Robert Kieszko - Academia.edu (original) (raw)
Papers by Robert Kieszko
Frontiers in Medicine
IntroductionSarcoidosis is a highly variable disease in terms of organ involvement, type of onset... more IntroductionSarcoidosis is a highly variable disease in terms of organ involvement, type of onset and course. Associations of genetic polymorphisms with sarcoidosis phenotypes have been observed and suggest genetic signatures.MethodsAfter obtaining a positive vote of the competent ethics committee we genotyped 1909 patients of the deeply phenotyped Genetic-Phenotype Relationship in Sarcoidosis (GenPhenReSa) cohort of 31 European centers in 12 countries with 116 potentially disease-relevant single-nucleotide polymorphisms (SNPs). Using a meta-analysis, we investigated the association of relevant phenotypes (acute vs. sub-acute onset, phenotypes of organ involvement, specific organ involvements, and specific symptoms) with genetic markers. Subgroups were built on the basis of geographical, clinical and hospital provision considerations.ResultsIn the meta-analysis of the full cohort, there was no significant genetic association with any considered phenotype after correcting for multipl...
AMB Express
The significance of Akkermansia bacteria presence in gut micobiome, mainly Akkermansia mucinifila... more The significance of Akkermansia bacteria presence in gut micobiome, mainly Akkermansia mucinifila, is currently being investigated in the context of supporting therapy and marker for response to immunotherapy in cancer patients. It is indicated that patients with non-small cell lung cancer (NSCLC) treated with immune checkpoint inhibitors (ICIs) respond better to treatment if this bacterium is present in the intestine.We performed next-generation sequencing of the gut microbiome from patients treated in the first or second line therapy with anti-PD-1 (anti-programmed death 1) or anti-PD-L1 (anti-programmed death ligand 1) monoclonal antibodies. In our study group of 47 NSCLC patients, the percentage of Akkermansiaceae was higher in patients with disease stabilization and with partial response to immunotherapy compared to patients with disease progression. Moreover, we found that a higher percentage of Akkermansiaceae was present in patients with squamous cell carcinoma compared to a...
Oncology in Clinical Practice
Onkologia w Praktyce Klinicznej - Edukacja, 2021
Mimo poznania czynników ryzyka raka płuca, pozostaje on główną przyczyną zgonów z powodu nowotwor... more Mimo poznania czynników ryzyka raka płuca, pozostaje on główną przyczyną zgonów z powodu nowotworów złośliwych w krajach wysokorozwiniętych. Powodem tego zjawiska jest narastające zanieczyszczenie środowiska naturalnego oraz przede wszystkim trudności w eliminacji nałogu palenia tytoniu. W polskich dużych aglomeracjach miejskich narażenie na pyły zawieszone zawierające na swojej powierzchni węglowodory oraz na lotne węglowodory, tlenki azotu i siarki stale wzrasta. Co więcej prawie 25% polskiej populacji pali papierosy, a eliminacja nałogu palenia za pomocą psychoterapii, nikotynowej terapii zastępczej i farmakoterapii bywa nieskuteczna. W pracy tej wykazujemy, że wykorzystanie innych niż papierosy produktów spalających tytoń (np. cygara czy fajki) oraz marihuanę jest równie niebezpieczne dla zdrowia co klasyczne papierosy. Pojawiły się też inne produkty zawierające nikotynę: e-papierosy i systemy podgrzewające tytoń. Produkty te powodują także silne uzależnienie od nikotyny, ale powstające w nich aerozole zawierają mniej substancji toksycznych w porównaniu do dymu papierosowego. Istnieją zatem przesłanki do stosowania tych produktów zamiast tradycyjnych papierosów u osób silnie uzależnionych od nikotyny w celu redukcji ryzyka zdrowotnego, w tym zmniejszenia ryzyka zachorowania na raka płuca. Trzeba pamiętać, że jedynie całkowite zaprzestanie palenia oraz wykorzystywania produktów zawierających nikotynę skutecznie redukuje ryzyko zachorowania na raka płuc
Drobnokomorkowy rak pluca (SCLC) stanowi obecnie 15–20% wszystkich nowotworow pluca. Cechuje sie ... more Drobnokomorkowy rak pluca (SCLC) stanowi obecnie 15–20% wszystkich nowotworow pluca. Cechuje sie szybkim wzrostem i wczesnym pojawianiem sie przerzutow odleglych. Jest ściśle związany z paleniem tytoniu. Charakterystyczną cechą tego typu nowotworu jest czeste wspolistnienie zespolow paraneoplastycznych (ok. 50% chorych). Zespoly paraneoplastyczne są klinicznie istotne, poniewaz mogą stanowic pierwszy objaw choroby nowotworowej. Wczesna diagnostyka niepokojących objawow jest istotnym czynnikiem zwiekszenia skuteczności leczenia i szansy chorego na dluzsze przezycie. Czestymi i klinicznie istotnymi zespolami paraneoplastycznymi w przebiegu SCLC są przede wszystkim zespol nieprawidlowego wydzielania hormonu antydiuretycznego (SIADH), paranowotworowe zwyrodnienie mozdzku i miasteniczny zespol Lamberta-Eatona. W niniejszej pracy przedstawiono przypadek chorej, ktora zglosila sie do szpitala z objawami hiponatremii. Podczas wyjaśniania przyczyny hiponatremii stwierdzono wystepowanie SIADH...
Pandemia COVID-19 spowodowala ograniczenia w dostepie do diagnostyki i leczenia chorych na nowotw... more Pandemia COVID-19 spowodowala ograniczenia w dostepie do diagnostyki i leczenia chorych na nowotwory. U chorych na niedrobnokomorkowego raka pluca (NDRP) w celu kwalifikacji do leczenia ukierunkowanego molekularnie lub immunoterapii w ramach programu lekowego B6 nalezy przeprowadzic badania czynnikow predykcyjnych. Celem pracy bylo określenie, w jaki sposob pandemia COVID-19 wplynela na wykonywanie badan czynnikow predykcyjnych oraz poziom kwalifikacji chorych do leczenia w ramach programu lekowego B6. Obliczono liczbe wykonanych badan mutacji w genie EGFR , rearanzacji genu ALK i ekspresji bialka PD-L1 oraz przeprowadzonych kwalifikacji do programu lekowego w wybranych okresach lat 2019 i 2020. W okresie kwiecien–maj 2020 roku zaobserwowano spadek liczby wykonywanych badan mutacji w genie EGFR w stosunku do analogicznego okresu roku 2019 — o 21,64%, a w porownaniu z okresem styczen–luty roku 2020 — o 24,72%. W kwietniu i maju 2020 roku mozna tez zauwazyc spadek liczby przeprowadzon...
Frontiers in Oncology, 2021
IntroductionExpression of PD-L1 protein on tumor cells, which is so far the only validated predic... more IntroductionExpression of PD-L1 protein on tumor cells, which is so far the only validated predictive factor for immunotherapy, is regulated by epigenetic and genetic factors. Among the most important ones that regulate gene expression are microRNAs.Materials and MethodsThe study included 60 patients with NSCLC who underwent first or second line immunotherapy with pembrolizumab or nivolumab. FFPE materials were collected before the start of immunotherapy. We examined relative expression of microRNAs (miR-141, miR-200a, miR-200b, miR-200c, miR-429, miR-508-3p, miR-1184, miR-1255a) and PD-L1 mRNA expression. Copy number variation (CNV) of PD-L1 gene by qPCR and FISH methods were assessed. Two single nucleotide polymorphisms (SNPs) in promoter region of PD-L1 gene (rs822335 and rs822336) were examined. Expression of PD-L1 protein on tumor cells was assessed by immunohistochemistry (IHC). The response rate to immunotherapy and progression free survival (PFS) measured in weeks and overal...
Archives of Medical Science, 2021
IntroductionThe importance of modern treatments for the extension of overall survival in advanced... more IntroductionThe importance of modern treatments for the extension of overall survival in advanced lung cancer (LC) patients is rarely reported in clinical trials (crossover effect). Recent clinical trials have compared experimental treatment methods and shown that chemotherapy is no longer a comparator. We studied the relevance of innovative treatment to the extension of overall survival in Polish lung cancer patients.Material and methodsWe described the outcome in 1463 patients diagnosed and treated for advanced LC. The study included patients receiving all available forms of treatment, i.e. chemotherapy, immunotherapy, EGFR tyrosine kinase inhibitors, ALK inhibitors, and best supportive care (BSC).ResultsMedian OS (mOS) for the whole group of patients was 6.5 months. mOS was significantly higher in patients with SCC (8.0 months) and AC (7.0 months) compared to patients with SCLC (6 months) and NSCLC NOS (3.5 months). mOS was 30 months for EGFR TKI-treated patients, 34 months for p...
Advances in Respiratory Medicine, 2020
Introduction: Osimertinib is a third-generation, irreversible epidermal growth factor receptor (E... more Introduction: Osimertinib is a third-generation, irreversible epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor that has demonstrated efficacy in the treatment of EGFR-mutant non-small-cell lung cancer (NSCLC) in prospective clinical trials. Material and methods: This retrospective analysis evaluated the outcomes of 32 pretreated patients with EGFR T790M mutation who received osimertinib in clinical practice at seven centers in Poland within the Expanded Drug Access Program. Osimertinib was used in the second line in 59% of patients and in later lines in 41%. Results: Objective response was attained in 16 patients (50%), and 12 subjects (38%) had stable disease. Median progression -free survival was 11.3 months in the overall population, 12.6 months in patients with EGFR exon 19 mutation and 7.5 months in patients with EGFR exon 21 mutation (p = 0.045). Median overall survival (OS) was 18.3 months. Overall, 58.4% and 45.6% of patients remained in follow-up after 12 a...
Archives of Medical Science, 2019
Oncology in Clinical Practice, 2019
Oncology in Clinical Practice, 2019
The European respiratory journal, 2018
Sarcoidosis is a highly variable, systemic granulomatous disease of hitherto unknown aetiology. T... more Sarcoidosis is a highly variable, systemic granulomatous disease of hitherto unknown aetiology. The GenPhenReSa (Genotype-Phenotype Relationship in Sarcoidosis) project represents a European multicentre study to investigate the influence of genotype on disease phenotypes in sarcoidosis.The baseline phenotype module of GenPhenReSa comprised 2163 Caucasian patients with sarcoidosis who were phenotyped at 31 study centres according to a standardised protocol.From this module, we found that patients with acute onset were mainly female, young and of Scadding type I or II. Female patients showed a significantly higher frequency of eye and skin involvement, and complained more of fatigue. Based on multidimensional correspondence analysis and subsequent cluster analysis, patients could be clearly stratified into five distinct, yet undescribed, subgroups according to predominant organ involvement: 1) abdominal organ involvement, 2) ocular-cardiac-cutaneous-central nervous system disease invo...
Archives of Medical Science, 2016
Introduction: Sarcoidosis is a multisystem granulomatous disease of unknown etiology. Current the... more Introduction: Sarcoidosis is a multisystem granulomatous disease of unknown etiology. Current theory on the etiology of this disease involves participation of genetic factors and unknown antigens present in the patients' environment. The aim of the study was to evaluate the prevalence of different polymorphic forms of the ACE gene in healthy individuals and sarcoidosis patients, and to estimate the risk of sarcoidosis in carriers of different ACE genotypes living in rural and urban settings. Material and methods: The study group included 180 patients with pulmonary sarcoidosis. Assessment of the disease was based on clinical features, laboratory and imaging examinations, as well as bronchoscopy with bronchoalveolar lavage (BAL). ACE gene polymorphism was examined in DNA isolated from peripheral blood or BAL fluid (BALF) leukocytes. Results: Incidence of sarcoidosis was not influenced by gender, age or place of residence of the patients. There were no differences in the frequency of particular genotypes in patients with sarcoidosis and in healthy individuals. The risk of disease did not depend on the ACE gene polymorphism. There were no differences in the frequencies of the different genotypes and alleles of the ACE gene in patients with sarcoidosis divided by gender, age and place of residence or by clinical manifestation of sarcoidosis. Conclusions: Our results do not support the previous concept which suggested a higher incidence of sarcoidosis in individuals living in rural areas and in carriers of selected ACE genotypes. It is possible that this is related to the changing environment of rural areas, increasing urbanization and pollution.
Annales Universitatis Mariae Curie-Skłodowska. Sectio D: Medicina, 2003
The analysis of eight cases of CAP (Community Acquired Pneumonia) was performed. The clinical sam... more The analysis of eight cases of CAP (Community Acquired Pneumonia) was performed. The clinical samples of sputum were obtained from patients at which C. pseudodiphtheriticum strains were isolated in the quantity indicating the etiologic agent of infection. In two patients, K. pneumoniae and S. aureus were isolated simultaneously. They were considered as coexisting in the infection. C. pseudodiphtheriticum strains were highly susceptible to antibiotics. They were resistant to Erythromycin (87.5%), Clindamycin (87.5%), Lincomycin (75.5%), Trimeth./Sulfam.(37.5%), Chloramfenicol (37.5%). In the examined group of patients (five persons), the infection with C. pneumoniae was detected as recently passed or in progress with chronic character as the high level of specific antibodies (IgG or IgG and IgA) was present. That fact could predispose to infection with the opportunistic species of C. pseudodiphtheriticum. Of all the examined patients, three were infected with C. pseudodiphtheriticum ...
Annales Universitatis Mariae Curie-Skłodowska. Sectio D: Medicina, 2003
Dendritic cells play a specific regulatory role in the immune system. In this paper, the signific... more Dendritic cells play a specific regulatory role in the immune system. In this paper, the significance of myeloid and lymphoid dendritic cells in sarcoidosis and extrinsic allergic alveolitis (EAA) was evaluated. Myeloid dendritic cells are connected with Th1 type of immunological response, whereas lymphoid ones--with Th2 type. The latest findings indicate that both diseases are characterized by serious disturbances of Th1/Th2 response to Th1 dominance. Our studies seem to confirm these suggestions. In the peripheral blood of patients with sarcoidosis as well as with EAA, myeloid dendritic cells outnumbered lymphoid ones.
Annales Universitatis Mariae Curie-Skłodowska. Sectio D: Medicina, 2003
The aim of the study was a retrospective analysis of effectiveness of surgical treatment of sever... more The aim of the study was a retrospective analysis of effectiveness of surgical treatment of severe diffuse emphysema, including urgent cases with symptomatic pneumothorax. We analyzed 99 patients with severe diffuse emphysema who underwent surgical treatment in Department of Thoracic Surgery in Lublin between 1995 and 2001. The evaluated group consisted of 86 men and 13 women aged from 27 to 83 (mean age 56.6). Among them 54 were operated on due to sudden pneumothorax, which was a result of bursted emphysematous parenchyma. Those patients were not evaluated with spirometry and CT of the chest. All the other patients were carefully examined and qualified for surgical treatment according to precise criteria: presence of clinical and radiological symptoms of diffuse severe emphysema (DSE), FEV1<35%, pCO2>50mmHg. Those 43 patients eligible for Lung Volume Reduction Surgery iLVRS) also did not have any main contraindications for lung surgery. In the whole analyzed population 89 res...
Annales Universitatis Mariae Curie-Skłodowska. Sectio D: Medicina, 2003
The objective of the study was determination of the most frequent bacterial factors, including Ha... more The objective of the study was determination of the most frequent bacterial factors, including Haemophilus parainfluenzae, suspected of causing COPD exacerbation, of the relation between bacterial strains and respiratory system functional status as well as of antibiotic sensitivity of sputum isolated bacteria. The examined group comprised 28 patients treated in the Pulmonary Department of Medical University of Lublin. The subjects fulfilled the criteria of type I COPD bacterial exacerbation. Patient's chest x-ray and spirometry tests were performed. Forty-nine bacterial strains were isolated. In the case of nine patients, more than one strain was isolated. Subjects having H. parainfluenzae in sputum had significantly higher (p<0.05) FVC and FEV1 values comparing to patients with H. influenzae or other Gram-negative bacteria. H. parainfluenzae may be an important etiologic factor of COPD exacerbation. Aetiology of bacterial COPD exacerbation depends on the level of respiratory...
Frontiers in Medicine
IntroductionSarcoidosis is a highly variable disease in terms of organ involvement, type of onset... more IntroductionSarcoidosis is a highly variable disease in terms of organ involvement, type of onset and course. Associations of genetic polymorphisms with sarcoidosis phenotypes have been observed and suggest genetic signatures.MethodsAfter obtaining a positive vote of the competent ethics committee we genotyped 1909 patients of the deeply phenotyped Genetic-Phenotype Relationship in Sarcoidosis (GenPhenReSa) cohort of 31 European centers in 12 countries with 116 potentially disease-relevant single-nucleotide polymorphisms (SNPs). Using a meta-analysis, we investigated the association of relevant phenotypes (acute vs. sub-acute onset, phenotypes of organ involvement, specific organ involvements, and specific symptoms) with genetic markers. Subgroups were built on the basis of geographical, clinical and hospital provision considerations.ResultsIn the meta-analysis of the full cohort, there was no significant genetic association with any considered phenotype after correcting for multipl...
AMB Express
The significance of Akkermansia bacteria presence in gut micobiome, mainly Akkermansia mucinifila... more The significance of Akkermansia bacteria presence in gut micobiome, mainly Akkermansia mucinifila, is currently being investigated in the context of supporting therapy and marker for response to immunotherapy in cancer patients. It is indicated that patients with non-small cell lung cancer (NSCLC) treated with immune checkpoint inhibitors (ICIs) respond better to treatment if this bacterium is present in the intestine.We performed next-generation sequencing of the gut microbiome from patients treated in the first or second line therapy with anti-PD-1 (anti-programmed death 1) or anti-PD-L1 (anti-programmed death ligand 1) monoclonal antibodies. In our study group of 47 NSCLC patients, the percentage of Akkermansiaceae was higher in patients with disease stabilization and with partial response to immunotherapy compared to patients with disease progression. Moreover, we found that a higher percentage of Akkermansiaceae was present in patients with squamous cell carcinoma compared to a...
Oncology in Clinical Practice
Onkologia w Praktyce Klinicznej - Edukacja, 2021
Mimo poznania czynników ryzyka raka płuca, pozostaje on główną przyczyną zgonów z powodu nowotwor... more Mimo poznania czynników ryzyka raka płuca, pozostaje on główną przyczyną zgonów z powodu nowotworów złośliwych w krajach wysokorozwiniętych. Powodem tego zjawiska jest narastające zanieczyszczenie środowiska naturalnego oraz przede wszystkim trudności w eliminacji nałogu palenia tytoniu. W polskich dużych aglomeracjach miejskich narażenie na pyły zawieszone zawierające na swojej powierzchni węglowodory oraz na lotne węglowodory, tlenki azotu i siarki stale wzrasta. Co więcej prawie 25% polskiej populacji pali papierosy, a eliminacja nałogu palenia za pomocą psychoterapii, nikotynowej terapii zastępczej i farmakoterapii bywa nieskuteczna. W pracy tej wykazujemy, że wykorzystanie innych niż papierosy produktów spalających tytoń (np. cygara czy fajki) oraz marihuanę jest równie niebezpieczne dla zdrowia co klasyczne papierosy. Pojawiły się też inne produkty zawierające nikotynę: e-papierosy i systemy podgrzewające tytoń. Produkty te powodują także silne uzależnienie od nikotyny, ale powstające w nich aerozole zawierają mniej substancji toksycznych w porównaniu do dymu papierosowego. Istnieją zatem przesłanki do stosowania tych produktów zamiast tradycyjnych papierosów u osób silnie uzależnionych od nikotyny w celu redukcji ryzyka zdrowotnego, w tym zmniejszenia ryzyka zachorowania na raka płuca. Trzeba pamiętać, że jedynie całkowite zaprzestanie palenia oraz wykorzystywania produktów zawierających nikotynę skutecznie redukuje ryzyko zachorowania na raka płuc
Drobnokomorkowy rak pluca (SCLC) stanowi obecnie 15–20% wszystkich nowotworow pluca. Cechuje sie ... more Drobnokomorkowy rak pluca (SCLC) stanowi obecnie 15–20% wszystkich nowotworow pluca. Cechuje sie szybkim wzrostem i wczesnym pojawianiem sie przerzutow odleglych. Jest ściśle związany z paleniem tytoniu. Charakterystyczną cechą tego typu nowotworu jest czeste wspolistnienie zespolow paraneoplastycznych (ok. 50% chorych). Zespoly paraneoplastyczne są klinicznie istotne, poniewaz mogą stanowic pierwszy objaw choroby nowotworowej. Wczesna diagnostyka niepokojących objawow jest istotnym czynnikiem zwiekszenia skuteczności leczenia i szansy chorego na dluzsze przezycie. Czestymi i klinicznie istotnymi zespolami paraneoplastycznymi w przebiegu SCLC są przede wszystkim zespol nieprawidlowego wydzielania hormonu antydiuretycznego (SIADH), paranowotworowe zwyrodnienie mozdzku i miasteniczny zespol Lamberta-Eatona. W niniejszej pracy przedstawiono przypadek chorej, ktora zglosila sie do szpitala z objawami hiponatremii. Podczas wyjaśniania przyczyny hiponatremii stwierdzono wystepowanie SIADH...
Pandemia COVID-19 spowodowala ograniczenia w dostepie do diagnostyki i leczenia chorych na nowotw... more Pandemia COVID-19 spowodowala ograniczenia w dostepie do diagnostyki i leczenia chorych na nowotwory. U chorych na niedrobnokomorkowego raka pluca (NDRP) w celu kwalifikacji do leczenia ukierunkowanego molekularnie lub immunoterapii w ramach programu lekowego B6 nalezy przeprowadzic badania czynnikow predykcyjnych. Celem pracy bylo określenie, w jaki sposob pandemia COVID-19 wplynela na wykonywanie badan czynnikow predykcyjnych oraz poziom kwalifikacji chorych do leczenia w ramach programu lekowego B6. Obliczono liczbe wykonanych badan mutacji w genie EGFR , rearanzacji genu ALK i ekspresji bialka PD-L1 oraz przeprowadzonych kwalifikacji do programu lekowego w wybranych okresach lat 2019 i 2020. W okresie kwiecien–maj 2020 roku zaobserwowano spadek liczby wykonywanych badan mutacji w genie EGFR w stosunku do analogicznego okresu roku 2019 — o 21,64%, a w porownaniu z okresem styczen–luty roku 2020 — o 24,72%. W kwietniu i maju 2020 roku mozna tez zauwazyc spadek liczby przeprowadzon...
Frontiers in Oncology, 2021
IntroductionExpression of PD-L1 protein on tumor cells, which is so far the only validated predic... more IntroductionExpression of PD-L1 protein on tumor cells, which is so far the only validated predictive factor for immunotherapy, is regulated by epigenetic and genetic factors. Among the most important ones that regulate gene expression are microRNAs.Materials and MethodsThe study included 60 patients with NSCLC who underwent first or second line immunotherapy with pembrolizumab or nivolumab. FFPE materials were collected before the start of immunotherapy. We examined relative expression of microRNAs (miR-141, miR-200a, miR-200b, miR-200c, miR-429, miR-508-3p, miR-1184, miR-1255a) and PD-L1 mRNA expression. Copy number variation (CNV) of PD-L1 gene by qPCR and FISH methods were assessed. Two single nucleotide polymorphisms (SNPs) in promoter region of PD-L1 gene (rs822335 and rs822336) were examined. Expression of PD-L1 protein on tumor cells was assessed by immunohistochemistry (IHC). The response rate to immunotherapy and progression free survival (PFS) measured in weeks and overal...
Archives of Medical Science, 2021
IntroductionThe importance of modern treatments for the extension of overall survival in advanced... more IntroductionThe importance of modern treatments for the extension of overall survival in advanced lung cancer (LC) patients is rarely reported in clinical trials (crossover effect). Recent clinical trials have compared experimental treatment methods and shown that chemotherapy is no longer a comparator. We studied the relevance of innovative treatment to the extension of overall survival in Polish lung cancer patients.Material and methodsWe described the outcome in 1463 patients diagnosed and treated for advanced LC. The study included patients receiving all available forms of treatment, i.e. chemotherapy, immunotherapy, EGFR tyrosine kinase inhibitors, ALK inhibitors, and best supportive care (BSC).ResultsMedian OS (mOS) for the whole group of patients was 6.5 months. mOS was significantly higher in patients with SCC (8.0 months) and AC (7.0 months) compared to patients with SCLC (6 months) and NSCLC NOS (3.5 months). mOS was 30 months for EGFR TKI-treated patients, 34 months for p...
Advances in Respiratory Medicine, 2020
Introduction: Osimertinib is a third-generation, irreversible epidermal growth factor receptor (E... more Introduction: Osimertinib is a third-generation, irreversible epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor that has demonstrated efficacy in the treatment of EGFR-mutant non-small-cell lung cancer (NSCLC) in prospective clinical trials. Material and methods: This retrospective analysis evaluated the outcomes of 32 pretreated patients with EGFR T790M mutation who received osimertinib in clinical practice at seven centers in Poland within the Expanded Drug Access Program. Osimertinib was used in the second line in 59% of patients and in later lines in 41%. Results: Objective response was attained in 16 patients (50%), and 12 subjects (38%) had stable disease. Median progression -free survival was 11.3 months in the overall population, 12.6 months in patients with EGFR exon 19 mutation and 7.5 months in patients with EGFR exon 21 mutation (p = 0.045). Median overall survival (OS) was 18.3 months. Overall, 58.4% and 45.6% of patients remained in follow-up after 12 a...
Archives of Medical Science, 2019
Oncology in Clinical Practice, 2019
Oncology in Clinical Practice, 2019
The European respiratory journal, 2018
Sarcoidosis is a highly variable, systemic granulomatous disease of hitherto unknown aetiology. T... more Sarcoidosis is a highly variable, systemic granulomatous disease of hitherto unknown aetiology. The GenPhenReSa (Genotype-Phenotype Relationship in Sarcoidosis) project represents a European multicentre study to investigate the influence of genotype on disease phenotypes in sarcoidosis.The baseline phenotype module of GenPhenReSa comprised 2163 Caucasian patients with sarcoidosis who were phenotyped at 31 study centres according to a standardised protocol.From this module, we found that patients with acute onset were mainly female, young and of Scadding type I or II. Female patients showed a significantly higher frequency of eye and skin involvement, and complained more of fatigue. Based on multidimensional correspondence analysis and subsequent cluster analysis, patients could be clearly stratified into five distinct, yet undescribed, subgroups according to predominant organ involvement: 1) abdominal organ involvement, 2) ocular-cardiac-cutaneous-central nervous system disease invo...
Archives of Medical Science, 2016
Introduction: Sarcoidosis is a multisystem granulomatous disease of unknown etiology. Current the... more Introduction: Sarcoidosis is a multisystem granulomatous disease of unknown etiology. Current theory on the etiology of this disease involves participation of genetic factors and unknown antigens present in the patients' environment. The aim of the study was to evaluate the prevalence of different polymorphic forms of the ACE gene in healthy individuals and sarcoidosis patients, and to estimate the risk of sarcoidosis in carriers of different ACE genotypes living in rural and urban settings. Material and methods: The study group included 180 patients with pulmonary sarcoidosis. Assessment of the disease was based on clinical features, laboratory and imaging examinations, as well as bronchoscopy with bronchoalveolar lavage (BAL). ACE gene polymorphism was examined in DNA isolated from peripheral blood or BAL fluid (BALF) leukocytes. Results: Incidence of sarcoidosis was not influenced by gender, age or place of residence of the patients. There were no differences in the frequency of particular genotypes in patients with sarcoidosis and in healthy individuals. The risk of disease did not depend on the ACE gene polymorphism. There were no differences in the frequencies of the different genotypes and alleles of the ACE gene in patients with sarcoidosis divided by gender, age and place of residence or by clinical manifestation of sarcoidosis. Conclusions: Our results do not support the previous concept which suggested a higher incidence of sarcoidosis in individuals living in rural areas and in carriers of selected ACE genotypes. It is possible that this is related to the changing environment of rural areas, increasing urbanization and pollution.
Annales Universitatis Mariae Curie-Skłodowska. Sectio D: Medicina, 2003
The analysis of eight cases of CAP (Community Acquired Pneumonia) was performed. The clinical sam... more The analysis of eight cases of CAP (Community Acquired Pneumonia) was performed. The clinical samples of sputum were obtained from patients at which C. pseudodiphtheriticum strains were isolated in the quantity indicating the etiologic agent of infection. In two patients, K. pneumoniae and S. aureus were isolated simultaneously. They were considered as coexisting in the infection. C. pseudodiphtheriticum strains were highly susceptible to antibiotics. They were resistant to Erythromycin (87.5%), Clindamycin (87.5%), Lincomycin (75.5%), Trimeth./Sulfam.(37.5%), Chloramfenicol (37.5%). In the examined group of patients (five persons), the infection with C. pneumoniae was detected as recently passed or in progress with chronic character as the high level of specific antibodies (IgG or IgG and IgA) was present. That fact could predispose to infection with the opportunistic species of C. pseudodiphtheriticum. Of all the examined patients, three were infected with C. pseudodiphtheriticum ...
Annales Universitatis Mariae Curie-Skłodowska. Sectio D: Medicina, 2003
Dendritic cells play a specific regulatory role in the immune system. In this paper, the signific... more Dendritic cells play a specific regulatory role in the immune system. In this paper, the significance of myeloid and lymphoid dendritic cells in sarcoidosis and extrinsic allergic alveolitis (EAA) was evaluated. Myeloid dendritic cells are connected with Th1 type of immunological response, whereas lymphoid ones--with Th2 type. The latest findings indicate that both diseases are characterized by serious disturbances of Th1/Th2 response to Th1 dominance. Our studies seem to confirm these suggestions. In the peripheral blood of patients with sarcoidosis as well as with EAA, myeloid dendritic cells outnumbered lymphoid ones.
Annales Universitatis Mariae Curie-Skłodowska. Sectio D: Medicina, 2003
The aim of the study was a retrospective analysis of effectiveness of surgical treatment of sever... more The aim of the study was a retrospective analysis of effectiveness of surgical treatment of severe diffuse emphysema, including urgent cases with symptomatic pneumothorax. We analyzed 99 patients with severe diffuse emphysema who underwent surgical treatment in Department of Thoracic Surgery in Lublin between 1995 and 2001. The evaluated group consisted of 86 men and 13 women aged from 27 to 83 (mean age 56.6). Among them 54 were operated on due to sudden pneumothorax, which was a result of bursted emphysematous parenchyma. Those patients were not evaluated with spirometry and CT of the chest. All the other patients were carefully examined and qualified for surgical treatment according to precise criteria: presence of clinical and radiological symptoms of diffuse severe emphysema (DSE), FEV1<35%, pCO2>50mmHg. Those 43 patients eligible for Lung Volume Reduction Surgery iLVRS) also did not have any main contraindications for lung surgery. In the whole analyzed population 89 res...
Annales Universitatis Mariae Curie-Skłodowska. Sectio D: Medicina, 2003
The objective of the study was determination of the most frequent bacterial factors, including Ha... more The objective of the study was determination of the most frequent bacterial factors, including Haemophilus parainfluenzae, suspected of causing COPD exacerbation, of the relation between bacterial strains and respiratory system functional status as well as of antibiotic sensitivity of sputum isolated bacteria. The examined group comprised 28 patients treated in the Pulmonary Department of Medical University of Lublin. The subjects fulfilled the criteria of type I COPD bacterial exacerbation. Patient's chest x-ray and spirometry tests were performed. Forty-nine bacterial strains were isolated. In the case of nine patients, more than one strain was isolated. Subjects having H. parainfluenzae in sputum had significantly higher (p<0.05) FVC and FEV1 values comparing to patients with H. influenzae or other Gram-negative bacteria. H. parainfluenzae may be an important etiologic factor of COPD exacerbation. Aetiology of bacterial COPD exacerbation depends on the level of respiratory...