Glioblastoma multiforme - case presentation and literature review

Glioblastoma multiforme is a most common primary brain tumor with extreme malignancy index. Presented case of 75y.o. patient diagnosed with GBM underwent full treatment : surgery and adjuvant proton-therapy. Despite new therapy development, overall survival time of GBM patients is still unacceptable

Retrospective assessment of the Lung-RADS performance in the Silesian Lung Cancer Screening Pilot Study

Background. A high percentage of false positive results, observed in lung cancer screening studies with low-dose computed tomography (LDCT), caused the modification of radiological assessment methods. According to the International Early Lung Cancer Action Program (IELCAP) all non-calcified nodules with a dimension ≥ 4 mm were considered as positive. Implementation of classification the Lung CT screening Reporting and Data System (Lung-RADS®) recommends additional testing only for nodules ≥ 6 mm, which reduced of false positive results. Methods. We provided a retrospective analysis of 601 LDCT scans, in asymptomatic volunteers of Pilot Silesian Study of Early Lung Cancer Detection, with at least 20 pack-years of cigarette smoking. The analysis of non- and invasive interventions was done. Assessment of nodules according to the Lung-RADS® system was done. Then the percentage of interventions that could be avoided using the Lung-RADS® criteria was estimated. Results. In total, 1016 nodules were identified in 265 participants. The positive result of screening was defined as a presence of solid or part-solid nodule ≥ 5 mm and ≥ 8 mm in the case of a nonsolid nodule in line with the IELCAP protocol. Screening based on the IELCAP protocol resulted in 200 positive results and based on Lung-RADS® in the 116 positives. The frequency of lung cancers among participants with a positive result was 7 of 200 (4.0%) (95% CI: 1.0%, 6.0%) for IELCAP and 7 of 116 (6.0%) (95% CI: 2.7%, 9.3%) for Lung-RADS®. The Lung-RADS® criteria reduced number of non- and invasive procedures by 48.8% and 24.1%, compared to IELCAP protocol. Conclusions. Adopting the Lung-RADS® classification system may reduce harms and improve the efficiency of lung cancer screening programs.xx

A patient with an acute traumatic subdural hematoma chronically treated with rivaroxaban – a challenge for neurosurgeons

Czyżewski Wojciech, Tyzo Bartłomiej, Litak Jakub, Podkowiński Arkadiusz. A patient with an acute traumatic subdural hematoma chronically treated with rivaroxaban – a challenge for neurosurgeons. Journal of Education, Health and Sport. 2017;7(9):357-363. eISSN 2391-8306. DOI http://dx.doi.org/10.5281/zenodo.998963 http://ojs.ukw.edu.pl/index.php/johs/article/view/4897 The journal has had 7 points in Ministry of Science and Higher Education parametric evaluation. Part B item 1223 (26.01.2017). 1223 Journal of Education, Health and Sport eISSN 2391-8306 7 © The Authors 2017; This article is published with open access at Licensee Open Journal Systems of Kazimierz Wielki University in Bydgoszcz, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 15.08.2017. Revised: 10.09.2017. Accepted: 10.09.2017. A patient with an acute traumatic subdural hematoma chronically treated with rivaroxaban – a challenge for neurosurgeons Wojciech Czyżewski1, Bartłomiej Tyzo2, Jakub Litak2, Arkadiusz Podkowiński2 1 Medical University of Lublin, Department of Didactics and Medical Simulation 2 Department of Neurosurgery and Pediatric Neurosurgery SPSK-4 in Lublin Abstract Rivaroxaban (Xareltoâ), selective direct inhibitor of activated clotting factor Xa belongs to the new oral anticoagulatns (NOACs). Rivaroxaban works to inhibit thrombin formation, and the interruption of the intrinsic and extrinsic pathway of blood coagulation and is strongly dose-dependent. It prolongs Prothrombin Time (PT) and Activated Partial Thromboplastin Time (APTT) without influence on bleeding time and platelet aggregation. It is indicated as a prophylactic to cerebral infarction and peripheral thrombosis in adults with nonvalvular atrial fibrillation as well as the treatment and secondary prevention of deep vein thrombosis and pulmonary thromboembolism. We are presenting a case of an elderly female patient chronically treated with rivaroxaban, who was qualified for neurosurgical treatment in a life threatening state due to an acute subdural hematoma. Despite the lack of unequivocal guidelines for pharmacological and surgical management in cases of intracranial haemorrhage in adults whom are chronically treated with direct factor Xa inhibitors, we managed to obtain a favourable outcome. Key words: rivaroxaban, atrial fibrillation, acute subdural hematoma Pacjentka z ostrym pourazowym krwiakiem podtwardówkowym przewlekle leczona rywaroksabanem - wyzwanie dla neurochirurgii Wojciech Czyżewski1, Bartłomiej Tyzo2, Jakub Litak2, Arkadiusz Podkowiński2 1 Zakład Dydaktyki i Symulacji Medycznej Uniwersytetu Medycznego w Lublinie 2 Klinika Neurochirurgii i Neurochirurgii Dziecięcej SPSK4 w Lublinie Abstrakt Rywaroksaban (Xareltoâ), wybiórczy bezpośredni inhibitor aktywnego czynnika krzepnięcia Xa należy do tzw. nowych leków przeciwzakrzepowych. Działanie leku polega na hamowaniu wytwarzania trombiny, zahamowanie zewnątrz- i wewnątrzpochodnego szlaku krzepnięcia jest silnie zależne od przyjętej dawki. Dochodzi do wydłużenia czasu protrombinowego (PT) oraz czasu częściowej tromboplastyny po aktywacji (APTT), bez wpływu na czas krwawienia i agregację płytek. Preparat znajduje zastosowanie w profilaktyce udaru i zatorowości obwodowej u dorosłych pacjentów z niezastawkowym migotaniem przedsionków oraz leczeniu i profilaktyce wtórnej zakrzepicy żył głębokich i zatorowości płucnej. Prezentujemy przypadek pacjentki w podeszłym wieku przewlekle leczonej rywaroksabanem, która została zakwalifikowana w stanie zagrożenia życia do leczenia neurochirurgicznego z powodu ostrego krwiaka podtwardówkowego. Pomimo braku jednoznacznych wytycznych postępowania farmakologicznego oraz operacyjnego w sytuacji krwotoku wewnątrzczaszkowego u chorych leczonych bezpośrednimi inhibitorami aktywnego czynnika X, u prezentowanej pacjentki uzyskano pomyślny przebieg leczenia. Słowa kluczowe: rywaroksaban, migotanie przedsionków, ostry krwiak podtwardówkow

Immunomodulation - hope for patient with Glioblastoma Multiforme

Glioblastoma multiforme is the most common and highly aggressive brain tumor, causing high number of death worldwide. Current therapies are not sufficient for patients. The surgical removal followed by radio- and chemotherapy became golden standard. Overall survival is still disappointing. New approach to GBM therapy is required . Immunotherapy seems to be a proper direction

Pineal cyst-related sleep disorders – a narrative review

The pineal gland is an endocrine gland, which is responsible for the human circadian rhythm, through the regulation of its hormone – melatonin. The most common pathology of a pineal gland is pineal cyst – its population incidence is estimated as 1-23%, depending on the publication. The most common symptoms of a pineal cyst include headache (87%), visual field defects (54%), nausea/vomiting (34%), and dizziness/vertigo (31%). Among the majority of patients with the asymptomatic pineal cyst, the wait-and-see strategy is proper.             According to the newest meta-analyze, the prevalence of sleep disturbances among patients with pineal cyst estimates to be 17%. The results of direct melatonin level measurements in pineal cysts remain unclear. The study focused on sleep disturbances in pediatric patients with pineal cysts and showed a significantly higher score on Sleep Disturbance Scale for Children (SDSC) in the domains of disorders of excessive sleepiness and disorders of initiating and maintaining sleep than the control groups. The impact of lesion on sleep quality correlated with its size.             The pineal cyst may be considered a rare, and potentially reversible, cause of sleep disorders. Nevertheless, according to the present reports (often opposite to each other), this thesis and the mechanism of its occurrence need to be further researched

Long - term concequences of subdural hematoma on quality of life

Czyżewski Wojciech, Litak Jakub, Kulesza Bartłomiej, Rolińska Agnieszka, Staniewicz Dominik, Grochowski Cezary, Kruk Rafał, Tyzo Bartłomiej. Long - term concequences of subdural hematoma on quality of life. Journal of Education, Health and Sport. 2018;8(9):961-965. eISNN 2391-8306. DOI http://dx.doi.org/10.5281/zenodo.1419662 http://ojs.ukw.edu.pl/index.php/johs/article/view/5990 https://pbn.nauka.gov.pl/sedno-webapp/works/877650 The journal has had 7 points in Ministry of Science and Higher Education parametric evaluation. Part b item 1223 (26/01/2017). 1223 Journal of Education, Health and Sport eissn 2391-8306 7 © The Authors 2018; This article is published with open access at Licensee Open Journal Systems of Kazimierz Wielki University in Bydgoszcz, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 02.09.2018. Revised: 12.09.2018. Accepted: 15.09.2018. Long - term concequences of subdural hematoma on quality of life Wojciech Czyżewski1, Jakub Litak2, Bartłomiej Kulesza2, Agnieszka Rolińska3, Dominik Staniewicz4, Cezary Grochowski2, Rafał Kruk2, Bartłomiej Tyzo2 1 Department of Didactics and Medical Simulation Medical University of Lublin. 2 Department of Neurosurgery and Pediatric Neurosurgery SPSK-4 in Lublin. 3 Department of Clinical Psychology, 4 Medical University of Lublin. \ Krwiak podtwardówkowy i jego długoterminowy wpływ na jakość życia 1 Zakład Dydaktyki i Symulacji Medycznej Uniwersytetu Medycznego w Lublinie. 2 Klinika Neurochirurgii i Neurochirurgii Dziecięcej SPSK4 w Lublinie. 3 Zakład Psychologii Stosowanej Uniwersytet Medyczny w Lublinie. 4 Uniwersytet Medyczny w Lublinie. Abstract Subdural hematoma (SDH) could be an acute state required rapid neurosurgical decompression, could also represent chronic form; both develop after head trauma as well. Long term influence on a quality of life depend on many factors. Researchers put a lot of effort to find those which play most predictive role. Abstrakt Krwiak podtwardówkowy jako stan nagły może wymagać szybkiej dekompresji neurochirurgicznej, może również mieć formę przewlekłą - oba mogą być związane z urazem głowy. Długoterminowy wpływ na jakość życia zależy od wielu czynników. Badacze poszukuję tych ,które maja największa wartość predykcyjną. Key words: Subdural hematoma, bleeding. Słowa kluczowe: Krwiak podtwardówkowy, krwawienie

Multidisciplinary approach for a severe head burn caused by high-voltage electrical shock - a case report

In modern reconstructive medicine, personalized bone substitutes provide therapeutic hope for patients with non-standard bone defects. The study aims to present a description of a case of using a personalized bone substitute material, taking into account the vascular connections formed after a previous skin transplant.  The 29-year-old patient was admitted to the plastic surgery department urgently after being electrocuted with high voltage. Due to extensive scalp burns, a skin graft was performed in the area of previously removed skin along with a charred skull bone vault.  After a few months, the patient was qualified for cranioplasty with the use of personalized bone substitutes. The necessity to make cuts around the vascular connections present in the transplanted tissue was the main difficulty in the for the operator.  The operation was successful and the recovery was uneventful. The patient was discharged home in good general and local condition.  The presented case illustrates the need to take into account creating vascular connections with the use of personalized bone substitutes in patients after skin transplants

Reasons for reoperation of patients undergoing surgical evacuation of an acute subdural hematoma – case raport and review of literature

Background: We are presenting a case and as well as its analyzis regarding subdural hematoma reoperations. Case description: A 48-year-old patient after head trauma operated on due to diagnosed right-sided subdural hematoma. On the second day of hospitalization he developed epidural hematoma at the operation site, which reuired second surgery. Conclusion: Early detection and prompt treatment may improve the poor outcome in this group of patients. The choice between craniotomy and craniectomy and additional risk factors as ASA and antiplatelet intake as well as age and alcohol abuse have unverified importance in the context of reoperation

Long - term concequences of subdural hematoma on quality of life

Subdural hematoma (SDH) could be an acute state required rapid neurosurgical decompression , could also represent chronic form ; both develope after head trauma as well. Long term influence on a quality of life depend on many factors. Reaserchers put a lot of effort to find those wchich play most predictive role