Wirtualna rzeczywistość jako narzędzie wspomagające zrozumienie świata osób ze spektrum autyzmu

Over the past few years, the rapid development of virtual reality (VR) has made the technology available to the common user. VR is used extensively in the entertainment industry, training tasks, medicine, tourism, architecture, art and many other fields. It also plays an increasingly important role in education and growing awareness and sensitivity of real social phenomena. The created VR application addresses the difficulties faced by people suffering from autism spectrum. Autism, a disorder that is diagnosed more and more frequently and, according to European data, occurs in 1% of the population (with a male to female ratio between 3: 1 and 4: 1) (Lai 2014; Loomes 2017). It is characterized by difficulties in social interactions, verbal and nonverbal communication, repetitive and stereotypical behaviours. Autism spectrum disorder is often associated with withdrawal and avoidance of contact with the world and people. The COVID-19 pandemic and the isolation associated with it have created an even greater separation between people on the spectrum and their surroundings. This article presents the use of virtual reality, which allows ordinary people to see the world of autism spectrum, and thus to better understand this different perception of the environment and the problems encountered in daily functioning of people with autism spectrum disorder. The created VR application increases the level of empathy among users, which positively affects the elimination of exclusion in a world full of uncertainty and variability

Edukacja wobec zjawiska niepełnosprawności – osoba z niepełnosprawnością w przestrzeniach edukacyjnych

Tekst jest wprowadzeniem do tematyki związanej ze zjawiskami niepełnosprawności w różnie rozumianych formach edukacji. Autorzy, ukazując perspektywę modelu niepełnosprawności opartego na prawach człowieka (the human rights based disability model), poruszają takie zagadnienia, jak edukacja włączająca, inkluzja w różnych typach edukacji, osoby ze szczególnymi potrzebami w systemie szkolnictwa. W tekście przybliżona jest także tematyka poszczególnych rozdziałów tomu.The text is an introduction to topics related to the phenomena of disability in various forms of education. The author, showing the perspective of the human rights based disability model, addresses issues such as inclusive education, inclusion in various types of education, people with special needs in the education system. The text also presents the topics of the individual chapters of the volume

Perioperative bleeding in patients undergoing liver transplantation

Liver transplantation (LT) remains one of the most challenging surgical procedures. For many years uncontrolled bleeding and catastrophic haemorrhages were one of the major causes of perioperative mortality and morbidity. During the past fifty years or so, significant progress in surgical techniques and perioperative management has led to a marked change in transfusion practice over time, where up to 79.6% of LTs in experienced transplant centers are performed without any blood product transfusion. Despite this, perioperative bleeding and transfusion requirements remain potent predictors of patient’s mortality, as well as postoperative complications and graft survival. The major impact of blood product transfusion on LT recipient outcomes implies that all patients on waiting lists should be carefully screened for the presence of risk factors of perioperative bleeding. Although multiple predictors of transfusion requirements during LT have been identified, no predictive model validated across centers has been constructed. The most suitable strategies to reduce intraoperative blood loss in this group should be employed on a case-to-case basis. This paper aims to summarize the most up-to-date evidence in the management of haemostasis in LT recipients

Evolution Of The Results Of 1500 Liver Transplantations Performed In The Department Of General, Transplant And Liver Surgery Medical University Of Warsaw

Liver transplantation is a well-established treatment of patients with end-stage liver disease and selected liver tumors. Remarkable progress has been made over the last years concerning nearly all of its aspects. The aim of this study was to evaluate the evolution of long-term outcomes after liver transplantations performed in the Department of General, Transplant and Liver Surgery (Medical University of Warsaw). Material and methods. Data of 1500 liver transplantations performed between 1989 and 2014 were retrospectively analyzed. Transplantations were divided into 3 groups: group 1 including first 500 operations, group 2 including subsequent 500, and group 3 comprising the most recent 500. Five year overall and graft survival were set as outcome measures. Results. Increased number of transplantations performed at the site was associated with increased age of the recipients (p<0.001) and donors (p<0.001), increased rate of male recipients (p<0.001), and increased rate of piggyback operations (p<0.001), and decreased MELD (p<0.001), as well as decreased blood (p=0.006) and plasma (p<0.001) transfusions. Overall survival was 71.6% at 5 years in group 1, 74.5% at 5 years in group 2, and 85% at 2.9 years in group 3 (p=0.008). Improvement of overall survival was particularly observed for primary transplantations (p=0.004). Increased graft survival rates did not reach the level of significance (p=0.136). Conclusions. Long-term outcomes after liver transplantations performed in the Department of General, Transplant and Liver Surgery are comparable to those achieved in the largest transplant centers worldwide and are continuously improving despite increasing recipient age and wider utilization of organs procured from older donors

1000 Liver Transplantations at the Department of General, Transplant and Liver Surgery, Medical University of Warsaw - Analysis of Indications and Results

The aim of the study was to analyze indications and results of the first one thousand liver transplantations at Chair and Clinic of General, Transplantation and Liver Surgery, Medical University of Warsaw.Material and methods. Data from 1000 transplantations (944 patients) performed at Chair and Clinic of General, Transplantation and Liver Surgery between 1994 and 2011 were analyzed retrospectively. These included 943 first transplantations and 55 retransplantations and 2 re-retransplantations. Frequency of particular indications for first transplantation and retransplantations was established. Perioperative mortality was defined as death within 30 days after the transplantation. Kaplan-Meier survival analysis was used to estimate 5-year patient and graft survival.Results. The most common indications for first transplantation included: liver failure caused by hepatitis C infection (27.8%) and hepatitis B infection (18%) and alcoholic liver disease (17.7%). Early ( 6 months) retransplantations were dominated by hepatic artery thrombosis (54.3%) and recurrence of the underlying disease (45%). Perioperative mortality rate was 8.9% for first transplantations and 34.5% for retransplantations. Five-year patient and graft survival rate was 74.3% and 71%, respectively, after first transplantations and 54.7% and 52.9%, respectively, after retransplantations.Conclusions. Development of liver transplantation program provided more than 1000 transplantations and excellent long-term results. Liver failure caused by hepatitis C and B infections remains the most common cause of liver transplantation and structure of other indications is consistent with European data