Polish Annals of Medicine最新文献_第2页

The unfortunate events of bowel ischaemia post-Whipple surgery Whipple 手术后肠道缺血的不幸事件

Polish Annals of Medicine Pub Date : 2024-02-27 DOI: 10.29089/paom/177641

Dinesh Alagoo, Harivinthan Sellappan, T. Maiyauen, Guang Hong Ong, Zae Szen Anderson Yong, F. Hayati

{"title":"The unfortunate events of bowel ischaemia \u0000post-Whipple surgery","authors":"Dinesh Alagoo, Harivinthan Sellappan, T. Maiyauen, Guang Hong Ong, Zae Szen Anderson Yong, F. Hayati","doi":"10.29089/paom/177641","DOIUrl":"https://doi.org/10.29089/paom/177641","url":null,"abstract":"Pancreaticoduodenectomy is an extensive procedure with multiple postoperative complications which include surgical site infections, bleeding, delayed gastric emptying, and anastomotic leakage. Among all, postoperative bowel ischaemia is the rarest complication that might be difficult to diagnose and ascertain the cause. If it is left untreated, it may lead to mortality.The aim is to describe the management of bowel ischaemia post-Whipple surgery.A 76-year-old female patient underwent a Whipple procedure for adenocarcinoma of the ampulla which was complicated by postoperative bowel ischemia. A series of investigations, namely endoscopy and imaging, revealed postoperative bowel ischemia beyond the gastro-jejunostomy anastomosis. The patient underwent a series of surgeries and was eventually discharged well. The final histology was consistent with pancreatic cancer and did not require adjuvant chemotherapy.Bowel ischemia in any major surgery occurs due to thrombosis. It is multifactorial including cancer patients, complex reconstruction and major surgery. Identification of thrombosis early in the postoperative follow-up is difficult due to non-specific symptoms, postoperative paralysis of the gastrointestinal tract and modified pain reaction after analgesia. Once diagnosed, the goal is for cessation of thrombosis and fibrinolytic destruction of the thrombus.Bowel ischemia post-Whipple procedure is rare yet dreaded and requires a high level of clinical suspicion. Once diagnosed, an aggressive approach is needed, including relaparotomy and relook surgery. This complication is salvageable with a controlled fistula and adequate nutrition support.","PeriodicalId":38569,"journal":{"name":"Polish Annals of Medicine","volume":"91 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140426562","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

A neuroendocrine tumor in a macroscopically unchanged appendix 大体无变化的阑尾中的神经内分泌肿瘤

Polish Annals of Medicine Pub Date : 2024-02-27 DOI: 10.29089/paom/178458

Wojciech Całka

{"title":"A neuroendocrine tumor in a macroscopically unchanged appendix","authors":"Wojciech Całka","doi":"10.29089/paom/178458","DOIUrl":"https://doi.org/10.29089/paom/178458","url":null,"abstract":"The intraoperative failure to find a macroscopically visible pathological condition within the appendix or other abnormalities of abdominal organs that could explain clinical symptoms in patients eligible for appendectomy does not prejudge the absence of underlying disease in an apparently healthy appendix.The aim of the study is to highlight the problem of possible hidden pathological conditions in a macroscopically unchanged appendix in patients scheduled for appendectomy.In this article, we present a case of female patient who was qualified to laparoscopic appendectomy due to symptoms of acute appendicitis. Although intra-operatively appendix did not show any pathological signs, histopathological examination revealed neuroendocrine tumor in the organ.This publication describes a case of the removal of a macroscopically unchanged appendix in a patient with clinical and laboratory signs of acute appendicitis. A neuroendocrine neoplasm was histopathologically revealed in the removed appendix. The correct eligibility for appendectomy can present great difficulties even for experienced surgeons. Failure to identify visible abnormalities in the appendix after ruling out other possible causes of clinical symptoms does not prejudge the absence of pathological conditions in this organ.This clinical case shows that the removal of a morphologically normal appendix in a patient eligible for appendectomy, in the absence of other intra-abdominal pathological conditions explaining the clinical signs, is not necessarily a mistake.","PeriodicalId":38569,"journal":{"name":"Polish Annals of Medicine","volume":"18 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140424925","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

Anesthesia of a drug-addicted pregnant woman. The current state of knowledge 吸毒孕妇的麻醉。知识现状

Polish Annals of Medicine Pub Date : 2024-02-27 DOI: 10.29089/paom/177290

Paweł Radkowski, Magdalena Wojtczak, Dorota Bartoś-Zdrojewska, Damian Bronisław Truszczyński, Aneta Pruszkowska

{"title":"Anesthesia of a drug-addicted pregnant woman. The current state of knowledge","authors":"Paweł Radkowski, Magdalena Wojtczak, Dorota Bartoś-Zdrojewska, Damian Bronisław Truszczyński, Aneta Pruszkowska","doi":"10.29089/paom/177290","DOIUrl":"https://doi.org/10.29089/paom/177290","url":null,"abstract":"Stimulant use during pregnancy is a growing concern, particularly in the USA and Europe. This article explores anesthesia challenges in pregnant patients with substance abuse, optimizing analgesic treatment, and addressing newborns of addicted mothers. Understanding substance use differences is crucial for managing complications and providing long-term care.Investigate anesthesia management, analgesic optimization, and care for newborns of drug-addicted pregnant patients.A comprehensive literature review included articles from PubMed (from January 2009 to December 2021) and relevant Polish, English, and German literature.Opioid use by pregnant women, especially in North America, raises concerns for maternal and child health. The incidence of newborns with withdrawal syndrome is rapidly increasing. Anesthesia challenges arise in managing pregnant patients with addiction, including analgesia optimization and reducing neonatal abstinence syndrome risk. Individualized approaches like regional anesthesia minimize systemic opioids and neonatal withdrawal symptoms. Medication-assisted therapy, e.g., buprenorphine and methadone, reduces illicit opioid use and improves outcomes for mother and baby. Collaborative care among providers is essential.Managing drug-addicted pregnant women requires a multidisciplinary approach. Anesthesia providers play a crucial role in ensuring safety and pain control.","PeriodicalId":38569,"journal":{"name":"Polish Annals of Medicine","volume":"16 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140426914","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

Metformin intake among geriatric patients may predispose to vitamin B12 deficiency: Polish population-based study 老年病人摄入二甲双胍可能导致维生素 B12 缺乏：基于波兰人口的研究

Polish Annals of Medicine Pub Date : 2024-02-27 DOI: 10.29089/paom/176287

Justyna Kacperczyk, Adrian Perdyan, Klaudia Kitala-Tańska, Ewa Kania-Zimnicka, K. Osowiecka, Mateusz Wyszatycki, M. Stompór

{"title":"Metformin intake among geriatric patients may predispose to vitamin B12 deficiency: Polish population-based study","authors":"Justyna Kacperczyk, Adrian Perdyan, Klaudia Kitala-Tańska, Ewa Kania-Zimnicka, K. Osowiecka, Mateusz Wyszatycki, M. Stompór","doi":"10.29089/paom/176287","DOIUrl":"https://doi.org/10.29089/paom/176287","url":null,"abstract":"Vitamin B12 deficiency is becoming a major problem among geriatric population worldwide. It may contribute to higher prevalence of cognitive impairment and depression, and may occur as a side effect of commonly prescribed anti-diabetic and anti-acid treatments. However, the scale of this phenomenon in Poland remains unknown.We investigated the scale of vitamin B12 deficiency across population of geriatric patients over 70 years old. Additionally, we examined the association between vitamin B12 deficiency, cognitive impairment or depression prevalence, and metformin or proton pump inhibitors intake.Based on the measured vitamin B12 serum level, we divided patients into 3 groups: (1) normal (≥300 pg/mL); (2) borderline (191–300 pg/mL), and (3) low (≤191 pg/mL). The assessment of cognitive impairment or depression was performed by using 5 distinct tests (mini-mental state examination, abbreviated mental test score, clock drawing test, and 4-item or 15-item geriatric depression scale). For statistical analysis, we used χ2 and ANOVA tests.We showed no differences in the frequency of cognitive impairment, depression, and vitamin among characterized groups. Importantly, we found that metformin intake was associated with vitamin B12 deficiency (P = 0.009), contrary to proton pump inhibitor (P = 0.53) and combined these drugs (P = 0.24).We showed a relatively high prevalence of vitamin B12 deficiency across a population of geriatric patients. A preventive vitamin B12 supplementation should be considered when treating, especially geriatric diabetic patients. Due to conflicting results of retrospective studies, prospective clinical trial should be undertaken to describe the association between vitamin B12 deficiency and prevalence of cognitive impairment or depression.","PeriodicalId":38569,"journal":{"name":"Polish Annals of Medicine","volume":"64 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140424160","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

Congenital transsphenoidal meningocele in a newborn: A case report 新生儿先天性经鼻脑膜脑积水：病例报告

Polish Annals of Medicine Pub Date : 2024-02-26 DOI: 10.29089/paom/177338

Azliana Aziz, Yi Wee Lim, Baharudin Abdullah, Zamzuri Idris, Mei Sin Lim

引用次数: 0

Combined right and left sided endocarditis in a hemodialysis patient: A cautionary tale 一名血液透析患者合并左右侧心内膜炎：一个值得警惕的故事

Polish Annals of Medicine Pub Date : 2024-02-02 DOI: 10.29089/paom/176244

Erjola Bolleke (Likaj), E. Likaj, S. Seferi, Kristi Saliaj, Fjorba Mana, S. Dumani, Alma Idrizi

引用次数: 0

Combined right and left sided endocarditis in a hemodialysis patient: A cautionary tale 一名血液透析患者合并左右侧心内膜炎：一个值得警惕的故事

Polish Annals of Medicine Pub Date : 2024-02-02 DOI: 10.29089/paom/176244

Erjola Bolleke (Likaj), E. Likaj, S. Seferi, Kristi Saliaj, Fjorba Mana, S. Dumani, Alma Idrizi

引用次数: 0

Chest wall reconstruction in recurrent breast carcinoma – a case report 复发性乳腺癌的胸壁重建--病例报告

Polish Annals of Medicine Pub Date : 2024-02-01 DOI: 10.29089/paom/175798

Rebecca Xin Yi Choy, Hamidah Mohd Zainal, Mohd Ali Mat Zain

引用次数: 0

Chest wall reconstruction in recurrent breast carcinoma – a case report 复发性乳腺癌的胸壁重建--病例报告

Polish Annals of Medicine Pub Date : 2024-02-01 DOI: 10.29089/paom/175798

Rebecca Xin Yi Choy, Hamidah Mohd Zainal, Mohd Ali Mat Zain

引用次数: 0

Limy bile syndrome or milk of calcium bile: An unexpected encounter 胆汁乳糜综合征或胆汁钙乳：不期而遇

Polish Annals of Medicine Pub Date : 2024-02-01 DOI: 10.29089/paom/175881

Mitali Madhumita Rath, Rashmi Patnayak, Sambit Kumar Mohanty, Brundaban Nahak, Manoranjan Mohapatra

{"title":"Limy bile syndrome or milk of calcium bile: An unexpected encounter","authors":"Mitali Madhumita Rath, Rashmi Patnayak, Sambit Kumar Mohanty, Brundaban Nahak, Manoranjan Mohapatra","doi":"10.29089/paom/175881","DOIUrl":"https://doi.org/10.29089/paom/175881","url":null,"abstract":"Limy bile or milk of calcium bile caused due to precipitation of calcium salts in bile is an extremely rare condition of gall bladder, wherein the lumen of gall bladder is filled with chalky white paste like material. Not many cases have been reported till date.In this exceptional case, we tried to correlate the radiological and surgical findings with the histopathology.We hereby present an interesting case of a 59-year-old male who presented with dyspepsia and painful abdomen and was finally diagnosed with limy bile syndrome.The etiology of this rare entity is not fully understood, but it certainly has strong association with impacted stone at the neck of gall bladder and hyperparathyroidism. Females are more commonly affected than males. Patients usually present with complaints of painful abdomen and are commonly diagnosed radiologically, as a radiopacity in gall bladder. Cholecystectomy is the preferred method of treatment for this unusual condition and histopathologically chronic cholecystitis is seen along with presence of slender needle shaped crystals of calcium salts.A thorough evaluation of the clinicoradiological and histopathological findings can sometimes bring to light many uncommon variants of common looking pathologies.","PeriodicalId":38569,"journal":{"name":"Polish Annals of Medicine","volume":"332 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139830927","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