European Journal of Clinical and Experimental Medicine T.21, z. 3 (2023)
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- PozycjaManagement challenges and therapeutic strategies for metastatic melanoma – a case report(Publishing Office of the University of Rzeszow, 2023-09) Aglio, Andrea M.; Cracchiolo, Salvatore; Impellizzeri, Giuseppe; Górecki, MichałIntroduction and aim. This case report focuses on a 26-year-old female with metastatic melanoma. It highlights the diagnostic process, initial immunotherapy, disease progression, and successful response to second-line therapy. Emphasizing the importance of early detection, personalized treatment, and adaptive strategies, it provides valuable insights into managing this aggressive form of skin cancer. Description of the case. A 26-year-old Caucasian female presented with a suspicious pigmented lesion on her thigh in 2013. The lesion was confirmed as superficial skin melanoma. No lymph node biopsy was performed. In 2021, she had abdominal pain and imaging revealed melanoma metastasis in the peritoneum, lungs and brain. Genetic testing showed BRAF V600E mutation and PD-L1 expression in tumor cells. She received immunotherapy and radiation for a central nervous system metastases but developed a brain hematoma. Follow-up imaging showed disease progression. She started second-line therapy with iBRAF/iMEK, and her condition rapidly improved with regression of metastatic lesions. Follow-up imaging confirmed significant positive changes and almost complete regression of neoplastic lesions. She continues to receive the targeted therapy and shows a positive response. Conclusion. Early diagnosis improves outcomes in metastatic melanoma. Peritoneal metastases should be considered in patients with abdominal symptoms. The combination of gamma knife radiosurgery with immunotherapy or targeted therapy shows promise for managing brain metastases, but careful patient selection and monitoring are vital due to potential risks. Treatment responses in advanced melanoma vary, with this case highlighting a favorable response to BRAF/MEK inhibitor therapy in a patient with a BRAF gene mutation. Further research and clinical trials are needed to refine treatment approaches and improve outcomes in metastatic melanoma.
- PozycjaA patient with overlap syndrome: systemic lupus erythematosus, dermatomyositis, and Sjögren’s syndrome – a rare overlapping diseases case report(Publishing Office of the University of Rzeszow, 2023-09) Sokołowska, Aldona; Iwański, Mateusz; Dąbrowski, PiotrIntroduction and aim. Autoimmune rheumatic diseases are a group of disorders with similar clinical, laboratory and immunological manifestations. Connective tissue diseases include systemic scleroderma, dermatomyositis or polymyositis, Sjögren’s syndrome, rheumatoid arthritis, and systemic lupus erythematosus. If the patient meets the diagnostic criteria for at least two of these diseases and has specific serologic markers, a diagnosis of overlap syndrome is possible. Description of the case. This case describes a 27-year-old man who had a history of paroxysmal fever, night sweats, erythema-like skin lesions on the forearms and lower legs, a feeling of progressive muscle weakness especially in the proximal muscles, and dry mouth. The patient was diagnosed with an overlap syndrome: systemic lupus erythematosus, dermatomyositis, and Sjögren’s syndrome. Conclusion. Overlap syndrome is difficult to treat due to its multisystem nature, requiring a symptomatic therapeutic approach and careful control of medication doses to reduce side effects while controlling disease activity.
- PozycjaUnilateral double maxillary paramolars in a non-syndromic child – a rare case report(Publishing Office of the University of Rzeszow, 2023-09) Acharya, Sonu; Singh, Bismay; Sahoo, Alkananda; Godhi, Brinda SuhasIntroduction and aim. Extra teeth are the teeth which are more than the normal number of teeth in jaws. They can be present on a single side or both sides, singular or many, maxillary or mandibular. Paramolars are uncommon supernumerary molars which can be present on buccal or palatal side of molars. Very few reports of supernumerary teeth in maxilla or mandible being paramolars has been stated. No literature on unilateral twin paramolars in maxilla has been reported in literature yet. This is a first case report of unilateral twin paramolars in maxilla in a child. Description of the case. This case report describes the presence of unilateral double maxillary paramolars and their handling in a thirteen-year-old boy, whose primary concern was that of severe pain in maxilla on both sides. After an identification of double maxillary paramolars was put forward and established by cone beam computer tomography, both the paramolars were extracted. Conclusion. Supernumerary teeth have to be removed as soon as detected otherwise they can lead to malocclusion and pain due to caries after pulp involvement.
- PozycjaAnalysis of dysarthria in a 55-year-old female patient with multiple sclerosis by means of an IT tool based on respiratory and phonatory examination – a case study(Publishing Office of the University of Rzeszow, 2023-09) Warmbier, Wojciech A.; Popiel, Małgorzata; Guzik, Agnieszka; Drużbicki, Mariusz; Bartosik-Psujek, HalinaIntroduction and aim. There are no available objective tools for assessing dysarthric disorders in the course of multiple sclerosis (MS). The aim of the study is to analyse a case of mixed dysarthria in a 55-year-old female patient in the course of secondary progressive MS and to present the severity of the patient’s dysarthric disorder in contrast with the control group as evaluated by means of an IT tool based on respiratory and phonatory examination. Description of the case. A 55-year-old patient was admitted to the Clinic of Neurology with the Stroke Unit due to a worsening condition in the course of MS. She was examined with an objective tool for respiratory and phonatory disorders. Her results were, then, compared to those of 24 healthy individuals from the control group, matched in terms of sex and age. Following speech parameters were analysed: phonetics of utterances, number of produced syllables per breath during the execution of individual texts, sound quality, intonation, and the total performance time of each. Conclusion. The analysed case indicates that the developed objective IT tool is a promising diagnostic method that can facilitate diagnosis and can be used in clinical practice.
- PozycjaEffectiveness of novel iron regulators in the treatment of diabetic nephropathy(Publishing Office of the University of Rzeszow, 2023-09) Banerjee, Dekai; Kaur, Ginpreet; Chatterjee, Bappaditya; Joshi, Hemant; Ramniwas, Seema; Tuli, Hardeep SinghIntroduction and aim. The novel advancements of upcoming iron regulators used to treat diabetic nephropathy have implicated a common manifestation of combination chelation therapy used to eliminate end-stage renal disease associated with inflammation and iron imbalance that is altered by renal iron absorption. However, iron accumulation in the clustered kidneys that filter blood may cause problems that affect diabetic blood sugar regulation. Material and methods. A well-designed method was employed to discover relevant research publications on iron chelators and their potential to treat diabetic nephropathy. “Iron chelators”, “diabetic nephropathy”, “end-stage renal disease”, and “chelation therapy” were searched in Google Scholar, Web of Science, PubMed, and EMBASE. Analysis of literature. Although the specific etiology and development have not been fully explored, emerging evidence on iron pathophysiology helps comprehend the pathogenesis of acute kidney damage and chronic kidney disease, which crucially provides novel iron chelation therapy techniques. Ferroptosis and hepcidin marker proteins increase oxidative/nitrifying stress and kidney injury. Iron chelator medicines including deferoxamine, deferasirox, and deferiprone were tested as prophylactic strategies. Conclusion. This article covers both preclinical and clinical aspects of iron chelators to avoid diabetic nephropathy, including novel iron therapies that must be reviewed when selecting dosing regimens.