Correlation between Endosonographic and Doppler Ultrasound Features of Portal Hypertension in Patients with Cirrhosis

Purpose. Endoscopic ultrasound (EUS) permits the detailed visualization of clinically significant features of portal hypertension; however, it is an invasive procedure that is not widely available. The aim of this cross-sectional study was to determine whether a correlation exists between the features of portal hypertension detected using both Doppler ultrasound and EUS in subjects with liver cirrhosis. Materials and Methods. Analyzed cohort included 42 patients who underwent a detailed Doppler ultrasound focusing on the parameters of blood flow in the portal/splenic vein as well as an endoscopic/EUS procedure that included the assessment of the size and localization of “deep” varices. Results. The size of “deep” oesophageal varices detected with EUS exhibited no correlation with the parameters assessed by Doppler ultrasound. However, the size of the “deep” gastric varices detected using EUS correlated with the time averaged maximum velocity (Tmax as well as Vmin, Vmax) for the portal vein using Doppler ultrasound and exhibited a correlation with the Vmax and Tmax for the splenic vein. No significant correlation was determined between the diameter of the azygous vein and the thickness of the gastric wall when seen on EUS versus the parameters measured with Doppler ultrasound. Conclusion. EUS provides important information regarding the features of portal hypertension, and in the case of “deep” oesophageal varices exhibits a limited correlation with the parameters detected by Doppler ultrasound. Thus, despite its invasiveness, EUS is a method that provides a reliable and unique assessment of the features of portal hypertension in patients with liver cirrhosis

The initial zones of the atrioventricular node: really neglected anatomical features of potential clinical significance?

The constant evolution of medical knowledge and accompanying development of diagnostic and treatment possibilities for arrhythmias and conduction disturbances has reawakened interest in the structure and function of the conduction system of the human heart, especially in the region of the atrioventricular (AV) junction and within the junction itself. Of the large number of studies dealing with the AV junction few focus on the initial zones of the AV node. These were described for the first time by Tawara in 1906. Similarly, Anderson et al. distinguished two origins of the AV node, the left one running towards the basis of the mitral valve and the right one leading towards the tricuspid valve. The differences in length and scale could be the result of the adoption of different reference points. The study was carried out on the material of 50 human hearts, of both sexes and ranging in age from 22 to 93, which were fixed in 10% formalin and 98% ethanol solution. The tissue obtained was fixed in the 10% formalin solution and, after being sunk in the paraffin, was cut into layers of about 10 μm thick. According to the age of the hearts, every 10th or 6th section was stained by the Masson-Goldner method. The preparations were examined under a LEICA 2000 and BIOLAR 2 microscope at magnifications of 2× to 400×. Each of the 50 examined hearts contained the atrioventricular node and its initial parts. We observed that the initial zone of the AV node is created by an assembly of cells typical for a conduction system that can create three groups that are initially independent of each other and are always arranged around the AV nodal artery. In all the hearts examined we found at least two initial parts of the node: the superior and inferior. These two groups were present in 45 hearts (90%). In the last 5 cases (10%) there was also a middle group. No cases were found either with a single initial group or without any initial groups. In the sections examined the superior group appeared to be first in 27 hearts (54%), while in 23 cases (46%) the inferior group was first. The length of each group was measured from its first appearance to its first direct contact with the second part. The length of the superior part varied from 0.15 to 2.91 mm (mean 0.90 ± 0.6 mm), the inferior from 0.11 to 2.41 mm (mean 0.88 ± 0.6 mm) and the middle from 0.67 to 2.21 mm (mean 1.04 ± 0.7 mm). As mentioned above, in all 50 hearts there was a direct connection between the atrial muscle and the upper origin of AV node. Furthermore, in all sections (100%) the same part of the interatrial septal muscle was connected to the compact part of the node. Additionally, in 3 cases (6%) we were able to observe direct connections between the muscle fibres running from the fasciculus limbicus inferior to the initial zone of the AV node: in 2 cases (4%) with the superior group and in 1 case (2%) with the inferior group. In 8% of the material the atrial muscle of the supra-orificial zone made direct contact with the superior initial group and the compact zone of the node and in 10% there was contact between the suborificial muscle and the inferior group and the compact part of the node. This configuration was not observed in relation to the middle and inferior groups

239. Ocena efektu przeciwnowotworowego genetycznie modyfikowanej szczepionki komórkowej w mysim modelu raka nerki

CelGenetycznie modyfikowane szczepionki komórkowe (GMTV) mają za zadanie indukcję efektywnej odpowiedzi przeciwnowotworowej. Postanowiliśmy ocenić efekt protekcyjny dwóch różnych GMTV w mysim modelu raka jasnokomórkowego nerki, oraz rolę komórek dendrytycznych w fazie indukcji przeciwnowotworowej odpowiedzi komórkowej.MetodyPrzy wykorzystaniu wektorów retrowirusowych DCCMV-IRES-Neo-H-6 oraz DCCMV-IRES-Neo-IL-6 wprowadzono do komórek mysiego raka jasnokomórkowego (RenCa) skonstruowano dwa rodzaje GMTV: (i) Komórki RenCa wykazujące ekspresję genu Interleukiny-6, (ii) komórki RenCa wykazujące ekspresję genu Hyper-lnterleukiny-6 (sztuczna cytokina będąca białkiem fuzyjnym składającym się z IL-6 powiązanej sztucznym linkerem z agonistycznym rozpuszczalnym receptorem) W celu oceny efektu protekcyjnego GMTV, myszy Balb/c w wieku 8–12 tygodni (8 osobników w jednej grupie eksperymentalnej) immunizowano podając podskórnie w lewe udo, 1×10^6 naświetlonych (80 Gy) komórek (RenCa w/t, RenCa-IL-6, Renca-H6). Po 14 dniach myszom podawano podskórnie w prawe udo wyjściowe komórki RenCa w/t w ilości 5×10^5. Następnie oceniano dynamikę pojawiania się guzów oraz kinetykę ich wzrostu. W celu oceny mechanizmów indukcji odpowiedzi immunologicznej postanowiono ocenić in situ wpływ poszczególnych rodzajów GMTV na komórki dendrytyczne. Myszy Balb/c otrzymywały w okolicy śródbrzusza, podskórnie 2×10^6 napromienionych (80 Gy) komórek Renca w/t, Renca-IL-6, Renca H-6 zawieszonych w Matrigelu™. Po 7 dniach przy pomocy cytometru przepływowego analizowano komórki naciekające Matrigel.Wyniki i podsumowanieImmunizacja myszy komórkami RenCa-H6 okazała się najbardziej efektywna w porównaniu do komórek RenCa w/t i RenCa-IL-6. Jakkolwiek nie przeciwdziałała wzrostowi guzów. Aktywowane komórki DC naciekały najsilniej komórki RenCa-H6. Efekt protekcyjny wyraźnie korelował z ilością aktywowanych komórek DC naciekających miejsce podania GMTV. Intensywna infiltracja miejsca podania GMTV przez komórki DC o wysokim poziomie aktywacji wskazuje na silną role Hyper-Interleukiny-6 w procesie indukcji funkcjonalnej przeciwnowotworowej odpowiedzi immunologicznej

The self-care of diabetics : the role of a nurse

Chorzy na cukrzycę powinni stać się samowystarczalni w zakresie kontroli stężenia glukozy we krwi oraz wstrzyknięć insuliny do tkanki podskórnej. Posiadanie tych umiejętności nie uzależnia ich od innych osób. Stawiają się w komfortowej sytuacji, jaką jest zdolność do samoopieki. Wychodząc naprzeciw tej tezie autorzy omawiają korzystanie ze strzykawki do wstrzyknięć insuliny, charakteryzują obsługę automatycznych wstrzykiwaczy ( PEN-ów). Przedstawiają także nowoczesne rozwiązania techniczne stosowane w leczeniu chorych na cukrzycę insulinozależną.Diabetics should become self-sufficient as far as controlling their glucose level and injecting insulin to the subcutaneous tissue are concerned. Having these skill makes them independent from the help of others. It puts them in a convenient position of being capable of self-care. With the intention of exploring this matter, the authors discuss using the syringe to inject insulin and characterize the use of automatic injectors (pens). They also present modern technological solutions used for treating the insulin-dependent diabetics

Effectiveness of the third wave cognitive behavior therapy for peripartum depression treatment – a systematic review

Introduction: To investigate the effectiveness of third-wave cognitive behavior therapies in the treatment of peripartum depression. Method: A systematic review of the effectiveness of psychological interventions in treating peripartum depression focus on the Third Wave has been conducted. The electronic databases MEDLINE, PsycINFO, Web of Science and Clinical Trials were searched, using a combination of different search terms. Data were independently extracted by two authors and a synthesis of the results was offered. Methodological quality was assessed by three authors, using ROBE-2 and MINORS. Search date was conducted in February 2022 and the search was re-run in November 2022 for new entries. Findings: Six papers were included and reported, focused on, the effectiveness of Third Wave approach interventions in reducing depressive symptoms. Papers included the following intervention approaches: Behavioral intervention (n = 2), Mindfulness (n = 2), Dialectical Behavior Therapy (n = 1) and Acceptance and Commitment Therapy (n = 1). All six papers were consistent in that interventions lead to a decrease in depression symptoms. However, risk of bias evaluation showed that all were critical low, but one paper was high quality. Conclusion and implications for practice and research: Systematic review showed that third-wave approaches are promising in effectiveness to reduce depression symptoms in peripartum women. However, more high-quality studies with follow-up are needed.info:eu-repo/semantics/publishedVersio

Prevention and psychotherapy for suicides

Autorzy dokonali przeglądu piśmiennictwa poddając analizie znaczenie promocji zdrowia psychicznego, prewencji zachowań samobójczych oraz metod i sposobów pomocy w sytuacjach po próbach suicydalnych.The authors have overviewed the literature, analysing the significance of physical health, preventing from suicidal behaviour and methods as well as some ways to get help after suicide attempts

Suicidal behaviour in mental disorders

Autorzy dokonali przeglądu piśmiennictwa poddając analizie uwarunkowania samobójstw w depresji, ryzyko zachowań suicydalnych w przebiegu schizofrenii oraz zaburzenia osobowości, jako bodźca do samobójstwa.The authors have overviewed professional literature, analysing the determinants of suicides during depression, the risk of suicidal behaviour in schizophrenia as well as personality disorders as stimuli for suicide

Educating diabetics

Cukrzyca podobnie jak wiele innych chorób jest nieuleczalna. Diabetycy, aby mogli skutecznie kontrolować i panować nad chorobą muszą znać jej tajniki. Dogłębne poznanie choroby pozwoli na przewidywanie reakcji, z jakimi można się spotkać. Nieodzownym elementem w leczeniu cukrzycy typu 1 oprócz insulinoterapii jest sposób żywienia. I właśnie zasadom żywienia w cukrzycy poświęcony jest niniejszy artykuł.Like many other illnesses, diabetes is incurable. In order to have the illness under control in a proper manner, diabetics must know all the details related to it. An in-depth knowledge on the disease allows them to anticipate possible reactions. Apart from insulin therapy, an essential element of the treatment of type 1diabetes is a proper diet. This article is devoted precisely to the way diabetics should select their food