Wszystko płynie

wywiad z: Kufel, Katarzyn

Neonatal outcome after cesarean section

Cesarean section is the most commonly performed procedure all over the world. Both American and European data reveal constant and steady increase of pregnancies resolved by a cesarean section. The reasons include: growing number of medical indications or requests of the pregnant women. Regardless of the fact that elective cesarean section decreases the risk of intrauterine hypoxia, meconium aspiration and injury during labor, it remains a significant risk factor for respiratory failure in the course of transient tachypnea of the newborn, infant respiratory distress syndrome and pulmonary hypertension, both for term and late preterm infants. As a consequence, the infant requires a prolonged stay in the intensive care unit, together with advanced and often expensive medical procedures such as mechanical (often high-frequency) ventilation, nitric oxide therapy and extracorporeal membrane oxygenation. The American Association of Obstetricians and Gynecologists and the European Association of Perinatal Medicine recommend for a cesarean section due to medical indications to be performed after 39 weeks gestation, preferably after uterine contractions started, and elective cesarean section, particularly if there are indications to finish the pregnancy before 39 weeks gestation, after lung maturity has been assessed (in other case steroids ought to be administered prenatally to mature the lung muscles). That includes also cases of elective cesarean sections performed due to previous cesarean sections , which are the most frequent reasons for repeating procedure. The recommendations also restrict the indications for cesarean section in case of significant prematurity, what in turn is connected with more restricted indications for resuscitation of extremely premature infants and babies with extremely low birth weight

Obraz kliniczny zapaleń płuc u dzieci z grupy ryzyka pulmonologicznego - opis przypadków

W pracy prezentujemy 3 przypadki ciężkich zapaleń płuc leczonych w Szpitalu Dziecięcym w Gdańsku Oliwie w latach 2006–2008. Na przebieg schorzeń miały wpływ czynniki ryzyka, takie jak: młody wiek dziecka, współistnienie choroby refluksowej przełyku, zaburzeń odporności, astmy czy zaburzeń genetycznych. W takich przypadkach istnieje zawsze konieczność zarówno poszerzenia diagnostyki, jak i terapii z włączeniem leczenia chirurgicznego

Aktywność rybocyklibu i hormonoterapii u chorych na zaawansowanego, luminalnego HER2-ujemnego raka piersi w praktyce klinicznej — opisy przypadków

Selektywne inhibitory kinaz zależnych od cyklin CDK4 i CDK 6 (iCDK4/6, cyclin-dependent kinase inhibitors) — palbocyklib, rybocyklib i abemacyklib — stanowią nową grupę leków zmniejszających proliferację przez zahamowanie przejścia komórek w cyklu komórkowym z fazy G1 do S. Leki te są obecnie standardem postępowania u chorych na miejscowo zaawansowanego lub uogólnionego raka piersi z ekspresją receptorów estrogenowych (ER, estrogen receptor) i progesteronowych (PR, progesterone receptor) bez nadekspresji receptora naskórkowego czynnika wzrostu typu 2 (HER2, human epidermal growth factor receptor type 2) w skojarzeniu z jednym z inhibitorów aromatazy lub fulwestrantem w pierwszej linii leczenia lub po niepowodzeniu wcześniejszej hormonoterapii. W niniejszym opracowaniu przedstawiono opisy przypadków chorych na raka piersi leczonych rybocyklibem w skojarzeniu z hormonoterapią w ramach programu rozszerzonego dostępu (MAP, managed access program)

Breast-conserving surgeries in HER-positive breast cancer patients are performed too rarely in Poland

Breast cancer is the most common cancer among women in Poland and worldwide; after lung cancer it is the second highest cause of death among females with malignancies. HER2 positive breast cancer occurs in ca.15–20% of all cases. More often than other subtypes, it affects younger patients and more often spreads metastasises to internal organs. The new drugs against the HER2 receptor significantly improve patients’ prognoses, regardless of the initial stage. The authors of the study involved 1503 patients with HER2 positive breast cancer from all stages (I–IV); 482 patients received preoperative systemic therapy (chemotherapy or hormonal therapy), 385 trastuzumab. Among the 1219 females qualified to surgery, 734 (60%) underwent a mastectomy, 485 (40%) had breast conserving therapy with adjuvant radiotherapy, some of them had preoperative systemic treatment

Pro Libris: Lubuskie Pismo Literacko-Kulturalne, nr 4 (2010)

145 s. : il., portr.

Soil as the landscape balance indicator

The subordinated position of soil in the geosystem allows it to be used as an indicator of the landscape balance. Examples where soil plays such an indicative role are presented in this paper. The theory of the “geochemical landscape” has been used as the theoretical-methodological basis. Soil properties indicating direction, intensity and quality of matter migration in the landscape have been discussed (profile environment, pH, redox, quantitative and qualitative humus properties). The indicative role of soil in the monitoring of “sustainable landscape” has also been characterized. According to the authors, three models of this landscape can be created: natural, rural and urban sustainable landscapes

Intestinal Elastography in the Diagnostics of Ulcerative Colitis: A Narrative Review

Ulcerative colitis (UC) is an inflammatory bowel disease (IBD) that mainly affects developed countries, but the number of cases in developing countries is increasing. We conducted a narrative review on the potential application of ultrasound elastography in the diagnosis and monitoring of UC, as this newly emerging method has promising results in other gut diseases. This review fulfilled the PRISMA Statement criteria with a time cut-off of June 2022. At the end of the review, of the 1334 identified studies, only five fulfilled all the inclusion criteria. Due to the small number of studies in this field, a reliable assessment of the usefulness of ultrasound elastography is difficult. We can only conclude that the transabdominal elastography examination did not significantly differ from the standard gastrointestinal ultrasonography examination and that measurements of the frontal intestinal wall should be made in the longitudinal section. The reports suggest that it is impossible to estimate the clinical scales used in disease assessment solely on the basis of elastographic measurements. Due to the different inclusion criteria, measurement methodologies, and elastographic techniques used in the analysed studies, a reliable comparative evaluation was impossible. Further work is required to assess the validity of expanding gastrointestinal ultrasonography with elastography in the diagnosis and monitoring of UC

Iatrogenic Esophageal Perforation in Premature Infants: A Multicenter Retrospective Study from Poland

Greater awareness of possible iatrogenic esophageal perforation (EP) is needed. Though rare, EP is a legitimate health risk as it may lead to long-term morbidities. This study presents and discusses iatrogenic EP in a subset of preterm infants. Using radiographic images, we study and describe the consequences of the orogastric/nasogastric tube position (in radiographic images). We analyze the possible influence of histological chorioamnionitis on the development of esophageal perforation. This retrospective study examines the hospital records of 1149 preterm infants, 2009–2016, with very low birth weight (VLBW) and iatrogenic EP, comparing mortalities and morbidities between the two groups of preterm infants who had birth weights (BWs) of less than 750 g and were less than 27 weeks gestation age at birth: one group with iatrogenic esophageal perforation (EP group) and one group without perforation (non-EP group—the control group). Histopathological chorioamnionitis of the placenta showed no statistically significant differences between the groups. The only statistically significant difference was in the air leaks (p = 0.01). Three types of nasogastric tube (NGT) X-ray location were identified, depending on the place of the perforation: (1) high position below the carina mimicking esophageal atresia; (2) low, intra-abdominal; (3) NGT right pleura-directed. We also highlight the particular symptoms that may be indicative of EP due to a displacement of the nasogastric tube