• Klíčová slova
• onkogenní osteomalacie,
• MeSH
• dějiny 15. století MeSH
• osteomalacie diagnóza   MeSH
• paleopatologie * MeSH
• příčina smrti MeSH
• významné osobnosti MeSH
• Check Tag
• dějiny 15. století MeSH
• Publikační typ
• historické články MeSH

• O autorovi
• Ladislav, 1440-1457 Autorita

Hypoglykémie sú symptómom pomerne širokej skupiny ochorení s rôznou epidemiológiou, etiológiou, klinickým obrazom, liečbou a prognózou. Deti sú náchylnejšie na rozvoj hypoglykémie ako dospelí, nakoľko ich regulačné procesy na udržiavanie stabilnej glykémie majú menšiu kapacitu. Etiologicky ide o rozmanitú skupinu ochorení, pričom viaceré sú typické pre detský vek. Medzi najčastejšie formy hypoglykémií u detí patria liečba inzulínom pri diabetes mellitus, idiopatické ketotické hypoglykémie, hyperinzulinizmus (v novorodeneckom období), k menej častým, avšak závažným príčinám patria deficity kontra egulačných hormónov, niektoré dedičné poruchy metabolizmu, prípadne intoxikácie. Ich diagnostika je často komplexná, pričom na odlíšenie jednotlivých foriem hypoglykémií je kľúčové stanovenie ketolátok. Liečba a prognóza závisí najmä od typu hypoglykémie. Článok sa venuje nediabetickým hypoglykémiám u detí.

Hypoglycemia is a symptom of a relatively broad group of diseases with different epidemiology, etiology, clinical picture, treatment and prognosis. Children are more susceptible to developing hypoglycemia than adults, as their regulatory processes to maintain stable glycaemia have less capacity. Etiologically, hypoglycemia is a diverse group of diseases, with several being typical of childhood. The most common forms of hypoglycemia in children include insulin treatment in diabetes mellitus, idiopathic ketotic hypoglycemia, hyperinsulinism (in neonatal period), less common but serious causes include deficits of counterregulatory hormones, some inherited metabolic disorders, or intoxication. Their diagnosis is often complex. Determination of ketone bodies is crucial to differentiate the various forms of hypoglycemia. Treatment and prognosis depend mainly on the type of hypoglycemia. This article is dedicated to Non-diabetic hypoglycemias in children.

• MeSH
• diferenciální diagnóza MeSH
• glykogenóza diagnóza   genetika   metabolismus   MeSH
• hladovění komplikace   metabolismus   patofyziologie   MeSH
• hyperinzulinismus diagnóza   komplikace   MeSH
• hypoglykemie * diagnóza   etiologie   komplikace   terapie   MeSH
• ketolátky krev   MeSH
• ketóza diagnóza   metabolismus   MeSH
• lidé MeSH
• Check Tag
• lidé MeSH

Hypoglykémia v starobe je spojená s významnými chorobnosťami vedúcimi k fyzickej aj kognitívnej dysfunkcii. Opakované hospitalizácie v dôsledku častých hypoglykémií sú tiež spojené s ďalším zhoršovaním celkového zdravotného stavu pacientov. Tento negatívny vplyv hypoglykémie pravdepodobne nakoniec povedie ku krehkosti, invalidite. Zdá sa, že vzťah medzi hypoglykémiou a krehkosťou je obojsmerný a je sprostredkovaný radom vplyvov vrátane podvýživy. Preto je potrebné venovať pozornosť manažmentu podvýživy u geriatrických pacientov zlepšením energetického príjmu a udržaním svalovej hmoty. Dôležité je zamerať sa na zvýšenie fyzickej aktivity a konzervatívnejší prístup ku glykemickým cieľom u krehkých starších diabetikov.

Hypoglycemia in elderly is associated with significant morbidities leading to both physical and cognitive dysfunction. Repeated hospital admissions due to frequent hypoglycemia are also associated with further deterioration in patients’ general health. This negative impact of hypoglycemia is likely to eventually lead to frailty and disability. It appears that the relationship between hypoglycemia and frailty is bidirectional and mediated through a series of influences including under nutrition. Therefore, attention should be paid to the management of under nutrition in the general elderly population by improving energy intake and maintaining muscle mass. Increasing physical activity and having a more conservative approach to glycemic targets in frail geriatric patients with diabetes may be worthwhile.

• MeSH
• diabetes mellitus terapie   MeSH
• hodnocení stavu výživy MeSH
• hypoglykemie * etiologie   komplikace   prevence a kontrola   MeSH
• křehkost diagnóza   komplikace   prevence a kontrola   MeSH
• lidé MeSH
• podvýživa MeSH
• sarkopenie MeSH
• Check Tag
• lidé MeSH

BACKGROUND: Vitamin D deficiency associates with the risk of developing many diseases, including cancer. At the molecular level, vitamin D appears to have an antineoplastic effect. However, the role of vitamin D deficiency in cancer pathogenesis remains unelucidated and numerous studies have resulted in discordant results. This study aimed to determine whether vitamin D deficiency during melanoma diagnosis increases the risk of developing non-cutaneous second primary cancers (SPC). MATERIALS AND METHODS: A retrospective study on 663 patients diagnosed with melanoma between 1 January 2011 and 31 October 2022. The effect of each variable on the development of a subsequent non-cutaneous cancer was performed using Kaplan-Meier curves and differences were assessed by log-rank tests. Cox proportional hazard univariate and multivariate models were used to quantify the effect of each variable in the time to develop a non-cutaneous neoplasia. RESULTS: Out of 663 patients, 34 developed a non-cutaneous SPC. There was no statistically significant association between vitamin D levels and non-cutaneous SPC development (log-rank, p=0.761). Age>60 years, stage III/IV, and nodular melanoma subtype were significantly associated with the development of a SPC. After multivariate analysis, only age>60 years (HR 3.4; HR CI 95%: 1.5-7.6) and nodular melanoma subtype (HR 2.2; HR CI 95%: 1.0-4.8) were included in the final model. CONCLUSIONS: Our results suggest that vitamin D deficiency is not associated with an increased risk of developing non-cutaneous SPC in melanoma patients. However, age over 60 years and nodular melanoma subtype increase the risk for non-cutaneous SPC development.

• MeSH
• lidé středního věku MeSH
• lidé MeSH
• melanom * epidemiologie   etiologie   diagnóza   MeSH
• nádory kůže * etiologie   komplikace   MeSH
• nedostatek vitaminu D * komplikace   epidemiologie   MeSH
• retrospektivní studie MeSH
• sekundární malignity * epidemiologie   etiologie   MeSH
• vitamin D škodlivé účinky   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• pozorovací studie MeSH

Úvod: Akutní poškození ledvin (AKI – acute kidney injury) se vyskytuje u kriticky nemocných pacientů s výrazným dopadem na jejich morbiditu a mortalitu. Náhlé snížení renálních funkcí ovlivňuje činnost a funkci jiných orgánů, mezi jinými také střevo navozením střevní dysmikrobie, jež recipročně zhoršuje průběh AKI a může také vést k rozvoji chronické nefropatie. Cíl: Patofyziologie AKI, sepse a střevní dysmikrobie v kritickém stavu pacienta s dopadem na vývoj nemoci a jiné orgánové systémy s možnostmi jejího pozitivního ovlivnění nutričními opatřeními. Závěr: Kriticky nemocní pacienti zejména v septickém stavu komplikovaném AKI jsou náchylní ke komplikacím typu střevní dysmikrobie, sekundární sepse a imunodeficience. Léčba základního onemocnění a jeho komplikací spolu s nutriční podporou napomáhá ke zlepšení klinického stavu této skupiny nemocných.

Introduction: Acute kidney injury (AKI) occurs in critically ill patients with significant impact on their morbidity and mortality. The sudden reduction in renal function affects the function of other organs, comprising the intestine, inducing intestinal dysmicrobia, which reciprocally worsens the course of AKI and may also lead to the development of chronic nephropathy. Purpose: Pathophysiology of AKI, sepsis and intestinal dysmicrobia in a critical patient with impact on the development of the disease and other organ systems with possibilities of its positive influence by nutritional measures. Conclusion: Critically ill patients especially in septic status complicated by AKI are prone to complications such as intestinal dysmicrobia, secondary sepsis and immunodeficiency. Treatment of the underlying disease and its complications along with nutritional support helps to improve the clinical outcome of this group of patients.

• MeSH
• akutní poškození ledvin * komplikace   patofyziologie   MeSH
• dysbióza * etiologie   mikrobiologie   patologie   MeSH
• lidé MeSH
• nutriční podpora MeSH
• péče o pacienty v kritickém stavu MeSH
• podvýživa etiologie   terapie   MeSH
• sepse patologie   MeSH
• septický šok patologie   MeSH
• uremické toxiny škodlivé účinky   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• práce podpořená grantem MeSH
• přehledy MeSH

BACKGROUND/OBJECTIVE: Optimal vitamin D levels are required for bone health and proper functionality of the nervous, musculoskeletal and immune systems. The objective of this study was to assess the efficacy and safety profiles of new weekly calcifediol formulations with the potential to improve adherence and outcome. METHODS: A Phase II-III, double-blind, randomized, multicentre trial (EudraCT 2020-001099-14 and NCT04735926). Subjects were randomized 2:2:1 to calcifediol 75 μg, 100 μg and placebo. 25(OH)D levels were measured at 4, 16, 24, 32 and 52 weeks. The main outcome was the percentage of subjects who achieved a response defined as 25(OH)D levels ≥20 ng/mL and/or ≥30 ng/mL at week 16. RESULTS: 398 subjects (51.1 ± 15.96 years, 74.2% females, 98.7% Caucasian) with plasma 25(OH)D levels between 10 and 20 ng/mL were randomized. A total of 376 subjects completed 16 weeks of treatment, and 355 subjects completed the study. Six patients withdrew due to an adverse event, all unrelated to treatment. At week 16, 93.6% and 74.4% of subjects receiving calcifediol 75 μg achieved response levels of ≥20 ng/mL and ≥30 ng/mL, respectively. The calcifediol 100 μg group showed 98.7% and 89.9% of responders for ≥20 ng/mL and ≥30 ng/mL, respectively. Both calcifediol groups showed superiority over placebo at each response level at all time points analyzed (p < 0.0001). Calcifediol treatments increased 25(OH)D levels from baseline to week 24 and remained stable thereafter. The frequency of treatment-emergent adverse events was balanced between groups. CONCLUSIONS: New weekly calcifediol 75 and 100 μg formulations showed an effective and sustained response with a good long-term safety profile.

• MeSH
• dospělí MeSH
• dvojitá slepá metoda MeSH
• kalcifediol * krev   aplikace a dávkování   MeSH
• lidé středního věku MeSH
• lidé MeSH
• nedostatek vitaminu D * farmakoterapie   krev   MeSH
• potravní doplňky MeSH
• senioři MeSH
• vitamin D krev   analogy a deriváty   aplikace a dávkování   MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• klinické zkoušky, fáze II MeSH
• klinické zkoušky, fáze III MeSH
• multicentrická studie MeSH
• randomizované kontrolované studie MeSH

• MeSH
• antropometrie metody   MeSH
• hodnocení stavu výživy MeSH
• kwashiorkor diagnóza   etiologie   MeSH
• nutriční podpora klasifikace   metody   MeSH
• podvýživa * diagnóza   etiologie   klasifikace   terapie   MeSH
• poruchy výživy diagnóza   klasifikace   MeSH
• protein-energetická malnutrice diagnóza   etiologie   MeSH
• Publikační typ
• přehledy MeSH

• MeSH
• bisfosfonáty farmakologie   klasifikace   terapeutické užití   MeSH
• denosumab farmakologie   terapeutické užití   MeSH
• metabolické nemoci kostí * diagnóza   klasifikace   metabolismus   MeSH
• nedostatek vitaminu D farmakoterapie   komplikace   MeSH
• osteomalacie diagnóza   etiologie   farmakoterapie   MeSH
• osteoporóza diagnóza   farmakoterapie   metabolismus   prevence a kontrola   MeSH
• Pagetova kostní nemoc diagnóza   farmakoterapie   MeSH
• Publikační typ
• přehledy MeSH

As of the 7th of July 2024, 775,754,322 confirmed cases of COVID-19, including 7,053,902 deaths worldwide, had been reported to the WHO (World Health Organization). Nevertheless, untill the 15th of July 2024, a total of 13,578,710,228 vaccine doses had been administered, with almost no country spared from COVID-19 attacks. The pathophysiology of this virus is complicated, and several symptoms require a deep understanding of the actual mechanisms. It is unclear why some patients develop severe symptoms while others do not, although literature suggests a role for vitamin D. Vitamin D plays a crucial role in the infection or in ameliorating the severity of symptoms. The mechanism of action of vitamin D and vitamin D deficiency (VDD) is well understood. VDD is associated with increased hospitalization of severely ill patients and increased levels of COVID-19-caused mortality. Recent studies suggest that vitamin D levels and genetic variations in the vitamin D receptor (VDR) gene significantly impact the severity and outcomes of COVID-19, especially in the infections caused by Delta and Omicron variants. Furthermore, VDD causes immune system dysregulation upon infection with SARS-CoV-2, indicating that vitamin D sufficiency is crucial in fighting against COVID-19 infection. The therapeutic effect of vitamin D raises interest in its potential role as a prophylactic and treatment adjunct. We evaluate the immunomodulatory effects of vitamin D and its ability to enhance the efficacy of new antiviral drugs like molnupiravir and paxlovid against SARS-CoV-2. This review discusses the role of vitamin D sufficiency and VDD in COVID-19 initiation and progression, emphasizing the molecular mechanisms by which vitamin D exerts its actions as a proactive step for the next pandemic. However, there is still no clear evidence of vitamin D's impact on prevention and treatment, leading to contradictory findings. Therefore, large-scale randomized trials are required to reach a definitive conclusion. A bibliometric analysis of publications related to vitamin D, immunity, and COVID-19 revealed a significant increase in research activity in this area, particularly in 2020-2024, underscoring the growing recognition of vitamin D's potential role in the context of the pandemic.

• MeSH
• COVID-19 * imunologie   MeSH
• farmakoterapie COVID-19 MeSH
• lidé MeSH
• nedostatek vitaminu D * farmakoterapie   imunologie   MeSH
• pandemie MeSH
• receptory kalcitriolu metabolismus   MeSH
• SARS-CoV-2 imunologie   MeSH
• vitamin D * terapeutické užití   aplikace a dávkování   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

Vitamin D is an important steroid hormone that exerts immunomodulatory actions, controls calcium and phosphate homeostasis, and significantly affects human health. Vitamin D deficiency is a global health problem, affecting approximately 60% of adults worldwide, and has been implicated in a range of different types of diseases, e.g., cancer. Vitamin D is involved in the regulation of cell proliferation, differentiation, energetic metabolism, and different types of cell death (e.g., apoptosis, autophagy, etc.). In physiological conditions, it is also able to modulate immune responses, angiogenesis, etc., which belongs to fundamental cancer-related processes. Vitamin D deficiency has been associated with an increased risk of some types of cancer, e.g., colorectal, breast, ovarian, prostate, pancreatic, etc. The role of vitamin D in cancer prevention, carcinogenesis, and cancer treatment is still under investigation and depends on the type of cancer. This review summarizes the role of vitamin D in all three above-mentioned aspects and discusses the mechanism of action and potential possibilities in cancer treatment.

• MeSH
• lidé MeSH
• nádory * prevence a kontrola   farmakoterapie   MeSH
• nedostatek vitaminu D komplikace   MeSH
• potravní doplňky * MeSH
• vitamin D * terapeutické užití   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH