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1

The Influence Of Obesity On Results Of AT (Doxorubicin Plus Docetaxel) Neoadjuvant Chemotherapy In Locally Advanced Breast Cancer Patients

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Karpińska A., Safranow K., Kładny J., Sulżyc-Bielicka V.

Polish Journal of Surgery

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2015

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vol. 87

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issue 5

231-237

EN

The achieve pathologic complete response is proven to be the most important parameter of prognosis. Thereports evaluating the impact of obesity on the obtained pathologic response to chemotherapy are unequal. The aim of the study was to evaluate in locally advanced breast cancer patients, treated with AT(doxorubicin plus docetaxel) neoadjuvant chemotherapy: 1. The relationship of obesity with obtaining pathological response. 2. The relationship of obesity and free of disease recurrence survival (DFS) and overall survival (OS) associated with the tumour. Material and methods. A retrospective study was carried out in a group of 105 patients with locally advanced breast cancer, treated with AT neoadjuvant chemotherapy and then treated with radical surgery. Two variants of pathological response have been adopted: a pCR (T0N0) and pCR1 (TisN0, TxN1, T1N0, T1N1, T0N1). The relationship of obesity with pathological response and survival was investigated. Results. In univariate analysis the pCR1 was obtained with its arising from the borderline of statistical significance with lower incidence of obesity. In pCR1 multivariate analysis, negative pCR1 relationship with obesity was on the borderline of the statistical significance. The multivariate analysis showed a significant negative association OS with obesity (p=0.047) and positive with the occurrence of menopause (p = 0.029). Conclusions. In patients with locally advanced breast cancer treated with AT neoadjuvant chemotherapy. 1. Obesity seems to be an independent and unfavourable predictor of the lack of obtaining pCR1 pathological response 2. In the multivariate analysis, the obesity was a significant independent factor related to shorter OS.

2

Analysis of the reliability of clinical examination in predicting traumatic cerebral lesions and skull fractures in patients with mild and moderate head trauma

100%

Żyluk A., Mazur A., Piotuch B., Safranow K.

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vol. 85

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issue 12

699-705

EN

The aim of the study was to assess the reliability of neurological examination and other factors in predicting traumatic cerebral lesions and skull fractures in patients with mild and moderate head trauma (GCS 10-15). Material and methods. Over a one-year period, 227 patients: 145 male and 82 female, aged a mean of 51 years who sustained mild or moderate head trauma (GSC 10-15) were examined neurologically and had performed head CT scans. The neurological examination as a whole and each finding of the neurological examination were tested as predictors of the presence of traumatic abnormalities in the head CT scan. Results. Post-traumatic lesions in head CT scan were found in 109 patients (48%): skull fractures in 66 of these and brain injuries in 94; fifty-eight patients had skull fracture combined with brain injury. Seventeen patients required neurosurgical intervention (hematoma evacuation). Abnormal neurological examination showed the highest reliability in identifying patients with brain injuries in CT (sensitivity 87%, specificity 79%). Of single findings, gait abnormalities and consciousness disturbances, present in sober patients, were the strongest predictors of cerebral lesions. Likewise, abnormal neurological examination was the best indicator of skull fractures (sensitivity 77%, specificity 63%). Gait abnormalities and “racoon eyes” present in alcohol intoxicated patients were the strongest individual predictors of skull fractures. Conclusion. Results of our study show neurological abnormalities as the most reliable (although not 100% accurate) in identifying patients who are likely to have brain injuries and/or skull fracture following head trauma. Use of clinical decision rules may reduce the number of head CT scans performed “just in a case”.

3

Serum soluble Klotho protein level is associated with residual diuresis in incident peritoneal dialysis patients

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Golembiewska E., Safranow K., Kabat-Koperska J., Myślak M., Ciechanowski K.

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EN

Aim: Active vitamin D (1,25-dihydroxyvitamin D3), PTH, fibroblast growth factor-23 (FGF-23) and Klotho protein are key regulators of phosphate metabolism. Hyperphosphatemia and increased FGF-23 level in patients with end-stage renal disease are associated with increased morbidity and mortality. The relationships among key regulators of phosphate metabolism are still being investigated. FGF-23, the humoral factor involved in phosphate metabolism, is strongly associated with serum phosphorus level. Klotho, a transmembrane protein expressed primarily in renal tubules, functions as an obligatory co-receptor for FGF-23. The soluble form of Klotho, produced by the shedding of the transmembrane protein, is detectable in body fluids. The purpose of the study was to assess if serum soluble alpha-Klotho level was related to phosphate metabolism parameters and residual renal function (RRF) in incident peritoneal dialysis (PD) patients. Methods: Thirty-five clinically stable patients 4 to 6 weeks after the onset of PD were included in the study. For each patient, clinical and laboratory data were reviewed. Serum phosphorus concentration, urinary and peritoneal phosphate clearance, serum FGF-23 and soluble Klotho protein concentrations were determined. Results: Serum soluble alpha-Klotho was strongly negatively correlated with 24-hour diuresis (Rs = -0.55, p = 0.004) and renal phosphate clearance (Rs = -0.40, p = 0.049), but not with RRF. Conclusions: Serum soluble Klotho protein concentration is inversely related to residual diuresis and renal phosphate clearance in incident PD patients.

4

Prevalence ofCryptosporidiumsp. In Patients with Colorectal Cancer

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Sulżyc-Bielicka V., Kołodziejczyk L., Jaczewska S., Bielicki D., Kładny J., Safranow K.

Polish Journal of Surgery

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2012

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vol. 84

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issue 7

348-351

EN

Parasitic protozoans of the Cryptosporidium genus are intracellular intestinal parasites of mammals, causing cryptosporidiosis. Clinically, cryptosporidiosis manifests as chronic diarrhoea. Individuals with immune disorders, including those with neoplasms, are at risk of symptomatic invasion.The aim of the study was the evaluation of Cryptosporidium sp. prevalence in patients with diagnosed colorectal cancer.Material and methods. The studied group encompassed 87 patients with diagnosed colorectal cancer, undergoing surgery at the Department of General and Oncological Surgery, Pomeranian Medical University, in the years 2009-2010. Immunoenzymatic tests for Cryptosporidium sp. on faeces samples were performed with the use of commercial test kit, ProSpecT®Cryptosporidium Microplate Assay (Remel Inc).Results. The presence of Cryptosporidium sp. was found in 12.6% of studied patients with colorectal cancer. The performed statistical analysis did not reveal any correlation between Cryptosporidium sp. infection and gender, age, neoplasm advancement stage as per Astler-Coller scale, neoplasm differentiation grade, or neoplastic tumour localisation in relation to the splenic flexure.Conclusions. There was found high prevalence of Cryptosporidium sp. in patients with colorectal cancer. It was comparable to the prevalence reported for patients with immune deficiency.

5

The Role of Isolated Profundaplasty in Attempts to Lower the Level of Amputation in Critical Limb Ischemia

76%

Cnotliwy M., Szumiłowicz J., Safranow K., Petriczko W., Wiernicki I., Gutowski P.

Polish Journal of Surgery

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2007

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vol. 79

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issue 12

773-778

EN

The aim of the study was to verify the usefulness of isolated profundaplasty performed prior to amputation in attempts to salvage the knee joint in patients scheduled for the major amputation due to critical limb ischemia.Material and methods. The study enrolled 46 patients treated between January 1992 and December 2005 due to critical limb ischemia who were primarily scheduled for major amputation. Arteriography performed in all studied patients disqualified these patients from attempts to reconstruct the lower leg arteries, but simultaneously provided information on possibilities for profunda repair. A few days prior to below-knee amputation, a profundaplasty was performed. The following parameters were evaluated: the course of wound healing in the groin and tibial stump, the rate of conversion of the transtibial amputation to an above-knee amputation and patency of the deep femoral artery 12 months postoperatively.Results. One patient died within the first 30 postoperative days. Complications of wound healing in the groin requiring surgical debridement occurred in 7 patients. Early conversion to above-knee amputation was necessary in 10 cases due to lack of stump healing; this group included 6 patients with infected pedal tissue necrosis and 4 patients with reocclusion of the deep femoral artery. The cumulative proportion of survivors at 12 months with a preserved knee joint was 0.50, and that of those with a patent deep femoral artery was 0.47. No significant differences were found between profundaplasty methods regarding patency of the deep femoral artery and tibial stump healing. Similarly, no significant differences were found between diabetic and non-diabetic patients. It has been found that infection of pedal tissue necrosis had a significant negative influence on the patency of the deep femoral artery following the profundaplasty (p=0.02) and resulted in lower rates of salvage of the knee joint (p=0.0002)Conclusions. 1. In the case when other methods of vascular reconstruction are no longer possible, an isolated profundoplasty performed prior to below-knee amputation creates a chance for stump healing and salvage of the knee joint for the patients with critical limb ischemia who have no infection within the foot. 2. Pedal tissue infection in the same group of patients should constitute an indication for primary above-knee amputation.

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Adipokines and parameters of peritoneal membrane transport in newly started peritoneal dialysis patients

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Golembiewska E., Safranow K., Ciechanowski K., Bober J., Bogacka A., Stepniewska J.

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2013

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vol. 60

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issue 4

617-621

EN

Aim: Adiponectin and leptin are two adipokines playing important roles in the regulation of body weight, appetite, carbohydrate and lipid metabolism. In patients with chronic kidney disease (CKD) adipokines accumulate in serum due to reduced renal clearance. Since adipokines have pleiotropic actions, the adipokine balance may have an impact on peritoneal membrane transport. The aim of this study was to assess whether serum adiponectin and leptin levels were related to peritoneal transport and residual renal function (RRF) in newly started peritoneal dialysis patients. Methods: 25 clinically stable patients, 4 to 6 weeks after the onset of PD, were included in the study. For each patient clinical and laboratory data were reviewed and standard PET test was performed. Serum adiponectin and leptin concentrations were determined and leptin/adiponectin (L/A) ratio was calculated. Results: Serum adiponectin correlated negatively with weight, BMI and glucose concentration. Serum leptin and L/A ratio correlated positively with BMI. Serum adiponectin correlated positively with dialysate to plasma (D/P) creatinine ratio and ultrafiltration in PET test. Serum leptin level and L/A ratio correlated strongly negatively with peritoneal creatinine clearance. Conclusions: Serum adiponectin concentration is positively associated with baseline solute transport. Leptin concentration and L/A ratio are negatively associated with dialysis adequacy in newly started PD patients.

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Zespół Kelleya-Seegmillera jako przyczyna nawracającego ostrego uszkodzenia nerek u 9-letniego chłopca

76%

Marciniak H., Jarmoliński T., Safranow K., Jakubowska K., Olszewska M., Chlubek D.

Annales Academiae Medicae Silesiensis

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2017

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vol. 71

116-121

EN

Defekt fosforybozylotransferazy hipoksantynoguaninowej (HPRT) jest drugą co do częstości występowania po ksantynurii wrodzoną wadą metabolizmu puryn. Opisany w 1967 r. u pacjentów z dną moczanową i kamicą nerkową zespół Kelleya-Seegmillera wynika z częściowego niedoboru tego enzymu. Jego całkowity brak wywołuje ponadto ciężkie objawy neurobehawioralne i znany jest od 1964 r. jako zespół Lescha-Nyhana. Badania enzymatyczne i molekularne, pozwalające na dokładną diagnostykę tych wad, są w Polsce trudno dostępne, co wpływa na bardzo rzadkie ich rozpoznawanie. Przedstawiono przypadek 9-letniego chłopca z nawracającym ostrym uszkodzeniem nerek (4 epizody), u którego analiza obrazu klinicznego i proste testy laboratoryjne pozwoliły na wstępne rozpoznanie zespołu Kelleya-Seegmillera, potwierdzone badaniem aktywności HPRT.

PL

Hypoxanthine-guanine phosphoribosyltransferase (HPRT) deficiency is the second most common, after xanthinuria, inherited defect of purine metabolism. Described in 1967 in patients with gout and nephrolithiasis, the Kelley-Seegmiller syndrome is caused by HPRT partial deficiency. A complete lack of enzyme activity leads to additional severe neurobehavioral symptoms with self-mutilation creating clinical a picture known since 1964 as the Lesh-Nyhan syndrome. Enzymatic and molecular analyses useful for precise diagnosis are not routinely available in Poland, so the prevalence of HPRT defects is very low. Here we presented a case of a 9-year-old boy suffering from recurrent acute kidney injury (4 episodes) with diagnosis of the Kelley-Seegmiller syndrome based on the clinical picture and simple laboratory tests confirmed by evaluation of HPRT enzyme activity.

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N-acetyl-beta-glucosaminidase urine activity as a marker of early proximal tubule damage and a predictor of the long-term function of the transplanted kidneys

64%

Kwiatkowska E., Domański L., Bober J., Kłoda K., Safranow K., Szymańska-Pasternak J., Romanowski M., Sulecka A., Pawlik A., Ciechanowski K.

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2014

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vol. 61

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issue 2

275-280

EN

Introduction: Ischaemia-reperfusion injury (IRI) is a factor leading to the damages of the transplanted kidney, what affects mainly the proximal tubules. Early monitoring of tubule damage can be an efficient tool to predict the allograft dysfunction. Present in proximal tubules, N-acetyl-beta-glucosaminidase (NAG) is a lysosomal enzyme whose excretion rises as a result of IRI or acute rejection. The aim of this study was to monitor the NAG urine activity to evaluate the early proximal tubule damage, and to try to predict the long-term function of the transplanted kidney. Material and methods: The study enrolled 87 Caucasian renal transplant recipients (61.7% males, 38.3% females, mean age 45.56±14.34 years). Urine samples were collected for NAG and creatinine analysis on the 1st day after transplantation, and then in the 3rd and 12th month. Protocol biopsies were performed in the 3rd and 12th month. Results: A significant positive correlation between NAG urine activity in the 3rd month after transplantation and creatinine concentration on the 14th (p=0.004) and 30th day (p=0.05), in the 3rd month (p=0.009) and after the 1st (p=0.005) and 2nd year (p=0.003) was observed. A statistically significantly higher urinary NAG activity in samples collected in the first 3 days and in the 3rd month after transplantation among patients with DGF (p=0.006 and p=0.03 respectively) was found. There was a significant positive correlation between NAG urine activity in the 3rd month and the grade of tubular atrophy in specimens collected in the 3rd (p=0.03) and 12th (p=0.04) month. Conclusions: Monitoring of NAG urine activity is useful in the evaluation of early proximal tubule damage and predicting the long-term function of the transplanted kidneys.

Refine search results

The Influence Of Obesity On Results Of AT (Doxorubicin Plus Docetaxel) Neoadjuvant Chemotherapy In Locally Advanced Breast Cancer Patients

Analysis of the reliability of clinical examination in predicting traumatic cerebral lesions and skull fractures in patients with mild and moderate head trauma

Serum soluble Klotho protein level is associated with residual diuresis in incident peritoneal dialysis patients

Prevalence ofCryptosporidiumsp. In Patients with Colorectal Cancer

The Role of Isolated Profundaplasty in Attempts to Lower the Level of Amputation in Critical Limb Ischemia

Adipokines and parameters of peritoneal membrane transport in newly started peritoneal dialysis patients

Zespół Kelleya-Seegmillera jako przyczyna nawracającego ostrego uszkodzenia nerek u 9-letniego chłopca

N-acetyl-beta-glucosaminidase urine activity as a marker of early proximal tubule damage and a predictor of the long-term function of the transplanted kidneys