Abstract The authors present new cases of malignant melanoma seen at the Skin Cancer Clinic of the University Hospital in Martin in the year 2017. There have been 112 new cases of malignant melanoma, 66 in men and 46 in women, diagnosed in 2017. We have recorded a occurence of two melanomas in one person in 3 patients, two men and one women. One patient had metastatic melanoma found in lymph nodes without corresponding skin lesions. The most common tumor body localisation in both men and women was on the back (51 melanomas, 45 %). In women, the most common localisation was upper extremities (13 melanomas, 29 %), followed by lower extremities and the back at the same rate (11 melanomas, 24 %). In men, the most common localisation was on the back (40 melanomas, 60 %). Histologically, the most common type was superficial spreading malignant melanoma (50 melanomas), the second most common was non specific type of malignant melanoma (19 melanomas). The majority of cases were low risk lesions with histological Breslow thickness in the range from 0,1 mm to 1 mm (47 melanomas). High risk lesions with histological Breslow thickness more than 4 mm were the second most common type (24 melanomas).
{"title":"Activity of Skin Cancer Clinic at Martin University Hospital in 2017","authors":"E. Minarikova, M. Smolárová, M. Minárik","doi":"10.2478/acm-2018-0003","DOIUrl":"https://doi.org/10.2478/acm-2018-0003","url":null,"abstract":"Abstract The authors present new cases of malignant melanoma seen at the Skin Cancer Clinic of the University Hospital in Martin in the year 2017. There have been 112 new cases of malignant melanoma, 66 in men and 46 in women, diagnosed in 2017. We have recorded a occurence of two melanomas in one person in 3 patients, two men and one women. One patient had metastatic melanoma found in lymph nodes without corresponding skin lesions. The most common tumor body localisation in both men and women was on the back (51 melanomas, 45 %). In women, the most common localisation was upper extremities (13 melanomas, 29 %), followed by lower extremities and the back at the same rate (11 melanomas, 24 %). In men, the most common localisation was on the back (40 melanomas, 60 %). Histologically, the most common type was superficial spreading malignant melanoma (50 melanomas), the second most common was non specific type of malignant melanoma (19 melanomas). The majority of cases were low risk lesions with histological Breslow thickness in the range from 0,1 mm to 1 mm (47 melanomas). High risk lesions with histological Breslow thickness more than 4 mm were the second most common type (24 melanomas).","PeriodicalId":30233,"journal":{"name":"Acta Medica Martiniana","volume":"18 1","pages":"21 - 29"},"PeriodicalIF":0.0,"publicationDate":"2018-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41813311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Chmúrny, S. Křivánek, M. Melišík, M. Rovňák, L. Nečas
Abstract Introduction Background: Optimal femoral component rotation in total knee arthroplasty (TKA) is crucial to establish a balanced knee reconstruction. Unbalanced knees can lead to instability, patellofemoral problems, persistent pain, stiffness, and generally poorer outcomes including early failure. There are several methods to achieve the femoral component rotation such as balanced gap technique, measured resection technique, and bone landmarks such as transepicondylar line (TEA) and Whiteside line. The purpose of this study was to compare the balan ced gap technique with the TEA technique. Materials and Methods: This randomised prospective study compares the femoral component rotation obtained with the use of balanced gap technique and the TEA, as well as compares the differences due to preoperative knee desaxations. The study includes 50 knees, 19 with neutral alignment, 22 with varus, and 9 with valgus desaxation. The femoral component rotation was measured postoperatively on photodocumentation taken after determining the TEA and balanced gap technique line peroperatively. These lines were compared to the posterior femoral condyles obtaining the degree of rotation. In case of transepicondylar line it is condylar twist angle (CTA) and in case of ligament balancer rotation axis it is ligament balancer angle (LBA). Results: The statistically significant differences in femoral component rotation using the techniques mentioned above as well as differences in individual knee desaxations were observed. The average LBA was 3.42 degrees and average CTA 3.58 in neutral knees group, but in the varus knees the average CTA value was 2.27 degrees and LBA value was 1.05 degrees. The average CTA value in patients with valgus desaxation is 4.78 degrees and LBA value is 5.22 degrees. According to Tukey Post Hoc test a statistically significant difference in LBA value is between neutral and varus knees with a significance level of p = 0.000022 and the most significant difference between varus and valgus knees with a significance level of p = 0.000011. Conclusion: The statistically significant differences in femoral component rotation using the techniques mentioned above as well as differences in individual knee desaxations were observed.
背景:全膝关节置换术(TKA)中最佳的股骨假体旋转对于建立平衡的膝关节重建至关重要。不平衡的膝盖会导致不稳定、髌骨问题、持续疼痛、僵硬，通常会导致较差的结果，包括早期衰竭。有几种方法可以实现股骨假体旋转，如平衡间隙技术、测量切除技术和骨标记，如经耻骨髁线(TEA)和怀特塞德线。本研究的目的是比较平衡间隙技术和TEA技术。材料和方法:这项随机前瞻性研究比较了使用平衡间隙技术和TEA获得的股骨假体旋转，并比较了术前膝关节脱位造成的差异。该研究包括50个膝关节，其中19个膝关节为中性位，22个膝关节为内翻，9个膝关节为外翻脱位。在术中确定TEA和平衡间隙技术线后，通过摄影记录测量股骨假体旋转。将这些线与股骨后髁进行比较，获得旋转程度。经髁线为髁扭转角(CTA)，韧带平衡器旋转轴为韧带平衡器角(LBA)。结果:观察到使用上述技术的股骨假体旋转以及个体膝关节脱位的差异具有统计学意义。中性膝组平均LBA为3.42度，平均CTA为3.58度;膝内翻组平均CTA为2.27度，平均LBA为1.05度。外翻脱索患者的平均CTA值为4.78度，LBA值为5.22度。经Tukey Post Hoc检验，中性膝与内翻膝间LBA值差异有统计学意义，显著性水平为p = 0.000022;内翻膝与外翻膝间LBA值差异最显著，显著性水平为p = 0.000011。结论:观察到上述技术在股骨假体旋转方面的统计学差异以及个体膝关节脱位的差异。
{"title":"The comparison of femoral component rotation in the total knee arthroplasty","authors":"M. Chmúrny, S. Křivánek, M. Melišík, M. Rovňák, L. Nečas","doi":"10.1515/acm-2017-0014","DOIUrl":"https://doi.org/10.1515/acm-2017-0014","url":null,"abstract":"Abstract Introduction Background: Optimal femoral component rotation in total knee arthroplasty (TKA) is crucial to establish a balanced knee reconstruction. Unbalanced knees can lead to instability, patellofemoral problems, persistent pain, stiffness, and generally poorer outcomes including early failure. There are several methods to achieve the femoral component rotation such as balanced gap technique, measured resection technique, and bone landmarks such as transepicondylar line (TEA) and Whiteside line. The purpose of this study was to compare the balan ced gap technique with the TEA technique. Materials and Methods: This randomised prospective study compares the femoral component rotation obtained with the use of balanced gap technique and the TEA, as well as compares the differences due to preoperative knee desaxations. The study includes 50 knees, 19 with neutral alignment, 22 with varus, and 9 with valgus desaxation. The femoral component rotation was measured postoperatively on photodocumentation taken after determining the TEA and balanced gap technique line peroperatively. These lines were compared to the posterior femoral condyles obtaining the degree of rotation. In case of transepicondylar line it is condylar twist angle (CTA) and in case of ligament balancer rotation axis it is ligament balancer angle (LBA). Results: The statistically significant differences in femoral component rotation using the techniques mentioned above as well as differences in individual knee desaxations were observed. The average LBA was 3.42 degrees and average CTA 3.58 in neutral knees group, but in the varus knees the average CTA value was 2.27 degrees and LBA value was 1.05 degrees. The average CTA value in patients with valgus desaxation is 4.78 degrees and LBA value is 5.22 degrees. According to Tukey Post Hoc test a statistically significant difference in LBA value is between neutral and varus knees with a significance level of p = 0.000022 and the most significant difference between varus and valgus knees with a significance level of p = 0.000011. Conclusion: The statistically significant differences in femoral component rotation using the techniques mentioned above as well as differences in individual knee desaxations were observed.","PeriodicalId":30233,"journal":{"name":"Acta Medica Martiniana","volume":"17 1","pages":"24 - 31"},"PeriodicalIF":0.0,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42549180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Introduction: Biology therapies in a various medical specializations and for a broad spectrum of indications were launched during last two decades. As a new in class the therapies were obliged to provide additional data re gar ding efficacy and safety after their real medical practice integration. Patient registries, databases collecting various patient data, were introduced to grant data on the treatment effectiveness, safety, and long-term on treatment survival. Satisfactory treatment effect and acceptable safety profile were confirmed after couple of years of careful observation. However, the benefits were usually offered at much higher treatment costs compared to the standard therapies. Biologically similar drugs, so-called biosimilars (B.S), are being launched after original molecule patent protection expiry during recent years. They were expected as an ideal solution to avoid distinct impact on the medical budget: comparable effect for less money. The unsubstantiated doubts about biosimilar efficacy and safety were the reason of the late launch in many markets. Since biosimilars are considered as new therapy entities, the cautiousness to certain extent should be required. Information gained from post-marketing observations and patient registries over several years, confirmed the biosimilar product comparable quality. Healthcare budget savings could secure easier therapy access for more new patients.
{"title":"Biosimilar medicines and patient registries – expectations, limitations, and opportunities","authors":"R. Sutka, J. Péč, T. Péčová","doi":"10.1515/acm-2017-0016","DOIUrl":"https://doi.org/10.1515/acm-2017-0016","url":null,"abstract":"Abstract Introduction: Biology therapies in a various medical specializations and for a broad spectrum of indications were launched during last two decades. As a new in class the therapies were obliged to provide additional data re gar ding efficacy and safety after their real medical practice integration. Patient registries, databases collecting various patient data, were introduced to grant data on the treatment effectiveness, safety, and long-term on treatment survival. Satisfactory treatment effect and acceptable safety profile were confirmed after couple of years of careful observation. However, the benefits were usually offered at much higher treatment costs compared to the standard therapies. Biologically similar drugs, so-called biosimilars (B.S), are being launched after original molecule patent protection expiry during recent years. They were expected as an ideal solution to avoid distinct impact on the medical budget: comparable effect for less money. The unsubstantiated doubts about biosimilar efficacy and safety were the reason of the late launch in many markets. Since biosimilars are considered as new therapy entities, the cautiousness to certain extent should be required. Information gained from post-marketing observations and patient registries over several years, confirmed the biosimilar product comparable quality. Healthcare budget savings could secure easier therapy access for more new patients.","PeriodicalId":30233,"journal":{"name":"Acta Medica Martiniana","volume":"17 1","pages":"39 - 51"},"PeriodicalIF":0.0,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49301775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
I. Bujnakova, I. Ondrejka, M. Mestanik, D. Flešková, N. Sekaninova, I. Farský, I. Tonhajzerova
Abstract Background: Autism spectrum disorder (ASD) is a serious neurodevelopmental disorder associated with autonomic nervous system (ANS) abnormalities. Moreover, at least 50% of children with ASD suffer from other comorbid diseases such as anxiety, depression, and attention deficit hyperactivity disorder (ADHD) associated with receiving psychotropic medication. From this context we aimed to evaluate changes in sympathetic arousal using analysis of electrodermal activity (EDA) as an index of sympathetic cholinergic activity in treated and non-treated autistic children under resting conditions. Methods: We examined 23 children with ASD and 14 healthy age- and gender-matched children at the age of 7–15 years. The ASD patients were divided into ASD non-treated group (n=12) and ASD treated group (n=11). The EDA was continuously monitored during resting phase in a supine position. The EDA amplitude (μS) was computed as an average of 5 min baseline period. Results: We found significantly lower EDA in ASD non-treated subgroup compared to controls indicating subtle abnormalities in the regulation of the sympathetic nervous system. Although no significant differences were found between the ASD treated and non-treated subgroups the ASD treated group showed comparable sympathetic activity relative to controls indicating a potential ameliorated treatment effect on sympathetic arousal in ASD. Conclusions: These findings could help to determine differences in sympathetic arousal in treated and non-treated children with ASD, which is important for assessment of autism-linked cardiovascular risk depending on pharmacotherapy.
{"title":"Potential Effect of Pharmacotherapy on Sympathetic Arousal in Autism","authors":"I. Bujnakova, I. Ondrejka, M. Mestanik, D. Flešková, N. Sekaninova, I. Farský, I. Tonhajzerova","doi":"10.1515/acm-2017-0013","DOIUrl":"https://doi.org/10.1515/acm-2017-0013","url":null,"abstract":"Abstract Background: Autism spectrum disorder (ASD) is a serious neurodevelopmental disorder associated with autonomic nervous system (ANS) abnormalities. Moreover, at least 50% of children with ASD suffer from other comorbid diseases such as anxiety, depression, and attention deficit hyperactivity disorder (ADHD) associated with receiving psychotropic medication. From this context we aimed to evaluate changes in sympathetic arousal using analysis of electrodermal activity (EDA) as an index of sympathetic cholinergic activity in treated and non-treated autistic children under resting conditions. Methods: We examined 23 children with ASD and 14 healthy age- and gender-matched children at the age of 7–15 years. The ASD patients were divided into ASD non-treated group (n=12) and ASD treated group (n=11). The EDA was continuously monitored during resting phase in a supine position. The EDA amplitude (μS) was computed as an average of 5 min baseline period. Results: We found significantly lower EDA in ASD non-treated subgroup compared to controls indicating subtle abnormalities in the regulation of the sympathetic nervous system. Although no significant differences were found between the ASD treated and non-treated subgroups the ASD treated group showed comparable sympathetic activity relative to controls indicating a potential ameliorated treatment effect on sympathetic arousal in ASD. Conclusions: These findings could help to determine differences in sympathetic arousal in treated and non-treated children with ASD, which is important for assessment of autism-linked cardiovascular risk depending on pharmacotherapy.","PeriodicalId":30233,"journal":{"name":"Acta Medica Martiniana","volume":"17 1","pages":"16 - 23"},"PeriodicalIF":0.0,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49401271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Introduction: Decompressive craniectomy (DC) has been recently proven effective tier II therapeutic procedure in the treatment of refractory posttraumatic intracranial hypertension. However, its full potential and effectivity is yet to be described and this surgery remains controversial. The goals of our study include analysis of efficiency of DC and description of risk factors associated with unfavourable outcome. Methods: 24 patients who underwent DC at the Clinic of Neurosurgery, JFM CU in Martin, during years 2015–2016 were prospectively observed. Selected demographic, clinical, and radiographic factors were analysed and compared with patient’s GOS (Glasgow Outcome Scale) at the time of their first ambulatory control (after 3.5 months in average). Results: We observed mortality of 29.17 %. Good outcome (GOS 4–5) was achieved by 29.17 % of the patients as well. Preoperative GCS ≤ 5 (p = 0.049), intraventricular bleeding (p = 0.0268), midline shift ≥ 15 mm (p = 0.0067), and the volume of intracranial lesion (R = −0.41, p = 0.046), especially its extracerebral component (R = −0.46, p = 0.02), were identified as statistically significant negative prognostic factors. Conclusion: DC is effective in the management of patients with traumatic brain injury. Good outcome is achieved by 29.17 % of the patients. Described negative prognostic factors (preoperative GCS ≤ 5, intraventricular bleeding, midline shift ≥ 15 mm, and increasing the volume of traumatic mass lesion) could help in targeting this surgery only to patients who are expected to benefit from it.
{"title":"Efficiency and Limitations of Decompressive Craniectomy in Patients after Traumatic Brain Injury – Preliminary Results","authors":"M. Hanko, R. Richterová, B. Kolarovszki","doi":"10.1515/acm-2017-0015","DOIUrl":"https://doi.org/10.1515/acm-2017-0015","url":null,"abstract":"Abstract Introduction: Decompressive craniectomy (DC) has been recently proven effective tier II therapeutic procedure in the treatment of refractory posttraumatic intracranial hypertension. However, its full potential and effectivity is yet to be described and this surgery remains controversial. The goals of our study include analysis of efficiency of DC and description of risk factors associated with unfavourable outcome. Methods: 24 patients who underwent DC at the Clinic of Neurosurgery, JFM CU in Martin, during years 2015–2016 were prospectively observed. Selected demographic, clinical, and radiographic factors were analysed and compared with patient’s GOS (Glasgow Outcome Scale) at the time of their first ambulatory control (after 3.5 months in average). Results: We observed mortality of 29.17 %. Good outcome (GOS 4–5) was achieved by 29.17 % of the patients as well. Preoperative GCS ≤ 5 (p = 0.049), intraventricular bleeding (p = 0.0268), midline shift ≥ 15 mm (p = 0.0067), and the volume of intracranial lesion (R = −0.41, p = 0.046), especially its extracerebral component (R = −0.46, p = 0.02), were identified as statistically significant negative prognostic factors. Conclusion: DC is effective in the management of patients with traumatic brain injury. Good outcome is achieved by 29.17 % of the patients. Described negative prognostic factors (preoperative GCS ≤ 5, intraventricular bleeding, midline shift ≥ 15 mm, and increasing the volume of traumatic mass lesion) could help in targeting this surgery only to patients who are expected to benefit from it.","PeriodicalId":30233,"journal":{"name":"Acta Medica Martiniana","volume":"17 1","pages":"32 - 38"},"PeriodicalIF":0.0,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1515/acm-2017-0015","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44516377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Theophylline has been used in the treatment of bronchial asthma and chronic obstructive pulmonary disease (COPD) for over 70 years. In order to maximize the effectiveness and safety of theophylline therapy it is important to individualize the dosage of the drug. In our study we focused on determination of theophylline concentrations in guinea pig plasma. A rapid, specific, and reliable LC-MS/MS-based method was developed and validated according to European Medicine Agency (EMA) guidelines. A hydrophilic interaction liquid chromatography (HILIC) separation mode for reduction time of sample preparation was used. The analysed sample was quantified in a positive ionization mode. Multiple reaction monitoring (MRM) using transition m/z 181.06→124.06 and m/z 187.17→127.06 was performed to quantify theophylline with deuterated internal standard ([2H6]-theophylline), respectively. Modification of collision energies was performed in parallel with chromatographic separation to further eliminate interference from the matrix. The method was validated for a range of 0.5 to 30 μg/mL of plasma sample. The intra-day and inter-day precision and accuracy of the quality control samples at low, me dium, and high concentration levels exhibited relative standard deviations (RSD) of less than 10 %. The method was successfully applied for the quantitation of theophylline in guinea pig plasma for better understanding its effects in a model of ovalbumin-induced allergic inflammation.
{"title":"Quantification of Theophylline in Guinea Pig Plasma by LC-MS/MS Using Hydrophilic Interaction Liquid Chromatography Stationary Phase: Method Development, Validation, and Application in Study","authors":"M. Kertys, A. Urbanová, J. Mokrý","doi":"10.1515/acm-2017-0012","DOIUrl":"https://doi.org/10.1515/acm-2017-0012","url":null,"abstract":"Abstract Theophylline has been used in the treatment of bronchial asthma and chronic obstructive pulmonary disease (COPD) for over 70 years. In order to maximize the effectiveness and safety of theophylline therapy it is important to individualize the dosage of the drug. In our study we focused on determination of theophylline concentrations in guinea pig plasma. A rapid, specific, and reliable LC-MS/MS-based method was developed and validated according to European Medicine Agency (EMA) guidelines. A hydrophilic interaction liquid chromatography (HILIC) separation mode for reduction time of sample preparation was used. The analysed sample was quantified in a positive ionization mode. Multiple reaction monitoring (MRM) using transition m/z 181.06→124.06 and m/z 187.17→127.06 was performed to quantify theophylline with deuterated internal standard ([2H6]-theophylline), respectively. Modification of collision energies was performed in parallel with chromatographic separation to further eliminate interference from the matrix. The method was validated for a range of 0.5 to 30 μg/mL of plasma sample. The intra-day and inter-day precision and accuracy of the quality control samples at low, me dium, and high concentration levels exhibited relative standard deviations (RSD) of less than 10 %. The method was successfully applied for the quantitation of theophylline in guinea pig plasma for better understanding its effects in a model of ovalbumin-induced allergic inflammation.","PeriodicalId":30233,"journal":{"name":"Acta Medica Martiniana","volume":"17 1","pages":"15 - 5"},"PeriodicalIF":0.0,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1515/acm-2017-0012","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43303259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mohanad Abusultan, P. Hanzel, D. Durcansky, A. Hajtman
Abstract Prostate cancer usually metastasis to the regional lymph nodes and can rarely metastases to nonregional supradiaphragmatic lymph nodes. Cervical lymph node metastasis of prostate cancer is extremely rare. However, it should be considered in the differential diagnosis of cervical lymphadenopathy in male patients with adenocarcinoma of unknown primary site. In this report we present a rare case of metastatic prostate adenocarcinoma with left supraclavicular lymphadenopathy as the only clinical presentation with no other evidence of metastasis to the regional lymph nodes or bone metastasis.
{"title":"Left Supraclavicular Lymphadenopathy as the Only Clinical Presentation of Prostate Cancer: A Case Report","authors":"Mohanad Abusultan, P. Hanzel, D. Durcansky, A. Hajtman","doi":"10.1515/acm-2017-0011","DOIUrl":"https://doi.org/10.1515/acm-2017-0011","url":null,"abstract":"Abstract Prostate cancer usually metastasis to the regional lymph nodes and can rarely metastases to nonregional supradiaphragmatic lymph nodes. Cervical lymph node metastasis of prostate cancer is extremely rare. However, it should be considered in the differential diagnosis of cervical lymphadenopathy in male patients with adenocarcinoma of unknown primary site. In this report we present a rare case of metastatic prostate adenocarcinoma with left supraclavicular lymphadenopathy as the only clinical presentation with no other evidence of metastasis to the regional lymph nodes or bone metastasis.","PeriodicalId":30233,"journal":{"name":"Acta Medica Martiniana","volume":"17 1","pages":"41 - 44"},"PeriodicalIF":0.0,"publicationDate":"2017-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46400156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. Stasko, J. Stasko, M. Janíčková, K. Mikušková, I. Malachovský, P. Gengelova, M. Kasaj, M. Smatanová, D. Statelová
Abstract The direct oral anticoagulant drugs (DOAC) are generally safe and effective in several clinical settings including acute venous thromboembolic disease, prophylaxis in the postoperative setting, prevention of thromboembolism in patients with non-valvular atrial fibrillation, and in the management of acute coronary syndrome. The relatively short half-life, rapid onset of action, and predictable pharmacokinetics should simplify periprocedural use of the DOAC. The aim of this work is to propose and summarize periprocedural management of patients treated with the DOAC in dental practice and to inform about the principal specifications of this treatment.
{"title":"Direct Oral Anticoagulant Drugs in Dental Clinical Practice","authors":"J. Stasko, J. Stasko, M. Janíčková, K. Mikušková, I. Malachovský, P. Gengelova, M. Kasaj, M. Smatanová, D. Statelová","doi":"10.1515/acm-2017-0008","DOIUrl":"https://doi.org/10.1515/acm-2017-0008","url":null,"abstract":"Abstract The direct oral anticoagulant drugs (DOAC) are generally safe and effective in several clinical settings including acute venous thromboembolic disease, prophylaxis in the postoperative setting, prevention of thromboembolism in patients with non-valvular atrial fibrillation, and in the management of acute coronary syndrome. The relatively short half-life, rapid onset of action, and predictable pharmacokinetics should simplify periprocedural use of the DOAC. The aim of this work is to propose and summarize periprocedural management of patients treated with the DOAC in dental practice and to inform about the principal specifications of this treatment.","PeriodicalId":30233,"journal":{"name":"Acta Medica Martiniana","volume":"17 1","pages":"20 - 27"},"PeriodicalIF":0.0,"publicationDate":"2017-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1515/acm-2017-0008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41833752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Background: Anti-citrullinated peptides antibodies (ACPA) are specific for rheumatoid arthritis and have been implicated in disease pathogenesis. ACPA examination is a new component of ACR/EULAR 2010 classification criteria for rheumatoid arthritis. ACPA positivity predicts a more erosive disease course with severe joint damage and extra-articular manifestations. Objectives: To evaluate the benefits of ACPA examination in patients with early undifferentiated arthritis and patients with rheumatoid arthritis. Methods: We examined patients with arthritis and tested them for ACPA positivity. In every individual patient we evaluated if ACPA examination was necessary to establish the diagnosis of rheumatoid arthritis, or to change treatment, or if the diagnosis could have been established without ACPA examination (ACR/EULAR 2010 classification criteria was met without ACPA scoring). Results and Conclusions: We examined 833 patients with arthritis. There were 43 patients, or 62 % of a subgroup of 69 who were ACPA positive whose ACPA examination was not needed - ACR/EULAR criteria was met without ACPA scoring. This number represents 5.1 % of the total number examined. There were 15 patients, or 22 % of the subgroup and 1.8 % of the total whose diagnosis was revised to rheumatoid arthritis due to ACPA positivity - ACR/EULAR criteria was met solely with ACPA scoring. There were 11 patients (16 % and 1.3 %) whose medication was changed due to ACPA positivity. ACPA examination is useful in 3,1 % of all examined patients. When we correlate data on ACPA positive patients, 38 % of the patients profit from ACPA examinations. Considering the relatively low price of ACPA testing, this examination should not be excluded.
{"title":"Early Diagnosing and Treatment of Rheumatoid Arthritis, Benefits of Anti-Citrullinated Peptides Examination","authors":"G. Belakova, V. Maňka, E. Záňová, P. Račay","doi":"10.1515/acm-2017-0009","DOIUrl":"https://doi.org/10.1515/acm-2017-0009","url":null,"abstract":"Abstract Background: Anti-citrullinated peptides antibodies (ACPA) are specific for rheumatoid arthritis and have been implicated in disease pathogenesis. ACPA examination is a new component of ACR/EULAR 2010 classification criteria for rheumatoid arthritis. ACPA positivity predicts a more erosive disease course with severe joint damage and extra-articular manifestations. Objectives: To evaluate the benefits of ACPA examination in patients with early undifferentiated arthritis and patients with rheumatoid arthritis. Methods: We examined patients with arthritis and tested them for ACPA positivity. In every individual patient we evaluated if ACPA examination was necessary to establish the diagnosis of rheumatoid arthritis, or to change treatment, or if the diagnosis could have been established without ACPA examination (ACR/EULAR 2010 classification criteria was met without ACPA scoring). Results and Conclusions: We examined 833 patients with arthritis. There were 43 patients, or 62 % of a subgroup of 69 who were ACPA positive whose ACPA examination was not needed - ACR/EULAR criteria was met without ACPA scoring. This number represents 5.1 % of the total number examined. There were 15 patients, or 22 % of the subgroup and 1.8 % of the total whose diagnosis was revised to rheumatoid arthritis due to ACPA positivity - ACR/EULAR criteria was met solely with ACPA scoring. There were 11 patients (16 % and 1.3 %) whose medication was changed due to ACPA positivity. ACPA examination is useful in 3,1 % of all examined patients. When we correlate data on ACPA positive patients, 38 % of the patients profit from ACPA examinations. Considering the relatively low price of ACPA testing, this examination should not be excluded.","PeriodicalId":30233,"journal":{"name":"Acta Medica Martiniana","volume":"17 1","pages":"28 - 31"},"PeriodicalIF":0.0,"publicationDate":"2017-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1515/acm-2017-0009","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47798686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Objective: The aim of our study was to determine the relation of particular genetic variants in selected genes (GSTM1, GSTT1 null genotypes; rs1695 GSTP1; rs10735781 EVI5) to the risk of multiple sclerosis (MS) development and find out the possible association with disease disability progression rate. Material and methods: Our study included 202 MS patients and 174 healthy control volunteers. MS patients were divided according to disability progression rate to three groups - slowly progressing, mid-rate progressing and rapidly progressing. All DNA samples were isolated from venous blood. Genotyping was performed by PCR-RFLP and multiplex PCR. Results: Our analysis showed that GSTT1 null genotype (OR 0.56; 95%CI 0.33 -0.95; p=0.04) and GSTM1, GSTT1 double null genotype (OR 0.32; 95%CI 0.14 - 0.74; p=0.006) are potentially protective in relation to MS. We observed similar result in GSTT1 null genotype in association with mid-rate progression (OR 0.48; 95%CI 0.24 - 0.97; p=0.05). Frequency of GSTM1 and GSTT1 double null genotype is significantly lower in subgroup of MS patients with progression rate defined as slow (OR 0.22; 95%CI 0.05 - 0.98; p=0.05) and middle (OR 0.33; 95%CI 0.11 - 0.99; p=0.045). We did not show any significant association of genetic changes rs1695 in GSTP1 and rs10735781 in EVI5 with MS or rate of disease progression. Conclusions: Genetic basis of multiple sclerosis is still not fully elucidated. Further research may clarify our results and confirm the value of studied factors for clinical practice.
{"title":"Genetic Factors Associated with Risk and Disability Progression of Multiple Sclerosis in Slovak Population","authors":"S. Hányšová, D. Čierný, E. Kurča, J. Lehotský","doi":"10.1515/acm-2017-0007","DOIUrl":"https://doi.org/10.1515/acm-2017-0007","url":null,"abstract":"Abstract Objective: The aim of our study was to determine the relation of particular genetic variants in selected genes (GSTM1, GSTT1 null genotypes; rs1695 GSTP1; rs10735781 EVI5) to the risk of multiple sclerosis (MS) development and find out the possible association with disease disability progression rate. Material and methods: Our study included 202 MS patients and 174 healthy control volunteers. MS patients were divided according to disability progression rate to three groups - slowly progressing, mid-rate progressing and rapidly progressing. All DNA samples were isolated from venous blood. Genotyping was performed by PCR-RFLP and multiplex PCR. Results: Our analysis showed that GSTT1 null genotype (OR 0.56; 95%CI 0.33 -0.95; p=0.04) and GSTM1, GSTT1 double null genotype (OR 0.32; 95%CI 0.14 - 0.74; p=0.006) are potentially protective in relation to MS. We observed similar result in GSTT1 null genotype in association with mid-rate progression (OR 0.48; 95%CI 0.24 - 0.97; p=0.05). Frequency of GSTM1 and GSTT1 double null genotype is significantly lower in subgroup of MS patients with progression rate defined as slow (OR 0.22; 95%CI 0.05 - 0.98; p=0.05) and middle (OR 0.33; 95%CI 0.11 - 0.99; p=0.045). We did not show any significant association of genetic changes rs1695 in GSTP1 and rs10735781 in EVI5 with MS or rate of disease progression. Conclusions: Genetic basis of multiple sclerosis is still not fully elucidated. Further research may clarify our results and confirm the value of studied factors for clinical practice.","PeriodicalId":30233,"journal":{"name":"Acta Medica Martiniana","volume":"17 1","pages":"15 - 19"},"PeriodicalIF":0.0,"publicationDate":"2017-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46894416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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