[Histological grading of endometrial carcinoma. Clinical and patomorphological analysis]. / Dojrzalosc histologiczna raka blony sluzowej trzonu macicy. Analiza kliniczna i patomorfologiczna.

OBJECTIVE: Retrospective clinical and pathomorphological analysis of patients undergoing surgery due to endometrial carcinoma; analysis of the correlation between histological grading of endometrial cancer and selected pathomorphological results. MATERIAL AND METHODS: Statistical analysis was based on the pathomorphological results in a group of 353 patients operated because of endometrial carcinoma at the Clinical Department of Gynecologic Oncology Medical University of Lodz, between 2003 and 2013. A possible correlation between histological grading, clinical staging, myometrial infiltration, parametrial invasion and nodal metastases to ilio-obturator lymph nodes was investigated. RESULTS: Among poorly differentiated carcinomas G3, myometrial infiltration above half of its thickness was observed in 67.44% of the cases, whereas in the G2 and G1 groups it was detected in 60.82% and 39.33% of the affected individuals, respectively. Parametrial invasion was found in 24.39% of G3 cases, i.e. 4.23 times more often than in G2 (5.76%) and 10.65 times more often than in G1 (2.29%). Nodal metastases to ilio-obturator lymph nodes were present in 27.50% of poorly 10.86% of moderately and 8.11% of well-differentiated carcinomas. Uterine appendages were infiltrated in 23.25% of G3 cases--3.45 times more than in G2 (6.73%) and 6.82 times more than in G1 (3.4 1%). CONCLUSIONS: Histologic grading for carcinoma at the time of diagnosis is significantly related to clinical staging. No correlation between patient age and carcinoma grading or its clinical staging was observed. Risk of lymph node invasion for well-differentiated carcinomas is similar to the risk for moderately differentiated carcinomas, and should also be an indication for lymphadenectomy in that group of patients.

Diagnostic performance of point-of-use ultrasound of resuscitation outcomes: A systematic review and meta-analysis of 3265 patients.

BACKGROUND: Echocardiography in the setting of resuscitation can provide information as to the cause of the cardiac arrest, as well as indicators of futility. This systematic review and meta-analysis were performed to determine the value of point-of-care ultrasonography (PoCUS) in the assessment of survival for adult patients with cardiac arrest. METHODS: This meta-analysis was performed in adherence to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PubMed, EMBASE, Web of Science, Cochrane have been searched from databases inception until March 2nd 2021. The search was limited to adult patients with cardiac arrest and without publication dates or country restrictions. Papers were chosen if they met the required criteria relating to the sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of this diagnostic technique concerning resuscitation outcomes. RESULTS: This systematic review identified 20 studies. Overall, for survival to hospital discharge, PoCUS was 6.2% sensitivity (95% confidence interval [CI] 4.7-8.0%) and 2.1% specific (95% CI 0.8-4.2%). PoCUS sensitivity and specificity for return of spontaneous circulation were 23.8% (95% CI 21.4-26.4%) and 50.7% (95% CI 45.8-55.7%) respectively, and for survival to admission 13.8% (95% CI 12.2-15.5%) and 20.1% (95% CI 16.2-24.3%), respectively. CONCLUSIONS: The results do not allow unambiguous recommendation of PoCUS as a predictor of resuscitation outcomes and further studies based on a large number of patients with full standardization of operators, their training and procedures performed were necessary.

The influence of menstrual cycle on the efficiency of stretching.

BACKGROUND: Muscle stretching has been practiced by people for thousands of years. Its effectiveness is well-proven, but the diversity of the obtained results should prompt a search for causative factors. One of the possible explanations can be hormonal fluctuations, which occur during the menstrual cycle. OBJECTIVES: To assess the influence of menstrual cycle on the efficiency of static stretching of hamstrings with special reference to changes in their length. MATERIAL AND METHODS: A total of 534 young women were recruited for the study, but after applying the inclusion criteria, only 48 of them have been accepted. The inclusion criteria for the study comprised a reduced length of the hamstring muscles and a regular menstrual cycle. The whole study included a twofold examination of hamstring length before and after the stretching (3 × 45 s), performed by a physiotherapist. All the measurements were carried out 3 times in individual phases of the menstrual cycle. RESULTS: Statistically significant influence of static stretching upon the length of hamstring muscle was revealed. A change in the passive knee extension (PKE) test was 13.34% (standard deviation (SD) = 10.97), and in active knee extension (AKE) test it was 8.46% (SD = 9.26). Hamstrings length demonstrated no differences in various phases of the menstrual cycle. CONCLUSIONS: Static stretching is an effective tool for the improvement of the length of the hamstring muscle in young women. However, the effectiveness of stretching in healthy women is not influenced by the menstrual cycle phases.

ECG in the clinical and prognostic evaluation of patients with pulmonary arterial hypertension: an underestimated value.

BACKGROUND: Pulmonary arterial hypertension (PAH) is a rare disease leading to right ventricular (RV) failure and manifests in decreasing exercise tolerance. Our study aimed to assess the usefulness of electrocardiographic parameters reflecting right heart hypertrophy as predictors of clinical status in PAH. METHODS: The retrospective analysis included 26 patients, mean 49 ± 17 years of age, diagnosed with PAH, and eligible to undergo cardiopulmonary exercise test (CPET). The relations between ECG values and parameters obtained in procedures such as six-minute walk test (6-MWT), echocardiography, right heart catheterization (RHC), and CPET were analyzed. RESULTS: P-wave amplitude in lead II correlated positively with CPET parameter of respiratory response: minute ventilation to carbon dioxide production slope (VE/VCO2 slope; r = 0.436, p = 0.029) and echocardiographic estimated RA pressure (RAP; r = 0.504, p = 0.02). RV Sokolow-Lyon index (RVSLI) positively correlated with echocardiographic parameters reflecting RV function, overload, and afterload-tricuspid regurgitation pressure gradient (TRPG; r = 0.788, p < 0.001), RV free wall thickness (r = 0.738, p < 0.001), and mean pulmonary arterial pressure (mPAPECHO; r = 0.62, p = 0.0016), respectively, as well as VE/VCO2 slope (r = 0.593, p = 0.001) and mPAP assessed directly in RHC (mPAPRHC; r = 0.469, p = 0.0497). R-wave in lead aVR correlated positively with TRPG (r = 0.719, p < 0.001), mPAPECHO (r = 0.446, p = 0.033), and several hemodynamic criteria of PAH diagnosis: positively with mPAPRHC (r = 0.505, p = 0.033) and pulmonary vascular resistance (r = 0.554, p = 0.026) and negatively with pulmonary capillary wedge pressure (r = -0.646, p = 0.004). QRS duration correlated positively with estimated RAP (r = 0.589, p = 0.004), vena cava inferior diameter (r = 0.506, p = 0.016), and RA area (r = 0.679, p = 0.002) and negatively with parameters of exercise capacity: peak VO2 (r = -0.486, p = 0.012), CPET maximum load (r = - 0.439, p = 0.025), and 6-MWT distance (r = -0.430, p = 0.046). ROC curves to detect intermediate/high 1-year mortality risk (based on ESC criteria) indicate RVSLI (cut-off point: 1.57 mV, AUC: 0.771) and QRS duration (cut-off points: 0.09 s, AUC: 703 and 0.1 s, AUC: 0.759) as relevant predictors. CONCLUSION: Electrocardiography appears to be an important and underappreciated tool in PAH assessment. ECG corresponds with clinical parameters reflecting PAH severity.

Does the Self-Myofascial Release Affect the Activity of Selected Lower Limb Muscles of Soccer Players?

Myofascial therapy has already become one of the basic forms of treatment of the locomotor system. One form of the therapy is Self-Myofascial Release, in which external force is applied to the body with the help of special rollers (foam rolling, FR). The aim of the study was to investigate the direct effect of Self-Myofascial Release of hamstring muscles using a foam roller on the bioelectric activity of selected muscles (biceps femoris and gluteus maximus) during squats. The study involved 40 male soccer players, who were randomly divided into two groups: experimental and control. The tests used did not show significant differences in the analyzed variables before the experiment (baseline measurement p > 0.05), while significant intergroup differences appeared for subsequent measurements, both for reference MVC values (p < 0.01 - for % gluteus maximus MVC, p < 0.001 - for % biceps femoris MVC) and for raw EMG values (p < 0.01 gluteus maximus and p < 0.001 - for % 0.0001 for biceps femoris). The use of self-myofascial release within the hamstring muscles leads to changes in the electrical potential of the muscles of the lower limb.

Self-Assessed Personality Traits and Adherence to the COVID-19 Lockdown.

Introduction: The COVID-19 pandemic, caused by the SARS-CoV-2 coronavirus, has forced all countries affected by it to introduce quarantine and isolation to prevent the spread of the virus, as well as masking and distancing. Not everyone is equally willing to follow the rules related to limit the extent of the coronavirus epidemic. This might be connected with personality traits, especially openness, positive attitude, and optimism. Materials and Methods: An online survey was created and completed by participants in April-May 2020. Self-assessment of personality traits and adherence to lockdown recommendations were assessed. A total of 7404 participants took part in the study, mainly from Poland (83.6%) and Italy (12.7%). Univariate and multivariate regression analysis was performed. Results: The participants were divided into groups depending on the degree of compliance with the lockdown rules. In the multivariate analysis, variables that increased the odds for stricter lockdown compliance were temporary work suspension OR 1.27 (95% CI 1.10-1.48), income level "we can't handle this situation" OR 1.67 (95%CI 1.20-2.33), and junior high school education OR 1.68 (95% CI 1.13-2.50). Other significant factors included age and place of residence. Each point of self-assessed sociability OR 1.07 (95% CI 1.00-1.13) also increased the likelihood of adhering to lockdown rules. Conclusions: Taking the basic demographic characteristics as well as working and health environment conditions traits into account may be helpful when forecasting epidemiological compliance during a pandemic, as well as in other public health tasks. The key role of self-assessed personality traits was not confirmed in this study. Reliability of the results is limited by significant disproportions in the size of the study groups.

Perceived Stress Levels among Ukrainian Migrant and LGBT+ Minorities in Poland during the COVID-19 Pandemic.

The Coronavirus disease 2019 (COVID-19) pandemic, immigrant status and being a member of the LGBT+ community are all independent factors associated with increased stress levels. Few studies provide more complex analysis on this issue, and there has been no research on the cumulative burden of perceived stress that people belonging to both minorities experience in the current epidemiological situation. The aim of this study was to assess the ability to deal with an external situation during the third wave of the COVID-19 pandemic in Poland in the following groups with different stress levels (total sample n = 370): Polish heterosexual men (n = 202), heterosexual men from Ukraine (n = 131) and homo- and bisexual men (men who have sex with men-MSM) from Ukraine (n = 37). A Perceived Stress Scale (PSS-10) was used. The analysis of the survey did not show statistically significant differences between the three study groups in the general level of perceived stress (24.71, 24.77 and 26.49 points, respectively, p = 0.551), but it revealed numerous differences in coping with various aspects of everyday functioning between these groups. Negative assessment of one's own health proved to be the main factor negatively affecting the level of perceived stress, however specific health risks, medical history or the participants' previous experience have not been taken into account in the study. Our research shows differences in the needs, resources and methods of coping with stress between men who are Polish citizens and migrants from Ukraine, both heterosexual and belonging to the MSM group. Proper identification and addressing of these needs, taking into account different availability of health services, could be the responsibility of NGOs or insurance providers. This should result in the reduction of mental health burdens and the risk of developing serious mental disorders, and consequently in better functioning of persons belonging to minorities and in a reduced burden on the health care system.

Should we supplement zinc in COVID-19 patients? Evidence from a meta-analysis.

INTRODUCTION: Preliminary retrospective reports showed that zinc supplementation may decrease mortality in patients with COVID-19, postulating the potential therapeutic efficacy of zinc in the management of the disease. OBJECTIVES: We sought to summarize the studies published to date regarding the antiviral activity of zinc in patients with COVID-19. PATIENTS AND METHODS: A meta-analysis was performed to compare the outcomes of hospitalized patients receiving zinc supplementation and those treated with standard care. The primary outcome was survival to hospital discharge. Secondary outcomes were in-hospital mortality and length of stay in hospital or intensive care unit (ICU). RESULTS: Data relating to 1474 patients included in 4 studies were analyzed. Survival to hospital discharge was 56.8% in the zinc group compared with 75.9% in the nonzinc group (P = 0.88). In-hospital mortality was 22.3% in the zinc group compared with 13.6% in the standard care group (P = 0.16). The mean (SD) length of hospital stay was 7.7 (3.7) days in the zinc group and 7.2 (3.9) days in the standard treatment group (P <⁠0.001). The mean (SD) length of ICU stay was 4.9 (1.7) days in the zinc group and 5.8 (1.9) days in the standard care group (P = 0.009). CONCLUSIONS: Zinc supplementation did not have any beneficial impact on the course of COVID-19 evaluated as survival to hospital discharge and in-hospital mortality. The zinc-supplemented group had longer hospital stay despite shorter ICU stay. At present, there are no evidence-based data to support routine zinc supplementation in patients with COVID-19.

Social Isolation During COVID-19 Pandemic. Perceived Stress and Containment Measures Compliance Among Polish and Italian Residents.

BACKGROUND: In this study, we analyze the association of social isolation in the first phase of the pandemic with perceived stress among residents of Poland and Italy with a look at how these populations adjust to and comply with implemented regulations, guidelines, and restrictions. MATERIALS AND METHODS: Internet survey with Perceived Stress Scale (PSS-10) and questions regarding mobility patterns, attitude, and propensity to adjust toward the implemented measures and current health condition was made among Polish and Italian residents (Cronbach's alpha 0.86 and 0.79, respectively). The sample size was 7,108 (6,169 completed questionnaires in Poland and 939 in Italy). RESULTS: The Polish group had a higher stress level than the Italian group (mean PSS-10 total score 22,14 vs 17,01, respectively; p < 0.01). There was a greater prevalence of chronic diseases among Polish respondents. Italian subjects expressed more concern about their health, as well as about their future employment. Italian subjects did not comply with suggested restrictions as much as Polish subjects and were less eager to restrain from their usual activities (social, physical, and religious), which were more often perceived as "most needed matters" in Italian than in Polish residents. CONCLUSION: Higher activity level was found to be correlated with lower perceived stress, but the causality is unclear. Difference in adherence to restrictions between Polish and Italian residents suggests that introducing similar lockdown policies worldwide may not be as beneficial as expected. However, due to the applied method of convenience sampling and uneven study groups, one should be careful with generalizing these results.

Attitudes and Perceptions of Health Protection Measures Against the Spread of COVID-19 in Italy and Poland.

Background: During the first wave of the COVID-19 pandemic (April to May 2020), 6,169 Polish and 939 Italian residents were surveyed with an online questionnaire investigating socio-demographic information and personality traits (first section) as well as attitudes, position, and efficacy perceptions on the impact of lockdown (second section) and various health protection measures enforced (third section). Methods: The "health protection attitude score" (HPAS), an endpoint obtained by pooling up the answers to questions of the third section of the survey tool, was investigated by multiple linear regression models, reporting regression coefficients (RC) with 95% confidence intervals (95% CI). Results: Concerns for business and health due to COVID-19 were associated with a positive attitude toward risk reduction rules. By contrast, male sex, concerns about the reliability of information available online on COVID-19 and its prevention, along with the feeling of not being enough informed on the transmissibility/prevention of SARS-CoV-2 were associated with a negative attitude toward risk mitigation measures. Discussion: A recent literature review identified two social patterns with different features in relation to their attitude toward health protection rules against the spread of COVID-19. Factors positively associated with adherence to public health guidelines were perceived threat of COVID-19, trust in government, female sex, and increasing age. Factors associated with decreased compliance were instead underestimation of the COVID-19 risk, limited knowledge of the pandemic, belief in conspiracy theories, and political conservativism. Very few studies have tested interventions to change attitudes or behaviors. Conclusion: To improve attitude and compliance toward risk reduction norms, a key intervention is fostering education and knowledge on COVID-19 health risk and prevention among the general population. However, information on COVID-19 epidemiology might be user-generated and contaminated by social media, which contributed to creating an infodemic around the disease. To prevent the negative impact of social media and to increase adherence to health protection, stronger content control by providers of social platforms is recommended.