Robert Vyšehradský

Comenius University Bratislava · Clinic of Pneumophthisiology

Non-invasive positive pressure ventilation (NIPPV) is increasingly used as a treatment method for patients with respiratory failure. The first recommendations for the use of NIPPV in Slovakia were developed by the Slovak Society of Pulmonology and Phthisiology in 2007 and were partially revised in 2015. New scientific evidence prompted the present...

The aim of this study was to detect whether the COVID-19 pandemic has caused changes in the sleep cycle (subjective sleep shifts) of high school students divided into a sample of young women – W (n = 1999, age = 17.65 ± 2.39 y) and young men – M (n = 1094, age = 17.49 ± 1.74 y) in Slovakia depending on circadian preference in comparison with the te...

Metabolomics is a relatively new research area that focuses mostly on the profiling of selected molecules and metabolites within the organism. A SARS-CoV-2 infection itself can lead to major disturbances in the metabolite profile of the infected individuals. The aim of this study was to analyze metabolomic changes in the urine of patients during th...

Several relatively recently published studies have shown changes in plasma metabolites in various viral diseases such as Zika, Dengue, RSV or SARS-CoV-1. The aim of this study was to analyze the metabolome profile of patients during acute COVID-19 approximately one month after the acute infection and to compare these results with healthy (SARS-CoV-...

Background: Patients with idiopathic pulmonary fibrosis (IPF) frequently have multiple comorbidities, which may influence survival but go under-recognised in clinical practice. We therefore report comorbidity, antifibrotic treatment use and survival of patients with IPF observed in the multi-national EMPIRE registry. Methods: For this prospectiv...

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), that spread around the world during the past 2 years, has infected more than 260 million people worldwide and has imposed an important burden on the healthcare system. Several risk factors associated with unfavorable outcome were identified, including elderly age, selected comorbidities,...

This report presents a rare case of adolescent patient treated by novel antidepressant vortioxetine for depressive disorder comorbid to narcolepsy type 1 (NT1) and newly diagnosed REM behavior disorder (RBD) and describes the overall clinical improvement of the conditions. Additionally, we discuss effect of vortioxetine on sleep architecture by eva...

Background: COVID-19 represents a severe inflammatory condition. Our work was designed to monitor the longitudinal dynamics of the metabolomic response of blood plasma and to reveal presumable discrimination in patients with positive and negative outcomes of COVID-19 respiratory symptoms. Methods: Blood plasma from patients, divided into subgroups...

The velocity of the COVID-19 pandemic spread and the variable severity of the disease course has forced scientists to search for potential predictors of the disease outcome. We examined various immune parameters including the markers of immune cells exhaustion and activation in 21 patients with COVID-19 disease hospitalised in our hospital during t...

Itch is the most common chief complaint in patients visiting dermatology clinics and is analogous to cough and also sneeze of the lower and upper respiratory tract, all three of which are host actions trying to clear noxious stimuli. The pathomechanisms of these symptoms are not completely determined. The itch can originate from a variety of etiolo...

Introduction: Sarcoidosis is a multisystem granulomatous disease of unknown aetiology, commonly involving the lungs. Cough is a frequent and troublesome symptom of sarcoidosis that reduces patients' quality of life. Aim: Retrospective analysis of different factors-smoking history, Scadding stage, results of lung function testing, calcium metabol...

Sarcoidosis is a granulomatous multisystemic disease of unknown cause most often affecting the lungs, lymph nodes of the pulmonary hilus, eyes, skin, and other structures including central (CNS) or peripheral nervous system (PNS). Isolated neurosarcoidosis is extremely rare. The diagnosis of isolated neurosarcoidosis is challenging because of its r...

Aims: Many patients with idiopathic pulmonary fibrosis (IPF) have a delay in diagnosis and thus also in treatment. We investigated whether such delay influenced survival and treatment response to pirfenidone and nitedanib. Methods: The retrospective study used data from European Multipartner IPF registry (EMPIRE). 1170 IPF patients were divided to...

Most patients with IPF have comorbidities, which affect functional status, quality of life and survival. Our study aims are to analyze comorbidities in a series of 1210 IPF patients from the EMPIRE registry (European Multipartner IPF registry). Comorbidities were noted in 85.6% (1036pts), one in 23.5%, 2 in 23.0% and 3 or more in 53.5%. Median age...

Key feature of IPF is decline in forced vital capacity (FVC) and CO diffusion (DLco), but data on clinical determinants of this change in patients who have established disease are scarce. For a given patient it is unknown if different natural histories represent distinct phenotypes of IPF or if geographic, ethnic or other factors might have influen...

Discussed in the review are practical issues regarding the pharmacological treatment of idiopathic pulmonary fibrosis (IPF). Particular attention is paid to recently approved antifibroproliferative therapy. Presented are results of recently published clinical trials focused on the efficacy and safety of antifibroproliferative therapy and metaanalys...

Presented are results of a retrospective analysis of clinical data. First, the value of the CD4+/CD8+ T-lymphocyte ratio for diagnosing sarcoidosis was assessed based on analysis of 241 samples of bronchoalveolar lavage fluid (BALF) from patients with various diseases. An optimal cut-off ratio of 3.5:was determined by to receiver operating characte...

A retrospective analysis of spirometry tests performed in 102 patients with chronic obstructive pulmonary disease, matching the American Thoracic Society and European Respiratory Society reproducibility and acceptability criteria is presented. Measured values of FEV6 and FVC were compared and correlated. The difference between FVC and FEV6 was calc...

Hyperkinetic disorder / ADHD is the most frequently mental disorder in children and is often related with other psychiatric disorders including sleep disorders. Primary sleep disorders are also common in childhood and they can present as hyperkinetic syndrome during the day. This paper offers review of current knowledges of mutual relationships bet...

The paper is focused on particularity of selected sleep disorders in childhood: insomnia, obstructive sleep apnea, narcolepsy, somnambulism and sleep terrors. Some atypical symptoms and differences in clinical picture of these disorders are emphasized in comparison with adult age, which are important in differential diagnosis of somatic and mental...

Relationship between serum vascular endothelial growth factor (VEGF) level and parameters of endothelial injury and/or dysfunction in patients with diabetes mellitus type 2 with or without microalbuminuria was investigated. Eighty-four diabetic patients were divided in two subgroups (42 each): normoalbuminuric (NAU) and microalbuminuric (MAU). Fort...

The aim was to determine the percentage of eosinophilic leukocytes and the level of eosinophilic cationic protein (ECP) in induced sputum of patients with seasonal allergic rhinitis without clinical signs of bronchial asthma, and to compare their levels during and outside the pollen season. For this purpose, twenty patients with seasonal allergic r...

The authors present the case of a 25-year-old woman presenting with systemic lupus erythematosus (SLE), in whom at the age of 24 an embolism of the pulmonary artery was diagnosed. The progressing exercise dyspnoea and a serious deteriorating pulmonary hypertension called for a revision of the diagnosis and an attempt to start a therapy aimed at mod...

Authors present the first results of a project focused on epidemiology of sleep-related breathing disorders in Slovakia. An anamnestic questionnaire, which diagnostic value was determinated in previous study using correlation with the results of polysomnographic studies, was mailed to 1600 responders from Martin county, randomized from the database...

A clinical study, which evaluates potential use of original anamnestic questionnaire for detection of serious sleep-related breathing disorders, is presented. The for detection of serious sleep-related breathing disorders most important parameters of the questionnaire, were selected using multiple regression. Then a simplified evaluation of the que...

A clinical study, which evaluates potential use of original anamnestic questionnaire for detection of serious sleep-related breathing disorders, is presented. The for detection of serious sleep-related breathing disorders most important parameters of the questionnaire, were selected using multiple regression. Then a simplified evaluation of the que...

The aim of these clinical serie was to evaluate, which pressure from the automatic nCPAP titration is the lowest effective pressure for treatment of obstructive or mixed (predominantly obstructive) sleep apnea/hypopnea syndrome. Thirty six patients with the diagnosis mentioned above of the moderate or severe stage are analyzed. Automated titration...

The authors submit a cross-sectional analysis of out-patient pharmacotherapy of chronic obstructive lung disease in 138 patients where long-term home oxygen therapy was indicated. To this group of patients no inhalatory bronchodilatating drugs were administered in 19.6% of the patients! The authors provide evidence of a non-significant better survi...

The authors present a clinical observation with the objective to test which objective indicators make it possible to predict the effect of treatment in patients with cryptogenic fibrotizing alveolitis. Retrospective analysis of the documentation of a longitudinal follow up of 34 patients with this diagnosis revealed that the presence of fibroprolif...

A review of current knowledge about therapy of cryptogenic fibrosing alveolitis is presented. Authors try to answer the questions like which patients should be treated, how to choose the medicine, what dose is appropriate, when and on which criteria to evaluate the treatment effectivity and how long should be the treatment. The treatment effectivit...

Sleep related breathing disorders represent life threatening disorders for cardiovascular and neuropsychiatric complications. Sleep apnea syndrome is evaluated in Slovak Republic since 1990. Four sleep laboratories are established with polysomnography ALICE 3. 628 investigations together were realized till March 31, 2000. Except diagnostic and ther...

Medical doctors should be the leaders in tobacco prevention activities. As role models for their patients and as helpers, leaders and activists, they are needed in campaigns to reduce smoking. We were interested in the smoking behaviour and attitudes towards smoking of Slovak medical students, who represent the next generation of medical doctors.

Authors present outcomes of automatic nCPAP-titration using AutoSet(TM)- machine in 12 patients with obstructive and mixed sleep apnoea/hypopnoea syndrome followed by constant nCPAP set-up according to the outcomes of the automatic titration in 7 patients. Highly significant decrease of sleep- related breathing disorders was observed both during au...

Authors refer about an analysis of community acquired pneumonias in a group of 108 patients. They present the results of microbiological analysis of sputum. Authors show a low profitability of this examination in clinical conditions. The most frequent etiological agent in the investigated group were Klebsiellas and Haemophiluses. The most frequent...

Authors present a review of papers concerning the use of pulse oxymetry in the diagnostics of sleep disordered breathing. They state the sensitivity and specificity of this examination (66.0-100.0 %, and 41.0-75.0 %) and its positive and negative predictive value (61.4-90.0 %, and 94.0-96.9 %) according to literature sources. Authors discuss the ad...

Authors present the results of a prospective study with the aim of evaluate the effectivity of the AutoSet(TM)- monitoring in the diagnostication of obstructive sleep apnoea syndrome. Authors in a group of 20 patients compare the results of this monitoring with simultaneously provided polysomnographic recordings. They evaluate the sensitivity of th...

Authors present a comparison of ergospirometric examinations results calculated from blood gases using arterial and arterialized capillary blood. On the basis of 84 examinations made during the past 5 years they document the unsubstituable role of arterial blood for valuable results of these examinations. They found significant differences between...

Authors present their experiences with high resolution computerised tomography (HRCT) in the diagnostics of fibrosing alveolitis (FA) in a group of 16 patients. They compare HRCT findings with the results of histologic examination of lung biopsy, made in 10 patients. In the examined group they found one false negative and one false positive HRCT re...