1
|
Stastna N, Kunovsky L, Svoboda M, Pokojova E, Homola L, Mala M, Gracova Z, Jerabkova B, Skrickova J, Trna J. Improved nutritional outcomes and gastrointestinal symptoms in adult cystic fibrosis patients treated with elexacaftor/tezacaftor/ivacaftor. Dig Dis 2024:000538606. [PMID: 38569478 DOI: 10.1159/000538606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 03/27/2024] [Indexed: 04/05/2024]
Abstract
INTRODUCTION CFTR modulator therapy improves nutritional status and quality of life. Clinical trials have shown pancreatic insufficiency conversion, mostly in pediatric patients treated with ivacaftor. Studies with elexacaftor/tezacaftor/ivacaftor (ETI) in older patients have not suggested restoration of exocrine pancreas function, but quality data in adults are lacking. Our aim was to show the effect of ETI in adults with CF on nutritional status and digestive function. We hypothesized improvement of nutritional parameters and gastrointestinal symptoms, reduction of pancreatic enzyme replacement therapy, but uncertain improvement in exocrine pancreatic function. METHODS We prospectively enrolled adults with CF treated with ETI from August 2021 to June 2022. We measured anthropometric parameters, laboratory nutritional markers, change of fecal elastase, pancreatic enzymes replacement therapy needs, and gastrointestinal symptoms. RESULTS In the cohort of 29 patients (mean age 29.1 years), 82.8% suffered exocrine pancreatic insufficiency. After ETI, mean BMI increased by 1.20 kg/m2 (p < 0.001), mean body weight by 3.51 kg (p < 0.001), albumin by 2.81 g/L, and prealbumin by 0.06 (both p < 0.001). Only one patient, initially pancreatic insufficient (4.5%, p < 0.001), developed pancreatic sufficiency, indicated by increased fecal elastase from 45 µg/g to 442.1 µg/g. Mean change in lipase substitution decreased by 1,969 units/kg/day (p < 0.001) and stools frequency by 1.18 per day (p < 0.001). CONCLUSION Our data suggest increased nutritional parameters, lower pancreatic substitution requirements, and improved defecation in adult CF patients on ETI. Improvement in exocrine pancreatic function might be mutation-specific and needs further study.
Collapse
|
2
|
Vetrovsky T, Siranec M, Frybova T, Gant I, Svobodova I, Linhart A, Parenica J, Miklikova M, Sujakova L, Pospisil D, Pelouch R, Odrazkova D, Parizek P, Precek J, Hutyra M, Taborsky M, Vesely J, Griva M, Semerad M, Bunc V, Hrabcova K, Vojkuvkova A, Svoboda M, Belohlavek J. Lifestyle Walking Intervention for Patients With Heart Failure With Reduced Ejection Fraction: The WATCHFUL Trial. Circulation 2024; 149:177-188. [PMID: 37955615 PMCID: PMC10782943 DOI: 10.1161/circulationaha.123.067395] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 10/13/2023] [Indexed: 11/14/2023]
Abstract
BACKGROUND Physical activity is pivotal in managing heart failure with reduced ejection fraction, and walking integrated into daily life is an especially suitable form of physical activity. This study aimed to determine whether a 6-month lifestyle walking intervention combining self-monitoring and regular telephone counseling improves functional capacity assessed by the 6-minute walk test (6MWT) in patients with stable heart failure with reduced ejection fraction compared with usual care. METHODS The WATCHFUL trial (Pedometer-Based Walking Intervention in Patients With Chronic Heart Failure With Reduced Ejection Fraction) was a 6-month multicenter, parallel-group randomized controlled trial recruiting patients with heart failure with reduced ejection fraction from 6 cardiovascular centers in the Czech Republic. Eligible participants were ≥18 years of age, had left ventricular ejection fraction <40%, and had New York Heart Association class II or III symptoms on guidelines-recommended medication. Individuals exceeding 450 meters on the baseline 6MWT were excluded. Patients in the intervention group were equipped with a Garmin vívofit activity tracker and received monthly telephone counseling from research nurses who encouraged them to use behavior change techniques such as self-monitoring, goal-setting, and action planning to increase their daily step count. The patients in the control group continued usual care. The primary outcome was the between-group difference in the distance walked during the 6MWT at 6 months. Secondary outcomes included daily step count and minutes of moderate to vigorous physical activity as measured by the hip-worn Actigraph wGT3X-BT accelerometer, NT-proBNP (N-terminal pro-B-type natriuretic peptide) and high-sensitivity C-reactive protein biomarkers, ejection fraction, anthropometric measures, depression score, self-efficacy, quality of life, and survival risk score. The primary analysis was conducted by intention to treat. RESULTS Of 218 screened patients, 202 were randomized (mean age, 65 years; 22.8% female; 90.6% New York Heart Association class II; median left ventricular ejection fraction, 32.5%; median 6MWT, 385 meters; average 5071 steps/day; average 10.9 minutes of moderate to vigorous physical activity per day). At 6 months, no between-group differences were detected in the 6MWT (mean 7.4 meters [95% CI, -8.0 to 22.7]; P=0.345, n=186). The intervention group increased their average daily step count by 1420 (95% CI, 749 to 2091) and daily minutes of moderate to vigorous physical activity by 8.2 (95% CI, 3.0 to 13.3) over the control group. No between-group differences were detected for any other secondary outcomes. CONCLUSIONS Whereas the lifestyle intervention in patients with heart failure with reduced ejection fraction improved daily steps by about 25%, it failed to demonstrate a corresponding improvement in functional capacity. Further research is needed to understand the lack of association between increased physical activity and functional outcomes. REGISTRATION URL: https://www.clinicaltrials.gov; Unique identifier: NCT03041610.
Collapse
Affiliation(s)
- Tomas Vetrovsky
- Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic (T.V., M. Semerad, V.B.)
| | - Michal Siranec
- 2nd Department of Medicine, Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Czech Republic (M. Siranec, T.F., I.G., I.S., A.L., J.B.)
| | - Tereza Frybova
- 2nd Department of Medicine, Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Czech Republic (M. Siranec, T.F., I.G., I.S., A.L., J.B.)
| | - Iulian Gant
- 2nd Department of Medicine, Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Czech Republic (M. Siranec, T.F., I.G., I.S., A.L., J.B.)
| | - Iveta Svobodova
- 2nd Department of Medicine, Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Czech Republic (M. Siranec, T.F., I.G., I.S., A.L., J.B.)
| | - Ales Linhart
- 2nd Department of Medicine, Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Czech Republic (M. Siranec, T.F., I.G., I.S., A.L., J.B.)
| | - Jiri Parenica
- Department of Internal Medicine and Cardiology, University Hospital Brno and Faculty of Medicine of Masaryk University, Brno, Czech Republic (J.P., M.M., L.S., D.P.)
| | - Marie Miklikova
- Department of Internal Medicine and Cardiology, University Hospital Brno and Faculty of Medicine of Masaryk University, Brno, Czech Republic (J.P., M.M., L.S., D.P.)
| | - Lenka Sujakova
- Department of Internal Medicine and Cardiology, University Hospital Brno and Faculty of Medicine of Masaryk University, Brno, Czech Republic (J.P., M.M., L.S., D.P.)
| | - David Pospisil
- Department of Internal Medicine and Cardiology, University Hospital Brno and Faculty of Medicine of Masaryk University, Brno, Czech Republic (J.P., M.M., L.S., D.P.)
| | - Radek Pelouch
- 1st Department of Internal Medicine, Cardioangiology, Faculty of Medicine in Hradec Kralove, Charles University in Prague and University Hospital Hradec Kralove, Czech Republic (R.P., D.O., P.P.)
| | - Daniela Odrazkova
- 1st Department of Internal Medicine, Cardioangiology, Faculty of Medicine in Hradec Kralove, Charles University in Prague and University Hospital Hradec Kralove, Czech Republic (R.P., D.O., P.P.)
| | - Petr Parizek
- 1st Department of Internal Medicine, Cardioangiology, Faculty of Medicine in Hradec Kralove, Charles University in Prague and University Hospital Hradec Kralove, Czech Republic (R.P., D.O., P.P.)
| | - Jan Precek
- Department of Internal Medicine 1, Cardiology, University Hospital Olomouc, Czech Republic (J.P., M.H., M.T.)
| | - Martin Hutyra
- Department of Internal Medicine 1, Cardiology, University Hospital Olomouc, Czech Republic (J.P., M.H., M.T.)
| | - Milos Taborsky
- Department of Internal Medicine 1, Cardiology, University Hospital Olomouc, Czech Republic (J.P., M.H., M.T.)
| | - Jiri Vesely
- Edumed sro, Broumov, and Faculty of Medicine in Hradec Kralove, Charles University, Prague, Czech Republic (J.V.)
| | - Martin Griva
- Department of Cardiology, Tomas Bata Regional Hospital, Zlin, Czech Republic (M.G.)
| | - Miroslav Semerad
- Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic (T.V., M. Semerad, V.B.)
| | - Vaclav Bunc
- Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic (T.V., M. Semerad, V.B.)
| | - Karolina Hrabcova
- Institute of Biostatistics and Analyses, Ltd, Brno, Czech Republic (K.H., A.V., M. Svoboda)
| | - Adela Vojkuvkova
- Institute of Biostatistics and Analyses, Ltd, Brno, Czech Republic (K.H., A.V., M. Svoboda)
| | - Michal Svoboda
- Institute of Biostatistics and Analyses, Ltd, Brno, Czech Republic (K.H., A.V., M. Svoboda)
| | - Jan Belohlavek
- 2nd Department of Medicine, Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Czech Republic (M. Siranec, T.F., I.G., I.S., A.L., J.B.)
| |
Collapse
|
3
|
Priščáková P, Svoboda M, Feketová Z, Hutník J, Repiská V, Gbelcová H, Gergely L. Syncytin-1, syncytin-2 and suppressyn in human health and disease. J Mol Med (Berl) 2023; 101:1527-1542. [PMID: 37855856 PMCID: PMC10697888 DOI: 10.1007/s00109-023-02385-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 10/06/2023] [Accepted: 10/09/2023] [Indexed: 10/20/2023]
Abstract
In this review, we summarized the results of experimental and clinical studies about three human endogenous retroviruses and their products-syncytin-1, syncytin-2, and suppressyn in human physiology and pathophysiology. We summed up the described connection with various pathological processes and diseases, mainly with pregnancy-induced hypertensive diseases such as preeclampsia, oncogenesis, gestational trophoblastic disease, and multiple sclerosis. Supposed mechanisms of action and the potential of clinical applications are also described.
Collapse
Affiliation(s)
- Petra Priščáková
- Institute of Medical Biology, Genetics and Clinical Genetics, Faculty of Medicine, Comenius University Bratislava, Sasinkova 4, Bratislava, 811 08, Slovak Republic
| | - Michal Svoboda
- Institute of Medical Biology, Genetics and Clinical Genetics, Faculty of Medicine, Comenius University Bratislava, Sasinkova 4, Bratislava, 811 08, Slovak Republic
| | - Zuzana Feketová
- Institute of Medical Biology, Genetics and Clinical Genetics, Faculty of Medicine, Comenius University Bratislava, Sasinkova 4, Bratislava, 811 08, Slovak Republic
| | - Juraj Hutník
- Institute of Medical Biology, Genetics and Clinical Genetics, Faculty of Medicine, Comenius University Bratislava, Sasinkova 4, Bratislava, 811 08, Slovak Republic
| | - Vanda Repiská
- Institute of Medical Biology, Genetics and Clinical Genetics, Faculty of Medicine, Comenius University Bratislava, Sasinkova 4, Bratislava, 811 08, Slovak Republic
| | - Helena Gbelcová
- Institute of Medical Biology, Genetics and Clinical Genetics, Faculty of Medicine, Comenius University Bratislava, Sasinkova 4, Bratislava, 811 08, Slovak Republic
| | - Lajos Gergely
- Institute of Medical Biology, Genetics and Clinical Genetics, Faculty of Medicine, Comenius University Bratislava, Sasinkova 4, Bratislava, 811 08, Slovak Republic.
| |
Collapse
|
4
|
Koblizek V, Milenkovic B, Svoboda M, Kocianova J, Holub S, Zindr V, Ilic M, Jankovic J, Cupurdija V, Jarkovsky J, Popov B, Valipour A. RETRO-POPE: A Retrospective, Multicenter, Real-World Study of All-Cause Mortality in COPD. Int J Chron Obstruct Pulmon Dis 2023; 18:2661-2672. [PMID: 38022829 PMCID: PMC10661906 DOI: 10.2147/copd.s426919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 11/09/2023] [Indexed: 12/01/2023] Open
Abstract
Purpose The Phenotypes of COPD in Central and Eastern Europe (POPE) study assessed the prevalence and clinical characteristics of four clinical COPD phenotypes, but not mortality. This retrospective analysis of the POPE study (RETRO-POPE) investigated the relationship between all-cause mortality and patient characteristics using two grouping methods: clinical phenotyping (as in POPE) and Burgel clustering, to better identify high-risk patients. Patients and Methods The two largest POPE study patient cohorts (Czech Republic and Serbia) were categorized into one of four clinical phenotypes (acute exacerbators [with/without chronic bronchitis], non-exacerbators, asthma-COPD overlap), and one of five Burgel clusters based on comorbidities, lung function, age, body mass index (BMI) and dyspnea (very severe comorbid, very severe respiratory, moderate-to-severe respiratory, moderate-to-severe comorbid/obese, and mild respiratory). Patients were followed-up for approximately 7 years for survival status. Results Overall, 801 of 1,003 screened patients had sufficient data for analysis. Of these, 440 patients (54.9%) were alive and 361 (45.1%) had died at the end of follow-up. Analysis of survival by clinical phenotype showed no significant differences between the phenotypes (P=0.211). However, Burgel clustering demonstrated significant differences in survival between clusters (P<0.001), with patients in the "very severe comorbid" and "very severe respiratory" clusters most likely to die. Overall survival was not significantly different between Serbia and the Czech Republic after adjustment for age, BMI, comorbidities and forced expiratory volume in 1 second (hazard ratio [HR] 0.80, 95% confidence interval [CI] 0.65-0.99; P=0.036 [unadjusted]; HR 0.88, 95% CI 0.7-1.1; P=0.257 [adjusted]). The most common causes of death were respiratory-related (36.8%), followed by cardiovascular (25.2%) then neoplasm (15.2%). Conclusion Patient clusters based on comorbidities, lung function, age, BMI and dyspnea were more likely to show differences in COPD mortality risk than phenotypes defined by exacerbation history and presence/absence of chronic bronchitis and/or asthmatic features.
Collapse
Affiliation(s)
- Vladimir Koblizek
- Department of Pneumology, University Hospital, Hradec Kralove, Czech Republic
- Faculty of Medicine Hradec Kralove, Charles University, Hradec Kralove, Czech Republic
| | - Branislava Milenkovic
- Clinic for Pulmonary Diseases, Clinical Center of Serbia, Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Michal Svoboda
- Institute of Biostatistics and Analyses Ltd., Brno, Czech Republic
- Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Jana Kocianova
- Outpatient Department of Pneumology Alveolus, APRO MED, Ostrava, Czech Republic
| | - Stanislav Holub
- Outpatient Chest Clinic, Plicni Stredisko Teplice Ltd., Teplice, Czech Republic
| | - Vladimir Zindr
- Outpatient Chest Clinic, PNEUMO KV Ltd., Karlovy Vary, Czech Republic
| | - Miroslav Ilic
- Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
- Clinic for Tuberculosis and Interstitial Lung Diseases, PolyClinic Department, Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, Serbia
| | - Jelena Jankovic
- Clinic for Pulmonary Diseases, Clinical Center of Serbia, Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Vojislav Cupurdija
- Department of Internal Medicine, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
- Clinic for Pulmonology, University Clinical Center Kragujevac, Kragujevac, Serbia
| | - Jiri Jarkovsky
- Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Boris Popov
- Medicine Department, Boehringer Ingelheim Serbia d.o.o. Beograd, Belgrade, Serbia
| | - Arschang Valipour
- Karl Landsteiner Institute for Lung Research and Pulmonary Oncology, Klinik Floridsdorf, Vienna Health Care Group, Vienna, Austria
| |
Collapse
|
5
|
Grombirikova H, Bily V, Soucek P, Kramarek M, Hakl R, Ballonova L, Ravcukova B, Ricna D, Kozena K, Kratochvilova L, Sobotkova M, Zachova R, Kuklinek P, Kralickova P, Krcmova I, Hanzlikova J, Vachova M, Krystufkova O, Dankova E, Jesenak M, Novackova M, Svoboda M, Litzman J, Freiberger T. Systematic Approach Revealed SERPING1 Splicing-Affecting Variants to be Highly Represented in the Czech National HAE Cohort. J Clin Immunol 2023; 43:1974-1991. [PMID: 37620742 PMCID: PMC10661775 DOI: 10.1007/s10875-023-01565-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 08/02/2023] [Indexed: 08/26/2023]
Abstract
Hereditary angioedema due to C1 inhibitor deficiency (C1-INH-HAE) is a rare and life-threatening condition characterized by recurrent localized edema. We conducted a systematic screening of SERPING1 defects in a cohort of 207 Czech patients from 85 families with C1-INH-HAE. Our workflow involved a combined strategy of sequencing extended to UTR and deep intronic regions, advanced in silico prediction tools, and mRNA-based functional assays. This approach allowed us to detect a causal variant in all families except one and to identify a total of 56 different variants, including 5 novel variants that are likely to be causal. We further investigated the functional impact of two splicing variants, namely c.550 + 3A > C and c.686-7C > G using minigene assays and RT-PCR mRNA analysis. Notably, our cohort showed a considerably higher proportion of detected splicing variants compared to other central European populations and the LOVD database. Moreover, our findings revealed a significant association between HAE type 1 missense variants and a delayed HAE onset when compared to null variants. We also observed a significant correlation between the presence of the SERPING1 variant c.-21 T > C in the trans position to causal variants and the frequency of attacks per year, disease onset, as well as Clinical severity score. Overall, our study provides new insights into the genetic landscape of C1-INH-HAE in the Czech population, including the identification of novel variants and a better understanding of genotype-phenotype correlations. Our findings also highlight the importance of comprehensive screening strategies and functional analyses in improving the C1-INH-HAE diagnosis and management.
Collapse
Affiliation(s)
- Hana Grombirikova
- Centre for Cardiovascular Surgery and Transplantation, Brno, Czech Republic
- Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Viktor Bily
- Centre for Cardiovascular Surgery and Transplantation, Brno, Czech Republic
- Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Premysl Soucek
- Centre for Cardiovascular Surgery and Transplantation, Brno, Czech Republic
- Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Michal Kramarek
- Centre for Cardiovascular Surgery and Transplantation, Brno, Czech Republic
- Faculty of Medicine, Masaryk University, Brno, Czech Republic
- Faculty of Science, Masaryk University, Brno, Czech Republic
| | - Roman Hakl
- Faculty of Medicine, Masaryk University, Brno, Czech Republic
- Department of Allergology and Clinical Immunology, St. Anne's University Hospital in Brno, Brno, Czech Republic
| | - Lucie Ballonova
- Centre for Cardiovascular Surgery and Transplantation, Brno, Czech Republic
- Faculty of Science, Masaryk University, Brno, Czech Republic
| | - Barbora Ravcukova
- Centre for Cardiovascular Surgery and Transplantation, Brno, Czech Republic
| | - Dita Ricna
- Centre for Cardiovascular Surgery and Transplantation, Brno, Czech Republic
| | - Karolina Kozena
- Centre for Cardiovascular Surgery and Transplantation, Brno, Czech Republic
- Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | | | - Marta Sobotkova
- Department of Immunology, 2nd Medical School, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Radana Zachova
- Department of Immunology, 2nd Medical School, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Pavel Kuklinek
- Faculty of Science, Masaryk University, Brno, Czech Republic
| | - Pavlina Kralickova
- Institute of Clinical Immunology and Allergy, University Hospital Hradec Kralove, Faculty of Medicine in Hradec Kralove, Charles University, Hradec Kralove, Czech Republic
| | - Irena Krcmova
- Institute of Clinical Immunology and Allergy, University Hospital Hradec Kralove, Faculty of Medicine in Hradec Kralove, Charles University, Hradec Kralove, Czech Republic
| | - Jana Hanzlikova
- Department of Immunology and Allergology, University Hospital Pilsen, Pilsen, Czech Republic
| | - Martina Vachova
- Department of Immunology and Allergology, University Hospital Pilsen, Pilsen, Czech Republic
- Department of Immunology and Allergology, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic
| | - Olga Krystufkova
- Institute of Rheumatology and Department of Rheumatology, 1st Faculty of Medicine, Charles University, Prague, Czech Republic
| | | | - Milos Jesenak
- National Centre for Hereditary Angioedema, Department of Pediatrics, Department of Pulmonology and Pathophysiology, Department of Clinical Immunology and Allergology, Comenius University in Bratislava, Jessenius Faculty of Medicine, University Teaching Hospital in Martin, Martin, Slovakia
| | | | - Michal Svoboda
- Institute of Biostatistics and Analyses, Ltd., Brno, Czech Republic
| | - Jiri Litzman
- Faculty of Medicine, Masaryk University, Brno, Czech Republic
- Department of Allergology and Clinical Immunology, St. Anne's University Hospital in Brno, Brno, Czech Republic
| | - Tomas Freiberger
- Centre for Cardiovascular Surgery and Transplantation, Brno, Czech Republic.
- Faculty of Medicine, Masaryk University, Brno, Czech Republic.
| |
Collapse
|
6
|
Svoboda M, Lohajova Behulova R, Slamka T, Sebest L, Repiska V. Comprehensive Genomic Profiling in Predictive Testing of Cancer. Physiol Res 2023; 72:S267-S275. [PMID: 37888970 PMCID: PMC10669951 DOI: 10.33549/physiolres.935154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 06/07/2023] [Indexed: 12/01/2023] Open
Abstract
Despite the rapid progress in the field of personalized medicine and the efforts to apply specific treatment strategies to patients based on the presence of pathogenic variants in one, two, or three genes, patient response to the treatment in terms of positive benefit and overall survival remains heterogeneous. However, advances in sequencing and bioinformatics technologies have facilitated the simultaneous examination of somatic variants in tens to thousands of genes in tumor tissue, enabling the determination of personalized management based on the patient's comprehensive genomic profile (CGP). CGP has the potential to enhance clinical decision-making and personalize innovative treatments for individual patients, by providing oncologists with a more comprehensive molecular characterization of tumors. This study aimed to highlight the utility of CGP in routine clinical practice. Here we present three patient cases with various advanced cancer indicated for CGP analysis using a combination of SOPHiA Solid Tumor Solution (STS, 42 genes) for DNA and SOPHiA RNAtarget Oncology Solution (ROS, 45 genes and 17 gene fusions with any random partners) for RNA. We were able to identify actionable genomic alterations in all three cases, thereby presenting valuable information for future management of these patients. This approach has the potential to transform clinical practice and greatly improve patient outcomes in the field of oncology.
Collapse
Affiliation(s)
- M Svoboda
- Institute of Medical Biology, Genetics and Clinical Genetics, Faculty of Medicine, Comenius University, Bratislava, Slovak Republic.
| | | | | | | | | |
Collapse
|
7
|
Pourali P, Dzmitruk V, Benada O, Svoboda M, Benson V. Conjugation of microbial-derived gold nanoparticles to different types of nucleic acids: evaluation of transfection efficiency. Sci Rep 2023; 13:14669. [PMID: 37674013 PMCID: PMC10482973 DOI: 10.1038/s41598-023-41567-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 08/29/2023] [Indexed: 09/08/2023] Open
Abstract
In this study, gold nanoparticles produced by eukaryotic cell waste (AuNP), were analyzed as a transfection tool. AuNP were produced by Fusarium oxysporum and analyzed by spectrophotometry, transmission electron microscopy (TEM), scanning electron microscopy (SEM), and energy dispersive X-ray spectroscopy (EDS). Fourier transform infrared spectroscopy (FTIR) and dynamic light scattering (DLS) were used before and after conjugation with different nucleic acid (NA) types. Graphite furnace atomic absorption spectroscopy (GF-AAS) was used to determine the AuNP concentration. Conjugation was detected by electrophoresis. Confocal microscopy and quantitative real-time PCR (qPCR) were used to assess transfection. TEM, SEM, and EDS showed 25 nm AuNP with round shape. The amount of AuNP was 3.75 ± 0.2 µg/µL and FTIR proved conjugation of all NA types to AuNP. All the samples had a negative charge of - 36 to - 46 mV. Confocal microscopy confirmed internalization of the ssRNA-AuNP into eukaryotic cells and qPCR confirmed release and activity of carried RNA.
Collapse
Affiliation(s)
- P Pourali
- Institute of Microbiology, Czech Academy of Sciences, Prague, Czech Republic
| | - V Dzmitruk
- Center of Molecular Structure, Institute of Biotechnology, Czech Academy of Sciences, Vesec, Czech Republic
| | - O Benada
- Institute of Microbiology, Czech Academy of Sciences, Prague, Czech Republic
| | - M Svoboda
- Institute of Analytical Chemistry, Czech Academy of Sciences, Brno, Czech Republic
| | - V Benson
- Institute of Microbiology, Czech Academy of Sciences, Prague, Czech Republic.
| |
Collapse
|
8
|
Stastna N, Brat K, Heroutova M, Svoboda M, Cundrle I. Endobronchial cryobiopsy may shorten the time to cancer diagnosis: a retrospective study. ERJ Open Res 2023; 9:00179-2023. [PMID: 37650086 PMCID: PMC10463030 DOI: 10.1183/23120541.00179-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 06/14/2023] [Indexed: 09/01/2023] Open
Abstract
Endobronchial cryobiopsy from visualised intraluminal tumour lesions may decrease the rate of diagnostic failure and shorten the time to diagnosis https://bit.ly/3NkyJ98.
Collapse
Affiliation(s)
- Nela Stastna
- Department of Respiratory Diseases, University Hospital Brno, Brno, Czech Republic
- Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Kristian Brat
- Department of Respiratory Diseases, University Hospital Brno, Brno, Czech Republic
- Faculty of Medicine, Masaryk University, Brno, Czech Republic
- International Clinical Research Center, St Anne's University Hospital, Brno, Czech Republic
| | - Michaela Heroutova
- Department of Respiratory Diseases, University Hospital Brno, Brno, Czech Republic
| | - Michal Svoboda
- Institute of Biostatistics and Analyses, Ltd, Brno, Czech Republic
| | - Ivan Cundrle
- Faculty of Medicine, Masaryk University, Brno, Czech Republic
- International Clinical Research Center, St Anne's University Hospital, Brno, Czech Republic
- Department of Anesthesiology and Intensive Care, St Anne's University Hospital, Brno, Czech Republic
| |
Collapse
|
9
|
Cundrle I, Merta Z, Bratova M, Homolka P, Mitas L, Sramek V, Svoboda M, Chovanec Z, Chobola M, Olson LJ, Brat K. The risk of post-operative pulmonary complications in lung resection candidates with normal forced expiratory volume in 1 s and diffusing capacity of the lung for carbon monoxide: a prospective multicentre study. ERJ Open Res 2023; 9:00421-2022. [PMID: 36891072 PMCID: PMC9986753 DOI: 10.1183/23120541.00421-2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 11/02/2022] [Indexed: 11/27/2022] Open
Abstract
Introduction According to the guidelines for preoperative assessment of lung resection candidates, patients with normal forced expiratory volume in 1 s (FEV1) and diffusing capacity of the lung for carbon monoxide (D LCO) are at low risk for post-operative pulmonary complications (PPC). However, PPC affect hospital length of stay and related healthcare costs. We aimed to assess risk of PPC for lung resection candidates with normal FEV1 and D LCO (>80% predicted) and identify factors associated with PPC. Methods 398 patients were prospectively studied at two centres between 2017 and 2021. PPC were recorded from the first 30 post-operative days. Subgroups of patients with and without PPC were compared and factors with significant difference were analysed by uni- and multivariate logistic regression. Results 188 subjects had normal FEV1 and D LCO. Of these, 17 patients (9%) developed PPC. Patients with PPC had significantly lower pressure of end-tidal carbon dioxide (P ETCO2 ) at rest (27.7 versus 29.9; p=0.033) and higher ventilatory efficiency (V'E/V'CO2 ) slope (31.1 versus 28; p=0.016) compared to those without PPC. Multivariate models showed association between resting P ETCO2 (OR 0.872; p=0.035) and V'E/V'CO2 slope (OR 1.116; p=0.03) and PPC. In both models, thoracotomy was strongly associated with PPC (OR 6.419; p=0.005 and OR 5.884; p=0.007, respectively). Peak oxygen consumption failed to predict PPC (p=0.917). Conclusions Resting P ETCO2 adds incremental information for risk prediction of PPC in patients with normal FEV1 and D LCO. We propose resting P ETCO2 be an additional parameter to FEV1 and D LCO for preoperative risk stratification.
Collapse
Affiliation(s)
- Ivan Cundrle
- Department of Anesthesiology and Intensive Care, St. Anne's University Hospital, Brno, Czech Republic.,Faculty of Medicine, Masaryk University, Brno, Czech Republic.,International Clinical Research Center, St. Anne's University Hospital, Brno, Czech Republic
| | - Zdenek Merta
- Faculty of Medicine, Masaryk University, Brno, Czech Republic.,Department of Respiratory Diseases, University Hospital Brno, Brno, Czech Republic
| | - Monika Bratova
- Faculty of Medicine, Masaryk University, Brno, Czech Republic.,Department of Respiratory Diseases, University Hospital Brno, Brno, Czech Republic
| | - Pavel Homolka
- International Clinical Research Center, St. Anne's University Hospital, Brno, Czech Republic.,Department of Sports Medicine and Rehabilitation, St. Anne's University Hospital, Brno, Czech Republic
| | - Ladislav Mitas
- Faculty of Medicine, Masaryk University, Brno, Czech Republic.,Department of Surgery, University Hospital Brno, Brno, Czech Republic
| | - Vladimir Sramek
- Department of Anesthesiology and Intensive Care, St. Anne's University Hospital, Brno, Czech Republic.,Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Michal Svoboda
- Faculty of Medicine, Masaryk University, Brno, Czech Republic.,Institute of Biostatistics and Analyses Ltd, Brno, Czech Republic
| | - Zdenek Chovanec
- Faculty of Medicine, Masaryk University, Brno, Czech Republic.,International Clinical Research Center, St. Anne's University Hospital, Brno, Czech Republic.,First Department of Surgery, St. Anne's University Hospital, Brno, Czech Republic
| | - Milos Chobola
- Department of Anesthesiology and Intensive Care, St. Anne's University Hospital, Brno, Czech Republic.,Faculty of Medicine, Masaryk University, Brno, Czech Republic.,International Clinical Research Center, St. Anne's University Hospital, Brno, Czech Republic
| | - Lyle J Olson
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA
| | - Kristian Brat
- Faculty of Medicine, Masaryk University, Brno, Czech Republic.,International Clinical Research Center, St. Anne's University Hospital, Brno, Czech Republic.,Department of Respiratory Diseases, University Hospital Brno, Brno, Czech Republic
| |
Collapse
|
10
|
Ostadal P, Rokyta R, Karasek J, Kruger A, Vondrakova D, Janotka M, Naar J, Smalcova J, Hubatova M, Hromadka M, Volovar S, Seyfrydova M, Jarkovsky J, Svoboda M, Linhart A, Belohlavek J. Extracorporeal Membrane Oxygenation in the Therapy of Cardiogenic Shock: Results of the ECMO-CS Randomized Clinical Trial. Circulation 2023; 147:454-464. [PMID: 36335478 DOI: 10.1161/circulationaha.122.062949] [Citation(s) in RCA: 98] [Impact Index Per Article: 98.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 10/31/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is increasingly being used for circulatory support in patients with cardiogenic shock, although the evidence supporting its use in this context remains insufficient. The ECMO-CS trial (Extracorporeal Membrane Oxygenation in the Therapy of Cardiogenic Shock) aimed to compare immediate implementation of VA-ECMO versus an initially conservative therapy (allowing downstream use of VA-ECMO) in patients with rapidly deteriorating or severe cardiogenic shock. METHODS This multicenter, randomized, investigator-initiated, academic clinical trial included patients with either rapidly deteriorating or severe cardiogenic shock. Patients were randomly assigned to immediate VA-ECMO or no immediate VA-ECMO. Other diagnostic and therapeutic procedures were performed as per current standards of care. In the early conservative group, VA-ECMO could be used downstream in case of worsening hemodynamic status. The primary end point was the composite of death from any cause, resuscitated circulatory arrest, and implementation of another mechanical circulatory support device at 30 days. RESULTS A total of 122 patients were randomized; after excluding 5 patients because of the absence of informed consent, 117 subjects were included in the analysis, of whom 58 were randomized to immediate VA-ECMO and 59 to no immediate VA-ECMO. The composite primary end point occurred in 37 (63.8%) and 42 (71.2%) patients in the immediate VA-ECMO and the no early VA-ECMO groups, respectively (hazard ratio, 0.72 [95% CI, 0.46-1.12]; P=0.21). VA-ECMO was used in 23 (39%) of no early VA-ECMO patients. The 30-day incidence of resuscitated cardiac arrest (10.3.% versus 13.6%; risk difference, -3.2 [95% CI, -15.0 to 8.5]), all-cause mortality (50.0% versus 47.5%; risk difference, 2.5 [95% CI, -15.6 to 20.7]), serious adverse events (60.3% versus 61.0%; risk difference, -0.7 [95% CI, -18.4 to 17.0]), sepsis, pneumonia, stroke, leg ischemia, and bleeding was not statistically different between the immediate VA-ECMO and the no immediate VA-ECMO groups. CONCLUSIONS Immediate implementation of VA-ECMO in patients with rapidly deteriorating or severe cardiogenic shock did not improve clinical outcomes compared with an early conservative strategy that permitted downstream use of VA-ECMO in case of worsening hemodynamic status. REGISTRATION URL: https://www. CLINICALTRIALS gov; Unique identifier: NCT02301819.
Collapse
Affiliation(s)
- Petr Ostadal
- Department of Cardiology, Na Homolce Hospital, Prague, Czech Republic (P.O., A.K., D.V., M.J., J.N.)
| | - Richard Rokyta
- Department of Cardiology, University Hospital and Faculty of Medicine Pilsen, Charles University, Pilsen, Czech Republic (R.R., M. Hromadka, S.V., M. Seyfrydova)
| | - Jiri Karasek
- Hospital Liberec, Liberec, Czech Republic (J.K.)
- 2nd Department of Medicine-Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University and General University Hospital, Prague, Liberec, Czech Republic (J.K., J.S., M. Hubatova, A.L., J.B.)
| | - Andreas Kruger
- Department of Cardiology, Na Homolce Hospital, Prague, Czech Republic (P.O., A.K., D.V., M.J., J.N.)
| | - Dagmar Vondrakova
- Department of Cardiology, Na Homolce Hospital, Prague, Czech Republic (P.O., A.K., D.V., M.J., J.N.)
| | - Marek Janotka
- Department of Cardiology, Na Homolce Hospital, Prague, Czech Republic (P.O., A.K., D.V., M.J., J.N.)
| | - Jan Naar
- Department of Cardiology, Na Homolce Hospital, Prague, Czech Republic (P.O., A.K., D.V., M.J., J.N.)
| | - Jana Smalcova
- 2nd Department of Medicine-Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University and General University Hospital, Prague, Liberec, Czech Republic (J.K., J.S., M. Hubatova, A.L., J.B.)
| | - Marketa Hubatova
- 2nd Department of Medicine-Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University and General University Hospital, Prague, Liberec, Czech Republic (J.K., J.S., M. Hubatova, A.L., J.B.)
| | - Milan Hromadka
- Department of Cardiology, University Hospital and Faculty of Medicine Pilsen, Charles University, Pilsen, Czech Republic (R.R., M. Hromadka, S.V., M. Seyfrydova)
| | - Stefan Volovar
- Department of Cardiology, University Hospital and Faculty of Medicine Pilsen, Charles University, Pilsen, Czech Republic (R.R., M. Hromadka, S.V., M. Seyfrydova)
| | - Miroslava Seyfrydova
- Department of Cardiology, University Hospital and Faculty of Medicine Pilsen, Charles University, Pilsen, Czech Republic (R.R., M. Hromadka, S.V., M. Seyfrydova)
| | - Jiri Jarkovsky
- Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic (J.J., M. Svoboda)
| | - Michal Svoboda
- Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic (J.J., M. Svoboda)
- Institute of Biostatistics and Analyses, Ltd, Brno, Czech Republic (M. Svoboda)
| | - Ales Linhart
- 2nd Department of Medicine-Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University and General University Hospital, Prague, Liberec, Czech Republic (J.K., J.S., M. Hubatova, A.L., J.B.)
| | - Jan Belohlavek
- 2nd Department of Medicine-Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University and General University Hospital, Prague, Liberec, Czech Republic (J.K., J.S., M. Hubatova, A.L., J.B.)
| |
Collapse
|
11
|
Motovska Z, Hlinomaz O, Aschermann M, Jarkovsky J, Želízko M, Kala P, Groch L, Svoboda M, Hromadka M, Widimsky P. Trends in outcomes of women with myocardial infarction undergoing primary angioplasty-Analysis of randomized trials. Front Cardiovasc Med 2023; 9:953567. [PMID: 36684569 PMCID: PMC9845716 DOI: 10.3389/fcvm.2022.953567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 12/07/2022] [Indexed: 01/06/2023] Open
Abstract
Background Sex- and gender-associated differences determine the disease response to treatment. Aim The study aimed to explore the hypothesis that progress in the management of STE-myocardial infarction (STEMI) overcomes the worse outcome in women. Methods and results We performed an analysis of three randomized trials enrolling patients treated with primary PCI more than 10 years apart. PRAGUE-1,-2 validated the preference of transport for primary PCI over on-site fibrinolysis. PRAGUE-18 enrollment was ongoing at the time of the functional network of 24/7PCI centers, and the intervention was supported by intensive antiplatelets. The proportion of patients with an initial Killip ≥ 3 was substantially higher in the more recent study (0.6 vs. 6.7%, p = 0.004). Median time from symptom onset to the door of the PCI center shortened from 3.8 to 3.0 h, p < 0.001. The proportion of women having total ischemic time ≤3 h was higher in the PRAGUE-18 (OR [95% C.I.] 2.65 [2.03-3.47]). However, the percentage of patients with time-to-reperfusion >6 h was still significant (22.3 vs. 27.2% in PRAGUE-18). There was an increase in probability for an initial TIMI flow >0 in the later study (1.49 [1.0-2.23]), and also for an optimal procedural result (4.24 [2.12-8.49], p < 0.001). The risk of 30-day mortality decreased by 61% (0.39 [0.17-0.91], p = 0.029). Conclusion The prognosis of women with MI treated with primary PCI improved substantially with 24/7 regional availability of mechanical reperfusion, performance-enhancing technical progress, and intensive adjuvant antithrombotic therapy. A major modifiable hindrance to achieving this benefit in a broad population of women is the timely diagnosis by health professional services.
Collapse
Affiliation(s)
- Zuzana Motovska
- Cardiocentre, Third Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady, Prague, Czechia,*Correspondence: Zuzana Motovska,
| | - Ota Hlinomaz
- Department of Cardioangiology, International Clinical Research Center, St. Anne’s University Hospital Brno, Brno, Czechia
| | - Michael Aschermann
- Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University, General University Hospital, Prague, Czechia
| | - Jiri Jarkovsky
- Institute of Biostatistics and Analyses Ltd., Faculty of Medicine, Masaryk University, Brno, Czechia
| | - Michael Želízko
- Department of Cardiology, Institute of Clinical and Experimental Medicine, Prague, Czechia
| | - Petr Kala
- Department of Internal and Cardiology, Faculty of Medicine, Masaryk University and University Hospital Brno-Bohunice, Brno, Czechia
| | - Ladislav Groch
- Department of Cardioangiology, International Clinical Research Center, St. Anne’s University Hospital Brno, Brno, Czechia
| | - Michal Svoboda
- Department of Cardiology, Institute of Clinical and Experimental Medicine, Prague, Czechia
| | - Milan Hromadka
- Department of Cardiology, Charles University, University Hospital in Pilsen, Pilsen, Czechia
| | - Petr Widimsky
- Cardiocentre, Third Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady, Prague, Czechia
| |
Collapse
|
12
|
Válek V, Svoboda M, Bartušek D, Procházka V, Mechl M, Šprláková-Puková A. Case report Ileal diverticulitis with covered perforation complicated by pulmonary embolism - case report. Rozhl Chir 2023; 102:32-36. [PMID: 36809893 DOI: 10.33699/pis.2023.102.1.32-36] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Diverticulitis of the ileum is an inflammatory complication of diverticulosis. It is an uncommon cause of acute abdomen that can have a very serious course, leading, for example, to intestinal perforation or bleeding. Imaging findings are very often negative and the true cause of the condition is only revealed peroperatively. In this case report, we present a case of perforated ileal diverticulitis in a patient with bilateral pulmonary embolism. This was the main reason for conservative management in the first period of time. After resolution of the pulmonary embolism, resection of the affected bowel segment was performed at the time of the next attack.
Collapse
|
13
|
Brat K, Svoboda M, Zatloukal J, Plutinsky M, Volakova E, Popelkova P, Novotna B, Dvorak T, Koblizek V. Prognostic Properties of the GOLD 2023 Classification System. Int J Chron Obstruct Pulmon Dis 2023; 18:661-667. [PMID: 37114105 PMCID: PMC10126720 DOI: 10.2147/copd.s410372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 04/15/2023] [Indexed: 04/29/2023] Open
Abstract
Introduction Recently, the Global Initiative for Chronic Obstructive Lung Disease (GOLD) has published an update on the Global Strategy for Prevention, Diagnosis and Management of COPD, introducing a new classification of chronic obstructive pulmonary disease (COPD). Our aim was to assess the prognostic value of the new GOLD classification system in comparison with the previous GOLD classification systems (GOLD stages I-IV and GOLD groups A-D) and the BODE index. Methods We used the data of 784 patients with COPD from the Czech Multicenter Research Database of COPD. Patient survival was analyzed with the use of Kaplan-Meier estimate and Cox model of proportional risks. ROC analysis and area under curve (AUC) were used for comparison of GOLD classifications and BODE index. The analyses were performed with the use of software R (version 4.2.0). Results We analyzed data of 782 patients with complete data on GOLD classifications. The study population comprised 72.9% of men, 89.1% current or former smokers, with a mean age of 66.6 years, a mean BMI of 27.4 and a mean FEV1 44.9% of predicted. Probability of 5-year survival differed by GOLD classification. Application of the 2023 GOLD classification showed increased risk of death in group B (HR 1.82, 95% CI 1.14-2.92; p = 0.013) and in group E (HR 2.48, 95% CI 1.54-3.99; p˂0.001). The ROC analysis showed that the overall prognostic value of the 2023 GOLD classification was similarly weak to previous A-D GOLD classification schemes (AUCs 0.557-0.576) and was lower compared to the GOLD 1-4 system (AUC 0.614) and even lower when compared to the BODE index (AUC 0.715). Conclusion We concluded that the new GOLD classification system has poor prognostic properties and that specific prediction tools (eg, the BODE index) should be used for mortality risk assessment.
Collapse
Grants
- Czech Pneumological and Phthisiological Society
- The CMRD research project was funded by the Ministry of Health of the Czech Republic
- consortium of pharmaceutical companies (Sandoz, Novartis, GSK, CSL Behring, Cipla, Boehringer Ingelheim, AstraZeneca, and Angelini)
- The companies supported the CMRD project via unrestricted research grants. The supporters had no role in the study design, data analysis or in preparation of the manuscript. All opinions, results, and conclusions reported in this paper are independent from the sponsors
Collapse
Affiliation(s)
- Kristian Brat
- Department of Respiratory Diseases, University Hospital Brno, Brno, Czech Republic
- Faculty of Medicine, Masaryk University, Brno, Czech Republic
- International Clinical Research Center, St. Anne’s University Hospital, Brno, Czech Republic
- Correspondence: Kristian Brat, Department of Respiratory Diseases, University Hospital Brno and Faculty of Medicine, Masaryk University, Jihlavska street 20, Brno, 62500, Czech Republic, Tel +420 532 232 556, Email
| | - Michal Svoboda
- Institute of Biostatistics and Analyses, Ltd., Brno, Czech Republic
| | - Jaromir Zatloukal
- Pulmonary Department, University Hospital Olomouc, Olomouc, Czech Republic
- Faculty of Medicine, Palacky University, Olomouc, Czech Republic
| | - Marek Plutinsky
- Department of Respiratory Diseases, University Hospital Brno, Brno, Czech Republic
- Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Eva Volakova
- Pulmonary Department, University Hospital Olomouc, Olomouc, Czech Republic
- Faculty of Medicine, Palacky University, Olomouc, Czech Republic
| | - Patrice Popelkova
- Pulmonary Department, University Hospital Ostrava, Ostrava, Czech Republic
- Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
| | - Barbora Novotna
- Pulmonary Department, Bulovka Hospital, Prague, Czech Republic
| | - Tomas Dvorak
- Pulmonary Department, Mlada Boleslav Hospital, Mlada Boleslav, Czech Republic
| | - Vladimir Koblizek
- Pulmonary Department, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
- Faculty of Medicine in Hradec Kralove, Charles University, Hradec Kralove, Czech Republic
| |
Collapse
|
14
|
Svaton M, Drosslerova M, Fischer O, Marel M, Hrnciarik M, Venclicek O, Zuna P, Svoboda M, Blazek J, Bratova M, Mullerova A, Vankova B, Krejci D. Comedication with corticosteroids and nonsteroidal antiphlogistics does not affect PD-L1 expression in non-small cell lung cancer. Transl Cancer Res 2022; 11:3017-3023. [PMID: 36237267 PMCID: PMC9552102 DOI: 10.21037/tcr-22-260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 07/18/2022] [Indexed: 12/03/2022]
Abstract
Background Programmed death-ligand 1 (PD-L1) expression is a standard predictor in the selection of immunotherapy for locally advanced/advanced non-small cell lung cancer (NSCLC). However, comedication with corticosteroids or non-steroidal anti-inflammatory drugs (NSAIDs) may influence the effectiveness of this treatment as documented in several previous studies. Due to certain molecular linkages between PD-L1 and corticosteroids or NSAIDs, we therefore addressed the question of whether there is a relationship between PD-L1 expression in NSCLC and the use of this comedication. Methods This is a retrospective study using the Czech tumor registry LUng CAncer focuS (LUCAS), from which patient data were drawn. Independence of two categorical parameters was tested by Pearson’s chi-square test. Results In our group of 1,148 patients, we observed no significant relationship between PD-L1 expression and the use of corticosteroids or NSAIDs. Conclusions According to our data, treatment with corticosteroids or NSAIDs during biopsy does not affect the expression of PD-L1 and it is therefore not necessary to take this treatment into account in this regard.
Collapse
Affiliation(s)
- Martin Svaton
- Department of Pneumology and Phthisiology, University Hospital in Pilsen, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic
| | - Marie Drosslerova
- Department of Respiratory Medicine, Thomayer Hospital, Prague, Czech Republic
| | - Ondrej Fischer
- Department of Respiratory Medicine, Faculty of Medicine, Palacky University, Olomouc, Czech Republic
| | - Miloslav Marel
- Department of Pneumology, 2nd Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Michal Hrnciarik
- Department of Pneumology, Faculty of Medicine in Hradec Kralove, Charles University, Hradec Kralove, Czech Republic
| | - Ondrej Venclicek
- Department of Respiratory Diseases, Faculty of Medicine and University Hospital Brno, Masaryk University, Brno, Czech Republic
| | - Petr Zuna
- Department of Pneumology and Thoracic Surgery, Bulovka Hospital, Prague, Czech Republic
| | - Michal Svoboda
- Institute of Biostatistics and Analyses, Ltd. Brno, Czech Republic
| | - Jiri Blazek
- Department of Pneumology and Phthisiology, University Hospital in Pilsen, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic
| | - Monika Bratova
- Department of Respiratory Diseases, Faculty of Medicine and University Hospital Brno, Masaryk University, Brno, Czech Republic
| | - Andrea Mullerova
- Department of Respiratory Medicine, Faculty of Medicine, Palacky University, Olomouc, Czech Republic
| | - Bohuslava Vankova
- Department of Pathology, University Hospital in Pilsen, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic
| | - Daniel Krejci
- Department of Pneumology and Thoracic Surgery, Bulovka Hospital, Prague, Czech Republic
| |
Collapse
|
15
|
Hendrychova T, Svoboda M, Maly J, Vlcek J, Zimcikova E, Dvorak T, Zatloukal J, Volakova E, Plutinsky M, Brat K, Popelkova P, Kopecky M, Novotna B, Koblizek V. Self-Reported Overall Adherence and Correct Inhalation Technique Discordance in Chronic Obstructive Pulmonary Disease Population. Front Pharmacol 2022; 13:860270. [PMID: 36034870 PMCID: PMC9411979 DOI: 10.3389/fphar.2022.860270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Accepted: 06/02/2022] [Indexed: 11/18/2022] Open
Abstract
Background: Adherence to inhaled medication constitutes a major problem in patients with chronic obstructive pulmonary disease (COPD) globally. However, large studies evaluating adherence in its entirety and capturing a large variety of potentially associated factors are still lacking. Objective: To study both elementary types of adherence to chronic inhaled COPD medication in “real-life” COPD patients and to assess relationships with a wide-ranging spectrum of clinical parameters. Methods: Data from the Czech Multicentre Research Database (CMRD) of COPD, an observational prospective study, were used. Overall adherence (OA) was evaluated with Morisky Medication Adherence Scale (©MMAS-4) and adherence to an application technique (A-ApplT) with the Five Steps Assessment. Mann–Whitney U test, Spearman’s correlation, and logistic regression were used to explore relationships between variables. Results: Data of 546 participants (69.6% of all patients from the CMRD) were analyzed. Two-thirds self-reported optimal OA, but only less than one-third demonstrated A-ApplT without any error. OA did not correlate with A-ApplT. Next, better OA was associated with higher education, a higher number of inhalers, a lower rate of exacerbations, poorer lung function, higher degree of upper respiratory tract symptoms (SNOT-22), absence of depressive symptoms, ex-smoking status, regular mouthwash after inhaled corticosteroids (ICS), and flu vaccination. By contrast, better A-ApplT was associated with a lower number of inhalers, better lung function, and regular mouthwash after ICS. Independent predictors of nonoptimal OA included lower degree of education, absence of flu vaccination, anemia, depression, and peptic ulcer history, whereas independent predictors of lower A-ApplT were lower education, absence of regular mouthwash after ICS, and higher COPD Assessment Test score. Conclusions: Parameters associated with OA and A-ApplT differ, and those associated with both adherence domains are sometimes associated inversely. Based on this finding, we understand these as two separate constructs with an overlap.
Collapse
Affiliation(s)
- Tereza Hendrychova
- Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Kralove, Charles University, Hradec Kralove, Czechia
| | - Michal Svoboda
- Institute of Biostatistics and Analyses, Ltd. Spin-off Company of the Masaryk University, Brno, Czechia
| | - Josef Maly
- Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Kralove, Charles University, Hradec Kralove, Czechia
| | - Jiri Vlcek
- Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Kralove, Charles University, Hradec Kralove, Czechia
| | - Eva Zimcikova
- Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Kralove, Charles University, Hradec Kralove, Czechia
| | - Tomas Dvorak
- Pulmonary Department, Klaudian Hospital, Mlada Boleslav, Czechia
| | - Jaromir Zatloukal
- Department of Respiratory Diseases and Tuberculosis, University Hospital Olomouc, Olomouc, Czechia
- Faculty of Medicine, Palacky University Olomouc, Olomouc, Czechia
| | - Eva Volakova
- Department of Respiratory Diseases and Tuberculosis, University Hospital Olomouc, Olomouc, Czechia
- Faculty of Medicine, Palacky University Olomouc, Olomouc, Czechia
| | - Marek Plutinsky
- Department of Respiratory Diseases, University Hospital Brno, Brno, Czechia
- Faculty of Medicine, Masaryk University, Brno, Czechia
| | - Kristian Brat
- Department of Respiratory Diseases, University Hospital Brno, Brno, Czechia
- Faculty of Medicine, Masaryk University, Brno, Czechia
- International Clinical Research Center, St. Anne´s University Hospital, Brno, Czechia
| | - Patrice Popelkova
- Department of Pulmonary Diseases and Tuberculosis, University Hospital Ostrava, Ostrava, Czechia
- Faculty of Medicine in Ostrava, Ostrava, Czechia
| | - Michal Kopecky
- Department of Pneumology, University Hospital Hradec Kralove, Hradec Kralove, Czechia
- Faculty of Medicine in Hradec Kralove, Charles University, Hradec Kralove, Czechia
| | - Barbora Novotna
- Department of Pneumology, Bulovka Hospital, Prague, Czechia
- 3rd Faculty of Medicine, Charles University, Prague, Czechia
| | - Vladimir Koblizek
- Department of Pneumology, University Hospital Hradec Kralove, Hradec Kralove, Czechia
- Faculty of Medicine in Hradec Kralove, Charles University, Hradec Kralove, Czechia
- *Correspondence: Vladimir Koblizek,
| |
Collapse
|
16
|
Hakl R, Kuklínek P, Sobotková M, Krčmová I, Králíčková P, Vachová M, Hanzlíková J, Nováčková M, Svoboda M, Kováčová I, Litzman J. Registry-based analysis of Icatibant and C1-inhibitor use in treatment of laryngeal attacks of hereditary angioedema. Clin Exp Allergy 2022; 52:994-997. [PMID: 35662289 DOI: 10.1111/cea.14182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 05/22/2022] [Accepted: 05/29/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Roman Hakl
- Department of Clinical Immunology and Allergology, St. Anne's University Hospital in Brno, Brno, Czech Republic.,Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Pavel Kuklínek
- Department of Clinical Immunology and Allergology, St. Anne's University Hospital in Brno, Brno, Czech Republic
| | - Marta Sobotková
- Department of Immunology, University Hospital in Motol, Charles University, Prague, Czech Republic
| | - Irena Krčmová
- Institute of Clinical Immunology and Allergy, University Hospital Hradec Kralove, Charles University, Faculty of Medicine in Hradec Kralove, Hradec Kralove, Czech Republic
| | - Pavlína Králíčková
- Institute of Clinical Immunology and Allergy, University Hospital Hradec Kralove, Charles University, Faculty of Medicine in Hradec Kralove, Hradec Kralove, Czech Republic
| | - Martina Vachová
- Department of Immunology and Allergology, Teaching Hospital, Pilsen, Czech Republic.,Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic
| | - Jana Hanzlíková
- Department of Immunology and Allergology, Teaching Hospital, Pilsen, Czech Republic
| | | | - Michal Svoboda
- Institute of Biostatistics and Analyses, Ltd., Brno, Czech Republic
| | - Ingrid Kováčová
- International Clinical Research Centre, St Anne's University Hospital, Brno, Czech Republic
| | - Jiří Litzman
- Department of Clinical Immunology and Allergology, St. Anne's University Hospital in Brno, Brno, Czech Republic.,Faculty of Medicine, Masaryk University, Brno, Czech Republic
| |
Collapse
|
17
|
Tužil J, Mlčoch T, Závada J, Svoboda M, Pavelka K, Doležal T. Time in remission as an alternative outcome measure for rheumatoid arthritis: a 10-year prospective study of 2618 new users of anti-TNF. Rheumatology (Oxford) 2022; 61:2295-2306. [PMID: 34599798 DOI: 10.1093/rheumatology/keab737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 09/20/2021] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE Achieving targeted disease activity (DA) is the primary therapeutic strategy in RA. Point measurements of DA are done at out-patient visits, however true DA between visits remains unobserved. This study sought to describe and validate a new outcome measure, i.e. time in remission (TIR). METHODS Patients were enrolled in the Czech ATTRA-RA registry. TIR was calculated using linear interpolation of the DAS28-ESR determined at outpatient visits. Correlation coefficients were computed between TIR and DAS28-CRP, HAQ, Simple Disease Activity Index (SDAI), patient global assessment (PGA) and physician global assessment (PhGA). Using logistic regression, TIR was used as a predictor of remission (SDAI ≤3.3) and non-disability (HAQ <0.5). The predictive value of TIR was compared with point and sustained remission using the cross-validated area under receiver-operating curves. RESULTS Since 2010, 2618 RA patients started anti-TNF therapy and were followed until 2020 or until treatment discontinuation. During the first 6 months of therapy, 56% of patients had no remission (TIR = 0), and 22% of patients reached sustained remission (TIR = 1), while 22% of patients had point remissions with 0 < TIR < 1. EULAR good responders and moderate/non-responders spent 64 ± 42% and 6 ± 18% of time in remission, respectively. The mean TIR grew during the follow-up and was correlated with DAS28-CRP, SDAI, HAQ, PGA, and PhGA (P < 0.0001). TIR at 3 and 6 months predicted remission (SDAI ≤3.3) and non-disability (HAQ <0.5) at 13 and 19 months better than point or sustained remission. CONCLUSIONS TIR is an intuitive way of estimating unobserved DA between scheduled visits; its calculation only requires two consecutive DA values (https://www.medevio.cz/tir-calculator/). TIR is a valid predictor of RA outcomes.
Collapse
Affiliation(s)
- Jan Tužil
- Institute of Health Economics and Technology Assessment.,1st Faculty of Medicine, Charles University in Prague
| | - Tomáš Mlčoch
- Institute of Health Economics and Technology Assessment
| | - Jakub Závada
- 1st Faculty of Medicine, Charles University in Prague.,Institute of Rheumatology, Prague
| | - Michal Svoboda
- Institute of Biostatistics and Analyses, Ltd, Spinoff Company of the Faculty of Medicine of the Masaryk University, Brno
| | - Karel Pavelka
- 1st Faculty of Medicine, Charles University in Prague.,Institute of Rheumatology, Prague
| | - Tomáš Doležal
- Institute of Health Economics and Technology Assessment.,Department of Pharmacology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| |
Collapse
|
18
|
Marel M, Chladkova Z, Casas Mendez LF, Venclicek O, Skrickova J, Fischer O, Mullerova A, Havel L, Gyorfy Z, Hrnciarik M, Jirousek M, Krejci J, Krejci D, Buresova M, Alahakoon J, Svoboda M, Svaton M. Worse Prognosis in the Symptomatic Patients With Lung Cancer - Czech Multicentric Study. Cancer Diagn Progn 2022; 2:167-172. [PMID: 35399169 PMCID: PMC8962806 DOI: 10.21873/cdp.10091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 01/19/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND/AIM This study aimed at contributing to a better diagnosis of lung cancer by analyzing the patient's symptoms and their linkage to other characteristics. PATIENTS AND METHODS We analyzed the data of 3,322 patients from LUCAS (LUngCAncerfocuS) National Registry of the Czech Republic. Overall survival was assessed using the Kaplan-Meier method. RESULTS The most common symptoms were cough (47.5%), dyspnea (45.6%), pain (27.3%), and weight loss (25.7%). Among all patients, 16% were asymptomatic. We demonstrated the negative prognostic significance of increasing number of lung cancer symptoms, that was significant after adjustment for age, TNM stages, and performance status, and morphological types of the cancer. CONCLUSION Monitoring the severity and type of symptoms in patients with lung cancer can help in the diagnostics of the disease and the estimation of prognosis.
Collapse
Affiliation(s)
- Miloslav Marel
- Department of Pulmonology, 2nd Faculty of Medicine, Charles University, University Hospital Motol, Prague, Czech Republic
| | - Zdenka Chladkova
- Department of Pulmonology, 2nd Faculty of Medicine, Charles University, University Hospital Motol, Prague, Czech Republic
| | - Luis Fernando Casas Mendez
- Department of Pulmonology, 2nd Faculty of Medicine, Charles University, University Hospital Motol, Prague, Czech Republic
| | - Ondrej Venclicek
- Department of Respiratory Diseases, Faculty of Medicine, Masaryk University, University Hospital, Brno, Czech Republic
| | - Jana Skrickova
- Department of Respiratory Diseases, Faculty of Medicine, Masaryk University, University Hospital, Brno, Czech Republic
| | - Ondej Fischer
- Department of Respiratory Medicine, University Hospital, Faculty of Medicine and Dentistry, Palacky University, Olomouc, Czech Republic
| | - Andrea Mullerova
- Department of Respiratory Medicine, University Hospital, Faculty of Medicine and Dentistry, Palacky University, Olomouc, Czech Republic
| | - Libor Havel
- Department of Respiratory Medicine, Thomayer Hospital, 1st Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Zuzana Gyorfy
- Department of Respiratory Medicine, Thomayer Hospital, 1st Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Michal Hrnciarik
- Pulmonary Department, University Hospital, Charles University, Faculty of Medicine, Hradec Kralove, Czech Republic
| | - Michal Jirousek
- Pulmonary Department, University Hospital, Charles University, Faculty of Medicine, Hradec Kralove, Czech Republic
| | - Jana Krejci
- Department of Pneumology, Bulovka University Hospital, 3rd Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Daniel Krejci
- Department of Pneumology, Bulovka University Hospital, 3rd Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Marcela Buresova
- Department of Pneumology and Phthiseology, University Hospital, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic
| | | | - Michal Svoboda
- Institute of Biostatistics and Analyses, Ltd., Brno, Czech Republic
| | - Martin Svaton
- Department of Pneumology and Phthiseology, University Hospital, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic
| |
Collapse
|
19
|
Svoboda M, Gallo J, Zapletalová J, Prošková J, Juráňová J, Lovečková Y. [Glucose, Lactate, NGAL and Coefficient of Energy Balance in Synovial Fluid in Patients with Hip and Knee Prosthetic Joint Infection]. Acta Chir Orthop Traumatol Cech 2022; 89:16-26. [PMID: 35247240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
PURPOSE OF THE STUDY Laboratory methods are central to prosthetic joint infection (PJI) diagnosis. Most research teams focus on detection of specific inflammatory markers, causative pathogens, or on assessment of the tissue response. This study sought to determine the optimal cut-off values and diagnostic performance of selected synovial markers in relation to the diagnosis of hip or knee PJI. The studied markers were synovial level of glucose, lactate, coefficient of energy balance (CEB) and NGAL (neutrophil gelatinase-associated lipocalin). MATERIAL AND METHODS This prospective study includes 89 patients who underwent revision total knee or hip arthroplasty for septic or aseptic reasons in the period from 2014 to 2017. Among these 89 patients, there are 2 cases of prosthetic hip infection, 22 cases of prosthetic knee infection, 31 aseptic revision total hip arthroplasties and 34 aseptic revision total knee arthroplasties. The diagnostic characteristics of the studied methods were set in relation to the reference standard, the 2013 MSIS (Musculoskeletal Infection Society) criteria. The cut-off values were calculated using the ROC (receiver operating characteristic curve) analysis. RESULTS The synovial glucose test is considered positive if the glucose level drops below 2.65 mmol/L. The area under the curve is 0.813, sensitivity 75.0%, specificity 83.1%. The synovial lactate test is considered positive if lactate level rises above 8.87 mmol/L. The area under the curve is 0.882, sensitivity 70.8%, specificity 95.4%. Synovial NGAL is considered positive if its level exceeds 998 μg/L. The area under the curve is 1.000, sensitivity 100.0%, specificity 100.0%. CEB is considered positive if its value is lower than +4.665. The area under the curve is 0.883, sensitivity 91.7% and specificity 69.8%. Combining of these tests with other synovial markers does not improve the diagnostic performance of the studied tests. CONCLUSIONS The glucose and lactate levels and CEB undoubtedly reflect the presence of an inflammatory process in a prosthetic joint. However, the diagnostic characteristics of these tests are not better than those of other modern diagnostic techniques. As opposed to these tests, synovial NGAL shows excellent diagnostic performance. Nonetheless, the potential of this method shall be verified on larger cohorts of patients. Key words: prosthetic joint infection, periprosthetic infection, total knee arthroplasty, total hip arthroplasty, diagnosis, glucose, lactate, CEB, NGAL.
Collapse
Affiliation(s)
- M Svoboda
- Ortopedická klinika Fakultní nemocnice Olomouc a Lékařské fakulty Univerzity Palackého v Olomouci
| | - J Gallo
- Ortopedická klinika Fakultní nemocnice Olomouc a Lékařské fakulty Univerzity Palackého v Olomouci
| | - J Zapletalová
- Ústav lékařské biofyziky Lékařské fakulty Univerzity Palackého v Olomouci
| | - J Prošková
- Oddělení klinické biochemie Fakultní nemocnice Olomouc
| | - J Juráňová
- Hematoonkologická klinika Fakultní nemocnice Olomouc a Lékařské fakulty Univerzity Palackého v Olomouci
| | - Y Lovečková
- Ústav mikrobiologie Fakultní nemocnice Olomouc a Lékařské fakulty Univerzity Palackého v Olomouci
| |
Collapse
|
20
|
Brat K, Homolka P, Merta Z, Chobola M, Heroutova M, Bratova M, Mitas L, Chovanec Z, Horvath T, Benej M, Ivicic J, Svoboda M, Sramek V, Olson LJ, Cundrle I. Prediction of Postoperative Complications: Ventilatory Efficiency and Rest End-tidal Carbon Dioxide. Ann Thorac Surg 2022; 115:1305-1311. [PMID: 35074321 DOI: 10.1016/j.athoracsur.2021.11.073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 11/10/2021] [Accepted: 11/22/2021] [Indexed: 11/01/2022]
Abstract
BACKGROUND Cardiopulmonary exercise testing parameters including ventilatory efficiency (VE/VCO2 slope) are used for risk assessment of lung resection candidates. However, many patients are unable or unwilling to undergo exercise. VE/VCO2 slope is closely related to the partial pressure of end-tidal carbon dioxide (PETCO2). We hypothesized PETCO2 at rest predicts postoperative pulmonary complications. METHODS Consecutive lung resection candidates were included in this prospective multicenter study. Postoperative respiratory complications were assessed from the first 30 postoperative days or from the hospital stay. Student t test or Mann-Whitney U test was used for comparison. Multivariate stepwise logistic regression analysis was used to analyze association with the development of postoperative pulmonary complications. The De Long test was used to compare area under the curve (AUC). Data are summarized as median (interquartile range). RESULTS Three hundred fifty-three patients were analyzed, of which 59 (17%) developed postoperative pulmonary complications. PETCO2 at rest was significantly lower (27 [24-30] vs 29 [26-32] mm Hg; P < .01) and VE/VCO2 slope during exercise significantly higher (35 [30-40] vs 29 [25-33]; P < .01) in patients who developed postoperative pulmonary complications. Both rest PETCO2 with odds ratio 0.90 (95% confidence interval [CI] 0.83-0.97); P = .01 and VE/VCO2 slope with odds ratio 1.10 (95% CI 1.05-1.16); P < .01 were independently associated with postoperative pulmonary complications by multivariate stepwise logistic regression analysis. There was no significant difference between AUC of both models (rest PETCO2: AUC = 0.79 (95% CI 0.74-0.85); VE/VCO2 slope: AUC = 0.81 (95% CI 0.75-0.86); P = .48). CONCLUSIONS PETCO2 at rest has similar prognostic utility as VE/VCO2 slope, suggesting rest PETCO2 may be used for postoperative pulmonary complications prediction in lung resection candidates.
Collapse
|
21
|
Venclicek O, Skrickova J, Brat K, Fischer O, Havel L, Hrnciarik M, Marel M, Opalka P, Krakorova G, Rozsivalova D, Kultan J, Mullerova A, Zarnayova L, Smickova P, Vasakova M, Gyorfy Z, Jirousek M, Krejci D, Krejci J, Zuna P, Svaton M, Hrda K, Duba J, Alahakoon J, Svoboda M, Silar J. Lung Cancer in Non-smokers in Czech Republic: Data from LUCAS Lung Cancer Clinical Registry. Anticancer Res 2021; 41:5549-5556. [PMID: 34732425 DOI: 10.21873/anticanres.15368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 10/15/2021] [Accepted: 10/18/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM LUCAS is a clinical lung cancer registry (ClinicalTrials.gov identifier is NCT04228237), prospectively collecting data from newly diagnosed lung cancer patients in seven pneumooncology centers in the Czech Republic, since June 1, 2018. The aim of the study was to assess the stage of the disease at the time of diagnosis, percentage of morphological types, survival, percentage of driving mutations, eligibility for radical surgery, and percentage of patients who undergo radical surgery, in the non-smoking population in comparison with smokers and former smokers. PATIENTS AND METHODS The total number of patients in the registry at the time of the analysis was 2,743. Only 2,439 patients with complete records (smoking status, stage, and type of tumor) were included in this study. RESULTS The analysis indicated that non-smokers are diagnosed at a later stage of the disease but they have a better survival rate than smokers. Fewer smokers with stage III disease who are eligible for radical surgery will undergo surgery compared to non-smokers with the same clinical stage. Driving mutations are more common in non-smokers, even after adjustment for the more frequent occurrence of adenocarcinoma in the group of non-smokers. CONCLUSION The data from LUCAS registry are consistent with already known facts, suggesting that the LUCAS registry is a useful clinical tool.
Collapse
Affiliation(s)
- Ondrej Venclicek
- Department of Respiratory Diseases, University Hospital Brno, Brno, Czech Republic; .,Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Jana Skrickova
- Department of Respiratory Diseases, University Hospital Brno, Brno, Czech Republic.,Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Kristian Brat
- Department of Respiratory Diseases, University Hospital Brno, Brno, Czech Republic.,Faculty of Medicine, Masaryk University, Brno, Czech Republic.,International Clinical Research Center, St. Anne's University Hospital, Brno, Czech Republic
| | - Ondrej Fischer
- Department of Respiratory Medicine, University Hospital Olomouc, Olomouc, Czech Republic.,Faculty of Medicine and Dentistry, Palacky University, Olomouc, Czech Republic
| | - Libor Havel
- Department of Respiratory Medicine, Thomayer Hospital, Prague, Czech Republic.,1 Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Michal Hrnciarik
- Pulmonary Department, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic.,Charles University, Faculty of Medicine, Hradec Kralove, Czech Republic
| | - Miloslav Marel
- Department of Pulmonology, University Hospital Motol, Prague, Czech Republic.,2 Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Petr Opalka
- Department of Pneumology, Bulovka University Hospital, Prague, Czech Republic.,3 Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Gabriela Krakorova
- Department of Pneumology, Bulovka University Hospital, Prague, Czech Republic.,3 Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Denisa Rozsivalova
- Department of Respiratory Medicine, University Hospital Olomouc, Olomouc, Czech Republic.,Faculty of Medicine and Dentistry, Palacky University, Olomouc, Czech Republic
| | - Juraj Kultan
- Department of Respiratory Medicine, University Hospital Olomouc, Olomouc, Czech Republic.,Faculty of Medicine and Dentistry, Palacky University, Olomouc, Czech Republic
| | - Andrea Mullerova
- Department of Respiratory Medicine, University Hospital Olomouc, Olomouc, Czech Republic.,Faculty of Medicine and Dentistry, Palacky University, Olomouc, Czech Republic
| | - Lydia Zarnayova
- Department of Respiratory Medicine, University Hospital Olomouc, Olomouc, Czech Republic.,Faculty of Medicine and Dentistry, Palacky University, Olomouc, Czech Republic
| | - Petra Smickova
- Department of Respiratory Medicine, University Hospital Olomouc, Olomouc, Czech Republic.,Faculty of Medicine and Dentistry, Palacky University, Olomouc, Czech Republic
| | - Martina Vasakova
- Department of Respiratory Medicine, Thomayer Hospital, Prague, Czech Republic.,1 Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Zsuzsanna Gyorfy
- Department of Respiratory Medicine, Thomayer Hospital, Prague, Czech Republic.,1 Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Michal Jirousek
- Pulmonary Department, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic.,Charles University, Faculty of Medicine, Hradec Kralove, Czech Republic
| | - Daniel Krejci
- Department of Pneumology, Bulovka University Hospital, Prague, Czech Republic.,3 Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Jana Krejci
- Department of Pneumology, Bulovka University Hospital, Prague, Czech Republic.,3 Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Petr Zuna
- Department of Pneumology, Bulovka University Hospital, Prague, Czech Republic.,3 Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Martin Svaton
- Department of Pneumology, University Hospital Pilsen, Pilsen, Czech Republic.,Faculty of Μedicine in Pilsen, Charles University, Pilsen, Czech Republic
| | - Kristyna Hrda
- Department of Pneumology, University Hospital Pilsen, Pilsen, Czech Republic.,Faculty of Μedicine in Pilsen, Charles University, Pilsen, Czech Republic
| | | | | | - Michal Svoboda
- Faculty of Medicine, Masaryk University, Brno, Czech Republic.,Institute of Biostatistics and Analyses, Ltd., Brno, Czech Republic
| | - Jiri Silar
- Institute of Biostatistics and Analyses, Ltd., Brno, Czech Republic
| |
Collapse
|
22
|
Hlinomaz O, Motovska Z, Knot J, Miklik R, Sabbah M, Hromadka M, Varvarovsky I, Dusek J, Svoboda M, Tousek F, Majtan B, Simek S, Branny M, Jarkovský J. Stent Selection for Primary Angioplasty and Outcomes in the Era of Potent Antiplatelets. Data from the Multicenter Randomized Prague-18 Trial. J Clin Med 2021; 10:jcm10215103. [PMID: 34768623 PMCID: PMC8584734 DOI: 10.3390/jcm10215103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Revised: 10/20/2021] [Accepted: 10/27/2021] [Indexed: 11/29/2022] Open
Abstract
Drug-eluting stents (DES) are the recommended stents for primary percutaneous coronary intervention (PCI). This study aimed to determine why interventional cardiologists used non-DES and how it influenced patient prognoses. The efficacy and safety outcomes of the different stents were also compared in patients treated with either prasugrel or ticagrelor. Of the PRAGUE-18 study patients, 749 (67.4%) were treated with DES, 296 (26.6%) with bare-metal stents (BMS), and 66 (5.9%) with bioabsorbable vascular scaffold/stents (BVS) between 2013 and 2016. Cardiogenic shock at presentation, left main coronary artery disease, especially as the culprit lesion, and right coronary artery stenosis were the reasons for selecting a BMS. The incidence of the primary composite net-clinical endpoint (EP) (death, nonfatal myocardial infarction, stroke, serious bleeding, or revascularization) at seven days was 2.5% vs. 6.3% and 3.0% in the DES, vs. with BMS and BVS, respectively (HR 2.7; 95% CI 1.419–5.15, p = 0.002 for BMS vs. DES and 1.25 (0.29–5.39) p = 0.76 for BVS vs. DES). Patients with BMS were at higher risk of death at 30 days (HR 2.20; 95% CI 1.01–4.76; for BMS vs. DES, p = 0.045) and at one year (HR 2.1; 95% CI 1.19–3.69; p = 0.01); they also had a higher composite of cardiac death, reinfarction, and stroke (HR 1.66; 95% CI 1.0–2.74; p = 0.047) at one year. BMS were associated with a significantly higher rate of primary EP whether treated with prasugrel or ticagrelor. In conclusion, patients with the highest initial risk profile were preferably treated with BMS over BVS. BMS were associated with a significantly higher rate of cardiovascular events whether treated with prasugrel or ticagrelor.
Collapse
Affiliation(s)
- Ota Hlinomaz
- ICRC, Department of Cardioangiology, St. Anne University Hospital, Masaryk University, 65691 Brno, Czech Republic; (O.H.); (M.S.)
| | - Zuzana Motovska
- Third Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady, Cardiocentre, 10034 Prague, Czech Republic;
- Correspondence: ; Tel.: +420-267-163-760; Fax: +420-267-163-763
| | - Jiri Knot
- Third Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady, Cardiocentre, 10034 Prague, Czech Republic;
| | - Roman Miklik
- Department of Internal Medicine and Cardiology, Faculty of Medicine of Masaryk University and University Hospital, 62500 Brno, Czech Republic;
| | - Mahmoud Sabbah
- ICRC, Department of Cardioangiology, St. Anne University Hospital, Masaryk University, 65691 Brno, Czech Republic; (O.H.); (M.S.)
- Faculty of Medicine, Suez Canal University, Ismailia P.O. Box 41522, Egypt
| | - Milan Hromadka
- Department of Cardiology, University Hospital and Faculty of Medicine, Charles University, 30599 Pilsen, Czech Republic;
| | | | - Jaroslav Dusek
- First Department of Internal Medicine, University Hospital Hradec Kralove, 50005 Hradec Kralove, Czech Republic;
| | - Michal Svoboda
- Faculty of Medicine, Institute of Biostatistics and Analyses, Masaryk University, 62500 Brno, Czech Republic; (M.S.); (J.J.)
| | - Frantisek Tousek
- Cardiocentre—Department of Cardiology, Regional Hospital, 37001 Ceske Budejovice, Czech Republic;
| | - Bohumil Majtan
- Cardiocentre, Regional Hospital, 36001 Karlovy Vary, Czech Republic;
| | - Stanislav Simek
- Department of Physiology and Second Department of Medicine—Department of Cardiovascular Medicine, 1st Faculty of Medicine, Charles University, 12808 Prague, Czech Republic;
| | - Marian Branny
- Cardiovascular Center, Hospital Podlesi, AGEL Research and Training Institute, 73961 Trinec, Czech Republic;
| | - Jiří Jarkovský
- Faculty of Medicine, Institute of Biostatistics and Analyses, Masaryk University, 62500 Brno, Czech Republic; (M.S.); (J.J.)
| |
Collapse
|
23
|
Hlinomaz O, Sabbah M, Knot J, Miklik R, Hromadka M, Varvarovsky I, Dusek J, Jarkovsky J, Tousek F, Majtan B, Simek S, Branny M, Svoboda M, Widimsky P, Motovska Z. Clinical outcomes with drug-eluting stents, bare-metal stents, and bioresorbable scaffolds implanted in patients with AMI treated with primary PCI. Data from the Prague-18 trial. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Drug-eluting stents (DESs) are the recommended choice of stents for primary PCI.
Purpose/Methods
The study aimed to determine why interventional cardiologists used non-DESs and how they had influenced the patient prognosis. The efficacy and safety outcomes of the different stents were also compared in treated with either prasugrel or ticagrelor.
Results
Of the PRAGUE 18 study patients, 749 (67.4%) were treated with DESs, 296 (26.6%) with BMS, and 66 (5.9%) with BVS. Cardiogenic shock at presentation and the left main disease, especially as culprit lesion, and right coronary artery stenosis were the reasons for BMS selection.
The incidence of the primary net-clinical EP (CV death, nonfatal MI, stroke, major bleeding, or revascularization) at 7 days was 2.6% vs. 6.5%, and 3.0% in the DESs, BMSs, and BVSs, respectively (HR 2.7; 95% CI 1.419–5.15, P=0.002 for BMS vs. DES and 1.25 (0.29–5.39) for BVS vs. DES, P=0.76). Patients with BMSs were at higher risk of death at 30 days (HR 2.20; 95% CI 1.01–4.76; for BMS vs. DES, P=0.045), and at one year (HR 2.1; 95% CI 1.19–3.69; P=0.01); they also had higher composite of cardiac death, re-MI and stroke (HR 1.66; 95% CI 1.0–2.74; P=0.047) at one year. BMSs were associated with significantly higher rate of primary EPs either treated with prasugrel or ticagrelor.
Conclusion
Patients with the highest risk profile were preferably treated with BMS the contrary to BVS. BMSs were associated with a significantly higher rate of cardiovascular events either treated with prasugrel or ticagrelor.
Funding Acknowledgement
Type of funding sources: Public Institution(s). Main funding source(s): Charles University Cardiovascular Research Program P-35 and Q-38, Charles University, Czech Republic
Collapse
Affiliation(s)
- O Hlinomaz
- ICRC, St. Anne University Hospital, Department of Cardioangiology, Brno, Czechia
| | - M Sabbah
- ICRC, St. Anne University Hospital, Department of Cardioangiology, Brno, Czechia
| | - J Knot
- Third Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady, Prague, Czechia
| | - R Miklik
- Faculty of Medicine of Masaryk University and University Hospital, Department of Internal Medicine and Cardiology, Brno, Czechia
| | - M Hromadka
- University Hospital Pilsen, Department of Cardiology, Pilsen, Czechia
| | | | - J Dusek
- University Hospital Hradec Kralove, First Department of Internal Medicine, Hradec Kralove, Czechia
| | - J Jarkovsky
- Faculty of Medicine and the Faculty of Science of Masaryk University, Institute of Biostatistics and Analyses, Brno, Czechia
| | - F Tousek
- Regional Hospital, Cardiocentre, Department of Cardiology, Ceske Budejovice, Czechia
| | - B Majtan
- Regional Hospital, Cardiocentre, Karlovy Vary, Czechia
| | - S Simek
- Charles University and General University Hospital, Second Department of Medicine, Prague, Czechia
| | - M Branny
- University Hospital Ostrava, Department of Cardiology, Ostrava, Czechia
| | - M Svoboda
- Faculty of Medicine and the Faculty of Science of Masaryk University, Institute of Biostatistics and Analyses, Brno, Czechia
| | - P Widimsky
- Third Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady, Prague, Czechia
| | - Z Motovska
- Third Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady, Prague, Czechia
| | | |
Collapse
|
24
|
Válek V, Bartušek D, Svoboda M, Válek V, Procházka V. Appendiceal mucocele - a radiologists view. Rozhl Chir 2021; 100:266-270. [PMID: 34465115 DOI: 10.33699/pis.2021.100.6.266-270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Appendiceal mucocele is an obstructive dilatation of the appendix, which results from the filling of its lumen with mucus. This is a rare condition that is asymptomatic in half of the patients. Its severity depends on the cause of appendiceal dilatation. In a small percentage of cases, the dilated appendix ruptures, leading to the development of serious complication; this is termed as pseudomyxoma peritonei. Due to the possibility of malignant etiology of the mucocele, surgical resection remains an essential part of the treatment.
Collapse
|
25
|
Brat K, Svoboda M, Hejduk K, Plutinsky M, Zatloukal J, Volakova E, Popelkova P, Novotna B, Engova D, Franssen FM, Vanfleteren LE, Spruit MA, Koblizek V. Introducing a new prognostic instrument for long-term mortality prediction in COPD patients: the CADOT index. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2021; 165:139-145. [DOI: 10.5507/bp.2020.035] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 08/10/2020] [Indexed: 11/23/2022] Open
|
26
|
Hromadka M, Motovska Z, Hlinomaz O, Kala P, Tousek F, Jarkovsky J, Beranova M, Jansky P, Svoboda M, Krepelkova I, Rokyta R, Widimsky P, Karpisek M. MiR-126-3p and MiR-223-3p as Biomarkers for Prediction of Thrombotic Risk in Patients with Acute Myocardial Infarction and Primary Angioplasty. J Pers Med 2021; 11:jpm11060508. [PMID: 34199723 PMCID: PMC8230013 DOI: 10.3390/jpm11060508] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 05/17/2021] [Accepted: 05/31/2021] [Indexed: 12/12/2022] Open
Abstract
Aim. This study was designed to evaluate the relationship between microRNAs (miRNAs), miR-126-3p and miR-223-3p, as new biomarkers of platelet activation, and predicting recurrent thrombotic events after acute myocardial infarction (AMI). Methods and Results. The analysis included 598 patients randomized in the PRAGUE-18 study (ticagrelor vs. prasugrel in AMI). The measurements of miRNAs were performed by using a novel miRNA immunoassay method. The association of miRNAs with the occurrence of the ischemic endpoint (EP) (cardiovascular death, nonfatal MI, or stroke) and bleeding were analyzed. The miR-223-3p level was significantly related to an increased risk of occurrence of the ischemic EP within 30 days (odds ratio (OR) = 15.74, 95% confidence interval (CI): 2.07-119.93, p = 0.008) and one year (OR = 3.18, 95% CI: 1.40-7.19, p = 0.006), respectively. The miR-126-3p to miR-223-3p ratio was related to a decreased risk of occurrence of EP within 30 days (OR = 0.14, 95% CI: 0.03-0.61, p = 0.009) and one year (OR = 0.37, 95% CI: 0.17-0.82, p = 0.014), respectively. MiRNAs were identified as independent predictors of EP even after adjustment for confounding clinical predictors. Adding miR-223-3p and miR-126-3p to miR-223-3p ratios as predictors into the model calculating the ischemic risk significantly increased the predictive accuracy for combined ischemic EP within one year more than using only clinical ischemic risk parameters. No associations between miRNAs and bleeding complications were identified. Conclusion. The miR-223-3p and the miR-126-3p are promising independent predictors of thrombotic events and can be used for ischemic risk stratification after AMI.
Collapse
Affiliation(s)
- Milan Hromadka
- Department of Cardiology, University Hospital and Faculty of Medicine in Pilsen, Charles University, 304 60 Pilsen, Czech Republic; (M.H.); (R.R.)
| | - Zuzana Motovska
- Cardiocentre, Third Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady, 100 34 Prague, Czech Republic;
- Correspondence: ; Tel.: +420-267-163-760; Fax: +420-267-163-763
| | - Ota Hlinomaz
- First Department of Internal Medicine—Cardioangiology, International Clinical Research Center, Faculty of Medicine, Masaryk University and St. Anne’s University Hospital, 656 91 Brno, Czech Republic; (O.H.); (M.B.)
| | - Petr Kala
- Department of Internal Medicine and Cardiology, University Hospital and Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic;
| | - Frantisek Tousek
- Cardiocentre—Department of Cardiology, Regional Hospital, 370 01 Ceske Budejovice, Czech Republic;
| | - Jiri Jarkovsky
- Institute of Biostatistics and Analyses at the Faculty of Medicine and the Faculty of Science, Masaryk University, 602 00 Brno, Czech Republic; (J.J.); (M.S.)
| | - Marketa Beranova
- First Department of Internal Medicine—Cardioangiology, International Clinical Research Center, Faculty of Medicine, Masaryk University and St. Anne’s University Hospital, 656 91 Brno, Czech Republic; (O.H.); (M.B.)
| | - Pavel Jansky
- Department of Anestesiology and Resuscitation, University Hospital Kralovske Vinohrady, 100 34 Prague, Czech Republic;
| | - Michal Svoboda
- Institute of Biostatistics and Analyses at the Faculty of Medicine and the Faculty of Science, Masaryk University, 602 00 Brno, Czech Republic; (J.J.); (M.S.)
| | - Iveta Krepelkova
- BioVendor—Laboratory Medicine, 621 00 Brno, Czech Republic; (I.K.); (M.K.)
- Department of Human Pharmacology and Toxicology, Faculty of Pharmacy, University of Veterinary and Pharmaceutical Sciences, 621 00 Brno, Czech Republic
| | - Richard Rokyta
- Department of Cardiology, University Hospital and Faculty of Medicine in Pilsen, Charles University, 304 60 Pilsen, Czech Republic; (M.H.); (R.R.)
| | - Petr Widimsky
- Cardiocentre, Third Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady, 100 34 Prague, Czech Republic;
| | - Michal Karpisek
- BioVendor—Laboratory Medicine, 621 00 Brno, Czech Republic; (I.K.); (M.K.)
- Department of Human Pharmacology and Toxicology, Faculty of Pharmacy, University of Veterinary and Pharmaceutical Sciences, 621 00 Brno, Czech Republic
| |
Collapse
|
27
|
Brat K, Svoboda M, Zatloukal J, Plutinsky M, Volakova E, Popelkova P, Novotna B, Dvorak T, Koblizek V. The Relation Between Clinical Phenotypes, GOLD Groups/Stages and Mortality in COPD Patients - A Prospective Multicenter Study. Int J Chron Obstruct Pulmon Dis 2021; 16:1171-1182. [PMID: 33953554 PMCID: PMC8089082 DOI: 10.2147/copd.s297087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Accepted: 03/22/2021] [Indexed: 11/23/2022] Open
Abstract
Introduction The concept of phenotyping emerged, reflecting specific clinical, pulmonary and extrapulmonary features of each particular chronic obstructive pulmonary disease (COPD) case. Our aim was to analyze prognostic utility of: “Czech“ COPD phenotypes and their most frequent combinations, ”Spanish” phenotypes and Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages + groups in relation to long-term mortality risk. Methods Data were extracted from the Czech Multicenter Research Database (CMRD) of COPD. Kaplan-Meier (KM) estimates (at 60 months from inclusion) were used for mortality assessment. Survival rates were calculated for the six elementary “Czech” phenotypes and their most frequent and relevant combinations, “Spanish” phenotypes, GOLD grades and groups. Statistically significant differences were tested by Log Rank test. An analysis of factors underlying mortality risk (the role of confounders) has been assessed with the use of classification and regression tree (CART) analysis. Basic factors showing significant differences between deceased and living patients were entered into the CART model. This showed six different risk groups, the differences in risk were tested by a Log Rank test. Results The cohort (n=720) was 73.1% men, with a mean age of 66.6 years and mean FEV1 44.4% pred. KM estimates showed bronchiectases/COPD overlap (HR 1.425, p=0.045), frequent exacerbator (HR 1.58, p<0.001), cachexia (HR 2.262, p<0.001) and emphysematous (HR 1.786, p=0.015) phenotypes associated with higher mortality risk. Co-presence of multiple phenotypes in a single patient had additive effect on risk; combination of emphysema, cachexia and frequent exacerbations translated into poorest prognosis (HR 3.075; p<0.001). Of the “Spanish” phenotypes, AE CB and AE non-CB were associated with greater risk of mortality (HR 1.787 and 2.001; both p=0.001). FEV1% pred., cachexia and chronic heart failure in patient history were the major underlying factors determining mortality risk in our cohort. Conclusion Certain phenotypes (“Czech” or “Spanish”) of COPD are associated with higher risk of death. Co-presence of multiple phenotypes (emphysematous plus cachectic plus frequent exacerbator) in a single individual was associated with amplified risk of mortality.
Collapse
Affiliation(s)
- Kristian Brat
- Department of Respiratory Diseases, University Hospital Brno, Brno, Czech Republic.,Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Michal Svoboda
- Faculty of Medicine, Masaryk University, Brno, Czech Republic.,Institute of Biostatistics and Analyses, Ltd., Brno, Czech Republic
| | - Jaromir Zatloukal
- Pulmonary Department, University Hospital Olomouc, Olomouc, Czech Republic.,Faculty of Medicine, Palacky University, Olomouc, Czech Republic
| | - Marek Plutinsky
- Department of Respiratory Diseases, University Hospital Brno, Brno, Czech Republic.,Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Eva Volakova
- Pulmonary Department, University Hospital Olomouc, Olomouc, Czech Republic.,Faculty of Medicine, Palacky University, Olomouc, Czech Republic
| | - Patrice Popelkova
- Pulmonary Department, University Hospital Ostrava, Ostrava, Czech Republic.,Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
| | - Barbora Novotna
- Pulmonary Department, Bulovka Hospital, Prague, Czech Republic
| | - Tomas Dvorak
- Pulmonary Department, Mlada Boleslav Hospital, Mlada Boleslav, Czech Republic
| | - Vladimir Koblizek
- Pulmonary Department, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic.,Faculty of Medicine in Hradec Kralove, Charles University, Prague, Czech Republic
| |
Collapse
|
28
|
Svoboda M, Procházka V, Grolich T, Kala Z. Quality of life after transanal total mesorectal excision - our experience. Rozhl Chir 2021; 100:534-542. [PMID: 35021847 DOI: 10.33699/pis.2021.100.11.534-542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Functional outcomes and quality of life (QoL) after transanal total mesorectal excision (TaTME) are very important factors in the evaluation of TaTME in comparison with other approaches to TME. The most common functional problems after resection of the rectum include bowel, urologic and sexual dysfunctions. In this study, we present our experience with QoL after TaTME; the results are compared with worldwide literature in the discussion. METHODS QoL was assessed by a questionnaire. The total of 54 patients were analysed. A general questionnaire for oncological diseases was used - European Organisation for Research and Treatment of Cancer (EORTC)-QLQ-C30, together with EORTC-QLQ-CR29 - a specific questionnaire for colorectal cancer. The Low Anterior Resection Syndrome (LARS) score was also obtained in all patients. Mean follow-up was 42.65 months (range 9-91 months). RESULTS The mean LARS score in patients undergoing TaTME was 30.7 while a major LARS was observed in 64.2% of those with LARS. Of all of the symptoms in the EORTC-QLQ-C30 survey, the most serious problems which affected patients undergoing TaTME were diarrhoea (30.25), fatigue (23.87) and insomnia (20.37). In the QLQ-CR29 survey the problems included flatulence (50.94), faecal incontinence (45.06) and stool frequency (35.19). The results of EORTC-QLQ-C30 and QLQ-CR29 are quite heterogeneous. CONCLUSION In this study the QoL of patients with advanced rectal tumours (of whom 81.5% received neoadjuvant therapy) undergoing TaTME is comparable to results in the current literature. The most severe symptoms affecting QoL after TaTME are flatulence, faecal incontinence, and stool frequency. Other serious symptoms include fatigue and insomnia. LARS was recorded in 73.6% of patients undergoing TaTME, mostly a major LARS.
Collapse
|
29
|
Klimová D, Styk J, Svoboda M, Humplíková S, Repiská V. Preleukemic fusion genes typical for acute myeloid leukemia. Vnitr Lek 2021; 67:9-12. [PMID: 35459386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Acute myeloid leukemia (AML) is a highly heterogeneous subtype of leukemia, accounting for 25 % of childhood leukemias. By the presence of genetic mutations in hematopoietic/ progenitor stem cells, the bone marrow produces a large number of abnormal undifferentiated leukocytes (blasts), which significantly impairs the proper differentiation of cells. AML is induced by two interventions. Chromosomal translocation during hematopoiesis of intrauterine development is the first intervention. This creates preleukemic fusion genes (PFG), which can later be transformed by a second intervention (point genetic mutation - deletion, insertion ) into a functional malignant clone. Characteristic AML fusion genes include AML1-ETO, PML-RARA or MLL-AF9, which in turn produce hybrid proteins with altered function. Several studies suggest that these PFGs are considered an important prognostic tool in disease assessment. While the incidence of PFG characteristic of acute lymphoblastic leukemia (ALL) has been relatively well studied by several research groups and has been estimated at 1 to 5% in the umbilical cord blood of healthy neonates, PFG relevant to AML are still not sufficiently clarified.
Collapse
|
30
|
Sopoušek J, Pinkas J, Buršík J, Svoboda M, Krásenský P. Continuous Flow Synthesis of Iron Oxide Nanoparticles Using Water-in-Oil Microemulsion. Colloid J 2020. [DOI: 10.1134/s1061933x20060174] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
31
|
Hromadka M, Motovska Z, Hlinomaz O, Kala P, Varvarovsky I, Dusek J, Svoboda M, Jarkovsky J, Tousek F, Majtan B, Simek S, Branny M, Mrozek J, Cervinka P, Widimsky P. Relationship between symptom-onset-to-balloon time and outcomes in patients with acute myocardial infarction treated with primary percutaneous coronary intervention. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1648] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Time delay is an important prognostic factor and indicator of quality of care for patients with AMI indicated for primary percutaneous coronary intervention (PCI).
Purpose
Assessment of total ischaemia time and its relationship to catheterization findings and the incidence of ischaemic events within 1 year in patients treated with primary PCI.
Method
The analysis included 1230 patients with AIM and primary PCI randomized in the Prague-18 study (prasugrel vs. ticagrelor). We evaluated the total ischaemia time and two the intermediate intervals: A - from the symptom onset to the arrival to the hospital and B - from the entry the hospital to balloon time. We assessed the time delay in relation to patient characteristics, PCI results and ischaemic endpoints (death, reIM, stroke) within 30 days and 1 year.
Results
Median total ischaemia time was 3.2 hours. Its prolongation resulted in more frequent incidence of TIMI flow <2 before PCI (p=0.029), TIMI flow <3 after PCI (p=0.004) and suboptimal PCI (p=0.018). The interval A was significantly prolonged in women (p=0.001) and obese patients with BMI ≥30 kg / m2 (p=0.001). The interval B <30 min was achieved in 70% of patients, only 5.3% had interval >90 min. In 717 (61,6%) patients with increased risk (at least 1 criterion: age >70 years, STEMI anterior wall or LBBB, Killip II-IV, history of MI and CABG, SBP <100 mmHG and HR >100 / min), the prolongation of total ischaemia time (≤2 vs. 2.1–4 vs. 4.1–6 vs. >6 hours) resulted in a more frequent incidence of combined ischaemic endpoints within 1 year (p=0.034) and left ventricular systolic dysfunction (p=0.028).
Conclusion
The extension of total ischaemia time in patients treated with primary PCI resulted in a more frequent suboptimal result with TIMI flow <3. Female gender, older age and obesity in women were associated with an increase in total ischaemia time. In patients with increased risk, time delay resulted in a higher incidence of combined ischaemic endpoints within 1 year and left ventricular systolic dysfunction.
Funding Acknowledgement
Type of funding source: None
Collapse
Affiliation(s)
- M Hromadka
- University Hospital in Pilsen, Department of Cardiology, Pilsen, Czechia
| | - Z Motovska
- Faculty Hospital Kralovske Vinohrady, Prague, Czechia
| | - O Hlinomaz
- St. Anne University Hospital Brno (FNUSA), Brno, Czechia
| | - P Kala
- University Hospital Brno, Brno, Czechia
| | | | - J Dusek
- University Hospital Hradec Kralove, Hradec Kralove, Czechia
| | - M Svoboda
- Institute of Biostatistics and Analyses of Masaryk University, Brno, Czechia
| | - J Jarkovsky
- Institute of Biostatistics and Analyses of Masaryk University, Brno, Czechia
| | - F Tousek
- Regional Hospital of Ceske Budejovice, Ceske Budejovice, Czechia
| | - B Majtan
- Na Homolce Hospital, Cardiology department, Prague, Czechia
| | - S Simek
- First Faculty of Medicine and General Teaching Hospital, Prague, Czechia
| | - M Branny
- University Hospital Ostrava, Ostrava, Czechia
| | - J Mrozek
- University Hospital Ostrava, Ostrava, Czechia
| | - P Cervinka
- Masaryk Hospital, Usti Nad Labem, Czechia
| | - P Widimsky
- Faculty Hospital Kralovske Vinohrady, Prague, Czechia
| |
Collapse
|
32
|
|
33
|
Enenkel M, Brown ME, Vogt JV, McCarty JL, Reid Bell A, Guha-Sapir D, Dorigo W, Vasilaky K, Svoboda M, Bonifacio R, Anderson M, Funk C, Osgood D, Hain C, Vinck P. Why predict climate hazards if we need to understand impacts? Putting humans back into the drought equation. Clim Change 2020; 162:1161-1176. [PMID: 33071396 PMCID: PMC7545810 DOI: 10.1007/s10584-020-02878-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 09/25/2020] [Indexed: 06/01/2023]
Abstract
Virtually all climate monitoring and forecasting efforts concentrate on hazards rather than on impacts, while the latter are a priority for planning emergency activities and for the evaluation of mitigation strategies. Effective disaster risk management strategies need to consider the prevailing "human terrain" to predict who is at risk and how communities will be affected. There has been little effort to align the spatiotemporal granularity of socioeconomic assessments with the granularity of weather or climate monitoring. The lack of a high-resolution socioeconomic baseline leaves methodical approaches like machine learning virtually untapped for pattern recognition of extreme climate impacts on livelihood conditions. While the request for "better" socioeconomic data is not new, we highlight the need to collect and analyze environmental and socioeconomic data together and discuss novel strategies for coordinated data collection via mobile technologies from a drought risk management perspective. A better temporal, spatial, and contextual understanding of socioeconomic impacts of extreme climate conditions will help to establish complex causal pathways and quantitative proof about climate-attributable livelihood impacts. Such considerations are particularly important in the context of the latest big data-driven initiatives, such as the World Bank's Famine Action Mechanism (FAM).
Collapse
Affiliation(s)
- M. Enenkel
- Harvard Humanitarian Initiative, Harvard University, Cambridge, MA USA
- World Bank Disaster Risk Financing and Insurance (DRFI) Program, Washington, DC USA
| | - M. E. Brown
- Department of Geographical Sciences, University of Maryland, College Park, MD USA
| | - J. V. Vogt
- European Commission, Joint Research Center, Ispra, VA Italy
| | - J. L. McCarty
- Department of Geography, Miami University, Oxford, OH USA
| | - A. Reid Bell
- Department of Environmental Studies, New York University, New York, USA
| | - D. Guha-Sapir
- Centre for Research on the Epidemiology of Disasters, Institute for Health and Society, Université Catholique de Louvain, Brussels, Belgium
| | - W. Dorigo
- Department of Geodesy and Geoinformation, Vienna University of Technology, Vienna, Austria
| | - K. Vasilaky
- Department of Economics, Orfalea College of Business, California Polytechnic University, San Luis Obispo, CA USA
| | - M. Svoboda
- US National Drought Mitigation Center, University of Nebraska-Lincoln, Lincoln, USA
| | - R. Bonifacio
- United Nations World Food Programme, Rome, Italy
| | - M. Anderson
- U.S. Department of Agriculture, Agricultural Research Service, Beltsville, MD USA
| | - C. Funk
- U.S. Geological Survey Center for Earth Resources Observation and Science and the University of Santa Barbara, Climate Hazards Center, Santa Barbara, CA USA
| | - D. Osgood
- International Research Institute for Climate and Society, Columbia University, New York, NY USA
| | - C. Hain
- NASA Marshall Space Flight Center, Earth Science Branch, Huntsville, AL USA
| | - P. Vinck
- Harvard Humanitarian Initiative, Harvard University, Cambridge, MA USA
| |
Collapse
|
34
|
Simek S, Motovska Z, Hlinomaz O, Kala P, Hromadka M, Knot J, Varvarovsky I, Dusek J, Rokyta R, Tousek F, Svoboda M, Vodzinska A, Mrozek J, Jarkovsky J. The Effect of Diabetes on Prognosis Following Myocardial Infarction Treated with Primary Angioplasty and Potent Antiplatelet Therapy. J Clin Med 2020; 9:jcm9082555. [PMID: 32781780 PMCID: PMC7464834 DOI: 10.3390/jcm9082555] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 08/03/2020] [Accepted: 08/05/2020] [Indexed: 01/14/2023] Open
Abstract
Purpose: To investigate the prognostic significance of diabetes mellitus (DM) in patients with high risk acute myocardial infarction (AMI) treated with primary percutaneous coronary intervention (pPCI) in the era of potent antithrombotics. Methods: Data from 1230 ST-segment elevation myocardial infarction (STEMI) patients enrolled in the PRAGUE-18 (prasugrel vs. ticagrelor in pPCI) study were analyzed. Ischemic and bleeding event rates were calculated for patients with and without diabetes. The independent impact of diabetes on outcomes was evaluated after adjustment for outcome predictors. Results: The prevalence of DM was 20% (N = 250). Diabetics were older and more often female. They were more likely to have hypertension, hyperlipoproteinemia, multivessel coronary disease and left main disease, and be obese. The primary net-clinical endpoint (EP) containing death, spontaneous nonfatal MI, stroke, severe bleeding, and revascularization at day 7 occurred in 6.1% of patients with, and in 3.5% of patients without DM (HR 1.8; 95% CI 0.978–3.315; p = 0.055). At one year, the key secondary endpoint defined as cardiovascular death, spontaneous MI, or stroke occurred in 8.8% with, and 5.5% without DM (HR 1.621; 95% CI 0.987–2.661; p = 0.054). In those with DM the risk of total one-year mortality (6.8% vs. 3.9% (HR 1.773; 95% CI 1.001–3.141; p = 0.047)) and the risk of nonfatal reinfarction (4.8% vs. 2.2% (HR 2.177; 95% CI 1.077–4.398; p = 0.026)) were significantly higher compared to in those without DM. There was no risk of major bleeding associated with DM (HR 0.861; 95% CI 0.554–1.339; p = 0.506). In the multivariate analysis, diabetes was independently associated with the one-year risk of reinfarction (HR 2.176; 95% Confidence Interval, 1.055–4.489; p = 0.035). Conclusion: Despite best practices STEMI treatment, diabetes is still associated with significantly worse prognoses, which highlights the importance of further improvements in the management of this high-risk population.
Collapse
Affiliation(s)
- Stanislav Simek
- Second Department of Medicine—Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University and General University Hospital, 12808 Prague, Czech Republic;
| | - Zuzana Motovska
- Cardiocenter, Third Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady, 10034 Prague, Czech Republic;
- Correspondence:
| | - Ota Hlinomaz
- First Department of Internal Medicine—Cardioangiology, ICRC, Faculty of Medicine of Masaryk University and St. Anne’s University Hospital, 65691 Brno, Czech Republic;
| | - Petr Kala
- Department of Internal Medicine and Cardiology, Faculty of Medicine of Masaryk University and University Hospital, 65991 Brno, Czech Republic;
| | - Milan Hromadka
- Department of Cardiology, University Hospital and Faculty of Medicine Charles University, 30460 Plzen, Czech Republic; (M.H.); (R.R.)
| | - Jiri Knot
- Cardiocenter, Third Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady, 10034 Prague, Czech Republic;
| | | | - Jaroslav Dusek
- First Department of Internal Medicine, University Hospital and Faculty of Medicine Charles University, 50005 Hradec Kralove, Czech Republic;
| | - Richard Rokyta
- Department of Cardiology, University Hospital and Faculty of Medicine Charles University, 30460 Plzen, Czech Republic; (M.H.); (R.R.)
| | - Frantisek Tousek
- Cardiocenter—Department of Cardiology, Regional Hospital, 37001 Ceske Budejovice, Czech Republic; (F.T.); (J.J.)
| | - Michal Svoboda
- Institute of Biostatistics and Analyses at the Faculty of Medicine and the Faculty of Science of Masaryk University, 62500 Brno, Czech Republic;
| | - Alexandra Vodzinska
- AGEL Research and Training Institute—Trinec Branch, Cardiovascular Center, Podlesi Hospital, 73961 Trinec, Czech Republic;
| | - Jan Mrozek
- Cardiovascular Department, University Hospital Ostrava, 70800 Ostrava, Czech Republic;
| | - Jiri Jarkovsky
- Cardiocenter—Department of Cardiology, Regional Hospital, 37001 Ceske Budejovice, Czech Republic; (F.T.); (J.J.)
| | | |
Collapse
|
35
|
Shen S, Svoboda M, Zhang G, Cavasin MA, Motlova L, McKinsey TA, Eubanks JH, Bařinka C, Kozikowski AP. Structural and in Vivo Characterization of Tubastatin A, a Widely Used Histone Deacetylase 6 Inhibitor. ACS Med Chem Lett 2020; 11:706-712. [PMID: 32435374 DOI: 10.1021/acsmedchemlett.9b00560] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Accepted: 01/15/2020] [Indexed: 12/23/2022] Open
Abstract
Tubastatin A, a tetrahydro-γ-carboline-capped selective HDAC6 inhibitor (HDAC6i), was rationally designed 10 years ago, and has become the best investigated HDAC6i to date. It shows efficacy in various neurological disease animal models, as HDAC6 plays a crucial regulatory role in axonal transport deficits, protein aggregation, as well as oxidative stress. In this work, we provide new insights into this HDAC6i by investigating the molecular basis of its interactions with HDAC6 through X-ray crystallography, determining its functional capability to elevate the levels of acetylated α-tubulin in vitro and in vivo, correlating PK/PD profiles to determine effective doses in plasma and brain, and finally assessing its therapeutic potential toward psychiatric diseases through use of the SmartCube screening platform.
Collapse
Affiliation(s)
- Sida Shen
- Department of Medicinal Chemistry and Pharmacognosy, College of Pharmacy, University of Illinois at Chicago, Chicago, Illinois 60612, United States
| | - Michal Svoboda
- Laboratory of Structural Biology, Institute of Biotechnology of the Czech Academy of Sciences, Prumyslova 595, 252 50 Vestec, Czech Republic
| | - Guangming Zhang
- Division of Experimental and Translational Neuroscience, Krembil Research Institute, University Health Network, Toronto, Ontario M5G 2C4, Canada
| | - Maria A. Cavasin
- Department of Medicine, Division of Cardiology, University of Colorado Anschutz Medical Campus, Aurora, Colorado 80045, United States
- Consortium for Fibrosis Research & Translation, University of Colorado Anschutz Medical Campus, Aurora, Colorado 80045, United States
| | - Lucia Motlova
- Laboratory of Structural Biology, Institute of Biotechnology of the Czech Academy of Sciences, Prumyslova 595, 252 50 Vestec, Czech Republic
| | - Timothy A. McKinsey
- Department of Medicine, Division of Cardiology, University of Colorado Anschutz Medical Campus, Aurora, Colorado 80045, United States
- Consortium for Fibrosis Research & Translation, University of Colorado Anschutz Medical Campus, Aurora, Colorado 80045, United States
| | - James H. Eubanks
- Division of Experimental and Translational Neuroscience, Krembil Research Institute, University Health Network, Toronto, Ontario M5G 2C4, Canada
| | - Cyril Bařinka
- Laboratory of Structural Biology, Institute of Biotechnology of the Czech Academy of Sciences, Prumyslova 595, 252 50 Vestec, Czech Republic
| | | |
Collapse
|
36
|
Konopka L, Jantač S, Vrzáček M, Svoboda M, Kosek J. Triboelectric charging of polyethylene powders: Comparison of same-material and different-material contributions to the charge build-up. POWDER TECHNOL 2020. [DOI: 10.1016/j.powtec.2020.04.029] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
37
|
Kadlcikova D, Musilova P, Hradska H, Petrovova M, Selingerova I, Vozdova M, Svoboda M, Rubes J. Different chromosome damage in lymphocytes of newly diagnosed gastrointestinal and breast cancer patients. Neoplasma 2020; 67:668-676. [PMID: 32039626 DOI: 10.4149/neo_2020_190604n485] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 09/18/2019] [Indexed: 11/08/2022]
Abstract
Structural chromosome aberrations are a predictive biomarker of cancer risk. Conventional chromosome analysis widely used for these purposes detects unstable chromosome aberrations that are eliminated during cell division. Stable aberrations that may persist in the body and tend to accumulate during a lifetime can be detected by fluorescence in situ hybridization (FISH). The aim of the study was to investigate the level of chromosome damage in newly diagnosed cancer patients and control subjects by FISH. Both groups of untreated cancer patients had increased frequency of aberrant cells. However, chromosome damage affected different cytogenetic endpoints. Stable translocations and cells with complex rearrangements were elevated in breast cancer patients whereas unstable chromosome aberrations (dicentric chromosomes and acentric fragments) were elevated in gastrointestinal cancer patients. These associations observed in nonsmokers were typically not pronounced in smokers (with the exception of dicentric chromosomes in gastrointestinal patients). Exposure to tobacco smoke increased aberrations in healthy controls but not in the cancer patients. Our study suggests an association between cancer and stable chromosomal rearrangements in breast cancer patients. Unstable aberrations elevated in gastrointestinal cancer patients may be at least partly ascribed to the exposure to diagnostic X-rays.
Collapse
Affiliation(s)
- D Kadlcikova
- Department of Genetics and Reproduction, Central European Institute of Technology - Veterinary Research Institute, Brno, Czech Republic
| | - P Musilova
- Department of Genetics and Reproduction, Central European Institute of Technology - Veterinary Research Institute, Brno, Czech Republic
| | - H Hradska
- Department of Genetics and Reproduction, Central European Institute of Technology - Veterinary Research Institute, Brno, Czech Republic
| | - M Petrovova
- Clinic of Comprehensive Cancer Care, Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - I Selingerova
- Regional Centre for Applied Molecular Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - M Vozdova
- Department of Genetics and Reproduction, Central European Institute of Technology - Veterinary Research Institute, Brno, Czech Republic
| | - M Svoboda
- Clinic of Comprehensive Cancer Care, Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - J Rubes
- Department of Genetics and Reproduction, Central European Institute of Technology - Veterinary Research Institute, Brno, Czech Republic
| |
Collapse
|
38
|
Procházka V, Grolich T, Farkašová M, Čan V, Svatoň R, Svoboda M, Ostřížková L, Eid M, Frola L, Bohatá Š, Kala Z. Our experience with transanal total mesorectal excision (TaTME) procedures in middle and distal rectal tumors. Rozhl Chir 2020; 99:124-130. [PMID: 32349496 DOI: 10.33699/pis.2020.99.3.124-130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
INTRODUCTION Transanal total mesorectal excision (TaTME) is a relatively new approach in surgical treatment of rectal cancer. There are no clear indications when to choose this strategy. It is a technically demanding procedure for the surgeon with a long learning curve, which should also be taken into account in evaluation of this method. The results of both oncological and postoperative complications must be properly evaluated to explore the benefit of TaTME. The aim of this study is to assess the potential benefit of TaTME compared to other alternatives in middle and distal rectal tumors. METHODS Retrospective evaluation of patients undergoing TaTME procedure performed by one team of surgeons between October 2014 and June 2019. The authors analyzed demographic indicators of the group of patients, tumor characteristics, specimen quality, early postoperative complications and the possibility of stoma reversal. RESULTS A total of 93 patients underwent TaTME procedure for middle and distal rectal cancer. Mean BMI was 27.6 (4.8). T3 or T4 tumor was found in 73 (78.5%) patients, 68 (73.1%) patients had positive lymph nodes and 12 (12.9%) patients were treated for synchronous metastatic rectal cancer. Neoadjuvant therapy was used in 80 (86%) patients. Conversion to open laparotomy was necessary in one case (1%). Stapled anastomosis was performed in 37 (39.7%) cases, handsewn in 56 (60.2%). A positive circumferential resection margin (CRM) was found in 10 (10.7%) cases. Distal resection margin (DRM) was positive in 3 (3.2%) patients. Pathological analysis showed a complete mesorectum in 18 patients (19.4%), nearly complete in 39 (41.9%) and an incomplete mesorectum in 36 (38.7%). Complications in the first 30 days after primary surgery were observed in 38 (40.8%) patients, mainly for anastomotic leak (19 patients, 20.4%). Reoperation was required in 7 (7.5%) patients. Permanent colostomy had to be performed in 4 (4.3%) cases. No patient died after surgery. CONCLUSION In a selected group of patients it is possible to perform resection using this approach with acceptable postoperative morbidity and quality of the specimen. We used TaTME procedure in patients expected to have difficult TME due to obesity, size and distal localization of tumor. The incidence of conversion to open surgery was very low. Further studies for long term oncological outcomes are needed.
Collapse
|
39
|
Tužil J, Mlčoch T, Jirčíková J, Závada J, Nekvindová L, Svoboda M, Uher M, Křístková Z, Vencovský J, Pavelka K, Doležal T. Short-term response in new users of anti-TNF predicts long-term productivity and non-disability: analysis of Czech ATTRA ankylosing spondylitis biologic registry. Expert Opin Biol Ther 2019; 20:183-192. [PMID: 31736377 DOI: 10.1080/14712598.2020.1694900] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Objectives: To assess the role of short-term response to first anti-TNF in long-term prediction of disability.Methods: In nationwide registry ATTRA, we identified ankylosing spondylitis patients starting anti-TNF between 01/2003 and 12/2016. Full disability and work impairment (WI; WPAI questionnaire) were predicted via the Cox- and lagged-parameter mixed-effect regression.Results: 2,274 biologicals-naïve patients newly indicated to anti-TNF were prospectively followed (6,333 patient-years; median follow-up 1.9 years). Reaching BASDAI < 4 (77.4%) and ASDAS-CRP < 2.1 (61.1%) after 3 months of anti-TNF both decreased the risk of future disability by ≈2.5-fold. ASDAS-CRP < 2.1 predicted non-disability better than BASDAI < 4 & CRP < 5 mg/L (p = 0.032). BASDAI < 4 & CRP < 5 mg/L was comparable to BASDAI < 4 (p = 0.941) and to BASDAI change by >50% or by >2 points (p = 0.902). ASDAS-CRP change >1.1 and >2.0 both failed to predict non-disability. Once on anti-TNF therapy, the strongest predictor of WI was Pain (SF36). Yearly increase in indirect costs remains below €3,000 in those reaching ASDAS-CRP < 2.1.Conclusions: Low disease activity measured by ASDAS-CRP ≤ 2.1 should be used to measure the outcome of new anti-TNF therapy. Continuous WI could be decreased through pain management.
Collapse
Affiliation(s)
- Jan Tužil
- Institute of Health Economics and Technology Assessment, Prague, Czech Republic.,1st Faculty of Medicine, Charles University in Prague, Prague, Czech Republic
| | - Tomáš Mlčoch
- Institute of Health Economics and Technology Assessment, Prague, Czech Republic
| | - Jitka Jirčíková
- Institute of Health Economics and Technology Assessment, Prague, Czech Republic
| | - Jakub Závada
- 1st Faculty of Medicine, Charles University in Prague, Prague, Czech Republic.,Institute of Rheumatology, Prague, Czech Republic
| | - Lucie Nekvindová
- 1st Faculty of Medicine, Charles University in Prague, Prague, Czech Republic.,Institute of Biostatistics and Analyses, Ltd., Spinoff company of the Faculty of Medicine of the Masaryk University, Brno, Czech Republic
| | - Michal Svoboda
- Institute of Biostatistics and Analyses, Ltd., Spinoff company of the Faculty of Medicine of the Masaryk University, Brno, Czech Republic
| | - Michal Uher
- Faculty of Medicine of the Masaryk University, Institute of Biostatistics and Analyses, Brno, Czech Republic
| | - Zlatuše Křístková
- Institute of Biostatistics and Analyses, Ltd., Spinoff company of the Faculty of Medicine of the Masaryk University, Brno, Czech Republic
| | - Jiří Vencovský
- 1st Faculty of Medicine, Charles University in Prague, Prague, Czech Republic.,Institute of Rheumatology, Prague, Czech Republic
| | - Karel Pavelka
- 1st Faculty of Medicine, Charles University in Prague, Prague, Czech Republic.,Institute of Rheumatology, Prague, Czech Republic
| | - Tomáš Doležal
- Institute of Health Economics and Technology Assessment, Prague, Czech Republic.,Department of Pharmacology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| |
Collapse
|
40
|
Procházka V, Svoboda M, Svatoň R, Grolich T, Farkašová M, Kala Z. Use of preperitoneal wound catheter for continuous local anaesthesia after laparoscopic colorectal surgery. Rozhl Chir 2019; 98:356-361. [PMID: 31698911 DOI: 10.33699/pis.2019.98.9.356-361] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
INTRODUCTION The main cause of postoperative pain after abdominal surgery is the wound where laparotomy is made. Recently, laparoscopic procedures have become common in colorectal surgery. Although improving the tolerance of the surgery, postoperative pain management still remains a discussed problem. The use of an epidural catheter used to be generally recommended in the open surgery era; however, an ideal strategy for postoperative analgesic therapy after laparoscopy remains unclear. Reduced administration of opioid analgesic drugs after colorectal resection is a generally accepted goal. Preperitoneal catheter insertion for continuous local anaesthetic (LA) infusion in the wound after surgery is a simple alternative to other pain management methods. METHODS Retrospective analysis of analgotherapy outcomes in patients undergoing laparoscopic colorectal resection procedures, divided in three patient groups according to the type of analgesia: Group 1: use of a catheter for local wound infusion (KAT) n=73; group 2: epidural analgesia (EPI) n=23; and control group 3 with combined parenteral and subcutaneous analgesia (CON) n=66. The main objective of this study was to analyse postoperative pain and the consumption of opioid analgesics in the first three days from the surgery and the incidence of any complications related to the analgesic therapy. RESULTS Opioid consumption in KAT and EPI groups was significantly lower compared to CON in the first 72 hours from the surgery. The lowest postoperative pain was measured in the EPI group. Subjective perception of pain, measured using VAS, was not significantly different between the KAT and CON groups. In KAT patients, vomiting was statistically less frequent than in CON patients. There was no significantly different incidence of paralytic ileus in the KAT and CON groups and no paralytic ileus was observed in the EPI group. There was no increased incidence of SSI (surgical site infections) in the KAT group compared to the other groups. CONCLUSION The use of the catheter was assessed as safe. Insertion and management of the catheter is unsophisticated, and we did not observe any complications in terms of application of the catheter or toxic side effects of the LA. The use of the catheter clearly reduced opioid administration in the postoperative period compared to the control group (CON) with combined parenteral and subcutaneous analgesics. The best pain control measured using the visual analog scale (VAS) was observed in the EPI group.
Collapse
|
41
|
Snopkova S, Matyskova M, Havlickova K, Jarkovsky J, Svoboda M, Zavrelova J, Svacinka R, Penka M, Husa P. Increasing procoagulant activity of circulating microparticles in patients living with HIV. Med Mal Infect 2019; 50:555-561. [PMID: 31611134 DOI: 10.1016/j.medmal.2019.09.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 03/01/2019] [Accepted: 09/17/2019] [Indexed: 11/25/2022]
Abstract
OBJECTIVES HIV-infected individuals are at higher risk of non-AIDS diseases associated with procoagulant status. Microparticles are elevated in disorders associated with thrombosis (e.g., cardiovascular diseases). We investigated the association between microparticle levels in untreated and treated HIV-infected subjects, and determined the association with immune status, viral replication, and duration of antiretroviral therapy. PATIENTS AND METHODS We included 144 HIV-infected subjects, including 123 on antiretroviral therapy (ART) and 21 before treatment initiation. A control group of 40 HIV-negative healthy adults matched for age and sex was used for comparison of microparticle levels. Treated subjects were divided into five groups depending on the period of antiretroviral exposure. Statistically significant differences were determined by Kruskal-Wallis test and Chi2 test. The relation between microparticles and other parameters was assessed using Spearman's coefficient of correlation. RESULTS Microparticle levels were significantly higher in treated and untreated HIV-infected subjects than in non-HIV-infected controls (P<0.001). The microparticle level was similar between the groups on treatment (P=0.913). No association between the microparticle level and CD4+ count, CD4+/CD8+ ratio, number of HIV-1 RNA copies, or duration of exposure to antiretroviral treatment was observed. CONCLUSION Increased levels of microparticles may be due to processes independent of viral replication and CD4+ cell count, and microparticle release might persist even during viral suppression by antiretroviral treatment. Elevated microparticle levels might occur in response to other triggers.
Collapse
Affiliation(s)
- S Snopkova
- Department of infectious diseases, Faculty hospital Brno and Faculty of medicine, Masaryk University Brno, Jihlavska 340/20, 62500 Brno, Czech Republic.
| | - M Matyskova
- Department of hematology, Faculty hospital Brno and Faculty of medicine, Masaryk University Brno, Jihlavska 340/20, 62500 Brno, Czech Republic
| | - K Havlickova
- Department of infectious diseases, Faculty hospital Brno and Faculty of medicine, Masaryk University Brno, Jihlavska 340/20, 62500 Brno, Czech Republic
| | - J Jarkovsky
- Institute of biostatistics and analyses, Faculty of medicine, Masaryk University Brno, Kamenice 126/3, 62500 Brno, Czech Republic
| | - M Svoboda
- Institute of biostatistics and analyses, Faculty of medicine, Masaryk University Brno, Kamenice 126/3, 62500 Brno, Czech Republic
| | - J Zavrelova
- Department of hematology, Faculty hospital Brno and Faculty of medicine, Masaryk University Brno, Jihlavska 340/20, 62500 Brno, Czech Republic
| | - R Svacinka
- Department of infectious diseases, Faculty hospital Brno and Faculty of medicine, Masaryk University Brno, Jihlavska 340/20, 62500 Brno, Czech Republic
| | - M Penka
- Department of hematology, Faculty hospital Brno and Faculty of medicine, Masaryk University Brno, Jihlavska 340/20, 62500 Brno, Czech Republic
| | - P Husa
- Department of infectious diseases, Faculty hospital Brno and Faculty of medicine, Masaryk University Brno, Jihlavska 340/20, 62500 Brno, Czech Republic
| |
Collapse
|
42
|
Wind A, Bessems M, van Eekeren R, Wijburg C, Mattson J, Halamkova J, Svoboda M, Oliveira J, de Sousa JA, van Harten W. Achieving best possible cancer treatment outcomes in care pathways through benchmarking; ABC-Benchmarking. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz263.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
43
|
Hlinomaz O, Motovska Z, Knot J, Miklik R, Hromadka M, Varvarovsky I, Dusek J, Jarkovsky J, Tousek F, Majtan B, Simek S, Branny M, Svoboda M, Widimsky P. P1727Prognosis predictors of patients with initial cardiogenic shock complicated acute myocardial infarction treated with primary angioplasty and intense antiplatelet therapy. PRAGUE-18 shock substudy. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Early reperfusion of the infarct related artery is the only treatment improving prognosis of patients with initial cardiogenic shock (CGS) complicated acute myocardial infarction (AMI) (Killip class IV at admission).
Purpose
The analysis focused on subgroup of patients with initial CGS randomized into the multicenter PRAGUE-18 study (prasugrel vs. ticagrelor in primary PCI).
Methods
In the PRAGUE-18 study, patients with acute myocardial infarction (AMI) (n=1230) treated with primary percutaneous coronary intervention (pPCI) were immediately randomized to prasugrel or ticagrelor with intended treatment duration of 12 months. 53.6% (n=659) switched to clopidogrel after discharge. Major ischemic and bleeding events were followed throughout the entire study period. Beside standard laboratory tests, efficacy of ticagrelor and prasugrel was measured by flow cytometric VASP evaluation in patients selected for a laboratory sub-study (n=218). Acute heart failure (KILLIP >1) was present in 11.8%, and 46 patients (3.7%) randomized to the study were in CGS.
Results
Patients with CGS were older [66.7 (48,3; 83,3) years] than those without CGS (KILLIP <4), and had the highest prevalence of bundle brunch block on the initial ECG (RBBB in 6.5%, LBBB in 8.7%, p=0.003 for difference in bundle brunch blocks). Time delay to hospital admission [1,7 (0,4; 36,0) hs] was significantly shorter than in patients KILLIP <4 [2,8 (0,8; 28,3hs; p=0.003]. Significantly more CGS patients had history of previous MI (19.6% vs 7.9%, p=0.011) and bypass graft surgery (6.5% vs 1.5%, p=0.041). 67.4% of CGS patients had multivessel disease and in 17.4% of these patients primary PCI was evaluated as suboptimal result or procedural failure (compared to 4.3% in patients without shock, p<0.001).
No difference was observed in clinical (primary and secondary endpoints, p=0.564) or laboratory efficacy between prasugrel and ticagrelor treated patients with CGS (p=0.800 for VASP index difference between prasugrel and ticagrelor 20±4 hs after loading doses). We did not find any difference in initial platelet activation (VASP index before P2Y12 inhibitors administration) in patients without acute heart failure (KILLIP I) [83.2 (54.1–94.2) %] and with KILLIP > I [82.5 (65.7–96.9), p=0.999], and this was also confirmed for the difference between KILLIP I and KILLIP IV patients (p=0.416).
Conclusion
Results of the present analysis and defined predictors of mortality showed that prognosis of patients with initial cardiogenic complicated AMI treated with pPCI cannot be influenced by more potent platelet inhibition (than in AMI patients without CGS). Furthermore, the concluding evidence underscored adherence to the current guidelines' recommendation of the earliest possible reperfusion of infarct related artery as well as administration of prasugrel or ticagrelor.
Collapse
Affiliation(s)
- O Hlinomaz
- ICRC, St. Anne University Hopital, Department of Cardioangiology, Brno, Czechia
| | - Z Motovska
- Third Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady, Cardiocentre, Prague, Czechia
| | - J Knot
- Third Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady, Cardiocentre, Prague, Czechia
| | - R Miklik
- Faculty of Medicine of Masaryk University and University Hospital, Department of Internal Medicine and Cardiology, Brno, Czechia
| | - M Hromadka
- University Hospital Pilsen, Department of Cardiology, Pilsen, Czechia
| | | | - J Dusek
- University Hospital Hradec Kralove, First Department of Internal Medicine, Hradec Kralove, Czechia
| | - J Jarkovsky
- Faculty of Medicine and the Faculty of Science of Masaryk University, Institute of Biostatistics and Analyses, Brno, Czechia
| | - F Tousek
- Regional Hospital, Cardiocentre – Department of Cardiology, Ceske Budejovice, Czechia
| | - B Majtan
- Regional Hospital, Cardiocentre, Karlovy Vary, Czechia
| | - S Simek
- Charles University and General University Hospital, Second Department of Medicine – Department of Cardiovascular Medicine, First Faculty of Medicine, Prague, Czechia
| | - M Branny
- Hospital Podlesi, AGEL Research and Training Institute, Cardiovascular Center, Trinec, Czechia
| | - M Svoboda
- Faculty of Medicine and the Faculty of Science of Masaryk University, Institute of Biostatistics and Analyses, Brno, Czechia
| | - P Widimsky
- Third Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady, Cardiocentre, Prague, Czechia
| |
Collapse
|
44
|
Mrozek J, Necasova T, Svoboda M, Simkova I, Jansa P. Prediction Score for persisting perfusion defects after pulmonary embolism. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2019; 164:394-400. [PMID: 31551608 DOI: 10.5507/bp.2019.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2019] [Accepted: 07/02/2019] [Indexed: 11/23/2022] Open
Abstract
AIMS Long-term persistence of perfusion defect after pulmonaryembolism (PE) may lead to the development of chronic thromboembolic pulmonary hypertension. Identification of patients at risk of such a complication using a scoring system would be beneficial in clinical practice. Here, we aimed to derive a score for predicting persistence of perfusion defects after PE. METHODS 83 patients after PE were re-examined 6, 12 and 24 months after the PE episode. Data collected at the time of PE and perfusion status during follow-ups were used for modelling perfusion defects persistence using the Cox proportional hazards model and validated using bootstrap method. RESULTS A simple scoring system utilizing two variables (hemoglobin levels and age at the time of PE) was developed. Patients with hemoglobin levels over 140 g/L who were older than 65 years were at the highest risk of perfusion defects; in patients with the same hemoglobin levels and age <65 years, the risk was reduced by 79%, and by 89% in patients with hemoglobin <140 g/L. CONCLUSION The proposed scoring system may be useful in clinical practice for identifying patients with high risk of persisting perfusion defects, flagging them for closer follow up, thus improving the effectiveness of long-term treatment of patients after PE.
Collapse
Affiliation(s)
- Jan Mrozek
- Department of Cardiovascular Diseases, University Hospital Ostrava, 17. listopadu 1790, 708 52 Ostrava-Poruba, Czech Republic
| | - Tereza Necasova
- Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University Brno, Postovska 68/3, 602 00 Brno, Czech Republic
| | - Michal Svoboda
- Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University Brno, Postovska 68/3, 602 00 Brno, Czech Republic
| | - Iveta Simkova
- National Institute of Cardiovascular Diseases and Slovak Medical University, Pod Krasnou horkou 7185/1, 831 01 Bratislava - Nove Mesto, Slovak Republic
| | - Pavel Jansa
- Clinical Department of Cardiology and Angiology, 1st Faculty of Medicine, 2nd Medical Department, Charles University, U Nemocnice 499/2, 128 08 Praha 2 - Nove Mesto, Czech Republic
| |
Collapse
|
45
|
Srb P, Svoboda M, Benda L, Lepšík M, Tarábek J, Šícha V, Grüner B, Grantz-Šašková K, Brynda J, Řezáčová P, Konvalinka J, Veverka V. Capturing a dynamically interacting inhibitor by paramagnetic NMR spectroscopy. Phys Chem Chem Phys 2019; 21:5661-5673. [PMID: 30794275 DOI: 10.1039/c9cp00416e] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Transient and fuzzy intermolecular interactions are fundamental to many biological processes. Despite their importance, they are notoriously challenging to characterize. Effects induced by paramagnetic ligands in the NMR spectra of interacting biomolecules provide an opportunity to amplify subtle manifestations of weak intermolecular interactions observed for diamagnetic ligands. Here, we present an approach to characterizing dynamic interactions between a partially flexible dimeric protein, HIV-1 protease, and a metallacarborane-based ligand, a system for which data obtained by standard NMR approaches do not enable detailed structural interpretation. We show that for the case where the experimental data are significantly averaged to values close to zero the standard fitting of pseudocontact shifts cannot provide reliable structural information. We based our approach on generating a large ensemble of full atomic models, for which the experimental data can be predicted, ensemble averaged and finally compared to the experiment. We demonstrate that a combination of paramagnetic NMR experiments, quantum chemical calculations, and molecular dynamics simulations offers a route towards structural characterization of dynamic protein-ligand complexes.
Collapse
Affiliation(s)
- Pavel Srb
- Institute of Organic Chemistry and Biochemistry of the Czech Academy of Sciences, Prague, Czech Republic.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
46
|
Svoboda M, Konvalinka J, Trempe JF, Grantz Saskova K. The yeast proteases Ddi1 and Wss1 are both involved in the DNA replication stress response. DNA Repair (Amst) 2019; 80:45-51. [PMID: 31276951 DOI: 10.1016/j.dnarep.2019.06.008] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 05/23/2019] [Accepted: 06/26/2019] [Indexed: 01/05/2023]
Abstract
Genome integrity and cell survival are dependent on proper replication stress response. Multiple repair pathways addressing obstacles generated by replication stress arose during evolution, and a detailed understanding of these processes is crucial for treatment of numerous human diseases. Here, we investigated the strong negative genetic interaction between two proteases involved in the DNA replication stress response, yeast Wss1 and Ddi1. While Wss1 proteolytically acts on DNA-protein crosslinks, mammalian DDI1 and DDI2 proteins remove RTF2 from stalled forks via a proposed proteasome shuttle hypothesis. We show that the double-deleted Δddi1, Δwss1 yeast strain is hypersensitive to the replication drug hydroxyurea and that this phenotype can be complemented only by catalytically competent Ddi1 protease. Furthermore, our data show the key involvement of the helical domain preceding the Ddi1 protease domain in response to replication stress caused by hydroxyurea, offering the first suggestion of this domain's biological function. Overall, our study provides a basis for a novel dual protease-based mechanism enabling yeast cells to counteract DNA replication stress.
Collapse
Affiliation(s)
- Michal Svoboda
- Institute of Organic Chemistry and Biochemistry of the Czech Academy of Sciences, Flemingovo n. 2, 16610, Prague, Czech Republic; Department of Physical and Macromolecular Chemistry, Charles University, Hlavova 8, 12843, Prague, Czech Republic; Department of Genetics and Microbiology, Charles University, Viničná 5, 12843, Prague, Czech Republic
| | - Jan Konvalinka
- Institute of Organic Chemistry and Biochemistry of the Czech Academy of Sciences, Flemingovo n. 2, 16610, Prague, Czech Republic; Department of Biochemistry, Charles University, Hlavova 8, 12843, Prague, Czech Republic
| | - Jean-François Trempe
- Centre for Structural Biology and Department of Pharmacology & Therapeutics, McGill University, Montreal, Quebec, Canada
| | - Klara Grantz Saskova
- Institute of Organic Chemistry and Biochemistry of the Czech Academy of Sciences, Flemingovo n. 2, 16610, Prague, Czech Republic; Department of Genetics and Microbiology, Charles University, Viničná 5, 12843, Prague, Czech Republic.
| |
Collapse
|
47
|
Harazim H, Stourac P, Blaha J, Grochova M, Klozova R, Noskova P, Seidlova D, Richterova S, Svoboda M, Jarkovsky J, Silova X, Jezova B, Steinbach J, Zemanek M, Mannova J, Slavik J, Novakova Z, Misakova L, Firment J. The influence of mode of anaesthesia for caesarean delivery on neonatal Apgar scores in the Czech Republic and Slovakia: secondary analysis of the results of an international survey in 2015. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2019; 163:147-154. [PMID: 30976125 DOI: 10.5507/bp.2019.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Accepted: 03/04/2019] [Indexed: 12/23/2022] Open
Abstract
AIMS The purpose of this international survey was to describe the impact of current practices and techniques of caesarean section on the neonatal Apgar score in the Czech Republic (CZE) and Slovakia (SVK). METHODS All Czech and Slovak departments that provide obstetric anaesthesia were invited to participate in a one-month (November 2015) prospective study that monitored in details all peripartum anaesthetic practices, delivered by anaesthesiologists. Participating centers recorded all data on-line in the CLADE-IS database (Masaryk University, CZE). RESULTS AND DISCUSSIONS We collected data of 10119 women who delivered 10226 newborns. A caesarean section was recorded in 25.1% of deliveries (CZE 23.2%; SVK 30%). General anaesthesia was used for caesarean section in 37.5% of the cases (CZE 40%, SVK 33%). There was no statistically significant difference in the Apgar score lower than 7 in the 1, 5 or 10 min in groups of general and regional anaesthesia for caesarean section, when only elective sections of in-term babies with birth weight over 2500 g were analyzed. We found no statistically significant differences in the Apgar score in newborns of women intubated for caesarean section in rocuronium (n=21; 2.2%) and suxamethonium (n=889; 93%). CONCLUSION We found no difference in neonatal outcomes in groups of general and regional anaesthesia for caesarean section when only out-of-risk newborns were analyzed. The risk factors were identified as follows: an acute caesarean section, preterm babies, birth weight less than 2 500 g, born in perinatological center and multiple pregnancy - second baby. TRIAL REGISTRATION ClinicalTrials.gov (ID: NCT02380586) https://clinicaltrials.gov/ct2/show/NCT02380586.
Collapse
Affiliation(s)
- Hana Harazim
- Department of Anaesthesiology and Intensive Care Medicine, Faculty of Medicine, Masaryk University and University Hospital Brno, Brno, Czech Republic
| | - Petr Stourac
- Department of Paediatric Anaesthesiology and Intensive Care Medicine, Faculty of Medicine, Masaryk University and University Hospital Brno, Brno, Czech Republic
| | - Jan Blaha
- Department of Anaesthesiology and Intensive Care Medicine, 1 st Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Monika Grochova
- Department of Anaesthesiology and Intensive Care Medicine, L. Pasteur University Hospital, Kosice, Slovakia
| | - Radka Klozova
- Department of Anaesthesiology and Intensive Care Medicine, 2 nd Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | - Pavlina Noskova
- Department of Anaesthesiology and Intensive Care Medicine, 1 st Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Dagmar Seidlova
- 2 nd Department of Anaesthesiology and Resuscitation, Faculty of Medicine, Masaryk University and University Hospital Brno, Brno, Czech Republic
| | - Stanislava Richterova
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital Martin, Martin, Slovakia
| | - Michal Svoboda
- Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Jiri Jarkovsky
- Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Xenia Silova
- Department of Anaesthesiology and Intensive Care Medicine, Faculty of Medicine in Hradec Kralove, Charles University and University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
| | - Bozena Jezova
- Department of Anaesthesiology and Intensive Care Medicine, Opava Hospital, Opava, Czech Republic
| | - Jiri Steinbach
- Department of Anaesthesiology and Intensive Care Medicine, Horovice Hospital, Horovice, Czech Republic
| | - Martin Zemanek
- Department of Anaesthesiology and Intensive Care Medicine, Chrudim Hospital, Chrudim, Czech Republic
| | - Jitka Mannova
- Department of Anaesthesiology and Intensive Care Medicine, Havlickuv Brod Hospital, Havlickuv Brod, Czech Republic
| | - Jan Slavik
- Department of Anaesthesiology and Intensive Care Medicine, Kosice-Saca Hospital, Kosice, Slovakia
| | - Zuzana Novakova
- Department of Anaesthesiology and Intensive Care Medicine, Piestany Hospital, Piestany, Slovakia
| | - Lubica Misakova
- Department of Anaesthesiology and Intensive Care Medicine, Trencin Hospital, Trencin, Slovakia Corresponding author: Petr Stourac, e-mail
| | - Jozef Firment
- Department of Anaesthesiology and Intensive Care Medicine, L. Pasteur University Hospital, Kosice, Slovakia
| |
Collapse
|
48
|
Miravitlles M, Koblizek V, Esquinas C, Milenkovic B, Barczyk A, Tkacova R, Somfay A, Zykov K, Tudoric N, Kostov K, Zbozinkova Z, Svoboda M, Sorli J, Krams A, Valipour A. Determinants of CAT (COPD Assessment Test) scores in a population of patients with COPD in central and Eastern Europe: The POPE study. Respir Med 2019; 150:141-148. [PMID: 30961941 DOI: 10.1016/j.rmed.2019.03.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 03/15/2019] [Accepted: 03/17/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND The COPD Assessment Test (CAT) has been proposed to help guide therapy in chronic obstructive pulmonary disease (COPD). It is important to understand the distribution of scores in different COPD populations and their determinants. METHODS The POPE study is an international, observational cross-sectional study of COPD subjects in 11 Central and Eastern European countries aimed at characterizing COPD phenotypes. Here we report the analysis of CAT scores with the objective of identifying their determinants, evaluating symptom load and investigating the distribution of scores among the participating countries. Additionally, we investigated the discrepancies between the CAT and modified Medical Research Council (mMRC) scores when used to classify patients according to the GOLD strategy. RESULTS The study included 3452 patients (69.2% men, mean forced expiratory volume in 1 s (FEV1% predicted) 52.5%). The mean CAT score was 17.5 (SD = 7.8), ranging from 15.1 in Hungary to 21.2 in Bulgaria. Multiple linear regression analysis showed six variables significantly associated with CAT scores: depression, number of previous exacerbations, 6-min walking distance, FEV1(%), mMRC and country and explained 47.2% of the variance of CAT. According to either CAT or mMRC, up to 23.9% patients would be classified in different GOLD groups. CONCLUSIONS The CAT score may be predicted by factors related to COPD severity, depression and exercise capacity, with significant differences in the distribution of CAT scores in different countries. According to our results CAT >10 is not equivalent to mMRC >2 for assessing symptom burden. TRIAL REGISTRATION ClinicalTrials.gov, identifier NCT02119494.
Collapse
Affiliation(s)
- Marc Miravitlles
- Pneumology Department, Hospital Universitari Vall d'Hebron/Vall d'Hebron Research Institute (VHIR), CIBER de Enfermedades Respiratorias (CIBERES), Barcelona, Spain.
| | - Vladimir Koblizek
- Department of Pneumology, University Hospital Hradec Králové, Charles University, Faculty of Medicine in Hradec Králové, Czech Republic
| | - Cristina Esquinas
- Pneumology Department, Hospital Universitari Vall d'Hebron/Vall d'Hebron Research Institute (VHIR), CIBER de Enfermedades Respiratorias (CIBERES), Barcelona, Spain
| | - Branislava Milenkovic
- Clinic for Pulmonary Diseases, Faculty of Medicine, Clinical Center of Serbia, Belgrade, Serbia
| | - Adam Barczyk
- Department of Pneumology, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
| | - Ruzena Tkacova
- Department of Respiratory Medicine and Tuberculosis, Faculty of Medicine, P.J. Safarik University, Kosice, Slovakia
| | - Attila Somfay
- Department of Pulmonology, University of Szeged, Deszk, Hungary
| | - Kirill Zykov
- Pulmonology Scientific Research Institute under FMBA of Russia, Moscow State University of Medicine and Dentistry Named after A.I.Evdokimov, Russia
| | - Neven Tudoric
- School of Medicine Zagreb, University Hospital Dubrava, Zagreb, Croatia
| | - Kosta Kostov
- Clinic of Pulmonary Diseases, Military Medical Academy, Sofia, Bulgaria
| | - Zuzana Zbozinkova
- Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Michal Svoboda
- Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Jurij Sorli
- Pulmonary Department, Topolsica Hospital, Topolsica, Slovenia
| | - Alvils Krams
- Faculty of Medicine, University of Latvia, Riga, Latvia; Riga East University Hospital, Latvia
| | - Arschang Valipour
- Department of Respiratory and Critical Care Medicine, Ludwig-Boltzmann-Institute for COPD and Respiratory Epidemiology, Otto-Wagner-Spital, Wien, Austria
| |
Collapse
|
49
|
Vytrisalova M, Hendrychova T, Touskova T, Zimcikova E, Vlcek J, Nevoranek L, Svoboda M, Hejduk K, Brat K, Plutinsky M, Novotna B, Musilova P, Cernohorsky M, Koblizek V. Breathing Out Completely Before Inhalation: The Most Problematic Step in Application Technique in Patients With Non-Mild Chronic Obstructive Pulmonary Disease. Front Pharmacol 2019; 10:241. [PMID: 30914956 PMCID: PMC6423151 DOI: 10.3389/fphar.2019.00241] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Accepted: 02/26/2019] [Indexed: 12/22/2022] Open
Abstract
Background: Patient adherence to an inhaled medication application technique (A-ApplT) represents a major health-care issue in patients with chronic obstructive pulmonary disease (COPD). However, there is a lack of studies evaluating this issue thoroughly. The aim of our study was to introduce a universal easy-to-use method of assessing the A-ApplT to chronic medication in moderate to very severe COPD individuals. Methods: The Czech Multicenter Research Database of COPD (COPD CMRD), a large observational prospective study, was used as a source of clinical data. A-ApplT was evaluated using our Five Steps Assessment. This measure is based on dichotomous evaluation of each of five predefined consecutive application technique steps and can be used in all settings for all currently available inhalation systems in COPD subjects. Results: A total of 546 participants (75.0% men; mean age 66.7 years; mean forced expiratory volume in 1s 44.7%) were available for analysis. This represents 69.6% of all patients recruited in the COPD CMRD. Less than one third of patients presented their application technique without any erroneous steps. The most problematic steps were breathing out completely in one breath immediately before inhalation (step No. 3), and the actual inhalation maneuver (step No. 4). The total number of errors was similar for dry powder inhalers and pressurized metered-dose inhalers. Conclusion: Our novel instrument, Five Steps Assessment, is comfortable for use in routine clinical practice to explore A-ApplT. The A-ApplT in real-life patients with non-mild COPD was inadequate and patients should be repeatedly trained by properly (re-)educated medical staff.
Collapse
Affiliation(s)
- Magda Vytrisalova
- Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University, Hradec Králové, Czechia
| | - Tereza Hendrychova
- Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University, Hradec Králové, Czechia
| | - Tereza Touskova
- Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University, Hradec Králové, Czechia
| | - Eva Zimcikova
- Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University, Hradec Králové, Czechia
| | - Jiri Vlcek
- Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University, Hradec Králové, Czechia
| | - Libor Nevoranek
- Department of Pneumology, Faculty of Medicine in Hradec Králové and University Hospital Hradec Králové, Charles University, Hradec Králové, Czechia
| | - Michal Svoboda
- Faculty of Medicine, Institute of Biostatistics and Analyses of the Faculty of Medicine, Masaryk University, Brno, Czechia.,Institute of Biostatistics and Analyses, Ltd., Brno, Czechia
| | - Karel Hejduk
- Faculty of Medicine, Institute of Biostatistics and Analyses of the Faculty of Medicine, Masaryk University, Brno, Czechia
| | - Kristian Brat
- Department of Pulmonary Diseases and Tuberculosis, Faculty of Medicine, University Hospital Brno, Masaryk University, Brno, Czechia
| | - Marek Plutinsky
- Department of Pulmonary Diseases and Tuberculosis, Faculty of Medicine, University Hospital Brno, Masaryk University, Brno, Czechia
| | | | | | - Matej Cernohorsky
- Department of Pneumology, Faculty of Medicine in Hradec Králové and University Hospital Hradec Králové, Charles University, Hradec Králové, Czechia
| | - Vladimir Koblizek
- Department of Pneumology, Faculty of Medicine in Hradec Králové and University Hospital Hradec Králové, Charles University, Hradec Králové, Czechia
| |
Collapse
|
50
|
Virreira M, Jin L, Djerbib S, De Deken X, Miot F, Massart C, Svoboda M, Van Sande J, Beauwens R, Dumont JE, Boom A. Expression, Localization, and Regulation of the Sodium Bicarbonate Cotransporter NBCe1 in the Thyroid. Thyroid 2019; 29:290-301. [PMID: 30526387 DOI: 10.1089/thy.2017.0576] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND The intrafollicular space of thyroid follicles is the storage compartment for thyroid hormones. Its pH has been established at around 7.6 at least after thyrotropin (TSH) stimulation. This alkaline intrafollicular pH is thought to be critical for iodide coupling to thyroglobulin and internalization of iodinated thyroglobulin. At least in mice, this alkalinization requires the expression of pendrin (Slc26a4) within the apical membrane, and a lack of pendrin results in acidic follicular lumen pH. Yet, the mechanism importing HCO3- into the cytoplasm is unknown. This study investigated whether the rather ubiquitous sodium bicarbonate cotransporter NBCe1 (SLC4A4) might play this role. It also examined which variant was expressed and where it was localized in both rat and human thyroid tissue. Lastly, the dependence of its expression on TSH was studied. METHODS Reverse transcription polymerase chain reaction, immunofluorescence, and Western blotting were used to test whether TSH stimulated NBCe1 protein expression in vivo. Subcellular localization of NBCe1 was performed using immunofluorescence in both rat and human thyroid. Cultured thyroid cells were also used to attempt to define how TSH affects NBCe1 expression. RESULTS Only transcripts of the NBCe1-B variant were detected in both rat and human thyroid. Of interest, NBCe1-C was not detected in human tissues, not even in the brain. On immunofluorescence microscopy, the immunostaining of NBCe1 mainly appeared in the basolateral membrane upon stimulation with TSH. This TSH induction of basolateral membrane expression of NBCe1 protein was confirmed in vivo in rat thyroid and in vitro on human thyroid slices. CONCLUSIONS This study demonstrates the expression of the sodium bicarbonate cotransporter NBCe1-B in rat and human thyroid. Additionally, the data suggest that TSH blocks the degradation of NBCe1 protein by trafficking it to the basolateral membrane. Hence, TSH increases NBCe1 half-life without increasing its synthesis.
Collapse
Affiliation(s)
- Myrna Virreira
- 1 Laboratoire de Physiologie Cellulaire et Moléculaire; de Neuroanatomie et de Neuropahologie, Université libre de Bruxelles, Brussels, Belgium
| | - Ling Jin
- 2 Institut de Recherche Interdisciplinaire en Biologie Humaine et Moléculaire (IRIBHM); de Neuroanatomie et de Neuropahologie, Université libre de Bruxelles, Brussels, Belgium
| | - Sami Djerbib
- 1 Laboratoire de Physiologie Cellulaire et Moléculaire; de Neuroanatomie et de Neuropahologie, Université libre de Bruxelles, Brussels, Belgium
| | - Xavier De Deken
- 2 Institut de Recherche Interdisciplinaire en Biologie Humaine et Moléculaire (IRIBHM); de Neuroanatomie et de Neuropahologie, Université libre de Bruxelles, Brussels, Belgium
| | - Françoise Miot
- 2 Institut de Recherche Interdisciplinaire en Biologie Humaine et Moléculaire (IRIBHM); de Neuroanatomie et de Neuropahologie, Université libre de Bruxelles, Brussels, Belgium
| | - Claude Massart
- 2 Institut de Recherche Interdisciplinaire en Biologie Humaine et Moléculaire (IRIBHM); de Neuroanatomie et de Neuropahologie, Université libre de Bruxelles, Brussels, Belgium
| | - Michal Svoboda
- 3 Laboratoire Chimie Biologique et de la Nutrition; de Neuroanatomie et de Neuropahologie, Université libre de Bruxelles, Brussels, Belgium
| | - Jacqueline Van Sande
- 2 Institut de Recherche Interdisciplinaire en Biologie Humaine et Moléculaire (IRIBHM); de Neuroanatomie et de Neuropahologie, Université libre de Bruxelles, Brussels, Belgium
| | - Renaud Beauwens
- 1 Laboratoire de Physiologie Cellulaire et Moléculaire; de Neuroanatomie et de Neuropahologie, Université libre de Bruxelles, Brussels, Belgium
| | - Jacques-Emile Dumont
- 2 Institut de Recherche Interdisciplinaire en Biologie Humaine et Moléculaire (IRIBHM); de Neuroanatomie et de Neuropahologie, Université libre de Bruxelles, Brussels, Belgium
| | - Alain Boom
- 4 Laboratoire d'Histologie, de Neuroanatomie et de Neuropahologie, Université libre de Bruxelles, Brussels, Belgium
| |
Collapse
|