Selected aspects of patient health in nuclear medicine

Nuclear radiation plays an important role in nuclear medicine. The health risk to patients undergoing screening only concerns the fact of gamma-ray emission, of course, the magnitude of this risk is dose-dependent. The purpose of the study is to assess patient safety in ionizing radiation studies in the light of applicable laws. The principle of optimizing the health protection of people subjected examinations using ionizing radiation mainly concerns the choice of the best protection option under specific exposure conditions and the greater benefits of ionizing radiation to the potential damage that could be caused by radiation exposure. Unfortunately, in some cases, patients are unnecessarily exposed to ionizing radiation during the diagnostic process, often as a result of lack of supervision of doses or undue imaging studies by physicians. Due to the numerous evidence highlighting the negative impact of high doses of ionizing radiation on the human body, we are not able to accurately track and evaluate all mechanisms of its action

Education or business? - exhibition of human corpses

Wróbel Grzegorz Paweł. Education or business? - exhibition of human corpses. Journal of Education, Health and Sport. 2017;7(9):510-516. eISSN 2391-8306. DOI http://dx.doi.org/10.5281/zenodo.997496 http://ojs.ukw.edu.pl/index.php/johs/article/view/4842 The journal has had 7 points in Ministry of Science and Higher Education parametric evaluation. Part B item 1223 (26.01.2017). 1223 Journal of Education, Health and Sport eISSN 2391-8306 7 © The Authors 2017; This article is published with open access at Licensee Open Journal Systems of Kazimierz Wielki University in Bydgoszcz, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 15.08.2017. Revised: 10.09.2017. Accepted: 10.09.2017. Education or business? - exhibition of human corpses Grzegorz Paweł Wróbel Department of Human Anatomy, Faculty of Medicine and Health Sciences, Jan Kochanowski University; Al. IX Wieków Kielc 19 A, 25-317 Kielce, Poland; E-mail: [email protected]; Phone: 41-349-69-65 Grzegorz Wróbel http://orcid.org/0000-0003-3788-1692, e-mail: [email protected] Abstract Exhibition "BODY WORLDS" which are presented exhibits of human remains are presented all over the world and are a major problem for the modern man, as presented on the preparations of the human not only serve scientific research, are not transferred to the medical schools to educate future doctors, but they were made available to the general public in the form of commercial and ambiguous. The aim of this study was to assess the ethical commercialization of human corpses "BODY WORLDS" exhibitions. Individual approach to the problems presented the dignity and value of human remains after death, of course, strongly related to the professed worldview. In the exhibits can be seen in both the scientific interest anatomical structures, as well as desecrated human remains or beautiful by its functional perfection of the body, understood also in terms of art. The question of ethics determines the right to decide for themselves, on the other hand, allows you to protect bodily integrity even after death. "BODY WORLDS" exhibition goes for the moral and ethical boundaries. In terms of people Gunther von Hagens for plastination of human remains which became a very profitable business, and its current activities defined as "plastination business" should be firmly said about the lack of moral principles. Keywords: anatomy, ethics, art, trad

Comparison of the usefulness of selected formulas for GFR estimation in patients with diagnosed chronic kidney disease

Introduction: The diagnosis and classification of chronic kidney disease (CKD) are based on the glomerular filtration rate value. The simplest way to evaluate glomerular filtration rate is to estimate it based on serum creatinine concentration using one of many specific mathematical formulas. None of the formulas created for this purpose are perfect. Differences in eGFR values are frequently observed in specific stages of chronic kidney disease by KDIGO classification based on different formulas. Aim: The aim of the study is to compare the eGFR value in patients previously diagnosed with CKD treated in the Outpatient Nephrology Unit of the University Hospital in Krakow using the selected formulas. Material/Methods: The study was performed in a group of 882 patients (392 women, 490 men) aged 65.0 ± 14.8 years. GFR values were estimated using Bjornsson, the abbreviated MDRD, and CKD-EPI formulas. These values were then compared according to chronic kidney disease stage and age groups: above and below 60 years. Results: The mean eGFR value was for Bjornsson formula- 47.2 ± 21.1 ml/min/1.73m2, abbreviated MDRD formula- 38.8 ± 15.2 ml/min/1.73m2, and CKD-EPI formula- 37.7 ± 15.9 ml/min/1.73m2. There was a large concordance in eGFR values obtained using the CKD-EPI and abbreviated MDRD formulas in every stage of chronic kidney disease and in both age groups. The Bjornsson formula significantly increased the number of patients in early stages of CKD, G1 - 33 vs 2 (abbreviated MDRD) and 6 (CKD-EPI), G2- 186 vs 70 (abbreviated MDRD) and 69 (CKD-EPI). Conclusions: CKD-EPI and abbreviated MDRD formulas have a similar usefulness in GFR value estimation in patients with diagnosed chronic kidney disease. Lower eGFR values achieved using abbreviated MDRD formula and CKD-EPI equation in comparison with Bjornsson’s formula may result in an increased number of patients diagnosed with CKD

Anthropometric aspects of the human skeleton

The anatomy deals with learning about the shape and structure of the human body, and at the same time it is the basis for all sciences whose scope of interest relates to the human body. Anthropometric studies are aimed at translating the size and shapes of the human body into specific numbers and quantitative ratios, thus they constitute a set of measurement techniques and methods, through which it is possible to closely examine the diversity of human measurable features as well as variability in individual and evolutionary development. The scope of measurements in anthropometry applies mainly to sections, circumferences, angles between planes or body lines. The aim of the work is to present selected anatomical features of the human skeleton in the aspect of sexual dimorphism and individual human variabilit

Scattering correction for samples with cylindrical domains measured with polarized infrared spectroscopy

Scattering artifacts are one of the most common effects distorting transmission spectra in Fourier-Transform Infrared spectroscopy. Their increased impact, strongly diminishing the quantitative and qualitative power of IR spectroscopy, is especially observed for structures with a size comparable to the radiation wavelength. To tackle this problem, a wide range of preprocessing techniques based on the Extended Multiplicative Scattering Correction method was developed, using physical properties to remove scattering presence in the spectra. However, until recently those algorithms were mostly focused on spherically shaped samples, for example, cells. Here, an algorithm for samples with cylindrical domains is described, with additional implementation of a linearly polarized light case, which is crucial for the growing field of polarized IR imaging and spectroscopy. An open-source code with GPU based implementation is provided, with a calculation time of several seconds per spectrum. Optimizations done to improve the throughput of this algorithm allow the application of this method into the standard preprocessing pipeline of small datasets

Primary central nervous system lymphoma

Pierwotny chłoniak ośrodkowego układu nerwowego (PCNSL) jest rzadkim nowotworem charakteryzującym się agresywnym przebiegiem i niekorzystnym rokowaniem. Stanowi około 4–6% chłoniaków pozawęzłowych. W 95% przypadków PCNSL rozpoznaje się chłoniak rozlany z dużych komórek B. Do najczęściej występujących objawów u pacjentów z PCNSL należą neurologiczne zmiany ogniskowe, zaburzenia osobowości oraz objawy wzmożonego ciśnienia śródczaszkowego.W leczeniu pierwszej linii u pacjentów z PCNSL stosuje się duże dawki metotreksatu w monoterapii lub w skojarzeniu z arabinozydem cytozyny. Radioterapii najczęściej poddawani są pacjenci ze zmianami resztkowymi oraz niekwalifi kujący się do chemioterapii z nawrotowąpostacią PCNSL.Primary central nervous system lymphoma (PCNSL) is a rare malignancy with aggressive course and unsatisfactory outcome. This lymphoma represents 4–6% of all extranodal lymphomas. Ninety-five percent PCNSLs are diffuse large B-cell lymphomas. The most common symptoms are: focal deficits, personality changes and increased intracranial pressure. High-dose of methotrexate as monotherapy or in combination with high-dose arabinoside cytosine is the fi rst line treatment in patients with PCNSL. Radiotherapy is the treatment option in patients with residual disease and as a salvage therapy in relapsed patients

Nowa era w farmakologicznym leczeniu pęcherza nadreaktywnego (OAB): mirabegron – selektywny agonista receptora β3

Overactive bladder is defined by ICS as urgency, frequency and nocturia, with or without urgency urinary incontinence in the absence of urinary tract infection, or other obvious causative pathology. Lower urinary tract symptoms (LUTS) are highly prevalent, especially in aging populations. Epidemiological studies reported LUTS in 62% of men and 67% of women, rising to 81% and 79%, respectively in adults over 60 years old. However, the actual burden of LUTS remains relatively unrecognized. LUTS, mainly due to considerable distress including almost all aspects of social functioning, impact on sleep and mental health, may significantly affect quality of life. Management of LUTS including OAB has undergone dramatic changes since 1972, when the first antimuscarinic drug – oxybutynin, was introduced into clinical practice. In the last two decades, six new antimuscarinic drugs entered OAB field and this was accompanied by introduction of botulinum toxin into clinical practice in patients resistant to or not compliant with antimuscarinics. Nowadays, it is recognized that OAB is progressive, age-related and non sex-specific condition with most patients experiencing a combination of storage, voiding and post-micturition symptoms. In 2013, the next step was taken, with new therapeutic options for OAB, enabling an even more patient-tailored approach. This was possible for both, male and female OAB sufferers with new class of oral β3 adrenoreceptor agonist (mirabegron). This drug, by stimulation of β3-adrenoceptors, couples via Gs proteins to adenylyl cyclase, what results in an increase of intracellular cAMP levels and a subsequent activation of cAMP-dependent protein kinase A, which then phosphorylates myosin light chain kinase responsible for inhibition of calcium-calmodulin dependent interaction of myosin with actin. Moreover, the cAMP increase also leads to the reduction of cytoplasmic Ca2+ concentration by removal of calcium ions from cytoplasm. These both actions result in a significant increase in the storage bladder capacity and by this interval between micturitions is prolonged. Mirabegron was evaluated in three 12-week, double blind, randomized, placebo controlled, parallel-group, multicenter clinical trials in OAB patients with symptoms of urge urinary incontinence, urgency and frequency – study 046, 047 and 074. It should be pointed out that efficacy of mirabegron was maintained through the entire 12-month period in phase III long-term study. Discoveries on the physiology of the normal bladder and on the pathophysiology underlying OAB have led to the development of new treatment options for OAB. Pharmacological management of OAB should be tailored to patient’s characteristics. New and recent options of pharmacological treatment have undoubtedly expanded treatment possibilities, what should allow physicians to select the optimal treatment for each patient.Nadreaktywność pęcherza moczowego definiowana jest przez ICS jako uczucie parcia na pęcherz, częstomoczu i nokturii z obecnością lub bez naglącego nietrzymania moczu przy nieobecności infekcji układu moczowego lub innego znanego czynnika sprawczego. Zaburzenia funkcjonowania dolnych dróg moczowych są szeroko rozpowszechnione, zwłaszcza pośród starzejących się populacji. Z badań epidemiologicznych wynika, że cierpi na nie 62% mężczyzn i 67% kobiet, a w populacji osób powyżej 60 roku życia – odpowiednio 81% i 79%. Jednak rzeczywista skala problemu nie jest dokładnie znana. Zaburzenia dolnych dróg moczowych istotnie wpływają na komfort życia poprzez wpływ na funkcje społeczne, sen oraz zdrowie psychiczne. Przełomem w leczeniu tych zaburzeń, w tym OAB, było wprowadzenie do praktyki klinicznej w 1972 roku oksybutyniny, pierwszego leku antymuskarynowego. W okresie ostatnich 20 lat do farmakoterapii OAB wprowadzono sześć nowych leków antymuskarynowych, a także toksynę botulinową przeznaczoną dla pacjentów opornych na leczenie cholinolitykami lub osób, które rezygnowały z terapii z powodu nasilonych objawów ubocznych wywoływanych przez te leki. W 2013 roku nastąpił olbrzymi progres w farmakoterapii OAB dzięki pojawieniu się nowej opcji leczenia tej choroby, która umożliwia precyzyjne dostosowanie terapii do potrzeb pacjenta. Jest to możliwe dzięki mirabegronowi – nowemu, doustnemu agoniście receptorów β3-adrenergicznych. Lek ten poprzez stymulację receptorów adrenergicznych typu β3, aktywuje za pośrednictwem białka Gs cyklazę adenylową, czego wynikiem jest wzrost stężenia wewnątrzkomórkowego cAMP z następczą aktywacją zależnej od cAMP kinazy białkowej A, która z kolei fosforyluje lekkie łańcuchy miozyny odpowiedzialne za hamowanie interakcji aktyny z miozyną zależnej od kompleksu wapń – kalmodulina. Ponadto wzrost cAMP powoduje redukcję stężenia Ca2+ w cytoplazmie. W efekcie tych zmian dochodzi do istotnego wzrostu funkcjonalnej objętości pęcherza moczowego, co w konsekwencji pozwala na wydłużenie okresu pomiędzy mikcjami