The Prevalence of Orthostatic Hypotension in Cancer Patients.

BACKGROUND: Orthostatic hypotension (OH) is associated with a higher risk of mortality in the general population; however, it has not been studied in the cancer population. This study aimed to assess the prevalence of OH in cancer patients compared to that in the noncancer population. METHODS: A total of 411 patients (mean age 63.5 ± 10.6 years) were recruited: patients with active cancer (n = 223) and patients hospitalised for other reasons, but without a cancer diagnosis (n = 188). Medical histories were collected and an orthostatic challenge test was performed. OH was defined as a blood pressure (BP) decrease upon standing of ≥20 mmHg for the systolic or ≥10 mmHg for the diastolic BP after 1 or 3 min; or a systolic BP decrease <90 mmHg. RESULTS: The prevalence of OH in the subjects with cancer was significantly higher than in the subjects without cancer (28.7% vs. 16.5%, respectively, p = 0.003). OH was the most common in the lung cancer patients (57.5%). In a single-variable analysis, the predictors of OH were cancer presence, age ≥ 65 years, and body mass index (BMI) ≥ 30 kg/m2. In the multivariable model, the strongest independent predictor of OH was cancer status, which doubled the risk of OH, and BMI ≥ 30 kg/m2 and diabetes. CONCLUSIONS: Cancer patients are characterised by a high prevalence of OH. In this population, the recommendation of routine orthostatic challenge tests should be considered.

A COVID-19 Diagnosis Like an Avalanche Triggers a Series of Adverse Events but Saves a Life in the End.

Patients diagnosed with cancer are less frequently covered by preventive measures for cardiovascular diseases. The frequent co-occurrence of these diseases makes it necessary to apply parallel diagnostics and cardiological treatment with anti-cancer therapy. Frequently. multidisciplinary team discussions are needed. Case report: We present a case of a 73-year-old former smoker with hyperlipidemia, type 2 diabetes, and arterial hypertension, after a partial right nephrectomy in 2005 due to kidney cancer, diagnosed with SARS-CoV-2 infection in April 2022. Subsequent chest imaging showed a 20 mm focal lesion in the left lung further classified as a small-cell neuroendocrine carcinoma. Unexpectedly, the patient was hospitalized due to ST-segment elevation inferior left ventricular (LV) myocardial infarction. It was treated successfully with percutaneous coronary angioplasty (PCI) of the circumflex and first marginal artery with drug-eluting stent (DES) implantation. One day later, PCI of the left anterior artery was performed with two DES implantation; however, heart failure (HF) with a reduced left ventricle ejection fraction of 30% was diagnosed. One month later, the patient required hospitalization again due to HF decompensation, and cardiological treatment was optimized with flozin in addition to standard HF therapy. Subsequently, after cardiological approval the patient qualified for chemotherapy with the cisplatin-etoposide regimen. Therapy was continued for 6 months without HF decompensation and significant deterioration in renal function. After that, the patient underwent radical radiotherapy. Follow-up chest computed tomography scans showed regression of the neoplastic lesion. Conclusions: The coincidence of newly recognized cancer and inflammatory disease might contribute to and provoke serious cardiological events. To reduce the risk of cardiovascular complications, periodic cardiological surveillance and optimal pharmacotherapy are required.

Contents of bioelements and toxic metals in the Polish population determined by hair analysis. Part IV. Adults aged 40 to 60 years.

The aim of this study was to define referential values of 5 basic bioelements (Ca, Mg, Zn, Cu, Fe) and 2 toxic metals (Pb and Cd) in the hair of Polish adults aged 40 to 60 years, based on the research conducted from 1991 to 2006 on a group of 3349 formally healthy women and men. The results of our biochemical tests were subjected to statistical analysis and they can be treated as referential norms for the concentrations of analyzed bioelements in the hair of Polish population. Our analyses confirm significant differences in accumulations of certain elements (Ca, Mg, Zn) in women's and men's hair. The hair element analysis of the tested women population indicates the age 49-50 as the one in which a significant decrease of hair Ca and Zn begins. Marked decrease of Ca and Zn in men begins 2-3 years later than in women. A slight tendency to decrease hair Mg in women and men during the period observed of 40-60 years of age was noticed. Significant differences (alpha = 0.05) between hair Cu contents in women and men were not observed. The increase of variances of hair Fe concentrations in women, especially after 50, has been observed. Significantly higher hair Pb and Cd concentrations were shown in men. The analysis of correlation confirms the significance (p < 0.050000) of synergistic interactions between bioelements: Ca-Mg (r = +0.7635), Ca-Zn (r = +0.36), Ca-Cu (r = +0.124), Ca-Fe (r = +0.054), Mg-Zn (r = +0.35), Mg-Cu (r = +0.11), Mg-Fe (r = +0.0757), Zn-Cu (r = +0.11), Cu-Fe (r = +0.0765). Significance (p < 0.050000) of antagonistic interactions of bioelements with toxic metals: Ca-Pb (r = -0.0965), Zn-Pb (r = -0.2476), Mg-Pb (r = -0.13), Zn-Cd (r = -0.0889) was established. Significance (p < 0.050000) of synergistic effects with toxic metals: Pb-Cd (r = +0.3322), Cu-Pb (r = +0.09), Fe-Pb (r = +0.1413), Fe-Cd (r = +0.1161) was confirmed. Adults in whose hair bioelements and hair toxic metal concentrations have shown values outlying from reference and who have too much toxic elements and too little bioelements should undergo further diagnostic tests since these results could be a sign of disturbances, that could lead to various diseases.

[The effects of operative SUI treatment established using Burch colposuspension and IVS tape and evaluated through various urogynecologic tests]. / Efekty leczenia operacyjnego wysilkowego mietrzymania moczu (wnm) za pomoca kolpopsuspensji sposobem Burcha oraz tasmy IVS oceniane przy uzyciu róznych badan uroginekologicznych.

OBJECTIVES: Numerous diagnostic instruments have been used in modern urogynecology; alas, sufficient comparative analysis between most of them has not been carried out in world literature. DESIGN: The aim of the study was to compare the results of selected urogynecology tests, used to analyze the effectiveness of SUI treatment, using Burch colposuspension and IVS tape. MATERIAL: The study was conducted among 76 patients selected for operative treatment of SUI II and III degree, using of Burch colposuspension (I group, n=47) and IVS tape, Tyco (II group, n=29). METHODS: The following investigations: urogynecologic anamnesis and examination with cough test, miction diary, pad test, urodynamic exam and UDI-6 questionnaire, have been used to evaluate SUI symptoms before and half a year after the operation. RESULTS: The percentage of the cured, depending on the adopted urogynecology investigation, oscillated in group I between 56.8% to 91.5%, and 56.5% to 86.2% in group II. The best results were obtained in anamnesis and cough test. CONCLUSIONS: 1. The analyzed methods of urogynecology tests correlate with anamnesis as far as SUI symptoms after operative treatment are concerned. 2. There are relevant differences between several tests, in case of the estimation of SUI cure rate after colposuspension, as well as when using IVS tape.

[The efficacy of SUI treatment with Burch colposuspension evaluated with use of ITT analysis]. / Skutecznosc leczenia wysilkowego nietrzymania moczu (wnm) za pomoca operacji sposobem Burcha oceniana przy uzyciu analizy ITT.

OBJECTIVES: Search for methods of assessment of effects of SUI treatment, which goal is to minimize risk of bias, are inconclusive and remain the subject of investigation. DESIGN: The aim of the study was to analyze the influence of application of different methods of efficacy measurement of SUI treatment with use of Burch colposuspension on final conclusions concerning the treatment effects. MATERIAL AND METHODS: Prospective investigation was carried out among 50 women with SUI symptoms II or Ill degree, scheduled for Burch colposuspension. The analysis of obtained results was carried out with use of ITT and modified ITT. To compare, therapy effects were explored with the use of principles which have been, until quite recently, most often used in urogynecology. RESULTS: Differences in percentage of cured, based on results of several urogynecologic examinations according to method of analysis (previously used method, ITT, modified ITT), have oscillated between 3% to 20%. CONCLUSIONS: (1) While selecting diagnostic methods to analyze SUI treatment effectiveness, potential problems with obtaining complete data after the treatment should be taken into account. (2) In order to minimize statistic bias, the usage of few methods of analysis of obtained results is highly recommended.

[The influence of SUI operative treatment with use of IVS tape on quality of life]. / Wplyw operacyjnego leczenia wysilkowego nietrzymania moczu (wnm) za pomoca tasmy IVS na jakosc zycia pacjentek.

OBJECTIVES: Real influence of urinary incontinence symptoms and adopted modes of treatment on patient's quality of life is not known. DESIGN: Assessment of influence of operative SUI treatment with the use of IVS tape on patient's quality of life. MATERIAL AND METHODS: Prospective study was conducted among 57 patients with SUI symptoms II and III degree (type III according to Blavais), who were classified to apply IVS tape. Diagnostic investigations were completed by questionnaires: IIQ-7 and UDI-6, which were filled by patients. In analysis there were included results obtained before the operation and 6 months after procedure. RESULTS: We recognized women as cured: based on physicians anamnesis--80.7% of patients, according to UDI-6 --71.93%. Half year after operation relevant improvement of quality of life, evaluated by IIQ-7 questionnaire, showed 89.47%. Improvement of quality of life correlated with lack of SUI symptoms in anamnesis (r = 0.631; p < 0.001) and in UDI-6 questionnaire (r = 0.597; p < 0.001). CONCLUSIONS: (1) Operation with the use of IVS tape is effective according to improvement of quality of life in majority of patients treated due to SUI. (2) Efficacy of operative treatment in domain with SUI symptoms correlates with influence of procedure on quality of life. (3) Assessment of SUI operative treatment should include analysis of SUI symptoms and their influence on quality of life, achieved upon standardized questionnaires filled by patients.

Contents of bioelements and toxic metals in the Polish population determined by hair analysis. Part III. Adults aged 20 to 40 years.

The aim of the present study was to define referential values of 5 basic bioelements (Ca, Mg, Zn, Cu, Fe) and 2 toxic metals (Pb and Cd) in the hair of Polish adults aged 20 to 40 years, based on the research conducted from 1991 to 2006 on a group of 5733 formally healthy subjects of both sexes. The results of our biochemical tests were subjected to statistical analysis and they can be treated as referential norms for the concentrations of analyzed bioelements in the hair of the Polish population. Our analyses confirm significant differences in accumulations of certain elements in women's and men's hair. We established that women's hair Ca, Mg, Zn (p = 0.000000) and hair Cu (p = 0.0001) concentrations are higher than they are in men. A lower mean of hair Fe concentrations in women were confirmed by some tests. Men have significantly higher (p = 0.0000) concentrations of toxic metals (hair Pb and Cd), which keep increasing with age. Analyses of correlations confirm significance (for the assumed level of significance alpha = 0.05) of synergistic interactions between bioelements: Ca-Mg (r = +0.70), Ca-Zn (r = +0.39), Ca-Cu (r = +0.14), Mg-Zn (r = +0.31), Mg-Cu (r = +0.10), Zn-Cu (r = +0.11), Zn-Fe (r = +0.07). Significance (a < 0.05) of antagonistic interactions with toxic metals: Ca-Pb (r = -0.13), Zn-Pb (r = -0.15), Mg-Pb (r = -0.15), Zn-Cd (r =-0.02) was confirmed. Significance (alpha < 0.05) of synergistic effects with toxic metals: Pb-Cd (r = +0.35), Fe-Pb (r = +0.16), Fe-Cd (r = +0.08) was also confirmed. Adults in whose hair bioelements and hair toxic metals concentrations have shown values outlying from reference and who have too many toxic elements and too few bioelements should undergo further diagnostic tests since the results could be a sign of disturbances that could lead to various diseases.