Evaluation of quality of life in patients treated for colorectal cancer at the University Hospital Trnava

Introduction: The aim of the study was to evaluate quality of life (QoL) in patients with colorectal cancer (CRC) during complex treatment using the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 and QLQ-CR29 questionnaires and to implement routine QoL assessment into our practice. Methods: 30 patients diagnosed with CRC at the Department of Surgery, Faculty Hospital Trnava, Slovakia were included in the study between May 2014 and April 2015. QoL was assessed using EORTC QLQ-C30 and QLQ-CR29 questionnaires before surgery and 1 month after surgery. Data are presented as means, and a paired t-test and independent t-test were used for statistical analysis. Results: A significant correlation between the type of treatment and QoL was identified in the cohort. A trend to lower QoL was observed in patients with completed neoadjuvant chemoradiotherapy (CRT) and after surgery with stoma formation. The QoL was also affected by the age and gender of the patients. Conclusion: QoL assessment provides important outcomes reflecting the consequences of particular therapeutic modality in patients with CRC. The worse effect of neoadjuvant CRT and stoma formation was shown in our study in comparison to radical resection with adjuvant chemotherapy

Treatment with Proprotein Convertase Subtilisin/Kexin Type 9 Inhibitors (PCSK9i): Current Evidence for Expanding the Paradigm?

Background: Proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i) are low-density lipoprotein cholesterol (LDL-C)-lowering drugs that play a critical role in lipoprotein clearance and metabolism. PCSK9i are used in patients with familial hypercholesterolemia and for the secondary prevention of acute cardiovascular events in patients with atherosclerotic cardiovascular disease (CVD). Methods: We focused on the literature from 2015, the year of approval of the PCSK9 monoclonal antibodies, to the present on the use of PCSK9i not only in the lipid field but also by evaluating their effects on metabolic factors. Results: PCSK9 inhibits cholesterol efflux from macrophages and contributes to the formation of macrophage foam cells. PCSK9 has the ability to bind to Toll-like receptors, thus mediating the inflammatory response and binding to scavenger receptor B/cluster of differentiation 36. PCSK9i lower the entire spectrum of apolipoprotein B-100 containing lipoproteins (LDL, very LDLs, intermediate-density lipoproteins, and lipoprotein[a]) in high CVD-risk patients. Moreover, PCSK9 inhibitors are neutral on risk for new-onset diabetes mellitus and might have a beneficial impact on the development of nonalcoholic fatty liver disease by improving lipid and inflammatory biomarker profiles, steatosis biomarkers such as the triglyceride-glucose index, and hepatic steatosis index, although there are no comprehensive studies with long-term follow-up studies. Conclusion: The discovery of PCSK9i has opened a new era in therapeutic management in patients with hypercholesterolemia and high cardiovascular risk. Increasingly, there has been mounting scientific and clinical evidence supporting the safety and tolerability of PCSK9i

Malondialdehyde as an independent predictor of body mass index in adolescent girls

Background: Given the fact that the studies that examined oxidative stress in relation to obesity that included late adolescents are scarce and show inconclusive results we aimed to investigate a wide spectrum of nitro-oxidative stress biomarkers i.e., malondialdehyde (MDA), xanthine oxidase (XO), xanthine oxidoreductase (XOD), xanthine dehydrogenase (XDH), advanced oxidation protein products (AOPP) and nitric oxide products (NOx), as well as an antioxidative enzyme, i.e., catalase (CAT) in relation with obesity in the cohort of adolescent girls ages between 16 and 19 years old. Methods: A total of 59 teenage girls were included in this cross-sectional study. Binary logistic regression analysis was performed to examine possible associations between biochemical and nitro-oxidative stress markers and body mass index (BMI). Results: There were not significant differences between oxidative stress markers between normal weight and overweight/obese girls (i.e., AOPP, XOD, XO, XDH) and CAT, except for MDA (p<0.001) and NOx (p=0.010) concentrations which were significantly higher in overweight/obese adolescent girls. Positive associations were evident between BMI and high sensitivity C-reactive protein (hsCRP) (OR=2.495), BMI and uric acid (OR=1.024) and BMI and MDA (OR=1.062). Multivariable binary regression analysis demonstrated significant independent associations of BMI and hsCRP (OR=2.150) and BMI and MDA (OR=1.105). Even 76.3% of the variation in BMI could be explained with this Model. Conclusions: Inflammation (as measured with hsCRP) and oxidative stress (as determined with MDA) independently correlated with BMI in teenage girls

Lipid profile and left ventricular geometry pattern in obese children

Background: Left ventricular hypertrophy (LVH) is an important risk factor for cardiovascular and all-cause mortality. Previous studies reported conflicting results concerning the relationship between serum lipid levels and left ventricular geometry pattern. We sought to explore the relationship between standard serum lipid profile measures with left ventricular geometry pattern in obese children. Patients and methods: In this cross-sectional study, a total of 70 obese children were examined. Fasting blood samples were taken to measure total cholesterol, low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), triglycerides (TGs), glucose, and insulin. Based on these values TG/HDL ratio, BMI and HOMA index were calculated. We also measured the average 24-h ambulatory systolic blood pressure (SBP) and two-dimensional (2/D) transthoracic echocardiography was performed to determine left ventricular mass index (LVMI) and relative wall thickness (RWT). Multiple regression analyses were conducted to explore relationships between study variables and the LVMI or RWT as outcome variables. The final model with LVMI included TG/HDL ratio, BMI, 24 h-average SBP, age and sex, while for the RWT we included BMI, insulin, age and sex. Results: Our study included 70 children (65.71% boys and 34.29% girls) median age (14 years, IQR = 12-16)." We demonstrated independent and positive association of TG/HDL ratio, BMI and 24 h-average SBP with LVMI (effect = 3.65, SE = 1.32, p &lt; 0.01; effect = 34.90, SE = 6.84, p &lt; 0.01; effect = 0.32, SE = 0.12, p &lt; 0.01, respectively). On the other hand, in model with RWT as outcome variable, only BMI and insulin were significantly linked (BMI: effect = 13.07, SE = 5.02, p = 0.01 Insulin: effect = 2.80, SE = 0.97). Conclusion: Increased TG/HDL ratio in obese children is associated with the development of eccentric left ventricular hypertrophy while increased BMI and insulin were associated with concentric left ventricular hypertophy

Post-Hypoglycemic hyperglycemia are highly relevant markers for stratification of glycemic variability and partial remission status of pediatric patients with new-onset type 1 diabetes.

AimsTo evaluate whether parameters of post-hypoglycemic hyperglycemia (PHH) correlated with glucose homeostasis during the first year after type 1 diabetes onset and helped to distinguish pediatric patients undergoing partial remission or not.MethodsIn the GLUREDIA (GLUcagon Response to hypoglycemia in children and adolescents with new-onset type 1 DIAbetes) study, longitudinal values of clinical parameters, continuous glucose monitoring metrics and residual β-cell secretion from children with new-onset type 1 diabetes were analyzed during the first year after disease onset. PHH parameters were calculated using an in-house algorithm. Correlations between PHH parameters (i.e., PHH frequency, PHH duration, PHH area under the curve [PHHAUC]) and glycemic homeostasis markers were studied using adjusted mixed-effects models.ResultsPHH parameters were strong markers to differentiate remitters from non-remitters with PHH/Hyperglycemia duration ratio being the most sensitive (ratioConclusionPHH parameters are new minimal-invasive markers to discriminate remitters from non-remitters and evaluate glycemic homeostasis during the first year of type 1 diabetes. PHH parameters may also allow patient-targeted therapeutic management of hypoglycemic episodes

Natural and natural-like polyphenol compounds: in vitro antioxidant activity and potential for therapeutic application

Introduction Phenols are a large family of natural and synthetic compounds with known antioxidant activity. The aim of this study was to preform an in vitro screening of natural and natural-like phenol monomers and their C2-symetric dimers (hydroxylated biphenyls) in order to identify those representatives which pharmacophores have the strongest antioxidant and the lowest prooxidant activity. Material and methods Antioxidative properties of 36 compounds (monomers and their C2-symmetric dimers) were evaluated in vitro. Different (red/ox) assays were used to measure their total oxidative potential (TOP), their total antioxidative capacity (TAC), the pro-oxidative-antioxidant balance (PAB) and total SH-group content (SHG) in a biologically relevant environment. The Pro-oxidative Score, Antioxidative Score and the Oxy Score were also calculated. Trolox, a water soluble analogue of α- tocopherol was used as a positive control. Results In an assay consisting of pooled human serum 6 of the 36 compounds indicated significant antioxidant activity (compounds 6, 7, 12, 13, 26, and 27) whereas 4 indicated extremely weak antioxidant activity (compounds 2, 29, 30, and 31). Within the 36 compounds comprising of zingerone, dehydrozingerone, aurone, chalcone, magnolol derivatives, in both monomeric and dimeric forms, the 2 compounds that indicated the highest antioxidant activity were dehydrozingerone derivatives (compounds 6 and 12). Trolox’s activity was found between the strong and weak antioxidant compounds analysed in our study. Conclusions In this study selected dehydrozingerones were identified as good candidates for in-depth testing of their biological behaviour and for possible precursors for the synthesis of novel polyphenolic molecules with potential therapeutic applications

Erotic fantasy, spirituality and Song of Songs

Fantasy plays an essential role in sexual activities. This article investigates (erotic) fantasy from a literary text perspective according to Song of Songs in the Christian Bible. The Song, according to many commentaries, starts with a reference to sex in Canticle 1:2, ‘Let him kiss me with the kisses of his mouth! For your love is better than wine’. Although the word sex is not mentioned in the Song, it is referred to and implied a number of times in the deep structure of the text. The fantasies of this most beautiful woman (beauty, a secondary motif in the Song that is complementary to the main theme of love) are part of the rhetoric of the poet (probably a woman) to convince the reader about the enjoyment and beauty of erotic love. These could most likely stimulate erotic fantasies when reading the text. Part of the poet’s rhetoric is the way in which she describes this most beautiful woman and her most attractive lover using metaphors, allusions, symbols and similes to evoke all sorts of imaginations and fantasies in the mind of the reader to complement the erotic fantasies of the reader. The investigation of the composition and ‘lived experiences’ (spiritualities) of erotic fantasies is approached from the perceptions of how the entanglement of the reader in the text augments fantasies, how the dynamic interaction between the text of Song of Songs and the reader involves the reader in the fantasies and spiritualities of the protagonists and the poet, how the lived experiences of the composed images and erotic fantasies in the text of the Song grip and involve the reader in the text and finally how the use or application of human senses in fantasies can intensify the lived experiences of fantasies. This research points out how God’s love and concern for his creatures are present as revealed in the relationship between two lovers. His love and concern are clearly visible in the enjoyment and pleasure given by God to humans in his creation which the lovers find in each other.Christian Spirituality, Church History and Missiolog

Clinical improvement and radiological progression in a girl with early onset scoliosis (EOS) treated conservatively – a case report

BACKGROUND: Chêneau-Brace treatment of a certain standard reduces the rate of surgery, prevents progression and in a certain patient population leads to marked improvement of Cobb angle and cosmetic appearance. During the last two years a patient refusing surgery with a double major curvature of initially 60° showed a clear cosmetic improvement and a clear radiological progression at the same time. The findings of this patient have been reviewed in order to find out how cosmetic appearance and Cobb angle can develop differently. METHODS: The patient entered conservative treatment at the age of 13 years, premenarchial with Tanner II and a Cobb angle of 60° thoracic and 59° lumbar. The angle of trunk rotation (ATR; Scoliometer) was 13° thoracic and 13° lumbar. We have documented the findings of this patient (Surface topography, ATR, Cobb angles and angles of vertebral rotation (according to Raimondi) during the treatment period (27 Month) until 2 years after the onset of menarche. RESULTS: After a treatment time of 27 Month the Cobb angle increased to 74° thoracic and 65° lumbar. The angles of vertebral rotation according to Raimondi increased slightly from 26° thoracic and 28° lumbar to 30° thoracic and 28° lumbar. The ATR improved to 12° thoracic and 5° lumbar while Lateral deviation improved from 22,4 mm to 4,6 mm and average surface rotation improved from 10,6° to 6°. In the X-rays a reduction of decompensation was visible. The patient felt comfortable with the cosmetic result. CONCLUSION: Conservative treatment may improve cosmetic appearance while the curve progresses radiologically. This could be explained by assuming that (1) the Rigo Chêneau brace is able to improve cosmetic appearance by changing the shape of the thorax when the curve itself is too stiff to be corrected by a brace, that (2) reduction of decompensation leads to significant cosmetical improvements or (3) that the patient gained weight and therefore the deformation is masked. However, the weight the patient gained cannot explain the cosmetical improvement in this case. Conservative treatment with a certain standard of quality seems a viable alternative for patients with Cobb angles of > 60° when surgical treatment is refused. Specialists in scoliosis management should be aware of the fact that curve progression can occur even if the clinical measurements show an improvement