Medical sciences

Folia Medica Cracoviensia

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Folia Medica Cracoviensia | 2022 | Vol. 62 | No 1

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Abstract

Introduction: The musculus flexor carpi radialis (FCR) is a muscle with an important function for the mechanics and physiology of the hand. Its isolation during intrauterine development occurs relatively late, which may result in the presence of high variability during the fetal period. The aim of this study is to determine the detailed typology of FCR in the fetal period based on the available material.
Material and Methods: A total of 114 human fetuses (53 female, 61 male) aged between 117.0 and 197.0 days of fetal life were included in the study. The research material was derived from the collections of the Department of Anatomy, Medical University of Wrocław. Fetuses were stored in typical conservation solvents. The study incorporated the following methods: anthropological, preparational, and image acqui-sition, which was obtained using an innovative digital microscope. Statistical analysis was performed using R software.
Results: The typology of FCR was determined based on the characteristics of the distal attachment of the investigated muscle.
The statistical analysis revealed a predominance of type I in the examined fetal material — the attachment located on metacarpal bone II (about 82% of cases). Type IV (attachment to the 4th metacarpal bone) occurs with a frequency of less than 10% and the remaining types II and III occur with a frequency of 4–6%. The statistical analysis did not reveal bilateral or dimorphic differences in the prevalence of each FCR type. In respect of the collected anthropometric parameters, no statistically significant dimorphic differences were revealed. For a more complete description, the FCR proportionality index was intro-duced. The mean value of this index was 0.6 and was independent of the side or sex of the analyzed fetus.
Conclusions: FCR in the fetal period is characterized by a stable course in both the proximal and distal attachments.
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Authors and Affiliations

Małgorzata Suchanecka
1
Katarzyna Siwek
1
Jacek Ciach
1
Krzysztof Eicke
1
Victoria Tarkowski
2

  1. Division of Anatomy, Department of Human Morphology and Embryology, Wroclaw Medical University
  2. Clinical and Dissecting Anatomy Students Scientific Club, Wroclaw Medical University
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Abstract

This paper describes a unique case of craniosynostosis in a female skull in which sagittal sutures were completely fused by adolescence. Despite sagittal synostosis, the skull was of normal shape and size. Regarding craniometric features, the synostotic normocephalic skull was markedly different than that of scaphocephalic skulls which typically result from premature obliteration of the sagittal suture.
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Authors and Affiliations

Janusz Skrzat
1
Matthew J. Zdilla
2
Paweł Brzegowy
3
Jerzy Walocha
1

  1. Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
  2. Department of Pathology, Anatomy, and Laboratory Medicine (PALM), West Virginia University School of Medicine, Morgantown, West Virginia, USA
  3. Department of Radiology, Jagiellonian University Medical College, Kraków, Poland
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Abstract

Objectives: Designing and printing out a 3D model of a mandible, including the teeth with replicated carious lesions, to be fitted into the Dental Patient Simulator. Students assessed the 3D teeth models against the extracted teeth and the standard models, identifying specific restorative dentistry procedures where they might be applied as the teaching aids.
Methods: A 3D tooth model was printed out against a patient’s Cone Beam Computed Tomography scan. The study was attended by 22, 5th-year students, who, having prior removed the caries, filled in the cavities of different classes and trepanned the pulp chamber in the 3D models, subsequently rating them against a questionnaire.
Results: Over 95% of students recommended introducing the 3D models into teaching conservative dentistry with endodontics at the pre-clinical stage to enhance manual skills in cavity preparation and filling. The replication of tissue hardness and anatomical characteristics in the 3D models was rated significantly higher, as compared to the standard ones (p <0.05). Over 90% of students also asserted that working on the 3D models would enhance their pulp chamber trepanation skills, and rated overall replication of the anatomical characteristics significantly higher, in comparison with the standard teeth models (p <0.05).
Conclusions: In pre-clinical education, the 3D teeth models offer a viable alternative, as there is an appreciable potential for different types of teeth to be printed out, in full consideration of their anatomical diversity. Further design refinements in the 3D teeth models are required, though, particularly the ones regarding true-to-life replication of the soft tissues.
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Authors and Affiliations

Katarzyna Dobroś
1
Justyna Hajto-Bryk
1
Joanna Zarzecka
1

  1. Department of Conservative Dentistry with Endodontics, Institute of Dentistry, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
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Abstract

Introduction: Inflammatory bowel disease (IBD) represents a group of chronic inflamma-tory disorders characterized by dysbiosis and altered short-chain fatty acid (SCFA) level. The association between individual SCFA levels and cytokine levels is unknown.
Objectives: We aimed to determine the fecal SCFA levels in patients with IBD in relation to disease severity and the serum levels of pro- and anti-inflammatory cytokines.
Patients and Methods: The study included 61 patients with IBD (inactive, 22; active, 39) and 16 controls. Fecal levels of organic acids (acetic, lactic, propionic, butyric, isovaleric, isobutyric, and valeric), serum levels of tumor necrosis factor-alpha (TNF-α), interleukin-10 (IL-10), IL-17, and IL-22, complete blood count and C-reactive protein (CRP) were measured.
Results: Patients with active IBD had reduced butyric, acetic, valeric, and isovaleric acid levels and elevated lactic acid levels in stool. Hemoglobin levels were positively correlated with the levels of acetic and butyric acids ( R = 0.266 and R = 0.346, respectively; P <0.05). In addition, CRP levels were inversely correlated with butyric acid levels ( R = –0.573; P <0.05). Higher serum TNF-α levels were observed in patients with active IBD compared with controls (6.64 pg/ml vs 2.05 pg/ml, P <0.05). No relationship was noted between the SCFA profile and cytokine levels.
Conclusions: The study showed that determination of SCFA levels can be used to evaluate the activity of IBD. The relationship between individual SCFA and cytokine levels seems to be complex and requires further studies.
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Authors and Affiliations

Olga Kaczmarczyk
1
Agnieszka Dąbek-Drobny
2
Michał Woźniakiewicz
3
Paweł Paśko
4
Justyna Dobrowolska-Iwanek
4
Aneta Woźniakiewicz
3
Aneta Targosz
5
Agata Ptak-Belowska
5
Agnieszka Piątek-Guziewicz
1
Kacper Wcisło
6
Paweł Zagrodzki
4
Małgorzata Zwolińska-Wcisło
1 2

  1. Department of Gastroenterology and Hepatology, Jagiellonian University Medical College, Kraków, Poland
  2. Unit of Clinical Dietetics, Department of Gastroenterology and Hepatology, Jagiellonian University Medical College, Kraków, Poland
  3. Department of Analytical Chemistry, Faculty of Chemistry, Jagiellonian University, Kraków, Poland
  4. Department of Food Chemistry and Nutrition, Jagiellonian University Medical College, Kraków, Poland
  5. Department of Physiology, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
  6. Department of Pathomorphology, University Hospital, Kraków, Poland
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Abstract

Authors, mostly specialists on rehabilitation and orthopedic surgery prove that arthrofibrosis is a commonly overlooked phenomenon, which may lead to serious limitation in the range of movement, leading to limitation in patients quality of functioning. The main goal of this article is to emphasize the importance of understanding a such complex condition. Non typical patomechanism, lack of biomarkers dedicated to this dysfunction and general lack of under-standing in this pathology causes that risk factors and the most effective strategies remain vastly unknown. Pathophysiology of the arthrofibrosis in the joints is definitely multifactorial, but intense production of collagen seems to be the main factor. Most modern pharmacological methods concentrate on the regula-tion of collagen fiber production and reducing the inflammation. Inflammation from joint contractures stimulates the proliferation of activated cells that results in the production of extracellular matrix macromolecules to form fibrotic tissue that is deposited into the capsule, thereby resulting in fibrosis.
Lack of unified classification scale is caused by relatively high variation of the functions fulfilled by particular joints and each treatment plan should be constructed individually. Quality of surgical treatment and physical therapy play a major role in both prevention and treatment of such complex condition as arthrofibrosis.
Both iatrogenic mistakes and overly aggressive manual therapy are some of main factors increasing the risk of this pathological condition. Introducing properly conducted physical therapy treatment in the early stage is crucial to main the range of movement and preventing this significant problem.
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Authors and Affiliations

Andrzej Walocha
1
Bartosz Rutowicz
2
Wojciech Przybycień
2
Michał Zarzecki
2
Michał Kłosiński
2
Paweł Depukat
2
Bernard Solewski
2
Ewa Mizia
2
Anna Gil
2
Ewa Walocha
3

  1. Boom Boxing Studio, Kraków, Poland
  2. Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
  3. Laboratory of Nursing Theory and Fundamentals, Institute of Nursing and Midwifery, Faculty of Health Sciences, Jagiellonian University Medical College, Kraków, Poland
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Abstract

Background: Preeclampsia (PE) is a condition characterized by high blood pressure and significant proteinuria in pregnant women. It affects about 7% pregnancies and can be cause of fetal and maternal morbidity and mortality. During pregnancy, a physiological overexpression of the Renin-An-giotensin System (RAS) components is observed, including increased plasma Ang II level. Dysregulation of RAS in placenta may contribute to preeclampsia and uterine growth retardation. The aim of the study was to evaluate the Ang I metabolism in human preeclamptic placentas and to compare to normal pregnancies condition.
Method: Fragments of placental tissues were collected right after ceasarian section from PE and phy-siological pregnancies. Tissues were incubated in Krebs buffer in the presence of Ang I. Evaluation of Ang I metabolites in incubating fluid was performed by LC/MS/MS method. mRNA expression of main RAS components was measured by RT-PCR.
Results: Pattern of angiotensin metabolites did not differ between groups. The main products were Ang 1–7 and Ang II. Comparing to control group, more than 3-fold lower production of Ang II and Ang 1–7 in preeclampsia was observed. mRNA expressions of ACE and AT1 were significantly decreased in pre-eclamptic placentas, whereas higher expression of mRNA of ACE2 and MAS receptor were observed.
Conclusions: Production of Ang 1–7 by PE placentas was significantly lower than in control group. Significantly decreased mRNA expression of ACE and AT1 receptor and lower production of Ang II in placentas of PE patients suggest that placental Ang II/ACE/AT1r pathway could be less important than Ang 1–7/ACE-2/MASr pathway in development of preeclampsia, but this requires further investigations.
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Authors and Affiliations

Dominika Stettner-Kołodziejska
1
Beata Bujak-Giżycka
2
Anna Wiśniewska
3
Magdalena Łomnicka
3
Michał Kołodziejski
1
Marcin Wiecheć
1
Krzysztof Rytlewski
1
Hubert Huras
1
Rafał Olszanecki
3

  1. Chair of Gynecology and Obstetrics, Jagiellonian University Medical College, Kraków, Poland
  2. Department of Clinical Pharmacology, Jagiellonian University Medical College, Kraków, Poland
  3. Chair of Pharmacology, Jagiellonian University Medical College, Kraków, Poland
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Abstract

Each piece of information is distributed in the form of a message. Its character takes various forms, it can be expressed by words or in images. It is the visual form which is the most effective tool of influence. Graphic signs are often used to convey or exchange thoughts. The signs have an informative function but they are also meant to force a specific behavior. Such a change in expectations and beliefs of a specific regulator is called the social impact. The intensity of interpersonal relationships is deliberately stimulated through an appropriate form of communication. The more expressive and emotional is its character, the greater the benefits for the quality of communication in the process of promoting healthy behaviors.
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Authors and Affiliations

Artur Fałek
1
Franciszek Burdan
2

  1. Independent Public Healthcare, Puławy, Poland
  2. St. John’s Cancer Center; Human Anatomy Department, Medical University of Lublin, Lublin, Poland
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Abstract

Coronavirus infection (COVID-19) is a highly infectious disease of viral etiology. SARS-CoV-2 virus was first identified during the investigation of the outbreak of respiratory disease in Wuhan, China in December 2019. And already on March 11, 2020 COVID-19 in the world was characterized by the WHO as a pandemic. In Ukraine the situation with incidence COVID-19 remains difficult. The purpose of this study is to to develop a mathematical forecasting model for COVID-19 incidence in Ukraine using an exponential smoothing method. The article analyzes reports on basic COVID-19 incidence rates from 29.02.2019 to 01.10.2021. In order to determine the forecast levels of statistical indicators that characterize the epidemic process of COVID-19 the method of exponential smoothing was used. It is expected that from 29.02.2019 to 01.10.2021 the epidemic situation of COVID-19 incidence will stabilize. The indicator of “active patients” will range from 159.04 to 353.63 per 100 thousand people. The indicator of “hospitalized patients” can reach 15.43 and “fatalities” — 1.87. The use of the method of exponential smoothing based on time series models for modeling the dynamics of COVID-19 incidence allows to develop and implement scientifically sound methods in order to prevent, quickly prepare health care institutions for hospitalization.
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Authors and Affiliations

Nina Malysh
1
Alla Podavalenko
2
Olga Kuzmenko
3
Svitlana Kolomiets
3

  1. Department of Infectious Diseases with Epidemiology, Sumy State University, Rymskogo-Korsakova 2, Sumy, Ukraine
  2. Department of Hygiene, Epidemiology and Occupational Diseases, Kharkiv Medical Academy of Postgraduate Education, Amosova, 58, Kharkiv, Ukraine
  3. Department of Economic Cybernetics, Sumy State University, Rymskogo-Korsakova 2, Sumy, Ukraine
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Abstract

Introduction: Cardiac implantable electronic devices (CIED) such as pacemakers or car-dioverter defibrillators prevent dangerous heart arrhythmias and conduction abnormalities. Post-inter-vention education is crucial in the patient recovery process and aims to avoid both dangerous behavior and unnecessary restraints in daily living.
Objective: The evaluation of knowledge of daily activities’ safety among patients with CIEDs and an analysis of the relationship between the state of knowledge and perceived post-intervention quality of life.
Materials and Methods: The study group included 100 patients (57% men) with CIEDs, recruited in the University Hospital in Kraków. Data on the patients’ knowledge about permissible daily activities, medical procedures and perceived quality of life was collected using a dedicated questionnaire, which comprised 57 simple and multiple-choice questions.
Results: The analyzed group included patients aged 28 to 97 years (mean age 73). Among them, 26% either have not received or have not read the information booklet. Two-thirds of them either need more information about their device (51%) or do not possess essential knowledge (15%). Patients raised con-cerns about performing daily activities such as: car-driving (38%), using seat belts (14%), bathing (15%), returning to work (51%) or climbing stairs (16%). They reported anxiety when using computers (39%), mobile phones (51%), microwaves (73%) and even electric toothbrushes (51%). It has been observed that patients with a greater general understanding of the pacemaker and post-implantation restraints had a higher quality of life on average.
Conclusions: Patients with CIEDs restrain themselves excessively in daily living. There is a strong need to provide them with knowledge of their medical condition, concomitant capabilities, and limitations to undergo a fully successful rehabilitation. Comprehensive and easily comprehensible recommendations may play a key role in improving patients’ quality of life.
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Authors and Affiliations

Szymon Góral
1
Marta Teliżyn
1
Marek Rajzer
2
Agnieszka Olszanecka
2

  1. Students’ Scientific Group at the 1st Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Kraków, Poland
  2. 1st Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Kraków, Poland
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Abstract

Background: Oral Health Related Quality of Life (OHRQoL) is a significant patient-oriented outcome which should be considered in diagnostic, decision making and therapeutic process by dentists.
Objectives: To evaluate the influence of a condition of teeth, oral mucosa and dentures on the OHRQoL among patients seeking dental treatment in the University Dental Clinic (UDC) in Kraków, Poland.
Material and Methods: 250 patients took part in a cross-sectional study conducted in the UDC in Kraków. Collected clinical data included: oral mucosa and periodontal condition, number of Decayed, Missed and Filled Teeth (DMFT index), presence of dentures. Questionnaire part of the study has been based on OHIP-14 questionnaire.
Results: The condition of teeth worsened OHRQoL in following groups of patients: first-time visitors, smokers, with periodontal diseases and without oral mucosal diseases. There was a positive significant correlation between number of decayed teeth and OHRQoL related to teeth. The condition of oral mucosa significantly impaired OHRQoL in: women, patients with oral mucosal diseases and those who undergone prosthetic treatment in the last year. There was a correlation between number of missing teeth, DMFT index, age and subscale 2 of the form. The condition of dentures significantly impaired the OHRQoL in patients: who used removable dental prostheses, undergone prosthetic treatment in the last year and females. There was a positive correlation between subscale 3 of the questionnaire and number of missing teeth and DMFT index and a negative correlation with number of filled teeth within this subscale.
Conclusions: Evaluation of patient’s OHRQoL is one of important components for successful dental treatment.
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Authors and Affiliations

Katarzyna Wąsacz
1
Dominika Hukowska
2
Maria Chomyszyn-Gajewska
1

  1. Department of Periodontology, Dental Prophylaxis and Oral Pathology, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
  2. Private practice, Kraków, Poland

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