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Previous reports provided recommendations for familial renal glucosuria diagnosis without complex view on differential diagnosis of glucosuria. The aim of this review was to provide an overview of the causes of glucosuria and to create an evidence-based diagnostic approach for children with glucosuria. We searched the current literature with a focus to identify the possible etiology of glucosuria, gaining insight into the pathophysiology of glucosuria. Urinary glucose is completely reabsorbed in the proximal tubule of kidneys. It only appears in the urine if the plasma glucose concentration exceeds the renal threshold for glucose or in the case of insufficient renal glucose reabsorption. The proteins that provide glucose reabsorption are SGLT2 and SGLT1 - sodium-dependent co-transporters that transport glucose from the lumen into epithelial cells - and GLUT2 - a passive transporter providing facilitative glucose transport from epithelial cells to plasma. Renal glucose reabsorption is affected in case of acquired or inherited complex dysfunction of proximal tubule called Fanconi Syndrome or due to pathogenic variants of genes encoding glucose transporters. Prior to diagnosing any of these, diabetes mellitus must be excluded together with other conditions leading to hyperglycemia. In conclusion, glucosuria is always an abnormal finding. The review provides a simple evidence-based diagnostic approach to navigate the differential diagnosis of glucosuria.
- MeSH
- diferenciální diagnóza MeSH
- dítě MeSH
- Fanconiho syndrom diagnóza komplikace MeSH
- glukosa * metabolismus MeSH
- glykosurie * diagnóza etiologie MeSH
- lidé MeSH
- přenašeč glukosy typ 2 metabolismus MeSH
- proximální tubuly ledvin metabolismus MeSH
- renální glykosurie * diagnóza etiologie patofyziologie MeSH
- transportér 1 pro sodík a glukosu metabolismus MeSH
- transportér 2 pro sodík a glukózu metabolismus MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
This article provides an up-to-date review of the management of chronic pancreatitis, highlighting advancements in medical therapy, nutritional support, endoscopic and surgical approaches, and emerging treatments. Nutritional management accentuates addressing malabsorption and nutrient deficiencies. Advances in endoscopy and parenchyma-sparing surgical techniques have opened new avenues for improved patient outcomes, with total pancreatectomy and islet autotransplantation offering the only definitive solution for selected patients. Additionally, emerging therapies, including anti-inflammatory and immune-modulating agents, show promise for future treatment options. Emphasizing a multidisciplinary approach, this review aims to equip health care professionals with a comprehensive overview of current management strategies and future directions.
- MeSH
- chronická pankreatitida * terapie MeSH
- lidé MeSH
- nutriční podpora * metody MeSH
- pankreatektomie * metody MeSH
- transplantace Langerhansových ostrůvků metody MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
This conceptual study introduces the "virtual waiting room," an innovative, interactive, web-based platform designed to enhance the waiting experience in oncology by providing personalized, educational, and supportive content. Central to our study is the implementation of the circular entry model, which allows for non-linear navigation of health information, empowering patients to access content based on their immediate needs and interests. This approach respects the individual journeys of patients, acknowledging the diverse pathways through which they seek understanding and manage their health. The virtual waiting room is designed not only to support patients but also to facilitate stronger communication and shared understanding between patients, caregivers, and families. By providing a shared digital space, the platform enables caregivers and family members to access the same information and resources, thereby promoting transparency and collective knowledge. This shared access is crucial in managing the emotional complexities of oncology care, where effective communication can significantly impact treatment outcomes and patient well-being. Furthermore, the study explores how the circular entry model within the virtual waiting room can enhance patient autonomy and engagement by offering customized interactions based on user feedback and preferences. This personalized approach aims to reduce anxiety, improve health literacy, and prepare patients more effectively for clinical interactions. By transforming passive waiting into active engagement, the virtual waiting room turns waiting time into a meaningful, informative period that supports both the psychological and informational needs of patients and their support networks.
- MeSH
- komunikace MeSH
- lékařská onkologie * MeSH
- lidé MeSH
- nádory * psychologie terapie MeSH
- vyprávění MeSH
- vzdělávání pacientů jako téma MeSH
- zdravotní gramotnost MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
G protein-coupled receptors (GPCRs) play a crucial role in cell function by transducing signals from the extracellular environment to the inside of the cell. They mediate the effects of various stimuli, including hormones, neurotransmitters, ions, photons, food tastants and odorants, and are renowned drug targets. Advancements in structural biology techniques, including X-ray crystallography and cryo-electron microscopy (cryo-EM), have driven the elucidation of an increasing number of GPCR structures. These structures reveal novel features that shed light on receptor activation, dimerization and oligomerization, dichotomy between orthosteric and allosteric modulation, and the intricate interactions underlying signal transduction, providing insights into diverse ligand-binding modes and signalling pathways. However, a substantial portion of the GPCR repertoire and their activation states remain structurally unexplored. Future efforts should prioritize capturing the full structural diversity of GPCRs across multiple dimensions. To do so, the integration of structural biology with biophysical and computational techniques will be essential. We describe in this review the progress of nuclear magnetic resonance (NMR) to examine GPCR plasticity and conformational dynamics, of atomic force microscopy (AFM) to explore the spatial-temporal dynamics and kinetic aspects of GPCRs, and the recent breakthroughs in artificial intelligence for protein structure prediction to characterize the structures of the entire GPCRome. In summary, the journey through GPCR structural biology provided in this review illustrates how far we have come in decoding these essential proteins architecture and function. Looking ahead, integrating cutting-edge biophysics and computational tools offers a path to navigating the GPCR structural landscape, ultimately advancing GPCR-based applications. LINKED ARTICLES: This article is part of a themed issue Complexity of GPCR Modulation and Signaling (ERNST). To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v182.14/issuetoc.
- MeSH
- konformace proteinů MeSH
- lidé MeSH
- receptory spřažené s G-proteiny * chemie metabolismus MeSH
- zvířata MeSH
- Check Tag
- lidé MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
A ubiquitous property of bacteria is their ability to move toward more suitable environments, which can also facilitate host-associated activities like colonization and offer the cell several benefits such as bacteria moving towards a favorable gradient or away from a harmful gradient is known as chemotaxis. Bacteria achieve this by rotating flagella in clockwise and anticlockwise directions resulting in "run" and "tumble." This ability of bacteria to sense and respond to any type of change in the environmental factors like pH, osmolarity, redox potential, and temperature is a standard signal transduction system that depends on coupling proteins, which is the bacterial chemotaxis system. There are two architectures for the coupling proteins in the chemotaxis system: CheW and CheV. Typically, a signal transduction system for chemotaxis to form a core signaling complex couples CheA activity to chemoreceptor control: two CheW coupling protein molecules span a histidine kinase CheA dimer and two chemoreceptors (also known as methyl-accepting chemotaxis protein, MCP) trimers of dimers which further transfer the signal to the flagellar motor through CheY. The current review summarizes and highlights the molecular mechanism involved in bacterial chemotaxis, its physiological benefits such as locating suitable nutrients and niches for bacterial growth, and various assay techniques used for the detection of chemotactic motility.
Cíl: Referovat výsledky léčby pacientů s centrální serózní chorioretinopatií léčených pomocí laseru Navilas. Materiál a metody: Retrospektivně byly vyhodnoceny výsledky ošetření 39 očí 37 pacientů s akutní formou centrální serózní chorioretinopatie, u kterých nedošlo při konzervativní terapii k vstřebání serózní ablace smyslového epitelu sítnice. U těchto pacientů jsme provedli ošetření tvrdou stopou v místě průsaku (hotspot) pomocí navigovaného laseru Navilas. Výsledky: 3 pacienti se na kontrolu nedostavili, ze zbylých 36 došlo u 32 očí k úplnému vstřebání tekutiny. U 2 pacientů bylo nutné opětovné ošetření, u jednoho pacienta se rozvinula choroideální neovaskularizace a u jednoho nedošlo ani při opětovném ošetření ke vstřebání tekutiny. Závěr: Laserové ošetření hotspotu u pacientů s centrální serózní chorioretinopatií je stále velmi efektivní léčebná metoda. Pomocí navigačního laseru Navilas lze ošetřit i léze juxtafoveolární s vysokou mírou bezpečnosti.
Aim: To report the results of treatment of patients with central serous chorioretinopathy treated with a Navilas laser. Material and Methods: We retrospectively evaluated the results of the treatment of 39 eyes of 37 patients with acute form of central serous chorioretinopathy, who did not respond to conventional treatment. In these patients we performed focal laser treatment at the point of leakage (hotspot) using a Navilas guided laser. Results: 3 patients did not report for the check-up, of the remaining 36 eyes, complete liquid absorption was achieved in 32. Retreatment was necessary in 2 patients, choroidal neovascularization developed in one patient, and in one patient fluid absorption was not achieved even after retreatment. Conclusion: Focal laser treatment of hotspots in patients with central serous chorioretinopathy is still a very effective treatment method. Juxtafoveolar lesions can also be treated with a high degree of safety using a Navilas navigation laser.
Glioblastomas are aggressive brain tumors for which effective therapy is still lacking, resulting in dismal survival rates. These tumors display significant phenotypic plasticity, harboring diverse cell populations ranging from tumor core cells to dispersed, highly invasive cells. Neuron navigator 3 (NAV3), a microtubule-associated protein affecting microtubule growth and dynamics, is downregulated in various cancers, including glioblastoma, and has thus been considered a tumor suppressor. In this study, we challenge this designation and unveil distinct expression patterns of NAV3 across different invasion phenotypes. Using glioblastoma cell lines and patient-derived glioma stem-like cell cultures, we disclose an upregulation of NAV3 in invading glioblastoma cells, contrasting with its lower expression in cells residing in tumor spheroid cores. Furthermore, we establish an association between low and high NAV3 expression and the amoeboid and mesenchymal invasive phenotype, respectively, and demonstrate that overexpression of NAV3 directly stimulates glioblastoma invasive behavior in both 2D and 3D environments. Consistently, we observed increased NAV3 expression in cells migrating along blood vessels in mouse xenografts. Overall, our results shed light on the role of NAV3 in glioblastoma invasion, providing insights into this lethal aspect of glioblastoma behavior.
- MeSH
- fenotyp * MeSH
- glioblastom * patologie genetika metabolismus MeSH
- invazivní růst nádoru * genetika MeSH
- lidé MeSH
- membránové proteiny MeSH
- mikrotubuly metabolismus MeSH
- myši MeSH
- nádorové buněčné linie MeSH
- nádory mozku * patologie genetika metabolismus MeSH
- pohyb buněk genetika fyziologie MeSH
- proteiny nervové tkáně metabolismus genetika MeSH
- zvířata MeSH
- Check Tag
- lidé MeSH
- myši MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
Cíl: V retrospektivní studii jsme porovnali efektivitu navigace punkce portální žíly pomocí abdominální ultrasonografie oproti CO2 portografii. Efektivitu navigace jsme posuzovali dle počtu punkcí nutných k dosažení katetrizace větve vena portae, délkou skiaskopie a radiační dávkou charakterizovanou produktem dávkové plochy (DAP). Metodika: Do studie bylo zahrnuto 102 po sobě jdoucích pacientů, kterým byl proveden TIPS v období 3 let (od počátku roku 2022 do konce roku 2024). V souboru bylo 29 žen (28 %) a 73 mužů (72 %), ve věkovém rozmezí 27–81 let. Hlavní indikací k TIPS byl refrakterní ascites u 52 (51 %) a krvácení při portální hypertenzi u 50 pacientů (49 %). TIPS byl proveden jako urgentní výkon u 19 pacientů (v 18,6 %) pro nezastavené variceální krvácení. Childovo-Pughovo skóre A bylo 22 % pacientů, Childovo-Pughovo skóre B 44 % a Childovo-Pughovo skóre C 26 %, u 8 % pacientů nebyla klasifikace zjistitelná. Výsledky: Ze 102 TIPS výkonů nebyl tento zaveden u tří pacientů pro technické selhání (2,9 %). Počet vpichů nutných k dosažení portální žíly se zavedením vodiče byl v průměru 5,6 (od jednoho do 20) u 50 pacientů, jejichž punkce byla naváděna pomocí CO2 portografie. U 28 výkonů, kde byl k navádění použit UZ, bylo průměrně nutných 2,7 vpichů (od jednoho do šesti). Délka skiaskopie byla u 28 výkonů provedených pomocí navigace CO2 v průměru 28 minut (9–50 min), u 28 výkonů s navigací pod UZ to bylo 22,8 min (8–43 min). Ve skupině 19 výkonů před obměnou angiolinky a s CO2 navigací byl v průměru DAP 181 497 mGy/cm2 (27 649–399 657 mGy/cm2 ), ve skupině 17 výkonů po obměně angiolinky a navigovaných pomocí CO2 portografie byl DAP v průměru 159 339 mGy/cm2 (52 613–309 440 mGy/cm2 ) a v časově nejmladší skupině 21 výkonů navigovaných pomocí UZ byl DAP v průměru 120 731 mGy/cm 2 (38 180–315 121 mGy/cm2 ). U sedmi výkonů bylo provedeno měření dávky osobními dozimetry. V části výkonu do zavedení vodiče do portální žíly operatér měl dávku v průměru 6 μSv (0 do 12 μSv), zatímco lékař provádějící UZ navigaci v průměru 4,4 μSv (0 do 9 μSv). Celková dávka pro operatéra byla v průměru 19,5 μSv (8–35 μSv). Závěr: Z naměřených hodnot lze uzavřít, že počet vpichů při navigaci pomocí UZ klesl v průměru z 5,6 na 2,7, tento rozdíl se velmi blíží statistické významnosti (p = 0,052). Skiaskopický čas při výkonu klesl v průměru o 7 minut. Dávka druhého lékaře navigujícího punkci pomocí UZ je do doby katetrizace por- tální žíly srovnatelná s dávkou operatéra. DAP klesl po inovaci přístroje a na novém přístroji a dále ještě více klesl i u výkonů prováděných s navigací punkce pomocí UZ.
Aim: In our retrospective study, we compared the efficacy of portal vein puncture navigation using abdominal ultrasonography versus CO2 portography. We assessed navigation efficiency according to the number of punctures required to achieve vena portae branch catheterization, the length of the fluoroscopy, and the dose area product (DAP). Method: The study included 102 consecutive patients who underwent TIPS over a 3-year period (from the beginning of 2022 to the end of 2024). In this cohort, there were 29 women (28%) and 73 men (72%), ranging in age from 27 to 81 years. The main indications for TIPS were refractory ascites in 52 patients (51%) and bleeding with portal hypertension in 50 patients (49%). TIPS was performed as an emergency procedure in 19 patients (18.6%) for uncontrolled variceal bleeding. Child Pugh A, Child Pugh B and Child Pugh C were 22%, 44% and 26% respectively, with 8% of patients having no detectable classification. Results: Of the 102 TIPS procedures, TIPS was not inserted in 3 patients due to technical failure (2.9%). The number of punctures required to reach the portal vein with guidewire insertion averaged 5.6 (range 1 to 20) in 50 patients whose puncture was guided by CO2 portography. In the 28 procedures where ultrasound was used for guidance, the mean number of punctures required was 2.7 (range, 1 to 6). The mean duration of fluoroscopy was 28 min (9–50 min) in the 28 procedures performed with CO2 guidance and 22.8 min (8–43 min) in the 28 procedures with ultrasound guidance. In the group of 19 procedures before angiomachine exchange and with CO2 navigation, the mean DAP was 181 497 mGy/ cm2 (27 649–399 657 mGy/cm2 ), in the group of 17 procedures after angiomachine exchange and navigated by CO 2 portography, the DAP averaged 159 339 mGy/cm 2 (52 613–309 440 mGy/cm2 ) and in the youngest group of 21 procedures navigated by ultrasound, the DAP averaged 120 731 mGy/cm2 (38 180–315 121 mGy/cm 2 ). Dose measurements with personal dosimeters were performed for 7 procedures. In the part of the procedure until the insertion of the guidewire into the portal vein, the operator had a dose of 6 μSv (0 to 12 μSv) on average, while the physician performing the ultrasound navigation had a dose of 4.4 μSv (0 to 9 μSv) on average. The total dose to the operator averaged 19.5 μSv (8 to 35 μSv). Conclusion: From the measured values it can be concluded that the number of punctures during navigation with US decreased from 5.6 to 2.7 on average, this result is close to statistic significance (p = 0.052). The fluoroscopic time during the procedure decreased by 7 minutes. However, the dose of the second physician navigating the puncture using ultrasound is comparable to that of the main operator. The DAP decreased after the device upgrade, and even more decreased for procedures performed with ultrasound-guided puncture navigation.
V publikacích o elektronických cigaretách (e-cigaretách) často nacházíme kontroverzní závěry. Metodiky jednotlivých studií se značně liší, což se odráží i v různorodých výsledcích, a orientace v těchto publikacích pak bývá obtížná. To se mimo jiné týká i souvislosti mezi prevalencí vapování (užívání elektronických cigaret) a prevalencí kouření, zejména u mladých lidí. Častým tématem je obava, že vapování nikotinu může být vstupní branou k pozdějšímu kouření tabáku (gateway efekt). V tomto článku uvádíme zásady, které by studie na toto téma měly dodržovat a kterých by si měli všímat i recenzenti publikací.
Publications on electronic cigarettes (e-cigarettes) often present controversial conclusions. Methodologies and results vary widely, making it challenging to navigate the evidence. This is particularly true for the studies examining the association between the prevalence of vaping (EC use) and the prevalence of smoking, especially among young people. A frequently discussed concern is that nicotine vaping may serve as a gateway to later tobacco smoking (the gateway effect). Below, we outline key principles that studies on this topic should follow and that reviewers of publications should consider.
- MeSH
- klinická studie jako téma normy MeSH
- kouření tabáku * MeSH
- lidé MeSH
- prevalence MeSH
- vaping * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- práce podpořená grantem MeSH
Aim: The aim of this article is to investigate and describe the coping strategies of elderly widows. Theoretical base: The grieving process is well described in the literature. However, in real life, it is always necessary to respect the uniqueness of the process for each individual. Most previous studies have focused on difficulties of the bereaved and their risk of dying. More recently, the strengths of the bereaved and how they develop have also been emphasised. A dual-proces model of coping with bereavement was used. It is based on loss-oriented and restoration-oriented strategies and the oscillation between them. In the Czech context, there is a lack of research based on this dual-process model describing coping strategies after the loss of a loved one. Methods: The paper presents the results of ethically demanding research using semi-structured interviews with 15 elderly widows. The authors based the model on a questionnaire survey using a qualitative methodology because of the aspiration to describe the strategies of individual women in detail. Results: The output is a description of coping strategies, categorized into loss- and recovery-oriented approaches, used by elderly women to navigate the period following their partner's death. Conclusion: Describing how the women interviewed have coped with their challenging life situation could inspire not only other elderly women but also their relatives and aid workers who come into contact with this target group.
- MeSH
- adaptace psychologická MeSH
- copingové dovednosti * metody MeSH
- kvalitativní výzkum MeSH
- lidé MeSH
- manželé psychologie MeSH
- rozhovory jako téma MeSH
- senioři MeSH
- smrt MeSH
- vdovský stav psychologie MeSH
- zármutek MeSH
- zpráva o sobě MeSH
- ztráta blízké osoby * MeSH
- Check Tag
- lidé MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- práce podpořená grantem MeSH