Bratislavske Lekarske Listy[JOURNAL]
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200 papers
Zahorec index or Neutrophil-to-lymphocyte ratio, valid biomarker of inflammation and immune response to infection, cancer and surgery.
Firment J, Hulin I
Bratisl Lek Listy · 2024 · PMID 38219059 · Publisher ↗
BACKGROUND: For many years, the physicians are searching for easily measurable marker of immune response to the stress and inflammation. More than, 20 years ago Zahorec (2001) proposed neutrophil-to-lymphocyte ratio (NLR...
BACKGROUND: For many years, the physicians are searching for easily measurable marker of immune response to the stress and inflammation. More than, 20 years ago Zahorec (2001) proposed neutrophil-to-lymphocyte ratio (NLR) as an easy available and valid biomarker of inflammation, stress, and activation of immune system. METHODS: In this narrative review we focused on the utility of neutrophil-to-lymphocyte ratio (Zahorec's index) in clinical practice of general medicine (inflammation and infection), intensive medicine (sepsis), oncology (prediction of prognosis in cancer of solid organs), surgery and perioperative medicine (diagnosis of complications, and prediction of clinical outcome). RESULTS AND CONCLUSION: We provide many evidences of clinical research which confirm that Neutrophil-to-lymphocyte ratio is a very sensitive marker of inflammation, stress reliable and valid parameter in everyday clinical practice. NLR (Zahorec index) is an effective tool for diagnosis of infection and severity of disease of variable etiologies. NLR reflect the grade of inflammation in cancer disease, which has a significant impact on the prognosis of cancer patients. Zahorec index should be used routinely in emergency medicine, surgery and perioperative medicine as a marker of the severity of affliction, infection, and complications in general. NLR may help physicians in decision making process for early diagnosis and therapy. NLR should be investigated frequently in acute states (sepsis, shock, peritonitis, stroke, trauma) on a daily basis, in subacute states few times per week (during hospital stay), and few times per year in chronic disease (cancer, diabetes mellitus, ischemic heart disease, psychiatry disorders). NLR has a deep biological sense connecting together function of three suprasystems: immune, endocrinne and autonomous nervous system (Tab. 2, Fig. 3, Ref. 86).
Glutathione peroxidase 1 and 2 during preimplantation period of pregnancy in mouse.
Krehelova A, Kovarikova V, Fabian D … +5 more , Solar P, Curgali K, Neratzakis I, Hodorova I, Mihalik J
Bratisl Lek Listy · 2024 · PMID 38041849 · Publisher ↗
OBJECTIVES: This study describes the presence of glutathione peroxidase (GPx) 1 and 2 in oocytes, preimplantation embryos, and mouse female genital organs. BACKGROUND: GPx1 and 2 are antioxidant enzymes, which play impor...
OBJECTIVES: This study describes the presence of glutathione peroxidase (GPx) 1 and 2 in oocytes, preimplantation embryos, and mouse female genital organs. BACKGROUND: GPx1 and 2 are antioxidant enzymes, which play important roles in protection of cells against oxidation, which may be formed during cell physiological processes. METHODS: After superovulation of female mice, oocytes and preimplantation embryos (O/PE) were isolated for immunofluorescent analysis, female genital organs were removed for immunohistochemical and Western blot analyses. RESULTS: Using immunofluorescence, GPx1 was detected in all OP/E, where it formed clusters near nuclei, or under the cytoplasmic membrane. GPx2 was not detected in any O/PE. Using immunohistochemistry, GPx1 was observed in corpus luteum and oocytes, and in oviductal and uterine epithelium. GPx2 was detected in corpus luteum, but not in oocytes. Oviductal and uterine epithelium was mostly negative. Using Western blot, two GPx1 bands of different molecular weights were detected in uterus. One GPx2 band was observed in all investigated organs. CONCLUSION: These results show that both enzymes may be important during preimplantation period of pregnancy in genital organs, GPx1 also in O/PE. GPx2 may play roles in embryo after the implantation, when gastrointestinal tract is formed (Fig. 10, Ref. 75).
Importance of CHB's grey zone: analysis of patients with HBeAg negative chronic hepatitis B virus infection.
Lenartova PD, Hockickova I, Janicko M … +5 more , Jarcuska P, Drazilova S, Lami F, Schreter I, Kristian P
Bratisl Lek Listy · 2024 · PMID 38041848 · Publisher ↗
INTRODUCTION: HBeAg-negative chronic HBV infection is defined by viremia < 2,000 IU/ml (or < 20,000 IU/ml), normal ALT activity and minimal liver fibrosis. Some patients do not meet all the criteria and belong to the so-...
INTRODUCTION: HBeAg-negative chronic HBV infection is defined by viremia < 2,000 IU/ml (or < 20,000 IU/ml), normal ALT activity and minimal liver fibrosis. Some patients do not meet all the criteria and belong to the so-called grey zone. The aim of the work was to analyse a group of patients with asymptomatic chronic HBV infection, divide them according to the levels of HBV DNA during follow-up and to compare the clinical and laboratory parameters of the patients within the groups. METHODS: We retrospectively analysed patients with HBeAg-negative chronic HBV infection examined in the Centre for Viral Hepatitis of the Department of Infectology in Košice, Slovakia, from September 2018 to December 2021. Patients were divided into three groups based on HBV DNA levels during long-term follow-up ( 2,000 IU/ ml). We evaluated selected demographic, anamnestic and laboratory data (HBV DNA, ALT, fibrosis stage). RESULTS: Of the 280 enrolled patients, 160 were men (57.1 %), the average age was 48.0 years, and the mean length of follow-up was 4.7 years. HBV DNA levels were consistently 2,000 IU/ml in 62 patients. 165 patients had normal ALT activity, 74 had fluctuating ALT activity, and permanently increased ALT in 41 patients. 139 patients underwent transient elastography examination, 16 of them had stage F2 fibrosis, two stage F3 and 1 had cirrhosis. When comparing the three groups divided according to HBV DNA, patients with fluctuating HBV DNA had the longest follow-up, but patients with HBV DNA permanently over 2,000 IU/ml were the youngest and the highest proportion of them had elevated ALT activity. 165 patients (58.9%) met the extended criteria of asymptomatic carriers, 115 were in the grey zone. CONCLUSION: Patients with HBeAg-negative chronic HBV infection often have fluctuating HBV DNA and ALT values during follow-ups. Statistically significantly higher proportion of abnormal ALT activity in patients with HBV DNA > 2,000 IU/ml may suggest higher risk of adverse outcomes. Initiation of treatment in such patients is not always necessary unless they also meet the other indication criteria for treatment. The exact definition of the grey zone is currently absent (Tab. 2, Fig. 2, Ref. 16).
Atypical variable origins of the left inferior phrenic artery and left gastric artery.
Hvizdosova N, Vecanova J, Vrzgula M … +1 more , Hodorova I
Bratisl Lek Listy · 2024 · PMID 38041847 · Publisher ↗
OBJECTIVES: The current report describes the combined unusual origin of the left inferior phrenic and left gastric arteries observed during a routine dissection of the upper abdominal region. BACKGROUND: The branches of...
OBJECTIVES: The current report describes the combined unusual origin of the left inferior phrenic and left gastric arteries observed during a routine dissection of the upper abdominal region. BACKGROUND: The branches of the abdominal aorta are important vessels that supply blood to various organs and structures in the abdominal cavity. While there is typically a common pattern of branching, anatomical variations can occur, leading to differences in the branching patterns of the abdominal aorta. METHODS: An accidental finding in an 80-year-old male cadaver within anatomical dissection was assessed. RESULTS: We observed that the left inferior phrenic artery originated from the celiac trunk and gives off middle and superior suprarenal arteries, while the left gastric artery arose from the abdominal aorta independently. CONCLUSION: The identification of anatomic vascular abnormalities of the abdominal aorta and its branches is clinically important in surgical and invasive arterial procedures and preoperative knowledge of vascular anomalies should prevent iatrogenic vascular trauma and complications during surgery (Fig. 3, Ref. 14).
Characteristics of delirium among COVID-19 patients.
Jarcuskova D, Kozarova M, Bali-Hudak M … +2 more , Lackova A, Gazda J
Bratisl Lek Listy · 2024 · PMID 38041846 · Publisher ↗
OBJECTIVE: This study estimated delirium incidence in Slovak COVID-19 patients, explored treatment associations and examined the impact on hospitalization and mortality. BACKGROUND: The COVID-19 pandemic caused by SARS-C...
OBJECTIVE: This study estimated delirium incidence in Slovak COVID-19 patients, explored treatment associations and examined the impact on hospitalization and mortality. BACKGROUND: The COVID-19 pandemic caused by SARS-CoV-2 has significantly affected global health. Delirium, a severe form of acute brain dysfunction, is common in hospitalized patients, including those with COVID-19. METHODS: A retrospective study analyzed data from 474 hospitalized patients with confirmed SARS-CoV-2 infection in Kosice, Slovakia. Delirium was diagnosed using standardized ICD-10 criteria. Statistical analyses examined associations between delirium, psychiatric symptoms, treatment modalities, hospitalization duration, and mortality. RESULTS: 29.54 % (140 patients) had delirium. Insomnia, anxiety, and delirium were prevalent psychiatric symptoms. Delirium patients had higher insomnia, anxiety, somnolence, agitation, and aggression rates. Treatments like high-flow nasal oxygen, glucocorticoids, antibiotics, and anakinra were associated with higher delirium incidence. Delirium was more common with antipsychotic use (tiapride, quetiapine, haloperidol), while citalopram seemed protective. No significant associations were found with mortality. Patients using benzodiazepines, hypnotics, or tiapride had longer hospital stays. CONCLUSION: This study provides insights into delirium incidence in Slovak COVID-19 patients, treatment associations, and the importance of managing psychiatric symptoms and treatment choices for optimal outcomes (Tab. 6, Ref. 33).
The presence of glutathione peroxidase 8 (GPx8) in rat male genital organs.
Mihalik J, Solar P, Curgali K … +5 more , Svana M, Krehelova A, Vrzgula M, Almasiova V, Hodorova I
Bratisl Lek Listy · 2024 · PMID 38041845 · Publisher ↗
OBJECTIVES: The aim of our work was to determine the presence of GPx8, the latest discovered member of glutathione peroxidase family, in rat male genital organs. BACKGROUND: The oxidative stress is considered as one of t...
OBJECTIVES: The aim of our work was to determine the presence of GPx8, the latest discovered member of glutathione peroxidase family, in rat male genital organs. BACKGROUND: The oxidative stress is considered as one of the most important causalities of male infertility. To defend itself, the organism comprises many different antioxidants. METHODS: We assessed the GPx8 presence in tissues of genital organs from adult rat Sprague-Dawley males by mRNA expression, Western Blot analysis, and immunohistochemistry. RESULTS: The highest mRNA and protein levels were detected in the testis, followed by seminal vesicle. Within testis the enzyme was observed predominantly in the Leydig and Sertoli cells, residual and Hermes bodies. In other organs, such as epididymis, seminal vesicle and prostate gland, the GPx8 was seen in the cytoplasm of epithelial cells. The enzyme was also observed in the muscular layer of hollow organs, in blood plasma and extracellular matrix. CONCLUSIONS: The antioxidant enzyme GPx8 was detected in all examined male genital organs. The fact, that the enzyme was released into lumen of genital organs probably means, that GPx8 is also a component of the semen. To our knowledge, this is the first paper describing GPx8 presence in male genital organs of mammals (Fig. 8, Ref. 63).
Advantages of endoscopic transsphenoidal pituitary gland tumor surgery.
Suchan M, Kaliarik L, Zeliznak V … +3 more , Skalova M, Kollova A, Banocy J
Bratisl Lek Listy · 2024 · PMID 38041844 · Publisher ↗
OBJECTIVE: The aim of the study was to hihglight the benefits and safety of the endoscopic transsphenoidal pituitary gland tumor surgery. BACKGROUND: The endoscopic transsphenoidal approach to the Turkish sella minimizes...
OBJECTIVE: The aim of the study was to hihglight the benefits and safety of the endoscopic transsphenoidal pituitary gland tumor surgery. BACKGROUND: The endoscopic transsphenoidal approach to the Turkish sella minimizes traumatization of nasal cavity structures, allows direct access to the tumor and intra, para and suprasellar views (13). METHODS: The surgical procedure was described. We monitored postoperative complication such as postoperative bleeding, cerebrospinal fluid leak, infection in 136 patients who underwent endoscopic transsphenoidal pituitary gland tumos resection. RESULTS: Bleeding from the bed after tumor removal occured in 3 patients (2.2 %). Bleeding from the nasal cavity requiring surgical intervention was in 1 patient (0.7 %). Postoperative cerebrospinal fluid leak was detected in 12 cases (8.8 %). Duroplasty with itratecal cerebrospinal fluid drainage led to the cessation of the cerebrospinal fluid leak in all cases. We recorded meningitis in 4 patients (2.9 %) Rhinosinusitis was not recorded. CONCLUSIONS: The endoscopic transsphenoidal surgery of pituitary gland tumors has become preferred becouse of its safety, low rate of complications and minimal trauma to the patient (Fig. 5, Ref. 13).
Comprehensive review of the timing of surgical management of macroglossia in Beckwith-Wiedemann syndrome.
Kizek P, Glinska KK, Riznic M … +3 more , Borza B, Schwartzova V, Kotulicova Z
Bratisl Lek Listy · 2024 · PMID 38041843 · Publisher ↗
Beckwith-Wiedemann Syndrome (BWS) is a rare genetic disorder that causes developmental defects as well as an elevated risk of malignancies. Macroglossia, or an enlarged tongue, is a common symptom of BWS that may have a...
Beckwith-Wiedemann Syndrome (BWS) is a rare genetic disorder that causes developmental defects as well as an elevated risk of malignancies. Macroglossia, or an enlarged tongue, is a common symptom of BWS that may have a negative influence on a person's quality of life. The aim of this systematic review is to look at the present state of knowledge about the repercussions of macroglossia, as well as the influence of the timing of surgical resection, or glossectomy, in the treatment of severe cases of macroglossia (Ref. 35). Keywords: macroglossia, Beckwith-Wiedemann syndrome, glossectomy.
Use of hepatocyte transplantation after extensive liver resections in experiment.
Kalanin R, Gajdzik T, Katuchova J … +6 more , Farkasova Iannaccone S, Jarcuska P, Hulik S, Adandedjan D, Gala I, Radonak J
Bratisl Lek Listy · 2024 · PMID 38041842 · Publisher ↗
he aim of our research is to prove, that the transplanted hepatocytes can survive and compensate for inadequate liver function in experimental animals. Thesis discusses the basic principles of hepatocyte transplantations...
he aim of our research is to prove, that the transplanted hepatocytes can survive and compensate for inadequate liver function in experimental animals. Thesis discusses the basic principles of hepatocyte transplantations, the process of their adaptation and effect on the organism as well as possibilities of their further use as a promising treatment method.In the experiment we used hepatocytes isolated and produced from explanted livers of laboratory rats. Hepatocytes form the basis of liver tissue and are responsible for a number of metabolic processes ocurring in the liver, therefore is the possibility of their use as a cell therapy one of the alternative treatment methods for liver failure.Into the laboratory experiment, rats of the Sprague Dawleyspecies were placed, which we divided into five groups of equal numbers. Groups consisted of healthy rats, rats after 2/3 liver resection and rats with liver damage induced by intraperitoneal administration of thioacetamide.Two groups with impaired liver had hepatocytes prepared in advance transplanted into their portal vein.Hepatocyte function was assessed in the blood serum and compared with a control group of healthy animals and groups with liver damage without the application of hepatocytes at the same time intervals.Whole experiment lasted 21 days. On the last day of the experiment all the animals were killed by decapitation.Livers of all animals were explanted and sent for histopathological analysis which used classical histological methods. After evaluating the results we observed significant changes of evaluated laboratory levels in blood serum and weight in experimental animals after the transplantation of hepatocytes in comparison with the laboratory results of the control group of healthy animals and groups with liver damage without transplanted hepatocytes. The results of our experiment show that by biochemical and histological analysis we managed to clearly prove the function of transplanted hepatocytes in the model of laboratory rat with impaired liver function (Tab. 5, Fig. 17 , Ref. 17) Keywords: liver, transplantation, hepatocytes, liver tumors, resection of liver, liver failure, experiment.
Distribution and relevance of hepatitis B genotypes in the general population of Slovakia.
HockickovA I, HatalovA E, Gazda J … +8 more , LenArtovA PD, JaniCko M, JarCuSka P, DraZilovA S, Logoida M, HalAnova M, SchrEter I, Kristian P
Bratisl Lek Listy · 2024 · PMID 38041841 · Publisher ↗
AIMS: The aim of the presented study was to determine the distribution of HBV genotypes and their influence on selected parameters in patients in eastern Slovakia. METHODS: The study includes 202 patients with confirmed...
AIMS: The aim of the presented study was to determine the distribution of HBV genotypes and their influence on selected parameters in patients in eastern Slovakia. METHODS: The study includes 202 patients with confirmed chronic HBV infection or hepatitis. For each patient, basic demographic data, and serum samples were collected. The degree of liver fibrosis was determined by transient elastography. The obtained data were evaluated statistically. RESULTS: Out of a total of 202 patients, 96.0 % of the patients were from the EU region and 27 patients (13.4 %) self-identified as Roma ethnic group. The most common genotype among our patients was genotype A (n = 104; 51.5 %), followed by genotype D (n = 76; 37.6 %) and A/D (n = 13; 6.4 %). In patients from the EU region, genotypes A and D predominated statistically significantly (p < 0.0001). Due to a low number of patients with other genotypes, in the subsequent analysis, we only compared patients with HBV genotypes A or D. Patients with genotypes D and A/D significantly more often mention tattoos as a possible risk factor for disease transmission compared to patients with genotype A (p = 0.043). Subsequently, we divided patients into two groups - treated and untreated. The level of qHBsAg was significantly higher in untreated patients with genotypes A (p < 0.0001). The influence of HBV genotypes on other laboratory parameters was not confirmed in our study. CONCLUSION: This is the first HBV genotypes study from Slovakia. We suggest that HBV genotypes may play a role in the virus-host relationship Keywords: chronic hepatitis B, genotypes, hepatitis B virus, prognostic factors, distribution.
Prevalence of diastasis m. rectus abdominis and pelvic floor muscle dysfunction in postpartum women.
Hagovska M, Dudic R, Dudicova V … +2 more , Svihra J, Urdzik P
Bratisl Lek Listy · 2024 · PMID 38041840 · Publisher ↗
OBJECTIVE: The aim of this study was to determine the prevalence of Diastasis of the rectus abdominis muscles (DRAM) and pelvic floor muscle dysfunction (PFMD) in postpartum women. Design: The observational prospective s...
OBJECTIVE: The aim of this study was to determine the prevalence of Diastasis of the rectus abdominis muscles (DRAM) and pelvic floor muscle dysfunction (PFMD) in postpartum women. Design: The observational prospective study. MATERIAL: 150 of 180 women (83.3 %) from 6 weeks to 6 months postpartum, with a mean age of 33.1 years. METHODS: For diastasis examination, inter recti distance (IRD) was measured by a linear 2D ultrasound probe, 4.5 cm above the navel, in its area and 4.5 cm below the navel when lying on the back at rest and under a load test. The degree of DRAM was classified into four grades. Urinary leakage symptoms were assessed by the International Incontinence Consultation Questionnaire (ICIQ - UI SF). RESULTS: The first degree of diastasis during the load test was 38.1 % above the navel, 36.4 % in the navel area, and 23.7 % below the navel. The second degree of diastasis with load was 28.8 % above the navel, 21.2 % in the navel area, and 10.2 % below the navel. PFMD showed 31.3 % of women with mild symptoms of SUI, 32.2 % of women with grade 1 cystocele. CONCLUSION: The average IRD distance at rest and during the load test confirmed the first grade of DRAM out of four degrees of severity. Moderate and medium DRAM occurred according to location in an average of one-third of the cases. The highest percentage of DRAM was above the navel, and the lowest percentage below the navel. PFMD was detected in an average of one-third of cases. It is important to monitor these parameters with a view to improving the quality of life index in the future (Tab. 5, Ref. 22).
Impact of autologous stem cell transplantation (ASCT) on progression free survival (PFS) in newly diagnosed multiple myeloma patients (NDMM) with high risk cytogenetic abnormalities.
Guman T, Sykora J
Bratisl Lek Listy · 2024 · PMID 38041839 · Publisher ↗
OBJECTIVES: 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 st...
OBJECTIVES: 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. METHODS: Retrospective analysis of NDMM patients eligible for HD chemotherapy followed by upfront ASCT in the era of novel agents, who underwent the ASCT in the Department of hematology and oncohematology LF UPJŠ and UNLP Košice in the timeframe of 54 months (from 01/JAN/2019 to 30/JUN/2023). Patients were stratified according to their cytogenetic profile. PFS was defined by the time from ASCT to the disease progression. The OS was defined as the time from the the start of treatment to the death from disease progression. The high risk cytogenetic abnormalities (HRCA) were defined as t(4;14), del(17/17p), t(14;16), t(14;20), nonhyperploidy, gain (1q). RESULTS: Inclusion criteria were met by 65 patients with NDMM who received HD chemotherpy followed by ASCT. We identified 22 (33.8 %) patients with HRCA and 43 (66.2 %) patients with standard cytogenetic risk. During the monitored period we recorded 4 deaths due to disease progression, all of them in the HCRA subgroup. The response was enhanced by the ASCT in both subgroups. The very good partial response (VGPR) increased from 42 % to 46 % and complete remission (CR) increased from 23 % to 45 % after the ASCT. The number of patients achieving only partial response (PR) decreased from 35 % to 9 % after ASCT. In the subgroup of patients with HRCA the median PFS after ASCT was lower compared to the patients with standard cytogenetic risk (17 vs 38 months). The average PFS in both subgroups was 22.9 months. The median OS in both subgroups was not reached, however the only deaths due to disease progression were recorded in the HRCA subgroup. At the time of analysis, 100 % (43) of patients are alive in the standard cytogenetic subgroup versus 72 % (18) of patients in HRCA subgroup. CONCLUSION: 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).
The founding of the UPJS Faculty of Medicine from the memories of the first dean Prof. MUDr. Jan Knazovicky. 75th anniversary of the UPJS Faculty of Medicine in Kosice.
Knazovicky M
Bratisl Lek Listy · 2024 · PMID 38041838 · Publisher ↗
Abstract loading — click title to view on PubMed.
Surgical outcomes of trabeculectomy augmented with sub-Tenon injected mitomycin C.
Majtanova N, Keri P, Kriskova P … +4 more , Kurilova V, Cholevik D, Majtan J, Kolar P
Bratisl Lek Listy · 2023 · PMID 37983286 · Publisher ↗
BACKGROUND: Recently, trabeculectomy with mitomycin C (MMC) where MMC is applied by injection into the Tenon layer has attracted close attention. However, the data on efficacy and safety of this technique is still limite...
BACKGROUND: Recently, trabeculectomy with mitomycin C (MMC) where MMC is applied by injection into the Tenon layer has attracted close attention. However, the data on efficacy and safety of this technique is still limited and more clinical studies are needed. Therefore, the work is aimed at comprehensive evaluation of the effectiveness of trabeculectomy using MMC applied by intra-Tenon injection. METHODS: A set of 50 eyes in 50 patients underwent trabeculectomy using MMC at concentration of 0.4 mg/ml in a total volume of 0.05 ml. The primary end point was to control intraocular pressure (IOP) on postoperative days 1, 8, 30 and 90 and subsequently at 6 and 12 months after surgery. The secondary end point was to evaluate the changes in various corneal parameters prior to and 90 days after surgical procedure. RESULTS: The mean preoperative IOP was 32.34 ± 9.45 mmHg. After surgery, the mean IOP significantly decreased to 17.52 ± 4.58 mmHg at the 90-day follow-up, and to 18.14 ± 3.74 and 19.30 ± 3.82 mmHg at 6 and 12 months after the procedure, respectively. The mean BCVA values remained unchanged compared to baseline (0.77 ± 0.23) to the 90-day follow-up (0.80 ± 0.23). The mean number of anti-glaucoma medications significantly reduced from 3.50 ± 0.74 to 0.58 ± 1.03 postoperatively. Similarly, the mean corneal hysteresis and ACD of the eye as well as CECD were significantly changed postoperatively. CONCLUSIONS: Trabeculectomy using MMC applied by injection is a safe and effective surgical method for the treatment of primary and secondary forms of open-angle glaucoma. It has a significant hypotonising effect and allows a complete discontinuation of antiglaucoma drugs (Tab. 3, Fig. 3, Ref. 58).
Recent advances in understanding the pathogenesis and biological treatment of multiple sclerosis.
Buc M
Bratisl Lek Listy · 2023 · PMID 37983285 · Publisher ↗
Multiple sclerosis is the most common demyelinating disease that develops in genetically predisposed individuals through various immunopathological mechanisms induced by environmental factors, especially viral infections...
Multiple sclerosis is the most common demyelinating disease that develops in genetically predisposed individuals through various immunopathological mechanisms induced by environmental factors, especially viral infections. Th1, Th17, γδ T cells, activated macrophages, MAIT cells, and proinflammatory cytokines, particularly IFN-γ, TNF, IL-17, and GM-CSF, are the principal pathological players whose activities cause damage to the white matter. Furthermore, a recently identified subset of CD4+ T cells has been found to migrate directly to the brain cortex and cause damage to neurons. In 2022, a new mechanism was discovered in addition to these processes. It was shown that molecular mimicry between the EBNA-1 antigen of the Epstein-Barr virus and the GlialCAM molecule of glial cells forms the basis that triggers the entire pathological process. EBV is a highly B cell-tropic human herpesvirus that placed B cells at the centre of our attention. As a result, we must down-regulate their numbers using anti-CD20 monoclonal antibodies to treat such patients (Tab. 1, Fig. 1, Ref. 37). Keywords: multiple sclerosis, GlialCAM, HLA-DR15, T-, B-, MAIT-cells, EBV, monoclonal antibodies.
Pharmacology and toxicology of kratom.
Pohanka M
Bratisl Lek Listy · 2023 · PMID 37983284 · Publisher ↗
The term kratom is commonly used for both Mitragyna speciosa and herbal products prepared mainly from leaves. Kratom is well known as a drug that can serve as a less toxic and less-addictive pain-relieving substitute for...
The term kratom is commonly used for both Mitragyna speciosa and herbal products prepared mainly from leaves. Kratom is well known as a drug that can serve as a less toxic and less-addictive pain-relieving substitute for opium, as well as a therapy for hypertension, cough, and diarrhea. Its major alkaloid, mitragynine, also deserves concern. However, most people use kratom as a psychological stimulant, which carries a risk of addiction associated with negative social and health impacts. This paper reviews basic facts about kratom and its potential use in pharmacology, pharmacokinetics, and pharmacokinetics of its major alkaloid mitragynine (Tab. 3, Fig. 1, Ref. 87). Keywords: 7-hydroxymitragynine; alkaloid; anesthetics; antitussive; drug; mitragynine; Mitragyna speciosa; addictive substance; opioid receptor.
The effects of local anesthetics on cancer cells.
Humplikova S, Priscakova P, Repiska V
Bratisl Lek Listy · 2023 · PMID 37983283 · Publisher ↗
During cancer surgery, the perioperative period is characterized by stress response and immunosuppression that can lead to further worsening of the disease and metastatic spread. Local anesthetics have antiproliferative,...
During cancer surgery, the perioperative period is characterized by stress response and immunosuppression that can lead to further worsening of the disease and metastatic spread. Local anesthetics have antiproliferative, cytotoxic and antimetastatic effects on cancer cells in vitro. There is scientific evidence that local anesthetics possess anti-inflammatory effects, help to preserve normal immune function and reduce the possibility of metastatic spread. Anesthetic care affects pain, inflammation, and immunosuppression, which may have a great impact on the outcome of oncological patients. The use of local anesthetics during the perioperative period in oncological patients may have a beneficial effect on their survival and cancer recurrence. This article summarizes the effects of local anesthetics in vitro (Tab. 1, Fig. 1, Ref. 36). Keywords: local anesthetics, cancer cells.
Relation between carotid intima-media thickness, serum paraoxonase levels and severity of obstructive sleep apnea syndrome.
Akkurt ES, Savas Bozbas S, Eroglu S … +4 more , Ozcalik E, Ozturan Ozer E, Akinci Ozyurek B, Oner Eyuboglu F
Bratisl Lek Listy · 2023 · PMID 37983282 · Publisher ↗
NTRODUCTION: Obstructive sleep apnea (OSA) has a significant effect on the development of cardiovascular complications. The aim of this study was to evaluate the relationship between carotid intima-media thickness (IMT),...
NTRODUCTION: Obstructive sleep apnea (OSA) has a significant effect on the development of cardiovascular complications. The aim of this study was to evaluate the relationship between carotid intima-media thickness (IMT), paraoxonase 1 (PON 1) enzyme levels and severity of OSA. MATERIAL AND METHODS: A total of 120 cases were included in the study with 30 cases in each group, as follows: Group 1 (AHI 30/h). Blood samples of the patients were taken to measure serum PON1 activity. Carotid IMT of all patients included in the study was measured by means of echocardiography using vascular probe and results were recorded. RESULTS: With regard to carotid IMT, a statistically significant increase was detected as severity of OSA increased (p < 0.001). A positive relationship was detected between IMT level and total oxygen desaturation time, oxygen desaturation index and SpO2 time < 90 % (p < 0.01). When the groups were compared, a statistically significant decline was observed in serum PON 1 level as severity of OSA increased (p < 0.05). CONCLUSIONS: The findings of our study indicate that PON1 and carotid IMT might be used as indicators of vascular damage in patients with OSA. Depending on the severity of OSA, measurement of PON1 enzyme activity in conjunction with carotid IMT may help us in predicting the cardiovascular risk in patients with OSA (Tab. 4, Fig. 2, Ref. 27).
Incidence and severity of dysphagia after anterior cervical discectomy and fusion with zero-profile spacer: prospective study with 3-years follow-up.
Opsenak R, Snopko P, Sutovsky J … +4 more , Micurova G, Matuska T, Richterova R, Kolarovszki B
Bratisl Lek Listy · 2023 · PMID 37983281 · Publisher ↗
INTRODUCTION: Dysphagia after anterior cervical discectomy and fusion (ACDF) is a regular complication. The aim of this study was to identify risk factors for incidence and severity of dysphagia after ACDF with zero-prof...
INTRODUCTION: Dysphagia after anterior cervical discectomy and fusion (ACDF) is a regular complication. The aim of this study was to identify risk factors for incidence and severity of dysphagia after ACDF with zero-profile spacer. METHODS: Incidence and severity of dysphagia was evaluated preoperatively and for time of three years after ACDF (regular outpatient check-ups) ‒ prospective study with 3-years follow-up. Severity of dysphagia was assessed subjectively using Bazaz‒Yoo dysphagia score. Influence of selected factors on the incidence and severity of postoperative dysphagia was evaluated. Following statistical methods were used: Fisher's exact test, unpaired Student's t-test, one-way ANOVA and Spearman's correlation coefficient. Level of significance was defined as p ˂ 0.05. Correlations between paired parameters were evaluated according to Spearman's correlation. RESULTS: Our study included 133 patients who underwent one-, two- or three-level ACDF with zero-profile spacer in years 2013‒2018. Myelopathy and GERD had significant impact on incidence and severity of pre-existing dysphagia. Risk factors for incidence of dysphagia after ACDF were number of treated segments, myelopathy, pre-existing dysphagia and surgery of C4/5 segment. Age of patients, duration of surgery and pre-existing dysphagia correlated positively very weakly to weakly with severity of dysphagia after ACDF. Number of treated segments, myelopathy, GERD and surgery of the C4/5 segment were risk factors for greater severity of postoperative dysphagia. CONCLUSION: Risk factors for incidence and severity of pre-existing dysphagia were myelopathy and GERD. Risk factors for dysphagia incidence after ACDF were number of treated segments, pre-existing dysphagia, myelopathy and surgery of C4/5 segment (Tab. 6, Fig. 1, Ref. 30).
20-year follow-up and comparison of homografts with bovine jugular vein conduits in children less than 2 years of age.
Sabateen F, Nosal M, Sojak V
Bratisl Lek Listy · 2023 · PMID 37983280 · Publisher ↗
OBJECTIVES: Repair of congenital heart defects involving right ventricular outflow tract (RVOT) may require pulmonary valve replacement at time of primary repair or reoperation. This study compares the outcomes of cryop...
OBJECTIVES: Repair of congenital heart defects involving right ventricular outflow tract (RVOT) may require pulmonary valve replacement at time of primary repair or reoperation. This study compares the outcomes of cryopreserved homografts with bovine jugular vein conduits (BJVC) in children < 2 years of age with RVOT reconstruction. METHODS: Retrospective, single-center review of 70 conduits implanted in 63 patients undergoing right ventricle-to-pulmonary artery reconstruction with valved conduit from 2002 to 2022. RESULTS: A total of 70 conduits were implanted in 63 patients, with mean age of 4.5 ± 6.9 months (range 1 day ‒ 23.5 months). The following conduits were used; homografts 38 (54.2 %), BJVC 32 (45.8 %). During mean follow-up of 6.2 ± 5.6 years, there were 12 deaths, 24 conduit reoperations, and 25 catheter reinterventions. Overall survival, reoperation-free, and catheter reintervention-free survival at 15 years was 82.7 %, 31.2 %, and 25.7 %, respectively. Multivariate analysis revealed that low patient weight, age < 30 days at repair, ventilation time, and ICU length of stay were associated with increased risk of death. CONCLUSION: The performance of homografts and BJVC is comparable in patients ent between the two groups (Tab. 3, Fig. 3, Ref. 16).
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