operations had a significantly shorter time of performing the task with the use of the model 2. According to the subjective assessment of firefighters, the most effective is model 3, which is confirmed by the suction time obtained at the work station.
Anorexia nervosa (AN) is an eating disorder characterized by distinct etiopathogenetic concepts that are gradually being linked together to unravel the dominant pathophysiological pathways underlying the disease. Excessi...Anorexia nervosa (AN) is an eating disorder characterized by distinct etiopathogenetic concepts that are gradually being linked together to unravel the dominant pathophysiological pathways underlying the disease. Excessive food restrictions, often accompanied by over-exercise and undertaken to lose weight, lead to the development of numerous complications. The biological concept of neurohormonal dysfunction in AN seems incomplete without demonstrating or excluding the role of the enteric nervous system (ENS). Using an animal model of activity-based anorexia (ABA), we conducted the preliminary assessment of the ENS structure. Here we show, in preparations stained by immunohistochemistry with anti- ChAT, anti-NOS, anti-PGP 9.5, anti-c-fos, and anti-TH antibodies, a lower density of cholinergic and nitrergic nerve fibers as well as reduced neuronal activity in myenteric plexus. Such structural and functional damage to the ENS may be responsible for a number of gastrointestinal symptoms that worsen the course of the disease. In addition, we expanded the study to address the unresolved issue of mechanical and thermal pain sensitivity in AN. The Von Frey and hot plate tests revealed, that in ABA animals, the pain threshold for mechanical stimulus decreases while for thermal increases. In this way, we have significantly supplemented the background of AN with potentially observable nervous system changes which may influence the evolution of the therapeutic approach in the future.
Temporomandibular disorder (TMD) is a disease of multifactorial etiology and a complex of symptoms, related to disorders of the masticatory muscles, temporomandibular joints and the surrounding orofacial structures. One...Temporomandibular disorder (TMD) is a disease of multifactorial etiology and a complex of symptoms, related to disorders of the masticatory muscles, temporomandibular joints and the surrounding orofacial structures. One of the main problems in the course of TMD disorders is the systematic increase in the tension of the masticatory muscles (masseter muscles, temporalis and medial and lateral pterygoid muscles), what is the cause of many damages and the development of pathological conditions in the stomatognathic system. The article discusses the differences in the structure of the masticatory and skeletal muscles, as well as the different nature and isoforms of myosin, which determines the much faster generation of contraction in the masticatory muscles and consequently easier generation of excessive, harmful tensions in the masticatory muscles. The article describes the causes of increased tension in the masticatory muscles and methods of their relaxation used in the basic and supportive treatment of temporomandibular disorders. The use of occlusal splints, physiotherapeutic procedures and TMD treatment with botulinum toxin type A were characterized. A role of psychological support and the methods used for patients with TMD were emphasized.
I n t r o d u c t i o n: Seasonal variation has been observed for bacterial and viral infections (e.g., COVID-19 [1]), but also for numerous cardiac problems. However, little information is available on the seasonality o...I n t r o d u c t i o n: Seasonal variation has been observed for bacterial and viral infections (e.g., COVID-19 [1]), but also for numerous cardiac problems. However, little information is available on the seasonality of infectious endocarditis (IE), a rare disease that is usually linked to a bacterial origin. Data from the Polish population are lacking. Materials and M e t h o d s: Our retrospective study focused on the identification of patients with IE, who were hospitalized at the University Hospital in Krakow between 2005-2022. For this purpose, we searched the medical records system using the ICD-10 code. We decided to divide our patients into four groups (winter, spring, summer, autumn), based on the date of admission to the hospital. Comparison of the distribution of IE incidents by season was performed with the ch2 test. R e s u l t s: One hundred and ten patients were included in the study (median age 62.5 years (range 20-94), 72 men (65.45%)). The left native valve IE was diagnosed in 49% of the patients, the prosthetic valve IE in 16%, the right valve IE in 27% and the implantable cardiac electronic devices IE in 12% of the subjects. The outcomes comprised of cardiac surgery (n = 53), embolism (n = 16), death (n = 15) and metastatic infections (n = 5). No differences in the incidence of IE by season were observed. C o n c l u s i o n s: In the preliminary observation of IE cases of patients admitted to the University Hospital in Krakow, Poland no seasonal pattern of IE was detected. Therefore, IE should be taken into account in the differential diagnosis at any time of the year.