Prevalence of common comorbidities among urogynaecological patients

Objectives: Due to prolonged life expectancy, regardless of the fact that elderly women are more likely to suffer from comorbidities, urogynaecologists worldwide should expect a growing demand for counseling and effective treatment for patients with pelvic floor defects. The aim of the study was to investigate the incidence of popular comorbidities among urogynaecological patients. Material and methods: The retrospective analysis included clinical data of 4,065 consecutive female patients who under­went surgical treatment in the 2nd Department of Gynaecology at the Medical University of Lublin due to urogynaecological disorders between January 2005 and December 2014. Patients were divided into two groups (< 65 years and ≥ 65 years). The vast majority of patients affected by stress urinary incontinence were treated with mid-urethral slings. Most of patients affected by pelvic organ prolapse underwent reconstructive vaginal surgery with reinforcement using anterior and/or pos­terior meshes. Statistical analysis was performed using STATISTICA 10.0 PL (unpaired Student t-test, U Mann Whitney, χ2 test). Results: In both study groups, overweight and obesity were the most common disorders affecting urogynaecological patients (72.6% overall). Furthermore, the elderly patients suffered more often from the most common comorbidities, such as hypertension (p < 0.01), coronary artery disease (p < 0.001) and diabetes mellitus (p < 0.005). Conclusions: Common comorbidities such as overweight and obesity, followed by hypertension and coronary heart diseases, are usual among urogynaecological patients. Changes in lifestyle leading to a decrease in obesity should be considered as an important line treatment when counselling urogynaecological patients

Power morcellation for women undergoing laparoscopic supracervical hysterectomy — safety of procedure and clinical experience from 426 cases

  Objectives: Minimally invasive gynaecological surgeries are performed for several malignant and nonmalignant indications. The aim of our study was to evaluate the rate of unexpected malignancies among women who underwent laparoscopical supracervical hysterectomy (LASH) with power morcellation. Material and methods: The retrospective analysis included clinical data of 426 consecutive female patients who underwent LASH with power morcellation due to presumed benign disorders (78.4% — symptomatic uterine fibromas, 12.7% — abnormal uterine bleeding, 8.9% — suspicion of uterine adenomyosis) between January 2011 and December 2015. Pre­malignant or malignant preoperative abnormalities in the cervix and the uterine corpus were contraindications for LASH. Results: The unexpected malignancies were found in four patients from study group: one ovarian cancer located on the inner part of simple ovarian cyst and 3 endometrial carcinomas (0.9%) were documented. All these patients underwent abdominal reoperations and no histological abnormalities were detected in the extirpated cervix and adnexa. Conclusions: The incidence of unintended endometrial carcinoma in morcellated uterus after LASH was relatively small. However, careful pre-operative counseling should be undertaken in order to exclude the possibility of any malignant disease in uteri among women scheduled to power morcellation.

Zalecenia Polskiej Grupy Mięsakowej w odniesieniu do postępowania diagnostyczno-terapeutycznego oraz kontroli u chorych na neurofibromatozę typu 1 (NF1) oraz związanego z nią złośliwego nowotworu osłonek nerwów obwodowych

Type 1 neurofibromatosis (NF1 syndrome in von Recklinghausen’s disease) is inherited as an autosomal dominant disease, caused by mutations in the NF1 gene encoding the neurofibromin protein. NF1 patients are at an increased risk of the develop­ment of a malignant neoplasm and their life span is shorter by 20 years than that of the general population. National Institute of Health (NIH) criteria make a diagnosis possible from about 4 years of age. Examination of children and adults should encom­pass a physical and a subjective component, but also next-generation sequencing (NGS) genetic analysis, histopathological examination of skin lesions, neurological, ophthalmological and radiological examination. If a malignant peripheral nerve sheath tumor (MNPST) is diagnosed in a patient with NF1, the therapeutic procedure should not differ from the general principles of treating soft tissue sarcomas. Patients from the high risk group should be monitored at least once a year, the remaining patients once every 2–3 years by a specialized medical team, and every year by their primary physicians, internal medicine specialists and dermatologists. Patients should have access to genetic counselling.Neurofibromatoza typu 1 (zespół NF1 w chorobie Recklinghausena, nerwiakowłókniakowatość typu 1), jest dziedziczona au­tosomalnie dominująco, a odpowiadają za nią mutacje genu NF1 kodującego białko neurofibrominy. Pacjenci z NF1 są naraże­ni na zwiększone ryzyko rozwoju nowotworu złośliwego i żyją około 20 lat krócej niż populacja ogólna. Kryteria National Insti­tute of Health (NIH) umożliwiają postawienie diagnozy już około 4 roku życia. Badanie dzieci i dorosłych powinno objąć bada­nie przedmiotowe i podmiotowe, ale też badanie genetyczne techniką sekwencjonowania nowej generacji (NGS), badanie histopatologiczne zmian skóry, badanie neurologiczne, okulistyczne i radiologiczne. W przypadku postawienia roz­poznania złośliwego nowotworu osłonek nerwów obwodowych (malignant peripheral nerve sheath tumor – MPNST) u chorego na NF1 postępowanie terapeutyczne nie powinno odbiegać od ogólnych zasad leczenia mięsaków tkanek miękkich. Pacjenci z grupy wysokiego ryzyka powinni być monitorowani przynajmniej raz w roku, pozostali – raz na 2–3 lata – przez zespół lekarzy specjalistów, a co roku przez lekarzy podstawowej opieki zdrowotnej (POZ), chorób wewnętrznych i dermatologów. Pacjentom należy zapewnić poradnictwo genetyczne

Texture Analysis in Diagnosing Skin Pigmented Lesions in Normal and Polarized Light—A Preliminary Report

The differential diagnosis of benign nevi (BN), dysplastic nevi (DN), and melanomas (MM) represents a considerable clinical problem. These lesions are similar in clinical examination but have different prognoses and therapeutic management techniques. A texture analysis (TA) is a mathematical and statistical analysis of pixel patterns of a digital image. This study aims to demonstrate the relationship between the TA of digital images of pigmented lesions under polarized and non-polarized light and their histopathological diagnosis. Ninety pigmented lesions of 76 patients were included in this study. We obtained 166 regions of interest (ROI) images for MM, 166 for DN, and 166 for BN. The pictures were taken under polarized and non-polarized light. Selected image texture features (entropy and difference entropy and long-run emphasis) of ROIs were calculated. Those three equations were used to construct the texture index (TI) and bone index (BI). All of the presented features distinguish melanomas, benign and dysplastic lesions under polarized light very well. In non-polarized images, only the long-run emphasis moment and both indices effectively differentiated nevi from melanomas. TA is an objective method of assessing pigmented lesions and can be used in automatic diagnostic systems

Przerzuty nowotworowe do trzonów kości długich z perspektywy lekarza ortopedy – przegląd literatury

Bone metastases are a great challenge in the practice of an orthopedic surgeon. Due to the development of oncological treatment, the approach to patients with bone metastases is changing. Previously, these patients were treated palliatively, mainly to decrease the pain intensity. However, with appropriate systemic, surgical and orthopedic treatment, patients with bone metastases often live for many years. Therefore, proper diagnosis and appropriate orthopedic treatment can significantly improve patients’ prognosis. On the other hand, poor qualification for surgery and selection of the wrong treatment method contribute to shortening the patients’ survival. Hence, knowledge of the diagnosis and qualification of patients for surgical treatment is essential in the practice of an orthopedist. In the presented review, the authors focused on summarizing the knowledge in the field of diagnostics, qualification for surgical treatment and orthopedic treatment methods for patients with bone diaphysis metastases.Przerzuty nowotworowe do kości stanowią duże wyzwanie w praktyce lekarza ortopedy. Rozwój onkologii sprawił, że podejście do pacjentów z przerzutami do kości ulega zmianie. Wcześniej chorzy ci leczeni byli głównie paliatywnie i przeciwbólowo. Jednakże obecnie przy odpowiednim leczeniu systemowym, chirurgicznym i ortopedycznym chorzy z przerzutami do kości przeżywają niejednokrotnie wiele lat. Dlatego właściwa diagnoza oraz odpowiednie leczenie ortopedyczne może znacząco poprawić rokowania pacjentów. Z drugiej strony zła kwalifikacja do leczenia operacyjnego i dobór złej metody leczenia przyczynia się do skrócenia przeżycia pacjentów. Stąd wiedza z zakresu diagnostyki i kwalifikacji chorych do leczenia operacyjnego jest niezbędna w praktyce lekarza ortopedy. Autorzy pracy w przedstawionym przeglądzie skupili się na podsumowaniu wiedzy z zakresu diagnostyki, kwalifikacji do leczenia chirurgicznego oraz metod leczenia ortopedycznego pacjentów z przerzutami do kości długich

Solitary breast cancer metastasis to pelvic bone treated with a unique method of surgery combined with local doxorubicin administration

Treatment of bone metastasis is a major challenge for current and future orthopedic and oncology specialists. For the treatment of single metastases, there is a continuing search for effective local treatments that do not affect the whole patient. The current report describes the case of single breast cancer metastasis to the pelvic bone in a 50-year-old woman treated surgically by bone osteotomy combined with local doxorubicin application. The presence of cancer cells was confirmed by histopathological examination. After 6 months, the same defect was operated on again and a successful therapeutic result was confirmed by negative tumor pathology tests. The bone defect caused by osteotomy was reconstructed with allogenic bone grafts that healed completely over 14 months. To the best of our knowledge, this report is the first to combine the removal bone metastasis with direct local cytostatic drug administration without the use of a specific carrier, followed by successful bone reconstruction 6 months later using bone allografts. Thus, single bone metastasis may be successfully treated with resection and local cytostatic administration, enabling bone reconstruction in the postoperative period. The potential benefits of such treatments must be evaluated by considering the potential risks involved, including necrosis of surrounding soft tissues and general reactions to the chemotherapy. No data has been available until now regarding the risk of cancer disease generalization being influenced by such treatments, but patient quality of life can be improved significantly by the successful removal of a solitary bone metastasis. The present case report supports the continuation of research on improving local cytostatic drug administration during the treatment of bone metastasis

Accuracy Evaluation of Selected Mobile Inspection Robot Localization Techniques in a GNSS-Denied Environment

Locating an inspection robot is an essential task for inspection missions and spatial data acquisition. Giving a spatial reference to measurements, especially those concerning environmental parameters, e.g., gas concentrations may make them more valuable by enabling more insightful analyses. Thus, an accurate estimation of sensor position and orientation is a significant topic in mobile measurement systems used in robotics, remote sensing, or autonomous vehicles. Those systems often work in urban or underground conditions, which are lowering or disabling the possibility of using Global Navigation Satellite Systems (GNSS) for this purpose. Alternative solutions vary significantly in sensor configuration requirements, positioning accuracy, and computational complexity. The selection of the optimal solution is difficult. The focus here is put on the assessment, using the criterion of the positioning accuracy of the mobile robot with no use of GNSS signals. Automated geodetic surveying equipment is utilized for acquiring precise ground truth data of the robot’s movement. The results obtained, with the use of several methods, compared: Wheel odometry, inertial measurement-based dead-reckoning, visual odometry, and trilateration of ultra-wideband signals. The suitability, pros, and cons of each method are discussed in the context of their application in autonomous robotic systems, operating in an underground mine environment

Impact of Varied Factors on Iron, Nickel, Molybdenum and Vanadium Concentrations in the Knee Joint

The aim of this study was to determine the concentrations of iron, nickel, molybdenum, and vanadium in the knee joint. We also examined the relationships between the concentrations of these metals in the knee joint and the influence of varied factors on the concentration of Fe, Ni, Mo, and V. The study of these trace elements is important, because these elements are used alone and in combination in diet supplements, and they are components of biomaterials implanted in medicine. The study materials, consisting of the spongy bone, cartilage, meniscus, anterior cruciate ligament (ACL), and infrapatellar fat pad, were obtained from 34 women and 12 men from northwestern Poland. The concentrations of Ni, Fe, Mo, and V were determined using spectrophotometric atomic absorption in inductively coupled argon plasma (ICP-AES). We found significantly higher Mo concentrations in the ACL of women than men. There was a significant difference in the Mo concentration in the spongy bone between patients from cities with fewer than 100,000 inhabitants and patients from cities with more than 100,000 residents. Iron concentrations in the spongy bone were higher in non-smoking patients and those who did not consume alcohol. Vanadium concentrations were higher in the infrapatellar fat pads in abstainers. In patients who had not undergone arthroscopy surgery, V concentration was lower in cartilage. The concentrations of V in the cartilage and infrapatellar fat pad were higher in osteoporotic patients than in non-osteoporotic patients. There were significant differences in Fe concentrations in the meniscus, with the lowest in osteoporotic patients. We noted lower Mo concentrations in the spongy bone of patients with rheumatoid arthritis. Furthermore, we noted some new interactions among metals in the studied structures of the knee joint. The results reported in this study show the influence of gender, place of residence, smoking, consumption of alcohol, arthroscopy surgery, osteoporosis, and rheumatoid arthritis on the Fe, Ni, Mo, and V concentrations in the studied structures of the knee joint

Analysis of Lidar Actuator System Influence on the Quality of Dense 3D Point Cloud Obtained with SLAM

Mobile mapping technologies, based on techniques such as simultaneous localization and mapping (SLAM) and surface-from-motion (SfM), are being vigorously developed both in the scientific community and in industry. They are crucial concepts for automated 3D surveying and autonomous vehicles. For various applications, rotating multiline scanners, manufactured, for example, by Velodyne and Ouster, are utilized as the main sensor of the mapping hardware system. However, their principle of operation has a substantial drawback, as their scanning pattern creates natural gaps between the scanning lines. In some models, the vertical lidar field of view can also be severely limited. To overcome these issues, more sensors could be employed, which would significantly increase the cost of the mapping system. Instead, some investigators have added a tilting or rotating motor to the lidar. Although the effectiveness of such a solution is usually clearly visible, its impact on the quality of the acquired 3D data has not yet been investigated. This paper presents an adjustable mapping system, which allows for switching between a stable, tilting or fully rotating lidar position. A simple experiment in a building corridor was performed, simulating the conditions of a mobile robot passing through a narrow tunnel: a common setting for applications, such as mining surveying or industrial facility inspection. A SLAM algorithm is utilized to create a coherent 3D point cloud of the mapped corridor for three settings of the sensor movement. The extent of improvement in the 3D data quality when using the tilting and rotating lidar, compared to keeping a stable position, is quantified. Different metrics are proposed to account for different aspects of the 3D data quality, such as completeness, density and geometry coherence. The ability of SLAM algorithms to faithfully represent selected objects appearing in the mapped scene is also examined. The results show that the fully rotating solution is optimal in terms of most of the metrics analyzed. However, the improvement observed from a horizontally mounted sensor to a tilting sensor was the most significant