Have actual waiting times been reduced by introducing the DILO reform for cancer patients in Poland?

Introduction. Relative 5-year cancer survival rates in Poland are around 10% lower than the average of the whole EU. One of the likely factors for poorer treatment outcomes in Poland may be the long times between when cancer is suspected to starting treatment. This study has thus aimed to determine whether the introduced oncology reforms have succeeded in reducing such times. Materials and methods. The study survey was undertaken at 6 oncological centres on patient subjects before (n = 1373) and after (n = 431) the oncological reform (DILO) had been introduced. Data was obtained from an in-house devised questionnaire together with patient interview and their medical history. The following waiting times were estimated: A) from suspicion of cancer, (date of first doctor visit due to appearance of symptoms, screening/follow-up or prevention), to diagnosis (date of histopathological confirmation), B) from suspicion of cancer to the start of treatment and C) from diagnosis to starting treatment before and after the DILO reform had been introduced. Results. The median waiting time between suspicion of cancer and treatment was 11 weeks before the DILO reform but was not significantly shortened after its introduction; the reduction being barely 3 days. This waiting time was however increased by 8 days in those patients without DILO cards. Before the DILO reform, the median time from diagnosis was 5.9 weeks, but was reduced by 8 days in patients bearing the DILO card and indeed increased in those without the DILO card by over 2 weeks. Conclusions. Cancer treatment waiting times in Poland is still somewhat long (over 9 weeks in most cases). Introducing the oncological reform has not significantly impacted on shortening the waiting times in cancer patients for receiving oncological treatment

Treatment of single tooth scissors-bite. Presentation of two cases with a 2.5 year post treatment observation period

This study reports the treatment of two patients with single tooth scissors bite. The first patient had a scissors bite which affected the two first premolars. The second patient had buccal crossbite in the second left molar. The cause of this malocclusion was the buccal tipping of the upper teeth. Modification of the palatal arch was used in the treatment therapy. This modification allowed for the palatal movement and intrusion of the affected teeth. Changes in certain dental arch parameters were observed during both the active and post treatment period. Premolars were correctly positioned within 1.5 months and 2 months. The molar was well positioned within 2.5 months. Correct intercuspidation of the opposing teeth was the only form of retention. During the 2.5 years of the observation period there was no recurrence of the malocclusion

Combined radiotherapy and chemotherapy

Kojarzenie radioterapii i chemioterapii jest standardowym postępowaniem w radykalnym leczeniu wielu nowotworów. Celem radio-chemioterapii jest zwiększenie kontroli lokoregionalnej, zmniejszenie ryzyka rozwoju przerzutów odległych i wydłużenie czasu przeżycia chorych, a tym samym poprawa skuteczności leczenia przy mniej okaleczających terapiach. Równoczasowa radio-chemioterapia jest jednak bardziej toksyczna niż stosowanie każdej metody osobno lub sekwencyjnie. Konieczne są dalsze badania, aby zoptymalizować leczenie skojarzone. Nowe możliwości przynosi dołączanie leczenia celowanego i immunoterapii do klasycznej radio-chemioterapii.Combined radiotherapy and chemotherapy is a standard procedure in radical treatment of many cancers. The objective of chemoradiotherapy is to increase loco-regional control, to reduce the risk of distant metastases and to prolong survival, and thus to improve treatment efficiency with less mutilating therapies. Concurrent chemoradiotherapy, however, is more toxic than chemotherapy and radiotherapy alone or sequential application of these methods. Optimalisation of combined treatment requires further research. New possibilities arise with inclusion of targeted treatment and immu­notherapy in classical chemoradiotherapy

Scissors bite – epidemiology, etiology and methods of treatment

The study presents the literature review of the epidemiology, etiology and methods of treatment of the scissors bite. This maloocclusion is recognized when there is no contact between the occlusal surfaces of the posterior teeth in occlusion and when palatal surfaces of the upper teeth contact with buccal surfaces of the lower teeth. The frequency of this malocclusion ranges from 1,8% to 19% and it depends on the study population. The cause of such a malocclusion is a discrepancy between the width of the maxilla and mandible and axial malpositioning of the lateral teeth. This malocclusion is usually accompanied with elongation of the teeth in scissors bite, buccal tipping of the upper teeth and lingual tipping of the lower teeth. In the treatment methods which allow to balance the discrepancy between the width of the bony bases and dental arches and obtain both correct axis and intrusion of the elongated teeth are used. Removable functional appliances, palatal and lingual arches, miniscrews, dragon helix spring, modified orthodontic crown, corticotomy, osteodistraction and appropriate surgery methods are used. The choice of the treatment methods depend on the range and severity of the defects, age, cooperation with the patient and possibile side effects

Poziom wiedzy pielęgniarek oddziałów chirurgicznych na temat występowania udaru u pacjentów w okresie pooperacyjnym

Introduction. Each year 80 000 Poles are suffering from stroke. The most common risk factors are hypertension, diabetes and complications, hyperlipidemia, obesity, atrial fibrillation. Lifestyle modification, such as diseases controlling, diet changing, exercises, stop smoking and limiting alcohol consumption are known as stroke prevention. Thrombectomy and thrombolytic therapy definitely increase long-term survival and prognosis.Aim. Objective of the work is assessment of surgical nurses knowledge level about postoperative stroke.Material and Methods. The research was conducted on a group of 55 randomly chosen surgical nurses. The diagnostic survey method with a proprietary questionnaire was used for the research.Results. Nurses knowledge was poor. Education and age affect to answers. Higher education qualification nurses have higher knowledge level relative to less educated nurses. Younger nurses have higher knowledge level than older nurses.Conclusions. Cardiosurgery and vascular surgery are charged as the most risk onset postoperative stroke. Knowledge of surgical nurses about risk factors, prevention, symptom, complications and procedures in case of stroke onset have particular meaning in postoperative caring. (JNNN 2020;9(4):138–144)Wstęp. Każdego roku na udar mózgu choruje 80 tysięcy Polaków. Jako najczęstsze czynniki ryzyka podkreśla się nadciśnienie tętnicze, cukrzycę i jej powikłania, hiperlipidemię, otyłość oraz występowanie migotania przedsionków. Jako działania profilaktyczne uznaje się modyfikację stylu życia z uwzględnieniem kontroli chorób podstawowych, zmianę diety, ćwiczenia fizyczne, ograniczenie nałogu tytoniowego oraz spożywania alkoholu. Wprowadzenie trombektomii mechanicznej oraz terapii trombolitycznej pozwoliło na zwiększenie przeżywalności i poprawę rokowania w tej grupie chorych.Cel. Celem pracy była ocena poziomu wiedzy pielęgniarek pracujących w oddziałach chirurgicznych, na temat udaru mózgu w okresie pooperacyjnym.Materiały i metody. Badaniem objęto 55 pielęgniarek pracujących w oddziałach chirurgicznych. W pracy zastosowano metodę sondażu diagnostycznego i analizy piśmiennictwa. Posłużono się autorskim kwestionariuszem ankiety.Wyniki. Wiedza badanych osób jest na niskim poziomie. Dowiedziono, iż wykształcenie oraz wiek ma wpływ na deklarowane przez respondentki odpowiedzi. Osoby z wykształceniem wyższym wykazały się wyższym poziomem wiedzy w stosunku od osób z wykształceniem średnim. Pielęgniarki młodsze posiadają większy zasób wiedzy od pielęgniarek starszych.Wnioski. Procedurami operacyjnymi, które obciążone są największym ryzykiem wystąpienia udaru w okresie pooperacyjnym, są operacje kardiochirurgiczne i naczyniowe. Wiedza pielęgniarek na temat czynników ryzyka, profilaktyki, objawów, powikłań i wdrożenia postępowania w przypadku wystąpienia udaru mózgu, ma szczególne znaczenie w pielęgnowaniu pacjenta w kluczowym okresie po operacji. (PNN 2020;9(4):138–144

Prehabilitation as an extra approach to usual care for cancer patients

Prehabilitation seems to be an important issue in oncology. The main purpose of prehabilitation is to improve a patient’s physical and psychological condition at the beginning of and during cancer treatment. Prehabilitation also reduces the risk of potential complications, average length of stay at hospital, stress and risk of depression, and improves quality of life. Prehabilitation activities should be individualized. Multimodal prehabilitation is more recommended and it can include a spectrum of interventions like: general conditioning exercise, targeted exercise, nutritional interventions, psychological interventions, smoking cessation and education. There is a lack of clinical trials concerning prehabilitation. Therefore new studies are still needed to standardize protocols for different types of cancer and clinical situations, and to estimate the efficacy of prehabilitation programs