D. Zaryjewski, J. Malarkiewicz, Jarosław Ciuńczyk, D. Onichimowski
Introduction. Actinomycosis is a disease caused by anaerobic Gramme positive bacterium Actinomyces israeli. This is a specific inflammation with characteristic pathomorphological changes (sulphur granules), which is accompanied by focuses of fibrosis and the formation of abscesses or fistulas. Actinomycosis may develop in any organ, but the most frequent localization involvs face and neck (63%), lungs (15%) and abdominal cavity, including pelvis minor (22%). Regardless of the observed decrease in the total incidence of actinomycosis in recent years, the number of cases involving the abdominal cavity and pelvis minor localization in the population of women who use intrauterine contraceptive devices (IUD) has increased. Aim. To present, on the basis of own experience, a case of multiorgan actinomycosis within the pelvis minor, as a disease which is too rarely considered in the differentiating diagnostic process in cases of tumour originating from the reproductive organ, urinary tract or alimentary tract. Materials and methods. This article discusses a case of actinomycosis of the pelvis minor, involving the left ovary and tube, bladder, rectum, sigmoideum and pelvic wall. It describes the diagnostic process preceding the surgery, the surgery itself, during which an intraoperative histopathological examination was performed, facilitating the final diagnosis and the application of penicillin therapy. Diagnostic problems involving actinomycosis and a significant role of intraoperative histopathological examination are emphasised. The relationship between pelvic actinomycosis and the application of intrauterine contraceptive device is highlighted. Conclusions. 1. Clinical picture of actinomycosis localized in the reproductive organ may be similar to that of a neoplastic process. 2. In the case of tumours of the pelvis minor of non-specific localization, associated with the application of intrauterine device as a contraceptive method, the possibility of actinomycosis should be considered. 3 Histopathological examination, performed intraoperatively or by biopsy before the surgical procedure, is decisive in the diagnostic process and subsequent treatment. 4. The evaluation of a diagnostic value of bacteriological cultures taken from the uterine cervix to detect anaerobic bacteria in the female population with an increased risk of infection caused by Actinomyces israeli requires further research performed on a large group of patients.
{"title":"Actinomycosis of the pelvis minor involving the ovary, fallopian tube, bladder, rectum, sigmoideum and pelvic wall, mimicking a dispersed neoplastic process","authors":"D. Zaryjewski, J. Malarkiewicz, Jarosław Ciuńczyk, D. Onichimowski","doi":"10.29089/paom/162204","DOIUrl":"https://doi.org/10.29089/paom/162204","url":null,"abstract":"Introduction. Actinomycosis is a disease caused by anaerobic Gramme positive bacterium Actinomyces israeli. This is a specific inflammation with characteristic pathomorphological changes (sulphur granules), which is accompanied by focuses of fibrosis and the formation of abscesses or fistulas. Actinomycosis may develop in any organ, but the most frequent localization involvs face and neck (63%), lungs (15%) and abdominal cavity, including pelvis minor (22%). Regardless of the observed decrease in the total incidence of actinomycosis in recent years, the number of cases involving the abdominal cavity and pelvis minor localization in the population of women who use intrauterine contraceptive devices (IUD) has increased. Aim. To present, on the basis of own experience, a case of multiorgan actinomycosis within the pelvis minor, as a disease which is too rarely considered in the differentiating diagnostic process in cases of tumour originating from the reproductive organ, urinary tract or alimentary tract. Materials and methods. This article discusses a case of actinomycosis of the pelvis minor, involving the left ovary and tube, bladder, rectum, sigmoideum and pelvic wall. It describes the diagnostic process preceding the surgery, the surgery itself, during which an intraoperative histopathological examination was performed, facilitating the final diagnosis and the application of penicillin therapy. Diagnostic problems involving actinomycosis and a significant role of intraoperative histopathological examination are emphasised. The relationship between pelvic actinomycosis and the application of intrauterine contraceptive device is highlighted. Conclusions. 1. Clinical picture of actinomycosis localized in the reproductive organ may be similar to that of a neoplastic process. 2. In the case of tumours of the pelvis minor of non-specific localization, associated with the application of intrauterine device as a contraceptive method, the possibility of actinomycosis should be considered. 3 Histopathological examination, performed intraoperatively or by biopsy before the surgical procedure, is decisive in the diagnostic process and subsequent treatment. 4. The evaluation of a diagnostic value of bacteriological cultures taken from the uterine cervix to detect anaerobic bacteria in the female population with an increased risk of infection caused by Actinomyces israeli requires further research\u0000performed on a large group of patients.","PeriodicalId":38569,"journal":{"name":"Polish Annals of Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46218457","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. Górecki, J. Kiwerski, I. Kowalski, W. Marczynski, J. Nowotny, M. Rybicka, Urszula Jarosz, Maria Suwalska, Wanda Szelachowska-Kluza
Introduction. The Minister of Health, aware of the need to draw up a uniform study, based on up-to-date medical knowledge, which would provide guidelines for educational workers concerning the prophylactics of postural deformities in children and youth, addressed a group of specialists to help arrive at the aforementioned document. All abnormalities of human posture are generally termed postural deformities, although this term is not clearly defined and is rather ambiguous. The issue of postural deformities has already been analysed within numerous publications of various natures; still, however, it remains unsolved. The reasons for postural deformities are ample. Apart from the cases when their aetiology stems from congenital deformities or specific diseases, postural deformities usually develop without any evident reasons. Factors which lead to adopting an improper posture of the body certainly play a significant role. In time they result in the formation and retention of the habit of adopting an improper posture and thus contribute to the development of deformities. The incidence of postural deformities at the developmental age is assessed approximately at 50–60% of the population, depending on the region. Usually, these are habitual deformities, which to a large degree then contribute to the increase of the number of individuals with postural deformities in the population. Providing care for children and youth with developing or already developed postural deformities is a complex matter. Deformities developed due to a specific cause or those which are much more advanced require specialist treatment, which is beyond the sphere of interest and duties of the teaching environment. The basic tasks of this environment include primary prophylactics, i.e. eliminating these factors which may contribute to the development of deformities as well as promoting a proper body posture. Aim. The aim of this study was to draw up a uniform and up-to-date document which would provide guidelines concerning the prophylactics of postural deformities in children and youth. Methods. Prophylactic activities within the teaching environment are carried out by: director of the teaching institution, teacher/form tutor, physical education teacher, nurse working within the teaching environment/ school hygienist. Conclusions. The aforementioned document drawn up by the specialists is forwarded by the Minister of Health to the Minister of National Education, with the hope that it will prove useful for educational workers in undertaking activities that promote healthy habits amongst children and youth.
{"title":"Prophylactics of postural deformities in children and youth carried out within the teaching environment – experts recommendations","authors":"A. Górecki, J. Kiwerski, I. Kowalski, W. Marczynski, J. Nowotny, M. Rybicka, Urszula Jarosz, Maria Suwalska, Wanda Szelachowska-Kluza","doi":"10.29089/paom/162260","DOIUrl":"https://doi.org/10.29089/paom/162260","url":null,"abstract":"Introduction. The Minister of Health, aware of the need to draw up a uniform study, based on up-to-date medical knowledge, which would provide guidelines for educational workers concerning the prophylactics of postural deformities in children and youth, addressed a group of specialists to help arrive at the aforementioned document. All abnormalities of human posture are generally termed postural\u0000deformities, although this term is not clearly defined and is rather ambiguous. The issue of postural deformities has already been analysed within numerous publications of various natures; still, however, it remains unsolved. The reasons for postural deformities are ample. Apart from the cases when their aetiology stems from congenital deformities or specific diseases, postural deformities usually develop without\u0000any evident reasons. Factors which lead to adopting an improper posture of the body certainly play a significant role. In time they result in the formation and retention of the habit of adopting an improper posture and thus contribute to the development of deformities.\u0000The incidence of postural deformities at the developmental age is assessed approximately at 50–60% of the population, depending on the region. Usually, these are habitual deformities, which to a large degree then contribute to the increase of the number of individuals with postural deformities in the population. Providing care for children and youth with developing or already developed postural deformities is a complex matter. Deformities developed due to a specific cause or those which are much more advanced require specialist treatment, which is beyond the sphere of interest and duties of the teaching environment. The basic tasks of this environment include primary prophylactics, i.e. eliminating these factors which may contribute to the development of deformities as well as promoting a proper body posture. Aim. The aim of this study was to draw up a uniform and up-to-date document which would provide guidelines concerning the prophylactics of postural deformities in children and youth. Methods. Prophylactic activities within the teaching environment are carried out by:\u0000director of the teaching institution, teacher/form tutor, physical education teacher, nurse working within the teaching environment/ school hygienist. Conclusions. The aforementioned document drawn up by the specialists is forwarded by the Minister of Health to the Minister of National Education, with the hope that it will prove useful for educational workers in undertaking activities that promote healthy habits amongst children and youth.","PeriodicalId":38569,"journal":{"name":"Polish Annals of Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45721122","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}
Primary hyperparathyroidism (PHPT) is an unusual childhood disease characterized by an excessive secretion of parathyroid hormone (PTH). Its presentation may consist of nonspecific symptoms. Consequently, physicians have trouble diagnosing the disease as they fail to check the level of calcium or PTH.To describe a case of a paediatric patient with primary hyperparathyroidism, who was successfully diagnosed and treated.A 14-year-old boy was admitted to the Paediatric Department with suspected PHPT after performing tests at the Endocrinology Outpatient Clinic, which revealed hypercalcaemia and high PTH level. The ordering of tests was motivated by non-specific symptoms that could indicate PHPT. The ultrasonography, single photon emission computed tomography of the neck and Tc-99m MIBI parathyroid scintigraphy of the neck and upper thorax were performed, which revealed the presence of hypoechogenic structure and focal accumulation of a marker, consistent with the presence of adenoma. The patient was qualified for surgical treatment, which resulted in a resolution of pathological symptoms.Because PHPT is a rare disease among paediatric patients, and is initially characterised by non-specific clinical picture, it is usually diagnosed when advanced organ changes occur. Screening tests, such as calcium and PTH determinations, are also not routinely ordered in this age group. Once the diagnosis is made, the treatment is largely supportive and includes prevention of life-threatening complications.A rare case of a boy with parathyroid adenoma was successfully managed with a multidisciplinary approach combining input from paediatric endocrinologists, radiologists and surgeons.
{"title":"Primary hyperparathyroidism in a 14-year-old boy \u0000– a case report","authors":"J. Lewandowska, D. Charemska","doi":"10.29089/paom/152262","DOIUrl":"https://doi.org/10.29089/paom/152262","url":null,"abstract":"Primary hyperparathyroidism (PHPT) is an unusual childhood disease characterized by an excessive secretion of parathyroid hormone (PTH). Its presentation may consist of nonspecific symptoms. Consequently, physicians have trouble diagnosing the disease as they fail to check the level of calcium or PTH.To describe a case of a paediatric patient with primary hyperparathyroidism, who was successfully diagnosed and treated.A 14-year-old boy was admitted to the Paediatric Department with suspected PHPT after performing tests at the Endocrinology Outpatient Clinic, which revealed hypercalcaemia and high PTH level. The ordering of tests was motivated by non-specific symptoms that could indicate PHPT. The ultrasonography, single photon emission computed tomography of the neck and Tc-99m MIBI parathyroid scintigraphy of the neck and upper thorax were performed, which revealed the presence of hypoechogenic structure and focal accumulation of a marker, consistent with the presence of adenoma. The patient was qualified for surgical treatment, which resulted in a resolution of pathological symptoms.Because PHPT is a rare disease among paediatric patients, and is initially characterised by non-specific clinical picture, it is usually diagnosed when advanced organ changes occur. Screening tests, such as calcium and PTH determinations, are also not routinely ordered in this age group. Once the diagnosis is made, the treatment is largely supportive and includes prevention of life-threatening complications.A rare case of a boy with parathyroid adenoma was successfully managed with a multidisciplinary approach combining input from paediatric endocrinologists, radiologists and surgeons.","PeriodicalId":38569,"journal":{"name":"Polish Annals of Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42961142","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}
M. Cichoń, Beata Wańczyk-Dręczewska, W. Placek, W. Biernat, W. Potocka, Agnieszka Owczarczyk-Saczonek
Eosinophilic pustular folliculitis (EPF), sometimes called Ofuji disease, is a chronic skin disorder of unknown etiology which develops predominantly in elderly man. Clinically it usually presents as itching centrifugally extending papulopustular rash.To present a case of EPF and to raise dermatologists’ awareness of this this dermatosis when dealing with patients who are in higher risk of EPF occurrence.A 90-year-old man presented to the dermatology clinic due to the itching rash that had been present for 3 months. Physical examination of the patient revealed red-brown papulopustules covering trunk and extremities, most severe on the frontal part of thighs. Other possible causative agents of the symptoms were excluded. Histopathological results together with clinical symptoms led us to the final diagnosis of classic EPF.EPF is challenging to diagnose. The disease is very rare, especially in Europe, and clinical and/or histological appearance may mimic other dermatological conditions. The most commonly affected areas are face, back and trunk. EPF is usually classified into three main subtypes: classic, infantile and immunosuppression-associated. There are many viable therapeutic algorithms for the treatment of EPF.Eosinophilic pustular folliculitis should be considered in differential diagnosis of pruritic follicular papulopustular rash affecting elderly men. Histopathological results play a crucial role in the making of final diagnosis.
{"title":"Eosinophilic pustular folliculitis in a 90-year-old patient","authors":"M. Cichoń, Beata Wańczyk-Dręczewska, W. Placek, W. Biernat, W. Potocka, Agnieszka Owczarczyk-Saczonek","doi":"10.29089/paom/156267","DOIUrl":"https://doi.org/10.29089/paom/156267","url":null,"abstract":"Eosinophilic pustular folliculitis (EPF), sometimes called Ofuji disease, is a chronic skin disorder of unknown etiology which develops predominantly in elderly man. Clinically it usually presents as itching centrifugally extending papulopustular rash.To present a case of EPF and to raise dermatologists’ awareness of this this dermatosis when dealing with patients who are in higher risk of EPF occurrence.A 90-year-old man presented to the dermatology clinic due to the itching rash that had been present for 3 months. Physical examination of the patient revealed red-brown papulopustules covering trunk and extremities, most severe on the frontal part of thighs. Other possible causative agents of the symptoms were excluded. Histopathological results together with clinical symptoms led us to the final diagnosis of classic EPF.EPF is challenging to diagnose. The disease is very rare, especially in Europe, and clinical and/or histological appearance may mimic other dermatological conditions. The most commonly affected areas are face, back and trunk. EPF is usually classified into three main subtypes: classic, infantile and immunosuppression-associated. There are many viable therapeutic algorithms for the treatment of EPF.Eosinophilic pustular folliculitis should be considered in differential diagnosis of pruritic follicular papulopustular rash affecting elderly men. Histopathological results play a crucial role in the making of final diagnosis.","PeriodicalId":38569,"journal":{"name":"Polish Annals of Medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42552507","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}
Various risk factors have been attributed to coronavirus disease 19 (COVID-19) severity. Omalizumab as an immunoglobulin E blocker that enhances anti-viral immunity might be a potential cytokine storm trigger.Our goal was to investigate if the treatment with omalizumab due to severe asthma is a risk factor of severe COVID-19 pneumonia and if severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can trigger asthma exacerbation.We report the case of a 65-year-old patient with severe allergic asthma receiving treatment with omalizumab for last 8 months with good results, who in December 2020 was infected with SARS-CoV-2. The patient was not vaccinated against COVID-19 (no vaccine was available at that time), and had comorbidities.COVID-19 course of presented patient was asymptomatic and resolved quickly without the need for hospitalization or asthma exacerbation. There was a slightly worse score on the asthma control questionnaire after COVID-19 resolution (2.1 point vs. 1.5 points) and a threefold increase in eosinophil counts (660 cell/µL vs. 230 cell/µL). However, no wheezing or deterioration in pulmonary function tests were found. A computed tomography of the chest revealed only minor densities of pulmonary parenchyma and thickened walls of bronchi.Omalizumab used in the treatment of severe allergic asthma proved to be safe and beneficial for the course of COVID-19 in the case reported. Simultaneously, SARS-CoV-2 was not a factor for asthma exacerbation.
{"title":"Impact of omalizumab therapy on the course of COVID-19 in a patient with severe asthma: A case report","authors":"A. Zaleska, A. Radlińska","doi":"10.29089/paom/153600","DOIUrl":"https://doi.org/10.29089/paom/153600","url":null,"abstract":"Various risk factors have been attributed to coronavirus disease 19 (COVID-19) severity. Omalizumab as an immunoglobulin E blocker that enhances anti-viral immunity might be a potential cytokine storm trigger.Our goal was to investigate if the treatment with omalizumab due to severe asthma is a risk factor of severe COVID-19 pneumonia and if severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can trigger asthma exacerbation.We report the case of a 65-year-old patient with severe allergic asthma receiving treatment with omalizumab for last 8 months with good results, who in December 2020 was infected with SARS-CoV-2. The patient was not vaccinated against COVID-19 (no vaccine was available at that time), and had comorbidities.COVID-19 course of presented patient was asymptomatic and resolved quickly without the need for hospitalization or asthma exacerbation. There was a slightly worse score on the asthma control questionnaire after COVID-19 resolution (2.1 point vs. 1.5 points) and a threefold increase in eosinophil counts (660 cell/µL vs. 230 cell/µL). However, no wheezing or deterioration in pulmonary function tests were found. A computed tomography of the chest revealed only minor densities of pulmonary parenchyma and thickened walls of bronchi.Omalizumab used in the treatment of severe allergic asthma proved to be safe and beneficial for the course of COVID-19 in the case reported. Simultaneously, SARS-CoV-2 was not a factor for asthma exacerbation.","PeriodicalId":38569,"journal":{"name":"Polish Annals of Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42652421","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}
Coronavirus disease (Covid-19) was first discovered in December 2019 with no signs of conceding to date. Many operations which are regarded as not lifesaving are postponed indefinitely owing to hospital bed shortage as well as to reduce the spread of infection among patients and staff. However, healthcare professionals are thrown down a huge challenge when deciding the timing of treatment for non-life-threatening conditions like severe paediatric obstructive sleep apnoea syndrome (OSAS) with a substantial impact on the development of very young children.To outline management of postoperative respiratory complication in a child with severe obstructive sleep anoea syndrome during Covid-19.We present a case of a major respiratory event requiring reintubation that developed post-adenotonsillectomy in a 3-year-old child with severe OSAS.The child was given close monitoring for 6 h in the post-anaesthetic care unit (PACU) before he was transferred to the general paediatric ward, without PICU admission during his stay in the hospital.Postoperative monitoring at the step-down unit with a high nurse-to-patient ratio appears to be beneficial as it does not compromise the need for close postoperative observation, meanwhile saving costs.
{"title":"Management of postoperative respiratory complication in a child with severe obstructive sleep apnoea syndrome during Covid-19","authors":"W. E. Wong, J. Saniasiaya, S. Abu bakar","doi":"10.29089/paom/155079","DOIUrl":"https://doi.org/10.29089/paom/155079","url":null,"abstract":"Coronavirus disease (Covid-19) was first discovered in December 2019 with no signs of conceding to date. Many operations which are regarded as not lifesaving are postponed indefinitely owing to hospital bed shortage as well as to reduce the spread of infection among patients and staff. However, healthcare professionals are thrown down a huge challenge when deciding the timing of treatment for non-life-threatening conditions like severe paediatric obstructive sleep apnoea syndrome (OSAS) with a substantial impact on the development of very young children.To outline management of postoperative respiratory complication in a child with severe obstructive sleep anoea syndrome during Covid-19.We present a case of a major respiratory event requiring reintubation that developed post-adenotonsillectomy in a 3-year-old child with severe OSAS.The child was given close monitoring for 6 h in the post-anaesthetic care unit (PACU) before he was transferred to the general paediatric ward, without PICU admission during his stay in the hospital.Postoperative monitoring at the step-down unit with a high nurse-to-patient ratio appears to be beneficial as it does not compromise the need for close postoperative observation, meanwhile saving costs.","PeriodicalId":38569,"journal":{"name":"Polish Annals of Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42566328","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}
M. Puliński, W. Choiński, Katarzyna Zubik, Julia Talaśka
A long-term intragastric feeding is the indication for percutaneous endoscopic gastrostomy (PEG) placement in a patient. The procedure is performed in children with central nervous system (CNS) disorders, congenital heart defects and neoplastic or metabolic diseases. The PEG placement procedure is most commonly performed by a gastroscopy procedure.The study aimed to retrospectively analyse the methods applied and complications following PEG tube insertion in patients of the Regional Specialist Children's Hospital in Olsztyn, Poland, in the years 2000–2019.A retrospective analysis was conducted of medical histories and records of children qualified for PEG placement procedure. PEG procedure was performed on 48 children: 24 boys and 24 girls. The mean age was 7 years. PEG was inserted in cerebral plasy in 30 patients, congenital defects in 11 and genetic disorders in 7.The reasons for PEG insertion included dysphagia in 30 children, no weight gain in 7, aspiration of gastric contents to the bronchial tree in 6, and feeding difficulties in 10. Two methods for performing PEG insertion procedure were employed: a gastroscopy alone (31 cases) and a laparoscopic-assisted gastroscopy (17). The following complications were: local complications at the incision site (28), PEG dysfunction (13), vomiting (9), sepsis (2), buried bumper syndrome (1), oesophagitis (1), and gastrointestinal fistula (1).The PEG placement procedure is burdened with a significant number of complications, however, they are mainly related to local inflammation or PEG dysfunction.
{"title":"Retrospective analysis of the methods and complications following the insertion of a PEG tube in children","authors":"M. Puliński, W. Choiński, Katarzyna Zubik, Julia Talaśka","doi":"10.29089/paom/148133","DOIUrl":"https://doi.org/10.29089/paom/148133","url":null,"abstract":"A long-term intragastric feeding is the indication for percutaneous endoscopic gastrostomy (PEG) placement in a patient. The procedure is performed in children with central nervous system (CNS) disorders, congenital heart defects and neoplastic or metabolic diseases. The PEG placement procedure is most commonly performed by a gastroscopy procedure.The study aimed to retrospectively analyse the methods applied and complications following PEG tube insertion in patients of the Regional Specialist Children's Hospital in Olsztyn, Poland, in the years 2000–2019.A retrospective analysis was conducted of medical histories and records of children qualified for PEG placement procedure. PEG procedure was performed on 48 children: 24 boys and 24 girls. The mean age was 7 years. PEG was inserted in cerebral plasy in 30 patients, congenital defects in 11 and genetic disorders in 7.The reasons for PEG insertion included dysphagia in 30 children, no weight gain in 7, aspiration of gastric contents to the bronchial tree in 6, and feeding difficulties in 10. Two methods for performing PEG insertion procedure were employed: a gastroscopy alone (31 cases) and a laparoscopic-assisted gastroscopy (17). The following complications were: local complications at the incision site (28), PEG dysfunction (13), vomiting (9), sepsis (2), buried bumper syndrome (1), oesophagitis (1), and gastrointestinal fistula (1).The PEG placement procedure is burdened with a significant number of complications, however, they are mainly related to local inflammation or PEG dysfunction.","PeriodicalId":38569,"journal":{"name":"Polish Annals of Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48383148","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 Szymak, M. Puliński, W. Choiński, Michał Szostawicki
Sciatica is a common reason for a medical consultation throughout the population. Piriformis pyomyositis is a rare cause of these symptoms. Its probable etiology is transient bacteraemia co-existing temporarily with a muscle injury.The aim of the study is to present a method for treating a piriformis muscle abscess with transabdominal ultrasound-guided transrectal drainage.A 14-year old boy, previously healthy, was admitted with symptoms of sciatica that appeared after intense physical exertion. Laboratory tests revealed elevated inflammatory parameters and positive blood culture results indicating Staphylococcus aureus. Antibiotic therapy was implemented. MRI of the small pelvis revealed a forming abscess of the right piriformis muscle. On day 6 of the antibiotic therapy, in the absence of improvement, it was decided to perform transrectal drainage under ultrasound guidance. Clinical improvement was achieved, and the inflammatory parameters decreased.Co-existence of sciatica symptoms and signs of an inflammatory condition should prompt the consideration of piriformis pyomyositis. The mainstay of treatment for piriformis pyomyositis is antibiotic therapy. The abscess formation reduces its effectiveness, which necessitates surgical intervention. The authors present the application of transrectal drainage under transabdominal ultrasound guidance as the shortest route of abscess evacuation.Transrectal drainage of piriformis pyomyositis is an effective and safe method. Concomitant use of ultrasound scans reduces the patient’s exposure to ionising radiation. However, the widespread use of this method requires more in-depth research and broadened experience.
{"title":"Abscess of the piriformis muscle in a 14-year old boy - a transrectal drainage method under transabdominal ultrasound guidance","authors":"Katarzyna Szymak, M. Puliński, W. Choiński, Michał Szostawicki","doi":"10.29089/paom/154893","DOIUrl":"https://doi.org/10.29089/paom/154893","url":null,"abstract":"Sciatica is a common reason for a medical consultation throughout the population. Piriformis pyomyositis is a rare cause of these symptoms. Its probable etiology is transient bacteraemia co-existing temporarily with a muscle injury.The aim of the study is to present a method for treating a piriformis muscle abscess with transabdominal ultrasound-guided transrectal drainage.A 14-year old boy, previously healthy, was admitted with symptoms of sciatica that appeared after intense physical exertion. Laboratory tests revealed elevated inflammatory parameters and positive blood culture results indicating Staphylococcus aureus. Antibiotic therapy was implemented. MRI of the small pelvis revealed a forming abscess of the right piriformis muscle. On day 6 of the antibiotic therapy, in the absence of improvement, it was decided to perform transrectal drainage under ultrasound guidance. Clinical improvement was achieved, and the inflammatory parameters decreased.Co-existence of sciatica symptoms and signs of an inflammatory condition should prompt the consideration of piriformis pyomyositis. The mainstay of treatment for piriformis pyomyositis is antibiotic therapy. The abscess formation reduces its effectiveness, which necessitates surgical intervention. The authors present the application of transrectal drainage under transabdominal ultrasound guidance as the shortest route of abscess evacuation.Transrectal drainage of piriformis pyomyositis is an effective and safe method. Concomitant use of ultrasound scans reduces the patient’s exposure to ionising radiation. However, the widespread use of this method requires more in-depth research and broadened experience.","PeriodicalId":38569,"journal":{"name":"Polish Annals of Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46187760","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}
Tomasz Zemleduch, K. Ratajczyk, J. Majewska, Piotr Kimla, B. Kudliński, K. Marek-Bukowiec, E. Straburzyńska-Migaj
Heart failure (HF) nowadays in western countries is an immense problem largely due to its social impact as well as an economic burden. A widely accepted biomarker-based strategy to establish prognosis and predict re-hospitalization events in HF is lacking. Currently, besides natriuretic peptides and cardiac troponins, a variety of molecules are being studied. Phoenixin (PNX) is a neuropeptide mainly involved in the regulation of gonadotropin secretion. Recently, a significant cardioprotective effect of PNX was reported.The aim of this study was to measure PNX plasma concentration in a group of HF with reduced ejection fraction (HFrEF) patients and to compare it to levels found in HF-negative participants.A group of 74 HFrEF patients and a control group consisting of 40 participants without systolic or diastolic myocardial dysfunction were studied. Each individual underwent anthropometric measurements, laboratory testing, clinical and echocardiographic examination. To evaluate PNX plasma concentration, an immunoenzymatic assay (ELISA) was performed.PNX plasma concentration in the HFrEF group was not statistically different than in the control group. No significant correlation between PNX level and age, sex, BMI, HF etiology, diabetes or atrial fibrillation presence was found. PNX concentration correlated positively with total and LDL cholesterol blood levels in HFrEF patients. A negative correlation was found with creatinine in HFrEF, uric acid and triglycerides levels as well as AlAT activity in the control group.There is no significant difference in PNX plasma concentration between HF and non-HF individuals. PNX role in cardiovascular disease requires further investigation.
{"title":"Phoenixin plasma concentration in heart failure with reduced ejection fraction patients","authors":"Tomasz Zemleduch, K. Ratajczyk, J. Majewska, Piotr Kimla, B. Kudliński, K. Marek-Bukowiec, E. Straburzyńska-Migaj","doi":"10.29089/paom/150551","DOIUrl":"https://doi.org/10.29089/paom/150551","url":null,"abstract":"Heart failure (HF) nowadays in western countries is an immense problem largely due to its social impact as well as an economic burden. A widely accepted biomarker-based strategy to establish prognosis and predict re-hospitalization events in HF is lacking. Currently, besides natriuretic peptides and cardiac troponins, a variety of molecules are being studied. Phoenixin (PNX) is a neuropeptide mainly involved in the regulation of gonadotropin secretion. Recently, a significant cardioprotective effect of PNX was reported.The aim of this study was to measure PNX plasma concentration in a group of HF with reduced ejection fraction (HFrEF) patients and to compare it to levels found in HF-negative participants.A group of 74 HFrEF patients and a control group consisting of 40 participants without systolic or diastolic myocardial dysfunction were studied. Each individual underwent anthropometric measurements, laboratory testing, clinical and echocardiographic examination. To evaluate PNX plasma concentration, an immunoenzymatic assay (ELISA) was performed.PNX plasma concentration in the HFrEF group was not statistically different than in the control group. No significant correlation between PNX level and age, sex, BMI, HF etiology, diabetes or atrial fibrillation presence was found. PNX concentration correlated positively with total and LDL cholesterol blood levels in HFrEF patients. A negative correlation was found with creatinine in HFrEF, uric acid and triglycerides levels as well as AlAT activity in the control group.There is no significant difference in PNX plasma concentration between HF and non-HF individuals. PNX role in cardiovascular disease requires further investigation.","PeriodicalId":38569,"journal":{"name":"Polish Annals of Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43291360","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}
Hüseyin Akkaya, Okan Dilek, Sinan Sözütok, H. Onan, Cengiz Yılmaz, Ümit Çelik, B. Gülek
Rasmussen’s aneurysm is an inflammatory pseudoaneurysmal dilatation of a branch of the pulmonary artery adjacent to the tuberculous cavity. It often presents with hemoptysis resulting from its rupture. Massive hemoptysis seen in giant aneurysms is a rare but life-threatening complication of cavitary tuberculosis.In this case, we aimed to present a case of giant rasmussen aneurysm that did not bleed and was diagnosed incidentally.In this article, we present a female patient who was surprisingly diagnosed with Rasmussen’s aneurysm during her follow-up after having been admitted to our emergency department due to diabetic ketoacidosis, fever, and shortness of breath and not responding to tuberculosis treatment. She was diagnosed using multi-detector computed tomography angiography and underwent embolization with a percutaneous thrombin injection. On the day after the procedure, thoracotomy had to be performed because the pseudoaneurysm continued to show contrast enhancement on imaging. She was successfully treated with surgery.Although pulmonary artery aneurysms are rare, it should be kept in mind that they may be related to tuberculosis. Pulmonary artery aneurysms are large asymptomatic and can reach gigantic dimensions as in this case. Rupture of an aneurysm of this size can be predicted to be mortal. Percutaneous thrombin injection can be used for treatment. However, percutaneous treatment may recur in large aneurysms, in which case surgical treatment is curative.Rasmussen aneurysm is very rare, and when it is asymptomatic, its diagnosis may be delayed until it reaches gigantic dimensions. Contrast-enhanced thorax computed tomography and especially multi-detector computed tomography angiography are helpful in diagnosis.
{"title":"The forgotten bomb: Ramussens’s aneurysm","authors":"Hüseyin Akkaya, Okan Dilek, Sinan Sözütok, H. Onan, Cengiz Yılmaz, Ümit Çelik, B. Gülek","doi":"10.29089/paom/151915","DOIUrl":"https://doi.org/10.29089/paom/151915","url":null,"abstract":"Rasmussen’s aneurysm is an inflammatory pseudoaneurysmal dilatation of a branch of the pulmonary artery adjacent to the tuberculous cavity. It often presents with hemoptysis resulting from its rupture. Massive hemoptysis seen in giant aneurysms is a rare but life-threatening complication of cavitary tuberculosis.In this case, we aimed to present a case of giant rasmussen aneurysm that did not bleed and was diagnosed incidentally.In this article, we present a female patient who was surprisingly diagnosed with Rasmussen’s aneurysm during her follow-up after having been admitted to our emergency department due to diabetic ketoacidosis, fever, and shortness of breath and not responding to tuberculosis treatment. She was diagnosed using multi-detector computed tomography angiography and underwent embolization with a percutaneous thrombin injection. On the day after the procedure, thoracotomy had to be performed because the pseudoaneurysm continued to show contrast enhancement on imaging. She was successfully treated with surgery.Although pulmonary artery aneurysms are rare, it should be kept in mind that they may be related to tuberculosis. Pulmonary artery aneurysms are large asymptomatic and can reach gigantic dimensions as in this case. Rupture of an aneurysm of this size can be predicted to be mortal. Percutaneous thrombin injection can be used for treatment. However, percutaneous treatment may recur in large aneurysms, in which case surgical treatment is curative.Rasmussen aneurysm is very rare, and when it is asymptomatic, its diagnosis may be delayed until it reaches gigantic dimensions. Contrast-enhanced thorax computed tomography and especially multi-detector computed tomography angiography are helpful in diagnosis.","PeriodicalId":38569,"journal":{"name":"Polish Annals of Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48147797","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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