Acta Informatica Medica最新文献

Background: Carotid atherosclerosis is often mentioned as one of the main causes of stroke. Currently, embolization is considered the most common mechanism that causes ischemic strokes due to atherosclerotic lesions in the carotid artery. Transcranial Doppler (TCD) ultrasound provides relatively inexpensive, noninvasive, real-time measurement of blood flow characteristics and cerebrovascular hemodynamics within brain arteries. The pulsatile index measured by transcranial Doppler is a parameter that indicates the degree of elasticity of the blood vessels of the brain.

Objective: The aim of this study is to determine the relationship between the value of the pulsatile index of the middle cerebral artery and the basilar artery in patients with carotid stenosis using transcranial Doppler and the value of the pulsatile index in relation to the degree of carotid stenosis.

Methods: The study involved a total of 140 patients examined at the Color Doppler and Transcranial Doppler Department of the Neurology Department of the General Hospital "Prim Dr. Abdulah Nakas" Sarajevo The patients were divided into two groups. The research was conducted in the General Hospital "Prim. dr. Abdulah Nakas" in Sarajevo at the Department for Color Doppler and Transcranial Doppler of the Department of Neurology and included patients examined in the period from February 2022 to December 2022. All patients underwent extracranial Doppler of the carotid arteries and transcranial Doppler of the middle cerebral artery and basilar artery.

Results: The mean values of PI in ACM in the total sample were statistically significantly lower in patients with stenosis up to 50% compared to the average in patients with stenosis over 50%. Average values of PI in AB in the total sample were statistically significantly lower in patients with stenosis up to 50% compared to the mean values in patients with stenosis over 50%.

Conclusion: Transcranial Doppler findings showed an increased pulsatile index in patients who had carotid stenosis greater than 50% compared to patients with mild carotid stenosis. The study showed that in clinical work it would be necessary to introduce the pulsatile index as an indispensable neurosonological parameter that would be included in the findings of the transcranial Doppler and thus objectify the potential risk of a cerebrovascular ischemic event.

Background: Prion diseases or TSE diseases are a group of neurodegenerative disorders that manifest in several forms in humans, such as Kuru disease, Creutzfeldt‒Jakob disease (CJD), Gerstmann-Sträussler-Scheinker syndrome (GSS) and fatal familial insomnia.

Objective: In this study, we propose a multimodular hypothesis of prion diseases. According to this hypothesis, a prion disease manifests because of the interaction of two genetic modules, such as the PRNP gene module and that of the gene or genes responsible for one or more chaperones, with one or some chemical module on whose structure the products of the genes or genetic modules interact.

Methods: This study presents the perspective that modular thinking can allow us to overcome conceptual obstacles in the understanding and interpretation of prion diseases.

Results and discussion: The structure of the chemical module or modules is directly responsible for the folding or misfolding of the PrP^C protein. The etiology of acquired prion diseases is explained based on this hypothesis. Hence, it has been proposed that (g) CJD involves the PRNP gene mutant and one or more mutant genes for one or more chaperone genes. In contrast, sCJD has one or more mutant chaperone genes. When does iCJD occur? Healthy individuals manifest acquired prion disease through contamination when infected with one or more mutant chaperones. The mutant chaperones interact with the prion protein, and PrP^C is converted to its isoform PrP^Sc. In a recent study, there was a case of an individual with CJD after COVID-19 infection.

Conclusion: This case emphasizes the link between neuroinflammation and protein misfolding and provides proof that chemical module formation is a necessary condition for the manifestation of prion diseases.

Background: Inflammatory cytokines like Matrix Metalloproteinases (MMPs) are associated with the destruction observed in periodontal disease. There has been evidence of significant increases in MMP levels in patients with systemic disorders, such as Diabetes Mellitus (DM), which is associated with microvascular complications, causing increased MMP activity, directly or indirectly, due to oxidative stress.

Objective: The aim of this study was conducted in order to assess wound healing using MMP-8 levels in GCF of diabetics with chronic periodontitis after diode laser assisted flap surgery.

Methods: This interventional, comparative clinical trial, was conducted after obtaining approval from the Institutional Ethics Committee (IEC), (Study protocol number: 48/2020), and registered with Clinical Trials Registry of India (CTRI/2022/07/043898). Purposive sampling technique was used to select 30 patients with chronic periodontitis (15 systemically healthy patients, and 15 diabetic patients), who visited the Department of Periodontology.

Results: Out of the 30 patients initially selected, 3 patients were lost to follow up and 1 patient was excluded from the study due to lack of compliance towards oral hygiene maintenance. Intragroup comparison of the clinical parameters at baseline and 3 months in both groups was statistically significant (p=0.000). This concludes that there was statistically significant improvement in the periodontal parameters of non-diabetic patients after diode laser assisted flap surgery. Inter-group comparison of the clinical parameters did not show statistical significance at baseline and at 3 months (p > 0.05). It can be concluded that there was comparable changes in the periodontal parameters in both groups after surgery.

Conclusion: MMP-8 could be used as a futuristic tool for assessing wound healing especially in diabetics, so that necessary treatment interventions can be undertaken prior to development of any post-op complications. Laser assisted Modified Widman flap showed noteworthy improvement in the clinical parameters in both groups. Thus, proving that laser assisted MWF surgery is a favorable treatment modality, especially in diabetics who are immunocompromised and prone to infections.

Background: Obstructive sleep apnea (OSA) is a common disorder characterized by recurrent upper airway collapse during sleep, leading to neurological and cardiovascular adverse effects.

Objective: The present study aimed to explore seasonal compliance with Continuous Positive Airway Pressure (CPAP) therapy among OSA patients in Greece.

Methods: Data from 954 OSA patients using CPAP devices were collected during summer and winter months. Factors evaluated included the Apnea-Hypopnea Index (AHI), mask type, mask leaks, and hours of CPAP device usage.

Results: The majority of patients were male (78.2%) and aged 60 years or above (58.5%). Most patients had been using CPAP for over 2 years (82.8%), with auto CPAP devices and nasal or pillow masks being most common. Compliance was observed in 57.7% of patients, while 22.1% were non-compliant. A significant number of patients (8.2% and 12%) were compliant only in summer or winter, respectively. Compliance was influenced by duration of CPAP use, BMI up to 25, and the use of nasal/pillow masks. Higher compliance was associated with lower summer severity and both low and severe winter severity. Logistic regression analysis confirmed these findings.

Conclusion: The findings suggest that utilizing CPAP device data can provide actionable insights on seasonal compliance among OSA patients. Summer compliance is lower, and the use of nasal/pillow masks and auto CPAP devices is recommended for improved compliance.

Background: Birt-Hogg-Dube syndrome (BHDS), also known as Hornstein-Knickenberg syndrome is a rare, autosomal dominant genetic disorder characterized by a triad of clinical manifestations: skin fibrofolliculomas, renal tumors, and multiple pulmonary cysts. The exact incidence of BHDS syndrome is unknown. This hereditary syndrome is caused by mutations in the folliculin (FLCN) gene, located on chromosome 17p11.2, which encodes the folliculin protein.

Objective: This case report aims to highlight the importance of increased vigilance and long-term follow-up in BHDS patients, even decades after surgical intervention, to detect and manage potential pulmonary complications effectively. Case presentation: We present a unique case of spontaneous pneumothorax recurrence in a 63-year-old patient with a history of Birt-Hogg-Dube syndrome. The patient had undergone surgical treatment for pneumothorax 30 years ago and remained asymptomatic until presenting to our clinic with acute dyspnea and a dry cough. A recurrent pneumothorax was diagnosed and treated with a chest tube. Further chest imaging revealed extensive ground-glass opacities and cysts in both lungs. The patient was diagnosed with active pneumonia. A conservative approach was adopted due to the pneumonia diagnosis, and the patient showed a successful recovery without pneumothorax recurrence.

Conclusion: This case highlights the importance of long-term follow-up in patients with Birt-Hogg-Dube syndrome and previous pneumothorax episodes.

Background: Coronary artery disease (CAD) is a major public health issue and a leading cause of death globally. It is one of the most common indications for surgical intervention. There are a lot of different techniques, including CABG, which consists of two approaches: sternotomy and mini-thoracotomy. Different techniques have been developed to improve surgical outcomes, including the use of machine for extracorporal circulation (on-pump) or without it (off-pump).

Objective: The objective of this study was to assess whether off-pump CABG offers superior short-term outcomes compared to traditional on-pump CABG in patients undergoing isolated CABG..

Methods: In period between 2022 - 2023, we performed CABG operation in 80 patients. CABG was performed either on- pump or off-pump.

Results: The results have shown advantages and disadvantages of one or another type of CABG. We were comparing the duration of surgical procedure, time on mechanical ventilation, drainage volume, neurological incidents, time to discharge, indication for repeat revascularization and mortality between two groups.

Conclusion: The choice of surgical technique should be based on individual patient factors, including comorbidities and surgical risks. It is important to say that OPCABG is more challenging than ONCABG, and it is very important that OPCABG is done by skilled, experienced and confident surgeon, which contributes to better outcome and survival.

Background: Osteoarthritis of the knee (OA) and osteoporosis are two conditions that have a significant impact on society, have a great impact on quality of life, and can lead to functional impairment. However, the relationship between knee OA and osteoporosis is unclear.

Objective: The aim of this study was to examine if there is a link between symptomatic advanced knee osteoarthritis and low bone mineral density.

Methods: A total of 430 patients with symptomatic and advanced radiographic knee OA served as participants in this study. Plain radiographs were used to screen participants for osteoarthritis, and a Dual Energy X-ray Absorptiometry (DEXA) scan was used to determine each participant's bone mineral density (BMD).

Results: The lumbar spine, whole femur, and femoral neck BMD levels were statistically higher in the early OA (Kelldren-Lawrence (KL) I and II) group compared with the advanced (III and IV) OA group. Higher BMD at the whole femur and femoral neck but not at the lumbar spine was observed when comparing patients with grades I, II, and III with patients with grade IV after adjustment for body mass index.

Conclusion: The findings of this study indicate that the degree of knee OA is correlated with a decline in BMD. These findings lend credence to the theory that the two conditions may be linked to one another. Our study concluded that patients with advanced knee osteoarthritis are at risk of developing osteoporosis. As a result, orthopedic doctors are required to screen for osteoporosis in patients with advanced knee osteoarthritis to both prevent and treat osteoporosis at an earlier stage.

Background: Osseointegration is defined as the direct structural and functional connection between neo-formed bone and dental implants. Among the parameters suggested to predominantly influencing the establishment of a successful osseointegration is the quality of the implant surface, which may enhance the strength and speed of this biomechanical process.

Objective: The purpose of this study was to evaluate the ability of a novel laser-treated surface, compared to sandblasted, large-grit, acid-etched (SLA) surfaces, to enhance and accelerate implant integration in delayed implant placement.Methods: Thirty patients with two missing posterior teeth were enrolled in this study. Each patient received, at a randomly allocated site, an implant with a conventional SLA surface, and at a second site, an implant with laser-textured surface. A total of 60 tissue-level implants were subsequently placed. Implant stability (ISQ) was measured using resonance frequency analysis (RFA). ISQ was assessed at baseline (T0), 8 weeks (T1), and 12 weeks (T2) following implant placement. Results: There was a statistical difference in implant stability between laser-textured and SLA group at 12 weeks postoperatively. Implant stabilization showed a successful osseointegration with both surface types.

Conclusion: Both laser and SLA surface treatments had positive impacts on implant stabilization following delayed placement. Laser-treated surfaces presented higher values of osseointegration at 3 months postoperatively.

Background: Colorectal cancer (CRC) is a diverse disease with various clinical, pathological and molecular features that affect tumor biological behavior, treatment response and prognosis.

Objective: The aim of this study was to evaluate the correlation between metabolic 18F-FDG PET/CT parameters (SUVmax, MTV and TLG) and CEA in recurrent and metastatic CRC and to evaluate prognostic value of metabolic 18F-FDG PET/CT parameters in recurrent and metastatic CRC.

Methods: A descriptive study of 100 patients with previously detected and surgically treated CRC referred to PET/CT with a suspicion of recurrent or metastatic CRC. CEA was measured within three months from the imaging. A low-dose PET/CT was performed per institutional protocol. For each hypermetabolic lesion, metabolic PET/CT parameters (SUVmax, MTV, TLG) were calculated semiautomatically. Pathohistology or clinical data from the follow-up were used as the gold standard. Sensitivity, specificity, PPV and NPV for 18F-FDG PET/CT and CEA in detection of recurrent or metastatic CRC were calculated. Correlation between CEA and SUVmax, MTV and TLG was calculated, separately. To assess the prognostic values of metabolic parameters in CRC, survival analysis with 18-month progression-free survival (PFS) as an endpoint was performed. Microsoft Excel sheets, ROC and Kaplan-Meier curves were used to present the data. Logrank and Tarone-Ware test and Cox model of proportional hazards were used to compare the groups.

Results: Study included 100 patients, 45 males and 55 females, age range 36-81 years, mean age 61,4 years. Cancer site was colon in 56% and rectum in 44%. Sensitivity, specificity, PPV and NPV of 18F-FDG PET/CT in detection of recurrent or metastatic CRC was 95%, 73%, 70% and 95%, respectively. Sensitivity, specificity, PPV and NPV of CEA in detection of recurrent or metastatic CRC was 58%, 96%, 91% and 78%, respectively. SUVmax, MTV and TLG positively correlated with CEA, but only CEA-TLG correlation was considered significant (r=0,67). The regression model analysis revealed: SUVmax (HR=0,63, 95%CI=0,28-1,41, p=0,214), MTV (0,59, 95%CI=0,28-1,22, p=0,111) and TLG (HR=0,45 95%CI=0,21-0,99, p=0,028), and the prognostic role in CRC was proven for TLG only.

Conclusion: Metabolic 18F-FDG PET/CT parameters may have the prognostic value in CRC, but further multicentric prospective studies are required for validation.

Background: The body has a thermoregulation setting where when it gets hot, the body responds by dilating blood vessels or vasodilation, otherwise it gets a cold response, which causes narrowing of blood vessels or vasoconstriction. The thermal conditioning system is a system that can influence the baby in terms of its thermal quality. So that the baby can feel a comfortable environment or not. Skin temperature is a fundamental factor in heat exchange between the body and its environment.

Objective: The purpose of this study was to analyze the effect of thermal exposure to carbon fiber filaments in the thermoreceptor area on the physiological response of hypothermic baby rabbits to changes in body temperature, to analyze the time needed for physiological adaptation of the body's skin to occur and to analyze the response of the thermoreceptor area on the head, neck, chest, arms, wrists, soles of the feet, to changes in each local area of the body.

Methods: The research method used is pure experimental or laboratory experimental, with a post-test only control group design approach that uses experimental animals as experimental objects. The treatment in this study was using baby rabbits. The Sampling of test animals was carried out using simple random sampling. Statistical analysis was performed using IBM SPSS Statistics version 20. The confidence level was set at 95% by one way ANOVA test.

Results: The results showed that the response of the thermoreceptor area to thermal exposure on the neck was the highest with an average of 39.77'.

Conclusion: Based on the results of the analysis, it was concluded that there was an effect of thermal exposure to carbon fiber filaments in the thermoreceptor area on the physiological response of hypothermic baby rabbit models to changes in body temperature.