Arteriální hypertenze je nejdůležitější modifikovatelný rizikový faktor kardiovaskulární morbidity a mortality. Léčbu arteriální hypertenze u dítěte/adolescenta je třeba zahájit co nejdříve po stanovení diagnózy a posouzení rizikových faktorů pro hypertenzí mediovaného orgánového poškození (HMOD). Léčba zahrnuje jak vhodná nefarmakologická (také režimová opatření nebo změnu životního stylu), tak farmakologická opatření. Změny životního stylu u dítěte a adolescenta se skládají z kombinace intervencí (dieta k redukci nadváhy/obezity a omezení příjmu soli, pohyb, behaviorální terapie aj.). Nefarmakologická opatření v případě primární hypertenze mohou vést k dostatečné redukci TK bez nutnosti antihypertenzní medikace, u hypertenze sekundární pak jsou součástí komplexní terapie zahrnující i podání farmak.
Arterial hypertension is the most important modifiable risk factor for cardiovascular morbidity and mortality. Appropriate therapy of the disease should be initiated in children and adolescents as early as possible; mostly at the time of the diagnosis confirmation and the evaluation of the risk factors for hypertension-mediated organ damage (HMOD). Therapy includes non-pharmacological and pharmacological interventions. Nonpharmacological therapy consists from combined lifestyle interventions (diet, physical activity, body weight changes and behavioral therapy components). The complex of lifestyle interventions can lead to effective reduction in blood pressure without pharmacotherapy in the case of primary hypertension, and is important part of therapeutic approach in the case of secondary hypertension in children and adolescents, where the medication is necessary.
OBJECTIVE: Patients with chronic idiopathic intracranial hypertension (IIH) commonly experience a high level of disability and low satisfaction with medical treatment. We aim to evaluate long-term functional improvement and patient satisfaction in IIH patients with similar symptoms by comparing venous sinus stenting (VSS) to standard medical therapy. METHODS: We conducted a cross-sectional questionnaire study of 111 IIH patients, comparing 37 adult female patients who underwent venous sinus stenting with 74 patients treated medically. Propensity score matching was used to balance age and presence of papilledema at presentation between groups. Headache-related disability was evaluated using the Migraine Disability Assessment Scale (MIDAS), while general function and treatment satisfaction were assessed using custom questionnaires. Electronic medical records and the results of imaging upon diagnosis were reviewed retrospectively. RESULTS: The stented group reported significantly better outcomes in physical well-being (median 4.0 vs. 1.0, p < 0.001), task completion (4.0 vs. 1.0, p < 0.001), work/school persistence (5.0 vs. 1.0, p < 0.001), and mental well-being (4.0 vs. 1.0, p < 0.001). Additionally, the stented group had a lower proportion of patients with severe MIDAS (MIDAS > 4, 24.3% vs. 47.9%, p = 0.017). Logistic regression suggested venous stenting as a protective factor against severe MIDAS scores (OR = 0.174, p = 0.004). CONCLUSION: Cerebral venous stenting in patients with IIH is associated with lower disability and higher patient satisfaction from medical treatment compared to those treated with medications only. These findings suggest that venous sinus stenting may be a valuable treatment option for selected IIH patients. However, larger prospective studies are needed to further validate our results.
- Publikační typ
- časopisecké články MeSH
- MeSH
- bariatrická chirurgie * MeSH
- lidé MeSH
- metabolické nemoci * chirurgie MeSH
- morbidní obezita * chirurgie MeSH
- obezita chirurgie MeSH
- výročí a významné události MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- dopisy MeSH
Týden po ukončení udržovací léčby byla v krvi 11leté dívky s akutní lymfoblastickou leukemií metodou DNA potvrzena akutní infekce parvovirem B19. Klinickými projevy byly dva týdny trvající horečka, vlhký kašel a intermitentní bolesti na hrudi při nádechu. Byly detekovány zvýšené hodnoty sérového CRP, N-terminálního natriuretického peptidu, ale mírné zvýšení hodnoty troponinu. Na EKG záznamu byla přítomna nápadně nízká voltáž vlny P, komplexu QRS a vlny T. Echokardiografické vyšetření potvrdilo akutní myoperikarditidu s rozsáhlým perikardiálním výpotkem. Zotavení pacientky bylo podpořeno diuretickou léčbou a kortikosteroidy, proběhlo rychle. Po týdenní léčbě došlo k úplné redukci perikardiálního výpotku.
One week after the end of maintenance treatment, acute parvovirus B19 infection was confirmed by DNA in the blood of an 11-year-old girl with acute lymphoblastic leukaemia Clinical manifestations were two weeks of fever, moist cough, and intermittent chest pain on inspiration. Elevated serum CRP, N-terminal natriuretic peptide, but slightly elevated troponin values were detected. The ECG recording showed strikingly low P-wave, QRS complex and T-wave voltages. Echocardiographic examination confirmed acute myopericarditis with extensive pericardial effusion. The patient's recovery, supported by diuretic therapy and corticosteroids was prompt, with complete reduction of the pericardial effusion after one week treatment.
- MeSH
- akutní lymfatická leukemie komplikace MeSH
- dítě MeSH
- lidé MeSH
- lidský parvovirus B19 izolace a purifikace MeSH
- nežádoucí účinky léčiv MeSH
- perikarditida * diagnóza etiologie mikrobiologie terapie MeSH
- udržovací chemoterapie škodlivé účinky MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
Fifth edition 2 svazky (celkem 958 stran) : ilustrace
- MeSH
- klasifikace MeSH
- nádory diagnóza MeSH
- Publikační typ
- monografie MeSH
- Konspekt
- Patologie. Klinická medicína
- NLK Obory
- patologie
- onkologie
The purpose of this study was to determine the effects of resistance training (RT) alongside creatine-hydrochloride (Cr-HCl) or creatine monohydrate (CrM) supplementation on anabolic/catabolic hormones, strength, and body composition. Forty participants with an age range of 18-25 years were randomly divided into four groups (n=10): RT+Cr-HCl (0.03 g.kg-1 of body mass), RT+CrM-loading phase (CrM-LP) (0.3 g.kg-1 of body mass for five days (loading) and 0.03 g.kg-1 body mass for 51 days (maintenance)), RT+CrM-without loading phase (CrM-WLP) (0.03 g.kg-1 body mass), and RT+placebo (PL). The participants consumed supplements and performed RT with an intensity of 70-85 % 1RM for eight weeks. Before and after the training and supplementation period, strength (1RM), body composition (percent body fat (PBF), skeletal muscle mass (SMM), muscular cross-sectional area (MCSA)) and serum levels of testosterone, growth hormone (GH), insulin-like growth factor-1 (IGF-1), cortisol, adrenocorticotropic hormone (ACTH), follistatin and myostatin were measured. The results showed that in the supplementation groups, strength, arm and thigh MCSA, and SMM significantly increased, and PBF significantly decreased (P
- MeSH
- dospělí MeSH
- hydrokortison krev MeSH
- insulinu podobný růstový faktor I metabolismus MeSH
- kosterní svaly metabolismus účinky léků MeSH
- kreatin * MeSH
- lidé MeSH
- lidský růstový hormon krev MeSH
- mladiství MeSH
- mladý dospělý MeSH
- odporový trénink * metody MeSH
- potravní doplňky * MeSH
- složení těla * MeSH
- svalová síla * účinky léků MeSH
- testosteron krev MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- randomizované kontrolované studie MeSH
- MeSH
- biologické markery MeSH
- lidé MeSH
- novorozenec MeSH
- placentární růstový faktor MeSH
- předčasná porodní činnost * MeSH
- prediktivní hodnota testů MeSH
- preeklampsie * MeSH
- receptor 1 pro vaskulární endoteliální růstový faktor MeSH
- Check Tag
- lidé MeSH
- novorozenec MeSH
- ženské pohlaví MeSH
- Publikační typ
- dopisy MeSH
RATIONALE: Cabergoline (CAB) is an ergot derivative typically prescribed for the treatment of hyperprolactinemia. It suppresses the release of prolactin through agonist actions on dopamine (DA) D2 receptors; however, it possesses binding affinity for other DA and 5-HT receptors. Side effects that exacerbate valvular heart disease can occur with high doses. OBJECTIVE: The present study examined the acute, subchronic, and chronic dose-response effects of CAB and a derivative dimethylcabergoline (DMC) which acts as an antagonist instead of agonist at 5-HT 2B receptors, on appetitive and consummatory sexual behaviors of male rats. METHODS: CAB (0, 0.03, 0.15, or 0.3 mg/kg/ml) was administered daily to sexually experienced male rats (N = 10/dose) by oral gavage for a total of 68 days. Sexual behavior was tested every 4 days during this period for a total of 16 trials. On the 17th trial, rats were administered their dose of CAB, and 4 h after were overdosed with sodium pentobarbital, perfused intracardially, and their brains processed for Fos immunohistochemistry. DMC (0, 0.03, 0.15, 0.3 mg/kg/ml) was administered daily to sexually experienced male rats (N = 10/dose) by oral gavage for a total of 36 days. Sexual behavior was tested every 4 days for a total of 9 trials. RESULTS: CAB increased anticipatory level changes, intromissions, and ejaculations significantly across all timepoints, with the medium and high doses being most potent. The medium and high doses also increased Fos protein significantly within the medial preoptic area, whereas in the nucleus accumbens shell, the low and medium doses decreased Fos protein but the high dose increased it significantly from control. Similar to CAB, the medium and high doses of DMC increased the number of ejaculations significantly. Rats in all drug dose groups appeared healthy for the duration of the experiments. CONCLUSIONS: Both CAB and DMC facilitate ejaculations, and CAB further facilitates measures of anticipatory sexual motivation and intromissions. These data suggest that both could be used as treatments for sexual arousal disorders and ejaculation/orgasm disorders with little or no untoward side effects at low doses.
- MeSH
- kabergolin farmakologie MeSH
- kopulace * MeSH
- krysa rodu rattus MeSH
- motivace MeSH
- mozek MeSH
- pohlavní steroidní hormony MeSH
- receptory dopaminu D2 MeSH
- sexuální chování zvířat * MeSH
- zvířata MeSH
- Check Tag
- krysa rodu rattus MeSH
- mužské pohlaví MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- MeSH
- lidé MeSH
- poranění mozku etiologie patologie MeSH
- postakutní syndrom COVID-19 komplikace MeSH
- Check Tag
- lidé MeSH
