Gestational diabetes mellitus (GDM) is diabetes that is first diagnosed in the second or third trimester of pregnancy in patients who did not have a history of diabetes before pregnancy. Consequences of GDM include increased risk of macrosomia and birth complications in the infant and an increased risk of maternal type 2 diabetes mellitus (T2DM) after pregnancy. There is also a longer-term risk of obesity, T2DM, and cardiovascular diseases in the child. GDM is the result of impaired glucose tolerance due to pancreatic β-cell dysfunction on a background of insulin resistance that physiologically increases during pregnancy. The strongest clinical predictors of GDM are overweight and obesity. The fact that women with GDM are more likely to be overweight or obese suggests that adipose tissue dysfunction may be involved in the pathogenesis of GDM, similarly to T2DM. Adipose tissue is not only involved in energy storage but also functions as an active endocrine organ secreting adipokines (specific hormones and cytokines) with the ability to alter insulin sensitivity. Recent evidence points to a crucial role of numerous adipokines produced by fat in the development of GDM. The following text summarizes the current knowledge about a possible role of selected adipokines in the development of GDM.

• MeSH
• dospělí MeSH
• gestační diabetes etiologie   patofyziologie   MeSH
• lidé MeSH
• nemoci endokrinního systému komplikace   patofyziologie   MeSH
• těhotenství MeSH
• tuková tkáň patofyziologie   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

Pituitary adenomas are frequently occurring intracranial neoplasms. The aim of the treatment of pituitary adenomas is to normalize hormonal hypersecretion, to preserve the normal pituitary function, to reserve or treat impaired pituitary function and to control tumor growth and its mechanical effects on the surrounding structures. Treatment modalities include surgical, medical and radiation therapy. Radiosurgery is mainly used as a secondary line treatment after surgery for residual or recurrent tumors. The antiproliferative effect is achieved by LKG irradiation in more than 90% of patients. Regarding the functioning pituitary adenomas, the manifestation of the treatment effect is slow and depends mainly on the type of adenoma. Gamma knife irradiation is safe when the maximal doses to pituitary and infundibulum are respected.

• MeSH
• adenom chirurgie   MeSH
• dávka záření MeSH
• lidé MeSH
• nádory hypofýzy chirurgie   MeSH
• radiochirurgie škodlivé účinky   metody   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

Thyroid abscess is a relatively rare yet dramatic condition of the thyroid gland requiring immediate therapeutic intervention. Traditionally, more or less aggressive surgical approaches and administration of broad-spectrum antibiotics have been used. Clinically less severe disease allows non-surgical treatment as well. The case report describes successful treatment of a large abscess of iatrogenic origin after biopsy of a cystic cavity. A combination of broad-spectrum antibiotics was used based on culture results, administered both orally and by repeated application directly into the abscess cavity using an ultrasound-guided fine-needle approach. Concurrent repeated evacuation of the cavity replaced drainage. Ultimately, a small residual cavity with sterile contents was managed by sclerotization with absolute alcohol. Clinical condition permitting, thyroid abscess may be successfully treated by repeated application of a targeted antibiotic, using a fine needle and ultrasound guidance, directly into the abscess cavity, with repeated evacuation replacing drainage.

• MeSH
• absces farmakoterapie   etiologie   mikrobiologie   terapie   ultrasonografie   MeSH
• antibakteriální látky aplikace a dávkování   terapeutické užití   MeSH
• ciprofloxacin aplikace a dávkování   terapeutické užití   MeSH
• cysty patologie   MeSH
• dospělí MeSH
• Enterobacter * izolace a purifikace   MeSH
• enterobakteriální infekce farmakoterapie   etiologie   mikrobiologie   terapie   ultrasonografie   MeSH
• ethanol aplikace a dávkování   terapeutické užití   MeSH
• gentamiciny aplikace a dávkování   terapeutické užití   MeSH
• infekce v ráně farmakoterapie   etiologie   mikrobiologie   terapie   ultrasonografie   MeSH
• intervenční ultrasonografie * MeSH
• kombinovaná terapie MeSH
• lidé MeSH
• nemoci štítné žlázy farmakoterapie   etiologie   mikrobiologie   terapie   ultrasonografie   MeSH
• skleroterapie * MeSH
• sklerotizující roztoky aplikace a dávkování   terapeutické užití   MeSH
• tenkojehlová biopsie škodlivé účinky   MeSH
• tracheotomie MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH
• přehledy MeSH

In the beginning of the 21st century obesity still represents health, social and economical threat for most of economically wealthy countries worldwide. Estimated direct costs for obesity and related comorbidities treatment exceed 5% of the total health care costs both in the US and in European Union. However, in addition there are obesity-related indirect costs linked to more frequent work sickness leave, higher unemployment rates and overall lower productivity of obese patients. Surgical treatment of obesity (bariatric surgery) is the most effective long-term treatment modality for those patients suffering from higher degrees of obesity. Bariatric surgery has not only positive effects on weight loss, but is also extremely effective in improving or resolving many of obesity-related comorbidities, which have evolved rapidly into the so-called metabolic surgery. T2DM may serve as excellent example of metabolic, obesity-related comorbidity which can be treated with bariatric-metabolic procedure even without direct relation to weight loss. In such cases bariatric surgery evolves into metabolic surgery. Thus metabolic operations (namely from the malabsorptive end) deeply influence hormonal secretion especially in the proximal part of small bowel, change parametres of entero-insular axis and have positive influence on insulin secretion, sensitivity and on the entire complex of glucose tolerance. Nowadays we can witness dramatic changes in perception of T2DM from bariatric surgeons, diabetologists, and many other medical specialists. T2DM has evolved from primarily medical disease into a condition where surgeons may play a more active role in the management of the diabetic patient. However, it has to be stressed that metabolic treatment of T2DM and other metabolic disorders need multidisciplinary approach and collaboration and that surgeon should play very important role as a multidisciplinary team member, however metabolic surgery should not yet be considered as stand-alone treatment modality.

• MeSH
• bariatrická chirurgie * metody   trendy   MeSH
• biologické modely MeSH
• diabetes mellitus 2. typu epidemiologie   metabolismus   chirurgie   MeSH
• gastrointestinální hormony sekrece   MeSH
• glukosa metabolismus   MeSH
• hmotnostní úbytek MeSH
• homeostáza MeSH
• inzulin sekrece   MeSH
• komorbidita MeSH
• lidé MeSH
• malabsorpční syndromy patofyziologie   MeSH
• mezioborová komunikace MeSH
• obezita ekonomika   epidemiologie   metabolismus   patofyziologie   chirurgie   MeSH
• osobní újma zaviněná nemocí MeSH
• postgastrektomické syndromy patofyziologie   MeSH
• tenké střevo sekrece   chirurgie   MeSH
• tuková tkáň metabolismus   MeSH
• týmová péče o pacienty MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

This review concerns the relation between most frequent thyroid gland diseases and diabetes mellitus in adult patients. Special attention is paid to autoimmune thyroiditis, Graves' disease, thyroid autoimmunity in pregnant diabetic women, and iodine metabolism. We focused on mechanisms leading to coexistence of both endocrine disorders, and on distinctions in the prevalence, diagnosis, clinical course and treatment of thyroid diseases in diabetic patients. The prevalence of thyroid diseases in diabetic patients is 2-3 times higher than in nondiabetic subjects; it raises with age, and is strongly influenced by female gender and autoimmune diabetes. Clinical relevance of thyroid diseases, especially in diabetic patients, significantly increases if it is associated with deteriorated function, which always cause a number problems with metabolic compensation of diabetes. Most serious consequences are increased frequency of hypoglycaemia in hypothyroidism and development of potentially life-threatening ketoacidosis in thyrotoxicosis. In spite of that, little attention is paid to the diagnosis of thyroid diseases in diabetics, as they are diagnosed in only about half of the patients. At the end, we provide recommendations for the thyroid disease screening and diagnosis in patients with diabetes mellitus based on our experience.

• MeSH
• diabetes mellitus 1. typu komplikace   patofyziologie   MeSH
• diabetes mellitus 2. typu komplikace   patofyziologie   MeSH
• dospělí MeSH
• komplikace diabetu diagnóza   patofyziologie   MeSH
• lidé MeSH
• nemoci štítné žlázy diagnóza   komplikace   patofyziologie   MeSH
• plošný screening MeSH
• rizikové faktory MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• Publikační typ
• přehledy MeSH