BACKGROUND: The safety profile of venom immunotherapy (VIT) is a relevant issue, and considerable differences have been reported in the safety and efficacy of this treatment modality. The primary aim of this study was to evaluate the safety of angiotensin-converting enzyme inhibitors and ß-blockers during VIT. In a second analysis, we evaluated data on premedication and venom preparations and their association with systemic adverse events (AEs) during the up-dosing phase and the first year of the maintenance phase, as well as the outcome of field stings and sting challenges. METHODS: Ours was an open, prospective, observational, multicenter study that recruited 1425 patients, of whom 1342 underwent VIT. RESULTS: Premedication with oral antihistamines was taken by 52.1% of patients during up-dosing and 19.7% of patients during the maintenance phase. Antihistamines had no effect on the frequency of systemic AEs (P=.11), although large local reactions (LLRs) were less frequent (OR, 0.74; 95%CI, 0.58-0.96; P=.02). Aqueous preparations were preferred for up-dosing (73.0%), and depot preparations were used for the maintenance phase (64.5%). The type of venom preparation had no influence on the frequency of systemic AEs or on the effectiveness of VIT (P=.26 and P=.80, respectively), while LLRs were less frequent with depot preparations (P<.001). CONCLUSIONS: Pretreatment with oral antihistamines during VIT significantly reduces the frequency of LLRs but not systemic AEs. All venom preparations were equally effective and did not differ in terms of the frequency of systemic AEs.
- MeSH
- alergeny imunologie aplikace a dávkování MeSH
- antihistaminika terapeutické užití MeSH
- beta blokátory terapeutické užití MeSH
- desenzibilizace imunologická * metody škodlivé účinky MeSH
- dítě MeSH
- dospělí MeSH
- inhibitory ACE terapeutické užití škodlivé účinky MeSH
- kousnutí a bodnutí hmyzem imunologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- prospektivní studie MeSH
- senioři MeSH
- výsledek terapie MeSH
- živočišné jedy imunologie škodlivé účinky terapeutické užití MeSH
- zvířata MeSH
- Check Tag
- dítě MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- pozorovací studie MeSH
BACKGROUND: Sex and gender influence many aspects of chronic obstructive pulmonary disease (COPD). Limited data are available on this topic in alpha-1 antitrypsin deficiency (AATD). We therefore aimed to investigate sex issues in the EARCO registry, a prospective, international, observational cohort study. METHODS: Baseline data from PiZZ individuals, enrolled in the registry with complete data on sex and smoking history were analysed by group comparisons and binary logistic regression analyses. RESULTS: 1283 patients with AATD, 49.3% women were analysed. Females reported less tobacco consumption (16.8±12.2 vs. 19.6±14.5 PY, p=0.006), occupational exposures towards gases, dusts or asbestos (p<0.005 each) and consumed less alcohol (5.5±7.6 vs. 8.4±10.3u/week, p<0.001). Females reported COPD (41% vs. 57%, p<0.001) and liver disease (11% vs. 20%, p<0.001) less often. However, they had a higher prevalence of bronchiectasis (24% vs. 13%, p<0.001). Despite better lung function (FEV1%pred. 73.6±29.9 vs. 62.7±29.5, p<0.001) females reported a similar symptom burden (CAT 13.4±9.5 vs. 12.5±8.9, p=ns) and exacerbation frequency (at least one in the previous year 30% vs. 26%, p=ns) compared to males. In multivariate analyses, female sex was an independent risk factor for exacerbations in the previous year OR 1.6 p=0.001 in addition to smoking history, COPD, asthma and bronchiectasis and was also identified as risk factors for symptom burden (CAT≥10) OR 1.4 p=0.014 besides age, BMI, COPD and smoking history. CONCLUSION: Men had higher rates of COPD and liver disease, women were more likely to have bronchiectasis. Women's higher symptom burden and exacerbation frequency suggest they may need tailored treatment approaches.
- MeSH
- bronchiektazie epidemiologie etiologie MeSH
- chronická obstrukční plicní nemoc epidemiologie etiologie MeSH
- deficit alfa1-antitrypsinu * epidemiologie komplikace MeSH
- komorbidita MeSH
- kouření epidemiologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- nemoci jater epidemiologie etiologie MeSH
- pití alkoholu epidemiologie MeSH
- pracovní expozice škodlivé účinky MeSH
- prevalence MeSH
- prospektivní studie MeSH
- registrace * MeSH
- senioři MeSH
- sexuální faktory MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- pozorovací studie MeSH
- srovnávací studie MeSH
Five cases of patients with systemic connective tissue diseases (CTD) who developed connective tissue disease-associated interstitial lung disease (CTD-ILD) with progressive pulmonary fibrosis (PPF) are reported here. Unspecified ILD was diagnosed using high-resolution computed tomography (HRCT). Histologically, all cases were usual interstitial pneumonia (UIP) with findings of advanced (3/5) to diffuse (2/5) fibrosis, with a partially (4/5) to completely (1/5) formed image of a honeycomb lung. The fibrosis itself spread subpleurally and periseptally to more central parts (2/5) of the lung, around the alveolar ducts (2/5), or even without predisposition (1/5). Simultaneously, there was architectural reconstruction based on the mutual fusion of fibrosis without compression of the surrounding lung parenchyma (1/5), or with its compression (4/5). The whole process was accompanied by multifocal (1/5), dispersed (2/5), or organized inflammation in aggregates and lymphoid follicles (2/5). As a result of continuous fibroproduction and maturation of the connective tissue, the alveolar septa thickened, delimiting groups of alveoli that merged into air bullae. Few indistinctly visible (2/5), few clearly visible (1/5), multiple indistinctly visible (1/5), and multiple clearly visible (1/5) fibroblastic foci were present. Among the concomitant changes, areas of emphysema, bronchioloectasia, and bronchiectasis, as well as bronchial and vessel wall hypertrophy, and mucostasis in the alveoli and edema were observed. The differences in the histological appearance of usual interstitial pneumonia associated with systemic connective tissue diseases (CTD-UIP) versus the pattern associated with idiopathic pulmonary fibrosis (IPF-UIP) are discussed here. The main differences lie in spreading lung fibrosis, architectural lung remodeling, fibroblastic foci, and inflammatory infiltrates.
- MeSH
- dospělí MeSH
- idiopatická plicní fibróza patologie komplikace MeSH
- intersticiální plicní nemoci * patologie komplikace MeSH
- lidé středního věku MeSH
- lidé MeSH
- nemoci pojiva * patologie komplikace MeSH
- plíce patologie diagnostické zobrazování MeSH
- počítačová rentgenová tomografie MeSH
- senioři MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
INTRODUCTION AND OBJECTIVES: Limited information is available on the safety of pregnancy in patients with genetic dilated cardiomyopathy (DCM) and in carriers of DCM-causing genetic variants without the DCM phenotype. We assessed cardiac, obstetric, and fetal or neonatal outcomes in this group of patients. METHODS: We studied 48 women carrying pathogenic or likely pathogenic DCM-associated variants (30 with DCM and 18 without DCM) who had 83 pregnancies. Adverse cardiac events were defined as heart failure (HF), sustained ventricular tachycardia, ventricular assist device implantation, heart transplant, and/or maternal cardiac death during pregnancy, or labor and delivery, and up to the sixth postpartum month. RESULTS: A total of 15 patients, all with DCM (31% of the total cohort and 50% of women with DCM) experienced adverse cardiac events. Obstetric and fetal or neonatal complications were observed in 14% of pregnancies (10 in DCM patients and 2 in genetic carriers). We analyzed the 30 women who had been evaluated before their first pregnancy (12 with overt DCM and 18 without the phenotype). Five of the 12 (42%) women with DCM had adverse cardiac events despite showing NYHA class I or II before pregnancy. Most of these women had a history of cardiac events before pregnancy (80%). Among the 18 women without phenotype, 3 (17%) developed DCM toward the end of pregnancy. CONCLUSIONS: Cardiac complications during pregnancy and postpartum were common in patients with genetic DCM and were primarily related to HF. Despite apparently good tolerance of pregnancy in unaffected genetic carriers, pregnancy may act as a trigger for DCM onset in a subset of these women.
- MeSH
- dilatační kardiomyopatie * genetika komplikace MeSH
- dospělí MeSH
- fenotyp MeSH
- genetická variace MeSH
- kardiovaskulární komplikace v těhotenství * genetika MeSH
- lidé MeSH
- těhotenství MeSH
- výsledek těhotenství * MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
The introduction of ChatGPT3 in 2023 disrupted the field of artificial intelligence (AI). ChatGPT uses large language models (LLMs) but has no access to copyrighted material including scientific articles and books. This review is limited by the lack of access to: (1) prior peer-reviewed articles and (2) proprietary information owned by the companies. Despite these limitations, the article reviews the use of LLMs in the publishing of scientific articles. The first use was plagiarism software. The second use by the American Psychological Association and Elsevier helped their journal editors to screen articles before their review. These two publishers have in common a large number of copyrighted journals and textbooks but, more importantly, a database of article abstracts. Elsevier is the largest of the five large publishing houses and the only one with a database of article abstracts developed to compete with the bibliometric experts of the Web of Science. The third use and most relevant, Scopus AI, was announced on 16 January 2024, by Elsevier; a version of ChatGPT-3.5 was trained using Elsevier copyrighted material written since 2013. Elsevier's description suggests to the authors that Scopus AI can write review articles or the introductions of original research articles with no human intervention. The editors of non-Elsevier journals not willing to approve the use of Scopus AI for writing scientific articles have a problem on their hands; they will need to trust that the authors who have submitted articles have not lied and have not used Scopus AI at all.
- MeSH
- lidé MeSH
- periodika jako téma MeSH
- psaní MeSH
- publikování * normy MeSH
- umělá inteligence * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
OBJECTIVES: Patients with non-muscle invasive bladder cancer (NMIBC) face a high risk of recurrence and progression after transurethral resection, making adjuvant therapies necessary. Intravesical device-assisted therapies, such as radiofrequency-induced thermochemotherapy (RITE), have shown promise in enhancing the effectiveness of intravesical chemotherapies. This study aimed to evaluate oncological outcomes in patients with NMIBC treated with RITE in a real-world setting, encompassing those unresponsive to prior Bacillus Calmette-Guérin (BCG) or intravesical chemotherapy, as well as those who declined or were ineligible for BCG or radical cystectomy (RC). METHODS: A retrospective multicenter analysis of patients treated with RITE for NMIBC between 2015 and 2024 was performed. Co-primary endpoints of the study were intravesical recurrence free survival (RFS) and high-grade intravesical recurrence free survival (HG-RFS). Secondary endpoints included radical cystectomy-free survival (RC-FS), overall survival (OS), cancer-specific survival (CSS), and adverse events (AEs). RESULTS: Fifty-nine consecutive patients were included in the final analyses. Overall, 12 (20%) and 45 (76%) patients failed previous intravesical chemotherapy, and immunotherapy with BCG, respectively. The 24-months RFS and HG-RFS following RITE were 68.6% (95% CI: 0.568, 0.828) and 74.8% (95% CI: 0.632, 0.885). RC-FS at 24 months was 93.8% (95% CI: 0.872, 1.000). The OS probability at 24 months was 91%, with a CSS of 97.8%. Most common AEs were dysuria and urgency in 27 (45.7%) patients, treatment limiting bladder spasms in 11 (19%) patients, low bladder compliance in 11 (19%) patients and urethral strictures in 5 (8%) patients. CONCLUSION: In our analyses, RITE resulted in notable antitumor activity and allows for the avoidance of more aggressive and quality-of-life-limiting therapies, such as radical cystectomy. RITE might be considered as a second-line bladder-sparing option in patients failing previous intravesical therapies. Long-term follow-up and larger-scale data are required to validate our findings.
- MeSH
- cystektomie MeSH
- indukovaná hypertermie * metody MeSH
- invazivní růst nádoru MeSH
- lidé středního věku MeSH
- lidé MeSH
- nádory močového měchýře neinvadující svalovinu MeSH
- nádory močového měchýře * terapie patologie mortalita MeSH
- retrospektivní studie MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- výsledek terapie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
INTRODUCTION: Opium is used recreationally and for pain relief in certain regions and has been classified as a human carcinogen by the IARC. While its use is rare in Europe and Oceania, it remains a major public health issue in other parts of the world. This study evaluates the risk of bladder cancer (BCa) among opium users compared to non-users. METHODS: A comprehensive search of MEDLINE, Scopus, and Web of Science was conducted up to July 2024 to identify studies examining the link between opium use and BCa. A meta-analysis was performed to calculate the pooled risk ratio (RR) with 95% confidence intervals (CIs) (PROSPERO: CRD42024562623). RESULTS: A total of 15 studies (n=60,149) were included. The analysis showed that opium users had a significantly higher risk of developing BCa than non-users (RR: 2.36; 95% CI: 1.92-2.90; P<.001). The risk increased with the amount of opium consumed, regardless of type or method of use. CONCLUSIONS: Opium consumption increase the risk of developing BCa by more than twofold among users. Awareness of its carcinogenic potential and public health implications is crucial. Our findings underscore the need for global prevention strategies and further research into opium-related BCa risks.
OBJECTIVES: To evaluate the role of circulating tumor DNA (ctDNA) as a prognostic and predictive biomarker in the perioperative management of muscle-invasive bladder cancer (MIBC). METHODS: We conducted a systematic literature review using PubMed, MEDLINE, and Embase, following PRISMA guidelines. Studies from January 2013 to March 2024 were included if they examined ctDNA in MIBC patients undergoing radical cystectomy (RC) and perioperative chemotherapy or immunotherapy. RESULTS: Eight studies were included. ctDNA detected before RC was associated with poor recurrence-free survival and higher risk of nodal and locally advanced disease. Postoperative ctDNA levels correlated with shorter disease-free survival and higher recurrence rates. ctDNA clearance during neoadjuvant chemotherapy was predictive of treatment response. ctDNA status post-neoadjuvant immunotherapy correlated with pathological outcomes and recurrence rates. CONCLUSIONS: ctDNA is a promising biomarker for predicting oncological outcomes in MIBC, with potential to guide perioperative treatment decisions. Further randomized controlled trials are needed to validate these findings.
- MeSH
- cirkulující nádorová DNA * krev MeSH
- cystektomie MeSH
- invazivní růst nádoru MeSH
- lidé MeSH
- nádorové biomarkery krev MeSH
- nádory močového měchýře * patologie krev terapie genetika MeSH
- prognóza MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
- systematický přehled MeSH
INTRODUCTION: Most patients with idiopathic pulmonary fibrosis (IPF) treated with antifibrotics (AF) have progressive disease despite treatment. A switch of AF may improve survival, but evidence from randomised controlled trials is missing. We aimed to evaluate the efficacy of an AF switch on survival and FVC decline in patients from the European MultiPartner IPF registry (EMPIRE). METHODS: The study included 612 patients who discontinued the first antifibrotic therapy. Patients were grouped and analysed from two perspectives: (1) whether they had received a second antifibrotic treatment after the discontinuation of the first therapy, and (2) a reason for discontinuation of the first AF - "lack of efficacy" (LE) and "intolerance" (INT). RESULTS: While 263 (43%) of 612 patients received no second AF ("non-switched"), 349 (57%) patients switched. Overall survival was higher in patients who received a second AF (median 50 vs. 29 months; adjusted HR 0.64, P=0.023). Similarly, the annual FVC decline was significantly reduced in switched patients: -98ml/y in switched and -172ml/y in non-switched patients (P=0.023), respectively. The switched patients had similar risk for mortality in both LE and INT groups (adjusted HR 0.95, P=0.85). The high impact of switching on survival was demonstrated in LE patients (adjusted HR 0.27, P<0.001). CONCLUSION: The patients without a second AF had significantly shorter overall survival. Our analysis suggests the importance of switching patients with an ineffective first AF therapy to a second AF therapy.
BACKGROUND: Vitamin D deficiency associates with the risk of developing many diseases, including cancer. At the molecular level, vitamin D appears to have an antineoplastic effect. However, the role of vitamin D deficiency in cancer pathogenesis remains unelucidated and numerous studies have resulted in discordant results. This study aimed to determine whether vitamin D deficiency during melanoma diagnosis increases the risk of developing non-cutaneous second primary cancers (SPC). MATERIALS AND METHODS: A retrospective study on 663 patients diagnosed with melanoma between 1 January 2011 and 31 October 2022. The effect of each variable on the development of a subsequent non-cutaneous cancer was performed using Kaplan-Meier curves and differences were assessed by log-rank tests. Cox proportional hazard univariate and multivariate models were used to quantify the effect of each variable in the time to develop a non-cutaneous neoplasia. RESULTS: Out of 663 patients, 34 developed a non-cutaneous SPC. There was no statistically significant association between vitamin D levels and non-cutaneous SPC development (log-rank, p=0.761). Age>60 years, stage III/IV, and nodular melanoma subtype were significantly associated with the development of a SPC. After multivariate analysis, only age>60 years (HR 3.4; HR CI 95%: 1.5-7.6) and nodular melanoma subtype (HR 2.2; HR CI 95%: 1.0-4.8) were included in the final model. CONCLUSIONS: Our results suggest that vitamin D deficiency is not associated with an increased risk of developing non-cutaneous SPC in melanoma patients. However, age over 60 years and nodular melanoma subtype increase the risk for non-cutaneous SPC development.
- MeSH
- lidé středního věku MeSH
- lidé MeSH
- melanom * epidemiologie etiologie diagnóza MeSH
- nádory kůže * etiologie komplikace MeSH
- nedostatek vitaminu D * komplikace epidemiologie MeSH
- retrospektivní studie MeSH
- sekundární malignity * epidemiologie etiologie MeSH
- vitamin D škodlivé účinky MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- pozorovací studie MeSH
