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FilareckaAgnieszka, Biernacki Maciej, Jęchorek Michał, Dudzic Piotr,Wyląg Joanna, Lisiński Jarosław, Polakowska-Mierzwa Karolina, Nowak Beata, Jabłoński Wiktor, Hozakowski Mateusz. Physiotherapy in a patient with colorectal cancer - preoperative management. Journal of Education, Health and Sport. 2021;11(10):193-203. eISSN 2391-8306. DOI http://dx.doi.org/10.12775/JEHS.2021.11.10.017 https://apcz.umk.pl/JEHS/article/view/JEHS.2021.11.10.017 https://zenodo.org/record/5602405 The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019. © The Authors 2021; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 05.10.2021. Revised: 10.10.2021. Accepted: 26.10.2021. Physiotherapy in a patient with colorectal cancer - preoperative management Agnieszka Filarecka1,4, Maciej Biernacki2,4, Michał Jęchorek3, Piotr Dudzic4, JoannaWyląg4, Jarosław Lisiński4, Karolina Polakowska-Mierzwa4, Beata Nowak4, Wiktor Jabłoński4, Mateusz Hozakowski4 Collegium Medicum, UMK Bydgoszcz, Chair of Oncological Surgery Collegium Medicum, UMK Bydgoszcz, Chair and Department of Anatomy TOTU Addiction Therapy Center in Karnice Saint Celestine Association in Mikoszów Corresponding author: mgr Agnieszka Filarecka Collegium Medicum, UMK Bydgoszcz, hair and Clinic of Oncological Surgery Ul. Izabeli Romanowskiej 2, 85-796 Bydgoszcz, Poland Tel. 503074346 e-mail: aga.filarecka@gmail.com Summary During the surgical treatment of colorectal cancer, whether by laparoscopic or classic open method, the tissues in the abdominal cavity are traumatized. The cuts of the muscle fibers are associated with the disturbance of the tone of the postural muscles. A scar within the abdominal cavity also causes movement limitations in the form of restrictions in the mobility of the spine. The implementation of patient rehabilitation in the form of targeted physiotherapy before the procedure should be an indispensable element of the treatment of colorectal cancer. The aim of the study is to propose a therapy that uses the spine mobility test to diagnose deficits. The proposed preoperative therapy focuses mainly on improving the parameters of the spine's mobility. The paper presents examples of activities that can be used in therapy before surgery. A review of the available literature and own experience were used for the work. It can be concluded from the analyzed literature that physiotherapy in oncological patients is not very widespread and is neglected in the treatment process. Patients, by In the literature, before colorectal cancer removal surgery, they are not subjected to physical rehabilitation, which is associated with complications resulting from the course of the procedure. The process of rehabilitating patients after surgical treatment of colorectal cancer should take place in the pre-operative period. Physiotherapy should take into account the weakening of the muscle strength in the trunk and limitations of mobility caused by age. Rehabilitation should be aimed at restoring functionality. Key words:cancer, rehabilitation, spine mobility ranges

FilareckaAgnieszka, Biernacki Maciej, Jęchorek Michał, Leksowski Łukasz, MałekMichał, Tysowski Robert, Molek Karolina, TysowskaMagdalena, Szymura Karolina. The process of physiotherapy in patients treated for colorectal cancer. Journal of Education, Health and Sport. 2021;11(9):735-741. eISSN 2391-8306. DOI http://dx.doi.org/10.12775/JEHS.2021.11.09.088 https://apcz.umk.pl/JEHS/article/view/JEHS.2021.11.09.088 https://zenodo.org/record/5534624 The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019. © The Authors 2021; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 15.09.2021. Revised: 20.09.2021. Accepted: 27.09.2021. The process of physiotherapy in patients treated for colorectal cancer Agnieszka Filarecka1,2, Maciej Biernacki3, Michał Jęchorek4, Łukasz Leksowski5, Michał Małek6, Robert Tysowski6, Karolina Molek6,Magdalena Tysowska7, KarolinaSzymura7 Collegium Medicum, UMK Bydgoszcz, Chair of Oncological Surgery State School of Higher Education in Gniezno, Institute of Health Science Collegium Medicum, UMK Bydgoszcz, Chair and Department of Anatomy TOTU Addiction Therapy Center in Karnice Collegium Medicum, UMK Bydgoszcz, Chair and Clinic of Rehabilitation St. Celestine Society, Mikoszow R-med, Wroclaw Tarnów School of Higher Education, Faculty of Applied Sciences Corresponding author: mgr Agnieszka Filarecka Collegium Medicum, UMK Bydgoszcz, Chair of Oncological Surgery Ul. Izabeli Romanowskiej 2, 85-796 Bydgoszcz, Poland Tel. 503074346 e-mail: aga.filarecka@gmail.com Summary Cancer is the cause of almost 1/3 of premature deaths worldwide. The problem of cancer incidence is a global problem. Better and better medical care and modern methods of treatment make the effects of treatment high. The invasiveness of the procedures, introducing systemic methods, causes traumatization of tissues, which causes disability. The paper presents the proposed method of physiotherapeutic treatment in a patient treated for colorectal cancer. A review of the available literature and own experiences were used for the study It can be concluded from the available literature that in the case of cancer treatment, treatment should be interdisciplinary and the use of physiotherapy is necessary at every stage of treatment. Keywords: disability, oncology, rehabilitation

FilareckaAgnieszka, Jęchorek Michał. Application of positioning and transfers in oncological physiotherapy.Journal of Education, Health and Sport. 2020;10(9):868-876. eISSN 2391-8306. DOI http://dx.doi.org/10.12775/JEHS.2020.10.09.105 https://apcz.umk.pl/czasopisma/index.php/JEHS/article/view/JEHS.2020.10.09.105 https://zenodo.org/record/4055268 The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019. © The Authors 2020; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 23.09.2020. Revised: 28.09.2020. Accepted: 28.09.2020. Application of positioning and transfers in oncological physiotherapy Zastosowanie pozycjonowania i transferów w fizjoterapii onkologicznej Agnieszka Filarecka1, Michał Jęchorek2 Katedra Chirurgii Onkologicznej, Collegium Medicum Uniwersytetu Mikołaja Kopernika W Toruniu Ośrodek terapii i leczenia uzależnień ToTu w Karnicach Collegium Medicum, UMK Bydgoszcz, Chair and Clinic of Oncological Surgery Ośrodek terapii i leczenia uzależnień ToTu w Karnicach Corresponding author: mgr Agnieszka Filarecka Collegium Medicum, UMK Bydgoszcz, Chair and Clinic of Oncological Surgery Ul. Izabeli Romanowskiej 2, 85-796 Bydgoszcz, Poland Tel. 503074346 e-mail: aga.filarecka@gmail.com Streszczenie Rehabilitacja jako proces powrotu do sprawności powinna odbywać się na każdym etapie choroby. Stymulacja mająca na celu przywrócenie utraconych funkcji ruchowych powinna trwać cała dobę, także podczas leżenia chorego w łóżku lub jego transferu – przemieszczania się z pozycji do pozycji. Pozycje ułożeniowe są nieodzowną składowa przywracania spławność, a także elementem pielęgnacji chorego. Poprzez prawidłowe ułożenie chorego wpływamy na układ nerwowy pobudzająco. Dzięki poprawnemu ułożeniu zapobiegamy zmianą kostno - stawowym, obrzękom limfatycznym, a także wpływamy na pobudzenie kory mózgowej. Praca ma na celu zaproponowanie pozycjonowania pacjenta i jego transferów jako bierny sposób rehabilitacji. Słowa kluczowe: pozycje ułożeniowe, pozycjonowanie pacjenta, rehabilitacja, pielęgnacja, transfer pacjenta. Summary Rehabilitation as a process of return to fitness should take place at every stage of the disease. Stimulation to restore lost motor function should take place all day, including when lying in bed or transferring from one position to another. Placement items are an indispensable component of restoring floatation, as well as the element of nursing the patient. By correct arrangement of the patient we affect the stimulatory nervous system. Thanks to the correct arrangement we prevent bone-joint changes, lymphedema and also stimulate the cerebral cortex. This articule aims to propose the positioning of the patient and his transfers as a passive way of rehabilitation. Key words:positional positions, rehabilitation, chronic care, nursing, patient transfer.

Introduction: Transbronchial lung cryobiopsy (TBLC) is commonly used in diagnosing interstitial lung diseases (ILDs). Ageneral anesthesia with endotracheal intubation, balloon blockers and fluoroscopy control is the most common modality. Simplifying the procedure without decreasing it’s safety could result in wider use. Prospective, observational study was conducted in three Polish pulmonology centers to evaluate safety and diagnostic yield of TBLC under conscious sedation, without intubation and bronchial blockers and with radial-EBUS guidance instead of fluoroscopy. Material and methods: In patients suspected of ILD, in accordance with high resolution computer tomography (HRCT) selected lung segments were examined with radial-EBUS mini probe without aguide sheath. If the lung infiltrations were visible this locations were preferred. If not, specimens were taken from two different segments of the same lobe. Two to five biopsies with freezing time 5–8 seconds were performed. Moreover ultrasound examination was used to avoid injury of lung vessels. Results: From March 2017 to September 2019 — 114 patients (M: 59, F: 55) of mean (SD) age 54 (14) years were included to the study on the basis of medical history and HRCT. Histopathology was conclusive in 90 (79%) patients and included 16 different diagnoses (sarcoidosis, EAA, COP predominantly). 24 inconclusive biopsies of unclassifiable pulmonary fibrosis were followed up. Complications included five cases (4.4%) of pneumothorax requiring achest tube drainage and aminor and moderate bleeding in few cases. There was no need for use of balloon bronchial blockers. Conclusions: TBLC under conscious sedation guided by radial EBUS mini-probe is novel, reasonable and safe technique for histological diagnosis of ILDs.

Introduction: Lung cancer patients (LCP) require invasive evaluation of left adrenal glands (LAG) if distant metastases (M1b/1c) are suspected in CT or PET-CT. Only few studies showed utility of endosonography and particularly EUS-b-FNA as minimally invasive endoscopic method of LAG analysis. Material and Methods: A retrospective study of consecutive LCP was conducted in two pulmonology centers between January 2010 and December 2019. Records of complete endosonographic staging with use of single ultrasound bronchoscope or two scopes were overviewed. The analysis included cases of enlarged LAG (body size or limbs > 10 mm) examined and sampled by EUS-b-FNA or EUS-FNA. Results: 142 of 2596 LCP staged by complete endosonography (M: 88, F: 54 mean age 64.7) had enlarged LAG, which were biopsied by conventional EUS-FNA (52) and/or by EUS-b-FNA (90). Strong correlation with gland diameter (p < 0.001) was observed. The incidence of LAG metastases in analyzed group was 52.1% (74/142) and regarding histology: SCLC 76.9% (10/13), adenocarcinoma 66.7% (44/66), NSCLC 56.3% (9/16) and SCC 17.5% (7/40). A specificity and PPV for both methods were 100%. A sensitivity, accuracy and NPV for EUS-FNA were 91.7%, 96.2%, 93.3% and for EUS-b-FNA 88%, 93.3% and 87%, respectively and no significant differences for both methods were noted (p = 0.62, 0.44, 0.35). No severe complications afterall biopsies were observed. A six months clinical follow up included all negative LCP with enlarged LAG. Conclusions: After our study EUS-b-FNA seems to be a reasonable method of choice for LAG assesssment in LCP.

Introduction: Needle biopsy of enlarged lymph nodes is accepted method for the diagnosis of sarcoidosis, but there is still place for investigating the optimal endosonography guided approach. Objectives: The aim of this study was to assess the relative diagnostic yield of the combination (CUS-b-NA) of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) and endoscopic ultrasound fine-needle aspiration (EUS-b-FNA) but also a role of cell blocks (CB) and lymph node localization for the diagnosis of sarcoidosis. Methods: This was a prospective, multicenter study including consecutive patients with clinical diagnosis of stage I or II sarcoidosis. CUS-b-NA with smears and CB technique was performed within all group. If sarcoidosis was not confirmed invasive diagnostics was scheduled and 6 months follow-up was continued. Results: Since Nov 2017 to Sep 2019 fifty patients were enrolled for the final analysis. The overall sensitivity of EBUS-TBNA, EUS-b-FNA and CUS-b-NA was 76.6%, 70.2% and 91.7%, respectively. There were no significant differences between EBUS-TBNA and EUS-b-FNA (P=0.52) but CUS-b-NA had significantly higher yield (P=0.005 and P=0.001). No serious complications after all biopsies were observed. Adding CB to smear technique (P=0.008) and biopsy of the subcarinal lymph nodes (P=0.001) significantly increases the diagnostic yield. Conclusions: A diagnostic yield of CUS-b-NA is higher than endosonographic techniques alone in stage I and II of sarcoidosis. The preparation of cytological material including CB technique and the biopsy of subcarinal lymph node station increases diagnostic efficacy.

Filarecka Agnieszka, Biernacki Maciej. Rehabilitation of women after mastectomy - proposed procedure. Journal of Education, Health and Sport. 2018;8(9):1127-1138. eISNN 2391-8306. DOI http://dx.doi.org/10.5281/zenodo.1421632 http://ojs.ukw.edu.pl/index.php/johs/article/view/6030 https://pbn.nauka.gov.pl/sedno-webapp/works/878094 The journal has had 7 points in Ministry of Science and Higher Education parametric evaluation. Part b item 1223 (26/01/2017). 1223 Journal of Education, Health and Sport eissn 2391-8306 7 © The Authors 2018; This article is published with open access at Licensee Open Journal Systems of Kazimierz Wielki University in Bydgoszcz, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 22.08.2018. Revised: 28.08.2018. Accepted: 17.09.2018. Rehabilitation of women after mastectomy - proposed procedure Agnieszka Filarecka 1, Maciej Biernacki 2 1Collegium Medicum, UMK Bydgoszcz, Chair and Clinic of Oncological Surgery 2Collegium Medicum, UMK Bydgoszcz, Chair and Department od Anatomy Corresponding author: mgr Agnieszka Filarecka Collegium Medicum, UMK Bydgoszcz, hair and Clinic of Oncological Surgery Ul. Izabeli Romanowskiej 2, 85-796 Bydgoszcz, Poland Tel. 503074346 e-mail: aga.filarecka@gmail.com Abstract Breast cancer is a leading cancer among women, high incidence of cancer is not synonymous with high mortality. Women subjected to radical or partial mastectomy after the surgery want to return to full fitness as soon as possible. Movement restrictions associated with surgery do not have a positive effect on the patients' psyche. One of the complications of surgery in the axillary region is damage to the long thoracic nerve. An impairment of the blade mechanics affects the nonergergic movement in the shoulder joint. Using the neurorehabilitation methods, the correct spatula pattern should be reconstructed. Facilitation, or traffic paving, is an effective method used also for peripheral nerve injuries. In each method, the movement is assisted by a therapist who can determine the direction of movement through resistance, or assist it. The study presents examples of activities that can be used in therapy in its various phases. The method of using methods depends on the degree of structural damage and should be modified for the purposes of therapy. A review of available literature and own experience were used for the work. Keywords: breast cancer, thoracic nerve damage, physiotherapy &nbsp

Introduction Needle biopsy of enlarged lymph nodes is an accepted method for the diagnostic workup of sarcoidosis, but the optimal endosonography‑guided approach is yet to be determined. Objectives The aim of our study was to assess the relative diagnostic yield of combined ultrasound‑guided needle aspiration (CUS‑b‑NA), which includes endobronchial ultrasound‑guided transbronchial needle aspiration (EBUS‑TBNA) with endoscopic ultrasound fine‑needle aspiration (EUS‑b‑FNA), as well as the role of the cell block (CB) technique and lymph node localization in the diagnostic workup of sarcoidosis. Patients and methods This was a prospective multicenter study including consecutive patients with clinical suspicion of stage I or II sarcoidosis. CUS‑b‑NA with smears and CB technique were performed in the whole study group. If a biopsy result was not conclusive, an invasive diagnostic workup and a 6-month follow‑up were scheduled. Results Out of 77 screened patients, 54 signed written consent and 50 were enrolled for the final analysis. The overall sensitivity of EBUS‑TBNA, EUS‑b‑FNA, and CUS‑b‑NA was 76.6%, 70.2%, and 91.7%, respectively. There were no differences between EBUS‑TBNA and EUS‑b‑FNA (P = 0.52) but CUS‑b‑NA had a higher diagnostic yield (P = 0.005 and P = 0.001, respectively). Adding the CB method to smear technique (P = 0.008) and biopsy of the subcarinal lymph nodes increased the diagnostic yield (P = 0.001). Conclusions: The diagnostic yield of CUS‑b‑NA is higher than that of endosonographic techniques alone in the diagnostic workup of stage I and II sarcoidosis. The preparation of cytological material including CB and the choice of the subcarinal lymph node station for the biopsy increase the diagnostic efficacy.

Filarecka Agnieszka, Biernacki Maciej, Kaźmierczak Paweł, Kaźmierczak Rafał. Colorectal cancer - Progress rehabilitation after surgery. Journal of Education, Health and Sport. 2019;9(9):1009-1017. eISNN 2391-8306. DOI http://dx.doi.org/10.5281/zenodo.3462990 http://ojs.ukw.edu.pl/index.php/johs/article/view/6031 The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019. © The Authors 2019; This article is published with open access at Licensee Open Journal Systems of Kazimierz Wielki University in Bydgoszcz, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 25.08.2019. Revised: 31.08.2019. Accepted: 22.09.2019. Colorectal cancer - Progress rehabilitation after surgery Agnieszka Filarecka 1,3, Maciej Biernacki 2,3, Paweł Kaźmierczak 3, Rafał Kaźmierczak 3 Collegium Medicum, UMK Bydgoszcz, Chair and Clinic of Oncological Surgery Collegium Medicum, UMK Bydgoszcz, Chair and Department od Anatomy Saint Celestine Association Mikoszyn Corresponding author: mgr Agnieszka Filarecka Collegium Medicum, UMK Bydgoszcz, hair and Clinic of Oncological Surgery Ul. Izabeli Romanowskiej 2, 85-796 Bydgoszcz, Poland Tel. 503074346 e-mail: aga.filarecka@gmail.com Abstract Summary: When colorectal cancer is removed, either by laparoscopic or classical open method, traumatization of the abdominal tissues occurs. Damage in the form of cutting muscle fibers is associated with a disorder of postural muscle tone. A scar itself within the abdominal cavity can create mobility restrictions in the form of restrictions on the mobility of the spine. The implementation of rehabilitation before and after surgery should be an indispensable element in the treatment of colorectal cancer. The work aims to present therapy proposals using modern special rehabilitation methods to improve patients after surgical treatment of colorectal cancer. The paper presents examples of activities that can be used in therapy in its various phases. A review of available literature and own experience were used for the work. From the analyzed literature, it can be concluded that rehabilitation of oncological patients is not widespread and often overlooked in the treatment process. Patients often after surgery to remove colorectal cancer are not subject to rehabilitation, pre-operative rehabilitation also occurs sporadically according to literature. Rehabilitation of patients after surgical treatment of colorectal cancer should take place before and after surgery. Rehabilitation should take into account the weakening of the muscle strength in the torso and mobility limitations caused by the postoperative scar. Rehabilitation should be aimed at restoring functionality. Key words: physiotherapy, colorectal cancer, cancer, oncological rehabilitation

A diagnosis of pulmonary sarcoidosis is based on the assessment of clinical outcome, radiology findings and detection of noncaseating granulomas in cytology or histology specimens. Cytological material obtained from enlarged lymph nodes and/or histological specimens from bronchial mucosa and lung tissue are examined according to sarcoidosis stage. The most available are standard bronchoscopic methods as conventional transbronchial needle aspiration (cTBNA), endobronchial biopsy (EBB) and transbronchial lung biopsy (TBLB) both performed with use of forceps. The new endoscopic techniques introduced to pulmonary diagnostics are: endobronchial ultrasoundguided transbronchial needle aspiration (EBUS-TBNA) and endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) or if used by the ultrasound bronchoscope (EUS-b-FNA) and transbronchial lung cryobiopsy (TBLC). Considering a dynamic improvement in cytology assessment techniques (processed as cytology smears and cell blocks) the endoscopic methods with use of fine needle aspiration biopsy of enlarged lymph nodes became a method of choice in sarcoidosis with lymphadenopathy, and published data suggest a higher diagnostic yield when performed under endosonographic guidance. The optimal approach (transbronchial or transesophageal) and the selection of mediastinal lymph node stations considered for biopsy still need evaluation. Also TBLC, successfully used in the diagnosis of other diffuse parenchymal lung diseases, requires more experiences and trials to establish its role in diagnosis of pulmonary sarcoidosis.