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Oncological treatment-related cystitis — pathophysiology, diagnosis, and treatment
No full textRadiotherapy and chemotherapy are commonly used in the treatment of pelvic cancers, including prostate, bladder, cervical, and rectal malignancies. Despite progress in treatment planning and delivery, cystitis remains a frequent and challenging complication. It can occur in both acute and chronic forms and significantly affects patient quality of life. This review outlines the current knowledge on the pathophysiology, clinical manifestations, and diagnostic approaches to treatment-induced cystitis. The article also discusses available therapeutic options, such as preventive strategies, intravesical therapies, hyperbaric oxygen treatment, and invasive procedures. Greater emphasis on early recognition and tailored treatment strategies may help improve outcomes and reduce the burden of this complication
Immediate breast reconstruction in Poland — description of the protocol for the prospective, multicenter, cohort study PSSO_04 under the auspices of the Polish Society of Surgical Oncology
No full textBreast cancer is the most common cancer among women in Poland, and the number of annual diagnoses is projected to rise. Due to early detection and multidisciplinary treatments, over 60% of cases can undergo breast-conserving procedures. However, mastectomy remains necessary for 30–40% of patients. Immediate breast reconstruction (IBR) following mastectomy provides therapeutic, aesthetic, and psychological benefits, yet the best surgical techniques for IBR are still not well established.
The PSSO_04 study is a Polish multicenter research initiative to assess the availability of immediate breast reconstructions (IBR) in therapeutic and prophylactic mastectomies. The study will also evaluate surgical and oncological outcomes, as well as the quality of life, in eligible patients.
The study’s primary endpoint is to determine the IBR ratio across different procedures. Secondary endpoints will examine surgical complications, radical excision rates, and their relationship with patient quality of life. Data collection will include surgical techniques, patient demographics, and postoperative outcomes, analyzed using dedicated online tools for comprehensive data management.
The Polish Society of Surgical Oncology supports this study, which is expected to conclude by March 2028. The findings are anticipated to enhance breast reconstruction practices and improve patient care in Poland
One-year clinical outcomes in patients with acute coronary syndrome treated with clopidogrel versus prasugrel versus ticagrelor: Results of the Polish Registry of Acute Coronary Syndromes (PL-ACS)
No full textBackground: Efficient dual antiplatelet therapy is crucial in reducing adverse cardiovascular events in patients with acute coronary syndrome (ACS). Comparative effectiveness between clopidogrel, prasugrel, and ticagrelor remains unclear in real-world settings.Aims: The objective was to evaluate one-year clinical outcomes in ACS patients treated with clopidogrel, prasugrel, or ticagrelor using data from the Polish Registry of Acute Coronary Syndromes (PL-ACS).Material and methods: This retrospective cohort study analyzed 381 278 ACS patients from the PL-ACS registry from 2009 to 2022, who were treated with clopidogrel, prasugrel, or ticagrelor during hospitalization with a 12-month consistent regimen. The primary outcome was one-year all-cause mortality. Secondary outcomes included a composite of death, myocardial infarction, or stroke, and the net clinical outcome, a composite of all-cause death, myocardial infarction, stroke, and bleeding. Propensity score matching was applied to reduce confounding factors. Cox proportional hazards models were used for analysis.Results: Of 381 278 ACS patients, 332 338 (87.2%) were treated with clopidogrel, 5312 (1.4%) with prasugrel, and 43 628 (11.4%) with ticagrelor. After propensity score matching, prasugrel and ticagrelor reduced mortality compared with clopidogrel (hazard ratios 1.69 and 1.72, respectively; P <0.0001). Ticagrelor also showed superior net clinical outcomes compared with both prasugrel and clopidogrel.Conclusions: This large-scale study confirms better clinical outcomes of dual antiplatelet therapy with prasugrel or ticagrelor compared to clopidogrel in ACS, with ticagrelor demonstrating superiority over prasugrel in terms of net clinical outcome. Despite the high clopidogrel usage rate in Poland, these findings support the preference for ticagrelor or prasugrel in ACS
The HARMONY-CR study: Protocol and rationale for a randomized trial of harmonica-based breathing exercises in hybrid cardiac telerehabilitation
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Ovarian serous cystadenoma mimicking polycystic ovarian morphology in prepubertal girl: a case report and literature review
No full textBackground: Precocious puberty (PP) in girls is defined as the appearance of clinical signs of puberty before the age of eight. While central precocious puberty (CPP) is commonly idiopathic, peripheral precocious puberty (PPP) can be linked to estrogen-producing ovarian cysts or tumors. This study presents a rare case of ovarian serous cystadenoma mimicking polycystic ovarian morphology (PCOM) in a prepubertal girl, contributing to persistent hormonal disturbances and symptoms of PP. The objective is to highlight the diagnostic challenges and management strategies for such cases.
Methods: A retrospective case review was performed, detailing the clinical course, diagnostic imaging, laboratory findings, treatment decisions, and histopathological results. A literature review was conducted using the EMBASE and MEDLINE databases to compare this case with previously reported instances of ovarian cystadenoma associated with precocious puberty.
Results: A 15-year-old girl presented with persistent ovarian cysts and PP symptoms first noted at the age of 5. Initial imaging revealed enlarged ovaries with a polycystic appearance. Despite treatment with a GnRH analog, hormonal abnormalities persisted, with increasing estrogen and androgen levels. MRI demonstrated progressive ovarian enlargement with cystic transformation. Surgical intervention was performed at age 15, and histopathological examination confirmed serous cystadenoma. Following surgery, hormonal levels normalized, and clinical symptoms resolved.
Conclusions: This case illustrates an unusual presentation of ovarian serous cystadenoma mimicking PCOM and contributing to persistent precocious puberty. Given the diagnostic challenge, a multidisciplinary approach involving endocrinologists and gynecologists is essential. Early recognition, close monitoring, and appropriate surgical intervention are crucial to managing such rare cases effectively
Colposcopy in pregnancy
No full textColposcopy is a method of enhanced diagnostics of cervical dysplasia, aimed at preventing cervical cancer. Its role is the same in and out of pregnancy. It is often performed after obtaining abnormal results of cervical cytology or a test for human papillomavirus (HPV16 and HPV18), or any other abnormal findings such as polyps, or unexplained bleeding from the cervix. However, in pregnancy, the first screening test is still a cytological examination of the cervical smear. Colposcopy allows for the identification of suspicious lesions, which allows for a biopsy to be collected for histopathological evaluation. Biopsy is not recommended during pregnancy except for the detection of lesions suspected of being invasive. Colposcopy is minimally invasive, generally well tolerated and crucial for the early detection of cervical intraepithelial neoplasia (CIN) and other gynecological lesions. In pregnancy, this role is reduced to observing the cervix for the progression of lesions. Pregnancy-related lesions in the cervix sometimes make it difficult to assess the cervix effectively and reliably. Therefore, the experience of the physician performing colposcopy during pregnancy is of great importance. In this review we want to summarize the current data about colposcopy during pregnancy
