Justified granulation aided noninvasive liver fibrosis classification system

According to the World Health Organization 130-150 million (according to WHO) of people globally are chronically infected with hepatitis C virus. The virus is responsible for chronic hepatitis that ultimately may cause liver cirrhosis and death. The disease is progressive, however antiviral treatment may slow down or stop its development. Therefore, it is important to estimate the severity of liver fibrosis for diagnostic, therapeutic and prognostic purposes. Liver biopsy provides a high accuracy diagnosis, however it is painful and invasive procedure. Recently, we witness an outburst of non-invasive tests (biological and physical ones) aiming to define severity of liver fibrosis, but commonly used FibroTest®, according to an independent research, in some cases may have accuracy lower than 50 %. In this paper a data mining and classification technique is proposed to determine the stage of liver fibrosis using easily accessible laboratory data. Methods: Research was carried out on archival records of routine laboratory blood tests (morphology, coagulation, biochemistry, protein electrophoresis) and histopathology records of liver biopsy as a reference value. As a result, the granular model was proposed, that contains a series of intervals representing influence of separate blood attributes on liver fibrosis stage. The model determines final diagnosis for a patient using aggregation method and voting procedure. The proposed solution is robust to missing or corrupted data. Results: The results were obtained on data from 290 patients with hepatitis C virus collected over 6 years. The model has been validated using training and test data. The overall accuracy of the solution is equal to 67.9 %. The intermediate liver fibrosis stages are hard to distinguish, due to effectiveness of biopsy itself. Additionally, the method was verified against dataset obtained from 365 patients with liver disease of various etiologies. The model proved to be robust to new data. What is worth mentioning, the error rate in misclassification of the first stage and the last stage is below 6.5 % for all analyzed datasets. Conclusions: The proposed system supports the physician and defines the stage of liver fibrosis in chronic hepatitis C. The biggest advantage of the solution is a human-centric approach using intervals, which can be verified by a specialist, before giving the final decision. Moreover, it is robust to missing data. The system can be used as a powerful support tool for diagnosis in real treatmen

The use of modern telemedicine technologies in an innovative optimal cardiac rehabilitation program for patients after myocardial revascularization: Concept and design of RESTORE, a randomized clinical trial

Despite proven efficacy of cardiac rehabilitation (CR) in reducing the all-cause mortality in patients after myocardial revascularization, the penetration of CR, due to patient-related factors and referral rates remains limited. To improve the outcomes, home-based tele-rehabilitation (TR) has been proposed recently. In theory TR enhances the effects of standard CR procedures due to implementation of an intelligent monitoring system designed to ensure optimal training through on-demand transmission of vital signs, aimed at motivating the patients through daily schedule reminders, setting daily goals and creating a platform for mutual feedback. Several meta-analyses assessing various studies comparing these two methods (CR and TR) have proven that they are at least equally effective, with some of the research showing superiority of TR. Although there was a small sample size, lack of long-term follow-up, reporting effects of TR itself, no integration with tools designed for coaching, motivating and promoting a healthy lifestyle constitutes an important limitation. The latter carries a hopeful prognosis for improvement when utilizing a broad-spectrum approach, especially with use of dedicated technological solutions exploiting the fact of a large and yet rapidly increasing penetration of smartphones, mobile PCs and tablets in the population. The above-mentioned findings worked as the basis and rationale for commencing the RESTORE project aimed at developing and delivering state-of-the-art, comprehensive TR for patients after myocardial revascularization and evaluating its molecular aspect in view of how it influences the atherosclerosis progression attenuation. This paper presents the current state and rationale behind the project based on up-to-date TR efficacy data

Postural defects correction in the process of physical education and sport

Postural defects are the real blight of the contemporary world. The scientific research has shown that the more inactive and sedentary lifestyle one leads, the faster their muscular system becomes dysfunctional. It also loses the ability of active spinal stabilization, which results in postural defects, a serious 21st century problem among young generation. Postural defects are believed to be caused by the lack of physical activity. Undoubtedly, physical education and sport play an important role in prevention and correction of poor posture as in this way particular body systems are affected, which consequently can lead to the elimination of postural defects or at least to their reduction. The objective of the article is to justify the need for corrective exercise during physical education classes as well as to show the role of sport and physical activity in maintaining good body posture and in correcting the existing defects

Postural defects correction in the process of physical education and sport

Postural defects are the real blight of the contemporary world. The scientific research has shown that the more inactive and sedentary lifestyle one leads, the faster their muscular system becomes dysfunctional. It also loses the ability of active spinal stabilization, which results in postural defects, a serious 21st century problem among young generation. Postural defects are believed to be caused by the lack of physical activity. Undoubtedly, physical education and sport play an important role in prevention and correction of poor posture as in this way particular body systems are affected, which consequently can lead to the elimination of postural defects or at least to their reduction. The objective of the article is to justify the need for corrective exercise during physical education classes as well as to show the role of sport and physical activity in maintaining good body posture and in correcting the existing defects

Amyotrophic lateral sclerosis – a motor neuron disease. Case report

Amyotrophic lateral sclerosis, also known as Charcot’s disease and motor neuron disease, is a progressive neurodegenerative disease that causes muscle weakness, paralysis, and ultimately, respiratory failure. The aetiology and the pathogenesis of the syndrome remain unknown. Most people live 2–5 years after their first signs of the disease. There is no cure or effective treatment. We present a case of a female patient affected by progressing Charcot’s disease. On the Amyotrophic Lateral Sclerosis Functional Rating Scale – Revised (ALSFRS-R), the patient obtained 21 points. Atrophy and muscle spasm were very extended. Electromyography revealed features of coexisting denervation and reinnervation in the examined muscles. A growing number of Charcot’s disease cases require multidirectional actions to meet patient’s physical, emotional, and nutritional needs. Amyotrophic lateral sclerosis is an incurable disease. However, it is possible to relieve its symptoms by applying systematic physical rehabilitation

Vertetrac system performance analysis regarding BMI

BACKGROUND Performing symmetrical or asymmetrical lumbar spine traction using the Vertetrac system allows relief of pinched ligaments and nerve roots in the case of herniated nucleus pulposus. The aim of the study was to analyze the effectiveness of Vertetrac in lumbar disc herniation due to the weight of the patient. METHODS Using the Vertetrac targeted traction system, 68 patients with lumbar spine pain were treated. According to their BMI, the patients were divided into three groups: M1, M2, M3. After a thorough interview and testing, the pa-tient was fastened to the Vertetrac device where traction was increased or reduced, depending on the patient's feeling of pain. The rehabilitation was carried out twice a week until the pain subsided. RESULTS Our findings are presented according to the three division groups, depending on BMI, analyzed pain reduction after the first treatment session and after the therapeutic series; the number of treatment sessions required to reduce pain and return of pain. Analyzing the difference between all the tests, examinations and symptoms, the highest average improvement of positive reactions was observed in the M2 group – overweight people -14.83 with a standard deviation of 8.75. The weakest average was obtained by the M3 group – obese people – 9.17 with a standard deviation of 5.15. CONCLUSIONS BMI has the influence of lowering the degree of pain after the first treatment session. The people with the correct weight recorded the largest decrease in feelings of pain, while the group of obese people has the weakest improvement in pain sensation. In the period up to 3 years after the end of therapy, in the vast majority of patients treated with Vertetrac targeted traction, the pain does not return.WSTĘP Wykonanie trakcji symetrycznej lub asymetrycznej kręgosłupa lędźwiowego za pomocą systemu Vertetrac umożliwia odciążenie uciśniętego więzadła i korzenia nerwu w przypadku przepukliny jądra miażdżystego. Celem pracy była analiza skuteczności działania systemu Vertetrac w dyskopatii lędźwiowej ze względu na wagę pacjenta. M E T O D Y Leczeniu za pomocą systemu trakcji celowanej Vertetrac poddano 68 pacjentów z bólem odcinka lędźwiowego kręgosłupa. Ze względu na wskaźnik masy ciała BMI (body mass index), badanych podzielono na trzy grupy: M1, M2, M3. Badany po przeprowadzeniu szczegółowego wywiadu i przeprowadzonych testach – zapinany był w urządzeniu Vertetrac, gdzie zwiększano lub zmniejszano trakcję, w zależności od odczuć bólowych badanego. Rehabilitację prowadzono dwa razy w tygodniu do czasu zniwelowania bólu. W Y N I K I Wyniki badań własnych zostały przedstawione zgodnie z trzema podziałami grupowymi, zależnie od wskaźnika masy ciała BMI (body mass index) , przean a- lizowano redukcję bólu po pierwszej sesji terapeutycznej i po zakończeniu serii terapeutycznej, liczbę sesji terapeutycznych koniecznych do zredukowania bólu, powrót dolegliwości bólowych. Analizując różnicę między wszystkimi testami, badaniami i objawami, najwy ż- szą średnią poprawy reakcji dodatnich odnotowano w grupie M2 – osób z nadwagą 14,83, przy odchyleniu standardowym 8,75. Najsłabszą średnią osiągnęła grupa osób z otyłością M3 – 9,17, przy odchyleniu standardowym 5,15. W N I O S K I 1. BMI ma wpływ na obniżenie stopnia bólu po pierwszej sesji terapeutycznej. 2. U osób z poprawną wagą odnotowuje się największy spadek odczuć bólowych, natomiast grupę osób otyłych cechuje najsłabsza poprawa odczuć bólowych. 3. W okresie do 3 lat od zakończenia terapii u znacznej większości osób leczonych trakcją celowaną Vertetrac dolegliwości bólowe nie powracają

Disturbances of discriminative sensation in patients after ischemic and haemorrhagic stroke, illustrated with example of area of innervation of median nerve and radial nerve

INTRODUCTION One of the basic functions of the nervous system is sensation, which enables the recognition and, as a conse-quence, appropriate reaction to various stimuli from external and internal environments. Sensation disturbances of a central origin were essential to this study. The purpose of this study was to assess the disturbances of sensa-tion in the paretic upper limb and determination of the dependence between the kind of stroke and the degree of tactile sensation impairment. MATERIAL AND METHODS The study was conducted among patients hospitalized at the neurological department. A total of 40 patients (22 women and 18 men) after ischemic and haemorrhagic stroke were enrolled in the study. The mean age was 58 years. Two methods were employed in the area of innervation of the median and radial nerves: Weber’s two-point discrimination test and an aesthesiometer. RESULTS The research has shown that regardless of the kind of stroke suffered, there is always an occurrence of tactile sensation disturbances within the area of paresis. The disturbances of sensation were found to be more serious in patients after haemorrhagic stroke. A correlation was found between disturbances of discriminative sensation and disturbances of skin sensation. As a result of the applied therapy, gradual improvement of both skin and discriminative sensation was observed in both research groups. CONCLUSIONS Both methods have confirmed that patients after haemorrhagic stroke suffer from more serious disturbances of skin and discriminative sensation than patients after ischemic stroke.W S T ĘP Jedną z podstawowych funkcji układu nerwowego jest czucie pozwalające na rozpoznawanie, a w konsekwencji na prawidłowe reagowanie na różne bodźce ze świata zewnętrznego i wewnętrznego. Niniejsza praca dotyczy zaburzeń czucia pochodzenia ośrodkowego. Celem pracy była ocena zaburzeń czucia w obrębie kończyny górnej niedowładnej oraz określenie zależności między rodzajem udaru a stopniem upośledzenia czucia. MATERIAŁ I METODY Badania przeprowadzono wśród pacjentów hospitalizowanych na oddziale neurologii. Objęto nimi 40 pacjentów (22 kobiety i 18 mężczyzn) po przebytym udarze niedokrwiennym i krwotocznym mózgu. Średnia wieku całej grupy badanej wynosiła 58 lat. Każda grupa została przebadana za pomocą dwóch metod badawczych: cyrkla Webera oraz estezjometru włókienkowego. Badania odbywały się na określonych wcześniej dwóch obszarach unerwienia nerwu pośrodkowego i promieniowego. W Y N I K I Analiza wyników pozwoliła stwierdzić, iż bez względu na rodzaj dokonanego udaru mózgu, zawsze dochodzi do upośledzenia czucia w obrębie niedowładu lub porażenia. Wykazano, iż u pacjentów po udarze krwotocznym zaburzenia te są większe. Zanotowano istotną korelację między zaburzeniami czucia dyskryminacyjnego a zaburzeniami czucia skórnego. Terapia w obu grupach badawczych przyniosła stopniowę poprawę czucia zarówno skórnego, jak i dyskryminacyjnego. U pacjentów krwotocznych była ona mniejsza i przebiegała wolniej, często pozostawiając duże ubytki. W N I O S K I Obie metody badawcze potwierdziły, że pacjenci po przebytym udarze krwotocznym cierpią na zaburzenia czucia dyskryminacyjnego i czucia skórnego w większym stopniu i z większym nasileniem niż pacjenci po przebytym udarze niedokrwiennym

Protective and Predisposing Morphological Factors in Suprascapular Nerve Entrapment Syndrome: A Fundamental Review Based on Recent Observations

Suprascapular nerve entrapment syndrome (SNES) is a neuropathy caused by compression of the nerve along its course. The most common compression sites include the suprascapular notch and the spinoglenoid notch. The aim of this article was to review the anatomical factors influencing the occurrence of SNES in the light of the newest reports. Potential predisposing morphological factors include a V-shaped, narrow, or “deep” suprascapular notch; a band-shaped, bifurcated, or completely ossified superior transverse scapular ligament (STSL); particular arrangements of the suprascapular nerve and vessels at the suprascapular notch. A very recent report indicates structures at the suprascapular notch region that may protect from SNES, such as the suprascapular notch veins (SNV). The role of the anterior coracoscapular ligament (ACSL) is still not clear. While some studies indicate that it may predispose for SNES, the newest study proposes a protective function. Knowledge of these variations is essential for arthroscopic and other surgical procedures of this area in order to avoid iatrogenic injury of the suprascapular nerve or unexpected bleeding from the suprascapular vessels running alongside the STSL

Selected SNPs of <i>FCN2</i> Associated with Chronic Tonsillitis in the Polish Adult Population

Chronic tonsillitis is a problem related to bacterial and viral infections. Ficolins play a key role in the defence against various pathogens. In the present study, we investigated the associations between the selected single nucleotide polymorphisms (SNPs) of the FCN2 gene and chronic tonsillitis in the Polish population. The study included 101 patients with chronic tonsillitis and 101 healthy individuals. The selected SNPs of FCN2 (rs3124953, rs17514136 and rs3124954) were genotyped using TaqMan SNP Genotyping Assays (Applied Biosystem, Foster City, CA, USA). The analysis of rs17514136 and rs3124953 showed no significant differences in genotype frequencies between the chronic tonsillitis patients and controls (p > 0.01). The CT genotype of rs3124954 was significantly more frequent, while the CC genotype was less frequent in chronic tonsillitis patients (p = 0.003 and p = 0.001, respectively). The frequency of the A/G/T haplotype (rs17514136/rs3124953/rs3124954) was significantly more common in chronic tonsillitis patients (p = 0.0011). Moreover, the FCN2 CT genotype of rs3124954 was associated with a higher risk of chronic tonsillitis, while the CC genotype of rs3124954 decreased this risk. Our findings demonstrate that FCN2 rs3124954 may be associated with chronic tonsillitis in the Polish adult population

Selected SNPs of FCN2 Associated with Chronic Tonsillitis in the Polish Adult Population

Chronic tonsillitis is a problem related to bacterial and viral infections. Ficolins play a key role in the defence against various pathogens. In the present study, we investigated the associations between the selected single nucleotide polymorphisms (SNPs) of the FCN2 gene and chronic tonsillitis in the Polish population. The study included 101 patients with chronic tonsillitis and 101 healthy individuals. The selected SNPs of FCN2 (rs3124953, rs17514136 and rs3124954) were genotyped using TaqMan SNP Genotyping Assays (Applied Biosystem, Foster City, CA, USA). The analysis of rs17514136 and rs3124953 showed no significant differences in genotype frequencies between the chronic tonsillitis patients and controls (p &gt; 0.01). The CT genotype of rs3124954 was significantly more frequent, while the CC genotype was less frequent in chronic tonsillitis patients (p = 0.003 and p = 0.001, respectively). The frequency of the A/G/T haplotype (rs17514136/rs3124953/rs3124954) was significantly more common in chronic tonsillitis patients (p = 0.0011). Moreover, the FCN2 CT genotype of rs3124954 was associated with a higher risk of chronic tonsillitis, while the CC genotype of rs3124954 decreased this risk. Our findings demonstrate that FCN2 rs3124954 may be associated with chronic tonsillitis in the Polish adult population