The role of parathyroid hormone and vitamin D serum concentrations in patients with cardiovascular diseases

25-hydroxyvitamin D (25(OH)D) plays a crucial role in human homeostasis. Its deficiency (vitamin D deficiency-VDD), being common in European population, combined with elevated concentration of parathyroid hormone (PTH), represents a vicious cycle of mechanisms leading to heart failure (HF). Despite several papers published in that field, the effect of VDD and PTH concentration on cardiovascular system remains unequivocal; thus, the aim of the study was to compare these data among HF and non-HF patients being prospectively enrolled into the study during hospital stay in the cardiology ward. Patients with HF had higher PTH concentration (85.0 ± 52.6 versus 64.5 ± 31.7, p = 0 02) compared to non-HF patients. Mean PTH values were associated with the clinical status expressed by the New York Heart Association class (NYHA class) (“0”-66.04, "I"-56.57, "II"-72.30, "III"-85.59, and "IV"-144.37 pg/ml, p = 0 00004). Interestingly, neither 25(OH)D (31.5 versus 29.7 ng/ml, p = ns) nor phosphorus (P) (1.23 versus 1.18 mmol/l, p = ns) nor total calcium (Ca2+) concentration (2.33 versus 2.37 mmol/l, p = ns) differed among the groups. Reassuming PTH serum concentration in contrary to 25(OH)D, P and Ca2+ are significantly raised among the patients with HF and shows significant relationship with the clinical status expressed by the NYHA class

Perforacja jelita cienkiego jako wczesne powikłanie leczenia systemowego według schematu R-CHOP u chorych na chłoniaka DLBCL — opis dwóch przypadków

Diffuse large B-cell lymphoma (DLBCL) is the most common lymphoma in adult patients. The R-CHOP regimen (rituximab in combination with cyclophosphamide, doxorubicin, vincristine, and prednisone) is the gold standard of the treatment for patients with DLBCL. Different adverse events are observed during this treatment, for example: adverse events related to the infusion (cytokine release syndrome, tumor lysis syndrome), hematologic events, cardiovascular events, infections. Perforations of the stomach and small intestine are rare but life-threatening complications of the R-CHOP immunochemotherapy. We present two patients with DLBCL, who were treated with R-CHOP regimen. Both had perforation of the small intestine shortly after first cycle. One of them underwent partial resection of the small intestine, another had enterorhaphy. Intraoperatively no neoplastic infiltration of gastrointestinal tract was noted. After recovery the patients continued R-CHOP immunochemotherapy achieving complete remission.Chłoniak rozlany z dużych komórek B (DLBCL) jest najczęstszym chłoniakiem występującym u ludzi dorosłych. Metodą referencyjną w leczeniu pierwszej linii tych chorych jest program R-CHOP zawierający rytuksymab, cyklofosfamid, winkrystynę, doksorubicynę i prednizon. W przebiegu immunochemioterapii R-CHOP można zaobserwować szereg działań niepożądanych, m.in.: powikłania związane z wlewem (zespół uwalniania cytokin, zespół lizy guza), powikłania hematologiczne, kardiologiczne, infekcje. Do rzadkich, lecz groźnych dla życia powikłańtego leczenia należą perforacje żołądka i jelit. W pracy przedstawiono opis dwóch chorych na chłoniaka DLBCL, leczonych według schematu R-CHOP, u których krótko po pierwszym cyklu doszło do perforacji jelita cienkiego. Obaj pacjenci byli operowani ze wskazań nagłych. Śródoperacyjnie nie stwierdzono u nich cech zajęcia przewodu pokarmowego przez proces nowotworowy. U jednego z nich wykonano odcinkową resekcję jelita cienkiego, u drugiego zeszyto dwuwarstwowo miejsce perforacji. Po okresie rekonwalescencji kontynuowanoleczenie systemowe według schematu R-CHOP, uzyskując całkowitą remisję choroby

Diagnostic and therapeutic quandaries in NK-cell lymphomas - a report of two cases

W niniejszej pracy przedstawiono opis przebiegu klinicznego chłoniaków z komórek naturalnej cytotoksyczności (NK). U pierwszego chorego rozpoznanie chłoniaka NK/T nosowego postawiono na podstawie wyniku badania histopatologicznego zmiany guzowatej u nasady nosa (IIA według klasyfikacji Ann Arbor). Chorego leczono według schematów CN3OP (cyklofosfamid, mitoksantron, winkrystyna, prednizon) oraz IVAC (etopozyd, ifosfamid, cytarabina), ale pomimo początkowej dobrej odpowiedzi na chemioterapię u pacjenta szybko nastąpiła progresja choroby w postaci uogólnionych zmian skórnych i zajęcia płuc. Chory zmarł po 7 miesiącach od momentu postawienia rozpoznania wśród objawów niewydolności oddechowo-krążeniowej. U drugiego chorego podstawą rozpoznania chłoniaka blastycznego z komórek NK był wynik badania histopatologicznego skóry i szpiku (IVB według klasyfikacji Ann Arbor). Chory otrzymywał chemioterapię według schematów COP (cyklofosfamid, winkrystyna, prednizon), CC (cyklofosfamid, kladrybina) oraz 2 kursy złożone z mitoksantronu, cytarabiny i etopozydu. Początkowo uzyskano częściową remisję, jednak szybko nastąpiła progresja choroby w obrębie szpiku i skóry, oporna na chemioterapię. Chory zmarł po 9 miesiącach od momentu postawienia rozpoznania z powodu krwawienia do ośrodkowego układu nerwowego w przebiegu zespołu wykrzepiania wewnątrznaczyniowego. Oba przypadki dokumentują trudności diagnostyczne i terapeutyczne w bardzo rzadko występujących w tej szerokości geograficznej chłoniakach z komórek NK.In the present paper we describe clinical course of natural killer (NK) cell lymphomas. In the first patient, diagnosis of nasal NK/T cell lymphoma was based on histopathologic examination of tumor lesion within the base of nose (Ann Arbor IIA). The patient received chemotherapy according to CN3OP (cyclophosphamide, mitoxantrone, vincristine, prednisone) and IVAC (etoposide, ifosfamide, cytarabine) protocols. His initial response to chemotherapy was good, but rapid disease progression within skin and lungs subsequently occured. The patient died due to cardio-pulmonary insufficiency 7 months after lymphoma diagnosis. In the second patient, diagnosis of blastic NK cell lymphoma was based on histopathologic findings in skin and trephine biopses. The patient was treated according to COP (cyclophosphamide, vincristine, prednisone) and CC (cyclophosphamide, cladribine) protocols and after disease progression he received 2 additional courses of mitoxantrone, etoposide and cytarabine. His initial response to chemotherapy was good, but rapid disease progression within bone marrow and skin occured. The patient zajmowadied due to central nervous system hemorrhage in the course of disseminated intravascular coagulopathy 9 months after lymphoma diagnosis. These two case reports reveal diagnostic and therapeutic difficulties of the very rare NK cell lymphomas

Non-Hodgkin lymphoma in locoregional lymph nodes in a patient with breast cancer

Współwystępowanie nowotworów jest zjawiskiem rzadkim, ale wielokrotnie opisanym. Przedstawionyopis przypadku dokumentuje przebieg wczesnego raka piersi z jednoczesnym zajęciemipsilateralnych węzłów pachowych przez chłoniaka z małych limfocytów B.The occurence of two malignancies is a rare diagnosis, but described many times previously.The presented case report is the first paper describing a patient with early breast cancer withinvolvement of ipsilateral axillary lymph nodes by small lymphocytic lymphoma

Copeptin as a Prognostic Marker in Acute Chest Pain and Suspected Acute Coronary Syndrome

: Background. In patients admitted with chest pain and suspected acute coronary syndrome (ACS), it is crucial to early identify those who are at higher risk of adverse events. The study aim was to assess the predictive value of copeptin in patients admitted to the emergency department with chest pain and nonconclusive ECG. Methods. Consecutive patients suspected for an ACS were enrolled prospectively. Copeptin and high-sensitive troponin T (hs-TnT) were measured at admission. Patients were followed up at six and 12 months for the occurrence of death and major adverse cardiac and cerebrovascular events (MACCE). Results. Among 154 patients, 11 patients died and 26 experienced MACCE. Mortality was higher in copeptin-positive than copeptin-negative patients with no difference in the rate of MACCE. Copeptin reached the AUC 0.86 (0.75-0.97) for prognosis of mortality at six and 0.77 (0.65-0.88) at 12 months. It was higher than for hs-TnT and their combination at both time points. Copeptin was a strong predictor of mortality in the Cox analysis (HR14.1 at six and HR4.3 at 12 months). Conclusions. Copeptin appears to be an independent predictor of long-term mortality in a selected population of patients suspected for an ACS. The study registration number is ISRCTN14112941

Lipid peroxidation and glutathione peroxidase activity relationship in breast cancer depends on functional polymorphism of GPX1

Functional SNPs selected for the study. Table S2. Restriction fragment analysis for BRCA1 mutations. Table S3. Oxidative stress parameters in breast cancer cases according to treatment. (DOCX 31 kb

Results of Polish Adult Leukemia Study Group (PALG) project assessing TP53 mutations with next-generation sequencing technology in relapsed and refractory chronic lymphocytic leukemia patients — an 18-month update

Indtroduction and methods: In chronic lymphocytic leukemia (CLL), molecular and cytogenetic diagnostics are crucial for the determination of accurate prognosis and treatment choice. Among different genetic aberrations, del(17p13) or TP53 mutations constitute high-risk factors, and early identification of such defects is a high priority for CLL patients. While cytogenetic diagnostics is well-established and accessible for the majority of CLL patients in Poland, molecular diagnostics of TP53 mutations is performed only in a few ERIC-certified centers (eight as of September 2020), and only two of these employ next-generation sequencing (NGS) for routine analysis of TP53 status in CLL patients. Here we report the interim results of a project assessing TP53 mutations with NGS technology in relapsed or refractory CLL patients with confirmed negative del(17p13) status. 249 patients from 32 clinical centers were included in the study. Results: NGS analysis revealed TP53 mutations in 42/249 (17%) patients, half of whom (21/249, 8.5%) had subclonal mutations (VAF ≤10%). These results are in line with published data in relapsed/refractory CLL patients. Conclusions: The results of the project demonstrated the feasibility and accuracy of NGS testing in CLL patients despite several initial logistical and technical obstacles. Our study also proved that, with appropriate funding, CLL patients from any hematological center in Poland can have access to state-of-the-art molecular diagnostic