OBJECTIVES: This case series evaluated the clinical efficacy of the novel "lateral approach" combined with an enamel matrix derivative (EMD) and bone grafting in the regenerative surgical treatment of intrabony defects associated with an edentulous ridge. MATERIAL AND METHODS: The innovative flap, called the "lateral approach," is explicitly designed for regeneration of unchallenged isolated intrabony defects associated with edentulous alveolar ridges. The flap is defined by a curved vertical incision on the buccal side opposite the treated defect and a sulcular incision on the buccal and defect-associated sides, promoting uneventful healing and regeneration while minimizing complications. Seven intrabony defects (one per patient) distal to the lower second molar were treated using the "lateral approach" combined with EMD and grafting with deproteinized bovine bone mineral. The primary outcome was clinical attachment level (CAL) change. As additional parameters, pocket probing depth (PPD) reduction and complication rate were analyzed. All the outcomes were assessed 6 months post-surgery and compared with the baseline values. RESULTS: Primary wound healing occurred in 100% of cases, and no complications were reported. At the 6-month re-evaluation, the initial median CAL of 6 mm (interquartile range 5-8 mm) was reduced to 3 mm (3-5 mm). The corresponding median PPD was reduced from 6 mm (IQR 6-8 mm) to 4 mm (IQR 3-5 mm). These differences were statistically significant (p < 0.05). CONCLUSIONS: The "lateral approach" is a technique for the surgical treatment of intrabony defects associated with the edentulous ridge. Within the limitations of the study, this method seems to be suitable for distal intrabony defects in the lower second molars, which frequently develop after third molar extraction.
- MeSH
- augmentace alveolárního výběžku * metody MeSH
- čelist bezzubá chirurgie MeSH
- chirurgické laloky transplantace MeSH
- dospělí MeSH
- hojení ran MeSH
- kostní náhrady terapeutické užití MeSH
- lidé středního věku MeSH
- lidé MeSH
- prospektivní studie MeSH
- proteiny zubní skloviny terapeutické užití MeSH
- regenerace kostí MeSH
- resorpce alveolární kosti * chirurgie MeSH
- řízená tkáňová regenerace parodontu metody MeSH
- senioři MeSH
- transplantace kostí metody 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
Hypoxic pulmonary vasoconstriction (HPV) rapidly and reversibly matches lung ventilation (V) and perfusion (Q), optimizing oxygen uptake and systemic oxygen delivery. HPV occurs in small pulmonary arteries (PA), which uniquely constrict to hypoxia. Although HPV is modulated by the endothelium the core mechanism of HPV resides in PA smooth muscle cells (PASMC). The PASMC's mitochondrial oxygen sensor lies within the electron transport chain (ETC) and includes NDUFS2 in ETC Complex-I. PASMC mitochondria respond to hypoxia by varying production of reactive oxygen species (ROS) and hydrogen peroxide in proportion to alveolar oxygen tension. Hypoxic ROS inhibition results in a state of reduction which triggers a redox-mediated inhibition of oxygen-sensitive, voltage-gated, potassium channels, including Kv1.5 and Kv2.1. Kv channel inhibition depolarizes the PASMC, opening of large-conductance calcium channels (CaL), elevating cytosolic calcium and activating the contractile apparatus. HPV is strongest in small PAs where sensors (hypoxia-responsive mitochondria) and effectors (oxygen-sensitive K+ channels) are enriched. Oxygenation at birth reverses fetal HPV, contributing to the rapid neonatal drop in pulmonary vascular resistance (PVR). A similar mitochon-drial-K+ channel sensor-effector mechanism exists in the ductus arteriosus (DA), however in DASMC it is oxygen-induced increases in mitochondrial ROS that inhibit DASMC K+ channels, causing DA constriction. Atelectasis and pneumonia elicit HPV, which optimises V/Q matching, increasing systemic oxygenation. Whilst HPV in response to localized hypoxia in a single lung lobe does not increase PA pressure; global airway hypoxia, as occurs with altitude or sleep apnea, causes pulmonary hypertension. HPV can be inhibited by drugs, including calcium channel blockers, or used to maintain a dry operative field during single lung anesthesia for lung surgery. HPV does not normally cause lung edema but excessive, heterogenous HPV contributes to high altitude pulmonary edema. HPV is suppressed in COVID-19 pneumonia by a SARS-CoV-2 mitochondriopathy. HPV is a component of the body's homeostatic oxygen sensing system. Keywords: Ductus arteriosus, Redox, NDUFS2, Oxygen sensitive potassium, Channels, High altitude pulmonary edema (HAPE), Mitochondrial electron transport chain, COVID-19 pneumonia, Atelectasis.
- MeSH
- arteria pulmonalis metabolismus MeSH
- COVID-19 metabolismus komplikace MeSH
- homeostáza * fyziologie MeSH
- hypoxie * metabolismus patofyziologie MeSH
- kyslík * metabolismus MeSH
- lidé MeSH
- vazokonstrikce * fyziologie MeSH
- zvířata MeSH
- Check Tag
- lidé MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
Lithium is the gold standard treatment for bipolar disorder (BD). However, its mechanism of action is incompletely understood, and prediction of treatment outcomes is limited. In our previous multi-omics study of the Pharmacogenomics of Bipolar Disorder (PGBD) sample combining transcriptomic and genomic data, we found that focal adhesion, the extracellular matrix (ECM), and PI3K-Akt signaling networks were associated with response to lithium. In this study, we replicated the results of our previous study using network propagation methods in a genome-wide association study of an independent sample of 2039 patients from the International Consortium on Lithium Genetics (ConLiGen) study. We identified functional enrichment in focal adhesion and PI3K-Akt pathways, but we did not find an association with the ECM pathway. Our results suggest that deficits in the neuronal growth cone and PI3K-Akt signaling, but not in ECM proteins, may influence response to lithium in BD.
- MeSH
- bipolární porucha * farmakoterapie genetika MeSH
- celogenomová asociační studie MeSH
- fokální adheze MeSH
- fosfatidylinositol-3-kinasy genetika MeSH
- lidé MeSH
- lithium * farmakologie terapeutické užití MeSH
- multiomika MeSH
- protoonkogenní proteiny c-akt genetika MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
Východiska: V posledních letech je ve vzdělávání pa- trný vzestup využití inovativních metod a integrace simulační medicíny do pregraduálního vzdělávání v nelékařských oborech. Simulace umožňuje navoze- ní reálného klinického stavu, a to v bezpečném pro- středí studenta. Soubor a metody: Pro stanovení výzkumné otázky byl požit systém PICO, rešerše slouží pro identifikaci přínosů simulační výuky. Klinická otázka: Jaký je pří- nos simulační výuky (O) pro studenty ošetřovatelství (P) v akademickém prostředí (I) oproti běžně použí- vaným výukovým metodám (C). Začleněno 5 studií, zdůrazňujících signifikantní podíl na vzestupní výsled- ky učení, sebeuplatnění, sebevědomí nebo spokoje- nosti studenta. Výsledky: Studie ukázaly pozitivní vliv po použití u studentů ošetřovatelství. Simulační výuka dokáže nahradit až 50 % klinické praxe u lůžka pacienta/ klienta (1). Hlavním argumentem k využití simulační výuky je schopnost opakovaně vytvořit reálnou kli- nickou situaci, která pomáhá studentovi aplikovat své teoretické znalosti, procvičit si dovednosti a až 81 % studentů hodnotí simulační výuku jako skvělou mož- nost k rozvoji kritického myšlení. 69 % studentů (účastníků simulační výuky), by zcela souhlasilo s po- vinnou účastí v průběhu studia (2). Zároveň umožňuje studentům dělat chyby, které nikoho neohrozí na zdraví a na životě (1). Portugalská studie uvádí, že simulační výuka a strukturovaný debriefing umožnil zvýšit sebevědomí, potenciál pro týmovou práci, roz- víjet vůdčí schopnosti a také zlepšit schopnost zvlá- dat své emoce (3). Závěr: Doporučujeme integrovat simulační výuku do sylabů studentů nelékařských oborů, ale i do celoži- votního vzdělávání již stávajících nelékařských profe- sionálů.
Introduction: In recent years, there has been an in- crease in the use of innovative methods in educati- on. As part of the training of non-medical personnel, the integration of simulation medicine into the under- graduate education of non-medical fields was noted. Simulation, or the possibility of inducing a real clini- cal situation, in a safe student environment. File and methods: We conduct research to identify the benefits of simulation teaching. The PICO system was used to identify the research question. The clinical question was defined as follows: What is the benefit of simulation teaching (O) for nursing students (P) in an academic setting (I) versus commonly used teaching methods (C). Included 5 studies highlighting a signifi- cant contribution to upward learning outcomes, self- -efficacy, self-confidence or student satisfaction. Results: Studies have shown a positive effect on nur- sing students. Simulation training can replace up to 50% of clinical practice at the patient/client bedside (1). The main argument for using simulation teaching is the ability to repeatedly create a real clinical si- tuation, which helps the student to apply his theo- retical knowledge, to practice skills, and up to 81% of students rate simulation teaching as a great opti- on for developing critical thinking. 69% of students (simulation teaching participants) would completely agree with mandatory participation during the cour- se of study (2). At the same time, it allows students to make mistakes that do not endanger anyone’s health and life (1). A Portuguese study reported that simulation training and structured debriefing helped to increase self-confidence, the potential for tea- mwork, develop leadership skills and also improve the ability to manage one’s emotions (3). Conclusion: We recommended to integrate simulati- on teaching into the syllabi of students of non-me- dical fields, but also into the lifelong education of already existing non-medical professionals
OBJECTIVES: This study aims to analyse the way immigrants and their personality traits get affected by traumatic events in the post-migration process. METHODS: This descriptive study was conducted through Google Forms with the involvement of 2,509 immigrants. A descriptive questionnaire, the "IFOMA Post-Migration Post-Traumatic Effect Scale" and the "GADOT Personality Types Determination Scale" were used to collect the research data. Independent samples t-test, one-way ANOVA, and related sample Friedman's two-way analysis tests were used in data analysis. RESULTS: Immigrants were exposed to significant effects in all sub-dimensions of the Post-Migration Post-Traumatic Effect Scale. Experiencing post-traumatic stress was found to be significantly related to the research parameters, which, respectively, are gender, age, marital status, educational background, legal status, years of living in the current country, employment status, ethnicity, Turkish language proficiency, and post-migration psychological problems (p < 0.05); 42.8% of the immigrants had the Type 9 personality, and all personality types were affected by the Psychological Affection, Physical Affection, Anxiety, and Social Adaptation sub-dimensions, respectively (p < 0.05). CONCLUSION: By analysing the impact of migration-induced trauma on immigrants within their society, it can be recommended to implement initiatives specific to immigrants' personality traits and to carry out protective/preventive projects that will minimize immigrants' exposure to trauma and encourage their participation in social adaptation processes.
- MeSH
- emigranti a imigranti * MeSH
- etnicita MeSH
- lidé MeSH
- manželský stav MeSH
- osobnost MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
BACKGROUND: The fixed dose combination of calcipotriene (CAL) and betamethasone dipropionate (BDP) is a well-established topical treatment option for psoriasis based on strong scientific rationale for the single agents having complementary efficacy and safety. CAL/BDP PAD-cream is an easily spreadable cream based on PAD TechnologyTM, an innovative formulation and drug delivery system. OBJECTIVES AND METHODS: A Phase 3, multicentre, randomized, investigator-blind, active and vehicle-controlled trial enrolling 490 patients with mild to moderate psoriasis according to the Physician Global Assessment (PGA) scale was conducted in three European countries. Products were applied once daily for 8 weeks. The aim of the trial was to evaluate the efficacy and safety of CAL/BDP PAD-cream as well as treatment acceptability compared to CAL/BDP gel and PAD-cream vehicle. Primary endpoint was percentage change in modified Psoriasis Area and Severity Index (mPASI) from baseline to Week 8. RESULTS: The percentage mean change from baseline to Week 8 in mPASI for CAL/BDP PAD-cream (67.5%) was superior compared to PAD-cream vehicle (11.7%; p < 0.0001) and non-inferior to CAL/BDP gel (63.5%). The proportion of patients achieving PGA treatment success (at least two-step improvement to clear or almost clear) after 8 weeks was superior for CAL/BDP PAD-cream (50.7%) compared to PAD-cream vehicle (6.1%, p < 0.0001) and statistically significantly greater than CAL/BDP gel (42.7%, p = 0.0442). Patient-reported psoriasis treatment convenience score (PTCS) for CAL/BDP PAD-cream was rated superior to CAL/BDP gel at Week 8 (p < 0.0001) and the mean change in DLQI from baseline to Week 8 improved statistically significantly more in the CAL/BDP PAD-cream group compared to both PAD-cream vehicle (p < 0.0001) and CAL/BDP gel (p = 0.0110). Safety assessments during the trial demonstrated that CAL/BDP PAD-cream was well-tolerated. CONCLUSION: CAL/BDP PAD-cream is a novel topical treatment of psoriasis that has a high efficacy and a favourable safety profile combined with a superior patient-reported treatment convenience.
- MeSH
- betamethason škodlivé účinky MeSH
- dermatologické látky * škodlivé účinky MeSH
- emoliencia terapeutické užití MeSH
- fixní kombinace léků MeSH
- kalcitriol škodlivé účinky MeSH
- lidé MeSH
- psoriáza * farmakoterapie chemicky indukované MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- klinické zkoušky, fáze III MeSH
- multicentrická studie MeSH
- randomizované kontrolované studie MeSH
Septooptická dysplázie (SOD) zahrnuje poruchu vývoje středočárových struktur mozku, hypoplázii optických nervů a hypopituitarismus. Jde o onemocnění velmi pestré co do spektra projevů i jejich tíže. Autoři se v textu věnují zejména endokrinním projevům SOD a jejich vztahu k nálezům na magnetické rezonanci. V samotné kazuistice pak popisují případ dvouletého děvčátka, u kterého k diagnóze vedly symptomatické hypoglykemie na podkladě centrálního hypokorticismu, nález na magnetické rezonanci v podobě hypoplázie corpus cal- losum, drobné adenohypofýzy s absencí stopky hypofýzy, ektopickou neurohypofýzou a hypoplázie levého optického nervu potvrzená i nálezem na očním pozadí. Po zahájení sub- stituce hydrokortizonem došlo k ústupu hypoglykemií. Z dalších deficitů byl zjištěn nedostatek růstového hormonu
Septo-optic dysplasia (SOD) includes developmental disorders of the brain midline struc- tures, optic nerves hypoplasia and hypopituitarism. This disorder is greatly variable in terms of its manifestations as well as their severity. The authors of the text focus mostly on the endocrine manifestations of SOD and their relation to MRI findings. The case report describes a case of a two-year-old girl, whose diagnosis was made by symptomatic hypogly- caemia on the bases of central hypocorticism, MRI findings in the form of hypoplasia corpus callosum, small adenohypophysis with the absence of hypophyseal stalk, ectopic neurohy- pophysis, and left optic nerve hypoplasia confirmed by a finding on ophthalmology background. After the initiation of hydrocortisone substitution the hypoglycaemias subsided. Among other deficits, growth hormone insufficiency was discovered.
- MeSH
- adrenální insuficience MeSH
- centrální nervový systém abnormality MeSH
- hypoglykemie MeSH
- hypopituitarismus farmakoterapie patofyziologie vrozené MeSH
- hypoplazie optického nervu diagnóza MeSH
- hypotyreóza MeSH
- lidé MeSH
- magnetická rezonanční tomografie MeSH
- mezioborová komunikace MeSH
- předškolní dítě MeSH
- růstový hormon nedostatek MeSH
- septo-optická dysplazie * embryologie genetika komplikace patologie MeSH
- Check Tag
- lidé MeSH
- předškolní dítě MeSH
- ženské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
INTRODUCTION: Psoriasis ranges from mild to severe with the majority of patients having mild disease. Mild to moderate disease is often treated with topical therapies while photo-, oral, and biologic therapies are generally reserved for moderate-to-severe disease. There is a strong scientific rationale for the combination of calcipotriene (CAL) and betamethasone dipropionate (BDP) with respect to mode of action, efficacy, and safety and CAL/BDP has shown an inhibitory effect on key pathogenic cytokines in psoriasis including tumor necrosis factor-α, interleukin (IL)-17, and IL-23. METHODS: The objective of this pooled post hoc analysis is to investigate the efficacy of CAL/BDP polyaphron dispersion (PAD)-cream in subgroups of patients with moderate-to-severe psoriasis from two completed phase 3 studies conducted in the USA and Europe. RESULTS: The proportion of patients achieving Physician Global Assessment (PGA) treatment success as well as a modified Psoriasis Area and Severity Index (mPASI)75 response was higher in the subgroup with a body surface area > 10% and mPASI > 10 and Dermatology Life Quality Index > 10 at baseline compared to the overall patient population. Furthermore, the numerical difference in treatment efficacy between CAL/BDP PAD-cream and CAL/BDP topical suspension/gel increased in patient subgroups with higher baseline severity. Similar patterns were shown for the patient-reported outcomes. CONCLUSION: In this subgroup analysis, patients who had higher disease severity at baseline achieved greater efficacy than the total patient population when treated with 8 weeks of CAL/BDP PAD-cream as compared to a currently marketed active comparator. Additionally, as indicated by this analysis, CAL/BDP PAD-cream treatment may also be more convenient and less greasy, which may reduce the burden of daily treatment and improve adherence to therapy. TRIAL REGISTRATION: NCT03308799 and NCT03802344.
- Publikační typ
- časopisecké články MeSH
Background: Home-based video exercise programmes might be a suitable alternative to traditional physi¬cal activity in older adults to preserve muscle health. The aim of this systematic review and meta-analysis was to examine the effects of home-based video exercise programmes on physical fitness in older adults. Methods: A systematic review and robust variance estimation meta-analysis with meta-regression were carried out according to the recommendations and criteria outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Results: Thirteen studies involving 1,056 participants were included. Meta-analysis showed statistically significant positive changes in balance (p = 0.023), upper extremity strength (p = 0.049, and strength overall (p = 0.042), there was also statistically significant positive effect based on all the 28 outcomes in eight studies, including 696 participants (p = 0.008). Conclusion: The present systematic review and meta-analysis indicate that home-based video exercise programmes positively affect essential components of physical fitness, such as balance and strength, to prevent falls in older adults. Promoting home-based video exercise in clinical practice and ideally sup¬porting it through supervision is vital to effectively combat the age-related physical decline, especially for those in home isolation.
