[Oncolytic viruses as a new way of treatment of neoplastic diseases]. / Wirusy onkolityczne najnowszym sposobem walki z chorobami nowotworowymi.

Despite the unceasing progression in chemotherapy, radiotherapy and surgery, neoplasms are still the second, after cardiovascular diseases, cause of death in the world. The creation of oncolytic viruses gives hope for increase of anticancer therapy effectiveness. Oncolytic viruses are the type of viruses that selectively infect and cause the lyse of tumor cells excluding normal cells. This mechanism allows to avoid the consequences of the possible replication of the virus, which having entered to the organism, replicates in organism's cells by using the DNA of host cells. The development of genetic engineering and molecular biology has enabled the creation of this kind of genetically modified viruses, which deprive them of their virulence. Currently, there are many clinical trials in progress including the use of oncolytic viruses in head and neck squamous cell carcinoma, thyroid cancer, colorectal cancer, liver cancer, melanoma and glioblastoma multiforme treatment. There are parallel studies in animals using the subsequent viruses. Oncolytic viruses treatment is generally well tolerated, without significant side effects. It is worth to point out that this method combined with chemotherapy and radiotherapy allows to reduce the use of therapeutic doses, which significantly reduces the toxicity of conventional treatment. Further clinical studies evaluating the efficacy and safety of oncolytic viruses will develop more effective and better tolerated therapeutic protocols in the future.

[Mental disorders in digestive system diseases - internist's and psychiatrist's insight]. / Zaburzenia psychiczne w chorobach przewodu pokarmowego - spojrzenie internisty i psychiatry.

Mental disorders accompanying digestive system diseases constitute interdisciplinary yet scarcely acknowledged both diagnostic and therapeutic problem. One of the mostly recognized examples is coeliac disease where patients endure the large spectrum of psychopathological symptoms, starting with attention deficit all the way down to the intellectual disability in extreme cases. It has not been fully explained how the pathomechanism of digestive system diseases affects patient's mental health, however one of the hypothesis suggests that it is due to serotonergic or opioid neurotransmission imbalance caused by gluten and gluten metabolites effect on central nervous system. Behavioral changes can also be invoked by liver or pancreatic diseases, which causes life-threatening abnormalities within a brain. It occurs that these abnormalities reflexively exacerbate the symptoms of primary somatic disease and aggravate its course, which worsens prognosis. The dominant mental disease mentioned in this article is depression which because of its effect on a hypothalamuspituitary- adrenal axis and on an autonomic nervous system, not only aggravates the symptoms of inflammatory bowel diseases but may accelerate their onset in genetically predisposed patients. Depression is known to negatively affects patients' ability to function in a society and a quality of their lives. Moreover, as far as children are concerned, the occurrence of digestive system diseases accompanied by mental disorders, may adversely affect their further physical and psychological development, which merely results in worse school performance. All those aspects of mental disorders indicate the desirability of the psychological care for patients with recognized digestive system disease. The psychological assistance should be provided immediately after diagnosis of a primary disease and be continued throughout the whole course of treatment.

[Antiangiogenic therapy of malignant pheochromocytoma and paraganglioma with the view to the recent scientific developments]. / Antyangiogenna terapia zLoSliwej postaci pheochromocytoma i paraganglioma w Swietle najnowszych doniesieN naukowych.

Pheochromocytoma is a very rare tumor that stems from chromaffin cells and usually develops in the adrenal glands. Its equivalent, which exists outside of the adrenal glands, is paraganglioma. Approximately 10-26% of pheochromocytoma is malignant, what poses a significant therapeutical problem, as its presence, together with an abundant production of catecholamines, may lead to a number of perilous complications, such as spinal cord oppression or the damage of organs, what is responsible for producing catecholamines. Due to the risk that the tumor is, it is essential to event new and effective ways of treatment. In case of malignant tumors stemming from chromaffin cells, much is expected from antiangiogenic medicine. Its functioning consists of stopping of the process of neovascularization, which is indispensable for the development of the tumor. Sunitinib - a tyrosine kinase inhibitor - is perhaps the most promising antiangiogenic medicine, whose effectiveness is currently being evaluated in 2nd phase clinical trials. Attempts are also being made to conduct treatment with the use of other medicine of similar functioning, such as: thalidomide, imatinib or evrolimus.

[Hyperthermic intraperitoneal chemotherapy as a new way of peritoneal metastases treatment]. / Dootrzewnowa chemioterapia perfuzyjna w hipertermii jako nowy sposób leczenia przerzutów nowotworowych do otrzewnej.

Peritoneal neoplastic disease may originate primarily from neoplasms developing in peritoneum or metastases of cancers mostly arising in digestive or female reproductive systems. Peritoneal neoplasia leads to a much poorer prognosis and in most cases the palliative care, which focus on gastrointestinal motility and patency, adequate analgesia and psychological care, is being introduced. Systemic chemotherapy is ineffective as a result of existence of physiological blood-peritoneal barrier that blocks hydrophilic chemotherapeutics. Nowadays there are attempts to eliminate this problem by performing cytoreductive surgery accompanied by hyperthermic intraperitoneal chemotherapy (HIPEC). Undoubtedly the possibility to gain high local concentration of chemotherapeutic directly in peritoneal cavity is primary advantage of this method. In the carried out clinical trials the efficiency of this procedure in prolonging patient life in a relatively good comfort was proven. This method is highly recommended in case of peritoneal metastases from colorectal cancer treatment. There are ongoing studies focused on proving the effectiveness of HIPEC in case of other types of neoplasms and use of that therapy as a prophylactic treatment before metastases occur.

[Radioiodine--today's trends in treatment of benign thyroid diseases]. / Radiojod--aktualne trendy w terapii lagodnych schorzen tarczycy.

Radioiodine therapy is a highly recognizable method of treatment of benign thyroid diseases. The therapy gains a widespread interest of research groups, which find it as a promising weapon against endocrine disorders caused by benign thyroid diseases. According to the latest scientific research, factors, previously thought to be impossible to modify (intra-individual variation in radiosensitivity), has become modifiable. This will allow to establish a dose, which will affect functioning of other organs in the smallest possible way and will minimize the risk of side effects. The word, radioiodine" may raise some concern among those who are not highly familiar with endocrinology, but in fact it is a safe method. It is worth to mention that, according to recent research, consumption of common food products can reduce or even prevent potential side effects of radioiodine treatment.

[Safety of bariatric surgery in women of childbearing age and its future impact on their offspring]. / Bezpieczenstwo operacji bariatrycznych u kobiet w okresie rozrodczym oraz ich pózniejszy wplyw na potomstwo.

Obesity is the greatest epidemic of the 21st century. Unfortunately, it is more and more common among young people, including women in reproductive age who may suffer from difficulties with conceiving, pregnancy complications and increased maternal-fetal risk in the perinatal period. As a result of poor effectiveness of conservative treatment of obesity, a new trend has emerged to use surgical methods, which show positive effects on patients'fertility. It has been proved that pregnancy among women after bariatric surgery is safer than for other obese women who didn't undergo this procedure. Moreover, children of mothers who were operated were less likely to suffer from cardiovascular complications, obesity and other metabolic disorders in the future. However, it is vital to have in mind the likelihood of side effects, which include mainly serious vitamins, micro-, and macronutrient deficiencies that usually leads to constant and lifelong supplementation and the need of medical supervision of the patient and her child.