Leczenie ukierunkowane molekularnie chorych na niedrobnokomórkowego raka płuca

Rak płuca stanowi najczęstszą przyczynę zgonów z powodu choroby nowotworowej zarówno u mężczyzn, jak i u kobiet w Polsce i na świecie. Chorzy z rozpoznaniem niedrobnokomórkowego (NDRP) niepłaskonabłonkowego raka płuca, a także chorzy z nowotworem o nieokreślonym podtypie histologicznym (NOS) mogą odnieść korzyść z leczenia celowanego, ponieważ w tych typach nowotworów najczęściej stwierdza się obecność zaburzeń molekularnych, takich jak mutacja aktywująca w genie EGFR, rearanżacja genów ALK, ROS1 czy NTRK oraz mutacja w genie BRAF. Zaburzenia te są dodatnim czynnikiem predykcyjnym odpowiedzi na leczenie inhibitorami kinazy tyrozynowej. Podkreśla się konieczność oznaczeń molekularnych u chorych na zaawansowanego niedrobnokomórkowego niepłaskonabłonkowego raka płuca przed kwalifikacją do chemioterapii systemowej i w przypadku stwierdzenia zaburzeń molekularnych — zastosowania terapii celowanej w 1. linii leczenia

Salinomycin – a breakthrough in the treatment of ovarian cancer?

It is believed that cancer stem cells are the primary cause of cancer chemotherapy resistance, metastasis and relapse. The cancer stem cells form a small population of cells present in the tumor (accounting for less than 2% of the tumor mass) and have properties which enable them to survive chemo- and radiotherapy. These cells have the ability to self-renew, do not undergo apoptosis, display overexpression of the ALDH1A1 enzyme and ABC genes which encode transport proteins, and furthermore make use of various signaling pathways (Wnt, Notch, Hedgehog). Cancer stem cells may be identified and isolated from the tumor based on the characteristic biomarkers (CD44+, CD133+, CD117+, BMi1, Oct-4, nestin). It has been demonstrated that salinomycin, an antibiotic obtained from Streptomyces albus, eliminates cancer stem cells, which are resistant to treatment with cytostatics. Salinomycin causes apoptosis of these cells through a number of mechanisms, including the disruption of the Na+/K+ ion balance in biological membranes, inhibition of the Wnt pathway and resistance to transporters, increase in the activity of caspases, activation of the MAPKp38 pathway and inhibition of the nuclear transcription factor NF-κB. Salinomycin has an effect on many types of cancer. It may turn out to be a breakthrough in the therapy of chemotherapy-resistant cancers

One step closer – the impact of daily step count on health and how many steps should be taken per day

Introduction: Physical activity is an essential component of a healthy lifestyle. Walking is an open-accessed form of physical activity that requires no specialized equipment and can be performed at practically any moment of the day. In recent years, it has gained increasing interest and stands out as one of the most widely recommended forms of exercise. Since the beginning of the 21st century, the number of studies focusing on the impact of mean daily step count on health has been growing each year, with a significant surge observed since 2017. Undoubtedly, this topic is relevant to current health trends. Hitherto, there are no evidence-based recommendations regarding the number of steps that should be taken per day. Within this review, we conducted an analysis on the impact of daily step count on the risk of death and the incidence of selected diseases. Aim of the study: The aim of our study is to review of current literature on the influence of daily step count on both physical and mental health. Materials and Methods: We reviewed the literature available in PubMed, using the key words: „daily step count”, „step count mental health”, „ physical activity”, „pedometr”. Results: The daily step count can prominently impact the improvement and maintenance of human health and significant health benefits can be achieved by taking 4000-10000 steps per day. Summary: Research has shown that individuals who take more steps throughout the day are less prone to certain diseases, experience milder symptoms, exhibit better overall physical fitness, and have a lower risk of all-cause mortality. In the upcoming years, we can expect further studies aimed at identifying the most optimal daily step count

Physical activity of patients with chronic kidney disease

Introduction: The main causes of chronic kidney disease (CKD) are diabetic and hypertensive nephropathy. The incidence of civilization diseases is increasing, which also indirectly affects the increase in the incidence of CKD. The patient's therapy after the diagnosis should include the care of a multi-specialist therapeutic team that will remove as many restrictions as possible in everyday functioning and ensure a high quality of life. In addition to the selection of individual renal replacement therapy, i.a. physical rehabilitation. Despite the fact that in the course of chronic kidney disease physical activity is impaired by numerous pathophysiological processes, the patient should be encouraged to undertake physical activity in order to reduce the risk of death due to cardiovascular diseases, as well as to eliminate many other adverse health effects of the disease. The following paper aims to analyze the impact of physical activity on CKD patients and the pathophysiological causes of low physical activity in this group of patients and the possibility of implementing rehabilitation as an element of comprehensive therapy. Aim of the study: To review the current literature on the physical activity of patients with chronic kidney disease Materials and Methods: A review of the publications available in PubMed, using the key words „chronic kidney disease”, „psychical activity in chronic kidney disease”, physical activity”, „kidney failure”, „dialysis”, „renal rehabilitation”, „quality of life

Myocarditis as a cause of neonate’s circulatory failure during delivery - case study

Myocarditis (MCI) is a heart pathology characterized by its rare occurrence and a possible fatal course. In the natural history of the disease inflammatory cell infiltrates are present. There are subtypes of MCI depending on the predominant cell type in the biopsy sampls. One of them is eosinophilic myocarditis. In eosinophilic myocarditis more that 50% of the cells are eosinophils. In the later phases of the disease the myocardium is infiltrated by fibrous tissue and the heart vessels are often affected by thrombosis. Cardiomyopathy is a common long-term complication of the MCI.   Reported case presents a death of a male neonate. The neonate was delivered by vaginal delivery. Both prenatal development and all the prenatal tests indicated proper development of the fetus. At the delivery the neonate weight was 3900 grams and was evaluated with only 1 point on the Apgar score. Moreover, the neonate presented a complete acute cardiorespiratory failure at birth. Despite the 2 hour-long cardio-pulmonary resuscitation no return of spontaneous circulation was observed. The neonate’s remains were pathologically as well as histologically examined. The microscopic examination of the neonate’s heart samples contained many inflammatory cell infiltrations. Microabscesses with Charcot-Leyden crystals inside were also observed. Furthermore, the presence of atypical, polynuclear cells was noted. On the basis of the morphological image, it was recognized as an eosinophilic MCI

SGLT2 inhibitors - a breakthrough in treatment of heart failure and their multipotential beneficial role in cardiology, diabetology, nephrology and neurology

Inhibitors of the sodium-glucose cotransporter 2 (SGLT2 inhibitors) are relatively new andinnovative antihyperglycemic drugs which by inhibiting sodium-glucose cotransporter 2 minimalisereabsorption of glucose in nephrones. Due to this process, SGLT2 inhibitors became a first-choicedrugs in diabetology. Flozins were a turning point in many clinical trials and currently consequentlyconquer pharmacoterapy in cardiology. In the past years, clinical studies proved vast role of SGLT2inhibitors in other fields of medicine. Flosins protect heart muscle and kidneys among patients with orwithout type diabetes mellitus type 2. They have positive effect on hypertension, arteries and braintissue.Cardiological condition with the lowest long-term outcome in patients is heart failure with reducedejection fraction. Until flozins, treatment in heart failure with reduced ejection fraction was based onfour groups of drugs: β-blocker, inhibitors of the renin-angiotensin aldosterone system (RAA),including angiotensin converting enzyme ACE/ARB inhibitors, angiotensin and neprilysin receptorblockers (ARNI) and mineralocorticoid receptor antagonists (MRA). It was an appropriate HFrEFtreatment over the last years. However thanks to large-scale researches a role of flozins in cardiologyhave been established and they became hope for a change in the course of heart failure.The following article presents aspects of using flozins in treatment of patients with HFrEF,multipotential usage, vast benefits for patients, not solely cardiologic, and side effects of thesemiraculous group of drugs

Indications of Platelet-Rich Plasma (PRP) in Dermatology

Introduction: PRP is an autologous serum containing high concentrations of platelets and growth factors. It is used in dermatology for a variety of purposes, including hair growth, skin renewal, the removal of acne scars, dermal augmentation, and the treatment of striae distensae. The origins of PRP trace back to the 1970s, originating within the field of hematology as a treatment for patients grappling with thrombocytopenia. The subsequent decades, specifically the 1980s and 1990s, witnessed the integration of PRP into surgical procedures, notably in maxillofacial and plastic surgeries. The rationale underlying the employment and therapeutic potential of a concentrated platelet solution hinges upon their remarkable ability to furnish elevated levels of vital growth factors, thus instigating a regenerative impetus that facilitates repair in tissues characterized by limited innate healing capabilities. This comprehensive review delves into the multifaceted facets of PRP, encompassing mechanisms of action, prevailing indications, existing clinical substantiation, safety considerations, and the burgeoning spectrum of potential applications within the domain of skin condition treatments. Aim of the study: To review the current literature on the use of PRP in the field of dermatology Materials and Methods: We reviewed the literature available in PubMed, using the key words “platelet rich plasma”, “prp”, “autologous platelet rich plasma”, “alopecia”, “anti-aging” Results: PRP has a lot of potential in dermatology and its therapeutic uses are growing. Future research should standardize PRP therapy procedures for particular reasons. Summary: The versatile action of PRP has made it the subject of intense research. However, the reports in the literature to date on its use require further studies on larger groups of people to confirm its effects

Clinical and economic benefits of using next-generation sequencing (NGS) in the diagnostics of patients with non-small cell lung cancer with rare mutations

Molecular diagnostics are necessary to make therapeutic decisions in patients with non-small cell lung cancer (NSCLC), especially regarding targeted therapies. They include the analysis of PD-L1 expression and mutations or rearrangements in the EGFR, KRAS, BRAF, ALK, ROS1, NTRK1/2/3, and RET genes. In Poland, it is recommended to perform analyses for point mutations in exons 18, 19, 20, and 21 of the EGFR gene and rearrangements of the ALK and ROS1 genes. Due to the turnaround time, costs, and availability of biological material, the benefits of routine use of NGS in NSCLC patients are increasingly highlighted compared to performing multiple tests of individual genes. Pharmacoeconomic analyzes were conducted to assess the impact of the use of next-generation sequencing (NGS) in clinical practice on the budget of the public payer in Poland in comparison with the current practice. They demonstrated a decrease in incremental expenses of the public payer related to molecular diagnostics with NGS in all eligible patients by approx. 3.4 million PLN in 2023 and 2024 and a reduction in diagnostic costs per patient by 1 695 (21%) PLN. This article presents the efficacy and safety of amivantamab in NSCLC patients with an insertion in exon 20 of the EGFR gene. In conclusion, NGS should be the preferred diagnostic method in patients with advanced NSCLC

Ostatecznie gruźlica, a nie choroba nowotworowa. Prezentacja trzech przypadków pediatrycznych

Gruźlica wieku dziecięcego należy obecnie w krajach wysoko rozwiniętych do rzadkości. W pracy zaprezentowano przypadki trojga dzieci z objawami nasuwającymi podejrzenie choroby nowotworowej, u których ostatecznie dzięki interwencji chirurgicznej rozpoznano gruźlicę (węzłowo-płucną, wielonarządową oraz ściany klatki piersiowej). Tylko u jednej pacjentki uzyskano potwierdzenie bakteriologiczne. Objawy gruźlicy wymagają różnicowania z chorobą nowotworową. Chirurg, który pobiera materiał diagnostyczny, powinien pamiętać o wykonaniu badań bakteriologicznych w kierunku gruźlicy. Forum Medycyny Rodzinnej 2010, tom 4, nr 6, 464–47

Etiology, Epidemiology, and Therapeutic Approaches for Primary Sclerosing Cholangitis in the Context of Concurrent Non-specific Inflammatory Bowel Diseases

Introduction: Primary sclerosing cholangitis (PSC) is a chronic, idiopathic disease characterized by persistent and progressive inflammation of the intrahepatic and/or extrahepatic bile ducts. This leads to fibrosis, cholestatic complications, and liver failure. In over 70% of patients, non-specific intestinal inflammations coexist, particularly ulcerative colitis, and sporadically Crohn's disease. Aim: Our study aimed to assess current literature on primary sclerosing cholangitis (PSC), covering its causes, symptoms, treatment methods, and the connection between PSC and inflammatory bowel disease (IBD) co-occurrence. Materials and methods: We conducted a PubMed literature review using keywords like "primary sclerosing cholangitis pathogenesis," "primary sclerosing cholangitis and inflammatory bowel disease," and "primary sclerosing cholangitis and ulcerative colitis.” Results: Our research extensively covered PSC epidemiology, pathogenesis, and treatment options. Emphasis was placed on the heightened prevalence of inflammatory bowel diseases, including ulcerative colitis, among PSC patients. Summary: Primary sclerosing cholangitis (PSC) is a disease causing gradual damage to bile ducts within or outside the liver. Over 70% of patients also experience inflammatory bowel disease (IBD), mainly ulcerative colitis. The exact causes of PSC and its connection to IBD remain unclear. The theories involve hyperactive "intestinal" T cells or the impact of gut microbiome on their growth. Presently, a liver transplant stands as the sole remedy