Journals of Rzeszow University - Open Journal System
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Factors affecting prognosis in high-intermediate risk endometrial cancer in according to ESMO/ESGO/ESTRO risk classification – FIGO 2023 analysis of survival outcomes and staging dynamics compared to the FIGO 2009 system
Get PDFIntroduction and aim. Accurate staging is essential for determining treatment strategies and predicting outcomes in endometrial cancer (EC). The FIGO staging system was updated in 2023 to incorporate histological and molecular features. This study evaluates the impact of the FIGO 2023 system on high-intermediate risk endometrioid EC cases and compares its prognostic value with the FIGO 2009 system.
Material and methods. A retrospective analysis of 140 high-intermediate risk endometrial cancer cases from two tertiary hospitals was conducted. Patients were reclassified using FIGO 2023, and staging shifts were analyzed. Survival outcomes, including overall survival (OS) and progression-free survival (PFS), were assessed using Kaplan-Meier analysis and log-rank tests. Univariate and multivariate regression analyses were performed to identify prognostic factors.
Results. Within this high-intermediate risk group, patients were stratified into three groups: group 1 (n=79) consisted of those with LVSI (+) Stage I, group 2 (n=17) included patients with LVSI (-) Stage IB grade 3, and group 3 (n=44) comprised individuals with Stage II. Based on age, a statistically significant difference was identified between group 1 and group 3 (p<0.05), while no statistically significant difference in BMI was observed among the groups (p>0.05). Additionally, there was a statistically significant difference among the groups concerning the type of surgery performed (p<0.05) Although no statistically significant difference in survival outcomes was observed, a trend toward improved risk stratification in OS was noted. Positive lymphovascular space invasion emerged as a key factor influencing upstaging.
Conclusion. FIGO 2023 provides a refined staging approach that better aligns with clinical outcomes. Larger prospective studies incorporating molecular profiling are needed to confirm its prognostic utility
The pleiotropic effects of liraglutide in obesity-linked diseases
Get PDFIntroduction and aim. Obesity, defined by a BMI ≥30 kg/m², is a global epidemic associated with increased mortality rates and an increased prevalence of chronic diseases. Such diseases include type 2 diabetes mellitus (T2DM), non-alcoholic fatty liver disease (NAFLD), cardiovascular disease (CVD), and polycystic ovary syndrome (PCOS), besides several mental health disorders. Liraglutide, a glucagon-like peptide 1 (GLP-1) analogue, is widely recognized for its efficacy in glycemic control and weight loss and this review aims to explore the pleiotropic effects of liraglutide in obesity-related diseases.
Material and methods. Literature search was performed between 2022 and 2024 using the following databases: PubMed (MEDLINE) and Google Scholar. The comprehensive review of the literature focused on the action of liraglutide on NAFLD/ NASH, CVD, mental disorders, and PCOS. A qualitative synthesis of the data focusing on efficacy of liraglutide in obesity-related disease outcomes was performed.
Analysis of the literature. Liraglutide improves metabolic outcomes by promoting weight loss, reducing appetite, and improv ing glycemic control. In NAFLD/NASH, liraglutide reduces intrahepatic fat, liver fibrosis, and inflammation that strongly relate to the degree of weight loss. The LEADER trial showed its cardiovascular benefits in terms of reducing all-cause mortality and major cardiovascular events in patients with T2DM, although its chronotropic effects may pose risks in patients with heart fail ure. In women with PCOS, liraglutide reduces hyperandrogenism, insulin resistance, and body weight, and thus has even more favorable effects compared with metformin. Liraglutide also counteracts antipsychotic-induced weight gain and improves metabolic markers in patients with severe mental disorders.
Conclusion. Liraglutide demonstrates significant pleiotropic effects apart from weight reduction, including improved hepatic metabolism, cardiovascular protection, and better outcomes in PCOS and mental health. While semaglutide and tirzepatide may offer enhanced efficacy, liraglutide remains a promising therapeutic option for managing obesity and its related comor bidities
Transient ischemic attacks – the role of arterial spin labelling
Get PDFIntroduction and aim. Transient ischemic attacks are usually diagnosed by clinical criteria. Arterial spin labelling (ASL) is a noninvasive technique based on magnetic labeling of hydrogen ions in arterial blood with high sensitivity for the detection of oligemic areas in the corresponding cerebral hemisphere to the clinical phenotype. The aim is to demonstrate hypoperfusion using Arterial spin labelling techniques in TIA cases with the objective of intervening with appropriate methods to stop the stroke progression.
Description of the cases. The authors analyzed 90 cases of TIA in order to ultimately select four cases of clinical TIA with Arterial spin labelling to test the proof of concept.
Case 1. 47-year-old male with transient right-sided limb weakness and corresponding ASL hypoperfusion.
Case 2. 57-year-old male with recurrent transient ischemic symptoms and ASL showing hypoperfusion in the right parietal lobe.
Case 3. 73-year-old male with a high risk TIA and right parietal hypoperfusion on ASL that evolved into an infarct.
Case 4. 30-year-old female with a sensory TIA and hypoperfusion in the right cerebral hemisphere on ASL.
The hypothesis is that Arterial spin labelling will be able to demonstrate a penumbra in brain tissue in TIA cases which suggests likely progression to stroke and help in appropriate intervention to stop progression in real time. The following sequences were used during the brain MRI: diffusion-weighted imaging, fluid attenuated inversion recovery, apparent diffusion coefficient, and ASL sequences after written informed consent. Philips Ingenia 3Tesla machine obtains a 3D pseudocontinuous ASL sequence with a color coded map is obtained by Philips Ingenia 3 Tesla machine with a magnet weight of 4600 kg, 90-degree flip angle, and total duration of 3 minutes and 19 seconds. The authors present a series of 4 cases in which patients had clinical TIA and had hypoperfusion on ASL sequence correspond ing to the clinical manifestation depicting the penumbra. ASL hypoperfusion was assessed visually and cerebral blood flow (CBF) data was averaged to develop a visual CBF map.
Conclusion. Arterial spin labelling is a novel marker for hypoperfusion that indicates brain parenchyma under threat due to either stenosis in vessels of the cerebral circulation or embolic phenomenon
Comparison of falls and non-fall admissions to the emergency department in older adults and evaluation of the Barthel index and the Falls Efficacy Scale International scores
Get PDFIntroduction and aim. The aim of this study was to describe the characteristics of patients aged 65 years and older who expe rienced falls and to examine the distribution of the Barthel index (BI) and Falls Efficacy Scale International (FES-I) scores.
Material and methods. Participants over 65 years of age who were admitted to the emergency department (ED) between 31.07.2019 and 31.01.2020 and who met the inclusion criteria were included in the study. Characteristics, BI, and FES-I scores of patients admitted to the emergency department for falls and nontraumatic reasons were compared.
Results. The study was carried out with 259 participants, 133 in the fall group and 126 in the control group. The mean age was 79±8.3 years in the fall group and 76.3±7.9 years in the control group (p=0.011). In the fall group, 61 (46.2%) were male and 71 (53.8%) were females. The most common trauma after a fall was soft tissue trauma. The FES-I and BI scores were found to be at higher risk in the fall group aged 75-84 years compared to the control group and there was a statistically significant difference between them (p=0.009; p=0.030, respectively).
Conclusion. FES-I and BI did not show significant differences between fall and control groups in all age groups. In the 75-84 age group, both scales showed higher values in the fall group. We believe these scales can be used as follow-up tools in screening and preventing fall risks, especially in this age group
Identification of bacterial isolates in urinary tract infections patients of Basrah province
Get PDFIntroduction and aim. Urinary tract infections (UTIs) are among the most common bacterial diseases worldwide that are caused primarily by members of the Enterobacteriaceae family. This study aimed to identify the most frequent bacterial agents associated with UTIs and analyze their patterns of antibiotic resistance using the Vitek®2 system.
Material and methods. The study included 200 urine samples collected from adult UTI patients of both sexes.
Results. The characterization of bacterial isolates revealed the following distribution: Escherichia coli (35 isolates, 50%), Staphylococcus aureus (18 isolates, 25.7%), Klebsiella pneumoniae (5 isolates, 7.14%), Staphylococcus spp. (4 isolates, 5.7%), Streptococcus spp. (3 isolates, 4.2%), Pseudomonas spp. (3 isolates, 4.2%), and Proteus mirabilis (2 isolates, 2.86%). Antibiotic resistance testing showed that ceftazidime had the highest resistance rate (88.57%), while amikacin had the lowest (17.14%). Additionally, extended-spectrum β-lactamase (ESBL) production was detected in 35 E. coli isolates. Of these, 22 isolates (62.86%) tested positive for ESBL production, while 13 isolates (37.14%) were negative.
Conclusion. This study concluded that E. coli is the most prevalent bacterial species causing UTIs. Furthermore, the E. coli isolates demonstrated a high capacity for ESBL production, highlighting the need for effective antimicrobial management and monitoring
Postural, behavioural and cognitive effects of sit-stand desk use in primary school children – a crossover intervention pilot study
Get PDFIntroduction and aim. This study explores the effects of implementing stand-biased desks in a classroom setting on physical posture, cognitive performance, and attention in elementary school students aged 11 to 12 years old.
Material and methods. The study group consisted of 51 boys from 5th and 6th grades. A crossover intervention design was employed, where students alternated between using traditional and sit-stand desks over the course of the study lasting three months. Anthropometric measurements, posture assessments, and cognitive tests (the d2 Test of Attention and Stroop), were conducted at three intervals (T1/T2/T3): initial, mid-intervention, and post-intervention.
Results. During the intervention, significant changes were observed in anthropometric parameters, except for a decrease in body fat percentage. Cognitive testing revealed significant improvements in attentiveness and cognitive control when using the sit-stand desks. Specifically, the d2 test indicated enhanced concentration performance and test effectiveness, particularly when conducted in a standing position. The Stroop test also showed improvements in both time and corrected errors between the second and third assessments.
Conclusion. The findings suggest that sit-stand desks may associate with better weight distribution and improved posture, with positive effects on attentiveness and cognitive performance of schoolchildren
Zariaspa and the “Kunduz” Hoards
No full textPtolemy’s Geography contains extensive data on Bactria, the land above the Hindu Kush and south of the Oxus (Amu Darya). A comparison of his data with the events surrounding Alexander’s Anabasis has revealed contradictions regarding the locations of rivers and cities. The most significant difficulty concerned the location of a river called Ochus (Ωχος). We propose leaving the Ochus where Ptolemy knew it, namely as Balkhāb near Balkh. Furthermore, the city of Zariaspa is not considered a second name for Balkh, but is placed on the Oxus, south of Kobadian, following Ptolemy. A review of other places and rivers reinforces the impression that Ptolemy’s map of Bactria and the surrounding countries must be taken more seriously. If Zariaspa is located on the Oxus, then Alexander spent the winter of 329/328 BC there for military reasons. The imprisonment and possible execution of the last Achaemenid king, Bessus (Artaxerxes), at this location adds to the mythical character of the place where Alexander demonstrated his final conquest of the country.
It appears that Zariaspa, or a temple within it, represented Alexander’s presence, and that donations to the temple conferred legitimacy on all subsequent rulers throughout the Bactrian region. Under the controversial rulers Eucratides I, II, and Heliocles I, particularly large donations were made to the temple treasury. After the Yuezhi also conquered Bactria south of the Oxus, the non-Bactrian Indo-Greek rulers minted special coins with their portrait in the Attic style, which were donated almost exclusively in Zariaspa. A connection to Alexander could explain the rarity and numismatic peculiarity of the donations
Artabanos und die Meder
No full textArtabanos II, before becoming the Parthian Great King, served as regent or king of Greater Media, a key Parthian territory. This post was typically occupied by brothers or sons of the reigning Parthian king, suggesting that Artabanos was likely the brother or son of King Orodes III. The article challenges the frequent assumption in scholarship that Artabanos or Orodes belonged to a secondary branch of the Arsacid family, finding no substantive evidence for this view. It also disputes theories of Artabanos’ origins from Media Atropatene or eastern nomadic groups, arguing that he was undoubtedly an Arsacid on his father’s side. The article contextualizes the royal office in Greater Media as a customary position for prominent Arsacid princes and not as the basis for a lasting secondary dynasty. Ultimately, the author concludes that Artabanos’ right to the throne stemmed from his close kinship with the ruling dynasty and not from any external or secondary lineage, thereby calling into question models of Parthian aristocratic factionalism based on local or regional affiliations found in some modern interpretations
Parthian Weapons and Military Equipment: Some Remarks
No full textThis article examines the evolution and distinctiveness of Parthian weapons and military equipment, emphasizing the deep influence of “Skythian” (nomadic steppe) traditions on Arsakid warfare. The study reconstructs the technological transitions that accompanied the Parthian conquest of Iran and the emergence of their unique military art. Special attention is given to the composite bow – its design, innovations, and strategic role – tracing its origins from Skythian prototypes to more advanced, horn-reinforced variants widely used by Parthian mounted archers. The article also analyzes the adoption and spread of the four-horned saddle, a significant development in cavalry equipment that afforded greater stability for heavily armored horsemen (cataphracts), and explores the integration of long spears (kontos) in Parthian tactics, showing direct and indirect borrowings from both nomadic and Hellenistic influences.
Drawing on ancient literary sources, archaeological finds, and modern scholarship, Olbrycht underscores how the predominance of cavalry – particularly elite mounted archers and heavily armored lancers – was rooted in ongoing technological, tactical, and cultural exchanges between the Parthians and Central Eurasian steppe peoples. The article provides a comprehensive synthesis of weapon types, armor, and equestrian equipment, situating Parthian military innovations within the broader context of steppe and Hellenistic warfare. Ultimately, Olbrycht argues that the distinctive character and long-lasting success of the Arsakid military rested on the creative adaptation of steppe traditions, culminating in the rise of the Parthian cataphract and mounted archer as the dominant arms of the Arsakid Empire’s forces. Mounted warfare, which involved the extensive use of horse riders in military operations, revolutionized the art of war during ancient and early medieval times