A case of ultrasound diagnosis of retroperitoneal lesion caused by unnoticed foreign body ingestion.

We report the case of a 52-year-old patient who was initially admitted to the District Hospital's Surgery Ward with strong abdominal pain. The patient's medical history before the hospitalization was unremarkable. The man did not recall any worrisome situations before the onset of pain. During the hospital stay, he underwent an ultrasound scan, computed tomography and magnetic resonance imaging evaluations, and laboratory tests suggesting that paraduodenal abscess or gastrointestinal stromal tumor should be considered. The patient was referred to the provincial hospital in order to undergo endoscopic ultrasonography. This was when a retroperitoneal foreign body, a toothpick, was found and removed.We report the case of a 52-year-old patient who was initially admitted to the District Hospital's Surgery Ward with strong abdominal pain. The patient's medical history before the hospitalization was unremarkable. The man did not recall any worrisome situations before the onset of pain. During the hospital stay, he underwent an ultrasound scan, computed tomography and magnetic resonance imaging evaluations, and laboratory tests suggesting that paraduodenal abscess or gastrointestinal stromal tumor should be considered. The patient was referred to the provincial hospital in order to undergo endoscopic ultrasonography. This was when a retroperitoneal foreign body, a toothpick, was found and removed.

Effects of coronary artery by-pass grafting on haemostatic factors.

BACKGROUND: Atherogenesis is triggered by functional or structural endothelial injury which leads to humoral and secretion alterations. The haemostatic system plays a significant role in the development of atherosclerosis and its complications, especially acute coronary syndromes. AIM: To assess the effects of coronary artery by-pass grafting (CABG) on some haemostatic factors in patients with stable coronary artery disease (CAD). METHODS: The study group consisted of 45 patients (11 females, 34 males, mean age 60.4+/-9.4 years, range 35-75 years). Endothelial function marker - von Willebrand factor (vWF), and thrombin generation parameters - thrombin-antithrombin complexes (TAT) and prothrombin fragments - F1+2 were measured before as well as 3 days, 7 days and 3 months after CABG. The control group consisted of 33 healthy volunteers (17 females, 16 males, mean age 48.8+/-17.2 years). RESULTS: Serum concentration of vWF as well as TAT and F1+2 levels were significantly higher in the CABG group than in controls. Compared with baseline values, the vWF levels were significantly higher 3 and 7 days after CABG. CONCLUSIONS: There is a hypercoagulability state in patients with CAD who undergo CABG. The use of extracorporeal circulation causes a significant increase in the vWF level which suggests a marked endothelial injury caused by CABG procedure.

[Health-related quality of life in the elderly after coronary artery bypass grafting]. / Zdrowotne wykladniki jakosci zycia osób starszych po zabiegach pomostowania tetnic wiencowych.

Despite of higher operative risk in the elderly, coronary artery bypass grafting (CABG) is more often performed in this age group to achieve the remission of the disease and to improve the quality of life. The aim of the study was to assess some subjective and objective health indices in the elderly two years after CABG (I group) in comparison to analogous group of older patients just waiting for CABG (II group). 109 patients aged 65 years and older, consecutively discharged from the Cardiac Surgery Department 2 years ago, were analyzed as well as 60 patients currently waiting for such surgery. Both groups of patients did not differ with demographic features. The health related quality of life was measured with the EASYCare questionnaire and similar one of own construction supplemented with some items of the WHOQol-BREF scale. Two years after CABG, 100 patients were available for the study (six persons died and three persons refused). Response rate was 92%. Significant reduction of symptoms of the coronary artery disease were shown. The chest pain was declared in 18% in I group vs 70% in II group; palpitation in 23% in I group vs 38% in II group and effort angina in 38% in I group vs 65% in II group. The positive evaluation of the health status was declared significantly more often in the patients of I group in comparison to patients in II group. CABG caused positive change concerning health-related quality of life in the elderly two years after surgery.

[Coronary artery bypass grafting in the elderly: early results]. / Pomostowanie tetnic wiencowych u chorych w wieku starszym--wczesne wyniki leczenia operacyjnego.

Indications for CABG (coronary artery bypass grafting) procedures are on the rise with ageing population. Because in the world literature there is not consensus on the elderly patients operative risk estimation we have conducted a retrospective analysis of 300 consecutive patients treated at Cardiac Surgery Department of Bialystok University Centre. The postoperative mortality and morbidity rates were assessed in an each case. 103 patients over 65 and 197 younger patients were included to the study. An operative risk was assessed according to EuroSCORE protocol and was higher in the elderly group. Strangely enough, this was not accompanied by higher mortality and morbidity rates, which were rather similar in the two groups. A female gender and an inclination to gastrointestinal bleeding were the independent risk factors in the elderly group. Probably diabetes mellitus is to be held for the higher mortality rate amongst them. In conclusion, the results of the presented investigation suggest that a biological and not a chronological age is essential in the qualification for CABG procedures.