Bratislava Medical Journal-Bratislavske Lekarske Listy最新文献

The term kratom is commonly used for both Mitragyna speciosa and herbal products prepared mainly from leaves. Kratom is well known as a drug that can serve as a less toxic and less-addictive pain-relieving substitute for opium, as well as a therapy for hypertension, cough, and diarrhea. Its major alkaloid, mitragynine, also deserves concern. However, most people use kratom as a psychological stimulant, which carries a risk of addiction associated with negative social and health impacts. This paper reviews basic facts about kratom and its potential use in pharmacology, pharmacokinetics, and pharmacokinetics of its major alkaloid mitragynine (Tab. 3, Fig. 1, Ref. 87). Keywords: 7-hydroxymitragynine; alkaloid; anesthetics; antitussive; drug; mitragynine; Mitragyna speciosa; addictive substance; opioid receptor.

During cancer surgery, the perioperative period is characterized by stress response and immunosuppression that can lead to further worsening of the disease and metastatic spread. Local anesthetics have antiproliferative, cytotoxic and antimetastatic effects on cancer cells in vitro. There is scientific evidence that local anesthetics possess anti-inflammatory effects, help to preserve normal immune function and reduce the possibility of metastatic spread. Anesthetic care affects pain, inflammation, and immunosuppression, which may have a great impact on the outcome of oncological patients. The use of local anesthetics during the perioperative period in oncological patients may have a beneficial effect on their survival and cancer recurrence. This article summarizes the effects of local anesthetics in vitro (Tab. 1, Fig. 1, Ref. 36). Keywords: local anesthetics, cancer cells.

Aim: To analyse prenatal and postnatal characteristics, clinical and laboratory findings, results of investigations in the group of 11 newborns with congenital CMV infection, who were hospitalized at Neonatal Department of Intensive Medicine between January 1st 2012 and March 31st, 2022 were included.

Results: Prenatal foetal sonography revealed in patients 5 and 8, positive calcifications in the brain; in patients 6, 9 and 11, isolated ventriculomegaly was found. Neurological examination was clinically negative in patients 1 and 10, changes of muscular tonicity and spontaneous activity were confirmed in the rest of the group. In patients 5 and 10, one-sided positivity of otoacoustic emissions was confirmed. Chorioretinitis with bilateral negative otoacoustic emissions was confirmed in patient 5. Clinical status of patient 11 was complicated by pneumonitis. Three patients were treated with antiviral drugs orally, and 11 newborns had a combination of intravenous and oral form of treatment.

Conclusion: The results of analysis will contribute to a society-wide solution of prevention. Monitoring of the frequency of CMV infection in the population with education of the population can decrease the number of affected newborns (Tab. 4, Ref. 29).

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).

Objective: Propranolol (PRO) has been recently discovered to possess anti-tumorigenic effects in cancer patients. So, we aimed to enlighten the in vitro effects of propranolol in A549 lung cancer cells and BEAS2B nontumoral lung cells.

Methods: The gene expression levels of apoptotic proteins; caspases 3, 8, and 9 (CASP3, 8, 9), apoptosis inducing factor (AIF), and DNA damage inducible transcript 3 (DDIT3) and cell cycle regulatory proteins; WEE1 G2 checkpoint kinase (WEE1) and cyclin dependent kinase inhibitor 1A (CDKN1A) were analyzed with quantitative reverse-transcription PCR to assess the effect of PRO on A549 tumor and BEAS2B nontumoral cells. The protein levels of caspase 3 and AIF1 were detected with Western blot.

Results: PRO exerted its anti-tumorigenic effects against A549 cells by arresting cell cycle via CDNK1A and by inducing apoptosis via caspase-dependent (CASP3) and -independent pathways (AIF, DDIT3). As to nontumoral BEAS2B cells, PRO decreased the cell viability at a lesser extent compared to tumoral cells. In contrast to tumor cells, PRO reduced the protein levels of CASP3 and AIF1. Notably, at 48th hour of PRO treatment, we observed a sustained expression of elevated DDIT3 mRNA levels at 24h in BEAS2B cells unlike in A549 cells.

Conclusion: We suggest that DDIT3 and CDKN1A play a critical role during cell fate decision after PRO treatment by protecting nontumoral cells against apoptosis and by triggering apoptosis in tumor cells. The selective action mechanism of PRO with less cytotoxicity in nontumoral lung cells puts it forward as a promising adjuvant agent in lung cancer therapy (Tab. 1, Fig. 4, Ref. 50). Text in PDF www.elis.sk Keywords: propranolol, BEAS2B, A549, lung cancer, apoptosis, DDIT3.

The work was aimed to determine the level of oral dysbiosis of patients depending on the type of prosthetics constructures.

Materials and methods: The study involved 48 patients with the presence in the oral cavity of fixed dentures from 4 to 6 units with a service life of no more than 3 years. The samples of plaque from the vestibular surface of dentures were collected to determine the microorganisms in the gingival plaque. Bacteriological research was carried out by the multiplex polymerase chain reaction in real time using the Phemoflor 8 reagent kit. The degree of dysbiosis of the oral cavity was determined according to the classification of V. Khazanova.

Results: The results of the study of patients' samples did not reveal significant changes in the microbial landscape of the cervical areas. The total bacterial mass in the group of healthy individuals was lower than the total bacterial mass of patients in the investigated group significantly. IV degree of oral dysbiosis with a decrease in the number of lactobacilli, streptococci was characteristic of patients of denture wearers. The II degree of dysbiosis in patients with metal-ceramic structures was established. Patients who used solid cast and metal-plastic structures were diagnosed with II-III degree of dysbiosis of the oral cavity. The worst indicators were characteristic of prosthesis wearers of stamped-brazed structures.

Conclusions: Quantitative indicators of the composition of the microbiota of the cervical areas of denture wearers have significant differences and different levels of dysbiosis of the oral cavity, depending on the type of dentures in the patients' mouth (Tab. 2, Fig. 1, Ref. 21). Text in PDF www.elis.sk Keywords.

Introduction: The study presents associations between prevalence of chronic diseases and selected socio-economic (SES) attributes in adult population of Slovakia and analyses the prevalence of chronic diseases in regions of Slovakia.

Methods: In total, 735 respondents (146 men and 589 women) with a mean age of 37.79 ± 13.6 participated in this cross-sectional study. The main observed characteristics were chronic diseases and their associations with SES attributes, namely household income, education, age and lifestyle represented by frequency in engaging in recondition-relaxation activities. In order to obtain data, a self-administrated online questionnaire was used. Data were analysed by calculation of odds ratio and chi-square test. The significance level was set at 0.05.

Results: Apart from lung disease which are least suffered in central Slovakia (χ^2 = 9.850, df = 1, p = 0.043), the prevalence of chronic diseases is equally represented in all 8 administrative regions of Slovakia. Prevalence of chronic diseases is significantly influenced by age. The age of 40 is critical for the occurrence of chronic diseases. Respondents with higher education level have a lower prevalence of chronic diseases and vice versa (OR = 1.127; RR = 1.079). A better lifestyle represented by higher frequency of engaging in recondition relaxation activities was found in healthy respondents (OR = 0.700549 and RR = 0.936958; χ^2 test p = 0.000798). Household income did not show a significant association with the prevalence of chronic diseases (OR = 1.06; RR = 1.025; χ^2 test, p = 0.778).

Conclusion: The study did not confirm a higher prevalence of chronic diseases in regions with weaker SES in Slovakia. Out of the 4 monitored SES attributes, 3 of them (age, education and lifestyle) had a significant impact on the prevalence of chronic diseases. Household income showed only a minimal association with the prevalence of chronic diseases, but this interdependence was not significant (Tab. 6, Ref. 41). Text in PDF www.elis.sk Keywords: socio-economic status, chronic diseases, age, household income, education.

Objectives: Aging is characterized by appetite loss and cachexia, i.e., factors that contribute to malnutrition. An inflammation marker, neutrophil-to-lymphocyte ratio (NLR), is a significant prognostic predictor of many geriatric syndromes. We aim to determine the association between NLR and malnutrition.

Methods: We designed a retrospective study on hospitalized patients in the geriatric unit of a university hospital between January 2019 and January 2021. Demographic data, chronic diseases, history of smoking, length of hospital stay, number of drugs, laboratory and further examinations, and comprehensive geriatric assessment scores were recorded from the hospital data system. The nutritional status of the patients was evaluated using the mini-nutritional assessment (MNA) questionnaire.

Results: Of the 220 patients, 121 (55 %) were female, and the mean age was 77.9 ± 7.3 years. According to the MNA, 60 % (n = 132) were malnourished or at risk of malnutrition. As many as 47.3 % (n = 104) of the patients had depressive symptoms, and 41.4 % (n = 91) were cognitively impaired. The mean age (79.3 ± 7.3), NLR, and GDS scores were significantly higher, and MMSE scores were significantly lower in malnourished patients or in those at risk of malnutrition as compared to patients with normal nutritional status. We showed that NLR (OR: 1.248; 95% CI: 1.066‒1.461; p = 0.006), age (OR: 1.056; 95% CI: 1.005‒1.109; p = 0.031), depressive symptoms (OR: 1.225; 95% CI: 1.096‒1.369; p 4.5, with a sensitivity of 37.9 %, specificity of 85.2 %, negative predictive value of 47.8 %, and positive predictive value of 79.4 %.

Conclusion: NLR, age, depressive symptoms, and cognitive impairment were independently associated risk factors for malnutrition. NLR may be a useful nutritional marker for evaluating the nutritional status of hospitalized geriatric patients (Tab. 4, Fig. 1, Ref. 28). Text in PDF www.elis.sk Keywords: malnutrition, neutrophil-to-lymphocyte ratio, geriatric syndromes, inpatient, older adults.

Objectives: This study aimed to analyze the global profile of the literature in non-alcoholic fatty liver disease (NAFLD) research.

Background: Non-alcoholic fatty liver disease is a clinically heterogeneous condition characterized by fat accumulation in the liver and the absence of significant alcohol consumption or underlying genetic disorders. These manifestations are associated with inflammation, steatosis, and fibrosis that can develop into cirrhosis and even hepatocellular carcinoma. However, a study about the research trend in NAFLD has never been reported before.

Methods: The NAFLD bibliometric analysis was performed on articles indexed in the Scopus database from 1973 to 2022.

Results: The total number of articles published worldwide is 28,673 documents, with an annual average of 561 documents. The United States generated the most articles (n = 6548), followed by China (n = 6180), Italy (n = 2434), and Japan (n = 2032). Since 2013, the number of publications on NAFLD has increased dramatically worldwide. The popular topics in the field include medicine, biochemistry, genetics and molecular biology, pharmacology, toxicology and pharmaceutics, and nursing.

Conclusions: This study provides a unique composite picture of NAFLD research worldwide and evaluates research productivity from 1973 to 2022. This finding suggests that the prospects for interventions in NAFLD remain promising (Tab. 5, Fig. 4, Ref. 57). Text in PDF www.elis.sk Keywords: bibliometric analysis, NAFLD, Scopus.

Objective: Recently, older people's cardiovascular systems have been affected by aging-related changes. An electrocardiogram (ECG) provides information about cardiac health. Analyzing ECG signals can help doctors and researchers diagnose many deaths. ‎Besides direct ECG analysis, some measurements can be extracted from the ECG signals, and ‎one of the most important measurements is heart rate variability (HRV). Research and clinical domains can benefit from HRV measurement and analysis as a potential noninvasive tool for assessing autonomic nervous system activity. The HRV describes the variation between an ECG signal's RR intervals over time and the change in that interval over time. An individual's heart rate (HR) is a non-stationary signal, and its variation can indicate a medical condition or impending cardiac disease. Many factors, such as stress, gender, disease, and age, influence HRV.

Methods: The data for this study is taken from a standard database, the Fantasia Database, which contains 40 subjects, including two groups of 20 young subjects (21‒34 years old) and 20 older subjects (68‒85 years old). We used two non-linear methods, Poincare and Recurrence Quantification Analysis (RQA), to determine how different age groups affect HRV using Matlab and Kubios software.

Results: By analyzing some features extracted from this non-linear method based on a mathematical model and making a comparison, the results indicate that the SD1, SD2, SD1/SD2, and area of an ellipse (S) in Poincare will be lower in old people than in young people, but %REC, %DET, Lmean and Lmax will recur more often in older people than in younger ones. Poincare Plot and RQA show opposite correlations with aging. In addition, Poincaré's plot showed that young people have a greater range of changes than the elderly.

Conclusion: According to the result of this study, heart rate changes can be reduced by aging, and ignoring this issue could lead to cardiovascular disease in the future (Tab. 3, Fig. 7, Ref. 55).