Pub Date : 2014-07-31DOI: 10.2478/s11536-013-0314-y
M. Vytřísalová, L. Fuksa, V. Palička, S. Byma, S. Blazková, J. Stepan, T. Hendrychova, J. Vlček, P. Pávek
Rationale and objectivesGeneral practitioners (GPs) play an important role in management of patients at risk of osteoporosis (OP). The objectives were to assess (1) knowledge about OP and use of OP clinical guideline in comparison with other information sources and (2) association between the use of individual information sources and knowledge and self-reported quality of care among GPs.MethodsSurvey among random sample of Czech GPs was performed to find out their attitudes and role in OP management. The return rate of the postal questionnaire was 38% (525 respondents). Quality of care was assessed using three indicators: suspicion on OP, referral to the specialist and initial check-up.ResultsRespondents (median age 52 years, 59% women) had a very good knowledge of several risk factors, while others, namely low body mass index, history of hip fracture in mother and smoking were perceived as risk factors by only 40%, 45% and 55% of respondents, respectively. 10% of GPs stated the correct answer regarding daily calcium intake recommended for postmenopausal women. The OP guideline was considered accessible by 83% of respondents and used repeatedly by 54%. Use of the guideline correlated positively with knowledge score (P < 0.001), while use of each individual other source of information did not. Use of the guideline correlated with all three indicators of quality of care. Use of each other information source correlated only with a maximum of two indicators.ConclusionWe identified areas of insufficient knowledge that should be targeted in educational activities for GPs. It is recommended to further motivate GPs to use their clinical guidelines regularly.
{"title":"Adherence to osteoporosis guideline: survey among Czech general practitioners","authors":"M. Vytřísalová, L. Fuksa, V. Palička, S. Byma, S. Blazková, J. Stepan, T. Hendrychova, J. Vlček, P. Pávek","doi":"10.2478/s11536-013-0314-y","DOIUrl":"https://doi.org/10.2478/s11536-013-0314-y","url":null,"abstract":"Rationale and objectivesGeneral practitioners (GPs) play an important role in management of patients at risk of osteoporosis (OP). The objectives were to assess (1) knowledge about OP and use of OP clinical guideline in comparison with other information sources and (2) association between the use of individual information sources and knowledge and self-reported quality of care among GPs.MethodsSurvey among random sample of Czech GPs was performed to find out their attitudes and role in OP management. The return rate of the postal questionnaire was 38% (525 respondents). Quality of care was assessed using three indicators: suspicion on OP, referral to the specialist and initial check-up.ResultsRespondents (median age 52 years, 59% women) had a very good knowledge of several risk factors, while others, namely low body mass index, history of hip fracture in mother and smoking were perceived as risk factors by only 40%, 45% and 55% of respondents, respectively. 10% of GPs stated the correct answer regarding daily calcium intake recommended for postmenopausal women. The OP guideline was considered accessible by 83% of respondents and used repeatedly by 54%. Use of the guideline correlated positively with knowledge score (P < 0.001), while use of each individual other source of information did not. Use of the guideline correlated with all three indicators of quality of care. Use of each other information source correlated only with a maximum of two indicators.ConclusionWe identified areas of insufficient knowledge that should be targeted in educational activities for GPs. It is recommended to further motivate GPs to use their clinical guidelines regularly.","PeriodicalId":50709,"journal":{"name":"Central European Journal of Medicine","volume":"9 1","pages":"687-693"},"PeriodicalIF":0.0,"publicationDate":"2014-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2478/s11536-013-0314-y","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68851523","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}
Pub Date : 2014-07-31DOI: 10.2478/s11536-013-0338-3
O. Zubkova, V. Semenova, I. Samosiuk, Walery Zukow, V. Vaslovich, N. Samosiuk
BackgroundMagnetic laser therapy is widely used in general medicine in a complex treatment of many diseases. This is due to its unique and versatile biological properties; it which activates intracellular metabolic processes and expedites the repair of damaged tissues. Magnetic laser therapy is an important area of modern theoretical and clinical physiotherapy; It is used in the treatment of dermatological, general surgical, endocrinological, and dental diseases; pain syndromes; and other conditions.ObjectivesOur objective is to assess the therapeutic efficacy of magnetic laser therapy in experimental mild traumatic brain injury in rabbits.Material and MethodsWe evaluated the therapeutic efficacy of magnetic laser therapy in experimental mild traumatic brain injury in 20 rabbits based on an analysis of ultrastructure of synaptic apparatus of neurons in the parietal and midbrain regions. Magnetic transcranial laser influence exercised by our developed method.ResultsThe course of magnetic laser therapy led to statistically significant changes in quantitative characteristics of the ultrastructural components in the synaptic apparatus of neurons that express the activation of compensatory processes and restoration of structural and functional integrity of the synaptic apparatus of neurons in experimental mild traumatic brain injury.
{"title":"Analysis of ultrastructural synaptic apparatus in parietal neurocortical and midbrain neurons in animals with experimental mild craniocerebral injury prior to and following magneto-laser therapy","authors":"O. Zubkova, V. Semenova, I. Samosiuk, Walery Zukow, V. Vaslovich, N. Samosiuk","doi":"10.2478/s11536-013-0338-3","DOIUrl":"https://doi.org/10.2478/s11536-013-0338-3","url":null,"abstract":"BackgroundMagnetic laser therapy is widely used in general medicine in a complex treatment of many diseases. This is due to its unique and versatile biological properties; it which activates intracellular metabolic processes and expedites the repair of damaged tissues. Magnetic laser therapy is an important area of modern theoretical and clinical physiotherapy; It is used in the treatment of dermatological, general surgical, endocrinological, and dental diseases; pain syndromes; and other conditions.ObjectivesOur objective is to assess the therapeutic efficacy of magnetic laser therapy in experimental mild traumatic brain injury in rabbits.Material and MethodsWe evaluated the therapeutic efficacy of magnetic laser therapy in experimental mild traumatic brain injury in 20 rabbits based on an analysis of ultrastructure of synaptic apparatus of neurons in the parietal and midbrain regions. Magnetic transcranial laser influence exercised by our developed method.ResultsThe course of magnetic laser therapy led to statistically significant changes in quantitative characteristics of the ultrastructural components in the synaptic apparatus of neurons that express the activation of compensatory processes and restoration of structural and functional integrity of the synaptic apparatus of neurons in experimental mild traumatic brain injury.","PeriodicalId":50709,"journal":{"name":"Central European Journal of Medicine","volume":"9 1","pages":"714-721"},"PeriodicalIF":0.0,"publicationDate":"2014-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2478/s11536-013-0338-3","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68852721","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}
Pub Date : 2014-07-31DOI: 10.2478/s11536-013-0350-7
I. Maniecka-Bryła, Aleksandra Maciak-Andrzejewska, M. Bryła
IntroductionThe aim of this study was to evaluate changes in the levels of certain lipids in a group of participants in the Prophylaxis and Early Detection of Cardiovascular Diseases Programme and also to determine factors contributing to positive changes in the variables.Materials and methodsThe study was conducted in Zgierz, a town in central Poland. 458 people, former participants of the Prophylaxis and Early Detection of Cardiovascular Diseases Programme, were included in the study. The study tool was a questionnaire. The authors made laboratory tests to determine the lipid profile and serum glucose. They also took arterial pressure twice and made anthropometric measurements. The authors used single-factor logistic regression to evaluate the obtained results. They adopted statistical significance level of p<0.05. The data were presented as odds ratios (OR) with 95% confidence intervals (CIs).ResultsA positive change in TC levels was observed in 64% of the respondents, LDL cholesterol level in 47.8% and HDL cholesterol level in 60.7%. In 46.5% of the respondents, a decrease in the level of triglycerides was observed.ConclusionsThere is a need to initiate prophylactic activities, especially among males, people who are less educated and also among older people.
{"title":"Determinants of changes in lipid levels in a prophylactic programme","authors":"I. Maniecka-Bryła, Aleksandra Maciak-Andrzejewska, M. Bryła","doi":"10.2478/s11536-013-0350-7","DOIUrl":"https://doi.org/10.2478/s11536-013-0350-7","url":null,"abstract":"IntroductionThe aim of this study was to evaluate changes in the levels of certain lipids in a group of participants in the Prophylaxis and Early Detection of Cardiovascular Diseases Programme and also to determine factors contributing to positive changes in the variables.Materials and methodsThe study was conducted in Zgierz, a town in central Poland. 458 people, former participants of the Prophylaxis and Early Detection of Cardiovascular Diseases Programme, were included in the study. The study tool was a questionnaire. The authors made laboratory tests to determine the lipid profile and serum glucose. They also took arterial pressure twice and made anthropometric measurements. The authors used single-factor logistic regression to evaluate the obtained results. They adopted statistical significance level of p<0.05. The data were presented as odds ratios (OR) with 95% confidence intervals (CIs).ResultsA positive change in TC levels was observed in 64% of the respondents, LDL cholesterol level in 47.8% and HDL cholesterol level in 60.7%. In 46.5% of the respondents, a decrease in the level of triglycerides was observed.ConclusionsThere is a need to initiate prophylactic activities, especially among males, people who are less educated and also among older people.","PeriodicalId":50709,"journal":{"name":"Central European Journal of Medicine","volume":"9 1","pages":"609-618"},"PeriodicalIF":0.0,"publicationDate":"2014-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2478/s11536-013-0350-7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68852881","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}
Pub Date : 2014-07-31DOI: 10.2478/s11536-013-0317-8
A. Pallisera, R. Jorba, L. O. Zárate, J. Catalá, I. Moysset, M. Jimeno
The diagnosis of inguinal hernia is usually clinical and it is performed with high sensitivity and specificity. Very occasionally, it may be confused with other diseases (lymphadenopathy, testicular pathology,etc). We report a rare case of a 80-year-old woman with a clinical diagnosis of hernia, which was underwent surgery and a tumor from the hernia orifice was found. After histological analysis we discovered that the misdiagnosed hernia was actually a tumor on a rudimentary testis. After radiological, gynecological and cytogenetic assessment we obtained an unexpected diagnosis: Male psheudohermaphroditism and Sertoli-Leydigtumor (SLCT) development on the testis. Diagnostic guidance for disorders of sexual development is based almost entirely on pediatric experience and very few guidelines are available for adults. Male pseudohermaphroditism is an intersex condition in which the carriers show a phenotype that includes external female genitalia, but a male genetic and gonadal sex. SLCT are sex-cord stromal tumors which develop in ovary and very rarely in the testis, representing 0.1–0.5% of ovarian tumors and less than 0.2% of testicular tumors. Thus far 24 case have been reported in the literature in which SLCT tumor has developed on testis.
{"title":"Sertoli-Leydig tumor and male pseudohermaphroditism discovered during inguinal hernia surgery","authors":"A. Pallisera, R. Jorba, L. O. Zárate, J. Catalá, I. Moysset, M. Jimeno","doi":"10.2478/s11536-013-0317-8","DOIUrl":"https://doi.org/10.2478/s11536-013-0317-8","url":null,"abstract":"The diagnosis of inguinal hernia is usually clinical and it is performed with high sensitivity and specificity. Very occasionally, it may be confused with other diseases (lymphadenopathy, testicular pathology,etc). We report a rare case of a 80-year-old woman with a clinical diagnosis of hernia, which was underwent surgery and a tumor from the hernia orifice was found. After histological analysis we discovered that the misdiagnosed hernia was actually a tumor on a rudimentary testis. After radiological, gynecological and cytogenetic assessment we obtained an unexpected diagnosis: Male psheudohermaphroditism and Sertoli-Leydigtumor (SLCT) development on the testis. Diagnostic guidance for disorders of sexual development is based almost entirely on pediatric experience and very few guidelines are available for adults. Male pseudohermaphroditism is an intersex condition in which the carriers show a phenotype that includes external female genitalia, but a male genetic and gonadal sex. SLCT are sex-cord stromal tumors which develop in ovary and very rarely in the testis, representing 0.1–0.5% of ovarian tumors and less than 0.2% of testicular tumors. Thus far 24 case have been reported in the literature in which SLCT tumor has developed on testis.","PeriodicalId":50709,"journal":{"name":"Central European Journal of Medicine","volume":"9 1","pages":"653-656"},"PeriodicalIF":0.0,"publicationDate":"2014-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2478/s11536-013-0317-8","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68851326","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}
Pub Date : 2014-07-31DOI: 10.2478/s11536-013-0328-5
G. Žekonis, Ingrida Barzdžiukaitė, J. Žekonis, R. Šadzevičienė, S. Simonyte, Juozas Žilinskas
ObjectiveThe aim of this study was to determine the effect of gingivitis and periodontitis on white blood cell (WBC) count and differential WBC count in gingival microvascular blood (GMB) and in venous blood (VB).Material and methods102 systemically healthy adult patients — 32 with gingivitis, 36 with periodontitis, and 34 controls — underwent evaluation of the total WBC count, and the count of different types of WBC in VB and GMB.ResultsInflammation of periodontal tissues was persistently associated with a systemic (in VB) elevation of the WBC count (p<0.05 in gingivitis and p<0.01 in periodontitis), compared to that in control group subjects, and with elevated systemic and local lymphocyte counts (p<0.05), compared to the analogous cell count in the control group. Patients with periodontitis were found to have reduced polymorphonuclear leucocyte (PMN) counts in GMB, compared to patients with gingivitis.ConclusionPersistent chronic bacterial infection affects the systemic elevation of WBC in subjects with gingivitis and periodontitis. A local decrease in PMN in periodontitis patients and a systemic increase in lymphocytes in gingivitis and periodontitis patients may indicate the inability of these patients’ organisms to defend against periodontopathic bacteria — and thus susceptibility to disease.
{"title":"Local and systemic immune responses in gingivitis and periodontitis","authors":"G. Žekonis, Ingrida Barzdžiukaitė, J. Žekonis, R. Šadzevičienė, S. Simonyte, Juozas Žilinskas","doi":"10.2478/s11536-013-0328-5","DOIUrl":"https://doi.org/10.2478/s11536-013-0328-5","url":null,"abstract":"ObjectiveThe aim of this study was to determine the effect of gingivitis and periodontitis on white blood cell (WBC) count and differential WBC count in gingival microvascular blood (GMB) and in venous blood (VB).Material and methods102 systemically healthy adult patients — 32 with gingivitis, 36 with periodontitis, and 34 controls — underwent evaluation of the total WBC count, and the count of different types of WBC in VB and GMB.ResultsInflammation of periodontal tissues was persistently associated with a systemic (in VB) elevation of the WBC count (p<0.05 in gingivitis and p<0.01 in periodontitis), compared to that in control group subjects, and with elevated systemic and local lymphocyte counts (p<0.05), compared to the analogous cell count in the control group. Patients with periodontitis were found to have reduced polymorphonuclear leucocyte (PMN) counts in GMB, compared to patients with gingivitis.ConclusionPersistent chronic bacterial infection affects the systemic elevation of WBC in subjects with gingivitis and periodontitis. A local decrease in PMN in periodontitis patients and a systemic increase in lymphocytes in gingivitis and periodontitis patients may indicate the inability of these patients’ organisms to defend against periodontopathic bacteria — and thus susceptibility to disease.","PeriodicalId":50709,"journal":{"name":"Central European Journal of Medicine","volume":"9 1","pages":"694-703"},"PeriodicalIF":0.0,"publicationDate":"2014-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2478/s11536-013-0328-5","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68851998","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}
Pub Date : 2014-07-31DOI: 10.2478/s11536-013-0308-9
R. Pogorzelski, S. Toutounchi, Patryk Fiszer, Ewa Krajewska, B. Gornicka, Ł. Zapała, M. Szostek, W. Jakuczun, R. Tworus, Tomasz Wołoszko, M. Skórski
IntroductionPheochromocytomas may cause life-threatening episodes of arterial hypertension and surgical treatment is obligatory following proper general medical preparation.Material and methodsThere were 63 patients in years 2006–2011 operated in the department due to pheochromocytoma. The group comprised 38 women and 25 men of the age range 16–80, mean 44,7. All the specimen were analyzed in pathological examination. The regressive changes that were found were subsequently compared with the clinical course of the pheochromocytoma both in the preoperative period and at the time of the surgery.ResultsThere were 44 laparoscopic adrenalectomies performed, out of which 5 resulted in conversions to open surgery, while 19 patients were operated primarily via open access. The indications for the open procedures: extraadrenal tumors, fibrotic-infiltrative lesions suggestive of malignancy, vast intratumoral extravasation, and respiratory failure. In all the postoperative specimens pheochromocytomas were found. In 29 cases intratumoral haemorrhages were observed, in 17 — tumoral necrosis at different stages, and in 3 cases posthaemorrhagic cystis. In 6 cases the lesions were accompanied by major fibrosis and hyalinization.ConclusionsThere is a statistically significant relationship between regressive changes observed within phaeochromocytomas and a reduction of paroxysmal hypertension at the time of adrenalectomy (p=0,012).
{"title":"Regressive changes in phaeochromocytomas and paroxysmal hypertension","authors":"R. Pogorzelski, S. Toutounchi, Patryk Fiszer, Ewa Krajewska, B. Gornicka, Ł. Zapała, M. Szostek, W. Jakuczun, R. Tworus, Tomasz Wołoszko, M. Skórski","doi":"10.2478/s11536-013-0308-9","DOIUrl":"https://doi.org/10.2478/s11536-013-0308-9","url":null,"abstract":"IntroductionPheochromocytomas may cause life-threatening episodes of arterial hypertension and surgical treatment is obligatory following proper general medical preparation.Material and methodsThere were 63 patients in years 2006–2011 operated in the department due to pheochromocytoma. The group comprised 38 women and 25 men of the age range 16–80, mean 44,7. All the specimen were analyzed in pathological examination. The regressive changes that were found were subsequently compared with the clinical course of the pheochromocytoma both in the preoperative period and at the time of the surgery.ResultsThere were 44 laparoscopic adrenalectomies performed, out of which 5 resulted in conversions to open surgery, while 19 patients were operated primarily via open access. The indications for the open procedures: extraadrenal tumors, fibrotic-infiltrative lesions suggestive of malignancy, vast intratumoral extravasation, and respiratory failure. In all the postoperative specimens pheochromocytomas were found. In 29 cases intratumoral haemorrhages were observed, in 17 — tumoral necrosis at different stages, and in 3 cases posthaemorrhagic cystis. In 6 cases the lesions were accompanied by major fibrosis and hyalinization.ConclusionsThere is a statistically significant relationship between regressive changes observed within phaeochromocytomas and a reduction of paroxysmal hypertension at the time of adrenalectomy (p=0,012).","PeriodicalId":50709,"journal":{"name":"Central European Journal of Medicine","volume":"9 1","pages":"663-666"},"PeriodicalIF":0.0,"publicationDate":"2014-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2478/s11536-013-0308-9","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68850996","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}
Pub Date : 2014-07-19DOI: 10.2478/s11536-013-0281-3
A. Serrablo, L. Tejedor, Jessica Martínez
Acute pancreatitis (AP) is a local inflammatory response with systemic effects and an adverse evolution in 20% of cases. Its mortality rate is 5–10% in sterile and 15–40% in infected pancreatic necrosis. Infection is widely accepted as the main reason of death in AP. The evidence to enable a recommendation about antibiotic prophylaxis against infection of pancreatic necrosis is conflicting and difficult to interpret. Up to date, there is no evidence that supports the routine use of antibiotic prophylaxis in patients with severe AP. Treatment on demand seems to be the better option, avoiding excessive treatment and selection of bacterial. In infected acute pancreatitis, antibiotics of choice are imipenem, meronem or tigecycline in patients allergic to beta-lactams. Also fluconazole must be given in determinate clinical situations.
{"title":"Antibiotics in severe acute pancreatitis","authors":"A. Serrablo, L. Tejedor, Jessica Martínez","doi":"10.2478/s11536-013-0281-3","DOIUrl":"https://doi.org/10.2478/s11536-013-0281-3","url":null,"abstract":"Acute pancreatitis (AP) is a local inflammatory response with systemic effects and an adverse evolution in 20% of cases. Its mortality rate is 5–10% in sterile and 15–40% in infected pancreatic necrosis. Infection is widely accepted as the main reason of death in AP. The evidence to enable a recommendation about antibiotic prophylaxis against infection of pancreatic necrosis is conflicting and difficult to interpret. Up to date, there is no evidence that supports the routine use of antibiotic prophylaxis in patients with severe AP. Treatment on demand seems to be the better option, avoiding excessive treatment and selection of bacterial. In infected acute pancreatitis, antibiotics of choice are imipenem, meronem or tigecycline in patients allergic to beta-lactams. Also fluconazole must be given in determinate clinical situations.","PeriodicalId":50709,"journal":{"name":"Central European Journal of Medicine","volume":"9 1","pages":"565-573"},"PeriodicalIF":0.0,"publicationDate":"2014-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2478/s11536-013-0281-3","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68850504","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}
Pub Date : 2014-07-19DOI: 10.2478/s11536-014-0500-6
Visitación Álvarez-de Frutos, S. Herranz-Antolín, M. García-Martínez
We perform an update about nutritional measures that have been adopted in patients with acute pancreatitis (AP). The nutritional support is an essential part of treatment in AP. When the AP is mild or moderate, there is no doubt that is not necessary to use an artificial nutritional support, and it is recommended that oral nutritional support should begin as soon as possible. If the AP is severe, the best way to provide nutritional support is through enteral nutritional (EN) because it reduces infection, length of hospitalization and mortality rate. Parenteral nutrition (PN) should be used only when EN is Impossible. However, there is no scientific evidence for recommending the most optimal route necessary to administer this type of nutritional support; we seek to uncover whether this is by gastric or jejunal route and the proper formula to use. There is an international agreement that the nutritional support should begin quickly, within the first 24 and 72 hours of hospitalization. As conclusion, more research needs to be done concerning nutritional support in AP, and many questions are not been answered yet.
{"title":"Nutrition in acute pancreatitis: a review","authors":"Visitación Álvarez-de Frutos, S. Herranz-Antolín, M. García-Martínez","doi":"10.2478/s11536-014-0500-6","DOIUrl":"https://doi.org/10.2478/s11536-014-0500-6","url":null,"abstract":"We perform an update about nutritional measures that have been adopted in patients with acute pancreatitis (AP). The nutritional support is an essential part of treatment in AP. When the AP is mild or moderate, there is no doubt that is not necessary to use an artificial nutritional support, and it is recommended that oral nutritional support should begin as soon as possible. If the AP is severe, the best way to provide nutritional support is through enteral nutritional (EN) because it reduces infection, length of hospitalization and mortality rate. Parenteral nutrition (PN) should be used only when EN is Impossible. However, there is no scientific evidence for recommending the most optimal route necessary to administer this type of nutritional support; we seek to uncover whether this is by gastric or jejunal route and the proper formula to use. There is an international agreement that the nutritional support should begin quickly, within the first 24 and 72 hours of hospitalization. As conclusion, more research needs to be done concerning nutritional support in AP, and many questions are not been answered yet.","PeriodicalId":50709,"journal":{"name":"Central European Journal of Medicine","volume":"9 1","pages":"574-579"},"PeriodicalIF":0.0,"publicationDate":"2014-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2478/s11536-014-0500-6","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68852952","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}
Pub Date : 2014-07-19DOI: 10.2478/s11536-013-0293-z
A. Pallisera, Farah Adel, J. Ramia
Until Atlanta Classification (AC) made in 1992, there was not any classification of acute pancreatitis (AP). Last twenty years AC let us compare results and papers. But the increasing understanding of the pathophysiology of AP, improvements in diagnostic methods and the development of minimally invasive tools for radiological, endoscopic and surgical management of local complications, several authors have called for the AC to be reviewed. Last months, two new classifications of AP have been published. We made a historical review of AC, the two new classifications and a comparison between them.
{"title":"Classifications of acute pancreatitis: to Atlanta and beyond","authors":"A. Pallisera, Farah Adel, J. Ramia","doi":"10.2478/s11536-013-0293-z","DOIUrl":"https://doi.org/10.2478/s11536-013-0293-z","url":null,"abstract":"Until Atlanta Classification (AC) made in 1992, there was not any classification of acute pancreatitis (AP). Last twenty years AC let us compare results and papers. But the increasing understanding of the pathophysiology of AP, improvements in diagnostic methods and the development of minimally invasive tools for radiological, endoscopic and surgical management of local complications, several authors have called for the AC to be reviewed. Last months, two new classifications of AP have been published. We made a historical review of AC, the two new classifications and a comparison between them.","PeriodicalId":50709,"journal":{"name":"Central European Journal of Medicine","volume":"9 1","pages":"543-549"},"PeriodicalIF":0.0,"publicationDate":"2014-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2478/s11536-013-0293-z","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68850349","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}
Pub Date : 2014-07-19DOI: 10.2478/s11536-014-0501-5
A. Kisaoglu, B. Aydinli, Gurkan Ozturk, S. Atamanalp, Bunyami Ozogul, M. Yıldırgan, K. Y. Polat
To evaluate the effectiveness of serum levels of resistin and CD14 expression in monocytes, and high-sensitivity C-reactive protein (hsCRP) in early stages of acute pancreatitis and correct prediction of the severity of acute pancreatitis (AP) using scoring systems. The study involved 10 (29.41%) male and 24 (70.59%) female patients (total n=34) followed for AP diagnosis at the Department of General Surgery, Ataturk University Medical School between July 2008 and September 2009. In all the patients, Ranson and APACHE II scores, serum resistin, hsCRP, and monocyte CD14 expression levels were determined. The patients were divided into two groups as mild and severe AP groups. A control group was formed and the intergroup comparisons were made. Values ≥ 3 based on the Ranson scoring scale and values ≥ 8 in APACHE II scoring scale were considered to indicate severe AP. Evaluations were based on the values obtained on the 1st and 7th days for serum resistin and hsCRP levels and monocyte CD 14 expression. In 17 (50%) patients, severe AP was determined. No statistically significant differences were found between the mean serum resistin levels of AP groups, while the difference for the same parameter between the mild and severe AP groups and the control group was statistically significant. In the severe AP group, the mean 1st day and 7th day serum hsCRP levels were statistically significantly higher. The CD14 expression in monocytes was similar in all the groups. Serum hsCRP concentrations and Ranson and APACHE II scores and serum resistin and hsCRP concentrations on the 1st day were positively correlated. Serum hsCRP measurement is effective in determining the severity of acute pancreatitis. Serum resistin measurement may be a useful early marker in determining the inflammatory response in AP. However, CD14 expression in monocytes was not found to be a useful marker in the diagnosis and prediction of the disease severity in AP patients.
{"title":"Severity markers in patients with acute pancreatitis","authors":"A. Kisaoglu, B. Aydinli, Gurkan Ozturk, S. Atamanalp, Bunyami Ozogul, M. Yıldırgan, K. Y. Polat","doi":"10.2478/s11536-014-0501-5","DOIUrl":"https://doi.org/10.2478/s11536-014-0501-5","url":null,"abstract":"To evaluate the effectiveness of serum levels of resistin and CD14 expression in monocytes, and high-sensitivity C-reactive protein (hsCRP) in early stages of acute pancreatitis and correct prediction of the severity of acute pancreatitis (AP) using scoring systems. The study involved 10 (29.41%) male and 24 (70.59%) female patients (total n=34) followed for AP diagnosis at the Department of General Surgery, Ataturk University Medical School between July 2008 and September 2009. In all the patients, Ranson and APACHE II scores, serum resistin, hsCRP, and monocyte CD14 expression levels were determined. The patients were divided into two groups as mild and severe AP groups. A control group was formed and the intergroup comparisons were made. Values ≥ 3 based on the Ranson scoring scale and values ≥ 8 in APACHE II scoring scale were considered to indicate severe AP. Evaluations were based on the values obtained on the 1st and 7th days for serum resistin and hsCRP levels and monocyte CD 14 expression. In 17 (50%) patients, severe AP was determined. No statistically significant differences were found between the mean serum resistin levels of AP groups, while the difference for the same parameter between the mild and severe AP groups and the control group was statistically significant. In the severe AP group, the mean 1st day and 7th day serum hsCRP levels were statistically significantly higher. The CD14 expression in monocytes was similar in all the groups. Serum hsCRP concentrations and Ranson and APACHE II scores and serum resistin and hsCRP concentrations on the 1st day were positively correlated. Serum hsCRP measurement is effective in determining the severity of acute pancreatitis. Serum resistin measurement may be a useful early marker in determining the inflammatory response in AP. However, CD14 expression in monocytes was not found to be a useful marker in the diagnosis and prediction of the disease severity in AP patients.","PeriodicalId":50709,"journal":{"name":"Central European Journal of Medicine","volume":"9 1","pages":"556-564"},"PeriodicalIF":0.0,"publicationDate":"2014-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2478/s11536-014-0501-5","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68853038","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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