Bratislavske Lekarske Listy[JOURNAL]
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200 papers
Imunological aspects of kidney retransplantation.
Gala I, Baltesova T, Hulik S … +5 more , Kalanin R, Adandedjan D, Katuchova J, Bena L, Jr JB
Bratisl Lek Listy · 2024 · PMID 39629658 · Publisher ↗
The number of patients on the waiting list for a kidney retransplant has increased. Patients who are candidates for a second kidney transplant often have higher levels of PRA (Panel of Reactive Antibodies). The previous...
The number of patients on the waiting list for a kidney retransplant has increased. Patients who are candidates for a second kidney transplant often have higher levels of PRA (Panel of Reactive Antibodies). The previous failed kidney transplant is one of the main factors that leads to the production of antibodies against human leukocyte antigens ‒ HLA. The consequences of sensitisation are a long waiting time for repeated kidney transplantation and a negative effect on graft survival after retransplantation.The aim of our analysis was to evaluate the immunological parameters of patients undergoing renal retransplantation at the Kosice Transplant Centre, their influence on graft function, the occurrence of rejection episodes and to analyse the sensitisation status of recipients on the waiting list for renal retransplantation at the Kosice Transplant Centre.We retrospectively analysed 46 adult patients who underwent secondary renal transplantation. In the group of retransplanted patients, we found a higher immunological risk and PRA values (p<0.001) and a higher need for induction therapy to reduce the lymphocyte count (p<0.001). Retransplant patients with DGF were 48% more likely to experience acute rejection.In the context of the published literature, we have observed increased sensitisation in retransplanted patients, which is a major challenge to overcome the immunological barrier in transplantation medicine (Tab. 4, Fig. 1, Ref. 24). Keywords: retransplantation, sensitisation, panel of reactive antibodies.
The effect of lengthening of the percutaneous implant in the surgical treatment of Th-L ankylosed spine fractures: 4 segment fixation versus 5 to 8 segment fixation.
Svac J, Stranak P, Hrin T … +4 more , Hrabalek L, Alberty R, Zamborsky R, Kilian M
Bratisl Lek Listy · 2024 · PMID 39629657 · Publisher ↗
BACKGROUND: Fractures of thoracolumbar spine in the field of ankylosing diseases such as ankylosing spondylitis (AS) and diffuse idiopathic skeletal hyperostosis (DISH) can by surgically treated with miniinvasive posteri...
BACKGROUND: Fractures of thoracolumbar spine in the field of ankylosing diseases such as ankylosing spondylitis (AS) and diffuse idiopathic skeletal hyperostosis (DISH) can by surgically treated with miniinvasive posterior transpedicular fixation. The exact length of implant is the subject of several studies. In our study, we retrospectively evaluated the treatment of B3 fractures of the ankylosed thoracolumbar spine with use a shorter versus longer implant, always with 8 screws. METHODS: A total of 46 patients were included in the study (36 men and 10 women). Sixteen patients had AS and 30 patients had DISH. Patients treated between 2018 and 2022 with minimally invasive dorsal transpedicular fixation using 8 transpedicular screws were included in this study. We compared two groups where the first consisted of patients operated on with fixation of a maximum of 4 segments and the second group of patients consisted of patients in whom longer stabilization was used, at least 5 to 8 segments, with skipping of some vertebra between screws. We compared the effect of fixation length on reduction and retention before surgery, after surgery, and after 6 and 12 months. We evaluated the effect of reduction and retention on the basis of differences in the measurement of the Cobb angle and the angle, which we called "vege", which was formed by dislocation of the fracture. Furthermore, we monitored demographic data, the length of surgery, the number of complications, the number of concomitant injuries, the presence of a neurological deficit, and the result was assessed by the AO Spine PROST questionnaire. RESULTS: In the entire group of 46 patients, the difference in the "vege" angle was significant (p<0.001). When comparing the reduction between the groups with short and longer fixation, the difference was not significant (p=0.829). The difference of the Cobb angle before and after the surgery in the comparison between the two groups did not show a statistically significant difference (p=0.434). Measurements of the Cobb angle bisegmentally after 6 and 12 months showed a progressive change in terms of kyphotization, which was smaller in the group with longer fixation, this difference was not statistically significant (p=0.709). Complete reduction was achieved in the group with short fixation vs 75% vs 63.3% with longer fixation (p-0.739). At the check-up after 6 months, all incomplete intraoperative reductions were spontaneously reduced. CONCLUSIONS: Based on this study, we could conclude that both used constructions are comparable in terms of treatment results. It can be observed that longer fixation is more resistant to kyphotization at 6 and 12 months, but we would need a larger group of patients to confirm this hypothesis. In all incomplete reduced fractures through the surgery, complete reduction after verticalization occurred within 6 months in both groups. The angle of reduction was greater in the group with longer fixation, but the difference was not significant (Tab. 6, Fig. 8, Ref. 31).
Prostate cancer in Slovakia: last decade overview.
Babela R, Balaz V, Jr JB
Bratisl Lek Listy · 2024 · PMID 39629656 · Publisher ↗
BACKGROUND: Prostate cancer is a significant health issue worldwide, with varying incidence and mortality rates across different regions. This study focuses on Slovakia, a country with an increasing trend in number of pr...
BACKGROUND: Prostate cancer is a significant health issue worldwide, with varying incidence and mortality rates across different regions. This study focuses on Slovakia, a country with an increasing trend in number of prostate cancer cases. The manuscript aims to provide a comprehensive overview of the burden of prostate cancer in Slovakia, encompassing epidemiological trends, economic impact, diagnostic approaches, and treatment modalities. The study emphasizes the need for effective management strategies and healthcare policies to address the increasing burden of this disease in the Slovak population. METHODS: This retrospective study utilized data from various Slovak health databases, including the National Cancer Registry, hospital records, and insurance claims from 2009 to 2022. We employed epidemiological measures such as incidence, prevalence, and mortality rates to evaluate the burden of prostate cancer. Economic analysis involved assessing direct costs (hospitalizations, treatments, diagnostics) and indirect costs (lost productivity, disability). Additionally, the study reviewed cost of current diagnostic methods in Slovakia. RESULTS: The study revealed a steady increase in prostate cancer incidence in Slovakia, with a notable rise in cases among men aged 50 and above. Mortality rates showed a moderate increase, highlighting the disease's impact on the healthcare system. The economic analysis indicated substantial direct and indirect costs, with a significant portion allocated to advanced treatments and productivity loss. Diagnostic methods showed improvements over time, with increased utilization of advanced imaging techniques. CONCLUSIONS: The burden of prostate cancer in Slovakia is significant and growing, with rising incidence and economic costs posing challenges to the healthcare system. The study underscores the need for improved and early access to effective diagnostic and treatment options, and robust health policies to manage the rising burden. Additionally, public health initiatives focusing on awareness and early detection could play a crucial role in reducing the impact of prostate cancer in Slovakia. The findings of this study contribute valuable insights for policymakers and healthcare providers in developing targeted strategies to mitigate the burden of prostate cancer in the Slovak population (Tab. 7, Ref. 53).
Cancer epidemiology in Slovakia.
Kutakova L, Reckova M, Brazinova A
Bratisl Lek Listy · 2024 · PMID 39629655 · Publisher ↗
Slovakia, in accordance with a global trend, is experiencing an increasing cancer burden. Development and assessment of preventive and healthcare interventions are informed by cancer epidemiology.This study presents the...
Slovakia, in accordance with a global trend, is experiencing an increasing cancer burden. Development and assessment of preventive and healthcare interventions are informed by cancer epidemiology.This study presents the current epidemiological situation and trends for three prevalent malignancies: breast, colorectal, and cervical cancer in the Slovakia. Population-based screening programs for these cancers have recently been reinforced.Breast cancer is the most common newly diagnosed cancer and also the most common cause of death of all cancer in women. Cervical cancer is the second most common cancer in women with decreasing mortality. Colorectal cancer belongs to the cancer diseases with highest incidence and mortality in both the male and female populations, with the majority of cases diagnosed in later stages. Despite progress in specific areas of cancer care, Slovakia acknowledges the need for further improvements. Enhancing cancer screening uptake presents a crucial area for advancement (Fig. 7, Ref. 19). Keywords: epidemiology, Slovakia, breast cancer, colorectal cancer, cervical cancer.
Peculiarities of nutritional support in patients with neoplasms of the hepatopancreatoduodenal zone as a component of intensive therapy in the postoperative period.
Davanov SK, Vasilyeva NN, Plyassovskaya SV … +6 more , Mkhitaryan XE, Zhanalina GA, Rogova SI, Priz VN, Toktibayeva GZ, Aubakirova DS
Bratisl Lek Listy · 2024 · PMID 39629654 · Publisher ↗
BACKGROUND: A pressing concern involves the efficient and intensive treatment of complications arising from malignant tumors in the hepatopancreatoduodenal region. This matter is closely tied to rectifying energy deficit...
BACKGROUND: A pressing concern involves the efficient and intensive treatment of complications arising from malignant tumors in the hepatopancreatoduodenal region. This matter is closely tied to rectifying energy deficits, addressing insufficient body weight, and restoring proper metabolic processes. This is particularly crucial post-surgery, as the process is hindered by significant hypercatabolism, heightened nutritional requirements, and the presence of intoxication syndrome. OBJECTIVE: To consider the features of nutritional support in patients with tumors of the hepatopancreatoduodenal zone in the early postoperative period. METHODS: An investigation was carried out on 91 individuals aged 18 years and older who were afflicted with malignant tumors situated in the hepatopancreatoduodenal area. These patients were categorized into three distinct groups, each receiving a different form of nutritional assistance.The assessment encompassed various aspects of the patients' nutritional well-being, including outcomes from the screening protocol, body mass index, basal metabolic rate, and critical laboratory measurements such as blood lymphocyte count, total protein level, total bilirubin concentration, as well as ALaT and ASaT levels. RESULTS: Under the provision of parenteral nutritional support, as per the applied screening protocols, a span of 10 to 12 days saw 17 patients sustaining a "normal" nutritional state, while 14 patients experienced a condition of "moderate malnutrition." Notably, one patient (3.2%) demonstrated a regression from the status of "severe malnutrition."In the mixed nutrition group, within the same 10 to 12-day timeframe post-operation, there was a rise in the prevalence of patients classified as having "moderate malnutrition" according to the SGA and NRI scales by 10% and 6.7%, respectively. Remarkably, all indicators pointing to "severe malnutrition" were entirely eliminated as assessed by the mentioned nutritional evaluation scales (p<0.005). CONCLUSION: A notable degree of effectiveness in stabilizing and upholding the nutritional condition of patients was attainable within the isolated parenteral nutrition group. This achievement was realized by elevating the count of patients classified under "moderate" and "normal" nutritional statuses, and concurrently diminishing the number of patients experiencing severe and moderate nutritional insufficiency, respectively.The mixed type of nutritional support in this case can be considered with a high degree of probability as an alternative replacement for parenteral nutrition, due to the statically similar indicators of the nutritional status of patients achieved in this study (Fig. 4, Ref. 12).
A comparative review of coronary computed tomography angiography and myocardial perfusion imaging.
Coma M, Gibarti C, Murin P … +5 more , Vicha B, Alusik D, Studencan M, Lukacin S, Gal P
Bratisl Lek Listy · 2024 · PMID 39629653 · Publisher ↗
Coronary artery disease remains a leading cause of morbidity and mortality worldwide. Non-invasive imaging techniques have revolutionized the diagnosis and management of coronary artery disease. This review aims to compa...
Coronary artery disease remains a leading cause of morbidity and mortality worldwide. Non-invasive imaging techniques have revolutionized the diagnosis and management of coronary artery disease. This review aims to compare the utility and effectiveness of two emerging non-invasive imaging modalities: coronary computed tomography angiography and myocardial perfusion imaging. Thus we provide here a comprehensive overview of the advancements in non-invasive imaging techniques for coronary artery disease assessment. In parallel, we discuss the role of coronary computed tomography angiography and myocardial perfusion imaging in the diagnosis and management of coronary artery disease, their comparative efficacy, and their potential to guide subsequent interventions (Fig. 4, Ref. 70). Keywords: angiography, heart, perfusion, myocardial blood flow, ischemic heart disease.
Overview of typical dental abnormalities in rare genetic syndromes occurring in the Czech Roma population.
Dostalova T, Havlovicova M, Timkova S … +5 more , Filipova D, Eliasova H, Batkova M, Liskova P, Macek M
Bratisl Lek Listy · 2024 · PMID 39629652 · Publisher ↗
BACKGROUND: The Roma population is a genetically isolated population with a shared origin, totaling between 10 to 14 million individuals worldwide, stemming from a limited number of "genetic founders". Roma individuals e...
BACKGROUND: The Roma population is a genetically isolated population with a shared origin, totaling between 10 to 14 million individuals worldwide, stemming from a limited number of "genetic founders". Roma individuals exhibit specific hereditary diseases, often stemming from recessive genetic variants due to a higher degree of consanguinity, with recent molecular-genetic investigations shedding light on several conditions prevalent within the Czech Roma population. However, an overview of stomatological issues in diagnosing such diseases proves challenging, leading to frequent underdiagnosis or misdiagnosis. METHODS: The contribution monitors the clinical description, typical symptoms and treatment options including dental abnormalities in rare genetic diseases in the Roma population which are treated in ERN CRANIO centre at Motol University Hospital in Prague. RESULTS: Our research provides examples of autosomal recessive diseases, which can be molecularly confirmed, and prevalent within the Roma community. These include congenital cataract syndrome, facial dysmorphism and demyelinating neuropathy, non-syndromic prelingual e.g. deafness with GJB2 gene impairment, and myasthenic syndrome. CONCLUSION: Our report aimed to provide a systematic review of dental phenotypes which can relate to Czech Roma's rare genetic disorders therapy including dental treatment. Understanding is important for preventing unterdiagnosis or treatment for the patients affected review of observed (Fig. 6, Ref. 27).
Secondary complications of vestibular neuropathy.
Skacik P, Sivak S, Kurca E
Bratisl Lek Listy · 2024 · PMID 39629651 · Publisher ↗
Vestibular neuropathy represents the third most common cause of peripheral vestibular disorders. The clinical picture of the disease is characterized by acute vertigo with vegetative accompaniment. A typical course is mo...
Vestibular neuropathy represents the third most common cause of peripheral vestibular disorders. The clinical picture of the disease is characterized by acute vertigo with vegetative accompaniment. A typical course is monophasic with the resolution of symptoms within a few days to complete adjustment. In some patients, secondary complications may occur, which we define into three groups: organic, cognitive, and functional. The occurrence of complications and their persistence is often an overlooked issue, which does not receive sufficient attention and can lead to a significant deterioration in quality of life. Therefore, the management of these patients requires a comprehensive approach and interdisciplinary cooperation between neurologists, physiotherapists, psychologists, and psychiatrists. In the following text, the authors attempt to elucidate this issue further (Fig. 1, Ref. 49). Keywords: vestibular neuropathy, secondary complications, vertigo, acute vestibular syndrome.
Necrotizing fasciitis as a result of a black widow spider bite.
Zavacka M, Pobehova J, Virag M … +2 more , Vasko L, Zavacky P
Bratisl Lek Listy · 2024 · PMID 39629650 · Publisher ↗
The poison ivy does not normally occur in Slovakia, like in the Czech Republic, but it can be introduced. The venom of the black widow spider is an effective weapon for capturing prey. It is a mixture of various active s...
The poison ivy does not normally occur in Slovakia, like in the Czech Republic, but it can be introduced. The venom of the black widow spider is an effective weapon for capturing prey. It is a mixture of various active substances containing a protein neurotoxin called α-latrotoxin (α-LTX). Necrotizing fasciitis (NF) is a rapidly progressive soft tissue infection caused by fulminant tissue destruction with severe systemic toxicity and high mortality (Fig. 9, Ref. 16). Keywords: poisonous weaver, necrotizing fasciitis, streptococcus pyogenes, latrodectism, multiorgan failure.
The first kidney transplantation in an HIV positive recipient in Slovakia.
Stefancikova K, Jr JB, Javorkova M … +8 more , Bystricanova A, Cirbusova M, Cvoligova M, Chrastina M, Maris J, Otavkova J, Tibensky I, Zilinska Z
Bratisl Lek Listy · 2024 · PMID 39629649 · Publisher ↗
Patients infected with human immunodeficiency virus (HIV) have long been considered unsuitable candidates for solid organ transplantation due to their poor prognosis. After the introduction of combination antiretroviral...
Patients infected with human immunodeficiency virus (HIV) have long been considered unsuitable candidates for solid organ transplantation due to their poor prognosis. After the introduction of combination antiretroviral therapy, the survival of this group of patients improved significantly. HIV positive patients had been successfully transplanted for the last 18 years. HIV positive patients encounter very specific issues after transplantation, specifically related to drug interactions and higher rejection rates. Despite that, HIV positive patients have similar results to HIV negative patients post transplantation. We present the case of the first kidney transplantation in an HIV positive patient in Slovakia. The procedure was possible due to a change in legislation, as HIV positivity was an absolute contraindication for transplantation in Slovakia until October 2023. The aim of our case report is to draw attention to the possibility of kidney transplantation in an HIV positive patient and to the specific problems related to the preparation of an HIV positive patient for transplantation, post-transplant complications and the possibilities of their management (Fig. 6, Ref. 37). Keywords: kidney transplantation, HIV, human immunodeficiency virus, acute rejection, HAART, drug interaction.
Computational neuroscience as a tool for studying neurons.
Sabo M, Kopani M
Bratisl Lek Listy · 2024 · PMID 39629648 · Publisher ↗
OBJECTIVES: Computational neuroscience uses a neuron model to investigate the behavior of a neuron under different stimuli e.g. magnetic field. The aim of the study is to investigate the effect of conductivity change of...
OBJECTIVES: Computational neuroscience uses a neuron model to investigate the behavior of a neuron under different stimuli e.g. magnetic field. The aim of the study is to investigate the effect of conductivity change of sodium (Na+) and potassium (K+) ion channels on the generation and course of action potential, excitability and firing rate of neuron. METHODS: HHSim (Hodgkin-Huxley) graphical simulator was used for investigation of generation and firing rate of action potential (AP) and investigation of neuronal excitability. RESULTS: Na+ channel downregulation of conductance reveals a decrease of AP amplitude, and upregulation an increase of amplitude. Higher conductance of Na+ channel leads to higher firing rate from the value 53 HZ to 66 Hz. K+ channel downregulation of conductance reveals an increase of AP amplitude. Lower conductance of K+ channel leads to higher firing rate from the value 62 HZ to 68 Hz. K+ channel upregulation of conductance shows a decrease of AP amplitude. CONCLUSION: From the results it can be drawn that effect of conductivity change as a result of magnetic field is significant and can leads to change of neurons. uman brain cultures, often termed "glia-like" cells (Tab. 4, Fig. 6, Ref. 21).
Problematic visualization of human protoplasmic astrocytes Immunohistochemical stains.
Sivakova I, Polak S, Perzelova A
Bratisl Lek Listy · 2024 · PMID 39629647 · Publisher ↗
OBJECTIVE: Traditionally, astrocytes are categorized into fibrous and protoplasmic types based on their morphological appearance. BACKGROUND: For a long time, glial fibrillary acidic protein (GFAP) has been considered th...
OBJECTIVE: Traditionally, astrocytes are categorized into fibrous and protoplasmic types based on their morphological appearance. BACKGROUND: For a long time, glial fibrillary acidic protein (GFAP) has been considered the best astroglial marker. However, protoplasmic astrocytes stain negatively for GFAP using immunohistochemical methods. METHODS: Immunohistochemical methods with antibodies to GFAP were used to identify astrocytes. Paraffin sections were prepared from brain biopsy samples of adult patients diagnosed with aneurysm, traumatic contusion, subdural hematoma, gliomas or brain metastases. RESULTS: In all samples, the GFAP-positive fibrous astrocytes were located in the subpial area and in the white matter. Several GFAP-positive protoplasmic astrocytes were found only in one brain sample from a patient with ruptured aneurysm. Conversely, GFAP-positive astrocytes of intermediate shape were rarely observed in the cortical gray matter from patients with tumoral diagnoses. CONCLUSION: Our immunohistochemical study demonstrates that GFAP-positive cells with morphology similar to protoplasmic astrocytes rarely occur in injured brain cortex. We conclude that brain tissue contains GFAP-negative glial precursor cells, which can differentiate into GFAP-positive cells under pathological conditions and sometimes exhibit protoplasmic or intermediate morphology. Similarly, GFAP staining is increased in fibrous astrocytes, typically described as reactive to brain noxa. These results raise many questions about astrocytes identification and classification. In addition, these findings may explain the absence of GFAP-positive cells in adult human brain cultures, often termed "glia-like" cells (Fig. 3, Ref. 18).
Neuroendoscopy-assisted evacuation for supratentorial intracerebral hemorrhage versus conventional craniotomy: A comparative analysis of efficacy and outcome.
Banoci J, Magocova V, Katuch V … +1 more , Tomkova M
Bratisl Lek Listy · 2024 · PMID 39629646 · Publisher ↗
BACKGROUND: The endoscopic-assisted approach for intracerebral hemorrhage minimizes traumatization of the brain and allows direct access to hematoma. The study aimed to compare the results of the endoscopic-assisted evac...
BACKGROUND: The endoscopic-assisted approach for intracerebral hemorrhage minimizes traumatization of the brain and allows direct access to hematoma. The study aimed to compare the results of the endoscopic-assisted evacuation for supratentorial hemorrhage versus conventional craniotomy. METHODS: A retrospective study analyzed medical records of patients with supratentorial intracerebral hemorrhage treated at our Neurosurgical Department between January 2015 and December 2023. The study included 91 patients who underwent either neuronavigational-assisted neuroendoscopy (n=25) or conventional craniotomy treatment (n=66). RESULTS: For conventional craniectomy procedures, the average residual volume was 10.1 ml, representing an average 82.1% hematoma evacuation efficacy. After endoscopically assisted procedures, the average residual volume was 3.9 ml, achieving a 92.5% hematoma evacuation efficacy. After the endoscopically assisted procedure, fewer than 10% of patients were revised for early or late complications (2 out of 25 patients), whereas after the craniectomy procedure, revision or the introduction of lumbar drainage for cerebrospinal fluid leakage was performed on 35% of patients (20 patients). CONCLUSIONS: The endoscopic-assisted evacuation of supratentorial intracerebral hemorrhage is becoming preferred because of its efficacy, a small number of complications, and minor trauma for the patient (Tab. 1, Fig. 3, Ref. 16). Text in PDF www.elis.sk Keywords: intracerebral hemorrhage, treatment, endoscopy.
Computational study of endogenous magnetic particles' effect on action potential processing in a Purkinje cell model.
Sabo M, Kopani M
Bratisl Lek Listy · 2024 · PMID 39629645 · Publisher ↗
OBJECTIVES: The study aims to investigate how changes in the conductance of axonal (Na+) and calcium (Ca2+) ion channels affect the generation, course, excitability and firing rate of action potentials in a model of Purk...
OBJECTIVES: The study aims to investigate how changes in the conductance of axonal (Na+) and calcium (Ca2+) ion channels affect the generation, course, excitability and firing rate of action potentials in a model of Purkinje cell neurons. METHODS: The NEURON Simulator was utilized with a Purkinje cell model to investigate generation, time to first spike, firing rate and pattern of action potential (AP) as well as neuronal excitability in relation to the influence of magnetic field on axonal ion channels. RESULTS: The downregulation of axonal Na+ and Ca2+ conductance led to a significant delay in the generation of the first spike, with completely blocked action potential generation when downregulated by 75%. Conversely, upregulation of axonal Na+ and Ca2+ conductance accelerated the emergence of the first spike. CONCLUSION: Our findings demonstrate that alterations in ion channel conductance influence the timing and generation of action potentials, suggesting that magnetic fields can modulate neuronal behaviour (Tab. 4, Fig. 12, Ref. 34). Text in PDF www.elis.sk Keywords: axon, ion channels, conductance, action potential, magnetic field, Purkinje cell.
The sodium-glucose cotransporter-2 inhibitors in patients with chronic kidney disease with or without kidney transplantation - a single centre study.
Kleinova P, Granak K, Vnucak M … +3 more , Beliancinova M, Blichova T, Dedinska I
Bratisl Lek Listy · 2024 · PMID 39629644 · Publisher ↗
INTRODUCTION: The sodium-glucose cotransporter-2 inhibitors (SGLT2i) represent the first-line treatment for chronic kidney disease. The question remains of their benefit and safety for patients after kidney transplantat...
INTRODUCTION: The sodium-glucose cotransporter-2 inhibitors (SGLT2i) represent the first-line treatment for chronic kidney disease. The question remains of their benefit and safety for patients after kidney transplantation. The study aimed to show the renoprotective effect and safety of use in patients with chronic kidney disease with or without kidney transplantation. MATERIAL: This is a prospective monocentric study of the Transplant-Nephrology Department in Martin in which patients with chronic kidney disease with or without kidney transplant in therapy with dapagliflozin were included (n=79). The changes in glomerular filtration rate, albuminuria and side effects associated with SGLT2i were studied in patients with chronic kidney disease with or without kidney transplantation and in patients with or without diabetes mellitus. RESULTS: Patients without diabetes mellitus achieved a significantly higher decrease in albuminuria at the time of the third month of follow-up (p=0.0396), with the continuation of the decrease until the average follow-up (10.9 months) (p=0.7866) than patients with diabetes mellitus. During the observed period, we recorded the cessation of the primary decrease in glomerular filtration with a return to the baseline values. In our group, we did not confirm a significant occurrence of adverse effects associated with dapagliflozin. CONCLUSION: SGLT2i significantly reduces albuminuria and stabilizes glomerular filtration in patients with chronic kidney disease. Based on our analysis, treatment with gliflozins is effective and safe for patients after kidney transplantation (Tab. 4, Fig. 6, Ref. 16).
Prognostic and predictive significance of inflammatory markers in patients with locally advanced unresectable and metastatic pancreatic cancer treated with first-line chemotherapy FOLFIRINOX or Gemcitabine/Nabpaclitaxel.
Novisedlakova M, Chovanec M, Ciernikova S … +1 more , Danihel L
Bratisl Lek Listy · 2024 · PMID 39487847 · Publisher ↗
BACKGROUND: Advanced pancreatic ductal adenocarcinoma (PDAC) remains a disease with a dismal prognosis, significantly limited therapeutic options, and few innovative drugs. Inflammation plays a significant role in the de...
BACKGROUND: Advanced pancreatic ductal adenocarcinoma (PDAC) remains a disease with a dismal prognosis, significantly limited therapeutic options, and few innovative drugs. Inflammation plays a significant role in the development and progression of PDAC. Systemic inflammatory indexes reflect the anti-tumor inflammatory capacity of and are of prognostic and predictive value in the treatment of patients with PDAC. METHODS: In our retrospective study, we investigated the prognostic and predictive significance of inflammatory markers in chemonaive patients with locally advanced unresectable pancreatic cancer (LAPC) and metastatic pancreatic cancer (mPDAC), in relation to progression-free survival (PFS) and overall survival (OS). Survival analysis was conducted using the Kaplan-Meier method with log-rank tests in univariate analysis. We used multivariate Cox regression analysis to determine the impact of inflammatory markers on survival time. RESULTS: The present clinical study included 46 patients with LAPC and mPDAC treated with FOLFIRINOX (folinic acid, fluorouracil, irinotecan, oxaliplatin) or GEM/Nab-P (gemcitabine/nab-paclitaxel) as first-line chemotherapy regimens. Performance status (PS) ECOG 0-1, neutrophil-to-lymphocyte ratio (NLR)≤2.09 and the prognostic nutritional index (PNI)≥49.09 were associated with significantly longer OS in the analyzed patient cohort, Multivariate analysis confirmed PS, NLR and PNI as independent prognostic factors for OS. CONCLUSION: In our cohort of patients with advanced PDAC, PS, NLR and PNI were confirmed as independent prognostic factors for OS (Tab. 9, Fig. 2, Ref. 82). Text in PDF www.elis.sk Keywords: pancreatic cancer, inflammatory markers, tumor microenvironment, chemotherapy.
Transforming emergency triage: A preliminary, scenario-based cross-sectional study comparing artificial intelligence models and clinical expertise for enhanced accuracy.
Eraybar S, Dal E, Aydin MO … +1 more , Begenen M
Bratisl Lek Listy · 2024 · PMID 39487846 · Publisher ↗
INTRODUCTION: This study examines triage judgments in emergency settings and compares the outcomes of artificial intelligence models for healthcare professionals. It discusses the disparities in precision rates between s...
INTRODUCTION: This study examines triage judgments in emergency settings and compares the outcomes of artificial intelligence models for healthcare professionals. It discusses the disparities in precision rates between subjective evaluations by health professionals with objective assessments of AI systems. MATERIAL AND METHOD: For the analysis of the efficacy of emergency triage; 50 virtual patient scenarios had been created. Emergency medicine residents and other healthcare providers who had triage education were tasked with categorizing triage levels for virtual patient scenarios. Also artificial intelligence systems, tasked for resolving the same scenarios. All of them were asked to use three color-coded triage of the Republic of Turkey Ministry of Health. The answer keys were created by consensus of the researchers. In addition, Emergency medicine specialists were asked to evaluate the acuity level of each scenario in order to perform sub-analyses. RESULTS: The study consisted of 86 healthcare professionals, comprising 31 Emergency medicine residents (26.5%), 1 paramedic (0.9%), 5 emergency health technicians (4.3%), and 80 nurses (68.4%). Google Bard AI and OpenAI Chat GPT v.3.5 were used as artificial intelligence systems. The responses compared with the answer key to determine each groups efficacy. As planned the responses from healthcare professionals were analyzed individually for acuity level of scenarios. Emergency medicine residents and other groups of healthcare providers had significantly higher numbers of correct answers compared to Google Bard and Chat GPT (n=30.7 vs n=25.5). There was no significant difference between ChatGPT and Bard for low and high acuity scenarios (p=0.821)CONCLUSION: AI models can examine extensive data sets and make more accurate and quicker triage judgments with sophisticated algorithms. However, in this study, we found that the triage ability of artificial intelligence is not as sufficient as humans. A more efficient triage system can be developed by integrating artificial intelligence with human input, rather than solely relying on technology (Tab. 4, Ref. 41). Text in PDF www.elis.sk Keywords: emergency triage, AI applications, health technology, artificial intelligence, emergency management.
Risk factors for external ventricular drainage infections.
Magocova V, Banoci J, Katuch V … +1 more , Gajdos M
Bratisl Lek Listy · 2024 · PMID 39487845 · Publisher ↗
INTRODUCTION: External ventricular drainage (EVD) is frequently used in neurosurgical interventions to drain cerebrospinal fluid (CSF). Nevertheless, it carries a high incidence of infectious complications, notably secon...
INTRODUCTION: External ventricular drainage (EVD) is frequently used in neurosurgical interventions to drain cerebrospinal fluid (CSF). Nevertheless, it carries a high incidence of infectious complications, notably secondary meningitis and ventriculitis. In light of the previous rates of these EVD-related infections, we introduced a set of guidelines to lower the infection rate. This study aimed to assess the influence of the hospital-wide adoption of the EVD handling protocol on secondary infections related to EVD. MATERIAL AND METHODS: We enrolled 171 patients scheduled for EVD placement for reasons other than infectious meningitis or ventriculitis from January 2021 to March 2024. A matched cohort of patients underwent logistic regression to adjust for and analyze regression discontinuity. RESULTS: Infections were more prevalent in the group before the protocol's implementation (18.27% compared to 7.46%, p<0.0001). Regression analysis within the matched score cohort (n=104 in pre-protocol groups and n=67 in post-protocol groups) indicated that the period before the protocol was independently linked to a higher incidence of infections. CONCLUSION: Implementing a stringent hospital-wide protocol for EVD handling can significantly diminish the rate of secondary infections associated with EVD (Tab. 3, Fig. 1, Ref. 15). Text in PDF www.elis.sk Keywords: external ventricular drainage, meningitis, ventriculitis, infection.
Efficiency of photodynamic inactivation Actinomyces israelii and Prevotella melaninogenica.
Voronkina I, Liptakova A, Dyachenko V … +2 more , Derkach S, Sklyar N
Bratisl Lek Listy · 2024 · PMID 39487844 · Publisher ↗
BACKGROUND: The goal of our work was to develop a composition for antimicrobial photodynamic inactivation (aPDI) of anaerobic periodontopathogenic pathogens. METHODS: The three test groups were as follows: light plus dox...
BACKGROUND: The goal of our work was to develop a composition for antimicrobial photodynamic inactivation (aPDI) of anaerobic periodontopathogenic pathogens. METHODS: The three test groups were as follows: light plus doxycycline (L+DOX+), light plus doxycycline and hypericin (L + DOX + HYP +), and control groups. aPDI was evaluated by the number of grown colonies on a dense nutrient medium after 12, 24, and 48 hours of bacterial suspension cultivation. RESULTS: Based on the results of microbiological studies, the combined photosensitising effect of a subinhibitory dose of doxycycline and hypericin was determined. The delay of growth of A. israelii, P. melaninogenica in the second group (L+DOX+HYP) was significantly significant compared to the first group (L+DOX+), and the statistical difference in colony formation activity was found for both gram-positive and gram-negative cultures (p<0.05). CONCLUSIONS: aPDT is a promising therapeutic alternative for the local treatment of purulent-inflammatory diseases of various localisation caused by antibiotic-resistant bacteria, including in the oral cavity (Fig. 3, Ref. 57). Text in PDF www.elis.sk Keywords: peri-implant diseases, photodynamic therapy, photosensitiser, anaerobic bacteria.
MMP9 and pancreatic cancer.
Roskovicova V, Katuchova J, Vecurkovska I … +4 more , Maslankova J, Marekova M, Radonak J, Katuch V
Bratisl Lek Listy · 2024 · PMID 39487843 · Publisher ↗
BACKGROUND: Pancreatic carcinoma is one of the most severe oncological diseases of the gastrointestinal tract. At the time of diagnosis, up to 28% of patients have metastatic liver damage, and only 5% of patients survive...
BACKGROUND: Pancreatic carcinoma is one of the most severe oncological diseases of the gastrointestinal tract. At the time of diagnosis, up to 28% of patients have metastatic liver damage, and only 5% of patients survive five years. Scientific research focuses on non-invasive markers that could help screen for the disease and identify patients more quickly. Potential biomarkers also include matrix metalloproteinases, which play a role in oncogenesis. MATERIAL AND METHODS: We prospectively followed 46 patients with pancreatic cancer and benign pancreatic diseases from September 2022 to March 2023. We determined the level of MMP9 in serum and tissue biopsied during surgeries. RESULT: As a result, MMP9 levels were elevated from the T2 stage. The correlation between disease stage and MMP9 level was not confirmed in lower stages, possibly due to the small group of patients. CONCLUSION: MMP9 seems suitable for detecting late stages of pancreatic cancer, possibly for secondary prevention. We could not confirm a correlation between MMP9 levels and the initial stages of the disease (Tab. 1, Fig. 3, Ref. 21). Text in PDF www.elis.sk Keywords: pancreatic cancer, MMP9, marker, non-invasive, screening.
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