Wiadomosci lekarskie最新文献

{"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":"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":"Adaptation of the small intestinal mucosa after single anastomosis gastric bypass.","authors":"Roman Vynohradov, Olexandr Usenko, Olexandr Tyvonchuk, Vladyslav Kropelnytskyi, Ivan Romasko","doi":"10.36740/WLek/216926","DOIUrl":"10.36740/WLek/216926","url":null,"abstract":"<p><strong>Objective: </strong>Aim: The aim of our study was to perform morphological and morphometric analysis of biopsy specimens of the common and biliopancreatic loops after gastric bypass with a single anastomosis 3, 12, 24 months after surgery, which included measurement of villi length, ratio of villi length to the thickness of the lamina propria layer containing crypts, estimation of the number and distribution of goblet cells, quantification of number crypts and Paneth cells and comparing the changes in the biliopancreatic and common loops.</p><p><strong>Patients and methods: </strong>Materials and Methods: This study included 36 patients who underwent bariatric surgery due to morbid obesity. Patients underwent one of the following procedures: long-loop gastric bypass with one anastomosis, distal gastric bypass with one anastomosis, or mini-gastric bypass. Patients underwent EGDS with mucosal biopsy from the common and biliopancreatic loop at 3, 12, 24 months after gastric bypass with one anastomosis, followed by morphologic and morphometric study of biopsy specimens, which was part of our study.</p><p><strong>Results: </strong>Results: 2 years follow up show statistically significant differences in villus length were observed between the common and biliopancreatic limbs, with the length being greater in the common limb (0.390 ± 0.199 mm) than in the biliopancreatic limb (0.377 ± 0.184 mm) (p < 0.05). These changes may indicate hypertrophy of the villi in the efferent limb to increase the absorptive surface area. The thickness of the basal layer was greater in the biliopancreatic limb than in the common limb, measuring 0.196 ± 0.068 mm versus 0.167 ± 0.043 mm, respectively (p< 0.05). Regulatory functions of Paneth cells were preserved in both groups.</p><p><strong>Conclusion: </strong>Conclusions: Adaptation of the small intestinal mucosa occurs after gastric bypass with one anastomosis, and these changes are more pronounced in the common loop of the small intestine. The regulatory functions of Paneth cells and their number involve both the common loop and the biliopancreatic region.</p>","PeriodicalId":23643,"journal":{"name":"Wiadomosci lekarskie","volume":"79 4","pages":"779-787"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147949842","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":"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":"Minimally invasive treatment of recurrent varicose veins with thrombotic complications using EVLA: A case report.","authors":"Serhii Shchukin","doi":"10.36740/WLek/218751","DOIUrl":"https://doi.org/10.36740/WLek/218751","url":null,"abstract":"<p><p>We present a clinical case of a 59-year-old male who complained of varicose veins and a burning sensation in the right lower limb. His medical history included bilateral great saphenous vein (GSV) removal (2003), type 2 diabetes mellitus, stage 4 chronic kidney disease, gout, and arterial hypertension. Duplex ultrasound revealed varicothrombophlebitis of the small saphenous vein (SSV) and a floating thrombus in the popliteal vein. Initial treatment consisted of oral anticoagulation with rivaroxaban, followed by EVLA of the SSV and ultrasound-guided sclerotherapy of tributaries. After anticoagulant therapy, partial recanalization of the SSV and thrombus lysis in the popliteal vein were observed. EVLA of the SSV was performed without complications. Anticoagulant therapy was continued in coordination with a hematologist. At 6-month follow-up, duplex ultrasound showed the SSV as a fibrotic cord (diameter 3-4 mm), with regression of symptoms of chronic venous insufficiency. Despite the patient's high-risk profile, individualized management and careful monitoring allowed for the successful performance of a minimally invasive procedure. In selected high-risk patients with recurrent varicose disease complicated by thrombosis, EVLA may be considered following appropriate anticoagulant preparation. This case highlights the potential feasibility of an individualized and staged treatment approach in complex clinical settings.</p>","PeriodicalId":23643,"journal":{"name":"Wiadomosci lekarskie","volume":"79 7","pages":"1700-1708"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148983769","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":"Clinical effectiveness of various methods of inguinal hernia repair.","authors":"Stepan S Filip, Rudolf M Slivka, Yuriy P Skrypynets, Anatoliy I Shitev","doi":"10.36740/WLek/220831","DOIUrl":"10.36740/WLek/220831","url":null,"abstract":"<p><strong>Objective: </strong>Aim: To improve the results of surgical treatment of patients with inguinal hernias.</p><p><strong>Patients and methods: </strong>Materials and Methods: The paper analyzes the results of surgical treatment of 198 patients who underwent inguinal hernia repair in the period from 2018 to 2024. The study was conducted at the clinical base of the Department of General Surgery of Uzhhorod National University - KNP «Uzhgorod City Multidisciplinary Clinical Hospital» of the Uzhgorod City Council of the SE «Clinical Hospital of Planned Treatment» The study was a bidirectional (ambidirectional study), namely, it included: 1) retrospective analysis (\"case-control\", randomized multicenter analysis); 2) prospective observation and treatment. The inclusion criteria in the study were: the presence of acquired inguinal hernia, hernioplasty according to the Lichtenstein, Shouldis method, TAPP hernioplasty (transabdominal preperitoneal hernioplasty) and TAPP with suturing of the internal inguinal ring (TAPP with SIIR ) and TEP - total extraperitoneal allohernioplasty, which was performed in the preperitoneal space without entering the abdominal cavity.</p><p><strong>Results: </strong>Results: The smallest number of complications was recorded after laparoscopic TAPP and TAPP-SIIR hernioplasty, including in people with overweight and obesity. The results obtained were statistically processed with the inclusion of all possible risk factors that could affect the postoperative outcome of each specific patient. Based on the obtained values, χ2 in all cases was equal to or greater than the value of 3.99, which exceeds the critical value of 3.84; p=0.05..</p><p><strong>Conclusion: </strong>Conclusions: A comprehensive differentiated approach to preoperative preparation of patients with inguinal hernias with correction of comorbid pathology, body mass index and factors that increase intra-abdominal pressure significantly reduces the frequency of early postoperative complications compared with standard treatment tactics (χ²>3.84; p≤0.05).</p>","PeriodicalId":23643,"journal":{"name":"Wiadomosci lekarskie","volume":"79 5","pages":"997-1002"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148340407","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":"Cephalic tetanus progressing to generalized tetanus after facial trauma in an unvaccinated elderly patient: A case report.","authors":"Anton I Kohutych, Andriana A Halamba, Vlasta V Vysochanska, Monika T Maroshan, Oles S Vakarov","doi":"10.36740/WLek/220841","DOIUrl":"https://doi.org/10.36740/WLek/220841","url":null,"abstract":"<p><p>A 67-year-old unvaccinated male patient was analyzed. Clinical manifestations, laboratory and imaging findings, treatment, and disease progression were evaluated using hospital records. Eight days after facial trauma from a bicycle accident, the patient developed progressive trismus, dysphagia, neck stiffness, and respiratory discomfort. He was hospitalized on day 10 post-injury. Initial treatment included 500 IU of tetanus immunoglobulin. Two days later, his condition deteriorated with progression to generalized tetanus, requiring ICU admission. Additional 2000 IU of tetanus immunoglobulin, sedation, and oxygen therapy were administered. The course was complicated by pneumonia. Gradual improvement occurred, and he was discharged in stable condition on day 35. Cephalic tetanus is a rare but severe form that may progress to generalized disease. Early recognition and prompt administration of tetanus immunoglobulin are crucial for favorable outcomes.</p>","PeriodicalId":23643,"journal":{"name":"Wiadomosci lekarskie","volume":"79 5","pages":"1149-1154"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148340400","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":"Development and validation of a non-invasive risk prediction nomogram for metabolic syndrome in young adults: A crosssectional study based on NHANES 2011-2018.","authors":"Olga S Palamarchuk, Oleh O Moroz, Volodymyr P Feketa","doi":"10.36740/WLek/220835","DOIUrl":"https://doi.org/10.36740/WLek/220835","url":null,"abstract":"<p><strong>Objective: </strong>Aim: To develop and validate non-invasive predictive models for detecting metabolic syndrome in young adults using NHANES 2011-2018 data to enable effective screening without laboratory testing.</p><p><strong>Patients and methods: </strong>Materials and Methods: Using data from the National Health and Nutrition Examination Survey (NHANES 2011-2018), we established a homogeneous cohort of Non-Hispanic White individuals (N=2,911). Gender-specific multivariate logistic regression models were developed to predict MetS risk using strictly non-invasive anthropometric and clinical parameters, including age, waist-to-height ratio (WHtR), and blood pressure.</p><p><strong>Results: </strong>Results: The resulting algorithms demonstrated robust discriminatory power, achieving an area under the ROC curve (AUC) of 0.87 for males and 0.84 for females. WHtR emerged as the most significant independent predictor across both genders (Adjusted OR 1.10 per 0.01 unit increment; p < 0.001). Notably, while chronological age was significantly associated with risk in males (OR 1.07), it lacked statistical significance in the female population (p = 0.904). This divergence suggests a dominant role of phenotypic features over chronological aging in shaping MetS risk among young women.</p><p><strong>Conclusion: </strong>Conclusions: The developed nomograms and risk heatmaps enable precise cardiometabolic risk stratification in primary care without requiring laboratory resources. This non-invasive framework provides a scalable and practical tool for early intervention and personalized health management in young adults.</p>","PeriodicalId":23643,"journal":{"name":"Wiadomosci lekarskie","volume":"79 5","pages":"1031-1043"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148340426","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":"Photodynamic therapy in modern dentistry: Mechanisms, clinical applications, and future perspectives - a narrative review.","authors":"Małgorzata Antończyk, Barbara Lipka, Michał Lipka, Mikołaj Rycerski, Małgorzata Toroń, Nikola Krajewska, Julia Bartecka, Wojciech Widz","doi":"10.36740/WLek/219792","DOIUrl":"https://doi.org/10.36740/WLek/219792","url":null,"abstract":"<p><strong>Objective: </strong>Aim: To review the mechanisms of action, clinical applications, current evidence, challenges, and future directions of photodynamic therapy in modern dental practice.</p><p><strong>Patients and methods: </strong>Materials and Methods: A narrative synthesis of recent experimental, clinical, and review literature was conducted. The review focused on PDT mechanisms, commonly used photosensitizers and light delivery systems, clinical outcomes across dental specialties, and emerging technological developments aimed at improving therapeutic performance. Photodynamic therapy demonstrates strong antimicrobial efficacy, effective biofilm disruption, and selective tissue action without inducing microbial resistance. Clinical evidence supports its use as an adjunctive therapy in periodontology, endodontics, peri-implant therapy, caries management, oral infections, and early oral malignancies. PDT is associated with a favorable safety profile and minimal invasiveness. However, variability in treatment protocols, differences in photosensitizer properties, limited light penetration, and cost considerations contribute to inconsistent clinical outcomes.</p><p><strong>Conclusion: </strong>Conclusions: Photodynamic therapy represents a valuable adjunct in minimally invasive dentistry, offering targeted therapeutic benefits across multiple clinical applications. Despite promising evidence, barriers to routine clinical adoption remain. Ongoing advances in photosensitizer design, nanotechnology-based delivery systems, and light technologies are expected to enhance standardization, clinical effectiveness, and wider implementation.</p>","PeriodicalId":23643,"journal":{"name":"Wiadomosci lekarskie","volume":"79 5","pages":"1092-1099"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148340580","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":"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}

{"title":"Values of future healthcare specialists in wartime in Ukraine.","authors":"Olga М Dankovych, Maria A Mudrak, Volodymyr I Savka, Larysa Ya Fedoniuk","doi":"10.36740/WLek/225510","DOIUrl":"https://doi.org/10.36740/WLek/225510","url":null,"abstract":"<p><strong>Objective: </strong>Aim: The aim of the study is to define the values typical for medical students by analysing the career choice motivations in wartime in Ukraine.</p><p><strong>Patients and methods: </strong>Materials and Methods: Overview, Data Retrieval and Thematic Analysis (Braun&Clarke) methods were used. The total of 45 students' essays were analysed in the study.</p><p><strong>Results: </strong>Results: The professional values of future healthcare specialists in Ukraine in wartime have been defined: restoring health, believing in recovery, recovering the joy of life, helping the military (rehabilitation students); alleviating suffering, respecting dignity, giving people hope, helping them overcome illness (medical students); supporting people who have experienced trauma, providing psychological support in life hardships (clinical psychology students); health and beauty care, volunteer dental care for the military (dentist students). It is established that the frequency of mentions in student essays about the war as a factor in the development of medicine in present Ukraine and the military who need assistance in restoring health/rehabilitation is quite the same as the frequency of mentions of the concept of \"compassion\" as an important professional value of future healthcare specialists.</p><p><strong>Conclusion: </strong>Conclusions: To support and develop professional values of medical students (empathy, compassion), implementing courses that help improve awareness of the role of healthcare specialists in wartime into medical school curricula is recommended; as well as to cooperate with institutions that take care for socially vulnerable groups of the population and persons affected by war; and to expand the system of mental health support for students.</p>","PeriodicalId":23643,"journal":{"name":"Wiadomosci lekarskie","volume":"79 6","pages":"1331-1339"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148649107","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}