Although coronavirus disease 2019 (COVID-19)-related major health consequences involve the lungs, a growing body of evidence indicates that COVID-19 is not inert to the pancreas either. This review presents a summary of the molecular mechanisms involved in the development of pancreatic dysfunction during the course of COVID-19, the comparison of the effects of non-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on pancreatic function, and a summary of how drugs used in COVID-19 treatment may affect this organ. It appears that diabetes is not only a condition that predisposes a patient to suffer from more severe COVID-19, but it may also develop as a consequence of infection with this virus. Some SARS-CoV-2 inpatients experience acute pancreatitis due to direct infection of the tissue with the virus or due to systemic multiple organ dysfunction syndrome (MODS) accompanied by elevated levels of amylase and lipase. There are also reports that reveal a relationship between the development and treatment of pancreatic cancer and SARS-CoV-2 infection. It has been postulated that evaluation of pancreatic function should be increased in post-COVID-19 patients, both adults and children.
For almost a year, the major medical problem has been the pandemic caused by the SARS-CoV-2 virus. People with diabetes who contract COVID-19 are likely to experience more serious symptoms than patients without diabetes. This article presents new research about the epidemiology of COVID-19 in a group of patients with diabetes. It details the mortality and prognosis in such patients, as well as the relationship between COVID-19 and the diseases most often coexisting with diabetes: obesity, atherosclerosis, hypertension, and increased risk for infection. It also details how the virus infects and affects patients with hyperglycemia. The context of glycation and receptors for advanced glycation products (RAGE) seems to be of particular importance here. We also present a hypothesis related to the cause-and-effect axis—it turns out that diabetes can be both the cause of the more difficult course of COVID-19 and the result of SARS-CoV-2 infection. The last part of this article discusses the impact of antihyperglycemic drugs on the development of COVID-19 and other pharmacological implications, including which non-classical antihyperglycemic drugs seem to be effective in both the treatment of coronavirus infection and glucose homeostasis, and what strategies related to RAGE and glycation should be considered.
Multitrauma is defined as injury involving two or more different body parts, with a condition that at least one of these injuries is life-threatening. They represent serious traumas, requiring treatment in the intensive care units and frequently surgical intervention. The objective of this study was epidemiological and clinical analysis of patients treated in 2015 year in Multitrauma Centre of the University Teaching Hospital no 1 in Szczecin, and comparison the results with outcomes of similar study conducted in the same Centre in 2007 year. Clinical material comprised medical notes of 82 patients, 52 men (63%) and 30 women (37%), with a mean age of 44 years, who sustained multitrauma injuries. An analysis included causes of traumas, spectrum of injuries, involvement of body parts, methods and outcomes of the treatment. Results. The most common cause of multitrauma was traffic accident - 45 cases (55%), followed by fall from height - 22 (27%) and other mechanism - 15 (18%). The most frequent component of multitrauma made bone fractures (spine, pelvis, limbs) - 64 cases (78%), followed by head traumas - 63 (77%), chest - 53 (65%) and abdominal 30 (36%) injuries. A total of 48 patients (58%) required surgical intervention, the most frequently fixation of bone fractures - 24 patients (29%), repair of abdominal and head injuries - 18 (22%) either. Of 82 treated patients 64 (78%) survived and 18 (22%) died. A mean period of stay in Multitrauma Centre was 23 days for survived patients and 17 days for those who died. Comparing to similar analysis conducted 8 years earlier, a change in involvement of particular body parts comprising multitrauma injury was observed: number of head injuries increased of 14%, number of chest traumas and bone fractures decreased of 21% and 11%, respectively. The survival rate improved of 10%.
Background Microsurgery is a specific surgical expertise that involves operating on very small structures, and requires the assistance of a magnifying device: a microscope or loupes. Several factors have been identified that could affect the quality of microsurgical performance in training or surgical procedures. Objective The objective of this study was to assess the impact of the selected factors – caffeine, alcohol and physical exercise – on a microsurgical task prior its performance. Methods Ten students from the 5th and 6th years of medical studies who had completed the advanced microsurgical course performed a “6-stitches test” on a latex glove spanned over a cup prior to and after consumption of caffeine, alcohol and performing physical exercises. The times taken to complete the task at baseline and post-exposure were recorded. Results The results of the study show a statistically significant positive effect of caffeine and a statistically significant negative effect of physical exercise on microsurgical performance when performed shortly before the task. Small dose of alcohol taken before the task showed had little effect on performance.
Introduction: Paresthesia (numbness, tingling, "pins and needles" sensation) and pain in the hand comprise a typical set of symptoms of carpal tunnel syndrome. Most authors consider a typical occurrence of these features within the palmar surface of digits I-IV, innervated by a compressed median nerve. Observations of patients by various authors show that some patients feel paresthesia in all digits of the affected hand and within the forearm. The objective of this study was investigation of the distribution of paresthesia in patients diagnosed with carpal tunnel syndrome, and verification of the hypothesis that this occurrence in areas beyond the innervation by the median nerve is an atypical manifestation of the syndrome. Materials and methods: Questionnaires and notes filled out during baseline examination of 276 patients admitted to authors' institution for carpal tunnel release over a period of 1 year were reviewed. The group consisted of 211 women (76%) and 65 men (24%) at a mean age of 59 years.Results: Two hundred seventy-four patients (99%) reported feeling paresthesia within the involved extremity, and 2 did not, but complained of pain and reduced sensation. Most patients -140 (51%) -felt paresthesia on the palmar surface of all 5 digits, including the little finger. Seventy-eight persons (28%) reported a "typical" distribution of paresthesia within digits I-IV and 31 (11%) in digits I-III. As many as 152 patients (55%) felt paresthesia in the little finger, most of them being cases with numbness and tingling present in all 5 digits. The feeling of paresthesia in the midhand, close to the involved digits was reported by 158 patients (57%). Conclusion: We found that the distribution of symptoms in carpal tunnel syndrome does not closely match the anatomy of the median nerve and this presentation should no longer be considered atypical. ABSTRAKTWstęp: Parestezje (drętwienia, mrowienia, zjawisko "igły-szpilki") i ból ręki należą do charakterystycznych objawów zespołu kanału nadgarstka. Większość autorów uważa, że typowa lokalizacja parestezji dotyczy dłoniowej powierzchni palców I-IV, które są unerwione przez uciśnięty nerw pośrodkowy. Obserwacje pacjentów z kliniki autorów wskazują, że niektórzy odczuwają parestezje na wszystkich palcach, w całej ręce i na przedramieniu. Celem pracy było zbadanie rozmieszczenia parestezji wśród pacjentów z zespołem kanału nadgarstka i weryfikacja hipotezy, że ich występowanie poza anatomicznym unerwieniem przez nerw pośrodkowy jest nietypową manifestacją kliniczną tego schorzenia. Materiały i metody: Analizie poddano zapisy ankiet wypełnionych przy badaniu 276 pacjentów przyjętych w ciągu 1 roku do ośrodka autorów w celu leczenia operacyjnego zespołu kanału nadgarstka. W badanej grupie było 211 kobiet (76%) i 65 mężczyzn (24%). Średnia ich wieku wynosiła 59 lat.Wyniki: Parestezje odczuwało 274 chorych (99%), a 2 pacjentów nie odczuwało tego typu dolegliwości, zgłaszało natomiast ból ręki i osłabienie czucia palców. Najwięcej -140 osób (51%) -odczuwało je na dłoniowej powi...
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