European Journal of Clinical and Experimental Medicine T.18, z. 2 (2020)

URI dla tej Kolekcjihttp://repozytorium.ur.edu.pl/handle/item/5788

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Memory of Professor Antoni Leśniowski 1867–1940
(Wydawnictwo Uniwersytetu Rzeszowskiego, 2020) Osuchowski, Michał; Aebisher, David
Brachial artery injury
(Wydawnictwo Uniwersytetu Rzeszowskiego, 2020) Milik, Krzysztof; Pasternak, Grzegorz; Aebisher, David
Introduction. Arterial damage associated with musculoskeletal injuries at room conditions is very common. Aim. It is worth remembering that examining a patient who has suffered an accident with a broken bone or traumatic joint dislocation may be accompanied by vascular damage. A dislocation or fracture often masks damage to the artery. Description of the case. In this paper, a 20-year-old patient being a passenger suffered upper right limb trauma in a car accident. Conclusion. The effects of vascular injuries appear only after a few hours after setting the fracture. It is not known then whether the artery was damaged at the same time with the fracture, whether the injury occurred during the adjustment, or whether the ischemia is finally the result of the pressure exerted by too tight plaster casts.
Diagnostic and therapeutic difficulties of tick-borne encephalitis – a two case reports
(Wydawnictwo Uniwersytetu Rzeszowskiego, 2020) Przetacznik, Dominika; Leksa, Natalia; Aebisher, David; Galiniak, Sabina; Bartosz, Seweryn; Leksa, Dawid; Bartusik-Aebisher, Dorota
Introduction. The paper presents epidemiology, routes of infection, forms of the disease, diagnostic and treatment methods, and prophylaxis of tick-borne encephalitis. Aim. In this paper, we present two descriptions of the cases of tick-borne encephalitis. Description of the cases. Case 1. A 60-year-old man with fever up to 39 degrees for 3 days, multi-site headache and other body aches, as well as an earstuck feeling. The day before hospitalization, there was a feeling of numbness on the right side of the face from eye level to the chin and speech distortion. Case 2. A 60-year-old patient with headaches and an increase in temperature to 39 degrees for 3 days, who, approximately, three weeks earlier was ticked by a tick in the lower parts of the back. Conclusion. It is also important for doctors to take a broader view and to make society aware of that Lyme disease is not associated only with Lyme disease. Further work is also needed towards effective treatments for Tick-borne encephalitis (TBE).
Generation of retractive spine circuits in the process of vitamin B12 deficiency
(Wydawnictwo Uniwersytetu Rzeszowskiego, 2020) Mucha, Patrycja; Leksa, Natalia; Aebisher, David; Galiniak, Sabina; Bartosz, Seweryn; Leksa, Dawid; Bartusik-Aebisher, Dorota
Introduction. Subacute degeneration of the posterior and lateral spinal cord is a rare neurological complication of B12 avitaminosis. Aim. In this paper, we present the case of a 65-year-old man who, in the course of long-term vitamin B12 deficiency associated with atrophic gastritis, developed a severe set of neurological symptoms that are part of the retinal spinal cord degeneration with characteristic features in MR imaging of the cervical spine in the form of an inverted “V mark” ‘in axial images and typical localization in the spinal cord. Description of the case. After careful analysis of the syndrome and making an early diagnosis, parenteral vitamin B12 supplementation began, resulting in improved neurological status, laboratory parameters as well as regression of changes in magnetic resonance imaging. Conclusion Significant symptoms of this syndrome are paresthesia in the distal parts of the limbs, ataxia, spastic paresis.
Hyalinising clear cell carcinoma of salivary gland: a case report
(Wydawnictwo Uniwersytetu Rzeszowskiego, 2020) Osuchowski, Michał; Bartusik-Aebisher, Dorota; Kaznowska, Ewa; Aebisher, David
Introduction. Clear cell carcinoma, not otherwise specified/hyalinising clear cell carcinoma of the salivary gland (HCCC) is a malignancy that arises in minor salivary glands. It rarely leads to distant metastases or cancer-related death but has the potential for recurrence and focal metastases. Aim. A case is reported. Description of the case. A 72 years old female patient has reported to the Clinic of Otolaryngology with a tongue lesion. The patient had no history of malignancy. The lymph node has been surgically removed for further examination. Cords and nests of clear cells and cells with eosinophilic cytoplasm in a hyalinized stroma were identified within the lymph node. After the diagnosis the patient has been transferred to another Oncology Hospital for further treatment. Conclusion. The diagnosis of clear cell carcinoma may be challenging because many of it‘s features frequently overlap with other salivary gland lesions.
Triple thyroglossal duct cysts in an adult: a rare case report and review of literature
(Wydawnictwo Uniwersytetu Rzeszowskiego, 2020) Bhardwaj, Abhishek; Gupta, Kartikesh; Malhotra, Manu; Priya, Madhu; Verma, Mamta
Introduction. Thyroglossal duct cyst (TDC) is the most common cause of congenital neck mass. These can present anywhere from foramen caecum to mediastinum. Usually presents as a solitary cyst, the double thyroglossal cyst is very rare and a triple thyroglossal cyst has never been reported. Aim. Herein, we report an atypical case of triple thyroglossal cyst, at levels of hyoid, thyrohyoid membrane and thyroid isthmus managed surgically without any complication. Description of the case. We are presenting case of a 48-year-old female who presented to us with the complaint of anterior neck swelling since birth. On work up it was diagnosed as a case of the thyroglossal duct cyst and was intraoperatively found to have 3 distinct cystic swellings connected to a common stalk lying beneath the hyoid. It was successfully treated by modified Sistrunk’s procedure. There was no evidence of recurrence on follow up for 6 months. Considering atypical presentations, there are 9 cases reported with the double thyroglossal duct cyst, TDC within the thyroid gland and sublingual TDC. Such presentations make the diagnosis more challenging, leading to improper treatment. Conclusion. We are presenting this case as there is no case reported in English literature with a triple thyroglossal duct cyst. An awareness that thyroglossal cyst can present as multiple cysts is important for clinician in order to perform correct surgical management and to avoid the most feared complication of recurrence.
Traumatic “TERSON SYNDROME PLUS”: Pneumocephalocele with optic atrophy
(Wydawnictwo Uniwersytetu Rzeszowskiego, 2020) Chowdhury, Sanjoy; Srivastava, Madhumita; Chowdhury, Nilanjan
Introduction. Terson Syndrome is subarachnoid hemorrhage (SAH) with sub retinal hemorrhage flowing through channel. Reduced vision in such fresh case is due to hemorrhage itself, blocking macula/other photo receptors in the long run macular cellophane retinopathy which causes profound visual loss. SAH causes neurological problems which can become a risk factor for evacuating blood from vitreous. Hypertension is commonest cause to cause Terson Syndrome, but trauma is also devastating cause as it can lead to irreversible visual consequences like total loss of perception of light or blindness. Aim. Here we describe a case of Terson Syndrome plus disease features SAH in frontal lobe. Description of the case. When there is traumatic pneumocephalocele, it gives space to blood to imbibe towards bony optic canal and form hematoma around nerve sheath which causes compression around the same and leads to optic atrophy. Optic nerve can be injured by direct traumatic dissection during road traffic accidents (RTA), but even without that blood may accumulate around optic nerve and in turn leads to formation of hematoma and subsequently pressure induced optic atrophy. Moreover, blood can slowly travel to sub hyaloid space/sub retinal space (beneath internal limiting membrane or sub ILM) with probable gliosis covering typical boat shaped blood as seen in this case. This sub ILM hemorrhage or gliosis may have resolved through three injections of Triamcinolone in the orbital floor (OFTA) near apex, but optic atrophy snatches vision. This protocol was followed to treat traumatic compressive (peri optic hematoma) optic neuropathy and traumatic retinopathy associated with sub hyaloid hemorrhage. Conclusion. Diagnosis of Terson syndrome plus disease was established by addressing all features on computed tomography (CT) scan and magnetic resonance imaging (MRI). Plus, features include pneumocephalus, optic nerve sheath hematoma, optic atrophy and gliosis over sub-hyaloid hemorrhage, typical boat shaped. The part of hemorrhage still endured as seen on optical coherence topography, but vision was lost by virtue of optic atrophy. OCT shows clot in sub hyaloid space.
Gastro-esophageal reflux and obstructive sleep apnea – is there a link?
(Wydawnictwo Uniwersytetu Rzeszowskiego, 2020) Pardak, Piotr; Pękala, Anna; Jarmakiewicz, Sara; Filip, Rafał
Introduction. The epidemic of obesity has led to an increase in the occurrence of obstructive sleep apnea and gastro-esophageal reflux disease. The mechanism of development of gastro-esophageal reflux disease is multifactorial, and studies conducted in the last decade have shed new light on the causes of its development in patients with sleep apnea and obesity. Aim. The aim of the study was to discuss the mechanism of development of gastro-esophageal reflux disease is multifactorial, and studies conducted in the last decade have shed new light on the causes of its development in patients with sleep apnea and obesity and the dysfunction of the lower esophageal sphincter. Material and methods. An analysis of literature regarding gastro-esophageal reflux and obstructive sleep apnea. Results. In obstructive sleep apnea and obesity, high levels of cytokines and insulin resistance are observed, resulting in disorders in the levels of ghrelin – a hormone responsible for normal gastrointestinal motility. Conclusion. The effect of deviations in the ghrelin profile on the development of gastro-esophageal reflux disease remains a matter for further research.
Prospect of Tele-Pharmacists in Pandemic Situations: Bangladesh Perspective
(Wydawnictwo Uniwersytetu Rzeszowskiego, 2020) Mohiuddin, Abdul Kader
Introduction. Telemedicine and telehealth technologies are especially effective during epidemic outbreaks, when health authorities recommend implementing social distance systems. Currently, coronavirus COVID-19 has affected 210 countries around the world, killed more than 240,000 and infected more than 3.4 million, according to Worldmeter, 03 May, 2020. Aim. The article reveals scope of pharmacy professionals in telemedicine sector during epidemic outbreaks. Material and methods. PubMed, ALTAVISTA, Embase, Scopus, the Science Web and the Cochrane Central Register have been carefully searched. The keywords were used to search out extensively followed journals from various publishers such as Elsevier, Springer, Willey Online Library, and Wolters Kluwer. Results. Home-care is especially important in these situations because hospitals are not seemingly safe during pandemic outbreaks. Also, the chance to get out of the home during the lockdown period is limited. Telephone-based measures improve efficiency by linking appropriate information and feedback. It can also help provide education at distance on various health issues and topics. Conclusion. In addition to increasing access to healthcare, telemedicine is a fruitful and proactive way to provide a variety of benefits to patients seeking healthcare; diagnose and monitor critical and chronic health conditions; improve healthcare quality and reduce costs.
Genetic study of a family with affected members with Waardenburg syndrome type 4 without Hirschsprung disease
(Wydawnictwo Uniwersytetu Rzeszowskiego, 2020) Moghadam, Mitra Sabetghadam; Rayat, Sima; Morovvati, Saeid
Introduction. Waardenburg syndrome (WS) is an autosomally inherited disorder with the most common state compounding pigmentary abnormality and sensorineural deafness. The rarest type of the disease is WS4 with the general characteristic discriminated from other types by the attendance of Hirschsprung disease (HD). Among the several genes, one of the causative genes in WS4 is endothelin 3 (EDN3) with both autosomal recessive and dominant inheritance. Aim. The intention of the present study is to report a pathogenic mutation as the genetic cause of WS in an Iranian family with four patients without any segregation criteria for the type of the disease. Material and methods. In order to detect of causing gene or genes related to the disease, Whole exome sequencing (WES) technique in proband’s sample was done. To confirm the detected mutation in proband and some family members with or without the disease direct sequencing of END3 gene was performed using Sanger method. Results. Pedigree analysis suggested segregation of WS as an autosomal recessive trait in the family. WES analysis suggested a gene (EDN3) related to WS type 4B. DNA sequencing confirmed a pathogenic missense mutation c.293C>T, p.T98M in EDN3 gene in all of the four patients. Conclusion. Determination of WS can usually be missed owing to the lack of some attributes in every sufferer and also conventional clinical variance, in spite of several affected members in a single family. So, Genetic counseling is pivotal for families with multiple members influenced. We detected c.293C>T, p.T98K mutation in EDN3 gene as a pathogenic variant which has been known as a likely pathogenic state in the American College of Medical Genetics and Genomics (ACMG) guidelines, despite one prior report. It will be helpful in genetic diagnosis of affected persons and increases the mutation spectrum of EDN3 gene.
Discharge against medical advice at the adult accident and emergency department in a tertiary hospital of a developing nation
(Wydawnictwo Uniwersytetu Rzeszowskiego, 2020) Ekwedigwe, Henry Chinedum; Edeh, Anthony Jude; Nevo, Anthony Chigozie; Ekwunife, Remigius Tochukwu
Introduction. The goals of health care provision include that it be accessible, acceptable, affordable and adequate. Discharge against medical advice (DAMA) is a failure of proper health care provision as there is disagreement arising from dissatisfaction with provided health care. DAMA is common in our sub-region because of many reasons; these includes ignorance, financial constraint of the patient, beliefs in unorthodox care and patients feeling that they are well when their caregivers do not think so. Aim. The objectives of this study are to determine the incidence, method of documentation of DAMA in the case notes and patients reasons for DAMA in our tertiary health institution. The A&E of any hospital in our environment attracts public criticism when there is dissatisfaction with services and DAMA when not handled well can lead to justifiable criticisms and/or litigations. Material and methods. This is a retrospective study. It was carried out at the adult accident and emergency department of Enugu state university of technology teaching hospital Enugu. Duration of the study was from January 2017 to December 2018. Results. A total of 8,152 patients were seen in the accident and emergency during this period. One hundred and seventy one (171) case notes were retrieved and reviewed for the study, DAMA rate of 2.1% was obtained. Fifty one folders (29.8%) did not have reason for the DAMA documented in them. The commonest reason for the DAMA was to seek traditional medical care with frequency of 17.5%. This was closely followed by financial constraint with 15.8%. Documentation for DAMA was done directly in the case notes. Conclusion. The incidence of DAMA from this study is similar to what is obtainable from other local studies, financial constraint on the patients and seeking alternative medical treatment were the commonest reasons for DAMA in our sub-region. Also, the documentation for the DAMA in this study was poorly done.
Evaluation of the dose-response for electrostimulation with Aussie current in the core strength
(Wydawnictwo Uniwersytetu Rzeszowskiego, 2020) Bonito Lopes, Andressa; Espindola Amboni, Dhebora; Macedo Schmidel, Marilis; Junges Maciel, Miriélly; de Carvalho, Alberito Rodrigo; Bertolini, Gladson Ricardo Flor
Introduction. Muscle strengthening to improve joint stability is widely used in the rehabilitation process, and the use of neuromuscular electrical stimulation is a useful tool, but the use of Aussie current still has little documentation about its effectiveness. Aim. To verify if there is a dose-response effect to Aussie current, both in the strength and in the static and dynamic stability of the deep pelvic lumbar muscles. Material and methods. 39 volunteers divided into four groups, one control and three electrostimulation with intensity variation, one with intensity at the contraction threshold (GT), another with intensity maintained at 20% more (G20), and another with intensity maintained at 30% more (G30) than the intensity at the contraction threshold. The intervention lasted four weeks, with three weekly sessions lasting 15 minutes. Initially and after the intervention period, the strength and stability of the deep muscles of the pelvic lumbar region were measured in a static and dynamic manner by a biofeedback pressure unit. Results. There was a significant increase of pressure under the lordoses in the pre- and post-evaluation moments, there were no differences in the evaluation of indirect force (dynamic stability), but there was an increase in the time for GT. The effect sizes presented advantages for the electrostimulated groups in static stability. Conclusion. The doses used did not promote significant statistical differences, but the effects were positive for the electrostimulated groups, especially with respect to static stability.

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