Bolesti hlavy spojené s onemocněním COVID-19 jsou novinkou posledních čtyř let. Postcovidová bolest hlavy se může se projevit migrenózním charakterem bolesti nebo tenzní cephaleou. Bolest hlavy může přetrvávat až 60 dní a zejména z tohoto důvodu je zapotřebí věnovat diagnostice a léčbě postcovidové bolesti hlavy pozornost. Z patofyziologického hlediska je přetrvávající aktivace imunitního systému a trigeminovaskulární aktivace. Prevence by měla být zvážena pro přetrvávající bolesti hlavy a indikace analgetik má být zvolena podle fenotypu postcovidové bolesti hlavy. Léčba postcovidové bolesti hlavy do značné míry řídí stávajícími pokyny pro primární bolesti hlavy s odpovídajícím fenotypem.
Headaches associated with COVID-19 have been a new development for the past four years. Post-covid headache may present with a migrainous character of pain or tension cephalea. The headache may persist for up to 60 days and, particularly for this reason, attention should be paid to the diagnosis and treatment of post-covid headache. Pathophysiologically, there is persistent immune system activation and trigeminovascular activation. Prevention should be considered for persistent headache and the indication of analgesics should be chosen according to the phenotype of postcovid headache. Treatment of post-covid headache largely follows existing guidelines for primary headache with an appropriate phenotype.
- MeSH
- Amitriptyline therapeutic use MeSH
- Headache * epidemiology drug therapy physiopathology MeSH
- Central Nervous System Agents therapeutic use MeSH
- Humans MeSH
- Analgesics, Non-Narcotic therapeutic use MeSH
- Post-Acute COVID-19 Syndrome * drug therapy physiopathology pathology MeSH
- Check Tag
- Humans MeSH
- Publication type
- Case Reports MeSH
- Research Support, Non-U.S. Gov't MeSH
- Review MeSH
- Keywords
- fremanezumab,
- MeSH
- Amitriptyline administration & dosage MeSH
- Biological Therapy MeSH
- Adult MeSH
- Antibodies, Monoclonal, Humanized * administration & dosage immunology MeSH
- Middle Aged MeSH
- Humans MeSH
- Migraine Disorders * drug therapy prevention & control MeSH
- Treatment Failure MeSH
- Topiramate administration & dosage MeSH
- Treatment Outcome MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Case Reports MeSH
- Geographicals
- Czech Republic MeSH
- Keywords
- histaminová intolerance,
- MeSH
- Amitriptyline therapeutic use MeSH
- Depression etiology drug therapy MeSH
- Diet Therapy methods MeSH
- Diagnosis, Differential MeSH
- Adult MeSH
- Exanthema etiology therapy MeSH
- Histamine * metabolism poisoning adverse effects MeSH
- Amine Oxidase (Copper-Containing) * deficiency MeSH
- Attention Deficit Disorder with Hyperactivity MeSH
- Marijuana Smoking MeSH
- Humans MeSH
- Food Intolerance diagnosis etiology therapy MeSH
- Somatoform Disorders diagnosis MeSH
- Sulpiride therapeutic use MeSH
- Irritable Bowel Syndrome diagnosis complications therapy MeSH
- Tryptases blood MeSH
- Treatment Outcome MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Male MeSH
- Publication type
- Case Reports MeSH
- Research Support, Non-U.S. Gov't MeSH
- MeSH
- Amitriptyline therapeutic use MeSH
- Buprenorphine administration & dosage therapeutic use MeSH
- Gabapentin administration & dosage adverse effects therapeutic use MeSH
- Carboplatin administration & dosage adverse effects therapeutic use MeSH
- Carcinosarcoma diagnosis therapy MeSH
- Middle Aged MeSH
- Humans MeSH
- Lynch Syndrome II diagnosis complications MeSH
- Uterine Neoplasms surgery therapy MeSH
- Neuralgia * chemically induced drug therapy MeSH
- Drug-Related Side Effects and Adverse Reactions drug therapy MeSH
- Analgesics, Opioid * pharmacology therapeutic use MeSH
- Paclitaxel administration & dosage adverse effects therapeutic use MeSH
- Polyneuropathies chemically induced drug therapy MeSH
- Antineoplastic Agents adverse effects MeSH
- Tapentadol administration & dosage therapeutic use MeSH
- Transdermal Patch MeSH
- Treatment Outcome MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Female MeSH
- Publication type
- Case Reports MeSH
Diabetická polyneuropatia je najčastejšou komplikáciou diabetu a súčasne najčastejšou príčinou syndrómu diabetickej nohy a bolesti pacientov s diabetes mellitus. V klinickej praxi ide stále o nedostatočne, resp. neskoro diagnostikované ochorenie, pričom práve terapeutický zásah v skorých štádiách ochorenia môže spomaliť (prípadne až zastaviť) progresiu polyneuropatie. Práca poskytuje súhrn aktuálnych možností prevencie a liečby diabetickej polyneuropatie a podáva prehľad o liekoch a nutraceutických produktoch, ktoré boli alebo sú v klinickom skúšaní.
Diabetic polyneuropathy is the most frequent complication of diabetes mellitus and at the same time the most common cause of diabetic foot syndrome and pain in patients with diabetes. This disorder is still being diagnosed insufficiently and too late in many cases. Therapeutic intervention in early stages could slow down (or completely stop) progression of the neuropathy. Presented paper reviews current possibilities of prevention and therapy of diabetic polyneuropathy as well as pharmaceuticals and nutraceuticals that were, or still are involved in clinical trials.
- MeSH
- Acetylcarnitine therapeutic use MeSH
- Amitriptyline administration & dosage therapeutic use MeSH
- Diabetic Neuropathies * therapy MeSH
- Duloxetine Hydrochloride administration & dosage therapeutic use MeSH
- Gabapentin administration & dosage therapeutic use MeSH
- Thioctic Acid administration & dosage therapeutic use MeSH
- Humans MeSH
- Neuralgia therapy MeSH
- Polyneuropathies etiology therapy MeSH
- Pregabalin administration & dosage therapeutic use MeSH
- Tapentadol administration & dosage therapeutic use MeSH
- Thiamine administration & dosage therapeutic use MeSH
- Tramadol administration & dosage therapeutic use MeSH
- Vitamin B Complex therapeutic use MeSH
- Check Tag
- Humans MeSH
- Publication type
- Review MeSH
Neuromodulační techniky patří mezi výběrové metody léčby chronické bolesti. Z hlediska jejich medicínské indikace se řadí svou finanční náročností i operačním přístupem mezi nejnáročnější algeziologické techniky z ekonomického i odborného hlediska. Mezi neuromodulace patří invazivní i neinvazivní přístupy. Popisujeme základní neuromodulační invazivní metody - neurostimulace a lékové aplikace pomocí pumpových systémů, jejich léčebné indikace, základní způsoby použití i diagnózy, u kterých se nejčastěji tyto metody používají.
Neuromodulatory approaches are among the selective methods of chronic pain management. In terms of their medical indication, its financial demands and operational approach, it ranks among the most challenging algesiological techniques from the economic and professional point of view. Neuromodulation includes both invasive and non-invasive methods. We describe the basic invasive methods - neurostimulation and intrathecally drug therapy using pump systems, their indications, basic uses and diagnoses in which these methods are most commonly used.
- MeSH
- Amitriptyline therapeutic use MeSH
- Central Nervous System pathology MeSH
- Stroke * complications MeSH
- Duloxetine Hydrochloride therapeutic use MeSH
- Humans MeSH
- Central Nervous System Diseases etiology physiopathology MeSH
- Neuralgia * etiology drug therapy physiopathology MeSH
- Check Tag
- Humans MeSH
U nemocných po cévní mozkové příhodě může vzniknout bolestivý syndrom, tzv. post-stroke pain. U značného procenta osob se časně po iktu objeví bolest hlavy, většinou tenzního typu s přechodem do chronicity. Centrální poiktová bolest (Central Post-Stroke Pain, CPSP) se vyskytuje u 7-10 % nemocných po CMP. Objevuje se za 1-3 měsíce po prodělaném iktu, u většiny osob se objeví po 6 měsících. V patofyziologii CPSP hraje roli nadměrná aktivita sympatického nervového systému, senzitizace dráhy bolesti, zvýšená zánětlivá odpověď a lokální hypoxie nervové tkáně. Léze se týká dráhy bolesti zejména v talamu, kdy malý podnět na periferních receptorech bolesti vyvolá výrazný bolestivý vjem. Zodpovědné jsou i další struktury centrálního nervového systému (postižení spinotalamické dráhy v jejím centrálním průběhu, trigeminotalamické dráhy nebo lemniscus medialis). Účinným lékem na centrální poiktovou bolest je amitriptylin, karbamazepin, gabapentin, pregabalin, lamotrigin, levetiracetam nebo duloxetin. V akutní fázi po CMP je důležité zahájit rehabilitaci s časnou mobilizací a aerobním cvičením, což vede k významnému snížení bolesti.
Post-stroke pain may occur in post-stroke patients. A significant percentage of people develop headaches early after stroke, mostly of the tension type with tendency to chronicity. Central post-stroke pain (CPSP) occurs in 7-10% of patients after stroke. CPSP usually appears in 1-3 months after stroke; in most people 6 months later. The most important role in pathophysiology of CPSP play overactivity of the sympathetic nervous system, sensitization of the pain pathway, increased inflammatory response and local nerve tissue hypoxia, respectively. The lesion relates to the pain pathway, particularly in the thalamus, where a slight stimulus of the peripheral pain receptors produces a pronounced painful sensation. Other structures of the central nervous system (involvement of the spinothalamic pathway in its central part, trigeminothalamic pathway or lemniscus medialis) are also responsible for CSPS. Amitriptyline (75 mg daily), carbamazepine (800 mg daily), gabapentin, pregabalin, lamotrigine, levetiracetam or duloxetine are effective oral pharmacotherapy for CSPS. In the acute phase after stroke, it is important to start rehabilitation with early mobilization and aerobic exercise, leading to a significant reduction in pain. The most frequent interventions are: epidural administradion of steroids, intradiscal intervention, radiofrequency procedures.
- MeSH
- Amitriptyline therapeutic use MeSH
- Central Nervous System pathology MeSH
- Stroke * complications MeSH
- Duloxetine Hydrochloride therapeutic use MeSH
- Humans MeSH
- Central Nervous System Diseases etiology physiopathology MeSH
- Neuralgia * etiology drug therapy physiopathology MeSH
- Check Tag
- Humans MeSH
Now-a-days, the occurrence of antidepressant residues in surface waters has become a major concern. Amitriptyline (AMI) has been described to treat depression and other disorders for decades. However, little is known about its effect on non-target organisms. The aim of this study was to assess the potential impact of AMI on the mRNA expression of antioxidant and detoxification enzymes during the early embryonic development of zebrafish (Danio rerio). Fertilized D. rerio embryos were exposed to AMI at concentrations of 300 ng/L and 30 μg/L and sampled 24, 48, 96, and 144 h post fertilization (hpf) to assess the mRNA expressions of cytochrome P450 1A1, glutathione-S-transferase, glutathione peroxidase, superoxide dismutase, and catalase. The time courses of the mRNA expressions of antioxidant and detoxification enzymes revealed characteristic changes during embryonic development causing generally transient changes post hatching; however, AMI did not cause any significant impact except in the case of CAT after 144 h, which was significantly upregulated by the AMI concentration of 30 μg/L. The results suggest that the antidepressant AMI causes only moderate to minor impacts on antioxidant and detoxification enzymes during early embryonic development of the non-target organism D. rerio and that CAT is the only biomarker affected by AMI.
- MeSH
- Amitriptyline pharmacology therapeutic use MeSH
- Antidepressive Agents, Tricyclic pharmacology therapeutic use MeSH
- Antioxidants metabolism MeSH
- Zebrafish MeSH
- Embryo, Nonmammalian drug effects metabolism MeSH
- Embryonic Development drug effects MeSH
- RNA, Messenger metabolism MeSH
- Oxidative Stress drug effects MeSH
- Animals MeSH
- Check Tag
- Animals MeSH
- Publication type
- Journal Article MeSH
Děti s bolestí hlavy jsou velmi častými pacienty v ambulancích dětských lékařů. Primární bolesti hlavy přes svůj benigní charakter výrazně negativně ovlivňují kvalitu života těchto dětí. Dětský věk je specifický nejen průběhem jednotlivých atak, ale zejména i možnostmi léčby. Článek seznamuje s aktuálními možnostmi klasifikace primárních bolestí hlavy a možnostmi akutní a profylaktické terapie a odlišnostmi od terapie a diagnostiky používané u dospělých pacientů.
Children with headache are very frequent patients of general pediatricians. Primary headaches despite benign nature are condition with significant negative impact on the quality of life of the affected children. Childhood migraine not only has a typical clinical course that matches a typical range of nosological units, but also requires specific treatment. This article reviews the current possibilities of classification and acute and profylactic treatment options of primary headaches and differences between child and adult treatment and diagnostics.
- MeSH
- Amitriptyline administration & dosage adverse effects therapeutic use MeSH
- Anti-Inflammatory Agents, Non-Steroidal administration & dosage adverse effects MeSH
- Anticonvulsants administration & dosage adverse effects therapeutic use MeSH
- Adrenergic beta-Antagonists adverse effects therapeutic use MeSH
- Headache MeSH
- Cyproheptadine administration & dosage therapeutic use MeSH
- Child MeSH
- Humans MeSH
- Pain Management MeSH
- Metoclopramide administration & dosage therapeutic use MeSH
- Migraine Disorders drug therapy MeSH
- Adolescent MeSH
- Pizotyline administration & dosage adverse effects therapeutic use MeSH
- Headache Disorders, Primary * diagnosis drug therapy MeSH
- Sumatriptan administration & dosage adverse effects therapeutic use MeSH
- Tension-Type Headache MeSH
- Check Tag
- Child MeSH
- Humans MeSH
- Adolescent MeSH
- Publication type
- Review MeSH
Bolest je jedním z nejčastějších a zároveň nejzávažnějších symptomů nádorového onemocnění. Dle dostupných dat trpí bolestí asi 60 % pacientů, kteří podstupují onkologickou léčbu, u pacientů s pokročilým onemocněním se vyskytuje v 70 %, v terminálním stadiu až v 90 %. Nedostatečně kontrolovaná bolest má negativní dopad na celkový komfort pacienta, ovlivňuje jeho denní aktivity a zhoršuje kvalitu života. Léčba bolesti je často součástí komplexní terapie celého souboru symptomů nádorového onemocnění a měla by být vedena tak, abychom dosáhli optimální kontroly bolesti, při zachování maximální možné aktivity pacienta a minimálních či snesitelných nežádoucích účinků takovéto léčby. Zcela zásadní postavení v léčbě nádorové bolesti má farmakoterapie, která vychází ze známého třístupňového žebříčku Světové zdravotnické organizace (World Health Organization, WHO). K dispozici máme celou řadu neopioidních analgetik, slabé a silné opioidy, v různých aplikačních formách. Analgetickou medikaci je v určitých případech žádoucí doplnit o koanalgetika, především ze skupiny antidepresiv a antikonvulziv.
Pain is one of the most frequent and most serious symptoms of advanced malignancies. We know, that pain is reported by 60 % of patients undergoing oncology treatment, about 70 % with advanced cancer and up to 90 % terminally ill patients. Uncontrolled pain can have a negative impact on the whole comfort and daily activities of the patient and can lead to deterioration of quality of his/her life. Treatment of the pain is just one part of the complex therapy of the whole set of cancer symptoms. The main aim of the pain treatment is to reach optimal control of the pain, to keep the highest level of the patient's activity and to minimize the side effects of such treatment. The crucial position in the cancer pain management has pharmacotherapy which is based on the WHO three step algorithm. We have a lot of pharmacology treatment options available, such as nonopioid analgesics, weak, and strong opioid medication, in several application forms. It is useful to add coanalgesics such as antidepressants or anticonvulsants in some cases.
- MeSH
- Amitriptyline administration & dosage pharmacology MeSH
- Anti-Inflammatory Agents, Non-Steroidal administration & dosage pharmacology MeSH
- Diphosphonates administration & dosage pharmacology MeSH
- Denosumab administration & dosage pharmacology MeSH
- Gabapentin administration & dosage pharmacology MeSH
- Glucocorticoids administration & dosage pharmacology MeSH
- Cannabinoids administration & dosage pharmacology MeSH
- Humans MeSH
- Pain Measurement MeSH
- Cancer Pain * drug therapy classification physiopathology MeSH
- Bone Neoplasms drug therapy secondary MeSH
- Analgesics, Non-Narcotic administration & dosage pharmacology MeSH
- Neuralgia etiology drug therapy MeSH
- Drug-Related Side Effects and Adverse Reactions epidemiology etiology MeSH
- Analgesics, Opioid administration & dosage pharmacology adverse effects MeSH
- Pregabalin administration & dosage pharmacology MeSH
- Breakthrough Pain drug therapy MeSH
- Drug Administration Routes MeSH
- Check Tag
- Humans MeSH
- Publication type
- Review MeSH
