Ocena skuteczności stosowania Cicatridiny w procesie gojenia i reparacji szyjki macicy, pochwy i krocza – otwarte nierandomizowane badanie kliniczne

Abstract Purpose: The aim of the study was to evaluate the efficacy of Cicatridine application in healing and repairing process after operative procedures concerning uterine cervix, vagina and vulva and after brachytherapy due to cervical and endometrial cancer. We also analyzed Cicatridine effect on vaginal athrophical signs in post-menopausal women. Patients and Methods: The examined group consist of 319 women. They were divided into 2 arms. The active arm concerns 213 women who used Cicatridine, while controlled one consists of 106 women. The effect of treatment was estimated after 6 weeks and 3 months by the visual inspection of the cervix and vagina. We also analyzed the subjective filling of patients bound to sexual intercouses by using of Visual Analogue Scale (0% – no effect; 100% – disappearance of pathological symptoms). Results: In active arm according to control one the reparation of cervix was more often: after surgery procedures (respectively after 6 weeks 93% vs 70%; after 3 months 99% vs 89%) and after brachytherapy (respectively after 3 months 86% vs 0%). In brachytherapy group the lack of discomfort during sexual intercourses was also more often in active arm (respectively 55% vs 0%). In postmenopausal women reduction of symptoms associated with atrophic vaginitis was observed only in active group (respectively after 6 weeks 43% vs 0%; after 3 months 57% vs 0%). In the group of patients after ephisiotomy due to delivery the relief of discomfort during sexual intercourses was also more often in active arm (respectively 94% vs 25%). Conclusion: Cicatridine causes fast healing of cervix after gynecological procedures. It influences improvement of atrophical, inflammatory and after radiation therapy effects which improve quality of life and comfort of vagina after brachytherapy due to cervical and endometrial cancer. Cicatridine causes similar effect in vagina of pos-menopausal women as locally used estrogens. Cicatridine also causes the feeling of relief and comfort in vagina after delivery as well as fast healing after episiotomy.Streszczenie Cel pracy: Celem pracy była ocena skuteczności stosowania Cicatridiny w postaci globulek w procesie gojenia i reperacji po zabiegach operacyjnych na szyjce macicy, pochwie i sromie oraz brachyterapii z powodu raka szyjki macicy i raka błony śluzowej trzonu macicy a także jej wpływu na objawy atroficzne w pochwie kobiet po menopauzie. Materiał i metody: Materiał obejmował 213 kobiet, u których zastosowano Cicatridinę oraz 106 kobiet z grupy kontrolnej. Efekt leczenia oceniono po upływie 6 tygodni i następnie 3 miesięcy od rozpoczęcia terapii poprzez wizualną ocenę szyjki macicy i/ lub pochwy. Oceniano również subiektywne odczucia pacjentek dotyczące dolegliwości związanych ze współżyciem płciowym poprzez zastosowanie procentowej skali zgłaszanych odczuć (0% brak poprawy – 100% całkowite ustąpienie objawów lub dolegliwości). Wyniki: W grupie stosującej Cicatridinę w porównaniu do grupy kontrolnej w wi´kszym odsetku doszΠo do wygojenia szyjki po zabiegach (odpowiednio w 6 tygodniu po leczeniu 93% v.s. 70% i w 3 miesiącu 99% v.s. 89%); do poprawy wizualnej po brachyterapii (odpowiednio 86% v.s. 0 % po 3 miesiącach); braku dyskomfortu przy współżyciu po brachyterapii (odpowiednio 55% vs 0%); ustąpienie dolegliwości wśród pacjentek w okresie fizjologicznego przekwitania (odpowiednio w 6 tygodniu po leczeniu 43% v.s. 0% i w 3 miesiącu 57% v.s. 0%); oraz braku dyskomfortu przy współżyciu po nacięciu krocza w (odpowiednio 94% v.s. 25%). Wnioski: Cicatridina powoduje szybsze gojenie się szyjki macicy po zabiegach ginekologicznych. Po brachyterapii z powodu raka szyjki i trzonu macicy Cicatridina wpływa na popraw´ objawów atroficzno-zapalnych i popromiennych co poprawia jakość życia oraz zwiększa komfort w pochwie. U kobiet po fizjologicznym przekwitaniu Cicatridina wywiera podobny efekt w pochwie jak stosowane lokalnie estrogeny. Cicatridina zwiększa komfort w pochwie po przebytych porodach a krem powoduje szybsze gojenie się rany po epizjotomii

Living with diabetes - case study

Introduction. Diabetes is a chronic disorder of metabolism. It is caused by impaired insulin secretion and action. There are type 1 diabetes,type 2 diabetes, gestational diabetes and other specific types of diabetes. Risk factors for this disease include age (risk increases after 45 years ofage), obesity, low physical activity, hypertension, lipid disorders genetics. Symptoms of the disease are frequent urination, excessive thirst, weakness,lethargy, emaciation, fungal infections, furunculosis. Patients have elevated blood glucose levels. Complications of diabetes can be divided into acuteand chronic. Complications include acute hyperglycemia and hypoglycemia. Chronic complications is microangiopathy (retinopathy, nephropathy,neuropathy) and macrovascular disease (myocardial infarction, stroke, peripheral vascular disease). Diabetes occurs more frequently, is an importantsociological and social problem. Her diagnosis always causes anxiety, uncertainty, sense of danger. Ill try to find answers to many questions.Objective. The aim of this study was to determine the quality of life for patients with diabetes, diagnosis of care problems, patienteducation in terms of information essential for living with chronic disease.Materials. Material - the subject of research was a woman aged 64 suffering from diabetes type II. Patient presented information aboutdiabetes, we got to know her health problems and their solutions.Methods. A Study of the individual case. Techniques: Observation, interview, examination of documents.Research problems posed in the work are:What are the health problems common in patients with diabetes?The extent to which a patient with diabetes is capable of self-care and self-control?As the nurse prepares the patient to change and lifestyle modification in chronic disease that is diabetes?The paper presents a range of activities including patient self-care and self-control.Results. The patient reported the following health problems relating to diabetes: the lack of insulin, inability to use the meter, the lack ofsufficient knowledge about the complications of diabetes, skin abrasion on the foot and clammy skin between the toes, being overweight.Conclusion. Patient is a walking, self-contained. All nursery operations performed alone. With the support of her daughter is trying toovercome all the difficulties associated with the disease. She uses medical care as a medical indication, every 6-8 weeks in primary exercise controlstudy of blood glucose levels, use of medical visits, always ordered the hypoglycemic drugs, insulin, diabetic diet, was informed by a nurse for furthercare and self-control. The paper presents a range of activities including patient self-care and self-control.The patient was informed of the need for lifestyle changes such as diet, avoidance of drugs, the constant control of blood glucose(glucometer training will be offered), a small regular exercise, etc.First of all making clear to patient that diabetes is not cited, you can live with this disease, do not fall apart. The proper operation oftreatment with a conscious discipline of the patient, can maintain good performance in life and personal life satisfaction.She learned to use the same meter and examine the level of blood sugar at a specified time. She is aware of the problems associated withthe disease. He is aware that only applies to the stringent requirements and restrictions, will allow it to avoid future complications. Despite anincurable disease is trying to discern the meaning of life and the meaning of their sacrifices. He believes in the fact that a positive attitude to thedisease is part of the success on the road to quality of life

The role of nesfatin and selected molecular factors in various types of endometrial cancer

Objectives: Endometrial cancers (ECs) are the most common gynaecological cancers in well developed countries. Diabetes and metabolic syndrome are among the biggest risk factors. Nesfatin-1, the adipokine derivative of NUCB2 (nucleobindin derivative 2) is linked to the clinical course of EC. Molecular factors, including mutations in MLH1 and MHS2 genes, c-MET and ARID1A are also related to prognosis in endometrial cancer. Material and methods: Using sections of paraffin-embedded preparations and immunohistochemistry, the expression of NESF1, MLH1, MSH2,c-MET and ARID1A were examined. Results: In this study on protein expression, EC tissues manifested (although insignificantly) an elevated expression of NESF-1 in type II EC. In type I EC, NESF-1 expression was significantly higher in G1 in comparison to G2 and G3 together. A significantly lower expression of MLH1 was demonstrated in type I EC. Conclusions: The most pronounced expression involved c-MET in all EC I and EC II tissues (in over 80% of cases). A tendency was detected for a high expression of NESF-1 in patients with type II EC, who also exhibited a high expression of MSH2

Myoelectrical activity of muscles stabilizing the sacroiliac joints before and after the use of elastic tapes in women suffering from Pregnancy-related Pelvic Girdle Pain

Objectives: The aim of this study was the analysis of activity of selected muscles stabilizing the sacroiliac joints in pregnantwomen suffering from pelvic pain and changes in the pattern in response to the implementation of Kinesio Taping(elastic tape).Material and methods: Seventeen women with Pregnancy-related Pelvic Girdle Pain and 20 pregnant women withoutpain in the lumbar-pelvic complex were enrolled into the study. In patients with pelvic pain, the parameters describing theaction of the muscles were assessed: before the tape was applied, immediately after application, 3 days into applicationand 5 days after the cessation of taping. In the control group, the test was carried out one time. The activity of the muscleswas measured during extension of the hip from a four-point kneeling position.Results: The gluteus maximus muscle shows higher resting activity values than in the control group, before and after applicationof the tape as well as five days after the removal of the tape. Before application, the gluteus maximus activatesquicker than in the control group while the ipsilateral extensor spinae had a delayed activation when compared to thecontrol group.Conclusions: The patterns of activation of tested muscles and their action potential values are different in the groupof women with pelvic pain compared to the group without pelvic pain. The application of KT in the lumbar region appearsto alter the activation of the GM muscle as well as improve activation of IES muscle during hip extension from thefour-point-kneeling position

Impact of Kinesio Taping application on pregnant women suffering from pregnancy-related pelvic girdle pain — preliminary study

Objectives: The aim of the study was to assess the impact of pregnancy-related pelvic girdle pain on every day functioning and evaluate how effective Kinesio Taping is in reducing pain for pregnant women. Material and methods: 24 women filled the author’s questionnaire, Oswestry Disability Index Questionnaire and Pelvic Girdle Questionnaire before starting the therapy. Elastic tape was applied onto the lumbosacral area for 5 days and was evaluated 1st day of the test immediately before application, day 2, 3, 4, 5, 6 and 10 day of the examination. Results: ODI score was 20.09 and showed major disability resulting from severity of the pain. PGQ score was 19.909. Sig­nificant pain reduction was registered on the 3rd day after tape was applied, significant pain reduction on the day of tape removal, and 5 days after tape removal. Conclusions: Elastic tape decreases pain in pregnancy-related pelvic girdle pain. Pelvic girdle pain deteriorates the quality of life for pregnant women

Znaczenie PD-1 – receptora programowanej śmierci-1 – i jego ligandów w immunoterapii raka jajnika

The immune system plays an important role in both cancer development and destruction. Tumor cells have developed mechanisms to evade an effective immune response. One of these involves the use of immune checkpoint pathways, which modulate the intensity and duration of such responses. There are two immune checkpoint receptors that have been most thoroughly studied: CTLA-4 (cytotoxic T lymphocyte-associated antigen 4) and PD-1 (programmed cell death protein 1 pathway), involved in regulatory T cell responses. The anti-CTLA-4 antibody is used in the treatment of many malignancies,including non-small-cell lung cancer, prostate cancer and melanoma. PD-1 and its ligands, PD-L1 and PD-L2, represent an immune axis protecting cancer cells against regulatory T cells (cytotoxic CD8+ cells and CD4+ helper cells). Nivolumab,a monoclonal antibody, blocks PD-1 and, as a result, its binding to its ligands. Consequently, T cell antitumor activity is restored, which appears promising in clinical trials involving patients with malignancies in multiple locations, including non-small-cell lung cancer, melanoma and ovarian cancer, clear cell ovarian carcinoma in particular. Nivolumab therapy is not devoid of adverse effects, which affect about 40% of patients with ovarian cancer. These include e.g. arrhythmia, fever,anemia and decreased lymphocyte count. It is believed that combining a therapy that blocks the key immune checkpoints with other anticancer agents, including chemotherapy, radiation therapy or other targeted therapies, will improve treatment efficacy in malignancies, including ovarian cancer

The role of selected molecular factors in ovarian cancer metastasis

The main reason for treatment failure in ovarian cancer is chemoresistance and the presence of metastasis. Ascites, which allows the physical movement of cancer cells, the lymphovascular pathway, and several molecular factors and signalling axes, are involved in metastasis. Ascites, with the involvement of cytokines and chemokines, MAPK/STAT1 and NOTCH as well as CXCL12/CXCR4 signaling pathways and circulating anoikis induces cancer dissemination, in particular to the peritoneum and omentum. The spread of lymphatic and bloodstream cancer cells is a multi-stage process. Tumour infiltration of the stroma and lymphovascular space (LVSI) produces biologically active cancer-associated fibroblasts and macrophages (CAFs, TAMs) that secrete numerous cytokines, chemokines and growth factors, inhibit NK function, induce epithelial-mesenchymal transition (EMT), resulting in an increase of the metastatic potential of cancer cells and the formation of cancer stem cells (CSCs). Overexpression of some genes, and microRNAs, in LVSI-(LMGS) associated with metastasis has been identified. The role of extracellular vesicles (EVs) transporting metastasis-associated factors has been described as has the role of cancer stem cells (CSCs) in chemotherapy resistance and metastasis. Sirtuins, enzymes involved in metastasis formation, have also been detected. Certain types of microRNAs (miR-509-3p, microRNA-506-3p) and melatonin have been shown to inhibit metastasis.  

BADANIE OBECNOŚCI POLIMORFIZMU C/T W POZYCJI 34 DRUGIEGO INTRONU GENU MIOSTATYNY KRÓLIKÓW

Myostatin gene is a negative regulator of skeletal muscles growth. It is responsible for normal development of skeletal muscles. The objective of the research was to detect variation of C/T at position 34 of the second intron of the MNST gene in rabbits. The research included 114 rabbits: 54 of them Polish Rabbits, and 60 of them White Flemish Giants, examined by means of the PCR-RFLP method using AluI restriction enzyme. We found allele C with a frequency of 0.6184 of the examined rabbit population, and allele T with a frequency of 0.3816 of the examined rabbits.Gen miostatyny jest ujemnym regulatorem wzrostu mięśni szkieletowych. Gen MNST odpowiedzialny jest za prawidłowy rozwój mięśni szkieletowych. Celem badań była detekcja zmienności C/T w pozycji 34 drugiego intronu genu MNST królików. Badaniu poddano 114 królików: 54 osobniki rasy hermelin i 60 osobników rasy belgijski olbrzym biały metodą PCR-RFLP przy użyciu enzymu restrykcyjnego AluI. Wykryto allel C stanowiący 0,6184 przebadanej populacji królików oraz allel T stanowiacy 0,3816 przebadanych osobników