Hospital In Krakow Research Articles

436-P: Low Prevalence of Diabetic Retinopathy in Type 1 Diabetes Patients with a Long-Term Modernly Treated Disease and Very Good Glycaemic Control: A Retrospective Single-Center Analysis

Despite continuous progress in the therapy of type 1 diabetes (T1DM), diabetic retinopathy (DR) is still a common chronic complication. We aimed to analyse DR prevalence and its predictors in patients with T1DM lasting 10 years or more, treated with modern methods, and with excellent glycaemic control. The analysis included data from 384 (80.7% women) patients taking part in the Polish National Health Fund’s Program of Comprehensive Outpatient Specialist Care at the University Hospital in Krakow between 2014-2020. A retrospective analysis of data from medical records was applied. T1DM patients of average 34 ± 9.2 years, mean BMI of 25.0 ± 3.9 and diabetes duration of 20.5 ± 7.9 years was included. The mean HbA1c of all patients throughout the follow-up period was 6.9 ± 1 % [52 mmol/l]. The analysed group consisted of 238 (62,0%) patients treated with CSII, 99 (25.8%) treated with MDI; and 47 (12.2%) who used both methods during the observation period. All patients used short-acting analogues, 144 (98.6%) MDI users were treated with long-acting analogues. DR was confirmed in 150 (39.1%) patients, 109 (72.2 %) of them were diagnosed de novo in the analysed period. Severe DR, defined as an advanced non-proliferative DR or proliferative DR, was observed in 31 persons (8.07% of the entire study group and 20.7% of the DR group).In the multivariate logistic regression model, T1DM duration (OR 1.13; 95% CI, 1.09-1.19), HbA1c level (OR 1.41; 95% CI, 1.08-1.84), LDL level (OR 1.79; 95% CI, 1.16-2.87), and combined incidence of non-DR micro- and macrovascular chronic complications (OR 1.86; 95% CI, 1.16-3.03) were independent risk factors for DR presence. In our long-term retrospective study, the prevalences of both any stage of DR and severe DR were lower than reported in other cohorts from earlier periods. Independent risk factors for DR in this highly selected cohort did not differ from the previously reported. Disclosure P. Surowiec: None. B. Matejko: Other Relationship; Self; Ascensia Diabetes Care, Roche Diabetes Care. M. Kopka: None. A. Filemonowicz-skoczek: None. T. Klupa: Advisory Panel; Self; Dexcom, Inc., Ypsomed Group, Employee; Spouse/Partner; Ascensia Diabetes Care, Research Support; Self; Abbott Diabetes, Speaker’s Bureau; Self; Bioton S. A., Boehringer Ingelheim International GmbH, Eli Lilly and Company, Medtronic, Novo Nordisk Inc., Sanofi-Aventis. B. A. Romanowska-dixon: None. K. Cyganek: Advisory Panel; Self; Medtronic, Speaker’s Bureau; Self; Lilly Diabetes, Novo Nordisk. M. Malecki: Advisory Panel; Self; Abbott Diabetes, Medtronic, Speaker’s Bureau; Self; AstraZeneca, Boehringer Ingelheim International GmbH, Lilly Diabetes, Merck & Co., Inc., Mundipharma International, Novo Nordisk, Sanofi-Aventis, Servier Laboratories.

Inflammatory syndromes including PIMS-TS in children hospitalised in the Malopolska region of Poland in the first wave of the COVID-19 pandemic

Aim of the study: To describe cases meeting the criteria of Kawasaki disease (KD), with particular consideration of the first 2 cases of paediatric inflammatory multisystem syndrome temporarily associated with SARS-CoV-2 infection (PIMS-TS) in patients in the Malopolska region in the first wave of the disease caused by SARS-CoV-2 infection (COVID-19) pandemic. Material and methods: From 4 March to 15 July 2020 a total of 11 children meeting KD criteria were hospitalised in the Department of Infectious Diseases and Paediatrics, S. Zeromski Specialist Hospital in Krakow and the Clinic of Children's Diseases, Department of Paediatrics, Jagiellonian University Medical College in Krakow. This paper analyses the data collected and describes in detail the disease in 2 children with PIMS-TS. Results: None of the 11 children who met the criteria of KD had a positive SARS-CoV-2 PCR test on admission. SARS-CoV-2 IgG test results were positive in 2 patients. All children presented with fever, rash, and conjunctivitis;9 with swollen hands and feet;8 with mucous membrane changes;5 with abdominal symptoms;5 with respiratory symptoms;and 1 with neurological signs. As regards laboratory tests, C-reactive protein (CRP), procalcitonin, lymphocytes, platelets, All were assessed in all patients, albumin in 10/11, lactate dehydrogenase (LDH), fibrinogen in 9/11, troponin and ferritin in 6/11, pro-BNP, D-dimers in 8/11. Echocardiography was performed in all patients and showed coronary artery abnormalities in 4 children. In PIMS-TS significant elevation of procalcitonin, CRP, D-dimers, N-terminal prohormone of brain natriuretic peptide (NT-pro-BNP), and thrombocytopaenia were observed. Conclusions: 1. Because of the asymptomatic course of SARS-CoV-2 infection in children who subsequently developed PIMS-TS and the absence of any viral genetic material in a sample collected from the upper airways upon PIMS-TS diagnosis, a detailed epidemiological interview and a reliable serology testing for SARS-CoV-2 infection are necessary in each case meeting KD or PIMS-TS criteria. 2. There is a need to look for new factors differentiating PIMS-TS and KD, other than polymerase chain reaction (PCR) and serology tests. © 2021 Termedia Publishing House Ltd.. All rights reserved.

Koordynacja jako element nowoczesnej opieki nad pacjentem onkologicznym. Praca koordynatorów onkologicznych na przykładzie Szpitala Uniwersyteckiego w Krakowie

Coordination as an Element of Modern Oncological Patient Care – the Example of the Oncological Coordinators Work at the University Hospital in Krakow The aim of this article is to look at coordination as a new approach to working with cancer patients. Knowledge about the physical, social, emotional, existential and spiritual consequences of the disease is the basis for the ability to assess to what extent disruptions in these spheres affect the well-being of the patient and his family. I present an example of the work of coordinators at the university hospital in Krakow in the context of knowledge on this subject from more advanced centers. Moreover, I confront the coordination approach with the work of oncology social workers. It is the oncology social workers who undertake effective interventions to deal with the consequences of the crisis caused by the disease and to strengthen the resources inherent in interpersonal relationships and in the patient’s environment. Professional social work, focused on strengthening the families of people with oncological diseases, is a special area that may extend the professional identity of a social worker to be active in the field, which although it is a statutory task of social work, its use in practice is not a common phenomenon. It seems an important combination of the work of oncology coordinators working in hospitals with the work of social workers working in patients’ living environments.

Assessment of Functional Status and Quality of Life of Elderly Patients Undergoing Radiotherapy and Radiotherapy Combined with Chemotherapy - A Cross-Sectional Study.

BackgroundAging is associated with various diseases, a plethora of which are oncological. Selected treatment methods influence the performance status and the adaptability to changing circumstances.ObjectiveThe aim of the study was to assess the functional status, quality of life, and adaptation to disease of elderly patients who underwent only radiotherapy or chemotherapy combined with radiotherapy.Patients and MethodsThe cross-sectional study was conducted in a sample of 76 patients diagnosed with cancer, over 60 years of age (mean 69.3/SD 6.8) who were hospitalized in the Radiotherapy Department at the Ludwik Rydygier Hospital in Krakow. Standardized research tools were: Functional Assessment of Chronic Illness Therapy (FACIT-F), Mental Adjustment to Cancer Scale (Mini-MAC), Lawton Instrumental Activity of Daily Living (IADL), Yesavage Geriatric Depression Scale (GDS), an assessment scale of the post radiation reaction devised by Eastern Cooperative Oncology Group (ECOG).ResultsMost (n=37) patients were treated with a combination of radiotherapy and chemotherapy (48.6%), whereas 21 patients underwent only radiotherapy (27.6%). More than half of the respondents were male (68.4%, n = 52), whereas 24 (31.6%) were female. The assessment of the participants’ performance status yielded results indicating an average level of all domains. Men performed better in terms of physical condition compared to a group of women (p=0.010). Women experienced fatigue more frequently than men (p=0.012). Patients who had received radiation therapy combined with chemotherapy achieved on average better results in functional well-being (FWB) than the patients who had undergone radiotherapy only (p=0.046). Depression had a significant impact on all spheres of functioning (p<0.001) except social/family well-being.ConclusionThe results pointed to the essential elements that should be taken into consideration in relation to treatment planning and providing care. Particular attention should be paid to women who suffered from depression and negative adaptation strategies that directly affect their functioning.

A 2D COS study of lymphocytes in the course of infectious mononucleosis

Activation of lymphocytes during contact with the Epstein–Barr virus (EBV) was studied. The lymphocytes were obtained from patients treated due to the acute phase of infectious mononucleosis in the Jagiellonian University Hospital in Krakow. The changes in the averaged Raman spectra of the lymphocytes during their treatment, on the 1st, 3rd, 5th, 9th and 12th day of hospitalization, were analyzed using the 2D-COS method. The most interesting activation marker was the Raman band at 520 cm−1 attributed to the formation of immunoglobulins. This band does not occur in the control group samples. The 2D-COS analysis revealed some additional details of lymphocyte activation. In the 2D synchronous maps, the greatest changes occur for auto-peaks at 2929 cm−1, due to the CH vibrations in the methyl groups of lipids and proteins, at 1638 cm−1, corresponding to the changes in α -helix amide I, 1585 cm−1 corresponding to nucleic acids and some amino acids, Trp, Phe and Gln, indicating cell remodeling. 2D synchronous maps monitor the formation of a receptor complex, as a subsequent functional lymphocyte maturation. 2D asynchronous maps point to the B-cell development towards immune response, i.e., the formation of immunoglobulins.

Transformacja i zasady działania psychiatrycznego oddziału jednoimiennego w trakcie pandemii COVID-19

Celem niniejszego artykułu jest prezentacja doświadczeń Oddziału Klinicznego Psychiatrii Dorosłych Dzieci i Młodzieży Szpitala Uniwersyteckiego w Krakowie (OKPDDiM) w podejmowaniu roli psychiatrycznego oddziału jednoimiennego dla Województwa Małopolskiego dla osób dorosłych oraz dla Polski południowej w wypadku dzieci i młodzieży w trakcie pandemii COVID-19. W pracy zaprezentowane zostały etapy transformacji, przyjęte rozwiązania praktyczne oraz trudności, na jakie napotkał zespół w trakcie tego procesu. W okresie od 9.04-29.05.2020 roku w warunkach stacjonarnych budynku OKPDDiM leczonych było 9 pacjentów zakażonych SARS-CoV-2, natomiast w dniach 23.03-23.05.2020 roku w głównej siedzibie Szpitala Uniwersyteckiego w Krakowie konsultujący psychiatrzy zaopatrywali 97 chorych zakażonych SARS-CoV-2. Nasze doświadczenia wskazały, że placówki opieki medycznej w Polsce, zwłaszcza te dedykowane pacjentom ze schorzeniami psychicznymi oraz domy opieki długoterminowej, nie były przygotowane do pracy w warunkach kryzysu pandemii. Sytuacja ta uwydatniła też brak rozwiązań systemowych na wypadek kryzysu na szczeblu ogólnokrajowym, w tym zwłaszcza dotyczących psychiatrii dzieci i młodzieży oraz psychiatrii sądowej. Funkcjonowanie w ramach kryzysu sanitarno-epidemiologicznego związanego z możliwością szybkiego pogarszania się stanu somatycznego pacjentów psychiatrycznych wskazuje dobitnie na konieczność powstawania oddziałów psychiatrycznych w szpitalach ogólnych. Wymóg posiadania w ramach oddziałów różnych stref dla pacjentów z wykluczoną infekcją SARS-CoV-2 oraz bez wykluczonej infekcji powinien być uwzględniony w ramach reformy psychiatrii zakładającej regionalną odpowiedzialność ośrodków stacjonarnych.

HEALTH-RELATED QUALITY OF LIFE IN A PATIENT FOLLOWING ANEURYSMOTOMY OF RARE MEGA-GIANT ANEURYSM OF THE COMMON CAROTID ARTERY

In the subject literature there are only a few articles devoted to the Health-Related Quality of Life (HRQoL) of patients with large ex- tracranial aneurysms of the carotid artery segment. There are no reports on the quality of life of patients with rare Mega-Giant Carotid Artery Aneurysms (MGCAA) manifesting themselves as chronically large and growing neck tumors. The aim of the research was an evaluation of the health related quality of life (HRQL) of a patient following aneurysmotomy of Mega-Giant Carotid Artery Aneurysms (MGCAA). An 82-year-old patient was referred to the Department of Vascular Surgery at the John Paul II Hospital in Krakow, due to the presence of a megagiant, painful tumor covering the entire left side of the neck. A physical examination and angio-CT confirmed the pres- ence of a pulsating tumor, which extended vertically from the level of the angle of the mandible to the clavicle, and horizontally from the trachea to the cervical spine. An aneurysmotomy and recon- struction of LICA with cerebral protection using a shunt catheter was performed. The patient was awakened from anesthesia and extubated shortly after the procedure, without any Central Nervous System neurological defects. The surgery was complicated by left recurrent laryngeal nerve paresis and aphonia without dyspnoea, which was only partially resolved around 3 months after the oper- ation itself. The postoperative period was uncomplicated. Health related Quality of Life (HRQoL) was studied using the 36-Item Short Form Health Survey (SF-36) to study both the clinical symp-toms and how these symptoms would be reduced in a year follow up after the aneurysmotomy. Despite the increasing availability of endovascular options and techniques, open surgical repair of ICA aneurysms, especially Mega- Giant Carotid Artery Aneurysms (MGCAA), using cerebral protection (shunts), remains a basic option, providing an opportunity to avoid major intraoperative and postoperative complications. The aneurysmotomy, despite laryngeal nerve paresis and aphonia without dyspnoea, improves the patient’s health-related quality of life.

Basic serum biochemical parameters in the assessment of calcium-phosphate metabolism in children

Introduction: The calcium-phosphate homeostasis is important for proper child growth and development and vitamin D plays a crucial role in this process. Aim: The aim of the study was to assess the relationship between total calcium (Ca), phosphates (Pi), parathyroid hormone (PTH) and the concentration of 25-hydroxycholecalciferol (25 (OH) D3) in children. Materials and methods: 164 serum samples were collected from children (1 day to 18 years) hospitalized in University Children’s Hospital in Krakow. Concentrations of Ca, Pi (dry chemistry-method), PTH (immunoradiometric-method) and 25(OH)D3 (HPLC) were determined. The results were analysed for all children, regardless of the age and for children under and above the age of four. Results: Analyzing all results, the mean of Ca concentration was significantly higher in the children with optimal 25(OH)D3 concentration compared to the children, who had 25(OH)D3 deficiency (p &lt; 0.05). In samples from children ≤4 years of age, the significantly higher mean concentrations of Ca and Pi in the children with optimal 25(OH)D3 concentration compared to the children, who had suboptimal levels of 25(OH)D3 were found (p = 0.04; p = 0.002; respectively). For all results and for results from children ≤ 4 years of age, Ca and Pi concentrations were positively correlated with 25(OH)D3 concentration (p &lt; 0.002, p &lt; 0.01; p &lt; 0.003, p &lt; 0.004; respectively), there were no relationship between PTH and 25(OH)D3 concentrations. Conclusion: Comparing the results of calcium and phosphate concentration only to the appropriate reference ranges may not be sufficient to evaluate calcium-phosphate metabolism. Probably the reference values for total calcium and phosphates should be established depending on vitamin D levels, especially for young children.

The urinary disorder-specific quality of life in patients after spinal cord injury: Polish translation, adaptation and validation of the Qualiveen and SF-Qualiveen.

Prospective cohort validation study. In spinal cord injury (SCI), neurogenic lower urinary tract dysfunction is associated with a reduced quality of life. No specific questionnaire has been translated, culturally adapted, and validated into Polish language to assess urinary disorder-specific quality of life in people after SCI. In this study, we translated, adapted, and validated the Polish versions of the Qualiveen and SF-Qualiveen in individuals with SCI. University Hospital in Krakow, Poland. Translation and cross-cultural adaptation of the Qualiveen and SF-Qualiveen were done using international recommendations and well-established methods. Adult patients with SCI from the Department of Urology at the University Hospital in Krakow, Poland completed the Polish versions of the Qualiveen, SF-Qualiveen, and International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) at baseline and 2 weeks later. The ICIQ-SF served as the reference instrument. Validity and reliability were determined. Polish-speaking patients with SCI (n = 178) were included. Content validity/cross-cultural adaptation of the translated questionnaires was investigated during face-to-face interviews. Construct/criterion validity was assessed, and positive correlations were found between the Qualiveen and ICIQ-SF as well as the SF-Qualiveen and ICIQ-SF. A reliability study revealed good internal consistency (Cronbach's alpha > 0.8) and reproducibility (intraclass correlation coefficients > 0.8) for both adapted questionnaires. We did not identify floor or ceiling effect. The Polish versions of the Qualiveen and SF-Qualiveen showed good measurement properties. Polish healthcare providers can now reliably and directly assess the urinary disorder-specific quality of life in individuals after SCI.

How we prepared our operating theatre for patients with SARS-CoV-2 virus.

The COVID-19 disease continues to cause a global pandemic. The University Hospital in Krakow has been designated as one of the COVID-19 hospitals. To prepare for the pandemic we needed to implement strategies that would protect the health care workers, reduce in-hospital transmission, and provide optimal care for the patients. In the operating department, these preparations involve the cooperation of multiple teams and can pose significant difficulties. Here, we describe measures taken in response to the COVID-19 outbreak. These include, adjustments made in OR set-ups, modification of workflow and processes, and the introduction of adequate personal protective equipment. We believe that these containment measures are required in order to provide an adequate quality of care to COVID-19 patient and to minimise the risk of cross-infection to staff members and other patients.

Emergence of linezolid-resistant Staphylococcus epidermidis in the tertiary children\u2019s hospital in Cracow, Poland

Coagulase-negative staphylococci, ubiquitous commensals of human skin, and mucous membranes represent important pathogens for immunocompromised patients and neonates. The increasing antibiotic resistance among Staphylococcus epidermidis is an emerging problem worldwide. In particular, the linezolid-resistant S. epidermidis (LRSE) strains are observed in Europe since 2014. The aim of our study was to genetically characterize 11 LRSE isolates, recovered mostly from blood in the University Children’s Hospital in Krakow, Poland, between 2015 and 2017. For identification of the isolates at the species level, we used 16S rRNA sequencing and RFLP of the saoC gene. Isolates were characterized phenotypically by determining their antimicrobial resistance patterns and using molecular methods such as PFGE, MLST, SCCmec typing, detection of the ica operon, and analysis of antimicrobial resistance determinants. All isolates were multidrug-resistant, including resistance to methicillin, and exhibited so-called PhLOPSA phenotype. In PFGE, all isolates (excluding one from a catheter) represented identical patterns, were identified as ST2, and harbored the ica operon, responsible for biofilm formation. Linezolid resistance was associated with acquisition of A157R mutation in the ribosomal protein L3 and the presence of cfr gene. All isolates revealed new SCCmec cassette element composition. Recently, pediatric patients with serious staphylococcal infections are often treated with linezolid. The increasing linezolid resistance in bacterial strains becomes a real threat for patients, and monitoring such infections combined with surveillance and infection prevention programs is very important to decrease number of linezolid-resistant staphylococcal strains.

Long-term evaluation of outcomes and survival of patients treated for retinoblastoma

PurposeThe purpose of our study was to assess long-term outcomes of patients suffering from retinoblastoma who underwent systemic chemotherapy using vincristine, etoposide, and carboplatin (VEC protocol) followed by other local treatments. Material and methodsA retrospective review of patients diagnosed with retinoblastoma from 1997 to 2012 in the Department of Ophthalmology and Ocular Oncology of the University Hospital in Krakow was performed. A total of 58 eyes of 42 patients were analyzed. The main outcome measures were survival rate of the patient, final visual acuity, preservation of affected eyeball, intraocular relapse, extraocular orbital tumor recurrence, and occurrence of other neoplasms. ResultsThe overall survival rate was 97.6%. The majority of eyes (67.2%) had retinoblastomas of group V in the Reese-Ellsworth Classification (REC). Ocular preservation was achieved in 41.4% eyes. Of the 24 preserved eyes, 41.7% had a final visual acuity of 6/12 or better, 12.5% had visual acuity worse than 6/12 but better than 6/60, and 45.8% had visual acuity of 6/60 or worse. Three patients (7.1%) experienced orbital recurrence of retinoblastoma and one patient (2.4%) developed a second malignancy (chronic myeloid leukemia associated with the Philadelphia chromosome). ConclusionsRetinoblastomas, especially in Reese-Ellsworth group V (RE group V), not only impair vision, but may lead to metastases and death. Early diagnosis and prompt treatment are essential to salvage the eye and vision, and to avoid metastases. Long-term follow-up of retinoblastoma survivors is important to identify late effects associated with treatment and the occurrence of second malignancies.

Risk Factors of Pneumonia Associated with Mechanical Ventilation.

Background: The hospitalization of patients treated in the intensive care unit (ICU) in 5–15% of cases is associated with the occurrence of a complication in the form of ventilator-associated pneumonia (VAP). Purpose: Retrospective assessment of risk factors of VAP in patients treated at ICUs in the University Hospital in Krakow. Methods: The research involved the medical documentation of 1872 patients treated at the ICU of the University Hospital in Krakow between 2014 and 2017. The patients were mechanically ventilated for at least 48 h. The obtained data were presented by qualitative and quantitative analysis (%). The qualitative variables were compared using the Chi2 test. Statistically significant was the p < 0.05 value. Results: VAP was demonstrated in 23% of all patients treated in ICU during the analyzed period, and this infection occurred in 13% of men and 10% of women. Pneumonia associated with ventilation was found primarily in patients staying in the ward for over 15 days and subjected to intratracheal intubation (17%). A statistically significant was found between VAP and co-morbidities, e.g., chronic obstructive pulmonary disease, diabetes, alcoholism, obesity, the occurrence of VAP and multi-organ trauma, hemorrhage/hemorrhagic shock, and fractures as the reasons for admitting ICU patients. Conclusions: Patients with comorbidities such as chronic obstructive pulmonary disease, obesity, diabetes, and alcoholism are a high-risk group for VAP. Particular attention should be paid to patients admitted to the ICU with multi-organ trauma, fractures, and hemorrhage/hemorrhagic shock as patients predisposed to VAP. There is a need for further research into risk factors for non-modifiable VAP such as comorbidities and reasons for ICU admission in order to allow closer monitoring of these patients for VAP.

PERSONALITY TRAITS OF PATIENTS SUFFERING FROM PFO AND ASD AND INFLUENCE OF COVID-19 PANDEMIC TIME FOR PATIENTS SUFFERING FROM CONGENITAL HEART DEFECTS

Introduction: The work presents a research project carried out in John Paul II Hospital in Cracow in Clinical Department of Cardiac and Vascular Diseases with the Intensive Cardiac Supervision Subdivision, with participation of 100 (50 F, 50 M) patients with congenital heart defects. The purpose of the work is to resolve the issue of personality specifics, and thus the different characteristics of people who suffer from congenital heart defects. Therefore, the following questions should be answered: Is there a relationship between personality traits and the occurrence of a congenital heart defect? What personality traits are characteristic for patients with congenital heart defects? The aim: We aimed to assess personality traits of clients suffering from PFO and ASD. The article also talks about how coronavirus pandemic affects patients with congenital heart disease. Materials and methods: The research was conducted by psychologist Adrianna Skoczek. We performed a psychological clinical assessment and conducted the psychological tests like Eysenck Personality Questionnaire-Revised Short Version [EPQ-R(S)] and Eysenck's Impulsivity Inventory [IVE] by Hans J. Eysenck and Sybil G. Eysenck, the State-Trait Anxiety Inventory [STAI] by C. D. Spielberger, R. L. Gorsuch, R. E. Lushene describing personality traits of patients. Patients (F=50, M=50), with ASD (n=70) and with PFO (n=30). Results: In people suffering from ASD, the level of declared empathy was statistically significantly higher than the levels of impulsiveness and tendency to risk-taking. In people suffering from PFO, a statistically significant difference was observed only between the level of psychoticism and other variables. The level of declared empathy was statistically significantly higher than the levels of impulsiveness and tendency to risk-taking, a statistically significant difference was found between the analyzed variables - anxiety as a trait and anxiety as a condition. Conclusions: The results of the study allowed us to isolate the specific personality traits of patients suffering from congenital heart defects.

Gender as a predictive factor in cholecystectomy - is it true or false?

Cholecystolithiasis is one of the most frequent disorders of the human digestive system in a present population. It is common to point out that male gender is one of strong risk factors for complications during cholecystectomy, however the debate about that seems to be still open. The aim of this study was to compare the values related to the course and treatment effects between gender in patients undergoing cholecystectomy, based on own material. The study encompassed 504 patients who were admitted to General Surgery And Polytraumatic Injury Department of University Hospital in Kraków, Poland between 2013 and 2018, with the initial diagnosis of cholecystolithiasis (scheduled cases) and acute cholecystitis (emergency cases). The patients underwent surgical gallbladder removal. In this group there were 326 (64.7%) female and 178 (35.3%) male patients. Statistically significant differences between both genders were found containing age, type of admission, numeric rating scale of pain during admission, results in American Society of Anesthesiologists physical status classification system, outcomes in Acute Physiology And Chronic Health Evaluation II severity-of-disease classification system, percentage of conversions, mortality, period of time from admission to surgical procedure, mean duration of the procedure, blood tests and histopathological results. Subgroups of the cases where determining factor is gender are strongly heterogeneous. Although treatment results were different for both subgroups and these differences were partly statistically significant, it cannot be clearly determined on the basis of a study with such selection of patients, that gender is an independent risk factor for surgical gallbladder removal.

Assessment of diet quality, nutrient intake, and dietary behaviours in obese children compared to healthy children.

Obesity has been recognised by the World Health Organisation as the most common chronic disease in the world. An increase in the prevalence of childhood obesity has been seen in Poland. The aim of this study was to compare the dietary behaviours, quality of diet, and nutrient intake in a group of obese children compared to children with normal body weight. A total of 105 children aged between seven and 15 years were surveyed. The test group consisted of 52 obese patients from a Dietary Clinic in the Children's University Hospital in Cracow, without accompanying chronic diseases, and 53 normal weight patients. Chil-dren's nutritional behaviours and diet were assessed with a questionnaire (FFQ) and a 24-hour recall. To assess diet quality the Healthy Eating Indicator (HDI) was used. The diet of the studied obese children was rich in highly processed and high-fat products, and poor in vegetables, fruits, and wholegrain products. Obese children consumed on average 73.42 ±19.60 kcal per body weight whereas normal-weight children consumed 49.89 ±12.20 (p < 0.01) and obtained more energy from fat than from carbohydrates. A low intake of vitamins A and D, folic acid, calcium, iodine, and iron in both groups was observed. The HDI showed a low-quality diet in nearly 40% of obese children. Dietary treatment of obese children should concentrate not only on reduction of calories from food products but also on choices of high-nutrient-density products and on developing healthy eating habits.

Illness perception in patients suffering from systemic lupus erythematosus

Introduction. Systemic lupus erythematosus (SLE) is a multifaceted autoimmune disease with a diverse clinical picture which may manifest itself in the form of non-specific general symptoms or multiorgan disorders. Its aetiopathogenesis is still unclear, which hinders both diagnosis of the disease and introduction of proper treatment. Moreover, as a chronic disease, SLE has an enormous impact on patients’ life often forcing them to change their lifestyle.The aim of the study. The objective of the study was to define the way in which patients suffering from systemic lupus erythematosus perceive their disease and the relationship between sociodemographic variables and the acceptance of illness.Materials and methods. The study was conducted in a group of 65 patients diagnosed with systemic lupus erythematosus at least 6 months before and undergoing medical treatment in the University Hospital in Krakow. The following research tools were applied in the study: Acceptance of Illness Scale (AIS), Brief Illness Perception Questionnaire (Brief IPQ) and the authors’ own questionnaire.Results. The findings emerging from the study suggest that patients suffering from systemic lupus erythematosus perceive their level of knowledge about their disease as good. A correlation was discovered between the level of the acceptance of illness and its consequences. The patients who have a stronger subjective control over their condition are also characterised by higher acceptance of illness. However, exacerbation of the disease results in the decrease of its acceptance. There is a correlation between components of illness perception in the following areas: illness perception and the timeline and the disease character understood from the perspective of its exacerbation and its duration. No correlation was found in the study between illness perception and respondents’ gender, education or place of residence.Conclusions. The study defined correlations between particular components of illness perception and the level of its acceptance. Further findings included correlations between sociodemographic factors, duration of the disease and its perception.

Acute Hepatitis A Outbreak Among Men Who Have Sex With Men in Krakow, Poland; February 2017-February 2018.

Since February 2017 in Poland, an increasing number of acute hepatitis A (AHA) cases have been reported; a noteworthy increase to 3,072 cases of AHA in 2017 compared to 35 cases in 2016 was reported by the National Institute of Public Health (NIPH). The aim of this study was to evaluate the demographic features, clinical manifestations, laboratory results, and sexually transmitted coinfections. All cases of AHA diagnosed between February 2017 and February 2018 at the University Hospital in Krakow were analyzed. A total of 119 cases of hepatitis A virus (HAV) were reported; 105 (88%) were males and 14 (12%) were females, with a mean age 31 years (range 19–62). In 84 patients (71%), the HAV was transmitted by oral–anal sexual contact between men. Six women were infected by close house contact with men infected with HAV. The route of transmission was not identified for 29 cases, and 88 patients (74%) required hospitalization. Among the cases, the following coinfections were already diagnosed: HIV 36 patients (30%), chronic hepatitis C virus (HCV) 4 patients (3%), and chronic hepatitis B virus (HBV) 2 patients (1.5%). During AHA diagnosis, some new sexually transmitted infections (STIs) were detected; syphilis eight patients (6.7%), HIV/syphilis seven patients (6%), HIV//HCV/syphilis one patient, and acute retroviral syndrome/Shigella flexneri one patient. Overall, AHA outbreak in Poland in 2017 affected primarily men who have sex with men (MSM) and was connected with oral–anal sexual contacts, and the majority of patients did not have HAV vaccination. These results show a clear need for routinely offering HAV vaccination to at-risk populations and that awareness among health-care workers about HAV sexual transmission may help introduce prevention methods.

Intravenous, Perioperatively Administered Lidocaine Regulates Serum Pain Modulators' Concentrations in Children Undergoing Spinal Surgery.

We analyzed the influence of perioperative, intravenous (i.v.) lidocaine infusion as a part of multimodal anesthesia on concentrations of selected pain modulators. An observational study. University Children's Hospital in Cracow, Poland, from May 2015 to May 2018. Forty-four children undergoing extensive spinal surgery, divided into two groups after surgery: the study group (N = 23), anesthetized generally with lidocaine as a co-analgesic, and the control group (N = 22), anesthetized generally without lidocaine. We assessed proinflammatory mediators like neuron growth factor (NGF), high mobility group box 1 (HMGB1), interleukin 6 (IL-6), and FOS protein before, immediately after, six hours and 12-15 hours after surgery. We evaluated pain intensity at corresponding time points using a 10-point numerical/graphical scale. We observed that children in the lidocaine group had reduced pain intensity in the resting state and during movement until six hours after surgery when compared with controls. We found lower NGF concentrations in the lidocaine group vs controls only at six hours after surgery. Mean HMGB1 concentrations during the postoperative period in the study group were relatively stable, whereas we observed significant increases at six hours after surgery and a slight decrease at 12-15 hours after surgery in the control group. IL-6 concentrations at six hours were lower in lidocaine patients when compared with controls. We noted a negative correlation between HMGB1, NGF, Il-6, and lidocaine concentrations after surgery. We did not find any differences in FOS protein concentrations between the groups. Our findings suggest that intraoperative and postoperative i.v. lidocaine administration as a part of multimodal anesthesia may reduce inflammatory-dependent postoperative pain intensity.

Newborns bilirubin concentration determined by different methods in relation to hematocrit and albumin level.

Monitoring of bilirubin is essential during early neonatal life. Bilirubin in high concentration is toxic to the brain and might cause irreversible neurological damage. Several different methods for bilirubin determination are available nowadays, but inconsistent results may be obtained. The study aimed to compare dry chemistry methods with vanadate oxidation method for bilirubin determination in relation to hematocrit and albumin level in neonates and infants. The study included 98 consecutive serum samples from newborns and infants (47 boys and 51 girls, mean age 19 ± 15 days) treated in the University Children's Hospital in Krakow. Total bilirubin (TBil) and neonatal bilirubin (NBil) concentration were measured by dry chemistry analyser (Vitros 4600, Ortho Clinical Diagnostics Inc.). Total bilirubin (TBilV) was also measured using vanadate oxidation method (Cormay, Poland). Albumin concentration and blood morphology have been routinely determined in all children. No significant differences between the mean value of NBil (69.00 ± 67.76 μmol/L), TBil (81.26 ± 70.13 μmol/L) and TBilV (75.90 ± 60.62 μmol/L) were noticed. High coefficient correlation between NBil and TBil as well as between NBil and TBilV were noticed (Pearson's analysis, r = 0.99, r = 0.97, respectively; p < 0.0001 in both cases). There was a positive correlation between the difference (TBilV - NBil) and hematocrit (p < 0.009, r = 0.2664). In newborns and infants the same method for bilirubin determination should be used when the concentration of bilirubin is monitored. When using vanadate oxidation method for bilirubin determination, hematocrit value should be taken into account when results are interpreted.