The problem of divers, aviators and paratroopers - barotrauma of the paranasal sinuses

Barotrauma of the paranasal sinuses is a trauma caused by a large difference in air pressure between the sinuses and the environment. It concerns essentially divers, aviators, as well as paratroopers. A characteristic symptom is sudden and piercing pain in the sinus area. The pain begins while the ambient's pressure is changing or an instant later. The result of a pressure injury may be an epistaxis. Sinusitis may be also an effect of sinuses' mucosal damage. Drugs used primarily in patients with pressure-related injury are vasoconstructive medicaments and analgesics. Antibiotics are also applied in some situations. Because the incidence of barotrauma increases in predisposed people, e.g. with anatomical abnormalities, nose surgery, including correction of the nasal septum or paranasal sinuses, i.e. conchotomy, is used to prevent injury

The problem of divers, aviators and paratroopers - barotrauma of the paranasal sinuses

Adamczyk Katarzyna, Adamczyk Dorota, Wójcik Rafał. The problem of divers, aviators and paratroopers - barotrauma of the paranasal sinuses. Journal of Education, Health and Sport. 2018;8(9):786-793 eISNN 2391-8306. DOI http://dx.doi.org/10.5281/zenodo.1414170 http://ojs.ukw.edu.pl/index.php/johs/article/view/5937 https://pbn.nauka.gov.pl/sedno-webapp/works/876946 The journal has had 7 points in Ministry of Science and Higher Education parametric evaluation. Part b item 1223 (26/01/2017). 1223 Journal of Education, Health and Sport eissn 2391-8306 7 © The Authors 2018; This article is published with open access at Licensee Open Journal Systems of Kazimierz Wielki University in Bydgoszcz, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 02.08.2018. Revised: 18.08.2018. Accepted: 12.09.2018. The problem of divers, aviators and paratroopers - barotrauma of the paranasal sinuses Katarzyna Adamczyk1, Dorota Adamczyk1, Rafał Wójcik2 1Student, Medical University of Lublin 2Department of Human Anatomy, Medical University of Lublin Abstract Barotrauma of the paranasal sinuses is a trauma caused by a large difference in air pressure between the sinuses and the environment. It concerns essentially divers, aviators, as well as paratroopers. A characteristic symptom is sudden and piercing pain in the sinus area. The pain begins while the ambient pressure is changing or an instant later. The result of a pressure injury may be an epistaxis. Sinusitis may be also an effect of sinuses' mucosal damage. Drugs used primarily in patients with pressure-related injury are vasoconstrictive medicaments and analgesics. Antibiotics are also applied in some situations. Because the incidence of barotrauma increases in predisposed people, e.g. with anatomical abnormalities, nose surgery, including correction of the nasal septum or paranasal sinuses, i.e. canthotomy, is used to prevent injury. Keywords: barotrauma, paranasal sinuses, ascend injury, descend injury, divin

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

Atypical regressive corneal endothelial cysts in long-term confocal follow-up

Corneal endothelium is formed of 1 layer of mitochondria-rich cubic cells whose main role is to maintain corneal transparency. Corneal endothelial disorders represent group of both inherited and noninherited and may affect proper vision. A 36-year-old male patient with suspicion of corneal endothelial dystrophy underwent visual acuity, intraocular pressure, the basic slit-lamp examination, anterior segment optical coherence tomography (AS-OCT) (Visante, Carl Zeiss Meditec, Dublin, CA), and corneal confocal microscopy in vivo (Rostock Cornea Module, Heidelberg Engineering Retina Tomograph III, Heidelberg, Germany). During the 3-year observation the patient reported symptoms mainly in the right eye. Slit-lamp examination revealed endothelial changes, much more pronounced in the right eye. Examination by the AS-OCT Visante showed hyperreflective dots within the right corneal endothelium. In order to assess endothelial cell morphology, analysis using corneal confocal microscopy in vivo was performed. Scans revealed presence of single endothelial deposits and severe cell changes of different morphology in both eyes. In the right eye, less pronounced changes of the polymorphic structure-polygonal guttas in different stages, linear and branched loss with "nuclear-like" formations and accompanying sediments. In the left eye, severe homomorphous polygonal "guttas-like" changes with "nuclear-like" formations were observed. Endothelial cysts' features were dynamically changing during follow-up time with different effects on the patient's clinical state. Corneal confocal microscopy allows accurate imaging of the endothelial cells and their detailed characteristics. Structural changes within the endothelial cells are not always proportional to visual acuity and slit-lamp image. The presented case is an example of an unusual corneal endothelial syndrome with probably nondystrophic background due to observed dynamic state with regressive tendency

Solution of a class of the first kind singular integral equation with multiplicative Cauchy kernel

In the present paper, we give the exact solutions of a singular equation with logarithmic singularities in two classes of functions and construct formulae for the approximate solutions

Ion Exchange Method for Removal and Separation of Noble Metal Ions

Ion exchange has been widely applied in technology of chemical separation of noble metal ions. This is associated with dissemination of methods using various ion exchange resins which are indispensable in many fields of chemical industry. Due to small amounts of noble elements in nature and constant impoverishment of their natural raw materials, of particular importance are physicochemical methods of their recovery from the second sources e.g. worn out converters of exhausted gases, chemical catalysts, dental alloys, anodic sludges from cooper and nickiel electrorefining as well as waste waters and running off waters from refineries containing trace amount of noble metals. It should be stated that these waste materials are usually pyro- and hydrometallurgically processed. Recovery of noble metals, from such raw materials requires individual approach to each material and application of selective methods for their removal. Moreover, separation of noble metals, particularly platinum metals and gold from geological samples, industrial products, synthetic mixtures along with other elements is a problem of significant importance nowadays. In the paper the research on the applicability of different types of ion exchangers for the separation of noble metals will be presented. The effect of the different parameters on their separation will be also discussed. The examples of the removal of noble metals chlorocomplexes will also be presented in detail

An exploration of perceived stress, burnout syndrome, and self-efficacy in a group of Polish air traffic controllers and maritime navigators : similarities and differences

Background: This cross-sectional study aimed to assess the level of perceived stress and occupational burnout in groups of Polish maritime navigators and air traffic controllers. The study was part of research into occupational groups regarded as equally emotionally burdened. We tested the usability of a model linking occupational burnout, perceived stress, and seniority. Methods: The set of questionnaires, including the link burnout questionnaire, perceived stress scale—10, and generalized self-efficacy scale were distributed to 54 maritime navigators and 88 air traffic controllers (rate of return: 18–56%). Spearman’s rho, χ2 test, the Mann–Whitney U test, Cohen’s d and Hedge’s g coefficients, linear regression, and F statistic were used. Results: The assumption that persons employed in occupations with the special professional requirements as air traffic controllers and maritime navigator with a risk of strong, chronic emotional overload evaluate their life situation as less stressful than other employees was confirmed. A higher level of occupational burnout was observed in groups of controllers and navigators compared to an equally emotionally burdening occupational group of Polish firefighters, but not Polish psychiatrists. The research groups differed regarding the source of stress: fear of helplessness in the air traffic controller group and inefficacy in overcoming adversities in the maritime navigators. Maritime navigators reported a higher level of occupational burnout, deterioration of relations with coworkers, and disappointment with their work compared to the air traffic controllers. Conclusions: The results showed differences in factors linked to workplace demands and the personal predispositions of employees, and the role these may play in mutual relations between occupational burnout, life situation evaluation, and personal resources. We postulate that the level of perceived stress should be taken into account in the studies of occupational burnout syndrome

Efficacy and safety of Voriconazole in immunocompromised patients – single centre experience

BackgroundData on epidemiology and survival after fungal infections in patients with cancer are primarily based on studies in adults, whereas few data are available on children.AimThe objective of this study was to determine the safety and tolerability of the oral and i.v. formulations of voriconazole Vfend®, previously not reported in Poland.Materials/MethodsTwenty consecutive children and young adults aged 1 to 25 years, submitted for blood and marrow transplantation (BMT), were recruited during 10 months. When suspected or verified breakthrough systemic fungal infection occurred while kept on primary prophylactic fluconazole regimen, all patients received two loading doses of i.v. or oral voriconazole 6–9 mg/kg every 12 hrs, followed by a maintenance dose of 3 mg/kg every 12 hrs for five doses. If well tolerated, the voriconazole dosage was increased to 4 mg/kg every 12 hrs thereafter.ResultsFungal infection was possible in 15/20, organ involvement with pulmonary process in 13 pts; CNS changes in 2 pts. Fungal aetiology was proven in 3 children (pulmonary Aspergillosis in 2 and Candida krusei in 1 patient), and considered as probable in 2 patients, having lung (2) and CNS (1) involvement. Four patients died. Clinical and radiological improvement was obtained in 14 patients, while uncontrolled, progressive disease occurred in 1 patient. Transient visual disturbances occurred in one patient. Major caution is warranted due to drug interaction via the cytochrome P-450 system which may lead to unexpected toxicity of the coadministered drugs (e.g. Vinca alkaloids, cyclosporine, rifampicin, erythromycin, etc).ConclusionsVoriconazole is an advantageous new azole well tolerated in 20 patients. Outcome in BMT breakthrough infections was good

Bilateral slipped capital femoral epiphysis as first manifestation of primary hyperparathyroidism in a 15-year-old boy

Pierwotna nadczynność przytarczyc (primary hyperparathyroidism - PHP) u dzieci jest rzadkim schorzeniem o burzliwym przebiegu i nietypowych objawach, co utrudnia rozpoznanie i opóźnia leczenie. Prezentacja przypadku: Chłopiec, lat 15, został przyjęty na Oddział Ortopedii z rozpoznaniem obustronnego złuszczenia głowy kości udowej oraz koślawości kończyn dolnych. Zaburzenia chodu, bóle i deformacje kończyn obserwowano od 5 miesięcy, polidypsję, poliurię i utratę masy ciała od 8 miesięcy. Mimo hiperkalcemii stwierdzonej w badaniach laboratoryjnych oraz destrukcji kości, którą wykazała tomografia komputerowa bioder, wykonano zabieg ortopedyczny. W badaniu histopatologicznym stwierdzono guzy brunatne kości. Stężenie PTH - 589.1 pg/ml; (N: 10–60). Pacjenta skierowano na Oddział Endokrynologii Dziecięcej, gdzie stwierdzono ciężką hiperkalcemię (Ca c. - 4.07 mmol/l; N: 2.2-2.84), hipofosfatemię (P - 0.68 mmol/l; N: 0.95-1.75). Rozpoznano gruczolaka lewej, dolnej przytarczycy. Po zastosowaniu forsowanej diurezy, diuretyków pętlowych i kwasu pamidronowego uzyskano normokalcemię. Wykluczono powikłania hiperkalcemii oraz zespoły MEN 1 i MEN 2A. Na Oddziale Chirurgii Endokrynologicznej usunięto gruczolaka przytarczyc. Wnioski: 1) Pacjenci z PHP powinni być diagnozowani na podstawie typowych objawów klinicznych, a oznaczenie stężenia Ca przed zabiegami ortopedycznymi jest konieczne. 2) W każdym przypadku PHP należy oznaczyć Ca, P, PTH w surowicy oraz wykluczyć zespoły MEN 1 i MEN 2A. 3) Pacjenci z PHP wymagają diagnostyki wielonarządowych powikłań hiperkalcemii. 4) Po operacji gruczolaka przytarczyc niezbędna jest długoterminowa opieka endokrynologiczna.Primary hyperparathyroidism (PHP) in children is a rare condition and has a very dynamic course with nonspecific symptoms, what complicates the diagnosis and delays PHP treatment. Case presentation: A 15-year-old boy was admitted to the Orthopedic Ward with the diagnosis of juvenile bilateral slipped capital femoral epiphysis and valgus deformities. Gait disturbances, limb pains and valgus knee deformities, polyuria, polydipsia and weight loss, have been increasing for 8 months. Despite the hypercalcemia found in laboratory tests and bone destruction demonstrated in computed tomography of the hips, orthopedic correction was performed. In histopathological examination -brown bone tumors. The PTH concentration was determined (PTH - 589.1 pg/ml; (N: 10-60) and the child was referred to the Department of Pediatric Endocrinology, where severe hypercalcemia (Ca - 4.07 mmol/l, N: 2.2-2.84) and hypophosphatemia (P - 0.68 mmol/l; N: 0.95-1.75) and adenoma of the left lower parathyroid gland was diagnosed. Forced diuresis, loop diuretics and pamidronic acid were used to obtain normocalcemia. The complications of hypercalcemia were excluded; diagnostic management excluding multiple endocrine neoplasia type 1 and 2a (MEN 1 and MEN 2A) syndrome were performed. The child was referred to the Department of Endocrinological Surgery, where the adenoma of the left inferior parathyroid gland was resected. Conclusions: 1) Patients with PHP should be diagnosed of the condition based on clinical symptoms. In patients with specific symptoms, it is necessary to determine serum Ca levels, especially prior to the surgical procedures. 2) In each case of PHP, determinations should be made of blood PTH, Ca and P and detection of MEN 1 and MEN 2A syndromes. 3) Patients with hyperparathyroidism require management of multiorgan complications of hypercalcemia. 4) Following surgical treatment of parathyroid adenoma, longterm endocrinological follow-up is necessary

Use of silver nitrate for the assessment of sperm measurements in selected farm and free-living animal species

The study was conducted on spermatozoa of selected farm and free-living animal species, isolated post mortem from the tail of the epididymis, and stained with silver nitrate – AgNO3. The material was collected from pigs, goats, wild boar, and European roe deer. Twenty morphologically normal spermatozoa randomly selected from each animal and well visible under the microscope, were analysed. The following measurements were considered: head length, width, perimeter and area, acrosome area, mid-piece length, tail length, and overall sperm length. AgNO3 staining differentiated the acrosomal (light hue) and distal (dark hue) part of the sperm head, and a light-hued mid-piece was visible within the sperm tail. Silver nitrate staining revealed species and variety-related differences, particularly in reference to the sperm head. Clear-cut differentiation within the head and tail area made it possible to perform detailed morphometric measurements of the spermatozoa