A review of ultrasonographic methods for the assessment of the anterior cruciate ligament in patients with knee instability – diagnostics using a posterior approach

Aim: The purpose of the study was to improve the ultrasonographic assessment of the anterior cruciate ligament by an inclusion of a dynamic element. The proposed functional modification aims to restore normal posterior cruciate ligament tension, which is associated with a visible change in the ligament shape. This method reduces the risk of an error resulting from subjectively assessing the shape of the posterior cruciate ligament. It should be also emphasized that the method combined with other ultrasound anterior cruciate ligament assessment techniques helps increase diagnostic accuracy. Methods: Ultrasonography is used as an adjunctive technique in the diagnosis of anterior cruciate ligament injury. The paper presents a sonographic technique for the assessment of suspected anterior cruciate ligament insufficiency supplemented by the use of a dynamic examination. This technique can be recommended as an additional procedure in routine ultrasound diagnostics of anterior cruciate ligament injuries. Results: Supplementing routine ultrasonography with the dynamic assessment of posterior cruciate ligament shape changes in patients with suspected anterior cruciate ligament injury reduces the risk of subjective errors and increases diagnostic accuracy. This is important especially in cases of minor anterior knee instability and bilateral anterior knee instability. Conclusions: An assessment of changes in posterior cruciate ligament using a dynamic ultrasound examination effectively complements routine sonographic diagnostic techniques for anterior cruciate ligament insufficiency

Przegląd metod oceny ultrasonograficznej więzadła krzyżowego przedniego w niestabilności przedniej stawu kolanowego – diagnostyka z dostępu tylnego

Aim: The purpose of the study was to improve the ultrasonographic assessment of the anterior cruciate ligament by an inclusion of a dynamic element. The proposed functional modification aims to restore normal posterior cruciate ligament tension, which is associated with a visible change in the ligament shape. This method reduces the risk of an error resulting from subjectively assessing the shape of the posterior cruciate ligament. It should be also emphasized that the method combined with other ultrasound anterior cruciate ligament assessment techniques helps increase diagnostic accuracy. Methods: Ultrasonography is used as an adjunctive technique in the diagnosis of anterior cruciate ligament injury. The paper presents a sonographic technique for the assessment of suspected anterior cruciate ligament insufficiency supplemented by the use of a dynamic examination. This technique can be recommended as an additional procedure in routine ultrasound diagnostics of anterior cruciate ligament injuries. Results: Supplementing routine ultrasonography with the dynamic assessment of posterior cruciate ligament shape changes in patients with suspected anterior cruciate ligament injury reduces the risk of subjective errors and increases diagnostic accuracy. This is important especially in cases of minor anterior knee instability and bilateral anterior knee instability. Conclusions: An assessment of changes in posterior cruciate ligament using a dynamic ultrasound examination effectively complements routine sonographic diagnostic techniques for anterior cruciate ligament insufficiency.Cel pracy: Celem pracy jest ocena możliwości poprawienia ultrasonograficznej oceny niewydolności więzadła krzyżowego przedniego poprzez wprowadzenie elementu badania dynamicznego. Modyfikacja czynnościowa ma na celu przywrócenie prawidłowego napięcia więzadła krzyżowego tylnego, czemu towarzyszy widoczna zmiana jego kształtu. Opisywana metoda zmniejsza ryzyko popełnienia błędu wynikającego z subiektywnej oceny kształtu więzadła krzyżowego tylnego i – co należy podkreślić – w połączeniu z innymi sposobami ultrasonograficznej oceny więzadła krzyżowego przedniego pozwala zwiększyć trafność diagnozy. Metoda: Jako metodę wspomagającą w diagnostyce uszkodzeń więzadła krzyżowego przedniego wykorzystuje się ultrasonografię. W pracy przedstawiono technikę badania i oceny ultrasonograficznej wydolności więzadła rozszerzoną o badanie dynamiczne. Technika ta może być rekomendowana jako dodatkowa procedura w diagnostyce ultrasonograficznej uszkodzeń więzadła krzyżowego przedniego. Rezultaty: Podczas ultrasonograficznego badania pacjentów z podejrzeniem uszkodzenia więzadła krzyżowego przedniego uzupełnionego metodą dynamicznej oceny zmiany kształtu więzadła krzyżowego tylnego zmniejsza się ryzyko popełnienia subiektywnego błędu przy ocenie i zapewnia większą trafność diagnozy. Ma to znaczenie zwłaszcza u osób z niewielką niestabilnością przednią stawu kolanowego, jak również z niestabilnością przednią występującą jednocześnie w obu stawach kolanowych. Wnioski: Ocena zmiany przebiegu więzadła krzyżowego tylnego w badaniu dynamicznym USG skutecznie uzupełnia dotychczasowe sposoby diagnozowania niewydolności więzadła krzyżowego przedniego

The use of various types of hip prostheses depending on the patient’s age and level of everyday activity

Hip replacement surgery is becoming more and more common in clinical practice, as a growing number of patients qualify to receive this form of treatment. This is because the aging of the society, high prevalence of overweight, and little physical activity contribute to the development of osteoarthritis. Moreover, patients have come to expect good quality of life even at advanced age. Thanks to progress in surgical techniques, these expectations can now be met. Endoprosthesis selection – apart from medical indications – must be based on the patient’s age, everyday activity, and further plans. There are two main types of clinical situations where hip arthroplasty is performed; these are hip joint degeneration and femoral neck fracture. This article aims to present current options of total hip replacement to healthcare professionals who wish to learn more on the subject, including physical therapists, nurses, and professional caretakers for patients with walking difficulties

The Covid 19 pandemic as a factor of compliance with the rules of hand hygiene of hospital staff:: assessment of the usefulness of the “Clean Care is a Safer Care” program as a tool to enhance compliance with hand hygiene principles in hospital conditions.

Introduction. Hand cleansing and disinfection is the most effi- cient method for reducing the rates of hospital-acquired infections which are a serious medical and economic problem. Striving to ensure the maximum safety of the therapeutic process, we decided to promote hand hygiene by implementing the educational pro- gram titled “Clean Care is a Safer Care”. The occurrence of the COVID-19 pandemic affected the compliance with procedures related to the sanitary regime, including the frequency and accu- racy of hand decontamination by medical personnel. Objective. The objective of the study was to assess the useful- ness of the educational program titled “Clean Care is a Safer Care” as a tool for increasing compliance with hand hygiene principles. Methods. We monitored the compliance with the hygiene proce- dure before implementation of the program as well as during the hand hygiene campaign by means of direct observation as well as the disinfectant consumption rates. Results. In the initial self-assessment survey, the hospital had scored 270/500 points (54%). Preliminary audit revealed the hygiene compliance rate at the level of 49%. After broad-scaled educational efforts, the semi-annual audit revealed an increase in hand hygiene compliance rate up to 81% (hospital average) while the final audit carried out after one year of campaigning revealed a compliance rate of 77%. The final score for the hospi- tal increased to 435/500 points. Conclusions. COVID-19 pandemic dramatically increased accu- racy of proper hand hygiene procedures and consumption of dis- infectant agents. The educational program has succeeded to reach its goal; however, long-term educational efforts are required to maintain and improve the quality of provided services

Basic Differences and Most Common Findings in Ultrasound Examinations of Musculoskeletal System in Children: A Narrative Literature Review

We present basic differences in the musculoskeletal ultrasound examinations between adults and children. Examiners who deal with adults on a daily basis have shared concerns about examining children. Such concerns may arise from the different approach to child ultrasounds, but they also come from differences in anatomical characteristics according to developmental age. We discuss the presence of growth plates, as well as non-mineralized parts of the bones. We also refer to the pathologies most often found in ultrasounds in early developmental stages. In the PubMed database, the set of keywords: “msk ultrasound in children”, “pediatric msk sonoanatomy”, “coxitis fugax”, “pediatric Baker’s cyst”, “Baker’s cyst ultrasonography”, “bone septic necrosis in ultrasonography”, “ultrasonography in juvenile idiopathic arthritis”, and “ultrasonography in juvenile spondyloarthropathies”, was used to identify a total of 1657 results, from which 54 was selected to be included in the article. We discuss the problem of osteochondritis dissecans, Osgood-Schlatter disease, examples of ligament injuries (especially in relation to the knee and ankle joints), exfoliation of growth cartilages, osteochondroma, exudates and inflammations affecting joints, and Baker’s cysts. In this way, we have collected useful information about the most common diseases of the musculoskeletal system in children

Wsparcie ICT i środowiskowe dla pacjentów z zespołem słabości: projekt CareWell, projekt Focus i projekt SUNFRAIL

Maintaining wellbeing and independence by elderly people results from implementing the rules of “successful aging” , based on activity and participation in professional and social life, as well promotion of healthy lifestyle. Increasingly greater importance is attributed to frailty syndrome among patients of old age. These patients are characterized by increased sensitivity to stimuli, impaired ability to cope with inner and environmental stressinducing factors, and they also have limited ability to maintain the state of physiological and psychosocial homeostasis. In such cases it is necessary to provide the patients with integrated care based on the support of the environment and the latest technology. Providing the residents of Lower Silesian Province with high quality of life, adjusting social services to residents’ needs, and social integration alone are compliant with The Strategy of Social Integration in Lower Silesia. For that reason, supporting such patients with technology in Lower Silesia was started with the CareWell and WRP® pilot projects. The use of the latest technologies requires a social campaign, media-distributed information, and awakening social interest or even a trend related to their use. It will allow the refining of new services, reduce costs and improve safety for people. Instead of costly specialist care, elderly patients will receive individualized care located within the environment, which will be less costly but more intensive. The FOCUS project deals with reducing the frailty syndrome load in the population of elderly Founpeople in Europe, taking note of enhancing the environmental support. The purpose of the SUNFRAIL project is to improve the identification, prevention and management of frailty, and care of multimorbidity by regional centers and institutions in EU countries of people aged 65 years and over living in the local community.Zachowania dobrostanu i samodzielności przez osoby starsze wynika z wdrażania zasad „dobrego starzenia się” opartego na aktywności i uczestnictwie w życiu zawodowym i społecznym oraz promocji zdrowego stylu życia. Coraz większe znaczenie przypisuje się rozpowszechnieniu zespołu słabości wśród pacjentów w wieku podeszłym. Pacjenci ci charakteryzują się zwiększoną wrażliwością na bodźce, upośledzoną zdolnością do radzenia sobie z wewnętrznymi i środowiskowymi czynnikami stresogennymi, a także posiadają ograniczoną zdolność do utrzymania stanu fizjologicznej i psychospołecznej homeostazy W takich przypadkach konieczne jest wsparcie pacjentów opieką zintegrowaną polegającą na wsparciu środowiska oraz najnowszej technologii. Zapewnienie mieszkańcom województwa dolnośląskiego wysokiej jakości życia, dopasowanie usług społecznych do potrzeb mieszkańców oraz sama integracja społeczna są zgodne ze Strategia Integracji Społecznej na Dolnym Śląsku. Dlatego też, na Dolnym Śląsku wsparcie takich pacjentów technologią, zostało zapoczątkowane pilotażem projektu CareWell i WRP®. Zastosowanie nowych technologii wymaga kampanii społecznej, informacji w mediach i wzbudzenia społecznego zaciekawienia, wręcz mody na ich stosowanie. Pozwoli to na doskonalenie nowych usług, obniżenie kosztów i poprawę bezpieczeństwa ludzi. W miejsce kosztownej opieki specjalistycznej pacjenci w wieku podeszłym uzyskują opiekę indywidualizowaną, lokowaną w środowisku, mniej kosztowną lecz bardziej intensywną. Projekt FOCUS zajmuje się zmniejszeniem obciążenia zespołem słabości w populacji osób w wieku podeszłym w Europie z uwzględnieniem wzmocnienia wsparcia środowiskowego. Celem projektu SUNFRAIL jest poprawa identyfikacji, zapobiegania i zarządzanie zespołem słabości oraz opieką nad wielochorobowością wśród osób po 65 roku życia mieszkających w społeczności lokalnej przez regionalne ośrodki i instytucje krajów UE

Physical Conditions Prevailing in the Nasal and Maxillary Sinus Cavities Based on Numerical Simulation

Background and Objectives: This paper presents a unique study that links the physical conditions in the nasal passage with conditions that favour the development of bacterial strains and the colonization of the mucous membranes of the nose and paranasal sinuses. The physical parameters considered were air flow, pressure, humidity, and temperature. Materials and Methods: Numerical models of the human nose and maxillary sinus were retrospectively reconstructed from CT images of generally healthy young subjects. The state-of-the-art numerical methods and tools were then used to determine the temperature, humidity, airflow velocity, and pressure at specific anatomical locations. Results: The results were compared with optimal conditions for bacterial growth in the nose and sinuses. Conclusions: Temperature, humidity, air velocity, and pressure were shown to play critical roles in the selection and distribution of microorganisms. Furthermore, certain combinations of physical parameters can favour mucosal colonisation by various strains of bacteria