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Urbanska M.,University Medyczny Im Karola Marcinkowskiego znaniu
Przegla̧d lekarski | Year: 2012

Presently cigarette smoking is one of the most dangerous activities for health and human life. In tobacco smoke, nicotine and other dangerous substances have detrimental influence not only for smokers but for the "passive smokers" whom very often are children. Cigarette smoke causes unfavorable skin changes or intensifies course of many skin diseases including cancer. Tobacco smoke additionally quickens the natural process of skin aging. It has been observed that the skin of smoking addicts at the age of 40 years resembles skin of non-smoking 70 year old adults. Skin damage due to tobacco smoke is irreversible, where further damage can be avoided by stopping smoking. Present trends try to find ways to stop or at least delay changes caused by aging. Perhaps maybe it's first signs- wrinkles- more than the deadly consequences of smoking will be the most motivating reason for smokers to "kick the habit".

Pupek-Musialik D.,University Medyczny Im Karola Marcinkowskiego znaniu
Chirurgia narzadów ruchu i ortopedia polska | Year: 2010

In 1997 World Health Organization regarded obesity as an illness caused by modern civilization. Elevated values of BMI index over 30 kg/m2 increase the risk of movement organ diseases. Growing ailment pains in lumbar part of vertebral column and disfunction of its joints leads to severe disability. Many studies revealed, that BMI > 30 kg/m2 increased the risk of joints injuries up to 4-5 times. Most common cause of back pain and knee pains, amount obese patients, seems to be a degenerative disease. Finn studies prove correlation between visceral obesity index (waist/hip ratio) and intensification of pain in lower part of vertebral column. Women were suffering more often than men, 39.5% vs 31.2%. Amount causes of individual degeneration changes the most common is "overloaded mechanism". Nowadays, scientists claim, that subclinical inflammatory process might be connected with obesity. Fat tissue is a source of many adipocytokines. Such adipocytokines as leptin, resistin, adiponectin and proinflammatory cytokines such as IL-6, IL-1, IL-8, TNF-alpha, IL-18 and hsCRP modulate inflammatory process and lead to damage of joint cartilage. Other cytokine, like osteoprotegrin, exerts osteo-protection impact. The reduction of body mass index seems to be necessary as far as patients with joints and vertebrae bone illnesses are concerned. That aim might be achieved by excessive physical activity and proper diet. Physical training should be fitted individually to every patient. Static and endurance training are not recommended. Proper weight loss should be more less 1 kg per week, and general physical ability improves. Cooperation between obesitologists and orthopedists seems to be necessary.

Mielcarek J.,University Medyczny Im Karola Marcinkowskiego znaniu
Przegla̧d lekarski | Year: 2011

Nanotechnology is a very promising technology with a potential that can revolutionise the pharmaceutical industry. One interesting nanostructure are carbon nanotubes whose application possibilities are restricted by their solubility. Their solubility can be improved by applying endo- and exohedral modifications. The paper offers a review of the hitherto applied methods of functionalisation permitting the use of carbon nanotubes for biomedical purposes.

Total hip replacement (THR) is at present an accepted treatment in patients with severe deformity of the hip caused by advanced ankylosing spondylitis. The aim of this paper is to evaluate the results of THR in patients suffering from ankylosing spondylitis, operated from 1987 to 2007 at the Orthopaedic and Traumatologic Department of Poznan University of Medical Sciences. Material. Material included 26 patients, 2 females and 24 males, on whom 34 THR were performed, lateral approach was used in all cases. At the time of operation, the age of patients ranged from 27 to 77 years (mean 57). Follow-up ranged from 3 to 21 years (mean 10.5 years). The operative treatment was a multistage process (during one operation only one joint was replaced). Cemented totalhip arthroplasty was used during 16 of the THR, 17 of them were cementless and 1 as a hybrid. The patients were clinically and radiologically evaluated preoperatively, postoperatively, and at final examination. The clinical state was evaluated with Harris hip score and WOMAC scale. We based our radiological examination on Hip Society system. The average preoperative Harris score for the group of patients was 27.3, WOMAC score 78.5. After an average of 10 years follow-up all hips and knees were considered excellent, with average Harris score of 91.4, WOMAC Score of 5.0. All patients had increased function and decreased pain. The radiograms of all patients revealed that the acetabular and femoral components were correctly positioned with no radiographic evidence of loosening in the last examination. No ectopic ossification concentrations were found. Clinical and radiological evaluation of our material showed that total hip replacement in the treatment of severe deformity of the hip caused by advanced ankylosing spondylitis allows regaining good lower limb function, which helps the patients staying less dependant on the surrounding environment. Ectopic ossification is not the clinical problem during THR in patients who suffer from spondylytis deformans.

In Europe, since the 40's of the previous century the tendency of decreasing number of stroke cases has been observed. In Poland, epidemiological data concerning the stroke have shown relatively stable index of stroke incidence and stroke mortality rates in the last few decades. The decline concerns mostly early poststroke mortality which results directly in the increase of the number of people who have recovered from stroke. However, the index of post-stroke mortality is still higher in Poland than in other European countries and the USA. The prognosis referring to the incidence in next years, caused by demographic alterations related to the increasing number of elderly people, is not optimistic. Significant increase of population at the age of 65 and more is going to contribute to the increase of the number of new stroke cases in Poland and other European countries. This fact becomes a challenge both for hospitals, care-giver agencies and patients' families.

Trzeciak T.,University Medyczny Im Karola Marcinkowskiego znaniu
Chirurgia narzadów ruchu i ortopedia polska | Year: 2011

Continuous passive motion (CPM) is frequently used method in the early post-operative rehabilitation in patients after knee surgery. Aim of this study was to evaluate the effectiveness of CPM after primary total knee arthroplasty. Efficacy was assesed in terms of clinical score and functional recovery. 93 patients (101 knee joints) undergoing total knee replacement were assigned into two groups. The experimental group received continuous passive motion and active exercises. A control group received conventional physical therapy only. CPM was initiated in the first day after surgery, for 120 minutes, starting with 0-40 degrees range of motion, increased as tolerated (mean 10 degrees per day) and maintained during the hospital stay. Outcome measures were those included in Knee Society Score (KSS). Functional recovery was evaluated using WOMAC. All subjects were evaluated once before the surgery and on 10th day postoperatively. Mean clinical score (KSS) at the day 10 was 70 +/- 15 points in the experimental group and 74 +/- 12 in a control group. There were no statistical difference between the two groups for any outcome measures. CPM group mean range of motion was 83 degrees +/- 14 degrees and a group without CPM 77 degrees +/- 21 degrees. KSS functional score was 66 +/- 9 points in the experimental group compared to 62 +/- 7 points in a control group. Subjective estimation of pain level, joint stiffness and function showed no statistical difference between the two groups regarding total and subscale scores. Mean total score was 24 +/- 19 points in the CPM group and 22 +/- 17 in a group without CPM. These findings show that CPM had no significant advantage in terms of improving clinical measurements. However, there was beneficial effect on subjective assessment of pain level, joint stiffness and functional ability.

Tobacco and its use was discovered by Christopher Columbus in parallel with the discovery of America. Soon after, tobacco became a known medicinal plant in Europe. Its harmful effects were gradually discovered, especially those of tobacco smoke, and now it is considered a toxic plant. Tobacco leaf has a monograph in German "Hagers Enzyklopädie derArzneistoffe und Drogen", which describes its old, already not valid, medicinal use and clearly shows the toxic effects. Epidemiological studies indicate about 50% lower incidence of Parkinson's disease in smokers than in non-smokers. In turn, studies of the brains of smokers using positron emission tomography showed significantly decreased level of monoamine oxidase B--an enzyme which degrades dopamine--the neurotransmitter which the significant insufficiency of about 80-85%, is responsible for the symptoms of Parkinson's disease. From the tobacco leaves there were isolated MAO-B inhibitors--naphthoquinone--2,3,6-trimethyl-1,4-naphthoquinone and diterpenoid -trans,trans-farnesol, which occur also in tobacco smoke. In the last decade many papers have appeared on the neuroprotective activity of nicotine, the best known component of tobacco. through the effect of this compound on specific nicotinic cholinergic receptors (nAChRs), which interacts with nigrostriatal dopaminergic system as well as the possibility of using nicotine for the treatment of Parkinson's disease and other neurodegenerative diseases. Moreover, tobacco was also found to contain inhibitors of neuronal nitric oxide synthase (nNOS). Tobacco cannot be considered a medicinal plant, but some compounds occurring in that plant may find therapeutic use.

Baszczuk A.,University Medyczny Im Karola Marcinkowskiego znaniu | Kopczynski Z.,University Medyczny Im Karola Marcinkowskiego znaniu
Postepy Higieny i Medycyny Doswiadczalnej | Year: 2014

Homocysteine (Hcy) is an endogenous, non-structural protein, a sulfur-containing amino acid emerging on the pathway of methionine and cysteine, actively involved in numerous biochemical reactions. Total concentration of homocysteine in plasma of healthy humans is low and its level is between 5.0 and 15.0 μmol/l, assessed with the use of HPLC, or 5.0-12.0 mmol/l, using immunoassay methods. Higher concentration of this amino acid in blood is called hyperhomocysteinemia. Hyperhomocysteinemia is significantly correlated with cardiovascular disease and its complications: heart attacks and strokes. It is believed that hyperhomocysteinemia damages endothelial cells, reduces the flexibility of vessels, and adversely affects the process of hemostasis. In addition, hyperhomocysteinemia enhances the adverse effects of risk factors such as hypertension, smoking, and impaired glucose, lipid and lipoprotein metabolism, as well as promoting the development of inflammation. The concentration of homocysteine can be effectively lowered by supplementation with folic acid and vitamins B12 and B6. However, intervention studies conducted in the past decade did not confirm the clinical benefit of vitamin therapy lowering the level of homocysteine in blood of patients with cardiovascular disease. Moreover, there is not clear evidence from genetic studies that the presence of the gene for MTFHR polymorphism 677C>T, which is one of the most common causes of hyperhomocysteinemia, is also associated with the development of cardiovascular disease. These results led the researchers to discuss the role of homocysteine in the development and treatment of cardiovascular disease as well as the need for further research on this issue. Copyright © Postepy Higieny i Medycyny Dos̈wiadczalnej 2015.

Splawski R.,University Medyczny Im Karola Marcinkowskiego znaniu
Chirurgia narzadów ruchu i ortopedia polska | Year: 2011

Shoulder arthroscopy used since sixties of the XXth century, becomes now dominating operative technique. Surgeon's skills are most important that's why perfect training model is still needed. Ideal training model for shoulder arthroscopy should combine best possible image of human anatomical structures, good accessibility and low price. Despite of great similarity, animal shoulder joint differs from human one. More spherical shape of animal glenoid gives better support for humeral head. As a result of different shape of glenoid, labrum is significantly less developed, and can actually be clearly seen on dorsal part of the glenoid rim. Glenohumeral ligaments are visible but not as well developed as in human joint. METHODS: We have used pig shoulder joints, all of the muscles externally surrounding joint capsulewere resected. Classical 30 degrees optical equipment and standard arthroscopy tools were used. Labrum stabilization was achieved using anchors and screws. Cannulas were used only in a few cases, in others, joint access was very easy and did not require one. RESULTS: Animal shoulder model is useful only in case of arthroscopic practice of instability treatment. Implants can be snapped back after practice.

Adolescents and young patients may have ongoing problems with active rheumatic diseases, particularly with juvenile idiopathic arthritis. They require continuation of care and transfer from pediatric to adult services. The process of "transition" ought to include collaboration between pediatric and adult healthcare providers aswell as involvement the young people themselves. The exact documentation is crucial for transitional care.

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