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Ostrowiec Świętokrzyski, Poland

Mitura K.,Siedlce Hospital | Oslowska J.,Siedlce Hospital
Polski Przeglad Chirurgiczny/ Polish Journal of Surgery | Year: 2015

Nearly 1% of population is affected with burn trauma annually. Among patients seeking advanced medical care almost 8% require hospital stay. Most burns are superficial and do not cause full thickness damage to the skin. Standard topical treatment of burn wounds with creams and ointments requires frequent dressings' changes. The healing process is long and expensive. The technological revolution, as occurred in the last decade in the field of dressing care allows us to introduce the use of advanced material solutions. Modern materials allow to shorten the treatment time, reduce the expenses and diminish the patient discomfort leading to good outcome. The study presented a case of four patients treated due to the partial thickness burn wound. Hydrofiber dressing with silver ions were introduced in the treatment. We observed good short and long term results. Source

Mitura K.,Siedlce Hospital | Garnysz K.,Siedlce Hospital
Wideochirurgia I Inne Techniki Maloinwazyjne | Year: 2015

Introduction: The dietary management of obesity is associated with a high failure rate. Methods which enable the long-term reduction of food intake have been developed. Patients treated with an intragastric balloon may experience some unwanted symptoms during therapy. The severity of these symptoms may result in poor tolerance of treatment, while patients who do not experience these symptoms may refuse to follow dietary modifications. In these cases, weight reduction at the end of treatment may be below expectations. Aim: To assess the tolerance of intragastric balloon treatment in obese patients as well as their satisfaction with this treatment. Material and methods: Fifty-seven gastric balloon procedures were performed in 51 females and 6 males aged 17 to 65 years (39.5 ±10.7 years). Baseline weight was 104 ±14.5 kg (78-140 kg), body mass index 37.2 ±4.1 kg/m2 (29.8-48.1 kg/m2), mean excess body weight 41.2 ±11.5 kg (20.4-63.1 kg). The balloon was filled with 669 ±25.8 ml of saline solution (550-700 ml). Upon balloon removal 6 months later, the patients completed a 12-question survey. Results: We obtained 57 surveys. The most common symptoms included vomiting, heartburn, abdominal pain and others. Twenty-two patients reported > 2 symptoms. Two patients were symptom-free. The mean duration of symptoms was 24.8 days. Patients reported better control of hypertension, diabetes and resolution of obstructive sleep apnoea and joint symptoms. Only 14 patients did not observe any significant improvement in their bodily function. Fifty-four patients expressed satisfaction after treatment, 6 patients were dissatisfied with the weight loss, and 5 patients would not opt for balloon re-treatment. Conclusions: The balloon treatment is a safe and well-tolerated therapy with a low complication rate. Source

Mitura K.,Siedlce Hospital | Garnysz K.,Siedlce Hospital
Wideochirurgia I Inne Techniki Maloinwazyjne | Year: 2015

Introduction: Treating concomitant diseases in obese patients generates costs which are twice as high as the costs of the therapies in individuals with a normal weight. The conservative management of obesity involving lifestyle and dietary modifications and medical treatment shows only short-term efficacy and carries a 90% risk of recurrence. The intragastric balloon causes a permanent feeling of satiety, thus reducing the amount of food consumed by the patient. Aim: To assess the early and long-term effect of intragastric balloon treatment in obese patients. Material and methods: In 2012, we performed 75 intragastric balloon procedures in obese patients. A total of 70 patients were enrolled in the study. The balloon was removed at 6 months. The patients were interviewed 2 years after removal. Results: Upon balloon removal, mean total weight loss (TWL) was 15.9 kg, and excess weight loss (EWL) was 41 ±19.6% (p < 0.001). Only one patient was classified as a non-respondent. Satisfactory results (> 10% TWL) were achieved in all other patients. The mean body mass index (BMI) reduction was 5.8 kg/m2 (15.5%) (p < 0.001). Two years later 45 patients still maintained reduced weight, 7 returned to baseline body weight, whereas 18 subjects experienced a full yo-yo effect (mean gain of 2.7 kg). During 2 years following the balloon removal, mean total weight increased by 10.9 kg, and mean BMI increased by 3.9 kg/m2 (12.5%). A satisfactory effect (> 10% TWL) was achieved in only 19 patients. Conclusions: Obesity management with the intragastric balloon is a safe treatment method, which effectively induces weight loss. Poor tolerance and lack of response occurring in some individuals should be taken into consideration. The best results are achieved in women with class 1 obesity. Source

Mitura K.,Siedlce Hospital | Mikolaj R.,Siedlce Hospital
International Journal of Surgery Case Reports | Year: 2013

INTRODUCTION: Retroperitoneal cysts are rare, usually asymptomatic, abdominal lesions. Epidermoid cysts developing in this space usually occur in middle-aged women and are incidentally discovered in the presacral region during ultrasound examination. Occasionally, cysts may arise from splenic tissue or adrenal glands and develop above the presacral area. PRESENTATION OF CASE: We present the unusual location of a cyst in the retroperitoneal space in a 41-year-old woman admitted to hospital due to detection of a lesion in ultrasound imaging. A CT scan confirmed large intra-abdominal cyst. At operation, a large retroperitoneal thin-walled cyst with no evident arising point was discovered. Histologic analysis revealed epidermoid cyst. DISCUSSION: Our patient presented with giant retroperitoneal cyst extending from the subhepatic region to the uterine and bladder. To our knowledge, this unusual location in adult has not been previously reported in the literature. In our case the lesion was adjacent to inferior vena cava and mesenteric vessel which required special attention during preparation and was technically demanding. CONCLUSION: Surgery is the gold standard for the diagnosis and treatment of retroperitoneal epidermoid cysts. Successful treatment of benign retroperitoneal epidermoid cysts depends on appropriate diagnosis, careful operative technique, and adequate management of the underlying pathology. © 2012 Surgical Associates Ltd. All rights reserved. Source

Mitura K.,Siedlce Hospital | Blicharz P.,Siedlce Hospital | Romanczuk M.,Siedlce Hospital
Polski Przeglad Chirurgiczny/ Polish Journal of Surgery | Year: 2012

Meckel diverticulum is the most common congenital abnormality of gastrointestinal track (2-4%), however complications occur rarely (4-16%). We describe a case of 63-years old female presenting simultaneously two serious complications of Meckel diverticulum. Operated patient was diagnosed with perforated tumor of Meckel diverticulum. Segmental resection of small bowel including tumor was performed. Pathology examination revealed gastrointestinal stromal tumor (GIST) in Meckel diverticulum. No significant malignancy risk factors were found (low mitotic count). Consequently, computed tomography periodic surveillance was implemented.We report the possibility of simultaneous presentation of two serious complications of Meckel diverticulum. Tumors of Meckel diverticulum may mimic other abdominal pathologies and thus, they should be considered in differential diagnosis of abdominal tumors. Source

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