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  1. Article ; Online: Survival analysis after stereotactic ablative radiotherapy for early stage non-small cell lung cancer: a single-institution cohort study.

    Resova, Kamila / Knybel, Lukas / Parackova, Tereza / Rybar, Marian / Cwiertka, Karel / Cvek, Jakub

    Radiation oncology (London, England)

    2024  Volume 19, Issue 1, Page(s) 50

    Abstract: Background: Stereotactic ablative radiotherapy (SABR) is the standard treatment for medically inoperable early-stage non-small cell lung cancer (ES-NSCLC), but which patients benefit from stereotactic radiotherapy is unclear. The aim of this study was ... ...

    Abstract Background: Stereotactic ablative radiotherapy (SABR) is the standard treatment for medically inoperable early-stage non-small cell lung cancer (ES-NSCLC), but which patients benefit from stereotactic radiotherapy is unclear. The aim of this study was to analyze prognostic factors for early mortality.
    Methods: From August 2010 to 2022, 617 patients with medically inoperable, peripheral or central ES-NSCLC were treated with SABR at our institution. We retrospectively evaluated the data from 172 consecutive patients treated from 2018 to 2020 to analyze the prognostic factors associated with overall survival (OS). The biological effective dose was > 100 Gy
    Results: The median OS was 35.3 months. In univariate analysis, no correlation was found between OS and ventilation parameters, histology, PET, or centrality. Tumor diameter, biological effective dose, gender, and AACCI met the criteria for inclusion in the multivariate analysis. The multivariate model showed that males (HR 1.51, 95% CI 1.01-2.28; p = 0.05) and AACCI > 5 (HR 1.56, 95% CI 1.06-2.31; p = 0.026) were significant negative prognostic factors of OS. However, the analysis of OS showed that the significant effect of AACCI > 5 was achieved only after 3 years (3-year OS 37% vs. 56%, p = 0.021), whereas the OS in one year was similar (1-year OS 83% vs. 86%, p = 0.58).
    Conclusion: SABR of ES-NSCLC with precise image guidance is feasible for all medically inoperable patients with reasonable performance status. Early deaths were rare in our real-life cohort, and OS is clearly higher than would have been expected after best supportive care.
    MeSH term(s) Male ; Humans ; Carcinoma, Non-Small-Cell Lung/radiotherapy ; Carcinoma, Non-Small-Cell Lung/surgery ; Lung Neoplasms/radiotherapy ; Lung Neoplasms/surgery ; Cohort Studies ; Retrospective Studies ; Neoplasm Staging ; Survival Analysis ; Small Cell Lung Carcinoma/pathology ; Radiosurgery/methods ; Treatment Outcome
    Language English
    Publishing date 2024-04-18
    Publishing country England
    Document type Journal Article
    ZDB-ID 2224965-5
    ISSN 1748-717X ; 1748-717X
    ISSN (online) 1748-717X
    ISSN 1748-717X
    DOI 10.1186/s13014-024-02439-0
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  2. Article ; Online: Adherence to application technique of inhaled corticosteroid in patients with asthma and COVID-19 improves outcomes.

    Tichopád, Aleš / Žigmond, Jan / Jeseňák, Miloš / Solovič, Ivan / Breciková, Katarína / Rybář, Marian / Rožánek, Martin / Sedlák, Vratislav

    BMJ open respiratory research

    2024  Volume 11, Issue 1

    Abstract: Background: Inhaled corticosteroids have been widely reported as a preventive measure against the development of severe forms of COVID-19 not only in patients with asthma.: Methods: In 654 Czech and Slovak patients with asthma who developed COVID-19, ...

    Abstract Background: Inhaled corticosteroids have been widely reported as a preventive measure against the development of severe forms of COVID-19 not only in patients with asthma.
    Methods: In 654 Czech and Slovak patients with asthma who developed COVID-19, we investigated whether the correct use of inhaler containing corticosteroids was associated with a less severe course of COVID-19 and whether this had an impact on the need for hospitalisation, measurable lung functions and quality of life (QoL).
    Results: Of the studied cohort 51.4% had moderate persistent, 29.9% mild persistent and 7.2% severe persistent asthma. We found a significant adverse effect of poor inhaler adherence on COVID-19 severity (p=0.049). We also observed a lower hospitalisation rate in patients adequately taking the inhaler with OR of 0.83. Vital capacity and forced expiratory lung volume deterioration caused by COVID-19 were significantly reversed, by approximately twofold to threefold, in individuals who inhaled correctly.
    Conclusion: Higher quality of inhalation technique of corticosteroids measured by adherence to an inhaled medication application technique (A-AppIT) score had a significant positive effect on reversal of the vital capacity and forced expiratory lung volume in 1 s worsening (p=0.027 and p<0.0001, respectively) due to COVID-19. Scoring higher in the A-AppIT was also associated with significantly improved QoL. All measured variables concordantly and without exception showed a positive improvement in response to better adherence. We suggest that corticosteroids provide protection against the worsening of lungs in patients with COVID-19 and that correct and easily assessable adherence to corticosteroids with appropriate inhalation technique play an important role in preventing severe form of COVID-19.
    MeSH term(s) Humans ; Quality of Life ; COVID-19 ; Asthma/drug therapy ; Adrenal Cortex Hormones ; Forced Expiratory Volume
    Chemical Substances Adrenal Cortex Hormones
    Language English
    Publishing date 2024-01-06
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2736454-9
    ISSN 2052-4439 ; 2052-4439
    ISSN (online) 2052-4439
    ISSN 2052-4439
    DOI 10.1136/bmjresp-2023-001874
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  3. Article: Uptake and Effectiveness of Risk-Reducing Surgeries in Unaffected Female

    Zimovjanova, Martina / Bielcikova, Zuzana / Miskovicova, Michaela / Vocka, Michal / Zimovjanova, Anna / Rybar, Marian / Novotny, Jan / Petruzelka, Lubos

    Cancers

    2023  Volume 15, Issue 4

    Abstract: Unnafected female carriers ... ...

    Abstract Unnafected female carriers of
    Language English
    Publishing date 2023-02-08
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2527080-1
    ISSN 2072-6694
    ISSN 2072-6694
    DOI 10.3390/cancers15041072
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  4. Article ; Online: Sequential hybrid ablation vs. surgical CryoMaze alone for treatment of atrial fibrillation: results of multicentre randomized controlled trial.

    Bulava, Alan / Wichterle, Dan / Mokráček, Aleš / Osmančík, Pavel / Budera, Petr / Kačer, Petr / Vetešková, Linda / Němec, Petr / Skála, Tomáš / Šantavý, Petr / Chovančík, Jan / Branny, Piotr / Rizov, Vitalii / Kolesár, Miroslav / Šafaříková, Iva / Rybář, Marian

    Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology

    2024  Volume 26, Issue 2

    Abstract: Aims: Data on the hybrid atrial fibrillation (AF) treatment are lacking in patients with structural heart disease undergoing concomitant CryoMaze procedures. The aim was to assess whether the timely pre-emptive catheter ablation would achieve higher ... ...

    Abstract Aims: Data on the hybrid atrial fibrillation (AF) treatment are lacking in patients with structural heart disease undergoing concomitant CryoMaze procedures. The aim was to assess whether the timely pre-emptive catheter ablation would achieve higher freedom from AF or atrial tachycardia (AT) and be associated with better clinical outcomes than surgical ablation alone.
    Methods and results: The trial investigated patients with non-paroxysmal AF undergoing coronary artery bypass grafting and/or valve repair/replacement with mandatory concomitant CryoMaze procedure who were randomly assigned to undergo either radiofrequency catheter ablation [Hybrid Group (HG)] or no further treatment (Surgery Group). The primary efficacy endpoint was the first recurrence of AF/AT without class I or III antiarrhythmic drugs as assessed by implantable cardiac monitors. The primary clinical endpoint was a composite of hospitalization for arrhythmia recurrence, worsening of heart failure, cardioembolic event, or major bleeding. We analysed 113 and 116 patients in the Hybrid and Surgery Groups, respectively, with a median follow-up of 715 (IQR: 528-1072) days. The primary efficacy endpoint was significantly reduced in the HG [41.1% vs. 67.4%, hazard ratio (HR) = 0.38, 95% confidence interval (CI): 0.26-0.57, P < 0.001] as well as the primary clinical endpoint (19.9% vs. 40.1%, HR = 0.51, 95% CI: 0.29-0.86, P = 0.012). The trial groups did not differ in all-cause mortality (10.6% vs. 8.6%, HR = 1.17, 95%CI: 0.51-2.71, P = 0.71). The major complications of catheter ablation were infrequent (1.9%).
    Conclusion: Pre-emptively performed catheter ablation after the CryoMaze procedure was safe and associated with higher freedom from AF/AT and improved clinical outcomes.
    MeSH term(s) Humans ; Atrial Fibrillation/diagnosis ; Atrial Fibrillation/surgery ; Atrial Fibrillation/drug therapy ; Treatment Outcome ; Tachycardia, Supraventricular/surgery ; Anti-Arrhythmia Agents/therapeutic use ; Hemorrhage ; Catheter Ablation/adverse effects ; Catheter Ablation/methods ; Recurrence
    Chemical Substances Anti-Arrhythmia Agents
    Language English
    Publishing date 2024-02-19
    Publishing country England
    Document type Randomized Controlled Trial ; Multicenter Study ; Journal Article
    ZDB-ID 1449879-0
    ISSN 1532-2092 ; 1099-5129
    ISSN (online) 1532-2092
    ISSN 1099-5129
    DOI 10.1093/europace/euae040
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 5434: Show issues Location:
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    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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  5. Article ; Online: Sequential hybrid ablation versus surgical CryoMaze alone for treatment of atrial fibrillation (SurHyb Trial): a protocol of the multicentre randomized controlled trial.

    Bulava, Alan / Mokracek, Ales / Wichterle, Dan / Budera, Petr / Osmancik, Pavel / Kacer, Petr / Veteskova, Linda / Nemec, Petr / Skala, Tomas / Santavy, Petr / Chovancik, Jan / Branny, Piotr / Rizov, Vitalii / Kolesar, Miroslav / Rybar, Marian

    Journal of applied biomedicine

    2023  Volume 21, Issue 2, Page(s) 67–72

    Abstract: Background: Atrial fibrillation is common in patients with structural heart disease who are undergoing cardiac surgery. Surgical CryoMaze has been shown to be an effective treatment in several trials, but success rates have varied considerably, between ... ...

    Abstract Background: Atrial fibrillation is common in patients with structural heart disease who are undergoing cardiac surgery. Surgical CryoMaze has been shown to be an effective treatment in several trials, but success rates have varied considerably, between 47-95%. The sequential hybrid approach, combining surgical CryoMaze followed by radiofrequency catheter ablation, can achieve high freedom from atrial arrhythmias. However, in patients with concomitant surgical atrial fibrillation treatment, data comparing the hybrid approach to CryoMaze alone are lacking.
    Methods: The SurHyb study was designed as a prospective, open-label, multicentre randomized trial. Patients with non-paroxysmal atrial fibrillation who were scheduled for coronary artery bypass grafting or valve repair/replacement were randomized to either surgical CryoMaze alone or surgical CryoMaze followed by radiofrequency catheter ablation 3 months post-surgery. The primary outcome measure was arrhythmia-free survival without class I or III antiarrhythmic drugs, which has been evaluated using implantable cardiac monitors.
    Conclusions: This is the first randomized study that compares concomitant surgical CryoMaze alone with the staged hybrid surgical CryoMaze followed by catheter ablation, in patients with non-paroxysmal atrial fibrillation using rigorous rhythm monitoring. The results may contribute to the optimization of the treatment in patients undergoing concomitant CryoMaze for atrial fibrillation.
    MeSH term(s) Humans ; Anti-Arrhythmia Agents/therapeutic use ; Atrial Fibrillation/surgery ; Atrial Fibrillation/drug therapy ; Cardiac Surgical Procedures/methods ; Catheter Ablation/methods ; Multicenter Studies as Topic ; Prospective Studies ; Randomized Controlled Trials as Topic ; Treatment Outcome
    Chemical Substances Anti-Arrhythmia Agents
    Language English
    Publishing date 2023-05-11
    Publishing country Poland
    Document type Clinical Trial Protocol ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2171142-2
    ISSN 1214-0287 ; 1214-0287
    ISSN (online) 1214-0287
    ISSN 1214-0287
    DOI 10.32725/jab.2023.007
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  6. Article ; Online: Cardiovascular risk in myositis patients compared with the general population.

    Oreska, Sabina / Storkanova, Hana / Pekacova, Aneta / Kudlicka, Jaroslav / Tuka, Vladimir / Mikes, Ondrej / Krupickova, Zdislava / Satny, Martin / Chytilova, Eva / Kvasnicka, Jan / Spiritovic, Maja / Hermankova, Barbora / Cesak, Petr / Rybar, Marian / Pavelka, Karel / Senolt, Ladislav / Mann, Herman / Vencovsky, Jiri / Vrablik, Michal /
    Tomcik, Michal

    Rheumatology (Oxford, England)

    2023  Volume 63, Issue 3, Page(s) 715–724

    Abstract: Objectives: We aimed to evaluate cardiovascular (CV) risk in patients with idiopathic inflammatory myopathies (IIM) compared with healthy controls (HC) and to assess its association with disease-specific features.: Methods: Ninety IIM patients and ... ...

    Abstract Objectives: We aimed to evaluate cardiovascular (CV) risk in patients with idiopathic inflammatory myopathies (IIM) compared with healthy controls (HC) and to assess its association with disease-specific features.
    Methods: Ninety IIM patients and 180 age-/sex-matched HC were included. Subjects with a history of CV disease (angina pectoris, myocardial infarction and cerebrovascular/peripheral arterial vascular events) were excluded. All participants were prospectively recruited and underwent examinations of carotid intima-media thickness (CIMT), pulse wave velocity (PWV), ankle-brachial index (ABI), and body composition. The risk of fatal CV events was evaluated by the Systematic COronary Risk Evaluation (SCORE) and its modifications.
    Results: Compared with HC, IIM patients had a significantly higher prevalence of traditional CV risk factors, carotid artery disease (CARD), abnormal ABI and PWV. After propensity score matching (using traditional CV risk factors), the prevalence of CARD and pathological PWV remained significantly higher in IIM than HC. No significant difference in SCORE was observed. The most unfavourable CV risk profile was observed in patients with necrotizing myopathy, especially in statin-induced anti-HMGCR+ patients. The calculated CV risk scores by SCORE, SCORE2 and SCORE multiplied by the coefficient 1.5 (mSCORE) were reclassified according to CIMT and the presence of carotid plaques. SCORE was demonstrated to be most inaccurate in predicting CV risk in IIM. Age, disease activity, lipid profile, body composition parameters and blood pressure were the most significant predictors of CV risk in IIM patients.
    Conclusion: Significantly higher prevalence of traditional risk factors and subclinical atherosclerosis was observed in IIM patients compared with HC.
    MeSH term(s) Humans ; Cardiovascular Diseases/epidemiology ; Cardiovascular Diseases/etiology ; Carotid Intima-Media Thickness ; Pulse Wave Analysis ; Risk Factors ; Myositis/epidemiology ; Heart Disease Risk Factors ; Carotid Artery Diseases
    Language English
    Publishing date 2023-06-07
    Publishing country England
    Document type Journal Article
    ZDB-ID 1464822-2
    ISSN 1462-0332 ; 1462-0324
    ISSN (online) 1462-0332
    ISSN 1462-0324
    DOI 10.1093/rheumatology/kead271
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    In stock of ZB MED Cologne/Königswinter

    Zs.B 240: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
    ab Jg. 2022: Lesesaal (EG)
    Zs.MO 497: Show issues

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  7. Article: Cardiovascular Risk in Myositis Patients Compared to the General Population: Preliminary Data From a Single-Center Cross-Sectional Study.

    Oreska, Sabina / Storkanova, Hana / Kudlicka, Jaroslav / Tuka, Vladimir / Mikes, Ondrej / Krupickova, Zdislava / Satny, Martin / Chytilova, Eva / Kvasnicka, Jan / Spiritovic, Maja / Hermankova, Barbora / Cesak, Petr / Rybar, Marian / Pavelka, Karel / Senolt, Ladislav / Mann, Herman / Vencovsky, Jiri / Vrablik, Michal / Tomcik, Michal

    Frontiers in medicine

    2022  Volume 9, Page(s) 861419

    Abstract: Background: Idiopathic inflammatory myopathies (IIM) are associated with systemic inflammation, limited mobility, and glucocorticoid therapy, all of which can lead to metabolism disturbances, atherogenesis, and increased cardiovascular (CV) risk. The ... ...

    Abstract Background: Idiopathic inflammatory myopathies (IIM) are associated with systemic inflammation, limited mobility, and glucocorticoid therapy, all of which can lead to metabolism disturbances, atherogenesis, and increased cardiovascular (CV) risk. The aim of this study was to assess the CV risk in IIM patients and healthy controls (HC), and its association with disease-specific features.
    Methods: Thirty nine patients with IIM (32 females; mean age 56; mean disease duration 4.8 years; dermatomyositis:
    Results: Compared to HC, there was no significant difference in IIM patients regarding blood pressure, ABI, PWV, CIMT, and the risk of fatal CV events by SCORE or SCORE2, or subclinical atherosclerosis (CIMT, carotid plaques, ABI, and PWV). The calculated CV risk scores by SCORE, SCORE2, and SCORE multiplied by the coefficient 1.5 (mSCORE) were reclassified according to the results of carotid plaque presence and CIMT; however, none of them was demonstrated to be significantly more accurate. Other significant predictors of CV risk in IIM patients included age, disease duration and activity, systemic inflammation, lipid profile, lean body mass, and blood pressure.
    Conclusions: No significant differences in CV risk factors between our IIM patients and HC were observed. However, in IIM, CV risk was associated with age, disease duration, duration of glucocorticoid therapy, lipid profile, and body composition. None of the currently available scoring tools (SCORE, SCORE2, mSCORE) used in this study seems more accurate in estimating CV risk in IIM.
    Language English
    Publishing date 2022-05-03
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2775999-4
    ISSN 2296-858X
    ISSN 2296-858X
    DOI 10.3389/fmed.2022.861419
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  8. Article ; Online: The analysis of respiration-induced pancreatic tumor motion based on reference measurement.

    Knybel, Lukas / Cvek, Jakub / Otahal, Bretislav / Jonszta, Tomas / Molenda, Lukas / Czerny, Daniel / Skacelikova, Eva / Rybar, Marian / Dvorak, Pavel / Feltl, David

    Radiation oncology (London, England)

    2014  Volume 9, Page(s) 192

    Abstract: Background: To evaluate pancreatic tumor motion and its dynamics during respiration.: Methods and materials: This retrospective study includes 20 patients with unresectable pancreatic cancer who were treated with stereotactic ablative radiotherapy. ... ...

    Abstract Background: To evaluate pancreatic tumor motion and its dynamics during respiration.
    Methods and materials: This retrospective study includes 20 patients with unresectable pancreatic cancer who were treated with stereotactic ablative radiotherapy. An online respiratory tumor tracking system was used. Periodical maximum and minimum tumor positions with respiration in superior-inferior (SI), latero-lateral (LL), and anterior-posterior (AP) directions were collected for tumor motion evaluation. The predictability of tumor motion in each axis, based on reference measurement, was analyzed.
    Results: The use of a 20-mm and 5-mm constant margins for SI and LL/AP directions, avoids target underdosage, without the need for reference measurement. Pearson's correlation coefficient indicated only a modest correlation between reference and subsequent measurements in the SI direction (r = 0.50) and no correlation in LL (r = 0.17) and AP (r = 0.35) directions. When margins based on the reference measurement of respiratory tumor motion are used, then 30% of patients have a risk zone of underdosage >3 mm (in average). ITV (internal target volume) optimization based on the reference measurement is possible, but allows only modest margin reduction (approximately from 20 mm to 16-17 mm) in SI direction and no reduction in AP and LL directions.
    Conclusion: Our results support the use of 20-mm margin in the SI direction and 5-mm margins in the LL and AP directions to account for respiratory motion without reference measurement. Single measurement of tumor motion allows only modest margin reduction. Further margin reduction is only possible when there is on-line tumor motion control according to internal markers.
    MeSH term(s) Artifacts ; Carcinoma/surgery ; Female ; Humans ; Male ; Motion ; Pancreatic Neoplasms/surgery ; Radiosurgery ; Radiotherapy Planning, Computer-Assisted/methods ; Respiration ; Retrospective Studies
    Language English
    Publishing date 2014-08-30
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ISSN 1748-717X
    ISSN (online) 1748-717X
    DOI 10.1186/1748-717X-9-192
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