Folia medica Cracoviensia最新文献

Bifid ribs are a congenital anomaly that in the majority of cases does not demonstrate clinical symptoms. Nevertheless, their presence may be linked to several genetic disorders that affect different systems of the human body. Symptomatic conditions of bifid ribs can appear as follows: chest deformity and pain, breathing difficulties due to the structural changes in the thoracic wall, and neurological complaints caused by compression of the intercostal nerves. Hereby, we presented a concise review of clinical reports documenting symptomatic cases of bifid ribs and their potential associations with systemic disorders. This article also examines cases of bifid ribs encountered in the clinical practice of plastic surgeons, pediatric surgeons, and cardiothoracic surgeons.

The gold standard for assessing liver fibrosis is core needle biopsy. Its invasive nature, however, limits its wide use. Hence the need for non-invasive methods in patients with hepar venostaticum due to right ventricular [RV] failure: one of them is the FIB4 index. Another method, Fibroscan, is based on an ultrasound technique from elastography.

Objective: to assess the correlation and determination indices between the FIB4 index and the assessment of liver stiffness by Fibroscan (E) on one hand and echocardiographic parameters describing RV function on the other hand. The study group: 33 patients (74 ± 13 years) with heart failure due to pulmonary hypertension, arterial hypertension, valvular diseases, myocardial infarction or cardiomyopathy.

Results: echocardiography - RV dimension 38 ± 8 mm, systolic pressure in pulmonary artery (SPAP) 53 ± 24 mmHg, tricuspid annular plane systolic excursion (TAPSE) 17 ± 4mm, acceleration time of flow through the pulmonary valve (ACT) 79 ± 23 ms, the degree of tricuspid valve regurgitation 2 ± 1; the FIB4 result in this group - 2.54 ± 1.19, and the stiffness index E: 13.79 ± 12.55 kPa. Only RV dimension and the degree of tricuspid valve regurgitation showed moderately strong positive correlation with the stiffness index E: the correlation index - 0.327 and 0.382, respectively, with the determination index 27.9% and 43.4%, respectively.

Conclusion: The results emphasize the relationship between the morphological remodeling of the RV and the degree of secondary tricuspid regurgitation and the advancement of fibrotic changes in the liver and encourage the continuation of studies on larger groups of patients with a homogeneous etiology of RV failure, using a wider spectrum of echocardiographic parameters.

Imaging diagnostics, supported by advances in medical equipment and software, is a dynamically evolving field of medicine. Methods that improve the precision of disease detection are currently in high demand. This paper discusses spectral computed tomography (CT), specifically dual-energy computed tomography (DECT), which is a modern and advanced imaging technique offering significant advantages over conventional single-energy CT (SECT). DECT provides additional diagnostic information and reduces the effective dose of ionizing radiation to the patient. A key benefit of DECT is its ability to reduce image artifacts compared to SECT. The article explains the operating principles of DECT and reviews its clinical indications, with a focus on neuroradiology. Special attention is given to the differentiation of intracranial hemorrhage from calcifications and distinguishing fresh blood from iodinated contrast media - especially in overlapping areas - through the interpretation of base pair images. DECT also plays an important role in evaluating the progression of intracerebral hematomas and detecting the "spot sign" in CT angiography (CTA) of the brain. Another application is in imaging the vascular system of the head and neck using DECTA, where bone removal and virtual non-contrast image reconstruction are particularly useful. The final section of the paper addresses artifact reduction methods in neuroradiology and outlines the key advantages and limitations of DECT in clinical practice.

The mast cell is an immune cell involved primary in host defense of organism. Moreover, it plays an important role in atopic diseases. Recently, accumulating evidence established the contribution of the mast cell in atherogenesis. Through its release of mediators, activated mast cells can have proatherogenic effects on its surroundings in the vessel wall. In this review, we will discuss the current knowledge on mast cell function in atherogenesis and atherosclerosis - caused cardiovascular diseases.

Immunoassays are widely utilized in urine drug screens due to their simplicity, ease of automation, and rapid results, making them the standard for clinical and workplace drug testing, as well as in rehabilitation programs and legal systems. However, the potential for cross-reactivity with both structurally related and unrelated compounds increases the risk of false-positive results. This poses significant challenges for healthcare professionals, especially in populations undergoing routine drug testing, such as those in recovery or court-ordered monitoring programs. The ongoing opioid epidemic in the United States, which has resulted in countless deaths from both prescription and illicit opioids, underscores the critical importance of accurate drug detection methods. This review evaluates specialized drug assays, highlighting their effectiveness and limitations. While immunoassays are highly sensitive, they often lack specificity, increasing the risk of false positives, which can affect clinical and legal decisions. This research also details substances prone to causing false positives, aiding clinicians in making informed diagnostic and therapeutic decisions.

Saliva, a seemingly unpretentious secretion, is actually a multifaceted and multipurpose biofluid. Performing numerous functions, far exceeding only lubrication of oral mucosa, it is essential for general health. Saliva's remarkable properties are primarily due to its constituents, mainly peptides and proteins. Excreted at the entrance to the gastrointestinal tract, this biofluid-active in the oral cavity-also affects other sections of the canal alike, particularly esophagus, where its active components do not undergo degradation. Animal models employing sialoadenectomy consistently with clinical data of patients afflicted with issues related to insufficient salivation, clearly demonstrate how indispensable proper saliva secretion is. In this paper we briefly summarize current perspectives on saliva, with a focus on its protein components and its impact on the upper part of the alimentary tract, particularly on oral and esophageal mucosa. The practical aspects of the modern proteomic research of saliva being at the forefront of salivaomics progress are also discussed, and the current state-of-the-art proteomic methodology is outlined.

Pregnancy of unknown location is still a significant diagnostic and therapeutic problem in the population of women of reproductive age. The management of women with PUL can vary widely, as there are still no standardized guidelines for the diagnosis and treatment of such a clinical situation. The diagnostic effort in this initial diagnosis should be directed both to the exclusion of ectopic pregnancy, which carries a significant risk to the patient, as well as a properly implanted pregnancy, since the implementation of treatment may be associated with adverse effects on its subsequent fate. The authors reviewed the literature on this issue, taking into account their own experience in the management of pregnancies of unknown location. They conducted a critical analysis of the literature on PUL found in MEDLINE, Google Scholar, the Cochrane Central Register of Controlled Trials, and Clinical Trials.

In Poland, preterm infants account for 6-7% of all births. Preterm deliveries are associated with a number of short- and long-term health conditions and therefore pose a major public health challenge. Monitoring the psychomotor development of children born prematurely is a significant challenge for pediatricians and neonatologists. Early diagnosis of delayed functional development enables timely therapeutic intervention by developmental specialists, such as physiotherapists, educators, psychologists, and speech therapists. Currently, monitoring the development of preterm infants during the first year of life is common practice. However, due to the significant percentage of late preterm infants in the population of prematurely born newborn population, there is a justified need to focus on the periodic assessment of their functional development also beyond the first year of life. Regular and multidimensional developmental monitoring in this group of patients is crucial due to the increased risk of subtle but clinically significant developmental delays that may manifest at later stages of life.

Introduction: Childbirth, regardless of its course, is one of the most significant events in a woman's life. In perinatal care, both medical aspects and the woman's needs for choice, information, and support are crucial. The fulfillment of these needs influences satisfaction, which is an element of care quality evaluation. The aim of this study was to analyze tools for measuring women's experiences in perinatal care, considering the subjective nature of satisfaction and factors affecting care quality.

Review methods: A literature review was conducted on validated tools and questionnaires used to assess patient-reported outcomes. Systematic searches in PubMed, Scopus, and Google Scholar databases included keywords such as "satisfaction of care," "maternal satisfaction," and "questionnaires" in Polish and English. The analysis was part of research conducted within the doctoral dissertation of one of the authors.

Conclusions: Publications highlight the use of diverse measurement tools, ranging from general satisfaction surveys to specialized questionnaires. These tools address aspects such as the quality of communication with medical staff, pain management effectiveness, and respect for patient autonomy. However, most tools have not been adapted or validated for use in Poland. The importance of employing verified measurement tools in evidence-based practices and their role in improving patient-provider relationships was also discussed.

Henryk Kadyi's (1851-1912) work in anatomical research is closely related to researching fundamental problems of preserving anatomic specimens for science and teaching. The goal of this study is to describe the professional life of Henryk Kadyi, to highlight his achievements for modern anatomy and to use his story to demonstrate the importance of mentoring, international scientific communication and cross border cooperations for scientific success. The development of novel conservation methods gained him enormous respect of the scientific community and secured him a place in the history of medicine. Kadyi was educated in Vienna and shaped by Hyrtl and Langer. He then started residency in Krakow, where he was supervised by Teichmann, a disciple of Hyrtl. There, he received a call for professorship in Lviv. At each location, he was influence by local conditions, which improved his anatomical skills. This is a good example of the interconnection of knowledge, skills, scholarship, and scientific tradition between academic centers - in this case, Vienna, Krakow, and Lviv in the second half of the 19th century. Our paper focuses on Kadyi's preparatory techniques with a particular emphasis on the influence that the education and skills acquired in Vienna and Krakow had on them and how they were shaped when Kadyi was already an independent researcher in Lviv.