Some aspects of pharmacotherapy of tinnitus. Compound therapy with Xylocaine and directive counseling--long-term results

29 out of 49 patients, who were treated in 1996-1998 with Xylocaine and directive counselling for their tinitus, were reevaluated. Non of the patients used any other pharmacological treatment of the tinnitus or underwent full tinnitus retraining therapy (TRT) since 10-days treatment with Xylocaine had been completed. Initially 65.3% of patients declared improvement in their tinnitus. After over 5 years of observation success rate decreased to only 41.3%. Since the positive effect of 10-days treatment with Xylocaine and directive counselling was not stable we concluded that tinnitus patients should receive full TRT.     

Cysteine proteases as disease markers

This review comprises issues concerning cysteine cathepsins (CCs): human peptidases belonging to papain family (C1) of clan CA of cysteine proteases: cathepsins B, L, H, S, K, F, V, X, W, O and C. The involvement of these enzymes in physiological and pathological processes is described, especially with respect to their application as diagnostic and prognostic markers. They participate in precursor protein activation (including proenzymes and prohormones), MHC-II-mediated antigen presentation, bone remodeling, keratinocytes differentiation, hair follicle cycle, reproduction and apoptosis. Cysteine cathepsins upregulation has been demonstrated in many human tumors, including breast, lung, brain, gastrointestinal, head and neck cancer, and melanoma. Besides cancer diseases, they have been implied to participate in inflammatory diseases, such as inflammatory myopathies, rheumatoid arthritis, and periodontitis. Also, certain hereditary disorders are connected with mutations in CCs genes, what is observed in pycnodysostosis resulted from catK gene mutation and Papillon-Lefevre and Haim-Munk syndrome caused by catC gene defect. The potential application of cysteine cathepsins in diagnosis and/or prognosis is discussed in cancer diseases (breast, lung, head and neck, ovarian, gastrointestinal cancers, melanoma), as well as other disorders (periodontitis, rheumatoid arthritis, osteoarthritis).     

Incidence of congenital malformations and neonatal mortality in children born at the Regional Hospital in Brzeziny in years 1990-2001

The aim of the study was to estimate the incidence of congenital malformations and neonatal mortality rate in children born in our hospital from 1990 to 2001, taking into account the effects of low birth weight and premature delivery. We investigated medical documentation of 5496 children born during the analyzed period. Presence of major and minor malformations and survival through the neonatal period were determined for each subject. Among newborns with low birth weight 8.3% were born with congenital malformations, among those born preterm--12.1%. The major malformations were 3 times more often in children with low birth weight and 4 times more often in children born prematurely. In our cohort the mortality of 0.2% was observed. Congenital defects, followed by the complications of preterm delivery, were the predominant causes of natal death. Deaths due to congenital defects occurred twice as often as the deaths caused by prematurity complications. The congenital malformations mortality in newborns with congenital malformations reached 4.8%. The majority of congenital defects deaths were caused by central nervous system defects, chromosomal aberrations and multiple congenital malformations.     

Expected change of direction in Polish law regarding cosmetics

In connection with adaptation of Polish law to UE regulations, new Polish Act on cosmetics was published. There were also prepared regulations concerning: lists the substances forbidden to be used in cosmetics, permitted to be used in cosmetics only with restrictions, allowed colouring agents, preservatives and UV filters, rules of non-inclusion of one or more ingredients on the list used for the labelling, establishing National System for Informing about Cosmetics and methods of analysis necessary for checking the composition of cosmetic products. Publication in Official Journal of the European Union L. 66/26 Directive 2003/15/EC shows direction necessary changes in Polish Act on cosmetics.     

A novel highly pathogenic Alzheimer presenilin-1 mutation in codon 117 (Pro117Ser): Comparison of clinical, neuropathological and cell culture phenotypes of Pro117Leu and Pro117Ser mutations

A novel presenilin-1 (PS1) mutation (P117S) in an American pedigree is described. We compare clinical, neuropathological and cell culture phenotypes produced by this mutation with another codon 117 mutation that was earlier discovered by our group in a Polish kindred. Both mutations are associated with an unusually severe Alzheimer disease (AD) phenotype, with the onset starting before the third decade of life, rapid disease progression and acute presentation of clinical symptoms. The severity of clinical phenotype was closely correlated with the abundance of pathology: massive deposition of Abeta42 in plaques, severe neurofibrillary degeneration and neuronal loss. When overexpressed in mouse neuroblastoma N2a cells, both mutations caused loss of an ability to promote neurite outgrowth and produced an increase in the ratio of secreted Abeta42/40 amyloid peptides. In stably transfected N2a cell lines only mutant proteins were endoproteolytically cleaved indicating some dependability of this process on the presence of mutation. Taken together, our results show that clinical and cell culture phenotypes produced by these 2 codon 117 mutations are closely related suggesting that the pathogenic action of PS1 may involve effect on neurite outgrowth and endoproteolytic cleavage of the full-length protein. Given the high potency in vivo and in vitro of both codon 117 mutations, this site of PS1 must be particularly important for its normal/pathogenic function.     

BRCA1 and BRCA2 mutation analysis in breast-ovarian cancer families from northeastern Poland

Sixty high-risk breast and/or ovarian cancer families from North-Eastern Poland were screened for germline mutations in BRCA1 (MIM# 113705) and BRCA2 (MIM# 600185), using a combination of protein truncation test, denaturing high-performance liquid chromatography and direct sequencing. Sixteen (27%) of the families were found to carry nine different BRCA mutations, including 14 families with BRCA1 mutation and two families with BRCA2 mutation. The results suggest the presence of two strong BRCA1 founder mutations in the Polish population - 5382insC (6 families) and 300T>G (Cys61Gly; 3 families). The remaining seven mutations were found in single families and included three previously reported BRCA1 mutations (185delAG, 2682C>T [Gln855Ter] and 3819del5), a novel BRCA1 mutation (IVS14+1G>A), as well as two BRCA2 mutations (4088delA and 7985G>A [Trp2586Ter]) not previously observed in Polish families. We confirm the strong influence of two Central-Eastern European BRCA1 founder mutations in familial breast and/or ovarian cancer in Poland. We also conclude that the Polish population has a more dispersed BRCA mutation spectrum than had been earlier thought. This warrants further careful BRCA mutation screening in order to optimise genetic counselling and disease prevention in affected families.     

Assessment of the midwives preparation to take care of patients with cervical cancer

INTRODUCTION: The success of the cervical cancer treatment depends not the only on the early diagnosis, but also on the immediate initiation of the appropriate treatment and proper nursing care, which should be adequate with the present knowledge. OBJECTIVE: The objective of the research was the assessment of the theoretical preparation of nurses taking care of patients with cervical cancer. MATERIALS AND METHOD: 50 nurses, working in the departments of gynecological diseases, have been interviewed. All the nurses graduated from College of Nursing, 3 of them additionally studied in the Pedagogical Graduate School. 60% of the nurses had 10-20 years of professional experience. We used special questionnaire made of 3 parts: describing the objective of the research/test, characteristics of the patient, specific questions. There were 18 questions: 5-closed, 1-open, 12-semiopen. They were checking the knowledge about the diagnostics, preparation of the patient to the operation using Wertheim-Meigs-Valle method, postoperative care until the discharge from the hospital and then oncological care. RESULTS: Almost all of them (88%-92%) have known the sequence of the diagnosis and treatment of the cervical cancer. 90% of them have been knowledgeable what kind of diagnostic and nursing procedures were required before the surgery using Wertheim-Meigs-Valle method. Almost all of the tested nurses (96%-100%) have known the procedure of postoperative care. They had a practical knowledge how to assess the patient condition and components of care that the patients require during the first few days after the surgery. According to the tested nurses, 90% of the patients operated because of cervical cancer, should follow up in oncological centers. CONCLUSION: 1. The nurses' preparation to take care of patients with cervical cancer is sufficient and it affects the effectiveness of the treatment. 2. The nurses have knowledge about pre- and postoperative procedures that the patients require, as well as assessment of general condition and patients' care, which are so important in the first few days after the surgery.     

Complex management of osteoporotic vertebral fracture

Background. Compression fractures of the thoraco-lumbar spine are the most common form of damage to the skeletal system caused by osteoporosis. These fractures are stable and do not produce neurological deficits. The intensity of the clinical symptoms depends on the degree of kyphotic distortion of the spine and the number of fractured vertebrae. Among the most serious consequences of such injuries are chronic pain, habituated poor body posture (deeper thoracic kyphosis with compensatory hyperlordosis in the lumbar spine), motor and functional limitations, reduced quality of life, and heightened risk of subsequent spinal fractures.
Material and methods. We analyzed a group of 26 patients treated for spinal fractures associated with osteoporosis, in order to evaluate the effectiveness of the treatment methods applied.
Conclusions. Our results indicate that the best outcomes are obtained when the period of immobility is reduced to a minimum and rehabilitation is commenced as early as possible.