Marzena Demska - artykuły i informacje

Dodane 02.07.2012

Powikłania psychosomatyczne w przebiegu leczenia wrzodziejącego zapalenia jelita grubego

Leki immunosupresyjne mogą wywoływać poważne działania niepożądane. Opisano przypadek młodej pacjentki z wrzodziejącym zapaleniem jelita grubego (WZJG), u której po leczeniu azatiopryną wystąpiło ostre zapalenie trzustki. Stosowana przez 4 miesiące tioguanina oraz krótkotrwale (5 dni) cyklosporyna A były przyczyną pancytopenii, mononukleozy zakaźnej oraz opryszczkowego zapalenia skóry. Powikłaniom tym towarzyszyły zaburzenia nastroju w postaci zespołu lękowo-depresyjnego. Powrócono do klasycznej terapii mesalazyną podawaną łącznie z tianeptyną i uzyskano kilkumiesięczną remisję WZJG oraz poprawę stanu psychicznego.

Dodane 16.12.2011

Clinical study on magnesium, copper and chrome levels in patients with oesophageal squamous cell carcinoma

Background: Oesophageal squamous cell carcinoma is one of the most common malignancies in China. The association of trace elements and high cancer risk has been found in many studies. The present study was performed to investigate the relationship between the concentration of magnesium, copper and chrome and the incidence and prognosis of oesophageal squamous cell carcinoma. Material and methods : The study was conducted on 36 patients with oesophageal squamous cell carcinoma and all patients underwent oesopha-gectomy. The cancerous tissue samples and the normal tissue samples came from the patients. The concentration of magnesium, copper and chrome was measured by flame atomic absorption spectroscopy and comparison was made using Student’s t-test. Results : The content of magnesium in cancerous tissues was significantly lower than that in the normal tissues. In contrast, copper level in cancerous tissues was significantly higher than that in the normal tissues. Copper level in patients with lymph node metastasis was significantly higher than in patients without lymph node metastasis. There was a significant increase in mean copper in cancerous tissues with a worse histological grade. Our study showed that a lower magnesium level and a higher copper level may play an important role in oesophageal squamous cell carcinoma induction. And the chrome level may not be associated with the induction of oesophageal squamous cell carcinoma.

Dodane 16.12.2011

The influence of aerobic training on body composition in premenopausal women undergoing endocrine therapy for breast cancer

Aim of the study : The objective of the study was to determine the body composition (BC) changes in women with breast cancer after endocrine therapy, and the influence of aerobic training on the parameters under discussion. Material and methods : 41 women aged 32-48 (mean ± SD 44.1 ±4.4) with breast cancer during endocrine therapy (ET). This was a nonrandomized, prospective trial. The following examinations were conducted in patients according to the schedule: I before the beginning of ET; II after 6 months of the ET; III after 12 months of ET and after 6-month aerobic training. Body composition was evaluated using dual X-ray absorptiometry (DEXA) with respect to free fatty mass, lean, fat and the percentage location of android and gynoid fat. The body build was evaluated with respect to body height, body weight and selected anthropometric parameters BMI and WHR. Results : During the first six months of ET without regular physical activity the following was reported: a significant increase of body weight, BMI, the amount of fatty tissue, including android fat distribution (p 0.05). At that time muscle (p 0.05) reductions were reported. After the six-month aerobic workout no significant body weight or BMI increase was observed. However, there was a significant reduction in WHR (p Conclusions : The outcome analysis allows us to conclude that during breast cancer ET the patients are reported to have negative changes in BC and physique. Therefore, this patient group is advised to receive regular rehabilitation with the aim of reducing the side effects of the treatment. However, aerobic training seems to be insufficient in order to fully reduce the side effects of this form of cancer therapy.

Dodane 16.12.2011

Prognostic value of expression of intracellular and extracellular domains of HER2 in patients with HER2-possitive breast cancer

Background : HER2 consists of an extracellular domain (the target for trastuzumab), a transmembrane domain, and an intracellular domain, which is recognized by an antibody used in the immunohistochemical assessment of HER2 overexpression. The study consisted of 31 patients with metastatic breast cancer treated with trastuzumab. The aim of the study was to evaluate retrospectively expression of extracellular and intracellular HER2 domains in primary breast cancers treated with surgery and to assess their correlation with biological features of tumours, disease-free survival, overall survival, as well as progression-free survival and survival since the start of trastuzumab treatment. Material and methods : All these patients relapsed and were treated with trastuzumab because of metastatic disease – none of them received trastuzumab in an adjuvant setting. Two kinds of antibodies were used in immunohistochemical evaluation: against extracellular and intracellular domains of the HER2. Results : A significant correlation between different patterns of HER2 domain overexpression and disease-free survival was found. Disease-free survival (the time from the primary operation to relapse – prior to the start of any palliative treatment) was the shortest in patients with overexpression of both domains compared to patients without overexpression of both domains and the group with intracellular domain overexpression combined with absence of extracellular domain overexpression (median 13.2 vs. 24.3 vs. 52.4 months, p = 0.01). There was no significant difference between these 3 groups of patients in aspects of biological features of tumours, overall survival, progression-free survival and survival since the start of trastuzumab treatment. Conclusion: Concurrent assessment of extracellular and intracellular domains of HER2 may have prognostic value for HER2-positive patients.

Dodane 16.12.2011

The association of complementary alternative medicine use with anxiety, depression and quality of life in Turkish cancer patients

Aim of the study : The purpose of this study is to investigate the complementary/alternative medicine (CAM) usage and the factors affecting this among cancer patients in the western region of Turkey. 220 adult cancer patients participated in the study and 93 patients (42.3%) were found to use at least one CAM method. Material and methods : Our study was done by face-to-face communication in a university hospital, in Turkey. Oncology patients’ primary diseases, sociodemographic characteristics, complementary alternative medicine usage, psychological conditions and quality of life were evaluated with proper psychological scales. Patients using and not using CAM were compared with respect to Beck Depression, State Trait Anxiety and Beck Hopelessness scores. No statistically significant difference was detected between/among the groups in BDI (12.0 ±8.4, 11.9 ±8.7, p = 0.96), BHS (5.5 ±4.9, 4.8 ±4.4, p = 0.27) or STAI (43.7 ±8.0, 44.3 ±8.2, p = 0.64) scores. Patients using and not using CAM were compared with respect to WHOQOL-BREF quality of life scores. There was no statistically significant difference between/among the groups in WHOQOL-BREF sub-group scores (physical, psychological, social relations, environment, standardized by culture (environment), general health). Results : Nearly half of the patients (42.3%) in this region were found to be using at least one of the CAM methods. The patients mostly preferred herbal methods, with the leading product being stinging nettle (Urtica dioica). The severity of disease (recurrence and dissemination) and patients’ knowledge of the diagnoses were the most important factors affecting the CAM usage. Conclusions : The usage of CAM by oncology patients and the effects of CAM on the present medication prescribed by oncology practitioners must be remembered when they are admitted to polyclinics. Also it must be known that patients with advanced stage and patients with recurrence are more likely to use complementary alternative medications than early stage patients. Therefore oncology patients must be informed about CAM besides their clinical situations. At least physicians should give answers about the CAM to their patients.

Dodane 16.12.2011

Practical guidance on implementation of the Personal Data Security Management System in an oncology centre

Aim of the study : To analyse practical aspects of implementing the Personal Data Security Management System (PDSMS) in an oncology centre based on applicable legal requirements and professional standards. Material and methods : The research method is based on the analysis of legal documents, quality standards, analysis of progress in the achievement of objectives of the PDSMS based on interviews with heads of units and on review of data protection documentation. Results : The implementation of the PDSMS has caused the processed data to be adequately protected, minimised the risk of such data being used in a manner incompatible with their purpose, while ensuring the hospital’s compliance with applicable legal regulations. Conclusions : The implementation of the PDSMS has required technical and organisational measures to be taken in the centre’s organisational units, in particular appointing data protection officers, engaging staff in the data protection process by awarding them with authorisations to process data and familiarising them with securities that have been put in place.

Dodane 16.12.2011

Head and neck squamous cell cancer – the role of computed tomography enhanced with perfusion imaging in tumour staging

Aim of the study: To determine the added value of computed tomography perfusion (CTP) images combined with contrast-enhanced computed tomography (CECT) images in staging of head and neck squamous cell cancer (SCC). Material and methods: Forty-seven consecutive patients with histologically proven squamous cell cancer of the head and neck and qualified for surgical treatment were prospectively evaluated in 2 groups: based on CECT multiplanar reformations (axial, coronal and sagittal), and separately, based on CTP images combined with CECT data. Tumour stage was assessed in each group separately, with special emphasis on T4 stage, and results were compared with histological findings. Five patients underwent endoscopic laser tumour resection, 11 underwent other tumour resection (glossectomy, pharyngectomy) and 31 patients underwent en-bloc resection of the hypopharynx and larynx, allowing detailed pathological evaluation of possible tumour infiltration into surrounding structures. Two experienced head and neck radiologists evaluated the images. Inter-observer agreement was tested with the modified k test. The χ 2 test was applied to compare the number of correctly staged tumours for the two methods and readers. Results : Inter-observer agreement was high (k = 0.88-0.90). Significant differences between the two groups were observed; with added CTP assessment more anatomical structures were rated positive for tumour infiltration and diagnostic accuracy of this method was significantly higher when compared to CECT images. Sole evaluation of CECT images in less advanced cases led to overestimation of the disease, since inflammation and slight oedema could not be differentiated from tumour. Conclusions : Contrast-enhanced computed tomography multi-planar images enhanced with CTP images were proven to improve accuracy in head and neck cancer staging. The added value of CTP may help to avoid overestimation of the malignant process and at the same time may facilitate depiction all infiltrated structures.

Dodane 16.12.2011

The tumour and its microenvironment – a complicated interplay

A whole range of complex interactions develops between growing malignant neoplastic cells and non-malignant stromal elements of a tumour. The tumour microenvironment includes a number of interrelated elements: fibroblasts, macrophages and dendritic cells, endothelial cells, pericytes, inflammatory cells and extracellular matrix components. All these elements are actively involved in tumour growth and progression and angiogenesis, and can either promote or inhibit these processes. Understanding of the relationship between the various components of the tumour microenvironment and tumour cells may allow the introduction of combination drug therapy having different target points which gives hope of reducing the doses of medicines, and thus reducing their toxicity while increasing their efficiency.

Dodane 16.12.2011

Biological and clinical significance of BRCA2

Nowadays, diagnostics enables detection of cancer-related mutations. It concerns germline mutations as well as de novo mutations. The number of genetics tests available for specific tumors increase incessantly. BRCA1 and BRCA2 are high-penetrant genes, but still their functions and mechanisms leading to cancer caused by their mutations remain unknown. Germline alterations in BRCA1 and BRCA2 sequences are related to hereditary breast cancer syndrome (HBC), hereditary breast and ovarian cancer syndrome (HBOC), hereditary ovarian cancer syndrome (HOC). Primary and secondary tumors prevention and choice of the best treatment are the benefits of the detection of BRCA2 mutations. Research on correlation between the tumor phenotype and the type of mutation is continuously performed. This research may have an impact on the development of more effective drugs.

Dodane 16.12.2011

Prostate cancer radiotherapy
[Polish version: Radioterapia raka gruczołu krokowego p... 323]

Rak gruczołu krokowego jest jednym z najczęściej rozpoznawanych nowotworów złośliwych u mężczyzn. Podstawowymi metodami leczenia radykalnego chorych z tym rozpoznaniem jest leczenie chirurgiczne oraz radioterapia. Rozwój możliwości technicznych oraz wieloletnie doświadczenie kliniczne dają możliwość optymalizacji radioterapii przeprowadzanej we wszystkich stopniach zaawansowania klinicznego. Celem niniejszej pracy jest przedstawienie lekarzom innych specjalności niż onkologia kliniczna i radioterapia onkologiczna ogólnych zasad kwalifikacji i postępowania terapeutycznego z chorymi na raka gruczołu krokowego. W przypadku teleradioterapii promieniowanie jonizujące jest generowane poza ciałem pacjenta, najczęściej przy użyciu przyspieszaczy liniowych. Brachyterapia jest drugim podstawowym działem radioterapii, gdzie źródło promieniowania jonizującego umieszczane jest w guzie nowotworowym lub w jego bezpośrednim sąsiedztwie. Wyniki licznych badań klinicznych wskazują, że radioterapia daje szansę na wyleczenie chorych z różnym stopniem zaawansowania klinicznego choroby przy stale zmniejszającym się odsetku poważnych powikłań popromiennych.