Prevalence of the persistent median artery in patients undergoing surgical open carpal tunnel release : a case series

Background: Carpal tunnel syndrome is a common condition in adults with an estimated prevalence of up to 5% in the general population. The presence of a persistent median artery is an important consideration for plastic and orthopedic surgeons who frequently perform carpal tunnel release. This artery may persist into adulthood and constitute a significant supply of blood to the hand, sometimes compressing the median nerve. Purpose: In this case series, we describe the prevalence of the persistent median artery identified intraoperatively in Polish subjects undergoing surgical open carpal tunnel release. Methods: The data regarding the prevalence of persistent median artery were retroactively collected postoperatively from the standard surgical protocols. Results: Persistent median artery was identified in 36 out of 1285 operated hands (2.8%). The observed PMAs were identified in 15 (2.0%) cases out of 750 right upper limbs and in 21 (3.9%) cases out of the 535 left upper limbs. Conclusions: Persistent median artery can be present in the operating field of any surgeon that performs carpal tunnel release and any other surgical procedures in the wrist region. Therefore awareness of its presence is crucial to minimize intraoperative complications such as bleeding or digital ischemia

Coeliac trunk and its anatomic variations : a cadaveric study

Background: Coeliac trunk (CT) is the first major visceral branch of the abdominal aorta. The aim of this work was to present the CT division pattern and its anatomical variants in a sample of Polish population. Materials and methods: Coeliac trunk dissection was performed in 50 adult cadavers in the Department of Anatomy, Jagiellonian University Medical College. Cadavers of Polish subjects were included. Cadavers with previous upper abdominal surgery, abdominal trauma, disease process that distorted arterial anatomy or signs of putrefaction were excluded. CT variations, accessory vessels, and vertebral level of origin were described. CT patterns were reported according to the Adachi classification. This study was reviewed and approved by the local Ethics Committee. Results: Coeliac trunk consisting of the left gastric, common hepatic and splenic artery (type 1 according to the Adachi classification) was found in 82% of cadavers. The true tripod was found in 20% and the false one in 80%. Additional vessels were also found: greater pancreatic from the splenic artery and left inferior phrenic from the left gastric artery, which accounted for 2% sections. Type 2 according to the Adachi classification (i.e. the hepatosplenic trunk) was found in 16% of the sections. Other types of CT were not observed. The level of origin was found to be at the inter-vertebral disc between T12 and L1 in all of the cases. Conclusions: Based on the analysis of the sectional material of the Department of Anatomy, it was found that the typical visceral segmental division is approximate to that observed by Adachi in its classification, whereas the second type of CT was twice as frequent and no other, less frequent types were found

Diagnostic hysteroscopy and the risk of malignant cells intraabdominal spread in women with endometrial cancer

Although hysteroscopy is currently the undisputed gold standard for the examination of the uterine cavity in women with suspected endometrial cancer, it remains controversial as a procedure that can enhance metastasis spread. Endometrial cancer cells may shed during hysteroscopy and be passively transported with fluid flow into the peritoneal cavity. The paper presents the review of current knowledge regarding the risk of neoplasm metastases in women who had diagnostic hysteroscopy and the conditions that have to be met for the procedure to be safe. We searched PubMed, Ovid, Medline and Scopus databases for data published in the years 1985–2017. The following browsing criteria, the “MeSH headings”: hysteroscopy, endometrial cancer, intraperitoneal or metastatic spread were used to find relevant papers. Based on the current data analysis we conclude that (1.) diagnostic hysteroscopy performed in women with endometrial cancer, especially in its early stages, is a very useful, efficient and safe diagnostic method and (2.) the distension media used for endoscopic procedures in the uterine cavity must be strictly controlled for relatively low pressures to prevent the increase in risk of endometrial cancer intraperitoneal spread

CHANGES OF DEHYDROASCORBIC ACID CONTENT IN RELATION TO TOTAL CONTENT OF VITAMIN C IN SELECTED FRUITS AND VEGETABLES

Abstract. Vitamin C performs many functions in the human body and is very important for its proper functioning. The main vitamin C sources in the human diet are fruits and vegetables. Changes of total content of vitamin C (T c ), L-ascorbic acid (AA) and dehydro-L-ascorbic acid (DHA) in selected fruits and vegetables during storage at 20°C until spoilage were determined. A decrease of T c and AA contents and an increase of DHA concentration were noted. Products of high acidity such as lemon and tomato were characterized by the highest retention of vitamin C. An increase of the DHA to T c ratio (%) was observed. On the first day of storage the DHA/T c ratio was higher than 10% in broccoli, cucumber and banana, while on the last day -it amounted over 40% in banana and cucumber, between 20 and 40% in parsley leaves and broccoli, and below 20% in tomato, cauliflower and lemon. In order to obtain correct results of vitamin C determination in fruits and vegetables it is necessary to take DHA content into consideration

Erythropoietin as banned substance in professional sports: effects on maximal aerobic capacity, endurance and detection methods - a review

Introduction and purpose: Erythropoietin (Epo) and its analogs used as performance-enhancing substance and are considered doping and are therefore forbidden in sports, however the scientific evidence behind doping is frequently weak. We aimed to determine the effects erythropoietin on maximal aerobic capacity(VO₂ max), endurence and to present direct detection methods.  State of knowledge: Erythropoietin is a glycoprotein cytokine. During cellular hypoxia, Epo is secreted mainly by the kidneys, it stimulates bone marrow production of red blood cells. To compensate for normal red cell turnover, low levels of Epo are constantly secreted in sufficient quantities. In addition to anemia and chronic lung disease, cellular hypoxia can result in elevated levels of Epo. VO₂ max is the peak volume of oxygen that a person can consume during exercise. Essential for breathing, oxygen is inhaled by the lungs and converted into energy, which then fuels human cells and expels carbon dioxide in the exhaled breath. This allows the body to manage more efficiently aerobic workouts that involve a large amount of oxygen intake, such as running, swimming or other cardio exercises.  Conclusions: Current data from PubMed indicate a significant relationship between Epo overuse and endurance in professional sports. That is one of the most important reasons to pay attention to the effects of EPO and new detection methods.

Semaglutide in the treatment of nonalcoholic fatty liver disease and nonalcoholic steatohepatitis

Background: Non-alcoholic fatty liver disease (NAFLD) is an increasing problem in the modern world due to increased morbidity and due to its clinical consequences. It is a chronic liver disease, histologically divided into non-alcoholic steatohepatitis (NAFL) with isolated steatosis to non-alcoholic steatohepatitis (NASH), which is characterized by hepatocyte injury, inflammation, and variable degrees of fibrosis that can progress to cirrhosis in a fraction of patients. Data on the prevalence of NAFLD vary depending on the population studied and the method used to establish the diagnosis, but the prevalence rate ranges from 6% to 35%, with a median of 20%. The prevalence of NASH in the European population is estimated at 5-6%, which makes NAFLD a new civilizational challenge. Aim of the study: The following article as an analysis of the current medical knowledge on the effectiveness and safety of NAFLD and NASH treatment with semaglutide based on available publications. Methods and materials: Literature review based on PubMed data using the following key words: NAFLD; NASH; semaglutide; Glucagon-like peptide-1 (GLP-1) analogues State of knowledge: GLP-1 receptor agonists are incretin drugs. This class of drugs has been approved by the FDA for the treatment of type 2 diabetes. Results: There is currently no approved therapy for NAFLD or nonalcoholic steatohepatitis (NASH). Beneficial effect of semaglutide on glycemia and weight loss makes them an attractive potential therapeutic form in NASH. However, there is a need for more clinical studies, on larger groups of people to recognize the effective form of semaglutide NAFLD therapy

Glucagon-like peptide-1 (GLP-1) agonists in the treatment of obesity

Background: Obesity is an increasing problem in the modern world due to increased morbidity and due to its clinical consequences. It is a chronic disease that causes the development of numerous complications, such as cardiovascular diseases, type 2 diabetes or cancer. The problem of the excessive body weight is global and affects over 2 billion people around the world. Due to the increasing problem of obesity, pharmacotherapy is recommended in patients with BMI ≥30 kg/m2 or BMI ≥27 kg/m2 with accompanying risk factors. To fight obesity, however, we primarily use lifestyle modification methods, such as a rational and balanced diet based on reduced caloric content and a low-carbohydrate diet. Another aspect is the use of the optimal amount of exercise of moderate intensity. Only the combination of all these methods gives a real chance for long-term weight loss and maintenance. Scientific research on GLP-1 analogue drugs such as semaglutide and liraglutide brings us a lot of prospects. The mechanism of their action is based on mimicking the natural GLP-1 secreted in the body. Aim of the study: The following article as an analysis of the current medical knowledge on the effectiveness and safety of obesity treatment with GLP-1 agonists based on available publications. Methods and materials: Literature review based on PubMed data using the following key words: obesity; semaglutide; Glucagon-like peptide-1 (GLP-1) agonists State of knowledge: GLP-1 receptor agonists are incretin drugs. This class of drugs has been approved by the FDA for the treatment of type 2 diabetes. Results: Numerous studies have shown that chronic systemic delivery of GLP-1 agonists led to weight loss and helped to maintain a lower body weight. Reduction in food intake is reported as the main mechanism

Irritable bowel syndrome – a literature review

Introduction: Irritable bowel syndrome (IBS) is one of the most common diseases affecting people around the world. It is characterized by irregular bowel movements and abdominal pain. IBS significantly reduces the quality of life of patients. Despite such a frequent occurrence of this disease, its correct diagnosis and treatment still causes many problems for primary care physicians. Aim of the study: The aim of the study is to present the current state of knowledge on the pathophysiology, diagnostics and drugs used in irritable bowel syndrome. Description of the state of knowledge: Many factors may play a role in the pathogenesis of IBS. The most common are: genetic factors, intestinal motility disorders, visceral hypersensitivity, mental disorders, especially disorders of the brain-gut axis regulation, past intestinal infections, intestinal microbiota disorders and food intolerances. The Rome IV criteria are currently used in the diagnosis of IBS. Treatment of irritable bowel syndrome includes lifestyle modification and dietary management, pharmacotherapy and psychotherapy. Summary: Irritable bowel syndrome is a chronic disease, symptoms often recur and complete recovery is not possible.                                                                                                                                                                                     

Pain therapy in the pediatric population

  Introduction: The assessment and treatment of pain in the pediatric population is a huge challenge for doctors and medical staff dealing with this group of patients. It is also one of the most important elements of pediatric care practice. There are many factors that contribute to the difficulty of assessing and managing pain in children, but the most important seems to be the lack of unified standards of care. In pain therapy, both pharmacotherapy and behavioral methods and psychological care are used. Purpose of the work: The aim of this work is to systematize the current state of knowledge in the field of pain therapy in the pediatric population, focusing particular attention on pharmacotherapy Materials and Evidence: We reviewed the literature available in the PubMed database using the following keywords: pediatric; pain therapy; analgesia Summary: Pain therapy in the pediatric population, despite the fact that it is often underestimated and insufficiently managed, is crucial both in terms of avoiding health complications and in the overall therapeutic process. Despite the presence of many drugs for pain therapy on the market, many of them are not approved for use in this group of patients. Knowledge of their mechanisms of action and predicting the impact on metabolism in a pediatric patient compared to an adult is crucial for the management of both acute and chronic pain syndromes. Despite the current knowledge, there is still a need for broader research on the possibility of the drugs used, their impact on the therapy process and side effects in the youngest patients. &nbsp

Pompe disease - What do we currently know about the disease?

Introduction: Pompe disease (PD) is a rare metabolic disorder caused by a partial or complete deficiency of acid α-glucosidase (GAA) which leads to lysosomal accumulation of glycogen. Excessive amounts of glycogen accumulate mainly in the cells of the heart and skeletal muscles and cause dysfunction of these tissues. It is inherited in an autosomal recessive manner. The most common diagnostic methods include genetic tests and the measurement of enzyme activity in leukocytes or fibroblasts. A screening test is also available that tests the enzyme activity in dried blood spot (DBS). The treatment of PD is mostly based on synthetic GAA enzyme supply to the patients. The therapy reduces glycogen storage and improves muscle function, decreases heart size and prolongs the lives of those with infantile form of PD. In the adult onset of the disease treatment increases physical efficiency and reduces the progression of respiratory failure. Aim of the study: Systematization of current knowledge about Pompe disease with particular emphasis on possible clinical presentations, diagnostics and therapeutic options. Material and methods: Literature review based on PubMed data using the following keywords: Pompe disease, Glycogenosis type ii, glucosidase alpha Summary : Pompe disease is a rare disease with many problems related to diagnosis and possible therapies. Its symptoms can be very misleading and cause a delay in diagnosis . It is critical to start the therapy as soon as possible to best manage the disease. The prognosis of PD is poor, especially in children under 12 months of age. Gene therapy research is currently underway and early results are very promising. There is still much to learn about dealing with this disease