Pericarditis with cardiac tamponade - a misleading complication of appendicitis : a rare case report

Introduction: As severe complication of appendicitis as effusive pericarditis is a rare phenomenon. Taking into consideration open access data in a 50-year period we perceived three pediatric cases with pericarditis as a complication of appendicitis. Presentation of case: We report a 15-year-old boy who presented cardiac tamponade, bilateral pleural effusions, liver enlargement and ascites as a presentation of atypical appendicitis. Discussion: Even nowadays appendicitis could be difficult to diagnose in children. A delayed diagnosis could be responsible for severe morbidity and mortality. Conclusion: This report is aimed to be a reminder of serious life-threatening complications after a common abdomen condition - appendicitis

Preoperative thrombocytosis in surgically treated patients with non-small cell lung cancer

Lung cancer is the most common cause of cancer‑related death. Accurate and easy‑to‑use prognostic factors are necessary. Increased platelet count might be a potential prognostic factor. We aimed to investigate the relationship between thrombocytosis and stage of lung cancer and to assess the frequency and clinical importance of thrombocytosis in this patient group. We retrospectively analyzed hospital records of consecutive patients with non-small cell lung cancer (NSCLC) who underwent curative‑intent pulmonary resections. Of 323 patients, 285 patients with NSCLC were selected (mean [SD] age, 66.55 [8.52] years; men, 63.86%). Squamous cell carcinoma was diagnosed in 130 patients (45.61%); adenocarcinoma, in 128 (44.91%); large cell carcinoma, in 16 (5.61%); and adenosquamous carcinoma, in 11 (3.86%). The prevalence of preoperative thrombocytosis in the whole sample was 10.18% (n = 29). Anemia was more common in patients with thrombocytosis compared with those without thrombocytosis (65.52% vs 30.08%; P <0.001). Thrombocytosis was found in 22.41% of patients with stage III+IV cancer and in 3.82% of those with stage I (P <0.001). Moreover, in patients with no metastases (N0, M0 according to the 7th edition of the TNM classification), thrombocytosis was more frequent in the group with stage II than in that with stage I cancer (3.85% vs 20.00%; P = 0.002). Thrombocytosis was also more frequent in patients with N2 than with N1 disease (9.76% vs 23.81%; P = 0.09). Thrombocytosis is often observed in patients with NSCLC and is significantly associated with the higher stage of disease

Recent achievements in transcatheter closure of ventricular septal defects : a systematic review of literature and a meta-analysis

Background: Ventricular septal defect (VSD) is one of the most common congenital heart defects. Currently, surgery remains the treatment of choice. However, transcatheter techniques for closing of various types of VSDs have become an alternative. Aims: The objective of our study was to present the outcomes of transcatheter closure of various types of VSD based on a systematic review of recent publications. Methods: A systematic review of studies published in English between January 2014 and March 2020 was performed using the PubMed database (MEDLINE) independently by 2 reviewers. Data on success and complication rates were extracted. Studies including fewer than 5 patients and those with acquired VSD were excluded from the analysis. Results: Finally, 44 studies were included for analysis, with a total number of 4050 patients. The pooled estimate of the overall success rate based on the random effects model was 97.96% (95% CI, 97.37–98.56; Q test P 0.99; I 2 = 0%) for permanent VSD. Conclusions: Transcatheter closure of selected VSDs appears to be an effective and safe method of treatment. Recent studies have shown high rates of successful interventions with a low incidence of complications

Isolated systolic hypertension — evaluation of the scale of the problem among medical students — pilot study

Introduction. Interest in isolated systolic hypertension (ISH) in young people has increased in recent years. The applanation tonometry technique provides new diagnostic opportunities in this group of patients. The aim of the study was to evaluate the incidence of ISH among young adults and factors contributing to its occurrence. Material and methods. One hundred and two medical students aged 21 to 26 years were examined. The study was based on three peripheral blood pressure measurements and central blood pressure measurement. Information on health status and physical activity was collected using the author-developed questionnaire. Results. Based on the mean of peripheral blood pressure measurements, hypertension (HT) was detected in 23 students (22.55%): 18 had ISH, 4 — combined systolic/diastolic HT and 1 — isolated diastolic HT. Pulse wave analysis showed that all individuals with ISH had central blood pressure within the normal range — higher than those without HT, but lower than in the combined systolic/diastolic HT group (p &lt; 0.001). Subjects with ISH were characterized by higher pulse pressure amplitude and lower augmentation index (AIx) compared to those with normal blood pressure. Subjects with ISH were taller, had a higher body mass index (BMI) and were more likely to have a positive family history of HT compared to normotensives. They also reported more frequent coffee consumption; and 22% of them used creatine supplements (vs. 0% in non-HT group). Conclusions. Measurement of central arterial blood pressure by applanation tonometry should be an integral part of the assessment of young patients with ISH. The study confirmed that ISH patients are characterized by higher growth, weight and physical activity. Further studies are needed to assess the clinical significance of ISH

Principles of qualification and surgical treatment of the nose and paranasal sinuses in the era of COVID-19

Introduction: The COVID-19 pandemic is one of the greatest challenges of modern medicine. Despite implemented social and economic restrictions, the epidemiological situation is still dynamic. Otolaryngologists, especially rhynologists, are at particular risk of SARS-CoV-2 infection. In order to reduce the spread of the virus, it is necessary to implement procedures to minimize the risk of transmission between healthcare professionals and patients. Due to the location of the virus, it is very important with regard to rhinologic procedures and surgery. Literature review: We reviewed the literature on the topic and presented effective methods of reducing the likelihood of virus transmission during surgery of the nasal and paranasal sinuses performed in our center. It is important that the restrictions brought about by the pandemic do not affect the length of diagnostic process and delay initiation of oncological treatment. Malignancies of the nasal region and paranasal sinuses are detected relatively late due to the time the symptoms appear, and further delays starting therapy can be extremely unfavorable. We believe that at present rhinologic procedures, especially in people with unknown epidemiological status, should be limited to the necessary minimum – life-threatening conditions and tumor resections. Even in such cases, however, it is necessary to strictly follow the procedures in order to reduce the risk of virus transmission. We hope that implementation of the guidelines presented in this work will help fight against the current pandemic and its subsequent waves

Zasady kwalifikacji i leczenia chirurgicznego w obrębie nosa i zatok przynosowych w dobie koronawirusa

Wstęp: Pandemia COVID-19 jest jednym z największych wyzwań współczesnej medycyny. Pomimo wdrożonych restrykcji społecznych i gospodarczych, sytuacja epidemiologiczna wciąż pozostaje dynamiczna. Otolaryngolodzy, a w szczególności rynolodzy, stanowią grupę lekarzy szczególnie narażonych na zakażenie SARS-CoV-2. W celu ograniczenia rozprzestrzeniania się wirusa, należy wdrożyć procedury minimalizujące ryzyko zakażenia personelu medycznego oraz pacjentów. Ze względu na miejsce bytowania wirusa, bardzo istotne jest to w odniesieniu do procedur i operacji rynologicznych. Wnioski: Autorzy dokonali przeglądu piśmiennictwa dotyczącego podejmowanego tematu oraz przedstawili skuteczne metody zmniejszające prawdopodobieństwo transmisji wirusa podczas operacji nosa i zatok przynosowych stosowane w naszym ośrodku. Ważne jest, aby ograniczenia związane z pandemią nie wpływały na czas trwania diagnostyki i rozpoczęcia leczenia onkologicznego. Ze względu na czas pojawiania się objawów, nowotwory regionu nosa i zatok przynosowych są wykrywane stosunkowo późno, zaś dalsze opóźnienia rozpoczęcia procesu terapeutycznego mogą działać wyjątkowo niekorzystnie. Uważamy, że obecnie operacje rynologiczne, szczególnie u osób o nieznanym statusie epidemiologicznym, powinny być ograniczone do niezbędnego minimum – stanów zagrażających życiu oraz resekcji nowotworów złośliwych. Nawet w tych przypadkach konieczne jest jednak ścisłe przestrzeganie procedur zmniejszających ryzyko transmisji wirusa. Mamy nadzieję, że wprowadzenie wskazówek przedstawionych w poniższej pracy pomoże w walce zarówno z obecnie panującą pandemią, jak i jej kolejnymi falami