Fulltext search in archive

This is a comparison of postoperative distress related to selected surgical techniques: conventional open surgery (OS) and transoral robotic surgery (TORS) used in the treatment of base of tongue and supraglottis malignant tumours. There were statistically significant deviations in two main areas: blood loss and somatic problems. The study confirms that there are significant differences between the use of TORS and conventional open surgery for the removal of malignant carcinomas located in the tongue base or supraglottis.

The authors report on the development and preliminary validation of a new prognostic scale (the COPD Prognostic Score - CPS) using a retrospective analysis of the National Emphysema Treatment Trial cohort. The CPS included: the age mMRC dyspnea scale, post-bronchodilator FEV1 (% predicted), hemoglobin level, respiratory emergency admission rate and daily activity. The CPS ranged from 0 to 16, with 16 indicating the poorest prognosis. A one-point increase in the CPS was associated with an increase,in all-cause death (with a HR of 1.28). The preliminary validation suggests that the CPS (new prognostic scale) had a slightly better prognostic ability than the BODE index and the ADO index. Future validation in a prospective cohort is anticipated.

This paper is an overview of the impact of the human gut microbiota on the metabolism of drugs in the intestinal lumen, on the pharmacokinetics of orally administered drugs and the links between xenobiotics and the composition of the gut microbiota leading to variations in response to medication.

This study is the only one demonstrating the absence (using both polymerase chain reaction and electron microscopy) of Borrelia burgdorferi in the myocardium of subjects with normal left ventricular systolic function and no history of Lyme disease or myocarditis. The absence of B. burgdorferi in these individuals supports the idea of its pathogenicity in the development of dilated cardiomyopathy.

Aims: To assess the impact of autologous serum eye drops on the level of ocular surface apoptosis in patients with bilateral severe dry eye disease. Methods: This prospective study was conducted on 10 patients with severe dry eye due to graft versus host disease (group 1) and 6 patients with severe dry eye due to primary Sjögren's syndrome (group 2). Impression cytology specimens from the bulbar conjunctiva were obtained before and after a three-month treatment with 20% autologous serum eye drops applied a maximum of 12 times a day together with regular therapy with artificial tears. The percentage of apoptotic epithelial cells was evaluated immunochemically using anti-active caspase 3 antibody. Results: In group 1, the mean percentage of apoptotic cells was 3.6% before the treatment. The three-month treatment led to a significant decrease to a mean percentage of 1.8% (P = 0.028). The mean percentage of apoptotic conjunctival cells decreased from 5.4% before the treatment to 3.8% in group 2; however, these results did not reach the level of significance. Conclusion: Three-month autologous serum treatment led to the improvement of ocular surface apoptosis, especially in the group of patients with severe dry eye due to graft versus host disease. This result supports the very positive effect of autologous serum on the ocular surface in patients suffering from severe dry eye.

Ureterocele in duplex kidney leads to more serious damage of upper pole kidney parenchyma than ectopic ureter. Upper pole function 3% or less in the case of ureterocele and 2% or less in the case of ectopic ureter indicates irreversible parenchymal damage. Ultrasound examination of duplex kidney is not able to predict the severity of histological lesions of upper pole parenchyma.

This paper is a concise review of the available data on the potential importance of MDR1/P-gp in respiratory disease pathogenesis and treatment. The literature includes references to experimental in vitro and in vivo investigations, and clinical results on MDR1 genetic polymorphisms and P-gp expression levels which aim to elucidate their influence on chronic obstructive pulmonary disease and different types of lung tumor pathogenesis and treatment.

Background: During the past nine years three cases of cystic adventitial disease of the popliteal artery have been diagnosed and treated in our medical institution. Different approaches were used in the treatment in all these cases. The purpose of this report is to summarise the current knowledge of the etiology, presentation, diagnostics and treatment of this condition, with the addition of new cases. Methods: Information about three new cases is presented and discussed together with that from the relevant publications obtained from the Pubmed database. Results: In the first case resection with synthetic graft interposition was used. Nine years after the surgery the patient is without any signs of recurrence, but he experienced local thrombolysis of the occluded graft and repeated PTA of hemodynamically significant anastomotic stenoses. The second case treated with US-guided aspiration has demanded repeated reinterventions due to recurrence; nevertheless, the result is satisfactory. In the last instance, the cyst was evacuated and excised. Six months after the surgery the patient is symptom-free and without signs of recurrence. Conclusions: CAD of the popliteal artery is a rare vascular condition. However, it must be considered in the differential diagnosis, especially in middle-aged male patients without evidence of atherosclerotic disease in whom intermittent claudication has developed suddenly with a rapid progression or with fluctuation in severity. Duplex ultrasound and MRA are the the best diagnostic methods. Based on the existing knowledge, the treatment of choice is surgery (either evacuation with the removal of the cystic wall or resection and grafting).

Aims: The aim of this review was to summarize recent knowledge of the structure and function of a transcriptional repressor, B lymphocyte induced maturation protein 1 (BLIMP1) and its participation in the pathogenesis of B lymphomas. Methods and results: This review summarizes the structure and function of BLIMP1, its major target genes and its role as a tumour suppressor in B cell lymphomas. We review our recent data implicating the loss of BLIMP1α as an important step in the pathogenesis of the Epstein-Barr virus (EBV) associated B cell lymphomas. Conclusions: BLIMP1 is a transcriptional repressor essential for the differentiation of germinal centre (GC) B cells to plasma cells. The loss of BLIMP1 in GC B cells could contribute to the pathogenesis of EBV-associated lymphomas by preventing plasma cell differentiation and viral replication.

Background: ADAM33 and STAT6 belong to the candidate genes that have been commonly associated with asthma, bronchial hyperresponsiveness or IgE levels. Our objective was to assess the association of 11 SNPs of the ADAM33 and 6 of the STAT6 and their haplotypes with IgE levels and asthma. We also evaluated the possible role of parental origin of haplotypes on IgE levels. Methods: We enrolled 109 children with asthma and 45 healthy controls. Genotyping was performed by TaqMan probes and confirmed by sequencing. Haplotype construction was based on the knowledge of parental genotypes and also inferred by using the EM algorithm and Bayes' theorem. Results: None of the SNPs were associated with elevated IgE level or asthma. We found that the most frequent STAT6 haplotype ATTCAA (built from rs324012, rs324011, rs841718, rs3024974, rs3024974, rs4559 SNPs, respectively) was associated with elevated total IgE levels (P=0.01) and this haplotype was predominantly transmitted paternally (P<0.001). We compared our results with those of studies performed on German and Australian Caucasian populations and found that rs324011, rs3024974 and rs4559 SNPs in STAT6 should have a major effect on IgE levels. Therefore, we suggest the TCA haplotype alone (built from rs324011, rs3024974 and rs4559 SNPs, respectively) in STAT6 is associated with total IgE elevation. Conclusions: The influence of paternal origin of the STAT6 haplotype on IgE levels is surprising but the exact role of possible paternal imprinting in STAT6 regulation should be investigated and confirmed in future studies.

Background: Malakoplakia is an unusual chronic inflammatory disease with distinctive histopathological features rarely involving the parenchyma of a transplanted kidney, and to date less than ten cases have been reported. Methods and results: We present a case of malakoplakia of a kidney graft in a 31 year old woman after simultaneous kidney and pancreas transplantation, which was successfully treated with quinolones. After the treatment of malakoplakia, she was monitored regularly, and her renal and pancreas grafts functioned well for the following 9 years, which is 12 years post transplantation. Moreover, 1 year after treatment of malakoplakia she became pregnant and gave birth to a healthy child. Conclusion: Evaluation of a kidney biopsy sample represents the key to diagnosis of malakoplakia which is important for correct patient management. Treatment with antibiotics with intracellular penetration (quinolone type) may result in curing the disease. According to our knowledge, this is the first case of allograft renal malakoplakia after combined kidney and pancreas transplantation.

Introduction: Functional 3D training originating in rehabilitation and physiotherapy routines, is modelled on the basis of a patient's functional impairment and muscle function test results. 3-D functional rehabilitation comprises two key components. The first is three-dimensional movements of the body and the second is restoration of function, The aim of 3D training is not only to improve physical fitness and muscular coordination, it is recommended for all age groups regardless of health status. The aim of this review is to highlight the main principles, roles and methods of 3D functional training from a clinically-anatomical perspective and its application in clinical practice. Second, we present a case study of 3d training in an obese boy. Methods: Database search using the lemmatization method and data bases: Web of Knowledge, Web of Science, UpToDate, PubMed and Google Scholar for the years 2005-2011. Results and Conclusions: Functional 3D training is an effective method for, among others, strengthening the postural muscles of the human body, increasing articular stability, strengthening the ligaments and stability of muscle groups,especially the back muscles and for improving lung capacity. The method of functional training is of considerable significance in activating the pelvic floor muscles and the pelvic-trochanteric muscles for gynegymnastics and incontinence prevention. It has application in the prevention of falls in patients with neurodegenerative diseases and, as shown below, in the therapy of obesity.

Background: Psychotherapy requires clinical supervision. This is systematic guidance of a therapist by a supervisor. Inevitably, there is a question of training new high-quality therapists. This is related to supervision of their basic training. Later, it is important to provide an opportunity for lifelong supervision throughout the entire psychotherapeutic practice. Method: PUBMED data base was searched for articles using the key words "supervision in CBT", "therapeutic relations", "transference", "countertransference", "schema therapy", "dialectical behavioral therapy". The search was repeated by changing the key word. No language or time constraints were applied. The lists of references of articles detected by this computer data base search were examined manually to find additional articles. We also used the original texts of A. T. Beck, J. Beck, M. Linehan, R. Leahy, J. Young and others. Basically this is a review with conclusions about supervision in cognitive behavioral therapy. Results: The task of supervision is obvious - to increase the value of the therapeutic process in the client's best interest. At the same time, supervision is an educational process in the truest sense of the word, including an opportunity to select one's own supervisor. This is a very important procedural aspect since the therapist identifies with his/her supervisor, either consciously or unconsciously. Establishing the supervisor-supervisee relationship is based on principles similar to those in the therapeutic relationship. There is an important parallel reflecting the therapist-client relationship. This is because any changes in the supervisory process are analogically transferred onto the therapist-client relationship. Additionally, supervision is oriented towards increasing the therapist's competencies. The CBT therapist's basic skills involve good theoretical knowledge, professional behaviour towards clients, ability to use specific therapeutic strategies for maintaining the therapeutic relationship, sensitivity to parallel processes and accomplishment of changes, and adherence to ethical norms. Given the fact that during supervision, the supervisee may be in any stage of his/ her training, supervision must take into consideration where the therapist is in his/her training and development and what he/she has or has not learnt. Conclusions: Both the literature and our experience underscore the importance of careful supervision of cognitive behavioral therapy. The supervisory relationship is similar to a therapeutic relationship and the supervisee also needs security, acceptance and appreciation for his/her professional growth. However, there is more freedom in the relationship. Supervision may only lead to the supervisee's professional growth if it supports his/her individuality and helps him/her to discover things. Therefore, numerous approaches are used in supervision which are associated with the abilities to self-reflect and to realize transference and countertransference mechanisms.

Patients with chronic heart failure (HF) need self-care training to integrate their health problem into everday life. The article maps the level of patients' problems and level of self-care actions performed by patients with HF.

Non-alcoholic fatty liver disease (NAFLD) represents a hepatic manifestation of metabolic syndrome which affecting a substantial percentage of modern populations. The study showed that NAFLD is present in 79% of patients with diabetes mellitus type 2 and a number of these patients could have liver cirrhosis/advanced fibrosis. The presence of NAFLD was related to the components of metabolic syndrome but not to the parameters of diabetes compensation. The validity of liver fibrosis scoring systems in this group of patients needs to be assessed.

The presence of metallic particles in pathologically altered tissues may signal an alternative causation of some diseases. The ethiopathogenic explanation of the diseases associated with the presence of nano-sized particles in the organism is emerging as a new field of pathology, nanopathology.

This is the first study conducted in the Czech Republic on intravenous incompatibility. Physicochemical incompatibility is a typical medication error in the administration of parenteral drugs and may lead to therapeutic failure, catheter occlusion or embolism. The authors aimed to identify the actual incidence of the medication error in a 12 month study in two ICUs. The results show that the incidence of drug incompatibilities could be reduced by adhering to a few simple rules for medication administration and following a set of recommendations for multiple lumen catheter use.

Acute promyelocytic leukemia is the most curable subtype of adult acute leukemias. Fatal bleeding complications occur at diagnosis or during the induction part of treatment and remain a major cause of death. The authors report a case of a very rare spontaneous splenic rupture as a complication of initial antileukemic treatment in a patient with the highest risk of fatal bleeding, according to prognostic factors.

Therapeutic drug monitoring is a specific method of clinical pharmacology for monitoring drugs, using the measurement of drug serum concentrations followed by interpretation and good cooperation with clinician. It facilitates personalized medicine as dosing as rational therapy, minimising side effects, reducing negative consequences and cost of health care. Phenotyping and genotyping can improve monitoring of antidepressant drugs.

This study provided preliminary evidence for several cardiovascular risk factors associated with genetic variation in the endocannabinoid system gene. Common functional single nucleotide polymorphisms in the endocannabinoid system gene (G1359A in CNR1,C385A in FAAH) are associated with increased total cholesterol level and increased risk of myocardial infaction in patients with a history of heart failure.

This article provides up-to-date information on the frequency of contact allergens in the Czech population. Preventive measures are discussed.

This paper compares serum levels of 17 cytokines and 5 adhesion molecules in patients with newly diagnosed AML and ALL using biochip array technology. The authors found significant increase in AML in serum IL-4, IL-2, IL-3, and significant decrease in serum VEGF and VCAM-1. The results show that the serum profile of cytokines and adhesion molecules differs in newly diagnosed AML and ALL patients.

Na+/H+ exchanger-1 (NHE-1) is involved in pH regulation and is up-regulated in different malignancies. Inhibitors of NHE-1 are able to decrease intracellular pH and induce apoptosis. This review presents progress in understanding the mechanisms of action of these inhibitors, connections with certain genetic mutations and acquired treatment resistance, as well as new patents on them. NHE-1 inhibitors are promising adjuvant drugs for overcoming acquired resistance to treatment in various malignant hemopathies.

Adhesive interactions are vital for the persistence of both normal and malignant cells. Malignant cells trigger positive feedback loops causing adhesion molecule inflammatory overexpression. Disruption of adhesive interactions can overcome the high resistance to treatment and increase the selectivity of malignant cell targeting. Understanding adhesive interactions may underlie the basis of novel therapeutic approaches.

The authors describe the results of a single-center prospective study assessing the incidence of obstructive sleep apnea syndrome in a population of patients with exacerbation of COPD requiring in-hospital care. The design and outcomes of the study are novel and original as there are very limited data on this clinical scenario published worldwide.

One strategy for new platinum-based candidate development is the synthesis of compounds which combine platinum-based moiety with another biologically active structure in augment anticancer effects. An important aspect of a new candidate´s route to clinical application is studies of interactions with liver microsomal cytochromes P450. In this work, the authors studied platinum(II) complexes which carry roscovitine derivatives and their interactions with nine human liver microsomal CYP forms.

This article describes the use of kinematic analysis of movement in newborns. By determining the center of mass (COM) and its motion in time, neonatal postural activity may be indirectly assessed. Significant differences in certain characteristics of motion of the COM in the group of preterm infants were found.

This was a study of the effect of continuous positive airway pressure (CPAP) on the prevalence of masked hypertension in Obstructive Sleep Apnea patients. Masked hypertension is very prevalent in these patients and CPAP could be effective in blood pressure lowering. However this study nopositive effect of CPAP on the prevalence of masked hypertension was found

This review provides current insight into the clinical uses of Prostate Specific Antigen with focus on the controversies and future perspectives of this biomarker and including a summary of the latest research in this field.

This work assessed the development of selected local inflammatory markers in pleural effusion after talcage. Using these markers, could enable the selection of patients who will benefit from pleurodesis in the treatment of malignant pleural effusion.