Search results

1

Serum and salivary chemerin concentrations in patients with colorectal cancer and obesity

100%

Waniczek D., Świętochowska E., Lorenc Z.

Annales Academiae Medicae Silesiensis

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2021

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issue 75

11-17

EN

INTRODUCTION: Chemerin is an adipokine, whose pro-inflammatory and carcinogenesis-related properties have recently been emphasized. The aim of this study was to examine the concentrations of chemerin in the serum and saliva of healthy subjects and patients with colorectal cancer (CRC) in II and III stage of TNM (tumor, node, metastasis) classification as well as to assess the relationship between the results and the clinical and pathological parameters. MATERIAL AND METHODS: 52 persons were qualified to the study, divided into two equal groups – control and study with cancer in stage II N0 and in stage III N+ according to TNM classification. Inside the groups, subgroups of persons with normal body weight 18.5 ≤ BMI < 25 and obese and overweight persons with a BMI ≥ 25 were distinguished. Serum and saliva chemerin concentrations were determined by immunoenzymatic methods. RESULTS: The median concentrations of chemerin were significantly higher in the study group as compared to the control group both in serum (384.36 ng/ml vs. 170.53 ng/ml) and saliva (15.45 ng/ml vs. 4.57 ng/ml; p < 0.0001). In the subgroups with a BMI above and below 25, we found no significant differences in the concentrations of chemerin either group. There were no significant differences in the levels of chemerin in the serum or saliva between stage II and III stage of TNM (p = 0.82 and p = 0.52). CONCLUSIONS: The assessment of serum and saliva chemerin concentrations in patients with CRC suggests that chemerin may be a valuable biomarker for early diagnosis of CRC. The influence of BMI on the results seems to be insignificant in patients with CRC. It seems that in some cases an easily accepted saliva test can replace a serum one.

PL

WSTĘP: Chemeryna jest hormonem wydzielanym przez adipocyty. W ostatnim czasie zwraca się uwagę na jej właściwości prozapalne i związane z karcynogenezą. Celem pracy było zbadanie stężeń chemeryny w surowicy i ślinie osób zdrowych oraz chorych z rakiem jelita grubego (RJG) w II i III stopniu zawansowania według klasyfikacji TNM (tumor, node, metastasis), a także ocena związku uzyskanych wartości z otyłością oraz wybranymi parametrami kliniczno-patologicznymi. MATERIAŁ I METODY: Do badania zakwalifikowano 52 osoby, które podzielono na dwie równe grupy – kontrolną i badaną z nowotworem w II stopniu zaawansowania z cechą N0 oraz w III stopniu z cechą N+ według klasyfikacji TNM. Wewnątrz grup wyróżniono podgrupy osób o prawidłowej masie ciała (18,5 ≤ BMI < 25) oraz osoby otyłe i z nadwagą (BMI ≥ 25). Stężenia chemeryny w surowicy i ślinie oznaczano metodami immunoenzymatycznymi. WYNIKI: Mediany stężeń chemeryny były istotnie wyższe w grupie badanej w porównaniu z grupą kontrolną, zarówno w surowicy (384,36 ng/ml wobec 170,53 ng/ml), jak i ślinie (15,45 ng/ml wobec 4,57 ng/ml; p < 0,0001). W żadnej grupie w podgrupach z BMI powyżej i poniżej 25 nie znaleziono istotnych różnic w stężeniach badanej adipokininy. Nie odnotowano również istotnych różnic stężeń chemeryny w surowicy i ślinie między nowotworami w II i III stopniu zaawansowania TNM (p = 0,82 i p = 0,52). WNIOSKI: Ocena stężeń chemeryny w surowicy i ślinie u pacjentów z RJG sugeruje, że badana adipokina może być cennym biomarkerem wczesnej diagnostyki tego nowotworu. Wpływ BMI na uzyskane wyniki stężeń w surowicy i ślinie wydaje się nieistotny u chorych z RJG. Wydaje się, że w pewnych przypadkach łatwo akceptowane przez chorych badanie śliny może zastąpić badanie surowicy.

2

Primary Duodenal Carcinoma - Case Report

88%

Wesecki M., Niemiec S., Radziuk D., Waniczek D., Lorenc Z.

Polish Journal of Surgery

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2015

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vol. 86

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issue 11

540-543

EN

Duodenal carcinoma is a rare tumor of the gastrointestinal tract of an insidious and secretive course, often diagnosed during the advanced stage of the disease. The study presented a case of a female patient diagnosed with duodenal carcinoma, subjected to two-staged surgery. The initial surgical intervention consisted in the implementation of a gastrointestinal anastomosis, followed by radical surgery by means of Whipple's method performed after three years.

3

Calcifying Fibrous Tumor of the Small Bowel Mesentery in a 27-Year Old Male Patient - Case Report

88%

Wesecki M., Radziuk D., Niemiec S., Waniczek D., Lorenc Z.

Polish Journal of Surgery

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2015

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vol. 86

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issue 9

436-439

EN

Calcifying fibrous tumor is a rare disease entity, usually concerning the soft tissues of the limbs, neck, trunk, or scrotum. Cases of the above-mentioned pathology have also been reported considering the pleural and peritoneal cavity, and small bowel mesentery. The essence of the disease, whose etiology and pathogenesis remains unclear, is the fibrous tissue infiltration and diffuse inflammation with focal calcifications. The study presented a case of a 27-year old male patient subjected to surgical intervention, due to an abdominal cavity tumor. The tumor was radically removed, and its character and definitive diagnosis were established postoperatively. After a seven-year follow-up period, recurrence was not observed.

4

Łagodna symetryczna tłuszczakowatość – choroba metaboliczna o nieznanej etiologii

88%

Waniczek D., Kamińska E., Kamiński T., Pilch J., Nawrocki P.

Annales Academiae Medicae Silesiensis

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2012

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vol. 66

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issue 6

85-90

EN

Benign symmetrical lipomatosis (BSL) is known as Madelung’s disease or the Launois-Bensaude syndrome (LBS) and Multiple symmetrical lipomatosis (MSL) as well. It is a rare metabolic disorder, whose etiology remains unknown. The condition mainly aff ects 30–60 year-old people, 15–30 times more males than females. Typically BSL progression occurs during the period of a few months to a few years in patients who have or have had a history of alcohol abuse. The patient’s appearance is characterized by symmetrical, multiple, nonencapsulated masses of lipomata mainly around the head and neck but also in other regions excluding the face, forearms and legs. Neurological disturbances in the form of polyneuropathy in BSL are accompanied by hepatopathy, nephropathy, glucose intolerance or diabetes. The molecular genetic examinations of patients with BSL showed numerous deletions of mitochondrial DNA in muscle and tissue cells due to alcohol abuse as well. The diagnosis of BSL confi rms the unique appearence of the patients and anamnesis. No laboratory parameters specifi c to the condition exist. USG with biopsy, cross-sectional imaging with CT or MR imaging confi rm the diagnosis. The main indications for the treatment of BSL are shortness of breath, swallowing disorders, restriction of head and neck motion and aesthetic considerations. The standard treatment is surgical excision of the pathological tissues. The disease is progressive and relapses after removal are often observed.

PL

Łagodna symetryczna tłuszczakowatość (benign symmetrical lipomatosis – BSL) jest znana również pod nazwami: choroba Madelunga, zespół Launois- Bensaude (Launois-Bensaude syndrome – LBS) czy też liczna symetryczna tłuszczakowatość (multiple symmetrical lipomatosis – MSL). Jest to rzadka choroba metaboliczna o nieznanej etiologii. Najczęściej ujawnia się między 30. a 60. rokiem życia, rozwija się w okresie od kilku miesięcy do kilku lat, 15–30 razy częściej u mężczyzn niż u kobiet. Głównie dotyczy osób długotrwale nadużywających alkoholu. Chrakteryzuje się symetrycznym gromadzeniem nieotorebkowanych mas tłuszczakowych głównie w okolicy głowy i szyi, ale także w innych okolicach, z wyjątkiem przedramion, podudzi i twarzy. Obok zaburzeń neurologicznych o charakterze polineuropatii, w chorobie występują marskość stłuszczeniowa wątroby oraz uszkodzenie kanalików nerkowych, a także nietolerancja glukozy lub cukrzyca. Molekularne badania genetyczne chorych na BSL potwierdzają liczne delecje mitochondrialnego DNA w komórkach mięśniowych i tłuszczowych, które są także wywołane wpływem alkoholu. Rozpoznanie ustala się głównie na podstawie badania podmiotowego i przedmiotowego. Nie ma żadnego specyficznego parametru laboratoryjnego charakteryzującego BSL. Pomocnymi metodami diagnostycznymi są USG z możliwością BAC, TK oraz MRI. Głównymi wskazaniami do leczenia BSL są duszność, zaburzenia połykania, trudności w poruszaniu głową i szyją, względy estetyczne. Podstawową metodą leczenia jest chirurgiczne usunięcie patologicznych tkanek. Choroba ma charakter postępujący, po usunięciu tkanek często obserwuje się nawroty.

5

Adult cutaneous diphtheria in Poland – a case report and literature overview

88%

Fick J., Bichalska-Lach M., Bichalski B., Rudzki M., Waniczek D.

Annales Academiae Medicae Silesiensis

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2023

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issue 77

146-150

EN

Corynebacterium diphtheriae (C. diphtheriae) is the primary pathogen causing diphtheria, which basically exists in two forms: nasopharyngeal and cutaneous. According to a commonly introduced vaccination programme against diphtheria, pertussis and tetanus (DPT), the incidence of diphtheria has significantly dropped around the world, in some areas disappearing almost completely. However nowadays, we observe the reappearance of diphtheria, especially the cutaneous form, even in countries with very high vaccination rates due to the increasing migration from countries with a lower level of vaccinated citizens. We present a case study of a Ukrainian immigrant diagnosed with cutaneous diphtheria to raise the awareness of the medical community about this returning disease, its cutaneous form and new medical challenges connected to it. It has been the first reported case of C. diphtheriae infection in Poland since 2005. We analysed the most recent articles available in PubMed and Google Scholar databases using criterion keywords such as: “diphtheria case”, “diphtheria case report”, “cutaneous diphtheria”. We selected the most suitable out of approximately 1,700 articles. The presented case report and analysis of scientific publications on cutaneous diphtheria show the importance of this form of the disease in the modern, post-vaccination era. We claim that the importance of vaccination, self-protection during contact with patients, and awareness of the risks of the medical environment are becoming even more important.

PL

Corynebacterium diphtheriae (C. diphtheriae) jest pierwotnym patogenem wywołującym błonicę, która zasadniczo występuje w dwóch postaciach: nosowo-gardłowej i skórnej. W związku z powszechnymi szczepieniami przeciwko błonicy, krztuścowi i tężcowi (diphtheria, pertussis and tetanus – DPT) częstość występowania błonicy na świecie znacząco zmalała, na niektórych obszarach zanikając niemal całkowicie. W dzisiejszych czasach ponownie obserwujemy przypadki błonicy, zwłaszcza postaci skórnej, nawet w krajach z wysokim wskaźnikiem wyszczepienia, w związku z nasilającą się migracją z krajów o niższym odsetku zaszczepionych obywateli. Prezentujemy studium przypadku ukraińskiego imigranta ze zdiagnozowaną błonicą skóry, by zwiększyć świadomość środowiska medycznego o tej powracającej chorobie, jej postaci skórnej oraz związanych z tym nowych wyzwaniach. To pierwszy zaraportowany przypadek zakażenia C. diphtheriae w Polsce od 2005 r. Przeanalizowano najnowsze artykuły dostępne w bazach PubMed i Google Scholar, używając jako kryterium następujących słów kluczowych: „błonica przypadek”, „błonica opis przypadku”, „błonica skóry”. Wybrano artykuły o najwyższej korelacji z ponad 1700 wyników wyszukiwania. Opis przypadku i analiza publikacji naukowych na temat błonicy skóry pokazują znaczenie tej postaci choro-by w nowej, poszczepiennej erze. Twierdzimy, że szczepienia, stosowanie ochrony osobistej podczas kontaktu z pacjentem oraz świadomość środowiska medycznego dotycząca możliwych zagrożeń stają się jeszcze bardziej istotne.

6

Neovascularization in the Region of Saphenofemoral Junction Following Babcock Excision of Great Saphenous Vein

88%

Mikusek W., Waniczek D., Arendt J., Buda K., Rudzki M.

Polish Journal of Surgery

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2009

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vol. 81

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issue 9

383-391

EN

Recurrent varicose veins are an important problem in the surgical practice. They can be caused by neovascularization. New venous anastomoses, formed at the site of primary surgical intervention, can result in venous reflux and then recurrence of the disease.The aim of the study was to investigate whether there is a neovascularization at the site of saphenofemoral junction and if so, how common it is, in patients undergoing surgical treatment for varicose veins of the lower limbs.Material and methods. The study enrolled 60 patients: 43 women and 17 men. In all study subjects the region of saphenofemoral junctions was dissected, visualized collateral vessels and great saphenous vein were ligated and cut; the latter was dissected using Babcock method. Ultrasound imaging of the saphenofemoral junction was performed twice: 30 days and 6 months after the surgical procedure. We sough vessels that persisted after the primary procedure as well as vessels formed in the process of neovascularization.Results. Thirty days after the surgical procedure, we did not find any blood vessels in the study group that would suggest that the process of neovascularization took place. In 10 (16.7%) patients we found collaterals left in the region of saphenofemoral junction. Six months after the surgical procedure, small newly formed venules were found in 17 (28.3%) patients in the region of previous surgical intervention. Certain neovascularization was found in 12 (20%) patients and probable neovascularization in 5 (8.3%) of the study group.Conclusions. Six months after the surgical procedure small, tortuous veins appeared at the site of saphenofemoral junction. Their formation is inevitable and occurs irrespectively of completeness of the primary surgical procedure. Throughout six months of follow-up we did not find any evidence to support the assumption that neovascularization could be the cause of recurrent varicose veins.

7

PTEN – clinical significance in colorectal cancer

76%

Copija A., Waniczek D., Walkiewicz K., Głogowski Ł., Augustyniak H., Nowakowska-Zajdel E.

OncoReview

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2016

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vol. 6

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issue 2

A86-90

EN

Phosphatase and tensin homolog deleted on chromosome ten (PTEN) is a human suppressor gene. Its protein product is a bispecific phosphatase playing the complex role in the cell cycle regulating processes and apoptosis by the mechanism of signal transduction into the cell via tyrosine kinase B signaling pathway (PI3K/Akt/mTOR). Reduction or loss of PTEN function is implicated in the pathogenesis of many malignancies, including colorectal cancer. A gradual decrease in the function of PTEN in the sequence of transformations: normal tissue–polyp–adenocarcinoma – disseminated cancer was indicated. The relation between the PTEN loss and the higher clinical severity of colorectal cancer was observed, i.a. higher TNM status and higher tendency to form metastases, leading in some of the studies to shortened patients survival during the observation period. The potential predictive value of the PTEN function loss for the EGFR-targeted therapy in patients with advanced colorectal cancer is the subject of controversy. The potential application of PTEN assessment in clinical practice as a prognostic and/or predictive factor requires further well-designed prospective studies on larger patient population, using the unified methodology. The aim of the study is to summarize the current knowledge on the role of PTEN gene and PTEN protein in the pathogenesis of colorectal cancer and the role of PTEN in clinical practice.

8

Mikulicz’S Procedure with Levator Muscle and External Anal Sphincter Plasty in the Treatment of Rectal Prolapse

76%

Waniczek D., Copija A., Janiszewska J., Maruszczak P., Raźnikiewicz A., Arendt J.

Polish Journal of Surgery

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2012

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vol. 84

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issue 12

626-631

EN

Rectal prolapse is the partial or complete protrusion of the rectal wall into the anal canal. The most common etiology consists in the insufficiency of the diaphragm of the lesser pelvis and anal sphincter apparatus. Methods of surgical treatment involve perineal or abdominal approach surgical procedures. The aim of the study was to present the method of surgical rectal prolapse treatment, according to Mikulicz’s procedure by means of the perineal approach, based on our own experience and literature review. Material and methods. The study group comprised 16 patients, including 14 women and 2 men, aged between 38 and 82 years admitted to the department, due to rectal prolapse, during the period between 2000 and 2012. Nine female patients, aged between 68 and 82 years (mean age-76.3 years) with fullthickness rectal prolapse underwent surgery by means of Mikulicz’s method with levator muscle and external anal sphincter plasty. The most common comorbidities amongst patients operated by means of Mikulicz’s method included cardiovascular and metabolic diseases. Results. Mean hospitalization was 14.4 days (ranging between 12 and 17 days). Despite advanced age and poor general condition of the patients, complications during the perioperative period were not observed. Good early and late functional results were achieved. The degree of anal sphincter continence was determined 6-8 weeks after surgery showing significant improvement, as compared to results obtained prior to surgery. One case of recurrence consisting in mucosal prolapse was noted, being treated surgically by means of Whitehead’s method. Good treatment results were observed. Conclusion. Transperineal rectosigmoidectomy using Mikulicz’s method with levator muscle and external anal sphincter plasty seems to be an effective, minimally invasive and relatively safe procedure that does not require general anesthesia. It is recommended in case of patients with significant comorbidities and high surgical risk.

9

The “biological chamber” method – use of autologous platelet-rich plasma (PRP) in the treatment of poorly healing lower-leg ulcers of venous origin

76%

Waniczek D., Mikusek W., Kamiński T., Wesecki M., Lorenc Z., Cieślik-Bielecka A.

Polish Journal of Surgery

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2015

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vol. 87

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issue 6

283-289

EN

Wound healing is a complex pathophysiological process, in which platelets play a crucial role. Platelet alpha-granules release growth factors to the wound bed; the factors are necessary in the healing process. In chronic wounds, such as poorly healing lower-leg ulcers of venous origin, there is decreased activity of multiple growth factors, so the concept of exogenous delivery of such factors seems a logical strategy. Platelet-rich plasma therapy in patients with lower-leg ulcers of venous origin combined with conventional treatment methods (previously ineffective in these patients) seems, based on our observation, an important adjunct leading to recovery. The aim of the study was to present an original method of autologous platelet-rich plasma application through the creation of a sort of “biological chamber” containing a concentrate of growth factors. Material and methods. The described therapy was implemented in 10 patients, who had been ineffectively treated for more than one year in the outpatient setting. Patients with exacerbation of inflammatory process, signs of wound infection and ankle brachial pressure index < 0.8 were excluded from the study. After the application of platelet-rich plasma, further treatment was continued with the use of moist therapy and compression therapy according to a uniform regimen. Results. Complete healing was achieved within 4-10 weeks from the beginning of the product administration in all patients. Conclusion. The presented method seems technically simple, effective and relatively inexpensive

10

The Usefulness of Preoperative Doppler Ultrasonographic Evaluation of Saphenofemoral Complex For Improving Lower Limb Varicose Veins Surgery

76%

Mikusek W., Arendt J., Waniczek D., Rudzki M., Buda K., Orkisz W.

Polish Journal of Surgery

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2008

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vol. 80

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issue 11

594-603

EN

The aim of the study was to determine whether detailed preoperative Doppler ultrasonographic examination of saphenofemoral complex can improve the results of the lower limb varicose veins surgery.Two groups of patients (30 people each) were operated due to lower limbs primary varicose veins caused by saphenous vein insufficiency. All patients had a routine duplex examination performed. Group B had additional ultrasound examination before the operation to evaluate the number, diameter, and localization of the tributary vessels in the area of saphenofemoral junction. 30 days after the operation, in both groups control duplex examination was performed to evaluate the sparingness of the surgical procedure. The control ultrasonography showed 8 and 2 tributary vessels overlooked in groups A and B, respectively. The differences were statistically significant. The conformity of the preoperative ultrasound and the scene found during the operation in group B was 83.3%. The chance of overlooking peripheral vessels in group A increased 5.1 times.Preoperative Doppler ultrasound estimates localization of tributary vessels within the saphenofemoral junction, which makes detecting vessels during the operation much easier. It allows to minimize the number of technical mistakes and improve the lower limb varicose veins surgery results.

11

Giant cell tumor of tendon sheath in the pediatric population – review

76%

Kopcik K., Koberling A., Koper J., Bichalska-Lach M., Rudzki M., Waniczek D.

European Journal of Translational and Clinical Medicine

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2023

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vol. 6

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issue 1

64-69

EN

Giant cell tumor of tendon sheath is a rare and benign so-fttissue tumor, which is even less common in the pediatric population. It may be connected with chromosomal translocations, oeftn the 1p11-13. Symptoms include pain, swelling, palpable mass or limited range of motion. Magnetic resonance is the diagnostic method of choice. Histopathological image obtained from biopsy should be also evaluated. The gold standard of treatment is total surgical resection of the tumor, as incomplete excision may result in recurrence. Physicians should also consider the future function of the aefcted joint or limb. Our aim was to review the available literature about GCTTS in the pediatric population. Kopcik K, Koberling A, Koper J, Bichalska-Lach M, Rudzki M, Waniczek D. Giant cell tumor of tendon sheath in the pediatric population - review. Eur J Transl Clin Med. 2023;6(1):64-69.

12

Ocena znaczenia białka YKL-40 jako biomarkera w raku jelita grubego oraz jego powiązań z wybranymi parametrami kliniczno-patologicznymi

64%

Nadbrzeżna-Barczyk D., Waniczek D., Świętochowska E., Nowakowska-Zajdel E., Copija A., Raźnikiewicz A., Rykaczewska-Czerwińska M., Lorenc Z.

Annales Academiae Medicae Silesiensis

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2021

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issue 75

136-146

EN

INTRODUCTION: Colorectal cancer (CRC) is one of the most common cancers in the world, accounting for 10% of the annual global cancer incidence. This malignant neoplasm can remain asymptomatic for a long time and, despite medical advances, is too frequently diagnosed too late. The YKL-40 protein is a growth factor that stimulates endothelial cell migration, and plays a role in inflammation and neoplasia. The aim of the study was to assess the significance of YKL-40 as a biomarker in CRC and to determine the correlation between the serum YKL-40 levels in CRC patients and selected clinical and pathological parameters. MATERIAL AND METHODS: In a prospective study involving 133 patients over the age of 50, the serum YKL-40 protein level concentration was determined by the ELISA method. The patients were divided into two groups: 91 with CRC and 42 healthy. For the statistical analysis Student's t-test for independent data, the Mann-Whitney U test, and logistics regression were used. RESULTS: The YKL-40 serum concentration was significantly higher in the CRC patients (163 ± 36 μg/l) than the healthy patients (54 ± 20 μg/l; p < 0.0001). There was a statistically significant difference in the serum YKL-40 concentration between the early and intermediate stages of CRC. There was no correlation between the clinical parameters, i.e. sex, age and BMI and the serum YKL-40 protein concentration in the people with CRC. CONCLUSIONS: The YKL-40 protein seems to be a promising CRC biomarker. Its serum concentration is correlated with the stage of the cancer depending on the depth of the growth relative to the submucosa and may be a prognostic factor for an adverse prognosis of this cancer.

PL

WSTĘP: Rak jelita grubego (colorectal cancer – CRC) jest jednym z najczęstszych nowotworów na świecie – odpowiada za 10% rocznej globalnej zapadalności na raka. Przez długi czas może pozostać bezobjawowy i mimo postępu medycyny zbyt często zostaje zdiagnozowany za późno. Białko YKL-40 jest czynnikiem wzrostu stymulującym migrację komórek śródbłonka, odgrywającym rolę w stanach zapalnych oraz nowotworowych. Celem pracy była ocena znaczenia YKL-40 jako biomarkera w CRC oraz określenie powiązań stężeń YKL-40 w surowicy u chorych na CRC z wybranymi parametrami kliniczno-patologicznymi. MATERIAŁ I METODY: W badaniu prospektywnym, obejmującym 133 osoby powyżej 50 roku życia, oznaczono stężenie białka YKL-40 w surowicy metodą ELISA. Pacjentów podzielono na dwie grupy: 91 osób chorujących na CRC oraz 42 osoby zdrowe. W analizie statystycznej wykorzystano testy t-Studenta dla danych niezależnych, U Manna-Whitneya i regresję logistyczną. WYNIKI: Stężenie YKL-40 w surowicy było znacznie wyższe u chorych na CRC (163 ± 36 μg/l) niż u osób zdrowych (54 ± 20 μg/l; p < 0,0001). U osób z CRC nie wykazano zależności między parametrami klinicznymi, tj. płcią, wiekiem i wskaźnikiem masy ciała (body mass index – BMI), a stężeniem białka YKL-40 w surowicy. U chorych z CRC stężenie YKL-40 w surowicy statystycznie istotnie różniło się we wczesnym i średniozaawansowanym stadium nowotworowym. WNIOSKI: Białko YKL-40 wydaje się obiecującym biomarkerem CRC. Jego stężenie w surowicy jest skorelowane ze stopniem zaawansowania nowotworu zależnie od głębokości nacieku w stosunku do błony podśluzowej i może być czynnikiem rokowniczo niepomyślnym dla tego nowotworu.

13

Depth and rate of chest compression in CPR simulation during 10-minute continuous external cardiac compression

64%

Bucki B., Karpe J., Michnik R., Niczyporuk A., Makarska J., Waniczek D., Bieniek A., Misiołek H.

Annales Academiae Medicae Silesiensis

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2017

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vol. 71

1-6

EN

INTRODUCTION: External cardiac massage has been a basic CPR maneuver for years. The aim of the study was to assess the quality of chest compression during a real-time continuous cardiac compression simulation on a cardio-pulmonary resuscitation mannequin (considering medical rescuer experience and BMI). MATERIAL AND METHODS: This was a prospective study involving 17 medical rescuers, and 21 Medical Rescue stu-dents and university lecturers. During the simulation the participants performed continuous external cardiac compres-sion for 15 minutes or until the refusal to continue. The depth and rate were analyzed at 60-second periods, leading to average values of cardiopulmonary resuscitation effectiveness. The analysis covered complete research data gathered in real time (10 minute periods). RESULTS: The average compression depth significantly decreased from the first (40.66 SE ± 0.80 mm) to the fourth minute of the study (38.21 SE ± 0.95 mm). The average compression rate was significantly different between the initial values (120.97 SE ± 2.83/min) and the sixth minute of the study (123.69 SE ± 2.55/min). The average com-pression depth amounted to n 36.03 SE ± 1.22 mm in non-professionals and 40.06 SE ± 1.37 mm in professionally active participants. In the participants with a BMI > 25, the only differentiating point in time was the beginning of the task when the average compression depth was 41.97 SE ± 1.12 mm. In the participants with a BMI < 25, there was a gradual decrease in the compression depth within the initial four minutes of the task. CONCLUSION: Rescuer body mass is an important factor influencing proper chest compression depth during conti-nuous cardiac compression. Professional rescuers are capable of performing continuous cardiac compression longer than non-professionals, at the same time maintaining acceptable sternum deflection and compression rate.

PL

WSTĘP: Celem pracy była prospektywna ocena jakości kompresji klatki piersiowej podczas symulacji ciągłego masażu serca na manekinie w czasie rzeczywistym, wykonywanego przez czynnych zawodowo ratowników medycznych, z uwzględnieniem ich BMI. MATERIAŁ I METODA: Badanie przeprowadzono w grupie 17 ratowników medycznych oraz 21 studentów kierunku ratownictwo medyczne i wykładowców uczelni. Podczas próby każdy badany wykonywał nieprzerywany masaż ze-wnętrzny serca na manekinie do osiągnięcia punktu końcowego, jakim był czas 15 minut lub odmowa dalszego wy-konywania zadania. WYNIKI: Średnia głębokość wykonywanych uciśnięć zmniejszała się istotnie od pierwszej (40,66, SE ± 0,80 mm) do czwartej minuty badania, osiągając wartość 38,21 SE ± 0,95 mm. Średnia częstość uciśnięć klatki piersiowej istotnie różniła się od szóstej minuty (123,69 SE ± 2,55/min) w stosunku do wartości wyjściowych (120,97 SE ± 2,83/min). W dziesiątej minucie średnie wartości głębokości uciśnięć oraz częstości masażu klatki piersiowej osiągnęły odpo-wiednio 36,62 SE ± 1,04 mm oraz 128,06 SE ± 2,43/min. Istotnym czynnikiem wpływającym na głębokość kompresji klatki piersiowej była przynależność do grupy czynnych zawodowo ratowników medycznych. Średnia głębokość ucisku w całym badanym przedziale czasowym w grupie nie-profesjonalistów wynosiła 36,03 SE ± 1,22 mm, podczas gdy w grupie profesjonalistów – 40,06 SE ± 1,37 mm. Drugim istotnym czynnikiem różnicującymi zakres głębokości kompresji klatki piersiowej był czas oraz BMI ratow-nika. U osób z BMI > 25 jedynym różnicującym punktem czasowym był początek badania, w którym średnia głębo-kość ucisku wynosiła 41,97 SE ± 1,12 mm. WNIOSKI: Masa ciała ratownika jest istotnym czynnikiem wpływającym na uzyskanie głębszej kompresji klatki pier-siowej. Profesjonalni ratownicy są w stanie prowadzić skutecznie ciągłą kompresję klatki piersiowej w dłuższym czasie, osiągając zadowalające ugięcie oraz częstotliwość jej kompresji.

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