Biomedical Papers-Olomouc最新文献

Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) are crucial diagnostic modalities that require patients to remain immobile for extended periods, with anesthesia sometimes used for comfort and image quality enhancement. The study compares dexmedetomidine and propofol in reducing recovery time and sedation onset in pediatric and elderly patients undergoing CT and MRI procedures. A meta-analysis of fifteen studies assessing recovery time, sedation onset, and failed sedation between dexmedetomidine and propofol in pediatric and elderly patients during CT and MRI was conducted. The study indicated that the administration of anaesthesia markedly improved patient compliance and reduced motion artefacts in both CT and MRI (P<0.00001, I²=94%). The meta-analysis indicated that the mean difference (MD) in the onset of sedation was significantly faster in the control group (P<0.00001, I²=96%). The study reveals that dexmedetomidine and propofol anesthesia can improve patient image quality during CT and MRI procedures by reducing motion artefacts. Dexmedetomidine sedated people more quickly than propofol, but no significant differences in sedation duration were observed.

Aims: The aim of this study is to determine whether the risk of preterm births differs according to the conception method: with or without ART and according to the ART method used (in-vitro fertilisation (IVF) with fresh embryo transfer, frozen embryo transfer (FET) and oocyte receipt (OoR)).

Methods: The research is based on individualised anonymised data on deliveries in Czechia in 2013-2018 (n=651,049) obtained from the National Health Information System. We employ the survival analysis approach applying survival functions (Life tables method) and Cox regression to model the risk of preterm births according to the conception method when controlling for a set of covariates.

Results: The results revealed that the risk of preterm births in singleton pregnancies is higher for ART-treated women (1.56 to 2.06 depending on the ART method) than for non-ART-treated women. The proportion of preterm births differs according to the ART method; the highest proportion was observed for OoR mothers.

Conclusions: Overall, the differences between ART-treated mothers according to the conception method are due mainly to the structural differences between mothers. When controlling for the covariates (Cox regression model), no significant differences were observed concerning the risk of preterm births for women who underwent fresh IVF, FET and OoR.

Objectives: To determine the prognostic potential of S100B protein in patients with craniocerebral injury, correlation between S100B protein and time, selected internal diseases, body habitus, polytrauma, and season.

Methods: We examined the levels of S100B protein in 124 patients with traumatic brain injury (TBI).

Results: The S100B protein level 72 h after injury and changes over 72 h afterwards are statistically significant for prediction of a good clinical condition 1 month after injury. The highest sensitivity (81.4%) and specificity (83.3%) for the S100B protein value after 72 h was obtained for a cut-off value of 0.114. For the change after 72 h, that is a decrease in S100B value, the optimal cut-off is 0.730, where the sum of specificity (76.3%) and sensitivity (54.2%) is the highest, or a decrease by 0.526 at the cut-off value, where sensitivity (62.5%) and specificity (62.9%) are more balanced. The S100B values were the highest at baseline; S100B value taken 72 h after trauma negatively correlated with GCS upon discharge or transfer (r=-0.517, P<0.0001). We found no relationship between S100B protein and hypertension, diabetes mellitus, BMI, or season when the trauma occurred. Changes in values and a higher level of S100B protein were demonstrated in polytraumas with a median of 1.070 (0.042; 8.780) μg/L compared to isolated TBI with a median of 0.421 (0.042; 11.230) μg/L.

Conclusion: S100B protein level with specimen collection 72 h after trauma can be used as a complementary marker of patient prognosis.

Systematic strategies for preventing and treating esophagogastric variceal rebleeding (EVRB) are currently inadequate. This systematic review aimed to update this critical gap by searching contemporary studies from major guideline websites, databases, and professional associations focused on EVRB prevention in cirrhosis patients. Key findings highlight evaluation methods, risk management, preventive measures, health education, and follow-up strategies. Notably, a hepatic venous pressure gradient exceeding 18 mmHg is identified as a reliable predictor of gastroesophageal varices (GOV) rebleeding. Effective management of primary diseases is crucial, with methods including antiviral and anti-fibrotic therapies, alcohol avoidance, vaccination, and careful medication management. The combination of nonselective β-blockers (NSBBs) and endoscopic variceal ligation (EVL) is established as the gold standard for secondary EVRB prevention. For patients experiencing recurrent bleeding despite NSBBs and EVL, transjugular intrahepatic portosystemic shunt (TIPS) therapy is recommended. Surgical options, such as surgical shunt and devascularization, are advised for those unsuitable for endoscopic therapy or TIPS, particularly in Child-Pugh A and B patients unresponsive to treatment. Additionally, traditional Chinese medicine options, such as Fufang Biejia Ruangan Tablets, Fuzheng Huayu Capsules, and Anluo Huaxian Pills, have shown promise in improving hepatic fibrosis and GOV in cirrhotic patients. This review offers a comprehensive overview of current prevention and treatment strategies for EVRB, providing valuable insights for clinicians and healthcare professionals.

Background and aims: A significant source of man-made radiation is now linked to medical devices especially X-ray imaging based ones like CT scans which expose the body to cumulative ionizing radiation and thus attendant cancer risks. The aim of this study was to determine whether using a combination of Automatic Tube Current Modulation (ATCM) and Automatic Tube Voltage Selection (ATVS) during two-phase whole-body CT (2PWBCT) examinations would reduce the radiation dose while preserving the image quality.

Patients and methods: This was a prospective, observational, single-centre study of 127 adult patients who had undergone the 2PWBCT polytraumatic protocol. All were examined on a Somatom Drive scanner (Siemens). The patients were divided into two groups: ATCM only (42 patients) and ATCM +ATVS (85 patients). Patients' arm positions during examination and the examination dose length product (DLP) values were recorded, as well the standard deviations (SD) of the density in reference areas on CT scans for the image quality assessment. The DLP values and image quality in the groups were compared using ANOVA.

Results: Mean Total DLP (in mGy*cm): ATCM only: 3337 +/-797, ATCM+ATVS: 3402 +/-830; P=0.674. No effect of arm position (P=0.586). Mean density SD values in reference areas (in HU) in ATCM only: 49 +/-45, 15 +/-6, 9 +/-2, 12 +/-4, 10 +/-3, in ATCM+ATVS: 48 +/-45, 17 +/-6, 11 +/-3, 15 +/-6, 12 +/-4. SD values was higher in ATCM+ATVS group (P<0.001).

Conclusion: Combination of ATVS and ATCM in polytraumatic 2PWBCT leads to no significant radiation load reduction compared with ATCM only but does lead to a slight degradation of image quality. The radiation load is significantly reduced if the patient has their arms behind the head when scanning, regardless of the activation of ATVS.

Objective: The best results in glioblastoma (GBM) are obtained through aggressive treatment comprising maximally radical but safe resection followed by chemoradiotherapy. However, certain patients will undergo only stereotactic biopsy. This paper aims to evaluate life expectancy in GBM patients who underwent only stereotactic biopsy, including the effect of subsequent oncological treatment.

Patients and methods: Patients with confirmed GBM histology who had undergone stereotactic biopsy between June 2006 and December 2016 were retrospectively selected. Each patient had received a CT scan, followed by an MRI scan with a contrast agent. None of the patients were amenable to microsurgical resection.

Results: Of the 60 patients, 41 (69%) received no subsequent oncological treatment, while 14 (23%) underwent isolated radiotherapy. Mean survival time of all patients was 2.8 months. Those who received no additional treatment had an average survival time of 2.3 months; patients who received any type of oncological treatment was 3.7 months. Of these, those receiving radiotherapy alone had a mean survival of 3.1 months. Patients who received oncological treatment with the Stupp protocol had a survival time of 6.6 months.

Conclusion: Diagnostic and surgical advances related to GBM treatment mean that radical resections can be performed even in eloquent brain areas. However, patients not indicated for resection will experience a major reduction in life expectancy. Patients who underwent stereotactic biopsy and received some form of oncological treatment experienced slightly increased overall survival relative to patients with a natural disease course. Patients with favorable clinical factors reacted better to treatment.

Objective: To determine the added value of fetal magnetic resonance imaging (MRI) when clarifying a suspected anomaly detected by mid-trimester scan.

Methods: Women attending two centers of fetal medicine between January 2017 and December 2021 were identified. The centers carried out routine mid-trimester ultrasound scans to detect fetal anomalies. Those with a suspected anomaly which required further clarification were referred for fetal magnetic resonance imaging (MRI). The medical records of all referred women were examined to determine the anomalies found at scan, MRI and termination of pregnancy or delivery. A total of 9571 women had a routine mid-trimester scan and an anomaly was either diagnosed or suspected in 449 (4.7%); an MRI examination was made in 76 cases (0.79%).

Results: MRI confirmed the presence of an abnormality in 61 referrals (80%) and failed to yield a result in one case. Outcome information was available for 69 cases: the MRI confirmation rate was 89% (48/54) in those with abnormal outcome and 40% (6/15) if the outcome was normal, P.

Aims: Mild Traumatic Brain Injury (mTBI) is the most common type of craniocerebral injury. Proper management appears to be a key factor in preventing post-concussion syndrome. The aim of this prospective study was to evaluate the effect and safety of selected training protocol in patients after mTBI.

Methods: This was a prospective study that included 25 patients with mTBI and 25 matched healthy controls. Assessments were performed in two sessions and included a post-concussion symptoms questionnaire, battery of neurocognitive tests, and magnetic resonance with tractography. Participants were divided into two groups: a passive subgroup with no specific recommendations and an active subgroup with simple physical and cognitive training.

Results: The training program with slightly higher initial physical and cognitive loads was well tolerated and was harmless according to the noninferiority test. The tractography showed overall temporal posttraumatic changes in the brain. The predictive model was able to distinguish between patients and controls in the first (AUC=0.807) and second (AUC=0.652) sessions. In general, tractography had an overall predictive dominance of measures.

Conclusion: The results from our study objectively point to the safety of our chosen training protocol, simultaneously with the signs of slight benefits in specific cognitive domains. The study also showed the capability of machine learning and predictive models in mTBI patient recognition.

This is an overview of relation between acute and chronic pancreatitis and between acute pancreatitis and pancreatic cancer. Acute pancreatitis and recurrent acute pancreatitis are an etiological factor of chronic pancreatitis. Population-based studies have calculated the risk of acute recurrent pancreatitis after the first attack of acute pancreatitis to be 20% and development of chronic pancreatitis after first attack of acute pancreatitis is 10%. An important risk factor is tobacco smoking. Acute and chronic pancreatitis are risk factors for pancreatic cancer. The risk of acute pancreatitis is related to the number of recurrences of acute pancreatitis, but not the etiology of acute pancreatitis. Acute pancreatitis, as well as chronic pancreatitis, are risk factors for pancreatic cancer. After an attack of acute pancreatitis or recurrent acute pancreatitis a patient should be regarded as a high risk.

Background and aims: Neurodegenerative disorders affecting the brain and spinal cord are caused by a large number of factors. More recently, imbalances in gut microbiota are found to be one factor linked directly to neurological dysfunction. Probiotics prevent cognitive decline. For the first time, the effect of probiotics was assessed by monitoring the concentrations of the neurodegeneration biomarker neurofilament light chains (NfL) in a well-defined group of community-dwelling individuals. The aim of this study was to determine whether administration of our new probiotics could reduce NfL concentrations.

Methods: The serum NfL concentrations were measured in total of 190 serum samples of 85 older community-dwelling individuals. The participants were randomly divided into two groups: the PROPLA group and the PLAPRO group. Individuals in the PROPLA group started with a three-month use of probiotics and continued with a three-month use of placebo while the order was reversed in the PLAPRO group. The participants underwent detailed examinations at three time points: at baseline, in three and six months. The serum NfL concentrations were determined using ultrasensitive single-molecule array (SIMOA) assay.

Results: Longitudinal comparisons of NfL concentrations between samplings at different time points in the PROPLA and PLAPRO groups showed no statistically significant differences. Baseline NfL concentrations at the beginning of the study and in the succeeding samplings were not significantly different for the two groups in cross-sectional comparisons.

Conclusions: Serum NfL concentrations were not influenced by the three-month use of probiotics.