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Macrophage activation syndrome (MAS) is one of the most severe complications of systemic juvenile idiopathic arthritis (sJIA). Around 10% of patients with sJIA exhibit systemic symptoms accompanied by macrophage activation syndrome (MAS), but it may occur subclinically in another 30-40%. In this article, we present a case of a 3-year-old girl diagnosed with sever MAS as an onset of sJIA complicated by disseminated intravascular coagulation (DIC). First symptoms of sJIA were observed about 5 months before setting the diagnose, and it was resembling urticaria. A comprehensive allergological diagnostics were conducted, but no cause for the skin changes was identified. A few weeks before admission to the hospital, the girl was presented with a high fever. During the hospital stay, viral, bacterial, and fungal infections were ruled out. However, the findings indicated significantly elevated markers of inflammation (ferritin, CRP, ESR) in the conducted tests. Meanwhile, swelling of the feet and ankle joints was also observed. Based on Ravelli criteria, we set the diagnosis of MAS in a course of sJIA. We implemented treatment with steroid pulses, followed by cyclosporine; however, her clinical condition did not improve. Despite intensive treatment, skin petechiae were observed twice, and laboratory tests revealed a very high INR along with an extremely low level of fibrinogen. The patient required multiple plasma transfusions and clotting factor administrations. Due to the severe condition of the girl, we initiated biological treatment with anakinra, after which the child's condition gradually improved. In this case, we want to present how dynamic and life-threatening the course of MAS can be. In the discussion, we are also comparing our approach and the applied treatment with the currently available knowledge.
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Antirreumáticos , Artrite Juvenil , Coagulação Intravascular Disseminada , Proteína Antagonista do Receptor de Interleucina 1 , Síndrome de Ativação Macrofágica , Humanos , Síndrome de Ativação Macrofágica/tratamento farmacológico , Síndrome de Ativação Macrofágica/etiologia , Síndrome de Ativação Macrofágica/diagnóstico , Feminino , Artrite Juvenil/tratamento farmacológico , Artrite Juvenil/complicações , Artrite Juvenil/diagnóstico , Pré-Escolar , Proteína Antagonista do Receptor de Interleucina 1/uso terapêutico , Coagulação Intravascular Disseminada/tratamento farmacológico , Coagulação Intravascular Disseminada/etiologia , Coagulação Intravascular Disseminada/diagnóstico , Antirreumáticos/uso terapêutico , Resultado do TratamentoRESUMO
Mitogen-activated protein kinase (MAPK) cascades are conserved signaling pathways that transduce extracellular signals into diverse cellular responses. Arabidopsis MAPKKK18 is a component of the MAPKKK17/18-MKK3-MPK1/2/7/14 cascades, which play critical roles in abscisic acid (ABA) signaling, drought tolerance and senescence. A very important aspect of MAP kinase signaling is both its activation and its termination, which must be tightly controlled to achieve appropriate biological responses. Recently, the ubiquitin-proteasome system (UPS) has received increasing attention as a key mechanism for maintaining the homeostasis of MAPK cascade components and other ABA signaling effectors. Previous studies have shown that the stability of MAPKKK18 is regulated by the UPS via the ABA core pathway. Here, using multiple proteomic approaches, we found that MAPKKK17/18 turnover is tightly controlled by three E3 ligases, UPL1, UPL4 and KEG. We also identified lysines 154 and 237 as critical for MAPKKK18 stability. Taken together, this study sheds new light on the mechanism that controls MAPKKK17/18 activity and function.
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Proteínas de Arabidopsis , Arabidopsis , Arabidopsis/metabolismo , Ubiquitina-Proteína Ligases/metabolismo , Ácido Abscísico/metabolismo , Proteínas de Arabidopsis/metabolismo , Proteômica , Complexo de Endopeptidases do Proteassoma/metabolismo , Ubiquitina/metabolismo , MAP Quinase Quinase Quinases/metabolismoRESUMO
Wound healing is a complex process influenced by age, systemic conditions, and local factors. The wound microbiota's crucial role in this process is gaining recognition. This concise review outlines wound microbiota impacts on healing, emphasizing distinct phases like hemostasis, inflammation, and cell proliferation. Inflammatory responses, orchestrated by growth factors and cytokines, recruit neutrophils and monocytes to eliminate pathogens and debris. Notably, microbiota alterations relate to changes in wound healing dynamics. Commensal bacteria influence immune responses, keratinocyte growth, and blood vessel development. For instance, Staphylococcus epidermidis aids keratinocyte progression, while Staphylococcus aureus colonization impedes healing. Other bacteria like Group A Streptococcus spp. And Pseudomonas affect wound healing as well. Clinical applications of microbiota-based wound care are promising, with probiotics and specific bacteria like Acinetobacter baumannii aiding tissue repair through molecule secretion. Understanding microbiota influence on wound healing offers therapeutic avenues. Tailored approaches, including probiotics, prebiotics, and antibiotics, can manipulate the microbiota to enhance immune modulation, tissue repair, and inflammation control. Despite progress, critical questions linger. Determining the ideal microbiota composition for optimal wound healing, elucidating precise influence mechanisms, devising effective manipulation strategies, and comprehending the intricate interplay between the microbiota, host, and other factors require further exploration.
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Microbiota , Cicatrização , Humanos , Inflamação , Queratinócitos , Antibacterianos/farmacologia , Antibacterianos/uso terapêuticoRESUMO
In northern peatlands, reduction of Sphagnum dominance in favour of vascular vegetation is likely to influence biogeochemical processes. Such vegetation changes occur as the water table lowers and temperatures rise. To test which of these factors has a significant influence on peatland vegetation, we conducted a 3-year manipulative field experiment in Linje mire (northern Poland). We manipulated the peatland water table level (wet, intermediate and dry; on average the depth of the water table was 17.4, 21.2 and 25.3 cm respectively), and we used open-top chambers (OTCs) to create warmer conditions (on average increase of 1.2°C in OTC plots compared to control plots). Peat drying through water table lowering at this local scale had a larger effect than OTC warming treatment per see on Sphagnum mosses and vascular plants. In particular, ericoid shrubs increased with a lower water table level, while Sphagnum decreased. Microclimatic measurements at the plot scale indicated that both water-level and temperature, represented by heating degree days (HDDs), can have significant effects on the vegetation. In a large-scale complementary vegetation gradient survey replicated in three peatlands positioned along a transitional oceanic-continental and temperate-boreal (subarctic) gradient (France-Poland-Western Siberia), an increase in ericoid shrubs was marked by an increase in phenols in peat pore water, resulting from higher phenol concentrations in vascular plant biomass. Our results suggest a shift in functioning from a mineral-N-driven to a fungi-mediated organic-N nutrient acquisition with shrub encroachment. Both ericoid shrub encroachment and higher mean annual temperature in the three sites triggered greater vascular plant biomass and consequently the dominance of decomposers (especially fungi), which led to a feeding community dominated by nematodes. This contributed to lower enzymatic multifunctionality. Our findings illustrate mechanisms by which plants influence ecosystem responses to climate change, through their effect on microbial trophic interactions.
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Sphagnopsida , Traqueófitas , Ecossistema , Sibéria , Europa (Continente) , Solo , ÁguaRESUMO
Perinatal hypoxia is a major cause of neurodevelopmental impairment and subsequent motor and cognitive dysfunctions; it is associated with fetal growth restriction and uteroplacental dysfunction during pregnancy. This review aims to present the current knowledge on brain development resulting from perinatal asphyxia, including the causes, symptoms, and means of predicting the degree of brain damage. Furthermore, this review discusses the specificity of brain development in the growth-restricted fetus and how it is replicated and studied in animal models. Finally, this review aims at identifying the least understood and missing molecular pathways of abnormal brain development, especially with respect to potential treatment intervention.
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Lesões Encefálicas , Feto , Gravidez , Humanos , Animais , Feminino , Feto/metabolismo , Hipóxia/metabolismo , Encéfalo , Retardo do Crescimento Fetal/genética , Retardo do Crescimento Fetal/metabolismo , Lesões Encefálicas/metabolismoRESUMO
Diffuse fasciitis with eosinophilia (EF) is a rare condition classified as a part of the connective tissue disorders. The clinical presentation of this condition can be diverse, however the main symptoms include symmetrical swelling and hardening of distal parts of limbs accompanied by peripheral eosinophilia. The diagnostic criteria are not specified. In inconclusions cases Magnetic Resonance Imaging (MRI) and skin to muscle biopsy may be useful. The pathogenesis and ethiology remain unknown, but extensive physical exertion, certain infectious factors, such as Borrelia burgdorferi, or medications may serve as a trigger. EF affects equally women and men, mainly in their middle age, however the disease can occur at any age. The standard therapy contents gluccocorticosteroids. As a second-line treatment, methotrexate is usually chosen. In this article we compare world reports of EF in paediatric patients with the cases of two adolescent male patients recently hospitalized in the Department of Paediatric Rheumatology.
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Eosinofilia , Fasciite , Pessoa de Meia-Idade , Adolescente , Humanos , Masculino , Feminino , Criança , Eosinofilia/complicações , Fasciite/diagnóstico por imagem , Fasciite/tratamento farmacológico , Pele/patologia , BiópsiaRESUMO
OBJECTIVES: Our study evaluates the impact of adjuvant treatment with external beam radiotherapy (EBRT) combined with vaginal high dose rate brachytherapy (HDR BT) on health related quality of life (HRQL) in patients with early stage endometrioid endometrial carcinoma. MATERIAL AND METHODS: From March 2019 to February 2021, 60 patients were enrolled with early stage endometrioid endometrial carcinoma, and qualified to adjuvant treatment after hysterectomy. HRQL was assessed using the EORTC QLQ-C30 questionnaire, with the endometrial cancer-specific HRQL module EORTC QLQ-EN24. Questionnaires were completed in four timepoints during adjuvant radiotherapy. RESULTS: A significant decrease in mean global health status / quality of life (p < 0.001) and role functioning (p = 0.028) was noted, as assessed in EORTC QLQ-C30 scale. Among the EORTC QLQ-C30 symptoms scales, significant differences were noted in the fatigue scale (p = 0.003), pain scale (p = 0.001), constipation scale (p < 0.001) and diarrhea scale (p < 0.001) over time. The EORTC QRQ-EN24 analysis showed significant deterioration in the urological symptoms scale (p < 0.001), gastrointestinal symptoms scale (p < 0.001) and in the mean pain in back and pelvis scale (p = 0.003). CONCLUSIONS: Adjuvant radiotherapy in patients with early-stage endometrioid endometrial cancer after hysterectomy is associated with worse quality of life, especially due to the toxicity of the treatment in relation to the gastrointestinal tract and urinary system.
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The aim of the study was to assess immunohistochemical CD34, podoplanin and Ki-67 expression in cervical tumour of patients with cervical squamous cell carcinoma (SCC) staged IIB and IIIB, a relationship with selected clinical and histological parameters and its prognostic significance. This prospective study included 52 patients. Microvessel density (MVD) by CD34, lymphatic vessel density (LVD) by podoplanin and the Ki-67 index in specimens from paraffin blocks with cervical SCC tissues were examined. The relationship between these data and selected clinical and histological parameters was analysed. Positive correlation of MVD and the Ki-67 index was observed. No correlation was observed for MVD, LVD and the Ki-67 index in the tumour with staging, grading, length of treatment and squamous cell carcinoma antigen (SCC-Ag) concentration before and after treatment. The expression of MVD, LVD and the Ki-67 index in cervical SCC did not contribute to the risk of relapse and cancer-related death. No relationship was found for MVD, LVD and the Ki-67 index in cervical tumour of patients with locally advanced cervical SCC with staging, grading and serum SCC-Ag level. MVD, LVD and the Ki-67 index in the tumour did not contribute to the risk of relapse or cervical SCC-related death.Impact StatementWhat is already known on this subject? In many patients, invasive cervical squamous cell carcinoma (SCC) is diagnosed in a locally advanced stage, when the prognosis depends on many well-known factors connected with tumour biology, staging and general condition of the patient. Despite numerous studies, the value of immunohistochemical CD34, podoplanin and Ki-67 expression in cervical tumour of these patients is still not well defined.What do the results of this study add? In our prospective study, no relationship for microvessel density (MVD), lymphatic vessel density (LVD) and the Ki-67 index in cervical tumour of patients with locally advanced cervical SCC with staging, grading and serum squamous cell carcinoma antigen (SCC-Ag) level was found. Additionally, MVD, LVD and the Ki-67 index in the tumour did not contribute to the risk of relapse or cervical SCC-related death.What are the implications of these findings for clinical practice and/or further research? Our study underlines the limited value of immunohistochemical CD34, podoplanin and Ki-67 expression in cervical tumour of patients with locally advanced cervical SCC. Further research should be focussed on identifying and validating novel prognostic and predictive factors.
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Carcinoma de Células Escamosas , Vasos Linfáticos , Neoplasias do Colo do Útero , Feminino , Humanos , Antígenos CD34 , Carcinoma de Células Escamosas/patologia , Células Epiteliais , Antígeno Ki-67 , Vasos Linfáticos/patologia , Glicoproteínas de Membrana , Recidiva Local de Neoplasia/patologia , Estadiamento de Neoplasias , Prognóstico , Estudos Prospectivos , Neoplasias do Colo do Útero/patologiaRESUMO
PURPOSE: The aim of the prospective study was to assess changes during treatment and prognostic significance of cervical vascularization density in patients with cervical squamous cell carcinoma (SCC) staged II B and III B and to find relationship of cervical vascularization density with tumour diameter, grading, staging and age of patients. METHODS: The study group included 50 patients who underwent transvaginal Doppler ultrasonography prior to chemoradiotherapy, after external beam radiation therapy (EBRT) and 6 weeks after HDR brachytherapy. The colour Doppler (CD) vascularity index (CDVI) and the power Doppler (PD) vascularity index (PDVI) in cervical tumour were examined. RESULTS: CDVI and PDVI values decreased significantly during radiotherapy (0.13 (95% CI 0.09-0.16); 0.09 (95% CI 0.07-0.11) and 0.05 (95% CI 0.03-0.06) for CDVI (p < 0.001) and 0.26 (95% CI 0.22-0.31); 0.18 (95% CI 0.14-0.22) and 0.08 (95% CI 0.06-0.11) for PDVI (p < 0.001)). No statistically significant associations of CDVI and PDVI with tumour diameter, grading, staging and age of patients were found. The higher (above median) CDVI values before EBRT were associated with better OS (p = 0.041). The higher (above median) PDVI values before EBRT were associated with superior DFS (p = 0.011) and OS (p < 0.001). DFS and OS did not differ significantly regarding CDVI and PDVI values after EBRT and after the treatment. CONCLUSIONS: In the study group, cervical vascularization density evaluated in CD and PD functions did not depend on tumour diameter, grading, staging and age of patients and decreased during radiotherapy. The prognosis for our patients with CDVI and PDVI before the treatment above the median value was better than compared to patients with these parameters below the median value.
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Braquiterapia , Carcinoma de Células Escamosas , Neoplasias do Colo do Útero , Carcinoma de Células Escamosas/diagnóstico por imagem , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/terapia , Cor , Células Epiteliais/patologia , Feminino , Humanos , Estadiamento de Neoplasias , Estudos Prospectivos , Ultrassonografia Doppler , Neoplasias do Colo do Útero/diagnóstico por imagem , Neoplasias do Colo do Útero/patologia , Neoplasias do Colo do Útero/terapiaRESUMO
OBJECTIVES: Our study evaluates the impact of adjuvant treatment with external beam radiotherapy (EBRT) combined with vaginal high-dose-rate brachytherapy (HDR BT) on health-related quality of life (HRQL) in patients with early-stage endometrioid endometrial carcinoma. MATERIAL AND METHODS: We assessed HRQL of patients based on the EORTC QLQ-C30 questionnaire, with endometrial cancer specific HRQL module - EORTC QLQ-EN24. From March 2019 to April 2020 we enrolled 20 patients with early-stage endometrioid endometrial carcinoma, qualified for adjuvant treatment after hysterectomy. We compared the scores measured with the questionnaires at the beginning and at the end of the treatment. RESULTS: There was a statistically significant decrease in the mean of global health status/quality of life assessed according to the EORTC QLQ-C30 scale, from 62.25 ± 13.12 at the beginning of the adjuvant radiotherapy to 55.85 ± 14.68 at the end of the treatment (p = 0.047). The mean appetite loss score was higher at the onset of the treatment as compared to its value after EBRT, 19.9 ± 27.33 vs 11.6 ± 19.52 (p = 0.043). Similarly to the mean constipation score, which was 29.85 ± 30.40 vs 11.6 ± 19.52 (p = 0.013). The mean diarrhoea symptom scale increased from 16.55 ± 20.16 to 56.75 ± 36.10 (p = 0.001). In the EORTC QLQ-EN24 scales, gastrointestinal symptoms scores were higher at the end of the treatment, (with the mean of 26.45 ± 22.76) as compared to 14.30 ± 16.52 at the beginning of EBRT (p = 0.003). CONCLUSIONS: Patients who receive adjuvant radiotherapy have decreased quality of life during the treatment reporting more serious gastrointestinal symptoms. The potential risk of treatment-related toxicity should be taken into account during the treatment planning process in order to minimize the deterioration of HRQL.
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We evaluated cervical volume and spectral Doppler parameters: peak systolic velocity (PSV), resistance index (RI) and pulsatility index (PI) in the tumour dominant vessel of 50 patients with cervical squamous cell carcinoma (SCC) staged IIB and IIIB and their changes during treatment. The patients underwent transvaginal Doppler ultrasonography prior to treatment, after external beam radiation therapy (EBRT) and 6 weeks after brachytherapy. Radiotherapy decreased cervical volume and PSV values of the tumour dominant vessel. The PSV values before EBRT in G1 + G2 tumours were higher than in G3 tumours. No correlations between cervical volume, PSV, RI and PI values with disease-free survival (DFS) and overall survival (OS) were found. We concluded, that sonographic assessment of changes in cervical volume of patients with locally advanced cervical SCC during treatment did not allow to predict treatment results. Spectral Doppler parameters PSV, RI and PI of tumour dominant vessel did not predict prognosis for these patients.Impact StatementWhat is already known on this subject? Transvaginal Doppler sonography is considered as a useful diagnostic method in patients with cervical carcinoma. However, despite numerous studies, the value of spectral Doppler parameters in tumour dominant vessel and cervical volume of patients with locally advanced cervical SCC is still not well defined.What the results of this study add? In our prospective study, we found that sonographic assessment of changes in cervical volume of patients with locally advanced cervical SCC during treatment did not allow to predict treatment results and spectral Doppler parameters of tumour dominant vessel did not predict prognosis for these patients.What the implications are of these findings for clinical practice and/or further research? Our study underlines the limited value of spectral Doppler technique in patients with cervical carcinoma. Further research should be focussed on identifying and validating novel prognostic and predictive factors.
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Carcinoma de Células Escamosas/irrigação sanguínea , Carcinoma de Células Escamosas/diagnóstico por imagem , Ultrassonografia Doppler , Neoplasias do Colo do Útero/irrigação sanguínea , Neoplasias do Colo do Útero/diagnóstico por imagem , Adulto , Velocidade do Fluxo Sanguíneo , Carcinoma de Células Escamosas/patologia , Colo do Útero/irrigação sanguínea , Colo do Útero/diagnóstico por imagem , Colo do Útero/patologia , Feminino , Humanos , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Tamanho do Órgão , Valor Preditivo dos Testes , Estudos Prospectivos , Fluxo Pulsátil , Taxa de Sobrevida , Carga Tumoral , Neoplasias do Colo do Útero/patologia , Vagina/diagnóstico por imagem , Resistência VascularRESUMO
Aim: Comparison of injuries to the facial and cerebral parts of the skull causing death and grievous bodily harm, resulting solely from punches to the facial area of the skull. Assessment and confrontation of both groups in terms of the final criminal-legal classification of the perpetrator's acts. Review of reasons for court judgements with a focus on the subjective elements of the prohibited act. Attempt to verify the hypothesis assuming that death or grievous bodily harm can be caused by a single punch to the facial part of the skull. Material and methods: Final judgements passed by criminal divisions of common courts of law in cases where death or grievous bodily harm was caused by injuries to the facial and cerebral parts of the skull resulting solely from punches to the facial area of the skull. Assessment of individual cases within each group to determine similarities and differences. Comparative analysis of both groups. Results: The cause of death in cases involving injuries to the facial part of the skull was rapid suffocation following blood aspiration into the respiratory tract. However, the criminal-legal classification of the perpetrators' actions in these cases was varied. In one case, death resulted from injuries to the cerebral part of the skull, which are extremely rare as a result of a punch to the facial area within the skull. Grievous bodily harm was due to the loss of vision in the eye, typically due to eyeball rupture. Conclusions: Even though the circumstances of the injuries were similar, different mechanisms were responsible for causing death and grievous bodily harm in the victims. The most severe consequences (death and grievous bodily harm) were not caused by injuries of the same type in any of the cases studied. A single punch to the facial part of the skull may be enough to lead to either grievous bodily harm or death, but the criminal-legal assessment of punching to the face can vary greatly.
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OBJECTIVES: Evaluate spectral Doppler parameters peak systolic velocity (PSV), end diastolic velocity (EDV), resistance index(RI) and pulsatility index (PI) in infiltrated and non-infiltrated uterine arteries of patients with locally advanced (stages II B,III B) squamous cell cervical cancer and their changes during treatment. MATERIAL AND METHODS: the study group included 36 patients aged 35-78 years old. At diagnosis, PSV, EDV, RI and PI inuterine arteries were examined and compared with MRI findings. All patients underwent transvaginal doppler ultrasonographyprior to the treatment, after external beam radiation therapy and six weeks after the last application of brachytherapy. RESULTS: The median PSV value in the first examination was higher in infiltrated uterine arteries than compared to non-infiltratedones (p = 0.001). The PSV values for all vessels decreased between the first and the third observation (p < 0.001).There was a significant difference in PI values between infiltrated and non-infiltrated uterine arteries between the first andthe third examination (p = 0.027). CONCLUSIONS: In patients with locally advanced cervical cancer of uterine arteries, assessment of PSV but not EDV, RI or PIcan be helpful in differentiating infiltrated from non-infiltrated vessels. In this group of patients, radiotherapy decreasesPSV, but not EDV, RI or PI values in uterine arteries. An observation conducted from the onset of radiotherapy to end ofthe follow-up in uterine arteries reveals that PI, but not RI, PSV or EDV, is different in infiltrated and non-infiltrated vessels.
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Carcinoma de Células Escamosas , Ultrassonografia Doppler , Artéria Uterina/diagnóstico por imagem , Neoplasias do Colo do Útero , Adulto , Idoso , Velocidade do Fluxo Sanguíneo/fisiologia , Carcinoma de Células Escamosas/irrigação sanguínea , Carcinoma de Células Escamosas/diagnóstico por imagem , Feminino , Humanos , Pessoa de Meia-Idade , Neoplasias do Colo do Útero/irrigação sanguínea , Neoplasias do Colo do Útero/diagnóstico por imagemRESUMO
AIM OF THE STUDY: The aim of the study was to evaluate the prevalence of effects equivalent to moderate and severe impairment to health within the meaning of the Penal Code in patients with zygomatico-maxillo-orbital fractures and isolated orbital floor fractures. In addition, the study addressed the possibilities of applying the presented results in the preparation of medicolegal opinions in cases provided for in Articles 158 and 160 of the PC with respect to evaluating the plausibility of inflicting such bodily injuries and causing moderate and severe health impairment. MATERIAL AND METHODS: The study covered a total of 124 patients operated on in the then Clinic of Cranio-Maxillofacial Surgery, Medical Academy of Lodz, in 1996-2001, because of fractures involving the inferior orbital wall including zygomatico-maxillo-orbital fractures (95 cases) and isolated orbital floor fractures (29 cases). The group was analyzed in a statistical and descriptive manner. RESULTS: All the study patients (100%) with both types of fractures involving the inferior orbital wall exhibit symptoms and disorders which, pursuant to the PC, would constitute at least moderate, or possibly even severe, impairment to health. CONCLUSIONS: Punches or kicks to the orbital region create a real danger of causing both types of orbital fracture under study, and resulting in at least moderate health impairment.
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Fraturas Maxilares/cirurgia , Traumatismos Maxilofaciais/cirurgia , Fraturas Orbitárias/cirurgia , Procedimentos de Cirurgia Plástica , Fraturas Zigomáticas/cirurgia , Implantes Absorvíveis , Feminino , Fixação Interna de Fraturas , Humanos , Masculino , Polônia , Estudos Retrospectivos , Resultado do Tratamento , Violência/legislação & jurisprudênciaRESUMO
INTRODUCTION: Parameters that will help to identify patients with better and worse prognosis are sought in subjects with locally advanced squamous cell cervical carcinoma. AIM OF THE STUDY: To assess the relationship between squamous cell carcinoma antigen (SCC-Ag) concentration and the risk of relapse in patients with squamous cell cervical carcinoma staged IIB-IIIB. MATERIAL AND METHODS: The study group consisted of 52 patients with cervical squamous cell carcinoma staged II B (n = 39) and IIIB (n = 13). Serum SCC-Ag concentration was assessed prior to radiochemotherapy or radiotherapy and four weeks after treatment. RESULTS: The follow-up after treatment ranged from 1 to 33 months (16.2 ±10.5). During follow-up, nine relapses were diagnosed (17.3%). The concentration of SCC-Ag before the treatment was elevated in 41 cases (78.8%) and in 11 cases (21.2%) it was ≤ 2 ng/ml. In all the patients with relapses SCC-Ag concentration before the treatment was elevated. Relapses were diagnosed in five patients with elevated SCC-Ag concentration after the treatment (55.6%) and in four patients with normal SCC-Ag concentration after the treatment (9.3%). There was a positive correlation between SCC-Ag concentration before and after the treatment and relapse occurrence. CONCLUSIONS: Evaluation of serum SCC-Ag concentration in patients with locally advanced squamous cell cervical carcinoma before treatment is a valuable supplementary diagnostic tool and patients with high SCC-Ag concentration are at an increased risk of relapse. Due to the relationship between elevated serum SCC-Ag concentration after treatment and increased risk of relapse, these patients may require a more intensive post-treatment follow-up.
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AIM OF THE STUDY: The aim of the paper is analysis of the impact of immobilization treatment of "less severe" motor organ injuries affecting soft tissues on the position of medical experts and court decisions in crimes against health. We also analysed the attitude of courts to expert opinions and present a proposal for a model of judicial and medical opinion in such cases. MATERIAL AND METHODS: In the study, we analysed judgments of the criminal divisions of common courts, in which the use of medical immobilization of a given part of the body or lack thereof could have an impact on the degree of health impairment determined by the medical expert. RESULTS: Some experts consider medical immobilization to be tantamount to an impairment of the function of a body organ, and the courts rarely reject such opinions. For some experts, the key is not the actual function of the immobilized part of the musculoskeletal system after 7 days from injury, but the immobilization treatment itself, and not the time it takes. In addition, experts determine the severity of injuries when immobilization is/is not used. CONCLUSIONS: The degree of health impairment, as defined in the Penal Code, should be determined by a medical check-up carried out 7 days after the injury, with an assessment of its "biological" effects, and not by the use of immobilization treatment and the time for which it is maintained.
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Prova Pericial/legislação & jurisprudência , Restrição Física/legislação & jurisprudência , Gestão da Segurança/legislação & jurisprudência , Medicina Baseada em Evidências/legislação & jurisprudência , Medicina Legal/legislação & jurisprudência , Humanos , Exame Físico/métodos , Polônia , Qualidade da Assistência à Saúde/legislação & jurisprudência , Violência/prevenção & controleRESUMO
Mitogen-activated protein kinase (MAPK) modules play key roles in the transduction of environmental and developmental signals through phosphorylation of downstream signaling targets, including other kinases, enzymes, cytoskeletal proteins or transcription factors, in all eukaryotic cells. A typical MAPK cascade consists of at least three sequentially acting serine/threonine kinases, a MAP kinase kinase kinase (MAPKKK), a MAP kinase kinase (MAPKK) and finally, the MAP kinase (MAPK) itself, with each phosphorylating, and hence activating, the next kinase in the cascade. Recent advances in our understanding of hormone signaling pathways have led to the discovery of new regulatory systems. In particular, this research has revealed the emerging role of crosstalk between the protein components of various signaling pathways and the involvement of this crosstalk in multiple cellular processes. Here we provide an overview of current models and mechanisms of hormone signaling with a special emphasis on the role of MAPKs in cell signaling networks. One-sentence summary: In this review we highlight the mechanisms of crosstalk between MAPK cascades and plant hormone signaling pathways and summarize recent findings on MAPK regulation and function in various cellular processes.
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OBJECTIVES: Uveitis and juvenile idiopathic arthritis (JIA) relatively often coexist. Inflammatory changes in the anterior segment of the eye are the most common extra-articular symptom in children with JIA, and JIA is, in turn, the main systemic cause of anterior uveitis in children. The aim of our study was to compare the course of anterior uveitis accompanying JIA and isolated uveitis. MATERIAL AND METHODS: We analyzed 25 children with JIA and uveitis (group I) and 28 children with isolated uveitis (group II). The study population was retrospectively selected from the patients treated in our center in the years 1998-2016 through a search of the hospital database. All data were presented as descriptive statistics. RESULTS: In group I there was a higher percentage of girls than in group II (64% vs. 50%) and uveitis occurred at a significantly younger age (8.7 years vs. 11.6). Patients from group I more often presented with immunological abnormalities (positive antinuclear antibodies or HLA-B27 antigen). The majority of children from group I developed uveitis prior to (44%) or simultaneously with (20%) arthritis. In patients who first presented with uveitis, arthritis appeared on average after 28 months (median 12 months). In children in whom arthritis developed first, uveitis appeared on average after 51 months (median 36 months). In some patients the time interval between the involvement of these two organs was as long as 9-10 years. Four children from group I and three from group II were qualified for biological treatment. CONCLUSIONS: The results of our analysis indicate the need for constant cooperation between the pediatric rheumatologist and the ophthalmologist. Although the risk of uveitis in JIA decreases with the disease duration, in some cases this complication can develop after many years. Children with present antinuclear antibodies, at younger age and of female gender should be subject to particularly close observation.
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The paper presents the case of an unexplained and the most mysterious death in the history of Polish Tatra tourism. It concerns three people of different ages and occurred on August 3, 1925 in the Valley of Jaworowa. Kazimierz Kasznica, his son Waclaw Kasznica and a newly discovered mountaineer Ryszard Wasserberger died suddenly for unknown reasons in 15 minutes during a mountain trek. This story is interesting due to the mysterious, simultaneous death of three people of different ages and due to the fact that Waleria Kasznica - the wife of Kazimierz and the mother of Waclaw Kasznica survived the journey. KEY WORDS.