Search

INTRODUCTION: Infections affect all patients, including those with diabetes mellitus (DM), which can determine the course of infection. The aim of the study was to compare the course and treatment of infection in patients with DM and without DM. MATERIAL AND METHODS: 180 medical records of patients hospitalized in 2021 at the Department of Internal Medicine, Autoimmune and Metabolic Diseases in Katowice, with infections were analyzed. The analysis included age, sex, clinical diagnosis, DM treatment, antibiotic therapy, and laboratory parameters. The Statistica program was used for statistical analysis. RESULTS: The most prevalent reasons for hospitalization in both groups were: pneumonia in the course of COVID-19 (35.5% DM vs 33.7% non-DM) and urinary tract infections (26.3% DM vs 19.2% non-DM). Significantly more non-DM patients required polyantibiotic treatment (69.7% DM vs 89.4% non-DM). The most frequently used antibiotics were β-lactams (59.2% DM vs 57.7% non-DM). In-hospital mortality was 20% (21% DM vs 19.2% non-DM). The length of hospitalization was 1–35 days, the median in the whole group was 9 days (10 days DM vs 8 days non-DM). Both the initial and terminal CRP concentrations were analyzed. The median of the initial value was 71.6 (72.3 DM vs 66.2 non-DM) and the median of the terminal value was 17.15 (17.9 DM vs 15.3 non-DM). The glucose concentration on admission was assessed with the median 123.5 mg/dL (156 mg/dL DM vs 107 mg/dL non-DM). CONCLUSIONS: Many DM complications are well known, yet the course and treatment of infection do not differ significantly in patients with DM and without DM. Despite that, each patient should be considered individually, so the chosen treatment constitutes an optimized therapy.

Simple Summary: Renal cancer is the eighth most frequent cancer in Europe, and its prevalence is increasing. Surgery is the treatment of choice for localised renal cell carcinoma requiring interventional management, but less invasive treatment methods are emerging. Stereotactic body radiotherapy (SBRT) utilises precise delivery of high doses of radiation to ablate the primary cancer. In our systematic review and meta-analysis, we pooled data from available prospective trials, including 13 studies involving 308 patients. The results of the meta-analysis show that SBRT for localised renal cell carcinoma is highly effective in controlling local diseases and has low complication rates. In the second year, 97% of patients were free from local recurrence. Only 3% experienced severe adverse events, which included abdominal pain and fatigue. SBRT presents a valuable treatment for patients who require treatment but cannot undergo surgery; however, it has not been yet confirmed to be equieffective to surgery as trials directly comparing these methods are missing. Context: Surgery is the gold standard for the local treatment of primary renal cell carcinoma (RCC), but alternatives are emerging. We conducted a systematic review and meta-analysis to assess the results of prospective studies using definitive stereotactic body radiotherapy (SBRT) to treat primary localised RCC. Evidence acquisition: This review was prospectively registered in PROSPERO (CRD42023447274). We searched PubMed, Embase, Scopus, and Google Scholar for reports of prospective studies published since 2003, describing the outcomes of SBRT for localised RCC. Meta-analyses were performed for local control (LC), overall survival (OS), and rates of adverse events (AEs) using generalised linear mixed models (GLMMs). Outcomes were presented as rates with corresponding 95% confidence intervals (95% CIs). Risk-of-bias was assessed using the ROBINS-I tool. Evidence synthesis: Of the 2983 records, 13 prospective studies (n = 308) were included in the meta-analysis. The median diameter of the irradiated tumours ranged between 1.9 and 5.5 cm in individual studies. Grade ≥ 3 AEs were reported in 15 patients, and their estimated rate was 0.03 (95%CI: 0.01–0.11; n = 291). One- and two-year LC rates were 0.98 (95%CI: 0.95–0.99; n = 293) and 0.97 (95%CI: 0.93–0.99; n = 253), while one- and two-year OS rates were 0.95 (95%CI: 0.88–0.98; n = 294) and 0.86 (95%CI: 0.77–0.91; n = 224). There was no statistically significant heterogeneity, and the estimations were consistent after excluding studies at a high risk of bias in a sensitivity analysis. Major limitations include a relatively short follow-up, inhomogeneous reporting of renal function deterioration, and a lack of prospective comparative evidence. Conclusions: The short-term results suggest that SBRT is a valuable treatment method for selected inoperable patients (or those who refuse surgery) with localised RCC associated with low rates of high-grade AEs and excellent LC. However, until the long-term data from randomised controlled trials are available, surgical management remains a standard of care in operable patients. [ABSTRACT FROM AUTHOR]

The incidence of Autoimmune Hepatitis (AIH) increases worldwide. If undiagnosed, it may progress end-stage liver disease. Unfortunately, there is no characteristic clinical presentation of this disease, which makes the illness hard to recognize. A case report illustrates the difficulties of diagnosing the patient during his two hospitalizations and his final treatment with prednisolone which improved the patient’s condition.

Peyronie's disease (PD) is a connective tissue disorder affecting the tunica albuginea. It can cause pain and penile deformation, and its prevalence increases with age. Although surgery is the gold standard for the chronic phase of the disease, there are several conservative treatment methods available, and the optimal management of the acute phase of the disease remains a matter of debate. In this article, we aim to summarize the recent trends in research on the subject of non‐surgical treatment of PD. The search was performed in PubMed, Scopus, and Web of Science databases and included studies in English published between 2012 and 2022 investigating the clinical outcomes of non‐surgical PD management in humans. We have identified 20 distinct conservative treatment strategies. Among the oral therapeutics, only the use of phosphodiesterase type 5 inhibitors is currently recommended for clinical use in patients with concomitant erectile dysfunction. The use of collagenase from Clostridium histolyticum is supported by the best quality evidence in terms of intralesional injections for patients suffering from significant penile curvature; however, interferon alpha‐2b can also be an option in such patients. Among other non‐invasive methods, extracorporeal shockwaves can be useful for pain reduction, and penile traction therapy can lead to a reduction in penile curvature and plaque size. Despite a wide range of non‐surgical methods available for PD treatment, the majority are not supported by sufficient scientific evidence, and the treatment efficacy is underwhelming. Further research on the subject of non‐surgical management of PD is highly warranted. [ABSTRACT FROM AUTHOR]

Introduction: Celiac plexus radioablation (CPR) is an emerging non-invasive interventional treatment for severe pain associated with cancer-related damage to the celiac plexus. Due to its complex aetiology, such pain often responds poorly to conventional analgesics, and high doses of these medications can cause toxicity. Celiac plexus radiosurgery employs advanced radiotherapy techniques to administer a high single dose of 25 Gy to the anatomically defined celiac plexus, aiming to reduce pain intensity and enhance patients' quality of life. Material and methods: The safety and efficacy of CPR have been validated in a prospective single-arm clinical trial that included 125 patients. Results: The positive outcomes of this trial led to the integration of CPR into pain management guidelines; however, the novel approach to radiotherapy planning might be initially challenging to grasp. Conclusions: In this article, we provide a brief overview of the method along with a comprehensive, Polish and English-language guide on how to perform CPR and manage patients, based on our clinical experience. [ABSTRACT FROM AUTHOR]

Review article of the book: My, ludzie z Marca. Autoportret pokolenia ’68, Wołowiec 2015, ss. 366

The study presents two opinions about the events of 1920, especially about the Soviet offensive under the command of M. Tuchaczewski and the counter-attack near Wieprz prepared and commanded by Józef Piłsudski – from the point of view of the main characters, who fought in 1920, and presented two different points of view a few years later. A polemical clash, especially in the case of Piłsudski, proves a talent for writing.

Endoleak type II is the most common complication of endovascular treatment of aortic aneurysm. The case report presents a patient with a high risk of ELII, in whom prophylactic embolization of aortic sides was successfully applied. [ABSTRACT FROM AUTHOR]

The article presents the significance of Józef Piłsudski (the Head of the State and the Commander-in-Chief at the beginning of the Polish state re-established in the 20th century) for the process of regaining independence by Poland. Piłsudski acted in this direction as a socialist activist, a creator of a paramilitary movement before World War I, and a legionary commander in 1914-1916. Without his actions, both on paramilitary and purely political grounds, the process of re-establishment of Poland as a sovereign state would have been significantly hampered and slowed down. [ABSTRACT FROM AUTHOR]