Medical sciences

Folia Medica Cracoviensia

Content

Folia Medica Cracoviensia | 2021 | Vol. 61 | No 1 |

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Abstract

Irritable bowel syndrome (IBS) is a multifactorial gastrointestinal disorder with still not fully understood pathogenesis. At first, the treatment of IBS was mainly focused on alleviating symptoms (with the use of laxatives, anti-diarrheals, anti-spasmodics and painkillers) and then became more specific by targeting discovered pathways responsible for proper functioning of the gastrointestinal system, for in-stance: 5HT3, 5HT4, cannabinoid and opioid receptors, guanylyl cyclase C, chloride channels and sodium- hydrogen exchanger. Nowadays, there is a growing number of experimental IBS treatment strategies and in this article we discuss these novel and therapeutic options in IBS, their efficacy and future perspectives.
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Authors and Affiliations

Jakub Włodarczyk
1
Patrycja Szałwińska
1
Anna Waśniewska
1 2
Jakub Fichna
1

  1. Department of Biochemistry, Medical University of Lodz, Poland
  2. Department of Normal and Clinical Anatomy, Medical University of Lodz, Poland
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Abstract

Background: pharmacists remain on the frontline of public health around the globe and their performance directly impacts patients’ safety. So far, to our knowledge, no European study has been dedicated to their heath-related quality of life (HQoL). Therefore, the primarily aim of our study was to evaluate HQoL of Polish pharmacists utilizing the SF-36 health survey with regard to anthropometric and lifestyle-related variables.
Methods: A total sample screened consisted of 1412 respondents, yet 765 pharmacists (mean age 40, 86.3% females) finally participated in the study. HQoL was assessed with the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36).
Results: The lowest median scores were noted for general health (GH, 50.0) and vitality (V, 60.0) domains. No gender differences regarding physical and mental summary scores were found. Significant difference of HQoL was found among the assessed age groups in several domains, especially physical functioning (PF) and GH (p <0.001) scores, and especially in the group of 51–60-year-old-respondents. Correlations were found between PF (r = –0.29, p <0.001), GH (r = –0.25, p <0.001) and age as well PF (r = –0.27, p <0.001), GH (r = –0.21, p <0.001) and BMI. Self-assessed dietary habits were correlated with PF (r = 0.22, p <0.001), mental health (r = 0.25, p <0.001), GH (r = 0.27, p <0.001) and V (r = 0.30, p <0.001) scores.
Conclusions: The analysis indicates that pharmacists tend to have similar mental and physical burden according to SF-36, with age, BMI and dietary habits as predominant factors influencing their HQoL. The study presents unique values for future comparative analyses related, for instance, to the influence of the ongoing pandemic on HQoL of health-care providers.
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Authors and Affiliations

Magdalena Kurnik-Łucka
1
Paweł Pasieka
1
Agnieszka Górecka-Mazur
1
Elżbieta Rząsa-Duran
2
Jakub Pękala
1
Krzysztof Gil
1

  1. Department of Pathophysiology, Jagiellonian University Medical College, Kraków, Poland
  2. Pharmacists’ Chamber of Lesser Poland, Kraków, Poland
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Abstract

Aim: The aim of this study was to assess long-term outcomes and complications associated with conservative and operative treatment of distal radius fractures and to determine if restoration of radio-graphic parameters influences functional outcomes.
Introduction: Distal radius fractures (DRFs) are common injuries associated with many complica-tions. Numerous studies suggest that operative treatment with anatomic reduction and restoration of radiographic parameters leads to better functional outcomes than nonsurgical treatment.
Materials and Methods: We enrolled 207 patients with isolated DRF (mean age 64 ± 17.9 years, women 150 (72.5%)) to our retrospective, single-center study (101 treated operatively, 106 treated non-operatively). There were no significant differences in sex, age, AO type fracture between study groups. After 3.9 ± 1.6 years (mean ± SD) clinical, functional and radiological assessment was conducted using Disabilities of the Arm, Shoulder and Hand (DASH), Patient Rated Wrist Evaluation (PRWE), 9-Hole Peg Test (9-HPT), grip and pinch strength tools.
Results: We found higher rates of malunion in nonoperative group (p <0.0001) and worse radiologic parameters such as volar tilt (p <0.0001), teardrop angle (p <0.0001) versus operative cohort. Nevertheless radiological parameters were not correlated with DASH and PRWE results. Moreover, patients aged 50 years and above treated operatively had similar functional outcomes (DASH, PRWE) to those treated nonoperatively.
Conclusions: Restoration of anatomic and thus radiologic parameters of radius may not be obligatory to achieve satisfactory functional outcome in patients with DRF aged 50 years or above. Patient is the most important ‘factor’ in determining appropriate and successful treatment method of distal radius fractures.
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Authors and Affiliations

Jakub Marchewka
1 2
Jakub Szczechowicz
1
Wojciech Marchewka
3
Edward Golec
1

  1. Department of Physiotherapy, University of Physical Education, Kraków, Poland
  2. Department of Orthopedics and Trauma Surgery, 5th Military Hospital, Kraków, Poland
  3. Jagiellonian University Medical College, Kraków, Poland
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Abstract

Isolated internal iliac artery aneurysms are rarely described in the available literature. The paper presents a case of a 70-year-old female with idiopathic thrombocytopenia, squamous cell cervical carci-noma, and saccular aneurysm of the left internal iliac artery, detected in magnetic resonance. The review of aneurysm of the common, external and internal iliac arteries is added.
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Authors and Affiliations

Franciszek Burdan
1 2
Krzysztof Czarnocki
1
Agnieszka Mocarska
1
Maciej Burdan
2
Iwonna Żelazowska-Cieślińska
1
Elżbieta Starosławska
1

  1. St. John’s Cancer Centre, Lublin, Poland
  2. Human Anatomy Department, Medical University of Lublin, Lublin, Poland
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Abstract

Temporomandibular disorders (TMD) encompass a diverse group of abnormalities in the functioning of the masticatory muscles, temporomandibular joints, and surrounding structures within the facial skull. One of the important etiological factors, contributing to the development of TMD are psychoemotional disorders, which include: depression, dysthymia, personality disorders, panic attacks as well as states and anxiety neuroses.
The aim of the study was to carry out a retrospective evaluation of the occurrence of psychoemotional disorders reported in the application form of medical interview of patients treated at the Consulting Room of Temporomandibular Disorders in Dental Institute (University Dental Clinic) for TMD.
The research material consisted of a subjective survey according to the protocol of the RDC/TMD questionnaire, axis II, of the 360 patients (224 women, 136 men), aged 19 to 43 who came to the University Dental Clinic in Krakow due to TMD management.
Result: The results of the conducted studies indicate the common occurrence of emotional disorders in the group of patients treated for TMD, both in the group of muscular and joint form of dysfunctions. The most often the patients selected: loss of sexual interest or pleasure, crying easily, feeling lonely, indifference to every-thing and feeling of worthlessness. These aspects show a significant influence of emotional factors on TMD.
Conclusion: The results of the conducted research indicate a significant frequencies of psychological and emotional disturbances reported in a survey among patients with TMD. Key
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Authors and Affiliations

Małgorzata Pihut
1
Magdalena Krasińska-Mazur
1
Joanna Biegańska-Banaś
2
Andrzej Gala
1

  1. Consulting Room of Temporomandibular, Disorders, Dental Institute, Prosthodontics Department, Jagiellonian University Medical College, Kraków, Poland
  2. Institute of Nursing and Midwifery, Department of Health Psychology, Jagiellonian University Medical College, Kraków, Poland
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Abstract

Background/Aim: Factors influencing the survival of the nursing home population have not yet been clearly defined. The aim of the study was to investigate the impact of nutritional, mental, functional, disease and pharmacological factors on the survival of nursing home residents with severe disabilities.
Material and Methods: A retrospective cohort study was conducted with a 9-year follow-up period among nursing home residents with a Barthel score ≤40. The initial assessment included the following scales: Mini Nutritional Assessment Short-Form (MNA-SF), Abbreviated Mental Test Score (AMTS), the Barthel Index, and blood pressure (BP) measurements. Comorbidities, medications and all-cause mortality were extracted from medical records. The analyzed cohort was divided into two groups: Deceased — residents who died ≤3 years and Survivors — those who survived >3 years of observation.
Results: Survivors (n = 40) and Deceased (n = 48) did not differ significantly in terms of age, sex, systolic and diastolic BP, the Barthel Index, number of diseases and medications used. Survivors had significantly higher scores in MNA-SF (p <0.001) and AMTS (p <0.003) than Deceased. Moreover, Survivors had hyper-tension significantly more often and took aspirin and ACE inhibitors (p <0.05). The multivariable logistic regression analysis showed that the MNA-SF score significantly affected mortality [OR = 0.62, (95%CI, 0.46– 0.84), p <0.001].
Conclusion: Higher MNA-SF scores were a factor that significantly affected the survival of nursing home residents, while functional status assessed using the Barthel Index had no effect on survival. MNA-SF was found to be a useful tool for assessing the risk of death in a nursing home.
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Authors and Affiliations

Anna Kańtoch
1
Jadwiga Wójkowska-Mach
2
Barbara Wizner
1
Piotr Heczko
2
Tomasz Grodzicki
1
Barbara Gryglewska
1

  1. Department of Internal Medicine and Gerontology, Faculty of Medicine, Jagiellonian University Medical College, University Hospital in Kraków, Kraków, Poland
  2. Department of Microbiology, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
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Abstract

Introduction: The Dundee Ready Education Environment Measure (DREEM) is an instru-ment that assesses the educational environment.
Aim: The aim of this study was to psychometrically evaluate a Polish version of the DREEM instrument.
Material and Methods: 203 medical students who fully completed the DREEM questionnaire were included in the study. Validity was evaluated through the analysis of construct validity and reliability.
Results: After language validation the internal consistency was assessed. Cronbach’s alpha for the overall score was 0.93 and the five subscales were: perceptions of learning 0.86, perceptions of teachers 0.82, perceptions of atmosphere 0.75, academic self-perceptions 0.61, and social-self perceptions 0.61. The exploratory factor analyses, however, yielded dimensions that did not fully correspond to the original DREEM subscales.
Conclusions: Internal consistency of the Polish version of the DREEM scale as a whole was excellent, however for each of five originally developed subscales it was lower and vary a lot; construct validity of Polish version was not compatible with the original structure of the DREEM scale but was reasonable. A new five-factor solution obtained in this study could be a reliable tool for assessing the medical education environment in the Polish circumstances, but it will require confirmation in future study.
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Authors and Affiliations

Dorota Zawiślak
1
Kamila Żur-Wyrozumska
1
Mariusz Habera
1
Karolina Skrzypiec
1
Agnieszka Pac
2
Grzegorz Cebula
1

  1. Department of Medical Education, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
  2. Chair of Epidemiology and Preventive Medicine, Jagiellonian University Medical College, Kraków, Poland
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Abstract

It was assumed that the temperature at which caffeine is consumed may cause changes in the mechanical and morphological properties of bones and affect the bone metabolism of pregnant female. The aim of the study was to assess the effect of caffeine used at different temperatures on selected morphological and mechanical properties of the femur as well as biochemical indicators of bone formation in female rats in pregnancy. It was use test solution at the temperature 10, 25 and 45ºC from 8 to 21 day during pregnancy, once a day. It was found that the temperature of administrated caffeine may have an effect on changing the morphometric properties and on the bone metabolism of pregnant female rats. The application of caffeine solution, was administrated at 10ºC caused the most constrained growth of the femur and weakened resistance to load, and caused increased susceptibility to cracks. Analysis of bone metabolism indicators showed that caffeine administered in the form of a solution at 10ºC and 25ºC caused the most negativity effects for bone formation and bone turnover indicators. The administration of caffeine at 10ºC causes the largest negative changes in bone morphological and strength indicators and hasn’t a beneficial effect on the bone metabolism of pregnant female rats.
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Authors and Affiliations

Monika Cendrowska-Pinkosz
1
Wojciech Dworzański
1
Magdalena Krauze
2
Paulius Matuseviĉius
3
Katarzyna Ognik
2
Franciszek Burdan
1

  1. Department of Human Anatomy, Medical University in Lublin, Lublin, Poland
  2. Department of Biochemistry and Toxicology, University of Life Sciences in Lublin, Lublin, Poland
  3. Department of Animal Nutrition, Lithuanian University of Health, Kaunas, Lithuania
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Abstract

Introduction: Screening sinonasal evaluation is routinely performed before allogeneic hematopoietic cell transplantation (allo-HCT), however, data supporting such evaluation is inconsistent.
Objectives: Assessment of the utility of screening sinonasal evaluation with computed tomography (CT).
Methods: A retrospective analysis of acute leukemia patients who underwent allo-HCT, for whom screening sinonasal CT scans were reevaluated, and for whom Lund-Mackay score (LMS) was calculated.
Results: Forty-eight patients, the median age at allo-HCT 38 years (18–58), 52% males, were included. 79% had acute myeloid leukemia (AML), 21% acute lymphoblastic leukemia (ALL). Conditioning inten-sity was myeloablative in 96% of patients, 21% of patients received total body irradiation. 19% of patients had a history of sinusitis before allo-HCT. Screening sinus CT was performed a median of 22 days before allo-HCT. The median LMS was 1 point (0– 10). The severity of sinus abnormalities was: no abnormalities (31%), mild (67%), moderate (2%), severe (0%). Mucosal thickening was the most frequent abnormality (69%). Eleven patients experienced sinusitis after a median of 93 days (11–607) after allo-HCT. 1-year cumulative incidence of sinusitis was 22%. No threshold of LMS and no type of sinus abnormalities were correlated with sinusitis development after allo-HCT. Mild sinus disease at screening did not negatively impact survival in comparison to no sinus disease.
Conclusions: Despite the fact, that majority of analyzed patients had either no or mild sinus disease at screening a significant proportion of patients developed sinusitis after allo-HCT. Evaluation of LMS before allo-HCT did not help predict the development of sinusitis after the procedure.
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Authors and Affiliations

Jacek Sokołowski
1
Joanna Drozd-Sokołowska
2
Katarzyna Kobylińska
3
Przemysław Biecek
3
Ewa Karakulska-Prystupiuk
2
Agnieszka Tomaszewska
2
Tomasz Gotlib
1
Kazimierz Niemczyk
1
Wiesław Wiktor-Jędrzejczak
2
Grzegorz Władysław Basak
2

  1. Department of Otolaryngology, Medical University of Warsaw, Warsaw, Poland
  2. Department of Hematology, Transplantation and Internal Medicine, Medical University of Warsaw, Warsaw, Poland
  3. Faculty of Mathematics and Information Science, Warsaw University of Technology, Warsaw, Poland
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Abstract

Undisturbed branched-chain amino acids (BCAA) catabolism is necessary for normal heart function. The key enzyme in BCAA catabolism is a multienzyme branched-chain α-keto acid dehydro-genase complex (BCKDH). BCKDH activity is regulated mainly by reversible dephosphorylation (activa-tion)/phosphorylation (inactivation) cycle catalyzed by regulatory enzymes, a specific phosphatase (PPM1K) and kinase (BDK). 5-fluorouracil (5-FU) is widely used in the treatment of different types of cancer. 5-FU has the potential to cause a wide spectrum of cardiotoxicity, ranging from asymptomatic electrocardiographic changes to cardiomyopathy and subsequent cardiac failure. We hypothesize that 5-FU modifies BCKDH activity and affects cardiac muscle metabolism. The current study was aimed at the investigation of the in vivo effect of 5-FU on BCKDH activity and mRNA levels for E1, PPM1K and BDK. Wistar male rats were administered with 4 doses of 5-FU, 150 mg/kg b.wt. each (study group) or 0.3% methylcellulose (control group). BCKDH activity was assayed spectrophotometrically. The mRNA levels were quantified by real-time PCR. 5-FU treatment caused an increase in BCKDH activity that appears to result mainly from increased dephosphorylation of the complex and is associated with an increase of PPM1K mRNA level and reduction of BDK and E1 mRNA levels. It is conceivable that 5-FU stimulation of BCKDH is an adaptive reaction with the purpose of enhancing the BCAA catabolism and protecting from toxic effect caused by excessive accumulation of these amino acids in heart.
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Authors and Affiliations

Małgorzata Knapik-Czajka
1
Michał Jurczyk
2
Justyna Bieleń
1
Veronika Aleksandrovych
2
Anna Gawędzka
1
Paulina Stach
2
Jagoda Drąg
1
Krzysztof Gil
3

  1. Department of Biochemical Analytics, Jagiellonian University Medical College, Kraków, Poland
  2. Department of Pathophysiology, Jagiellonian University Medical College, Kraków, Poland
  3. 2Department of Pathophysiology, Jagiellonian University Medical College, Kraków, Poland

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