Can life satisfaction be considered a predictor of quality of life in patients with lung cancer?

OBJECTIVE: To evaluate the association between satisfaction with life and Quality of Life (QoL) in lung cancer patients, and to analyze the correlations of selected variables with QoL. PATIENTS AND METHODS: 250 patients with lung cancer were enrolled into the study, with a mean age of 63.2± 9.4, and who were treated at the Regional Lung Hospital in Poland between January and June 2019. 110 patients (43.9%) were moderately satisfied with their life (18-23 points from SWLS). 72 (28.8%) had a high level of satisfaction, and 68 (27.2%) had a low level of satisfaction with life. RESULTS: Patients with a high level of satisfaction with life had a better QoL (p<0.001) and experienced less severe symptoms, with the exception of constipation, haemoptoe, soreness in the mouth, dysphagia, hair loss, and pain in the arms. Patients with a high level of satisfaction with life have a significantly lower intensity of behaviors associated with anxious preoccupation (p<0.001) and helplessness/hopelessness (p<0.001). Destructive coping styles increase as satisfaction with life decreases (p<0.001). Patients with a high level of satisfaction with life were more accepting of their illness (p<0.001). CONCLUSIONS: Patients being treated for lung cancer have a moderate level of satisfaction with life. QoL is associated with satisfaction with life and increases depending on the level of satisfaction. Symptoms are less severe when patients are more satisfied with their life. Satisfaction with life was associated with acceptance of the illness and coping strategies. Not smoking, chest pain, time from diagnosis, performance status, and symptomatic treatment adversely affected satisfaction with life. Conversely, a lack of family history of cancer positively affected satisfaction with life.

1,161 patients with adrenal incidentalomas: indications for surgery.

BACKGROUND AND AIMS: The aim of this study is to analyze the clinical data and criteria for surgery in a group of over 1,100 patients with adrenal incidentalomas (AI) observed at the Department of Endocrinology. PATIENTS AND METHODS: The material consisted of 1,161 patients (842 women and 319 men, 10-87 years old) with AI ranging in size from 1.0 to 23.0 cm. The methods included clinical examination, imaging studies, hormonal determinations in the blood and in the urine as well as histological and immunocytochemical investigations in 390 patients treated by surgery. RESULTS: Basing on these studies, we diagnosed 112 patients with primary malignant adrenal tumors (100 with carcinoma), 45 with metastatic infiltrations, and 1,004 with probable benign AI. Imaging phenotypes (especially high density on computed tomography, CT) were characteristic of malignant and chromaffin tumors. Subclinical adrenal hyperactivity was found in 8% of the patients with pre-Cushing's syndrome as the most frequent form (6.5%). Chromaffin tumors were detected in 3%. CONCLUSIONS: (1) Indications for surgery include malignant tumors (both primary and metastatic), tumors with subclinical hyperfunction, and chromaffin tumors. High density on CT, >20 HU, appeared to be an important indication for surgery. (2) A slight prevalence of oncological indications over endocrinological indications (14 vs. 11%) was found.

Post-traumatic otosclerosis: coincidence or trigger factor?

OBJECTIVE: The etiology of otosclerosis is poorly understood and environmental as well as genetic factors have been implicated. In this paper we will present 3 cases of otosclerosis with a clinical history of trauma and we will discuss with a literature review the place of trauma in otosclerosis etiology. CLINICAL CASES: 3 patients with clinically diagnosed otosclerosis, operated, and with a clinical history of previous head trauma. DISCUSSION AND CONCLUSION: It is probable that environmental factors could be involved in the development of the disease and we think that trauma could be one of them. The mechanisms by which it could results in otosclerosis remain unknown. However these cases appear to be rare and under studied.

Active middle-ear implant fixation in an unusual place: clinical and audiological outcomes.

OBJECTIVE: The Vibrant Soundbridge is an active middle-ear implant for hearing rehabilitation that is usually placed in the long process of the incus or round window. This study reports on the unusual implant attachment to the short process of the incus in a patient with ear malformation, and describes their audiological and clinical outcomes. METHODS: Case report and literature review. RESULTS: Audiological evaluation with the Vibrant Soundbridge implant showed a pure tone average of 31 dB. The speech test, at 65 dB HL, revealed correct recognition of 92 per cent of disyllabic words. The Glasgow Hearing Aid Benefit Profile showed high levels of satisfaction, hearing aid use and benefit. CONCLUSION: Fixation of the Vibrant Soundbridge implant on the short process of the incus is a feasible option, with good clinical and audiological outcomes. Coupling the floating mass transducer to the short process of the incus is a good surgical option, especially when the long process and the oval or round window are inaccessible.

A method for generating obstructive thrombi in the coronary arteries of the conscious dog.

A technique for staging the generation of obstructive thrombi in the coronary arteries of conscious dogs is described. At thoracotomy, electrodes are placed in the lumina of coronary artery branches. When thrombus generation in proximity to the intraluminal electrode tip is desired, anodal current is applied to the exteriorised end of the electrode. In each of nine anaesthetised adult mongrel dogs two to seven intracoronary electrodes were implanted for a total of 35. One to 75 days later, 50 to 800 microA anodal current was applied to 16 electrodes for 30 min to 48 h. Upon autopsy, thrombi in various stages of organisation were found in proximity to the intracoronary portion of 15 electrodes. Six electrodes were found to be damaged or broken. In contrast, only four of the 13 control electrodes were sites of thrombus formation. In seven dogs tissue sections indicated either myocardial ischaemia or infarct in regions whose perfusion was blocked by thrombi. This method may provide for discretionary generation of intracoronary thrombi in the desired quantity, at the preferred site(s), at selected times of onset. Consequently, it offers the possibility of adjusting the onset, severity, and time course of myocardial ischaemia.

Self-organizing neural networks for screening and development of novel artificial sweetener candidates.

The use of Kohonen feature maps for the visualization of various aspects of molecular similarity is briefly reviewed and illustrated. It is shown that a specific feature of self-organizing maps (SOM) makes them of special interest for the screening of compounds. In particular, these methods were used to design candidates for new sweeteners, which were then synthesized.

Self-organizing neural network for modeling 3D QSAR of colchicinoids.

A novel scheme for modeling 3D QSAR has been developed. A method involving multiple self-organizing neural network adjusted to be analyzed by the PLS (partial least squares) analysis was used to model 3D QSAR of the selected colchicinoids. The model obtained allows the identification of some structural determinants of the biological activity of compounds.

Aldehyde dehydrogenase isoenzymes in tumours--assay with possible prognostic value for oxazaphosphorine chemotherapy.

A novel fluorimetric assay, allowing independent measurement of the activities of two principal cytosolic forms of human aldehyde dehydrogenase, ALDH-1 and ALDH-3 (known as a tumour-associated ALDH) was applied to estimate the activities of these isoenzymes in human liver and thyroid tumours. The assay is based on two artificial substrates, 6-methoxy-2-naphthaldehyde (MONAL-62) and 7-methoxy-1-naphthaldehyde (MONAL-71), exhibiting excellent substrate properties toward various forms of human ALDH (see Wierzchowski et al., 1997, Anal. Biochem. 245, 69-78). We have found significant differences in ALDH activities between malignant and non-malignant tissue fragments, particularly in cancerous livers. Out of 16 tumours examined, only 4 exhibited ALDH-1 activities comparable to that found in the tumour-free tissue (0.5-2.5 U/g), while in the remaining 12 this activity was at least 10-fold lower. The ALDH-3 activity was detectable in about 40% of both tumour and tumour-free liver samples (maximum value 1.5 U/g). Comparison of 13 pathological thyroid fragments revealed ALDH activities in the range of 0.02 to 0.35 U/g, with two malignant samples showing activities of 0.27 and 0.18 U/g. Both substrate specificity and kinetic behaviour of the thyroid ALDH (Km values for the fluorogenic naphthaldehydes as well as propanal inhibition profile) were similar to those of the purified ALDH-1. In 5 thyroid samples traces of ALDH-3 activity was detected, using MONAL-62 and NADP+ as substrates (maximum value 0.04 U/g). Possible prognostic value of the foregoing measurements for cyclophosphamide chemotherapy is discussed.

Human cystic and alveolar echinococcoses as indication to liver transplantation.

The human cystic and alveolar echinococcoses are zoonotic diseases caused by larval stages of the tapeworms Echinococcus granulosus and E multilocularis. In man the liver form of the diseases develops most frequently. Recent epidemiological data indicate that the distribution of E multilocularis in the central Europe is wider than was previously anticipated; more cases of human alveococcosis during the last years have also been noted in Poland. In the present paper we analyzed several cases of human echinococcoses from Poland with respect to diagnosis and treatment as well as the indications for liver transplantation.

The non-grid technique for modeling 3D QSAR using self-organizing neural network (SOM) and PLS analysis: application to steroids and colchicinoids.

A novel method for modeling 3D QSAR has been developed. The method involves a multiple training of a series of self-organizing networks (SOM). The obtained networks have been used for processing the data of one reference molecule. A scheme for the analysis of such data with the PLS analysis has been proposed and tested using the steroids data with corticosteroid binding globulin (CBG) affinity. The predictivity of the CBG models measured with the SDEP parameter is among the best one reported. Although 3-D QSAR models for colchicinoid series is far less predictive, it allows for a discussion on the relative influence of the structural motifs of these compounds.

A search for new glucophores by isosteric replacement of carboxylic function.

We used arylsulfonylalkanoic acids as parent structures for designing new potential sweeteners. The Kohonen maps of the molecular electrostatic potential of the possible bioisosteric replacements of carboxylic function have been simulated and used for the selection of the potential synthetic targets which are now under synthesis.

Self-organizing neural networks for modeling 3D QSAR--a comparative study.

Different architectures of self-organizing neural networks (SOM) have been used for modeling 3D QSAR. The atomic coordinates and partial atomic charges were used as input signals. In particular, the steroids complexing corticosteroid binding globulin (CBG) that are used as a benchmark measuring the performance of drug design methods have been applied to compare between individual methods. The sensitivity of the different architectures for changes of the alignments of the molecules within series, as well as the possibility for alignments based on the molecular inertial axes have been tested.

Analogues of the styrylquinoline and styrylquinazoline HIV-1 integrase inhibitors: design and synthetic problems.

In our work, leading to new styrylquinoline and styrylquinazoline inhibitors of HIV integrase, we analyzed virtual combinatorial library that includes these compounds. Using this method we were able to find interesting synthetic targets. We optimized synthetic procedure yielding such compounds and obtained a couple of new analogues. Their activity will be evaluated in the near future.

[Ketone bodies in patients after partially liver resection]. / Wskaznik ketonowy u pacjentów poddanych czesciowym resekcjom watroby.

This study explores the relationship between Arterial Ketone Body Ratio (AKBR = acetoacetate/3-hydroxybutyrate) and the patients state after partially liver resections. Enzymatic methods of Mellanby and Williamson for the determination of ketone bodies (acetoacetate and 3-hydroxybutyrate) were used. Twelve surgical patients (8 women and 4 men) were examined. The control group consisted of 5 persons. Ketone bodies were measured in samples of arterial blood taken before operation and in the postoperative period. Then AKBR values were calculated. Patients were classified into three groups. Group A patients (8 subjects) had AKBR value higher than 0.7, group B patients had AKBR between 0.4 and 0.7 (2 cases), and group C patients had AKBR below 0.4 (2 cases). We observed that incidence of postoperative complications increased with the decrease of AKBR value. No postoperative complications and good general conditions of patients were observed in group A only. Group B patients had postoperative complications, whereas group C patients decreased in the postoperative period. These results indicate that Arterial Ketone Body Ratio is a good indicator for prognosis of postoperative survival of patients after partially liver resections.

[A case of hemorrhagic pancreonecrosis successfully treated by repeated laparotomies using an Ethizip zipper]. / Przypadek martwicy krwotocznej trzustki leczony z powodzeniem wielokrotnymi laparotomiami z uzyciem suwaka Ethizip.

A 26-year-old man is reported in whom during acute pancreatitis haemorrhagic necrosis developed with formation of abscesses in the organ. The patient was successfully treated with repeated multiple laparotomies using an Ethizip zipper. The total time of treatment was 87 days. The zipper was sutured-in during the first operation on the 11th day of hospitalization, and was removed after 28 days after another three explorations of the abdominal cavity. The patient had thus 5 operations, including one for removal of the zipper.

[A case of B-cell lymphoma imitating bronchocentric granulomatosis]. / Przypadek chloniaka limfocytarnego z komórek B imitujacego ziarniniakowatosc okolooskrzelowa.

A case is presented of primary, pulmonary B-cell lymphoma imitating bronchocentric granulomatosis. The initial manifestations were of multiple, pulmonary nodules, without intra- and extrathoracic lymph node, bone marrow and spleen involvement. Despite the initial removal of the affected pulmonary tissue the progression of the disease led to additional immunohistochemical evaluation of the resected tissue and final diagnosis. The authors also carry out a differential diagnosis of the reported changes.

Synergy against fungal pathogens: working together is better than working alone.

Opportunistic fungi are the most important pathogens in modern world. They are responsible for severe infections in majority of immunocompromised patients. These microorganisms are commonly present in our environment which is natural reservoir of new, resistant species. For this reason mycoses are mainly chronic or long-lasting diseases. Our arsenal of antifungal drugs is growing but still insufficient for emerging resistant pathogens. An alternative for novel chemical entity drugs is the multidrug approach. This exploiting the drugs being currently on market applying simultaneously for better efficacy or to eradicate resistance. Synergy is the term that describes the phenomenon of increased potency of two or more drugs administered in combination. In the last decades it gains more interest and numbers of synergy claimed reports is growing exponentially. However these have rather low impact on clinical trials or practical use of antimycotics. In present review we wish to discuss current status of synergy between antifungal drugs. Both theoretical point of view and practical applicability in clinical terms are covered. There are serious differences between the assumptions, methods and interpretations of the results and sometimes even obvious mistakes in the procedure that was applied or in the outcomes discussed. On the other hands the specificity of fungal infections introduce dozens of factors affecting the observed results. Shift form in vitro studies to clinical trials reveals further difficulties. Hopefully multi-drug approach seems to be effective even if no strong synergy is displayed.

Evaluation of antioxidant treatment in presbyacusis: prospective, placebo-controlled, double-blind, randomised trial.

OBJECTIVE: There are many well-known aetiological mechanisms of presbyacusis, and free radicals have been shown to play an important role. This study aimed to evaluate the effect of antioxidant agents on the hearing threshold of patients with presbyacusis. METHODS: One hundred and twenty individuals were divided into four groups and received one of the following treatment schemes: ginkgo biloba dry extract, α-lipoic acid plus vitamin C, papaverine chlorhydrate plus vitamin E, or placebo. All participants were evaluated at recruitment and after six months, using pure tone audiometry (at isolated and average frequencies), speech recognition threshold and percentage index of speech recognition. RESULTS: The various treatments had no effect on any of the evaluated measures of hearing, either between groups or over time. CONCLUSION: There was no statistically significant change in the hearing threshold after treatment with any of the tested drugs, during the study period.

Pharmacophore-based database mining for probing fragmental drug-likeness of diketo acid analogues.

A number of the structurally diverse chemical compounds with functional diketo acid (DKA) subunit(s) have been revealed by combined online and MoStBiodat 3D pharmacophore-guided ZINC and PubChem database screening. We used the structural data available from such screening to analyse the similarities of the compounds containing the DKA fragment. Generally, the analysis by principal component analysis and self-organizing neural network approaches reveals four families of compounds complying with the chemical constitution (aromatic, aliphatic) of the compounds. From a practical point of view, similar studies may reveal potential bioisosteres of known drugs, e.g. raltegravir/elvitegravir. In this context, it seems that mono-halogenated aryl substructures with para group show the closest similarity to these compounds, in contrast to structures where the aromatic ring is halogenated in both ortho- and para-locations.

Privileged structures - dream or reality: preferential organization of azanaphthalene scaffold.

The concept of privileged structures/substructures (PS) is the idea that certain structural features produce biological effects more often than others. The PS method can be seen as an offspring of fragonomics, which is based on recent experimental measurements of protein-ligand interactions. If PS prove to be true, then chemical motives that enrich biological activity can be used when designing new drugs. However, PS remain controversial because we cannot be sure whether the excess of active structures does not result from an abundance in chemical libraries. In this review, we will focus, in particular, on the preferential organization of azanaphthalene scaffolds (AN) in drugs and natural products (NP), which are preferred by Nature in evolution. We will show that knowledge discovery in molecular databases can reveal interesting time-trends profiles for important classes of potentially privileged scaffolds. The chemical library of AN is dominated by monoaza-compounds, among which quinoline appears to be the most frequently investigated scaffold; however; more sophisticated database mining seems to indicate different PS patterns within the AN scaffold family.