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Publikace se zaměřuje na různé aspekty chronické kritické ischemie dolních končetin. Určeno odborné veřejnosti.
- Konspekt
- Patologie. Klinická medicína
- NLK Obory
- angiologie
- NLK Publikační typ
- kolektivní monografie
- MeSH
- lidé MeSH
- muskuloskeletální systém * diagnostické zobrazování MeSH
- ultrasonografie * metody MeSH
- vyšetření u lůžka MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
Existence syndromu časného normoglykemického zhoršení byla dlouhou dobu předmětem sporů. V současné době je tento syndrom široce akceptován pod zkratkou EWDR. Jeho podstatou je rychlá kompenzace subkompenzovaného až dekompenzovaného diabetu, která vede k progresi diabetické retinopatie. Významnou roli v jeho patogenezi hrají vysoké hladiny růstového faktoru. V kazuistice upozorňujeme na současný přístup v prevenci této závažné komplikace.
The existence of normoglycaemic re-entry phenomenon has long been a matter of controversy. Currently, this syndrome is widely accepted under the acronym EWDR. Its essence is rapid compensation of subcompensated to decompensated diabetes, which leads to progression of diabetic retinopathy. High levels of growth factor play a significant role in its pathogenesis. In the case report, we draw attention to the current approach to the prevention of this serious complication.
BACKGROUND: Subtle, prognostically important ECG features may not be apparent to physicians. In the course of supervised machine learning, thousands of ECG features are identified. These are not limited to conventional ECG parameters and morphology. We aimed to investigate whether neural network-derived ECG features could be used to predict future cardiovascular disease and mortality and have phenotypic and genotypic associations. METHODS: We extracted 5120 neural network-derived ECG features from an artificial intelligence-enabled ECG model trained for 6 simple diagnoses and applied unsupervised machine learning to identify 3 phenogroups. Using the identified phenogroups, we externally validated our findings in 5 diverse cohorts from the United States, Brazil, and the United Kingdom. Data were collected between 2000 and 2023. RESULTS: In total, 1 808 584 patients were included in this study. In the derivation cohort, the 3 phenogroups had significantly different mortality profiles. After adjusting for known covariates, phenogroup B had a 20% increase in long-term mortality compared with phenogroup A (hazard ratio, 1.20 [95% CI, 1.17-1.23]; P<0.0001; phenogroup A mortality, 2.2%; phenogroup B mortality, 6.1%). In univariate analyses, we found phenogroup B had a significantly greater risk of mortality in all cohorts (log-rank P<0.01 in all 5 cohorts). Phenome-wide association study showed phenogroup B had a higher rate of future atrial fibrillation (odds ratio, 2.89; P<0.00001), ventricular tachycardia (odds ratio, 2.00; P<0.00001), ischemic heart disease (odds ratio, 1.44; P<0.00001), and cardiomyopathy (odds ratio, 2.04; P<0.00001). A single-trait genome-wide association study yielded 4 loci. SCN10A, SCN5A, and CAV1 have roles in cardiac conduction and arrhythmia. ARHGAP24 does not have a clear cardiac role and may be a novel target. CONCLUSIONS: Neural network-derived ECG features can be used to predict all-cause mortality and future cardiovascular diseases. We have identified biologically plausible and novel phenotypic and genotypic associations that describe mechanisms for the increased risk identified.
- MeSH
- časové faktory MeSH
- elektrokardiografie * MeSH
- fenotyp * MeSH
- hodnocení rizik MeSH
- kardiovaskulární nemoci diagnóza mortalita genetika patofyziologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- neuronové sítě * MeSH
- prediktivní hodnota testů * MeSH
- prognóza MeSH
- reprodukovatelnost výsledků MeSH
- rizikové faktory MeSH
- senioři MeSH
- srdeční frekvence MeSH
- strojové učení bez učitele MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- Geografické názvy
- Spojené státy americké MeSH
Idiopathic ventricular fibrillation is diagnosed in survivors of sudden cardiac death that has been caused by ventricular fibrillation without known structural or electrical abnormalities, even after extensive investigation. It is a common cause of sudden death in young adults. Although idiopathic ventricular fibrillation is a diagnosis of exclusion, in many cases only a partial investigation algorithm is performed. The aim of this review is to present a comprehensive diagnostic evaluation algorithm with a focus on diagnostic assessment of inherited arrhythmic syndromes and genetic background.
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
Human induced pluripotent stem cell (iPSC) lines were generated from peripheral blood mononuclear cells (PBMCs) isolated from two related patients diagnosed with either idiopathic ventricular fibrillation or catecholaminergic polymorphic ventricular tachycardia, carrying an unknown variant in the RYR2 gene, c.14201A>G (p.Y4734C) and one healthy related individual. Reprogramming was done using a commercially available Epi5 Reprogramming Kit. The pluripotency of the iPSC lines was verified by the expression of pluripotency markers and by their capacity to differentiate into all three embryonic germ layers in vitro. These iPSC lines are available for functional analysis and in vitro studies of RYR2 channelopathy.
- MeSH
- buněčná diferenciace MeSH
- buněčné linie MeSH
- dospělí MeSH
- fibrilace komor * genetika MeSH
- indukované pluripotentní kmenové buňky * metabolismus MeSH
- katecholaminergní polymorfní komorová tachykardie MeSH
- komorová tachykardie * genetika metabolismus MeSH
- lidé MeSH
- ryanodinový receptor vápníkového kanálu * genetika metabolismus MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Although the term articularis cubiti muscle is incorporated in the official anatomical nomenclature, only sparse data about its appearance are available. It is usually described as few fibres originating from the medial head of the triceps brachii muscle and inserting to the capsule of the elbow joint. However, the most recent observations regarding the morphological relations in the posterior elbow region point towards the absence of a well-defined muscle. Therefore, this study was designed to verify the existence of the articularis cubiti muscle in question and to compile more data on the topographical features of the subtricipital area near the posterior aspect of the elbow. To address these questions, 20 embalmed upper limbs were dissected, and seven samples were collected for histological analysis. The laboratory findings were then correlated with 20 magnetic resonance imaging (MRI) scans of the elbow. Consequently, a narrative review of literature was performed to gain more information on the discussed muscle in a historical context. Upon the anatomical dissection, muscular fibres running from the posterior aspect of the shaft of the humerus to the elbow joint capsule and olecranon were identified in 100% of cases. Histologically, the connection with the joint capsule was provided via winding bands of connective tissue. On MRIs, the muscular fibres resembled a well-demarcated thin muscle located underneath the medial head of the triceps brachii muscle. Combined with the review of literature, we concluded that the constant articularis cubiti muscle originates from the posterior shaft of the humerus and attaches indirectly to the posterior aspect of the elbow joint capsule and directly to the superior portion of the olecranon. The obtained results slightly differ from the modern description, but are in agreement with the original publication, which has become misinterpreted throughout time. Presumably, the misused description has led to questioning the existence of an independent muscle. Moreover, our findings attribute to the articularis cubiti muscle, a function in pulling on the posterior aspect of the elbow joint capsule to prevent its entrapment, and possibly also a minor role in extension of the forearm. The presented results should be taken into consideration when intervening with the posterior aspect of the elbow joint because the articularis cubiti muscle poses a consistently appearing landmark.
- MeSH
- analgezie metody MeSH
- antibiotická profylaxe metody MeSH
- časné pohybování metody MeSH
- hydratace organismu MeSH
- hypotermie prevence a kontrola MeSH
- katetrizace močového měchýře metody MeSH
- lidé MeSH
- nauzea farmakoterapie prevence a kontrola MeSH
- perioperační péče * metody MeSH
- protézy a implantáty normy MeSH
- protézy kloubů * normy trendy MeSH
- rehabilitace metody trendy MeSH
- tromboembolie prevence a kontrola MeSH
- vzdělávání pacientů jako téma metody MeSH
- Check Tag
- lidé MeSH
