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1
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Trudności w leczeniu zakażeń pooperacyjnych – opis przypadku

100%
Różalska M., Józefowicz-Korczyńska M.
Otolaryngologia Polska
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2008
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vol. 62(6)
776-778
PL
Postoperative wounds infections due to surgical intervention of laryngeal cancer are serious therapeutic problem. This process led to the necrosis of surrounding tissues and in consequence prolongs the wounds healing and cause longer hospitalisation, delay of vocal rehabilitation and cause chronic infl ammation of trachea and bronchi. We investigated a cause of patient after surgical intervention. Postoperative wound as well as upper respiratory tracts of this patient were colonized by methicillinresistant Staphylococcus aureus (MRSA). The following symptoms of in infl ammation were noticed: subfebrile condition, muscles and joints pain, excessive secretion of mucus in respiratory tracts and malaise. Patient was treated many times (repeatedly) with antibiotics and chemotherapeutics ambulatory and during hospitalisation. The susceptibility to antibiotics and chemotherapeutics to isolated MRSA strain was established. The effective therapy occurred using combine of rifampicin and co-trimoxasole. The patient status was radically improved. Patient after therapy was monitored microbiologically for a several month and in clinical material isolated from him did not found MRSA.
2
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Diffi culties in treating postoperative infections – case report

100%
Różalska M., Józefowicz-Korczyńska M.
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EN
Postoperative wounds infections due to surgical intervention of laryngeal cancer are serious therapeutic problem. This process led to the necrosis of surrounding tissues and in consequence prolongs the wounds healing and cause longer hospitalisation, delay of vocal rehabilitation and cause chronic infl ammation of trachea and bronchi. We investigated a cause of patient after surgical intervention. Postoperative wound as well as upper respiratory tracts of this patient were colonized by methicillinresistant Staphylococcus aureus (MRSA). The following symptoms of in infl ammation were noticed: subfebrile condition, muscles and joints pain, excessive secretion of mucus in respiratory tracts and malaise. Patient was treated many times (repeatedly) with antibiotics and chemotherapeutics ambulatory and during hospitalisation. The susceptibility to antibiotics and chemotherapeutics to isolated MRSA strain was established. The effective therapy occurred using combine of rifampicin and co-trimoxasole. The patient status was radically improved. Patient after therapy was monitored microbiologically for a several month and in clinical material isolated from him did not found MRSA.
3
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Kliniczne testy oceny stabilności równowagi i chodu – testy przyłóżkowe

81%
Józefowicz-Korczyńska M., Chmielecka-Rutkowska J., Mazerant A.
Polski Przegląd Otorynolaryngologiczny
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2016
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vol. 5(1)
57-63
PL
Ocena równowagi i  chodu jest ważnym elementem badania otoneurologicznego. W  artykule przedstawiono najważniejsze kliniczne „testy przyłóżkowe” stosowane u pacjentów w diagnostyce zaburzeń układu równowagi. Problemy ze stabilnością mogą pojawiać się zarówno w uszkodzeniu błędnika, jak i w dysfunkcji układu nerwowego, mięśniowego i wzrokowego. Badanie ruchomości gałek ocznych, w tym: zakres ruchów, stabilność fiksacji, obecności oczopląsu, test sakkadowy i śledzenia, wskazują na zaburzenia motoryki. Omówiono testy oceniające stabilność pacjenta podczas stania i funkcję móżdżku. Przedstawiono kryteria interpretacji zaburzeń w ocenie klinicznej. Opisano testy potrząsania głową oraz pchnięcia głowy, oceniające niestabilność układu przedsionkowego. Autorzy zwrócili uwagę na powiązanie wyników badania z uszkodzeniem błędnika i zaburzeniami ośrodkowego układu nerwowego. Przeanalizowano testy stosowane w diagnostyce łagodnych położeniowych zawrotów głowy oraz stosowane w ocenie chodu i zdolności pacjentów do samodzielnego poruszania się. W bardziej rozbudowanych i czasochłonnych testach – dynamicznym indeksie chodu i skali równowagi Berga – ocena dotyczy ilościowych aspektów sprawności chodu, a wyniki uzyskuje się na podstawie przyznawanych punktów w  różnych zadaniach, na przykład wykonywanie obrotu, przechodzenie nad przeszkodami i wokół nich. Wszystkie przedstawione testy są ważnym elementem badania klinicznego, dają pierwsze informacje o stanie pacjenta i pozwalają ukierunkować dalsze postępowanie diagnostyczne.
4
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Clinical tests for balance stability and gait assessment – bedside tests

81%
Józefowicz-Korczyńska M., Chmielecka-Rutkowska J., Mazerant A.
Polski Przegląd Otorynolaryngologiczny
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2016
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vol. 5(1)
57-63
EN
Balance and gait stability assessment is an important part of the otoneurological examination. We present the review of the clinical bedside tests procedures for diagnosis patients with balance disorders. Instability may occur not only in vestibular system dysfunction but in neurological, musculoskeletal and visual system lesions as well. An accurate clini-cal bedside ocular motor examination like, range of motion, stability of fixation, the presence of nystagmus, saccadic and smooth pursuit tests, give information about dynamic character of ocular motility. Tests of the balance system and cerebellum functioning were elaborated. Interpretations criteria for clinical bedside tests in different disease were pre-sented. Head shaking and head trust tests for vestibular system imbalance were described. Authors paid attention to the connection between examinations results and labyrinth or central nervous system disorders. Other tests are suggested to be used in benign paroxysmal positional vertigo diagnosis and ability to self-contained patients gait evaluation. There are some more complex and time-consuming tests like Dynamic Gait Index and Berg Balance Scale, measuring quanti-tative aspects of gait efficiency. The results are obtained based on points which are obtained in various tasks e.g. walking with pivot turn, stepping over and around obstacles. All of these tests are essential part of clinical examination and give preliminary information about patients functioning status and allow to focus on further diagnosis.The final results based on points which are obtained in various tasks e.g. walking with pivot turn, stepping over and around obstacles. All of these tests are essential part of clinical examination and give preliminary information about patients functioning status and allow to focus on further diagnosis.
5
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Rehabilitation in elderly patients with dizziness and balance unsteadiness

61%
Krajewski K., Rosiak O., Szczepanik M., Walak J., Woszczak M., Gawrońska A., Józefowicz-Korczyńska M.
Otolaryngologia Polska
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2018
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vol. 72(1)
5-10
EN
Introduction: In elderly patients the dizziness and balance disorders may be elicited by the central nervous system dysfunction on various levels, caused be aging process and the coexisting diseases. The aim of the study was to assess the efficiency of rehabilitation in elderly patients with dizziness and balance unsteadiness.Material and methods: Out of the 84 patients over 65 years, with central vestibular impairment diagnosed in videonystagmography VNG, 31 with dizziness and balance unsteadiness, were enrolled to the study. Otolaryngological examination, Tinetti test, Time and Go test (TUG) and Functional Reach (FR) tests were conducted in all patients. They were assessed twice before and after 2 weeks of vestibular rehabilitation (VR). Training sessions took place five times a week.Results: Statistically significant improvement in total DHI and 3 subscale were observed after therapy. As many as 70% of patients presented better outcome in the gait and stability tests - in Time and Go test (TUG) an average score of 15.3 seconds, in Tinetti test an average of 22 points (low chance to fall) and in the FR test 27 cm were observed.Conclusion: In elderly patients, vestibular rehabilitation is a method that significantly improves posture and gait stability. In ageing patients with dizziness and unsteadiness clinical, functional and objective tests could confirm diagnosis and monitor VR therapy.
6
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Expression of activation antigens on the lymphocytes T in patients with carcinoma of the larynx and connection with tumor features

61%
Starska K., Głowacka E., Łukomski M., Lewy-Trenda I., Józefowicz-Korczyńska M., Durko M., Lewkowicz P.
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EN
Introduction. Results of studies analyzing the role of immunocompetent cells in tumor environment and whole peripheral blood indicate their responsibility for aggressiveness of neoplasm, prognosis and therapeutic effect. Atcivation of lymhocytes T is connected with expression the markers (antigens) on their surface. The aim of this study was the analysis of activation antigens expression on lymphocytes T in patients with laryngeal carcinoma and the connection with clinicomorphological features. Material and methods. Analysis of activation antigens expression CD69, CD71 and CD25, CD26, HLA/DR on lymphocytes T CD4+ i CD8+ in 33 patients with squamous cell carcinoma of the larynx was performed. Flow cytometry-based analysis of activation antigens in T cell cultures with and without PHA stimulation was used. The connection of these molecules and clinicomorphological features was examined (pT, pN, G, Anneroth, Batsakis and Lunas’ classifi cation). Results. The signifi cant correlation between chosen markers of activation and tumor features were noted: pT with HLA/DR/CD4, CD69CD8, CD71CD8, pN with CD26CD8, G with CD25CD8, CD71CD8, ABL score with CD25CD4. Conclusion. Our data indicated the connetion of immunocompetent cell activity and spread of neoplasm in patients with laryngeal carcinoma.
7
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Rehabilitacja chorych w wieku podeszłym z zawrotami głowy i zaburzeniami równowagi

61%
Krajewski K., Rosiak O., Szczepanik M., Walak J., Woszczak M., Gawrońska A., Józefowicz-Korczyńska M.
|
PL
Wstęp: Zawroty głowy i zaburzenia równowagi w wieku podeszłym mogą być wywołane dysfunkcją ośrodkowego układu nerwowego na różnych poziomach, związaną zarówno procesem starzenia, jak i współistniejącymi chorobami ogólnoustrojowymi. Cel pracy: Ocena skuteczności rehabilitacji u pacjentów w wieku podeszłym z zawrotami głowy i zaburzeniami równowagi. Materiał i metody: Do badań włączono 31 osób z zawrotami głowy i zaburzeniami równowagi. Pacjentów wyłoniono z grupy 84 pacjentów w wieku powyżej 65. roku życia, u których rozpoznano uszkodzenie ośrodkowe w badaniu wideonystagmograficznym (VNG). U chorych przeprowadzono badanie otoneurologiczne z oceną równowagi i chodu wg skali Tinetti, test „Wstań i idź“ oraz test sięgania (FR). Badani wypełniali też kwestionariusz samooceny (DHI). Pacjentów badano dwukrotnie – na wstępie i po zakończeniu terapii. Sesje rehabilitacji przedsionkowej (VR) trwały 2 tygodnie, po 5 razy w tygodniu. Wyniki: Po terapii VR stwierdzono istotne statystycznie różnice w kwestionariuszu samooceny DHI w punktacji całkowitej jak i w 3 podskalach. U 70% pacjentów stwierdzono istotną poprawę w testach chodu i stabilności. W teście „Wstań i idź” średnio 15,3 sekund, w teście Tinetti średnio 22 punkty (mniejsze prawdopodobieństwo upadków), w teście sięgania 27 cm. Wnioski: U pacjentów w wieku podeszłym rehabilitacja przedsionkowa jest metodą znacznie poprawiającą stabilność postawy i chodu. U osób z zawrotami głowy i zaburzeniami równowagi w wieku podeszłym kliniczne badania funkcjonalne oraz dodatkowe mogą służyć nie tylko do potwierdzenia diagnozy, ale i do monitorowania postępów VR terapii.
8
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Ekspresja wybranych antygenów aktywacji na limfocytach T u chorych z rakiem krtani a cechy kliniczno-morfologiczne guza

61%
Starska K., Głowacka E., Łukomski M., Lewy-Trenda I., Józefowicz-Korczyńska M., Durko M., Lewkowicz P.
Otolaryngologia Polska
|
2008
|
vol. 62(6)
674-679
PL
Introduction. Results of studies analyzing the role of immunocompetent cells in tumor environment and whole peripheral blood indicate their responsibility for aggressiveness of neoplasm, prognosis and therapeutic effect. Atcivation of lymhocytes T is connected with expression the markers (antigens) on their surface. The aim of this study was the analysis of activation antigens expression on lymphocytes T in patients with laryngeal carcinoma and the connection with clinicomorphological features. Material and methods. Analysis of activation antigens expression CD69, CD71 and CD25, CD26, HLA/DR on lymphocytes T CD4+ i CD8+ in 33 patients with squamous cell carcinoma of the larynx was performed. Flow cytometry-based analysis of activation antigens in T cell cultures with and without PHA stimulation was used. The connection of these molecules and clinicomorphological features was examined (pT, pN, G, Anneroth, Batsakis and Lunas’ classifi cation). Results. The signifi cant correlation between chosen markers of activation and tumor features were noted: pT with HLA/DR/CD4, CD69CD8, CD71CD8, pN with CD26CD8, G with CD25CD8, CD71CD8, ABL score with CD25CD4. Conclusion. Our data indicated the connetion of immunocompetent cell activity and spread of neoplasm in patients with laryngeal carcinoma.
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