Bratisl Med J
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C4d, a split product of C4 activation in classical and lectin pathways of the complement system activation, has been regarded as a footprint of tissue damage in antibody-mediated rejection in transplantology. The introduction of C4d staining into daily clinical practice aroused an ever-increasing interest in the role of antibody-mediated mechanisms in kidney allograft rejection. However, this marker of complement activation is also important in other various kidney glomerular pathologies such as immunoglobulin A nephropathy, membranoproliferative glomerulonephritis, lupus nephritis, and others. ⋯ Immunohistochemical staining for C4d has revolutionized the field of renal histopathology. Despite being a simple diagnostic test, its utility can be of utmost importance, especially in a resource-poor setting where immunofluorescence and frozen tissue may not be available (Fig. 2, Ref. 53). Keywords: C4d deposition, immunohistochemistry, kidney glomerular diseases, kidney transplant, renal tubular damage.
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Deviations in haemostasis are found in about 50 % of patients with cancer and up to 90% of those with metastatic disease. Many studies investigate the dynamics of the processes of coagulation and fibrinolysis and their role as a predictor of therapeutic response, early relapse, or metastasis risk. ⋯ Ongoing research on uPA and cancer will enrich our knowledge and expand the possibilities for clinical utilization of the marker in the oncology setting (Tab. 2, Ref. 18).
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ASCT has been considered the standard of care for younger patients with NDMM, however, not all the studies published so far have uniformly demonstrated the complete superiority of ASCT over chemotherapy at standard doses. A systematic review and meta-analysis of randomized studies has shown a significant benefit with single ASCT in terms of prolonged progression-free survival (PFS), but not of overall survival (OS). In our retrospective analysis we investigated the impact of high dose (HD) chemotherapy followed by ASCT in special population of patients with high risk cytogenetic profile on the PFS and treatment outcome. ⋯ HD chemotherapy followed by ASCT remains the standard of care for NDMM eligible for high dose chemotherapy. Our results confirm the benefit of ASCT even in the presence of HRCA. Lower PFS in the HRCA subgroup might indicate the need for more intensive treatment, which may be achieved by tandem ASCT defined as two ASCT performed within a period of no more than six months. Additionally, as three- and four-drug induction therapies are becoming increasingly available and effective, resulting in high minimal residual disease (MRD) negative rates, it is important to continue discussing and further personalizing upfront ASCT to avoid overtreatment and possible toxicities especially in the non-high-risk patient population (Tab. 5, Fig. 2, Ref. 9).
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Medication adherence is crucial for optimal treatment outcomes, yet many patients struggle to follow their prescribed regimens, impacting patients, families, and healthcare systems. Measurement of adherence is vital for effective care planning and intervention. This review explores medication adherence challenges and measurement methods, including therapeutic drug monitoring (TDM), medication event monitoring system (MEMS), analysis of adherence in insurance/pharmacy database, pill counts, and self-reports, each with its advantages and limitations. ⋯ In summary, medication adherence is vital but complex. The article covers various adherence measurement methods to promote medication adherence as an important matter (Tab. 5, Fig. 2, Ref. 91). Text in PDF www.elis.sk Keywords: medication adherence, adherence barriers, primary non-adherence, medication event monitoring system, pill count, self-report.
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This study aims to explore new treatments for type 1 diabetes that could serve as an alternative or adjunct to insulin therapy. This is a literature review based on a search of relevant scientific articles in PubMed, Scopus, Google Scholar, and Cochrane Library databases. The scrutiny of publications revealed that the introduction of glucagon-like peptide-1 agonists into insulin therapy can improve disease control and reduce the frequency of hypoglycaemic episodes. ⋯ While gene therapy holds promise, much of its research is currently in the preclinical stage. Further development of innovative therapies for type 1 diabetes has the potential to enhance the quality of life of patients, improve disease control and prevent the development of complications (Fig. 1, Ref. 54). Keywords: diabetes type 1, treatment, cell therapy, insulin, pancreatic β-cells.