Introduction Of New Diagnostic Methods Research Articles

Application of the International classification of functioning, disability and health in medical rehabilitation of children with severe traumatic brain injury

BACKGROUND: The problem of rehabilitation of patients with severe traumatic brain injury has been and remains very important and relevant for both adults and children. Patients with severe traumatic brain injury often develop severe physical, mental, emotional and cognitive impairments, which are often difficult to correct and require long-term treatment, including rehabilitation, relying solely on the body's potential, which is accompanied by a heavy financial burden for the patient, his family, and society in general. The introduction of new diagnostic methods, the improvement of resuscitation measures, the use of modern methods of neurosurgical intervention and timely rehabilitation can increase the proportion of children who survived after severe traumatic brain injury and their quality of life.
 AIM: to evaluate the effectiveness of medical rehabilitation of children with severe traumatic brain injury with the participation of a multidisciplinary rehabilitation team and relatives of patients.
 MATERIALS AND METHODS: The study included 50 children with severe traumatic brain injury. Two groups were distinguished by the randomization method: the main group 25 patients (50%) and the control group, which included 25 patients (50%). The follow-up period was 1 year after the onset of severe traumatic brain injury. In the main group, an individual plan for early rehabilitation was drawn up on the 2nd day after a severe traumatic brain injury in intensive care. At the first stage of rehabilitation, which is carried out in the intensive care unit and the neurosurgery department, an individual medical rehabilitation plan was developed for the children of the main group, depending on somatic indicators and the severity of the condition, and a rehabilitation diagnosis based on the International classification of functioning, disability and health was established. In the control group, after transfer from the intensive care unit to the specialized neurosurgical department, patients received basic rehabilitation therapy: articular gymnastics, paraffin therapy, and psychological support.
 RESULTS: In the main group, more effective changes were noted in domains associated with impaired structure and function of the nervous system, which led to improved activity and participation, self-service. In patients of the control group, there were no significant changes in the state of functions, activity and participation.
 CONCLUSION: The early start of complex medical rehabilitation of children with severe traumatic brain injury reduces disability and accelerates the process of the patient's socialization, which is more clearly demonstrated by the International classification of functioning, disability and health approach. The use of International classification of functioning, disability and health for with severe traumatic brain injury in children in medical rehabilitation departments is a good tool for setting rehabilitation goals, choosing rehabilitation measures and assessing the effectiveness of rehabilitation.

Ocular adverse effects of anti-cancer chemotherapy.

Cancer ranks as the second leading cause of mortality in Europe, following cardiovascular diseases. Every year, 2.6 million people are diagnosed with this disease, and 1.2 million die. It has an impact not only on individual health but also on society and the economy. The survival rate has improved with the introduction of new diagnostic methods and anti-cancer chemotherapy. While more aggressive chemotherapeutic regimens and combination therapies have demonstrated efficacy against cancer cells, they also have detrimental effects on normal cells, leading to systemic and ocular adverse reactions associated with cytotoxicity, inflammation, and neurotoxicity. Consequently, we have an increased survival rate, but the appearance of these ocular adverse effects decreases the quality of life. Ocular toxicity induced by chemotherapeutic agents is often underestimated. While prevention may not be possible, proper management by an ophthalmologist, an integral part of the oncology patient's medical team, is crucial. The ophthalmologist should assess the patient before initiating chemotherapeutic treatment and continue monitoring throughout to identify any adverse ocular reactions resulting from the systemic chemotherapy. This article aimed to briefly highlight the adverse reactions occurring at the ocular surface in patients undergoing chemotherapeutic treatment. Fortunately, these ocular side effects are limited only to the period in which the chemotherapeutic treatment is done, with most of them disappearing a few weeks after stopping the treatment.

A New Digital Platform for Collecting Measurement Data from the Novel Imaging Sensors in Urology.

The use of UT and EIT technologies gives the opportunity to develop new, effective, minimally invasive diagnostic methods for urology. The introduction of new diagnostic methods into medicine requires the development of new tools for collecting, processing and analysing the data obtained from them. Such system might be seen as a part of the electronic health record EHR system. The digital medical data management platform must provide the infrastructure that will make medical activity possible and effective in the presented scope. The solution presented in this article was implemented using the newest computer technologies to obtain advantages such as mobility, versatility, flexibility and scalability. The architecture of the developed platform, technological stack proposals, database structure and user interface are presented. In the course of this study, an analysis of known and available standards such as Hl7, RIM, DICOM, and tools for collecting medical data was performed, and the results obtained using them are also presented. The developed digital platform also falls into an innovative path of creating a network of sensors communicating with each other in the digital space, resulting in the implementation of the IoT (Internet of Things) vision. The issues of building software based on the architecture of microservices were discussed emphasizing the role of message brokers. The selected message brokers were also analysed in terms of available features and message transmission time.

Długotrwałe odpowiedzi na leczenie brentuksymabem vedotin u chorych na chłoniaka Hodgkina

Progress in Hodgkin lymphoma (HL) treatment has been achieved due to introduction of new diagnostic methods, disease staging, and new therapy implementations. In spite of it, some patients are challenging in diagnostic and therapeutic process. The topic will provide a brief review of 2 young patients with HL who failed to achieve remission following few therapeutic treatment lines. Both of them response has been achieved when brentuximab vedotin was used. Many patients requires up to date new diagnostic methods implementation. Their interpretation is possible only in the context of clinical data.

Analysis of Determinants of Readiness for Professional Development Among Polish Nurses

The continuous development of medical sciences and the introduction of new diagnostic methods and treatment with the use of specialized equipment means that the knowledge and skills acquired during university studies are no longer sufficient. This obliges nursing staff to raise their professional qualifications in order to provide the appropriate quality of medical services. The aim of the study was an analysis of nurses readiness for learning and development and factors determining this readiness. The study was conducted among 756 nurses. The questionnaire method adopted was the readiness of employees for learning and development (RELD) standardized questionnaire, and a questionnaire containing sociodemographic data of the respondents. For the subscales of readiness for learning and development, average results were predominant and concerned in particular the level of openness to changes in environment (A1 scale), and self-evaluation of past educational development (C5 scale). The readiness of the nurses examined to learn and develop was on an average level for all the subscales. Younger nurses, with a lower seniority, having higher education and additional qualifications had a higher readiness for learning and development.

The first reported case of pelvic inflammatory disease caused by Actinobaculum massiliense

We report the first case of pelvic inflammatory disease (PID) caused by Actinobaculum massiliense. A 53-year-old woman attended the emergency department with symptoms compatible with a PID episode, finally resolved by intramuscular antibiotic treatment. Actinobaculum sp. was isolated by culture, and A. massiliense was confirmed by matrix assisted laser desorption time-of-flight mass spectrometry and 16S rRNA gene sequencing. Only a few cases of A. massiliense infections have been reported, and the pathogenesis of infections by these bacteria is poorly understood. The introduction of new diagnostic methods into hospital routines will improve the detection of new and little-studied pathogens.

New Microbes New Infections promotes modern prokaryotic taxonomy: a new section "TaxonoGenomics: new genomes of microorganisms in humans".

“New Microbes and New Infections” being devoted to new facts in infections and clinical microbiology comprises a “New Genomes of Microorganisms and Viruses in Humans” section featuring its own format. This section will evolve towards a “TaxonoGenomics: new genomes of microorganisms in humans” section to better take into consideration recent developments in prokaryote genome sequencing and incorporate the recent proposal that genome sequence and proteome must be part of the description of microbes of medical interest. Indeed, there is an impressive rise in bacterial genome sequencing, with 35,000 genomes currently available from virtually all major bacterial phyla. These sequences are an unprecedented source of information to develop molecular assays for detection or genotyping, to detect antibiotic resistance and virulence markers, to develop new culture media or to identify candidate antigens for vaccines [1]. A second breakthrough was the use of MALDI-TOF-mass spectrometry (MALDI-TOF-MS) for the routine identification of clinical isolates of bacteria and fungi [2,3]. Finally, the renewal of culture, through the culturomics strategy based on a diversification of culture conditions, enabled identifying more than 120 new human-associated bacterial species in a limited time [4]. These three tools have in common the advantage of producing data that can easily be shared and compared, either in international databases or culture collections. Surprisingly, although it has undergone many changes over time according to the introduction of new diagnostic methods, microbial systematics has not been adapted to incorporate genomic sequence and MALDI-TOF-MS, despite the fact that these methods are now widely used worldwide. Currently, although there is no universal agreement on the rules and criteria used for microorganism identification, several taxonomic criteria, based on phenotypic and genotypic characteristics [5–7], are used to determine whether a new bacterium fulfils the requirements to be classified as a new taxon. These include: i) routinely obtainable phenotypic properties (morphology, staining and antigenic properties, growth preferences, enzyme production, sugar metabolism, susceptibility to antibiotics, pathogenesis and habitat) [8]; ii) chemotaxonomic parameters such as the characterization of polar lipids, whole cell fatty acid content, respiratory quinones and peptidoglycan structure [9–11]; and iii) the determination of DNA-DNA hybridization (DDH) [12]. However, the latter two taxonomic criteria lack inter- and intra-laboratory reproducibility, require the use of methods restricted to few laboratories, are of no practical value for the routine identification of bacterial isolates. Recently, several genomic tools have been proposed as alternatives of DDH for the taxonomic classification of prokaryotes, including average genomic identity of orthologous gene sequence (AGIOS), average nucleotide identity (ANI), digital DDH, maximum unique matches index (MUMi), multilocus sequence analysis, multilocus sequence typing, and tetranucleotide regression [13], the former three of which have permitted the valid publication of several new species names [14–24]. In addition, a new polyphasic taxonomic strategy named taxono-genomics including both MALDI-TOF-MS instead of chemotaxonomic analysis and genome sequence analysis, in addition to common phenotypic criteria, was proposed to describe eight new bacterial species [17–24]. Therefore, there is now clear evidence that genomic and MALDI-TOF-MS data may be integrated as alternatives to chemotaxonomy and DDH, respectively, for the taxonomic description of bacteria, provided that the new isolates are compared to the phylogenetically closest species with standing in nomenclature. Accordingly, “New Microbes and New Infections” will now accommodate two formats in the new “TaxonoGenomics” section, including a short 500-words format and one item to report on new genome of already described organism and a 1,500-word format and three items to report on new genome as part as the description of a novel organisms. This new section will accommodate only microbes of medical interest and not environmental ones without known connection with populations and patients.

Алгоритмы диагностики неисправностей штанговых глубинно-насосных установок

Обсуждается разработка алгоритмов автоматической диагностики неисправностей штанговых глубинных насосов в нефтедобыче. Приведены алгоритмы выделения массива сигналов усилия из текущей информации, нормализации по периоду и масштабирования по параметру, а также алгоритм позиционно-бинарной идентификации неисправностей глубинно-насосных установок. Приведены результаты идентификации сигналов, получаемых от скважины.

Detection of laboratory biomarkes in haematological and pulmonology patients at high risk for aspergillosis

During the past decades a dramatic increase in the incidence of invasive fungal diseases, especially invasive aspergillosis has been observed. Undiagnosed and diagnosed late invasive aspergillosis is followed by lethality of up to 90%. Detection of early laboratory biomarkers (galactomannan and anti-Aspergillus antibodies) contributes to early diagnosis and is used for screening, as well as for monitoring therapy of aspergillosis. The aim was to evaluate usefulness of "non-culture" methods (galactomannan and anti-Aspergillus antibodies IgA, IgM and IgG) for early diagnosis of aspergillosis in high-risk patients. Prospective two-year study involved 262 high-risk patients for aspergillosis. In pulmonology and haematology patients (adults and children) blood samples were tested on galactomannan and anti-Aspergillus antibodies. Early laboratory biomarkers were statistically significantly higher in pulmonology patients (p = 0.00033). However, in haematological patients galactomannan was a more frequently positive finding, while in pulmonology patients it was the finding of anti-Aspergillus antibodies. It is interesting that, despite the possible immunosuppression, in about 1/3 of haematological patients anti-Aspergillus antibodies were confirmed. Early diagnosis and treatment of aspergillosis represent both clinical and laboratory problem. Nowadays, the application of new "non-culture" methods is of particular importance for the outcome of aspergillosis. Clinical features, laboratory findings of biomarkers and their correct interpretation significantly increase the possibility of timely implementation of appropriate therapy. In this regard, the new organization of reference laboratory for medical mycology has significantly improved the outcome of aspergillosis in high-risk patients in our country. However, further investigations, implementation of European standards and introduction of new diagnostic methods are necessary in this field.

¿Implica el aislamiento de Candida spp. en muestras intraabdominales de pacientes críticos la necesidad de tratamiento antifúngico?

The diagnostic and therapeutic approaches to IFI have changed significantly in recent years, fostered by the introduction of new diagnostic methods and new antifungal products. The diagnosis of invasive candidiasis (IC) involves both clinical and laboratory parameters, but neither of these are specific and the majority of the yeast isolated showed only colonization but not true infection. This situation occurs in critical care setting especially when surgical drainages are used. A substantial number of patients become colonized with Candida spp. after abdominal surgery, but only a minority subsequently develops invasive candidiasis. The clinical and microbiological diagnosis of Candida peritonitis remains problematic. It is still unclear which patients with may benefit from antifungal treatment. Antifungal therapy can be suggested in critically ill patients with peritonitis where Candida is diagnosed based on perioperatively sampled peritoneal fluid. Since fungal infection is also a relatively common complication of severe pancreatitis it seems reasonable that fungal prophylaxis may be an important component of management although actually there is no evidence to support this approach. However, the high mortality associated with IC is partly correlated to the difficulties of making an early diagnosis, thus, to improve earlier diagnosis and survival of IC, new nonculture-based microbiological tools such as Candida albicans germ tube antibodies (CAGTA) and/or polymerase chain reaction (PCR) techniques for the detection of fungal-specific DNA should be used in conjunction with recent published "Candida score" prediction rule. An algorithm based on this approach has been provided to assess early treatment in surgical patients with yeasts isolated from intra-abdominal samples.

Critical overview of clinical guidelines relating to invasive fungal infections

The incidence of invasive fungal infections (IFIs) has continued to grow in recent years. IFIs are associated with significant morbidity and mortality as well as costs. The diagnostic and therapeutic approaches to IFI have changed significantly in recent years, fostered by the introduction of new diagnostic methods and new antifungal products. There are also new therapeutic approaches such as de-escalation, pre-emptive antifungal treatment or combined treatment with antifungals. All of these aspects have been described in many trials, meta-analyses and reviews. There are also different clinical guidelines for IFIs with diagnostic and therapeutic recommendations. They are of unquestionable value and at the same time represent different perspectives on the problem. The lack of homogeneity when selecting and drafting the recommendations is a problem, and some of them are based more on personal opinion than on evidence. In this paper, we have put together a critical overview of the role of guidelines for IFIs, with emphasis on non-neutropenic critical patients.

Prolonged neonatal cholestasis: prospective study

Due to the urgency in choosing either clinical treatment or immediate surgical intervention, the study of the prolonged neonatal cholestasis involves two basic aims: the differential diagnosis between biliary atresia and neonatal hepatitis and the research into the associated etiological agents. So, in a prospective trial carried out in the 70's, 77 children with prolonged neonatal cholestasis were studied in order to establish the differential diagnosis between biliary atresia and neonatal hepatitis, followed by the evaluation of 108 children towards a pathogenesis of the prolonged neonatal cholestasis. The results of the differential diagnosis showed that within 18 items examined only 8 proved to be good biliary atresia indicators. They are as follows (in decreasing order): ductular proliferation (portal tracts), fibrosis (portal tracts), cholestasis (portal tracts), stools colour--acholia, hepatomegaly, canalicular cholestasis (lobule), infiltrate (portal tracts), giant cells (lobule). These eight items were then gathered in a sole indicator of great discriminative power, with a confidence level of 99%. The figures regarding the pathogenesis are: rubella virus 0%, herpes simplex virus 0%, listeriosis 0%, cytomegalovirus 2.2%, hepatitis B virus 2.4%, toxoplasmosis 2.8%, alpha-1-antitrypsin deficiency 13.1%, syphilis 21.1%, autoantibodies against the liver 58.4%. Such work thus revealed that those eight most important factors when differentiating biliary atresia from neonatal hepatitis remain as fundamental indicators and, when employed alongside other diagnostic methods, can help in the assembling of a multifactorial strategy less and less invasive and more precise. The pathogenic study, with its heavy dependency on time and place, has become more complete with the introduction of new diagnostic methods, evolving to the ideal progressive reduction of idiopathic processes.

Research by the Department of Otorhinolaryngology on the problem of hearing loss

The struggle for the prevention of hearing lesions, early detection and treatment of ear diseases are urgent problems of both domestic otorhinolaryngology and medicine in general. The introduction of new diagnostic methods and effective treatments have led to a significant decrease in the frequency of inflammatory ear diseases. At the same time, a number of factors contribute to the prevalence and growth of hearing loss among the population - influenza epidemics, the increasing impact of noise and vibration due to the mechanization of industrial and agricultural production, transport, the use of aminoglycoside antibiotics, etc. The increase in life expectancy also increases the number of hearing loss due to the development of presbyacusis in old age. The results of mass examinations of the population showed that 6% of the population has a hearing organ pathology. These circumstances dictate the need for further development and improvement of surdological care.