Acta medica (Hradec Kralove)最新文献

Background: Breast cancer is the second leading cause of cancer-related death and the most common type of cancer in women. Recent studies have shown that the development of carcinogenesis is influenced by impaired XRCC1 expression. Therefore, research on the relationship between the XRCC1 Arg399Gln polymorphism and the luminal subtype of breast cancer is important so that it can be used as a reference for further research development.

Methods: This study lasted for 12 months at the Integrated Biomedical Laboratory and Biochemistry Laboratory, Faculty of Medicine, Udayana University. The samples consisted of 30 samples of stored biological material from previous studies with a case-control study design. The status of the XRCC1 Arg399Gln polymorphism was determined by performing PCR on blood samples. Furthermore, the samples were analyzed with SPSS version 25.0.

Results: The number of samples in this study was 15 cases and 15 controls with the majority aged > 50 years. The results of the analysis showed that differences in age groups, menstrual status, and cancer grade were significantly associated with breast cancer subtypes (p < 0.05). Based on the results of sequencing and bivariate analysis, the XRCC1 Arg399Gln polymorphism acted as a protective risk factor for the development of luminal subtype breast cancer (OR = 0.182; p = 0.028).

Conclusion: XRCC1 Arg399Gln polymorphism is associated with the risk of luminal subtype breast cancer in Bali.

Parotid oncocytoma is a rare benign salivary gland tumor, often misdiagnosed due to overlapping features with other parotid neoplasms. We present the case of an 87-year-old male with a progressively enlarging right parotid mass, confirmed as oncocytoma through imaging and histopathological analysis. The excised oncocytoma measured approximately 9 cm in its greatest dimension, making it one of the largest parotid oncocytomas reported in the literature to date. This case highlights the diagnostic challenges associated with parotid oncocytomas, the limitations of fine-needle aspiration, and the importance of comprehensive diagnostic tools. Surgical resection was curative, with no recurrence at 12 months.

Background: Sickle cell anemia (SCA), a form of sickle cell disorder (SCD), is characterized by chronic hemolytic anemia, recurrent acute and persistent pain episodes, and progressive multiorgan complications. Among these, sickle cell nephropathy (SCN) is a significant and severe complication that may advance to chronic kidney disease (CKD), often beginning asymptomatically in childhood. Despite its clinical relevance, data on the early assessment of renal function in patients with SCA remain limited in Nigeria, hindering timely detection and intervention. This study, therefore, investigates the diagnostic utility of urinary kidney injury molecule-1 (KIM-1) as a biomarker for renal dysfunction in patients with steady-state SCA.

Objective: This study assessed urinary kidney injury molecule 1 as an early biomarker of nephropathy in patients with sickle cell anemia.

Method: This cross-sectional comparative study included ninety participants, comprising forty-five individuals with a normal hemoglobin genotype (HbAA) and forty-five with sickle cell anemia (HbSS). Hemoglobin genotype was determined using cellulose acetate electrophoresis. Serum creatinine levels were measured using the modified Jaffe method, and the estimated glomerular filtration rate (eGFR) was calculated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. Urinary kidney injury molecule-1 (KIM-1) concentrations were assessed using the enzyme-linked immunosorbent assay (ELISA) technique.

Results: This study observed no significant difference in mean age between the HbAA and HbSS groups (14.16 ± 2.54 vs. 13.52 ± 3.33 years; p = 0.121). However, the mean body mass index (BMI) was significantly higher in the HbAA group (21.40 ± 1.02 kg/m2) compared to the HbSS group (18.69 ± 2.19 kg/m2; p = 0.004). Serum creatinine levels did not differ significantly between the two groups (p = 0.311). In contrast, urinary KIM-1 levels were significantly elevated in the HbSS group relative to the HbAA group (p r = -0.64, p = 0.005; HbSS: r = -0.79, p = 0.002).

Conclusion: The findings from this study observed no significant difference in serum creatinine levels between individuals with HbAA and HbSS genotypes. However, urinary KIM-1 concentrations were significantly higher in the HbSS group, with a stronger negative correlation with eGFR. These findings suggest that, while serum creatinine may not be effective in detecting early renal impairment in sickle cell anemia, urinary KIM-1 has promising potential for detecting renal dysfunction in this population.

Introduction: Long-term peritoneal dialysis (PD) beyond 10 years is uncommon and reflects both advances in dialysis care and the complexity of long-term patient management. The objective of this study is to describe the clinical characteristics, complications, and outcomes of patients undergoing peritoneal dialysis for more than 10 years, and to identify factors associated with long-term technique survival.

Methods: This is a retrospective, descriptive, and analytical study including 12 patients treated with peritoneal dialysis (PD) for more than 10 years between June 2006 and January 2024. Data collected included demographics, comorbidities, dialysis parameters, complications, and outcomes.

Results: The mean age at PD initiation was 45.5 ± 16.5 years. Tubulointerstitial nephropathy was the most common etiology of end-stage kidney disease. The mean duration on PD was 10.4 ± 0.9 years. During follow-up, residual kidney function significantly declined. Seven patients remained on PD at last follow-up. The peritonitis rate was low (0.024 episodes/patient-month), with favorable technique survival and no cases of encapsulating peritoneal sclerosis.

Discussion: PD beyond 10 years is feasible with proper patient selection, education, and follow-up. Preservation of residual kidney function and effective management of complications are key to long-term success, especially in non-transplantable patients.

Objective: To evaluate whether baseline serum creatinine is associated with survival outcomes in patients with advanced high-grade serous ovarian carcinoma undergoing neoadjuvant chemotherapy.

Methods: We retrospectively analyzed 77 patients treated between 2009 and 2018. Patients were stratified by baseline serum creatinine levels (<84 vs. ≥84 µmol/L), and survival outcomes were assessed using Kaplan-Meier analysis.

Results: No statistically significant differences in progression-free or overall survival were observed between groups. A trend toward shorter OS in the elevated creatinine group did not reach significance.

Conclusion: Baseline serum creatinine was not found to be a statistically significant prognostic marker in this cohort. These results highlight the need for adjusted analyses incorporating established prognostic factors in future research.

Background: Point-of-care testing (POCT) helps accelerate and streamline many processes in primary care. However, there is little information on the characteristics of their users.

Methods: Data were provided by the largest Czech health insurance company, covering 60% of the population. A proprietary spatial categorization model based on OECD typology, adapted to Czech primary care conditions, was used for localization.

Results: In all monitored groups, we observed continuous growth in the number of general practices using POCT methods, unaffected by Covid-19. Absolute numbers of POCT-INR and POCT-CRP examinations decreased during the pandemic years. The number of POCT-INR tests is more affected by practice location, while the number of POCT-CRP tests is influenced by the age of GPs.

Conclusions: Although POCT methods are a voluntary part of general practitioners' office equipment in Czechia, their more frequent use indicates that system-level conditions are appropriately set. The interest of GPs aged 60+ is surprising. Despite using POCT examinations the least, they show similar growth to other groups.

Myosteatosis refers to the infiltration of fat into skeletal muscle tissue, being influenced by factors such as advanced age and overweight, which increase the inability of adipocytes to store lipids. This condition not only alters the structure of the muscle but is also associated with endocrinological imbalances such as insulin resistance (IR) and hyperinsulinemia, increasing the risk of developing type 2 diabetes mellitus (T2DM) and cardiovascular diseases. Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) are effective methods for measuring myosteatosis, identifying areas of fat accumulation that may indicate specific regional patterns. This review aimed to evaluate the main evidence that associates myosteatosis with T2DM, compiling the epidemiological data already available on the subject and the main gaps in the literature. Ten observational studies were selected, from different regions of the world, which showed a relationship between myosteatosis and a higher incidence of T2DM, as well as IR, worse glycemic status, increased inflammatory mediators and a tendency to coronary artery disease. In conclusion, myosteatosis and T2DM are conditions with a relevant relationship and that have significant implications for public health, requiring greater standardization of myosteatosis assessment methods and interventional studies that address potential therapeutic strategies for this condition.

Arteriovenous fistulas (AVFs) are widely accepted as the gold standard for vascular access in chronic hemodialysis patients due to their superior long-term patency and low complication rates. However, up to half of all created AVFs fail to mature adequately, and many develop late complications such as stenosis, thrombosis, or aneurysmal degeneration. This review provides an overview of the AVF development process, focusing on the biomechanical forces that drive vascular remodeling and contribute to maturation and pathological changes. We summarize the role of endothelial mechanotransduction and insights from recent studies that reveal how wall shear stress (WSS) patterns and oscillatory flow relate to the genesis of neointimal hyperplasia and later stenosis. Understanding these mechanobiological processes has led to novel surgical techniques, anastomosis design optimization, and better cannulation strategies. Although the knowledge of hemodynamic-biological interactions remain limited, further research can offer directions for better AVF performance.

Despite advances in neonatal care, neonatal jaundice remains a common problem in maternity wards. The present retrospective epidemiological study collected data on a sample of 710 newborns and compared the incidence of neonatal jaundice in infants born to Rh (D) negative and 0 Rh (D) positive mothers. The primary aim was to determine whether the higher incidence of maternal alloimmunisation in newborns was causally related to a potentially higher incidence of neonatal jaundice in newborns of 0 Rh (D) positive mothers. To the end, we investigated a possible association between the incidence of neonatal jaundice in 0 Rh (D) positive mothers and the neonatal blood group. The incidence of neonatal jaundice was not found to differ between maternal blood groups. We discuss new preventive measures that may reduce the incidence of neonatal jaundice and thereby reduce the length of hospital stay.