Folia medica Cracoviensia最新文献

Myocardial extracellular volume (ECV) expansion is associated with myocardial abnormalities such as interstitial fibrosis, inflammation or amyloid deposition. Our aim was to search for correlates of ECV fraction (ECVF) derived from routine cardiac computed tomography (CT) of real-world patients. We retrospectively derived ECVF from archived chest CT scans performed in 103 patients (51 women and 52 men; mean age: 66 ± 13 years) during a diagnostic work-up based on clinical indications. From recorded echocardiographic images, we calculated indices of left ventricular (LV) structure and function, including systolic (S') and diastolic (E' and A') mitral annular velocities. There were no significant relations between ECVF and clinical or echocardiographic parameters. LV function was comparable according to median ECVF (24.7%) (S': 10.4 ± 4.1 vs. 9.5 ± 8.0 cm/s; E': 9.2 ± 3.4 vs. 9.4 ± 3.1 cm/s; E'/A' ratio: 1.0 ± 0.6 vs. 1.2 ± 0.9; E/E' ratio: 9.0 ± 4.8 vs. 9.4 ± 5.8 for ECVF above and below the median, respectively). S' and E' were positively correlated in 52 subjects with an over-median ECVF (r = 0.46, p = 0.001), in contrast to their 51 counterparts with a below-median ECVF (r = 0.15, p = 0.3). In conclusion, ECV expansion might be associated with a marked interdependence of S' and E', corresponding to systolic and early diastolic LV performance, respectively. As E' is a rough surrogate index of LV active relaxation, these findings could reflect a contribution of LV fibrosis to early LV diastolic dysfunction, known to coincide with discrete LV long-axis systolic dysfunction. Further studies are warranted to investigate relations between CT-derived ECVF and LV mechanics.

Complex regional pain syndrome (CRPS) is a descriptive term for a complex of symptoms and signs, including pain, swelling and vasomotor disturbances. The disease causes also functional impairment of the affected extremity and limitation in daily activities. Even after effective treatment, the condition frequently leaves residual symptoms and impairment of the limb. The objective of this study was assessment of the level of functional impairment in patients who got over CRPS. Materials and Methods: Fifty-two patients, 45 women (86%) and 7 men (14%) in a mean age of 57 years who were got over CRPS were asked to fill 2 questionnaires for assessment of function of their upper limbs in daily living. The questionnaires included the Raadboud Skills Questionnaire (the RASQ) and the Disability of Arm, Shoulder and Hand (the DASH). Results of this study show statistically significant differences in functional impairment of the limbs between the groups with different recovery status and duration of CRPS: the patients with longer lasting disease and those, who did not feel recovered showed greater functional impairment of their limbs than remaining patients. Conclusion: These results suggest that, in spite of a satisfactory outcome of treatment, significant long- term sequelae of the disease impair function of the affected limbs and reduce quality of life in a proportion of patients.

Temporomandibular disorder (TMD), occurring in the form of articular disc displacement with- out reduction is one of the most serious and common forms of dysfunction. The aim of this article was to present a complete sequence of procedures and intervention that consequently led to the resolution of symptoms in most patients, associated with disc displacement without reduction and the resolution of joint's pain, as well as favorable results of treatment of disc displacement with reduction.

Material and methods: A group of 128 patients (86 females, 42 males) aged 20 to 42 years old, diagnosed with disc displacement without reduction undertook treatment at the Prosthodontics Clinic of the University Dental Clinic in Krakow, in period January 2020 - June 2024. Diagnosis of the condition was made on the basis of the DC/TMD (Diagnostic Criteria for Temporomandibular Disorders) questionnaire axis I (reduction in mouth opening <35 mm, oblique lowering path of mandibular motion, pain of the joint) and the results of ultrasonography (USG) of the temporomandibular joints. 121 patients reported experiencing intrinsic pain and 7 patients presented for treatment without feeling pain.

Result: Analysis of the results of the carried-out tests (maximal mouth opening, mandibular lowering trajectory deviation and pain intensity VAS + VNRS scale indicate that the displaced articular disc was unblocked and a statistically significant improvement in the clinical condition of the temporomandibular joints was achieved.

Conclusion: The proposed sequence of procedures carried out is an effective treatment for displacement of the articular disc with no reduction.

Introduction: Recent decades brought important insights into the role of vitamin D, showing, among others, its anti-inflammatory properties. Studies linked vitamin D deficiency with higher incidence and worse outcomes of acute inflammatory conditions. Several studies reported low vitamin D status in acute pancreatitis (AP), however, its association with AP severity is not clear, and there are no such studies in Polish population. The aim of the study was to evaluate the concentrations of 25-OH-D at the early phase (the first three days) of AP, to assess the changes in vitamin D concentrations in that period, and to study the relationship with AP severity.

Materials and methods: The prospective observational study included adult patients with AP admitted within the first 24 h from the onset of symptoms. Total 25-hydroxyvitamin D was measured at 24, 48 and 72 h from the AP onset, using electrochemiluminescent assay.

Results: Initial 25-OH-D was not associated with AP severity. In patients who developed moderately severe to severe AP and pancreatic necrosis, the decrease in 25-OH-D over two consecutive days was higher comparing to mild AP. The change in 25-OH-D concentrations during the first three days of AP was significantly correlated with inflammatory markers (C-reactive protein, leukocyte count, D-dimer), total calcium, hematocrit, and platelet count.

Conclusions: Our study confirmed the decrease in 25-OH-D in AP; however, it cannot be reliably used as an early prognostic factor of severity in AP as it appears too late from the onset of symptoms and its diagnostic accuracy is low.

The paper entitled "Ethics in cardiac surgery, the new times. Philosophy in the background" concentrates on the currently most preoccupying issues of medical deontology which are related to practicing the profession of a cardiac surgeon. In the background of his considerations the author refers to the philosophy of medicine. The paper discusses the dilemmas resulting from the lack of understanding of the essence of camaraderie, excessive ambition and responsibility in everyday activity in cardiac surgery. The article ends with sad reflections on the constant problems with which the Polish medicine has to struggle when faced with the degradation of the profession of a physician, excessive bureaucracy, endless haste, legal requirements obligatory in the modern highly commercialized world, underfinancing of the health care sector and shortage of personnel.

Temporomandibular disorders (TMD) are a muscular subset of temporomandibular joint disorders, that can cause orofacial pain. They can be triggered by overactive masticatory muscles due to prolonged disclusion times (DT), occlusal interferences, and occlusal surface friction. Regarding diagnostics, digital occlusal analysis systems are used to determine the parameters of opposing tooth contact and pressure, the ratio of forces on the right and left sides of the oral cavity, to accurately calculate disclusion and occlusion times, and to precisely measure resultant force during maximum and partial intercuspidation. Even though they can be an appropriate tool in modern orthodontic and prosthodontics treatments, these methods are rarely used for patients undergoing multidisciplinary treatment. The aim of this review was to summarize the current knowledge on the clinical application of digital occlusal analysis in the treatment of temporomandibular joint disorders using next-generation systems (T-Scan Novus III, Occlusense) and to identify future research directions for the use of this technology.

Introduction: Basal cell carcinoma (BCC) is the most common skin cancer with increasing prevalence in the last years. The most important risk factor for development of BCC is exposure to UV radiation. Surgical excision remains the first line treatment, but there are some non-surgical methods of treatment. The aim of this study is to present a case of 100-year-old patient with advanced BCC in temporal area who refused surgical treatment. The noninvasive treatment with imiquimod was successful.

Case presentation: The 100-year-old male patient was admitted to the dermatological outpatient clinic with an ulceration within the forehead, which had been increasing in size for 3 years. Physical examination revealed shallow irregular ulceration with erythematous pearly-shaped borders in the right temporal area measuring ca. 1.5 cm × 2 cm. Dermatoscopic examination of the lesion showed arborising vessels on the semitransparent background, white structureless area and numerous erosions, leading to an initial diagnosis of BCC. Patient refused any surgical interventions within the lesion including skin biopsy. Consequently, treatment with 5% imiquimod was initiated with cream application for 8 weeks, once daily 5 times a week. 8 months after termination of treatment there were no clinical and dermoscopic signs of recurrence of BCC. The patient remains under dermatological follow-up.

The pterygoid hamulus is a bony process that protrudes from the medial pterygoid plate of the sphenoid bone. In spite of its small size and fragile structure, the pterygoid hamulus is an important anatomical structure in many clinical aspects. Orofacial pain may be related to inflammation or irritation of the pterygoid hamulus; if not, other possible explanations should be explored. In addition, the pterygoid hamulus is an important landmark in the oral cavity and is utilized in a number of dental and medical procedures. Thus, the purpose of this work was to review recent studies demonstrating the role and significance of the pterygoid hamulus in clinical practice.

Magnesium is one of the bioelements necessary for proper human functioning. It is classified as a macronutrient. Together with calcium and phosphorus, it is the main building component of teeth. It has antibacterial properties, as consequence of which it can impede the formation of biofilm and thus reduce inflammation caused by bacterial toxins. Along with calcium, phosphorus and vitamins, magnesium helps maintain the health of the human body. The scientific literature contains an increasing number of studies describing new methods for preventing caries resulting from interference with the oral microbiome. Modification of the microbiome and the use of prebiotics may prove to be groundbreaking. Magnesium may have the potential to function as a prebiotic because it promotes the colonization of commensal streptococci in the oral cavity. By changing the oral microbiome, it could play an important role in dental caries prevention. Nanotechnology is a new concept of material production that has emerged both in dentistry and other fields. In view of the resistance of certain bacteria to antibiotics and other bactericidal agents, alternative dental materials with increased antibacterial properties are being sought by adding antibacterial nanoparticles (NP) to their composition. One of the most commonly used metal oxides is magnesium oxide. Its antibacterial action involves disrupting the bacterial cell membrane. It seems that nanoparticles may be promising fillers for dental composites. However, due to the limited character of the clinical trials to date, there is a need for further experiments.

Bloodstain Pattern Analysis (BPA) is now an obvious part of forensic medicine, a discipline with its own methodology, scientific aims and practical goals. Roots of it are in experimental work of Polish physician Eduard Piotrowski, with results published in 1895. Significance of it was not immediately recognized. In this paper we aim to show why and how Piotrowski's model for BPA was finally incorporated into the realm of medical tradition.