Bratislava Medical Journal-Bratislavske Lekarske Listy最新文献

Objectives: This study aimed to assess the mortality and prognosis of acute myocardial infarction (AMI) patients with out-of-hospital cardiac arrest (OHCA) initially admitted to Department of Anesthesiology and Intensive Care in comparison with patients initially admitted to Cardiac Centre (CC).

Background: Global acute coronary syndrome (ACS) registries often omit patients with OHCA initially admitted to anaesthesiology and intensive care units. This exclusion may lead to underestimated mortality rates in patients following acute MI worldwide.

Methods: A retrospective analysis was conducted in patients admitted in 2014 to the (Department of Anesthesiology and Intensive Care) at a single center, J.A. Reiman Teaching Hospital in Presov, Slovakia. Survival rates were evaluated in-hospital, at 30 days, and annually over a five-year period. Patients with STEMI and NSTEMI were analyzed separately, particularly during the early in-hospital phase.

Results: In the OHCA group, 52% of STEMI patients experienced in-hospital mortality, whereas the CC group reported only 3% mortality. The total hospital mortality for STEMI patients was 6.69%. Among NSTEMI patients in the OHCA group, in-hospital mortality reached 50%, compared to 4.33% in the CC group. The total center mortality for all NSTEMI patients was 6.09%.

Conclusion: Although the short-term prognosis for MI patients with OHCA is unfavorable, with a 30-day mortality rate of 54.9%, for those who survive the initial 30 days following cardiac arrest and are successfully discharged from the hospital, the long-term prognosis aligns with MI patients without OHCA. In light of these findings, the inclusion of all patients with MI (from both OHCA and CC groups) in global ACS registries could significantly raise in-hospital and 30-day mortality rates (Tab. 3, Fig. 4, Ref. 21).

Objective: Amid the COVID-19 pandemic in the Russian Federation, social care providers received incentives such as bonuses and welfare payments. The study examines the association between COVID-19 pandemic indicators and distribution of incentives to care providers in Russia.

Methods: To test the hypotheses, regression analysis is employed.

Results: Hypothesis H1, regarding the correlation between the COVID-19 case rate in a specific region of the Russian Federation and the actual monetary amount of bonus payments compensating for challenging working conditions of care workers in that region is supported. Hypotheses H2-H3, regarding the relationship between the COVID-19 cases/recovery rate and the monetary amount of special welfare payments to care workers distributed across the country during a given calendar month are also supported. Hypothesis H4, pertaining to the relationship between the Fiscal Year End and the monetary amount of special welfare payments distributed throughout the country to care providers during a given calendar month, is likewise supported.

Conclusion: There is a correlation between payments to social care providers and coronavirus pandemic indicators (Tab. 5, Ref. 31). Text in PDF www.elis.sk Keywords: welfare payment, bonus, care providers.

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Ntroduction: Type 2 Diabetes Mellitus (DM2) can lead to autonomic nervous system dysfunction and heart rate variability (HRV) is often used to assess this system both during rest and during physical exercise.

Objective: To evaluate the autonomic modulation at rest and the responses of heart rate and parasympathetic indices of individuals with DM2 to isometric handgrip exercise.

Method: The sample consisted of individuals of both sexes; over 40 years, divided into groups, with and without DM2 diagnosis. The collection of resting HRV was performed for 20 minutes in the supine position, and 256 points were selected for symbolic and linear analysis. The individuals performed isometric contraction for one minute with intensities of 10, 20, 30, 40 and 50 % of the maximum contraction, using the parasympathetic indexes RMSSD and SD1 for analysis.

Results: Linear and symbolic indices of HRV at rest and those obtained during exercise were similar (p-value>0.05). No association was found between the indices at rest and the responses to exercise, with a slight delay in the response of diabetics in HR and parasympathetic indices being identified.

Conclusion: There was no difference between the groups in the modulation of rest or in the parasympathetic adjustments of the exercise (Tab. 4, Ref. 32).

The role of vitamin D (VD) in the etiopathogenesis of autoimmune diseases (AI) is extensively studied. However, its association with autoimmune thyroid disease (AITD) is still controversial. AIM of this study was to assess the relationship between the vitamin D status and thyroid autoimmunity in Slovak premenopausal women with newly diagnosed AITD.

Subjects and methods: This prospective case-control study included 57 women with AITD and 41 age- and BMI-matched controls. All subjects were examined for summer and winter serum 25(OH)D, thyroid autoantibodies (a-TPO, a-TG), freeT4 and TSH concentrations. Thyroid volume was measured by ultrasound.

Results: There were no significant differences in serum 25(OH)D between AITD and control groups. No significant correlation between 25(OH)D and thyroid autoantibodies was found either in the whole cohort or in AITD women. The prevalence of vitamin D insufficiency was 60.31 % in AITD women and 52.5 % in the control group. No significant association between VD and thyroid autoantibodies, thyroid hormones and thyroid volume was detected in this study.

Conclusion: Authors conclude that VD insufficiency is common in Slovak premenopausal women independently of the presence of AITD. Vitamin D insufficiency is not associated with thyroid autoimmunity in patients with early diagnosis of AITD (Tab. 3, Ref. 31). Text in PDF www.elis.sk Keywords: vitamin D, autoimmune thyroid disease, thyroid autoantibodies.

Introduction: Based on a longtime voluntary registry founded by the Ministry of Healthcare of the Slovak Republic in 2012 and endorsed by the National Institute of Cardiovascular Diseases, well-defined data of all adult cardiac surgery procedures performed during the year 2021 are analyzed.

Material and method: For this period, data on 947 procedures were submitted to the registry.

Results: The unadjusted in-hospital survival rate for the 352 isolated coronary artery bypass grafting procedures including urgent and emergency procedures (relationship on-/off pump 3.8 : 1) was 96.3 %. For 331 isolated heart valve procedures (33 transcatheter interventions), it was 95.5 %. Concerning ventricular assist devices, 19 implantations were registered. In 2021 the number of isolated heart transplantations was 16, which is a decrease by 38.5 % as compared to the previous year.

Conclusion: These annually registered data are collected from voluntary public reporting and accumulate actual information on nearly all heart procedures carried out in the National Institute of Cardiovascular Diseases. These data capture advancements in heart medicine and represent the basis for quality management. In addition, the registry demonstrates that the provision of cardiac surgery in Slovakia is up to date, appropriate, and nationwide patient treatment is guaranteed all the time (Tab. 14, Fig. 2, Ref. 5). Text in PDF www.elis.sk Keywords: heart valve surgery, outcomes, coronary artery bypass grafting, aortic surgery, heart transplantation.

Objectives: The aim of the study was to evaluate renal arterial variations in Slovak context.

Methods: Forty cadavers (80 formalin-fixed cadaveric kidneys) were included in the study. The accessory renal arteries (ARAs) were evaluated on the basis of point of origin, termination in the kidney (superior pole, hilum, inferior pole), and symmetry.

Results: The incidence of ARAs was detected in 20 % (8/40) of the cadavers. Double renal arteries were observed in 9 (11.25 %, n = 80) of kidneys. Among 8 cadavers with ARAs, the unilateral presence of ARA was found in 7 cadavers and bilateral presence in 1 cadaver. Among 9 ARAs, polar artery was the most common anomaly seen in 7 (78 %) kidneys (inferior polar artery 5, superior polar artery 2) followed by the hilar artery in 2 kidneys.

Conclusions: This is the first cadaveric study on the incidence and morphology of ARAs in Slovakia. The study has shown that the variations in renal arterial anatomy are a frequent finding (20 % of cadavers) while all of the described variants have significant implications for a variety of surgical procedures in the retroperitoneal space. The variations in renal arteries should be considered an integral part of anatomy teaching as they point to the diverse clinical reality of anatomy (Tab. 1, Fig. 1, Ref. 35). Text in PDF www.elis.sk Keywords: renal artery, variation, polar artery, double renal artery, cadaver.

Objectives: Fibronectin (Fn) is a glycoprotein of extracellular matrix produced by a variety of mesenchymal and neoplastic cell types.

Background: In adult brain tissue, Fn is restricted to blood vessels. However, adult human brain cultures are almost entirely comprised of flat or spindle‑shaped Fn-positive cells usually referred to as "glia-like" cells. Since Fn is primarily present in fibroblasts, these cultures may be considered to be of non-glial origin.

Methods: Cells gained by long-term culturing of adult human brain tissue derived from brain biopsies obtained from 12 patients with non-malignant diagnoses were examined by immunofluorescence methods.

Results: Primary cultures contained GFAP-/Vim+/Fn+ "glia-like" cells (95-98 %) and GFAP+/Vim+/Fn- astrocytes (0.1 %) which disappeared by passage number 3. The formation of cell processes and enlargement of cell bodies was observed in 9 of 12 cultures with decreased cell growth during passages 12 to 17. It is remarkable that during this period, all "glia-like" cells became GFAP+/Vim+/Fn+.

Conclusion: Herein, we confirm our previously published hypothesis about the origin of adult human "glia-like" cells, which we consider to be precursor cells scattered through the brain cortex and subcortical white matter. Cultures were comprised entirely of GFAP-/Fn+ "glia-like" cells and showed morphological and immunochemical astroglial differentiation with spontaneously decelerated growth during prolonged passaging. We propose that the adult human brain tissue contains a "dormant population" of undefined glial precursor cells. Under culture, these cells show to have a high proliferative capacity and different stages of cell dedifferentiation (Fig. 2, Ref. 21).

Background: Insulin resistance (IR) is a consequence of chronic adipose tissue inflammation and underlies the pathogenesis of several diseases, such as type 2 diabetes mellitus, cardiovascular diseases and metabolic syndrome. In this study, we examined the association between dyslipidaemia and IR; directly comparing conventional lipid ratios and apoB/apoA1 ratios for strength and independence as risk factors for IR in a Kazakh population.

Methods: The design of this study was a case-control study. There were 507 participants in the study. We examined each participant's plasma total cholesterol, triglycerides, high-density lipoprotein, low-density lipoprotein, apolipoprotein B, and apolipoprotein A1. IR was determined using an IR homeostasis model assessment (HOMA-IR). To assess the risk of an atherogenic blood lipid profile, atherogenicity coefficients were calculated: Bad cholesterol to good cholesterol ratio ((TC-HDL)/HDL); TG to HDL ratio (TRG/HDL); apoB to apoA1 ratio (apoB/apoA1).

Results: In this study, high waist circumference and BMI were more common in men. The group with IR had significantly higher waist circumference (cm) (p = 0.0001) and BMI (kg/m2) (p = 0.04) than the group without IR. The risk of IR was significantly associated with the apoB/apoA1 ratio (p = 0.03). Analysis of the association between HOMA-IR and apoB/apoA1 ratio increased the risk of IR at apoB/apoA1 ratios of 0.71 to 0.85 and above 0.86 by a factor of 1.93 and 1.84, respectively. HOMA-IR levels were weakly significantly correlated with TG levels (rS = 0.3; p = 0.0001) and very weakly positively correlated with apoB levels (rS = 0.1; p = 0.002) and apoB/apoA1 (rS = 0.1; p = 0.001), there was a weak negative correlation with apoA1 levels (rS = -0.1; p = 0.02). Logistic regression analysis showed that the risk of developing IR was significantly lower in men than in women, adjusted OR (95% CI) = 0.75 (0.49-1.0) p = 0.02.

Conclusion: In our study, IR was more common in Kazakh women than in Kazakh men. IR was also associated with apoB and TG levels. Thus, we suggest that analysis of TG, apoB and apoB/apoA1 ratio may be recommended as early predictors of IR risk in the Kazakh population (Tab. 3, Ref. 22). Text in PDF www.elis.sk Keywords: insulin resistance, dyslipidaemia, apolipoproteins, triglycerides, lipids.