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Bratisl Lek Listy [journal]
- A rare endoscopic appearance of primary gastrointestinal mantle cell lymphoma resembling ulcerative colitis. [JOURNAL ARTICLE]
- Bratisl Lek Listy 2014; 115(12):800-801.
- The effect of Vancomycin degradation products in the topical treatment of osteomyelitis. [JOURNAL ARTICLE]
- Bratisl Lek Listy 2014; 115(12):796-799.
Background: The topical application of Vancomycin is increasingly being used in orthopedics because of the development of methicillin resistant bacteria. Consequently, resistance to Vancomycin has recently been on the rise. One possible explanation for this phenomenon could be the thermal degradation of Vancomycin to antibacterially inactive crystalline degradation products (CDP-1s). The aim of our in vitro experiment was to compare the creation and elution characteristics of CDP-1s and the active form of Vancomycin (factor B) released from bone grafts. Methods: CDP-1s and the factor B released from bone grafts into the buffer solution were measured using the high-performance liquid chromatography method at progressive intervals.Results: The factor B was released from bone grafts at the highest levels, typically on the first day (618.8 mg/L). CDP-1 levels kept increasing until the end of measurement on day 15, when the concentration of CDP-1s (1280.7 mg/L) was much higher compared to that of factor B (217.5 mg/L). Conclusions: We confirmed the tendency of Vancomycin to convert to antimicrobially ineffective CDP-1s. Although Vancomycin is decomposed into crystalline degradation products, its active forms are released from bone grafts in sufficient concentration for more than two keks (Tab. 3, Fig. 1, Ref. 15). Keywords: osteomyelitis, resistant bacterial infection, local antibiotic carriers, crystalline degradation products of Vancomycin.
- Objective determination of skin phototypes in healthy children by diffuse reflectance spectroscopy. [JOURNAL ARTICLE]
- Bratisl Lek Listy 2014; 115(12):791-795.
Introduction: The clinical method of evaluating the color of the skin based on visual assessment is subjective and thus inaccurate. The objective determination of skin phototypes and levels of melanin in the skin is important for diagnosing the pigment disorders and also for adequate photoprotection. Diffuse reflectance spectroscopy (DRS) is a non-invasive, precise and objective method for quantifying the melanin levels. Objective: The aim of this study is to assess the characteristic DRS spectrum of healthy skin in children and to detect the differences between them based on age, gender and skin phototype.Material and methods: Skin pigmentation was measured by DRS in 73 children patients with experimental spectrophotometer UM-ES600. The amount of melanin is quantified from the obtained DRS spectra by proposed melanin quantification angle α obtained by comparing the reflectance properties of skin sample and universal depigmented sample (albino skin).Results: We evaluated spectroscopic characteristics of children's healthy skin depending on age, gender and phototype. The value of melanin quantification angle α grew proportionally from phototype I to phototype IV, without any correlation to age or gender. We confirmed a clear association between clinical determination of Fitzpatrick's skin phototypes and objective data collected by DRS and related angle α.Conclusions: Our proposed index quantifies the difference in melanin levels in healthy children skin and also for different skin phototypes. The proposed method and melanin quantification angle α can further be used for the objectification of the progress of pigmentary diseases or for monitoring the effect of their therapy (Tab. 5, Fig. 4, Ref. 29). Keywords: diffuse reflectance spectroscopy, skin phototypes, quantification of skin melanin, melanin quantification angle α.
- Deceased elderly in-patients with pulmonary embolism. [JOURNAL ARTICLE]
- Bratisl Lek Listy 2014; 115(12):786-790.
Pulmonary embolism (PE) in the elderly is an immediate threat of life. Especially in old age clinical signs of PE are non-specific and could be both underestimated and overestimated. Aim of the study: The retrospective long-term study was aimed at conducting an analysis and comparison of pertinent influence of age, gender and immobility on occurrence of PE and sudden death. Patients and method: Between 1995 and 2012 years we had altogether 12,746 elderly patients of an average age 80.6 ± 7.0 y (range 65-103 y) hospitalized at the Department of Geriatrics. All in-patients 65+ y were randomly admitted for internal hospitalization from the catchment area of Brno city (100,000 inhabitants). The subject of our interest was to study the documentation of deaths (including autopsy findings), which was caused by PE. Out of this number there were 8,540 women (66.3 %) and 4,206 men (33.7 %). Among all hospitalized patients PE in 700 cases (5.5 % of all admitted patients) was shown in a medical report. Among them there were 424 survivors (60.6 %; 134 men and 290 women). Conclusion: The high occurrence of PE (particularly silent form) has crucial importance in the elderly mortality. Our recommendations would like to emphasize the need of no underestimation of this fact and to carry out preventive measures in all age groups (including the "oldest old" and frail persons) (Tab. 3, Ref. 41). Keywords: pulmonary embolism (PE), advanced age, mortality, risk factors, immobility, prophylaxis.
- Postoperative rectal anastomotic complications. [JOURNAL ARTICLE]
- Bratisl Lek Listy 2014; 115(12):781-785.
Colorectal cancer represents the most common tumour of the gastrointestinal tract and the second most common tumour in men as well as women. The trend of increasing incidence of colorectal cancer is alerting. We undertook a retrospective study on 588 patients with rectal cancer and operated by rectal resection with anastomosis between the years 2002-2012. In our sample, we observed 54 (9.2 %) cases of anastomosis insufficiencies requiring reoperation. Out of 54 insufficient anastomoses, 36 (66 %) were in the lower two thirds of the rectum and only 18 (34 %) in the oral one. Although we have observed similar occurrences of anastomosis insufficiency in both groups - classical vs. staple suture (9.5 % and 9.0 %, respectively), the majority of stapler anastomoses (94 %) were made in the aboral part of the rectum. However, we can state that a majority of authors prefer the staple anastomosis as the one with lowest risk, mainly in the distal region of anastomosis. The high ligation of inferior mesenteric artery was performed in 182 (31 %) patients; out of these, we observed anastomosis insufficiency in 12 cases (22 %), which is exactly similar to that in the group of patients without high ligation of the inferior mesenteric artery. We did not observe the use of antibiotics in therapeutical doses as a positive factor for anastomosis insufficiencies, and neither was oncological therapy observed as a risk factor. In our group of patients we agreed that age, level of anastomosis and corticosteroids are high-risk factors. The purpose of these reports, is for the sake of future to share and reference our experiences with cases of rectal and rectosigmoideal resection over the last 11 years. We consider it important to reference our results, especially the risk factors regarding the healing of rectal anastomosis, because anastomotic healing is a surgical problem with potentially deadly consequences for patients (Tab. 4, Ref. 24). Keywords: rectum, anastomosis, complication, human.
- Combined surgical treatment of lung cancer and heart diseases. [JOURNAL ARTICLE]
- Bratisl Lek Listy 2014; 115(12):776-780.
Objective: The co-incidence of lung cancer and heart disease is increasing. This can be caused by population ageing, which has more co-morbidities and most likely due to the common etiological causes of both entities, i.e. smoking, hypertension and obesity. The aim of this study was to analyze the outcomes of simultaneously performed heart surgery and pulmonary resection in a selected group of patients.Methods: From January 2002 to December 2011 we performed in our department 1115 pulmonary resections for lung tumor. Significant heart disease requiring surgical treatment was diagnosed in 21 patients from the whole group. In 12 patients, group A; simultaneous heart surgery and lung resection procedure were performed. Results: Group A consisted of 8 men and 4 women with the median age of 67.8 ± 5.9 years. In this group, 10 lobectomy procedures and 2 wedge resections for pulmonary metastasis were done. Nine patients underwent coronary artery revascularization, 2 patients underwent mitral valve replacement and one patient underwent tumor removal from the left atrium. In 5 patients, extracorporeal circulation (ECC) was needed, the remaining 7 patients underwent myocardial revascularization using an off-pump technique. Group B consisted of 7 men and 5 women with the age of 68.5 ± 7.4 years. Ten lobectomy procedures and 2 wedge resections were performed.Conclusion: The risk of simultaneously performed lung resection and cardiac surgery is not high. Despite the certain differences in clinical indicators between group A and B, the safety of simultaneous procedure, in group A, was evident. Furthermore, earlier lung resection was enabled and the eventual complications from further surgical procedure were avoided (Tab. 5, Ref. 33). Keywords: pulmonary resection, heart surgery, simultaneous heart and lung surgery, extracorporeal circulation.
- Comparison of history of adolescents with substance-induced psychosis, early onset schizophrenia and substance use disorders. [JOURNAL ARTICLE]
- Bratisl Lek Listy 2014; 115(12):771-775.
Objective: The contribution contains a comparison of the history data of adolescent patients hospitalized at the Department of Child Psychiatry, Children´s Faculty Hospital in Bratislava with the diagnoses of Substance-Induced Psychosis (SIP), Early Onset Schizophrenia (EOS) and with Substance Use Disorders (SUD).Background: SIP is rarely recorded and little documented by the age of 18. The etiology of this disorder is still relatively unclear.Methods: The data collection was carried out from patients hospitalized between January 1, 2001 and December 31, 2012. We recorded data from 20 patients hospitalized with SIP, 50 patients hospitalized with EOS, and 50 patients hospitalized with SUD. We collected and compared the data on family history, perinatal complications, early psychomotor development, data on psychical problems before their hospitalization, and presence of unfavorable life situations in their childhood. Conclusion: The data of adolescents with SIP are more similar to the data of patients with EOS than patients with SUD in terms of the burden of family history, the frequency of complications during pregnancy and delivery, and the frequency of the subsequent early psychomotor impairment. In terms of unfavorable life situations and psychological problems for which they were monitored in a psychiatric ward before their hospitalization with SIP, their data are more similar to those of patients with SUD than with EOS (Tab. 3, Fig. 1, Ref. 21). Keywords: adolescent, substance-related disorders, psychoactive drugs, substance-induced psychosis, early onset schizophrenia.
- The effect of ovariectomy on the skin flap viability and myeloperoxidase levels. [JOURNAL ARTICLE]
- Bratisl Lek Listy 2014; 115(12):766-770.
Objectives: Estrogen could affect the rate and quality of wound healing in skin. We aimed to investigate the effects of ovariectomy on skin flap viability and myeloperoxidase (MPO) levels in a rat model.Background: Estrogens have many important beneficial and protective roles in skin that they improve collagen content and quality, maintain skin thickness and enhance vascularization. It has been shown that estrogen supplementation accelerates cutaneous wound healing in elderly patients. Methods: Forty-eight cycling female Wistar albino rats were randomly divided into three groups (n = 16); ovariectomy (Group 1), sham (Group 2), and control (Group 3). Rats were subjected to bilateral ovariectomy in the Group 1, and only laparotomy in the Group 2. Twenty-one days later in the Group 1 and 2, a dorsal caudally based skin flap elevation was done. In the Group 3, the rats had a dorsal skin flap without any surgical intervention. Ten days later, the flaps were harvested for histopathologic examination and biochemical analyses.Results: The rats in the Group 1 had significantly larger necrotic area and lower flap viability than in the Group 2 and 3 (p<0.05). Histopathologic examination showed that necrotic flap regions contained muscle necrosis with an abundant neutrophil infiltration, and severe edema in the Group 1. The MPO activity in the distal of skin flaps was significantly higher in the Group 1 compared to the Group 2 and 3 (p<0.05). Conclusion: This study shows that ovariectomy has deleterious effects on skin flap viability in a rat model (Tab. 1, Fig. 6, Ref. 44). Keywords: ovariectomy, skin flap viability, myeloperoxidase, rat.
- Inhibitory effects of piperonylic acid on the excessive proliferation of vascular smooth muscle cells and luminal stenosis. [JOURNAL ARTICLE]
- Bratisl Lek Listy 2014; 115(12):761-765.
Purpose: Combining in vivo and in vitro experiments, we explored the function and mechanism of piperonylic acid inhibiteing excessive proliferation of vascular smooth muscle cells, and intimal hyperplasia and luminal stenosis after blood vessel injury. Methods: A model of rat thoracic aorta restenosis after balloon injury was constructed, intragastrically administered with piperonylic acid. 21days later, their thoracic aortas were subjected tests of morphology, SM-α-actin, proliferating cell nuclear antigen (PCNA), and expression levels of P21 and P27 by HE staining, immunohistochemistry, and computer image analysis. Results: The proliferation of vascular smooth muscle cells induced by fetal calf serum was active, and the expressions of P21 and P27 were low. Piperonylic acid obviously promoted the protein expressions of P21 and P27 while inhibiting proliferation and DNA synthesis. After the injury of rat thoracic aorta, the cells moved towards the intima and proliferated excessively, leading to evident neogenesis of intima and luminal stenosis. The SM-α-actin immunohistochemistry confirms that the intima contained abundant smooth muscle cells and that the expression of PCNA was high while the expression of P21 and P27 was low. The intervention of piperonylic acid significantly facilitated the gene expressions of P21 and P27, lowered the PCNA expression, and inhibited the formation of intima and the reconstruction of pathological vessels, thus remarkably suppressing luminal stenosis. Conclusion: Piperonylic acid can inhibit the excessive proliferation of vascular smooth muscle cells and the lumen narrowing after injury of blood vessels, the mechanism of which is associated with the promoted gene expressions of cell cycle key regulators P21 and P27 (Tab. 4, Fig. 4, Ref. 22). Keywords: piperonylic acid, cell cycle, vascular smooth muscle cell, restenosis, P21, P27, balloon injury.
- The comparison of preemptive analgesic effects of curcumin and diclofenac. [JOURNAL ARTICLE]
- Bratisl Lek Listy 2014; 115(12):757-760.
Objective: Preemptive analgesia is an antinociceptive treatment that prevents central sensitization. Antinociceptive effects of diclofenac are well-known. The aim of this study was to investigate preemptive analgesic effects of curcumin and diclofenac, before acute and inflammatory induced pain in rat model.Material and methods: Fourty eight old female (n = 6 in each group) Wistar Albino rats were included in the study. Paw movements in response to paw flinching in response to formalin injection or thermal stimulation were compared after curcumin (400 mg kg-1, p.o.) and diclofenac (10 mg kg-1, i.p.) administration. Saline was used as a control. The solvent ethanol was administered in another group of rats. Preemptive analgesic effect was significant in both tests when curcumin and diclofenac was administrated before the pain stimuli. Results: Oral administration of curcumin and intraperitoneal injection of diclofenac increase the response time in hot plate test and decrease the number of flinches in formalin test (p < 0.001 vs p < 0.05). Conclusion: These results suggest that curcumin had preemptive analgesic effects on acute thermal, and inflammatory induced pain in rats as diclofenac (Fig. 2, Ref. 35). Keywords: curcumin, diclofenac, preemptive analgesic effect, rat.