Introduction: Breast cancer is responsible for more than 50% of cutaneous metastases. One of the treatment options is electrochemotherapy (ECT). It is an effective method of local tumor ablation through the application of electroporation. The primary objective of the study was to demonstrate a response to the treatment in our group of patients. Methods: Between February 2015 and October 2016, in 3 centers in Poland, 47 ECT procedures were performed in 38 patients with metastasis of breast cancer to the skin. Results: At 12 weeks after the procedures, 71% of patients showed a positive response to the treatment (42% with complete response, and 29% with partial response). Multivariate analysis demonstrated that only the estrogen receptor status and the size of the metastatic lesion were predictive of overall response (p = 0.0243 and p = 0.03716, respectively). Conclusion: The results of our study demonstrate a high effectiveness of ECT in the treatment of cutaneous metastasis from breast cancer. This method, although used for palliative treatment, brings a significant improvement in the quality of life of patients.

The concentration of thiobarbituric acid reactive substances (TBARSs) in plasma and erythrocytes, the activity of selected antioxidant enzymes in erythrocytes: catalase (CAT), superoxide dismutase (SOD), and glutathione peroxidase (GPx), and the levels of hemoglobin (HGB) and haematocrit (HCT) were determined in 40 patients with sudden sensorineural hearing loss (SSNHL) subjected to 14 treatment sessions in a Haux Starmed 2200 hyperbaric chamber. Hyperbaric oxygen (HBO) therapy involved breathing 100% oxygen at 0.25 MPa. Blood for analysis was collected from the basilic vein at three time points: before the first HBO session, approximately 5 min after the first session, and after the 14th session. The control group included 20 healthy individuals never before treated with HBO therapy. Compared to the pre-HBO values, a 10% increase (P<0.05) in the TBARS concentration in erythrocytes, a 28% increase in the GPx activity (P<0.05), and a 7% decrease in the SOD activity (P<0.05) were observed after 14 HBO sessions. The CAT activity decreased by 6% (P<0.05) after the first session. The TBARS concentration in plasma was 13% higher (P<0.01), while that in erythrocytes was 24% lower (P<0.001) in the SSNHL patients before the first HBO session compared to the control group. The CAT activity in the SSNHL patients before HBO therapy was 26% higher (P<0.001) than that in the control group. A statistically significant reduction in HGB and HCT after 14 HBO sessions (P<0.01) compared to the pre-HBO values was demonstrated. SSNHL is accompanied by disturbance in the oxidant-antioxidant equilibrium. Repeated stimulation with hyperbaric oxygen modulates the activity of antioxidant enzymes. It seems that the increased generation of hydrogen peroxide is responsible for the changes in the activity of antioxidant barrier enzymes observed after HBO sessions.

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The activity of selected antioxidant enzymes: superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx) in erythrocytes, and the concentration of thiobarbituric acid reactive substances (TBARS) in blood plasma and erythrocytes, were determined in people subjected to hyperbaric oxygen (HBO) therapy due to sudden sensorineural hearing loss (SSNHL). Venous blood samples were taken immediately before entering the hyperbaric chamber and 5 min after leaving it. In the study group, two age subgroups were distinguished: group I consisting of subjects under 35 and group II consisting of subjects over 50. The obtained values were analysed statistically using Student’s t-test. Differences were considered as statistically significant at p < 0.05. A statistically significant decrease in the CAT activity was shown 5 min after leaving the hyperbaric chamber in pooled subjects (p < 0.01) and group I (p < 0.05). Furthermore, a statistically significant decrease in the erythrocyte TBARS concentration was observed in group II (p < 0.05). It was demonstrated that a single exposure to hyperbaric oxygen affects the oxidant-antioxidant equilibrium as evidenced by, e.g., a statistically significant decrease in the activity of catalase in erythrocytes. It is possible that the antioxidant response to HBO depends on the age of subjects.

Background. In intensive care units (ICUs), a patient's vital functions may be maintained, regardless of the patient's chances of survival. A key issue is how to precisely determine the moment in which life-support treatment should be withheld. In many countries, the decision-making process is regulated by the guidelines of scientific societies. However, heuristic errors may influence this process. Objectives. The objective of this study was to assess factors involved in decisions to implement or withhold treatment in general ICUs in Poland. Material and methods. The medical records of patients treated in 3 clinical ICUs of general, cardiosurgical and neurosurgical profile were retrospectively analyzed. Patients with a diagnosis of brain death were finally excluded from the study. Results. The records of 1,449 patients hospitalized between January 1, 2014 and December 31, 2014 were analyzed. Of these, 226 patient cases were evaluated. There were no correlations between the placement of restrictions on resuscitation in specific cases, use of noradrenaline, frequency of blood gas testing, and patients' age. There was a relationship between these factors and the duration of hospitalization in the ICU. There was a direct relation between a "do not resuscitate" (DNR) order in a patient's record and the frequency of both resuscitation procedures and withholding catecholamine treatment in the hours preceding a patient's death. Conclusions. Treatment was withheld in about 20% of cases involving dying patients in analyzed ICUs, regardless of age. Placing a limit on treatment consisted of either withholding new procedures or withdrawing existing therapy. The length of stay in the ICU affected the decisions to limit treatment.