Zadania I Wyzwania Medycyny – Diagnostyka I Leczenie

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Zadania I Wyzwania Medycyny – Diagnostyka I Leczenie Zadania i wyzwania medycyny – diagnostyka i leczenie Zadania i wyzwania medycyny – diagnostyka i leczenie Redakcja: Monika Maciąg Kamil Maciąg Lublin 2018 Wydawnictwo Naukowe TYGIEL składa serdecznie podziękowania dla zespołu Recenzentów za zaangażowanie w dokonane recenzje oraz merytoryczne wskazówki dla Autorów. Recenzentami niniejszej monografii byli: prof. dr hab. n. farm. Jolanta Rzymowska dr n. o zdr. Joanna Fidut-Wrońska dr n. o zdr. Mariola Janiszewska dr n. med. Małgorzata Kozioł dr n. med. Joanna Pawlus dr Dorota I. Piechocka dr n. med. Łukasz Pilarz dr Ewa Sajnaga dr inż. Katarzyna Skrzypczak dr Bartosz Słomiński dr Kamilla Stach dr n. o kult. fiz. Anna Stolecka-Warzecha dr Marta Wójcik dr n. med. Izabela Zakrocka dr n. med. Dorota Żołnierczuk-Kieliszek Wszystkie opublikowane rozdziały otrzymały pozytywne recenzje. Skład i łamanie: Monika Maciąg Projekt okładki: Marcin Szklarczyk © Copyright by Wydawnictwo Naukowe TYGIEL sp. z o.o. ISBN 978-83-65932-20-4 Wydawca: Wydawnictwo Naukowe TYGIEL sp. z o.o. ul. Głowackiego 35/341, 20-060 Lublin www.wydawnictwo-tygiel.pl Spis treści Katarzyna Kmiecik 4KScore Test – nowoczesna metoda wczesnej diagnostyki i profilaktyki raka prostaty .... 7 Patrycja Kopytko, Joanna Bujak CIRS-7 nowym markerem diagnostycznym? ..................................................................... 15 Stanisław Kwiatkowski, Beata Joanna Osiecka Zastosowanie diagnostyki i terapii fotodynamicznej w dermatologii onkologicznej z uwzględnieniem obszarów zagrożenia nowotworowego ................................................ 25 Edyta Knap, Beata Jakubowska-Solarska, Krzysztof Szewczak Diagnostyka niedokrwistości spowodowanej niedoborem żelaza .................................... 34 Anna Czajkowska-Żelazko, Beata Jakubowska-Solarska, Magdalena Nieśpiałowska Zastosowanie techniki LC-MS/MS w diagnostyce laboratoryjnej .................................... 45 Piotr Okrzeja, Krzysztof Zieliński, Marek Darowski Symulator układu krążeniowo-oddechowego jako platforma badawcza systemów wspomagających pracę płuc i serca .................................................................................. 59 Natalia Ambroży, Helena Bieniek, Jakub Morawski Wykorzystanie technologii VR w analgezji i radzeniu sobie z bólem ............................... 75 Joanna Skonieczna, Paweł Koczkodaj, Ilona Cieślak, Aleksandra Kielan, Dominik Olejniczak Korzystanie ze zdrowotnych aplikacji mobilnych ............................................................. 83 Paulina Chmielewska, Marcin Ciesielka, Barbara Miziak Migrena – nowe metody i potencjalne cele leczenia ......................................................... 91 Krzysztof Kędzierski, Jarosław Sieczkarek, Monika Nastaj, Joanna Wysokińska- Miszczuk Grzybice jamy ustnej – etiologia, różnicowanie i leczenie ............................................. 117 Monika Podhorecka, Justyna Muzyka-Kasietczuk, Agnieszka Szymczyk, Anna Wrona, Anna Orzeł Wrodzone patologie krwinki czerwonej .......................................................................... 131 Bożena Muszyńska, Katarzyna Kała, Jan Lazur, Katarzyna Sułkowska-Ziaja Grzyby jadalne stare/nowe surowce lecznicze jako odpowiedź na potrzeby medycyny XXI wieku ......................................................................................................................... 145 Alicja Mełgieś, Justyna Joniec-Wiechetek, Magdalena Kwiatek, Aleksander Michalski, Leszek Lisowski Wektory AAV – wiodąca technologia w terapii genowej ................................................ 176 Patrycja Gierszon, Joanna Milanowska, Izabela Morawska, Julita Poleszak Nowoczesne metody leczenia raka piersi ........................................................................ 193 Anna Kornaś Długotrwałe leczenie zaawansowanej choroby nowotworowej – spojrzenie wieloaspektowe ............................................................................................ 205 Anna Walter, Maja Nowacka-Kłos, Agnieszka Drozd, Rita Hansdorfer-Korzon Joga – jako uzupełnienie kompleksowej fizjoterapii po operacyjnym leczeniu raka piersi......................................................................................................................... 212 Paula Chechła, Iga Hołyńska- Iwan Medycyna spersonalizowana w terapii nowotworów...................................................... 228 Joanna Bujak, Patrycja Kopytko Nowotworowe komórki macierzyste ................................................................................ 234 Katarzyna Kowal, Aleksandra Kosztyła, Agnieszka Szymczyk, Monika Podhorecka Przeciwciała monoklonalne w leczeniu choroby przeszczep przeciwko gospodarzowi (GvHD) ............................................................................................................................. 244 Indeks Autorów ................................................................................................................ 255 Katarzyna Kmiecik1 4KScore Test – nowoczesna metoda wczesnej diagnostyki i profilaktyki raka prostaty 1. Wstęp Rak gruczołu krokowego, potocznie nazywany rakiem prostaty, to nowotwór złośliwy, którego częstość występowania jest silnie związana z wiekiem. Dotyka przede wszystkim mężczyzn po 65 roku życia, choć coraz częściej obserwuje się wzrost zachorowalności już po 50. roku życia. Średni wiek w momencie rozpoznania wynosi około 66 lat [16, 17, 23]. Liczba zgonów w związku z rozwojem tego nowotworu jest wysoka i, niestety, stale rośnie. Według najnowszych statystyk opracowanych przez American Cancer Society, rak gruczołu krokowego jest obecnie trzecim pod względem zachorowalności i szóstym pod względem umieralności nowotworem [Tab.1, Tab.2]. W Polsce rocznie na raka prostaty zapada około 9 tys. mężczyzn, a około 4-4,5 tys. umiera na ten nowotwór. Tab.1 Szacowane nowe przypadki zachorowań Tab.2. Szacowane zgony w 2018 r. [21] Mimo iż, rozwój nowoczesnych technik diagnostycznych wciąż postępuje, obserwuje się wzrost współczynnika zachorowalności w porównaniu z latami 2010-2014 [Tab.3] Prognozy dla mężczyzn z rakiem prostaty różnią się w zależności od stadium nowotworu – wskaźniki przeżycia są wyższe dla mężczyzn we wcześniejszym stadium raka. Jednakże wiele innych czynników może wpływać na rozwój choroby. Do głównych czynników ryzyka zalicza się wiek i predyspozycje genetyczne. Ważnym aspektem jest także pochodzenie etniczne, co stało się przedmiotem badań epidemiologicznych, które wykazały największy odsetek umieralności wśród Afroamerykanów i Afrykańczyków, a najmniejszą pośród Azjatów. Do czynników sprzyjających rozwojowi raka prostaty należy także dieta 1 [email protected], Studenckie Koło Naukowe Chemii Klinicznej, Katedra Patobiochemii i Chemii Klinicznej, Wydział Farmaceutyczny, Collegium Medicum im. Ludwika Rydygiera w Bydgoszczy Uniwersytet Mikołaja Kopernika w Toruniu. 7 Katarzyna Kmiecik wysokotłuszczowa, bogata w nasycone tłuszcze zwierzęce, czerwone mięso i otyłość, cukrzyca, palenie tytoniu, a także czynniki chemiczne, jak: pestycydy, dym tytoniowy i kadm. Ważnym aspektem jest również dodatni wywiad rodzinny w kierunku raka prostaty i czynniki hormonalne [15, 18]. Na podstawie badań udowodniono, że przyjmowanie dużych ilości wapnia, zwiększa ryzyko rozwoju nowotworu gruczołu krokowego [17]. Tab. 3 Współczynniki zachorowalności poszczególnych nowotworów w latach 2010-2014 wg danych American Cancer Society [21] W przypadku raka prostaty z reguły nie obserwuje się agresywnego rozwoju choroby, która rozwija się bardzo powoli, a pierwsze objawy mogą pojawić się nawet po kilku latach. Do najbardziej charakterystycznych objawów należą: ból w czasie oddawania moczu i zwiększona częstotliwość jego oddawania, uczucie niecałkowicie opróżnionego pęcherza moczowego, bolesny wytrysk, a przy powstawaniu przerzutów do kości, ból w okolicach miednicy czy pleców [23]. Baza danych SEER grupuje nowotwory na stadium lokalne, regionalne i odległe. Stadium lokalne oznacza, że nie ma oznak przerzutów. Względne 5-letnie przeżycie dla lokalnego raka prostaty wynosi prawie 100%. Regionalne stadium oznacza, że rak rozprzestrzenił się z prostaty na pobliskie obszary, natomiast odległe obejmuje nowotwory, które rozprzestrzeniły się na węzły chłonne, kości lub inne narządy. Względne 5-letnie przeżycie dla odległego stadium raka gruczołu krokowego wynosi około 29% [21]. 2. Diagnostyka raka prostaty Częstość występowania tego rodzaju nowotworu zwiększa się o około 3% rocznie. Obserwuje się rosnącą liczbę zdiagnozowanych przypadków, co jest ściśle związane z rozwojem biochemicznych i diagnostycznych technologii obrazowania. Podstawową czynnością w zdiagnozowaniu raka gruczołu krokowego jest wywiad z pacjentem i ocena obciążenia genetycznego. Nie istnieje jedna skuteczna metoda diagnostyczna, dlatego też, diagnostyka tego schorzenia opiera się na zastosowaniu badań przesiewowych, których czułość i swoistość przedstawia poniższa tabela [Tab.4]. Przy obecnie stosowanych metodach diagnoza na wczesnym etapie zwykle prowadzi do wyleczenia [14]. 8 4KScore Test – nowoczesna metoda wczesnej diagnostyki i profilaktyki raka prostaty Tab. 4. Poziom czułości i swoistości podstawowych metod diagnostyki raka gruczołu krokowego [1] Metoda Czułość [%] Swoistość [%] Palpacyjna ocena gruczołu 45 98 krokowego przez odbytnicę Oznaczenie stężenia PSA w 75 91 surowicy krwi Ultrasonografia 91 65 przezodbytnicza 2.1. Badanie per rectum – DRE (ang. Digital Rectal Examination) Gruczoł krokowy jest umiejscowiony tuż przed odbytnicą. W badaniu palpacyjnym przez odbyt lekarz może stwierdzić obecność wszelkich
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