INTRODUCTION:Ovarian tumours represent a highly malignant disease that is often diagnosed at an advanced stage and is associated with a poor prognosis. The most common histological type is high-grade serous carcinoma, characterized by significant genomic instability and homologous recombination defects, particularly due to pathogenic variants in the BRCA1 and BRCA2 genes. The introduction of high throughput sequencing methods has enabled the identification of a broader spectrum of predisposing genes and further emphasised the importance of genetic testing for targeted prevention and individualised treatment. METHODS:The aim of our study was to determine the frequency of germline mutations in 117 unrelated patients diagnosed with ovarian, tubal, or primary peritoneal cancer. We also assessed epidemiological and tumor pathogenesis data. The patients were examined with the "CZECANCA" gene panel sequenced by next-generation sequencing (NGS) on an Illumina platform. RESULTS:Pathogenic variants were found in 29% of patients, most commonly mutations in the BRCA1 and BRCA2 genes. The median age of patients with high-grade serous ovarian cancer was 61 years. The median age of BRCA1/2-positive women was 54 years, and all had a positive family history of cancer. CONCLUSION:Identifying carriers of pathogenic variants enables targeted prevention, earlier detection, and personalized therapy. Despite significant advances in treatment, early diagnosis and screening of at-risk individuals remain a major challenge.
BACKGROUND:Endometrial carcinogenesis involves complex interactions between hormonal signaling and the local immune microenvironment. While atypical endometrial hyperplasia is a recognized precursor to carcinoma, the spatial and phenotypic evolution of immune and hormonal markers during progression remains incompletely characterized. METHODS:A retrospective cohort of 150 endometrial specimens, including hyperplasia without atypia (n=40), hyperplasia with atypia (n=40), endometrioid carcinoma (n=40), and serous carcinoma (n=30), was analyzed using immunohistochemistry for CD3, CD4, CD8, FOXP3, CD68, CD163, estrogen receptor (ER), and progesterone receptor (PR). Digital whole-slide imaging and QuPath were applied to quantify immune cell densities in intratumoral and peritumoral compartments. Correlations between immune markers and hormonal receptors were evaluated, and a subgroup of 27 paired hyperplasia-carcinoma cases was analyzed separately. RESULTS:CD3+ and CD8+ T-cell densities increased progressively from hyperplasia to carcinoma (P<0.001), with hyperplastic lesions demonstrating predominant peritumoral localization consistent with immune exclusion. FOXP3+ regulatory T cells were enriched in neoplastic lesions, particularly in ER/PR-positive tumors. CD8+ intratumoral and peritumoral densities showed significant inverse correlations with ER and PR expression (both r=-0.76, P<0.001), whereas FOXP3+ infiltration correlated positively with ER and PR (r=0.64, P<0.001). M2 CD163+ macrophages demonstrated an inverse association with ER (r=-0.49, P<0.01), while M1 CD68+/iNOS macrophages showed no statistically significant correlations. In the paired subgroup, higher peritumoral than intratumoral CD8+ densities persisted, indicating residual immune exclusion despite malignant transformation. CONCLUSIONS:Endometrial neoplastic progression is characterized by a transition from peritumoral immune exclusion in hyperplasia to increased intratumoral immune infiltration in carcinoma, although this shift is not universal. Hormone receptor-positive tumors exhibit enrichment of FOXP3+ regulatory T cells and CD163+ macrophages, suggesting hormone-linked immune suppression. These findings highlight combined immune-hormonal biomarkers as potential indicators of progression risk and support further investigation of integrated immunomodulatory and hormone-targeted therapeutic strategies.
BACKGROUND:Chronic obstructive pulmonary disease (COPD) is now a major contributor to illness and death on a global scale. Traditional classifications based on pulmonary-function variables like the FEV1 (% predicted), lack sensitivity to early inflammatory changes and disease heterogeneity. In contrast, MiRNAs have emerged as promising biomarkers for respiratory conditions including COPD. The aim of this study was to examine the association between selected MiRNAs and COPD. METHODS:A total of 200 COPD patients (GOLD I-IV, n=50 each) and 50 healthy controls were enrolled. Differentially expressed miRNAs were identified from the GEO database and validated by RT-qPCR. Univariate analysis and LASSO regression were used for feature selection. A logistic regression model incorporating selected variables was established for the forecast COPD severity. KEGG pathway enrichment of miR-518b target genes was performed using DAVID. RESULTS:Five miRNAs (miR-216a, miR-518b, miR-106a, miR-1233, and miR-184) were substantially increased in COPD and correlated with disease severity (P<0.001). LASSO regression identified FEV1 (% predicted), DLCO (% predicted), CAT score, miR-518b, and age as key predictors. The combined model showed excellent classification performance (AUC=0.953; sensitivity=92.9%; specificity=81.3%). MiR-518b emerged as a strong independent risk factor (OR=18.91, P=0.003). Gene set enrichment of miR-518b targets pointed to involvement in both the Toll-like receptor and Hippo pathways, implicating its critical roles in inflammation and airway remodeling. CONCLUSIONS:MiR-518b is closely associated with COPD severity and may be useful in clinical practice. A model integrating miRNA expression and clinical parameters provides high predictive value for COPD classification and supports precision diagnosis.
BACKGROUND:The C-reactive protein-to-albumin ratio (CAR) has recently gained attention as a novel biomarker reflecting both systemic inflammation and nutritional status. Since inflammation plays a critical role in the formation of the coronary collateral circulation (CCC), this study aimed to investigate the association between CAR and the extent of CCC in patients with chronic coronary syndromes (CCS) and chronic total occlusion (CTO). METHODS:A total of 123 consecutive patients with CCS and angiographically documented CTO were included. CCC was assessed using the Rentrop classification and patients were divided into two groups: poor CCC (grades 0-1) and good CCC (grades 2-3). Laboratory data including C-reactive protein (CRP), albumin, lipid parameters, renal and liver function tests, glucose, and complete blood count were recorded. CAR was calculated by dividing CRP (mg/L) by albumin (g/dL), and neutrophil-to-lymphocyte ratio (NLR) was also evaluated. RESULTS:Patients with poor CCC had significantly higher CRP, CAR, and NLR levels (P<0.05 for all). In multivariate logistic regression, both CAR (OR=1.200, 95% CI: 1.102-1.394, P<0.001) and NLR were independently associated with poor CCC. ROC analysis showed that CAR had better predictive value (AUC=0.79) than CRP (AUC=0.75, P=0.02) and NLR (AUC=0.67, P=0.03). A CAR cutoff of 2.36 yielded 67% sensitivity and 68% specificity. CONCLUSION:Elevated CAR is independently associated with impaired CCC in patients with CCS and CTO. CAR may serve as a simple and superior marker over traditional inflammatory indices in assessing collateral vessel development.
BACKGROUND:Ceramides are a heterogeneous group of bioactive membrane sphingolipids that play specialized regulatory roles in cellular metabolism depending on their characteristic fatty acyl chain lengths and subcellular distribution. Ceramides have emerged as promising biomarkers for cardiovascular diseases. METHODS:Within the prospective Kardiovize study based in Brno, Czech Republic, we aimed to develop two carotid intima-media thickeness (CIMT) prediction models using available variables. One model incorporated, in addition to sex and age, conventional biomarkers (total cholesterol, triglycerides, lipid-lowering therapy), while the other included blood concentrations of selected ceramides. Lipids species were measured by a hyphenated mass spectrometry technique. RESULTS:A total of 139 men (mean age 61.8 ± 16.4) and 222 women (63.9 ± 14.8) were included in the present study. Both approaches yielded almost identical coefficients of determination (54.6 % vs 55.0%) with good classification abilities (weighted kappa 0.69 vs 0.71) in both models. The ceramide (d18:1/18:0) shows a strong negative association with CIMT (β = -1.39, P=0.04), while (d18:1/24:1) shows a positive association with carotid intima-media thickness (β=0.20, P=0.002). CONCLUSION:The tested ceramides were able to predict subclinical atherosclerosis by carotid intima-media thickness with comparable accuracy to a combination of routinely tested lipids.
BACKGROUND:The no-touch (NT) technique for saphenous vein harvesting aims to preserve vascular integrity and improve graft performance in coronary artery bypass grafting (CABG). However, concerns remain regarding wound healing disorders and local complications at the graft harvest site. METHODS:This prospective observational comparative study included 60 consecutive patients undergoing CABG, allocated to conventional saphenous vein harvesting (CONV, n=30) or the NT technique (NT, n=30). Group allocation was based on routine clinical practice and surgeon preference, without formal randomization. The primary outcome was the incidence of wound healing disorders and local complications at the harvest site. Secondary outcomes included perioperative parameters, major adverse cardiovascular events (MACE), and venous graft patency assessed by computed tomography coronary angiography one year after surgery. RESULTS:Operative time and aortic cross-clamp time were comparable between groups. Shorter graft harvesting time was observed in the NT group (35 ± 7.5 min vs. 43 ± 9.1 min; P=0.001), along with significantly reduced perioperative blood loss (15 ± 7 mL vs. 40 ± 12.1 mL; P<0.0001). The incidence of subcutaneous hematoma on postoperative day 7 was significantly lower in the NT group (20% vs. 60%; P=0.003). No statistically significant differences were found between groups in wound infection rates, MACE, or venous graft patency at one-year follow-up. CONCLUSION:The NT technique for saphenous vein harvesting offers relevant perioperative advantages, including shorter harvesting time, reduced blood loss, and fewer early local complications, without adversely affecting operative time, major adverse cardiac events, wound infection, or one-year graft patency.
BACKGROUND AND AIMS:Suicide represents a major public health issue influenced by a complex interplay of individual, social, and environmental factors. While suicidological research traditionally focuses on psychological and clinical aspects, spatial dimensions of suicidal behavior remain less explored, particularly in Central Europe. This study presents a geospatial analysis of completed suicides in the Olomouc and Zlín Regions of the Czech Republic between 2018 and 2022, using a unique dataset derived from forensic autopsy records. The primary goal was to demonstrate the potential of spatial processing and interdisciplinary collaboration between forensic medicine and geoinformatics in identifying contextual patterns of suicidal behavior. METHODS:A dataset of 585 completed suicides was compiled from forensic autopsy reports, including detailed individual-level characteristics and geolocation data. Spatial analyses were conducted using GIS software, integrating additional layers such as land use, demographic and socioeconomic indicators, and quality of life indices. Both point-level and aggregated data (municipality and administrative district levels) were used to explore correlations and spatial variability. RESULTS:The study confirmed known trends - such as male predominance and the role of alcohol - and identified new spatial relationships, including a negative correlation between blood alcohol concentration and latitude, and between age and distance from residence to suicide location. Spatial analyses were conducted at multiple levels of aggregation and combined with selected socioeconomic and environmental indicators, including quality of life, urban-rural context, and foreclosure (enforcement) rates. The results demonstrate that spatial patterns and correlations between suicide rates and area-based characteristics vary depending on the spatial scale of analysis. CONCLUSION:The findings illustrate the potential of interdisciplinary collaboration between forensic medicine and geoinformatics and provide an exploratory basis for further research and more context-sensitive suicide prevention approaches.
AIMS:This study aimed to investigate the relationship between sleep parameters and tear film hydration assessed by tear meniscus height (TMH), and to evaluate the usability of a mobile application for remote behavioral and physiological data collection. METHODS:Eighteen healthy adults (mean age 29.6 ± 6.4 years) completed five consecutive days of linked measurements combining objective sleep tracking (using Fitbit Charge 4) and slit-lamp imaging of TMH under standardized conditions. Behavioral data on stress, caffeine intake, and smartphone use were collected via a custom mobile application, whose usability was assessed by the System Usability Scale (SUS). RESULTS:Ninety valid daily records were analyzed. TMH correlated positively with total sleep time (r=0.31, P=0.0033), REM sleep duration (r=0.28, P=0.0066), and sleep quality (r=0.32, P=0.0024). Each additional 30 min of REM sleep increased TMH by approximately 0.014 mm. Short sleepers (<6 h) showed significantly lower TMH (0.121 mm) than normal sleepers (≥6 h; 0.153 mm; P=0.0023). Stress and evening smartphone use were associated with reduced sleep quality and lower TMH. The mobile application achieved excellent usability (SUS = 87 ± 6). CONCLUSIONS:Our data indicate that sleep duration and architecture play essential roles in maintaining tear film stability. Behavioral habits that impair sleep continuity may thus directly affect ocular surface physiology. The combined use of wearable sensors and mobile self-reporting represents a practical approach to studying the interaction between sleep and ocular physiology.
BACKGROUND:Chronic nonbacterial prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a prevalent urological disorder with a significant impact on quality-of-life. This study assessed the effects of rectal administration of dual cannabidiol (CBD)/hyaluronic acid (HA)-based therapy in men with CP/CPPS. METHODS:A single-arm, open-label pilot trial on 16 men (24-49 years) with CP/CPPS (NIH Chronic Prostatitis Symptom Index [NIH-CPSI] >10, pain subscore ≥4). The participants self-administered rectal CANNEFF® suppositories containing CBD (100 mg) and HA (6.6 mg) as active ingredients, nightly for 30 days. Outcome measures included changes in NIH-CPSI total score, International Prostate Symptom Score (IPSS), and International Index of Erectile Function (IIEF-5). Safety and tolerability were also assessed. RESULTS:The median baseline NIH-CPSI score was 24.5 points (range 11, 39) decreasing to a median 20.0 (range 2, 26) at day 30 (P=0.003), with a median reduction of 7.0 points (range -20.0, 6.0). Symptom improvement was found in 81.3 % (13/16) of participants. The IPSS total score decreased from a median of 14.0 points (range 4, 32) to a median 12.0 (range 3, 18) (P=0.033), with voiding symptoms showing the largest improvement. The IIEF-5 score increased modestly but without statistical significance. No adverse events were reported. CONCLUSIONS:The administration of the suppositories with CBD/HA action demonstrated potential symptom relief in CP/CPPS with a favourable tolerability profile. A more nuanced analysis of NIH-CPSI changes and IPSS and IIEF-5 data suggests a clinically meaningful benefit for most participants.
BACKGROUND:Proinflammatory cytokines are a pivotal factor in cancer initiation and progression. The paracrine and autocrine secretions of such inflammatory cytokines are reported in different cancer types. Recently, C-C motif ligand (CCL) 5 (CCL5), CCL22, granulocyte-colony stimulating factor (G-CSF), and interleukin-1 receptor antagonist (IL-1 RA) have been detected in basal secretions of breast cancer (BC) cells and linked to BC pathogenesis. While Vitamin D has been found to have anti-inflammatory effects, its modulation on cytokine expression is rarely studied in relation to cancer. AIMS:In this study, we evaluated whether vitamin D could modulate cytokine basal levels in BC. MATERIALS AND METHODS:This in vitro study was conducted on BC cell lines, MCF-7 and MDA-MB-231. Cells were treated with vitamin D (10 and 100 nM), and cytokine levels were measured using the Enzyme-Linked Immunosorbent Assay (ELISA). RESULTS:There was a significant reduction in CCL5 total levels in MCF-7 cells at both concentrations (P≤0.01) and in MDA-MB-231 at 100 nM (P≤0.05). Both concentrations reduced CCL22 levels significantly in MCF-7 (P≤0.05) and MDA-MB-231 (P≤0.01). Regarding G-CSF, a significant reduction was found in MCF-7 at both concentrations (P≤0.05) and at 100 nM in MDA-MB-231 (P≤0.01). In comparison, IL-1 RA levels were significantly elevated in MCF-7 (100 nM (P≤0.01)) and MDA-MB-231 (10 nM (P≤0.05) and 100 nM (P≤0.01)). CONCLUSION:Vitamin D down-regulated the pro-inflammatory and up-regulated the anti-inflammatory cytokines. This indicates that vitamin D can modulate the expression of inflammatory mediators, particularly in a cancer setting. The results support the potential use of vitamin D as an anti-cancer agent with anti-inflammatory properties.
OBJECTIVE:To evaluate transperitoneal laparoscopic adrenalectomies performed at the University Hospital, Olomouc over a period of 20 years. INTRODUCTION:Thanks to the increased availability of imaging, the detection of adrenal disease is increasing. Laparoscopic adrenalectomy is now regarded as the gold standard for the treatment of adrenal disease due to its safety and efficacy despite the increasing popularity of robotic-assisted surgery. METHODS:Over a period of 20 years, from 2002 to 2021, we retrospectively evaluated a cohort of 405 patients who had undergone laparoscopic adrenalectomy. The indication criteria for laparoscopic adrenalectomy were hormonally active symptomatic tumours (pheochromocytoma, Conn's syndrome, Cushing's syndrome, etc.), symptomatic cysts or myelolipomas, carcinomas, metastatic disabling or incidentalomas, growing at a rate >1 cm or more per year. Data collected focused on sex, age, medical classification, imaging, operative time, side dominance, hormonal activity, complications associated with surgery, length of hospital stay, and histopathologic verification. No patient who had undergone laparoscopic adrenalectomy was excluded from the cohort. Patients in our cohort were not operated by a single surgeon. RESULTS:Women accounted for 52.1% (211) and men 47.9% (194). The mean age was 55.6 years, BMI 28.7, and median ASA score was 2. Preoperative imaging included abdominal CT in 352 (86.9%) patients, abdominal MRI with contrast agent in 8 (2.0%), and PET/CT in 45 (11.1%) patients. More frequent findings were on the right side in 223 (54.39%) patients. Hormonal activity was found in 271 patients (67 %). Hormone overproduction from the right adrenal gland was found in 120 (44.3%) patients, and from the left in 151 (55.7%). Adenoma was the most frequent histological finding, followed by hyperplasia. Conversion to open surgery was due to bleeding in 2 patients. There was no perioperative or postoperative mortality. According to the Clavien-Dindo classification, minor complications (Grade I) occurred in 375 patients (92.6%). Grade II complications were reported in 17 patients (4.2%). Grade III complications were identified in 13 patients (3.2%) due to operative field bleeding; in three cases (0.7%), surgical revision of the adrenalectomy bed was required. CONCLUSION:Laparoscopic adrenalectomy is a safe surgical method for the management of adrenal disease and our retrospective follow-up confirmed that it remains the gold standard.
BACKGROUND:Heart failure (HF) remains a major global health challenge. Despite advancements in treatment, the prevalence of HF continues to rise. This study provides an updated analysis of HF incidence, prevalence, hospitalizations, and mortality trends in the Czech Republic from 2015 to 2023. METHODS:A retrospective observational study was conducted using anonymized data from the Czech National Healthcare Reimbursement Database (NRHZS). Patients diagnosed with HF (ICD-10 codes I50.x) were included. Descriptive statistics and trend analyses were used to analyse the data. RESULTS:The prevalence of HF has increased significantly, with 374,837 patients registered in 2023. The age-specific prevalence was highest in patients aged 75-79 years (25.1%). The incidence of HF remained stable (51,701 cases in 2023), while hospitalizations declined slightly. The mortality rate showed a minor decrease, with in-hospital mortality stabilizing at ~10% over the past decade. The use of modern HF pharmacotherapy, including SGLT2 inhibitors and ARNIs, has increased substantially over time. CONCLUSIONS:Despite improvements in HF management, the burden on the healthcare system remains high. Enhanced outpatient care and adherence to guideline-directed medical therapy (GDMT) are essential for further reducing hospitalizations and improving patient outcomes.
AIMS:Fibromyalgia (FM) is a chronic, widespread musculoskeletal disease that is usually accompanied by hyperalgesia, fatigue, sleep disturbance and depression. Although the etiopathogenesis of this syndrome is unclear, it is presumed to have an inflammatory basis. There are currently no laboratory markers available to diagnose the condition. The aim of this study was to investigate potential biochemical markers that would prove to be valid, simple, routinely used, quickly and cheaply studied and obtainable in blood count tests. METHODS:46 patients diagnosed with FM according to ACR (American College of Rheumatology) 2010 diagnostic criteria and 35 patients as a healthy control group were included in the study. Prealbumin, complete blood count, sediment and C-reactive protein (CRP) values of FM and control group patients were examined. Additionally, Hospital Anxiety and Depression Scale, Jenkins Sleep Scale and the Fibromyalgia Impact Questionnaire (FIQ) were administered to patients diagnosed with FM. RESULTS:There was a significant difference between fibromyalgia patients and control groups in terms of prealbumin, platelet, CRP, CRP/prealbumin and lymphocyte parameters (P=0.048, P=0.046, P<0.001, P=0.003 and P<0.001, respectively). Only a weak positive correlation was found between CRP and FIQ (rS =0.309, P=0.037, CI=0.012-0.556). CONCLUSION:The serum levels of some tested markers, including platelets, CRP, CRP/prealbumin and lymphocytes, were significantly higher and prealbumin was lower in patients with FM than in the control group, suggesting they could be valid in fibromyalgia diagnosis. The CRP level may be informative about the severity of the FM and it may play a role in the inflammation possibly underlying the pathogenesis of FM.
AIMS:Angiogenesis is activated in the retina of diabetic patients with retinopathy complications. Vascular endothelial growth factor (VEGF) plays an essential role as a mediator of the retinal induced neovascularization. VEGF levels are increased significantly in the vitreous and aqueous ocular fluids in the patients with proliferative diabetic retinopathy. The aim of this study is to investigate whether VEGF promoter/5'UTR polymorphisms are associated with diabetic retinopathy (DR) development and/or severity. METHODS:In this case-control study, Type 2 diabetic patients with or without DR, and normal controls were recruited. DR was classified based on the presence or absence of proliferative changes. The genotyping was analysed by polymerase chain reaction followed by restriction fragment length polymorphism. RESULTS:A total of 259 subjects (172 with diabetes+DR, 87 healthy controls; male:female, 125:134) were recruited. The average age was 59.5+9.6 years, diabetes duration was 8.5+4.5 years, body mass index was 30.6+6.0 kg/m2, and HbA1c was 7.37+1.2% (57 mmol/mol). Significant differences in the distribution of genotypes in T(-1,498)C, G(-1,190)A and G(-1,154)A polymorphism in diabetic patients versus controls, and DR patients versus DM without DR patients were shown. No association between DR severity and polymorphisms was detected. Non-significant differences in allele frequency were found. The haplotypes TGAGC, TGACT and CAGCT were significantly increased in DM patients, whereas CGGCC was the most common haplotype in DR patients. CONCLUSIONS:Multiple VEGF polymorphisms and CGGCC haplotype are significantly correlated with a higher DR risk in Type 2 diabetic patients.
AIMS:We aimed to assess the effects of intravesical cocktail instillation on the outcomes and serum pain factors of patients with bladder pain syndrome (BPS). METHODS:The clinical data of 86 female BPS patients hospitalized between March 2017 and March 2024 were collected for retrospective analysis. All patients were treated with oral medication (amitriptyline) + local intravesical instillation of drugs, and then assigned to a control group (sodium hyaluronate intravesical instillation) and a research group [intravesical instillation of dimethyl sulfoxide (DMSO) + chondroitin sulfate (CS) + low-molecular-weight heparin (LMWH) cocktail]. RESULTS:The research group (n=43) had lower urination frequency in 24 h, Pelvic Pain and Urgency/Frequency Patient Symptom Scale score, and O'Leary-Sant interstitial cystitis symptom index and interstitial cystitis problem index, as well as larger single urination volume than those of the control group (n=43) after 3 and 6 months of treatment (P<0.05). In the serum, the levels of substance P (SP), 5-hydroxytryptamine (5-HT), prostaglandin E2 (PGE2), neuropeptide Y (NPY), β-endorphin (β-EP), and dopamine (DA) declined in the two groups after 1 month of treatment in comparison to the pre-treatment levels. The levels of SP, 5-HT, PGE2, and NPY were lower, while the levels of β-EP and DA were higher in the research group than those in the control group (P<0.05). CONCLUSION:The intravesical instillation of DMSO + CS + LMWH cocktail is superior in long-term outcomes. It is more conducive to improving the levels of serum pain factors, with a good safety profile and without increasing adverse reactions.
BACKGROUND:Liver cirrhosis caused by hepatitis B is a critical progression of chronic hepatitis B. It is often accompanied by intestinal dysbiosis and impaired intestinal mucosal barrier function, which further exacerbate hepatic inflammation and fibrosis. Therefore, exploring effective combined therapeutic approaches to improve patient outcomes is of significant importance. OBJECTIVE:This study compares the efficacy and safety of entecavir combined with bifidobacterium triple viable capsules versus entecavir alone in treating Hepatitis B cirrhosis. METHODS:This retrospective case-control study enrolled 110 patients with Hepatitis B cirrhosis diagnosed and treated from January 2021 to January 2024. The control group received entecavir alone, while the observation group received entecavir combined with bifidobacterium triple viable capsules Efficacy was assessed at 24 weeks and 48 weeks post-treatment. Comparisons were made between the two groups regarding changes in intestinal flora count, intestinal mucosal barrier function, liver function, HBV-DNA negativity rate, liver fibrosis indices, liver stiffness measurement (LSM), inflammatory factor indices, and treatment safety. RESULTS:At 24 weeks and 48 weeks post-treatment, the observation group exhibited significant modulation of the intestinal microecology, with a notable decrease in the count of pathogenic bacteria (Candida albicans, Enterobacteriaceae, Enterococcus) in feces compared to pre-treatment and the control group (all P<0.05), and a significant increase in the count of probiotics (Lactobacillus, Bifidobacterium) (all P<0.05). Meanwhile, the observation group showed more significant improvement in intestinal mucosal barrier function, with lower levels of endotoxin, D-lactic acid, and diamine oxidase compared to the control group (all P<0.05). Regarding liver-related indices, the observation group demonstrated significantly greater improvement in liver function (ALT, AST, TBIL, ALB), liver fibrosis markers (HA, PC-III, IV-C, LN), and LSM compared to the control group (all P<0.05), with more pronounced improvement at 48 weeks than at 24 weeks (P<0.05). Notably, the observation group exhibited a higher HBV-DNA negativity rate at 48 weeks (90.91% vs 76.36%, P=0.039) and superior regulation of inflammatory factors (decreased TNF-α, IL-6, IL-8, and increased IL-10) (all P<0.05). The final clinical efficacy assessment revealed a significantly higher total effective rate in the observation group compared to the control group (83.64% vs 65.45%, P=0.029). Adverse event rates were comparable between the observation and control groups (7.27% vs. 10.91%, P=0.507), supporting the safety of the intervention. CONCLUSION:The treatment regimen of bifidobacterium triple viable capsules combined with entecavir is significantly superior to entecavir alone in improving intestinal flora, repairing the intestinal mucosal barrier, promoting liver function recovery, and alleviating liver fibrosis in patients with Hepatitis B cirrhosis. It also demonstrates more pronounced long-term efficacy, a higher HBV-DNA negativity rate, superior overall clinical efficacy, and good safety.
BACKGROUND:Hypogonadism is common among men with type 2 diabetes mellitus (T2DM), but diagnosis can be confounded by overlapping symptoms from diabetic complications. The Aging Males' Symptoms (AMS) questionnaire is widely used for screening, yet its validity in this specific population remains unclear. OBJECTIVE:To evaluate the relationship between AMS scores and serum testosterone levels in men with T2DM, assess diagnostic accuracy at various AMS cut-offs, and examine the influence of diabetic comorbidities on AMS scores. METHODS:We conducted a cross-sectional study in 158 men with T2DM. Participants completed the AMS questionnaire and underwent morning testosterone measurement. Comorbidities such as neuropathy, nephropathy, and obstructive sleep apnea were assessed. AMS diagnostic performance was evaluated using different cut-off values (≥27, 30, 35, 40). RESULTS:AMS total score showed a modest inverse correlation with testosterone (ρ = -0.16, P=0.047), primarily driven by the physical subscale. Neuropathy and nephropathy were associated with higher sexual subscale scores. An AMS ≥27 cut-off had high sensitivity (91%) but poor specificity (21%) for testosterone <12 nmol/L. CONCLUSION:AMS scores correlate weakly with testosterone levels in men with T2DM. Diabetic complications can elevate AMS scores independently, suggesting the need for caution and possibly higher cut-offs when using AMS for hypogonadism screening in this population.
BACKGROUND AND AIMS:Intraoperative Floppy Iris Syndrome (IFIS) is a condition that can lead to a number of complications during cataract surgery that threaten final vision of patients using alpha1-adrenergic receptor antagonists (α1-ARAs). There are two recommended pharmacological approaches to preventing IFIS development: intraoperative intracameral epinephrine and application of atropine drops twice a day for one week before surgery. The primary aim of this study was to identify the incidence and grade of IFIS using these two prophylactic approaches in patients at risk of IFIS development and to determine which approach is more effective for mild and severe IFIS. The second aim was to evaluate complication rates between the two. METHODS:The study consisted of 164 eyes of 164 men using α1-ARAs. 83 eyes were treated with atropine sulphate 1% drops (Group 1) while 81 eyes received an injection of epinephrine to the anterior chamber during cataract surgery (Group 2). RESULTS:Even though the incidence of IFIS was lower in the epinephrine group this was not statistically significant at the 5% level (P=0.269). Apropos severity, there was a statistically significantly higher incidence of moderate and severe forms of IFIS in Group 2 (P<0.0001). There was no significant difference between groups in the development of surgical complications (P=0.165). CONCLUSIONS:The instillation of epinephrine was more effective in preventing the overall incidence of IFIS. Nevertheless, the occurrence of IFIS in its moderate and severe forms was statistically significantly higher in this group. TRIAL REGISTRATION:The study protocol was retrospectively registered in the Clinical Trial registry clinicaltrials.gov under ID number NCT06266962.
BACKGROUND AND AIM:Vitamin D deficiency is linked to increased cancer risk and death but the effect of vitamin D substitution on the prognosis of patients with malignant disease is debatable. We aimed to investigate the value of serum vitamin D3 levels in patients with a history of malignancy and confirmed lung metastases. MATERIALS AND METHOD:Serum Vitamin D2 (25-hydroxyergokalciferol) and D3 (25‑hydroxycholekalciferol) levels were measured in 38 patients (28 with and 10 without lung metastases) using high performance liquid chromatography (HPLC). Serum Vitamin D2 + D3 levels of patients with lung metastases were analysed with respect to season, number of metastases, number of malignancies in the history, value according to the ASA (The American Society of Anaesthesiologists) physical status classification, and compared to patients with a history of malignancy without confirmed lung metastasis. RESULTS:Overall, mean serum vitamin D3 levels were significantly higher in summer (summer vs. winter; 85.06 nmol/L vs. 61.01 nmol/L; P=0.013). There was no significant difference in vitamin D3 levels in summer or winter between patients with or without lung metastases. There was also no significant difference in vitamin D3 levels in the summer months between patients with a history of one malignancy versus those with two or more. In winter however, patients with a history of one malignancy had significantly higher vitamin D3 levels (mean, 75.25 nmol/L) than those with two or more malignancies (mean 44.6 nmol/L) (P=0.027). The differences between vitamin D3 levels in patients with ASA 2 and 3 were not statistically significant. CONCLUSION:Vitamin D supplementation may be advisable for patients with a history of multiple malignancies, particularly during the winter months. However, confirmation in a clinical trial with a larger patient cohort is warranted before firm recommendations can be made.
AIM:The recurrence rate of colorectal cancer remains high even after radical surgery. Existing criteria for administering adjuvant treatment lack sufficient precision, often leading to undertreatment or overtreatment. This study investigates circulating tumour cells (CTCs) as a potential prognostic biomarker to improve the accuracy of patient selection. METHODS:Forty-six colorectal cancer patients without distant metastases who underwent radical surgery were enrolled in this prospective study conducted at Tomas Bata Hospital in Zlín. The study protocol was approved by the hospital's Ethics Committee. Circulating tumour cells (CTCs) were measured in peripheral blood samples collected preoperatively, on the second postoperative day, and one month after surgery. CTCs were detected and characterized using semiautomated microscopy. Comprehensive clinicopathological data were recorded as part of standardized perioperative care. The prognostic significance of CTCs was evaluated based on the time to recurrence (TTR) parameter. RESULTS AND CONCLUSION:Growing evidence from circulating tumour cell (CTC) research supports their potential role as a valuable biomarker in cancer management. In this study involving stage I-III colorectal cancer patients, a recurrence rate of 20% was observed among individuals with detectable CTCs, whereas no recurrence occurred in patients with a sustained absence of CTCs. Despite this apparent difference, the time to recurrence (TTR) did not differ significantly between the groups (log-rank test, P=0.175). Although the result was not statistically significant, the observed trend suggests a possible prognostic value of CTCs that merits investigation in a larger cohort. Furthermore, neither individual time-point measurements nor dynamic changes in CTC levels demonstrated a significant correlation with TTR.
