Wiadomosci lekarskie最新文献

{"title":"Assessment of interpersonal communications between doctors and patients in a military hospital: Factor analysis of the hcahps survey.","authors":"Oleksandr M Korneta, Iryna A Holovanova, Maksym V Khorosh","doi":"10.36740/WLek/213940","DOIUrl":"10.36740/WLek/213940","url":null,"abstract":"<p><strong>Objective: </strong>Aim: The aim of the study was to assess interpersonal communication between doctors and patients in a military hospital using factor analysis of the HCAHPS questionnaire.</p><p><strong>Patients and methods: </strong>Materials and Methods: A cross-sectional study was conducted, during which military personnel who were undergoing inpatient treatment in Poltava and Kremenchuk hospitals were surveyed. The HCAHPS questionnaire consists of 21 individual-level questions that are presented as 8 hospital-level indicators to reflect specific aspects of the healthcare experience. The process of extracting factors from the correlation matrix using principal component analysis led to the identification of factors. Factors were removed until then, regardless of whether the factor's influence on the variance was significant or not.</p><p><strong>Results: </strong>Results: The percentage of variance is the largest in the first factor - 36.566%. The higher the percentage of variance, the greater the weight of this factor. Therefore, the first factor has the largest percentage of loading. The cumulative percentage accumulated to the last factor is 69.351, which indicates an appropriate factor solution. Factor analysis allowed us to identify 4 main components that determine the main features of patient satisfaction with medical care: \"Responsibility for one's health\", \"Adherence to treatment\", \"Deontology\" and \"Mercy\".</p><p><strong>Conclusion: </strong>Conclusions: Based on the fact that patient satisfaction with care is a predictor of his future behavior regarding the attitude towards treatment, it can be stated that all the established components are extremely important for further obtaining a positive result of the patient's recovery. Therefore, organizational work aimed at improving the established predictors is of great importance for the organization of medical care.</p>","PeriodicalId":23643,"journal":{"name":"Wiadomosci lekarskie","volume":"79 1","pages":"184-195"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147318361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spontaneous coronary artery dissection following induced vaginal delivery.","authors":"Agata Stawska, Szymon Kaczyński, Małgorzata Głogiewicz, Rafał Adamczak","doi":"10.36740/WLek/217689","DOIUrl":"https://doi.org/10.36740/WLek/217689","url":null,"abstract":"<p><p>Cardiovascular diseases represent a significant threat to the health and life of women during pregnancy and the postpartum period, accounting for 13% of all maternal deaths and constituting the third most common cause of perinatal mortality. A particular cause of myocardial infarction in young women, including pregnant patients, is spontaneous coronary artery dissection (SCAD).The occurrence of spontaneous coronary artery dissection may be preceded by triggering factors such as intense physical exertion, intense Valsalva manoeuvres, emotional or physical stress, labour, as well as exposure to exogenous hormones and β hCG. Despite the increasing number of reported cases, the true incidence of pregnancy related SCAD remains unknown. The presented clinical case describes an acute coronary syndrome in a 32-year-old woman in the early postpartum period, secondary to spontaneous coronary artery dissection. The patient was qualified for urgent coronary angiography, which revealed critical, ninety-percent stenosis of the left anterior descending coronary artery (LAD). Following percutaneous transluminal coronary angioplasty, effective myocardial reperfusion was achieved. Young women with low cardiovascular risk and without clinically significant risk factors may develop acute myocardial ischaemia.</p>","PeriodicalId":23643,"journal":{"name":"Wiadomosci lekarskie","volume":"79 2","pages":"448-453"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147646745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reconstruction of the hip stump.","authors":"Yurii O Bezsmertnyi, Viktor I Shevchuk, Dmytro V Bondarenko, Olexandr Y Branitsky","doi":"10.36740/WLek/214418","DOIUrl":"https://doi.org/10.36740/WLek/214418","url":null,"abstract":"<p><p>The formation of a functional limb stump after combat injuries with extensive soft tissue damage is challenging. After amputations or revision surgeries, long femoral stumps may remain. Although functionally inferior to tibial stumps, they can still provide satisfactory movement and performance. However, prolonged prosthesis use or poor-quality muscle grafting can lead to complications, such as skin breakdown, trophic issues, and inability to continue prosthetic use. These problems are partly due to the mismatch between the area of the bone stump end and the applied body weight. Ilizarov compression-distraction osteosynthesis, radiographic assessment, and gait analysis before and after treatment using the GaitRite system. We describe a case of femoral stump reconstruction following a mine-blast injury. Prosthetic fitting was complicated by massive scars covering the bone fragments. A method was developed to expand the distal end of the femoral stump via distraction osteogenesis using the Ilizarov apparatus. This approach created a stable platform with a significantly larger bearing surface. For the first time, the bearing surface area was increased twofold, reducing soft tissue trauma and enhancing the load-bearing capacity of the prosthesis. The proposed reconstruction method significantly enlarges the distal femoral stump area, creates a mushroom-shaped end, decreases load per unit area, ensures even pressure distribution within the prosthetic socket, and improves the patient's functional outcome.</p>","PeriodicalId":23643,"journal":{"name":"Wiadomosci lekarskie","volume":"79 2","pages":"454-462"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147646780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postoperative rehabilitation of a patient with resected aggressive parasagittal meningioma infiltrating the superior sagittal sinus and presenting with paraplegia.","authors":"Valentyna Hombolevska, Nataliia Fedorenko, Mateusz Kaczmarski, Zeeshan Zulfiqar","doi":"10.36740/WLek/218285","DOIUrl":"https://doi.org/10.36740/WLek/218285","url":null,"abstract":"<p><p>The aim of this case report is to describes the postoperative neurological complications and importance of early rehabilitation course of a patient with an aggressive parasagittal meningioma. The particular emphasis on the role of intensive, multidisciplinary rehabilitation in the setting of postoperative spastic paraplegia. The program included physiotherapy, assisted verticalization, gait and locomotion training, proprioceptive neuromuscular facilitation techniques, and psychological support. Clinical status, imaging findings, and functional recovery were evaluated during rehabilitation. A 47-year-old woman with frontoparietal parasagittal tumor infiltrating the superior sagittal sinus underwent preoperative embolization followed by microsurgical resection. Postoperatively, patient developed bilateral spastic paralysis of the lower limbs, complicated by cerebrospinal fluid leakage and surgical-site infection. After neurosurgical treatment of parasagittal meningiomas involving the superior sagittal sinus severe neurological deficits may occur. This case shows the importance of early, structured and multidisciplinary rehabilitation as an essential component of postoperative care. Early rehabilitation may contribute to functional improvement and preservation of quality of life even in patients with severe motor deficits.</p>","PeriodicalId":23643,"journal":{"name":"Wiadomosci lekarskie","volume":"79 3","pages":"661-665"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147654915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From hip pain to MAS: A case of gonococcal arthritis in a child.","authors":"Mateusz Trubalski, Hubert Miłoś, Mateusz Haratym, Sandhra Treesa Santhosh, Anna Danielewicz, Michał Latalski","doi":"10.36740/WLek/217868","DOIUrl":"https://doi.org/10.36740/WLek/217868","url":null,"abstract":"<p><p>Joint pain in children presents a diagnostic challenge due to its multifaceted etiology, ranging from musculoskeletal injuries to systemic infections. This case report details a 3-year-and-5-month-old girl with bilateral hearing impairment and congenital cytomegalovirus infection, who was admitted with thigh pain, high fever, and difficulty walking. Despite being hemodynamically stable and without apparent infection signs, extensive diagnostic evaluations revealed gonococcal hip arthritis. This condition, caused by Neisseria gonorrhoeae, is unusual in young children and typically associated with perinatal transmission or sexual abuse. The diagnosis was confirmed through molecular testing, highlighting the importance of considering rare etiologies in pediatric joint pain cases. The patient's management included multidisciplinary consultations, various imaging and laboratory tests, and specific antimicrobial therapies. The case underscores the necessity of a comprehensive diagnostic approach in pediatric patients with joint pain, especially when associated with other health conditions, to ensure accurate diagnosis and appropriate treatment.</p>","PeriodicalId":23643,"journal":{"name":"Wiadomosci lekarskie","volume":"79 3","pages":"666-670"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147654985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Features of metabolism and peculiarities of organs' structural reorganization by sodium nitrite with underlying tobacco intoxication.","authors":"Larysa Ya Fedoniuk, Petro H Lykhatskyi, Liudmyla S Fira","doi":"10.36740/WLek/217275","DOIUrl":"10.36740/WLek/217275","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;Aim: To determine the characteristics of metabolism in rats of different ages exposed by sodium nitrite with underlying tobacco intoxication.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Patients and methods: &lt;/strong&gt;Materials and Methods: The experiments were conducted on male white rats kept on a standard vivarium diet. The rats were divided into three age groups: sexually immature with a body weight of 60-80 g (3 months old), sexually mature with a body weight of 180-200 g (12 months old), and elderly with a body weight of 300-350 g (18 months old). The animals received a single intragastric dose of sodium nitrite via a probe in the form of an aqueous solution at a dose of 45 mg/kg body weight, which is 1/4 of the LD50. The study was conducted 24 and 72 hours after exposure to this toxicant.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Results: It has been established, that during the whole experiment, after the affection of the rats, the hyperproduction of active forms of oxygen is present. Simultaneous exposure of rats to sodium nitrite and tobacco intoxication leads to increased generation of active oxygen species by neutrophil granulocytes in the blood. By the end of the experiment, sexually immature rats showed a maximum increase in the content of TBK-active products in all organs (in the liver - 3.3 times, in the kidneys - 3.6 times, in the lungs - 4.3 times, myocardium - 6.0 times). At the end of the experiment, the content of methemoglobin in the blood of young animals after exposure increased significantly (2.6 times). The simultaneous effect of sodium nitrite and tobacco smoke causes disturbances in the antioxidant system. Suppression of superoxide dismutase activity in the blood serum and liver of rats of all age groups was detected. Suppression of superoxide dismutase activity was detected in the blood serum and liver of rats of all age groups. By the end of the experiment, ceruloplasmin content had increased in the group of sexually immature rats, exceeding the level in control animals by 2.4 times at the end of the experiment. Glutathione levels decreased in the liver, lungs, kidneys, and myocardium of rats of all age groups, most significantly in sexually immature rats. At the same time, nitrooxidative stress developed, as evidenced by an increase in nitrite ion levels in all organs during the experiment. After exposure to sodium nitrite, rats of different ages that had been poisoned with tobacco smoke for 45 days showed a significant increase in enzyme activity in their blood serum (alanine aminotransferase activity in blood serum increased 7.7 times, aspartate aminotransferase 5.0 times, lactate dehydrogenase by 1.8 times, gamma-glutamyl transpeptidase by 4.1 times, and alkaline phosphatase by 3.6 times. Secondary endogenous toxins accumulated in the affected organism - medium-weight molecules, the content of which in blood serum was highest at the end of the experiment in sexually immature rats. The myocardium of elderly rats was most se","PeriodicalId":23643,"journal":{"name":"Wiadomosci lekarskie","volume":"79 1","pages":"78-86"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147318480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of genetic diversity of PCSK9 polymorphisms on coronary artery disease in a sample of Iraqi individuals.","authors":"Ruaa Heyder Hadi, Majid Kadhum Hussain","doi":"10.36740/WLek/216770","DOIUrl":"10.36740/WLek/216770","url":null,"abstract":"<p><strong>Objective: </strong>Aim: To assess the association of PCSK9 SNPs (rs2483205, rs2479394) with CAD susceptibility in an Iraqi population.</p><p><strong>Patients and methods: </strong>Materials and Methods: A case-control study recruited 110 CAD patients, angiographically confirmed, and 110 age-/sex-matched healthy controls. Serum PCSK9 was quantified by ELISA, and lipid profiles were analyzed enzymatically. Genotyping for rs2483205 (C/T) and rs2479394 (G/A) was performed using ARMS-PCR. Associations were evaluated using logistic regression, haplotype analysis, and genotype-phenotype correlations, adjusting for age and sex.</p><p><strong>Results: </strong>Results: CAD patients exhibited significantly higher PCSK9 levels (54.12 ± 19.04 vs. 20.94 ± 17.72 ng/mL, p < 0.0001), LDL-C, TG, and lower HDL-C (p ≤ 0.005) versus controls. Genotype analysis revealed a significant protective effect of the rs2479394 G/A genotype against CAD (OR = 0.21, 95% CI: 0.04-1.08, p = 0.024). The rs2483205 SNP showed no significant association. Haplotype analysis identified four major haplotypes; T-A demonstrated significant protection (OR = 0.45, 95% CI: 0.21-0.88, p = 0.020). No significant associations were found between rs2479394 genotypes and phenotypic parameters (blood pressure, lipids, PCSK9) in CAD patients.</p><p><strong>Conclusion: </strong>Conclusions: The rs2479394 G/A genotype and T-A haplotype are associated with reduced CAD risk in Iraqis, suggesting a protective role for specific PCSK9 variants. Elevated serum PCSK9 levels and dyslipidemia were confirmed in CAD patients; however, rs2479394 did not correlate with these phenotypic traits.</p>","PeriodicalId":23643,"journal":{"name":"Wiadomosci lekarskie","volume":"79 1","pages":"69-77"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147318499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interrelationship between lipid and bone metabolism in postmenopausal women.","authors":"Yurii Kazakov, Viktoriia Myhal, Svitlana Shut, Viktor Boriak, Viktoriia Sakevych, Nataliia Chekalina","doi":"10.36740/WLek/217690","DOIUrl":"10.36740/WLek/217690","url":null,"abstract":"<p><strong>Objective: </strong>Aim: To study the state and interrelationship of calcium-phosphorus metabolism, lipid profile, and bone mineral density in postmenopausal women.</p><p><strong>Patients and methods: </strong>Materials and Methods: A retrospective cohort study was conducted involving 42 women aged 51.9±2.95 years, with a postmenopausal period of 1.69±1.47 years. All patients underwent laboratory and instrumental examinations.</p><p><strong>Results: </strong>Results: The study found that most women were overweight or obese and had elevated levels of total cholesterol, low-density lipoprotein cholesterol, and atherogenicity index. The average level of 25(OH)D was 26.95±10.58 ng/ml, with more than half of the subjects diagnosed with deficiency or insufficiency. According to ultrasound densitometry, a significant proportion of women had varying degrees of BMD reduction, ranging from osteopenia to osteoporosis. Correlation analysis revealed statistically significant associations between lipid profile indicators, calcium-phosphorus metabolism, and bone tissue condition, in particular inverse correlations between HDL-C levels and phosphorus, parathyroid hormone, and alkaline phosphatase, as well as between the atherogenicity coefficient and vitamin D levels (p<0.05).</p><p><strong>Conclusion: </strong>Conclusions: The data obtained confirm the feasibility of a comprehensive assessment of calcium-phosphorus metabolism, lipid profile, and ultrasound densitometry results. This approach allows for the timely identification of women at increased risk of developing osteodismetabolic disorders and monitoring of bone tissue condition in the postmenopausal period.</p>","PeriodicalId":23643,"journal":{"name":"Wiadomosci lekarskie","volume":"79 1","pages":"202-209"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147318529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diet therapy as a component of ancient medicine.","authors":"Marta J Petryshyn, Halina M Zahaiska, Oxana V Liubimova","doi":"10.36740/WLek/214415","DOIUrl":"https://doi.org/10.36740/WLek/214415","url":null,"abstract":"<p><strong>Objective: </strong>Aim: To analyze of dietotherapy as employed by Roman physicians in the treatment of therapeutic diseases since one of the important methods of successful treatment and recovery is a properly formulated diet.</p><p><strong>Patients and methods: </strong>Materials and Methods: The subject of this study is De Medicina, the work of Aulus Cornelius Celsus, the renowned Roman scholar and encyclopedist, the author of an eight-volume medical treatise, which summarizes the experience of ancient medicine in the fields of therapy, surgery, pathology, and dietetics. The application of analytical and synthetic methods, contextual and comparative analysis, and the descriptive method enabled the investigation of the specifics of diet therapy as a key treatment modality in ancient medical practice.</p><p><strong>Conclusion: </strong>Conclusions: Critically summarizing the achievements of medicine in therapy, surgery, and pathology, Celsus consistently emphasized the importance of diet therapy in the treatment and prevention of diseases. As a result of the research, it has been established that even in ancient times, the nutrition of a sick person was considered the fundamental basis upon which other therapeutic measures should be applied. Dietary nutrition was aimed at reducing the risk of complications, restoring the body, and preventing diseases. The main principles of ancient diet therapy were based on the following: aligning the diet with the physiological needs of the body during illness, adapting food processing methods for specific diseases, determining the duration of the diet depending on the characteristics of the disease's progression, maintaining water balance, and applying principles of adjustment, substitution, and physical or mechanical protection of the affected system or organ.</p>","PeriodicalId":23643,"journal":{"name":"Wiadomosci lekarskie","volume":"79 2","pages":"377-383"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147646678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Periarticular artery embolization as a minimally invasive treatment for pain in osteoarthritis.","authors":"Hanna Tyc, Patryk Remiasz, Michał Merkisz, Małgorzata Drelich, Magdalena Sobiech","doi":"10.36740/WLek/218411","DOIUrl":"https://doi.org/10.36740/WLek/218411","url":null,"abstract":"<p><p>Osteoarthritis (OA) is a leading cause of chronic pain and disability worldwide, affecting approximately 607 million people in 2021, with projections exceeding 1.1 billion by 2050. The knee is the most commonly affected joint and many patients experience inadequate symptom relief with conservative management or are not candidates for total knee arthroplasty. Periarticular arterial embolization, particularly genicular artery embolization (GAE), has emerged as a minimally invasive treatment targeting pathological neovascularization and synovial inflammation in OA pathogenesis. This review aims to synthesize current evidence on the use of periarticular embolization in the treatment of OA across multiple joints including the knee, hip, shoulder, hand and temporomandibular joint (TMJ). A comprehensive literature review was conducted examining clinical studies, systematic reviews and meta-analyses evaluating periarticular artery embolization for OA treatment. Periarticular artery embolization represents a promising minimally invasive treatment option for patients with mild-to-moderate OA who have failed conservative therapy. It demonstrates high technical success rates (approaching 100%) with favourable safety profiles for knee OA, with emerging applications in other joints. However, standardized procedural protocols, long-term outcome data and multicenter randomized control trials are needed to definitively establish its role in OA treatment and optimize patient selection criteria.</p>","PeriodicalId":23643,"journal":{"name":"Wiadomosci lekarskie","volume":"79 3","pages":"655-660"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147654967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}