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Number of results: 440
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Abstract

Alcohol is a recognized teratogen that affects various aspects of fetal development. Tissue that is particularly susceptible to its teratogenicity is neuronal tissue. The effect of prenatal alcohol exposure (PAE) on the central nervous system has been extensively studied, yet the knowledge on the influence of PAE on the autonomic nervous system is scarce. The purpose of this article is to review the current state of knowledge about the impact of PAE on the autonomic nervous system. Studies conducted on the PAE animal model have shown that prenatal alcohol exposure is associated with significant alterations in the autonomic nervous system, but the mechanisms and consequences are not yet clearly defined. It was established that PAE causes decreased heart rate variability (HRV) in fetal cardiotocography. Several studies have revealed that later, in infancy and childhood, reduced parasympathetic activity with or without compensating sympathetic activity is observed. This may result in behavioral and attention disorders, as well as an increased predisposition to sudden infant death syndrome. Both animal and human studies indicate that the relationship between PAE and autonomic dysfunction exists, however large, well-designed, prospective studies are needed to confirm the causal relationship and characterize the nature of the observed changes.

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Authors and Affiliations

Michał Jurczyk
Katarzyna Anna Dyląg
Kamil Skowron
Krzysztof Gil
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Abstract

The anatomy of the human temporal bone is complex and, therefore, poses unique challenges for students. Furthermore, temporal bones are frequently damaged from handling in educational settings due to their inherent fragility. This report details the production of a durable physical replica of the adult human temporal bone, manufactured using 3D printing technology. The physical replica was printed from a highly accurate virtual 3D model generated from CT scans of an isolated temporal bone. Both the virtual and physical 3D models accurately reproduced the surface anatomy of the temporal bone. Therefore, virtual and physical 3D models of the temporal bone can be used for educational purposes in order to supplant the use of damaged or otherwise fragile human temporal bones.

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Authors and Affiliations

Janusz Skrzat
Matthew J. Zdilla
Paweł Brzegowy
Mateusz Hołda
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Abstract

B a c k g r o u n d: Regulation of energy balance in patients with short bowel syndrome (SBS) is disturbed due to lack of significant part of the intestine. The goal of the research was to analyse the plasma concentrations of selected regulatory peptides — ghrelin, visfatin, and irisin — in children with SBS.

M e t h o d s: To achieve this aim we recruited study group consisted of 28 children with SBS fed parenterally for at least two weeks, mean age 14 ± 5 months and mean standardised body mass index (SDS-BMI) –1.26 ± 0.84. The control group was represented 25 healthy children of matching age and SDS-BMI. The plasma concentrations of peptides (ghrelin, visfatin, and irisin) were determined using immunoassays, and liver enzymes (AST, ALT, GGT) using an auto-analyser.

R e s u l t s: We observed lower visfatin and ghrelin levels in the study group as compared to controls (both P <0.0001). The lowest total ghrelin concentration was observed in SBS children after ileal resection (P = 0.0016). Irisin concentration did not differ between the groups. Most of the SBS children showed elevated liver enzymes activities at the first measurement and during one-year follow-up.

C o n c l u s i o n: Our findings showed that plasma ghrelin and visfatin themselves may play a role in the course of SBS, while a lack of disturbance in irisin might imply that it is neither playing any role nor it is affected by SBS itself.

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Authors and Affiliations

Julita Pabisek-Miernik
Barbara Kościelniak-Merak
Mikołaj Spodaryk
Przemysław J. Tomasik
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Abstract

I n t r o d u c t i o n: Fecal calprotectin (FC) rises significantly in intestinal inflammation accompanied by neutrophil activation — such as Clostridium diffi cile infection (CDI). The aim of the study was to evaluate the benefi t of FC testing in assessing the severity of CDI.

Ma t e r i a l s a n d M e t h o d s: The study group included 76 patients with CDI hospitalized in the Jagiellonian University Hospital in Krakow from July 2017 till January 2018. FC levels were measured using an EIA (Enzyme Immunoassay). Demographic, clinical information and blood tests were recorded using standardized data collection forms. The selection of patients into non-severe and severe groups was carried out in accordance with the ESCMID criteria (European Society of Clinical Microbiology and Infectious Diseases) and some modifications to those criteria were proposed.

R e s u l t s: The studied population included 76 patients (39 men and 37 women) with CDI aged from 24 to 98 years (mean: 72). Median calprotectin level was 739 (Q25–Q75: 612–799 μg/g), characteristic of patients with colitis. A statistically signifi cant diff erence in FC concentration in patients with severe vs non-severe CDI was observed (severe — 770 vs non-severe — 659 μg/g, p = 0.009). FC directly correlated with platelets level; however, no correlation between FC level and the blood parameters prognostic for CDI (leukocyte, neutrophil count, albumin, creatinine levels) was found.

C o n c l u s i o n: FC level is an indication of ongoing intestinal inflammation in CDI patients. FC level significantly correlated with CDI severity, which demonstrates that FC could serve as a predictive marker for assessing CDI severity.

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Authors and Affiliations

Mirosław Dróżdż
Grażyna Biesiada
Hanna Pituch
Dorota Wultańska
Piotr Obuch-Woszczatyński
Michał Piotrowski
Jolanta Kędzierska
Mateusz Michalak
Aleksander Garlicki
Jacek Czepiel
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Abstract

Outbreaks of typhoid fever for centuries decimated armies, cities and large hosts of people. Discovery of an agent causing such a grave disease became one of the most important achievements of bacteriology — science, which had experienced rapid development in the last quarter of the 19th century and changed the course of our civilization.

The article deals with the discovery of Tadeusz Browicz, Polish anatomopathologist, who in 1874 reported about rod-shaped “parasites” in viscera of typhoid fever victim. His achievement became shaded by the later discoveries of Eberth, Klebs and Gaffky, but as authors stated below, Browicz should be recognized with mentioned scientists as a co-discoverer of the typhoid fever bacillus.

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Authors and Affiliations

Ryszard W. Gryglewski
Michał Chlipała
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Abstract

The aim of the study was to assess the course of posterior interosseous nerve in the wrist capsule in the transparent method of nerve staining.

M a t e r i a l a n d M e t h o d s: Thirty dorsal wrist capsules were collected bilaterally from 15 donors (thirty capsules) within 12 hours of death. By the dorsal incision the capsules were collected in the same manner. The specimens were stained according to the protocol of modified Sihler’s staining technique. The preserved capsules were analysed under 8–16× magnification of optical microscope for the presence of major posterior interosseous nerve trunks, their major and minor branches, and nerve connections.

R e s u l t s: Three main types of nerve course were identified within the joint capsule. Type I — the most common, with the presence of a single trunk with the excursion of the first main branch on the radial side, two main branches on the ulnar side, the presence of the prevailing number of small branches on the radial side and the presence of 3–4 branches extending beyond the level of the carpo-metacarpal joints. Type II with the presence of two main nerve trunks, running almost in parallel with the first main branch on the radial side, two main branches on the ulnar side with presence of a predominant number of small branches on the radial side and the presence of 3–4 branches running beyond the level of carpo-metacarpal joints. Type III (least often) with the presence of crossed main nerve trunks.

C o n c l u s i o n: The modified Sihler’s staining technique allows for transparent visibility of the nerves innervation the dorsal wrist capsule. However does not allow accurate assessment as histological examination, especially in evaluation of nerve endings, but it gives a significantly larger area of nerve observation.

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Authors and Affiliations

Tomasz Bonczar
Jerzy A. Walocha
Mariusz Bonczar
Ewa Mizia
Joanna Filipowska
Krzysztof Tomaszewski
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Abstract

Common variable immunodeficiency (CVID) is a primary immunodeficiency disorder related to recurrent infections, as well as a range of non-infectious manifestations including autoimmune and inflammatory disorders. We hypothesized that patients with CVID and different clinical phenotypes would demonstrate alterations in lymphocyte T subsets, including T lymphocytes expressing programmed cell death protein 1 (PD-1), and regulatory T lymphocytes. We performed flow cytometry in two CVID groups: group 1 with infections only, and group 2 with infections and concomitant noninfectious manifestations. Patients were 18–59 years old (mean 35.8 years of age). Increased proportions of CD8+PD-1+ T cells and reduced regulatory T cells were associated with lymphadenopathy. Amount of regulatory T cells correlated with CD8+PD-1+ T lymphocytes (r = 0.54; p = 0.013), and with CRP (r = –0.64; p = 0.004). Forty percent of patients expressed manifestations in addition to infections (group 2), and they had reduction in number of regulatory T cells [8 (3–12) vs. 24 (11–26)/μl; p = 0.034), naive CD4+ T lymphocytes [36 (27–106) vs. 149 (81–283)/μl; p = 0.034], and elevated C-reactive protein (CRP) [5.33 (3.15–8.82) vs. 1 (1–2.16) mg/l; p = 0.003] in comparison to group 1. In conclusion, the amount of CD8+ T cells expressing PD-1 is associated with lymphadenopathy and number of regulatory T cells in patients with CVID. Patients with CVID and non-infectious complications have increased level of inflammation and alterations in regulatory T cells.
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Authors and Affiliations

Ewelina Nowak
1
Joanna Sulicka-Grodzicka
2
Magdalena Strach
1
Karolina Bukowska-Strakova
3
Maciej Siedlar
3
Mariusz Korkosz
2
ORCID: ORCID
Tomasz Grodzicki
1

  1. Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, Kraków, Poland
  2. Department of Rheumatology, Jagiellonian University Medical College, Kraków, Poland
  3. Department of Clinical Immunology, Institute of Pediatrics, Jagiellonian University Medical College, Kraków, Poland
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Abstract

B a c k g r o u n d: During COVID-19 pandemic, it is necessary to collect and analyze data concerning management of hospitals and wards to work out solutions for potential future crisis. The objective of the study was to investigate how surgical wards in Poland are managing during rapid development of the COVID-19 pandemic.
M e t h o d s: An anonymous, online survey was designed and distributed to surgeons and surgery residents working in surgical departments during pandemic. Responders were divided into two groups: Group 1 (responders working in a “COVID-19-dedicated” hospital) and Group 2 (responders working in other hospitals).
R e s u l t s: Overall, 323 responders were included in the study group, 30.03% of which were female. Medical staff deficits were reported by 21.15% responders from Group 1 and 29.52% responders from Group 2 (p = 0.003). The mean number of elective surgeries performed weekly prior to the pandemic in Group 1 was 40.37 ± 46.31 and during the pandemic was 13.98 ± 37.49 (p <0.001). In Group 2, the mean number of elective surgeries performed weekly before the start of the pandemic was 26.85 ± 23.52 and after the start of the pandemic, it was 7.65 ± 13.49 (p <0.001). There were significantly higher reported levels of preparedness in Group 1 in terms of: theoretical training of the staff, equipping the staff and adapting the operating theater to safely perform procedures on patients with COVID-19. Overall, 62.23% of responders presume being infected with SARS-CoV-2.
C o n c l u s i o n s: SARS-CoV-2 pandemic had a significantly negative impact on surgical wards. Despite the preparations, the number of responders who presume being infected with SARS-CoV-2 during present crisis is high.


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Authors and Affiliations

Tomasz Stefura
1
Justyna Rymarowicz
1
Michał Wysocki
1
Jacek Szeliga
2
Grzegorz Wallner
3
Michał Pędziwiatr
1
Michał Nowakowski
1
Piotr Major
1

  1. 2nd Department of General Surgery, Jagiellonian University Medical College, Kraków, Poland
  2. Department of General, Gastroenterological, and Oncological Surgery, Collegium Medicum Nicolaus Copernicus University, Toruń, Poland
  3. 2nd Department of General, Gastrointestinal and Oncological Surgery of the Alimentary Tract, Medical University of Lublin, Lublin, Poland
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Abstract

The aim of the study was to determine the influence of posttraumatic enophthalmos in orbital blow-out fracture on the treatment results. The relationship between time from injury to treatment, type of surgical reconstruction, bone graft site, type of diplopia and treatment results were evaluated. The relationship between the location of the fracture and the degree of enophthalmos was also analyzed. The study included 730 patients, 128 women and 602 men, aged 4 to 77 years, average 28 years, treated because of orbital blow-out fracture in our Department between 1975 and 2015. The study included only patients with an isolated orbital floor or medial wall fracture, so-called „pure blow-out” or „internal blowout”. Fractures of the lower rim, roof or lateral wall of the orbit, as well as the coexistence of other fractures of the facial part of the skull, were excluding citeria from the study. Complete recovery in surgically treated patients was achieved in 405 (58.8%) patients, improvement in 179 (26%) and no improvement in 105 (15.2%) patients. The degree of post-traumatic enophthalmos affects the result of the treatment. The location of the orbital fracture affects the enophthalmos, in our group of patients the largest incidence occurred in the fracture located in the orbital floor combined with medial wall. Patients who underwent surgical treatment up to 14 days after the injury achieved better results than those postponed.
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Authors and Affiliations

Piotr Koryczan
1
Jan Zapała
1
Michał Gontarz
1
Grażyna Wyszyńska-Pawelec
1

  1. Department of Cranio-Maxillofacial, Oncological and Reconstructive Surgery, Jagiellonian University Medical College. University Hospital in Kraków, Poland
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Abstract

Early fetal cardiac scan (EFCS) is becoming an increasingly common element of the first trimester ultrasound screening carried out at 11–14 gestational weeks. It offers the first possibility to detect congenital heart defects (CHD) or, in ambiguous cases, to identify those pregnancies where a more detailed cardiac scan would be required later in pregnancy. The size of the fetal heart at the end of the first trimester and the associated relatively low image resolution make it impossible to capture all cardiac data to inform the ultimate picture. However, even at this stage, cues of anatomical and functional abnormalities can be picked up, which suggest not only a CHD, but also a likelihood of cardiovascular symptoms typical of genetic disorders. EFCS should focus on cardiac position, atrioventricular (AV) connections, AV valve function, initial assessment of ventriculo-arterial (VA) connections and the presence of red flag signs in the three vessel and trachea view (3VTV). Proper use of color Doppler mapping makes it possible to overcome the low resolution of B-mode to a certain extent. Here we present our long-term experience in EFCS.
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Authors and Affiliations

Michał Kołodziejski
1
Marcin Wiecheć
1
Agnieszka Nocuń
2
Anna Matyszkiewicz
1
Bartosz Rajs
1
Wojciech Sojka
3
Kazimierz Pityński
1

  1. Chair of Gynecology and Obstetrics, Jagiellonian University Medical College, Kraków, Poland
  2. Department of Rheumatology, Jagiellonian University Medical College, Kraków, Poland
  3. Department of Neonatology, Jagiellonian University Medical College, Kraków, Poland

Authors and Affiliations

Tomasz Bereza
Izabela Mróz
Ewa Mizia
Wojciech Kurzydło
Piotr Bachul
Joanna Jaworek
Monika Konarska
Klaudia Walocha
Małgorzata Mazur
Marcin Kuniewicz
Paweł Depukat
Przemysław Chmielewski
Łukasz Warchoł

Authors and Affiliations

Bernard Solewski
Tomasz Bereza
Veronika Aleksandrovych
Marek Sajewicz
Monika Konarska
Anna Natalia Wrona
Kinga Komnata
Aleksandra Maleszka
Paweł Depukat
Łukasz Warchoł

Authors and Affiliations

Tomasz Bereza
Janusz Skrzat
Izabela Mróz
Artur Pasternak
Krzysztof Tomaszewski
Ewa Mizia
Stanislas Kielczewski
Dominik Pawlicki
Wojciech Kurzydło
Piotr Bachul
Monika Konarska
Klaudia Walocha
Lourdes Niroja Kaythampillai
Paweł Depukat
Tomasz Bonczar
Przemysław Chmielewski
Małgorzata Mazur
Łukasz Warchoł

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