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 | 2023 | Vol. 63 | No 2

1 Neglect and self-rated health among older adults - a cross-sectional study in Poland

Agata Stodolska , Katarzyna Zawisza , Barbara Wizner , Beata Tobiasz-Adamczyk , Tomasz Grodzicki

Folia Medica Cracoviensia | 2023 | Vol. 63 | No 2 | 5-28 | DOI: 10.24425/fmc.2023.145910

Keywords: elder neglect self-rated health social network quality of life mediation analysis

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Abstract

The aim of this cross-sectional study is to examine if neglect is associated with self-rated health (SRH) and if neglect mediates the association between selected factors and self-rated health, among older men and women. The analyses were based on face-to-face computer-assisted personal interviews con-ducted with 1632 randomly selected community-dwelling individuals aged 65 years and more from among the general population of Lesser Poland. The regression models’ analysis revealed that elder neglect was associated with self-rated health, and the mediation analysis demonstrated that neglect mediates the association between frequency of church attendance and SRH, as well as between marital status (being a widower vs being married) and SRH, among men. These observations can be helpful in better under-standing of the broad context of elder neglect in order to develop instruments for an efficient improve-ment of older adults’ health and quality of life. In addition to this, the study underlines the role of social networks and social engagement as factors which might protect against neglect, and thus improve self- rated health of older people.

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Authors and Affiliations

Agata Stodolska

Katarzyna Zawisza

Barbara Wizner

Beata Tobiasz-Adamczyk

Tomasz Grodzicki

Chair of Epidemiology and Preventive Medicine, Jagiellonian University Medical College, Kraków, Poland
Chair of Internal Medicine and Gerontology, Jagiellonian University Medical College, Kraków, Poland

2 Clinical characteristics of elderly patients with atopic dermatitis — a retrospective observational study

Andrzej Kazimierz Jaworek , Przemysław Hałubiec , Natalia Kachnic , Alicja Podolska , Julia Radzikowska , Arletta Kozłowska , Anna Wojas-Pelc

Folia Medica Cracoviensia | 2023 | Vol. 63 | No 2 | 29-40 | DOI: 10.24425/fmc.2023.145911

Keywords: elderly atopic dermatitis clinical characteristics of patients phenotype atopy differential diagnosis

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Abstract

Atopic dermatitis (AD) is a chronic, recurrent inflammatory dermatosis. The most characteristic symptoms of the disease include itch, eczematous eruptions and excessive dryness of the skin. Elderly patients with AD represent a poorly characterized population because the physiological ageing, possible comorbidity and polypharmacy modify the clinical presentation typically observed in the younger age groups. The aim of the study is to comprehensively assess the clinical characteristics of elderly patients (>60 years old) with AD. Data were collected from 26 AD patients treated in the Department of Derma-tology of the University Hospital in Krakow. Late-onset AD with generalized/prurigo lesions was the most predominant phenotype. Skin biopsy was required in 15 (58%) patients in the differential diagnosis process. Allergic rhinitis, a positive family history of atopy and xerosis were associated with a higher number of hospitalizations during the year prior to the last admission (p = 0.034, p = 0.046 and p = 0.036, respectively). Xerosis was more prevalent among subjects with polypharmacy (p = 0.046) and higher serum total IgE concentration (p = 0.048). AD in elderly patients is a new phenotype of the disease that requires careful differential diagnosis. Aged patients with an individual or family history of atopy, due to the increased incidence of severe exacerbations of AD, may benefit from the introduction of proactive therapy.

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Authors and Affiliations

Andrzej Kazimierz Jaworek

Przemysław Hałubiec

e-mail:

ORCID:

Natalia Kachnic

Alicja Podolska

Julia Radzikowska

Arletta Kozłowska

Anna Wojas-Pelc

Department of Dermatology, Jagiellonian University Medical College, Kraków, Poland
University Hospital, Kraków, Poland
Student Scientific Group of Dermatology, Jagiellonian University Medical College, Kraków, Poland

3 The significance of nutritional strategies in patients with inflammatory bowel disease in the context of malnutrition and the development of malnourished obesity

Agnieszka Dąbek , Olga Kaczmarczyk , Tomasz Dziubyna , Agnieszka Piątek-Guziewicz , Małgorzata Zwolińska-Wcisło

Folia Medica Cracoviensia | 2023 | Vol. 63 | No 2 | 41-56 | DOI: 10.24425/fmc.2023.145912

Keywords: Crohn’s disease ulcerative colitis diet malnutrition malnubesity

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Abstract

Inflammatory bowel diseases (IBD), including Crohn’s disease and ulcerative colitis, despite the increasing incidence, still do not have a specific etiology. Diet seems to be an important factor, modifying the occurrence of the disease and its course. Diet can affect the symptoms of IBD both directly, e.g., by alleviating diarrhea, bloating and constipation, and indirectly by shaping the microbiota. Bacterial meta-bolites produced under the influence of supplied nutrients may contribute to the modulation of pro- and anti-inflammatory pathways, depending on the diet used. So far, IBD has been associated with weight loss and malnutrition. In recent years, a trend of sarcopenic obesity with concomitant malnutrition has been observed. The new phenomenon is called malnubesity. This work aims to review the most commonly used diets in IBD in order to evaluate them in terms of alleviating ailments, but also maintaining proper nutritional status and lack of obesity. Low-fiber, low FODMAPs, Mediterranean diet and Crohn’s Disease Exclusion Diet diet were considered. We assume that diet is modifiable factor that is related to nutritional status and healthy body weight. In addition, the current knowledge on the relationship between nutrition strategies, obesity and IBD will be demonstrated.

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Authors and Affiliations

Agnieszka Dąbek

Olga Kaczmarczyk

Tomasz Dziubyna

Agnieszka Piątek-Guziewicz

Małgorzata Zwolińska-Wcisło

1 2

Unit of Clinical Dietetics, Department of Gastroenterology and Hepatology, Jagiellonian University Medical College, Kraków, Poland
Department of Gastroenterology and Hepatology, Jagiellonian University Medical College, Kraków, Poland

4 Pathogenesis and prognosis of intrarenal reflux

Ioanna Gkalonaki , Evangelia Schoina , Michail Anastasakis , Ioannis Patoulias

Folia Medica Cracoviensia | 2023 | Vol. 63 | No 2 | 57-64 | DOI: 10.24425/fmc.2023.145913

Keywords: intrarenal reflux renal scar renal papillae vesicoureteral reflux N-acetyl-beta-glycosamini-dase beta 2 microglobulin Pentraxin 3 Liver-type fatty-acid-binding protein

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Abstract

Scar development in the children’s renal cortex with vesicoureteral reflux (VUR) is one of the most important parameters of prognosis. It can develop regardless of the chosen treatment, even after the regression of VUR. The shape of the renal papillae, the ascending urinary tract infection, the greater than third-degree VUR, and finally the increased intra-calyceal pressure, induce the formation of renal scarring in the renal parenchyma. Renal scarring may complicate VUR independently of the therapeutic strategy (conservative or operative) and its regression. For restitution of this entity, many scientific terms have been used and the most common of them is intrarenal reflux (IRR). The effects of VUR on future renal function result from the limited ability of the affected kidney to grow (failure of renal growth) due to the existence of scars in the renal cortex, the worsening of these scars, or finally the creation of new scars. With the present study, we intend to clarify the etiology and the pathophysiology of IRR and the relation of VUR prognosis to newer biomarkers such as N-acetyl-beta-glycosaminidase, beta-2 microglobulin, Pen-traxin- 3 and Liver-type fatty-acid-binding protein.

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Authors and Affiliations

Ioanna Gkalonaki

e-mail:

ORCID:

Evangelia Schoina

Michail Anastasakis

Ioannis Patoulias

First Department of Pediatric Surgery, Aristotle University of Thessaloniki, General Hospital “G. Gennimatas”, Thessaloniki, Greece

5 Unsuccessful linguistic validation of the Symptom Questionnaire for assessing quality of life in Polish patients with pelvic vein disorders

Paulina Kłapacz , Mikołaj Maga , Łukasz Drelicharz , Jakub Krężel , Ewa Graczkowska , Kinga Krupa , Gabriela Trąd , Wojciech Maga , Łukasz Partyka , Paweł Maga

Folia Medica Cracoviensia | 2023 | Vol. 63 | No 2 | 65-75 | DOI: 10.24425/fmc.2023.145914

Keywords: pelvic venous disorder pelvic varicose veins chronic pelvic pain validation of quality of life

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Abstract

Pelvic venous disorder (PeVD) is a prevalent chronic condition characterized by the presence of varicose veins in the pelvis, leading to the development of chronic pelvic pain. Despite the growing interest in assessing quality of life in PeVD, well-designed and validated disease-specific questionnaires are missing. The objective of this study was a linguistic and clinical validation of the Symptom Questionnaire (SQ) in a cohort of Polish females with pelvic vein incompetence. The Polish version of SQ was developed using a standardized validation process that involved a back-and- forth translation protocol.
A total of 58 female patients diagnosed with pelvic varicose veins, representing diverse educational back-grounds, participated in the study. Multiple issues were observed during linguistic validation, primarily originating from disparities between the Polish and British healthcare systems, as well as differing levels of sexual health education of those two populations. Cronbach α was calculated separately for each part of the questionnaire with results exceeded 0.6 for each section. Test-retest analysis indicated most Pearson correlation coefficients surpassing 0.70. The absolute agreement consistency between pretest and post- test measures, evaluated using the Intra Class Correlation (ICC), exceeded 0.8 in three sections and 0.7 in the remaining three sections.
However, the clinical validation failed due to the lack of standardized score calculation proposed by the authors of the questionnaire and inaccurately assigned values in the answer key for five questions. Consequently, the practical utility of SQ in daily clinical settings remains uncertain, highlighting the urgent need for the development of a new, user-friendly questionnaire specifically tailored to assess the quality of life in individuals with PeVD.

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Authors and Affiliations

Paulina Kłapacz

1 2

Mikołaj Maga

2 3

Łukasz Drelicharz

1 2

Jakub Krężel

Ewa Graczkowska

Kinga Krupa

Gabriela Trąd

Wojciech Maga

Łukasz Partyka

1 2

Paweł Maga

1 2

Department of Angiology, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
Clinical Department of Angiology, University Hospital in Kraków
Department of Rehabilitation in Internal Medicine, Faculty of Health Sciences, Jagiellonian University Medical College, Kraków, Poland
Prosthodontic and Orthodontic Department, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland

6 Melanoma of the gallbladder

Paweł Bojar , Franciszek Burdan , Lech Wronecki , Justyna Szumiło

Folia Medica Cracoviensia | 2023 | Vol. 63 | No 2 | 77-92 | DOI: 10.24425/fmc.2023.145915

Keywords: melanoma gallbladder epidemiology imaging morphology outcome

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Abstract

Melanoma is a highly malignant neoplasm with the most typical primary locations in the skin and eyeball and rarely reported in the other organs, including the gallbladder. More commonly metastases of melanoma of various primary sites to the gallbladder are observed. However, generally melanoma of the gallbladder is a rare entity with only 217 cases reported in the literature up to date. The paper summarizes knowledge on epidemiology, symptoms, laboratory and imaging findings, morphology, treatment options, and outcome of patients with both primary and metastatic melanoma to the gallbladder.

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Authors and Affiliations

Paweł Bojar

1 2

Franciszek Burdan

3 4

Lech Wronecki

Justyna Szumiło

Department of Clinical Pathomorphology, Medical University of Lublin, Lublin, Poland
Department of Pathomorphology, Beskid Oncology Centre — John Paul II Memorial City Hospital in Bielsko-Biala, Bielsko-Biała, Poland
Department of Human Anatomy, Medical University of Lublin, Lublin, Poland
epartment of Radiology, St Johns’ Cancer Center, Lublin, Poland

7 Clinical and surgical relevance of ipsilateral occurrence of the ossified interclinoid ligament and carotico-clinoid foramen in the juvenile sphenoid bone

Janusz Skrzat , Grzegorz Goncerz , Agnieszka Szczepanek , Magdalena Kozerska

Folia Medica Cracoviensia | 2023 | Vol. 63 | No 2 | 93-106 | DOI: 10.24425/fmc.2023.145916

Keywords: interclinoid ligament carotico-clinoid foramen sella turcica bridging sphenoid bone

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Abstract

This study is an illustrative case of the ipsilateral ossification of the dural folds stretched between the clinoid processes found in the juvenile sphenoid bone. Thereby, occurred inconstant bony formations are termed as the interclinoid bridge and the carotico-clinoid foramen.
Both structures are of clinical meaning if surgical operations are performed in the sellar region.

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Authors and Affiliations

Janusz Skrzat

Grzegorz Goncerz

Agnieszka Szczepanek

Magdalena Kozerska

Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland

8 Guilty or not guilty? — False positive results of common medicines in drug tests: review and practical guide

Kamil Możdżeń , Konrad Kaleta , Agnieszka Murawska , Jakub Pośpiech , Piotr Panek , Barbara Lorkowska-Zawicka , Beata Bujak-Giżycka

Folia Medica Cracoviensia | 2023 | Vol. 63 | No 2 | 107-134 | DOI: 10.24425/fmc.2023.145917

Keywords: urine drug test false positives amphetamine cross-reactivity cannabinoids benzodiazepines

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Abstract

Drug-abuse detection tests are becoming increasingly commonplace in patient care today and provide a rapid and effective method for identifying illicit substances. Occasionally, they may yield a positive result, indicating the presence of a substance, even though the individual has not consumed the suspected drug what sometimes can significantly impact both medical and legal decisions. The study outlines the substances that can lead to false-positive drug test results for amphetamines, cannabinoids, and benzodiazepines. The study’s findings have revealed pivotal insights for patients receiving chronic treatment and their primary care physicians. Notably, amphetamine assays appear to be most prone to cross-reactivity with other substances. The beta-blocker group of medications, confirmed by various studies to interfere with amphetamine assays, could pose a substantial challenge in drug screening given its widespread use. Efavirenz also warrants mention, as it frequently triggers positive results for both benzodiazepine and cannabinoid assays among its users. This research helps highlight new areas for further investigation and aims to guide clinicians in their daily practice, especially when interpreting questionable positive drug-abuse test results. This comprehensive review serves as a valuable resource for clinicians to navigate false-positive scenarios effectively and maintain the highest standard of patient care.

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Authors and Affiliations

Kamil Możdżeń

Konrad Kaleta

Agnieszka Murawska

Jakub Pośpiech

e-mail:

ORCID:

Piotr Panek

Barbara Lorkowska-Zawicka

Beata Bujak-Giżycka

Student Scientific Group of Clinical Pharmacology, Jagiellonian University Medical College, Kraków, Poland
Depatment of Clinical Pharmacology, Jagiellonian University Medical College, Kraków, Poland

9 Molecular biology techniques in real life — case study introducing medical students to QF-PCR technique used in medical diagnostics

Kinga A. Kocemba-Pilarczyk , Anna Bentke-Imiolek , Paulina Dudzik

Folia Medica Cracoviensia | 2023 | Vol. 63 | No 2 | 135-148 | DOI: 10.24425/fmc.2023.145918

Keywords: Problem Based Learning medical education QF-PCR prenatal diagnostics paternity tests Next Generation Sequencing

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Abstract

QF-PCR is a widely used molecular biology method. To name just a few of its uses, it is considered to be useful in paternity tests, identification tests or prenatal diagnostics. Therefore, there is a good chance that medical faculty students would come into contact with this technology — directly or indirectly — during their professional work. The following article proposes a teaching classes scenario conducted in the problem-based learning manner, which aims to familiarize students with the QF-PCR technique. In addition, other modern methods of molecular genetics are among topics that students can learn during the problem-based learning modules. The classes are divided into three parts. In the first part, students learn about the possible usage of QF-PCR in paternity tests. The second part focuses on learning about the advantages and limitations of QF-PCR in prenatal diagnosis. Learning activities in the last part are designed to show the limitations of the diagnostic properties of the method — students analyze the case study, in which QF-PCR must be replaced by other modern methods of molecular genetics. By analyzing three independent stories, students learn about usage, advantages and limitations of QF-PCR, and additionally gain knowledge in basic, pre-clinical and clinical sciences. This course is designated as an elective course for final year medical students who have completed either: a basic genetics course, a mo-lecular genetics course, a biochemistry course or a molecular biology course. The focus of the classes is to draw students’ attention to the possible application and rapid development of molecular biology techni-ques, which is the base for modern therapeutic and diagnostic strategies.

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Authors and Affiliations

Kinga A. Kocemba-Pilarczyk

Anna Bentke-Imiolek

Paulina Dudzik

Chair of Medical Biochemistry, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland

10 Prevalence of metabolic syndrome and improper nutritional status among adolescents

Agnieszka Ostromęcka , Elżbieta Sochacka-Tatara , Agnieszka Pac

Folia Medica Cracoviensia | 2023 | Vol. 63 | No 2 | 149-163 | DOI: 10.24425/fmc.2023.145919

Keywords: metabolic syndrome adolescents nutritional status cholesterol glucose obesity

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Abstract

Prevalence of metabolic syndrome (MetS) and its components is a growing issue, including pediatric populations. However, because of many definitions used, it is difficult to assess the true fre-quency of these problems.
The aim of this study was to assess the prevalence of MetS and its components as well as the frequency of problems with inadequate nutritional status among adolescents.
One hundred ninety-six teenagers aged 15–18 years, living in Krakow and its vicinity were examined including measurement of blood pressure, anthropometric parameters and blood levels of cholesterol and glucose.
The prevalence of MetS was low and varied from 0.5% to 2.0% depending on the definition. Based on Cook’s definition of MetS, the most common components were hypertension (12.8%) and hypertriglycer-idemia (12.8%). Improper body weight (based on BMI) was found in 23.5% of adolescents, including 5.1% underweight, and 18.4% overweight or obese. According to the body fat percentage (BF%), 45.8% of the boys were underfat and 6.3% had too much body fat, while only 4% of the girls were below the BF% reference values and 15% above. All girls and 86.5% of boys had too low total body water. In conclusion, the prevalence of metabolic syndrome in population of Krakow adolescents was relatively low, but more than 12% of the adolescents had a hypertension or hypertriglyceridemia. Based on BMI most of adolescents were found to have adequate body weight, but examination of fat content in the body high prevalence of underfat was observed, especially among boys.

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Authors and Affiliations

Agnieszka Ostromęcka

Elżbieta Sochacka-Tatara

Agnieszka Pac

Chair of Epidemiology and Preventive Medicine, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland

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.
SUBMISSION
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.
Original Articles
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).
Review Articles
Topical reviews of basic or clinical areas are invited by the Editor. Manuscript length is limited to 5000 words and 50 references. All Review articles are subject to review.
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The Folia Medica Cracoviensia uses American spelling. Authors for whom English is a second language may choose to have their manuscript professionally edited before submission to improve the English.

The complete set of instructions for Authors can be downloaded here as a PDF file: http://www.fmc.cm-uj.krakow.pl/pdf/Author_Guidelines_Folia_2017_Jul_31_KG1.pdf