Bratislava Medical Journal-Bratislavske Lekarske Listy最新文献

Objectives: The objective of this study was to investigate whether there are differences between brain natriuretic peptide (BNP) levels and computed tomography pulmonary angiography (CTPA) parameters, in patients with acute PE, with respect of sex.

Background: Acute pulmonary embolism (PE) may provoke sudden right ventricle overload and stretching of their thin walls, causing significant raise of BNP blood levels, which correlates to acute PE severity. The properties of RV are different between sexes.

Methods: This retrospective analysis was gained from the data of 1612 PE patients from the regional PE register. The patients have had CTPA verification of PE, with described localization of thrombus masses, as well as the ratio between RV and left ventricle (RV/LV), and BNP as biomarker, measured during the first 24 hours upon admission.

Results: Out of 96 male patients with detected central thrombus, 75.0% patients had an increase in BNP level compared to 25.0% patients with normal BNP value (p<0.001). Of the 94 female patients with central thrombus, 85.1% patients had an elevated BNP level, compared to 14.9% patients, with BNP normal values (p<0.001). Of the 135 male patients with RV/LV˃1, 79.3% of them, had elevated BNP, compared to 20.7% patients whose BNP level was normal (p<0.001). Out of 123 female patients with RV/LV˃1, 91.1% patients had elevated BNP compared to 8.9%, whose BNP was normal (p<0.001).

Conclusion: Elevated BNP blood level correlates with CTPA parameters, such as the presence of central thrombus and the ratio between right and left ventricles greater than 1, in patients with acute PE, regardless of sex (Tab. 2, Fig. 2, Ref. 23). Text in PDF www.elis.sk Keywords: acute pulmonary embolism, computed tomography pulmonary angiography, brain natriuretic peptide, right ventricle.

Background: Human milk oligosaccharide (HMO) is a unique component of breastmilk. To date, no study has investigated the correlation between HMO and infant nutritional status particularly through the lens of gut microbiota. Therefore, our study aims to investigate the relationships between 2'-Fucosyllactose (2'-FL) in HMO and Firmicutes/Bacteroidetes (F/B) ratio among stunted infants.

Methods: A case-control study was conducted among 103 mother-infant pairs in Malang City, Indonesia. The quantification of 2'-FL HMO was assessed using High-Performance Liquid Chromatography (HPLC). The F/B ratio was analyzed with real-time poly-chain reaction (RT-PCR). For bivariate analysis, we employed the Spearman correlation and Mann‒Whitney tests, while for multivariate analysis, we utilized multiple linear regression.

Results: The findings showed that the stunted nutritional status was detected in 49 out of 103 infants. In this group, 40.81% of mothers of infants with a stunted nutritional status had a secretor-positive status, while all mothers of infants with appropriate nutritional status tested positive for the secretor status (100%). However, the association between maternal secretor status and infant nutritional status was not statistically significant (p>0.05). The average levels of 2'-FL HMO in breast milk were lower in the group with stunted infants compared to non-stunted infants (1.21 mg/L vs 1.40 mg/L). The regression analysis revealed a significant association of 2'-FL HMO levels with the presence of Bacteroidetes and value of the F/B ratio (p>0.05).

Conclusions: The breast milk component 2'-FL HMO significantly influences the gut microbiota of stunted infants. Future research aimed at elucidating the mechanisms by which 2'-FL HMO modulates infant gut microbiota should consider not only concentration and specific bacterial taxa but also intake levels (Tab. 2, Fig. 1, Ref. 37). Text in PDF www.elis.sk Keywords: 2'-fucosyllactose, human milk, oligosaccharide, firmicutes, bacteroidetes, stunting, infant.

Introduction: This study examines triage judgments in emergency settings and compares the outcomes of artificial intelligence models for healthcare professionals. It discusses the disparities in precision rates between subjective evaluations by health professionals with objective assessments of AI systems.

Material and method: For the analysis of the efficacy of emergency triage; 50 virtual patient scenarios had been created. Emergency medicine residents and other healthcare providers who had triage education were tasked with categorizing triage levels for virtual patient scenarios. Also artificial intelligence systems, tasked for resolving the same scenarios. All of them were asked to use three color-coded triage of the Republic of Turkey Ministry of Health. The answer keys were created by consensus of the researchers. In addition, Emergency medicine specialists were asked to evaluate the acuity level of each scenario in order to perform sub-analyses.

Results: The study consisted of 86 healthcare professionals, comprising 31 Emergency medicine residents (26.5%), 1 paramedic (0.9%), 5 emergency health technicians (4.3%), and 80 nurses (68.4%). Google Bard AI and OpenAI Chat GPT v.3.5 were used as artificial intelligence systems. The responses compared with the answer key to determine each groups efficacy. As planned the responses from healthcare professionals were analyzed individually for acuity level of scenarios. Emergency medicine residents and other groups of healthcare providers had significantly higher numbers of correct answers compared to Google Bard and Chat GPT (n=30.7 vs n=25.5). There was no significant difference between ChatGPT and Bard for low and high acuity scenarios (p=0.821)CONCLUSION: AI models can examine extensive data sets and make more accurate and quicker triage judgments with sophisticated algorithms. However, in this study, we found that the triage ability of artificial intelligence is not as sufficient as humans. A more efficient triage system can be developed by integrating artificial intelligence with human input, rather than solely relying on technology (Tab. 4, Ref. 41). Text in PDF www.elis.sk Keywords: emergency triage, AI applications, health technology, artificial intelligence, emergency management.

Objectives: This study aimed to assess the mortality and prognosis of acute myocardial infarction (AMI) patients with out-of-hospital cardiac arrest (OHCA) initially admitted to Department of Anesthesiology and Intensive Care in comparison with patients initially admitted to Cardiac Centre (CC).

Background: Global acute coronary syndrome (ACS) registries often omit patients with OHCA initially admitted to anaesthesiology and intensive care units. This exclusion may lead to underestimated mortality rates in patients following acute MI worldwide.

Methods: A retrospective analysis was conducted in patients admitted in 2014 to the (Department of Anesthesiology and Intensive Care) at a single center, J.A. Reiman Teaching Hospital in Presov, Slovakia. Survival rates were evaluated in-hospital, at 30 days, and annually over a five-year period. Patients with STEMI and NSTEMI were analyzed separately, particularly during the early in-hospital phase.

Results: In the OHCA group, 52% of STEMI patients experienced in-hospital mortality, whereas the CC group reported only 3% mortality. The total hospital mortality for STEMI patients was 6.69%. Among NSTEMI patients in the OHCA group, in-hospital mortality reached 50%, compared to 4.33% in the CC group. The total center mortality for all NSTEMI patients was 6.09%.

Conclusion: Although the short-term prognosis for MI patients with OHCA is unfavorable, with a 30-day mortality rate of 54.9%, for those who survive the initial 30 days following cardiac arrest and are successfully discharged from the hospital, the long-term prognosis aligns with MI patients without OHCA. In light of these findings, the inclusion of all patients with MI (from both OHCA and CC groups) in global ACS registries could significantly raise in-hospital and 30-day mortality rates (Tab. 3, Fig. 4, Ref. 21).

Objective: Amid the COVID-19 pandemic in the Russian Federation, social care providers received incentives such as bonuses and welfare payments. The study examines the association between COVID-19 pandemic indicators and distribution of incentives to care providers in Russia.

Methods: To test the hypotheses, regression analysis is employed.

Results: Hypothesis H1, regarding the correlation between the COVID-19 case rate in a specific region of the Russian Federation and the actual monetary amount of bonus payments compensating for challenging working conditions of care workers in that region is supported. Hypotheses H2-H3, regarding the relationship between the COVID-19 cases/recovery rate and the monetary amount of special welfare payments to care workers distributed across the country during a given calendar month are also supported. Hypothesis H4, pertaining to the relationship between the Fiscal Year End and the monetary amount of special welfare payments distributed throughout the country to care providers during a given calendar month, is likewise supported.

Conclusion: There is a correlation between payments to social care providers and coronavirus pandemic indicators (Tab. 5, Ref. 31). Text in PDF www.elis.sk Keywords: welfare payment, bonus, care providers.

Background: A pressing concern involves the efficient and intensive treatment of complications arising from malignant tumors in the hepatopancreatoduodenal region. This matter is closely tied to rectifying energy deficits, addressing insufficient body weight, and restoring proper metabolic processes. This is particularly crucial post-surgery, as the process is hindered by significant hypercatabolism, heightened nutritional requirements, and the presence of intoxication syndrome.

Objective: To consider the features of nutritional support in patients with tumors of the hepatopancreatoduodenal zone in the early postoperative period.

Methods: An investigation was carried out on 91 individuals aged 18 years and older who were afflicted with malignant tumors situated in the hepatopancreatoduodenal area. These patients were categorized into three distinct groups, each receiving a different form of nutritional assistance.The assessment encompassed various aspects of the patients' nutritional well-being, including outcomes from the screening protocol, body mass index, basal metabolic rate, and critical laboratory measurements such as blood lymphocyte count, total protein level, total bilirubin concentration, as well as ALaT and ASaT levels.

Results: Under the provision of parenteral nutritional support, as per the applied screening protocols, a span of 10 to 12 days saw 17 patients sustaining a "normal" nutritional state, while 14 patients experienced a condition of "moderate malnutrition." Notably, one patient (3.2%) demonstrated a regression from the status of "severe malnutrition."In the mixed nutrition group, within the same 10 to 12-day timeframe post-operation, there was a rise in the prevalence of patients classified as having "moderate malnutrition" according to the SGA and NRI scales by 10% and 6.7%, respectively. Remarkably, all indicators pointing to "severe malnutrition" were entirely eliminated as assessed by the mentioned nutritional evaluation scales (p<0.005).

Conclusion: A notable degree of effectiveness in stabilizing and upholding the nutritional condition of patients was attainable within the isolated parenteral nutrition group. This achievement was realized by elevating the count of patients classified under "moderate" and "normal" nutritional statuses, and concurrently diminishing the number of patients experiencing severe and moderate nutritional insufficiency, respectively.The mixed type of nutritional support in this case can be considered with a high degree of probability as an alternative replacement for parenteral nutrition, due to the statically similar indicators of the nutritional status of patients achieved in this study (Fig. 4, Ref. 12).

Slovakia, in accordance with a global trend, is experiencing an increasing cancer burden. Development and assessment of preventive and healthcare interventions are informed by cancer epidemiology.This study presents the current epidemiological situation and trends for three prevalent malignancies: breast, colorectal, and cervical cancer in the Slovakia. Population-based screening programs for these cancers have recently been reinforced.Breast cancer is the most common newly diagnosed cancer and also the most common cause of death of all cancer in women. Cervical cancer is the second most common cancer in women with decreasing mortality. Colorectal cancer belongs to the cancer diseases with highest incidence and mortality in both the male and female populations, with the majority of cases diagnosed in later stages. Despite progress in specific areas of cancer care, Slovakia acknowledges the need for further improvements. Enhancing cancer screening uptake presents a crucial area for advancement (Fig. 7, Ref. 19). Keywords: epidemiology, Slovakia, breast cancer, colorectal cancer, cervical cancer.

Ahead of Print article withdrawn by publisher.

Ntroduction: Type 2 Diabetes Mellitus (DM2) can lead to autonomic nervous system dysfunction and heart rate variability (HRV) is often used to assess this system both during rest and during physical exercise.

Objective: To evaluate the autonomic modulation at rest and the responses of heart rate and parasympathetic indices of individuals with DM2 to isometric handgrip exercise.

Method: The sample consisted of individuals of both sexes; over 40 years, divided into groups, with and without DM2 diagnosis. The collection of resting HRV was performed for 20 minutes in the supine position, and 256 points were selected for symbolic and linear analysis. The individuals performed isometric contraction for one minute with intensities of 10, 20, 30, 40 and 50 % of the maximum contraction, using the parasympathetic indexes RMSSD and SD1 for analysis.

Results: Linear and symbolic indices of HRV at rest and those obtained during exercise were similar (p-value>0.05). No association was found between the indices at rest and the responses to exercise, with a slight delay in the response of diabetics in HR and parasympathetic indices being identified.

Conclusion: There was no difference between the groups in the modulation of rest or in the parasympathetic adjustments of the exercise (Tab. 4, Ref. 32).