Semi-Automatic Volumetric and Standard Three-Dimensional Measurements for Primary Tumor Evaluation and Response to Treatment Assessment in Pediatric Rhabdomyosarcoma.

Current prognostic classification of rhabdomyosarcoma in children requires precise measurements of the tumor. The purpose of the study was to compare the standard three-dimensional (3D) measurements with semi-automatic tumor volume measurement method concerning assessment of the primary tumor size and the degree of response to treatment for rhabdomyosarcoma in children. Magnetic Resonance Imaging data on 31 children with treated rhabdomyosarcoma based on the Cooperative Weichteilsarkom Studiengruppe (CWS) guidance was evaluated. Tumor sizes were measured by two methods: 3D standard measurements and semi-automatic tumor volume measurement (VOI) at diagnosis, and after 9 and 17/18 weeks of the induction chemotherapy. Response to treatment and prediction values were assessed. The tumor volume medians calculated using VOI were significantly higher in comparison with those calculated using the 3D method both during the diagnosis as well as after 9 weeks of the chemotherapy and during the 17-18th week of the treatment. The volume measurements based on the generalized estimating equations on the VOI method were significantly better than the 3D method (p = 0.037). The volumetric measurements alone can hardly be considered an unequivocal marker used to make decisions on modification of the therapy in patients with rhabdomyosarcoma.

Assessment of the Usefulness of Multiplex Real-Time PCR Tests in the Diagnostic and Therapeutic Process of Pneumonia in Hospitalized Children: A Single-Center Experience.

The aim of the study was assessment of the usefulness of multiplex real-time PCR tests in the diagnostic and therapeutic process in children hospitalized due to pneumonia and burdened with comorbidities. Methods. The study group included 97 children hospitalized due to pneumonia at the Karol Jonscher Teaching Hospital in Poznan, in whom multiplex real-time PCR tests (FTD respiratory pathogens 33; fast-track diagnostics) were used. Results. Positive test results of the test were achieved in 74 patients (76.3%). The average age in the group was 56 months. Viruses were detected in 61 samples (82% of all positive results); bacterial factors were found in 29 samples (39% of all positive results). The presence of comorbidities was established in 90 children (92.78%). On the basis of the obtained results, 5 groups of patients were established: viral etiology of infection, 34 patients; bacterial etiology, 7 patients; mixed etiology, 23 patients; pneumocystis, 9 patients; and no etiology diagnosed, 24 patients. Conclusions. Our analysis demonstrated that the participation of viruses in causing severe lung infections is significant in children with comorbidities. Multiplex real-time PCR tests proved to be more useful in establishing the etiology of pneumonia in hospitalized children than the traditional microbiological examinations.

British and Polish general practitioners' opinions on the importance of preventive medicine.

The delivery of preventive services in GPs' surgeries falls below recommended levels. Different attempts are performed to change the situation. The introduction in the UK in 2004 of a new GP contract based on a QOF fundamentally changed the way that primary practitioners are paid. Success of this intervention caused international interest in using financial incentives as a method of improving general practice. Polish primary care is still under development. In contemplating reform and the possible introduction of some of these British solutions in Poland, it would be valuable to compare what British and Polish GPs' think about prevention and see how their opinions can be affected by context in which they work. The aim of the survey involving 65 British and 65 Polish GPs was to compare what are their views of health promotion. The questionnaire solicited information on doctors' demographic characteristics, attitudes toward prevention, time they think they spend on preventive procedures and perceptions of the importance of 13 selected preventive procedures. Most British and Polish GPs answered that prevention is very important and they spend 10-30% of each consultation on it. Almost all doctors rated blood pressure measurement as important. For British GPs BMI, blood glucose, lipid profile, anti-alcohol and anti-smoking advice were important, in contrast to Polish doctors. In the presence of clear clinical guidelines, age and gender do not affect doctors' opinion on the importance of preventive procedures. Procedures in which GPs are directly involved are more important for them.

[Efficacy of densitometry and fracture risk assessment tool FRAX in making therapeutic decisions in osteoporosis--a study on female patients of university of medical sciences endocrinology outpatient clinic]. / Znaczenie densytometrii oraz zastosowania metody szacowania ryzyka zlamania osteoporotycznego za pomoca algorytmu FRAX dla podejmowania decyzji terapeutycznych w osteoporozie na przykladzie pacjentek Poradni Endokrynologicznej Uniwersytetu Medycznego w Poznaniu.

INTRODUCTION: Contemporary understanding of osteoporosis is based on the assessment of fracture risk. Evaluation of clinical risk factors of fracture with or without densitometry (DEXA) allows to identify patients requiring pharmacological treatment. AIM: The aim of the study was to estimate the usefulness of DEXA in assessment of fracture risk in women >50 years old. MATERIALS AND METHODS: In 296 previously untreated for osteoporosis women of Endocrinology Outpatient Clinic aged 50 to 85 years (mean 68.8+/-7.8) 10-year fracture risk using FRAX tool was computed from clinical risk factors alone (FRAX, FRAX hip) and after measurement of BMD (FRAX BMD). Then FRAX parameters were compared in 4 age categories. Fracture risk was confronted with therapeutic thresholds proposed in Poland. RESULTS: 10-year fracture risk by FRAX increased with age. The most frequent risk factors were: previous fracture and family history of fractures. FRAX and FRAX BMD were significantly different in the 50-59 year-olds and 60-69 year-olds. Statistically significant difference was found for FRAX hip and FRAX hip BMD in 50-59 year old women. FRAX and FRAXhip were better predictors of fractures than FRAX BMD in patients >80 years old. In 50-79 year old women qualification for treatment was more effective when risk was assessed according to FRAX BMD. DEXA performance did not change the number of women over 80 who were eligible for treatment according to FRAX. CONCLUSIONS: BMD is crucial for the 10-year risk assessment in 50-69 year-olds without previous fracture, as an increasing number of patients need therapy. In >80 year old women clinical risk factors alone are sufficient to make therapeutic decisions. DEXA in these women has no influence on the risk of future fractures, including hip fracture. In 60-69 women with previous fracture DEXA is a good predictor for future fractures but has no value as far as therapeutic decisions are concerned.