The role of inflammation and potential pharmacological therapy in intracranial aneurysms

Intracranial aneurysms remain important clinical concern. There is relatively low risk of rupture of symptomless aneurysms incidentally found in MRA or CTA performed due to other indications. Not all of the intracranial aneurysms should or can be treated with neurosurgery intervention or endovascular embolization. Clinical strategy for small, symptomless, unruptured aneurysms is still questionable. Mechanisms underlying aneurysms formation, progression and rupture are poorly understood. Inflammation is one of the factors suspected to participate in these processes. Therefore the aim of this manuscript is to present current state of knowledge about the role of inflammation in the formation and progression of intracranial aneurysms and in their rupture process. Current knowledge about possible pharmacological treatment of intracranial aneurysms will also be presented. Macrophages infiltration seems to participate in the formation of intracranial aneurysms. Inhibition of signals sent by macrophages may prevent the aneurysms formation. Inflammation present in the wall of the aneurysm seems to be also related to the aneurysm's rupture risk. However it does not seem to be the only cause of the degeneration, but it can be a possible target of drug therapy. Some preliminary studies in humans indicate the potential role of aspirin as a factor that decrease the level of inflammation and lower the risk of rupture of intracranial aneurysms. However further research including a greater number of subjects and a prospective randomized design are necessary to assess the role of aspirin in preventing strategy for small, symptomless, unruptured intracranial aneurysms

Możliwości rozwoju turystyki uzdrowiskowej w województwie lubelskim

The aim of the study is to present a quantitative analysis of the current development and forecasts of development of the spa tourism in the province of Lublin. The results of the research indicate significant changes in the dynamics of the analyzed characteristics thus clearly indicating the growing interest in spa tourism in the region of Lublin. The authors point to the need of developing the medicinal-service base and the need to prepare a plan for promoting the region in terms of spa tourism.Celem prezentowanego opracowania jest ukazanie stanu i kierunków rozwoju turystyki uzdrowiskowej oraz prognoza rozwoju tej dziedziny gospodarki turystycznej w województwie lubelskim, na podstawie kompilacji danych Głównego Urzędu Statystycznego w zakresie jednostek lecznictwa uzdrowiskowego w Polsce w latach 2010–2015 oraz bazy noclegowej województwa lubelskiego. Dane o lecznictwie uzdrowiskowym obejmują szpitale i sanatoria uzdrowiskowe (w tym szpitale i sanatoria dziecięce), przychodnie uzdrowiskowe oraz zakłady przyrodolecznicze

Pancreatic adenocarcinoma — current trends in diagnosis and treatment

Pancreatic cancer, despite significant medical advances, is still a significant clinical problem. This article focuses on discussing risk factors, diagnostic methods, and treatment options. These elements are crucial in making a prompt diagnosis and initiating treatment. On average, a physician in primary care sees a patient with undiagnosed pancreatic cancer once every few years. Knowing the underlying symptoms and referring the patient to an appropriate center can significantly increase survival. Diagnostic methods include physical examination, numerous imaging techniques, and determination of tumor markers in serum. Surgical treatment combined with adjuvant chemotherapy is the only chance of cure for pancreatic cancer patients qualified for surgery. However, most patients experience tumor recurrence. When a tumor recurs, treatment for these patients and patients with unresectable disease is palliative chemotherapy. Numerous studies are currently underway to improve diagnostic and treatment methods

Technical aspects of inter-recti distance measurement with ultrasonographic imaging for physiotherapy purposes: the scoping review

Background: Inter-recti distance (IRD) measurement using musculoskeletal USI has been used in physiotherapy research, in particular, to investigate pregnancy-related diastasis recti abdominis (DRA) and to seek its effective treatment methods. Severe and untreated diastasis may result in the formation of umbilical or epigastric hernias. Objective: This study aimed to systematically map physiotherapy-related research articles that included descriptions of IRD measurement procedures using USI to present their similarities and differences, and formulate recommendations on the procedure. Design: A scoping review was conducted according to PRISMA-ScR guidelines, including 49 of 511 publications from three major databases. Publications were selected and screened by two independent reviewers whose decisions were consulted with a third reviewer. The main synthesized data items were: the examinees' body position, breathing phase, measurement sites, and DRA screening methods. The final conclusions and recommendations were the result of a consensus between seven reviewers from four research centers. Results: Studies used 1-5 measurement sites that were differently determined. IRD was measured at the umbilicus (n = 3), at its superior (n = 16) and/or inferior border (n = 9), and at different levels: between 2 and 12 cm above the umbilicus, or a third of the distance and halfway between the umbilicus and xiphoid (n = 37); between 2 and 4.5 cm below the umbilicus or halfway between the umbilicus and pubis (n = 27). Different approaches were used to screen subjects for DRA. Conclusions: The discrepancies between the measurement procedures prevent between-study comparisons. The DRA screening method should be standardized. IRD measurement protocol standardization has been proposed. Critical relevance statement: This scoping review indicates that the inter-recti distance measurement procedures using ultrasound imaging differ between studies, preventing between-study comparisons. Based on the synthesis of the results, measurement protocol standardization has been proposed. Key points: The inter-recti distance measurement procedures using USI differ between studies. Proposed standardization concerns body position, breathing phase, and measurement number per location. Determination of measurement locations considering individual linea alba length is suggested. Recommended locations: umbilical top, ½ of umbilical top-xiphoid, ¼ of umbilical top-xiphoid/pubis distances. Diastasis recti abdominis diagnostic criteria are needed for proposed measurement locations.The Jerzy Kukuczka Academy of Physical Education has funded the article’s editorial expenses.info:eu-repo/semantics/publishedVersio

Editorial Comment on: D. Schreiber-Dietrich, M. Pohl, X.W. Cui, B. Braden, C.F. Dietrich, L. Chiorean Perihepatic lymphadenopathy in children with chronic viral hepatitis

The article entitled Perihepatic lymphadenopathy in children with chronic viral hepatitis(1) is an original paper of high clinical relevance – viral hepatitis B and C are the main causes of chronic hepatitis and liver cirrhosis in children. Based on ultrasound fi ndings, the authors assessed the presence of the perihepatic lymph nodes and their morphology in 49 children with chronic viral hepatitis B and C (38 and 11 children, respectively). The authors hoped that this investigation would help establish a new, non-invasive marker enabling screening examinations to be conducted in children with chronic viral hepatitis. In adults, a correlation was found between the activity of hepatitis and the morphology of the lymph nodes in a US examination, but such a correlation has, until now, not been reported in children(2–4). The results of the study have a clinically signifi cant aspect – the loops of the hepatoduodenal ligament are relatively readily available in a transabdominal examination, and ultrasonography is an inexpensive and safe method to be conducted in children