Central Clinical Hospital of Ministry of Interior

Warsaw, Poland

Central Clinical Hospital of Ministry of Interior

Warsaw, Poland
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Cornell H.J.,RMIT University | Czyzewska A.,Central Clinical Hospital of Ministry of Interior | Macrae F.A.,Royal Melbourne Hospital | Rydzewska G.,Jan Kochanowski University | And 3 more authors.
International Journal of Celiac Disease | Year: 2016

Background: The etiology of celiac disease (CD) is related to undigested fragments of gluten and gliadin which damage the small bowel. Mucosal enzyme deficiency is an important factor in CD pathology. A clinical trial has shown that the effects of a gluten challenge to patients with CD could be ameliorated by the use of an enzyme supplement. Objective: Enzyme therapy using enterically coated tablets containing caricain (Gluteguard) was investigated as a means of protecting patients with CD against wheat gluten. Methods: A randomized placebo-controlled trial was carried out on 20 CD patients in clinical remission. The patients were divided into a group of 14 given Gluteguard and a group of 6 given a placebo daily. Both groups were given a challenge of 1g of gluten daily. Symptoms were graded and recorded over a period of 42 days. Duodenal tissue was taken at the beginning and end of this period, together with blood for assay of tissue transglutaminase (tTG-IgA) antibodies. Results: The results showed that oral enzyme therapy based on caricain, was effective in ameliorating the symptoms of CD giving a statistically significant difference between treatment and placebo (P < 0.01) after 14 days challenge. General well-being was also improved from 6.1 to 8.4 (P < 0.01) by the enzyme therapy. Four of the six placebo group patients (67%) and one of the 14 treatment patients (7%) to withdraw from gluten challenge after 14 days due to development of serious symptoms. The difference between the groups was significant (p < 0.001). For the per protocol patients on Gluteguard therapy, there were no significant changes in markers of histological damage or biopsy results after 42 days of gluten challenge. Conclusions: This study demonstrated that oral anti-gluten enzyme therapy using Gluteguard was able to significantly protect celiac patients from adverse symptoms being induced by gluten challenge. Furthermore, mucosal damage was not exacerbated in patients taking Gluteguard along with their daily gluten challenge, suggesting that the enzyme tablets may also help with the recovery of epithelium in the longer term. Availability of a preventative enzyme treatment like Gluteguard will likely add to the quality of life and well-being of coeliac patients, especially those who have difficulty in strictly adhering to a gluten-free diet. © Science and Education Publishing.


Kaplon-Cieslicka A.,Medical University of Warsaw | Postula M.,Central Clinical Hospital of Ministry of Interior | Postula M.,Medical University of Warsaw | Rosiak M.,Central Clinical Hospital of Ministry of Interior | And 6 more authors.
Polskie Archiwum Medycyny Wewnetrznej | Year: 2015

Introduction Data regarding the effect of certain adipokines on lipid metabolism are equivocal. Objectives The aim of this study was to evaluate the association of lipid control with adipokines and inflammatory markers in patients with type 2 diabetes. Patients and Methods The analysis included 195 patients with type 2 diabetes. The achievement of treatment targets in terms of total cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, and triglycerides was assessed in accordance with the current guidelines. Homeostatic Model Assessment-Insulin Resistance (HOMA-IR) index as well as concentrations of highmolecular- weight (HMW) adiponectin, leptin, resistin, high-sensitivity C-reactive protein, interleukin 6, and tumor necrosis factor α (TNF-α) were measured in all patients. Logistic regression analyses were performed to determine the risk factors for inadequate lipid control. Results Optimal control in terms of total cholesterol, LDL, HDL, and triglycerides was achieved in 61%, 43%, 53%, and 68% of the patients, respectively. In multivariate analyses, female sex, lower resistin concentrations, and the absence of statin treatment were predictors of total cholesterol levels above the treatment target; older age and lower statin dose-of LDL cholesterol levels above the treatment targets; female sex, higher HOMA-IR index, lower HMW adiponectin concentrations, and higher TNF-α concentration-of HDL levels below the treatment targets; and higher HOMA-IR, lower HMW adiponectin concentration, and the absence of statin treatment-of triglycer ides above the treatment target. Conclusions In type 2 diabetes, lower HMW adiponectin concentrations are associated with inadequate triglyceride and HDL control; higher TNF-α, with inadequate HDL control, and lower resistin concentrations, with inadequate total cholesterol control. Copyright by Medycyna Praktyczna, Kraków 2015.


PubMed | Health Rehabilitation Center, Central Clinical Hospital of Ministry of Interior and Cracow University of Technology
Type: Journal Article | Journal: Ortopedia, traumatologia, rehabilitacja | Year: 2015

Secondary, post-traumatic, degenerative lesions of the ankle joint remain a serious clinical challenge. This paper presents the case of a 66-year-old patient with secondary, post-traumatic ankle osteoarthritis and subchondral cysts. The use of rapid computer modelling FEM 2D enabled optimization of surgical treatment. A FEM 2D model of biomechanical changes in bones may help in streamlining treatment as well as improve our understanding of the pathomechanism of osteoarthritis.


Lorkowski J.,Central Clinical Hospital of Ministry of Interior | Lorkowski J.,Rehabilitation Center Health | Mrzyglod M.,Cracow University of Technology | Grzegorowska O.,Rehabilitation Center Health
Advances in Experimental Medicine and Biology | Year: 2015

Posttraumatic pneumothorax still remains to be a serious clinical problem and requires a comprehensive diagnostic and monitoring during treatment. The aim of this paper is to present a computer method of modeling of small closed pneumothorax. Radiological images of 34 patients of both sexes with small closed pneumothorax were taken into consideration. The control group consisted of X-rays of 22 patients treated because of tension pneumothorax. In every single case the model was correlated with the clinical manifestations. The procedure of computational rapid analysis (CRA) for in silico analysis of surgical intervention was introduced. It included implementation of computerize tomography images and their automatic conversion into 3D finite elements model (FEM). In order to segmentize the 3D model, an intelligent procedure of domain recognition was used. In the final step, a computer simulation project of fluid-structure interaction was built, using the ANSYS\Workbench environment of multi-physics analysis. The FEM model and computer simulation project were employed in the analysis in order to optimize surgical intervention. The model worked out well and was compatible with the clinical manifestations of pneumothorax. We conclude that the created FEM model is a promising tool for facilitation of diagnostic procedures and prognosis of treatment in the case of small closed pneumothorax. © 2015, Springer International Publishing Switzerland.


Teul I.,Pomeranian Medical University | Lorkowski J.,Central Clinical Hospital of Ministry of Interior | Lorkowski J.,Jagiellonian University | Lorkiewicz W.,University of Lodz | Nowakowski D.,Wrocław University of Environmental and Life Sciences
Advances in Experimental Medicine and Biology | Year: 2013

Breathing vitally serves body homeostasis. The prevalence of upper airway infections is often taken as an indicator of overall health status of a population living at a given time. In the present study we examined the unearthed remains of skulls from the XIII-XV century inhabitants searching for signs of maxillary sinusitis. Maxillary sinuses of the skulls of 92 individuals were inspected macroscopically and, if necessary, endoscopically. Osseous changes, including the pitting and abnormal spicule formation were present in 69 cases (75.0 %). It was found that, overall, dental infection was a major cause of maxillary sinusitis (18.8 %). Severe bone changes were observed in the adults' skulls, but were also present in the sinus walls of children's skulls. Post-inflammatory changes were manifest as remodeling and damage to the sinus walls. The results indicate that both children and adults of the Middle Ages suffered from chronic sinusitis. These observations confirm that the climate, environment, and lifestyle of the medieval populations contributed to the morbidity of the upper respiratory tract. © 2013 Springer Science+Business Media Dordrecht.


Issat T.,Central Clinical Hospital of Ministry of Interior | Issat T.,Institute of Mother and Childs Health | Beta J.,Central Clinical Hospital of Ministry of Interior | Beta J.,Institute of Mother and Childs Health | And 3 more authors.
European Journal of Gynaecological Oncology | Year: 2014

Background: The aim of the study was to evaluate accuracy of the outpatient hysteroscopy. Materials and Methods: This was a retrospective cohort study of 494 women who underwent outpatient hysteroscopy after administration of non-steroidal anti-inflammatory agents with the 3.2 mm hysteroscope. Normal saline solution was used as the distension medium. All women were discharged in good general condition afterwards. Results: In cases of abnormal uterine bleeding, there was no apparent pathology found in 112 cases (83.6%). Detection rate (DR) of endometrial polyps was 88.7% with false positive rate (FPR) of 4.6%. Positive predictive value (PPV) was 82.7% with negative predictive value (NPV) of 93.1%. Detection rate (DR) of the submucosal fibroids was 57.7%. Positive predictive value (PPV) was 57.7% with negative predictive value (NPV) of 95.0%. Endometrial cancer was confirmed in ten cases (2.0%), being suspected in eight cases during the procedure. DR in case of the endometrial cancer was 80.0% with FPR of 0.4%. PPV was 66.7% with NPV) of 99.6%. Conclusions: Outpatient hysteroscopy seems to be an effective and accurate diagnostic tool.


Kotela I.,Central Clinical Hospital of Ministry of Interior | Lorkowski J.,Central Clinical Hospital of Ministry of Interior | Sikorski W.,Central Clinical Hospital of Ministry of Interior | Kotela A.,Central Clinical Hospital of Ministry of Interior
Polish orthopedics and traumatology | Year: 2013

BACKGROUND: Ceramic-on-ceramic articulation presents advancement in the development modern of hip prostheses. It is particularly important for young patients, in whom complications related with polyethylene damages and metalosis pose a serious clinical problem due to the long period of implant functioning. The aim of this study was to assess the effect of total cementless hip replacement using an implant with a ceramic insert embedded in a metal cup and large prosthetic head constituting a ceramic-on-ceramic system in patients with hip osteoarthritis.MATERIAL AND METHODS: During years 2012-2013 there were 26 total hip replacements in 24 patients with use of integrated ceramic cup at Department of Orthopedic and Traumatology of the Central Clinical Hospital of Ministry of Interior, Warsaw. We assessed clinical and radiological outcomes of this procedure using HHS (Harris Hip Score), WOMAC (The Western Ontario and McMaster Universities Arthritis Index) and NRS (Numeric Rating Scale) scores.RESULTS: In our study group patients presented with a significant degree of improvement in passive range of motion in the hip joint and no postoperative complications were noted. Significant statistical improvement was noted after surgery in each of the following scales HHS (50.84 vs. 87.16), WOMAC (51.01 vs. 91.88) and NRS (6.8 vs. 0.45). There were no signs of early or radiological evidence of loosening and implant migration among our patients.CONCLUSIONS: Cementless total hip arthroplasty using an acetabular component with a ceramic insert embedded in metal and a large prosthetic head (a ceramic-on-ceramic system) is an effective and a noteworthy method of treatment of hip osteoarthritis in young people.


PubMed | Central Clinical Hospital of Ministry of Interior
Type: | Journal: Advances in experimental medicine and biology | Year: 2015

Posttraumatic pneumothorax still remains to be a serious clinical problem and requires a comprehensive diagnostic and monitoring during treatment. The aim of this paper is to present a computer method of modeling of small closed pneumothorax. Radiological images of 34 patients of both sexes with small closed pneumothorax were taken into consideration. The control group consisted of X-rays of 22 patients treated because of tension pneumothorax. In every single case the model was correlated with the clinical manifestations. The procedure of computational rapid analysis (CRA) for in silico analysis of surgical intervention was introduced. It included implementation of computerize tomography images and their automatic conversion into 3D finite elements model (FEM). In order to segmentize the 3D model, an intelligent procedure of domain recognition was used. In the final step, a computer simulation project of fluid-structure interaction was built, using the ANSYS\Workbench environment of multi-physics analysis. The FEM model and computer simulation project were employed in the analysis in order to optimize surgical intervention. The model worked out well and was compatible with the clinical manifestations of pneumothorax. We conclude that the created FEM model is a promising tool for facilitation of diagnostic procedures and prognosis of treatment in the case of small closed pneumothorax.


PubMed | Central Clinical Hospital of Ministry of Interior
Type: | Journal: Polish orthopedics and traumatology | Year: 2013

Ceramic-on-ceramic articulation presents advancement in the development modern of hip prostheses. It is particularly important for young patients, in whom complications related with polyethylene damages and metalosis pose a serious clinical problem due to the long period of implant functioning. The aim of this study was to assess the effect of total cementless hip replacement using an implant with a ceramic insert embedded in a metal cup and large prosthetic head constituting a ceramic-on-ceramic system in patients with hip osteoarthritis.During years 2012-2013 there were 26 total hip replacements in 24 patients with use of integrated ceramic cup at Department of Orthopedic and Traumatology of the Central Clinical Hospital of Ministry of Interior, Warsaw. We assessed clinical and radiological outcomes of this procedure using HHS (Harris Hip Score), WOMAC (The Western Ontario and McMaster Universities Arthritis Index) and NRS (Numeric Rating Scale) scores.In our study group patients presented with a significant degree of improvement in passive range of motion in the hip joint and no postoperative complications were noted. Significant statistical improvement was noted after surgery in each of the following scales HHS (50.84 vs. 87.16), WOMAC (51.01 vs. 91.88) and NRS (6.8 vs. 0.45). There were no signs of early or radiological evidence of loosening and implant migration among our patients.Cementless total hip arthroplasty using an acetabular component with a ceramic insert embedded in metal and a large prosthetic head (a ceramic-on-ceramic system) is an effective and a noteworthy method of treatment of hip osteoarthritis in young people.


PubMed | Central Clinical Hospital of Ministry of Interior
Type: | Journal: Advances in experimental medicine and biology | Year: 2015

The prevalence of malignant pleural mesothelioma is often encountered in the areas highly exposed to asbestos. The aim of this paper was a retrospective analysis of shoulder pain as a rare, first symptom of pleural mesothelioma, which constitutes an interdisciplinary diagnostic problem concerning both orthopedics and pulmonology. The research was based on a retrospective review of the patients medical records. The considered period of time included the years 2006-2012. The study group included a total of 49 patients. Seven patients (14.3%) presented a complain of shoulder pain, as the first symptom of mesothelioma. The remaining 42 mesothelioma patients, without this symptom, constituted a reference group. The intensity of shoulder pain was, on average, 4/10 on an analog scale. A concomitant limitation of mobility was observed in five out of the seven subjects. In one case, limitation of motion and dysfunction of the shoulder joint were at an advanced stage. Neuralgia of upper limbs was found in two cases. We conclude that shoulder pain may be a manifesting symptom of malignant pleural mesothelioma. The neoplasm appears to have a pleiotropic effect on human body, reflected in different ways of its primary manifestation which may also include the motor system.

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