Possibilities of physical medicine in the treatment of wound of tarsal joint

The treatment of wounds that are hard to heal still poses a serious interdisciplinary medical and sociological problem. Intense development of methods belonging to physical medicine has been noted recently. The paper presents beneficial results of treatment of a 69-year-old female patient with persisting chronic wound in the right lower limb, as consequence of a surgery of tarsal joint (arthrodesis). In the treatment, variable magnetic fields and light therapy (ledtherapy) procedures were applied for 17 weeks, leading to complete healing of the surgical wound. These are treatment methods which in many cases allow a reduction of treatment time and positively influence life quality of patients undergoing treatment. The above applies to illnesses and injuries of locomotor system, diseases affecting soft tissues, as well as chronic wounds. The applied physiotherapeutic method contributed to complete healing of the lesion, abolishment of the ailments suffered, as well as improved life quality of the treated female patient

Selected physical medicine interventions in the treatment of diabetic foot syndrome

The diabetic foot syndrome (DFS) is among chronic complications of diabetes mellitus; it can affect individuals with both type 1 and type 2 diabetes. Diabetic patients have up to a 25% lifetime risk of developing DFS, which is both a medical and social problem. Several studies have indicated that, apart from pharmacotherapy and modern active wound dressings, physical medicine also has a role in prevention and management of diabetic foot ulcers. The paper presents physical medicine interventions most recognized in the conservative management of DFS.The diabetic foot syndrome (DFS) is among chronic complications of diabetes mellitus; it can affect individuals with both type 1 and type 2 diabetes. Diabetic patients have up to a 25% lifetime risk of developing DFS, which is both a medical and social problem. Several studies have indicated that, apart from pharmacotherapy and modern active wound dressings, physical medicine also has a role in prevention and management of diabetic foot ulcers. The paper presents physical medicine interventions most recognized in the conservative management of DFS

Regional variations of symptoms of the chronic venous disease among primary health care patients in Poland

Introduction. The diverse social and cultural contexts may cause differences in perceiving symptoms of the chronic venous disease (ChVD), not only in global, European terms, but also in a regional context. The purpose of the study was to find the regional differences of the reported symptoms and the applied conservative treatment methods among patients with ChVD diagnosed by the primary health care (PHC) doctors in Poland. Material and methods. 13 393 patients participated in the multi-centre PHLEBOS-2 research carried out by 330 PHC doctors in 15 voivodeships. Results. In the study group of patients, 31.9% of patients had ChVD symptoms – the C0 stage, telangiec­tasias and venulectasias (C1 stage) occurred among 56.1% of patients, varices without symptoms of venous insufficiency occurred among 6% of patients and venous insufficiency among 6% of patients. Venous ulcers (active or healed) occurred among 0.6% of subjects. Essential differences in the ChVD structure between voivodeships were noted. Among the most frequently reported ChVD ailments were heaviness of legs (72.9%), ankle swelling in the eve­nings (68.4%) and nighttime leg cramps (58.6%). Leg swelling during the night hours occurred less frequently — 39.8%, paraesthesias — 30.4%, restless legs syndrome — 18.6%. The average intensity of calf pain was moderate (3.82 ± 1.86 points in the 10 point scale). The territorial diversity in the prevalence of symptoms was significant and resulted neither from the ChVD seriousness, nor from the age of the patients. Compression therapy was applied on average by 12.5% of patients and 24.8% of patients used phlebotropic drugs with large territorial variations (respectively from 3.4% to 28.8% and from 11.2 to 56.1%). The differences between the voivodeships were greater than the regional differences and did not depend on the ChVD stage. Conclusions. There are significant territorial variations in Poland in the frequency of the reported symptoms and in the conservative therapy of the chronic venous disease

Clinical Study Can Whole-Body Cryotherapy with Subsequent Kinesiotherapy Procedures in Closed Type Cryogenic Chamber Improve BASDAI, BASFI, and Some Spine Mobility Parameters and Decrease Pain Intensity in Patients with Ankylosing Spondylitis?

The present study investigated whether whole-body cryotherapy (WBC) procedures could potentially have more beneficial effects on index of BASDAI and BASFI, pain intensity, and spine mobility parameters: Ott test, modified Schober test, chest expansion in ankylosing spondylitis (AS) patients, than kinesiotherapy procedures used separately. AS patients were exposed to a cycle of WBC procedures lasting 3 minutes a day, with a subsequent 60 minutes of kinesiotherapy or 60 minutes of kinesiotherapy only, for 10 consecutive days excluding weekend. After the completion of the cycle of WBC procedures with subsequent kinesiotherapy in the AS patients, BASDAI index decreased about 40% in comparison with the input value, whereas in the group of patients who received only kinesiotherapy it decreased only about 15% in comparison with the input value. After the completion of the treatment in the WBC group, BASFI index decreased about 30% in comparison with the input value, whereas in the kinesiotherapy group it only decreased about 16% in comparison with the input value. The important conclusion was that, in WBC group with subsequent kinesiotherapy, we observed on average about twice better results than in the group treated only by kinesiotherapy

Mutations in the COL1A1 and COL1A2 genes associated with osteogenesis imperfecta (OI) types I or III

Although over 85% of osteogenesis imperfecta (OI) cases are associated with mutations in the procollagen type I genes (COL1A1 or COL1A2), no hot spots for the mutations were associated with particular clinical phenotypes. Eight patients that were studied here, diagnosed with OI by clinical standards, are from the Polish population with no ethnic background indicated. Previously unpublished mutations were found in six out of those eight patients. Genotypes for polymorphisms (Sp1 - rs1800012 and PvuII - rs412777), linked to bone formation and metabolism were determined. Mutations were found in exons 2, 22, 50 and in introns 13 and 51 of the COL1A1 gene. In COL1A2, one mutation was identified in exon 22. Deletion type mutations in COL1A1 that resulted in OI type I had no effect on collagen type I secretion, nor on its intracellular accumulation. Also, a single base substitution in I13 (c.904-9 G>T) was associated with the OI type I. The OI type III was associated with a single base change in I51 of COL1A1, possibly causing an exon skipping. Also, a missense mutation in COL1A2 changing Gly→Cys in the central part of the triple helical domain of the collagen type I molecule caused OI type III. It affected secretion of the heterotrimeric form of procollagen type I. However, no intracellular accumulation of procollagen chains could be detected. Mutation in COL1A2 affected its incorporation into procollagen type I. The results obtained shall help in genetic counseling of OI patients and provide a rational support for making informed, life important decisions by them and their families

The comparison of multipotential for differentiation of progenitor mesenchymal-like stem cells obtained from livers of young and old rats.

The presence of stem cells differentiating to hepatocytes and cholangiocytes has been previously reported in livers of young rats. Here, we have isolated, cultured, and characterized mesenchymal stem cells (MSCs) from livers of young and old rats and tested their multipotential for differentiation. The mesenchymal stem cells in liver sections were identified by the presence of markers, respectively for primary stem cells Thy-1 and CD34, for differentiation to early cholangiocytes GST and CK19, and for differentiation to hepatocytes GSTalpha and CK18. Ki67 was detected as the cell proliferation marker. Cells isolated from livers of either age group were tested in a culture for their viability following storage and were characterized for the presence of most of the markers detected in cells in situ. The results revealed age-dependent changes in the number of recovered primary MSCs. In both age groups we have observed cells changing under differentiating conditions to liver cell lineages, such as cholangiocytes and hepatocytes, as well as to non-liver cells such as adipocytes, astrocytes, neuroblasts, and osteoblasts. Our data revealed that from the livers of rats 20 months and older the primary MSCs could be isolated and expanded; however, they were significantly fewer, even though their differentiation multipotential was preserved. The mechanism involved in the differentiation of liver MSCs seemed to depend on a constellation of signals in Notch signalling pathways. Thus, our results support the idea of potential use of liver as a source of MSCs, not only for liver reconstruction but also for cell therapy in general

Characteristic of cells isolated from human Abdominal Aortic Aneurysm samples cultured in vitro

Abstract Background: This study aimed to standardize cell culture methods for major cell types isolated from three layers of human AAA. We also aimed to determine cell types in each layer of each AAA segment and compare them with cell types in layers of control, unchanged segments. Material and methods We divided AAAs into three segments along the AAA and control segments flanking the aneurysm. Isolated cells following expansion were analyzed by flow cytometry, immunochemistry and microscopic methods. Fluorochrome-conjugated antibodies were used to detect the three major cell types (endothelial cells, smooth muscle cells, and fibroblasts) in each layer of every AAA segment. Results: Culture of cells from the three AAA segments was successfully established in 21% of patients. In all of the layers, only a small proportion of cells showed layer- specific markers of cell types. The majority of cells from every layer were positive for CD90, which is considered specific marker of fibroblasts in the aorta. Conclusions: We describe methodology for isolation of cells, their culture conditions, and phenotypic characterization for AAA. The wall of AAA loses its specific types of cells in all of the layers compared with the normal abdominal aortic wall

UEMS Training Requirements for Angiology and Vascular Medicine: European Standards of Postgraduate Medical Specialist Training (ETR Document)

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Thromboembolic Disease in Patients With Cancer and COVID-19: Risk Factors, Prevention and Practical Thromboprophylaxis Recommendations–State-of-the-Art.

Cancer and COVID-19 are both well-established risk factors predisposing to thrombosis. Both disease entities are correlated with increased incidence of venous thrombotic events through multifaceted pathogenic mechanisms involving the interaction of cancer cells or SARS-CoV2 on the one hand and the coagulation system and endothelial cells on the other hand. Thromboprophylaxis is recommended for hospitalized patients with active cancer and high-risk outpatients with cancer receiving anticancer treatment. Universal thromboprophylaxis with a high prophylactic dose of low molecular weight heparins (LMWH) or therapeutic dose in select patients, is currentlyindicated for hospitalized patients with COVID-19. Also, prophylactic anticoagulation is recommended for outpatients with COVID-19 at high risk for thrombosis or disease worsening. However, whether there is an additive risk of thrombosis when a patient with cancer is infected with SARS-CoV2 remains unclear In the current review, we summarize and critically discuss the literature regarding the epidemiology of thrombotic events in patients with cancer and concomitant COVID-19, the thrombotic risk assessment, and the recommendations on thromboprophylaxis for this subgroup of patients. Current data do not support an additive thrombotic risk for patients with cancer and COVID-19. Of note, patients with cancer have less access to intensive care unit care, a setting associated with high thrombotic risk. Based on current evidence, patients with cancer and COVID-19 should be assessed with well-established risk assessment models for medically ill patients and receive thromboprophylaxis, preferentially with LMWH, according to existing recommendations. Prospective trials on well-characterized populations do not exist