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Current evidence of sinonasal carcinoma for clinical practitioners. Part 2
No full textSinonasal carcinoma (SNC) is the most common malignant tumor of the nasal cavity and paranasal sinuses. Sinonasal carcinoma includes seven main histopatological subtypes and three most common have been presented in Part 1 of this manuscript. In the following, Part 2 of the manuscript the remaining four even more rare subtypes like olfactory neuroblastoma (ONB), sinonasal neuroendocrine carcinoma (snNEC), nuclear protein in testis carcinoma (NUT) and sinonasal undifferentiated carcinoma (snUC) are presented and discussed as to the epidemiology, etiology, clinical course, methods of treatment and outcome. It should be emphasized however that patients suspected of having a rare cancer should be directed to oncology centers with proven expertise in managing these uncommon malignancies.
The evaluation of serum magnesium and calcium/magnesium ratio in patients with breast cancer receiving adjuvant chemotherapy
No full textBackground: Magnesium (Mg) deficiency may promote tumor growth and metastasis, hence the need to monitor and possibly normalize its level during treatment is emphasized. Therefore, our study aimed to assess the effect of a six-week adjuvant chemotherapy on serum Mg and calcium (Ca)/Mg ratio in patients with breast cancer.
Materials and methods: The study included a group of 80 women with breast cancer who were qualified for adjuvant chemotherapy in the AC regimen (doxorubicin and cyclophosphamide). Serum magnesium and calcium levels were determined spectrophotometrically. Serum high-sensitivity C-reactive protein (hs-CRP) was measured using enzyme-linked immunosorbent assay (ELISA).
Results: In the postoperative period, decreased serum magnesium and increased Ca/Mg ratio were observed in breast cancer women compared to healthy controls. After six weeks of AC chemotherapy, magnesium levels increased significantly, reaching a lower reference value. The same trend was noticed for the Ca/Mg ratio, which increased slightly but remained higher than in the control group. In patients with higher values of hs-CRP after treatment, decreased serum magnesium level was observed.
Conclusions: Our study showed that the postoperative period is associated with magnesium deficiency in breast cancer patients. However, AC chemotherapy tends to normalize its concentration. During treatment, low magnesium concentration was associated with increased hs-CRP levels. This finding confirms that magnesium deficiency may induce inflammation, which has been implicated in tumor growth and metastasis. However, further research is needed to explain the role of magnesium in tumor development clearly
Two simultaneous anatomical variations of the cervical spine — a case report discussing the concept of tandem anomalies
Get PDFBackground: Arcuate foramen is an ossification of the posterior atlanto-occipital membrane, forming a bony opening through which the vertebral artery (VA) enters the vertebral canal. Block vertebra is a synostosis of at least 2 vertebral bodies that did not separate during the embryological development. It is worth distinguishing it from Klippel-Feil syndrome, as the latter oftentimes involves other abnormalities (namely skeletal) and is typically diagnosed in childhood. Both variants potentially lead to impairment of blood flow through the VA.
Case report: The following case report presents a finding of 2 anomalies of the cervical spine, found in a 38 y.o. female patient suffering from dizziness. A synostosis of the C4 and C5 vertebral bodies, arches, and zygapophysial (facet)joint was noted by the examining radiologist, with marked narrowing of the intervertebral foramen. Furthermore, a second anatomical variation in the form of the complete bilateral arcuate foramen was identified superior to the groovefor the VA on the upper surface of the posterior arch of the atlas.
Conclusions: To the best knowledge of the authors, this case report is the first to present a co-existing block vertebra and bilateral complete arcuate foramen. The common presence of at least 2 anatomical variations that could have a synergistic clinical effect could possibly be termed ‘tandem anomaly’. Notwithstanding, identification of a single anomaly explaining a patient’s symptoms does not absolve the medical professionals from searching for any other potential variations that could also be present and could further influence the clinical picture
Nivolumab with relatlimab in the treatment of melanoma patients — the position of the Section of Immuno-oncology of the Polish Society of Oncology
Get PDFTreatment of melanoma patients has undergone significant modification in recent years, resulting in improved outcomes. Still, the prognosis of patients with advanced stage or metastatic disease is not the best, and new therapeutic options are being sought. One direction of research is the combination of molecules with different mechanisms of action, the so-called fixed-dose combination (FDC) formulations, which are expected to improve the quality of life and safety of patients and provide improved treatment outcomes.
This article presents the position of the Immuno-oncology Section of the Polish Society of Oncology on the use of the combination of nivolumab and relatlimab in the treatment of patients with inoperable melanoma or metastatic disease.
Glycemic Variability as an Independent Predictor of 30-Day Mortality in Type 2 Diabetes Individuals with Sepsis in the Intensive Care Unit
No full textObjective: Diabetes individuals are more likely to develop dysglycemia in 72 hours after intensive care admission and are associated with mortality. This retrospective study aimed to determine the role of glycemic variability (GV) in mortality in individuals with type 2 diabetes (T2D) with sepsis in the intensive care unit (ICU). Materials and methods: Adult individuals diagnosed with sepsis or septic shock and T2D who were admitted to the ICU between January 2022 and June 2024 were include in the study. The GV parameters of mean amplitude of glucose excursion (MAGE) and the glucose coefficient of variation (GluCV) were used to determined survival at 30 days and length of stay (LoS). Acute Physiology and Chronic Health Evaluation-IV (APACHE-IV) and the Sequential Organ Failure Assessment (SOFA) score were used for comparison with the GV parameters for the survival outcome. Results: A total 233 individuals were included for final analysis, divided into high GV (39.48%) and low GV (60.52%) based on a cut-off MAGE of 65 mg/dL. The low-GV group had a significantly lower mortality rate (1.4% vs. 97.8%, p = 0.000). The was no significant difference in LoS using MAGE (p = 0.14), but the difference became significant using GluCV < 25% (p = 0.029). Multivariate analysis with linear logistic regression showed that APACHE-IV, SOFA, hypoglycemic episode, MAGE, and GluCV were independently associated with survival at 30 days. Survival analysis showed a significant difference in the estimated survival time for patients with low MAGE (29.65 vs. 4.24 days, p = 0.000). Conclusions: High glycemic variability was observed in 39% of individuals; it was associated with higher mortality in diabetic individuals with sepsis and was independently associated with high 30-day mortality
Pilot study on the development of digitally supported health promotion for seafarers on sea
No full textBackground: Seafarers are exposed to a variety of job-specific physical and psychosocial stressors. Health promotion on board is of great importance for the salutogenesis of this occupational group. Due to the difficult accessibility of seafarers, electronically supported health management can be highly valuable. However, surveys on the needs and interests of seafarers in health promotion regarding e-health applications have not yet been carried out.
Material and methods: This pilot study uses a cross-sectional design to assess the need for digital health promotion for seafarers on board. This need was derived from the individual responses of 73 crew members on 3 merchant ships on health as well as addictive behavior, sports, coping strategies, and the level of knowledge regarding health-related issues. Conspicuous parameters on mental health and fatigue were compared to the general population.
Results: It was found that 31.9% of seafarers were smokers and 80.6% were alcohol consumers. 82.4% of the seafarers practiced sport. The most common coping strategies for stress were calming down (44.6%), listening to music (32.1%), resting and sleeping (25.0%) and sports (25.0%). The evaluation of the PHQ-9 mental health questionnaires indicated that 85.4% of respondents had moderate to severe symptoms of a depressive mood. The average WHO-5 Well-Being Index resulted in level of 69.7% of the maximum possible score. Knowledge questions on health-related issues were answered correctly in less than 60% of cases. With regard to fatigue, there was an increased score for the Epworth Sleepiness Scale (ESS) in 33.8% and the Pupillary Unrest Index (PUI) was elevated in 47.7%.
Conclusions: Nicotine and alcohol consumption is higher among the participating seafarers compared to a reference population living on land. Various coping strategies for managing stress are already used in the daily live. However, there is a demand and interest in acquiring more knowledge about health-promoting behavior. The risk of daytime sleepiness and depression is elevated among seafarers. This leads to key issues that should be taken into account for preventive medicine, health promotion and possible digitally supported health management on board