rss_2.0Pomeranian Journal of Life Sciences FeedSciendo RSS Feed for Pomeranian Journal of Life Sciences Journal of Life Sciences Feed of the vermiform appendix strangulated in the femoral hernia: a case report<abstract> <title style='display:none'>Abstract</title> <p>Strangulation of the vermiform appendix into the femoral hernia sac (de Garengeot hernia) is very rare. This article presents a case of a 63-year-old woman with this kind of hernia which contained a strangulated tumour of the appendix. The patient presented to the hospital with a 3-day-long history of a palpable lump in the right groin. She had no other significant complaints, but USG imaging showed suspicion of the strangulated femoral hernia containing a bowel. The patient was operated on. As the tumour was not suitable to remove via groin incision, laparotomy was performed, followed by a release of the appendix with the tumour and their resection together with a fragment of the caecum. The postoperative course was uneventful, and histological examination showed appendiceal mucinous neoplasm with high-grade dysplasia. After oncological consultation, the patient underwent prophylactic right hemicolectomy.</p> </abstract>ARTICLEtrue events of intra-articular temporomandibular joint injections: a systematic search and review<abstract> <title style='display:none'>Abstract</title> <p>Temporomandibular joint (TMJ) disorders manifest as joint pain and limited mobility of the mandible. Treatment options include arthrocentesis and intra-articular drug administration. Adverse events associated with such interventions are rarely described in separate articles and may be overlooked when presented in clinical trial reports. Their identification in the medical literature is difficult due to the need to develop a rich set of keywords. This systematic search and review aims to identify and map adverse events associated with injections into the TMJ. Primary clinical trials of TMJ disorders treated with joint irrigation and/or drug administration were included. Data were extracted using a predesigned form and presented in text, tables, and graphs. A total of 58 adverse events were identified, more than half of which were pain and/or swelling. Overall, 14 types of events were classified into 3 categories (distant, local, and articular), none of which were fatal or life-threatening. These were, in order of most frequently diagnosed: pain and/or swelling (52%), ear pressure (5%), eyelid paresthesia (5%), periarticular tissue atrophy (5%), generalized rash (4%), hypoesthesia (4%), open bite (4%), skin hypopigmentation (4%), headache (3%), local rash (3%), malocclusion (3%), mandibular hypomobility (3%), TMJ noises (3%), and fever (2%).</p> </abstract>ARTICLEtrue ileus – case description and literature review<abstract> <title style='display:none'>Abstract</title> <p>Gallstone ileus is a rare disease, arising due to intestinal obstruction caused by cholelith. It affects mainly patients between 60–70 years old and is a consequence of biliary intestinal fistula. Due to its uncommonness and the patients’ age and comorbidities there is a lack of precise treatment and diagnostic guidelines. The aim of this article is gallstone ileus literature review and case report from Independent Public Clinical Hospital No. 1 of Pomeranian Medical University in Szczecin, Department of General, Minimally Invasive and Gastroenterological Surgery Department.</p> </abstract>ARTICLEtrue effect of thermal cycling on the surface roughness of nanohybrid and high-viscosity bulk-fill resin-based composites<abstract> <title style='display:none'>Abstract</title> <p><bold>Introduction</bold>: The aim of this study was to investigate the effect of thermal cycling on the surface geometry of high-viscosity bulk-fill resin-based composites (RBCs) compared to conventional nanohybrid composites.</p> <p><bold>Materials and methods</bold>: Four conventional nanohybrid composites (Tetric EvoCeram – TEC, GrandioSO – GD, Filtek Z550 – FZ, and Ceram·X Mono – CX) and 4 high-viscosity bulk-fill composites (Tetric EvoCeram Bulk Fill – TBF, X-tra fil – XF, Filtek Bulk Fill Posterior – FBF, and QuixFil – QF) were tested. After the 2-step polishing procedure, the samples were divided into 2 groups: control group (K) and thermal cycling group (TC). Samples from the TC were subjected to thermal cycling according to ISO 11405 (THE-1100, SD Mechatronik GmbH). Surface geometry was evaluated by profilometry (Turbowave v. 7.36, Hommel-Etamic) and scanning electron microscope – SEM (VEGA 3, Tescan Analytics).</p> <p><bold>Results</bold>: The applied thermal cycles increased the surface roughness of conventional RBCs: TEC (p = 0.000007), GD (p = 0.04), and CX (p = 0.0005). A reduction in the surface roughness of bulk-fill composites was observed in the case of materials: XF (p = 0.000003) and QF (p = 0.0002). Thermal cycling was shown to alter the surface roughness of the TEC, CX, XF, and QF materials.</p> <p><bold>Conclusion</bold>: The application of thermal cycling in a water environment in accordance with the ISO 11405 standard causes the degradation of the organic matrix and the exposure of filler molecules on the surface of both conventional and high-viscosity bulk-fill composites. Some of the tested RBCs, especially those containing modern hydrophobic monomers, are less susceptible to these processes.</p> </abstract>ARTICLEtrue of dens invaginatus: 4-year follow-up<abstract> <title style='display:none'>Abstract</title> <p>Dens invaginatus is a rare developmental defect that can complicate the proper diagnosis and treatment of teeth. The most common location of an invaginated tooth is the second lateral maxillary incisor, while the least common locations are the mandibular incisors and canines. Due to the complicated anatomy of invaginated teeth, the endodontic treatment of these teeth can present many difficulties. The present case report describes the endodontic treatment of the dens invaginatus – permanent second maxillary lateral incisor with a 4-year clinical and radiologic follow-up.</p> </abstract>ARTICLEtrue impact of transurethral microwave thermotherapy on erectile function and lower urinary tract symptoms in men with benign prostatic hyperplasia – short communication<abstract> <title style='display:none'>Abstract</title> <p><bold>Introduction</bold>: Although microwave thermotherapy is becoming an almost forgotten therapy, occasional reports confirm that transurethral microwave thermotherapy (TUMT) still seems to be a good alternative for benign prostate hyperplasia (BPH). The aim of this study was to re-evaluate the advantages and disadvantages of TUMT.</p> <p><bold>Materials and methods</bold>: The non-randomized study included 4590 patients with BPH. All patients were on pharmacological treatment. Prior to the study, patients underwent digital rectal examination (DRE), ultrasound examination, uro-dynamic examination, and prostatic specific antigen (PSA) concentration. Exclusion criteria included suspected prostate cancer on DRE, an ambiguous result of the urodynamic examination, suggesting a neurological component in lower urinary tract symptoms (LUTS), and elevated PSA concentration. In the end, 3329 patients were enrolled for further analysis. Of this group 2159 patients elected to receive TUMT. The others decided to continue their pharmacotherapy. Two questionnaires were used to evaluate the effect of TUMT on the relief of urinary symptoms and erectile dysfunction (ED). The International Prostate Symptom Score (IPSS) was used for LUTS and the International Index of Erectile Function-5 (IIEF-5) for ED.</p> <p><bold>Results</bold>: After 6 months from thermotherapy, more than 50% of patients experienced an improvement in their urination (p &lt; 0.0018), while in the pharmacological group only 30% did (p &lt; 0.031). Approximately 28% of all patients regained erection. Before thermotherapy, only 12% reported no erection problems. In contrast, a further deterioration of erectile function (EF) was observed in the reference group (differences with TUMT at p &lt; 0.0001). Apart from transient fever or temporary urinary retention, no serious complications were observed.</p> <p><bold>Conclusions</bold>: It appears that TUMT is still a valuable option for BPH, especially in outpatient practice and for those patients who wish to protect their EF.</p> </abstract>ARTICLEtrue in the lifestyle among dialysis patients – a descriptive study<abstract> <title style='display:none'>Abstract</title> <p><bold>Introduction</bold>: End-stage renal disease (ESRD) requires dialysis treatment. This treatment changes patients’ lives, including limitations on physical activity.</p> <p>In this study, we highlighted the mobility aspects of patients’ lives compared to the control group (non-dialyzed).</p> <p><bold>Materials and methods</bold>: Seventy-nine dialysis patients and 125 controls were studied. The study used an original questionnaire on socioeconomic status, physical activity, and lifestyle. All data were statistically analyzed between dialysis patients and controls divided into female and male groups.</p> <p><bold>Results</bold>: Most of the dialysis patients were obese, and each had concomitant chronic diseases of other organs. Significantly lower levels of employment (p = 0.001 for women; p = 0.005 for men) and physical activity (p = 0.047 for women; p = 0.001 for men) were observed in dialysis patients compared with controls. Both groups had high motivation and knowledge about the health benefits of physical activity. However, dialysis patients had significantly more concerns about engaging in physical activity (p &lt; 0.001).</p> <p><bold>Conclusions</bold>: Dialysis patients are at risk for the negative consequences of occupational and physical inactivity. Healthcare professionals (physicians and physiotherapists) can take advantage of the high motivation of dialysis patients to overcome the fear of physical activity. Based on the current study and a previous study on the posture of dialysis patients, a universal set of exercises for dialysis patients has been created and is available on the YouTube platform: <ext-link ext-link-type="uri" xmlns:xlink="" xlink:href=";">;</ext-link>. The exercises can be done during dialysis and at home.</p> </abstract>ARTICLEtrue effect of releasing critical pulleys of the fibrous sheath during flexor tendons repair in Kleinert–Verdan Zone II: a review<abstract> <title style='display:none'>Abstract</title> <p>The fibrous flexor tendon sheath is a relatively thick structure surrounding both flexor tendons (superficial and profundus) along the finger and distal part of the metacarpus. It consists of circumferentially and obliquely passing bands, so-called ‘pulleys’. The flexor tendon fibrous sheath with its pulley system plays an important role in the proper gliding of the tendons by maintaining them close to the bone of phalanges during full finger flexion, and its major defects manifest by impaired flexion of the finger because the tendon bowstringing. There is no commonly accepted opinion about the range of pulley release which is safe and would not cause bowstringing. The article presents current recommendations about the safe range of release of pulleys during repair of the flexor tendons which essentially allows longer incisions than was suggested previously. The priority is the undisturbed gliding of repaired tendon along the finger and avoiding catching the repair at edge of the pulley, which would result in a reduction of the finger’s range of motion.</p> </abstract>ARTICLEtrue influence of ozone on the effectiveness of the vital pulp therapy with Biodentine *<abstract> <title style='display:none'>Abstract</title> <p><bold>Introduction</bold>: The aim of the present study was to clinically evaluate the influence of ozone on the vital pulp therapy (VPT) in human mature teeth. Vital pulp therapy – pulp capping helps to salvage caries-exposed pulp and prevent the need for further endodontic treatment. There are <italic>in vitro</italic> and <italic>in vivo</italic> studies using extracted teeth that indicate that Biodentine is an interesting alternative to mineral trioxide aggregate (MTA). It is believed that unfavourable outcomes of VPT are caused by infection, either due to residual bacteria in the carious cavity or caused by bacterial microleakage. Ozone is a strong oxidant with a beneficial antimicrobial effect.</p> <p><bold>Materials and methods</bold>: Ninety-one teeth were randomly assigned to 1 of 2 groups. Forty-one teeth were treated with ozone and Biodentine (O3 &amp; B) – the experimental group and 50 teeth were treated with Biodentine only (B) – the control group. Clinical evaluations were performed at 3, 6, and 12 months after direct pulp capping.</p> <p><bold>Results</bold>: There was no statistically significant difference in success rates between the 2 groups. However, the success rates in both groups were high, ranging from 88.2% to 76.9% (p = 0.34) in the experimental and control groups, respectively.</p> <p><bold>Conclusions</bold>: Vitality pulp treatment with Biodentine combined with ozone and without ozone was found to be equivalent in terms of therapy efficacy. Biodentine was found to be a highly effective pulp capping material in VPT. There is a need for further <italic>in vivo</italic> studies to evaluate whether <italic>in vitro</italic> results of other studies translate to clinical practice.</p> </abstract>ARTICLEtrue of administering GLP-1 analogs to patients with polycystic ovary syndrome, considering their effect on adipose tissue metabolism<abstract> <title style='display:none'>Abstract</title> <p>Mammals have 2 primary types of adipose tissue: brown adipose tissue (BAT) and white adipose tissue (WAT). White adipose tissue, one of the largest organs, spans the entire body and persists throughout an individual’s life, with the highest concentrations found in the abdominal cavity or subcutaneously. In obese individuals, the amount of WAT can reach up to 70% of total body weight. Today, glucagon-like peptide-1 (GLP-1) analogs have gained popularity in the treatment of obesity, insulin resistance, and related metabolic disorders. Patients using glucagon-like peptide-1 receptor agonists (GLP-1RAs) have improved lipid profiles, reduced visceral fat accumulation, and improved glucose tolerance. Polycystic ovarian syndrome (PCOS) is a disorder strongly associated with insulin resistance and obesity. It is the most common heterogeneous endocrine disorder, affecting an estimated 1 in 5 women of reproductive age. The introduction of GLP-1 analog treatment in women with PCOS could help to manage the disease, improve the quality of life of PCOS patients, increase their chances of conception, and maintain pregnancy until delivery. This review presents the latest reports on the use of GLP-1RAs and the treatment of PCOS.</p> </abstract>ARTICLEtrue antimicrobial susceptibility and contribution of to surgical site infections in patients hospitalized in the West Pomeranian region (Poland) during the COVID-19 pandemic period – a 3-year follow-up<abstract> <title style='display:none'>Abstract</title> <p><bold>Introduction</bold>: Surgical site infections (SSIs) are at the fore-front of healthcare-associated infections and the second most common cause of hospital readmission. The etiology of these infections is generally monobacterial with a predominance of <italic>Staphylococcus aureus</italic>. Although it is a preventable infection it significantly increases the cost of hospitalization and doubles the mortality rate.</p> <p>The aim of the present study was to evaluate the prevalence of SSIs and antimicrobial susceptibility of <italic>S. aureus</italic> isolated from SSIs in patients hospitalized at the Clinical Hospital No. 1 of the Pomeranian Medical University in Szczecin (Poland) – CH-1 – during the period 2019–2021, in the course of the COVID-19 pandemic.</p> <p><bold>Materials and methods</bold>: Analysed specimens were collected from patients with diagnosed skin and soft tissue infections (SSTIs) caused by <italic>S. aureus</italic>, collected in 2019–2021, and then examined during routine microbiological diagnostics. The collection included specimens from patients hospitalized at CH-1, as well as consulted at the Emergency Department (ED) of CH-1, patients from healthcare facility of the Ministry of Internal Affairs and Administration in Szczecin, and from detain-ees of the Szczecin Detention Centre (Poland). Out of the total of 1140 results, 232 were classified as SSIs caused by <italic>S. aureus</italic> and then analysed. All the data were systemically entered into a spreadsheet (Excel 2019) and later subjected to several statistical tests (using StatSoft Statistica 13 package).</p> <p><bold>Results</bold>: From the collection of results, 20.4% (232/1140) were considered as SSIs of <italic>S. aureus</italic> etiology. In the following years 2019, 2020, and 2021, the SSIs of <italic>S. aureus</italic> etiology were 17.1% (72/421), 19.5% (66/339), and 24.7% (94/380), respectively. Methicillin-resistant <italic>S. aureus</italic> (MRSA) was the cause of 7% of analysed SSIs. The highest incidence of SSIs was observed mainly in patients admitted to the trauma and orthopaedic wards and in patients seen in the ED. The majority of SSIs were mono-etiologic, caused by <italic>S. aureus</italic> only (93%). Mixed etiology was determined in 7% of SSIs with a significant share of beta hemolytic streptococci, enterobacteria, and non-fermentative Gram-negative rods. A slight increase in the prevalence of SSIs was observed during the analysed period. The overall antimicrobial susceptibility of all examined strains was noted, with a low rate of MRSA. The obtained results demonstrate the good practice of both strategies of hospital infection control, as well as the coherent and rational antibiotic policy in the CH-1 in the West Pomeranian region in Poland. The 2017–2018 data on the incidence of SSTIs and the percentage of SSIs among patients hospitalized in CH-1 show that in 2017, SSIs represented 17.9% of all cases classified as SSTIs (57/318), followed by SSIs in 2018, which represented 19.5% of all SSTIs analysed in CH-1 (68/348). The percentage of SSIs among the total SSTIs confirmed during the 2-year pre-pandemic period did not indicate significant changes in the number of SSIs among CH-1 patients hospitalized during the period of analysis. Therefore, it can be concluded that pandemic restrictions did not significantly affect the trend in the predominant proportion of <italic>S. aureus</italic> among SSIs during the study period.</p> </abstract>ARTICLEtrue of the spermatic cord: case report and literature review<abstract> <title style='display:none'>Abstract</title> <p>Leiomyosarcoma of the spermatic cord is a rare entity. It can arise from any mesenchymal cell of its structure. It occurs mainly in elderly patients. It presents as a firm and painless intrascrotal mass. We present a case of a 30-year-old man with a 3-year history of a painless left-sided scrotal mass. Ultra-sound examination showed a scrotal mass. Further work-up revealed no distant metastasis before surgery. A left radical 1-block orchidectomy with epididymis and spermatic cord was performed. The final histopathologic examination showed a pattern of leiomyosarcoma of the spermatic cord. Considering the result of the histopathological examination, the Onco-logical Council did not recommend any additional surgery, but only watchful waiting. Almost 4 years of follow-up have passed without additional treatment. Primary scrotal leiomyosarcoma is an exceptional entity with only 100 cases reported in the literature. Due to its rarity, additional studies are needed to better define the optimal therapeutic management. A literature review and treatment strategy are discussed.</p> </abstract>ARTICLEtrue toxicity of Bis-GMA, a basic monomer of the dental composite’s organic matrix – a narrative review<abstract> <title style='display:none'>Abstract</title> <p>The long history of bisphenol A glycidyl dimethacrylate (Bis GMA) as a major component in resin-based composites is also associated with numerous reports of its toxicity. Since one of the substrates used in the production of BisGMA is bisphenol A (BPA), the question of its release from materials containing this monomer is also raised. Due to the widespread use of BisGMA in modern dentistry, the aim of this narrative review is to provide and summarize information on its toxicity based on the current literature.</p> <p>It covers the chemical structure and possible synthesis pathways of BisGMA, as well as the toxicity of its substrates. The toxicity of the BisGMA monomer is also discussed, in particular its effect on pulp cells, the release of composite components in the gastrointestinal tract, and its metabolic degradation.</p> <p>BisGMA and BPA are eluted from resin composites in the oral cavity. Acute toxicity is unlikely due to the small amounts of amounts eluted, but knowledge of chronic exposure is very limited. In addition, the amount of BPA released from dental materials is incomparably low, considering the environmental exposure levels in everyday life. Composite resins provide a highquality treatment that outweighs the potential complications.</p> </abstract>ARTICLEtrue of clinical estimation of bone union in hand fractures: a preliminary report<abstract> <title style='display:none'>Abstract</title> <p>An assessment of the healing of bone fractures is mainly based on X-ray confirmation of some characteristic features of fracture consolidation. This paper presents a new method of estimation of bone union of hand fractures based on examination of pain resulting from pressure of the fracture site. It was assumed that bone is united if at 2–3 weeks the fracture site is painless. The pain at the fracture site was examined in 12 patients with fractures of phalanges and metacarpals of specified configuration; an assessment was performed at the beginning of the treatment and after 2, 3, and finally at 4 weeks. All patients were treated by functional method, without any immobilization. At baseline, the mean level of pain in numeric rating scale was 6.4 and in subsequent assessments a significant reduction in pain was observed, down to 0.6 at 4 weeks. Radiological assessment at 4 weeks showed a lack of consolidation of the fracture in 8 patients and at 8 weeks in 4. Despite this, all patients demonstrated normal function of the hand and all returned to normal daily activity and to work. The results of this study demonstrate that clinical assessment of phalangeal or metacarpal fracture healing based on the lack of pain in reaction to applying pressure on the fracture site is a better and more reliable method than radiological estimation which shows bone union significantly later. The proposed clinical assessment allows patients a significantly earlier normal use of the affected hand.</p> </abstract>ARTICLEtrue of the surgical treatment of gastrointestinal stromal tumours: a case series<abstract> <title style='display:none'>Abstract</title> <p>Gastrointestinal stromal tumours (GISTs) are rare malignant neoplasms that develop mainly in the gastrointestinal tract. They typically cause non-specific dyspeptic symptoms in the abdominal cavity or gastrointestinal bleeding. Treatment may vary depending on the location, mitotic activity and clinical manifestations of the tumour. This study analyses the cases of patients with GISTs treated at the Department of General, Minimally Invasive and Gastroenterological Surgery of the Independent Public Teaching Hospital in Szczecin, Poland, from 2017 to 2022.</p> </abstract>ARTICLEtrue genes and antibiotic resistance among clinical strains<abstract> <title style='display:none'>Abstract</title> <p><bold>Introduction</bold>: <italic>Klebsiella pneumoniae</italic> is one of the etiological factors of nosocomial infections. Recently, infections caused by these bacteria have become more dangerous due to the acquired resistance to many antibiotics, severely limiting therapeutic options. The most common mechanism of resistance in <italic>K. pneumoniae</italic> rods is the production of extended-spectrum β-lactamases (ESBL). However, a more perilous mechanism is the production of carbapenemases. The course of the infection process is also influenced by various virulence characteristics, primarily enabling adhesion and aiding in avoiding host immune responses. Most genes encoding mechanisms of resistance and virulence are located on plasmids, facilitating their spread. The aim of the study was to detect selected virulence genes among clinical multidrug-resistant strains of <italic>K. pneumoniae</italic>.</p> <p><bold>Materials and methods</bold>: We determined the drug susceptibility of strains and confirmed the presence of antibiotic resistance mechanisms using phenotypic methods. Additionally, we assessed the presence of genes encoding selected resistance mechanisms and genes determining selected virulence factors. A total of 134 strains from various hospital units were used for the study.</p> <p><bold>Results</bold>: The highest percentage of strains was isolated from urine (46%). Among the isolates, 72% were from male patients. Fifty-seven percent of <italic>K. pneumoniae</italic> produced ESBL (KpESBL), while the remaining 43% carried the New Delhi metallo-β- lactamase (NDM) mechanism. The drug susceptibility of the KpESBL varied, with full sensitivity observed only in the case of antibiotics from the carbapenem group. New Delhi metallo- β-lactamase-producing <italic>K. pneumoniae</italic> showed sensitivity only to amikacin and gentamicin. In KpESBL strains, genes from the TEM family were most observed (74/76). Most of the strains had all 4 β-lactamase-encoding genes (61/76). In the group of strains producing carbapenemases, only the bla NDM gene was detected. Regardless of the resistance mechanisms, the tested strains most often had virulence genes related to the adhesion ability (fimH) and the structure of LPS (wabG).</p> </abstract>ARTICLEtrue dental considerations of outpatient inhalation therapy<abstract> <title style='display:none'>Abstract</title> <p>Inhalation is one of the routes of drug administration used in therapy. Medicines are dispersed via an aerosol spray, mist, powder or vapour that patients breathe into their airways. Depending on the intrapulmonary behaviour of each molecule of the inhaled agent, the prevailing effect obtained may be local or general. Inhaled therapy, due to its local effect, is a cornerstone of obstructive pulmonary diseases like asthma and chronic obstructive pulmonary disease (COPD), while the general effects of vaporised medical cannabis support its use in other indications (e.g. epilepsy, insomnia, spastic pain). Regardless of the purpose of use, an inhaled drug passes through the oropharynx and a major portion of its dose remains there. This paper focuses on the impact of inhaled therapy on the oral cavity, highlighting the issues important for dental practitioners. The most common indications for inhaled therapy are presented together with the devices used for this route of administration and the drugs employed in outpatient care. Particular attention is paid to oral side effects of inhaled medicines and their pathophysiology. The advisable measures for dental care of patients using inhaled therapy are presented.</p> </abstract>ARTICLEtrue analysis of mandibular movements during speech depending on the skeletal class<abstract> <title style='display:none'>Abstract</title> <p>Speech is one of the most important functions of the stomatognathic system. The aim of the study was to assess mandibular movements during speech depending on the skeletal class and the mutual relationship between the incisors. Forty-nine patients without functional disorders of the masticatory organ were examined. In subjects with skeletal class I, the mean length of condylar motion in the sagittal plane was 0.8 mm; in the case of class II, it was – 1.2 mm; and for class III, it was 0.9 mm. There was no statistically significant correlation between the examined parameters of mandibular translation movement during speech with gender or skeletal class. However, the correlations between the maximum mandibular rotation angle and the position of the incisors were statistically significant.</p> </abstract>ARTICLEtrue of direct coercive measures. Report of medical staff’s opinions (Part 1)<abstract> <title style='display:none'>Abstract</title> <p><bold>Introduction</bold>: Our research aimed to assess the application of direct coercive measures based on the opinions of medical staff.</p> <p><bold>Materials and methods</bold>: A cross-sectional study was held using an original questionnaire, implemented in 2019 and 2020, with 205 medical staff as respondents (including 170 nurses and 23 doctors) in 3 hospitals in Poland.</p> <p><bold>Results</bold>: According to healthcare staff opinions, the most frequent reason for the application of direct coercive measures involved the patients’ aggression directed at themselves (active self-abuse, 70.73%) or others (67.80%). Other reasons for coercion (such as damaging or throwing things, disturbing the operation of the facility, and passive self-abuse) accounted jointly for 80.04% of the cases. The main reason for the significantly more frequent application of coercion (once a month or more often) involved alcohol consumption (25.6%) and consumption of other psychoactive substances (18.84%; p &lt; 0.001). It was significantly more frequently used (once a month or more often) for mentally ill patients (24.15%) than for patients with intellectual disabilities (5.8%; p &lt; 0.001). The most frequently used measure was immobilisation (once a month or more often: 37.68%), and the rarest one was seclusion (6.76%).</p> <p><bold>Conclusions</bold>: The most frequent reason for the application of coercive measures involved self-abuse or aggression caused by the consumption of psychoactive substances. Frequent application of the measures for other reasons that do not directly threaten human life or health requires further research. In particular, the frequent use of immobilisation compared to the infrequent use of seclusion requires further research. To protect patients’ rights, it is urgently needed to clarify ambiguous terms used to describe reasons for the application of coercive measures by the legislator. Preventing violent behaviour through architectural solutions and preparing staff and wards for crisis intervention would benefit patients and staff. The public funding of the hospital-type facilities from which the respondents came highlights the need for government investment in treatment facilities where people with mental disorders and mental illnesses are located.</p> </abstract>ARTICLEtrue reattachment of fractured anterior teeth with pulp exposure: a 10-year follow-up<abstract> <title style='display:none'>Abstract</title> <p>Coronal fractures of the anterior teeth are a common form of dental injury. Reattachment of fractured tooth fragments using dental adhesive techniques offers some advantages, including restoration of the function, aesthetics, shape, texture, and brightness of the surface. The present report describes a clinical case of partial pulpotomy by the Cvek technique and reattachment with a 10-year clinical and radiographic follow-up in permanent maxillary central incisors with complicated crown fractures.</p> </abstract>ARTICLEtrue