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Bratisl Lek Listy [journal]
- One-stage surgical approach to coarctation of the aorta and ascending aortic aneurysm. [Journal Article]
- Bratisl Lek Listy 2014; 115(9):593-6.
Aortic coarctation in adults is sometimes associated with concomitant cardiovascular pathologies which require intervention. The optimal operative approach for such patients remains unsettled. An extra-anatomic aortic bypass from the ascending aorta to the descending aorta via median sternotomy allows simultaneous performance of repair of complex aortic coarctation and concomitant cardiac operation.We present herein an adult female with coarctation of the aorta combined with an ascending aortic aneurysm associated with concomitant aortic valve regurgitation. We performed a single-stage operation which consisted of Bentall's procedure and extra-anatomic bypass from the ascending to the descending aorta. The patient's postoperative period was uneventful and twelve months after the surgery she is doing well.The conclusions of our work resulted in one essential experience, namely that clinically serious, previously almost intractable conditions can be successfully resolved in unusual ways. Extra-anatomic reconstruction of aorta coarctation that for various reasons could not have been solved by resection of the affected aortic segment allowed us to achieve a structurally as well as functionally excellent outcome. Therefore, we recommend to consider this option in appropriate patients and/or incorporate it into the therapeutic armamentarium of cardiosurgical centers (Fig. 5, Ref. 11).
- Acromegaly is protective for periodontal tissue - advanced chronic periodontitis is rare in acromegalics. [Journal Article]
- Bratisl Lek Listy 2014; 115(9):588-92.
Acromegaly is a complex syndrome which influences the connective tissue and bone metabolism. Although the effects of excess growth hormone on bone tissue are well known, its effect on periodontal tissue is an enigma.A total of 23 acromegalic patients (mean age 48.13 ± 9.4 years) were included randomly in to this cross-sectional study. The control group consisted of 60 healthy (mean age 50.3 ± 8.5) individuals. All participants were examined by the same periodontist to evaluate periodontal disease status.We studied a group of 23 acromegalic patients (11 females, 12 males) with estimated duration of disease from minimum of one year to 10 years (mean 4.52 ± 2.9 years). The frequency of advanced chronic periodontitis in acromegalics was significantly lower than in the healthy group (p = 0.002). Advanced periodontitis was 10 times more frequent in healthy population than in the acromegalics.Advanced chronic periodontitis is 10 times less frequent in acromegalics than in healthy population. Acromegaly is a disease which seems to be protective for periodontal tissue (Tab. 4, Ref. 30).
- Importance of histological verification of mediastinal lymphadenopathy in exact staging of non-small cell bronchogenic carcinoma. [Journal Article]
- Bratisl Lek Listy 2014; 115(9):585-7.
Diagnostics and treatment of bronchogenic non-small cell lung carcinoma is a severe clinical problem. Radical surgery is the major treatment modality with the highest chance for a long-time survival. The aim of the study was to map metastasizing of bronchogenic non-small cell lung carcinoma into homolateral mediastinal lymph nodes and to assess the importance of histological verification of mediastinal lymphadenectomy for exact staging and treatment.Study of 29 patients with non-small cell lung carcinoma in stage IIIa, IIIb and IV (TNM classification) diagnosed from September 2006 to March 2007, with mediastinal lymph nodes invasion according to CT, and with subsequent mediastinal lymph node dissection during autopsy.50% of the right upper lobe tumors metastasized into group 1 nodes (N1-N4) and 50% into group 3 (N7). 66% of the right lower lobe tumors metastasized into group 3 nodes (N7) and 33.3% into group 1 (N1-4). 20.0% of the left upper lobe tumors metastasized into group 1 nodes (N1-4), 33.0% into group 2 (N5-6), 25.0% into group 3 (N7) and 16.7% into group 4 (N8-9). 23.5% of the left lower lobe tumors metastasized into group 1 nodes (N1-4), 23.5% into group 2 (N5-6), 23.5 % into group 4 (N8-9) and 29.5% into group 3 (N7). 27.6% of examined patients had false positivity of lymph node metastasis according to CT.Histological verification of suspect mediastinal lymph nodes via Endobronchial Ultrasound Biopsy (EBUS) or mediastinoscopy or thoracoscopy is crucial for determining the stage of the disease according to the TNM classification. False positivity of imaging methods in diagnostics of non-small cell brochogenic carcinoma can contraindicate up to quarter of potentially operable patients (Tab. 3, Ref. 11).
- Predictors of cardiovascular risk in a population of diabetic adults of Gypsy origin, in Granada. [Journal Article]
- Bratisl Lek Listy 2014; 115(9):579-84.
The aim of this work is to identify cardiovascular risk factors in a population of ethnic Gypsy diagnosed with type 2 diabetes mellitus (T2DM) and to compare this population with a control group of non-Gypsy patients also diagnosed with T2DM and with a similar sociological background.Observational descriptive cross-cutting study.Using a systematic random sampling, we selected a sample of 220 Gypsy patients diagnosed with T2DM and another sample of 230 non-Gypsy patients, also diagnosed with T2DM. Both samples were composed of patients registered at the Almanjáyar and Cartuja health centres, in Granada (Spain). The data were collected between October 2010 and October 2011.There were statistically significant differences between the Gypsy and non-Gypsy patients in the following variables concerning the control of cardiovascular risk: systolic blood pressure, diastolic blood pressure, HDL cholesterol, triglycerides and cardiovascular risk.The factors of cardiovascular risk presented by Gypsy patients diagnosed with T2DM were more acute than those of non-Gypsy patients (Tab. 7, Ref. 26).
- Vitamin D status, bone metabolism and bone mass in patients with alcoholic liver cirrhosis. [Journal Article]
- Bratisl Lek Listy 2014; 115(9):573-8.
Osteoporosis is seen in some 12-50 % patients with liver cirrhosis. Detrimental effects of alcohol are exerted directly on the bone cells and indirectly on hormones. Vitamin D is involved in osteoblast differentiation, bone matrix synthesis and bone mineralization, as well as in its decomposition. Vitamin D deficiency has been reported in about 2/3 patients with liver cirrhosis.Determination of vitamin D status, bone metabolic activity and bone mass in patients with alcoholic liver cirrhosis (ALC).Thirty male patients with ALC were investigated in the period October 2011- March 2012. Total vitamin D, parathormone, osteocalcin and CrossLaps were determined by the ECLIA method (electrochemiluminiscence immunoassay) using Elecsys 2010 analyzer. Bone mineral density was measured by means of dual-energy x-ray absorptiometry (DXA) using the Lunar Prodigy. Result analysis was performed using descriptive statistics and hypothesis testing, as well as nonparametric one-way analysis of variance, Kruskal-Wallis test, Mann-Whitney U-test, Pearson correlation coefficient.Deficiency in vitamin D (< 50 nmol/l) was noted in 66.66 % patients, with highest prevalence in Child-Pugh C class patients (chi-square = 5.878, p < 0.05). Osteocalcin levels were below the lower limit of normal in 86.7 % patients. CrossLaps was increased in only 20 % patients, but a significant increase was noted in Child-Pugh C class patients. Osteoporosis was diagnosed in 20 % of patients, with no correlation with disease severity and vitamin D status.Vitamin D deficiency is present in patients with ALC. Decrease in bone formation and bone mass is most probably multicausal (Tab. 2, Fig. 1, Ref. 30).
- The importance of lipid spectrum changes in women with polycystic ovary syndrome(PCOS). [Journal Article]
- Bratisl Lek Listy 2014; 115(9):569-72.
of the study was to compare levels of blood lipids, anthropometric characteristics and their relationship in women with PCOS with a group of healthy women.We determined anthropometric indicators (BMI - body mass index, waist measurement, waist/hip ratio), blood lipid levels (total cholesterol TCH, high density cholesterol HDL, low density cholesterol LDL and triglycerides TAG) in a group of women with PCOS and a healthy control group. Levels of evaluated blood lipids in women with PCOS and the healthy control group were within the normal range. Women with PCOS differed statistically significantly from the control group in a higher concentration of triglycerides (control 1.01 ± 0.7 mmol.l-1, PCOS 1.17 ± 0.58). In women with PCOS we proved a positive correlation between BMI, total cholesterol, LDL cholesterol and levels of triglycerides. In women with PCOS waist measurement showed a statistically significant relationship to values of LDL cholesterol, HDL cholesterol and level of triglycerides.All women with PCOS in our study had very good levels of blood lipoproteins (total cholesterol, LDL and HDL cholesterol, triglycerides) so we are not sure if there is any importance of changes in blood lipid metabolism in these patients (Tab. 1, Fig. 2, Ref. 16).
- Frequencies of polymorphisms in CYP2C9 and VKORC1 genes influencing warfarin metabolism in Slovak population: implication for clinical practice. [Journal Article, Research Support, Non-U.S. Gov't]
- Bratisl Lek Listy 2014; 115(9):563-8.
The study was aimed at establishing an effective molecular-genetic method for detecting polymorphisms in genes CYP2C9 and VKORC1, which affect the pharmacogenetics of warfarin, and at determining their prevalence in Slovak population.Warfarin, derivative of coumarin, belongs to the most commonly prescribed oral anticoagulants with narrow therapeutic index. An insufficient dose of warfarin can result in failure to produce the antithrombotic effect, whereas an overdose increases the risk of bleeding. It was proven that genetic variability in two genes, CYP2C9 a VKORC1, has a significant influence on the individual's response to the dosage of warfarin.In a control group of 112 randomly selected individuals, we tested the frequency of selected single nucleotide polymorphisms including CYP2C9*2 (430C>T), CYP2C9*3 (1075A>C), VKORC1*2 (1173C>T) by allele-specific Real-Time PCR and VKORC1*2 (-1639G>A) by using PCR-RFLP.Due to the combination of frequent alleles CYP2C9*2, CYP2C9*3 and VKORC1*2 in Slovak population we determine that 25% of population need a standard 5-mg daily dose of warfarin, while 44%, 23%, and 8% need 4 mg, 3 mg and 2 mg of warfarin per day.Slovak population is in Hardy-Weinberg equilibrium and frequencies of SNPs were in accordance with other published results in European populations (Tab. 5. Fig. 3, Ref. 51).
- The examination of protective effects of gallic acid against damage of oxidative stress during induced-experimental renal ischemia-reperfusion in experiment. [Journal Article]
- Bratisl Lek Listy 2014; 115(9):557-62.
In this study, probable effects of gallic acid were investigated in experimentally induced renal I/R injury in rats.For this purpose, each group consisted of 7 Spraque dawley male albino rats. Groups were defined as follows; Group I: control group; Group II: I/R group; Group III, IV and V: I/R+Gallic acid (50, 100 and 200 mg.kg-1 respectively-i.p.). Left kidney was removed by nephrectomy except for Group I. I/R was induced in the other kidney. Gallic acid was given 15 mins before ischemia induction. SOD, CAT and Gpx activities were determined by electrophoresis. MDA, MPO levels were determined spectrophotometrically. Histopathological investigations were also performed in kidney tissues. BUN and Creatinine levels in serum were determined.BUN, Creatinine and MDA levels were statistically significant but MPO level was not statistically significantly increased in Group II. For SOD, CAT, Gpx activities in Group II, an increase was determined with respect to Group I. Histopathological investigations revealed widespread hyperemia in glomerulus, expansion of the structure between tubules and cell disruptions in Group II. In Group V (200 mg.kg-1 gallic acid), in terms of biochemical parameters, in spite of the significant decrease in BUN, Creatinine and MDA levels; a decrease was determined in SOD, CAT and Gpx isoenzyme activities. Group V showed histologically that I/R injury had been prevented to a greater extent and appearances were close to the control.As a result, in terms of our study, evaluations regarding kidney functions and histopathology have shown that gallic acid has protective effects in renal I/R injury (Tab. 2, Fig. 5, Ref. 36).
- Mutation detection in the promoter region of survivin gene on N-methyl-N-nitrosourea induced colon tumor model in experiment. [Journal Article, Research Support, Non-U.S. Gov't]
- Bratisl Lek Listy 2014; 115(9):554-6.
Survivin (also known as BIRC5) is one of the first reported inhibitors of apoptosis proteins (IAPs), which is an important family of proteins that regulate apoptosis. It is developmentally regulated and expressed during cell differentiation in humans, mice and rat. Survivin is expressed in a series of human cancers and it has been widely accepted that survivin is strongly related to the onset and development of cancer. In the present study, we tried to determine differences in the promoter region of survivin gene in colon tissue samples from N-methyl-N-nitrosourea (MNU) induced rat colon tumor model and control group. Polymerase chain reaction (PCR) - single strand conformation polymorphism (SSCP) analysis was used for this aim. No significant differences were found in the promoter region of survivin gene between the normal and tumor tissues (Tab. 2, Fig. 1, Ref. 16).
- Analysis of the effects of heparin and enoxaparin on degloving injuries. [Journal Article]
- Bratisl Lek Listy 2014; 115(9):550-3.
Heparin and low molecular weight heparin are the most frequently used antithromboembolic drugs in fractures.We aimed to compare the effects of heparin and enoxaparin, which are used as standard treatment, on viability in degloving injuries.Thirty rats were used in the study. Three groups were composed including 10 rats in each group. Degloving injuries were formed in the tails of the rats. Enoxaparin was injected subcutaneously to the rats in group 1. Standard heparin was injected subcutaneously to the rats in group 2. Serum physiologic solution was injected subcutaneously to the rats in group 3. The experiment was ended on day 15. The tails of the rats were evaluated clinically and histopathologically.There was a statistically significant difference in the clinical results (p < 0.05). There was a statistically significant difference in the histopathological results (p < 0.05).We encountered positive effects of both heparin and enoxaparin on the treatment of degloving injuries in this experimental study. However, the findings of this study should be supported and improved by new experimental and especially clinical studies (Fig. 3, Ref. 18).