Komunikacja w wojsku w sytuacjach niepewności

The present publication presents problems of communication in situations of insecurity in staff commanders of the Armed Forces. It refers to the problems of verbal and non-verbal communication in hierarchical structures and its importance in the process of communicating in difficult situationsNiniejsza publikacja prezentuje problematykę komunikowania w sytuacjach niepewności wśród kadry dowódczej Sił Zbrojnych. Odnosi się do problemów komunikowania werbalnego i niewerbalnego w strukturach zhierarchizowanych i jej znaczenia w procesie porozumiewania się w trudnych sytuacjac

A comparison of pathological findings in head computed to-mography with clinical presentation of pediatric patients in the Emergency Department

Pediatric trauma is a cause for over 750.000 visits to emergency departments each year. Of all types of traumas, head injuries represent the group at most risk. Computed tomography (CT) is still the most frequently used advanced imaging method to distinguish cases of severe injuries out of thousands of mild or apparently trivial injuries. The aim of this study was to review the results of CT in terms of clinical prediagnosis and radiological findings in children categorized into four age groups, who underwent a CT scan in the Pediatric Emergency Department (ED). Among all CT studies, no findings were found in 552 (80.23%) patients, whereas CT findings were detected in 98 (14.2%) boys and 38 (5.5%) girls from all participants. The incidence of lesions in the male group is 2 times higher than in the female group. The most common abnormality was hematoma representing 26.47% of all confirmed lesions and 5.23% among all head CTs performed from the ED. Head CT is an incredibly useful tool in the evaluation of some head emergencies. However, in the majority of cases, the clinical presentation with which children present to the ED does not correlate with the severity of neuroimaging results

The role of imaging techniques in the diagnostics and monitoring of treatment of Sturge-Weber’s syndrome

Sturge-Weber\u27s syndrome (encephalotrigeminal angiomatosis) is a rare, non-hereditary syndrome of congenital abnormalities. It is one of the phakomatoses. The incidence of this syndrome is estimated at 1 in 20,000 - 50,000 live births. The cause of SWS is a somatic mutation in the GNAQ gene. A typical picture of a person suffering from SWS is a child with vascular malformation on the face - a \u27port-wine stain\u27 birthmark. Other clinical symptoms include seizures, glaucoma, headache, stroke-like transient neurological deficits, and behavior problems

Polysplenia and other anatomical variants of the spleen

The anatomy, physiology and embryology of the spleen are essential fields of study for the determination of congenital varieties as well as the pathological processes occurring in this organ.The aim of this study is to summarize the current knowledge on the proper development of the spleen and to present structural variants that may be of clinical significance or be important from the radiologist's point of view.Structural changes of the spleen may result in non-specific clinical symptoms, which may confuse an inexperienced physician. Inaccurate diagnosis and late diagnosis have various negative, often even fatal, consequences. In order to make an appropriate diagnosis, and thus help the patient in a timely manner, it is necessary to have extensive knowledge about the variants of the structure of the spleen. Knowledge of anatomical variations is essential for the development of a differential diagnosis, which enables the correct diagnosis to be made

Ketoacidosis and otitis media as a potencial cause of cerebral venous thrombosis in a 7-year-old boy

Cerebral venous sinus thrombosis (CVST) in childhood is a rare disorder, occurring most often in the neonatal period, with mortality approaching 10%. This condition has multifactorial etiology including common childhood illnesses such as fever, infection, dehydration, and anemia, as well as acute and chronic medical conditions such as congenital heart disease, nephrotic syndrome,  and malignancy. Thrombosis can also develop and propagate in response to local venous stasis. A large number of children have coincident local head or neck pathology, including head trauma, brain tumors, or recent intracranial surgery. Clinical symptoms are frequently nonspecific and include seizures, depressed level of consciousness, coma, lethargy, nausea, vomiting, headache, visual impairment, papilledema, and hemiparesis, which may often obscure the diagnosis and delay treatment. In the case of patients with neurological symptoms, imaging studies such as computed tomography (CT)  and magnetic resonance imaging (MRI) are invaluable in diagnostics of various pathologies of the nervous system, because of their non-invasiveness, high sensitivity, and specificity. Early diagnosis with management along with a plan for secondary prevention can save from catastrophic consequences

A comparison of pathological findings in head computed to-mography with clinical presentation of pediatric patients in the Emergency Department

Pediatric trauma is a cause for over 750.000 visits to emergency departments each year. Of all types of traumas, head injuries represent the group at most risk. Computed tomography (CT) is still the most frequently used advanced imaging method to distinguish cases of severe injuries out of thousands of mild or apparently trivial injuries. The aim of this study was to review the results of CT in terms of clinical prediagnosis and radiological findings in children categorized into four age groups, who underwent a CT scan in the Pediatric Emergency Department (ED). Among all CT studies, no findings were found in 552 (80.23%) patients, whereas CT findings were detected in 98 (14.2%) boys and 38 (5.5%) girls from all participants. The incidence of lesions in the male group is 2 times higher than in the female group. The most common abnormality was hematoma representing 26.47% of all confirmed lesions and 5.23% among all head CTs performed from the ED. Head CT is an incredibly useful tool in the evaluation of some head emergencies. However, in the majority of cases, the clinical presentation with which children present to the ED does not correlate with the severity of neuroimaging results

RHD variant in RhD/-/ mother with anti-D makes noninvasive fetal RHD genotyping impossible

Abstract Objectives: Noninvasive fetal RHD genotyping from maternal plasma of RhD(/-) pregnant women of Caucasian race may be used for predicting the risk of hemolytic disease because the RHD gene is usually absent in such populations. If detected in plasma of such women, the RHD gene originates from the RhD(+) fetus. The number of fetal copies of the gene in maternal plasma is extremely small. In the presented case of the RhD(/-) pregnant woman with anti-D it was impossible to give a fetal RHD result due to mother’s RHD(+) genotype. The fetal RHD was determined from amniocytes. Aim: to present the difficulties related to the interpretation of results of invasive and noninvasive procedures. Material and methods: whole blood, plasma and amniotic fluid of the RhD(-) woman with anti-D (14 week of pregnancy) as well as whole blood of the newborn. RHD and RHCE*c were genotyped by real-time PCR in DNA isolated from maternal plasma and amniocytes and the RHD and d-genotypes were tested by SSP methods in DNA isolated from whole blood and amniocytes . Results: RHD and RHCE*c were detected in DNA isolated from plasma. The high level of RHD suggested its origin from the mother’s DNA therefore it was impossible to determine the fetal RHD. The d-little test identified a RHD(IVS3+1G>A) variant in the mother’s genome. A weak signal of real-time PCR for the RHD was obtained in amniocytes but the RHD was not detected by SSP. The RHCE*c was detected by both methods. Results were inconclusive; the fetal RHD status remained unknown. The child was RhD(-) with RHD in its DNA undetected by either method. Conclusions: 1/ The RHD(IVS3+1G>A) variant in the RhD(-) mother precluded formal noninvasive fetal RHD genotyping. 2/Real-time PCR is too sensitive for amniocyte testing and may lead to false results as it detects trace maternal DNA in amniotic fluid 3/ The frequency of RHD(IVS3+1G>A) occurrence in Poland requires further studies

Stężenie interleukiny-6, receptora dla interleukiny-6 i glikoproteiny 130 oraz cytokin zależnych od limfocytów Th17 u pacjentek z cukrzycą ciążową

Introduction: Interleukin-6 (IL-6) is a pleiotropic cytokine which signals through a cell surface receptor complex consisting of a cognatereceptor subunit (IL-6R) and glycoprotein 130 (gp130), which is considered an antagonist to the IL-6R/IL-6 pathway. The aim of the present study was to assess IL-6/IL-6R/gp130 system and Th17 associated cytokines in different time points during and after pregnancy in women with gestational diabetes mellitus (GDM) and normal glucose tolerance (NGT).Material and methods: Serum levels of IL-6, sIL6R, sgp130, IL-17 and IL-23 were measured in 91 women divided into three groups: GDMin the 24th–28th week of gestation (visit 1), NGT at the 1st visit and GDM in the 29th-32nd week, and NGT at both visits.Results: The patients with GDM recognised at the 1st visit had significantly higher IL-6 (p = 0.02) and sgp130 (p = 0.03) concentrations than had the women with NGT, whereas the women with GDM diagnosed at the 2nd visit had elevated sIL-6R concentrations (p = 0.03). The patients with low sIL-6R but high sgp130 concentration had significantly higher glucose levels (p = 0.04) and lower IL-6 values (p = 0.04) than had the patients with low sIL-6R and sgp130 concentrations. IL-17 and IL-23 were detected in approximately one-third of the population studied. A trend towards higher IL-17 levels was observed in the subjects with GDM, but the differences were not significant.Conclusions: Our results suggest that an increased serum sgp130 concentration in the patients with GDM might represent a compensatory mechanism, controlling intracellular IL-6 signalling and preventing the activation of the IL-6/IL-6R pathway.Wstęp: Interleukina-6 (IL-6) jest plejotropową cytokiną, która przekazuje sygnał do wnętrza komórki za pośrednictwem receptora błonowego złożonego z właściwej podjednostki receptorowej (Il-6R) i glikoproteiny 130 (gp130), uważanej za antagonistę kompleksu IL-6R//IL-6. Celem pracy była analiza szlaku IL-6/IL-6R/gp130 i cytokin zależnych od limfocytów Th17 w II i III trymestrze ciąży oraz po porodzie u pacjentek z cukrzycą ciążową i prawidłową tolerancją glukozy.Materiał i metody: Dokonano pomiaru stężenia IL-6, IL6R, gp130, IL-17 i IL-23 w surowicy 91 kobiet podzielonych na 3 podgrupy: pacjentki z cukrzycą ciążową zdiagnozowaną w 24.–28. tygodniu ciąży (wizyta 1), pacjentki z prawidłową tolerancją glukozy w trakcie 1 wizyty i cukrzycą ciążową rozpoznaną w 29.–32. tygodniu ciąży oraz pacjentki z prawidłową tolerancją glukozy w trakcie obu wizyt.Wyniki: U pacjentek z cukrzycą ciążową rozpoznaną w trakcie 1 wizyty wykazano istotnie wyższe stężenia IL-6 (p = 0,02) i gp130(p = 0,03) w porównaniu z kobietami z prawidłową tolerancją glukozy, podczas gdy pacjentki z cukrzycą ciążową rozpoznaną w trakcie 2 wizyty charakteryzowały się wyższym stężeniem IL-6R (p = 0,03). U pacjentek z niskim stężeniem IL-6R i wysokim stężeniem gp130 obserwowano znamiennie wyższe wartości glikemii (p = 0,04) i niższe stężenia IL-6 (p = 0,04) w porównaniu z kobietami z niskimi stężeniami IL-6R i sgp130. Obecność krążących IL-17 i IL-23 stwierdzono u około 1/3 spośród badanych kobiet. Wykazano również tendencję do wyższych stężeń IL-17 u pacjentek z cukrzycą ciążową, różnice nie były jednak istotne statystycznie.Wnioski: Wyniki sugerują, że podwyższone stężenie gp130, obserwowane u kobiet z cukrzycą ciążową, może stanowić mechanizm kompensacyjny, zapobiegający nadmiernej aktywacji szlaku IL-6/IL-6R

The current possible treatment approaches of Polycystic Ovary Syndrome (PCOS)

Introduction             Polycystic ovary syndrome (PCOS), first described by Stein and Leventhal in 1935, is one of the most prevalent endocrine system conditions affecting women of reproductive age. It affects between 6% and 13% of women and the majority of cases are identified between the ages of 20 and 30. Unfortunately, the disease is usually diagnosed only when bothersome symptoms such as hair loss, alopecia, acne, and infertility-related problems occur. Based on the Rotterdam criteria, four phenotypes of PCOS are distinguished. Aim of the study             This review aims to present the current state of knowledge about possible treatment approaches, both non-pharmacological and pharmacological. Materials and methods            The paper was created based on the Pubmed database. The literature was reviewed using the keywords: ”PCOS”, ”PCOS treatment” and “ PCOS medications “. The current state of knowledge           Treatments for PCOS must be tailored to the specific needs of each patient. In the management of PCOS, special attention is paid to diet, physical activity, and restoration of the Gut Microbiome. Medications used in therapy are oral contraceptives and anti-androgens, insulin sensitizers, ovulation inducers, calcium and vitamin D supplements, statins, Glucagon-like-peptide-1 (GLP-1) agonists, inositols and interleukin 22 (IL-22)  therapy. Summary            Treatment options for menstrual irregularities and hirsutism are based on the clinical goals and preferences of the patient. The ideal would be causal treatment, but due to the ongoing lack of full understanding of the pathogenesis of the syndrome, is not entirely feasible. The ideal would be causal treatment, but due to the ongoing lack of full understanding of the pathogenesis of the syndrome, is not entirely feasible. The most important is a multimodal approach to treat comorbid conditions such as diabetes mellitus type 2, obesity, hyperlipidemia, depression, and infertility

The multimodal approach to obesity treatment – current pharmacological and surgical methods and lifestyle changes

Introduction            Obesity is one of the major health problems of today’s population and is defined as a body mass index ≥ 30 kg/m2.  It is known that obesity may cause many complications such as type 2 diabetes, cardiovascular disease, osteoarthritis, obstructive sleep, apnoea, and several cancers. The only effective treatment of obesity can be pharmacological or surgical, especially when a years-long attempt to change habits has had no effects.  Aim of the study This review aims to present the current state of knowledge about non-pharmacological and pharmacological obesity treatment methods. Materials and methods            The paper was created based on the Pubmed database. The literature was reviewed using the keywords: ”obesity”, ”obesity treatment”, “ obesity lifestyle changes”, “obesity medications” and ”obesity surgery”. The current state of knowledge           The treatment of obesity requires a multimodal approach to treatment, including the addition of anti-obesity medications or bariatric surgery, or both, to assist people in reaching and sustaining sufficient weight loss to meet treatment goals. The 3 principal components of a comprehensive lifestyle intervention are diet, physical activity, and behavioral therapy. Among available anti-obesity medications include orlistat, phentermine, topiramate, naltrexone, bupropion, liraglutide, and semaglutide. Summary            The key challenge in the treatment of obesity is to maintain the effects obtained with multimodal therapy. Without proper motivation of patients and changes in eating and behavioral habits, it is impossible to achieve optimal results, therefore, in addition to medical interventions, more and more attention should be paid to psychological interventions