Folia medica Cracoviensia最新文献

Background: The right phrenic nerve is vulnerable to injury (PNI) during cryoballoon ablation (CBA) isolation of the right pulmonary veins. The complication can be transient or persistent. The reported incidence of PNI fluctuates from 4.73% to 24.7% depending on changes over time, CBA generation, and selected protective methods. M e t h o d s: Through September 2019, a database search was performed on MEDLINE, EMBASE, and Cochrane Database. In the selected articles, the references were also extensively searched. The study provides a comprehensive meta-analysis of the overall prevalence of PNI, assesses the transient to persistent PNI ratio, the outcome of using compound motor action potentials (CMAP), and estimated average time to nerve recovery. R e s u l t s: From 2008 to 2019, 10,341 records from 48 trials were included. Out of 783 PNI retrieved from the studies, 589 (5.7%) and 194 (1.9%) were persistent. CMAP caused a significant reduction in the risk of persistent PNI from 2.3% to 1.1% (p = 0.05; odds ratio [OR] 2.13) in all CBA groups. The mean time to PNI recovery extended beyond the hospital discharge was significantly shorter in CMAP group at three months on average versus non CMAP at six months (p = 0.012). CMAP (in contrast to non-CMAP procedures) detects PNI earlier from 4 to 16 sec (p <0.05; I2 = 74.53%) and 3 to 9o (p <0.05; I2 = 97.24%) earlier. C o n c l u s i o n s: Right PNI extending beyond hospitalization is a relatively rare complication. CMAP use causes a significant decrease in the risk of prolonged injury and shortens the time to recovery.

The aim of this article is to describe surgical technique and early results of Total Ankle Replacement (TAR) from lateral approach using Zimmer TM prosthesis. The study uses theoretical knowledge which is the result of research conducted by other authors, and practical knowledge due to the fact that our center performs that type of operation. Arthrodesis as the current standard in the treatment of advanced degenerative ankle disease, apart from its advantages, also has many disadvantages. The relative durability and reduction of the patients' pain have been achieved at the expense of the adjacent joints. Their accelerated arthrosis is the result of compensatory loads as a consequence of change in foot biomechanics. That determined implementation of solutions that will guarantee elimination of pain in the ankle joint, preserve its motor function and improve gait, while having no negative impact on the mobility of adjacent joints.

Platelet aggregation contributes to the pathogenesis of cardiovascular diseases. After activation it leads to dense granule secretion and 5-HT release. The question arises; how platelet aggregation is endogenously controlled during blood circulation. In preliminary studies, we observed that human platelets aggregate more rapidly when suspended in buffer as compared to those suspended in plasma (PRP). These observations point to the presence of an endogenous substance that may inhibit arachidonic acid- induced platelet aggregation. An analysis of plasma Cohn fractions demonstrated that most of the plasma inhibitory activity was associated with albumin-rich and α-globulin rich protein fractions. The identity of plasma endogenous inhibitors of platelet aggregation (EIPA) was established by affinity chromatography on Cibacron Blue F3G-A for specific removal of albumin. The association of α-globulins to EIPA activity was recognized as due to haptoglobin by affinity chromatography on a column of hemoglobin-sepharose. In addition, we also found that the distribution of EIPA activity varies according to sex and physiological state. These findings reveal that EIPA may act by modulation of arachidonic acid metabolism or sequestering the fatty acid substrate.

Colorectal cancer (CRC) is the third most common malignancy worldwide and the second most deadly cancer. Scientists have projected that by 2040, the prevalence will reach up to 3.2 million new cases annually due to population aging, disadvantageous diet transformations, and elevated exposure to risk factors. In the past decades, the five-year survival rate in colorectal cancer has significantly increased to 65% due to the development of an early endoscopic diagnosis and new chemotherapeutic approaches. Fluoropyrimidines, such as 5-fluorouracil or capecitabine, are commonly used to treat CRC. One of the most fundamental mechanisms of 5-FU is based on the inhibition of thymidylate synthase. This action is responsible for the therapeutic, but also toxic, effects of the drug. In this short review, we discuss the possible effects of vitamin D activity on colorectal cancer cells in relation to fluoropyrimidines. PubMed, Embase, and Web of Science databases were searched up to January 2022 for studies on vitamin D and 5-fluorouracil interaction mechanisms. Original studies, case reports, and review articles were included. Vitamin D or its analogs target multiple biochemical pathways and modulate numerous pathophysiological mechanisms in the course of colon cancer, including those related to the pharmacological sites of fluoropyrimidines. However, the available data concerning vitamin D-fluoropyrimidine pharmacological interactions are limited, especially regarding patients suffering from colon cancer and being treated with fluoropyrimidines.s.

Malignant neoplasms are currently a severe medical challenge and the second leading cause of death worldwide. The modern anesthesia applied may improve the patient outcome. This paper presents a review of anesthesia management related to patients with gynaecologic malignancies. It includes the influence of the type of anesthesia on cancer recurrence, application of regional anesthesia in gynaecologic oncologic surgery, and selected aspects of anesthesia for robotic surgery. We performed a literature search on MEDLINE, EMBASE, Google Scholar, the Cochrane Central Register of Controlled Trials, and Clinical Trials. The database search focused on the topics related to anesthesia in gynecological oncology. The authors also contributed through individual, independent literature searches.

This article characterizes the etiology of temporomandibular disorder with particular emphasis on emotional factors that have a major impact on the development of these dysfunctions and the most common their symptoms. They mainly affect people in the third and fourth decade of life and women predominate among this group of patients. The article analyzes the current literature (Pub Med Database, Scopus and EMBASE) in relation to the conditions in the work environment, which often constitute important causes of emotional tensions, constant state of mental tension and susceptibility to the effects of stressors, which have an impact on the state of functioning of the musculoskeletal system of the masticatory system. Despite the high frequency of temporomandibular disorders, unfortunately only a few studies describe the influence of harmful factors related to the work environment, and own experience (information from the patient's interview) and data from the literature indicate a significant share of these factors in the development of temporomandibular disorder. The relationships and anatomical connections affecting the influence of stressors on the functioning of masticatory muscles and temporomandibular joints are also discussed. In conclusion, it should be stated that the work environment and the emotional tensions generated in it constitute a serious sociological problem and increase the risk of developing and intensify the symptoms of TMD.

TMD is a group of pathological changes including increased tension in the masticatory muscles, pain in the muscles and/or the temporomandibular joints, abnormal range of the mandibular movement or the presence of acoustic symptoms in the joints in the form of clicking or poping. The aim of the project was to compare the effectiveness of two methods of physiotherapeutic rehabilitation, used in adolescent patients with temporomandibular disorders.

Material and methods: The material consisted of 68 patients, aged 14 to 17, of both sexes, generally healthy, who came to the Dental Prosthetics Department for treatment due to pain in the masticatory muscles. Dental examination and diagnostics revealed Ia in all cases in accordance with RDC/TMD protocol. Manual therapy was performed in group I (34 people) and kinesitherapy with massage was performed in group II (34 people). Patients were allocated randomly to both groups. Contraindications were considered for both methods.

Results: Within the first study, mean values of pain intensity between group I and group II were not significantly different (6.12 and 6.24 respectively). Within the second study significantly lower VAS scores in both groups have been revealed (0.92 and 0.74 respectively). Results of the first and second study differed significantly in both groups. Similar results were obtained for the maximum abduction of the mandible.

Conclusions: The results of the conducted studies indicate a beneficial effect of the assessed physiotherapeutic procedures in terms of functional rehabilitation of adolescent patients with temporomandibular disorders.

Background: Autonomic dysfunction, impaired baroreflex sensitivity (BRS), and deranged circulatory homeostasis have been observed in chronic hyperglycemia and found to be associated with increased cardiovascular morbidity and mortality. However, the acute effects of hyperglycemia in healthy subjects have been rarely studied. The present study explores the effect of acute hyperglycemia on conventional and unconventional parameters of BRS in healthy young adults.

Methods: For the estimation of BRS beat-to-beat blood pressure (BP) and electrocardiogram were recorded in forty-two young, healthy subjects during fasting and at 1hr of the oral glucose load. Analysis of BRS was carried out by sequence and spectral method. Number of UP-, DOWN- and ALL-sequences between ramps of BP and RR-interval were calculated as an unconventional measure of BRS along with the other conventional parameters.

Results: We observed significant alteration of unconventional parameters of autonomic functions [the number of sequences of UP- (p = 0.0039) and ALL-sequences (p = 0.0233) of systolic BP and RR interval; and, UP- (p = 0.0380), DOWN- (p = 0.0417) and ALL-sequences (p = 0.0313) of mean BP and RR- interval] during acute hyperglycemia as compared to the fasting state. However, no significant changes were observed in any of the conventional parameters of BRS during acute hyperglycemia as compared to the fasting state.

Conclusions: Present study concludes that the unconventional parameters of BRS - the number of sequences between the ramp of BP and RR-interval - change significantly during acute hyperglycemia. However, the conventional parameters do not show significant changes during acute hyperglycemia. We may hypothesize that the relatively constant BRS is maintained at the expense of increased oscillations in the ramp of BP and RR-interval.

The main target during management of a male pediatric patient with clinical signs of acute scrotum is the timely diagnosis, in order not to jeopardize the viability of the affected testicle. Thorough evaluation of the patient's medical history, symptomatology, clinical and ultrasonographic findings, constitutes the basis of the diagnostic procedure. After comprehensive research of the relevant literature, we highlight the remaining difficulties in the evaluation of the clinical and ultrasonographic findings for the accurate diagnosis of the acute scrotum. In conclusion, it is worth emphasizing on the following: a. the most common diseases that come under the diagnosis of the acute scrotum may present with similar symptoms, b. in neglected cases the diagnostic approach becomes more difficult, constituting the evaluation of the pathognomonic clinical signs challenging, and c. inability to exclude the diagnosis of spermatic cord torsion should be an indication for the surgical exploration of the affected hemiscrotum.

The interstitial cells known as telocytes have been described in various organs. Their role in the normal physiology and pathogenesis of numerous diseases is well known. They have been described in the context of various diseases (gallstone disease, endometriosis, uterine myoma, hydronephrosis, myocardial infraction, psoriasis, etc.), while their impact on inflammation, involvement in angiogenesis, and repair highlights their part in local homeostasis. What is known about their relationship with the immune system? Their secretomes, genome, immune profiles, contacts with surrounding cells, and specific localization allow us to give a possible explanation for their involvement in pathological pathways. This review aims to present the roles and features of telocytes in the context of intestinal immunity (the largest in our body), in the spleen, their interactions with immunocytes, and their place in stem cell niches.