The bioavailability of rivaroxaban at the higher doses (15 and 20 mg) is considerably reduced when the drug is administered on an empty stomach. This can lead to inadequate anticoagulant effect, and therefore, it is recommended to use the higher doses at fed state. However, proper posology may represent a barrier for some patients.
View Article and Find Full Text PDFThis case report presents a rare case of an atypical head stab wound suffered by a drug addict and inflicted with a screwdriver during drug-induced psychosis. It describes the diagnostic and treatment procedures in the hospital and the findings of the subsequent autopsy. It also analyzes the review of the interpretation of the CT scans made upon admission and the subsequent treatment by an independent medical review panel, which revealed signs of medical mismanagement.
View Article and Find Full Text PDFObjective: This study was designed to evaluate the possibility of predicting the minimum size of septal resection for safe tumor extraction in transnasal paraseptal pituitary adenoma resection from preoperative computed tomography scans.
Methods: A retrospective CT scan analysis was performed on 20 patients who underwent endoscopic pituitary surgery at the University Hospital in Ostrava. Virtual insertion of the straight instrument into the sphenoid cavity was simulated using a CT scan.
Excessive daytime sleepiness (EDS) is a common symptom of sleep disorders such as narcolepsy, obstructive sleep apnea, and hypersomnia. The most common tools for assessing EDS are various specialized questionnaires such as Epworth Sleepiness Scale (ESS) and Stanford Sleepiness Scale (SSS). However, the scores obtained from self-rating questionnaires do not seem to measure physiological sleepiness but rather a more complex phenomenon of subjective sleepiness modulated by other factors such as motivation, expectation, and capability of self-perception.
View Article and Find Full Text PDFNilotinib is a selective tyrosine-kinase inhibitor approved for the treatment of chronic myeloid leukemia. It is poorly soluble in aqueous media and has a low oral bioavailability. Nilotinib encapsulation into yeast glucan particles (GPs) was investigated in this work as a means of increasing bioavailability.
View Article and Find Full Text PDFThe present study investigates the physicochemical properties and stability of a novel lipid-based formulation-surfactant-enriched oil marbles containing abiraterone acetate. While the biopharmaceutical performance of this formulation has been reported recently, this study aims to fill the gap between a promising in vivo performance and industrial applicability. A series of techniques were employed to assess the solid-state characteristics of oil marble cores along with their physicochemical properties upon stability testing.
View Article and Find Full Text PDFIatrogenic injury of the internal carotid artery (ICA) is a rare, and probably underreported, complication of transnasal endoscopic skull base surgery. Although treatment algorithms have been suggested, there is no definite consensus or guideline for the management of this severe complication. We describe a case of ICA injury that occurred during a transsphenoidal biopsy of a tumor in the cavernous sinus and we present a treatment algorithm for managing this complication.
View Article and Find Full Text PDFIntroduction: The clinical management of parasellar meningiomas (PM) is challenging due to their intimate association with critical neurovascular structures. Consensus regarding the recommended treatment protocol is lacking. This study will evaluate patients' visual outcomes following endoscopic transnasal optic nerve decompression (ETOND) and will investigate the possibility of reducing the rate of complications associated with stereotactic radiosurgery (SRS).
View Article and Find Full Text PDFCurrent guidelines suggest radiotherapy as a first-line treatment for prostate cancer, along with prostatectomy, and androgen deprivation therapy. Abiraterone is a first-in-class medicinal product recommended in the treatment of metastatic castration resistant prostate cancer (mCRPC) that targets androgen receptors and inhibits systemic synthesis. However, successful therapy with this drug may pose some challenges.
View Article and Find Full Text PDFJ Neurol Surg A Cent Eur Neurosurg
November 2023
Spontaneous regression of cysts of the cavum septi pellucidi (CSP) and cavum vergae (CV) is rare and little discussed. The authors present their case report of this phenomenon following a severe headache in a 23-year-old woman, in whom magnetic resonance imaging (MRI) had previously confirmed significant thinning of the left lateral cyst wall. We consider this finding to be a possible predisposing factor to rupture and the spontaneous regression of such cysts.
View Article and Find Full Text PDFInt J Environ Res Public Health
December 2021
In the 21st century, rural communities face many challenges, including implications of dynamic population aging, a lack of social care services, and the occurrence of abandoned post-agricultural brownfields. This paper is methodologically based on the findings derived from a set of qualitative in-depth interviews with the key rural stakeholders, explores the decisive factors and limits, accelerators, and barriers governing successful regeneration of the post-agricultural brownfield in the post-socialist environment. We are using the case of the regeneration project of a large-scale former communist agricultural cooperative, located in Vranovice, the Czech Republic, to illuminate how complex and challenging the redevelopment of a post-agricultural brownfield into a social care facility for elderly people is.
View Article and Find Full Text PDFA combined experimental and numerical study on titanium porous microstructures intended to interface the bone tissue and the solid homogeneous part of a modern dental implant is presented. A specific class of trabecular geometries is compared to a gyroid structure. Limitations associated with the application of the adopted selective laser melting technology to small microstructures with a pore size of 500 μm are first examined experimentally.
View Article and Find Full Text PDFCalcifying pseudoneoplasm of neuroaxis (CAPNON) is a rare lesion of the central nervous system with uncertain histogenesis. We further explored phenotypic spectrum of the entity with respect to possible histogenesis. We collected 5 cases of CAPNONs, performed a detailed morphological assessment, and performed an extensive immunohistochemical analysis (EMA, progesterone receptors, MUC4, SSTR2A, cytokeratin AE1/3, cytokeratin 18, GFAP, neurofilaments, desmin, nestin, synaptophysin, S100 protein, SOX10, CD56, Podoplanin, SATB2, ERG, CD45, and CD163) to elucidate the histogenesis.
View Article and Find Full Text PDFObjective: Primary fourth ventricle outlet obstruction (PFVOO) is a rare cause of hydrocephalus with an unclear etiopathogenesis, and thus, consensus regarding the recommended treatment protocol is lacking. This study aims to summarize current knowledge of this condition in the light of our own treatment experience.
Methods: Retrospective analysis was carried out of all patients treated for noncommunicating tetraventricular hydrocephalus between 2006 and 2019, from which a subgroup of patients with PFVOO was created.
The authors present the unusual case of a 15-year-old boy with a primary empty sella caused by non-communicating hydrocephalus due to fourth ventricle outflow obstruction whose secondary symptoms of growth hormone deficiency and delayed puberty were successfully treated by endoscopic third ventriculocisternostomy (ETV). Hypopituitarism occurs only rarely in cases of hydrocephalus; rarer still are cases where hypopituitarism is the sole symptom of hydrocephalus. A primary empty sella may indicate elevated intracranial pressure; if the cause is non-communicating hydrocephalus, ETV is indicated as the preferred treatment modality.
View Article and Find Full Text PDFObjective: Preoperative third ventricle deformation (known as 'bowing') is associated with higher endoscopic third ventriculostomy (ETV) success. In children, the effect of bowing has not to date been systematically studied. Aim of of this study is to determine the effect of bowing on ETV success in adult and child patients.
View Article and Find Full Text PDFPortal vein thrombosis (PVT) is a partial or complete thrombotic occlusion of the portal vein and is rare in noncirrhotic patients. 78 adult patients with noncirrhotic acute PVT without known malignity were evaluated. Patients with initial CRP level 61-149 mg/l were excluded.
View Article and Find Full Text PDFObjective: Cysts of the Cavum septi pellucidi (CSP), cavum vergae (CV) and cavum veli interpositi (CVI) are anterior midline intracranial findings which are typically incidental - only rarely do we encounter symptomatic cysts of this type. Only a quite small number of these cysts series have been published, controversies regarding optimal management still exist.
Patients And Methods: This is a retrospective study of 10 patients treated at 2 clinics between 2002-2018.
Background: This work aims to determine how antibiotic therapy influences MR spectroscopic findings in patients undergoing treatment for pyogenic brain abscess.
Methods: This prospective, single center study included all patients who received treatment for brain abscesses at the Neurosurgery Department of University Hospital Ostrava between 2012-2017. Preoperative MR imaging was carried out on all patients including diffusion-weighted imaging and in vivo single-voxel proton spectroscopy with intermediate echo time.
Introduction: Pyocephalus always presents serious complications in the treatment of brain abscesses, and is associated with high rates of mortality and morbidity. This study aimed to comprehensively evaluate this understandably feared complication from a purely medical perspective by using an evidence-based approach and drawing comparisons from the available literature, which mostly comprises case reports.
Methods: This was a prospective monocentric study of all patients treated for brain abscesses at the Neurosurgery Clinic of the University Hospital Ostrava between 2012 and 2017.
Posttraumatic hydrocephalus (PH) is a common complication of craniocerebral trauma. It is necessary to bear this entity in mind, especially when managing craniocerebral trauma patients, because if not detected in time, it can significantly affect morbidity and mortality. It needs to be distinguished from brain atrophy with axonal degeneration, a condition requiring an entirely different treatment approach.
View Article and Find Full Text PDFBackground: Prospective randomized data is currently lacking which compares endoscopically assisted surgery with open surgical techniques in the treatment of cubital tunnel syndrome (CUTS). The aim of this study is to compare patient outcome in both techniques.
Method: This prospective study comprised of 45 patients who, between October 2014 and February 2017, were randomly assigned to undergo either endoscopic or open surgery (22 and 23 patients respectively) for decompression of the ulnar nerve.
Foraging is one of the main evolutionary driving forces shaping the phenotype of organisms. In predators, a significant, though understudied, cost of foraging is the risk of being injured by struggling prey. Hunting spiders that feed on dangerous prey like ants or other spiders are an extreme example of dangerous feeding, risking their own life over a meal.
View Article and Find Full Text PDFObjective: We describe a case of spontaneous hepatic rupture associated with undiagnosed focal nodular hyperplasia of a patient in the third trimester of pregnancy. Additionally, we provide a brief review of literature.
Design: Case report.