Types of outlet of the major saphenous vein tributaries in patients with chronic vein insufficiency of the lower limbs

Chronic vein insufficiency (CVI) is a disease which, when it develops, leads to varicose veins of the lower limbs. As approximately 25% to 50% of people suffer from it, it should be recognised as a public disease. The treatment of chronic vein insufficiency is based on a surgical approach. The aim of the operation is to remove (strip) the insufficient major saphenous vein (MSV), the main cause of the disease. The major saphenous vein drains into the femoral vein and forms the sapheno-femoral junction, which is located in the hiatus saphenous within the femoral triangle. We conducted 94 varicose vein operations by the Babcock method on patients suffering from chronic vein insufficiency. This surgical treatment was performed in "Therapy", a private clinic for peripheral vessel disease. We operated on 52 left lower limbs and 42 right lower limbs. The patients were qualified for the operation procedure after physical examination and Doppler ultrasonography imaging. We identified 5 types of major saphenous vein tributary drainage. The most common was Type I, in which there were 3 tributaries draining directly into the major saphenous vein. This type consisted of 45 cases (47.87%). We distinguished here 3 modifications. In Type II, however, there were 4 direct tributaries that drained into the major saphenous vein in 23 cases (24.46%). In this group of patients also 3 modifications were distinguished. Type III occurred in 14 cases (14.89%). We identified here 2 direct tributaries that drained into the saphenous vein and divided this type into 2 modifications. Type IV occurred in 8 cases (8.51%). Here we found 5 or 6 direct tributaries depending on the number of the external pudendal veins. Type V turned out to be very rare, occurring in only 4 cases (4.25%). Among all the types mentioned a thin tributary 1–2 mm wide was found in 10 cases (10.63%). This ran from under the fascia cribrosa into the saphenofemoral junction in the hiatus saphenous. This may be one of the causes of the recurrences of chronic vein insufficiency. There is also the possibility that a tributary will be overlooked or ignored during the operation, particularly when Type IV appears with 5 or 6 direct collaterals

Plasma Interleukin-18 and Dendritic Cells in Males with Psoriasis Vulgaris

Peripheral blood dendritic cells seem to play a crucial role in psoriatic inflammatory processes. The aim of our study is to investigate the relationship between plasma interleukin-18 (IL-18) levels and blood dendritic cells in psoriatic patients. IL-18 plasma levels were measured by ELISA. Phenotypes of dendritic cell subsets were analyzed by double-colour flow cytometry. Plasma IL-18 level in psoriatic males was significantly higher, whereas counts of BDCA-2+ cells were lower than in the control group. The myeloid/plasmacytoid ratio was significantly higher in the patient group compared to the control one. In the patient group, significant negative correlations between plasma IL-18 level and both the BDCA-1+ and BDCA-2+ counts were found. BDCA-1+ counts correlated negatively with percentage of skin involvement. IL-18 seems to play a role in psoriasis pathogenesis. The decreased counts of blood plasmacytoid DCs in psoriatic patients might result from IL-18 down-regulation of plasmacytoid DC precursor proliferation

Diagnostic and therapeutic proceeding in cases of duodenum injury at the example of a post-traumatic duodenum rupture - a case study

Urazy, po chorobach układu krążenia i nowotworach, zajmują 3. miejsce wśród przyczyn zgonów ogółu populacji ludzkiej. U ludzi młodych do 40. roku życia są one najczęstszą przyczyną śmierci. W pracy przedstawiono przypadek pourazowego pęknięcia dwunastnicy. Pęknięcie trafnie rozpoznano i zaopatrzono chirurgicznie dopiero podczas relaparotomii, mającej miejsce w 3. dobie po laparotomii. Chorego wypisano do domu w stanie ogólnym dobrym po 33 dniach hospitalizacji z zaleceniem dalszej opieki w ramach chirurgicznego leczenia ambulatoryjnego. Omówiono etiologię, diagnostykę i sposoby zaopatrzenia chirurgicznego pourazowych uszkodzeń dwunastnicy. Postawiono tezę, że jednym z kluczowych czynników prognostycznych w mnogich obrażeniach ciała jest, obok trafnie postawionego rozpoznania i właściwego leczenia, czas, jaki minął pomiędzy urazem a ostatecznym zaopatrzeniem narządów.Injuries occupy third place among causes of death in the total human population, just after cardiovascular system diseases and cancer. They constitute the most common cause of death in the group of people aged up to 40. A case of post-traumatic duodenum rupture is presented, which was properly diagnosed and surgically treated only during a repeated laparotomy performed three days after an initial laparotomy. After 33 days of hospital stay the patient was released home in good overall condition, with a recommendation for further care in a surgical outpatients clinic. The aetiology, diagnostics and methods of surgical treatment of post-traumatic duodenum injuries are discussed. A thesis was formulated that one of the key prognostic elements in multiple body injuries is, besides proper diagnosis and treatment, the time passed between the injury and the final treatment of the injured organs

Diagnostic and therapeutic proceedings in cases of duodenum injury concerning an example of a post-traumatic duodenum rupture - a case study

Urazy, po chorobach układu krążenia i nowotworach, zajmują trzecie miejsce wśród przyczyn zgonów ogółu populacji ludzkiej. U osób młodych do 40. roku życia są one najczęstszą przyczyną śmierci. W pracy przedstawiono przypadek pourazowego pęknięcia dwunastnicy, które zostało trafnie rozpoznane i zaopatrzone chirurgicznie dopiero podczas relaparotomii, mającej miejsce w trzeciej dobie po laparotomii. Chorego po 33 dniach hospitalizacji, w stanie ogólnym dobrym, wypisano do domu z zaleceniem dalszej opieki w ramach chirurgicznego leczenia ambulatoryjnego. Omówiono etiologię, diagnostykę i sposoby zaopatrzenia chirurgicznego pourazowych uszkodzeń dwunastnicy. Postawiono tezę, że jednym z kluczowych czynników prognostycznych w mnogich obrażeniach ciała jest, obok trafnie postawionego rozpoznania i właściwego leczenia, czas jaki upłynął między urazem a ostatecznym zaopatrzeniem narządów.Injuries occupy third place among the causes of death in the total human population, just after cardiovascular system diseases and cancer. They constitute the most common cause of death in the group of people aged up to 40. A case of post-traumatic duodenum rupture is presented, which was properly diagnosed and surgically treated only during a repeated laparotomy performed three days after the initial laparotomy. After 33 days of hospital stay the patient was released home in a good overall condition, with a recommendation for further care in surgical outpatient’s clinic. The aetiology, diagnostics and methods of surgical treatment of post-traumatic duodenum injuries are discussed. A thesis was formulated that one of the key prognostic elements in multiple body injuries is, besides the proper diagnosis and treatment, the time passed between the injury and the final treatment of the injured organs

Motivation for Physical Activity and Mental Health Indicators in Male Gym Attendees

The significance of physical activity for mental well-being has been discussed in detail in the literature on the subject. However, a question arises concerning the relationship between motivation to exercise and psychological functioning. The objective of the present study was to test the relationship between the types of motivation for physical activity and selected indicators of mental health

Trauma – controversies surrounding the concept, diagnosis, aftermath, and practical implications

The way of understanding trauma still remains a crucial issue in both theoretical and practical terms (in diagnosis and therapy). In this article, we discuss the controversies around the definition, the process of diagnosing, and the consequences of trauma. The subject of analysis is the current diagnostic criteria for trauma (the narrow and broad approaches to trauma), including those set out in the current classifications of mental disorders: ICD-10 and DSM-5. We discuss posttraumatic stress disorder syndromes as well as the impact of traumatic events on mental health and psychosocial functioning. The principles of support for people who have experienced trauma are also suggested

Trauma – kontrowersje wokół pojęcia, diagnoza, następstwa, implikacje praktyczne

Rozumienie pojęcia traumy pozostaje ważnym zagadnieniem zarówno pod względem teoretycznym, jak i praktycznym (diagnoza i terapia). W artykule przedstawia się kontrowersje wokół definiowania, diagnozowania traumy oraz ich konsekwencje. Przedmiotem rozważań uczyniono współczesne kryteria definiowania traumy (ujęcie szerokie i wąskie), w tym obowiązujące w aktualnych klasyfikacjach zaburzeń psychicznych ICD-10 i DSM-5. Omówiono zespoły zaburzeń po stresie traumatycznym, wpływ doświadczeń traumatycznych na stan zdrowia psychicznego i funkcjonowanie psychospołeczne, przedstawiono także propozycję zasad wsparcia wobec osób, które doświadczyły traumy

Original paper<br>Psychosocial Functioning Questionnaire for Patients with Low Back Pain: development and psychometric properties

Background: Low back pain (LBP) is a common chronic disease causing pain and severe imitations in mobility. Apart from physical impairment, LBP also affects psychosocial functioning in such domains as interpersonal relationships, emotions or everyday-living activities. In Poland there is a relative lack of tools evaluating the psychosocial functional status in patients with LBP. Objective: The objective of the study was to develop and test psychometric properties of a new instrument measuring dimensions of psychosocial functioning in patients with LBP – Psychosocial Functioning Questionnaire (PFQ) for Patients with Low Back Pain. Subjects and methods: 100 subjects with LBP took part in the study and completed the initial version of PFQ. A subgroup of 30 random patients was tested with PFQ again after 72 hours. Results: Factor analysis revealed five factors explaining 43% of the total variance. After deleting items with inadequate psychometric properties, the factors were taken to construct five subscales of PFQ: 1. Distress in interpersonal context; 2. Limitations in everyday functioning; 3. Acceptance of life with the disease; 4. Depressive complaints; and 5. Sense of being disabled. Intercorrelations between the subscales ranged from 0.36 to 0.69 and showed an expected pattern. Internal consistency coefficients for the subscales ranged from 0.86 to 0.89, and test-retest correlations ranged from 0.80 to 0.90. None of the subscales showed statistically significant associations with such sociodemographic variables as age, gender, marital status, place of residence or duration of the disease. Scores of one subscale – Acceptance of life with the disease – differed significantly in subgroups with various educational levels. Conclusions: PFQ is a reliable questionnaire which could be a useful instrument in evaluation of psychosocial functioning in patients with LBP. Further research is needed to assess other psychometric properties of PFQ