Intensive anticancer therapy in elderly patients – does it make sense? A case report

Anticancer therapy in elderly patients poses a great challenge for doctors since not all available therapeutic modalities can improve the wellbeing, alleviate symptoms or improve prognosis in this patient population. The paper presents a case of a 75-year-old woman diagnosed with advanced ovarian cancer who, despite advanced age, received intensive anticancer therapy, i.e. surgical treatment (modified posterior exenteration with the resection of pelvic peritoneum and tumor invasion in the diaphragmatic peritoneum along with its fragment, subtotal colectomy, resection of the omentum, spleen and gastric fragment along with the gastro-transverse ligament and an end ileostomy) as well as adjuvant chemotherapy. Severe complications occurring during treatment were not directly related to the therapy, but resulted from the lack of proper patient care in a home setting

The role of neoadjuvant chemotherapy in the management of advanced ovarian cancer in geriatric patients

It is increasingly common for ovarian cancer to affect older women, with over half of all cases involving patients aged 65 years and older. Unfortunately, elderly patients with ovarian malignancy tend to be treated less aggressively than younger patients, with less extensive surgery and less intensive chemotherapy regimens. This is due to a variety of factors, such as overall medical fitness and the function of specific organs. Moreover, multiple morbidities are typical for geriatric patients and affect their eligibility for certain forms of cancer therapy as well as their treatment outcomes, which are commonly less satisfactory than in younger patients. Additionally, for fear of complications, treating physicians sometimes limit the extent of the necessary surgery, or adjust chemotherapy doses, even though such a course of management tends to be largely misguided. One available management option is neoadjuvant chemotherapy followed by a surgical treatment known as interval debulking surgery. This type of combination therapy is associated with fewer postoperative complications, thus increasing the patient's chances of receiving a full course of adjuvant treatment. The decision to begin treatment with neoadjuvant chemotherapy tends to restrict later surgical therapy; however, under certain circumstances, this therapy can be a valid therapeutic option and, in fact, facilitate surgery. Prior to initiating therapy in elderly patients, their eligibility for combination therapy must be evaluated and the geriatric assessment of their performance and condition must be considered during the course of interdisciplinary preoperative management

Stopping power of Au for silver ions at low velocities

Energy loss measurements for the slowing down of Ag ions in Au, in the velocity range 1:6v0 < v < 4:4v0, where v0 is the Bohr velocity, are presented. The measurements were performed using the Doppler shift technique and also with a new method, where a secondary beam of low velocity heavy ions is produced by elastic scattering of the accelerated beam. The results are compared to the SRIM2000 calculations (www.srim.org) and to recent measurements in this velocity region

Lipemia poposiłkowa — problem kliniczny i potencjalne miejsce w algorytmach diagnostycznych Stanowisko polskich ekspertów

The following elaboration presents positions of experts from various, mainly European scientific societies regarding utility of postprandial hypertriglyceridemia (HTG) in predicting cardiovascular (CV) risk. New studies and different categories of patients have been included. The following text has been based mainly on 2019 European Society of Cardiology and European Atherosclerosis Society guidelines regarding the management of dyslipidemia, as well as the 2019 international expert panel document. The position of Polish experts on using oral fat tolerance test in clinical practice has also been presented. Remaining problem is to assess potential usefulness of postprandial HTG in estimation of CV risk and to determine whether performing the oral fat tolerance test, that involves consumption of a standard high-fat preparation followed by blood collection at indicated time intervals, can improve CV risk assessment. Although importance of postprandial HTG in the assessment of atherogenic risk is increasingly well documented, there is still need for further research.W poniższym opracowaniu przedstawiono stanowiska ekspertów z różnych towarzystw, głównie europejskich, dotyczące roli hipertriglicerydemii (HTG) poposiłkowej w przewidywaniu ryzyka sercowo-naczyniowego (CV). Uwzględniono nowe badania i różne kategorie pacjentów. Oparto się głównie na wytycznych European Society of Cardiology i European Atherosclerosis Society z 2019 roku, dotyczących postępowania w dyslipidemii, oraz panelu Postprandial hypertriglyceridaemia revisited in era of non-fasting lipid profile testing: a 2019 Expert Panel Statement, main text. Przedstawiono także stanowisko polskich ekspertów stosujących doustny test tolerancji tłuszczów w praktyce klinicznej. Problemem pozostaje ocena roli HTG w szacowaniu ryzyka CV oraz ustalenie, czy spożycie standardowego wysokotłuszczowego preparatu, a następnie pobranie krwi we wskazanym przedziale czasowym, czyli doustny test tolerancji tłuszczów, może poprawić ocenę ryzyka CV. Znaczenie HTG poposiłkowej w ocenie ryzyka aterogennego jest coraz lepiej udokumentowane, jakkolwiek istnieje potrzeba dalszych badań

Poprawa skuteczności osiągania celu terapeutycznego w zakresie docelowego stężenia cholesterolu frakcji LDL u pacjentów po ostrym zespole wieńcowym. Stanowisko grupy ekspertów

Intensywna terapia hipolipemizująca powoduje obniżenie ryzyka zgonu z przyczyn sercowo-naczyniowych, zawału serca, udaru niedokrwiennego mózgu oraz rewaskularyzacji wieńcowej. Niestety, mimo szerokiej dostępności na rynku farmaceutycznym preparatów hipolipemizujących, nadal obserwuje się niewielką skuteczność osiągania celów terapeutycznych w zakresie redukcji stężenia cholesterolu frakcji LDL, szczególnie u pacjentów po ostrym zespole wieńcowym. Poniższy dokument, będący stanowiskiem grupy ekspertów, w postaci krótkich i zwięzłych treści odnosi się do przyczyny takiego stanu rzeczy, jak również proponuje możliwe rozwiązania terapeutyczne i organizacyjne

ERAP1 and HLA-C*06 are strongly associated with the risk of psoriasis in the population of northern Poland

Introduction: HLA-C*06 is a major psoriasis genetic risk marker. Recent reports have been focused on the role of different polymorphisms within genes involved in the functioning of the epidermal barrier and antigen processing in the pathogenesis of psoriasis. Data on the association between genetic variants of LCE3B_LCE3C, CSTA, ERAP1, ZAP70 and this dermatosis in the population from Eastern Europe are lacking. Aim: To compare the association between known genetic risk markers and psoriasis in a cohort of northern Polish patients with psoriasis and healthy controls. Material and methods: Based on previous studies’ results, five susceptibility loci: HLA-C, LCE3C_LCE3B, ERAP1, ZAP70 and CSTA were selected for genotyping in 148 patients with chronic plaque psoriasis and 146 healthy controls. Each patient with this disease was clinically assessed with the Psoriasis Area and Severity Index. Results: The study population showed a significant association of psoriasis and a single nucleotide polymorphism in the ERAP1 – rs26653 (p = 3.11 × 10–5) and HLA-C*06 allele (p = 1.02 × 10–11) when compared with the control group. The presence of HLA-C*06 or rs26653 G allele significantly increased the risk of psoriasis by 2.4 times or twice, respectively. Carrying rs26653 C allele considerably decreased the risk of psoriasis by 1.5 times. Conclusions: In the context of pathogenesis of psoriasis, our findings might give the evidence on disturbances in the proteolytic processing of N-terminal fragments of antigens presented via major histocompatibility complex class I to T cells

A nanostructural view of the cell wall disassembly process during fruit ripening and postharvest storage by atomic force microscopy

Background: The mechanical properties of parenchyma cell walls and the strength and extension of adhesion areas between adjacent cells, jointly with cell turgor, are main determinants of firmness of fleshy fruits. These traits are modified during ripening leading to fruit softening. Cell wall modifications involve the depolymerisation of matrix glycans and pectins, the solubilisation of pectins and the loss of neutral sugars from pectin side chains. These changes weaken the cell walls and increase cell separation, which in combination with a reduction in cell turgor, bring about textural changes. Atomic force microscopy (AFM) has been used to characterize the nanostructure of cell wall polysaccharides during the ripening and postharvest storage of several fruits. This technique allows the imaging of individual polymers at high magnification with minimal sample preparation. Scope and approach: This paper reviews the main features of the cell wall disassembly process associated to fruit softening from a nanostructural point of view, as has been provided by AFM studies. Key findings and conclusions: AFM studies show that pectin size, ramification and complexity is reduced during fruit ripening and storage, and in most cases these changes correlate with softening. Postharvest treatments that improve fruit quality have been proven to preserve pectin structure, suggesting a clear link between softening and pectin metabolism. Nanostructural characterization of cellulose and hemicellulose during ripening has been poorly explored by AFM and the scarce results available are not conclusive. Globally, AFM could be a powerful tool to gain insights about the bases of textural fruit quality in fresh and stored fruits