Perception of cancer in patients diagnosed with the most common gastrointestinal cancers.

BACKGROUND: Gastrointestinal cancers, including colorectal cancer, stomach cancer and pancreatic cancer are among the most common cancers in Poland. Cancer patients usually assess their quality of life much worse than the general population, while negative emotions associated with the illness may affect the results of treatment. METHODS: The study involved 378 patients with colorectal cancer, stomach cancer and pancreatic cancer, treated as outpatients at the Oncology Center - Maria Sklodowska-Curie Institute in Warsaw in 2013-2018. Standardized tools were used in the study: the Beliefs about Pain Control Questionnaire (BPCQ), the Pain Coping Strategies Questionnaire (CSQ), Approval Illness Scale (AIS), Mental Adjustment to Cancer (MiniMAC). The main goal of the study was to assess pain control, pain management strategies, illness acceptance and adaptation to cancer in patients with the most common gastrointestinal cancers. RESULTS: Patients with gastrointestinal cancers ascribe the greatest role in controlling pain to internal factors (M = 16.84, SE = .34), and the highest score in this area was obtained by patients with colorectal cancer (M = 17.33, SE = .35). The most frequently chosen strategy is declaring coping (M = 20.95, SE = .57), although patients with pancreatic cancer obtained a high score also in the area of catastrophizing (M = 17.99, SE = 1.14). The average value of illness acceptance for patients with gastrointestinal cancers was M = 25.00 (SE = .50) and it was the lowest in the group of patients diagnosed with pancreatic cancer (M = 23.41, SE = 1.16), and the highest in a group of people with colorectal cancer (M = 27.76, SE = .51). Patients with gastrointestinal cancers obtained the highest values of the MiniMAC test in the area of the fighting spirit (M = 21.30, SE = .25), characteristic mainly for patients with colorectal cancer. Patients with pancreatic cancer were characterized by high anxiety and helplessness/hopelessness. CONCLUSIONS: Patients with gastrointestinal cancers use different methods of pain control and pain coping strategies, with active behaviors being preferred by patients with colorectal cancer and destructive - by patients with pancreatic cancer. The majority of socio-economic variables, as well as the treatment method, affect the patients' behaviors.

Refusal to Take Sick Leave after Being Diagnosed with a Communicable Disease as an Estimate of the Phenomenon of Presenteeism in Poland.

OBJECTIVE: The purpose of this study was to estimate the prevalence of presenteeism in patients with communicable diseases in Poland. SUBJECT AND METHODS: This study was based on data from the medical records of 2,529 patients aged 19-64 years. All of the patients were diagnosed with communicable diseases. The inclusion criteria were based on implementing decision concerning communicable diseases made by the Commission of the European Union. Associations between refusal to take sick leave and patients' age, gender, and diagnosis in terms of the International Statistical Classification of Diseases and Related Health Problems (ICD-10) were tested. Linear regression analysis of the data acquired from the patients who agreed to take sick leave was further used to estimate the possible length of sick leave in patients who refused to take it. RESULTS: The number of patients who refused to take sick leave was 18.1%. The presenteeism rate was related to the age of patients (periods of sick leave were longer in older patients) and the ICD-10 diagnosis (largely in bacterial intestinal infections and measles). The estimated number of days spent on sick leave in patients who refused to take it, assuming that they made a different decision and complied with it, was in the range of 4-6 days. CONCLUSION: The prevalence of presenteeism in the case of communicable diseases in Poland is lower than in the general population. However, as the refusals to take sick leave took place in the case of potentially contagious diseases, the negative impact on productivity may be significant.

Non-endometrioid and high-grade endometrioid endometrial cancers show DNA fragmentation factor 40 (DFF40) and B-cell lymphoma 2 protein (BCL2) underexpression, which predicts disease-free and overall survival, but not DNA fragmentation factor 45 (DFF45) underexpression.

BACKGROUND: The expression of DNA fragmentation factor 45 (DFF45) and B-cell lymphoma 2 (BCL2) in glands of the normal human endometrium is related to phases of the menstrual cycle and decreases after menopause, whereas the expression of DNA fragmentation factor 40 (DFF40) is stable. Moreover, DF45, BCL2 and DFF40 underexpression has been reported in numerous malignancies, including uterine leiomyosarcomas. In this study, we aimed to investigate DFF45, BCL2 and DFF40 expression in endometrioid and non-endometrioid types of endometrial cancers (ECs). We also evaluated the correlations between DFF45, BCL2 and DFF40 expression levels and clinicopathological parameters and determined the value of these three proteins as prognostic markers of disease-free survival (DFS) and overall survival (OS). METHODS: Immunohistochemistry was performed to evaluate DFF45, BCL2 and DFF40 expression in 342 cases of ECs. Student's t-test, the Mann-Whitney U-test, and the chi-squared test were used for the statistical analyses as appropriate. The Cox-Mantel test, Cox's proportional hazard model, and relative risk analyses were used to evaluate associations between DFF40, DFF45, and BCL2 expression and clinicopathological characteristics. RESULTS: DFF40 and BCL2, but not DFF45, were significantly underexpressed in non-endometrioid and high-grade endometrioid ECs compared with low- and moderate-grade endometrioid ECs. Women with DFF40- and BCL2-negative tumors had higher risks of disease recurrence, lymph node involvement, lympho-vascular space infiltration, and deep myometrial invasion compared with women with DFF40- and BCL2-positive tumors. Additionally, women with DFF40- and BCL2-negative tumors had significantly lower OS and DFS than women with DFF40- and BCL2-positive tumors. A multivariable analysis of the model, including the clinicopathological characteristics and immunohistochemical results, showed that negative BCL2 expression, lymph node involvement, and high-stage and high-grade disease were independent predictors of OS, whereas negative BCL2 expression, lymph node involvement, and high-stage disease were independent predictors of DFS. CONCLUSIONS: Compared with low- and moderate-grade endometrioid ECs, non-endometrioid and high-grade endometrioid ECs showed significant DFF40 and BCL2 underexpression. The absence of DFF40 and BCL2 expression negatively affects DFS and OS. Further prospective studies are warranted to assess the potential utility of DFF40 and BCL2 as targets in the diagnosis or treatment of ECs.

Endometrial Polyps and Benign Endometrial Hyperplasia Have Increased Prevalence of DNA Fragmentation Factors 40 and 45 (DFF40 and DFF45) Together With the Antiapoptotic B-Cell Lymphoma (Bcl-2) Protein Compared With Normal Human Endometria.

DNA fragmentation factor 40 (DFF40) is a key executor of apoptosis. It localizes to the nucleus together with DNA fragmentation factor 45 (DFF45), which acts as a DFF40 inhibitor and chaperone. B-cell lymphoma (Bcl-2) protein is a proven antiapoptotic factor present in the cytoplasm. In this study, we aimed to investigate DFF40, DFF45, and Bcl-2 immunoexpression in endometrial polyps (EPs) and benign endometrial hyperplasia (BEH) tissue compared with that in normal proliferative endometrium (NPE) and normal secretory endometrium (NSE) as well as normal post menopausal endometrium (NAE). This study used archived samples from 65 and 62 cases of EPs and BEH, respectively. The control group consisted of 52 NPE, 54 NSE, and 54 NAE specimens. Immunohistochemistry was used to detect DFF40, DFF45, and Bcl-2. DFF40, DFF45, and Bcl-2 were more highly expressed in the glandular layer of EPs and BEH compared with the stroma, and this was not influenced by menopausal status. Both glandular and stromal expression of DFF40, DFF45, and Bcl-2 were significantly higher in EPs compared with NPE, NSE, and NAE. Glandular BEH tissue showed significantly higher DFF40, DFF45, and Bcl-2 expression than in NPE, NSE, and NAE. No differences in the glandular expression of DFF40, DFF45, and Bcl-2 were observed between EP and BEH tissues, while Bcl-2 stromal expression in BEH was significantly lower than in EPs. Glandular, menopause-independent DFF40, DFF45, and Bcl-2 overexpression may play an important role in the pathogenesis of EPs and BEH.

Ultrasound evaluation of inferior facial angle (IFA) in a population of normal fetuses at 11-13 weeks (+6 days) gestation.

Retrognathia is a common feature of many fetal anomalies that may be diagnosed during ultrasound examination. The most common method used for the diagnosis of this condition is the inferior facial angle (IFA). The existing reference ranges for IFA have been established for the fetuses at 18- 28 weeks gestation and may be not applicable in the first trimester. The aim of the study was to document changes of IFA from 11+0 to 13+6 weeks gestation, to verify the reproducibility of IFA calculations obtained by the same examiner and to investigate the possible association between IFA values at the first and second trimester scans. Material and Methods: A prospective study was performed in 512 singleton pregnancies during the first trimester ultrasound exam. IFA was calculated by measuring the angle made by the cross-section of a line orthogonal to the forehead at the level of nasofrontal suture and the line from the tip of the mentum to the anterior border of the more protrusive lip. In 100 cases, stored images were used to calculate IFA twice by the same examiner. In a second trimester scan, IFA was measured again in 215 fetuses. Results: The median IFA value at the time of the first trimester (IFA-1) was 880 (IQR: 8.0) and decreased with crown-rump length (CRL) and biparietal diameter (BPD). A moderate negative correlation was shown between IFA-1 and CRL (r= 0.3; p<0.001) as well as between IFA-1 and BPD-1 (r= 0.176; p=0.010). An intraclass correlation coefficient (ICC) of 0.87 (95% CI: 0.81 ­ 0.91) confirmed strong intraobserver agreement between two IFA measurements. In 215 fetuses that underwent a second trimester screening, the median IFA-2 was significantly lower compared to IFA-1(215) (750; IQR: 10.0 vs.870; IQR: 8.0; p<0.001), and there was no correlation between IFA1215 and IFA-2 (r= -0.024; p=0.731). Conclusions: In the first trimester, IFA decreases with CRL and BPD. When performed by the same operator, measurement of IFA is reproducible. There is no correlation between the IFA values in the first and second trimesters.

The influence of medical education level on the Jagiellonian University Collegium Medicum medical students' knowledge concerning oral hormonal contraceptive pills.

In December 2014 the authors carried out a research among Jagiellonian University Collegium Medicum medical students in a form of a questionnaire which consisted of two parts: personal information and multiple choice test concerning student's knowledge on OCPs. It showed that the level of medical education, defined as the year of study, increases student's knowledge about oral hormonal contraceptive pills. New program of study introduced from academic year 2012/2013 gives students wider knowledge on OCPs at earlier stage of education. Factors as female sex, usage of OCPs by student or his partner, positive attitude towards recommending OCPs to future patients show positive correlation with student's knowledge.

[The role of cytologic-colposcopic diagnostics in qualification to LEEP (loop electrical excision procedure)].

Loop electrosurgical excision procedure (LEEP) is both a diagnostic and a therapeutic method in cervical intraepithelial neoplasia (CIN). The key for the therapeutic effect is accurate diagnostics, in particular precise colposcopic localisation of CIN in the cervical area. It enables localising a lesion highly suspected of neoplasmatic character, excising a sample for histopathologic examination and making a pre-therapeutical diagnosis, as well as choosing optimal way of treatment. Colposcopic examination conducted in 115 women with inapropriate cytologic exam, i.e. HGSIL, revealed CIN-suspected image in all cases. Highly positive and statistically relevant correlation between results of colposcopic examination and histologial examination of samples excised with the use of high frequency electrosurgical loop in examined group was stated. Due to its efficiency, easy implementation, great tolerance and wide acceptance the procedure is widespread.

Age-related trends in anti-Mullerian hormone serum level in women with unilateral and bilateral ovarian endometriomas prior to surgery.

BACKGROUND: Endometriosis is a well-known cause of infertility, and the anti-Mullerian hormone (AMH) is an accepted biomarker of ovarian reserve and response to artificial reproductive technology procedures. The present study was a prospective analysis of age-dependent AMH serum concentration in women with bilateral and unilateral ovarian endometriomas before therapy onset compared with healthy controls. METHODS: This prospective cross-sectional study included 384 women aged 18-48 years. AMH serum concentration was assessed between days 3 and 6 of the menstrual cycle in 78 patients with bilateral and 157 patients with unilateral ovarian endometriomas and compared with 149 healthy controls. Ovarian endometriosis was confirmed histopathologically, and data were presented as medians with interquartile range (IQR). RESULTS: Stage III endometriosis was diagnosed in 53.2 %, stage IV in 18.3 %, stage V in 23.4 % and stage VI in 5.4 % of the patients. Patients with bilateral ovarian endometriomas showed the lowest median AMH levels compared with patients suffering from unilateral ovarian endometriosis (0.55; IQR: 0.59 vs. 2.00; IQR: 2.80; p < 0.001) and the control group (0.55; IQR: 0.59 vs. 2.84; IQR: 3.2; p < 0.001). Median AMH concentration values were not significantly different between patients with unilateral ovarian endometriosis and the healthy controls (2.00; IQR: 2.80 vs. 2.84; IQR: 3.2; p = 0.182). A strongly negative correlation between AMH levels and age was confirmed in healthy individuals (R = -0.834; p < 0.001) and women with unilateral ovarian endometriomas (R = -0.774; p < 0.001). Patients with bilateral ovarian endometriosis showed a significantly negative but only moderate correlation between AMH levels and age (R = -0.633; p < 0.001), which was significantly lower than in the healthy controls (R = -0.633 vs. R = -0.834; p = 0.006) but not in the patients with unilateral ovarian endometriosis (R = -0.663 vs. R-0.774; p = 0.093). Based on a multivariate regression analysis, only bilateral localization of ovarian endometrial cysts (p = 0.003) and patient age (p < 0.001), but not left/right localization of unilateral cyst or cyst volume, were negatively associated with AMH serum concentration. CONCLUSION: According to our data, unilateral ovarian endometriosis had a moderately negative and nonsignificant effect on AMH-based ovarian reserve evaluated prior to surgery, irrespective of age. In contrast, the ovarian reserve was significantly reduced in women with bilateral ovarian endometriomas.

Primary Vulvo-Vaginal Cancers: Trends in Incidence and Mortality in Poland (1999-2012).

BACKGROUND: The aim of this study was to determine the incidence, mortality rates and trends of vulvar and vaginal cancers in Poland. METHODS: Data were retrieved from the Polish National Cancer Registry. Age-standardised rates (ASRs) of cancer incidence and mortality were calculated by direct standardisation, and joinpoint regression was performed to describe the trends using the average annual percent change (AAPC). RESULTS: From 1999 to 2012, the number of diagnosed cases of vulvar cancer was 5,958, and the ASRs of incidence varied from 0.99 to 1.18, with a significant trend towards a decrease (AAPC -0.78; p < 0.05). The ASR of mortality varied from 0.39 to 0.62, with a slight but insignificant increase in trend (AAPC 0.72; p > 0.05). The ASR of vaginal cancer incidence varied from 0.21 to 0.31, while the ASR of mortality ranged from 0.09 to 0.22. This study also proved a significantly falling trend in vaginal cancer mortality (AAPC -4.69; p < 0.05) and a decreasing trend in vaginal cancer incidence (AAPC -1.67; p > 0.05). CONCLUSION: The rarity of vulvar and vaginal cancers as well as the decline in their incidence rates should not discourage further research on the epidemiology and treatment of these conditions.

[Carbon monoxide poisoning in pregnant woman]. / Zatrucie tlenkiem wegla u kobiety ciezarnej.

Carbon monoxide poisoning is one of the most frequent types of poisoning caused by gases. Exposure of a pregnant woman to carbon monoxide is connected with transmission of this gas to her fetus what may cause oxygen deficiency, and further, the damage to its organs. The article describes a case of carbon monoxide poisoning of a 28-weeks pregnant woman who was treated in a hyperbaric chamber. Therapy was successful and the woman gave birth to a healthy, full term infant. In case of poisoning to a pregnant woman the above seems to be the most advantageous solution.

[Adherence to disease-modifying antirheumatic drugs in patients with rheumatoid arthritis]. / Przestrzeganie wskazan lekarskich dotyczacych przyjmowania leków modyfikujacych przebieg choroby u pacjentów z reumatoidalnym zapaleniem stawów.

UNLABELLED: A close collaboration between doctor and patient is essential for optimization of treatment outcomes in patients with chronic disease. Nonadherence to disease-modifying antirheumatic drugs (DMARDs) in rheumatoid arthritis (RA) may contribute to treatment failure and result in loss of joint function. The aim of the study was to evaluate adherence to prescribed drug therapy by patients with RA 6 months after hospital discharge. The influence of age, sex, level of education and DAS28 score on compliance with treatment regimen was also evaluated. MATERIALS AND METHODS. A telephone survey was conducted using a questionnaire. The survey involved 146 randomly selected patients who were previously treated at the Department of Rheumatology for worsening of rheumatoid arthritis. RESULTS: Most of the patients gave their consent for participation in the survey. 113 (82.5%) of the respondents reported good compliance /adherence with the DMARD treatment regimen. 24 (17.5%) of the patients did not take prescribed medications, primarily due to adverse side effects and, less commonly, due to ineffective treatment or lack of clinical symptoms, and also for financial reasons. Age, sex, level of education and DAS28 score did not significantly influence medication adherence. CONCLUSIONS: Most of the patients treated for RA are followed up at rheumatology outpatient clinics and they continue treatment with DMARDs after discharge from hospital. Adverse side effects are the main cause of a change or discontinuation of the treatment.

Two- and three-dimensional ultrasonography and sonohysterography versus hysteroscopy with laparoscopy in the differential diagnosis of septate, bicornuate, and arcuate uteri.

STUDY OBJECTIVE: To estimate the diagnostic accuracy and to compare the diagnostic value of 3-dimensional sonohysterography (3D-SIS), 3-dimensional transvaginal ultrasonography (3D-TVS), 2-dimensional sonohysterography (2D-SIS), and 2-dimensional transvaginal ultrasonography (2D-TVS) (initial and expert diagnosis) in the differential diagnosis of septate, bicornuate, and arcuate uteri. DESIGN: Prospective clinical study (Canadian Task Force II-2). SETTING: University hospital and private hospital and clinic. PATIENTS: A total of 117 women with a history of recurrent abortions or infertility and a 2D-TVS initial diagnosis of a septate, bicornuate, or arcuate uterus. INTERVENTIONS: Expert 2D-TVS, 3D-TVS, 2D-SIS, and 3D-SIS performed by experienced examiners and hysteroscopy with laparoscopy to establish the final diagnosis. MEASUREMENTS AND MAIN RESULTS: Hysteroscopy performed in conjunction with laparoscopy (HL) detected 23 arcuate, 60 septate, 22 bicornuate, and 12 normal uteri. 3D-SIS showed perfect diagnostic accuracy (100.0%) in general detection of uterine abnormalities, compared with initial 2D-TVS (77.8%), expert 2D-TVS (90.6%), 2D-SIS (94.0%), and 3D-TVS (97.4%). In the overall diagnosis of uterine anomalies, all of the diagnostic methods had statistically significantly better diagnostic value than initial 2D-TVS (p < .001), whereas 3D-SIS was the only method that was better than expert 2D-TVS (p < .001). CONCLUSIONS: Although 3D-SIS was identical to HL, with the highest accuracy, there was no significant difference in diagnostic value between 3D-TVS with 2D-SIS and 3D-SIS or between expert 2D-TVS and 3D-TVS with 2D-SIS. The high diagnostic value of these ultrasonographic tools questions the need for endoscopy in the differential diagnosis of the most common congenital uterine anomalies.

Transrectal ultrasound-guided hysteroscopic myomectomy of submucosal myomas with a varying degree of myometrial penetration.

STUDY OBJECTIVE: To predict the 1-step complete resection rate after transrectal ultrasound-guided hysteroscopic myomectomy and to determine the usefulness of intraoperative transrectal ultrasonography (TRUS) in monitoring hysteroscopic electroresection of submucosal myomas. DESIGN: Prospective cohort study (Canadian Task Force classification II-1). SETTING: University hospital. PATIENTS: One hundred twenty women with symptomatic (abnormal uterine bleeding or reproductive disorder), single, submucosal myomas underwent hysteroscopic electroresection. Groups 1 and 2 were monitored, respectively, with or without TRUS. Anatomical inclusion criteria were myoma ≤5 cm and myometrial free margin ≥3 mm above the myoma. INTERVENTIONS: Myomas were evaluated preoperatively via sonohysterograpy and were graded according to the guidelines outlined by the European Society of Hysteroscopy (ESH), including size and myometrial free margin, and according to the STEPW (size, topography, extension, penetration, and lateral wall) classification. On the basis of sonographic findings, patients with myomas >3 cm received gonadotropin-releasing hormone therapy for 1 to 3 months. Hysteroscopic myomectomy was performed with or without TRUS guidance. At 4 to 8 weeks after the initial procedure, postoperative transvaginal ultrasonography, sonohysterography, or second-look hysteroscopy was performed. MEASUREMENTS AND MAIN RESULTS: In the TRUS group, a significantly higher percentage of 1-step complete resections was observed than in the group without TRUS (91% vs 73%) (p = .02). This was associated with a statistically significant difference in the subgroups of myomas that were deeply penetrating into the myometrium (89% vs 55%) (p < .01). One-way logistic analysis of data for all treated patients indicated the use of TRUS, as well as the ESH and STEPW classifications, as significant factors influencing the 1-step complete resection. At multivariable logistic regression analysis, use of TRUS (odds ratio [OR], 2.74; p < .001), myomas graded 0 or 1 according to ESH (OR, 3.55; p < .001), and size <3 cm (OR, 2.35; p < .05) were significantly associated with 1-step complete resection (area under the curve, 0.80; p < .001). In the TRUS group there were two significant predictors: size <3 cm (OR = 5.21; p < .05) and myometrial free margin <5 mm (OR, 0.18; p < .05). CONCLUSION: Intraoperative use of TRUS during hysteroscopic myomectomy increases the chance of complete 1-step removal of submucosal myomas that deeply penetrate the myometrium.

Trends in Systemic Inflammatory Reaction (SIR) during Paclitaxel and Carboplatin Chemotherapy in Women Suffering from Epithelial Ovarian Cancer.

BACKGROUND: Epithelial ovarian cancer (EOC) is the most fatal gynaecological malignancy treated with cytoreductive surgery followed by adjuvant taxane-platinum-based chemotherapy. It has been shown that the pretreatment systemic inflammatory reaction (SIR) in women with OC can be evaluated using the neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR) and systemic inflammatory index (SII), depending on the stage of disease, and has prognostic value for overall survival. The aim of this study was to evaluate the changes in NLR, LMR, PLR and SII during chemotherapy. METHODS: A total of 107 women with EOC (23 with type I and 84 with type II tumours) were included in a retrospective single-centre analysis. The Kologomorov-Smirnoff, Kruskal-Wallis or Friedman analysis of variance tests were used for data analysis, and a p value of 0.05 was considered statistically significant. RESULTS: A significant decrease in NLR, PLR and SII but not LMR was observed during adjuvant treatment. Pretreatment NLR, PLR and SII were dependent on disease stage and tumour grade; however, this association was lost during therapy. Additionally, strong and positive mutual correlations between NLR, LMR, PLR and SII were sustained during the whole course of chemotherapy. CONCLUSIONS: During first-line adjuvant chemotherapy in women with EOC, a decrease in SIR is confirmed.

Treatment Costs and Social Burden of Pancreatic Cancer.

(1) Background: Pancreatic cancer is the cancer with the third-highest mortality rate, and forecasts indicate its growing share in morbidity. The basis of treatment is inpatient chemotherapy and there is a strong focus on palliative care. (2) Methods: A literature review was conducted based on the rapid review methodology in PubMed and Cochrane databases. The search was supplemented with publications from the snowball search. Qualitative assessment of included publications was performed using AMSTAR2 modified scheme. (3) Results: The review included 17 publications, of which majority concerned direct costs related to the adopted treatment regimen. Most of the publications focused on comparing the cost-effectiveness of drug therapies and the costs of palliative treatment. Other publications concerned indirect costs generated by pancreatic cancer. They particularly focused on the economic burden of lost productivity due to sickness absence. (4) Conclusion: The increase in the incidence of pancreatic cancer translates into an increase in the costs of the health care system and indirect costs. Due to the significant share of hospitalization in the health care structure, direct costs are increasing. The inpatient treatment regimen and side effects translate into a loss of productivity for patients with pancreatic cancer. Among gastrointestinal cancers, pancreatic cancer generates the second largest indirect costs, although it has a much lower incidence rate than the dominant colorectal cancer. This indicates a significant problem of the economic burden of this cancer.

Quality of Life in Patients with Pancreatic Cancer-A Literature Review.

Pancreatic cancer is the malignant disease with the highest mortality rate, and it ranks third in the world after lung and colon cancer. Identified factors that increase the risk of developing pancreatic cancer include chronic pancreatitis, radiation therapy to the pancreatic area due to another cancer, diabetes mellitus, obesity, smoking, and age. The objective of this study was to present the current state of knowledge on the quality of life of patients diagnosed with pancreatic cancer, factors that determine QoL, and ways of coping with the disease. The low curability and low survival rates of pancreatic cancer significantly affect the quality of life of patients, often in the form of significant deterioration, especially in terms of mental changes, cognitive functions, and coping with the disease. Cognitive decline with comorbid depression is also typical for patients with this type of cancer. Research has shown that the health-related quality of life of patients with pancreatic cancer is low, so further research is needed to improve the situation in this area.

Evaluation of Health Pattern and Stress Levels among Patients Undergoing Alcohol Addiction Treatment-A Cross Sectional Study.

Alcohol consumption is linked to over 200 diseases and injuries. It is also classified as a risk factor for several types of neoplasms as well as infectious diseases (i.e., HIV and tuberculosis). In 2019, among people aged 25 to 49, alcohol use was the leading risk factor for attributable burden of disease. There are many factors that affect alcohol drinking patterns such as social and economic status, social norms, cultural customs, availability of alcohol, etc. Stress also plays a significant role in the process of developing alcohol addiction. The aim of our study was to examine health patterns and stress levels among patients undergoing alcohol addiction treatment. The study sample consisted of 104 patients who were treated in a hospital ward due to alcohol dependence. Three standardized questionnaire tools were used to measure the sense of coherence and the level of stress among those patients. The main results suggest that the level of perceived stress correlated negatively with all dimensions of sense of coherence and all indicators of health behaviors, however, age was positively correlated with positive mental attitude, proper eating habits, and health behaviors. In conclusion, it is worth noting that developing patterns for positive health behaviors will make it possible to avoid alcohol dependence or reinforce the treatment results if alcohol dependence syndrome occurs.

Acceptance of Illness and Coping with Stress among Patients Undergoing Alcohol Addiction Therapy.

(1) Background: Acceptance of illness is a process in which a person with an illness accepts its presence and treats it as an integral part of their life. With regard to alcoholism, acceptance of illness is one of the important elements of the healing process. (2) Methods: The study group consisted of 104 residents in an addiction treatment ward. Questionnaires SOC-29, AIS and PSS-10 were used to check levels of coherence, stress and acceptance of illness. The analysis was based on regression analysis. Patient age was analysed as a moderator of correlations between perceived indicators. Moderation analysis was based on the simple moderation model. (3) Results: The level of perceived stress correlated negatively with all areas of the sense of coherence and with acceptance of illness. All areas of the sense of coherence correlated with acceptance of illness positively. (4) Conclusions: The acceptance of illness by the patient is a factor that can be motivating for further treatment, through a positive approach to illness and strengthening the sense of control in experiencing it. The combination of strengthening behavioural, cognitive and motivational resources can be used in the treatment of people experiencing the challenges of addiction to alcohol.

DFF45 expression in human endometrium is associated with menstrual cycle phases and decreases after menopause.

BACKGROUND: Human endometrium undergoes cyclic structural and functional modifications, and if no conception occurs menstruation is observed as the result of endometrial cell apoptosis via DFF40/DFF45 complex activation. In postmenopausal endometrium, the proliferative potential of endometrial cells is decreased, while their susceptibility to apoptosis increases. METHODS: The study group comprised 104 nonpregnant adult women (78 of reproductive age and 36 after menopause) with no neoplasm or hormonal treatment during the past 6 months. Immunohistochemistry and Western blot methods were used for DFF45 identification and semiquantitative assessment of its amount. RESULTS: Significantly more DFF45-positive cells were detected in the endometrial glands compared to stroma, and this pattern was constant throughout the whole menstrual cycle and also present in postmenopausal endometrial species. The lowest mean relative amount of DFF45 was detected in postmenopausal endometrial samples. In women of reproductive age, the highest mean relative amount of DFF45 was identified in an early secretory phase of the menstrual cycle, the lowest median value of the relative amount of DFF45 was observed in the late proliferative phase, and the difference was significant. CONCLUSION: The DFF45 level in human endometrium corresponds to the respective phase of the menstrual cycle and decreases significantly after menopause.

Prevalence of HPV-DNA in Pap smears containing ASC and AGC performed within Population Programme of Prophylaxis and Early Detection of Early Cervical Cancer.

AIM: to assess the incidence of HPV -DNA in women with ASC/AGC compared to patients with normal Pap smears. MATERIAL AND METHODS: The study group consisted of 242 women (207 ASC and 35 AGC cases). The control group counted 200 age-matched women with negative Pap smears. Cervical samples collected from all the participants were tested for the presence of HPV-DNA using the Hybrid Capture-2 test. RESULTS: Total HPV infection was significantly higher in the study than in the control group (43.0% vs.14.0%) (p=0.005). There was no difference in the incidence of HPV -DNA between ASC and AGC groups. Prevalence of HPV-DNA ASC-H was significantly higher in ASC-US group (83.3% vs. 40.5%) (p=0.004). HPV positive endometrial AGC significantly outnumbered HPV positive endocervical AGC (88.9% vs. 26.9%) (p=0.003). Similar trends were observed for the high-risk type of HPV (p<0.001). CONCLUSIONS: The significant difference in HPV -DNA incidence between the study and control groups suggests that HPV plays a role in the development of ASC and AGC. The implementation of HPV testing in all women diagnosed with ASC or AGC can lead to tailored therapeutic management and more careful follow-up care.