Long-term peritoneal dialysis is associated with the development of peritoneal membrane alterations, both in morphology and function. Impaired ultrafiltration (UF) is the most important functional change, and peritoneal fibrosis is the major morphological alteration. Both are caused by the continuous exposure to dialysis solutions that are different from plasma water with regard to the buffer substance and the extremely high-glucose concentrations. Glucose has been incriminated as the major cause of long-term peritoneal membrane changes, but the precise mechanism has not been identified. We argue that glucose causes the membrane alterations by peritoneal pseudohypoxia and by the formation of advanced glycosylation end products (AGEs). After a summary of UF kinetics including the role of glucose transporters (GLUT), and a discussion on morphologic alterations, relationships between function and morphology and a survey of the pathogenesis of UF failure (UFF), it will be argued that impaired UF is partly caused by a reduction in small pore fluid transport as a consequence of AGE-related vasculopathy and - more importantly - in diminished free water transport due to pseudohypoxia, caused by increased peritoneal cellular expression of GLUT-1. The metabolism of intracellular glucose will be reviewed. This occurs in the glycolysis and in the polyol/sorbitol pathway, the latter is activated in case of a large supply. In both pathways the ratio between the reduced and oxidised form of nicotinamide dinucleotide (NADH/NAD+ ratio) will increase, especially because normal compensatory mechanisms may be impaired, and activate expression of hypoxia-inducible factor-1 (HIF-1). The latter gene activates various profibrotic factors and GLUT-1. Besides replacement of glucose as an osmotic agent, medical treatment/prevention is currently limited to tamoxifen and possibly Renin/angiotensis/aldosteron (RAA) inhibitors.

• MeSH
• dialyzační roztoky škodlivé účinky   metabolismus   MeSH
• glukosa škodlivé účinky   metabolismus   MeSH
• glykosylace MeSH
• lidé MeSH
• peritoneální dialýza * škodlivé účinky   MeSH
• peritoneum metabolismus   MeSH
• ultrafiltrace MeSH
• voda metabolismus   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

UNLABELLED: PURPOSE : To compare the efficacy and safety of the fixed-dose combination (FDC) of netarsudil 0.02%/latanoprost 0.005% ophthalmic solution (NET/LAT; Roclanda®) with bimatoprost 0.03%/timolol maleate 0.5% (BIM/TIM; Ganfort®) ophthalmic solution in the treatment of open-angle glaucoma (OAG) and ocular hypertension (OHT). METHODS: MERCURY-3 was a 6-month prospective, double-masked, randomized, multicenter, active-controlled, parallel-group, non-inferiority study. Patients (≥ 18 years) with a diagnosis of OAG or OHT in both eyes that was insufficiently controlled with topical medication (IOP ≥ 17 mmHg in ≥ 1 eye and < 28 mmHg in both eyes) were included. Following washout, patients were randomized to once-daily NET/LAT or BIM/TIM for up to 6 months; efficacy was assessed at Week 2, Week 4, and Month 3; safety was evaluated for 6 months. Comparison of NET/LAT relative to BIM/TIM for mean IOP at 08:00, 10:00, and 16:00 h was assessed at Week 2, Week 6, and Month 3. Non-inferiority of NET/LAT to BIM/TIM was defined as a difference of ≤ 1.5 mmHg at all nine time points through Month 3 and ≤ 1.0 mmHg at five or more of nine time points through Month 3. RESULTS: Overall, 430 patients were randomized (NET/LAT, n = 218; BIM/TIM, n = 212), and all received at least one dose of study medication. Efficacy analyses were performed at Month 3 on 388 patients (NET/LAT, n = 184; BIM/TIM, n = 204). NET/LAT demonstrated non-inferiority to BIM/TIM, with a between-treatment difference in IOP of ≤ 1.5 mmHg achieved at all time points and ≤ 1.0 mmHg at the majority of time points (six of nine) through Month 3. Mean diurnal IOP during the study ranged from 15.4 to 15.6 mmHg and 15.2 to 15.6 mmHg in the NET/LAT and BIM/TIM groups respectively, with no between-group statistically significant difference. No significant differences were observed in key secondary endpoints. No serious, treatment-related adverse events (AEs) were observed, and AEs were typically mild/moderate in severity. The most common treatment-related AEs were conjunctival hyperemia (NET/LAT, 30.7%; BIM/TIM, 9.0%) and cornea verticillata (NET/LAT, 11.0%; BIM/TIM, 0%). CONCLUSIONS: Once-daily NET/LAT was non-inferior to BIM/TIM in IOP reduction in OAG and OHT, with AEs consistent with previous findings. NET/LAT offers a compelling alternative FDC treatment option for OAG and OHT.

• MeSH
• antihypertenziva škodlivé účinky   MeSH
• benzoáty * MeSH
• beta-alanin analogy a deriváty   MeSH
• bimatoprost terapeutické užití   MeSH
• dvojitá slepá metoda MeSH
• glaukom s otevřeným úhlem * diagnóza   farmakoterapie   MeSH
• latanoprost škodlivé účinky   MeSH
• lidé MeSH
• nitrooční tlak MeSH
• oční hypertenze * diagnóza   farmakoterapie   MeSH
• oční roztoky MeSH
• prospektivní studie MeSH
• timolol škodlivé účinky   MeSH
• tonometrie oční MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• randomizované kontrolované studie MeSH

• MeSH
• analgosedace MeSH
• antibiotická profylaxe MeSH
• gastrointestinální endoskopie klasifikace   metody   normy   MeSH
• gastrointestinální krvácení diagnóza   prevence a kontrola   terapie   MeSH
• gastrointestinální nemoci diagnóza   prevence a kontrola   terapie   MeSH
• hematologické látky aplikace a dávkování   MeSH
• hemostáza endoskopická metody   MeSH
• kolonoskopie * klasifikace   metody   normy   škodlivé účinky   MeSH
• lidé MeSH
• předoperační péče metody   MeSH
• riziko MeSH
• roztoky analýza   klasifikace   terapeutické užití   MeSH
• terciární prevence metody   MeSH
• vysazování léků MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• směrnice pro lékařskou praxi MeSH

• Klíčová slova
• abdominální katastrofa,
• MeSH
• břišní dutina * chirurgie   patologie   MeSH
• centrální žilní katétry * klasifikace   normy   škodlivé účinky   MeSH
• lékové roztoky MeSH
• lidé MeSH
• roztoky pro parenterální výživu MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• přehledy MeSH

Spektrum roztoků určených k ošetření a léčbě ran se neustále rozšiřuje a v současné době čítá kolem dvou desítek názvů s obsahem rozličných terapeutických látek. V klinické praxi zdravotníci ztrácejí přehled v indikacích jednotlivých roztoků a v rozdílech mezi nimi. Příspěvek se zaměřuje na rozdělení jednotlivých roztoků do skupin s jejich charakteristikami týkající se obsahu účinné látky, působení na patogeny, kontraindikace, expozičního času, pH a dalších vlastností včetně způsobu aplikace.

The spectrum of solutions of intended for the treatment and healing of wounds is constantly expanding and curently includes around two dozen names containing various therapeutic substances. In clinical practice, health professiolnals lose track of the indications of individual liquid solutions and the differences between them. The contribution focuses on the division of individual solutions into groups with their characteristics regarding the content of the active substance, action on pathogens, contraindications, exposure time, pH and other properties, including the method of application.

• MeSH
• hojení ran * účinky léků   MeSH
• lidé MeSH
• ošetřovatelská péče metody   MeSH
• roztoky terapeutické užití   MeSH
• Check Tag
• lidé MeSH

BACKGROUND: Since many acutely admitted older adults display signs of dehydration, treatment using balanced crystalloids is an important part of medical care. Additionally, many of these patients suffer from chronic malnutrition. We speculated that the early addition of glucose might ameliorate the hospital-related drop of caloric intake and modify their catabolic status. METHODS: We included patients 78 years and older, admitted acutely for non-traumatic illnesses. The patients were randomized into either receiving balanced crystalloid (PlasmaLyte; group P) or balanced crystalloid enriched with 100 g of glucose per liter (group G). The information about fluid balance and levels of minerals were collected longitudinally. RESULTS: In the G group, a significantly higher proportion of patients developed signs of refeeding syndrome, i.e., drops in phosphates, potassium and/or magnesium when compared to group P (83.3 vs. 16.7%, p < 0.01). The drop in phosphate levels was the most pronounced. The urinalysis showed no differences in the levels of these minerals in the urine, suggesting their uptake into the cells. There were no differences in the in-hospital mortality or in the 1-year mortality. CONCLUSION: The short-term administration of balanced crystalloids with glucose induced an anabolic shift of electrolytes in acutely admitted older adults.

• MeSH
• dehydratace terapie   MeSH
• glukosa * metabolismus   aplikace a dávkování   MeSH
• krystaloidní roztoky aplikace a dávkování   MeSH
• lidé MeSH
• mortalita v nemocnicích MeSH
• potravní doplňky MeSH
• realimentační syndrom prevence a kontrola   MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• tekutinová terapie * metody   MeSH
• vodní a elektrolytová rovnováha MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• randomizované kontrolované studie MeSH

Druhá část cyklu o parenterální nutrici v neonatologii se zaměřuje na makronutrienty a energii. Makronutrienty poskytují primární nutriční zdroj energie a můžeme je rozdělit na bílkoviny (proteiny), tuky (lipidy) a cukry (sacharidy). V parenterální nutrici se bílkoviny dodávají ve formě aminokyselin, cukry ve formě glukózy a tuky jsou podávány v podobě intravenózních lipidových emulzí. Zhodnocení aktuálního stavu novorozence a biochemický monitoring přívodu makronutrientů jsou zásadní pro optimalizaci dodávky živin a prevenci závažných komplikací.

The second part of the neonatal parenteral nutrition series focuses on macronutrients and energy. Macronutrients provide the primary nutritional source of energy and can be classified into proteins, fats (lipids), and sugars (carbohydrates). In neonatal parenteral nutrition, proteins are provided in the form of amino acids, sugars in the form of glucose, and fats are administered in the form of intravenous lipid emulsions. Evaluating the condition of a newborn and biochemical monitoring of macronutrient intake are essential for optimizing nutrient delivery and preventing serious complications.

• MeSH
• aminokyseliny aplikace a dávkování   klasifikace   MeSH
• energetický příjem MeSH
• hypertriglyceridemie etiologie   patologie   MeSH
• krevní glukóza analýza   MeSH
• lipidy fyziologie   terapeutické užití   MeSH
• novorozenec MeSH
• parenterální výživa * metody   škodlivé účinky   MeSH
• poruchy metabolismu glukózy etiologie   MeSH
• proteiny terapeutické užití   MeSH
• roztoky pro parenterální výživu analýza   aplikace a dávkování   farmakologie   MeSH
• sacharidy terapeutické užití   MeSH
• selhání střeva diagnóza   etiologie   farmakoterapie   MeSH
• tukové emulze intravenózní aplikace a dávkování   farmakologie   klasifikace   MeSH
• živiny * aplikace a dávkování   klasifikace   MeSH
• Check Tag
• novorozenec MeSH
• Publikační typ
• přehledy MeSH

(1) Objectives: Intestinal failure in home parenteral nutrition patients (HPNPs) results in oxidative stress and liver damage. This study investigated how a high dose of fish oil (FO) added to various lipid emulsions influences antioxidant status and liver function markers in HPNPs. (2) Methods: Twelve HPNPs receiving Smoflipid for at least 3 months were given FO (Omegaven) for a further 4 weeks. Then, the patients were randomized to subsequently receive Lipoplus and ClinOleic for 6 weeks or vice versa plus 4 weeks of Omegaven after each cycle in a crossover design. Twelve age- and sex-matched healthy controls (HCs) were included. (3) Results: Superoxide dismutase (SOD1) activity and oxidized-low-density lipoprotein concentration were higher in all baseline HPN regimens compared to HCs. The Omegaven lowered SOD1 compared to baseline regimens and thus normalized it toward HCs. Lower paraoxonase 1 activity and fibroblast growth factor 19 (FGF19) concentration and, on the converse, higher alkaline phosphatase activity and cholesten concentration were observed in all baseline regimens compared to HCs. A close correlation was observed between FGF19 and SOD1 in baseline regimens. (4) Conclusions: An escalated dose of FO normalized SOD1 activity in HPNPs toward that of HCs. Bile acid metabolism was altered in HPNPs without signs of significant cholestasis and not affected by Omegaven.

• MeSH
• cholestáza * MeSH
• lidé MeSH
• parenterální výživa doma * metody   MeSH
• rybí oleje MeSH
• sójový olej MeSH
• superoxid dismutáza 1 MeSH
• tukové emulze intravenózní MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• randomizované kontrolované studie MeSH

Freezing and lyophilization have been utilized for decades to stabilize pharmaceutical and food products. Freezing a solution that contains dissolved salt and/or organic matter produces pure primary ice crystal grains separated by freeze-concentrated solutions (FCS). The microscopic size of the primary ice crystals depends on the cooling conditions and the concentration of the solutes. It is generally accepted that primary ice crystals size influences the rate of sublimation and also can impact physico-chemical behaviour of the species in the FCS. This article, however, presents a case where the secondary ice formed inside the FCS plays a critical role. We microscoped the structures of ice-cast FCS with an environmental scanning electron microscope and applied the aggregation-sensitive spectroscopic probe methylene blue to determine how the microstructure affects the molecular arrangement. We show that slow cooling at -50 °C produces large salt crystals with a small specific surface, resulting in a high degree of molecular aggregation within the FCS. In contrast, fast liquid nitrogen cooling yields an ultrafine structure of salt crystals having a large specific surface area and, therefore, inducing smaller aggregation. The study highlights a critical role of secondary ice in solute aggregation and introduces methylene blue as a molecular probe to investigate freezing behaviour of aqueous systems with crystalline solute.

• MeSH
• led * MeSH
• lyofilizace MeSH
• methylenová modř * MeSH
• roztoky MeSH
• voda chemie   MeSH
• zmrazování MeSH
• Publikační typ
• časopisecké články MeSH

• MeSH
• bronchiolitida * diagnóza   etiologie   farmakoterapie   MeSH
• bronchitida * diagnóza   etiologie   farmakoterapie   MeSH
• bronchodilatancia terapeutické užití   MeSH
• diferenciální diagnóza MeSH
• infekce respiračními syncytiálními viry patologie   MeSH
• lidé MeSH
• oxygenoterapie MeSH
• rehydratační roztoky MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• přehledy MeSH