Via Medica Journals
Not a member yet
55128 research outputs found
Sort by
Morphometric evaluation of the left atrioventricular valve complex and its clinical relations
Get PDFBackground: This study aims to evaluate morphometrically and morphologically the left fibrous ring, mitral leaflets, tendinous cords, and papillary muscles, which are the components of the left atrioventricular valve complex (LAVC), and to reveal their clinical relationships. Materials and methods: A total of 120 human hearts were examined at the Forensic Medicine Institute. The study included cases aged 30 years and older, less than 24 hours post-mortem. Heart length, width, height/width ratio, anteroposterior and mediolateral diameters of the annulus, annular area, length and width of leaflets, number and attachment sites of tendinous cords, number, shape, length, the width of papillary muscles, and distances to various points were recorded to determine their spatial configurations. Additionally, the measurement data of LAVC components in cases with and without cardiovascular disease (CVD) and their relationships with the demographic characteristics of the cases were also explained. Results: In the diagnostic performance test (ROC analysis), it was determined that body mass index ( > 26.7), heart weight ( > 414 g), heart height/width ratio (≤ 1.24), mitral valve width ( > 99.96 mm), left ventricular wall thickness ( > 15.08 mm), annular area ( > 619.37 mm2), and mediolateral diameter of the annulus ( > 30.71 mm) are important diagnostic criteria in determining CVD if they are outside the specified reference values. Conclusions: This study provides anatomical information about LAVC, along with recommendations for diagnosis and surgical treatment planning. We believe that our findings will be useful to clinicians
A new corrosion method (Aycan’s method)
No full textBackground: As it is known, the anatomy of the vessels is examined by removing the cast of the vessels inside the organs. Generally, liquid material (polyester, takilon, etc.) is injected into the vessels with positive pressure to remove the cast from the vessels of the organs. We built a machine to remove the cast of the vessels inside the organ. We named it corrosion machine.
Materials and methods: Sheep kidneys were used in our experiment. After the kidneys were cannulated, they were placed in the vacuum chamber. With the operation of the vacuum pump, negative pressure was created in the vacuum chamber. With negative pressure, kidneys and its vessels expanded. Takilon or polyester easily entered the vessels of the kidney. The cast of the vessels of the kidney was removed. With this newly developed technique, the anatomy of the vessels whose casts were removed was examined with the naked eye, stereomicroscope or SEM.
Results: The corrosion machine we built can cast the vessels of the organs very well. Takilon or polyester (which we used in our experiment) easily entered the capillaries under the effect of negative pressure.
Conclusions: We think that this method can also be applied to other organs and used in vascular research
Decalcification-free technique for analysis of dental pulp tissue: histological and immunohistochemical analysis
Get PDFBackground: Histological techniques are essential for the microscopic study and investigation of human dental pulp. The aim of this study was to evaluate the impact of a decalcification-free technique by examining dental pulp morphology by histological staining with haematoxylin and eosin and immunohistochemistry.Materials and methods: The sample consisted of 30 healthy third molars extracted for orthodontic indication. The pulp tissue was obtained by removing the mineralised tissues, separating the enamel and dentine and by marking with a flexible diamond disc on the coronal surface and longitudinal axis of the root. This made it possible to separate the fragments and obtain the pulp tissue for fixation and staining with H&E and subsequent immunohistochemistry with CD34 and S-100 antibodies.Results: The technique showed preservation of pulp morphology with adequate preservation of microscopic structures. No alterations in tissue viability were observed. The staining allowed an accurate assessment of vascular and nervous components by means of CD34 and S-100 markers, respectively.Conclusions: This technique allows preservation of pulp tissue, maintaining viable tissue for histological analysis and immunohistochemistry tests, as well as reducing sample processing time
Spiritual care provided by a physician in a pain management clinic: a bidirectional relationship between chronic non-cancer pain and spirituality
Get PDFOstatnie lata przyniosły znaczący wzrost liczby badań na temat związków pomiędzy duchowością a doświadczeniem choroby przewlekłej. Zmiany zachodzące w tej sferze mogą przyjąć jeden z trzech kierunków. U niektórych pacjentów doświadczenia i przekonania duchowe mogą obniżać ich jakość życia (ang. spiritual distress), a nawet nasilać odczuwanie bólu. U innych chorych cierpienie może wywołać całkowity zanik życia duchowego. Duchowość może też rozwijać się i pomagać zaadaptować się do choroby. Ta trzecia możliwość polega na tzw. pozytywnym duchowym radzeniu sobie z chorobą (ang. spiritual coping). Pacjent może wykorzystać swoje przekonania i doświadczenia związane z sensem życia, sensem cierpienia oraz transcendencją, aby odnaleźć odporność, a nawet akceptację w obliczu lepiej lub gorzej kontrolowanego bólu przewlekłego. Biorąc pod uwagę istnienie takiej możliwości celem opieki duchowej będzie właśnie przywrócenie pacjentom, którzy prezentują dystres duchowy, dobrostan w tym zakresie (ang. spiritual well-being). Lekarze mogą zapewnić poprawiającą jakość życia opiekę duchową, poprzez przyjęcie odpowiedniej postawy wobec pacjentów oraz rozmawiając z nimi o historii ich życia oraz przekonaniach i doświadczeniach duchowych. Celem niniejszego artykułu jest przedstawienie publikacji i dowodów naukowych na ten temat oraz opisanie propozycji modelu udzielania opieki duchowej w poradni leczenia bólu. Omówione zostanie również przygotowanie lekarzy do udzielania opieki duchowej, które polega m.in. na poznaniu i umocnieniu ich własnej duchowości. Należy podkreślić, że lekarze nie powinni wchodzić w kompetencje kapelanów ani uprawiać żadnego rodzaju prozelityzmu.Introduction: Recent years have seen a significant increase in research on the relationship between spirituality and chronic disease. This article aims to present the publications and research evidence on this topic and to propose a model for providing spiritual care in pain management clinic.
Methods: The study uses the snowball method. The key source for this article was Professor Christina Puchalski’s book entitled A Time for Listening and Caring: Spirituality and the Care of the Chronically Ill and Dying.
Results: Changes occurring in this sphere can take one of three directions. In some patients, spiritual experiences and beliefs may reduce their quality of life (spiritual distress) and even increase pain. In other patients, suffering can cause a complete disappearance of spiritual life. Spirituality can also be developed and help to adapt to illness. This third possibility is what is known as positive spiritual coping. The patient can use their spiritual beliefs and experiences to find resilience and even acceptance in the face chronic pain.
Conclusions: Given the existence of this possibility, the aim of spiritual care will be precisely to restore spiritual well-being to patients who experience spiritual distress. Physicians can provide spiritual care that improves the quality of life by adopting the right attitude towards patients and talking to them about their life story and spiritual beliefs and experiences
Komunikacja na temat chorowania i kresu życia z chorymi na zaawansowaną przewlekłą obturacyjną chorobę płuc -wieloośrodkowe badanie kwestionariuszowe
Get PDFBackground: Higher levels of knowledge about the disease among patients with chronic obstructive pulmonary disease (COPD) were shown to result in better physician-patient communication. Nonetheless, a sizable percentage of patients within this group continue to lack sufficient information about their disease and prognosis. The objective of this study was to collect the opinions of COPD patients regarding their knowledge of their condition, the sources of this knowledge, the most important barriers to end-of-life communication, and the needs regarding such communication from a pneumonologist.
Subjects and methods: A questionnaire survey was carried out among 474 patients with advanced COPD at three pneumonology centers in Poland (Gdańsk, Katowice, Toruń). The questionnaire consisted of a total of 25 questions. The article presents the conclusions of the part of the survey relating to the level of patients’ knowledge of their condition and end-of-life communication with physicians.
Results: Slightly more than 40% of respondents declared their knowledge of the disease to be good or sufficient (“I have good knowledge or I have some knowledge”). The primary source of knowledge for survey participants was their physicians, albeit a vast majority of patients have not talked to their physicians about the subsequent course of their illness. The main barriers to end-of-life discussions as pointed out by the patients included insufficient time when visiting a specialist, the lack of notions regarding the further course of the disease, the lack of knowledge on the disease and end-of-life issues, or the reluctance to discuss such topics.
Conclusions: The analysis of the data confirms the continued deficit of knowledge regarding the future course of the disease among COPD patients as the majority of them have not discussed this issue with their physicians despite having identified them as the primary source of disease-related information.Wstęp:
Obserwacje wskazują, że wyższy poziom wiedzy o chorobie wśród chorych na POChP wpływa na lepsze porozumienie lekarza z chorym. Mimo to spory odsetek pacjentów z tej grupy ciągle odczuwa niedobór informacji na temat swojej choroby i rokowania.
Cel badania: celem badania było poznanie opinii chorych na POCHP na temat ich wiedzy o swojej chorobie, źródeł jej pozyskiwania, najważniejszych przeszkód w komunikacji końca życia oraz potrzeby takiej rozmowy z lekarzem pneumonologiem.
Materiał i Metoda:
Przeprowadzono badanie kwestionariuszowe wśród 474 chorych na zaawansowaną postać POChP w trzech ośrodkach pneumonologicznych w Polsce (Gdańsk, Katowice, Toruń). Kwestionariusz zawierał 25 pytań. W niniejszym opracowaniu zawarto wnioski z części badania obejmującej odpowiedzi dotyczące wiedzy chorych na temat choroby oraz komunikacji końca życia z lekarzami.
Wyniki: Niewiele ponad 40% badanych określa swoją wiedzę o chorobie jako dobrą lub dostateczną (wiem dużo lub trochę). Podstawowym źródłem wiedzy dla uczestników badania jest lekarz, ale zdecydowana większość nie rozmawiała z nim na temat dalszego przebiegu swojej choroby. Jako główne bariery utrudniające rozmowy dotyczące końcowego okresu chorowania i życia pacjenci wskazują brak czasu podczas wizyty u specjalisty, brak wyobrażenia o dalszym przebiegu choroby, brak wiedzy z zakresu choroby i końca życia lub niechęć do rozmowy na takie tematy.
Wnioski: Analiza danych potwierdza, że ciągle istnieje niedobór wiedzy wśród chorych na POChP na temat przebiegu choroby, większość nie prowadzi rozmów z lekarzami na ten temat, mimo że wskazuje ich jako podstawowe źródło takich informacji
A comparative study of the effectiveness and safety of pregabalin and duloxetine in the treatment of chemotherapy-induced neuropathic pain
Get PDFBackground: Chemotherapeutic medicines are among the several medication types that can cause peripheral neuropathy, a serious disorder marked by symmetrical, distal damage to the peripheral nerves. Chemotherapy-induced peripheral neuropathy (CIPN) is a significant problem that is becoming more prevalent as oncological treatments that use potentially neurotoxic chemotherapy improve the prognosis and cure of cancer. CIPN can need dose decrease or discontinuance, which can have an adverse effect on survival. Relieving the patient from CIPN is required because it enhances their quality of life as well as their mental and physical health.
Patients and methods: The patients who were diagnosed with chemotherapy-induced neuropathic pain were randomized into two groups after obtaining written informed consent. Group D received duloxetine 30 mg orally daily in the 1st week followed by 30 mg twice daily until 3 weeks and Group P received pregabalin 75 mg orally daily in the 1st week followed by 75 mg twice daily until 3 weeks. The intensity of pain was measured using the NRS (Numerical Rating Scale) and the DN4 questionnaire was used to evaluate the neuropathic component. Changes in pain score and neuropathic component were assessed at baseline and then at the 2nd and 4th week of follow-up. Data was collected and analyzed using SPSS 20.0 software at a level of significance p < 0.05.
Results: At baseline, the mean ± standard deviation (SD) of the NRS score in Group D was 7.12 ± 0.89; in Group P was 7.01 ± 0.66 at the end of the study 4th week, the mean ± SD of the NRS score in Group D was 4.04 ± 0.98; in Group P was 5.18 ± 0.64. At baseline, the mean ± SD of the DN4 score in Group D was 7.21 ± 0.80; in Group P was 6.93 ± 0.85 at the end of the study 4th week, the mean ± SD of the DN4 score in Group D was 4.73 ± 0.42; in Group P was 5.13 ± 0.82. The reduction in NRS scores and DN4 scores at the end of the study (4th weeks) when compared to baseline scores were statistically significant in each group (p < 0.0001).
Conclusions: Both pregabalin and duloxetine are effective in improving the CIPN in patients with cancers. Both the drugs were well tolerated with mild side effects like headache, drowsiness, and sedation. However, duloxetine was found to be more favorable with fewer side effects than pregabalin
Precision in preservation: mastering cadaver embalming with the femoral artery approach — a technical note
Get PDFBackground: Human anatomy is a fundamental aspect of a physician’s knowledge. While novel technologies offer innovative ways to teach anatomy, cadavers remain an essential component of anatomical education. The quality of specimens begins with well-preserved cadavers, and the chosen vascular access for injection plays a crucial role. Unfortunately, there is a lack of literature regarding embalming procedures, as discourse on such practices could enhance the quality, safety, and effectiveness of anatomical instruction.
Materials and methods: In this study, a femoral artery approach is described for embalming, which entails a meticulous process of cutting through the skin, and navigating through fascias and adipose tissue by means of blunt dissection, ultimately reaching the artery for embalming injection. Tips and techniques pertaining to this technique are provided, including vital details for convenient accessibility and minimal impairment of tissue.
Conclusions: The objective of this study is to facilitate anatomists and technicians in the adoption of the femoral artery approach, and to encourage further exploration of alternative embalming methods, thus contributing to the continuous advancement of anatomical sciences
Number and localisation of nutrient foramen on clavicle and its relationship with other clavicle parameters
No full textBackground: Nutrient foramen (NF) is a hole in the long bones that allows the passage of the nutrient artery. The vasculature of the bone is very important for fracture healing and vascularised bone grafting. Therefore, information about the location and number of NFs is important for surgical and clinical practice. The clavicle is the most commonly fractured bone. The aim of this study was to analyse the relationship between the location and number of NFs on the clavicle and other clavicle parameters.
Materials and methods: This study was performed on 86 dry clavicles of contemporary adult individuals without age and gender records. Some clavicle parameters and NF parameters were measured and the relationship between them was analysed. Measurements were performed using a digital caliper.
Results: Most of the clavicles had a single NF. There was a positive correlation between DFant/DFpost (distance between NF and anterior border/distance between NF and posterior border) and vertical thickness of sternal end (VTs), verticalthickness of thinnest point (VTt) and clavicular thinnest point index (CIt) in all cases (p < 0.05). Sagittal thickness of acromial end (STa), vertical thickness of clavicle (VTc), sagittal thickness of clavicle (STc), and sagittal thickness of thinnest point (STt) were associated with NF counts. The most common localisation of NFs was type 2. The NFs were mostly located in the inferior position.
Conclusions: Relationships between the number and morphometric characteristics of NFs and some clavicle parameters were determined. We suggest that knowledge of the number and morphometric characteristics of NFs is important for the protection of the nutrient artery in orthopaedic surgery applications
Is it leukemia? Hematological disorders in pediatric patients with Down syndrome — case report and literature review
Get PDFIntroduction: Down syndrome (DS) is the most common chromosomal aberration. DS is characterized by a higher incidence of many disorders, including those involving the haematopoietic system. The risk of developing acute myeloid leukaemia is up to 150 times higher in this group. Also, characteristic is the presence of transient abnormal myelopoiesis (TAM), which can precede the development of malignancy. These phenomena are primarily associated with mutation of the GATA1 gene, cohesin complex and signalling pathways genes, as well as overactivity of foetal liver stromal cells and intensification of inflammation, stimulating the expansion of blastic cells.
Case report: A 15-month-old patient diagnosed with DS was admitted to the Clinic for diagnosis of neutropenia and thrombocytopenia. The myelogram showed no features of proliferative disease; however, TAM was suspected based on the bone marrow biopsy result. Six months later, based on the evaluation of the myelogram and immunophenotype of tumour cells, myeloid leukaemia (ML-DS) with megakaryoblastic differentiation was diagnosed. Genetic testing revealed a mutation in the GATA1 gene. The girl was qualified for treatment according to the AML-BFM 2019-ML-DS Protocol. The treatment was carried out as planned and the patient has achieved remission.
Conclusions: The pathogenesis of myelopoietic disorders in children with DS is mainly due to a cascade of mutations and genetic abnormalities. For this reason, DS patients must have appropriate molecular testing and regular haematologic follow-up to closely observe the evolution of myelopoietic disorders
Tubo-ovarian abscess management in our clinic
Get PDFObjectives: It is aimed to examine and determine the sociodemographic, clinical parameters and ultrasonographic (USG) findings and to make various predictions about patients who will need tube-ovarian abscess (TOA) surgery. Material and methods: Within the scope of the study conducted between April 2016 and March 2021, 140 patients diagnosed with TOA were evaluated. The parties in the comparison were compared based on clinical and USG findings of demographic characteristics of the patients who received medical and surgical treatment and those who received only medical treatment. Results: Ninety-eight (72.05%) patients whose surgical and medical treatment required underwent laparotomy, laparoscopy, and USG-guided drainage. The most important potential hazards for surgical procedures include severe abdominal pain, extent of abscess, and length of hospital stay. Critical threshold for a surgical procedure is when the abscess size becomes 5.5 cm (95% CI: 0.686–0.855, 0.686–0.855, p < 0.05). In the USG-guided drainage group no other complications were noticed. Conclusions: The size of the abscess is a valuable indicator of whether surgical treatment is required to manage TOAs and the USG-guided drainage led to fewer complications