Polski Merkuriusz Lekarski最新文献

Objective: Aim: The purpose of this study was to evaluate sub-species typing by matrix-activated laser desorption/ionisation mass spectrometry on the example of Klebsiella pneumoniae isolated from patients with pulmonary tuberculosis in Karaganda region..

Patients and methods: Materials and Methods: This study evaluated the potential of MALDI-TOF MS for epidemiological identification of Klebsiella pneumoniae isolated from pulmonary tuberculosis patients in Karaganda region. A total of 47 strains of Klebsiella pneumoniae obtained between 2015 and 2019 were typed. Mass spectra were taken using Microflex LT MALDI-TOF (Bruker) according to standard procedure.

Results: Results: As a result, MALDI-TOF evaluation of subspecies typing on the example of Klebsiella pneumoniae isolated from patients with pulmonary tuberculosis in Karaganda region, predominantly showed the diversity of isolates, indicating their out-of-hospital nature. Based on all available information, including facts, sources, and experimental results, it can be reasonably concluded that the current study of Klebsiella pneumoniae does not provide a complete picture of the epidemiology of this microorganism.

Conclusion: Conclusions: The current study provided a limited opportunity to investigate the genetic structure and diversity of Klebsiella pneumoniae subspecies more accurately. The findings suggest that the time-of-flight laser-ionisation ablation mass spectrometry method with magnetic focusing is more likely to detect differences in external characteristics between individual specimens of the same species than internal genetic variation in the microorganisms under study. The practical relevance of this study is to inform the development of more effective infection control strategies in clinical practice and infection control.

Objective: Aim: The purpose was to identify the morphological features of the great saphenous vein in patients with chronic venous disease of the lower extremities undergoing treatment with endovenous high-frequency electric welding in automatic mode, endovenous laser ablation, and ultrasound-guided microfoam sclerotherapy.

Patients and methods: Materials and Methods: The material for the comprehensive morphological study consisted of fragments of the great saphenous vein obtained from 32 patients with chronic venous disease of the lower extremities. The material was divided into three groups according to the endovenous treatment techniques applied. Group 1 included vein fragments from 12 patients who underwent endovenous high-frequency electric welding in automatic mode. Group 2 comprised material from 9 patients treated with endovenous laser ablation. Group 3 included material from 11 patients who underwent ultrasound-guided microfoam sclerotherapy using a 3% polidocanol solution. Histological and immunohistochemical research methods were used.

Results: Results: The great saphenous vein in patients with chronic venous disease of the lower extremities undergoing treatment with endovenous high-frequency electric welding in automatic mode and endovenous laser ablation was characterized by similarly pronounced diffuse alterative and desquamative changes in endothelial cells, disruption of the structural organization of the venous wall layers accompanied by edema, and alterative changes in both muscular and connective tissue fibers. In cases where ultrasound-guided microfoam sclerotherapy was applied, the great saphenous vein showed focal alterative and desquamative changes in endothelial cells, preservation of the layered structure, edematous changes in the media and adventitia, focal areas of dysmucoidosis, and regions of angiomatosis.

Conclusion: Conclusions: The severity of structural changes in the great saphenous vein in patients with chronic venous disease of the lower extremities following ultrasoundguided microfoam sclerotherapy was significantly lower compared to endovenous high-frequency electric welding in automatic mode and endovenous laser ablation, resulting in less favorable conditions for the qualitative development of the fibrous process.

Objective: Aim: To detect anti-measles viruses IgG and IgM antibodies using rapid test Cassette and enzyme-linked immunosorbent assay (ELISA).

Patients and methods: Materials and Methods: From October 2024 to December 2024, 352 blood samples obtained from female individuals, including 176 women who had abortions and 176 women with normal pregnancies. IgG and IgM samples were detected using the Cassette and ELISA methods.

Results: Results: Recent measles virus infections, as indicated by rapid IgM test results, showed no significant difference between the abortion group and the control group p=0.248. Additionally, past infections, confirmed by rapid IgG tests, were not significantly different between the patient group and the control group p=0.135. Overall, there was no significant difference in measles virus IgM and IgG levels between the abortion and control groups p>0.05.

Conclusion: Conclusions: The level of education showed significant impact on abortion. Age, residency, and occupation do not affect the risk of abortion, while a low level of education is a significant risk factor for abortion. MV, there was no significant difference in the levels of IgM and IgG between the abortion group and the control group.

Objective: Aim: To determine whether the Trendelenburg position during laparoscopic urological surgery changed the ONSD and whether changes correlated with postoperative complications.

Patients and methods: Materials and Methods: In this prospective study, we measured ONSD before patients were placed in the Trendelenburg position. Then the Trendelenburg position was established by tilting the operating table to 20-25 degrees. After surgery, the patients were placed in a horizontal position, and the second measurement of ONSD was obtained.

Results: Results: The study included 69 patients. The average preoperative ONSD in the right eye was 5.8±0.7 mm and 5.8±0.8 mm in the left eye. The average postoperative ONSD in the right eye was 6.6±0.8 mm and 6.6±0.7 mm in the left eye. The differences between postoperative and preoperative values in the right and left eyes were statistically significant (p<0.000001). ONSD increases above the norm did not correlate with the incidence of postoperative nausea (p=0.94), delirium (p=0.81), or the time to patient awakening (p=0.29).

Conclusion: Conclusions: ONSD increased in patients who underwent surgical procedures performed in the Trendelenburg position, but the increase did not correlate with postoperative complications.

Objective: Aim: Evaluate the prognostic value of the proposed scale on determining hospital stay duration of patients with COVID-19. Establish baseline values of the scale for further implementation into primary care.

Patients and methods: Materials and Methods: We gathered and analyzed data of 140 hospitalized patients who underwent treatment in Uzhhorod CMCH and had a positive COVID-19 test from the start of the pandemic and until January of 2022. 4 models were proposed, each patient was analyzed based on a point system determined by the model, to compare the number of accumulated points with hospital stay duration.

Results: Results: Linear regression results showed that models I and IV provide a low practical usage as per R2. Models II and III are most promising showing a high prognostic value (R2 are 0.0703 and 0.111 respectively). Models II and III showed a statistically significant increase in hospital stay for scores 2 and 5 compared with 0. The accumulated data shows that scores 2 and 5 show a significant increase in hospital stays, while 1, 3 and 4 did not show any significant increase for practical usage.

Conclusion: Conclusions: Overall, this analysis showed that middle scores and maximum scores showed significance compared to hospital stays, while Models II and III showed the highest practical usage coefficients in COVID-19 scenarios. Despite the fact that the number of asthma and COPD patients was low, these models may prove useful for practical usage in triage scenarios and primary care.

Objective: Aim: To study different aspects of quality of life depending on the type and severity of sexual disorders in men.

Patients and methods: Materials and Methods: An observed case-control study was carried out during 2023-2024, at three private-funded out-patient health care facilities of the Ivano-Frankivsk region of Ukraine. A survey of the quality of life of 402 men with sexual dysfunctions and 200 men without ones was carried out. The control group included men who visited the health care facilities for the check-up and were recognized as practically healthy. The study data were analyzed using Microsoft Excel data analysis and the Statistica10.0 software packages. Statistical processing of qualitative data was carried out by calculating their prevalence per 100 respondents, and the reliability of their differences in different observation groups was assessed by calculating the chi-square (χ2) test. The research design and programs were reviewed and approved by the Ethics Commission of the Ivano-Frankivsk National Medical University (protocol No. 133/23 dated March 29, 2023).

Results: Results: The quality-of-life integral index in sexual dysfunctions was (64.9±7.14) % of the maximum possible 100% vs (92.4±3.52) % in the control group. The progression of erectile dysfunction was accompanied by a decrease of the quality-of-life integral index from -25.2% in mild to -33.3% in moderate and -41.6% in severe, and the presence of premature ejaculation reduces the quality of life by 38.6%, hypoactive sexual desire disorder by 38.0%, orgasmic dysfunction by 39.8%. The greatest impact on the men`s quality-of-life reduction in sexual dysfunctions was the dissatisfaction with sexual drive, interest and/ or performance (on average 2.1 points on a 5-point scale, compared to 4.9 points in the control group), especially expressed in hypoactive sexual desire disorder (1.6 points, respectively), orgasmic dysfunction (1.7) and severe erectile dysfunction (1.5). Respondents with sexual dysfunctions were the least satisfied with the psychological components of the quality-of-life, in particular in case of severe erectile dysfunction (3.0 points), premature ejaculation (2.9), hypoactive sexual desire disorder (3.0) and orgasmic dysfunction (3.0).

Conclusion: Conclusions: Male sexual dysfunctions negatively affect the psychological component of the quality of life without significant impact on the physical and socio-economic. The complex of treatment measures for men`s sexual dysfunctions must necessarily include psychological interventions.

Objective: Aim: To evaluate emotional burnout, anxiety, and depression in men with chronic pain undergoing rehabilitation during wartime in Ukraine, with attention to age and pain duration.

Patients and methods: Materials and Methods: The study included 35 male military personnel aged 25-60 years, undergoing inpatient rehabilitation at the State Institution «Veteran Mental Health and Rehabilitation Center «Forest Glade» Ministry of Health of Ukraine (Kyiv, Ukraine) (January-May 2025). The mean age was 43±10 years; average pain duration was 23±17 months. Data were collected via structured questionnaires and clinical interviews. Standardized instruments included the Maslach Burnout Inventory (MBI), State-Trait Anxiety Inventory (STAI), and Hospital Anxiety and Depression Scale (HADS).

Results: Results: Most participants exhibited moderate-to-high levels of emotional exhaustion (88,6%), depersonalization (80%), and reduced personal accomplishment (85,7%) (by MBI). More than 70% showed moderate-to-high levels of both state and trait anxiety (by STAI). Сlose to half of patients (48,6%) demonstrated borderline or abnormal depression patterns. Participants with pain lasting over 12 months showed significantly higher anxiety score, with 78,9% experiencing clinically relevant anxiety versus 37,5% in the short-term (3-12 months) group (p=0,018). Strong (or close to strong) correlations were identified between burnout, anxiety, and depression subscales (ρ=0,68-0,89; p<0,001 [n=35]).

Conclusion: Conclusions: Chronic pain in wartime conditions is linked to severe psychological distress. Extended pain duration increases anxiety. The strong interplay between burnout and affective symptoms underscores the need for integrative, multidisciplinary rehabilitation tailored to psychological needs.

Objective: Aim: This preclinical study was oriented towards evaluating the efficiency of newly developed antibiotics against a selection of multi-drug-resistant Staphylococcus aureus strains, with the broader aim of finding a potent candidate to counteract the increasing resistance issue.

Patients and methods: Materials and Methods: The study utilized four distinct strains of multi-drug-resistant Staphylococcus aureus (SA-1 to SA-4) and three novel antibiotics (NA-1 to NA-3) under controlled laboratory conditions. The bacterial strains were cultured in vitro, and a series of tests including drug susceptibility testing and the determination of minimum inhibitory concentrations (MIC) were conducted. Statistical analysis was carried out using two-way ANOVA and Bonferroni post-hoc tests to analyze the significance of the observed results.

Results: Results: Our data showcased variations in the growth characteristics and resistance profiles of the different strains, helping in identifying the most potent antibiotic among the tested compounds. Notably, antibiotic NA-1 manifested the lowest MIC values against the strains SA-1 and SA-3, indicating a higher potency (p < 0.01). Moreover, NA-1 exhibited significantly lower MIC₅₀ and MIC₉₀ values (0.56 μg/mL and 0.95 μg/mL, respectively), suggesting that it had the best inhibitory power amongst the antibiotics tested against a majority of the strains (p < 0.05).

Conclusion: Conclusions: The findings from this preclinical in-vitro study accentuate the potential of novel antibiotic NA-1 as a promising candidate in combatting multidrug- resistant Staphylococcus aureus strains. However, further research, including in-vivo studies, is requisite to substantiate the efficacy of this antibiotic in a clinical setting.

Objective: Aim: The purpose of study was to analyse the interaction between COVID-19 and chronic diseases, with a focus on evaluating the effectiveness of treatment strategies.

Patients and methods: Materials and Methods: The study, conducted at the Infectious Disease Centre of the Regional Clinical Hospital of Karaganda, aimed to determine factors influencing therapy effectiveness in 236 COVID-19 patients. It assessed the dynamics of laboratory indicators and their relationship with chronic diseases like diabetes, hypertension, cardiovascular conditions, chronic respiratory diseases, and cancer. Demographic data, including age and gender, were also considered.

Results: Results: The study revealed no significant age difference between patients with moderate and severe COVID-19 courses, with both groups averaging a similar age of 66 years. The duration of hospitalization was significantly longer for patients with severe disease, who required an average of 15 days, compared to 11 days for patients with moderate disease (p<0.001). Comorbidities, especially arterial hypertension and coronary artery disease, were common in patients with moderate disease but had less impact on outcomes compared to severe cases, where multiple chronic conditions were linked to higher mortality. Some treatments had a more pronounced effect in this group of patients, while others may have been less effective or had negative effects.

Conclusion: Conclusions: The study highlights the critical impact of chronic diseases on the severity and outcomes of COVID-19, emphasizing the need for personalized, multidisciplinary treatment strategies that consider comorbidities to optimize patient outcomes.

Objective: Aim: To assess the quality of life using the PAC-QOL scale in patients with chronic slow-transit constipation depending on the histological subtypes of the colonic wall after colectomy.

Patients and methods: Materials and Methods: The dynamics of quality-of-life scores were studied in 107 patients with slow-transit constipation resistant to conservative treatment after colectomy using PAC-QOL questionnaire.

Results: Results: Significant improvement in quality of life was observed for all PAC-QOL subscales one year after surgery: physical discomfort improved by 58.7% to 67.7%, psychological discomfort - by 50.5%-67.2%, worries and concerns - by 53.3%- 67.6%, satisfaction with treatment - by 80.7%-82.6%, the PACQOL score - by 54-67.9%. The best outcomes for the PAC-QOL scale were demonstrated in patients with cajal subtype - 67,9% compared to the neuropathic (54,0%), myopathic inflammatory (56,1%), histologically intact (61,2%). Cajal histological subtype showed a greater improvement in the physical discomfort score - 67,7%, compared to the histologically intact subtype (58,7%), and the neuropathic subtype (58,9%); for Psychosocial discomfort - 67,2% compared to the dystrophic myopathic (55,5%), the neuropathic (50,7%), and the myopathic inflammatory subtype (50,5%); for the worries and concerns - 67,6% compared to the neuropathic subtype (53,3%).

Conclusion: Conclusions: In patients with STC resistant to conservative treatment, colectomy leads to significant improvement in quality of life according to the Pac-Qol questionnaire, one year after surgery with the best improvement for the Cajal subtype.