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

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

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

Structure and Thermal Properties of 2,2’-Azobis(1H-Imidazole-4,5-Dicarbonitrile). A Promising Starting Material for a Novel Group of Energetic Compounds

A high-nitrogen compound, 2,20-azobis(1H-imidazole-4,5-dicarbonitrile) (TCAD), was synthesized from commercially available 2-amino-1H-imidazole-4,5-dicarbonitrile. It was characterized with infrared and nuclear magnetic resonance spectroscopy. Its structure was determined by single crystal X-ray diffraction. The crystal of TCAD tetrahydrate is monoclinic, with space group P21/c with crystal parameters of a = 10.2935(2) Å, b = 7.36760(10) Å, c = 20.1447(4) Å, V = 1500.27(5) Å3, Z = 4, and F(000) = 688. Computational methods were used in order to fully optimize the molecular structure, calculate the electrostatic potential of an isolated molecule, and to compute thermodynamic parameters. TCAD has very high thermal stability with temperature of decomposition at 369 C. Kinetics of thermal decomposition of this compound were studied and apparent energy of activation as well as the maximum safe temperature of technological process were determined

Assessment of patient knowledge and awareness of the occurrence of addiction

Introduction. Drug treatment and substance abuse treatment centers are mostly involved in the treatment of alcohol or drug addicts. At present, an increasing number of patients depend on several psychoactive substances simultaneously. These people have a phenomenon called mixed addiction.Aim. The aim of the study was an attempt to answer the question about the state of mind of psychiatric hospital patients about the occurrence of addiction.Material and methods. The study included a group of 100 patients in the Neuropsychiatric Hospital's Neuropsychiatric Ward and the SPZOZ Psychiatric Day Ward in Kraśnik. The survey was conducted between February and August 2017. The author's questionnaire method was fully anonymous.Results. Misuse of psychoactive substances is a serious social problem. The phenomenon of addiction is more common among men living in rural areas, working professionally in the age range of 31 to 40 years. The respondents acknowledge that their knowledge of narcotics is based on their experience and their friends.Conclusion. Respondents are aware of the occurrence of mixed dependency

Poród a schorzenia narządu wzroku

There are many controversies among ophthalmologists and obstetricians regarding indications for caesarean section due to preexisting eye diseases. Many ophthalmologists still believe myopia, retinal detachment, glaucoma or diabetic retinopathy to be indications for a caesarean section. There is a discrepancy between clinical practice and evidence-based medicine, as none of the published trials have reported any retinal changes after vaginal delivery. This report provides information on the infl uence of physiological changes on eye diseases during the fi nal stage of the delivery. We conclude that an eye disease is not an indication for a caesarean section.Wskazania do skrócenia drugiego okresu porodu z powodu współistniejących schorzeń okulistycznych stanowią wciąż źródło wielu kontrowersji zarówno wśród okulistów, jak i ginekologów. Schorzenia narządu wzroku, takie jak: krótkowzroczność, odwarstwienie siatkówki, retinopatia cukrzycowa oraz jaskra są nadal uważane przez wielu okulistów za wskazanie do cięcia cesarskiego. Istnieje rozbieżność pomiędzy praktyką kliniczną a doniesieniami naukowymi, nie istnieją bowiem żadne udokumentowane publikacjami badania potwierdzające pogorszenie stanu narządu wzroku będące wynikiem porodu siłami natury. Niniejsza praca przedstawia zmiany fizjologiczne zachodzące w oku podczas końcowych etapów porodu. Wnioskujemy, że choroby narządy wzroku nie są wskazaniem do cięcia cesarskiego

Cell Wall Anchoring of the Campylobacter Antigens to Lactococcus lactis

Campylobacter jejuni is the most frequent cause of human food-borne gastroenteritis and chicken meat is the main source of infection. Recent studies showed that broiler chicken immunization against Campylobacter should be the most efficient way to lower the number of human infections by this pathogen. Induction of the mucosal immune system after oral antigen administration should provide protective immunity to chickens. In this work we tested the usefulness of Lactococcus lactis, the most extensively studied lactic acid bacterium, as a delivery vector for Campylobacter antigens. First we constructed hybrid protein – CjaA antigen presenting CjaD peptide epitopes on its surface. We showed that specific rabbit anti-rCjaAD serum reacted strongly with both CjaA and CjaD produced by a wild type Campylobacter jejuni strain. Next, rCjaAD and CjaA were fused to the C-terminus of the L. lactis YndF containing the LPTXG motif. The genes expressing these proteins were transcribed under control of the L. lactis Usp45 promoter and their products contain the Usp45 signal sequences. This strategy ensures a cell surface location of both analysed proteins, which was confirmed by immunofluorescence assay. In order to evaluate the impact of antigen location on vaccine prototype efficacy, a L. lactis strain producing cytoplasm-located rCjaAD was also generated. Animal experiments showed a decrease of Campylobacter cecal load in vaccinated birds as compared with the control group and showed that the L. lactis harboring the surface-exposed rCjaAD antigen afforded greater protection than the L. lactis producing cytoplasm-located rCjaAD. To the best of our knowledge, this is the first attempt to employ LAB (Lactic Acid Bacteria) strains as a mucosal delivery vehicle for chicken immunization. Although the observed reduction of chicken colonization by Campylobacter resulting from vaccination was rather moderate, the experiments showed that LAB strains can be considered as an alternative vector to deliver heterologous antigens to the bird immune system. Additionally, the analysis of the structure and immunogenicity of the generated rCjaAD hybrid protein showed that the CjaA antigen can be considered as a starting point to construct multiepitope anti-Campylobacter vaccines

Clinical and economic benefits of using next-generation sequencing (NGS) in the diagnostics of patients with non-small cell lung cancer with rare mutations

Molecular diagnostics are necessary to make therapeutic decisions in patients with non-small cell lung cancer (NSCLC), especially regarding targeted therapies. They include the analysis of PD-L1 expression and mutations or rearrangements in the EGFR, KRAS, BRAF, ALK, ROS1, NTRK1/2/3, and RET genes. In Poland, it is recommended to perform analyses for point mutations in exons 18, 19, 20, and 21 of the EGFR gene and rearrangements of the ALK and ROS1 genes. Due to the turnaround time, costs, and availability of biological material, the benefits of routine use of NGS in NSCLC patients are increasingly highlighted compared to performing multiple tests of individual genes. Pharmacoeconomic analyzes were conducted to assess the impact of the use of next-generation sequencing (NGS) in clinical practice on the budget of the public payer in Poland in comparison with the current practice. They demonstrated a decrease in incremental expenses of the public payer related to molecular diagnostics with NGS in all eligible patients by approx. 3.4 million PLN in 2023 and 2024 and a reduction in diagnostic costs per patient by 1 695 (21%) PLN. This article presents the efficacy and safety of amivantamab in NSCLC patients with an insertion in exon 20 of the EGFR gene. In conclusion, NGS should be the preferred diagnostic method in patients with advanced NSCLC

A water-soluble [60]fullerene-derivative stimulates chlorophyll accumulation and has no toxic effect on Chlamydomonas reinhardtii

Chlamydomonas reinhardtii (WT 2137) P. A. Dang. (Volvocales, Chlorophyceae) is a green microalgae serving as a suitable model in scientific research and a promising industrial biotechnology platform for production of biofuel, hydrogen and recombinant proteins. Fullerenes (C60) are allotropic carbon nanoparticles discovered in 1985 and used in biomedical studies since the early 1990s, when water solubilization methodologies were developed. Recently, surface-modified hydroxylated derivatives of fullerenes were proven to enhance algal growth and drought tolerance in plants. Here, a novel type of water-soluble [60]fullerene derivative with 12 glycine residues (GF) has been synthesized and tested for acute toxicity (up to 50 μg/ml) and as a potential biostimulant of algal growth. The effects of GF on pigment composition and growth rate of Chlamydomonas reinhardtii were systematically investigated. Our results suggest that GF was not toxic, and no negative change in the pigment content and no stress symptoms were observed. No changes in the photosynthetic parameters based on the fluorescence of chlorophyll a in Photosystem II (NPQ, Fv/Fm, Fv/F0, PI and RC/ABS) were observed. The GF had no effect on cell size and growth rate. At a concentration of 20 μg/ml, GF stimulated chlorophyll accumulation in 3-day-old cultures