Quality of sexual life after inguinal hernia repair

Inguinal hernia repair is one of the most common surgical procedures. Post-operative pain is one of the main factors determining sexual life satisfaction and general quality of life. However, not much research has focused on the problem of chronic pain after a corrective surgery and its impact on the quality of human sex life. Recurrent inguinal hernia to a large extent has been reduced due to the use of synthetic mesh, but there was a serious problem - chronic postoperative pain, which significantly reduces the overall quality of life of patients

The assessment of the patients disability degree using the EDSS scale in various forms of multiple sclerosis

Purpose. The aim of the study is to assess the patients disability degree using the Extended Scale of Disability in various forms of multiple sclerosis.Material and Methods. The study was conducted on a group of 40 people suffering from multiple sclerosis, diagnosed and treated in the Neurology Clinic of the 10th Military Clinical Hospital in Bydgoszcz. In order to assess the patients disability degree, the Extended Disability Management Scale was used. The other information needed for statistical analysis was obtained from the clinical observation chart established for each patient.Results. The disability degree of patients with multiple sclerosis is determined by many variables. The Expanded Disability Rating Scale is a good tool to assess the degree of disability of patients with multiple sclerosis.Conclusion. 1. In the group of people with relapsing remitting MS, the average value of the degree of disability in the Expanded Disability Scale was the smallest. 2. The childbirth during the course of multiple sclerosis causes exacerbation of clinical symptoms immediately after the childbirth. 3. Optic neuritis as the initial symptom of multiple sclerosis predisposes to a milder course of the disease. 4. Symptoms of the first relapse of multiple sclerosis that support faster progression of disability are: lower limb paresis, sphincter dysfunction and balance disorders. 5. Multifocal symptomatology of the first relapse of multiple sclerosis speaks for faster progression of disability in relation to patients with the first relapse characterized only by one symptom

Preoperative neutrophil-lymphocyte and lymphocyte-monocyte ratios reflect immune cell population rearrangement in resectable pancreatic cancer

BACKGROUND: Neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and lymphocyte-monocyte ratio (LMR) may serve as a simple index of the immune function. The aim of this study was to investigate the prognostic significance of NLR, PLR, and LMR in patients with resectable pancreatic ductal adenocarcinoma (PDAC) and to verify whether such biomarkers are associated with changes in populations of lymphoid cells. METHODS: The prognostic implications of blood count parameters were evaluated in a retrospective cohort of 442 subjects undergoing pancreatic resections for PDAC. Subpopulations of lymphocytes and monocytes in peripheral blood were identified by FACS in a prospective cohort of 54 patients. RESULTS: In the univariate analysis, NLR < 5 and LMR ≥ 3 were associated with significantly longer median survival of 25.7 vs 12.6 months and 29.2 vs 13.1 months, respectively. PLR did not influence survival. The Cox proportional hazards model showed that high NLR (HR 1.66, 95 % CI 1.12 to 2.46, P = 0.012) and low LMR (HR 1.65, 95 % CI 1.06 to 2.58, P = 0.026) were independent predictors of poor prognosis. NLR ≥ 5 and LMR < 3 correlated with an approximately twofold decrease in counts of helper and cytotoxic T cells, B cells, and NK cells. High NLR was also accompanied with increased neutrophil counts, while low LMR showed increased numbers of monocytes, mostly classical. CONCLUSIONS: NLR and LMR may carry important prognostic information for patients with resected PDAC. The unfavorable prognosis likely correlates with reduced numbers of immune cells effective against the tumor and increased populations of cells involved in immune suppression

Expression of CD10 on minimal residual cells in children with B-cell precursor acute leukemia

BackgroundThe most common childhood malignancy is B-cell precursor acute leukemia (BCP-ALL). Leukemic cells remaining in the patient's bone marrow during treatment are the major cause of relapse; therefore, minimal residual disease monitoring (MRD) during the induction therapy is predicting factor of treatment outcome. Multicolor flow cytometry (MFC) is the commonly used technique during follow-up of leukemia in bone marrow.Materials and methodsMRD was assessed by MFC in 44 patients with BCP-ALL from the Oncology and Hematology Department, Children's University Hospitalin Krakow diagnosed between 2011 and 2013. The level of residual leukemic cells and the quality of antigen expression was assessed on leukemic cell on diagnosis day and 15th day of induction chemotherapy. Six-color panel of monoclonal antibodies was used. To achieve expected sensitivity of the method (10-4), at least 300.000 nucleated cells were collected.ResultsCD10 expression was changed in residual leukemic cells of most patients on day 15 of treatment, in comparison to day 0. The most significant decrease of CD10 expression occurs in standard risk group. CD10 level is correlated with the level of blasts in day 15, which is the most significant in high-risk group. The patients, in whom the level of CD10 expression increases during treatment, were statistically significantly associated with worse response to therapy.ConclusionsThe immunophenotypic shifts at day 15 were observed in most patients. Not only are the quantitative MRD results important, but also qualitative changes of immunophenotype of residual leukemic cells might bring additional clinical information

Large extracellular vesicles do not mitigate the harmful effect of hyperglycemia on endothelial cell mobility

Extracellular vesicles, especially the larger fraction (LEVs – large extracellular vesicles), are believed to be an important means of intercellular communication. Earlier studies on LEVs have shown their healing properties, especially in the vascular cells of diabetic patients. Uptake of LEVs by endothelial cells and internalization of their cargo have also been demonstrated. Endothelial cells change their properties under hyperglycemic conditions (HGC), which reduces their activity and is the cause of endothelial dysfunction. The aim of our study was to investigate how human umbilical vein endothelial cells (HUVECs) change their biological properties: shape, mobility, cell surface stiffness, as well as describe the activation of metabolic pathways after exposure to the harmful effects of HGC and the administration of LEVs released by endothelial cells. We obtained LEVs from HUVEC cultures in HGC and normoglycemia (NGC) using the filtration and ultracentrifugation methods. We assessed the size of LEVs and the presence of biomarkers such as phosphatidylserine, CD63, beta-actin and HSP70. We analyzed the LEVs uptake efficiency by HUVECs, HUVEC shape, actin cytoskeleton remodeling, surface stiffness and finally gene expression by mRNA analysis. Under HGC conditions, HUVECs were larger and had a stiffened surface and a strengthened actin cortex compared to cells under NGC condition. HGC also altered the activation of metabolic pathways, especially those related to intracellular transport, metabolism, and organization of cellular components. The most interesting observation in our study is that LEVs did not restore cell motility disturbed by HGC. Although, LEVs were not able to reverse this deleterious effect of HGC, they activated transcription of genes involved in protein synthesis and vesicle trafficking in HUVECs

Blinatumomab as a bridge therapy for hematopoietic stem cell transplantation in pediatric refractory/relapsed acute lymphoblastic leukemia

Despite the progress that has been made in recent decades in the treatment of pediatric acute leukemias, e.g., converting acute lymphoblastic leukemia (ALL) from a fatal to a highly curable disease, 15&ndash;20% of children still relapse. Blinatumomab, a bispecific CD3/CD19 antibody construct, has been successfully used in relapsed/refractory r/r B-cell precursor ALL (BCP-ALL) as a bridge to hematopoietic stem cell transplantation (HSCT). We retrospectively assessed the efficacy and toxicity of blinatumomab in 13 children with r/r BCP-ALL. Between 2017 and 2021, thirteen children, aged 1&ndash;18 years, with r/r BCP-ALL were treated with blinatumomab. Two patients were administered blinatumomab for refractory relapse without complete remission (CR), one due to primary refractory disease, and ten patients were in CR with minimal residual disease (MRD) &ge; 10&minus;3. The response rate in our cohort of patients was 85%, with subsequent feasible HSCT in 11 out of 13 children. Ten children reached MRD negativity after the first blinatumomab administration. The three-year OS for the study patients was 85% (Mantel&ndash;Cox, p &lt; 0.001) and median follow-up was 24.5 (range: 1&ndash;47). All responders proceeded to HSCT and are alive in CR, and MRD negative. Although our study had some limitations with regard to its retrospective design and limited patient population, it clearly showed blinatumomab as not only a feasible but also an effective therapeutic option in pretreated children with r/r BCP-ALL, with a tolerable toxicity profile, paving the way for an HSCT procedure

Go with the flow - early assessment of measurable residual disease in children with acute lymphoblastic leukemia treated according to ALL IC-BFM2009

SIMPLE SUMMARY: Monitoring of residual disease is a very important aspect of modern treatment approaches in many types of cancer. In acute leukemias in both children and adults, molecular and cytometric methods are used to assess the burden of leukemia at different points during therapy. Residual disease measured at the end of induction was shown to be the strongest predictor of outcome. Analyzing the outcomes of children with acute lymphoblastic leukemia (ALL), we aimed to establish the most informative cut-off and time point of assessment. Applying only the measurement of residual disease by flow cytometry along with genotypic findings, we managed to identify patients with a poor prognosis. Although new precise, molecular techniques as the next generation sequencing strategy are approaching daily clinical practice, flow cytometry is still a reliable, standardized method of residual disease detection. We may say ‘go with the flow’; thus, the assessment of residual disease by multiparametric flow cytometry is a proper method for the management of ALL patients according to risk-adapted therapies. ABSTRACT: Measurable residual disease (MRD) is a well-known tool for the evaluation of the early response to treatment in patients with acute lymphoblastic leukemia (ALL). In respect to predicting the relapse the most informative cut-off and time point of MRD measurement during therapy were evaluated in our study. Between 1 January 2013 and 31 December 2019, multiparametric flow cytometry (MFC) MRD was measured in the bone marrow of 140 children with ALL treated according to the ALL IC-BFM2009 protocol. The MRD cut-off of 0.1% and day 33, end of induction, were the most discriminatory for all patients. Patients with negative MRD on day 15 and 33 had a higher 5-year overall survival—OS (100%) and a higher relapse-free survival—RFS rate (97.6%) than those with positive levels of MRD (≥0.01%) at both time points (77.8% and 55.6%, p = 0.002 and 0.001, respectively). Most patients with residual disease below 0.1% on day 15 exhibit hyperdiploidy or ETV6-RUNX1 in ALL cells. Measurement of MRD at early time points can be used with simplified genetic analysis to better identify low and high-risk patients, allowing personalized therapies and further improvement in outcomes in pediatric ALL