Primary Hyperparathyroidism Secondary to Ectopic Parathyroid Adenoma: A Case Report.

Primary hyperparathyroidism (PHPT) secondary to parathyroid gland adenoma is mildly symptomatic and thus often incidentally diagnosed. In this report, we present a case of a 46-year-old man who was treated for hypertension and other nonspecific complaints. An elevated level of blood calcium led to the suspicion of parathyroid adenoma. Technetium-99m-methoxyisobutylisonitrile (99mTc-MIBI) planar and single-photon emission computed tomographic scintigraphy (SPECT/CT) confirmed the presence of a 10-mm-wide adenoma behind the sternal handle in the anterior mediastinum. The tumor was excised by Kocher's cervical access along with the right and left upper horns of the thymus gland and was histologically confirmed as being of parathyroid nature. However, blood parathyroid hormone and calcium remained persistently elevated. Repeated scintigraphy imaging revealed the presence of another retrosternal tracer focus at the level of Ludwig's angle. The patient was reoperated with the longitudinal sternotomy access, and thymus remnants, parathymic nodule, and fragments of mediastinal fat and right parietal pleura were removed. On the second postoperative day, parathyroid hormone and calcium reverted to normal values, but the patient remained hypertensive. Despite the successful surgical treatment, the patient remained hypertensive suggesting that the underlying reason was a familial hypertensive disease rather than parathyroid adenoma. In conclusion, this report underscores the need for diagnostic vigilance in the case of persisting hypercalcemia with hypertension and diagnostic and surgical difficulties in the management of ectopic PHPT secondary to parathyroid gland adenomas.

Leveraging independence and mental fitness - keys to reducing in-hospital mortality among geriatric COVID-19 patients in the intensive care unit: A cross-sectional study in Poland.

BACKGROUND: Coronavirus disease 2019 (COVID-19) quickly reached the pandemic status, with 765.22 million confirmed cases of COVID-19 and 6.92 million COVID-19 deaths reported worldwide by May 2023. Due to its sudden and global nature, the COVID-19 pandemic has had a significant impact on the emotional and mental health of many people. A group of COVID-19 patients who frequently require intensive care are geriatric patients. The cognitive performance of these patients and their independence in instrumental activities of daily living (IADL) may be crucial to their prognosis and risk of in-hospital death. OBJECTIVES: The present study aimed to assess the level of independence in activities of daily living (ADL), mental fitness, the level of fear of COVID-19, and cognitive functions to determine their impact on in-hospital mortality in geriatric COVID-19 patients. MATERIAL AND METHODS: A total of 300 intensive care unit (ICU) patients with COVID-19 were included in the cross-sectional study, using the following questionnaires: the Lawton IADL scale, the Katz ADL index of independence, the fear of COVID-19 scale (FCV-19S), the abbreviated mental test score (AMTS), and the 15-item geriatric depression scale (GDS15). RESULTS: Patients aged 64 or below reported significantly greater independence on the IADL scale and the basic ADL scale, and showed a significantly higher level of mental fitness (Mann-Whitney U test; p = 0.001). Patient survival and in-hospital mortality were influenced by independence in basic and complex ADL. CONCLUSIONS: The level of independence is an important prognostic indicator for in-hospital mortality in geriatric COVID-19 patients. The higher the level of mental fitness, the higher the level of independence in basic and instrumental activities of daily living. Patients aged ≥65 years are less independent in basic and instrumental activities of daily living. Moreover, they show a significantly lower level of cognitive functions.

Impact of Loneliness on Functioning in Lung Cancer Patients.

Lung cancer is the leading cause of cancer death and carries a greater degree of stigma. Lung cancer stigma contributes to social isolation and increases loneliness, which has an impact on quality of life, increases depressive symptoms and hence affects all aspects of functioning. Functioning is assessed in five dimensions (physical, psychological, cognitive, social and life roles). The aim of the study was to assess the impact of loneliness on the functioning, nutritional status and quality of life of patients with lung cancer. METHODS: The survey study was conducted among 310 lung cancer patients. The patients were asked to complete the Mini-MAC, HADS-M, MNA, EORTC QoL, AIS and VAS questionnaires. RESULTS: In total, 136 patients were lonely and 174 were married or in a relationship. Lonely patients had significant difficulty accepting their illness and demonstrated higher levels of depression. The factors most strongly associated with loneliness were being unemployed, age 61 or over and a less score in the constructive coping strategies. CONCLUSIONS: Loneliness is a significant factor affecting the functioning of patients with lung cancer. It increases the risk of anxiety and depression, reduces levels of illness acceptance, reduces levels of constructive coping and increases the risk of malnutrition.

Physical Activity and Cancer Care-A Review.

In 2020, 19.3 million new cancer cases were diagnosed, and almost 10 million deaths from cancer were recorded. Cancer patients may experience fatigue, depression, anxiety, reduced quality of life and sleep problems. Cancer treatments cause numerous side effects and have a negative impact on all body systems. Physical activity is important for cancer patients. The aim of this review is to analyse recent studies on the role of physical activity in cancer patients and emphasize its importance. The review included 36 papers published in English between 2017 and 2021. The findings from these studies show that physical activity decreases the severity of side effects of cancer treatment, reduces fatigue, improves quality of life, has a positive impact on mental health and improves aerobic fitness in cancer patients. Moreover, it reduces the risk of cancer recurrence and death. Physical activity is recommended for patients with any type of cancer and at all stages of treatment. The type of physical activity should depend on the condition of the individual patient. It is extremely difficult to determine what type, intensity and duration of physical activity is likely to have the greatest effect.

Depressive and Anxiety Disorders of Parents of Children with Cancer.

Every year in Poland there are approximately 1200 new cases of malignant tumours in children and adolescents. Leukaemia, CNS tumours, and lymphomas are the most frequently diagnosed cancers. Coping with a child's illness is challenging, which is why many parents suffer from anxiety, depression disorders, and even PTSD (post-traumatic stress disorder). The aim of this study is to assess the anxiety and depression levels of carers of children with cancer. METHOD: The study participants were 101 carers of children suffering from cancer. The study was conducted using standardized questionnaires: the Zung ccale, HADS scale, and Karnofsky scale, and three questionnaires designed by the author. RESULTS: According to the results of the Karnofsky scale, carers' anxiety and depression levels were negatively affected by their children's poor performance. The younger age of children significantly correlated with the severity of depression in their parents. HADS and Zung scale anxiety levels were observed to have statistically significant effect on the severity of depressive disorders. CONCLUSIONS: Receiving a diagnosis of childhood cancer contributes to the incidence of depression and anxiety disorders among carers. Carers' anxiety and depression levels were strongly associated with their child's age and their child's performance.

Coping Strategies, Pain, and Quality of Life in Patients with Breast Cancer.

INTRODUCTION: Each year, around 16,500 women in Poland are diagnosed with breast cancer, the second most common cause of death in women. In Poland, nearly 70,000 women live with breast cancer diagnosed within the last 5 years. Quality of life (QoL) research is particularly important in cancer patients, as it provides knowledge on their psychological and physical health, as well as the environment in which the patients function, all of which is essential to implementing multidisciplinary care involving the best use of the appropriate methods. Carrying the burden of cancer is a major challenge for patients. The strategy that patients use to cope with breast cancer significantly affects their quality of life. The purpose of the study is to assess the impact of coping strategies on the QoL in breast cancer patients. MATERIAL AND METHODS: The prospective study included a group of 202 women who had undergone surgical treatment for breast cancer at the Lower Silesian Cancer Center and who reported for follow-up appointments at the Oncology Clinic and the Surgical Oncology Clinic. For the study, we used the: EORTC QLQ-C30 cancer questionnaire, EORTC QLQ-BR23 module, Mental Adjustment to Cancer (Mini-MAC) scale, visual analog scale (VAS) for pain intensity, as well as the patients' medical records, hospital records, and our own survey form. RESULTS: The mean patient age was 53 years. Most patients had been diagnosed with cancer between one and two years before. In the women studied, there was a negative association between QoL and the choice of a destructive strategy for coping with cancer, and a positive one between QoL and a constructive coping strategy. Severe pain caused by the disease and its treatment significantly decreased the patients' QoL in multiple domains. CONCLUSIONS: Patients choosing constructive strategies obtained higher QoL scores, while greater reliance on destructive coping strategies was associated with significantly worse QoL. In all functioning domains, higher levels of pain were associated with poorer QoL and more severe symptoms associated with the disease and its treatment.