Veterinary medicine - Repository of PHD, master's thesis
Veterinary medicine - Repository of PHD, master's thesisNot a member yet
9490 research outputs found
Sort by
Troponins in urine
No full textTroponini su proteinske molekule koje čine dio kontraktilnog aparata srca. Postoje tri različite molekule troponina: troponin C, troponin I i troponin T. Troponin C nema široku kliničku primjenu jer se homologna izoforma nalazi i u srcu i u sporim mišićnim vlaknima poprečnoprugastih mišića. S druge strane, troponin I i troponin T imaju izoforme specifične za miokard. Većina je troponina unutar stanice vezana, dok manji udio egzistira slobodno u citosolu. Upravo je citosolni troponin najodgovorniji za rano povišenje koncentracije u serumu tijekom razvoja AIM. Kontinuirano oslobađanje troponina iz strukturnog bazena osigurava produljenu perzistenciju u cirkulaciji, unatoč kratkom poluživotu. Razvojem „visokoosjetljivih“ testova za detekciju troponina, utvrđeno je da se mala povišenja koncentracije troponina u serumu mogu detektirati u odsutnosti nekroze miokarda. Pri visokim koncentracijama troponina u serumu, primarni način eliminacije je posredovan receptorima u jetri, dok pri nižim i stabilnim razinama, bubreg ima ključnu ulogu u eliminaciji troponinskih molekula. Atribut „visokoosjetljivi“ kod naziva troponinskih testova nove generacije ne odnosi se na molekule troponina koje se detektiraju, nego na analitičke karakteristike testova. U većini eksperimentalnih studija na temu troponina u urinu, mjeren je samo hs-cTnI. Razlog leži u proteolitičkoj degradaciji i fragmentaciji troponina I, za koji se pretpostavlja da na taj način lakše prolazi glomerularnu membranu nego intaktne molekule troponina T. Malobrojna provedena istraživanja dokazala su prisutnost troponina u urinu, a utvrđen je i preliminarni referentni interval. Pronađena je statistički značajna razlika u koncentraciji hs-cTnI u prvom jutarnjem urinu kod hipertoničara u odnosu na zdrave ljude. Prilikom uzorkovanja ljudi s teškom AS, nađeno je statistički značajno smanjenje koncentracije troponina u urinu u odnosu na zdravu kontrolu. Istraživanja na pedijatrijskoj populaciji do 24 mjeseca starosti utvrdila su limitiranost ovog potencijalnog biomarkera u toj populaciji. U bliskoj budućnosti očekuju se istraživanja koja bi dokazala povišenu razinu troponina u urinu kod pacijenata s KBB.Troponins are protein molecules that form part of the contractile apparatus of the heart. There are three different troponin molecules: troponin C, troponin I, and troponin T. Troponin C has limited clinical application because a homologous isoform is found both in the heart and in slow-twitch fibers of skeletal muscle. On the other hand, troponin I and troponin T have isoforms that are specific to the myocardium. Most of the intracellular troponin is bound, while a smaller fraction exists freely in the cytosol. It is this cytosolic troponin that is primarily responsible for the early rise in serum concentration during the development of acute myocardial infarction. Continuous release of troponin from the structural pool ensures prolonged persistence in the circulation, despite its short half-life. With the development of high-sensitivity troponin assays, it has been found that small increases in serum troponin concentrations can be detected even in the absence of myocardial necrosis. At high serum troponin concentrations, the primary route of elimination is mediated by hepatic receptors, whereas at lower and stable levels, the kidneys play a key role in the elimination of troponin molecules. The attribute "high-sensitivity" in the names of new-generation troponin tests does not refer to the troponin molecules being detected, but rather to the analytical characteristics of the assays themselves. In most experimental studies on troponin in urine, only hs-cTnI has been measured. This is due to proteolytic degradation and fragmentation of troponin I, which is presumed to allow easier passage through the glomerular membrane compared to intact troponin T molecules. The few conducted studies have confirmed the presence of troponin in urine and have established a preliminary reference interval. A statistically significant difference in hs-cTnI concentration was found in first-morning urine samples between individuals with hypertension and healthy subjects. In patients with severe aortic stenosis, a statistically significant decrease in urinary troponin concentration was found compared to healthy controls. Studies in pediatric populations up to 24 months of age have demonstrated the limitations of this potential biomarker in that age group. In the near future, studies are expected to confirm elevated urinary troponin levels in patients with chronic kidney disease
Cardiovascular risk factors in patients with venous thromboembolic disease
No full textVenska tromboembolija (VTE), koja obuhvaća duboku vensku trombozu (DVT) i plućnu emboliju (PE), jedna je od najčešćih vaskularnih bolesti, pri čemu u velikom broju slučajeva uzrok ostaje nejasan, bez jasno utvrđenog provocirajućeg čimbenika. Cilj ovog istraživanja bio je analizirati prisutnost kardiovaskularnih (KV) čimbenika rizika u pacijenata s VTE, te utvrditi njihovu povezanost s izazvanom i neizazvanom PE, kao i s težinom bolesti procijenjenom pomoću indeksa ozbiljnosti plućne embolije (PESI). Kohortno istraživanje provedeno je na ukupno 147 pacijenata s dijagnozom PE hospitaliziranih u Kliničkom bolničkom centru Sestre milosrdnice od 2020. do 2023. godine. Pacijenti s aktivnom malignom bolesti ili COVID-19 infekcijom bili su isključeni iz analize. Prikupljeni su podaci o demografskim obilježjima (dob, spol), indeksu tjelesne mase (ITM), prisutnosti kardiovaskularnih bolesti, arterijske hipertenzije, šećerne bolesti, dislipidemije i pušenja, kao i vrijednosti PESI-a i Charlsonova indeksa komorbiditeta (CCI). Ispitanici su podijeljeni u skupine s izazvanom i neizazvanom PE, te s niskim i visokim PESI rizikom. Neizazvana PE zabilježena je kod 68% ispitanika. Ova skupina bila je značajno starija (67 naspram 60 godina, p=0,027) te je imala veću prevalenciju arterijske hipertenzije (77% naspram 57%, p=0,024), dok ostali promatrani KV čimbenici rizika, kao ni vrijednosti CCI-a i PESI-a, nisu pokazali značajne razlike među skupinama. Uočen je i trend prema većem kumulativnom broju KV čimbenika rizika (2,4 naspram 2,0, p=0,09). Nakon prilagodbe za dob i spol, analiza logističke regresije pokazala je da prisutnost dvaju ili više KV čimbenika rizika značajno povećava rizik za neizazvanu PE (omjer izgleda 2,27; 95% CI 1,08–4,79; p=0,031). U skupini s visokim PESI rizikom zabilježena je veća prevalencija starije dobi, hipertenzije i šećerne bolesti. S obzirom na to da su dob i hipertenzija sastavni dio PESI algoritma, njihova veća učestalost očekivana je, dok veća prevalencija šećerne bolesti može upućivati na njezin doprinos težini bolesti. Dobiveni rezultati upućuju na povezanost arterijske hipertenzije, starije životne dobi te većeg kumulativnog broja KV čimbenika rizika sa neizazvanom VTE. Slične vrijednosti CCI i PESI indeksa u skupinama s izazvanom i neizazvanom PE ukazuju na odsustvo razlika u težini bolesti i prisutnosti komorbiditeta.Venous thromboembolism (VTE), which includes deep vein thrombosis (DVT) and pulmonary embolism (PE), is one of the most common vascular diseases, with a significant number of cases occurring without an identifiable provoking factor. The aim of this study was to analyze the presence of cardiovascular (CV) risk factors in patients with VTE and to assess their association with provoked and unprovoked PE, as well as with disease severity estimated using the Pulmonary Embolism Severity Index (PESI). A cohort study was conducted on 147 patients diagnosed with PE and hospitalized at the Sisters of Charity University Hospital Center between 2020 and 2023. Patients with active malignancy or COVID-19 infection were excluded from the analysis. Data were collected on demographic characteristics (age, sex), body mass index (BMI), presence of cardiovascular diseases, arterial hypertension, diabetes mellitus, dyslipidemia, and smoking, as well as PESI and Charlson Comorbidity Index (CCI) values. Patients were divided into groups with provoked and unprovoked PE, and also stratified into low and high PESI risk groups based on their PESI score. Unprovoked PE was observed in 68% of participants. This group was significantly older (67 vs. 60 years, p=0,027) and had a higher prevalence of arterial hypertension (77% vs. 57%, p=0,024), whereas other assessed CV risk factors, as well as CCI and PESI scores, showed no significant differences between the groups. A trend toward a higher cumulative number of CV risk factors was noted (2,4 vs. 2,0, p=0,09). After adjustment for age and sex, logistic regression analysis showed that the presence of two or more CV risk factors significantly increased the risk of unprovoked PE (odds ratio 2,27; 95% CI 1,08–4,79; p=0,031). In the high PESI risk group, older age, hypertension, and diabetes were more common. Since age and hypertension are integral components of the PESI algorithm, their higher prevalence is expected, while the increased prevalence of diabetes may suggest its contribution to disease severity. The results indicate an association between arterial hypertension, older age, and a higher cumulative number of CV risk factors with unprovoked VTE. Similar CCI and PESI values in the provoked and unprovoked PE groups suggest no significant differences in disease severity or comorbidity burden
Emergency care of the respiratory tract
No full textHitno osiguravanje dišnog puta uključuje tehnike s ciljem održavanja prohodnosti dišnog puta. Također osiguravaju oksigenaciju i mogućnost ventilacije pacijenta što je ključno za adekvatnu brigu u životno ugrožavajućim stanjima. Osim poznavanja osnova anatomije dišnog puta, za uspješno provođenje ovih tehnika potrebna je i vještina procjene dišnog puta kao i razumijevanja mogućih komplikacija. Osnovne tehnike koje čine bazu zbrinjavanja dišnog puta su tehnika zabacivanja glave, podizanja brade te potiskivanje donje čeljusti. Za održavanje kontinuirane prohodnosti dišnog puta koriste se naprednije tehnike poput postavljanja orofaringealnog i nazofaringealnog tubusa koji su zlatni standard u zbrinjavanja pacijenata s poremećajem svijesti. Značajan napredak u mogućnosti otvaranja dišnog puta na terenu i drugim otežavajućim uvjetima, označen je razvojem supraglotičkih pomagala. Nezamjenjiva metoda vizualizacije dišnog puta je laringoskopija koja dodatno olakšava postavljanje endotrahealne intubacije, najučinkovitije tehnike održavanja dišnog puta.
Kada konvencionalne metode zakažu, kirurške metode uspostave dišnog puta najsigurniji su pristup.
Pravilno upravljanje dišnim putem spasonosna je vještina koja zahtijeva teorijsko i praktično znanje, ali je u konačnici nezamjenjiva za adekvatno zbrinjavanje ugroženog pacijenta. Osiguran dišni put poboljšava ishode hitnih i rutinskih intervencija te je vještina nezamjenjiva u profesionalnom arsenalu svakog liječnika.Emergency airway management involves techniques aimed at maintaining airway patency. These techniques also ensure oxygenation and the ability to ventilate the patient, which is crucial for providing adequate care in life-threatening conditions. In addition to a solid understanding of airway anatomy, successful execution of these techniques requires the skill to assess the airway and understand potential complications.
Basic techniques that form the foundation of airway management include the head tilt, chin lift, and jaw thrust maneuvers. To maintain continuous airway patency, more advanced methods such as the insertion of oropharyngeal and nasopharyngeal airways are used—these are the gold standard in managing patients with impaired consciousness.
A significant advancement in the ability to secure the airway in the field and under challenging conditions has been marked by the development of supraglottic airway devices. An indispensable method for visualizing the airway is laryngoscopy, which facilitates endotracheal intubation—the most effective airway management technique.
When conventional methods fail, surgical airway procedures become the safest approach.
Proper airway management is a life-saving skill that requires both theoretical and practical knowledge, and is ultimately irreplaceable in the adequate care of critically ill patients. A secured airway improves outcomes in both emergency and routine interventions, and is an essential skill in every physician’s professional toolkit
Old concept and new forms of hysteria
No full textHisterija je jedan od najupečatljivijih pojmova u povijesti medicine i psihijatrije, iako danas više nije prisutan kao službena dijagnoza u suvremenim psihijatrijskim klasifikacijama (DSM, MKB). U ovom je radu prikazana povijesna, teorijska i klinička evolucija pojma histerije. Pregled literature pokazuje dugu i složenu povijest koncepta histerije, počevši od pogrešnih interpretacija staroegipatskih i antičkih tekstova. Tijekom srednjega vijeka pojam histerije bio je vezan uz religijske predodžbe, povezivajući je s grijehom i opsjednutošću demonima, a pojavom renesansnih liječnika, poput Johanna Weyera i Edwarda Jordena, započinje interes za pronalaskom medicinskog uzroka bolesti. U razdoblju prosvjetiteljstva, liječnici poput Thomasa Willisa i Thomasa Sydebhana, počeli su povezivati histeriju s emocionalnim podražajima i umom. U 19. i 20. stoljeću dolazi do najvećih promjena u shvaćanju histerije, kada je Paul Briquet sustavno proučavao histeriju kao neuropsihijatrijski poremećaj, dok Jean Martin Charcot klasificirao histeriju kao zasebnu neurološku bolest. Njegov učenik Pierre Janet uveo koncept suženja svijesti i pojam disocijacije. Sigmund Freud dodatno je razvio pojam histerije kroz psihoanalizu povezujući je s nesvjesnim konfliktima, potisnutim emocijama i psihoanalitičkim procesima. Tijekom 20. stoljeća, došlo je do težnje prema jasnim dijagnostičkim kriterijima postepenim raščlanjivanjem širokog i sveobuhvatnog koncepta histerije na više specifičnih poremećaja kao što su poremećaji sa somatskim simptomima i srodni poremećaji, i disocijativni poremećaji te poremećaji ličnosti iz klastera B. Iako je histerija kao naziv nestala, njezini simptomi su i dalje prisutni, integrirani u suvremeno razumijevanje psihopatologije.Hysteria is one of the most striking concepts in the history of medicine and psychology, although today it is not recognized as an official diagnosis in contemporary psychiatric classifications (DSM, ICD). This paper presents historical, theoretical, and clinical evolution of the concept of hysteria. A review of the literature reveals the long and complex history of the concept, dating back to the misinterpretations of ancient Egyptian and classical texts. During the Middle Ages, the notion of hysteria was linked to religious belifes, associating it with sin and demonic possession. With the emergence of Renaissance physicians, such as Johann Weyer and Edward Jorden, the interest began to shift toward identifying medical causes of the hysteria condition. In the Enlightenment period, physicians like Thomas Willis and Thomas Sydenham began associating hysteria with emotional stimuli and the mind. The 19th century brought the most significant changes in the understanding of hysteria. Paul Briquet systematically studied hysteria as a neuropsychiatric disorder, while Jean-Martin Charcot classified hysteria as a distinct neurological disease. His student Pierre Janet introduced the concepts of narrowing of the field of consciousness and dissociation. Sigmund Freud developed the concept further through psychoanalysis, linking hysteria to unconscious conflicts, repressed emotions, and psychoanalytic processes. During the 20th century, with the growing need for clear diagnostic criteria, the broad and comprehensive concept of hysteria was gradually broken down into more specific disorders such as somatic symptoms and related disorders, and dissociative disorders and cluster B personality disorders. Althrough the term hysteria has disappeared, its symptoms remain present, integrated into the modern understanding of psychopathology
Non-Invasive Retinal Biomarkers for Early Diagnosis of Alzheimer’s Disease
No full textAlzheimer’s disease (AD) is a progressive neurodegenerative disorder of the brain associated with ageing and is the most prevalent form of dementia, affecting an estimated 55 million people worldwide, with projections suggesting this number will exceed 150 million by 2050. With its increasing prevalence, AD represents a significant global health challenge with potentially serious social and economic consequences. Diagnosing AD is particularly challenging as it requires timely recognition. Currently, there is no effective therapy for AD; however, certain medications may help slow its progression. Existing diagnostic methods such as magnetic resonance imaging (MRI), computed tomography (CT), positron emission tomography (PET), and biomarker analysis in cerebrospinal fluid tend to be expensive and invasive, making them impractical for widespread use. Consequently, research into non-invasive biomarkers that enable early detection and screening for AD is a crucial area of contemporary clinical investigation. One promising approach for the early diagnosis of AD may be retinal imaging. As an extension of the central nervous system, the retina offers a distinctive opportunity for non-invasive brain structure and function assessment. Considering their shared embryological origins and the vascular and immunological similarities between the eye and brain, alterations in the retina may indicate pathological changes in the brain, including those specifically related to AD. Studies suggest that structural and vascular changes in the retina, particularly within the neuronal network and blood vessels, may act as markers of cerebral changes caused by AD. These retinal alterations have the potential to act as biomarkers for early diagnosis. Since AD is typically diagnosed only after a significant neuronal loss has occurred, identifying early diagnostic markers could enable timely intervention and help prevent disease progression. Non-invasive retinal imaging techniques, such as optical coherence tomography (OCT) and OCT angiography, provide accessible methods for the early detection of changes linked to AD. This review article focuses on the potential of retinal imaging as a non-invasive biomarker for early diagnosis of AD. Investigating the ageing of the retina and its connections to neurodegenerative processes could significantly enhance the diagnosis, monitoring, and treatment of AD, paving the way for new diagnostic and therapeutic approaches
Structural and functional changes in the retina and optic nerve of patients with dysthyroid orbitopathy and elevated intraocular pressure
No full textDistiroidna orbitopatija (DO) je autoimuni poremećaj koji se javlja uslijed Gravesove bolesti, a manifestira se retrakcijom vjeđa, proptozom, zadebljanjem ekstraokularnih mišića, kemozom i periorbitalnim edemom. Neka od navedenih stanja mogu dovesti do povišenog intraokularnog tlaka (IOT-a) i posljedičnog glaukomatoznog oštećenja oka. Stoga je cilj ovoga istraživanja bio utvrditi može li sekundarno povišeni IOT koji nastaje kao posljedica DO-a dovesti do specifičnih strukturnih promjena u oku, napose u sloju živčanih stanica mrežnice, vidnom živcu i kompleksu ganglijskih stanica makule te, posljedično tome, i do funkcionalnih promjena.
Istraživanje je provedeno na 90 ispitanika podijeljenih u tri skupine: bolesnici bez DO-a s primarnim glaukomom otvorenog kuta (POAG) (kontrola), bolesnici s DO-om bez povišenog IOT-a (skupina 1) i bolesnici s DO-om i povišenim IOT-om (skupina 2). Podaci su prikupljani tijekom dvije godine korištenjem alata vidnoga polja Octopus 900 i optičke koherentne tomografije. Utvrđene su i uspoređene vrijednosti pokazatelja strukturnih i funkcionalnih promjena oka te IOT-a između skupina. Izračunate su korelacije između tih parametara te su analizirani najvažniji prediktori tih oštećenja.
U istraživanje je bilo uključeno trostruko više ispitanika ženskog nego muškog spola. Bolesnici u kontrolnoj skupini bili su 16 godina stariji od ispitanika u skupinama 1 i 2. Retrakcija vjeđa, proptoza i zadebljanje ekstraokularnih mišića bili su najučestaliji u skupini 2, potom u skupini 1, a najmanja učestalost je bila u kontrolnoj skupini. Među nalazima standarnog oftalmološkog pregleda ističu se statistički značajne razlike u vrijednostima IOT-a (p < 0,001) koji je bio najviši u skupini 2, a slijede kontrolna skupina i skupina 1. Među strukturnim promjenama najvažniji nalazi bili su statisitčki značajno tanji sloj retinalnih živčanih vlakana (RNFL) (p < 0,001), veće vrijednosti parametara promjena papile vidnog živca te tanji sloj ganglijskih stanica makule (GCC) u ispitanika kontrolne skupine u odnosu na preostale dvije ispitivane skupine. IOT je tijekom cijelog razdoblja istraživanja bio najviši u skupini 2, nešto niži u kontrolnoj, a najniži u skupini 1. Sekundarno povišeni IOT u bolesnika s DO-om bio je statistički značajno pozitivno povezan s MD-om i LV-om, a statistički značajno negativno povezan s prosječnom debljinom RNFL-a i prosječnom debljinom GCC-a makule.
Statistički značajna pozitivna povezanost utvrđena je između debljine medijalnog ravnog mišića, egzoftalmometrije, retrakcije vjeđa i intraokularnog tlaka na početku istraživanja. Debljina lateralnog ravnog mišića bila je statistički značajno pozitivno povezana samo s retrakcijom vjeđa. Glavni prediktori funkcionalnog i strukturnog oštećenja oka su bili mlađa dob, ženski spol, veća debljina medijalnog ravnog mišića, veće vrijednosti egzoftalmometrije, prisutna retrakcija vjeđa, te povišeni IOT na početku istraživanja i tijekom prve godine praćenja.
Ovim istraživanjem utvrđeno je da su strukturne i funkcionalne promjene oka veće u bolesnika s POAG-om, nego u bolesnika s DO-om, no sekundarno povišeni intraokularni tlak u bolesnika s DO-om, ukoliko se ne tretira, dovodi do promjena u perimetrijskom nalazu i nalazu optičke koherentne tomografije.Dysthyroid orbitopathy (DO) is an autoimmune disorder that occurs as a result of Graves' disease, and is manifested by eyelid retraction, proptosis, extraocular muscle thickening, chemosis, and periorbital edema. Some of the mentioned conditions can lead to increased intraocular pressure (IOP) and consequent glaucomatous damage to the eye. Therefore, the aim of this research was to determine whether the secondary elevated IOT that occurs as a result of DO can lead to specific structural changes in the eye, especially in the nerve cell layer of the retina, the optic nerve and the macular ganglion cell complex, and, consequently, to functional changes.
The research was conducted on 90 subjects divided into three groups: patients without DO with primary open-angle glaucoma (POAG) (control), patients with DO without elevated IOT (group 1) and patients with DO and elevated IOT (group 2 ). Data was collected over two years using the Octopus 900 visual field and optical coherence tomography. The values of indicators of structural and functional eye changes and IOT between groups were determined and compared, correlations between these parameters were calculated and the most important predictors of these damages were analyzed.
The study included three times more female than male participants. Patients in the control group were, on average, 16 years older than participants in Groups 1 and 2. Eyelid retraction, proptosis, and thickening of extraocular muscles were most prevalent in Group 2, followed by Group 1, with the lowest prevalence observed in the control group. Among the findings from the standard ophthalmologic examination, statistically significant differences were noted in intraocular pressure (IOP) values (p < 0.001), which were highest in Group 2, followed by the control group, and lowest in Group 1.
Among the structural changes, the most important findings were a statistically significantly thinner retinal nerve fiber layer (RNFL) (p < 0.001), greater values in optic nerve head parameter changes, and a thinner ganglion cell complex (GCC) in the control group compared to the other two groups. IOP remained highest in Group 2 throughout the entire study period, slightly lower in the control group, and lowest in Group 1. Secondary elevated IOP in patients with dysthyroid orbitopathy (DO) was statistically significantly positively correlated with mean defect (MD) and loss variance (LV) and statistically significantly negatively correlated with the average thickness of the RNFL and GCC. A statistically significant positive correlation was found between the thickness of the medial rectus muscle, exophthalmometry values, eyelid retraction, and IOP at the beginning of the study. The thickness of the lateral rectus muscle was statistically significantly positively correlated only with eyelid retraction.
The main predictors of functional and structural eye damage were younger age, female sex, greater thickness of the medial rectus muscle, higher exophthalmometry values, the presence of eyelid retraction, and elevated IOP at the beginning of the study and during the first year of follow-up.
This study determined that structural and functional changes in the eye are more pronounced in patients with primary open-angle glaucoma (POAG) than in patients with DO. However, if secondary elevated intraocular pressure in patients with DO is not treated, it can lead to changes in perimetric findings and optical coherence tomography results
Efficacy of Ixazomib in treatment of relapsed Multiple Myeloma patients – experience of University Hospital Centre Zagreb
No full textMultipli mijelom (MM) je zloćudna hematološka bolest obilježena klonskom proliferacijom plazma stanica. U terapijskom pristupu relapsiranom i/ili refraktornom multiplom mijelomu (RRMM) tijekom posljednjeg desetljeća uvedeni su brojni novi lijekovi, uključujući ixazomib – prvi oralni inhibitor proteasoma. Cilj ovog retrospektivnog istraživanja bio je procijeniti učinkovitost i sigurnost ixazomiba u kombinaciji s lenalidomidom i deksametazonom (IRd) u stvarnim kliničkim uvjetima. U istraživanje su uključena 44 bolesnika liječena u KBC-u Zagreb u razdoblju od studenog 2016. do veljače 2023. godine. Analizirani su demografski i klinički podaci, odgovor na terapiju, preživljenje bez progresije bolesti (PFS), ukupno preživljenje (OS) i podnošljivost terapije. Ukupna stopa odgovora (ORR) iznosila je 82%, pri čemu je 64% bolesnika postiglo vrlo dobar djelomičan odgovor (VGPR) ili bolji. Medijan PFS-a bio je 14 mjeseci, a medijan OS-a 24 mjeseca. Terapija je općenito bila dobro podnošljiva, a profil nuspojava bio je u skladu s poznatim sigurnosnim profilom lijeka. Nije bilo statistički značajne razlike u ishodima s obzirom na liniju terapije ili ISS stadij. Dobiveni rezultati potvrđuju učinkovitost i sigurnost IRd režima u realnim kliničkim uvjetima te se podudaraju s nalazima iz kliničkih ispitivanja. Potrebna su dodatna prospektivna istraživanja na većem broju bolesnika radi daljnje optimizacije terapijskih pristupa.Multiple myeloma (MM) is a malignant hematologic disease characterized by clonal proliferation of plasma cells. In the management of relapsed and/or refractory multiple myeloma (RRMM), several novel agents have been introduced in recent years, including ixazomib – the first oral proteasome inhibitor. The aim of this retrospective study was to evaluate the real-world efficacy and safety of ixazomib in combination with lenalidomide and dexamethasone (IRd). The study included 44 patients treated at the University Hospital Centre Zagreb between November 2016 and February 2023. Demographic and clinical data, treatment response, progression-free survival (PFS), overall survival (OS), and tolerability were analyzed. The overall response rate (ORR) was 82%, with 64% of patients achieving a very good partial response (VGPR) or better. The median PFS was 14 months, and the median OS was 24 months. The therapy was generally well tolerated, with a safety profile consistent with existing data. No statistically significant differences were observed in outcomes according to line of therapy or ISS stage. These findings confirm the effectiveness and safety of IRd in real-world settings and are consistent with data from clinical trials. Further prospective studies in larger patient cohorts are warranted to optimize treatment strategies
Myeloid sarcoma of the urinary bladder as the presenting feature of secondary acute myeloid leukemia, successfully treated with venetoclax and azacitidine
No full text
