Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 11 de 11
Filter
1.
Bratisl Lek Listy ; 122(12): 871-875, 2021.
Article in English | MEDLINE | ID: mdl-34904849

ABSTRACT

OBJECTIVES: This study evaluated the role of ultrasound in postoperative care after major lung resection. BACKGROUND: High accuracy of lung ultrasound imaging was proved in various medical fields. The experience with ultrasound after thoracic surgery is limited. METHODS: Patients scheduled for major lung resection were consecutively included in a prospective study comparing two modalities of imaging examinations, namely those employing ultrasound and X-ray in the diagnoses of pneumothorax and pleural effusion. Two examinations were performed. One after recovery from anaesthesia, the second before chest tube removal. RESULTS: Forty-eight patients underwent 87 examinations. X-ray and ultrasound examinations showed substantial and fair agreements for pneumothorax (Cohen's kappa coefficients 0.775 and 0.397) and slight and substantial agreements for pleural effusion (Cohen's kappa coefficients 0.036 and 0.611). The sensitivity bounds for pneumothorax were 45.5-58.5 % at the first and 29.7-59.4 % at the second examination. Sensitivity bounds for pleural effusion were 0-86.2 % at the first and 32.6-36.9 % at the second examination. Except for two cases of pneumothorax being missed by X-ray imaging, the rest of mismatches were clinically irrelevant conditions with no impact on clinical decision and patient's outcome. CONCLUSION: The use of ultrasound can reduce the number of X-ray examinations and thus lower the radiation exposure after major lung resections (Tab. 4, Ref. 30).


Subject(s)
Lung , Humans , Lung/diagnostic imaging , Lung/surgery , Prospective Studies , Radiography , Ultrasonography , X-Rays
2.
Bratisl Lek Listy ; 122(9): 618-620, 2021.
Article in English | MEDLINE | ID: mdl-34463105

ABSTRACT

Contrast-induced encephalopathy (CIE) is a rare complication of the intravascular application of a contrast agent. CIE can be manifested by headache, cortical blindness, consciousness disorders, seizures, or focal neurological deficit. Neurological symptoms are typically transient with temporary abnormal findings on a brain scan. Urgent neuroimaging is important to obtain the correct diagnosis, especially in cases that require an acute management and treatment. We present a case of CIE after a digital subtraction angiography of the vertebral arteries in the patient with a symptomatic pre-occlusive stenosis of the posterior cerebral artery (Ref. 36). Text in PDF www.elis.sk Keywords: encephalopathy, iodixanol, contrast agent, cortical blindness, cerebral angiography.


Subject(s)
Brain Diseases , Contrast Media , Brain Diseases/diagnosis , Brain Diseases/diagnostic imaging , Cerebral Angiography , Contrast Media/adverse effects , Humans , Seizures
3.
Eur. j. psychiatry ; 35(2): 92-98, abril-junio 2021.
Article in English | IBECS | ID: ibc-217548

ABSTRACT

Background and objectives: Magnetic resonance imaging (MRI) studies suggest that depression is associated with volumetric hippocampal changes. Investigations of these structures during antidepressant therapy is therefore important, however, volumetric studies are rare in this case. We aimed to study the effect of AD treatment on volumetric changes in hippocampus depending on stress factors in depressive patients.MethodsThirty patients with major depressive disorder (MDD) underwent MRI of the brain on the day of admission and at the time of stabilization of acute depressive symptomatology by venlafaxine. The presence of long-lasting stress factors in these patients was investigated by the social readjustment rating scale questionnaire.ResultsNo significant differences were found in hippocampi volumes before and after venlafaxine treatment. However, regression analysis revealed significant positive relation between stress factors and volumetric hippocampus change during AD treatment.ConclusionIt seems that antidepressant treatment by venlafaxine could be more suitable in the MDD patients with presence of stress-factors. (AU)


Subject(s)
Humans , Depression , Depressive Disorder, Major , Hippocampus , Magnetic Resonance Spectroscopy
4.
Bratisl Lek Listy ; 121(7): 488-492, 2020.
Article in English | MEDLINE | ID: mdl-32990002

ABSTRACT

Phosphorus-31 magnetic resonance spectroscopy (31P MRS) is currently not accepted as a diagnostic tool in the neuro-oncological practice, although it provides useful non-invasive information about biochemical processes ongoing in the intracranial tumours. This pilot study was aimed to present the diagnostic capability of the 31P MRS in brain tumour examination, even its application on clinical 1.5T MR scanner.Seven patients with brain tumorous lesions (four glioblastomas, one ependymoma, and two lung metastasis) underwent multivoxel in vivo 31P MRS performed on clinical 1.5 T MR scanner within measurement time of 20 minutes. Comparing two selected voxels, one in the tumour and the other one in the normal-appearing brain tissue, enabled to investigate their metabolic differences. Enhanced markers of membrane phospholipids synthesis (significantly increased phosphomonoesters ratios) than markers of their degradation (significantly decreased phosphodiesters ratios) manifested a higher cell proliferation ongoing in tumours. High energetic tumorous tissue demands leading to anaerobic metabolic turnover were present as a significant decline in phosphocreatine ratios and adenosine triphosphates. Intracellular pH evaluation showed a tumorous tendency to alkalize. 31P MRS enables the non-invasive metabolic characterization of intracranial tumours and thus appears to be a clinically useful method for the determination of ongoing tumour pathomechanisms (Fig. 2, Ref. 26). Keywords: brain tumour, 31P MRS, 1.5 Tesla; energetic metabolism.


Subject(s)
Brain Neoplasms , Magnetic Resonance Spectroscopy , Phosphorus , Brain Neoplasms/diagnostic imaging , Brain Neoplasms/metabolism , Humans , Magnetic Resonance Imaging , Pilot Projects
5.
Rozhl Chir ; 99(1): 5-14, 2020.
Article in English | MEDLINE | ID: mdl-32122134

ABSTRACT

Through the decades of its use in the management of neurosurgical emergencies decompressive craniectomy has found its place as a life-saving procedure capable of a radical reduction of the intracranial pressure. Clinical results and rate of survival after decompressive craniectomy vary according to the primary diagnosis, and they have been a subject of multicentric randomized trials. However,  considerable attention also needs to be kept on complications associated with the craniectomy. They are based not only on the procedures invasivity but also on the pathophysiological changes associated with a conversion of the closed intracranial space to an open one. The complications may further disturb the postoperative care and convalescence in the surviving patients, and therefore in the salvageable patients the indication of decompressive craniectomy should be based on information about the expected outcome and complications rate, at the same moment prevention, early recognition and adequate therapy of the complications should be emphasized. This work describes the most common complications occurring in patients after decompressive craniectomy, their pathophysiological principles and means of treatment and prevention.


Subject(s)
Brain Injuries , Decompressive Craniectomy/adverse effects , Plastic Surgery Procedures , Humans , Intracranial Pressure , Postoperative Complications , Treatment Outcome
6.
Neurol Res ; 39(4): 323-330, 2017 Apr.
Article in English | MEDLINE | ID: mdl-28191860

ABSTRACT

OBJECTIVES: Disturbances in the hypothalamo-pituitary axis are supposed to modulate activity of multiple sclerosis (MS). We hypothesised that the extent of HYP damage may determine severity of MS and may be associated with the disease evolution. We suggested fatigue and depression may depend on the degree of damage of the area. METHOD: 33 MS patients with relapsing-remitting and secondary progressive disease, and 24 age and sex-related healthy individuals (CON) underwent 1H-MR spectroscopy (1H-MRS) of the hypothalamus. Concentrations of glutamate + glutamin (Glx), cholin (Cho), myoinositol (mIns), N-acetyl aspartate (NAA) expressed as ratio with creatine (Cr) and NAA were correlated with markers of disease activity (RIO score), Multiple Sclerosis Severity Scale (MSSS), Depressive-Severity Status Scale and Simple Numerical Fatigue Scale. RESULTS: Cho/Cr and NAA/Cr ratios were decreased and Glx/NAA ratio increased in MS patients vs CON. Glx/NAA, Glx/Cr, and mIns/NAA were significantly higher in active (RIO 1-2) vs non-active MS patients (RIO 0). Glx/NAA and Glx/Cr correlated with MSSS and fatigue score, and Glx/Cr with depressive score of MS patients. In CON, relationships between Glx/Cr and age, and Glx/NAA and fatigue score were inverse. CONCLUSION: Our study provides the first evidence about significant hypothalamic alterations correlating with clinical outcomes of MS, using 1H-MRS. The combination of increased Glu or mIns with reduced NAA in HYP reflects whole-brain activity of MS. In addition, excess of Glu is linked to severe disease course, depressive mood and fatigue in MS patients, suggesting superiority of Glu over other metabolites in determining MS burden.


Subject(s)
Depression/metabolism , Fatigue/metabolism , Hypothalamus/metabolism , Multiple Sclerosis, Chronic Progressive/metabolism , Multiple Sclerosis, Relapsing-Remitting/metabolism , Adult , Aging/metabolism , Aspartic Acid/analogs & derivatives , Aspartic Acid/metabolism , Case-Control Studies , Choline/metabolism , Creatine/metabolism , Cross-Sectional Studies , Depression/diagnostic imaging , Disability Evaluation , Fatigue/diagnostic imaging , Fatigue/psychology , Female , Glutamic Acid/metabolism , Humans , Hypothalamus/diagnostic imaging , Inositol/metabolism , Male , Multiple Sclerosis, Chronic Progressive/diagnostic imaging , Multiple Sclerosis, Chronic Progressive/psychology , Multiple Sclerosis, Relapsing-Remitting/diagnostic imaging , Multiple Sclerosis, Relapsing-Remitting/psychology , Proton Magnetic Resonance Spectroscopy , Psychiatric Status Rating Scales , Severity of Illness Index
7.
Spinal Cord ; 53(12): 877-80, 2015 Dec.
Article in English | MEDLINE | ID: mdl-26123208

ABSTRACT

STUDY DESIGN: Case report. OBJECTIVES: We report on a 52-year-old male patient with tumefactive demyelination of the spinal cord. SETTING: University Hospital and Jessenius Faculty of Medicine, Comenius University, Martin, Slovakia. BACKGROUND: In contrast to relatively frequent tumefactive fulminant lesions in the brain, cases affecting the spinal cord in isolation have been reported less frequently. METHODS: Description of the case report. RESULTS: Clinical, neuroradiological and necropsy findings are described in a 52-year-old man with tumefactive fulminant demyelination of the spinal cord. Progression of the demyelination process produced paraplegia, mild paresis of the right upper limb, neurogenic bladder and sensitive loss over 2 weeks. MRI scans revealed several ovoid lesions in cervical segments and tumefactive T2-hyperintense signals with oedema and post-contrast enhancement located in thoracic segments Th3 to Th6. Cerebrospinal fluid (CSF) examination displayed lymphomonocytic pleocytosis with normal proteinorhachia, positive CSF oligoclonal IgG bands (OCB) and elevated IgG index (1.55). Serum anti-AQP4-Ab was not tested. Stored frozen CSF samples were later repeatedly examined with negative findings of anti-AQP4-Ab. Treatment with high-dose methylprednisolon and plasma exchange had limited effect. Immunosuppressive medication was interrupted because of an acute urinary infection. The patient died suddenly because of pulmonary embolism as a secondary complication. Histopathology of the spinal cord confirmed active demyelination. We considered that tumefactive demyelination could be a variant of neuromyelitis optica. CONCLUSION: Our case could be anti-AQP4-Ab-negative longitudinally extensive transverse myelitis, a variant of neuromyelitis optica.


Subject(s)
Myelitis, Transverse/complications , Spinal Cord Injuries/complications , Aquaporin 4/immunology , Humans , Magnetic Resonance Imaging , Male , Methylprednisolone/therapeutic use , Middle Aged , Myelitis, Transverse/cerebrospinal fluid , Myelitis, Transverse/pathology , Myelitis, Transverse/therapy , Neuroprotective Agents/therapeutic use , Oligoclonal Bands/cerebrospinal fluid , Plasma Exchange , Spinal Cord/pathology , Spinal Cord Injuries/cerebrospinal fluid , Spinal Cord Injuries/pathology , Spinal Cord Injuries/therapy
8.
Bratisl Lek Listy ; 112(6): 327-31, 2011.
Article in English | MEDLINE | ID: mdl-21692407

ABSTRACT

UNLABELLED: Treatment results of non-varicose bleeding from upper gastrointestinal tract are changing by improved endoscopic methods and introduction of new drugs in treatment. OBJECTIVE: Objective of this work was to compare the results in treatment of patients with non-varicose bleeding from upper gastrointestinal tract in two different 5-years periods. MATERIAL: We hospitalised 229 patients with non-varicose bleeding from upper gastrointestinal tract at the Department of Surgery in Faculty Hospital of Martin in the period 1992-1996. (161 men and 68 women, average age 56.7, patients up to 60 were 42.4%). 203 patients were hospitalised in the years 2003-2008 (146 men and 57 women, average age 61.5, patients up to 60 were 54%). METHODS: We compared both groups by retrospective analysis and we evaluated differences by using statistical methods (nonparametric test of independence of the qualitative data). RESULTS: There was only minimal difference in primary conservative and endoscopic haemostasis in both groups. Relaps of bleeding was the same in both groups. Definitive conservative and endoscopic haemostasis was higher by 3.2% in the period 2003-2008 and number of urgent operations decreased by 5.1%. Differences in total mortality were minimal between both groups but postoperative mortality was higher by 5.9% in the years 2003-2008. CONCLUSION: Number of urgent operations decreased due to improved results in definitive conservative and endoscopic haemostasis in the treatment of non-varicose bleeding from upper gastroinestinal tract. There was no significant change in the relaps of bleeding. There were only minimal changes in total mortality between both groups, but postoperative mortality increased in the second period (Tab. 8, Ref. 35).


Subject(s)
Gastrointestinal Hemorrhage/therapy , Female , Gastrointestinal Hemorrhage/etiology , Hemostasis, Endoscopic , Hemostasis, Surgical , Humans , Male , Middle Aged
9.
Vnitr Lek ; 55(3): 179-83, 2009 Mar.
Article in Slovak | MEDLINE | ID: mdl-19378842

ABSTRACT

BACKGROUND: Critical limb ischaemia (CLI) is defined as a chronic rest pain, lasting more than 2 weeks, requiring analgesics and/or with present skin defects. Autologous transplantation of bone marrow mononuclear cells has been used successfully in CLI. AIM: The salvage of critically ischaemic limb by endotel progenitory cells (EPCs) from patient's bone marrow. To assess efficacy and safety of critical lower limb ischaemia treatment with marrow stem cell autotransplantation. METHODS: 9 patients suffering from CLI have been enrolled. They did not require emergency amputation and had previously been unsuccessfully treated with conventional therapy. Mononuclear cells were isolated from the bone marrow taken from illiac crest and injected in the gastrocnemius muscle and pedal region of the affected limb. Patients have had evaluated: local finding, pain index, quality of life index, ABI, fotopletysmography, markers of endothelium and trombocytes' activation and digital subtractive angiography. RESULTS: Pain severity decreased in all of patients. Three of them are with no pain and no claudication. Lesions resolved in two patients, partially in three patients. Crural amputation was required in two patients, amputation of leg in 1 patient. No side effects of the therapy were observed. One patient died without connection with procedure. CONCLUSIONS: Marrow stem cell autotransplantation into the ischaemic lower limb seems to be a potentially effective method of peripheral perfusion enhancement. Further studies are needed to clarify the underlying mechanisms of such improvement.


Subject(s)
Bone Marrow Transplantation , Ischemia/therapy , Leg/blood supply , Limb Salvage , Neovascularization, Physiologic , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Transplantation, Autologous
10.
Eur J Med Res ; 14 Suppl 4: 101-3, 2009 Dec 07.
Article in English | MEDLINE | ID: mdl-20156736

ABSTRACT

BACKGROUND: Impairment in cardiovascular autonomic regulation participates in the onset and maintenance of primary hypertension. OBJECTIVE: The aim of the present study was to evaluate cardiac autonomic control using long-term heart rate variability (HRV) analysis in adolescents with primary hypertension. SUBJECTS AND METHODS: Twenty two adolescent patients with primary hypertension (5 girls/17 boys) aged 14-19 years and 22 healthy subjects matched for age and gender were enrolled. Two periods from 24-hour ECG recording were evaluated by HRV analysis: awake state and sleep. HRV analysis included spectral power in low frequency band (LF), in high frequency band (HF), and LF/HF ratio. - RESULTS: In awake state, adolescents with primary hypertension had lower HF and higher LF and LF/HF ratio. During sleep, HF was lower and LF/HF ratio was higher in patients with primary hypertension. CONCLUSIONS: A combination of sympathetic predominance and reduced vagal activity might represent a potential link between psychosocial factors and primary hypertension, associated with increased cardiovascular morbidity.


Subject(s)
Autonomic Nervous System/physiopathology , Heart/innervation , Hypertension/physiopathology , Adolescent , Adult , Female , Heart Rate , Humans , Male , Vagus Nerve/physiopathology
11.
Brain Inj ; 22(2): 193-7, 2008 Feb.
Article in English | MEDLINE | ID: mdl-18240048

ABSTRACT

INTRODUCTION: Mild traumatic brain injury (MTBI) is a common neurotraumatologic diagnosis. It is possible to confirm objective cognitive impairment in MTBI patients not only by complex neuropsychological testing but also by event-related potentials (ERPs). The most common ERPs used in clinical practice are based on an oddball paradigm. Magnetic resonance imaging (MRI) is not routinely used in MTBI despite its proven greater sensitivity and specificity in comparison with computer tomography (CT). METHODS: This study investigated 31 MTBI patients and 31 sex and age-matched healthy controls. Both groups underwent clinical neurological examinations. Auditory oddball ERPs and brain MRI were done early after the injury and 3-7 months later. RESULTS: There were no significant sex, age and education differences between the analysed groups. No significant differences were found in N2 and P3 wave parameters in both ERP examinations. CONCLUSION: Standard auditory oddball ERPs are not sensitive enough to detect and/or quantify subtle objective neuropsychological changes in selected MTBI patients, especially those with traumatic MRI brain lesions. More complex auditory or other oddball paradigms have to be tested in the future.


Subject(s)
Brain Injuries/physiopathology , Evoked Potentials, Auditory/physiology , Evoked Potentials/physiology , Adolescent , Adult , Case-Control Studies , Female , Humans , Magnetic Resonance Imaging/methods , Male , Middle Aged , Reaction Time/physiology , Sensitivity and Specificity , Tomography Scanners, X-Ray Computed
SELECTION OF CITATIONS
SEARCH DETAIL
...