Assessment of the condition severity and prediction of postoperative complications in elderly and senile patients with perforated gastric and duodenal ulcer

Aim. To assess the condition severity and predict postoperative complications and mortality in elderly and senile patients with perforated gastric and duodenal ulcer using the P-POSSUM score. Materials and methods. To conduct a scientific study, 80 (100.0 %) cases of treatment for patients aged 60 to 89 years with a diagnosis of gastric or duodenal ulcer perforation were analyzed. At the stage of hospitalization, the general condition was assessed using the variables of the P-POSSUM score. All patients underwent emergency surgery. Results. The obtained sum of points was compared with postoperative complications and mortality. We defined the discrimination point as >43 points for postoperative complications and >48 points for mortality. Based on the result, the patients were divided into group A with a sum of points up to 43 inclusive – 39 patients (48.8 %), and with a greater number of points – 41 patients (51.2 %) – group B. Evaluation of the detected complications in the postoperative period and comparison with the sum of points significantly confirmed an increase in their frequency in group B (sum of points >43) as compared to group A (sum of points ≤43) – p = 0.0018, U = 474.0. To compare the mortality rate, all the patients were divided into group C – 48 (60.0 %) patients with a sum of points ≤48, and group D – 32 patients (40.0 %) with a sum of points ≥49. In the group of patients with a total score >48 (group D), the mortality rate was significantly increased compared to group C with a score ≤48, p = 0.0002, U = 384.0. Conclusions. Our study has led to the following conclusions: the P-POSSUM score use in elderly and senile patients with perforated gastric and duodenal ulcers significantly confirms the increase in the frequency of postoperative complications, in group A – 6 (15.4 %) patients, while in group B – 23 (56.1 %), p = 0.0018, U = 474.0 and increased mortality, in group C – 6.3 %, in group D – 56.3 %, p = 0.0002, U = 384.0; the P-POSSUM score provides reliable prediction an increase in the risk of postoperative complications and mortality. This, in turn, makes it possible to predict and change treatment approaches and improve the quality of emergency surgical care for elderly and senile patients

36. A prospective, randomized study to compare the value of two fractionation schemes of palliative radiotherapy for inoperable non-small cell lung cancer

A prospective, randomized study was conducted in eight Polish institutions to compare the value of two fractionation schemes of palliative radiotherapy for inoperable non-small cell lung cancer. Assessed was the impact of either treatment on the degree and duration of relief of tumor-related symptoms and on patient's performance status. Secondary endpoints included treatment side-effects, objective response and overall survival. One hundred patients were randomly assigned to the dose of 20 Gy/5×/5 days (Arm A) or 16 Gy/2×/8 days (Arm B). There were 90 men and 10 women aged between 47 and 79 (mean 66). Eighty four patients had locally advanced tumor and 16 patients had metastatic disease. Squamous cell carcinoma was diagnosed in 65 patients, adenocarcinoma – in 9 patients, large cell carcinoma – in 1 patient and unspecified non-small cell carcinoma – in 25 patients. Fifty five patients were assigned to Arm A and 45 – to Arm B. Ninety eight patients received assigned treatment whereas two patients died before the end of treatment. The final results of the study will be presented at the conference

Malnutrition in patients treated for oral or oropharyngeal cancer—prevalence and relationship with oral symptoms: an explorative study

This study aimed to assess prevalence of malnutrition after treatment for oral/oropharyngeal cancer and to explore how oral symptoms relate to malnutrition after treatment. In this cross-sectional study, malnutrition (weight loss a parts per thousand yenaEuro parts per thousand 10% in 6 months or a parts per thousand yen5% in 1 month), oral symptoms (EORTC QLQ-H&N35 questionnaire and additional questions to assess chewing problems), dental status, trismus and dietary intake were assessed in 116 adult patients treated for oral/oropharyngeal cancer. Prevalence of malnutrition was 16% (95%CI: 10% to 23%). Prevalence of malnutrition in the period 0-3 months after treatment was significantly higher (25%) than in the periods > 3-12 months (13%) and > 12-36 months after treatment (3%, p = 0.008). Logistic multivariate regression analysis revealed that swallowing problems (p = 0.021) and insufficient protein intake were significantly related to malnutrition (p = 0.016). In conclusion, malnutrition is a considerable problem in patients treated for oral/oropharyngeal cancer, shortly after treatment. Of all oral symptoms, only swallowing problems were significantly related to malnutrition in the period after treatment for oral/oropharyngeal cancer

Criteria for geo-environmental evaluation of prospective areas of mineral deposit occurrence

W pracy tej przedstawiono problematykę waloryzacji geośrodowiskowej obszarów perspektywicznych występowania kopalin w Polsce. Zagadnienia te rozpatrywane są w głównej mierze na podstawie danych z bazy Mapy Geośrodowiskowej Polski w skali 1:50 000 (MGśP II). O ile dla udokumentowanych złóż stosowana jest od lat klasyfikacja pod kątem uwarunkowań środowiskowych, o tyle w odniesieniu do obszarów perspektywicznych wystąpień kopalin taka ocena nie jest prowadzona. Biorąc pod uwagę nie tylko ochronę środowiska przyrodniczego, ale także ochronę zasobów kopalin w Polsce, konieczna jest weryfikacja podejścia do obszarów perspektywicznych w kontekście ich roli w procesach planowania przestrzennego. Obszary perspektywiczne posiadają, w zależności od rodzaju kopaliny, zasięgu przeprowadzonego rozpoznania surowcowego, budowy geologicznej, bardzo zróżnicowane powierzchnie, od kilku do tysięcy hektarów. Sprawia to, że podejście do ocen środowiskowych na ich terenie musi różnić się od ocen stosowanych dla udokumentowanych już złóż kopalin. W artykule przedstawiono ilościową charakterystykę obszarów perspektywicznych kopalin dla obszaru całej Polski prezentowanych na MGśP II. Zaproponowano kryteria oceny konfliktowości obszarów perspektywicznych kopalin, różnicując je przede wszystkim w zależności od rodzaju kopaliny, sposobu eksploatacji, powierzchni obszaru i formy jego użytkowania oraz możliwości przyszłej rekultywacji.In this work, we present the problem of geo-environmental assessment of prospective areas of mineral deposits occurrence in Poland. The issue is discussed mainly based on data from the database of Geo-environmental map of Poland, scale 1:50 000 (MGśP II). While for proven deposits a classification based on environmental conditions has been used for many years, for prospective areas of mineral occurrence such an assessment is not conducted. Taking into consideration not only protection of the natural environment, but also protection of mineral resources in Poland, it is necessary to review the approach to areas with prospective mineral resources from the point of view of their role in land use planning. Such prospective areas have – depending on the type of mineral in question, how large an area has been prospected, its geological structure – highly diverse surface area, from just a few to thousands of hectares. This means the approach to environmental assessments of prospective areas of mineral occurrence must be different from that for already proven locations of mineral resources. The article presents quantitative characteristics of prospective areas of mineral occurrence presented on the aforementioned MGśP II map for Poland. We propose herein criteria for environmental evaluation of such prospective areas, differentiating them mainly depending on the type of mineral, manner of exploitation, surface area and land use legal forms, as well as possibility of future reclamation

Safeguarding of mineral raw materials deposits – a concept of valorization and selection of mineral deposits of public importance

W artykule przedstawiono propozycję nowych zasad selekcji złóż, które, z uwagi na swoją wartość, powinny być objęte ochroną jako Złoża Kopalin o Znaczeniu Publicznym (ZKoZP) szczebla krajowego. Przyjęto, że ochroną należy objąć tylko największe udokumentowane złoża pod względem zasobów, zlokalizowane w obszarach nie wykluczających eksploatacji. Złoża takie powinny spełniać łącznie dwa kryteria: sumaryczne zasoby największych złóż powinny obejmować co najmniej 50% krajowych geologicznych zasobów bilansowych i jednocześnie zasoby te powinny spełniać kryterium bezpieczeństwa dostaw danej kopaliny przez co najmniej 50 lat, przy średnim zapotrzebowaniu obliczonym na podstawie ostatnich 10 lat. Stosując powyższe kryteria, przeprowadzono analizę złóż gipsów i anhydrytów, bazaltów, granitów, granodiorytów, głazów narzutowych i sjenitów, dolomitów, margli, trawertynu, wapieni i wapieni dolomitycznych, kwarcytów, szarogłazów, piaskowców, piaskowców kwarcytowych, margli i wapieni dla przemysłu cementowego oraz wapieni i margli dla przemysłu wapienniczego. Łącznie analizie poddano 828 złóż, a założone kryteria wypełnia grupa 82 złóż. Wśród analizowanych złóż pod względem środowiskowym 6 z nich zaliczono do bardzo konfliktowych, 71 – do konfliktowych, a 5 – do mało konfliktowych. W przypadku kilku złóż bardzo konfliktowych podjęcie eksploatacji, z dużym prawdopodobieństwem, nie będzie możliwe, spełnienie stawianych kryteriów będzie wymagało wówczas poszerzenia listy o kolejnych 6 złóż. Zaproponowano przeprowadzanie weryfikacji waloryzacji złóż zaliczanych do ZKoZP okresowo – nie częściej niż co 5, ale nie rzadziej niż co 10 lat. Zadanie to powinno należeć do obowiązków służby geologicznej.The article presents a proposal for the new rules for the selection of deposits, which due to their value should be protected as Mineral Deposits of Public Importance (MDoPI) on national level. It was assumed that safeguarding should cover only the largest recognized deposits in terms of resources located in areas not excluding exploitation, which meet jointly two criteria: the total resources of the largest deposits should cover at least 50% of national geological resources and simultaneously they should meet the criterion of security of supply minerals for at least 50 years, with average demand calculated based on data from the last 10 years. Using the above criteria, analysis of the following deposits was performed: gypsum and anhydrite, basalt, granite, granodiorite, erratic boulder and syenite, dolomite, marl, travertine, limestone and dolomitic limestone, quartzite, greywacke, sandstone, quartzite sandstone, marl and limestone for the cement industry as well as limestone and marl for the lime industry. In total, 828 deposits were analyzed, and the assumed criteria were fulfilled in this group of deposits by a total number of 82 deposits. Among them, 6 deposits are very conflict, 71 – conflict, and 5 – partly conflict. In the case of several very conflict deposits, there is a high probability that their exploitation will not be possible, so meeting the criteria will require extending the list of deposits by 6 other ones. It was proposed that the verification of valorisation of deposits classified as MDoPI should be carried out periodically – not more often than every 5, but not less than every 10 years. This task should belong to the duties of the geological survey