Prognostic value of fluorescence in situ hybridization (FISH) in patients with chronic lymphocytic leukemia

Flourescencijska in situ hibridizacija omogućila je detekciju citogenetskih promjena u bolesnika s kroničnom limfocitnom leukemijom. Ova metoda koristi se u dijagnostičkoj obradi bolesnika prije inicijacije kemoimunoterapije. Ova retrospektivna studija obuhvatila je 70 novodijagnosticiranih bolesnika u razdoblju između 2013. i 2017. godine s ciljem praćenja ishoda bolesti, odnosno brzine progresije bolesti i odgovora na konvencionalnu terapiju u odnosu na nalaz citogenetskih promjena, uzimajući u obzir i druge prognostičke čimbenike dobi, spola te kliničkog stadija. Citogenetske promjene nađene su u 20 bolesnika. Najčešći nalaz bila je delecija 13q14 (16%), zatim 17p (9%), dok su delecija 11p i trisomija 12 nađene u samo jednog bolesnika. Iako je broj bolesnika s nađenim citogenetskim promjenama bio malen, nađene su statistički značajne razlike u OS-u i PFS-u među skupinama, gdje se istaknula delecija 17p kao citogenetska promjena najlošijeg ishoda.Flourescence in situ hybridization has improved the detection of genomic aberrations in patients with chronic lymphocytic leukemia (CLL). This method is used to identify chromosomal abnormalities in patients with CLL before treating a patient on protocol . We applied FISH to blood smear samples from all newly diagnosed patients with CLL in the period from 2013 to 2017. Overall survival and progression free survival in 70 patients were analysed to evaluate prognosis regarding chromosomal aberrations, age, gender, Binet and Rai stage. Chromosomal aberrations were found in 20 of 70 patients. Most frequent aberrations were deletions in 13q14 (16%), 17p (9%), while deletion 11q and trisomy 12 were found in one patient. Patients with 17p deletion had the shortest progression free survival and overall survival. In conclusion, FISH is an important prognostic factor of disease progression and overall survival

Prognostic value of fluorescence in situ hybridization (FISH) in patients with chronic lymphocytic leukemia

Flourescencijska in situ hibridizacija omogućila je detekciju citogenetskih promjena u bolesnika s kroničnom limfocitnom leukemijom. Ova metoda koristi se u dijagnostičkoj obradi bolesnika prije inicijacije kemoimunoterapije. Ova retrospektivna studija obuhvatila je 70 novodijagnosticiranih bolesnika u razdoblju između 2013. i 2017. godine s ciljem praćenja ishoda bolesti, odnosno brzine progresije bolesti i odgovora na konvencionalnu terapiju u odnosu na nalaz citogenetskih promjena, uzimajući u obzir i druge prognostičke čimbenike dobi, spola te kliničkog stadija. Citogenetske promjene nađene su u 20 bolesnika. Najčešći nalaz bila je delecija 13q14 (16%), zatim 17p (9%), dok su delecija 11p i trisomija 12 nađene u samo jednog bolesnika. Iako je broj bolesnika s nađenim citogenetskim promjenama bio malen, nađene su statistički značajne razlike u OS-u i PFS-u među skupinama, gdje se istaknula delecija 17p kao citogenetska promjena najlošijeg ishoda.Flourescence in situ hybridization has improved the detection of genomic aberrations in patients with chronic lymphocytic leukemia (CLL). This method is used to identify chromosomal abnormalities in patients with CLL before treating a patient on protocol . We applied FISH to blood smear samples from all newly diagnosed patients with CLL in the period from 2013 to 2017. Overall survival and progression free survival in 70 patients were analysed to evaluate prognosis regarding chromosomal aberrations, age, gender, Binet and Rai stage. Chromosomal aberrations were found in 20 of 70 patients. Most frequent aberrations were deletions in 13q14 (16%), 17p (9%), while deletion 11q and trisomy 12 were found in one patient. Patients with 17p deletion had the shortest progression free survival and overall survival. In conclusion, FISH is an important prognostic factor of disease progression and overall survival

Methods of Preparing the Tooth for DNA Isolation

U ovoj je radnji i teoretski i praktički prikazana vrijednost koju zub ima u identifikaciji ljudi nepozna identiteta. Teoretski je pokazana razlika između genomske i mitohondrijske DNK. Ta se razlika odnosi na njihovu trajnost, svojstva koja nose u sebi, i njihovu vrijednost u identifikaciji. Uz tu razliku iznesena je mikroanatomija zuba, moguće lokacije pronalaska stanica u zubu i načini prikupljanja materijala za izolaciju DNK iz zuba. U praktičnom dijelu iznesene su metode koje su upotrebljene u izolaciji DNK iz zuba u pojedinim slučajevima. Za dobivanje materijala iz zuba primijenjena je metoda vodoravnog presjeka u području zubnoga vrata. Iz materijala izolirana je genomska DNK s pomoću dviju organskih fenol-kloroform metode. Rezultati su prikazani na 1 postotnom agaroznom gelu i snimljeni Polaroid kamerom.In this paper, the importance of the tooth in identification an unknown person has been demonstrated. The theoretical part shows the difference between genomic and mitochondrial DNA. That difference is the durability and properties which they carry and the value they have in identification. Microanatomy has also been described, possible locations of cells in the tooth and methods to collect material for DNA extraction. The practical part shows the methods used in particular cases for DNA isolation. Horizontal section through the cervical root is used to collect material for DNA isolation. Genomic DNA , from the material, is extracted by organic phenol-chloroform methods. The results are shown on 1 % agarose gel and photographed by a Polaroid camera

Epidemiological characteristics, baseline clinical features, and outcomes of critically ill patients treated in a coronavirus disease 2019 tertiary center in continental Croatia

Aim To describe epidemiological characteristics and base - line clinical features, laboratory findings at intensive care unit (ICU) admission, and survival rates of critically ill coro - navirus disease 2019 (COVID-19) patients treated at a ter - tiary institution specialized for COVID-19 patients. Methods This retrospective study recruited 692 patients (67.1% men). Baseline demographic data, major comorbid - ities, anthropometric measurements, clinical features, and laboratory findings at admission were compared between survivors and non-survivors. Results The median age was 72 (64-78) years. The median body mass index was 29.1 kg/m 2 . The most relevant comor - bidities were diabetes mellitus (32.6%), arterial hyperten - sion (71.2%), congestive heart failure (19.1%), chronic kid - ney disease (12.6%), and hematological disorders (10.3%). The median number of comorbidities was 3 and median Charlson Comorbidity Index (CCI) was 5. A total of 61.8% patients received high-flow nasal oxygen therapy (HFNO) and 80.5% received mechanical ventilation (MV). Median duration of HFNO was 3, and that of MV was 7 days. ICU mortality rate was 72.7%. Survivors had significantly lower age, number of comorbidities, CCI, sequential organ failure assessment score, serum ferritin, C-reactive protein, D-dim - er, and procalcitonin, interleukin-6, lactate, white blood cell, and neutrophil counts. They also had higher lymphocyte counts, Pa O 2 /FiO 2 ratio, and glomerular filtration rate at ad - mission. Length of ICU stay was 9 days. The median surviv - al was 11 days for mechanically ventilated patients, and 24 days for patients who were not mechanically ventilated. Conclusion The parameters that differentiate survivors from non-survivors are in agreement with published data. Further multivariate analyses are warranted to identify in - dividual mortality risk factor

Bacterial superinfections in critically ill COVID-19 patients – experiences from University Hospital Dubrava tertiary COVID-19 center

Cilj istraživanja: Utvrditi incidenciju najčešćih bakterijskih superinfekcija, distribuciju uzročnika ovisno o sijelu infekcije, demografske podatke, relevantne laboratorijske i kliničke parametre te ishode liječenja kritično oboljelih bolesnika liječenih u tercijarnom regionalnom centru specijaliziranom za liječenje COVID-19 bolesnika PRIC KB Dubrava. Ispitanici i metode: Provedeno je retrospektivno opservacijsko ispitivanje te su podaci skupljeni pregledom povijesti bolesti u bolničkom informacijskom sustavu (BIS, In2, Zagreb) pacijenata liječenih u jedinicama intenzivne medicine PRIC-IC KB Dubrava tijekom razdoblja od 01. ožujka 2020. do 01. veljače 2021. Skupljeni podaci analizirani su u statističkom programskom paketu jamovi. Rezultati: Od ukupno 692 pacijenta, 383 je razvilo bakterijsku ili gljivičnu superinfekciju. Njih 305 je razvilo pneumoniju, 133 bakterijemiju a 120 urinarnu infekciju. 66,3% pacijenata bilo je muškog spola, te su češće primani sa bolničkih odjela i JIM-ova drugih bolnica. Od 305 pacijenata sa pneumonijom 295 je bilo mehanički ventilirano te je razvilo VAP. Kod pacijenata koji nisu razvili bakterijemiju primjećen je porat omjera neutrofili leukociti, te limfopenija i pad vrijednosti CRP-a. Urinarna infekcija češća je kod žena. U sve tri skupine, pacijenti su imali produljen period boravka u JIM-u i u bolnici. Zaključci: Incidencija bakterijskih superinfekcija u kritično oboljelih COVID-19 pacijenata vrlo je visoka i iznosi 55,3%. Najčešće bakterijske superinfekcije su VAP, bakterijemija i urinarna infekcija. Najčešći uzročni patogeni su MDR bakterije. Pacijenti sa sekundarnom infekcijom imaju dulji period boravka u JIM. Povećanje omjera neutrofili / limfociti i progresija limfopenije povezane su sa nepovoljnim kliničkim ishodima.Goal: To determine incidence of bacterial superinfections, causative pathogens demographic data, relevant laboratory parameters and outcomes in critically ill COVID-19 patients treated in primary respiratory intensivist center (PRIC) UH Dubrava. Patients and methods: In this retrospective observational study, clinical and laboratory data of 692 critically ill patients treated in PRIC UH Dubrava between March 1st 2020. and February 1st 2021. was collected using the hospital information system software (BIS) and statistical analysis was performed using the jamovi statistical package. Results: Out of 692 patients admitted to the ICU, 383 acquired bacterial or fungal superinfections. 305 acquired pneumonia, 133 bloodstream infections and 120 urinary infections. 66.3% of patients were males, and bacterial superinfections were more common in patients admitted from hospital wards or external ICUs. Out of 305 patients with pneumonia, 295 were receiving mechanical ventilation and satisfied the criteria for ventilator associated pneumonia. Patients with bloodstream infections maintained elevated neutrophil lymphocyte ratio, lymphopenia and elevated CRP levels on day 7 compared to those without BSI. Urinary infections were more common in females, and did not have an effect on outcomes. All patients that developed superinfections had prolonged ICU and hospital stay. Conclusion: Incidence of bacterial superinfections in critically ill COVID-19 patients is 55.3%. Most common infections are ventilator associated pneumonia, bloodstream infections and urinary infections. Most common pathogens are multi-drug resistant pathogens. Patients with bacterial superinfections have longer ICU and hospital stay, and in these patients, persistent elevation of NLR ratio and worsening of lymphopenia are characteristic for patients with worse outcomes

Prognostic value of fluorescence in situ hybridization (FISH) in patients with chronic lymphocytic leukemia

Flourescencijska in situ hibridizacija omogućila je detekciju citogenetskih promjena u bolesnika s kroničnom limfocitnom leukemijom. Ova metoda koristi se u dijagnostičkoj obradi bolesnika prije inicijacije kemoimunoterapije. Ova retrospektivna studija obuhvatila je 70 novodijagnosticiranih bolesnika u razdoblju između 2013. i 2017. godine s ciljem praćenja ishoda bolesti, odnosno brzine progresije bolesti i odgovora na konvencionalnu terapiju u odnosu na nalaz citogenetskih promjena, uzimajući u obzir i druge prognostičke čimbenike dobi, spola te kliničkog stadija. Citogenetske promjene nađene su u 20 bolesnika. Najčešći nalaz bila je delecija 13q14 (16%), zatim 17p (9%), dok su delecija 11p i trisomija 12 nađene u samo jednog bolesnika. Iako je broj bolesnika s nađenim citogenetskim promjenama bio malen, nađene su statistički značajne razlike u OS-u i PFS-u među skupinama, gdje se istaknula delecija 17p kao citogenetska promjena najlošijeg ishoda.Flourescence in situ hybridization has improved the detection of genomic aberrations in patients with chronic lymphocytic leukemia (CLL). This method is used to identify chromosomal abnormalities in patients with CLL before treating a patient on protocol . We applied FISH to blood smear samples from all newly diagnosed patients with CLL in the period from 2013 to 2017. Overall survival and progression free survival in 70 patients were analysed to evaluate prognosis regarding chromosomal aberrations, age, gender, Binet and Rai stage. Chromosomal aberrations were found in 20 of 70 patients. Most frequent aberrations were deletions in 13q14 (16%), 17p (9%), while deletion 11q and trisomy 12 were found in one patient. Patients with 17p deletion had the shortest progression free survival and overall survival. In conclusion, FISH is an important prognostic factor of disease progression and overall survival

Inflammatory Biomarkers Affecting Survival Prognosis in Patients Receiving Veno-Venous ECMO for Severe COVID-19 Pneumonia

Severe COVID-19 pneumonia in which mechanical ventilation is unable to achieve adequate gas exchange can be treated with veno-venous ECMO, eliminating the need for aggressive mechanical ventilation which might promote ventilator-induced lung injury and increase mortality. In this retrospective observational study, 18 critically ill COVID-19 patients who were treated using V-V ECMO during an 11-month period in a tertiary COVID-19 hospital were analyzed. Biomarkers of inflammation and clinical features were compared between survivors and non-survivors. Survival rates were compared between patients receiving ECMO and propensity matched mechanically ventilated controls. There were 7 survivors and 11 non-survivors. The survivors were significantly younger, with a higher proportion of females, higher serum procalcitonin at ICU admission, and before initiation of ECMO they had significantly lower Murray scores, PaCO2, WBC counts, serum ferritin levels, and higher glomerular filtration rates. No significant difference in mortality was found between patients treated with ECMO compared to patients treated using conventional lung protective ventilation. Hypercapnia, leukocytosis, reduced glomerular filtration rate, and increased serum ferritin levels prior to initiation of V-V ECMO in patients with severe COVID-19 pneumonia may be early warning signs of reduced chance of survival. Further multicentric studies are needed to confirm these findings

Epidemiological characteristics, baseline clinical features, and outcomes of critically ill patients treated in a coronavirus disease 2019 tertiary center in continental Croatia

Aim: To describe epidemiological characteristics and baseline clinical features, laboratory findings at intensive care unit (ICU) admission, and survival rates of critically ill coronavirus disease 2019 (COVID-19) patients treated at a tertiary institution specialized for COVID-19 patients. ----- Methods: This retrospective study recruited 692 patients (67.1% men). Baseline demographic data, major comorbidities, anthropometric measurements, clinical features, and laboratory findings at admission were compared between survivors and non-survivors. ----- Results: The median age was 72 (64-78) years. The median body mass index was 29.1 kg/m2. The most relevant comorbidities were diabetes mellitus (32.6%), arterial hypertension (71.2%), congestive heart failure (19.1%), chronic kidney disease (12.6%), and hematological disorders (10.3%). The median number of comorbidities was 3 and median Charlson Comorbidity Index (CCI) was 5. A total of 61.8% patients received high-flow nasal oxygen therapy (HFNO) and 80.5% received mechanical ventilation (MV). Median duration of HFNO was 3, and that of MV was 7 days. ICU mortality rate was 72.7%. Survivors had significantly lower age, number of comorbidities, CCI, sequential organ failure assessment score, serum ferritin, C-reactive protein, D-dimer, and procalcitonin, interleukin-6, lactate, white blood cell, and neutrophil counts. They also had higher lymphocyte counts, PaO2/FiO2 ratio, and glomerular filtration rate at admission. Length of ICU stay was 9 days. The median survival was 11 days for mechanically ventilated patients, and 24 days for patients who were not mechanically ventilated. ----- Conclusion: The parameters that differentiate survivors from non-survivors are in agreement with published data. Further multivariate analyses are warranted to identify individual mortality risk factors

Distribution of Pathogens and Predictive Values of Biomarkers of Inflammatory Response at ICU Admission on Outcomes of Critically Ill COVID-19 Patients with Bacterial Superinfections—Observations from National COVID-19 Hospital in Croatia

Background: Superinfections contribute to mortality and length of stay in critically ill COVID-19 patients. The aim of this study was to determine the incidence and pathogen distribution of bacterial and fungal superinfections of the lower respiratory tract (LRTI), urinary tract (UTI) and bloodstream (BSI) and to determine the predictive value of biomarkers of inflammatory response on their ICU survival rates. Methods: A retrospective observational study that included critically ill COVID-19 patients treated during an 11-month period in a Croatian national COVID-19 hospital was performed. Clinical and diagnostic data were analyzed according to the origin of superinfection, and multivariate regression analysis was performed to determine the predictive values of biomarkers of inflammation on their survival rates. Results: 55.3% critically ill COVID-19 patients developed bacterial or fungal superinfections, and LRTI were most common, followed by BSI and UTI. Multidrug-resistant pathogens were the most common causes of LRTI and BSI, while Enterococcus faecalis was the most common pathogen causing UTI. Serum ferritin and neutrophil count were associated with decreased chances of survival in patients with LRTI, and patients with multidrug-resistant isolates had significantly higher mortality rates, coupled with longer ICU stays. Conclusion: The incidence of superinfections in critically ill COVID-19 patients was 55.3%, and multidrug-resistant pathogens were dominant. Elevated ferritin levels and neutrophilia at ICU admission were associated with increased ICU mortality in patients with positive LRTI