- O autorovi
- Kavcová, Elena, 1941-2024 Autorita
Uvádzame kazuistiku pacientky s akútne vzniknutou respiračnou insuficienciou, dlhodobo odkázanej na umelú pľúcnu ventiláciu, s generalizovanou svalovou slabosťou nejasnej genézy. Pacientka absolvovala množstvo vyšetrení, ktoré nakoniec napriek nie typickému klinickému obrazu, nešpecifickému výsledku prvého EMG vyšetrenia a negativite svalových enzýmov viedli k správnej diagnóze a následne k liečbe Pompeho choroby.
We present the case report of a patient with acute respiratory insufficiency, long-term dependent on artificial pulmonary ventilation with generalized muscle weakness of unclear origin. The patient underwent a series of examinations, which ultimately led to the correct diagnosis and subsequent treatment of Pompe disease despite the non-specific clinical picture and the non-specific result of the first EMG examination and the negativity of muscle enzymes.
- MeSH
- glykogenóza typu II * diagnóza terapie MeSH
- lidé středního věku MeSH
- lidé MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
1. elektronické vydání 1 online zdroj (226 stran)
Prvá slovenská monografia o difúznych parenchýmových chorobách pľúc vznikla syntézou prehľadu najaktuálnejších vedeckých poznatkov a viac ako 30 ročných klinických skúseností autorov, ktorí sa tejto problematike systematicky venujú. Je určená na postgraduálne vzdelávanie lekárov.
Úvod: Pandémia covid-19 celosvetovo skomplikovala dostupnosť zdravotnej starostlivosti. Telemedicína predstavuje potencionálne riešenie. Cieľom práce bolo preukázať efektívnosť telemedicínskeho riešenia pri liečbe pacientov so spánkovými poruchami dýchania. Materiál a metódy: Autori porovnávali 2 skupiny pacientov so syndrómom spánkového apnoe/hypopnoe. Prvý súbor zahŕňal 223 pacientov, ktorí boli indikovaní na ambulantnú telemetrickú titráciu neinvazívnej pretlakovej ventilačnej liečby. V druhej skupine bolo 276 pacientov hospitalizačne nastavovaných na ventilačnú liečbu. Výsledky: Miera úspešnosti nastavenia na ventilačnú liečbu v obidvoch súboroch bola porovnateľná. Prostredníctvom telemedicíny sa podarilo uskutočniť 91,93 % úspešných titrácii na neinvazívnu pretlakovú ventiláciu a v prípade konvenčného nastavovania hospitalizačnou formou bolo úspešne nastavených 95,65 % pacientov. Záver: Výsledky práce podporujú použitie telemedicínskej titrácie neinvazívnej pretlakovej ventilačnej liečby.
1. vydanie 223 stran, 1 nečíslovaný list obrazové přílohy : ilustrace ; 24 cm
Príručka sa zameriava na rôzne aspekty intersticiálnej pľúcnej choroby. Určené odbornej verejnosti.
- MeSH
- intersticiální plicní nemoci MeSH
- Publikační typ
- příručky MeSH
- Konspekt
- Patologie. Klinická medicína
- NLK Obory
- pneumologie a ftizeologie
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), that spread around the world during the past 2 years, has infected more than 260 million people worldwide and has imposed an important burden on the healthcare system. Several risk factors associated with unfavorable outcome were identified, including elderly age, selected comorbidities, immune suppression as well as laboratory markers. The role of immune system in the pathophysiology of SARS-CoV-2 infection is indisputable: while an appropriate function of the immune system is important for a rapid clearance of the virus, progression to the severe and critical phases of the disease is related to an exaggerated immune response associated with a cytokine storm. We analyzed differences and longitudinal changes in selected immune parameters in 823 adult COVID-19 patients hospitalized in the Martin University Hospital, Martin, Slovakia. Examined parameters included the differential blood cell counts, various parameters of cellular and humoral immunity (serum concentration of immunoglobulins, C4 and C3), lymphocyte subsets (CD3+, CD4+, CD8+, CD19+, NK cells, CD4+CD45RO+), expression of activation (HLA-DR, CD38) and inhibition markers (CD159/NKG2A). Besides already known changes in the differential blood cell counts and basic lymphocyte subsets, we found significantly higher proportion of CD8+CD38+ cells and significantly lower proportion of CD8+NKG2A+ and NK NKG2A+ cells on admission in non-survivors, compared to survivors; recovery in survivors was associated with a significant increase in the expression of HLA-DR and with a significant decrease of the proportion of CD8+CD38+cells. Furthermore, patients with fatal outcome had significantly lower concentrations of C3 and IgM on admission. However, none of the examined parameters had sufficient sensitivity or specificity to be considered a biomarker of fatal outcome. Understanding the dynamic changes in immune profile of COVID-19 patients may help us to better understand the pathophysiology of the disease, potentially improve management of hospitalized patients and enable proper timing and selection of immunomodulator drugs.
- Publikační typ
- abstrakt z konference MeSH
The velocity of the COVID-19 pandemic spread and the variable severity of the disease course has forced scientists to search for potential predictors of the disease outcome. We examined various immune parameters including the markers of immune cells exhaustion and activation in 21 patients with COVID-19 disease hospitalised in our hospital during the first wave of the COVID-19 pandemic in Slovakia. The results showed significant progressive lymphopenia and depletion of lymphocyte subsets (CD3+, CD4+, CD8+ and CD19+) in correlation to the disease severity. Clinical recovery was associated with significant increase in CD3+ and CD3+CD4+ T-cells. Most of our patients had eosinopenia on admission, although no significant differences were seen among groups with different disease severity. Non-survivors, when compared to survivors, had significantly increased expression of PD-1 on CD4+ and CD8+ cells, but no significant difference in Tim-3 expression was observed, what suggests possible reversibility of immune paralysis in the most severe group of patients. During recovery, the expression of Tim-3 on both CD3+CD4+ and CD3+CD8+ cells significantly decreased. Moreover, patients with fatal outcome had significantly higher proportion of CD38+CD8+ cells and lower proportion of CD38+HLA-DR+CD8+ cells on admission. Clinical recovery was associated with significant decrease of proportion of CD38+CD8+ cells. The highest AUC values within univariate and multivariate logistic regression were achieved for expression of CD38 on CD8+ cells and expression of PD1 on CD4+ cells alone or combined, what suggests, that these parameters could be used as potential biomarkers of poor outcome. The assessment of immune markers could help in predicting outcome and disease severity in COVID-19 patients. Our observations suggest, that apart from the degree of depletion of total lymphocytes and lymphocytes subsets, increased expression of CD38 on CD3+CD8+ cells alone or combined with increased expression of PD-1 on CD3+CD4+ cells, should be regarded as a risk factor of an unfavourable outcome in COVID-19 patients. Increased expression of PD-1 in the absence of an increased expression of Tim-3 on CD3+CD4+ and CD3+CD8+ cells suggests potential reversibility of ongoing immune paralysis in patients with the most severe course of COVID-19.
- MeSH
- CD4-pozitivní T-lymfocyty MeSH
- CD8-pozitivní T-lymfocyty MeSH
- COVID-19 * MeSH
- lidé MeSH
- pandemie MeSH
- SARS-CoV-2 MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
