Prognostic value of pretreatment neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios in multiple myeloma patients treated with thalidomide-based regimen.

Neutrophils to lymphocytes ratio (NLR) and platelets to lymphocytes ratio (PLR) are considered as laboratory markers of inflammation. They can be potentially useful in predicting the course of multiple neoplasms including selected hematological cancers. The aim of the study was to assess the value of NLR and PLR in predicting the effects of therapy and prognosis in multiple myeloma patients treated with thalidomide-based regimen. The study group consisted of 100 patients treated with the first line CTD (cyclophosphamide, thalidomide, and dexamethasone) chemotherapy. The NLR and PLR were calculated before treatment. High NLR was observed in patients with higher stage of the disease, with poor performance status, hypercalcemia, and high CRP. High PLR was associated with low BMI and high CRP. In patients with high NLR, significantly shorter PFS was observed (17 vs. 26 months, p = 0.0405). In addition, high values of NLR and PLR were associated with significantly shorter OS (38 vs. 79 months, p = 0.0010; 40 vs. 78 months, p = 0.0058). Summarizing, NLR and PLR have a significant independent prognostic value for multiple myeloma patients. Furthermore, the NLR can be a predictive marker for the outcome of thalidomide-based chemotherapy.

Polymorphisms in the promoter region of the CRBN gene as a predictive factor for the first-line CTD therapy in multiple myeloma patients.

Cereblon is a primary molecular target for immunomodulatory drugs. The aim of this study was to evaluate the influence of selected clinical and molecular factors including single nucleotide polymorphisms (SNPs) in CRBN gene on the efficacy of first line CTD (cyclophosphamide, thalidomide, dexamethasone) chemotherapy in patients with multiple myeloma. Study group consisted of 68 patients. Analysis of CRBN gene SNPs (rs6768972, rs1672753) was performed using Real-Time PCR genotyping technique. Median progression free survival (PFS) was 15 months and overall survival (OS) 79 months. Factors associated with significantly shorter OS included ISS 3, kidney disease, weight loss, anemia, thrombocytopenia, hypoalbuminemia, elevated ß2-microglobuline and CRP. The presence of t(4;14) was associated with significantly shorter PFS and OS. Both examined SNPs proved to be statistically significant, independent predictive factors of efficacy of the CTD chemotherapy. The presence of AA genotype (rs6768972) correlated with longer median PFS (18 vs 9 months; HR=0.49,95% CI: 0.26-0.91, p=0.0062). Conversely, in the carriers of CC genotype (rs1672753) significantly shorter median PFS was observed (4 vs 16 months; HR=3.93, 95% CI: 0.26-59.64, p=0.0321). In conclusion, SNPs of the CRBN gene may be useful in qualifying patients for treatment with regimens containing thalidomide.

Agriculture and forestry work-related injuries among farmers admitted to an Emergency Department.

UNLABELLED: The objective of the study was to describe the characteristics of agriculture and forestry related injury cases admitted to an Emergency Department (ED), and to asses factors related to injury severity and hospital admission. Retrospective analysis of ED case records in Teaching Hospital No 1 in Lublin, from January 2004 to December 2005 were utilized. INCLUSION CRITERIA: patient>14 years old, with agriculture and forestry related injuries. Univariate and bivariate descriptive analyses and multiple logistic regressions were performed. 3791 cases were included, 63.1% males, 53.3% cases younger than 30 years and 47.1% of the patients sustained injuries related to machines or falls. After adjusting for age, sex and the presence of multiple injuries, animal related injuries, followed by machine related injuries and falls, were at higher risk of a more severe injury (OR: 1.77, 1.61 and 1.50, respectively). This groups also showed a higher likelihood of hospital admission (OR: 2.03, 192 and 2.00, respectively). Patients attended to in the ED during night hours (OR: 2.06) were also at a higher risk of hospitalization. It was concluded that animal related injuries, agriculture machine operators, and falls, besides accounting for two thirds of analyzed cases, are the mechanism of injury with a greater risk of a more severe injury and higher likelihood of a hospitalization.

Application of local innervated skin flaps in healing of posterior and sole calcanea surfaces defects.

In the paper were shown the methods of the local innervated skin flaps, harvested from the posterior surface of the lower leg, the lateral malleolus region and the plantar surface of the foot, used in treatment of soft tissues defects of posterior and plantar surface of the heel.