Sławomir Marszałek

Poznan University of Medical Sciences, Posen, Greater Poland Voivodeship, Poland

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Publications (22)8.22 Total impact

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    ABSTRACT: Introduction Skin cancer is the most commonly diagnosed cancer type worldwide, and 80 % of skin cancers are basal cell carcinoma (BCC). The main risk factor for developing BCC is exposure to ultraviolet radiation (UVR), particularly high-dose exposure at a young age. Outdoor workers, particularly farmers, are at high risk of developing BCC. However, studies of BCC in this population are scant. Objective To comprehensively evaluate all cases of BCC of the head and neck region treated during the years 2007–2013 at our hospital in Poland, and to compare the tumour characteristics in farmers to non-farmers. Materials and methods Retrospective analysis of 312 patients treated for head and neck BCC during the study period (2007–2013). Results Most patients (198 cases; 63 %) were males, with 114 females (37 %). Median age was 73 years (range 32–96 years). The most common tumour location was the nose and cheek (114 pts; 37 %) followed by the auricle (82 pts; 26 %), lips (54 pts; 18 %), scalp (26 pts; 8 %), and eye (36 pts; 12 %). The most common disease stage on presentation was stage T2 (104 pts, 33 %), followed by stage T1 (79 pts; 25 %), stage T3 (89 pts; 28 %), and stage T4 (40 pts; 14 %). By occupation, farmers accounted for 33 % of all patients (102 of 312 pts). The most common tumour localisations in the farmer subgroup were the nose and cheek (50 pts; 49 %; p < 0.001; odds ratio [OR] 2.19; 95 % confidence interval [CI] 1.35–3.57), followed by the auricle (32 pts; 31 %), scalp (16 pts; 16 %), ocular region (3 pts; 3 %), and lips (1 pt; 1 %). Patients in the farmer group were significantly younger than non-farmers (62 vs. 73 years; p < 0.001; OR 0.90, 95 % CI 0.88–0.93). Farmers were significantly more likely to present disease recurrence (27 vs. 12 % of cases; p < 0.001; OR 5.94; 95 % CI 2.86–12.33). Conclusion The results highlight the increased incidence and risk of recurrence of BCC in farmers. It is therefore necessary to consider enhancing educational programmes and other preventative measures in this occupational group and to evaluate the effectiveness of such programmes.
    Full-text · Article · Oct 2015 · International Archives of Occupational and Environmental Health
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    ABSTRACT: Changes in body posture, musculoskeletal disorders and somatic dysfunctions are frequently observed during pregnancy especially ligament, joint and myofascial impairment. The aim of the paper is to present the use of osteopathic manipulative treatment (OMT) for back and pelvic pain in pregnancy on the basis of a review of the available literature. MEDLINE and Cochrane Library were searched in January 2014 for relevant reports, randomized controlled trials, clinical and case studies of OMT use in pregnant women. Each eligible source was verified and analyzed by two independent reviewers. OMT procedures appear to be effective and safe for pelvic and spinal pain management in the lumbosacral area in pregnant women.
    Full-text · Article · Mar 2015 · Ginekologia polska
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    ABSTRACT: Cutaneous squamous cell carcinoma (cSCC) accounts for 20 % of all skin malignancies and 20 % of deaths. In contrast to mucosal SCC, treatment results are very good. However, regional metastases are present in 5-20 % of cases, and the prognosis for patients with metastases is 50 % lower. It has been reported that several risk factors are responsible for the head and neck lymph node regional metastasis, such as: poor cell differentiation, local recurrence, immunosuppression, and tumour dimension. Multivariate analysis of metastatic neck lesions in head and neck cSCC. Retrospective analysis of patients treated at our department for head and neck cSCC. The study includes 100 patients: 66 males (66 %) and 34 females (34 %), aged 26-98 years (mean age 74.6). The tumour was evaluated for: sex predilection, local recurrence, stage (according to 7th edition of American Joint Committee on Cancer TNM staging), differentiation, and site. Most patients (79 cases; 79 %) were treated for primary cSCC, while the other 21 patients presented local recurrence of cSCC. Neck metastases were diagnosed in five patients with primary cSCC and in three with recurrent cSCC. No distant metastasis was observed. The most common tumour location was the auricle (29 cases; 29 %). Neck dissection was performed most frequently in patients with lip tumours (17/22 cases; 77 %). Neck metastasis was diagnosed most often in patients with cSCC on the lip (2 patients) and buccal region (2 patients). The most common tumour location in males was the auricle (25/66 cases; 38 %) whereas in females the nasal and buccal regions were the most common locations, with 8 patients each (8/34 cases; 23 %). Neck dissection was performed in 20 of the 66 males (30 %) and in 12 of the 34 females (35 %). Neck metastasis was confirmed in 5 females (15 %) and 3 males (5 %). The most common histopathological tumour stage was G2 (57 cases; 57 %). Of the eight patients with confirmed neck metastasis, four had poorly-differentiated (histopathological stage G3). Thus, 4 of the 24 patients (17 %) with stage G3 tumours experienced metastasis. Our findings suggest that factors such as local recurrence, degree of cell differentiation, tumour dimension and/or location, can increase the risk of neck metastases. For this reason, in patients with such risk factors, neck dissection should be considered to evaluate for metastatic lesions.
    Full-text · Article · Sep 2014 · Archiv für Klinische und Experimentelle Ohren- Nasen- und Kehlkopfheilkunde
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    ABSTRACT: Introduction Basal cell carcinoma (BCC) is the most common type of non-melanoma malignant skin tumors. Eighty-five percent of all cases are located on the skin of the head and neck. The risk of recurrence after surgery is estimated at 5–15%. Aim To evaluate the selected risk factors for recurrence after surgical treatment of head and neck BCC at the Department of Head and Neck Surgery in the Greater Poland Cancer Centre of the Poznan University of Medical Sciences. Material and methods A retrospective analysis was made of patients treated at the Department of Head and Neck Surgery in the Greater Poland Cancer Centre of the Poznan University of Medical Sciences in 2007–2012 for BCC of the head and neck region. The study covered 312 patients: 198 males (63%) and 114 females (37%), aged 32–96 years. Results In the study group of 312 tumors, recurrence after initial treatment in this Centre was diagnosed in 18 patients (9%), whereas in patients who were previously operated elsewhere, recurrence was found in 22 cases (17%). The nodular type was the most common BCC type in the study group and concerned 175 patients (56%). The most numerous group (114; 37%) in this study group comprised patients with external nose and cheek tumors. Conclusions The importance of preoperative biopsy to assess the histological type as a routine treatment of patients with BCC is essential. Ultrasound evaluation to assess the exact size and depth of tumor invasion should also be implemented.
    Full-text · Article · Jun 2014 · Postepy Dermatologii I Alergologii
  • Sławomir Marszałek

    No preview · Article · Nov 2013

  • No preview · Article · Nov 2013
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    ABSTRACT: Occupational voice disorders are accompanied by increased tension of the external laryngeal muscle which changes the position of the larynx and consequently disturbs the conditions of functioning of the vocal tract. The aim of the study is to assess the use of osteopathic procedures in the diagnosis and treatment of occupational dysphonia. Study subjects included 40 teachers with chronic diseases of the voice organ (38 women and 2 men) aged from 39 to 59 (mean age: 48.25). Before and after the voice therapy the osteopathic examination according to Libermann's protocol was performed as well as phoniatric examination including laryngovideostroboscopy (LVSS), assessment of the maximum phonation time (MPT) and the Voice Handicap Index (VHI) score. The voice therapy, scheduled and supervised by a laryngologist-phoniatrician and conducted by a speech-language pathologist, was supplemented with osteopathic myofascial rehabilitation of the larynx. The chi-square McNemar test and non-parametric Wilcoxon matched pairs test were applied in the statistical assessment. The applied interdisciplinary treatment including osteopathic and vocal therapy resulted in a statistically significant decrease in tenderness of muscles raising the larynx (cricothyroid ligament, sternocleidomastoid muscles, and pharyngeal constrictor muscles) and in lowering the tonus (geniohyoid muscles, pharyngeal constrictor muscles and sternocleidomastoid muscles). A significant improvement was also observed in the case of dysfunction of the cricothyroid joint examined during glissando and yawning, as well as in asymmetry of the thyrohyoid apparatus. Moreover, the therapy resulted in significantly better normalization of the head position and better control of the centre of gravity of the body. Statistically significant post-therapy improvement was observed in the phoniatric examination, including VHI scores, MPT results and parameters of videostroboscopic examination. The use of osteopathic therapy helps significantly improve the functions of the vocal tract in patients with occupational dysphonia.
    Full-text · Article · Jun 2012 · International Journal of Occupational Medicine and Environmental Health
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    ABSTRACT: As a result of laryngeal injures an abnormal phonation is frequently observed. It is the consequence of structural and functional changes of the laryngeal tissues directly and indirectly responsible for the voice emission. Physiotherapy enables the normalization of the tension and function of the anatomical structures changed after trauma. The aim of the study Presentation of the results of the physiotherapy and voice rehabilitation treatment established for patient with voice disorders, occurred after cranio-cerebral trauma. Material and Methods The 47 year old man two years after cranio-cerebral trauma was presented, which voice was hoarse, produced with a strong neck and shoulder girdle muscle tension. Phonation time was significantly shortened. During the manual examination the abnormal of mobility, range of movement and soft tissue tension in neck, head and upper trunk area has been observed. The systematic rehabilitation program was started 2 years after injury and it was continued for four months. The individual program contains physiotherapy, osteopathic and speech therapy treatment. The phoniatric examination was performed before and after rehabilitation Results After four months of treatment and after self-therapy exercises the significant changes were observed. Patient's voice became no more strain, but stronger and socially effective. Conclusions The application of an individual therapy which contained osteopathic manual muscle-fascial techniques allows a subjective and objective improvement of voice in a examined patient. This procedure is an effective complement to logopedic and phoniatric therapy for patients after trauma of the larynx.
    Full-text · Article · Jul 2011 · Otolaryngologia polska. The Polish otolaryngology
  • Katarzyna Hojan · Sławomir Marszałek · Owidia Ozga-Majchrzak · Marta Liszka
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    ABSTRACT: W pracy przedstawiono przypadek postępowania usprawniającego u 47-letniej pacjentki u której rozpoznano i usunięto guzy typu GIST, a następnie zastosowano terapię celowaną w leczeniu zaawansowanej postaci tego nowotworu. Metodyka. U chorej oceniono badaniu podmiotowym dolegliwości ze strony układu pokarmowego w tym ból oraz przeprowadzono ocenę jakości życia przy użyciu kwestionariusza QLQ-C30. Natomiast w badaniu fizykalnym dokonano oceny zakresu ruchomości w stawach kręgosłupa (skala SFTR), oceniono rozszerzalność oddechową klatki piersiowej oraz przeprowadzono test marszowy (ocena ogólnej wydolności krążeniowo-oddechowej). U pacjentki w okresie 12 tygodni zastosowano regularne postępowanie fizjoterapeutyczne w oparciu o metody terapii skojarzonej to znaczy kinezyterapię, techniki osteopatyczne i manualne oraz kinesiotaping mając na celu poprawę ogólnej wydolności fizycznej, zwiększenie przesuwalności tkanek miękkich oraz wzmocnienie siły mięśni. Wyniki. Po zastosowanym postępowaniu usprawniającym u chorej stwierdzono znaczącą poprawę sprawności ruchowej szczególnie w stawach kręgosłupa, zmniejszenie napięcia powłok jamy brzusznej, jak również odczuwanego bólu i dysfunkcji ze strony układu pokarmowego oraz poprawę jakości jej życia. Wnioski. W trakcie leczenia onkologicznego GIST dochodzi do ograniczenia sprawności fizycznej u chorych, która wynika z niekorzystnych następstw leczenia onkologicznego. Kompleksowe leczenie usprawniające z zastosowaniem osteopatycznych technik tkanek miękkich stanowi uzupełnienie leczenia onkologicznego zmniejszając niekorzystne następstwa leczenia GIST.
    No preview · Article · Jan 2011 · Onkologia Polska
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    Agnieszka Wójcik · Sławomir Marszałek · Anna Pyszora · Marian Majchrzycki
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    ABSTRACT: Neoplastic diseases are the second most frequent cause of death in Poland (after dis- eases of the circulatory system). Oncology is a collective specialization in our country. The physiotherapist as a member of a multidisciplinary team has a chance to participate actively in medical actions at the beginning and at the end of the patient’s life. In patients at every disease stage, who are treated curatively and symptomatically, a complicated clinical image is strengthened by different symptoms: pain, dyspnoea, constipation, tired- ness, and complications from long immobilization, myofascial pain and lymphoedema. These problems are directly connected with soft tissue injury (healthy tissue or organ) and functional disorders resulting from the proliferative process and applied treatment methods (surgery, chemotherapy, radiotherapy, etc.). All these elements contribute to decreased quality of life of oncological patients and patients at advanced disease stages under palliative care. Timely rehabilitation helps the patient to return to functional independence and improves quality of life. So far there has been a lack of theoretical discussion about the use of manual medicine and osteopathy in oncology, although the importance of rehabilitation of patients with neoplastic disease is commonly understood and accepted. Osteopathic manual therapy is not about to replace specialized treatment. Its main aims are diagnosis, prophylaxis and therapy of reversible functional disorders (somatic dysfunctions) in the locomotor system. Especially impor- tant is therapy of areas not covered by the disease, but involved because of functional continuity of the movement apparatus. The therapist’s actions are non-invasive and con- centrate mostly on diagnosis and treatment. Using gentle, safe palpation examination techniques, myofascial relaxation, positioning relaxation, restoration of the physiological muscular work standard, and trigger point therapy, a physiotherapist can perform non- invasive examination. It more precisely locates pain, its source and connections, or even allows treatment of neuro-musculoskeletal disorders. Simultaneously it takes into consid- eration the influence of visceral, psychosomatic and environmental factors.
    Full-text · Chapter · Jan 2010
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    ABSTRACT: The article presents the role of a physiotherapist and an ostheopath in the multidimensional management of occupational voice disorders. The influence ofbiomechanical characteristics of the musculo-fascial system on vocal apparatus is described. The visual and palpating methods used in physiotherapeutic/ostheopatic diagnostics, including the assessment of joint mobility and ergonomics in dynamic and static situations are also outlined.
    Full-text · Article · Jan 2010 · Medycyna pracy
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    ABSTRACT: Treatment in a health spa with proper infrastructure and professional medical care can provide optimal conditions for intensive voice rehabilitation, especially for people with occupational voice disorders. The most numerous group of people with voice disorders are teachers. In Poland, they have an opportunity to take care of, or regain, their health during a one-year paid leave. The authors describe a multi-specialist model of extensive treatment of voice disorders in a health spa, including holistic and interdisciplinary procedures in occupational dysphonia. Apart from balneotherapy, the spa treatment includes vocal training exercises, relaxation exercises, elements of physiotherapy with the larynx manual therapy and psychological workshops. The voice rehabilitation organized already for two groups of teachers has been received with great satisfaction by this occupational group. The implementation of a model program of extensive treatment of voice disorders in a health spa should become one of the steps aimed at preventing occupational voice diseases.
    No preview · Article · Jan 2010 · Medycyna pracy
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    ABSTRACT: Patient with hypopharyngeal cancer are difficult to treat because they usually present with advanced disease, poor general health status and severe nutritional problems. Because of the poor prognosis, careful consideration has to be given regarding the choice of the correct surgical approach for respirato-digestive tract reconstruction. The authors present a case of recurrent hypopharyngeal cancer with cervical esophagus infiltration successfully treated with total laryngectomy and esophagectomy and gastric pull up reconstruction. Indications for technique, method of reconstruction and complications are discussed. As most authors we consider the gastric transposition method as the preferred approach to restore digestive continuity after total esophagectomy. As the method is the single stage procedure it provides the best palliation of dysphagia and allows early resumption of an oral diet.
    No preview · Article · Dec 2008 · Otolaryngologia polska. The Polish otolaryngology
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    ABSTRACT: The increase of patients after total laryngectomy myofascial neck and arms area tension might be observed. Via fascial continuity it has an adverse impact on superior oesophageal constrictor, forming the “mouth of oesophagus”, which hinders learning oesophagus speech. The aim The assessment of manual myofascial release techniques influence on the patients’ oesophagus pressure after total laryngectomy. Material 40 patients (12 F, 28 M), aged 43–75 (middle 56,8 years), 9 months to 13 years (average 3 years) after total laryngectomy, 35 patients (87.5%) after neck lymph node's resection, 38 patients (95%) after radiotherapy. Methods The oesophagus pressure was checked by modified Seeman's method. Manual myofascial release techniques were applied within head, neck, arms, upper trunk and upper limbs area. Wilcoxon and Shapiro-Wilk's test was used for the purpose of statistical analysis. Results A statistical significant decrease of the mean of oesophagus pressure was observed after physiotherapy treatment. The average pressure among the examined group decreased from 37,9 to 26,6 mm Hg. Conclusions The application of myofascial manual techniques decreased an oesophagus pressure which allows patients to obtain faster oesophagus speech.
    No preview · Article · Dec 2008 · Otolaryngologia polska. The Polish otolaryngology
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    ABSTRACT: In patients after total laryngectomy, increased tension in myofascial neck and arm areas might be observed. Via fascial continuity it has an adverse impact on the superior esophageal constrictor forming the "mouth of the oesophagus", which hinders learning of esophageal speech. The aim is to assess the effect of manual myofascial release techniques on esophageal pressure in patients after total laryngectomy. Forty patients (12 F, 28 M), aged 43-75 (mean 56.8 years), 9 months to 13 years (average 3 years) after total laryngectomy, 35 patients (87.5%) after neck lymph node resection, 38 patients (95%) after radiotherapy. Esophageal pressure was assessed using modified Seeman's method. Manual myofascial release techniques were applied within head, neck, arms, upper trunk and upper limb areas. Wilcoxon and Shapiro-Wilk's test was used for the purpose of statistical analysis. Statistically significant decrease of the mean esophageal pressure was observed after the physiotherapy treatment. The average pressure among the examined patients decreased from 37.9 to 26.6 mmHg. The application of myofascial manual techniques decreases esophageal pressure, thus allowing patients to learn esophagus speech at a faster pace.
    No preview · Article · Dec 2008 · Archives of Oto-Rhino-Laryngology
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    ABSTRACT: The increase of patients after total laryngectomy myofascial neck and arms area tension might be observed. Via fascial continuity it has an adverse impact on superior oesophageal constrictor, forming the "mouth of oesophagus", which hinders learning oesophagus speech. The assessment of manual myofascial release techniques influence on the patients' oesophagus pressure after total laryngectomy. 40 patients (12 F, 28 M), aged 43-75 (middle 56, 8 years), 9 months to 13 years (average 3 years) after total laryngectomy, 35 patients (87.5%) after neck lymph node's resection, 38 patients (95%) after radiotherapy. The oesophagus pressure was checked by modified Seeman's method. Manual myofascial release techniques were applied within head, neck, arms, upper trunk and upper limbs area. Wilcoxon and Shapiro-Wilk's test was used for the purpose of statistical analysis. A statistical significant decrease of the mean of oesophagus pressure was observed after physiotherapy treatment. The average pressure among the examined group decreased from 37.9 to 26.6 mm Hg. The application of myofascial manual techniques decreased an oesophagus pressure which allows patients to obtain faster oesophagus speech.
    No preview · Article · Feb 2008 · Otolaryngologia polska. The Polish otolaryngology
  • Sławomir Marszałek · Andrzej Minczykowski · Wojciech Golusiński
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    ABSTRACT: After total laryngectomy and follow-up treatment (including radiotherapy) there are many functional disorders in the head and neck. This restricts the movement of the chest and shoulders, and also decreases the ventilation of the lungs. Consequently the level of endurance in people following total laryngectomy is significantly lower. Many patients also view cancer as physically disenabling, so they don't want to do as much physical activity as they could. However it could be seen that intensive physiotherapy with aerobic training and physical exercises led to a decrease in the negative effects of oncological treatment. The influence of physical exercise on aerobic efficiency was examined on a mechanical track during the aerobic test according to a modified version of Bruce's protocol. In conclusion when aerobic training and physical exercises are included in the physiotherapy program for laryngectomised patients an increase in their physical endurance is visible.
    No preview · Article · Feb 2005 · Otolaryngologia polska. The Polish otolaryngology
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    ABSTRACT: Background. This paper presents a new physiotherapy program for persons recovering from a total laryngectomy, who took part in a two-week rehabilitation camp. Material and methods. The program was based on individual physiotherapy, breathing exercises, and aerobic training. During individual physiotherapy, we applied postisometrical relaxation and massage of the cervical and arm muscles. The effects of physiotherapy were verified by biomechanical and physiological methods. Results. After the comprehensive physiotherapy program there was a significant improvement in the function of the neck muscles, lung capacity, and tolerance to physical exertion. Conclusions: The model of motor rehabilitation presented here should constitute an integral part of comprehensive rehabilitation for persons recovering from laryngectomy.
    No preview · Article · Jan 2005
  • Sławomir Marszałek · Wojciech Golusinski · Lechosław B Dworak
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    ABSTRACT: After total laryngectomy and after complete treatment (radiotherapy) there are many functional disorders in the range of head and neck. These decrease muscle strength and flexibility of muscles of cervical spine. This causes disorders of physiological range of motions of this area. The introduction of the stretching techniques (postisometric relaxation) to the physiotherapy program allows to decrease negative effects of treatment, mentioned above. The therapy of main cervical muscles was carried out during a two week rehabilitation camp. Biomechanical-kinesiological tests were used to assess the effect of the physiotherapy program. The application of postisometrical relaxation and the massage of the cervical and arm muscles increased the average motor ranges and muscle strength. Cervical muscles disbalance was decreased at the same time.
    No preview · Article · Feb 2004 · Otolaryngologia polska. The Polish otolaryngology
  • S. Marszałek · W. Golusiński · L. B. Dworak

    No preview · Article · Dec 2003 · Reports of Practical Oncology and Radiotherapy