Place of residence does not significantly influence radiological morphology of cervical cancer.

INTRODUCTION AND OBJECTIVE: Cervical squamous cell carcinoma is one of the most common malignancies of women. Its incidence and morphology was analyzed based on the magnetic resonance (MR) data among rural and urban residents. MATERIAL AND METHODS: The study involved 61 Caucasian women (58.26±9.63 years) preliminary diagnosed with a cervical cancer without any previous treatment. Standard MR examination, including diffusion weighted imagining, apparent diffusion coefficient (ADC) value measurement and dynamic contrast enhancement, was performed. RESULTS: The rural residents (n=22) were insignificantly older. Their first and last menstruation were observed later and number of pregnancy was higher than in urban women (n=39). However, the incidence of miscarriage was insignificantly rarer. All the tumour linear diameters as well as its volume were insignificantly higher in rural women. The ADC value of the cervical tumor was insignificantly lower, while ADC of lymphatic nodules was higher in rural women. Insignificant changes in tumour grade between both examined groups were found in histological, clinical and radiological examinations. Place of residence did not influence any clinical symptoms nor tumour volume and its ADC. Colporrhoea and colpodynia were insignificantly more often observed in urban women, while parametrium, urinary bladder and rectal infiltrations were more commonly seen in rural residents. Higher risk of lymphatic spread to the internal iliac and parametral lymphatic nodes was reporte[b]d in the rural community. CONCLUSIONS: Cervical cancer had similar morphology and growth pattern, regardless of the place of residence. However, a insignificantly larger tumour size among rural residents may suggest a higher incidence of lymphatic spread, probably as a result of less aaccess to modern health care.

Selected non-somatic risk factors for pregnancy loss in patients with abnormal early pregnancy.

INTRODUCTION AND OBJECTIVE: Spontaneous abortion constitutes one of the most frequent complication of human pregnancy. Despite intensive research efforts undertaken to date, the etiopathogenesis of early pregnancy loss has not been fully elucidated. The objective of this study was to analyze the role of selected non-somatic risk factors for early pregnancy loss in patients with various clinical manifestations of spontaneous abortion. MATERIALS AND METHODS: The study included 242 women hospitalized between 2001 and 2004 in the 3rd Chair and Department of Gynecology, Medical University of Lublin, Poland (Teaching Hospital No.4) with various clinical categories of spontaneous abortion. Each patient completed a questionnaire assessing her exposure to the examined factors. In patients with threatened abortion dismissed from the hospital with viable gestation, the course of pregnancy was followed-up using questionnaire data and medical records. RESULTS: In the studied population of women with abnormal early pregnancy course, a significant impact on the risk of miscarriage was observed in case of such factors as: exposure to stress at home and limited number of hours of nightly sleep. Factors such as occupational hazards, diet, stress, heavy housework and use of cigarettes or alcohol did not exert a significant effect on the risk of miscarriage in the studied population. CONCLUSIONS: The results of this study confirm the complexity of the early pregnancy loss etiopatogenesis. Further research need to be conducted in order to identify the non-somatic causative agents of various clinical forms of miscarriage. It may help do select women in reproductive age at high risk of early pregnancy loss and show the ways in which effective preventive measures can be introduced in such population.

Selected breast cancer risk factors and early detection of the neoplasm in women from Lublin region attending screening program in St. John's Cancer Center, years 2005-2006.

INTRODUCTION AND OBJECTIVE: In Poland, consulting is offered to women about risk factors of breast cancer, breast symptoms and early cancer detection. Study aims were to evaluate the correlation between some risk factors and women's attendance to breast checkups, and to assess links between risk factors and detection of early breast cancer. MATERIALS AND METHODS: The study involved 8014 women aged 50-69 years, participating in breast cancer screening program. The frequency of breast checkups (mammography, CBE and BSE) and occurrence of breast cancer risk factors in studied women were evaluated as well as clinical stage of detected tumors. Odds ratios were used to compare relative odds of breast cancer with exposure to risk factors. RESULTS: 47.11% studied women had regularly undergone MMG, 30.82% had CBE within the previous year, 14.26% regularly performed BSE. The incidence of risk factors varied from 2.94% (menarche at ≤11 years) to 12.38% (current use of HRT). In 47.82% women, no evidence of studied risk factors was found. Women with history of breast biopsies and current users of HRT had MMG, CBE and BSE significantly more often (p<0.0001). 29.27% early breast cancers (pTis, pT1abN0) were found among 82 detected tumors. Relative odds of breast cancer occurrence in women without the risk factors were significantly lower (OR=0.55, 95% CI [0.35; 0.86]). Only nulliparous women had significantly higher odds of early breast cancer (OR=7.37, 95% CI [1.32; 41.17]). CONCLUSIONS: Women using HRT and women after breast biopsy were significantly more likely to attend breast checkups. There were no significant links between most risk factors and odds of early stages of breast cancer. Women should have preventive checkups irrespective of their breast cancer risk factors.

Solid-pseudopapillary neoplasm of the pancreas - comparisons between magnetic resonance and histological findings.

Solid-pseudopapillary neoplasm is a rare pancreatic tumor typically observed in young adults. A new case of the tumor was diagnosed in a 22-year-old woman. An abnormal mass connected with the pancreatic body was found on ultrasound and computed tomography. Magnetic resonance revealed weak homogeneous contrast enhancement and a low ADC value (0.824 mm/s2; b1000). Primary radiological diagnosis suggested a solid pancreatic neoplasm, which was confirmed during histopathological assessment after resection of the pancreatic body with preservation of the spleen and normal drainage through the main pancreatic duct. Histological appearance of the solid-pseudopapillary neoplasm corresponded with its radiological morphology.

Incidence of spinal perineurial (Tarlov) cysts among East-European patients.

The spinal perineurial cyst (Tarlov) is a dilatation between the perineurium and endoneurium of spinal nerve roots, located at level of the spinal ganglion and filled with cerebrospinal fluid but without communication with the perineurial subarachnoid space. The aim of the study was to evaluate it incidence among East-European patients. The retrospective data collected during various magnetic resonance spinal examinations and stored on the picture archiving and communication system was analyzed for an incidence of perineurial cysts. From among 842 patients that underwent examination, 75 cases perineurial cysts were revealed. In 22 cases single anomalies were found. In remaining 53 cases, multiple uni- or less frequently bilateral changes were noted. The most common position was the sacral canal, particularly the level of S2 and S3. Occasionally, cysts were also visible on the cervical, thoracic and lumbar level. Incidence of sacral perineurial cysts was significantly higher in females than in males. Similar data was found for single and multiple changes despite of their localization. Insignificant changes were seen for patient age and cyst size. Perineurial spinal cysts were the most frequently observed on the sacral level and such changes were more common in females.

[Lymphoedema--diagnosis and treatment]. / Obrzeki limfatyczne--diagnostyka i leczenie.

Lymphoedema is a common complication of oncological treatment. Various methods of imaging are used in its diagnosing and monitoring. However, presently lymphoscintigraphy has become the golden standard. A physical examination and detailed medical history also play a very important role. There are still no effective methods of prevention and treatment of lymphoedema in spite of medical progress. The treatment requires a multidisciplinary approach with the use of various methods of physiotherapy (pressure therapy, pneumatic pumps and electric high-voltage treatment), pharmacology and surgery. Patient's education and suitable physical exercises are also significant.

[Radiation-induced neuropathy]. / Powiklania neurologiczne po radioterapil.

Radiation-induced neuropathy is commonly observed among oncological patients. Radiation can affect the nervous tissue directly or indirectly by inducing vasculopathy or dysfunction of internal organs. Symptoms may be mild and reversible (e.g., pain, nausea, vomiting, fever, drowsiness, fatigue, paresthesia) or life-threatening (cerebral oedema, increased intracranial pressure, seizures). Such complications are clinically divided into peripheral (plexopathies, neuropathies of spinal and cranial nerves) and central neuropathy (myelopathy, encephalopathy, cognitive impairment). The degree of neuronal damages primarily depends on the total and fractional radiation dose and applied therapeutic methods. The conformal and megavoltage radiotherapy seems to be the safeties ones. Diagnostic protocol includes physical examination, imaging (in particular magnetic resonance), electromyography, nerve conduction study and sometimes histological examination. Prevention and early detection of neurological complications are necessary in order to prevent a permanent dysfunction of the nervous system. Presently their treatment is mostly symptomatic, but in same cases a surgical intervention is required. An experimental and clinical data indicates some effectiveness of different neuroprotective agents (e.g. anticoagulants, vitamin E, hyperbaric oxygen, pentoxifylline, bevacizumab, methylphenidate, donepezil), which should be administered before and/or during radiotherapy.

[Chemotherapy induced peripheral neuropathy]. / Neuropatia obwodowa wywolana chemioterapia.

Modern cancer therapy prolongs patients life but commonly increases incidence of treatment-related complications. One of such adverse effect is a neurotoxicity, which usually manifestates as peripheral neuropathies (CIPN), characterised by various sensory (tingling, numbness, pain), motor (foot and hands drop, fastening buttons difficulties) and autonomic (constipation, arythmia) abnormalities as well as pain. Despite of intensive epidemiological and clinical studies, standardized diagnostic criteria and methods of the neuropathy prevention and treatment have not been fully established. The most commonly used form of treatment is symptomatic therapy, including anticonvulsant and antidepressant drugs. Proper education of patients and their families of symptoms and neuropathy consequences is desirable to reduce anxiety and stress.

[The epidemiologic and clinical characteristics of patients in hospice care]. / Charakterystyka populacyjno-kliniczna chorych objetych opieka terminalna.

The Good Samaritan Hospice in Lublin was created in 1989. At the beginning only home care was available but since 1997 stationary care is. The aim of the article was to present the clinical-population characteristics of patients treated terminally in the hospice in the year 2000. Over 294 patients were evaluated, and 173 within this group were treated in ward and died in the ward. The remaining 121 patients were treated out of the ward and died at home. It was estimated that the majority of the hospice patients were people from the city (81.7%) with primary or vocational education. The average age was 66.4 and the most numerous group (58.2%) consisted of patients older than 60. Women were more likely to be treated at the hospice (55.5%). The most frequent reason of death among the hospice patients were cancers of: the alimentary tract (26%), the respiratory system (13.9%), feminine sexual organs (11.6%), and the urinary system (10.9%). 43.5% of the patients were unaware of the diagnosis, and only 34.4% were treated radically. The majority (65.6%) was treated either palliative or symptomatically. The average duration of the in-ward treatment was 22.1 days and was considerably shorter in comparison to the duration of the treatment provided at home. Concluding, the in-ward terminal care is a short term care.

[The course of vulvar carcinoma in a 35-year old female patient]. / Przebieg raka sromu u 35-letniej kobiety.

A vulvar carcinoma is a malignant disease concerning women usually in their 7th or 8th decade of life. The course of this disease is very dynamic in young females. It is often diagnosed in the advanced stage, when it should be treated as a systemic disease. We present a case which is an example of a very sudden course, the diagnostic difficulty and the evidence of the systemic process of the disease. The case is a challenge to make an attempt to apply combined treatment in such cases.