Medical sciences

Folia Medica Cracoviensia

ISSN

ISSN 0015-5616

Publishers

Oddział PAN w Krakowie; Uniwersytet Jagielloński – Collegium Medicum

Editorial Board:

Editor-in-Chief
dr hab. Krzysztof Gil, prof. UJ, Department of Pathophysiology, Jagiellonian University Medical College, Kraków, Poland
ORCID 0000-0002-4732-7698

Vice Editor-in-Chief
Prof. Andrzej Surdacki, 2nd Department of Cardiology, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
ORCID 0000-0001-7949-3140

Secretary Editor
Prof. Beata Kuśnierz – Cabala, Department of Diagnostics, Jagiellonian University Medical College, Kraków, Poland
ORCID 0000-0001-8639-5688

Editorial Board Members:

Prof. Benjamin Chain, Department of Infection and Immunity, University College London, London, England

Prof. Paul Enck, Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen Germany

Prof. Tomasz Grodzicki, Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, Kraków, Poland

Prof. Kalina Kawecka-Jaszcz, 1st Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Kraków, Poland

Prof. Maciej Małecki, Department of Metabolic Diseases, Jagiellonian University Medical College, Kraków, Poland

Prof. Janusz Marcinkiewicz, Department of Immunology, Jagiellonian University Medical College, Kraków, Poland

Prof. Franz H. Messerli, Swiss Cardiovascular Center, University of Bern, Switzerland and Department of Cardiology, Icahn School of Medicine, Mount Sinai Health Center, New York, USA

Prof. Jacek Musiał, 2nd Department of Internal Medicine, Jagiellonian University Medical College, Kraków, Poland

Prof. Wiesław Pawlik, Department of Physiology, Jagiellonian University Medical College, Kraków, Poland

Prof. Jacek J. Pietrzyk, 1st Department of Children's Diseases and the Department of Pediatrics, Jagiellonian University Medical College, Kraków, Poland

Prof. Władysław Sułowicz, Department of Nephrology, Jagiellonian University Medical College, Kraków, Poland

Prof. Jerzy A. Walocha, Department of Anatomy, ,Jagiellonian University Medical College, Kraków, Poland

Adres redakcji
ul. Czysta 18
31-121 Kraków
e-mail: folmedcrac@pan.pl

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Content

Folia Medica Cracoviensia | 2022 | Vol. 62 | No 2

1 Teledentistry and oral health in older adults — aspects for implementation of the “Patient centric solution for smart and sustainable healthcare (ACESO)” project

Barbara Gryglewska , Ian Perera , Ewa Klimek , Małgorzata Fedyk-Łukasik , Karolina Piotrowicz , Irina Mocanu , Ligia Muntianu , Jerzy Gąsowski

Folia Medica Cracoviensia | 2022 | Vol. 62 | No 2 | 5-16 | DOI: 10.24425/fmc.2022.141697

Keywords: teledentistry older adults oral health oral health-related diseases

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Abstract

Purpose: Oral health and diseases are significant components of general health. However, oral health-care remains at the lowest of older patients’ priorities. The inability to obtain dental care can result in progression of dental disease, leading to a diminished quality of life and overall health. Teledentistry (TD) provides an opportunity to improve the quality of oral health services. The aim of our narrative review was to analyze the usefulness of teledentistry as a part of telemedicine to improve oral health in the elderly.
Materials/Methods: The PubMed database search was done for: teledentistry, oral health, oral- health related diseases, elderly, older adults.
Results: The applicability of TD has been demonstrated from children to older adults. Older adults have many obstacles in getting oral health care, including low income, lack health insurance, frailty, anxiety, depression, mobility problems or other handicaps. Available data suggests that the usefulness of TD in the provision of oral care in elderly people living in residential aged care facilities. Moreover, TD procedures were found to be as accurate as traditional face-to-face dental examinations, they was cost-effective and well accepted among patients and caregivers.
Conclusions: TD might be a very useful tool for professional education, improving access and patient satisfaction of dental care. However, such TD modes would be difficult to widely implementation in community-dwelling older people who cannot access dental care. The ongoing “Patient centric solution for smart and sustainable healthcare (ACESO)” project will add to the intelligent oral health solutions.

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Authors and Affiliations

Barbara Gryglewska

1 2

Ian Perera

Ewa Klimek

1 2

Małgorzata Fedyk-Łukasik

1 2

Karolina Piotrowicz

1 2

Irina Mocanu

Ligia Muntianu

Jerzy Gąsowski

1 2

Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, Kraków, Poland
University Hospital, Kraków, Poland
Centrul IT Pentru Stiinta si Tehnologie, and Computer Science Department, University Politehnica of Bucharest, Romania
UMF Carol Davila Bucharest Faculty of Dental Medicine, Department of Removable Prosthodontics, Bucharest, Romania

2 Penetration of the posterior interosseous nerve fibers into the dorsal capsule of the wrist — a new perspective on wrist innervation

Michał Bonczar , Tomasz Bonczar , Patryk Ostrowski , Martyna Dziedzic , Mariusz Bonczar , Dawid Plutecki , Anna Gil , Małgorzata Jasińska , Grzegorz Lis , Jerzy Walocha , Mateusz Koziej

Folia Medica Cracoviensia | 2022 | Vol. 62 | No 2 | 17-25 | DOI: 10.24425/fmc.2022.141700

Keywords: wrist innervation pin dorsal capsule of the wrist

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Abstract

The dorsal capsule of the wrist and the DCSS may play a significant role in the conduction of nerve signals transmitted from proprioceptors present in SL to PIN, which is located above the dorsal capsule. Hence, this study aimed to determine if nerve fibers of PIN penetrate inside the dorsal capsule. The dorsal capsules of the wrist were dissected from both sides from 15 cadavers. Eventually, 30 dorsal capsules were dissected. It can be concluded that the PIN nerve fibers penetrate the dorsal capsule of the wrist, as the penetration was noticeable in every part evaluated.
The present study proves that afferent fibers from the mechanoreceptors of the SLIL potentially pass through the DCSS and subsequently through the dorsal capsule of the wrist to the PIN. This knowledge can surely be of great use for hand surgeons that perform procedures on the dorsal wrist.

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Authors and Affiliations

Michał Bonczar

Tomasz Bonczar

Patryk Ostrowski

Martyna Dziedzic

Mariusz Bonczar

Dawid Plutecki

Anna Gil

Małgorzata Jasińska

Grzegorz Lis

Jerzy Walocha

Mateusz Koziej

Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
Collegium Medicum, Jan Kochanowski University, Kielce, Poland
Department of Histology, Jagiellonian University Medical College, Kraków, Poland

3 The influence of 5-fluorouracil on the α-ketoglutarate dehydrogenase complex in rat’s cardiac muscle — a preliminary study

Małgorzata Knapik-Czajka , Anna Gawędzka , Michał Jurczyk , Jagoda Drąg , Małgorzata Belczyk , Veronika Aleksandrovych , Anna Gil , Krzysztof Gil

Folia Medica Cracoviensia | 2022 | Vol. 62 | No 2 | 27-35 | DOI: 10.24425/fmc.2022.141705

Keywords: 5-fluorouracil α-ketoglutarate dehydrogenase rats cardiac muscle

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Abstract

5-fluorouracil (5-FU), which is a commonly used chemotherapy agent exerts undesired cardiac toxicity. Mitochondrial dysfunction is thought to be one of potentially important mechanisms of 5-FU- induced cardiotoxicity. α-ketoglutarate dehydrogenase (α-KGDHC) is the key regulatory enzyme of TCA cycle. The complex consists of multiple copies of three catalytic subunits: α-ketoglutarate dehydrogenase (E1), dihydrolipoamide succinyltransferase (E2) and dihydrolipoamide dehydrogenase (E3). α-KGDHC together with branched chain α-ketoacid dehydrogenase (BCKDHC) and pyruvate dehydrogenase (PDHC), are the members of 2-oxoacid dehydrogenases family that share some structural and functional similarities. Recently, it has been found that 5-FU stimulates BCKDHC in rat’s cardiac muscle. Therefore, we hypothesize that 5-FU modifies α-KGDHC activity and affects cardiac muscle metabolism. The aim of this study was to determine the effect of 5-FU on α-KGDHC activity and protein levels of E1 and E2 subunits of the complex in rat’s cardiac muscle. 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). α-KGDHC activity was assayed spectrophotometrically. The E1 and E2 proteins levels were quantified by Western blot. 5-FU administration resulted in stimulation of myocardial α-KGDHC activity in rats. In addition, E2 protein level increased in response to 5-FU treatment, while the E1 protein level remained unchanged. Up- regulation of α-KGDHC appears to result from change in E2 subunit protein level. However, the effect of 5-FU on factors modifying α-KGDHC activity at post-translational level cannot be excluded.

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Authors and Affiliations

Małgorzata Knapik-Czajka

Anna Gawędzka

Michał Jurczyk

Jagoda Drąg

Małgorzata Belczyk

Veronika Aleksandrovych

Anna Gil

Krzysztof Gil

Department of Biochemical Analytics, Jagiellonian University Medical College, Kraków, Poland
Department of Pathophysiology, Jagiellonian University Medical College, Kraków, Poland
Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland

4 New insights on the link between body composition, nutritional status and physical performance in elderly outpatients

Paulina Fatyga-Kotula , Barbara Wizner , Małgorzata Fedyk-Łukasik , Tomasz Grodzicki , Anna Skalska

Folia Medica Cracoviensia | 2022 | Vol. 62 | No 2 | 37-48 | DOI: 10.24425/fmc.2022.141698

Keywords: aged geriatric assessment body composition nutrition status physical performance

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Abstract

Objectives: The aim of the study was to assess the relationship between body composition, nutritional status and physical ability in elderly outpatients.
Method:. In this cross-sectional study, demographic data and medical history were collected from patients aged ≥60 years followed in the Geriatric Outpatient Clinic from October 2010 to February 2014. Body composition was examined using a dual-energy X-ray absorptiometry. Physical performance was assessed by gait speed (GS), Timed Up & Go Test (TUG), Six Minute Walk Test (6MWT). The nutritional status was evaluated using the Mini Nutritional Assessment (MNA) and serum albumin level.
Results: Mean age (± SD) of 76 patients (64.47% men) was 71.93 ± 8.88 yrs. The most common diseases were: hypertension (89.47%), coronary heart disease (81.58%) and chronic heart failure (68.4%). In multiple regression analyses, the factors significantly affecting GS were: age (B = –0.017, p ≤0.0001), good nutritional status (B = 0.038, p <0.01) and percent of lower extremity fat (B = –0.009, p <0.05). Longer TUG time was associated with poorer nutritional status (B = –0.031, p <0.01), older age (B = 0.01, p <0.01) and a higher number of comorbidities (B = 0.034, p <0.05). 6MWT was influenced negatively by age (B = –3.805, p <0.01) and percent of lower extremity fat (B = –2.474, p <0.05).
Conclusions: Age and nutritional status remain a strong determinant of physical fitness deterioration. Different measures of physical performance are influenced by different elements of body composition — no single element of body composition was found determining the deterioration of all assessed parameters of physical fitness.
Identifying the relationship between body composition, nutritional status and physical performance can help elucidate the causes of disability and target preventive measures.

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Authors and Affiliations

Paulina Fatyga-Kotula

Barbara Wizner

Małgorzata Fedyk-Łukasik

Tomasz Grodzicki

Anna Skalska

Department of Toxicology and Occupational Diseases, Jagiellonian University Medical College, Kraków, Poland
Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, Kraków, Poland

5 Medical students’ perception of e-learning approach (MeSPeLA) — a mixed method research

Mirosława Püsküllüoğlu , Michał Nowakowski , Sebastian Ochenduszko , David Hope , Helen Cameron

Folia Medica Cracoviensia | 2022 | Vol. 62 | No 2 | 49-70 | DOI: 10.24425/fmc.2022.141699

Keywords: e-learning online-learning medical education virtual learning environment

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Abstract

There is a discrepancy between the research exploring e-learning at medical universities in Central/Eastern and Western European countries. The aim of the MeSPeLA study was to explore the understanding, experience and expectations of Polish medical students in terms of e-learning. Questionnaire containing open-ended and closed questions supplemented by focus group discussion was validated and performed among 204 medical students in Poland before COVID-19 pandemia. Several domains: understanding of e-learning definitions; students’ experience, preferences, expectations and perceptions of e-learning usefulness, advantages and disadvantages were addressed. The qualitative data were analyzed using an inductive approach. 46.0% of students chose a communication-oriented definition as the most appropriate. 7.4% claimed not to have any experience with e-learning. 76.8% of respondents indicated they had contact with e-learning. The main reported e-learning advantages were time saving and easier time management. The most common drawback was limited social interactions. The acceptance of the usage of e-learning was high. Medical undergraduates in Poland regardless of the year of studies, gender or choice of future specialization showed positive attitudes towards e-learning. Students with advanced IT skills showed a better understanding of the e-learning definition and perceived e-learning to be a more useful approach. The expectations and perceptions about e-learning in Polish medical schools seems similar to some extent to that in Western European and the United States so we can be more confident about applying some lessons from these research to Poland or other post-communist countries. Such application has been accelerated due to COVID-19 pandemia.

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Authors and Affiliations

Mirosława Püsküllüoğlu

Michał Nowakowski

Sebastian Ochenduszko

David Hope

Helen Cameron

Department of Clinical Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Cracow Branch, Kraków, Poland
2nd Department of General Surgery, Jagiellonian University Medical College, Kraków, Poland
Department of Medical Oncology, Hospital Universitario Dr Peset, Valencia, Spain
Centre for Medical Education, The Chancellor’s Building, College of Medicine and Veterinary Medicine, The University of Edinburgh, Edinburgh, Scotland
Aston Medical School, Aston University, Birmingham, UK

6 The growing need for reliable online health information during lockdown in Europe: An infodemiologic analysis of myocardial infarction management in the COVID-19 era

Dominik Felkle , Michał Ł. Korman , Andrzej Surdacki

Folia Medica Cracoviensia | 2022 | Vol. 62 | No 2 | 71-92 | DOI: 10.24425/fmc.2022.141701

Keywords: acute myocardial infarction COVID-19 lockdown Google Trends infodemiology

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Abstract

Introduction: The COVID-19 pandemic has put healthcare systems worldwide under huge strain, resulting in a significant loss of their capacity and availability. Patients have become more reluctant to contact their doctors or call an ambulance in case of myocardial infarction (MI) symptoms onset. It has been accompanied by a significant decrease in the number of coronary angiography and PCI procedures performed.
Objectives: The aim of the study is to evaluate the role of online health information in the patient- dependent phase of MI management during the COVID-19 lockdown in Europe.
Methods: We analyzed Google Trends data on the popularity of phrases related to MI symptoms, respiratory tract infection, urological complaints, and terms unrelated to health, for the period of the first COVID-19 lockdown, along with the data from the corresponding weeks from 2017–2019 in seven European countries.
Results: The search volume for particular symptoms of myocardial infarction increased in all studied countries, compared to the analogous period from 2017–2019, with a significant increase in for chest pain, shortness of breath, fear, and palpitations in most countries. These changes have not been accompanied by increased interest in terms related to respiratory tract infection symptoms and urological complaints.
Conclusions: Our findings suggest that during lockdown, patients with MI symptoms may have tried to manage their complaints on their own, using information from the Internet. This demonstrates the growing role of the Internet in the patient’s decision-making process in the emergency situation, indicating a grow-ing need for reliable and freely available online information provided by healthcare professionals.

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Authors and Affiliations

Dominik Felkle

Michał Ł. Korman

Andrzej Surdacki

Students’ Scientific Group at Second Department of Cardiology, Institute of Cardiology, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
Second Department of Cardiology, Institute of Cardiology, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland

7 Tenosynovial giant cell tumor

Monika Kager , Richard Kager , Paulina Fałek , Artur Fałek , Grzegorz Szczypiór , Joanna Niemunis-Sawicka , Ludomira Rzepecka-Wejs , Elżbieta Starosławska , Franciszek Burdan

Folia Medica Cracoviensia | 2022 | Vol. 62 | No 2 | 93-107 | DOI: 10.24425/fmc.2022.141702

Keywords: pigmented villonodular synovitis PVNS tenosynovial giant cell tumor epidemiology diagnosis treatment

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Abstract

Tenosynovial Giant Cell Tumor (TGCT) is a group of typically benign lesions arising from the synovium of joints, bursae and tendon sheaths. Depending on their growth pattern and clinical course, they are divided into localized and diffuse types. It is predominantly caused by a mutation in the stromal cells of the synovial membrane leading to overexpression of the colony stimulating factor 1 that recruits CSF1R-expressing cells of the mononuclear phagocyte lineage into the tumor mass. The lesions contain mainly histiocyte-like and synovial cells accompanied by varying numbers of multinucleated giant cells, mononuclear cells, foam cells, inflammatory cells and hemosiderin deposits. The gold standard for detect-ing and monitoring the disease is MRI, where the characteristic hemosiderin accumulation can be best appreciated, but it is a histological examination that is most conclusive. The main treatment is surgical resection of all pathological tissue, but radio- and chemotherapy are also viable options for certain groups of patients.

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Authors and Affiliations

Monika Kager

Richard Kager

Paulina Fałek

Artur Fałek

Grzegorz Szczypiór

Joanna Niemunis-Sawicka

4 5

Ludomira Rzepecka-Wejs

Elżbieta Starosławska

Franciszek Burdan

1 7

Radiology Department, St Johns’ Cancer Center, Lublin, Poland
Public Independent Clinical Hospital Number 4, Lublin, Poland
Independent Public Healthcare, Puławy, Poland
MRI Unit of Maritime Medical Center, Gdańsk, Poland
2nd Radiology Department, Medical University of Gdańsk, Gdańsk, Poland
Goris-Med, Gdańsk, Poland
Human Anatomy Department, Medical University of Lublin, Lublin, Poland

8 Arterial stiffness — a cardiovascular risk factor to assess among primary care patients

Anna Kamieńska , Sławomir Chlabicz

Folia Medica Cracoviensia | 2022 | Vol. 62 | No 2 | 109-120 | DOI: 10.24425/fmc.2022.141704

Keywords: arterial stiffness cardiovascular risk atherosclerosis primary care

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Abstract

Arterial stiffness is a characteristic of the arterial wall strongly associated with ageing and hypertension. It has been confirmed as a significant cardio-vascular risk factor. Despite available non- invasive measurement methods of central artery stiffening, it has not become a prevalent diagnostic marker in primary care so far. This article provides an overview of pathophysiology of arterial stiffness, possible diagnostic techniques, association with cardiovascular conditions and potential perspective of primary care to implement an additional distinctive parameter to evaluate cardiac risk.

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Authors and Affiliations

Anna Kamieńska

Sławomir Chlabicz

Department of Family Medicine, Medical University of Białystok, Poland

9 Differential diagnosis of temporomandibular disorders — a review of the literature

Magdalena Krasińska-Mazur , Paulina Homel , Andrzej Gala , Justyna Stradomska , Małgorzata Pihut

Folia Medica Cracoviensia | 2022 | Vol. 62 | No 2 | 121-137 | DOI: 10.24425/fmc.2022.141703

Keywords: differential diagnosis of TMD pain of non-dental origin chronic orofacial pain Lyme disease orofacial symptoms

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Abstract

Pain in the masticatory muscles or temporomandibular joints may in some cases be a symptom of other afflictions occurring in this region. The aim of the study was to present the differential diagnosis of temporomandibular disorders (TMD) and other diseases in the craniofacial area, based on review of the literature. Using the key words: “differential diagnosis of TMD”, “pain of non-dental origin” and “chronic orofacial pain”, PUBMED and Scopus databases were systematically searched for articles in English from 2005 to 2020. Additionally, the PUBMED database was supplementarily reviewed using the keywords “Lyme disease orofacial symptoms” for the English-language articles published in the years 1996–2020. Out of 445 publications from PUBMED and Scopus databases as well as other sources, 57 articles describ-ing the pathogenesis and characteristic symptoms of diseases that may cause pain similar to that occurring in TMD as well as diagnostic methods used in differential diagnosis of TMD were selected for analysis. Dental and jawbones-related conditions, ear and maxillary sinus diseases, as well as ailments of neuro-pathic and vascular origin, were taken into account. Neoplastic processes taking place in this region and less often occurring diseases caused by viruses, bacteria and parasites were also described. Conclusions. Correct diagnosis of temporomandibular disorders is based on medical history and thorough physical examination, as well as results of additional tests. Pain localized in the head and neck structures may have diverse, sometimes complex aetiology, and may require multidisciplinary treatment. Observation of the patient’s behaviour and — in selected cases — the results of additional laboratory tests, also play a sig-nificant role.

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Authors and Affiliations

Magdalena Krasińska-Mazur

Paulina Homel

Andrzej Gala

Justyna Stradomska

Małgorzata Pihut

Department of Prosthodontics and Orthodontics, Institute of Dentistry, Jagiellonian University Medical College, Kraków, Poland

10 A comparison of temporomandibular disorder headache in young adults in relation to perceived stress

Aneta Wieczorek , Małgorzata Pihut , Jolanta E. Loster

Folia Medica Cracoviensia | 2022 | Vol. 62 | No 2 | 139-146 | DOI: 10.24425/fmc.2022.141706

Keywords: pain headache PSS-10

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Abstract

Chronic pain in the head and face region has a predicted prevalence of 20% in Europe, and is more common in women than men. The etiology of temporomandibular disorder (TMD) is multifactorial, and high levels of psychological stress amplify its symptoms. We were interested in how headache reported in RDC/TMD is associated with stress. Individuals with an average age of 18 years were included in the study. They were all volunteer participants in a research project. Clinical evaluation of each subject was performed using the RDC/TMD dual-axis diagnostic system. All participants filled out the PSS-10 ques-tionnaire. A total of 138 individuals participated in the study, of which 107 were female. Headache was reported by 83 participants (59.4%), with females presenting higher scores on the PSS-10; this was statistically significant. A comparison between PSS-10 questionnaire results and headache level shows insignificant differences. However, the higher the stress level in the participant, the higher the headache score. Females are more susceptible to perceived stress, which can have an effect on TMD.

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Authors and Affiliations

Aneta Wieczorek

Małgorzata Pihut

Jolanta E. Loster

Department of Prosthodontics and Orthodontics, Institute of Dentistry, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland

11 Contents

Folia Medica Cracoviensia | 2022 | Vol. 62 | No 2

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Instructions for authors

Manuscripts will be considered for publication in the form of Original Articles or Reviews. Submitted work must comply with ethical policy, which is based on the Committee on Publication Ethics (COPE) guidelines on good publication. (http://publicationethics.org/). Only manuscripts that are previously unpublished, and are not offered simultaneously elsewhere will be considered.
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Folia Medica Cracoviensia only accepts electronic submission via e-mail at folmedcrac@pan.pl. Manuscripts will be assigned a unique manuscript number that must be quoted in correspondence. Papers and Reviews are refereed by experts in the field; the Editors reserve the right to reject an article without review. Please submit your covering letter or comments to the Editor as well as the names of two potential referees (including name, affiliation, and e-mail address). Currently, Authors have the only option to publish their articles in printed version. The online version will be available soon.
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Original Articles describe the results of basic or clinical studies. The length of all Original Articles is limited to 6000 words, excluding acknowledgements and disclosures, references, tables, figures, table legends and figure legends. Please limit the number of figures and tables to a maximum of eight (e.g. four figures and four tables). Color figures can be included as necessary; however authors will be charged a fee (for details please contact editorial office).
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