ABSTRACT
Acute mesenteric ischemia is a serious problem with high morbidity and mortality rates. Mesenteric ischemia is difficult to diagnose and treat, mainly due to late diagnosis when irreversible changes are already present. The authors present a case of a patient who died after being admitted to an infectious disease department with gastroenteritis subsequently complicated by acute mesenteric ischemia. Crucial for these patients survival are early diagnosis as well as rapid and adequate treatment. There is still no laboratory marker suggesting ongoing intestinal ischemia. The most suitable diagnostic tool seems to be CT angiography combined with surgery to inspect the abdominal cavity. Early diagnosis of acute intestinal ischemia is very difficult because the manifestations are not specific enough and the differential diagnosis is wide. Therefore, it is important to consider visceral ischemia when the differential diagnosis is made.
Subject(s)
Communicable Diseases , Gastroenteritis , Mesenteric Ischemia , Acute Disease , Communicable Diseases/complications , Diagnosis, Differential , Early Diagnosis , Fatal Outcome , Gastroenteritis/complications , Humans , Mesenteric Ischemia/diagnosis , Mesenteric Ischemia/etiologyABSTRACT
AIM: The first aim of this study was to search for new biomarkers to be used in gastric cancer diagnostics. The second aim was to verify the findings presented in literature on a sample of the local population and investigate the risk of gastric cancer in that population using a multivariant statistical analysis. PATIENTS AND METHODS: We assessed a group of 36 patients with gastric cancer and 69 healthy individuals. We determined carcinoembryonic antigen, cancer antigen 19-9, cancer antigen 72-4, matrix metalloproteinases (-1, -2, -7, -8 and -9), osteoprotegerin, osteopontin, prothrombin induced by vitamin K absence-II, pepsinogen I, pepsinogen II, gastrin and Helicobacter pylori for each sample. RESULTS: The multivariate stepwise logistic regression identified the following biomarkers as the best gastric cancer predictors: CEA, CA72-4, pepsinogen I, Helicobacter pylori presence and MMP7. CONCLUSION: CEA and CA72-4 remain the best markers for gastric cancer diagnostics. We suggest a mathematical model for the assessment of risk of gastric cancer.
Subject(s)
Biomarkers, Tumor/blood , Models, Theoretical , Stomach Neoplasms/blood , Adult , Aged , Aged, 80 and over , Antibodies, Bacterial/blood , Antigens, Tumor-Associated, Carbohydrate/blood , Carcinoembryonic Antigen/blood , Helicobacter Infections/immunology , Helicobacter pylori/immunology , Humans , Immunoglobulin G/blood , Matrix Metalloproteinase 7/blood , Middle Aged , Multivariate Analysis , Pepsinogen A/blood , Risk Factors , Stomach Neoplasms/diagnosisABSTRACT
MicroRNAs have the potential to become valuable predictive markers for gastric cancer. Samples of biopsy tissue, routinely taken from gastric cancer patients undergoing palliative chemotherapy, constitute suitable material for microRNA profiling with the aim of predicting the effect of chemotherapy. Our study group consisted of 54 patients, all of whom underwent palliative chemotherapy based on 5-fluorouracil (5-FU) or 5-FU in combination with platinum derivatives between 2000 and 2013. The expression of 29 selected microRNAs and genes BRCA1, ERCC1, RRM1 and TS, in gastric cancer tissue macrodissected from FFPE tissue samples, was measured by quantitative RT-PCR. The relationship between gene expression levels and time to progression (TTP) and overall survival (OS) was analysed. From the set of the 29 microRNAs of interest, we found high expression of miR-150, miR-342-3p, miR-181b, miR-221, miR-224 and low levels of miR-520h relate to shorter TTP. High levels of miR-150, miR-192, miR-224, miR-375 and miR-342-3p related to shorter OS. In routinely available FFPE tissue samples, we found 6 miRNAs with a relation to TTP, which may serve as predictors of the effectiveness of palliative treatment in gastric cancer patients. These miRNAs could also help in deciding whether to indicate palliative chemotherapy.
Subject(s)
Cisplatin/administration & dosage , Fluorouracil/administration & dosage , MicroRNAs/genetics , Stomach Neoplasms/drug therapy , Stomach Neoplasms/genetics , Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Antineoplastic Combined Chemotherapy Protocols/pharmacology , Biomarkers, Tumor/genetics , Cisplatin/pharmacology , Disease Progression , Fluorouracil/pharmacology , Gene Expression Profiling , Gene Expression Regulation, Neoplastic/drug effects , Humans , Palliative Care , Prognosis , Treatment OutcomeABSTRACT
INTRODUCTION: The objective of this study was to assess the impact of weather phenomena on the occurrence of spontaneous pneumothorax (SP) in the Plzen region (Czech Republic). METHODS: A retrospective analysis of 450 cases of SP in 394 patients between 1991 and 2013. We observed changes in average daily values of atmospheric pressure, air temperature and daily maximum wind gust for each day of that period and their effect on the development of SP. RESULTS: The risk of developing SP is 1.41 times higher (P=.0017) with air pressure changes of more than±6.1hPa. When the absolute value of the air temperature changes by more than±0.9°C, the risk of developing SP is 1.55 times higher (P=.0002). When the wind speed difference over the 5 days prior to onset of SP is less than 13m/sec, then the risk of SP is 2.16 times higher (P=.0004). If the pressure difference is greater than±6.1hPa and the temperature difference is greater than±0.9°C or the wind speed difference during the 5 days prior to onset of SP is less than 10.7m/s, the risk of SP is 2.04 times higher (P≤.0001). CONCLUSION: Changes in atmospheric pressure, air temperature and wind speed are undoubtedly involved in the development of SP, but don't seem to be the only factors causing rupture of blebs or emphysematous bullae.
