Tyroidálne hormóny (TH) ovplyvňujú vrodené aj adaptívne imunitné reakcie prostredníctvom genetických a negenomických dráh. 3,5,3 ́-trijódtyronínu (T 3) a tyroxín (T4) zvyšujú syntézu a uvoľňovanie cytokínov, ktoré sú zložkami „cytokínovej búrky“, ktorú môžu vyvolať aj systémové vírusové infekcie. Jednovláknový RNA koronavírus 2 môže spôsobiť alebo negatívne ovplyvniť už existujúce rôzne ochorenia štítnej žľazy (ŠŽ) – subakútnu tyroiditídu, tyreotoxikózu, autoimunitnú chronickú lymfocytárnu tyroiditídu, hypotyreózu a syndróm nízkeho T3.
Thyroid hormones (TH) influence both innate and adaptive immune responses through genetic and non-genomic pathways. 3,5,3 ́-triiodothyronine (T 3) and thyroxine (T 4) increase the synthesis and release of cytokines, which are components of the „cytokine storm“ that can also be triggered by systemic viral infections. Single-stranded RNA coronavirus 2 can cause or negatively affect pre-existing various thyroid diseases – subacute thyroiditis, thyrotoxicosis, autoimmune chronic lymphocytic thyroiditis, hypothyroidism and low T3 syndrome.
Importance: Heart failure with recovered ejection fraction (HFrecEF) is a recently recognized phenotype of patients with a history of reduced left ventricular ejection fraction (LVEF) that has subsequently normalized. It is unknown whether such LVEF improvement is associated with improvements in health status. Objective: To examine changes in health-related quality of life in patients with heart failure with reduced ejection fraction (HFrEF) whose LVEF normalized, compared with those whose LVEF remains reduced and those with HF with preserved EF (HFpEF). Design, Setting, and Participants: This prospective cohort study was conducted at a tertiary care hospital from November 2016 to December 2018. Consecutive patients seen in a heart failure clinic who completed patient-reported outcome assessments were included. Clinical data were abstracted from the electronic health record. Data analysis was completed from February to December 2020. Main Outcomes and Measures: Changes in Kansas City Cardiomyopathy Questionnaire overall summary score, Visual Analog Scale score, and Patient-Reported Outcomes Measurement Information System domain scores on physical function, fatigue, depression, and satisfaction with social roles over 1-year follow-up. Results: The study group included 319 patients (mean [SD] age, 60.4 [15.5] years; 120 women [37.6%]). At baseline, 212 patients (66.5%) had HFrEF and 107 (33.5%) had HFpEF. At a median follow-up of 366 (interquartile range, 310-421) days, LVEF had increased to 50% or more in 35 patients with HFrEF (16.5%). Recovery of systolic function was associated with heart failure-associated quality-of-life improvement, such that for each 10% increase in LVEF, the Kansas City Cardiomyopathy Questionnaire score improved by an mean (SD) of 4.8 (1.6) points (P = .003). Recovery of LVEF was also associated with improvement of physical function, satisfaction with social roles, and a reduction in fatigue. Conclusions and Relevance: Among patients with HFrEF in this study, normalization of left ventricular systolic function was associated with a significant improvement in health-related quality of life.
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- dospělí MeSH
- dysfunkce levé srdeční komory patofyziologie MeSH
- hodnocení výsledků péče pacientem MeSH
- kohortové studie MeSH
- kvalita života * MeSH
- lidé středního věku MeSH
- lidé MeSH
- obnova funkce fyziologie MeSH
- prospektivní studie MeSH
- senioři MeSH
- srdeční selhání patofyziologie MeSH
- tepový objem * MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Research Support, N.I.H., Extramural MeSH
Background. The relative rarity of ischemic compared with traumatic spinal cord injury (SCI) has limited a comparison of the outcomes of these conditions. Objective. To investigate the neurological and functional recovery of ischemic compared with traumatic acute SCI. Methods. Data were derived from the European Multicenter Study Spinal Cord Injury database. Patients with ischemic (iSCI) or traumatic SCI (tSCI), aged 18 years or older were evaluated at different time points from incidence: at about 1 month, 3 months, and 6 months. The neurological status was assessed at each time point by the International Standards for Neurological Classification of Spinal Cord Injury and the functional status by the Spinal Cord Independence Measure. Walking ability was evaluated by Walking Index for Spinal Cord Injury, 10-Meter Walk Test, and 6-Minute Walk Test. Because of the imbalances of the 2 groups in respect to size and lesion severity, a matching procedure according to age, neurological level, and severity of injury was performed. Outcomes evaluation was performed by means of a 2-way repeated-measures ANOVA. Results. The matching procedure resulted in 191 pairs. Both groups significantly improved from about 15 days after the lesion to 6 months. No differences were found in the course of neurological and functional recovery of iSCI compared with tSCI. Conclusions. This analysis from a representative cohort of participants revealed that from 15 days following the cord damage onward, the outcomes after iSCI and tSCI are comparable. This finding supports the potential enrolment of patients with acute iSCI into clinical trials from that point in time after the event and an evaluation up to 6 months afterward.
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- akutní nemoc MeSH
- databáze faktografické MeSH
- dospělí MeSH
- funkční status * MeSH
- hodnocení výsledků zdravotní péče * MeSH
- lidé středního věku MeSH
- lidé MeSH
- míšní ischemie patofyziologie MeSH
- následné studie MeSH
- obnova funkce fyziologie MeSH
- poranění míchy patofyziologie MeSH
- senioři MeSH
- stupeň závažnosti nemoci MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- práce podpořená grantem MeSH
- srovnávací studie MeSH
STUDY DESIGN: Multicenter prospective cohort. OBJECTIVE: To discern neurological- and functional recovery in patients with a traumatic thoracic spinal cord injury (TSCI), conus medullaris syndrome (CMS), and cauda equina syndrome (CES). SETTING: Specialized spinal cord injury centers in Europe. METHOD: Lower extremity motor score (LEMS) and spinal cord independent measure (SCIM) scores from patients with traumatic TSCI, CMS, and CES were extracted from the EMSCI database. Scores from admittance and during rehabilitation at 1, 3, 6, and 12 months were compared. Linear mixed models were used to statistically analyse differences in outcome, which were corrected for the ASIA Impairment Scale (AIS) in the acute phase. RESULTS: Data from 1573 individuals were analysed. Except for the LEMS in patients with a CES AIS A, LEMS, and SCIM significantly improved over time for patients with a TSCI, CMS, and CES. Irrespectively of the AIS score, recovery in 12 months after trauma as measured by the LEMS showed a statistically significant difference between patients with a TSCI, CMS, and CES. Analysis of SCIM score showed no difference between patients with TSCI, CMS, or CES. CONCLUSION: Difference in recovery between patients with a traumatic paraplegia is based on neurological (motor) recovery. Regardless the ceiling effect in CES patients, patients with a mixed upper and lower motor neuron syndrome (CMS) showed a better recovery compared with patients with a upper motor neuron syndrome (TSCI). These findings enable stratifications of patients with paraplegia according to the level and severity of SCI.
- MeSH
- bederní obratle zranění MeSH
- dospělí MeSH
- hodnocení výsledků zdravotní péče * MeSH
- hrudní obratle zranění MeSH
- komprese míchy etiologie patofyziologie rehabilitace MeSH
- lidé středního věku MeSH
- lidé MeSH
- obnova funkce fyziologie MeSH
- onemocnění motorického neuronu etiologie patofyziologie rehabilitace MeSH
- paraplegie etiologie patofyziologie rehabilitace MeSH
- poranění míchy komplikace patofyziologie rehabilitace MeSH
- prospektivní studie MeSH
- syndrom kaudy etiologie patofyziologie rehabilitace MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- Geografické názvy
- Evropa MeSH
OBJECTIVE: To evaluate the impact of age on recovery from multiple sclerosis relapses. BACKGROUND: Increasing disability in multiple sclerosis is a consequence of progressive disease and incomplete relapse recovery. METHODS: The first and last-ever relapse data (357 relapses in 193 patients) from the Olmsted County population-based multiple sclerosis cohort were systematically reviewed for age, fulminance, location (optic nerve, brainstem/cerebellar, spinal cord), peak deficit, and maximum recovery. Three different relapse-outcome measures were studied both as paired analyses and as an overall group effect: change from peak deficit to maximum recovery in raw functional system score related to the relapse (ΔFSS), a previously published FSS-based relapse-impact model, and change from peak deficit to maximum recovery in Extended Disability Status Scale (ΔEDSS) score. RESULTS: Older age was linearly associated with worse recovery in the ΔFSS outcome (p = 0.002), ΔEDSS outcome (p < 0.001), and the FSS-based relapse-impact model (p < 0.001). A multivariate analysis of ΔFSS outcome linked poor recovery to older age (p = 0.015), relapse location (transverse myelitis or brainstem/cerebellar syndrome; p < 0.001), and relapse fulminance (p = 0.004). CONCLUSION: Multiple sclerosis-relapse recovery declines in a linear fashion with increased age, which should be considered when making treatment decisions.
- MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- obnova funkce fyziologie MeSH
- progrese nemoci MeSH
- recidiva MeSH
- relabující-remitující roztroušená skleróza patofyziologie MeSH
- věkové faktory * MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
BACKGROUND: Internal carotid artery stenosis (ICAS) is associated with significantly higher risk of stroke. Autonomic function can be impaired in the presence of atheroma in the carotid sinus region. Two parameters of autonomic nervous system (ANS) function e.g. heart rate variability (HRV) and baroreflex sensitivity (BRS) are respected predictors of cardiovascular prognosis. We assessed the effect of elective unilateral carotid endarterectomy (CEA) on cardiovascular autonomic functions as a major prognostic factor for cardiovascular health. METHODS: Nineteen patients indicated for CEA underwent formal autonomic assessment in the laboratory. Hemodynamic profiles, HRV and BRS were evaluated with the dedicated high-tech device Task Force Monitor before surgery (day-1) and postoperatively (day 3±1). Data were obtained during 5 min orthostatic challenge and subsequent 5 min in a supine position. RESULTS: There were no significant early postoperative changes in evaluated parameters after CEA. There was a mild decrease of blood pressure and therefore only a slight increase in BRS. It was also possible to observe a rise in the value of total power and high frequency power. CONCLUSION: In the early postoperative period, healing processes are occurring and the sympatho-vagal interaction is probably still unbalanced. Given the considerable clinical potential of BRS and HRV measurement, further short-term and, more importantly, long-term investigations are needed.
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- autonomní nervový systém fyziologie MeSH
- baroreflex fyziologie MeSH
- hemodynamika MeSH
- karotická endarterektomie * MeSH
- krevní tlak MeSH
- lidé MeSH
- nervus vagus fyziologie MeSH
- obnova funkce fyziologie MeSH
- pooperační období MeSH
- prediktivní hodnota testů MeSH
- senioři MeSH
- srdeční frekvence MeSH
- stenóza arteria carotis patofyziologie chirurgie MeSH
- sympatický nervový systém fyziologie MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Traumatic injuries to peripheral nerves are frequent, however, specific pharmacological treatments are currently lacking. Curcumin has antioxidant, anti-inflammatory and neuroprotective properties but high oral doses are required for therapeutic use, particularly due to its low bioavailability. The aim of the present study was to investigate the effects of local and continuous treatment using low curcumin doses on functional recovery and nerve regeneration after rat sciatic nerve crush (SNC). Curcumin was administered by osmotic pumps with a catheter delivering the drug at the injury site (0.2 mg/day for 4 weeks). Functionally, early improvements in mechanical sensitivity, finger spacing of the injured paw, skilful walking and grip strength were observed in curcumin-treated animals. The curcumin treatment increased expression of compact myelin proteins (MPZ and PMP22), myelin sheath thickness and, correspondingly, increased motor and sensitive nerve conduction velocity. Microscopic analysis of gastrocnemius muscle indicated a curcumin-induced decrease in neurogenic lesions. Curcumin treatment reduced the production of reactive oxygen species (ROS) (which were notably produced by macrophages), lipid peroxidation and increased expression of transcription factor Nrf2. In silico analyses indicated that curcumin combines all the characteristics required to be an efficient lipid peroxidation inhibitor at the heart of biological membranes, hence protecting their degradation due to ROS. This antioxidant capacity is likely to contribute to the beneficial effects of curcumin after SNC injury. These results demonstrate that, when administrated locally, low doses of curcumin represent a promising therapy for peripheral nerve regeneration.
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- antioxidancia farmakologie MeSH
- drtivá poranění farmakoterapie patologie patofyziologie MeSH
- faktor 2 související s NF-E2 metabolismus MeSH
- kosterní svaly účinky léků patologie patofyziologie MeSH
- kultivované buňky MeSH
- kurkumin farmakologie MeSH
- náhodné rozdělení MeSH
- nervové vedení účinky léků MeSH
- nervus ischiadicus účinky léků zranění patologie patofyziologie MeSH
- neuroprotektivní látky farmakologie MeSH
- obnova funkce účinky léků fyziologie MeSH
- oxidační stres účinky léků MeSH
- peroxidace lipidů účinky léků MeSH
- potkani Sprague-Dawley MeSH
- remyelinizace účinky léků fyziologie MeSH
- simulace molekulární dynamiky MeSH
- zvířata MeSH
- Check Tag
- mužské pohlaví MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
BACKGROUND: Atrial fibrillation (AF) catheter ablation is increasingly proposed for patients suffering from AF and concomitant heart failure (HF). However, the optimal ablation strategy remains controversial. We performed this study to assess the prevalence of pulmonary vein (PV) or linear lesion reconnection in HF patients undergoing repeated procedures. METHODS AND RESULTS: At seven high-volume centres, 165 patients with HF underwent a repeat procedure after a first AF ablation including PV isolation alone (47 patients, group A) or PV isolation plus left atrial lines (118 patients, group B). Group A patients presented more often paroxysmal AF (p<0.001), less enlarged left atrium (p<0.001) and less left ventricular systolic dysfunction (p=0.031) compared to Group B, that more commonly had atypical atrial flutter (p<0.001). Forty-one (87%) patients in Group A and 69 (58%) in Group B presented at least one reconnected PV (p<0.001). Sixty-one (52%) patients in Group B presented at least one reconnected atrial line (left isthmus or roof). Patients without any reconnected PV (n=54, 33%) more frequently experienced persistent AF (p<0.001), had longer AF duration (p=0.047) and larger left atrial volume (p<0.001). Twenty-five patients (15%) with no PV and/or line reconnection did not significantly differ, concerning baseline characteristics, compared to those with at least one reconnected ablation site. CONCLUSION: As in the general AF population undergoing catheter ablation, PV reconnection is frequent in patients with HF and symptomatic recurrence. However, one third of patients presented arrhythmic recurrences even in the absence of PV reconnection, highlighting the importance of the underlying atrial substrate.
- MeSH
- dospělí MeSH
- fibrilace síní epidemiologie patofyziologie chirurgie MeSH
- katetrizační ablace trendy MeSH
- lidé středního věku MeSH
- lidé MeSH
- obnova funkce * fyziologie MeSH
- převodní systém srdeční fyziologie MeSH
- recidiva MeSH
- retrospektivní studie MeSH
- senioři MeSH
- srdeční selhání epidemiologie patofyziologie chirurgie 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
- multicentrická studie MeSH
This study aimed to (1) evaluate the effect of hand shaking during recovery phases of intermittent testing on the time-force characteristics of performance and muscle oxygenation, and (2) assess inter-individual variability in the time to achieve the target force during intermittent testing in rock climbers. Twenty-two participants undertook three finger flexor endurance tests at 60% of their maximal voluntary contraction until failure. Performances of a sustained contraction and two intermittent contractions, each with different recovery strategies, were analysed by time-force parameters and near-infrared spectroscopy. Recovery with shaking of the forearm beside the body led to a significantly greater intermittent test time (↑ 22%, P < .05), force-time integral (↑ 28%, P < .05) and faster muscle re-oxygenation (↑ 32%, P < .05), when compared to the hand over hold condition. Further, the ratio of intermittent to continuous test time distinguished specific aerobic muscular adaptations among sport climbers (2.02), boulderers (1.74) and lower grade climbers (1.25). Lower grade climbers and boulderers produced shorter duration contractions due to the slower development of target force during the intermittent test, indicating worse kinaesthetic differentiation. Both the type of recovery and climbing discipline determined muscle re-oxygenation and intermittent performance in rock climbers.
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- cvičení fyziologie MeSH
- dospělí MeSH
- lidé MeSH
- obnova funkce fyziologie MeSH
- předloktí fyziologie MeSH
- prsty ruky fyziologie MeSH
- síla ruky fyziologie MeSH
- sportovní výkon fyziologie MeSH
- sporty fyziologie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
PURPOSE: The aim of the study was to evaluate intraocular pressure (IOP) before and after moderate exercise in normal healthy individuals with defined physical exertion. The second aim of this investigation was to determine the correlation between resting IOP (IOPr) and its change induced by exercise as well as the relationship between resting heart rate (HRr) and changes in IOP after exercise. METHODS: Forty-one healthy volunteers between the ages of 19 and 25 years were recruited for the study. First, the resting (reference) values IOPr and HRr were measured after 30 min of resting time. Volunteers consequently performed 30 min of exercise on a bicycle ergometer. Intraocular pressure was remeasured immediately after the end of exercise (the relevant IOP change was denoted as ΔIOP0) and subsequently repeated 5, 10, 20, and 30 min after exercise. RESULTS: A significant decrease in IOP compared with the resting value (post hoc Tukey honest significant difference test) was found immediately after exercise (p = 2 × 10) and 5 and 10 min after exercise (p = 2 × 10 and p = 3 × 10). Significant relationships were found between the change in IOP (ΔIOP0) and baseline IOP (IOPr) and between the baseline resting heart rate (HRr) and the change in IOP (ΔIOP0). CONCLUSIONS: There was a significant IOP-lowering effect, which was persistent for 10 min after 30 min of exercise. The IOP change was dependent on the initial IOP reading and initial HR.
- MeSH
- cvičení fyziologie MeSH
- dospělí MeSH
- lidé MeSH
- mladý dospělý MeSH
- nitrooční tlak fyziologie MeSH
- obnova funkce fyziologie MeSH
- srdeční frekvence fyziologie MeSH
- tonometrie oční MeSH
- zátěžový test MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
