Lipids from microorganisms, and especially lipids from Archaea, are used as taxonomic markers. Unfortunately, knowledge is very limited due to the uncultivability of most Archaea, which greatly reduces the importance of the diversity of lipids and their ecological role. One possible solution is to use lipidomic analysis. Six radioactive sources were investigated, two of which are surface (Wettinquelle and Radonka) and four deep from the Svornost mine (Agricola, Behounek, C1, and Curie). A total of 15 core lipids and 82 intact polar lipids were identified from the membranes of microorganisms in six radioactive springs. Using shotgun lipidomics, typical Archaea lipids were identified in spring water, namely dialkyl glycerol tetraethers, archaeol, hydroxyarchaeol and dihydroxyarchaeol. Diverse groups of polar heads were formed in archaeal IPLs, whose polar heads are formed mainly by hexose, deoxyhexose, and phosphoglycerol. The analysis was performed using shotgun lipidomics and the structure of all molecular species was confirmed by tandem mass spectrometry. After acid hydrolysis, a mixture of polar compounds was obtained from the polar head. Further analysis by GC-MS confirmed that the carbohydrates were glucose and rhamnose. Analysis by HPLC-MS of diastereoisomers of 2-(polyhydroxyalkyl)-3-(O-tolylthiocarbamoyl)thiazolidine-4(R)-carboxylates revealed that both L-rhamnose and D-glucose are present in spring samples only in varying amounts. The glycoside composition depends on the type of spring, that is, Wettinquelle and Radonka springs are basically shallow groundwater, while the samples from the Svornost mine are deep groundwater and do not contain glycosides with rhamnose. This method enables quick screening for characteristic Archaea lipids, allowing decisions on whether to pursue further analyses, such as metagenomic analysis, to directly confirm the presence of Archaea.
Úvod: Dlouhodobé užívání metforminu může vést vedle zažívacích potíží, ke vzniku laktátové acidózy, zhoršení renálních funkcí i k deficitu vitaminu B12 (VB12). Cílem naší práce bylo poukázat na rizikovost dlouhodobého užití metforminu zejména ve vyšších dávkách na konkrétním souboru námi léčených diabetiků 2. typu. Pacienti a metodika: V roce 2024 bylo celkem v diabetologické ambulanci Diastop, s. r. o., (NZZ – nestátní zdravotnické zařízení) dlouhodobě léčeno 2 136 diabetiků 2. typu (T2DM), a to 1 111 mužů a 1 025 žen. Jejich věk byl 72,7 ± 12,5 roků. Z nich 70 % bylo ≥ 65 roků a 12,6 % ≥ 80 roků. Z nich bylo v roce 2024 pouze diabetickou dietou léčeno 12 % (věku 74,5 ± 10,6 roků). Preparáty PAD, inkretinovými mimetiky nebo inzulinem v roce 2024 bylo léčeno celkem 1 880 diabetiků 2. typu (88 %) průměrného věku 72,3 ± 10,7 roků. Šlo o retrospektivní studii. Výsledky: Sledovanými parametry byly věk, trvání diabetu, hodnocení polyneuropatie, základní biochemické a hematologické vyšetření (krevní obraz), VB12, folát a homocystein (u nemocných s metforminem). Metforminem bylo dlouhodobě léčeno (ve studii nejméně posledních 6 měsíců) 522 osob – 250 žen a 272 mužů věku 68,8 ± 10,4 roků. Z nich 24 % bylo ≥ 65 roků a 5 % ≥ 80 roků. Výrazný pokles hladiny VB12 pod 148 pmol/l jsme nalezli 81krát (15,5 %); hraniční výsledek v pásmu 148–221 pmol/l u 157 jedinců (30,1 %). Závěr: Naše sdělení ve shodě s literaturou na souboru našich pacientů poukazuje na riziko rozvoje deficitu VB12 ve vztahu k denní dávce metforminu. Podobně i věk by měl vždy být brán v úvahu jako další potencionálně rizikový faktor s respektováním všech kontraindikací a možných lékových interakcí. U diabetiků s deficitem VB12 jsme nenalezli závažné klinické projevy (anémie atp.).
Introduction: Long-term use of metformin can lead to digestive problems, lactic acidosis, and deterioration of renal function, as well as vitamin B12 deficiency. The aim of our work was to point out the risk of long-term use of metformin, especially in higher doses, in a specific group of patients with type 2 diabetes treated by us. Patients and methodology: In 2024, a total of 2,136 patients with type 2 diabetes (T2DM) were treated in the diabetes outpatient clinic Diastop, l. t. d. (non-state healthcare facility) a long time - 1,111 men and 1,025 women. Of these, 70 % were ≥ 65 years old and 12.6 % were ≥ 80 years old. Their age was 72.7 ± 12.5 years. Of these, 12 % (age 74.5 ± 10.6 years) were treated with a diabetic diet alone in 2024. A total of 1,880 patients with T2DM (88 %) with an average age of 72.3 ± 10.7 years were treated with OAD preparations, incretin mimetics or insulin in 2024. It was a retrospective study. Results: The monitored parameters were age, duration of diabetes, assessment of polyneuropathy, basic biochemical and hematological examination (blood count), VB12, folate and homocysteine (in patients with metformin). Metformin was treated long-term (in the study for at least the last 6 months) by 522 people - 250 women and 272 men aged 68.8 ± 10.4 years. Of these, 24 % were ≥ 65 years old and 5 % were ≥ 80 years old. A significant decrease in VB12 levels below 148 pmol/l was found in 81 cases (15.5 %); a borderline result in the range of 148-221 pmol/l in 157 individuals (30.1 %). Conclusion: Our report, in agreement with the literature, on our patient population points to the risk of developing VB12 deficiency in relation to the daily dose of metformin. Similarly, age should always be taken into account as another potential risk factor, respecting all contraindications and possible drug interactions. We did not find any serious clinical manifestations (anemia, etc.) in T2DM patients with VB12 deficiency.
- MeSH
- Diabetes Mellitus, Type 2 drug therapy MeSH
- Middle Aged MeSH
- Humans MeSH
- Metformin * administration & dosage adverse effects MeSH
- Vitamin B 12 Deficiency * chemically induced MeSH
- Retrospective Studies MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Clinical Study MeSH
V kohortových studiích měli muži s diabetes mellitus 2. typu (DM2) konzistentně 2krát vyšší frekvenci nízké hladiny testosteronu než muži bez diabetu. Metabolický syndrom a diabetes mellitus 2. typu vedou k nižší hladině testosteronu u mužů zejména útlumem hypotalamické sekrece gonadoliberinu a zvýšenou konverzí testosteronu na estrogen. Hypogonadismus potom sám o sobě zhoršuje obezitu a inzulinovou rezistenci. Za hypogonadismus je podle současných doporučení považován stav, kdy jsou zároveň přítomny typické příznaky hypogonadismu a současně snížená hladina testosteronu (pod 12 nmol/l). Dle doporučených postupů je vhodné aktivně pátrat po hypogonadismu u mužů s DM2 a v případě jeho potvrzení zahájit vhodnou léčbu. Ke screeningu příznaků hypogonadismu se mezinárodně používá Aging Males’ Symptoms (AMS) dotazník, který je cenným nástrojem pro hodnocení kvality života a symptomů souvisejících se zdravím u stárnoucích mužů. Na základě výsledků a hladiny testosteronu se rozhodujeme o léčbě, která při nízkých hladinách testosteronu je substituční. Dotazník nám také pomáhá prolomit komunikační bariéru na téma sexuálního života pacienta a případné erektilní dysfunkce, kterou lze v řadě případů úspěšně léčit.
In cohort studies, men with type 2 diabetes mellitus (T2DM) consistently had twice the frequency of low testosterone levels compared to men without diabetes. Metabolic syndrome and type 2 diabetes mellitus lead to lower testosterone levels primarily by suppressing hypothalamic gonadoliberin secretion and by increasing the conversion of testosterone to oestrogen. Hypogonadism itself then worsens obesity and insulin resistance. According to current recommendations, hypogonadism is defined as the presence of typical hypogonadal symptoms together with a reduced testosterone level (below 12 nmol/l). It is advisable to actively screen for hypogonadism in men with T2DM and, if confirmed, initiate appropriate treatment. The Aging Males’ Symptoms (AMS) questionnaire is used internationally to screen for symptoms of hypogonadism; it is a valuable tool for assessing quality of life and health-related symptoms in aging men. Based on the questionnaire results and testosterone levels, treatment decisions are made; in cases of low testosterone levels, testosterone replacement therapy is indicated. The questionnaire also helps break down communication barriers regarding the patient’s sexual life and potential erectile dysfunction, which can often be successfully treated.
The association and causal role of infectious agents in chronic inflammatory diseases have major implications for public health, treatment, and prevention. Pharmacological treatment of combined infectious and inflammatory diseases requires the administration of multiple drugs, including antibiotics and anti-inflammatory drugs. However, this can cause adverse effects, and therefore, dual-action drugs need to be developed. Anti-inflammatory drugs that have already shown antimicrobial properties appear to be promising candidates. NSAIDs, namely aceclofenac, diclofenac, and ibuprofen, were tested in clinical trials with patients diagnosed with uncomplicated urinary tract infections (UTIs) and cellulitis. The administration of ibuprofen, a drug tested in the highest number of studies, resulted in symptom resolution in patients with UTIs. Additionally, ibuprofen caused a high survival rate in mice infected with Pseudomonas aeruginosa and demonstrated potent in vitro antibacterial effects against Bacillus cereus, Escherichia coli, and Staphylococcus aureus, including methicillin-resistant S. aureus (MRSA) (MIC 0.625-2.5 mg/L). For most anti-inflammatory drugs, only data showing their in vitro and in vivo antimicrobial effects are available. Among these, auranofin caused a high survival rate in mice infected with Enterococcus faecium, S. aureus, and Clostridioides difficile. It also produced a strong in vitro growth-inhibitory effect against Streptococcus agalactiae, S. pneumoniae, S. aureus, S. epidermidis, Bacillus subtilis, C. difficile, E. faecalis, E. faecium, and Mycobacterium tuberculosis (MIC 0.0015-5 mg/L). Similarly, aspirin caused a high survival rate in M. tuberculosis-infected mice and strong to moderate in vitro activity against E. coli, B. cereus, P. aeruginosa, Enterobacter aerogenes, Klebsiella pneumoniae and Salmonella choleraesuis (MIC 1.2-5 mg/L). Moreover, topical application of celecoxib resulted in a high reduction in MRSA burden in mice. However, it only caused moderate in vitro effects against S. epidermidis, S. aureus and Bacillus subitilis (MIC 16-64 mg/L). These data suggest that certain non-steroidal anti-inflammatory drugs (NSAIDs) are promising drug candidates for the development of dual-action drugs for the potential treatment of combined infectious and inflammatory diseases such as tuberculosis, musculoskeletal infections and UTIs. Nevertheless, future clinical trials must be conducted to ascertain the antibacterial effect of these NSAIDs before their practical use.
- Publication type
- Journal Article MeSH
- Review MeSH
OBJECTIVE: Despite availability of an array of antihypertensive drugs, malignant hypertension remains a life-threatening condition, and new therapeutic strategies for the treatment of malignant hypertension and malignant hypertension-associated organ damage are needed. The aim of the present study was to assess the effects of nitric oxide (NO)-independent soluble guanylyl cyclase (sGC) stimulator on the course of malignant hypertension. The second aim was to investigate if the treatment with sodium-glucose cotransporter type 2 (SGLT2) inhibitor would augment the expected beneficial actions of the sGC stimulation on the course of malignant hypertension. METHODS: As a model of malignant hypertension, Ren-2 transgenic rats (TGR) treated with nonspecific NO synthase inhibitor (Nω-nitro- l -arginine methyl ester, l -NAME) was used. Blood pressure (BP) was monitored by radiotelemetry, and the treatment was started 3 days before administration of l -NAME. RESULTS: The treatment with sGC stimulator BAY 41-8543, alone or combined with SGLT2 inhibitor empagliflozin, abolished malignant hypertension-related mortality in TGR receiving l -NAME. These two treatment regimens also prevented BP increases after l -NAME administration in TGR, and even decreased BP below values observed in control TGR, and prevented cardiac dysfunction and malignant hypertension-related morbidity. The treatment with the SGLT2 inhibitor empagliflozin did not further augment the beneficial actions of sGC stimulator on the course of malignant hypertension-related mortality. CONCLUSION: The treatment with NO-independent sGC stimulator displayed marked protective actions on the course of malignant hypertension-related mortality and malignant hypertension-related cardiac damage. This suggests that application of sGC stimulator could be a promising therapeutic means for the treatment of malignant hypertension.
- MeSH
- Benzhydryl Compounds pharmacology MeSH
- Sodium-Glucose Transporter 2 Inhibitors MeSH
- Glucosides pharmacology therapeutic use MeSH
- Hypertension, Malignant * prevention & control drug therapy MeSH
- Blood Pressure drug effects MeSH
- Rats MeSH
- Morpholines MeSH
- NG-Nitroarginine Methyl Ester pharmacology MeSH
- Rats, Transgenic MeSH
- Pyrazoles * pharmacology therapeutic use MeSH
- Pyrimidines * therapeutic use pharmacology MeSH
- Soluble Guanylyl Cyclase * metabolism MeSH
- Animals MeSH
- Check Tag
- Rats MeSH
- Male MeSH
- Animals MeSH
- Publication type
- Journal Article MeSH
Diseases caused by staphylococci and streptococci are a serious burden on livestock production, causing significant losses. In addition, the associated antibiotic resistance of these pathogens often makes treatment impossible or prolonged. Cannabis sativa L. contains many compounds with antibacterial properties and shows great potential as a natural antimicrobial agent for agricultural use against both of these bacterial species. The aim of this study was to compare the in vitro antibacterial activity of ethanol extracts from five cultivars of hemp, namely, Bialobrzeskie, Felina 32, Futura 75, mixed and Santhica 27, against Staphylococcus aureus, Streptococcus agalactiae and Streptococcus dysgalactiae. All five cultivars exhibited a certain degree of inhibitory effect against all the pathogens tested with minimum inhibitory concentrations (MICs) ranging from 128 to 2048 μg/mL. The extract from the Santhica 27 cultivar was the most effective antibacterial agent with the lowest MIC value of 128 μg/mL against Str. agalactiae and two clinical isolates of S. aureus, followed by Bialobrzeskie and mixed cultivars with the same growth-inhibitory potential against Str. agalactiae. The extracts from the Felina 32 and Futura 75 cultivars presented only weak activity with MIC values ranging from 256 to 2048 μg/mL. The extract from the Santhica 27 cultivar appears to be a promising product for future use in the treatment of staphylococcal and streptococcal infections in livestock.
- Publication type
- Journal Article MeSH
Fibroblast growth factor 21 (FGF21), a metabolic hormone with pleiotropic effects, is beneficial for various cardiac disorders. However, FGF21's role in heart failure with preserved ejection fraction (HFpEF) remains unclear. Here, we show that elevated circulating FGF21 levels are negatively associated with cardiac diastolic function in patients with HFpEF. Global or adipose FGF21 deficiency exacerbates cardiac diastolic dysfunction and damage in high-fat diet (HFD) plus N[w]-nitro-L-arginine methyl ester (L-NAME)-induced HFpEF mice, whereas these effects are notably reversed by FGF21 replenishment. Mechanistically, FGF21 enhances the production of adiponectin (APN), which in turn indirectly acts on cardiomyocytes, or FGF21 directly targets cardiomyocytes, to negatively regulate pyruvate dehydrogenase kinase 4 (PDK4) production by activating PI3K/AKT signals, then promoting mitochondrial bioenergetics. Additionally, APN deletion strikingly abrogates FGF21's protective effects against HFpEF, while genetic PDK4 inactivation markedly mitigates HFpEF in mice. Thus, FGF21 protects against HFpEF via fine-tuning the multiorgan crosstalk among the adipose, liver, and heart.
- MeSH
- Adiponectin * metabolism genetics MeSH
- Diet, High-Fat * adverse effects MeSH
- Energy Metabolism * drug effects MeSH
- Fibroblast Growth Factors * metabolism genetics MeSH
- Phosphatidylinositol 3-Kinases metabolism MeSH
- Myocytes, Cardiac * metabolism drug effects MeSH
- Humans MeSH
- Mice, Inbred C57BL MeSH
- Mice, Knockout MeSH
- Mice MeSH
- Pyruvate Dehydrogenase Acetyl-Transferring Kinase * metabolism genetics MeSH
- Proto-Oncogene Proteins c-akt metabolism MeSH
- Signal Transduction MeSH
- Mitochondria, Heart * metabolism drug effects MeSH
- Heart Failure * metabolism prevention & control genetics MeSH
- Stroke Volume drug effects MeSH
- Adipose Tissue metabolism MeSH
- Animals MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Mice MeSH
- Animals MeSH
- Publication type
- Journal Article MeSH
John Charles Steele (1934-2022) byl kanadský neurolog, který spolu s Richardsonem a Olszewskim popsal novou nozologickou jednotku, které byla původně pojmenována eponymně, časem se ale ujalo označení progresivní supranukleární paralýza. Později se věnoval epidemiologickému a klinickému výzkumu endemického onemocnění amyotrofická laterální skleróza - parkinsonismus - demence komplex z ostrova Guam, zdokumentoval jeho výskyt, fenotypy, klinickou manifestaci, dědičnost a klesající incidenci i prevalenci. Zabýval se taktéž patofyziologií tohoto onemocnění, a řadu let zastával názor, že se jedná o hereditární polygenní onemocnění; až ke konci života přijal hypotézu, která manifestaci nemoci přisuzovala chronické intoxikaci neurotoxickými sloučeninami obsaženými v cykasových plodech: beta-methylamino-L-alanin (BMAA) a metylazoxymetanol (MAM).
John Charles Steele (1934-2022) was a Canadian neurologist who, together with Richardson and Olszewski, described a new nosological entity that was originally named eponymously; however, over time, it became known as progressive supranuclear palsy. Later, he was concerned with epidemiological and clinical research on the endemic disease of amyotrophic lateral sclerosis-parkinsonism-dementia complex of Guam, documenting its occurrence, phenotypes, clinical manifestations, heredity, and decreasing incidence as well as prevalence. He also studied the pathophysiology of this disease, for years holding the view that it was a hereditary polygenic disease; it was only at the end of his life that he accepted the hypothesis which attributed the manifestation of the disease to chronic intoxication with neurotoxic compounds contained in cycad fruits: beta-methylamino-L-alanine (BMAA) and methylazoxymethanol (MAM).
- MeSH
- Humans MeSH
- Neurodegenerative Diseases history MeSH
- Neurology history MeSH
- Supranuclear Palsy, Progressive * history MeSH
- Famous Persons MeSH
- Check Tag
- Humans MeSH
- Publication type
- Biography MeSH
- About
- Steele, John C Authority
Východiska: Zhoubné nádory jater jsou agresivní a mají špatnou prognózu přežití. Metalothionein (MT) je nízkomolekulární intracelulární protein, jehož primární funkcí je udržení homeostázy těžkých kovů v živých organizmech. Molekulární mechanizmus exprese MT je velmi málo prostudován. Nedávné výzkumy ukazují na jeho významný vztah ke karcinogenezi, spontánní mutagenezi a účinnosti protinádorových léčiv. Již v předchozích studiích bylo dokázáno, že hladiny MT stoupají u nádorového onemocnění. Cílem naší práce bylo studium MT za účelem zvýšení efektivity diagnostiky zhoubných nádorů jater. Metody: V pilotní studii (2022–2023) byla sledována skupina 15 pacientů s hepatocelulárním karcinomem (hepatocellular carcinoma – HCC, diagnóza C220) a skupina 15 pacientů s hepatoblastomem (diagnóza C222). Kontrolní skupina byla vybrána ze zdravých probandů (n = 20). Pro analýzu byla použita námi vyvinutá modifikovaná metoda. Vzorky krevních sér probandů byly tepelně denaturovány (99 ̊C, 20 min). MT byl stanoven pomocí elektrochemie. Získaná data byla uložena a zpracována v laboratorním informačním systému QINSLAB. Výsledky: U vzorků denaturovaných krevních sér byly získány voltametrické křivky MT. Stanovením plochy pod křivkou (area under the curve – AUC) byly vypočteny koncentrace MT. Pro porovnání normální a abnormální hladiny MT byla použita kontrolní séra zdravých probandů (n = 20) se zjištěným průměrným množstvím MT 2,0 ± 1,3 μg/l a mediánem 1,9 μg/l. U skupiny pacientů s HCC bylo zjištěno průměrné množství MT 9,1 ± 6,5 μg/l a medián 9,0 μg/l. Tzv. receiver operating characteristic (ROC) analýza ukázala AUC 0,864 (95% CI 0,736–0,992), senzitivitu 0,74 a specificitu 0,75. U pacientů s hepatoblastomem bylo zjištěno průměrné množství MT 11,5 ± 7,5 μg/l a medián 10,9 μg/l. ROC analýza ukázala AUC 0,868 (95% CI 0,751–0,993), senzitivitu 0,84 a specificitu 0,86. V korelační analýze byla pozorována korelace MT ke karcinoembryonálnímu antigenu (CEA) (r = 0,99), kyselině močové (r = −0,86) a iontům draslíku (r = −0,94). Závěr: V této pilotní studii se podařilo sledovat pravděpodobnou asociaci hladiny MT u probandů se zhoubnými nádory jater. Z publikovaných prací je známo, že hladiny MT jsou dlouhodobě zvýšené a předpokládáme, že souvisí se zvýšenou metabolickou aktivitou nádorových buněk. Studie bude dále pokračovat na větším souboru pacientů.
Background: Malignant liver tumors are highly aggressive with a poor prognosis. Metalothionein (MT) is a low-molecular intracellular protein, whose primary function is to regulate the homeostasis of heavy metals in many organisms. There are only few studies focusing on the molecular mechanisms of MT expression. Recent studies show its significant relations to carcinogenesis, spontaneous mutagenesis and efficiency of antitumor medicine. In previous studies, the increase of MT levels in cancer patients was proven. The aim of this work is to study MT as well as to increase the efficiency of malignant liver tumor diagnosis. Methods: In our pilot study (2022–2023) we observed a group of 15 patients with hepatocellular carcinoma (diagnosis C220) and a group of 15 patients with hepatoblastoma (diagnosis C222). The control group included 20 healthy probands. We developed our own modified method for the analysis. Blood serum samples of the probands were denaturated (99 ̊C, 20 min). MT was determined by an electrochemical method. Obtained data were stored and processed in the laboratory information system QINSLAB. Results: In denaturated blood serum samples, we obtained voltametric curves of MT. We determined concentrations of MT by evaluating the area under the curve (AUC). To differentiate normal and abnormal concentrations of MT, blood samples of healthy probands were used (N = 20), with the average MT levels of 2.0 ± 1.3 μg/L and median 1.9 μg/L. In patients diagnosed with HCC, the average MT levels were 9.1 ± 6.5 μg/L and median 9.0 μg/L. The receiver operating characteristic (ROC) analysis showed AUC 0.864 (95% CI 0.736–0.992), sensitivity 0.74 and specificity 0.75. In patients diagnosed with hepatoblastoma, the average MT concentrations measured were 11.5 ± 7.5 μg/L and the median was 10.9 μg/L. The ROC analysis displayed AUC 0.868 (95% CI 0.751–0.993), sensitivity 0.84 and specificity 0.86. The correlation analysis showed correlation between MT and carcinoembryonic antigen (CEA) (r = 0.99), uric acid (r = −0.86) and potassium ions (r = −0.94). Conclusion: In this pilot study, we observed the association of MT levels in healthy probands and malignant liver tumor patients. Many previous studies show that MT concentrations are increasing as the illness progresses. We assume that this increase is connected to the high metabolic activity of cancer cells. This study will continue with collecting a larger number of samples.
- MeSH
- Electrochemical Techniques classification methods MeSH
- Hepatoblastoma blood pathology MeSH
- Carcinoma, Hepatocellular blood pathology MeSH
- Humans MeSH
- Metallothionein * analysis blood MeSH
- Biomarkers, Tumor analysis blood MeSH
- Liver Neoplasms * diagnosis drug therapy blood MeSH
- Pilot Projects MeSH
- Prognosis MeSH
- Check Tag
- Humans MeSH
- Publication type
- Research Support, Non-U.S. Gov't MeSH
Hyponatremie je stanovena jako koncentrace sodíku nižší než 135 mmol/l. Jedná se o celosvětově nejčastější poruchu elektrolytů. Nejčastějšími projevy hyponatremie jsou gastrointestinální a neurologické obtíže. Příležitostně může vést hyponatremie k poruchám srdečního rytmu. V námi prezentované kazuistice vedla těžká hyponatremie k sinusové bradykardii s alternujícím stupněm atrioventrikulární blokády a srdeční zástavě. Obnovení sinusového rytmu bylo dosaženo až po úpravě koncentrace sodíku. Těžká hyponatremie a protrahovaná zástava oběhu však u pacienta vedly k malignímu otoku mozku. Tento jedinečný případ zdůrazňuje kritickou roli sodíku v srdeční elektrofyziologii a ukazuje důležitost monitorace koncentrace sodíku u pacientů se zástavou oběhu.
Hyponatremia, characterized by sodium levels below 135 mmol/l, is the most prevalent electrolyte disorder worldwide. It presents with a wide range of clinical symptoms, particularly in the neurological and gastrointestinal domains, occasionally leading to cardiac arrhythmias. In our specific case, severe hyponatremia resulting from potomania resulted in sinus bradycardia with alternating atrioventricular block and subsequent cardiac arrest. Restoration of sinus rhythm was achieved following correction of the sodium levels. However severe hyponatremia and long-lasting CPR resulted in brain oedema, which ultimately led to brain death. Per national regulations, the patient was enrolled in an organ donor program, resulting in successful organ transplants. This unique case underscores the critical role of sodium levels in cardiac electrophysiology and highlights the necessity of monitoring electrolyte levels in patients experiencing cardiac arrest.
- MeSH
- Brain Edema etiology MeSH
- Electrocardiography MeSH
- Phosphopyruvate Hydratase analysis MeSH
- Hypertrophy, Right Ventricular complications MeSH
- Hyponatremia * complications MeSH
- Cardiopulmonary Resuscitation MeSH
- Middle Aged MeSH
- Humans MeSH
- Brain Death MeSH
- Alcohol Drinking adverse effects MeSH
- Autopsy MeSH
- Recurrence MeSH
- Heart Arrest * etiology complications pathology therapy MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Publication type
- Case Reports MeSH
