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Opis przypadku 27-letniego mężczyzny z zawałem serca z uniesieniem odcinka ST ściany dolnej w następstwie infekcyjnego zapalenia wsierdzia
No full textSystemic embolism is a frequent complication of infective endocarditis (IE), but ST-elevation myocardial infarction (STEMI) due to septic coronary artery embolism is exceedingly rare and associated with high mortality. Herein, we illustrate the case of a 27-year-old male presenting with inferior wall STEMI secondary to IE. Despite established guidelines regarding the diagnosis and treatment of IE, this condition remains underdiagnosed, thus elevating the risk of fatal complications.Występowanie zatorów obwodowych stanowi częste powikłanie infekcyjnego zapalenia wsierdzia (IZW), jednak zawał mięśnia sercowego z uniesieniem odcinka ST (STEMI, ST-elevation myocardial infarction) spowodowany septycznym zatorem tętnicy wieńcowej występuje niezwykle rzadko i zazwyczaj wiąże się z wysoką śmiertelnością. W niniejszej pracy przedstawiono przypadek 27-letniego mężczyzny z zawałem ściany dolnej z uniesieniem odcinka ST, wtórnym do IZW. Pomimo obowiązujących wytycznych dotyczących diagnostyki i leczenia, choroba ta często pozostaje nierozpoznana we wczesnym stadium, co zwiększa ryzyko wystąpienia śmiertelnych powikłań
Atypical course of the azygos vein and its tributaries: a case report
No full textDuring routine cadaveric dissection of an 88-year-old man, an atypical course of the azygos vein was found. The azygos vein was formed by the subcostal and lumbar veins at the level of the eleventh vertebra and to the left of the midline. Initially ascending on the left side, the vein gradually shifted to the right at approximately T8 level, eventually draining into the superior vena cava. The large venous vessel, measuring up to 9 mm in diameter, served as the sole independent outlet for bilateral posterior intercostal veins from the fourth to the eleventh intercostal spaces. An atypical course and morphological variations of venous structures is clinically significant, especially for radiologists and thoracic surgeons, to avoid confusion with with aneurysms, tumours, or lymphadenopathies and improve perioperative outcomes
Hipoglikemia u pacjentki poddanej operacji bariatrycznej — opis przypadku
No full textObesity is one of the most significant global health challenges of the 21st century, associated with over 200 comorbidities and a marked reduction in li fe expectancy. Bariatric surgery remains the most effective treatment for obesity, with procedures such as sleeve gastrectomy and Roux-en-Y gastric bypass (RYGB) being the most commonly performed. Despite its effectiveness, bariatric surgery can lead to both acute and chronic complications, one of which is post-bariatric hypoglycemia (PBH). Post-bariatric hypoglycemia is defined as postprandial hyperinsulinemic hypoglycemia, occurring 2–4 ho urs after a meal, with glucose levels below 54 mg/dl and typical neuroglycopenic and neurovegetative symptoms. We present the case of a 39-year-old woman who developed PBH after undergoing a mini gastric bypass following a previously performed sleeve gastrectomy. The patient experienced recurrent episodes of postprandial hypoglycemia with associated symptoms such as weakness, drowsiness, sweating, and transient loss of consciousness. Extensive diagnostics excluded other causes of hypoglycemia. Initial dietar y modification led to par tial improvement, and the introduction of acarbose significantly reduced hypoglycemic episodes. Post-bariatric hypoglycemia is a diagnosis of exclusion. T reatment focuses on patient education, dietary management, and, in refractory cases, pharmacotherapy. Acarbose is the first-line pharmacological agent, with other options including octreotide, pasireotide, and diazoxide. In severe cases, surgical intervention may be considered. Post-bariatric hypoglycemia is becoming an increasingly significant challenge due to the growing number of bariatric surgeries performed worldwide. This highlights the need for long-term multidisciplinary care and ongoing patient education.Otyłość jest jednym z najpoważniejszych globalnych wyzwań zdrowotnych XXI wieku, związanym z ponad 200 chorobami współistniejącymi oraz znacznym skróceniem oczekiwanej długości życia. Chirurgia bariatryczna pozostaje najskuteczniejszą metodą leczenia otyłości, a najczęściej wykonywanymi zabiegami są rękawowa resekcja żołąd ka (sleeve gastrectomy) oraz ominięcie żołądkowe metodą R oux-en-Y (RYGB, Roux-en-Y gastric bypass). Pomimo swojej skuteczności, chirurgia bariatryczna może prowadzić do powikłań zarówno ostrych, jak i przewlekłych — jednym z nich jest hipoglikemia pooperacyjna (PBH, post-bariatric hypoglycemia). Hipoglikemię pooperacyjną definiuje się jako poposiłkową hipoglikemię hiperinsulinemiczną, występującą 2–4 godziny po posiłku, z poziomem glukozy poniżej 54 mg/dl oraz typowymi objawami neuroglikopenicznymi i neurowegetatywnymi.Przedstawiamy przypadek 39-letniej kobiety, u której po przeprowadzeniu mini gastric bypass — zabiegu wykonanego po uprzedniej rękawowej resekcji żołądka — rozwinęła się PBH. Pacjentka doświadczała nawracających epizodów poposiłkowej hipoglikemii, którym towarzyszyły objawy, takie jak osłabienie, senność, nadmierna potliwość oraz przemijające utraty przytomności. Rozszerzona diagnostyka wykluczyła inne przyczyny hipoglikemii. Początkowe leczenie niefarmakologiczne przyniosło częściową poprawę, natomiast wprowadzenie akarbozy znacząco ograniczyło liczbę epizodów hipoglikemii.PBH jest rozpoznaniem z wykluczenia. Leczenie opiera się na edukacji pacjenta, modyfikacji diety, a w przypadkach opornych — na farmakoterapii. Akarboza jest lekiem pierwszego wyboru, a inne opcje terapeutyczne to między innymi oktreotyd, pasyreotyd oraz diazoksyd. W ciężkich przypadkach rozważa się interwencję chirurgiczną. Hipoglikemia pooperacyjna stanowi rosnący problem z uwagi na zwiększającą się liczbę zabiegów bariatrycznych na całym świecie. Sytuacja ta uwydatnia konieczność zapewnienia pacjentom długoterminowej multidyscyplinarnej opieki i edukacji zdrowotnej
Initial results of treating thermal burns by hyperbaric oxygen at the Vietnam National Institute of Maritime Medicine
No full textBackground: Burns, especially heat-related ones, are common injuries at work as well as in daily life. Ifthere is no proper treatment, burns will leave a lot of sequelae, affecting daily activities, working ability,aesthetic and psychology of patients. Hyperbaric oxygen therapy is a new treatment, supporting pain relief,accelerating wound healing process, and reducing hospital stay.Aim: To describe the clinical characteristics of thermal burn patients right at the time of admission and initialresults of hyperbaric oxygen therapy.Material and methods: Prospective and retrospective case series report. This study comprised of thermalburn patients, who came to the Vietnam National Institute of Maritime Medicine (VINIMAM) for treatmentvia hyperbaric oxygen therapy from 2018–2022. Patients were first treated by VINIMAM 1, 2 and 3 regimens,then monitored and periodically assessed for some clinical features demonstrating the effect of thistreating method.Results: The mean age of 82 patients was 48.4 ± 19.5; 74.4% of patients were burned by boiling water;51.2% of them had 3rd degree burns; percentage of patients with < 10% of total body surface area(TBSA) burned was 80.5%; the mean length of stay was 8.9 ± 3.0 days, which was significantly lower thanthe expected figures.Conclusions: Hyperbaric oxygen therapy is an effective treatment for thermal burn patients, with a varietyof positive effects on burned tissues, therefore it should be scaled up, especially in facilities specializedin burn treatment
Sexual functioning of women and men with thyroid diseases
No full textThyroid hormones have a wide range of effects on different body systems, and both hypothyroidism andhyperthyroidism can affect sexual health in both men and women. Studies have shown that women withovert hypothyroidism score significantly lower on the Female Sexual Function Index (FSFI) in all areas,particularly lubrication.Subclinical hypothyroidism is associated with lower arousal and orgasm scores, while treatment for hypothyroidismreduces but does not completely eliminate sexual problems, which are still more commonthan in healthy individuals. Hypothyroidism also affects men's sexual health, leading to decreased libido,delayed ejaculation, erectile dysfunction, lower testosterone levels and reduced sperm motility. However,erectile dysfunction does not appear to be associated with either subclinical or overt hypothyroidism inlarger sample studies. The effect of hyperthyroidism on sexual function in women remains unclear.While two trials suggest a significant association, another does not, probably because of small sample sizes.The effect of hyperthyroidism on sexual dysfunction in men has been studied more extensively, with moststudies showing an increased incidence of premature ejaculation and erectile dysfunction. More researchwith larger sample sizes is needed to better understand these relationships
A retrospective analysis of the effectiveness of a community mental health center program in improving patient well-being
No full textIntroduction: Community mental health centers provide complex care related to the mental health conditionsof people living locally. The support provided takes the form of outpatient, remote, and home supportto enable the patient to continue functioning in society. The study aimed to determine the effectiveness ofinterventions provided at the center.Material and methods: The study retrospectively used data from 124 selected patients from the entire populationof patients treated in a community mental health center throughout the duration of the program.The patients were evaluated with the mental health continuum-short form.Results: It was shown that the well-being of patients receiving support at the center improved bothemotionally, socially, and psychologically. Having a job was associated with a greater improvement inwell-being between the first and second measurement. The lack of relationship between the amount ofimprovement in well-being and demographic variables or diagnosis indicates the universal nature of thesupport provided by CMHC.Conclusions: In the period between measurements, the well-being of patients undergoing the interventionat the Community Mental Health Center improved. Positive relationships between employment andimprovement of the patient's condition indicate the value of introducing and evaluating activities aimedat professional activation
Prevalence of depression in anemic patients: a systematic review and meta-analysis
No full textIntroduction: This study uses an exhaustive meta-analysis of descriptive epidemiological studies to determinethe prevalence of major depression in patients with all forms of anemia, across all ages and genders.Material and methods: Using the PRISMA criteria as a guide, the authors looked through databases suchas Google Scholar, Embase, PubMed, Scopus, and Scopus to locate research articles released between2003 and 2024. Version 4.3.0 of the R software was used to conduct the meta-analysis, and the JBI score wasused to evaluate the quality. Heterogeneity was assessed with the Q and I2 statistics. Egger's regressiontest and a funnel plot were used to evaluate publication bias.Results: Utilizing a random effects model, the combined results of the publications were used to estimatethe prevalence of major depression to be 36% (95% CI: 28–45%). A sub-group study revealed that individualswith sickle cell anemia had a greater prevalence of depression (42%), followed by those with thalassemia(35%), and those with iron deficiency anemia (20%). Sub-group analysis also revealed that anemic patientsfrom Asia (40%) and the African continent (37%) had a greater prevalence of depression (almost twice ashigh) than those from America (28%) and Europe (20%). The meta-regression analysis's falling trend indicatesthat young anemia individuals (children and adolescents) had a higher prevalence of depressionthan older patients.Conclusions: Patients who are anemic have a significant prevalence of depression. Regular follow-ups withanemic patients may need routine depression screening, particularly in settings with limited resources
The Nationwide Program for Skin Cancer Prevention — summary and future perspectives
No full textIntroduction. Malignant and in situ skin neoplasms (ICD-10: C43-44; D03-D04) constitute approximately 12% of all diagnosed malignant tumors in Poland. Between 2019 and 2023, the National Skin Cancer Prevention Program (the Program) was implemented in Poland, which targeted professionally active individuals aged 15–64. The aim of this study was to present the results of the Program’s implementation and draw conclusions beneficialto the effective execution of its future editions.
Material and methods. The study material consisted of reporting data from entities implementing the Program. Measures evaluating Program implementation were used to estimate the forecasted monetary benefits. It was assumed that, due to early detection of skin lesions, approximately 8% of patients would be able to return to professional activity sooner. The reduction period of professional inactivity was estimated at 15 days, with a cost of approximately PLN 423 per person.
Results. A total of 23,469 people used medical services under the Program. Detailed whole-body skin examinations were conducted for 13,527 individuals, dermoscopy was performed on 5,074 people, and videodermoscopy on 7,024 individuals. A total of 159 malignant lesions were detected.
Conclusions. The value of lives saved due to the Program’s implementation was estimated at PLN 103,350,000, while the value derived from reducing the period of professional inactivity amounted to PLN 794,191. The total profit from the Program, after deducting costs, reached PLN 95,051,828.40.
Opportunities and challenges of the oncology infrastructure as a tool for enhancing patient-centered care — developing a physical built environment (p-BE) index for cancer care
No full textIntroduction. Cancer care remains fundamentally anchored in physical infrastructures, with oncology infrastructure (OI) serving as the main interface between patients and the healthcare system. Despite increasing recognition of how the built environment (BE) can shape health experiences, its systematic evaluation and integration within cancer care remains limited and underutilized.
Material and methods. This study employed a mixed-methods framework to develop and validate the physical built environment (pBE) index, aimed at evaluating how OI interfaces support or constrain care delivery. The methodology was structured around the identification and analysis of 21 patient-facing components of the BE. Each component was operationalized into measurable indicators and grouped into six composite variables reflecting patient functional capabilities and infrastructure performance. Spatial and perceptual data were collected through service design (SD), user experience (UX), and user interface (UI) methodologies, combined with architectural tools (GIS, BIM) and a structured questionnaire administered to 286 breast cancer patients. Statistical validation was performed using analysis of variance (ANOVA), regression analysis, and principal component analysis (PCA).
Results. Among the six interface-based variables constructed from 21 components of the BE, three demonstrated statistically significant associations with patient-reported well-being: navigation and wayfinding (p = 0.00478), accessibility and comfort (p = 0.00296), and physical infrastructure status (p = 0.00288). Mediation analysis revealed that the perceived importance of each component modulated its effect on well-being. Integration of these findings for the creation of the infrastructural DT (IDT) enabled the identification of zones with higher risk for infrastructural underperformance and reduced patient capability.
Conclusions. Rather than offering a definitive measure, the pBE index should be understood as a first step toward making OI visible as a psychosocial actor in care delivery. This study highlights the opportunities that interdisciplinary frameworks can offer, providing a lens to understand and improve how the BE shapes care delivery — by enabling patient capacities or exposing the underperformance of critical interfaces. The p‑BE index invites further exploration, adaptation, and critique across diverse cancer care settings.