Efficacy, quality of life, and safety of methotrexate versus interferon in head-to-head treatment in advanced stages of mycosis fungoides and Sezary syndrome. Prospective trial (NCT02323659).

Introduction: ESMO guidelines recommend interferon (IFN) and methotrexate (MTX) as first-line systemic therapies in mycosis fungoides (MF) and Sezary syndrome (SS). Aim: A prospective, head-to-head trial comparing the efficacy and safety of INF-α and MTX as first-line treatment in MF/SS patients. Material and methods: Forty-three patients were enrolled in the trial. The response to treatment and side effects were assessed. Study variables included mSWAT, DLQI, and VAS scores. Results: The response rate in stage IV including SS was significantly higher in the IFN-α group than in the MTX group (100% vs. 40%; p = 0.03, respectively). No significant differences were found in response rate in stage IIB and III between treatment groups. Patients treated with IFN-α had significantly shorter time to achieve response (TTR). Significantly fewer in the IFN-α group experienced adverse events (AE) in comparison to patients treated with MTX (81% vs. 45%; p = 0.02). There was no statistically significant difference between both groups in terms of time to progression (TTP), progression-free survival (PFS), time on treatment (ToT), and time to next treatment (TTNT). The improvement in quality of life and reduction of pruritus was comparable in both treatment groups. Conclusions: The obtained data suggest that the efficacy of IFN-α as first-line treatment in advanced stage (IV) MF and SS is significantly better than MTX. IFN-α presented significantly better safety and tolerability and shorter TTR than MTX. However, the results should be interpreted with caution due to scarce study groups.

[The analysis of smoking tobacco of patients with tuberculosis--data from ten years observation in Regional Center of Pulmonology in Bydgoszcz]. / Analiza palenia tytoniu wsród chorych na gruzlice--dane z dziesieciu lat obserwacji z Kujawsko Pomorskiego Centrum Pulmonologii w Bydgoszczy.

UNLABELLED: Tobacco smoking is recognised by the society as the the main problem of the public health in the world and as the factor of the risk of tuberculosis, it grew up last decades considerably, universally particularly in countries developing. That is why also our studies also represents in the clinical aspect the relationship between tuberculosis - as active disease and tobacco smoking. THE METHOD: The retrospective investigation comprised 2025 patients with tuberculosis in the period 10 years from Regional Center of Pulmonology in Bydgoszcz. Data these patients worked out from the central base of hospital. Age of patients was comprising in the range from 16 to 98 years. In the studied group were 665 (32.8%) women and 1360 (67.2%) men. Data on the subject of the tobacco smoking was collected from medical history applied during admission to hospital. RESULTS: There were analysed data 1403 (69.3%) smokers and 613 (30.3%) non-smoking persons. Data for 9 patients (0.4%) not establish what they belong from considered groups. For 1252 smokers was established how they long smoke. As much as 602 passed that they smoked above 20 years from among them. These symptoms as shortness of breathe and weakness related smoking persons longer more indeed often. It was confirmed that the smoking predominates among men and was indeed higher than among non-smoking persons. Smokers significant group takes out from among persons being deriving from cities above 30 thousands occupants. Percentage in smokers group homeless was significantly higher than in non-smoking. Smokers displayed oneself to be also the more faintly educated group, after the divorce. Among unemployeds smokers percentage carried out as much as 84.8, among working persons 69.1.Alcoholics percentage turned out significantly higher in smokers group. Above 5% smokers and only 1% non-smoking persons had recurrence of the disease. Percentage of patients with cachexy among smokers turned out indeed higher than among non-smoking persons. It was confirmed, that percentage to go out of wilful from the hospital among smokers was indeed higher than among non-smoking persons. CONCLUSIONS: Retrospective studies provides signs that tobacco smoking is important factor of the development of tuberculosis as symptomatic disease. Anti-nicotine education applied in the face of patients should be the standard while the treatment of tuberculosis in hospital.

[Tobacco smoking among young patients with bronchial asthma and determination of smoking-related behavior in the patient's closest environment]. / Palenie tytoniu wsród mlodych chorych na astme oskrzelowa i okreslenie zachowan dotyczacych palenia w najblizszym srodowisku chorego.

BACKGROUND: The negative influence of tobacco smoke on the course of bronchial asthma is complex and includes direct toxic effects on the epithelium of the respiratory tract. It is estimated that in developed countries, approximately 25 percent of adult asthmatics are tobacco smokers. Knowledge of the scale of the habit, may considerably contribute to the optimization of effective pro-health activity. The aim of this study was to analyze the occurrence of tobacco smoking among patients with the respiratory system disease. MATERIAL AND METHODS: The study group comprised 371 patients (136 men and 235 women, aged 18-30) with diagnosed bronchial asthma and treated in the Allergy Outpatient Clinic in Swiecie, Poland. They were subjected to an analysis aimed at determining the reasons for tobacco smoking and smoking-related behavior in the patient's closest environment. RESULTS: In the examined group, there were 92 tobacco smokers (63 men and 29 women). The multi-variant analysis showed that hanging around smoking friends, the pleasure of smoking and experienced relaxation were the most frequent motivation for taking up smoking. Similar reasons, hanging around smoking friends, group acceptance, and pleasure of smoking, were reported by 59.8%, 43.5%, and 43.5% of patients, respectively. The behavior of people in the closest environment influenced the majority of smokers with asthma; 80% of patients reported current smoking and 88% of patients in medical history. The proportion of non-smokers was 47 and 34%, respectively. CONCLUSION: To sum up, it should be stated that despite of the fact that smoking is a documented risk factor, young patients with bronchial asthma are still subjected to this habit.

A case report of a patient with dermatomyositis as a prodromal sign of lung cancer.

Dermatomyositis (DM) is a connective tissue disease characterized by specific inflammatory lesions in muscle biopsy. It is caused by vasculitis determined by humoral factors with subsequent inflammatory cell accumulation, mainly T CD4+ and B cells, which infiltrate myocytes leading to its vacuolization and degeneration (mainly in the skeletal muscles, rarely in the smooth muscles). The incidence of DM is estimated at 1-10 per million in adults and at 1-3.2 per million in children. The autoimmune mechanism of disease induction is not fully recognized. Several lines of evidence showed the link between DM and neoplastic disease. The first report of dermatomyositis associated with stomach cancer, by Stertz, comes from 1916. In the same time, Kankeleit reported DM associated with breast cancer. Presumably, it is the result of immune reaction against antigens common for muscle and neoplastic cells or some paraneoplastic syndrome underlying mechanism. The report presents the case of a 52-year-old woman with DM (diagnosed according to the Bohan and Peter criteria) and with coexistent squamous lung cancer in situ. The left upper lobectomy was performed. No complications in postoperative period were observed. During more than 2 years of follow-up after the surgery, the patient remained in good condition, without DM symptoms, or cancer relapse. Considering that DM may be associated with lung cancer; extensive diagnostic work-up to exclude neoplastic lesions should be performed. Patients aged 40 years or more should be particularly screened.

[Analysis of spreading of smoking habit among pregnant women admitted to the Prenatal Outpatient Clinic in 2005-2006]. / Analiza rozpowszechnienia palenia tytoniu u ciezarnych kobiet pacjentek Poradni Badan Prenatalnych w latach 2005-2006.

A harmful influence smoking on health is well known and documented. Smoking during pregnancy has negative influence not only on mothers but also on embryos. In spite of pregnancy is a very good reason to stop smoking only every third pregnant stop smoking during pregnancy. Nicotine, carbon monoxide and cyanide, components of smoke, are very toxic. They have negative influence on immunological mechanisms, and may cause some abnormalities. The aim of this article was to analyse smoking among pregnant, patients of Prenatal Outpatient Clinic where risk of abnormalities and defects during pregnancy is very high. 1088 pregnant, admitted to the prenatal clinic during 2005-2006, was analysed. 288 women were smokers, which made 26% of all patients. There was 23.2% high educated and 43.3% with basic education. Despite of the fact that smoking has negative influence on embryos, pregnant still are smokers. That's why antinicotine therapy should be used during pregnancy.