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Kielce, Poland

Sadowski M.,Swietokrzyskie Cardiology Center | Pasiarski M.,Hollycross Cancer Center | Janion-Sadowska A.,Swietokrzyskie Cardiology Center
American Journal of Emergency Medicine

Hypereosinophilic syndromes are rare diseases; however, cardiac involvement is frequently seen. When diagnosed promptly, the prognosis is relatively good; however, a final diagnosis is made by ruling out many conditions leading to secondary eosinophilia. We present a case of Loeffler's endomyocarditis primarily misdiagnosed as an acute coronary syndrome, complicated by low output heart failure and cardiac arrest. After hypereosinophilic syndrome was confirmed and treatmentwith prednisone initiated, the patient respondedwell to therapy, and her further recovery was complete and uneventful. © 2013 Elsevier Inc. All rights reserved. Source

Grywalska E.,Medical University of Lublin | Markowicz J.,Medical University of Lublin | Grabarczyk P.,Institute of Haematology and Transfusion Medicine | Pasiarski M.,Hollycross Cancer Center | Rolinski J.,Medical University of Lublin
Postepy Higieny i Medycyny Doswiadczalnej

The Epstein-Barr virus (EBV) is one of the most common human viruses, infecting more than 90% of the world's adult population. In some individuals the interplay between EBV replication, latency and immune control can be disrupted and evokes prolonged proliferation of EBV-infected lymphocytes and their malignant transformation. Since its discovery as the first human tumor virus, EBV has been implicated in the development of a wide range of human cancers. The evidence for an association with EBV is the strongest for Burkitt's lymphoma, NK/T cell lymphoma, nasopharyngeal carcinoma, Hodgkin's lymphoma and for malignant lymphomas in immune incompetent patients. Additionally, certain epithelial cell tumors, such as gastric carcinoma and breast carcinoma, have been defined as EBV related. However, the virus may be encountered in other types of malignancies. The oncogenic potential of EBV is related to its ability to infect and transform B lymphocytes into continuously growing lymphoblastoid cell lines. EBV encodes a series of products mimicking several growth, transcription and anti-apoptotic factors, to usurp control of the pathways that regulate diverse homeostatic cellular functions. However, the exact mechanism by which EBV promotes oncogenesis remains unclear. The focus of this review is to summarize the current knowledge of oncogenic potential of the Epstein-Barr virus and its role in the pathogenesis of EBV-associated lymphoproliferative disorders. Source

Walczyk A.,Hollycross Cancer Center | Kowalska A.,Hollycross Cancer Center | Sygut J.,The Surgical Center
Endokrynologia Polska

Introduction: Poorly differentiated thyroid carcinoma (PDTC, insular carcinoma) occurs rarely. It is described with more aggressive behaviour, poorer prognosis, and higher mortality than well differentiated thyroid carcinoma (WDTC). The aim of this study was to evaluate the clinical course of patients with PDTC, in addition to frequency, clinical stage at the time of diagnosis and the possibility of radical surgical resection, the necessity and kind of complementary treatment, occurrence of distant metastases, and the survival of patients. Material and methods: The study involved 14 patients (9 females, 5 males) diagnosed and treated for PDTC between 2000 and 2009, aged 38 to 78 years. The medical records of patients with PDTC were analyzed to estimate assumed parameters according to the purpose of the study. Results: PDTC was diagnosed in 14 among 801 patients with thyroid carcinoma (1.75%). Clinical stages (UICC 2002) at the time of diagnosis were as follows: 3 patients - pT 1-2N o-xM x (21.5%); 10 patients - pT 3 4N x o 1M x-1(71.4%); and 1 was unresectable - T xN 1M 1 (7.1%). Total thyroidectomy was achieved in 9 patients (64.3%), and 4 patients (28.6%) received non radical surgery. Complementary radioiodine treatment was given to 12 patients (85.8%). Radiation therapy of the neck was applied to 7 patients, palliative radiotherapy of the brain to 1 patient, and chemotherapy to 1 patient. Distant metastases to the lung and to the brain at diagnosis were observed in 2 patients (14.3%). During follow-up of 3-62 months lung metastases were observed in 4 patients (28.6%), three patients were observed above 5 years as disease-recurrence free (21.5%), but in one patient after 5 years and 2 months distant metastases were diagnosed. Three patients died after 2-30 months (21.5%), 2 patients were lost for control, and in the remaining 6 follow-up lasted for less than 5 years. Conclusions: Poorly differentiated thyroid carcinoma is still a challenge both for pathologists and clinicians. Infrequent prevalence, more aggressive course, and poorer prognosis constitute major problems for the clinicians. Source

Introduction: The presence of regional nodal and/or distant metastases has an influence on the results of treatment in patients with differentiated thyroid carcinoma (DTC). The aim of the study was to evaluate the frequency of complete remission in patients with DTC depending on the presence of lymph nodes and/or distant metastases. Material and methods: A total of 102 patients (82 females, 20 males) aged 20-86 with N1 or M1 (according to TNM staging) after thyroidectomy and 131I therapy were chosen from among the 625 patients with DTC who were treated in our Department. The patients were divided in 3 groups: group I - TxN1M0, group II - TxN0M1, and group III - TxN1M1. The documentation was analyzed by classifying the complete remission patients as being those without the presence of radioiodine uptake in the neck or pathological lesions in the whole body 131I scintigraphy scan after six months of ablation therapy, with negative serum thyroglobulin in the absence of anti-thyroglobulin antibodies, and with normal ultrasound image of the neck. We compared the frequency of complete remission in three groups of patients. Results: We recognized complete remission in 57 patients (82.6%) in group I (TxN1M0), 4 patients (28.6%) in group II (TxN0M1) and 6 patients (31.6%) in group III (TxN1M1). Conclusions: 1. The highest percentage of complete remission was observed in patients with lymph nodes but without distant metastases (group I). 2. In the case of the presence of distant metastases there was no statistically significant difference in the percentage of complete remission between patients with or without the presence of metastases in lymph nodes. Source

Walczyk A.,Hollycross Cancer Center | Szalecki M.,Childrens Memorial Health Hospital | Szalecki M.,Jan Kochanowski University | Kowalska A.,Hollycross Cancer Center
Endokrynologia Polska

Primary hyperparathyroidism (PHPT) is thought to be a common disease in adults. However, it is a rare endocrine disorder in children and adolescents. We report two cases of primary hyperparathyroidism in children diagnosed at the Department of Endocrinology and Diabetes (E&D) in the Children's Hospital (ChH), Kielce. The clinical course of the disease in these cases was fundamentally dissimilar, which confirms the observation that this rare endocrinopathy in children presents various clinical profiles, leading to diagnostic difficulties. In the first case, the severe course of PHPT was observed with signs suggesting a hypercalcemic crisis. In the second case, the patient was in a good condition with a mild hypercalcemia and symptoms limited to the skeleton, due to early identification of the disease. We believe these cases indicate the significant role of calcemia determination as a screening test in the diagnosis of PHPT, including in children. Source

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