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
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.
- MeSH
- Myocardial Ischemia diagnosis epidemiology MeSH
- Middle Aged MeSH
- Risk Factors MeSH
- Check Tag
- Middle Aged MeSH
- Male MeSH
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
