Ladislav Mica - Academia.edu (original) (raw)

Papers by Ladislav Mica

Journal of Clinical Medicine

Introduction: Big data-based artificial intelligence (AI) has become increasingly important in me... more Introduction: Big data-based artificial intelligence (AI) has become increasingly important in medicine and may be helpful in the future to predict diseases and outcomes. For severely injured patients, a new analytics tool has recently been developed (WATSON Trauma Pathway Explorer) to assess individual risk profiles early after trauma. We performed a validation of this tool and a comparison with the Trauma and Injury Severity Score (TRISS), an established trauma survival estimation score. Methods: Prospective data collection, level I trauma centre, 1 January 2018–31 December 2019. Inclusion criteria: Primary admission for trauma, injury severity score (ISS) ≥ 16, age ≥ 16. Parameters: Age, ISS, temperature, presence of head injury by the Glasgow Coma Scale (GCS). Outcomes: SIRS and sepsis within 21 days and early death within 72 h after hospitalisation. Statistics: Area under the receiver operating characteristic (ROC) curve for predictive quality, calibration plots for graphical g...

Objectives: Early stabilization of the spine in severely injured patients aims to reduce ventilat... more Objectives: Early stabilization of the spine in severely injured patients aims to reduce ventilation time, rate of pneumonia as well as hospital stay without increasing injury-related complications rates. The aim of this study was to assess the influence of stabilization of the spine on the outcome [for full text, please go to the a.m. URL]

Introduction: Cervical ligamentous injuries in patients with ankylosing spondylitis (AS) may be d... more Introduction: Cervical ligamentous injuries in patients with ankylosing spondylitis (AS) may be difficult to detect, even with the utilization of computed tomography (CT) scans. The purpose of this study was to investigate the influence AS has on various radiologic parameters used to detect traumatic and degenerative pathologies of the cervical spine. Methods: A matched, case-control retrospective analysis of patients with AS and controls without AS admitted at two level-1 trauma centers was performed. All patients were admitted via shock room and received a polytrauma CT. Study patients were included if they had no injury to the cervical spine. Twenty-four CT parameters of atlanto-occipital dislocation/ instability, traumatic and degenerative spondylolisthesis, basilar invagination, and prevertebral soft-tissue swelling were assessed. Study patients were matched by age and sex. Results: A total of 78 patients were included (AS group, n=39; control group, n=39). The evaluated cervic...

European Journal of Medical Research, 2021

IntroductionResuscitative endovascular balloon occlusion of the aorta (REBOA) may be used in seve... more IntroductionResuscitative endovascular balloon occlusion of the aorta (REBOA) may be used in severely injured patients with uncontrollable bleeding. However, zone-dependent effects of REBOA are rarely described. We compared the short-term zone- and organ-specific microcirculatory changes in abdominal organs and the extremity during occlusion of the aorta in a standardized porcine model.MethodsMale pigs were placed under general anesthesia, for median laparotomy to expose intra-abdominal organs. REBOA placement occurred in Zone 1 (from origin left subclavian artery to celiac trunk), Zone 2 (between the coeliac trunk and most caudal renal artery) and Zone 3 (distal most caudal renal artery to aortic bifurcation). Local microcirculation of the intra-abdominal organs were measured at the stomach, colon, small intestine, liver, and kidneys. Furthermore, the right medial vastus muscle was included for assessment. Microcirculation was measured using oxygen-to-see device (arbitrary units, A...

European Journal of Trauma and Emergency Surgery, 2020

Trauma and Emergency Care, 2018

International Journal of Surgery Case Reports, 2017

Journal of neurotrauma, Jan 28, 2017

To evaluate group-by-time interactions between gray matter morphology of healthy controls and tha... more To evaluate group-by-time interactions between gray matter morphology of healthy controls and that of patients with mild traumatic brain injury (mTBI) as they transitioned from acute to chronic stages and to relate these findings to long-term cognitive alterations to identify distinct recovery trajectories between good (GO) and poor outcome (PO). High-resolution T1-weighted MR images were acquired in 49 mTBI patients within 7 days and 1 year post-injury and at equivalent times in 49 healthy controls. Using linear mixed-effects models, we performed mass-univariate analyses and associated the results of the interaction with changes in cognitive performance. Morphological alterations indexed by increased or decreased cortical thickness have been expected mainly in frontal, parietal and temporal brain regions. A significant interaction was found in cortical thickness, spatially restricted to bilateral structures of the prefrontal cortex showing thickening in mTBI and normal developmenta...

Frontiers in human neuroscience, 2017

Brain connectivity after mild traumatic brain injury (mTBI) has not been investigated longitudina... more Brain connectivity after mild traumatic brain injury (mTBI) has not been investigated longitudinally with respect to both functional and structural networks together within the same patients, crucial to capture the multifaceted neuropathology of the injury and to comprehensively monitor the course of recovery and compensatory reorganizations at macro-level. We performed a prospective study with 49 mTBI patients at an average of 5 days and 1 year post-injury and 49 healthy controls. Neuropsychological assessments as well as resting-state functional and diffusion-weighted magnetic resonance imaging were obtained. Functional and structural connectome analyses were performed using network-based statistics. They included a cross-sectional group comparison and a longitudinal analysis with the factors group and time. The latter tracked the subnetworks altered at the early phase and, in addition, included a whole-brain group × time interaction analysis. Finally, we explored associations bet...

European journal of medical research, Jan 13, 2016

Multiple trauma is often accompanied by systemic inflammatory response syndrome (SIRS). The aim o... more Multiple trauma is often accompanied by systemic inflammatory response syndrome (SIRS). The aim of this study was to investigate the impact of polymeric plasma substitutes on the development of SIRS or sepsis. We included 2969 patients aged ≥16 years with an Injury Severity Score (ISS) >16 in this study. The sample was subdivided into three groups: patients who did not receive colloids and those who received <5L colloids and >5L colloids within the first 48 h. Data were analyzed using IBM SPSS(®) for Windows version 22.0; analysis of variance was used for continuous normally distributed data and Kruskal-Wallis test for categorical data. The predictive quality of colloid treatment was analyzed using the receiver operating characteristic (ROC) curves. Independent predictively was analyzed by binary logistic regression. Data were considered significant if P < 0.05. Data are presented as the mean ± standard deviation. The SIRS score increased with the amount of colloid used ...

European journal of medical research, Jan 6, 2016

Although under discussion, induced hypothermia (IH) is an established therapy for patients with c... more Although under discussion, induced hypothermia (IH) is an established therapy for patients with cardiac arrest or traumatic brain injuries. The influences on coagulopathy and bleeding tendency in severely injured patients (SIP) with concomitant traumatic brain injury are most widely unclear. Therefore, the aim of this study was to quantify the effect of mild IH in SIP with concomitant severe traumatic brain injuries on transfusion rate and mortality. In this retrospective multi-centre study, SIP from three European level-1 trauma centres with an ISS ≥16 between 2009 and 2011 were included. At hospital A, patients qualified for IH with age ≤70 years and a severe head injury with an abbreviated injury scale (AISHead) of ≥3. IH was defined as target core body temperature of 35 °C. Hypothermic patients were matched with two patients, one from hospital B and one from hospital C using age and AISHead. The effect of IH on the transfusion rate, complications and mortality was quantified wit...

PRAXIS, 2015

Violent behaviour associated with alcohol consumption is frequently reported by different media. ... more Violent behaviour associated with alcohol consumption is frequently reported by different media. Clinical data analysing the correlation between alcohol intoxication, age, gender and violence are scarce. The aim of this study was to evaluate the influence of age, gender and blood alcohol content on violent behaviour under the influence of alcohol under central European conditions. Three hundred patients admitted to the emergency department were included into this study in the time period from January 01. to December 31. 2009. The inclusion criteria were a blood alcohol content (BAC) of ≥10 mmol/l, any traumatic injury and an age ≥16 years. Violence was defined as an evitable act committed by others leading to patient's hospitalisation. The data were compared with Wilcoxon and χ2-test for proportions. The data were considered as significant if p<0,05. Predictive quality was evaluated by using receiver operating characteristic (ROC) curve. Independent predictors were analyzed b...

The journal of trauma and acute care surgery, 2013

Obesity is a growing problem in western societies. The aim of this retrospective cohort study was... more Obesity is a growing problem in western societies. The aim of this retrospective cohort study was to determine the association between the overweight and obese polytrauma patients and pneumonia after injury. A total of 628 patients with an Injury Severity Score (ISS) of 16 or greater and 16 years or older were included in this retrospective study. The sample was subdivided into three groups as follows: body mass index (BMI) of less than 25 kg/m2; BMI of 25 kg/m2 to 30 kg/m2; and BMI more than 30 kg/m2. The Murray score was assessed at admission and at its maximum during hospitalization to determine pulmonary problems. Pneumonia was defined as bacteriologically positive sputum with appropriate radiologic and laboratory changes (C-reactive protein and interleukin 6). Data are given as mean ± SEM. One-way analysis of variance and the Kruskal-Wallis test were used for the analyses, and the significance level was set at p < 0.05; Bonferroni-Dunn test was performed as post hoc analysis...

Brain and skull injuries in patients with polytrauma lead mostly to adverse outcomes. We investig... more Brain and skull injuries in patients with polytrauma lead mostly to adverse outcomes. We investigated how such injuries influenced the physiology, infectious complications and outcomes. A total of 1465 patients with polytrauma were included in this retrospective cohort study with an Injury Severity Score (ISS) ≥ 16 and an age ≥ 16 years. The patients were subdivided into six groups according to the Abbreviated Injury Score (AIS) of the head. Marshall, Goris, Sequential Organ Failure Assessment (SOFA), Murray and Systemic Inflammatory Response Syndrome (SIRS) scores were calculated retrospectively. Infections were determined according to clinical signs and bacteremia. Data were analyzed using SPSS® 22.0; analysis of variance was used for continuous normally distributed data, the Kruskal–Wallis test was used for categorical data, and P < 0.05 was considered significant. The Marshall score increased along with the head AIS (P < 0.01). The Goris (P < 0.01) and SOFA (P < 0.01) score also increased significantly with increased head AIS. In the severe AIS groups the incidence of pneumonia was high (60%; P = 0.003) without correlation with the AIS of the thorax. Ventilator-assisted days increased significantly (P < 0.01) as well as the death rate (P < 0.01) along with the head AIS severity. The mortality reached 80% in the group with the maximum head AIS. These injuries have an adverse impact on physiology and outcome in polytrauma patients without being associated with the overall injury pattern. However, there appeared to be side effects of intensive-care-unit therapy on the patients’ physiology.

Case Reports in Gastroenterology, 2007

Liposarcoma represents one of the most frequent (10–20%) malignant mesenchymal tumors in the adul... more Liposarcoma represents one of the most frequent (10–20%) malignant mesenchymal tumors in the adult, affecting mostly the soft tissue of extremities, the trunk or the retroperitoneum. This tumor type occurs exceptionally rarely in the gastrointestinal tract with only few cases described in the literature. In this case we present a 73-year-old male patient who was admitted due to loss of weight, anorexia and postprandial emesis with dysphagy. Gastrographin esophagography failed to make precise diagnostics. CT scan of the upper gastrointestinal tract revealed a large esophageal tumor filling out the whole length of the esophagus. The tumor was removed by parasternocleidomastoidal approach with a stapler. Histopathological examination revealed a well-differentiated liposarcoma (grade I). Well-differentiated liposarcomas are characterised by amplified material of the 12q13–15 chromosomal region, present in the form of giant or ring chromosomes and leading to the overexpression of MDM2 an...

World Journal of Surgery, 2009

Psychosomatic Medicine, 2006

Journal of the American College of Surgeons, 2003

Reduction of PMN apoptosis during sepsis contributes to the pathogenesis of multiple organ failur... more Reduction of PMN apoptosis during sepsis contributes to the pathogenesis of multiple organ failure. Differential expression of Bcl-2 proteins, which participate in apoptosis regulation, may be responsible for the dysbalanced apoptosis seen in neutrophils from septic patients. In this study, expression of Mcl-1, Bid, Bcl-2, and Bax were investigated in septic neutrophils. PMN (1 x 10(6)/mL) from septic patients (n = 16) or healthy volunteers (n = 10) were incubated with either lipopolysaccharide (1 microg/mL), agonistic CD95 antibody (100 ng/mL), or medium for 16 hours. Apoptosis was quantified in FACS after propidium iodine staining. Mcl-1, Bid, Bcl-2, and Bax mRNA expression was detected by reverse transcriptase-polymerase chain reaction and protein determined by Western blot analysis. Spontaneous apoptosis was significantly reduced in PMN from septic patients (28.8% versus 64.0% in controls). Mcl-1 protein levels decreased in patients after 16 hours but remained stable in controls. Mcl-1 mRNA was found in freshly isolated PMN from controls and patients but remained elevated only in patients. Bid protein level decreased significantly in control PMN undergoing apoptosis but differences were less prominent in septic patients. Bid mRNA was detected only in freshly isolated PMN. No Bcl-2 mRNA or protein was detected in neutrophils from patients or controls, and detectable Bax protein and mRNA levels remained unchanged in all samples. Alterations of Bid and Mcl-1 protein in neutrophils may reflect the level of apoptosis. The upregulation of Mcl-1 mRNA in patients with sepsis suggests an active role for Mcl-1 in regulation of apoptosis during sepsis; Bax remains unchanged.