Folia medica Cracoviensia最新文献

The knowledge of anatomical variation of lumbar plexus helps to interpret the causes of lumbar plexopathies and at the same time minimise iatrogenic nerve injuries. This report describes a unique variation in the branching pattern of lumbar plexus in a 63-year-old male's cadaver. On both sides, the genitofemoral nerve emerged from the lateral border of the psoas major instead of from its ventral surface. Furthermore, on the left side, the iliohypogastric and the ilioinguinal nerve had a common trunk before its bifurcation which took place just proximal to the lateral end of the left inguinal ligament. The rest of the branches of the lumbar plexus on both sides were normal. In the present case, the bilateral genitofemoral emergence from the lateral border of the psoas major is a very rare aberration having immense relevance in the clinical management of genitofemoral neuralgia.

In 2022, an estimated 660 000 women were diagnosed with cervical cancer worldwide and about 350 000 women died from the disease. Human papillomavirus (HPV) infection is one of the most common sexually transmitted infections. However, only a small percentage of high-risk (HR) HPV infections progress to cervical precancer and cancer. In this study, we presented the role of the cervicovaginal microbiome(CVM) in the natural history of HPV infection. Non-viral factors associated with the outcomes of HR-HPV infections have not been fully elucidated. While smoking, hormonal contraceptive use, and parity are associated with developing precancer and cancer, systemic and local immune responses are thought to be important for clearance and control of infection. In addition, specific host immune regulatory alleles are associated with risk of cervical cancer development. There is a strong association between changes in vaginal microbiota and persistent HPV infection, and improving vaginal microbial environment would reduce the risk of developing cervical cancer.

In contemporary medical practice, a reductionist focus on physical symptoms and biotechnological interventions often sidelines the relational and emotional dimensions of patient care. This paper explores the potential benefits of integrating phenomenological approaches into everyday healthcare practice. Drawing on the seminal works of Merleau-Ponty, Gallagher, Mazis, Benner, and Svenaeus, among others, the study illustrates how a phenomenological stance - characterized by a suspension of preconceptions and an embrace of "not-knowing" - can transform clinical encounters. By acknowledging the intersubjective and affective layers of health, clinicians can move beyond viewing the body as a mere mechanistic entity to appreciate it as an embodied, dynamic presence embedded in a network of social and personal meanings. Such a perspective not only fosters attentiveness and more effective communication between patients and providers, but also challenges entrenched biomedical paradigms that isolate the physical from the experiential. Ultimately, this integrated approach calls for healthcare policies and clinical practices that respect the multifaceted nature of human existence, paving the way for a more relation-centered model of care.

Introduction: Prostate benign hyperplasia affects a significant number of men over 50 years, often causing symptoms in the lower urinary tract. While, prostate cancer is the most common cancer in recent decades.

Aim: The aim of the study was assessment of the level of illness acceptance, sexual, and urinary disorders among men with prostate cancer or benign prostatic hyperplasia.

Methods: In the study, 100 patients who have been treated in the urology departments because of benign hyperplasia or prostate cancer participated. The Acceptance of Illness Scale (AIS), International Index of Erectile Function (IIEF-15), and International Prostate Symptom Scale (IPSS) were used in the research.

Results: The respondents weakly accepted their illness (26.9 points). The intensity of symptoms accompanying prostate diseases was moderate (18.8 points), and they were mainly characterized by moderate disorders in the IIEF-15 scale (erectile function - 9.3 pts, orgasmic function - 2.9 pts, sexual desire - 5.1 pts, intercourse satisfaction - 3.7 pts, overall satisfaction - 4.4 pts). There are statistically significant differences in the acceptance of illness due to marital status and treatment method. There is also a statistically significant correlation between the level of symptoms accompanying prostate diseases (IPSS), illness acceptance (AIS), and the level of sexual disorders in overall satisfaction (OS).

Conclusions: A low level of illness acceptance, moderate severity of symptoms related to urination, and serious sexual disorders suggest the implementation of broader help for patients, including psychological, sexological, urological, and other specialists. The outcomes showed how difficult the condition of prostate disease is for men, including sexual and urination disorders.

Anthocyanins are a group of organic compounds believed to show anti-inflammatory, anti-proliferative, antioxidant, pro-apoptotic effects. For these reasons, anthocyanins may potentially be lied in the cancer chemoprevention as well as in providing a metabolic support during oncological treatment.

Objective: The aim of this study is to compare the antioxidant activity and analyze the content of bioactive substances in selected freeze-dried fruit species in order to determine the optimal source of anthocyanins for subsequent clinical trials involving patients undergoing treatment for colon cancer.

Materials and methods: The study employed freeze-dried fruits of chokeberry, blackberry, strawberry and raspberries: black, yellow and red. The total antioxidant activity was determined using the FRAP, the DPPH method and total polyphenol by UV-VIS spectrophotometer.

Results: Chokeberry exhibited the highest antioxidant activity, as measured by the FRAP method, followed by black raspberry, blackberry, strawberry, yellow and red raspberry. The highest content of polyphenols was found in chokeberry and black raspberry, while the other fruits had relatively lower levels. Black raspberry fruits contained the highest concentration of anthocyanins. The highest concentration of vitamin C was detected in yellow raspberry fruits.

Discussion and conclusion: Based on biochemical analysis and considering organoleptic properties, particularly taste and the potential for good tolerance of the formulation by patients, freeze-dried fruits of black raspberry and strawberry were selected for clinical study on the use of anthocyanins in the nutritional and metabolic support of patients undergoing treatment for colorectal cancer.

The use of cone beam computed tomography (CBCT) in endodontic diagnostics and treatment is gaining importance due to its ability to provide three-dimensional imaging of tooth structures and their surroundings. CBCT allows a precise assessment of the anatomy of the endodontic space, which is crucial in planning and performing effective root canal treatment. Traditional two-dimensional imaging techniques often prove insufficient in diagnosing the complex morphology of dental canals, increasing the risk of leaving areas untreated and potential treatment failure. The aim of the study was to assess the ability to analyses the morphology of anterior mandibular teeth in adolescents aged 18-20 from Kraków using two diagnostic methods: panoramic radiographs (OPG) and cone beam computed tomography (CBCT). The study compared the effectiveness of both methods in identifying key anatomical and morphological parameters of teeth. The analysis covered radiographs of 306 permanent teeth (102 central incisors, 102 lateral incisors, 102 canines) in 51 patients. The analyzed parameters included the number of roots, the number of root canals, the length of teeth and canals, the presence of apical delta, lateral canals, denticles, and the classification of dental cavity morphology according to Vertucci. The results were compared statistically using McNamara and Wilcoxon tests. • Central incisors: CBCT showed more pronounced differences in the number of canals and the presence of additional structures (e.g., apical delta in 50% of cases), when compared to OPG (4%). • Lateral incisors: CBCT showed incisors with two canals in 37% of the cases, while OPG identified none. CBCT also presented the apical delta more precisely (43% vs. 6% in OPG). • Canines: CBCT identified two channels in 19% and apical delta in 60% of the cases, while OPG identified two channels in 2% and 20% of the cases, respectively. CBCT proved to be a more precise diagnostic method when compared to OPG, especially in assessing the number of canals, and the presence of apical delta and lateral canals. The results suggest that CBCT provides important information in the diagnostics of.

Introduction: Acute cholecystitis (AC) is a condition that requires surgical treatment. Laparoscopic cholecystectomy (LC) is considered the gold standard. Based on routine blood tests, it is possible to determine the neutrophil-to-lymphocyte ratio (NLR), which accurately characterizes the body's systemic inflammatory response. The NLR is used as a prognostic tool in many gastrointestinal diseases and may therefore be useful in the diagnosis of AC.

Aim: The objective of this study is to assess the prognostic value of the NLR index in the course of AC.

Materials and methods: This is a retrospective analysis of patients with AC who underwent LC. The study analyzed the following factors: emergency or elective admission, white blood cell count and bilirubin levels which are the part of preoperative laboratory tests, intraoperative complications such as gallbladder perforation and empyema formation, surgery duration, and length of hospital stay.

Results: The study involved 306 patients treated with LC. In the group of patients with NLR >5, there was a statistically significant correlation with higher risk of emergency admission, elevated bilirubin levels, higher risk of empyema, longer surgery time and hospital stay. We did not find an association between the NLR index and the risk of gallbladder perforation or patient gender.

Conclusions: High NLR values are associated with an increased risk of complications during AC. Therefore, this predictor can be successfully used in clinical practice to identify the severe course of cholecystitis.

Introduction: Bariatric surgery is critical for management of pathological obesity. In Poland, there is a paucity of data regarding bariatric care in the private sector.

Aim: This study evaluates the characteristics of private bariatric centres in terms of performed procedure types, regional distribution, and the level of care in comparison to public facilities.

Materials and methods: An online survey was distributed to bariatric centres in Poland. Collected data included numbers and types of bariatric procedures performed in 2023 and centre characteristics. Responses were analysed using chi-square and Kruskal-Wallis tests, with significance set at p <0.05.

Results: 7 of 54 surveyed centres were private and performed 872 bariatric surgeries (9.1% of the total procedures in Poland). The most common type of surgery was laparoscopic sleeve gastrectomy (LSG) in both sectors (70.1% in private, 83.1% in public). Endoscopic sleeve gastroplasty (ESG) was exclusive to private centres. Significant regional disparities were noted. The level of care was comparable with public hospitals. Private centres offered significantly shorter wait times (median 1.5 months vs. 4 months in public).

Discussion: Private centers demonstrated comparable care standards to public facilities, with certified surgeons, multidisciplinary teams, and postoperative support. Factors such as cost and regional disparities can limit the access to private healthcare.

Conclusions: One in ten bariatric procedures in Poland are performed in private centers. These centers offer similar procedure types and quality standards as public hospitals while providing shorter wait times and procedures unavailable in the nationalized healthcare system, such as ESG.

Jan (Johann) Mikulicz-Radecki (1850-1905) was one of the most illustrious surgeons in the history of medicine, and eponyms in modern medicine bearing his name are still numerous. In this paper we present only a small part of his achievements, focusing on oncological aspects and narrowing our investigation to the period of 1882-1887, when Mikulicz was a professor in the Medical Faculty of Jagiellonian University, in Krakow.

Background: Bereavement support can benefit caregivers suffering from the loss of a loved one. We report successes and challenges of a randomized clinical trial comparing cognitive behavioral therapy (CBT) to supportive care counseling for caregivers.

Methods: We recruited caregivers of individuals who previously received palliative care treatment and were now deceased. The study was conducted in a public hospital in New York City predominantly serving low-income patients. Treatments were either CBT or supportive care counseling. Treatment consisted of eight sessions over six months. Outcomes were measured at three and six months. Outcomes were the Bereavement Experience Questionnaire-24 (BEQ-24) which contains three subscales of existential loss/emotional needs, guilt/blame/anger, and preoccupation with thoughts of deceased and the Patient Health Questionnaire-9 (PHQ-9) which measures depressive symptoms.

Results: Only two people were enrolled in the trial and 101 people declined to participate. For both CBT and supportive care counseling, there were reduced bereavement symptoms for BEQ-24 existential loss/emotional needs, BEQ-24 preoccupation with thoughts of deceased, and PHQ-9 depressive symptoms from baseline to six months. For supportive care counseling, BEQ-24 guilt/blame/anger increased from baseline to six months while CBT had the same value from baseline to six months. The most common reason (87.1%) for declining to participate was that support was available elsewhere.

Conclusions: Both treatment approaches appear beneficial for improving bereavement and depressive symptoms except for BEQ-24 guilt/blame/anger. Clinicians recruiting those with bereavement from public hospitals serving low-income patients may find it challenging to recruit participants.