University Hospital of Brno

Brno, Czech Republic

University Hospital of Brno

Brno, Czech Republic
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Von Tresckow B.,University of Cologne | Plutschow A.,University of Cologne | Fuchs M.,University of Cologne | Klimm B.,University of Cologne | And 13 more authors.
Journal of Clinical Oncology | Year: 2012

Purpose: In patients with early unfavorable Hodgkin's lymphoma (HL), combined modality treatment with four cycles of ABVD (adriamycin, bleomycin, vinblastine, and dacarbazine) and 30 Gy involved-field radiotherapy (IFRT) results in long-term tumor control of approximately 80%. We aimed to improve these results using more intensive chemotherapy. Patients and Methods: Patients with newly diagnosed early unfavorable HL were randomly assigned to either four cycles of ABVD or an intensified treatment consisting of two cycles of escalated BEACOPP (bleomycin, etoposide, adriamycin, cyclophosphamide, vincristine, procarbazine, and prednisone) followed by two cycles of ABVD (2 + 2). Chemotherapy was followed by 30 Gy IFRT in both arms. The primary end point was freedom from treatment failure (FFTF); secondary end points included progression-free survival (PFS) and treatment-related toxicity. Results: With a total of 1,528 qualified patients included, the 2 + 2 regimen demonstrated superior FFTF compared with four cycles of ABVD (P < .001; hazard ratio, 0.44; 95% CI, 0.30 to 0.66), with a difference of 7.2% at 5 years (95% CI, 3.8 to 10.5). The difference in 5-year PFS was 6.2% (95% CI, 3.0% to 9.5%). There was more acute toxicity associated with 2 + 2 than with ABVD, but there were no overall differences in treatment-related mortality or secondary malignancies. Conclusion: Intensified chemotherapy with two cycles of BEACOPP escalated followed by two cycles of ABVD followed by IFRT significantly improves tumor control in patients with early unfavorable HL. © 2012 by American Society of Clinical Oncology.

Raja K.R.M.,Masaryk University | Hajek R.,Masaryk University | Hajek R.,University Hospital of Brno | Hajek R.,University of Ostrava
OncoImmunology | Year: 2013

Multiple myeloma (MM) patients exhibit consistent degrees of immune dysfunction. Regulatory T cells contribute to the establishment of an immunosuppressive status in MM patients, hence favoring disease progression © 2013 Landes Bioscience.

Mica L.,University of Zürich | Vomela J.,University Hospital of Brno | Keel M.,University of Bern | Trentz O.,University of Zürich
Injury | Year: 2014

Purpose: Obesity is a growing problem in industrial nations. Our aim was to examine how overweight patients coped with systemic inflammatory response syndrome (SIRS) after polytrauma. Methods: A total of 651 patients were included in this retrospective study, with an ISS ≥ 16 and age ≥ 16 years. The sample was subdivided into three groups: body mass index (BMI; all in kg/m 2) < 25, BMI 25-30 and BMI > 30, or low, intermediate and high BMI. The SIRS score was measured over 31 days after admission together with measurements of C-reactive protein (CRP), interleukin-6 (IL-6) and procalcitonin (PCT). Data are given as the mean ± SEM if not otherwise indicated. Kruskal-Wallis and χ2 tests were used for statistical analysis and the significance level was set at p <.05. Results: The maximum SIRS score was reached in the low BMI-group at 3.4 ± 0.4, vs. 2.3 ± 0.1 and 2.5 ± 0.2 in the intermediate BMI-group and high BMI-group, respectively (p <.0001). However, the maximum SIRS score was reached earlier in the BMI 25-30 group at 1.8 ± 0.2 days, vs. 3.4 ± 0.4 and 2.5 ± 0.2 days in the BMI < 25 and BMI > 30 groups, respectively (p <.0001). The incidence of sepsis was significantly higher in the low BMI group at 46.1%, vs. 0.2% and 0% in the BMI 25-30 and BMI > 30 groups, respectively (p <.0001). No significant differences in the CRP, IL-6 or PCT levels were found between groups. Conclusions: A higher BMI seemed to be protective for these patients with polytrauma-associated inflammatory problems. © 2012 Elsevier Ltd.

Krejci T.,University of Ostrava | Buzrla P.,University of Ostrava | Vecera Z.,University of Ostrava | Kren L.,University Hospital of Brno | And 4 more authors.
Ceska a Slovenska Neurologie a Neurochirurgie | Year: 2015

Aim: The aim of this study was to summarize clinical, radiological and pathological data on calcifying pseudoneoplasm of the neural axis (CAPNON). Methods: A case report of a female patient with CAPNON is presented. In addition, all CAPNON patient case histories published in English language are included. Articles were identified via PubMed searches using the following key words: calcifying pseudoneoplasm, calcifying pseudotumour, brain stone, cerebral calculi and fibro-osseous lesion. All cases referenced within the identified publications are also included in this review. Results: Seventy two cases were identified, including our case report. Of these, 62% were intracranial, 31% spinal and 7% were located in the cranio-cervical junction (CCJ).The mean age of the CAPNON patients was 45.6 (range 2-83) years. 74% of intracranial CAPNON were supratentorial and 26% were infratentorial. Symptoms of intracranial CAPNON included epilepsy in 33.3%, headaches in 24% and posterior fossa symptoms in 16.7%. The majority of patients with epileptic seizures had lesions in the temporal lobe (50%). Pain was the dominant symptom in 82% and gait disorder in 27% of spinal CAPNON cases. Pain was the dominant symptom (80%) in CCJ CAPNON. Conclusion: CAPNON is a rare, benign, slowly-growing lesion of the central nervous system. In the majority of cases, location is intracranial and there is a slightly higher prevalence in men. The origin of CAPNON remains unclear. CAPNON should be considered whenever a CT scan reveals a calcified lesion combined with hypointensity on T1 and T2-weighted MRI. Radical removal is the treatment of choice. Incidental lesions must be monitored, as they may grow and become symptomatic.

Mica L.,University of Zürich | Keller C.,University of Cologne | Vomela J.,University Hospital of Brno | Trentz O.,University of Zürich | And 2 more authors.
Journal of Trauma and Acute Care Surgery | Year: 2013

BACKGROUND: Obesity is a growing problem in western societies. The aim of this retrospective cohort study was to determine the association between the overweight and obese polytrauma patients and pneumonia after injury. METHODS: A total of 628 patients with an Injury Severity Score (ISS) of 16 or greater and 16 years or older were included in this retrospective study. The sample was subdivided into three groups as follows: body mass index (BMI) of less than 25 kg/m; BMI of 25 kg/m2 to 30 kg/m2; and BMI more than 30 kg/m2. The Murray score was assessed at admission and at its maximum during hospitalization to determine pulmonary problems. Pneumonia was defined as bacteriologically positive sputum with appropriate radiologic and laboratory changes (C-reactive protein and interleukin 6). Data are given as mean ± SEM. One-way analysis of variance and the Kruskal-Wallis test were used for the analyses, and the significance level was set at p < 0.05; Bonferroni-Dunn test was performed as post hoc analysis. RESULTS: The Abbreviated Injury Scale (AIS) score for the thorax was 3.2 ± 0.1 in the group with a BMI of less than 25 kg/m, 3.3 ± 0.1 in the group with a BMI of 25 kg/m2 to 30 kg/m, and 2.8 ± 0.2 in the group with BMI of more than 30 kg/m 2 (p = 0.044). The Murray score at admission was elevated with increasing BMI (0.8 ± 0.8 for BMI < 25 kg/m2, 0.9 ± 0.9 for BMI 25-30 kg/m2, and 1.0 ± 0.8 for BMI > 30 kg/m2; p = 0.137); the maximum Murray score during hospitalization revealed significant differences (1.2 ± 0.9 for BMI < 25 kg/m 2, 1.6 ± 1.0 for BMI 25-30 kg/m2, and 1.5 ± 0.9 for BMI > 30 kg/m; p < 0.001). The incidence of pneumonia also increased with increasing BMI (1.6% for BMI < 25 kg/m2, 2.0% for BMI 25-30 kg/m2, and 3.1% for BMI > 30 kg/m2; p = 0.044). CONCLUSION: Obesity leads to an increased incidence of pneumonia in a polytrauma situation. © 2013 Lippincott Williams and Wilkins.

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