Journals of Rzeszow University - Open Journal System
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Open rings of demyelination – a rare case of tumefactive multiple sclerosis
Get PDFIntroduction and aim. Tumefactive multiple sclerosis (MS), a rare and atypical subtype of MS, presents with large demyelinating lesions that can mimic acute stroke, leading to diagnostic uncertainty. Stroke-like symptoms in such cases require a thorough neuroimaging. We describe the case of a 35-year-old woman who presented with acute onset of right-sided hemiparesis and hemisensory loss, along with facial weakness of the left upper motor neuron facial weakness and focal seizures. Initially suspected to be a cerebrovascular event, the condition was later diagnosed as tumefactive multiple sclerosis.
Description of the case. Comprehensive neurological assessment with neuroimaging and magnetic resonance peduncle, and bilateral cerebral hemispheres, raising suspicion of a demyelinating process. A differential diagnosis, including neoplastic, infectious, and inflammatory conditions was carefully evaluated before confirming tumefactive MS. The patient’s stroke-like deficits improved significantly with high-dose intravenous methylprednisolone therapy. Follow-up imaging demonstrated the resolution of the enhancing lesions, strengthening the diagnosis. The dramatic response to steroids and the absence of progressive deterioration helped differentiate tumefactive MS from gliomas or infectious abscesses.
Conclusion. This case highlights the importance of considering tumefactive MS in acute neurological deficits with ring-enhancing lesions. Advanced imaging techniques are crucial for accurate differentiation that allows for timely and appropriate treatment
Corrigendum: The effect of different blood groups on visual evoked potentials
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The effect of different blood groups on visual evoked potentials by Eski MT, Yabalak A, Şahan H, Ayaslı AAH, Sezer T. Eur J Clin Exp Med. 2023;21(3):576–581. doi: 10.15584/ejcem.2023.3.25
Frailty in liver cirrhosis ‒ insights into prevalence, determinants, and clinical impact from a tertiary center experience
Get PDFIntroduction and aim. Frailty has emerged as a critical determinant of poor outcomes in patients with liver cirrhosis. This study aims to determine the prevalence and predictors of frailty in patients with liver cirrhosis and assess its clinical impact on disease severity.
Material and methods. This cross-sectional study included 460 patients with liver cirrhosis were classified into frail Clinical Frailty Scale (CFS) >4 and non-frail (CFS≤4) groups.
Results. The prevalence of frailty among the studied patients was 45.7%. Frail patients were significantly older (60.61±9.06 years), without gender predilection (43.7%, 47.9%). Patients with frailty exhibited significantly worse liver function; higher bilirubin (1.30 (0.90–2.0) vs 0.90 (0.66–1.30) mg/dL, p<0.001) and low albumin (3.9 (3.50–4.10) vs 3.2 (2.60–3.70) g/dL, p<0.001). Multivariate analysis identified age (OR=1.055, 95%CI: 1.023–1.088, p<0.001), body mass index (OR=9.803, 95%CI: 5.067–18.963, p<0.001), and high nutritional risk (OR=20.186, 95%CI: 8.456–48.191, p<0.001) as independent predictors of frailty.
Conclusion. Frailty is a significant concern in patients with liver cirrhosis, particularly those with advanced age, diabetes, and severe hepatic dysfunction. Optimizing outcomes for this patient population requires a multi-faceted approach that considers liver disease management, routine frailty assessment, and interventions to enhance physical resilience and address co-morbidities
Ezetimibe mitigates DNCB-induced mouse model of eczematous dermatitis
Get PDFIntroduction and aim. Atopic dermatitis (AD) is a life-long inflammatory dermatosis that features dry, erythematous skin. Ezetimibe is a lipid-lowering agent with enhanced anti-inflammatory and anti-oxidative capacities. This work attempted to evaluate the anti-eczematous action of topically administered ezetimibe in a mouse prototype of 1-chloro-2,4-dinitrobenzene (DNCB)-evoked AD. To our knowledge, this is the first study to investigate the topical use of ezetimibe in an experimental model of AD.
Material and methods. Thirty male Swiss albino mice were randomly allocated into five groups: healthy control, DNCB-induced model, vehicle, tacrolimus (0.1% ointment), and ezetimibe (2% ointment). Treatments were applied daily for 21 days. Clinical severity scores, total and differential leukocyte counts, histopathological changes, immunohistochemical expression of interleukin (IL)-4 and IL-13, and tissue levels of IgE, malondialdehyde (MDA), IL-17, IL-31, transforming growth factor-β (TGF-β), and tumor necrosis factor-α (TNF-α) were assessed.
Results. DNCB increased dermatitis severity (EASI score 9.8±0.7 vs. 0.5±0.1 in controls, p<0.001), total leukocytes (14.2±1.6 ×10³/mL vs. 3.9±0.6 ×10³/mL, p<0.001), and IgE (356±42 ng/mL vs. 92±15 ng/mL, p<0.001). Ezetimibe treatment significantly reduced EASI scores (2.1±0.4, p<0.01 vs. DNCB), leukocytes (5.9±0.3 ×10³/mL, p<0.01 vs. DNCB), IgE (128±18 ng/mL, p<0.01 vs. DNCB), and MDA (2.3±0.4 µmol/L vs. 5.9±0.7 µmol/L in DNCB, p<0.001). Pro-inflammatory cytokines IL-4, IL-13, IL-17, IL-31, TGF-β, and TNF-α were also markedly decreased (all p<0.05), with effects comparable to tacrolimus.
Conclusion. Topical ezetimibe significantly alleviated DNCB-induced AD-like lesions by reducing histopathological changes, leukocyte infiltration, IgE, oxidative stress, and key inflammatory cytokines. These findings support ezetimibe as a potential adjunctive topical therapy for immune-mediated dermatoses, warranting future clinical evaluation
A retrospective study on sickle cell disease-associated cardiovascular anomalies
Get PDFIntroduction and aim. Sickle cell disease (SCD), a chronic inherited hemolytic disorder prevalent in certain regions of India and globally, is associated with various cardiovascular complications that significantly impact morbidity and mortality. The objective is to assess the relationship among clinical, electrocardiographic, and echocardiographic findings in individuals diagnosed with sickle cell disease, and, as a secondary aim, to contrast these findings with those observed in patients with SCTtaking into account different age groups across both sexes.
Material and methods. This study included thirty-four individuals previously diagnosed with sickle cell disease or SCTbased on hemoglobin electrophoresis. Clinical records were reviewed to obtain data from comprehensive examinations, including electrocardiographic and echocardiographic assessments. Cardiac function was evaluated, interpreted, and compared between the two groups using documented ECG and echocardiography results.
Results. A total of 34 participants were enrolled, including 23 individuals with SCD and 11 with sickle cell trait (SCT). The mean age was 28.6±9.3 years in the SCD group and 30.2±8.7 years in the SCT group (p=0.57). Males predominated in both groups (SCD: 65.2%; SCT: 63.6%). Clinical examination revealed a statistically significant higher frequency of displaced apex beat in the SCD group (60.9%) compared to SCT (18.2%) (p=0.03). Electrocardiographic abnormalities such as left ventricular hypertrophy were more common in SCD (47.8%) than SCT (18.2%) (p=0.04). ST-T changes were seen in 56.5% of SCD vs. 9.1% of SCT (p=0.01). Echocardiographic findings demonstrated significantly elevated pulmonary artery systolic pressure (PASP) in the SCD group (38.6±6.2 mmHg) compared to SCT (28.4±5.7 mmHg) (p < 0.001). Mean pulmonary artery pressure (mPAP) was also higher in SCD (25.3±4.8 mmHg) vs. SCT (19.2±3.9 mmHg) (p=0.002). Tricuspid regurgitation velocity (TRV) was elevated in SCD (2.9±0.3 m/s) compared to SCT (2.4±0.2 m/s) (p=0.001). Right ventricular dilatation and diastolic dysfunction were noted in 39.1% and 34.8% of SCD cases, respectively, while absent in SCT (p<0.05 for both). In univariate logistic regression, apex beat displacement (OR=4.6; p=0.04), elevated PASP (OR=5.2; p=0.01), increased mPAP (OR=4.3; p=0.02), and TRV (OR=6.1; p=0.009) were significant predictors of SCD. Multivariate logistic regression identified PASP as an independent predictor of SCD (OR=4.8; 95% CI: 1.3‒17.9; p=0.02).
Conclusion. The findings highlight that patients with sickle cell disease exhibit a significantly higher burden of cardiac abnormalities than those with sickle cell trait. Among the evaluated parameters, pulmonary artery systolic pressure emerged as an independent predictor of sickle cell disease
Apelin, C-reactive protein, and serum protein correlation with blood pressure ‒ a biomarker analysis
Get PDFIntroduction and aim. Hypertension is a major global health burden and a leading cause of cardiovascular disease and premature death. This study aimed to evaluate the association between serum apelin, inflammatory markers, and protein metabolism parameters in hypertensive patients compared to normotensive controls. This study uniquely explores the interplay between inflammatory and protein metabolism biomarkers using advanced multivariate models in hypertensive adults, a combination not previously examined in this population
Material and methods. Two hundred adults aged 35–65 years were divided into hypertensive (n=100) and normotensive (n=100) groups. Serum apelin and C-reactive protein (CRP) levels were measured using enzyme-linked immunosorbent assay, while albumin and total protein were assessed via spectrophotometry. Statistical analyses included t-tests, multiple regression, structural equation modeling (SEM), and Cox regression.
Results. Hypertensive patients had significantly higher blood pressure (p<0.001), CRP (7.52±4.21 vs. 1.35±0.51 mg/L; p<0.001), globulin (3.4±1.0 vs. 1.8±0.9 g/dL; p<0.001), and total protein, but lower apelin (2386.2±401.7 vs. 2873.4±572.8 pg/mL; p<0.001) and albumin levels. SEM revealed a direct association between CRP and systolic blood pressure (β=0.45, p<0.001), and a negative association between apelin and systolic pressure (β=−0.20, p=0.03). CRP (HR=1.75, p=0.005) and systolic BP (HR=1.52, p<0.001) were independent predictors of cardiovascular events.
Conclusion. The findings suggest that systemic inflammation and dysregulation of serum protein metabolism are significantly associated with hypertension and cardiovascular risk. Apelin may play a protective role by mitigating the impact of inflammation on blood pressure
Risk factors for ischemic stroke in the elderly in Morocco – a case-control study
Get PDFIntroduction and aim. Ischemic strokes occur most frequently in the elderly (more than 80%). This study aimed to determine the risk factors for ischemic stroke in elderly subjects in the Souss Massa region of southern Morocco.
Material and methods. Two hundred and thirteen cases and four hundred and thirty-two controls of the same age (76.51±2 years vs. 73.90±2 years) and sex were collected. Cases were selected from patients with ischemic stroke hospitalized in the neurology department of the regional hospital Souss Massa. All risk factors have been documented from interviews and review of patient medical records.
Results. Multivariate regression analysis showed that low-income families (odds ratios [OR]=4.19, 95% confidence intervals [95% CI] 2.886–6.09, p<0.001), residence area (urban OR=9.408, 95% CI 4.7133–18.778, p<0.001), high blood pressure (OR=62.984, 95% CI 26.7374–148.367, p<0.001), diabetes (OR=18.138, 95% CI 5.2320–62.880, p<0.001), are risk factors for ischemic stroke. On the contrary, health insurance (OR=0.295, 95% CI 0.1513–0.577, p<0.001) and marital status (in couple OR=0.448, 95% CI 0.284–0.708, p<0.001) are protective factors.
Conclusion. In addition to traditional risk factors of ischemic strokes such as high blood pressure and diabetes, low-income family as well as lack of health insurance and marital status (living with a partner) require particular attention. Integrating these new factors into public health strategies could significantly reduce the risk of stroke in the elderly
Antimicrobial activity of ozonated oils and their applications in medicine – a narrative review
Get PDFIntroduction and aim. Ozonated oils have emerged as promising agents due to their potent antimicrobial properties and broad therapeutic potential across various medical fields. This review aims to evaluate the antibacterial activity of ozonated oils, focusing on their applications in dermatology, dentistry, ophthalmology, gynecology, and proctology, while addressing their safety profiles and limitations.
Material and methods. This review compiles and evaluates peer-reviewed publications on the antibacterial properties and therapeutic uses of ozonated oils. The authors conducted a comprehensive literature review by searching through the largest scientific databases using Google Scholar, Google Patents, Scopus, Web of Science, and PubMed within the last 15 years.
Analysis of the literature. Ozonated oils exhibited strong antibacterial effects against a wide range of microorganisms, including those resistant to antibiotics. Their efficacy has been confirmed in treating conditions such as onychomycosis, oral and vaginal candidiasis, and MRSA skin infections, among others. Clinical studies highlight their ability to reduce symptoms and improve outcomes in ophthalmic applications as well. Despite their effectiveness there are limitations which include a lack of long-term safety data, insufficient number of studies conducted on human subjects.
Conclusion. Ozonated oils have a lot of potential as antimicrobials that can be used in a variety of medicinal fields. However, further clinical trials are needed to establish their long-term safety and efficacy
Mapping the use of virtual reality in health promotion and weight management among overweight and obese individuals ‒ a scoping review
Get PDFIntroduction and aim. Obesity and overweight, defined by excess body fat, are major global public health challenges. Virtual reality (VR) is emerging as a novel tool for health promotion and weight management. This scoping review aimed to map existing research on VR applications in overweight and obese populations.
Material and methods. Following PRISMA-ScR guidelines, systematic searches were conducted in PubMed, SCOPUS, EBSCO, Pedro, Embase, Web of Science, and Google Scholar up to March 2025. Keywords included ‘obese’, ‘overweight’ and “virtual reality.” Eligible studies were cross-sectional, experimental or randomized controlled trials involving overweight or obese individuals exposed to VR-based interventions targeting physical health, behavior change, or weight control. Two reviewers independently screened and extracted the data.
Results. Ten studies published between 2012 and 2025 were included. Most involved adolescents and women, with limited representation of men and older adults. VR interventions varied in immersion, platform, and focus, targeting physical activity, behavioral change, and nutrition. Outcomes commonly included body composition, physical activity, emotional well-being, and diet. Heterogeneity prevented meta-analysis.
Conclusion. VR holds promise as a multidimensional tool for the management of obesity. However, more inclusive, culturally adapted, and long-term studies are needed to validate its effectiveness and applicability in diverse populations
Design and testing of breathing retraining device a multiphasic exploratory study in healthy subjects
Get PDFIntroduction and aim. Traditional spirometers are limited by bulkiness and lack of biofeedback, which can hinder their effec tiveness in pulmonary rehabilitation. This study aimed to evaluate the accuracy of an innovative breathing retraining device in measuring inhaled volume and assess user satisfaction compared to standard spirometers.
Material and methods. A multiphasic exploratory study was conducted with 102 healthy adults (aged 18–60 years). The study included three phases: need analysis through focus group discussions, prototype development using polycarbonate materials and 3D printing, and effectiveness testing. Inhalation exercises were performed with both the new device and a standard spi rometer. Primary outcomes were inhaled volume and marker displacement, with user satisfaction assessed via the Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST 2.0) questionnaire.
Results. The new device showed a strong correlation between inhaled volume and marker displacement (r=0.842, p<0.001). The mean inhaled volume was 2.07±0.61 liters, with a mean marker displacement of 5.19±0.59 cm. The mean QUEST 2.0 satis faction score was 3.54, indicating high user satisfaction.
Conclusion. The redesigned breathing retraining device not only addresses critical gaps in existing technologies but also offers a practical, user-friendly solution for pulmonary rehabilitation. By combining accuracy, real-time feedback, and portability, this innovation has the potential to redefine respiratory therapy standards in both clinical and home-based settings, paving the way for broader applications and improved patient outcomes