BACKGROUND: A special care of MS women planning a pregnancy is highly demanding especially in the terms of disease modifying treatment (DMD) decisions and counselling regarding periods of conception, pregnancy and postpartum period. OBJECTIVE: To provide data about impact of pregnancy, delivery or miscarriage/artificial abortion on MS disease course in Czech women with MS based on analysis of retrospective data from the Czech national registry ReMuS. METHODS: The analysis focused on women with MS with at least one record of pregnancy in the registry. Clinical data (EDSS, relapses) were collected prior to conception, during pregnancy and after delivery or miscarriage/artificial abortion. These data were analysed according to baseline characteristics of DMD treatment prior to conception and according to breastfeeding status. RESULTS: A total of 1 533 pregnancies were analysed from the period of 2013 until 31st December 2019. The occurrence of relapses and worse EDSS was significantly related to the treatment with escalation therapy prior to conception. Relapses were significantly more frequent in women who breastfed less than 3 months than in women who breastfed more than 3 months or did not breastfeed at all. Patients treated with either fingolimod or natalizumab prior to pregnancy were significantly more likely to develop relapses during pregnancy. CONCLUSION: Pregnancy and postpartum period were generally safe for Czech women with MS. Better disease outcomes were observed in those who had been treated with first line injectable DMDs prior to conception and those who either breastfed more than 3 months or did not breastfeed at all. We confirmed the assumption of rebound phenomenon of MS after discontinuation of treatment due to planned pregnancy both for fingolimod and natalizumab.
- MeSH
- fingolimod hydrochlorid terapeutické užití MeSH
- lidé MeSH
- natalizumab terapeutické užití MeSH
- retrospektivní studie MeSH
- roztroušená skleróza * chemicky indukované farmakoterapie epidemiologie MeSH
- těhotenství MeSH
- Check Tag
- lidé MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
Úvod: Práce je zaměřená na měření kvality života pacientů po polytraumatu, které zanechává ve velkém měřítku trvalé následky. Vlivem zavádění nových léčebných metod dochází k vysokému procentu přeživších tohoto zranění. Následky pak mohou zraněným přinášet problémy v sociální interakci s prostředím. Cíl: Zjistit subjektivní výši kvality života, zda má výše kvality života souvislost s ISS (Injury Severity Score), zda souvisí subjektivní kvalita života a spokojenost se zdravím s uplynulou dobou po těžkém úrazu a jaké má zraněný předpoklady uplatnit se na trhu práce. Metoda: Nemocniční informační systém a statistické vyhodnocení dotazníků respondentů. Respondenti byli pacienti léčení na Klinice úrazové chirurgie Fakultní nemocnice Ostrava. K měření jsme použili dotazník WHOQOL-BREF (WHO, 2008) a porovnali s populační normou subjektivní kvality života podle Dragomirecké et al. (2006). Metoda: Statisticky bylo zhodnoceno 49 dotazníků, u kterých respondenti hodnotili ve třech doménách svoji kvalitu života výše, než uvádí interval populační normy. Doménu Sociální vztahy hodnotili všichni respondenti jako velmi špatnou. Taktéž odpovědi na kvalitu života a spokojenost se zdravím byly pod průměrem populační normy. Závěr: Subjektivní kvalita života pacientů po polytraumatu jistě stojí v popředí pozornosti sociální práce, a to zejména vzhledem k trvalým následkům, a tím o možnost uplatnění se na trhu práce. Velký rozptyl dat v našem souboru a různé metody měření uváděné v literatuře nás dovedly k závěru, že průkaznější způsob měření bude cesta kvalitativními metodami, společně s pacientem od doby úrazu, léčení, rehabilitaci až po resocializaci.
Introduction: The aim of the presented work was to measure the quality of life of patients after polytrauma, which is associated with significant permanent consequences for the patient. Introduction of new treatment techniques results in a high percentage of these patients surviving this type of injury. Permanent consequences may cause problems for the injured, especially in social interaction with their environment. Aim: To determine the subjective of quality of life and to determine whether the quality of life is associated with the ISS score (Injury Severity Score), whether the subjective quality of life and satisfaction with medical condition are associated in any way with the period of time which has elapsed from the serious injury, and what are the prerequisites for successful reintegration of these patients onto the labour market. Method: The authors performed a literature review using the PubMed online database, hospital information system, and statistical evaluation of questionnaires from the responders. The group of responders consisted of patients treated at our department. In order to perform the measurements, the authors used the WHOQOL-BREF (WHO, 2008) questionnaire, and compared the obtained results with the population standard of subjective quality of life reported by Dragomirecká et al. (2006). Results: A total of 49 questionnaires were statistically evaluated; the responders evaluated their quality of life to be higher than the interval of population standard in three domains. The domain of Social Relations was evaluated as very bad in all responders. Also the responses to questions concerning the quality of life and satisfaction with medical condition were below the average value of the population standard. The quality of life was not related to the ISS score of the trauma in any way. The period, which has elapsed from the injury, influences the subjective quality of life of the individual, and the satisfaction with medical condition. Conclusion:The subjective quality of life of patients after polytrauma certainly is in the foreground of attention of social work, especially due to the permanent consequences, limiting the patient’s abilities to find application at the labour market. The broad distribution of data in our dataset and various measurement techniques presented in the literature lead the authors to the conclusion that more conclusive means of measurement will include qualitative techniques, working together with the patient, ever since the injury, over the treatment period, physiotherapy, up to social reintegration.
- Klíčová slova
- Injury Severity Score (ISS),
- MeSH
- kvalita života * MeSH
- lidé MeSH
- polytrauma * MeSH
- průzkumy a dotazníky MeSH
- Check Tag
- lidé MeSH
AIM: The therapeutic potential of adipose-derived stem cell conditioned medium (ASC-CM) was studied in the rabbit model of critical limb ischemia (CLI). METHODS: Rabbits received treatment with ASC-CM or placebo. Gastrocnemius muscle tissue was collected 35 days after ischemia induction. Ischemic changes were evaluated in hematoxylin-eosin stained tissues for early (necrotic lesions/granulation tissue) and late (fibrous scars) phases of tissue repair. The expression of proangiogenic miR-126 was also evaluated using in situ hybridization. The levels of cytokines, insulin, and C-peptide were measured in blood. RESULTS: Early repair phases were observed more often in placebo-treated samples (45.5%) than in ASC-CM-treated ones (22.2%). However, the difference was not statistically significant. We demonstrated a statistically significant positive correlation between the early healing phases in tissue samples and C-peptide levels in peripheral blood. The expression of proangiogenic miR-126 was also shown in a number of structures in all phases of ischemic tissue healing. CONCLUSION: Based on our results, we believe that treatment with ASC-CM has the potential to accelerate the healing process in ischemic tissues in the rabbit model of CLI. The whole healing process was accompanied by miR-126 tissue expression. C-peptide could be used to monitor the course of the tissue healing process.
- MeSH
- C-peptid krev MeSH
- cytokiny krev MeSH
- diabetická noha MeSH
- dospělí MeSH
- experimentální diabetes mellitus krev MeSH
- fibróza MeSH
- fyziologická neovaskularizace účinky léků MeSH
- granulační tkáň patologie MeSH
- hojení ran účinky léků fyziologie MeSH
- hybridizace in situ MeSH
- inzulin krev MeSH
- ischemie krev MeSH
- jizva patologie MeSH
- kosterní svaly krevní zásobení účinky léků patologie MeSH
- králíci MeSH
- kultivační média speciální farmakologie MeSH
- lidé MeSH
- mezenchymální kmenové buňky * MeSH
- mikro RNA metabolismus MeSH
- modely nemocí na zvířatech MeSH
- nekróza MeSH
- zadní končetina MeSH
- zvířata MeSH
- Check Tag
- dospělí MeSH
- králíci MeSH
- lidé MeSH
- mužské pohlaví MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
BACKGROUND We investigated the properties and effects of 5 mechanical thrombectomy procedures in patients with acute ischemic stroke. The relationships between the type of procedure, the time required, the success of recanalization, and the clinical outcome were analyzed. MATERIAL AND METHODS This prospective comparative analysis included 500 patients with acute ischemic stroke and large-vessel occlusion. We compared contact aspiration thrombectomy (ADAPT, n=100), stent retriever first line (SRFL, n=196), the Solumbra technique (n=64), mechanical thrombectomy plus stent implantation (n=81), and a combined procedure (n=59). RESULTS ADAPT provided shorter procedure (P<0.001) and recanalization times (P<0.001) than the other techniques. Better clinical outcome was achieved for ischemia in the anterior circulation than ischemia in the posterior fossa (P<0.001). Compared to the other techniques, patients treated with ADAPT procedure had increased odds of achieving better mTICI scores (P=0.002) and clinical outcome (NIHSS) after 7 days (P=0.003); patients treated with SRFL had increased odds of achieving better long-term clinical status (3M-mRS=0-2; P=0.040). Patients with SRFL and intravenous thrombolysis (IVT) had increased odds of better clinical status (3M-mRS=0-2; P=0.031) and decreased odds of death (P=0.005) compared to patients with SRFL without IVT. The other treatment approaches had no additional effect of IVT. Patients with SRFL with a mothership transfer had increased odds of achieving favorable clinical outcome (3M-mRS) compared to SRFL with the drip-and-ship transfer paradigm (P=0.015). CONCLUSIONS Our results showed that ADAPT and SRFL provided significantly better outcomes compared to the other examined techniques. A mothership transfer and IVT administration contributed to the success of the SRFL approach.
- MeSH
- cévní mozková příhoda chirurgie terapie MeSH
- ischemie mozku terapie MeSH
- ischemie terapie MeSH
- lidé středního věku MeSH
- lidé MeSH
- mechanická trombolýza metody MeSH
- prospektivní studie MeSH
- senioři MeSH
- stenty MeSH
- trombektomie metody MeSH
- trombolytická terapie metody MeSH
- výsledek terapie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- srovnávací studie MeSH
BACKGROUND The aim of the study was to investigate the role of von Willebrand factor (vWF), the vWF-cleaving protease, ADAMTS13, the composition of thrombus, and patient outcome following mechanical cerebral artery thrombectomy in patients with acute ischemic stroke. MATERIAL AND METHODS A prospective cohort study included 131 patients with ischemic stroke (<6 hours) with or without intravenous thrombolysis. Interventional procedure parameters, hemocoagulation markers, vWF, ADAMTS13, and histological examination of the extracted thrombi were performed. The National Institutes of Health Stroke Scale (NIHSS) score was used on hospital admission, after 24 hours, at day 7; the three-month modified Rankin Scale score was used. RESULTS Mechanical thrombectomy resulted in a Treatment in Cerebral Ischemia (TICI) score of 2-3, with recanalization in 89% of patients. Intravenous thrombolysis was used in 101 (78%). Patients with and without intravenous thrombolysis therapy had a good clinical outcome (score 0-2) in 47% of cases (P=0.459) using the three-month modified Rankin Scale. Patients with a National Institutes of Health Stroke Scale (NIHSS) score ≥15 had significantly increased vWF levels (P=0.003), and a significantly increased vWF: ADAMTS13 ratio (P=0.038) on hospital admission. Significant correlation coefficients were found for plasma vWF and thrombo-embolus vWF (r=0.32), platelet (r=0.24), and fibrin (r=0.26) levels. In the removed thrombus, vWF levels were significantly correlated with platelet count (r=0.53), CD31-positive cells (r=0.38), and fibrin (r=0.48). CONCLUSIONS In patients with acute ischemic stroke, mechanical cerebral artery thrombectomy resulted in a good clinical outcome in 47% of cases, with and without intravenous thrombolysis therapy.
- MeSH
- arteriae cerebrales metabolismus patologie MeSH
- cévní mozková příhoda krev metabolismus chirurgie MeSH
- demografie MeSH
- hemokoagulace MeSH
- ischemie mozku krev metabolismus chirurgie MeSH
- lidé středního věku MeSH
- lidé MeSH
- protein ADAMTS13 metabolismus MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- trombektomie * MeSH
- trombóza krev imunologie metabolismus MeSH
- von Willebrandův faktor metabolismus MeSH
- výsledek terapie MeSH
- zánět patologie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
BACKGROUND The immune system may have a role in the pathogenesis of autism spectrum disorder (ASD), including typical and atypical autism. The aim of this study was to determine whether a cytokine and growth factor panel could be identified for the diagnosis and prognosis in children with ASD, including typical and atypical autism. MATERIAL AND METHODS This study included 26 children with ASD (typical or atypical) and 11 of their siblings who did not have ASD. A panel of ten serum cytokines and growth factors were investigated using addressable laser bead assay (ALBIA) and enzyme-linked immunosorbent assay (ELISA) kits. Results were correlated with scores using the Childhood Autism Rating Scale (CARS) and Autism Diagnostic Observation Schedule (ADOS) for the children with ASD and compared with the findings from their siblings without ASD. RESULTS There were no statistically significant differences in serum cytokine and growth factor levels between children with ASD and their siblings. The scores using CARS and ADOS were significantly greater in children with typical autism compared with children with atypical autism as part of the ASD spectrum. Serum levels of cytokines and growth factors showed a positive correlation with CARS and ADOS scores but differed between children with typical and atypical autism and their siblings. CONCLUSIONS The findings of this study showed that serum measurement of appropriately selected panels of cytokines and growth factors might have a role in the diagnosis of ASD.
- Publikační typ
- abstrakt z konference MeSH
BACKGROUND Paracrine factors secreted by adipose-derived stem cells can be captured, fractionated, and concentrated to produce therapeutic factor concentrate (TFC). The present study examined whether TFC effects could be enhanced by combining TFC with a biological matrix to provide sustained release of factors in the target region. MATERIAL AND METHODS Unilateral hind limb ischemia was induced in rabbits. Ischemic limbs were injected with either placebo control, TFC, micronized small intestinal submucosa tissue (SIS), or TFC absorbed to SIS. Blood flow in both limbs was assessed with laser Doppler perfusion imaging. Tissues harvested at Day 48 were assessed immunohistochemically for vessel density; in situ hybridization and quantitative real-time PCR were employed to determine miR-126 expression. RESULTS LDP ratios were significantly elevated, compared to placebo control, on day 28 in all treatment groups (p=0.0816, p=0.0543, p=0.0639, for groups 2-4, respectively) and on day 36 in the TFC group (p=0.0866). This effect correlated with capillary density in the SIS and TFC+SIS groups (p=0.0093 and p=0.0054, respectively, compared to placebo). A correlation was observed between miR-126 levels and LDP levels at 48 days in SIS and TFC+SIS groups. CONCLUSIONS A single bolus administration of TFC and SIS had early, transient effects on reperfusion and promotion of ischemia repair. The effects were not additive. We also discovered that TFC modulated miR-126 levels that were expressed in cell types other than endothelial cells. These data suggested that TFC, alone or in combination with SIS, may be a potent therapy for patients with CLI that are at risk of amputation.
- MeSH
- extracelulární matrix metabolismus MeSH
- ischemie genetika patologie terapie MeSH
- kmenové buňky cytologie MeSH
- končetiny krevní zásobení patologie MeSH
- králíci MeSH
- kůže patologie MeSH
- laser doppler flowmetrie MeSH
- lidé středního věku MeSH
- lidé MeSH
- mikro RNA genetika metabolismus MeSH
- mikropartikule metabolismus MeSH
- modely nemocí na zvířatech MeSH
- perfuze MeSH
- regulace genové exprese MeSH
- reperfuzní poškození patologie terapie MeSH
- střevní sliznice fyziologie MeSH
- tenké střevo fyziologie MeSH
- transplantace kmenových buněk * MeSH
- tuková tkáň cytologie MeSH
- zvířata MeSH
- Check Tag
- králíci MeSH
- lidé středního věku MeSH
- lidé MeSH
- ženské pohlaví MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
Transplantation of adipose-derived stem cells (ADSCs) is an emerging therapeutic option for addressing intractable diseases such as critical limb ischemia (CLI). Evidence suggests that therapeutic effects of ADSCs are primarily mediated through paracrine mechanisms rather than transdifferentiation. These secreted factors can be captured in conditioned medium (CM) and concentrated to prepare a therapeutic factor concentrate (TFC) composed of a cocktail of beneficial growth factors and cytokines that individually and in combination demonstrate disease-modifying effects. The ability of a TFC to promote reperfusion in a rabbit model of CLI was evaluated. A total of 27 adult female rabbits underwent surgery to induce ischemia in the left hindlimb. An additional five rabbits served as sham controls. One week after surgery, the ischemic limbs received intramuscular injections of either (1) placebo (control medium), (2) a low dose of TFC, or (3) a high dose of TFC. Limb perfusion was serially assessed with a Doppler probe. Blood samples were analyzed for growth factors and cytokines. Tissue was harvested postmortem on day 35 and assessed for capillary density by immunohistochemistry. At 1 month after treatment, tissue perfusion in ischemic limbs treated with a high dose of TFC was almost double (p < 0.05) that of the placebo group [58.8 ± 23 relative perfusion units (RPU) vs. 30.7 ± 13.6 RPU; mean ± SD]. This effect was correlated with greater capillary density in the affected tissues and with transiently higher serum levels of the angiogenic and prosurvival factors vascular endothelial growth factor (VEGF) and hepatocyte growth factor (HGF). The conclusions from this study are that a single bolus administration of TFC demonstrated robust effects for promoting tissue reperfusion in a rabbit model of CLI and that a possible mechanism of revascularization was promotion of angiogenesis by TFC. Results of this study demonstrate that TFC represents a potent therapeutic cocktail for patients with CLI, many of whom are at risk for amputation of the affected limb.
- MeSH
- cytokiny terapeutické užití MeSH
- fyziologická neovaskularizace účinky léků MeSH
- hepatocytární růstový faktor metabolismus MeSH
- injekce intramuskulární MeSH
- ischemie farmakoterapie MeSH
- králíci MeSH
- kultivační média speciální farmakologie MeSH
- kultivované buňky MeSH
- lidé MeSH
- mezenchymální kmenové buňky metabolismus MeSH
- mezibuněčné signální peptidy a proteiny terapeutické užití MeSH
- průtoková cytometrie MeSH
- tuková tkáň metabolismus MeSH
- vaskulární endoteliální růstový faktor A metabolismus MeSH
- zadní končetina patologie MeSH
- zvířata MeSH
- Check Tag
- králíci MeSH
- lidé MeSH
- ženské pohlaví MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
OBJECTIVE: It was hypothesized that increasing the time for which onabotulinum toxin A (OnabotA) is exposed to the urothelium following intravesical instillation will augment its effect. TC-3 is an inert heat-sensitive hydrogel, which creates an intravesical bulk providing a slow release of the embedded drug after instillation. The aim of this study was to evaluate the effect of OnabotA, embedded in inert TC-3 hydrogel, in patients with idiopathic overactive bladder (OAB). METHODS: In total, 39 female patients (age 30-65, average 53.8 years) with OAB symptoms were randomized for the study into four groups, each receiving 50 ml of the following intravesical instillations: Group A, 0.9% NaCl (placebo, n = 11); Group B, TC-3 gel + 200 U OnabotA (n = 9); Group C, TC-3 gel + 200 U OnabotA + dimethyl sulfoxide (DMSO) (n = 10); and Group D, DMSO (n = 9). The parameters were compared before and 1 month after treatment. RESULTS: When comparing parameters using conventional statistical methods (Kruskal-Wallis test), no statistically significant changes were observed within the groups. Comparison of the medians using an analysis based on the mathematical gnostics showed the superiority of the method used in Group B over the other groups in the following parameters: number of urgency grade 3 + 4 episodes/72 h, number of leakage episodes/72 h, Overactive Bladder Questionnaire total score and Patient Perception of Bladder Condition total score. Group D showed its superiority over the other groups in respect to the number of nocturia episodes/72 h. CONCLUSIONS: The results indicate that intravesical instillation of OnabotA, embedded in TC-3 gel, could become an alternative to intramural injection for a well-selected subgroup of patients.
- MeSH
- aplikace intravezikální MeSH
- botulotoxiny typ A aplikace a dávkování MeSH
- dospělí MeSH
- dvojitá slepá metoda MeSH
- hyperaktivní močový měchýř farmakoterapie MeSH
- inhibitory uvolňování acetylcholinu aplikace a dávkování MeSH
- lidé středního věku MeSH
- lidé MeSH
- nosiče léků MeSH
- PEG-DMA hydrogel MeSH
- pilotní projekty MeSH
- prospektivní studie MeSH
- senioři MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- randomizované kontrolované studie MeSH
- srovnávací studie MeSH
