Usunięcie jajników podczas zabiegu histerektomii z przyczyn nieonkologicznych – bilans korzyści i strat

Usunięcie macicy to jedna z najczęstszych interwencji chirurgicznych w ginekologii. Zazwyczaj wskazaniami dozabiegu są schorzenia łagodne. Podczas każdego zabiegu histerektomii chirurg staje przed decyzją co do losujajników — w wielu przypadkach są one usuwane jednocześnie w ramach profilaktyki raka jajnika. W piśmiennictwiemożna znaleźć argumenty wskazujące na istotność tej decyzji wobec dowodów na hormonalną aktywnośćgonad także po menopauzie, niskie ryzyko rozwoju procesu złośliwego w populacji ogólnej i możliwe konsekwencjeustania czynności hormonalnej jajników w wyniku interwencji chirurgicznej. Z drugiej strony grupa pacjentekz podwyższonym ryzykiem raka jajnika, jajowodu i otrzewnej może odnieść niewątpliwą korzyść z wycięcia gonadpodczas zabiegu histerektomii

Ultrasonographic analysis of cesarean scars features in nonpregnant uterus

Abstract Objectives: To define and assess the new ultrasonographic parameters of cesarean hysterotomy scars and to analyze their variation depending on the number of cesarean sections. Material and methods: Transvaginal ultrasound was carried out among 109 patients after cesarean section in the lower uterine segment with single-layer uterine closure. The following cesarean hysterectomy scar parameters were assessed: angle of the apex (K), basis (P) and height (W) of the anechoic triangle, the thickness of the knit tissue scar segment (G), G/P index and G/W index. Results: Transvaginal ultrasound detected the cesarean hysterectomy scar in 100% of the examined woman. In 5,5% of cases the completely knit hysterectomy scar tissue was identified. All patients from this group underwent a single cesarean section. In the remaining 94,5% of women, the ultrasound detected a presence of the anechoic triangle, defined as scar defect. No difference of statistical importance considering assessed scar parameters was observed between the groups of patients after one and two cesarean sections. The decrease of the thickness of the knit tissue scar segment (G) in the group of patients after three cesarean, sections in comparison to the group of patients after single (1,3 mm vs 6,7 mm, p=0,0134) and two (1,3 mm vs 7,4 mm, p=0,0366) abdominal deliveries, was found, as well as statistically important decrease in G/P index value in the group of patients after three cesarean sections in comparison to the patients after one (0,3 vs 1,3, p=0,0263) and two cesarean sections (0,3 vs 1,2, p=0,0138). Conclusions: The new ultrasonographic parameters to assess the cesarean hysterectomy scar in nonpregnant uterus were introduced. Statistically important decrease in the thickness of the knit tissue scar segment (G) and G/P index value in the group of patients after three cesarean sections in comparison to the group of patients after single and two abdominal deliveries was revealed

Measurement of regional innovations - methods and their limitations

Celem niniejszej pracy jest przegląd metod pomiaru innowacyjności regionów wraz ze wskazaniem ich ograniczeń. Realizacji celu służyć ma krytyczna analiza opracowań metodycznych poświęconych temu tematowi. Pracę rozpocznie zagadnienie znaczenia pomiaru w politykach publicznych. Następnie zaprezentowane zostaną najważniejsze wskaźniki wykorzystywane do pomiaru innowacyjności regionów wraz z ich zaletami oraz dostrzeganymi słabościami. Najwięcej uwagi poświęcone zostanie systemowi pomiaru innowacyjności regionów w Unii Europejskiej (European Innovation Scoreboard - EIS), który jest najbardziej rozwiniętym systemem. W pracy przedstawione zostaną zmiany, które na przestrzeni lat zachodziły w metodyce EIS oraz problemy związane z tym systemem.The main aim of this paper is to investigate methods used to measure regional innovation and identify their limitations. In order to achieve this purpose the critical analysis of methodological papers will be used. This paper starts with the issue connected with significance of the measurement in public policy. Next, the most important indicators used to measure regional innovations with their advantages and disadvantages will be presented. The attention will be paid to system of measurement regional innovation in European Union (European Innovation Scoreboard - EIS), which is the most developed system. The reader will be also presented with changes in the EIS methodology and problems appearing in this system

The diagnosis of the diagnosis – the use of the strategic diagnosis in the management of the regional development, based on the development strategies of the districts from year 2005-2006

Celem niniejszej pracy jest przede wszystkim przyjrzenie się diagnozie strategicznej, możliwościom jej wykorzystania w zarządzaniu rozwojem regionu, a także zidentyfikowanie cech, jakie powinna posiadać prawidłowo przeprowadzona diagnoza, tak aby mogła być użyteczna na dalszych etapach planowania strategicznego.Na podstawie analizy diagnoz umieszczonych w strategiach rozwoju województw powstałych w latach 2005-06 (ze szczególnym uwzględnieniem zagadnienia kapitału ludzkiego) zidentyfikowane zostaną pojawiające się podczas diagnozowania problemy. Przedstawione zostaną również wskazówki dotyczące tego, o czym warto pamiętać sporządzając diagnozę kapitału ludzkiego na potrzeby tworzenia strategii rozwoju województwa podlaskiego.The main aim of this paper is to investigate some strategic diagnosis, the possibilities of using it in the management of the regional development, to identify those features which are adequate in terms of the well carried out diagnosis and to determine those characteristics which will be useful in the following phases of the strategic planning. Problems with drawing up diagnosis will be identified on the basis of the analysis of the diagnosis which are enclosed in the development strategies of districts’ from year 2005 to 2006 (special attention will be paid to the human capital issue).The reader will be also presented with the crucial clues which have to be taken into account during drawing up the human capital diagnosis for the development strategy of the podlaskie district

Pierwszy przypadek w Polsce zastosowania hipotermii leczniczej całego ciała w leczeniu encefalopatii niedotlenieniowo--niedokrwiennej u noworodka

Hypoxic-ischemic encephalopathy (ENN) concerns neonates born after 35 completed weeks of gestation. The incidence rate has been shown to be 1-6/1000 births and can lead to signifi cant permanent neurological damage, cerebral palsy and even death. Until the whole body cooling and selective brain cooling methods have been accepted, the treatment of children with ENN was only symptomatic. The article describes the fi rst case of ENN neonatal treatment with the whole body hypothermia in Poland, which took place at the Department of Neonatology, Poznań University of Medical Sciences. Currently, both methods – whole body hypothermia and selective brain cooling – off er a chance for a normal neurological development and a better life for children born with ENN. Both methods are accessible in a few centers in Poland.Encefalopatia niedotlenieniowo-niedokrwienna (ENN) dotyczy noworodków urodzonych po ukończeniu 35 tygodnia ciąży. Problem występuje z częstością 1-6/1000 porodów i może prowadzić do istotnych trwałych uszkodzeń neurologicznych, do mózgowego porażenia dziecięcego a nawet do śmierci. Do momentu zaakceptowania metody leczenia ENN hipotermią całego ciała oraz metodą selektywnego chłodzenia mózgu, dzieci z ENN leczone były jedynie w sposób objawowy. W artykule opisano pierwszy przypadek zastosowania w Polsce u noworodka leczenia ENN za pomocą hipotermii całego ciała, który miał miejsce w październiku 2009 na Oddziale Intensywnej Terapii Noworodka UM im. Karola Marcinkowskiego w Poznaniu. Aktualnie obie metody – hipotermia całego ciała oraz selektywnego chłodzenia mózgu dają szanse na prawidłowy rozwój neurologiczny i lepszy start w życie dzieci urodzonych z ENN

Researches on a photocatalytic device for toxic hydrocarbons removal from IC engine exhausts

Hydrocarbons, especially aromatic volatile organic compounds (AVOCs) and polyaromatic hydrocarbons (PAHs), emitted by IC engines, indisputably have a negative impact on the environment and public health. Even though current legislation strongly impacts on their low concentration in the exhausts, not quantity but the quality of those substances determines fumes toxicity. The paper presents results of the researches on a photocatalytic device dedicated to BTX (benzene-toluene-xylene) removal from IC engine exhausts, which can be applied in a vehicle cabin ventilation system. According to the results, the system is able to decrease toxic compounds concentration (caused by mobile emission sources) in inlet-air delivered to the vehicle interior. In effect, the system application reduces the users of a vehicle to exposure on contaminants

Structural and Biofunctional Insights into the Cyclo(Pro-Pro-Phe-Phe-) Scaffold from Experimental and In Silico Studies: Melanoma and Beyond

Short peptides have great potential as safe and effective anticancer drug leads. Herein, the influence of short cyclic peptides containing the Pro-Pro-Phe-Phe sequence on patient-derived melanoma cells was investigated. Cyclic peptides such as cyclo(Leu-Ile-Ile-Leu-Val-Pro-Pro-Phe-Phe-), called CLA, and cyclo(Pro-homoPro-β3homoPhe-Phe-), called P11, exert the cytotoxic and the cytostatic effects in melanoma cells, respectively. CLA was the most active peptide as it reduced the viability of melanoma cells to 50% of control at about 10 µM, whereas P11 at about 40 µM after 48 h incubation. Interestingly, a linear derivative of P11 did not induce any effect in melanoma cells confirming previous studies showing that cyclic peptides exert better biological activity compared to their linear counterparts. According to in silico predictions, cyclic tetrapeptides show a better pharmacokinetic and toxic profile to humans than CLA. Notably, the spatial structure of those peptides containing synthetic amino acids has not been explored yet. In the Cambridge Structural Database, there is only one such cyclic tetrapeptide, cyclo((R)-β2homoPhe-D-Pro-Lys-Phe-), while in the Protein Data Bank—none. Therefore, we report the first crystal structure of cyclo(Pro-Pro-β3homoPhe-Phe-), denoted as 4B8M, a close analog of P11, which is crucial for drug discovery. Comparative molecular and supramolecular analysis of both structures was performed. The DFT findings revealed that 4B8M is well interpreted in the water solution. The results of complex Hirshfeld surface investigations on the cooperativity of interatomic contacts in terms of electrostatic and energetic features are provided. In short, the enrichment ratio revealed O…H/H…O and C…H/H…C as privileged intercontacts in the crystals in relation to basic and large supramolecular H-bonding synthon patterns. Furthermore, the ability of self-assemble 4B8M leading to a nanotubular structure is also discussed