Piotr Mirosław Misiowiec, Hanna Zajączkiewicz, Natalia Jarmołowicz-Aniołkowska, Bartosz Karwat, Edyta Zomkowska
Introduction Diabetes mellitus (DM) is an independent factor for the occurrence of neurogenic dysphagia following an acute cerebrovascular accident in the form of a stroke. This study assesses the role of DM as a risk factor for post-stroke dysphagia (PSD), confirmed by the fiberoptic endoscopic examination of swallowing (FEES) with particular emphasis on silent aspiration (SA) as a high risk factor of aspiration pneumonia (AP). Aim The aim of the study is to assess the role of DM as a risk factor for PSD. Material and methods Statistical analysis was performed on the cohort of 81 post-cerebrovascular-accident patients hospitalized in the neurological rehabilitation department. DM was diagnosed in more than one third of the cohort (35.8%). After the FEES examination, which was assessed in the penetration–aspiration scale (PAS), an analysis of DM incidence was performed in patients with diagnosed pharyngeal dysphagia of moderate degree (PAS 3–6) and severe degree (PAS 7–8). Results and discussion The incidence of DM in patients with moderate dysphagia was lower than in the cohort. The incidence of DM in patients with severe dysphagia (aspiration) was comparable to the percentage in the cohort. Although diabetes was twice as frequent among patients with aspiration than among those with mild dysphagia (24% vs. 12%), the odds ratio (OR) of the diabetes incidence in these groups was not statistically significant. Conclusions Although DM is an independent factor for PSD occurrence after cerebrovascular accident in the form of a stroke and a potential factor for lower cranial nerve neuropathy, no correlation between DM and PSD was found.
{"title":"Assessment of diabetes as a risk factor for neurogenic dysphagia confirmed by FEES examination in post-CVA patients","authors":"Piotr Mirosław Misiowiec, Hanna Zajączkiewicz, Natalia Jarmołowicz-Aniołkowska, Bartosz Karwat, Edyta Zomkowska","doi":"10.29089/paom/167461","DOIUrl":"https://doi.org/10.29089/paom/167461","url":null,"abstract":"Introduction Diabetes mellitus (DM) is an independent factor for the occurrence of neurogenic dysphagia following an acute cerebrovascular accident in the form of a stroke. This study assesses the role of DM as a risk factor for post-stroke dysphagia (PSD), confirmed by the fiberoptic endoscopic examination of swallowing (FEES) with particular emphasis on silent aspiration (SA) as a high risk factor of aspiration pneumonia (AP). Aim The aim of the study is to assess the role of DM as a risk factor for PSD. Material and methods Statistical analysis was performed on the cohort of 81 post-cerebrovascular-accident patients hospitalized in the neurological rehabilitation department. DM was diagnosed in more than one third of the cohort (35.8%). After the FEES examination, which was assessed in the penetration–aspiration scale (PAS), an analysis of DM incidence was performed in patients with diagnosed pharyngeal dysphagia of moderate degree (PAS 3–6) and severe degree (PAS 7–8). Results and discussion The incidence of DM in patients with moderate dysphagia was lower than in the cohort. The incidence of DM in patients with severe dysphagia (aspiration) was comparable to the percentage in the cohort. Although diabetes was twice as frequent among patients with aspiration than among those with mild dysphagia (24% vs. 12%), the odds ratio (OR) of the diabetes incidence in these groups was not statistically significant. Conclusions Although DM is an independent factor for PSD occurrence after cerebrovascular accident in the form of a stroke and a potential factor for lower cranial nerve neuropathy, no correlation between DM and PSD was found.","PeriodicalId":38569,"journal":{"name":"Polish Annals of Medicine","volume":" 11","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135292265","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}
Sentilnathan Subramaniam, Wan Syazli Rodzaian, Shah Jumaat Yussof, Salina Ibrahim, Firdaus Hayati
Introduction Early tangential excision and wound coverage by autologous skin grafting is the mainstay of treatment for deep dermal and full-thickness burns. They are challenging in children with major burns involving more than 50% of the body surface area. Aim This article highlights a young boy who suffered from 52% mixed deep dermal and full-thickness burns after alleged thermal burns and we discuss his treatment strategies. Case study A 10-year-old boy suffered 52% mixed deep dermal and full-thickness burns after alleged thermal burns. After initial resuscitation, pain relief and fluid replacement, he underwent an emergent escharotomy of bilateral lower limbs followed by a series of surgeries. His treatment was complicated by many hurdles such as graft failure, difficult intravenous access, nutritional support and local wound infection which were tackled aptly with a multidisciplinary approach. Results and discussion A sequential excision of eschar tissue and advocation of multiple modalities of burn wound coverage, including glycerol-preserved cadaveric allograft (GPCA) and MEEK micrografting. GPCA decreases the bacterial load and helps to re-establish the skin barrier, normalise the physiological state and promote capillary ingrowth into the wound. MEEK micrografting allows better re-epithelization and has a shorter operation time. Conclusions Various modalities can be used to achieve skin coverage such as GPCA and MEEK micrografting. Extensive burns need to be managed in a tertiary centre with a combination of skin coverage techniques such as GPCA and MEEK micrografting in order to overcome the unavailability of normal skin for conventional skin grafting.
{"title":"Multimodal management of more than 50% mixed deep dermal and full thickness burns in a child","authors":"Sentilnathan Subramaniam, Wan Syazli Rodzaian, Shah Jumaat Yussof, Salina Ibrahim, Firdaus Hayati","doi":"10.29089/paom/162611","DOIUrl":"https://doi.org/10.29089/paom/162611","url":null,"abstract":"Introduction Early tangential excision and wound coverage by autologous skin grafting is the mainstay of treatment for deep dermal and full-thickness burns. They are challenging in children with major burns involving more than 50% of the body surface area. Aim This article highlights a young boy who suffered from 52% mixed deep dermal and full-thickness burns after alleged thermal burns and we discuss his treatment strategies. Case study A 10-year-old boy suffered 52% mixed deep dermal and full-thickness burns after alleged thermal burns. After initial resuscitation, pain relief and fluid replacement, he underwent an emergent escharotomy of bilateral lower limbs followed by a series of surgeries. His treatment was complicated by many hurdles such as graft failure, difficult intravenous access, nutritional support and local wound infection which were tackled aptly with a multidisciplinary approach. Results and discussion A sequential excision of eschar tissue and advocation of multiple modalities of burn wound coverage, including glycerol-preserved cadaveric allograft (GPCA) and MEEK micrografting. GPCA decreases the bacterial load and helps to re-establish the skin barrier, normalise the physiological state and promote capillary ingrowth into the wound. MEEK micrografting allows better re-epithelization and has a shorter operation time. Conclusions Various modalities can be used to achieve skin coverage such as GPCA and MEEK micrografting. Extensive burns need to be managed in a tertiary centre with a combination of skin coverage techniques such as GPCA and MEEK micrografting in order to overcome the unavailability of normal skin for conventional skin grafting.","PeriodicalId":38569,"journal":{"name":"Polish Annals of Medicine","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135617578","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}
Aleksandra Kamińska, Małgorzata Wojtaś, Monika Ruszała, Tomasz Rechberger, Marek Gogacz
Introduction Uterine myomas are one of the most frequently discussed issues in gynecology. Most of them are asymptomatic, however, severe pain in pelvis minor, heavy uterine bleeding or infertility may be reported by the patients and worsen quality of women’s daily life. Giant myomas are very rare and can be directly life-threatening. Aim The aim of this study was to present a clinical case of giant myoma, its management and highlight the potential impact on women’s health and well-being. Case study A 70-years-old patient with a pain in lower part of abdomen, constipation and tiredness manifested difficulties in breathing. Abdominal examination revealed a huge, elastic abdominal mass extending from xiphoid process to the pubic bone. A total abdominal hysterectomy with right salpingo-oophorectomy was done.The patient was discharged from the hospital on the day 9 after the surgery and recovered without any incident. Results and discussion Patients with giant uterine myomas may develop respiratory failure and require intensive respiratory care. One of the highest priorities should be adequate ventilation and reduction the vena cava compression. Cleansing the intestines before surgery decreases the risk of contamination the peritoneal cavity by digestive tract content, in case of possible extension of the scope of surgery. Conclusions In the case of treatment of large uterine myomas, interdisciplinary cooperation of specialists in various fields is necessary in order to protect the patient’s vital parameters and prevent the occurrence of rare complications.
{"title":"Management of giant myoma – case report and literature review","authors":"Aleksandra Kamińska, Małgorzata Wojtaś, Monika Ruszała, Tomasz Rechberger, Marek Gogacz","doi":"10.29089/paom/173463","DOIUrl":"https://doi.org/10.29089/paom/173463","url":null,"abstract":"Introduction Uterine myomas are one of the most frequently discussed issues in gynecology. Most of them are asymptomatic, however, severe pain in pelvis minor, heavy uterine bleeding or infertility may be reported by the patients and worsen quality of women’s daily life. Giant myomas are very rare and can be directly life-threatening. Aim The aim of this study was to present a clinical case of giant myoma, its management and highlight the potential impact on women’s health and well-being. Case study A 70-years-old patient with a pain in lower part of abdomen, constipation and tiredness manifested difficulties in breathing. Abdominal examination revealed a huge, elastic abdominal mass extending from xiphoid process to the pubic bone. A total abdominal hysterectomy with right salpingo-oophorectomy was done.The patient was discharged from the hospital on the day 9 after the surgery and recovered without any incident. Results and discussion Patients with giant uterine myomas may develop respiratory failure and require intensive respiratory care. One of the highest priorities should be adequate ventilation and reduction the vena cava compression. Cleansing the intestines before surgery decreases the risk of contamination the peritoneal cavity by digestive tract content, in case of possible extension of the scope of surgery. Conclusions In the case of treatment of large uterine myomas, interdisciplinary cooperation of specialists in various fields is necessary in order to protect the patient’s vital parameters and prevent the occurrence of rare complications.","PeriodicalId":38569,"journal":{"name":"Polish Annals of Medicine","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135570169","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}
Przemysław Stachurski, Katarzyna Podhorodecka, Joanna Wojtkiewicz
Introduction Jerzy Majkowski was a Polish neurologist who made significant contributions to the field of neuroscience. Majkowski was a renowned physician and researcher who specialized in studying and treating movement disorders such as Parkinson’s disease and dystonia. Throughout his career, he was known for his innovative approaches to diagnosing and treating these complex conditions, and he was widely respected by his peers for his deep understanding of the brain and its functions. Aim The purpose of our work is to introduce the reader to the person of Jerzy Majkowski. Material and methods The work is based on the available literature. The search process resulted in the detection of relevant articles using valid keywords on electronic databases, including Embase, PubMed, Scopus, Web of Science, and Cochrane Library. Subsequently, 10 were identified as eligible for our review. Results and discussion Jerzy ‘Czarny’ Majkowski, a Polish neurologist and neurophysiologist. During World War II, he joined the Polish Scouting Association, where he participated in the underground activities of the organization under the pseudonym Czarny. After the war, he studied medicine at Warsaw University and graduated in 1952. Majkowski was interested in epilepsy, electroencephalography, and neurophysiology and put forward several hypotheses based on his research. He was the author of about 500 scientific publications and edited 14 books. He was also the editor of several journals, including Epileptologia and the Journal of Epileptology. Conclusions Majkowski’s work has helped to advance our understanding of neurological disorders, and his legacy continues to inspire future generations of scientists and physicians.
耶日·马杰科夫斯基是一位波兰神经学家，他在神经科学领域做出了重大贡献。Majkowski是一位著名的医生和研究员，专门研究和治疗帕金森病和肌张力障碍等运动障碍。在他的职业生涯中，他以诊断和治疗这些复杂疾病的创新方法而闻名，并因其对大脑及其功能的深刻理解而受到同行的广泛尊重。我们工作的目的是向读者介绍耶日·马伊科夫斯基这个人。材料和方法本工作以现有文献为基础。搜索过程的结果是在电子数据库中检测到使用有效关键词的相关文章，包括Embase、PubMed、Scopus、Web of Science和Cochrane Library。随后，10个被确定为符合我们审查的条件。波兰神经学家和神经生理学家Jerzy ' Czarny ' Majkowski。第二次世界大战期间，他加入了波兰童军协会，在那里他以笔名Czarny参加了该组织的地下活动。战后，他在华沙大学学医，并于1952年毕业。Majkowski对癫痫、脑电图和神经生理学很感兴趣，并在他的研究基础上提出了几个假设。他发表了大约500篇科学出版物，编辑了14本书。他也是几个期刊的编辑，包括癫痫学和癫痫学杂志。Majkowski的工作有助于提高我们对神经系统疾病的理解，他的遗产继续激励着后代的科学家和医生。
{"title":"Jerzy Majkowski – a Polish neurologist and neurophysiologist","authors":"Przemysław Stachurski, Katarzyna Podhorodecka, Joanna Wojtkiewicz","doi":"10.29089/paom/170129","DOIUrl":"https://doi.org/10.29089/paom/170129","url":null,"abstract":"Introduction Jerzy Majkowski was a Polish neurologist who made significant contributions to the field of neuroscience. Majkowski was a renowned physician and researcher who specialized in studying and treating movement disorders such as Parkinson’s disease and dystonia. Throughout his career, he was known for his innovative approaches to diagnosing and treating these complex conditions, and he was widely respected by his peers for his deep understanding of the brain and its functions. Aim The purpose of our work is to introduce the reader to the person of Jerzy Majkowski. Material and methods The work is based on the available literature. The search process resulted in the detection of relevant articles using valid keywords on electronic databases, including Embase, PubMed, Scopus, Web of Science, and Cochrane Library. Subsequently, 10 were identified as eligible for our review. Results and discussion Jerzy ‘Czarny’ Majkowski, a Polish neurologist and neurophysiologist. During World War II, he joined the Polish Scouting Association, where he participated in the underground activities of the organization under the pseudonym Czarny. After the war, he studied medicine at Warsaw University and graduated in 1952. Majkowski was interested in epilepsy, electroencephalography, and neurophysiology and put forward several hypotheses based on his research. He was the author of about 500 scientific publications and edited 14 books. He was also the editor of several journals, including Epileptologia and the Journal of Epileptology. Conclusions Majkowski’s work has helped to advance our understanding of neurological disorders, and his legacy continues to inspire future generations of scientists and physicians.","PeriodicalId":38569,"journal":{"name":"Polish Annals of Medicine","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135616729","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}
Nurul Najwa Mohd Zakir, Irfan Mohamad, Lee Shen-Han, Zulkifli Yusof, Zahidah Muhammod Riaz
Introduction Tracheostomy is a surgical airway management procedure that involves making an incision on the anterior neck and opening a direct airway through an incision in the trachea. Aim We report a case of a difficult tracheostomy complicated by massive immediate bleeding from the innominate artery that required a median sternotomy for vascular access and control. Case study A 26-year-old lady with a short neck underwent a tracheostomy in a semi-emergency setting in view of prolonged intubation and frequent intubation prior. The tracheal incision was performed in between the 3rd and 4th tracheal rings and was complicated by massive bleeding from the innominate artery tear that was located below the sternum and necessitated a midline sternotomy procedure to access the artery. The artery was then repaired primarily and covered with a strap muscle that was swung over to the right and sutured to the periosteum of the right clavicle. She lost 6 L of blood, prompting a massive blood transfusion. Postoperatively, there was no bleeding from the wound, but she had an infected sternotomy wound that was managed with antibiotics and dressings. The tracheostomy tube care was uneventful. Results and discussion The short-neck hyperextension during trachea exposure can cause major thoracic vessels and tracheal rings to move upward, leading to tracheal incisions being made lower than intended and risking major vessel injury. Conclusions Imaging before surgery is recommended to delineate the anatomy and detect any major vessels present in the case of anticipated difficult tracheostomy.
{"title":"Massive immediate post-tracheostomy bleeding from the innominate artery","authors":"Nurul Najwa Mohd Zakir, Irfan Mohamad, Lee Shen-Han, Zulkifli Yusof, Zahidah Muhammod Riaz","doi":"10.29089/paom/166809","DOIUrl":"https://doi.org/10.29089/paom/166809","url":null,"abstract":"Introduction Tracheostomy is a surgical airway management procedure that involves making an incision on the anterior neck and opening a direct airway through an incision in the trachea. Aim We report a case of a difficult tracheostomy complicated by massive immediate bleeding from the innominate artery that required a median sternotomy for vascular access and control. Case study A 26-year-old lady with a short neck underwent a tracheostomy in a semi-emergency setting in view of prolonged intubation and frequent intubation prior. The tracheal incision was performed in between the 3rd and 4th tracheal rings and was complicated by massive bleeding from the innominate artery tear that was located below the sternum and necessitated a midline sternotomy procedure to access the artery. The artery was then repaired primarily and covered with a strap muscle that was swung over to the right and sutured to the periosteum of the right clavicle. She lost 6 L of blood, prompting a massive blood transfusion. Postoperatively, there was no bleeding from the wound, but she had an infected sternotomy wound that was managed with antibiotics and dressings. The tracheostomy tube care was uneventful. Results and discussion The short-neck hyperextension during trachea exposure can cause major thoracic vessels and tracheal rings to move upward, leading to tracheal incisions being made lower than intended and risking major vessel injury. Conclusions Imaging before surgery is recommended to delineate the anatomy and detect any major vessels present in the case of anticipated difficult tracheostomy.","PeriodicalId":38569,"journal":{"name":"Polish Annals of Medicine","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135617307","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}
Józefa Dąbek, Halina Kulik, Kamila Puk, Oskar Sierka
Introduction Continuous progress in medicine generates new ethical challenges faced by members of the healthcare system. The use of persistent therapy is referred to when the methods and measures used in treatment do not offer a realistic chance of recovery or significant improvement of the patient’s condition. Aim The aim of the study was to analyse adults’ knowledge about the use of persistent therapy. Material and methods The study involved 200 (100%) adults, the vast majority of whom were women (160; 80.00%). An original online survey questionnaire was used to conduct the study, consisting of questions covering the topic in question and regarding the sociodemographic data of the respondents. The study was completely anonymous and voluntary, and all respondents gave their informed consent to participate. Results and discussion The most common procedures included in the persistent therapy, according to the respondents, were mechanical circulatory support (124; 62.00%) and mechanical ventilation (90; 45.00%). Among the most frequently cited factors influencing the decision to discontinue persistent therapy, respondents mentioned the patient’s statement of intent (146; 37.00%). There was also a statistically significant result (P = 0.002) indicating large differences in the level of knowledge between those declaring a conenction with patient care and those who did not declare such connection. Conclusions Among participants, knowledge regarding persistent therapy was incomplete, especially among non-medical respondents. Informational activities should therefore be undertaken to raise public awareness about end-life decisions and treatment options in the last hours of one’s life.
{"title":"What do Polish adults know about persistent therapy? Preliminary results","authors":"Józefa Dąbek, Halina Kulik, Kamila Puk, Oskar Sierka","doi":"10.29089/paom/163585","DOIUrl":"https://doi.org/10.29089/paom/163585","url":null,"abstract":"Introduction Continuous progress in medicine generates new ethical challenges faced by members of the healthcare system. The use of persistent therapy is referred to when the methods and measures used in treatment do not offer a realistic chance of recovery or significant improvement of the patient’s condition. Aim The aim of the study was to analyse adults’ knowledge about the use of persistent therapy. Material and methods The study involved 200 (100%) adults, the vast majority of whom were women (160; 80.00%). An original online survey questionnaire was used to conduct the study, consisting of questions covering the topic in question and regarding the sociodemographic data of the respondents. The study was completely anonymous and voluntary, and all respondents gave their informed consent to participate. Results and discussion The most common procedures included in the persistent therapy, according to the respondents, were mechanical circulatory support (124; 62.00%) and mechanical ventilation (90; 45.00%). Among the most frequently cited factors influencing the decision to discontinue persistent therapy, respondents mentioned the patient’s statement of intent (146; 37.00%). There was also a statistically significant result (P = 0.002) indicating large differences in the level of knowledge between those declaring a conenction with patient care and those who did not declare such connection. Conclusions Among participants, knowledge regarding persistent therapy was incomplete, especially among non-medical respondents. Informational activities should therefore be undertaken to raise public awareness about end-life decisions and treatment options in the last hours of one’s life.","PeriodicalId":38569,"journal":{"name":"Polish Annals of Medicine","volume":"51 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135994873","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}
Anna Cieślińska, Ewa Fiedorowicz, Dominika Rozmus, Maria Latacz, Edyta Sienkiewicz-Szłapka, Janusz Płomiński, Roman Grzybowski, Beata Jarmołowska, Jadwiga Snarska, Andrzej Grzybowski
Introduction Severe acute respiratory syndrome, coronavirus type 2 (SARS-CoV-2) has become a global threat for every healthcare system, and the coronavirus disease 2019 (COVID-19) pandemic has resulted in over 3 million deaths worldwide. SARS-CoV-2 brings symptoms such as fever, cough, shortness of breath, headache, sore throat and loss of taste or smell. Diagnostic of COVID-19 may include specific RT-PCR for viral ribonucleic acid detection, and ELISA testing for virus-derived spike protein or nucleocapsid. Aim The aim of this study was to measure the antinucleocapsid level of SARS-CoV-2 IgG to identify the number of asymptomatic cases of COVID-19 after infection in a population of workers from a production company. Material and methods Human anti-SARS-CoV-2(N) IgG ELISA kit was used to determine serum IgG level. Study includes 107 individuals (48% female, 52% male) in different ages (18–60 years). Results and discussion Of 107 tested individuals in 80 (74.7%) cases SARS-CoV-2(N)-specific IgG antibodies were detected, with an average antibody concentration of the whole study group 4.08 µg/mL (n = 107 with the range 0.59–7.91 µg/mL; n = 80 were included in the study with the sensitivity of the method above 2.344 µg/mL). In only 9 cases, SARS-CoV-2 infection was confirmed before using the PCR test. Our data underscore the need for a population study in Poland to test the proportion of asymptomatic IgG positive for SARS-CoV-2 individuals. Conclusions This study indicates that within studied sample large proportion of asymptomatic people have undergone SARS-CoV-2 infection and suggests that isolation of only symptomatic patients would not stop the transmission of the virus.
{"title":"Cross-sectional assessment of a history of SARS-CoV-2 infections using IgG","authors":"Anna Cieślińska, Ewa Fiedorowicz, Dominika Rozmus, Maria Latacz, Edyta Sienkiewicz-Szłapka, Janusz Płomiński, Roman Grzybowski, Beata Jarmołowska, Jadwiga Snarska, Andrzej Grzybowski","doi":"10.29089/paom/161497","DOIUrl":"https://doi.org/10.29089/paom/161497","url":null,"abstract":"Introduction Severe acute respiratory syndrome, coronavirus type 2 (SARS-CoV-2) has become a global threat for every healthcare system, and the coronavirus disease 2019 (COVID-19) pandemic has resulted in over 3 million deaths worldwide. SARS-CoV-2 brings symptoms such as fever, cough, shortness of breath, headache, sore throat and loss of taste or smell. Diagnostic of COVID-19 may include specific RT-PCR for viral ribonucleic acid detection, and ELISA testing for virus-derived spike protein or nucleocapsid. Aim The aim of this study was to measure the antinucleocapsid level of SARS-CoV-2 IgG to identify the number of asymptomatic cases of COVID-19 after infection in a population of workers from a production company. Material and methods Human anti-SARS-CoV-2(N) IgG ELISA kit was used to determine serum IgG level. Study includes 107 individuals (48% female, 52% male) in different ages (18–60 years). Results and discussion Of 107 tested individuals in 80 (74.7%) cases SARS-CoV-2(N)-specific IgG antibodies were detected, with an average antibody concentration of the whole study group 4.08 µg/mL (<i>n</i> = 107 with the range 0.59–7.91 µg/mL; <i>n</i> = 80 were included in the study with the sensitivity of the method above 2.344 µg/mL). In only 9 cases, SARS-CoV-2 infection was confirmed before using the PCR test. Our data underscore the need for a population study in Poland to test the proportion of asymptomatic IgG positive for SARS-CoV-2 individuals. Conclusions This study indicates that within studied sample large proportion of asymptomatic people have undergone SARS-CoV-2 infection and suggests that isolation of only symptomatic patients would not stop the transmission of the virus.","PeriodicalId":38569,"journal":{"name":"Polish Annals of Medicine","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135992601","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}
Maria Krystyna Michna, Magda Bichalska-Lach, Marek Rudzki, Dariusz Waniczek
Introduction Colorectal cancer is one of the most common type of cancers worldwide. Simultaneous occurrence of at least two tumours in a single patient within 6 months is defined as synchronous colorectal carcinoma (SCC). Within all large intestine tumors, the occurrence of SCC is approximately 3.5%. Patients with more than two tumours account for 1.8% to 16.7% of all SCC cases. Aim We present a case of a 65-year-old female patient with triple synchronous colorectal cancer. Case study 65-year-old female patient reporting increasing fatigue and shortness of breath, lasting for 6 months, underwent preoperative colonoscopy and computed tomography (CT) scan. Both examinations indicated double malignant lesions in separate parts of the transverse colon. During the subtotal colectomy a third lesion has been found. Results and discussion The histopathology results confirmed three adenocarcinoma type tumours (two of grade 3 and one grade 2). Our patient does not suffer from any conditions that increase the probability of SCC. In her family history there are no known ancestors suffering from colon cancers or multiple primary malignant tumor. The patient does not suffer from ulcerative colitis or familial adenomatous polyposis. Conclusions The presented clinical case proves that a comprehensive pre-surgical recognition of SCC is not always possible. If a full colonoscopy is impossible, one should consider carrying out a second colonoscopy 3 months after a surgery, particularly in case of patients whose CT results are ambiguous. During a surgery, the entire length of the bowel should be palpably checked for a presence of additional tumours.
{"title":"A rare case of a trifocal synchronous colon cancer in a 65-year old patient","authors":"Maria Krystyna Michna, Magda Bichalska-Lach, Marek Rudzki, Dariusz Waniczek","doi":"10.29089/paom/161659","DOIUrl":"https://doi.org/10.29089/paom/161659","url":null,"abstract":"Introduction Colorectal cancer is one of the most common type of cancers worldwide. Simultaneous occurrence of at least two tumours in a single patient within 6 months is defined as synchronous colorectal carcinoma (SCC). Within all large intestine tumors, the occurrence of SCC is approximately 3.5%. Patients with more than two tumours account for 1.8% to 16.7% of all SCC cases. Aim We present a case of a 65-year-old female patient with triple synchronous colorectal cancer. Case study 65-year-old female patient reporting increasing fatigue and shortness of breath, lasting for 6 months, underwent preoperative colonoscopy and computed tomography (CT) scan. Both examinations indicated double malignant lesions in separate parts of the transverse colon. During the subtotal colectomy a third lesion has been found. Results and discussion The histopathology results confirmed three adenocarcinoma type tumours (two of grade 3 and one grade 2). Our patient does not suffer from any conditions that increase the probability of SCC. In her family history there are no known ancestors suffering from colon cancers or multiple primary malignant tumor. The patient does not suffer from ulcerative colitis or familial adenomatous polyposis. Conclusions The presented clinical case proves that a comprehensive pre-surgical recognition of SCC is not always possible. If a full colonoscopy is impossible, one should consider carrying out a second colonoscopy 3 months after a surgery, particularly in case of patients whose CT results are ambiguous. During a surgery, the entire length of the bowel should be palpably checked for a presence of additional tumours.","PeriodicalId":38569,"journal":{"name":"Polish Annals of Medicine","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136113925","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}
Liong Boy Kurniawan, Winda Mulyamin, Arif Santoso, Ika Yustisia
Introduction High-sensitivity C-reactive protein (hsCRP) is a microinflammation biomarker that has been widely accepted as an assessment tool for cardiovascular risk. Excess of serum uric acid levels is also linked to metabolic disorders and cardiovascular disease risk factors. Aim The study aimed to investigate the association between serum uric acid and cardiovascular risk defined based on hsCRP levels in non-diabetic adults. Material and methods This cross-sectional study included 90 non-diabetic adult subjects which comprised 45 males and 45 females. The uric acid test was performed by enzymatic colorimetric method while hsCRP was performed by immunoturbidimetric assay. High cardiovascular risk was defined as hsCRP of more than 3 mg/L. Results and discussion Serum uric acid had significant correlation with hsCRP levels in male and female subjects (r = 0.376, P = 0.011 and r = 0.378, P = 0.011, respectively). In male subjects, the uric acid cut-off of 7.415 mg/dL had 62.5% sensitivity and 83.8% specificity in predicting high cardiovascular risk (AUC = 0.671), while in females, the cut-off of 4.215 mg/dL had 73.3% sensitivity and 63.3% specificity (AUC = 0.704) in predicting the high risk. Males with uric acid of more than 7.415 mg/dL had 8.61 times having high cardiovascular risk compared those below the cut-off (P = 0.014, 95%CI = 1.609–46.07). Females with uric acid of more than 4.215 mg/dL had 4.75 times having high cardiovascular risk compared those below the cut-off (P = 0.02, 95%CI = 1.214–18.584). Conclusions Uric acid and hsCRP levels have a significant association. Serum uric acid levels may predict high cardiovascular risk defined based on hsCRP in males and females.
{"title":"Serum uric acid levels predict high hs-CRP levels in non-diabetic adult","authors":"Liong Boy Kurniawan, Winda Mulyamin, Arif Santoso, Ika Yustisia","doi":"10.29089/paom/161969","DOIUrl":"https://doi.org/10.29089/paom/161969","url":null,"abstract":"Introduction High-sensitivity C-reactive protein (hsCRP) is a microinflammation biomarker that has been widely accepted as an assessment tool for cardiovascular risk. Excess of serum uric acid levels is also linked to metabolic disorders and cardiovascular disease risk factors. Aim The study aimed to investigate the association between serum uric acid and cardiovascular risk defined based on hsCRP levels in non-diabetic adults. Material and methods This cross-sectional study included 90 non-diabetic adult subjects which comprised 45 males and 45 females. The uric acid test was performed by enzymatic colorimetric method while hsCRP was performed by immunoturbidimetric assay. High cardiovascular risk was defined as hsCRP of more than 3 mg/L. Results and discussion Serum uric acid had significant correlation with hsCRP levels in male and female subjects (<i>r</i> = 0.376, <i>P</i> = 0.011 and <i>r</i> = 0.378, <i>P</i> = 0.011, respectively). In male subjects, the uric acid cut-off of 7.415 mg/dL had 62.5% sensitivity and 83.8% specificity in predicting high cardiovascular risk (AUC = 0.671), while in females, the cut-off of 4.215 mg/dL had 73.3% sensitivity and 63.3% specificity (AUC = 0.704) in predicting the high risk. Males with uric acid of more than 7.415 mg/dL had 8.61 times having high cardiovascular risk compared those below the cut-off (<i>P</i> = 0.014, 95%CI = 1.609–46.07). Females with uric acid of more than 4.215 mg/dL had 4.75 times having high cardiovascular risk compared those below the cut-off (<i>P</i> = 0.02, 95%CI = 1.214–18.584). Conclusions Uric acid and hsCRP levels have a significant association. Serum uric acid levels may predict high cardiovascular risk defined based on hsCRP in males and females.","PeriodicalId":38569,"journal":{"name":"Polish Annals of Medicine","volume":"225 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136113149","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}
Michał Starczewski, Wojciech Choiński, Michał Puliński
Introduction Heminephrectomy is considered the method of choice in the treatment of symptomatic or poorly working moiety of a duplex kidney as well as in oncology. Aim The study aims to retrospectively analyze the laparoscopic approach to heminephrectomy (LHN) in comparison with the open approach (OHN). Material and methods From 2011 to 2020, 28 heminephrectomies were performed in the Clinical Ward of Pediatric Surgery and Urology of the Regional Specialized Children’s Hospital in Olsztyn: 10 with the laparoscopic transperitoneal method (LHN), and 18 with the open method (OHN). The mean age was 37.4 months (1–197 months). In total, 20 patients were female, and 8 were male. Loss of function of the moiety was a prerequisite for surgery. Hydronephrosis, dysplasia of the moiety, and vesicoureteral reflux were the most prevalent in both groups. Data regarding patients were collected based on available medical documentation and retrospectively analyzed. Results and discussion There was no significant difference between the LHN and OHN groups regarding mean operating time (157 vs 128 minutes; P = 0.226) and mean postoperative hospital stay (5.20 vs 6.53; P = 0.64). The refeeding time is comparable and not statistically significant (1.90 vs 1.83 days; P = 0.555). Postoperative analgesic intake was found to be significantly lower (10.4 vs 17.5 doses, P = 0.004). Conclusions Both open and laparoscopic approaches are safe and feasible in the pediatric population. Both are comparable in operative time, hospital stay and refeeding time. LHN displays a better cosmetic effect and requires significantly lesser analgesic use.
半肾切除术被认为是治疗双肾症状或工作不良部分以及肿瘤的首选方法。目的回顾性分析腹腔镜半肾切除术(LHN)与开放入路(OHN)的比较。材料与方法2011 - 2020年，在Olsztyn地区儿童专科医院儿科外科和泌尿外科临床病房进行了28例半肾切除术:10例采用腹腔镜经腹膜法(LHN)， 18例采用开放法(OHN)。平均年龄37.4个月(1 ~ 197个月)。其中女性20例，男性8例。部分功能丧失是手术的先决条件。肾积水、部分发育不良和膀胱输尿管反流在两组中最为常见。根据现有的医学文献收集患者资料并进行回顾性分析。结果与讨论LHN组和OHN组在平均手术时间上无显著差异(157 vs 128分钟;& lt; i>术中;/ i>= 0.226)和术后平均住院时间(5.20 vs 6.53;& lt; i>术中;/ i>= 0.64)。再饲喂时间具有可比性，但无统计学意义(1.90 vs 1.83天;& lt; i>术中;/ i>= 0.555)。术后镇痛药的摄入明显降低(10.4 vs 17.5剂量)。= 0.004)。结论开放和腹腔镜入路在儿童中均是安全可行的。两者在手术时间、住院时间和再喂养时间上具有可比性。LHN表现出更好的美容效果，需要明显较少的止痛剂使用。
{"title":"Heminephrectomy in the pediatric population – single-center comparison of the open versus transperitoneal laparoscopic approach","authors":"Michał Starczewski, Wojciech Choiński, Michał Puliński","doi":"10.29089/paom/157522","DOIUrl":"https://doi.org/10.29089/paom/157522","url":null,"abstract":"Introduction Heminephrectomy is considered the method of choice in the treatment of symptomatic or poorly working moiety of a duplex kidney as well as in oncology. Aim The study aims to retrospectively analyze the laparoscopic approach to heminephrectomy (LHN) in comparison with the open approach (OHN). Material and methods From 2011 to 2020, 28 heminephrectomies were performed in the Clinical Ward of Pediatric Surgery and Urology of the Regional Specialized Children’s Hospital in Olsztyn: 10 with the laparoscopic transperitoneal method (LHN), and 18 with the open method (OHN). The mean age was 37.4 months (1–197 months). In total, 20 patients were female, and 8 were male. Loss of function of the moiety was a prerequisite for surgery. Hydronephrosis, dysplasia of the moiety, and vesicoureteral reflux were the most prevalent in both groups. Data regarding patients were collected based on available medical documentation and retrospectively analyzed. Results and discussion There was no significant difference between the LHN and OHN groups regarding mean operating time (157 vs 128 minutes; <i>P</i> = 0.226) and mean postoperative hospital stay (5.20 vs 6.53; <i>P</i> = 0.64). The refeeding time is comparable and not statistically significant (1.90 vs 1.83 days; <i>P</i> = 0.555). Postoperative analgesic intake was found to be significantly lower (10.4 vs 17.5 doses, <i>P</i> = 0.004). Conclusions Both open and laparoscopic approaches are safe and feasible in the pediatric population. Both are comparable in operative time, hospital stay and refeeding time. LHN displays a better cosmetic effect and requires significantly lesser analgesic use.","PeriodicalId":38569,"journal":{"name":"Polish Annals of Medicine","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135758624","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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