The evolution of maternal birthing positions

Birth of a child is an unique time in the life of every woman. Unfortunately, labor is often one of the most painful and traumatic experiences suffered in her life. For a long time lying on the back position was the most commonly used birthing position. In many hospitals, women were even forced to give birth in this position. However, multiple studies revealed that the supine position is linked to multiple negative maternal and neonatal outcomes. The purpose of this paper was to describe the history and advantages of alternative birthing positions

Ocular manifestations in a newborn from a pregnancy complicated by an antiphospholipid syndrome – a case report

The paper presents a case of ophthalmologic manifestations, episcleritis and retinal branch vein thrombosis, in a neonate born to a mother with antiphospholipid syndrome (APS) in the course of systemic lupus erythematosus. Female neonate (birth weight 1150 g, Apgar scores 6, 7 and 7) was born with respiratory distress syndrome, moderate anemia and grades I and II intraventricular hemorrhage. Ophthalmic examination revealed an enormous pre-retinal hemorrhage with accompanying thrombotic changes typical of retinal vein in the fundus of the left eye. Episcleritis was found in the anterior segment of the eye and later confirmed by ultrasound. Laboratory tests showed increased levels of maternal antibodies aCL IgG, antyβ2GP1 IgG and antyβ2GP1 IgM. No ANA, LA and SS-A/SS-B antibodies were detected. Increased concentrations of aCL IgG and a lengthening APTT were observed in newborn blood at first but the parameters normalized by 6 months of age. Our observations allowed us to conclude that early examination of neonates born to mothers with antiphospholipid syndrome is essential as it allows fast identification of pathological retinal changes by means of assessing the presence of aPL antibodies

Horizontal skin traction in abduction in physiotherapy management of Legg–Calvé–Perthes disease

Legg–Calvé–Perthes disease is one of the many types of avascular necrosis with etiologies that have not been clearly confirmed yet. It affects the hip joint and is more prevalent in boys between the ages of 3 and 10. The purpose of this paper is to present physiotherapy management of Legg–Calvé–Perthes disease (LCPD) with horizontal skin traction in abduction. The treatment can be either conservative or operative. In both the cases, appropriate rehabilitation must be performed to facilitate the child’s full recovery. The objective of the comprehensive treatment is to restore the shape of the affected head of femur. The entire course of the disease, from onset to resolution, may take as long as a few years. This article is intended as an effective guide to choosing suitable exercises in the given stage of treatment

Contemporary determinants of international relatioos

Z wprowadzenia: "Nauka o stosunkach międzynarodowych nie może się obejść bez systematyzowania i porządkowania omawianej przez siebie niezwykle szerokiej materii. Poszukując odpowiedzi na pytania związane z relacjami pomiędzy uczestnikami interakcji międzynarodowych, nie sposób nie dostrzegać czynników, jakie na nie wpływają, czy to w sposób pośredni czy też bezpośredni, zależny lub niezależny od nich. Wielość tych czynników i zmienność wagi przykładanej do poszczególnych, zależnie od epoki, stwarza konieczność gruntownego badania i wskazywania na najważniejsze z nich, decydujące w danym okresie."(...

A study of the influence of newly synthesized acyclonucleosides and 1,2,3,4-tetrahydroisoquinoline derivatives on deoxythymidine and deoxycytidine kinase activities in human neurofibrosarcoma and ovarian cancer.

The influence of nine newly synthesized uracil acyclonucleosides, and 36 derivatives of 1,2,3,4-tetrahydroisoquinoline on the activity of enzymes catalysing dTMP and dGMP synthesis, on the content of dTTP and dGTP in acid soluble fraction and on the incorporation of [14C]dThd and [14C ]dGuo into DNA in tumour homogenates was studied. The influence of the compounds was studied in the cytosol from intraoperatively excised human tumours - neurofibrosarcoma and ovarian cancer. It was shown that dTMP and dGMP synthesis is inhibited competitively by 34.1±4.0% in both types of tumours by 0.2 mM 1-N-(3'-hydroxypropyl)-6-methyluracil (1) and 0.2 mM 1-N-(3'-hydroxypropyl)- 5,6- tetramethyleneuracil (2). The mentioned acyclonucleosides reduced the content of dTTP and dGTP in the acid soluble fraction of tumours (59.7±3.1% of control). 1-(4-chlorophenyl)-6,7-dihydroxy- 1,2,3,4-tetrahydroisoquinoline (3), 1-(2,3-dichlorophenyl)-6,7-dihydroxy 1,2,3,4-tetrahydroisoquinoline (4) and 1-(3-methoxyphenyl)-6,7-dihydroxy 1,2,3,4-tetrahydroisoquinoline (5) at 0.2 mM concentration caused a mixed type inhibition of the synthesis of dTMP and dGMP by, on average, 33.2±4.4%, and reduced the content of dTTP and dGTP in the acid soluble fraction (52.6±3.7% of control) but were active only in the cytosol of neurofibrosarcoma. While acyclonucleosides undergo phosphorylation in the cytosol by cellular kinases, with their triphosphates being active acyclonucleoside metabolites, active 1,3,4,5-tetrahydroisoquinoline derivatives (compounds not containing a deoxyribose moiety), cannot be phosphorylated. ACN and THI derivatives which inhibit dThd and dCyd kinase activities, inhibit also the incorporation of [14C]dThd and [14C]dGuo (ACN - 50.2±2.7%, THI - 53.4±3.9% of incorporation inhibition) into tumour DNA. The obtained results point to the mechanism of uracil acyclonucleosides and 1,2,3,4-tetrahydroisoquinoline biological activity consisting in inhibiting the synthesis of DNA components

Novel Interdisciplinary Enhanced Recovery after Surgery Protocol Implementation in Paediatric Orthopaedics

The enhanced recovery after surgery (ERAS) protocol is not routine management in paediatric orthopaedics. Cultural differences or assumptions about the financing of medical care in different countries encourage creative adaptation of general assumptions in local communities. The aim of this study was to compare the quality of the perioperative period before and after the introduction of an interdisciplinary protocol adopted to organisational conditions. A group of 4098 children were included in the “before–after” observational study. The data of 1553 patients (BEFORE group) were analysed in terms of compliance with the enhanced recovery after surgery protocol guidelines and the time and cost of hospitalisation over a 20-month period. A novel interdisciplinary protocol was developed, including an education and training app called BackOnFeet (BOF®), standardised hospital management, and the introduction of methods novel to Poland (intraoperative nerve cryoanalgesia in children). A further 2545 patients (AFTER group) were reassessed over a period of 20 months. It was found that the groups differed in hospitalisation time (p ® app as an effective educational tool was demonstrated. The optimisation of perioperative management in paediatric orthopaedics based on novel tools and the interdisciplinary ERAS protocol is possible and brings tangible benefits in psychological, organisational, and financial terms

From ophthalmologist to dentist via radiology

Background: The aim of this paper was to analyze the causes of orbital cellulitis in connection with covert dental changes as well as to establish the role of radiological procedures in the final diagnosis and further treatment of such cases. Material/Methods: Thirty-two patients, aged 25-56, 22 women and 10 men were diagnosed and treated between January 2007 and April 2011 at the Pomeranian Medical University in Szczecin. The patients were examined in the infirmary of the ophthalmological department due to unilateral blepharo-oedema, abrupt pain and vision disturbances; in 5 cases, body temperature increased up to 37.8°C was observed. Next, the patients underwent conventional X-ray examinations of the orbit to exclude any foreign bodies in the eyeball, as well as pantomographies to evaluate the dental status. Visible periapical or periodontal changes in dentition were analyzed with intraoral X-rays with the use of DIGORA System 2.1. Changes found in 3 patients on pantomograms and connected with iatrogenic procedures were further evaluated with CT (64 lines and 128 layers) in frontal, sagittal and axial projections. Orbital disorders were also diagnosed by an ophthalmologist and radiologist with Doppler ultrasound (US) examinations. A linear transducer of 7.5-10 MHz to observe the morphology and vascularity of the eyeball was applied. Results: Iatrogenic treatment was the cause of sinusitis and cellulitis in three cases: incorrectly implanted dental implant in one case, root of the 3rd molar pushed into the sinus in the second case, and communication between the maxillary alveolar process and the sinus after extraction in case of the third patient. Asymptomatic periapical osteolysis, periodontal disease or dead teeth were found in all cases. Diagnosis of orbital cellulitis of dental origin was determined on the basis of clinical, radiographic and ultrasound findings. Ophthalmologic and dental treatment was applied simultaneously. Conclusions: Co-operation between ophthalmologists, radiologists and dentists is necessary during the treatment of such orbital diseases