Paraneoplastic optic neuropathy (PON) is a very rare condition. In this study, a case of PON whose first complaint was painless vision loss in one eye is presented. In the follow-up of our case, optic neuropathy developed in the fellow eye. Electromyography examination performed due to diffuse body pain and motor loss in the left extremity is compatible with peripheral sensorimotor polyneuropathy. Lung biopsy was planned due to EMG result and and lymphadenopathy detection in thorax computed tomography (CT). The biopsy result of the patient was reported as nonspecific hyperplasia. As the patient's complaints increased, the paraneoplastic antibody panel was requested and CV2 / CRMP5 antibody was found positive. Thereupon, as a result of repeated biopsy, our patient was diagnosed with small cell lung cancer. We think that paraneoplastic optic neuropathy should be considered in the differential diagnosis in patients with advanced age, smoking, painless subacute vision loss, optic disc swelling, and we should insist on research in this direction as in our case.

• Klíčová slova
• CV2/CRMP5 antibodies, Small cell lung cancer, paraneoplastic optic neuropathy,
• MeSH
• lidé MeSH
• malobuněčný karcinom plic * komplikace   diagnóza   MeSH
• městnavá papila * MeSH
• nádory plic * komplikace   diagnóza   MeSH
• nemoci zrakového nervu * diagnóza   etiologie   MeSH
• nervus opticus MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

We report the case of isolation of Bordetella trematum from the respiratory tract of a patient with lung carcinoma. This gram-negative, opportunistic rod was firstly described in 1996. To date, only several strains of Bordetella trematum have been isolated and reported, mostly from skin and soft tissue infections. The patient was admitted to the ICU of the Pulmonary Department in incipient septic shock with respiratory failure. Intravenous fluid resuscitation and non-invasive ventilation were administered immediately. A broad spectrum antibiotic piperacillin/tazobactam was administered empirically after sampling of material for microbiological examination. The bronchoscopy showed a large cavern of decayed tumour invading into mediastinum. Both sample cultures showed significant quantities of gram-negative non-fermenting bacteria. The isolate was identified using MALDI-TOF MS as Bordetella trematum and the identification was confirmed using 16S ribosomal RNA sequencing. In the last few years, routine bacterial identification using MALDI-TOF MS has enabled correct discrimination of this species. Nevertheless, isolation of Bordetella trematum in clinical samples is still very uncommon, and it is appropriate to confirm the species identification via 16S ribosomal RNA sequencing. To our knowledge, this is the first case of B. trematum isolated from the human respiratory tract since its first description. The clinical significance of Bordetella trematum in the rapid deterioration of the patient's status remains unclear.

• Klíčová slova
• 16S rRNA sequencing, Bordetella trematum, Case report, MALDI-TOF MS, Respiratory tract,
• MeSH
• antibakteriální látky terapeutické užití   MeSH
• Bordetella účinky léků   izolace a purifikace   MeSH
• dýchací soustava mikrobiologie   MeSH
• fatální výsledek MeSH
• infekce bakteriemi rodu Bordetella diagnóza   farmakoterapie   MeSH
• lidé MeSH
• nádory plic komplikace   MeSH
• RNA ribozomální 16S genetika   MeSH
• senioři MeSH
• spektrometrie hmotnostní - ionizace laserem za účasti matrice MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH
• Názvy látek
• antibakteriální látky MeSH
• RNA ribozomální 16S MeSH

The association between kidney and liver polycystosis and arterial aneurysms is well documented. However, it remains unclear whether these patients are at increased risk of malignant transformation. In this article, we describe a case of a primary angiosarcoma of the femoral artery with metastatic spread into the lungs and hilar lymph node arising in a 74-year-old man with kidney and liver polycystosis and multiple arterial aneurysms.

• Klíčová slova
• Aneurysm, Angiosarcoma, Femoral artery, Polycystic kidney,
• MeSH
• aneurysma komplikace   diagnóza   MeSH
• arteria femoralis * chemie   patologie   MeSH
• biopsie MeSH
• cysty komplikace   diagnóza   MeSH
• hemangiosarkom chemie   komplikace   sekundární   MeSH
• imunohistochemie MeSH
• lidé MeSH
• lymfatické metastázy MeSH
• nádorové biomarkery analýza   MeSH
• nádory plic chemie   komplikace   sekundární   MeSH
• nemoci jater komplikace   diagnóza   MeSH
• polycystická choroba ledvin komplikace   diagnóza   MeSH
• senioři MeSH
• vaskulární nádory chemie   komplikace   patologie   MeSH
• Check Tag
• lidé MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH
• systematický přehled MeSH
• Názvy látek
• nádorové biomarkery MeSH

AIM: To investigate potential associations between clinical and standard peripheral blood biomarkers and clinical outcome in patients with non-small cell lung cancer (NSCLC) treated with nivolumab. PATIENTS AND METHODS: A total of 120 patients with advanced NSCLC treated at seven comprehensive cancer care centers were analyzed in this national retrospective study. Survival statistics were evaluated using the Kaplan-Meier method and Cox analysis. RESULTS: Among clinical parameters, histology was significantly associated with progression-free survival. Univariate Cox-proportional hazards model indicated prognostic and predictive role of a panel of laboratory parameters reflecting chronic inflammatory pattern (elevated neutrophil count, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, C-reactive protein and decrease in hemoglobin and albumin). Higher serum calcium concentration was also associated with nivolumab treatment effect. CONCLUSION: Tumor histology was the only clinical parameter predicting the outcome of nivolumab treatment. Among the laboratory parameters, our analysis identified a laboratory panel reflecting chronic inflammation as a potential predictive marker of nivolumab treatment.

• Klíčová slova
• Nivolumab, biomarker, non-small cell lung cancer, overall survival, progression-free survival,
• MeSH
• analýza přežití MeSH
• chronická nemoc MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• nádory plic komplikace   diagnóza   farmakoterapie   mortalita   MeSH
• nemalobuněčný karcinom plic komplikace   diagnóza   farmakoterapie   mortalita   MeSH
• nivolumab terapeutické užití   MeSH
• prognóza MeSH
• retrospektivní studie MeSH
• rizikové faktory MeSH
• senioři MeSH
• zánět komplikace   diagnóza   mortalita   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• nivolumab MeSH

Neuromyelitis optica spectrum disorders (NMOSD) are demyelinating, autoimmune diseases affecting the central nervous system. Typically, recurrent optic neuritis and longitudinal extensive transverse myelitis dominates the clinical picture. In most cases NMOSD are associated with autoantibodies targeting the water channel aquaporin-4 (AQP-4). NMOSD usually present in young adults. Clinical findings suggestive of NMOSD in elderly patients should raise the suspicion of a paraneoplastic etiology. To our knowledge, we report the first case of a 66 year-old female patient with paraneoplastic NMOSD that is associated with squamous cell lung carcinoma. Anti-AQP-4 was present in both the serum and cerebrospinal fluid of the patient. However, immunhistological staining of the malignant tissue did not show presence of AQP-4 on the surface of tumour cells.

• Klíčová slova
• Aquaporin-4, Neuromyelitis optica, Paraneoplastic,
• MeSH
• akvaporin 4 imunologie   MeSH
• autoprotilátky analýza   krev   mozkomíšní mok   MeSH
• imunohistochemie MeSH
• kouření MeSH
• lidé MeSH
• magnetická rezonanční tomografie MeSH
• nádory plic komplikace   MeSH
• neuromyelitis optica komplikace   diagnostické zobrazování   terapie   MeSH
• paraneoplastická polyneuropatie diagnostické zobrazování   etiologie   terapie   MeSH
• páteř diagnostické zobrazování   MeSH
• senioři MeSH
• spinocelulární karcinom komplikace   MeSH
• Check Tag
• lidé MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH
• přehledy MeSH
• Názvy látek
• akvaporin 4 MeSH
• AQP4 protein, human MeSH Prohlížeč
• autoprotilátky MeSH

BACKGROUND: Assessing the relationship between lung cancer and metabolic conditions is challenging because of the confounding effect of tobacco. Mendelian randomization (MR), or the use of genetic instrumental variables to assess causality, may help to identify the metabolic drivers of lung cancer. METHODS AND FINDINGS: We identified genetic instruments for potential metabolic risk factors and evaluated these in relation to risk using 29,266 lung cancer cases (including 11,273 adenocarcinomas, 7,426 squamous cell and 2,664 small cell cases) and 56,450 controls. The MR risk analysis suggested a causal effect of body mass index (BMI) on lung cancer risk for two of the three major histological subtypes, with evidence of a risk increase for squamous cell carcinoma (odds ratio (OR) [95% confidence interval (CI)] = 1.20 [1.01-1.43] and for small cell lung cancer (OR [95%CI] = 1.52 [1.15-2.00]) for each standard deviation (SD) increase in BMI [4.6 kg/m2]), but not for adenocarcinoma (OR [95%CI] = 0.93 [0.79-1.08]) (Pheterogeneity = 4.3x10-3). Additional analysis using a genetic instrument for BMI showed that each SD increase in BMI increased cigarette consumption by 1.27 cigarettes per day (P = 2.1x10-3), providing novel evidence that a genetic susceptibility to obesity influences smoking patterns. There was also evidence that low-density lipoprotein cholesterol was inversely associated with lung cancer overall risk (OR [95%CI] = 0.90 [0.84-0.97] per SD of 38 mg/dl), while fasting insulin was positively associated (OR [95%CI] = 1.63 [1.25-2.13] per SD of 44.4 pmol/l). Sensitivity analyses including a weighted-median approach and MR-Egger test did not detect other pleiotropic effects biasing the main results. CONCLUSIONS: Our results are consistent with a causal role of fasting insulin and low-density lipoprotein cholesterol in lung cancer etiology, as well as for BMI in squamous cell and small cell carcinoma. The latter relation may be mediated by a previously unrecognized effect of obesity on smoking behavior.

• MeSH
• fenotyp MeSH
• index tělesné hmotnosti MeSH
• inzulin krev   MeSH
• inzulinová rezistence MeSH
• jednonukleotidový polymorfismus MeSH
• lidé MeSH
• lipidy krev   MeSH
• mendelovská randomizace * MeSH
• nádory plic krev   komplikace   metabolismus   patologie   MeSH
• obezita krev   komplikace   MeSH
• omezení příjmu potravy MeSH
• pravděpodobnostní funkce MeSH
• rizikové faktory MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• inzulin MeSH
• lipidy MeSH

BACKGROUND: Chemical pleurodesis using videothoracoscopically applied powdered talc under general anaesthesia and selective pulmonary ventilation is the most effective method of palliative therapy for malign pleural exudate. Talc produces an intense systemic inflammatory reaction with the development of aseptic pleurisy. The result is obliteration of the pleural cavity provided there is an intense inflammatory reaction in the pleural cavity and good contact of both pleural leaves. The course of the adherence of pleural leaves can be followed using skiascopy. In routine practice, the course of local inflammatory markers is difficult to evaluate. Selection of suitable patients who will respond to this procedure is another principal obstacle of this surgical method. AIM: To evaluate the course of local inflammatory changes in the pleural cavity following application of talc and to quantify their dynamics. Selection of specific biomarkers to predict the intensity of inflammation in the pleural exudate for targeted selection of patients suitable for talcage was the second aim of this study. MATERIALS AND METHODS: 114 patients were retrospectively divided into Group A (N1 = 98) or patients without relapse and Group B (N2 = 16), patients with relapse of exudate formation. The need for repeated thoracic punctures or drainage over the course of a 12-month monitoring period was a criterion of treatment failure. Quantification of the effusion was performed by ultrasonic examination over a one year observational period at 3-monthly intervals. The concentration of soluble CD163 scavenger receptor and soluble Apo/Fas molecule was determined in exudate by ELISA. RESULTS: Soluble receptors in the 2 groups differed significantly. Group B showed higher sCD163 levels before talcage (P0 = 0.00024), faster dynamic decline in 2 h (P2 = 0.0092) and in 24 h (P24 = 0.0087). During monitoring, decrease in group B was statistically significant at 2 h (P2 = 0.056) and at 24 hrs (P24 = 0.0066). CONCLUSION: This pilot study showed that high values of sCD163 and sApo/Fas in the pleural exudate can predict treatment failure. Unsuitable candidates for this type of therapy couldbe selected in this way.

• Klíčová slova
• malignant pleural exudate, sApo/Fas, sCD163, talc, thoracoscopy,
• MeSH
• biologické markery metabolismus   MeSH
• exsudáty a transsudáty metabolismus   MeSH
• lidé středního věku MeSH
• lidé MeSH
• lymfom komplikace   MeSH
• maligní pleurální výpotek etiologie   terapie   MeSH
• mastek aplikace a dávkování   škodlivé účinky   MeSH
• mezoteliom komplikace   MeSH
• nádory plic komplikace   MeSH
• paliativní péče metody   MeSH
• pleurální dutina MeSH
• pleuritida chemicky indukované   MeSH
• pleurodéza škodlivé účinky   metody   MeSH
• retrospektivní studie MeSH
• senioři MeSH
• výběr pacientů * MeSH
• výsledek terapie MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• biologické markery MeSH
• mastek MeSH

BACKGROUND: One option for the palliative treatment of recurrent malignant pleural effusion is powdered talc using thoracoscopy. This paper presents the results of selected systemic and local manifestations of the talc-induced inflammatory reaction using a videothoracoscope. METHOD: A total of 114 patients with repeated malignant pleural effusion were treated at the Cardiac Surgery Clinic in Hradec Kralove from January 2010 to December 2012. Those with a life expectancy more than ≥ 3 months were eligible for talcage surgery. The group was retrospectively divided according to treatment results into Group A (N1 = 98 - successful) and Group B (N2 = 16 - relapsing). The pleural effusion was quantified using ultrasound over 1 year at 3-month intervals. Systemic changes due to the inflammatory reaction (body temperature, serum leukocyte and CRP levels) were evaluated. Local indicators of inflammation included changes in the leukocyte cell population in the effusion and changes in the pleural CRP levels. The dynamics of local expression of membrane receptors TLR-2 and CD-64 on granulocyte and monocyte cell populations in the pleural effusion were also evaluated. RESULTS: The reaction after talcage, included a significant increase in axillary temperature and leukocyte count, 12 h after the procedure. The dynamics were different in the two groups. The dynamics of local inflammatory changes were an early increase in the pleural CRP levels in both groups. The time interval of local inflammatory development and duration was related to the treatment efficacy and showed a significant rise 2 h after talcage in Group A. In Group B the local inflammatory reaction was slower and the rise was only observed 24 h after talc application. A decrease in lymphocyte count and an increase in granulocyte count 2 h after talcage were found. After an initial drop in monocyte level, a rise occurred within 24 h after talcage. Changes in the expression of TLR-2 and CD-64 receptors in relation to their cell carriers were observed depending on time after talcage. CONCLUSION: The differences in the serum and pleural effusion CRP levels suggest that the surgical stress manifests itself locally in the pleural space with a lower intensity and time delay. The TLR-2 and CD-64 receptors exhibit different behaviour depending on the type of cell membrane where they are found. The inverse relation between the granulocyte increase and TLR-2 receptor decrease in the membrane immediately after talcage is a new finding. The dynamics of TLR-2 expression on the monocytes demonstrates a direct proportion between the increasing expression of the TLR-2 receptor and increasing percent fraction of the cell carrier.

• Klíčová slova
• CD-64, CRP, TLR-2, malignant pleural effusion, talc, thoracoscopy,
• MeSH
• C-reaktivní protein metabolismus   MeSH
• délka pobytu MeSH
• leukocyty fyziologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• lymfom komplikace   MeSH
• maligní mezoteliom MeSH
• maligní pleurální výpotek diagnostické zobrazování   etiologie   terapie   MeSH
• mastek aplikace a dávkování   škodlivé účinky   MeSH
• metastázy nádorů MeSH
• mezoteliom komplikace   MeSH
• nádory plic komplikace   MeSH
• paliativní péče metody   MeSH
• pleuritida chemicky indukované   MeSH
• pleurodéza škodlivé účinky   metody   MeSH
• prediktivní hodnota testů MeSH
• recidiva MeSH
• retrospektivní studie MeSH
• senioři MeSH
• tělesná teplota fyziologie   MeSH
• torakoskopie metody   MeSH
• ultrasonografie MeSH
• výsledek terapie MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• C-reaktivní protein MeSH
• mastek MeSH

BACKGROUND: Malnutrition in cancer patients may be associated with poor tolerance of chemotherapy and lower response rate after oncological treatment. METHODS: Nutritional Risk Screening 2002 (NRS) adapted for oncological patients was used to assess the risk of undernutrition in a group of 188 patients with lung cancer. The risk was evaluated on a 6-point scale according to common signs of nutritional status (weight loss, body mass index, and dietary intake), tumor, and its treatment risk factors. A score of 3 or more (called "nutritional risk") means significant risk of malnutrition and poor outcome. RESULTS: Acceptable NRS score was found in 50.6%, and in 45.3% a score of 3-5 suggested the risk of malnutrition (nutritional risk). Unexpectedly, the toxicity of anticancer treatment was not significantly different between the subgroups (acceptable score vs nutritional risk). The rate of treatment response evaluated by imaging techniques was significantly higher in patients with an acceptable score compared to nutritional risk. Overall survival rate was significantly higher in cytostatically treated patients with lung cancer with an acceptable score. CONCLUSION: Nutritional risk screening is a significant predictor of tumor response in patients with lung cancer. Early detection of malnutrition is important to determine the prognosis of cancer patients as well as to plan effective supportive care.

• Klíčová slova
• lung cancer, nutritional risk screening, treatment tolerance, tumor response,
• MeSH
• hodnocení stavu výživy * MeSH
• index tělesné hmotnosti MeSH
• lidé středního věku MeSH
• lidé MeSH
• nádory plic komplikace   MeSH
• nutriční stav MeSH
• podvýživa komplikace   diagnóza   MeSH
• prognóza MeSH
• rizikové faktory MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

BACKGROUND: Most lung cancers are already advanced at the time of dia-gnosis. In these patients, a frequent symptom is protein energy malnutrition, often diagnosed prior to oncological treatment. Malnutrition results in poor tolerance of treatment and increased morbidity and mortality. METHODS: Nutritional Risk Screening (NRS) 2002 adapted for oncological patients was used to assess the risk of undernutrition in a group of 188 lung cancer patients. The risk was evaluated on a 6- point scale according to common signs of nutritional status and tumor and its treatment risk factors. A score of 3 and more (called "nutritional risk") means a significant risk of malnutrition. Furthermore, pretreatment nutritional characteristics were evaluated in patients (including the value of BMI) and laboratory values indicating malnutrition/ acute phase response (albumin/ C reactive protein - CRP). RESULTS: Acceptable NRS score was found in 50.6%, while in 45.3% was suggested into risk of malnutrition ("nutritional risk"). Only 6.6% of our patients had a BMI less than 20 kg/ m2. Significant differences in albumin and CRP values in various categories of NRS were confirmed. CONCLUSION: Initial signs of cancer malnutrition may be overlooked in patients who fall within or above the range of BMI for adequate weight, although these patients may be at significant risk of malnutrition. The indicators of nutritional status and systemic inflammatory responses were significantly associated with resulting values NRS score.

• MeSH
• albuminy metabolismus   MeSH
• C-reaktivní protein metabolismus   MeSH
• lidé MeSH
• nádory plic komplikace   metabolismus   MeSH
• nutriční stav * MeSH
• podvýživa etiologie   terapie   MeSH
• rizikové faktory MeSH
• syndrom systémové zánětlivé reakce krev   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH
• Názvy látek
• albuminy MeSH
• C-reaktivní protein MeSH