Dawid Kordykiewicz, M. Szaj, J. Pieróg, Konrad Ptaszyński, Tomasz Grodzki, Janusz Wójcik, Jacek Szymański, Karina Witkiewicz, M. Wojtyś
A minimally invasive approach in the diagnosis of peripheral pulmonary lesions may pose a challenge for thoracic surgeons when selecting the most appropriate technique. Electromagnetic navigation bronchoscopy (ENB) is an innovative technique used in the diagnosis of lung tumors.Evaluation of the merits of ENB in patient manifesting undiagnosed pulmonary and mediastinal lesions, while concurrently investigating its influence on the determination of the ultimate therapeutic strategy.The 73-year-old male patient with a suspicious lung mass was admitted to the hospital for diagnosis and subsequent treatment. The patient underwent an invasive diagnosis of lung and mediastinum using ENB with cryobiopsy. The histopathological examination revealed adenocarcinoma and lymphoma cells, ultimately guiding the initiation of appropriate therapeutic measures.Among the available methods, those with the highest diagnostic yield and safety should be chosen. Precise diagnosis of pulmonary lesions holds paramount importance for guiding appropriate treatment in cases of suspected malignancy.ENB with cryobiopsy proves effective diagnosis in case of peripheral lesions that are difficult to access for classical techniques.
{"title":"Enhancing diagnostic precision: Electromagnetic navigation bronchoscopy with cryobiopsy in pulmonary and mediastinal lesions – A case study","authors":"Dawid Kordykiewicz, M. Szaj, J. Pieróg, Konrad Ptaszyński, Tomasz Grodzki, Janusz Wójcik, Jacek Szymański, Karina Witkiewicz, M. Wojtyś","doi":"10.29089/paom/175728","DOIUrl":"https://doi.org/10.29089/paom/175728","url":null,"abstract":"A minimally invasive approach in the diagnosis of peripheral pulmonary lesions may pose a challenge for thoracic surgeons when selecting the most appropriate technique. Electromagnetic navigation bronchoscopy (ENB) is an innovative technique used in the diagnosis of lung tumors.Evaluation of the merits of ENB in patient manifesting undiagnosed pulmonary and mediastinal lesions, while concurrently investigating its influence on the determination of the ultimate therapeutic strategy.The 73-year-old male patient with a suspicious lung mass was admitted to the hospital for diagnosis and subsequent treatment. The patient underwent an invasive diagnosis of lung and mediastinum using ENB with cryobiopsy. The histopathological examination revealed adenocarcinoma and lymphoma cells, ultimately guiding the initiation of appropriate therapeutic measures.Among the available methods, those with the highest diagnostic yield and safety should be chosen. Precise diagnosis of pulmonary lesions holds paramount importance for guiding appropriate treatment in cases of suspected malignancy.ENB with cryobiopsy proves effective diagnosis in case of peripheral lesions that are difficult to access for classical techniques.","PeriodicalId":38569,"journal":{"name":"Polish Annals of Medicine","volume":"31 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139684072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nataliia Sydorova, Svitlana Bychkova, Inna Chernenko, Taras Kuts, Oleh Druz
Although as of today, the hypothesis of bradykinin storm in COVID-19 cannot be directly confirmed, many theoretical assumptions and empirical data support its validity.The purpose of this article is, using the example of a clinical case, to draw attention to the need for further study of the pathogenesis and clinical manifestations of COVID-19 and post-COVID-19 syndrome, considering the assessment of various theories, including bradykinin storm hypothesis.We analysed the data from a young male patient with post-COVID-19 syndrome who referred to a consultant and expressed complaints of palpitation, blood pressure increase, muscle weakness, feeling of fear, hypochondria, sleep disturbances, and reduced working performance.We found a high degree of autonomic dysregulation (predominantly sympathetic hyperactivation), anxiety, and sleep disorder. There was no hypertension, though ambulatory blood pressure monitoring allowed to determine the status of non-dipper. Patient's blood tests after COVID-19 revealed a decrease in the plasma level of aldosterone, a significant increase in both homocysteine blood level and free cortisol in urine, and mild transient isolated increase in free triiodothyronine. All abnormal blood test parameters turned to normal in 3 months after the onset of COVID-19. We assume that the clinical symptoms and changes in a number of laboratory parameters of the presented case may be associated with the effects of bradykinin storm.This clinical case suggests continuing the discussion about the potential role of bradykinin storm in the clinical course of COVID-19 and post-COVID-19 syndrome.
{"title":"Cardiovascular and mental symptoms of post-COVID-19 syndrome as a possible consequence of the bradykinin storm: A clinical case","authors":"Nataliia Sydorova, Svitlana Bychkova, Inna Chernenko, Taras Kuts, Oleh Druz","doi":"10.29089/paom/176217","DOIUrl":"https://doi.org/10.29089/paom/176217","url":null,"abstract":"Although as of today, the hypothesis of bradykinin storm in COVID-19 cannot be directly confirmed, many theoretical assumptions and empirical data support its validity.The purpose of this article is, using the example of a clinical case, to draw attention to the need for further study of the pathogenesis and clinical manifestations of COVID-19 and post-COVID-19 syndrome, considering the assessment of various theories, including bradykinin storm hypothesis.We analysed the data from a young male patient with post-COVID-19 syndrome who referred to a consultant and expressed complaints of palpitation, blood pressure increase, muscle weakness, feeling of fear, hypochondria, sleep disturbances, and reduced working performance.We found a high degree of autonomic dysregulation (predominantly sympathetic hyperactivation), anxiety, and sleep disorder. There was no hypertension, though ambulatory blood pressure monitoring allowed to determine the status of non-dipper. Patient's blood tests after COVID-19 revealed a decrease in the plasma level of aldosterone, a significant increase in both homocysteine blood level and free cortisol in urine, and mild transient isolated increase in free triiodothyronine. All abnormal blood test parameters turned to normal in 3 months after the onset of COVID-19. We assume that the clinical symptoms and changes in a number of laboratory parameters of the presented case may be associated with the effects of bradykinin storm.This clinical case suggests continuing the discussion about the potential role of bradykinin storm in the clinical course of COVID-19 and post-COVID-19 syndrome.","PeriodicalId":38569,"journal":{"name":"Polish Annals of Medicine","volume":"40 23","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139685659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Limy bile or milk of calcium bile caused due to precipitation of calcium salts in bile is an extremely rare condition of gall bladder, wherein the lumen of gall bladder is filled with chalky white paste like material. Not many cases have been reported till date.In this exceptional case, we tried to correlate the radiological and surgical findings with the histopathology.We hereby present an interesting case of a 59-year-old male who presented with dyspepsia and painful abdomen and was finally diagnosed with limy bile syndrome.The etiology of this rare entity is not fully understood, but it certainly has strong association with impacted stone at the neck of gall bladder and hyperparathyroidism. Females are more commonly affected than males. Patients usually present with complaints of painful abdomen and are commonly diagnosed radiologically, as a radiopacity in gall bladder. Cholecystectomy is the preferred method of treatment for this unusual condition and histopathologically chronic cholecystitis is seen along with presence of slender needle shaped crystals of calcium salts.A thorough evaluation of the clinicoradiological and histopathological findings can sometimes bring to light many uncommon variants of common looking pathologies.
{"title":"Limy bile syndrome or milk of calcium bile: An unexpected encounter","authors":"Mitali Madhumita Rath, Rashmi Patnayak, Sambit Kumar Mohanty, Brundaban Nahak, Manoranjan Mohapatra","doi":"10.29089/paom/175881","DOIUrl":"https://doi.org/10.29089/paom/175881","url":null,"abstract":"Limy bile or milk of calcium bile caused due to precipitation of calcium salts in bile is an extremely rare condition of gall bladder, wherein the lumen of gall bladder is filled with chalky white paste like material. Not many cases have been reported till date.In this exceptional case, we tried to correlate the radiological and surgical findings with the histopathology.We hereby present an interesting case of a 59-year-old male who presented with dyspepsia and painful abdomen and was finally diagnosed with limy bile syndrome.The etiology of this rare entity is not fully understood, but it certainly has strong association with impacted stone at the neck of gall bladder and hyperparathyroidism. Females are more commonly affected than males. Patients usually present with complaints of painful abdomen and are commonly diagnosed radiologically, as a radiopacity in gall bladder. Cholecystectomy is the preferred method of treatment for this unusual condition and histopathologically chronic cholecystitis is seen along with presence of slender needle shaped crystals of calcium salts.A thorough evaluation of the clinicoradiological and histopathological findings can sometimes bring to light many uncommon variants of common looking pathologies.","PeriodicalId":38569,"journal":{"name":"Polish Annals of Medicine","volume":"47 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139890468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Excessive torsion of a pregnant uterus is a rare and potentially extremely dangerous pathology for both the mother and fetus. The diagnosis is most often made intraoperatively.The main aim was to show that when it is impossible to detort the uterus, a low transverse caesarean section through the posterior uterine wall can be safely performed.We report a case of a 41-year-old multiparous woman at G II P II 39/40 weeks' gestation, who presented to the Gynecology and Obstetrics Department for an elective caesarean section due to a breech presentation of the fetus. During the caesarean section, a uterine torsion of 180° was found. As the uterus could not be detorted to its normal position, a low transverse caesarean section was performed through the posterior uterine wall. At follow-up visits after 8 weeks and 12 months, normal healing of the uterine muscle was confirmed.The treatment of torsion of the pregnant uterus depends on gestational age and symptoms, in particular the presence of significant hemodynamic and ischemic lesions.The procedure of choice in a full-term pregnancy should be an attempt to detort the uterus to its normal position and then perform a cesarean section through the anterior uterine wall. If detorsion of the uterus is not possible, a caesarean section through the posterior uterine wall should be performed. Based on the literature review and the case presented, it appears that this procedure is safe.
妊娠子宫过度扭转是一种罕见的病理现象，对母亲和胎儿都有极大的潜在危险。我们报告了一例 41 岁的多产妇，妊娠 G II P II 39/40 周，因胎儿臀躺到妇产科进行选择性剖腹产。在剖腹产过程中，发现子宫扭转 180°。由于无法将子宫扭转到正常位置，医生通过子宫后壁进行了低位横切剖腹产。妊娠子宫扭转的治疗取决于胎龄和症状，尤其是是否存在明显的血流动力学和缺血性病变。足月妊娠的首选手术应该是尝试将子宫扭转到正常位置，然后通过子宫前壁进行剖宫产。如果无法剥离子宫，则应通过子宫后壁进行剖腹产。根据文献综述和本病例，这种手术似乎是安全的。
{"title":"Low transverse caesarean section through the posterior uterine wall in a pregnant patient with asymptomatic uterine torsion of 180°: A case report","authors":"Jarosław Kopko, Jakub Marek, Wojciech Laskowski","doi":"10.29089/paom/176985","DOIUrl":"https://doi.org/10.29089/paom/176985","url":null,"abstract":"Excessive torsion of a pregnant uterus is a rare and potentially extremely dangerous pathology for both the mother and fetus. The diagnosis is most often made intraoperatively.The main aim was to show that when it is impossible to detort the uterus, a low transverse caesarean section through the posterior uterine wall can be safely performed.We report a case of a 41-year-old multiparous woman at G II P II 39/40 weeks' gestation, who presented to the Gynecology and Obstetrics Department for an elective caesarean section due to a breech presentation of the fetus. During the caesarean section, a uterine torsion of 180° was found. As the uterus could not be detorted to its normal position, a low transverse caesarean section was performed through the posterior uterine wall. At follow-up visits after 8 weeks and 12 months, normal healing of the uterine muscle was confirmed.The treatment of torsion of the pregnant uterus depends on gestational age and symptoms, in particular the presence of significant hemodynamic and ischemic lesions.The procedure of choice in a full-term pregnancy should be an attempt to detort the uterus to its normal position and then perform a cesarean section through the anterior uterine wall. If detorsion of the uterus is not possible, a caesarean section through the posterior uterine wall should be performed. Based on the literature review and the case presented, it appears that this procedure is safe.","PeriodicalId":38569,"journal":{"name":"Polish Annals of Medicine","volume":"32 16","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139685095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Żurada, Jerzy Gielecki, Marcelina Łopińska, Katarzyna Polak-Boroń, Michał Ciucias
This paper provides an in-depth analysis of the anatomical and morphometrical attributes of the popliteal artery (PA) in human fetuses. Additionally, it showcases significant interindividual variation in branching patterns, which are of great clinical importance in the context of vascular surgery and interventional radiology.The purpose of this research was to systematically examine and categorize the anatomical and morphometrical diversities observed in the PA among a 166 sample of human fetuses at various gestational stages, spanning from 16 to 30 weeks of pregnancy.The latex was injected into the 166 PA within the fetal specimens to visually analyze their anatomical features, and high-resolution digital images were captured at 24-bit color depth for detailed analysis.The PAs were systematically classified into three distinct categories, further subcategorized into specific types. The classification system employed was based on the framework established initially by Lippert and Pabst, with modifications by Kim. The results of the analysis revealed the following distribution: Category I – it was mainly detected in the majority of specimens, comprising 144 cases (86.7%) of the sample population, and represented the most common anatomical configuration; Category II – it was found in 19 specimens (11.4%) of the total sample population (this category represented a less common anatomical variation within the PA); Category III – the rarest anatomical configuration observed in only 3 specimens (1.8%) from the sample population.The frequent occurrence of short tibiofibular trunks in PA may be due to incidental lesions or postnatal developmental changes, highlighting the need for further research.
{"title":"Variations of the popliteal artery in human fetuses: preliminary study","authors":"A. Żurada, Jerzy Gielecki, Marcelina Łopińska, Katarzyna Polak-Boroń, Michał Ciucias","doi":"10.29089/paom/175376","DOIUrl":"https://doi.org/10.29089/paom/175376","url":null,"abstract":"This paper provides an in-depth analysis of the anatomical and morphometrical attributes of the popliteal artery (PA) in human fetuses. Additionally, it showcases significant interindividual variation in branching patterns, which are of great clinical importance in the context of vascular surgery and interventional radiology.The purpose of this research was to systematically examine and categorize the anatomical and morphometrical diversities observed in the PA among a 166 sample of human fetuses at various gestational stages, spanning from 16 to 30 weeks of pregnancy.The latex was injected into the 166 PA within the fetal specimens to visually analyze their anatomical features, and high-resolution digital images were captured at 24-bit color depth for detailed analysis.The PAs were systematically classified into three distinct categories, further subcategorized into specific types. The classification system employed was based on the framework established initially by Lippert and Pabst, with modifications by Kim. The results of the analysis revealed the following distribution: Category I – it was mainly detected in the majority of specimens, comprising 144 cases (86.7%) of the sample population, and represented the most common anatomical configuration; Category II – it was found in 19 specimens (11.4%) of the total sample population (this category represented a less common anatomical variation within the PA); Category III – the rarest anatomical configuration observed in only 3 specimens (1.8%) from the sample population.The frequent occurrence of short tibiofibular trunks in PA may be due to incidental lesions or postnatal developmental changes, highlighting the need for further research.","PeriodicalId":38569,"journal":{"name":"Polish Annals of Medicine","volume":" 21","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138612934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Xerostomia is not a disease in itself but is caused by a change in the amount or composition of saliva or both. Some systemic diseases and the use of some medicines cause this complaint.Considering the high prevalence of cardiac diseases, the present study aimed to examine risk factors and serum parameters associated with xerostomia among hospitalized cardiac patients.In this case-control study, 369 hospitalized cardiac patients were divided into two groups (with and without xerostomia) using a valid FOX questionnaire. Demographic information and laboratory analysis results were extracted from the subjects’ medical records. Finally, data were analyzed using SPSS v. 24 software at a significance level of 0.05.According to the findings, 187 (50.7%) patients were suffering from xerostomia, whose prevalence was significantly higher in patients with a history of hypertension (P = 0.017) and thrombocytosis (P = 0.023). However, no significant relationship was observed between xerostomia and other serum parameters.Xerostomia is associated with a history of hypertension and the use of certain medications, such as nitroglycerin. Other serum parameters seem to be unrelated to xerostomia, except thrombocytosis. Therefore, it is recommended to check the quantity and quality of saliva to evaluate the presence of hyposalivation along with xerostomia more accurately.
口干症本身并不是一种疾病，而是由唾液数量或成分的变化引起的，或者两者兼而有之。一些全身性疾病和一些药物的使用会引起这种抱怨。考虑到心脏疾病的高患病率，本研究旨在探讨住院心脏病患者口干症的危险因素和血清参数。在这项病例对照研究中，369名住院心脏病患者使用有效的FOX问卷分为两组(有和没有口干症)。人口统计信息和实验室分析结果从受试者的医疗记录中提取。最后，采用SPSS v. 24软件对数据进行分析，显著性水平为0.05。结果显示，187例(50.7%)患者存在口干症，其中有高血压(P = 0.017)和血小板增多(P = 0.023)病史的患者口干症患病率明显高于有高血压(P = 0.017)病史的患者。然而，口干症与其他血清参数无显著关系。口干症与高血压史和某些药物(如硝酸甘油)的使用有关。除血小板增多症外，其他血清参数似乎与口干症无关。因此，建议检查唾液的数量和质量，以更准确地评估有无唾液分泌不足和口干症。
{"title":"Risk factors and serum parameters associated with xerostomia in cardiac patients – a case-control study","authors":"Maryam Basirat, Seyedeh Fatemeh Mirrazeghi, Faezeh Soleimani, Fereshteh Najar Karimi","doi":"10.29089/paom/175108","DOIUrl":"https://doi.org/10.29089/paom/175108","url":null,"abstract":"Xerostomia is not a disease in itself but is caused by a change in the amount or composition of saliva or both. Some systemic diseases and the use of some medicines cause this complaint.Considering the high prevalence of cardiac diseases, the present study aimed to examine risk factors and serum parameters associated with xerostomia among hospitalized cardiac patients.In this case-control study, 369 hospitalized cardiac patients were divided into two groups (with and without xerostomia) using a valid FOX questionnaire. Demographic information and laboratory analysis results were extracted from the subjects’ medical records. Finally, data were analyzed using SPSS v. 24 software at a significance level of 0.05.According to the findings, 187 (50.7%) patients were suffering from xerostomia, whose prevalence was significantly higher in patients with a history of hypertension (P = 0.017) and thrombocytosis (P = 0.023). However, no significant relationship was observed between xerostomia and other serum parameters.Xerostomia is associated with a history of hypertension and the use of certain medications, such as nitroglycerin. Other serum parameters seem to be unrelated to xerostomia, except thrombocytosis. Therefore, it is recommended to check the quantity and quality of saliva to evaluate the presence of hyposalivation along with xerostomia more accurately.","PeriodicalId":38569,"journal":{"name":"Polish Annals of Medicine","volume":"160 10‐12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138625986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Obstructive sleep apnea in spinal cord injured (SCI) patients is an important but underestimated clinical problem. Spinal cord injury weakens the muscles responsible for breathing, resulting in a reduction in lung capacity. Training of respiratory muscles may present an effective method of increasing respiratory muscle strength and lung volume.The aim of study was to evaluate the effectiveness of robot-assisted gait training (RAGT) in 34 patients with SCI in sleep-disordered breathing (SDB) reduction.We conducted a control trail to compare RAGT (exoskeleton EKSO-GT or Locomat Pro) with conventional gait training using conventional physiotherapy with dynamic parapodium. We included patients with SCI (above T8 level of injury) recruited between 3 months and 2 years post injury. Polysomnographic studies were performed before and after the completion of the 7-week rehabilitation program. Patients were divided into 2 groups above and up 40 years old.The comparison of all polysomnographic parameters before and after rehabilitation with RAGT revealed the decline in all polysomnographic parameters (the apnea-hypopnea index – AHI; score reached statistically significant value – P < 0.02). In comparison in patients aged up to 40 years with conventional gait rehabilitation the number of apnoea’s and shortness of breath during sleep even increased: the AHI index increased after rehabilitation from 1.7 to 3.2 values.RAGT therapy should be considered as a therapeutic option for SDB reduction in patients after SCI. Additionally, the study identified the need to conduct further studies on larger groups of patients.
{"title":"Polysomnography in patients with spinal cord injury who underwent robotic assisted gait training","authors":"Tarnacka Beata, Bogumił Korczyński","doi":"10.29089/paom/175360","DOIUrl":"https://doi.org/10.29089/paom/175360","url":null,"abstract":"Obstructive sleep apnea in spinal cord injured (SCI) patients is an important but underestimated clinical problem. Spinal cord injury weakens the muscles responsible for breathing, resulting in a reduction in lung capacity. Training of respiratory muscles may present an effective method of increasing respiratory muscle strength and lung volume.The aim of study was to evaluate the effectiveness of robot-assisted gait training (RAGT) in 34 patients with SCI in sleep-disordered breathing (SDB) reduction.We conducted a control trail to compare RAGT (exoskeleton EKSO-GT or Locomat Pro) with conventional gait training using conventional physiotherapy with dynamic parapodium. We included patients with SCI (above T8 level of injury) recruited between 3 months and 2 years post injury. Polysomnographic studies were performed before and after the completion of the 7-week rehabilitation program. Patients were divided into 2 groups above and up 40 years old.The comparison of all polysomnographic parameters before and after rehabilitation with RAGT revealed the decline in all polysomnographic parameters (the apnea-hypopnea index – AHI; score reached statistically significant value – P < 0.02). In comparison in patients aged up to 40 years with conventional gait rehabilitation the number of apnoea’s and shortness of breath during sleep even increased: the AHI index increased after rehabilitation from 1.7 to 3.2 values.RAGT therapy should be considered as a therapeutic option for SDB reduction in patients after SCI. Additionally, the study identified the need to conduct further studies on larger groups of patients.","PeriodicalId":38569,"journal":{"name":"Polish Annals of Medicine","volume":"46 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139227801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A giant inguinal hernia is described as an extension of the hernia below the midpoint of the patient’s inner thigh in the standing position. It is relatively rare but severely affects a patient’s quality of life and imposes specific challenges to the surgeons.The aim of this paper is to describe the management of giant inguinal hernia and its related challenges.A 51-year-old man, a chronic smoker, and a labourer at a construction site complained about a rapidly growing reducible right groin swelling with heaviness, and discomfort. He was counselled for surgical intervention a year earlier but defaulted on follow-up. There was a right giant inguinoscrotal swelling extending beyond the mid-thigh on standing position. He underwent inguinal hernioplasty successfully without any intra- or post-operative complication.Challenges in managing giant inguinal hernias include loss of domain and a higher risk of cardiovascular compromises, intra- and post-operatively. Compared to other inguinal hernias, a giant inguinal hernia is also at a higher risk of surgical site infections, scrotal haematoma, and hernia recurrences.A giant inguinal hernia is a rare and challenging surgical problem for surgeons. Meticulous perioperative managements are important in ensuring such patients with a promising outcome.
{"title":"Challenges and hurdles in managing giant inguinoscrotal hernia: A case report","authors":"Jin-Jiun Mah, Chang Haur Lee, F. Hayati","doi":"10.29089/paom/174651","DOIUrl":"https://doi.org/10.29089/paom/174651","url":null,"abstract":"A giant inguinal hernia is described as an extension of the hernia below the midpoint of the patient’s inner thigh in the standing position. It is relatively rare but severely affects a patient’s quality of life and imposes specific challenges to the surgeons.The aim of this paper is to describe the management of giant inguinal hernia and its related challenges.A 51-year-old man, a chronic smoker, and a labourer at a construction site complained about a rapidly growing reducible right groin swelling with heaviness, and discomfort. He was counselled for surgical intervention a year earlier but defaulted on follow-up. There was a right giant inguinoscrotal swelling extending beyond the mid-thigh on standing position. He underwent inguinal hernioplasty successfully without any intra- or post-operative complication.Challenges in managing giant inguinal hernias include loss of domain and a higher risk of cardiovascular compromises, intra- and post-operatively. Compared to other inguinal hernias, a giant inguinal hernia is also at a higher risk of surgical site infections, scrotal haematoma, and hernia recurrences.A giant inguinal hernia is a rare and challenging surgical problem for surgeons. Meticulous perioperative managements are important in ensuring such patients with a promising outcome.","PeriodicalId":38569,"journal":{"name":"Polish Annals of Medicine","volume":"31 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139264157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Svitlana Bychkova, Viktor Dyachenko, N. Sydorova, Iryna Petukhova, L. Sydorova
Accumulated evidence suggests that pulmonary fibrosis is a common complication of COVID-19. Fibrotic post-coronavirus lung changes are similar to the changes found in patients with idiopathic pulmonary fibrosis.The paper describes the outcomes of pirfenidone usage in treatment of patients with post-coronavirus pulmonary fibrosis.The paper presents a case study about a 51-year-old male patient, who had diffuse post-coronavirus pulmonary fibrosis with significant impairment of external respiratory function. The patient had experienced severe COVID-19 bilateral polysegmental pneumonia. In the 3rd week of the disease, multislice computed tomography detected signs of fibrosis that affected 80% of lung tissue. It was decided to start antifibrotic treatment with pirfenidone, which is usually used to treat idiopathic pulmonary fibrosis.Pirfenidone was prescribed for 3 months according to the conventional scheme in combination with methylprednisolone. This therapy resulted in significant decrease of fibrosis scope , normalization of respiratory function and improvement of patient's quality of life. A key feature of the presented clinical case is a significant positive effect of pirfenidone in treating coronavirus-associated pulmonary fibrosis, which affected 80% of lung tissue of the patient.Post-coronavirus pulmonary fibrosis is characterized by the severe oxygen insufficiency and requires a constant oxygen support. The treatment that included pirfenidone in combination with steroids has demonstrated convincing positive effect. It reduces post-coronavirus pulmonary fibrosis and improves lung function.
{"title":"A case of successful treatment of diffuse post-coronavirus pulmonary fibrosis with pirfenidone","authors":"Svitlana Bychkova, Viktor Dyachenko, N. Sydorova, Iryna Petukhova, L. Sydorova","doi":"10.29089/paom/165960","DOIUrl":"https://doi.org/10.29089/paom/165960","url":null,"abstract":"Accumulated evidence suggests that pulmonary fibrosis is a common complication of COVID-19. Fibrotic post-coronavirus lung changes are similar to the changes found in patients with idiopathic pulmonary fibrosis.The paper describes the outcomes of pirfenidone usage in treatment of patients with post-coronavirus pulmonary fibrosis.The paper presents a case study about a 51-year-old male patient, who had diffuse post-coronavirus pulmonary fibrosis with significant impairment of external respiratory function. The patient had experienced severe COVID-19 bilateral polysegmental pneumonia. In the 3rd week of the disease, multislice computed tomography detected signs of fibrosis that affected 80% of lung tissue. It was decided to start antifibrotic treatment with pirfenidone, which is usually used to treat idiopathic pulmonary fibrosis.Pirfenidone was prescribed for 3 months according to the conventional scheme in combination with methylprednisolone. This therapy resulted in significant decrease of fibrosis scope , normalization of respiratory function and improvement of patient's quality of life. A key feature of the presented clinical case is a significant positive effect of pirfenidone in treating coronavirus-associated pulmonary fibrosis, which affected 80% of lung tissue of the patient.Post-coronavirus pulmonary fibrosis is characterized by the severe oxygen insufficiency and requires a constant oxygen support. The treatment that included pirfenidone in combination with steroids has demonstrated convincing positive effect. It reduces post-coronavirus pulmonary fibrosis and improves lung function.","PeriodicalId":38569,"journal":{"name":"Polish Annals of Medicine","volume":"6 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139262825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Katarzyna Anna Szymak, Michał Edward Bobrowicz, Michał Tomasz Puliński, Wojciech Michał Choiński, Natalia Hawryluk
Introduction The use of ultrasonography (USG) is no longer restricted to the radiology department. It is becoming the equivalent of a stethoscope. Point-of-care ultrasound (POCUS) is an USG examination method designed to answer specific clinical questions. Aim To encourage doctors to use POCUS in their everyday practice based on a presentation of its use in diagnostics of acute appendicitis in the paediatric patient. Material and methods A retrospective evaluation was performed of 95 cases of abdominal pain referred by a paediatrician for surgical assessment at emergency department between November 2021 and October 2022. The assessment included a clinical examination supplemented with POCUS. Based on the assessment made by the emergency department doctor, the patients were divided into two groups – those who did not require hospitalisation in the paediatric surgery department (group 1) and those who did (group 2). Each group was subsequently divided into subgroup A, where no abdominal cavity USG was performed by a radiologist and subgroup B, where the patients were examined by a radiologist. Results and discussion The use of POCUS in the context of clinical symptoms allows for achieving the same degree of detectability as in an examination performed by a radiologist. A positive result of POCUS or clinical symptoms indicative of acute appendicitis requires continuing the diagnostic process. Conclusions The application of USG in abdominal pain diagnostics in a paediatric patient helps to reduce the time needed for the correct diagnosis and, in consequence, for the patient's treatment. Due to its availability, USG should be widely used to supplement clinical examination by each physician.
{"title":"Use of point-of-care ultrasound in abdominal pain diagnostics in a paediatric patient","authors":"Katarzyna Anna Szymak, Michał Edward Bobrowicz, Michał Tomasz Puliński, Wojciech Michał Choiński, Natalia Hawryluk","doi":"10.29089/paom/174027","DOIUrl":"https://doi.org/10.29089/paom/174027","url":null,"abstract":"Introduction The use of ultrasonography (USG) is no longer restricted to the radiology department. It is becoming the equivalent of a stethoscope. Point-of-care ultrasound (POCUS) is an USG examination method designed to answer specific clinical questions. Aim To encourage doctors to use POCUS in their everyday practice based on a presentation of its use in diagnostics of acute appendicitis in the paediatric patient. Material and methods A retrospective evaluation was performed of 95 cases of abdominal pain referred by a paediatrician for surgical assessment at emergency department between November 2021 and October 2022. The assessment included a clinical examination supplemented with POCUS. Based on the assessment made by the emergency department doctor, the patients were divided into two groups – those who did not require hospitalisation in the paediatric surgery department (group 1) and those who did (group 2). Each group was subsequently divided into subgroup A, where no abdominal cavity USG was performed by a radiologist and subgroup B, where the patients were examined by a radiologist. Results and discussion The use of POCUS in the context of clinical symptoms allows for achieving the same degree of detectability as in an examination performed by a radiologist. A positive result of POCUS or clinical symptoms indicative of acute appendicitis requires continuing the diagnostic process. Conclusions The application of USG in abdominal pain diagnostics in a paediatric patient helps to reduce the time needed for the correct diagnosis and, in consequence, for the patient's treatment. Due to its availability, USG should be widely used to supplement clinical examination by each physician.","PeriodicalId":38569,"journal":{"name":"Polish Annals of Medicine","volume":"122 21","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135136557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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