Inability to live independently in the course of breast cancer: main risk factors.

INTRODUCTION: A number of articles focus on functioning in breast cancer. However, there are no papers on factors which result in the inability to live independently in the course of the disease. OBJECTIVES: This study assesses risk factors regarding the inability to live independently among individuals with breast cancer. PATIENTS AND METHODS: This study included 130 patients who displayed interest in obtaining a certificate of inability to live independently. RESULTS: Over the study period, 52% of patients did not obtain the certificate of inability to live independently (group A) and 48% did so (group B). There was only a single man in the whole cohort. Metastases were revealed in 13.4% of patients from group A and in 74.2% from group B. Patients from group A had a significantly higher score in the Barthel Index for Activities of Daily Living compared with those from group B (P <⁠0.001). In group A, only 10.6% of patients had no surgery, while in group B, 41.7%. In group B, only 16.7% of patients had breast-conserving surgery, while in group A, 51.5%. CONCLUSIONS: Information on the presence of metastases and on the type of surgery is useful in assessing the risk of being unable to live independently in patients with breast cancer. The Barthel Index for Activities of Daily Living is helpful in assessing the inability to live independently.

[Certification of the inability to an independent existence in Social Insurance Institution]. / Orzecznictwo o niezdolnosci do samodzielnej egzystencji w Zakladzie Ubezpieczen Spolecznych.

On October 1, 2019 the Act of July 31, 2019 on supplementary benefit for persons who are unable to exist independently, commonly referred to as the "500 plus act on the disabled people", entered into force. In accordance with the will of the Legislator, pensions institutions including the Social Insurance Institution (ZUS) are the competent authority to examine applications for supplementary benefit. One of the conditions to get that benefit is having a certificate of the inability to an independent existence which is issued in ZUS by evaluating doctors and medical boards. Therefore in this article we would like to look closely at the aspects of certification of the inability to an independent existence in ZUS. From October 1, 2019 not only insured persons may apply for a certificate of the inability to an independent existence. According to the new Act supplementary benefit may be applied for by anyone who is at least 18 years old and the sum of this person's cash benefits financed from public funds other than one-offs does not exceed PLN 1,600. The answer to the question of who is incapable of independent existence can be found in the Act of 17 December 1998 on pension benefits from the Social Insurance Fund. This is the basis to issue medical opinions in ZUS.

Occurrence of Demodex species in patients with blepharitis and in healthy individuals: a 10-year observational study.

PURPOSE: Two Demodex species (eyelash mites)-D. folliculorum and D brevis-are believed to be associated with human skin and eye diseases. However, the clinical significance of infection with Demodex species remains controversial. STUDY DESIGN: The aim of this study was to estimate the prevalence of ocular demodicosis in patients with blepharitis as compared with the prevalence in the healthy population in Poland. METHODS: This case-control prospective study was carried out from 2007 to 2016. The enrolled patients (668) were divided into 2 groups: the study group, comprising 553 patients with blepharitis (349 women and 204 men, aged 17-88 years), and the control group, comprising 115 healthy volunteers without a history of ocular pathologies (78 women and 37 men, aged 17-88 years). A sample of 10 eyelashes was taken aseptically from each eye of the examined person and later studied under a light microscope. RESULTS: Demodex species were found in 62.4% (345/544) of the patients in the study group and in 24.3% (28/100) of the controls (P = .001, OR = 0.006). The overall prevalence was 55.8% (373/668) in all the examined participants. The presence of Demodex infection increased with age in both groups. No association of Demodex infection with gender was found (119/204 vs 226/349; P > .05, OR 1.086). A high mean number of mites was present more frequently in patients aged older than 50 years and in those who complained especially about itching (P < .05). CONCLUSION: The prevalence of ocular demodicosis is significantly correlated with blepharitis and increases with age.

Influence of Essential Oils on Infectious Agents.

Essential oils are substances of plant origin used to produce cosmetics, to preserve and aromatize food. Recently, they have become more popular among scientists and doctors due to their germicidal, antifungal, antiviral and anti-parasitic properties. As a consequence, essential oils are regarded as the source of new therapeutic substances. Numerous publications have been written regarding their effect on microorganisms in vitro. There have also been reports regarding their use in therapy as an additive to the traditional medical treatment. Essential oils may have other properties with positive effect on health because they may have an influence on the central nervous system and human mental state. It should be, however, kept in mind that compounds of essential oils might also have side effects and lead, like antibiotics, to the selection of resistant pathogens. It is necessary to develop quality standards of obtaining and using these plant preparations, so that they may provide safe and effective assistance in the fight against human pathogens.

Demodex - an old pathogen or a new one?

Demodex was first identified over 150 years ago, but only recently has it attracted wider interest as a contributor to chronic diseases such as acne rosacea or marginal blepharitis. Demodex is commonly found in the human population, in skin sebaceous glands or follicles. The frequency of Demodex infection increases with age, as it is mainly diagnosed after the age of seventy; however, it can sometimes be found in children and teenagers. Demodex is supposed to contribute to the development of marginal blepharitis or acne rosacea, but the pathogenic mechanisms have not yet been explained in detail. These diseases are chronic and the long-term treatment effects are not satisfactory. This paper presents the characteristics of Demodex as well as its prevalence in the pathogenesis of eye and skin diseases, and describes the diagnostics and treatment of these disorders.

[Costs and range of health care consumption under general health insurance and sick leaves among patients with inflammatory bowel disease in chosen countries -- a literature review]. / Koszty i zakres korzystania ze swiadczen zdrowotnych w ramach powszechnego ubezpieczenia zdrowotnego oraz czasowa niezdolnosc do pracy u pacjentów z nieswoistymi zapaleniami jelit w wybranych krajach -- przeglad pismiennictwa.

Inflammatory bowel disease (IBD) is considered to be common in the developed countries of Europe and in North America. A chronic nature of the disease, bowel and systemic symptoms debilitating daily functioning, coexisting extraintestinal complications, recurrent, not infrequently severe and unpredictable clinical course significantly lower patients' quality of life. When compared with the general population, IBD patients more often take use of health care services. They also experience more episodes of sick leave, which is associated with a greater number of sick leave days per year.

[Role of endotoxin in pathomechanism of sepsis]. / Rola endotoksyn w patomechanizmie sepsy.

The nosocomial infections caused by Gram-negative bacteria, in this number Acinetobacter baumannii and Pseudomonas aeruginosa, have severe course and relatively high prevalence of sepsis cases. Pathomechanism of sepsis is related to activation and release of bacterial endotoxin, which is a macromolecule engaged in initiation of cytokine cascade. These mediators are responsible for heavy tissues and organs devastation. Factors that bind and neutralize endotoxin in organism are promising candidates for experimental therapy of sepsis.

[Profile of selected cytokines in various forms of uveitis]. / Profil wybranych cytokin w zapaleniach blony naczyniowej róznego typu.

PURPOSE: The estimation of the level of selected inflammatory mediators in serum of patients with various types of uveitis. MATERIAL AND METHODS: The level of IL-1, IL-6 and TNF was assessed by means of microbiological tests and ELISA test in the group of 60 patients with uveitis, divided as regards to the character of uveitis and the type of the treatment and in control group. RESULTS: The levels of IL-1, IL-6 and TNF were higher in serum of patients with uveitis then in the control group. Patients with known etiology of uveitis had higher level of IL-6 and TNE Patients with autoimmunological etiology of uveitis had higher level of IL-1 and IL-6 than volunteers in control group. CONCLUSIONS: Higher levels of cytokines in serum of patients with uveitis than in control group indicate the activation of immunological response in various types of uveitis.

[Immunological properties of the Gram-negative bacilli Pseudomonas aeruginosa]. / Wlasciwosci immunologiczne Gram-ujemnych paleczek Pseudomonas aeruginosa.

Pseudomonas aeruginosa, which is commonly present in the environment, causes opportunistic infections in immunocompromised patients as well as in those with severe burns or cystis fibrosis. Its pathogenic properties are connected with both intracellular and extracellular constituents. They are able to stimulate the production of proinflammatory cytokines contributing to the development of inflammation. The paper presents the role of Pseudomonas aeruginosa in the infection of various tissues. The authors describe bacterial antigens, toxins, and their ability to induce cytokine production on the basis of the contemporary literature.

[Diagnostic difficulties in differentiating of arteriovenous fistula -- case report]. / Trudnosci diagnostyczne w róznicowaniu przetoki tetniczo-zylnej -- opis przypadku.

Arteriovenous carotid-cavernous fistula is an abnormal connection between the dural branches of carotid artery or vertebral artery and the dural sinuses. Its clinical manifestations can resemble the crucial signs of thyroid orbitopathy, an inflammatory disorder of the orbit associated with Graves' disease. Therefore, differential diagnosis of thyroid orbitopathy and the congestion of the orbit seen in arteriovenous fistula is often clinically and radiologically confused. This is the case report of the simultaneous occurrence of dural arteriovenous fistula in 59 years old woman. The first manifestation was unilateral exophthalmia. After Computer Tomography and Magnetic Resonance Imaging were performed, the preliminary diagnosis of thyroid orbitopathy was established. The response of eye disorder to corticosteroid treatment resulted in evident deterioration. This prompted a reconsideration of the diagnosis and a new evaluation of the patient with sensitive techniques, leading to the final diagnosis of arteriovenous fistula.

Pretreatment of plantar warts with azone enhances the effect of 5-aminolevulinic acid photodynamic therapy.

5-Aminolevulinic acid (5-ALA) is a well characterized precursor in the synthesis of various endogenous porphyrins used in photodynamic therapy (PDT). It is most often administered topically into a tumor which is then irradiated with visible light at established wavelength to sensitize porphyrins accumulated therein. Our main aim in the present study was to increase the penetration of 5-ALA through the altered skin by application of 3% azone (1-dodecyl-azepan-2-one) before the application of 20% 5-ALA in patients with plantar warts: mosaic warts (MW) and myrmecia (MY). We also used 20% 5-ALA only to treat warts in other patients. We compared the therapeutic and cosmetic effects of the two treatment modalities. The lesions treated with modification of 5-ALA-PDT by pretreatment with azone responded with better effectiveness. In 18 patients subjected to 5-ALA-PDT plus 3% azone, we observed 66.7% complete response of MW and 100% of MY following PDT repeated two or three times; whereas in other 18 patients treated with 5-ALA-PDT alone, we observed only 37.5% complete response of MW and 70% of MY. These results provide evidence that the pretreatment with azone should be considered as the step that enhances 5-ALA penetration in tissues and thus increases the effectiveness of applied PDT.

Expression of cystatin C in clinical human colorectal cancer tissues.

We studied the relation between the antipapain activity of cysteine proteinase inhibitors (CPI) and immunohistochemical staining for cystatin C, using anti-chicken cystatin antibodies, in the colorectal cancer tissues. In primary tumour tissues immuno-peroxidase reactivity was present in the cytoplasm and on the cell surface membranes. Sections of non malignant tissues showed no staining. The percentages of positive staining were greater for adenocarcinoma than carcinoma,100% and 77% respectively. Antipapain activity which was increased in malignant tissues in comparison to control, rose successively from well differentiated carcinomas through moderately to poor differentiated. Invasive adenocarcinomas had higher antipapain activity than noninvasive ones. The results indicated that immunohistochemical detection of cystatin using anti-chicken cystatin antibodies could be useful in studying the prognostic significance of cystatin C expression in colorectal cancer.

[Secretion of interleukin 2, 6 and tumor necrosis factor by peripheral blood mononuclear cells in patients with uveitis induced by phytohemagglutinin or lipopolysaccharide]. / Wydzielanie interleukin 2 i 6 oraz czynnika martwicy nowotworów przez jednojadrowe obwodowe komórki krwi u chorych z zapaleniem blony naczyniowej oka, indukowane fitohemaglutynina lub lipopolisacharydem.

The aim of the study was to determine the concentration of selected cytokines secreted by peripheral blood mononuclear cells (PBMC) of patients with uveitis. We determined the spontaneous secretion and PHA- or LPS-induced production of IL-2, IL-6 and TNF in supernatants. The concentration of examined cytokines in patients with uveitis in comparison with healthy controls was not statistically significantly higher.

[Phytohemagglutinin-induced proliferation of peripheral blood mononuclear cells in patients with uveitis]. / Proliferacja komórek jednojadrzastych krwi obwodowej pod wplywem fitohemaglutyniny u chorych z zapaleniem blony naczyniowej oka.

Uveitis is a disease of unknown etiology. In development of the disease immunological abnormalities are considered. Studies include 20 patients (8 women and 12 men) at the age from 10 to 50 (average 32) with uveitis. The control group consists of 11 healthy persons. Presented findings show that local process in the eyeball doesn't modify PHA-induced mononuclear cell response in the lymphoblastic transformation test. The index of proliferation was the same in patients and healthy controls both before the treatment and after a month.

[Significance and the course of cell-mediated response in uveitis]. / Znaczenie i przebieg odpowiedzi komórkowej w zapaleniach blony naczyniowej oka.

In this paper the course of cell-mediated response in uveitis was presented. In recent years, it has been considered that this type of response has had an important role in the pathogenesis and development of this disease.