WHOQOL-BREF survey of quality of life among dialyzed end-stage renal disease patients

Introduction: Hemodialysis (HD) improves health and prolongs the life of end-stage renal disease patients, but simultaneously leads to emotional disturbances and impairs the quality of life (QOL). The study was conducted to evaluate the QOL of HD patients. The study was approved by the Regional Bioethical Committee (K.B.Cz.-0014/2017). Material and methods: The World Health Organization Questionnaire of QOL (WHOQOL-BREF) was used in this study with the formal agreement of the WHO. The associations between each patient-related and dialysis-related factor and WHOQOL-BREF domains and questions were computed. The variables were compared by the Student t-test. Results: Data were collected in August 2017 in a single access center. Sixty-nine patients, including 23 (33.3%) women, were evaluated. The factors lowering the scores for particular questions and domains of WHOQOL-BREF were senility, marriage, wrist and arm AVF, not-tunneled CVCs (vs. tunneled), and unwillingness to have a kidney graft. The factors that increased scores for particular questions and domains of WHOQOL-BREF were short dialysis, tunneled CVCs (vs. not-tunneled), and higher URR. The relations between domains and questions of WHOQOL-BREF and sex, education, months on dialysis, kidney graft in the past, fulfillment of medical recommendations, Kt/V and UF were not significant. Conclusions: Although a kidney graft is the best kidney replacement therapy, there is a large group of patients who do not want to receive this treatment. This group should be given special attention. The medical professionals in HD units should remember that patients may not feel comfortable with their disease and satisfied with their body image affected by therapy

Palaeogeographical distribution of early Bathonian ammonites of the Asphinctites-Polysphinctites group

The study of ammonites representing the dimorphic pair Asphinctites tenuiplicatus (Brauns) — Polysphinctites secundus (Wetzel) in the Tenuiplicatus Zone of Lower Bathonian in Central Poland, reveals their abnormal large sizes when compared with those occurring in other areas of Europe. The biogeographic distribution of the discussed ammonites, as well as older representatives of Asphinctites and Polysphinctites shows a general decrease in size of both forms towards south from the Submediterranean Province to the Mediterranean Province, and to the general disappearance of Polysphinctites in the Mediterranean Province. The phenomena may be related to changing environmental conditions which influenced the development of the discussed ammonites. We suggest that the ammonites inhabiting more distant areas from the Mediterranean Province, at the periphery of geographic range of the species, could have reached larger sizes due to prolonged time of maturation

Popromienne guzy opon mózgowo-rdzeniowych. Opis ośmiu przypadków i przegląd piśmiennictwa

Background and purpose Despite their rarity, post-radiation meningeal tumours seem to be a growing problem due to the increasing application of radiation therapy. The aim of the study was to ascertain the specific features of these tumours. Material and methods Among 433 intracranial meningeal tumours treated from 2000 to 2008, eight cases (2%) have been presumed to be associated with high-dose therapeutic radiation for previous neoplasm of the head (7) or neck (1). On average, tumours were diagnosed 24 years after irradiation. All patients had a solitary meningeal tumour, but two of them also developed other neoplasms in the irradiated area. Results All tumours were microsurgically removed. The postoperative course was uncomplicated in two cases only. In the remaining 6 (75%), complications included liquorrhoea (2), brain oedema (1), venous thrombosis (1), bleeding into the tumour bed (1) and focal deficit due to manipulation (3). Most tumours (5) were WHO grade I meningiomas. These benign meningiomas exhibited some peculiar histological features, including focal increase of cellularity, focal enhancement of proliferation index, pleomorphism of nuclei, occasional mitotic figures and, in one case, evidence of brain invasion. One meningioma was assigned to WHO grade II, one to WHO grade III and one appeared to be meningeal fibrosarcoma. The event-free survival and overall survival rate at 4.4 years of follow-up were 63% and 75%, respectively. Conclusions Radiation-induced tumours of the meninges show certain characteristic histopathological features, which may promote invasiveness of the tumour and higher risk of malignancy.Wstęp i cel pracy Popromienne guzy opon mózgowo-rdzeniowych – mimo że stwierdzane rzadko – wydają się narastającym problemem ze względu na szerokie zastosowanie radioterapii. Celem pracy jest charakterystyka kliniczna i histopatologiczna tych guzów. Materiał i metody Spośród 433 śródczaszkowych guzów oponowych operowanych w latach 2000–2008, w 8 przypadkach (2%) stwierdzono związek pomiędzy powstaniem guza a przebytą radioterapią z powodu nowotworów głowy (7) i szyi (1). Guzy popromienne były rozpoznawane średnio po 24 latach od napromieniania. U wszystkich pacjentów wystąpiły pojedyncze guzy opon, ale u 2 dodatkowo pojawiły się inne nowotwory w obszarze napromienianym. Wyniki Wszystkie guzy były leczone mikrochirurgicznie. Przebieg pooperacyjny bez powikłań obserwowano tylko u 2 pacjentów. U pozostałych 6 (75%) komplikacje pooperacyjne obejmowały: płynotok (2), obrzęk mózgu (1), zakrzepicę żylną mózgu (1), krwawienie do loży pooperacyjnej (1) oraz ogniskowe deficyty neurologiczne wskutek manipulacji (3). W większości przypadków (5) stwierdzono oponiaki o niskim stopniu złośliwości histologicznej (I stopień wg WHO), które jednak wykazywały szczególne cechy histopatologiczne: ogniskowy wzrost zagęszczenia komórkowego i podwyższony indeks proliferacyjny, pleomorfizm jąder komórkowych, pojedyncze figury podziałów mitotycznych oraz, w jednym przypadku, cechy naciekania mózgu. W jednym przypadku rozpoznano oponiaka II stopnia wg WHO, w jednym III stopnia wg WHO i w jednym włókniakomięsaka opon. Przeżycie wolne od zdarzeń i przeżycie całkowite w okresie obserwacji trwającym 4,4 roku wyniosły odpowiednio 63% i 75%. Wnioski Popromienne guzy opon mózgowo-rdzeniowych wykazują znamienne cechy histopatologiczne, które mogą sprzyjać większej inwazyjności i złośliwości tych guzów