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Kobecki J, Gajdzis P, Mazur G, Chabowski M. Prognostic Potential of Nectin Expressions in Colorectal Cancer: An Exploratory Study. Int J Mol Sci 2023; 24:15900. [PMID: 37958883 PMCID: PMC10650805 DOI: 10.3390/ijms242115900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 10/17/2023] [Accepted: 10/31/2023] [Indexed: 11/15/2023] Open
Abstract
Colorectal cancer (CRC) is a pressing global health challenge, with an estimated 1.9 million new cases in 2020. Ranking as the third most diagnosed cancer globally, CRC accounts for nearly 930,000 cancer-related deaths annually. Nectins, immunoglobulin-like adhesion molecules, are pivotal in intercellular adhesion formation and cellular function regulation. Altered nectin expression patterns have been identified in various cancers. However, the intricacies of their role in cancer development and progression remain underexplored. This study aimed to evaluate the expression of specific nectins in CRC tumors, explore their association with clinicopathological factors, and ascertain their potential as prognostic indicators for CRC patients post-resection. We retrospectively analyzed the medical records of 92 CRC patients who underwent surgical treatment between 2013 and 2014. Tumor specimens were re-evaluated to determine nectin expression using immunohistochemistry. The study identified heterogeneous expressions of nectin-2, -3, and -4 in 58%, 62.6%, and 87.9% of specimens, respectively. Elevated nectin-4 expression correlated with worse 5-year and overall survival rates, presenting a negative prognostic value (HR = 4, 95% CI: 2.4-6.8, p < 0.001). Conversely, reduced nectin-3 expression was linked to poorer CRC prognosis (HR = 0.54; 95% CI: 0.31-0.96; p = 0.036). Nectin-4 expression positively correlated with elevated carcinoembryonic antigen (CEA) levels and advanced disease stages. In contrast, nectin-3 expression negatively correlated with CEA levels, tumor size, presence of distant metastases, and disease stage. Notably, tumors in the right colon were statistically more likely to express nectin-2 compared to those in the left. This study underscores the potential prognostic significance of nectins in CRC. The high prevalence of nectin-4-expressing cells offers promising avenues for further evaluation in targeted therapeutic interventions with already available agents such as PADCEV.
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Affiliation(s)
- Jakub Kobecki
- Department of Surgery, 4th Military Teaching Hospital, 5 Weigla Street, 50-981 Wroclaw, Poland;
- Division of Anaesthesiological and Surgical Nursing, Department of Nursing and Obstetrics, Faculty of Health Science, Wroclaw Medical University, 5 Bartla Street, 51-618 Wroclaw, Poland
| | - Paweł Gajdzis
- Department of Pathomorphology, 4th Military Teaching Hospital, 5 Weigla Street, 50-981 Wroclaw, Poland;
- Department of Clinical Pathology, Wroclaw Medical University, 213 Borowska Street, 50-556 Wroclaw, Poland
| | - Grzegorz Mazur
- Department of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, 213 Borowska Street, 50-556 Wroclaw, Poland;
| | - Mariusz Chabowski
- Department of Surgery, 4th Military Teaching Hospital, 5 Weigla Street, 50-981 Wroclaw, Poland;
- Division of Anaesthesiological and Surgical Nursing, Department of Nursing and Obstetrics, Faculty of Health Science, Wroclaw Medical University, 5 Bartla Street, 51-618 Wroclaw, Poland
- Department of Clinical Surgical Sciences, Faculty of Medicine, Wroclaw University of Science and Technology, 50-556 Wroclaw, Poland
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Szymanska-Chabowska A, Juzwiszyn J, Tański W, Świątkowski F, Kobecki J, Chabowski M. The fatigue and quality of life in patients with chronic pulmonary diseases. Sci Prog 2021; 104:368504211044034. [PMID: 34541942 PMCID: PMC10359652 DOI: 10.1177/00368504211044034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Patients with pulmonary diseases often experience fatigue. Severe fatigue is associated with a worse health status and worse physical and social functioning. The study aimed to evaluate the relationship between fatigue and quality of life in patients with nonmalignant pulmonary diseases. METHODS The St George's Respiratory Questionnaire (SGRQ) was used to assess health status and the Fatigue Impact Scale (MFIS) to measure the level of fatigue. The Shapiro-Wilk test was used to test for normal distribution. Correlations were described as Spearman's rank correlation coefficient. RESULTS The study included 200 consecutive patients (mean age, 57.7) with the following diagnoses: COPD (26%), asthma (36%), obstructive sleep apnoea (19%), pneumonia or bronchitis of various aetiologies (8.5%), bronchiectasis (2.5%), interstitial lung disease (3%). The mean score in the SGRQ was 44.62 ± 24.94. The mean score in the MFIS was 28.64 ± 15.8. The strongest correlations appeared between quality-of-life scales and fatigue as measured by physical functioning (symptoms r = 0.622; activity r = 0.632; impact r = 0.692; p < 0.001 for all subscales); however, all the correlations between SGRQ and MFIS were significant. CONCLUSIONS Patients with chronic pulmonary diseases were revealed to have a reduced level of quality of life and an increased level of fatigue. The negative influence of fatigue on quality of life highlights the need for careful and routine assessment of this symptom in pulmonary patients. Treating fatigue may improve quality of life and increase the ability of patients with chronic pulmonary diseases to perform activities in daily life.
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Affiliation(s)
- Anna Szymanska-Chabowska
- Department of Internal Medicine,
Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, Poland
| | - Jan Juzwiszyn
- Division of Nervous System Diseases,
Department of Clinical Nursing, Faculty of Health Science, Wroclaw Medical
University, Poland
| | - Wojciech Tański
- Department of Internal Medicine, 4th Military Teaching
Hospital, Wrocław, Poland
| | - Filip Świątkowski
- Division of Oncology and Palliative
Care, Department of Clinical Nursing, Faculty of Health Science, Wroclaw Medical
University, Wroclaw, Dolnoslaskie, Poland
- Department of Surgery, 4th Military
Teaching Hospital, Wroclaw, Poland
| | - Jakub Kobecki
- Division of Oncology and Palliative
Care, Department of Clinical Nursing, Faculty of Health Science, Wroclaw Medical
University, Wroclaw, Dolnoslaskie, Poland
- Department of Surgery, 4th Military
Teaching Hospital, Wroclaw, Poland
| | - Mariusz Chabowski
- Division of Oncology and Palliative
Care, Department of Clinical Nursing, Faculty of Health Science, Wroclaw Medical
University, Wroclaw, Dolnoslaskie, Poland
- Department of Surgery, 4th Military
Teaching Hospital, Wroclaw, Poland
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Porycka U, Szmuc K, Kobecki J, Chabowski M. Surgical management of cholecystoduodenal fistula complicated by ileus (Mirizzi syndrome type Vb). A case report. Ann Ital Chir 2021; 10:S2239253X21035428. [PMID: 34230436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Mirizzi Syndrome (MS) is a rare gallbladder disease described by Argentine surgeon, Pablo Luis Mirizzi in 1948. It concerns a wide range of clinical manifestations, including gallstone obstruction of the intestine. The modified classification by Csendes distinguishes five types of MS. The case described by the authors of this paper could be classified as type Vb, which means MS with a complication of obstruction. A 74-year-old woman with nonspecific, permanent, diffuse abdominal pain and bile vomiting was admitted to the emergency department where conservative treatment was administered. Based on the preoperative diagnosis of ileus, the patient was qualified for a laparotomy. The patient had a cholecystoduodenal fistula which was responsible for the displacement of the stone into the intestinal lumen and consequently for the mechanical obstruction of the intestine. It must be taken into account that the clinical manifestation of MS may be biliary obstruction, as occurred in the case presented below. Biliary symptoms may occur, but this is not a common situation, whereas half of patients with an obstruction have a history of biliary disease. The case presented here can be a valuable lesson in being mindful of the possibility of elderly and female patients developing biliary obstruction, even without having a history of chronic gallstone disease. Therefore, a meticulous intraoperative inspection should be performed in such cases in order to search for possible fistulas. KEY WORDS: Cholecystoduedenal fistula, Gallstone disease, Mirizzi syndrome.
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Turowicz A, Kobecki J, Laskowska A, Wojciechowski J, Świątkowski F, Chabowski M. Association of Metformin and Abdominal Aortic Aneurysm Repair Outcomes. Ann Vasc Surg 2021; 75:390-396. [PMID: 33826959 DOI: 10.1016/j.avsg.2021.02.048] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 02/14/2021] [Accepted: 02/22/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Metformin is a commonly used drug in diabetes mellitus treatment. Recently it has been suggested that the use of metformin on diabetes mellitus patients may lower the prevalence and slow the progression of AAA (abdominal aortic aneurysm) as well as the risk of rupture related mortality. The aim of this studywas to investigate the impact of metformin treatment on the risk of AAA repair related mortality and surgical complications. METHODS In this retrospective study, the clinical data of 306 patients, including 77 patients with diabetes mellitus, who underwent abdominal aortic aneurysm repair has been analyzed. Treatment outcomes have been investigated. The diabetes and metformin prescription status has been obtained from the medical history. Patients were divided into three groups: diabetes-free individuals, diabetics treated with metformin and diabetics treated with other glucose lowering drugs. The association between metformin treatment and AAA diameter, surgical complications and mortality were assessed using chi-square independence test and odds ratio analysis. In order to assess which factors are influencing AAA repair related complications and mortality a multi-variables analysis has been performed. RESULTS A significant protective effect of metformin treatment towards AAA repair related mortality (P = 0.019) and complications (P = 0.032) among patients suffering from diabetes mellitus was revealed. These findings were statistically insignificant when considering all groups of patients (diabetes-free individuals, diabetics treated with metformin and diabetics treated with other glucose lowering drugs). CONCLUSION Metformin may lower the risk of AAA repair related mortality and surgical complications among patients with diabetes.
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Affiliation(s)
- Agnieszka Turowicz
- Dept of Vascular, General and Transplantation Surgery, Faculty of Medicine, Wroclaw Medical University, Wrocław, Poland; Dept of Surgery, 4(th) Military Teaching Hospital, Wroclaw, Poland.
| | - Jakub Kobecki
- Dept of Surgery, 4(th) Military Teaching Hospital, Wroclaw, Poland; Division of Oncology and Palliative Care, Department of Clinical Nursing, Faculty of Health Science, Wroclaw Medical University, Wroclaw, Poland
| | | | - Jan Wojciechowski
- Dept of Surgery, 4(th) Military Teaching Hospital, Wroclaw, Poland; Division of Oncology and Palliative Care, Department of Clinical Nursing, Faculty of Health Science, Wroclaw Medical University, Wroclaw, Poland
| | | | - Mariusz Chabowski
- Dept of Surgery, 4(th) Military Teaching Hospital, Wroclaw, Poland; Division of Oncology and Palliative Care, Department of Clinical Nursing, Faculty of Health Science, Wroclaw Medical University, Wroclaw, Poland
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Janczak D, Merenda M, Litarski A, Pormańczuk K, Malinowski M, Kobecki J, Chabowski M. Wyniki lecznia operacyjnego pękniętych tętniaków aorty brzusznej (PTAB) w materiale własnym. Acta Angiologica 2020. [DOI: 10.5603/aa.2020.0001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Chabowski M, Chabowski M, Bieganski B, Kobecki J, Szponder M, Janczak D, Janczak D. Idiopathic Dilatation of the Colon in a Nursing Home Resident, with a Suspected Acute Colonic Pseudo-Obstruction (Ogilvie Syndrome). J Coll Physicians Surg Pak 2019; 29:178-180. [PMID: 30700361 DOI: 10.29271/jcpsp.2019.02.178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 08/30/2018] [Indexed: 11/11/2022]
Abstract
Ogilvie syndrome (acute colonic pseudo-obstruction) represents a clinical condition with symptoms of colonic obstruction without a distinct mechanical factor. The damage to the neural ganglia in the intestinal wall is the most likely etiology. A 62-year man was admitted to the Emergency Department due to acute dyspnea and vomiting. The patient had not defecated for 10 days prior to admission. An angio-CT revealed dilated colon, especially its left part, up to 85 mm with gas inside its lumen. During laparotomy, extremely dilated colon was confirmed with signs of the intestinal wall necrosis. A left sided hemicolectomy was performed. Despite the intensive treatment in the intensive care unit (ICU), the patient died on 3rd day after the surgery. In this case, the acute pseudo-obstruction of the large intestine was recognised late. This is due to overcrowding in this type of institution, overworked staff, and their inability to give individual attention to each patient.
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Affiliation(s)
- Mariusz Chabowski
- Department of Clinical Nursing, Faculty of Health Science, Wroclaw Medical University, 5 Bartla Street, 51-618 Wroclaw, Poland
| | - Mariusz Chabowski
- Department of Surgery, Fourth Military Teaching Hospital, 5 Weigla Street, 50-981 Wroclaw, Poland
| | - Bartosz Bieganski
- Department of Surgery, Fourth Military Teaching Hospital, 5 Weigla Street, 50-981 Wroclaw, Poland
| | - Jakub Kobecki
- Department of Surgery, Fourth Military Teaching Hospital, 5 Weigla Street, 50-981 Wroclaw, Poland
| | - Mateusz Szponder
- Department of Surgery, Fourth Military Teaching Hospital, 5 Weigla Street, 50-981 Wroclaw, Poland
| | - Dariusz Janczak
- Department of Clinical Nursing, Faculty of Health Science, Wroclaw Medical University, 5 Bartla Street, 51-618 Wroclaw, Poland
| | - Dariusz Janczak
- Department of Surgery, Fourth Military Teaching Hospital, 5 Weigla Street, 50-981 Wroclaw, Poland
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Janczak D, Ziomek A, Kobecki J, Malinowski M, Pormańczuk K, Chabowski M. Neurological complications after thoracic endovascular aortic repair. Does the left subclavian artery coverage without revascularization increase the risk of neurological complications in patients after thoracic endovascular aortic repair? J Cardiothorac Surg 2019; 14:5. [PMID: 30621728 PMCID: PMC6325786 DOI: 10.1186/s13019-018-0825-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Accepted: 12/26/2018] [Indexed: 01/05/2023] Open
Abstract
Introduction One of the most severe complications after TEVAR is ischemic stroke and spinal cord ischemia (SCI) resulting in severe disability. These complications can be fatal up to 30% of cases, so it is very important to define risk factors associated with the occurrence of such events. The aim of this study was to define the causes and risk factors associated with the occurrence of neurological complications in patients after TEVAR. Materials and methods We performed a retrospective analysis of 51 patients undergoing TEVAR in the Department of Vascular Surgery of Military Teaching Hospital in Wroclaw between 2014 and 2017. In 18 patients LSA coverage was managed without revascularization (35.29%), and in 33 patients LSA remained uncovered (64.71%). Results We did not find any statistically significant difference in the incidence of stroke and spinal cord ischemia in patients with covered and uncovered LSA (stroke p = 0.37, SCI p = 0.58). In the group of patients with covered and uncovered LSA, we did not find any significant differences in the incidence of additional comorbidities such as obesity, ischemic heart disease, hypertension or previous stroke. Conclusions There is no difference in stroke and SCI occurrence between patients with covered and uncovered LSA. Although there are many studies analysing the risk of such complications, there is no specific consensus regarding the treatment of LSA coverage. Randomised clinical trials on a large group of patients are still needed.
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Affiliation(s)
- Dariusz Janczak
- Department of Vascular, General and Transplantation Surgery, Faculty of Postgraduate Medical Training, Wroclaw Medical University, 213 Borowska street, 50-556, Wroclaw, Poland
| | - Agnieszka Ziomek
- Department of Vascular, General and Transplantation Surgery, Faculty of Postgraduate Medical Training, Wroclaw Medical University, 213 Borowska street, 50-556, Wroclaw, Poland.,Department of Surgery, 4th Military Teaching Hospital, 5 Weigla street, 50-981, Wroclaw, Poland
| | - Jakub Kobecki
- Department of Surgery, 4th Military Teaching Hospital, 5 Weigla street, 50-981, Wroclaw, Poland
| | - Maciej Malinowski
- Department of Vascular, General and Transplantation Surgery, Faculty of Postgraduate Medical Training, Wroclaw Medical University, 213 Borowska street, 50-556, Wroclaw, Poland
| | - Kornel Pormańczuk
- Department of Surgery, 4th Military Teaching Hospital, 5 Weigla street, 50-981, Wroclaw, Poland.,Division of Surgical Specialties, Department of Clinical Nursing, Faculty of Health Science, Wroclaw Medical University, 5 Bartla Street, 51-618, Wroclaw, Poland
| | - Mariusz Chabowski
- Department of Surgery, 4th Military Teaching Hospital, 5 Weigla street, 50-981, Wroclaw, Poland. .,Division of Surgical Specialties, Department of Clinical Nursing, Faculty of Health Science, Wroclaw Medical University, 5 Bartla Street, 51-618, Wroclaw, Poland.
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Janczak D, Malinowski M, Ziomek A, Kobecki J, Leśniak M, Dorobisz T, Dorobisz K, Janczak D, Chabowski M. Carotid artery stenting versus endarterectomy for the treatment of both symptomatic and asymptomatic patients with carotid artery stenosis: 2 years' experience in a high-volume center. ADV CLIN EXP MED 2018; 27:1691-1695. [PMID: 30063301 DOI: 10.17219/acem/75902] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND Carotid endarterectomy (CEA) and carotid artery stenting (CAS) are the 2 current standard treatments for carotid artery stenosis. There is still no well-defined consensus with regard to their superiority. However, the minimally invasive nature of endovascular treatment makes CAS increasingly popular among vascular surgeons. OBJECTIVES The aim of the study is to compare the safety and efficacy of CEA and CAS in patients with symptomatic and asymptomatic carotid artery stenosis. MATERIAL AND METHODS A single-center, retrospective analysis of patients who were treated for carotid artery stenosis using CAS or CEA between January 2014 and December 2015 was carried out. There were 471 patients (266 CEA and 205 CAS) who were eligible for inclusion. The vast majority of the patients had significant (>70%) stenosis of the internal carotid artery (92.1% of CEA and 87.8% of CAS). The occlusion of the contralateral carotid artery was observed in 9.8% of all cases (2.6% of CEA vs 17.7% of CAS). RESULTS The occurrence of complications, such as stroke, myocardial infarction (MI) and death, did not vary statistically between the groups. There were 9 events of stroke in the CEA group (3.4%) and 8 in the CAS group (3.9%), 3 of which were fatal. There were no significant differences between the 2 groups (χ2 = 0.76; p > 0.05). There was no higher risk of mortality in any group (Fisher's exact test; p = 0.08). Symptomatic patients had a higher incidence of stroke than asymptomatic patients across both groups (χ2 = 6.36; p < 0.05; hazard ratio 3.03 (1.26-7.33)). CONCLUSIONS Carotid endarterectomy is equally effective as CAS in stroke prevention, but is associated with a higher incidence of cranial nerve palsy, access site hematoma and other non-stroke complications. Symptomatic patients had a higher incidence of stroke, regardless of the treatment method.
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Affiliation(s)
- Dariusz Janczak
- Division of Surgical Procedures, Department of Clinical Nursing, Faculty of Health Sciences, Wroclaw Medical University, Poland
| | - Maciej Malinowski
- Division of Surgical Procedures, Department of Clinical Nursing, Faculty of Health Sciences, Wroclaw Medical University, Poland
| | - Agnieszka Ziomek
- Division of Surgical Procedures, Department of Clinical Nursing, Faculty of Health Sciences, Wroclaw Medical University, Poland
| | - Jakub Kobecki
- Department of Surgery, 4th Military Teaching Hospital, Wrocław, Poland
| | - Michał Leśniak
- Division of Surgical Procedures, Department of Clinical Nursing, Faculty of Health Sciences, Wroclaw Medical University, Poland
| | - Tadeusz Dorobisz
- Division of Oncology and Palliative Care, Faculty of Health Sciences, Wroclaw Medical University, Poland
| | - Karolina Dorobisz
- Department of Otolaryngology, Head and Neck Surgery, Faculty of Postgraduate Medical Training, Wroclaw Medical University, Poland
| | - Dawid Janczak
- Division of Oncology and Palliative Care, Faculty of Health Sciences, Wroclaw Medical University, Poland
| | - Mariusz Chabowski
- Division of Surgical Procedures, Department of Clinical Nursing, Faculty of Health Sciences, Wroclaw Medical University, Poland
- Department of Surgery, 4th Military Teaching Hospital, Wrocław, Poland
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