• Klíčová slova
• tyreoidální orbitopatie,
• MeSH
• Gravesova nemoc * prevence a kontrola   terapie   MeSH
• Gravesova oftalmopatie farmakoterapie   chirurgie   terapie   MeSH
• hormony kůry nadledvin * aplikace a dávkování   škodlivé účinky   terapeutické užití   MeSH
• lidé MeSH
• radioizotopy jodu * aplikace a dávkování   škodlivé účinky   terapeutické užití   MeSH
• receptory thyreotropinu antagonisté a inhibitory   účinky léků   MeSH
• retrospektivní studie MeSH
• statistika jako téma MeSH
• thyreostatika škodlivé účinky   terapeutické užití   MeSH
• tyreoidektomie metody   využití   MeSH
• tyreotoxikóza etiologie   farmakoterapie   chirurgie   MeSH
• Check Tag
• lidé MeSH

• Publikační typ
• abstrakt z konference MeSH

The aim of the study is to perform a randomized study determining the effect of extracorporal elimination of immunoglobulins and immune complexes haemorheopheresis on the course of TAO in patients with very severe form of disease.

Cílem výzkumu je zjistit randomizovanou studií efekt extrakorporální eliminace imunoglobulinů a imunitních komplexů pomocí hemoreoferézy na průběh thyreoidální orbitopatie u nemocných s velmi těžkou formou onemocnění.

• MeSH
• Gravesova oftalmopatie terapie   MeSH
• hypertyreóza patofyziologie   MeSH
• plazmaferéza metody   využití   MeSH
• separace krevních složek metody   MeSH

• Konspekt
• Patologie. Klinická medicína
• NLK Obory
• endokrinologie
• oftalmologie
• NLK Publikační typ
• závěrečné zprávy o řešení grantu IGA MZ ČR

• Publikační typ
• abstrakty MeSH

The aim of this study was to perform a randomized study to evaluate the role of plasma filtration in the treatment of severe thyroid-associated ophthalmopathy (TAO). 20 patients were enrolled, and all patients were treated with methylprednisolone IV pulses. 10 randomly chosen patients were also subjected to plasma filtration (twice weekly in Weeks 1, 2, 4, 7, and 10). The procedure proved to be safe. All immunoglobulin classes as well as autoantibodies directed against thyroglobulin, thyroid peroxidase, and TSH receptor exhibited statistically significantly decreases. Some markers of cell-mediated immunity such as soluble antigen CD30 and monocyte chemotactic protein 1 decreased, but serum levels of other markers such as CD40 ligand and soluble protein Fas/Apo-1 did not change significantly. The decrease of immunoglobulins was long lasting, whereas cytokine levels returned to basal values before the next apheresis. Although the clinical activity score (CAS) dropped in all patients, it occurred more rapidly in patients treated with plasma filtration. The CAS difference between the two groups was statistically significant (p = 0.027). The amplitude of visual evoked potentials improved after 3 months in the plasma filtration group. At the end of the study, there was no difference between patients treated with aphereses and the control group. Eye muscle width and proptosis measured by CT scan did not differ between the two groups. We conclude that apheresis can decrease disease activity more rapidly than standard high-dose IV glucocorticoid therapy. Whether this superior treatment effect could potentially avoid surgical procedures remains to be determined.

• MeSH
• autoprotilátky krev   MeSH
• dospělí MeSH
• exoftalmus MeSH
• Gravesova oftalmopatie * terapie   MeSH
• hemofiltrace * metody   MeSH
• imunoglobuliny krev   MeSH
• lidé středního věku MeSH
• lidé MeSH
• methylprednisolon terapeutické užití   MeSH
• separace krevních složek MeSH
• výsledek terapie MeSH
• zrakové evokované potenciály MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• práce podpořená grantem MeSH
• randomizované kontrolované studie MeSH

• Publikační typ
• abstrakty MeSH

CONTEXT: Fine-needle aspiration cytology (FNAC) is the gold standard for evaluating thyroid nodules. It has a sensitivity rate of about 95%, i.e. false negative results represent up to 5% of cases. The value of repeated FNAC during follow-up is still controversial. OBJECTIVE: To evaluate the usefulness of repeating the FNAC for initially benign nodules. DESIGN AND METHODS: All 5017 patients who underwent FNAC of the thyroid nodule in years 1991-2008 were retrospectively evaluated. RESULTS: Repeated FNAC was performed in 574 nodules with initially benign results. The number of repetitions varied from one to six. Repeatedly benign results were found in 498 cases, and malignant/suspicious results with initially benign cytology were found in 76 nodules (13.2%). Carcinoma was present in 13 out of the 58 surgically treated malignant/suspicious results of initially benign cytology. CONCLUSIONS: A change from a benign FNAC result to a malignant/suspicious one was present in more than 13% of the patients with initially benign cytology; malignancy has been recognised on the basis of repeated FNAC in 2.3% patients. In the majority of cases, the repetition corrected wrong cytological interpretation of results other than colloidal goitre, especially Hashimoto's thyroiditis and regressive changes. We believe that repeating FNAC in patients with benign cytology in about a 1-year horizon can reduce the rate of undiagnosed tumours.

• MeSH
• dospělí MeSH
• falešně negativní reakce MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• reoperace MeSH
• retrospektivní studie MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• tenkojehlová biopsie metody   MeSH
• uzly štítné žlázy diagnóza   patologie   ultrasonografie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• práce podpořená grantem MeSH

INTRODUCTION: Hemaphereses are sophisticated procedures performed for many indications even in severely ill patients. Many authors consider quite necessary to register as many details as possible of treatments with therapeutic apheresis. WAA meets the requirement to compare data with centers not performing apheresis for the same diagnosis. In Czech Republic hemaphereses are used in a broad spectrum of indications. Since the year 2004 data on hemaphereses done in Czech Republic have been registered. In this paper we present a survey of our to date recordings. PATIENTS AND METHODS: Data of performed therapeutic hemaphereses (plasma exchange, erythrocytapheresis, leukapheresis, thrombocytapheresis, photopheresis, immunopheresis, and rheopheresis) have been entered in WAA registry with many details. We have been evaluated 1289 procedures in 216 patients done in our two centers (center I, center II). RESULTS: Center I registered 129 procedures in 41 patients, center II 1260 procedures in 175 patients. The patients are divided according to centers specialization (center II has registered 12 long-term treated patients with LDL-apheresis; mean time of therapy 7.1 years and a median of 34 procedures/patient. Side-effects registered in center I and center II were 3.1% and 5.6% of the procedures, respectively. Most frequent side-effects were citrate toxicity, neurovegetative lability, problems with venous access and hypotension. All were easy to treat, no serious events or death occurred. CONCLUSIONS: In Czech Republic hemaphereses are performed in a broad scale of indications and now it is nearly 5 years that data are registered in our two university centers. In 2004 we entered WAA registry because it meets the requirement to compare data with centers that do not perform aphereses for the same diagnosis. This comparison would certainly improve efficacy of the hemapheresis therapy even further. To enter WAA registry is easy, at no expense and without any problems.

• MeSH
• dospělí MeSH
• fotoferéza MeSH
• hypercholesterolemie terapie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• plazmaferéza metody   statistika a číselné údaje   škodlivé účinky   MeSH
• registrace statistika a číselné údaje   MeSH
• separace krevních složek metody   statistika a číselné údaje   škodlivé účinky   MeSH
• transfuze erytrocytů MeSH
• transfuze leukocytů MeSH
• transfuze trombocytů MeSH
• trombocytaferéza MeSH
• výměna plazmy statistika a číselné údaje   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• multicentrická studie MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika MeSH

• MeSH
• financování organizované MeSH
• Publikační typ
• abstrakty MeSH

• MeSH
• adsorpce MeSH
• chemická precipitace MeSH
• diabetická noha terapie   MeSH
• filtrace metody   přístrojové vybavení   využití   MeSH
• financování organizované MeSH
• heparin terapeutické užití   MeSH
• hluchota terapie   MeSH
• imunologické techniky využití   MeSH
• klinické laboratorní techniky metody   trendy   využití   MeSH
• lidé MeSH
• lipoproteiny MeSH
• makulární degenerace terapie   MeSH
• mikrocirkulace fyziologie   patologie   MeSH
• nemoci endokrinního systému terapie   MeSH
• reologie krve účinky záření   trendy   MeSH
• sírany terapeutické užití   MeSH
• viskozita krve fyziologie   MeSH
• Check Tag
• lidé MeSH