Bratislavske Lekarske Listy[JOURNAL]
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200 papers
Catatonia during COVID-19 pandemic - diagnostic and therapeutic approach.
Valkucakova V, Bezakova G, Sutovsky S … +1 more , Izakova L
Bratisl Lek Listy · 2023 · PMID 37789789 · Publisher ↗
Catatonia can be defined as an etiologically heterogeneous syndrome, with predominant psychomotor disturbances. Historically, the concept of catatonia has been associated with mental disorders, especially schizophrenia....
Catatonia can be defined as an etiologically heterogeneous syndrome, with predominant psychomotor disturbances. Historically, the concept of catatonia has been associated with mental disorders, especially schizophrenia. However, nowadays our understanding of catatonia has evolved to recognize it as neuropsychiatric syndrome that can arise from diverse etiological factors ranging from neurological to systemic diseases. Furthermore, there is now a recognized association between catatonia and a broader spectrum of mental disorders. Catatonia as a secondary neuropsychiatric syndrome may be a clinical manifestation of COVID-19 also due to the known neuroinvasive potential of the SARS-CoV-2 virus or in connection with the overall somatic alteration of the patient. In clinical practice, co-infection with SARS-CoV-2 could impede the process of diagnosing and treating catatonia as the primary psychopathological syndrome. The administration of benzodiazepines and electroconvulsive therapy could endanger the patient's physical health with active COVID-19 infection. Management of catatonic syndrome associated with COVID-19 is a challenge and requires a comprehensive therapeutic approach. The article demonstrates the above-mentioned difficulties of treatment through two case presentations (Tab. 2, Ref. 29). Text in PDF www.elis.sk Keywords: catatonia, COVID-19, SARS-CoV-2, neuropsychiatry, diagnosis, differential.
Risk of genitourinary malignancy in patients that receive anticoagulant or antiplatelet therapy.
Rysankova K, Vrtkova A, Viktoria MG … +2 more , Vesela A, Krhut J
Bratisl Lek Listy · 2023 · PMID 37789788 · Publisher ↗
OBJECTIVES: Haematuria is a common indication for a urology evaluation. In many cases, its cause is not determined unequivocally, but it does not pose any threat to the patient. However, it can represent the first sympto...
OBJECTIVES: Haematuria is a common indication for a urology evaluation. In many cases, its cause is not determined unequivocally, but it does not pose any threat to the patient. However, it can represent the first symptom of urinary tract cancer. BACKGROUND: The present study aimed to compare the risk of urological malignancies in patients with haematuria who received antiplatelet or anticoagulant therapy versus those who did not. METHODS: This prospective study included 562 patients with haematuria during the period of 2018‒2021. Among these, 129 patients had macroscopic haematuria. All patients underwent a urinary tract ultrasound, CT with urography, and cystoscopy. Patients with suspected malignancy underwent an appropriate surgical procedure with a pathology examination. Data were analysed with univariate and multiple logistic regression. RESULTS: The incidence rates of malignancies were 21.5 % overall, and 44.2 % and 14.8 % among patients with macroscopic and microscopic haematuria, respectively. Univariate regression showed that the odds of malignancy was significantly higher among patients with antiplatelet therapy compared to patients without antiplatelet therapy (OR: 1.88, 95% CI: 1.14‒3.05). In contrast, anticoagulation therapy did not significantly increase the odds of malignancy compared to no anticoagulation therapy (OR: 1.45, 95% CI: 0.74‒2.69). However, a multiple logistic regression model that included other known risk factors (e.g., sex or age) showed similar odds of malignancy among these patient groups. CONCLUSIONS: Malignancy risk for patients who received anticoagulant or antiplatelet therapy was similar to the risk observed in the general population. Antiplatelet and anticoagulant therapy were not significant risk factors of urological malignancy in patients with haematuria. The results from the present study will be used in a power analysis for an upcoming multicentre study (Tab. 4, Ref. 17). Text in PDF www.elis.sk Keywords: anticoagulation therapy, antiplatelet therapy, cancer, haematuria, risk factor.
Pelvic floor muscle injuries in women with a history of Caesarean section.
Melnikova L, Ostatnikova M, Psenkova P … +5 more , Matusikova Z, Kollarova K, Serator V, Borovska L, Zahumensky J
Bratisl Lek Listy · 2023 · PMID 37789787 · Publisher ↗
OBJECTIVE: The aim of the paper is to determine the prevalence of levator ani muscle injuries and identify risk factors among women undergoing vaginal birth after Caesarean section (VBAC) compared to those with elective...
OBJECTIVE: The aim of the paper is to determine the prevalence of levator ani muscle injuries and identify risk factors among women undergoing vaginal birth after Caesarean section (VBAC) compared to those with elective repeat Caesarean section (ERCS). MATERIAL AND METHODS: This prospective observational comparative study was conducted at the 2nd Clinic of Gynaecology and Obstetrics of FM CU and UN Bratislava. Women with a history of one Caesarean section were included in the study. They were divided into those who had a successful VBAC and those who delivered by ERCS. The mothers underwent a 3D/4D ultrasound examination of the pelvic floor muscles 3‒5 days after childbirth. The study evaluates the frequency and risk factors of avulsion injury of the levator ani muscle (LAM) in a group of 46 women after a successful vaginal delivery after a previous Caesarean section and 32 women after ERCS using 3D/4D transperineal ultrasound examination of the pelvic floor. RESULTS: A total of 78 women were included in the study, 46 after VBAC and 32 after ERCS. In the first group, we recorded LAM avulsion injury in 13 cases (28.3 %); in the post-ERCS group, we did not record this injury (p < 0.0001). We also found an overdistended hiatal area (21.0 vs 19.4 cm2) and a more frequent occurrence of the area exceeding 25 cm2 (21.3 % vs 6.2 %, p = 0.0340) which was approaching the statistical significance. In the first group, we identified an increase in weight during pregnancy to 15 kg and a neonatal birthweight of 4,000 g or higher as risk factors for LAM injury. CONCLUSION: In the group of women with VBAC, there is a statistically significant risk of LAM avulsion and a higher occurrence of the overdistended area of the hiatus urogenitalis, especially in women with larger foetuses and in those who experienced greater weight gain during pregnancy (Tab. 3, Ref. 50). Text in PDF www.elis.sk Keywords: pelvic floor, levator ani muscle avulsion, vaginal birth after Caesarean section.
Urinary tract infection in the context of mini-invasive procedures after kidney transplantation.
Kleinova P, Beliancinova M, Vnucak M … +3 more , Granak K, Mokan M, Dedinska I
Bratisl Lek Listy · 2023 · PMID 37789786 · Publisher ↗
INTRODUCTION: The use of antibiotic prophylaxis in invasive procedures is generally accepted and highly recommended. The question is the need to apply antibiotic prophylaxis even in the case of mini-invasive procedures i...
INTRODUCTION: The use of antibiotic prophylaxis in invasive procedures is generally accepted and highly recommended. The question is the need to apply antibiotic prophylaxis even in the case of mini-invasive procedures in the post-transplantation period. The aim of the study was to dermine the occurrence of infectious complications during mini-invasive procedures (pig-tail extraction, protocol biopsy) withou the use of antibiotic (ATB) prophylaxis. The secondary aim was to identify risk factors for a positive urine culture finding at the time of mini-invasive procedures. MATERIAL: This is a prospective monocentric study in which pacients after kidney transplantation at Transplantation centrum in Martin were included (n = 68). We investigated the incidence of positive urine findings at the time of pig-tail extraction (6 weeks after transplantation) and at the time of protocol biopsy (3 months after transplantation) with comparison within the group with and without ATB prophylaxis. RESULTS: Patients in group without ATB prophylaxis had a significantly higher tacrolimus value at the time of pig-tail extraction (p = 0.0274) and a significantly higher dose of mycophenolic acid at the time of protocol biopsy (p = 0.0429). We did not confirm significant difference in occcurence of positive urine findings at the time of pig-tail extraction or at the time of protocol biopsy. We completed a univariate logistic regression in order to identify a potential risk predictor for positive urine findings at the time of pig-tail extraction and protocol biopsy. None of the monitored parameters, including ATB prophylaxis, was confirmed as risk or protective factor. CONCLUSION: The use of antibiotic prophylaxis during mini-invasive procedures (pig-tail extraction, protocol biopsy) in the posttransplantation period had no effect on positive culture findings at our department. Based on our analysis, we therefore do not use antibiotic prophylaxis in the case of these procedures at our centre (Tab. 3, Fig. 6, Ref. 23).
Geriatric mortality risk factors in emergency department for non-traumatic abdominal pain.
Kanbakan A, Cakmak F, Ipekci A … +2 more , Akdeniz YS, Ikizceli I
Bratisl Lek Listy · 2023 · PMID 37635670 · Publisher ↗
OBJECTIVES: The study aimed to determine the factors affecting the mortality of geriatric patients presenting to the emergency department with non-traumatic abdominal pain, as well as the associations of these factors wi...
OBJECTIVES: The study aimed to determine the factors affecting the mortality of geriatric patients presenting to the emergency department with non-traumatic abdominal pain, as well as the associations of these factors with mortality. BACKGROUND: With the increasing number of elderly patients, early recognition of patients with risk-bearing diagnoses is crucial. METHODS: This prospective cross-sectional study included 466 patients over 65 years of age who were admitted to THE emergency department of a tertiary hospital and consented to participate. Data was collected on patient demographics, vital signs, chronic diseases, laboratory investigations, diagnoses, disposition, and 30-day mortality. RESULTS: The results showed that the mean patient age was 74.42 years, with 47.4 % being male and 52.6 % female. 15.6 % of the patients had nonspecific causes. The risk of mortality within one month was 5.797 times higher in patients with neurological diseases and 5.183 times higher in those with a history of surgery. A one-unit decrease in hemoglobin increased the mortality risk by 0.656 times. CONCLUSION: This study highlights the importance of careful evaluation of elderly patients with neurological diseases, previous surgical history, and anemia in the emergency department with non-traumatic abdominal pain (Tab. 5, Ref. 18).
Molecular mechanisms of antidiabetic effect of betulinic acid in lotus rhizome.
De Silva D, Senarath U, Perera PK
Bratisl Lek Listy · 2023 · PMID 37635669 · Publisher ↗
OBJECTIVES: To explain the bio-physiological mechanisms of the antidiabetic effect of betulinic acid in Lotus rhizome. BACKGROUND: Even though Sri Lankan native medicine uses Lotus rhizome as a medicinal food for diabete...
OBJECTIVES: To explain the bio-physiological mechanisms of the antidiabetic effect of betulinic acid in Lotus rhizome. BACKGROUND: Even though Sri Lankan native medicine uses Lotus rhizome as a medicinal food for diabetes mellitus, its antidiabetic property has not been scientifically explained yet. It is found to compose several medicinally active components with antidiabetic properties, including Betulinic acid. METHODS: A narrator review was conducted with a literature search in PubMed and Google Scholar databases using the search terms "Nelumbo nucifera rhizome", "Lotus rhizome", "phytochemicals", "antidiabetic effect", "hypoglycaemic effect" "Betulinic acid", and "molecular mechanism". RESULTS: The triterpenoid, Betulinic acid exerts its antidiabetic effect via seven bio-physiological mechanisms including, inhibiting α-glucosidase and α-amylase, upregulating the expression of peroxisome proliferator-activated receptor gamma coactivator-1 α, enhancing AS160 protein phosphorylation, stimulating adenosine monophosphate-activated protein kinase activation, stimulating Glucose transporter type 4 synthesis and translocation, inhibiting Protein Tyrosine Phosphatase 1 B activity preventing dephosphorylation of insulin receptor and stimulating Takeda-G-protein-receptor-5 resulting in an increased release of insulin from insulin-containing granulesCONCLUSION: The available scientific knowledge explains that betulinic acid in Lotus rhizome can improve glucose homeostasis contributing to the antidiabetic effect of this root (Tab. 1, Fig. 6, Ref. 29).
Rutaecarpine ameliorates cardiomyocyte injury induced by high glucose by promoting TRPV1-mediated autophagy.
Song C, Gong Z, Ji Y
Bratisl Lek Listy · 2023 · PMID 37635668 · Publisher ↗
AIM: Diabetic cardiomyopathy (DCM) is a dominant factor contributing to diabetic death. Rutaecarpine has many cardiovascular biological effects and anti-high-glucose activity. Therefore, this paper aimed to investigate t...
AIM: Diabetic cardiomyopathy (DCM) is a dominant factor contributing to diabetic death. Rutaecarpine has many cardiovascular biological effects and anti-high-glucose activity. Therefore, this paper aimed to investigate the impact of rutaecarpine on high glucose (HG)-elicited cardiomyocyte injury. METHOD: Cell counting kit 8 (CCK-8) and 5-ethynyl-2'-deoxyuridine (EdU), TdT-mediated dUTP Nick-End Labeling (TUNEL) assays judged H9c2 cell activity and apoptosis, and oxidative stress was assessed by corresponding assay kits. The expression of apoptosis, oxidative stress, autophagy-associated factors and TRPV1 were examined with western blot. IF assay tested GFP-LC3 expression. RESULTS: As a result, rutaecarpine had no obvious effect on the viability of H9c2 cells while elevated HG-exposed H9c2 cell viability. Rutaecarpine inhibited the apoptosis and oxidative stress of H9c2 cells induced by HG. In addition, rutaecarpine activated TRPV1 to induce autophagy. However, inhibition of TRPV1 inactivated the autophagy, which drove HG-evoked H9c2 apoptosis and oxidative stress. CONCLUSIONS: In conclusion, rutaecarpine suppressed HG-stimulated H9c2 cell viability injury, apoptosis as well as oxidative stress via promoting TRPV1-mediated autophagy (Fig. 10, Ref. 40).
Inhalation of multi-wall carbon nanotubes changes the expression of apoptosis and cancer genes in rat brain and lungs.
Samiei F, Torshabi M, Shirazi FH … +2 more , Azari MR, Pourahmad J
Bratisl Lek Listy · 2023 · PMID 37635667 · Publisher ↗
One of the important issues in urban areas is air pollution which causes respiratory disorders. A significant association between exposure to inhaled particulate matter (PM), mainly ultrafine particles, and increased neu...
One of the important issues in urban areas is air pollution which causes respiratory disorders. A significant association between exposure to inhaled particulate matter (PM), mainly ultrafine particles, and increased neurological and pulmonary morbidity and mortality was observed in some research. This study aimed to demonstrate the relation between multi-wall carbon nanotubes (MWCNTs) inhalation and the carcinogenic effect of these materials in the brain and lungs. For this purpose, we investigated gene expression in rat brain and lung tissues induced by exposure to MWCNTs. Rats were exposed to MWCNTs in diameters of 10 and 100 nm (pure and impure) at a concentration of 5 mg/m3. Exposure was done through a whole-body exposure chamber for 5 h/day, 5 days/week for 14 days. After exposure, both brain and lung tissues were isolated to evaluate certain gene expressions including Bax, Bcl2, Rac1, Tp53, Mmp12, and Arc. The results showed that exposure to impure and pure MWCNTs (10 and 100 nm) at a concentration of 5 mg/m3 causes up-regulation or down-regulation of some of these genes. The results suggest that impure and pure MWCNTs (10 and 100 nm) can increase the risk of central nervous system disorders such as Alzheimer's disease and increase the risk of carcinogenesis in the lung tissues of rats exposed to MWCNTs (Tab. 2, Fig. 2, Ref. 64). Text in PDF www.elis.sk Keywords: multi-wall carbon nanotube, inhalation, gene expression, carcinogenicity, brain, lung.
Diagnostic value of the preoperative platelet/lymphocyte ratio and red cell distribution volume in patients with renal masses.
Bulut N, Unsal A, Erdem GU … +1 more , Simsek A
Bratisl Lek Listy · 2023 · PMID 37635666 · Publisher ↗
OBJECTIVES: Inflammatory markers indicate immune system responses. BACKGROUND: We retrospectively explored whether the platelet/lymphocyte ratio (PLR), neutrophil/lymphocyte ratio (NLR), and red blood cell distribution w...
OBJECTIVES: Inflammatory markers indicate immune system responses. BACKGROUND: We retrospectively explored whether the platelet/lymphocyte ratio (PLR), neutrophil/lymphocyte ratio (NLR), and red blood cell distribution width (RDW) were predictive of malignant disease. MATERIAL AND METHODS: Between 2019 and 2023, 148 patients diagnosed with malignant and benign renal tumors via imaging or biopsy were included. Of these tumors, 117 were malignant and 31 were benign. Blood samples were taken for calculation of the NLR, PLR, and RDW prior to renal biopsy or operation. RESULTS: The NLR, PLR, and RDW did not differ significantly between patients with malignant and benign renal masses (all p > 0.05). The PLR significantly increased with the T stage of malignant masses (p = 0.011). According to the T stage, the RDW cutoff was 45.7, the sensitivity was 40 %, and the specificity 82.4 %; the respective values for PLR were 134.9, 70 %, and 70.5 % (p = 0.026 and p = 0.003, respectively). CONCLUSION: The NLR, PLR, and RDW were not predictive in this study because we only included early- stage patients lacking lymph node involvement and the follow-up was short. In patients with renal cell carcinomas, the RDW and PLR increase with the tumor burden and predict poor prognosis (Tab. 5, Fig. 1, Ref. 23). Text in PDF www.elis.sk Keywords: neutrophil/lymphocyte ratio, platelet/ lymphocyte ratio, renal mass.
Abnormal kidney ultrasound and function in a five-year-old boy born prematurely with a birth weight of 370 grams.
Konopasek P, Korcek P, Kodytkova A … +6 more , Flachsova E, Frantova M, Koci M, Stranak Z, Janda J, Zieg J
Bratisl Lek Listy · 2023 · PMID 37635665 · Publisher ↗
It is known that prematurity and low birth weight are associated with chronic kidney disease and hypertension. A positive correlation between kidney volume and birth weight was also described. In our ongoing observationa...
It is known that prematurity and low birth weight are associated with chronic kidney disease and hypertension. A positive correlation between kidney volume and birth weight was also described. In our ongoing observational study in 5-year-old children, we perceived highly abnormal kidney ultrasound and functions of a male patient born weighing 370 grams. It was his first nephrology examination since discharge from the hospital. We believe that thorough follow up and timely diagnosis of developing renal insufficiency may help us to initiate proper treatment in high-risk children (Tab. 1, Fig. 1, Ref. 7). Text in PDF www.elis.sk Keywords: prematurity; extremely low birth weight; chronic kidney disease; renal ultrasound; renal function.
Thrombocyte decrease and hemoglobin level as simple non-inflammatory predictors of anastomotic leakage in rectal-cancer surger.
Rezac T, Vrba R, Klos D … +4 more , Zboril P, Spicka P, Klementa I, Starý L
Bratisl Lek Listy · 2023 · PMID 37635664 · Publisher ↗
PURPOSE: The study aimed to determine a simple diagnostic test that could predict the risk of anastomotic leakage in early postoperative period. METHODS: A single-center, retrospective study was conducted. The electronic...
PURPOSE: The study aimed to determine a simple diagnostic test that could predict the risk of anastomotic leakage in early postoperative period. METHODS: A single-center, retrospective study was conducted. The electronic medical records of patients who underwent resection for rectal tumor between January 1, 2016, and December 31, 2021, in University Hospital Olomouc, were reviewed. The data included risk factors for leakage and laboratory parameters commonly obtained. RESULTS: The decrease in platelets was significant as for the possibility of being a marker of anastomotic leakage; OR = 0.980 (p = 0.036). A decrease of 34 or higher predicts leakage with a sensitivity of 45 % (95 % CI: 23.1-68.5 %) and specificity of 81.1 % (95 % CI: 75.2-86.1 %). Postoperative leukocyte blood level (OR = 1.134; p = 0.019) and leukocyte level on postoperative day 1 (OR = 1.184; p = 0.023) were significant predictors for leakage. WBC values ≥ 8.8 predict leakage with a sensitivity of 70.0 % (95 % CI: 45.7-88.1 %) and specificity of 55.3 % (95 % CI: 48.4-62.0 %). Hemoglobin blood level ≤ 79.5 predicts leakage with a sensitivity of 70.0 % (95 % CI: 45.7-88.1 %) and specificity of 62.2 % (95 % CI: 55.5-68.7 %). CONCLUSION: Despite the fact that the specificity and sensitivity of the followed parameters are low, they could serve as markers useful for early diagnosis or suspicion for leakage (Tab. 5, Fig. 3, Ref. 14).
The role of computed tomography pulmonary angiography in COVID-19 patients with suspected pulmonary embolism.
Stevik M, Zelenak K, Dzian A … +10 more , Jakus J, Trabalkova Z, Lozan D, Grendar M, Sykora J, Vorcak M, Malik M, Meyer L, Kopani M, Fiehler J
Bratisl Lek Listy · 2023 · PMID 37635663 · Publisher ↗
OBJECTIVES: This study is aimed to determine the location and distribution of pulmonary embolism (PE) and presence of signs potentially indicative of right heart overload on computed tomography pulmonary angiography (CTP...
OBJECTIVES: This study is aimed to determine the location and distribution of pulmonary embolism (PE) and presence of signs potentially indicative of right heart overload on computed tomography pulmonary angiography (CTPA) in COVID-19 and non-COVID-19 patients. We also evaluated the extent and severity of COVID-19-associated lung changes in relation to PE. METHODS: The total number of 1,698 patients with CTPA included in the study were divided into 2 groups according to their COVID-19 status and each group was divided into 2 subgroups based on their PE status. These groups and subgroups were compared in terms of location of PE, diameter of pulmonary artery, right heart strain, ground-glass opacities (GGO), consolidations and other imaging features. RESULTS: In COVID-19 patients, there was a significant predominance of PE in peripheral branches of pulmonary artery (p < 0.001). There was an increased right-to-left ratio of ventricular diameters in cases with PE (p = 0.032 in patients with COVID-19 and p < 0.001 in non-COVID-19 patients). There was no association between the extent and severity of the disease and distribution of PE. CONCLUSION: COVID-19 is associated with a higher incidence of peripheral location of PE and presence of GGO. There were signs indicative of right heart overload in cases with PE regardless of COVID-19 (Tab. 3, Fig. 1, Ref. 29) Keywords: COVID-19, computed tomography, CTPA, pneumonia, pulmonary embolism.
Traditional and deep learning-oriented medical and biological image analysis.
Zdimalova M, Ghosh M, Lasker A … +4 more , Obaidullah SKM, Shvydka RPS, Boratkova K, Kopani M
Bratisl Lek Listy · 2023 · PMID 37635662 · Publisher ↗
We investigated various methods for image segmentation and image processing for the segmentation of MRI of human medical data, as well as bioinformatics for the segmentation of brain cell details, in this work. The goal...
We investigated various methods for image segmentation and image processing for the segmentation of MRI of human medical data, as well as bioinformatics for the segmentation of brain cell details, in this work. The goal is to demonstrate and bring various mathematical analyses for medical and biological image analysis. We proposed new software and methods for improving the segmentation of biological and medical data. This way, we can find new ways to improve the diagnostic process in medical data and improve results in cell and iron diagnostics. We present the GrabCut algorithm as well as new, improved software for this part, a fuzzy approach and fuzzy processing of tissues, and finally machine‑learning techniques with neural networks. We implemented the new software in the C++ programming language for the Grab cut algorithm. Consequently, we present a fuzzy approach to the diagnosis of image data in Matlab. Finally, a deep learning-based approach is used, with a U-Net-based segmentation architecture proposed to measure the various brain cell parameters. We will be able to proceed with data that we were unable to proceed when using other methods. As a result, we improved biological and medical data segmentation to obtain better boundaries and sharper edges on the objects. There is still space to extend these methods to other medical and biological applications (Tab. 1, Fig. 34, Ref. 46). Keywords: segmentation; image processing; fuzzy segmentation, GrabCut, deep learning.
Understanding cognitive frailty in aging adults: prevalence, risk factors, pathogenesis and non-pharmacological interventions.
Gajdosova L, Jakus V, Muchova J
Bratisl Lek Listy · 2023 · PMID 37635661 · Publisher ↗
The worldwide increase in the aged population raises health concerns for elderly individuals. Cognitive frailty of the elderly (apart from those suffering from Alzheimer´s disease or other type of dementia) is a complex...
The worldwide increase in the aged population raises health concerns for elderly individuals. Cognitive frailty of the elderly (apart from those suffering from Alzheimer´s disease or other type of dementia) is a complex construct associated with aging, which is composed of physical and cognitive components, while physical frailty and cognitive impairment mutually affect each other. Although the prevalence of cognitive frailty in community-dwelling older adults without neurodegenerative disease is low, it can rise dramatically in clinical settings. Early identification of this condition can contribute to delaying the adverse outcomes that lead to higher mortality rates. This review aims to define cognitive frailty, its prevalence, risk factors, and pathogenesis, while highlighting the need for further research on identification, prevention, and non-pharmacological management of cognitive frailty in older adults in view of promoting healthy aging and secondary prevention strategies for dementia (Fig. 1, Ref. 93). Keywords: cognitive frailty, older adults, risk factors, nutrition, exercise.
Cognitive changes associated with cerebral emboli during coronary intervention.
Viszlayova D, Skoloudik D, Brozman M … +6 more , Langova K, Herzig R, Valis M, Kurray P, Patrovic L, Kiralova S
Bratisl Lek Listy · 2023 · PMID 37635660 · Publisher ↗
OBJECTIVE: To investigate factors influencing the frequency and type of microembolic signals (MES) detected using transcranial Doppler (TCD) in patients undergoing elective coronary intervention, and to correlate MES wit...
OBJECTIVE: To investigate factors influencing the frequency and type of microembolic signals (MES) detected using transcranial Doppler (TCD) in patients undergoing elective coronary intervention, and to correlate MES with silent stroke detected using magnetic resonance imaging (MRI) and cognitive dysfunction. METHODS: The subset study of a randomized clinical trial was conducted on 70 patients (58 males; mean age 59.9 ± 8.4 years) who underwent bilateral TCD monitoring of middle cerebral arteries (MCAs) during elective coronary interventions. Neurologic examination and brain MRI were performed prior to, and 24 h post‑intervention. Cognitive function tests were performed prior to, and on day 30 post‑intervention. RESULTS: The incidence of detected MES was 94.3 %. Eighteen (25.7 %) patients had new clinically asymptomatic ischemic lesions on MRI. The number of solid MES negatively correlated with changes in revised Addenbrooke's Cognitive Examination test (ACE-R) and, the number of solid MES and combinations of solid and gaseous MES negatively correlated with changes in Mini Mental‑State Examination (MMSE) conducted on day 30 after the intervention (p < 0.05 in all cases). CONCLUSION: Cardiac catheterization was associated with a high risk of cerebral embolism in our patients. A higher number of solid MES and combinations of solid and gaseous MES was associated with the deterioration in cognitive tests (Tab. 5, Fig. 3, Ref. 30).
Surgery for cardiac myxomas: 12-year experience.
Gasparovic I, Artemiou P, Bezak B … +2 more , Michut S, Hulman M
Bratisl Lek Listy · 2023 · PMID 37635659 · Publisher ↗
INTRODUCTION: Cardiac myxoma is a rare benign cardiac tumor observed in approximately 0.5-1 case per 1 million people per year. The aim of this study is to review our 12-year experience in the surgical treatment of cardi...
INTRODUCTION: Cardiac myxoma is a rare benign cardiac tumor observed in approximately 0.5-1 case per 1 million people per year. The aim of this study is to review our 12-year experience in the surgical treatment of cardiac myxoma with an emphasis on the clinical, pathologic, diagnostic, and surgical features. METHODS AND PATIENTS: From January 2010 to December 2022, 90 patients (0.67 %) with cardiac myxomas were surgically treated in our institute. Patients´ demographics, cardiac and surgical medical history, surgical procedures, and pre- and post-operative data were analyzed. The median follow-up time was 76 (1-216) months. RESULTS: The mean age of the patients was 59.4 ± 13.5 years, with a higher prevalence of women. The most common preoperative symptoms were arterial embolism and dyspnea, and 35.6 % of patients were asymptomatic. Only 8.9 % of the patients had systemic and constitutional manifestations. The most common location of cardiac myxoma was in the left atrium, followed by the right atrium. Recurrent myxoma developed in 3 patients (2.7 %), and the mean time of recurrence was 55 ± 19.7. Hospital and long-term mortality were 2.2 % and 15.6 %, respectively. CONCLUSION: Cardiac myxoma is the most common heart tumor with a low incidence. Surgical excision yields very good short and long-term outcomes with low recurrence rate after surgery, and remains the treatment of choice (Tab. 4, Fig. 2, Ref. 13). Text in PDF www.elis.sk Keywords: cardiac myxoma, cardiac tumor, recurrence, survival.
Changing profile of infective endocarditis during a 20-year observation period.
Tazina S, Fedorova T, Semenenko N … +3 more , Ilina Y, Mamonov A, Pavlov C
Bratisl Lek Listy · 2023 · PMID 37218496 · Publisher ↗
BACKGROUND: Infective endocarditis (IE) is most often caused by bacteria. OBJECTIVES: The aim of this work is the research of the dynamics of the clinical laboratory and instrumental methods of the diagnostics during the...
BACKGROUND: Infective endocarditis (IE) is most often caused by bacteria. OBJECTIVES: The aim of this work is the research of the dynamics of the clinical laboratory and instrumental methods of the diagnostics during the period of two decades. METHODS: The data of 241 patients with infective endocarditis (IE) who were treated at the State Clinical Hospital named after Botkin S.P. was included in the research. 121 patients were observed from 2011 till 2020 (the first group) and 120 patients - from 1997 to 2004 (the second test group). These data included age and social structure of pathology, peculiarities of clinical picture, laboratory, and instrumental methods of research, as well as the outcome of the disease. We studied the concentrations of procalcitonin and presepsin in patients hospitalized after 2011. We observed pathomorphism of the modern IE. RESULTS: To discover the bacteriological origin of the disease, we found the diagnostic evaluation of inflammation, procalcitonin, and presepsin activities, using C-reactive protein, important. We observed decrease in the number of general and hospital deaths. CONCLUSIONS: The knowledge of the IE peculiarities during the IE progression is essential for timely diagnosis and more accurate pathology prediction (Fig. 5, Ref. 38). Text in PDF www.elis.sk Keywords: infectious endocarditis, valve apparatus disease, thromboembolic complications, immunocomplex complications, procalcitonin, presepsin.
Experience of using genetically engineered biological drugs in children with a systemic form of JIA in the Karaganda region.
Kenzhetaeva T, Kenzhetayeva Z, Meldebekova A … +3 more , Batyrbekova L, Ablasano A, Zhumanova G
Bratisl Lek Listy · 2023 · PMID 37218495 · Publisher ↗
Despite all the achievements of science and medicine, juvenile idiopathic arthritis today remains one of the main childhood diseases that lead to severe irreversible consequences. This, in turn, makes it urgent to search...
Despite all the achievements of science and medicine, juvenile idiopathic arthritis today remains one of the main childhood diseases that lead to severe irreversible consequences. This, in turn, makes it urgent to search for effective drugs for the treatment of juvenile idiopathic arthritis, of which interleukin 1 (anakinra) and interleukin 6 (tocilizumab) inhibitors are becoming increasingly popular. AIM: to analyse the efficacy of genetically engineered biological drugs, namely anakinra and tocilizumab in children with systemic juvenile idiopathic arthritis among patients of the Karaganda region. The study involved 176 patients aged 4-17 years with a diagnosis of systemic juvenile idiopathic arthritis and with resistance to methotrexate for 3 months. Among all patients, 64 children received injections of anakinra, and 63 received tocilizumab in standard doses. The control group consisted of 50 patients of the same age category. Assessment of the efficacy of treatment was conducted at 2, 4, 8, 16, 24, and 48 weeks using ACR Pediatric criteria. The clinical effect of both drugs was detected as early as the second week after the start of therapy. At week 12 of the study in the tocilizumab group, the efficacy of treatment for ACR Pediatric 30, 50, and 70 reached 82 %, 71 %, and 69 %, and in the anakinra group - 89 %, 81 %, and 80 % respectively, while in the control group ACR Pediatric 30 after 12 weeks of treatment was achieved in 21 % of patients, ACR Pediatric 50 - in 12 %, and ACR Pediatric 70 - in 9 % (p Keywords: systemic arthritis, polyarthritis, tocilizumab, anakinra, genetically engineered biological drugs.
Efficiency of interlaminar uniportal endoscopic lumbar discectomy.
Kostysyn R, Hosszu T, Travnicek P … +3 more , Jandura J, Poczos P, Cesak T
Bratisl Lek Listy · 2023 · PMID 37218494 · Publisher ↗
AIM: Prospective evaluation of the results of endoscopic lumbar discectomy. METHODS: 95 patients were consecutively enrolled in the study between 2017 and 2021. We monitored low back pain and sciatica according to the Vi...
AIM: Prospective evaluation of the results of endoscopic lumbar discectomy. METHODS: 95 patients were consecutively enrolled in the study between 2017 and 2021. We monitored low back pain and sciatica according to the Visual Analogue Scale (VAS), the limitations in daily activities (Oswestry Disability Index, ODI), overall satisfaction according to a 0-100 % scale, and the rate of surgical complications and reoperations. RESULTS: Postoperatively, the VAS values of low back pain and sciatica decreased significantly from 5 to 1 point and from 6 to 1 point, respectively, and the pain remained in the tolerable range (VAS 1-2) throughout the follow-up period. The ODI score improved significantly from severe disability (46 %), preoperatively, to moderate disability at discharge and one month after surgery (29 % and 22 %, respectively), down to minimal disability at 3 and 12 months after surgery (12 % and 14 %, respectively). Overall patient satisfaction improved significantly at all follow-up time points (46 %, 70 %, 77 %, 80 %, and 78 %, respectively). Reoperation rate was 6.3 %. Cerebrospinal fluid leakage was observed in one case only (1.1 %). Transient postoperative perianogenital sensory impairment occurred in two patients (2.1 %). There was no evidence of surgical site infection or haematoma. CONCLUSION: Endoscopic discectomy provides significant pain relief and improves the patient's ability to perform activities of daily living, contributing to greater satisfaction. It is a safe method with a low risk of surgical and neurological complications (Tab. 3, Fig. 3, Ref. 27).
Association of lipid parameters with insulin resistance in the Kazakh population.
Shakhanova A, Aukenov N, Nurtazina A … +3 more , Kasskabayeva A, Massabayeva M, Kenzhebayeva D
Bratisl Lek Listy · 2023 · PMID 37218493 · Publisher ↗
BACKGROUND: Insulin resistance (IR) is a consequence of chronic adipose tissue inflammation and underlies the pathogenesis of several diseases, such as type 2 diabetes mellitus, cardiovascular diseases and metabolic synd...
BACKGROUND: Insulin resistance (IR) is a consequence of chronic adipose tissue inflammation and underlies the pathogenesis of several diseases, such as type 2 diabetes mellitus, cardiovascular diseases and metabolic syndrome. In this study, we examined the association between dyslipidaemia and IR; directly comparing conventional lipid ratios and apoB/apoA1 ratios for strength and independence as risk factors for IR in a Kazakh population. METHODS: The design of this study was a case-control study. There were 507 participants in the study. We examined each participant's plasma total cholesterol, triglycerides, high-density lipoprotein, low-density lipoprotein, apolipoprotein B, and apolipoprotein A1. IR was determined using an IR homeostasis model assessment (HOMA-IR). To assess the risk of an atherogenic blood lipid profile, atherogenicity coefficients were calculated: Bad cholesterol to good cholesterol ratio ((TC-HDL)/HDL); TG to HDL ratio (TRG/HDL); apoB to apoA1 ratio (apoB/apoA1). RESULTS: In this study, high waist circumference and BMI were more common in men. The group with IR had significantly higher waist circumference (cm) (p = 0.0001) and BMI (kg/m2) (p = 0.04) than the group without IR. The risk of IR was significantly associated with the apoB/apoA1 ratio (p = 0.03). Analysis of the association between HOMA-IR and apoB/apoA1 ratio increased the risk of IR at apoB/apoA1 ratios of 0.71 to 0.85 and above 0.86 by a factor of 1.93 and 1.84, respectively. HOMA-IR levels were weakly significantly correlated with TG levels (rS = 0.3; p = 0.0001) and very weakly positively correlated with apoB levels (rS = 0.1; p = 0.002) and apoB/apoA1 (rS = 0.1; p = 0.001), there was a weak negative correlation with apoA1 levels (rS = -0.1; p = 0.02). Logistic regression analysis showed that the risk of developing IR was significantly lower in men than in women, adjusted OR (95% CI) = 0.75 (0.49-1.0) p = 0.02. CONCLUSION: In our study, IR was more common in Kazakh women than in Kazakh men. IR was also associated with apoB and TG levels. Thus, we suggest that analysis of TG, apoB and apoB/apoA1 ratio may be recommended as early predictors of IR risk in the Kazakh population (Tab. 3, Ref. 22). Text in PDF www.elis.sk Keywords: insulin resistance, dyslipidaemia, apolipoproteins, triglycerides, lipids.
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