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Wprowadzenie. Leczenie uzupełniające chorych na czerniaka z obecnością mutacji BRAF za pomocą terapii ukierunkowanej molekularnie
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Dermoscopy — 3rd Conference of the Section of Dermoscopy and Other Skin Imaging Techniques (DiTOS) of the Polish Dermatological Society — Programme
No full textClassification of hemostatic methods and their efficacy in placenta increta
No full textIntroduction: Placenta increta is a serious complication of pregnancy that needs a variety of intraoperative hemostatic methods to stop bleeding. However, the efficacy of different hemostatic methods is still not known. This study aimed to evaluate the efficacy of different hemostatic methods in placenta increta. Material and methods: A total of 187 placenta increta patients that underwent treatment at Xiangya Hospital Central South University from March 1, 2017 to January 31, 2021 were included in this retrospective study. Perioperative data of patients with placenta increta were retrospectively analyzed. The patients were distributed into two groups according to the hemostasis methods, namely permanent group (n = 29), permanent plus temporary group (n = 158). Permanent hemostasis included the subgroups of uterine hemostasis (e.g., uterine tamponade, B-Lynch suture, and uterine local suture) and vascular hemostasis (e.g., uterine artery ligation and internal iliac artery ligation). The clinical information and maternal-fetal outcomes of the groups and subgroups were analyzed. Results: A significant difference in blood loss was detected between the permanent hemostasis group and the permanent plus temporary hemostasis group. Compared with the uterine hemostatic, the vascular, and combined hemostatic methods had a significant reduction in postpartum blood loss (p < 0.05). No differences were found within these subgroups in the permanent plus temporary group. Pregnancy outcomes did not differ significantly among the subgroups. Conclusions: Vascular hemostasis and combined hemostasis may be better than uterine hemostasis alone for placenta increta without temporary hemostasis. Prospective and large-scale studies are needed to investigate long-term outcomes and confirm the efficacy of these hemostatic techniques
Pregnant women's knowledge of and attitudes toward pertussis, influenza and COVID-19 vaccination
No full textObjectives: Despite the robust scientific evidence supporting the safety and efficacy of vaccinations in preventing severe illness, complications, and death, trust in immunizations has been declining, among others, in a particularly vulnerable group, such as pregnant women. This study aimed to present women's attitudes towards vaccinations against pertussis, influenza, and COVID-19 during pregnancy, their knowledge of the subject, and their motivations for getting vaccinated. Material and methods: An anonymous, self-reported questionnaire developed for this study was distributed to postpartum women hospitalized at the Department of Obstetrics and Perinatology, Jagiellonian University Medical College in Cracow, Poland, between February and April 2023. Participants provided sociodemographic and obstetric information, reasons for getting vaccinated or not, and their sources of vaccination knowledge. Results: Women's primary motivation (96.4%) for vaccinating during pregnancy was to protect their children from severe cases of pertussis, influenza or COVID-19. Among the reasons for not getting vaccinated against pertussis and influenza during pregnancy, most patients cited the belief in the lack of necessity for vaccination (42.9%, 34.3% respectively), and in the case of COVID-19 — receiving the vaccine before pregnancy (27.6%). Obstetricians provided information about recommended vaccinations only to 49.3% of respondents. 64.2% of surveyed patients expressed a willingness to vaccinate their child in the future with both mandatory and recommended vaccines. Conclusions: Our results indicate that a lack of knowledge leads to an insufficient vaccination rate during pregnancy. We see a crucial role for physicians, especially obstetricians, in providing patient information while underlining undeniable benefits of maternal vaccination to the children’s health
Częstość występowania hiperkortyzolizmu u pacjentów z cukrzycą typu 2 i powikłaniami mikronaczyniowymi: prospektywne, kliniczno-kontrolne badanie obserwacyjne
No full textObjective: The goal of this study was to examine the prevalence of hypercortisolism in patients with type 2 diabetes (T2D), and the association of cortisol with microvascular complications. Materials and methods: This prospective observational case-control, single-center study included 107 patients with T2D. After evaluating their microvascular complications, the patients were divided into 2 groups. Group 1 consisted of 57 patients with complications, and group 2 consisted of 50 patients without. Serum 08h cortisol and adrenocorticotropic hormone (ACTH), 09h cortisol after a short dexamethasone test (DEX cortisol), traditional risk factors, and lipid and inflammatory profiles were determined and correlated among the 2 groups. Results: Prevalence of hypercortisolism in patients with T2D was 6.3%, in patients with complications it was 10.5%, and 2.0% in patients without complications. In group 1 we found higher basal cortisol and ACTH, and higher low-density lipoprotein cholesterol (LDL-C) and C-reactive protein (CRP) levels when compared to group 2 (p < 0.05). A more positive correlation of cortisol with CRP was found in group 1 compared to group 2 (rho = 0.255, p = 0.011). We did not find a significant difference in sex, body mass index (BMI), treatment modality, diabetes duration, triglyceride, or fibrinogen levels among the groups. Conclusions: Higher serum cortisol levels and higher prevalence of hypercortisolism were significantly associated with diabetic microvascular complications. Systemic inflammation indicators positively correlated with cortisol levels and microvascular complications. This suggests a potential connection between cortisol, inflammation, and microvascular complications in T2D. Further research is needed to clarify the causality of thisrelationship.Cel pracy: Celem niniejszego badania było określenie częstości występowania hiperkortyzolemii u pacjentów z cukrzycą typu 2 (T2D, type 2 diabetes) oraz związku między stężeniem kortyzolu a powikłaniami mikronaczyniowymi. Materiały i metody: Przedstawione badanie miało charakter prospektywnego, jednoośrodkowego kliniczno– kontrolnego badania obserwacyjnego z udziałem 107 pacjentów z T2D. Na podstawie oceny powikłań mikronaczyniowych pacjentów podzielono na 2 grupy: 57 pacjentów z powikłaniami (grupa I) i 50 pacjentów bez powikłań (grupa II). W obu grupach dokonywano pomiarów stężenia kortyzolu i hormonu adrenokortykotropowego (ACTH, adrenocorticotropic hormone) w surowicy o godzinie 8:00 rano, kortyzolu po teście supresji z użyciem deksametazonu (kortyzol DEX) o godzinie 9:00 rano, tradycyjnych czynników ryzyka oraz profili lipidowych i zapalnych, z następczym dokonaniem korelacji ww. pomiarów między grupami. Wyniki: Częstość występowania hiperkortyzolemii u pacjentów z T2D wynosiła 6,3% — u pacjentów z powikłaniami odsetek ten wynosił 10,5%, u pacjentów bez powikłań zaś 2,0%. W grupie I stwierdzono wyższe wyjściowe stężenia kortyzolu i ACTH oraz wyższe stężenie cholesterolu lipoprotein o niskiej gęstości (LDL-C, low-density lipoprotein cholesterol) i białka C-reaktywnego (CRP, C-reactive protein) w porównaniu z grupą II (p < 0,05). W grupie I w porównaniu z grupą II stwierdzono bardziej dodatnią korelację między stężeniami kortyzolu i CRP (ρ = 0,255, p = 0,011). Między grupami nie stwierdzono istotnych różnic w zakresie płci, wskaźnika masy ciała (BMI, body mass index), sposobu leczenia, czasu trwania cukrzycy, a także stężeń triglicerydów lub fibrynogenu. Wnioski: Wyższe stężenie kortyzolu w surowicy i większa częstość występowania hiperkortyzolemii były istotnie związane z powikłaniami mikronaczyniowymi cukrzycy. Wskaźniki ogólnoustrojowego stanu zapalnego dodatnio korelowały ze stężeniem kortyzolu i powikłaniami mikronaczyniowymi. Obserwacje te sugerują potencjalny związek między kortyzolem, stanem zapalnym i powikłaniami mikronaczyniowymi w T2D. Konieczne jest przeprowadzenie dalszych badań w celu wyjaśnienia przyczynowości tego związku
The development of a standardized earthquake emergency health kit using combined ABC-VED classification and considering local wisdom for disaster response in Indonesia
No full textINTRODUCTION: This research aims to develop a tailored earthquake emergency health kit (EEHK) for a population of 1,000 during the emergency response period for earthquake disasters in Indonesia by using combined always better control and vital, essential, and desirable (ABC-VED) classification and considering local wisdom in terms of herbal medicine options embedded in the package. This kit was designed for immediate post-earthquake delivery, incorporating adjustments for common illnesses without the need for rapid health assessments post-disaster. MATERIAL AND METHODS: This study employed a mixed-methods approach, combining quantitative and qualitative analyses to explore pharmaceutical logistics in earthquake disasters. Data triangulation was conducted through document reviews, historical data analysis, and expert insights. The combined ABC-VED methods were applied to classify and prioritize medical supplies based on criticality and cost, while also assessing the accessibility of these pharmaceutical commodities. RESULTS: A kit was developed comprising 171 medical and health supply items. The evaluation also considered Indonesia’s socio-cultural, local wisdom, beliefs, and habits context, leading to the inclusion of traditional herbal items deemed necessary in disaster situations. CONCLUSION: These findings can enhance health logistics preparedness in earthquake disasters, enabling the rapid delivery of kits. The EEHK serves as a guideline for the provision of medications by external parties, ensuring the effectiveness of pharmaceutical logistics. This is the first study to design a health kit specifically for post-earthquake diseases, considering direct distribution after earthquakes occur. It is ready for immediate use in primary healthcare services, such as field hospitals, health centers, and mobile clinics
