Planning and preparation for pregnancy among women with and without a history of infertility

Objectives: Preconception counseling, maternal health-related habits, diet, folic acid consumption, substances abuse, may all impact the outcome of pregnancy. The aim of this study was to compare the planning and preparation for pregnancy among pregnant women with and without infertility. Material and methods: A survey of health behaviors prior to and during pregnancy that could affect pregnancy outcomes, including laboratory tests performed, stimulant usage, initiation of prenatal care, and folic acid intake, was conducted among 400 pregnant women. The study group included 121 women (30.25%) diagnosed with prior infertility, while the control group included 279 women (69.74%) who did not report any problems conceiving. Results: All patients (100%) from the study group and 70,97% from the control group planned their pregnancy(p < 0.0001). Patients in the study group performed significantly more laboratory tests prior to pregnancy, including: complete blood count, urine analysis, fasting blood glucose concentration, testing for toxoplasmosis, and Pap smear, compared with the control group (p < 0.0001). There was no difference between groups regarding the knowledge of when and why folic acid supplementation is required (p > 0.05). Conclusions: Effective education of women, regarding pregnancy planning and behaviours, that may impact pregnancy outcome is still a serious challange to public health in Poland. Our study indicates that reaching general population with the education is most important to achieve best results in preconceptional care

Is mastectomy with immediate breast reconstruction an alternative to breast-conserving treatment?

Mimo że leczenie oszczędzające pierś uznawane jest za metodę z wyboru w leczeniu chorych na wczesnego raka piersi, w niektórych badaniach zaobserwowano wzrost częstości wykonywanych mastektomii. Coraz częściej w trakcie mastektomii wykonywana jest natychmiastowa rekonstrukcja piersi, mająca na celu zmniejszenie okaleczenia związanego z utratą piersi. Wykazano, że zarówno leczenie oszczędzające pierś, jak i mastektomia z natychmiastową rekonstrukcją piersi są zabiegami bezpiecznymi onkologicznie i przynoszą porównywalny komfort życia. Jednak zabieg mastektomii z rekonstrukcją natychmiastową piersi jest obarczony większym odsetkiem powikłań pooperacyjnych, zwłaszcza w przypadku zastosowania radioterapii uzupełniającej. Dodatkową korzyścią leczenia oszczędzającego pierś jest możliwość odstąpienia od wykonania limfadenektomii pachowej w przypadku przerzutów ograniczonych do 1–2 węzłów wartowniczych, przez co chore mogą uniknąć powikłań związanych z usunięciem węzłów chłonnych pachowych. Ustalając plan leczenia chorych, należy zwrócić uwagę na potencjalną przewagę, jaką posiada leczenie oszczędzające pierś, nad mastektomią z rekonstrukcją natychmiastową pod względem ryzyka wystąpienia powikłań.Beside the fact that breast-conserving treatment is the method of choice in early breast cancer, several studies have demonstrated good results when mastectomy is involved in the treatment. Such studies are currently increasing. Immediate breast reconstruction is gaining popularity as the method that mitigates post-mastectomy deformation. Comparing breast-conserving treatment and immediate breast reconstruction after mastectomy both methods did not worsen the treatment outcome and have a positive impact to quality of life. However, the complications rate is higher after mastectomy with immediate breast reconstruction, especially in the subgroup of patients receiving postmastectomy radiotherapy. Breast-conserving therapy additionally gives the opportunity to avoid axillary lymph nodes dissection in the subgroup of patients with positive 1–2 sentinel nodes. It should be taken into consideration when a treatment schedule is established, that breast-conserving therapy has an advantage regarding risk of complications

Znaczenie ekspresji antygenu Ki-67 ocenianej metodą mikromacierzy tkankowych dla rokowania u chorych z gruczolakorakiem endometrialnym endometrium

Objectives: To assess the prognostic significance of Ki-67 expression in the tissue microarray method (TMA) for disease free survival (DFS) and overall survival (OS) in endometrioid endometrial cancer (EEC). Material and methods: The study examined 159 consecutive patients aged 37-86 (62.82±9.95) with EEC stages I-III according to FIGO, treated surgically at the Pirogow Memorial Hospital of Lodz between 2000 and 2007. Afterwards they were subsequently treated and examined at the Regional Cancer Center, Copernicus Memorial Hospital of Lodz. Tissue cores 2 mm in size, in duplicate, were taken from the formalin-fixed and paraffin-embedded tissue donor blocks from surgery, and constructed into the TMA recipient blocks. Using TMA method, the relationship between Ki-67 expression, DFS and OS was examined. DFS was defined as a period from primary surgery until relapse. OS was defined as a period from primary surgery until the end of the follow-up (60 months) or until the death of the patient. The study was approved by the Ethics Committee of the Medical University of Lodz (RNN/82/11/KE; KE/1673/12). Results: The follow-up time varied between 3 - 60 months (51.42±15.87). In 31 patients (19.50%) the relapse of was diagnosed 1–59 months (24.97±16.08) after commencement of the treatment. During follow-up 32 patients (20.12%) died. DFS and OS were 80.50% and 79.88%, respectively. The lack of Ki-67 expression was found in 37 cases (23.27%) while in 122 patients (76.73%) the expression was present (p20% was present in 76 cases, 26 cases and 20 cases, respectively. Positive correlation between the expression of Ki-67 and staging was present (r=0.353; pCel pracy: Celem pracy była ocena znaczenia rokowniczego obecności i wielkości ekspresji antygenu Ki-67 ocenianej metodą mikromacierzy tkankowych (TMA) dla przeżycia wolnego od choroby (DFS) oraz przeżycia ogólnego (OS) chorych z gruczolakorakiem endometrialnym endometrium (GEE). Materiał i metody: Grupę badaną stanowiło 159 chorych. Wykorzystując metodę TMA, oceniono zależność między obecnością i wielkością ekspresji Ki-67 a DFS i OS. Wyniki: Okres obserwacji wynosił 3-60 miesięcy (51,42±15,87). DFS i OS wynosiły odpowiednio 80,50% i 79,88%. Brak ekspresji Ki-67 stwierdzono w 37 przypadkach (23,27%), a obecność ekspresji Ki-67 u 122 chorych (76,73%;

Effectiveness of tissue microarray technique for the assessment of estrogen and progesterone receptors expression in endometrioid endometrial cancer – preliminary report

Objectives: To assess the effectiveness of the donor-block biopsies with a 2 mm-size needle in endometrioid endometrial cancer (EEC) in the tissue microarray (TMA) technique and the application of the TMA for estrogen receptors (ER) and progesterone receptors (PR) expression in EEC. Material and methods: The study examined EEC tissues from 60 patients. Tissue cores, 2 mm in size, in duplicate, were taken from the formalin-fixed and paraffin-embedded tissue donor blocks and constructed into the TMA recipient block. The presence of EEC tissue in the TMAs was analyzed, and the ER and PR expressions were examined. Results: EEC tissue in TMAs was confirmed in 56 cases (93.33%). In 49 of them (81.67%), both cores presented with cancer tissues. In 4 cases (6.67%) EEC tissue was absent. All cases with ECC present on the TMA slides were appropriate for the ER and PR analysis. In 29 EEC cases (51.98%) both ER and PR were expressed. In 3 cases (5.36%) only ER was expressed, in 8 cases (14.29%) only PR was expressed, and in 16 cases (28.57%) ER and PR were assessed as negative. Conclusions: Two 2 mm-sized tissue cores from donor-block biopsies constructed into the TMA recipient block were sufficient to diagnose EEC and enabled the assessment of ER and PR expression in 93.3% of the cases. The use of the described TMA technique makes the immunohistochemical study of EEC easier and more timeefficient

Znaczenie ekspresji receptorów progesteronowych i estrogenowych ocenianej metodą mikromacierzy tkankowych dla rokowania u chorych z gruczolakorakiem endometrioidalnym endometrium

Objectives: To assess prognostic significance of progesterone receptors (PR) and estrogen receptors (ER) expression in the tissue microarray (TMA) technique for disease free survival (DFS) and overall survival (OS) in endometrioid endometrial cancer (EEC). Material and methods: The study included 151 consecutive patients, aged 37-86 years (62.80±9.99), with the EEC in stages I-III (FIGO), treated surgically at the Pirogow Memorial Hospital of Lodz between 2000 and 2007. Afterwards, they were subsequently treated and examined at the Regional Cancer Center, Copernicus Memorial Hospital of Lodz. Tissue cores 2 mm in size, in duplicate, were taken from the formalin-fixed and paraffin-embedded tissue donor blocks from surgery, and constructed into the TMA recipient blocks. Using TMAs, the expression of PR and ER was examined and presented as Total Score (TS). The TS was determined by adding the intensity and marker distribution scores in a given case. The relationship between PR and ER expression, DFS and OS was examined. DFS was defined as the period from primary surgery until relapse. OS was defined as the period from primary surgery until the end of the follow-up (60 months) or until the death of the patient. The study was approved by the Ethics Committee of the Medical University of Lodz (RNN/82/11/KE). Results: Lack of the PR and ER expression was found in 46 cases (30.46%) and 67 cases (44.37%), respectively. The expression of the PR and ER was weak in 24 cases (15.89%) and 22 cases (14.57%), respectively. Strong PR and ER expression was found in 81 patients (53.65%) and 62 patients (41.06%), respectively. Follow-up after surgery varied from 3 to 60 months (50.95±16.36). In 30 patients (19.87%) relapse was diagnosed 1–54 months (22.17±15.59) after surgery. During follow-ups, 29 patients (19.21%) died. In univariate analysis better DFS was related to the presence of PR (p=0.010), higher TS of PR (HR=0.81; 95% CI 0.71-0.94), the presence of ER (p=0.001) and higher TS of ER (HR=0.88; 95% CI 0.78-0.99). DFS differed significantly between the groups: without PR and ER expression (A), with presence of the PR but not ER expression (B), with the ER but not PR expression (C) and with the PR and ER expression (D) (p=0.004). In univariate analysis OS was not related to PR expression (p=0.110), TS of PR (HR= 0.89; 95% CI 0.80-1.02) and ER expression (p=0.070). TS of ER was connected to better OS (HR= 0.83; 95%CI 0.72-0.96). The OS differed between groups A, B, C and D (p=0.006). In multivariate analysis variants of PR/ER expression influenced the DFS (p=0.039) and OS (p=0.016). Conclusions: The expression of the PR and ER can significantly affect therapeutic decisions in selected patients with EEC. In EEC, common assessment of PR and ER expression is of higher prognostic value, than compared to single evaluation of PR and ER receptors.Cel pracy: Celem pracy była ocena znaczenia rokowniczego obecności i wielkości ekspresji receptorów estrogenowych (ER) i progesteronowych (PR) ocenianej metodą mikromacierzy tkankowych (TMA) dla przeżycia wolnego od choroby (DFS) oraz przeżycia ogólnego (OS) chorych z gruczolakorakiem endometrioidalnym endometrium (GEE). Materiał i metody: Grupę badaną stanowiło 151 chorych. Wykorzystując metodę TMA, oceniono zależność między obecnością i wielkością ekspresji ER i PR a DFS i OS. Wyniki: W analizie jednoczynnikowej stwierdzono zależność między wzrostem DFS a obecnością PR (p=0,010), wzrostem wskaźnika całkowitego (TS) ekspresji PR (HR=0,81; 95%CI 0,71-0,94), obecnością ER (p=0,001) i wzrostem TS ekspresji ER (HR=0,88; 95%CI 0,78-0,99). Stwierdzono występowanie różnic w DFS między grupami: bez ekspresji PR i ER (A), z ekspresją PR bez ekspresji ER (B), z ekspresją ER bez ekspresji PR(C), z ekspresją PR i ER (D) (p=0,004). Nie wykazano związku obecności PR (p=0,11), TS ekspresji PR (HR= 0,89; 95%CI 0,80-1,02) i ekspresji ER (p=0,07) z OS w analizie jednoczynnikowej. TS ekspresji ER było istotnym czynnikiem ochronnym, sprzyjającym dłuższemu OS (HR= 0,83; 95%CI 0,72-0,96). Stwierdzono różnice w OS między grupami: A, B, C i D (p=0,006). W analizie wieloczynnikowej kombinacje ekspresji PR/ER istotnie wpływały na DFS (p=0,039) i OS (p=0,016). Wnioski: Określenie ekspresji PR i ER może być istotnym elementem wpływającym na decyzje terapeutyczne u części chorych na GEE. Jednoczesna ocena ekspresji PR i ER ma większą wartość kliniczną od oceny tylko PRlub tylko ER

O harmonijny rozwój człowieka. Myśl pedagogiczna Profesora Andrzeja Jaczewskiego

Z wprowadzenia: "Andrzej Jaczewski, Profesor Honorowy Krakowskiej Akademii im. Andrzeja Frycza Modrzewskiego w Krakowie, uczony, który we wrześniu b.r. ukończy 90. rok życia, to najstarszy i jeden z nielicznych obecnie autorytetów naukowych w dziedzinie badań nad rozwojem seksualnym dzieci i młodzieży. Jego działalność sytuuje się na pograniczu nauk medycznych i pedagogicznych."(...

Does vimentin help to delineate the so-called 'basal type breast cancer'?

<p>Abstract</p> <p>Background</p> <p>Vimentin is one of the cytoplasmic intermediate filament proteins which are the major component of the cytoskeleton. In our study we checked the usefulness of vimentin expression in identifying cases of breast cancer with poorer prognosis, by adding vimentin to the immunopanel consisting of basal type cytokeratins, estrogen, progesterone, and HER2 receptors.</p> <p>Methods</p> <p>179 tissue specimens of invasive operable ductal breast cancer were assessed by the use of immunohistochemistry. The median follow-up period for censored cases was 90 months.</p> <p>Results</p> <p>38 cases (21.2%) were identified as being vimentin-positive. Vimentin-positive tumours affected younger women (p = 0.024), usually lacked estrogen and progesterone receptor (p < 0.001), more often expressed basal cytokeratins (<0.001), and were high-grade cancers (p < 0.001). Survival analysis showed that vimentin did not help to delineate basal type phenotype in a triple negative (ER, PgR, HER2-negative) group. For patients with 'vimentin or CK5/6, 14, 17-positive' tumours, 5-year estimated survival rate was 78.6%, whereas for patients with 'vimentin, or CK5/6, 14, 17-negative' tumours it was 58.3% (log-rank p = 0.227).</p> <p>Conclusion</p> <p>We were not able to better delineate an immunohistochemical definition of basal type of breast cancer by adding vimentin to the immunopanel consisted of ER, PgR, HER2, CK5/6, 14 and 17 markers, when overall survival was a primary end-point.</p

Test REST API by omega-dspace-integrator at 2022-09-02T10:40:30.347500

testowa publikacjatestowa publikacja abstrac