Materia socio-medica最新文献

Background: Normal sleep duration is crucial for maintaining brain homeostasis. Sleep disorders in Parkinson's disease are numerous, multifactorial, and result in significant morbidity.

Objective: The aim of the study was to investigate the association between gender and the duration of therapy on sleep quality in patients with Parkinson's disease.

Methods: The study is prospective, and includes 40 consecutively hospitalized patients with verified Parkinson's disease. The study included subjects of both genders and all age groups. To analyze the data on the subjects, we used: medical histories, nursing documentation of patients, a questionnaire with sociodemographic data, and the Parkinson's Disease Sleep Assessment Scale. We divided all subjects into two groups: subjects who have been using therapy for up to 5 years and those who have been using therapy for more than 5 years.

Results: Among subjects who have been taking medication for less than 5 years, 33.3% were female and 66.6% were male. Of the total number of respondents who have been taking therapy for more than 5 years, 36.3% are female and 63.6% are male. The duration of the therapy has a statistically significant effect on the quality of sleep in patients with Parkinson's disease (p < 0.05). The subject's gender does not have a significant independent influence on the quality of sleep in patients with Parkinson's disease (p > 0.05). The interaction of gender and length of therapy use has no significant separate effect on the quality of sleep in Parkinson's disease patients (p > 0.05). The quality of sleep is better in male and female subjects who take the therapy until the age of 5.

Conclusion: The duration of therapy use has a significant impact on the quality of sleep in Parkinson's disease patients. The gender of the subject has no significant independent influence on the quality of sleep in patients with Parkinson's disease.

Background: Community-acquired bacterial meningitis (CABM) remains a life-threatening infection with high morbidity and mortality, despite advances in antibiotic therapy and vaccination. Understanding local epidemiology is crucial for improving outcomes.

Objective: To evaluate clinical and epidemiological characteristics and outcome of patients with bacterial meningitis in all age groups.

Methods: This retrospective study analyzed 78 cases of CABM treated at the University Clinical Center Tuzla from 2014 to 2024. Patients were divided by age and outcome. Clinical features, laboratory results, microbiological findings, and prognostic factors were examined.

Results: Adults comprised 59% of cases, and children 41%, with a median age of 29 years. The most common symptoms were fever (91%), positive meningeal signs (76.9%), vomiting (69.2%), and headache (66.7%). Streptococcus pneumoniae (24.4%) and Neisseria meningitidis (14.1%) were the leading pathogens. Mortality was 14.1%, significantly higher in adults (19.6%) than in children (6.3%). Poor outcomes were associated with older age, coma, ICU admission, and complications such as cerebral abscess or shock. Laboratory indicators of worse prognosis included thrombocytopenia, elevated urea and creatinine, hypokalemia, and low CSF cell count.

Conclusion: CABM remains a serious clinical problem in Tuzla Canton. Early recognition, appropriate empiric antibiotic treatment, ICU management, and preventive measures such as vaccination are essential for improving survival, particularly in high-risk populations.

Background: The COVID-19 pandemic has significantly affected people's lifestyles, particularly influencing existing chronic conditions such as hypertension. It is estimated that 1.28 billion adults aged 30-79 worldwide have hypertension. In addition to its impact on blood pressure levels, the pandemic also affected the quality of life and mental health of hypertensive patients. Mental health among individuals with chronic diseases who have recovered from COVID-19 is an important and complex issue. Research indicates that these patients are at a considerably higher risk of developing anxiety, depression, and PTSD, as well as experiencing deterioration of their underlying conditions.

Objective: The aim of this study was to analyze the impact of independent factors on the mental health score using the SF-36 questionnaire among hypertensive patients who recovered from COVID-19.

Methods: A cross-sectional study was conducted in selected primary healthcare centers across four cantons in the Federation of Bosnia and Herzegovina (FBiH). The study included a total of 240 patients, randomly selected from those diagnosed with hypertension who had recovered from COVID-19 (experimental group, n = 120). The control group consisted of 120 participants who had recovered from COVID-19 but did not have hypertension. The European SF-36 questionnaire was used for longitudinal self-assessment of health status in patients with various chronic conditions.

Results: The analysis of independent factors affecting mental health during the COVID-19 pandemic showed poorer mental health outcomes among older, single participants with higher educational attainment. In relation to COVID-19 treatment, patients who had been hospitalized or treated in Intensive Care Units and who experienced cardiac complications exhibited worse mental health scores.

Conclusion: The findings of this study indicate a statistically significant higher likelihood of poorer mental health among hypertensive patients who had contracted COVID-19.

Background: The oncogenic potential of HPV remains a major global public health challenge and various natural therapeutics are being investigated to prevent cancer. The natural components of the Alchemilla vulgaris plant have various anti-inflammatory, antioxidant, antiviral, and anticancer effects.

Objective: Therefore, the aim of this study was to bioinformatically examine the potential inhibitory effect of A. vulgaris compounds on the HPV target protein.

Methods: The structures of quercetin, catechin, apigenin, luteolin, caffeic and gallic acid were taken from the PubChem database, and the protein structure of the target HPV 16 E6 oncoprotein (PDB ID: 4XR8) from the Protein Data Bank. Virtual screening and docking analysis were performed in AutoDock Vina. Protein-ligand complexes were visualized using Discovery Studio. The molecular dynamics simulation of 4XR8 in complex with quercetin was performed using Desmond.

Results: Docking analysis showed that quercetin has the strongest binding affinity with 4XR8 (quercetin -8.9 kcal/mol, apigenin -8.7 kcal/mol, luteolin -8.7 kcal/mol, catechin -8.4 kcal/mol, caffeic acid -7.3 kcal/mol, gallic acid -6.8 kcal/mol). The molecular dynamics simulation results reinforce the stability and strong binding affinity of quercetin within the HPV 16 E6 oncoprotein.

Conclusion: Natural components of Alchemilla vulgaris, especially quercetin, have shown promising potential for the treatment of HPV infection and additional in vitro and in vivo studies are needed for their further research.

Background: The global pandemic caused by the COVID-19 virus is a serious disease that has significantly affected the lives of millions of people.

Objective: The objective of this case study is to describe the development of a necrotic ulcer on the palate in a COVID-19 patient.

Case presentation: This is the clinical case of a 35-year-old male patient with a 20-year history of two pack-a-day smoking who contracted COVID-19. He was admitted to the Department of Oral and Maxillofacial Surgery at the "Mother Teresa" University Hospital Center in Tirana, Albania, presenting with oral pain, facial swelling, and necrosis in the palatal region and the lower lip.

Conclusion: This case report from Albania is significant as it presents an ulcer with necrotic tissue located in the hard palate region of a patient infected with SARS-CoV-2.

Background: Laryngeal squamous cell carcinoma (LSC) is the leading malignant tumour of the head and neck. Establishing new biomarkers is extremely important because they can be important for early diagnosis and prognosis of LSC.

Objective: The aim of this study was to establish the significance of cytokeratin fragment antigen 21-1 (CYFRA 21-1) in the early diagnosis and prognosis of LSC.

Methods: This was prospective research involving 35 patients of both sexes with pathohistologically confirmed LSC, who were treated in the period from 2022 to 2024. The control group consisted of 30 patients who underwent surgery for other non-malignant diseases and who had a normal indirect laryngoscopy findings. The levels of CYFRA 21-1 were determined for three time periods: preoperative, four weeks after surgery, and three months after radiotherapy or concomitant chemoradiotherapy. For the statistical analysis of data we used descriptive statistics methods, the Student T-test and the χ2 test to calculate the significance of the tested differences, where differences on the level of p<0.05 were considered to be statistically significant.

Results: Statistically significantly higher mean serum levels of CYFRA 21-1 were found preoperatively in the experimental group in comparison with the control group (p<0.001). Statistically significant lower levels of CYFRA 21-1 were found four weeks after surgery in the experimental group in comparison with preoperative levels (p=0.004). A statistically significant decrease in serum levels of CYFRA 21-1 was also found three months after radiotherapy or concomitant chemoradiotherapy in comparison with the preoperative levels (p=0.001). The serum levels of CYFRA 21-1 were statistically significantly higher preoperatively in patients with stage III/IV of the disease in comparison with stage I/II (p<0.001).

Conclusion: Increased levels of CYFRA 21-1 are a significant indication of the presence of LSC, especially in patients with advanced stages of the disease.

Background: Aphasia is an acquired communication disorder that affects language comprehension and production, typically occurring after brain damage. It is a frequent clinical manifestation of both benign and malignant brain tumors, particularly when lesions are localized in language-dominant areas.

Objective: To assess the prevalence and characterize the types of aphasia in patients with intracranial tumors, emphasizing its clinical significance and the importance of early speech-language evaluation.

Methods: This prospective study included patients with confirmed brain tumors diagnosed through neuroimaging (CT or MRI of the neurocranium), who were hospitalized at the Clinic of Neurosurgery, University Clinical Center Tuzla, over a one-year period. Patients with pre-existing aphasia of any etiology, as well as those who had not acquired reading and writing skills, were excluded. All assessments were performed prior to surgical intervention using the Boston Diagnostic Aphasia Examination.

Results: Aphasia was diagnosed in 25 patients (27.5%). The most common type was anomic aphasia in 10 patients (40%), followed by Broca's aphasia in 7 patients (28%), transcortical motor aphasia in 3 patients (12%), and transcortical sensory aphasia in 1 patient (4%). The highest number of patients with aphasia had tumors localized in the left temporal lobe, followed by the parietal and temporoparietal regions.

Conclusion: Aphasia is a common clinical finding in patients with intracranial tumors, affecting more than one-quarter of the studied population. The distribution of aphasia types is consistent with the localization of lesions in language-dominant areas, particularly the left temporal lobe. Early recognition and detailed speech-language assessment are essential for timely intervention, rehabilitation planning, and optimizing functional outcomes.

Background: Corticosteroid usage is very widespread these days. However, the way corticosteroids are administered, the side effects of the drug and the risks associated with its usage are not widely known.

Objective: The authors evaluated the responses of a diverse group who were aware of the methods of corticosteroid administration, side effects and information provided by the health care provider. To assess the awareness level and identify the gaps in knowledge descriptive statistics were used.

Methods: The study was a cross sectional online survey conducted during July and December of 2024 using non-probability convenience sampling. A collection of queries were used to test knowledge of steroids as well as its effects. The sample included Jordanians aged 18 and above. The data was analyzed using logistic regression and chi-square with the SPSS (version 27).

Results: From the participants, it was seen that 39.8% used corticosteroids. The most recognized were the oral (81%) and intravenous (60.9%). Most commonly noticed side effects were weight gain (81%) and mood swings (45.9%), rare ones being anemia (7%) and epilepsy (4.3%) were less known. There was high awareness about corticosteroid use in respiratory illnesses like asthma (71%) and autoimmune conditions like rheumatoid disease (64%), but awareness about their use in metabolic and oncological diseases was limited. Only 40.9% of participants said that side effects info was provided to them.

Conclusion: There were significant gaps in community awareness which might compromise the therapeutic utility of corticosteroids.

Background: Stroke patients have significant disability and an increased risk of falling.

Objective: To determine the incidence of falls and the degree of disability in stroke patients and to determine the correlation of falls with the degree of disability.

Methods: This is a prospective study of 100 stroke patients confirmed by computed tomography and magnetic resonance imaging of the brain. We used a demographic questionnaire together with the Glasgow Coma Scale, Stroke Assessment Scale, Rankin Scale and Morse Scale to collect data and analyzed them using SPSS 17, including statistical measures, including Pearson correlation.

Results: Hemorrhagic stroke patients had a higher incidence of falls (p = 0.06). There was no difference in the incidence of falls according to the gender of the patients (p = 0.07). Older people had a higher frequency of falls, and women and patients with hemorrhagic stroke had a higher risk of falling (p = 0.2). Patients with a stroke in the area of the anterior circulation were statistically significantly more disabled (p < 0.05). A weak positive correlation was calculated between the frequency of falls of patients after stroke and the degree of disability (r = 0.08, n = 94, p = 0.4). Stroke patients who also had atrial fibrillation as a comorbidity had a statistically significantly higher frequency of falls compared to patients with other comorbidities (p = 0.02).

Conclusion: Patients with hemorrhagic stroke have a higher frequency of falls. Women, elderly people, patients with a stroke in the area of the anterior circulation and with atrial fibrillation as a comorbidity are statistically significantly more disabled after a stroke. There is a positive correlation between the frequency of falls in patients after a stroke and the degree of disability.

Background: Pulmonary embolism is a frequent, serious and life-threatening complication that represents the embolization of mostly thrombotic material into the pulmonary arteries, with complete or partial occlusion of one or more of its branches.

Objective: To analyze the effectiveness of new anticoagulants (NOAC) in the long-term treatment of pulmonary embolism (PE) in patients with and without COVID-19.

Methods: Retrospective and descriptive analysis based on data from medical records in the period 2021-2023. from the Zenica Cantonal Hospital.

Results: Data were collected from 160 respondents, of which 33 (20.6%) were COVID-19 positive and 127 (79.4%) were not. Subjects with COVID-19 in 12 (36.4%) cases had reference D-dimer values, while 21 (63.6%) had elevated values. 9.1% had elevated platelet values, 78.8% had reference values, and 12.1% had decreased values. Among subjects without COVID-19, 50 (39.4%) had reference values of D-dimer, while 77 (60.6%) had an increase. 1 (0.8%) of subjects had decreased platelet values, 118 (92.9%) had reference values, and 8 (6.3%) had increased platelet values. No subjects with decreased D-dimer values were recorded.

Conclusion: DOAC therapy showed equal efficacy in the long-term treatment of pulmonary embolism in both study groups, regardless of whether the subjects had COVID-19 or not.