Bratislava Medical Journal-Bratislavske Lekarske Listy最新文献

Objective: Vascular endothelium is a tissue in which several vasoactive substances are produced and secreted. Reactive oxygen species can cause endothelial dysfunction (ED). miRNAs can be implicated in the oxidative stress-related ED during vascular disease pathogeneses. Our aim is to investigate effect of H2O2-induced oxidative stress on expression levels of genes and miRNAs that are key players in ED.

Methods: H2O2 effect on cell viability of human umbilical-vein endothelial cells (HUVEC) at 24-hour was measured with MTT. Low sub-cytotoxic H2O2 concentrations (25, 50 µM) were selected to analyze their oxidative stress-inducing capacities with MDA assay and their effects on EDN1, NOS3, VCAM1, SERPINE1, miR21, miR22, miR126, and miR146a levels with RT-qPCR.

Results: Each tested H2O2 concentration reduced HUVEC cell viability. Fifty µM H2O2 augmented cellular MDA levels. Intriguingly, EDN1, VCAM1, and SERPINE1 and all analyzed miRNAs' levels attenuated upon H2O2 treatment whereas there was no change in NOS3 levels compared to control. There was a positive correlation between miR-21 and VCAM1.

Conclusion: Rather than individual alterations in analyzed parameters, consistent changes in our findings i.e., parallel decreases in EDN1, VCAM1, SERPINE1 mRNA levels as well as miRNAs, suggests that H2O2 concentration-dependent modulation of expression patterns can bring about various impacts on ED (Tab. 1, Fig. 5, Ref. 63).

Non-invasive diabetes detection refers to the utilization and development of technologies and methods that can monitor and diagnose diabetes without requiring invasive procedures, namely invasive glucose monitoring or blood sampling. The objective is to provide a more convenient and less burdensome approach to screening and management of diabetes. It is noteworthy that while non-invasive method offers promising avenues for diabetes detection, they frequently require validation through clinical studies and might have limitation in terms of reliability and accuracy than classical invasive approaches. In recent times, deep learning (DL) and feature selection (FS) are used to monitor and diagnose diabetes accurately without requiring invasive procedures. This technique combines the FS method with the DL algorithm for making accurate predictions and extracting relevant features from non-invasive data. This article introduces a new Binary Fire Hawks Optimizer with Deep Learning-Driven Non-Invasive Diabetes Detection and Classification (BFHODL-NIDDC) technique. The major intention of the BFHODL-NIDDC technique focuses on the involvement of non-invasive procedures for the detection of diabetes. In the BFHODL-NIDDC technique, data preprocessing is initially performed to preprocess the input data. Next, the BFHO algorithm chooses an optimal subset of features and improves the classifier results. For the identification of diabetes, multichannel convolutional bidirectional long short-term memory (MC-BLSTM) model is used. At last, the beetle antenna search (BAS) algorithm is used for the hyperparameter selection of the MC-BLSTM method which in turn enhances the detection performance of the MC-BLSTM model. A series of simulations were conducted on the diabetes dataset to assess the diabetes detection performance of the BFHODL-NIDDC technique. The experimental outcomes illustrated better performance of the BFHODL-NIDDC method over other recent approaches in terms of different metrics (Tab. 4, Fig. 9, Ref. 23). Keywords: diabetes, non-invasive detection, binary fire hawks optimizer, deep learning, hyperparameter tuning.

Medication adherence is crucial for optimal treatment outcomes, yet many patients struggle to follow their prescribed regimens, impacting patients, families, and healthcare systems. Measurement of adherence is vital for effective care planning and intervention. This review explores medication adherence challenges and measurement methods, including therapeutic drug monitoring (TDM), medication event monitoring system (MEMS), analysis of adherence in insurance/pharmacy database, pill counts, and self-reports, each with its advantages and limitations.This review advocates a partnership-based approach to adherence, stressing standardized reporting and team-based care. Adherence is influenced by many factors such as complex regimens, packaging, patient perspectives, side effects. Effectively addressing these factors is crucial for improving patient outcomes. In summary, medication adherence is vital but complex. The article covers various adherence measurement methods to promote medication adherence as an important matter (Tab. 5, Fig. 2, Ref. 91). Text in PDF www.elis.sk Keywords: medication adherence, adherence barriers, primary non-adherence, medication event monitoring system, pill count, self-report.

Despite the worldwide decrease in the incidence of gastric cancer, the proportion of occurrence of carcinomas of the esophagogastric junction and proximal third of stomach is on the rise. The cause of this development is believed to lie in an increasing incidence of reflux esophagitis with Barrett´s metaplasia and successful eradication of Helicobacter pylori infection. The aim of this work is to present various views on the definition of the esophagogastric junction itself and to give an overview of tumor classification schemes being used (Fig. 2, Ref. 54). Keywords: gastric cancer, esophagogastric junction, definition, classification.

Objectives: The objective of this study was to identify a parameter that can facilitate the diagnosis of prediabetes and predict the likelihood of its development in individuals at high risk.

Methods: In this retrospective study, the study population was selected from Bolu Abant Izzet Baysal University Hospital's patients. Participants were divided into two groups, prediabetes and healthy group. We excluded individuals with certain conditions or taking certain medications. The study compared the ratios of uric acid to high-density lipoprotein (HDL) between the two groups and identified the optimal point of differentiation.

Results: The study analyzed data from 228 individuals, including 125 with prediabetes and 103 healthy controls. Those with prediabetes had a significantly higher median UHR (0.13 (0.07-0.24) %) compared to healthy individuals (0.09 (0.05-0.16) %) (p < 0.001). Higher UHR values were associated with a greater risk of prediabetes. A UHR cut-off points greater than 0.11 % had a sensitivity of 74 % and specificity of 69 % in detecting prediabetes.

Conclusion: The study provides evidence that UHR can serve as a practical and valuable diagnostic and screening tool for prediabetes (Tab. 2, Fig. 1, Ref. 23). Text in PDF www.elis.sk Keywords: serum uric acid, HDL cholesterol, UHR, prediabetes.

Aim: To analyse postnatal characteristics, clinical and laboratory findings, results of investigations in the newborn (25 gestational weeks; Apgar score: 6/9 points; born per caesarean section; birth weight: 600 g; birth length: 31 cm; head circumference: 21 cm) from the first high-risk pregnancy with acquired form of acrodermatitis enteropathica.

Results: After summarizing the clinical picture with laboratory findings, we analysed the components of parenteral nutrition with regard to the deficiency of trace elements and vitamins. The zinc depletion dominated.

Conclusion: The diagnosis is clinical, based on the presence of a typical clinical picture together with a low serum zinc concentration. Standard preparations with elementary elements do not sufficiently cover the daily needs of children, other possibilities of supplementation in intravenous form are not available. It is necessary to supplement zinc in premature children, in children with high losses of zinc (with diarrhoea, in patients with a stoma, in patients with severe skin disease) (Fig. 4, Ref. 15).

Objective: To predict the possibility of postoperative atrial fibrillation (AF) with mitral annular plane systolic excursion (MAPSE) measurement, which is a cheap, reproducible echocardiographic method and to monitor these patients more closely and to evaluate them more effectively postoperatively.

Material and methods: 247 patients scheduled for coronary artery bypass surgery were evaluated and 200 patients were included in the study.The enrolled patients were classified into the two groups according to the occurrence of postoperative AF or maintained sinus rhythm after coronary artery bypass surgery (normal sinus rhythm [NSR] group vs. AF group).The clinical and demographic data of all the patients were recorded on admission. Two-dimensional transthoracic echocardiography (TTE) was performed prior to elective surgery.

Results: Postoperative new onset AF occurred in 37 (18.5%) patients. In the multivariate logistic regression analysis carried out after the formation of the model based on the parameters related to AF development, the relationships with white blood cell count, LAd and MAPSE were observed to be prevalent.When MAPSE, which is a parameter used to predict the development of postoperative atrial fibrillation, was compared in the ROC analysis, the area under the curve was found to be 0.831, 95% CI lower-95% CI upper (0.761-0.901) (p<0.001).The distinguishing MAPSE value in predicting postoperative atrial fibrillation development was found to be 11.6 (sensitivity: 90%, specificity: 81%).

Conclusions: We showed that MAPSE could play a role in determining postoperative atrial fibrillation development after coronary artery bypass surgery (Tab. 2, Fig. 2, Ref. 28).

Ntroduction: Distal pancreatectomy is a standard surgical procedure for selected benign, premalignant, and malignant lesions localized in the pancreatic body or tail. Surgical resection remains the only curative option for patients diagnosed with adenocarcinoma of the pancreas.

Patients and methods: Perioperative and postoperative clinical courses were retrospectively assessed in patients, who underwent distal pancreatectomy during the 2011‒2021 period.

Results: During the 2011‒2021 period, a total of 112 distal pancreatectomies were performed. 67 patients (59.8%) underwent laparoscopic distal pancreatectomy, and 45 patients (40.2%) open laparotomy. The conversion was necessary for 13 patients (11.6%). Distal pancreatectomies performed laparoscopically were associated more often with biochemical leak and the development of grade B fistula, on the other hand grade C fistula developed only in patients operated by open laparotomy (LPT). The mean operating time was slightly longer in the laparoscopic group (227.1 min vs 214.6 min). The mean estimated blood loss was significantly higher in the LPT group (540.4 ml vs 191.9 ml). The mean hospitalization time was slightly longer in the LPT group (11.8 days vs 9.3 days). The rates of early reoperations were comparable between both groups (6 vs 5).

Conclusion: Laparoscopic techniques are preferred in centers around the world to bring patients benefits by using a minimally invasive approach. These techniques are also preferred in our center, in nearly 60% of all distal pancreatectomies performed during 10 years, but on the other hand, there is a much more careful approach chosen in cases of malignant disease to achieve adequate radicality (Tab.4, Ref. 20).

Objectives: The main objective was to explore the effect of exoskeleton-assisted rehabilitation on quality of life in the subacute state of ischemic stroke.

Background: Central upper extremity hemiparesis affects self-care, social participation, and quality of life. Exoskeleton devices serve as a therapeutic tool and an assessment tool that offers precise tracking of patient progress and evaluation of impairment.

Methods: The trial was carried out from April 2022 to September 2023. Twenty-seven patients were randomly assigned to the intervention (14 participants; mean age 64.71 years; 5 women, 9 men) and control group (13 participants; mean age 64.69 years; 6 women, 7 men). Both groups received equal total therapy (10 to 12 sessions, 5 times a week). The intervention group received 30 minutes of Armea®Spring training combined with conventional rehabilitation. The control group was subjected to conventional rehabilitation.

Results: In the comparison between groups, the experimental group achieved significant changes in quality of life, movement efficiency, and functional performance of the upper extremities.

Conclusions: Armeo®Spring therapy combined with usual care led to significantly larger changes in health-related quality of life and upper extremity movement efficiency compared to conventional rehabilitation (Tab. 4, Fig. 3, Ref. 64.) Text in PDF www.elis.sk Keywords: stroke, hemiparesis, health-related quality of life, Armeo®Spring, movement efficiency, activities of daily living.

Introduction: External ventricular drainage (EVD) is frequently used in neurosurgical interventions to drain cerebrospinal fluid (CSF). Nevertheless, it carries a high incidence of infectious complications, notably secondary meningitis and ventriculitis. In light of the previous rates of these EVD-related infections, we introduced a set of guidelines to lower the infection rate. This study aimed to assess the influence of the hospital-wide adoption of the EVD handling protocol on secondary infections related to EVD.

Material and methods: We enrolled 171 patients scheduled for EVD placement for reasons other than infectious meningitis or ventriculitis from January 2021 to March 2024. A matched cohort of patients underwent logistic regression to adjust for and analyze regression discontinuity.

Results: Infections were more prevalent in the group before the protocol's implementation (18.27% compared to 7.46%, p<0.0001). Regression analysis within the matched score cohort (n=104 in pre-protocol groups and n=67 in post-protocol groups) indicated that the period before the protocol was independently linked to a higher incidence of infections.

Conclusion: Implementing a stringent hospital-wide protocol for EVD handling can significantly diminish the rate of secondary infections associated with EVD (Tab. 3, Fig. 1, Ref. 15). Text in PDF www.elis.sk Keywords: external ventricular drainage, meningitis, ventriculitis, infection.