Polyp of jejunum detected by endoscopy as a reason of chronic anemia in a patient with polyps of stomach. A case report

Wstęp: Polipy jelita cienkiego stanowią bardzo rzadką patologię i równie rzadko są przyczyną krwawienia w obrębie przewodu pokarmowego. Opis przypadku: Przedstawiono przypadek chorego z przewlekłą niedokrwistością, okresowo zaostrzającą się, wymagającą wielokrotnych przetoczeń masy erytrocytarnej i suplementacji żelaza, u którego rozpoznano endoskopowo dużego polipa hiperplastycznego w jelicie czczym jako źródło przewlekłego krwawienia do przewodu pokarmowego. Wnioski: Polipy w jelicie czczym mogą być rzadką przyczyną przewlekłych krwawień do przewodu pokarmowego. Aby znaleźć miejsce krwawienia, wykonuje się badanie endoskopowe górnego odcinka przewodu pokarmowego. W badaniu tym należy także ocenić jelito znajdujące się poza częścią zstępującą dwunastnicy, najdalej jak tylko jest to możliwe w zasięgu endoskopu.Background: Polyps of the small intestine are a very rare pathology and they are also a reason for rare gastrointestinal bleeding. Case report: A case of a patient with chronic anemia, periodically becoming aggravated requiring multiple blood transfusions and iron supplementation, with a large hyperplastic polyp of jejunum detected by endoscopy as a source of chronic gastrointestinal bleeding, is described. Conclusions: Polyps of the small intestine can be a rare reason for gastrointestinal bleeding. A gastrointestinal upper endoscopy should be performed in every case of searching for gastrointestinal bleeding, with an attempt to estimate the small intestine beside the descendent part of the duodenum as far as possible

The mask of duodenal tumor in the course of colon cancer

Rak dwunastnicy należy do najrzadszych nowotworów przewodu pokarmowego. W każdym przypadku podejrzenia pierwotnego nowotworu dwunastnicy należy rozważyć możliwość, czy jest to nowotwór wychodzący z innego narządu, z wtórnym zajęciem dwunastnicy. Autorzy niniejszej pracy przedstawiają przypadek raka zagięcia wątrobowego jelita grubego z przetoką okrężniczo-dwunastniczą i naciekaniem dwunastnicy, przebiegającego pod maską raka dwunastnicy.Duodenal cancers are the most rare neoplasms of the digestive duct. Every time when we suspect primary duodenal neoplasm, we should consider the possibility, that in fact it is a neoplasm of a different origin site, secondarily infiltrating the duodenum. We present a case of cancer of the hepatic flexure of the colon, accompanied by a colo-duodenal fistula, infiltrating the duodenum, which could be misdiagnosed as duodenal cancer

Enhancing the nutritional profile of regular wheat bread while maintaining technological quality and adequate sensory attributes

Plant proteins, and legume proteins in particular, have become the centre of attention moving towards a more sustainable and, therefore, more plant-based human diet. Especially hybrid products, containing wheat and legume proteins, promise a balanced amino acid composition and an upgraded nutritional value of both protein sources. This study investigates a high-protein hybrid bread (HPHB) formulation, where wheat flour was partially replaced by high-protein ingredients from faba bean, carob and gluten. In addition to a detailed characterisation of technological quality and sensory profile, also the formulation's nutritional value was examined in comparison to regular wheat bread. Therefore, macronutrient composition, antioxidant potential, amino acid profile and contents of antinutritional compounds were analysed. Furthermore, protein digestibility was determined in an in vitro model and in vivo. Dough analysis revealed significant differences of the HPHB formulation compared to regular wheat dough. However, results obtained for bread quality characteristics prove HPHB to be equal to regular wheat bread and sensory results and the determined sensory attributes suggest high consumer acceptance. Nutritional analyses of HPHB showed a more favourable macronutrient composition in comparison to regular wheat bread; as well as low contents of antinutritional compounds and high antioxidant potential linked to high levels of phenolics. Also an improved amino acid profile, increased nitrogen utilisation rate (by 69%) and higher protein efficiency ratio were determined, which are associated with enhanced protein quality. This suggests HPHB, and similar formulations of its kind, as a valuable and healthy food choice, which can contribute to adequate protein supply in predominantly plant-based diets

Całkowite wytrzewienie narządów miednicy mniejszej z powodu raka pochwy – opis przypadku

Vaginal cancer is a rare neoplasm and in about 65% to 90% of cases it is a metastatic one. It is diagnosed in women aged from 60 to 70 years, but it can also appear in younger patients. Squamous cell carcinoma is the most frequently found histopathological type. Risk factors for the development of vaginal cancer are thought to be similar to those of cervical cancer. We present a case of a 52-year old woman with vaginal cancer treated with brachytherapy. Due to neoplasm recurrence, additional examinations were performed in the course of one year. The patient was qualified for total pelvic exenteration. A leakage from the abdominal wound was observed post operatively. It was successfully noninvasively treated. In 3 months time she was hospitalized because of the superficial abdominal abscess which was located next to the left ureterostomy. The patient undergoes regular gynecological, surgical and urological control examinations. So far, the results do not show any recurrence of the neoplastic process. Total pelvic exenteration should be considered in selected groups of patients.Rak pochwy jest rzadkim nowotworem i w 65%-90% przypadków jest to przerzut innego nowotworu. Rak pochwy diagnozowany jest przede wszystkim wśród pacjentek 60-70 letnich, chociaż opisywany jest także w grupie kobiet młodszych. Najczęstszym stwierdzanym typem histopatologicznym jest rak płaskonabłonkowy. Uważa się, że czynniki rozwoju raka pochwy są zbliżone do czynników ryzyka rozwoju raka szyjki macicy. Przedstawiamy opis przypadku 52-letniej pacjentki z rakiem pochwy pierwotnie leczonej brachyterpią. Z powodu wznowy procesu nowotworowego i wyczerpania możliwości dalszego leczenia radioterapią wykonano szereg badań dodatkowych, co pozwoliło na zakwalifikowanie pacjentki do leczenia operacyjnego. Wykonano zabieg całkowitego wytrzewienia narządów miednicy mniejszej. W przebiegu pooperacyjnym obserwowano jedynie powierzchowny wyciek z rany w powłokach brzusznych. W okresie 3 miesięcy od zakończenia hospitalizacji pacjentka wymagała ponownego leczenia z powodu ropnia okolicy lewej urostomii. Pacjentka pozostaje pod stałą kontrola ginekologiczną, chirurgiczną oraz urologiczną. Wyniki dotychczasowych badań kontrolnych nie budzą podejrzenia wznowy procesu nowotworowego. Całkowite wytrzewienie narządów miednicy mniejszej powinno być wykonywane w ściśle wyselekcjonowanej grupie pacjentek

Zmiany ilościowe populacji limfocytów CD3+ i CD45RA+ we krwi szczurów poddanych działaniu wolnozmiennego pola elektromagnetycznego

It was reported that an extremely low frequency (ELF) electromagnetic field causes biological effects in vitro and in vivo. The major functions of the immune system are to develop the concept of "self" and eliminate what is "non-self". In our preliminary study we proved that an extremely low frequency (ELF) magnetic field increased IgG concentration in the serum of rats. The study was carried out on male Wistar rats. The rats were exposed during 3 or 6 days (8 minute a day) to an ELF magnetic field of a complex shape generated by a device used in medicine. Five groups were used in this experiment: Group I - control group, absence of ELF magnetic field, Group II - exposure during 3 days (B = 0.06 mT), Group III - exposure during 3 days (B = 0.14 mT), Group IV - exposure during 6 days (B = 0.06 mT), Group V - exposure during 6 days (B = 0.14 mT). The animals were sacrificed for the experiment on the 2nd day after exposure to the ELF magnetic field. The leukocytosis and lymphocytes subpopulations (CD3+ and CD45RA+) in the blood of rats were assayed. Our results did not show significant changes of leukocytosis in groups II, III and IV. In rats of group V the leukocytosis decreased. In all groups we observed a decrease of CD3+ lymphocytes during the experiment. ELF magnetic field (B = 0.14 mT) induced a decrease of CD45RA+ lymphocytes in rats of groups III and V

The effect of climate change on avian offspring production: A global meta-analysis

Climate change affects timing of reproduction in many bird species, but few studies have investigated its influence on annual reproductive output. Here, we assess changes in the annual production of young by female breeders in 201 populations of 104 bird species (N = 745,962 clutches) covering all continents between 1970 and 2019. Overall, average offspring production has declined in recent decades, but considerable differences were found among species and populations. A total of 56.7% of populations showed a declining trend in offspring production (significant in 17.4%), whereas 43.3% exhibited an increase (significant in 10.4%). The results show that climatic changes affect offspring production through compounded effects on ecological and life history traits of species. Migratory and larger-bodied species experienced reduced offspring production with increasing temperatures during the chick-rearing period, whereas smaller-bodied, sedentary species tended to produce more offspring. Likewise, multi-brooded species showed increased breeding success with increasing temperatures, whereas rising temperatures were unrelated to reproductive success in single-brooded species. Our study suggests that rapid declines in size of bird populations reported by many studies from different parts of the world are driven only to a small degree by changes in the production of young.This meta-analysis was financed by the grant of the Polish National Science Centre (Narodowe Centrum Nauki) (no. 2017/27/B/NZ8/00465) awarded to Lucyna Hałupka.Peer reviewe

The effect of climate change on avian offspring production: A global meta-analysis

Climate change affects timing of reproduction in many bird species, but few studies have investigated its influence on annual reproductive output. Here, we assess changes in the annual production of young by female breeders in 201 populations of 104 bird species (N = 745,962 clutches) covering all continents between 1970 and 2019. Overall, average offspring production has declined in recent decades, but considerable differences were found among species and populations. A total of 56.7% of populations showed a declining trend in offspring production (significant in 17.4%), whereas 43.3% exhibited an increase (significant in 10.4%). The results show that climatic changes affect offspring production through compounded effects on ecological and life history traits of species. Migratory and larger-bodied species experienced reduced offspring production with increasing temperatures during the chick-rearing period, whereas smaller-bodied, sedentary species tended to produce more offspring. Likewise, multi-brooded species showed increased breeding success with increasing temperatures, whereas rising temperatures were unrelated to repro- ductive success in single-brooded species. Our study suggests that rapid declines in size of bird populations reported by many studies from different parts of the world are driven only to a small degree by changes in the production of young

Atrial fibrillation genetic risk differentiates cardioembolic stroke from other stroke subtypes

AbstractObjectiveWe sought to assess whether genetic risk factors for atrial fibrillation can explain cardioembolic stroke risk.MethodsWe evaluated genetic correlations between a prior genetic study of AF and AF in the presence of cardioembolic stroke using genome-wide genotypes from the Stroke Genetics Network (N = 3,190 AF cases, 3,000 cardioembolic stroke cases, and 28,026 referents). We tested whether a previously-validated AF polygenic risk score (PRS) associated with cardioembolic and other stroke subtypes after accounting for AF clinical risk factors.ResultsWe observed strong correlation between previously reported genetic risk for AF, AF in the presence of stroke, and cardioembolic stroke (Pearson’s r=0.77 and 0.76, respectively, across SNPs with p &lt; 4.4 × 10−4 in the prior AF meta-analysis). An AF PRS, adjusted for clinical AF risk factors, was associated with cardioembolic stroke (odds ratio (OR) per standard deviation (sd) = 1.40, p = 1.45×10−48), explaining ∼20% of the heritable component of cardioembolic stroke risk. The AF PRS was also associated with stroke of undetermined cause (OR per sd = 1.07, p = 0.004), but no other primary stroke subtypes (all p &gt; 0.1).ConclusionsGenetic risk for AF is associated with cardioembolic stroke, independent of clinical risk factors. Studies are warranted to determine whether AF genetic risk can serve as a biomarker for strokes caused by AF.</jats:sec

Usefulness assessment of preoperative MRI fistulography in patients with perianal fistulas

Background: Accurate preoperative assessment of the perianal fistulous tract is the main purpose of the diagnostics and to a large extend determines surgery effectiveness. One of the useful diagnostic methods in perianal fistulas is magnetic resonance imaging. The authors presented experiences in the application of MRI fistulography for evaluation of cases of perianal fistulas difficult to diagnose and treat. Material/Methods: Own examination method was described; MRI fistulography findings were analyzed and compared with intraoperative conditions in 14 patients (11 men and 3 women) diagnosed in the years 2005-2009. Eight patients had recurrent fistulas and 6 had primary fistulas. Imaging was performed with a GE SIGNA LX HS scanner with a 1.5-Tesla field strength and a dedicated surface coil placed at the level of hip joints. Contrast agent was a gadolinium-based solution. Results: Intraoperative findings were consistent with radiological descriptions of 13 MRI fistulographies. Only in one case, according to surgery findings, it was a transsphincteric fistula with an abscess in the ischioanal fossa, with an orifice in the posterior crypt; the radiologist described it as a transsphincteric, internal blind fistula. Conclusions: Due to its accuracy in the assessment of the perianal fistulous tracts in soft tissues, MRI fistulography becomes a useful and recommended diagnostic method in this pathology. It shows the location of the fistula regarding the system of anal sphincters, and identifies the internal orifice and branching of the fistula. It enables precise planning of surgical treatment. Authors suggest that this diagnostic method should be improved and applied more commonly

Mikulicz’S Procedure with Levator Muscle and External Anal Sphincter Plasty in the Treatment of Rectal Prolapse

Rectal prolapse is the partial or complete protrusion of the rectal wall into the anal canal. The most common etiology consists in the insufficiency of the diaphragm of the lesser pelvis and anal sphincter apparatus. Methods of surgical treatment involve perineal or abdominal approach surgical procedures. The aim of the study was to present the method of surgical rectal prolapse treatment, according to Mikulicz’s procedure by means of the perineal approach, based on our own experience and literature review. Material and methods. The study group comprised 16 patients, including 14 women and 2 men, aged between 38 and 82 years admitted to the department, due to rectal prolapse, during the period between 2000 and 2012. Nine female patients, aged between 68 and 82 years (mean age-76.3 years) with fullthickness rectal prolapse underwent surgery by means of Mikulicz’s method with levator muscle and external anal sphincter plasty. The most common comorbidities amongst patients operated by means of Mikulicz’s method included cardiovascular and metabolic diseases. Results. Mean hospitalization was 14.4 days (ranging between 12 and 17 days). Despite advanced age and poor general condition of the patients, complications during the perioperative period were not observed. Good early and late functional results were achieved. The degree of anal sphincter continence was determined 6-8 weeks after surgery showing significant improvement, as compared to results obtained prior to surgery. One case of recurrence consisting in mucosal prolapse was noted, being treated surgically by means of Whitehead’s method. Good treatment results were observed. Conclusion. Transperineal rectosigmoidectomy using Mikulicz’s method with levator muscle and external anal sphincter plasty seems to be an effective, minimally invasive and relatively safe procedure that does not require general anesthesia. It is recommended in case of patients with significant comorbidities and high surgical risk