Bratislava Medical Journal-Bratislavske Lekarske Listy最新文献

Objectives: Numerous studies consistently report on the frequent presence of low-grade systemic inflammation in individuals with schizophrenia, bipolar disorder (BD), and depression. Neutrophil-to-lymphocyte ratio (NLR) and a recently established marker, systemic immune inflammation index (SII), are markers used to assess systemic inflammation and immune response. In this study, NLR and SII index values were examined and compared across patients diagnosed with major psychiatric disorders and healthy controls.

Methods: The study included, totaling 129 patients, encompassed individuals who were diagnosed with schizophrenia in remission or BD in the euthymic period, and those undergoing treatment for major depressive disorder (MDD). The control group consisted of 62 healthy individuals. White blood cell (WBC), neutrophil, lymphocyte, platelet, and monocyte counts obtained retrospectively from complete blood profiles served as the basis for calculating NLR and SII values.

Results: In this study, higher WBC, neutrophil counts, NLR, and SII values were observed in schizophrenia and BD patients compared to the control group. In patients with MDD, no significant difference was found in terms of inflammatory blood cell markers compared to healthy controls. Higher NLR and Sİİ values were found in patients with schizophrenia and BD compared to patients with MDD.

Conclusion: The results of the study indicate that the significant difference in NLR and SII values persists after treatment in patients with schizophrenia and BD, and that the abnormal inflammatory response continues during the treatment process (Tab. 2, Ref. 41).

Ntroduction: The last two decades have been leading to the development of several types of surgical techniques and procedures to manage the LHB lesions. This paper analyses and compares the difference in muscle strength pre- and post-operatively in two most commonly used surgical procedures - LHB tenotomy and tenodesis.

Method: The study includes 68 patients who underwent surgery between 2016 and 2020. The patients who had met the prospective study inclusion criteria were divided into two groups based on type of surgery they had undergone (LHB tenotomy or tenodesis); each group consisted of 34. The muscle strength during elbow flexion was measured preoperatively and postoperatively using the Commander Echo Console ultrasound muscle testing device. All patients enrolled in the study had been assessed for elbow flexion strength preoperatively. The muscle strength was measured preoperatively and then 3 years postoperatively (12 to 60 months) on average.

Conclusion: The study confirmed that the patients who had undergone LHB tenodesis show a significantly lower decrease in elbow flexion strength and a significantly lower incidence of "Popeye" deformity than the patients after LHB tenotomy. Moreover, in the tenodesis group, it was possible to initiate rehabilitation earlier. The incidence of postoperative complications was almost identical in both groups of patients (Tab. 10, Fig. 6, Ref. 40).

The efficacy of taxane‑containing regimens has been demonstrated for various cancers, particularly ovarian, endometrial, breast, lung, and prostate cancers. However, extensive taxane-induced toxicities limit their use. Prediction and management of many toxic complications in cancer patients have evolved significantly over the last decade. Peripheral neuropathy is the most typical non-hematological taxane-related complication, and it has a multifactorial pathogenesis. It is often dose-dependent and progressive during therapy and sometimes even after treatment. Unfortunately, the prediction of these common adverse events remains unclear. In the past few years, several polymorphisms of candidate genes with a possible role in the development of this consequence were studied. This minireview aims to highlight the critical yet underappreciated roles of genetic predictors that may increase susceptibility to taxane-induced peripheral neuropathy in cancer patients (Ref. 40). Keywords: taxanes, paclitaxel, docetaxel, peripheral neuropathy, risk factors, genetic polymorphisms.

Introduction: In patients with acute myeloid leukemia (AML), allogeneic hematopoietic stem cell transplantation (HSCT) remains the priority treatment option as the most effective prevention of relapse. When an HLA-matched sibling is available, these transplants are preferred.

Objectives: We stratificated patients according to risk, disease state (an active disease, the 1st or 2nd complete remission ‒ CR1, CR2, which was achieved after the 1st or 2nd induction) and type of graft (from brother or sister). Finally, the overall survival (OS) of patients in individual groups was evaluated.

Material and methods: The retrospective single-center study included 104 transplantations in 97 adult patients with AML who underwent HSCT from matched sibling donor in a period of 10 years between January 2011 and December 2020.

Results: 54 patients (55.7%) were alive as of the January 1, 2022. The median OS of the entire group, as well as the cohort with favorable (5y-OS 75.0%) and intermediate prognosis risk (5y‒OS 78.5%) was not reached. We found that patients, who required second induction therapy to achieve CR, had poorer OS after allogeneic HSCT, median 20.7 months (95% CI, 6.5-35.5) than those who achieved CR after first induction, median not reached (95% CI, 63.5‒63.5, p=0.0048). Statistically significant effect on OS shows transplantation in CR2 (HR 6.76, CI 95% 2.19‒20.80, p=0.0009), In addition, this parameter influenced OS more than achieving CR up to the 2nd induction course (HR 2.44, CI 95% 1.17‒5.11; p=0.0180) or entry to transplantation without CR (HR 2.81, CI 95% 1.09‒7.26; p=0.0326).

Conclusion: The results presented in the work show the high efficiency of HSCT in each risk group. The number of induction therapies required to achieve CR is a good prognostic factor. The gender of a sibling has no impact on OS (Tab. 11, Fig. 7, Ref. 18). Text in PDF www.elis.sk Keywords: acute myeloid leukemia, allogeneic hematopoietic stem cell transplantation, overall survival, remission status, donor tender.

Objectives: The study aims to investigate how changes in the conductance of axonal (Na+) and calcium (Ca2+) ion channels affect the generation, course, excitability and firing rate of action potentials in a model of Purkinje cell neurons.

Methods: The NEURON Simulator was utilized with a Purkinje cell model to investigate generation, time to first spike, firing rate and pattern of action potential (AP) as well as neuronal excitability in relation to the influence of magnetic field on axonal ion channels.

Results: The downregulation of axonal Na+ and Ca2+ conductance led to a significant delay in the generation of the first spike, with completely blocked action potential generation when downregulated by 75%. Conversely, upregulation of axonal Na+ and Ca2+ conductance accelerated the emergence of the first spike.

Conclusion: Our findings demonstrate that alterations in ion channel conductance influence the timing and generation of action potentials, suggesting that magnetic fields can modulate neuronal behaviour (Tab. 4, Fig. 12, Ref. 34). Text in PDF www.elis.sk Keywords: axon, ion channels, conductance, action potential, magnetic field, Purkinje cell.

Objectives: Computational neuroscience uses a neuron model to investigate the behavior of a neuron under different stimuli e.g. magnetic field. The aim of the study is to investigate the effect of conductivity change of sodium (Na+) and potassium (K+) ion channels on the generation and course of action potential, excitability and firing rate of neuron.

Methods: HHSim (Hodgkin-Huxley) graphical simulator was used for investigation of generation and firing rate of action potential (AP) and investigation of neuronal excitability.

Results: Na+ channel downregulation of conductance reveals a decrease of AP amplitude, and upregulation an increase of amplitude. Higher conductance of Na+ channel leads to higher firing rate from the value 53 HZ to 66 Hz. K+ channel downregulation of conductance reveals an increase of AP amplitude. Lower conductance of K+ channel leads to higher firing rate from the value 62 HZ to 68 Hz. K+ channel upregulation of conductance shows a decrease of AP amplitude.

Conclusion: From the results it can be drawn that effect of conductivity change as a result of magnetic field is significant and can leads to change of neurons. uman brain cultures, often termed "glia-like" cells (Tab. 4, Fig. 6, Ref. 21).

Background: The pathophysiology of mental illnesses is not fully understood, leading to insufficient remission, frequent adverse drug reactions, and treatment resistance. Pharmacogenetic (PGx) testing, a personalized approach recently adopted also in psychiatry, can guide effective drug therapy and minimize side effects. The objective of this study was to determine the perspective of Slovak clinicians regarding the integration of PGx testing in psychiatric clinical practice.

Methods: Questionnaires covering various aspects such as prior experience with PGx testing, self-perceived competence, perceived utility, potential risks and challenges were distributed directly to attendees at two psychiatric conferences held in Slovakia in 2023 and their responses were statistically analysed.

Results: Out of 54 respondents, only 7.4% had previous experience with PGx in clinical practice. The most clinicians felt that they should possess the skills to apply PGx testing in psychiatric clinical practice and were enthusiastic about increasing their expertise. They found PGx useful in medication selection, adverse effect management, and treatment-resistant depression. The primary concerns centered around the lack of well-defined guidelines and the financial considerations linked to the testing.

Conclusions: Considering the participants' interest in PGx and its integration into clinical practice, educational programmes based on recommendations, guidelines, and convincing evidence could be organized (Tab. 4, Ref. 30). Text in PDF www.elis.sk Keywords: pharmacogenetics, pharmacogenomics, psychiatry, personalized treatment, Slovakia, perspective.

This study aims to explore new treatments for type 1 diabetes that could serve as an alternative or adjunct to insulin therapy. This is a literature review based on a search of relevant scientific articles in PubMed, Scopus, Google Scholar, and Cochrane Library databases. The scrutiny of publications revealed that the introduction of glucagon-like peptide-1 agonists into insulin therapy can improve disease control and reduce the frequency of hypoglycaemic episodes. While immune therapy is pathogenetically justified, its utility is limited in patients with recent onset of type 1 diabetes. It may, however, find application in prophylaxis in individuals at increased risk of developing this type of diabetes. Concurrently, stem cell therapy is under active investigation in clinical trials and has shown promise in reducing insulin dependence, improving β-cell function and controlling glucose levels. In addition, stem cells have demonstrated efficacy in treating complications of diabetes such as diabetic nephropathy, peripheral neuropathy and diabetic angiopathy. There is compelling evidence supporting the significant potential of gene-editing technology. Intravenous administration of T-regulatory cells, as one method of cell therapy, shows potential in stabilising the course of diabetes and slowing its progression. However, further research is warranted to confirm efficacy. While gene therapy holds promise, much of its research is currently in the preclinical stage. Further development of innovative therapies for type 1 diabetes has the potential to enhance the quality of life of patients, improve disease control and prevent the development of complications (Fig. 1, Ref. 54). Keywords: diabetes type 1, treatment, cell therapy, insulin, pancreatic β-cells.

Aims: Individuals with a higher De Ritis ratio (aspartate transaminase/alanine transaminase) and neutrophil-to-lymphocyte ratio (NLR) have an inferior survival in varied malignancies. To our knowledge, the prognostic potential of the De Ritis ratio and NLR to predict the survival in nonmetastatic glioblastoma multiforme (GBM) patients remains unclear. In this study, we aimed to explore the prognostic power of the De Ritis ratio and NLR in patients with nonmetastatic glioblastoma multiforme.

Methods: Data of 262 patients with glioblastoma multiforme have been retrospectively analyzed. Their age, gender, tumor characteristics, AST/ALT ratio, NLR and hemogram values, including age at diagnosis and date of diagnosis were recorded.

Results: The median survival time of the study group was 21 months (95% CI: 19‒23 months). The first-year and second-year survival rates were 73.0% and 40.5%, respectively. The univariate analysis revealed that the correlation of survival with age, gender, left/right location of tumor, mean platelet volume and De Ritis ratio did not reach the level of significance. The univariate analysis of the prognostic potential of NLR indicated that a 1-unit increase in NLR value translates to a 1.05 times higher risk of death (95% CI: 1.01‒1.09).

Conclusion: The results of this study lead to the observation that NLR value can serve as an effective prognostic marker in predicting the outcomes of patients with glioblastoma multiforme. It can be positioned as an easily accessible and cost-effective biomarker for establishing appropriate therapeutic strategies (Tab. 2, Fig. 1, Ref. 20).

Despite being the second most often diagnosed form of cancer, lung cancers are rarely found in the general population. It is proposed in this study to employ a methodology of extracting both global and local features from CT scan images for the identification of lung cancer. Data gathering, globalised and localised training as well as testing the model are all part of this structure. This study makes use of 800 CT scan images. Images are pre-processed by warping and cropping in advance of the global testing step. Each image is represented by a feature vector employing eight distinct types of image characteristics, which are taken from the images. After creating feature vectors, three machine learning methods are employed to create detection models. Every medical image has been partitioned over a series of simple divisions throughout the training and testing process locally. To describe each block, feature vectors are derived from the image features that worked effectively in the general phase of the experiment. Similar extracted features are then used to build detection systems for all picture blocks using the learning strategies that were effective in the global stage. SVM using Haar Wavelet characteristics had an accuracy, sensitivity, and specificity of 89%, 90%, and 89%, respectively. One might get 90%‑accurate results with SVM and 91%‑sensitive and 91%‑specific results using SVM plus HOG features. Finally, the utilisation of SVM with Gabor Filter characteristics achieved the greatest correctness, specificity, and sensitivity values, particularly 87%, 86%, and 87%, respectively (Tab. 3, Fig. 7, Ref. 18). Keywords: feature extraction, support vector machine, lung cancer, classification, machine learning.