Effectiveness of mesh hernioplasty in incarcerated inguinal hernias

INTRODUCTION: The use of mesh is still controversial in patients undergoing emergency incarcerated hernia repair, mostly because of potential infectious complications. AIM: The main aim of this study was to assess the efficacy of tension-free methods in treating incarcerated inguinal hernias (IIH), with and without intestine resection. The secondary aim was to establish an algorithm on how to proceed with incarcerated hernias. MATERIAL AND METHODS: A retrospective analysis of patients who underwent surgery due to an inguinal hernia at the First Department of General Surgery Jagiellonian University Medical College in Krakow, in the period 1999–2009. Operative methods included Lichtenstein, Robbins-Rutkow and Prolene Hernia System. The rate of postoperative complications was compared in patients who underwent elective and emergency surgery. RESULTS: The study group consisted of 567 patients (546 male) age 19–91 years. In this group 624 hernias were treated using the three tension-free techniques – 295 using the Lichtenstein method, 236 using PHS and 93 using the RR technique. Out of the 561 operations 89.9% were elective. No correlation (p > 0.05) was found between the type of surgery and such complications as postoperative pain duration and intensity, fever, micturation disorders, wound healing disorders, testicle hydrocoele, testicle atrophy, spermatic cord cyst, sexual dysfunction, wound dehiscence, wound suppuration, seroma, haematoma and hernia recurrence. CONCLUSIONS: Mesh repairs can be safely performed while operating due to an IIH. The use of a synthetic implant, in emergency IIH repairs, does not increase the rate of local complications. Synchronous, partial resection of the small intestine, due to intestinal necrosis, is not a contraindication to use mesh

The role of spirituality in management processes on the example of the John Paul II Family Home Museum in Wadowice

Tematem niniejszej pracy są przejawy duchowości w procesach zarządzania organizacją. Jestto studium przypadku, a badana organizacja to instytucja kultury, Muzeum DomuRodzinnego Jana Pawła II w Wadowicach. Praca obejmuje przedstawienie zagadnieniaduchowości i korelacji tego zjawiska z tworzeniem sensu w instytucji, a także omówieniepodstawowych teorii zarządzania w których duchowość się pojawia, ze szczególnymuwzględnieniem tożsamości organizacyjnej. Na podstawie tych treści oraz badańjakościowych, które opierają się na wywiadach, praca pokazuje jak duchowość możewpływać na zarządzanie organizacją.The subject of this text are manifestations of spirituality in the processes of organizationmanagement. This is a case study. The organization which is explorated is a culturalinstitution, John Paul II Family Home Museum in Wadowice. The text includes presentationof the issue of spirituality and correlation of this phenomenon with the creation of sense inthe institution. As well it is discussing the basic management theories in which spiritualityappears, with particular emphasis on organizational identity. Based on these contents andqualitative research, which is based on interviews, this text shows how spirituality can affectthe organization's management

Spirituality in leading a humanitarian aid organization on the example of the Polish Humanitarian Action.

Przedmiotem badania o charakterze jakościowym jest duchowość w przewodzeniu organizacją, a celem znalezienie nowych, niestandardowych propozycji sposobów zarządzania. Jest to analiza przypadku Polskiej Akcji Humanitarnej. W pracy – w oparciu o przegląd podstawowych teorii dotyczących poruszanych zagadnień oraz za pomocą analizy danych formalnych i nieformalnych, wywiadów z przełożonymi zespołów oraz z pracownikami – duchowość analizowana jest pod kątem przywództwa w specyficznej organizacji zajmującej się pomocą ofiarom kryzysów humanitarnych. Badanie odpowiada na pytania w jaki sposób przejawia się oparte na duchowości przywództwo, jakimi działaniami się charakteryzuje oraz jakie są jego powszechne elementy. Wnioski wskazują na to, iż duchowość przejawiać się może w kilku kategoriach za które odpowiedzialny jest menedżer. Wspierają one proces nadawania sensu w organizacji oraz nadają przywództwu autentyczny charakter, przez co wpływają na efektywność działań organizacji.The subject of the research, based on qualitative methodology, is spirituality in leading the organization. Its purpose is to propose new, non-standard methods of management. It is a study of the Polish Humanitarian Action. In the master's thesis, based on an overview of the raised issues' basic theories and through the analysis of formal and informal data as well as interviews with team leaders and employees, spirituality is analyzed in terms of leadership in a specific organization that helps victims of humanitarian crises. The research answers questions about how spirituality-based leadership is manifested, what sort of activities are characteristic to it, and what are its common atributes. The conclusions indicate that spirituality can manifest itself in several categories all under a manager's responsibility. They support the process of giving meaning in an organization, provide leadership with an authentic character, and hence, influence the effectiveness of the organization

Abdominal Ultrasonography in Detecting and Surgical Treatment of Pancreatic Carcinoma

The aim of the study was to asses the clinical value of percutaneous abdominal ultrasonography in diagnosis, staging and surgical treatment of patients with pancreatic carcinoma.Material and methods. Prospective clinical trial on diagnostic accuracy of percutaneous abdominal ultrasonography was conducted in 409 consecutive patients with pancreatic cancer which were operated on at the I Dept. of General Surgery in Cracow between 2000 and 2010.Results. Diagnostic accuracy of percutaneous abdominal ultrasonography in pancreatic cancer was 91,1%. The accuracy in detecting different stages of local advancement according to TNM classification was assessed respectively 92.3%-T1, 91.3%-T2, 89.4%-T3, 92.1%-T4, a whole T1-T4 on 91.3%. Diagnostic accuracy of percutaneous abdominal ultrasonography in diagnosis of metastasis to lymph nodes, vascular infiltration, and resectability was respectively 80.7%, 86%, 91.4%.Conclusions. Percutaneous abdominal ultrasonography has high diagnostic accuracy in diagnosis, staging and predicting surgical treatment of patients with pancreatic carcinoma

Hospital inpatient falls across clinical departments

Background: Inpatient falls are common hospital adverse events. We aimed to determine inpatient fall rates in an urban public hospital and analyzed their characteristics across clinical departments. Methods: The study was conducted in a 350-bed urban, multi-specialty public hospital in the 2013–2019 period. Patient data were retrieved from the hospital’s standardized falls reporting system. Descriptive statistics and statistical tests: chi2 and ANOVA tests with multiple comparison tests (post-hoc analysis) were used. For fall incidence estimation a joint-point regression was applied. p-value of 0.05 was considered as statistically significant for all the calculations. Results: The highest prevalence of falls was reported in the rehabilitation and internal medicine wards (1.915% and 1.181%, respectively), the lowest in the orthopedic (0.145%) and rheumatology wards (0.213%) (p < 0.001). The vast majority of falls took place in the late evening and during the night (56.711%) and were classified as bed falls (55.858%). The crude incidence rate (cIR) of falls was 6.484 per one thousand hospitalizations. In the 2013–2017 period, an increase in total cIR was observed, reaching the peak value in 2016; it was followed by a slight decline from 2017 to 2019, however, differences in changes were observed between the wards. Conclusion: Fall rates and trends as well as circumstances of inpatient falls varied significantly among clinical departments, probably due to differences in patient characteristics