A large scale prospective clinical and psychometric validation of the EORTC colorectal (QLQ-CR29) module in Polish patients with colorectal cancer.

The purpose of our study was to assess if the Polish translation of the European Organisation for Research and Treatment of Cancer (EORTC) Colorectal Cancer (CRC)-Specific Quality of Life Questionnaire (QLQ-CR29) is an acceptable and psychometrically valid measure to collect quality of life (QoL) data in Polish patients with CRC for use in clinical trials and clinical practice. A total of 150 patients undergoing treatment for CRC were prospectively enrolled in the study. Psychometric assessment of the translated QLQ-CR29 structure, reliability, convergent and divergent validity, and clinical validity was subsequently performed. The Cronbach's alpha coefficient ranged from 0.70-0.89, indicating acceptable internal consistency. For test-retest reliability, the ICCs for each item ranged from 0.59-0.91, with exceptions for urinary incontinence and dysuria, indicating good to excellent reproducibility. In multi-trait scaling analyses, the criterion for item convergent and divergent validity was satisfied. The correlations between the EORTC QLQ-CR29 and QLQ-C30 scales were mostly low (r < .40), with a few items demonstrating higher correlations. The known group comparisons analyses demonstrated the ability of the questionnaire to distinguish between patients' differing age, stoma status, and treatment intent. The Polish translation of the QLQ-CR29 is a psychometrically reliable and valid tool. The results of this study are congruent with that of EORTC validation.

Validation of the Polish version of the EORTC QLQ-CX24 module for the assessment of health-related quality of life in women with cervical cancer.

The aim of our study was to undertake a prospective validation study of the Polish version of the EORTC cervical cancer (EORTC QLQ-CX24) module used alongside the EORTC core measure. The translated module was pilot-tested according to the established EORTC guidelines. Patients with histological confirmation of cervical cancer were eligible for the study. All patients filled out the Polish version of the EORTC QLQ-CX24 module in addition to EORTC QLQ-C30 and a demographic questionnaire. Standardised validity and reliability analyses were performed. One hundred and seventy-one patients were enrolled into the study, mean age ± SD: 52.1 ± 9.6. Cronbach alpha coefficients, range 0.81-0.88, showed positive internal consistency. Re-test was undertaken with 40 patients (23.4%). Interclass correlations for the EORTC QLQ-CX24 ranged from 0.85 to 0.89 and proved appropriate test-retest reliability. Satisfactory convergent and discriminant validity in multi-trait scaling analyses was seen. Concluding, the Polish version of the EORTC QLQ-CX24 module is a reliable and valid tool for measuring HRQoL in patients with cervical cancer. It can be fully recommended for use in clinical and epidemiological settings in the Polish population.

Use of contraception by women treated with leflunomide due to rheumatic arthritis.

A total of 46 premenopausal patients treated with leflunomide (LMF) for rheumatic arthritis (RA) and 107 women of reproductive age free from chronic diseases were investigated to evaluate methods of contraception. Among 31 LMF-treated women using contraception, 48.4% chose oestrogen-progesterone hormonal contraception (E-PHC); 16.1% condoms; 3.2% had an intrauterine device and 32.0% preferred natural methods. These methods differed significantly from women in the control group, who mostly used condoms (56.8%) and E-PHC (35.3%) and rarely, natural methods (3.95%) or progesterone injections (3.95%). As many as 32.6% LMF-treated patients did not use any method of birth control. The choice of contraception among RA patients with LFM therapy was significantly dependent on the experience with methods used prior to the LFM therapy introduction (p < 0.001). Compared with women free from chronic diseases, LMF-treated patients use E-PHC significantly more often but still as many as 33% do not use any contraceptive method, despite strong recommendations.

Spinal epidural abscess: common symptoms of an emergency condition. A case report.

Spinal epidural abscess (SEA) is a severe pyogenic infection of the epidural space that leads to devastating neurological deficits and may be fatal. SEA is usually located in the thoracic and lumbar parts of the vertebral column and injures the spine by direct compression or local ischemia. Spinal injury may be prevented if surgical and medical interventions are implemented early. The diagnosis is difficult, because clinical symptoms are not specific and can mimic many benign conditions. The classical triad of symptoms includes back pain, fever and neurological deterioration. The gold standard in the diagnostic evaluation is magnetic resonance imaging with gadolinium enhancement, which determines the location and extent of the abscess. Increased awareness of the disease is essential for rapid recognition and immediate implementation of treatment. Here we describe the case of a 26-year-old woman with SEA with fever, back pain in the thoracic region and delayed symptoms of a transverse spinal cord injury.

[Colposcopy screening for prevention of uterine neck neoplasms]. / Kolposkopowe badania przesiewowe w profilaktyce raka szyjki macicy.

Cervical cancer, throughout the world, is the second most common neoplasm among women. In Europe approximately 22,000 new cases of cervical cancer are diagnosed each year. This study assessed colposcopy as a screening method in the detection of pre- and early neoplastic lesions. This retrospective study analysed 3264 women hospitalized or treated on an outpatient basis at the Gynaecology and Oncology Clinic of CMUJ from 1995 to 1997. Among 81.2% patients the unsuspected colposcopic pictures were found which were histologically verified. In 5.9% of all examined patients the colposcopic pictures suggested lesions of CIN and early invasive cancer. In these cases the colposcopy presented false positive pictures in 2.6%. From this analysis the colposcopy is a method of good concordance with histologic examination result. This allows to eliminate unnecessary punch biopsies and even diagnostic conisation in significant percentage.

[Operative treatment of early cancerous stages and a woman's quality of life]. / Leczenie operacyjne wczesnych stanów nowotworowych szyjki macicy, a jakosc zycia kobiety.

The operative treatment of early cervical cancerous stages changes the womans quality of life. In the literature there exist works on influence of radical treatment of invasive cervical cancer on the psychical and psychological state of the operated woman. There are few works on the influence of early cancerous stages and social activity of woman. The aim of this work is the assessment of influence of precancerous and cancerous cervical disease of psychical state, partnership, family life and professional and social activity of woman. The material were 153 women aged 20-47 years diagnosed and treated in the Department of Gynaecology and Oncology CM UJ Krakow in the period 1989-1994 for CIN 3 and the cervical cancer in IA stage. During the hospitalisation the women were tested psychologically and were performed special examination with originally constructed formula in 3, 6 and 12 month after the treatment. There has been stated that the precancerous and early cancerous disease diagnosis causes the disease awareness in these women who stated themselves as healthy, causes the fear of the life and saving the reproductive organ and protection the reproduction ability, their further family, professional activities i.e. woman's quality of life.