Mariusz Jojczuk

Association between Serum Selenium Concentrations and Levels of Proinflammatory and Profibrotic Cytokines—Interleukin-6 and Growth Differentiation Factor-15, in Patients with Alcoholic Liver Cirrhosis

According to some authors, serum selenium levels are strongly associated with the severity of liver diseases, including liver cirrhosis. The aim of this study was to determine the relationship between the concentration of selenium and pro-inflammatory and profibrotic cytokines—interleukin-6 (IL-6) and growth differentiation factor 15 (GDF-15) in patients with alcoholic liver cirrhosis. The parameters studied were determined in the serum of 99 patients with alcoholic liver cirrhosis divided based on the severity of disease according to the Child-Turcotte-Pugh criteria. In patients with liver cirrhosis, the serum selenium concentration was statistically lower, whereas serum IL-6 and GDF-15 concentrations were higher than those in the control group. Moreover, the concentration of selenium negatively correlated with the levels of GDF-15 and IL-6. The above results may indicate a role of selenium deficiency in the pathogenesis and progression of alcoholic liver disease.

Distribution of injuries among patients of Department of Trauma and Emergency Medicine of Independent Public Teaching Hospital No. 1 in 2011

Abstract Introduction. Injuries are an extremely important public health problem, in both developed and developing countries. Various traumas contribute to some one third of deaths of the entire human population followed by cardiovascular diseases and cancer only. Understanding the epidemiology of trauma might improve hospitals’ ability to provide proper diagnoses and treatment. Aim. The aim of this study was to provide epidemiological characteristics of injuries in the analyzed group of patients. Material and methods. A retrospective analysis of patients admitted in state of emergency and hospitalized in the Department of Trauma Surgery and Emergency Medicine at the Medical University of Lublin due to injuries that occurred from January 1st 2011 till December 31st 2011 was conducted. Mechanism of injury, mortality rate, age and gender correlations were studied. Results. Some 485 patients were looked at in the study. The mortality rate reached 4.52% and was highest among males. Falling was the leading cause of injuries among patients Discussion. The results of this study correspond with the observations of other authors concerning the age distribution. Mortality rates noticed in this study were lower than in other studies. Conclusions. Trauma in elderly patients is a growing problem in trauma centers. Moreover, in the analyzed material incidence of blunt and non-transport related injuries increased.

Behavior of new hydroxyapatite/glucan composite in human serum

Biomaterials for bone tissue regeneration, including polymer-based composites, are typically evaluated in vitro prior to the clinical trials. However, such composites tested in vivo may behave different due to the specific body conditions. For example, some composites implanted into the tissue acidified due to transient postoperative inflammation may unexpectedly swell which delays the wound healing. Such massive swelling in acidic medium was previously observed for new elastic hydroxyapatite (HAp)/β-glucan biomaterial. However, in further clinical cases concerning the composite implantation in patients without significant inflammation indicators, no side effects were observed. Therefore, it was reasonable to test the effect of human serum of neutral pH (typical for noninflamed tissues) on the composite parameters, in particular volume changes. Thus, this article shows the characterization of physicochemical parameters of the composite after incubation (5 days) in human serum of neutral pH by means of weight and volume measurement, scanning electron microscopy, X-ray diffraction, Fourier-transform infrared spectroscopy, microcomputed tomography, mercury intrusion, and biochemical techniques. Results showed that human serum collected from healthy people caused no uncontrolled changes in weight and volume, porosity and mechanical properties of the composite. Therefore, this suggests the lack of volume change-related side effects of HAp/glucan composite in bone defects treatment if postoperative inflammation is prevented.

History of trauma and posttraumatic disorders in literature

In 1980 a third edition of Diagnostic and Statistical Manual of Mental Disorders (DSM) brought diagnostic criteria for a new diagnosis - posttraumatic stress disorder (PTSD). This disorder is a result of highly intensive stressor and in many cases leads to sever psychiatric distress. Despite relatively recent introduction of PTSD as a new diagnosis, this disorder was excessively described in scientific papers as well as in fiction novels. Analysis of those descriptions across ages allows for the conclusion that character and type of stressors has changed, however, peoples reactions to highly intensive stressors are basically similar. First descriptions are found in notes of Egyptian physicians and then in papers of Homer, Herodotus and Plutarch. In consecutive parts of this paper, the authors present history of posttraumatic stress disorder describing contribution of Polish authors - Kepiński and Szymusik. Presented historical perspective of posttraumatic stress disorder allows for better understanding of reasons for introducing PTSD into classifications as well as controversies related to it.

Circulating cytokeratin-18 and tumour necrosis factor-α in patients with alcoholic liver cirrhosis

Aims. The aim of the study was to assess the usefulness of TNF-α and CK-18 as diagnostic markers of alcoholic liver cirrhosis. Additionally, the effects of the stage of liver cirrhosis on concentrations of TNF-α and CK-18, as well as their correlation, were evaluated. Materials and method. Sixty-two patients with alcoholic liver cirrhosis treated in various hospitals were randomly enrolled. The stage of cirrhosis was assessed according to the Child-Turcotte-Pugh scoring system. The control group consisted of 31 healthy people without liver disease. Concentrations of TNF-α and cytokeratin-18 in blood plasma of patients and controls were measured using the sandwich enzyme immunoassay technique, with commercially available quantitative ELISA test kits. Results. The concentration of CK-18 was statistically higher in patients with alcoholic liver cirrhosis, compared to the control group. The concentration of TNF-α was significantly higher in patients with alcoholic liver cirrhosis, compared to the control group. Higher concentrations of TNF-α were found only in patients with stage C and B alcoholic liver cirrhosis, compared to healthy persons. Conclusions. The levels of TNF-α and total CK-18 were higher in patients with alcoholic liver cirrhosis than in healthy individuals. No correlation was found between the level of CK-18 and stage of liver cirrhosis.

Modern methods of treatment of post-traumatic bone defects in Department of Trauma Surgery and Emergency Medicine, Medical University of Lublin

Abstract Motor organ injuries are one of the most common consequences of trauma, out of which comminuted fractures with a bone loss are the most challenging. Numerous methods are applied to treat these injuries; however, still in many cases we are unable to suggest successful medical treatment. Therefore, treating these injuries using elastic and surgically handleable bone replacement materials was started at Trauma Surgery and Emergency Medicine of Medical University of Lublin (provided for the experiments by Medical Inventi Lt). Preliminary assessment based on the results of treatment with bone replacement materials of two patients with comminuted fractures of femur was promising. Bone union was achieved without any adverse effects.

Life-threatening conditions in psychiatry – neuroleptic malignant syndrome (NMS)

The introduction of neuroleptics in the 1950’s was a turning point in psychiatric treatment. The new drugs brought hope to millions of patients and their doctors. However, there were also some side-effects, one of which is Neuroleptic malignant syndrome (NMS), a rare complication of antipsychotic treatment and untreated it may lead to mortality as high as 20%. The incidence of NMS, estimated to be 0.01–0.02%, has decreased significantly probably due to higher awareness of the diseases and shift to atypical antipsychotics. The aim of this study was to present the signs and symptoms of this rare condition and describe management possibilities since this condition is observed not only in psychiatric departments but also in emergency rooms. NMS is thought to be related to change caused by neuroleptics within the central nervous system due to dopamine D2 receptor antagonism, especially nigrostriatal pathways and the hypothalamus. There are three symptoms which are considered as major and indicate a high probability of NMS: muscle rigidity, hyperthermia (core body temperature above 38.5 °C), and elevated creatine phosphokinase concentration (above 1000 U/l). NMS is a diagnosis of exclusion and clinicians must be vigilant in detecting early signs of NMS. The basic management in NMS is antipsychotic discontinuation and proper supportive care of the patient (vital signs monitoring, hydration, correction of electrolyte and acid-base disturbances). In more severe cases, the introduction of bromocriptine or dantrolene, as well as benzodiazepines, may indicated. Further usage of neuroleptic in patients with a history of NMS should be with care, and low doses of low-potency neuroleptics or atypical neuroleptics seem to be the best treatment choice.

Life hazard ratio – a new scale for assessing the severity of injury in the populetionalstud

UNLABELLED The heterogeneous population of patients affected by trauma is extremely difficult to systematize. This is due to the diversity of mechanisms of injury, the nature and severity of the injury and the population, which relate to injuries, diverse in terms of gender, age, presence of comorbidities that make up the final severity of the injury and a certain degree of danger to life. THE AIM OF THE STUDY To develop a universal method to assess the severity of injury and loss of life resulting from their consequences, using the parameters available in the Polish administrative databases, a similar diagnostic efficacy as other used scales to assess the severity of damage. MATERIAL AND METHODS The study analyzed a group of 92,463 patients hospitalized due to injuries sustained as a result of injuries in all hospitals of the Lublin region in 2003-2005. Developed catalogs risk factors, reference to the population of the Lublin province. RESULTS Developed five models predictive of injury severity scale counterparts, which include different combinations of risk factors associated with the type of injury, age of the patient and the mechanism of injury that have been evaluated for their diagnostic efficacy in differentiating the expected outcomes. Prediction model have the best diagnostic efficacy AUROC 0.9615, SE 0.0025 and 95% CI 0,9565-0,9665, hereinafter referred to as Life Hazard Ratio (LHR), which has a similarly high diagnostic efficacy as the other, examined in the work of the rock assess the severity of damage AUROC 0.9585, SE 0.0368, 95% CI0 0.8849-1. CONCLUSIONS 1. The proposed method of use of the International Classification ICD-10 allows the use of regional administrative databases to conduct detailed analyzes of population and monitor trends in the epidemiology of injuries. 2. Developed Life Hazard Ratio (LHR)is a universal method for the objective evaluation of the severity of injuries and the associated risk of life-threatening, can also conduct population studies. 3. LHR has a comparable rate of diagnostic efficacy as other commonly used scales assessing the severity of the injury.