Folia Medica Cracoviensia

Introduction: Despite increased awareness of malnutrition and improved nutrition-related policies, there are still cases of deterioration of nutritional status during hospitalisation. NutritionDay is an audit organised by the European Society for Clinical Nutrition and Metabolism (ESPEN), the Medical University of Vienna and the Friedrich-Alexander University Erlangen-Nürnberg (FAU) to prevent the onset of malnutrition and to improve hospital policies to deal with this problem. The aim of the study was to analyse the results of the audit with regard to factors that may contribute to the deterioration of a patients’ nutritional status in hospital setting. Materials and Methods: This cross-sectional study was performed in a tertiary teaching hospital and was part of an international audit. The questionnaires used were provided by the nutritionDay office, and included information on weight loss, patients’ appetite, dietary restrictions, food intake and reasons for food rejection during hospital stay. Results: Of the examined patients, 61% reported weight loss prior to the current hospital stay. We identified 25 patients who did not consume a whole portion of their main meal on the day the audit took place. Approximately 17% of the patients’ complaints could be resolved within a hospital ward. Conclusions: Hospital patients often eat less than a standard meal portion. Identifying the reasons for meal rejection may be helpful for development of standards for nutritional care in the hospitals.

Introduction: An endoscopic intragastric balloon (IGB) placement is one of the minimally invasive methods of obesity treatment. One of the rare serious complications is mechanical bowel obstruction requiring operative management. We report a case of a male patient with small bowel obstruction due to IGB migration and the literature review of complications during IGB treatment. Detailed Case Description: A patient with a BMI of 28 kg/m2 was admitted to the hospital with spontaneous deflation of an IGB. Due to the suspected location of IGB in the ileum laparoscopy was performed. The enterotomy was performed and the IGB removed. The procedure and the postoperative period were uneventful. Discussion: Spontaneous IGB ruptures are reported in the literature with a frequency ranging from 0.6 to 23%. The majority of deflated devices are spontaneously excreted with the stool with no abdominal symptoms. Only 0.38% of IGBs cause mechanical bowel obstruction of requiring surgical management. Based on our own experience and literature review, we propose the diagnostic and therapeutic algorithm. Conclusion: Complications after IGB placement can range from mild to severe, that is why it is so important to make an early diagnosis based on the emerging symptoms and to implement prompt management to reduce or avoid serious complications. Any patient reporting disturbing symptoms occurring over a prolonged period of time requires hospitalization and careful observation for the occurrence of gastrointestinal obstruction. The ideal option is hospitalization in the center which implemented the IGB and start with the algorithm we proposed.

Tooth loss extends beyond oral health concerns, impacting overall well-being and quality of life. It is a global issue, with approximately 7% of individuals aged 20 years or older affected. Research reveals associations between tooth loss and cardiovascular diseases, including hypertension, atherosclerosis, and peripheral arterial disease, attributed mainly to chronic inflammation and altered dietary habits. However, tooth loss has also been associated with cognitive decline, depression, and certain cancers, including lung, head and neck, pancreatic, and esophageal, suggesting the involvement of complex pathophysiological mechanisms that are increasingly the subject of experimental research. In addition, there are psychosocial consequences, such as self-esteem issues and social discomfort. Therefore, it is indisputable that comprehensive oral care is of utmost importance. Recognizing the importance of oral health for overall well-being highlights the necessity for preventative measures and enhanced dental care. As the global population ages, it is increasingly important to comprehend and address the systemic effects of tooth loss. This review aims to summarize the complex pathomechanisms underlying tooth loss and emphasize the need for a comprehensive approach to address its diverse consequences. It advocates for preventive oral health measures to sustain general health and well-being.

Background: Kidney diseases are a major global health problem affecting millions of people. Despite this, there is as yet no effective drug therapy improving outcome in patients with renal disease. The aim of this study was to examine the nephroprotective effect of α-lipoic acid (ALA) in vitro and to examine the effect of ALA administered in vivo on the production of reactive sulfur species (RSS), including hydrogen sulfide (H2S) and compounds containing sulfane sulfur. Methods: The effect of ALA was studied in vitro by determining the viability of human embryonic kidney cells (HEK293) in normoxic and hypoxic conditions as well as in vivo in two groups of chronic kidney disease (CKD) patients: non-dialyzed (ND) and undergoing continuous ambulatory peritoneal dialysis (PD) after 30 days of ALA supplementation. Results: The results revealed that the viability of HEK293 cells was significantly decreased by hypoxic conditions, while ALA administered during hypoxia increased the viability to the level observed in normoxic conditions. Studies performed in plasma of CKD patients after ALA supplementation suggested that ALA did not affect the parameters of oxidative stress, while significantly increased the level of reactive sulfane sulfur in both ND and PD patients suffering from CKD. The results suggest that ALA can exert nephroprotective effects which are related to sulfane sulfur production.

Herein we present the fatal case of premature baby with coincidence of extreme form of ectopia cordis and hypoplastic left heart structures

In 2019, three regulations of the Minister of Health regarding sports medicine examinations in children, adolescents and young athletes came into force. The publication presents in detail the current scope of tests and the frequency of required medical examinations necessary to obtain medical certificates qualifying patients to practice sports. The publication also presents the Regulation of the Minister of Health on the required qualifications of doctors authorized to issue medical certificates to athletes. It is very important to properly assess the health of potential and current athletes to ensure their safety while participating in sports competitions. There are diseases that increase the risk of sudden cardiac death which doctors should keep in mind when qualifying athletes for competition. The publication draws attention to the underestimated role of echocardiography and electrocardiographic stress testing.

Xanthogranulomatous Pyelonephritis (XGP) is a serious and rare inflammatory disease of unknown etiology. This systematic review analyzes XGP cases. We performed a literature search for “Pyelonephritis, Xanthogranulomatous.” The primary composite outcome was recovery with post-surgery complications, partial recovery, death, or chronic kidney disease. The secondary outcome was any presentation or treatment complication. Predictor variables consisted of demographics, history, symptoms, and diagnosis/management. Among the 251 patients, the mean age was 36.1 years, and 57.4% were female. The most common symptom and finding were fever (55.0%) and renal stones (53.8%), respectively. There were 15.5% with the composite outcome. There were 51.0% with any presentation or treatment complication. Multivariate logistic regression analysis for the composite outcome showed that kidney of both/horseshoe (OR:3.86, 95% CI:1.01, 14.73, p = 0.048), dialysis required (OR:8.64, 95% CI:2.27, 32.94, p = 0.002), and operative treatment of nephrostomy or nephrostomy followed by nephrectomy (OR:4.57, 95% CI:1.58, 13.17, p = 0.01) were each significantly associated with increased odds. Fever (OR:3.04, 95% CI:1.63, 5.67, p <0.001) and renal stones (OR:2.55, 95% CI:1.35, 4.81, p = 0.004) were each significantly associated with increased odds for any presentation/treatment complication. In conclusion, XGP patients with involvement of both or horseshoe kidneys, dialysis requirements, or treatment of nephrostomy or nephrostomy followed by nephrectomy may require aggressive treatment to mitigate poor patient outcomes.

Background: One of the promising methods of influencing the wound process is photobiomodulation (PBM) therapy. The optimal parameters of PBM therapy have not yet been found because the molecular mechanisms of light interaction with tissue are not fully understood. Objective: Studying the influence of PBM of various parameters on the regulation of reparative processes of chronic wounds using the example of indicators of aggregation activity of platelets, platelet-derived growth factor (PDGF), interleukin-8 (IL-8), and amino-terminal propeptide of type III procollagen (PIIINP) at the remodeling stage. And also the study of the structural and functional features of chronic wound healing in an experiment under various parameters of PBM therapy. Methods: Experiments were carried out on Wistar rats. Chronic wounds were simulated. Experimental animals were exposed to PBM at a wavelength of 660 nm and an energy density of 1 J/cm2. In serum, PDGF, IL-8, and PIIINP levels were measured by enzyme-linked immunosorbent assay. The functional activity of platelets was measured using the turbidimetric method. Histological analysis was performed. Results: The work noted the dose-dependent effect of PBM using the example of platelet aggregation at the remodeling stage during the healing of chronic wounds. The use of PBM therapy resulted in increased serum PDGF levels. Histological examination data indicate a positive effect of PBM therapy on the wound healing process. Conclusions: The effectiveness of the use of PBM therapy for the healing of chronic wounds to regulate reparative processes has been proven.

Background: Polycystic ovary syndrome (PCOS) is a common chronic endocrine disorder in women with complex and poorly understood etiologies. The present study aimed to describe the clinical features of PCOS in a sample of Syrian women as well as the risk factors, associated comorbid diseases, and patterns and efficacy of treatment. Methods: The present study is cross-sectional observational study conducted on a sample of Syrian women diagnosed with PCOS, using self-administered questionnaire during the period between December 25, 2023 and January 18, 2024. Overall, 1666 women with PCOS were recruited through online platforms. Results: Higher frequency of PCOS was observed in young women aged 15–25 years (63.1%) and in single ladies (76.5%). The main chief complaints experienced by patients with PCOS were hirsutism (71.25%), irregular menstrual cycle (70.95%), depressed mood (53.9%), acne (49.52%), abdominal obesity (43.88%), alopecia (38.12%), and weight gain (34.57%). The most common risk factors observed in patients with PCOS were lack of physical exercise (76.4%), unhealthy food habits (51.6%), family history (38.5%), and history of taking anabolic steroids (17.2%). Comorbid diseases were found in 11.5% of PCOS patients. These diseases were hypothyroidism (5.7%), hypertension (3.06%), dyslipidemia (1.68%), heart diseases (1.56%), and diabetes mellitus (0.78%). Most patients were treated with oral contraceptive pills (82.11%) or metformin (64.83%). The efficacy of treatment was observed as complete cure in 430 patients (25.8%) and partial response alleviating symptoms in 819 patients (49.2%), while and no benefit was found in 417 patients (25%). Conclusions: PCOS is associated with widespread dermatological and metabolic aberrations that pose psychological burden on women and increase their risk for having comorbid diseases. Most patients with PCOS do not receive adequate therapy. Understanding the risk factors and clinical features for each patient is essential to choose the proper treatment.

Objective: Analyze the influence of oral hygiene guidance for the maintenance of fixed partial dentures (FPD) and the influence of this treatment on the quality of life (QL) of rehabilitated patients. Material and Methods: The Simplified Oral Hygiene Index (OHI-S) and Bleeding on Probing Index (BOP) methods was employed to evaluate oral hygiene (OH), and the OHIP-14 questionnaire to assessment QL. The sample consisted of 33 patients (26 females and 7 males, mean age 51.53 years) in treatment with FPD. The OH and QL assessments were conducted in temporary FPD placing session and 30 days after definitive cementation. Results: OHI-S and BOP showed increasing results (p <0.05) comparing initial and final assessments. There was a negative correlation between OHI-S and BOP, in both periods of analysis. The OHIP-14 showed a significant result according to the Likert scale scores, with an impact reduction from 9.33 to 0.57. Conclusions: It was concluded that FPD rehabilitations need of properly oral hygiene guidance, that could be influence on oral health status. In addition, the FPD rehabilitation improved the QL of the patients.