The position of a duodenal diverticulum in the area of the major duodenal papilla and its potential clinical implications

Background: Although duodenal diverticula are associated with less frequent pathology than the colonic diverticula in the large intestine, their periampullary position may have significant clinical implications. The aim of the study was to identify any possible correlation between the type of localisation of the major duodenal papilla, duodenal diverticula, and some particular clinical issues. Materials and methods: In total, 628 patients (408 females and 220 males; aged 21–91 years), who underwent endoscopic retrograde cholangiopancreatography were included in this study. The patients were divided into two groups: a study group comprising 66 (10.5%) patients with periampullary position of diverticula (group A), and a control group comprising 562 (89.5%) patients without diverticula (group B). Results: A duodenal diverticulum was diagnosed in the periampullary position in 66/628 (10.5%) patients: 41 women (aged 52–91 years) and 25 men (aged 54–83 years). Conclusions: Three types of localisation were observed for the major duodenal papilla with regard to the diverticula, with the most common type being next to each other (type III). In patients with diverticula, similar frequencies of gallstone occurrence are observed in men and women. Patients with papilla in the diverticulum who underwent cholecystectomy are more prone to develop lithiasis

Results of the treatment of adrenocortical cancer patients at the Maria Sklodowska-Curie National Research Institute of Oncology – Krakow Branch

Introduction.Adrenocortical carcinoma (ACC) has an incidence of 1–2 cases per million and the 5-year overall survival (OS) is 16–47%. Surgery is the treatment of choice. Post-operative radiotherapy has been shown to prolong overall survival and the purpose of this work was to show our own, first time in Poland, results of adjuvant radiotherapy in tre­ating this disease. Material and methods.Between 2012 and 2021, 12 patients with ACC were treated. The analyzed group included 9 women and 3 men at a mean age of 44 years (range: 33 to 76 years). A significant increase of tumor size was found in 30% of the subjects. In the analyzed group, 12 patients were qualified to adjuvant radiotherapy, but it was feasible only in 7 patients. The other 5 patients did not undergo radiotherapy. Two patients were disqualified due to metastatic disease and in 3 patients radiotherapy could not be performed due to excessive tumor size and too high a risk of com­plications within the critical organs. Results.3 out of 7 patients who received adjuvant radiotherapy are still alive and 4 of them died. Mean overall survival time was 32 months. The 12-month overall survival rate was 80%. In the group of 5 patients who have not received radiotherapy, 2 patients are still alive. The mean overall survival time is 13.5 months and the 12-month overall survival rate is 60%. Conclusions.Due to rapid disease progression and poor prognosis associated with ACC, patients with tumors located in the adrenal gland require urgent surgical treatment at a reference center. Adjuvant radiotherapy improves treatment results significantly, but is not feasible in some patients due to cancer progression or the tumor location. In patients with ACC, it is important to diagnose the disease and to start adequate treatment as early as possible

Results of the treatment of adrenocortical cancer patients at the Maria Sklodowska-Curie National Research Institute of Oncology – Krakow Branch

Introduction.Adrenocortical carcinoma (ACC) has an incidence of 1–2 cases per million and the 5-year overall survival (OS) is 16–47%. Surgery is the treatment of choice. Post-operative radiotherapy has been shown to prolong overall survival and the purpose of this work was to show our own, first time in Poland, results of adjuvant radiotherapy in tre­ating this disease. Material and methods.Between 2012 and 2021, 12 patients with ACC were treated. The analyzed group included 9 women and 3 men at a mean age of 44 years (range: 33 to 76 years). A significant increase of tumor size was found in 30% of the subjects. In the analyzed group, 12 patients were qualified to adjuvant radiotherapy, but it was feasible only in 7 patients. The other 5 patients did not undergo radiotherapy. Two patients were disqualified due to metastatic disease and in 3 patients radiotherapy could not be performed due to excessive tumor size and too high a risk of com­plications within the critical organs. Results.3 out of 7 patients who received adjuvant radiotherapy are still alive and 4 of them died. Mean overall survival time was 32 months. The 12-month overall survival rate was 80%. In the group of 5 patients who have not received radiotherapy, 2 patients are still alive. The mean overall survival time is 13.5 months and the 12-month overall survival rate is 60%. Conclusions.Due to rapid disease progression and poor prognosis associated with ACC, patients with tumors located in the adrenal gland require urgent surgical treatment at a reference center. Adjuvant radiotherapy improves treatment results significantly, but is not feasible in some patients due to cancer progression or the tumor location. In patients with ACC, it is important to diagnose the disease and to start adequate treatment as early as possible

Economics Imperialism in Law and Economics

Non peer reviewe

The transfer and fate of Pb from sewage sludge amended soil in a multi-trophic food chain: a comparison with the labile elements Cd and Zn

The contamination of agroecosystems due to the presence of trace elements in commonly used agricultural materials is a serious issue. The most contaminated material is usually sewage sludge, and the sustainable use of this material within agriculture is a major concern. This study addresses a key issue in this respect, the fate of trace metals applied to soil in food chains. The work particularly addresses the transfer of Pb, which is an understudied element in this respect, and compares the transfer of Pb with two of the most labile metals, Cd and Zn. The transfer of these elements was determined from sludge-amended soils in a food chain consisting of Indian mustard (Brassica juncea), the mustard aphid (Lipaphis erysimi) and a predatory beetle (Coccinella septempunctata). The soil was amended with sludge at rates of 0, 5, 10 and 20 % (w/w). Results showed that Cd was readily transferred through the food chain until the predator trophic level. Zn was the most readily transferred element in the lower trophic levels, but transfer to aphids was effectively restricted by the plant regulating shoot concentration. Pb had the lowest level of transfer from soil to shoot and exhibited particular retention in the roots. Nevertheless, Pb concentrations were significantly increased by sludge amendment in aphids, and Pb was increasingly transferred to ladybirds as levels increased. The potential for Pb to cause secondary toxicity to organisms in higher trophic levels may have therefore been underestimated