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The pathological stage of the cancer and presence of postoperative complications are the most important predictors of survival in older oncologic patients. Therefore, determining biological age, and risks connected with it, should be the key factor in the preoperative assessment. It may be accomplished by using a Geriatric Assessment (GA). However, it is not established which components are most useful for predicting short- and long-term postoperative outcomes in cancer patients undergoing high-risk abdominal surgery.A total of 334 consecutive cancer patients aged ≥70 years underwent elective abdominal surgery and were followed-up prospectively for 12 months. The preoperative GA consisted of eight domains: functional, physical activity, comorbidity, polypharmacotherapy, nutritional, cognition, mood, and social support. Logistic regression analyses were used to analyse the predictive ability.All components of GA were independent risk factors of 30-day major morbidity apart from ADL, BOMC, Polypharmacy (OR 0.6-1.3; p 0.001). However, ADL, TUG, the polypharmacy and the MOS-SSS turned out to be significant predictors of 30-day mortality (OR 0.72-1.46; p 0.001). In turn, only ADL, CDT and MOS-SSS were valid predictors of 12-months mortality (OR 0.46-0.85; p 0.001). Frailty (surrogate of the biological age), not the chronological age, were also independent predictors of all outcomes (OR 4.71-8.56 p 0.001).Not the chronological age but components of GA and frailty are significant predictors of both 30-day postoperative outcome and 12-months mortality in older cancer patients undergoing high-risk abdominal surgery.

Mumio (Shilajit) is a traditional medicinal drug known and used for hundreds of years. Bladder cancer is one of the most common cancer types and better treatments are needed. This study analysed the in vitro effect of Mumio on urinary bladder cancer cells (T24 and 5637) in comparison to normal uroepithelial cells (SV-HUC1). Cytotoxicity of Mumio was analysed in these cell lines via MTT and real-time cell growth assays as well via the assessment of the cytoskeleton, apoptosis, and cell cycle. Mumio affected the viability of both cell types in a time and concentration dependent manner. We observed a selectivity of Mumio against cancer cells. Cell cycle and apoptosis analysis showed that Mumio inhibited G0/G1 or S phase cell cycle, which in turn induced apoptosis. Our results showed that Mumio was significantly more cytotoxic to urinary bladder cancer cells than to normal cells. These results are promising and indicate Mumio as a great candidate for urinary bladder cancer treatment and further investigations should be performed.

Introduction The aim of this study was to compare the ability of eight frailty screening scores to predict short- (30-day major morbidity and mortality), long-term outcomes (12-month mortality) and to compare their accuracy for predicting frailty among older patients with cancer undergoing elective abdominal surgery with curative intent. Materials and methods Consecutive patients aged ≥70 years were enrolled prospectively. The diagnostic performance of eight screening tests were evaluated: The Vulnerable Elderly Survey (VES-13), Triage Risk Screening Tool (TRST), Geriatric 8 (G8), Groningen Frailty Index (GFI), abbreviated Comprehensive Geriatric Assessment (aCGA), Rockwood, Balducci and Fried score. Frailty was defined based on the Geriatric Assessment (GA) with two (2ID) or three impaired domains (3ID). Results The study included 269 consecutive patients; median age 78 (range 70–94) years. The prevalence of frailty based on the reference GA was: 40.9% (2ID), 34.2% (3ID) and using screening tools 40–75.5%. The area under the curve (AUC) for predicting the postoperative outcome was: 0.58–0.75 (30-day morbidity), 0.54–0.71 (30-day mortality) and 0.59–0.74 (12-month mortality), respectively, being the highest for the G8. The AUC for the frailty screening tests was: 0.67–0.85 (at the 2ID) and 0.63–0.83 (at the 3ID), being the highest for the aCGA. Conclusion The G8 was the best predictor of 30-day major morbidity, 30-day and 12-month mortality. It also had the highest sensitivity and negative predictive value in frailty screening, in case of both frailty definitions. In turn, the aCGA had the highest discriminatory ability in terms of frailty screening.

Lethal defects lead to the intrauterine death of the fetus or the passing away of the child immediately after birth or in early infancy, regardless of the treatment used. In the case of lethal defects, it is not possible to effectively help the child, despite using the most modern equipment or medicines in the treatment or the progress made by medicine. Parents, who decide to continue the pregnancy, although the fetus has a lethal defect that cannot be cured, may be covered by perinatal hospice care, which is comprehensive and consists in supporting the pregnant woman during the prenatal time, during delivery and after delivery and support of her family, giving full information to the parents about their child's illness. Childcare after birth is focused on protecting the infant from persistent therapy and providing him with appropriate conditions. Aim: To demonstrate the role of perinatal palliative care for pregnant women in whom the results of prenatal tests pointed to a severe developmental disorder in the fetus with a potentially lethal prognosis, and to present a pattern of behavior for their hospitalization in the perinatal hospice.Materials and methods: The retrospective analysis included documentation of 67 patients referred to the RAZEM (TOGETHER) Program in Wrocław in 2014-2018 due to abnormal results of (ultrasound and / or genetic) prenatal tests, which indicated a serious developmental disorder in the fetus with potentially lethal prognosis. Analysis was conducted of sociodemographic data, clinical data on fetal diagnosis, pregnancy and delivery, the procedure for prenatal delivery and postnatal birth.Results: 67 women aged 20-43 years (mean 31.2) were referred to the RAZEM Program. Out of these, 57 women were enrolled for palliative care, which accounted for 85% of those referred to the program. Palliative care was continued in 51 patients, because 6 women decided to terminate their pregnancy during the diagnostic process (10.5%). The most common abnormalities in the fetuses were chromosomal aberrations, CNS defects and kidney defects. In 95% of the cases, intrauterine fetal death or neonatal death occurred.Conclusions: Perinatal palliative care is an indispensable form of care for pregnant women in whom the results of prenatal tests indicate a serious developmental disorder in the fetus with potentially lethal prognosis. The in-hospital model of a perinatal hospice is a beneficial form of care, as it ensures consistency and good communication in the team, which favourably affects its quality.

The growing awareness of air quality in our country has triggered a keen interest in its impact on human health. Much of the interest has focused on the concentration of particulate matter. This work is an attempt to synthetically present the significance of particulate matter and the most important health effects. Suspended dust in the air is pollution of special epidemiological significance. It is indicative of air quality and is also the basis for estimating the effect of air pollution on health. This paper presents a short historical overview of suspended dust measurements and its significance in epidemiological research. Its impact on health in terms of short-term exposure as well as long-term exposure is presented according to the meta-analysis conducted by the World Health Organization. The remainder of the paper gives a review of the literature on the impact of particulate matter on respiratory and cardiovascular diseases as the most important health effect of particulate matter.

Background Internal iliac artery begins at the bifurcation of the common iliac artery and divides into anterior and posterior trunks. Comprehension of the location and anatomical variations of this vessel is essential in performing safe pelvic procedures without operative complications. The aim of our study is to analyze the variations of internal iliac artery and its relationship with important anatomical structures. Methods We have performed a dissection of male pelvis to analyze the anterior and posterior branching patterns of internal iliac artery. In order to identify eligible articles for our review, an extensive search through major electronic databases was accomplished. Results During dissection the branching patterns of anterior and posterior division of internal iliac artery were identified. Anterior division gives off lateral sacral artery, inferior gluteal artery and middle rectal artery. Umbilical artery arises from internal iliac artery and gives off superior vesical arteries. Superior gluteal artery arises from the posterior trunk. According to Adachi's classification of internal iliac artery, results demonstrate that type I occurs in 54,2% and is the most frequent in humans. Conclusions Analysis of collaborated classification of anatomical variants of the internal iliac artery with cadaveric dissection and proper recognition of structures within pelvis provides better widening of knowledge about spatial relationships between anatomical structures, especially blood vessels and urogenital organs. More precise knowledge of the anatomical variations of internal iliac artery can definitely reduce the risk of surgical complications to provide safe and effective medical treatment.

Precedensal Character Resolution of the Supreme Administrative CourtThe article presents the issue of the precedent character of some resolutions of the Supreme Administrative Court. At the same time he deals with the law-making and the precedent role of administrative courts. It deals with the issues of contemporary law change, including the transition from the syllogistic to the paradigmatic application of law. In addition, it describes Competence of the Supreme Administrative Court to adopt resolutions aimed at clarifying legal provisions, the application of which has caused divergences in the case law of administrative courts. At the end of the article is presented a review of the resolutions of the Supreme Administrative Court in the author’s assessment of the precedent character.

Introduction and objective: This paper is concerned with the harmful impact of nitric oxides (NOx) and particulate matter (PM) on humans. The objective was to determine which source of emission is the most urgent in terms of its reduction.Abbreviated description of the state of knowledge: In published epidemiological studies multiple notifications indicating the harmful impact of particulate matter on human health can be found. The harmful impact is underscored by the increase in the number of hospitalisations owing to diseases of respiratory and cardio-vascular systems, as well as by the rise in general fatality rate. The analysis of the PM impact on the human body is prompted by the fact that its detrimental effects are not clearly defined. Additionally, nitric oxides contribute to the increased number of exacerbations of respiratory disease and are a factor increasing susceptibility to development of local inflammation. Conclusions: The following study is meant to show that the air pollution which derives from vehicles (NOx and PM) has a significant impact on human health. This applies particularly to residents of cities and big towns. This issue has gained special importance in Poland. According to the data from the Central Statistical Office, the increasing number of vehicles in use and their age lead to increased emission of the pollutants considered.

Avalanches are one of the most spectacular phenomena which may occur in the mountains. Unfortunately they are often caused by humans and pose for him a big danger. In the Polish Tatras alone they represent 18% of all causes of death among 1996-2013. One fourth of the people caught by an avalanche dies, and their chances of survival depends on the depth of burial, burial time, the presence of an air pocket and the degree of injuries. The most common cause of death is asphyxiation, the next is injuries and hypothermia is the rarest cause of death. The fate of the buried people depends on their equipment such as avalanche transceiver, ABS backpack and AvaLung, and also from the equipment of the people who are seeking (avalanche probes, avalanche transceiver and shovels), which has been proven in practice and research.

Meteorological conditions have an impact on the human body on a permanent basis and lead to numerous of physiological and behavioural reactions. To a large extent, the meteorological conditions have shaped the civilisations, way of life, architecture and art. Nowadays, where dynamic changes of climate and frequent and violent weather anomalies are observed, the meteorological conditions are becoming a factor which directly influence the quality of life and which are often hazardous to the human health. In this range, heat and cold waves which cause a rapid increase in mortality are of the significant importance. Large diurnal changes in atmospheric pressure which lead to a worse well-being and tendency to aggression or weakened concentration are also significant. Due to more frequent weather anomalies, more and more people is exposed to the weather’s effects and elderly people constitute the most endangered group. In this regard, it is crucial to create an early warning system for unfavourable meteorological conditions altogether with providing a thorough information regarding the way of an effective protection against their influence. The mechanism of the impact of high and low temperatures to the human body has been presented in the thesis, including the life-threatening condition. A description of health effects of the influence of significant changes of the diurnal atmospheric pressure has been also provided.

The feature which characterizes Wroclaw city is the lack of heavy industry. The main sources of air pollutants are road transport, low emission from households and power plant. Road transport is particularly burdensome for residents of Wroclaw, as evidenced by the speed of passing traffic through the city amounting to 36 km/h, which leads to a significant concentration of the particulate matter (PM) and nitrogen oxides (NOx) along the main thoroughfares of the city. Air pollution from households is particularly noticeable within the densely populated downtown area where a significant part of flats is not connected to district heating. Emission from heat and power plant in Wroclaw city also contribute significantly to the level of PM10 especially during the heating season. The paper presents a summary of the number of days when PM10 concentration is exceeded. At the same time discussion took place on the potential impact of these air pollutants on human health.

The article presents an current knowledge overview about the importance of oxidative stress and reduced efficiency of repair processes during the aging process of the human body. Oxidative damage to cellular macromolecules (proteins, lipids, nucleic acids), are formed under the influence of reactive oxygen species (ROS). They are the part of important mechanism which is responsible for the process of aging and the development of many diseases. The most important effects result from DNA damage, due to the mutations formation, which can lead to the development of tumors. However, a well - functioning repair systems (i.a. homologous recombination) remove the damage and prevent harmful changes in the cells. Lipid peroxidation products also cause oxidative modification of nucleic acids (and proteins). Proteins and fats also have repair systems, but much simpler than those responsible for the repair of nucleic acids. Unfortunately, with increasing age, they are more weakened, which contributes to increase numbers of cell damage, and consequently development of diseases specific to old age: cancer, neurodegenerative diseases or atherosclerosis.

Odors are a mixture of volatile chemicals (organic and inorganic compounds), known as unpleasant gases which are perceptible even at low concentrations (low odor threshold). Chemicals which cause irritation of the mucous membranes of nose, throat and eyes through stimulation of the trigeminal nerve are among them. In some people psychosomatic symptoms occur as a result of exposure to odor. The sources of odors may be processes naturally occurring in nature (e.g. distribution of organic matter) and effects of human activities (sewage treatment plants, landfills, farms pigs). Emission of odors often goes beyond odor generating plants exposing the local population to their impact. Complaints of people motivate to create uniform criteria of smell and to study impact of odors on human health.

Background The stimuli acting on a person in a high mountain environment (such as hypobaric hypoxia with subsequent reoxygenation, physical exercise) can significantly increase oxidative stress, stimulate erythropoiesis, lead to changes in the blood count and participate in the development of altitude sickness. Objective The aim was to investigate changes in haematological parameters, indicators of oxidative stress (malondialdehyde - MDA) and antioxidant defences: catalase (CAT), superoxide dismutase (SOD), and total antioxidant status (TAS) in the plasma of young, healthy people after a 9-day expedition in the Alps. Materials and method A total of 5 patients (4 men and 1 woman), members of the Wroclaw Mountaineering Club, aged 24-26 years. Collection of blood samples was carried out immediately before departure and 3 days after the end of exposure to high-altitude conditions. During the expedition, the subjects were exposed to heights: 2,050-4,165 m.a.s.l., and exercise associated with climbing. Results Trekking in the Alps neither caused significant changes in the parameters of red blood cells nor increased the level of oxidative stress parameters in plasma. CAT activity increased, the ratio of SOD / CAT decreased. There was also a decrease in the total number of leukocytes, mainly monocytes and basophils. Conclusions 9-day exposure to high-altitude conditions is not a substantial burden for the organism of young, physically active people. The increase in antioxidant capacity is sufficient to stop oxidative processes, which are severe in these conditions, and to prevent the occurrence of significant oxidative stress. Discontinuation of exposure to allergens and dust pollution clears the airways, which is indicated by the reduction in the number of monocytes and basophils.

A man in a mountain environment is exposed to the occurrence of a number of diseases that can lead to loss of health, and frequently loss of life. Awareness of these threats already reduces the probability of their occurrence to some extent. Implementation of the appropriate preventive measures allows to control the risk factors and thus prevents the occurrence of adverse effects. The risk factors may include the effect of low atmospheric pressure, low air temperature, significant ultraviolet radiation, sudden changes of weather conditions and the specific elements of the mountain environment. The combination of these factors due to the lack of knowledge and ignorance can turn going to the mountains into a fatal danger.

This paper presents the most likely pathophysiological causes of the development of acute mountain sickness (AMS, also known as altitude sickness), its pulmonary form i.e. high altitude pulmonary edema (HAPE), and high altitude cerebral edema (HACE). These diseases constitute extraordinary environmental hazards because they are directly connected with low atmospheric pressure, and thus low partial oxygen pressure. The above adverse atmospheric conditions start to affect humans already at an altitude of 2,500 meters above the sea level and, coupled with extreme physical exertion, can quickly lead to respiratory alkalosis, which is not present under any other conditions in the lowlands. Mountaineering above 4,500 m a.s.l. leads to hypoxia of internal organs and, primarily, reduced renal perfusion with all its consequences. The above adverse changes, combined with inadequate acclimatization, can lead to a situation of imminent danger to life and health. This paper describes in detail the consequences of acute mountain sickness, which can ultimately lead to the development of AMS and one of severe forms of HACE and/or HAPE.

Synthesis and localization of inducible nitric oxide synthase mRNA (iNOS-mRNA) and iNOS protein in the cultures of human monocytes (Mφ) and colon carcinoma cell line (DeTa) that resulted in nitric oxide (NO) synthesis has been studied. The iNOS-mRNA was observed around the sixth hour of culture and peaked at the twelfth hour. The iNOS-mRNA, as determined by the in situ hybridization and iNOS protein, as detected by staining with specific anti-iNOS monoclonal antibodies, were observed preferentially in the cytoplasm of some Mφ, but not in cancer cells. Mφ cultured alone did not show detectable iNOS-mRNA expression and iNOS protein. Mφ sorted out from tumor cells after 8hof co-culture expressed iNOS protein and iNOS-mRNA, which were not detected in Mφ without previous contact with cancer cells. Prevention of NO synthesis by (L-N5-1-iminoethyl)-ornithine (L-NIO) partly inhibited Mφ cytotoxic activity against DeTa (NO-inducing cancer cell line) but not against the human pancreatic cancer (HPC-4) cell line that does not induce NO production in Mφ. This suggests that Mφ cytotoxic activity, at least in some cases, may be NO dependent. These observations provide further evidence that Mφ can be directly stimulated by cancer cells for de novo production of NO and suggest that iNOS occurring in the tumor-infiltrating macrophages may arise as a result of their interactions with tumor cells. However, because only some tumor cells are able to induce NO production in a small proportion of Mφ, its role in the anti-tumor response of the host is probably limited. J. Leukoc. Biol. 65: 597–604; 1999.