20 research outputs found

    Skin-sparing and nipple-sparing mastectomy with a positive sentinel node in patients with breast cancer

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    Introduction. A skin-sparing or nipple-sparing mastectomy is a surgical treatment that is increasingly used in the treatment of patients with breast cancer. More often women themselves decide or even ask to undergo this type of surgery. In our paper, we present the issue of combined treatment of 62 patients after nipple-sparing or skin-sparing mastectomy with a positive sentinel lymph node. Realisation of this type of surgery has further consequences in adjuvant treatment policies. Material and methods. The group of 62 previously untreated women with positive sentinel lymph nodes took part in this analysis. The individual plan of treatment was established for every patient by the multidisciplinary team according to the rules of the breast cancer unit. All patients were treated in the Holycross Cancer Centre in Kielce (in 2015–2018). Results. The early results show that proper qualification and realisation of oncological treatment is safe and effective. Severe complications appeared rarely. Conclusions. Skin-sparing or nipple-sparing mastectomy is a method of surgical treatment that is increasingly used in the treatment of patients with breast cancer. It should be remembered that the qualification for this type of procedure should be careful, and adjuvant treatment should be rationally planned. Our experience shows that it is an effective and safe method

    Wolne i biodostępne frakcje steroidów płciowych mogą wpływać na kości u młodych mężczyzn w zależności od wieku i stężenia estradiolu

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    Introduction: Longitudinal bone growth ceases by the end of puberty, and it is thought to be a result, in both sexes, of increased pubertal oestrogen serum concentrations. Since peak bone mass is achieved by the third decade of life or later, the aim of this study was to relate sex steroid hormones and sex hormone binding globulin (SHBG) levels to bone quality in men during their third and fourth decades of life.Material and methods: Eighty men, healthy volunteers aged between 18 and 39 years, were subjected to an interviewer-administered questionnaire, body mass index (BMI) measurement, blood sample and calcaneal quantitative ultrasound (QUS) (Hologic-SAHARA). Blood was assessed for testosterone (T), oestradiol (E2), dehydroepiandrosterone sulfate (DHEAS), SHBG, luteinising hormone (LH) and follicle stimulating hormone (FSH). Free and bioavailable T and E2 levels were calculated knowing SHBG and albumin levels.Results: While T, E2, DHEAS, LH and FSH levels were not related, free and bioavailable fractions of T and E2 were positively associated with QUS readings. SHBG level was associated negatively. After dichotomisation for age, the associations remained significant only for younger subjects (18–30 years, n = 47). After adjustment for other co-variants, only SHBG in younger subjects retained its negative association with QUS. Older subjects (31–39 years, n = 33) revealed higher BMI and lower serum concentrations of total (–17 %), free (–18.5%) and bioavailable (–22.5%) levels of E2 than younger subjects.Conclusion: Free and bioavailable fractions of sex steroids may influence bones in young men, depending on age and E2 level. (Endokrynol Pol 2014; 65 (5): 357–364)Wstęp: Wzrost kości na długość ustaje wraz z końcem dojrzewania płciowego i wykazano, że u obu płci jest to wynik wzrostu stężenia estrogenów we krwi. Skoro przyjęto, że szczytowa masa kostna jest osiągana dopiero w trzeciej dekadzie życia lub po trzydziestce, badano związki pomiędzy stężeniami steroidów płciowych i białka wiążącego steroidy płciowe (SHBG) a jakością kości u mężczyzn w trzeciej i czwartej dekadzie życia.Materiał i metody: Osiemdziesięciu mężczyzn, zdrowych ochotników w wieku 18–39 lat wypełniło kwestionariusz z wywiadem, zmierzono u nich wskaźnik masy ciała (BMI) i wykonano ilościową analizę ultrasonograficzną kości piętowej (QUS) (Hologic-SAHARA). We krwi oznaczono stężenia testosteronu (T), estradiolu (E2), siarczanu dehydroepiandrosteronu (DHEAS), SHBG, hormonu luteinizującego (LH) i hormonu folikulotropowego (FSH). Znając stężenia SHBG i albumin, wyliczano stężenia wolnego i biodostępnego T i E2.Wyniki: Podczas gdy stężenia T, E2, DHEAS, LH i FSH nie wykazywały powiązań, stężenia wolnych i biodostępnych frakcji T i E2 były dodatnio związane z parametrami QUS. Stężenie SHBG wykazywało związek ujemny. Relacje te zależały od wieku. Mianowicie, po podziale na dwie grupy wiekowe, relacje pozostały znamienne tylko wśród młodszych mężczyzn (18–30 lat, n = 47). Analiza wieloczynnikowa wykazała, że tylko stężenie SHBG u młodszych mężczyzn zachowało znamiennie ujemny związek ze stanem kości. Starsi (31–39 lat, n = 33) wykazali wyższy BMI, a niższe stężenie całkowitego (–17%), wolnego (–18,5%) i biodostępnego (–22,55%) E2 w porównaniu z młodszymi badanymi.Wnioski: Wolne i biodostępne frakcje steroidów płciowych mogą wpływać na kości u młodych mężczyzn, w zależności od wieku i stężenia E2. (Endokrynol Pol 2014; 65 (5): 357–364

    Choroba przyzębia a grubość kompleksu intima– –media u pacjentów z nadciśnieniem tętniczym i chorobą wieńcową

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    Background Periodontitis through the increase of pro inflammatoryand prothrombotic activity can significantlyaffect intima–media complex (IMT) which is an indicatorof early arteriosclerosis of arteries.The aim of the study was to examine periodontal status inpatients with hypertension and heart coronary disease andthe evaluation of the influence of periodontitis on IMTthickness in this group.Material and methods The study group consisted of 67 patients,aged < 60, hospitalized due to stable angina pectoris(SAP). The patients with hypertension (35 patients) were isolatedout of the whole study group. The IMT thickness andarteriosclerotic plaques in carotid artery were evaluated by theultrasound-based diagnostic imaging technique. The periodontalexamination included: approxymal plaque index (API),clinical attachment loss (CAL), pocket depth (PD), bleedingindex (BI) evaluation and the assessment of the teeth number.The correlation between periodontitis, arterial hypertensionand arteriosclerosis progression in arteries were analyzed.Results In patients with arterial hypertension and coronaryheart disease more severe periodontitis and more advancedarteriosclerotic changes in carotid artery were found whencompared with patients without hypertension. In multivariatelogistic regression analysis poor oral hygiene and periodontaldisease were independently associated with IMT thickening.Conclusions Periodontal disease independently effects theIMT thickness in patients with hypertension and coronarydisease. The prevention and treatment of periodontal diseaseshould be an integral part of the multidisciplinary procedurein patients with hypertension and coronary disease.Wstęp Choroba przyzębia, poprzez wzrost aktywnościprozapalnej i prozakrzepowej mogą prowadzićdo pogrubienia kompleksu intima–media (IMT), obrazującego wczesny etap zmian miażdżycowychw naczyniach tętniczych.Celem pracy było badanie stanu przyzębia u chorychz nadciśnieniem tętniczym i chorobą wieńcową orazocena wpływu choroby przyzębia na grubość kompleksuIMT w tej grupie chorych.Materiał i metody Do badania włączono 67 chorychw wieku < 60. rż. hospitalizowanych z powodu stabilnejchoroby wieńcowej (SAP). Z grupy badanejwyodrębniono podgrupę 35 pacjentów z nadciśnieniemtętniczym. Na podstawie badania ultrasonograficznegodokonano pomiaru grubości kompleksuIMT oraz oceny w kierunku obecności blaszek miażdżycowychw tętnicy szyjnej. Badanie periodontologiczneobejmowało ocenę wskaźników: aproksymalnegowskaźnika płytki (API), wskaźnika utratypoziomu przyczepu łącznotkankowego (CAL), głębokościkieszonek (PD), uproszczonego wskaźnikakrwawienia (BI) oraz ocenę liczby zębów. Poddanoanalizie statystycznej wpływ choroby przyzębia nagrubość kompleksu IMT i na zaawansowanie procesumiażdżycowego u chorych z nadciśnieniem tętniczymi chorobą wieńcową.Wyniki U chorych z nadciśnieniem tętniczym i chorobąwieńcową stwierdzono znaczniejsze nasilenie chorobyprzyzębia oraz bardziej zaawansowane zmianymiażdżycowe w tętnicy szyjnej od grupy bez nadciśnienia.W wieloczynnikowej analizie regresji logistycznejzła higiena jamy ustnej i choroba przyzębia okazały sięniezależnym od nadciśnienia tętniczego czynnikiemzwiązanym z pogrubieniem kompleksu IMT.Wnioski Choroba przyzębia może wywierać niezależnywpływ na pogrubienie IMT u chorych z nadciśnieniemtętniczym i chorobą wieńcową. Profilaktyka i leczeniechorób przyzębia powinny stanowić integralnączęść wielospecjalistycznego postępowania u pacjentówz nadciśnieniem tętniczym i chorobą wieńcową

    The influence of the reclassification of NIFTP as an uncertain tumour on risk of malignancy for the diagnostic categories according to the Bethesda system for reporting thyroid cytopathology

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    Introduction: The noninvasive encapsulated, follicular variant of papillary thyroid carcinoma was reclassified as noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP). The exclusion of NIFTP from the group of malignant tumours decreases the risk of malignancy (RoM) as defined by the Bethesda System for Reporting Thyroid Cytopathology (TBSRTC). The aim of the present study was to evaluate the RoM for each category in TBSRTC with and without exclusion of NIFTP from the tally of malignancies. Material and methods: The present study included 998 thyroid nodules cases. All patients underwent diagnostic tests, including fine-needle aspiration cytology, and received surgical treatment. Slides for all resection specimens with a diagnosis of cancer were reviewed to identify NIFTP. The RoM for each of the categories in TBSRTC with and without exclusion of NIFTP from the malignant tumours was evaluated. Results: The RoM decreased with the exclusion of NIFTP from malignant categorisation with the following values for the different TBSRTC categories: non-diagnostic (ND): 0%; benign: 0%; atypia/follicular lesion of undetermined significance (AUS/FLUS): 1.6%; follicular neoplasm/suspicious for follicular neoplasm (FN/SFN): 0.7%; suspicious for malignancy (SUS): 6.9%; and malignant: 2.5%. The difference of 2.5% in the malignant category was statistically significant (p = 0.0253). Conclusions: The RoM for specific TBSRTC categories needs to be defined for each treatment centre because it is important for the selection of the appropriate surgical treatment for thyroid tumours

    Changing geographical patterns and trends in cancer incidence in children and adolescents in Europe, 1991–2010 (Automated Childhood Cancer Information System): a population-based study

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    Background: A deceleration in the increase in cancer incidence in children and adolescents has been reported in several national and regional studies in Europe. Based on a large database representing 1·3 billion person-years over the period 1991–2010, we provide a consolidated report on cancer incidence trends at ages 0–19 years. Methods: We invited all population-based cancer registries operating in European countries to participate in this population-based registry study. We requested a listing of individual records of cancer cases, including sex, age, date of birth, date of cancer diagnosis, tumour sequence number, primary site, morphology, behaviour, and the most valid basis of diagnosis. We also requested population counts in each calendar year by sex and age for the registration area, from official national sources, and specific information about the covered area and registration practices. An eligible registry could become a contributor if it provided quality data for all complete calendar years in the period 1991–2010. Incidence rates and the average annual percentage change with 95% CIs were reported for all cancers and major diagnostic groups, by region and overall, separately for children (age 0–14 years) and adolescents (age 15–19 years). We examined and quantified the stability of the trends with joinpoint analyses. Findings: For the years 1991–2010, 53 registries in 19 countries contributed a total of 180 335 unique cases. We excluded 15 162 (8·4%) of 180 335 cases due to differing practices of registration, and considered the quality indicators for the 165 173 cases included to be satisfactory. The average annual age-standardised incidence was 137·5 (95% CI 136·7–138·3) per million person-years and incidence increased significantly by 0·54% (0·44–0·65) per year in children (age 0–14 years) with no change in trend. In adolescents, the combined European incidence was 176·2 (174·4–178·0) per million person-years based on all 35 138 eligible cases and increased significantly by 0·96% (0·73–1·19) per year, although recent changes in rates among adolescents suggest a deceleration in this increasing trend. We observed temporal variations in trends by age group, geographical region, and diagnostic group. The combined age-standardised incidence of leukaemia based on 48 458 cases in children was 46·9 (46·5–47·3) per million person-years and increased significantly by 0·66% (0·48–0·84) per year. The average overall incidence of leukaemia in adolescents was 23·6 (22·9–24·3) per million person-years, based on 4702 cases, and the average annual change was 0·93% (0·49–1·37). We also observed increasing incidence of lymphoma in adolescents (average annual change 1·04% [0·65–1·44], malignant CNS tumours in children (average annual change 0·49% [0·20–0·77]), and other tumours in both children (average annual change 0·56 [0·40–0·72]) and adolescents (average annual change 1·17 [0·82–1·53]). Interpretation: Improvements in the diagnosis and registration of cancers over time could partly explain the observed increase in incidence, although some changes in underlying putative risk factors cannot be excluded. Cancer incidence trends in this young population require continued monitoring at an international level. Funding: Federal Ministry of Health of the Federal German Government, the European Union's Seventh Framework Programme, and International Agency for Research on Cancer

    Measurements of signal delays in software defined radio with use of GNSS modules

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    In the work a method of latency measurement in software defined radio (SDR) is proposed and validated. The test setup uses customer grade GNSS modules as reference time sources and enables relative delay calculation between signals received directly and those bypassed through SDR platform. The method is hardware agnostic in a sense, that it does not involve any custom software or hardware modifications. Tests that compare reported carrier-to-noise ratio and positioning errors were performed to prove functionality of such system. Additionally, authors measured several gnuradio blocks with respect to their impact on total latency introduced into signal path. All tests were performed on a bladeRF low-cost RF front-end. Minimum observed latency for the signal was below 10 ms

    The Cut-Off Level of Recombinant Human TSH-Stimulated Thyroglobulin in the Follow-Up of Patients with Differentiated Thyroid Cancer.

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    The treatment of differentiated thyroid cancer (DTC) ends in full recovery in 80% of cases. However, in 20% of cases local recurrences or distant metastases are observed, for this reason DTC patients are under life-long follow-up. The most sensitive marker for recurrence is stimulated thyroglobulin (Tg) which, together with neck ultrasound (US), enables correct diagnosis in nearly all cases of the active disease. For many years the only known stimulation was a 4-5 week withdrawal from the L-T4 therapy (THW). For the last couple of years stimulation with the use of recombinant human TSH (rhTSH) has been available. This method of stimulation may have a significant influence in obtaining the Tg level. However, it is important to determine the cut-off level for rhTSH-stimulated Tg (rhTSH/Tg).This is a retrospective analysis of consecutive patients from one facility who have qualified over a period of two years for repeated radioiodine therapy (RIA). In our facility the ablation effectiveness evaluation is always carried out with the use of rhTSH, with the repeated therapy following THW. Such a procedure enables two Tg measurements in the same patient after both types of stimulation within 4-5 weeks. The obtained values were compared, cut-off levels in THW conditions were used (2.0 ng/ml for patients in remission and 10.0 ng/ml for patients with an active disease). In order to determine the cut-off level for rhTSH/Tg, regression analysis and ROC curves were used.In 63 patients the Tg measurement of both methods of stimulation were obtained. It was observed that there was a high correlation between rhTSH/Tg and THW/Tg. However, the rhTSH/Tg level was significantly lower than THW/ Tg. The rhTSH/ Tg cut-off levels which corresponded to the 2.0 ng/ml and 10.0 ng/ml limits for THW/Tg were calculated and the values were 0.6 ng/ml and 2.3 ng/ml respectively.The method of stimulation has a significant impact on the obtained Tg concentrations. The assumed THW/Tg cut off levels must not be transferred to rhTSH/Tg

    Recombinant human thyrotropin-stimulated thyroglobulin (rhTSH/Tg) sensitivity and specificity for cut-off level > 0.6 ng/ml.

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    <p>0-Group of patients with thyroid hormone withdrawal-stimulated thyroglobulin (THW/Tg) < 2 ng/ml 1-Group of patients with thyroid hormone withdrawal-stimulated thyroglobulin (THW/Tg) ≥ 2 ng/ml</p

    Recombinant human thyrotropin-stimulated thyroglobulin (rhTSH/Tg) levels in groups of patients divided in accordance to thyroid hormone withdrawal-stimulated thyroglobulin (THW/Tg) cut-off levels.

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    <p>N- number of patients</p><p>Recombinant human thyrotropin-stimulated thyroglobulin (rhTSH/Tg) levels in groups of patients divided in accordance to thyroid hormone withdrawal-stimulated thyroglobulin (THW/Tg) cut-off levels.</p

    Recombinant human thyrotropin-stimulated thyroglobulin (rhTSH/Tg) and thyroid hormone withdrawal-stimulated thyroglobulin (THW/Tg) in the same patients in three groups: Group 1- THW/Tg < 2ng/ml; Group 2-THW/Tg ≥ 2ng/ml and < 10ng/ml; Group 3- THW/Tg ≥ 10 ng/ml.

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    <p>Recombinant human thyrotropin-stimulated thyroglobulin (rhTSH/Tg) and thyroid hormone withdrawal-stimulated thyroglobulin (THW/Tg) in the same patients in three groups: Group 1- THW/Tg < 2ng/ml; Group 2-THW/Tg ≥ 2ng/ml and < 10ng/ml; Group 3- THW/Tg ≥ 10 ng/ml.</p
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