Kardiovaskulární onemocnění (KVO) zůstávají nejčastější příčinou morbidity a mortality související s diabetem (Gerstein, 2015; International Diabetes Federation, 2019), avšak současné znalosti o celosvětové prevalenci komplikací souvisejících s diabetem, včetně KVO, jsou stále omezené (Harding et al., 2019). Studie CAPTURE odhadovala prevalenci prokázaného KVO a jeho léčbu u dospělých s diabetem 2. typu ve 13 zemích pomocí standardizované metodiky. Česká republika byla jednou z těchto zemí se 400 účastníky ve studii. V České republice měl jeden ze čtyř účastníků zjištěnou KVO s váženou prevalencí KVO 22,8 % (95% interval spolehlivosti, confidence interval [CI]: 18,8–26,7 %). Většina případů KVO byla aterosklerotické etiologie (76,6 %) s váženou prevalencí 17,5 % (95% CI: 13,9–21,1 %). Jedním ze sekundárních cílů studie CAPTURE bylo dále charakterizovat studijní populaci, co se týče užívání léků snižujících glykemii se zaměřením na agonisty receptoru glukagon-like peptidu 1 (glucagon-like peptide 1 receptor agonists, GLP-1 RA) a inhibitory sodíko-glukózového kotransportéru 2 (sodium glucose cotransporter 2, SGLT2) s prokázaným KV benefitem. V České republice byly celkově u 16,8 % účastníků předepsány léky snižující glykemii (blood glucose-lowering agents, GLA) s prokázaným KV prospěchem. Léčba pomocí GLA s KV benefitem byla více zastoupena ve skupině s KVO než ve skupině bez KVO (24,2 % vs. 14,6 %). Ve studijní populaci byly SGLT2 užívány častěji než GLP-1 RA (10,5 % vs. 6,3 %), přičemž ve skupině s KVO bylo užívání obou terapeutických tříd vyšší. Nízká frekvence podání léčby GLA s KV benefitem, dokonce u pacientů s prokázaným KVO, značí, že většina účastníků není léčena v souladu se současnými diabetologickými a kardiologickými doporučenými postupy.
Cardiovascular disease (CVD) remains the largest cause of diabetes-related morbidity and mortality (1,2), yet the current understanding of the global prevalence of diabetes-related complications, including CVD, is still limited (3). The CAPTURE study estimated the prevalence of established CVD and its management in adults with type 2 diabetes across 13 countries using standardized methodology. The Czech Republic was one of the included countries with 400 enrolled participants. In the Czech Republic, one of the four participants had established CVD with a weighted CVD prevalence estimate at 22.8% [18.8–26.7%] 95% CI. Most cases of CVD were atherosclerotic (76.6%), with the weighted ASCVD prevalence estimated at 17.5% [13.9–21.1%]95% CI. One of the secondary objectives of the CAPTURE study was to further characterize the study population regarding GLAs (blood glucose-lowering agents) usage with reference to GLP-1 RAs and SGLT2is with demonstrated CV benefit. In the Czech Republic, 16.8% of participants in total were prescribed a GLA with demonstrated CV benefit. Treatment with GLA with CV benefit was present more in the CVD group than the non-CVD group (24.2% vs 14.6%). SGLT2is were used more frequently than GLP-1 RAs (10.5% vs 6.3%) in the study population with a higher use of both therapeutic classes in the CVD group. The low occurrence of treatment with GLAs with CV benefit even in participants with established CVD suggests that most participants were not managed according to contemporary diabetes and cardiology guidelines.
- Keywords
- studie CAPTUTRE,
- MeSH
- Diabetes Mellitus, Type 2 * complications MeSH
- Epidemiologic Studies MeSH
- Cardiovascular Diseases * epidemiology etiology therapy MeSH
- Humans MeSH
- Prevalence MeSH
- Check Tag
- Humans MeSH
- Geographicals
- Czech Republic MeSH
BACKGROUND: There is a paucity of global data on cardiovascular disease (CVD) prevalence in people with type 2 diabetes (T2D). The primary objective of the CAPTURE study was to estimate the prevalence of established CVD and its management in adults with T2D across 13 countries from five continents. Additional objectives were to further characterize the study sample regarding demographics, clinical parameters and medication usage, with particular reference to blood glucose-lowering agents (GLAs: glucagon-like peptide-1 receptor agonists and sodium-glucose co-transporter-2 inhibitors) with demonstrated cardiovascular benefit in randomized intervention trials. METHODS: Data were collected from adults with T2D managed in primary or specialist care in Australia, China, Japan, Czech Republic, France, Hungary, Italy, Argentina, Brazil, Mexico, Israel, Kingdom of Saudi Arabia, and Turkey in 2019, using standardized methodology. CVD prevalence, weighted by diabetes prevalence in each country, was estimated for the overall CAPTURE sample and participating countries. Country-specific odds ratios for CVD prevalence were further adjusted for relevant demographic and clinical parameters. RESULTS: The overall CAPTURE sample included 9823 adults with T2D (n = 4502 from primary care; n = 5321 from specialist care). The overall CAPTURE sample had median (interquartile range) diabetes duration 10.7 years (5.6-17.9 years) and glycated hemoglobin 7.3% (6.6-8.4%) [56 mmol/mol (49-68 mmol/mol)]. Overall weighted CVD and atherosclerotic CVD prevalence estimates were 34.8% (95% confidence interval [CI] 32.7-36.8) and 31.8% (95% CI 29.7-33.8%), respectively. Age, gender, and clinical parameters accounted for some of the between-country variation in CVD prevalence. GLAs with demonstrated cardiovascular benefit were used by 21.9% of participants, which was similar in participants with and without CVD: 21.5% and 22.2%, respectively. CONCLUSIONS: In 2019, approximately one in three adults with T2D in CAPTURE had diagnosed CVD. The low use of GLAs with demonstrated cardiovascular benefit even in participants with established CVD suggested that most were not managed according to contemporary diabetes and cardiology guidelines. Study registration NCT03786406 (registered on December 20, 2018), NCT03811288 (registered on January 18, 2019).
- MeSH
- Time Factors MeSH
- Diabetes Mellitus, Type 2 diagnosis drug therapy epidemiology MeSH
- Risk Assessment MeSH
- Hypoglycemic Agents therapeutic use MeSH
- Cardiovascular Diseases diagnosis epidemiology prevention & control MeSH
- Middle Aged MeSH
- Humans MeSH
- Protective Factors MeSH
- Prevalence MeSH
- Prognosis MeSH
- Cross-Sectional Studies MeSH
- Risk Factors MeSH
- Aged MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Multicenter Study MeSH
- Research Support, Non-U.S. Gov't MeSH
Boron has been suggested to enhance the biological effectiveness of proton beams in the Bragg peak region via the p + 11B → 3α nuclear capture reaction. However, a number of groups have observed no such enhancement in vitro or questioned its proposed mechanism recently. To help elucidate this phenomenon, we irradiated DU145 prostate cancer or U-87 MG glioblastoma cells by clinical 190 MeV proton beams in plateau or Bragg peak regions with or without 10B or 11B isotopes added as sodium mercaptododecaborate (BSH). The results demonstrate that 11B but not 10B or other components of the BSH molecule enhance cell killing by proton beams. The enhancement occurs selectively in the Bragg peak region, is present for boron concentrations as low as 40 ppm, and is not due to secondary neutrons. The enhancement is likely initiated by proton-boron capture reactions producing three alpha particles, which are rare events occurring in a few cells only, and their effects are amplified by intercellular communication to a population-level response. The observed up to 2-3-fold reductions in survival levels upon the presence of boron for the studied prostate cancer or glioblastoma cells suggest promising clinical applications for these tumour types.
- MeSH
- Boron chemistry MeSH
- Glioblastoma radiotherapy drug therapy MeSH
- Humans MeSH
- Cell Line, Tumor MeSH
- Prostatic Neoplasms radiotherapy drug therapy MeSH
- Proton Therapy * methods MeSH
- Protons MeSH
- Boron Neutron Capture Therapy * methods MeSH
- Cell Survival drug effects radiation effects MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Publication type
- Journal Article MeSH
Knife attacks have become a global problem in recent years, especially in countries where access to firearms is limited. However, the current situation is that the method of selection and characteristics of protective equipment about the physical attributes of stabbing attacks is not systematically determined. Attacks with stab weapons can be divided according to the weapon's grip, the angle of the attack, and its execution into six different attacks (e.g., underarm action stab, overarm action stab, etc.). Our work presents a survey of methods for capturing and then evaluating the physical parameters of point attacks in specific motion capture and analysis programs. In this work, kinematic analysis was used to analyze motion during a stabbing attack and to obtain data on the kinetic energy of the stab. The measurements were performed with the MoCap system - Vicon Nexus 2.70. The results of the study show that the average value for the straight stab and the underarm stab is almost the same (66.5–67.1 J), while the overarm stab reaches a much higher value (92.8 J). The study aims to determine the kinetic energy of types of attacks, for standards state the level of protection based on energy levels. The results could provide new insights into the current state of protective equipment and energy values in national/international standards.
- MeSH
- Biomechanical Phenomena MeSH
- Biomedical Research MeSH
- Wounds, Stab * pathology prevention & control MeSH
- Kinetics MeSH
- Humans MeSH
- Signal Processing, Computer-Assisted instrumentation MeSH
- Motion Capture * methods instrumentation MeSH
- Firearms MeSH
- Weapons classification MeSH
- Check Tag
- Humans MeSH
- Publication type
- Research Support, Non-U.S. Gov't MeSH
- Review MeSH
V posledních letech se do klinické praxe dostávají nové metody trvalé kardiostimulace, které se v literatuře nazývají fyziologickou stimulací či stimulací Hisova-Purkyňova převodního systému. Patří mezi ně stimulace Hisova svazku, přímá stimulace levého Tawarova raménka a stimulace myokardu levokomorového septa. Tyto stimulační techniky jsou spojeny se změnou přístupu k trvalé kardiostimulaci, jak ji známe v posledních desetiletích. Na rozdíl od myokardiální stimulace pravé komory srdeční je u nich stimulační elektroda fixována přímo do oblasti výskytu buněk převodního systému (Hisova svazku či levého Tawarova raménka), či do jejich těsné blízkosti. Dalším významným rozdílem je nutnost použití speciálního vybavení k dosažení optimálního místa stimulace a obvykle i využití speciálních manévrů k potvrzení uchvácení buněk převodního systému. Narůstající evidence o bezpečnosti a účelnosti těchto metod se odrazila v doporučených postupech některých národních společností pro kardiostimulaci. Fyziologická stimulace (především stimulace Hisova svazku) je ve specifických indikacích doporučována jako alternativa pro pravokomorovou nebo biventrikulární stimulaci. Tento přehledový článek popisuje jednotlivé typy fyziologické stimulace, techniku jejich provádění, způsoby potvrzení typu komorové aktivace a výhody či nevýhody jejich použití u pacientů s indikací k implantaci kardiostimulátoru pro bradykardii.
New methods of cardiac pacing are being adopted in clinical practice in recent years. They are called physiological pacing or conduction system pacing and include His bundle pacing, direct left bundle branch pacing, and left ventricular septal pacing. These methods differ significantly from a standard pacemaker implant procedure. The lead is fixed directly into or adjacent to the tissue of the conduction system of the heart as opposed to lead fixation in myocardial tissue of the right ventricle. Specialized tools and maneuvers for confirming conduction system capture are necessary during the implant procedure. Growing evidence on the safety and feasibility of these methods is reflected in latest guidelines on cardiac pacing of several national societies. They recommend physiological pacing (mainly His bundle pacing) in some specific indications as an alternative to right ventricular myocardial or biventricular pacing. This review describes types of physiological pacing, implant technique, methods of confirming conduction system capture, and its advantages and disadvantages in patients with bradycardia and indication for pacemaker implantation.
- MeSH
- Bundle-Branch Block therapy MeSH
- Bundle of His physiology MeSH
- Electrodes, Implanted MeSH
- Cardiac Pacing, Artificial * methods MeSH
- Humans MeSH
- Myocardium MeSH
- Heart Conduction System * physiology MeSH
- Ventricular Function physiology MeSH
- Heart Septum physiology MeSH
- Check Tag
- Humans MeSH
- Publication type
- Research Support, Non-U.S. Gov't MeSH
- Review MeSH
We applied qPCR to compare relative telomere length in terminal villi microdissected from term control placentas and placentas of patients suffering from type 1 diabetes. Significant differences were not found in the relative T/S ratios between placental groups or between the diabetic placentas affected and those not affected with chorangiosis. We hypothesize that there is no relationship between decreased placental proliferative ability in maternal diabetes type 1 and telomere shortening.
- MeSH
- Diabetes Mellitus, Type 1 physiopathology MeSH
- Adult MeSH
- Telomere Homeostasis * MeSH
- Laser Capture Microdissection MeSH
- Humans MeSH
- Young Adult MeSH
- Placenta physiology MeSH
- Case-Control Studies MeSH
- Pregnancy MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Young Adult MeSH
- Pregnancy MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
Although the effects of glucocorticoids on proliferation, differentiation and apoptosis are well known, and steroid hormones have been identified to play a role in pathogenesis and the development of various cancers, limited data are available regarding the relationship between the local metabolism of glucocorticoids and colorectal adenocarcinoma (CRC) formation. Glucocorticoid metabolism is determined by 11β-hydroxysteroid dehydrogenases type 1 and 2 (11HSD1, 11HSD2), which increase the local concentration of cortisol due to the reduction of cortisone, or decrease this concentration due to the oxidation of cortisol. The objective of this study was to evaluate the extent of 11HSD1 and 11HSD2 mRNA in pre-malignant colorectal polyps and in CRC. The specimens were retrieved from patients by endoscopic or surgical resection and the expression of 11HSD1 and 11HSD2 was measured by real-time PCR. The polyps were of the following histological types: hyperplastic polyps and adenomas with low- or high-grade dysplasia. The neoplastic tissue of CRC obtained during tumor surgery was also studied. It was found that 11HSD2 was not only downregulated in CRC but already in the early stages of neoplastic transformation (adenoma with low-grade dysplasia). In contrast, the level of 11HSD1 was significantly increased in CRC but not in pre-malignant polyps. The results demonstrate that the downregulation of 11HSD2 gene expression is a typical feature of the development of colorectal polypous lesions and their transformation into CRC.
- MeSH
- 11-beta-Hydroxysteroid Dehydrogenase Type 1 analysis biosynthesis MeSH
- 11-beta-Hydroxysteroid Dehydrogenase Type 2 analysis biosynthesis MeSH
- Adenocarcinoma enzymology MeSH
- Adenomatous Polyps enzymology MeSH
- Child MeSH
- Adult MeSH
- Down-Regulation MeSH
- Colorectal Neoplasms enzymology MeSH
- Real-Time Polymerase Chain Reaction MeSH
- Laser Capture Microdissection MeSH
- Middle Aged MeSH
- Humans MeSH
- Adolescent MeSH
- Young Adult MeSH
- Biomarkers, Tumor analysis MeSH
- Reverse Transcriptase Polymerase Chain Reaction MeSH
- Precancerous Conditions enzymology MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Transcriptome MeSH
- Check Tag
- Child MeSH
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Adolescent MeSH
- Young Adult MeSH
- Male MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- MeSH
- Electrocardiography MeSH
- Ventricular Function, Left MeSH
- Bundle of His MeSH
- Cardiac Pacing, Artificial MeSH
- Humans MeSH
- Heart Conduction System * MeSH
- Heart Ventricles diagnostic imaging MeSH
- Cardiac Resynchronization Therapy * MeSH
- Treatment Outcome MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
Hybridogenesis is a reproductive tool for sexual parasitism. Hybridogenetic hybrids use gametes from their sexual host for their own reproduction, but sexual species gain no benefit from such matings as their genome is later eliminated. Here, we examine the presence of sexual parasitism in water frogs through crossing experiments and genome-wide data. We specifically focus on the famous Central-European populations where Pelophylax esculentus males (hybrids of P. ridibundus and P. lessonae) live with P. ridibundus. We identified a system where the hybrids commonly produce two types of clonal gametes (hybrid amphispermy). The haploid lessonae genome is clonally inherited from generation to generation and assures the maintenance of hybrids through a process, in which lessonae sperm fertilize P. ridibundus eggs. The haploid ridibundus genome in hybrids received from P. ridibundus a generation ago, is perpetuated as clonal ridibundus sperm and used to fertilize P. ridibundus eggs, yielding female P. ridibundus progeny. These results imply animal reproduction in which hybridogenetic taxa are not only sexual parasites, but also participate in the formation of a sexual taxon in a remarkable way. This occurs through a process by which sexual gametes are being captured, converted to clones, and returned to sexual populations in one generation.
- MeSH
- Principal Component Analysis MeSH
- Genetic Loci MeSH
- Genome * MeSH
- Haploidy MeSH
- Microsatellite Repeats genetics MeSH
- Rana esculenta genetics MeSH
- Rana ridibunda genetics MeSH
- Animals MeSH
- Check Tag
- Male MeSH
- Female MeSH
- Animals MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
Cyklotronové laboratórium (CYLAB) by malo zaplniť dnes na Slovensku existujúcu medzeru v oblasti nukleárnej medicíny, rádioterapie, v základnom výskume, v metrológii ionizujúceho žiarenia, vo vzdelávacom procese a v implikácii technológií urýchlovača. Hlavné plánované aktivity na urýchľovači sú predovšetkým v oblasti nukleárnej medicíny (produkcia rádioizotopov pre pozitrónovú emisnú termografiu - PET a pre onkológiu) ako aj v oblasti rádioterapie (neutrónová záchytová terapia - NZT, terapia rýchlymi neutrónmi - TRN a protónová terapia tumorov oka PTTO). Rádiobiologický a biofyzikálny výskum bude úzko viazaný na lekárske aplikácie, predovšetkým na rádioterapiu. V tejto oblasti bude nevyhnutné riešiť problémy, ako určovanie hodnôt relatívnej biologickej účinnosti (RBU) pre rôzne druhy žiarenia použité v terapeutickom procese, mikrodozimetrické charakteristiky a merania nevyhnutné pri výpočtoch absorbovaných dávok (spektrá lineálnej a špecifickej energie na bunkovej a makromolekulárnej úrovni). Radiačná biofyzika a lekárska fyzika má veľmi dôležitú rolu pri tvorbe plánov ožarovania pre rádioterapiu (NZT, TRN, PTTO). v oblasti nukleárnej medicíny, pri diagnostických a terapeutických procedúrach je nutné určiť biodistribúciu rádiofarmák a výpočet dávok v cieľových a kritických orgánoch, ako aj určenie celotelovej záťaže - efektívnej ekvivalentnej dávky pre novovyvinuté rádiofarmaká.
The Cyclotron Laboratory (CYLAB) should fill the gap in the field of nuclear medicine, radiotherapy, basic research, metrology of ionizing radiation, education and implication of accelerator technology existing today in Slovak Republic. The main planned activities of this facility are the fields of nuclear medicine (production of radioisotopes for Positron Emission Tomography - PET and for oncology) and radiotherapy (neutron capture therapy, fast neutron therapy and proton therapy). The radiobiological aijd biophysical research will be closely connected with medical applications, first of all with radiotherapy. It will be necessary to solve problems like - the determination of the values of Relative Biological Effectiveness (RBE) for different types of ionizing radiation involved in the therapy, microdosimetric measurements and calculations, which are indispensible in calcu¬ lation of the absorbed dose (lineal and specific energy spectra) on the cellular and macromolecular level. The very important role of radiation biophysics and medical physics is that it helps to create therapeutic plans for radiotherapy (NCT and fast neutron therapy). In nuclear medicine, in diagnostic and therapeutical procedures it is necessary to assess the biodistribution of radiopharmaceuticals and to calculate doses in target and critical organs and to determine whole body burden - effective equivalent dose for newly developed radiopharmaceuticals.
