Medical sciences

Folia Medica Cracoviensia

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Folia Medica Cracoviensia | 2021 | vol. 61 | No 2

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Abstract

The term peritonitis is relatively new in medical language, however some of its symptoms were observed and noted even in antiquity. The proper recognition of peritonitis as a distinct pathological entity was made possible when progress in the clinical and experimental sciences give birth to the methodology needed for the investigation of the etiology and mechanism of peritoneal inflammation. Research con-cerning this clinical topic began to yield significant results in the second half of 19th century. This paper aims to give some insight into this pioneering period of scientific investigation focused on the etiology and pathology of peritonitis. From the work of von Recklinghausen in the 1860s, through the later research of Wegner and Gravitz, the next major step in this field was made by the Polish experimental pathologist and pathophysiologist Karol Klecki.
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Authors and Affiliations

Ryszard W. Gryglewski
1

  1. Department of the History of Medicine, Jagiellonian University Medical College
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Abstract

Background: Problem-based learning is a method of acquiring knowledge and competences on the basis of work on the problem. Medical universities use the PBL method more widely in the course of teaching future physicians, in the CMUJ classes using the PBL method were introduced in the third year of studies, as a part of the Introduction to Clinical Sciences.

Methods: At the end of course, the students voluntarily filled in a questionnaire (17 questions con-cerning various aspects of the course). A total of 105 questionnaires were analyzed. Statistica 12.0 program was used for this analysis.

Results: 95.5% of respondents positively perceived the way of conducting classes in the form of PBL and considered them to be in line with their expectations (81%). 80% of respondents confirmed the usefulness of classes in acquiring knowledge and integrity with pre-clinical subjects. Divided opinions were expressed by the respondents as to the benefits and satisfaction from independent presentation and teaching of other students, 34.3% rather emphasized the benefits, while 28.6% expressed a negative opinion.

Conclusions: The study confirmed usefulness of classes conducted using the PBL method, both in terms of deepening the knowledge and repetition of already gained knowledge, as well as beneficial reception of classes by students. The course may be modified in the future by increasing the number of cases.
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Authors and Affiliations

Dorota Dębicka-Dąbrowska
1
Agnieszka Skrzypek
1
Marta Szeliga
1
Grzegorz Cebula
1

  1. Department of Medical Education, Faculty of Medicine, Jagiellonian University Medical College Kraków, Poland
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Abstract

Temporomandibular disorders includes abnormalities of the masticatory muscles, temporo-mandibular joints and the surrounding structures. The aim of the study was to carry out a retrospective assessment of the frequency of the pain form of TMD based on the analysis of medical records of patients treated at the Prosthodontics Department at Jagiellonian University in Kraków.
Material and Methods: The study included the results of a medical history and a clinical examina-tion of patients, who came for consultation at the Prosthodontics Department at Jagiellonian University in Kraków, due to pain of the masticatory muscles or/and TMJ and painless symptom of TMD like limitation of the jaw movements and joints’ sounds. Out of all the analyzed results of the examination of treated patients, a group of patients with a painless and painful TMD was selected.
Results: The study involved the results of a detailed specialized functional examination of 334 patients (210 women and 124 men), ranging from 41 to 68 years. Analysis of the results of clinical examinations conducted in all patients revealed that 161 had the painless form — SG (99 women and 62 men) and 173 patients had the pain form of the TMD — CG (111 women and 62 men). In the CG 104 patients reported mostly pain in the masticatory muscles, while the remaining (69 patients) had a history of pain in one or simultaneously two TMJs.
Conclusion: The analysis of the patients forms allows to conclude that more than half of patients seeking help are patients with the painful form of the TMD and these abnormalities occur more frequently in women than in men.
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Authors and Affiliations

Małgorzata Pihut
1
Agnieszka Pac
2
Andrzej Gala
1

  1. Department of Prosthodontics, Jagiellonian University Medical College, Kraków, Poland
  2. Department of Epidemiology, Jagiellonian University Medical College, Kraków Poland
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Abstract

Background: The histology of the lung includes a variety of cell types. Fibrosis is a universal process, occurring in the skin, intestine, heart, muscles, kidney, blood vessels, liver, and also the lungs. Telocytes are a type of cells with a wide range of properties, which were previously described in healthy and disease-affected organs of human and animal organisms.

Aim: This study aimed to identify telocytes in the lungs of rats and discuss their possible role in the development of pulmonary fibrosis.

Methods: Tissue samples were taken from a group of ten male Wistar rats. Further histological and immunohistochemical analysis was performed. Double immunolabeling for c-kit, vimentin, CD34, and PDGFRα has revealed telocytes in the lungs.

Results: In all tissue samples, telocytes have been identified (in the area of interalveolar septa, close to blood vessels, and between the airway epithelium).

Conclusion: Telocytes might be directly and indirectly (through contact with stem cells, secretomes, and reduction in number) involved in the development of pulmonary fibrosis. The heterogeneity of the telocyte population in different pathologies and their subtypes, as well as their tendency to be common stress their important role in pathological physiology.
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Authors and Affiliations

Anna Gil
1
Veronika Aleksandrovych
1

  1. Department of Pathophysiology, Jagiellonian University Medical College, Kraków, Poland
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Abstract

The purpose of this study was to determine the course of the main septum (MS) in the sphenoid sinuses in the adult population.

Materials and Methods: 296 patients (147 females, 149 males), who did not present any pathology in the paranasal sinuses, were included in this retrospective analysis of the computed tomography (CT) scans. Spiral CT scanner (Siemens Somatom Sensation 16) was used in order to glean the images of the paranasal sinuses, using standard procedure, in the option Siemens CARE Dose 4D, without using any contrast medium. Secondary reconstructions of the sagittal and frontal planes were obtained using multi-plans reconstruction (MPR) tool after obtaining transverse planes in the first instance.

Results: The course of the MS changed the most often from the anterior to the posterior part of the sphenoid sinuses. Such situation took place in 83.78% of the patients, in 32.43% of whom a clear shift to the lateral side was noticed only in the posterior part of the MS: in 18.24% of the patients to the right side, and in 14.19% of the patients to the left side. In 17.57% of the patients the lateral shift was visible in both anterior and posterior parts of the septum, where in 9.46% of the patients it was from the left side to the right, whereas in 8.11% of the patients the shift took place from the right side to the left. The MS had the shape of the letter ‘C’ in 22.29% of the cases, and 11.82% had the typical shape of the letter ‘C,’ and in 10.47% of the patients it paralleled the inverted letter ‘C’ (upside down). Amongst the types of the MS shifting directions the rarest was the MS that resembled the letter ‘S’ — 11.48% of the patients. In 5.74% of the cases it looked like the typical letter ‘S,’ and in 5.74% of the cases it was similar to the inverted letter ‘S.’ Only 16.22% of the cases had the MS that did not change its course nor its shape and ran medially in the sagittal plane from the anterior to the posterior part of the sinuses.

Conclusions: In furtherance of reducing the risk of problems occurring during a surgery in the paranasal sinuses, it is prudent to have a CT scan done in all the patients beforehand, due to the high prevalence of the anatomical variations in the sinuses.

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Authors and Affiliations

Joanna Jaworek-Troć
1 2
Michał Zarzecki
1
Wojciech Przybycień
1
Marcin Lipski
1
Anna Curlej-Wądrzy
3
Joe Iwanaga
4
Jerzy Walocha
1
Agata Mazurek
1
Robert Chrzan
2
Andrzej Urbanik
2

  1. Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
  2. Department of Radiology, Jagiellonian University Medical College, Kraków, Poland
  3. Department of Integrated Dentistry, Institute of Dentistry, Jagiellonian University Medical College, Kraków, Poland
  4. Department of Neurosurgery, Tulane University, New Orleans, USA
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Abstract

Introduction: There is increasing evidence that several autoimmune diseases, as well as their activity, are associated with vitamin D (VD) deficiency. Our study aimed to evaluate the prevalence of VD insufficiency in patients with Addison’s disease (AD), as well as to evaluate associations between VD concentrations and various clinical and laboratory parameters of the disease.
Materials and Methods: We retrospectively analyzed medical records of 31 adult patients diag-nosed with autoimmune Addison’s disease, in whom serum VD was measured. We assessed correlations between serum VD and various clinical and laboratory parameters.
Results: 90.3% of AD patients had inadequate VD concentrations (<30 ng/mL), and 19.3% of them were found to be severely VD deficient (<10 ng/mL). Among assessed laboratory variables, only serum calcium concentrations significantly correlated with VD status (r = 0.53, p = 0.006). The mean serum VD con-centration was significantly lower in patients with severe fatigue (15.17 ± 8.41 vs 26.83 ± 12.29 ng/mL, p = 0.011) and limited exercise capacity (12.38 ± 6.9 vs 21.63 ± 10.87 ng/mL, p = 0.016).
Conclusions: This study demonstrates a high prevalence of VD deficiency in AD patients, as well as the association between low VD concentrations with symptoms such as severe fatigue or limited exercise capacity. Further studies are needed to clarify if impaired VD status is a risk factor in the pathogenesis of AD and to assess if VD supplementation improves the quality of life of AD patients.
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Authors and Affiliations

Karolina Zawadzka
1
Katarzyna Matwiej
1
Grzegorz Sokołowski
2
Małgorzata Trofimiuk-Müldner
2
Anna Skalniak
2
Alicja Hubalewska-Dydejczyk
2

  1. Students’ Scientific Group of Endocrinology at the Department of Endocrinology, Jagiellonian University Medical College, Kraków, Poland
  2. Chair and Department of Endocrinology, Jagiellonian University Medical College, Kraków, Poland
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Abstract

The combination of the functional disorders of urination and defecation constitutes the Dys-functional Elimination Syndrome (DES). DES refers to an abnormal pattern of elimination of unknown etiology characterized by bowel and bladder incontinence and withholding, with no underlying anatomic or neurologic abnormalities. Essential precondition for a child to be subsumed under this entity is the exclusion of either anatomical or neurological causative factors. In the present review study the individual entities of dysfunctional filling, such as the unstable or lazy bladder, or dysfunctional urination, such as the detrusor sphincter dyssynergia and the functional constipation are being described comprehensively. Subsequently, the analysis of the pathophysiological effects of the dysfunctional elimination syndrome such as incontinence, urinary tract infections and the conservation or the deterioration of vesicoureteric reflux, is being accentuated. With the documentation of DES, the therapeutic strategy should aim at treating both the functional disorder of the vesicourethral unit and the functional constipation. The first part does not specify depending on the type of this disorder. Rarely, surgical treatment of functional urinary disorders may be required.
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Authors and Affiliations

Ioanna Gkalonaki
1
ORCID: ORCID
Ioannis Patoulias
1

  1. First Department of Pediatric Surgery, Aristotle University of Thessaloniki Greece, General Hospital “G.Gennimatas”, Thessaloniki, Greece
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Abstract

The article, based on the reports of the Ministry of Health of Ukraine, presents the materials of the epidemiological surveillance of salmonellosis in 2011–2018. To assess the influence of factors on the epidemic process of salmonellosis, the demographic situation, income and living conditions of the popu-lation were studied; average monthly air temperature, relative humidity, precipitation; the quantitative and qualitative composition of the microbiocenosis of patients with signs of acute intestinal infection. It was found that in Ukraine the incidence of salmonellosis is high. Outbreaks of salmonellosis are recorded. S. enteritidis is most often isolated from the clinical material of patients, carriers and human objects (p <0.05). The risk groups for salmonellosis are children (p <0.05), as well as the rural population (p <0.05). The low level of sanitary and epidemiological control at the stages of production, transportation and sale of food products, water supply contributes to the spread of salmonellosis. Natural factors have a regulating effect on the intensity of the epidemic salmonella process: a strong direct relationship is established between the incidence and air temperature and precipitation (p <0.05). Salmonella enters into a competitive or synergistic relationship with other microorganisms in the intestinal biotope. Thus, the intensity of the epidemic process of salmonellosis can be influenced not only by external (natural and social), but also by internal factors.
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Authors and Affiliations

Alla Podavalenko
1
Nina Malysh
2
Victoriya Zadorozhna
3
Mycola Chemych
2
Svetlana Biryukova
1
Inna Chorna
2

  1. Kharkiv Medical Academy of Postgraduate Education, Ukraine
  2. Sumy State University, Ukraine
  3. SI “Institute of Epidemiology and Infectious Diseases named after L.V. Gromashevsky National Academy of Medical Sciences of Ukraine”, Ukraine
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Abstract

Introduction: Mortality from myocardial infarction (MI) is determined by patients’ ability to prevent it and, in case of its occurrence, to recognise its symptoms and call an ambulance immediately. There is scarce data on rural populations’ knowledge of MI, even though they are disadvantaged in access to medical emergency services.
Objective: The aim of the study was to investigate the rural patients’ awareness of MI risk factors, symptoms, necessity of calling an ambulance in response to MI symptoms, and its determinants.
Materials and Methods: An anonymous and voluntary survey was conducted among 194 patients and their caregivers with median age 68 years at a rural non-public healthcare facility in Poland.
Results: 60.3% perceive their knowledge of MI as insufficient. Only 26.3% were able to recognise all suggested MI risk factors. 44.8% did not know whether they are at risk of MI. Furthermore, 78% of respondents who had at least three MI risk factors were unaware of being at risk. 45.4% recognised at least three out of four suggested MI symptoms. 76.2% would call an ambulance in response to chest pain suggesting they have MI. Merely 80% were able to provide the emergency phone number. Moreover, among respondents who declared they would not call an ambulance, 38.7% were afraid of in-hospital COVID-19 infection or healthcare system collapse.
Conclusions: Rural patients’ knowledge of MI risk factors, symptoms, and proper response to them is insufficient. The problem is exacerbated by the COVID-19 pandemic. To improve survival in MI an education campaign is needed.
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Authors and Affiliations

Michał Korman
1
Dominik Felkle
1
Tomasz Korman
2

  1. Students’ Scientific Group at the Second Department of Cardiology, Jagiellonian University Medical College, Kraków, Poland
  2. Family Medicine Practice, 32-740 Łapanów, Poland
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Abstract

Mucormycosis is an invasive fungal disease caused by saprophytic molds and is characterized by a fulminant course and high mortality. Reported increase of disease cases and more frequent mucormy-cosis superinfections in COVID-19 patients are of a serious concern. Head and neck area is the most typical location of mucormycosis and often the first symptoms are eminent in oral cavity, therefore a dentist may be the first healthcare practitioner to recognize signs of this dangerous and potentially fatal disease. Urgent diagnosis and implementation of appropriate treatment are essential for the patient’s survival. The dentist’s participation in postoperative care is necessary and due to the destructive nature of radical surgical treatment, prosthetic rehabilitation is required to improve the patient’s function and quality of life. Furthermore the vigilance of dentists will also allow early recognition of frequent recur-rences of this insidious infection.
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Authors and Affiliations

Marcin Pasternak
1
Rafał Olszanecki
1

  1. Chair of Pharmacology, Jagiellonian University Medical College, Kraków, Poland

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