Military Institute of Health Services

Warsaw, Poland

Military Institute of Health Services

Warsaw, Poland
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Badowska-Kozakiewicz A.M.,Medical University of Warsaw | Sobol M.,Medical University of Warsaw | Patera J.,Military Institute of Health Services | Kozlowski W.,Military Institute of Health Services
Archives of Medical Science | Year: 2013

Introduction: Estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER-2) expression are crucial in the biology of breast carcinoma. HER-2/neu gene is amplified and overexpressed in 15-30% of invasive breast cancers. HER-2-positive breast cancers have worse prognosis than HER-2 negative tumors and possess distinctive clinical features. The aim of this study was to assess the expression of HER2 in cancer tissue of patients with invasive breast cancer in correlation with tumor type, histological grade, tumor size, lymph node status, and expression of estrogen receptor and progesterone receptor. Material and methods: Formalin-fixed, paraffin-embedded tissues from 40 patients with invasive HER-2-positive breast cancer and from 191 patients with HER-2-negative breast cancer were used in this study. HER2 expression was determined using the test HerceptTest™ DAKO. Results: Among 231 cases of breast cancer, 18 invasive lobular carcinomas and 213 invasive ductal carcinomas were diagnosed. Sixty percent of HER-2- positive breast cancers were ER-positive compared with 77% in the HER-2- negative group ( p = 0.002). The expression of PR was observed in 43% of HER- 2-positive breast cancers and in 72% of HER2-negative tumors ( p = 0.003). Excessive expression of HER2 protein was detected in 60% of patients positive for estrogen receptors, which may worsen prognosis in these patients. Conclusions: Determination of HER2 overexpression in breast cancer patients, allows for a determination of a group of patients with a worse prognosis. Copyright © 2013 Termedia & Banach.

Niemczyk S.,Military Institute of Health Services | Niemczyk L.,Medical University of Warsaw | Romejko-Ciepielewska K.,Military Institute of Health Services
Endokrynologia Polska | Year: 2012

The aim of this study was to look at basic endocrinological disorders in chronic kidney disease, acquainting endocrinologists with information about the definition and classification of kidney diseases and basic metabolic disorders in uraemia. Secondary hyperparathyroidism, insulin resistance and hyperinsulinism, growth hormone disorders and the possibility of growth hormone treatment, the reasons for and the consequences of hyperprolactinaemia are presented in a practical way. Thyroid hormones management, a problem which requires further study, is portrayed extensively. Hypothalamic-pituitary-adrenal axis disorders are equally complex and not yet fully examined. We have largely concentrated on the practical aspects of diagnostics of the presented disorders.

Plusa T.,Military Institute of Health Services
Polski Merkuriusz Lekarski | Year: 2011

Macrolide antibiotics have been used to treat acute and chronic inflammation in the respiratory tract based on their antibacterial activity. Now it is well known that macrolides down-regulate damaging prolonged inflammation as well as increase mucous clearance and decrease bacterial virulence. Their ability to inhibit bacterial biofilm is a very important point in control of infections of the bronchial tree, where colonization of Haemophilus influenzae, Streptococcus pneumoniae and Pseudomonas aeruginosa were documented in clinical and experimental studies.

Jerzak M.,Military Institute of Health Services | Niemiec T.,Institute for Child and Family Health | Nowakowska A.,Institute for Child and Family Health | Klochowicz M.,Medical University of Warsaw | And 2 more authors.
American Journal of Reproductive Immunology | Year: 2010

Problem: Does addition of enoxaparin to sildenafil and etanercept immunotherapy improve IVF outcome? Methods: Report of a striking case with 15 IVF failures. Result When enoxaparin was added, the 16th IVF cycle generated a healthy male baby. Conclusions: Combination therapy that includes a heparin may allow successful IVF outcome and this issue merits further study. © 2010 John Wiley & Sons A/S.

Rzepecki P.,Military Institute of Health Services | Barzal J.,Military Institute of Health Services | Oborska S.,Military Institute of Health Services
Supportive Care in Cancer | Year: 2010

Introduction: Undernourishment on hospital admission has been considered as risk factor for complications and increased relapse/nonrelapse mortality in hematopoietic stem cell transplantation (HSCT) patients. Materials and methods: All patients undergoing HSCT are at an increased risk for malnutrition. The changes in these patients affect mainly protein, energy, and micronutrient metabolism. Nutrition support recommendations are now based on the nutritional status of the individual patient, and total parenteral nutrition is no longer indicated for all HSCT patients. As long as it is possible, an oral route should be use in feeding to avoid complications. When total parenteral nutrition (TPN) should be started is one of the most controversial issues. The following indications for TPN are now generally accepted: severe malnutrition at admission (BMI<18.5) or weight loss>10% during treatment or impossibility of oral feeding or failing to meet 60-70% of the requirements over 3 days. Specialized nutritional support containing glutamine or immunomodulatory formulas such as arginine, ω3 polyunsaturated fatty acids, purine/pyrimidines (RNA) may be useful. Result: The complications of TPN are divided into metabolic and those related to central venous catheter. TPN should be progressively decreased while increasing feedings by the oral route. When the patients can cover ≥50% of the daily energy requirements orally (for greater than 5 days), withdrawal of TPN may be appropriate. In patients who have suffered from graft-versus-host disease (GvHD) with intestinal involvement, TPN should be used until the stool volume decreases to <500 ml/day for at least 2 days. Conclusion: Parenteral nutrition allows better modulation of fluid, electrolytes, and nutrient administration which can be of critical importance when complications such as GvHD or VOD arise. © Springer-Verlag 2009.

Kolodziejczyk M.,Center of Oncology of Poland | Kepka L.,Center of Oncology of Poland | Dziuk M.,Military Institute of Health Services | Zawadzka A.,Center of Oncology of Poland | And 3 more authors.
International Journal of Radiation Oncology Biology Physics | Year: 2011

Purpose: To evaluate prospectively how positron emission tomography (PET) information changes treatment plans for non-small-cell lung cancer (NSCLC) patients receiving or not receiving elective nodal irradiation (ENI). Methods and Materials: One hundred consecutive patients referred for curative radiotherapy were included in the study. Treatment plans were carried out with CT data sets only. For stage III patients, mediastinal ENI was planned. Then, patients underwent PET-CT for diagnostic/planning purposes. PET/CT was fused with the CT data for final planning. New targets were delineated. For stage III patients with minimal N disease (N0-N1, single N2), the ENI was omitted in the new plans. Patients were treated according to the PET-based volumes and plans. The gross tumor volume (GTV)/planning tumor volume (PTV) and doses for critical structures were compared for both data sets. The doses for areas of potential geographical misses derived with the CT data set alone were compared in patients with and without initially planned ENI. Results: In the 75 patients for whom the decision about curative radiotherapy was maintained after PET/CT, there would have been 20 cases (27%) with potential geographical misses by using the CT data set alone. Among them, 13 patients would receive ENI; of those patients, only 2 patients had the PET-based PTV covered by 90% isodose by using the plans based on CT alone, and the mean of the minimum dose within the missed GTV was 55% of the prescribed dose, while for 7 patients without ENI, it was 10% (p = 0.006). The lung, heart, and esophageal doses were significantly lower for plans with ENI omission than for plans with ENI use based on CT alone. Conclusions: PET/CT should be incorporated in the planning of radiotherapy for NSCLC, even in the setting of ENI. However, if PET/CT is unavailable, ENI may to some extent compensate for an inadequate dose coverage resulting from diagnostic uncertainties. © 2011 Elsevier Inc.

Osemek P.,Military Institute of Health Services | Pasnik K.,Military Institute of Health Services | Trojanowski P.,Military Institute of Health Services
Wideochirurgia I Inne Techniki Maloinwazyjne | Year: 2010

Occurrence of pathological masses in the inguinal region, mimicking hernias, is an important surgical and radiological problem. Presence of a hernial sac is the determining factor. Herein, we present a case of irreducible femoral hernia with the greater omentum in its sac, interpreted as a preperitoneal lipoma in ultrasonography and computed tomography depictions. The patient underwent Rutkow tension-free hernioplasty with sac revision and dissection of the greater omentum.

Marusza W.,Medical University of Warsaw | Mlynarczyk G.,Medical University of Warsaw | Olszanski R.,Military Institute of Health Services | Netsvyetayeva I.,Medical University of Warsaw | And 3 more authors.
International Journal of Nanomedicine | Year: 2012

Injectable filling agents offer the promise of a better appearance without surgery and, among them, hyaluronic acid is the most commonly used. Although complications are rare, it is necessary to know the possible side effects and complications in order to be prepared for their management. That is why many researchers have been focusing on the interactions between hyaluronic acid and pathogens, inflammatory mediators, the immune system, and markers of oxidative stress to achieve efficient drug delivery, given that hyaluronic acid has widening applications in the field of nanomedicine. Here we report the case of a 37-year-old female patient who returned to our clinic with an abscess in her left cheek 3 months after a deep injection of 1 mL of stabilized hyaluronic acid in both cheeks. Steroid and antibiotic therapy was initiated without success, and abscess drainage was performed. Extraction of tooth 16 was performed 11 days after insertion of drains into the abscess. Laboratory blood tests showed acute inflammation of presumed bacterial etiology. Microbiological examination of pus was negative. Bacterial cultures were found in the extracted tooth. After antibiotic therapy, a complete reversal of the pathological process was observed. The present report highlights the need to assess periodontal problems prior to any aesthetic facial treatment. Analyses of further case reports and clinical studies are necessary to understand the potential role of hyaluronic acid in the formation of biofilm, and how to avoid this complication, thereby increasing the safety of hyaluronic acid-based procedures. © 2012 Marusza et al, publisher and licensee Dove Medical Press Ltd.

Niemczyk S.,Military Institute of Health Services | Romejko-Ciepielewska K.,Military Institute of Health Services | Niemczyk L.,Medical University of Warsaw
Endokrynologia Polska | Year: 2012

The authors discussed disorders in adipocytokines' function in chronic renal failure (CRF) and their clinical implications. Adipocytokines' concentrations in CRF are in most cases elevated, which is associated with decreased level of their excretion. This may cause number of clinical implications such as inflammation, loss of appetite, development of protein energy wasting (PEW) syndrome and the progress of artherosclerosis, what leads to increased mortality in a group of patients with end-stage renal disease (ESRD). Disturbances in sexual hormones function are also characteristic for CRF. Disorders in fertility, sexual life and decreased quality of life are observed in patients with CRF. Therapeutic procedure is complicated and not fully effective.

Saracyn M.,Military Institute of Health Services | Ploski R.,Medical University of Warsaw | Niemczyk S.,Military Institute of Health Services
Archives of Medical Science | Year: 2013

Molecular biology and medical genetics, one of the most dynamically developing fields of medicine, nowadays is also a base for development of basic and clinical research in internal medicine. Understanding of crucial genetic pathomechanisms of many common diseases was possible due to the newest and modern molecular methods and tools. Moreover, development of genetics also made possible the discovery and understanding of the pathogenesis of many different diseases. However, not so long ago, we discovered precise pathomechanisms leading from damage of a single gene to a related pathological phenotype. Now, we have just started to explain molecular mechanisms of complex, multifactorial diseases. To achieve these goals, we need permanent development of genetic tests, genomics and proteomics. After fulfilling these conditions, we will get a chance to implement all molecular and genetic hopes, particularly their practical application in the clinic. Copyright © 2013 Termedia & Banach.

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