Ultrasound-guided vacuum-assisted core biopsy in the diagnosis and treatment of focal lesions of the breast : own experience

INTRODUCTION: Vacuum-assisted core biopsy (VACB) guided by ultrasound is a minimally invasive method used in diagnosis and treatment of breast focal lesions. Vacuum-assisted core biopsy is an interesting minimally invasive alternative to open surgical biopsy. AIM: To assess the value of ultrasound-guided vacuum-assisted core biopsy in the diagnosis and treatment of breast focal lesions. MATERIAL AND METHODS: In the period 2009-2010, 397 ultrasound-guided vacuum-assisted core biopsies were performed. Mean age of the patients was 41.7 years (18-92 years), and size of the lesions ranged from 3 mm to 65 mm, mean size being 12 mm. All women with diagnosed atypical ductal hyperplasia or cancer were qualified for surgery. The patients with histopathologically benign lesions were under follow-up. RESULTS: Samples sufficient for histopathological examination were obtained from 394 cases (99.2%). Of all 397 lesions, 293 (73.7%) were diagnosed as benign, there were 6 (1.6%) cases of atypical ductal hyperplasia and 98 (24.7%) malignant lesions. Three hundred and sixty-nine lesions were below 15 mm in diameter, of which 339 (91.9%) were totally removed during the VACB. CONCLUSIONS: The results obtained confirm high efficiency of ultrasound-guided VACB in the differential diagnosis of breast focal lesions, including impalpable ones. It is a safe method with a low complication rate. In the case of benign lesions with a diameter not exceeding 15 mm, it allows one to excise the whole lesion and is a very good alternative to an open surgical biopsy. Vacuum-assisted core biopsy should be a standard and the method of choice in diagnosing breast lesions

Preoperative plasma level of IL-10 but not of proinflammatory cytokines is an independent prognostic factor in patients with gastric cancer

There have been many discrepant observations on the serum levels of cytokines in cancer patients and their prognostic value. The purpose of this study was to determine the plasma levels of pro- and anti-inflammatory cytokines and their clinical significance in a large group of patients with gastric carcinoma. The levels of tumour necrosis factor alpha (TNF α), interleukin-12p40 (IL-12p40), IL-12p70, IL-18, IL-10 and soluble TNF receptors I and II sTNF-Rs were investigated in the plasma of 136 consecutive patients with biopsy proven gastric cancer using specific enzymelinked immunoabsorbent assays (ELISA). Survival curves were estimated using the method of Kaplan and Meier and the differences in the survival rates were tested by the logrank test. For multivariate analysis of prognostic factors, the Cox proportional hazard model was used. Proinflammatory cytokines and sTNF-Rs were higher in the whole group of patients in comparison to healthy volunteers. IL-10 was elevated mostly in advanced disease. The increased levels of IL-10 (>10 pg/ml) were associated with significantly poorer survival of patients, while the levels of the other cytokines and sTNF-Rs showed no correlation with prognosis. The increased level of IL-10 is an independent unfavorable prognostic factor in patients with gastric cancer

Circulating tumour cells and survival of patients with gastric cancer

Background: The prognostic significance of the presence of tumour cells in the blood of gastric cancer patients remains unclear. Their occurrence and its association with the stage of disease and long-term survival was determined. Patients and Methods: Fifty-seven patients with stage I-IV gastric cancer were divided into two groups: these with and these without circulating tumour cells that were identified as cytokeratin positive (CK+) cells among CD45– cells (obtained by sorting of CD45+ leukocytes). Results: Tumour cells were detected prior surgery in the peripheral blood of 54.4% patients but no clear association with the stage of disease was observed. After gastrectomy detection rate was 21.1%. There was no significant difference in the 5-year survival of patients, with or without CK+ in the blood. Conclusion: The presence of circulating tumour cells is of no prognostic value in patients with resectable gastric cancer

The AB0 blood group system v. types of diseases diagnosed in patients admitted to surgical clinics

The distribution of human blood groups varies around the world. Many researchers have been trying to establish whether there are relationships between blood groups and diseases, personality, lifestyle, and nutrition. For some types of illnesses these relations were confirmed whereas for others no significant correlations were proven. There is also a group of studies where data are not yet complete. Describing relations between AB0 blood groups and diseases diagnosed in patients hospitalised in surgical clinics. The study group comprised 1144 adult patients hospitalised in surgical clinics in a hospital in Cracow. The authors used the methodology of diagnostic survey and analysed medical records from the hospital archives. Statistical analysis was performed using Microsoft Excel 2007 software. A blood group was the most common blood type among patients included in this study. Cholelithiasis was the most frequent diagnosis recorded in surgical clinics i.e. 32% of all patients suffered from this disease. We found correlations between the AB0 blood groups and the following morbidities: cholelithiasis and blood type A (p = 0.046), colorectal cancer and B group (p = 0.013), and pancreatic cancer and blood type B (p = 0.039). Individuals with blood type B presented the greatest risk of developing cancer (p < 0.003) and the odds ratio was 1.47. The lowest risk was observed for blood type 0

Physical activity among Polish and English residents of nursing homes

Physical activity is one of the indicators of a healthy lifestyle. Physical activity after the age of 65 gives the ability to maintain physical capacity at a much higher level than people who live inactive lifestyle. The aim of this study was to assess the physical activity of older people living in Polish and English nursing homes. The study was conducted in February and March 2013. The research material consisted of 59 people. 29 respondents are residents in Chislehurst and 30 respondents are residents in Krakow. The research method was a diagnostic survey and the research tool was a questionnaire of own authorship.CDS and Barthel scale were used also. The vast majority of respondents assessed their lifestyle which led in the past as active. In both groups, the most common response to the current fitness was moderate fitness. 76.3% of the respondents received Low levels depending on the care by CDS scale and the vast majority of people - 61 % was placed in Group I in accordance with the Barthel scale. It can be concluded that in the group of English respondents, lifestyle, fitness assessment were significantly associated with the results of the CDS scale and Barthel scale. The more active lifestyle in the past and higher subjective evaluation of the efficiency of the English residents, the favorable results of the CDS scale and Bartel scale. In the group of Polish residents such a relationship is not found

The development of a concept of nursing process : a review of articles published by Stefania Poznanska in "Nurse and Midwife"

With her life and work, Stefania Poznanska promoted the development of modern nursing in Poland. The concept of nursing process was formed in the course of many years. At first, nursing care was understood as an active process of cooperation between nurses and patients. This concept was followed by another one defining nursing as interpersonal interactions with behavioural and therapeutic significance. The next definition of nursing care assumed it delivered assistance to individuals requiring help and it met their basic health and biopsychosocial needs. From the beginning special attention was paid to the fact that patients' needs must be noticed and adequate actions should be taken referring to an individual plan of care. At first, the concept of "a plan" was often used as well as the idea of nursing process. Finally, they were defined as a plan and a process of nursing. With time the stages of nursing process evolved. Currently the following five concepts are used most frequently: data collection, nursing diagnosis, planning, nursing interventions, and evaluation

Properties of monocytes generated from haematopoietic CD34+ stem cells from bone marrow of colon cancer patients

Monocytes exhibit direct and indirect antitumour activities and may be potentially useful for various forms of adoptive cellular immunotherapy of cancer. However, blood is a limited source of them. This study explored whether monocytes can be obtained from bone marrow haematopoietic CD34(+) stem cells of colon cancer patients, using previously described protocol of expansion and differentiation to monocytes of cord blood-derived CD34(+) haematopoietic progenitors. Data show that in two-step cultures, the yield of cells was increased approximately 200-fold, and among these cells, up to 60 % of CD14(+) monocytes were found. They consisted of two subpopulations: CD14(++)CD16(+) and CD14(+)CD16(−), at approximately 1:1 ratio, that differed in HLA-DR expression, being higher on the former. No differences in expression of costimulatory molecules were observed, as CD80 was not detected, while CD86 expression was comparable. These CD14(+) monocytes showed the ability to present recall antigens (PPD, Candida albicans) and neoantigens expressed on tumour cells and tumour-derived microvesicles (TMV) to autologous CD3(+) T cells isolated from the peripheral blood. Monocytes also efficiently presented the immunodominant HER-2/neu(369–377) peptide (KIFGSLAFL), resulting in the generation of specific cytotoxic CD8(+) T lymphocytes (CTL). The CD14(++)CD16(+) subset exhibited enhanced cytotoxicity, though nonsignificant, towards tumour cells in vitro. These observations indicate that generation of monocytes from CD34(+) stem cells of cancer patients is feasible. To our knowledge, it is the first demonstration of such approach that may open a way to obtain autologous monocytes for alternative forms of adaptive and adoptive cellular immunotherapy of cancer