Treatment and management of migraine in neurological ambulatory practice in Poland by indicating therapy with monoclonal anti-CGRP antibodies

Aim of study. To analyse Polish neurologists’ familiarity with the diagnostic criteria for migraine, and how their methods of management of migraine work in daily practice.Clinical rationale for study. Migraine is a common primary headache disease that causes substantial disability and reduces quality of life. Many migraine patients remain undiagnosed and deprived of treatment. Migraine treatment is problematic, and many patients discontinue preventive treatment, mainly because of a lack of efficacy or adverse effects. Antibodies targeting calcitonin gene-related peptide and its receptor seem to be effective and well-tolerated agents in migraine prevention.Material and methods. This study was conducted using a computer-assisted web interview conducted with 51 neurologists in Poland, who agreed to participate in the study during a phone call. The questionnaire mainly assessed methods of treatment of migraine patients and diagnostic criteria used in neurological practice.Results. Only one neurologist listed all of the diagnostic criteria for migraine, and 80% of physicians in their practice used only a part of the migraine diagnostic criteria, usually the migraine without aura criteria. On average, each neurologist had 55 patients under continuous care, seeing roughly 18 patients per month. On average, neurologists estimated that 77% of all patients with migraine had episodic migraine, whereas the rest had the chronic form. Importantly, 40% of patients with chronic migraine received all available preventive treatments without a satisfactory effect. Neurologists could offer monoclonal antibodies that target the CGRP-pathway (i.e. anti-CGRP and anti-CGRP receptor monoclonal antibodies) for the prevention of chronic migraine to about one in three patients with a chronic form of the disease.Conclusions and clinical implications. Migraine is underdiagnosed and undertreated in Poland. Understanding of the diagnostic criteria for migraine among neurologists is insufficient. Most neurologists in Poland see patients in whom anti-CGRP/R-targeting treatment is indicated

Is routine performance of the uterine cervix canal curettage prior to the curettage of the uterine cavity justified?

Objectives: Endocervical curettage (ECC) together with the dilatation and curettage of the uterine cavity (D & C) is routinely performed in everyday clinical practice. The aim of this study is to assess the rationale of the performance of ECC prior to D & C in indications other than abnormal uterine bleeding (AUB). Material and methods: Case histories of 736 patients after ECC performed in the 1st Department of Obstetrics and Gynaecology, Medical University of Warsaw, were analyzed retrospectively, the indications for the procedure — age, menopausal status, parity, procedure operator’s experience — as well as the result of the histopathology examination were taken into account. Three groups of patients were distinguished based on the indications for the procedure. Results: In 645 (87.6%) of cases normal histopathology results were obtained. 40 (5.4%) cases were abnormal. 31 cases of uterine cervix dysplasia were disclosed (CIN 1–20; CIN 2–5; CIN 3–6), 8 cases of endometrial cancer and 1 case of cancer of the uterine cervix were disclosed. In 51 (7%) of cases tissue material for histopathology examination was not obtained. In patients where ECC and D & C were performed due to indications other than abnormal bleeding from uterine cavity, no abnormal results were revealed. In addition, in this group the highest number of non-diagnostic ECCs was reported (11.59%; p < 0.05). Conclusions: In the case of endometrial biopsy for indications other than AUB routine ECC prior to D & C need not be performed

Angular structure of QCD jets

We derive the angular correlation functions between an arbitary number of partons inside a quark or gluon jet emerging from a high energy hard collision. As an application results for the correlation in the relative angle between two partons as well as the multiplicity moments of any order for partons in a sidewise angular region are calculated. At asymptotic energies the distributions of rescaled angular variables approach a scaling limit of a new type with two redundant quantities. All observables reveal the power behaviour characteristic to the fully developed selfsimilar cascade in appropriate regions of phase space. We present analytical results from the double logarithmic approximation as well as Monte Carlo results.Comment: 99 pages, LATEX, figures and appendices uufiled and appene

Nanoindentation Study of Intermetallic Particles in 2024 Aluminium Alloy

Nanoindentation tests are useful for determining the local mechanical properties of materials. However, the method has its limitations, and its accuracy is strongly influenced by the nano-scale geometry of the indented area. The authors chose to perform measurements of the hardness and elastic modulus of intermetallic particles in 2024 aluminium alloys. The objective of this study was to investigate the influence of the particles’ depth and shape on the accuracy of the nanoindentation result. Several simulations were performed with the use of the finite element method on different geometries mirroring possible real-life configurations of the particle and matrix. The authors compared the force vs. deformation curves for all of the variants. The results showed that the nanoindentation process is different for a particle with the same mechanical properties depending on its depth under the investigated surface. Therefore, the measured values of hardness and elastic modulus for intermetallic particles are partly the result of interaction with a matrix

Clinopyroxene megacrysts from basanite of Ostrzyca Proboszczowicka in Lower Silesia SW Poland

Cenozoic basanite forming the Ostrzyca Proboszczowicka Hill in SW Poland contains 1.5 — 3.0 cm long clinopyroxene “megacrysts.” Th ey contain intergrowths of euhedral apatite up to 7 mm long and older clinopyroxene grains. Th e megacrysts have the composition of aluminian-sodian diopside Mg# 0.61–0.70, their REE contents are slightly 1–10 x greater than those of primitive mantle. The REE patterns of megacrysts are enriched in light REE relative to heavy REE. Trace element patterns exhibit strong positive Zr, Hf and Ta anomalies and pronounced negative Sr and Ti anomalies. Apatite has composition of fluor-apatite. The REE concentrations in apatite reach up to 1000 x primitive mantle values for LREE, while trace element patterns are characterized by strong negative anomalies of HFSE and Pb. Megacrysts come from the not solidified coarse-grained cumulate, which was formed at mid-crustal level from the fractionated silicate alkaline magma batch. The new pulse of primitive basanitic magma entrained the megacrysts and brought them to the surface.W obrębie kenozoicznego bazanitu budującego wzgórze Ostrzyca Proboszczowicka SW Polska występują liczne „megakryształy” klinopiroksenu osiągające długość od 1,5 do 3 cm. Megakryształy zawierają wrostki euhedralnego apatytu długości do 7 mm i starszego klinopiroksenu. Klinopiroksen tworzący megakryształy ma skład glinowo-sodowego diopsydu mg# 0,61–0,70 a zawartość REE jest nieznacznie 1–10 razy wyższa od ich zawartości w prymitywnym płaszczu. Diagramy pajęcze dla REE wykazują wzbogacenie w lekkie ziemie rzadkie. Klinopiroksen wykazuje pozytywne anomalie zawartości Zr, Hf i Ta oraz negatywne anomalie zawartości Sr i Ti. Apatyt ma skład apatytu fluorowego i jest silnie wzbogacony w pierwiastki ziem rzadkich do 1000 wartości w prymitywnym płaszczu. Apatyt wykazuje silne negatywne anomalie w zawartości HFSE i Pb. Megakryształy klinopiroksenu pochodzą z niekonsolidowanego, gruboziarnistego kumulatu, który wykrystalizował ze sfrakcjonowanej magmy alkalicznej na głębokościach opowiadających środkowej skorupie. Nowy puls prymitywnej magmy bazanitowej spowodował dezintegrację kumulatu i wyniósł jego fragmenty na powierzchnię.Cenozoic basanite forming the Ostrzyca Proboszczowicka Hill in SW Poland contains 1.5 — 3.0 cm long clinopyroxene “megacrysts.” Th ey contain intergrowths of euhedral apatite up to 7 mm long and older clinopyroxene grains. Th e megacrysts have the composition of aluminian-sodian diopside Mg# 0.61–0.70, their REE contents are slightly 1–10 x greater than those of primitive mantle. The REE patterns of megacrysts are enriched in light REE relative to heavy REE. Trace element patterns exhibit strong positive Zr, Hf and Ta anomalies and pronounced negative Sr and Ti anomalies. Apatite has composition of fluor-apatite. The REE concentrations in apatite reach up to 1000 x primitive mantle values for LREE, while trace element patterns are characterized by strong negative anomalies of HFSE and Pb. Megacrysts come from the not solidified coarse-grained cumulate, which was formed at mid-crustal level from the fractionated silicate alkaline magma batch. The new pulse of primitive basanitic magma entrained the megacrysts and brought them to the surface.W obrębie kenozoicznego bazanitu budującego wzgórze Ostrzyca Proboszczowicka SW Polska występują liczne „megakryształy” klinopiroksenu osiągające długość od 1,5 do 3 cm. Megakryształy zawierają wrostki euhedralnego apatytu długości do 7 mm i starszego klinopiroksenu. Klinopiroksen tworzący megakryształy ma skład glinowo-sodowego diopsydu mg# 0,61–0,70 a zawartość REE jest nieznacznie 1–10 razy wyższa od ich zawartości w prymitywnym płaszczu. Diagramy pajęcze dla REE wykazują wzbogacenie w lekkie ziemie rzadkie. Klinopiroksen wykazuje pozytywne anomalie zawartości Zr, Hf i Ta oraz negatywne anomalie zawartości Sr i Ti. Apatyt ma skład apatytu fluorowego i jest silnie wzbogacony w pierwiastki ziem rzadkich do 1000 wartości w prymitywnym płaszczu. Apatyt wykazuje silne negatywne anomalie w zawartości HFSE i Pb. Megakryształy klinopiroksenu pochodzą z niekonsolidowanego, gruboziarnistego kumulatu, który wykrystalizował ze sfrakcjonowanej magmy alkalicznej na głębokościach opowiadających środkowej skorupie. Nowy puls prymitywnej magmy bazanitowej spowodował dezintegrację kumulatu i wyniósł jego fragmenty na powierzchnię

Migraine diagnosis and treatment in Poland: survey of primary care practitioners

Aim of the study: This study aimed to analyze the daily clinical practice of primary care practitioners (PCPs) in Poland concerning migraine patients.Clinical rationale for the study: Migraine is a common chronic primary headache disease, which can be disabling if insufficiently managed. Numerous studies suggest that migraine remains underdiagnosed and undertreated. The first consultation of migraine patients is usually undertaken by a PCP. Materials and methods: This study was conducted in June and July 2019 in Poland using a computer-assisted web interview with 51 PCPs. The interview questions concerned knowledge of diagnostic criteria and methods of migraine treatment.Results: On average, each PCP consulted 12 patients with migraine per month. More than half of PCPs (63%) listed partial diagnostic criteria for migraine without aura or mentioned aura in their responses. Only 10% of PCPs listed all diagnostic criteria for migraine without aura. Although 55% of PCPs said that they distinguished between episodic and chronic migraine, 18% provided the wrong definition. The most commonly prescribed drugs were triptans (66%), paracetamol, metamizole, or non-steroidal anti-inflammatory drugs (42%).Conclusions and clinical implications: PCPs play a critical role in diagnosing, treating, and monitoring migraine; however, many of them have insufficient knowledge about its diagnosis and correct differentiation between chronic and episodic forms

Toll-Like Receptor as a Potential Biomarker in Renal Diseases

One of the major challenges faced by modern nephrology is the identification of biomarkers associated with histopathological patterns or defined pathogenic mechanisms that may assist in the non-invasive diagnosis of kidney disease, particularly glomerulopathy. The identification of such molecules may allow prognostic subgroups to be established based on the type of disease, thereby predicting response to treatment or disease relapse. Advances in understanding the pathogenesis of diseases, such as membranous nephropathy, minimal change disease, focal segmental glomerulosclerosis, IgA (immunoglobulin A) nephropathy, and diabetic nephropathy, along with the progressive development and standardization of plasma and urine proteomics techniques, have facilitated the identification of an increasing number of molecules that may be useful for these purposes. The growing number of studies on the role of TLR (toll-like receptor) receptors in the pathogenesis of kidney disease forces contemporary researchers to reflect on these molecules, which may soon join the group of renal biomarkers and become a helpful tool in the diagnosis of glomerulopathy. In this article, we conducted a thorough review of the literature on the role of TLRs in the pathogenesis of glomerulopathy. The role of TLR receptors as potential marker molecules for the development of neoplastic diseases is emphasized more and more often, as prognostic factors in diseases on several epidemiological backgrounds