How to give birth to yourself?

Recenzja książki: Katarzyna Czeczot. 2016. Ofelizm. Romantyczne zawłaszczenia, feministyczne interwencje. Warszawa: Wydawnictwo IBL PAN.The book review: Katarzyna Czeczot. 2016. Ofelizm. Romantyczne zawłaszczenia, feministyczne interwencje. Warszawa: Wydawnictwo IBL PAN

Agon, czyli biblijny Jakub i Harold Bloom przeciw teorii empowermentu

Agon: Jacob the Patriarch and Harold Bloom against the empowermentThe paper discusses the question of empowerment in management education and attempts to present internal contradictions of aforementioned concept. The main objection to the empowermet theory in management education here is the fact of concealing fundamental violence that defi nes relations within institution of academy. Removal of the question of confl ict from the concept of empowerment deprives it from real emancipating power. In contrast to empowerment, Harol Bloom’s idea of subjectivity as an agon is presented

Haemodynamic patterns in children with primary hypertension — preliminary brief report

Wstęp Zakłada się, że początkowy okres nadciśnienia tętniczego pierwotnego (NTP) charakteryzuje się występowaniem krążenia hiperkinetycznego. Nie udowodniono jednak związku między wartościami ciśnienia tętniczego (począwszy od normotensji, aż do ciężkiego ambulatoryjnego nadciśnienia tętniczego) a zaburzeniami hemodynamicznymi u dzieci z NTP. Celem badania było scharakteryzowanie takich parametrów hemodynamicznych, jak wskaźnik sercowy (CI) i całkowity opor obwodowy (TPR) u dzieci z NTP w zależności od stadium nadciśnienia tętniczego. Materiał i metody Do badania włączono 95 pacjentów (15,3 ± 2 lata; 27 dziewczynek) skierowanych z powodu podwyższonych wartości ciśnienia tętniczego, u których wykluczono wtórne przyczyny nadciśnienia tętniczego. Prędkość fali tętna (PWV), CI i TPR były mierzone przy użyciu funkcji oscylometrycznej analizy fali tętna aparatu Vicorder. Klasyfikacja ciśnienia tętniczego była określana zgodnie z obecnymi wytycznymi na podstawie całodobowego ambulatoryjnego pomiaru ciśnienia tętniczego (ABPM). Wyniki Pełnemu procesowi diagnostycznemu zostało poddanych 95 pacjentów z podwyższonym ciśnieniem tętniczym. W jego wyniku u 31 pacjentów stwierdzono normotensję, u 14 stan przednadciśnieniowy, u 7 ambulatoryjne nadciśnienie tętnicze, u 43 ciężkie ambulatoryjne nadciśnienie tętnicze. Porównanie średnich wartości CI dla poszczególnych grup wykazało znaczący wzrost CI powiązany z kategorią nadciśnienia tętniczego. Wzrostowi CI towarzyszył nieistotny statystycznie spadek TPR. Wartości CI korelowały ze średnim ciśnieniem tętniczym, częstością rytmu serca, szybkością fali tętna i ładunkiem ciśnienia skurczowego. Wartości TPR korelowały z parametrami antropometrycznymi, w tym ujemnie z obwodem talii, średnim ciśnieniem tętniczym i szybkością fali tętna. Analiza regresji krokowej nie wykazała predyktorów CI, natomiast dla TPR predyktorem okazał się obwód talii (Beta –0,310; p = 0,021). Wnioski U dzieci z pierwotnym nadciśnieniem tętniczym stwierdzono zaburzenia hemodynamiczne o cechach krążenia hiperkinetycznego narastające wraz ze wzrostem stadium nadciśnienia tętniczego. Wzrostowi CI towarzyszył jednak jedynie statystycznie nieistotny spadek TPRI. Ten rodzaj zaburzeń hemodynamicznych tłumaczy mechanizm wzrostu ciśnienia tętniczego u dzieci z NTP. Otyłość trzewna wyrażona jako obwód talii ma znaczenie w mechanizmie rozwoju krążenia hiperkinetycznego.Background It is assumed that the initial phase of primary hypertension (PH) is characterized by the presence of hyperkinetic circulation. However, the relationship between blood pressure status (from normal blood pressure to severe ambulatory hypertension) and haemodynamic patterns in children with PH were not described. The objective of this study was to characterize the haemodynamic parameters such as cardiac index (CI) and a total peripheral resistance index (TPR) in children with PH depending on the stage of hypertension. Materials and methods The study included 95 patients (15.3 ± 2.0 years; 27 girls) referred due to the elevated blood pressure, in whom secondary hypertension was excluded. Pulse wave velocity (PWV), CI and TPRI were assessed indirectly using Vicorder device. PH was diagnosed according to the European Society of Hypertension paediatric guidelines and confirmed by 24-hour ambulatory BP monitoring (ABPM). Results Of 95 patients, 31 had normal blood pressure, 14 prehypertension, 7 ambulatory hypertension and 43 severe ambulatory hypertension. Comparison of the mean values of cardiac index (CI) for each group showed significant increase in CI linked to the category of hypertension. CI increase was accompanied by a non-significant decrease of TPR. Mean CI values correlated with 24-hour mean arterial pressure, 24-hour heart rate, PWV-SDS and systolic blood pressure load. Mean TPR values correlated with anthropometrical parameters, including negative correlation with waist circumference and positive with 24- hour mean arterial pressure and negative with pulse wave velocity. Stepwise regression analysis showed no predictors for CI, but for TPR the only predictor was waist circumference Conclusions Children with PH are characterized by haemodynamic patterns typical of hyperkinetic circulation increasing with increasing stage of hypertension. Non-significant decrease in TPR in children with increased CI explains haemodynamic basis of elevation of blood pressure. Visceral Obesity expressed as a waist circumference seems to play role in the mechanism of the development of hyperkinetic circulation

Multicentre, prospective observational study of pegfilgrastim primary prophylaxis in patients at high risk of febrile neutropenia in Poland : PROFIL study

AIM OF THE STUDY: PROFIL was a prospective observational study conducted to investigate physicians’ evaluation of febrile neutropenia (FN) risk and reasons for giving pegfilgrastim primary prophylaxis (PP) in routine clinical practice in Poland. MATERIAL AND METHODS: Adult cancer patients treated with chemotherapy (CT), assessed by investigators as having high overall FN risk, and who received pegfilgrastim in cycle 1 were enrolled between 03/2009 and 09/2010. Investigators assessed FN risk of the CT regimen, individual risk factors, and overall FN risk, and were asked to provide the most important reasons for providing pegfilgrastim PP. Investigator-assessed CT FN risk was compared with guideline classification. RESULTS: Data were analysed from 1006 breast, ovarian, and lung cancer, and non-Hodgkin (NHL) and Hodgkin lymphoma (HL) patients. The most important reasons for using pegfilgrastim PP were high CT FN risk and advanced disease; these were consistent across tumour types and treatment intent. The investigators generally assessed high CT FN risk in agreement with guideline classification. Febrile neutropenia occurred in 4% of patients, most commonly in HL, NHL, and patients with advanced disease. CONCLUSIONS: High CT FN risk and advanced stage of disease were found to be the most important reasons for providing pegfilgrastim PP by physicians in Poland

Place of thyroglobulin antibodies assay in laboratory diagnostic of autoimmune thyroid diseases

Oznaczano poziom przeciwciał anty tyreoglobulinowych (anty-Tg) i anty- peroksydazowych (anty-TPO) u pacjentów z autoimmunologicznymi chorobami tarczycy, celem określenia przydatności oznaczania poziomu przeciwciał anty-tyreoglobulinowych w diagnostyce laboratoryjnej chorób autoimmunologicznych tarczycy. W grupie 109 pacjentów z chorobą Hashimoto przeciwciała anty-Tg wykryto u 85,53% a anty-TPO u 78,89%. Przeciwciała anty-Tg nie występowały u 14,67%, a anty-TPO u 21,1% pacjentów. U 1,83% pacjentów nie wykryto obydwu typów autoprzeciwciał. W grupie 79 pacjentów z chorobą Graves-Basedowa przeciwciała anty-Tg wykryto u 62,02%, a anty-TPO u 89,87%. Przeciwciała anty-Tg nie występowały u 37,97%, a anty-TPO u 10,12% pacjentów. Jeden pacjent z wytrzeszczem (1,26%) nie posiadał obydwu typów autoprzeciwciał. Nasze dane wskazują na celowość oznaczania poziomu autoprzeciwciał anty tyreoglobulinowych (anty-Tg) tylko u pacjentów z podejrzeniem wystąpienia choroby autoimmunologicznej tarczycy u których nie występują przeciwciała anty-peroksaydazowe (anty-TPO).Tyroglobulin and thyroid peroxidase antibodies have been estimated in patients with thyroid autoimmune diseases. In a group of 109 patients with Hashimoto’s thyroidities 85.53% and 78.89% were positive for Tyroglobulin antibodies and anti-TPO antibodies respectively. The anti-Tg antibodies has not been detected in 14.67% and anti-TPO in 21.1% patients. Both antibodies have not been detected in 1.83% of patients.In a group of 79 patients with Graves’ disease 62.02 and 91.13% were positive for anti-Tg and anti-TPO antibodies respectively. The anti-Tg antibodies has not been detected in 37.97% and anti-TPO in 8.66% patients. Both antibodies have not been detected in one patients with exophtalmos (1.26%). Our results indicate that anti-tyroglobulin antibodies should be estimated only in patients suspected for thyroid autoimmune disease and negative for thyroid peroxidase antibodies

IMPLEMENTATION OF THE MOTEK CAREN SYSTEM IN BEHAVIOURAL THERAPY FOR PATIENTS WITH ANXIETY DISORDERS

Background: Virtual reality exposure therapy (VRET) is becoming a more and more popular treatment method for patients suffering from anxiety disorders. One of the VRET methods, wchich could be used for this group of patients is MOTEK CAREN system, however, so far no studies have been published on its implementation in psychiatric disorders. Subject and methods: Presented here is a case of a 45 year old woman suffering from anxiety disorders, who underwent a series of four subsequent trainings with the use of MOTEK CAREN system repeted once a week. Data from the system were collected on the work of muscles, joints, reactions of the ground, etc. Blood pressure, pulse and salivary cortisol level were measured before and after each training. The level of state and trait anxiety was each time measured with the STAI inventory. Results: The changes of the values of heart rate, blood pressure and salivary cortisol suggest that all trainings we stressful events for the patients, as they were not observed in the control session. But the gradual decrease in the levels of salivary cortisol and axiety as state after subsequent trainings may be signs of a gradual adaptation of the patient to the stressful situation. A lower cadence during the trainings compared to the control session was observed, however the speed of the cadence increased with each session. Conclusions: Ttrainings with the MOTEK CAREN system can be promising in the treatment of anxiety disorders. Of course in order to draw more evidence based conclusions this observations must be confirmed on a larger sample of patients

Does conformal therapy improve dose distribution in comparison to old techniques in teleradiotherapy of cervical cancer patients?

SummaryBackgroundThe use of a combined modality approach – chemotherapy and radiation therapy – in the treatment of patients with cervical cancer is associated with significant toxicity, mainly haematological and gastrointestinal. Conformal radiotherapy has the potential to deliver an adequate dose to the target structures while sparing the normal tissue. Both the radiation dose to the small bowel and the volume are factors known to influence the risk of complications.AimThe aim of this study was to determine whether the implementation of conformal modality can reduce the volume of normal tissue included in the RT field.Methods and Materials14 cervical cancer patients (FIGO IIB and IIIB) treated with conformal radiotherapy concurrently with cisplatin (40 mg/m2) administration once a week were analyzed. According to ICRU 50 recommendations target volumes and the organs at risk were contoured on CT slices. For the gross tumour volume (GTV) the tumour of the uterus and cervix was traced. The clinical target volume (CTV) was defined as the vessels and lymph nodes from the obturator level to the aortic bifurcation, presacral region, and upper 1/3 of the vagina. The margin for planning target volume (PTV) was added. The normal tissue region included the small bowel, large bowel and bladder. Using a 3D system and multi-leaf collimator a four-field treatment plan was performed for each patient. All 14 patients were treated with radiotherapy using these conformal 3D plans. Additionally (just for study purposes) for each patient we prepared two simpler plans with (1) two-field: anterior-posterior (A-P) and posterior-anterior (P-A); and (2) four-field box techniques. Dose-volume histograms of target volumes and organs at risk were calculated for each three plans for every patient and compared. Analysis of variance was performed to compute the statistical significance.ResultsThere is no statistical difference between doses received by target volumes – in each plan PTV is covered by the 95% isodose. Significantly different volumes of critical organs were included in the treatment field, depending on radiotherapy technique (conformal 3D method vs AP–PA two-field method): rectum 96.82% vs 38.23%, bowels 61.37% vs 30.79%.ConclusionThese data suggest that implementation of conformal radiotherapy can reduce the irradiated volume in all the contoured critical organs, especially the bowels, compared to old techniques