AIMS: TheAIM of the study was to analyze lung growth and abnormality of infant pulmonary function tests (IPFT) in congenital diaphragmatic hernia (CDH) survivors younger than three years of age with respect to unfavorable prognostic factors. METHODS: Thirty high-risk CDH survivors at the age of 1.32±0.54 years, body weight 9.76±1.25 kg were examined using IPFT: tidal breathing analysis, baby resistance/compliance, whole baby body plethysmography and rapid thoraco-abdominal compression. Gore-Tex patch was used in 13% of patients (GORE group). Pulmonary hypertension was diagnosed and managed in 13% (iNO group). Standard protocols and appropriate reference values were used and obtained data were statistically analysed. RESULTS: High incidence of peripheral airway obstruction (70%), increased value of functional residual capacity (FRCp) 191.3±24.5 mL (126.5±36.9 % predicted; P < 0.0005), increased value of effective airway resistance (Reff) 1.71±0.93 kPa.L(-1).s (144.4±80.1 % predicted; P < 0.01) and decreased specific compliance of the respiratory system (Crs/kg) 14.1±2.3 mL.kPa.kg(-1) (i.e., 76.1±20.1 % predicted, P < 0.0005) was noted in infants with CDH in comparison with reference values. Increased value of FRCp was found in GORE group (165.7±51.9 versus 120.4±31.2, P < 0.02) and in iNO group (183.1±52.6 versus 117.8±25.7 mL; P < 0.0005). CONCLUSION: A high incidence of peripheral airway obstruction, an increased value of FRCp and decreased specific compliance of the respiratory system was noted in infants with CDH. Unfavorable prognostic factors (Gore-Tex patch, pulmonary hypertension) correlate with more severe alteration of pulmonary function in infants.

• MeSH
• kojenec MeSH
• lidé MeSH
• morbidita trendy   MeSH
• plíce patofyziologie   MeSH
• plicní hypertenze etiologie   patofyziologie   MeSH
• respirační funkční testy MeSH
• retrospektivní studie MeSH
• rizikové faktory MeSH
• vrozená brániční kýla komplikace   epidemiologie   patofyziologie   MeSH
• Check Tag
• kojenec MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika MeSH

Autoimunitný diabetes mellitus charakterizuje selektívna deštrukcia β pankreatických buniek celulárnou infiltráciou T (Th1) a B lymfocytmi.Markerom autoimunity je prítomnosť autoprotilátok (ICA, IAA, GADab, IA2ab). Etiológia tohto procesu nie je dodnes úplne vyjasnená. Predpokladá sa však, že na jeho patogenéze sa podieľajú genetické faktory a faktory prostredia. Interakcia genetických predispozičných faktorov s faktormi prostredia ovplyvňuje dobu vzniku i progresiu ochorenia. Najdôležitejším genetickým rizikovým faktorom autoimunitného diabetes mellitus sú alely HLA II. triedy (DQB1*0302,0201; DRB1*0301,0401; DQA1*0301,0501) a rizikové alely INS-VNTR promótorovej oblasti. V posledných rokoch sa však objavujú práce, v ktorých sa prikladá význam aj iným genetickým rizikovým faktorom. Sú to hlavne genetické polymorfizmy v génoch niektorých cytokínov (IL-10, IL-12, IL-18) a mikrosatelitový polymorfizmus v géne MHC Class I chain-related gene A (MIC-A).

Autoimmune diabetes mellitus is characterized by selective destruction of β pancreatic cells and by cellular infiltration with T-(p articularly Th1) and B-lymphocytes. The marker of autoimmunity is the presence of autoantibodies (ICA, IAA, GADab, IA2ab). Etiology of the autoimmune process is still unknown. It is suggested that the pathogenesis is activated by genetic and environmental factors. Individual predisposition can influence also the onset and progression of the disease. The most important genetic risk factors of autoimmune diabetes mellitus are the HLA class II alleles (DQB1*0302, 0201; DRB1*0301, 0401; DQA1*0301, 0501) and the risk alleles of INS-VNTR of the promoter region. Recent studies have shown various genetic risk factors for the autoimmune diabetes mellitus. Individual predispositions belong to the genetic polymorphisms in cytokine genes (IL-10, IL-12, IL-18) and the microsatelite polymorphism of MHC class I chain-related gene A (MIC-A).

• MeSH
• autoimunitní nemoci imunologie   patologie   MeSH
• diabetes mellitus genetika   imunologie   patologie   MeSH
• finanční podpora výzkumu jako téma MeSH
• genetická predispozice k nemoci MeSH
• HLA antigeny analýza   genetika   MeSH
• interleukiny genetika   MeSH
• inzulin genetika   MeSH
• lidé MeSH
• rizikové faktory MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• přehledy MeSH

OBJECTIVES: The aim was to validate the Framingham coronary heart disease (CHD) risk function with the formula by Wilson et al. (1998) in Czech men. METHODS: The validation was performed within the 20-year primary prevention study of atherosclerotic risk factors (STULONG) including 1417 middle-aged men from the Czech Republic (Prague). A total of 646 men examined in 1979-1988, and followed-up for ten years, were included into the validation study. The calibration and discrimination ability of the Framingham risk function in the Czech population were explored. RESULTS: The estimated 10-year risk of CHD by the Framingham risk function was 12.8% in 646 men, significantly higher than the observed risk (16.4 %), p = 0.013. The trend in the 10-year incidence of CHD was significantly increasing with quintiles of the estimated risk, p < 0.001. After the recalibration of the Framingham risk function, there was an insignificant difference between the estimated (18.2%) and observed (16.4%) risks of CHD, p = 0.320. The Framingham risk function classified men into those with and without CHD in the 10-year period with accuracy over 60%. CONCLUSIONS: Unlike some validation studies from Western Europe, the Framingham risk function significantly underestimated the 10-year CHD risk in the Czech Republic. In agreement with these studies, the incidence of CHD was significantly increasing across quintiles of the estimated risk.

• MeSH
• dospělí MeSH
• financování organizované MeSH
• hodnocení rizik metody   statistika a číselné údaje   MeSH
• incidence MeSH
• lidé středního věku MeSH
• lidé MeSH
• nemoci koronárních tepen epidemiologie   prevence a kontrola   MeSH
• primární prevence MeSH
• prospektivní studie MeSH
• rizikové faktory MeSH
• sexuální faktory MeSH
• statistické modely MeSH
• validační studie jako téma MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Geografické názvy
• Česká republika MeSH

U pacientov s polytraumou a mnohopočetnými poraneniami je súčasťou manažmentu okrem prvotného ošetrenia a stabilizácie vitálnych funkcií aj správne smerovanie. Nevyhnutnou podmienkou správneho smerovania je zatriedenie do patričnej rizikovej skupiny (tzv. triáž) na základe predpokladu rizika smrti. Na Slovensku sa obvykle žiaden prognostický model prednemocnične nepoužíva a pritom vhodný skórovací systém, môže byť pre správne smerovanie do trauma centra, alebo špecializovanej nemocnice veľmi užitočný. V našej práci sme sa zamerali na analýzu, použiteľnosť a porovnanie presnosti skórovacích systémov používaných v zahraničí. Potvrdili sme, že medzi hodnotením závažnosti stavu anatomicky podľa ISS a klinicky podľa GAP je významná korelácia a vzhľadom na obmedzenú možnosť použitia ISS prednemocnične je pre odhad prognózy vhodnejšie použiť skóre GAP. Literárne údaje sme porovnali s mortalitou pozorovanou v našom súbore a navrhujeme zaradenie systému GAP do prednemocničného manažmentu pacientov s ťažkým úrazom na Slovensku.

In the group of patients with polytrauma and multiple injuries an important part of management in addition to the initial treatment, stabilization of vital functions and the right routing. A necessary condition for a correct routing is sorting and classification and a proper setting in the appropriate risk groups (ie. triage) on the assumption of the risk of death. There is no prehospital forecasting model usually used in Slovakia while the reasonable scoring may be very useful for the proper direction to trauma centre or specialized hospital. In our work we focussed on the analysis, usability and accuracy comparison of scoring systems used abroad. We confirmed that between the severity assessment by ISS anatomically and by GAP clinically is a significant correlation. Due to the limitation of the assessment of the patient’s condition and forecasting the risk by means of ISS system at the place of accident, it becomes apparent that GAP score is a better prognostic indicator of mortality in prehospital care. Literature data were compared with the mortality observed in our study while the proposal of inclusion of GAP in prehospital management of patients with severe injuries in Slovakia have been prepared.

• MeSH
• APACHE MeSH
• Glasgowská stupnice kómat MeSH
• lidé MeSH
• polytrauma * klasifikace   mortalita   MeSH
• prognóza MeSH
• retrospektivní studie MeSH
• rizikové faktory MeSH
• skóre závažnosti úrazu * MeSH
• ukazatel závažnosti úrazu MeSH
• zohlednění rizika MeSH
• Check Tag
• lidé MeSH
• Geografické názvy
• Slovenská republika MeSH

BACKGROUND: Organ shortage leads to the increased use of expanded-criteria donor (ECD) kidneys, which contribute to a higher risk of delayed graft function (DGF) after transplantation. The aim of this study was to determine factors that may better predict the risk of DGF. METHODS: Histologic assessments of donor renal biopsy were used with other clinical variables to predict the risk of DGF after kidney transplantation. The total Banff score equaled the sum of interstitial fibrosis (CI), tubular atrophy, arteriolar hyaline thickening, fibrous intimal thickening (CV), and fraction of sclerotized glomeruli. RESULTS: In total, 126 of 344 patients developed DGF after kidney transplantation. The histologic score for CI, tubular atrophy, and CV and the total Banff score were increased in patients with DGF. Only CI and CV were independent predictors of DGF (P<0.01). A CIV score (CI+CV; odds ratio, 2.68; 95% confidence interval, 1.55-4.66; P<0.001) was superior to the combination of the total Banff score (odds ratio, 1.48; 95% confidence interval, 0.85-2.55; P=NS). A CIV score≥1, donor age more than 51 years, and anoxia donor brain injury were associated with the highest risk of DGF. A CIV<1 identified a subgroup of ECDs at a lower risk of DGF comparable with standard-criteria donors (29.3% vs. 28.4%). CONCLUSIONS: Composite CIV score better identifies ECD kidneys with a lower risk of developing DGF. Morphologic evaluation of ECD kidneys and donor characteristics may improve kidney allocation.

• MeSH
• biopsie MeSH
• dárci tkání zásobování a distribuce   MeSH
• dospělí MeSH
• fibróza MeSH
• hodnocení rizik MeSH
• ledviny patologie   chirurgie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• lineární modely MeSH
• logistické modely MeSH
• mladiství MeSH
• mladý dospělý MeSH
• multivariační analýza MeSH
• nefrektomie * MeSH
• odds ratio MeSH
• opožděný nástup funkce štěpu etiologie   prevence a kontrola   MeSH
• prediktivní hodnota testů MeSH
• retrospektivní studie MeSH
• rizikové faktory MeSH
• senioři MeSH
• transplantace ledvin škodlivé účinky   metody   MeSH
• výběr dárců metody   MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• srovnávací studie MeSH

• MeSH
• koronární nemoc MeSH
• kouření MeSH
• respirační funkční testy MeSH
• rizikové faktory MeSH

• Konspekt
• Patologie. Klinická medicína
• NLK Obory
• kardiologie
• pneumologie a ftizeologie
• epidemiologie

Autoři uvádí přehled vyšetření umožňující odhad operačního rizika před plicní resekcí pro bronchogenní karcinom. Důraz kladou na komplexní přístup za použití snadno dostupných metod. Upozorňují na význam předoperační přípravy.

Authors present a review of examinations enabling the judgment of surgical risk before pulmonary resection for bronchogenic carcinoma. They emphasise the complex access using easy accessible procedures. They stress the carefully preparation of patients before surgery.

• MeSH
• bronchogenní karcinom chirurgie   MeSH
• lidé MeSH
• mortalita MeSH
• pneumektomie MeSH
• předoperační péče MeSH
• respirační funkční testy MeSH
• rizikové faktory MeSH
• Check Tag
• lidé MeSH

Chronic kidney disease (CKD), defined at a specific time point, is an important risk factor for cardiovascular disease. Whether the rate of kidney function decline contributes additional cardiovascular risk is unknown. In the Cardiovascular Health Study, we compared the associations of changes in kidney function during the first 7 yr with the incidence of heart failure (HF), myocardial infarction (MI), stroke, and peripheral arterial disease (PAD) during the subsequent 8 yr. We defined a rapid decline in cystatin C-based estimated GFR as >3 ml/min per 1.73 m(2)/yr, on the basis of determination at baseline, year 3, and year 7. Among eligible participants, 1083 (24%) had rapid kidney decline. The incidence of each type of cardiovascular event was significantly higher among patients with rapid decline (all P < 0.001). After multivariate adjustment for demographics, cardiovascular disease risk factors, and baseline kidney function, rapid kidney function decline was significantly associated with HF (adjusted hazard ratio [HR] 1.32; 95% confidence interval [CI] 1.13 to 1.53), MI (HR 1.48; 95% CI 1.21 to 1.83), and PAD (HR 1.67; 95% CI 1.02 to 2.75) but not with stroke (HR 1.19; 95% CI 0.97 to 1.45). The association of rapid decline with each outcome did not differ by the presence or absence of CKD. In conclusion, declining kidney function associates with higher risk for HF, MI, and PAD among patients with or without CKD

• MeSH
• časové faktory MeSH
• cévní mozková příhoda epidemiologie   etiologie   MeSH
• chronická renální insuficience komplikace   patofyziologie   MeSH
• cystatin C krev   MeSH
• financování organizované MeSH
• hodnoty glomerulární filtrace MeSH
• infarkt myokardu epidemiologie   etiologie   MeSH
• kardiovaskulární nemoci epidemiologie   etiologie   MeSH
• kreatinin krev   MeSH
• lidé MeSH
• longitudinální studie MeSH
• onemocnění periferních cév epidemiologie   etiologie   MeSH
• rizikové faktory MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• srdeční selhání epidemiologie   etiologie   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• multicentrická studie MeSH
• Geografické názvy
• Spojené státy americké MeSH

BACKGROUND: The association between chronic obstructive pulmonary disease (COPD) and sudden cardiac death has not been fully elucidated. OBJECTIVE: The purpose of this study was to investigate whether decreased left ventricular ejection fraction (LVEF) can explain the increased rate of ventricular tachycardia (VT) in COPD. METHODS: This retrospective study included consecutive adult patients who underwent pulmonary function testing (PFT), Holter monitoring, and transthoracic echocardiography. COPD was correlated with the frequency of VT in a multivariate analysis that adjusted for known confounders including LVEF. Long-term all-cause mortality of patients with COPD and VT was examined. RESULTS: Of the 6351 patients included in this study (age 66 ± 15 years; 48% woman; 92% Caucasian, LVEF 59% ± 12%), 2800 (44%) had PFT indicative of COPD. VT was nearly twice as likely to occur during Holter monitoring in COPD patients (13% vs 23%; P <.001), and the severity of COPD correlated with the risk of VT (21% vs 28% vs 37% for mild-moderate, severe, and very severe COPD; P <.001). COPD and VT remained independently associated (P <.001) even after adjusting for LVEF, demographics, and comorbidities (age, sex, body mass index, hypertension, chronic kidney disease, coronary artery disease, cancer history, diabetes mellitus). COPD was associated with all-cause mortality independently of LVEF (P <.001). CONCLUSION: COPD patients are at higher risk for VT and mortality. This may not be fully attributed to the confounding effect of systolic heart failure measured by LVEF. Further studies are needed to explore the mechanistic interactions between VT and COPD in order to determine whether antiarrhythmic strategies would apply especially to patients with severe COPD.

• MeSH
• chronická obstrukční plicní nemoc komplikace   epidemiologie   MeSH
• echokardiografie MeSH
• elektrokardiografie ambulantní MeSH
• funkce levé komory srdeční fyziologie   MeSH
• hodnocení rizik metody   MeSH
• komorová tachykardie epidemiologie   etiologie   patofyziologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• následné studie MeSH
• retrospektivní studie MeSH
• rizikové faktory MeSH
• senioři MeSH
• srdeční komory diagnostické zobrazování   patofyziologie   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• Research Support, N.I.H., Extramural MeSH
• Geografické názvy
• Minnesota MeSH

Kardiovaskulárne choroby sú najčastejšou príčinou morbidity a mortality vo vyspelom svete. Ich patofyziologickým podkladom je ateroskleróza – ticho progredujúca deštrukcia cievnej steny so začiatkom už v detskom veku. Na jej počiatku stojí endotelová dysfunkcia. Spája negatívne pôsobenie kardiovaskulárnych rizikových faktorov na úrovni cievnej steny a predchádza jej manifestnému morfologickému poškodeniu. Aterosklerotický proces je v tejto fáze ešte reverzibilný, dá sa jednoducho diagnostikovať a terapeuticky ovplyvniť. V centre súčasného úsilia o zníženie kardiovaskulárnej morbidity a mortality preto stojí cievny endotel a možnosti neinvazívnej diagnostiky endotelovej dysfunkcie v rizikových skupinách mladej populácie. Jedným z perspektívnych nástrojov je ultrazvukové hodnotenie od endotelu závislej vazodilatácie – flow-mediated dilation (FMD).

Cardiovascular diseases are the leading cause of morbidity and mortality in developed world. Their principal underlying mechanism is atherosclerosis which starts in the population at risk already in childhood. Endothelial dysfunction is the first manifestation of the adverse influence that various cardiovascular risk factors have on vessel wall. As the beginning of atherosclerosis, it is reversible. Hence the current effort to minimize the overall population morbidity and mortality is based on detection of endothelial dysfunction in the young with increased cardiovascular risk. Flow-mediated dila - tion assessed non-invasively by ultrasound appears as a very promising tool in detection of early changes in vascular wall function.

• MeSH
• ateroskleróza diagnóza   komplikace   prevence a kontrola   MeSH
• cévní endotel abnormality   ultrasonografie   MeSH
• dilatace patologická diagnóza   komplikace   ultrasonografie   MeSH
• dítě MeSH
• financování organizované MeSH
• lidé MeSH
• morbidita MeSH
• mortalita MeSH
• rizikové faktory MeSH
• ultrasonografie metody   využití   MeSH
• Check Tag
• dítě MeSH
• lidé MeSH