Spinal cord lesions in children and adolescents with multiple sclerosis – Magnetic resonance imaging

Purpose The purpose of our study was to determine the prevalence of spinal cord lesions revealed by magnetic resonance (MR) imaging in children and adolescents with clinically definite multiple sclerosis (MS). Material and methods We retrospectively evaluated the spinal cord magnetic resonance examinations in a group of MS patients consisting of 58 children (37 girls and 21 boys) aged from 7 to 17.8 years (mean 13.7 years). All children met the criteria of clinically definite MS and had typical MS lesions revealed in the brain imaging. Results Spinal cord lesions, regardless of localization, were identified in 36 (62%) patients. In 22 of 58 patients (38%) no lesions were observed. The plaques were found in the cervical spinal cord and the thoracic spinal cord in 30 out of 36 (86.1%) and in 31 out of 36 (88.6%) patients, respectively. Contrast enhancement was noticed in 10 out of 36 patients (27.7%) and was not correlated with the number of lesions present. We noticed a tendency to higher EDSS score in patients with lesions in more than 1 spinal cord region. Our study showed that spinal cord lesions are more frequently present in patients with complex neurological disability. Conclusion The prevalence of spinal cord lesions in children and adolescents with MS is high. Therefore, spinal cord MRI should be included in diagnostic program of MS

Clinical Relevance and Immunosuppressive Pattern of Circulating and Infiltrating Subsets of Myeloid-Derived Suppressor Cells (MDSCs) in Epithelial Ovarian Cancer

Myeloid-derived suppressor cells (MDSCs) expansion is a hallmark of cancer. Three major MDSC subsets defined as monocytic (M)-MDSCs, polymorphonuclear (PMN)-MDSCs and early stage (e)MDSCs can be revealed in human diseases. However, the clinical relevance and immunosupressive pattern of these cells in epithelial ovarian cancer (EOC) are unknown. Therefore, we performed a comprehensive analysis of each MDSC subset and immunosupressive factors in the peripheral blood (PB), peritoneal fluid (PF), and the tumor tissue (TT) samples from EOC and integrated this data with the patients' clinicopathological characteristic. MDSCs were analyzed using multicolor flow cytometry. Immunosuppressive factors analysis was performed with ELISA and qRT-PCR. The level of M-MDSCs in the PB/PF/TT of EOC was significantly higher than in healthy donors (HD); frequency of PMN-MDSCs was significantly greater in the TT than in the PB/PF and HD; while the level of eMDSCs was greater in the PB compared with the PF and HD. Elevated abundance of tumor-infiltrating M-MDSCs was associated with advanced stage and high grade of EOC. An analysis of immunosuppressive pattern showed significantly increased blood-circulating ARG/IDO/IL-10-expressing M- and PMN-MDSCs in the EOC patients compared with HD and differences in the accumulation of these subsets in the three tumor immune microenvironments (TIME). This accumulation was positively correlated with levels of TGF-β and ARG1 in the plasma and PF. Low level of blood-circulating and tumor-infiltrating M-MDSCs, but neither PMN-MDSCs nor eMDSCs was strongly associated with prolonged survival in ovarian cancer patients. Our results highlight M-MDSCs as the subset with potential the highest clinical significance

Vulvovaginitis in young girls

Abstract Vulvovaginitis is the most common cause of gynecological complaints in young girls. Factors which cause vulvovaginitis include, among other things, low level of sexual hormones (hypoestrogenism), the anatomical proximity of the rectum and delicate vulvar skin and vaginal mucosa. Usually vulvovaginitis in young girls is caused by non-specific factors. The aim of the study was to present the most frequent causes of vulvovaginitis in young girls

Zalecenia Polskiej Grupy Mięsakowej w odniesieniu do postępowania diagnostyczno-terapeutycznego oraz kontroli u chorych na neurofibromatozę typu 1 (NF1) oraz związanego z nią złośliwego nowotworu osłonek nerwów obwodowych

Type 1 neurofibromatosis (NF1 syndrome in von Recklinghausen’s disease) is inherited as an autosomal dominant disease, caused by mutations in the NF1 gene encoding the neurofibromin protein. NF1 patients are at an increased risk of the develop­ment of a malignant neoplasm and their life span is shorter by 20 years than that of the general population. National Institute of Health (NIH) criteria make a diagnosis possible from about 4 years of age. Examination of children and adults should encom­pass a physical and a subjective component, but also next-generation sequencing (NGS) genetic analysis, histopathological examination of skin lesions, neurological, ophthalmological and radiological examination. If a malignant peripheral nerve sheath tumor (MNPST) is diagnosed in a patient with NF1, the therapeutic procedure should not differ from the general principles of treating soft tissue sarcomas. Patients from the high risk group should be monitored at least once a year, the remaining patients once every 2–3 years by a specialized medical team, and every year by their primary physicians, internal medicine specialists and dermatologists. Patients should have access to genetic counselling.Neurofibromatoza typu 1 (zespół NF1 w chorobie Recklinghausena, nerwiakowłókniakowatość typu 1), jest dziedziczona au­tosomalnie dominująco, a odpowiadają za nią mutacje genu NF1 kodującego białko neurofibrominy. Pacjenci z NF1 są naraże­ni na zwiększone ryzyko rozwoju nowotworu złośliwego i żyją około 20 lat krócej niż populacja ogólna. Kryteria National Insti­tute of Health (NIH) umożliwiają postawienie diagnozy już około 4 roku życia. Badanie dzieci i dorosłych powinno objąć bada­nie przedmiotowe i podmiotowe, ale też badanie genetyczne techniką sekwencjonowania nowej generacji (NGS), badanie histopatologiczne zmian skóry, badanie neurologiczne, okulistyczne i radiologiczne. W przypadku postawienia roz­poznania złośliwego nowotworu osłonek nerwów obwodowych (malignant peripheral nerve sheath tumor – MPNST) u chorego na NF1 postępowanie terapeutyczne nie powinno odbiegać od ogólnych zasad leczenia mięsaków tkanek miękkich. Pacjenci z grupy wysokiego ryzyka powinni być monitorowani przynajmniej raz w roku, pozostali – raz na 2–3 lata – przez zespół lekarzy specjalistów, a co roku przez lekarzy podstawowej opieki zdrowotnej (POZ), chorób wewnętrznych i dermatologów. Pacjentom należy zapewnić poradnictwo genetyczne

Mapping the Structure of Food Waste Management Research: A Co-Keyword Analysis

Food loss and waste represent a global problem in the ethical, social, environmental, and economic contexts. The aim of this article is to identify leading concepts in studies on food loss and waste in management research by network analysis of the co-occurrence of keywords, via mapping of knowledge domains, a method used in bibliometrics. We analyzed 2202 records from the Scopus database on food waste management with the aid of the VOSviewer software tool. In particular, keyword co-occurrence analysis was adopted to visually explore knowledge bases, topic distribution, and research fronts in the field of food waste management research. Ten representative areas were found concentrated in main keywords, namely, food waste, waste management, food, anaerobic digestion, waste disposal, recycling, waste treatment, municipal solid waste, solid waste, and refuse disposal

Epidemiological Analysis of Extended-Spectrum β-Lactamase-Producing <i>Klebsiella pneumoniae</i> Outbreak in a Neonatal Clinic in Poland

Klebsiella pneumoniae is one of the most common etiological agents isolated from epidemic outbreaks in neonatal wards. We describe how an extended-spectrum β-lactamase-producing K. pneumoniae (ESBL-KP) outbreak in a neonatal ward was extinguished. During the outbreak, which lasted over two months, 26 neonates were tested for K. pneumoniae, and 42 environmental swabs were taken. Drug susceptibility was determined for the isolated strains, and their virulence and phylogenetic similarity were checked. ESBL-KP colonization was confirmed in 18 neonates, and six were also confirmed to be infected. All strains isolated from patients represented one clonal type, K. pneumoniae. One strain isolated from an environmental source was determined to be a unique pulsed-field gel electrophoresis pattern. Gestational age and Apgar score were assessed as statistically significant for neonates with ESBL-KP infection. The epidemiological measures taken have been successful, and no further cases appeared. Immediate tightening of hospital hygiene rules, screening of all hospitalized neonates, and cohorting ESBL-KP-positive patients proved effective in controlling and ending the outbreak. The lack of ESBL-KP in the environment suggests that the outbreak was transmitted by colonized hospital staff. This theory could be confirmed by introducing mandatory screening for medical personnel

Does obesity increase the risk of ovarian cancer? A literature review

Obesity is one of the twenty-first century civilization diseases, which has been long linked to an increased risk of cardiovascular diseases, diabetes and cancer. Epidemiological data show that a slim body (body mass index, BMI 21–23 kg/m2 ) allows to avoid 20% of cancers related to excess fat tissue. Increased body weight (BMI >25 kg/m2 ) is associated with approximately 1.5-fold higher risk of cancer compared to the risk with normal BMI. There is growing evidence that high BMI may also increase the risk of cancer recurrence and mortality as well as reduce the efficacy of chemotherapy. While the relationship between obesity and numerous cancers, such as colon cancer, esophageal adenocarcinoma, breast cancer, endometrial cancer, kidney and pancreatic cancer, has been scientifically proven, studies assessing the relationship between ovarian cancer and obesity remain inconclusive. Some studies confirm the increased risk of cancer in obese women, whereas other authors do not show this correlation or even point to higher survival rates among obese patients with ovarian cancer, which is known as the obesity paradox. A variety of research methodologies may be found in the literature. Perhaps this is the reason for the significant divergence of results obtained in different studies. The aim of the paper was to describe selected substances produced by the adipose tissue, which play a crucial role in the induction of inflammation. We also present literature data on the relationship between obesity and ovarian cancer.Otyłość to jedna z chorób cywilizacyjnych XXI wieku, od dawna wiązana ze zwiększonym ryzykiem rozwoju chorób układu krążenia, cukrzycy czy nowotworów. Z badań epidemiologicznych wynika, że szczupła sylwetka (wskaźnik masy ciała – body mass index, BMI na poziomie 21–23 kg/m2 ) pozwala uniknąć do 20% nowotworów związanych z nadmiarem tkanki tłuszczowej. Z kolei przyrost masy ciała (BMI powyżej 25 kg/m2 ) podwyższa ryzyko zachorowania na nowotwór – mniej więcej półtora raza w porównaniu z ryzykiem przy prawidłowym BMI. Przybywa dowodów na to, że wysokie BMI może także zwiększać prawdopodobieństwo nawrotów raka i umieralność spowodowaną przez nowotwory czy osłabiać skuteczność chemoterapii. W przypadku licznych nowotworów, takich jak rak okrężnicy, gruczolakorak przełyku, rak piersi, trzonu macicy, nerki lub trzustki, związek z otyłością został naukowo udowodniony, natomiast wyniki badań analizujących związek otyłości z rakiem jajnika nie są jednoznaczne. Niektóre badania potwierdzają wzrost ryzyka zachorowania u kobiet otyłych, inne nie wykazują tej zależności albo wręcz wskazują na wyższe wskaźniki przeżywalności otyłych chorych z rakiem jajnika, co jest określane jako paradoks otyłości. Podczas przeglądu literatury przykuwa uwagę różnorodność metodyki badań – być może właśnie to jest przyczyną tak rozbieżnych wyników prac. W artykule scharakteryzowano wybrane substancje produkowane przez tkankę tłuszczową, które odgrywają istotną rolę w indukcji stanu zapalnego. Ponadto przedstawiono dane z piśmiennictwa dotyczące związków otyłości z zachorowaniem na raka jajnika