Cardiovascular diseases are among the leading causes of morbidity and mortality, particularly in individuals with type 2 diabetes. There is a need for new biomarkers to improve the prediction of cardiovascular events and overall mortality. We investigated the association of selected atherosclerosis related biomarkers, specifically osteoprotegerin (OPG), 25-hydroxy-vitamin D (25(OH)D), C-reactive protein (CRP), lipopolysaccharide-binding protein (LBP), and asymmetric dimethylarginine (ADMA), with the occurrence of any cardiovascular event or all-cause mortality (primary outcome) during a 5.6-year follow-up of 190 patients with type 2 diabetes. Data were analyzed using logistic regression to adjust for baseline cardiovascular status and cardiovascular risk factors. The primary outcome occurred in 89 participants (46.8%) during the study. When analyzed individually, 25(OH)D, CRP, and LBP significantly predicted the primary outcome in multivariable models. However, in a model that included all biomarkers, only a decreased level of 25(OH)D remained a significant predictor of the primary outcome. Moreover, the level of 25(OH)D significantly predicted all-cause mortality: a reduction of 10 ng/mL was associated with a two-fold increase in all-cause mortality. Our study thus demonstrates that vitamin D deficiency was the strongest factor associated with the primary outcome and all-cause mortality after a 5.6-year follow-up in patients with type 2 diabetes at high cardiovascular risk.

The Natura 2000 network is the key tool for preserving biodiversity in the EU. However, such a system of territorial protection is under increasing anthropogenic pressure and sites with no national designation are managed rather insufficiently across Europe. Therefore, we investigated six selected large areas consisting of Natura 2000 sites in the Czech Republic, which are not designated as national large-scale protected areas, analysed their landscape development over the last 70 years, and considered their suitability for establishment as national protected areas. All studied Natura 2000 sites have suitable conditions to become national protected areas; lower anthropogenic pressure than in current nationally protected areas and also natural and close-to-natural land cover in the vast majority of the areas. Moreover, designation of these areas as nationally protected areas could contribute significantly to ensuring connectivity between protected areas and could enhance proper management of the areas, which is especially needed in some valuable but vulnerable regions.

Background: The Alpha (B.1.1.7) and Omicron (B.1.1.529) waves of COVID-19 represented contrasting epidemiological phases in Slovakia, differing in severity, immunity, and outcomes. We aimed to compare clinical and immunological characteristics of hospitalized patients and identify predictors of mortality. Methods: A retrospective observational study was conducted including 609 adults hospitalized with RT-PCR-confirmed COVID-19 and ultrasound-verified viral pneumonia at the Department of Infectology and Travel Medicine in Košice. The Alpha cohort comprised 299 patients (January–March 2021) and the Omicron cohort 310 patients (January–March 2022). Demographic, clinical, and laboratory parameters were analyzed, focusing on lymphocyte subsets (CD4⁺, CD8⁺, CD19⁺), IL-6, lactate, and the neutrophil-to-lymphocyte ratio (Ne/Ly). Mortality associations were assessed using relative risk (RR) and 95% confidence intervals (CI). Additionally, we developed a composite risk score integrating six binary laboratory parameters. Results: Mortality decreased from 20.7% during Alpha to 6.8% during Omicron (p < 0.001). Low CD4⁺ and CD8⁺ T-cell counts, elevated IL-6, and high Ne/Ly were strong mortality predictors in both waves. IL-6 > 50 ng/L increased mortality risk nearly eightfold during Alpha and ninefold during Omicron (p < 0.001). CD19⁺ lymphopenia and elevated lactate were significant predictors only during Alpha. Vaccination during Omicron reduced mortality almost tenfold (p = 0.005). The composite score demonstrated a stepwise increase in mortality with higher values, indicating its potential utility as an exploratory prognostic tool. Conclusions: Mortality risk factors varied between waves, reflecting differences in variant virulence and population immunity. Incorporating immunological and inflammatory markers into prognostic models can improve risk stratification. The proposed composite score may aid in early identification of high-risk COVID-19 patients.

Arterioven?zne fistuly s? pova?ovan? za preferovan? cievny pr?stup pre pacientov s potrebou dlhodobej hemodial?zy. Ich vynikaj?ca priechodnos? spolu s n?zkou mierou infekci? a reintervenci? v porovnan? s centr?lnymi ven?znymi kat?trami a arter... Arterioven?zne fistuly s? pova?ovan? za preferovan? cievny pr?stup pre pacientov s potrebou dlhodobej hemodial?zy. Ich vynikaj?ca priechodnos? spolu s n?zkou mierou infekci? a reintervenci? v porovnan? s centr?lnymi ven?znymi kat?trami a arter...

Background: Brucellosis is a zoonotic infection with diverse clinical manifestations. Pulmonary involvement is rare—occurring in less than 1% of cases—and typically limited to endemic regions. In Slovakia, where brucellosis is non-endemic, human cases are exceptional. We present a rare and severe respiratory form of brucellosis in a patient with occupational exposure to livestock. Case presentation: We describe a 40-year-old female dairy farm worker admitted with fever, chills, and dyspnea. Initial workup revealed mild laboratory abnormalities and chest infiltrates. Despite empirical antibiotics, her condition rapidly progressed to acute respiratory distress syndrome (ARDS), acute kidney injury, and septic shock. Mechanical ventilation and vasopressor support were required. Serological testing confirmed Brucella abortus infection. Antibiotic therapy was escalated to tigecycline and meropenem, with subsequent clinical improvement. Follow-up imaging showed significant regression of pulmonary infiltrates. The patient completed a six-week course of doxycycline and fully recovered. Conclusion: This case underlines the importance of considering brucellosis in febrile patients with livestock exposure, even in non-endemic settings. Severe pulmonary forms are rare but life-threatening. Early recognition, targeted antibiotic therapy, and multidisciplinary care are critical for favorable outcomes.

Summary: Cholestasis syndrome is accompanied by a large number of diverse liver and biliary tract diseases. Many cholestatic changes are fully reversible in the fi rst phase. However, with long-term cholestasis, extensive hepatocyte dysfunction occurs, the disease progresses, and many cholestatic syndromes result in irreversible liver damage and failure. Cholestatic liver diseases represent an important group of liver diseases that are an indication for liver transplantation. Postcholecystectomy syndrome is an imprecisely defi ned term, which includes a set of ongoing or recurrent or new diffi culties of patients after gallbladder surgery. We distinguish between early postcholecystectomy syndrome immediately in the postoperative period, or late postcholecystectomy syndrome, which occurs months or even years later. Ultrasonography is the fi rst imaging examination method for diseases of the liver and hepatobiliary system. It is a non-invasive method, available, relatively cheap, easily repeatable, and it does not represent a burden for the patient. Common bile duct dilatation after cholecystectomy is a common accidental fi nding that is inconclusive in the absence of clinical symptomatology and with normal laboratory fi ndings. Ursodeoxycholic acid forms the basis of cholestasis therapy, the only treatment whose effi cacy in cholestatic liver disease has been demonstrated in randomized and long-term studies. A further positive is that many years of ursodeoxycholic acid administration are not accompanied by more serious side eff ects. This case report supports the concept of a prompt and at the same time deepening benefi cial eff ect of ursodeoxycholic acid treatment in patients with cholestatic hepatopathy verified by ultrasonography indicated for conservative treatment or refusing invasive treatment. Key words: cholestasis – postcholecystectomy syndrome – ultrasonography – ursodeoxycholic acid