Cíl studie: Zhodnotit, zda nemocní po srdeční zástavě léčení MH s nízkým srdečním indexem (CI) příznivě reagují na volumexpanzi. Posoudit, zda respirační variabilita maximální rychlosti průtoku krve aortální chlopní (?Vmaxao) a respirační variabilita integrálu rychlosti proudění krve aortální chlopní (?VTIao) predikují reaktivitu na volumexpanzi (klinicky relevantní nárůst CI o > 15 %). Typ studie: Prospektivní observační studie. Název a místo pracoviště: Územní středisko Záchranné služby, Interní klinika VFN Praha. Materiál a metoda: Vyšetřili jsme celkem deset konsekutivních pacientů po srdeční zástavě léčených MH s CI < 2,5 l . min-1. m-2. Po ekvilibrizaci tělesné teploty v rozmezí 32–34 °C byly transtorakální echokardiografií stanoveny CI, ?Vmaxao a ??VTIao. Po rychlé volumexpanzi fyziologickým roztokem v dávce 8 ml . kg-1 byla měření opakována. Výsledky: U 8 pacientů došlo k nárůstu CI (z 1,86 ± 0,36 na 2,69 ± 0,53 l . min-1 . m-2, p = 0,003, respondéři), u dvou ne (non-respondéři). U respondérů byly hodnoty ?Vmaxao (25,6 ± 4,8 vs 4,2 ± 3,4 %, p < 0,001) a ?VTIao (35,6 ± 4,3 vs 4,1 ± 0,8 %, p < 0,001) před volumexpanzí výrazně vyšší než u non-respondérů. Po volumexpanzi došlo u respondérů k jejich poklesu (?Vmaxao: na 6,9 ± 3,6 %, ?VTIao: na 7,0 ± 3,5 %, p < 0,001), u non- -respondérů se nezměnily. Absolutní hodnoty ?Vmaxao (r = 0,588, p = 0,003) a ?VTIao (r = 0,552, p = 0,003) před volumexpanzí korelovaly s nárůstem CI po volumexpanzi. Závěr: Většina nemocných po srdeční zástavě léčených MH a s nízkým CI v našem souboru příznivě reagovala na volumexpanzi. Vysoké hodnoty ?Vmaxao a ??VTIao predikovaly reaktivitu na volumexpanzi, nízké hodnoty areaktivitu na volumexpanzi.
Objective: To assess whether cardiac arrest survivors treated by MH with low cardiac index (CI) respond to volumexpansion.To assess whether respiratory variability of maximal aortic valve blood flow (?Vmaxao) and velocity time integral of aortic valve blood flow (?VTIao) predict fluid responsiveness (increase of CI of >15%). Design: Prospective observational study. Setting: Emergency Medical Service, Cardiovascular Medicine Department, University Hospital. Material and Method:We investigated 10 consecutive cardiac arrest survivors treated by MH, with CI of < 2.5 l/min/m2. CI, ?Vmaxao and ??VTIao were measured by transthoracic echocardiography after stabilization of body temperature in the range of 32–34 °C. This was followed by rapid administration of normal saline (8 ml/kg) and the second measurement. Results: Volumexpansion was followed by CI increase in 8 patients (from 1.86 ± 0.36 to 2.69 ± 0.53 l/min/m2, p = 0,003, responders) while in 2 subjects was not (non-responders). The values of ?Vmaxao (25.6 ± 4.8 vs. 4.2 ± 3.4 %, p < 0.001) and ?VTIao (35.6 ± 4.3 vs. 4.1 ± 0.8%, p < 0,001) before volumexpansion were higher in responders than in non-responders. In responders, it decreased after volumexpansion (?Vmaxao: to 6.9 ± 3.6%, ?VTIao: to 7.0 ± 3.5%, p < 0,001) while in non-responders not. The baseline values of ?Vmaxao (r = 0.588, p = 0.003) and ?VTIao (r = 0.552, p = 0.003) correlated with further increase of CI. Conclusion: Majority of MH treated cardiac arrest survivors with low CI in our set responded to volumexpansion. High values of ?Vmaxao and ??VTIao predicted fluid responsiveness, low values fluid unresponsiveness.
- MeSH
- Echocardiography methods instrumentation utilization MeSH
- Data Interpretation, Statistical MeSH
- Isotonic Solutions administration & dosage therapeutic use MeSH
- Blood Volume physiology drug effects MeSH
- Humans MeSH
- Prospective Studies MeSH
- Sensitivity and Specificity MeSH
- Heart Arrest therapy MeSH
- Statistics as Topic methods MeSH
- Hypothermia, Induced methods utilization MeSH
- Check Tag
- Humans MeSH
Retinoids are newly detected compounds in aquatic ecosystems associated with cyanobacterial water blooms. Their potential health risks are only scarcely described despite numerous detections of all-trans retinoic acid (ATRA) and its derivatives in the environment. Besides the known teratogen ATRA there is only little or no information about their potency and namely their effects in vivo. We characterize ATRA and 8 other retinoids reported to occur in the environment for their bioactivity and teratogenicity using four in vitro reporter gene assays and zebrafish (Danio rerio) embryotoxicity assay. Our results document the ability of these compounds to interfere with retinoid signalling and cause teratogenicity at environmentally relevant levels with EC50 values at nM (hundreds of ng/L) levels and teratogenic indexes ranging from 2.8 (9cis retinoic acid) to 15.8 (retinal). The relative potency of individual compounds for teratogenicity ranged from 0.059 (retinal) to 0.96 (5,6-epoxy ATRA) when compared to ATRA. An environmentally relevant mixture of retinoids was tested showing good predictability of teratogenicity from the in vitro activities and additive toxicity of the mixture. The high teratogenicity of the newly described compounds associated with cyanobacteria presents a concern for developmental stages due to high conservation of the retinoid signalling across vertebrates.
This study suggests an approach for the comparison and evaluation of particular compartments with modest experimental setup costs. A glucose level prediction model was used to evaluate the compartment's glucose transport rate across the blood capillary membrane and the glucose utilization rate by the cells. The glucose levels of the blood, subcutaneous tissue, skeletal muscle tissue, and visceral fat were obtained in experiments conducted on hereditary hypertriglyceridemic rats. After the blood glucose level had undergone a rapid change, the experimenter attempted to reach a steady blood glucose level by manually correcting the glucose infusion rate and maintaining a constant insulin infusion rate. The interstitial fluid glucose levels of subcutaneous tissue, skeletal muscle tissue, and visceral fat were evaluated to determine the reaction delay compared with the change in the blood glucose level, the interstitial fluid glucose level predictability, the blood capillary permeability, the effect of the concentration gradient, and the glucose utilization rate. Based on these data, the glucose transport rate across the capillary membrane and the utilization rate in a particular tissue were determined. The rates obtained were successfully verified against positron emission tomography experiments. The subcutaneous tissue exhibits the lowest and the most predictable glucose utilization rate, whereas the skeletal muscle tissue has the greatest glucose utilization rate. In contrast, the visceral fat is the least predictable and has the shortest reaction delay compared with the change in the blood glucose level. The reaction delays obtained for the subcutaneous tissue and skeletal muscle tissue were found to be approximately equal using a metric based on the time required to reach half of the increase in the interstitial fluid glucose level.
- MeSH
- Glucose analysis metabolism MeSH
- Hypertriglyceridemia MeSH
- Capillary Permeability physiology MeSH
- Muscle, Skeletal metabolism MeSH
- Blood Glucose analysis metabolism MeSH
- Rats MeSH
- Intra-Abdominal Fat metabolism MeSH
- Subcutaneous Fat metabolism MeSH
- Models, Statistical MeSH
- Animals MeSH
- Check Tag
- Rats MeSH
- Male MeSH
- Animals MeSH
- Publication type
- Journal Article MeSH
We compared selected thermal indices in their ability to predict heat-related mortality in Prague, Czech Republic, during the extraordinary summer 2015. Relatively, novel thermal indices-Universal Thermal Climate Index and Excess Heat Factor (EHF)-were compared with more traditional ones (apparent temperature, simplified wet-bulb globe temperature (WBGT), and physiologically equivalent temperature). The relationships between thermal indices and all-cause relative mortality deviations from the baseline (excess mortality) were estimated by generalized additive models for the extended summer season (May-September) during 1994-2014. The resulting models were applied to predict excess mortality in 2015 based on observed meteorology, and the mortality estimates by different indices were compared. Although all predictors showed a clear association between thermal conditions and excess mortality, we found important variability in their performance. The EHF formula performed best in estimating the intensity of heat waves and magnitude of heat-impacts on excess mortality on the most extreme days. Afternoon WBGT, on the other hand, was most precise in the selection of heat-alert days during the extended summer season, mainly due to a relatively small number of "false alerts" compared to other predictors. Since the main purpose of heat warning systems is identification of days with an increased risk of heat-related death rather than prediction of exact magnitude of the excess mortality, WBGT seemed to be a slightly favorable predictor for such a system.
- MeSH
- Humans MeSH
- Heat Stress Disorders mortality MeSH
- Seasons MeSH
- Models, Theoretical * MeSH
- Cities MeSH
- Wind MeSH
- Humidity MeSH
- Hot Temperature adverse effects MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Comparative Study MeSH
- Geographicals
- Czech Republic MeSH
- Cities MeSH
Tick-borne encephalitis is a serious arboviral infection with unstable dynamics and profound inter-annual fluctuations in case numbers. A dependable predictive model has been sought since the discovery of the disease. The present study demonstrates that four superimposed cycles, approximately 2·4, 3, 5·4, and 10·4 years long, can account for three-fifths of the variation in the disease fluctuations over central Europe. Using harmonic regression, these cycles can be projected into the future, yielding forecasts of sufficient accuracy for up to 4 years ahead. For the years 2016-2018, this model predicts elevated incidence levels in most parts of the region.
- MeSH
- Incidence MeSH
- Encephalitis, Tick-Borne epidemiology virology MeSH
- Humans MeSH
- Periodicity MeSH
- Models, Theoretical MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Geographicals
- Europe epidemiology MeSH
Pharmacological reviews, ISSN 0031-6997 vol. 36, no. 2, suppl., June 1984
182S s. : il., tab., grafy ; 28 cm
- MeSH
- Toxicity Tests MeSH
- Publication type
- Congress MeSH
- Conspectus
- Farmacie. Farmakologie
- NML Fields
- toxikologie
V článku je podána orientační informace o problematice prediktivní genetické medicíny s poukazem na povětšině zatím převažující komerční zájmy v této oblasti, nerespektování etických postojů a rozsáhlou legislativní problematiku a nedostatečnost ochrany soukromí osobnosti.
The paper outlines orientational information on the problem of predictive genetic medicine with reference to mostly so far prevailing commercial interests in this area, disregarding ethical attitudes and extensive legislative problems and insufficient protection of personal privacy.
