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1. Clinical Characteristics of EGPA Patients in Comparison to GPA Subgroup with Increased Blood Eosinophilia from POLVAS Registry

Author

Anna Drynda, Agnieszka Padjas, Krzysztof Wójcik, Radosław Dziedzic, Grzegorz Biedroń, Katarzyna Wawrzycka-Adamczyk, Anna Włudarczyk, Joanna Wilańska, Jacek Musiał, Zbigniew Zdrojewski, Zenobia Czuszyńska, Anna Masiak, Maria Majdan, Radosław Jeleniewicz, Hanna Augustyniak-Bartosik, Katarzyna Jakuszko, Magdalena Krajewska, Alicja Dębska-Ślizień, Hanna Storoniak, Barbara Bułło-Piontecka, Witold Tłustochowicz, Joanna Kur-Zalewska, Małgorzata Wisłowska, Piotr Głuszko, Marta Madej, Ewa Jassem, Iwona Damps-Konstańska, Eugeniusz Kucharz, Marek Brzosko, Marcin Milchert, Anna Hawrot-Kawecka, Joanna Miłkowska-Dymanowska, Paweł Górski, Anna Lewandowska-Polak, Joanna Makowska, Joanna Zalewska, Lech Zaręba, and Stanisława Bazan-Socha

Subjects
Immunologic diseases. Allergy, RC581-607
Abstract

Objective. To characterize the eosinophilic granulomatosis with polyangiitis (EGPA) population from the POLVAS registry depending on ANCA status and diagnosis onset, including their comparison with the granulomatosis with polyangiitis (GPA) subset with elevated blood eosinophilia (min. 400/μl) (GPA HE) to develop a differentiating strategy. Methods. A retrospective analysis of the POLVAS registry. Results. The EGPA group comprised 111 patients. The ANCA-positive subset (n = 45 [40.54%]) did not differ from the ANCA-negative one in clinics. Nevertheless, cardiovascular manifestations were more common in ANCA-negative patients than in those with anti-myeloperoxidase (MPO) antibodies (46.97% vs. 26.92%, p = 0.045). Patients diagnosed before 2012 (n = 70 [63.06%]) were younger (median 41 vs. 49 years, p

Published
2024
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2. ANCA-associated vasculitis patients treated in Polish intensive care units – retrospective characteristics based on the POLVAS registry

Author

Anna Włudarczyk, Grzegorz Biedroń, Krzysztof Wójcik, Zbigniew Zdrojewski, Anna Masiak, Zenobia Czuszyńska, Maria Majdan, Radosław Jeleniewicz, Magdalena Krajewska, Mariusz Kusztal, Marek Brzosko, Iwona Brzosko, Alicja Dębska-Ślizień, Hanna Storoniak, Witold Tłustochowicz, Joanna Kur-Zalewska, Andrzej Rydzewski, Marta Madej, Anna Hawrot-Kawecka, Małgorzata Stasiek, Eugeniusz Kucharz, Jacek Musial, and Wojciech Szczeklik

Subjects
autoimmune diseases, vasculitis, intensive care unit, anca, icu, aav., Anesthesiology, RD78.3-87.3, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Published
2020
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3. Respiratory involvement in antineutrophil cytoplasmic antibody-associated vasculitides: a retrospective study based on POLVAS registry

Author

Grzegorz Biedroń, Anna Włudarczyk, Katarzyna Wawrzycka-Adamczyk, Krzysztof Wójcik, Jacek Musiał, Stanisława Bazan-Socha, Zbigniew Zdrojewski, Anna Masiak, Zenobia Czuszyńska, Maria Majdan, Radosław Jeleniewicz, Marian Klinger, Magdalena Krajewska, Hanna Augustyniak-Bartosik, Katarzyna Jakuszko, Marek Brzosko, Iwona Brzosko, Alicja Dębska-Ślizień, Hanna Storoniak, Barbara Bułło-Piontecka, Witold Tłustochowicz, Joanna Kur-Zalewska, Małgorzata Wisłowska, Marta Madej, Anna Hawrot-Kawecka, Piotr Głuszko, Eugeniusz J. Kucharz, and Wojciech Szczeklik

Subjects
ANCA, Immunology, Granulomatosis with Polyangiitis, Microscopic Polyangiitis, Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis, AAV, Churg-Strauss Syndrome, vasculitis, Antibodies, Antineutrophil Cytoplasmic, lung involvement, Rheumatology, Recurrence, Humans, Immunology and Allergy, Registries, Retrospective Studies, respiratory involvement
Abstract

OBJECTIVES: The study aimed to characterise the Polish population of (ANCA)-associated vasculitides (AAV) with respiratory involvement (RI), in comparison to the subgroup without lung manifestations and the other cohorts. METHODS: Retrospective analysis of the Polish population of AAV with RI was conducted, based on data from the POLVAS registry. Standard descriptive statistics, χ2 test, and Mann-Whitney U test were used to perform comparisons. RESULTS: Among 461 cases qualified to this study, there were 316 cases with RI (68.5%), 206 with granulomatosis with polyangiitis (GPA) (65.2%), 80 with eosinophilic granulomatosis with polyangiitis (EGPA) (25.3%) and 30 with microscopic polyangiitis (MPA) (9.5%). Proportion of RI in GPA, MPA, and EGPA accounted for 67.8%; 40.0%; 97.6%, respectively. The number of relapses was higher in the RI group (median 1.0 vs. 0.0; p=0.01). In the subgroup of combined GPA and MPA with RI, the trends toward higher proportion of deaths (11.7% vs. 5.7%; p=0.07), relapses requiring hospitalisation (52.2% vs. 42.4%, p=0.07) and relapses requiring admission to the intensive care unit (5.6% vs. 1.4%, p=0.09) were observed, median maximal concentration of CRP was higher (46 vs. 25 mg/l; p=0.01) and more aggressive treatment was administered. CONCLUSIONS: Prevalence of RI in the Polish population of AAV is similar to the values reported in the literature, however, the proportion observed in GPA is closer to those presented in Asian than Western European cohorts. RI seems to be associated with a more severe course of disease and its presence prompts more aggressive treatment.

Published
2022

4. Accelerated surgery versus standard care in hip fracture (HIP ATTACK): an international, randomised, controlled trial

Author

Flavia K Borges, Mohit Bhandari, Ernesto Guerra-Farfan, Ameen Patel, Alben Sigamani, Masood Umer, Maria E Tiboni, Maria del Mar Villar-Casares, Vikas Tandon, Jordi Tomas-Hernandez, Jordi Teixidor-Serra, Victoria RA Avram, Mitchell Winemaker, Mmampapatla T Ramokgopa, Wojciech Szczeklik, Giovanni Landoni, Chew Yin Wang, Dilshad Begum, John D Neary, Anthony Adili, Parag K Sancheti, Abdel-Rahman Lawendy, Mariano Balaguer-Castro, Paweł Ślęczka, Richard J Jenkinson, Aamer Nabi Nur, Gavin CA Wood, Robert J Feibel, Stephen J McMahon, Alen Sigamani, Ekaterine Popova, Bruce M Biccard, Iain K Moppett, Patrice Forget, Paul Landais, Michael H McGillion, Jessica Vincent, Kumar Balasubramanian, Valerie Harvey, Yaiza Garcia-Sanchez, Shirley M Pettit, Leslie P Gauthier, Gordon H Guyatt, David Conen, Amit X Garg, Shrikant I Bangdiwala, Emilie P Belley-Cote, Maura Marcucci, Andre Lamy, Richard Whitlock, Yannick Le Manach, Dean A Fergusson, Salim Yusuf, PJ Devereaux, Laurent Veevaete, Bernard le Polain de Waroux, Patricia Lavand'homme, Olivier Cornu, Karim Tribak, Jean Cyr Yombi, Nassim Touil, Maike Reul, Jigme Tshering Bhutia, Carol Clinckaert, Dirk De Clippeleir, Justin de Beer, Diane L Simpson, Andrew Worster, Kim A Alvarado, Krysten K Gregus, Kelly H Lawrence, Darryl P Leong, Philip G Joseph, Patrick Magloire, Benjamin Deheshi, Stuart Bisland, Thomas J Wood, Daniel M Tushinski, David AJ Wilson, Clive Kearon, David D Cowan, Vickas Khanna, Amna Zaki, Janet C Farrell, Anne Marie MacDonald, Steven CW Wong, Arsha Karbassi, Douglas Steven Wright, Harsha Shanthanna, Ryan Coughlin, Moin Khan, Spencer Wikkerink, Faraaz A Quraishi, Waleed Kishta, Emil Schemitsch, Timothy Carey, Mark D Macleod, David W Sanders, Edward Vasarhelyi, Debra Bartley, George K Dresser, Christina Tieszer, Steven Shadowitz, Jacques S Lee, Stephen Choi, Hans J Kreder, Markku Nousiainen, Monica R Kunz, Ravianne Tuazon, Mopina Shrikumar, Bheeshma Ravi, David Wasserstein, David JG Stephen, Diane Nam, Patrick DG Henry, Stephen M Mann, Melanie T Jaeger, Marco LA Sivilotti, Christopher A Smith, Christopher C Frank, Heather Grant, Leone Ploeg, Jeff D Yach, Mark M Harrison, Aaron R Campbell, Ryan T Bicknell, Davide D Bardana, Katie McIlquham, Catherine Gallant, Samantha Halman, Venkatesh Thiruganasambandamoorth, Sara Ruggiero, William J Hadden, Brian P-J Chen, Stephanie A Coupal, Lisa M McLean, Hemant R Shirali, Syed Y Haider, Crystal A Smith, Evan Watts, David J Santone, Kevin Koo, Allan J Yee, Ademilola N Oyenubi, Aaron Nauth, Emil H Schemitsch, Timothy R Daniels, Sarah E Ward, Jeremy A Hall, Henry Ahn, Daniel B Whelan, Amit Atrey, Amir Khoshbin, David Puskas, Kurt Droll, Claude Cullinan, Jubin Payendeh, Tina Lefrancois, Lise Mozzon, Travis Marion, Michael J Jacka, James Greene, Matthew Menon, Robert Stiegelmahr, Derek Dillane, Marleen Irwin, Lauren Beaupre, Chad P Coles, Kelly Trask, Shelley MacDonald, J Andrew I Trenholm, William Oxner, C Glen Richardson, Niloofar Dehghan, Mehdi Sadoughi, Achal Sharma, Neil J White, Loretta Olivieri, Stephen B Hunt, Thomas R Turgeon, Eric R Bohm, Sarah Tran, Stephen M Giilck, Tom Hupel, Pierre Guy, Peter J O'Brien, Andrew W Duncan, Gordon A Crawford, Junlin Zhou, Yanrui Zhao, Yang Liu, Lei Shan, Anshi Wu, Juan Manuel Muñoz, Philippe Chaudier, Marion Douplat, Michel Henri Fessy, Vincent Piriou, Lucie Louboutin, Jean Stephane David, Arnaud Friggeri, Sebastien Beroud, Jean Marie Fayet, Frankie Ka Li Leung, Christian Xinshuo Fang, Dennis King Hang Yee, Parag Kantilal Sancheti, Chetan Vijay Pradhan, Atul Ashok Patil, Chetan Prabhakar Puram, Madhav Pandurang Borate, Kiran Bhalchandra Kudrimoti, Bharati Anil Adhye, Himanshu Vijaykumar Dongre, Bobby John, Valsamma Abraham, Ritesh Arvind Pandey, Arti Rajkumar, Preetha Elizabeth George, Manesh Stephen, Nitheesh Chandran, Mohammed Ashraf, AM Georgekutty, Ahamad Shaheel Sulthan, S Adinarayanan, Deep Sharma, Satish Prasad Barnawal, Srinivasan Swaminathan, Prasanna Udupi Bidkar, Sandeep Kumar Mishra, Jagdish Menon, Niranjan M, Varghese Zachariah K, Santosh Angad Hiremath, Madhusudhan NC, Abhijit Jawali, Kingsly Robert Gnanadurai, Carolin Elizabeth George, Tatarao Maddipati, Mary KP KP, Vijay Sharma, Kamran Farooque, Rajesh Malhotra, Samarth Mittal, Chavi Sawhney, Babita Gupta, Purva Mathur, Shivanand Gamangati, Vijaylaxmi Tripathy, Prem Haridas Menon, Mandeep S Dhillon, Devendra K Chouhan, Sharanu Patil, Ravi Narayan, Purushotham Lal, Prashanth Nabhirajappa Bilchod, Surya Udai Singh, Uttam Vaidya Gattu, Ravi Prabhakar Dashputra, Prashant Vitthal Rahate, Maurizio Turiel, Giuseppe De Blasio, Riccardo Accetta, Paolo Perazzo, Daniele Stella, Marika Bonadies, Chiara Colombo, Stefania Fozzato, Fabio Pino, Ilaria Morelli, Eleonora Colnaghi, Vincenzo Salini, Giuseppe Denaro, Luigi Beretta, Giacomo Placella, Giuseppe Giardina, Mirko Binda, Anna Marcato, Luca Guzzetti, Fabio Piccirillo, Maurizio Cecconi, HM Khor, Hou Yee Lai, CS Kumar, KH Chee, PS Loh, Kit Mun Tan, Simmrat Singh, Li Lian Foo, Komella Prakasam, Sook Hui Chaw, Meng-Li Lee, Joanne HL Ngim, Huck Wee Boon, Im Im Chin, Ydo V Kleinlugtenbelt, Ellie BM Landman, Elvira R Flikweert, Herbert W Roerdink, Roy B.G. Brokelman, Hannie F Elskamp-Meijerman, Maarten R Horst, Jan-Hein MG Cobben, Anila Anjum, Pervaiz Mehmood Hashmi, Tashfeen Ahmed, Haroon Ur Rashid, Mujahid Jamil Khattak, Rizwan Haroon Rashid, Riaz Hussain Lakdawala, Shahryar Noordin, Naveed Muhammed Juman, Robyna Irshad Khan, Muhammad Mehmood Riaz, Syedah Saira Bokhari, Ayesha Almas, Hussain Wahab, Arif Ali, Hammad Naqi Khan, Eraj Khurshid Khan, Kholood Abid Janjua, Sajjad Hassan Orakzai, Abdus Salam Khan, Khawaja Junaid Mustafa, Mian Amjad Sohail, Muhammad Umar, Siddra Ahmed Khan, Muhammad Ashraf, Muhammad Kashif Khan, Muhammad Shiraz, Ahmad Furgan, Piotr Dąbek, Adam Kumoń, Wojciech Satora, Wojciech Ambroży, Mariusz Święch, Jacek Rycombel, Adrian Grzelak, Jaroslaw Gucwa, Waldemar Machala, Mmampapatla Thomas Ramokgopa, Gregory Bodley Firth, Mwalimu Karera, Maria Fourtounas, Virsen Singh, Anna Biscardi, Muhammad Nasir Iqbal, Ryan Jonathan Campbell, Matimba Lenny Maluleke, Carien Moller, Lerato Nhlapo, Sithombo Maqungo, Margot Flint, Marcin B Nejthardt, Sean Chetty, Rubendren Naidoo, Miriam Garrido Clua, Vicente Molero-Garcia, Joan Minguell-Monyart, Jordi Selga Marsa, Juan A Porcel-Vazquez, Jose-Vicente Andres-Peiro, Marc Aguilar, Jaume Mestre-Torres, Maria J Colomina, Patricia Guilabert, M Luisa Paños Gozalo, Luis Abarca, Nuria Martin, Gemma Usua, Pedro Martinez-Ripol, MA Gonzalez Posada, Pilar Lalueza-Broto, Judith Sanchez-Raya, Jorge Nuñez Camarena, Antoni Fraguas-Castany, Pere Torner, Monsant Jornet-Gibert, Jorge Serrano-Sanz, Jaume Cámara-Cabrera, Mònica Salomó-Domènech, Christian Yela-Verdú, Anna Peig-Font, Laura Ricol, Anna Carreras-Castañer, Luis Martínez-Sañudo, Susana Herranz, Carlos Feijoo-Massó, Mònica Sianes-Gallén, Pablo Castillón, Martí Bernaus, Saioa Quintas, Olga Gómez, Jordi Salvador, Javiera Abarca, Cristina Estrada, Marga Novellas, Mercè Torra, Alfred Dealbert, Oscar Macho, Alexia Ivanov, Esther Valldosera, Marta Arroyo, Borja Pey, Antoni Yuste, Llorenç Mateo, Julio De Caso, Rafael Anaya, JL Higa-Sansone, Angelica Millan, Victoria Baños, Sergio Herrera-Mateo, Hector J Aguado, Gonzalo Martinez-Municio, Ricardo León, Silvia Santiago-Maniega, Ana Zabalza, Gregorio Labrador, Enrique Guerado, Encarnacion Cruz, Juan Ramon Cano, Jose Manuel Bogallo, Paphon Sa-ngasoongsong, Noratep Kulachote, Norachart Sirisreetreerux, Nachapan Pengrung, Theerawat Chalacheewa, Vanlapa Arnuntasupakul, Teerapat Yingchoncharoen, Bundit Naratreekoon, Miriam Adel Kadry, Surendini Thayaparan, Ihab Abdlaziz, Arash Aframian, Arjuna Imbuldeniya, Souad Bentoumi, Sherif Omran, Marcela Paola Vizcaychipi, Patricia Correia, Shashank Patil, Kevin Haire, Amy SE Mayor, Sally Dillingham, Laura Nicholson, Mohamed Elnaggar, Joby John, Shashi Kumar Nanjayan, Martyn J Parker, Susan O'Sullivan, Meir T Marmor, Amir Matityahu, Robert Trigg McClellan, Curt Comstock, Anthony Ding, Paul Toogood, Gerard Slobogean, Katherine Joseph, Robert O'Toole, Marcus Sciadini, Scott P Ryan, Molly E Clark, Charles Cassidy, Konstantin Balonov, Sergio D Bergese, Laura S Phieffer, Alicia A Gonzalez Zacarias, Andrew J Marcantonio, Sanela Dragic-Taylor, Chelsea Maxwell, Sarah Molnar, Jennifer R Wells, Sandra N Ofori, Stephen S Yang, Michael K Wang, Emmanuelle Duceppe, Jessica Spence, Javiera P Vasquez, Francesc Marcano-Fernández, Hyungjoo Ham, Carlos Prada, Terence CH Yung, Isidro Sanz Pérez, Michael J Bosch, Michael R Prystajecky, Chinmoy Chowdhury, James S Khan, Steffan F Stella, Behrouz Heidary, Allen Tran, Katarzyna Wawrzycka-Adamczyk, Yu Chiao Peter Chen, Aránzazu González-Osuna, Grzegorz Biedroń, Anna Wludarczyk, Marco Lefebvre, Jaclyn A Ernst, Bas Staffhorst, Jason D Woodfine, Emad M Alwafi, Marko Mrkobrada, Simon Parlow, Robin Roberts, Finlay McAlister, David Sackett, James Wright, (HIP ATTACK, Investigators), Landoni, G., Faculty of Medicine and Pharmacy, Orthopaedics - Traumatology, Supporting clinical sciences, Emergency Medicine, UCL - SSS/IONS - Institute of NeuroScience, UCL - SSS/IONS/CEMO - Pôle Cellulaire et moléculaire, UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - SSS/IREC/SLUC - Pôle St.-Luc, UCL - (SLuc) Service d'anesthésiologie, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, and UCL - (SLuc) Service de médecine interne générale

Subjects
Postoperative Complications/epidemiology, Male, Internationality, Femoral Neck Fractures/epidemiology, Arthroplasty, Replacement, Hip, Myocardial Ischemia, Comorbidity, Time-to-Treatment/statistics & numerical data, 030204 cardiovascular system & hematology, law.invention, Fracture Fixation, Internal, Postoperative Complications, 0302 clinical medicine, Randomized controlled trial, Residence Characteristics, law, Activities of Daily Living, Fracture fixation, Risk of mortality, Medicine and Health Sciences, Fracture Fixation, Internal/methods, Sepsis/epidemiology, 030212 general & internal medicine, Cardiovascular Diseases/mortality, Stroke, Aged, 80 and over, Hip fracture, Residence Characteristics/statistics & numerical data, Infections/epidemiology, General Medicine, Middle Aged, Open Fracture Reduction, Treatment Outcome, Cardiovascular Diseases, Diabetes Mellitus/epidemiology, Female, medicine.medical_specialty, Hip Fractures/epidemiology, Postoperative Hemorrhage, Infections, Early Medical Intervention/methods, Time-to-Treatment, 03 medical and health sciences, Arthroplasty, Replacement, Hip/methods, Early Medical Intervention, Sepsis, Diabetes Mellitus, medicine, Humans, Mortality, Myocardial Ischemia/epidemiology, Aged, Proportional Hazards Models, Postoperative Hemorrhage/epidemiology, Hip Fractures, Proportional hazards model, business.industry, Hemiarthroplasty/methods, Dementia/epidemiology, Delirium, Delirium/epidemiology, medicine.disease, Femoral Neck Fractures, Nursing Homes, Surgery, Open Fracture Reduction/methods, Dementia, Observational study, Hemiarthroplasty, business
Abstract

© 2020 Elsevier Ltd Background: Observational studies have suggested that accelerated surgery is associated with improved outcomes in patients with a hip fracture. The HIP ATTACK trial assessed whether accelerated surgery could reduce mortality and major complications. Methods: HIP ATTACK was an international, randomised, controlled trial done at 69 hospitals in 17 countries. Patients with a hip fracture that required surgery and were aged 45 years or older were eligible. Research personnel randomly assigned patients (1:1) through a central computerised randomisation system using randomly varying block sizes to either accelerated surgery (goal of surgery within 6 h of diagnosis) or standard care. The coprimary outcomes were mortality and a composite of major complications (ie, mortality and non-fatal myocardial infarction, stroke, venous thromboembolism, sepsis, pneumonia, life-threatening bleeding, and major bleeding) at 90 days after randomisation. Patients, health-care providers, and study staff were aware of treatment assignment, but outcome adjudicators were masked to treatment allocation. Patients were analysed according to the intention-to-treat principle. This study is registered at ClinicalTrials.gov (NCT02027896). Findings: Between March 14, 2014, and May 24, 2019, 27 701 patients were screened, of whom 7780 were eligible. 2970 of these were enrolled and randomly assigned to receive accelerated surgery (n=1487) or standard care (n=1483). The median time from hip fracture diagnosis to surgery was 6 h (IQR 4–9) in the accelerated-surgery group and 24 h (10–42) in the standard-care group (p

Published
2020

5. ANCA-associated vasculitis patients treated in Polish intensive care units : retrospective characteristics based on the POLVAS registry

Author

J. Kur-Zalewska, Andrzej Rydzewski, Zenobia Czuszyńska, Radosław Jeleniewicz, Alicja Dębska-Ślizień, Witold Tłustochowicz, Marta Madej, Maria Majdan, Mariusz Kusztal, Krzysztof Wojcik, Iwona Brzosko, Magdalena Krajewska, Grzegorz Biedroń, Wojciech Szczeklik, Anna Masiak, Zbigniew Zdrojewski, Jacek Musiał, Hanna Storoniak, Anna Hawrot-Kawecka, Małgorzata Stasiek, Eugeniusz J. Kucharz, Anna Włudarczyk, and Marek Brzosko

Subjects
Adult, Male, medicine.medical_specialty, health care facilities, manpower, and services, medicine.medical_treatment, Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis, Critical Care and Intensive Care Medicine, intensive care unit, vasculitis, law.invention, Anesthesiology, law, Internal medicine, Intensive care, icu, Medicine, Humans, autoimmune diseases, RD78.3-87.3, Registries, aav, Dialysis, Retrospective Studies, RC86-88.9, business.industry, Mortality rate, Medical emergencies. Critical care. Intensive care. First aid, Retrospective cohort study, General Medicine, anca, medicine.disease, Intensive care unit, Intensive Care Units, Anesthesiology and Pain Medicine, Cohort, Observational study, Female, business, Vasculitis
Abstract

INTRODUCTION ANCA-associated vasculitides (AAV) is a group of rare disorders where inflammation and damage of the small blood vessels lead to dysfunction of the supplied organs. In severe flares of the disease patients may require intensive care unit (ICU) admission and treatment. The study aims to characterize Polish patients with AAV who were admitted to the ICU and compare them to the others. MATERIAL AND METHODS An observational, retrospective study based on the POLVAS - registry of Polish adult patients with AAV was carried out. Patients admitted to the ICU (ICU group) were identified and compared with the patients who did not require ICU admission (non-ICU group). Characteristics and comparison between groups were made using standard statistic descriptive methods. RESULTS 30 patients admitted to the ICU were identified among 573 cases included in the registry. All patients in the ICU group with available data were ANCA positive. The clinical manifestations related to the ICU admission were respiratory, renal and central nervous system involvement. The treatment regimen for remission induction was similar in both groups. Almost half of the patients in the ICU-group (48.3%) required dialysis, whereas in the non-ICU group it was 21.8% (P = 0.01). Infections were also more frequent in the ICU group (72.4% vs. 36.9% P < 0.001). The mortality rate among patients who needed ICU treatment was significantly higher when compared to the rest of the patients (53.6% vs. 7.8%; P < 0.001). CONCLUSIONS In the Polish AAV cohort one in twenty patients required ICU admission. This group was characterized by multiple organ involvement and high mortality.

Published
2020

6. Treatment and its side effects in ANCA-associated vasculitides - Study based on POLVAS registry data

Author

Radosław Jeleniewicz, Krzysztof Wojcik, Marian Klinger, Zbigniew Zdrojewski, Iwona Brzosko, Marek Brzosko, J. Kur-Zalewska, M. Wisłowska, Wojciech Szczeklik, Anna Hawrot-Kawecka, Witold Tłustochowicz, Anna Włudarczyk, Katarzyna Wawrzycka-Adamczyk, Alicja Dębska-Ślizień, Eugeniusz J. Kucharz, Katarzyna Jakuszko, Grzegorz Biedroń, Jacek Musiał, Jan Sznajd, Hanna Storoniak, Anna Masiak, Zenobia Czuszyńska, Piotr Głuszko, Olumide Olatubosun Rowaiye, Maria Majdan, and Marta Madej

Subjects
Adult, Male, medicine.medical_specialty, Cyclophosphamide, Drug-Related Side Effects and Adverse Reactions, Azathioprine, Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis, 03 medical and health sciences, 0302 clinical medicine, Maintenance therapy, Internal medicine, medicine, Humans, Treatment complications, 030212 general & internal medicine, Registries, Adverse effect, Glucocorticoids, ANCA associated vasculitis, Retrospective Studies, business.industry, Vasculitis registry, General Medicine, Middle Aged, medicine.disease, Prognosis, Survival Rate, Methotrexate, 030220 oncology & carcinogenesis, Cohort, Rituximab, Drug Therapy, Combination, Female, Poland, Microscopic polyangiitis, Granulomatosis with polyangiitis, business, Vasculitis treatment, Immunosuppressive Agents, medicine.drug, Follow-Up Studies
Abstract

Purpose The aim of this study is to present the treatment modalities and associated side effects in a Polish nation-wide ANCA-associated vasculitides (AAV) patients’ cohort. Materials and methods Retrospective analysis of patients diagnosed with AAV between 1990 and 2016, included in the POLVAS registry was performed. Standard descriptive statistic methods were used with an emphasis on the treatment modalities. Results There were 625 patients diagnosed with AAV included in this study: 417 cases of granulomatosis with polyangiitis (GPA; 66.7%), 106 cases of microscopic polyangiitis (MPA; 17.0%) and 102 cases of eosinophilic granulomatosis with polyangiitis (EGPA; 16.3%). The mean age at the date of diagnosis was 50.4 (±15.7) years and the median observational period amounted to 4.0 (2.0–8.0) years. Glucocorticosteroids (GCs) were the medicaments most frequently used for remission induction (593/622; 95.3%), followed by cyclophosphamide (487/622; 78.3%), rituximab (44/622; 7.1%), and methotrexate (39/622; 6.3%). GCs were also most frequently administered for maintenance therapy (499/592; 84.3%), followed by azathioprine (224/592; 37.8%), methotrexate (136/592; 23.0%) and mycophenolate mofetil (99/592; 16.7%). The median cumulative doses of cyclophosphamide and rituximab equalled 7.99 g (4.18–14.0) and 2000 mg (1500–2800), respectively. The most commonly observed adverse events included: infections - 214/551 cases (38.8%), which were associated with the time of observation (OR = 1.05; 95% CI 1.01–1.10), the use of GCs intravenous pulses (OR = 2.76; 95% CI 1.68–4.54) and need for haemodialysis (OR = 1.73; 95% CI 1.10–2.71). Conclusions Polish patients with AAV were predominantly treated according to appropriate guidelines. The most frequent adverse events were typical for usually administered immunosuppressive treatment.

Published
2019

7. Kimura disease and immunoglobulin G4-related disease : a possible overlap in a patient with severe systemic symptoms

Author

Krystyna Gałązka, Grzegorz Biedroń, Jacek Musiał, Jolanta Gąsior, Mamert Milewski, and Joanna Kosałka

Subjects
Adult, Male, medicine.medical_specialty, business.industry, MEDLINE, Angiolymphoid Hyperplasia with Eosinophilia, Disease, Dermatology, White People, Text mining, Immunoglobulin g4, Internal Medicine, Humans, Medicine, Kimura Disease, Immunoglobulin G4-Related Disease, business
Published
2019

8. Patients with small-vessel vasculitides have the highest mortality among systemic autoimmune diseases patients treated in intensive care unit : a retrospective study with 5-year follow-up

Author

Kamil Polok, Jacek Musiał, Andrzej Hałek, Jacek Górka, Paweł Krawczyk, Anna Włudarczyk, Grzegorz Biedroń, and Wojciech Szczeklik

Subjects
Male, Vasculitis, medicine.medical_specialty, Allergy, Critical Care, Organ Dysfunction Scores, 030232 urology & nephrology, Critical Care and Intensive Care Medicine, law.invention, Autoimmune Diseases, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, law, Internal medicine, Intensive care, medicine, Humans, Hospital Mortality, APACHE, Retrospective Studies, 030203 arthritis & rheumatology, Simplified Acute Physiology Score, APACHE II, business.industry, Retrospective cohort study, Middle Aged, medicine.disease, Intensive care unit, Survival Analysis, Intensive Care Units, SAPS II, Observational study, Female, Poland, business, Follow-Up Studies
Abstract

Purpose Systemic autoimmune diseases are a heterogeneous group of disorders associated with dysfunction of multiple organs and unpredictable course. Complicated management and treatment become even more challenging when patients require critical care. This study aims to compare outcomes of small-vessel vasculitides (SVV) and other systemic autoimmune diseases (SAD) patients admitted to the intensive care unit (ICU). Materials and methods Retrospective, observational study conducted in the ICU of Allergy and Immunology Department at the University Hospital in Krakow, Poland, between years 2001–2014, with 5-years follow-up and no lost to follow-up patients. Results 74 patients with autoimmune diseases were enrolled in the study - 23 with SVV and 51 with SAD. Patients in the SVV group achieved higher scores in APACHE II and III SAPS II and SOFA at ICU admission. The SVV patients required renal replacement techniques, blood products transfusion and immunosuppressive treatment more often. SVV patients had higher ICU mortality (60.9% vs. 35.3%, p = .04), however after discharge from ICU, in long term follow-up (1 year and 5 years) mortality was similar in both studied groups. Conclusions Among systemic autoimmune diseases small vessel vasculitides appear to be associated with the highest ICU mortality, higher requirement for advanced procedures and aggressive immunosuppressive therapy.

Published
2018

9. Dabigatran in patients with myocardial injury after non-cardiac surgery (MANAGE) : an international, randomised, placebo-controlled trial

Author

P J Devereaux, Emmanuelle Duceppe, Gordon Guyatt, Vikas Tandon, Reitze Rodseth, Bruce M Biccard, Denis Xavier, Wojciech Szczeklik, Christian S Meyhoff, Jessica Vincent, Maria Grazia Franzosi, Sadeesh K Srinathan, Jason Erb, Patrick Magloire, John Neary, Mangala Rao, Prashant V Rahate, Navneet K Chaudhry, Bongani Mayosi, Miriam de Nadal, Pilar Paniagua Iglesias, Otavio Berwanger, Juan Carlos Villar, Fernando Botto, John W Eikelboom, Daniel I Sessler, Clive Kearon, Shirley Pettit, Mukul Sharma, Stuart J Connolly, Shrikant I Bangdiwala, Purnima Rao-Melacini, Andreas Hoeft, Salim Yusuf, P.J. Devereaux, Shrikant I. Bangdiwala, Stuart Connolly, John Eikelboom, Janice Pogue, Daniel I. Sessler, Sara Di Diodato, Zora Gasic, Louise J. Mastrangelo, Sarah H. Molnar, Jennifer L. Swanson, Makayla L. Tosh, Jennifer R. Wells, Rafael Diaz, Clara K. Chow, Beatriz Gonzales, Skarlet Vásquez, Petr Jansky, Radovan Dušek, Christian S. Meyhoff, Pierre Coriat, Maria Wittmann, Gerald Yonga, Nandini Mathur, Elena Seletti, German Malaga, Bernadette A. Tumanan-Mendoza, Maria Pamela A. Tagle, Bruce M. Biccard, Pablo Alonso-Coello, Ekaterine Popova, Martin Shields, Yannick Le Manach, Paul Moayyedi, Sander van Zanten, Edith Fleischmann, Amit Garg, Kamilu Karaye, Edward McFalls, Alben Sigamani, Emilie Belley-Côté, Grzegorz Biedroń, Flavia Borges, Steffan Frosi Stella, Christian Haarmark Nielsen, Darryl P. Leong, Jessica Spence, Allen Tran, Katarzyna Wawrzycka-Adamczyk, Stephen S. Yang, Terence Yung, D. George Wyse, Davy Cheng, David E. Johnstone, George A. Wells, Philip Joseph, Ameen Patel, Krysten Gregus, Kelly Lawrence, Lindsay Doharris, David Conen, Jason Cheung, Jim Douketis, Douglas Wright, Spencer Wikkerink, William Dechert, Mohamed Panju, Khalid Azzam, Theodore Rapanos, Tomas Van Helder, Anjali Shroff, Jacqueline Hare, Biniam Kidane, Thang Nguyen, Larissa Leydier, Vanessa Bayaraa, Joel Parlow, Deborah A. DuMerton, Amar Thakrar, Jessica Shelley, Benoit Deligne, Roberta Daila Carling, Marko Mrkobrada, George K. Dresser, Michael J. Jacka, David Hornstein, Gerrit B. Winkelaar, Zoeb Hussain Haider, Pravina Prashant Lanjewar, Valsamma Varughese, Rajneesh Calton, Hemani Ahuja, Preetha George, Ambika Sharma, Keyur Sureshchandra Bhatt, Dhaval Odhavajibhai Mangukiya, Karshan Vira Nandaniya, Viral Vasantrai Parekh, Ashok Bhaskaran Pillai, Vidya P. Menon, Sanjay Channappa Desai, Ravinder Singh Sidhu, Sandeep Kumar Gupta, Robbie K. George, T.R. Gurunath, Leanne W. Drummond, Alexandra M. Torborg, Belinda S. Küsel, Prebashini Naidoo, Datshana P. Naidoo, Chantal Rajah, Zane Farina, Richard Peter von Rahden, Simphiwe Gumede, Chishala Chishala, Ettienne Coetzee, Robert A. Dyer, Johan Diedericks, Piotr Bielański, Bogusz Kaczmarek, Dorota Studzińska, Maciej Zaniewski, Marek Józef Libura, Tomasz Mikołaj Zacharias-Nalichowski, Aurelia A.S. Sega, Jakub Salwa, Mateusz Kózka, Jacek Górka, Anna Wludarczyk, Ilona Nowak-Kózka, Paweł Szczepan Grudzień, Jaroslaw W. Gucwa, Michał Piotr Słowiaczek, Paweł P.D. Dobosz, Ismail Gögenur, Jens Ravn Eriksen, Tine Borup, Tove Kirkegaard, Dan Isbye, Asger Sonne, Lars S. Rasmussen, Sofie Pedersen, Hannibal Troensegaard, Camilla L. Duus, Benedikte M. Halle, Ossian N. Gundel, Katrine F. Bernholm, Kristian Rønsholt Martinsen, Søren Pedersen, Theis S. Itenov, Elena Camio, Carles Vázquez, Silvia Matarin, Esther Cano, Jesús Álvarez-García, Inmaculada India, Aránzazu González-Osuna, Marc Vives, Elena Rosselló, Ana B. Serrano, Maurizio Turiel, Lorenzo Drago, Chiara Colombo, Federica Marra, Lucio Mos, Franco Arteni, Rosalba Lembo, Alessandro Ortalda, Simonetta Passarani, Zhirajr Mokini, Estevao Lanna Figueiredo, Gustavo Fonseca Werner, Joao Luiz Petriz, Lilia Nigro Maia, Ricardo R. Bergo, Dalton Bertolim Precoma, José Francisco Kerr Saraiva, Oscar Gomez Vilamajo, Eduardo Allegrini, Mariano Benzadón, Maria Leonor Parody, Ernesto A. Duronto, Adrián C. Ingaramo, Gustavo Adolfo Parra, Danny Novoa, Scott A. Miller, Sabu Thomas, Sudhakar P. Karlapudi, Mohamad H. Bourji, Subhash Banerjee, Anita Gupta, Isaac O. Opole, Michal Fischer, Victor Lecaros Mendoza, Eugenio Borja Reyes, Richard J. Pierson, Martin O. Shields, Vincent Piriou, Kai Zacharowski, Aida Rotta-Rotta, Main Paper, Sadeesh K. Srinathan, Prashant Rahate, Navneet Chaudhry, Bogani Mayosi, and Mike Sharma

Subjects
Male, medicine.medical_specialty, Myocardial Infarction, Placebo-controlled study, Hemorrhage, 030204 cardiovascular system & hematology, Placebo, Antithrombins, Dabigatran, law.invention, Peripheral Arterial Disease, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, 030202 anesthesiology, law, Internal medicine, medicine, Humans, Perioperative Period, Stroke, Aged, Aged, 80 and over, business.industry, Hazard ratio, Proton Pump Inhibitors, Thrombosis, Venous Thromboembolism, General Medicine, Perioperative, Placebo Effect, medicine.disease, Troponin, Clinical trial, Treatment Outcome, Female, business, Omeprazole, medicine.drug
Abstract

Summary Background Myocardial injury after non-cardiac surgery (MINS) increases the risk of cardiovascular events and deaths, which anticoagulation therapy could prevent. Dabigatran prevents perioperative venous thromboembolism, but whether this drug can prevent a broader range of vascular complications in patients with MINS is unknown. The MANAGE trial assessed the potential of dabigatran to prevent major vascular complications among such patients. Methods In this international, randomised, placebo-controlled trial, we recruited patients from 84 hospitals in 19 countries. Eligible patients were aged at least 45 years, had undergone non-cardiac surgery, and were within 35 days of MINS. Patients were randomly assigned (1:1) to receive dabigatran 110 mg orally twice daily or matched placebo for a maximum of 2 years or until termination of the trial and, using a partial 2-by-2 factorial design, patients not taking a proton-pump inhibitor were also randomly assigned (1:1) to omeprazole 20 mg once daily, for which results will be reported elsewhere, or matched placebo to measure its effect on major upper gastrointestinal complications. Research personnel randomised patients through a central 24 h computerised randomisation system using block randomisation, stratified by centre. Patients, health-care providers, data collectors, and outcome adjudicators were masked to treatment allocation. The primary efficacy outcome was the occurrence of a major vascular complication, a composite of vascular mortality and non-fatal myocardial infarction, non-haemorrhagic stroke, peripheral arterial thrombosis, amputation, and symptomatic venous thromboembolism. The primary safety outcome was a composite of life-threatening, major, and critical organ bleeding. Analyses were done according to the intention-to-treat principle. This trial is registered with ClinicalTrials.gov, number NCT01661101. Findings Between Jan 10, 2013, and July 17, 2017, we randomly assigned 1754 patients to receive dabigatran (n=877) or placebo (n=877); 556 patients were also randomised in the omeprazole partial factorial component. Study drug was permanently discontinued in 401 (46%) of 877 patients allocated to dabigatran and 380 (43%) of 877 patients allocated to placebo. The composite primary efficacy outcome occurred in fewer patients randomised to dabigatran than placebo (97 [11%] of 877 patients assigned to dabigatran vs 133 [15%] of 877 patients assigned to placebo; hazard ratio [HR] 0·72, 95% CI 0·55–0·93; p=0·0115). The primary safety composite outcome occurred in 29 patients (3%) randomised to dabigatran and 31 patients (4%) randomised to placebo (HR 0·92, 95% CI 0·55–1·53; p=0·76). Interpretation Among patients who had MINS, dabigatran 110 mg twice daily lowered the risk of major vascular complications, with no significant increase in major bleeding. Patients with MINS have a poor prognosis; dabigatran 110 mg twice daily has the potential to help many of the 8 million adults globally who have MINS to reduce their risk of a major vascular complication. Funding Boehringer Ingelheim and Canadian Institutes of Health Research.

Published
2018

10. Evaluation of factors that influence anxiety and satisfaction in patients undergoing bronchofiberoscopy with analgosedation

Author

Krzysztof Sładek, Aleksandra Surowiec, Marta Salek, Karolina Górka, Sylwia Bartyzel, Wojciech Szczeklik, Katarzyna Konarska, Grzegorz Biedroń, Anna Andrychiewicz, and Jerzy Soja

Subjects
Pulmonary and Respiratory Medicine, medicine.medical_specialty, business.industry, Sedation, Bronchoscopies, Surgery, Patient management, 03 medical and health sciences, 0302 clinical medicine, Patient satisfaction, 030228 respiratory system, Internal medicine, Immunology and Allergy, Medicine, Anxiety, Observational study, In patient, 030212 general & internal medicine, medicine.symptom, business, Prospective cohort study, Genetics (clinical)
Abstract

Introduction Bronchofiberoscopy (BF) is a key tool used in the management of patients with respiratory diseases. Describing factors that contribute to patient anxiety surrounding BF has the potential to influence patient management and willingness to undergo the procedure again in the future if needed. Objectives This study sought to understand what factors influence anxiety and satisfaction experienced by patients undergoing BF under conscious sedation. Methods This study had a prospective observational character and evaluated 463 consecutive patients undergoing BF. Participants were divided into two groups, those undergoing BF for the first time and those who had undergone the procedure at least once in the past. Data were collected from three questionnaires prepared by the research team. Results Patients who had undergone multiple bronchoscopies were more satisfied with their physician's explanation of the procedure (P

Published
2015

11. Subphenotypes of ANCA-associated vasculitis identified by latent class analysis

Author

Krzysztof Wójcik, Grzegorz Biedroń, Katarzyna Wawrzycka-Adamczyk, Stanisława Bazan-Socha, Adam Ćmiel, Zbigniew Zdrojewski, Anna Masiak, Zenobia Czuszyńska, Maria Majdan, Radosław Jeleniewicz, Marian Klinger, Magdalena Krajewska, Mariusz Kusztal, Marek Brzosko, Iwona Brzosko, Alicja Dębska-Ślizień, Hanna Storoniak, Barbara Bullo-Piontecka, Witold Tłustochowicz, Joanna Kur-Zalewska, Małgorzata Wisłowska, Marta Madej, Anna Hawrot-Kawecka, Piotr Głuszko, Małgorzata Stasiek, Eugeniusz Kucharz, and Jacek Musiał

Subjects
Rheumatology, Latent Class Analysis, Immunology, Granulomatosis with Polyangiitis, Immunology and Allergy, Humans, Microscopic Polyangiitis, Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis, Poland, Antibodies, Antineutrophil Cytoplasmic, Peroxidase
Abstract

ANCA-associated vasculitides (AAV) are a heterogeneous group of rare diseases with unknown aetiology and the clinical spectrum ranging from life-threatening systemic disease, through single organ involvement to minor isolated skin changes. Thus, there is an unmet need for phenotype identification, especially among patients with granulomatosis with polyangiitis (GPA). Patients with microscopic polyangiitis (MPA) seem to be clinically much more uniform. Recently, three subcategories of AAV have been proposed and described as non-severe AAV, severe PR3-AAV, and severe MPO-AAV.In line with these attempts, we decided to use an unbiased approach offered by latent class analysis (LCA) to subcategorise GPA and MPA in a large cohort of Polish AAV patients included in a multicentre POLVAS registry.LCA of our AAV group identified a four-class model of AAV, including previously proposed three subphenotypes and revealing a fourth (previously not described) clinically relevant subphenotype. This new subphenotype includes only GPA patients, usually diagnosed at a younger age as compared to other groups, and characterised by multiorgan involvement, high relapse rate, relatively high risk of death, but no end-stage kidney disease.Based on multiple clinical and serological variables, LCA methodology identified 4-class model of AAV. This newly described fourth class of AAV may be of clinical relevance and may require prompt diagnosis and aggressive treatment due to the multiorgan involvement, high risk of relapse and marked mortality among these relatively young GPA subjects.

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