Nowa Medycyna最新文献_第6页

Animal hair as a rare cause of pilonidal sinus – a case report 动物毛发作为一种罕见的毛窦病因- 1例报告

Nowa Medycyna Pub Date : 2018-11-27 DOI: 10.25121/nm.2018.25.4.202

Paweł Dutkiewicz, P. Ciesielski

{"title":"Animal hair as a rare cause of pilonidal sinus – a case report","authors":"Paweł Dutkiewicz, P. Ciesielski","doi":"10.25121/nm.2018.25.4.202","DOIUrl":"https://doi.org/10.25121/nm.2018.25.4.202","url":null,"abstract":"Pilonidal sinus is a chronic inflammatory disease caused by the penetration of hair into the skin. Most often, it is located in the intergluteal area, but it may also develop at a different location. It is usually caused by the penetration of human hair, but animal hair can alaso cause it in rare cases. In the world publications, there are reports of the disease in other, often distant locations, e.g. the suprapubic area, armpit, foot, penis, umbilicus, eyelid, clitoris, intermammary cleft, nose, or scar after removing a Tenckhoff catheter. Usually, it is human hair that causes the formation of pilonidal sinus, but the literature also reports cases caused by animal hair in people who shear sheep. There is no other Polish publication describing pilonidal sinus of animal origin. The article presents a case of atypical pilonidal sinus caused by animal hair, located between the fingers of the patient who is professionally involved in shearing dogs. In the presented clinical case, treatment involved staged fistulotomy with the use of surgical thread. The patient was cured and full function of the hand was preserved. Staged fistulotomy is a safe procedure and can be used to treat pilonidal sinus of the hand.","PeriodicalId":311146,"journal":{"name":"Nowa Medycyna","volume":"106 1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133679553","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}

引用次数: 0

Endometriosis of the perianal region – epidemiology, diagnosis and treatment 肛周子宫内膜异位症的流行病学、诊断和治疗

Nowa Medycyna Pub Date : 2018-10-29 DOI: 10.25121/NM.2018.25.4.192

M. Kołodziejczak, I. Sudoł-Szopińska, M. Siergiej

{"title":"Endometriosis of the perianal region – epidemiology, diagnosis and treatment","authors":"M. Kołodziejczak, I. Sudoł-Szopińska, M. Siergiej","doi":"10.25121/NM.2018.25.4.192","DOIUrl":"https://doi.org/10.25121/NM.2018.25.4.192","url":null,"abstract":"Endometriosis is the presence of the uterine endometrium beyond the uterus. The disease usually affects women of childbearing age. Foci of endometriosis are mostly (in 95% of cases) located in the peritoneal cavity (cervix uteri, vaginal vault, vulva, urinary bladder, inguinofemoral region) and only rarely found beyond it. Occasionally, endometriosis is found in the perineal tissues, usually in the episiotomy scar, and, exceptionally rarely, in the anorectal region. Endometriosis usually develops in the period of hormonal activity. The disease may be asymptomatic or manifest with dyspareunia, pelvic pain syndrome, fertility problems, menstrual disorders and heavy menstruation. The diagnosis of anorectal endometriosis is established through a thorough interview and additional tests, including transrectal and transvaginal ultrasound or optionally magnetic resonance imaging. The final diagnosis is determined in a histopathological examination, usually of samples collected intraoperatively. Also, an endoscopic examination should be performed (at least rectoscopy) to rule out other pathological lesions. Treatment includes pharmacotherapy and surgery. In young patients, in the period of hormonal activity, extensive resection with primary sphincter reconstruction seems to be the most optimal option. In older patients, nearing menopause, conservative treatment is a better solution as endometriosis regresses and disease symptoms subside after menopause. In these cases, conservative treatment helps avoid iatrogenic sphincter injury and faecal incontinence.","PeriodicalId":311146,"journal":{"name":"Nowa Medycyna","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129604648","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}

引用次数: 0

Selected complications of colonoscopy – an anaesthetist’s point of view 结肠镜检查并发症的选择-麻醉师的观点

Nowa Medycyna Pub Date : 2018-08-28 DOI: 10.25121/nm.2018.25.3.164

Jacek Wadełek

{"title":"Selected complications of colonoscopy – an anaesthetist’s point of view","authors":"Jacek Wadełek","doi":"10.25121/nm.2018.25.3.164","DOIUrl":"https://doi.org/10.25121/nm.2018.25.3.164","url":null,"abstract":"Colonoscopy is a commonly performed procedure for the diagnosis and treatment of a wide range of conditions and symptoms, as well as for the screening and surveillance of colorectal neoplasia. Serious complications, such as bleeding and perforation, are reported in patients undergoing colonoscopy, especially during polypectomy. Bleeding is the most common complication of colonic polypectomy. It can occur immediately following polypectomy or be delayed from hours to up to days. Acute post-polypectomy haemorrhage is usually immediately apparent and amenable to endoscopic therapy. Nonendoscopic treatment modalities include angiographic embolization and surgery. Acute massive bleeding (internal bleeding/haemorrhage) into the lower gastrointestinal tract may cause hypovolaemia, which decreases cardiac output and tissue oxygen supply, which may require emergency surgery. Although colonic perforation is a rare complication, it is associated with a high rate of morbidity and mortality. This unpleasant complication could result in surgical intervention, stoma formation, intra-abdominal sepsis, prolonged hospital stay, and even death. An extra-intestinal structure identified during endoscopic examination is the most common clinical feature of colonic perforation. The management of patients with colonic perforation should be individualized based on patients’ clinical status and underlying diseases, the nature of perforation, and concomitant colorectal pathologies. Patients with both acute massive bleeding and lower gastrointestinal perforation may need emergency laparotomy, which requires perioperative cooperation of an endoscopist, a surgeon and an anaesthetist.","PeriodicalId":311146,"journal":{"name":"Nowa Medycyna","volume":"61 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128860543","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}

引用次数: 0

Perioperative management of an adult diabetic patient for elective colorectal surgery 1例成人糖尿病患者择期结肠手术的围手术期处理

Nowa Medycyna Pub Date : 2018-08-28 DOI: 10.25121/nm.2018.25.3.150

Jacek Wadełek

{"title":"Perioperative management of an adult diabetic patient for elective colorectal surgery","authors":"Jacek Wadełek","doi":"10.25121/nm.2018.25.3.150","DOIUrl":"https://doi.org/10.25121/nm.2018.25.3.150","url":null,"abstract":"Patients with diabetes mellitus are more likely to require admission to hospital for conditions other than the diabetes itself and are more likely to undergo colorectal surgery. The paper presents guidelines for the preoperative management in diabetic patients scheduled for elective colorectal surgeries. Colorectal cancer and diabetes are increasingly common diseases. A major colorectal surgery may affect metabolic control in diabetes. Surgical procedure, perioperative fasting and interruptions in therapy contribute to poor glycaemic control, which in turn is a significant factor increasing mortality, morbidity and the length of hospital stay among patients with diabetes. Minimising such effects may reduce the risk of adverse outcomes. An extended elective colorectal surgery should be postponed if possible in patients with poor preoperative glycaemic control (HbA1c ≥ 9%). The target range for the perioperative period is between 140 and 180 mg/dL. Hypoglycaemia should also be avoided. This paper presents preoperative management in adult patients with diabetes mellitus scheduled for elective colorectal surgery. Glycaemic control is a key aspect in the perioperative management. For minor surgeries, blood glucose should be monitored before and immediately after surgery in all patients.","PeriodicalId":311146,"journal":{"name":"Nowa Medycyna","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127965394","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}

引用次数: 0

Ulcerative colitis: assessment of disease activity based on contemporary scales 溃疡性结肠炎:基于当代量表的疾病活动性评估

Nowa Medycyna Pub Date : 2018-08-08 DOI: 10.25121/nm.2018.25.3.123

S. Glinkowski, D. Marcinkowska

{"title":"Ulcerative colitis: assessment of disease activity based on contemporary scales","authors":"S. Glinkowski, D. Marcinkowska","doi":"10.25121/nm.2018.25.3.123","DOIUrl":"https://doi.org/10.25121/nm.2018.25.3.123","url":null,"abstract":"Ulcerative colitis is a disease which has been attracting a growing interest in society. The contemporary lifestyle and diet cause an increasing number of patients to complain of gastrointestinal problems. The incidence of ulcerative colitis has not increased over the last few years; however, new medicinal substances and treatment possibilities have still been occurring. In order to standardise the assessment of patients with ulcerative colitis a number of scales have been developed for the assessment of their clinical status as well as changes in the endoscopic picture and nutritional status. The first scale assessing the severity of ulcerative colitis episodes, which is still being used today, was developed in 1955 by Truelove and Witts while they were studying the influence of cortisone on the course of ulcerative colitis. Currently, new scales are still being developed which aim to facilitate and standardise therapeutic decisions of doctors taking care of patients with ulcerative colitis as far as possible. Due to the prevalence of the disease the patients do not always find themselves in referral centres, but also in smaller hospitals that do not specialise in ulcerative colitis therapy. From the point of view of a surgeon the most important issue is determining whether the patient requires surgery or whether pharmacotherapy alone is sufficient. A rapid course of the disease, a high severity of complaints and malnutrition often leading to cachexia precludes conservative treatment and requires more radical management of the disease and surgical intervention.","PeriodicalId":311146,"journal":{"name":"Nowa Medycyna","volume":"290 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123109258","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}

引用次数: 3

Fournier gangrene: what’s new in treatment? 富尼耶坏疽:治疗的新进展?

Nowa Medycyna Pub Date : 2018-08-08 DOI: 10.25121/nm.2018.25.3.138

Z. Tański, Zbigniew Jarząbek, Bartosz Konowalski, Maciej Truszkowski, J. Biedrzycki, B. Kuzaka, P. Kuzaka

{"title":"Fournier gangrene: what’s new in treatment?","authors":"Z. Tański, Zbigniew Jarząbek, Bartosz Konowalski, Maciej Truszkowski, J. Biedrzycki, B. Kuzaka, P. Kuzaka","doi":"10.25121/nm.2018.25.3.138","DOIUrl":"https://doi.org/10.25121/nm.2018.25.3.138","url":null,"abstract":"Fournier gangrene is necrotic, life-threatening fasciitis occurring in the perineal region and within external sexual organs and anus. It may extend to the abdominal cavity, leading to soft tissue necrosis and sepsis. The article presents current methods of diagnosis and treatment of necrotising fasciitis (Fournier gangrene being a part of this disease) based on the medical literature and experience of two urological wards. The following methods are discussed: isotonic salt and balanced crystalloid fluids, antibiotics, steroids, immunoglobulin, hyperbaric oxygen therapy, surgical debridement and split-thickness mesh grafting. At the beginning broad spectrum antibiotics were administrated for the patients, according with local guidelines therapeutic committee and results of specimens for Gram’s staining and culture and laboratory tests. After receiving antibiogram prompt antibiotic treatment was continued. Cystostomy was done for everyone. Active dressing was applied rarely. Mortality was not observed in this group of patients. Fournier gangrene frequently ends with death due to sepsis, ARDS, or insufficiency of the kidneys, liver or other organs. Early diagnosis, careful debridement and application of a proper antibiotic are the basic factors that reduce mortality and improve treatment outcomes.","PeriodicalId":311146,"journal":{"name":"Nowa Medycyna","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123613229","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}

引用次数: 0

Intestinal perforation caused by ventriculoperitoneal shunt 脑室-腹膜分流引起的肠穿孔

Nowa Medycyna Pub Date : 2018-07-27 DOI: 10.25121/nm.2018.25.3.108

Jakub Noskiewicz, B. Kopaczewski, Małgorzata Rzanny-Owczarzak, K. Jarmusz, B. Kocąb, P. Mańkowski

引用次数: 0

Surgical treatment of rapidly advancing active ulcerative colitis: a case report 手术治疗快速进展的活动性溃疡性结肠炎1例报告

Nowa Medycyna Pub Date : 2018-07-27 DOI: 10.25121/nm.2018.25.3.112

S. Glinkowski, D. Marcinkowska

{"title":"Surgical treatment of rapidly advancing active ulcerative colitis: a case report","authors":"S. Glinkowski, D. Marcinkowska","doi":"10.25121/nm.2018.25.3.112","DOIUrl":"https://doi.org/10.25121/nm.2018.25.3.112","url":null,"abstract":"Ulcerative colitis is an inflammatory bowel disease with various clinical presentation. Due to an impaired immune response, diffuse inflammation develops in the intestinal tissue, which leads to bleeding and diarrhoea. The basis for diagnosis is the clinical presentation and the result of colonoscopy which confirms the presence of inflammatory lesions in the colon. The authors present the case of a patient admitted to their department following two previous hospitalisations at other centres who was suffering from active ulcerative colitis. After bacterial aetiology of the disease was excluded and conservative treatment was attempted at a gastroenterology ward, the patient was referred to a surgical department. During the previous hospitalisation colonoscopy was performed in which a lesion was observed in the splenic flexure, which precluded the visualisation of the further part of the colon. A colonoscopy performed at the surgical department did not confirm the presence of that lesion; however, it did reveal multiple pseudopolyps. Due to rapidly progressing cachexia and anaemia and a lack of improvement following attempted pharmacological treatment, a decision was made to perform an urgent colectomy with end ileostomy. After a week-long preparation of the patient (parenteral nutrition, packed red blood cells transfusion), pancolectomy was performed. Histopathological examination confirmed acute phase ulcerative colitis. In the postoperative period massive wound infection developed, which was treated for 14 days with vacuum therapy (VAC). The patient was treated for 30 days at the surgical department. He was discharged in a good general condition and instructed to report to his outpatient care centre.","PeriodicalId":311146,"journal":{"name":"Nowa Medycyna","volume":"35 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133407193","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}

引用次数: 0

Fournier gangrene – ward experience 富尼耶坏疽经验

Nowa Medycyna Pub Date : 2018-07-25 DOI: 10.25121/nm.2018.25.3.101

Z. Tański, Zbigniew Jarząbek, Bartosz Konowalski, Maciej Truszkowski, J. Biedrzycki, B. Kuzaka, P. Kuzaka

{"title":"Fournier gangrene – ward experience","authors":"Z. Tański, Zbigniew Jarząbek, Bartosz Konowalski, Maciej Truszkowski, J. Biedrzycki, B. Kuzaka, P. Kuzaka","doi":"10.25121/nm.2018.25.3.101","DOIUrl":"https://doi.org/10.25121/nm.2018.25.3.101","url":null,"abstract":"Introduction. Fournier’s gangrene is a necrotising soft-tissue infection characterized by insidious and rapid onset. It belongs to the group of necrotising soft-tissue infections. The disease is more common in patients with systemic predispositions such as diabetes mellitus, obesity, hepatic cirrhosis, cancer, etc. Aim. The results of medical treatment thirtieths patients (man from 34 to 84 years old, middle age 67 years old) and co-morbidity with Fournier’s gangrene was presented. Material and methods. The co-morbidity was discussed and analized. The patients were treated by antishock therapy, proper antibiotic therapy was applied. The complications were presented during treatment, procedures with wounds, debridement and wounds treatment and final treatment skin deficiency. All patients had covered skin deficiency by mesh grafts, they were discharged from hospital with healed wounds or almost healed. Treatment from medical literature dealing with treatment and experience of Urological Wards was also presented (Fournier’s gangrene is a part of this disease). Results. Mortality was not observed in this group of patients. Conclusions. Fournier’s gangrene is a rapid-onset, life-threatening, acute urological disease requiring immediate diagnosis, as well as anti-shock and antibacterial therapy combined with intensive surgical debridement followed by the management of skin and soft tissue defects.","PeriodicalId":311146,"journal":{"name":"Nowa Medycyna","volume":"52 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126219175","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}

引用次数: 0

Profesor Edward Loth – Sprawiedliwy Wśród Narodów Świata za sprawą doktora Ludwika Stabholza

Nowa Medycyna Pub Date : 2018-06-01 DOI: 10.25121/nm.2018.25.2.90

M. Ciesielska

{"title":"Profesor Edward Loth – Sprawiedliwy Wśród Narodów Świata za sprawą doktora Ludwika Stabholza","authors":"M. Ciesielska","doi":"10.25121/nm.2018.25.2.90","DOIUrl":"https://doi.org/10.25121/nm.2018.25.2.90","url":null,"abstract":"Professor Edward Loth was an outstanding scientist, author of numerous scientific dissertations, including 7 monographs cited all over the world to this day. The life and scientific achievements of prof. Loth have been described in many detailed studies focusing both on his didactic activities and active participation in the fight against the German invader during World War II. Due to the military experience gained during World War I and the Polish-Bolshevik war of 1920 as well as the medical specialization in the field of orthopedics and rehabilitation, prof. Loth was especially qualified to manage the sanitary facilities of the Home Army during the German occupation in Poland. Almost all studies show that Professor Loth was awarded, among others The Order of Virtuti Militari and that he was given the title of “Righteous Among the Nations”. Unfortunately none of the existing articles describe the circumstances in which Professor helped Jews and who applied for his candidacy for this prestigious distinction. Due to the scientific research on the history of the doctors of the Warsaw ghetto, the author reached documents and accounts describing the so-called ”rescue story” and the name of the person whom help was given.","PeriodicalId":311146,"journal":{"name":"Nowa Medycyna","volume":"2016 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128038749","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}

引用次数: 0