Wiadomosci lekarskie最新文献

Degenerative cervical myelopathy (DCM) is adults' most common form of spinal cord injury Its clinical symptoms result from spinal cord compression due to acute and chronic spinal column processes. However, DCM's exact pathophysiology is uncertain. Due to difficulty in diagnosis, many patients suffering from DCM remains undiagnosed until the symptoms become debilitating. The subject of this study is a 42-year-old male with no previous medical history. Neurological symptoms suddenly appeared three months prior to the hospital admission. An MRI revealed hernias of intervertebral discs between C4-C5, C5-C6, and C6-C7 and myelopathy in the most compressed parts of the spinal cord (C4-C5-C6 level). Cervical spondylodesis from anterior access, C3-C6 laminectomy, and spinal decompression were performed. The patient's postoperative symptoms worsened suddenly with the presence of tetraparesis. After prolonged rehabilitation, satisfactory motor function was regained. No possible cause for the development of myelopathy was apparent, although the patient recalled experiencing an injury 20 years earlier. Despite cervical injuries being challenging to diagnose and presenting no clinical symptoms at first, an almost complete recovery after the late onset of symptoms is possible with proper surgical treatment and rehabilitation.

Acupuncture as an alternative method of pain treatment was created in China 3000 years ago. It still has many supporters. For years, it has been used in many countries to relieve labor pains, postoperative pains, pains caused by osteoarthritis, toothaches, and headaches. The World Health Organization (WHO) has significantly expanded the indications for the use of acupuncture. The primary aim of this article is to critically evaluate whether acupuncture is a scientifically validated therapeutic intervention or primarily a placebo effect? Material and methods: The material and methods section of this article involves a comprehensive review of existing literature, including systematic reviews, randomized controlled trials (RCTs), and meta-analyses on acupuncture. The review also includes observational data on patient outcomes, potential risks, and reported complications. The effectiveness of acupuncture has been extensively studied, with varying levels of scientific support for different conditions. According to the National Institutes of Health (NIH), the strongest evidence supports acupuncture's effectiveness in dental pain, postoperative nausea and vomiting, chemotherapy-induced nausea, and pregnancy-related nausea. Studies on lower back pain, headaches, and knee osteoarthritis have shown moderate benefits, leading some physicians to recommend acupuncture as a complementary therapy. An analysis of studies has shown the effectiveness of acupuncture in the treatment of nausea and headaches. The results also showed the benefits of using this method in relieving back pain. Acupuncture has been shown to be one option for pain relief, but it needs more research.

Heat therapy has gained considerable attention as a noninvasive treatment for low back pain, a condition that affects a significant proportion of the world's population. This review examines the physiological mechanisms behind heat therapy, its efficacy in relieving pain, and its role in improving mobility and quality of life. By improving blood circulation, reducing muscle stiffness, and reducing inflammation, heat therapy offers promise as an alternative or complement to conventional treatments. Various methods, including heat packs and thermal pillows, have been studied for their effects on acute and chronic pain. This review highlights key findings from clinical trials and systematic analyses, demonstrating significant reductions in pain intensity and functional impairment. Despite its benefits, aspects such as patient compliance and safety remain important factors in its clinical use. Future research should focus on optimizing treatment parameters and integrating heat therapy with other rehabilitation strategies to maximize its therapeutic potential. This comprehensive review highlights the need for a broader perspective and further research on the long-term effectiveness of heat-based interventions in the treatment of low back pain.

The aim of this study is to present a case of a patient with spondylodiscitis. Spondylodiscitis is a infection of the spine involving the vertebral body and/or intervertebral disc, often caused by Staphylococcus aureus and Enterobacteriaceae. It most commonly affects the lumbar spine, begins in the vertebral body endplates and can lead to destruction of bone structures and involvement of the intervertebral disc and surrounding tissues. A 53-year-old man developed lumbar spine pain after an infection of unknown origin accompanied by fever and weakness. After two weeks, when the pain worsened and radiated to the left buttock, an MR examination showed features of L3/L4 spondylodiscitis. During hospitalization, a follow-up MR examination revealed destruction of the L3 and L4 vertebral bodies, inflammatory changes within the L3/L4 intervertebral disc, and widening of the intervertebral space. Inflammatory granules in the anterior part of the spinal canal with slight pressure on the meningeal sac were identified. A CT scan confirmed vertebral destruction. Empirical antibiotic therapy (clindamycin, ceftriaxone, vancomycin, rifampicin) was followed by spinal stabilization. After a year, CT scan showed improvement - reduced destruction of the L3/L4 vertebral bodies and no palpable infiltrative lesions. The stabilizing material was removed. Spondylodiscitis is a infection of the spine, often diagnosed late because of nonspecific symptoms such as back pain and fever. The MRI is the gold standard for diagnosis. Diagnosis is based on clinical, laboratory and imaging findings. It requires the cooperation of surgeons, radiologists and microbiologists. Early detection improves prognosis and quality of life.

Objective: Aim: To determine the features of hepatic lipid metabolism disorders and intestinal dysbiotic changes in patients with acne vulgaris and metabolic dysfunction- associated steatotic liver disease (MASLD).

Patients and methods: Materials and Methods: The study included 109 patients: 59 with a combination of acne vulgaris and MASLD and 50 with acne only.

Results: Results: It was found that patients with acne and MASLD are more likely to be overweight and have more pronounced changes in hepatic lipid metabolism. Also, patients with combined pathology showed a decrease in the number of the colonic normoflora , as well as an increase in the number of hemolytic forms of E. coli, Enterobacter, Citrobacter, Staphylococcus, Klebsiella, Clostridium, Proteus, Candida spp.

Conclusion: Conclusions: Our study highlighted that lipid profile determination and anthropometric examination are important factors in the diagnosis of patients with common acne and MASLD. Our data on changes in the composition of the colonic microflora in patients with comorbidities confirmed the existence of a relationship between the presence of intestinal dysbacteriosis and impaired skin homeostasis.

Objective: Aim: To analyze and compare the results of clinical usage of two protocols of bone drilling during the surgical stage of dental implantation.

Patients and methods: Materials and Methods: The clinical study group was formed from 30 patients. All selected patients underwent dental implantation in the lateral segments of the jaws using a delayed two-stage technique, using the standard drilling protocol (1000 rpm) and slow (50 rpm). The study included measuring implants' torque during the installation, bone density, and marginal bone resorption after 1,5 years.

Results: Results: The slow bone tissue preparation protocol showed the higher torque level during the installation, and did not cause significant changes in the structure of the bone tissue and level of sauserisation compared to the standard protocol for preparation.

Conclusion: Conclusions: The usage of two different protocols showed a significant difference at the moment of installation. However, it did not reveal any statistically significant differences between the two sgroups of patients during the long-term follow-up.

Objective: Aim: To evaluate the effects of constant light on the histological, histomorphometric and expression of EGFR of sublingual.

Patients and methods: Materials and Methods: 20 male mice were applied and classified in to group A was kept in continuous light and control group B was kept in the normal daily variance for 45 days.

Results: Results: Group A changes in behavior they become irritable, aggressive, loss of appetite, lethargic& lose weight. Histological examination with H&E showed degeneration of the sublingual tissue, loss architecture and necrosis (acini and ducts), the distraction of cell membrane and vacuolization, loss of nuclei in the necrotic tissue about 60%. Histomorphometric revealed significant differences in acini diameter between groups (p≤0.001). The mean of group A was 116.5960± 3.41668 compared with B group was 340.2720 ± 6.95821. Immunohistochemistry technique by used EGFR antibody in group A revealed expression evaluated as 0.8362±0.00822 increase in values in comparison with group B 0.6988 ± 0.02489.

Conclusion: Conclusions: Light has an indirect oxidative stress effects that causes oxidative damage to glands, which affects mucin secretion. Therefore, there was a decrease in diameter of acini sublingual glands of light group than control group, however, there was increase in the expression EGFR of sublingual glands in light group compare with control group as compensatory mechanism for oxidative stress in glands by light.

Objective: Aim: Review and analysis of contemporary professional literature on the impact of systemic osteoporosis on the bone structure of the alveolar processes, with a particular focus on the pathogenetic mechanisms of disorders of bone remodelling processes.

Patients and methods: Materials and Methods: The bibliosemantic method was used to clarify the state of the problem, to study the analysis of the results of previous scientific research based on the sources of literature and electronic resources.

Conclusion: Conclusions: Thus, the literature shows that the resorptive processes associated with osteoporosis not only alter the bones of the supporting and peripheral skeleton, but also alter the structure of the bone tissue of the jaw. The introduction of a pathogenesis-based approach to treatment will allow significant progress to be made in the dental care of patients with primary osteoporosis. Given the high prevalence of osteoporosis in patients of various profiles, the role of the dentist in the diagnosis and correction of this pathology is becoming increasingly important. It is of particular importance to direct attention to older patients, given the increased risk of developing postmenopausal and senile osteoporosis.

Objective: Aim: The current study aimed to evaluate the role of serum calprotectin, lactoferrin and serum zinc in patients with type II diabetes mellitus.

Patients and methods: Materials and Methods: Sixty subjects have been investigated in this study, (40) patients with T2DM and 20 apparently healthy participants (control group) during the period between October 2021 to January 2022. Zinc was measured using a calorimetric method, while calprotectin and lactoferrin were measured by ELISA.

Results: Results: The findings also revealed that levels of serum calprotectin and lactoferrin have significantly increased in in patients with T2DM as compared to healthy subjects. The result also showed that serum zin is decreased in patients groups. The correlation matrix exhibited that there was a strong positive correlation between calprotectin and lactoferrin, a significant negative correlation between zinc and calprotectin.

Conclusion: Conclusions: It was concluded that high serum calprotectin and lactoferrin indicated a strong inflammatory status in T2DM patients. Zinc is likely to be negative affected by the high inflammatory response indicated by that high serum calprotectin.

Clear cell renal cell carcinoma (ccRCC) is characterized by frequent mutations in chromatin-modifying genes, notably PBRM1 and SETD2, which play critical roles in tumorigenesis and disease progression. These mutations affect chromatin remodeling and histone methylation, influencing cellular functions such as tumor suppression, genomic integrity, and cell cycleregulation. Despite their prevalence, the distinct biological impacts and clinical implications of PBRM1 and SETD2 mutations remain incompletely understood. This review aims to elucidate the functional similarities and differences between PBRM1 and SETD2 mutations in ccRCC, investigate their roles in tumor progression and metastasis, and assess the potential clinical and therapeutic implications of these genetic alterations in the context of precision oncology. A comprehensive literature review was conducted, analyzing genomic, transcriptomic, and clinical data from ccRCC cohorts. Functional studies of PBRM1 and SETD2 mutations were examined alongside gene set enrichment analyses (GSEA), histopathologic observations, and molecular profiling of primary and metastatic tumor sites. Recent advances in therapeutic strategies targeting these mutations were also reviewed. PBRM1 mutations occur early in ccRCC development, altering chromatin accessibility and acting as tumor co-initiators, while SETD2 mutations arise later, exacerbating genomic instability and promoting metastasis. Both genes share tumor suppressor functions but differ in their genetic interactions and pathways. Co-mutation of PBRM1 and SETD2 correlates with increased tumor aggressiveness, poor prognosis, and higher metastatic potential. Emerging therapeutic approaches, including targeted molecular therapies and immunotherapies, show promise in addressing these mutation-driven pathways. PBRM1 and SETD2 mutations critically influence the molecular pathogenesis and clinical outcomes of ccRCC. Understanding their distinct and cooperative roles can enhance molecular profiling and guide personalized treatment strategies. Further research is warranted to develop targeted therapies that exploit the vulnerabilities associated with these chromatin-modifying gene mutations, ultimately improving prognosis and therapeutic response in ccRCC patients.