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The Polish system of undergraduate and postgraduate medical education, including specialization courses in surgery, provided only general guidelines concerning the issue of creating a leader or preparing for leadership. The process of building the position of a leader has had a rather spontaneous character thus far; it has been based on the individual, natural predispositions of a candidate for the position of a leader. There are no formal guidelines for this in Poland. It is required that graduates of medical studies or residents should acquire the so-called professional and social skills before they complete their specialization training. In the light of the ongoing debate, it seems worthwhile to give a thought on the role of a leader and to undertake harmonized actions to work out a common stance on understanding the issue of leadership and teach leadership skills as a part of a harmonized, methodologically correct system of education, so that the best ways of preparing residents to perform the role of a leader in surgical and other medical surroundings could be realized.

The protective barriers used so far in surgery do not provide adequate protection against SARS-CoV-2 virus, and reinforced protective equipment is needed. The rapid increase in the number of patients and the worldwide panic associated with the increasingly low availability of protective equipment has resulted in a shortage of protective equipment in many hospitals. Appropriatepersonal protective equipment must be provided so that the surgical team proceeding to surgery is not excluded from the further struggle for patients’ health, especially in MIS. Reckless and excessive use of maximum protective equipment may result in a severe shortage of these products when the number of infected persons requiring surgery increases. The use of a structured infection risk scheme for medical staff, depending on the results of reverse transcription polymerase chain reaction assays and COVID-19 symptoms, combined with the division of protection equipment into three groups, allows easy selection of an appropriate clothing scheme for the clinical setting. [ABSTRACT FROM AUTHOR]

The protective barriers used so far in surgery do not provide adequate protection against SARS-CoV-2 virus, and reinforced protective equipment is needed. The rapid increase in the number of patients and the worldwide panic associated with the increasingly low availability of protective equipment has resulted in a shortage of protective equipment in many hospitals. Appropriatepersonal protective equipment must be provided so that the surgical team proceeding to surgery is not excluded from the further struggle for patients' health, especially in MIS. Reckless and excessive use of maximum protective equipment may result in a severe shortage of these products when the number of infected persons requiring surgery increases. The use of a structured infection risk scheme for medical staff, depending on the results of reverse transcription polymerase chain reaction assays and COVID-19 symptoms, combined with the division of protection equipment into three groups, allows easy selection of an appropriate clothing scheme for the clinical setting. [ABSTRACT FROM AUTHOR]

Despite the variety of modern molecular techniques available, examination of foetal anatomy is still a fundamental part of teratological studies in evaluating the developmental toxicity of xenobiotics or other non-chemical factors. The article presents contemporary methods of embryotoxicity and foetotoxicity assessment. A single alizarin red S and double alcian blue followed by alizarin red S staining, as well as various methods of soft tissue examination are discussed. [ABSTRACT FROM AUTHOR]

In the last several weeks we have been witnessing the exponentially progressing pandemic SARS-CoV-2 coronavirus. As the number of people infected with SARS-CoV2 escalates, the problem of surgical management of patients requiring urgent surgery is increasing. Patients infected with SARS-CoV2 virus but with negative test results will appear in general hospitals and may pose a risk to other patients and hospital staff. Health care workers constitutes nearly 17% of infected population in Poland, therefore early identification of infected people becomes a priority to protect human resources and to ensure continuity of the access to a surgical care. Both surgical operations, and endoscopic procedures are considered as interventions with an increased risk of infection. Therefore, determining the algorithm becomes crucial for qualifying patients for surgical treatment, but also to stratify the risk of personnel being infected during surgery and to adequately protect staff. Each hospital should be logistically prepared for the need to perform urgent surgery on a patient with suspected or confirmed infection, including personal protective equipment. Limited availability of the equipment, working under pressure and staff shortages in addition to a highly contagious pathogen necessitate a pragmatic management of human resources in health care. Instant synchronized action is needed, and clear uniform guidelines are essential for the healthcare system to provide citizens with the necessary surgical care while protecting both patients, and staff. This document presents current recommendations regarding surgery during the COVID-19 pandemic in Poland.

Both acute and chronic inflammation of the pancreas often lead to complications that nowadays can be resolved using endoscopic and surgical procedures. In many cases, intraoperative ultrasound examination (IOUS) enables correct assessment of the extent of the lesion, and allows for safe surgery, while also shortening its length., Aim of the Research: At the authors' clinic, intraoperative ultrasound is performed in daily practice. In this paper, we try to share our experiences in the application of this particular imaging technique., Research Sample and Methodology: Intraoperative examination conducted by a surgeon who has assessed the patient prior to surgery, which enabled the surgeon to verify the initial diagnosis. The material presented in this paper includes 145 IOUS procedures performed during laparotomy due to lesions of the pancreas, 57 of which were carried out in cases of inflammatory process., Results and Conclusions: IOUS is a reliable examination tool in the evaluation of acute inflammatory lesions in the pancreas, especially during the surgery of chronic, symptomatic inflammation of the organ. The procedure allows for a correct determination of the necessary scope of the planned surgery. The examination allows for the differentiation between cystic lesions and tumors of cystic nature, dictates the correct strategy for draining, as well as validates the indications for the lesion's surgical removal. IOUS also allows the estimation of place and scope of drainage procedures in cases of overpressure in the pancreatic ducts caused by calcification of the parenchyma or choledocholitiasis in chronic pancreatitis. In pancreatic cancer, IOUS provides a verification of the local extent of tumor-like lesions, allowing for the assessment of pancreatic and lymph nodes metastasis, and indicating the presence of distant and local metastases, including the liver. IOUS significantly improves the effectiveness of intraoperative BAC aspiration or drainage of fluid reservoirs.

Unlabelled: Intraoperative ultrasound (IOUS) allows confirming and verifying the preoperative diagnosis. In many cases it allows correct determination of the severity of the disease, safe surgery performance and shortening its duration. Proper assessment of anatomic structures during the surgery and evaluation of the operating field after the treatment termination, in combination with their ultrasound evaluation that permits more complete assessment of radical treatment. The aim of the study was to define current indications for the use of intraoperative ultrasound in the treatment of pancreatic lesions, based on our own experience and the cited literature., Material and Methods: The Clinic, where the authors work, uses intraoperative ultrasound in everyday practice. In this paper we try to share our experience in this imaging technique. Studies were compared before the procedure both in the ultrasound and CT examination rooms with the images obtained intraoperatively. Intraoperative examination was performed by the surgeon who performed assessment before the procedure, what enabled verification of diagnoses. Presented material refers to 102 IOUS procedures performed during laparotomy due to pancreatic lesions., Results and Conclusions: IOUS is a reliable test for the evaluation of both inflammatory and acute lesions in the pancreas during the surgery of chronic, symptomatic pancreatitis. It correctly determines the extent of the planned surgery. In the case of pancreatic cancer it verifies local severity of the tumour lesions, assessing involving of the peripancreatic vessels, lymph nodes and the presence of local and distant metastases, including those in the liver. IOUS proved highly effective in the evaluation of endocrine and cystic pancreatic tumours. The study significantly improves the effectiveness of intraoperative BAC and aspiration or drainage of fluid reservoirs.

Unlabelled: Acute pancreatitis is a severe clinical conditio that causes significant mortality in patients. Since we do not have at the moment effective causal treatment research on the use of pro tease inhibitors can produce tangible benefits. In view of the growing number of cases and high mortality in severe AP with one hand, and the lack of a usal treatment research efforts undertaken to search for effective drugs for this disease seem to have deep reasons., Aim of the Study: was to determine the histopathological changes in the pancreas in the treatment of acute pancreatitis with Ulinastatin., Material and Methods: The study was conducted in male Wistar rats weighing 250-300 grams. 150 individuals were used for the experiment, 60 of them were treated with Ulinastatin. Experimental acute pancreatitis was induced by the model proposed by Aho and Henckel using sodium taurocholate. Ulinastatin dose numer depended on the duration of the experiment. For histopathological examination pancreatic fragments weighing approximately 1 g each were taken. Assessment and documentation of histopathological preparations were made by light microscopy., Results: Evaluation of the histological preparations of various time groups showed significantly improved results after application of Ulinastatin, depending on the duration of the inflammation and the number of doses of the drug., Conclusions: Application for the treatment of UTI leads to inhibition of the inflammatory process at the stage of pancreatic edema and in cases of severe necrotizing course limits the progression of the disease which gives grounds for its clinical use in humans.

The technique of 24-hour esophageal multichannel intraluminal impedance monitoring combined with pH-metry (MII-pH) is currently considered to be the golden standard in the diagnostics of gastroesophageal reflux disease (GERD). The technique allows for differentiation of gas and liquid reflux as well as detection of non-acid reflux, which cannot be detected with other techniques that are based only on measuring the pH of gastric contents.THE AIM OF THE STUDY was to assess the usefulness of MII-pH in the diagnostics and treatment of GERD and its complications. MATERIAL AND METHODS. A group of 213 patients referred to II Katedra i Klinika Chirurgii Ogólnej, Gastroenterologicznej i Nowotworów Układu Pokarmowego Uniwersytetu Medycznego w Lublinie [the Second Faculty and Clinic of General and Gastrointestinal Surgery and Gastrointestinal Oncology at Medical University of Lublin] due to persistent symptoms of GERD and 21 volunteers without any clinical evidence of GERD underwent esophageal monitoring via MII-pH. The results were correlated with those of upper gastrointestinal tract endoscopy. The data gathered during MII-pH and endoscopy as well as information from questionnaires were entered into an MS Excel spreadsheet and subsequently analyzed with STATISTICA PL software. RESULTS AND CONCLUSIONS. MII-pH proved to be considerably more useful than conventional pHmetry in recording acid reflux. The sensitivity of pH-metry based on the MII-pH technique was established at 74%. GERD-induced changes in the esophageal mucosa result in decreased impedance baseline. The presence and severity of inflammatory esophageal lesions was proven to be associated with acid reflux episodes and proximal reflux episodes. No direct relationship between the grade of GERD and the occurrence of non-acid reflux episodes was confirmed. Non-acid reflux episodes were shown to predispose to non-erosive reflux disease (NERD). The results of this study confirm that MIIpH is an essential technique in the diagnostics, as well as in assessment of the course of treatment and the severity of GERD.