Jakość życia osób z chorobami przyzębia

Wstęp. W ostatnim okresie czasu zdecydowanie wrasta zainteresowanie jakością życia w aspekcie zdrowia. Takie spojrzenie na zdrowie może wynikać z uznania i zaakceptowania holistycznego spojrzenia na człowieka. Badania dotyczące wpływu zdrowia jamy ustnej na jakość życia pacjentów są prowadzone stosunkowo rzadko. Współcześnie do tych badań można wykorzystywać wskaźniki zarówno ogólne, jak i specyficzne. Celem badań było określenie jakości życia chorych na choroby przyzębia na podstawie badania ankietowego kwestionariuszem GOHAI (Geriatric Oral Health Assessment Index). Materiał i metodyka. Badania przeprowadzono w okresie od 3 listopada do 15 grudnia 2013 r. w przyzakładowej przychodni stomatologicznej Państwowej Wytwórni Papierów Wartościowych w Warszawie. W badanej grupie było 32 osoby (11 kobiet i 21 mężczyzn) w wieku 27-67 lat. Każdego badanego objęto dwuetapowym badaniem: I etap Najpierw lekarz dentysta przystąpił do badania klinicznego, w którym oceniono występowanie potrzeb leczniczych u pacjentów oraz stan zdrowia jamy ustnej. Każdy pacjent został zbadany przy sztucznym oświetleniu, przy użyciu lusterka i zgłębnika. Na tym etapie wyselekcjonowano grupę chorych z chorobami przyzębia. Ta grupa była przedmiotem dalszych badań w II etapie- badań ankietowych. II etap Badanie ankietowe kwestionariuszem GOHAI (Geriatric Oral Health Assessment Index. Wyniki badań i wnioski. 1.Rozkład odpowiedzi (punktacji) na poszczególne pytania kwestionariusza GOHAI był mocno zróżnicowany. Wśród badanych rozkład punktacji wahał się w przedziale 19-46. Średnia ilość punków jaką uzyskali chorzy na choroby przyzębia wynosiła 30. 2. Większość dolegliwości wynikające z rozwoju chorób przyzębia występowały z różną częstością wahającą się od jednej trzeciej do około połowy liczby ankietowanych. 3. Dla dokonania bardziej pogłębionej analiz konieczne jest powtórzenie tego typu badań na zdecydowanie większej grupie chorych z chorobami przyzębia.Introduction. The interest in the quality of life as far as health is concerned has recently noticeably increased. Such an attitude towards health may result from the acceptance of a holistic approach to a person. Studies on the influence of the health of oral cavity on the patient's quality of life are relatively infrequent. Nowadays, such studies can utilise general as well as specific indices. The aim of this study was to determine the quality of life of persons suffering from periodontal diseases basing on the GOHAI (Geriatric Oral Health Assessment Index) questionnaire. Materials and Methods. The study was carried out between 3 November and 15 December 2014 in the company dental clinic of the Polish Security Printing Works in Warsaw. The studied group consisted of 32 persons (11 women and 21) men aged 27-67. Each of the studied people underwent a two-stage process: Stage I At first, a dentist carried out a clinical examination assessing the patient's needs for treatment and the health of oral cavity. Each of the patients was examined in artificial lighting, with a mirror and a dental probe. In this stage, a group of persons with periodontal diseases was selected. The group was subject to further study in the stage II – the survey. Stage II Survey study with the use of the GOHAI (Geriatric Oral Health Assessment Index) questionnaire. Results and Conclusions. 1.The distribution of answers (score) for given questions of the GOHAI questionnaire was strongly diversified. Among the studied persons, the score distribution ranged from 19 to 46. The average score obtained by the persons suffering from periodontal diseases was 30. 2.Most of the conditions resulting from the development of periodontal diseases occurred with various frequency in 1/3 to ca. 1/2 of the respondents. 3. For a more in-depth analysis, the repetition of this type of study on a considerably greater number of persons suffering from periodontal diseases will be required

Technique of double incision laparoscopic cholecystectomy (DILCH) as an alternative to SILS

Background. Single incisions laparoscopic surgery (SILS) applied for cholecystectomy can ensure a good cosmetic effect expecting without no visible scarring cosmetic effect after surgical procedures, but needrequires implementation of special ports, as well as articulating and banked instruments to be more comfortable for the surgeon. The aim of this paper is to present three three-ports cholecystectomy through two well hidden incisions – umbilical and suprapubic, – performed by with typical laparoscopic instruments. Methods. Ten consecutive elective patients with typical, symptomatic cholelithiasis were qualified for DILS cholecystectomy. All acute cases were excluded from intervention. Typical CO2 pneumoperitoneum was done after umbilical skin incision. Two ports, 5 mm and 11 mm, were inserted in the maximum external edges of this incision. The second incision for 11 mm optical trocar for optic was performed in the suprapubic median line, just in the hairy zonewithin the hair line, to hidden conceal himit. Results. DILCH were performed without any conversions to classical LCH or open cholecystectomy. Each procedure was different according to technical improvement of access and manipulation of instruments manipulations. Time of interventions ranged between from 2 hours for the first patients to 1 hour for the last according to the learning curve. No complications were observed and all patients were discharged as after conventional LCH. Conclusions. DILCH as a three three-port laparoscopic intervention, performed with typical laparoscopic instruments, is more convenient for the surgeon than single incision LCH. Transfer of the optic from the umbilical port site to hidden the concealed suprapubic hairy region gives thereprovides more space for instruments but didn’t did not spoil theed good cosmetic effect of intervention. This procedure is easy to learn and in case of technical problems we can always apply additional ports like foras in typical LCH. Background. Single incisions laparoscopic surgery (SILS) applied for cholecystectomy can ensure a good cosmetic effect expecting without no visible scarring cosmetic effect after surgical procedures, but needrequires implementation of special ports, as well as artic- ulating and banked instruments to be more comfortable for the surgeon. The aim of this paper is to present three three-ports chole- cystectomy through two well hidden incisions – umbilical and suprapubic, – performed by with typical laparoscopic instruments. Methods. Ten consecutive elective patients with typical, symptomatic cholelithiasis were qualified for DILS cholecystectomy. All acute cases were excluded from intervention. Typical CO2 pneumoperitoneum was done after umbilical skin incision. Two ports, 5 mm and 11 mm, were inserted in the maximum external edges of this incision. The second incision for 11 mm optical trocar for optic was per- formed in the suprapubic median line, just in the hairy zonewithin the hair line, to hidden conceal himit. Results. DILCH were performed without any conversions to classical LCH or open cholecystectomy. Each procedure was different according to technical improvement of access and manipulation of instruments manipulations. Time of interventions ranged between from 2 hours for the first patients to 1 hour for the last according to the learning curve. No complications were observed and all patients were discharged as after conventional LCH. Conclusions. DILCH as a three three-port laparoscopic intervention, performed with typical laparoscopic instruments, is more convenient for the surgeon than single incision LCH. Transfer of the optic from the umbilical port site to hidden the concealed supra- pubic hairy region gives thereprovides more space for instruments but didn’t did not spoil theed good cosmetic effect of intervention. This procedure is easy to learn and in case of technical problems we can always apply additional ports like foras in typical LCH.

Primary prophylaxis of febrile neutropenia with granulocyte stimulating factors in patient with locally advanced non-small cell lung cancer - case report

Przedstawiono przypadek chorej z rozpoznaniem niedrobnokomórkowego raka płuca leczonej w KliniceNowotworów Płuca i Klatki Piersiowej Centrum Onkologii w Warszawie. Ze względu na stopień zaawansowaniachorą zakwalifikowano do leczenia metodą radykalnej chemioradioterapii sekwencyjnej. Z uwagina współwystępujące obciążenia internistyczne i podeszły wiek chorej oraz radykalne założenie leczeniazdecydowano o włączeniu profilaktyki pierwotnej gorączki neutropenicznej (filgrastym). Chorej podano3 cykle chemioterapii w dawkach należnych, nie obserwując istotnych klinicznie toksyczności hematologicznychani pozahematologicznych.We are presenting a case of a women diagnosed with non-small cell lung cancer, who has been treated in Department of Lung and Chest Malignancies of Oncology Centre in Warsaw. As she presented with locally advanced disease radical sequential chemoradiotherapy was initiated. Due to comorbidities, advanced age and treatment with radical intend, primary prophylaxis with granulocyte stimulating factors was indicated. Patient received 3 cycles of chemotherapy in with planned dose intensity. Neither hematologic, nor non-hematologic toxicities were observed

Pembrolizumab in combination with chemotherapy in patients with advanced squamous cell lung cancer — clinical trials and real-world data

Advanced squamous-cell lung carcinoma remains a disease with an unfavorable prognosis. Until recently, chemotherapy was used in systemic treatment, and its effectiveness was limited. Implementation of immune check-point inhibitors allowed for an improvement in treatment results. The KEYNOTE-407 study included patients with squamous-cell lung cancer who received 4 immunochemotherapy cycles followed by maintenance treatment with pembrolizumab. Median overall survival of 17.2 months versus 11.6 months for chemotherapy was obtained (risk of death reduction by 29%) while the percentage of patients remaining in follow-up was 18%. Analysis of patients with good performance status treated in clinical practice confirms the results from the registration study and emphasizes the importance of taking into consideration clinical factors while qualifying patients for treatment

Postępowanie w przypadku wystąpienia płucnych działań niepożądanych przy stosowaniu niwolumabu

Immunopochodne zapalenie płuc jest rzadką, ale potencjalnie zagrażającą życiu toksycznością niwolumabu. Częstość występowania tego powikłania nie przekracza 10%, ale może być wyższa w przypadku stosowania leczenia skojarzonego z innym lekiem immunokompetentnym. W większości przypadków immunopochodne zapalenie płuc jest rozpoznawane w pierwszych tygodniach leczenia niwolumabem. Suchy kaszel i duszność są najczęściej zgłaszanymi objawami. Algorytmy diagnostyczne zalecają badanie metodą tomografii komputerowej celem wykluczenia innych przyczyn zgłaszanych dolegliwości. W przypadkach drugiego lub wyższego stopnia nasilenia zaleca się wykonanie bronchoskopii z BAL. Postępowanie terapeutyczne zależy od stopnia nasilenia objawów — kortykosteroidy i antybiotyki są lekami z wyboru. W ciężkich przypadkach konieczna jest hospitalizacja, niekiedy istnieją wskazania do zastosowania innych leków immunosupresyjnych (infliksymab, mykofenolan mofetylu)

Immune checkpoint inhibitors in the first-line treatment of metastatic small-cell lung cancer

Small-cell lung cancer is the most aggressive form of lung cancer. Most patients are diagnosed at a late disease stage when the prognosis is poor. The treatment algorithm for small-cell lung cancer remained unchanged for years, with chemotherapy as the first-line option. However, progress has been made with the recent development of immune checkpoint inhibitors, two of which — atezolizumab and durvalumab — have been approved in combination with chemotherapy as first-line treatment for advanced small-cell lung cancer. This review presents detailed data concerning the efficacy and safety of atezolizumab and durvalumab from both registration trials and real-world studies, as well as the results of clinical trials of other immune checkpoints inhibitors. Finally, the issue of identifying biomarkers to predict the efficacy of immunochemotherapy is discussed

Analysis of treatment results in primary germ cell tumours with mediastinal location: own experience

Wstęp: Pierwotne nowotwory z komórek rozrodczych o lokalizacji śródpiersiowej stanowią 1–6% guzów śródpiersia oraz 2–5% wszystkich nowotworów z komórek rozrodczych występujących u dorosłych. Rozpoznawane są najczęściej w 3. dekadzie życia, w 90% u mężczyzn. Najczęstsze objawy to: duszność, bóle w klatce piersiowej, kaszel, stany podgorączkowe i utrata masy ciała. Celem pracy była ocena wyników leczenia pierwotnych nowotworów z komórek rozrodczych o lokalizacji śródpiersiowej i przegląd piśmiennictwa poświęconego tej tematyce.Materiał i metody: W okresie od 1999 do 2009 roku w Klinice Nowotworów Płuca i Klatki Piersiowej Centrum Onkologii-Instytut im. Marii Skłodowskiej-Curie w Warszawie leczono 5 chorych z nowotworem z komórek rozrodczych o pierwotnej lokalizacji śródpiersiowej, 4 mężczyzn i 1 kobietę. Średnia wieku wyniosła 27,8 roku (zakres 23–30).Wyniki: U wszystkich chorych zastosowano chemioterapię według schematu BEP. U wszystkich chorych uzyskano obiektywną odpowiedź na leczenie. Dwóch chorych zmarło z powodu progresji choroby pomimo stosowania chemioterapii II i III linii. Trzech chorych nadal pozostaje w obserwacji. Mediana czasu przeżycia wyniosła 55,8 miesiąca (zakres 8,0–120,0).Wnioski: Pierwotne nowotwory z komórek rozrodczych o lokalizacji śródpiersiowej są nowotworami o rokowaniu gorszym niż w lokalizacji gonadalnej. Na podstawie obserwacji własnych i przeglądu piśmiennictwa można stwierdzić, że wyniki leczenia pierwotnych nienasieniaków w lokalizacji śródpiersiowej pozostają niezadowalające. Szczególnie niekorzystne są wyniki leczenia chorych, u których dochodzi do wczesnej wznowy lub progresji w trakcie chemioterapii I linii. Określenie nowych standardów postępowania w nowotworach opornych na cisplatynę wymaga dalszych badań oceniających skuteczność cytostatyków nowych generacji.Introduction: Primary germ cell tumours with mediastinal location comprise 1–6% of mediastinal tumours and 2–5% of all germ cell tumours occurring in adults. They are identified mostly in the 3rd decade of life, in 90% of cases in men. The most common symptoms are dyspnea, chest pain, cough, fever and weight loss. The aim of the present study was the analysis of our own results of treatment of primary germ cell tumours with mediastinal location, and a review of the literature concerning this subject.Material and methods: Five patients (4 males, 1 female) median age 27.8 years (range 23–30 years) treated in the period from 1999 to 2009 in Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Department of Lung Cancer and Chest Tumours in Warsaw, due to germinal tumours with primary mediastinal location, entered the study.Results: All patients received chemotherapy according to the BEP regimen. All patients achieved an objective response to treatment. Two patients died due to disease progression in spite of II- and III-line treatment. Three patients are still in follow-up. The median survival time was 55.8 months (range 8.0–120.0 months).Conclusions: Primary mediastinal germ cell tumours have worse prognosis than do those with gonadal location. Based on our observations and review of the literature, it can be concluded that the results of treatment of non-seminoma type germ cell tumours with primary mediastinal location remain poor. Patients who develop early recurrence or progression during first-line chemotherapy are particularly at risk of unfavourable outcome. Identification of new standards of treatment in tumours resistant to cisplatin require further studies evaluating the effectiveness of new generation cytostatic drugs

Applying the adverse outcome pathway (AOP) for food sensitization to support in vitro testing strategies

Background Before introducing proteins from new or alternative dietary sources into the market, a compressive risk assessment including food allergic sensitization should be carried out in order to ensure their safety. We have recently proposed the adverse outcome pathway (AOP) concept to structure the current mechanistic understanding of the molecular and cellular pathways evidenced to drive IgE-mediated food allergies. This AOP framework offers the biological context to collect and structure existing in vitro methods and to identify missing assays to evaluate sensitizing potential of food proteins. Scope and approach In this review, we provide a state-of-the-art overview of available in vitro approaches for assessing the sensitizing potential of food proteins, including their strengths and limitations. These approaches are structured by their potential to evaluate the molecular initiating and key events driving food sensitization. Key findings and conclusions The application of the AOP framework offers the opportunity to anchor existing testing methods to specific building blocks of the AOP for food sensitization. In general, in vitro methods evaluating mechanisms involved in the innate immune response are easier to address than assays addressing the adaptive immune response due to the low precursor frequency of allergen-specific T and B cells. Novel ex vivo culture strategies may have the potential to become useful tools for investigating the sensitizing potential of food proteins. When applied in the context of an integrated testing strategy, the described approaches may reduce, if not replace, current animal testing approaches

Biological activity of faba beans proanthocyanidins

The objective of the experiment was to determine whether small amounts of proanthocyanidins (0.1 and 0.3%) may increase the antioxidative properties of the rat diet without exerting an antinutritional effect. Proanthocyanidins of faba bean seed coats were extracted with a mixture of acetone and water (70:30) and lyophilized. The amount of proanthocyanidins was two- or fourfold higher in the experimental diets as compared to the control diet. The addition of proanthocyanidin extract had no significant effect on the coefficients of digestibility of crude protein, daily nitrogen retention and the coefficient of biological value of diet protein. In the blood serum of rats fed diets supplemented with proanthocyanidin extract, there was a slightly higher content of vitamin E and alanine aminotransferase activity, while the content of vitamin A and aspartate aminotransferase activity were similar to those of the control group. In the contents of the rat gut (caecum), a lower activity of â -glucuronidase was found as compared to the control group, whereas â -galactosidase was unaffected. The addition of proanthocyanidin extract to diet caused a decrease in the malondialdehyde content in the heart, kidneys, erythrocytes and blood plasma of rats. The results obtained indicate that the amount of proanthocyanidins used did not exert any antinutritional effects, but extended the pool of diet antioxidants and beneficially affected the activity of the large bowel microflora