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Recurrent laryngeal nerve paralysis represents a major complication in oesophageal cancer surgery. Nerve-muscle transplantation to the paraglottic space after resection of the recurrent laryngeal nerve with the ansa cervicalis (AC) has recently become the procedure of choice. The aim of this study was to investigate the anatomical variations of AC in order to avoid iatrogenic injuries and facilitate surgical procedures. We examined 100 adult human formalin-fixed cadavers. The ansa cervicalis showed a great degree of variation regarding origin and distribution. The origin of the superior root of AC was found to be superior to the digastric muscle in 92% of the cases. Its vertical descent was found to be superficial to the external carotid artery in 72% and superficial to the internal carotid artery in 28% of the specimens. The inferior root of AC was derived from the primary rami of C2 and C3 in 38%, from C2, C3 and C4 in 10%, from C3 in 40% and from C2 in 12% of the cases. The inferior root passed posterolaterally to the internal jugular vein in 74% and anteromedially in 26% of the cases. The roots of AC were long (70%) or short (30%), and the union between the two roots was situated inferior or superior to the omohyoid. Not only is knowledge of the anatomy of the ansa cervicalis important for nerve grafting procedures, but surgeons should be aware of AC and its relationships to the great vessels of the neck in order to avoid inadvertent injury during surgical procedures of the neck.
Infections with Campylobacter spp. occur as a result of consumption of live cells with food. In developing countries those infections are immensely common, particularly during early childhood and 5 to 10 cases can appear during the initial two years of life. The symptoms appear usually after 1-7 days from infection depending on the number of ingested cells and individual sensitivity. Characteristic symptoms of infections caused by Campylobacter spp. infrequently occurring jointly in the clinical form of the disease include: diarrhea, abdominal pain and increased temperature. In the majority of cases the disease is mild and lasts from 2 to 7 days. Usually Campylobacter are excreted with feces during a period of 7-21 days, sometimes even longer. Occasionally in the increased risk group dangerous complications may occur. They include: bacteremia, meningo-myelitis, neurological disturbances and reactive arthritis.
Lithium is a medicine of the first choice in the preventive treatment of bipolar affective disorder. It is also used to enhance the treatment of drug resistant depression. How excatly this element acts is not yet fully understood. Lithium influences the transportation of sodium via cellular membranes (sodium-potassium ATPase dependant), has an inhibitory influence on the second transmitter system (connected with phosphatidylinositol), thus probably acting as a stabiliser of inter cellular processes. Lithium does not associate with plasmatic proteins and is almost entirely excreted by kidneys. The side effects of the medicine are linked to its influence on the central nervous system and on the renal transportation of electrolytes as well as the narrow therapeutic index of the medicine, which can cause intoxication if the recommended doses are not when medical recommendations are not observed. The undesirable effects are more intensive when the level of lithium in the blood plasma increases. Among the most common side effects are stomachaches, nausea, diarrhoea, lack of appetite, polydipsia, polyuria, shaking hands, headaches, sleepiness or deterioration of memory. Complications during lithium therapy listed in literature are ataxia, dysarthria, nystagmus and extrapyramidal symptoms, but the most severe complication is lithium poisoning. Lithium can be applied for a long-term maintenance treatment, which limits recurrence of the disease and improves the patient’s family, social and occupational life. The inferior quality of life among patients with affective disease can result from the disorder itself or can develop on the somatic grounds, appear due to abuse of tobacco or alcohol, or else be a side effect of other medicines taken by the patient. Good co-operation with the patient during the therapy can lessen the pronouncement of undesirable symptoms and complications of a lithium treatment, and this in turn can improve of the quality of the patient’s life.
Breast cancer is one of the most common types of cancer among women. The most common form of treatment of this illness is a surgical intervention consisting of a partial or radical mastectomy. This article describes the psychological impacts of this experience on the frequency and occurrence of complications in the sexual activity of women and to determine the role that medical staff can play in helping patients cope with these challenges. The loss of a breast can have negative effects on a woman’s emotional state, specifically in terms of feeling feminine and the relationship with her partner. This is often reflected in a reduced quality of life. The care extended to post-mastectomy patients should routinely include an assessment of possible sexual dysfunctions and monitoring of how such dysfunctions are coped with. The PLISSIT model makes it possible to indicate how post-mastectomy patients may be effectively supported by medical staff. It serves to define a group of patients requiring specialist help. It also aims to initiate a conversation about the difficulties of functioning in this sphere, to provide general information and change existing perceptions, to give specific advice on making referrals to a specialist, and to consider these types of existing problems. The described intervention model is applicable to individual work, as well as to work with couples and groups. This method depends on the type of intervention desired and on the current psychophysical state of the patient and her readiness to start a conversation concerning sexual activity.
The aim of this study has been to determine the effects of hypertension on plasma lipid profile and the serum level of antioxidant vitamins in tobacco smokers. The study population comprised 62 smokers of whom 35 had hypertension (study group) and 27 were normotensive (control group). The levels of plasma lipids, albumins, uric acid, thiobarbituric acid reacting substances (TBARS) and vitamins A, E, C and ß-carotene were assayed. Cumulated index of antioxidant vitamins (CIAVIT) was also calculated. Total cholesterol (TC) (pO.OOl), LDL cholesterol (pO.OOl), uric acid (p<0.05), TBARS (p<0.05) and triglycerides levels were higher in hypertensive smokers compared to the control group. Hypertensive smokers also had lower HDL cholesterol and vitamin E levels (pO.Ol), as well as the levels of vitamins A, C and ß-carotene and the CIAVIT value. The study group exhibited negative correlation between TBARS and vitamins E levels (r=-0.46) and C (r=-0.33), and between TBARS and CIAVIT values (r=-0.34). The study results indicate that tobacco smoking exacerbates pre-existing lipid profile and antioxidant status abnormalities in hypertensive subjects.
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