The Influence of the Surgical Treatment Method on the Quality of Life of Women With Breast Cancer

Objective:

Breast cancer is the most common malignant neoplasm among women in Poland. The primary treatment for breast cancer is surgery. The choice of surgical treatment method can significantly affect the quality of life of women with breast cancer.

Materials and Methods:

Women treated surgically because of breast cancer were included. The quality of life was assessed by survey using the quality of live questionnaire (QLQ)-C30 and QLQ-BR23 (European Organization for the Research and Treatment of Cancer) questionnaires, taking into account the following factors: The method of surgery performed and comparing breast conserving therapy (BCT) with mastectomy, and breast reconstruction or the lack of it.

Results:

The study included 243 subjects. Women had a reduced overall quality of life (53.88 points out of 100), in particular emotional (59.77) and sexual (17.49) functioning, and a poor body image assessment (61.57). Patients after BCT functioned better in physical (p = 0.001) and sexual (p = 0.007) terms, and also experienced lower pain intensity (p = 0.003) and shoulder discomfort (p = 0.024). The quality of life was significantly higher (p = 0.003) in the opinion of women who underwent breast reconstructive surgery.

Conclusion:

The quality of life of women depends on the surgical treatment method used when treating breast cancer. For this reason, the choice of method, whenever possible, should promote breast protection or its postoperative reconstruction.

Patient satisfaction with oncological care during the virus pandemic - SARS-CoV-2 taking into account social and demographic factors

INTRODUCTION AND OBJECTIVE

The aim of the study was to examine the perception of medical services by oncological patients during the pandemic, identifying the key factors influencing it. The assessment of patient satisfaction with the treatment and care provided by doctors and other hospital staff provides important information on the quality of health services.

MATERIAL AND METHODS

The study involved 394 patients diagnosed with cancer treated as inpatients in five oncology departments. The diagnostic survey method was used with a proprietary questionnaire and the standardized EORTC IN-PATSAT32 questionnaire. Calculations were carried out using Statistica 10.0 with p≤0.05 s considered statistically significant.

RESULTS

Overall patient satisfaction with cancer care was 80.77/100. Higher values were shown for the competences of nurses than for doctors, especially for their interpersonal skills (79.34 - nurses vs. 74.13 - doctors) and availability (80.11 - nurses vs. 75.6 - doctors). It was also shown that the level of satisfaction with cancer care increased with age; women rated cancer care lower than men (p = 0.031), particularly its aspect related to the competences of doctors. A lower degree of satisfaction was observed among rural residents (p=0.042). Other demographic data, such as marital status and education, determined satisfaction with cancer care on the selected scale although it did not affect the overall level of satisfaction.

CONCLUSIONS

The analysed socio-demographic factors, primarily age, gender and place of residence, determined some of the scales concerning patient satisfaction with cancer care during the COVID-19 pandemic. The results of this and other studies of a similar profile should be used in the formation of health policy, particularly in implementing programmes to improve the quality of cancer care in Poland.

Di-bromo-Based Small-Molecule Inhibitors of the PD-1/PD-L1 Immune Checkpoint

Immune checkpoint blockade is one of the most promising strategies of cancer immunotherapy. However, unlike classical targeted therapies, it is currently solely based on expensive monoclonal antibodies, which often inflict immune-related adverse events. Herein, we propose a novel small-molecule inhibitor targeted at the most clinically relevant immune checkpoint, PD-1/PD-L1. The compound is capable of disrupting the PD-1/PD-L1 complex by antagonizing PD-L1 and, therefore, restores activation of T cells similarly to the antibodies, while being cheap in production and possibly nonimmunogenic. The final compound is significantly smaller than others reported in the literature while being nontoxic to cells even at high concentrations. The scaffold was designed using a structure–activity relationship screening cascade based on a new antagonist-induced dissociation NMR assay, called the weak-AIDA-NMR. Weak-AIDA-NMR finds true inhibitors, as opposed to only binders to the target protein, in early steps of lead compound development, and this process makes it less time and cost consuming.

Quality of Life of Women with Breast Cancer and Socio-Demographic Factors

BACKGROUND

Breast cancer treatment is an aggressive therapy that affects the deterioration of women's quality of life (QOL) in many areas. Knowledge about factors that influence the assessment of the QOL is of particular importance. The aim of the study was to analyse areas of the quality of life of women with breast cancer, taking into account social and demographic factors.

METHODS

The research was carried included 324 women with breast cancer. The research was carried out using a diagnostic survey, the author's questionnaire and a standardized questionnaire for measuring the QOL of women treated for breast cancer, ie the European Organization for Research and Treatment of Cancer, Quality of Life Questionnaire (EORTC) QLQ-C30 and QLQ-QLQ module BR23. Statistical analysis uses Statistica 10.0 software. The results were considered statistically significant when the calculated probability met the inequality of p.

Causes of delays in breast cancer diagnosis in Poland

Breast cancer is the most common malignant tumor in women. The results of breast cancer treatment to a large extent depend on the time of the primary diagnosis of the disease.

AIM

The aim of this study was to determine the most common causes of the delay and the delay time in the diagnosis of breast cancer in Polish women.

MATERIALS AND METHODS

The study was performed using a diagnostic survey and analysis of medical documentation from the Subcarpathian Regional Oncology Center, Poland. A total of 231 patients with diagnosed breast cancer were recruited to the study.

RESULTS

Delays in diagnosing of breast cancer were found in 83.1% of all the patients. The average time from the first symptom observation by a woman to the first medical consultation was on average 61.7 days. The most common cause of the delay in medical consultation in the examined group was a fear of diagnosing cancer (31.2%).

CONCLUSIONS

The examined women require permanent health education in the field of breast cancer and the importance of early diagnosis of the disease for the effectiveness of treatment and prognosis.

Surgical method of treatment and level of satisfaction with life among women diagnosed with breast cancer, according to time elapsed since performance of surgery

INTRODUCTION

In women diagnosed with breast cancer one of the methods most commonly applied in therapy is surgical treatment, which consists in a breast conserving surgery or total removal of the breast. The applied type of surgical treatment may exert an effect on the satisfaction with life of the women.

OBJECTIVE

The aim of the study was evaluation of the satisfaction with life among women surgically treated for breast cancer, according to the type of surgery on the breast, and the time elapsed since its performance.

MATERIAL AND METHODS

The study included 121 patients of the Sub-Carpathian Oncology Centre in Brzozów, south-east Poland, who had undergone surgical treatment due to breast cancer. The women expressed their informed consent to participate in the study. The method of a diagnostic survey was applied.

RESULTS

The women obtained a mediocre result in satisfaction with life - 5.64 sten scores. Patients who had undergone mastectomy had a considerably lower level of satisfaction with life, compared to those after breast-conserving surgery (4.73 sten scores vs. 6.30 sten scores). Evaluations of the satisfaction with life in the examined group significantly differed according to the time elapsed since performance of surgery.

CONCLUSIONS

There is a need for undertaking actions directed to women who have undergone surgical treatment for breast cancer within the period from 2-5 years, aimed at improving the satisfaction with life in this group of patients. In addition, special support should be provided for women who have undergone mastectomy, especially during the period of more than 1 and up to 2 years.

Satisfaction with life among women with breast cancer - selected demographic and social factors

OBJECTIVE

The aim of the study was evaluation of satisfaction with life among women ill with breast cancer, with consideration of selected demographic and social factors.

MATERIAL AND METHODS

In the study participated 121 patients from the Sub-Carpathian Oncology Centre in Brzozów, Poland, who had undergone surgical treatment due to breast cancer. The method of a diagnostic survey was used. The research instruments were an author-constructed questionnaire and the Satisfaction with Life Scale.

RESULTS

Women who received surgical treatment due to breast cancer evaluated their satisfaction with life on a mediocre level. Younger patients had a lower satisfaction with life than those who were older. Women living in urban areas evaluated their satisfaction with life in more positive terms than rural women. In turn, education level, marital status and material standard had no effect on the level of satisfaction with life among the women in the study.

CONCLUSIONS

According to the SWLS, women with the diagnosis of breast cancer obtained a mean result of 5.64 sten scores Younger women evaluated their satisfaction with life in more positive terms than those who were older. Women who lived in urban areas obtained a considerably higher result according to the SWLS, compared to rural inhabitants. Marital status, education level, material standard and occupational activity of the women were insignificant in the respondents' evaluation of satisfaction with life.

Analysis of the Content of Chromium in Certain Parts of the Human Knee Joint

Chromium is an essential microelement in the human body. It exerts an effect on bones by modulating their biochemical parameters: alkaline phosphatase (ALP) and tartrate-resistant acid phosphatase (TRAP). With considerable accumulation of chromium in the skeleton, the activity of alkaline phosphatase was found to decrease, which affected bone formation rate. The study objective was to analyze chromium content in the knee tissues. Tissues for analysis were obtained during endoprosthesoplasty of the knee joint and included tibia, femur, and meniscus tissues. Samples were collected from 50 patients, including 36 women and 14 men. The analysis was performed using the inductively coupled plasma atomic emission spectroscopy (ICP-AES) method, by means of a Varian 710-ES apparatus. The results revealed no significant differences in the content of chromium in the knee joint tissues between women and men. The highest level of chromium was found in the femoral bone of the knee joint, then in the meniscus, and was lowest in the tibia, although the differences were statistically insignificant. Chromium content increased with age.

Acceptance of illness by women with breast cancer

INTRODUCTION

Despite great progress in the diagnostics and treatment, breast cancer still remains the most frequently diagnosed malignant cancer in women. The outcomes of cancer treatment depend, to a considerable extent, on the degree of acceptance of the illness. The objective of the study was determination of the level of acceptance of the disease among the examined women with breast cancer.

MATERIAL AND METHODS

The study covered a group of 231 women who received treatment for breast cancer in the Rev. Bronislaw Markiewicz Subcarpathian Oncology Centre in Brzozow, south-eastern Poland, and conducted by the method of a diagnostic survey, using an author constructed questionnaire and the standard Acceptance of Illness Scale, adapted by Z. Juczyński. Statistical analyses were performed using the software IBM SPSS v. 21.0.0.1. The p values p≤0.05 were considered statistically significant.

RESULTS

The mean level of acceptance of the illness in the examined group of women was 26.53 (SD = 7.71; Me = 26). The largest number of respondents (50.6%) obtained scores within the range of 20-29, according to the AIS Scale. From among the adopted variables, the level of acceptance of the illness significantly varied according to age and occupational activity. However, no such differences were confirmed according to the place of residence, marital status, education level, or the type of occupation performed.

CONCLUSIONS

In the examined group of women, a mediocre level of acceptance of cancer was observed. The respondents' age and occupational situation exerted a significant effect on the level of acceptance of the illness. The results of the study should be considered as satisfactory because the number of women with a high level of acceptance of breast cancer was more than twice as high as those ones with a low acceptance of the disease.

The Content of Structural and Trace Elements in the Knee Joint Tissues

Many elements are responsible for the balance in bone tissue, including those which constitute a substantial proportion of bone mass, i.e., calcium, phosphorus and magnesium, as well as minor elements such as strontium. In addition, toxic elements acquired via occupational and environmental exposure, e.g., Pb, are included in the basic bone tissue composition. The study objective was to determine the content of strontium, lead, calcium, phosphorus, sodium and magnesium in chosen components of the knee joint, i.e., tibia, femur and meniscus. The levels of Sr, Pb, Ca, P, Na and Mg were the highest in the tibia in both men and women, whereas the lowest in the meniscus. It should be noted that the levels of these elements were by far higher in the tibia and femur as compared to the meniscus. In the components of the knee joint, the level of strontium showed the greatest variation. Significant statistical differences were found between men and women only in the content of lead.

The Slowly Enlarging Ventriculus Terminalis

Background

A cerebral spinal fluid (CSF) cavity within the conus medullaris has been described by the term ventriculus terminalis (VT) or the fifth ventricle. The finding of a VT on MRI imaging of the lumbar spine is often incidental but may be found in patients with low back pain or neuromuscular deficits. These lesions, when identified, are thought to regress or remain stable in terms of size, although some have been described to enlarge in the presence of post-traumatic meningeal hemorrhages or deformities of the vertebral canal.

Case Report

We describe a case of a slowly growing VT in a patient with progressing lower limb weakness without any history or imaging findings of trauma or spinal canal abnormalities.

Conclusions

We present an intriguing case of a slowly growing VT in a woman with progressive neurological symptoms. Surgical fenestration provided complete symptomatic relief and follow-up imaging two years after surgery demonstrated no evidence of recurrence. This, to our knowledge, is the first described case of a slowly enlarging VT independent of any other imaging findings.

Preparation of Triacetoneamine, II

The preparation of triacetoneamine (1) by the condensation of acetone with ammonia in the presence of calcium chloride is investigated. The progress of the reaction is monitored by gas chromatography. The effects of added ammonium chloride, the total amount of ammonia introduced, and the temperature of the reaction on the weight yield and purity of 1 are investigated. The optimized conditions for the preparation of 1 at 59 °C are described.

An Improved Method for the Preparation of Spin-Labeled Phosphates Using Imidazole as Transfer Agent

The (1-oxyl-2,2,6,6-tetramethyl-4-piperidyl)phenyl imidazole-1-phosphonate (9) is the reagent of choice for the preparation of spin-labeled phosphates 10 in yields, in most cases, exceeding 70%. The spin-labeled chloridate 8 also can be used to prepare phosphates 10, though in lower yields ranging between 27-69%.

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Preparation of Spin-Labeled Phosphoroamidates in High Yield Using Imidazole as the Transfer Agent

The spin-labeled (1-oxyl-2,2,6,6-tetramethyl-4-piperidyl)-phenyl imidazole-1-phosphonate (4) was used to prepare (1-oxyl-2,2,6,6-tetramethyl-4-piperidyl)phenyl N-alkyl and N-aryl phosphoroamidates (8) in yields generally exceeding 70%.

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Amidates 8 were also prepared from the corresponding chloridate 10. However, in the latter case, a basic condensing agent, such as, triethylamine was essential. The chloridate 10 was converted to the spin-labeled pyrophosphate 11 and the acid 12.

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The pyrophosphate 11 can be employed to phosphorylatively spin-label amines.

Preparation of Triacetoneamine, I

The preparation of triacetoneamine (1) by the condensation of acetone with ammonia in the presence of calcium chloride at room temperature is investigated. In addition to 1, acetonin (8), diacetone alcohol (4), mesityl oxide, and diacetoneamine (7) are formed during the reaction. The progress of the reaction is monitored by gas chromatography. The effects of the extent and the rate of stirring, the amount of ammonia introduced on the critical first day of the reaction, and the mesh size and the amount of calcium chloride on the purity and weight yield of 1 are studied. The yield of 1 is maximized by recovery of the unreacted acetone. The reaction at room temperature under optimized conditions is described.

Preparation of 4-Hydroxy-2,2,6,6-tetramethylpiperidine-1-oxyl A Reinvestigation of Methods Using Hydrogen Peroxide in the Presence of Catalysts

The preparation of the key intermediate for spin labeling, 4-hydroxy-2,2,6,6-tetramethylpiperidine-1-oxyl (2), was reinvestigated using sodium tungstate or phosphotungstic acid with or without either Trilon or Triton B. A two-fold and a 3.5-fold molar excess of a 30% aqueous hydrogen peroxide solution was used. The oxidation of 4-hydroxy-2,2,6,6-tetramethylpiperidine (1) with a two-fold molar excess of a 30% aqueous hydrogen peroxide solution in the presence of sodium tungstate alone, under vigorous stirring for two hours, is the superior method (A) for the preparation of 2 in virtually quantitative yield.

Soft effective interactions between weakly charged polyelectrolyte chains

We apply extensive molecular dynamics simulations and analytical considerations in order to study the conformations and the effective interactions between weakly charged, flexible polyelectrolyte chains in salt-free conditions. We focus on charging fractions lying below 20%, for which case there is no Manning condensation of counterions and the latter can be thus partitioned in two states: those that are trapped within the region of the flexible chain and the ones that are free in the solution. We examine the partition of counterions in these two states, the chain sizes and the monomer distributions for various chain lengths, finding that the monomer density follows a Gaussian shape. We calculate the effective interaction between the centers of mass of two interacting chains, under the assumption that the chains can be modeled as two overlapping Gaussian charge profiles. The analytical calculations are compared with measurements from molecular dynamics simulations. Good quantitative agreement is found for charging fractions below 10%, where the chains assume coil-like configurations, whereas deviations develop for charge fraction of 20%, in which case a conformational transition of the chain towards a rodlike configuration starts to take place.

[The effect of ovariectomy in women on metabolism of phenazone]

The studies were aimed to prove the effect of surgical ovariectomy in women with normal estrogen levels on the metabolism of medicaments in the hepatocyte. Phenazone, which has lost its significance as a medicament, was used as a model substance since it is often used as a preparation in the pharmacokinetic investigations. Phenazone levels in sera of women's blood were tested twice. The first test was carried out in the women before the operation which included among other things a surgical ovariectomy. Before the operation, the women manifested normal estrogen levels. The test was repeated 30 days after the operation. Phenazone levels were again tested after oral administration of phenazone in the dose of 18 mg/kg body mass. Before each test, the women were checked twice for the clinical and laboratory parameters of liver functions. Phenazone levels were determined seven times in the blood serum at 3- to 6-hour intervals within 24 hours. The determinations were performed using the Brodie (Brody) method. Average phenazone levels in blood sera were given mathematical analysis in the women before and after surgical ovarlectomy. The two curves were compared to obtain statistically significant differences in most pharmacokinetic parameters. It was shown that sudden drop in estrogen levels due to surgical ovariectomy causes a diminished constant elimination (K), prolongation of half-life (t0.5), an increase in distribution volume (Vd), its reduced derivative (Vd) and increased distribution volume calculated from the area under the curve (VdAUC). It points to the effect of estrogens on the metabolism of medicaments in the liver and indicates a careful dosage of some medicines in chronic use which have a long biological half-life in post-menopausal women and in women following surgical ovariectomy.

In the search for new anticancer drugs. 26. A comparison of anticancer activities of several TEPA, thio-TEPA, Seleno-TEPA, and azetidine analogs, including congeners containing an aminoxyl moiety

A series of TEPA, Thio-TEPA, Seleno-TEPA, and azetidine analogs, including congeners containing an aminoxyl moiety, were synthesized and evaluated in vivo for anticancer activity against the murine lymphocytic leukemia P388. All aziridine derivatives were found to be active with an increase in life span ranging from 42% to 272%, and all azetidine analogs were rated as inactive with one marginal exception. An attempt was made to rationalize the results on the basis of the lipophilic properties of the compounds. The most active compound (8) possessed the most balanced lipophilic properties, corresponding to a log P value near zero.

Surgical management of major varicose veins of the lower limb using a pneumatic tourniquet

A technique to facilitate ablation of varicose veins is described. We have tested this technique in 25 patients. A pneumatic tourniquet is place on the lower limb during operation for a maximum of 90 minutes. This technique allows the operative field to remain dry and clean, and the resulting bloodless field makes the operation easier and faster. Because the veins are empty, they are removed more easily and completely, even in cases of severe dermatitis or adhesion.

Metabolism and covalent binding to DNA of 7-methylbenzo(a)pyrene

The ultimate carcinogenic form of benzo(a)pyrene (BP) is thought to result from metabolic activation at the 7 to 10 positions. Substitution by a methyl group at these positions would be expected to inhibit strongly their metabolism even though 7-methylbenzo(a)pyrene (7-MeBP) has been reported to be carcinogenic in some tumor models. The metabolism of 7-MeBP was, therefore, studied using both microsomal preparations and whole cells, the products being analyzed by high-pressure liquid chromatography, fluorescence spectrophotometry, and mass spectrometry. These studies revealed that many of the expected metabolites were formed by microsomes, but in addition 7-MeBP yielded a compound which was isolated and identified as trans-7,8-dihydro-7,8-dihydroxy-7-methylbenzo(a)pyrene. These results indicate that, despite the presence of a methyl group at the 7 position, a substituted BP can undergo the same initial metabolic activation as BP itself. However, in contrast to BP, the 7,8-dihydrodiol formed from 7-MeBP was almost racemic, and neither enantiomer was very active in the Ames bacterial mutagenesis assay when compared with trans-7,8-dihydro-7,8-dihydroxybenzo(a)pyrene. The metabolism of 7-MeBP was also studied in 10T1/2 cells. The hydrocarbon was metabolized readily and bound to DNA of the cells to about one-eighth of the level found for BP. However, no 7,8-dihydro-7,8-dihydroxy-7-methylbenzo(a)pyrene could be detected in the culture medium.

Improvements in the Preparation of Spin-Labeled Phosphorus Compounds of Potential Cytotoxicity

The syntheses of spin-labeled phosphorus compounds containing the ethyleneimine, —N, and nitrogen mustard, —N(CH2CH2Cl)2, moieties were reinvestigated. By a judicious choice of solvents, stoichiometry, and reaction conditions yields of these compounds have been optimised. Thus, monoradical diamidates (5) and (9) wore prepared in 95 and 82% yields, respectively, and diradical monoamidates (7) and (12) were prepared in 95 and 45% yields, respectively. The nitrogen mustard derivative (16) was obtained in 92% yield.

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Preparation of N,N,N′,N′-Bis(ethylene)-phosphorodiamidates of Steroids, Diacetone-D-glucose, and α-Tocopherol

The phosphorodichloridates (1) of cholesterol, β-sitosterol, testosterone, diacetone-D-glucose, and tocopherol were prepared from phosphorus oxychloride in the presence of triethylamine. Tocopheryl phosphorodichloridate was too unstable to be isolated. Reaction of 1 with ethyleneimine in the presence of triethylamine gave the corresponding Ν,Ν,Ν′,N′-bis(ethylene)-phosphorodiamidates (2).