rss_2.0Acta Medica Martiniana FeedSciendo RSS Feed for Acta Medica Martinianahttps://sciendo.com/journal/ACMhttps://www.sciendo.comActa Medica Martiniana Feedhttps://sciendo-parsed.s3.eu-central-1.amazonaws.com/6470725c71e4585e08a9d4b2/cover-image.jpghttps://sciendo.com/journal/ACM140216Mycobacterium Abscessus – Diagnostic and Therapeutic Frontiers in Infection Managementhttps://sciendo.com/article/10.2478/acm-2023-0012<abstract> <title style='display:none'>Abstract</title> <p><italic>Mycobacterium (M.) abscessus</italic>, a highly pathogenic non-tuberculous mycobacterium, is responsible for several clinical manifestations. A very frequent occurrence is proven in patient with various lung diseases. Furthermore, it can result in complications such as skin and soft tissue diseases, central nervous system infections, bacteremia, eye infections, and others. <italic>M. abscessus</italic> is a clinical contraindication in cystic fibrosis patients awaiting a lung transplant, as it can exacerbate disease progression. Its pathogenicity and the emergence of resistance are influenced by factors including the composition of the cell envelope, rough and smooth <italic>M. abscessus</italic> morphotypes, efflux pumps, antibiotic-modifying/inactivating enzymes, and genetic polymorphisms in target genes. Management of the infection requires multicomponent therapy due to the high level of resistance. The following antibiotics are recommended according to the guidelines from the year 2017: amikacin, tigecycline, and imipenem with a macrolide. In order to properly manage patients with <italic>M. abscessus</italic> infection, correct identification of the subspecies as well as determination of resistance is essential. To achieve this goal, molecular-genetic techniques, such as whole-genome sequencing, are becoming increasingly favored in modern clinical practice. In this review, we provide up-to-date information on the issue of infections caused by non-tuberculous <italic>M. abscessus</italic>. We focus on its characteristics, possible infectious diseases, cystic fibrosis, and resistance, as well as the benefits of whole-genome sequencing.</p> </abstract>ARTICLEtruehttps://sciendo.com/article/10.2478/acm-2023-00122023-12-31T00:00:00.000+00:00An Observational Study of Glycemic Status in New Onset Acute Stroke and Their Clinical Outcome in a Tertiary Care Teaching Hospitalhttps://sciendo.com/article/10.2478/acm-2023-0013<abstract> <title style='display:none'>Abstract</title> <sec><title style='display:none'>Objective</title> <p>The study was aimed to test the blood glucose level in acute stroke patients to find out any correlation with types and prognosis of different glycaemic groups.</p> </sec> <sec><title style='display:none'>Method</title> <p>It was a prospective observational study of patients admitted to hospital in Nizamabad due to an acute ischemic or hemorrhagic stroke (&lt;24Hrs after the onset). Clinical parameters including history and clinical examination findings were recorded. CT scan of brain, blood glucose level, HbA1c, and other laboratory tests were taken in all the patients. 2D echocardiography (2D-ECHO) and X-Ray chest picture were also performed. According to glycaemia, the patients were classified into four groups such as Nondiabetic/euglycemic, known Diabetics on glycemic control therapy with or without glycemic control, Newly detected diabetics, and Stress hyperglycemia patients. On the day 1 and 15 National Institutes of Health Stroke Scale (NIHSS) was calculated to evaluate the severity of stroke and its outcome. Good prognosis was considered when NIHSS 5, moderate prognosis when NIHSS was 6–15, and poor prognosis when NIHSS was 16–20. Patients with NIHSS 20 died within 3 days of admission.</p> </sec> <sec><title style='display:none'>Results</title> <p>Finally, 158 patients with acute stroke were included. Hemorrhagic stroke was seen in 43 (27.2%) and ischaemic stroke in 115 (72.8%) patients. Maximum cases were found in 51–60 years age group (37.9%) followed by 41–50 (20.3%) and 61–70 years age group (20.3%). Majority of study subjects were males, 65.8 % (n=104). Maximum cases were Euglycemics (44.3%), followed by stress hyperglycemic (27.8%), known diabetes (15.9%), and newly diagnosed diabetes (12%) presenting with acute stroke. Higher NIHSS score was found in stress hyperglycemic patients (19.4%) followed by known diabetics (17.3%), newly detected diabetics (16.3%), and euglycemics (9.5%). Maximum proportion (81.8%) of ischaemic stroke cases were found with stress hyperglycemia compared to other glycemic conditions but in hemorrhagic stroke maximum proportion (47.3%) were newly diagnosed diabetics. Maximum proportion of large size of lesion (47.4%) was found in newly diagnosed diabetes followed by stress hyperglycemia (45.55). Medium size of the lesions was found more in newly diagnosed diabetes (52.6%) followed by known diabetes cases (52%). Good outcome was found in 51 cases (32.2%), moderate outcome in 34 (21.5%), and poor outcome was in 30 (18.9%). 43 patients with NIHSS score &gt;20 died within 3 days of admission (27.2%). Maximum proportion of death cases in ischemic group those belongs to newly diagnosed diabetes cases (8/9=88.8%). Higher deaths were found in blood sugar &lt;110 mg/dl and blood sugar &gt;199 mg/dl with an incidence rates of 41.2% and 53.4%.</p> </sec> <sec><title style='display:none'>Conclusion</title> <p>Hyperglycaemia in non-diabetic patients after acute stroke is a stress response reflecting more severe neurological damage. Elevated HbA1c presenting stroke glycaemia status has a significant trend in increasing the risk of cause mortality. The management of hyperglycaemia in patients with diabetes and non-diabetes is an important aspect of the emergency management of stroke.</p> </sec> </abstract>ARTICLEtruehttps://sciendo.com/article/10.2478/acm-2023-00132023-12-31T00:00:00.000+00:00Iron Citrate (Synthesit) Supplementation During Pancreas Cancer Showed Surprising Results – Case Studyhttps://sciendo.com/article/10.2478/acm-2023-0014<abstract> <title style='display:none'>Abstract</title> <p>Iron is a crucial mineral for our organism and its deficiency can cause serious health problems such as anaemia, fatigue, and impaired physical fitness. It has been shown that anaemia or iron deficiency is very common in patients with cancer. These patients benefit from iron supplementation either in intravenous or oral form. Our patient is a 67-year-old Russian woman with pancreatic cancer diagnosed in 2019. She fought off lymphocytic leukaemia in 2015. She refused treatment for her pancreatic cancer. The specific type of pancreatic cancer was not specified as the patient chose not to undergo targeted testing. Between March 2020 and February 2023, she took the dietary supplement Synthesit for three cycles (1 cycle lasted about a month).</p> <p>After taking the dietary supplement, a total percentage of neutrophils became in the reference range. Subjectively, the patient started to feel better after taking Synthesit and her quality of life and well-being has improved as well. It might be supposed that the dietary supplement could have some effect on her well-being and various blood parameters such as white cells count.</p> <p>Even though the dietary supplement is not supposed to be used for treatment of diseases, it can change some blood parameters and improve the immune system.</p> <p>This short case study presents the patient with pancreatic cancer who started to take the dietary supplement Synthesit which contains iron in the form of citrate salt in a dosage of 800 μg per capsule, 1 capsule per day. The dietary supplement was administered over three treatment cycles (1 cycle took about a month) from March 2020 to February 2023. It describes a difference in blood test results before taking Synthesit and after the administration of Synthesit.</p> </abstract>ARTICLEtruehttps://sciendo.com/article/10.2478/acm-2023-00142023-12-31T00:00:00.000+00:00Anatomical and Ultrasound Study of the Mid-Femoral Sciatic Nerve and Its Divisionhttps://sciendo.com/article/10.2478/acm-2023-0007<abstract> <title style='display:none'>Abstract</title> <sec><title style='display:none'>OBJECTIVES</title> <p>Anatomical variations of the sciatic nerve were supposed as potential causes for incomplete blocks at the level of the popliteal fossa. Therefore, we aimed to conduct an anatomical and ultrasound survey of the mid-femoral sciatic nerve and its division.</p> </sec> <sec><title style='display:none'>BACKGROUND</title> <p>A regional block of the sciatic nerve is a procedure for analgesia and anaesthesia of the lower extremity. Various approaches to the sciatic nerve are used in clinical practice. However, the sciatic nerve demonstrates several variations regarding its topography and division.</p> </sec> <sec><title style='display:none'>MATERIALS AND METHODS</title> <p>The anatomical study included twenty lower limbs of ten adult cadavers. The ultrasound study involved ten upper legs of five healthy volunteers</p> </sec> <sec><title style='display:none'>RESULTS</title> <p>The sciatic nerve was found distally to the piriformis muscle in all our cadaveric specimens. It was divided into two major branches (common peroneal nerve and tibial nerve) at a mean distance of 68.1 ± 19.3 mm above the popliteal crease. The observed distances ranged widely from 35 to 113 mm. The mid-femoral sciatic nerve and its division were entirely revealed using ultrasound in all volunteers.</p> </sec> <sec><title style='display:none'>CONCLUSION</title> <p>The sciatic nerve presents significant anatomical variations, which may cause an incomplete block. Understanding ultrasound anatomy and ultrasound appearance of the sciatic nerve is essential for performing ultrasound-guided sciatic blocks.</p> </sec> </abstract>ARTICLEtruehttps://sciendo.com/article/10.2478/acm-2023-00072023-08-20T00:00:00.000+00:00Fractured Exhaled Nitric Oxide and Biologic Therapies for Paediatric Asthmahttps://sciendo.com/article/10.2478/acm-2023-0011<abstract> <title style='display:none'>Abstract</title> <p>Bronchial asthma is the most frequently diagnosed chronic respiratory disease in children. Treatment approaches should aim to achieve the disease control, reduce limiting symptoms, and improve the quality of life. Routine treatment of patients with asthma relies on assessment of symptoms and spirometry results. These diagnostic and therapeutic strategies do not consider the level of inflammation in the airways as a fundamental pathognomonic feature of the disease. The use of biomarkers is increasing in the context of efforts to better understand individual asthma pathways (asthma endotyping), with the potential for personalized treatment with innovative biologics. Elevated levels of exhaled nitric oxide (FENO) represent an indirect marker of T2 inflammation in airways. FENO is one of the few biomarkers that have been applied in routine clinical practice. High levels predict a good therapeutic response to treatment with corticosteroids and selected biologics (Omalizumab, Dupilumab, Mepolizumab, Tezepelumab), or an increased risk of asthma exacerbation. The aim of this review is to evaluate the advantages, disadvantages, and potential applications of this test in relation to new treatment options using biologics for asthma.</p> </abstract>ARTICLEtruehttps://sciendo.com/article/10.2478/acm-2023-00112023-08-20T00:00:00.000+00:00Delivery Mode Affects the Sympathetic Nervous System in Healthy Term Newbornshttps://sciendo.com/article/10.2478/acm-2023-0010<abstract> <title style='display:none'>Abstract</title> <sec><title style='display:none'>Background</title> <p>Spontaneous delivery represents an important way triggering the physiological mechanisms essential for a proper postnatal adaptation of a newborn. Autonomic nervous system (ANS) plays a crucial role in this process. There is insufficient data concerning the impact of different delivery mode on ANS in newborns. Therefore, we aimed to study the effect of delivery mode on sympathetic nervous system (SNS) in healthy term newborns measured by electrodermal activity (EDA).</p> </sec> <sec><title style='display:none'>Material &amp; Methods</title> <p>The study conducted 50 healthy full – term newborns divided into two groups: the spontaneous delivery group (SD, n=27) and the caesarean section group (CS, n=23). EDA parameters (SCL – tonic level of skin conductance; NS.SCRs – non – specific phasic responses of skin conductance) were evaluated during three measurements: 2<sup>nd</sup> (M1), 24<sup>th</sup> (M2), and 72<sup>nd</sup> (M3) hours of life.</p> </sec> <sec><title style='display:none'>Results</title> <p>SCL significantly decreased during the first day of life (M1 vs. M2 – p &lt; 0.001). The lowest NS.SCRs values were demonstrated in M1 in both groups with significant differences in CS group between measurements – M1 vs. M2 (p=0.001) and M1 vs. M3 (p=0.005). However, a significantly lower NS.SCRs was found in CS group (p=0.01) early after birth (M1).</p> </sec> <sec><title style='display:none'>Conclusion</title> <p>Our findings revealed a reduced NS.SCRs indicating potential decreased „arousal“ in CS group – it seems that the attenuated „arousal“ could reflect the absence of physiological labor mechanisms as well as the effect of anesthesia leading to discrete early functional abnormalities in CS group. Further research is needed to validate these findings.</p> </sec> </abstract>ARTICLEtruehttps://sciendo.com/article/10.2478/acm-2023-00102023-08-20T00:00:00.000+00:00Platelet miRNA Expression in Patients with Sticky Platelet Syndromehttps://sciendo.com/article/10.2478/acm-2023-0009<abstract> <title style='display:none'>Abstract</title> <p>Sticky platelet syndrome (SPS) is a disorder with familial occurrence and autosomal dominant trait characterized by platelet hyperaggregability in response to a low concentration of adenosine diphosphate (ADP) and/or epinephrine (EPI). The etiology of SPS may be associated with platelet microRNAs (miRNAs), which are considered as potential biomarkers of platelet function and antiplatelet therapy. We were monitoring the expression of platelet miRNAs in patients with laboratory diagnosed SPS and healthy controls. We have found a statistically significant increased expression of both miR-423-5p and miR-338-3p as well as a statistically significant decreased expression of miR-425-5p between the group of patients with diagnosed SPS type II and the group of healthy controls, which seems to be an interesting issue for a further research.</p> </abstract>ARTICLEtruehttps://sciendo.com/article/10.2478/acm-2023-00092023-08-20T00:00:00.000+00:00Capillaroscopy and Endopat – Helpful Methods for the Early Assessment of Increased Cardiovascular Risk in Anorexia Nervosa?https://sciendo.com/article/10.2478/acm-2023-0008<abstract> <title style='display:none'>Abstract</title> <p>Anorexia nervosa (AN) as a life-threatening eating disorder is linked to a high mortality risk with many deaths attributable to cardiovascular etiology. Cardiovascular complications in AN include structural as well as functional cardiac alterations, hemodynamic changes, and peripheral vascular abnormalities. Despite the fact that peripheral vascular abnormalities are not identified as a major AN complication, several manifestations of peripheral vascular dysregulation including Raynaud's phenomenon and endothelial dysfunction have been described and, therefore, warrant attention. This article briefly summarizes so far findings of microvascular alterations in AN patients and presents easily accessible and non-invasive procedures for a microvascular evaluation such as capillaroscopy and endothelium-related peripheral arterial tone (EndoPAT) which could be involved in the clinical diagnostic process for the earliest identification of an increased risk of later cardiovascular complications.</p> </abstract>ARTICLEtruehttps://sciendo.com/article/10.2478/acm-2023-00082023-08-20T00:00:00.000+00:00Volumetric Absorptive Microsampling Technique in the LC-MS Determination of Direct Oral Anticoagulantshttps://sciendo.com/article/10.2478/acm-2023-0004<abstract> <title style='display:none'>Abstract</title> <p>Direct oral anticoagulants represent a significant group of drugs used in the prevention or treatment of venous thromboembolic events and stroke in patients with atrial fibrillation. Although routine therapy monitoring is not required, there is an increasing evidence that plasma levels may vary between individuals, suggesting the benefit of plasma levels measurement in some situations. Therapeutic drug monitoring is becoming more popular and accessible to the broader population. Introducing microsampling techniques for the quantitative collection of blood samples has arisen nowadays. The volumetric absorptive microsampling approach using a commercially available device such as a Mitra stick overcomes the hematocrit effect present in the dry blood spot technique. This review discusses the possible application of the volumetric absorptive microsampling approach in monitoring direct oral anticoagulant therapy efficacy.</p> </abstract>ARTICLEtruehttps://sciendo.com/article/10.2478/acm-2023-00042023-04-20T00:00:00.000+00:00Clinico-Etiological and Clinico-Haematological Study of Patients with Pancytopenia in Rural Areahttps://sciendo.com/article/10.2478/acm-2023-0005<abstract> <title style='display:none'>Abstract</title> <sec> <title style='display:none'>Background</title> <p>Pancytopenia is a manifestation of other underlying conditions, commonly associated with multiple benign and malignant conditions. Any patient presenting with pancytopenia requires a thorough evaluation to identify the underlying aetiology.</p> </sec> <sec> <title style='display:none'>Aim</title> <p>This current evaluates various hematological parameters including bone marrow aspiration (where ever feasible) in pancytopenia in adult group. Study also correlates clinico-haematological profile.</p> </sec> <sec> <title style='display:none'>Method</title> <p>Fifty patients with a hematological diagnosis of pancytopenia were studied during the period August 2020 to August 2022. The study included adult patients of both sexes having the age of 18 years and above. Tests for complete blood count, reticulocyte count, peripheral smear, bone marrow aspiration, and trephine biopsy were done.</p> </sec> <sec> <title style='display:none'>Results</title> <p>Various etiological factors were identified in which majority were of megaloblastic anaemia (48.9%), followed by mixed nutritional anaemia (22.2%), hypersplenism (13.3%), aplastic anaemia (8.9%), malignant conditions (6.7%), myelodysplastic syndromes (2%), and others (4%) respectively. Megaloblastic anaemia cases observed in the age group of 31–50 years with male preponderance. Hemoglobin, TLC, Platelet count, and Reticulocyte count ranged from 2 g% - 10g%, 500–4000 cells/cumm, 24,000–1.5 lakh cells/cumm, and 0.1% – 2%. MCV was higher than 100 fl in 57.5% of cases. Majority of the patients had macrocytic and dimorphic anaemia. Hypersegmented neutrophils were present in all the patients. Bone marrow of Megaloblastic anaemia was hypercellular. Megaloblastic erythropoiesis with giant meta- myelocytes and band forms were seen. Nutritional anaemia seen in the age group of 51-60 years. Haemoglobin, TLC, Platelet count, and Reticulocyte count ranges from 2.3 g%–7.8 g%, 1000–4000 cells/cumm, 5000–1.4 lakh cells/cumm, and 0.1–8%. Two cases had microcytic hypochromic anaemia in Nutritional anaemia. Bone marrow was hypercellular with a reversal of M:E ratio in 93.8% of cases. In hypersplenism seen in the age group of 51–60 years. Haemoglobin, TLC, Platelet count, and Reticulocyte count ranges from 3.8 g% – 10 g%, 1700–3800 cells/cumm, 26000-1.4 lakh cells/cumm, and 0.6–2% respectilvey in hypersplenism. 40% of hypersplenism patients had microcytic hypochromic anaemia. Bone marrow was hypercellular with a reversal of M:E ratio in 70% of hypersplenism cases. Aplastic anaemia seen in the age group of 41–50 years. Haemoglobin, TLC, Platelet count, and Reticulocyte count ranges from 3.1–10 g%, 1100–4000 cells/cumm, 51000–1.5lakh cells/cumm, and 0.2%–1.8%. Aplastic anaemia (35.8%) cases showed macrocytosis. Bone marrow was hypocellular with an increase in marrow fat and Lymphocytes and plasma cells were prominent in Aplastic anaemia cases. Leukaemia commonly seen in the age group of 31–40 years with male predominance. Hemoglobin, TLC, and Reticulocyte count ranges from 5.1–9.8%, 1100–4000 cells/cumm, and 0.6–2% respectively. Bone marrow was hypercellular with a reversal of M:E ratio in 80%.</p> </sec> <sec> <title style='display:none'>Conclusion</title> <p>Megaloblastic anaemia was the commonest cause of pancytopenia. Most other studies have reported aplastic anaemia as the commonest cause. This seems to reflect the higher prevalence of nutritional anaemia in the Indian subjects. The haematological parameters and bone marrow morphological features in patients with megaloblastic anaemia, aplastic anaemia, and malignant diseases including MDS in the present study were comparable to the findings by other authors. Uncommon etiological factors like dengue fever and hemolytic anaemia were identified in this study. A comprehensive clinical, haematological, and bone marrow study of patients with pancytopenia usually helps in identification of the underlying cause. However, in view of a wide array of etiological factors, pancytopenia continues to be a challenge for hematologists.</p> </sec> </abstract>ARTICLEtruehttps://sciendo.com/article/10.2478/acm-2023-00052023-04-20T00:00:00.000+00:00Is Nasal Nitric Oxide Measurement an Useful Diagnostic Tool in Respiratory Diseases?https://sciendo.com/article/10.2478/acm-2023-0002<abstract> <title style='display:none'>Abstract</title> <p>Nasal nitric oxide (nNO), discovered in exhaled air in 1991, is produced in the nose and paranasal sinuses. This small gaseous molecule plays various roles in the organism, e.g. the first line defense through its antiviral and antimicrobial activity, stimulation of ciliary motility, regulation of pulmonary function. The measurement of nNO has become a diagnostic tool in various diagnoses, such as primary ciliary dyskinesia, allergic rhinitis, chronic rhinosinusitis, and others. In this article, we discuss the potential benefit of nNO measurement in diagnosis and monitoring of various respiratory diseases.</p> </abstract>ARTICLEtruehttps://sciendo.com/article/10.2478/acm-2023-00022023-04-20T00:00:00.000+00:00Search for Molecular Biomarkers of Parkinson’s Disease. New Tissues and Methodshttps://sciendo.com/article/10.2478/acm-2023-0003<abstract> <title style='display:none'>Abstract</title> <p>Parkinson’s disease (PD) is a chronic neurodegenerative disorder that is clinically manifested by motor and non-motor symptoms. At the early stage of the disease, it can be misdiagnosed with some neurologic disorders due to overlapping or similar clinical features. In addition, the pathogenesis of this disease is initiated several years prior to the appearance of classical motor symptoms. This latent phase of neurodegeneration in PD characterised at cellular level by preservation of significant fraction of dopaminergic neurones is of particular interest with respect to the development of disease-modifying or neuroprotective therapies which would require intervention at the earliest stages of disease with an aim to slow down or reverse the disease progression. Therefore, huge effort was performed in order to find and validate a biomarker that would reliably differentiate PD from other neurologic diseases as well as a biomarker that would reveal preclinical/prodromal stage of PD. This short review summarises a recent progress in validation of molecular biomarkers of PD, distinct from genetic markers of PD, with some focus on new analysed tissues and new methods.</p> </abstract>ARTICLEtruehttps://sciendo.com/article/10.2478/acm-2023-00032023-04-20T00:00:00.000+00:00Fish Bone as a Cause of Retropharyngeal Abscesshttps://sciendo.com/article/10.2478/acm-2023-0006<abstract> <title style='display:none'>Abstract</title> <p>In this work, we describe the case of a 68-year-old female patient with an injury to the back wall of the pharynx by a foreign body and its atypical placement in the retropharyngeal space, causing a retropharyngeal abscess. The foreign body was extracted during a transorally direct pharyngolaryngoscopy under general anesthesia. The symptomatology, diagnosis, and therapy of retropharyngeal abscess are the topics of discussion. We emphasize the necessity of timely and thorough localization of the foreign body and its extraction.</p> </abstract>ARTICLEtruehttps://sciendo.com/article/10.2478/acm-2023-00062023-04-20T00:00:00.000+00:00Methods of Objectifying Coughhttps://sciendo.com/article/10.2478/acm-2023-0001<abstract> <title style='display:none'>Abstract</title> <p>Cough is one of the most common symptoms encountered by clinicians. Attempts to measure cough date back to early 1950s and since then, significant progress has been made in understanding cough and many methods have been developed. Methods for cough measurement can be divided into subjective and objective methods and further according to the aspect of cough they assess. Subjective methods for cough assessment provide us with information about patient’s personal experiences of cough and about psychosocial aspect of cough. Most widely used subjective methods include cough severity visual analogue scale, cough severity diaries, and various quality of life questionnaires. Objective methods for cough assessment focus mainly on cough frequency and on cough reflex sensitivity. Most widely used methods from this group include cough monitors and cough inhalation challenges. This review focuses on the most widely used cough measurement methods and points out their advantages and limitations for use in research and clinical practice. The ability to measure cough in clinical and research conditions could be used to determine treatment outcomes, to test new therapies, and to further study pathophysiology and physiology of cough.</p> </abstract>ARTICLEtruehttps://sciendo.com/article/10.2478/acm-2023-00012023-04-20T00:00:00.000+00:00Diagnosis and classification of hereditary fibrinogen disordershttps://sciendo.com/article/10.2478/acm-2022-0013<abstract><title style='display:none'>Abstract</title><p>Hereditary fibrinogen disorders (HFDs) are rare bleeding disorders with a wide spectrum of biological and clinical features. While most patients with HFDs are at risk to suffer from mild to severe, sometimes life-threatening bleeding, thrombotic events are also common. Therefore, an appropriate diagnosis is needed to offer the optimal treatment. Diagnosis of HFDs can be challenging and plenty of pitfalls. The sensitivity and specificity of hemostasis routine test are depending on the reagents, the methods, and the fibrinogen variants. To distinguish subtypes of HFDs additional tests are often required. Historically based on the assessment of fibrinogen levels, a recent classification also considers the clinical phenotype and the genotype. In this short review, diagnosis strategies and HFDs classification are reviewed.</p></abstract>ARTICLEtruehttps://sciendo.com/article/10.2478/acm-2022-00132022-12-22T00:00:00.000+00:00Effects of early dexamethasone treatment on several markers of inflammation and fibrosis in an animal model of lung silicosis in rats – A pilot studyhttps://sciendo.com/article/10.2478/acm-2022-0012<abstract><title style='display:none'>Abstract</title><p>Lung silicosis is primarily caused by inhalation of particles of silicon oxide (silica). Despite a huge progress in understanding the interactions among the pathomechanisms of lung silicosis in the last years, there is a lack of effective therapy. With respect to a wide therapeutic action of corticosteroids, the purpose of this pilot study was to evaluate early effects of dexamethasone on several markers of inflammation and lung fibrosis in a rat model of silicosis. The silicosis model was induced by a single transoral intratracheal instillation of silica (50 mg/ml/animal), while the controls received an equivalent volume of sterile saline. The treatment with intraperitoneal dexamethasone initiated the next day after the silica instillation and was given 2-times a week at a dose of 1 mg/kg, while the controls received an equivalent volume of saline. The animals were euthanized 14 or 28 days after the treatment onset. Total and differential counts of leukocytes in the blood and bronchoalveolar lavage (BAL) fluid were determined. The presence of collagen in the bronchioles and lung vessels was detected by Sirius red staining and a smooth muscle mass was detected by smooth muscle actin. In comparison to saline, the instillation of silica increased the total count of circulating leukocytes after 14 and 28 days of the experiment (both <italic>p</italic>&lt;0.05), which was associated with higher counts of lymphocytes (<italic>p</italic>&lt;0.05 after 14 days, <italic>p</italic>&gt;0.05 after 28 days) and slight but non-significant increases in neutrophils and eosinophils (both <italic>p</italic>&gt;0.05). Although the total cell count in the BAL fluid did not change significantly, the percentages and absolute counts of neutrophils, eosinophils, and lymphocytes (<italic>p</italic>&lt;0.05, <italic>p</italic>&lt;0.01 or <italic>p</italic>&lt;0.001) elevated after 14 and 28 days of the experiment. Silica induced an accumulation of collagen in the bronchioles (<italic>p</italic>&lt;0.001 after both 14 and 28 days) and pulmonary vessels (<italic>p</italic>&lt;0.01 after both 14 and 28 days) and elevated a formation of smooth muscle mass (<italic>p</italic>&lt;0.05 after 14 days, <italic>p</italic>&lt;0.01 or <italic>p</italic>&lt;0.001 after 28 days). Treatment with dexamethasone decreased circulating leukocytes (<italic>p</italic>&lt;0.01) and lymphocytes (<italic>p</italic>&lt;0.001) and increased neutrophils (<italic>p</italic>&lt;0.05), which was associated with a slightly decreased total cell count in BAL (<italic>p</italic>&gt;0.05), decline in lymphocytes (<italic>p</italic>&lt;0.01), and slight decreases in neutrophils and eosinophils after 28 days of the treatment. Moreover, dexamethasone reduced the accumulation of collagen (<italic>p</italic>&lt;0.01 after 14 days and <italic>p</italic>&lt;0.001 after 28 days) and the formation of smooth muscle mass (<italic>p</italic>&lt;0.01 for bronchioles and <italic>p</italic>&gt;0.05 for vessels after 24 days, <italic>p</italic>&lt;0.001 for both bronchioles and vessels after 28 days). In conclusion, early dexamethasone treatment mitigated silica-induced granulocytic-lymphocytic inflammation and decreased a formation of collagen and smooth muscle mass in the bronchiolar and vascular walls, demonstrating a therapeutic potential of dexamethasone in the lung silicosis.</p></abstract>ARTICLEtruehttps://sciendo.com/article/10.2478/acm-2022-00122022-12-22T00:00:00.000+00:00A correlative interaction between thyroid dysfunction and semen parameters in male infertility: A prospective case control studyhttps://sciendo.com/article/10.2478/acm-2022-0015<abstract><title style='display:none'>Abstract</title><p>The role of thyroid function on sperm quality has not been well studied from a pathological aspect. This study aimed to report the degree of association between the status of thyroid hormones, sperm quality and aetiology in infertile men compared to healthy subjects. A prospective case control investigative study was conducted on 100 infertile males and age matched healthy controls. Semen samples were collected for sperm quality examination, and the serum levels of tetraiodothyronine (T4), triiodothyronine (T3), and thyroid stimulation hormone (TSH) were measured. Out of 100 infertile men, oligozoospermia (32%), asthenozoospermia (48%), and oligo-asthenozoospermia (20%) were found. There was a statistical difference between the group I and group II groups related to sperm count (28.32 ± 14.60 vs 66.50 ± 10.50 x 106/ml), sperm motility (40.1 ± 13.8 vs 64.8 ± 7.85%), and sperm morphology (55.92 ± 5.27 vs 83.50 ± 5.25%, p&lt;0.05). There was a statistical difference among the oligozoospermia, asthenozoospermia, and oligo-asthenozoospermia groups related to T3 (115 + 0.40 vs 1.29 ± 0.59 vs 1.25 ± 0.32 ng/ml), T4 (7.35 ± 1.42 vs 9.15 ± 1.85 vs 7.85 ± 1.65 μg/dl), and TSH (1.69 ± 0.55 vs 2.12 ± 1.45 vs 1.98 ± 0.4 μIU/ml) (P&lt;0.05). There was a significant inverse correlation of TSH levels with sperm volume (r = -0.12, p= 0.02), sperm motility (r = -0.26, p= 0.02), and sperm morphology (r = -0.304, p = 0.02) observed. T4 levels were significantly correlated with sperm count (r = -0.278, p = 0.02), and sperm motility (r = -0.249, p = 0.032). T4 levels were very highly associated with asthenozoospermia. Relative operating curve analysis shows that Sperm motility of &gt;40.1%, T3 levels of &lt;1.29 ng/ml, total T4 levels of &lt;8.42 μg/dl, TSH levels of &lt;1.98 μIU/ml inferred the male infertility.</p> <p>Although thyroid function screening is not currently recommended as a part of the diagnostic workup of the infertile male, it may be reconsidered in light of the physiopathological background. Studies will be necessary to initiate the trial of a small dose of anti-thyroid drug in asthenozoospermic patients.</p></abstract>ARTICLEtruehttps://sciendo.com/article/10.2478/acm-2022-00152022-12-22T00:00:00.000+00:00Evaluation of acute pancreatitis based on BISAP scoring system: A cohort study of 50 caseshttps://sciendo.com/article/10.2478/acm-2022-0016<abstract><title style='display:none'>Abstract</title> <sec id="j_acm-2022-0016_s_005"><title style='display:none'>Background/Aim</title> <p>Acute pancreatitis is encountered in both medical and surgical specialty. Assessment of severity and grading is done using radiological investigations mostly like ultrasonography or CECT. We present a study to assess the severity of Acute Pancreatitis based on Bedside Index for Severity in Acute Pancreatitis (BISAP) scoring system.</p> </sec> <sec id="j_acm-2022-0016_s_006"><title style='display:none'>Material &amp; Methods</title> <p>The study was conducted on 50 patients presenting with acute pancreatitis who were included as per inclusion criteria and a detailed history, clinical examination and blood investigation performed. Data like serum amylase, serum lipase, serum calcium, blood urea nitrogen (BUN), pleural effusion and systemic inflammatory response syndrome (SIRS) was collected from the patients. Based on data collected in 24 hours of hospitalization, BISAP score was calculated.</p> </sec> <sec id="j_acm-2022-0016_s_007"><title style='display:none'>Results</title> <p>Results showed that no significant temperature rise, pancreatic necrosis, SIRS or impaired mental status in patients with BISAP severity of &lt;=3. However, patients having BISAP score &gt;3, factors like BUN, age, pleural effusion, and organ failure show significant correlation. Also on comparative analysis of patients showed that the hospital stay, respiratory rate, pulse and laboratory markers (blood urea, serum creatinine, serum amylase, serum lipase) were significantly higher in patients with BISAP score ≥3.</p> </sec> <sec id="j_acm-2022-0016_s_008"><title style='display:none'>Conclusion</title> <p>BISAP score is an easy, quick and bedside method to assess the severity of acute pancreatitis and predict its mortality. It is easy bedside procedure that can be done in every setup.</p> </sec> </abstract>ARTICLEtruehttps://sciendo.com/article/10.2478/acm-2022-00162022-12-22T00:00:00.000+00:00Simulator training in aneurysm clippinghttps://sciendo.com/article/10.2478/acm-2022-0017<abstract><title style='display:none'>Abstract</title><p>Due to an increased number of patients with aneurysms treated endovascularly, a resident does not have enough opportunities to come across such a complex procedure as surgical clipping. There have been many types of training methods designed for traditional surgical aneurysm treatment so far. A brief report regarding the helpfulness of vascular simulator AneurysmBox at our Neurosurgical Department is presented.</p></abstract>ARTICLEtruehttps://sciendo.com/article/10.2478/acm-2022-00172022-12-22T00:00:00.000+00:00Paroxysmal nocturnal hemoglobinuria: A rare case of recurrent episodes of icterushttps://sciendo.com/article/10.2478/acm-2022-0014<abstract><title style='display:none'>Abstract</title><p>In this work we describe a rare case of a patient with paroxysmal nocturnal hemoglobinuria (PNH) developed on the background of specific medical history of morbus Gilbert with chronically elevated bilirubin and recurrent attacks of macroscopic haematuria. We focus on a differential diagnosis of the disease, its obstacles, and treatment options.</p></abstract>ARTICLEtruehttps://sciendo.com/article/10.2478/acm-2022-00142022-12-22T00:00:00.000+00:00en-us-1