bluuebunny/crossref_metadata_2025 huggingface dataset:
Updates on the knowledge of Arbuscular Mycorrhizal Fungi (Glomeromycotina) in the Atlantic Forest biome â–“ an example of very high species richness in the Brazilian landscape
Authors: Jobim Khadija , Vista Xochitl Margarito , Goto Bruno Tomio
Published: May 2018

Mycotaxon is pleased to add to our 'web-list' page the following new species distribution list under South America (Brazil): Updates on the knowledge of arbuscular mycorrhizal fungi (Glomeromycotina) in the Atlantic Forest biome—an example of very high species richness
in the Brazilian landscape by Khadija Jobim, Xochitl Margarito Vista, and Bruno Tomio Goto. This brings to 128 the number of free access mycobiotas now available on the re-named Mycotaxon website: http://www.mycotaxon.com/mycobiota
Earth Systems Thinking: Global Consumerism, Climate Change, and the Spiritual Value of the Earth
Authors: Bothun G. D.
Published: May 2018

In this paper we consider the root cause of climate change to be the industrial waste heat by product of increasing global consumption. The embodied energy associated with the conversion of Earth’s resources into consumer goods has largely been driven by fossil fuel based energy. Using available data, we show how a) the rate of annual CO2 emissions to the atmosphere is increasing, b) the land+sea temperature anomaly index is increasing, particularly the last 3 years, c) the rate of heat addition to the world’s oceans is also accelerating as this is in direct response to a globally increasing consumption per capita. In short, all of our human induced rates related to consumption are accelerating with increasingly severe consequences to the Earth system that maintains us. This is occurring amidst the reality that humans are in a necessary physical partnership with nature. Despite this, many human cultures have pursued dominance over the Earth’s resources. This dominance is asserted by the mechanical philosophy of Descartes. Under this world view, the Earth is just a (soul-less) machine and man is distinct from nature and therefore entitled to dominate it; the Earth has no spiritual value. So this gives us license to dig up the planet to create the escalating distribution of products to global consumers and this is exactly what can be verified from the data. We refer to this as the business as usual trajectory. To correct this course trajectory, we propose two avenues: a) extend the concept and legality of the Public Trust Doctrine to all of Nature’s resources so that current generations have an obligation to ensure the future generations can same similar access to these resources, b) adopt a systems thinking approach that prioritizes human equity, dignity, environmental justice and environmental health over escalating global GDP. In short, global justice should be our priority, not global profit. From the systems thinking viewpoint, the Earth is not a market commodity subject to resource exhaustion, it is rather a sacred equilibrium system for the welfare of all.
Reconsidering Modernist Totality
Authors: DiGiacomo Mark
Published: May 2018

This review essay considers differing approaches to questions of totality in two recent volumes on modernism: Daniel Albright's Putting Modernism Together1 and Behind the Masks of Modernism,2 a collection edited by Andrew Reynolds and Bonnie Roos. Both volumes reexamine the history of modernist aesthetic production in a global and interdisciplinary context. Albright identifies a totalizing modernist aesthetic project across the arts, within a largely European framework. The contributors to Behind the Masks of Modernism, meanwhile, take a pluralizing approach to modernism(s), with substantial emphasis on the Global South.
Análisis comparativo de las últimas Reformas Fiscales operadas en España y en Honduras
Authors: Luque Cortella Ana , Mories Jiménez María Teresa
Published: May 2018

El presente artículo tiene por objeto: por un lado, analizar la última reforma fiscal operada en España, con especial atención a las modificaciones introducidas por la Ley 34/2015, de 21 de septiembre, de modificación parcial de la Ley 58/2003, de 17 de diciembre, General tributaria3; y por otro, realizar un resumen comparativo con la llevada a cabo en Honduras tras la reciente aprobación del Código Tributario. Se pretende con ello extraer algunas conclusiones que puedan contribuir a la configuración de un sistema tributario más justo y equitativo que permita, a la par, una recaudación más eficiente, pero sin que ello redunde en una merma de la seguridad jurídica y de los derechos y garantías que deben asistir a los con­tribuyentes en el marco de la relación jurídico-tributaria.  3 B.O.E. núm. 302, de 18 de diciembre de 2003.
La unificación de la Jurisprudencia en materia Civil y contencioso Administrativo del sistema jurídico hondureño
Authors: Gutiérrez Sánchez Jacobo
Published: May 2018

El nuevo Código Procesal Civil de Honduras introdujo significativos avances; sin embargo, por un lado, desapareció como causal de casación la infracción a la doctrina legal y, por otro, manifiesta que la casación tiene como fin la unificación de la jurisprudencia nacional, generando la pregunta de cómo se puede unificar la jurisprudencia sin existir doctrina legal. Esta reforma no solo perjudica la unificación de la jurisprudencia civil, sino también la jurisprudencia contenciosa administrativa, ya que se le aplica supletoriamente el Código Procesal Civil en lo relacionado al recurso de casación. En vista de lo anterior, el Congreso Nacional debe realizar una reforma al artículo 716, numeral 2) del Código Procesal Civil, añadiendo que se puede interponer el recurso de casación “por infracción de doctrina legal en la parte dispositiva de la sentencia”. De esta manera, sería posible unificar la jurisprudencia en la materia civil y, consecuentemente, en la materia contencioso-administrativa.Todos los autores están de acuerdo en que el tema de las “fuentes del Derecho” pertenece a la Teoría General del Derecho (Orellana, 2013); sin embargo, dichos autores, logrado establecer una diferencia sustancial entre las distintas fuentes del derecho. El vocablo “fuente” deriva del latín “fono, frontis, fundo”, que significa “provenir, derramar”. Así, desde el punto de visto etimológico, se indaga “de dónde emerge o surge el derecho” (Ricardo, 2015).
ESTUDO COMPARATIVO DE BIÓGAS PRODUZIDO COM DOIS TIPOS DE RESÍDUOS ANIMAIS
Authors: Costa Pereira Lucimar , Viana Balbino Maycon , Saraiva Viana Lorena , Do Socorro Nascimento Farias Nayara , Da Rocha Xavier Maria Renata , Queiroz Ramos Wellington , De Castro José Antonio
Published: May 2018

O presente trabalho objetivou verificar a quantidade e a qualidade do biogás produzido por dois biodigestores do tipo batelada, abastecidos com esterco caprino e cama avícola e analisar qual das biomassas residuais apresenta melhores vantagens (volume produzido e qualidade do gás gerado) quando submetidos a processo de biodigestão anaeróbia. Foram construídos dois biodigestores do tipo batelada, denominados B1 e B2. O primeiro foi abastecido com esterco caprino e o segundo com cama avícola. Ambos foram diluídos em água, em uma proporção de 1:1 e contaram com a adição de inóculo de esterco bovino. Os biodigestores permaneceram vedados em temperatura ambiente por seis semanas. As análises foram iniciadas uma semana após o abastecimento dos mesmos. Para quantificação de volume de biogás foram utilizados sacos plásticos de 2000 ml, 1000 ml e 500 ml. Para análises de concentração, foi usado o kit portátil para análise de biogás, proveniente da empresa Alfakit. B2 produziu maior volume de biogás em comparação a B1. As maiores concentrações de NH3 e H2S foram analisadas em B1, porém este apresentou durante todos os dias de análise maiores concentrações de CH4. O uso de um dos tipos de matéria orgânica utilizados neste trabalho para produção de biogás depende dos objetivos da produção. Em caso de busca por qualidade energética imediata, o esterco caprino (com uso de inóculo bovino) torna-se uma excelente alternativa. Entretanto, se a busca por qualidade energética não é imediata, a cama avícola apresenta-se como excelente opção a partir da terceira semana de biodigestão.
Transesterificação direta com diferentes solventes da microalga Chlorella vulgaris produzida em efluente doméstico
Authors: Trevisan Elias , Zandonadi Ferriani Branco Kemely Bruna , Arroyo Pedro Augusto
Published: May 2018

Para a produção de ésteres a partir de microalgas, uma das possibilidades é a utilização da transesterificação direta, metodologia que possibilita reduzir o número de operações no processamento de biocombustíveis. Desse modo, a transesterificação direta da biomassa apresentou diferenças quanto à adequação do hexano e clorofórmio para auxiliar na extração dos lipídeos durante a reação. Dessa forma o hexano possui um desempenho melhor do que o clorofórmio para temperatura de 75 e 90 °C, sendo que o melhor rendimento foi obtido pelo hexano com um tempo de 150 minutos a 90 °C alcançando um rendimento de 137,75 mgésteres gbiomassa-1. Enquanto que o clorofórmio alcançou o seu máximo rendimento com 75,40 mgésteres gbiomassa-1 com 60 minutos com temperaturas de 75 °C, entretanto ainda inferior ao hexano que neste ponto estava apresentando 91,25 mgésteres gbiomassa-1. A produção de ácidos graxos insaturados são os que possuem uma maior porcentagem dentro as reações avaliadas, sendo estas características promovem um ganho nas propriedades de ponto de entupimento do filtro a frio. Além disso o hexano promove um espécie de proteção na produção de ácido graxos poliinsaturados possivelmente pela menor oxidação dos mesmos.
Cluster Analysis for the Questionnaire Investigation on the Needs at Fuji City
Authors: Higuchi Yuki , Okubo Akane , Suzuki Daisuke , Takeyasu Kazuhiro
Published: May 2018

Shopping streets at local city in Japan became old and are generally declining. In this paper, we handle the area rebirth and/or regional revitalization of shopping street. We focus on Fuji city in Japan. Four big festivals are held at Fuji city (two for Fuji Shopping Street Town and two for Yoshiwara Shopping Street Town). Many people visit these festivals including residents in that area. Therefore a questionnaire investigation to the residents and visitors is conducted during these periods in order to clarify residents and visitors’ needs for the shopping street, and utilize them to the plan building of the area rebirth and/or regional revitalization of shopping street. These are analyzed by using Cluster Analysis and Multiple Regression Analysis. These are utilized for constructing a much more effective and useful plan building. We have obtained fruitful results. To confirm the findings by utilizing the new consecutive visiting records would be the works to be investigated.
Definición de infraestructuras verdes: una propuesta metodológica integrada mediante análisis espacial
Authors: Aguilera Benavente Francisco , Rodríguez Espinosa Víctor Manuel , Gómez Delgado Montserrat
Published: May 2018

El concepto de Infraestructura Verde (IV) ha comenzado a ocupar un lugar destacado en la planificación ambiental desde finales del siglo XX. Con un carácter eminentemente espacial, se plantea la necesidad de buscar procedimientos que permitan, de alguna forma, concretar estas infraestructuras a partir de la evaluación y cartografiado de las dimensiones que la integran. En el presente trabajo se propone una metodología de análisis espacial (mediante Sistemas de Información Geográfica) que pretende ayudar a concretar su delimitación y cartografía a partir del análisis en cada punto del territorio de cuatro dimensiones asociadas a la IV: la contribución a los servicios ecosistémicos de diversos elementos territoriales, la conectividad ecológica, la accesibilidad o permeabilidad a la población y el valor ecológico. A pesar de las limitaciones, se trata de una propuesta suficientemente concreta, pero a la vez abierta, y aplicable en cualquier área de estudio, lo que podría facilitar la implementación de IV al proceso de planificación en España.
Cerdà, Paco (2017). Los últimos, voces de la Laponia española
Authors: Pérez Platero Carlos
Published: May 2018

Cerdà, Paco (2017)Los últimos, voces de la Laponia españolaLogroño: Editorial Pepitas, 163 p.ISBN 978-84-15862-76-5
Wiest, Karin (ed.) (2016). Women and Migration in Rural Europe. Labour Markets, Representations and Policies
Authors: Solé Aimada
Published: May 2018

Wiest, Karin (ed.) (2016)Women and Migration in Rural Europe. Labour Markets, Representations and PoliciesNova York: Palgrave Macmillan, 257 p.ISBN 978-1-137-48304-1
Efficacy of camera sleeve in conveyance of conduits
Authors: Bharathi R Saranga
Published: May 2018

Background: Esophageal substitutes need conveyance from the abdomen into the neck for restoration of alimentary continuity. Reports suggest that the use of plastic camera sleeve may prove advantageous in restoring conveyance. This study aims to evaluate the practicability of this approach, specifically, in laparoscopy-assisted surgeries. Methods: The efficacy of camera sleeve in conduit transposition was prospectively evaluated over 2 years. The following parameters were assessed: success/failure; time taken; blood loss; adequacy of length of the conduit delivered into the neck; conduit orientation; ease of procedure through different routes; conduit damage; complications; and drawbacks. Results: The technique was used in 25 consecutive patients. Two ileo-colonic, 13 gastric, and 10 colonic conduits were transposed. Posterior mediastinal, retro-sternal, and ante-sternal routes were used in 15, 8, and 2 cases, respectively. There were no failures. The technique was easy to adopt. It added < 10 minutes to the procedure. It entailed no additional blood loss. Adequate length of the conduit was transposed into the neck, atraumatically. Conduits maintained their orientation without effort. Although no complications per se were associated with its use, extra conduit length became transposed into the neck, twice, necessitating its trimming/adjustment. In one case, traction suture became avulsed from the conduit, midway in the tunnel. This could easily be rectified by pulling out the sleeve from the neck, which brought up the conduit along with it, as desired. Conclusions: Use of camera sleeve proves efficacious in interposition of esophageal substitutes.
The influence of rifaximin on diverticulitis rate and quality of life in patients with diverticulosis
Authors: Banasiewicz Tomasz , Francuzik Wojciech , Bobkiewicz Adam , Krokowicz Łukasz , Borejsza-Wysocki Maciej , Paszkowski Jacek , Studniarek Adam , Krokowicz Piotr , Grochowalski Marcin , Zastawna Kinga , Szczepkowski Marek , Lorenc Zbigniew , Drews Michał
Published: May 2018

Diverticulosis, its associated symptoms and complications are one of the most common pathologies of the gastrointestinal tract in more economically developed countries. Presence of diverticuli and their clinical consequences can be divided into four categories: 1) diverticulosis, i.e. an asymptomatic presence of diverticuli that are usually found by accident 2) symptomatic uncomplicated diverticulosis 3) diverticulitis (acute uncomplicated diverticulitis) 4) complications of diverticulitis (conditions requiring hospital stay). The aim of this study was to retrospectively analyze the efficacy of rifaximin in preventing diverticulitis in patients visiting proctology clinics. The diagnostic criterium for diverticulosis was confirmation by colonoscopy, barium enema or CT colography (virtual colonoscopy) as well as history of at least one documented episode of diverticulosis. History of diverticulosis was evaluated based on medical records, clinical symptoms, elevated level of CRP (>5.0) and/or diagnostic imaging (ultrasound, CT). After setting strict exclusion criteria, 248 patients were qualified for the study out of 686, and they were later divided into two groups: control group (group I – 145 patients) and studied group (group II – 103 patients receiving rifaximin prophylaxis). Diverticulitis rate was comparable in both groups over a period of 6 months before study (p = 0.1306) and 6 months of treatment (p=0.3044). Between the 6th and 12th month of treatment, a significantly lower rate of diverticulitis was noted in the group receiving rifaximin compared to control group (p<0.0001). Patients receiving rifaximin reported higher quality of life (which was assessed using the VAS scale) compared to control group after 12 months. The results confirmed the efficacy of riaximin in prevention of diverticulitis, even in the scheme of repeated courses every 3 months. Not only did application of rifaximin lower the rate of diverticulitis and its complications in patients after an episode of diverticulitis, but also it improved the patients’ quality of life. It seems that diverticulitis prophylaxis based on rifaximin can be economically efficient, however, it requires further research.
Analysis of factors affecting the development of hypocalcaemia after multinodular goitre surgery
Authors: Papaj Piotr , Kozieł Sławomir , Mrowiec Sławomir
Published: May 2018

Introduction: Thyroidectomy is a common surgery performed especially in treatment of multinodular goitre. The most common post-thyroidectomy complication is a postoperative hypocalcaemia, and the percentage of postoperative hypoparathyroidism could reach even 50%. Tested group and methods: A forward-looking, randomized testing was done on a group of 113 women being subject to multinodular goitre surgery. In this article, we wish to present an analysis of the results obtained in the control group, focusing on the predicative factors which determine the development of postoperative hypocalcaemia. Obtained results: The rate of postoperative biochemical hypocalcaemia development was significantly higher in the group of patients, where the preoperative calcium concentration was lower than 2,4 mmol/l. In that group, the development of biochemical hypocalcaemia was observed in 93,7% of cases (30 out of 32 patients), in comparison with 65,3% (17 out of 26) in the group of higher preoperative concentration of calcium. The highest risk of occurrence of postoperative hypocalcaemia was borne by the total thyroidectomy, while the lowest one by the subtotal thyroid lobectomy of one lobe only. Conclusions: A higher preoperative concentration of calcium in blood serum is related to the lower rate of occurrence of postoperative biochemical hypocalcaemia. However, no such correlation was revealed in the case of postoperative symptomatic hypocalcaemia. Lack of correlation was determined between the preoperative concentration of TSH and FT4 in blood serum and the rate of occurrence of postoperative hypocalcaemia, both symptomatic and asymptomatic. The performed statistics did not reveal a relation between the postoperative hypocalcaemia and the duration of the surgery, but a significant correlation was stated with the scope of the performed surgery. Revealing a relation between the rate of occurrence of postoperative hypocalcaemia and the experience of the surgeon performing the surgery was not successful.
Safe and uncomplicated inguinal hernia surgery in the elderly – message from anesthesiologists to general surgeons
Authors: Chlebny Tomasz , Zelga Piotr , Pryt Mateusz , Zelga Marta , Dziki Adam
Published: May 2018

Introduction Elderly patients are often discouraged from surgery due to the risk of complications that increases with age. Aim We wanted to assess mortality, morbidity, and complications in patients older than 75 years who underwent elective or emergency inguinal hernia repair in a single center. Methods All patients older than 75 years who were operated on because of inguinal hernia in the Department of General and Colorectal Surgery, Medical University of Lodz between 2003 and 2015 were analyzed. Detailed information was collected with regard to patient demographics, mode of admission, comorbidities, type of intervention, applied anesthesia, and 30-day outcomes. Postoperative outcomes included medical and surgical complications, readmissions, and survival status. Results One hundred thirty-two patients older than 75 years were operated on for inguinal hernia, 16 (12.1%) in an emergency setting and 116 (87.9%) in an elective setting. Eighteen patients (13.6%) developed complications, 8 (50%) in the emergency group, and 10 (8.6%) in the elective group. In the emergency group, severe medical complications (Clavien-Dindo 4) were frequent, whereas in the elective group, severity of surgical and medical complications was not significantly different (Clavien-Dindo median score 2, p=0.6084), and these complications were classified as mild (Clavien-Dindo 1-2). One death occurred in the emergency group. Conclusion Inguinal hernia surgery in the elderly may be safe and effective in an elective setting and if regional anesthesia is used. Careful examination of patients before surgery and identification of potential risk factors associated with co-existing diseases are vital for reducing the risk of complications. Key point: Hernia surgery in patients older than 65 years is a low-risk intervention, if carried out in an elective setting.
Intramural gastric hematoma imitating a gastrointestinal stromal tumor – case report and literature review
Authors: Spychała Arkadiusz , Nowaczyk Piotr , Budnicka Aleksandra , Antoniewicz Ewa , Murawa Dawid
Published: May 2018

The article presents a case report of a patient with an intramural gastric hematoma. Diagnostic examinations were suggestive of a suspected gastrointestinal stromal tumor Normal image was observed in gastroscopic examination while abdominal CT scan revealed a nodular lesion along the greater curvature of the stomach extending from the posterior wall and adjoining the pancreas and the spleen. The patient was qualified for surgical treatment. Laparotomy was performed followed by total gastric resection and Roux-en-Y reconstruction of the gastrointestinal tract. Post-operative histopathological examination revealed the presence of an extensive hematoma penetrating the perigastric fat tissue along with numerous hemosiderinophages and segmental indicators of formation of inflammatory granulation tissue suggestive of a chronic nature of the lesion. Immunohistochemical GIST assays (CD117, DOG-1, CD34, CD31, SMA, S-100, CKAE1/AE3, Ki-67) were negative. No complications were observed in the post-operative course. Patient is subject to continued follow-up and observation. Follow-up gastroscopy and abdominal CT scan performed 6 months after the surgery revealed an unremarkable image.
Intraoperative neuromonitoring of hypogastric plexus branches during surgery for rectal cancer – preliminary report
Authors: Wałęga Piotr , Romaniszyn Michał , Wałęga Maciej , Szymon Świrta Jarosław , Nowak Wojciech
Published: May 2018

Aim: The aim of this study was to present our preliminary experience with intraoperative neuromonitoring during rectal resection. Materials and methods: We qualified 4 patients (2 women, 2 men; age 42 – 53 years) with rectal cancer for surgery with intraoperative neuromonitoring. In all patients, functional tests of the anorectal area were performed before surgery. Action potentials from the sphincter complex in response to nerve fiber stimulation were recorded with electrodes implanted before surgery. Moreover, we inserted a standard, 18FR Foley’s urinary catheter to which a T-tube was connected to allow urine outflow and measurement of pressure changes in the bladder induced by detrusor contractions during stimulation. Results: Setting up neuromonitoring prolonged surgery time by 30 to 40 minutes, or even by 60 to 80 minutes in the case of the first two patients. Neuromonitoring itself took additional 20 to 30 minutes during surgery. In all patients, we stimulated branches of the inferior hypogastric plexus in their anatomical position during dissection. In three patients, we evoked responses both from the bladder and the sphincter in all planes of stimulation. In one patient, there was no response from the left side of the bladder, and in the same patient, we observed symptoms of neurogenic bladder. Conclusions: Based on the available literature and our own experience, we state that monitoring of bladder pressure and electromyographic signals from rectal sphincters enables visualization and preservation of autonomic nervous system structures, both sympathetic and parasympathetic. Intraoperative signals seem to be correlated with clinical presentation and functional examinations after surgery. In order to objectify our results, it is necessary to perform functional examinations before and after surgery in a larger group of patients.
Surrogate and clinical endpoints for studies in peripheral artery occlusive disease: Are statistics the brakes?
Authors: Waliszewski Matthias W. , Redlich Ulf , Breul Victor , Tautenhahn Jörg
Published: May 2018

Background: The aim of this review is to present the available clinical and surrogate endpoints that may be used in future studies performed in patients with peripheral artery occlusive disease (PAOD). Importantly, we describe statistical limitations of the most commonly used endpoints and offer some guidance with respect to study design for a given sample size. The proposed endpoints may be used in studies using surgical or interventional revascularization and/or drug treatments. Methods: Considering recently published study endpoints and designs, the usefulness of these endpoints for reimbursement is evaluated. Based on these potential study endpoints and patient sample size estimates with different non-inferiority or tests for difference hypotheses, a rating relative to their corresponding reimbursement values is attempted. Results: As regards the benefit for the patients and for the payers, walking distance and the ankle brachial index (ABI) are the most feasible endpoints in a relatively small study samples given that other non-vascular impact factors can be controlled. Angiographic endpoints such as minimal lumen diameter (MLD) do not seem useful from a reimbursement standpoint despite their intuitiveness. Other surrogate endpoints, such as transcutaneous oxygen tension measurements, have yet to be established as useful endpoints in reasonably sized studies with patients with critical limb ischemia (CLI). Conclusions: From a reimbursement standpoint, WD and ABI are effective endpoints for a moderate study sample size given that non-vascular confounding factors can be controlled.
Clinical and microbiological aspects of the use of Lactobacillus rhamnosus PL1 strains in proctological patients with symptoms of chronic proctitis
Authors: Borycka-Kiciak K. , Strus M. , Pietrzak P. , Wawiernia K. , Mikołajczyk D. , Gałęcka M. , Heczko P. , Tarnowski W.
Published: May 2018

Recurrent proctitis and the symptoms associated therewith pose significant clinical problem in proctological patients. The objective of this study was to assess the impact of the probiotic Lactobacillus rhamnosus PL1 strain on the clinical presentation and composition of intestinal microbiota in patients with symptoms of proctitis in the course of hemorrhoidal disease and diverticulosis. Material consisted of 24 patients in whom no complete clinical improvement could be obtained after the treatment of the underlying disease. Subject to the assessment was the presence and the intensity of clinical symptoms as well as qualitative and quantitative changes in the composition of bacterial flora detected in the stool before, during and after a 9-week supplementation with the probiotic Lactobacillus rhamnosus PL1 strain. Results: In the entire study group, the intensity of pain after 12 weeks was significantly lower (p=0,.011) compared to baseline; the intensity of flatulence and abdominal discomfort was reduced significantly as early as after 3 weeks, with the difference reaching a highly significant level after 12 weeks (pP<0,.0001). No significant difference was observed in the frequency of the reported episodes of diarrhea, constipation, as well as itching and burning in the anal region. As early as after 3 weeks of supplementation with the probiotic L. rhamnosus PL1 strain, significant qualitative and quantitative changes were observed in the composition of intestinal microbiota; the changes differed depending on the underlying disease. An increase in the total counts of the bacteria of Lactobacillus genus, particularly L. rhamnosus PL1 strain was observed regardless of the underlying disease. Conclusion: Tthe probiotic Lactobacillus rhamnosus PL1 strain appears to be useful in restoring appropriate ratios of bacterial populations in patients presenting with symptoms of proctitis in the course of the treatment of certain diseases of the lower gastrointestinal tract.
Cholelithiasis – always infected?
Authors: Matyjas Tomasz , Pomorski Lech , Witas Henryk , Płoszaj Tomasz , Matyjas Katarzyna , Kaczka Krzysztof
Published: May 2018

This study aims to present results regarding the presence and identification of bacterial strains found in bile and gallstones located in the gallbladder and bile ducts in patients operated on due to cholelithiasis.
Materials and Methods. Bacterial culture was evaluated in 92 patients. There were 54 women (59%) and 38 men (41%) who underwent surgery on account of cholelithiasis and /or gallstones in bile ducts between 2013 and 2014. Bile and gallstone samples were cultured intraoperatively for bacteria; bacterial strains were identified, and their sensitivity to antibiotics was determined. Molecular methods (NGS and Sanger method) were used to separate bacterial strains in one of the gallbladder stones and the results were compared with bacterial strains grown from the bile.
Results. Bile cultures were positive in 46 patients that is, 50% of the study group. The following bacteria strains were grown: Enterococcus spp. (44%), Escherichia coli (37%) and Klebsiella spp. (35%). Candidiasis accompanied by bacterial infection was detected in 7 patients (15%). Molecular testing of gallstones revealed DNA of Enterococcus spp., Escherichia spp., Streptococcus spp. and Clostridium spp. In the bile culture of the same patient Enterococcus spp. (avium and faecalis) was detected.
Conclusion
1. More than one pathogen was grown on samples obtained from 31 patients (70%) with bile infection.
2. The most common pathogens include Enterococcus spp., Escherichia coli and Klebsiella spp.
3. Bacterial infections are often accompanied by a fungal infection (Candida albicans)
4. Bacterial strains grown from a gallstone sample partially corresponded with strains identified in the bile of the same patient.
Principles of follow-up assessments in patients with breast cancer after radical treatment
Authors: Hodorowicz-Zaniewska Diana , Herman Krzysztof
Published: May 2018

A follow-up assessment plan after radical treatment is a part of a comprehensive approach to treating patients with breast cancer. Because breast cancer is the most frequent cancer both worldwide and in Poland, adequate follow-up is important not only for patients but also for economic reasons.
Herein, we review current recommendations for follow-up assessments in patients with breast cancer. The main aim of such assessment is detection of early recurrence or tumor presence in the other breast, observation of long-term treatment complications, and creation of multidisciplinary infrastructure that will allow to reduce the risk of recurrence and alleviate physical, mental, and social consequences of treatment.
Niepełny, wrodzony zwrot jelita i niezwykle rzadki przypadek niepełnego zwrotu jelita dorosłego chorego z objawami wysokiej niedrożności przewodu pokarmowego
Authors: Rachel Franciszek , Łapiński Andrzej , Szczerba Dariusz , Gutterch Krystian
Published: May 2018

Autorzy przedstawiają 21 -letniego chorego z niepełnym zwrotem jelit z objawami przewlekłej niedrożności górnego odcinka przewodu pokarmowego i trudności diagnostyczne. Rozstrzygającym badaniem była TK jamy brzusznej z kontrastem. Po operacji sposobem Ladda chory został wyleczony.
Analysis of factors affecting the quality of life of those suffering from Crohn’s disease
Authors: Chrobak-Bień Joanna , Gawor Anna , Paplaczyk Małgorzata , Małecka-Panas Ewa , Gąsiorowska Anita
Published: May 2018

Introduction. Crohn’s disease is an inflammatory bowel disease of unknown etiology. Its chronic nature, as well as symptoms of intestinal and overall significantly impedes the daily functioning of patients. Alternately occurring periods of exacerbation and remission are the cause of reduced quality of life of patients. Understanding the factors that caused the decrease in the quality of life, it allows us to understand the behavior and the situation of the patient and the ability to cope with stress caused by the disease. Aim of the study. The aim of the study was to analyze the factors affecting the quality of life of people with Crohn’s disease. Material and methods. The study group consisted of 50 people diagnosed with Crohn’s disease. Respondents were treated at the Department of General Surgery and Colorectal Medical University of Lodz and Gastroenterological Clinic at the University Clinical Hospital No. 1 in Lodz. Quality of Life Survey was carried out by a diagnostic survey using a research tool SF-36v2 and surveys of its own design. Results. Analysis of the results demonstrated that the quality of life of patients with Crohn’s disease was reduced, especially during exacerbations. Evaluation of the quality of life of respondents in physical terms was slightly higher than in the mental aspect. Higher education subjects and the lack of need for surgical treatment significantly improves the quality of life. Conclusions. The occurrence of chronic disease reduces the quality of life of respondents. Elderly patients are better able to adapt to the difficult situation caused by the disease. The quality of life of women and men is at a similar level and patients in remission of the disease have a better quality of life of patients during exacerbations.
Coccygodynia – pathogenesis, diagnostics and therapy. Review of the writing
Authors: Dampc Bogumiła , Słowiński Krzysztof
Published: May 2018

Coccygodynia is a problem with a small percentage (1%) of the population suffering from musculoskeletal disorders. This pain is often associated with trauma, falling on the tailbone, long cycling, or by women after childbirth. The reason for the described problem can be the actual morphological changes. Idiopathic coccygodynia causes therapeutic difficulties to specialists of many fields. Unsatisfactory treatment, including coccygectomy tends to seek new solutions. They belong to them techniques exploited in the manual therapy which in their spectrum hold: direct techniques - per rectum as well as indirect techniques taking into account distant structures of the motor organ, remaining in dense interactions with the coccygeal part. Idiopathic coccygodynia is a result perhaps from exaggerated tension the muscle of the levator ani, coccygeus and gluteus maximus as well as from irritating soft tissue structures surrounding the coccyx: of sacrococcygeum, sacrospinale, and sacrotuberale ligament. Unfortunately we can’t see them in objective examinations so as: the RTG, MR or TK, therefore constitute the both diagnostic and therapeutic problem. For describing the problem a writing of the object was used both from the field of the surgery and of manual therapy. Detailed and multifaceted knowledge about causes of the described problem allows more accurately to categorize the patient to the appropriate group and helps to select the best procedure of treatment.
Large pancreatic pseudocyst penetrating into posterior mediastinum
Authors: Markowski Adam Roman , Brodalka Elżbieta , Guzinska-Ustymowicz Katarzyna , Zaręba Konrad , Cepowicz Dariusz , Kędra Bogusław
Published: May 2018

We report a rare case of a large mediastinal pancreatic pseudocyst compressing the left atrium and the esophagus and causing dyspnea,
palpitations, and emesis. Chest radiograph was non-diagnostic, esophagogastroduodenoscopy showed diffuse extrinsic compression
of the distal esophagus and gastric corpus, but a definitive diagnosis was confirmed by computed tomography. We decided to perform
surgery due to the recurrence of the pancreatic pseudocyst, a history of unsuccessful radiologically guided external drainage a few years
earlier, and a very large diameter of the pseudocyst causing acute cardio-pulmonary distress syndrome.
Risk factors of pancreatitis after endoscopic sphincterotomy. Review of literature and practical remarks based on approximately 10,000 ERCPs
Authors: Jamry Andrzej
Published: May 2018

Post-endoscopic pancreatitis (PEP) is the most common complication of endoscopic retrograde cholangiopancreatography (ERCP). Depending on the presence of risk factors, PEP can occur in 4,1% to about 43% of patients. According to the European Society of Gastrointestinal Endoscopy (ESGE) guidelines, only three to patient-associated risk factors have been identified: suspected sphincter of Oddi dysfunction (SOD) (OR 4.09), female gender (OR 2.23), and previous pancreatitis (OR 2.46). Another three procedure-associated factors include cannulation attempt duration > 10 minutes (OR 1.76), more than one pancreatic guidewire passage (OR 2.77, CI: 1.79 – 4.30), and pancreatic injection (OR 2.2, CI: 1.60 – 3.01). Importantly, analyses of cumulative risk due to coexistence of several factors emphasize the importance of female sex, difficult cannulation, CBD diameter <5 mm, young age, and many other factors. Unfortunately, studies performed to date have included only small numbers of patients with several co-existing risk factors. Therefore, further analysis of other risk factors and the cumulative risk related to their co-occurrence is necessary. Based on current evidence, special care must be given to patients with several risk factors. Also, care should be given to proper qualification of patients, use of guidewires, early pre-cut incision, protective Wirsung’s duct stenting, and rectal NSAID administration.
Absorbable sutures in general surgery – review, available materials, and optimum choices
Authors: Gierek Marcin , Kuśnierz Katarzyna , Lampe Paweł , Ochała Gabriela , Kurek Józef , Hekner Bartłomiej , Merkel Katarzyna , Majewski Jakub
Published: May 2018

Sutures are the most versatile materials used in surgery. Despite recent technological advances and availability of novel materials such as tissue cements, it appears that surgical sutures will continue to be used for many years to come. The objective of this study was to provide an overview of the most common absorbable sutures used in general surgery. The appropriate suture choice for a particular procedure is of key importance for the success of that procedure.
Peritoneal metastases of colorectal origin – cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC). The financial aspect
Authors: Jastrzębski Tomasz , Bębenek Marek
Published: May 2018

About 10% to 15% of patients with colon cancer have intraperitoneal metastases at diagnosis. The patients with intraperitoneal metastases and without distant metastases can benefit from cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). Because up to a half of patients live for at least 5 years after this treatment, the treatment is used more and more often. The treatment of patients with intraperitoneal metastases with CRS and HIPEC costs more than the majority of other medical procedures, because CRS is extensive and takes a lot of time, and after surgery, patients need intensive care and expensive medications and equipment. Currently, only 40% to 80% of costs of CRS and HIPEC are reimbursed in Poland. Because CRS and HIPEC mean a financial loss to hospitals, they are rarely performed. We analyzed the costs of treating patients with peritoneal metastases by CRS and HIPEC in two centers (Gdank, Wroclaw) and showed how this treatment is reimbursed outside Poland. We discussed whether adequate qualification of patients and experience of the teams giving the treatment could reduce the costs.
Landscape of oncoplastic breast surgery across Poland
Authors: Kolacinska Agnieszka , Hodorowicz-Zaniewska Diana , Bocian Artur , Michalik Dariusz , Matkowski Rafal , Kurylcio Andrzej , Pyka Pawel , Charytonowicz Michal , Berkan Maciej
Published: May 2018

Oncoplastic and reconstructive techniques are essential tools in the armamentarium of contemporary breast surgeons. The aim of the study was to identify oncoplastic reconstructive patterns in breast cancer centers across Poland. A questionnaire of 18 questions was sent by email to the members of the Polish Society of Surgical Oncology and the Polish Society of Plastic, Reconstructive and Esthetic Surgery via their dedicated websites. The numbers of breast cancer patients operated on in each center ranged from 120 to 904 per year. Breast-conserving surgery (BCS) predominated in all but one center (range 50-70%). Immediate breast reconstructions (IBR) accounted for 6-42% of procedures, The most frequent type of IBR was either a two-stage expander followed by a permanent implant or one-stage implant- based with or without synthetic mesh. The most frequent type of delayed breast reconstruction (DBR) was a two-stage expander followed by implant-based reconstruction. None of the surveyed cancer centers performed free flap reconstruction. Deep inferior epigastric perforator (DIEP) flaps were performed in the plastic surgery department. Reconstructions based on pedicled flaps were performed in cancer centers. Acellular dermal matrices (ADM) and fat transfer were used in selected centers. In the clinical scenario of adjuvant radiotherapy, delayed breast reconstruction was favored. The full range of oncoplastic BCS was performed. Patient-reported outcome measures (PROM) and complications were assessed. Our findings can act as a platform for further improvement in skills, certification, data collection and audit, including patient reported expectation measures. There is also an urgent need to address pan-European inconsistencies in procedural reimbursement.
Direct Trocar Insertion with Elevation of the Rectus Sheath in Bariatric Surgery: A Novel Technique
Authors: Habibi Mani , Seyit Hakan , Kones Osman , Kartal Bahadir , Alis Halil
Published: May 2018

Introduction. Initial trocar entry, the first step in laparoscopic surgery, is associated with several complications. In morbidly
obese patients, initial trocar placement is associated with a greater number of complications compared to non-obese patients.

Materials and Surgical Technique. In this study, we describe our use of an initial trocar entry technique which is direct trocar
insertion with elevation of the rectus sheath by a single Backhaus towel clamp and we would like to evaluate the sa fety and efficacy
of its administration in bariatric surgery.

Discussion. Our results indicate that gaining initial trocar entry using our technique leads to successful laparoscopic bariatric
surgery. Our technique is a safe, effective, and reliable first step in successful laparoscopic surgery for almost all patients, and is
only contraindicated in patients with severe hepatomegaly.
Barogenic rupture of esophagus (Boerhaave syndrome) as diagnostic and therapeutic challenge requiring rapid and effective interdisciplinary cooperation – case report
Authors: Czopnik Piotr , Aporowicz Michał , Niepokój-Czopnik Agnieszka , Szajerka Tobiasz , Domosławski Paweł
Published: May 2018

We describe a 47-year-old male who was admitted to our centre from a local emergency unit with septic shock due to suspected
Boerhaave syndrome. After the diagnosis was confirmed, the patient underwent emergency surgery. Postoperatively, the patient
had symptoms of acute alcoholic delirium, and developed an oesophagomediastinal fistula as the most serious local complication.
Successful conservative treatment enabled complete healing of the fistula, leading to patient recovery. No late complications like
oesophageal stenosis were found at 6 months from discharge.
Checklist in colorectal surgery – proposal of experts of the Polish Club of Coloproctology and National Consultant in general surgery
Authors: Banasiewicz Tomasz , Krokowicz Łukasz , Richter Piotr , Dziki Adam , Krokowicz Piotr , Lorenc Zbigniew , Szczepkowski Marek , Drews Michał , Wallner Grzegorz
Published: May 2018

A checklist is a collection of information that helps reduce the risk of failure due to limitations in human memory and attention. In surgery, the first Surgical Safety Checklist (SSC), created under the supervision of WHO (World Health Organization), was established in 2007 and covers three stages related to the patient's stay in the operating theater and operation: 1. Prior to initiation (induction) of anesthesia; 2. before cutting the skin; 3. before the patient leaves the operating room Colorectal surgery is particularly at high risk for complications and relatively high mortality. Elimination or, more likely, reducing the risk of complications by standardizing perioperative procedures may be particularly important in this group. The introduction of "dedicated" colorectal checklist surgery seems to be justified. The checklist proposed by the authors in colorectal surgery is divided into four stages, in which conscientious completion of checklists is intended to reduce the potential risk of complications due to hospitalization and surgical treatment. The presented checklist is obviously not closed, as a new publications or recommendations appear, some points may be modified, new issues may be added to the checklist. At present, however, it is a tool considering the well-known and confirmed elements of intraoperative procedures, the compliance of which may significantly reduce the rate of adverse events or surgical complications.
A comprehensive review on Primary gallbladder tuberculosis
Authors: Gupta Ashish , Gupta Amit , Anjum Rohik , Agrawal Saumya , Mallik Dhiraj
Published: May 2018

Tuberculosis (TB) is an infectious disease that can affect any organ system of the body. Abdominal TB can be gastrointestinal,
lymph nodal, visceral or peritoneal. The gallbladder (GB) is rarely involved in abdominal TB as a primary organ. Extensive research
literature on gallbladder TB is limited to case reports. There has been no review on this rare abdominal pathology. GB
tuberculosis is a difficult diagnosis preoperatively. It is a rare differential among the more common gallbladder pathologies
such as cholelithiasis, or a gallbladder malignancy. Typical histopathology of the resected specimen helps to establish this
rare diagnosis. Subjecting every specimen to histopathological examination followed by medical treatment offers the chance
of cure. Through this review, the authors attempt to provide an insight into this disease entity.