Lung cancer in the course of chronic obstructive pulmonary disease – the clinical picture in light of current diagnostic recommendations

Introduction. Lung cancer and chronic obstructive pulmonary disease (COPD) are one of the most significant causes of death. The co-existence of COPD and lung cancer has a strong influence on treatment. Material and methods. The data were collected retrospectively from patients diagnosed with lung tumors between 2016 and 2022. Of the 982 analyzed cases, 180 patients had co-existing primary lung cancer and COPD. Results. 46.1% of the study group were women. 99.0% of patients presented a history of smoking. 46.7% patients were diagnosed with COPD during lung tumor diagnosis. 71.1% of patients suffered from non-small-cell lung cancer (NSCLC). The majority of patients had locally advanced or metastatic lung cancer. Conclusions. The high incidences of COPD as well as lung cancer among women is striking. Almost half of the patients were diagnosed with COPD while diagnosing lung tumors. A long history of smoking is still the main factor as regards developing these diseases

Lung cancer in the course of chronic obstructive pulmonary disease – the clinical picture in light of current diagnostic recommendations

Introduction. Lung cancer and chronic obstructive pulmonary disease (COPD) are one of the most significant causes of death. The co-existence of COPD and lung cancer has a strong influence on treatment. Material and methods. The data were collected retrospectively from patients diagnosed with lung tumors between 2016 and 2022. Of the 982 analyzed cases, 180 patients had co-existing primary lung cancer and COPD. Results. 46.1% of the study group were women. 99.0% of patients presented a history of smoking. 46.7% patients were diagnosed with COPD during lung tumor diagnosis. 71.1% of patients suffered from non-small-cell lung cancer (NSCLC). The majority of patients had locally advanced or metastatic lung cancer. Conclusions. The high incidences of COPD as well as lung cancer among women is striking. Almost half of the patients were diagnosed with COPD while diagnosing lung tumors. A long history of smoking is still the main factor as regards developing these diseases

Achieving Thoracic Oncology data collection in Europe: a precursor study in 35 Countries

Background: A minority of European countries have participated in international comparisons with high level data on lung cancer. However, the nature and extent of data collection across the continent is simply unknown, and without accurate data collection it is not possible to compare practice and set benchmarks to which lung cancer services can aspire.Methods: Using an established network of lung cancer specialists in 37 European countries, a survey was distributed in December 2014. The results relate to current practice in each country at the time, early 2015. The results were compiled and then verified with co-authors over the following months.Results: Thirty-five completed surveys were received which describe a range of current practice for lung cancer data collection. Thirty countries have data collection at the national level, but this is not so in Albania, Bosnia-Herzegovina, Italy, Spain and Switzerland. Data collection varied from paper records with no survival analysis, to well-established electronic databases with links to census data and survival analyses.Conclusion: Using a network of committed clinicians, we have gathered validated comparative data reporting an observed difference in data collection mechanisms across Europe. We have identified the need to develop a well-designed dataset, whilst acknowledging what is feasible within each country, and aspiring to collect high quality data for clinical research

BioVeL : a virtual laboratory for data analysis and modelling in biodiversity science and ecology

Background: Making forecasts about biodiversity and giving support to policy relies increasingly on large collections of data held electronically, and on substantial computational capability and capacity to analyse, model, simulate and predict using such data. However, the physically distributed nature of data resources and of expertise in advanced analytical tools creates many challenges for the modern scientist. Across the wider biological sciences, presenting such capabilities on the Internet (as "Web services") and using scientific workflow systems to compose them for particular tasks is a practical way to carry out robust "in silico" science. However, use of this approach in biodiversity science and ecology has thus far been quite limited. Results: BioVeL is a virtual laboratory for data analysis and modelling in biodiversity science and ecology, freely accessible via the Internet. BioVeL includes functions for accessing and analysing data through curated Web services; for performing complex in silico analysis through exposure of R programs, workflows, and batch processing functions; for on- line collaboration through sharing of workflows and workflow runs; for experiment documentation through reproducibility and repeatability; and for computational support via seamless connections to supporting computing infrastructures. We developed and improved more than 60 Web services with significant potential in many different kinds of data analysis and modelling tasks. We composed reusable workflows using these Web services, also incorporating R programs. Deploying these tools into an easy-to-use and accessible 'virtual laboratory', free via the Internet, we applied the workflows in several diverse case studies. We opened the virtual laboratory for public use and through a programme of external engagement we actively encouraged scientists and third party application and tool developers to try out the services and contribute to the activity. Conclusions: Our work shows we can deliver an operational, scalable and flexible Internet-based virtual laboratory to meet new demands for data processing and analysis in biodiversity science and ecology. In particular, we have successfully integrated existing and popular tools and practices from different scientific disciplines to be used in biodiversity and ecological research.Peer reviewe

Comparison of reorganized versus unaltered cardiology departments during the COVID-19 era: a subanalysis of the COV-HF-SIRIO 6 study

Background: Since the beginning of the coronavirus disease-2019 (COVID-19) pandemic, numerous cardiology departments were reorganized to provide care for COVID-19 patients. We aimed to compare the impact of the COVID-19 pandemic on hospital admissions and in-hospital mortality in reorganized vs. unaltered cardiology departments. Methods: The present subanalysis is a multicenter retrospective COV-HF-SIRIO 6 study that includes all patients (n = 101,433) hospitalized in 24 cardiology departments in Poland between January 1, 2019 and December 31, 2020, with a focus on patients with acute heart failure (AHF). Results: Reduction of all-cause hospitalizations was 50.6% vs. 21.3% for reorganized vs. unaltered cardiology departments in 2020 vs. 2019, respectively (p < 0.0001). Considering AHF alone respective reductions by 46.5% and 15.2% were registered (p < 0.0001). A higher percentage of patients was brought in by ambulance to reorganized vs. unaltered cardiology departments (51.7% vs. 34.6%; p < 0.0001) alongside with a lower rate of self-referrals (45.7% vs. 58.4%; p < 0.0001). The rate of all-cause in-hospital mortality in AHF patients was higher in reorganized than unaltered cardiology departments (10.9% vs. 6.4%; p < 0.0001). After the exclusion of patients with concomitant COVID-19, the mortality rates did not differ significantly (6.9% vs. 6.4%; p = 0.55). Conclusions: In cardiology departments reorganized to provide care for COVID-19 patients vs. unaltered ones, observed: i) a greater reduction in hospital admissions in 2020 vs. 2019; ii) higher rates of patients brought by ambulance and lower rates of self-referrals; and iii) higher all-cause in-hospital mortality for AHF due to COVID-19 related deaths

Evaluating the potential of ecological niche modelling as a component in marine non-indigenous species risk assessments

Marine biological invasions have increased with the development of global trading, causing the homogenization of communities and the decline of biodiversity. A main vector is ballast water exchange from shipping. This study evaluates the use of ecological niche modelling (ENM) to predict the spread of 18 non-indigenous species (NIS) along shipping routes and their potential habitat suitability (hot/cold spots) in the Baltic Sea and Northeast Atlantic. Results show that, contrary to current risk assessment methods, temperature and sea ice concentration determine habitat suitability for 61% of species, rather than salinity (11%). We show high habitat suitability for NIS in the Skagerrak and Kattegat, a transitional area for NIS entering or leaving the Baltic Sea. As many cases of NIS introduction in the marine environment are associated with shipping pathways, we explore how ENM can be used to provide valuable information on the potential spread of NIS for ballast water risk assessment

Analiza porównawcza wyników leczenia zachowawczego oraz rewaskularyzacji przezskórnej i chirurgicznej u pacjentów z istotnie zwężonym pniem głównym lewej tętnicy wieńcowej na podstawie 5-letniej obserwacji

Background and aim: Significant left main coronary artery stenosis (LMS) conveys adverse prognosis and until recently its treatment has been restricted to surgical intervention. We evaluated the long term outcome of patients with LMS treated using different approaches i.e. medical treatment, surgical (CABG, coronary artery bypass graft) and percutaneous (PCI, percutaneous coronary intervention). Methods: We analysed 450 patients with significant LMS (%DS > 50%). Group 1 (G1) included 105 patients who did not qualify for invasive treatment. Group 2 (G2) included 282 patients who underwent CABG. Group 3 (G3) comprised 67 patients who received stent into LMS. We analysed the incidence of invasive treatment complications in G2 and G3 and the overall incidence of adverse cardiac events that comprised death, repeated myocardial infarction, and the necessity of repeated revascularisation during hospital stay and long term follow-up. Results: During the 5-year follow-up, the highest mortality was noted in the G1 in comparison to G2 and G3 (31.3% vs 24.5% vs 26.8% respectively). There was no difference in mortality between G2 and G3. The incidence of myocardial infarction was the lowest in G3 (22.2%) followed by G1 (40.8%) and G2 (45.1%). No difference was detected in the occurrence of repeated PCI in LMS (G2 - 19.85%, G3 - 13.4%) and CABG (G1 - 12.2%, G2 - 10.2%, G3 - 9.0%). The incidence of target vessel revascularisation was the highest in G1, followed by G2 and G3 (69.49% vs 53.19% vs 31.35% respectively). Conclusions: Our study showed that CABG and PCI provide similar long-term outcome in patients with LMS.Wstęp: Istotne zwężenie w pniu głównym lewej tętnicy wieńcowej (LMS) wiąże się ze znacznie gorszym rokowaniem pacjenta. Jeszcze do niedawna terapia zwężenia w tym odcinku drzewa wieńcowego była zarezerwowana dla kardiochirurgów. W niniejszej pracy oceniono rokowanie długoterminowe u chorych z istotnym zwężeniem w LMS w zależności od metody leczenia: farmakologiczne, kardiochirurgiczne (CABG) i przezskórne (PCI). Metody: Analizowano populację 450 pacjentów z istotnym zwężeniem w LMS (%DS > 50%). Do Gr. 1 włączono 105 pacjentów, niezakwalifikowanych do rewaskularyzacji. Do Gr. 2 zakwalifikowano 282 chorych poddanych CABG. Natomiast u 67 pacjentów z Gr. 3 w obrębie LMS implantowano stent. W Gr. 2 i Gr. 3 oceniano częstość występowania powikłań po zabiegach rewaskularyzacji. Ponadto, w całej populacji analizowano odsetek niekorzystnych zdarzeń sercowych, tj. zgon, ponowny zawał serca i konieczność ponownej rewaskularyzacji podczas hospitalizacji oraz w obserwacji długoterminowej. Wyniki: Podczas 5-letniej obserwacji największą śmiertelność stwierdzono w Gr. 1 w porównaniu z Gr. 2 i Gr. 3 (odpowiednio 31,3% v. 24,5% v. 26,8%). Nie wykazano różnicy w częstości zgonów między Gr. 2 i Gr. 3. Ponowny zawał serca najrzadziej występował w Gr. 3 (22,2%) w porównaniu z Gr. 1 (40,8%) i Gr. 2 (45,1%). Nie zanotowano różnicy w częstości ponownej rewaskularyzacji w LMS: PCI (Gr. 2 - 19,85%; Gr. 3 - 13,4%) oraz CABG (Gr. 1 - 12,2%; Gr. 2 - 10,2%; Gr. 3 - 9,0%). W Gr. 1 w porównaniu z Gr. 2 i Gr. 3 najczęściej zachodziła konieczność wykonania TVR (odpowiednio 69,49% v. 53,19% v. 31,35%). Wnioski: Analiza badanej populacji z istotnym zwężeniem LMS wykazała, że zarówno CABG, jak i PCI wiążą się z podobnym rokowaniem długoterminowym

Lung Cancer in the Course of COPD-Emerging Problems Today

Tobacco smoking remains the main cause of tobacco-dependent diseases like lung cancer, chronic obstructive pulmonary disease (COPD), in addition to cardiovascular diseases and other cancers. Whilst the majority of smokers will not develop either COPD or lung cancer, they are closely related diseases, occurring as co-morbidities at a higher rate than if they were independently triggered by smoking. A patient with COPD has a four- to six-fold greater risk of developing lung cancer independent of smoking exposure, when compared to matched smokers with normal lung function. The 10 year risk is about 8.8% in the COPD group and only 2% in patients with normal lung function. COPD is not a uniform disorder: there are different phenotypes. One of them is manifested by the prevalence of emphysema and this is complicated by malignant processes most often. Here, we present and discuss the clinical problems of COPD in patients with lung cancer and against lung cancer in the course of COPD. There are common pathological pathways in both diseases. These are inflammation with participation of macrophages and neutrophils and proteases. It is known that anticancer immune regulation is distorted towards immunosuppression, while in COPD the elements of autoimmunity are described. Cytotoxic T cells, lymphocytes B and regulatory T cells with the important role of check point molecules are involved in both processes. A growing number of lung cancer patients are treated with immune check point inhibitors (ICIs), and it was found that COPD patients may have benefits from this treatment. Altogether, the data point to the necessity for deeper analysis and intensive research studies to limit the burden of these serious diseases by prevention and by elaboration of specific therapeutic options

Ultrasonografia wewnątrzwieńcowa z opcją wirtualnej histologii w ocenie tętnicy zstępującej przedniej u pacjentów z przemijającymi zaburzeniami kurczliwości koniuszka lewej komory

Background: Transient left ventricular ballooning syndrome (TLVBS) has been recently recognised as an acute disease mimicking myocardial infarction. Aim: We used greyscale and virtual histology (VH) intravascular ultrasound (IVUS) to study the presence and characteristics of atherosclerotic plaque in the left anterior descending (LAD) artery in patients with TLVBS. Methods: The study population consisted of 14 consecutive patients with a TLVBS diagnosis based on typical symptoms and balloon-like left ventricle abnormalities. The IVUS imaging and analysis included at least the mid and proximal segments of each LAD. Virtual histology (VH)-IVUS analysis colour-coded plaque as calcific, fibrotic, fibrofatty, and necrotic core; VH-IVUS-derived thin-cap fibroatheroma (TCFA) and high-risk plaques were identified. Results: The total length of the IVUS-analysed LAD averaged 55 ± 14 mm. Greyscale analysis revealed a mean plaque burden of 28.9 ± 11%. There were 7 ruptured plaques; these were present in mid-segments of the LAD in 3 patients, and in the proximal segment in 4 patients. The VH-TCFAs were found in 8 patients, while the remaining 6 patients had a necrotic core > 25%. The average number of VH-TCFAs was 4.8 ± 2.9 per patient. Combining greyscale and VH-IVUS data, 8 patients had either a ruptured plaque or a VH-TCFA, while the other 6 patients had a necrotic core > 25%. The distance from the coronary ostium to the cross-sections with a VH-TFCA was 20 ± 2.8 mm. Conclusions: Vulnerable plaques are observed in patients with TLVBS. Our findings support the hypothesis that TLVBS may be related to the natural course of atherosclerotic plaque development. Further study into the relations between vulnerable plaque surface, platelet activity and subsequent thrombus formation is needed in this population. Kardiol Pol 2010; 68, 10: 1093-1098Wstęp: Zespół przemijających zaburzeń kurczliwości koniuszka lewej komory (TLVBS) został niedawno opisany jako zespół objawów imitujących ostry zawał serca. Cel: Celem niniejszej pracy była ocena blaszki miażdżycowej w tętnicy przedniej zstępującej za pomocą ultrasonografii wewnątrzwieńcowej. Metody: Badaniem objęto 14 kolejnych pacjentów z TLVBS, zdiagnozowanych na podstawie typowych objawów klinicznych i obrazu wentrykulografii lewostronnej. U wszystkich chorych wykonano ultrasonografię wewnątrzwieńcową w zakresie proksymalnych i środkowych segmentów tętnicy przedniej zstępującej, ze szczególnym uwzględnieniem charakterystyki blaszki miażdżycowej (zwapniała, włóknista, włóknisto-tłuszczowa i martwicza). Analizie poddano także obecność blaszki z cienką czapeczką łącznotkankową (TCFA). Wyniki: Średnia długość analizowanego segmentu tętnicy wyniosła 55 ± 14 mm, a objętość blaszki miażdżycowej 28,9 ± 11%. U 7 pacjentów stwierdzono cechy pękniętej blaszki miażdżycowej, z czego 3 były zlokalizowane w segmencie środkowym tętnicy, natomiast 4 w segmencie proksymalnym. Obecność TCFA stwierdzono u 8 osób, natomiast u pozostałych 6 były obecne blaszki miażdżycowe z martwiczym rdzeniem przekraczającym 25% objętości. Średnia liczba blaszek typu TCFA wyniosła 4,8 ± 2,9. U 8 pacjentów stwierdzono TCFA lub pęknięte blaszki miażdżycowe. Średnia odległość ujścia tętnicy do przekroju z TFCA wyniosła 20 ± 2,8 mm. Wnioski: U pacjentów z TLVBS stwierdza się potencjalnie niestabilnie blaszki miażdżycowe. Uzyskane wyniki potwierdzają hipotezę, że TLVBS może się wiązać z naturalnym rozwojem miażdżycy. Należy przeprowadzić kolejne badania oceniające aktywność blaszki i płytek krwi z następczym tworzeniem zakrzepu. Kardiol Pol 2010; 68, 10: 1093-109