Sławomir Jabłoński and Marian Brocki
Sławomir Jabłoński, Marcin Wawrzycki, Marian Brocki, Małgorzata Filgus and Jacek Kordiak
Intrathoracic Thyroid Goiters
In this article, the difficulties in treatment of 18 patients with intrathoracic thyroid goiters were discussed.
The aim of the study were: defining the etiology and symptomology of goiters within the chest in the own material, conducting the analysis of the diagnostic efficiency, the evaluation of the early results of surgery and postoperative complications.
Material and methods. The research material included 18 patients with intarhoracic thyroid goiters after surgical treatment (mediastinal goiters, ectopic goiters). The cases of retrosternal goiters were not analyzed. There was carried out the retrospective analysis of the medical documentation of goiters etiology, the frequency of dominating clinical symptoms, value of diagnostic methods, early effects of surgical treatment and postoperative complications.
Results. In the years 2004-2008, operations were performed on 14 women and 4 men with intrathoracic goiters, aged from 34 to 82. The average age of patients was 51.1. The etiology of intrathoracic thyroid goiters were as follows: thyroid goiters (struma nodosa) - 55%, adenoma and thyroid goiters - 17%, thyroid cancer (ca papillare) and thyroid goiters - 11%, ectopic thyroid gland - 11%, thyroid goiters and thyroid inflammation - 6%. The majority of the material were cases of a cervico-mediastinal thyroid gland, only 2 patients were diagnosed with an ectopic thyroid gland located in the mediastinum with no connection with the cervical thyroid. The local symptoms of compression on intrathoracic organs were mostly observed in the clinical picture, 22% of patients were asymptomatic. The diagnostic process included the estimation of the hormonal state and the radiology localised methods among which helical computer tomography was the most valuable. In order to estimate endotracheal intubation conditions 11 patients (61%) underwent brochofiberoscopy. The following accesses were used in the treatment: cervical - 3 cases, partial sternotomy - 11, longitudinal sternotomy - 2, thoracotomy - 1, combined thoracotomy with cervicotomy - 1. Good treatment results were obtained in all cases. The following complications were noted: a permanent paralysis of the laryngeal nerve - 1 case (6%), hypoparathyroidism - 1 (6%).
Conclusions. Thyroid goiters situated inside the chest are a rarely met pathology which may cause serious difficulties in surgical treatment. Patients with this illness require a thorough preparation for the treatment including balancing hormonal perturbations, preventing intubation difficulties and access to the necessary quality of a diagnostics wit purpose of planning the most optimal surgical access and avoiding serious perioperative complications.
Jarosław Domański, Jan Badziak and Sławomir Jabłoński
This contribution presents results of a Particle-in-Cell simulation of ion beam acceleration via the interaction of a petawatt 25 fs laser pulse of high intensity (up to ~1021 W/cm2) with thin hydrocarbon (CH) and erbium hydride (ErH3) targets of equal areal mass density (of 0.6 g/m2). A special attention is paid to the effect that the laser pulse polarization and the material composition of the target have on the maximum ion energies and the number of high energy (>10 MeV) protons. It is shown that both the mean and the maximum ion energies are higher for the linear polarization than for the circular one. A comparison of the maximum proton energies and the total number of protons generated from the CH and ErH3 targets using a linearly polarized beam is presented. For the ErH3 targets the maximum proton energies are higher and they reach 50 MeV for the laser pulse intensity of 1021 W/cm2. The number of protons with energies higher than 10 MeV is an order of magnitude higher for the ErH3 targets than that for the CH targets.
Piotr Misiak, Sławomir Jabłoński, Jerry Lazarek, Katarzyna Malinowska, Edyta Santorek-Strumiłło and Artur Terlecki
The cholecystectomy procedure is the most routinely performed intervention in general surgery. The current international gold standard is via the laparoscopic approach. It is a safe, minimally-invasive procedure; however, it is associated with complications in 1% of cases.
The aim of the study was to analyze patient feedback, by means of a survey, to determine how much knowledge patients possessed about their disease state and proposed surgical intervention, based primarily on information contained within the informed consent form developed by the Association of Polish Surgeons.
Material and methods. This study involved the participation of 51 patients who underwent laparoscopic cholecystectomy, indicated by a diagnosis of gallstones, in the years 2014 and 2015.
Results. Despite having signed the informed consent form, there was considerable variation among the responses given to the survey by the 51 patients in this study. Some patients’ responses were tangential to the questions asked; many patients did not respond to any of the sub points.
Conclusions. Given that this study is based on a small sample size of patients, it must be presumed that the process by which the patient declares his or her informed consent requires further consideration with respect to the means by which it is obtained. The authors of this study thus recommend that multimedia resources be harnessed as part of the process of obtaining the informed consent of patients prior to surgical intervention.
Izabela Kaczmarek, Sławomir Jabłoński, Paweł Kleka and Barbara Steinborn
Recently, extensive studies investigating executive functions in children with specific language impairment (SLI) have been performed. In the present study, we compared the level of executive functions (i.e., inhibitory control and cognitive flexibility) and literacy skills between 53 healthy children and 53 children with SLIs between the ages of 3 and 11 years. The groups were matched by age, gender and parental education level. Executive functions were assessed using the Children Card Sort, and the Literacy Assessment Battery was applied to measure literacy skills. The patients with SLI displayed a significantly lower level of cognitive flexibility than that of the healthy children. No significant differences were observed between the groups in inhibitory control and the majority of literacy skills. The results confirm the hypothesis that patients with SLI experience difficulties in cognitive flexibility.