Bratislava Medical Journal-Bratislavske Lekarske Listy最新文献

The number of patients on the waiting list for a kidney retransplant has increased. Patients who are candidates for a second kidney transplant often have higher levels of PRA (Panel of Reactive Antibodies). The previous failed kidney transplant is one of the main factors that leads to the production of antibodies against human leukocyte antigens ‒ HLA. The consequences of sensitisation are a long waiting time for repeated kidney transplantation and a negative effect on graft survival after retransplantation.The aim of our analysis was to evaluate the immunological parameters of patients undergoing renal retransplantation at the Kosice Transplant Centre, their influence on graft function, the occurrence of rejection episodes and to analyse the sensitisation status of recipients on the waiting list for renal retransplantation at the Kosice Transplant Centre.We retrospectively analysed 46 adult patients who underwent secondary renal transplantation. In the group of retransplanted patients, we found a higher immunological risk and PRA values (p<0.001) and a higher need for induction therapy to reduce the lymphocyte count (p<0.001). Retransplant patients with DGF were 48% more likely to experience acute rejection.In the context of the published literature, we have observed increased sensitisation in retransplanted patients, which is a major challenge to overcome the immunological barrier in transplantation medicine (Tab. 4, Fig. 1, Ref. 24). Keywords: retransplantation, sensitisation, panel of reactive antibodies.

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.

Background: Prostate cancer is a significant health issue worldwide, with varying incidence and mortality rates across different regions. This study focuses on Slovakia, a country with an increasing trend in number of prostate cancer cases. The manuscript aims to provide a comprehensive overview of the burden of prostate cancer in Slovakia, encompassing epidemiological trends, economic impact, diagnostic approaches, and treatment modalities. The study emphasizes the need for effective management strategies and healthcare policies to address the increasing burden of this disease in the Slovak population.

Methods: This retrospective study utilized data from various Slovak health databases, including the National Cancer Registry, hospital records, and insurance claims from 2009 to 2022. We employed epidemiological measures such as incidence, prevalence, and mortality rates to evaluate the burden of prostate cancer. Economic analysis involved assessing direct costs (hospitalizations, treatments, diagnostics) and indirect costs (lost productivity, disability). Additionally, the study reviewed cost of current diagnostic methods in Slovakia.

Results: The study revealed a steady increase in prostate cancer incidence in Slovakia, with a notable rise in cases among men aged 50 and above. Mortality rates showed a moderate increase, highlighting the disease's impact on the healthcare system. The economic analysis indicated substantial direct and indirect costs, with a significant portion allocated to advanced treatments and productivity loss. Diagnostic methods showed improvements over time, with increased utilization of advanced imaging techniques.

Conclusions: The burden of prostate cancer in Slovakia is significant and growing, with rising incidence and economic costs posing challenges to the healthcare system. The study underscores the need for improved and early access to effective diagnostic and treatment options, and robust health policies to manage the rising burden. Additionally, public health initiatives focusing on awareness and early detection could play a crucial role in reducing the impact of prostate cancer in Slovakia. The findings of this study contribute valuable insights for policymakers and healthcare providers in developing targeted strategies to mitigate the burden of prostate cancer in the Slovak population (Tab. 7, Ref. 53).

Objective: We aimed to evaluate the opinions of individuals aged 18 and above in our country regarding the use of artificial intelligence (AI) and robots in the field of healthcare.

Background: The growing population and patient load, coupled with increasing data, can expedite the diagnosis and treatment process for patients through faster, easier, and more accurate interpretation of information.

Methods: The study encompasses voluntary participants aged 18 and above, who have either undergone surgery in a hospital or have accompanied a family member during a surgical procedure and possess internet access as well as the capability to participate in online surveys.

Results: A total of 725 individuals participated in our study 61% (n=442) of respondents expressed trust in the operation of AI and robots in the hospital setting. 64.1% (n=465) of participants expressed trust in AI's contribution to disease diagnosis and laboratory tests. The confidence in AI's use in radiological examinations and its contribution reached 71.6% (n=519).

Conclusion: This study demonstrates that the use of AI and robots in healthcare services is accepted by our society and would be appropriate in our society (Tab. 5, Fig. 1, Ref. 24).

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.

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).

Background: Several studies have investigated independently of clinical education, it has been emphasized that students experience fear, anxiety, sadness and uncertainty during the pandemic.

Aim: This study aimed to investigate the effect of fear of COVID-19 on the level of anxiety and self-confidence of midwifery students who did their clinical internship during the pandemic.

Methods: Convenience sampling yielded 181 senior midwifery students who had experienced clinical internships during the COVID-19 pandemic. Two state universities conducted an online cross-sectional predictive study from February to June 2021. Data were collected by an Information Form, the COVID-19 Fear Scale, the State-Trait Anxiety Inventory, and the Self-Confidence Scale.

Results: The study findings were that the students' fear of COVID-19 (16.72 ± 4.89), state anxiety (52.65 ± 8.41), and trait anxiety (48.66 ± 6.80) were above average, and their self-confidence was moderate. The result indicated that midwifery students' fear of COVID-19 increased, their state anxiety increased (p < 0.01), and their self-confidence decreased (p < 0.01). Fear of COVID-19 accounted for 47% of state anxiety, 6% of trait anxiety, and 22% of self-confidence.

Conclusion: The level of COVID-19 fear of midwifery students who did clinical internships during the pandemic negatively affected their anxiety and self-confidence levels (Tab. 4, Ref. 34). Text in PDF www.elis.sk Keywords: pandemic, midwifery, fear of COVID-19, anxiety, self-confidence.

Objectives: ASCT has been considered the standard of care for younger patients with NDMM, however, not all the studies published so far have uniformly demonstrated the complete superiority of ASCT over chemotherapy at standard doses. A systematic review and meta-analysis of randomized studies has shown a significant benefit with single ASCT in terms of prolonged progression-free survival (PFS), but not of overall survival (OS). In our retrospective analysis we investigated the impact of high dose (HD) chemotherapy followed by ASCT in special population of patients with high risk cytogenetic profile on the PFS and treatment outcome.

Methods: Retrospective analysis of NDMM patients eligible for HD chemotherapy followed by upfront ASCT in the era of novel agents, who underwent the ASCT in the Department of hematology and oncohematology LF UPJŠ and UNLP Košice in the timeframe of 54 months (from 01/JAN/2019 to 30/JUN/2023). Patients were stratified according to their cytogenetic profile. PFS was defined by the time from ASCT to the disease progression. The OS was defined as the time from the the start of treatment to the death from disease progression. The high risk cytogenetic abnormalities (HRCA) were defined as t(4;14), del(17/17p), t(14;16), t(14;20), nonhyperploidy, gain (1q).

Results: Inclusion criteria were met by 65 patients with NDMM who received HD chemotherpy followed by ASCT. We identified 22 (33.8 %) patients with HRCA and 43 (66.2 %) patients with standard cytogenetic risk. During the monitored period we recorded 4 deaths due to disease progression, all of them in the HCRA subgroup. The response was enhanced by the ASCT in both subgroups. The very good partial response (VGPR) increased from 42 % to 46 % and complete remission (CR) increased from 23 % to 45 % after the ASCT. The number of patients achieving only partial response (PR) decreased from 35 % to 9 % after ASCT. In the subgroup of patients with HRCA the median PFS after ASCT was lower compared to the patients with standard cytogenetic risk (17 vs 38 months). The average PFS in both subgroups was 22.9 months. The median OS in both subgroups was not reached, however the only deaths due to disease progression were recorded in the HRCA subgroup. At the time of analysis, 100 % (43) of patients are alive in the standard cytogenetic subgroup versus 72 % (18) of patients in HRCA subgroup.

Conclusion: HD chemotherapy followed by ASCT remains the standard of care for NDMM eligible for high dose chemotherapy. Our results confirm the benefit of ASCT even in the presence of HRCA. Lower PFS in the HRCA subgroup might indicate the need for more intensive treatment, which may be achieved by tandem ASCT defined as two ASCT performed within a period of no more than six months. Additionally, as three- and four-drug induction therapies are becoming increasingly available and effective, resulting in high minima

Background: Vitamin D is a neuroactive steroid that carries out its biological functions through the vitamin D receptor (VDR). The VDR gene interacts with certain long noncoding RNAs (lncRNAs). The present study is aimed at evaluating the expression levels of the VDR gene as well as those of HOTAIR, H19, MALAT1, and P21 lncRNAs in patients with relapsing-remitting multiple sclerosis (RRMS).

Methods: This research was conducted on 38 RRMS patients and 38 healthy individuals. The expression levels of VDR and selected lncRNAs in peripheral blood as well as those of vitamin D in the plasma were measured.

Results: The results revealed a significant increase in the expression of lncRNA H19 in the RRMS group compared to the control group. The analysis of the receiver operating characteristic (ROC) curve for H19 gene expression demonstrated a diagnostic value of 0.699 (95% CI: 0.575-0.823). Positive correlations were detected between VDR and lncRNA HOTAIR (r = 0.446, p = 0.008), H19 (r = 0.351, p = 0.042), MALAT1 (r = 0.464, p = 0.006), and P21 (r = 0.512, p = 0.002) in MS patients.

Conclusion: The findings of this study suggest that lncRNA H19 could serve as a potential biomarker for MS diagnosis (Tab. 4, Fig. 1, Ref. 34).