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280, 95% CI 0.186 to 0.512; P<0.001), coronary artery bypass graft (CABG) surgery (OR 0.482, 95% CI 0.220 to 0.903; P=0.025), and rescue or facilitated PCI (OR 0.420, 95% CI 0.071 to 0.812; P=0.001) were all associated with reduced in-hospital mortality in comparison with medical treatment. Furthermore, primary PCI was a crucial protective factor against prolonged length of hospital stay (OR 0.307, 95% CI 0.266 to 0.594; P<0.001).
In-hospital mortality and hospitalization length were almost halved during the study period, and primary PCI has now replaced thrombolysis in the management of STEMI.
In-hospital mortality and hospitalization length were almost halved during the study period, and primary PCI has now replaced thrombolysis in the management of STEMI.
Miniinvasive approaches are a long-term trend in surgery. Maximum possible quality of life after treatment of rectal cancer is a long-term goal. Adequate radicality of surgery is a long-term necessity. It is sometimes very difficult to fulfill all the above-mentioned requirements in low-level rectal cancer. By applying a multidisciplinary approach in the treatment of mildly advanced stages of low-seated malignant rectal tumor, a treatment procedure resulting in continence preserving can be offered to a selected group of patients meeting the strict indication criteria. We document our results with respect to a small number of patients in several interesting case reports.
We are following up one patient after ideal treatment course achieving downstaging after neoadjuvant treatment, with uncomplicated operation and after operation period and with a long-term complete remission. One patient achieved dehiscence of the rectum suture. After secondary healing we observed a long-term remission. In one patient a res that the manuscript met the ICMJE recommendation for biomedical papers.
According to the worldwide data available, the combination of neoadjuvant chemoradiotherapy and local excision by means of an operative rectoscope is a safe alternative to a resection surgery with total mesorectal excision in T2N0 rectal cancer. However, there is a need of other studies with more patients included, optimally randomized and prospective ones, which will support these claims. Supported by MH CR - DRO (MOÚ, 00209805). The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study. The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers.Carcinoids have been classified according to their embryonic origin in the past and are now categorized and classified as neuroendocrine tumors, including low malignant typical carcinoids, moderate malignant atypical carcinoids, and highly malignant large cell neuroendocrine and small cell carcinomas. A typical carcinoid is a previously used term for the current designation of a grade I neuroendocrine tumor, well differentiated, belonging to a group of rare tumors with a good prognosis with metastasis of less than 15% with a five-year survival of more than 90%, rarely producing serotonin. Even this bio-logically favorable tumor with a relatively low degree of metastasis cannot be underestimated. Case The following section summarizes the classification of neuroendocrine tumors, their dia-gnosis and treatment, and the second section presents a specific case of a patient with multiple metastases of an original lung carcinoid (histology at the time of surgery 2012, at the time of using this older version of neuroendocrine tumors) describing its further treatment. Conclusion In well differentiated neuroendocrine tumors, there is a significant risk of metastasis despite their radical surgery; their dispensarization is therefore necessary. The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study. The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers.
Ultrasound-guided pectoral nerve block type II is a recently proposed technique for postoperative analgesia after breast cancer surgery. The thoracic paravertebral block is widely used for this purpose by decades. The presented study compares the efficacy of these two techniques for postoperative analgesia.
Sixty adult women were undergoing unilateral radical mastectomy or quadrantectomy with axillary dissection. The patients were randomized to receive either pectoral nerve block with 30ml ropivacaine 0.375% (Pecs group) or thoracic paravertebral block with 20ml ropivacaine 0.5% (TPVB group). The evaluated variables included pain intensity by the numerical rating scale at 0, 2, 4, 6, 12, 18 and the 24 hours, 24-hour postoperative opioid (promedol) and nonopioid (ketoprofen) consumption and the time to first rescue analgesia.
There were no statistically significant differences between both groups in the pain intensity after surgery. Ten (33%) patients from Pecs group and nine (30%) patients from TPVB group did not require any analgesia within the first 24 hours (P = 0.793). The mean postoperative ketoprofen consumption was lower in Pecs group 63.3 (± 66.87) mg vs. 90.0 (± 84.49) mg (Р = 0.283). The number of patients who required promedol was 6 (20%) vs. 8 (27%) in Pecs and TPVB groups, respectively (Р = 0.542). The time to first analgesic request was longer in Pecs group, 550 (400.0-600.0) min vs. 510 (360.0-600.0) min (Р = 0.506) in TPVB group.
In breast cancer surgery, the pectoral nerve block type II with ropivacaine 0.375% can provide postoperative analgesia that is comparable to the single-level thoracic paravertebral block.
In breast cancer surgery, the pectoral nerve block type II with ropivacaine 0.375% can provide postoperative analgesia that is comparable to the single-level thoracic paravertebral block.
Curative chemoradiotherapy of squamous cell carcinoma achieves long-term complete remissions in most patients and minimizing treatment toxicity becomes crucial issue. The aim of the retrospective analysis was to determine an acceptable dose to the bone marrow for radiotherapy planning not leading to increased haematological toxicity.
In the period 2013-2019, 40 patients with squamous cell carcinoma were curatively treated at the Department of Oncology of the University Hospital Motol using intensity modulated radiotherapy (IMRT) /volumetric modulated arc radiotherapy (VMAT) technique. Women make up 90% of the group, the average age at the time of dia-gnosis was 65 years (47-81). Chemotherapy mitomycin C and 5-fluorouracil was given to 68% of patients. The bone marrow was contoured in the Varian Eclipse planning system, version 15.6.
Acute hematotoxicity (G3, 4, 5 according to Common Terminology Criteria for Adverse Events - CTCAE) was significantly associated with the concomitant chemoradiotherapy (P = an to bone marrow lower than 27 Gy. The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study. The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical, papers.
Radical chemoradiotherapy in the treatment of squamous cell anal carcinoma is highly effective. IMRT/VMAT enabled to apply a sufficiently effective dose to the tumor and elective areas and reduced not only acute skin, GI and GU toxicity, but also acute haematological toxicity in cases with the dose Dmean to bone marrow lower than 27 Gy. The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study. The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical, papers.
Gamma-heavy chain disease is a rare disease, described so far in approximately 150 cases. The aim of this work was laboratory dia-gnostics of immunoglobulin heavy chain disease.
A 60-year-old patient was referred to the University Hospital in Ostrava for suspected marginal zone lymphoma from gastric bio-psy. Staging examinations including bone marrow trepanobio-psy and PET/CT were added; special examinations required serum protein electrophoresis, immunofixation electrophoresis, determination of polyclonal immunoglobulins, free light chains, and immunoglobulin heavy/light chain pairs. Isoelectric focusing in agarose gel followed by affinity immunoblotting and SDS electrophoresis was added due to unclear findings.
0.1 % of plasma cells were found in the bone marrow, of which 87 % were clonal (pathological) plasma cells, followed by the cyt cytotype LAMBDA + CD38 + CD138 + CD45 + CD19 + CD56- CD27 + CD81- CD117-. Monoclonal heavy chains were found in the patients serum. No monoclonal immunoglobulin heavy detection of a complete paraprotein molecule, additional methods must be used to confirm them. The finding of monoclonal heavy chain gamma in the serum of the study patient is related to the presence of marginal zone lymphoma, which was proven from a gastric bio-psy. The study was supported by the project of MH CZ - DRO - FNOs /2017 (Biobank in Teaching Hospital Ostrava) The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study. The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers.
Extracellular vesicles are closed structured surrounded by a lipid membrane that are secreted by almost all types of cells; their function is information delivery during cell-to-cell communication. They are most commonly divided into three categories - exosomes, microvesicles and apoptotic bodies. Exosomes are small vesicles with the size of 30-100 nm, and they are found in almost all body fluids, including peripheral blood, urine, breast milk, saliva and others. They are able to deliver their content to target cells and change their behavior. Cancer cells are able to secrete more exosomes and also contain different proteins and RNA species than the exosomes from healthy cells. Due to their specific composition that is connected to the cell of origin, exosomes could be used as bio-markers of various diseases in the future.
The aim of this work is to summarize current knowledge about exosomes and their role in various processes connected to resistance in tumors. This work was supported by grant of the Ministry of Health of the Czech Republic AZV 17-29343A. The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study. The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers.
The aim of this work is to summarize current knowledge about exosomes and their role in various processes connected to resistance in tumors. This work was supported by grant of the Ministry of Health of the Czech Republic AZV 17-29343A. OH-BBN The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study. The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers.
Cervical cancer is one of the most frequent cancers in pregnant women, despite this combination being a rare condition. More than 70% of cases are dia-gnosed in early stages and its treatment can be postponed after the delivery. Invasive cancer dia-gnosis in pregnancy is difficult for a patient, her family and doctors. A multidisciplinary team should take care of the patient and foetus and patients wishes are respected regarding her treatment and pregnancy. Radiotherapy in pregnancy is contraindicated. Neoadjuvant or adjuvant chemotherapy is therefore a main treatment method in patients with high risk disease either during pregnancy, or after the delivery. Neoadjuvant chemotherapy choice, delivery timing and definitive treatment are keys to mothers and childs health. Palliative treatment during pregnancy is extremely rare and the prognosis is poor. Bevacizumab and pembrolizumab are promising in the palliative treatment of non-pregnant patients. Neither bio-logical therapy by bevacizumab, nor immunotherapy by pembrolizumab can be administered to pregnant patient due to their mechanisms of action.
