Hepatic complications are an acknowledged cause of mortality and morbidity among patients undergoing hematopoietic stem cell transplantation. In this study, we aimed to evaluate the potential role in the prediction of liver injury of five selected microRNAs (miRNAs)—miR-122-5p, miR-122-3p, miR-15b-5p, miR-99b-5p, and miR-125a-5p—in the setting of autologous hematopoietic stem cell transplantation (ASCT). A total of 66 patients were included in the study: 50 patients (75.8%) with multiple myeloma (MM) and 16 (24.2%) with lymphoma. Blood samples were collected after the administration of the conditioning regimen, on the day of transplant (day 0). The expression levels of selected miRNAs were quantified by reverse transcription-quantitative polymerase chain reaction (RT-qPCR) using the miRCURY LNA miRNA Custom PCR Panels (QIAGEN). In a multivariate logistic regression analysis adjusted for age, sex, and the administered conditioning regimen, two miRNAs, hsa-miR-122-5p (odds ratio, OR 2.10, 95% confidence interval, CI: 1.29–3.42, p = 0.0029) and hsa-miR-125a-5p (OR 0.27, 95% CI: 0.11–0.71, p = 0.0079), were independent for hepatic toxicity occurrence during the 14 days after transplant. Our model in 10-fold cross-validation preserved its diagnostic potential with a receiver operating characteristics area under the curve (ROC AUC) of 0.75, 95% CI: 0.63–0.88 and at optimal cut-off reached 72.0% sensitivity and 74.4% specificity. An elevated serum level of miR-122-5p and decreased level of miR-125a-5p on day 0 are independent risk factors for hepatotoxicity in ASCT recipients, showing promise in accurately predicting post-ASCT complications. Identifying patients susceptible to complications has the potential to reduce procedure costs and optimize the selection of inpatient or outpatient procedures.

Background: Daratumumab (Dara) is the first monoclonal antibody introduced into clinical practice to treat multiple myeloma (MM). It currently forms the backbone of therapy regimens in both newly diagnosed (ND) and relapsed/refractory (RR) patients. However, previous reports indicated an increased risk of infectious complications (ICs) during Dara-based treatment. In this study, we aimed to determine the profile of ICs in MM patients treated with Dara-based regimens and establish predictors of their occurrence. Methods: This retrospective, real-life study included MM patients treated with Dara-based regimens between July 2019 and March 2024 at our institution. Infectious events were evaluated using the Terminology Criteria for Adverse Events (CTCAE) version 5.0. Results: The study group consisted of a total of 139 patients, including 49 NDMM and 90 RRMM. In the RR setting, the majority (60.0%) of patients received the Dara, bortezomib, and dexamethasone (DVd) regimen, whereas ND patients were predominantly (98%) treated with the Dara, bortezomib, thalidomide, and dexamethasone (DVTd) regimen. Overall, 55 patients (39.6%) experienced ICs. The most common IC was pneumonia (37.5%), followed by upper respiratory tract infections (26.8%). Finally, twenty-five patients had severe ICs (grade ≥ 3) and required hospitalization, and eight patients died due to ICs. In the final multivariable model adjusted for setting (ND/RR) and age, hemoglobin level (OR 0.77, 95% CI: 0.61–0.96, p = 0.0037), and Eastern Cooperative Oncology Group (ECOG) >1 (OR 4.46, 95% CI: 1.63–12.26, p = 0.0037) were significant factors influencing severe IC occurrence. Additionally, we developed predictive models using the J48 decision tree, gradient boosting, and random forest algorithms. After conducting 10-fold cross-validation, these models demonstrated strong performance in predicting the occurrence of pneumonia during treatment with daratumumab-based regimens. Conclusions: Simple clinical and laboratory assessments, including hemoglobin level and ECOG scale, can be valuable in identifying patients vulnerable to infections during Dara-based regimens, facilitating personalized prophylactic strategies.

This study aimed to identify risk factors of nociplastic pain in patients with autoimmune arthritis. Patients suffering from chronic pain and autoimmune arthritis were invited to participate in a study via moderated support groups on social media. Each invitation included a brief description of nociplastic pain. The study cohort comprised 185 patients, primarily those with rheumatoid arthritis (64%) and spondyloarthropathies (27%). 82% of patients scored positively (≥ 40 points) on the Central Sensitization Inventory (CSI), while 57% showed a neuropathic component as indicated by the PainDetect Questionnaire (PDQ). Of the participants with a positive CSI score, 86% achieved at least a borderline grade on the PDQ. More frequent use of painkillers (> once a day) correlated with higher CSI scores (mean difference (MD) = 7.1, p = 0.039, and MD = 8, p = 0.005 compared to daily and less frequent use, respectively). In a multivariable linear regression model, factors such as depression (β = 8.7, p < 0.001), nocturnal pain (β = 4.5, p = 0.013), need for painkillers (β = 5.3, p = 0.032), disease duration > 2 years (β = 3.3, p = 0.036), Chronic Pain Grade Scale (β = 2.8, from I to IV grade, p < 0.001), and worse mood (β = -0.9, on a 0–10 scale, p = 0.031) were independently associated with higher CSI scores. Nocturnal pain and pain-related disability may serve as clinical risk factors of nociplastic pain. The PDQ may lose its reliability in detecting neuropathic pain in patients with a high nociplastic component.

Introduction and objective: Patent ductus arteriosus is a heart defect primarily associated with extreme prematurity. It can lead to multiple morbidities due to diminished organ perfusion or a left-to-right shunt. It can be treated with paracetamol, among other options. Treatment includes fluid restriction, pharmacotherapy (paracetamol at a dose of 15 mg/kg, non-steroidal anti-inflammatory drugs), percutaneous interventions, and surgical ligation. This retrospective study aims to analyse whether the analgesic dose of paracetamol and artificial ventilation has any effect on the occurrence of ductus arteriosus. Materials and methods: Ninety-four prematurely born neonates (<32 weeks of gestation) between 2020 and 2023 were included in the study. The dose of paracetamol, surfactant supply, and steroid therapy in the prenatal period were analysed up to the first echocardiographic examination. Additionally, data were collected about the type of ventilation during the examination. Logistic regression was used to evaluate predictive factors for PDA presence. Results: The median gestational age and weight were 30 weeks and 1290 g, respectively. Among 49 preterm neonates treated with intravenous paracetamol at an analgesic dose of ≤10 mg/kg, the risk of ductus arteriosus patency was lower (p = 0.002). Both non-invasive and mechanical ventilation increased the risk of ductus patency (p = 0.042, p = 0.044). There was no significant relationship between previous ductus and surfactant treatment or prenatal steroid use (p = 0.611, p = 0.93). Conclusions: Paracetamol in an analgesic dose reduces the likelihood of open ductus arteriosus in extremely and very premature infants. Additionally, artificial ventilation is a significant factor affecting ductus patency.