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EN
Paraneoplastic neurological syndromes (PNS) are a group of rarely observed disorders, accompanying about 1% of cancer diseases. They have a typically aggressive course, leading to profound and essentially irreversible disability. The pathogenic cause behind PNS is damage of the nervous system structures as a consequence of the body’s immunological reaction induced by cancer. Onconeural antibodies generated as part of the reaction target the tumour tissues, but also the regular nervous tissue recognized as antigens. Presence of onconeural antibodies reveals a 50–60% sensitivity and 100% specificity in diagnosing PNS. Imaging and laboratory tests have a limited impact on diagnosis. What is crucial is the analysis of clinical systems following Graus’s criteria (elaborated in 2004). In the case presented here, the patient underwent treatment in many neurological departments due to the symptoms of progressive damage of the nervous system. She was eventually diagnosed with the stiff person syndrome related to breast cancer. In spite of the treatment, including an efficacious oncological therapy, the severe neurological deficit resulted in serious motor disability.
EN
Introduction: A steady increase of the incidence of colorectal cancer has been observed for over 30 years, particularly in well-developed countries. Colorectal cancer is one of the lifestyle-related neoplasms and depends on environmental factors. Aim: Aim of the study was to analyse selected clinical features of colorectal cancer patients. Material and methods: The study group consisted of 577 consecutive patients with colorectal cancer treated in the Department of Clinical Oncology in Bytom in 2006–2014. The patients were included into the study prospectively. The analysis of selected clinical, pathological and anthropometrical parameters was conducted. Results: The study group included 237 women and 341 men aged 26 to 86 years (mean age 64.3 ± 9.2 years). Primary tumours were mostly located in the colon and had histological grade 2. The surgical removal of the primary tumour was performed in 540 patients. 65 patients underwent preoperative radiotherapy, 201 – postoperative chemotherapy and 91 – postoperative radio-chemotherapy. 132 of patients obtained the first-line palliative chemotherapy. 88 of patients did not received oncological treatment. KRAS/RAS mutation were determined in 73 patients and the EGFR expression status in 53 patients. Conclusions: Colorectal cancer patients are a heterogeneous group with differential clinical, pathological and molecular features. 1. Therapeutic management of patients with colorectal cancer largely depends on its location, clinical and pathological stage, patients performance status and comorbidities. 2. Understanding the clinical features of patients with colorectal cancer becomes helpful in designing of screening, which take into account clinical profile of the patient, i.e. age, gender, comorbidities and anthropometric characteristics
EN
BACKGROUND Chronic kidney disease have a signifi cant impact on patient quality of life. The main aim of renal replacement therapy is not only extend life for patients, but also improve its quality. AIM OF THE STUDY The objectives of this study was evaluation of the quality of life of dialysis patients and after kidney transplantation, identifi cation of factors that aff ect the most essential quality of life scores in both groups and compare the quality of life in groups based on gender, age and education. MATERIAL AND METHODS The study was conducted on the basis of a questionnaire WHOQOL-Bref among 40 renal transplant patients (20 women and 20 men) aged from 22 to 64 years (the average was 46 years ± 13) and 80 patients undergoing hemodialysis (40 women and 40 men) aged from 22 to 76 years (the average was 60 years ± 12). RESULTS AND CONCLUSIONS Patients after kidney transplantation better rated their quality of life than dialysis patients across all surveyed areas. Socio-demographic factor, which is the greatest determined the quality of life scores in both groups was gender. In both groups, women better assess their quality of life. Age infl uence on the assessment of quality of life in patients after kidney transplantation: the younger patients (22–34 years), the higher rated quality of life. In both groups training does not aff ect the assessment of quality of life.
PL
WSTĘP Przewlekła choroba nerek znacząco wpływa na jakość życia chorego. Coraz doskonalsze metody leczenia, głównie substytucyjnego, takie jak dializoterapia i transplantacja, pozwalają obecnie wydłużyć życie pacjentom z niewydolnością nerek. Głównym celem terapii nerkozastępczej jest jednak nie tylko przedłużenie życia pacjentów, ale również poprawa jego jakości. CEL PRACY Celami pracy były ocena jakości życia pacjentów dializowanych i pacjentów będących po przeszczepie nerki, wyznaczenie czynników, które wpływają na ocenę jakości życia w obu badanych grupach oraz porównanie jakości życia w grupach w zależności od płci, wieku i wykształcenia. MATERIAŁ I METODY Badanie zostało przeprowadzone na podstawie kwestionariusza WHOQOL- Bref (WHO Quality of Life – BREF) w grupie 40 pacjentów po przeszczepie nerki (20 kobiet i 20 mężczyzn) w przedziale wiekowym 22–64 lat w średnim wieku 46 lat ± 13 oraz w grupie 80 pacjentów poddawanych hemodializie (40 kobiet i 40 mężczyzn) w przedziale wiekowym od 22 do 76 lat w średnim wieku 60 lat ± 12. WYNIKI I WNIOSKI Pacjenci po przeszczepie nerki lepiej ocenili jakość swojego życia w obrębie wszystkich badanych dziedzin w porównaniu do pacjentów dializowanych. Czynnikiem socjodemografi cznym, który w największym stopniu determinował ocenę jakości życia w obu badanych grupach, była płeć. Kobiety lepiej oceniały jakość swojego życia w porównaniu do badanych mężczyzn. Ocena jakości życia w grupie pacjentów po przeszczepie nerki dobrowykazała, że młodsi pacjenci (22–34 lata) wyżej ocenili jakość swojego życia. W obu badanych grupach wykształcenie nie miało wpływu na ocenę jakości życia.
EN
Co-occurrence of metabolic disorders is a recognized risk factor for the development of colorectal cancer which is currently the leading cause of morbidity due to malignant neoplasms in the world. The pathogenesis of colorectal cancer is not well understood yet. Among the postulated neoplastic mechanisms is the activation of insulin-like growth factors, with both epidemiological and clinical observations of their role. In this paper, the authors synthesize the current knowledge about the importance of activation of insulin-like growth factors in the development of colorectal cancer.
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Synchronous colorectal cancer

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EN
Colorectal cancer is one of the most common neoplasms worldwide. It is still characterized by high mortality and causes ¼ of deaths due to neoplasms. Synchronous cancer is defined as presence of more than one cancer focus (not metastatic) in a patient at the same time. Prevalence of synchronous cancer amounts to 1.1–8.1% of all colorectal carcinomas. More often it affects elderly people and men. Risk factors include inflammatory bowel diseases, hereditary non-polyposis colorectal cancer and familial adenomatous polyposis. Molecular mechanisms underlying the synchronous lesions are: microsatellite instability (MSI), P53 and KRAS mutations as well as glutathione S transferase mutations (GST). In this article, we present a case of a 76-year-old woman with synchronous colorectal cancer in the form of tumors of the sigmoid colon and the ascending colon with metastasis in the liver.
EN
Phosphatase and tensin homolog deleted on chromosome ten (PTEN) is a human suppressor gene. Its protein product is a bispecific phosphatase playing the complex role in the cell cycle regulating processes and apoptosis by the mechanism of signal transduction into the cell via tyrosine kinase B signaling pathway (PI3K/Akt/mTOR). Reduction or loss of PTEN function is implicated in the pathogenesis of many malignancies, including colorectal cancer. A gradual decrease in the function of PTEN in the sequence of transformations: normal tissue–polyp–adenocarcinoma – disseminated cancer was indicated. The relation between the PTEN loss and the higher clinical severity of colorectal cancer was observed, i.a. higher TNM status and higher tendency to form metastases, leading in some of the studies to shortened patients survival during the observation period. The potential predictive value of the PTEN function loss for the EGFR-targeted therapy in patients with advanced colorectal cancer is the subject of controversy. The potential application of PTEN assessment in clinical practice as a prognostic and/or predictive factor requires further well-designed prospective studies on larger patient population, using the unified methodology. The aim of the study is to summarize the current knowledge on the role of PTEN gene and PTEN protein in the pathogenesis of colorectal cancer and the role of PTEN in clinical practice.
EN
INTRODUCTION: Aging is a significant problem, arising from the current demographics. The health aspects of aging are described as major geriatric problems, but an important issue is also malnutrition, especially among social welfare home residents. Malnutrition is conditioned by many factors, inter alia by multidiseases. The aim of the study was to analyze the nutritional status of SWH residents depending on comorbidities, age and sex. MATERIALS AND METHODS: The analysis included 107 patients (72 women, 35 men) aged 65–99 years, residing permanently in an SWH. To assess their nutritional status, the Mini Nutritional Assessment and biometric indicators were used. Information about chronic diseases was also collected. The results were analyzed in the Statistica 10.0 program. RESULTS: Based on the data, it was found that only 22.4% of the group had a normal nutritional status, while as many as 33.7% suffered from malnutrition, and the results follow the same regardless of gender. The problem depends proportionally on the number of comorbidities and medication (p < 0.0001), whereas there was no association between poorer nutritional status and age of the patients (p > 0.05). CONCLUSIONS: This analysis show that malnutrition is result of multidiseases and medicines taken, and will also have a negative impact on the process of treatment of many chronic diseases.
PL
WSTĘP: Starzenie jest naglącym problemem wynikającym z aktualnej demografii. Aspekty zdrowotne starzenia opisywane są jako tzw. wielkie problemy geriatrii, ale ważnym zagadnieniem dotyczącym zwłaszcza pensjonariuszy domów pomocy społecznej (DPS) jest problem niedożywienia. Jest ono uwarunkowane wieloczynnikowo, a jednym z ważnych czynników jego jest wielochorobowość. Celem pracy jest analiza stanu odżywienia pensjonariuszy DPS w zależności od chorób współistniejących, wieku i płci. MATERIAŁ I METODY: Analizą objęto 107 badanych (72 kobiety, 35 mężczyzn) w wieku 65–99 lat, przebywających na stałe pod opieką DPS. Do oceny stanu odżywienia wykorzystano kwestionariusz Mini Nutritional Assesment oraz wskaźniki biometryczne. Zebrano także wywiad dotyczący chorób przewlekłych. Wyniki analizowano w programie Statistica 10.0. WYNIKI: Prawidłowy stan odżywienia charakteryzował tylko 22,4% zbadanej populacji, natomiast aż u 33,7% stwierdzono niedożywienie. Wyniki kształtują się podobnie, niezależnie od płci. Niedożywienie zależało od liczby chorób współwystępujących i przyjmowanych leków (p < 0,0001), natomiast nie było zależności między gorszym stanem odżywienia a wiekiem badanych chorych (p > 0,05). WNIOSKI: Przeprowadzona analiza wskazuje, że niedożywienie jest skutkiem wielochorobowości i stosowanych leków oraz może mieć negatywny wpływ na proces leczenia schorzeń przewlekłych.
EN
INTRODUCTION: Colorectal cancer (CRC) is one of the most common cancers in the world, accounting for 10% of the annual global cancer incidence. This malignant neoplasm can remain asymptomatic for a long time and, despite medical advances, is too frequently diagnosed too late. The YKL-40 protein is a growth factor that stimulates endothelial cell migration, and plays a role in inflammation and neoplasia. The aim of the study was to assess the significance of YKL-40 as a biomarker in CRC and to determine the correlation between the serum YKL-40 levels in CRC patients and selected clinical and pathological parameters. MATERIAL AND METHODS: In a prospective study involving 133 patients over the age of 50, the serum YKL-40 protein level concentration was determined by the ELISA method. The patients were divided into two groups: 91 with CRC and 42 healthy. For the statistical analysis Student's t-test for independent data, the Mann-Whitney U test, and logistics regression were used. RESULTS: The YKL-40 serum concentration was significantly higher in the CRC patients (163 ± 36 μg/l) than the healthy patients (54 ± 20 μg/l; p < 0.0001). There was a statistically significant difference in the serum YKL-40 concentration between the early and intermediate stages of CRC. There was no correlation between the clinical parameters, i.e. sex, age and BMI and the serum YKL-40 protein concentration in the people with CRC. CONCLUSIONS: The YKL-40 protein seems to be a promising CRC biomarker. Its serum concentration is correlated with the stage of the cancer depending on the depth of the growth relative to the submucosa and may be a prognostic factor for an adverse prognosis of this cancer.
PL
WSTĘP: Rak jelita grubego (colorectal cancer – CRC) jest jednym z najczęstszych nowotworów na świecie – odpowiada za 10% rocznej globalnej zapadalności na raka. Przez długi czas może pozostać bezobjawowy i mimo postępu medycyny zbyt często zostaje zdiagnozowany za późno. Białko YKL-40 jest czynnikiem wzrostu stymulującym migrację komórek śródbłonka, odgrywającym rolę w stanach zapalnych oraz nowotworowych. Celem pracy była ocena znaczenia YKL-40 jako biomarkera w CRC oraz określenie powiązań stężeń YKL-40 w surowicy u chorych na CRC z wybranymi parametrami kliniczno-patologicznymi. MATERIAŁ I METODY: W badaniu prospektywnym, obejmującym 133 osoby powyżej 50 roku życia, oznaczono stężenie białka YKL-40 w surowicy metodą ELISA. Pacjentów podzielono na dwie grupy: 91 osób chorujących na CRC oraz 42 osoby zdrowe. W analizie statystycznej wykorzystano testy t-Studenta dla danych niezależnych, U Manna-Whitneya i regresję logistyczną. WYNIKI: Stężenie YKL-40 w surowicy było znacznie wyższe u chorych na CRC (163 ± 36 μg/l) niż u osób zdrowych (54 ± 20 μg/l; p < 0,0001). U osób z CRC nie wykazano zależności między parametrami klinicznymi, tj. płcią, wiekiem i wskaźnikiem masy ciała (body mass index – BMI), a stężeniem białka YKL-40 w surowicy. U chorych z CRC stężenie YKL-40 w surowicy statystycznie istotnie różniło się we wczesnym i średniozaawansowanym stadium nowotworowym. WNIOSKI: Białko YKL-40 wydaje się obiecującym biomarkerem CRC. Jego stężenie w surowicy jest skorelowane ze stopniem zaawansowania nowotworu zależnie od głębokości nacieku w stosunku do błony podśluzowej i może być czynnikiem rokowniczo niepomyślnym dla tego nowotworu.
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