Radiologicky izolovaný syndrom je definován jako náhodně zjištěný obraz na magnetické rezonanci typický pro roztroušenou sklerózu u pacienta, který nemá žádné klinické příznaky pro toto onemocnění. Tento termín byl poprvé použit včetně definice kritérií v roce 2009. Cílem nových revidovaných kritérií radiologicky izolovaného syndromu z roku 2023 je zajistit přesnou a rychlejší diagnostiku, než umožňovala původní kritéria z roku 2009. Nová kritéria vyžadují alespoň jedno T2 hypersignální ložisko v jedné ze čtyř typických lokalizací pro roztroušenou sklerózu spolu se dvěma z následujících tří znaků: míšní léze, oligoklonální pásy omezené na mozkomíšní mok nebo nové T2 hypersignální ložisko nebo po podání kontrastní látky zvýrazňující se ložisko pozorované na následném vyšetření magnetickou rezonancí. V diagnostice radiologicky izolovaného syndromu se stanovují rizikové faktory pro konverzi do klinicky definitivní roztroušené sklerózy a hrozícího těžšího průběhu onemocnění. Jedná se o nižší věk pacienta, lokalizaci ložisek (infratentoriálně a intramedulárně) a přítomnost oligoklonálních pásů v mozkomíšním moku nepřítomných v séru. To je důležité pro zvážení léčebné intervence. Nedávné klinické studie ukázaly, že perorální léčba modifikující průběh onemocnění může u pacientů s radiologicky izolovaným syndromem oddálit první klinickou příhodu nebo jí zabránit. Tento posun diagnostiky a zvažování léčby již v preklinickém stadiu vytváří enormní tlak na precizní diagnostiku a management, aby tito náhodně vytypovaní pacienti byli směřováni do RS center, kde budou dále podrobně vyšetřeni. Revidovaná McDonaldova diagnostická kritéria pro roztroušenou sklerózu z roku 2024 budou klasifikovat osoby s pozitivními dalšími markery z mozkomíšního moku a pokročilými MR biomarkery jako osoby s preklinickou RS, což zdůrazňuje důležitost preciznosti v diagnostice a edukaci jak radiologů, tak neurologů, jakým způsobem postupovat, aby se pacient dostal včas do sledování v centrech vysoce specializované péče pro pacienty s roztroušenou sklerózou.
Radiologically isolated syndrome (RIS) is defined as an incidental finding on magnetic resonance imaging (MRI) that is typical of multiple sclerosis (MS) in a patient without clinical symptoms of the disease. This term, along with its definition criteria, was first introduced in 2009. The newly revised 2023 RIS criteria aim to provide a more accurate and faster diagnosis compared to the original 2009 criteria. These criteria require at least one T2-hyperintense lesion in one of the four typical locations for MS, along with two of the following three features: spinal cord lesions, oligoclonal bands confined to the cerebrospinal fluid (but absent in the serum), or a new T2-hyperintense lesion (or, after contrast administration, a prominent lesion visible on follow-up MRI scans). An MRI diagnosis of RIS establishes a risk factor for conversion to clinically definite MS and a more severe disease course. These risk factors include the patient’s age, the location of the lesions (infratentorial and intramedullary) and the presence of oligoclonal bands in the cerebrospinal fluid. These factors are critical when considering therapeutic interventions. Recent clinical trials have demonstrated that oral disease-modifying therapies can delay or prevent the first clinical event in patients with RIS. This shift in diagnosis and treatment considerations to preclinical stages places enormous pressure on ensuring precise diagnosis and management. It is essential that such patients are referred to MS centers for further specialized investigations. The forthcoming Revised McDonald Criteria of 2024 will classify individuals with additional cerebrospinal fluid markers and advanced MRI biomarkers as having preclinical MS. This highlights the importance of precise diagnosis and the need for radiologists and neurologists to familiarize themselves with the appropri- ate steps to ensure patients are monitored at highly specialized MS care centers.
Numerous studies have now documented that athletes of different competition levels vary in their motivational styles. Some are internally motivated and train to be better based on intrinsic values, whereas others are controlled by external pressures that drive performance. A third style does not make causal attributions regarding their performance and are amotivated. In the current study, we used latent profile analysis to examine unique typologies of sports motivation in 456 Czech university students comprised of both recreational and more elite athletes participating in various sports and attending a sport education program. Four qualitatively distinct profiles were distinguished varying in the composition of intrinsic, extrinsic, and amotivation. The four profiles differed in their mean levels of social physique anxiety, global self-esteem, and physical self-worth, three markers of how a person feels about themselves in terms of normative standards. Multiple group comparisons based on gender, individual versus team sports, and level of competition reinforced relative consistency in profile composition. Results are discussed in terms of how people can blend different motivational styles, what this portends for self-beliefs, and whether there is relative consistency across meaningful groups.
- MeSH
- Humans MeSH
- Young Adult MeSH
- Motivation * MeSH
- Body Image MeSH
- Cross-Sectional Studies MeSH
- Surveys and Questionnaires statistics & numerical data MeSH
- Self Concept MeSH
- Athletes * psychology statistics & numerical data MeSH
- Sports * psychology statistics & numerical data MeSH
- Students * psychology statistics & numerical data MeSH
- Universities statistics & numerical data MeSH
- Check Tag
- Humans MeSH
- Young Adult MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Geographicals
- Czech Republic MeSH
Pacientka náhle v domácím prostředí dušnost, kolaps a bezvědomí. Provedena laická telefonicky navigovaná kardiopulmonální resuscitace, po příjezdu lékaře rychlé záchranné služby úspěšná rozšířená kardiopulmonální resuscitace a poté pacientka převezena na oddělení urgentního příjmu Nemocnice České Budějovice. Byla provedena základní stabilizace klinického stavu, zajištění pacientky, intubace a odvoz na CT. Zde byla pomocí CT verifikována masivní bilaterální plicní embolie. Ihned v prostorách urgentního příjmu byla provedena trombolýza, stabilizace oběhu a pacientka byla uložena na ARO. Za hodinu na oddělení ARO znovu těžká oběhová nestabilita – vysoká podpora oběhu noradrenalinem. Provedeno UZ a následně CT břicha s nálezem masivního hemoperitonea. Urgentní chirurgické konzilium a doporučena operace z vitální indikace. Provedena urgentní laparotomie u hemodynamicky těžce nestabilní pacientky s TK 60/30 a pulzy 180/min. Za masivní oběhové podpory a převodů erymasy odsáty 4 l zcela nesrážlivé krve v oblasti jater. Játra byla tržena na několika místech od zlomených žeber a nejvíce dorzálně v levém laloku v oblasti jaterních žil. Chirurgicky při těžké oběhové nestabilitě neověřitelné a bylo rozhodnuto o stabilizaci pomocí perihepatického packingu a pacientka byl uložena na ARO RES. ARO pokračuje v konzervativní terapii a dochází k postupnému zmenšení odpadů do drénu. Provedena second-look operace za 48 hod – revize původní ranou, odstranění roušek. Nalezeny mnohočetné trhliny na pravém laloku od zlámaných žeber a dorzálně silně krvácející jaterní žíla. Provedena kombinace selektivních sutur s elektrokoagulací trhlin, pro přetrvávající oběhovou nestabilitu se znovu rozhodujeme dát pouze perihepatický packing. Pacientku znovu necháváme na ARO k oběhové stabilizaci a domlouváme se znovu na operační revizi po stabilizaci oběhu za 48 hod. Přistupujeme k další operační revizi. Provádíme znovu revize perihepatického prostoru a anatomickou resekci jaterního segmentu II a III a selektivní podvaz jaterní žíly. Následně dochází k hemodynamické stabilizaci oběhu. V rámci pooperačního průběhu nejprve dochází k rozvoji fluidothoraxu, který byl vyřešen hrudní drenáží, a akutní akalkulozní cholecystitidě, která byla vyřešena punkční cholecystostomií. Pacientka je nyní primárně zhojena a angiologiem nasazena trvalá antikoagulační terapie. Příčina plicní embolizace nebyla zjištěna.
The patient suddenly experienced shortness of breath, collapse, and loss of consciousness at home. Layperson-performed, telephone-guided cardiopulmonary resuscitation was initiated, and upon the arrival of the emergency medical team, successful extended CPR was performed, after which the patient was transported to the emergency department at Hospital of České Budějovice. Basic stabilization of the clinical condition was carried out, the patient was secured, intubated, and transported to the CT scanner. A massive bilateral pulmonary embolism was verified byCT. Thrombolysis was immediately performed in the emergency room, circulation was stabilized, and the patient was transferred to the ICU. An hour later, the patient experienced severe circulatory instability in the ICU, requiring high-dose norepinephrine support. Ultrasound was performed, followed by a CT scan of the abdomen, which revealed massive hemoperitoneum. An urgent surgical consultation was performed, and surgery was recommended on a vital indication. An urgent laparotomy was performed on a hemodynamically unstable patient with the blood pressure 60/30 and the pulse 180/min. Despite massive circulatory support and erythrocyte transfusion, 4 liters of noncoagulable blood were drained from the hepatic region. The liver was torn in several places due to fractured ribs, most severely in the left lobe at the hepatic veins. Due to severe circulatory instability, the injury was deemed inoperable, and it was decided to stabilize the condition with perihepatic packing, after which the patient was transferred to the ICU. The ICU continued conservative therapy, and there was a gradual reduction in the drainage output. A second-look operation was performed after 48 hours – revision of the original wound and removal of the drapes. Multiple fissures were found in the right lobe, caused by broken ribs, with heavy bleeding from the dorsal hepatic veins. A combination of selective suturing and electrocoagulation of the fissures was performed. Due to ongoing circulatory instability, the decision was made to use perihepatic packing once again. The patient was left in the ICU for further circulatory stabilization, with a plan to do another surgical revision after stabilization in 48 hours. Another surgical revision was performed, revisiting the perihepatic space and performing an anatomical resection of liver segments II and III, followed by selective ligation of the hepatic vein. Hemodynamic stabilization was achieved. Postoperatively, a fluidothorax developed, which was managed by thoracic drainage, and acute acalculous cholecystitis, which was treated with puncture cholecystostomy. The patient is now primarily healed and has been started on long-term anticoagulation therapy by the angiologist. The cause of the pulmonary embolism was not determined.
- Keywords
- damage control surgery,
- MeSH
- Hemoperitoneum * surgery diagnosis etiology MeSH
- Liver surgery diagnostic imaging injuries MeSH
- Laparotomy MeSH
- Humans MeSH
- Critical Care MeSH
- Pulmonary Embolism * diagnosis complications therapy MeSH
- Check Tag
- Humans MeSH
- Female MeSH
- Publication type
- Case Reports MeSH
This case report presents a unique study focused on relationship between nutritional parameters, C-reactive protein (CRP), and the marker of oxidative stress 8-hydroxy-2'-deoxyguanosine (8-OHdG), in 61-year-old male paraplegic patient with multiple pressure ulcers. A multidisciplinary approach was essential for the timing of the successful reconstruction process. The patient had a history of paraplegia since 1999 due to a skiing accident with fractures of thoracic vertebrae (Th6-Th9), requiring spinal surgery. His medical background includes acute pancreatitis with biliary tract revisions, partial pancreatic resection, acute respiratory failure with tracheostomy, renal failure treated with hemodialysis, bronchopneumonia, pseudomembranous colitis, and hyperuricemia. The patient also underwent multiple surgical interventions, including treatment for ulnar nerve paresis, cholecystectomy, and multiple pressure ulcer reconstructions. The study describes the relationship between selected biochemical parameters and overall clinical status in a paraplegic patient with three deep pressure ulcers located in the left-sided ischial, trochanteric, and sacral regions during their multistage surgical therapy. The reconstructive procedure and collection of biological samples for determination of selected biochemical parameters were performed according to the same schedule: debridement of pressure ulcers at the beginning of the particular hospitalization and on the day of surgical reconstruction. The patient's severe condition was accompanied by decreased levels of both 8-OHdG and selected nutritional parameters (albumin, prealbumin, and total protein) and increased CRP levels at the beginning of the treatment process. The evaluation of the dynamics of the measured parameters during the gradual improvement of the patient's condition and the multistage reconstruction of pressure ulcers in six hospitalizations over a period of 17 months was continued resulting in the healing of all pressure ulcers. This case highlights the crucial importance of investigating selected biochemical parameters, with emphasis on 8-OHdG, and nutritional parameters, for the timing of surgical strategy and comprehensive therapy in patients with multiple pressure ulcers and severe, complex medical histories.
- Publication type
- Journal Article MeSH
- Case Reports MeSH
Metabolický syndrom (MetS) představuje komplexní soubor různých metabolických poruch, které zahrnují abdominální obezitu, poruchu lipidů, zvýšený krevní tlak a zvýšenou glykemii nalačno a které ve vzájemné interakci představují významné rizikové faktory pro řadu onemocnění, včetně onemocnění močového traktu. Řada dokladů naznačuje, že MetS a jeho individuální komponenty predisponují nejen ke vzniku maligních onemocnění, jakými jsou karcinom ledvin, prostaty, ureteru či močového měchýře, ale také dalších onemocnění urologického charakteru, jakými jsou urolitiáza, benigní hypertrofie prostaty, mužský hypogonadismus či erektilní dysfunkce. Některé patofyziologické mechanismy či paradoxní nálezy nejsou v současnosti dostatečně objasněny a vyžadující další výzkum. Z klinického hlediska je důležitý poznatek, že pro úspěšnou prevenci a řešení řady urologických onemocnění může být často potřebná taková mezioborová spolupráce, která povede k léčbě a úpravě predisponujících rizikových metabolických faktorů vedoucích ke vzniku těchto onemocnění.
Metabolic syndrome (MetS) is a complex unit of various metabolic disorders, including abdominal obesity, dyslipidemia, elevated blood pressure and increased fasting glycemia, which act in mutual interplay as important risk factors for multiple diseases, including disorders of urinary tract. Increasing body of evidence suggest that MetS and its individual components predispose not only to the development of malignant tumors notably carcinoma of kidney, prostate, ureter or urinary bladder but also to the development of other urological diseases, such as urolithiasis, benign prostate hypertrophy, male hypogonadism or erectile dysfunction. Some patophysiological mechanisms or paradoxal findings are not currently sufficiently understood and require further research. From a clinical point of view it is important to respect the fact, that for successfull prevention and management of multiple urological disorders an increased interdisciplinary cooperation aimed to treat and decrease predisposing risk metabolic factors is required.
- MeSH
- Erectile Dysfunction etiology metabolism MeSH
- Hypogonadism etiology metabolism MeSH
- Kidney pathology MeSH
- Humans MeSH
- Metabolic Syndrome * complications MeSH
- Urinary Bladder Diseases etiology metabolism MeSH
- Ureteral Diseases etiology metabolism MeSH
- Prostatic Diseases etiology metabolism MeSH
- Risk Factors MeSH
- Urologic Diseases * etiology MeSH
- Check Tag
- Humans MeSH
High-salt diets (HSDs) are known to impact blood pressure and cardiovascular health, but their effects on glucose metabolism, liver function, and gut microbiota remain poorly understood. This study investigates how long-term HSD affects these physiological processes and evaluates the potential therapeutic effects of ACE inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs). Male Sprague-Dawley rats were fed a normal salt diet (0.3% NaCl), a moderate salt diet (2% NaCl), or a high-salt diet (8% NaCl) for 12 wk. Two subgroups in the HSD condition received telmisartan or enalapril. We assessed blood pressure, glucose homeostasis, liver inflammation, pancreatic function, and gut microbiota composition. HSD rats exhibited significantly higher blood pressure [130 ± 2 mmHg in normal diet (ND) vs. 144 ± 4 mmHg in HSD; P < 0.01], reduced fasting insulin (1.33 ± 0.14 ng/mL in ND vs. 0.60 ± 0.05 ng/mL in HSD; P < 0.01), and gut microbiota dysbiosis, with a 71% reduction in Ruminococcus species (P = 0.018). Liver inflammation, indicated by an increase in CD68+ macrophages, was also observed in the HSD group. Telmisartan treatment significantly reduced liver inflammation but did not fully restore metabolic homeostasis. HSD disrupts multiple physiological systems, including glucose metabolism and liver function, partly through gut microbiota alterations. ACEIs and ARBs provided partial protection, highlighting the need for multitargeted interventions to mitigate high-salt diet effects.NEW & NOTEWORTHY High-salt diet induces multisystem disruptions, including liver inflammation, reduced insulin levels, and gut microbiota imbalance. ACEIs and ARBs showed limited efficacy, highlighting the need for comprehensive therapeutic approaches.
- MeSH
- Angiotensin Receptor Antagonists * pharmacology MeSH
- Enalapril pharmacology MeSH
- Glucose * metabolism MeSH
- Angiotensin-Converting Enzyme Inhibitors * pharmacology MeSH
- Liver * drug effects metabolism MeSH
- Blood Glucose metabolism drug effects MeSH
- Blood Pressure drug effects MeSH
- Rats MeSH
- Sodium Chloride, Dietary * adverse effects MeSH
- Rats, Sprague-Dawley MeSH
- Gastrointestinal Microbiome * drug effects MeSH
- Telmisartan pharmacology MeSH
- Animals MeSH
- Check Tag
- Rats MeSH
- Male MeSH
- Animals MeSH
- Publication type
- Journal Article MeSH
Since cell dying in heart failure (HF) may vary based on the aetiology, we examined the main forms of regulated necrosis, such as necroptosis and pyroptosis, in the hearts damaged due to myocardial infarction (MI) or pressure overload. We also investigated the effects of a drug inhibiting RIP3, a proposed convergent point for both these necrosis-like cell death modes. In rat hearts, left ventricular function, remodelling, pro-cell death, and pro-inflammatory events were investigated, and the pharmacodynamic action of RIP3 inhibitor (GSK'872) was assessed. Regardless of the HF aetiology, the heart cells were dying due to necroptosis, albeit the upstream signals may be different. Pyroptosis was observed only in post-MI HF. The dysregulated miRNAs in post-MI hearts were accompanied by higher levels of a predicted target, HMGB1, its receptors (TLRs), as well as the exacerbation of inflammation likely originating from macrophages. The RIP3 inhibitor suppressed necroptosis, unlike pyroptosis, normalised the dysregulated miRNAs and tended to decrease collagen content and affect macrophage infiltration without affecting cardiac function or structure. The drug also mitigated the local heart inflammation and normalised the higher circulating HMGB1 in rats with post-MI HF. Elevated serum levels of HMGB1 were also detected in HF patients and positively correlated with C-reactive protein, highlighting pro-inflammatory axis. In conclusion, in MI-, but not pressure overload-induced HF, both necroptosis and pyroptosis operate and might underlie HF pathogenesis. The RIP3-targeting pharmacological intervention might protect the heart by preventing pro-death and pro-inflammatory mechanisms, however, additional strategies targeting multiple pro-death pathways may exhibit greater cardioprotection.
- MeSH
- Ventricular Function, Left drug effects MeSH
- Protein Kinase Inhibitors * pharmacology MeSH
- Myocytes, Cardiac * drug effects pathology enzymology MeSH
- Rats MeSH
- MicroRNAs metabolism genetics MeSH
- Disease Models, Animal MeSH
- Necroptosis * drug effects MeSH
- Necrosis MeSH
- Rats, Sprague-Dawley MeSH
- Pyroptosis * drug effects MeSH
- Ventricular Remodeling drug effects MeSH
- Receptor-Interacting Protein Serine-Threonine Kinases * antagonists & inhibitors metabolism MeSH
- Heart Failure * pathology enzymology physiopathology drug therapy etiology genetics MeSH
- Animals MeSH
- Check Tag
- Rats MeSH
- Male MeSH
- Animals MeSH
- Publication type
- Journal Article MeSH
Úvod: Mnohé štúdie a metaanalýzy preukázali, že telemonitorovanie krvného tlaku ako aj iných faktorov metabolického syndrómu môže zlepšiť ich manažment. Avšak mnoho pacientov nevyužíva telemonitorovanie kvôli osobným, technologickým a iným bariéram. Cieľom tejto štúdie bolo zistenie aké sú perspektívy a prekážky telemonitoringu lipitenzie na Slovensku z pohľadu pacienta. Metódy: Táto štúdia bola realizovaná ako dotazníková a mala za cieľ osloviť 2 545 pacientov. Dotazník pozostával z častí zameraných na osobné charakteristiky pacienta, návyky z hľadiska merania krvného tlaku (TK), na využívanie smart-technológií, ich predpokladané prínosy a prekážky z hľadiska pacienta ako aj na znalosť lipidového profilu a kardiovaskulárneho rizika samotným pacientom. Výsledky: Celkovo sme získali 252 odpovedí od pacientov (9,9 %). Z celkového počtu opýtaných má arteriálnu hypertenziu 67,4 %, kým nefarmakologickú terapiu užíva 7,9 %. Denne si TK meria len 21,2 % hypertonikov, signifikantne vyšší počet mužov ako žien (p = 0,011) a najčastejšie si meria TK veková kategória 31–45 rokov. Až 19,4 % využíva nositeľné zariadenia a 6,3 % tlakomery prepojené s aplikáciou. Signifikantne častejšie smart-technológie využíva kategória 31–45-ročných (p = 0,01). Závažné prekážky využitia smart-technológií neboli identifikované, väčšina si vyžadovala funkciu vzdialených konzultácií, úpravy liekov a jednoduché užívateľské rozhranie. Väčšina pacientov nevie svoju hodnotu LDL-cholesterolu a až 45,7 % tých čo vie, malo zvýšené hladiny. Záver: Celkovo prevláda záujem o využitie metód telemedicíny krvného tlaku, pri jej implementácii na Slovensku bude však nutná spolupráca pacienta a lekára.
Introduction: Numerous studies and meta-analyses have demonstrated that telemonitoring of blood pressure and other factors of metabolic syndrome can improve their management. However, many patients do not use telemonitoring due to personal, technological, and healthcare barriers. The aim of this study was to identify the perspectives and barriers to telemonitoring of lipid levels in Slovakia from the patient’s point of view. Methods: This study was conducted as a questionnaire-based survey targeting 2,545 patients. The questionnaire consisted of sections focused on patients’ personal characteristics, habits regarding blood pressure measurement, the use of smart technologies, their perceived benefits and barriers, as well as the patients’ knowledge of their lipid profile and cardiovascular risk. Results: A total of 252 responses were obtained (9.9 % response rate). Among the respondents, 67.4 % had hypertension, while 7.9 % were on non-pharmacological therapy. Only 21.2 % of hypertensive patients measured their blood pressure daily, with a significantly higher proportion of men compared to women (p = 0.011), and the most frequent blood pressure monitoring was observed in the 31–45 age group. A total of 19.4 % used wearable devices, and 6.3 % used blood pressure monitors connected to an app. Smart technology use was significantly more common in the 31–45 age group (p = 0.01). No severe barriers to the use of smart technologies were identified; most patients required features such as remote consultations, medication adjustments, and user-friendly interfaces. The majority of patients were unaware of their LDL-C values, and 45.7 % of those who were aware had elevated levels. Conclusion: There is a prevailing interest in implementing telemedicine methods for blood pressure monitoring. However, collaboration between patients and physicians will be necessary for its successful implementation in Slovakia.
- MeSH
- Digital Health MeSH
- Dyslipidemias prevention & control MeSH
- Hypertension * epidemiology prevention & control MeSH
- Humans MeSH
- Blood Pressure Determination methods MeSH
- Surveys and Questionnaires MeSH
- Heart Disease Risk Factors MeSH
- Statistics as Topic MeSH
- Telemedicine * methods MeSH
- Check Tag
- Humans MeSH
- Geographicals
- Slovakia MeSH
Pulse Wave Velocity (PWV) is widely used to assess arterial elasticity and is an independent risk factor for cardiovascular disease, but it is influenced by multiple factors. Objective is to assess the impact of blood pressure and heart rate on PWV. Twenty healthy young individuals were enlisted as subjects. Real-time blood pressure monitoring was performed by non-invasive continuous blood pressure measuring instrument during the detection of subjects' carotid PWV. During real-time blood pressure monitoring, exercise load caused fluctuations in blood pressure and heart rate, and PWV changes of each subject under different blood pressure and heart rate conditions were recorded simultaneously. Among the 20 subjects, PWV was associated with blood pressure in four subjects and heart rate in one subject. PWV increased with rising blood pressure when the systolic pressure fluctuation range was >=30mmHg, diastolic pressure fluctuation range was >=18mmHg, and mean arterial pressure fluctuation range was >=20mmHg. PWV increased with rising heart rate, when the heart rate fluctuation range was >30 beats/min. Blood pressure and heart rate have some influence on PWV. However, the fluctuation range of blood pressure and heart rate should reach a certain value, the impact is significant. Keywords: Pulse wave velocity, Blood pressure, Heart rate.
- MeSH
- Pulse Wave Analysis * methods MeSH
- Adult MeSH
- Blood Pressure * physiology MeSH
- Humans MeSH
- Blood Pressure Determination methods MeSH
- Young Adult MeSH
- Heart Rate * physiology MeSH
- Vascular Stiffness physiology MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Young Adult MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
Kontext: Endotelová dysfunkce (ED) je jedním z hlavních mechanismů rozvoje různých kardiovaskulárních onemocnění. Endotelová dysfunkce je spojena s obezitou a hypertenzí, což se odráží v nízkých hodnotách průtokem stimulované dilatace tepny (flow-mediated dilatation, FMD) a vysokých hodnotách endotelinu-1 (ET-1) u dospělých osob a starších. Méně se ví o hodnotách uvedených dvou parametrů u adolescentů. Cílem této studie bylo srovnat hodnoty FMD a ET-1 obézních adolescentů s hypertenzí, obézních adolescentů bez hypertenze a u adolescentů s normální tělesnou hmotností. Metoda: Celkem 72 indonéských adolescentů průměrného věku 195 (178–217) měsíců, převážně chlapců (61 %), bylo zařazeno do tří následujících skupin: obezita s hypertenzí (n = 21), obezita bez hypertenze (n = 19) a bez obezity a bez hypertenze (n = 32). Hodnota FMD se měřila na pažní tepně po vyvinutí zvýšeného systolického tlaku na předloktí po dobu pěti minut. Hodnoty ET-1 se měřily metodou ELISA v sendvičovém uspořádání. Výsledek: Medián hodnoty ET-1 byl 42 (2,4–384) pg/ml. Mezi skupinami však nebyly nalezeny žádné významné rozdíly v hodnotách ET-1 (p 0,269). I když byly hodnoty FMD podle deskriptivní analýzy vyšší u zdravých adolescentů, nebyly zjištěny žádné statisticky významné rozdíly (p 0,159) v hodnotách FMD ve skupinách obezita s hypertenzí (9,1 ± 5 %), obezita bez hypertenze (8,3 ± 3,1 %) a bez obezity a bez hypertenze (10,9 ± 6,2 %). Srovnání hodnot ET-1 mezi skupinami s ED a bez ED (mezní hodnota FMD 7,1 %) nevykázalo žádné rozdíly (p 0,77). Navíc hodnoty ET-1 nekorelovaly statisticky významně s hodnotami FMD (p 0,66, r –0.053). Závěr: U indonéských adolescentů s obezitou a hypertenzí, obezitou bez hypertenze a s normální tělesnou hmotností a bez hypertenze nebyly zjištěny žádné rozdíly v hodnotách ET-1 a FMD. Korelace mezi ET-1 a FMD není u adolescentů statisticky významná.
Background: Endothelial dysfunction (ED) is one of the major mechanisms in various cardiovascular dis- eases. ED is associated with obesity and hypertension, which is reflected by low flow-mediated dilatation (FMD) value and high endothelin-1 (ET-1) level in adults or older. However, their value in adolescents is less known. This study aims to compare the FMD and ET-1 between obesity with hypertension, obesity without hypertension, and normal adolescents. Method: A total of 72 Indonesian adolescents with a mean age of 195 (178-217) months and dominated by males (61%) were classified into the three following groups obesity with hypertension (n = 21), obesity with- out hypertension (n = 19), and normal (n = 32) adolescents. FMD was measured using the brachial artery by previously applied supra systolic pressure in the forearm in 5 minutes. ET-1 was measured by Sandwich ELISA. Results: The median ET-1 level was 42 (2.4-384) pg/mL. However, there are no significant differences in ET-1 levels between all groups (p 0.269). Although FMD values are descriptively higher in normal adolescents, however, there are no statistical differences (p 0.159) in FMD values between obese with hypertension (9.1 ± 5%), obese without hypertension (8.3 ± 3.1%), and normal (10.9 ± 6.2%) groups. Comparison of ET-1 levels between groups with ED and without ED (FMD cut-off 7.1%) showed no differences (p 0.77) among them. In addition, ET-1 was not significantly correlated with FMD (p 0.66, r -0.053). Conclusion: There are no differences in ET-1 and FMD values between obesity with hypertension, obesity without hypertension, and normal Indonesian adolescents. The correlation between ET-1 and FMD is not significant in adolescents.
- MeSH
- Brachial Artery pathology MeSH
- Dilatation, Pathologic etiology blood MeSH
- Endothelium physiopathology MeSH
- Endothelin-1 * blood MeSH
- Hypertension complications blood MeSH
- Humans MeSH
- Adolescent MeSH
- Pediatric Obesity * complications blood MeSH
- Statistics as Topic MeSH
- Check Tag
- Humans MeSH
- Adolescent MeSH
- Male MeSH
- Female MeSH
- Publication type
- Clinical Study MeSH
- Research Support, Non-U.S. Gov't MeSH