Bratislava Medical Journal-Bratislavske Lekarske Listy最新文献

Couples are increasingly using assisted reproduction technology (ART) to facilitate having children. This raises the question of whether using ART leads to the same health outcomes as spontaneous conception.One of the major health outcome factors concerns the weight of the newborn. Many foreign studies have proved that newborns conceived via ART evince lower birth weights than newborns that were conceived spontaneously. The purpose of this study is to determine whether the risk of low birth weight differs according to the ART method selected (in-vitro fertilisation with fresh embryo transfer, frozen embryo transfer, oocyte receipt), and which of these methods is associated with the lowest risk of a low birth weight. Anonymised individual data on all deliveries that took place in Czechia between 2013 and 2018 was used for the analysis. The dataset was obtained from the National Registry of Reproduction Health (administered by IHIS CR).The binary logistic regression revealed that concerning many of the covariates controlled, women who underwent IVF had a higher risk (30 %) of giving birth to a child with a low birth weight than women who received frozen embryo transfer treatment (CI 1.15-1.48). Women who underwent oocyte receipt treatment were found to have an even higher (52 %, CI 1.17-1.97) risk than women who received frozen embryo transfer. This study supports existing international knowledge of the specifics of the health outcomes of women who use ART (Tab. 1, Fig. 3, Ref. 32). Keywords: Low birth weight, assisted reproduction technology, in-vitro fertilisation, frozen embryo transfer, oocyte receipt.

Background: For many years, the physicians are searching for easily measurable marker of immune response to the stress and inflammation. More than, 20 years ago Zahorec (2001) proposed neutrophil-to-lymphocyte ratio (NLR) as an easy available and valid biomarker of inflammation, stress, and activation of immune system.

Methods: In this narrative review we focused on the utility of neutrophil-to-lymphocyte ratio (Zahorec's index) in clinical practice of general medicine (inflammation and infection), intensive medicine (sepsis), oncology (prediction of prognosis in cancer of solid organs), surgery and perioperative medicine (diagnosis of complications, and prediction of clinical outcome).

Results and conclusion: We provide many evidences of clinical research which confirm that Neutrophil-to-lymphocyte ratio is a very sensitive marker of inflammation, stress reliable and valid parameter in everyday clinical practice. NLR (Zahorec index) is an effective tool for diagnosis of infection and severity of disease of variable etiologies. NLR reflect the grade of inflammation in cancer disease, which has a significant impact on the prognosis of cancer patients. Zahorec index should be used routinely in emergency medicine, surgery and perioperative medicine as a marker of the severity of affliction, infection, and complications in general. NLR may help physicians in decision making process for early diagnosis and therapy. NLR should be investigated frequently in acute states (sepsis, shock, peritonitis, stroke, trauma) on a daily basis, in subacute states few times per week (during hospital stay), and few times per year in chronic disease (cancer, diabetes mellitus, ischemic heart disease, psychiatry disorders). NLR has a deep biological sense connecting together function of three suprasystems: immune, endocrinne and autonomous nervous system (Tab. 2, Fig. 3, Ref. 86).

Objectives: This study aimed to provide an overview on the HIV-1 subtypes circulating in Slovakia between 2017 and 2018 and to evaluate the risk of transmission of HIV‑resistant strains.

Background: The HIV epidemic in Slovakia is characterised by low incidence of new and pre-existing infections and a slightly elevated level of strain heterogeneity.

Methods: Partial HIV pol gene sequences of 110 individuals newly diagnosed with HIV between 2017 and 2018 were analysed.

Results: The genotypic analysis revealed sporadic occurrence of mutations linked to HIV resistance to antiretroviral therapy (ART). The HIV-1 B subtype has been found as predominant (84.55 %) and primarily linked to men who have sex with men (MSM). A total of eighteen individuals (15.45 %) were found to be infected with HIV-1 non-B subtypes.

Conclusion: The data suggest a minimal risk of a resistant HIV strain transmission and a marginal rise of HIV-1 subtypes´ diversity. The HIV-1 B subtype remains the most prevalent in the period 2017-2018 in Slovakia (Tab. 2, Fig. 2, Ref. 37).

Increased serum lactate dehydrogenase (LDH) activity is considered as a marker of cellular necrosis and serves as a metabolomic diagnostic marker in several types of cancer including head and neck squamous cell carcinoma (HNSCC). LDH, an enzyme involved in the glycolytic cycle, is correlated not only with the activation of oncogenes such as HIF-α and Myc, but also with effects such as tumor proliferation and metastasis. Serum alkaline phosphatase (ALP) is a marker of cell differentiation and tumor induction. Albumin-to-alkaline phosphatase ratio (AAPR) could be an advantageous biomarker due to its easily accessible dynamics and cost-effectiveness. Elevated values of AAPR could be associated with longer overall survival (OS) in cases with solid tumors. Diabetes mellitus (DM) could influence the outcome of patients with HNSCC by contributing to insulin resistance and chronic inflammation, and by being involved in various aspects of carcinogenesis, disease progression and metastasis. However, the use of antihyperglycemic medications (metformin) can have beneficial effects by inhibiting tumor metabolic pathways. The biomarker role of LDH and AAPR in HNSCC patients with DM has been less evaluated. The purpose of the study was to assess the prognostic value of pretreatment serum lactate dehydrogenase (LDH) and albumin-to-alkaline phosphatase ratio (AAPR) in predicting the duration of non-surgical oncological treatment and glycemic control in cases of head and neck cancers patients with DM, including cases selected from the database of the oncology clinic and oncology outpatient clinic of the Craiova County Hospital. Both LDH and AAPR can be used as pre-treatment biomarkers predictive of treatment response, or prognostic tools included in complex multi-parametric models in HNC associated with DM. However, given the impact of short-term glycemic control on the LDH level, it is necessary to evaluate these biomarkers after assessing and controlling for DM, and with the recommended cut-off value set around 0.5. Due to the limited number of cases, it is necessary to validate the results in multicentric trials with a larger number of patients (Tab. 5, Ref. 50). Keywords: diabetes mellitus, HNC, LDH, AAPR, biomarkers, predictive, head and neck cancers, lactate dehydrogenase, albumin-to-alkaline phosphatase ratio.

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.

Methods: This study conducted a genome-wide association study (GWAS) on longitudinal CSF t-tau and genotype data from 319 non-Hispanic Caucasians within the Alzheimer's Disease Neuroimaging Initiative (ADNI) cohort. The aim was to identify genetic determinants influencing the rate of change in CSF t-tau, a key biomarker in AD.

Results: The GWAS identified a significant single nucleotide polymorphism (SNP), rs17149074, within the C9orf171 (CFAP77) gene region that showed significant association with changes in CSF t-tau over time. Additionally, five other SNPs-rs10916844, rs10916846, rs9425869, rs3744474, and rs8078303-were found to potentially influence CSF t-tau variability.

Conclusions: These findings not only enhance our understanding of t-tau's progression in AD but also suggest that these identified SNPs could serve as novel genetic biomarkers, potentially providing novel insights in the prognostic landscape of AD by refining the predictive value of CSF-tau measurements (Tab. 2, Fig. 2, Ref. 31). Text in PDF www.elis.sk Keywords: cerebrospinal fluid, t-tau, genome-wide association study, single nucleotide polymorphism, genetic factors.

Mitochondria are subcellular organelles involved in many metabolic events, including oxidative phosphorylation and signaling in tissue-specific processes. They play a key role in cell proliferation, differentiation and death.Diseases in the pathogenesis of which mitochondrial oxidative stress and immunity play a significant role include cancer, cardiovascular, nervous and rheumatic diseases as well as liver, lung and kidney diseases. In addition, mitochondria participate in the pathogenesis of infections and autoimmunity.Mitochondrial dysfunction can be positively influenced by administration of antioxidants, including coenzyme Q10 (Tab. 1, Fig. 5, Ref. 20). Text in PDF www.elis.sk Keywords: mitochondria, immunopathogenesis, bronchial asthma, chronic hepatitis C, reactive oxidative species, antioxidants, coenzyme Q10.

Background: Human papillomavirus is known to be the main cause of cervical cancer. Given that cervical cancer is still one of the leading causes of death in women of reproductive age, it is very important to prevent HPV infection and its persistence.

Objective: The aim of our study was to explore the quality of the diet in the spontaneous clearance of cervical HPV infection and its persistence. Furthermore, we have assessed the associations of overall diet quality and dietary components with HPV occurrence and clinical resolution of HPV over time.

Methods: 200 women of age between 20 and 68 years were included in this prospective study. Patients were tested for the presence of HPV subtypes, and were given questionnaires about their dietary habits.

Results: 43 patients were positive for HPV virus, and 157 patients were negative. Among the positive HPV patients, the mean value (±SEM) of the score was 12.88±0.6822 (min=7, max=21) with upper CI of mean 14.26 and coefficient of variation of 34.72%.

Conclusion: Various antioxidants have different abilities to influence the course of HPV-mediated cervical cancer. This study showed that women who did not consume fruits, and dark-green vegetables had a higher risk of HPV infection (Tab. 2, Fig. 3, Ref. 40): Text in PDF www.elis.sk Keywords: cervical cancer, human papillomavirus, folate, vitamin D3, dietary intake.

Anencephaly, a fatal anomaly of the central nervous system, belongs to the group of defects of the neural tube (NTDs). It is considered the most common congenital NTD, characterized by concurrent absence of a significant portion of the brain and cranial vault. This deformity occurs between days 23 and 26 after fertilization due to improper closure of the neural tube at its cranial end. Many genetic, epigenetic, and non-genetic factors (nutritional, environmental and geographical factors, parental socioeconomic status) contribute to the etiology of this disease. Despite significant advances in treatment and preventive measures, NTDs continue to pose a significant health and financial burden on patients and society as a whole. This study aimed to examine the incidence of anencephaly in Slovakia compared to the Czech Republic between 2012 and 2020. The authors seek to elucidate the reasons behind the higher incidence of this disease in Slovakia as compared to the Czech Republic, explore the male predominance of anencephaly in Slovakia, and investigate whether the prevention standards used in Slovakia differ from those employed in other countries (Tab. 1, Fig. 2, Ref. 129). Keywords: neural tube defects, anencephaly, risk factors, folic acid, food fortification.

Objectives: To create a new mucoadhesive dosage form based on PluronicF127 followed by transformation into a gel form upon intranasal administration for targeted delivery to brain tissueMETHODS: Citicoline, cytidine diphosphocholine, designated as CDP-choline, was purchased as a white powder with the molecular weight of 510.31 g/mol. The triblock copolymers of polyethylene glycol-block-polypropylene glycol-block-polyethylene glycol (PEG-PPG-PEG), branded as Pluronic F127, was used.

Results: When instilled into the nasal cavity, Pluronic F127 for intranasal administration is transformed into a gel that remains retained for 45-55 minutes, which promotes better penetration of drugs into the brain tissue.

Conclusion: The polymer's gelling and adhesive properties performed well, which is crucial for further research at the preclinical stage (Tab. 1, Fig. 5, Ref. 28).