Bratislava Medical Journal-Bratislavske Lekarske Listy最新文献

Objectives:  This study aimed to predict individual COVID-19 patient prognosis at hospital admission using artificial intelligence (AI)-based quantification of computed tomography (CT) pulmonary involvement.

Background: Assessing patient prognosis in COVID-19 pneumonia is crucial for patient management and hospital and ICU organization.

Methods: We retrospectively analyzed 559 patients with PCR-verified COVID-19 pneumonia referred to the hospital for a severe disease course. We correlated the CT extent of pulmonary involvement with patient outcome. We also attempted to define cut-off values of pulmonary involvement for predicting different outcomes.

Results:  CT-based disease extent quantification is an independent predictor of patient morbidity and mortality, with the prognosis being impacted also by age and cardiovascular comorbidities. With the use of explored cut-off values, we divided patients into three groups based on their extent of disease: (1) less than 28 % (sensitivity 65.4 %; specificity 89.1 %), (2) ranging from 28 % (31 %) to 47 % (sensitivity 87.1 %; specificity 62.7 %), and (3) above 47 % (sensitivity 87.1 %; specificity, 62.7 %), representing low risk, risk for oxygen therapy and invasive pulmonary ventilation, and risk of death, respectively.

Conclusion: CT quantification of pulmonary involvement using AI-based software helps predict COVID-19 patient outcomes (Tab. 4, Fig. 4, Ref. 38).

Objectives: This investigation aims to analyze the characteristics and development of literature and advocate to include "Somatopsychic" as a Medical Subject Headings (MeSH) term.

Background: The interplay between physiological processes and psychological conditions, commonly referred to as "Somatopsychic," has garnered increasing attention in scientific literature over the years.

Methods: Somatopsychic-related research from the Scopus database using (Text word) and (MeSH) features. Publications were collected on Mar 22, 2023. The publication output was then analyzed using the R package's bibliometrics (Biblioshiny) and VOSviewer.

Results: In this study, search results for "somatopsychic" using (MeSH) resulted in a predictable return of 0 articles. Meanwhile, based on a search with (Text word), this study retrieved 306 documents for an unlimited period (and yielded published articles between 1913 and 2022). The analysis also revealed that 3,176 authors contributed to publications related to somatopsychic, with the United States ranking first in terms of authorship. In addition, the study presented a co-word network that illustrated frequent co-occurrence of particular keywords within somatopsychic research.

Conclusion: This study reveals that somatopsychic-related publications are becoming increasingly prevalent. Adding somatopsychic as a dedicated term to the MeSH thesaurus of the National Library of Medicine would assist in indexing and retrieving the most pertinent literature on this topic (Tab. 3, Fig. 5, Ref. 51).

Aim: We aimed to investigate the role and importance of immature granulocyte percentage and neutrophil/lymphocyte ratio in the etiology, diagnosis and follow-up of acute pancreatitis (AP) in patients tentatively diagnosed with AP in the emergency department. We evaluated these factors alongside other established markers proven effective in the diagnosis and follow-up of AP.

Material and methods: A total of 139 patients with a tentative diagnosis of acute pancreatitis who were hospitalized and followed up in the gastroenterology clinic in 2021‒2022 were included in the study. In addition, a control group, consisting of 139 individuals admitted to the clinic for various other reasons, was established. The cases were also compared with the control group in terms of NLR, ICG and IG%.

Results: There was a significant difference in the NLR, IGC and IG% measurements between the patients in the AP group and the control group. In all three markers, the average values of the patient group were higher than those of the control group. Furthermore, a significant difference in IGC and IG% blood measurements was noted between sub-groups of patients categorized based on the severity of acute pancreatitis, particularly the patients with severe pancreatitis exhibited higher mean IGC and IG% blood measurements compared to those with mild or moderate pancreatitis.

Conclusion: IGC and IG% values emerged as superior indicators to other acute-phase reactants for detecting inflammation, determining its severity, and establishing prognosis in acute pancreatitis. While the N/L ratio remains an important parameter in acute pancreatitis, our findings indicate that it was not significantly superior to other investigated markers in terms of prognosis (Tab. 5, Ref. 35).

Background: Advanced pancreatic ductal adenocarcinoma (PDAC) remains a disease with a dismal prognosis, significantly limited therapeutic options, and few innovative drugs. Inflammation plays a significant role in the development and progression of PDAC. Systemic inflammatory indexes reflect the anti-tumor inflammatory capacity of and are of prognostic and predictive value in the treatment of patients with PDAC.

Methods: In our retrospective study, we investigated the prognostic and predictive significance of inflammatory markers in chemonaive patients with locally advanced unresectable pancreatic cancer (LAPC) and metastatic pancreatic cancer (mPDAC), in relation to progression-free survival (PFS) and overall survival (OS). Survival analysis was conducted using the Kaplan-Meier method with log-rank tests in univariate analysis. We used multivariate Cox regression analysis to determine the impact of inflammatory markers on survival time.

Results: The present clinical study included 46 patients with LAPC and mPDAC treated with FOLFIRINOX (folinic acid, fluorouracil, irinotecan, oxaliplatin) or GEM/Nab-P (gemcitabine/nab-paclitaxel) as first-line chemotherapy regimens. Performance status (PS) ECOG 0-1, neutrophil-to-lymphocyte ratio (NLR)≤2.09 and the prognostic nutritional index (PNI)≥49.09 were associated with significantly longer OS in the analyzed patient cohort, Multivariate analysis confirmed PS, NLR and PNI as independent prognostic factors for OS.

Conclusion: In our cohort of patients with advanced PDAC, PS, NLR and PNI were confirmed as independent prognostic factors for OS (Tab. 9, Fig. 2, Ref. 82). Text in PDF www.elis.sk Keywords: pancreatic cancer, inflammatory markers, tumor microenvironment, chemotherapy.

Objectives: The aim of the study was to evaluate pulmonary sequestration (PS). We report on location, blood supply, histology, clinical manifestation, and surgical treatment of PS, as well as on postoperative course in patients with PS.

Background: PS is a rare congenital defect of the lower respiratory tract, it represents locus minoris resistentiae of the body. Occasionally, PS is diagnosed for the first time in adulthood.

Methods: We evaluated 7 cases of PS treated at the Centre of Thoracic Surgery in Vyšné Hágy, Slovakia, between years 2013 and 2020.

Results: Four of our seven patients were asymptomatic; the PS was found incidentally upon chest imaging. Three patients had recurrent bronchopneumonia related specifically to the intralobar type of sequestration. The most significant complication, observed in a singular patient, was a life-threatening episode of haemoptysis, requiring urgent surgical intervention. In the other 6 cases, the sequestra were surgically resected during the period when they were asymptomatic. and their sputum was confirmed negative upon microbiological examination. Anatomical resection of the affected pulmonary lobe by thoracotomy was the most common type of operation performed (4 cases, n = 7). There was no surgical mortality.

Conclusion: To prevent complications, it is crucial to perform surgical treatment for pulmonary sequestration in patients who have sufficient functional capacity (Tab. 2, Fig. 4, Ref. 30). Text in PDF www.elis.sk Keywords: pulmonary sequestration, anatomic lobectomy, haemoptysis.

Insulin resistance (IR) is the most significant risk factor for post-transplant diabetes mellitus (PTDM). This study aimed to determine the effects of regular physical activity on IR and PTDM in patients after kidney transplantation (KT). The study group (n = 22) participated in aerobic or combined sports (aerobic and anaerobic). Monitoring was provided by a sports tracker (Xiaomi Mi Band 4, compatible with the Mi Fit mobile application). Waist circumference was significantly lower (p = 0.0437, p = 0.0372), graft function was better (p = 0.0036, p = 0.0137), fasting blood glucose was lower (p = 0.0016, p = 0.0003), C-peptide level was lower (p = 0.0447, p = 0014) in the 3rd and 6th months of monitoring, and low-density lipoprotein was lower at 6 months (p = 0.0444) in the observed group than in the control group. IR was significantly lower at 6 months (p = 0.0202), and fasting blood glucose was significantly lower at 3 and 6 months (p = 0.0227) in the observed group. We confirmed the significant effect of regular physical activity on preventing the development of IR and impaired fasting glucose levels in patients after KT (Tab. 1, Fig. 4, Ref. 27). Text in PDF www.elis.sk Keywords: kidney transplantation, insulin resistance, physical activity.

The coronavirus disease 2019 (COVID-19) pandemic had a significant impact on the somatic and psychological state of the population worldwide, leading to a wide range of health complications. Most of the studies on the COVID-19 pandemic have focused on the direct psychological and somatic aspects of the disease. However, the negative consequences of the indirect aspect of the pandemic (i.e., stay-at-home orders leading to social isolation) represent a major stressor on psychosomatic health and warrant greater interest. This study examines the COVID-19 pandemic as a significant stressor of the 21st century through the lens of the "allostatic" stress response concept and highlights the stress-related psychosomatic consequences of the COVID-19 pandemic. A better understanding of the pathomechanisms underlying indirect impacts of the pandemic on psychosomatic health can contribute to the implementation of personalized interventions for managing stress responses, thereby reducing the pandemic-linked stress burden and preventing stress-associated disease emergence (Tab. 1, Fig. 1, Ref. 67). Text in PDF www.elis.sk Keywords: COVID-19 pandemic, social isolation, stress response, allostasis, allostatic load, psychosomatic symptoms.

Objectives: The main purpose of this study is to predict the effect of Tyr-Lys-Thr (YKT) tripeptide, recognized for its anticancer properties, on lung cancer through theoretical and experimental analyzes.

Background: Peptides are important therapeutic compounds that have been studied for many years. Among these, YKT tripeptide emerges as a significant therapeutic peptide, exhibiting cytotoxic effects on various cancer cell lines.

Methods: The study investigated the involvement of the PI3K/Akt/mTOR pathway, commonly activated in human cancer, and the pivotal role of caspases in apoptosis. The interactions of YKT tripeptide with mTOR, Akt, PI3K, caspase-3, and caspase-8 were investigated through the molecular docking method. Additionally, MTT test was used to determine the cytotoxic activity of YKT against the A549 cell line across concentrations set at 0.1, 0.25, 0.5, 1, 2.5 and 5 mg/mL for 24 and 48 h.

Results and conclusion: In silico docking studies were conducted with PI3K, Akt1, and mTOR, known to be active in human cancer, as well as caspase-3 and caspase-8, key enzymes in apoptosis. It was determined that YKT exhibited a robust binding tendency with each receptor. YKT tripeptide was also found to have a cytotoxic effect on human lung carcinoma cell line A549 (Tab. 5, Fig. 11, Ref. 28).

No abstract Keywords.

Background: Breast cancer is one of the main Cancers affecting patients all over the world; however, till now, there has been no successful treatment without any side effects on patient health, but there are groups of medications similar to MDM2 inhibitors that have promising effects. The aim of this study was to find out whether the use of mdm2 inhibitors can help treat breast cancer using three cell lines. The use of treatments belonging to the MDM2 inhibitor alone or with the use of doxorubicin together with a combination of Nutlin-3, Miladometan, Yh239-EE, and doxorubicin in breast cancer cell lines HP100, MCF7.

Materials and methods: Cell lines were treated with different concentrations of MDM2 inhibitors 1,5,10, and 20 micromolar alone or in combinations with doxorubicin. After that, cell viability was estimated by the MTT assay method. Then, we have assessed the expression of caspase as an indicator of cell apoptosis after treatment, and the expression of P53 and MDM2 after and before treatment.

Results: The IC50 of Doxorubicin in the MCf7 cell line was about 1.12 µM. The best IC50% in MDM2 inhibitors was for Nutlin, about 5.9 µM, then for Yh239-EE about 8.45 µM, and Milademetan about 11.07 µM the high IC50% values in normal epithelial cell HBl100. Also, the MDM2 inhibitor increased P53 levels, as did doxorubicin.

Conclusion: Our research concluded that Nutlin 3 has a superior effect over Yh239-EE and Miladometan in treating Breast cancer; moreover, the combination group has shown to be more effective than treatment with Doxorubicin or MDM2 inhibitors alone. Interesting information is that Doxorubicin also causes an increase in P53 levels. This result provided us with a promising therapeutic strategy for the treatment of breast cancer. However, more research is required to be conducted on more types of cell lines and in human or animal models (Tab. 4, Fig. 8, Ref. 33). Text in PDF www.elis.sk Keywords: breast cancer, Miladometan, cell viability, proliferation, therapeutic strategy.