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Open access

Monika Krajewska-Wędzina, Anna Zabost, Ewa Augustynowicz-Kopeć, Marcin Weiner and Krzysztof Szulowski

Abstract

Introduction: Tuberculosis is a highly infectious disease affecting humans and animals. It is caused by the Mycobacterium tuberculosis complex (MTBC) – Mycobacterium bovis and Mycobacterium caprae, which are aetiological factors of bovine tuberculosis (bTB). In Poland, the bTB eradication programme exists. Animals diagnosed with tuberculosis are in the majority of cases not treated, but removed from their herd and then sanitary slaughtered.

Material and Methods: In total, 134 MTBC strains isolated from cattle in Poland were subjected to microbiological analysis. The resistance phenotype was tested for first-line antimycobacterial drugs used in tuberculosis treatment in humans: streptomycin, isoniazid, rifampicin, ethambutol, and pyrazinamide. The strains were isolated from tissues collected post mortem, so the test for drug resistance fulfilled only epidemiological criterion.

Results: The analysis of drug-resistance of MTBC strains revealed that strains classified as M. bovis were susceptible to 4 antimycobacterial drugs: isoniazid, rifampicin, streptomycin, and ethambutol, and resistant to pyrazynamide. The strains classified as M. caprae were sensitive to all tested drugs.

Conclusion: The results indicate that despite enormously dynamic changes in mycobacterial phenotype, Polish strains of MTBC isolated from cattle have not acquired environmental resistance. The strains classified as M. bovis are characterised by natural resistance to pyrazinamide, which is typical for this species.

Open access

Patryk Fiszer, Sadegh Toutounchi, Ryszard Pogorzelski, Ewa Krajewska, Witold Cieśla and Maciej Skórski

Laparoscopic Adrenalectomy - Assessing the Learning Curve

Laparoscopic adrenalectomy (LA) has become the "gold standard" for treatment of most of adrenal tumors in last few years. It has many benefits comparing to open surgery, but still is considered as complicated procedure requiring experienced surgical team.

The aim of the study was to assess the learning curve of laparoscopic adrenalectomy and the outcome of the first consecutive 154 LA.

Material and methods. 154 consecutive patients undergoing LA between 2007 and 2010 were reviewed. Collected data included: patients demographics, clinical and histological diagnosis, side and length of operation, conversions to open surgery, complications and hospitalization time. Learning curve was evaluated by dividing all patients into three groups (group I - first 50 patients, group II - second 50 patients and group III last 54 patients). Differences between the groups were analyzed.

Results. There were 154 LAs performed. Indications for LA were hormonally inactive adrenal adenoma(n=57), Conn's syndrome (n=30), Cushing's syndrome (n=28), pheochromocytoma (n=27), adrenal cyst (n=8), and others (n=4). Mean tumor size was 45.28 mm. There were 79 left-sided and 75 right-sided procedures and the average time of hospitalization was 4.64 days. Mean operative time was statistically different between the groups (216.2 min. - 164.6 min. - 131.9 min.; p<0.01) as well as the number of conversions to open surgery (18% - 4% - 3.7%; p=0.013). There was not any significant difference in the number of complications between analyzed groups (2% - 2% -3.7%).

Conclusion. To improve the outcome of LA it is necessary to perform approximately 40 to 50 procedures.

Open access

Ewa Siemińska and Małgorzata Krajewska

Abstract

Strict connections of the real estate market with the financial market are an unquestionable phenomenon at every level of investing, starting from the lowest individual investor, and finishing with national and transnational players. One of the more interesting examples of such a dependency is the problem of the risk of financing the real estate market, which results from numerous macro-, mezo- and microeconomic conditions, including, inter alias, the phenomenon of capital migration, supranational bank regulations or the development of currency exchange rates on world markets. The most recent example of such a dependency is, among others, the decision of the National Bank of Switzerland from the beginning of 2015 to abandon the Swiss franc-euro cap, which will go down in the history of the world financial market. Its global effects will surely be very difficult to assess, while the resulting turbulences and consequences for many (institutional, corporation and individual) market participants cause, on the one hand, awaiting a reaction and actions aimed at helping entities affected by the consequences of the mentioned decision and, on the other, many questions and doubts.

The paper will present current selected aspects concerning currency risk in the context of financing the residential real estate market and the directions of actions prepared in reaction to the abovementioned risk. Polish conditions will be presented against the background of examples of foreign solutions.

The aim of the work is to present:

  1. the essence of currency risk in the context of the current financial situation of the Polish banking sector,

  2. the most important directions of proposals for remedial actions aimed at mitigating the effects of the significant increase in the exchange rate of the Swiss franc in relation to the Polish currency,

  3. a short overview of selected solutions/regulations regarding the exchange rate risk of mortgages taken out in a foreign currency in other countries.

The method employed was the critical analysis of the most-recent reports and recommendations of the National Bank of Poland, Polish Financial Supervision Authority, Polish Banking Union, and other experts on the subject of financing the real estate market, as well as a comparative analysis of solutions regarding currency risk in selected countries.

Open access

Ewa Siemińska and Małgorzata Krajewska

Abstract

The main topic assumed in the article are investments in the real estate market, with particular consideration given to their scale and changes in the directions of investing in the context of a dynamically changing geopolitical and economic situation throughout the world. This is seeing as how the activity of investors reflects the need and preferences of various groups of buyers and users of built surfaces, while accounting for the risk accompanying investment decisions as well as the widely understood operating conditions.

Constant observation and monitoring of these phenomena, their dynamics as well as structural changes is a remarkably important and very needed study, both as far as science and practical application are concerned, as it allows for the processes taking place to be tracked, while their informational value is more valuable the more uncertain the market and more difficult it and the behaviors of its participants are to predict.

The work uses the newest available reports and analyses of the largest auditors dealing with worldwide and global real estate markets, such as: JLL, Colliers International, CBRE, Cushman&Wakefield, KPMG, World Economic Forum, or Savills and UBS Group Ag.

The aim of the work is the synthetic analysis of changes and directions of investing on the real estate market on a global scale, in the context of the newest political-economic situations throughout the world.

Open access

Patryk Fiszer, Ryszard Pogorzelski, Sadegh Toutounchi, Małgorzata Szostek, Ewa Krajewska, Wawrzyniec Jakuczun, Robert Tworus and Maciej Skórski

Results of General Surgical Treatment of Patients Over 80 Years of Age in Single-Site Experience

The aim of the study was to evaluate the results of general surgical treatment of patients over 80 years of age.

Material and methods. Three hundred and four patients aged 80 to 105 years with general surgical disorders, treated in 2005-2009, were retrospectively included in the study. The collected information included demographic data, coexisting diseases, the mode of admission, the diagnosis, the method and result of treatment, and also potential complications and 30-day mortality. The data were subjected to statistical analysis.

Results. The study group included 186 women and 118 men. Two hundred patients (65.8%) were admitted in an emergency setting. The most common causes of immediate hospitalisation were: mechanical ileus (26.5%), gastrointestinal bleeding (22%), trauma (16%), and gall-bladder disorders (8.5%). The remaining 104 (34.2%) patients were operated upon on an elective basis. An emergency operation was required by 121 (60%) of the patients admitted in an emergency setting; the remaining ones were treated conservatively. Hernia plasties (27.5%), cholecystectomies (15.3%), colorectal resections (13.2%), strumectomies (11.2%) and endoscopies (6.1%) predominated among elective surgeries.

The total number of complications and mortality were 19.4% and 14.5%, respectively. The number of complications and mortality were significantly higher in the group of patients admitted in an emergency setting (25.5% and 20.5%, respectively) than in patients admitted on an elective basis (8.7% and 2.9%, respectively), p<0.01.

The mean duration of hospitalisation was 9.7 days (1 to 60 days), with a small difference between the groups of patients treated on an elective and emergency basis (8.5 and 10.4 days), p=0.181.

Conclusions. The results of surgical treatment of elderly patients do not significantly differ from the results of treatment of the general population. Much worse results, coupled with a significant increase in mortality, are observed in patients admitted and treated on an emergency basis.

Open access

Ryszard Pogorzelski, Patryk Fiszer, Sadegh Toutounchi, Ewa Krajewska, Małgorzata M. Szostek, Robert Tworus, Wawrzyniec Jakuczun and Maciej Skórski

Anastomotic aneurysms may develop after any type of vascular surgery, in different areas of the arterial system, and require reoperation. The frequency of occurrence of the above-mentioned is estimated at 1-5%.

Material and methods. During the period between 1989 and 2010, 180 patients with 230 anastomotic aneurysms were subject to surgical intervention at the Department of General and Thoracic Surgery, Warsaw Medical University. The study group comprised 21 (11.7%) female and 159 (88.3%) male patients, aged between 30 and 87 years (mean age - 62.8 years). In relation to the number of anastomoses aneurysms were diagnosed in 2.1% of cases. Twenty-four (10.4%) patients were diagnosed with recurrent aneurysms.

Results. Surgical procedures performed were as follows: artificial prosthesis implantation (119), reanastomosis (40), patch plasty (25), graftectomy (19), prosthesis replacement (9), and stent-graft (7) implantation. 195 (84.8%) aneurysms were subject to planned surgery, while 35 (15.2%) required emergency intervention.

77.8% of patients were diagnosed with aseptic aneurysms, while the remaining 22.2% with infected perioperative aneurysms.

Good treatment results were obtained in 149 (82.8%) patients. Limb amputations were performed in 19 (10.5%) cases. Twelve (6.7%) patients died as a consequence of infection and general complications.

Conclusions. Vascular reoperations are a difficult clinical problem and are burdened with a high rate of complications. The above-mentioned often require complex treatment, in order to improve therapeutic results.

Open access

Ewa Krajewska, Sadegh Toutounchi, Patryk Fiszer, Witold Cieśla, Ryszard Pogorzelski, Tomasz Bednarczuk, Andrzej Cieszanowski, Izabela Łoń and Maciej Skórski

Adrenal Tumors - Diagnostics and the Factual Situation

The study presented three cases of patients diagnosed with adrenal tumors subject to surgical intervention during the past 6 months in our Department. The patients presented with radiological diagnostic difficulties, as to the character and location of the primary tumor.

The aim of the study was to demonstrate differences between radiological examination results and the factual situation observed during the adrenalectomy. In all the presented cases patients' were subject to laparoscopic intervention. In two cases conversion to open surgery was necessary. The histopathological results of the surgically removed samples were as follows: leiomyoma, myoperycytoma and pheochromocytoma. In selected cases imaging examinations might be of limited value, especially when determining the character and location of the primary lesion of the adrenal gland.

Open access

Ewa Pietrykowska-Tudruj, Marta Krajewska and Bernard Staniec

Abstract

The pupa of Gabrius appendiculatus SHARP, 1910 is described and illustrated for the first time. A key to the known pupae of four Gabrius species applying newly defined morphological characters is provided.

Open access

Michał Szulc, Piotr Mularczyk, Patryk Grządzielski, Przemysław Zakowicz, Radosław Kujawski, Agnieszka Gryszczyńska, Waldemar Buchwald, Artur Teżyk, Anna Krajewska-Patan, Ewa Kamińska and Przemysław Ł. Mikołajczak

Summary

Introduction: Rhodiola rosea (RR) and Rhodiola kirilowii (RK) are well known for their influence on central nervous system, however their impact on the development of alcohol tolerance has not yet been proven.

Objective: The aim of this study was to determine the ability of RR and RK roots extracts to inhibit the development of alcohol tolerance in vivo, both, peripheral (metabolic) and central ones.

Methods: Male Wistar rats were treated with RR and RK extracts (p.o.) and ethanol (i.p.) for ten consecutive days. On the first, third, fifth and eighth days the hypothermic action of ethanol was measured, while on the ninth day the loss of righting reflex was examined. On the tenth day rats were treated with assigned extract and sacrificed 1 h after the ethanol injection.

Results: Both extracts inhibited development of tolerance to the hypothermic action of ethanol. The observed effect seems to be specific since none of the extracts affected body temperature in water-treated animals. RK extract also prolonged the hypnotic action of ethanol. RR-treated rats had higher blood-ethanol concentrations, in contrast to RK ones.

Conclusions: RR and RK extracts inhibited the development of tolerance to the hypothermic action of ethanol. Prolongation of the hypnotic action of ethanol by RK extract may be associated with influence on the central nervous system, while the RR one also inhibited the development of metabolic tolerance.

Open access

Ryszard Pogorzelski, Patryk Fiszer, Sadegh Toutounchi, Małgorzata M. Szostek, Ewa Krajewska, Wawrzyniec Jakuczun, Robert Tworus and Maciej Skórski