Background: Rectus abdominis diastasis (RAD) is an excessive divarication of the rectus abdominis muscle with concurrent stretching and thinning of the linea alba, which occurs due to mechanical and functional disturbances in the anterior abdominal wall and the whole body. The primary objective of this study is a palpation assessment of RAD in postpartum women before and after the application of KT tapes and a subsequent comparison of the results with those from a sham intervention group. Methods: A randomized clinical trial was conducted in the Physical Therapy Department at Wroclaw Medical University. The participants were randomly assigned to one of two groups: the KT group (intervention), in which KT tapes were applied (48 h intervention) and the sham KT group (control, sham intervention), in which non-stretch tapes were used (cloth surgical tape, 48 h intervention). In all participants, a palpation assessment of RAD was conducted and the inter-recti distance was measured using a digital caliper at three sites: at the umbilicus and 4.5 cm above and below it. Measurements were taken before and after the intervention. Results: The gathered results show a statistically significant reduction in rectus abdominis diastasis at each of the observed sites after the application of KT tapes in the intervention group (p < 0.05). In the intergroup comparison, a statistically significantly lower RAD (at umbilicus) was found after the intervention (p = 0.005) in KT group. Conclusions: the application of KT tapes using the corrective technique can contribute to reducing RAD in women up to 12 months after delivery.
Background: Patients with heart failure (HF) are at high risk of unfavorable courses of COVID-19. The aim of this study was to evaluate characteristics and outcomes of COVID-19 patients with HF. Methods: Data of patients hospitalized in a tertiary hospital in Poland between March 2020 and May 2021 with laboratory-confirmed COVID-19 were analyzed. The study population was divided into a HF group (patients with a history of HF) and a non-HF group. Results: Out of 2184 patients (65 ± 13 years old, 50% male), 12% had a history of HF. Patients from the HF group were older, more often males, had more comorbidities, more often dyspnea, pulmonary and peripheral congestion, inflammation, and end-organ damage biomarkers. HF patients had longer and more complicated hospital stay, with more frequent acute HF development as compared with non-HF. They had significantly higher mortality assessed in hospital (35% vs. 12%) at three (53% vs. 22%) and six months (72% vs. 47%). Of 76 (4%) patients who developed acute HF, 71% died during hospitalization, 79% at three, and 87% at six months. Conclusions: The history of HF identifies patients with COVID-19 who are at high risk of in-hospital complications and mortality up to six months of follow-up.
Pentraxin 3 (PTX3) plays a pathogenic role in experimental models of chronic liver injury and contributes to the progression of fibrosis. The detection of advanced fibrosis (METAVIR F≥3) is important to identify patients who are in urgent need of antiviral treatments versus those whose treatment could be deferred (F≥2). The aim was to assess the diagnostic value of PTX3 as a potential biomarker for clinically significant and advanced fibrosis. PTX3 associations with biochemical and histological parameters of inflammatory activity and fibrosis were investigated in 138 patients with chronic viral hepatitis C (HCV) before antiviral treatment. METAVIR histological scores of activity and fibrosis were obtained. PTX3 was measured by enzyme-linked immunosorbent assay. The diagnostic accuracy of serum PTX3 levels was compared to that of other fibrosis markers, including transforming growth factor‐ (TGF-), hyaluronic acid (HA), aspartate transaminase to platelet ratio index (APRI), fibrosis score based on four factors (FIB4), gamma-glutamyltranspeptidase to platelet ratio (GPR), and the liver stiffness measurement (LSM) by transient elastography (FibroScan®). In HCV patients the PTX3 level increased in parallel with the METAVIR histological score of activity, being independently associated with the METAVIR fibrosis score (P < 0.001). Using the receiver operating characteristics analysis, the best marker for detecting F≥2 and F≥3 was PTX3 with AUC = 0.802 and AUC = 0.867, respectively. The area under the curve of PTX3 for predicting significant fibrosis (F≥2) was significantly greater than those for the GPR ratio (AUC = 0.648) and FIB-4 score (AUC = 0.770) and similar to that for APRI index (AUC = 0.831). PTX3 provided clinically relevant diagnostic accuracy as a single marker of significant fibrosis.
Despite its enormous therapeutic potential, spa treatment is not always properly perceived, hence the numerous attempts to assess its effectiveness. In the world literature, there are few reports on therapy using sulphur- and radon-containing therapeutic waters. In countries with a long tradition of balneotherapy, activity in this field of medicine is evident. Undoubtedly, the interest in balneotherapy results also from natural resources used in spa medicine, which, as geological and balneochemical research shows, are enormous in Poland. A particular example of the occurrence of radon–sulphide waters, rare on the European scale, is the Przerzeczyn-Zdrój health resort. The mechanism of action of therapeutic waters is not fully explored, but their effectiveness in therapy is confirmed by many authors. It is believed to be an effect of combined action of many factors, the most important of which are thermal, mechanical, and chemical.
The coronavirus disease 2019 (COVID-19) shows high incidence of thromboembolic events in humans. In the present study, we aimed to evaluate if anticoagulation prior to COVID-19 infection may impact clinical profile, as well as mortality rate among patients hospitalized with COVID-19. The study was based on retrospective analysis of medical records of patients with laboratory confirmed SARS-CoV-2 infection. After propensity score matching (PSM), a group of 236 patients receiving any anticoagulant treatment prior to COVID-19 infection (AT group) was compared to 236 patients without previous anticoagulation (no AT group). In 180 days, the observation we noted comparable mortality rate in AT and no AT groups (38.5% vs. 41.1%, p = 0.51). Similarly, we did not observe any statistically significant differences in admission in the intensive care unit (14.1% vs. 9.6%, p = 0.20), intubation and mechanical ventilation (15.0% vs. 11.6%, p = 0.38), catecholamines usage (14.3% vs. 13.8%, p = 0.86), and bleeding rate (6.3% vs. 8.9%, p = 0.37) in both groups. Our results suggest that antithrombotic treatment prior to COVID-19 infection is unlikely to be protective for morbidity and mortality in patients hospitalized with COVID-19.
Introduction: The aim of the study was to evaluate chemerin levels as a potentially useful marker in diagnosing early-stage hepatocellular carcinoma (HCC) as well as in HCC staging.Material and methods: The cohort comprised 76 patients: 45 people with cirrhosis and HCC (including 13 with a single HCC lesion in the liver and 32 with metastatic lesions/spread of HCC in the liver) and 21 people with isolated cirrhosis. The control group included 10 clinically healthy people.Results: The degree of liver failure in the whole cohort was assessed using the Child-Turcotte-Pugh (CTP) score (class A – 34, class B – 28, class C – 4) and using the MELD score (≤ 12 points – 45 and > 12 points – 21 people). Serum chemerin level in patients with liver cirrhosis only was 53.30 ng/ml, in patients with a single HCC lesion 77.01 ng/ml, and in patients with disseminated HCC 83.58 ng/ml. In the control group, the chemerin level was 82.20 µg/ml. When patients with cirrhosis and with/without HCC were divided according to their CTP scores, the level of chemerin was as follows: class A – 83.90 µg/ml, class B – 61 µg/ml, class C – 30.10 µg/ml. For MELD scores ≤ and > 12 it was 75 µg/ml and 58 µg/ml, respectively. For BCLC staging the results were as follows: A – 20.10 µg/ml, B – 20.20 µg/ml, C –19.44 µg/ml.Conclusions: Chemerin increases with the number of neoplastic lesions and decreases with the progression of liver failure as assessed using the CTP score.