Superficial temporal artery aneurysm

Introduction: The superficial temporal artery (STA), an end branch of the external carotid artery, is a major artery of the head. Due to its location, where skin and fat tissue remain the only protection of the artery, it can be easily damaged while head injury, causing an aneurysm to form. So far around four hundreds of cases of STA aneurysms have been described in the literature. Material and methods: We present a 37-year-old woman with a painless pulsatile mass of approximatelyone centimeter above the left ear and headaches in the left temporal area. In the past, she was a victim ofdomestic violence with a few head trauma. Results: The STA aneurysm was confirmed in ultrasound imaging. The patient did not meet the criteria for the diagnosis of giant cell arteritis. She was presented for a vascular surgery consultation and qualified for surgical resection of the aneurysm. In addition, the patient was diagnosed with hepatic hemangioma and mild aortic and mitral valve regurgitation. Conclusions: According to the available literature, STA aneurysms have mostly been reported as post--traumatic. The gold standard for STA aneurysm treatment is surgical resection. The procedure was reported as safe, as well as a low grade of recurrence or complications during the procedure was shown in the literature

Chronic Lower Extremity Ischemia and Its Association with the Frailty Syndrome in Patients with Diabetes

Diabetes mellitus is an important risk factor for the development of cardiovascular diseases. Peripheral arterial disease affecting lower limb arteries is one of the clinical manifestations of atherosclerosis. The frailty syndrome (Frailty) is a problem associated with diminution of physiological reserves. The ankle-brachial index is a commonly used tool for diagnosing peripheral arterial disease (PAD). The usefulness of the ankle-brachial index (ABI) is limited in people with diabetes because of calcification of the middle layer of arteries. In this population, toe-brachial index should be measured. Frailty may be associated with worse prognosis for patients undergoing revascularization. Amputation may be an important factor leading to the development of Frailty. The risk of amputation and the prognosis after revascularization may be modified by some medications and blood glucose levels. The purpose of this paper is to review the literature about the association between PAD, especially in patients living with diabetes and Frailty

Pathogenesis and Clinical Significance of In-Stent Restenosis in Patients with Diabetes

Diabetes mellitus (DM) is a strong risk factor for the development of cardiovascular diseases such as coronary heart disease, cerebrovascular disease, and peripheral arterial disease (PAD). In the population of people living with DM, PAD is characterised by multi-level atherosclerotic lesions as well as greater involvement of the arteries below the knee. DM is also a factor that significantly increases the risk of lower limb amputation. Percutaneous balloon angioplasty with or without stent implantation is an important method of the treatment for atherosclerotic cardiovascular diseases, but restenosis is a factor limiting its long-term effectiveness. The pathogenesis of atherosclerosis in the course of DM differs slightly from that in the general population. In the population of people living with DM, more attention is drawn to such factors as inflammation, endothelial dysfunction, platelet dysfunction, blood rheological properties, hypercoagulability, and additional factors stimulating vascular smooth muscle cell proliferation. DM is a risk factor for restenosis. The purpose of this paper is to provide a review of the literature and to present the most important information on the current state of knowledge on mechanisms and the clinical significance of restenosis and in-stent restenosis in patients with DM, especially in association with the endovascular treatment of PAD. The role of such processes as inflammation, neointimal hyperplasia and neoatherosclerosis, allergy, resistance to antimitotic drugs used for coating stents and balloons, genetic factors, and technical and mechanical factors are discussed. The information on restenosis collected in this publication may be helpful in planning further research in this field, which may contribute to the formulation of more and more precise recommendations for the clinical practice

Nitrotyrosine, Nitrated Lipoproteins, and Cardiovascular Dysfunction in Patients with Type 2 Diabetes: What Do We Know and What Remains to Be Explained?

Diabetes mellitus (DM) is a strong risk factor for the development of cardiovascular diseases (CVDs), which are the most important cause of morbidity and mortality in the population of patients living with DM. DM is associated with lipid metabolism disorders characterized by a decrease in the high-density lipoprotein blood concentration, an increase in the triglyceride blood concentration, and the presence of modified lipoproteins not routinely measured in clinical practice. Nitrated lipoproteins are produced by the nitration of the tyrosyl residues of apolipoproteins by myeloperoxidase. There is some evidence from the research conducted showing that nitrated lipoproteins may play a role in the development of cardiovascular dysfunction, but this issue requires further investigation. It was found that the nitration of HDL particles was associated with a decrease in caspase-3 and paraoxonase-1 activity, as well as a decrease in the activity of cholesterol transport via ABCA1, which reduces the protective effect of HDL particles on the cardiovascular system. Less information has been collected about the role of nitrated LDL particles. Thus far, much more information has been obtained on the relationship of nitrotyrosine expression with the presence of cardiovascular risk factors and the development of cardiovascular dysfunction. The purpose of this paper is to provide an extensive review of the literature and to present the most important information on the current state of knowledge on the association between nitrotyrosine and nitrated lipoproteins with dysfunction of the cardiovascular system, especially in patients living with DM. Moreover, directions for future research in this area were discussed

Ektopia nerki jako przyczyna trudności diagnostycznych u 43-letniego mężczyzny hospitalizowanego z powodu podejrzenia raka jelita grubego

Colorectal cancer and its diagnosis remain a significant clinical problem. Renal ectopia is one of the major developmental anomalies of the urinary system, although it is relatively rare in the general population. It is most often asymptomatic and is revealed by chance. This study presents a case report of a 43-year-old man, in whom colorectal cancer was suspected due to the suggestive clinical picture (abdominal pain, constipation, weight loss, a family history of colorectal cancer) and the suspicion of a proliferative process described in an outpatient ultrasound examination of the abdominal cavity. As a result of the performed diagnostics, no proliferative process was found in the patient, and the previously diagnosed lesion that raised the suspicion of cancer turned out to be the right kidney located in the pelvis. The presented case report shows that renal ectopia may cause diagnostic difficulties, among others in patients diagnosed with a neoplastic process.Rak jelita grubego i jego diagnostyka pozostają istotnym problemem klinicznym. Ektopia nerki jest jedną z głównych anomalii rozwojowych układu moczowego, chociaż występuje stosunkowo rzadko w populacji ogólnej. Najczęściej przebiega bez objawów i jest wykrywana przypadkowo. W pracy przedstawiono opis przypadku 43-letniego mężczyzny, u którego podejrzewano raka jelita grubego z powodu sugestywnego obrazu klinicznego (ból brzucha, zaparcie, spadek masy ciała, obciążający wywiad rodzinny w kierunku raka jelita grubego) oraz podejrzenia procesu rozrostowego na podstawie wykonanego ambulatoryjnie badania ultrasonograficznego jamy brzusznej. W wyniku przeprowadzonej diagnostyki nie stwierdzono u chorego procesu rozrostowego, rozpoznawana zaś uprzednio zmiana budząca podejrzenie nowotworu okazała się położoną w miednicy prawą nerką. Przedstawiony opis przypadku pokazuje, że ektopia nerki może powodować trudności diagnostyczne, m.in. u chorych diagnozowanych w kierunku procesu rozrostowego jelita

Parazytoza przewodu pokarmowego rozpoznana w kolonoskopii jako przyczyna spadku masy ciała u 46-letniej kobiety z ujemnym wynikiem trzykrotnie wykonanego badania kału na obecność pasożytów

Parasitic infections of the digestive tract remain an important health problem on a global scale. The current epidemiological situation in Poland is unknown because most parasitic diseases, including all caused by helminths, are not subject to reporting. Clinical practice shows that diseases of such etiology are sometimes overlooked in the process of differential diagnosis. In addition, the commonly available classical examination of a stool sample utilizing a light microscope is a relatively low-sensitivity test. This study presents a case report of a 46-year-old patient admitted to the Clinic for planned diagnostics due to weight loss without other gastrointestinal symptoms. In the course of the diagnosis, it occurred that the cause of the weight loss was a parasitic infestation of the gastrointestinal tract with roundworms, which were observed in a colonoscopy, but no parasites were found in the collected material in stool examinations performed three times. The presented case report demostrates that parasitic diseases still should be taken into consideration in clinical practice in the process of differential diagnosis. In addition, further effort is needed to improve the sensitivity of parasitological diagnostic methods. Moreover, there is a need for research on the current epidemiological situation in Poland in the field of gastrointestinal parasitosis.Zarażenia pasożytnicze przewodu pokarmowego pozostają ważnym problemem zdrowotnym w skali globalnej. Aktualna sytuacja epidemiologiczna w Polsce nie jest znana, ponieważ większość chorób pasożytniczych, w tym wszystkie robaczyce, nie podlega obowiązkowi raportowania. Praktyka kliniczna pokazuje, że choroby o takiej etiologii bywają pomijane w procesie diagnostyki różnicowej. Ponadto powszechnie dostępne klasyczne badanie próbki kału w mikroskopie świetlnym jest badaniem o stosunkowo niskiej czułości. W pracy przedstawiono opis przypadku 46-letniej pacjentki, przyjętej do Kliniki w celu planowej diagnostyki z powodu spadku masy ciała, bez innych dolegliwości ze strony przewodu pokarmowego. W toku diagnostyki wykazano, że przyczyną spadku masy ciała była infestacja pasożytnicza przewodu pokarmowego robakami obłymi, co stwierdzono w kolonoskopii, natomiast trzykrotnie wykonane badanie kału nie wykazało obecności pasożytów w pobranym materiale. Przedstawiony opis przypadku pokazuje, że o chorobach pasożytniczych nadal należy pamiętać w praktyce klinicznej i uwzględniać je w procesie diagnostyki różnicowej. Ponadto potrzebne są prace nad poprawą czułości metod diagnostyki parazytologicznej. Konieczne są również badania dotyczące aktualnej sytuacji epidemiologicznej w Polsce w zakresie parazytoz przewodu pokarmowego

Arterial Stiffness Assessment by Pulse Wave Velocity in Patients with Metabolic Syndrome and Its Components: Is It a Useful Tool in Clinical Practice?

Metabolic syndrome (MS) is not a single disease but a cluster of metabolic disorders associated with increased risk for development of diabetes mellitus and its complications. Currently, the definition of MS published in 2009 is widely used, but there are more versions of the diagnostic criteria, making it difficult to conduct scientific discourse in this area. Increased arterial stiffness (AS) can predict the development of cardiovascular disease both in the general population and in patients with MS. Pulse wave velocity (PWV), as a standard method to assess AS, may point out subclinical organ damage in patients with hypertension. The decrease in PWV level during antihypertensive therapy can identify a group of patients with better outcomes independently of their reduction in blood pressure. The adverse effect of metabolic disturbances on arterial function can be offset by an adequate program of exercises, which includes mainly aerobic physical training. Non-insulin-based insulin resistance index can predict AS due to a strong positive correlation with PWV. The purpose of this paper is to present the results of the review of the literature concerning the relationship between MS and its components, and AS assessed by PWV, including clinical usefulness of PWV measurement in patients with MS and its components

Endothelial Function Assessment by Flow-Mediated Dilation Method: A Valuable Tool in the Evaluation of the Cardiovascular System

Cardiovascular diseases (CVDs) in the course of atherosclerosis are one of the most critical public health problems in the world. Endothelial cells synthesize numerous biologically active substances involved in regulating the functions of the cardiovascular system. Endothelial dysfunction is an essential element in the pathogenesis of atherosclerosis. Thus, the assessment of endothelial function in people without overt CVD allows for a more accurate estimate of the risk of developing CVD and cardiovascular events. The assessment of endothelial function is primarily used in scientific research, and to a lesser extent in clinical practice. Among the tools for assessing endothelial function, we can distinguish biochemical and physical methods, while physical methods can be divided into invasive and non-invasive methods. Flow-mediated dilation (FMD) is based on the ultrasound assessment of changes in the diameter of the brachial artery as a result of increased blood flow. FMD is a non-invasive, safe, and repeatable test, but it must be performed by qualified and experienced medical staff. The purpose of this paper is to present the literature review results on the assessment of endothelial function using the FMD method, including its methodology, applications in clinical practice and research, limitations, and future perspectives

“Obesity and Insulin Resistance” Is the Component of the Metabolic Syndrome Most Strongly Associated with Oxidative Stress

Metabolic syndrome (MS) is not a homogeneous entity, but this term refers to the coexistence of factors that increase the risk for the development of type 2 diabetes and cardiovascular disease. There are different versions of the criteria for the diagnosis of MS, which makes the population of patients diagnosed with MS heterogeneous. Research to date shows that MS is associated with oxidative stress (OS), but it is unclear which MS component is most strongly associated with OS. The purpose of the study was to investigate the relationship between the parameters of OS and the presence of individual elements of MS in young adults, as well as to identify the components of MS by means of principal components analysis (PCA) and to investigate how the parameters of OS correlate with the presence of individual components. The study included 724 young adults with or without a family history of coronary heart disease (population of the MAGNETIC study). Blood samples were taken from the participants of the study to determine peripheral blood counts, biochemical parameters, and selected parameters of OS. In addition, blood pressure and anthropometric parameters were measured. In subjects with MS, significantly lower activity of superoxide dismutase (SOD), copper- and zinc-containing SOD (CuZnSOD), and manganese-containing SOD (MnSOD) were found, along with significantly higher total antioxidant capacity (TAC) and significantly lower concentration of thiol groups per gram of protein (PSH). We identified three components of MS by means of PCA: “Obesity and insulin resistance”, “Dyslipidemia”, and “Blood pressure”, and showed the component “Obesity and insulin resistance” to have the strongest relationship with OS. In conclusion, we documented significant differences in some parameters of OS between young adults with and without MS. We showed that “Obesity and insulin resistance” is the most important component of MS in terms of relationship with OS