Survey on attitudes and knowledge on the organ recovery from deceased donors in Roman Catholic nuns and priests.

UNLABELLED: Deceased donors (DD) organ recovery rate in Poland has never been satisfactory but over the years kidney transplantation from deceased donors has reached the level of 26 transplants/pmp. In 2007 due to a number of reasons, a dramatic fall of organ recovery rate from deceased donors (DD) occurred. The survey on public attitude toward organ transplantation carried out in the same year showed a large reduction of the public trust toward medical profession. Since then, the number of kidney transplantations has never come back to its level from 2006, regardless of a positive attitude toward organ transplantation. The attitude and knowledge survey was recently carried out in 100 physicians and 100 nurses employed in one large district hospital. The results of the attitude survey among the hospital staff showed that the level of knowledge among nurses corresponded to their age and the time since graduation. Younger nurses showed much more appreciation and knowledge toward recovery of organs from the deceased donors. Survey among physicians indicated some hesitation toward recognition of the brain death. In the present paper results of the survey on attitude and knowledge toward organ transplantation among nuns (98 nuns), priests (100 priests) and students (98 students) of the Theological School living in the same area are presented. Despite quite high (>60%) acceptance of the deceased donation, one third of questioned population showed lack of knowledge not only on existing legal regulations, but also of important documents issued by the Catholic Church. CONCLUSIONS: Improvement of transplantation program in Poland requires extensive educational program among various parts of the society: most importantly among physicians, nurses and priests. The Partnership for Transplantation program has been directed to achieve these goals.

Partnership for transplantation: a new initiative to increase deceased organ donation in Poland.

Despite the long-standing history of transplantation, the shortage of organs has remained its most restrictive factor. In 2010, the number of actual deceased organ donors in Poland was 13.5/million population (pmp). However, a huge difference in organ recovery rates is evident between various regions, eg, 32 pmp, in western Pomerania compared with 1-3 pmp in southern districts. A substantial number of patients who die while awaiting organ transplantations could be saved were effective programs able to overcome barriers in deceased organ donation. Such programs, eg, the European Donor Hospital Education Program, Donor Action, European Training Program on Organ Donation, United States Collaborative in Donation were introduced several years ago, but after transient improvements there has not been real progress. A new comprehensive program-Regional Partnership for Transplantation-was initiated a year ago in 4 districts of southern Poland by the Polish Union for Transplantation Medicine. The letter of intent to activate the donation program was signed by the local administration, the president of the local medical school, president of the Physician's Chamber, transplant centers, the Polish Union for Transplantation, and the Polish Transplant Coordinating Center. The plan of action included training of in-hospital coordinators, visits to all regional hospitals in company of a representative of the hospital founding body, examination of the real donation pool and the need for participation in a donation program training and education of the hospital staff in legal and organizational aspects of donation, brain death recognition, and various aspects of donor care. In addition, the program included communication skills workshops for intensive care unit physicians (with participation of 2 actors, an experienced anesthesiologist, and a psychologist), lectures for high school and university students and for hospital chaplains as well as alumni of higher seminaries. The preliminary results (after the first year) showed 40%-70% increases in activity of the local hospitals in the organ donation process.

Serum sICAM, sVCAM and sE-selectin levels in colorectal cancer patients.

Colorectal cancer (CRC) is one of the most common cancers of the gastrointestinal tract and the fourth cause of cancers death in the world. Soluble adhesion molecules (CAMs) are thought to have an important role in host defense against carcinogenesis. They are biomarkers of inflammation and indicators of the immune response to tumors. The study included 40 CRC patients without remote metastases and 24 control subjects. Serum concentrations of sE-selectin, sICAM and sVCAM in patients with CRC were investigated by ELISA method. The level of the sCAMs decreased significantly after radical tumor resection. Preoperative serum concentrations of sICAM and sVCAM in CRC patients were significantly higher compared to the control group, whereas there were no differences regarding serum sE-selectin. Serum levels of sE-selectin, sICAM and sVCAM correlated significantly with each other. There was a significant correlation of serum levels of sICAM-1 and sVCAM-1, but not sE-selectin, with TNM stage and lymph node involvement. No significant relationship was found between serum concentrations of sICAM-1, sVCAM-1 and sE-selectin in CRC patients and patients' age or gender. Our findings suggest that an improved understanding of the mechanisms of membrane shedding of sICAM, sVCAM and sE-selectin is required to delineate their role in tumor progression.

Changes in PDGF concentration in surgically treated colorectal carcinoma.

PURPOSE: The aim of the present study was to asses the effect of tumor advancement, differentiation grade and surgery treatment on PDGF- AB level and platelet (PLT) count depending on the site of blood collection. MATERIAL AND METHODS: The study included 38 patients submitted to surgical treatment due to diagnosis of colorectal cancer (CRC) without remote metastasis: G2- 20 patients and group G3- 18 patients. The control group consisted of 24 healthy subjects. In CRC patients the blood samples was collected three times: 1) before surgery, 2) intrasurgically and 3) 90 days after surgery. Serum PDGF- AB concentration was determined by ELISA- Kit reagents. RESULTS: PDGF concentration in all the patients was several times higher than in the control group, irrespective of tumor differentiation grade and the site of blood collection. However the level of PDGF- AB in intraoperatively collected arterial blood and venous blood in group G3 (arterial blood- 379.9+/-12.1 ng/ml; venous blood- 398.4+/-13.2 ng/ml) was significantly higher than in group G2 (arterial blood- 169.4+/-88.6 ng/ml; venous blood- 194.2+/-84.0 ng/ml). No significant differences were observed between venous and arterial blood. No correlation was found between the PLT count and PDGF- AB concentration. CONCLUSION: High blood PDGF- AB concentration in CRC patients but no significant positive correlation observed between the PLT count and PDGF-AB suggest its neoplastic origin beside PLT. Determination of this factor in blood serum may have an important implication in early diagnosis of CRC, which is the second most common malignant neoplasm with high recurrence rates.

The role of a therapeutic team and The Pol-Ilko Association in readaptation of patients with a stoma to the life in a family and society in the 21st century.

Patients who crossed operation where exteriorization stoma was integral her part the aside from of cause, location and far-gone of illness which hereinto brought require special care. In moment of entry we to European Union should advert on introduction by us the surgeons of new operating techniques not only, but to attach importance to quality of sick's life after operations also, particularly these which violate beauty of our body. They are of the patients' groups the nation from stoma, particularly if cause the exteriorization stoma the state the neoplasmic disease of alimentary canal or arrangement urinary. The stay in Clinic whether the surgical squad, perspective of operation which is final effect producing artificial accompanying urinary content tract intestinal or fecal it joins with high-level of phobia. The Information Bureau for Stoma in year 1993 at Medical University was created and on the basis of this the information bureau the therapeutic complex worked out own model of these patients' care over group. The model of care over sick from stomy hugs three periods: preoperative, early and late surgical period (ambulant). On the basis of The Information Bureau from Stoma in 1994 year The Department was created of Podlasie the Society of Care over Patients from Stoma in Bialystok--association of working on thing sick's good. Organization this assembles from stomy the men, their family and guardians, workers of medical service and different men of good will. Meetings are forms of working, which performance of bothering patient's problems connected with nurturing and supply stomy is aim, and also psychical and help support in readaptation to life in family, company and society. The volunteers' training is to help different form of working this sick's group. Volunteer in this case--then living from stomy over year happily, adopted to life in every respect, person which exemplifies for sick prepared to operation positive (exteriorization stoma) or beginning one's "path stoma". Both the analysis and opinion of work of therapeutic complex, as and the workings The Association be made by only patients, their family and guardians, and also the workers of medical service. The elaborate model of care over sick from stoma on the basis of Information Bureau is accepted universally and resoluteness improves quality of life of this patients' group. Patient in XXI age from stomia on Podlasie it can appropriately living in family, work professionally, grow sport and hobby not only thanks to work therapeutic complex, but also and men who earlier found oneself in similar situation, as he alone.

[Diagnostic value of testing the procoagulant activity of neoplasms in cases of stomach and esophageal neoplasms]. / Wartosc diagnostyczna badania aktywnosci prokoagulanta nowotworowego w przypadkach raka zoladka i raka przelyku.

The cancer procoagulant (CP) activity has been evaluated in homogenates of stomach and esophagus cancer tissues and in patients serum. Activity of CP in homogenates of stomach and esophagus cancer tissues as well as in serum of examined cancer patients were statistically higher than in the control group. The data indicate that estimation of CP activity in the neoplasmic tissues homogenates and in serum may be suggested as an new biochemical marker of cancer process useful in oncological diagnosis.

[Significance of medium molecular weight peptides in pathologic processes]. / Znaczenie peptydów o sredniej masie czasteczkowej w patologii.

The literature concerning of prevalence and meaning of middle molecular peptids in experimental and clinical pathology has been reviewed. Middle molecular peptids have been extracted for the first time from plasma of the patients with renal insufficiency by Babb in 1970.

Cancer procoagulant as a marker in monitoring the therapy in cases of oesophageal, stomach and colorectal cancer.

Cancer procoagulant activity in the blood serum of patients with oesophagal, gastric and colorectal cancer was evaluated before and after the tumour removal. Cancer procoagulant activity was significantly higher before the operation in comparison to the control group and was reduced after a total operative procedure, whereas it was kept on a high level after a non-radical procedure or in cases of metastases. Examination results point to the possibility of using the evaluation of cancer procoagulant activity in monitoring the course of treatment of patients with oesophagal, gastric and colorectal cancer.

[Cancer procoagulant activity in cases of esophageal, stomach and colorectal cancer considering progression degree and histological type of cancer]. / Aktywnosc prokoagulanta nowotworowego w przypadkach raka przelyku, zoladka i jelita grubego z uwzglednieniem stopnia klinicznego zaawansowania i typu histologicznego nowotworu.

The cancer procoagulant activity has been evaluated in homogenates of esophagal, stomach and colorectal cancer tissues and in the blood serum of patients with these neoplasms's. Activity of CP was significantly higher in examined material than in control. The correlation between CP activity and progression degree as well as histological type was affirmed. The higher activity of CP in homogenates as well as in serum was observed in cases with higher degree of clinical progression and smaller activity of this enzyme corresponded with lower degree of the cancer progression. The highest activity of CP was observed in the cases of adenocarcinoma whereas the lowest in cases of squamous cell carcinoma. Higher activity of CP in homogenates of examined tissues correlated with higher activity of this enzyme in the serum. Activity of CP depended on the tissue localisation of the cancer and the highest was in the cases of stomach cancers whereas the lowest was in the cases of esophagal cancer.

Malignant and benign tumours of liver--problems of diagnostics, treatment and complications.

Non-invasive diagnostics development, and particularly introduction of ultrasound to everyday medical practice contributed to early detection of tumour lesions in the liver. The aim of the research was to analyse the patients with tumour lesions of livers in the north-eastern region of Poland. 325 patients with tumour lesions in livers underwent surgical treatment between year 1978 and 2000. In 197 patients metastatic malignant tumours were found in livers, while in 24 cases--primary malignant neoplasms of the organ. In the remaining cases benign tumours, mostly non-parasitic cysts were found. Out of 325 patients, who were surgically treated, 80 underwent resection procedures of liver parenchyma with tumour, 17--enucleation of tumour lesion with the enclosing capsula, 14--abscess drainage with necrotic mass evacuation. In 11 cases of non-parasitic as well as parasitic cysts fenestration was performed due to high risk of surgery, while in the remaining patients laparotomy was only performed and segments for histopathologic examination were taken due to the progression of the neoplasmatic disease. In the patients who had undergone resections of liver parenchyma in the postoperative course we noted complications such as: prolonged cholerrhagia from peritoneal cavity, stress duodenal ulcers complicated by bleeding, bleeding from liver parenchyma at the section line, jaundice as well as cisterns of fluid at the parenchyma section line. Mortality in the patients after the resection procedures of liver in our material was 7.5%. The development of diagnostics contributed to early detection and surgical treatment of tumour lesions of liver. The observation of our patients showed that resection procedures in benign tumours lead to complete recovery, while in malignant lesions--to clearly prolonged survival.

[Hydatoid cysts of liver--diagnostic and therapeutic problem]. / Torbiele watroby bablowcowe--problem diagnostyczny i leczniczy.

In the Department of General Surgery of Medical University 11 patients with hydatid cysts of liver were operated. Ultrasonography and computer tomography allowed to define exact localization, size and contents of the cysts, what made possible planning of operating procedure. In 2 cases nonanatomic resection of liver parenchyma was performed, in 2 ones with coexisting stomach neoplasm just excision of the frontal wall of the cyst and emptying of the interior. In all the other cases the cysts were removed with surrounding liver tissue. Late results of surgical treatment with albendazol therapy are good. Diagnosis of echinococcic desease should be precised, considering with possibility of co-existing foci in other organs.

[The time of maintainance of positive serologic results among patients operated on echinococcal liver cysts]. / Czas utrzymywania sie dodatnich wyników badan serologicznych u osób operowanych z rozpoznaniem bablowicy watroby - obserwacje wlasne.

The purpose of this work was to analyse results of serologie examinations and complaints reported by patients who were operated on echinococcal liver cysts. The analysis was conducted on patients who were qualified to surgical removal of echionococcal liver cysts. Persons who were analysed answered the questionaires and 11 of them send sera for serologie examination. The questionaires consisted of questions about time since operation, complaints before and after operation abdomen pains, distensions, vomits, exanthema, weakness, headaches). Results showed that patient were from 1 to 6 years after operation. Among 11 who send sera 18% results were negative (2 and 6 years after operation) and 82% was positive. Analysis of 15 questionnaires showed that majority of patients still had the complaints that were present before operation.

[Complications after surgical resection of liver parenchyma]. / Powiklania po zabiegach resekcyjnych miazszu watroby.

The number of liver resection in Poland has recently increased. Most frequent indications are benign tumors of the liver, metastatic changes and primary hepatic carcinoma. The aim of work is to discuss incidence of complications which appeared after liver resections at our Department. Among 56 patients aged 19-76, 32 anatomical and 24 nonanatomical resections of hepatic tissue were performed. In the early postoperation period, 8 patients had peritoneal fluid collections and 3 laparotomies with drainage were necessary, while in 5 cases fluid was aspirated under usg guidance. The outflow of bile and blood contents from subhepatic space was prolonged to 9 days in 3 patients, gastric or duodenal 3 stress ulcerations complicated with bleeding were observed as well as transitory hemobilia in 3 and jaundice in 6 cases. Early hemorrhage from excision line of hepatic tissue was observed in 2 patients which needed additional surgical intervention. Atelectasis and inflammatory changes of the right lung appeared in majority of patients operated on. The postoperative mortality of 16% (9 patients of total 56) was mainly dependent on hepatorenal or cardiorespiratory failure, however myocardial infarction and DIC syndrome were also noticed. In spite of progress of surgical technique and intensive perioperative care, resection procedures of the liver are still accompanied with large percentage of serious complications.