Search

Abstract Background An Organised Cervical Cancer Screening Programme (OCCSP) was started in Poland in 2006/2007. Each woman aged 25 to 59 is eligible for a free Pap test every 3 years in OCCSP. Despite implementation of the OCCSP, the age-standardised cervical cancer (CC) incidence and mortality rates in 2019 were 7.3/100 000 and 3.9/100 000 respectively and were still higher than those in Western European countries with well-organised screening programmes. Apart from low coverage of the OCCSP, suboptimal performance of the screening test (conventional cytology) may be partially responsible for this situation. Several countries have already incorporated high risk Human Papillomavirus (hrHPV) testing in CC screening as a more sensitive tool reducing the risk of missing precancerous lesions and allowing for extension of screening intervals. The European Guidelines for Quality Assurance in Cervical Cancer Screening recommend pilot evaluation of a new screening test in country-specific conditions before its implementation. Methods The HIPPO project (HPV testing In Polish POpulation-based cervical cancer screening program) is a randomised health services study nested in the OCCSP in Poland. The project will randomise 33 000 women aged 30–59 years to cytology or hrHPV testing (ratio: 1:1) with age stratification. In the cytology arm women with repeated Atypical Squamous Cells of Undetermined Significance (ASC-US) or ≥ Low–Grade Squamous Intraepithelial Lesions (LSIL) are referred for colposcopy. In the other arm, hrHPV ( +) women with ≥ ASC-US reflex Liquid-Based Cytology (LBC) are referred for colposcopy. Primary endpoints include detection rates of histologically confirmed high grade intraepithelial lesions or worse (CIN2 +) in each arm. Discussion This pilot randomised healthcare study nested in the OCCSP in Poland will assess and compare the performance of hrHPV testing to current standard—cytology in order to make decisions on implementation of HPV-based screening in the country. Trial registration This randomised healthcare service study was prospectively registered at https://clinicaltrials.gov/ (identifier: NCT04111835, protocol ID 28/2019) on 19th of September 2019.

In the production of cement, raw materials can be partially substituted by regenerable waste provided from glasses, construction and demolition waste in order to reduce the environmental problem and burden of landfills. In this study, limestone–silicate composites were synthesized using starting materials such as glass waste and lime, brick, autoclaved aerated concrete (ACC), mortar or plaster waste. The structure and mechanical properties of the nano-composite materials have been studied. The mean CaCO3 crystallite sizes are higher for composites containing ACC and brick than for doping with lime, mortar and plaster. Cement-based materials are formed by replacing 2.5% of the Portland cement with limestone–silicate composites. The results indicate new possibilities for introducing 2.5%of composites in cement paste because they promote the formation of the C-S-H network, which provides strength and long stability for the cement paste. The influence of varied types of mix composites in the expired cement on the initial cracking strain and stress, tensile strength and compressive strength were investigated. The compressive strength values of composite-expired cement specimens are situated between 11.8 and 15.7 MPa, respectively, which reflect an increase from 22.9 up to 63.54% over the compressive strength of expired cement matrix.

Abstract Background False‐negative (FN) results in cervical cancer (CC) screening pose significant risk for participants and should be audited. The aim of the study was to analyse the results of audit of FN slides collected in 2010–2013 in Polish Cervical Cancer Screening Program (CCSP) and to seek for risk factors of obtaining true‐negative result (TN; not containing abnormal cells as confirmed in audit) before CC diagnosis. Methods Screening database was merged with National Cancer Registry to identify negative slides preceding histologically confirmed CC diagnosis up to 42 months. Two blinding slides were randomly assigned per each FN. The whole set was reassessed independently by three pathologists with 30 years of experience in cytology evaluation. Final audit result was established in the case of ≥2 coherent reports. Agreement rates and kappa (κ) coefficients were calculated. Logistic analysis of risk factors for obtaining TN result was performed. Results Of 374 included FNs, 204 were considered abnormal (54.6%) and 91 were confirmed negative for intraepithelial neoplasia (24.3%). Agreement between experts was moderate for FNs (κ = 0.266) and fair for blinding slides (κ = 0.142) when grouping abnormal slides. Adenocarcinoma diagnosis elevated the risk of TN result (OR = 3.83); detection of macroscopic changes on the cervix and smoking lowered the risk (OR = 0.39, OR = 0.40 respectively). Conclusions Misinterpretation was the main reason for FN cytology in the CCSP which indicated the need of further personnel training to increase screening quality. Rather low agreement between auditors requires further insight. A standardised process of auditors' selection should be planned to increase audit quality.

High-risk Human Papillomavirus (HR-HPV) genotypes, specifically HPV16 and HPV18, pose a significant risk for the development of cervical intraepithelial neoplasia and cervical cancer. In the multifaceted cervical microenvironment, consisting of immune cells and diverse microbiota, Lactobacillus emerges as a pivotal factor, wielding significant influence in both stabilizing and disrupting the microbiome of the reproductive tract. To analyze the distinction between the cervical microbiota and Lactobacillus-dominant/non-dominant status of HR-HPV and non-infected healthy women, sixty-nine cervical swab samples were analyzed, included 44 with HR-HPV infection and healthy controls. All samples were recruited from Human Papillomavirus-based cervical cancer screening program and subjected to 16s rRNA sequencing analysis. Alpha and beta diversity analyses reveal no significant differences in the cervical microbiota of HR-HPV-infected women, including 16 and 18 HPV genotypes, and those with squamous intraepithelial lesion (SIL), compared to a control group. In this study we identified significantly lower abundance of Lactobacillus mucosae in women with HR-HPV infection compared to the control group. Furthermore, changes in bacterial diversity were noted in Lactobacillus non-dominant (LND) samples compared to Lactobacillus-dominant (LD) in both HR-HPV-infected and control groups. LND samples in HR-HPV-infected women exhibited a cervical dysbiotic state, characterized by Lactobacillus deficiency. In turn, the LD HR-HPV group showed an overrepresentation of Lactobacillus helveticus. In summary, our study highlighted the distinctive roles of L. mucosae and L. helveticus in HR-HPV infections, signaling a need for further research to demonstrate potential clinical implications of cervical microbiota dysbiosis.

We build a mathematical game model of pandemic transmission, including vaccinations of population and budget costs of different acting to eliminate pandemic. We assume the interactions among different groups: vaccinated, susceptible, exposed, infectious, super-spreaders, hospitalized and fatality, defining a system of ordinary differential equations, which describes compartment model of disease and costs of the treatment. The goal of the game is to describe the development disease under different types of treatment, but including costs of them and social restrictions, during the shortest time period. To this effect we construct a dual dynamic programming method to describe open-loop Nash equilibrium for treatment, a group of people having antibodies and budget costs. Next, we calculate numerically an approximate open-loop Nash equilibrium.

Several hundred million people are infected with genital genotypes of the human papillomavirus (HPV) annually in the world. The infections transmitted mainly through sexual routes are usually asymptomatic, but can lead to the development of cervical, vulvar, vaginal, anal, and penile cancers, some head and neck cancers, and genital warts (condylomas). The fraction HPV-related cancers ranges from nearly 100% in the case of cervical cancer to several/over a dozen percent in the case of other cancers and diseases. There are no effective drugs against HPV, but prophylactic HPV vaccines are available free of charge in immunization programmes in many countries around the world. In Poland, HPV vaccinations have so far been executed out of pocket or in free- of-charge, local-governmental prevention programmes, but the vaccination coverage of the target population does not exceed 10%. In November 2021, one of the vaccines became available with a 50% reimbursement, work is underway to reimburse the next ones, and the National Oncology Strategy assumes the implementation of the HPV immunization programmes and vaccination of 60% of the teenage population by 2028. Three prophylactic HPV vaccines are registered. All of them are safe and their effectiveness in the prevention of diseases caused by vaccine genotypes is almost 100%, provided that full post-vaccination immunity is obtained before contact with the virus. Girls aged 11–13 years are the priority target cohort for HPV vaccination in Poland. The implementation of routine, free-of-charge HPV immunization in the Preventive Immunization Programme (PIP) for all adolescents should be pursued. Persons over the age of 13 years may also benefit from HPV vaccination and should be vaccinated according to product specifications. In addition to free access under the PIP, the key element for the success of the implementation of HPV vaccinations in Poland will be the education of medical personnel and parents of adolescents to be vaccinated.

Several hundred million people are infected with genital genotypes of the human papillomavirus (HPV) annually in the world. The infections transmitted mainly through sexual routes are usually asymptomatic, but can lead to the development of cervical, vulvar, vaginal, anal, penile cancers, some head and neck cancers and genital warts (condylomas). The fraction of HPV-related cancers ranges from nearly 100% in the case of cervical cancer to several/over a dozen percent in the case of other cancers and diseases. There are no effective drugs against HPV, but prophylactic HPV vaccines are available free of charge in immunisation programmes in many countries around the world. In Poland, HPV vaccinations have so far been executed out of pocket or in free-of-charge, local-governmental prevention programs, but the vaccination coverage of the target population does not exceed 10%. Starting in November 2021, one of the vaccines has been available with a 50% reimbursement, and work is underway to reimburse the next ones. The National Oncology Strategy assumes the implementation of the HPV immunisation programmes and vaccination of 60% of the teen population by 2028. Three prophylactic HPV vaccines are registered. All of them are safe and their effectiveness in the prevention of diseases caused by vaccine genotypes is almost 100% provided that full post-vaccination immunity is obtained before contact with the virus. Girls aged 11–13 are the priority target cohort for HPV vaccination in Poland. The implementation of routine, free-of-charge HPV immunisation in the Preventive Immunisation Program (PIP) for all adolescents should be pursued. Persons over the age of 13 may also benefit from HPV vaccination and should be vaccinated according to product specifications. In addition to free access under the PIP, the key element for the success of the implementation of HPV vaccinations in Poland will be the education of medical personnel and parents of adolescents to be vaccinated.

We have aimed to study reasons for reporting false-negative cytology results preceding diagnosis of interval cervical cancers (CC) in Poland. Data on all Pap smears collected in the organised screening in 2010-2015 were retrieved from the electronic database and linked with Polish National Cancer Registry (PNCR) data. False-negative results were defined as those sampled and assessed normal up to 3.5 years before diagnosis of invasive CC. False-negative slides were then seeded among twice as many randomly selected slides from the same lab and reviewed independently by three expert cytomorphologists. New diagnosis was established when experts agreed on a result. Of 48 selected false-negative slides, 1 case was diagnosed as a low-grade abnormality, 22 cases as a high-grade abnormalities, 3 cases as unsatisfactory for evaluation and 5 as no intraepithelial lesion of malignancy (NILM) by all three experts. There was no agreement in 17 cases. Percentages of agreement between experts was 64.6. Interobserver agreement rate was moderate with Fleiss’ κ values. Our pilot study indicates evaluation errors as the main reason of false-negative cytology preceding interval CC in the organized screening programme in Poland. True lack of abnormal cells on the slide is the next reason.

The cervical microbiome (CM) is a complex ecosystem that can change in response to gynecological cancers. We aimed to evaluate changes in the CM of patients who underwent chemoradiation (CRT) therapy for locally advanced cervical cancer. Before and after CRT, cervical swab samples were collected from 16 patients with squamous cell carcinoma of the cervix, and 30 healthy women. All samples were subjected to 16s rRNA-Seq analysis. In healthy premenopausal women the CM comprised mostly Lactobacillus (>90%); the CM community in samples from both pre- and postmenopausal pre-treatment cancer patients was heterogeneous, with a low proportion of Lactobacillus in younger cases. On the genus level, 27 and 11 taxa differentiated healthy controls from cancer patients in pre- and postmenopausal age groups, while 31 and 2 genera differentiated pre- and post-radiation samples and pre-radiation and the follow-up samples, respectively. Microbiome diversity was significantly higher in pre-treatment patients than in healthy controls. The results reveal significant alterations in the CM of cervical cancer patients relative to that in healthy controls; these changes were more striking after CRT. However, further research is needed to determine whether alteration of the CM offers new therapeutic options.

Abstract Risk factors of cervical cancer (CC) development are well investigated, however, those influencing the risk of a potential false negative cytology preceding diagnosis of an invasive CC are not. We have aimed to explore these factors according to the data from Organised Cervical Cancer Screening Programme (OCCSP) in Poland. A total of 2.36 million of Pap tests sampled in 2010–2012 within OCCSP were merged with the Polish National Cancer Registry to identify CC cases after abnormal cytology and after normal cytology within 3 years of screening. Of 1460 invasive CCs, 1025 were preceded by abnormal and 399 by normal cytology result. Multivariate logistic analysis indicated that the presence of microorganisms in the Pap (OR = 2.18, 95% CI 1.65–2.87), evaluation by smaller (below 9000 slides processed per year) laboratories (OR = 1.60, 95% CI 1.22–2.09) and non‐squamous histology of cancer increased the odds for a potential false negative result (OR = 3.39, 95% CI 2.37–4.85 for adenocarcinoma, OR = 1.99, 95% CI 1.11–3.55 for other types of carcinoma), whereas cervical ectropion, other macroscopic changes on the cervix and smoking decrease the odds for a potential false negative Pap test result preceding CC (OR = 0.61, 95% CI 0.45–0.82, OR = 0.41, 95% CI 0.25–0.67, OR = 0.60, 95% CI 0.46–0.78, respectively). Proper triage of women with microscopic signs of microorganisms in the Pap smear should be reconsidered and cytology should be assessed in laboratories processing over 9000 slides annually to decrease the odds for negative Pap test result in 2 years before CC diagnosis. Information on macroscopic changes on the cervix provided to cytomorphologist may reduce the risk of a potential false negative cytology result.

In our pilot study we have aimed to assess interlaboratory variability of cytological diagnoses in selected laboratories participating in the Polish Cervical Cancer Screening Programme (CCSP) to establish grounds for certification system for cytodiagnosticians and to monitor the quality of services. Set of 50 selected Pap smears, previously reassessed by an expert on the grounds of clinical, colposcopic and histological data was blinded and sent to 15 laboratories in Poland with request for evaluation according to routine practice according to the Bethesda 2001 system. Concordance with expert diagnoses reached a median of 82% (range: 66% to 92%), with median unweighted κ coefficient at κ = 0.67 (range 0.40 to 0.86) depending on laboratory. This indicates substantial agreement among laboratories, however with essential differences in proper evaluation in some outlying laboratories. Agreement was highest in samples with high-grade, lower for low-grade abnormalities. Slides with ASC-US and ASC-H expert diagnoses were most troubling for cytodiagnosticians. Sets of highly selected cytological slides with expert diagnoses may serve as a tool in the process of comprehensive periodic recertification of cytodiagnosticians in the screening programme. A benchmark level of agreement with expert diagnoses should be established to guide corrective actions for cytodiagnosticians with lowest agreement.

False negative (FN) results in cervical cancer (CC) screening pose serious risks to women. We present a comprehensive literature review on the risks and reasons of obtaining the FN results of primary CC screening tests and triage methods and discuss their clinical and public health impact and implications. Misinterpretation or true lack of abnormalities on a slide are the reasons of FN results in cytology and p16/Ki-67 dual-staining. For high-risk human papillomavirus (HPV) molecular tests, those include: truly non-HPV-associated tumors, lesions driven by low-risk HPV types, and clearance of HPV genetic material before sampling. Imprecise disease threshold definition lead to FN results in visual inspection with acetic acid. Lesions with a discrete colposcopic appearance are a source of FN in colposcopic procedures. For FAM19A4 and hsa-miR124-2 genes methylation, those may originate from borderline methylation levels. Histological misinterpretation, sampling, and laboratory errors also play a role in all types of CC screening, as well as reproducibility issue, especially in methods based on human-eye evaluation. Primary HPV-based screening combined with high quality-assured immunocytochemical and molecular triage methods seem to be an optimal approach. Colposcopy with histological evaluation remains the gold standard for diagnosis but requires quality protocols and assurance measures.

We discuss the solvability of the Periodic-Dirichlet problem for the wave equation with forced vibrations $x_{tt}(t,y)-\Delta x(t,y)+l(t,y,x(t,y))=0$ in higher dimensions with sides length being irrational numbers and superlinear nonlinearity. To this effect we derive a new dual variational method.

The objective of the current study was to compare results relating to the compressive and tensile strength of rocks obtained during research undertaken according to Polish Standards (as part of the European standards known as Eurocodes), American Society for Testing and Materials (ASTM) Standards, and the recommendations of the International Society for Rock Mechanics (ISRM). A total of 130 experiments for uniaxial compression on axisymmetric samples, point loads, and transverse compression (so-called Brazilian tests) were performed on rock samples comprising granite, limestone, and sandstone. Geometric properties of the samples were selected depending on the applied research method, and the relationship between the specimen’s slenderness and shape, and the obtained values of compressive and tensile strength, were analyzed. The results of the study showed that values of compressive and tensile strength obtained in a laboratory depend significantly on specimen slenderness, different values of which are imposed by various ISRM standards and recommendations, wherein this sensitivity was much higher in the case of compressive strength. The study also raised doubt about the usefulness of the so-called point load test as a method for determination of the compressive strength of rocks and potential estimation of the tensile strength.

This work discusses the results of a study of the influence of rates of change of confining pressure on the result of a drained compressibility tests intended to determine the modulus of compressibility of a rock skeleton Ks. A series of cyclical compressibility tests was performed on samples of sandstone soaked in kerosene, for various rates of compression and decompression of the pressure liquid filling the cell and the pore volume of the sample. The studies showed that the deformability of the tested sample was directly proportional to the rate of change of the confining pressure. As a consequence, the value of the Ks modulus and Biot coefficient α decreased with increasing sample load rate. This phenomenon should be attributed primarily to equilibration of the liquid pressure inside the high-pressure cell with the liquid pressure in the sample pore space, caused by filtration of the pore liquid. These phenomena prove that the filtration process impacts the values of the modulus of compressibility of the rock skeleton Ks and of Biot coefficient α determined on the basis of the experiment. This is significant in the context of the use of Biot equations as constitutive equations for a porous rock medium.

Introduction and objective The study presents the problem of immune disturbances in pregnant women with vulvar carcinoma in situ (VIN3). Material and Methods NK cell and T reg activity in the study patient were analysed using flow cytometry. Results Decreased NK cell activity and but increased T reg activity were observed after vulvectomy, with subsequent successful pregnancy outcome. Conclusions Although vulvar cancer may influence immune cell activity, this issue merits further study.

The continuous development of the ITC systems, especially industrial Ethernet network using the IEC 61850 protocol allows to building a distributed sensor networks for control and monitor temporary states of the power infrastructure. In the paper the construction of the intelligent current sensors, Measurement Units (MU) for the Smart Grid network has been presented. In the paper the circuit diagram of sensor and synchronization method of the analog to digital converter based on the UTC timestamps has been described. The presented method allows to synchronize intelligent current sensors with an accuracy better than 1 μs. The presented innovative synchronization method is characterized by a high level of resistance to disappearance and attack of the reference time signal. The measuring device MU design is based on the embedded Linux-platform and as a sensing element used air core current transducers based on Rogowski coil. The connection between the current transducers and the central unit is made using a fiber optic link. Built-in IEC-61850 server provides a real-time measurement value of the True RMS, harmonics spectrum and samples value. The intelligent current transducers in addition to being used in the MUs create also new possibilities in the substation construction like the possibility to place the Autonomous Sensors in large distance from Intelligent Electronic Devices that are located in the substation.

Objective Although trace elements are regarded crucial and their content has been determined in number of tissue there are only few papers addressing this problem in intervertebral disc in humans. Most of the trace elements are important substrates of enzymes influencing metabolism and senescence process. Others are markers of environmental pollution. Therefore the aim of the research was to analyzed of the trace element content in the intervertebral disc, which may be a vital argument recognizing the background of degenerative changes to be the effect of the environment or metabolic factors. Material and Methods Material consist of 18 intervertebral disc from 15 patients, acquired in surgical procedure of due to the degenerative disease with Atomic Absorption Spectrometry content of Al, Cd, Co, Pb, Cu, Ni, Mo, Mg, Zn was evaluated. Results Only 4 of the trace elements were detected in all samples. The correlation analysis showed significant positive age correlation with Al and negative in case of Co. Among elements significant positive correlation was observed between Al/Pb, Co/Mo, Al/Mg, Al/Zn Pb/Zn and Mg/Zn. Negative correlation was observed in Al/Co, Cd/Mg, Co/Mg, Mo/Mg, Co/Zn and Mo/Zn. Conclusions This study is the first to our knowledge that profiles the elements in intervertebral disc in patients with degenerative changes. We have confirmed significant differences between the trace element contents in intervertebral disc and other tissue. It can be ground for further investigation.

In this paper a new shape optimization algorithm is presented. As a model application we consider state problems related to fluid mechanics, namely the Navier-Stokes equations for viscous incompressible fluids. The general approach to the problem is described. Next, transformations to classical optimal control problems are presented. Then, the dynamic programming approach is used and sufficient conditions for the shape optimization problem are given. A new numerical method to find the approximate value function is developed.

A population-based organised cervical cancer screening programme (OCCSP) was introduced in Poland in 2006. In this study we have aimed to analyse whether selected parameters related to invasive cervical cancer (ICC) of patients diagnosed in two distant gynaecological oncology centres changed after the first screening round of the programme run between 2006-2008. We have run a retrospective cross-sectional analysis of 189 women diagnosed with ICC between 2002-2005 (directly before introduction of the programme) and 165 patients diagnosed between 2009-2012 (just after the first screening round of the programme) and compared their age at diagnosis, histology, stage of tumours and overall survival (OS). Mean age of patients diagnosed in years 2002-2005 and 2009-2012 was 52.1 and 52.6 years respectively. Squamous cell carcinomas constituted 90.5% and 86.1% of tumours diagnosed in years 2002-2005 and 2009-2012 respectively and the rest of tumours had glandular and other histologies. 74.5% and 61.0% of women diagnosed in years 2002-2005 and 2009-2012 respectively had early ICC (FIGO-International Federation of Gynaecology and Obstetrics stages I-IIA) and the rest had advanced disease (FIGO IIB-IV). We have noticed no significant differences in mean age of patients, histology of tumours and OS of patients with ICC diagnosed before and after the first screening round of OCSSP in Poland. Advanced stages of ICC were more commonly diagnosed after the introduction of OCSSP. Changes only in some clinical parameters of patients with ICC were noticed before and after the first screening round of OCSSP in Poland but OS of patients remained the same.

Recenzja.

The paper presents practical guidelines in diagnosing the most frequent endocrinopathies in menopausalwomen. The frequency of thyroid disorders and type 2 diabetes rises with age and the hormones in theperimenopausal period create favourable conditions for the development of such endocrinopathies. Clinicalpicture, often mildly symptomatic, may resemble menopausal symptoms and their variety may mask theclinical picture of different cases of endocrinopathy, which makes the right diagnosis difficult to establish andcauses medical problems that require interdisciplinary cooperation of many different specialists. The questionof diagnostic screening tests still seems to be an unresolved issue. Some authors opt for routine thyroiddiagnostics, while others recommend only detailed case finding with the assessment of risks factors in thepost-menopausal period. The authors of this paper suggest that every perimenopausal woman should undergothyroid tests and the presence of goitre should be a recommendation for detailed thyroid diagnostics includingimaging. Taking into consideration natural development of type 2 diabetes together with a multidirectionalcharacter of pathogenic disorders induced by menopause, it seems that an oral glucose tolerance test (OGTT)rather than a fasting glucose test should serve as a primary diagnostic parameter.

Diabetes is a common and growing problem in the world. It is regarded now by World Health Organizationas the first non-contagious epidemic. At present there are over 285 million people in the world affected by thisdisease and this number is estimated to reach, in the year 2030, the value of 438 million. In the European Unionthis disease concerns at the moment over 30 million people, whereas in Poland there are over 2 million peoplewith diabetes which accounts for 5% of Polish population. Diabetic patients admitted to hospital constitutefrom 10 to 25% of all hospitalized patients, however, these data are underestimated as they do not includepatients with undiagnosed diabetes. Patients with diabetes are at a higher risk of perioperative complications.The course and prognosis of the perioperative period in this group of patients depends on many factors. Beingaware of them and providing proper perioperative management results in the reduction of complications tothe values typical of normoglycemic population. Furthermore, the right perioperative management reduces thehospitalization costs of diabetic patients.This study, focused on diabetic patients, including those undergoing gynecological surgery, has set itselfthe following aims: to review and explain the pathogenesis of the most common perioperative problems andindicate ways of preventing them.

Recenzja

The objective of this retrospective study was to analyze the clinical picture of hypothyroidism in women, inrelation to their menopausal status. Materials and methods: A total of 694 female ambulatory patients were divided into 3 groups: group I – 258menstruating patients aged up to 45, group II – 124 perimenopausal patients aged between 46 and 52, group III– 312 postmenopausal patients aged over 52. Medical documentation of the patients with hypothyroidism wasevaluated in terms of the selected features of their medical history and clinical picture of the disease. Results: The main cause of hypothyroidism was the chronic autoimmune thyroid gland inflammation; ingroup I it concerned 62.8% of patients, in the remaining two groups it was 50.0% and 51.6%, respectively. Analysing the prevalence of clinical symptoms it was found that the most frequent ones were: weight gain (18.6%),weakness (16.3%) and drowsiness (14.7%). In group II the prevailing symptoms were: hypertension (37.1%),weight gain (21.8%), drowsiness and weakness (12.1%) whereas in group III hypertension (60.3%), symptoms ofischemic heart disease (24.4%) and weight gain (14.4%) were dominant. Mean daily doses of levothyroxine usedin the 3 groups of patients were 90 μg, 81 μg ,74 μg, respectively. In women from groups II and III, a lipid balancedisorder (hypercholesterolemia) was observed significantly more often than in younger patients. Conclusions: Hyperthyroidism was diagnosed most frequently in postmenopausal women. The main causeof hypothyroidism was the chronic autoimmune thyroid gland inflammation. In postmenopausal women unusualclinical symptoms of hyperthyroidism dominated, which resulted from the coexistence of other diseases,mainly cardiovascular disorders. A 24-hour long-dose of levothyroxine in postmenopausal women was lower ascompared to menstruating women. Hypercholesterolemia was a considerably frequent element of the clinicalpicture of hypothyroidism in postmenopausal women.

Introduction: Inhibitors of DNA binding/inhibitors of differentiation (Id) protein family (Id1, Id2, Id3 and Id4)may play an important role in various cancer angiogenesis stimulation through interactions with strongmitogenic and angiogenic factors such as EGF and EGFR.Aim of the study: Our aim was to assess if the expression of Id1 protein with EGF and EGF-R serumconcentration assessment is associated with selected epidemiological, clinical and histological features ofmalignant ovarian tumours.Material and methods: The study group included 95 women operated because of ovarian tumours. In thisgroup, 83 masses proved to be malignant. The findings were correlated with the tumour type, histologicalgrading and tumour FIGO stage. Tumour Id1 protein was assessed by immunohistochemistry and EGF with EGF-Rserum concentrations were examined by ELISA.Results: The mean age of the patients was 52.6 ±15.1 years and 43 (45.2%) of women in this group werepremenopausal. Histological examination revealed that in the malignant group there were 38 serous ovariancancers, 23 mucinous cancers, 7 endometrioid cancers and 13 other malignant tumours including 6 metastaticto the ovary. Significant differences were found between concentrations of EGF and EGF-R depending on thepatient's menopausal status (p = 0.01 and p = 0.002, respectively). Histological grade was significantlycorrelated with EGF concentrations in women with malignant ovarian tumours (p = 0.01). FIGO stage was alsosignificantly correlated with Id1 expression (p = 0.09) and EGF concentration (p = 0.01). Also, significantcorrelations were found between Id1 expression, and histological grade and tumour FIGO stage (both p = 0.005). EGF and EGF-R concentrations were significantly correlated with each other (p = 0.008). Moreover, both EGF andEGF-R concentrations were correlated with Id1 expression (p = 0.0005 and p = 0.004, respectively).Conclusion: Our results indicate that Id1 protein and EGF with EGF-R concentration assessment may beused as additional prognostic markers in women with various types of malignant ovarian tumours.

Women in menopause may experience various thyroid disorders, with subclinical hyperthyroidism and hypothyroidismbeing the most problematic. Subclinical hyperthyroidism entails the risk of cardiovascular disorders(mostly arrhythmia) which require treatment. Subclinical hypothyroidism is more controversial because ofa less characteristic clinical picture and still arguable upper normal range of thyroid-stimulating hormone (TSH)concentration which determines the indication for treatment. Therefore, a question may be posed as to whetherand when the treatment should begin. Due to well defined risk factors in the menopausal period, coexistence ofthyroid disorders poses medical problems which require interdisciplinary cooperation of many specialists.

Od najdawniejszych czasów introligatorstwo było związane z nauką i sztuką, ściśle powiązane z książką – zarówno rękopiśmienną, jak i drukowaną. Na przestrzeni dziejów, dzięki korzystnej koniunkturze spowodowanej ciągłym zwiększaniem się liczby różnorodnych publikacji, introligatorzy zaczęli organizować się w cechy. Zrzeszały one między innymi mistrzów, czeladników oraz adeptów sztuki oprawiania książek. Uczniowie podczas 3-, 4-letniej nauki zdobywali potrzebną wiedzę i umiejętności zawodowe. Po jej zakończeniu stawali się czeladnikami. Jednym z etapów stanu czeladniczego był zwyczajowy obowiązek wędrowania zawodowego, mającego na celu wymianę doświadczeń, co miało prowadzić do podnoszenia kunsztu introligatorskiego w kraju. Poznańska „Książka wpisów wędrujących czeladników introligatorskich” jest dokumentem unikatowym i rejestruje działalność Stowarzyszenia Introligatorów w Poznaniu w drugiej połowie XIX wieku. Zawiera wiele wpisów niemieckich i polskich wędrujących czeladników, szukających w mieście zatrudnienia. „Książka” jest cennym i ważnym dowodem na istnienie bogatego życia rzemieślniczego z zakresu introligatorstwa w XIX-wiecznym Poznaniu.

W latach 2007-2008 w Bibliotece Uniwersyteckiej w Poznaniu przeprowadzono badania mające określić stan zachowania przechowywanych w jej magazynach gazet i czasopism wielkopolskich z lat 1800-1939 pod kątem ich zakwaszenia. W tym celu zastosowano metodę stanfordzką, połączoną z badaniem pH papieru. Wytypowana do analiz kolekcja obejmowała 7014 woluminów, z których wyodrębniono 384 egzemplarze stanowiące próbę reprezentatywną. W wyniku badań ustalono, że 40% kolekcji jest w bardzo złym stanie, a dalsze 45% to egzemplarze zniszczone i wymagające naprawy. Wszystkie przebadane obiekty wydrukowane zostały na kwaśnym papierze, co więcej – dla 96% kolekcji odnotowano pH poniżej 5. W świetle przeprowadzonych badań należy stwierdzić, że 85% kolekcji powinna zostać przeniesiona na nośniki analogowe i cyfrowe, a następnie, o ile pozwoli na to ich obecny stan zachowania, poddana procesowi odkwaszania.

Introduction. Invasive tumours in Nelson’s syndrome need aggressive therapy. Recent reports have documented the efficacy of temozolomide (TMZ) in the treatment of adenomas resistant to conventional management. Objective. The review of the literature concerning TMZ treatment of atypical corticotroph adenomas and a case study of 56-year-old woman who developed Nelson’s syndrome. Treatment Proceeding. The patient with Cushing’s disease underwent transsphenoidal adenomectomy followed by a 27-month-long period of remission. Due to a regrowth of the tumor, she underwent two reoperations followed by stereotactic radiotherapy. Because of treatment failures, bilateral adrenalectomy was performed. Then she developed Nelson’s syndrome. A fourth transsphenoidal adenomectomy was performed, but there was a rapid recurrence. Five months later, she underwent a right frontotemporal craniotomy. Due to a rapid regrowth of the tumour, the patient did not receive gamma-knife therapy and was treated with cabergoline and somatostatin analogue for some time. Only TMZ therapy resulted in marked clinical, biochemical, and radiological improvement. To date, this is the first case of invasive corticotroph adenoma in Nelson’s syndrome treated with temozolomide in Poland. Conclusion. In our opinion, temozolomide can be an effective treatment option of invasive adenomas in Nelson’s syndrome.

Using variational methods, we study the existence of positive solutions for a nonlocal boundary-value problem with vector-valued response. We develop duality and variational principles for this problem and present a numerical version which enables the approximation of solutions and gives a measure of a duality gap between primal and dual functional for approximate solutions for this problem.