Two cases of paediatric radial and ulnar nerve injuries occurring at operative treatment of distal humeral epiphyseal fractures. In one case, the nerve laceration was associated with a defect, requiring reconstruction by nerve grafting. In a 2nd case, the nerve was compressed and partially damaged by implanting, followed by entrapment in the scar; release of the nerve from the scar resulted in recovery of its function. The importance of being familiar with the nerves’ course at the distal end of the humerus, as well as proper and prompt reaction to symptoms of nerve dysfunction occurring immediately after the operation was emphasised.
Introduction: Modifications to teaching medicine introduced 5 years ago consisted of abolishing the internship, changing the surgical curriculum in the last year of studies by introduction of a so called “practical year”. The objective of this study was investigating how the practical year was undertaken at the Pomeranian Medical University in Szczecin in the academic year 2017/2018.
Materials and methods: A study was carried in a group of 154 students of the 6th year of Faculty of Medicine, just before the final test-exam in surgery. The questionnaire used in the study consisted of 11 closed questions concerning the organization, course, and accomplishment of the provided program.
Results: The questionnaire results show that the assumed aim of the curriculum, which was a skill/competency-oriented teaching of surgery, was half executed. Students were insufficiently engaged in typical doctor’s activities. One-half of them considered their practical-year as no different from classes practiced in the previous years. Ward-round teaching and the performance of manual skills was considered the most valuable portion of the surgical curriculum. Seminars were scored the lowest, as the least useful. Organization of the classes and the engagement of tutors were evaluated positively by the majority of students. The results of this survey show the grade of accomplishment of the assumed educative aims in teaching surgery in the practical year, and have revealed some drawbacks, which should translate into an improvement of teaching in the forthcoming years.
Phlegmon is a purulent infection which spreads in loose connective tissue. It occurs most commonly in the limbs as a complication of other local infections. Untreated or inadequately treated infections in the skin of the fingers or hands are susceptible to phlegmon. In most cases, the infecting organism is Staphylococcus aureus. This article reports 7 cases of phlegmon involving upper limbs, caused by the Streptococcus pyogenes organism. The course of these types of infection are more serious, and the range of tissue damage greater, than those caused by staphylococci. This article presents the causes of the phlegmon, the methods and course of management, and the results of these. The principles of surgical management include wide incisions in the skin and an evacuation of pus and necrotic tissue debris. The skin is then sealed with stitches or a skin graft once the wound is clean. Of the 7 treated patients, 1 died in the intensive care unit due to sepsis and mutli-organ failure and 1 patient lost his all fingers due to necrosis. The authors believe that it is desirable that doctors working in emergency units and surgical admission rooms should be familiar with the basic rules of diagnosing and managing these potentially life-threatening or hand crippling disease
Immune and oxidative parameters were evaluated as indicators of the influence of stress on the occurrence of respiratory syndrome in feedlot calves. The study was carried out on 60 2 and a half-month-old Simmentaler calves transported at feedlot. Mean daily feed consumption, daily weight gain, and behavioural activity were evaluated. Blood was collected on days 1, 3, 7, 14, 21, and 28 of feedlot. Serum NO ions, lipid peroxidation, acute phase proteins, IgG, and IgM were determined. The calves showed a decrease in feed consumption during the first 7 d of the feedlot. Sporadic stereotypies were noted. NO concentration showed a significant (P < 0.05) increase on days 7 and 14. Concentration of thiobarbituric acid reactive substances (TBARS) increased (P < 0.05) on days 1 and 3. IgM concentration was found to be considerably lower on days 14 and 28. Serum haptoglobin level showed a significant increase in stressed calves on days 1, 3, 7, and 14 of the feedlot. Based on these results, it can be suggested that stressors associated with transport and adaptation to the feedlot induce a stress reaction in calves, resulting in behavioural disorders, reduced weight gain, suppression of the humoral immunity and increased morbidity during the first weeks. These parameters seem to be crucial in evaluating the animals' health and welfare.
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 pares-thesia 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 occur-rence 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.
The aim of the study was to evaluate the effect of flunixin and florfenicol administered in combination with vitamin E or C on selected leukocyte immune mechanisms and on the inflammatory process during the first few weeks in the feedlot. Fifty calves divided into 5 groups (n = 10) received florfenicol and flunixin with vitamin E or C. Blood was collected on the 1st, 3rd, 7th, 14th, 21st, and 28th d of the experiment. Intracellular metabolism (NBT), apoptosis, chemotaxis, susceptibility to M. haemolytica leukotoxin, and expression of β2-integrins were determined in leukocytes. The symptoms of respiratory tract infection were observed in 40% of calves in control group, while in the other groups the morbidity rate ranged from 10% to 20%. Leukocytes showed decreased NBT, and the mean values for apoptosis ranged from 14% to 24%. The lowest percentage of apoptotic cells was observed in the calves that received florfenicol with flunixin and vitamins E and C. The chemotactic activity confirmed the significant inhibitory effect of the preparations on migration of the cells. A significant decrease (P ≤ 0.05) in the susceptibility of leukocytes to leukotoxin was noted in the group that received florfenicol and flunixin with vitamin E. Expression of β2-integrin receptors was the lowest in calves receiving florfenicol with flunixin and vitamin E or C. The application of an antibiotic and a non-steroidal anti-inflammatory drug with antioxidants protected the leukocytes involved in defence against M. haemolytica virulence factors and effectively limited oxidative stress in the calves.
The study was performed on nasal swabs, tracheal samples, and sera obtained from young beef heifers aged between 6 and 12 months, from farms in eastern and south-eastern Poland. The samples were evaluated using bovine herpesvirus 1 (BHV-1) ELISA kits (ELISA BHV1 antibody and ELISA BHV1 antigen) and PCR. Among all the animals examined, 37 (32.2%) were positive in the ELISA BHV1 antigen test. The presence of BHV-1 was confirmed by PCR in 42 (36.5%) animals. In the ELISA BHV1 antibody test, 39 (33.9%) seropositive animals were identified. The presence of BHV-1 positive samples was observed in all the examined breeds of young cattle. There were no significant differences (P ≤ 0.05) in BHV-1 positive samples. The results indicate that the incidence of BHV-1 infections in feedlot cattle herds studied was 32.2%-36.5%, which suggests that preventive measures should be implemented in order to limit transmission of the virus.