Herniated lumbar discs are a common cause of low back pain, which can negatively impact the quality of life of working-age individuals. This study aimed to evaluate changes in the quality of life in patients with sciatica who underwent endoscopic discectomy, a minimally invasive surgical procedure. The study (ClinicalTrials.gov NCT02742311) included 470 patients who underwent transforaminal, interlaminar, or translaminar endoscopic discectomy. Quality of life and pain perception were evaluated by comparing statistically weighted values of EQ-5D-5L, EQ-VAS, Oswestry disability index, and numerical pain scales for lower limb and back pain before and 12 months after the endoscopic procedure. After the procedure, there was a significant improvement in the reduction of back and lower limb pain, as well as in all monitored questionnaires (P < .001), which persisted 12 months after the endoscopy. All evaluated dimensions of the EQ-5D-5L questionnaire indicated a significant improvement in the assessed quality of life (P < .001). The study showed that percutaneous endoscopic lumbar discectomy is an effective pain-treating intervention that can improve the quality of life. There was no observed difference in the percentage of complications or re-herniations when comparing the transforaminal and interlaminar, approaches.
- MeSH
- bederní obratle chirurgie MeSH
- diskektomie MeSH
- endoskopie MeSH
- kvalita života MeSH
- lidé MeSH
- lumbalgie * etiologie chirurgie MeSH
- meziobratlová ploténka * MeSH
- perkutánní diskektomie * MeSH
- výhřez meziobratlové ploténky * chirurgie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- klinické zkoušky MeSH
Radiofrequency denervation of the zygapophysial (facet) joints is a frequently performed procedure for chronic low back pain. However, cryoablation represents a novel therapeutic approach for this condition. We observed and analyzed 3 cases with confirmed positive lumbar facet joint syndrome. Our results show a significant improvement in the clinical state of the patients in the first and third months after the procedure. The 6-month follow-up examination demonstrates a recurrence of pain and a gradual deterioration in the quality of life with a lasting partial pain-relief effect. Thermal radiofrequency denervation and cryoablation of the lumbar zygapophysial joints represent an effective, albeit temporary treatment option for lumbar facet joint syndrome patients, resulting from the pathophysiology of sensory nerve regeneration after destructive procedures. This type of treatment can be used repeatedly in the case of a positive response.
- Publikační typ
- kazuistiky MeSH
OBJECTIVE: Prospective observational multicentre two-arm parallel study describing clinical outcome after endoscopic discectomy provided via transforaminal and interlaminar approach. BACKGROUND: Endoscopic lumbar discectomy (ELD) is a percutaneous minimally invasive procedure for the treatment of herniated lumbar discs. Herniations at lumbar intervertebral disc levels of L1/2, L2/3, L3/4 and L4/5 are mostly accessed by the transforaminal (TF) approach. However, due to the anatomic position of the iliac crest, the L5/S1 level might not be reachable by the transforaminal approach, while the interlaminar (IL) percutaneous approach should be a suitable alternative. METHODS: In a prospective observational multicentre clinical trial NCT0274311, we compared the clinical outcomes of two groups of patients who underwent ELD via IL (83) and TF (103) approach. The subjects were followed for 12 months via planned examinations by pain physicians. The levels of leg pain and back pain intensity were assessed by an 11-point numerical ratings scale (NRS). Patient’s functional disability was assessed by the Oswestry Disability Index (ODI). RESULTS: Study subjects showed a significant decrease in ODI scores in both groups (p<0.001) The values of mean preoperative ODI in TF and IL groups were 39.1±15.7 and 43.4±16, respectively. Postoperative values in the latter groups were 14.8±14.9 and 17.5±14.3, respectively. Significantly lower pain scores for leg pain (p<0.001) and back pain (p<0.001) were also recorded at 12-month follow-ups. CONCLUSION: Because both procedures are strictly percutaneous; they are now more commonly performed by interventional pain physicians as a safe and effective alternative to open surgical spine procedures (Tab. 3, Fig. 7, Ref. 19).
- Klíčová slova
- transforaminální metoda, interlaminární metoda,
- MeSH
- degenerace meziobratlové ploténky chirurgie MeSH
- interpretace statistických dat MeSH
- ischialgie chirurgie etiologie MeSH
- lidé MeSH
- měření bolesti metody MeSH
- meziobratlová ploténka patofyziologie MeSH
- obnova funkce MeSH
- perkutánní diskektomie * metody MeSH
- prospektivní studie MeSH
- radikulopatie chirurgie etiologie MeSH
- výhřez meziobratlové ploténky * chirurgie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- multicentrická studie MeSH
- pozorovací studie MeSH
BACKGROUND: Epiduroscopy is a well-established diagnostic and to certain level therapeutic tool in complex situations, where conventional methods such as magnetic resonance imaging (MRI) lack power or resolution to detect pathological changes. Such a situation is primarily failed back surgery syndrome (FBSS) but also radicular pain without surgery. The aim of this study was to determine the effectiveness of epiduroscopic treatment in patients with FBSS. METHODS: A total of 79 patients with FBSS were randomized into 2 groups. The first group underwent epiduroscopy and received mechanical lysis of adhesions only, the second group received also medication into the epidural space (methylprednisolone and hyaluronidase). Patients were subsequently followed for 12 months, with evaluation also after 6 months post-epiduroscopy. Patients were checked in terms of mobility, self-care, usual activities, pain/discomfort and anxiety/depression as defined in the 5‑dimensional EQ-5D-5L questionnaire and to asses suitability of this questionnaire in chronic pain states. Data were collected using EQ-5D-5L questionnaire and also quality of life (QoL) questionnaire. RESULTS: In the terms of ability to walk (dimension mobility) and also ability to do housework, study or leisure activities (dimension usual activity) patients improved in both groups after 6 and 12 months after epiduroscopy. In pain dimension there was improvement mainly after 6 months which correlated also with self-care dimension and quality of life self-assessment. Results in anxiety/depression dimension were mixed. CONCLUSION: Epiduroscopy appears to be a beneficial procedure for both patient groups, especially after 6 months, with some benefit remaining after 12 months. The EQ-5D-5L questionnaire seems to be a suitable and comprehensive way to assess patient health in chronic pain states.
Biologically active natural compounds (e.g., isoprenoids, flavonoids, anthocyanins, alkaloids, organic acids, coumarins, etc.) have proven significant preventive and curative effects in various diseases. In the present study, we have provided a qualitative and quantitative monitoring of anthocyanins in a methanolic extract and a freeze-dried extract of three fruits rich in anthocyanin: blueberries of Vaccinium corymbosum "Berkeley", grapes of Vitis vinifera "Lemberger" and chokeberries of Aronia melanocarpa "Nero". The identification of anthocyanins was carried out by the reverse phase liquid chromatography and mass spectrometry. The results indicated that the average content of anthocyanins in the methanolic extract was lower than in the freeze-dried extract. The highest content of anthocyanins was obtained in chokeberry extracts. The process of freeze-drying, however, leads to changes that probably affect the biological activity via changes in the ratio of biologically active compounds.
INTRODUCTION AND OBJECTIVE: Polychlorinated biphenyls (PCBs) have been used commercially since 1929 as dielectric and insulating non-flammable substances, additives for paints, etc. In Slovakia, 60 chemical production workers highly exposed to PCBs (mainly to Delor 103) were studied with duration of exposure ranging from 3 months to 19 years. MATERIAL AND METHODS: Clinical examinations of skin, skin histology and laboratory tests concerning lipid metabolism, iron metabolism and levels of copper provided comparisons with a control group of healthy individuals and/or the upper limits of normal values. RESULTS: Skin changes were found in 47 % of individuals. In most cases, milia-like efflorescences (57.14 %) occurred, as well as comedones (55.35 %); other symptoms occurred in a smaller number of workers. Hyperkeratosis, acanthosis of the epidermis (particularly in hair follicles), and a cellular infiltration of the corium were all found through histology. The intensity of cutaneous affections was associated with the changes in laboratory tests. Elevated triglycerides, cholesterol, and phospholipids were found in exposed workers. After a further two years, a significant increase in triglycerides was found in exposed individuals when compared with the control group. In addition, a significant increase in serum levels of copper, and total and unsaturated iron-binding capacity was detected. CONCLUSIONS: Anamnesis showed that some people directly exposed to PCBs may develop skin changes after three months of occupational exposure. The results represent a unique snapshot of worker exposure at a given location, representing the basis for comparison with the population who grew up in the area and still live there today.
- MeSH
- cholesterol krev MeSH
- dospělí MeSH
- kožní nemoci krev epidemiologie etiologie patologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- měď krev MeSH
- mladý dospělý MeSH
- nemoci z povolání krev epidemiologie etiologie patologie MeSH
- polychlorované bifenyly toxicita MeSH
- pracovní expozice škodlivé účinky MeSH
- retrospektivní studie MeSH
- triglyceridy krev MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Slovenská republika epidemiologie MeSH
BACKGROUND: Cardiovascular disease is a serious problem increasingly affecting young people worldwide. Cardio-metabolic risk factors include lipid profile parameters and atherogenic index of plasma (AIP), as well as basic anthropometric parameters such as the ratio of waist circumference to height (WHtR). The aim of our study was to determine WHtR. METHOD: WHtR was determined in a group of 500 clinically healthy young people aged 18-25 and, on the basis of measured data, a reference range for WHtR was designed. RESULTS: The average WHtR value for the whole group was 0.45±0.06, with 0.46±0.06 for men, and 0.44±0.06 for women. WHtR values in respondents with all other parameters in normal range were from 0.41 to 0.52 for men and from 0.38 to 0.50 for women. Values are similar to those observed in other studies across diverse world populations. A positive correlation was observed between WHtR and atherogenic indices (AP1, AIP) uric acid levels and lipid profile parameters at p<0.001, with the exception of glucose and HDL. WHtR and HDL were negatively correlated at p<0.001. CONCLUSION: As WHtR can be easily determined, it can be used as another cardio-metabolic risk factor.
- MeSH
- antropometrie metody MeSH
- dospělí MeSH
- hodnocení rizik MeSH
- kardiovaskulární nemoci diagnóza MeSH
- lidé MeSH
- mladiství MeSH
- obvod pasu * MeSH
- referenční hodnoty MeSH
- rizikové faktory MeSH
- tělesná výška * MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Slovenská republika MeSH
The metabolic form of vitamin A, retinol, has a pivotal role in the nervous system development and neuronal differentiation, both during embryogenesis through maternal-fetal support and in the early postnatal life. Retinoic acid was administered orally at a dose of 10 mg/kg body weight to pregnant female rats through days 8-10 of gestation. Spinal cord sections were processed for histochemical visualization one day after birth and on day 21, when weaning is expected. NADPH-diaphorase (NADPH-d)-positive neurons were found in the dorsal horn, around the central canal, and at the intermediolateral cell column on postnatal days 1 and 21 in both control and experimental groups. There were no NADPHd-positive structures in the ventral horn. The results suggest that prenatal administration of high doses of retinoic acid is not associated with postnatal morphological changes in NADPH-d-positive neurons in the rat spinal cord. Levels of antioxidants and related enzymes in retinoid storage organs were measured to estimate possible side effects. The activities of enzymes detoxifying superoxide radicals and peroxides were supressed after birth. A decrease in the level of reduced glutathione was observed on postnatal day 21, indicating an unbalanced redox environment.
- MeSH
- játra účinky léků růst a vývoj metabolismus MeSH
- krysa rodu rattus MeSH
- mícha účinky léků růst a vývoj metabolismus MeSH
- NADP metabolismus MeSH
- potkani Wistar MeSH
- těhotenství MeSH
- vitamin A aplikace a dávkování farmakologie MeSH
- vztah mezi dávkou a účinkem léčiva MeSH
- zvířata MeSH
- Check Tag
- krysa rodu rattus MeSH
- mužské pohlaví MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
False drugs are unsafe products that are manufactured using incorrect, inactive, or harmful ingredients. These drugs are packaged and labeled to look like real trademark generic drugs to deceive the consumer. Chemical analysis is a crucial step in distinguishing original pharmaceutics and fakes. HPLC and MS analyses are standard methods for identification and quantitation of active ingredients and impurities. Thus they are often used to corroborate the results of less sophisticated methods such as colorimetry, TLC, GS, Raman, NIR, FTIR and NMR spectrometries. The analytical methods should be employed in forensic laboratories.
- MeSH
- artemisininy * analýza klasifikace MeSH
- chemické techniky analytické * metody využití MeSH
- chromatografie na tenké vrstvě metody využití MeSH
- chromatografie plynová metody využití MeSH
- farmaceutický průmysl zákonodárství a právo MeSH
- hmotnostní spektrometrie metody trendy využití MeSH
- inhibitory fosfodiesteras * analýza MeSH
- kolorimetrie metody využití MeSH
- kontaminace léku * prevence a kontrola zákonodárství a právo MeSH
- lidé MeSH
- magnetická rezonanční spektroskopie metody MeSH
- padělané léky * analýza zásobování a distribuce MeSH
- Ramanova spektroskopie metody MeSH
- spektroskopie infračervená s Fourierovou transformací metody přístrojové vybavení využití MeSH
- vysokoúčinná kapalinová chromatografie metody využití MeSH
- Check Tag
- lidé MeSH
Východisko: Závažné intraabdominálne infekcie patria medzi život ohrozujúce ochorenia. Vznikajú na podklade šírenia lokalizovaných zápalov alebo narušenia integrity črevnej steny. Metódy a výsledky: Liečebnou stratégiou je chirurgická intervencia, antimikrobiálna terapia, liečba distribučného šoku a cielená nutričná podpora (1). Predpokladá sa, že suplementácia glutamínu a selénu zlepšuje funkciu črevnej bariéry a regeneruje antioxidačnú obranu (2). U pacientky po endoskopickej polypektómii sa rozvinul septický šok s multiorgánovým zlyhávaním a rozvojom katabolizmu s výrazným poklesom albumínu. Origo sepsy zobrazovacími metódami a probatórnou laparotómiou nebolo zistené. Liečbou distribučného šoku, podávaním širokospektrálnych antibiotík, enterálnym a parenterálnym hradením nutrientov došlo k výraznému zlepšeniu zdravotného stavu. V rámci adjuvantnej terapie boli intavenózne suplementované: glutamín v dennej dávke 2 g a pentahydrát seleničitanu sodného v kontinuálnej infúzii v dávke 750 μg/24 hodín v priebehu 6 dní. Počas terapie došlo k poklesu zápalových markerov: C-reaktívny proteín, prokalcitonínu, leukocytov, neutrofilov. Došlo k zvýšeniu hladín albumínu. Závěry: Práca poukazuje na terapeutické možnosti pri liečbe septického šoku a možnosťami reverzie katabolickej fázy ochorenia. Kľúčové slová: kolonoskopia, septický šok, multiorgánové zlyhanie, enterálna výživa, parenterálna výživa.
Background: Serious intraabdominal infections belong among life treating diseases. They are based on spreading infections from focal sources of inflammation in abdomen or damaged intestinal wall. Methods and results: Treatment strategies are surgical intervention, antimicrobial therapy, distributional shock treatment and accurate nutritional support (1). Glutamine and selenium supplementation may improve intestinal functions and restore antioxidant defence (2). Septic shock with multiple organ failure accompanied by serious catabolism and decrease of albumin had developed in a patient after endoscopic polypectomy. Infection source was not discovered by medical imaging examinations non surgical laparotomy. After distributive shock treatment, wide spectral antibiotics and enteral and parenteral nutrition the patient’s health improved. As adjuvant therapy intravenous supplementation was administered: glutamine in daily dose 2g and sodium selenite in continual infusion in daily dose 750 μg over 6 days. During intensive therapy, inflammatory markers decreased: C-reactive protein, procalcitonin, leukocyte count and neutrophils. Albumin levels increased. Conclusions: The paper describes therapeutic options during septic shock treatment and reversion possibilities in the catabolic phase of disease. Key words: colonoscopy, septic shock, multiorgan failure, enteral nutrition, parenteral nutrition.
- MeSH
- antibakteriální látky aplikace a dávkování MeSH
- enterální výživa MeSH
- glutamin aplikace a dávkování MeSH
- kolonoskopie * metody škodlivé účinky MeSH
- lidé MeSH
- multiorgánové selhání * diagnóza etiologie terapie MeSH
- parenterální výživa MeSH
- polypy střeva * chirurgie komplikace MeSH
- selen aplikace a dávkování MeSH
- senioři MeSH
- septický šok * diagnóza farmakoterapie MeSH
- Check Tag
- lidé MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
