Acta medica (Hradec Kralove)最新文献

{"title":"Hyperlipidemia Associated Oxidative Stress and Its Impact on Bone Regeneration and Dental Implant Osseointegration.","authors":"Amalia Koutsoupia, Eleni Kotti, Kalliopi Topouzi, Maria Kateri, Panagiotis Kafas","doi":"10.14712/18059694.2026.2","DOIUrl":"10.14712/18059694.2026.2","url":null,"abstract":"<p><p>Hyperlipidemia is recently recognised as a factor that could impair bone regeneration and dental implant osseointegration. High fat diets raise oxidised lipid levels in blood, which accumulate in bone and suppress osteoblast function, tipping the balance toward bone resorption. Excess lipids also induce oxidative stress and inflammatory cytokine production in bone, further inhibiting bone formation. These changes may affect implant osseointegration. At the cellular level, high lipid levels cause overproduction of reactive oxygen species and inhibit Wnt/β-catenin signalling in osteoblasts. Health promotion strategies should address these mechanisms. Lipid lowering drugs such as statins may improve bone healing ability both by reducing blood lipids and by directly stimulating bone formation. Antioxidant nutrients or drugs may counteract lipid driven ROS and inflammation. Emerging approaches include epigenetic interventions to boost osteoblast gene expression and dampen inflammatory pathways. Improving lipid control alongside these future targeted therapies may help preserve bone health and implant success in patients with hyperlipidemia associated oxidative stress. While very exploratory, incorporating molecular level approaches into continuing clinical protocols could represent a path towards future therapies. Maximizing postoperative management is essential in order to limit the effects of hyperlipidemia induced negative microenvironment at implant sites. This could include controlling laboratory levels of lipids prior to surgery.</p>","PeriodicalId":101400,"journal":{"name":"Acta medica (Hradec Kralove)","volume":"68 4","pages":"123-128"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147505867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Age-Related Variations in Enteric Glial Cells: A Comprehensive Microscopic Analysis of the Human Colon.","authors":"Anam Ahmed, Seema Singh, Anand Verma, Swati Rohilla, Vivek Dubey, Saba Sarwar","doi":"10.14712/18059694.2026.6","DOIUrl":"10.14712/18059694.2026.6","url":null,"abstract":"<p><strong>Background: </strong>Constipation and other lower intestinal disorders are more common in the middle-aged population. According to recent research, enteric glial cells (EGCs) may have an impact on colonic motility. Little is known about how ageing impacts EGCs in the human colon. This study aims to compare the morphology of EGCs in the colons of young and middle-aged individuals.</p><p><strong>Objective: </strong>To study the age-related morphological variations in the EGCs of the myenteric plexus in human transverse colon.</p><p><strong>Materials and methods: </strong>Colon specimens from 11 deceased individuals were obtained from a mortuary and categorized into two age groups: Group 1 (Young, n = 6) and Group 2 (Middle-Aged, n = 5). Immunohistochemistry for Glial Fibrillary Acidic Protein (GFAP) and routine staining were performed. Both qualitative and quantitative evaluations were conducted.</p><p><strong>Results: </strong>In the middle-aged group 2, vacuolization was observed between Myenteric Ganglia (MG), and myenteric neurons appeared more scattered compared to the young group 1. The number of myenteric neurons and EGCs decreased with increasing age. The mean count of EGCs per MG and per mm2 of ganglionic area was significantly higher in group 1 (young) as compared to group 2 (middle-aged). The MG density, expressed relative to the thickness of the inner circular muscle, was significantly greater in group 1 (young).</p><p><strong>Conclusion: </strong>There is a significant decrease in the number of EGCs with advancing age, along with notable morphological changes. These changes may contribute to various gut motility disorders observed in the middle-aged, impacting their quality of life.</p>","PeriodicalId":101400,"journal":{"name":"Acta medica (Hradec Kralove)","volume":"68 4","pages":"151-159"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147505819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Statins and Dental Implant Osseointegration - Bridging Molecular Science and Next Generation Clinical Outcomes: A Review.","authors":"Konstantinos Rallis, Georgios Gkinopoulos, Konstantinos Manolakos, Georgios Militsis, Eleftheria Kotopoulou, Panagiotis Kafas","doi":"10.14712/18059694.2026.3","DOIUrl":"10.14712/18059694.2026.3","url":null,"abstract":"<p><p>Statins, widely prescribed for dyslipidemia, may exert bone modifying effects through coordinated stimulation of osteoblast activity and suppression of osteoclastogenesis. Lipophilic statins, including simvastatin, lovastatin, and atorvastatin, have been shown in preclinical models to enhance osteoblast differentiation and matrix synthesis via BMP-2/Smad and Ras-PI3K-Akt-Erk signaling, while attenuating osteoclast development through modulation of the OPG/RANKL axis, NF-kB inhibition, and blockade of p38 MAPK pathways. Despite mechanistic consistency in experimental systems, human data remain inconclusive, with modest increases in bone mineral density and no confirmed reduction in fracture risk. In implant dentistry, hyperlipidemia has been linked to impaired osseointegration, likely via reduced osteoblastic function, increased osteoclast activity, and compromised collagen turnover. The interplay between obesity, lipid metabolism, and skeletal biology introduces additional confounding variables, emphasizing the need for patient stratification in clinical research. Current evidence supports the biological plausibility of statin mediated enhancement of peri-implant bone formation, but definitive clinical translation requires large-scale, stratified trials with controlled delivery approaches and extended follow-up.</p>","PeriodicalId":101400,"journal":{"name":"Acta medica (Hradec Kralove)","volume":"68 4","pages":"129-133"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147505881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic Impact of Baseline Serum Creatinine in Patients with Advanced High-Grade Serous Ovarian Carcinoma Undergoing Neoadjuvant Chemotherapy.","authors":"Ivan Práznovec, Jiří Špaček, Munachiso Iheme Ndukwe, Denisa Pohanková, Eva Čermáková, Igor Sirák, Jiří Špaček","doi":"10.14712/18059694.2025.18","DOIUrl":"https://doi.org/10.14712/18059694.2025.18","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate whether baseline serum creatinine is associated with survival outcomes in patients with advanced high-grade serous ovarian carcinoma undergoing neoadjuvant chemotherapy.</p><p><strong>Methods: </strong>We retrospectively analyzed 77 patients treated between 2009 and 2018. Patients were stratified by baseline serum creatinine levels (<84 vs. ≥84 µmol/L), and survival outcomes were assessed using Kaplan-Meier analysis.</p><p><strong>Results: </strong>No statistically significant differences in progression-free or overall survival were observed between groups. A trend toward shorter OS in the elevated creatinine group did not reach significance.</p><p><strong>Conclusion: </strong>Baseline serum creatinine was not found to be a statistically significant prognostic marker in this cohort. These results highlight the need for adjusted analyses incorporating established prognostic factors in future research.</p>","PeriodicalId":101400,"journal":{"name":"Acta medica (Hradec Kralove)","volume":"68 2","pages":"45-49"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145254299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Age, Practice Location and Covid-19 on the Use of POCT Methods by General Practitioners in Czechia in 2017-2021.","authors":"Jan Bělobrádek, Luděk Šídlo, Tom Philipp","doi":"10.14712/18059694.2025.26","DOIUrl":"10.14712/18059694.2025.26","url":null,"abstract":"<p><strong>Background: </strong>Point-of-care testing (POCT) helps accelerate and streamline many processes in primary care. However, there is little information on the characteristics of their users.</p><p><strong>Methods: </strong>Data were provided by the largest Czech health insurance company, covering 60% of the population. A proprietary spatial categorization model based on OECD typology, adapted to Czech primary care conditions, was used for localization.</p><p><strong>Results: </strong>In all monitored groups, we observed continuous growth in the number of general practices using POCT methods, unaffected by Covid-19. Absolute numbers of POCT-INR and POCT-CRP examinations decreased during the pandemic years. The number of POCT-INR tests is more affected by practice location, while the number of POCT-CRP tests is influenced by the age of GPs.</p><p><strong>Conclusions: </strong>Although POCT methods are a voluntary part of general practitioners' office equipment in Czechia, their more frequent use indicates that system-level conditions are appropriately set. The interest of GPs aged 60+ is surprising. Despite using POCT examinations the least, they show similar growth to other groups.</p>","PeriodicalId":101400,"journal":{"name":"Acta medica (Hradec Kralove)","volume":"68 3","pages":"87-94"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145907455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical Management of Spondylodiscitis: A Single-Center Retrospective Analysis of 126 Cases.","authors":"Pavel Trávníček, Lenka Ryšková, Tomáš Hosszú, Roman Kostyšyn, Pavel Ryška, Jan Trlica, Tomáš Česák, Miroslav Cihlo","doi":"10.14712/18059694.2026.4","DOIUrl":"10.14712/18059694.2026.4","url":null,"abstract":"<p><strong>Background: </strong>Pyogenic spondylodiscitis is a severe spinal infection. Surgery can provide source control, neural decompression, and stability when indicated, but practice varies. We assessed outcomes of surgically treated cases at a tertiary neurosurgical center (2015-2024).</p><p><strong>Methods: </strong>Retrospective cohort of consecutive adults admitted with pyogenic spondylodiscitis to a tertiary neurosurgical center (2015-2024). Surgical and non-surgical cases were recorded; analyses focus on surgically managed patients with whole-cohort descriptors where indicated.</p><p><strong>Methods: </strong>We retrospectively analysed consecutive patients indicated for surgery. Variables included procedure type (decompression alone vs. instrumentation), presence of epidural abscess, reoperation for relapse or new-onset instability, microbiology, length of hospital stay (LOS), early outcomes, and admission clinical status.</p><p><strong>Results: </strong>We included 126 patients (87 men, 69%); mean age 65 years (range 13-91). Surgery was performed in 108 (85.7%): decompression alone in 76/108 (70.4%), instrumented decompression in 21/108 (19.4%), standalone instrumentation in 4/108 (3.7%), and multistage combined procedures in 7/108 (6.5%). Epidural abscess was present at the index operation in 98/108 (90.7%). Relapse, either confirmed intraoperatively or on preoperative MRI occurred in 29/126 (23.0%); reoperation for progressive instability in 17/108 (15.7%). Among patients with confirmed etiology (121/126, 96.0%), the most frequent pathogens were Staphylococcus aureus 69/121 (57.0%), Enterobacterales 18/121 (14.9%), and streptococci 16/121 (13.2%). Mean LOS was 35.3 days (median 27). Multiorgan failure developed in 44/126 (35.0%); in-hospital mortality was 7/126 (5.6%). No implant-related complications were observed.</p><p><strong>Conclusions: </strong>Early surgical source control with decompression without instrumentation was sufficient in most operated cases. When radiographic or intraoperative instability was present, instrumentation appeared safe despite active infection, provided meticulous debridement and pathogen-directed antibiotics were employed. Blood cultures and tissue samples should be taken timely and repeated if needed, as they both provide high diagnostic yield.</p>","PeriodicalId":101400,"journal":{"name":"Acta medica (Hradec Kralove)","volume":"68 4","pages":"134-141"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147505845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Trajectories and Outcomes of Acute Heart Failure in Internal Medicine: A Real-World Single-Centre Study.","authors":"Edgardo J Kaplinsky, Silvia Masmitjà Comajuan, Josefa Torres Martínez, Ana Serrado Iglesias, Daniel Cuartero Guerrero, Francesc Planas Ayma, Lourdes Zurita, Gustavo Tolchinsky Wiesen, Esther Moreno Ariño, Àngels Fumàs Comas, Cristina Carod Pérez","doi":"10.14712/18059694.2026.5","DOIUrl":"10.14712/18059694.2026.5","url":null,"abstract":"<p><strong>Purpose: </strong>To analyze the clinical characteristics and outcomes of patients with acute heart failure (AHF) admitted to an internal medicine department (IMD), with a focus on their trajectories, risk factors, and rehospitalisation/mortality rate.</p><p><strong>Methods: </strong>This retrospective cohort study included 410 hospitalisations (280 patients; 28% readmissions) for AHF during 2023. Diagnosis was validated using the European Society of Cardiology age-specific NT-proBNP thresholds and echocardiographic criteria. Baseline clinical and laboratory data were analyzed, prognostic markers were identified, and a risk algorithm was developed.</p><p><strong>Results: </strong>Mean patient age was 82 years (54% women). Most cases involved nonischemic etiology (80%) and HF with preserved ejection fraction (HFpEF, 69%). Frequent comorbidities included hypertension (85%), diabetes (45%), atrial fibrillation (44%), and multiple non-cardiac conditions. In-hospital mortality was 19.6%; 30-day readmission was 9.9%. Three clinical trajectories (index/first hospitalisation) were identified: single admission (n: 169), rehospitalisation (with/without death) (n: 73), and in-hospital death (n: 38). Prognostic markers included advanced age, elevated NT-proBNP, renal dysfunction, anemia, and non-cardiac cause of HF decompensation.</p><p><strong>Conclusions: </strong>This elderly IMD-HF cohort, mainly female and multimorbid, showed high HFpEF prevalence and adverse outcomes. NT-proBNP, renal function, haemoglobin, and non-cardiac causes of HF decompensation were key prognostic indicators.</p>","PeriodicalId":101400,"journal":{"name":"Acta medica (Hradec Kralove)","volume":"68 4","pages":"142-150"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147505854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Myosteatosis and Type 2 Diabetes Mellitus.","authors":"Lucian Batista de Oliveira, Vanessa de Oliveira E Silva, Ítalo Caio Lopes Jucá, João Victor Gonçalves Dos Santos Torres, Maria Roseneide Dos Santos Torres, Fabio Moura, Francisco Bandeira","doi":"10.14712/18059694.2025.17","DOIUrl":"https://doi.org/10.14712/18059694.2025.17","url":null,"abstract":"<p><p>Myosteatosis refers to the infiltration of fat into skeletal muscle tissue, being influenced by factors such as advanced age and overweight, which increase the inability of adipocytes to store lipids. This condition not only alters the structure of the muscle but is also associated with endocrinological imbalances such as insulin resistance (IR) and hyperinsulinemia, increasing the risk of developing type 2 diabetes mellitus (T2DM) and cardiovascular diseases. Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) are effective methods for measuring myosteatosis, identifying areas of fat accumulation that may indicate specific regional patterns. This review aimed to evaluate the main evidence that associates myosteatosis with T2DM, compiling the epidemiological data already available on the subject and the main gaps in the literature. Ten observational studies were selected, from different regions of the world, which showed a relationship between myosteatosis and a higher incidence of T2DM, as well as IR, worse glycemic status, increased inflammatory mediators and a tendency to coronary artery disease. In conclusion, myosteatosis and T2DM are conditions with a relevant relationship and that have significant implications for public health, requiring greater standardization of myosteatosis assessment methods and interventional studies that address potential therapeutic strategies for this condition.</p>","PeriodicalId":101400,"journal":{"name":"Acta medica (Hradec Kralove)","volume":"68 2","pages":"37-44"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145254352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biomechanics of Arteriovenous Fistula: An Overview of Hemodynamic and Remodeling Mechanisms.","authors":"Nikola Petrová, Zbyněk Sobotka, Lukáš Horný","doi":"10.14712/18059694.2025.25","DOIUrl":"10.14712/18059694.2025.25","url":null,"abstract":"<p><p>Arteriovenous fistulas (AVFs) are widely accepted as the gold standard for vascular access in chronic hemodialysis patients due to their superior long-term patency and low complication rates. However, up to half of all created AVFs fail to mature adequately, and many develop late complications such as stenosis, thrombosis, or aneurysmal degeneration. This review provides an overview of the AVF development process, focusing on the biomechanical forces that drive vascular remodeling and contribute to maturation and pathological changes. We summarize the role of endothelial mechanotransduction and insights from recent studies that reveal how wall shear stress (WSS) patterns and oscillatory flow relate to the genesis of neointimal hyperplasia and later stenosis. Understanding these mechanobiological processes has led to novel surgical techniques, anastomosis design optimization, and better cannulation strategies. Although the knowledge of hemodynamic-biological interactions remain limited, further research can offer directions for better AVF performance.</p>","PeriodicalId":101400,"journal":{"name":"Acta medica (Hradec Kralove)","volume":"68 3","pages":"82-86"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145907480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"A Paralyzing Snack\": An Endocrine Cause of Paralysis.","authors":"Ferdinando Rombola, Marianna Rodolico","doi":"10.14712/18059694.2026.8","DOIUrl":"10.14712/18059694.2026.8","url":null,"abstract":"<p><p>A case of a young Caucasian man presenting to the Emergency Department (ED) with lower limb weakness, anxiety, and sweating is described. Clinical and laboratory evaluations revealed severe hypokalemia (1.4 mmol/L) associated with thyrotoxicosis, leading to a diagnosis of Thyrotoxic Periodic Paralysis (TPP). After initial improvement following potassium infusion, the patient experienced symptom exacerbation. Further investigation linked the recurrence to excessive carbohydrate intake from vending machine snacks. TPP, a complication of hyperthyroidism, is extremely rare in Western countries but must be promptly recognized due to its potential life-threatening complications.</p>","PeriodicalId":101400,"journal":{"name":"Acta medica (Hradec Kralove)","volume":"68 4","pages":"167-169"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147505504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}