Bratislava Medical Journal-Bratislavske Lekarske Listy最新文献

Objective: To study the risk factors of cognitive impairment in elderly people in the Republic of Kazakhstan.

Methods: Study design - cross - sectional. 385 elderly people randomly selected from all over Kazakhstan took part in the survey. The questionnaire for the elderly included socio-demographic data and a small test that determines the absence or the risk of developing cognitive impairment.

Results: Incomplete secondary education increases the risk of developing CI 4.92 times, secondary education 1.24, secondary special education 2.25 times compared to higher education. The absence of work at this time increases the risk of cognitive impairment compared to those who continue to work 2.24 times, being retired 0.42 times. Smoking increases the risk of developing CI compared to those who do not smoke 2.51 times, smoking history 0.86 times. Alcohol consumption increases the risk of developing CI compared to those who do not drink alcohol 1.62 times, other (on holidays) 0.31 times    .

Conclusion: Prevention of dementia does not exist today, but it is possible to reduce the risk of its development. Risk factors increase the chances of getting sick but also serve as guidelines that can be influenced (Tab. 3, Ref. 17).

One of the most prevalent influenceable risk factors for poor cardiovascular outcome is arterial hypertension.This is a prospective analysis of liver transplant recipients in which 24-hour blood pressure (BP) measurement was performed. The primary aim was to identify post-LT (liver transplantation) patients without a history of arterial hypertension who meet the criteria for arterial hypertension using 24-hour BP monitoring. Secondary objectives were to determine how many patients with known treated arterial hypertension had suboptimal BP control. The group included 88 patients (men, 52.3%, history of arterial hypertension group: n=56, no history of arterial hypertension group: n=32) with an average age at the time of measurement of 62.4 years±11. The average time since LT at the time of measurement was 45.2 months. De novo arterial hypertension using 24-hour BP monitoring was diagnosed in 28%. Hypertonic changes in the fundus oculi were confirmed as predictor for suboptimally controlled hypertension [OR 5,1265, p=0.0279]. On the other hand, male sex [OR 3.1840, p=0.0311], together with age [OR 1.3347, p=0.0153] and waist circumference [OR 4.3490, p=0.0418] predicted the need of intensification of antihypertensive treatment. Male sex, age and waist circumference should increase the index of suspicion and lead to zoom-in on a possibility of poorly controlled blood pressure. Where automated blood pressure monitoring is unavailable, regular examination of the fundus could serve as an available surrogate marker of suboptimally controlled arterial hypertension (Tab.6, Fig. 1, Ref. 36). Text in PDF www.elis.sk Keywords: liver transplantation, arterial hypertension, automated blood pressure monitoring.

Objectives: Superoxide dismutase (SOD) is an enzyme that plays a crucial role in protecting cells from oxidative damage. Our study aims to address the lack of papers simultaneously analyzing the immunoreactivity of all three distinct isoforms of SOD in human exocrine pancreas cells.

Background: Superoxide dismutases (SODs) facilitate the conversion of superoxide radicals into less harmful substances. By neutralizing superoxide radicals, SODs help prevent the formation of highly reactive and destructive species that can adversely affect manifold cellular components.

Methods: The study analyzed immunoreactivity of SODs in samples of six healthy adult human pancreases, while using the indirect immunohistochemical method under a light microscope.

Results: SOD1 was predominantly found in centroacinar cells and epithelial cells of the duct system while SOD2 was mainly detected in the epithelial cells of interlobular ducts. Both enzymes were prominently present in the basal region of acinar cells near the cell nucleus. The expression of SOD3 was observed to be rare.

Conclusion: Understanding the intracellular metabolism of SODs in healthy exocrine pancreas cells serves as a basis for determining the precise role of oxidative damage and SOD signaling in the pathogenesis of various pancreatic diseases, including chronic pancreatitis and pancreatic cancer (Fig. 6, Ref. 24). Text in PDF www.elis.sk Keywords: antioxidants, histology, immunohistochemistry, pancreas, superoxide dismutase.

Objective: The aim of the study is to evaluate the functional status and quality of life parameters of patients in the 1st and 6th months post-COVID and to determine contributing factors.

Background: The effects of COVID-19 can continue in the post-COVID period. The mostcommon post-COVID symptoms are weakness, fatigue, nonproductive cough and exertionaldyspnea.

Method: The radiological findings of the patients at diagnosis, post-COVID 1st and 6th months; functional status and quality of life parameters at the 1st and 6th months of the post-COVID period were compared, and the factors affecting them were evaluated. The relationship between radiological involvement, quality of life and functional status parameters was investigated.

Results: Six months after the COVID infection, inpatient's resting oxygen saturation and effort capacity were comparable, even though they were significantly lower in the first month post-COVID. There was a correlation between functional and quality of life measures at 1 and 6 months after COVID-19 infection. In all patients, a significant improvement was found in the functional status and quality of life scales at 6 months after post-COVID infection compared to the 1st month. Even though radiological findings of both groups improved within the first month after COVID-19 infection, there remained a difference between them that disappeared after six months.

Conclusion: It was found that in the post-COVID period, the severity of the disease had a negative effect on functional measurements and quality of life; however, regardless of the severity of the disease, after six months improvements in radiological findings, effort capacity, and quality of life measures were noted (Tab. 2, Fig. 5, Ref. 20). Text in PDF www.elis.sk Keywords: post-COVID, quality of life, functional measurements, chest x-ray.

The disorders of temporomandibular joint manifest clinically with disruptions in its movement and facial pain. Women exhibit a three-fold higher propensity for developing temporomandibular joint disorders compared to men. There are several studies describing the effects of female reproductive hormones on temporomandibular joint structures and pain perception, shedding light on the genetic influence underlying these conditions. Several polymorphisms have been studied and documented in the literature, shedding light on the genetic background of temporomandibular joint disorders.This review aims to propose a novel approach to the complex diagnosis and treatment of this type of disorders. Specifically, we advocate for heightening the emphasis on young women diagnosed with temporomandibular joint disorders during their reproductive years, as such manifestation could potentially serve as early indicators of other underlying health conditions linked to the reproductive system. We posit that genetic studies hold promise as a cornerstone for tailoring personalized treatment strategies for TMJD in the future (Tab. 1, Ref. 46). Text in PDF www.elis.sk Keywords: temporomandibular joint disorders, infertility, female reproductive hormones, genetic polymorphism.

The poison ivy does not normally occur in Slovakia, like in the Czech Republic, but it can be introduced. The venom of the black widow spider is an effective weapon for capturing prey. It is a mixture of various active substances containing a protein neurotoxin called α-latrotoxin (α-LTX). Necrotizing fasciitis (NF) is a rapidly progressive soft tissue infection caused by fulminant tissue destruction with severe systemic toxicity and high mortality (Fig. 9, Ref. 16). Keywords: poisonous weaver, necrotizing fasciitis, streptococcus pyogenes, latrodectism, multiorgan failure.

Objective: Traditionally, astrocytes are categorized into fibrous and protoplasmic types based on their morphological appearance.

Background: For a long time, glial fibrillary acidic protein (GFAP) has been considered the best astroglial marker. However, protoplasmic astrocytes stain negatively for GFAP using immunohistochemical methods.

Methods: Immunohistochemical methods with antibodies to GFAP were used to identify astrocytes. Paraffin sections were prepared from brain biopsy samples of adult patients diagnosed with aneurysm, traumatic contusion, subdural hematoma, gliomas or brain metastases.

Results: In all samples, the GFAP-positive fibrous astrocytes were located in the subpial area and in the white matter. Several GFAP-positive protoplasmic astrocytes were found only in one brain sample from a patient with ruptured aneurysm. Conversely, GFAP-positive astrocytes of intermediate shape were rarely observed in the cortical gray matter from patients with tumoral diagnoses.

Conclusion: Our immunohistochemical study demonstrates that GFAP-positive cells with morphology similar to protoplasmic astrocytes rarely occur in injured brain cortex. We conclude that brain tissue contains GFAP-negative glial precursor cells, which can differentiate into GFAP-positive cells under pathological conditions and sometimes exhibit protoplasmic or intermediate morphology. Similarly, GFAP staining is increased in fibrous astrocytes, typically described as reactive to brain noxa. These results raise many questions about astrocytes identification and classification. In addition, these findings may explain the absence of GFAP-positive cells in adult human brain cultures, often termed "glia-like" cells (Fig. 3, Ref. 18).

Vestibular neuropathy represents the third most common cause of peripheral vestibular disorders. The clinical picture of the disease is characterized by acute vertigo with vegetative accompaniment. A typical course is monophasic with the resolution of symptoms within a few days to complete adjustment. In some patients, secondary complications may occur, which we define into three groups: organic, cognitive, and functional. The occurrence of complications and their persistence is often an overlooked issue, which does not receive sufficient attention and can lead to a significant deterioration in quality of life. Therefore, the management of these patients requires a comprehensive approach and interdisciplinary cooperation between neurologists, physiotherapists, psychologists, and psychiatrists. In the following text, the authors attempt to elucidate this issue further (Fig. 1, Ref. 49). Keywords: vestibular neuropathy, secondary complications, vertigo, acute vestibular syndrome.

Background: Few studies have evaluated health-related quality of life (HRQoL) with abiraterone acetate plus prednisone (abiraterone) compared to enzalutamide in metastatic castration resistant prostate cancer (mCRPC). So, this study aimed to assess impact of abiraterone and enzalutamide on patients´ functioning in mCRPC real-world setting.

Methods: In this 12-month, prospective, observational study, 36 mCRPC patients from Slovakia were included. Patients were treated with abiraterone or enzalutamide according to routine practice. HRQoL was assessed at baseline and 3-/6-/9-/12-month visits using the Functional Assessment of Cancer Therapy-Prostate (FACT‑P) and European Quality of Life 5 Dimensions (EQ-5D) questionnaires. Changes from baseline and occurrence of deteriorations/improvements were compared using two-sample t-test/Mann-Whitney test and Pearson's chi-square/Fisher's exact test, respectively. Mixed-effects model for repeated measures was used to evaluate the difference between the two arms in mean changes of quality of life after 12 months.

Results: Frequency of clinically meaningful deterioration of quality of life assessed by FACT-P was similar for abiraterone and enzalutamide: 0%, 14.3%, 23.1%, 16.7% vs. 10%, 26.3%, 22.2%, 40% at 3-, 6-, 9- and 12 months of therapy (p=0.496, 0.670, 1.000 and 0.236, respectively). After 12 months of treatment, no statistically significant difference between the treatment arms was observed in estimated mean changes in FACT-P total scores (p=0.620) and its components, EQ-5D index (p=0.108), and EQ-5D visual analogue scale (p=0.324).

Conclusion: According to the results of this study, abiraterone and enzalutamide had a comparable impact on quality of life in chemo-naive mCRPC in routine practice (Tab. 4, Fig. 4, Ref. 23). Text in PDF www.elis.sk Keywords: quality of life, abiraterone, enzalutamide, castration resistant prostate cancer.

Important metabolic variables that lead to the development of many diseases, including "mitochondrial diseases," include increased oxidative stress and mitochondrial malfunction. Given that the clinical picture and metabolic alterations in individuals suspected of having mitochondrial illnesses lack distinct characteristics, the development of sensitive and specific diagnostic techniques to detect alterations in mitochondrial bioenergetics is imperative. High-resolution respirometry (HRR), is a minimally invasive technique that enables the analysis of mitochondrial function in platelets taken from peripheral blood. This method allows for the detection of even the most subtle changes prior to disease development. HRR can identify minute variations in mitochondrial bioenergetics. Determining mitochondrial function and endogenous levels of CoQ10 in platelets can aid in the early detection of pathobiochemical changes in mitochondria and assessment of treatment efficacy. When combined with the measurement of endogenous coenzyme Q10 levels, HRR may be an effective approach for early identification of compromised mitochondrial function along with monitoring the therapeutic outcomes. Supplementing with coenzyme Q10, applying molecular hydrogen, transplanting mitochondria, and applying platelet-rich plasma (PRP) are some of the therapeutic strategies utilized to enhance mitochondrial function and reduce oxidative stress (Tab. 1, Fig. 1, Ref. 62). Text in PDF www.elis.sk Keywords: mitochondrial dysfunction, oxidative stress, mitochondrial bioenergetics, high-resolution respirometry, therapeutic approaches.