Polskie Archiwum Medycyny Wewnętrznej
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Radiotherapy is one of the oldest cancer treatment modalities, used for over 100 years. As its efficacy has been steadily increasing due to the introduction of novel treatment methods, adverse events (AEs) still pose a major obstacle limiting the therapeutic benefits in some patients and negatively impacting treatment outcomes. In light of the technological progress, the focus has been shifted from improving the efficacy to safeguarding patients from the most severe AEs through improvements of safety and accuracy of radiation delivery. ⋯ In this review, we present the most common and severe AEs of radiotherapy associated with damage to the nervous, respiratory, cardiovascular, gastrointestinal, and urogenital systems. We also describe the pathogenesis of these AEs, and provide guidelines for prevention, risk assessment, diagnosis, and treatment. Novel findings and future perspectives in this field are also elucidated, including examples of ongoing clinical trials aimed not only at improving treatment outcomes but also at reducing the risk of radiotherapy complications in cancer treatment survivors.
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Pol. Arch. Med. Wewn. · Jan 2022
Performance of plastic stents used for benign and malignant biliary strictures; experience of single high-volume endoscopy unit.
Endoscopic plastic biliary stenting has been used for more than 30 years as a temporary or definitive treatment of benign and malignant neoplasms. These stents are commonly available, inexpensive, and easy to implant. ⋯ The patency of plastic stents depends on the underlying disease. In patients with benign biliary disease, stent replacement is recommended after about 3.5 months. In patients with cancer, the timing of stent replacement should be guided by survival prognosis and location of stricture.
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Pol. Arch. Med. Wewn. · Jan 2022
The health risks of dual use of electronic and combustible cigarettes: exposure to acrylamide and glycidamide.
A combustible cigarette is a significant source of acrylamide, which is associated with numerous adverse effects. Electronic cigarette (e‑cigarette) is an emerging smoking device with uncertain health effects. OBJECTIVES The aim of the study was to explore the exposure risks of acrylamide (AA) by measuring biomarkers, hemoglobinadducts of AA (HbAA) and of glycidamide (HbGA), in serum samples of the general adult population with regard to different smoking status (smoking vs nonsmoking). ⋯ E‑cigarette users are exposed to AA, and users of both combustible and e‑cigarettes have highest measures of HbAA and HbGA. Aside from the adverse effects caused by e‑cigarette smoking, coexposure risks of combustible cigarettes and e‑cigarettes need to be communicated to the public. Further studies are warranted to aid in health promotion.
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Pol. Arch. Med. Wewn. · Jan 2022
Endosonographic predictors of malignancy in a left adrenal gland in lung cancer patients - a comparison of EUS-b, CT and PET-CT.
Patients with resectable lung cancer require invasive evaluation of the enlarged left adrenal gland (LAG). Few studies showed the utility of endoscopic ultrasound using ultrasound bronchoscope (EUS‑B) in LAG assessment. Moreover, little is known on the combination of computed tomography (CT), positron emission tomography-computed tomography (PET‑CT), and EUS‑B for predicting left adrenal metastasis. ⋯ Hypoechogenicity and loss of sea‑gull shape on EUS‑B are the most reliable predictors of left adrenal metastasis. The combination of CT, PET‑CT, and EUS‑B improves the noninvasive diagnosis of left adrenal metastases in lung cancer patients.