INTRODUCTION: Esophageal achalasia is a primary motility disorder. Although the exact pathogenesis is unknown, autoimmune, and neurodegenerative processes seem to be involved similarly to neurodegenerative and/or demyelinating disorders (NDDs). We hypothesized that the prevalence of NDD may be higher among patients with achalasia and vice versa as the background pathogenetic mechanisms are similar. METHODS: This was a prospective, comparative questionnaire-based study. Patients with achalasia and patients with NDD were enrolled. Selected patients with achalasia were thoroughly examined by a neurologist and selected patients with NDD were examined by a gastroenterologist to confirm or rule out NDD or achalasia. We assessed the prevalence of both achalasia and NDD and compared them with their prevalence in general population. RESULTS: A total of 150 patients with achalasia and 112 patients with NDD were enrolled. We observed an increased prevalence of NDD among patients with achalasia (6.0% (9/150); 95% CI (confidence interval): 3.1-11.2%) as compared to the estimated 2.0% prevalence in general population (p = 0.003). Although 32 out of 112 patients (28.6%) with NDD reported dysphagia, we did not observe significantly increased prevalence of achalasia in these patients (1.8% (2/112) vs 0.8% in general population, p = 0.226). CONCLUSION: The prevalence of NDD was significantly higher among patients with achalasia (6.0%) compared to general population (2.0%), suggesting an association of these disorders. Large-volume studies are necessary to confirm this finding.

• Publikační typ
• časopisecké články MeSH

Background: Internal carotid endarterectomy (CEA) is a method of stroke prevention in patients with severe internal carotid artery (ICA) stenosis. Patients with significant carotid stenosis tend to have lower cognitive performance than those without significant stenosis. This is believed to be due to hypoperfusion or ongoing microembolization to the brain. Methods: We evaluated 60 patients with at least 70% ICA stenosis with the RBANS test (Repeatable Battery for the Assessment of Neuropsychological Status, Czech research version), preoperatively and one month after endarterectomy. Results: Neuropsychological follow-up was completed by N = 57 patients one month after the procedure. At the group level, there was a significant improvement in Language, Attention, Delayed Memory and Total Scale Index Scores (p < 0.05). Conclusions: CEA not only decreases the long-term risk of ischemic stroke, but may also improve cognitive performance. In a small percentage of cases, there is higher risk of embolic stroke and silent microembolization due to surgery, which may have a negative impact on cognitive function. However, we did not detect any cognitive impairment after CEA in our patients.

• MeSH
• hodnocení výsledků zdravotní péče MeSH
• karotická endarterektomie * MeSH
• kognitivní dysfunkce etiologie   patofyziologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• následné studie MeSH
• neuropsychologické testy MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• stenóza arteria carotis komplikace   chirurgie   MeSH
• stupeň závažnosti nemoci MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH