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Coronavirus disease (COVID-19) pandemic is affecting the world unevenly. One of the highest numbers of cases were recorded in the most polluted regions worldwide. The risk factors for severe COVID-19 include diabetes, cardiovascular, and respiratory diseases. It has been known that the same disease might be worsened by chronic exposure to air pollution. The study aimed to determine whether long-term average exposure to air pollution is associated with an increased risk of COVID-19 cases and deaths in Poland. The cumulative number of COVID-19 cases and deaths for each voivodeship (the main administrative level of jurisdictions) in Poland were collected from March 4, 2020, to May 15, 2020. Based on the official data published by Chief Inspectorate of Environmental Protection voivodeship-level long-term exposure to main air pollution: PM2.5, PM10, NO2, SO2, O3 (averaged from 2013 to 2018) was established. There were statistically significant correlation between COVID-19 cases (per 100,000 population) and annual average concentration of PM2.5 (R2 = 0.367, p = 0.016), PM10 (R2 = 0.415, p = 0.009), SO2 (R2 = 0.489, p = 0.003), and O3 (R2 = 0.537, p = 0.0018). Moreover, COVID-19 deaths (per 100,000 population) were associated with annual average concentration of PM2.5 (R2 = 0.290, p = 0.038), NO2 (R2 = 0.319, p = 0.028), O3 (R2 = 0.452, p = 0.006). The long-term exposure to air pollution, especially PM2.5, PM10, SO2, NO2, O3 seems to play an essential role in COVID-19 prevalence and mortality. Long-term exposure to air pollution might increase the susceptibility to the infection, exacerbates the severity of SARS-CoV-2 infections, and worsens the patients’ prognosis. The study provides generalized and possible universal trends. Detailed analyzes of the phenomenon dedicated to a given region require taking into account data on comorbidities and socioeconomic variables as well as information about the long-term exposure to air pollution and COVID-19 cases and deaths at smaller administrative level of jurisdictions (community or at least district level).

Introduction The presence of lower urinary tract symptoms (LUTS) might be linked with elevated cardiovascular risk. There is a lack of data showing the prevalence of LUTS in the population of patients with cardiovascular diseases. The current study aimed to determine the prevalence of LUTS in patients hospitalized due to a cardiovascular disease. Material and methods Patients hospitalized in a tertiary cardiology department due to a primary diagnosis of cardiovascular disease (including coronary artery disease, heart failure and arrhythmia) were included in the study. All patients were screened for LUTS and assessed using the International Prostate Symptoms Score (IPSS). Results From 166 patients (age 62.8 ±12.1 years), moderate to severe LUTS was diagnosed in 62 patients (37.3%). Patients with LUTS were significantly older, but there were no other factors associated with LUTS. When we divided patients according to LUTS severity, we saw an increasing prevalence of arterial hypertension (69.5% vs 72.9% vs 100%), diabetes mellitus (29.5% vs 33.3% vs 38.5%), coronary artery disease (68.6% vs 72.9% vs 92.3%), but the observations were not statistically significant. Patients with coronary artery disease had significantly higher severity of LUTS compared to patients with arrhythmia or heart failure (mean IPSS 8.88 vs 5.6 vs 5.5, p = 0.004). Conclusions The prevalence of LUTS in patients with cardiovascular diseases is high, affecting 37.3% of the studied population. Patients with coronary artery disease have significantly higher severity of LUTS compared to other cardiovascular diseases.

Background: Infectious complications (IC) caused by bacterial strains often impede anticancer therapy. The study aimed to retrospectively analyze bacterial IC that could help predict the risk and o...

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus (SARS-CoV-2), spreads rapidly and has been announced a pandemic by the World Health Organization (WHO). COVID-19 especially affects cardiovascular system, mostly by leading to the dysfunction of endothelium and its consequences. On the other hand, patients with a history of chronic disease are believed to have a more severe course of COVID-19. Furthermore, apart from an undoubted influence on morbidity and mortality, COVID-19 results in changes in many aspects of human life. It is worth noting that pandemic will also affect people who did not suffer from disease. Nevertheless, due to constantly elevated stress level, COVID-19 may have influence on mental health. Paradoxically, in dealing with stress and COVID-related problems, faith and religiosity can play a leading role. In this review, attention was paid not only to possible cardiac complications of infection but also to the impact of the pandemic on psychological and spiritual effects of the pandemic.

Young girls before menarche or menstruating adolescent women may experience long-term drug-resistant chronic pelvic pain, as well as other symptoms associated with pelvic mass. In such cases, it is of great importance to consider ovarian endometrioma in the differential diagnosis. In general, endometrioma is recognized as an ovarian cyst. However, in most cases, the pathology represents pseudocyst with a partial or complete endometrial-like lining with extraovarian adhesions and endometriotic implants which are likely to occur at the sites of ovarian adhesions and at the ceiling of the ovarian fossa. Ovarian endometriomas occur in 17–44% patients with endometriosis and account for 35% of all benign ovarian cysts. The time span from the onset of menarche to the time of endometrioma formation, which requires surgical intervention, has been evaluated to be a minimum of 4 years. The pathogenesis of early-life endometrioma may be different from other types of endometriosis. Diagnosis is often delayed, especially in adolescents, who tend to wait too long before seeking professional help. The three specific aims of treatment in adolescents with endometriosis and endometriomas are control of symptoms, prevention of further progression of the disease as well as preservation of fertility. Increasing evidence demonstrates association between ovarian endometriosis and ovarian cancer. In the present mini-review, we draw the particular attention of clinicians to such a possibility, even if relatively infrequently reported.

The aim was to evaluate the incidence, clinical course, and outcome of adenoviral infection (AdVI) in pediatric patients diagnosed and treated due to cancer and in pediatric recipients of hematopoietic stem cell. Over a 72-month period, all-in 5599 children with cancer: 2441 patients with hematological malignancy (HM) and 3158 with solid tumors (ST), and 971 patients after transplantation: 741 after allogeneic (allo-HSCT) and 230 after autologous (auto-HSCT) were enrolled into the study. Among cancer patients, 67 episodes of AdVI appeared in 63 (1.1%) children, including 45 (1.8%) with HM and 18 (0.6%; P < .001) with ST. Within transplanted patients, AdVIs were responsible for 88 episodes in 81 (8.3%) children (P < .001), including 78 (10.5%) patients after allo-HSCT and 3 (1.3%) after auto-HSCT. Time to develop AdVI was short, especially after allo-HSCT. The most common clinical manifestation in cancer patients was enteritis diagnosed in 63 (94.0%) cases, while among HSCT recipient asymptomatic adenoviremia was found in 36 (40.9%) cases and the most common clinical manifestation was urinary tract infection. Cancer patients with disseminated disease, as well as HSCT recipients with either asymptomatic viremia or disseminated disease, received antiviral treatment. The most commonly used first-line therapy was cidofovir. None of the cancer patients died due to AdVI, while within HSCT recipients three patients developed disseminated adenoviral disease and died despite antiviral treatment. In cancer patients, AdVIs are rare and associated with very good prognosis even without specific treatment. However, in allo-HSCT recipients, disseminated disease with fatal outcome is more likely to occur.

Lower urinary tract symptoms (LUTS) are etiologically heterogeneous group of clinical symptoms, which are related to disorders of the lower urinary tract (bladder, prostate and urethra). LUTS are common break down into two symptoms groups: voiding (obstructive) symptoms or storage (irritative) symptoms. Patients may have mainly voiding symptoms, storage symptoms or a combination of both. The occurrence of LUTS is not limited to specific disease despite the frequent association of these symptoms with the bladder outlet obstruction. Furthermore, they can be an indicator of structural and functional abnormalities of the urinary tract, as well as the indicator of many other non-urological diseases ( e.g. chronic kidney disease, cardiovascular disease, disorders of the central nervous system and endocrine system). In many cases, LUTS are consequence of systemic changes that are caused by cardiovascular risk factors such as diabetes, hyperlipidemia or hypertension. This paper discusses the relationship between the occurrence of LUTS and the cardiovascular disease and the potential clinical implications regarding the management of the patients.

Introduction/Background* Endometrial cancer is the second most common carcinoma of the female genital tract globally, and its incidence is still increasing. Optimal treatment of EC depends on early diagnostics and pre-operative stratification to appropriately select the extent of surgery and to plan further therapeutic approach. Current diagnosis and treatment of EC patients is guided by histopathological and surgical findings since there are no accurate non-invasive diagnostic or prognostic methods available. The lack of non-invasive diagnostic and prognostic biomarkers of EC is addressed in the current clinical study titled ‘Biomarkers for Diagnosis and Prognosis of Endometrial Carcinoma’ (NCT03553589). Methodology Patient recruitment takes place at six medical centers (University Medical Centre Ljubljana, Slovenia; University Medical Centre Maribor, Slovenia; Maastricht University Medical Centre, The Netherlands; Lublin Medical University, Poland; University Hospital Brno, Czech Republic, University of Genoa, Italy). Plasma samples from women with diagnosed EC and controls will be examined using non-targeted and targeted metabolomics and targeted proteomics approaches. Combined blood metabolome (>850 metabolites), proteome (>900 proteins), clinical and epidemiological data will be analyzed in order to construct diagnostic/prognostic algorithms for early diagnosis of EC and to identify patients with low/high risk for cancer progression and recurrence. BioEndoCar consortium has defined inclusion/exclusion criteria and a strict standard operating procedure for sample collection, processing and storage that is followed in all medical centers. Result(s)* Since the beginning of the project we recruited more than 440 patients. Discovery proteomics and discovery metabolomics phase have been concluded. Targeted proteomics and targeted metabolomics analysis are currently in progress and we are awaiting the results. Conclusion* Within the project we expect to find different metabolic and protein profiles in patients with early stages of EC as compared to controls and in patients with poor prognosis and high risk of disease progression and recurrence as compared to those with favorable prognosis. Great effort was put into informing the lay and expert public about the importance of the translational studies in EC. We have established an official website (https://bioendocar.eu/), Twitter profile and Facebook page (https://www.facebook.com/bioendocar) where we post all news concerning the project. Funded by ERA-NET Transcan2 and MIZS. Nothing to disclose.

Infections caused by the toxigenic strains of Clostridioides difficile in the hospital environment pose a serious public health problem. The progressive increase in hospital infections in Poland indicates that risk management is a tool that is not used in an effective way and significantly differs from the goals set by the Leading Authorities, the Ministry of Health and its subordinate units. Systematic education of medical personnel constitutes the basic element of rational risk management aimed at reducing the number of infections as it allows for the transfer of knowledge, development of appropriate organizational procedures, and improves internal communication. This paper presents the results of a survey conducted in hospital facilities throughout Poland. The study dealt with what medical personnel know about channels of transmission and prevention of Clostridioides difficile infections in the hospital setting, professional training and risk management in terms of reducing the number of infections. The survey reveals that Clostridioides difficile continues to be a serious problem in the inpatient care system. Procedures and management strategies implemented by hospitals in order to limit the spread of the pathogen are predominantly focused on short-term action, which does not lead to a real improvement in terms of hospitalized patients’ safety. The infection risk management system was assessed at a fairly low level. The obtained research results confirmed the research hypotheses that had been formulated.

Background The presence of obstructive sleep apnea (OSA), a novel cardiovascular risk factor, contributes to the development of peripheral arterial diseases (PAD). There is a lack of data showing how often these diseases coexist. Aims The aim of the study was to determine the prevalence of OSA in the population of patients with PAD. Methods Patients previously qualified for the first revascularization due to PAD were included in the study. All patients underwent an overnight sleep study to detect OSA. Diagnosis of OSA was made when the apnea–hypopnea index (AHI) was ≥5 per hour. Results From 141 patients (60% men, age 69.6 ± 9.5 years), OSA was diagnosed in 68 patients (48%). OSA occurred in mild form (5 ≤ AHI < 15/h) in 39 cases (28%), in moderate form (15 ≤ AHI < 30/h) in 21 cases (15%), and in severe form (AHI ≥ 30/h) in 8 cases (6%). Patients without OSA had significantly lower body mass index (BMI; 26.9 ± 5.5 vs. 27.7 ± 5.3 kg/m2, p = 0.01) and lower hip circumference (97.4 ± 11.7 vs. 98.7 ± 7.4, p = 0.04). There were no differences in the distribution of other investigated cardiovascular risk factors and diseases between these groups. There were no significant differences in OSA distribution or its severity between patients with lower extremity artery disease and carotid artery disease. Conclusions The prevalence of OSA in patients with PAD is very high, affecting nearly half of the studied population.

Objectives: The analysis of epidemiology, risk factors and outcome of infections in children with malignant bone tumors (MBT) undergoing chemotherapy. Methods: In this retrospective nationwide multicenter cross-sectional study, a total number of 126 children with MBT including 70 with Ewing sarcoma (ES) and 56 with osteosarcoma (OSA) were screened for infections over a period of 72 consecutive months. Results: The risk of infection was 7.15-fold higher in patients with ES as compared to the OSA group, especially concerning bacterial infections (4.1-fold increase risk). Bacterial infections occurred in 74.3% patients with ES and in 41.1% with OSA. The median time from diagnosis to first infection was 4.9 months. 33.0% of bacterial episodes were diagnosed as bloodstream (BSI), 31.1% as gastrointestinal tract, 30.1% as urinary tract infection. Infection-related mortality (IRM) from bacterial infection was 6% and 15% in ES and OSA patients, respectively. Cumulative incidence was 7.1% for invasive fungal disease and 6.3% for viral infections. The only significant risk factor for IRM was time to infection ≥5 months since the beginning of chemotherapy. All patients who have died from infection had BSI and were in neutropenia. Conclusions: Infections in the children with MBT in our study occurred with high frequency, especially in patients with ES. The most frequent were bacterial infections, while fungal and viral infections were episodic. Among the bacterial infections, bloodstream, urinary tract and gastrointestinal tract infections occurred with similar frequency. All deceased patients died due to BSI. Bacterial infection occurring ≥5 months since the beginning of chemotherapy was a risk factor for death.

The incidence of scar endometriosis in Cesarean sections varies between 0.03 and 0.4%. However, the recently increased rate of Cesarean sections worldwide may be causing an increase in occurrence of scar endometriosis. This report presents anatomopathological evidence of an early-stage malignant transformation in endometriotic tissue from a post-Cesarean scar and briefly reviews possible underlying mechanisms. A 40-year-old woman with a body mass index of 42.7 was referred to the gynecological department with recurrent pain and presence of a palpable mass in her Cesarean section scar. She had undergone this procedure 7 years earlier and began experiencing discomfort and pain at the incision site 6 months postoperatively. Surgical treatment was instituted with complete removal of the lesion. Anatomopathological examination revealed endometriotic tissue intertwined with atypical endometrial hyperplasia and fibrosis. At 2 years’ follow-up, she was asymptomatic, both clinically and based on ultrasound examination. Endometriotic foci inoculated within an abdominal scar may undergo malignant transformation. Long-lasting abdominal scar endometriosis, in morbidly obese women, requires special attention from the physician.

BACKGROUND A noninvasive, accurate and quick diagnosis is very important to general practitioners and specialists who care for the health of patients' oral cavity mucosa. The main enemies are precancerous lesions: leukoplakia and lichen planus (LP). OBJECTIVES The aim of this study was to attempt to formulate a differential diagnosis for leukoplakia vs LP in the oral mucosa based on digital texture analysis in intraoral macrophotography. MATERIAL AND METHODS The study was comprised of 21 patients affected by leukoplakia, 21 affected by LP and 21 healthy volunteers. Intraoral photography of all participants was taken perpendicularly to the buccal mucosa. To achieve the maximum possible contrast, a high-pass filter was applied and level tools were then used to equalize the histograms of the images. After that, the images were converted into 8-bit grayscale. Two features of run length matrix and 2 of co-occurrence matrix were used for texture analysis. Analysis of variance (ANOVA) was used to check for differences. Factor analysis (FA) and classification with artificial neural network (ANN) were performed. RESULTS The results revealed a simple possible differentiation of both types of precancerous lesions from normal mucosa (p < 0.05). Factor analysis and ANN can help in differentiating the 3 study groups from one another. CONCLUSIONS Differential diagnosis of leukoplakia and LP in the oral mucosa based on digital texture analysis in intraoral macrophotography is possible. It can be used to develop smartphone applications and can be also a helpful tool for general dentists to define the clinical problem before a consultation with a specialist.

The aims of the study were to determine the effectiveness of blebbistatin (BLEB) on detrusor overactivity (DO) in an animal model induced by retinyl acetate (RA) and, because of potential urothelial permeability, to evaluate the degenerative impact of BLEB on the urothelium. Three days after RA instillation into the urinary bladder, BLEB was administered into the bladder and immediately after cystometric assessment was performed. Furthermore, Evans Blue extravasation into bladder tissue and urothelium thickness were measured. Sixty female Wistar rats were used and randomly assigned to one of four groups (n = 15 in each group): (1) control, (2) RA, (3) BLEB, and (4) RA + BLEB. RA administration induced changes in cystometric parameters reflecting DO, as previously reported. Treatment with BLEB did not significantly alter cystometric parameters in rats which did not receive RA. Administration of BLEB to rats pretreated with RA reversed changes in cystometric parameters induced by RA in basal pressure, threshold pressure, detrusor overactivity index, amplitude of nonvoiding contractions, frequency of nonvoiding contractions, voided volume, volume threshold, intercontraction interval, bladder compliance, and volume threshold to elicit nonvoiding contractions. There were no significant differences in Evans Blue extravasation into bladder tissue or urothelium thickness between the groups. The current research provides new data on the possible utility of blebbistatin in the pharmacotherapy of DO, which is an important feature of overactive bladder (OAB). Further studies in human patients with DO/OAB are warranted to confirm these preclinical results.

Background: Toward the goal of predicting individual long-term cancer survival to guide treatment decisions, this study evaluated the ability of a probabilistic neural network (PNN), an established model used for decision-making in research and clinical settings, to predict the 10-year overall survival in patients with cervical cancer who underwent primary surgical treatment. Patients and Method: The input dataset was derived from 102 patients with cervical cancer FIGO stage IA2-IIB treated by radical hysterectomy. We identified 4 demographic parameters, 13 tumor-related parameters, and 6 selected perioperative variables for each patient and performed computer simulations with DTREG software. The predictive ability of the model was determined on the basis of its error, sensitivity, and specificity, as well as area under the receiver operating characteristic curve. The results of the PNN predictive model were compared with those of logistic regression analysis and a single decision tree as reference models. Results: The PNN model had very high predictive ability, with a sensitivity of 0.949, a specificity of 0.679, and an error rate of 12.5%. The PNN's area under the receiver operating characteristic curve was high, 0.809, a value greater than those for both logistic regression analysis and the single decision tree. Conclusion: The PNN model effectively and reliably predicted 10-year overall survival in women with operable cervical cancer, and may therefore serve as a tool for decision-making process in cancer treatment.

Serotonin plays an important role in regulating the cardiovascular system. Drugs widely used in the treatment of depression, migraine, Parkinson’s disease or obesity affect the serotonergic system. The use of these compounds causes both acute and chronic effects, depending on the type of activated 5-HT receptor and its location. An acute cardiac response to 5-HT, known as Bezold-Jarisch reflex, leads to bradycardia and hypotension. The chronic contribution of serotonin may be associated with fibrosis and cardiac valve degeneration. This article analyses the impact of 5-HT receptors activation on the cardiovascular system and describes side effects of this activation and new therapies targeting this system.

Although in developed countries endometrial cancer (EC) is the most common gynecological malignancy, its occurrence in adolescents is exceedingly rare. The increasing rate of obesity in children and adolescents is held responsible for the increasing prevalence of EC in younger cohorts of patients. The diagnosis of this malignancy can have devastating consequences for future fertility because standard treatment protocols for EC include hysterectomy. Here, we present the first detailed review of the world literature on EC in subjects aged 21 years or younger (n = 19). The mean age at diagnosis was 16.7 ± 0.6 years. One patient (5.3%) had a Type II (high-risk) disease. No communication retrieved from the search reported on patient death; however, two (10.5%) patients were lost to follow-up. There was also a high proportion (five subjects, or 26.3%) of cases with genetic background (Cowden syndrome and Turner syndrome), therefore genetic screening or a direct genetic study should be considered in very young patients with EC. The current fertility-sparing options, limited to Type I (low-risk) disease, are presented and discussed. Such information, obtained from studies on older women, translates well to adolescent girls and very young women. Careful anatomopathological monitoring at follow-up is essential for the safety of a conservative approach. Improved survival in very young EC patients makes the preservation of fertility a central survivorship issue, therefore both patients and caregivers should undergo counseling regarding available options. Moreover, our study suggests that genetic syndromes other than Lynch syndrome may be associated with EC more frequently than previously thought.

Ovarian steroid-cell tumors (SCTs) are a rare subgroup of sex-cord tumors of the ovary, accounting for less than 0.1% of all ovarian tumors. Not otherwise specified (NOS) tumors are the most common subtype. More than half of patients with SCTs-NOS show hyperandrogenic symptoms. The primary treatment for SCTs is surgery, as most cases are early-staged and benign. Because of the low incidence of metastatic disease, there is insufficient reliable information on the role of adjuvant therapy and the most effective treatment regimen. In this report, a rare case of a recurrent SCT-NOS in a 36-year-old female patient without endocrine symptoms is presented, highlighting the significance of appropriate pathological evaluation and immunohistochemical testing for the accurate diagnosis of this malignancy, particularly in the case of hormonally “silent” tumors. The metastatic tumor described here showed no response to four courses of adjuvant chemotherapy after several debulking surgeries. Based on the clinical findings, the neoplastic etiology should always be considered during the resection of ovarian tumors to prevent possible disease dissemination due to inappropriate surgical techniques.

Borderline ovarian tumors (BOTs) represent an independent group among ovarian malignancies, being diagnosed at clinical stage earlier than invasive ovarian carcinomas (OCs) and characterized by a rather favorable outcome after careful surgical management. Data published worldwide showed a substantial discordance of p53 expression in BOTs. The purpose of this work was to present the current status of knowledge on the significance of TP53 gene and p53 protein product alterations in BOTs. In general, higher p53 expression patterns were reported for ovarian malignancies compared to BOTs. Serous, mucinous, and endometrioid BOTs differ substantially in relation to p53 immunostaining, but data concerning the relationship between the protein's immunoreactivity and other clinico-pathological variables are scarce. Finally, reports published to date support the view that TP53 alterations may not be commonly associated with the borderline phenotype of ovarian tumors but they probably occur during the development of invasive OCs. In light of these uncertainties, the impact of TP53 alterations and p53 expression on overall survival in women affected by BOTs requires further multi-institutional studies in large cohorts of patients.

We investigated single nucleotide polymorphism (SNP) of the betaglycan gene (TGFBR3) encoding the TGF&beta, co-receptor in endometrial cancer (EC) and its association with betaglycan expression. The study group included 153 women diagnosed with EC and 248 cancer-free controls. SNP genotyping and gene expression were analyzed using TaqMan probes. Three out of the eight SNPs tested, i.e., rs12566180 (CT, OR = 2.22, 95% CI = 1.15&ndash, 4.30, p = 0.0177), rs6680463 (GC, OR = 2.34, 95% CI = 1.20&ndash, 4.53, p = 0.0120) and rs2296621 (TT, OR = 6.40, 95% CI = 1.18&ndash, 34.84, p = 0.0317) were found to be significantly associated with increased risk of EC (adjusted to age, body mass index, menarche and parity). Among the analyzed SNPs, only rs2296621 demonstrated the impact on the increased cancer aggressiveness evaluated by the WHO grading system (G3 vs. G1/2, GT&mdash, OR = 4.04, 95% CI = 1.56&ndash, 10.51, p = 0.0026, T&mdash, OR = 2.38, 95% CI = 1.16&ndash, 4.85, p = 0.0151). Linkage disequilibrium (LD) analysis revealed high LD (r2 &ge, 0.8) in two haploblocks, constructed by rs2770186/rs12141128 and rs12566180/rs6680463, respectively. In the case of C/C haplotype (OR = 4.82, 95% CI = 1.54&ndash, 15.07, p = 0.0116&mdash, Bonferroni corrected) and T/G haplotype (OR = 3.25, 95% CI = 1.29&ndash, 8.15, p = 0.0328&mdash, Bonferroni corrected) in haploblock rs12566180/rs6680463, significantly higher frequency was observed in patients with EC as compared to the control group. The genotype-phenotype studies showed that SNPs of the TGFBR3 gene associated with an increased risk of EC, i.e., rs12566180 and rs2296621 may affect betaglycan expression at the transcriptomic level (rs12566180&mdash, CC vs. TT, p &lt, 0.01, rs2296621&mdash, GG vs. TT, p &lt, 0.001, GT vs. TT, p &lt, 0.05). Functional consequences of evaluated TGFBR3 gene SNPs were supported by RegulomeDB search. In conclusion, polymorphism of the TGFBR3 gene may be associated with an increased EC occurrence, as well as may be the molecular mechanism responsible for observed betaglycan down-regulation in EC patients.

ObjectiveSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is protean in its manifestations, affecting nearly every organ system. However, nervous system involvement and its effect on disease outcome are poorly characterized. The objective of this study was to determine whether neurologic syndromes are associated with increased risk of inpatient mortality.MethodsA total of 581 hospitalized patients with confirmed SARS-CoV-2 infection, neurologic involvement, and brain imaging were compared to hospitalized non-neurologic patients with coronavirus disease 2019 (COVID-19). Four patterns of neurologic manifestations were identified: acute stroke, new or recrudescent seizures, altered mentation with normal imaging, and neuro-COVID-19 complex. Factors present on admission were analyzed as potential predictors of in-hospital mortality, including sociodemographic variables, preexisting comorbidities, vital signs, laboratory values, and pattern of neurologic manifestations. Significant predictors were incorporated into a disease severity score. Patients with neurologic manifestations were matched with patients of the same age and disease severity to assess the risk of death.ResultsA total of 4,711 patients with confirmed SARS-CoV-2 infection were admitted to one medical system in New York City during a 6-week period. Of these, 581 (12%) had neurologic issues of sufficient concern to warrant neuroimaging. These patients were compared to 1,743 non-neurologic patients with COVID-19 matched for age and disease severity admitted during the same period. Patients with altered mentation (n = 258, p = 0.04, odds ratio [OR] 1.39, confidence interval [CI] 1.04–1.86) or radiologically confirmed stroke (n = 55, p = 0.001, OR 3.1, CI 1.65–5.92) had a higher risk of mortality than age- and severity-matched controls.ConclusionsThe incidence of altered mentation or stroke on admission predicts a modest but significantly higher risk of in-hospital mortality independent of disease severity. While other biomarker factors also predict mortality, measures to identify and treat such patients may be important in reducing overall mortality of COVID-19.

INTRODUCTION 2MACE is a risk assessment score designed to stratify cardiovascular risk in patients with atrial fibrillation (AF). Early detection of increased cardiovascular risk is of vital importance in this population, as it helps reduce mortality and morbidity rates. OBJECTIVES This study aimed to assess the utility of the 2MACE score in predicting long‑term mortality in patients with AF. PATIENTS AND METHODS This was a post hoc analysis of a prospective observational cohort study including consecutive patients with nonvalvular AF, who were followed for a median duration of 81 months. RESULTS The final analysis included 1351 patients (men, 53.1%; median [interquartile range] age, 71 [62-80] years). During the follow‑up, 142 patients (10.5%) died. Deceased patients were more often classified as high risk according to the 2MACE score than survivors (80.3% vs 53.2%; P

The purpose of this study was to investigate the association of iNKT (human invariant natural killer T) cells with the key marker of ovarian cancer (OC) - CA125 (cancer antigen125) in serum. The study reports the assessment of iNKT cells in peripheral blood and tissue of benign and borderline ovarian tumors (BOTs) and in the advanced-stage ovarian cancer. The study groups were as follows: 25 women with benign ovarian tumors, 11 women with BOTs, and 24 women with primary advanced-stage ovarian cancers. The control group consisted of 20 patients without the ovarian pathology. The rates of iNKT lymphocytes in the peripheral blood and tissue specimens were evaluated by a flow cytometry. Significant differences in the percentage of iNKT+/CD3+ of CD3+ lymphocytes, iNKT+/CD3+/CD161+ among CD3+ and iNKT+/CD3+/CD161+ among CD3+/iNKT+ between the control group and patients with ovarian tumors in the peripheral blood and tumor tissue were identified. Significant correlations were noticed between the proportion of lymphocytes iNKT+/CD3+/CD161+ among CD3+/iNKT cells in blood and in cancer tissue of both benign and malignant tumors. In the OC group, neither the ratio of iNKT cells in the blood (P = 0.07), nor the intra-tumor NKT-cell infiltration (P = 0.5) were independent prognostic factors for the follow-up. An increased rate of iNKT cells was detected in benign ovarian tumors compared to OCs. In patients with ovarian cancer, a higher rate of iNKT cells in tumor tissue was present related to that noted in the patient's blood. In addition, a correlation was discovered between the CA125 serum marker and NKT cells from the ovarian cancer tissue. This article has for the first time demonstrated a negative relationship between serum levels and NKT lymphocyte count from ovarian tissue. The inflammatory process in ovarian cancer tissue and the potential infiltration of endothelial immune cells, may result in a reduced number of NKT cells in the tumor microenvironment and increased circulation of the CA125 marker. Presented findings underscore new aspects of the iNKT cells involvement in the ovarian cancer development.

We present a case of acute myocardial infarction secondary to arterial thromboembolism in a 25-year-old man with systemic lupus erythematosus and antiphospholipid syndrome (APS). To our knowledge, based on the literature review, this patient is the youngest one with the acute coronary syndrome as a complication of APS. Acute myocardial infarction secondary to arterial thromboembolism is a rare presentation of APS. There are different recommended anticoagulation strategies in APS patients according to the presence of thrombosis of arterial or venous origin. Potential difficulties in the treatment may occur based on the clinical scenarios. A large number of APS patients require lifelong oral anticoagulation with vitamin K antagonists. Some non-vitamin K oral anticoagulants are being studied as drugs potentially useful in APS treatment. The recent studies suggest the role of aGAPSS score in assessing the risk of a recurrent thrombotic event as well as acute myocardial infarction in APS patients.

Varicella-zoster virus (VZV) infection in pediatric hemato-oncology patients can be a therapeutic problem when children are exposed to immunosuppression. The aim of this study is to evaluate the incidence of VZV infection, antiviral therapy and outcome in children with ALL treated in polish hemato-oncological centers between 2012 and 2019 years. This study included medical records of 1874 patients, aged 1 to 18 years, with newly diagnosed acute lymphoblastic leukemia. During chemotherapy, 406 children out of 1874 (21.6%) experienced viral infections. The incidence of VZV infection in the whole group children with ALL was 1.8%. Among them, 34 (8.4%) patients were diagnosed with VZV infection. Thirty-five episodes of viral infections were identified. The median time of VCV therapy was 12 days. Herpes zoster infection occurred in 24 (70.6%) children, and varicella in 10 (29.4%) ones. The average time from the start of chemotherapy to the appearance of herpes zoster was 7.26 ± 4.05 months. VZV infection occurred mainly during the maintenance therapy, the reinduction and induction phases. There was no correlation between steroid dosage or type and subsequent zoster. The total lymphocyte count of these patients on the first day of zoster was reduced. No serious complications were observed due to this infection. All patients survived. In conclusion, a low incidence of VZV infection was observed among pediatric patients with ALL in Poland. This analysis indicates that currently used therapeutic methods are effective in children with cancer and VZV infection. The main focus should be on the prevention of delayed chemotherapy.

Introduction The relationship between cardiovascular disease (CVD) and lower urinary tract symptoms (LUTS) is well established. A healthy lifestyle with a good quality diet and regular physical activity is important for reducing the severity of LUTS. Material and methods A literature search was performed on the subject of association between LUTS and cardiovascular risk. Results The recent data indicates that therapy for cardiovascular risk reduction might also reduce the severity of LUTS (e.g. statins reduce the risk of benign prostatic hyperplasia [BPH] and slow down the progression of LUTS in patients with hyperlipidaemia). Hypertensive patients treated with angiotensin II receptor blockers have a lower severity of LUTS. This paper shortly discusses the relationship between the occurrence of LUTS and CVD and the potential clinical implications regarding the management of the patients. Conclusions Patients with lower urinary tract symptoms require a holistic approach and cooperation of a urologist and cardiologist to diagnose concomitant cardiovascular diseases as early as possible and implement appropriate treatment. Antihypertensive, antithrombotic, hypolipemic therapies and healthy lifestyles reduce not only cardiovascular mortality, but also might reduce the severity of LUTS.

Ovarian adult-type granulosa cell tumors are often associated with endometrial hyperplasia or even uterine cancer. Herein, we present a case report of a 65-year-old female patient who had undergone curettage of the uterine cavity several times due to abnormal and irregular uterine bleeding. Owing to recurrent episodes of vaginal bleeding as well as ineffective pharmacological treatment of simple endometrial hyperplasia without atypia, the patient underwent a laparoscopically-assisted vaginal hysterectomy. Owing to an enlarged right ovary with bluish color, intra-operative pathological examination was immediately performed. Surprisingly, an ovarian adult-type granulosa cell tumor was diagnosed, and the surgery was extended to pelvic lymphadenectomy and omentectomy. Immunohistochemical staining with selected antibodies (Arginase 2, Nidogen 2, BAF250a/ARID1A, GPR30, SF-1/NR5A, and 1LRH-2E1/NR5A2) was also performed. In conclusion, in cases of recurrent vaginal bleeding concomitant with endometrial hyperplasia, the existence of rare ovarian tumors connected with extensive estrogenic stimulation must be taken into account. Immunostaining with selected antibodies (Arginase 2, Nidogen 2, ARID1A, or GPR30) may help elucidate the possible molecular mechanisms associated with the BAF250a/development of various ovarian/endometrial abnormalities.

The aging process does not occur in the same way for all patients. The pace of this process, both physical and mental, is very different. The quality of life of an elderly patient depends on many factors, including lifestyle, genetic predisposition and appropriate medical care. The quality of health care depends, among other things, on how quickly and, whether or not, the doctor sees correctly signs of premature or „abnormal” aging. To facilitate this, a set of symptoms was identified, the occurrence of which should alert the doctor due to the relationship with increased mortality. In the English-language literature, this group is called frailty syndrome. In the Polish literature, the most widely used description of this phenomenon is probably zespol kruchości . The aim of this paper was to present the importance of this syndrome in clinical practice.

Introduction: The coexistence of chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) with different gynecologic neoplasms is a rare phenomenon. Here, we report a case of simultaneously developed CLL/SLL with endometrioid-type uterine cancer. Case Report: A 58-year-old woman was admitted to the 2nd Department of Gynecology, Lublin Medical University, Lublin, Poland, in June 2017, where the uterine cancer was diagnosed. After the surgery, pathological examination revealed a uterine moderately differentiated adenocarcinoma of endometrioid subtype (subtype I according to Bokhman) deeply infiltrating the myometrium as well as the uterine cervix. Surprisingly, CLL/SLL was subsequently diagnosed in all removed pelvic as well as para-aortic lymph nodes. Immunohistochemical analysis showed CD45 (++), CD20 (+), CD3 (–/+), CD19 (+), CD23 (+), CD5 (+), and CD34 (+). Proliferative activity, assessed by MIB-1 proliferative index immunostaining, reached 18%. The patient was admitted to radiotherapy and chemotherapy at the Oncology Hospital, Lublin, Poland, and is still on follow-up. Conclusions: The coexistence of CLL/SLL with various gynecological malignancies, especially primary human endometrial cancer, is a rare entity. The detection of both tumors simultaneously, in general, is accidental, and the management should not be different from the situation in which malignancy appears de novo.

Cardiovascular risk assessment in clinical practice isessential. It affects treatment methods of cardiovascular diseases in patients. Recommended tools such as POL-SCORE do not take into account the clinical picture of all the patients. The clinical case shows that the use of nonclassical elements of risk factors in clinical practice changes the scheme of action undertaken so far.

Background Computational intelligence methods, including non-linear classification algorithms, can be used in medical research and practice as a decision making tool. This study aimed to evaluate the usefulness of artificial intelligence models for 5–year overall survival prediction in patients with cervical cancer treated by radical hysterectomy. Methods The data set was collected from 102 patients with cervical cancer FIGO stage IA2-IIB, that underwent primary surgical treatment. Twenty-three demographic, tumor-related parameters and selected perioperative data of each patient were collected. The simulations involved six computational intelligence methods: the probabilistic neural network (PNN), multilayer perceptron network, gene expression programming classifier, support vector machines algorithm, radial basis function neural network and k-Means algorithm. The prediction ability of the models was determined based on the accuracy, sensitivity, specificity, as well as the area under the receiver operating characteristic curve. The results of the computational intelligence methods were compared with the results of linear regression analysis as a reference model. Results The best results were obtained by the PNN model. This neural network provided very high prediction ability with an accuracy of 0.892 and sensitivity of 0.975. The area under the receiver operating characteristics curve of PNN was also high, 0.818. The outcomes obtained by other classifiers were markedly worse. Conclusions The PNN model is an effective tool for predicting 5–year overall survival in cervical cancer patients treated with radical hysterectomy.

Introduction/Background. Endometrial carcinoma (EC) is the most frequent gynecological malignancy in the developed world. Currently there are no valid non-invasive diagnostic or prognostic methods available and therefore, diagnosis and treatment of EC patients is guided by histopathological and surgical findings. The lack of non-invasive diagnostic and prognostic biomarkers of EC is addressed in the current clinical study titled “Biomarkers for Diagnosis and Prognosis of Endometrial Carcinoma” (BioEndoCar; NCT03553589). Methodology. Prospective observational case - control study. Patient recruitment takes place at six medical centers (University Medical Centre Ljubljana, Slovenia; Maastricht University, The Netherlands; Lublin Medical University, Poland; University Hospital Brno, Czech Republic; IRCCS Ospedale Policlinico San Martino, Genoa, Italy; University Medical Centre Maribor, Slovenia). Plasma samples from women with diagnosed EC and controls will be examined using non-targeted and targeted metabolomic (Helmholtz Zentrum München, Germany) and semi-quantitative immune-based proteomic (Sciomics GmbH, Heidelberg, Germany) approaches. Combined blood metabolome (>850 metabolites), proteome (>900 proteins), clinical and epidemiological data will be analyzed (University of Tartu, Estonia) in order to construct diagnostic/prognostic algorithms for early diagnosis of EC and to identify patients with low/high risk for cancer progression and recurrence. Results. BioEndoCar project has defined inclusion/exclusion criteria and a strict standard operating procedure for sample collection, processing and sample storage that is followed in all medical centers. Recently, the first milestone of the project was achieved: Since the beginning of the project (April 1st, 2018) more than 440 patients were recruited. Currently, proteomic analysis is ongoing: Using a selected cohort (100 patients), the discovery phase will allow to identify and select promising protein biomarker candidates, which will be validated on a separate cohort composed of 300 patients. Great effort was put into informing the lay and expert public about the importance of the translational studies in EC. BioEndoCar project has been presented at the ENITEC meeting and the ESGO congress. We have established an official website (https://bioendocar.eu/) and we are updating the community on the progress of the study using social media (https://twitter.com/car_endo). Conclusions. Within the project, we expect to find different metabolic and protein profiles in patients with early stages of EC as compared to controls and in patients with poor prognosis with high risk of disease progression and recurrence as compared to those with favorable prognosis. Citation Format: Eva Hafner, Špela Smrkolj, Andrea Romano, Henrica MJ Werner, Andrzej Semczuk, Aleksandra Kaminska, Aneta Adamiak-Godlewska, Dmytro Fishman, Jaak Vilo, Camille Lowy, Christoph Schröder, Janina Tokarz, Jerzy Adamski, Vít Weinberger, Markéta Bednaříková, Petra Vinklerova, Simone Ferrero, Fabio Barra, Iztok Takač, Jure Knez, Tea Lanišnik Rižner. BioEndoCar: in search of new Biomarkers for Diagnosis and Prognosis of Endometrial Carcinoma [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 464.

Previous research has described a woman of reproductive age who presented with a vesicouterine fistula (VUF) of 20 months' duration. The VUF was lined with a metaplastic glandular epithelium containing both estrogen receptors (ER) and progesterone receptors (PR) in abundance. The aim of the present investigation was to evaluate the histology of the VUF canal when exposure to urine of the cellular elements within the fistula was of much shorter duration. A 41-year-old woman who developed a VUF during her third cesarean section was treated with transvesical fistula excision, electrocoagulation, and subsequent attempted hormonal treatment. Later, the patient underwent open surgery fistula repair. Postoperative specimens were subjected to anatomopathological examination together with immunohistochemical staining for ER and PR using monoclonal anti-human antibodies. Herein, we present for the first time detailed microscopic evidence that, at two separate timepoints, the fistulous tract was lined with the endometrium, which covered approximately 80% of the length of the VUF canal. In its intermediate segment, the urothelium formed an additional layer on the surface of the endometrium. At both timepoints, in the columnar epithelial and stromal endometrial cells lining the fistula, both ER and PR were present in abundance. In conclusion, VUF in subjects of reproductive age fulfill criteria for endometriosis. This study provides a rationale for the conservative treatment of VUF consistent with the hormonal treatment of endometriosis.

Professional drivers are a group exposed to many cardiovascular risk factors. Nonsystematic working hours, stress, low physical activity, and unhealthy dietary habits are common among professional drivers. These translate into high risk of cardiovascular disease. The aim of the current analysis was to establish the prevalence of arterial hypertension in a group of continuous professional drivers. The RACER (Risk of Adverse Cardiovascular Events among professional dRivers in Poland) study is a prospective study focused on assessing cardiovascular risk factors in professional drivers. Patients included in the study were screened for the classical and nonclassical cardiovascular risk factors and had an ambulatory blood pressure monitoring (ABPM) performed. Of the RACER study population, 144 drivers were included into the RACER-ABPM study. Of this group 135 (95.7%) were male at mean age of 50.2 ± 9.3 years, with mean body mass index of 32.3 ± 3.0 kg/m2. In 21.3% of patients, family history of cardiovascular disease was noted, 28.1% were current smokers, and 2.9% had diabetes mellitus. Arterial hypertension was previously diagnosed in 39 patients (27.9%). In ABPM, the mean 24-hour blood pressure (BP) values were 130.3 ± 14.3 and 80.9 ± 9.9 for systolic and diastolic BP, respectively, and 46.1% of patients could be categorized as dippers. Based on the ABPM results, arterial hypertension was diagnosed in 104 of patients (73.8%). Patients with hypertension tend to be more often male and have a family history of cardiovascular disease. In conclusion, arterial hypertension is highly prevalent in professional drivers. Also abnormal day-to-night BP value patterns are often seen in this group.

Introduction. Arterial hypertension (AH) is a well-known cardiovascular risk factor. Currently, in Poland, approximately 32% of adults suffer from AH, and only 26% of them are treated successfully. The study aims to determine the incidence of atherosclerosis risk factors and their influence on the effectiveness of hypotensive treatment in the population of patients with AH and coexisting coronary artery disease (CAD) or coronary equivalent. Material and methods. The study included 204 adults. The inclusion criteria were: diagnosis of AH with coexisting a diagnosis of CAD (138 people) or coronary equivalent defined as high (≥ 5%) atherosclerosis-related risk of death in 10-year prognosis, estimated using the EURO SCORE scale (66 people). During observation, pharmacological and nonpharmacological treatments were modified according to the current AH treating standards. After 6 months of observation, the effectiveness of AH control was assessed. Results. Multivariate logistic regression analysis revealed that main factors affecting poor blood pressure control after six months of observation were: obesity, age > 65 years, LDL cholesterol level > 130 mg/dL. Moreover, systolic blood pressure (SBP) < 140 mmHg was more frequent in patients with diabetes mellitus. After six months of therapy, good control of SBP was found in 42.7% of patients and normal values of diastolic blood pressure (DBP) — in 65.2 % of patients. Conclusion. Independent risk factors for poor control of blood pressure were: high level of LDL-cholesterol, age > 65 years and female sex. Paradoxically, diabetes was not a risk factor for poor control of hypertension. The introduction of combined hypotensive and lipid-lowering drugs should contribute to a better control of hypertension in Poland.

The present study was carried out to assess the percentage of T helper 17 (Th17) lymphocytes in blood and tissue and IL-17A serum concentrations in patients with epithelial ovarian tumors. Two isoforms, IL-17A and IL-17F, as well as IL-21 and IL-22, were simultaneously investigated. The study group consisted of 60 women affected by epithelial ovarian tumors (benign, borderline and malignant) and 20 women without ovarian pathology as a control group. The evaluation of the percentage of Th17 cells secreting IL-17A, IL-17F, IL-21 and IL-22 in peripheral blood and tumor tissues was performed using flow cytometry applying a Th17 cytokine staining panel. The blood serum concentration of IL-17A was determined using ELISA. We found no statistically significant differences in the subpopulations of Th17 lymphocytes, either in peripheral blood or in ovarian tissues, following comparison of the women with and without ovarian pathology. Negative correlations were found between the percentage of CD4+/IL-21+ (rs=0.8, p=0.02) and CD4+/IL-17+ (rs=-0.78, p=0.03) in the tissue and IL-17A in blood serum in the group of patients with borderline ovarian tumors. A negative correlation was also found between IL-17A and the percentage of CD4+/IL-21+ in peripheral blood (rs=‑0.48, p=0.03) in the group of patients with ovarian cancer. The increased percentage of Th17 cells in tissue was not correlated with the overall survival of the ovarian cancer patients. In conclusion, we showed that more Th17 cells secreted IL-17A and IL-21 in the tissue of borderline ovarian tumors and less IL-17A in serum. We also observed that in peripheral blood of the patients with ovarian cancer, there was a higher percentage of Th17 lymphocytes and a lower concentration of IL-17A in serum indicating a negative correlation. An increased percentage of Th17 cells in ovarian tissue does not influence the time of survival of patients with ovarian cancer.

Wstep: Ocena ryzyka ma szczegolne znaczenie u pacjentow poddawanych interwencjom chirurgicznym. Zabiegi ortopedyczne, w szczegolności calkowita alloplastyka stawow, są operacjami związanymi z wysokim ryzykiem okolooperacyjnym, jak rowniez jednym z najwyzszych odsetkow powiklan. Cel: Celem niniejszej pracy bylo określenie czestości wystepowania klasycznych i nieklasycznych czynnikow ryzyka sercowo-naczyniowego u pacjentow poddawanych calkowitej alloplastyce stawu biodrowego lub kolanowego. Metody: CRASH-JOINT ( Cardiovascular Risk Assessment ScHeme in JOINT alloplasty ) bylo prospektywnym badaniem epidemio­logicznym przeprowadzonym u pacjentow poddawanych operacji calkowitej alloplastyki stawu biodrowego lub kolanowego. Chorzy wlączeni do projektu byli badani pod kątem klasycznych i nieklasycznych czynnikow ryzyka sercowo-naczyniowego i przeprowadzono u nich calodobowe pomiary wartości ciśnienia tetniczego. Wyniki: Do badania wlączono 98 osob. Podczas wstepnej ewaluacji 8 pacjentow zostalo wykluczonych z badania i wylączonych z zabiegu, w wiekszości z powodu przyczyn sercowych. U 65 chorych przeprowadzono wymiane stawu biodrowego i 25 stawu kolanowego (średni wiek 63,7 ± 12,2 roku, 62,2% kobiet). Wśrod klasycznych czynnikow ryzyka zwracalo uwage 50 (55,6%) osob z rozpoznaniem nadciśnienia tetniczego w przeszlości, 10 (11,1%) pacjentow mialo cukrzyce, 2 (2,2%) wystąpil zawal serca w przeszlości, a u 24 (26,7%) w wywiadzie rodzinnym zanotowano choroby sercowo-naczyniowe. Średni wskaźnik masy ciala (BMI) wynosil 28,0 ± 5,1 kg/m 2 , nadwage zaobserwowano u 39 (43,3%) pacjentow, a u 28 (31,1%) — otylośc. Pacjenci poddawani wymianie stawu biodrowego byli istotnie mlodsi (61,8 ± 12,6 vs . 68,5 ± 10,0 lat; p = 0,02), byli cześ­ciej palaczami tytoniu (24,6% vs . 4,0%; p = 0,03), mieli istotnie nizsze BMI (26,8 ± 4,5 vs . 31,2 ± 5,3 kg/m 2 , p < 0,0001) i rzadziej byli otyli (18,5% vs . 64,0%, p < 0,0001). Nie stwierdzono istotnych roznic miedzy pacjentami zakwalifikowanymi do operacji pierwotnej i ponownej reoperacji. Wnioski: Badanie wykazalo, ze czynniki ryzyka sercowo-naczyniowego u osob poddawanych calkowitej alloplastyce stawu biodrowego lub kolanowego są obecne cześciej niz w populacji ogolnej, co moze potencjalnie przyczynic sie do podwyzszonego ryzyka rozwoju powiklan okolooperacyjnych.

Objective: We assessed the prognostic factors related to 10-year overall survival and disease-free survival in cervical cancer patients that underwent primary surgical protocols in 1 institution. Materials and Methods: A total of 102 patients with uterine cervical cancer at FIGO stages IA2-IIB that underwent a Piver type III radical hysterectomy and pelvic lymphadenectomy between 1998 and 2001 were included. Univariate and multivariate analyses of 10-year overall survival and 10-year disease-free survival were performed. Results: Univariate analysis revealed that only lymphovascular space invasion significantly affected 10-year overall survival (p = 0.04), but it had no effect on the 10-year disease-free survival rate. Multivariate analysis demonstrated that survival rates were significantly affected by FIGO stage (p = 0.02, 95% CI: 1.18-5.55, for 10-year overall survival; p = 0.03, 95% CI: 1.07-6.12, for 10-year disease-free survival) and metastases to the pelvic lymph nodes (p = 0.0005, 95% CI: 1.81-8.53, for 10-year overall survival; p = 0.01, 95% CI: 1.26-7.24, for 10-year disease-free survival). Conclusions: The only independent prognostic factors for 10-year survival rates in patients with cervical cancer at FIGO stages IA2-IIB were clinical stage and presence of metastases to the pelvic lymph nodes. The presence of lymphovascular space invasion adversely affected 10-year overall survival.

Introduction/Background Endometrial carcinoma (EC) is the most frequent gynecological malignancy in the developed world. Currently there are no valid non-invasive diagnostic or prognostic methods available and therefore, diagnosis and treatment of EC patients is guided by histopathological and surgical findings. The lack of non-invasive diagnostic and prognostic biomarkers of EC is addressed in the current clinical study titled ‘Biomarkers for Diagnosis and Prognosis of Endometrial Carcinoma’ (BioEndoCar). Methodology Prospective observational case - control study. Patient recruitment takes place at three medical centers (University Medical Centre Ljubljana, Slovenia; Maastricht University, The Netherlands; Lublin Medical University, Poland). Plasma samples from women with diagnosed EC and controls will be examined using non-targeted and targeted metabolomics (Helmholtz Zentrum Munchen, Germany) and semi-targeted proteomics approaches (Sciomics GmbH, Heidelberg, Germany). Combined blood metabolome (>850 metabolites), proteome (900 different proteins), clinical and epidemiological data will be analyzed (University of Tartu, Estonia) in order to construct diagnostic/prognostic algorithms for early diagnosis of EC and to identify patients with low/high risk for cancer progression and recurrence. Results BioEndoCar project has defined inclusion/exclusion criteria and a strict standard operating procedure for sample collection, processing and sample storage that is followed by in all three medical centers. Since the beginning of the project (April 1st 2018) we recruited nearly 100 patients in total. Great effort was put into informing the lay and expert public about the importance of the translational studies in EC. We have established an official website (https://bioendocar.eu/) and Facebook page where we post all news concerning the project. Conclusion We expect to find different metabolic and protein profiles in patients with early stages of EC as compared to controls and in patients with poor prognosis with high risk of disease progression and recurrence as compared to those with favorable prognosis. The BioEndoCar project is currently ongoing. Disclosure Nothing to disclose.

Background Assessment of thromboembolic risk is crucial in choosing appropriate treatment in atrial fibrillation (AF). Current guidelines recommend basing the decision on the CHA2DS2-VASc score. However, the score is based only on clinical parameters and therefore its relationship with laboratory-assessed coagulation status might not always be objective. Objectives The aim of this study was to assess if the CHA2DS2-VASc score is associated with blood parameters in AF patients. Material and methods Patients with continuous AF prequalified for catheter ablation were enrolled into the study and had CHA2DS2-VASc calculated and blood taken for coagulation parameters. Results The study population comprised of 266 patients (65.0% males; age 57.6 ±10.1 years). Patients were divided into those with CHA2DS2-VASc score 0, and those with ≥1 points, respectively requiring and not requiring anticoagulation treatment. The group with CHA2DS2-VASc = 0 (12% of patients) compared to those with CHA2DS2-VASc ≥ 1 had a significantly lower fibrinogen concentration (285.6 ±82.0 vs 322.6 ±76.4 mg/dL; p = 0.02). Partial thromboplastin time was not significantly different between groups (p > 0.05). Differences were noticed in parameters concerning red blood cells. Lower risk patients had a lower red blood cell count (4.9 ±0.4 vs 5.1 ±6.0 106/μL); p = 0.03), higher hemoglobin concentration (14.9 ±1.0 vs 14.3 ±1.4 g/dL; p = 0.04), and higher hematocrit (43.5 ±2.6 vs 41.7 ±4.7%; p = 0.001). It was observed that along with the increase in CHA2DS2-VASc score mean fibrinogen concentration increased (p-value for trend = 0.04). Conclusions In summary, a higher CHA2DS2-VASc score is independently associated with an increase in fibrinogen concentration. Further research is needed to assess the value of fibrinogen in thromboembolic risk assessment.