Finansowe uwarunkowania decyzji ekonomicznych

Praca recenzowana / peer-reviewed pape

Mechanical thrombectomy in acute stroke – Five years of experience in Poland

Objectives Mechanical thrombectomy (MT) is not reimbursed by the Polish public health system. We present a description of 5 years of experience with MT in acute stroke in Comprehensive Stroke Centers (CSCs) in Poland. Methods and results We retrospectively analyzed the results of a structured questionnaire from 23 out of 25 identified CSCs and 22 data sets that include 61 clinical, radiological and outcome measures. Results Most of the CSCs (74%) were founded at University Hospitals and most (65.2%) work round the clock. In 78.3% of them, the working teams are composed of neurologists and neuro-radiologists. All CSCs perform CT and angio-CT before MT. In total 586 patients were subjected to MT and data from 531 of them were analyzed. Mean time laps from stroke onset to groin puncture was 250±99min. 90.3% of the studied patients had MT within 6h from stroke onset; 59.3% of them were treated with IV rt-PA prior to MT; 15.1% had IA rt-PA during MT and 4.7% – emergent stenting of a large vessel. M1 of MCA was occluded in 47.8% of cases. The Solitaire device was used in 53% of cases. Successful recanalization (TICI2b–TICI3) was achieved in 64.6% of cases and 53.4% of patients did not experience hemorrhagic transformation. Clinical improvement on discharge was noticed in 53.7% of cases, futile recanalization – in 30.7%, mRS of 0–2 – in 31.4% and mRS of 6 in 22% of cases. Conclusion Our results can help harmonize standards for MT in Poland according to international guidelines

STATURE AND RELATIVE BODY WEIGHT OF; POLISH CONSCRIPTS IN 1976 AND 1986: SECULAR CHANGES AND URBANIZATION - DEPENDENDENT GRADIENT

Statural gains were of similar magnitude, ca. 2.0 cm., in each of the five categories of urbanization defined by population size of the locality of habitation. As a result, the regular urbanization-dependent gradient in stature, first detected in the 1976'cohort, reappears in little changed form 10 years later. No significant secular changes and no regular gradients can be seen in weight-for-height

STATURE AND RELATIVE BODY WEIGHT OF; POLISH CONSCRIPTS IN 1976 AND 1986: SECULAR CHANGES AND URBANIZATION - DEPENDENDENT GRADIENT

Statural gains were of similar magnitude, ca. 2.0 cm., in each of the five categories of urbanization defined by population size of the locality of habitation. As a result, the regular urbanization-dependent gradient in stature, first detected in the 1976'cohort, reappears in little changed form 10 years later. No significant secular changes and no regular gradients can be seen in weight-for-height

Laparoscopy-Assisted Total Gastrectomy with D2 Lymphadenectomy and Roux-En-Y Reconstruction - Case Report

We report a case of patient with stage IIIb gastric cancer qualified for laparoscopy - assisted gastrectomy and our first impressions about this procedure. Total gastrectomy with complete omentectomy and extended lymphadenectomy (D2) was performed laparoscopically. The intestinal continuity was restored in a Roux-en-Y mode extracorporeally through the abdominal access system. The orogastric tube with anvil of the circular stapler was transorally introduced into the esophagus. Subsequently, intracorporeal stapling esophagojejunostomy was performed. There were no complications after the operation and the patient was discharged in good shape. Oncological radicality was sufficient and patient has undergone chemotherapy treatment

Gall-Stone Ileus – Own Patients And Literature Review

Cholelithiasis is diagnosed in 10% of the population of the USA and Western Europe. A rare but serious complication of cholelithiasis is the obstruction of the digestive tract caused by a gall-stone (Bernard syndrome). It can add up to 1-4% of the mechanical obstructions of a small intestine among the general population but it can result in nonstriangulational mechanical obstructions of a small intestine in 25% cases among the patients over the age of 65. 5 patients have undergone an operation due to a small intestine gall-stone ileus in years 2011-2013 (within 27 months) in the General Surgery Ward of the Beskid Oncology Center - Municipal Hospital. In 4 patients simple enterotomy with a gall-stone extraction was performed. In the fifth patient enterolitotomy was conducted together with cholecystectomy and fistulotomy