Hussain Alizadeh

Outcome of 3 pregnancies in a patient with chronic myeloid leukemia who received 3 types of tyrosine kinase inhibitors each in different pregnancy: follow-up of the case with a review of published reports.

The management of patients with chronic myeloid leukemia (CML) during pregnancy remains a matter of continuous debate. Tyrosine kinase inhibitors (TKIs) have become the standard of care in managing patients with CML. These drugs have a good safety profile, but animal studies have shown that they are potentially teratogenic. Therefore, these drugs are not recommended for use during pregnancy or if a female patient plans to conceive. Despite the extensive clinical experience with TKIs, the available information about the effects of TKIs on fertility, pregnancy, and outcome of babies who were exposed to TKIs during pregnancy and lactation is limited. We reported on 1 female CML patient who conceived 3 times while being on different types of TKIs in each pregnancy. All 3 pregnancies were uneventful, and only 1 of the babies was diagnosed with a minor cardiac malformation at the age of 30 months, which was corrected surgically.

Helicobacter pylori infection reduces the risk of Barrett's esophagus: A meta-analysis and systematic review

The prevalence of Helicobacter pylori infection (HPI) has been decreasing in developed countries, with an increasing prevalence of Barretts esophagus (BE) and esophageal adenocarcinoma (EAC) at the same time. The aim of our meta‐analysis was to quantify the risk of BE in the context of HPI.

Association between AIRE gene polymorphism and rheumatoid arthritis: a systematic review and meta-analysis of case-control studies

Autoimmune regulator (AIRE) is a transcription factor that functions as a novel player in immunological investigations. In the thymus, it has a pivotal role in the negative selection of naive T-cells during central tolerance. Experimental studies have shown that single nucleotide polymorphism (SNP) alters transcription of the AIRE gene. SNPs thereby provide a less efficient negative selection, propagate higher survival of autoimmune T-cells, and elevate susceptibility to autoimmune diseases. To date, only rheumatoid arthritis (RA) has been analysed by epidemiological investigations in relation to SNPs in AIRE. In our meta-analysis, we sought to encompass case-control studies and confirm that the association between SNP occurrence and RA. After robust searches of Embase, PubMed, Cochrane Library, and Web of Science databases, we found 19 articles that included five independent studies. Out of 11 polymorphisms, two (rs2075876, rs760426) were common in the five case-control studies. Thus, we performed a meta-analysis for rs2075876 (7145 cases and 8579 controls) and rs760426 (6696 cases and 8164 controls). Our results prove that rs2075876 and rs760426 are significantly associated with an increased risk of RA in allelic, dominant, recessive, codominant heterozygous, and codominant homozygous genetic models. These findings are primarily based on data from Asian populations.

Az alacsony átlagos vörösvértest-hemoglobin alkalmas a vashiány szűrésére

Absztrakt Bevezetes: A vashiany szeles nepreteget erintő problema, szűrővizsgalata fontos egeszsegugyi kerdes. Celkitűzes: A szerzők arra a kerdesre kerestek valaszt, hogy a laboratoriumi automatak altal meghatarozott verkepparameterek kozul az alacsony MCH alkalmas-e a vashiany szűresere. Modszer: A Somogy Megyei Kaposi Mor Oktato Korhaz kozponti laboratoriumaban a 2013. januar 1. es 2015. junius 30. kozotti 30 honapos időszakban 247 705 verkepvizsgalat es 10 840 vasanyagcsere-vizsgalat tortent. A verkepvizsgalat alacsony atlagos vorosvertest-hemoglobinerteket hasonlitottak ossze az egyidejűleg elvegzett vashianyt igazolo parameterekkel. Eredmenyek: 830 betegben talaltak alacsony (28 pg alatti) atlagos vorosvertest-hemoglobinerteket es szimultan elvegzett vasanyagcsere laboratoriumi parametereket. Kozuluk 679 beteg eseteben (82%) az alacsony atlagos vorosvertest-hemoglobinertek vashiannyal jart egyutt. 126 hemodializalt (15%), 6 thalassaemias (minor), 8 myelofibrosisos, 5 rheumatoid arthritises beteg ese...

Splenic dysfunction from celiac disease resulting in severe babesiosis

We describe a 79-year-old Irish man who, because he had hyposplenism and splenic atrophy due to adult celiac disease, became critically ill from a severe Babesia divergens infection. Greater awareness of the possible consequences of splenic dysfunction from adult celiac disease, such as serious pneumococcal infections and babesiosis, is warranted.

The effect of serum triglyceride concentration on the outcome of acute pancreatitis: systematic review and meta-analysis

Elevated serum triglyceride concentration (seTG, >1.7 mM or >150 mg/dL) or in other words hypertriglyceridemia (HTG) is common in the populations of developed countries. This condition is accompanied by an increased risk for various diseases, such as acute pancreatitis (AP). It has been proposed that HTG could also worsen the course of AP. Therefore, in this meta-analysis, we aimed to compare the effects of various seTGs on the severity, mortality, local and systemic complications of AP, and on intensive care unit admission. 16 eligible studies, including 11,965 patients were retrieved from PubMed and Embase. The results showed that HTG significantly elevated the odds ratio (OR = 1.72) for severe AP when compared to patients with normal seTG (<1.7 mM). Furthermore, a significantly higher occurrence of pancreatic necrosis, persistent organ failure and renal failure was observed in groups with HTG. The rates of complications and mortality for AP were significantly increased in patients with seTG >5.6 mM or >11.3 mM versus <5.6 mM or <11.3 mM, respectively. We conclude that the presence of HTG worsens the course and outcome of AP, but we found no significant difference in AP severity based on the extent of HTG.

Autológ haemopoeticus őssejt-transzplantáció szerepe T-sejtes lymphomában. Magyar adatok

T-cell lymphoma is a poor prognostic hematological malignancy. The generally used - not sufficiently effective - induction chemotherapy should be improved with consolidative autologous hemopoetic stem cell transplantation. The authors describe the role, place and effectiveness of transplantation in this disorder. One hundred thirty three autologous stem cell transplantations were performed in the last 22 years in Hungary. Detailed results are available from the last 6 years. In this period 43 transplantations were carried out in 4 Hungarian centers. Carmustine-etoposide-cytosine arabinoside-melphalan (BEAM) conditioning regimen was used in 95%. The transplantation was done mainly in complete remission (84%), 1 year after transplantation 65% of patients were still in complete remission. Eleven patients died, 82% of them have progressive disease. Brentuximab vedotin has already proved the effectiveness, several other chemoterapeutics, monoclonal antibodies, kinase inhibitors are under investigation. In certain cases allogeneic stem cell transplantation has real indication among therapeutic options. Orv Hetil. 2017; 158(41): 1615-1619.Absztrakt: A T-sejtes lymphoma rossz prognozisu hematologiai malignitas. Az altalanossagban alkalmazott – nem kellően hatekony – indukcios kemoterapiat javitani lehet konszolidativ autolog haemopoeticus őssejt-transzplantacioval. A szerzők ismertetik az autolog atultetes szerepet, helyet, hatasossagat ebben a betegcsoportban. Az elmult 22 ev alatt Magyarorszagon 133 autolog atultetest vegeztek T-sejtes lymphomaban. Reszletesebb adatok hat ev transzplantacios eredmenyeiről allnak rendelkezesre. Ebben a periodusban 43 atultetes tortent a negy magyar centrumban kozel azonos esetszamokkal. Kondicionalo kezeleskent 95%-ban carmustin-etoposid-cytosin arabinosid-melphalan (BEAM) semat hasznaltak. Az esetek dontő tobbsegeben komplett remisszioban tortent az atultetes (84%), a beavatkozas utan egy evvel a betegek 65%-a volt komplett remisszioban. Tizenegy beteg halt meg a vizsgalt periodusban, 82%-uk alapbetegseg progressziojaban. Az uj szerek kozul a brentuximab vedotin mar bizonyitotta hatasossagat, szamos egyeb...

„Centrális véna – nővér módra?” Perifériáról bevezetett centrális vénás kanülökkel szerzett tapasztalataink

Absztrakt: Mi is az a PICC (peripherally inserted central catheter) line kanul? A PICC egy puha, rugalmas kateter, amely poliuretanbol vagy szilikonbol keszult, a kar vagy lab periferias venain keresztul a vena cava superior vagy inferior erhető el vele. A periferiarol bevezetett centralis venas kanuloket az 1950-es evekben irtak le előszor. Megjelenese ota nyilvanvaloan nagy valtozason esett at mind a metodikat, mind az alkalmazott eszkozoket tekintve. Szeretnenk bemutatni a venabiztositas e formajat, az előnyeivel, a hatranyaival es a felhasznalt eszkozrendszereivel egyutt. Kozlemenyunkben osszefoglaljuk a klinikankon vegzett PICC line beultetesek soran szerzett tapasztalatainkat. A Pecsi Tudomanyegyetem ez idaig Magyarorszagon uttorő abban a tekintetben, hogy kizarolag apolo implantalja ezeket a kanuloket (kulfoldon ez mar bevett szokasnak szamit), es bizunk benne, hogy ez a metodika az apoloi kompetencia fejlődesevel hazankban is elterjed. Orv Hetil. 2017; 158(22): 856–863.What is PICC line insertion? The PICC is a soft, flexible catheter which is made of polyurethane or silicone, and is inserted via an upper or lower extremity peripheral vein into superior or inferior vena cava. The origin of PICC line dates back to the early 1950s. Since the introduction of the PICC catheter, this method of venous catheterization has gone through many changes as regards the technique of insertion or the type of catheter used. Despite the routine use of PICC line worldwide, little progress has been made in its use in Hungary. In this short review we will briefly summarise the use of PICC line, its indications, advantages, disadvantages, and on complementary devices which are necessary during the procedure. We discuss our experience in insertion of PICC line at Pécs University, where the procedure is solely done by a certified registered nurse. We hope that with continuous progression of nurse competency, this procedure will be implemented at a higher scale in Hungary. Orv Hetil. 2017; 158(22): 856-863.