Cíl studie: Přehled současných znalostí o možnostech využití dopplerometrie při posouzení stupněfetální anémie u těhotenství s rizikem erytrocytární alloimunizace. Typ studie: Souhrnný článek.Název a sídlo pracoviště: Gynekologicko-porodnická klinika LF Univerzity Palackého a FN, Olomouc.Předmět a metoda studie: Rešerše z literatury a z medicínských databází.Závěr: U těhotenství s rizikem rozvoje alloimunitní anémie plodu jsou při diagnostice a terapiitradičně užívány invazivní techniky, jako je amniocentéza a kordocentéza. Stanovení maximálnísystolické průtokové rychlosti v arteria cerebri media představuje vysoce senzitivní neinvazivnízpůsob zjištění stupně fetální anémie. Doporučovaný interval mezi měřeními je sedm dní. Zavedenítéto metody do managementu těhotenství se zvýšeným rizikem rozvoje alloimunitní anémieplodu by umožnilo snížit počet nutných amniocentéz a kordocentéz spojených s rizikem možnýchfetálních a těhotenských komplikací. Nezanedbatelné je i hledisko ekonomické.

Objective: To review (summarize), in maternal red blood cell alloimmunization, the diagnosticvalue of Doppler blood fl ow velocity in the evaluation and prediction of fetal anemia.Design: A review article.Setting: Department of Obstetric and Gynecology, University Hospital, Olomouc.Subject and Method: A review from literature and bibliographic databases.Conclusion: Invasive techniques such as amniocentesis and cordocentesis traditionally are usedfor diagnosis and treatment in fetuses at risk for anemia due to maternal red-cell alloimmunization.Middle cerebral artery peak systolic velocity is a highly sensitive non-invasive means for determiningthe degree of anemia. The interval of seven days between two Doppler tests is recommended.The widespread use of the Doppler method will minimize fetal complications associatedwith amniocentesis and fetal blood sampling and may signifi cantly lower health care cost.

• MeSH
• anemie etiologie   chirurgie   terapie   MeSH
• arteria cerebri media ultrasonografie   MeSH
• hematologické komplikace těhotenství diagnóza   etiologie   terapie   MeSH
• intrauterinní krevní transfuze metody   MeSH
• nemoci plodu etiologie   terapie   ultrasonografie   MeSH
• rychlost toku krve MeSH
• ultrasonografie dopplerovská metody   MeSH
• Publikační typ
• přehledy MeSH

INTRODUCTION: Chemotherapy during pregnancy can increase the risk of fetal anemia. Severe fetal anemia can lead to the development of hydrops fetalis and potentially fetal demise. Hence, it is imperative to implement consistent monitoring methods in the context of chemotherapy treatment. This study aimed to diagnose and monitor fetal anemia using middle cerebral artery peak systolic velocity (MCA-PSV) as a diagnostic tool during chemotherapy in pregnant women. MATERIAL AND METHODS: The study employed a prospective analysis involving a case series of 15 patients diagnosed with cancer during pregnancy and subsequently underwent chemotherapy. MCA-PSV was used to identify fetal anemia. The patients were scheduled for ultrasound examinations of the MCA-PSV. The first examination was performed on the same day as the administration of chemotherapy, while the second occurred on the 10th day after chemotherapy. The measurement technique used in the study was based on the methodology proposed by Mari and Barr. The multiples of the median were calculated using the calculators provided by Medicina Fetal Barcelona. Based on these values anemia severity was determined. When moderate or severe anemia was identified, chemotherapy was individually modified. Additionally, a blood count analysis was conducted immediately after the delivery of the newborn. RESULTS: Five patients were diagnosed with fetal or newborn anemia. With MCA-PSV, we identified moderate fetal anemia in two patients and severe fetal anemia in one. The complete blood count testing of newborns revealed mild anemia in three patients. One case was unrelated to chemotherapy-induced anemia. During treatment, fetal anemia did not corelate with maternal anemia. CONCLUSIONS: In four cases of anemia the combination of cisplatin and iphosphamide was used as a chemotherapy agent. No anemia was observed in other drug combinations. Our findings suggest that MCA-PSV is a reliable method for identifying anemia and should be included in the treatment protocol for chemotherapy-induced fetal anemia.

• MeSH
• anemie * chemicky indukované   diagnóza   MeSH
• arteria cerebri media diagnostické zobrazování   MeSH
• lidé MeSH
• nemoci plodu * chemicky indukované   diagnostické zobrazování   MeSH
• novorozenec MeSH
• protinádorové látky * MeSH
• rychlost toku krve MeSH
• těhotenství MeSH
• ultrasonografie prenatální MeSH
• Check Tag
• lidé MeSH
• novorozenec MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

BACKGROUND: Accurate assessment of carotid stenosis severity is important for proper patient management. The present study aimed to compare the evaluation of carotid stenosis severity using four duplex sonography (DUS) measurements, including peak systolic velocity (PSV), PSV ratio in stenosis and distal to stenosis (PSVICA/ICA ratio), end-diastolic velocity (EDV), and B-mode, with computed tomography angiography (CTA), and to evaluate the impact of plaque morphology on correlation between DUS and CTA. METHODS: Consecutive patients with carotid stenosis of ≥40% examined using DUS and CTA were included. Plaque morphology was also determined using magnetic resonance imaging. Spearman's correlation and Kendall's rank correlation were used to evaluate the results. RESULTS: A total of 143 cases of internal carotid artery stenosis of ≥40% based on DUS were analyzed. The PSVICA/ICA ratio showed the highest correlation [Spearman's correlation r = 0.576) with CTA, followed by PSV (r = 0.526), B-mode measurement (r = 0.482), and EDV (r = 0.441; p < 0.001 in all cases]. The worst correlation was found for PSV when the plaque was calcified (r = 0.238), whereas EDV showed a higher correlation (r = 0.523). Correlations of B-mode measurement were superior for plaques with smooth surface (r = 0.677), while the PSVICA/ICA ratio showed the highest correlation in stenoses with irregular (r = 0.373) or ulcerated (r = 0.382) surfaces, as well as lipid (r = 0.406), fibrous (r = 0.461), and mixed (r = 0.403; p < 0.01 in all cases) plaques. Nevertheless, differences between the mentioned correlations were not statistically significant (p > 0.05 in all cases). CONCLUSION: PSV, PSVICA/ICA ratio, EDV, and B-mode measurements showed comparable correlations with CTA in evaluation of carotid artery stenosis based on their correlation with CTA results. Heavy calcifications and plaque surface irregularity or ulceration negatively influenced the measurement accuracy.

• Publikační typ
• časopisecké články MeSH

Age at peak height velocity (APHV) is an indicator of maturity timing which is applicable to both sexes, and which is influenced by environmental factors. The objective of this study was to assess variation in APHV associated with several indicators of socioeconomic status (SES) in a longitudinal sample of Polish adolescents. The sample included 739 boys born in 1983 and followed annually from 12 to 16 years, and 597 girls born in 1985 and followed annually from 9 to 13 years. The height records were fitted with the SITAR model to estimate APHV. SES was estimated using principal component analysis of indicators of familial status based on parental education, family size, living conditions and household possessions. Statistical analyses included analysis of variance (one-way for general SES and three-way for parental education and family size) and Tukey post-hoc tests for unequal samples. General SES (p <.001) and family size (p < .05) significantly influenced APHV among boys, while only maternal education (p < .05) significantly influenced APHV among girls. Among youth from families of higher SES, as defined by the respective indicators, APHV was attained significantly earlier, on average, than in peers from families of lower SES. Overall, the results showed a sex-dependent effect of SES on APHV, and highlighted the influence of favorable socioeconomic conditions for optimal growth and maturation during adolescence.

• MeSH
• dítě MeSH
• lidé MeSH
• longitudinální studie MeSH
• mladiství MeSH
• sexuální faktory MeSH
• socioekonomické faktory * MeSH
• společenská třída MeSH
• tělesná výška * MeSH
• vývoj mladistvých MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Polsko MeSH

BACKGROUND: Assessment of coronary flow is only performed during pharmacological tests. Supine bicycle tests permit the visualization of coronary flow assessments during exercise. PURPOSE: To assess the parameters of coronary flow in the left anterior descending artery (LAD) during exercise, which could be a sign of significant LAD narrowing. MATERIAL AND METHODS: A total of 253 patients were enrolled: Group 1, 186 non-selective participants before undergoing a coronary angiography; and Group 2, 67 controls without coronary artery disease (CAD). All the patients performed a supine bicycle echocardiography test. Coronary flow velocities and coronary flow velocity reserve (CFVR) were measured at the mid-segment of the LAD during exercise. Patients in Group 1 underwent a coronary angiography. RESULTS: In comparison with participants without significant LAD stenosis, patients with LAD lesions had a lower ΔV (16 ± 21 vs. 27 ± 20 cm/s, P < 0.04) and a lower CFVR (1.5 ± 0.8 vs. 2.0 ± 0.6, P < 0.004). In comparison with patients without significant proximal LAD stenosis, the patients with proximal LAD lesions had a lower flow velocity at the peak of exercise (49 ± 32 vs. 61 ± 19 cm/s, P < 0.02), a lower ΔV (13 ± 19 vs. 26 ± 22 cm/s, P < 0.004), and a lower CFVR (1.4 ± 0.6 vs. 1.9 ± 0.7, P < 0.0001). In comparison with the control group, the patients with LAD stenosis had a lower flow velocity at the peak of exercise, a lower ΔV, and a lower CFVR. CONCLUSION: Non-invasive CFVR measurement in the LAD could provide valuable additional information to a conventional echocardiography exercise test. In routine clinical practice, CFVR is sufficient for a diagnosis of severe stenosis.

• MeSH
• cyklistika fyziologie   MeSH
• koronární angiografie MeSH
• koronární cirkulace * MeSH
• koronární nemoc diagnostické zobrazování   patofyziologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• pulzní dopplerovská echokardiografie * MeSH
• rychlost toku krve * MeSH
• studie případů a kontrol MeSH
• zátěžová echokardiografie * MeSH
• zátěžový test * MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

The purpose of the study was to evaluate predicted maturity offset (time before age at PHV) and age at PHV (chronological age [CA] minus maturity offset) in a longitudinal sample of 58 under-13 club level soccer players in central Portugal for whom ages at PHV were estimated with the SITAR model. Two maturity offset prediction equations were applied: the original equation which requires CA sitting height, estimated leg length, height and weight, and a modified equation which requires CA and height. Predicted maturity offset increased, on average, with CA at prediction throughout the age range considered, while variation in predicted maturity offset and ages at PHV within CA groups was considerably reduced compared to variation in observed ages at offset and at PHV. Predicted maturity offset and ages at PHV were consistently later than observed maturity offset and age at PHV among early maturing players, and earlier than observed in late maturing players. Both predicted offset and ages at PHV with the two equations were, on average, later than observed among players maturing on time. Intra-individual variation in predicted ages at PHV with each equation was considerable. The results for soccer players were consistent with similar studies in the general population and two recent longitudinal studies of soccer players. The results question the utility of predicted maturity offset and age at PHV as valid indicators of maturity timing and status.

• MeSH
• antropometrie MeSH
• dítě MeSH
• fotbal fyziologie   MeSH
• lidé MeSH
• mladiství MeSH
• pohlavní dospělost fyziologie   MeSH
• reologie MeSH
• sportovci * MeSH
• sportovní výkon fyziologie   MeSH
• tělesná výška fyziologie   MeSH
• věkové faktory MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Portugalsko MeSH

BACKGROUND: Predicted maturity offset, defined as time before peak height velocity (PHV) is increasingly used as an indicator of maturity status in studies of physical activity, fitness, and sport. OBJECTIVE: To validate maturity offset prediction equations in longitudinal samples of boys and girls. METHODS: The original and modified maturity offset prediction equations were applied to serial data for 266 boys (8-17 years) and 147 girls (8-16 years) from the Cracow Growth Study. Actual age at PHV for each youngster was estimated with the SITAR protocol. In addition to maturity offset, the difference between CA at prediction and maturity offset provided an estimate of predicted age at PHV. RESULTS: Predicted maturity offset and age at PHV increased, on average, with CA at prediction. Variation in predictions was reduced compared to that in observed ages at offset and at PHV, and was more apparent with the modified equations. Relatively few predicted ages at PHV approximated observed age at PHV in early and late maturing youth of both sexes; predictions were later than observed among the former, and earlier than observed among the latter. CONCLUSION: Predicted maturity offset and ages at PHV with the original and modified equations increase with CA at prediction, have reduced variation, and have major limitations with early and late maturing boys and girls.

• MeSH
• antropometrie MeSH
• cvičení MeSH
• lidé MeSH
• longitudinální studie MeSH
• mladiství MeSH
• sporty * MeSH
• tělesná výška * MeSH
• Check Tag
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

PURPOSE: The aim of our study was to acquire non-invasive data from coronary flow velocity profiles during exercise in groups of healthy subjects and of patients with arterial hypertension. MATERIAL AND METHODS: We enrolled 83 patients into two groups: (1) 35 non-selected consecutive healthy subjects; (2) 25 consecutive patients with arterial hypertension. All the patients performed supine bicycle symptoms-limited tests. Throughout exercise the diastolic peaks of coronary flow velocity in LAD were recorded. Coronary flow velocity reserve (CFVR) was calculated off-line. Profiles of coronary artery velocity were acquired for all groups. The coronary artery flow parameters investigated were comparable in healthy and hypertensive patients at every stage. RESULTS: The average diastolic velocities were 54.8 ± 12.9 vs. 51.8 ± 12.2 cm/s, at 50 W; 69.2 ± 17.1 vs 64.4 ± 19.1 cm/s at 75 W; 70.7 ± 16.4 vs. 76.1 ± 19.0 cm/s at 100 W; 80.0 ± 16.0 vs. 72.9 ± 16.1 cm/s at 125 W; 83.7 ± 12.2 vs. 81.4 ± 17.0 at 150 W, p- non-significant, respectively. On average, the healthy group reached CFVR > 2.0 at a heart rate of 110-120 beats/min at 75 W. During supine bicycle exercise, healthy subjects and patients with arterial hypertension have a similar coronary artery flow velocity profile. CONCLUSION: The routine exercise echocardiography test can feasibly be supplemented with the additional measurement of coronary flow velocity during routine supine exercise stress tests, as the normal range of CFVR is reached before submaximal heart rate.

• MeSH
• echokardiografie MeSH
• hypertenze * MeSH
• koronární cévy * diagnostické zobrazování   MeSH
• koronární cirkulace fyziologie   MeSH
• lidé MeSH
• rychlost toku krve fyziologie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

BACKGROUND: Studies addressing age at peak height velocity (PHV) in longitudinal samples of participants in sports are relatively limited. PURPOSE: To compare the growth status and estimated ages at PHV of longitudinal samples girls and boys active in sport with peers not active in sport, and to compare estimated ages at PHV among longitudinal samples of Polish youth active in sport. METHODS: Records from the Cracow Longitudinal Study, which measured youth annually from 8 to 18 years, were screened to identify individuals regularly active in sport. Participants in athletics (22 girls, 10 boys), soccer (12 boys), and other team (6 girls, 7 boys) and individual (6 girls, 9 boys) sports were identified; 107 girls and 172 boys were not active in sport. Heights and weights of participants in sports and non-involved peers were compared. Longitudinal height records of individuals were fit with the SITAR model to estimate age at PHV. Ages at PHV of boys and girls active in sport and peers not active in sports were compared with sex-specific ANOVAs. RESULTS: Ages at PHV of boys participating in athletics and soccer were similar to age at PHV of boys not active in sport, while ages at PHV of boys in other team sports (basketball, volleyball, handball) and individual sports (skiing, gymnastics, acrobatics) were, respectively, slightly earlier and later. Among girls, age at PHV of participants in team sports (basketball, netball) was earlier, while ages at PHV among participants in athletics and other individual sports (equestrian, acrobatics, shooting) were slightly later compared to non-athlete peers. CONCLUSION: Ages at PHV varied among participants in different sports and were consistent with estimates in other longitudinal samples of Polish youth athletes.

• Publikační typ
• časopisecké články MeSH

OBJECTIVES: To monitor fetal anemia during administration of chemotherapy to the fetus's mother. STUDY DESIGN: Between 2007 and 2012 six patients with malignancy diagnosed during pregnancy were included in our prospective study. For evaluation of fetal anemia, peak systolic velocimetry (PSV) of the middle cerebral artery is considered the best method. The patients were repeatedly examined one day before and on the third day after the administration of chemotherapy. At least three measurements were performed and the highest value was used as appropriate. Multiples of the median (MoM) were calculated using the website http://www.perinatology.com/calculators/MCA.htm. When the MoM reached 1.29, moderate anemia was diagnosed. RESULTS: The women's average age was 30 years. The average gestational age at diagnosis was 20.7 weeks of pregnancy. Borderline fetal anemia was detected in only in one patient. After delivery newborns were examined by standard pediatric evaluation and blood count was provided. There was no evidence of any newborn anemia. CONCLUSIONS: Chemotherapy administered during pregnancy is becoming more frequent due to increasing knowledge and data on such cases. Close monitoring of the fetus should be performed in specialized centers. For detection of chemotherapy-induced anemia, PSV measurement should be employed.

• MeSH
• anemie chemicky indukované   patofyziologie   ultrasonografie   MeSH
• arteria cerebri media ultrasonografie   MeSH
• dospělí MeSH
• gestační stáří MeSH
• krevní obraz MeSH
• lidé MeSH
• maternofetální výměna látek * MeSH
• nádorové komplikace v těhotenství farmakoterapie   MeSH
• nemoci plodu chemicky indukované   patofyziologie   ultrasonografie   MeSH
• novorozenec MeSH
• pilotní projekty MeSH
• prospektivní studie MeSH
• protinádorové látky škodlivé účinky   MeSH
• systola MeSH
• těhotenství MeSH
• ultrasonografie prenatální MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• novorozenec MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH