Via Medica Journals
Not a member yet
55128 research outputs found
Sort by
The effect of bone marrow reticulin fibrosis degree at diagnosis on the success of intensive and reduced Intensity Induction therapy in de novo AML patients: retrospective single-center study
No full textIntroduction: This study aimed to investigate the potential effect of bone marrow reticulin fibrosis (BMF) on laboratory values, induction therapy success, and survival in patients with AML receiving either intensive remission induction chemotherapy (IC) or reduced-intensity chemotherapy (RIC).
Material and methods: A total of 178 patients diagnosed with de novo AML were included in the study between 2016 and 2023. Patients were categorized into two groups: IC and RIC. Induction treatment success, neutrophil and platelet recovery times, survival data, and improvement in fibrosis were compared between patients with and without BMF at the time of diagnosis.
Results: Among the 178 patients, 66.9% had grade ≥ 1 BMF at diagnosis. There was no statistically significant difference in laboratory data (peripheral leukocyte count, serum LDH level, and bone marrow blast percentage; P = 0.911, P = 0.147, and P = 0.723, respectively) between those with and without BMF. Remission rates after induction therapy were also similar (RIC: P = 0.523; IC: P = 0.421). No significant difference was found in neutrophil or platelet recovery times after induction therapy (IC patients: P = 0.910 and P = 0.260, respectively). There was no statistically significant difference in overall survival, relapse-free survival, or bone marrow transplantation rates between those with and without BMF (IC patients: P = 0.724, P = 0.429, and P = 0.616, respectively; RIC patients: P = 0.141, P = 0.157, and P = 1.0, respectively). The rate of regression in BMF grade was 17.5% in the IC group and 8.5% in the RIC group.
Conclusions: Regardless of treatment intensity in patients with de novo AML, BMF has been shown not to affect laboratory findings at diagnosis, induction treatment success, or survival outcomes
Cutaneous Rosai–Dorfman disease: a comprehensive literature review and two case reports
No full textIntroduction: Cutaneous Rosai–Dorfman disease is a rare form of histiocytosis. There are no established standards for its treatment, and some patients have minimal or no response. To date, no published reports have described disease progression in cutaneous Rosai–Dorfman disease in relation to specific treatment modalities.
Material and methods: The patients were examined at the Department of Dermatology of the Dr. Bogomolets Institute of Dermatology and Cosmetology in Kyiv, Ukraine. Ultrasound imaging was performed using a linear transducer. Dermoscopy was performed using a digital video dermatoscope. Formalin-fixed paraffin-embedded tissue samples were processed using standard protocols. Qualitative assessment of tissue morphology was performed using commercially available Series S histological stains (Epredia, Kalamazoo, MI, USA). Immunohistochemical staining was carried out using a ready-to-use anti-S100 antibody. A literature search was conducted via PubMed using the keyword combination ‘cutaneous Rosai–Dorfman disease’.
Results: Two cases of cutaneous Rosai–Dorfman disease in Caucasian female patients are reported. One patient exhibited disease exacerbation following rapid tapering of systemic corticosteroids and another one after exposure to doxycycline. Diagnosis was confirmed by histopathologic evaluation and S100-positive immunohistochemical staining.
Conclusions: Further clinical studies on the treatment of cutaneous Rosai–Dorfman disease, including data on therapeutic outcomes (complete and partial responses) and treatment-related exacerbations, are needed to optimize clinical management and improve patient outcomes
Hypercalcemia as a rare complication of chronic lymphocytic leukemia
No full textIntroduction: Hypercalcemia (HC) is a rare complication of chronic lymphocytic leukemia (CLL). Only a few cases have been reported, mainly in patients with advanced-stage disease or Richter’s transformation (RT) into aggressive lymphoma. The pathophysiological mechanisms include osteolytic bone lesions, humoral mediators such as parathyroid hormone-related protein (PTHrP), and abnormal calcitriol production.
Material and methods: A retrospective analysis was conducted on five CLL patients with concurrent hypercalcemia hospitalized at the Department of Hematooncology and Bone Marrow Transplantation, University Hospital in Lublin between 2023–2024 (0.8% of all CLL cases treated at our center during that time). Hypercalcemia was defined as a serum calcium concentration exceeding 2.75 mmol/L (11 mg/dL) on at least three separate measurements.
Results: The median time to HC diagnosis was 36 months ( IQR: 13–84) from the initial CLL diagnosis. Three patients had advanced-stage disease (Rai stage 4). Elevated PTH levels were observed in one patient. Histopathological analysis confirmed Richter’s transformation in one case. Chemotherapy was effective for one patient. Two of the five patients died during the course of hypercalcemia.
Conclusions: Hypercalcemia in CLL patients is a rare but serious manifestation. Diagnosis should prompt evaluation for RT or additional conditions. Prompt management is essential
Application of the low-FODMAP diet in endometriosis treatment
No full textEndometrioza to przewlekła choroba zapalna, która dotyka około 10% kobiet w okresie rozrodczym na całym świecie. Jej objawami są między innymi te o charakterze żołądkowo-jelitowym, na przykład wzdęcia, biegunki, zaparcia czy bóle podbrzusza. Stąd coraz większym zainteresowaniem wśród lekarzy, dietetyków i chorych cieszy się zastosowanie spersonalizowanej diety. Dieta low-FODMAP, której celem jest wyeliminowanie fermentujących węglowodanów, pozwala na zniwelowanie dolegliwości jelitowych. Dieta ta przyczynia się również do obniżenia poziomu markerów zapalnych (CRP, PGE-2), poprawia skład mikrobioty jelitowej i pochwowej oraz umożliwia przywrócenie równowagi komórkowej (Th17/Treg). W efekcie kobiety z endometriozą mogą odczuwać redukcję przewlekłego bólu miednicy i tym samym zwiększyć komfort codziennego funkcjonowania. Wydaje się, że to właśnie założenia diety low-FODMAP mogą stanowić ważny element wspierający kompleksową terapię leczenia endometriozy.Endometriosis is a chronic inflammatory condition affecting approximately 10% of women of reproductive age worldwide. Among the symptoms of the disease, gastrointestinal manifestations such as bloating, diarrhea, constipation, and lower abdominal pain are also common. This has led to growing interest among physicians, dietitians, and patients in the application of personalized diets. The Low FODMAP diet, which aims to eliminate fermentable carbohydrates, helps alleviate gastrointestinal discomfort. This diet also contributes to the reduction of inflammatory markers (CRP, PGE-2), improves the composition of the gut and vaginal microbiota, and restores cellular balance (Th17/Treg). As a result, women with endometriosis may experience a reduction in chronic pelvic pain, thereby increasing their overall quality of life. It appears that the principles of the Low FODMAP diet could be an important component in supporting the comprehensive treatment of endometriosis
The use of kinesiotaping in conjunction with selected physical therapy treatments in people with spinal pain complaints
No full textIntroduction: Spinal pain, particularly in the lumbar region, poses significant health and social challenges, negatively impacting patients' well-being. There is a need for effective, non-invasive treatments to reduce pain and improve the quality of life for those who experience it.
Objectives: This study aimed to evaluate the effectiveness of combining kinesiotaping with specific physical therapy treatments to reduce pain and improve range of motion in individuals with spinal pain.
Material and methods: The study was conducted on 120 patients with back pain, ranging in age from 35 to 88 years old. The patients were divided into two groups: a control group that received physical therapy treatments and a study group that received additional kinesiotaping. The VAS scale was used to assess pain, while the Thomayer’s test and the Ott’s and Schober’s signs were used to assess spinal mobility.
Results: Using kinesiotaping in conjunction with physical therapy was more effective at reducing pain and improving spinal mobility than using these methods separately. Significant associations were also found between age, body mass index (BMI), duration of symptoms, and pain levels and mobility.
Conclusions: A combination of kinesiotaping and physical therapy treatments is an effective approach for treating chronic spinal pain. This approach can complement standard physiotherapy
Endoscopic dacryocystorhinostomy (EnDCR) supported by surgical planning in virtual reality (VR) for posttraumatic nasolacrimal duct obstruction resulting from Le Fort fractures
No full textBACKGROUND: The objective was to present the outcomes of endoscopic endonasal dacryocystorhinostomy (EnDCR) supported by virtual reality (VR)-assisted surgical planning in post-traumatic nasolacrimal duct obstruction (NLDO) secondary to Le Fort fractures.
MATERIAL AND METHODS: A retrospective analysis was performed on three patients who underwent EnDCR at the Department of Ophthalmology, Military Institute of Medicine, Warsaw, over a 1.5-year period. Preoperative imaging included computed tomography dacryocystography (CT-DCG) processed using OsiriX MD™ (Pixmeo SARL, Switzerland) and Medical Imaging XR™ (Medicalholodeck AG, Switzerland) to generate three-dimensional (3D) reconstructions. Immersive surgical planning was performed in VR using Meta Quest Pro™ goggles (Meta Platforms Inc., USA). Standard EnDCR was performed with patient-specific intraoperative adaptations. Postoperative anatomical patency was assessed by syringing, and functional patency by the Munk scale.
RESULTS: In all three cases, complete anatomical and functional patency was achieved, with patients remaining symptom-free during a 12–30-month follow-up period. Preoperative VR-based 3D planning provided a detailed understanding of the altered post-traumatic anatomy, enabling safe modification of the surgical approach, particularly in the presence of metal implants and distorted bony landmarks. The use of 0.02% mitomycin C reduced the risk of restenosis and maintained ostium patency. No intra- or postoperative complications occurred.
CONCLUSION: Virtual reality–assisted surgical planning facilitates precise anatomical orientation and improves procedural safety in complex post-traumatic NLDO, particularly in the Le Fort setting. The integration of immersive technologies into preoperative planning may enhance surgical accuracy, support individualized interventions, and improve long-term outcomes in lacrimal drainage surgery
The COVID-19 pandemic in the light of rheumatic diseases
No full textPandemia COVID-19, wywołana przez wirusa SARS-CoV-2, miała istotny wpływ na pacjen-tów z chorobami reumatologicznymi. Infekcja SARS-CoV-2 może prowadzić do rozwoju lub zaostrzenia objawów takich schorzeń, co jest szczególnie widoczne w przypadku chorób takich jak: toczeń rumieniowaty układowy (SLE), twardzina układowa, zespół Sjögrena (ZS) czy po-krzywka naczyniowa.
W przypadku SLE, wirus SARS-CoV-2 może nasilać stan zapalny i prowadzić do zaostrzeń choroby. Zakażenie to może wywołać burzę cytokinową, której skutkiem jest aktywacja proce-sów prozakrzepowych i uszkodzenie małych naczyń. W twardzinie układowej, zakażenie CO-VID-19 powoduje nasilenie objawów choroby śródmiąższowej płuc oraz może prowadzić do błędnych diagnoz, gdyż objawy infekcji COVID-19 przypominają początkowe stadia twardzi-ny. W tych przypadkach powiązania między infekcją a chorobami autoimmunologicznymi wy-magają szczególnej uwagi w diagnostyce i leczeniu.
Zespół Sjögrena (ZS), choroba autoimmunologiczna, której charakterystycznymi objawami są suchość jamy ustnej i oczu, może ulec zaostrzeniu w przebiegu infekcji SARS-CoV-2. Badania na myszach wskazują na pogorszenie funkcji ślinianek w wyniku zakażenia, a także na poja-wienie się przeciwciał ANA i przeciwciał specyficznych dla ZS. Wśród pacjentów z COVID-19 zgłaszano również objawy suchości w jamie ustnej, co może sugerować, że jama ustna jest miejscem wnikania wirusa. Ponadto, w niektórych przypadkach, takich jak reakcje po szczepie-niu, wirus może wyzwalać objawy subklinicznego zespołu Sjögrena u osób predysponowa-nych.
Wśród pacjentów reumatologicznych istotne były również psychiczne i społeczne skutki pan-demii COVID-19. Pacjenci doświadczyli zwiększonego lęku, depresji oraz zaostrzenia obja-wów chorób reumatologicznych. Badania wskazują, że zaburzenia lękowe były powszechne wśród pacjentów reumatologicznych w różnych częściach świata, a aktywność fizyczna oraz spędzanie czasu na świeżym powietrzu pomogły zmniejszyć objawy psychiczne.
Infekcja SARS-CoV-2 prowadzi do silnej odpowiedzi immunologicznej, która może sprzyjać rozwojowi autoprzeciwciał i chorób autoimmunizacyjnych. Zjawiska te, w połączeniu z uszko-dzeniem śródbłonka i wzrostem aktywności prozakrzepowej, stanowią istotny element patoge-nezy związanej z COVID-19.The COVID-19 pandemic, caused by the SARS-CoV-2 virus, has had a significant impact on patients with rheumatic disorders. SARS-CoV-2 infection can lead to a de novo onset or exacerbation of symptoms of an existing rheumatic disease, particularly of systemic lupus erythematosus (SLE), systemic sclerosis (SSc), Sjögren’s syndrome (SS), and urticarial vasculitis.
In the case of SLE, SARS-CoV-2 infection may exacerbate inflammation and trigger disease flares. The infection can cause a cytokine storm, resulting in the activation of prothrombotic processes and damage to small blood vessels. In systemic sclerosis, COVID-19 infection worsens interstitial lung disease symptoms and may lead to misdiagnoses, as the COVID-19 infection symptoms resemble the early stages of scleroderma. In these instances, the relationships between infection and autoimmune diseases require particular attention in diagnosis and treatment.
Sjögren’s syndrome, an autoimmune disease char-acterized by dry mouth and dry eyes, may also be influenced by SARS-CoV-2 infection. Studies on mice suggest the impairment of salivary gland function due to infection, as well as the appearanece of ANA and Sjögren-specific antibodies. Among COVID-19 patients, dry mouth symptoms have also been reported, suggesting that the oral cavity might be a site of viral invasion. Additionally, in certain cases, such as post-vaccination reactions, the virus may trigger subclinical Sjögren’s syndrome in pre-disposed individuals.
The psychological and social effects of the COVID-19 pandemic on patients with rheumatological condi-tions were also significant. The patients experienced increased anxiety, depression, and exacerbation of rheumatological symptoms. Studies have shown that anxiety disorders were particularly common among rheumatological patients worldwide, and physical activity and spending time outdoors helped alleviate psychological symptoms.
SARS-CoV-2 infection leads to a strong immune response, which may contribute to the development of autoantibodies and autoimmune diseases. These phenomena, combined with endothelial damage and increased prothrombotic activity, are key elements of the pathogenesis of COVID-19
Advanced imaging of abdominal wall endometriosis: a case report highlighting panoramic ultrasound
No full textERRATUM: Methotrexate-associated oral mucositis in children with acute lymphoblastic leukemia
No full textMethotrexate is an antifolate widely used in oncology and rheumatology that plays an important role in the treatment of acute lymphoblastic leukemia in children. One of its most common side effects is oral mucositis, which is a general term for ulceration and inflammation of the mucous membrane of the mouth. It can severely affect a patient’s quality of life, causes poor nutrition, and may lead to discontinuation of the next course of chemotherapy. Oral mucositis typically develops a few days after chemotherapy infusion. Due to this risk, it appears reasonable to use preventive agents against oral mucositis before the inclusion of methotrexate in therapy. To date, clinical trials have examined the effectiveness of medications such as glutamine, palifermin, chlorhexidine, amifostine, cyclooxygenase-1 inhibitor, leucovorin or other methods including laser therapy and oral cryotherapy. There are also several methods used to control already established inflammation and reduce pain more effectively: laser therapy, platelet-rich plasma and platelet gel, taxifolin, film-forming and coating agents. A crucial role is played by supportive interventions involving analgesic treatment, including topical morphine and benzydamine and a modern approach to pain management – for example, the use of virtual reality
Episodes of hypoglycemia in patients with Parkinson’s disease — results of two-week continuous glucose monitoring
No full textAim of the study. Recent evidence suggests that Parkinson's disease (PD) and glucose metabolism disorders may share some common dysregulation pathways. This study sought to determine the incidence of hypoglycemic episodes in PD patients and identify associated risk factors for these events. Clinical rationale for the study. Hypoglycemia in PD, especially at night, is not well understood. This study quantified hypoglycemia in PD patients and identified autonomic dysfunction as a key risk factor, providing new insights for research into metabolic aspects of PD.
Material and methods. Thirty-five patients diagnosed with PD and 20 control subjects underwent a study consisting of a clinical and biometric assessment and two weeks of continuous glucose monitoring using the Freestyle Libre system to detect episodic hypoglycemia.
Results. Among PD patients, 18 (51.4%) had episodes of hypoglycemia, and 67.8% of the events occurred between 0:00 and 6:00 a.m. Compared to the control group, there were significantly more hypoglycemic episodes registered in PD patients (3.6/pt vs. 1.4/pt; p = 0.0006). Predictors of the occurrence of hypoglycemic episodes in the PD group were lower two-week average glycemic levels (OR: 0.85, p = 0.016), glycemic variability index (OR: 1.46, p = 0.02), and SCOPA-AUT scale score (OR: 1.23, p = 0.04).
Conclusions and clinical implications. Patients with PD are at higher risk of hypoglycemic episodes, especially at night and in the morning. Patients with autonomic dysfunction are at risk for hypoglycemic episodes. Recognizing hypoglycemic episodes can enhance the management of PD by enabling targeted interventions aimed at reducing glycemic variability