Tom 35 (2022): Zeszyt 1 (July 2022)

World wide, breast cancer is the most common malignancy in women. Despite an increased incidence of this cancer, the mortality rates have been maintained at the same level. This is due to the continuous development of therapeutic, as well as diagnostic methods because appropriate, effective treatment is dependent on accurate diagnosis. At the same time, the success is that more and more patients undergo breast- and axillary lymph nodes-sparing surgeries, therefore, determining the initial advancement stage of breast cancer is absolutely essential for ensuring proper therapy. This is a review of current guidelines for both early and advanced stages of breast cancer diagnostics. The principles described are largely based on the work of the European School of Oncology (ESO) and the European Society for Medical Oncology (ESMO). The review includes the rule of imaging studies, especially mammography screening and histopathological evaluation with molecular classification of breast cancer.

Drug addiction is a chronic, recurrent disease of the central nervous system that leads to the development of comorbidities and premature death. Despite extensive scientific research concerning addiction, no effective method of addiction pharmacotherapy has been known so far. Glucagon-like peptide 1 has been suggested to play a role in the rewarding effect of addictive drugs. Linagliptin is a selective dipeptidyl peptidase-4 inhibitor that suppresses the rapid degradation of endogenous glucagon-like peptide-1. In clinical practice, it is used as an antidiabetic drug, but recent studies have confirmed its role in the activity of the central nervous system. This pilot study was conducted to ascertain whether linagliptin might influence morphine dependence – a locomotor activity test was carried out to assess the intensity of morphine withdrawal symptom. The obtained results clearly confirmed that linagliptin (0.01 and 0.1 mM) reduced the locomotor activity in morphine-dependent larval zebrafish. The undertaken experiments clearly indicates that linagliptin is involved in the addictive effects of morphine, thus, further studies on higher organisms should be carried out.

The RF9 compound, which is an antagonist of the FF neuropeptide receptors is used as a therapeutic substance to improve the effectiveness of opioids in the chronic treatment of pain. The purpose of this study was to find the most efficient method of RF9 synthesis. The optimization experiment involved solid-phase peptide synthesis. The Fmoc strategy is based on the usage of the 9-fluorenylmethoxycarbonyl group to block reactive amino groups. Commonly applied RF9 synthesis is based on DIC/HOBt activation of 1-adamantanecarboxylic acid prior to its substitution. The experiments carried out in this research were based on the routinely applied DIC/HOBt carboxylic group activation and this scheme was compared with the COMU/DIPEA and DIC approach. The obtained results showed that COMU/DIPEA was the most efficient and effective method of RF9 synthesis. Using this strategy, pure compound was obtained, without any by-products, and at a highest yield. The use of COMU/DIPEA can be an excellent alternative to the routinely used RF9 synthesis.

Ketoprofen (K) belongs to the family of nonsteroidal anti-inflammatory drugs (NSAIDs) and demonstrates analgesic, anti-inflammatory and antipyretic properties. K is one of the most commonly used NSAIDs because of the speed and effectiveness of its activity. K is currently used for the treatment of pain and treatment of symptoms in rheumatic diseases, however, many researchers are looking for new uses of K. The aim of the review was to present the possible applications of K as indicated in current literature. We searched research literature and compiled all the reports (2015 onwards) we could find about new possible employments of K in health practices. Many studies have been aimed at obtaining new uses of K. This article describes the use of ketoprofen lysine salt for treating injured gastric mucosa, the anti-allergic potential of K, the employment of K in treating nonalcoholic fatty liver disease, human lymphedema and seizures, as well as the antidepressant and anxiolytic effects of K, prospects for the use of K in oncology and transplantology. The findings of the review confirm that K, its derivatives and complexes have many newly discovered effects. It is likely that in the future, K will have more indications than it has today.

Chronic venous disease (CVD) is a common disease caused by hemodynamic disorders of the venous circulation in the lower extremities. The clinical image of this disease is complex and includes such signs as telangiectases, varicose veins, leg edema and skin changes, usually accompanied with ache, pain, tightness, heaviness, swelling and muscle cramps of legs. Venous ulcers develop in the advanced stages of the disease and lead to significant impairment of patient abilities and reduction of the quality of life. CVD is diagnosed based on physical and image examinations, and main treatment options include compression therapy, invasive treatments like endovenous ablation and foam sclerotherapy, as well as pharmacotherapy. Currently, there is no biochemical and molecular biomarkers utilized in diagnosis or treatment of CVD. With regard to this situation, one of the most investigated fields for identification of disease biomarkers is microRNA (miRNA). These constitute a pool of small, non-coding RNAs that play crucial roles in maintaining cellular homeostasis through posttranscriptional regulation of genes expression. Dysregulations of miRNA expression profiles have been found in patients with various diseases, and this situation provides information about potential miRNA signatures involved in pathophysiology. In this review, the studies focused on investigations of miRNA expression patterns in patients with CVD were collected. The performed literature analysis provides contemporary knowledge in the field of miRNA-dependent mechanisms involved in the etiopathogenesis of CVD and shows gaps that need to be filled in further studies.

Medicines are one of the critical elements of a well-functioning healthcare system, but their expiry remains one of the significant challenges in the healthcare sector. This study aims in assessing the extent of the issue and identifying the expired medicine types and their underlying causes in some selected public health facilities of Arsi Zone, Oromia Regional State, Ethiopia. This study is a mixed-method, which includes both quantitative and qualitative components. The quantitative research was undertaken by retrospective data extraction of recorded medicines as expired for the specified period. At the same time, the qualitative part is a facility-based cross-sectional survey study with self-administered questionnaires and semi-structured in-depth interviews engaging the health professionals of study facilities to explore the reasons for the expiration of medicines. Fifteen health facilities were selected from the study zone. The total monetary value of expired medicines in the studied health facilities during 2017-2019 was 185,938.86 USD. In the same period, all study facilities received medicines worth 2,425,882.64 USD, resulting in an expiry rate of 7.66%. The top classes of wasted medicines through expiry in terms of value were anti-infectives (35.51%) and medicines for central nervous system (CNS) disorders (20.48%). In comparison, by dosage forms, nearly half were solid dosage forms (48.81%), followed by liquid dosage forms (41.82%). Delivery of near expiry date medicines by Ethiopia’s Pharmaceuticals Supply Agency (PSA), lack of a system to exchange nearly expired medicines between facilities, and presence of overstocked medicines due to improper forecasting of need were the common perceived factors contributing to the expiry of medicines. Thus, the Policymakers should make decisions to reduce the contributing factors of medicines expiry to reduce wastage of medicines and promote appropriate utilization of finite resources.

This manuscript reviews evidences underlying the estimation of risk of malignancy enhancement of advanced aggressive cancers as a result of the gamma radiation emitted by tracers used in PET diagnostics. We conclude that among many cancers, such a phenomenon likely occurs, particularly in tumor cells with an aggressive biology in the advanced stages of their development, e.g. prostate cancer, melanoma and colorectal cancer. Moreover, we surmise based on gathered evidence that fluorine -18 (¹⁸F) labeled pharmaceuticals (¹⁸F-deoxyglucose and ¹⁸F-choline), commonly used in positron emission tomography (PET) can lead to malignancy enhancement of diagnosed cancer, manifesting as accelerated infiltration of the neighboring tissue, accelerated metastasis and/or radio- and chemotherapy resistance. In this review, some suggestions on future studies verifying this concept are also proposed. If our concerns are justified, it might be appropriate in the future to consider this assumption at the stage of deciding whether to undertake PET monitoring in some patients with advanced aggressive cancer.

Parvovirus B19 (B19V) is a widespread pathogen causing infection that occurs mostly in children. Even though infection of B19V is mainly asymptomatic, it can bring about a few conditions that may require medical intervention, including erythema infectiosum (fifth disease), slapped cheek syndrome, papular-purpuric gloves and socks syndrome (PPGSS), as well as other disorders related to the hematological system. Despite the fact that the most common route of transmission is through the respiratory system, B19V can be also transmitted transplacentally from mother to foetus. Vertical transmission may lead to myocarditis, thrombocytopenia, neural manifestations, and foetal hydrops, which may be life-threatening conditions to both mother and foetus. Detection of B19V infection is based mostly on molecular and serological screening and it is performed after suspected exposure to pathogen or exhibition of symptoms. Currently, there is no specific medication against B19V infection, therefore, treatment is based on the elimination of symptoms. New therapies are, however, under development.

Introduction. Bronchial asthma is a common disease characterized by chronic inflammation of the airways. Paediatric asthma is still a current problem and children with exacerbation frequently are hospitalized. The aim of the study was to determine the prevalence of allergic and non-allergic asthma in children hospitalized at the Department of Paediatric Pulmonology and Rheumatology of the University Children’s Hospital in Lublin in 2016-2020, and to analyze the most common allergens associated with allergic asthma.

Materials and methods. The study group consisted of 667 patients, aged 6 to 215 months (average 64 months). The data collected for this retrospective study includes: gender, age, month, quarter of year, and year of hospitalization, type of asthma and type of allergens.

Results. We observed a decrease of hospitalization in the analyzed years: in 2016 – 160 children, and in 2020 – 74. Children with allergic asthma (375 children) were more frequently hospitalized than patients with non-allergic asthma, and we found correlations between age and type of asthma and between age and type of allergy. Non-allergic asthma was observed in the youngest children, while in older children, allergic-asthma dominated. We also observed significant differences in children’s hospitalization depending on the season of the year. The most frequent allergen causing asthma was house dust mites.

Conclusions. The incidence of hospitalizations caused by asthma exacerbation is declining. Among the youngest population, exacerbations of asthma related to respiratory tract infection predominate, while in the older, allergy to inhalation allergens is the main cause.