Technique of endovascular rheolytic thrombectomy using AngioJet for treatment of acute pulmonary embolism

We present a technique of endovascular rheolytic thrombectomy using the AngioJet system for the treatment of acute pulmonary embolism. We describe the procedure in detail, suggesting the optimal catheter, wires and potential complications during the procedure. Recent advances in endovascular techniques, such as aspiration thrombectomy, endovascular thrombus fragmentation devices and rheolytic or rotational thrombectomy, suggest that the endovascular approach can represent an alternative for pharmacological thrombolysis and surgical embolectomy

Synchronous gastric and rectal tumour - case description

Postęp w metodach diagnostycznych przyczynił się do zwiększenia wykrywalności guzów synchronicznych przewodu pokarmowego. Częstość ich występowania według danych z piśmiennictwa waha się w przedziale 5–13% i wzrasta niemal 2-krotnie u pacjentów z obciążającym wywiadem rodzinnym. Nie ma jednoznacznych algorytmów postępowania leczniczego w tej grupie pacjentów. Autorzy przedstawiają przypadek 50-letniego chorego z synchronicznym guzem żołądka i odbytnicy, u którego jednocześnie wykonano resekcję żołądka metodą Reichel-Polya, przednią resekcję odbytnicy i usunięto 2 ogniska przerzutowe w obu płatach wątroby.The continuous progress in cancer diagnosis has increased the incidence of synchronous malignancy detection within the digestive system. According to the literature, the frequency of their occurrence ranges from 5 to 13% and almost doubles in the patients with a reported oncogenic pedigree. There is still no properly defined treatment algorithm in this group of patients. We present the case of a 50-year-old male patient with synchronous gastric and rectal cancers, in which B II gastrectomy and an anterior rectal resection together with an excision of two metastases of both lobes of the liver were performed simultaneously

Blind gut perforation in the course of salmonellosis - case report

W pracy przedstawiono przypadek perforacji kątnicy w przebiegu infekcji wywołanej Salmonella species. Omówiono ryzyko powikłań chirurgicznych u chorych z salmonellozą.In the paper the case of caecum perforation due to Salmonella species infection was described. The risk of surgical complications in patients with salmonellosis was discussed

Case Report Internal Jugular Vein Entrapment in a Multiple Sclerosis Patient

We describe a multiple sclerosis patient presenting with compression of the internal jugular vein caused by aberrant omohyoid muscle. Previously this patient underwent balloon angioplasty of the same internal jugular vein. Ten months after this endovascular procedure, Doppler sonography revealed totally collapsed middle part of the treated vein with no outflow detected. Still, the vein widened and the flow was restored when the patient's mouth opened. Thus, the abnormality was likely to be caused by muscular compression. Surgical exploration confirmed that an atypical omohyoid muscle was squeezing the vein. Consequently, pathological muscle was transected. Sonographic control three weeks after surgical procedure revealed a decompressed vein with fully restored venous outflow. Although such a muscular compression can be successfully managed surgically, future research has to establish its clinical relevance

Podścieliskowe guzy przewodu pokarmowego (GIST)

Gastrointestinal stromal tumors (GIST) originate from the mezenchymal tissue of gastrointestinal tract, most probably from interstitial (Cajal) cells. Being the most common mesenchymal malignancy, GISTs concern no more than 1% of all gastrointestinal neoplasmatic tumors. Stromal tumors appear in the elderly and are usually located in the stomach (70%) and the small intestine (20–30%). About 30% of GISTs are malignant with signs of organ infiltration or with the presence of distant metastases. The presence of the membrane protein KIT (positive reaction against CD 117 in immunohistochemistry) in histological material is the essential factor for the GIST diagnosis. Surgery is the most important method in the treatment of GISTs. The paper presents the authors’ own experience concerning 4 patients with gastrointestinal stromal tumors treated surgically.Podścieliskowe guzy przewodu pokarmowego (GIST) wywodzą się z tkanki mezenchymalnej przewodu pokarmowego, najprawdopodobniej z komórek rozrusznikowych, tak zwanych komórek Cajala. Guzy podścieliskowe są najczęstszymi nowotworami mezenchymalnymi, stanowią jednak mniej niż 1% wszystkich nowotworów przewodu pokarmowego. Występują najczęściej u osób starszych i są przeważnie zlokalizowane w żołądku (70%) i jelicie cienkim (20–30%). Około 30% GIST wykazuje cechy złośliwości z objawami naciekania i tworzeniem przerzutów. Czynnikiem decydującym dla rozpoznania GIST jest obecność błonowego białka receptorowego KIT (dodatni odczyn anty CD 117 w badaniu immunohistochemicznym) w preparatach histopatologicznych guza. Zasadniczym sposobem terapii GIST jest leczenie operacyjne. W pracy przedstawiono doświadczenia autorów niniejszej pracy w diagnostyce oraz leczeniu GIST na podstawie grupy 4 chorych w wieku 48–71 lat leczonych chirurgicznie w ośrodku autorów

Satisfaction and discontent of Polish patients with biological therapy of rheumatic diseases : results of a multi-center questionnaire study

Objectives: Biologics are medications widely applied in the management of inflammatory rheumatic diseases. The drugs were found to be effective but their application is associated with some disadvantages. Medication with biologics is relatively expensive, and in Poland, it is carried out in specialized centers. The study was designed to evaluate various aspects of satisfaction and dissatisfaction of Polish patients treated with biologics. Material and methods: An anonymous questionnaire was distributed in 23 Polish rheumatological centers involved in the treatment; 1212 returned questionnaires were used for analysis. Responses were received from 606 patients with rheumatoid arthritis, 427 with ankylosing spondylitis, 117 psoriatic arthritis, and 62 adult patients with juvenile idiopathic arthritis (in whom administration of the drugs had been introduced before they were 18 years old). The investigated group constituted about one-fifth of all rheumatic patients on biologics in Poland. Results: A beneficial or very beneficial influence of the medication on the state of physical health was found mostly in patients with rheumatoid arthritis (51.3 and 30.5%) and ankylosing spondylitis (51.0 and 36.8%). Family life was improved by the treatment especially in patients with ankylosing spondylitis (40.7 and 35.6% beneficial and very beneficial, respectively), sleep quality and sexual life mostly in those with ankylosing spondylitis (beneficial/very beneficial influence 41.5/38.4, and 38.7/23.9, respectively). There was a rather small influence of biological treatment on the financial situation of the patients. In general, satisfaction with the treatment was evaluated as positive or very positive in 88% of all investigated patients. In a significant part of the patients, transportation to the medical center was considered as a disadvantage of the treatment. About one-third of the patients considered laboratory and imaging tests to be done before initiation of the medication as a difficulty, and for about 40% waiting time for qualification for the medication was a significant disadvantage. The route of drug administration was without importance for 4/5 of the patients. Conclusions: Summing up, the results were similar in the patients suffering from various diseases although those with psoriatic arthritis felt the highest satisfaction (possibly due to the positive aesthetic effect), and those with ankylosing spondylitis had significant improvement in sexual life (probably due to younger age). Relatively low satisfaction was found in patients with juvenile idiopathic arthritis. There was a small influence of medication on financial status of the patients. Application of biologics has few disadvantages and most of them are associated with the organization of health services (waiting time for the tests, transportation to the medical centers)

Internal Jugular Vein Entrapment in a Multiple Sclerosis Patient

We describe a multiple sclerosis patient presenting with compression of the internal jugular vein caused by aberrant omohyoid muscle. Previously this patient underwent balloon angioplasty of the same internal jugular vein. Ten months after this endovascular procedure, Doppler sonography revealed totally collapsed middle part of the treated vein with no outflow detected. Still, the vein widened and the flow was restored when the patient’s mouth opened. Thus, the abnormality was likely to be caused by muscular compression. Surgical exploration confirmed that an atypical omohyoid muscle was squeezing the vein. Consequently, pathological muscle was transected. Sonographic control three weeks after surgical procedure revealed a decompressed vein with fully restored venous outflow. Although such a muscular compression can be successfully managed surgically, future research has to establish its clinical relevance

Nietypowe ciało obce w przewodzie żółciowym wspólnym — opis przypadku

This paper presents the case of atypical foreign body presence within the common bile duct. The etiology and treatment of this rare pathology is discussed.W pracy przedstawiono przypadek nietypowego ciała obcego w przewodzie żółciowym wspólnym. Omówiono etiologię oraz sposoby leczenia tej rzadkiej patologii