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Słowa kluczowe cancer pancreas elderly outcomes

Abstrakt

Background: The older population is very heterogeneous with regard to the co-morbidity and the physical reserve. This can result in unacceptably high postoperative complications rates. Th erefore, the aim of the study was to review the literature regarding the outcomes of older patients treated for pancreatic cancer, including the usage of minimal invasive techniques.

Methodology: A review of the literature was carried out including studies on pancreatic cancer in older patients published between 2011 and 2016.

Results: Seventeen retrospective studies were included. The total number of patients was 9981 with the age range of 65 years and more. Studies on surgical treatment alone (1.4%), neoadjuvant/adjuvant treatment with or without surgery (89.4%) and palliative therapy (9.2%) were assessed separately. Appropriate comparison was diffi cult due to the retrospective character and heterogeneity of the study population. Mortality was low, yet there was a great diff erence in morbidity ranging from some percent to even 100% of the study population. Long-term results were poor.

Conclusions: The functional status, not the chronological age alone, is the factor limiting therapeutic options in older patients with pancreatic cancer.

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Autorzy i Afiliacje

Mateusz Gajda
Jakub Kenig

Abstrakt

The objectives of this study were to develop a framework of the collaboration network, operational

performance, and reverse logistics determinants on the performance outcomes of the

auto parts industry, and to study the direct, indirect, and overall effects of the factors that

influence the performance outcomes of the auto parts industry. This quantitative research

utilized a questionnaire as the tool for data collection, which was completed by the managers

in the auto parts industry from 320 companies. According to the analysis with the Structural

Equation Modeling (SEM), it was found that the collaboration networks, operational

performance, and reverse logistics positively affect the performance outcomes; whereas, the

collaboration networks mainly affect the development of organizations by causing performance

outcomes to continue growing unceasingly, including the enhancement of sustainable

competitive capacity and the operational results of the auto parts industry.

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Autorzy i Afiliacje

Phasit Phoosawad
Wanno Fongsuwan
Wawmayura Chamsuk
Josu Takala

Abstrakt

Melanoma is a highly malignant neoplasm with the most typical primary locations in the skin and eyeball and rarely reported in the other organs, including the gallbladder. More commonly metastases of melanoma of various primary sites to the gallbladder are observed. However, generally melanoma of the gallbladder is a rare entity with only 217 cases reported in the literature up to date. The paper summarizes knowledge on epidemiology, symptoms, laboratory and imaging findings, morphology, treatment options, and outcome of patients with both primary and metastatic melanoma to the gallbladder.
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Autorzy i Afiliacje

Paweł Bojar
1 2
Franciszek Burdan
3 4
Lech Wronecki
1
Justyna Szumiło
1

  1. Department of Clinical Pathomorphology, Medical University of Lublin, Lublin, Poland
  2. Department of Pathomorphology, Beskid Oncology Centre — John Paul II Memorial City Hospital in Bielsko-Biala, Bielsko-Biała, Poland
  3. Department of Human Anatomy, Medical University of Lublin, Lublin, Poland
  4. epartment of Radiology, St Johns’ Cancer Center, Lublin, Poland

Abstrakt

The effects of climate change are much more rapid and visible in the Arctic than in the rest of the globe. The Arctic is extremely attractive scientifically and cognitively. Therefore, polar regions may serve as some of the most captivating natural settings capable of engage society in discussions on environmental changes. The primary objective of this paper is to present selected initiatives implemented by the Institute of Geophysics, Polish Academy of Sciences that aimed to connect polar research with schools and society, and show evidence on their effectiveness, with special focus on pupils from primary and secondary schools. In this paper, an overview of the educational and science communication initiatives undertaken by the Institute of Geophysics PAS for schools and whole society is presented, with the focus on polar research. Next, some results of the evaluation studies for those projects, that conducted detailed impact assessment, are discussed. Based on the evaluation studies and on general not-structured feedback received from diverse audiences of Institute’s activities, positive impact of bringing polar research closer to the society was observed. Using the Arctic and polar research as a vehicle to inspire interest in science and to raise societal awareness of the environmental challenges in various groups of non-specialists may be a very effective mean of science communication.
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Autorzy i Afiliacje

Agata Goździk
1
ORCID: ORCID

  1. Institute of Geophysics, Polish Academy of Sciences, Księcia Janusza 64, Warszawa, 01-452, Poland

Abstrakt

Psychoterapia jako praktyka kliniczna oparta na danych naukowych jest stosunkowo młodą dziedziną. Definiując psychoterapię, zarysujemy kontinuum – od zastosowania metod psychologicznych do poprawy dobrostanu, do psychoterapii jako metody leczenia zaburzeń psychicznych wspartej badaniami empirycznymi. Omawiamy rodzaje badań nad skutecznością, tworzenie zaleceń dla praktyki. Na przykładzie prowadzonych w Polsce badań nad psychoterapią i farmakoterapią PTSD wskażemy na ważne pytania współczesnej psychoterapii dotyczące interpretacji wyników badań, bezpieczeństwa pacjenta, personalizacji leczenia i dróg rozwoju, ale też miejsca w systemie opieki zdrowotnej.
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Autorzy i Afiliacje

Agnieszka Popiel
1
ORCID: ORCID
Bogdan Zawadzki
2
ORCID: ORCID

  1. Centrum Badań Klinicznych i Doskonalenia Psychoterapii,Instytut Psychologii, Uniwersytet SWPS
  2. Wydział Psychologii, UniwersytetWarszawski

Abstrakt

Aim: The aim of this study was to assess long-term outcomes and complications associated with conservative and operative treatment of distal radius fractures and to determine if restoration of radio-graphic parameters influences functional outcomes.
Introduction: Distal radius fractures (DRFs) are common injuries associated with many complica-tions. Numerous studies suggest that operative treatment with anatomic reduction and restoration of radiographic parameters leads to better functional outcomes than nonsurgical treatment.
Materials and Methods: We enrolled 207 patients with isolated DRF (mean age 64 ± 17.9 years, women 150 (72.5%)) to our retrospective, single-center study (101 treated operatively, 106 treated non-operatively). There were no significant differences in sex, age, AO type fracture between study groups. After 3.9 ± 1.6 years (mean ± SD) clinical, functional and radiological assessment was conducted using Disabilities of the Arm, Shoulder and Hand (DASH), Patient Rated Wrist Evaluation (PRWE), 9-Hole Peg Test (9-HPT), grip and pinch strength tools.
Results: We found higher rates of malunion in nonoperative group (p <0.0001) and worse radiologic parameters such as volar tilt (p <0.0001), teardrop angle (p <0.0001) versus operative cohort. Nevertheless radiological parameters were not correlated with DASH and PRWE results. Moreover, patients aged 50 years and above treated operatively had similar functional outcomes (DASH, PRWE) to those treated nonoperatively.
Conclusions: Restoration of anatomic and thus radiologic parameters of radius may not be obligatory to achieve satisfactory functional outcome in patients with DRF aged 50 years or above. Patient is the most important ‘factor’ in determining appropriate and successful treatment method of distal radius fractures.
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Autorzy i Afiliacje

Jakub Marchewka
1 2
Jakub Szczechowicz
1
Wojciech Marchewka
3
Edward Golec
1

  1. Department of Physiotherapy, University of Physical Education, Kraków, Poland
  2. Department of Orthopedics and Trauma Surgery, 5th Military Hospital, Kraków, Poland
  3. Jagiellonian University Medical College, Kraków, Poland
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Abstrakt

Intensive hypoglycemic treatment is the strongest preventive strategy against the development of microvascular complications of type 2 diabetes (T2DM), including diabetic nephropathy. However, some antidiabetic drugs, i.e. sodium-glucose cotransporter-2 inhibitors (SGLT-2i) and glucagon-like peptide-1 receptor agonists (GLP1-RA) have an additional renoprotective effect beyond glucose control by itself. Similar, both SGLT-2i and GLP1-RA have been demonstrated to decrease the risk of adverse cardiovascular (CV) events in CV outcome trials. Nevertheless, there are relevant differences in CV and renal effects of SGLT-2i and GLP1-RA. First, SGLT2i reduced the incidence and progression of albuminuria and prevented loss of kidney function, while predominant renal benefits of GLP1-RA were driven by albuminuria outcomes. Second, the risk of heart failure (HF) hospitalizations decreased on SGLT2i but not on GLP1-RA, which gives priority to SGLT2i in T2DM and HF, especially with depressed EF. Third, either GLP1-RA (reducing predominantly atherosclerosis-dependent events) or SGLT-2i, should be used in T2DM and established atherosclerotic CV disease (ASCVD) or other indicators of high CV risk. In this review, we have briefly compared clinical practice guidelines of the American Diabetes Association (2020 and 2021 versions), Polish Diabetes Association (2020) and the European Society of Cardiology/European Association for the Study of Diabetes (2019), with a focus on the choice between SGLT-2i and GLP1-RA in patients with diabetic kidney disease.
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Bibliografia

1. American Diabetes Association: Microvascular complications and foot care: Standards of Medical Care in Diabetes-2021. Standards of Medical Care in Diabetes–2020. Diabetes Care. 2020; 43 (Suppl 1): S135–S151.
2. American Diabetes Association: Pharmacologic approaches to glycemic treatment: Standards of Medical Care in Diabetes-2020. Diabetes Care. 2020; 43 (Suppl 1): S98–S110.
3. American Diabetes Association: Pharmacologic approaches to glycemic treatment: Standards of Medical Care in Diabetes-2021. Diabetes Care. 2021; 44 (Suppl 1): S111–S124.
4. Williams D.M., Nawaz A., Evans M.: Renal outcomes in type 2 diabetes: A review of cardiovascular and renal outcome trials. Diabetes Ther. 2020; 11: 369–386.
5. Heerspink H.J.L., Stefánsson, B.V., Correa-Rotter, et al.: Dapagliflozin in patients with chronic kidney disease. N Engl J Med. 2020; 383: 1436–1446.
6. Jhund P.S., Solomon S.D., Docherty K.F., et al.: Efficacy of dapagliflozin on renal function and outcomes in patients with heart failure with reduced ejection fraction: Results of DAPA-HF. Circulation 2020 Oct 12; doi: 10.1161/CIRCULATIONAHA.120.050391.
7. Packer M., Anker S.D., Butler J., et al.: Cardiovascular and renal outcomes with empagliflozin in heart failure. N Engl J Med. 2020; 383: 1413–1424.
8. American Diabetes Association: Pharmacologic approaches to glycemic treatment: Standards of Medical Care in Diabetes-2019. Diabetes Care. 2019; 42 (Suppl 1): S90–S102.
9. Diabetes Poland (Polish Diabetes Association): 2020 Guidelines on the management of diabetic patients: A position of Diabetes Poland. Clin Diabetol. 2020; 9: 1–101.
10. Cosentino F., Grant P.J., Aboyans V., et al.: 2019 ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD. Eur Heart J. 2020; 41: 255–323.
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Autorzy i Afiliacje

Ewa Wieczorek-Surdacka
1
Andrzej Surdacki
2
Jolanta Świerszcz
3
Bernadeta Chyrchel
4

  1. Chair and Department of Nephrology, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
  2. Second Department of Cardiology, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
  3. Department of Medical Education, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
  4. Second Department of Cardiology, Institute of Cardiology, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland

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