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Online article

An interview with Ewa Czochrowska

Czochrowska, Ewa
Author Czochrowska, Ewa Graduated in Dentistry at the Dental Faculty in Warsaw, Poland. » Postgraduated in Orthodontics at the Oslo University, Norway. » Professor at the Department of Orthodontics, Warsaw Medical University. » President of the Polish Orthodontic Society. » Former President of the European Orthodontic Society. » Active member of the Angle Society of Europe and the European Board of Orthodontists

Dental Press Journal of Orthodontics. 2018 ; 23 (3) : 14-23. [pub] -

Dental Press J. Orthod.
ISSN 2177-6709
Medvik
Source

About
Czochrowska, Ewa M Authority

Online article

Artroskopická resekce a spongioplastika skafolunátního kloubu v léčbě chronické dynamické skafolunátní nestability
[Arthroscopic resection and spongioplasty of scapholunate joint in treating chronic dynamic scapholunate instability]

... MATERIAL AND METHODS Twenty-six patients with chronic dynamic SL instability of Geisler-Messina - EWAS ...

Acta chirurgiae orthopaedicae et traumatologiae Čechoslovaca. 2018 ; 85 (1) : 34-39.

Acta chir. orthop. traumatol. Čechoslovaca
ISSN 0001-5415
Medvik
Source

PURPOSE OF THE STUDY The study evaluated the method of arthroscopic stabilisation of dynamic scapholunate (SL) instability by scapholunate joint resection using bone graft to create synarthrosis between the scaphoid and lunate. MATERIAL AND METHODS Twenty-six patients with chronic dynamic SL instability of Geisler-Messina - EWAS grade IIIB, C and IV were treated by artificial synarthrosis of SL joint using an arthroscopic technique. The mean follow-up period of the patients was 32.2 months (28-39 months, when the range of motion and grip strength were assessed. The functional results were evaluated through the Mayo wrist score. RESULTS Post-operatively, a statistically significant improvement in grip strength was reported, with the mean improvement of 9 kg. On the other hand, significant worsening of flexion with a mean change of -6°, a mean change in extension of -5° and ulnar deviation -2° were identified. According to the visual analogue scale, there was a significant reduction in pain associated with everyday activity (mean change -4) as well as with heavy manual work (mean change -4). According to the Mayo wrist score, the overall results in 3 patients were excellent, in 16 patients good, in 6 patients satisfactory, and in one patient poor. DISCUSSION A limited range of motion significantly influencing the overall results of the functional assessment on the Mayo wrist score does not have a substantial subjective impact on patients and their routine activities. All the studies evaluating the operative techniques restoring stability of proximal row of the carpal bones report limited range of motion in the wrist. These interventions aim at a strong, pain-free grip with preserved wrist function. CONCLUSIONS This study illustrates that the arthroscopic stabilisation of scapholunate joint by synarthrosis is a reliable, minimally invasive surgical method to treat the higher grade of dynamic SL instability. This method makes it possible to achieve good stability of the damaged joint and leads to satisfactory functional results. Key words:wrist, instability, scapholunate joint, arthroscopy, bone graft.

MeSH
Arthroscopy * adverse effects methods MeSH
Scaphoid Bone MeSH
Adult MeSH
Carpal Joints MeSH
Middle Aged MeSH
Humans MeSH
Pain Measurement methods MeSH
Minimally Invasive Surgical Procedures methods MeSH
Joint Instability * diagnosis physiopathology surgery MeSH
Lunate Bone MeSH
Pain, Postoperative diagnosis MeSH
Range of Motion, Articular MeSH
Hand Strength MeSH
Bone Transplantation methods MeSH
Treatment Outcome MeSH
Check Tag
Adult MeSH
Middle Aged MeSH
Humans MeSH
Male MeSH
Female MeSH
Publication type
Journal Article MeSH

Online article

Upper gastrointestinal bleeding in the setting of excessive warfarin anticoagulation: Risk factors, and clinical outcome

... Gastrointestinal tract is the most common source of severe bleeding following excessive warfarin anticoagulation (EWA ...

Cor et Vasa (Brno). 2017 ; 59 (2) : 154-159.

ISSN 0010-8650
Medvik
Source

Cíl: Gastrointestinální trakt (GIT) je nejčastějším zdrojem závažného krvácení při nadměrné antikoagulaci warfarinem (excessive warfarin anticoagulation, EWA). Naším cílem bylo určit rizikové faktory a výsledný stav spojené s krvácením do horní části GIT (upper gastrointestinal bleeding, UGIB) u pacientů přijatých s EWA. Metody: Zkoumali jsme demografi cké charakteristiky, klinické, laboratorní i endoskopické nálezy u pacientů hospitalizovaných s EWA mezi roky 2003 až 2015. Dále jsme zaznamenávali nemocniční mortalitu, použití krevních derivátů i délku hospitalizace. Pomocí regresních analýz jsme se pokusili vypracovat způsob predikce krvácení do GIT a mortality u pacientů s EWA. Výsledky: Prohlédli jsme nemocniční záznamy 157 žen a 121 mužů. Ze 41 hospitalizovaných pacientů s UGIB jich u 31 (75,6 %) bylo provedeno ezofagogastroduodenoskopické vyšetření. U těchto pacientů byly nejčastějším zdrojem krvácení (32,2 %) již přítomné peptické vředy. Nemocniční mortalita pacientů s UGIB činila 9,8 %, což byla podobná hodnota jako u nemocných bez UGIB. Pacientům s UGIB bylo v průměru nutno podat dvě jednotky erytrocytárního koncentrátu a čerstvě zmrazené plazmy. U pacientů s EWA byly prediktory UGIB vyšší věk (p = 0,045) a vředová choroba v anamnéze (p < 0,001). Závěr: U pacientů s EWA byla nejsilnějším prediktorem vzniku UGIB přítomnost peptického vředu, ať již v anamnéze, nebo v současnosti. Přes srovnatelnou nemocniční mortalitu bylo u těchto pacientů nutno častěji provádět transfuzi krevních derivátů.

Aim: Gastrointestinal tract is the most common source of severe bleeding following excessive warfarin anticoagulation (EWA). We aimed to describe the risk factors and outcome associated with upper gastrointestinal bleeding (UGIB) in patients admitted with EWA. Methods: Demographics, clinical, laboratory and endoscopic fi ndings of patients admitted with EWA from 2003 to 2015 were reviewed. Hospital mortality, blood product utilization and hospital length of stay were recorded. Regression analyses were performed for prediction of GI bleeding and mortality in patients with EWA. Results: Medical records of 157 women and 121 men were reviewed. From 41 patients presented with UGIB, 31 (75.6%) underwent esophagogastroduodenoscopy. Preexisting peptic ulceration (32.2%) was the most common source of bleeding in these patients. Hospital mortality was 9.8% in patients with UGIB which was similar to those without. In average, patients with UGIB required 2 units more packed red blood cells and fresh frozen plasma. Older age (p = 0.045) and previous history of peptic ulcer disease (p < 0.001) were the predictors of UGIB in patients with EWA. Conclusion: Presence of past or current peptic disorders was the strongest predictor of UGIB in patients with EWA. Despite comparable hospital mortality, these patients required more transfusion of blood products.