- Publikační typ
- abstrakt z konference MeSH
Reliable quantification of aortic regurgitation (AR) severity is essential for clinical management. We aimed to compare quantitative and indirect echo-Doppler indices to quantitative cardiac magnetic resonance (CMR) parameters in asymptomatic chronic severe AR. Methods and Results: We evaluated 104 consecutive patients using echocardiography and CMR. A comprehensive 2D, 3D, and Doppler echocardiography was performed. The CMR was used to quantify regurgitation fraction (RF) and volume (RV) using the phase-contrast velocity mapping technique. Concordant grading of AR severity with both techniques was observed in 77 (74%) patients. Correlation between RV and RF as assessed by echocardiography and CMR was relatively good (rs = 0.50 for RV, rs = 0.40 for RF, p < 0.0001). The best correlation between indirect echo-Doppler and CMR parameters was found for diastolic flow reversal (DFR) velocity in descending aorta (rs = 0.62 for RV, rs = 0.50 for RF, p < 0.0001) and 3D vena contracta area (VCA) (rs = 0.48 for RV, rs = 0.38 for RF, p < 0.0001). Using receiver operating characteristic analysis, the largest area under curve (AUC) to predict severe AR by CMR RV was observed for DFR velocity (AUC = 0.79). DFR velocity of 19.5 cm/s provided 78% sensitivity and 80% specificity. The AUC for 3D VCA to predict severe AR by CMR RV was 0.73, with optimal cut-off of 26 mm2 (sensitivity 80% and specificity 66%). Conclusions: Out of the indirect echo-Doppler indices of AR severity, DFR velocity in descending aorta and 3D vena contracta area showed the best correlation with CMR-derived RV and RF in patients with chronic severe AR.
- Publikační typ
- časopisecké články MeSH
Despite their low concentrations in many aquatic environments, evidence exists to suggest that herbicides do affect non-target organisms. Given that burrowing is a primary life-history trait in crayfish, herbicides could potentially have serious negative effects on these ecologically important freshwater macroinvertebrates. In this study, we exposed the red swamp crayfish Procambarus clarkii to terbuthylazine (a triazine) and metazachlor (a chloroacetanilide) at an environmental concentration of 2.0 μg/L for 28 days, and then observed their burrowing behaviour for two days. The metazachlor-exposed males excavated a greater number of burrows than the other tested groups, with comparable depths and volumes relative to individual specimen weight. The relative depth and volume of female burrows were identical in all groups. The natural habit of female crayfish of constructing deeper burrows than males was marginally significant in the control and META groups but was not significant for relative volume. The hypothesized adverse effects of chronic exposure to real environmental concentrations of herbicides were not documented in terms of either relative depth or volume. However, the increased number of burrows in metazachlor-exposed animals may mean that this invasive species will cause greater damage to embankments and river banks. The mechanisms behind these effects require closer study.
- MeSH
- acetamidy MeSH
- herbicidy * toxicita MeSH
- severní raci * MeSH
- triaziny toxicita MeSH
- zvířata MeSH
- Check Tag
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
Mechanical circulatory support (MCS) with an implantable left ventricular assist device (LVAD) is an established therapeutic option for advanced heart failure. Most of the currently used LVADs generate a continuous stream of blood that decreases arterial pulse pressure. This study investigated whether a change of the pulse pressure during different pump speed settings would affect cerebral autoregulation and thereby affect cerebral blood flow (CBF). The study included 21 haemodynamically stable outpatients with a continuous-flow LVAD (HeartMate II, Abbott, USA) implanted a median of 6 months before the study (interquartile range 3 to 14 months). Arterial blood pressure (measured by finger plethysmography) was recorded simultaneously with CBF (measured by transcranial Doppler ultrasound) during baseline pump speed (8900 rpm [IQR 8800; 9200]) and during minimum and maximum tolerated pump speeds (8000 rpm [IQR 8000; 8200] and 9800 rpm [IQR 9800; 10 000]). An increase in LVAD pump speed by 800 rpm [IQR 800; 1000] from the baseline lead to a significant decrease in arterial pulse pressure and cerebral blood flow pulsatility (relative change ?24% and ?32%, both p < 0.01), but it did not affect mean arterial pressure and mean CBF velocity (relative change 1% and ?1.7%, p = 0.1 and 0.7). In stable patients with a continuous-flow LVAD, changes of pump speed settings within a clinically used range did not impair static cerebral autoregulation and cerebral blood flow.
- MeSH
- dospělí MeSH
- hemodynamika * MeSH
- lidé středního věku MeSH
- lidé MeSH
- mozkový krevní oběh * MeSH
- podpůrné srdeční systémy statistika a číselné údaje MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- srovnávací studie MeSH
Úvod: Stimulace vagového nervu je paliativní výkon u farmakorezistentní epilepsie ke snížení frekvence a intenzity záchvatů. Při implantaci vagového stimulátoru se umístí elektroda na krční úsek levého vagového nervu a generátor stimulátoru do podkožní kapsy, nejčastěji v podklíčkové oblasti. Metody: Od března 1998 do listopadu 2019 jsme na Neurochirurgické klinice dětí a dospělých 2. LF UK a FN Motol provedli 196 operací spojených s vagovou stimulací. Z toho 126 operací byla levostranná primoimplantace vagového stimulátoru pro farmakorezistentní epilepsii. V našem souboru bylo 69 žen a 57 mužů s průměrným věkem 22±12,4 roku. Nejmladšímu pacientovi bylo 2,1 roku a nejstaršímu bylo 58,4 roku. Výsledky: V našem souboru jsme zaznamenali komplikace u 9 pacientů (7,1 %). Pooperační infekce se vyskytla u dvou pacientů (1,6 %), poruchy srdečního rytmu se objevily ve dvou případech (1,6 %), u jednoho pacienta došlo peroperačně k významnému krvácení (0,8 %). U tří pacientů se objevila paréza zvratného nervu (2,4 %) a u jednoho z těchto pacientů se souběžně projevila pooperačně těžká dysfagie (0,8 %). U jednoho pacienta (0,8 %) při extrastimulaci magnetem docházelo k výrazné déletrvající křeči v hrdle. Extra přidaným benefitem vagové stimulace u jedné pacientky bylo výrazné snížení pravidelných krutých bolestí hlavy. Závěr: Stimulace vagového nervu je možnou alternativou pro pacienty s farmakorezistentní epilepsií, u kterých není vhodná resekční operace. Implantace vagového stimulátoru je poměrně bezpečná operační technika.
Introduction: Vagus nerve stimulation is a palliative treatment for patients with refractory epilepsy to reduce the frequency and intensity of seizures. A bipolar helical electrode is placed around the left vagus nerve at the cervical level and is connected to the pulse generator placed in a subcutaneous pocket, most commonly in the subclavian region. Methods: Between March 1998 and October 2019, we performed 196 procedures related to the vagal nerve stimulation at the Neurosurgery Department in Motol University Hospital. Of these, 126 patients were vagal nerve stimulator implantation surgeries for intractable epilepsy. The cases included 69 female and 57 male patients with mean age at the time of the implantation surgery 22±12.4 years (range 2.1−58.4 years). Results: Nine patients (7.1%) were afflicted by complications related to implantation. Surgical complications included postoperative infection in 1.6%, VNS-associated arrhythmias in 1.6%, jugular vein bleeding in 0.8% and vocal cord paresis in 2.4%. One patient with vocal cord palsy also suffered from severe dysphagia. One patient (0.8%) did not tolerate extra stimulation with magnet due to a prolonged spasm in his throat. The extra added benefit of vagus stimulation in one patient was a significant reduction of previously regular severe headaches. Conclusion: Vagus nerve stimulation is an appropriate treatment for patients with drug-resistant epilepsy who are not candidates for focal resective surgery. Implantation of the vagus nerve stimulator is a relatively safe operative procedure.
- Klíčová slova
- epileptochirurgie,
- MeSH
- elektrická stimulace metody MeSH
- epilepsie * chirurgie MeSH
- klinická studie jako téma MeSH
- lidé MeSH
- vagová stimulace * metody MeSH
- Check Tag
- lidé MeSH
With increasing demand for aquaculture products, water reuse is likely to increase for aquaculture operations around the world. Herein, wastewater stabilization ponds (WSP) represents low cost and sustainable treatment technologies to reduce nutrients and various contaminants of emerging concern from effluent. In the present study, we examined bioaccumulation of selected pharmaceuticals from several therapeutic classes by two important fish species in aquaculture with different feeding preferences (Cyprinus carpio and Sander lucioperca) and their common prey to test whether species specific accumulation occurs. Forty and nineteen from 66 selected pharmaceuticals and their metabolites were positively found in water and sediment samples, respectively from the representative WSP. After a six-month study, which corresponds to aquaculture operations, fourteen pharmaceuticals and their metabolites were detected (at a frequency of higher than 50% of samples) in at least one fish tissue collected from the WSP. We observed striking differences for species and organ specific BAFs among study compounds. Though muscle tissues consistently accumulated lower levels of the target analytes, several substances were elevated in brain, liver and kidney tissues (e.g., sertraline) of both species. Low residual concentrations of these target analytes in aquaculture products (fish fillets) suggest WSPs are promising to support the water-food nexus in aquaculture.
- MeSH
- bioakumulace MeSH
- chemické látky znečišťující vodu * MeSH
- kapři * MeSH
- léčivé přípravky * MeSH
- odpadní voda MeSH
- rybníky MeSH
- voda MeSH
- vodní hospodářství MeSH
- zvířata MeSH
- Check Tag
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
Hypertrofi cká kardiomyopatie (HKMP) je jednou z nejčastějších příčin náhlé smrti mladých sportovců do 35 let. Její fenotypický projev se do značné míry může podobat fyziologické reakci myokardu na vysokou tréninkovou zátěž, kdy hovoříme o takzvaném atletickém (sportovním) srdci. Tyto dva stavy je třeba od sebe rozlišit, abychom neohrozili život sportovce či sportovkyně s nerozpoznanou HKMP a také abychom na druhou stranu zbytečně nezastavili jejich sportovní kariéru.
Hypertrophic cardiomyopathy (HCM) is one of the most common causes of sudden death of young athletes under 35 years of age. Its phenotypic manifestation may resemble the physiological response of the myocardium to a high training load in case of so-called athlete's heart. These two modalities must be distinguished from each other in order to preserve the life of athletes with yet unrecognized HCM, and also on the other side, to avoid unnecessary stopping the career of the healthy ones.
- MeSH
- diferenciální diagnóza MeSH
- echokardiografie metody trendy MeSH
- fyziologická adaptace MeSH
- kardiomegalie indukovaná tělesnou námahou * MeSH
- lidé MeSH
- magnetická rezonanční tomografie MeSH
- mladý dospělý MeSH
- sporty MeSH
- tělesná námaha fyziologie genetika MeSH
- Check Tag
- lidé MeSH
- mladý dospělý MeSH
- Publikační typ
- přehledy MeSH
The growth of cyanobacteria (blue-green algae) is a typical phenomenon in water bodies worldwide. The use of silver carp (Hypophthalmichthys molitrix) to reduce excessive phytoplankton development is controversial. In the case of cyanobacteria, many of which are toxic, understanding their possible digestion mechanism by fish is particularly desirable. A unique methodical approach, which consists of applying intestinal contents or extracts to a cyanobacteria culture, was used. Unicellular cyanobacteria (Cyanothece) were incubated in vitro with bile, contents of different parts of the intestinal tract, and cytosolic and microsomal extracts of the intestinal tissue of silver carp. The abundance of cyanobacteria decreased in all treatments containing either exclusively bile or its combination with intestinal contents. This research provides the first evidence of non-mechanical digestion of cyanobacteria by silver carp. Cyanobacteria incubated with intestinal contents or extracts reached mostly higher abundances than those incubated with the nutrient medium. The existence of non-mechanical digestion mediated via intestinal contents and extracts or its compensation connected with organic substance uptake is discussed.
Background: Determining the value of new imaging markers to predict aortic valve (AV) surgery in asymptomatic patients with severe aortic regurgitation (AR) in a prospective, observational, multicenter study. Methods: Consecutive patients with chronic severe AR were enrolled between 2015-2018. Baseline examination included echocardiography (ECHO) with 2- and 3-dimensional (2D and 3D) vena contracta area (VCA), and magnetic resonance imaging (MRI) with regurgitant volume (RV) and fraction (RF) analyzed in CoreLab. Results: The mean follow-up was 587 days (interquartile range (IQR) 296-901) in a total of 104 patients. Twenty patients underwent AV surgery. Baseline clinical and laboratory data did not differ between surgically and medically treated patients. Surgically treated patients had larger left ventricular (LV) dimension, end-diastolic volume (all p < 0.05), and the LV ejection fraction was similar. The surgical group showed higher prevalence of severe AR (70% vs. 40%, p = 0.02). Out of all imaging markers 3D VCA, MRI-derived RV and RF were identified as the strongest independent predictors of AV surgery (all p < 0.001). Conclusions: Parameters related to LV morphology and function showed moderate accuracy to identify patients in need of early AV surgery at the early stage of the disease. 3D ECHO-derived VCA and MRI-derived RV and RF showed high accuracy and excellent sensitivity to identify patients in need of early surgery.
- Publikační typ
- časopisecké články MeSH
