B a c k g r o u n d: Echocardiography is the first exam to establish the myocardial function in patients with takotsubo syndrome (TTS). However, ECG-Gated Myocardial Single-Photon Emission Tomography (G-SPECT) also allows to calculate left ventricular ejection fraction (LVEF) and can be useful in early stadium of TTS. A i m: To compare LVEF obtained from 99mTc-MIBI G-SPECT and echocardiography in patients with TTS. M a t e r i a l a n d M e t h o d s: Study population: 20 patients in medium age 77 (62–89) with TTS were included. In all patients 99mTc-MIBI G-SPECT and echocardiography was performed on the same day. R e s u l t s: LVEF measured by G-SPECT and echocardiography ranged from 34 to 83% and 38 to 69%, respectively. The LVEF values for ECHO were significantly lower than for SPECT. The correlation between the LVEF was r = 0.76. The calculated correlation coefficient (r) for linear regression analysis was 0.64. The following equation shows the approximate interdependence of both LVEF calculations: LVEF GSPECT = 10.35 + 0.93 * LVEF Echo. C o n c l u s i o n s: G-SPECT tends to overerestimate LVEF compared to echocardiography so these imaging techniques should not be used interchangeably. Calculated equation should be used for comparison of LVEF.
Developing the empathic attitude is one of the tasks of medical education as it aff ects the quality of therapeutic contact in the relationship between the doctor and the patient, conditioning the treatment process. According to Davis’s concept, empathy is defi ned as an aff ective-cognitive reaction in the context of the other person’s experience. Aim: Analysis of profi les of empathic sensitivity in students of medicine. Group: Male and female students of the fi ft h year of medicine who agreed to participate in an anonymous study (n = 153; M = 57, F = 96; mean age: 23 years). Tools: Th e Empathetic Sensitivity Scale (EES), which is the Polish tool for Davis’s Interpersonal Reactivity Index (IRI) was used. Th e ESS includes three sub-scales: Empathic Care (EC), Personal Distress (PD) and Adopting Perspective (AP). Results: The raw results were converted into sten scores and for sten scores for all three dimensions of empathetic sensitivity no diff erences were found between male and female students. Th ree clusters (1: n = 33%, 2: n = 39%, 3: n = 28%), which diff er in terms of each distinguished indicator, were identifi ed. Conclusions: Th e first cluster characterizes empathetic people, both in the aff ective and cognitive spheres, and those dealing well with unpleasant emotions in situations diffi cult to others. Th e second cluster characterizes participants with the ability to recognize the needs of others and to take into account their perspectives; the third cluster includes participants with a tendency to focus on their own experiences emerging in response to other people’s suff ering but with the ability to understand a situation and show empathic concern for the other person. The most favourable profi le — for a future doctor as well as for his patients — is the fi rst cluster because the doctor, with his empathic sensitivity directed towards the other man, can deal with his own unpleasant emotions.
Congestive heart failure (CHF) is the fi nal stage in several heart diseases. The diagnosis of CHF in older patients is a challenge. Preserved left ventricular systolic function is a characteristic type of CHF in seniors. The purpose of the study was to characterize elderly patients with CHF and to highlight specific features of the conditions in seniors. The most common etiology of HF in this group of patients is hypertension and coronary heart disease. In seniors atypical presentations of chronic heart failure is much more common than in younger patients. Malnutrition, limitations of exercise and sedentary lifestyles or comorbid diseases have an influence on asymptomatic, early stage of HF. Th ere are better outcomes of treatment in obese individuals. It is called the obesity paradox. Open communication with a patient and his/her family may improve their response to therapy. When heart failure becomes an incurable disease and aggressive treatment is ineffective, palliative care should be considered in end-of-life heart failure patients. The goal of treatment in the remaining moments of life last moments of life should be maximizing the patient’s comfort.
Ectopic pregnancy constitutes 2% of all pregnancies. In the last decades, due to the rising amount of caesarean sections, new localization of ectopic pregnancy has been observed — caesarean scar pregnancy (CSP). Cesarean scar pregnancy is an iatrogenic disease and a life-threatening condition which frequency will systematically rise. Because of possible serious complications, CSP should be swift ly diagnosed and treated. Th e purpose of this retrospective study was to demonstrate diff erent methods of CSP treatment performed between 2015–2018 in the Clinic of Endocrinological Gynaecology and Gynaecology Jagiellonian University Medical College in Cracow. Th e clinical characteristics, diagnosis, various methods of treatment and clinical outcomes were analysed. Defi nitive algorithm of CSP treatment is still not established. Pharmacological and operative methods are approved while expectant observation is considered unsafe due to possible risk of complications for the patient, including death.
Anatomy of the vascular system of the leg was studied using classical anatomical dissection methods. Based also on literature we have reviewed the current knowledge on the vascularization of the lower leg and its embryological background with special respect toward the posterior tibial artery and its branches.