- Publikační typ
- abstrakt z konference MeSH
Předkládaný přehledový článek se pokouší zobrazit aktuální pohled na problematiku nejčastějších a současně klinicky závažných onemocnění v oblasti ORL, s přihlédnutím k faktu, že tato onemocnění mají významnější algickou symptomatologii. Článek rozebírá jednotlivé orgánové systémy se zohledněním anatomických oblastí (nos, vedlejší nosní dutiny, orofarynx, ucho, endokraniální komplikace, onemocnění slinných žláz), zejména pak s důrazem na bolest jako hlavním symptomem těchto chorob. Zmíněna je i důležitost mezioborové spolupráce, která je pro správnou interpretaci klinického nálezu vždy nezbytná.
The aim of the article is to outline the most common and clinically important ENT diseases with pain as the main symptom and to emphasis the differential diagnostic forethought for individual disorders. The article analyzes individual organ systems taking into account anatomical areas (nose, paranasal sinuses, oropharynx, ear, endocranial complications, salivary gland diseases), especially with emphasis on pain as the main symptom of these diseases. This review stresses the need for interdiscipliniary cooperation to correctly intrepret cilnical findings.
- MeSH
- lidé MeSH
- otorinolaryngologické nemoci diagnostické zobrazování komplikace terapie MeSH
- sekundární bolesti hlavy * etiologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
Acyclovir is an antiviral drug frequently used in clinical practice. It is indicated for the treatment of infections caused by herpes simplex virus and varicella zoster virus. The drug has a good safety profile; however, severe side effects may rarely occur during therapy. These include renal failure as a major risk factor for neurotoxic side effects potentially developing within 24-48 hours of therapy initiation. The paper presents the cases of two patients developing neurotoxic side effects while treated for herpes zoster. The aim of the authors is to highlight the potential for developing neurotoxic side effects in high-risk groups such as the elderly, patients with impaired renal function or multiple comorbidities on polypharmacy, or those using nephrotoxic drugs. Acyclovir use could lead to renal impairment and an increase in its plasma and CNS concentrations with severe neuropsychiatric side effects. The neurotoxic side effects are reversible after therapy withdrawal. Thus, in patients developing mental impairment or showing other neurological symptoms during acyclovir therapy, the patient should be promptly assessed for potential drug neurotoxicity, their therapy should be discontinued and drug elimination with forced diuresis or hemodialysis considered. Early recognition of acyclovir neurotoxic side effects can significantly improve a patient's prognosis.
- MeSH
- acyklovir škodlivé účinky MeSH
- antivirové látky škodlivé účinky MeSH
- duševní poruchy * MeSH
- herpes zoster * chemicky indukované diagnóza farmakoterapie MeSH
- lidé MeSH
- senioři MeSH
- virus varicella zoster MeSH
- Check Tag
- lidé MeSH
- senioři MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
OBJECTIVE: The aim of our study was to establish whether or not tinnitus patients have higher platelet activity, as measured by plasma 11-dehydro-thromboxane B2 levels, compared with individuals without tinnitus. METHODS: The study group included patients without documented organic causes of tinnitus or a cause of non-vascular hearing impairment. Laboratory tests included complete blood count, biochemistry, coagulation activity, and thromboxane levels. To exclude a pathology in the cerebellopontine angle, CT and MRI were performed together with an X-ray scan of cervical vertebrae. For the purpose of this study, blood samples were screened for 11-dehydro-thromboxane B2 levels using commercial kits. RESULTS: A comparison of the main marker of increased platelet activity i.e., thromboxane levels of tinnitus patients with those of a control group, showed increased thromboxane levels in the former. The average plasma concentrations of 11-dehydro-thromboxane B2 were 2.0234±1.80 ng/ml in the group of tinnitus patients and 1.3247±1.33 ng/ml in the control group. Our results showed that patients with tinnitus have significantly higher values of 11-dehydro-thromboxane B2. CONCLUSION: Tinnitus patients showed higher levels of increased platelet activity, a marker that may play an important role in the pathogenesis of tinnitus.
- MeSH
- dospělí MeSH
- hemokoagulace MeSH
- lidé středního věku MeSH
- lidé MeSH
- longitudinální studie MeSH
- thromboxan B2 analogy a deriváty krev MeSH
- tinnitus krev MeSH
- trombocyty metabolismus MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Objective To evaluate the safety and tolerability of repeated intratympanic administration of the gel-formulated NMDA receptor antagonist AM-101 in acute patients with inner ear tinnitus. Study Design Prospective, double-blind, randomized, placebo-controlled study. Setting Sixty-nine secondary and tertiary sites in North America, Europe, and Asia. Subjects and Methods In total, 343 subjects with persistent acute tinnitus after traumatic cochlear injury or otitis media were randomized to receive 3 intratympanic doses of either AM-101 0.87 mg/mL or placebo over 3 to 5 days. They were followed for 84 days. The primary safety end point was the incidence of a clinically meaningful hearing deterioration from baseline to study day 35. Further safety assessments included tympanic membrane closure rates, analysis of adverse events, hematology, blood chemistry, and vital signs. In addition, data were collected on applied anesthetics and injection techniques. Results The treatment was well tolerated, with no intervention-related serious adverse events. The incidence of clinically meaningful hearing deterioration was low, comparable between treatment groups ( P = .82 for the primary safety end point) and not different between treated and untreated ears in unilaterally treated subjects. The rate of treatment and procedure-related adverse events was similar among treatment groups. The tympanic membrane was closed in 92% of subjects within 1 week and in all subjects by study day 84. Blood values and vital signs were inconspicuous. Conclusion Repeated intratympanic injections of AM-101 over a 3- to 5-day period appear to be safe and well tolerated, demonstrating the ability to potentially use this delivery approach over longer time periods.
- MeSH
- akutní nemoc MeSH
- dospělí MeSH
- dvojitá slepá metoda MeSH
- intratympanická injekce MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- prospektivní studie MeSH
- proteiny regulující apoptózu aplikace a dávkování škodlivé účinky MeSH
- senioři MeSH
- tinnitus farmakoterapie MeSH
- vnitřní ucho MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- randomizované kontrolované studie MeSH
While not a disease entity in itself; symptoms of tinnitus (from Latin tinnio - clink) accompany a number of diseases. Tinnitus prevalence increases with age, deteriorates one's quality of life, and may even result in suicidal behavior. Tinnitus develops in response to a variety of risk factors, otoxic substances, noise exposure, hearing disorders, and psychological alterations. Tinnitus is closely related to mood, depression, and psychological state. In the present study, we focused on alterations of the steroid metabolome and particularly neuroactive, neuroprotective, and immunomodulatory steroids in patients with tinnitus. The study group consisted of 28 patients without evidence of an organic cause of tinnitus as well as without associated diseases or the effect of ototoxic medications. All patients underwent a complete audiological assessment and laboratory tests including routine biochemical markers and quantification of circulating steroids using gas chromatography/mass spectrometry and immunoassays. To rule out a pathology in the cerebellopontine angle area, CT scan or MRI were performed. To diagnose stem lesions, evoked potentials were also measured. Pearson's correlations and multivariate regression were used to assess any links between tinnitus intensity and frequency on the one hand, and steroid levels on the other. Results indicated a significant and consistent negative correlation between tinnitus indices and intensity of adrenal steroidogenesis. The circulating steroid metabolome including hormones and neuroactive, neuroprotective, and immunomodulatory steroids negatively correlates with the degree of tinnitus due to hypothalamo-pituitary-adrenal axis malfunction. Our results may help explain the pathophysiology of tinnitus and improve its diagnosis. However, further studies are needed to verify our postulation.
- MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- magnetická rezonanční tomografie MeSH
- metabolomika MeSH
- počítačová rentgenová tomografie MeSH
- steroidy krev metabolismus MeSH
- tinnitus krev diagnostické zobrazování MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- MeSH
- antidepresiva terapeutické užití MeSH
- betahistin farmakologie terapeutické užití MeSH
- Ginkgo biloba MeSH
- incidence MeSH
- laserová terapie s nízkou intenzitou světla metody MeSH
- lidé MeSH
- nootropní látky terapeutické užití MeSH
- prevalence MeSH
- rizikové faktory MeSH
- rostlinné extrakty terapeutické užití MeSH
- senioři MeSH
- tinnitus * diagnóza epidemiologie etiologie terapie MeSH
- Check Tag
- lidé MeSH
- senioři MeSH
- Publikační typ
- přehledy MeSH
- Klíčová slova
- plazmatická koncentrace léčiva,
- MeSH
- analgetika MeSH
- antiastmatika farmakokinetika farmakologie krev škodlivé účinky MeSH
- antibakteriální látky farmakokinetika farmakologie krev MeSH
- antidepresiva farmakokinetika farmakologie krev MeSH
- antifungální látky farmakologie krev MeSH
- antikonvulziva farmakologie krev MeSH
- antipyretika MeSH
- cytostatické látky farmakologie krev MeSH
- farmakoterapie metody trendy MeSH
- hodnocení rizik MeSH
- imunosupresiva farmakologie krev škodlivé účinky MeSH
- individualizovaná medicína trendy MeSH
- kardiovaskulární látky farmakologie krev MeSH
- lidé MeSH
- monitorování léčiv * klasifikace metody statistika a číselné údaje trendy MeSH
- trankvilizéry farmakokinetika farmakologie krev MeSH
- Check Tag
- lidé MeSH
