The Martin University Hospital (Slovak: Univerzitná nemocnica Martin, abbreviated to UNM) is a Slovak public university hospital located in the Martin municipality, in the county of Zilina, north-east of the Slovak capital Bratislava. It is a teaching hospital and it is the main university hospital affiliated with the Jessenius School of Medicine. The hospital has over 1,700 employees. Martin University Hospital has 900 beds in total including all sectors. The current director of the hospital is Dr. Dušan Krkoška, M.D., PhD., MBA.
This research investigated electroencephalographic (EEG) power spectral density during sleep in pediatric patients with the classic phenotype of obstructive sleep apnea (OSA). The primary goal was to evaluate potential specific objective biomarkers of sleep quality within this clinical group. The study sample comprised 76 children (age range, 4–8 years), categorized into a classic OSA phenotype group (n = 36) and a healthy control group (n = 40). All participants underwent diagnostic overnight polysomnography (PSG) in a controlled laboratory setting. Following manual scoring of PSG data, quantitative EEG spectral evaluation was performed using the F4–M1 derivation. Absolute power in the theta, alpha, delta, sigma, and beta frequency bands was calculated across multiple sleep stages. Comparative statistical analyses were conducted to identify differences in frequency features between the two cohorts. Quantitative analysis showed that pediatric patients with the classic OSA phenotype exhibited significantly higher absolute power in the delta frequency range during NREM3 (deep) sleep compared to the control group (855.47 ± 297.75 vs. 646.11 ± 245.26, p < 0.05). Analysis of conventional polysomnographic parameters demonstrated significant changes in sleep macro-architecture, including increased percentage of NREM1 sleep (8.84 ± 5.81 vs. 5.31 ± 2.61, p < 0.05), decreased percentage of NREM2 sleep (41.15 ± 8.11 vs. 47.36 ± 6.42, p < 0.05), and significantly increased Arousal index (27.93 ± 9.49 vs. 19.82 ± 11.13, p < 0.05). in the group of patients with the classic OSA phenotype compared to the control group. No other significant differences were observed in other spectral bands or during other sleep stages. Monitoring EEG spectral power, particularly delta activity during slow-wave sleep, may provides a valuable objective measure of sleep quality in pediatric patients with the classic OSA phenotype.
To evaluate the clinical efficacy of subgingival instrumentation (SI) with adjunctive systemic amoxicillin (AMX) and metronidazole (MTZ) compared with SI and placebo in young adults with generalized stage III, grade C periodontitis. While systemic antibiotics are often prescribed for high-grade periodontitis, the clinical relevance of their statistical benefits remains debated within current disease classification and antibiotic stewardship frameworks. In this triple-blind, randomized controlled trial, 50 patients (18–35 years) received SI + AMX/MTZ (500 mg TID, 7 days) or SI + placebo. Periodontal parameters (PPD, CAL, BOP, and FMPI) were recorded at baseline, 6, and 12 months. The primary clinically relevant outcome was the therapeutic success rate (absence of pockets > 5 mm) at 12 months. Both groups showed significant clinical improvements at 12 months (p < 0.001). The test group achieved statistically greater mean PPD reduction (difference: 0.53 mm; p = 0.024) and CAL gain (difference: 0.61 mm; p < 0.001). However, no statistically significant differences were observed in therapeutic success rates at 12 months (96.0
Spinocerebellar ataxia type 27B (SCA27B) is an autosomal dominant late-onset cerebellar ataxia caused by a pathogenic GAA repeat expansion in the FGF14 gene. Although oculomotor abnormalities, particularly downbeat nystagmus, are well recognized, afferent visual pathway involvement has not been systematically investigated. We report a 67-year-old man with genetically confirmed SCA27B who presented with a two-year history of progressive cerebellar and somatosensory ataxia, with a Scale for the Assessment and Rating of Ataxia (SARA) score of 13. Neurological examination revealed typical oculomotor abnormalities, including downbeat nystagmus elicited during head-shaking testing. Brain MRI showed mild cerebellar atrophy. Electrophysiological studies demonstrated axonal sensory polyneuropathy and prolonged central conduction times on somatosensory evoked potentials. Comprehensive ophthalmological examination, including optical coherence tomography, showed no structural abnormalities. Pattern-reversal visual evoked potentials, recorded according to ISCEV standards, demonstrated mild bilateral prolongation of P100 latency, measuring 116 ms in the left eye and 115 ms in the right eye, with preserved amplitudes. Compared with laboratory normative data from individuals aged 60–70 years, these values exceeded the upper age-related reference limit. This case suggests possible subclinical functional involvement of the post-retinal afferent visual pathways in SCA27B. However, the findings should be interpreted cautiously and confirmed in larger, age-matched cohorts.
Background: Protein-energy wasting (PEW) is a major predictor of morbidity and mortality in patients with chronic kidney disease (CKD), even before the initiation of dialysis. Its multifactorial pathogenesis includes reduced dietary intake, chronic inflammation, metabolic acidosis, hormonal disturbances, and dysbiosis of the gut microbiota. Early recognition and targeted management are crucial for preventing muscle loss, functional decline, and adverse outcomes. Methods: This narrative review summarises and integrates current evidence from the literature on nutritional and metabolic interventions to prevent and treat protein-energy wasting in patients with nondialysis chronic kidney disease. Relevant clinical trials, meta-analyses, and experimental studies published up to date were evaluated, focusing on dietary strategies, metabolic modulation, physical exercise, and gut microbiome-targeted therapies. Results: Adequate energy and protein intake remain the cornerstone of PEW management, based on available clinical and observational evidence. Individualised diets emphasising high-quality and plant-based proteins, oral nutritional supplements, and ketoanalogues can attenuate muscle wasting. Correction of metabolic acidosis and inflammation enhances protein anabolism and nitrogen balance. Physical exercise acts synergistically with dietary interventions to preserve muscle mass and function. Novel approaches-such as modulating the gut-kidney axis with pre-, pro-, and postbiotics or supplementing with short-chain fatty acids-show promise in improving metabolic and inflammatory profiles. Conclusions: The management of PEW in nondialysis CKD requires a personalised approach that integrates nutrition, physical activity, metabolic correction and microbiome modulation. Early, coordinated intervention may help to slow the progression of CKD and improve patient survival and quality of life.
