Medical University of Bydgoszcz

of Bydgoszcz, Poland

Medical University of Bydgoszcz

of Bydgoszcz, Poland
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PubMed | lodowska Curie Memorial Cancer Center and Institute, Institute of Hematology and Blood Transfusion, Medical University of Lódz, Holycross Cancer Center and 13 more.
Type: | Journal: Leukemia & lymphoma | Year: 2016

Monosomal karyotype (MK) and complex karyotype (CK) are poor prognostic factors in acute myeloid leukemia (AML). A comprehensive analysis of cytogenetic and clinical factors influencing an outcome of AML-CK

De Luca G.,University of Piemonte Orientale | Malek L.A.,Institute of Cardiology | Maciejewski P.,Grochowski Hospital | Wasek W.,Grochowski Hospital | And 12 more authors.
Atherosclerosis | Year: 2010

Background: It has been shown that, among patients with ST-segment elevation myocardial infarction (STEMI), diabetes is associated with a significantly higher mortality. The aim of this study was to investigate in a large cohort of patients the impact of diabetes on mortality in a large cohort of patients with STEMI treated with primary angioplasty. Methods: Our population is represented by consecutive patients with STEMI treated by primary angioplasty and enrolled in the POLISH registry in 2003. All clinical, angiographic, and follow-up data were prospectively collected. Diagnosis of diabetes was based on history of diabetes at admission. Results: Among 7193 patients, 877 (12.2%) had diabetes at admission. Diabetes was associated with more advanced age (p<. 0.0001), higher prevalence of female gender (p<. 0.0001), hyperlipidemia (p<. 0.0001), shock at presentation (p<. 0.0001), renal failure (p<. 0.0001), previous myocardial infarction (p<. 0.0001), more often treated after 6. h from symptom onset (p<. 0.0001). Diabetes was associated with more extensive coronary artery disease (p<. 0.0001), less often treated with stenting (p<. 0.0001). Diabetes was significantly associated with impaired epicardial reperfusion (TIMI 0-2: OR [95% CI] = 1.81 [1.5-2.18], p<. 0.0001), that persisted after correction for baseline confounding factors (OR [95% CI] = 1.33 [1.075-1.64], p= 0.009). At a mean follow-up of 524 ± 194 days, diabetes was associated with higher mortality (unadjusted cumulative mortality: 23.5% vs. 12.6%, unadjusted HR = 1.95 [1.66-2.3], p<. 0.0001), that persisted after correction for confounding factors (adjusted cumulative mortality: 13.3% vs. 10.7%, adjusted HR = 1.23 [1.04-1.46], p= 0.013). Conclusions: This study shows that among STEMI treated by primary angioplasty diabetes is independently associated with impaired epicardial reperfusion and higher mortality. © 2010 Elsevier Ireland Ltd.

Madry K.,Medical University of Warsaw | Machowicz R.,Medical University of Warsaw | Waszczuk-Gajda A.,Medical University of Warsaw | Drozd-Sokolowska J.,Medical University of Warsaw | And 24 more authors.
Acta Haematologica | Year: 2015

Epidemiological studies on myelodysplastic syndromes (MDS) in Middle-Eastern Europe are scarce. No data about the demographic, clinical, and laboratory features of Polish MDS patients have been published. The aim of this study was to assess the epidemiological data and toxic exposure of Polish MDS patients and their association with hematological parameters and clinical outcomes. For 15 months, 966 living MDS patients were enrolled at 24 centers (12 university and 12 community hospitals). Follow-up was conducted for the next 55 months. The percentage of patients older than 80 years (16%) was between the values for Eastern and Western countries. In patients younger than 55 years, a female predominance was observed (male/female ratio 0.70:1 vs. 1.29:1; p < 0.001). Female patients had higher platelet counts (160 × 109/l vs. 111 × 109/l; p < 0.001). Patients exposed to chemicals were younger than patients without such exposure; their median age at MDS diagnosis was 66 vs. 70 years (p = 0.037). Smokers had significantly lower hemoglobin concentrations (8.6 vs. 9.1 g/dl; p = 0.032) and lower platelet counts (99 × 109/l vs. 137 × 109/l; p < 0.001) than nonsmokers. We provide the first description of the characteristics of Polish MDS patients. Females predominated in the group aged <60 years and they had higher platelet counts. The course of the disease is affected by toxic exposure and smoking. © 2015 S. Karger AG, Basel.

Bien E.,Medical University of Gdańsk | Kazanowska B.,Wroclaw Medical University | Dantonello T.,Olgahospital | Adamkiewicz-Drozynska E.,Medical University of Gdańsk | And 11 more authors.
Annals of Surgical Oncology | Year: 2010

Background. The rarity of malignant and intermediate vascular tumors in children means that little is known about their clinical course, optimal treatment, and variables predicting survival. Methods. A total of 32 children with malignant vascular tumors (14 angiosarcomas [AS], 5 epithelioid hemangioendotheliomas, and 13 intermediate vascular tumors, including other hemangioendotheliomas plus adult-type hemangiopericytomas), registered in the German and Polish Paediatric Soft Tissue Sarcomas Study Groups, were treated following the Cooperative Weichteilsarkom Studiengruppe (CWS)-81,-86,-91, and-96 protocols. Results. Male sex, AS histology, tumor size>5 cm, and T2 invasiveness were independent predictors of inferior 5-year overall survival, while AS histology and T2 invasiveness were predictors of inferior 5-year event-free survival. AS histology was the most important negative prognostic factor for overall survival and event-free survival. Completeness of primary tumor excision was a good prognostic factor for survival in univariate, but not multivariate, analysis. Local therapy (radiotherapy and delayed surgery) were provided to the minority of patients (28% and 38%, respectively) late in the course of disease (after a mean of 9 and 6 months, respectively) and did not prevent local relapses. Response to systemic treatment was poor (44%) and did not prevent local and distant relapses. Conclusions. The clinical course and outcome in childhood epithelioid HE seems to be similar to intravascular tumors and less aggressive than AS. RTX and delayed surgery should be performed more frequently and earlier in the disease course. An urgent need for modification of systemic therapy is needed because of the development of many metastatic and/or combined relapses and poor response to classic chemotherapy. The problem of effective therapy for childhood AS is the most appaling: 13 of 14 patients died of progression despite multimodal treatment. © Society of Surgical Oncology 2010.

Wierzbowska A.,Medical University of Lódz | Wawrzyniak E.,Medical University of Lódz | Siemieniuk-Rys M.,University of Lodz | Kotkowska A.,University of Lodz | And 29 more authors.
Leukemia and Lymphoma | Year: 2016

Monosomal karyotype (MK) and complex karyotype (CK) are poor prognostic factors in acute myeloid leukemia (AML). A comprehensive analysis of cytogenetic and clinical factors influencing an outcome of AML-CK+  was performed. The impact of cladribine containing induction on treatment results was also evaluated. We analyzed 125 patients with AML-CK+  treated within PALG protocols. MK was found in 75 (60%) individuals. The overall complete remission (CR) rate of 66 intensively treated patients was 62% vs. 28% in CK+ MK− and CK+ MK+  group (p = .01). No difference in CR rate was observed between DA and DAC arms. The overall survival (OS) in intensively treated patients was negatively influenced by MK, karyotype complexity (≥5 abnormalities), and WBC >20 G/L in multivariate analysis. The addition of cladribine to DA regimen improved OS only in MK− but not in MK+  group. In conclusion, concomitance of MK with ≥5 chromosomal abnormalities is associated with dismal treatment outcome in AMK-CK+. © 2016 Informa UK Limited, trading as Taylor & Francis Group

Oglodek E.,Medical University of Bydgoszcz | Araszkiewicz A.,Medical University of Bydgoszcz
Polski Merkuriusz Lekarski | Year: 2011

Yung was of an opinion that the borderline personality as a pathology results from the experiences of a frightened and violence-experiencing child who is left to their own devices in the hostile world. In that situation, the child, longing for safety, simultaneously experiences fear of abuse, hurt and rejection and remains distrustful. In order to understand the dramatic changes in the individual's behaviour, in case of the borderline personality disorders, Yung developed the concept, presented by Aaron Beck at the therapeutic workshops in the 1980s. Beck's concept was based upon the assumption that some pathological states expressed strong emotional states, experienced in childhood on the basis of regression. Yung presented them in the form of conceptualization in the categories of the active styles of schema. Apart from the states of regression, he also differentiated less regressive styles of schema. The style of schema should be interpreted as a pattern of experiencing, thinking and behaviour, based upon a determined set of schema, and characterized by independence from other styles.

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