The possible role of machine learning in detection of increased cardiovascular risk patients - KSC MR Study (design).

Introduction: Currently, just a few major parameters are used for cardiovascular (CV) risk quantification to identify many of the high-risk subjects; however, they leave a lot of them with an underestimated level of CV risk which does not reflect the reality. Material and methods: The submitted study design of the Kosice Selective Coronarography Multiple Risk (KSC MR) Study will use computer analysis of coronary angiography results of admitted patients along with broad patients' characteristics based on questionnaires, physical findings, laboratory and many other examinations. Results: Obtained data will undergo machine learning protocols with the aim of developing algorithms which will include all available parameters and accurately calculate the probability of coronary artery disease. Conclusions: The KSC MR study results, if positive, could establisha base for development of proper software for revealing high-risk patients, as well as patients with suggested positive coronary angiography findings, based on the principles of personalised medicine.

Outbreak of Alimentary Tick-Borne Encephalitis in Eastern Slovakia: An Analysis of Affected Patients and Long-Term Outcomes.

OBJECTIVE: Tick-borne encephalitis (TBE) is an endemic zoonotic viral disease in many European countries and in the central and eastern parts of Asia. Slovakia reports the highest occurrence of alimentary tick-borne encephalitis in Europe, after the consumption of unpasteurized milk and cheese from domestic ruminants. In May 2016, an outbreak of tick-borne encephalitis that emerged after the consumption of sheep cheese occurred in eastern Slovakia. In total, 44 people were ill and 36 were hospitalized. METHODS: Data from the 36 hospitalized patients at the Department of Infectology and Travel Medicine in Kosice with TBE were retrospectively analysed from the medical documentation. The patients were contacted 3 years after discharge. RESULTS: Twenty of the hospitalized patients had meningoencephalitis and 16 had meningitis. The main symptoms that occurred in all patients were fever and headache. Nuchal rigidity was seen in 50% of the patients. Three patients developed late systemic complications and another six patients had psychiatric complications. None of the patients died. Three years after the disease onset, 52% of contacted patients reported persistent discomfort. CONCLUSIONS: TBE is an infection with a wide range of clinical courses. Our findings suggest that alimentary-acquired TBE lead to severe disease and persistent discomfort.

Seroprevalence of hepatitis E among hospitalized patients in Slovakia: first report.

OBJECTIVE: Hepatitis E infection is one of the most frequent acute hepatitis in the world. Currently five human genotypes with different geographical distributions and distinct epidemiologic patterns are identified. In Slovakia, only rare cases of hepatitis E have been reported in recent years. Therefore, the aim of the study was to evaluate the prevalence of anti-HEV total antibodies and the main risk factors for HEV in the general population in Eastern Slovakia. METHODS: Detection of anti-HEV total antibodies samples was done by a commercial enzyme-linked immunosorbent assay (ELISA) kit. RESULTS: Of 175 hospitalized patients included in the study, 76 (43.5%) showed positivity for anti-HEV total antibodies. No statistically significant differences were found in anti-HEV positivity between men and women or in the groups of different living areas (town/village - urban/rural). CONCLUSION: Prevalence of anti-HEV total antibodies of hospitalised patients was high. The risk factor significantly associated with antibody positivity was eating raw meat. Other factors, such as sex, age, living area and contact with animals were not associated with antibody positivity.

[Tick-borne encephalitis in a pregnant patient].

There is a lack of information in the literature about the course and risk of vertical transmission of tick-borne encephalitis (TBE) during pregnancy. Presented is a case report of a female patient in the 37th week of pregnancy infected by foodborne transmission. She developed meningitis with no neurological damage. Three weeks after the first symptoms, she gave birth to a healthy child who, at the age of 30 months, had a negative result of anti-TBE antibodies in both IgM and IgG classes. In the child, no signs of neurological injury or impaired psychomotor development were observed throughout the follow-up period.

Case of human Dirofilaria repens infection manifested by cutaneous larva migrans syndrome.

Dirofilaria repens, parasite of subcutaneous tissues of dogs and other carnivores, represents high infection risk for animals and humans in Europe. In men, infection usually presents as nodule in subcutaneous tissues or, less often, the lesions are localised around the eyes. The work presents first confirmed clinical case of human D. repens infection connected with cutaneous larva migrans syndrome. In patient, the migration of the worm caused true signs of creeping eruption, elevated sinuous track under the skin. It was connected with severe pain, burning and erythema of adjacent skin. Symptoms appeared at least three times, approximately once a month, always in the evening or night and lasted from several minutes to several days. In December 2014, during the scratching of residual pruritic lesion, patient removed 6-cm long, whitish worm from the wound. Morphological features (longitudinal ridges) and PCR amplification of cytochrome oxidase subunit 1 (CO1) confirmed Dirofilaria repens as etiological agent of infection. Herein, presented case confirmed that D. repens infection in humans can be associated with real creeping eruption, clinical sign of cutaneous larva migrans and should be included in its differential diagnosis.

Regional and ethnic aspects of viral hepatitis B among pregnant women.

OBJECTIVES: The aim of this study was to determine the prevalence of HBV infection among pregnant women in districts of Eastern Slovakia with a diverse prevalence of Roma population. METHODS: Overall 59,279 serum samples from 9 regional departments of clinical microbiology from Eastern Slovakia were collected in the period from January 2008 till December 2009 and analysed. RESULTS: The number of HBsAg positive samples overall and during pregnancy was 1.74% and 2.12%, respectively. Comparing districts with higher (> 5%) and lower (< 5%) Roma population, there was no significant difference in the prevalence of HBsAg positive samples overall (1.95% vs.1.62%). However, in the subgroup of pregnant women the prevalence of HBsAg positive samples (2.72% vs. 0.95%) differs significantly (p < 0.01). CONCLUSIONS: The prevalence of HBV infection among pregnant women in Eastern Slovakia did not rapidly exceed the estimated nationwide prevalence. However, in districts with higher Roma population the expected higher prevalence of HBV infection was confirmed. This indicates the need to pay special attention to the prevention of hepatitis B in these districts.

[Experiences with the treatment of chronic hepatitis C and prognostic factors for its efficacy in clinical practice]. / Skúsenosti s liecbou chronickej hepatitídy C a prognostické faktory jej úspesnoti v klinickej praxi.

OBJECTIVE: The study aimed at evaluating antiviral therapy and the impact of selected factors on its efficacy in patients with chronic hepatitis C treated at the Department of Infectology and Travel Medicine in Kosice, Slovakia, between 2003 and 2007. MATERIAL AND METHODS: A retrospective analysis of a group of 213 patients treated for chronic hepatitis C and of prognostic factors for treatment efficacy in a subgroup of 159 patients who completed therapy with pegylated interferon alpha and ribavirin. RESULTS: From the entire group, 193 patients were treated with a combination of pegylated interferon and ribavirin, 5 received pegylated interferon monotherapy and in 15 cases, conventional interferon was used. A total of 179 patients (84 %) were treated for the first time, the remaining 34 patients were treated repeatedly. Genotype 1 was detected in 91.5 % of 189 studied patients. Liver biopsy was performed in 143 patients, with mild, moderate and severe histological changes or liver cirrhosis being detected in 46.9 %, 38.5 % and 14.7 % of them, respectively. In 12.2 % of cases, treatment was discontinued due to adverse effects. In the group of 159 patients who completed therapy, sustained viral response (SVR) was found in 35.8 %; another 12.6 % had viral response at the end of therapy (SVR has not been assessed as yet). Viral relapse or breakthrough were observed in 26.4 % and 25.2 % showed no response. Patients who achieved SVR were more frequently infected with genotypes 2 and 3, had lower degrees of liver fibrosis, lower mean age and more frequently achieved complete early viral response. By contrast, the group of non-responders was characterized by a higher proportion of patients with reduced therapy below 80 %. The other observed differences such as male/female ratio, weight, proportion of patients with normal ALT activity or proportion of previously untreated patients were not significant. CONCLUSION: The efficacy of treatment in our group adjusted for the adverse proportion of genotypes and proportion of patients with repeated therapy was comparable with the literature data. The favorable prognostic factors observed in the group included infection with genotypes 2 or 3, lower degree of liver fibrosis and lower age.