Relationship between HPV and HIV. Prevalence, molecular mechanisms and screening of HPV among HIV infected women

Introduction: Human papillomavirus (HPV) and human immunodeficiency virus (HIV) are the most common sexually transmitted infections (STI) globally. According to the World Health Organisation (WHO) there are around 17.4 million women living with HIV and over 290 million HPV infected women worldwide.Purpose: This review is to summarize available data concerning the relationship between HIV and HPV infection among women. The analysis comprises molecular mechanisms of HPV infection among HIV(+) women as well as HIV infection among HPV(+) women, prevalence of HPV and cervical lesions among women living with HIV and screening of HPV and cervical cancer (CC) among HIV infected women.Material and methods: The review includes publications from 2011 to 2020. The data has been collected by the use of the PubMed, Ovid, Up-To-Date and WHO website. Key words used to search for references include: HPV, HIV, prevalence, molecular mechanism, screening.Results: HIV infection is a risk factor for HPV acquisition. On the one hand, prevalence of HPV, multiple HPV, high risk HPV (hrHPV) infections and cervical intraepithelial neoplasia (CIN) is higher among HIV(+) women. On the other hand, HPV infection can also predispose to HIV acquisition. Evidence on how these viruses influence each other can be a breakthrough in the range of prevention, detection and treatment of both HIV and HPV infection.Conclusions: Relationship between HPV and HIV is an interest of nowadays medicine. Possibly, these viruses may cooperate and enable infection of each other. It has been showed that the prevalence of HPV, multiple HPV, hrHPV infections and cervical lesions is higher among HIV(+) in comparison to HIV(-) women. Further studies should be performed providing an insight into a molecular mechanism responsible for this cooperation

In situ detection of DNA and mRNA of human cytomegalovirus to distinguish different forms of viral infection in leukocytes

In situ PCR and in situ reverse transcription PCR (RT-PCR) were applied to discriminate between latent and productive infection of human cytomegalovirus (HCMV) in leukocytes. We investigated 28 samples, in which viral pp65 antigen was detected only in the cytoplasm of leukocytes. Additionally we assayed 12 specimens lacking pp65 antigen. Using nested PCR (nPCR), viral DNA was detected in 27 samples. In six samples the results of nPCR were unreadable due to the presence of polymerase inhibitors. By application of in situ PCR, we were able to confirm the presence of viral DNA in the nucleus and/or cytoplasm. Productive infection was recognized in 20 samples in which transcripts for late viral genes were detected. Among the 20 samples negative by in situ RT-PCR, we recognized phagocytosis of viral particles in eight and the latent form of HCMV infection in five

Sexuality and fertility of young women suffering from breast cancer

Breast cancer (BC) is the most common malignant tumor among women in the world. In Poland, it is the most commonly diagnosed cancer in women between the age of 25 and 44. The course of the disease in young women is more aggressive. As a result more aggressive anti-cancer therapies are used. BC treatment is associated with the occurrence of numerous adverse effects and long-term complications. Among them, sexuality and fertility disorders deserve special attention in the group of young patients. The aim of this study is to review on the occurrence of sexual dysfunction and fertility disorders among young patients suffering from BC. The impact of BC treatment on the occurrence of these disorders has been analyzed. This review emphasizes also possible methods of sexual dysfunction and potential options of fertility protection which may be used in women who want to get pregnant after the end of the treatment. This review is based on available data from medical publications and guidelines from 1987 to 2019, addressing issues of sexuality and fertility in young patients with breast cancer. Young patients suffering from BC experience a variety of sexuality and fertility disorders. Sexual dysfunction includes among others: reduced libido, dyspareunia and difficulty in reaching an orgasm. The reason of the deterioration of the quality of sexual life is complex. Among the emotional factors, the most important role is played by changes in appearance, such as hair loss or breast amputation. Organic causes include dryness or loss of vaginal elasticity. The risk of fertility disorders is primarily associated with the use of cytotoxic drugs, causing premature ovarian failure and inducing amenorrhea. Chemotherapeutic agents with the highest risk of gonadotoxicity are alkylating drugs. Oncofertility is a branch of medicine combining oncology and reproductive medicine. Fertility protection of women who desire bearing a child after treatment is possible thanks to various methods of preservation. These include cryopreservation of embryos and oocytes, ovarian suppression with the use of GnRH analogs, ovarian transposition, freezing and transplantation of ovarian tissue. The most recommended method is embryo cryopreservation at present. Available data suggest no increased risk of cancer recurrence due to pregnancy in women after BC treatment

The art of cheating medical staff- Munchausen Syndrome by Proxy

Background: Munchausen syndrome by proxy (MSBP) is a behavioral disorder in adults, that affects children. This phenomenon is also called a Medical Child Abuse or Caregiver-fabricated illness. Child becomes a victim of many unnecessary medical procedures without a commensurate disease. A mild form of this disorder is falsification of medical records and fabrication of medical evidences. Adults can also exaggerate existing symptoms of illness. The most harmful behavior is an intentional child abusing in order to cause symptoms of a disease. There are many difficulties in diagnosing this disorder and the following consequences for victims are devastating. For that reason MSBP is becoming a very dangerous medical problem. Material and methods: The analysis concerned publications in English and Polish language published in years 2013-2018, which were collected in the PubMed, Google Scholar and Medycyna Praktyczna. Particular attention was paid to articles presenting the problem of MSBP and to the role of medical staff in diagnosing this disorder. Results: Available data suggests that caregiver with MSBP is usually victim’s mother. Most commonly these women have others mental disorders. MSBP is very dangerous form of violence and it is proven that the mortality associated with this disorder reaches about 6-33%. It should be noted, that in addition to the obvious child’s physical injuries, abnormal relationships with caregiver cause long-term developmental damages. Conclusion: The role of medical staff in diagnosing MSBP is difficult, but also very important. Caregivers with MSBP seem to be solicitous and responsible. Their attitude can mislead the doctor. Pediatricians, while trying to diagnose a child, order many diagnostic tests. It may increase caregiver’s pathological behavior. Due to this fact, medical staff can unconsciously expose child to unnecessary medical procedures. Effective communication between health sectors and staff education can be a crucial element in MSBP diagnosing

Pregnancy-associated breast cancer - diagnosis, treatment and outcomes for women and their offspring

Introduction: Pregnancy-associated breast cancer (PABC) is the most common malignancy in pregnant women with an incidence of 1 in 3-10 thousand pregnancies. It is mostly defined as breast cancer diagnosed during pregnancy or within 1 year postpartum. The number of PABCs is going to raise due to the trend of delaying childbearing. Purpose: This review summarizes data on the occurrence and characteristics of PABC. The analysis comprises diagnosis and proper treatment of BC during pregnancy. Prognosis of women and their offspring are emphasized. Material and methods: The review is based on publications mainly from 2010 to 2019 and 5 articles from 1994-2008 collected on the PubMed.  Results: The sensitivity of breast ultrasonography (USG) in pregnancy is 70-100% and it is considered as safe for the fetus. Staging evaluation in pregnant women consists of chest x-ray, liver USG and non-contrast bone MRI. 71-88% of PABCs are invasive ductal carcinomas. Treatment consists of breast surgery regardless of time and optionally, chemotherapy from the 2nd trimester. Radiotherapy, tamoxifen and trastuzumab are contraindicated in PABC. Therapeutic abortion does not improve oncological outcome. Overall prognosis is similar for both pregnant and non-pregnant patients with similar type and stage of BC. The rate of congenital malformations is 1,3% for both children of PABC patients treated with chemotherapy and born from women without chemotherapeutic treatment. The most frequent obstetrical complication of PABC treatment is preterm delivery. Conclusions: Pregnancy does not impact oncologic outcome, if the treatment is appropriate. PABC patients have survival rates consistent with the stage of disease. Proper treatment of PABC does not increase the risk of congenital malformations and is relatively safe for the fetus. 

Mindfulness and its influence on quality of life and immune response in women with breast cancer

Mindfulness therapy is a psychological process, which main purpose is to concentrate attention on internal and external stimuli in the present moment. Practising mindfulness is correlated with well-being, greater energy and enthusiasm as well as the ability to cope with stressful situations. Breast cancer accounts for 22% of all malignant tumors in women. It is characterized by the highest mortality rate among all malignancies in this group. Diagnosis, applied treatment and changes in the women’s lifestyle may have a negative impact on their psyche. Symptoms such as depression, anxiety and fatigue often appear in patients diagnosed with breast cancer. These can lead to a decreased well-being and lower quality of life. Studies show that Mindfulness-Based Stress Reduction (MBSR) therapy has a positive impact on the quality of life of patients suffering from breast cancer. What is more, those patients may have a worse immune response and less natural killers cells activity (NKCA) than people who doesn not have a cancer disease. MBSR can re-establish NKCA and improve immune response. Patients who have noticed an improvement in their well-being during and after MBSR therapy showed higher NKCA. There is no doubt that MBSR therapy reduces the level of fatigue, depression and anxiety. Moreover, patients who undergo MBSR therapy are less afraid of a relapse and have less reactivity to the emotional stress

Braf protein mutation and its significancy within patients with melanoma

Introduction and purpose:   This review aims to analyze BRAF mutation significancy and its influence on progression and therapy methods within patients with melanoma.  Material and method:  This review was mainly based on articles collected in Pubmed in years 2004-2018. The research was done by looking through keywords as follows “braf kinase”, “braf mutation”, “melanoma” “wemurafenib”.  Results:  The selected studies have demonstrated that it is justified to identify patient with BRAF mutation due to it’s influence on treatment’s method choosing.  Conclusions:  Citied researches have proven BRAF mutation significancy in growth and progressions of many malignant tumors. Further tests are likely to not only prolong life expectancy within patients with melanoma, but also being a source of crucial knowledge about tumors development.&nbsp

Multiple myeloma and kidney disease

Abstract   Background: Multiple myeloma is a clonal plasma cell neoplasm which affects 1% of all malignancies. In this article we reviewed epidemiology, symptoms with particular attention to renal failure and its manifestation in multiple myeloma (MM). Material and methods: This paper was based on medical articles collected in PubMed from 2001 to 2022, medical websites and books. The research has been done by looking through key words such as: „multiple myeloma”, „myeloma cast nephropathy”, „bortezomib”, „RANKL” Results: Multiple myeloma has indolent course and many patients present renal disorders at the moment of diagnosis. The use of novel therapies can reverse renal failure. Conclusions: Treatment of the patients with MM and kidney disease is challenging for health care professionals. Doctors have to adjust treatment to provide the best therapeutic effects

Vitamin D toxicity – causes, symptoms and diagnosis

Abstract:  Introduction and purpose: This review aims to analyze causes, symptoms and diagnosis of overdosing vitamin D resulting in vitamin D toxicity (VDT).  Material and method: This paper was based on medical articles collected in Pubmed from 2008 to 2021 year. The research has been done by looking through keywords such as “vitamin D” “toxicity”.  Results: The review of studies showed that manifestation of VDT is mainly associated with hypercalcemia and its course can range from asymptomatic to life-threatening, including death. We also draw attention to inappropriate use and widespread of vitamin D products.  Conclusion: There is a high demand for medical health workers to advise patients on possible effects of inappropriate use of vitamin D products and its toxicity. Medical practitioners should be attentive to quickly identify VDT.&nbsp

Monkeypox - review

Introduction and purpose:  This review aims to analyze the current information about monkeypox and the virus which causes the disease.  Material and method: This review was based on articles collected in PubMed and published in the years 2012-2022 The research was done by looking through keywords as follows: „monkeypox”; „zoonosis”;„tecovirimat” Results: The selected studies have demonstrated that the monkeypox virus is a high-danger pathogen that causes a disease important to public health. More research on this topic has to be done to prevent and better comprehend the potential threat.  Conclusions:  According to the cited research, public health systems should be aware of practical methods to reduce the risk of monkeypox spreading. It is crucial to monitor the spreading of the monkeypox disease and create effective preparation. Moreover, governments should develop strategies to prevent their population.&nbsp