Annales Academiae Medicae Stetinensis最新文献

Acute limb ischaemia is relatively frequent in the population (800:1 million, with about 1000 cases per year in Zachodniopomorskie province) and is a life-threatening condition due to significant mortality (about 15%) and a high percentage of amputation (up to 25%). Early death is mainly caused by metabolic disorders associated with reperfusion syndrome following surgical revascularisation. Muscle injury caused by rhabdomyolysis leads to acute renal failure, cardiopulmonary insufficiency and generalised inflammatory reaction. Prompt treatment according to the current recommendations, including extensive fasciotomy and intensive and early nephroprotective and renal replacement therapy, offers the only chance to reduce early mortality in patients suffering from this disease. Differences in approach to the problem of renal replacement therapy presented by nephrologists/internists and surgeons are frequent and do not improve treatment outcome. The aim of this paper is to establish a standard consensus between the approach of the vascular surgeon, nephrologist and internist to achieve the best possible treatment outcomes in patients with acute limb ischaemia.

Introduction: The aim of the study was to evaluate the cleanliness of the walls of root canals with incomplete development of root, whose lumen was rinsed with 2% chlorhexidine solution during mechanical preparation.

Material and methods: Use was made of 8 maxillary premolar teeth with a single root canal and with incomplete development of the root apex (the teeth were removed during the growing stage for orthodontic reasons). The coronal and middle parts of the canals were instrumented using Gates-Glidden no. 3 and 4 drills, and the apical section with the help of Hedstroem size 50-80 files. During instrumentation of the canals irrigation was carried out using 2% chlorhexidine solution. Irrigating solution, volume 2 mL, was introduced into the canal with the use of a syringe and an endodontic needle after using each instrument, and 5 mL volume after complete instrumentation of the canal.

Results: Observations using a scanning electron microscope with x200 and x1000 magnification showed relatively effective removal of pulp remains and dentine chips, and the presence of a thick smear layer covering the canal walls throughout their length. Statistical analysis did not show significant differences in the degree of cleaning of particular sections of the canals.

Conclusion: The presence of the smear layer in canals irrigated with chlorhexidine is evidence that it does not have properties for it to be dissolved, and this dictates the necessity of using chelating agents.

Introduction: For last several years popularity of substances which improve concentration or/and cause hallucinations has considerably increased. There is a conviction that most frequent addictions among teenagers are cigarettes, alcohol or drugs of abuse. A very dangerous phenomenon has been ignored, becoming more common among scholars and students - usage of medicines available without doctor's prescription (over the counter drugs - OTC). Popularity and fame of these specifics comes from side effects observed especially when overdosed.

Material and methods: In years 2007-2012 in Clinical Toxicology Laboratory of Medical Pomeranian University 4304 toxicological analyses was conducted with specified direction on drugs analysis (39% of all analyses made in that period). In some cases, especially of young people, a doctor ordering the analysis pointed as possible cause of intoxication "recreational usage" of OTC drugs. Those suspicions were confirmed by toxicological examinations.

Conclusions: It seems that dominating character feature of people who abuse psychoactive substances is emotional immaturity. Maturation process can be impaired or completely inhibited by abusing psychoactive substances. This is processes are considered which enhance immaturity of person's personality - so called defense mechanisms.

Introduction: Although the Na+/H+ exchanger (NHE) has been extensively investigated, studies on the effect of fluoride ions on the function of this protein are relatively few and controversial. The aim of this study was to analyze the effect of fluoride on the activity of the transmembrane NHE in human platelets.

Material: The study material consisted of platelets in the form of platelet-rich plasma.

Conclusions: Based on the obtained results, the following conclusions were formulated: fluoride may affect NHE activity in non-stimulated human platelets; changes in NHE activity depend on fluoride dose and exposure time; as fluoride concentration and/or exposure time is increased, NHE activity is inhibited; inhibition of NHE activity results in the accumulation of protons inside the platelets and a reduction in intracellular pH (intracellular acidification); the accumulation of protons inside the platelets is accompanied by an increase in intracellular calcium concentration.

Background: The aim of the study was to evaluate the adaptation of sealer to the dentine and to the components of the post, i.e. the part made of composite reinforced with glass fibre and the part made of resilon.

Materials and methods: The study was carried out on 7 extracted one-canal human teeth that were treated using Mtwo nickel-titanium instruments and an Endo IT Professional endodontic micromotor. The canals were rinsed with NaOCl, EDTA and chlorhexidine, and then filled with the Epiphany sealer and FibreFill posts. Next, tooth roots were cut along the frontal plane, to expose the entire lumen length of the filled canal, and inspected under the scanning electron microscope.

Results: SEM study demonstrated good adaptation of sealers to the walls of the root canals on their entire length, despite occasional gaps between the sealer and dentine.

Conclusions: The results of preliminary studies suggest that FibreFill posts and Epiphany sealer are useful for canal filling. However, several-years' clinical follow-up is necessary for the complete evaluation of the system.

Introduction: Psoriasis is a chronic inflammatory dermatosis leading to the development of systemic inflammatory reaction. Previous data indicated the coexistence of psoriasis and the occurrence of metabolic disorders, with the common background of both processes determined by a chronic inflammation. The coexisting disorders, including type 2 diabetes, hypertension, heart ischemic disease, dislipidemia and obesity may have an important impact on intensity of psoriasis activity.

Material and methods: The analysis comprised of 82 randomly matched patients with various clinical forms of psoriasis, aged 17 to 81 years. In patients PASI and BSA indexes, BMI value and laboratory parameters of metabolic status (glucose and ureic acid levels, lipid fractions and CRP level in the serum) were evaluated.

Results: An average age in examined group was 54,3 years, an average time of presence of psoriasis symptoms was approximately 20 years. An average PASI value was 21,4; an average BSA value was 39.7%. The coexistence of type 2 diabetes was found in 14.6% of patients, hypertension in 42.7% and heart ischemic disease in 17%. Particularly large group of examined patients comprised persons with overweight (34.1%) and obesity (30.5%). Positive correlation between BSA and body weight, BSA and BMI value, BSA and abdominal circumference as well as positive correlation between PASI and body weight, PASI and BMI value, PASI and abdominal circumference were observed. Abnormal serum glucose levels were observed in 19.5% persons, ureic acid level in 2.9%, total cholesterol in 37.8% LDL cholesterol in 48.8%, and HDL cholesterol in 46.3%. CRP level was elevated in 43.9% patients. Positive correlation between BSA and ureic acid level, as well as PASI and ureic acid level was estimated. No correlation between PASI and the other laboratory parameters was found.

Conclusions: The occurrence of metabolic syndrome is more common in patients with psoriasis in comparison to the general population. The extent and severity of psoriatic lesions correlate with high body weight, BMI and the level of ureic acid.

Orthodontic microscrews are temporary implants providing skeletal anchorage, which may be used for en-masse incisor retraction, as well as for the protraction of posterior segments in order to close spaces without retracting anterior teeth. A patient, aged 16 was reported in whom a miniscrew of 9.5 mm length and 2 mm dimension was inserted distal to the lower left second premolar 2 months after extracting the first molar with periapical bone lesion after failed endodontic treatment. The lower third molar was mesialised using direct anchorage and a power arm to minimize mesial tipping. The space closed within 20 months, followed by a spontaneous eruption of the adjacent third molar. This treatment method constitutes a good alternative to third molar autotransplantation, allowing the avoidance of the risk of surgical procedure.

Background: According to the verdict of the Supreme Court in 2005, an employer may dismiss an employee if their conduct (including dress) exposes the employer to losses or threatens his interests. The aim of the study was a holistic assessment of the pleiotropic effects of high-heeled pointed shoes on the health condition of women's feet, wearing them at work, in accordance with the existing rules of the "business dress code".

Materials and methods: A holistic multidisciplinary analysis was performed. It takes into account: 1) women employees of banks and other large corporations (82 persons); 2) 2D FEM computer model developed by the authors of foot deformed by pointed high-heeled shoes; 3) web site found after entering the code "business dress code".

Results: Over 60% of women in the office wore high-heeled shoes. The following has been found among people walking to work in high heels: 1) reduction in the quality of life in about 70% of cases, through periodic occurrence of pain and reduction of functional capacity of the feet; 2) increase in the pressure on the plantar side of the forefoot at least twice; 3) the continued effects the forces deforming the forefoot.

Conclusions: 1. An evolutionary change of "dress code" shoes is necessary in order to lead to a reduction in non-physiological overload of feet and the consequence of their disability. 2. These changes are particularly urgent in patients with so-called "sensitive foot".