European Journal of Clinical and Experimental Medicine T.19, z. 3 (2021)

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Anomalous origin of the left vertebral artery from the arch of the aorta
(Wydawnictwo Uniwersytetu Rzeszowskiego, 2021) Jasiewicz, Maria; Sajdak, Piotr; Sopel, Aleksandra; Strzępek, Kamil; Ziajor, Seweryn; Pliszka, Anna; Balawender, Krzysztof
Introduction. Although there are lots of varieties of aorta arch, they seem to appear relatively rarely. Anomalies of aortic arch departures are mainly concerned with its location, course, the place of departure and number of its main branches. However, they warrant attention due to their importance in operative, diagnostic, and endovascular procedures. Aim. We want to present here a case of a female cadaver with rare aortic arch origin of the left vertebral artery. The aim of this article is to complete the frame of anomalies in aortic arch and to explore rare variability shown in this specific case. Description of the case. The present report describes an anomalous case of the left vertebral artery arising from the aortic arch between the left common carotid artery and the left subclavian artery in a female cadaver during dissection in an anatomical laboratory. Aortic origin of the vertebral artery is a rare anatomic variant. Conclusion. Thorough knowledge of anomalous origin is important for patients who undergo operation of an aortic arch or inferior part of the neck. Normally, the vertebral artery arises from the first part of the subclavian artery on both sides.
Basal ganglia calcifications is not inconsequential in pediatric cases
(Wydawnictwo Uniwersytetu Rzeszowskiego, 2021) Erok, Berrin; Tatar, Sertaç; Uzunhan, Tuğçe Aksu; Bezen, Diğdem; Önder, Hakan
Introduction. Basal ganglia calcification (BGC) in pediatric population is rare and is considered as a pathological finding. Various causes may be responsible for BGC including hypoparathyroidism, various infectious, toxicities or hereditary disorders. Aim. We aimed to present a 8 year old boy presented with generalized seizure and bilateral small amount of globus pallidum calcifications on neuroimaging studies leading to the diagnosis of idiopathic hypoparathyroidism, which is a treatable cause of seizure. Description of the case. A 8-year-old boy presented to our emergency department with generalized seizure for the first time in his life. There was no history of previous head trauma and his family history was unremarkable. Neurological examination revealed no pathological findings. Radiological imaging studies revealed only bilateral small amount of globus pallidus calcifications. He was referred to the pediatric endocrinology department for further evaluation of the hypocalcemic convulsion, where laboratory investigations revealed idiopathic hypoparathyroidism as the cause of hypocalcemic convulsion with exclusion of the other causes. Conclusion. Even a small amount of BGC in pediatric patients may be the sign of primary hypoparathyroidism and should be evaluated with serum electrolyte levels for early diagnosis and for the prevention of multisystemic complications of hypoparathyroidism.
Coagulation markers in diagnostic and monitoring of thromboembolic complication in COVID-19
(Wydawnictwo Uniwersytetu Rzeszowskiego, 2021) Czarnecka-Czapczyńska, Magdalena; Bartusik-Aebisher, Dorota; Krupka-Olek, Magdalena; Aebisher, David; Cieślar, Grzegorz; Latos, Wojciech; Kawczyk-Krupka, Aleksandra
Introduction. Coronavirus disease 2019 (COVID-19) was first observed in China in Wuhan city, Hubei province in December, 2019, and specified as a pandemic by the World Health Organization (WHO). COVID-19 is caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARSCoV2). Aim. The aim of this article is to discuss epidemiology of thromboembolic complication in COVID-19. Material and methods. This article is a review done in regards to discuss clinical features of the anticoagulation treatment in COVID-19. Analysis of the literature. A review is discussed an anticoagulation treatment in 41 manuscripts. Conclusion. Most commonly coagulation abnormalities in patient with COVID-19 is mild thrombocytopenia. Apart from their typical role in thrombosis and hemostasis, platelets mediate key aspects of immune and inflammatory.
Diffusion weighted imaging in differentiation of the clear cell RCC from the major non-clear cell RCC subtypes
(Wydawnictwo Uniwersytetu Rzeszowskiego, 2021) Kış, Naciye; Erok, Berrin
Introduction. Renal cell carcinoma (RCC) is the most common malignant renal tumor in adults accounting for 80-90% of primary malignant adult renal neoplasms. RCC represents a very heterogenous groups of tumors with a number of distinct histological varieties, of which the major 3 subtypes are clear cell RCC (70-80%), papillary RCC (13-20%), and chromophobe RCC (5%). Imaging features are varied from solid and relatively homogenous appearance to markedly heterogenous appearance with cystic changes, hemorrhage and necrosis. The use of diffusion weighted imaging (DWI) for RCC subtyping and also for differentiation of high grade and low grade tumors has been showed to be useful in many studies in the literature. Aim. In this study, we aimed to determine the comparative contribution of DWI in differentiation of the clear cell RCC from the major non-clear cell RCC subtypes at standard high b-value (1000 s/mm2) versus low b-value (500 s/mm2). In addition, we also aimed to assess the diagnostic performance of DWI for differentiating high grade clear cell RCC from low grade clear cell RCC based on Fuhrman grades in our patients. Material and methods. 62 cases with a prediagnosis of RCC according to MRI findings including DWI sequence with histological verification and subtyping of renal cortical tumor following a total or partial nephrectomy were included in the study. Results. Among 62 cases, 46 were male and 16 were female, with mean age of 59.5 ± 15.7. Pathological diagnoses of 62 cases were as follows, clear cell RCC, (44) papillary cell RCC (14) and chromophobe cell RCC (4). They were divided into two groups as clear cell RCC group (44 cases) and non-clear cell RCC group (18 cases). There was no statistically significant difference between the mean ADC values of clear cell and non-clear cell groups at b-value of 1000 s/mm2 (p>0.05). However, the mean ADC level for clear cell RCC group at b-value of 500 s/mm2 were significantly higher than for non-clear cell RCC group (p<0.05). When a value of 0.99x10-3 mm2/s was set as cut-off for ADC at b-factor of 500 s/mm2, differentiation was achieved with a high sensitivity (91%) and specificity (56%). Regarding the diagnostic performance of DWI for differentiating high from low Fuhrman grades clear cell RCCs, there was no statistically significant difference between the ADC values of Grade I-II clear cell RCC cases and Grade III-IV clear cell RCC cases at b-factor of 1000 s/mm2 (p>0.05). However, ADC values for grade III-IV group was statistically significantly lower than ADC values for Grade I-II group at b-factor of 500 s/mm2 level. Conclusion. ADC measurements at moderate b-value of 500 s/mm2 were more sensitive in subtyping and grading of RCC cases. This technique can be used in clinical practice as a fast and additional sequence in abdominal MRI.
Embolization as a method of treating aneurysms intracranial – a case study
(Wydawnictwo Uniwersytetu Rzeszowskiego, 2021) Kołodziej, Wojciech; Kołodziej-Lackorzyńska, Gabriela; Bodusz, Dawid; Kołodziej, Krzysztof
Introduction. Cerebrovascular accidents are the third leading cause of death in developed countries. It is a very debilitating disease of the brain structures in which aneurysms are located. For a long time, the only method of treating intracranial aneurysms was surgery. However, mainly due to the difficult placement of the aneurysms, surgical treatment was very difficult. Therefore, in 1953, the method of percutaneous arterial catheterization was developed, which became the basis for the improvement of the field of interventional radiology. Aim. The aim of the research is to describe the method of embolization of intracranial aneurysms and to illustrate it in selected clinical cases. Description of the case. Surgical management of a 60-year-old woman with intracranial aneurysm of the anterior communicating artery after performing computed tomography with contrast. Conclusion. The method of embolization of intracranial aneurysms is a reliable and accurate surgical method that significantly improves the health condition, quality of life of patients and reduces the mortality rate of cerebrovascular events.
Herbarium – Summer 2021
(Wydawnictwo Uniwersytetu Rzeszowskiego, 2021) Trójniak, Julia; Dynarowicz, Klaudia
Introduction. Medicinal plants are perfectly suited to interact with biological macromolecules like proteins and nucleic acids. All sources of natural products such as plants, microorganisms, animals, etc. are therefore biochemical potential. Aim. The goal was to present a typical plant often found in abandoned places, fields, meadows in the Podkarpacie region of Poland. Medicinal plants presented here were collected in Summer 2021 close to the city Jarosław. Material and methods. Plants collected for herbarium, immediately after harvest, are laid out between paper sheets that absorb moisture. Dried plants retain the shape of individual organs and usually also the colors. As the result of our collection, in this article are presented Papaver rhoeas L., Centaurea cyanus L., Capsella bursa – pastoris L., Taraxacum officinalle F.H., Wigg Coll and Lamium album L. Analysis of the literature. The desire to summarize information for future generations and to present the writings of the classical scholars to a wide audience was the major stimulations for presenting a most popular medicinal plants to the reader. The plants most often obtained for pharmaceutical purposes include: chamomile, fennel, St. John’s wort, nettle, mint, dandelion, yarrow, marshmallow, sage, foxglove, lemon balm, dandelion, rosehip, aloe, ginseng, and milk thistle. Conclusion. The history of plants collections is well documented.
Impact of chemotherapy on antioxidant micronutrient levels in patients with mature lymphoid malignancies
(Wydawnictwo Uniwersytetu Rzeszowskiego, 2021) Akunwata, Chima Uzoma; Olaniyi, John Ayodele
Introduction. Cancer treatments are now intense and are associated with nutritional deficiencies. The nutritional status of a patient may influence the tolerability of chemotherapy. Aim. We investigated the effects of chemotherapy on serum levels of trace elements (copper, iron, manganese, selenium, and zinc) and vitamins (A, C, and E) in patients with mature lymphoid malignancies (MLMs) at diagnosis and after 3 months. Material and methods. A case-control study of adults diagnosed with and treated for various MLMs. Thirty-nine cases and 39 age and sex-matched controls were recruited into this study. Venous blood samples were collected from the controls, cases at baseline and after 3 months of chemotherapy. Trace elements were determined by AAS while vitamins were determined by HPLC. Results. The levels of trace elements and antioxidant vitamins A and E were significantly higher (p<0.001) in cases than in controls while vitamin C was lower in cases compared to controls (p=0.005). After 3 months of treatment, 28 patients were available for analysis. There was a significant decline (p<0.001) in all the levels of trace elements and vitamins after chemotherapy. Conclusion. Chemotherapy is associated with a significant reduction in antioxidants levels in patients with MLMs.
Ivermectin for COVID-19 prophylaxis
(Wydawnictwo Uniwersytetu Rzeszowskiego, 2021) Hegazy, Abdelmonem Awad
Neuroendocrine tumor of appendix located Spiegel hernia – case report and review of the literature
(Wydawnictwo Uniwersytetu Rzeszowskiego, 2021) Karahan, Furkan; Atay, Arif; Ekinci, Neşe; Gür, Emine Özlem; Dilek, Osman Nuri
Introduction. Appendix, located within the Spiegel hernia is a rare condition. Few cases have been reported to date. Although it is generally asymptomatic, patients can apply with strangulation findings. Along with the physical examination findings, imaging methods play an important role in diagnosis and definitive diagnosis is made intraoperatively. Per-operative surgical method is determined according to the condition of the structures in the hernia sac. If an appendix is detected in the hernia sac, appendectomy is often preferred regardless of symptoms. Postoperative pathology is mostly benign but malign appendix pathologies should be kept in mind. Aim. Here, we aimed to present our case undergoing emergency surgery due to incarcerated hernia as it is the first case of appendix neuroendocrine tumor in the Spiegel hernia sac according to our literature review. Description of the case. A 77-year-old female patient who was admitted to the hospital with complaints of nausea and vomiting was evaluated as an emergency. In the clinical evaluation of the patient, we detected ileus due to hernia. We operated on the patient and found the appendix and cecum in the spiegel hernia. We did appendectomy and hernia repair. Histopathological examination of the appendix revealed a well-differentiated neuroendocrine tumor. Conclusion. Detection of the appendix in a Spiegel hernia is a rare condition. This is the first case of appendiceal malignancy in a Spiegelian hernia.
New fluorescent imaging technics in gastrology
(Wydawnictwo Uniwersytetu Rzeszowskiego, 2021) Sosna, Barbara; Bartusik-Aebisher, Dorota; Cieślar, Grzegorz; Kawczyk-Krupka, Aleksandra; Latos, Wojciech
Introduction. There is a need to develop a new imaging technique in medicine. Gastroenterology is the branch of medicine focused on the digestive system and its disorders therefore for this branch is needed to detect all problems affecting the gastrointestinal tract. Aim. The aim of this article is to complete discuss the possibility of the new fluorescent imaging technics in gastrology to use innovative screening to identify individuals at an early stage. Material and methods. We discuss here imaging techniques such as include x-rays, computed tomography, scans, and magnetic resonance imaging in gastrology. Spectroscopy is the study of the formation and interpretation of spectra resulting from the interaction of all types of radiation on matter understood as a community of atoms and molecules. Various spectroscopic techniques are obtained by combining different types of radiation with different ways of its interaction with the test sample. They provide the opportunity to obtain detailed information about the tested substance – from its atomic composition, through its chemical structure, to its surface structure. Analysis of the literatue. The tissue fluorescence spectrum can be obtained by: (1) autofluorescence, or natural or primary fluorescence, i.e. by direct irradiation of the tissue with laser radiation (laser-induced fluorescence – LIF) and (2) photodynamic diagnosis (PDD), where spectrum analysis is preceded by systemic or local administration of the photosensitizer. Conclusion. The use of fluorescence imaging in colon cancer patient has potential to improve quality of treatment and diagnosis.
Pericallosal berry aneurysm associated with azygous anterior cerebral artery – a case report
(Wydawnictwo Uniwersytetu Rzeszowskiego, 2021) Erok, Berrin; Win, Nu Nu; Tatar, Sertaç
Introduction. Azygos anterior cerebral artery is a rare variant of the anterior segment of the circle of Willis caused by an unusual fusion of the normally paired A2 segments of the anterior cerebral artery (ACA). Despite its rare occurrence, it is associated with various vascular and structural cerebral abnormalities, particularly berry aneurysms. Aim. We aimed to present a case of a 41-year-old female patient who presented to our neurology department with complaints of headache. Description of the case. She had a positive paternal history of aneurysmal subarachnoid hemorrhage. Magnetic resonance angiography (MRA) of her brain revealed an azygos ACA (bifurcating into two pericallosal arteries) which was associated with a saccular aneurysm at its bifurcation point. She was referred to the interventional radiology department for preventive endovascular treatment. Conclusion. Azygos ACA carries a high risk of aneurysm development and its occlusion can potentially compromise blood supply to both cerebral hemispheres. It is therefore crucial for clinicians to be aware of its significance and to report its presence in angiographic studies.
Posttraumatic arachnoid cyst rupturę and delayed acute subdural hygroma
(Wydawnictwo Uniwersytetu Rzeszowskiego, 2021) Erok, Berrin; Kıbıcı, Kenan
Introduction. Subdural hygromas (SDGs) are the accumulation of fluid in the subdural space. Arachnoid cysts (ACs) on the other hand are common cerebrospinal fluid (CSF) containing lesions of the central nervous system, located within the subarachnoid space. They are generally found incidentally on neuroimaging studies and remain asymptomatic throughout the life. Rupture into the subdural space resulting in subdural hygroma (SDG) is relatively rare. Aim. We aimed to show the importance of the radiological follow up in head trauma patients having large ACs. Description of the case. We report a case of a 69-year-old male patient with a known large Galassi type III AC, presented to our hospital with traumatic brain injuries and re-presented with acute posttraumatic SDG in association with AC rupture. Conclusion. This case emphasizes the importance of radiological follow up in head trauma patients having large ACs to reveal and appropriately manage traumatic subdural collections.
Randomized, open-label, controlled, comparative clinical study to evaluate the safety and efficacy of Pilex Forte tablets in combination with Pilex Ointment application for the effective management of common ano-rectal conditions
(Wydawnictwo Uniwersytetu Rzeszowskiego, 2021) Kumar, Suresh; Selvarajan, Sandhiya; Lakshmi, Prasanna; Paramesh, Rangesh; Kumawat, Rajesh; Palaniyamma, D; Srikrishna, HA
Introduction. Haemorrhoids and anal fissures are considered as the most common anorectal conditions. Aim. To evaluate the safety and efficacy of Pilex Forte tablets in combination with Pilex Ointment as compared to the Standard of Care in common anorectal conditions Material and methods. Randomized, open-label, controlled comparative clinical study conducted on 162 patients of either sex, aged between 18-50 years, confirmed with common anorectal conditions. As per randomization, patients received either standard of care or Pilex Forte tablet along with Pilex Ointment at a recommended dose of two tablets twice daily and twice daily local application (anal) for a period of 4 weeks. Clinical safety and efficacy assessments were carried out at study specific scheduled visits. Laboratory assessments were carried out only at screening and at the end of the study. Results. Patients who completed the study were considered for statistical analysis. Significant clinical improvement was observed in patients with anorectal conditions who received Pilex Forte tablet and Pilex Ointment than to those who received standards of care. No abnormal lab values were recorded and there were no adverse events reported during the study period. Conclusion. Pilex Forte tablet along with Pilex Ointment at recommended dose is safe and effective in the management of anorectal conditions like haemorrhoids and fissure-in-ano.
The relationship between mindful eating, body mass index and physical activity in nursing students – a cross-sectional study
(Wydawnictwo Uniwersytetu Rzeszowskiego, 2021) Topan, Aysel; Ayyıldız, Tülay Kuzlu; Seval, Müge; Kurt, Aylin; Top, Fadime Üstüner
Introduction. One of the reasons of obesity in university students might be mindful eating. Aim. This study was performed to evaluate the relationship between mindful eating, body mass index (BMI) and physical activity in nursing students. Material and methods. This cross-sectional study was conducted with 718 nursing students in a university in Turkey. “Personal Information Form” and “Mindful Eating Questionnaire (MEQ)” were used as data collection tools. Results. Statistically significant differences were found between some mean subscale and total scores of MEQ based on sex of the students, their state of exercising regularly, number of their meals, their state of having snacks, the type of bread they often consumed and the frequency of eating fast foods (p<0.05). A significant relationship was found between age and BMI of the students and their mean subscale and total scores of MEQ (p<0.05). Conclusion. The older the nursing students grew, the higher their level of mindful eating became. Sociodemographic characteristics such as sex and presence of a person with obesity within the family affected subscales of their mindful eating. Mindful eating decreased as body mass index increased; and besides, mindful eating increased as physical activity increased.
The significance of glycocalyx in medicine
(Wydawnictwo Uniwersytetu Rzeszowskiego, 2021) Wawrzkowicz, Jakub; Witek, Marcin; Winiarczyk, Izabela; Wyleciał, Michał; Drożdżyk, Agata; Szelengiewicz, Klaudia
Introduction. The glycocalyx is a gel-like layer covering the membrane of many cells, especially cells of epithelial tissue. It consists of membrane-bound proteoglycans, glycosaminoglycan chains, glycoproteins, and adjacent proteins. Glycocalyx is necessary in maintaining the permeability of vessels, modulation of inflammatory responses and interactions between cells. It is also involved in cell adherence, mobility, mechanotransduction, regulation of the cell cycle and cell. Abnormalities in the structure and function of the glycocalyx underlie many diseases and disorders such as dry eyes disease, diabetes and its complications as well as sepsis. Aim. In this review, we present the current view on the role of glycocalyx in human diseases. Material and methods. This review was performed according to latest literature from the following databases: EBSCO, PubMed, Science Direct, and Springer Link. Analysis of the literature. Pathological mechanisms such as disruption of the glycocalyx barrier and decreased hydration of the ocular epithelial surface cause dry eye disease. During hyperglycaemia, glycocalyx dysfunction occurs, which leads to its dysfunction and activation of the prothrombotic system. Moreover, the increase in the concentration of hyaluronidase leads to increase in the plasma hyaluronan levels and promotion of endothelial dysfunction. Additionally, degradation of glycocalyx in sepsis prevails over increased synthesis of its components strongly favors its enhanced enzymatic degradation. Conclusion. A better understanding of glycocalyx impairment in disease could alter therapeutic strategies to improve patient outcomes.

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