Spontaneous reports of adverse drug reactions related to oral anticoagulants in the Czech Republic

International Journal of Clinical Pharmacy - Background Oral anticoagulants are established drugs of choice for the prevention and treatment of thromboembolic events. However, monitoring their...     

Hepatocellular carcinoma (a 28-year necropsy review)

Although primary liver carcinoma is one of the most common forms of malignancy in most parts of Africa and the Far East, recent reports indicate that the incidence of primary liver cancer has been increasing in Western countries. Our retrospective study is in agreement with this suggestion. From 28,311 autopsies performed at the Department of Pathology in Hradec Kralove from 1951 to 1978, 91 primary liver carcinomas were found. The increase was apparent in the period 1971 to 1978: 0.53% compared to 0.22% in the period 1951 to 1970. Of the 91 cases, 68 were in association with cirrhosis. In 6 of 17 liver samples, aflatoxin B1 was proved. Some authors suggest that the increase of liver cancer is related to the increase of cirrhosis. Other authors note a striking association of tumors with HBAg. The increase of cirrhosis has not been confirmed in our study. We assume that the carcinogenic mechanism is more complex and that the determinating factor might be an interaction of HB infection and some of the environmental carcinogenic factors, e.g., aflatoxin.     

Helicobacter pylori infection and other bacteria in pancreatic cancer and autoimmune pancreatitis

Helicobacter pylori (H. pylori) is an infectious agent influencing as much as 50% of the world’s population. It is the causative agent for several diseases, most especially gastric and duodenal peptic ulcer, gastric adenocarcinoma and mucosa-associated lymphoid tissue lymphoma of the stomach. A number of other, extragastric manifestations also are associated with H. pylori infection. These include neurological disorders, such as Alzheimer’s disease, demyelinating multiple sclerosis and Parkinson’s disease. There is also evidence for a relationship between H. pylori infection and such dermatological diseases as psoriasis and rosacea as well as a connection with infection and open-angle glaucoma. Generally little is known about the relationship between H. pylori infection and diseases of the pancreas. Most evidence about H. pylori and its potential role in the development of pancreatic diseases concerns pancreatic adenocarcinoma and autoimmune forms of chronic pancreatitis. There is data (albeit not fully consistent) indicating modestly increased pancreatic cancer risk in H. pylori-positive patients. The pathogenetic mechanism of this increase is not yet fully elucidated, but several theories have been proposed. Reduction of antral D-cells in H. pylori-positive patients causes a suppression of somatostatin secretion that, in turn, stimulates increased secretin secretion. That stimulates pancreatic growth and thus increases the risk of carcinogenesis. Alternatively, H. pylori, as a part of microbiome dysbiosis and the so-called oncobiome, is proven to be associated with pancreatic adenocarcinoma development via the promotion of cellular proliferation. The role of H. pylori in the inflammation characteristic of autoimmune pancreatitis seems to be explained by a mechanism of molecular mimicry among several proteins (mostly enzymes) of H. pylori and pancreatic tissue. Patients with autoimmune pancreatitis often show positivity for antibodies against H. pylori proteins. H. pylori, as a part of microbiome dysbiosis, also is viewed as a potential trigger of autoimmune inflammation of the pancreas. It is precisely these relationships (and associated equivocal conclusions) that constitute a center of attention among pancreatologists, immunologists and pathologists. In order to obtain clear and valid results, more studies on sufficiently large cohorts of patients are needed. The topic is itself sufficiently significant to draw the interest of clinicians and inspire further systematic research. Next-generation sequencing could play an important role in investigating the microbiome as a potential diagnostic and prognostic biomarker for pancreatic cancer.     

Patterns in anticoagulant utilization in the Czech Republic during 2007–2017

Journal of Thrombosis and Thrombolysis - Direct oral anticoagulants (DOACs) have gradually entered the Czech market as alternatives to vitamin K antagonists and parenteral anticoagulants since...     

Immunoassay procedures to detect exposure to aflatoxin B1 and benzo(a)pyrene in animals and man at the DNA level

Summary Immunological methods were used to examine human liver for the presence of aflatoxin-DNA adducts and human lung for benzo(a)pyrene diol-epoxide DNA (BPDE-DNA) adducts. Eight liver samples obtained from Czechoslovakian patients with primary hepatocellular carcinoma were studied, seven of which had detectable anti-aflatoxin inhibitory material. Values ranged between 0.63 and 3.51 picomoles aflatoxin per mg DNA. In a separate, independent study performed in another laboratory the one sample with no aflatoxin bound to DNA also had no free aflatoxin present in the liver. In the case of the human lung DNA samples, 12 samples were examined, the samples having been removed during thoracic surgery, and five had detectable anti-BPDE-DNA antibody activity. The positive samples were all from smokers and had inhibitory values ranging from 4 to 12 femtomoles per mg DNA. Samples were prepared by immunoconcentration prior to analysis. These preliminary results support the view that immunological methods can be used to examine human tissue DNA for carcinogen adducts.     

EUS-FNA (endoscopic ultrasonography directed fine needle aspiration biopsy) and diagnostic pitfalls in diagnostic cytology of cystic lesions of the pancreas

Introduction: Endoscopic ultrasound-directed (EUS) fine needle aspiration (FNA) biopsy is a gold standard in diagnostics of focal and cystic lesions of the pancreas.Objectives: From March 2007 to January 2012 we performed 670 cytological examinations of the pancreatic lesions (mean age 61 years, 56% male). From the total 15.4% (n = 76) were diagnosed by imaging methods (CT, ultrasonography) as cystic lesions of the pancreas.Patients and methods: We present diagnostic structure of our set (n=76)      

Evidence for aflatoxin B1 in two cases of lung cancer in man

Summary The presence of aflatoxin B₁ has been demonstrated in two cases of pulmonary cancers both by thin-layer chromatography and fluorescence microscopy.