Nanotechnology for Dentistry: Prospects and Applications.

In the XXI century, application of nanostructures in oral medicine has become common. In oral medicine, using nanostructures for the treatment of dental caries constitutes a great challenge. There are extensive studies on the implementation of nanomaterials to dental composites in order to improve their properties, e.g., their adhesive strength. Moreover, nanostructures are helpful in dental implant applications as well as in maxillofacial surgery for accelerated healing, promoting osseointegration, and others. Dental personal care products are an important part of oral medicine where nanomaterials are increasingly used, e.g., toothpaste for hypersensitivity. Nowadays, nanoparticles such as macrocycles are used in different formulations for early cancer diagnosis in the oral area. Cancer of the oral cavity-human squamous carcinoma-is the sixth leading cause of death. Detection in the early stage offers the best chance at total cure. Along with diagnosis, macrocycles are used for photodynamic mechanism-based treatments, which possess many advantages, such as protecting healthy tissues and producing good cosmetic results. Application of nanostructures in medicine carries potential risks, like long-term influence of toxicity on body, which need to be studied further. The introduction and development of nanotechnologies and nanomaterials are no longer part of a hypothetical future, but an increasingly important element of today's medicine.

The role of cytoreductive nephrectomy in the treatment of patients with metastatic kidney cancer - review article.

The role of cytoreductive nephrectomy (CN), i.e. the removal of a kidney involved by cancer in patients with advanced kidney cancer with distant metastases, is the subject of intense debate among urologists and oncologists. For many years, CN has been considered the gold standard in the treatment of patients at this stage of the disease, especially in patients in good general health with no significant contraindications to surgical treatment. The starting point for questioning the validity of CN was the publication of the results of the cancer du rein metastatique nephrectomie et antiangiogéniques and SURTIME clinical trials (2018 and 2019, respectively), which questioned the validity of surgery in some patients with late-stage cancer. Given the complexity of the disease, the role of removing the involved kidney is the subject of much controversy. In recent years, several studies have been conducted to evaluate the efficacy and safety of nephrectomy in patients with metastatic kidney cancer, resulting in conflicting information regarding the eligibility criteria for patients in different risk groups. The aim of this article is to analyse the available data, provide an up-to-date review of the literature, and discuss the controversies and challenges related to CN in patients with metastatic kidney cancer. The present literature review aims to organize and systematize the current state of knowledge, which may help in making clinical decisions regarding qualification for CN in patients with advanced kidney cancer.

Excited State and Reactive Oxygen Species against Cancer and Pathogens: A Review on Sonodynamic and Sono-Photodynamic Therapy.

Photodynamic and sonodynamic therapy are therapies having great potential in the treatment of bacterial infections and cancer. Their background is associated with photo- and sonosensitizers - substances that can be excited when exposed to light or ultrasound. These sensitizers belong to a various groups of compound, including porphyrins, porphyrazines, and phthalocyanines. Releasing the energy when returning to the ground state can occur in the manner of transferring it to oxygen molecules, leading to reactive oxygen species able to disrupt membranes of bacterial and cancer cells, leaving the organism's cells unaffected. In recent years, the number of reports on numerous sensitizers being effective has been constantly growing. Therefore, the development of this field may prove beneficial for dealing with cancer and microbes. This review describes the development of photodynamic and sonodynamic therapy, as well as their combination, with emphasis on sonodynamic therapy and its potential in the treatment of cancer and bacterial infections.

Prognostic Value of Sarcopenia in Metastatic Colorectal Cancer Patients Treated with Trifluridine/Tipiracil.

Sarcopenia is common in metastatic colorectal cancer (mCRC), increases the risk of treatment-related toxicity and reduces survival. Trifluridine/tipiracil (TT) chemotherapy significantly improved survival in refractory mCRC patients, but the prognostic and predictive role of pretherapeutic sarcopenia and variation in the skeletal muscle index (SMI) during this treatment has not been investigated so far. In this retrospective, observational study, clinical data on mCRC patients treated with TT at six cancer centres in Poland were collected. Computed tomography (CT) scans acquired at the time of initiation of TT (CT1) and on the first restaging (CT2), were evaluated. SMI was assessed based on the skeletal muscle area (SMA) at the level of the third lumbar vertebra. Progression-free survival (PFS) and overall survival (OS) were calculated from the treatment start. Neither initial sarcopenia nor ≥5% skeletal mass loss (SML) between CT1 and CT2 had a significant effect on PFS in treated patients (p = 0.5526 and p = 0.1092, respectively). In the multivariate analysis, reduced OS was found in patients with ≥5% SML (HR: 2.03 (1.11-3.72), p = 0.0039). We describe the prognostic role of sarcopenia beyond second line treatment and analyze other factors, such as performance status, tumor histological differentiation or carcinoembryonic antigen level that could predict TT treatment response.

Polish Medical Students' Knowledge Regarding Human Papillomavirus's Ways of Transmission, Risk of Cancer Development and Vaccination, and Their Intention to Recommend Vaccination.

INTRODUCTION: Human papillomavirus (HPV) is associated with six types of cancer in men and women. A vaccine against HPV, preferably administered before initial sexual intercourse, has been proven to be highly effective in preventing these cancers. An effective healthcare provider recommendation has significant influence on HPV vaccine uptake; therefore, it is critical that medical students receive comprehensive training in this area. AIM: The aim of the study was to assess the knowledge of medical students regarding Human Papillomavirus's (HPV) ways of transmission, risk of cancer development, and vaccination against HPV. This study also investigated factors among medical students that would affect their intention to recommend HPV vaccination to others. MATERIALS AND METHODS: The study was conducted among 1061 (678 women and 383 men) medical students who filled in our questionnaire. The medical students were divided into two subgroups: (1) pre-clinical medical students (MS pre-clinical; first-to third-year students; n = 683) and (2) clinical medical students (MS clinical; fourth-to six-year students; n = 378). RESULTS: A total259 (24.41%) of the 1061 medical students were vaccinated against HPV. We found a significant improvement in the general level of knowledge in the later years of education (4-6) compared to the early years of education (1-3). However, it was demonstrated that, despite medical education advancements, there are still significant gaps of knowledge about the relationship between HPV infection and cancers other than cervical cancer, as well as in relation to the routes by which HPV is transmitted. Medical students' intentions to recommend HPV vaccine to others were related to their own HPV-related knowledge and their own vaccination status. CONCLUSION: Medical students have gaps of knowledge regarding particular issues and aspects of HPV. It is necessary to further educate medical students in the field of prevention and in the treatment of lesions caused by HPV infection. Medical students' intention to recommend the HPV vaccine can be improved by including them and members of their families in the HPV vaccination program.

Nodal areas of potential geographic error in adjuvant radiotherapy for biliary tract cancer.

PURPOSE: To determine the areas of potential geographic error in adjuvant radiotherapy (RT) for biliary-tract cancer (BTC) by comparing pathological-surgical data on the pattern of nodal spread with the extent of elective nodal CTV used in published RT studies in this setting. MATERIAL/METHODS: A literature search was performed to select articles on: 1/adjuvant RT for BTC, that provided information on the lymph node stations (LNS) included in the CTV; 2/the pathological-surgical data on the patterns of nodal involvement/recurrence in BTC. Risk of nodal involvement/recurrence and frequency of inclusion in the CTV in RT studies for each of the LNS were compared to determine the areas of potential geographic misses and unnecessary irradiation, separately for intrahepatic cholangiocarcinoma (IHC), extrahepatic cholangiocarcinoma (EHC) and gallbladder-cancer (GBC). RESULTS: Areas of potential geographic misses include: for right IHC: paraaortic and superior mesenteric artery (SMA) LNS; for left or hilar IHC: left gastric, lesser gastric curvature, paraaortic, and SMA LNS; for proximal EHC: paraaortic LNS; for middle EHC: paraaortic and SMA LNS; for distal EHC: paraaortic, SMA, and anterior pancreatico-duodenal LNS; for GBC: paraaortic, SMA, and posterior pancreatico-duodenal LNS. Celiac-LNS is unnecessarily irradiated for middle/distal EHC. CONCLUSIONS: In view of discrepancies between pathological-surgical data and the CTVs used in common practice, there is an obvious need for international consensus guidelines.

Thyroglossal duct cysts: anatomy, embryology and treatment.

Thyroglossal duct cysts are the most frequently encountered congenital abnormality of the neck, and are described extensively in the literature. The high incidence of this abnormality and its presence in all age groups requires clinicians to be aware of the clinical features, etiology, and current treatment options. Because it is readily accessible, relatively inexpensive, and non-invasive, sonography is arguably the ideal initial investigation. Computerized tomography and fine needle aspiration biopsy are often utilized as supplementary techniques for confirmation of the diagnosis. The treatment of choice for thyroglossal duct cysts continues to be the classic Sistrunk procedure, developed in 1920, although several modifications have since been employed. In this review, we aim to explore the embryological development, clinical presentation and diagnostic features of thyroglossal duct cysts. In addition, a useful adaptation to the Sistrunk procedure and the recent application of OK-432 therapy as a promising alternative for treatment of thyroglossal duct cysts will also be discussed.

A friend to the airways: a review of the emerging clinical importance of the bronchial arterial circulation.

Lungs receive the bulk of their blood supply through the pulmonary arteries. The bronchial arteries, on the other hand, vascularize the bronchi and their surroundings. These two arteries anastomose near the alveolar ducts. Contrary to the pulmonary circulation which is fairly well studied, the bronchial arteries have been appreciated more by their absence, and in some cases, by an interruption in the pulmonary arterial flow. Therefore, a more accurate anatomical and functional knowledge of these atherosclerosis-resistant vessels is needed to help surgeons and clinicians to avoid iatrogenic injuries during pulmonary interventions. In this review, we have revisited the anatomy and pathophysiology of the bronchial arteries in humans, considering the recent advances in imaging techniques. We have also elaborated on the known clinical applications of these arteries in both the pathogenesis and management of common pulmonary conditions.

Ruptured ectopic pregnancy diagnosed with computed tomography.

BACKGROUND: The rupture of ectopic pregnancy (EP) still remains the primary and direct cause of death in the first trimester of pregnancy. Ultrasonography is known to be a modality of choice in EP diagnostics. We found a severe discrepancy between the frequency of ectopic pregnancies (EP) and the number of available computed tomography (CT) examinations. CASE REPORT: A 29-year-old woman was admitted to the emergency department with a history of abdominal pain, nausea, vomiting and collapse. Sonographic findings of a suspected EP were unclear. Moreover, not all features of intrauterine pregnancy were present. Due to the patient's life-threatening condition, an emergency multi-slice CT with MPR and VRT reconstructions was performed, revealing symptoms of a ruptured EP. In the right adnexal area, a well-vascularized, solid-cystic abnormal mass lesion was found. Intraperitoneal hemorrhage was confirmed intraoperatively, and the right fallopian tube with a tubal EP was resected. In the surgery in situ, as well as in the pathological examination of the tumor mass, a human embryo of approximately 1.5 cm in length (beginning of the 8(th) week of gestation) was found. CONCLUSIONS: Although ultrasonography still remains the first-line imaging examination in EP diagnostics, sometimes the findings of suspected EPs are unclear and not sufficient. The rupture of EP, with serious bleeding and symptoms of shock, may require an emergent pelvic and abdominal CT inspection. A clear correlation was found between the macroscopic CT images and the intraoperatively sampled material.

Psychomotor and executive functioning after unilateral posteroventral pallidotomy in patients with Parkinson's disease.

The goal of the study was to explore the immediate effects of unilateral posteroventral stereotactic pallidotomy (PVP) on psychomotor and executive functioning in patients with Parkinson's disease (PD). The original drawing task, conducted on a digitizing tablet, and neuropsychological tests were administered to 25 patients with PD, 2 or 3 days before and after the surgery. To assess executive functions, the following tests were used: Trail Making Test (TMT), Stroop Colour Interference Test and Wisconsin Card Sorting Test (WCST). To evaluate global mental functioning, Mini Mental State Examination (MMSE) was applied. Benton Visual Retention Test (BVRT) was introduced as a control non-executive task. The patients undergoing a surgery were compared with age and education matched healthy and PD controls. PVP resulted in an increased movability of the upper contralateral limbs reflected in larger average pressure put during the drawing task after the surgery. Assessment of the emotional state showed a significant postoperative improvement. An isolated significant decline of WCST performance, not related to the side of the lesion, was observed immediately after the surgery. The performance of the other executive and non-executive tasks remained unchanged. The results showed that unilateral PVP may lead to immediate selective executive impairment and is needed to be explored in further studies.