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The impact of the COVID-19 pandemic on the clinical stage of laryngeal cancer

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Stępiński M. J.
Polski Przegląd Otorynolaryngologiczny
|
2024
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vol. 13
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issue 4
13-18
EN
Introduction: The COVID-19 pandemic, which lasted from 2019 to 2023, caused a significant stagnation in the healthcare system, not only in our country but also worldwide. Data from the National Cancer Registry for 2020 confirms a decrease of approximately 15% for men and 14% for women in diagnosed cancers compared to 2019. Aim: The aim of this study was to examine the baseline clinical stage of laryngeal cancer (using the TNM scale) of the larynx in the population of patients diagnosed at the Multispecialty Regional Hospital in Gorzow Wielkopolski between 2017 and 2024. Materials and methods: The author conducted a retrospective analysis of the initial clinical stage according to the TNM scale in patients over 18 years of age diagnosed with laryngeal cancer. The division into groups, the study group (n = 65) and the control group (n = 76), was based on the date of histopathological diagnosis (31.01.2020). The analysis also included the necessity of performing a tracheostomy, the size of the primary lesion, and metastatic changes. Results: Squamous cell carcinomas were most frequently diagnosed in the middle part of the larynx (61.84% of the control population and 70.77% of the study population) on the right side (61.84% of the control population and 61.54% of the study cohort). The percentage of patients requiring tracheostomy increased by approximately 3%. There was also an increase in the percentage of patients with T4a (+11.15%) and N2c (+6.39%) features. An increase in the number of patients in stage IVa (+19.74%) was noted. Despite the observed differences between the populations, they were not statistically significant. Discussion: There was an increase in the number of tracheostomies performed due to sudden dyspnea, including those performed under local anesthesia. Data confirms an increase in the size of the diagnosed tumor and metastatic changes. Conclusions: After the outbreak of the SARS-CoV-2 pandemic, an increased percentage of patients requiring tracheostomy due to sudden dyspnea was noted. The size (in terms of dimension and extent of infiltration) of tumors in the primary location and metastases in the cervical lymphatic system also increased. A decrease in the number of patients with distant metastatic changes was observed. The observed differences were not statistically significant. It is necessary to conduct studies on a larger population.
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Przypadek pacjenta z muszycą w obrębie metastatycznie zmienionych węzłów chłonnych szyi w przebiegu raka migdałka podniebiennego

63%
Stępiński M. J., Jaworowska E.
Polski Przegląd Otorynolaryngologiczny
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2023
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vol. 12
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issue 1
60-64
PL
Wstęp: Muszyce to grupa chorób pasożytniczych spowodowana przez larwy muchówek. Opis przypadku: W pracy zawarto studium przypadku pacjenta z muszycą w obrębie metastatycznych węzłów chłonnych szyi z mnogimi ogniskami martwicy w przebiegu raka płaskonabłonkowego migdałka podniebiennego, po wcześniej przebytej chemioterapii. Chorego poddano terapii zachowawczej, uzyskując maksymalną, możliwą do uzyskania, poprawę. Z uwagi na nieopanowaną chorobę nowotworową chory został przekazany do hospicjum stacjonarnego. Autorzy pracy dokonali przeglądu dostępnej literatury dotyczącej etiologii, diagnostyki, leczenia muszyc. Wnioski: Muszyce należą do chorób pasożytniczych, które dotykają między innymi chorych z zaawansowanym procesem nowotworowym. W leczeniu uwzględnić należy mechaniczne usuwanie larw, stosowanie środków odkażających, toaletę ran.
3
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A case report of a patient with myiasis within the metastatic lymph nodes in the course of tonsil cancer

63%
Stępiński M. J., Jaworowska E.
Polski Przegląd Otorynolaryngologiczny
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2023
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vol. 12
|
issue 1
60-64
EN
Introduction: The term “myiasis” refers to a group of parasitic diseases caused by fly larvae (maggots). Case report: The article presents a case study of a patient with myiasis within the metastatic cervical lymph nodes presenting with multiple necrotic foci in the course of squamous cell carcinoma of the palatine tonsil after chemotherapy. The patient was subjected to conservative treatment to achieve the maximum possible improvement. Due to the uncontrolled cancer, he was transferred to a stationary hospice. A review of the available literature on etiology, diagnosis, and treatment of myiasis is also presented. Conclusions: Myiases are a group of parasitic diseases developing, among others, in advanced cancer patients. The treatment should include mechanical removal of the larvae, disinfectants, and wound toilet
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Foreign body within the upper esophagus of a patient not consenting to surgical treatment – case report and legal proceedings in light of current case law

51%
Stępiński M. J., Tymiński R., Hrydnova V.
Polski Przegląd Otorynolaryngologiczny
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2024
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vol. 13
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issue 1
54-60
EN
Introduction: Patients intentionally inserting foreign bodies into the lumen of their gastrointestinal tract usually aim at achieving certain benefits, such as postponement or avoidance of punishment. Aim: In view of the ever-increasing number of proceedings (including criminal proceedings) against health care professionals, the authors carried out a review of the available literature on: medical actions undertaken in cases of foreign bodies within the esophagus, current legislation and jurisprudence as practiced in the Republic of Poland within the context of model legal proceedings in cases involving patients raising doubts about being fully conscious and not consenting to necessary treatment. Case report: The article presents a case of a patient with an esophageal foreign body who had not consented to the proposed surgical treatment. Doubts as raised within the otorhinolaryngological team with regard to the patient’s state of consciousness were not dispelled as the result of psychiatric consultation. Following a meticulous analysis of the current jurisprudence of the Polish judicial system and obtaining a court’s permission to intervene, the procedure (esophagoscopy with removal of esophageal foreign body) was performed. After exclusion of any life-threatening complications, the patient was transferred to the Psychiatric Department. Conclusions: In the current state of the law, performing a procedure to remove a foreign body from the esophagus without prior court approval could qualify as a violation of patient’s rights. In such case, legal liability of the physician would arise regardless of the fact that the patient would have received care in accordance with the current medical knowledge and practice.
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