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Introduction: One of the most serious complications associated with the use of implants in hernia surgery is deep surgical site infection involving an implanted biomaterial. Among the major etiological factors of this complication are Staphylococcus aureus and Escherichia coli strains, which have the ability to form a biofilm on the surface of the mesh implant. This process is influenced by many factors, of which, according to current medical knowledge, the concentration of glucose may have a clinical significance. The aim of the presented study was to evaluate the effect of glucose on the formation of biofilm on the surface of monofilament polypropylene mesh., Methods: The study included 140 bacterial strains (70 S. aureus and 70 E. coli) from the collection of Department of Microbiology Collegium Medicum im. L. Rydygier in Bydgoszcz, Nicolaus Copernicus University in Torun. Evaluation of the effect of two glucose concentrations (0.1% and 0.2%) on biofilm formation was performed using a qualitative (2,3,5-triphenyltetrazolium chloride reduction) and a quantitative ( serial 10-fold dilutions) methods., Results: A qualitative analysis, performed after a period of incubation on substrates containing various concentrations of glucose, has revealed a statistically significant increase in the percentage of S. aureus strains with a very high potential for biofilm formation, while for E. coli an increase was observed in the percentage of strains with a low potential for biofilm formation. In a quantitative analysis of the biofilm of S. aureus forming after incubation on a substrate containing 0.1% and 0.2% glucose, significantly more colony forming units (CFUs) were isolated per one milliliter of the suspension (CFU/ml) than in the control group biofilm samples. On the other hand, the biofilm created by E. coli after a period of incubation on a substrate containing 0.2% glucose yielded significantly fewer CFUs per one milliliter than from the biofilm resulting from incubation on substrate with 0.1% glucose or the control group. No statistically significant difference was found between the numbers of CFUs per one milliliter isolated from E. coli strains after incubation on a substrate with 0.1% glucose and the control group., Conclusions: At concentrations of 0.1% and 0.2%, glucose increases biofilm formation by S. aureus strains on the surface of monofilament polypropylene mesh; at 0.2% glucose limits biofilm formation in E. coli.

A serious complication of hernioplasty with the use of a biomaterial implant is deep surgical site infection (SSI) encompassing the implant. Among the most common etiological factors of deep SSI in patients after hernioplasty are Staphylococcus aureus and Escherichia coli strains, which may create a biofilm on the surface of synthetic implants. The aim of this study was assessment of biofilm formation by S. aureus and E. coli on the surface ofpolypropylene mesh. The study included 108 strains (62 S. aureus and 46 E. coli) from the collection of Department of Microbiology Collegium Medicum im. L. Rydygier in Bydgoszcz, Nicolaus Copernicus University in Torun (CM UMK). Evaluation of biofilm formation was performed using the method of reduction of 2,3,5-triphenyltetrazolium chloride (TTC) and a scanning electron microscope. In the group of S. aureus strains, 88.7% isolates formed biofilm very strongly, 1.6% strongly, and 9.7% poor. Among E. coli strains, 54.3% isolates were characterized by very strong biofilm formation, while 45.7% strong biofilm formation. Strains ofS. aureus strongly than E. coli form a biofilm on the surface of monofilament polypropylene mesh.

Aim of the Study: The results of a survey designed to investigate abdominal wall closure techniques have been analyzed in this report., Material and Methods: The participants were asked to choose a method of abdominal wall closure in groups of patients with progressively increasing risk of wound healing complications., Results: Sixty-nine surgeons responded (median age 41 years), with a median professional life of 15 years. In low and moderate-risk patients, abdominal wall closure plan was similar; the peritoneum and fascia would be closed separately. Continuous absorbable sutures were most frequently picked. Treatment option choices were more diversified in the high-risk group. No dominant surgical method could be found; different suturing materials were proposed, mainly in the form of interrupted sutures. In almost every third patient antieventration sutures were taken as a option., Conclusion: A correlation was found between the risk group and surgical technique, the use of interrupted/continuous sutures and anti-eventration sutures. Dexon, Vicryl and PDS were most frequently selected sutures by surgeons who responded to the survey.

A comprehensive, up-to-date assessment of the incidence and treatment cost of inguinal hernias in Poland is made difficult by the lack of a central data registry and insufficient accuracy of the data available. Therefore, research was undertaken in order to evaluate the incidence and cost of inguinal hernia treatment in the years 2001-2002 in Poland. Survey-derived data was collected from Regional Health Funds operating similar data management systems in 2002 and the Regional Branches of the National Health Fund in 2003. The number of inguinal hernia repairs, length of hospital stay, as well as the cost of these procedures and the overall number of insured people in the region were assessed. Data was obtained from 11 units (Regional Health Funds, Branches of the National Health Fund). The length of hospital stay differed between individual Regional Health Funds. The annual cost of inguinal hernia treatment amounts to approximately 100 million PLN.

The ever-increasing use of biomaterials in many areas of medicine has led to a significant increase of reports concerning medical materials science. Much of the vocabulary used in English literature lacks proper unambiguous equivalents in the Polish language; inaccurate translations are frequent, leading to significant alterations of the meaning. The authors of this report have attempted to create a glossary of the terms pertaining to materials science most frequently encountered in herniological reports.

To study the influence of venous hypertension, which develops in lower-limbs under pneumoperitoneal pressure, on microcirculation-plethysmographic measurements were performed in patients before and during laparoscopic and traditional (open) cholecystectomy. During laparoscopy isovolumetric venous pressure (estimate of capillary pressure), and filtration coefficient (estimate of patent capillary surface) decreased, which was not the case during open surgery. Results indicates that venous hypertension during laparoscopic surgery does not extend to microcirculation; vasoconstriction is due to protective mechanisms, which disable excessive fluid filtration in microcirculation. Parameters of macrocirculation (ambient venous pressure, compliance of calf tissue) changed peroperatively in both groups similarly, irrespectively of the surgical technique.

Abstracts play an important role in medical literature as the carriers of synthetic information. Their significance grows as computerized data bases are in use in which whole information should comprise no more than 250 words. Critical appraisal the abstracts' standard resulted in a proposal for data presentation divided into significant parts (structured abstracts). The abstract of an original clinical trial should contain description of the objective, design, setting, patients, intervention, main outcome measures, results and conclusions. The abstract of the review article should provide information about the purpose, data identification, study selection, data extraction, results of data synthesis and conclusions. This form obliges the authors to precise, logical formulation draws out the essential aspects of the work, facilitates literature review, and critical appraisal.

Seven diagnostic tests were employed to detect the infection of gastric mucosa with the H. pylori bacteria, among patients with epigastric pain and dyspeptic complains. The tests' results were compared to the bacteriologic culture. For each test the following criteria were taken into consideration: sensitivity, specificity, positive and negative predictive values. The tests' accuracy was compared with the agreement expected by chance and beyond chance (kappa). For each test the likelihood ratio was calculated for its positive and negative results. The construction of so called diagnostic decision tree was presented, which allows on the evaluation of the diagnostic test and its utility. The best result were obtained from the test, in which the identification of bacteria took place in the histopathologic specimen after its Gram staining. The interpretation of clinical significance of diagnostic data is simplified with the use of likelihood ratio calculated for a positive test result.

The effectiveness of flexible endoscopes disinfection was evaluated. Since 1991 to 1994--157 inoculations were taken from endoscopic equipment--right after the examination and after their disinfection. Following the endoscopes examinations were contaminated by microorganisms normally resident in the throat, respiratory and digestive tracts, but also with bacteria (Acinetobacter, Pseudomonas, Proteus) which could be source of severe nosocomial infections. Three times there was Ps. aeruginosa on an endoscope after its disinfection, which demonstrates ineffectiveness of the whole sanitary process. Constant surveillance demands sterility of the fluids employed during the disinfection process. The improvement in sanitary level is achieved when endoscope exposition to glutaraldehyde has been elongated, to each endoscope a new solution of detergent has been applied, and sterile water handling (its production, storage, and use) has been polished up.