Pregnant women with pre-existing diabetes mellitus type 2 differ from those with diabetes mellitus type 1

Background: Type 2 diabetes has reached epidemic proportions in recent years. The aim of this study was to compare perinatal outcomes in type 2 and type 1 diabetic patients. Materials and Methods: Maternal and fetal outcomes were compared between 62 pregnant women with type 2 pregesta- tional diabetes mellitus and 448 pregnant women with type 1 diabetes who delivered in the University Hospital of Warsaw from 2000 to 2011. Results: Women with type 2 diabetes were older, more overweight prior to pregnancy (BMI 29.3 vs 24.2 kg/m2, p<0.0001), gained less weight during pregnancy and presented with hypertension during pregnancy. The patients with type 2 diabe- tes exhibited lower 1-hour postprandial glycemia levels (104.7 vs 117.4 mg/dL, p<0.001) in the 3rd trimester and lower mean glycemia levels during labor (89.9 vs 107.8 mg/dL, p<0.001). The durations of the pregnancies of these patients were significantly longer (37.1 vs 36.3 weeks, p<0.05). Neonates of mothers with type 2 diabetes were significantly less likely to exhibit low 1st-minute Apgar scores (3.6% vs 18.1%, p<0.05). Conclusions: Pregnant women with type 2 diabetes mellitus present with more risk factors for metabolic syndrome such as hypertension and obesity and exhibit better metabolic control during the 3rd trimester of pregnancy. Read full text »

The use of smart glasses in healthcare – review

Aim. Nowadays technical innovations appear rapidly. One of new possibilities is smart glasses – wearable compu- ting devices wore as standard glasses. Although most smart glasses were not initially targeted at healthcare, they have been already implemented in multiple different medical applications across different specialties. In general such devices can be utilized whenever a screen or external monitor is already required. Head mounted displays can be implemented for very basic purposes such as education, simulation, live streaming of visualized data (i.e. vital signs, imaging studies, tests results, etc)., to more interactive functions such as video recording and digital photo documen- tation, for telemedicine, telementoring and many others. Ultimately smart glasses would implement artificial intelligence engines in the daily clinical practice and several other promising application for the future. Digital health is already growing exponentially, and with no doubt, the market for smart glasses in healthcare will grow accordingly in the very near future. The aim of this paper is to analyze current possible applications of smart glasses in patient care as well as the advantages and drawbacks of this kind of devices in everyday clinical practice. Read full text »

Demographic features of type 2 diabetes patients are associated with diabetes control in terms of primary health care

Aim. The aim of this study was to evaluate the association between selected demographic features of type 2 diabetes (T2D) patients and glycemia control expressed as the percentage of glycated hemoglobin (HbA1c) in the period of publishing the first diabetes treatment guidelines for general practitioners (GPs). Material and method. Medical records of 209 patients with type 2 diabetes (84 men and 125 women) aged from 22 to 87 years (mean age 65.8 years) from two general practitioners’ (GPs) practices in 2009 and 2010 were retrospec- tively assessed. Analysis of HbA1c was performed using high performance liquid chromatography (HPLC). Results. In regard to 2010 significantly higher mean percentage of HbA1c was found: in men compared to women (7.9±1.9% vs 7.1±1.1%); in patients <70 years of age compared to ≥70 years of age (7.7±1.8% vs 7.0±0.9%); in the population <70 years of age – in men compared to women (8.2±2.0% vs 7.2±1.3%) and in the group of men <70 years of age compared with ≥70 years of age (8.2±2.0% vs 7.0±1.1%). Among the 66 patients analyzed in both years, lower mean percentage of HbA1c was demonstrated in the group <70 years of age in 2009 compared to 2010 (7.3 ± 1.1% vs 7.8 ± 1.5%). By contrast, regarding 2010 patients <70 years of age had a higher HbA1c than those ≥70 years of age (7.8 ± 1.5% vs 7.1 ± 0.9%). Discussion and conclusions. Demographic features of patients with type 2 diabetes treated in primary care are associated with glycemia control. GPs should take into consideration patients’ demographic characteristics, especially being a younger men, when planning treatment of type 2 diabetes. Read full text »

Effect of Left Ventricular Systolic Dysfunction on Renal Transplantation Outcomes- A Paired Kidney Analysis

Background: Reduced left ventricular ejection fraction (LVEF) is thought to be a rel-ative contraindication for kidney transplantation (KT). It is not clear how to manage congestive heart failure (CHF) due to left ventricular systolic dysfunction in patients with end-stage renal disease (ESRD). Material and Methods: A total of 21 kidney recipients transplanted between 2011 and 2013 who had LVEF <55% were ana-lysed in this retro- spective single-centre study. This group was compared with 21 patients with LVEF ≥ 55% who had received another kidney from the same de-ceased donor. The mean duration of follow-up was 32Ī10 months. Results: Con-cerning post – transplant characteristics there were no significant differences be-tween groups regarding rate of urinary tract infection after transplantation, level of serum creatinine at 12 months post KT, patient survival and subjective opinion of patient about their ability to physical effort at the end of follow up comparing to pre-transplant condition. In the group with reduced EF there were more incidences of delayed graft func- tion(28.8% vs 14.3%, p=0.29)and lower rate of graft survival( 85.7% vs 100%, p=0.23) but the differences did not reach statistical significance. Conclusion: Reduced EF should not exclude patients from consideration for KT, however greater caution is recommended.
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Heat Stroke. Review

The HS is an acquired disease that cla- ims many lives as they pass the hottest stages of each year, taking a record in each country and sometimes increased mortality figures for this entity associated with hot flashes, which are Frequent daily as a result of natural disasters, pollution, sudden climatic changes, etc.
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Is there a limit for expanding criteria of kidney donors? How far can we go?

Introduction: The lack of organs for transplantation has forced the transplant community to expand the pool of donors. Using expanded criteria donor (ECD) organs is one of the strategies. Although there are organs that do not fit into definition of ECD and remains controversial for transplantation. The aim of this paper is to report the criteria of discharging kidney from transplantation.
Material and methods: 704 patients received cadaveric renal transplants between January 1, 2010 and August 31, 2015. In this time 181 kidneys were discharged from the transplantation – 125 kidneys (63 referred potential donors) were disqu- alified before organ procurement and 56 kidneys were rejected from transplantation during organ storage. Data on donors and preservation parameters were collected. Causes of organ refusal were analysed.
Results: The most common causes of kidney rejection from transplantation was poor donor kidney parameters with pro- bability of kidney irreversible injury (84 kidneys – 46,4%) and malignancy or strong suspicion of malignancy in donor body (44 organs – 24,3%). The next causes of kidneys disqualifications were unsatisfactory parameters during machine per- fusion (20 kidneys – 11%) and hepatitis C virus (HCV) or hepatitis B virus (HBV) infection in donor body with no recipients with negative crossmatch (7 kidneys – 3,9%). The less common causes of kidney rejection from transplantation were anatomical abnormalities (6 organs), nephrolithiasis (5 kidneys) and the others less frequent causes.
Conclusion: Careful kidney selection is recommended in cases of expanded criteria donor kidneys in order to diminish factors that can negatively affect graft function and survival.
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Music therapy – history of development (part 2)

The contemporary music therapy is a relatively new scientific and therapeutic field, which has its beginnings in ancient times. Records of music therapy treatment can be found both in the Holy Bible, as well as in old Roman sources, Greek mythology and the Far East writings. Since the introduction of the current term of the music therapy, the very concept of using music for therapeutic purposes has been constantly changing and evolving. Apart from the American and Swedish research, Polish scientist have also contributed to the deve- lopment of the method. The therapeutic effects of music have already been used in pedagogy, psychology, rehabilitation and many other areas. Music finds numerous applications in various branches of medicine due to its influence on the emotional sphere of human life and, in consequence, also on the physiological parameters of the human body. Music therapy can be divided into two categories: receptive and active one. Although in medicine mainly the former is preferred, it is an interesting alternative to the pharmacological treatment, which in itself encounters many limitations. The possibility of using music therapy in reducing the level of anxiety in patients is particularly important in dental practice. The high percentage of patients suffering from dentophobia and a profound impact of the increased anxiety level on the intensification of pain perception may provide sufficient incentive for introducing music therapy as a standard procedure.
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Recurrent incisional hernia sublay repair with fully reabsorbable monofilament mesh – a case report

Incisional hernia is the most common indication for reoperation after abdominal surgery. Mesh hernioplasty is almost a gold standard of treatment, associated with the low recurrence rate. Study presents a case of usage of a fully reabsorbable mesh for successful sublay hernioplasty in recurrent incisional hernia with a past history of many wound complications.
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Impacted uterine myoma in a 14 week pregnant patient

Uterine myomas are some of the most frequent neoplasms in women in the reproductive age. The frequency of uterine myomas in pregnancy varies between 0.1 and 3.9 %. The pregnancy in a woman with uterine myomas is usually uncomplicated, but in 10% of them, the myomas may cause symptoms. The study presents the case of a pedunculated submucosal myoma impacted in the rectouterine pouch in a woman 14 weeks pregnant.
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Fragments od bacterial DNA presence in hemodialisis patients’ blood-preliminary report

Cardiovascular disease (CVD) accounts for most of morbidity and mortality in patients with end-stage renal disease treated by chronic hemodialysis. The idea that inflammation state present in uremia plays an important role in the development of atherosclerosis has enjoyed much attention. We have investigated therefore pos- sible presence of bacterial DNA in the blood of chronically hemodialyzed patients. There were retrospectively studies of 59 patients without any signs of active infection, who had been undergoing intermittent HD. In 54 among 59 investigated DNA blood samples from HD patients we were able to detect a DNA fragment about 790 bp in length, consistent with the presence of 16sRNA bacterial DNA. Bacterial DNA could not be detected in any of the samples from control subjects. We were not able to detect bacterial DNA in any of 9 investigated dialysate samples although in 4 blood samples of these patients bacterial DNA encoding ribosomal RNA was observed. Bacterial DNA is detectable in blood of HD patients. This might be one of the inflammatory stimuli.
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