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The management of patients undergoing stem cell transplantation requires a multipurpose central venous catheter (CVC) to facilitate drug administration, parenteral nutrition, transfusion of blood products, and collection of blood samples. Peripherally inserted central venous catheters (PICCs) appear to meet these requirements but are rarely used for stem cell infusion. We aimed to retrospectively assess the safety and feasibility of stem cell infusion through PICC and to evaluate its impact on transplantation kinetics. We retrospectively analyzed the outcomes of peripheral blood stem cell (PBSC) transplantation in patients receiving cryopreserved autologous or allogeneic PBSC by PICCs and compared the results with patients receiving transplants through a conventionally inserted central venous catheter (CICC). Despite statistically significant differences in CD34+ dose, infusion rate, and total length of administration, the clinical outcomes of transplantation, exemplified by platelet and neutrophil engraftment, along with the length of hospitalization, were not affected by the prolonged infusion time and lower infusion velocity in the PICC group. Our study showed that the clinical outcomes of PBSC transplantation did not differ between the PICC and CICC groups, suggesting that both types of catheters can be implemented in a PBSC transplantation setting.

Introduction: Due to the SARS-CoV-2 coronavirus pandemic, the wearing of masks has become a common phenomenon. Most of the undesirable effects of using a protective face covering are usually related to the prolonged time of its wearing, and the adverse consequences of face coverings should be considered two-fold. The aim of the study was to evaluate the rate of contamination of the three types of face coverings (surgical, N95, and FFP2 masks) with the microorganism—aerobic bacteria, yeasts, and molds—after the 3 h exposure time. The study aimed to investigate the effects of wearing FFP2 masks (KN95) on respiratory function and the acid–base balance of the human body. Results: The presence of S. aureus was confirmed in both nasal carriers and non-carriers which may demonstrate the cross-contamination and spread of this bacterium via hands. S. aureus was found on external and internal surfaces of face masks of each type, and therefore could also be transmitted via hands from external sources. The 3 h exposure time is not sufficient for Gram-negative rods and mold contamination. Moreover, there were no significant differences in most of the parameters studied between the first and second examinations, both in spirometry and capillary blood gas analysis (p > 0.05).

Piotr Zawodny,1 El&zdot;bieta Stój,1 Piotr Kulig,2 Karolina Skonieczna-&Zdot;ydecka,3 Jerzy Sie&nacute;ko4 1Zawodny Esthetic Medicine Clinic, Szczecin, Poland; 2Department of General Pathology, Pomeranian Medical University in Szczecin, Szczecin, Poland; 3Department of Biochemical Science, Pomeranian Medical University in Szczecin, Szczecin, Poland; 4Department of General and Transplantation Surgery, Pomeranian Medical University in Szczecin, Szczecin, 70-111, PolandCorrespondence: Jerzy Sie&nacute;ko, Department of General and Transplantation Surgery, Pomeranian Medical University, Szczecin, Poland, Tel +48 91 466-11-36, Fax +48 91 466 11 30, Email jsien@poczta.onet.plPurpose: Esthetic medicine is a rapidly developing field of medicine that is not only beneficial in terms of external appearance, but also significantly improves overall quality of life. Currently, pigmented and vascular skin lesions are more prevalent due to multiple environmental factors and are a characteristic manifestation of skin aging. The development of modern laser therapy has contributed to the successful management of multiple skin conditions. The aim of our study was to show the effect of concomitant reduction of both vascular and hyperpigmented skin lesions located on the facial area after repetitive 532 nm laser therapy and to emphasize that the detection of such observation was possible due to the implementation of System of Skin Analysis and Assessment.Patients and Methods: We retrospectively analyzed 100 patients’ records with “VISIA” Skin Analysis System after 532nm laser therapy.Results: Laser therapy significantly decreased VISIA scores for all tested lesions, ie, macules, pigmented and vascular lesions (p< 0.0001 for all). The efficacy of laser treatment was not significantly different regarding skin phototype (p> 0.05) and did not correlate with age of participants (p> 0.05). The more laser sessions were performed, the higher improvement in vascular lesion VISIA scores was observed (r=0.26, p=0.0097).Conclusion: 532 nm laser therapy is effective regarding vascular and hyperpigmented skin lesions located on the facial area. The System of Skin Analysis and Assessment is a good tool to test the treatment efficacy during regular follow-up procedure.Keywords: laser therapy, aesthetic medicine, cosmetic dermatology, VISIA, pigmented skin lesions, vascular skin lesions, skin aging

Background/Aim: The purpose of this study was to examine the impact of clinicopathological prognostic factors on tumor resectability, perioperative complications, and 5-year survival rates in patients with gastric cancer treated surgically. Patients and Methods: A cohort of 834 patients operated on for gastric cancer between 2007 and 2016 was analyzed. Results: Patients over 70 years of age manifested a significantly higher rate of overall complications, systemic complications, surgical complications, perioperative mortality, and a worse 5-year survival. The diffuse type according to the Lauren classification was an independent prognostic factor for perioperative mortality. TNM stage significantly influenced resectability and 5-year survival rates. Furthermore, the presence of distant metastases (M1 stage) significantly increased the rates of overall complications, systemic complications, and perioperative mortality. Conclusion: Although TNM stage was the most important prognostic factor for resectability, perioperative complications and 5-year survival, other clinicopathological prognostic factors, such as age, and Lauren type also significantly affected treatment outcomes in gastric cancer surgery.

ALS remains a fatal, neurodegenerative motor neuron disease. Numerous studies seem to confirm that innate immune system is involved in the pathophysiology of ALS. Hence, the assessment of the complement system and attempts to modify its activity remain the target of medical intervention in ALS. In the present study, three intrathecal administrations of autologous bone marrow-derived lineage-negative (Lin–) cells were performed every 6 weeks in 20 sporadic ALS patients. The concentrations of various complement components in the cerebrospinal fluid and plasma at different time points after cell injection were quantified using a Luminex multiplex. The results of the complement system were correlated with the level of leukocytes, neutrophils, lymphocytes, fibrinogen and CRP in the peripheral blood and the functional status of ALS patients using Norris and ALS-FRSr scales. The study showed a statistically significant decrease in plasma C3b concentration in all 7th days after cell application. In parallel, a peak decrease in neutrophil count and CRP level was observed on days 5–7, with a simultaneous maximum clinical improvement on days 7–28 of each Lin– cell administration. Adjuvant Lin– cell therapy appears to have the silencing potential on the complement-mediated immune system and thus suppress pro-inflammatory reactions responsible for neurodegeneration. However, further in-depth studies are necessary to address this issue.

The launch of novel chemotherapeutic agents—in particular, proteasome inhibitors and immunomodulatory drugs—dramatically changed multiple myeloma (MM) therapy, improving the response rate and prolonging progression-free survival. However, none of the anti-MM drugs are deprived of side effects. Peripheral neuropathy (PN) seems to be one of the most pressing problems. Despite extensive research in this area, the pathogenesis of drug-induced peripheral neuropathy (DiPN) has not yet been fully elucidated. In the present study, we aimed to assess the potential relationship between proinflammatory factors and the development of PN in MM patients with particular emphasis on the application of VTD (bortezomib, thalidomide, dexamethasone) regimen. Our analysis identified increased concentrations of CCL2, IL-1β, and IFN-γ in plasma of MM patients during treatment, both with and without symptoms of PN, compared with untreated neuropathy-free MM patients. At the same time, the plasma concentration of IL-1β in patients with neuropathy was significantly increased compared with patients without PN before and during treatment. Moreover, the results were enhanced at the transcript level by performing global mRNA expression analysis using microarray technology. The most significant changes were observed in the expression of genes responsible for regulating immunological and apoptotic processes. An in-depth understanding of the mechanisms responsible for the development of DiPN might in the future reduce the incidence of PN and accelerate diagnosis, allowing the choice of neuropathy-free treatment strategies for MM.

Introduction The endovascular method as a less invasive treatment for patients with abdominal aortic aneurysm (AAA) has become an alternative to conventional open surgery. Aim The objective of the present study was to analyse the outcomes of endovascular treatment of AAA patients in long-term observation. Material and methods A group of 236 AAA patients subjected to planned endovascular aneurysm repair (EVAR) between 2010 and 2015 was reviewed. Rates of mortality, surgical complications and re-interventions were collected in the separate time periods, i.e. up to 30 days after surgery, 30 days to 3 years, and from 3 to 5 years after surgery. Cumulative rates of these parameters were evaluated in the short-term (up to 30 days after surgery), medium-term (up to 3 years), and long-term (up to 5 years after surgery) perspective. Results The median age of patients was 75 years, and the most common comorbidities were arterial hypertension (54%) and ischaemic heart disease (52%). Cumulative short-, medium- and long-term mortality rates were 2.5%, 14.2% and 28.9%, respectively. Total rates of surgical complications in short-, medium- and long-term observation were 7.6%, 12.6% and 17.5%, respectively. The cumulative rate of re-interventions ranged from 4.2% to 11.4%. Conclusions In the consecutive time periods, the increase in the percentage of surgical complications and re-interventions increased gradually, in contrast to mortality, where the curve grew significantly, which is expected due to the aging and numerous comorbidities in the observed group of patients.

Background: Little data are available for abscess and non-abscess abdominal fluid collections (AFCs) after gastric cancer surgery and their clinical implications. We sought to analyse the natural history of such collections in a population of patients subject to routine postoperative imaging.Methods: From 1996 to 2012, 1381 patients underwent gastric resections and routine postoperative monitoring with abdominal ultrasound. As a unit protocol, examinations were carried out in all patients prior to drain removal, immediately before discharge, and at follow-up visits.Results: AFCs were diagnosed in 134 (9.7%) patients after a median time from surgery of seven days (interquartile range (IQR) 5-11 days). Sixty-four of the 134 AFCs (48%) were asymptomatic and resolved spontaneously after a median follow-up of 26.5 days (IQR 14-91 days). Seventy (52%) AFCs required interventional drainage. A stepwise logistic regression model demonstrated that interventional treatment was much more likely among patients with enteric fistula (odds ratio (OR) 9.542, 95% CI 1.418-46.224, p=.003) and pancreatic fistula (OR 7.157, 95% CI 1.340-39.992, p=.012).Conclusions: About one half of AFCs after gastric surgery were asymptomatic and eventually resolved spontaneously without any intervention. However, the need for interventional drainage was significantly increased by coexisting pancreatic or enteric fistula.

Introduction Endovascular aneurysm repair as a minimally invasive alternative has become a commonly used surgical method for treating patients with abdominal aortic aneurysm (AAA). Aim To analyze short-term outcomes of endovascular treatment of AAA patients, including ruptured cases. Material and methods From 2010 to 2015, 247 patients with AAA were treated using the endovascular aneurysm repair technique. A short-term analysis was conducted - up to 30 days after surgery. It included 236 patients with planned surgery and 11 operated on in emergency mode, due to ruptured AAA. Results Rates of short-term mortality and re-interventions among patients undergoing planned surgery were 2.5% and 4.2%, respectively. Surgical complications occurred in 18 (7.6%) patients, with the most common being thrombosis and blockage of the stent graft (2.5%). Systemic complications were found in 19 (8%) planned cases, with the most common being arrhythmias (1.7%). In patients with ruptured AAA, short-term mortality was 36.4%, while re-interventions were performed in 3 (27.3%) patients. Rates of surgical and systemic complications for ruptured AAA were 45.4% and 72.7%, respectively. Conclusions The AAA patients undergoing endovascular aneurysm repair showed relatively low short-term mortality. However, larger groups of patients with ruptured AAA are required in order to assess the outcomes in this sub-population.

Background The anatomical Siewert classification for adenocarcinoma of the oesophagogastric junction (OGJ) was dictated by the potential differences in tumour epidemiology and pathology. However, there are some uncertainties whether the distinction of true carcinoma of the cardia (type II) and subcardial gastric cancer (type III) is of clinical value. Methods Using a multicentre data set, we studied 243 patients with OGJ adenocarcinomas who underwent gastric resections between 1998 and 2008. Postoperative complications and long-term survival were compared to evaluate the potential differences in clinically relevant outcomes. Results A group of 109 patients with Siewert type II and 134 with Siewert type III OGJ adenocarcinoma was identified. Both groups showed similar baseline characteristics, including clinical symptoms and duration of diagnostic delay. However, the prevalence of node-negative cancers and superficial (T1–T2) lesions was significantly higher among type II tumours, i.e. 42% vs 21% ( P = 0.003) and 43% vs 20% ( P = 0.045), respectively. Morbidity and mortality rates were 25% and 3.7%, respectively, but types and incidence of postoperative complications were not affected by the anatomical location of the tumour. The overall median survival was significantly longer for Siewert type II tumours (42 vs 16 months; P 70 years, depth of tumour infiltration, lymph node metastases, distant metastases, and radical resection were identified as independent prognostic factors using the Cox proportional hazards model. Conclusion The topographic-anatomic sub-classification of OGJ adenocarcinomas does not correspond to relevant differences in clinical parameters of safety and efficacy of surgical treatment.

INTRODUCTION Various imaging modalities are used for the diagnosis and staging of pancreatic cancer. Abdominal ultrasonography is the most widely available method and usually the first -line diagnostic tool used in patients with suspicion of pancreatic carcinoma. OBJECTIVES The aim of the study was to assess the clinical value of abdominal ultrasonography used in a tertiary center for staging of pancreatic carcinoma. PATIENTS AND METHODS This prospective clinical trial included 454 consecutive patients with pancreatic cancer, who underwent a surgery between 2000 and 2012. The diagnostic accuracy of ultrasonography was established for each T category and lymph node involvement. Computed tomography and intraoperative staging of the pancreatic cancer were used as reference methods. RESULTS The diagnostic accuracy of ultrasonography in cancer staging according to T categories was 94.1% for T1, 95.7% for T2, 85.4% for T3, and 81.7% for T4 tumors. The diagnostic accuracy of abdominal ultrasonography in the diagnosis of lymph node metastasis and assessment of tumor resectability was 66.1% and 74.8%, respectively. CONCLUSIONS The results of our study summarize 12 years of our experience with abdominal ultrasonography in patients with pancreatic cancer and confirm that ultrasonography remains a valuable diagnostic modality in this patient group.

Background/objectives: Inflammation is a central process responsible for health outcomes among surgical patients. Immunonutrition has been investigated as a promising modifying factor; however, inflammatory properties of habitual diet have not yet been investigated. The purpose of this study was to describe inflammatory properties of diet measured by the dietary inflammatory index (DII) among surgical patients treated for colorectal cancer and to link inflammatory properties of habitual diet with a duration of hospitalization. Subjects/methods: A follow-up study among colorectal cancer patients treated surgically was performed in Krakow, Poland. In total, 689 patients were recruited for the study. Habitual diet was assessed using a standardized semiquantitative food frequency questionnaire. Overall, 23 dietary items (including macro-and micronutrients) were used to calculate individuals' DII. Gender, age, marital status, body mass index, smoking status, lifetime physical activity, taking vitamin supplements, number of chronic diseases, cancer site, Duke's staging and surgery type were considered as potential covariates. Results: Participants were aged 58 years, with the average hospitalization time of 11 days. Higher DII (meaning diet with higher anti-inflammatory properties) was negatively associated with the duration of hospitalization (univariable linear regression: b=−0.59; P=0.005). Multivariable logistic regression has shown the decrease of the risk of longer stays (>7 days) among patients with the DII >−4.25, but only among younger (⩽60 years) patients, irrespective of Duke's staging. Conclusions: The DII might be used as a potential predictor of longer hospitalization among colorectal cancer patients treated surgically. The study provides evidence for the role of dietary-related low-grade inflammation among surgical patients.

In patients with metastatic gastric cancer, median overall survival remains under 1 year and standard chemotherapy regimens are not able to substantially improve the prognosis of the patients. Amplification and over-expression of HER2 is reported in approximately 20% of gastric tumours, challenging the use of targeted therapies. There are several targeted therapies in different stages of clinical development with trastuzumab being the first overcoming the regulatory hurdle and getting European Medicines Agency approval. In patients with advanced gastric or gastro-oesophageal junction cancer, addition of trastuzumab to chemotherapy significantly improved overall survival compared with chemotherapy alone. Addition of trastuzumab to chemotherapy did not increase the incidence of adverse events. Other agents targeting the HER2 pathway (lapatinib) or other domains of epidermal growth factor receptor family (cetuximab) are currently being investigated for the treatment of an advanced gastric cancer.