The role of computed tomography in the diagnosis of lung cancer - a case report

Introduction Lung cancer has been the main oncological problem in the world for years. It is extremely important to use appropriate diagnostic methods that enable its detection and implementation of appropriate treatment. Aim The presented case shows the advantage of computed tomography over chest X-ray (X-ray) in visualizing neoplastic changes in the lungs. Case Study The paper presents a description of a patient diagnosed with centrally located advanced lung adenocarcinoma with a strong expression of PD-L1 qualified for treatment with pembrolizumab. Results and Discussion Presented case confirms that X-ray is less sensitive, especially in the case of centrally located tumors. Therefore, the emergence of a new cough in a smoker or ex-smoker should raise concerns related to lung cancer despite a normal X-ray image. The central location of the tumor may cause dramatic course of the symptoms. In the presented case, a sudden significant deterioration of the condition was observed due to atelectasis of the entire lung. Haemoptysis observed during hospitalization was another symptom of centraly located tumor mass. Conclusions In conclusion, the history of cigarette smoking, presence of typical symptoms should provide an in-depth diagnosis of lung cancer, despite normal X-ray. Diagnostic procedures include computed tomography in the first place. The course of centrally localized disease may change rapidly during on first cycle of treatment. Due to the possibility of serious complications of the ongoing neoplastic disease, the patient should be under constant medical supervision.

Efficacy and safety of fenfluramine in the treatment of Dravet syndrome - literature review

Dravet Syndrome is a severe, drug-resistant, and rare epileptiform disorder that is typically presented in the first year of life in an otherwise healthy child. It is characterized by prolonged seizures that are often resistant to current anti-epileptic drug regimens, which made them poorly controlled, and almost 50% of patients experience at least four tonic-clonic seizures per month. There are three new medicines: stiripentol, cannabidiol, and fenfluramine, with documented efficacy and safety as adjunctive therapies in pharmacoresistant Dravet syndrome treatment. This study aimed to assess the efficacy and safety of fenfluramine in the treatment of Dravet syndrome. Our study material consisted of publications, which were found in PubMed, Google Scholar, and Embase databases. In order to find the proper publications, the search has been conducted with the use of a combination of keywords like: “fenfluramine”, “Dravet syndrome”, “epilepsy treatment”, “Dravet syndrome pediatric patients”. The first step was to find proper publications from the last 10 years. The second step was to carry out an overview of the found publications. Results of mentioned studies proved that in Dravet syndrome, fenfluramine provided a significantly greater reduction in convulsive seizure frequency compared with placebo. No patient developed valvular heart disease or pulmonary arterial hypertension, the side effects that occurred during its use were mild and the drug was generally well-tolerated. The bioequivalence and tolerability of single oral doses of fenfluramine hydrochloride oral solution in the fed and fasted states support drug administration without regard to meals. Fenfluramine may represent a new important treatment option for Dravet syndrome.

Morphofunctional changes in the rat's liver of different ages after L-methionine administration

Background: Literature data on the effect of methionine on functional activity and, especially, on morphological changes in the liver parenchyma in animals of different ages are sporadic, and research results are often ambiguous. Aim: The purpose of this work was to study and compare the morphofunctional changes in the liver of rats of different ages on prolonged administration of L-methionine. Material and Methods: The experiment was performed on 48 male Wistar rats of 3 and 15 months of age. Animals of the experimental group received L-methionine at a dose of 250 mg/kg body weight in addition to the standard diet, daily for 21 days. Histological preparations were prepared from liver tissue by a standard technique. Morphometry was performed on digital images using the computer program «Image J». Succinate dehydrogenase activity and protein concentration were determined in the suspension of hepatocyte mitochondria. Results: It was revealed that 21-day administration of L-methionine to rats led to hypertrophy of the hepatocyte nucleus, an increase in the nuclear-cytoplasmic ratio, the number of binuclear hepatocytes, and the nucleolus in the cell nucleus. The relative area of ​​the sinusoids network increased by 50% in 3-month-old animals. This indicated a better blood filling of the liver parenchyma. The increase in succinate dehydrogenase activity and protein concentration was revealed in the suspension of hepatocyte mitochondria of the experimental rats. This indicated an increase in the mitochondria energy potential and protein-synthetic activity. Conclusions: The administration of prophylactic doses of methionine to healthy rats leads to the appearance of pronounced morphological and functional signs of increased activity of hepatocytes. The severity of this effect has a distinct age-dependent character. In young rats, it is more pronounced than in mature rats. The results of the study are important for practical medicine when using methionine for therapeutic and prophylactic purposes.

Influence of latent iron deficiency on cognitive abilities in students

The aim of the study is to assess the impact of latent iron deficiency on students' cognitive abilities. Material and methods. The study was conducted during 2018-2021 at the Department of Hygiene and Medical Ecology of Odessa National Medical University. A survey of 188 medical students aged 18-20 was conducted using a screening survey. Estimation of the qualitative content of iron compounds in the diet was performed by a calculation method using the USDA / FDA database. Persons with probable iron deficiency were examined for hemoglobin, erythrocytes, hematocrit (general clinical blood test) and serum ferritin. Additionally, the cognitive abilities of people with latent iron deficiency were assessed using MoSA, TMT, GPB, Schulte tables and TAS-20. As a control, 30 students aged 18-20 years who showed no signs of latent or overt iron deficiency were interviewed. Statistical processing was performed by methods of variance and correlation anamnesis using the software Statistica 13.0 (TIBCO, USA). Results. When evaluating diets, probable iron deficiency was identified in 69 (36.7%) students surveyed. A significant number of students reported signs of iron deficiency, namely general weakness (27 or 14.4%), increased fatigue (30 cases or 15.9%), pale skin and mucous membranes (6 or 3.2%), drowsiness (8 or 4.3%), dry mouth (11 or 5.9%), brittle hair (4 or 2.1%), bleeding gums (3 or 1.6%). In isolated cases, hyposmia, dysgeusia and dysphagia have occurred. Probable iron deficiency was found at the previous stage of the study in 29 (15.4%) patients, they subsequently underwent verifying laboratory tests. In the analysis of the obtained data, the diagnosis of mild iron deficiency anemia was confirmed in 2 (6.9%) girls. Latent iron deficiency was identified in 16 (55.2%) students, among whom girls predominated (10 people or 62.5%). Subsequent studies have shown that a significant number of students with latent iron deficiency showed moderate signs of decreased cognition. Conclusions: 1. The frequency of latent iron deficiency in the surveyed contingent was 8.5%, with an absolute predominance of girls (62.5%). 2. Latent iron deficiency in student youth can be manifested by cognitive impairment, and therefore affect academic performance. 3. The most pronounced correlation was found for ferritin content and severity of alexithymia (r = -0.61).

Wiedza i postawy mieszkańców gminy Czaplinek w zakresie profilaktyki raka jelita grubego

Wprowadzenie i cel: Rak jelita grubego (C18-C21) stanowi obecnie w Polsce drugą wśród mężczyzn i trzecią wśród kobiet przyczynę zgonów nowotworowych. Celem pracy była ocena wiedzy oraz postaw mieszkańców gminy Czaplinek w zakresie profilaktyki raka jelita grubego. Materiał i metoda: Badanie przeprowadzono w okresie od października do grudnia 2020 roku wśród 238 mieszkańców gminy Czaplinek, położonej w województwie zachodniopomorskim, w powiecie drawskim. Narzędzie badawcze stanowił autorski kwestionariusz ankiety, składający się z 22 pytań o charakterze zamkniętym. Otrzymane wyniki opracowano w arkuszu kalkulacyjnym Microsoft® Excel® 2016 MSO i poddano analizie statystycznej przy użyciu oprogramowania Statistica® (TIBCO Software Inc.). Wyniki: Przeważająca część ankietowanych (74,8%) wiedziała, że wczesne zdiagnozowanie raka jelita grubego znacząco zwiększa szanse na jego wyleczenie. Tylko połowa respondentów (50,8%) miała świadomość tego, że nowotwór ten może rozwijać się bezobjawowo. Znajomość czynników ryzyka oraz objawów raka jelita grubego w grupie badanej była niska. Ogólny poziom wiedzy respondentów na temat raka jelita grubego i jego profilaktyki był najczęściej dostateczny (62,5%). Niespełna jedna trzecia ankietowanych (31,5%) słyszała o Programie Badań Przesiewowych raka jelita grubego. Wnioski: Poziom wiedzy oraz postaw mieszkańców gminy Czaplinek w zakresie raka jelita grubego i jego profilaktyki jest zdecydowanie niezadowalający. Istnieje pilna potrzeba prowadzenia intensywnych działań edukacyjnych, skupiających się przede wszystkim na promowaniu badań przesiewowych w kierunku raka jelita grubego.

Wpływ zanieczyszczenia powietrza na stężenie tlenku azotu w wydychanym powietrzu (FeNO) u dzieci – przegląd literatury

Obciążenie chorobami związanymi z zanieczyszczeniem powietrza ma poważne znaczenie dla zdrowia ludzi na całym świecie. Wpływ zanieczyszczenia powietrza na organizm człowieka zawiera bardzo szerokie spektrum objawów od najłagodniejszych aż do zgonu. Dzieci, zwłaszcza najmłodsze, ze względu na okres rozwojowy oraz związaną z tym niedojrzałość, są w większym stopniu niż dorośli narażone na wnikanie, koncentrację i toksyczne skutki zanieczyszczeń powietrza w drogach oddechowych. Pomiar stężenie tlenku azotu w wydychanym powietrzu (FeNO) jest cenną i prostą metodą diagnostyczną dostarczającą istotnych informacji o procesach chorobowych toczących się w układzie oddechowym. Jest uznanym biomarkerem oraz wyznacznikiem ilościowym w wykrywaniu oraz monitorowaniu stanu zapalnego górnych i dolnych dróg oddechowych, zwłaszcza zapalenia eozynofilowego, astmy oraz alergicznego nieżytu nosa. Celem pracy jest przedstawienie pomiaru stężenie tlenku azotu w wydychanym powietrzu (FeNO) jako prostej metody przydatnej w ocenie stanu pacjenta pediatrycznego oraz ukazanie wpływu zanieczyszczeń powietrza na poziom FeNO na podstawie dostępnej literatury. Wiele prac badawczych wykazało związek pomiędzy poziomem FeNO a zanieczyszczeniem powietrza. Potrzebne są dalsze badania oceniające wpływ gazowych i pyłowych zanieczyszczeń powietrza na poziom FeNO.

Search for a way to improve the serum albumin binding function and the functional state of the liver when hypertension combined with non-alcoholic fatty liver disease

Recently, there has been a significant increase in interest in research on hypertension (HT), primarily due to its high prevalence. The interest in studying this problem is also exacerbated by the often insufficient effectiveness of existing treatments. The effect of concomitant pathologies on HT, in particular non-alcoholic fatty liver disease (NAFLD), remains poorly understood. The aim of the study – to evaluate the changes in the serum albumin binding function (SABF) and its relationship with the biochemical parameters of the blood when HT and HT combined with NAFLD and to suggest ways of medical correction of the detected disorders. Material and methods. 76 individuals with stage 2 HT with degree 2–3 arterial hypertension were examined. They were divided into two groups. Group 1 included 28 patients with HT without concomitant diseases who received basic hypertension therapy, and group 2 included patients with concomitant NAFLD. The latter in turn was divided into two subgroups: 2a – 27 patients who in addition to basic HT therapy received additional Antral hepatoprotector 200 mg three times a day for 2 months, and 2b – 21 patients who received only basic HT therapy. All of them underwent a standard clinical examination, as well as SABF, protein fractions, and liver function indicators. The comparison group consisted of 25 healthy individuals, comparable in age and sex. Results and Discussion. Patients in group 1 showed moderate changes in the functional state of the liver, but they did not exceed the norm, patients in group 2 – a significant decrease in SABF, as well as protein metabolism (decrease in total protein, albumin, albumin-globulin ratio and increase globulins) and liver function (increased activity of aspartate aminotransferase, alanine aminotransferase, gamma-glutamyltranspeptidase, thymol levels, alkaline phosphatase and total bilirubin). After treatment, the majority of patients in subgroup 2 had a statistically significant increase in SABF and a quantitative improvement in protein fractions and functional state of the liver. In subgroup 2-b, where hepatoprotective treatment was not performed, significant changes in most indicators did not occur. The results may be related to the positive effect of the drug on the liver, which leads to improved functional status of hepatocytes and their protein-synthesizing ability. In subgroup 2 b, where hepatoprotective treatment was not performed, significant changes in most indicators did not occur. The results may be related to the positive effect of the drug on the liver leading to improved functional status of hepatocytes and their protein-synthesizing ability. Conclusions. Changes of the functional state of the liver are observed when HT without concomitant pathology. HT with NAFLD is accompanied by a significant decrease in SABF, changes in protein metabolism and the functional state of the liver. Prescribing Antral to such patients helps to increase SABF, normalize protein metabolism and improve the functional state of the liver.

Myocardial stunning in patients with coronary artery disease before and after treatment by method of coronary artery bypass grafting (own studies)

Aim of the study: Determination of quantitative radiological indicators of myocardial revascularization effectiveness in patients with coronary artery disease in the early postoperative period. Materials and methods of research: For the implementation of the clinical objectives, 62 patients with coronary artery disease, heart failure, with preserved systolic function and systolic dysfunction were examined in the early postoperative period (up to 7 days). The patients' age ranged from 40 to 79 years, the average age of the examined was 59.6 ± 8.2 years. 35 (56%) patients had HF with LV systolic dysfunction with EF of 49% or less. 27 (44%) patients had preserved systolic function - ejection fraction greater than or equal to 50%. Results: In the group before treatment, the average value ​​of MV was 69.4% CI 95% [65.3%; 73.5%], and after treatment the value of MV was 75.0% CI 95% (70.8%; 79.3%], p = 0.0000. Percentage of RFP inclusion in the anterior wall was 69.5% CI [66.2%; 72.8%] before treatment and significantly improved to 72.3% CI [69.1%; 75.4%] after treatment (p = 0.023). Lateral wall had a parameter value of 73.9% CI [70.7%; 77.1%] before treatment and improved perfusion up to 77.2% CI [74.3%; 80.2%] (p = 0.018). Parameter values for the intraventricular septum were 64.5% CI [60.7%; 68.3%] before treatment and 69% CI [65.2%; 72.8%] after treatment (p = 0.000034) and for the inferior wall those were 54.0% CI (49.7%; 58.3%] and 61.7% CI (57.9%); 65.6%] before and after treatment respectively (p = 0.000032). Conclusion: The determination of quantitative radiological parameters proposed as a result of this study is extremely important for the early postoperative period (7-10 days) for determination of stunned myocardial reserve and late stage of patients` management (1-1.5 years) for determination of hibernation reserve and final assessment of CABG effectiveness.

Somatic status of adolescent girls with gynecological disorders born with low and excessive weight

In modern conditions, health problems (somatic, reproductive, mental) of adolescent girls occupy a special place in the health care system, as a reserve in reducing maternal and infant mortality, maintaining the fertility of the expectant mother. The aim. To study the frequency and character of extragenital diseases of adolescent girls with gynecological pathology, born with low and excessive body weight. Materials and methods. The project design is a population-based prospective cohort study. To achieve the goal and the implementation of the tasks, a prospective examination of girls and adolescent girls born with deficiency or excess body weight was carried out. The sample size was 77 people. Additionally, statistical processing was carried out using the Excell software. Results. Thus, the study of somatic health indicates its deterioration in the groups of girls born with polar values ​​of body weight. In groups 1 and 3, infectious diseases were identified, which can serve as a starting point in the development of reproductive system disorders. In girls of group 1, mumps prevailed (20.0%), which could cause damage to the follicular apparatus, while in group 3, girls were more likely to have influenza (25.8%), the virus of which has a damaging effect not only on the structure of the ovaries, but also on endometrium. Conclusions. Comparative analysis of the structure of somatic morbidity made it possible to identify the most significant pathology characteristic of each of the groups. Girls born with a large body weight have an increased risk of endocrine pathology. In girls born with low body weight, somatic diseases associated with manifestations of diseases of the musculoskeletal system prevail. This dictates the need to single out girls born with polar values ​​of body weight in the risk group for the development of somatic pathology and requires complex therapeutic and prophylactic measures.

Quality of life of women after mastectomy

Streszczenie Wprowadzenie. Wystąpienie choroby nowotworowej piersi u kobiety jest kryzysowym wydarzeniem, które wiąże się z koniecznością wdrożenia długotrwałego i obciążającego leczenia. Jakość życia kobiet będących w takiej sytuacji ulega zmianie. Z tego względu bardzo ważna jest ocena kondycji psychicznej, stanu emocjonalnego kobiet oraz stopnia zaakceptowania przez nie nowej sytuacji, a także rozpoznanie oczekiwań i potrzeb pacjentek z rakiem piersi. Celem pracy była ocena jakości życia kobiet z rozpoznanym rakiem piersi, u których przeprowadzono zabieg mastektomii. Materiał i metody. Badania przeprowadzono w Podkarpackim Ośrodku Onkolo­gicz­nym w Brzozowie wśród 231 kobiet z rakiem piersi, u których zastosowano leczenie chirurgiczne (mastektomia). Badania przeprowadzono za pomocą sondażu diagnostycznego przy wykorzystaniu autorskiego kwestionariusza ankiety składającego się z 39 pytań. Na przeprowadzanie badań uzyskano zgodę Dyrektora Szpitala oraz Komisji Bioetycznej. Wyniki. Stan emocjonalny badanych został oceniony jako zły (26,9%) lub raczej zły (21,3%), a jedna trzecia respondentek odczuwała smutek i apatię (bardzo często – 26,9%; codziennie-6,8%). Kobiety najczęściej obawiały się przerzutów nowotworu (47,2%), nawrotu choroby (33,3%) oraz wystąpienia bólu (29,0%). Jako ograniczenia życia codziennego wynikające z choroby kobiety w większości uznawały zakłócenia w życiu rodzinnym i towarzyskim (38,3%) oraz zmniejszenie efektywności pracy (30,6%). Wnioski. Kobiety posiadały obniżoną jakość życia, w szczególności w sferze emocjonalnej, życia rodzinnego i zawodowego. Respondentki z rakiem piersi oczekują większego wsparcia ze strony lekarza, co może stanowić podstawę do wprowadzenia zmian w kształceniu studentów medycyny i prowadzeniu szkolenia podyplomowego w tym zakresie. Słowa kluczowe: rak piersi, jakość życia, mastektomia, życie rodzinne i zawodowe