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1
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The role of erythropoiesis-stimulating agents in contemporary clinical practice

100%
Frąckowiak M., Lewandowski T.
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vol. 8
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issue 1
11-14
EN
Anaemia is one of the most significant factors that lead to deteriorated quality of life and limited therapeutic possibilities in cancer patients. When treating chronic anaemia associated with a neoplastic disease, one should consider RBC transfusion or the use of recombinant human erythropoiesis-stimulating agents (ESA). In 2007, following the golden era of ESA at the beginning of the 21st century, the American Food and Drug Administration (FDA) issued a number of warnings related to the use of ESAs. They concerned, i.e., the increased risk of cancer progression, probability of venous thromboembolism (VTE), and reduced overall survival times. That has led to a decrease in the use of erythropoiesis-stimulating agents in clinical practice. Results of the most recent studies and meta-analyses indicate the possibility of using ESA in patients undergoing palliative myelosuppressive chemotherapy, with haemoglobin levels < 10 g/dl, and without absolute iron deficiency, in order to avoid red cell concentrate transfusions, and with the hope to improve the patient’s quality of life.
2
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Assessment of the Knowledge of GPS Considering the Surgical Treatment of Obesity

81%
Giaro M., Wyleżoł M., Truszczyński O., Lewandowski T.
Polish Journal of Surgery
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2012
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vol. 84
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issue 8
383-389
EN
Bariatric surgery is currently the only effective treatment option for morbidly obese patients. There has been observed a considerable disproportion between the number of procedures conducted in Poland and the number of patients requiring such treatment. There are no studies assessing bariatric knowledge among general practitioners who play crucial role in polish health care system.The aim of the study was to assess the knowledge of general practitioners regarding bariatric surgery.Material and methods. An anonymous questionnaire conducted among 282 general practitioners in 2010-2011 during local educational conferences. The questionnaire consisted of 10 questions relating to fundamental issues of bariatric surgery.Results. Only one twelfth (8.1%) of the general practitioners questioned knows the indications for bariatric surgery, can apply them, and has epidemiological awareness. 61.5% of general practitioners know the surgical procedures used for the treatment of obesity, whereas 58% of them show the knowledge of surgical technique in which they are performed. Only 23% of general practitioners were aware that bariatric surgery decreases cancer risk. 92% of the participants noticed a necessity of education regarding the surgical treatment of obesity.Conclusions. Bariatric knowledge among general practitioners is not adequate to scientific research results published during the last years. Most general practitioners who participated in our study are aware of that and are awaiting for educational programmes focused on this issue.
3
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Novel oral anticoagulants in the treatment of cancer patients

81%
Biernacka R., Lewandowski T., Andrzejuk J., Szmyd M.
OncoReview
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2014
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vol. 4
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issue 1
A11-17
EN
Cancer and its treatment are well-recognized risk factors for venous thromboembolism. The risk of thrombotic complications increases 4–7-fold in cancer patients and coexistence of both pathologies is associated with shorter survival. Incidence of thrombosis depends on the tumour type, antineoplastic and supportive therapy, and patient-related factors such as age, physical activity and comorbidities. Current recommendations of scientific societies indicate a dominant role of low molecular weight heparins in the treatment and prevention of venous thromboembolism in cancer patients. Long duration of the anticoagulant effect, and the subcutaneous administration route of heparins call for a safer therapeutic option, and one that would be more convenient for the patient. New oral anticoagulants: dabigatran, rivaroxaban, and apixaban, are indicated as prevention of venous thromboembolism following an orthopaedic surgery, and as stroke prevention in nonvalvular atrial fibrillation, with rivaroxaban also applied in the treatment of acute deep vein thrombosis and pulmonary embolism. In the trials evaluating the efficacy of novel oral anticoagulants, they have been compared with enoxaparin or vitamin K antagonists. Cancer patients accounted for a small percentage of the trial population, and they were rarely analysed in subgroup analysis. It was only in the phase II ADVOCATE study that the target group were patients receiving chemotherapy. Direct comparison between test drug and low molecular weight heparins was not performed. The currently available study results do not allow us to recommend the new oral anticoagulants for the treatment and prevention of venous thromboembolism associated with cancer.
4
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ARMS-PCR for detection of BRAF V600E hotspot mutation in comparison with Real-Time PCR-based techniques

61%
Machnicki M. M., Glodkowska-Mrowka E., Lewandowski T., Ploski R., Wlodarski P., Stoklosa T.
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2013
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vol. 60
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issue 1
57-64
EN
BRAF mutation testing is one of the best examples how modern genetic testing may help to effectively use targeted therapies in cancer patients. Since many different genetic techniques are employed to assess BRAF mutation status with no available comparison of their sensitivity and usefulness for different types of samples, we decided to evaluate our own PCR-based assay employing the amplification refractory mutation system (ARMS-PCR) to detect the most common hotspot mutation c. T1799A (p. V600E) by comparing it with two qPCR based assays: a commercially available test with hybridizing probes (TIB MOLBIOL) and high resolution melting (HRM). Positive results were verified with Sanger sequencing. DNA from two cancer cell lines with known mutation status and from tissue samples from melanoma and gastric cancer was used. ARMS-PCR was the most sensitive method with the level of detection of the mutant allele at 2%. Similar sensitivity was observed for the qPCR-based commercial test employing hybridizing probes; however, this test cannot exclude negative results from poor or low quality samples. Another qPCR-based method, HRM, had lower sensitivity with the detection level of approximately 20%. An additional drawback of HRM methodology was the inability to distinguish between wild type and mutant homozygotes in a straightforward assay, probably due to the character of this particular mutation (T\>A). Sanger sequencing had the sensitivity of the detection of mutant allele similar to HRM, approx. 20%. In conclusion, simple ARMS-PCR may be considered the method of choice for rapid, cost-effective screening for BRAF p. V600E mutation.
5
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Specialized Movement on the Rowing Ergometer and Post-workout Changes in Selected Peripheral Blood Parameters - a Case Report.

52%
Proia P., Amato A., Contró V., Thiel D., Vostatková P., Buryta B., Kolbowicz M., Lewandowski T., Nowakowska A.
Central European Journal of Sport Sciences and Medicine
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2018
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vol. 24
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issue 4
5-13
EN
Rowing is a sport discipline, which requires extreme physical strength and endurance and appropriate aerobic and anaerobic capacity as well. However, when the workout intensity and load is very high, exercise is associated with temporary changes in cellular metabolism and the immune system. The study included one male rower aged 28 years - the highly-skilled and experienced athlete. We determined basic cardiorespiratory fitness measures, complete blood count, and 24 clinical chemistry parameters including relevant biochemical and haematological parameters and matrix metaloproteinases activities. Maximal exercise on the rowing ergometer induced 2-fold increase in absolute counts of all leukocytes subsets. There was observed an increase in C-reactive protein concentrations as well. MMP-9 activity increased 1,3-fold compared to the baseline value. Exhaustive exercise caused significant changes in creatinine and urea serum levels, but the most prominent changes were found in total and direct bilirubin concentrations. Maximal exercise induced also a decrease in the iron and magnesium levels. No changes in ALT, GGT and ALP activity were observed, while increase in CK, AST and LDH activity in post-exercise time and the decrease during the recovery was found. Therefore acute specialized movement on the rowing ergometer is not the cause of muscular damage, but rather indicate efficient adaptation to the physical exercise. Moreover, it seems that maximal exercise induces an inflammatory response characterized by greater count of all subpopulations of leukocytes, elevated levels of CRP and MMP-9 serum activity.
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