Acute kidney injury (AKI) is a consequence of several diseases that can severely damage kidney function. It is a frequent complication of hospitalization and very common in critically ill patients because of other serious illnesses, such as septic conditions. New diagnostic options, including renal biomarkers, may help in early diagnosis. Our study included 46 patients, 31 with AKI and 15 without AKI on admission. Blood samples were collected on the first, fourth, and seventh days of treatment, and in addition to basic biochemical parameters, neutrophil gelatinase-associated lipocalin (NGAL) levels in serum were also examined. Data from the first and seventh day were used for statistical analysis. On the first follow-up day, NGAL values were categorized according to an optimal cut-off value of 290 μg/l. We demonstrated that if NGAL levels were higher, the risk of renal injury increased approximately 16 times. Other results showed that NGAL levels were moderately correlated with serum creatinine (r = 0.613, p < 0.0001), procalcitonin (PCT) (r = 0.627, p < 0.0001), and AKI stage (r = 0.589, p < 0.0001). There was also a significant positive correlation with SOFA (Sequential Organ Failure Assessment) score (r = 0.395, p = 0.007). Early diagnosis and treatment are crucial in managing AKI and preventing further kidney damage. NGAL levels can increase within a few hours after injury, making it a useful tool for early AKI detection and diagnosis. Key words: Acute kidney injury, Biomarker, NGAL, Sepsis.
- MeSH
- akutní poškození ledvin * krev diagnóza MeSH
- biologické markery * krev MeSH
- dospělí MeSH
- kritický stav * MeSH
- lidé středního věku MeSH
- lidé MeSH
- lipokalin-2 * krev MeSH
- prediktivní hodnota testů MeSH
- senioři MeSH
- sepse * krev diagnóza MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
List of changes Authors and affiliation: Lubica CIBICKOVA1,3, Katerina LANGOVA2, Jan SCHOVANEK1,3, Dominika MACAKOVA1,3, Ondrej KRYSTYNIK1,3, David KARASEK1,3 1Department of Internal Medicine III - Nephrology, Rheumatology and Endocrinology, Faculty of Medicine and Dentistry, Palacky University, Olomouc, Czech Republic, 2Department of Medical Biophysics, Faculty of Medicine and Dentistry, Palacky University, Olomouc, Czech Republic, 3Department of Internal Medicine III - Nephrology, Rheumatology and Endocrinology, University Hospital Olomouc, Olomouc, Czech Republic Acknowledgement: Supported by the grants: MH CZ - DRO (FNOl, 00098892); AZV NV18-01-00139.
- Publikační typ
- časopisecké články MeSH
- Publikační typ
- abstrakt z konference MeSH
BACKGROUND: The aim of the study was to propose a classification of alveolar morphotype and assess a relationship between extraction/non-extraction orthodontic treatment and changes to the alveolar process. MATERIALS AND METHODS: Seventy-five subjects (mean age = 23.2, SD = 5.1) were selected. Areas of the sections of the alveolar process (ASAP) at three different levels (0, 2, and 4 mm) were measured on pre- and post-treatment three-dimensional digital models. Method reliability was analysed using Dahlberg's formula, intraclass correlation coefficient, and paired t-tests. RESULTS: The mean ASAP was smallest at level 0 and largest at level 4. Pre-treatment ASAP < 773 mm2, < 863.9 mm2, and < 881.1 mm2 at levels 0, 2, and 4 mm, respectively, should be described as a "thin" alveolar morphotype. Regression models showed that pre-treatment ASAP was a predictor of the change of the alveolus during treatment only at level 2. CONCLUSIONS: Patients for whom pre-treatment ASAP is < 773 mm2, < 863.9 mm2, and < 881.1 mm2 at levels 0, 2, and 4 mm, respectively, should be described as having a "thin" alveolar morphotype. In these patients, extraction treatment, associated with a decrease in the alveolus area, should be exercised with caution.
Purpose: Transcranial B-mode sonography (TCS) of brain parenchyma is increasingly used as a diagnostic tool for movement disorders. Accordingly, experimental B-Mode Assist software was developed to enable digitized analysis of the echogenicity of predefined brain regions. The aim of the study was to assess the reproducibility of digitized TCS image analysis of the insula. Materials and Methods: A total of 130 patients with an indication for neurosonological examination were screened for participation in the study. The insula was imaged from the right temporal bone window using Virtual Navigator and TCS-MRI (magnetic resonance imaging) fusion imaging. All subjects were examined three times by two experienced sonographers. Corresponding images of the insula in the axial thalamic plane were encoded and digitally analyzed. Interclass correlation coefficient (ICC) and Spearman's rank correlation coefficient were used for the assessment of intra- and inter-reader as well as intra- and inter-investigator reliabilities. Results: TCS images of 114 patients were evaluated (21 patients with TIA, 53 patients with headache, 18 patients with essential tremor, 22 patients with neurodegerative disease). 16 patients were excluded from analysis due to insufficient bone window. The intra-reader, inter-reader, intra-investigator and inter-investigator ICCs/Spearman's rank correlation coefficients were 0.995/0.993, 0.937/0.921, 0.969/0.961 and 0.875/0.858, resp. Conclusion: The present study demonstrates a high reliability to reproduce echogenicity values of the insula using digitized image analysis and TCS-MRI fusion images with almost perfect intra-reader, inter-reader, intra-investigator and inter-investigator agreement.
- MeSH
- bolesti hlavy diagnostické zobrazování MeSH
- esenciální tremor diagnostické zobrazování MeSH
- interpretace obrazu počítačem metody MeSH
- kontrastní látky * MeSH
- lidé MeSH
- magnetická rezonanční tomografie metody MeSH
- mozková kůra diagnostické zobrazování MeSH
- multimodální zobrazování metody MeSH
- neurodegenerativní nemoci diagnostické zobrazování MeSH
- novorozenec MeSH
- odchylka pozorovatele MeSH
- reprodukovatelnost výsledků MeSH
- statistika jako téma MeSH
- těhotenství MeSH
- thalamus diagnostické zobrazování MeSH
- tranzitorní ischemická ataka diagnostické zobrazování MeSH
- ultrasonografie dopplerovská transkraniální metody MeSH
- uživatelské rozhraní počítače MeSH
- vylepšení obrazu metody MeSH
- Check Tag
- lidé MeSH
- novorozenec MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
UNLABELLED: Chronic kidney disease-mineral and bone disorder (CKD-MBD) ranks among clinically and pathogenetically significant complications in patients with CKD. Numerous factors are involved in its development, and histomorphometric analysis of the bone tissue is still necessary for accurate diagnosis. METHODS: The open, pilot, prospective study aimed at performing a comprehensive histomorphometric bone analysis in 26 dialysis patients and assessing the relationships of different types of CKD-MBD to selected parameters of calcium and phosphate metabolism, densitometry, activity of parathyroid glands, presence of diabetes mellitus, and duration of dialysis treatment. RESULTS: Comparison of the histomorphometric characteristics demonstrated statistically significant correlations between the volume of bone trabeculae and s-procollagen 1 (.754) as well as s-calcitonin (.856). Similarly, there was a positive correlation between the size of tetracycline lines and volume of bone trabeculae (.705) and a strong negative correlation with the thickness of trabeculae (-.442). When assessing the serum levels of s-osteoprotegerin and serum RANKL, there was a correlation with osteoid thickness and bone trabeculae thickness. In case of s-osteoprotegerin, a statistical power was demonstrated in relation to osteoid thickness (.880); in case of s-RANKL, a statistical power was demonstrated in relation to the thickness of trabeculae (.830). When assessing the influence of dialysis duration, relationships to the volume of trabecular bone (.665) and volume of bone trabeculae (.949) were demonstrated. Finally, a relationship between s-1,25-hydroxyvitamin D and s-osteoprotegerin was observed (.739); also the relationships demonstrated were significantly lower volume of bone trabeculae in men (p = 0.067) and lower values of s-osteocalcin and s-procollagen 1 in diabetic patients (p = 0.014). CONCLUSION: The results provide new noninvasive possibilities of CKD-MBD detection that are based on selected serum parameters of bone metabolism. Presented are possibilities of noninvasive assessment of different types of CKD-MBD using serum osteomarkers in relation to comprehensive CKD-MBD histomorphometry.
- MeSH
- biologické markery metabolismus MeSH
- chronická renální insuficience * diagnóza metabolismus terapie MeSH
- dialýza ledvin metody MeSH
- kalcitriol metabolismus MeSH
- kardiovaskulární nemoci epidemiologie MeSH
- kosti a kostní tkáň patologie MeSH
- kostní denzita * MeSH
- ledviny metabolismus MeSH
- lidé MeSH
- ligand RANK krev MeSH
- minerálová a kostní nemoc při chronickém onemocnění ledvin * krev diagnóza MeSH
- osteokalcin krev MeSH
- osteoprotegerin krev MeSH
- parathormon metabolismus MeSH
- pilotní projekty MeSH
- prospektivní studie MeSH
- reprodukovatelnost výsledků MeSH
- rizikové faktory MeSH
- senioři MeSH
- vápník metabolismus MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Česká republika MeSH
BACKGROUND AND PURPOSE: Increased echogenicity of the substantia nigra is a typical transcranial sonography finding in Parkinson disease. Experimental software for digital analysis of the echogenic substantia nigra area has been developed. The aim of this study was to compare the evaluation of substantia nigra echogenicity by using digital analysis with a manual measurement in patients with Parkinson disease and healthy volunteers. MATERIALS AND METHODS: One hundred thirteen healthy volunteers were enrolled in the derivation cohort, and 50 healthy volunteers and 30 patients with Parkinson disease, in the validation cohort. The substantia nigra was imaged from the right and left temporal bone window by using transcranial sonography. All subjects were examined twice by using different sonographic machines by an experienced sonographer. DICOM images of the substantia nigra were encoded; then, digital analysis and manual measurement of the substantia nigra were performed. The 90th percentile of the derivation cohort values was used as a cut-point for the evaluation of the hyperechogenic substantia nigra in the validation cohort. The Spearman coefficient was used for assessment of the correlation between both measurements. The Cohen κ coefficient was used for the assessment of the correlation between both measurements and Parkinson disease diagnosis. RESULTS: The Spearman coefficient between measurements by using different machines was 0.686 for digital analysis and 0.721 for manual measurement (P < .0001). Hyperechogenic substantia nigra was detected in the same 26 (86.7%) patients with Parkinson disease by using both measurements. Cohen κ coefficients for digital analysis and manual measurement were 0.787 and 0.762, respectively (P < .0001). CONCLUSIONS: The present study showed comparable results when measuring the substantia nigra features conventionally and by using the developed software.
- MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mozkový kmen ultrasonografie MeSH
- Parkinsonova nemoc ultrasonografie MeSH
- počítačové zpracování obrazu * MeSH
- senioři MeSH
- spánková kost ultrasonografie MeSH
- substantia nigra ultrasonografie MeSH
- ultrasonografie dopplerovská transkraniální * MeSH
- zdraví dobrovolníci pro lékařské studie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
BACKGROUND AND PURPOSE: Sonolysis is a new therapeutic procedure for arterial recanalization. The aim of this study was to confirm the safety and efficacy of endovascular sonolysis by using the EkoSonic Endovascular System in subjects with acute ischemic stroke. MATERIALS AND METHODS: Patients with acute ischemic stroke with occlusion of the middle cerebral artery or basilar artery were enrolled consecutively in this prospective study. The control group (44 MCA and 12 BA occlusions) was selected from historical controls. EkoSonic Endovascular System was started within 8 hours after stroke onset. The NIHSS score at hospital admission, after 24 hours, and at 7 days; arterial recanalization; early neurologic improvement; symptomatic intracerebral hemorrhage; and favorable 3-month clinical outcome defined as a modified Rankin Scale score of 0-2 were evaluated by statistical means. RESULTS: Fourteen patients (10 men; mean age, 65.1 ± 11.2 years; median NIHSS score, 16.5) underwent EkoSonic endovascular sonolysis. Arterial recanalization after endovascular treatment was achieved in 6 of 7 (85.7%) patients with MCA occlusion (4 complete recanalizations) and in all 7 (100%) patients with BA occlusion (6 complete recanalizations). No (0%) symptomatic intracerebral hemorrhage or periprocedural complications occurred. Seven (50%) patients were independent at 3 months (median mRS score, 2). Early neurologic improvement and favorable clinical outcome were significantly more frequent in patients with MCA occlusion undergoing EkoSonic endovascular sonolysis than in controls (100% and 71.4% versus 4.6% and 13.6% of patients; P = .0001 and P = .003, respectively). Three-month mortality was significantly lower in patients with BA occlusion undergoing EkoSonic endovascular sonolysis than in controls (0% versus 66.7% patients, P = .013). CONCLUSIONS: In this small study, EkoSonic endovascular sonolysis allowed safe and potentially effective revascularization in patients experiencing acute ischemic stroke.
- MeSH
- angioplastika metody MeSH
- bezpečnost MeSH
- časové faktory MeSH
- cévní mozková příhoda terapie MeSH
- endovaskulární výkony metody MeSH
- fibrinolytika terapeutické užití MeSH
- infarkt arteria cerebri media terapie MeSH
- ischemie mozku terapie MeSH
- lidé středního věku MeSH
- lidé MeSH
- mechanická trombolýza přístrojové vybavení metody MeSH
- míra přežití MeSH
- následné studie MeSH
- neurologické vyšetření MeSH
- obnova funkce fyziologie MeSH
- prospektivní studie MeSH
- recidiva MeSH
- revaskularizace mozku přístrojové vybavení metody MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- stenty MeSH
- studie případů a kontrol MeSH
- vertebrobazilární insuficience terapie MeSH
- vibrace ultrazvukové přístrojové vybavení metody MeSH
- výsledek terapie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- srovnávací studie MeSH
AIM: We sought to compare clinical outcomes, in-hospital mortality and 1-year survival of two different treatment modalities of deep sternal wound infection, topical negative pressure and the closed irrigation therapy. METHODS: Retrospective analysis of 66 consecutive patients treated for deep sternal infection at our institution. A total of 28 patients (February 2002 through September 2004) underwent primarily closed irrigation therapy, and 34 patients (November 2004 through December 2007) had the application of topical negative pressure. Four patients (July 2004 through December 2004) who underwent a combination of both strategies were excluded from the study. Clinical and wound care outcomes were compared, focusing on therapeutic failure rate, in-hospital stay and the 1-year mortality of both treatment strategies. RESULTS: Topical negative pressure was associated with a significantly lower failure rate of the primary therapy (P<0.05), shortening of the intensive care unit stay (P<0.001), a particular decrease in the in-hospital stay (P<0.05) and the 1-year mortality (P<0.05) in comparison with closed irrigation therapy. Comparable overall length of the therapy, in-hospital stay and the risk of wire-related fistulas after chest reconstruction were found. CONCLUSION: Topical negative pressure is a superior method of treatment for deep sternal wound infection, which is based on lower therapeutic failure rate, significant decrease in-hospital stay, and the decrease of the 1-year mortality rate, compared with primarily applied closed irrigation.
- MeSH
- časové faktory MeSH
- debridement metody MeSH
- délka pobytu trendy MeSH
- hojení ran MeSH
- infekce chirurgické rány terapie MeSH
- kardiochirurgické výkony škodlivé účinky metody MeSH
- léčebná irigace metody MeSH
- lidé MeSH
- mortalita v nemocnicích trendy MeSH
- následné studie MeSH
- retrospektivní studie MeSH
- rizikové faktory MeSH
- senioři MeSH
- sternotomie škodlivé účinky MeSH
- sternum MeSH
- terapie ran pomocí řízeného podtlaku metody MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- srovnávací studie MeSH
- Geografické názvy
- Švédsko MeSH
