Short sleep duration and poor sleep quality are common in the general population. This study tested if a 2-week course of daily transcutaneous vagal nerve stimulation (tVNS) improves sleep in community-dwelling adults. Participants were n = 68 men and women aged 18-75 years randomised into four groups: early and sham tVNS and late and sham tVNS. Early groups underwent daily 4 h stimulation between Day 0 and 13, while late groups underwent daily 4 h stimulation between Day 14 and 28. tVNS was performed with transcutaneous electrical nerve stimulation (TENS) on the left tragus, and sham tVNS (control conditions) was applied on the left earlobe. Sleep was measured with the Pittsburgh Sleep Quality Index. Analysis of prespecified contrasts (C), based on linear mixed modelling, revealed that for tVNS there were significant improvements in global sleep scores over time between Day 0 and Day 13 in the early stimulation phase (C = -1.90; 95% CI = -2.87 to -0.94), and between Day 14 and Day 28 in the late phase (C = -0.87; 95% CI = -1.41 to -0.32). No such differences were found under sham tVNS (applied early or late). However, global sleep scores showed no significant improvement under tVNS when compared against control groups during both the early (χ2 = 0.83, p = 0.36), or late stimulation phase (χ2 = 0.24, p = 0.63). We showed that two weeks of tVNS improves global sleep scores, but the change in sleep was not significantly different to control groups. Further studies are warranted to test the utility of tVNS in alleviating sleep complains in community-dwelling adults.
- MeSH
- dospělí MeSH
- lidé MeSH
- nervus vagus fyziologie MeSH
- samostatný způsob života MeSH
- spánek MeSH
- transkutánní elektrická neurostimulace * MeSH
- vagová stimulace * MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- randomizované kontrolované studie MeSH
<b>Aim:</b> The aim was to compare hearing loss between men and women over 65 in pure tone audiometry and to evaluate the sensitivity of the abbreviated version of the Hearing Handicap Inventory (HHIE-S). This questionnaire highlights hearing handicaps in understanding speech. </br></br><b> Materials and Methods:</b> The data was collected in the years 2011-2015 from respondents above 18 years of age using a standar-dized HHIE-S questionnaire and specialized tests. The cohort was divided into groups based on the severity of hearing loss in the better ear according to the World Health Organization (WHO) as measured by tone threshold audiometry at 500 Hertz (Hz), 1000 Hz, 2000 Hz and 4000 Hz. </br></br> <b> Results:</b> Of the 7070 people (61.8% female and 38.2% male), 68.93% had hearing impairment. Most people had a slight he-aring loss. Based on HHIE-S, 56.94% reported impaired hearing. A statistically significant difference was found between the genders, but according to HHIE-S, females with impaired hearing were not statistically significantly more numerous than males. The diagnostic sensitivity of the HHIE-S was assessed in particular by its sensitivity (75.43%) and specificity (82.53%). The probability that a person has a hearing impairment when the HHIE-S test is positive is 90.21%. </br></br> <b> Conclusions:</b> The HHIE-S is fast, inexpensive and short, and can be included as a screening test for hearing impairment in ca-ring for the elderly. Even a minor hearing impairment can be a significant handicap in elderly patients by restricting not only social interactions but also weakening mental functioning.
- MeSH
- audiometrie čistými tóny MeSH
- hluchota * MeSH
- lidé MeSH
- nedoslýchavost * diagnóza MeSH
- plošný screening MeSH
- průzkumy a dotazníky MeSH
- senioři MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
AIMS: The study aims were to verify the serum (S) and synovial fluid (SF) reference intervals (RIs) for human neutrophil defensins (HNP1-3); measure S and SF defensin concentrations in different types of SF, including non-inflammatory, inflammatory non-pyogenic, inflammatory pyogenic, and hemorrhagic; and to compare the HNP1-3 concentrations in SF and S with those of other inflammatory biomarkers. METHODS: SF and S samples were collected from 92 patients. HNP1-3 concentrations were determined using enzyme-linked immunosorbent assays; glucose, lactate, interleukin-6, and procalcitonin using an automatic analyzer; and presepsin using a Pathfast system. There were 61 non-inflammatory, 11 inflammatory non-pyogenic, 11 inflammatory pyogenic, and 9 hemorrhagic SF. Non-inflammatory SF was divided into non-inflammatory normal and non-inflammatory osteoarthritis. The former was used to estimate the HNP1-3 RI in SF and S. RESULTS: The estimated HNP1-3 RIs of SF and S were 12.47-437.42 mg/L and 5.45-44.75 μg/L, respectively. HNP1-3 differed significantly between S and SF and individual groups of SF (P<0.001 and P=0.001, respectively). There were significant relationships between SF HNP1-3 and S HNP1-3 (P<0.001), S C-reactive protein (P<0.001), and S interleukin-6 (P=0.007), and between SF HNP1-3 and SF C-reactive protein (P=0.004) and SF interleukin-6 (P<0.001). The highest kappa coefficient was between SF HNP1-3 and SF interleukin-6 (κ=0.507). CONCLUSIONS: We validated the SF HNP1-3 diagnostic kit and demonstrated that SF and S HNP1-3 are promising biomarkers for distinguishing inflammatory from non-inflammatory joint diseases.
- MeSH
- alfa-defensiny * MeSH
- antigeny CD14 MeSH
- biologické markery MeSH
- C-reaktivní protein MeSH
- ELISA * MeSH
- interleukin-6 MeSH
- lidé MeSH
- peptidové fragmenty MeSH
- synoviální tekutina MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
OBJECTIVE: Cadmium exposure is a common problem in the production of nickel-cadmium batteries. However, keeping the respective legislative occupational and safety policies is essential, but there are problems with compliance. We analysed the effect of strategies to increase compliance with precautions during 20132015 on 59 workers at a nickel-cadmium battery factory. MATERIAL AND METHODS: A health promotion program was implemented in two phases. The first phase included comprehensive education on the importance of appropriate behaviour and changes to the sanitation program. The second phase included renovation of sanitary facilities and modernization of the air exhaust ventilation. RESULTS: The initial median cadmium urinary level in workers was 1.9 µg/g creatinine. After the first phase of interventions, levels dropped to 1.0 µg/g creatinine. After the second phase no significant further decrease was observed. CONCLUSION: Comprehensive education and changes in the sanitation program were able to halve cadmium levels and can be considered a useful and cost-effective preventive tool.
- MeSH
- dospělí MeSH
- hygiena práce * MeSH
- kadmium moč MeSH
- lidé MeSH
- nikl MeSH
- otrava kadmiem prevence a kontrola moč MeSH
- podpora zdraví metody MeSH
- pracoviště MeSH
- pracovní expozice prevence a kontrola MeSH
- výrobní a průmyslová zařízení MeSH
- zdroje elektrické energie * MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
BACKGROUND: Ankle brachial index (ABI) is the principal screening method for peripheral arterial disease (PAD). In this study, we compare various types of Doppler-derived and oscillometric ABIs with results obtained through duplex ultrasonography. METHODS: 62 patients were enrolled in the study. For each limb, blood pressures for both ankle arteries and the arm were measured using Doppler and an automated oscillometric device. Duplex ultrasound was performed for all limbs and occlusions >50% were considered PAD-positive. ABI was calculated using both higher (HABP) and lower (LABP) arterial blood pressure on the individual limbs and the ability to predict duplex-detected stenoses was evaluated. RESULTS: LABP calculation provided results superior to the guideline-recommended HABP. Considering patients with ABI >1.4 or measurement failure as PAD-positive further enhanced the test parameters. The higher ABI cut-off of 1.0 resulted in somewhat better sensitivities (max 92%) and negative predictive values (max 87%) at the expense of a substantial increase in the number of false positives. Oscillometric method yielded poor sensitivities but very good specificities (max 94%) and positive predictive values (max 90%). CONCLUSIONS: Doppler-based LABP provides better results than the guideline-recommended HABP in diabetic patients, nevertheless even this method is not perfect. Increasing the cut-off value to 1.0 in these patients does not bring a substantial improvement of the test performance. Patients with high ABI should be automatically considered PAD-positive and referred for further investigation using imaging techniques.
- MeSH
- arteriální okluzní nemoci diagnóza patofyziologie MeSH
- diabetické angiopatie diagnóza patofyziologie MeSH
- krevní tlak fyziologie MeSH
- lidé MeSH
- onemocnění periferních arterií diagnóza patofyziologie MeSH
- senioři MeSH
- senzitivita a specificita MeSH
- tlakový index kotník-paže metody MeSH
- ultrasonografie dopplerovská metody MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- srovnávací studie MeSH
OBJECTIVES: In diabetic patients, there is a discrepancy in guidelines for ankle-brachial index (ABI) screening for peripheral arterial disease (PAD). While diabetes organizations suggest the value of upper limit of normal ABI to be 1.3, cardiologists recommend 1.4. Also, guidelines recommend using the higher value of ankle pres-sure (HAP) but multiple recent studies propose the opposite (LAP). METHODS: In this prospective study, we performed ABI measurements in 62 diabetic patients. Results were calculated by comparing higher and lower values of ankle pressure to those of duplex ultrasound (stenosis ≥ 50 % was considered PAD). Special attention was paid to patients with high and non-measurable ABI.RESULTS: LAP ABI appears to be a preferable method for PAD screening in diabetics. The upper cut-off value of 1.4 yielded better results with sensitivity of 93 % and negative predictive value of 91 %. No limbs with ABI between 1.3 and 1.4 with signifi cant stenosis were found. However, using HAP for the upper cut-off captured additional PAD patients. PAD was abundant among patients with high or non-measurable ABI.CONCLUSIONS: LAP should be used for assessing low ABI (cut-off 0.9) while HAP for detecting the abnormally high ABI. The preferable high ABI cut-off is 1.4. Condition with abnormally high or non-measurable ABI should be considered as PAD (Tab. 3, Ref. 22). Text in PDF www.elis.sk.KEY WORDS: ankle-brachial index, diabetes, peripheral arterial disease, lower extremity arterial disease, cut-off.
Out-of-hospital cardiac arrest (OHCA) is a leading cause of death in developed industrial countries. The global worldwide average of OHCA incidence in adults is 95.9/100,000/year. European incidences vary according to source from 16 to 119/100,000/year. The aim of this study was to provide an overview of current information on OHCA. The incidences in various populations are discussed, along with the factors affecting the prognosis and outcome of these patients. The etiology and pathophysiological mechanisms are also described, especially in relation to the most common causes - acute and chronic forms of coronary artery disease and cardiomyopathies. Measures that could improve survival rates are discussed, with emphasis on the role of the general public and deployment of automatic external defibrillators.
- MeSH
- defibrilátory MeSH
- incidence MeSH
- lidé MeSH
- míra přežití MeSH
- prognóza MeSH
- zástava srdce mimo nemocnici epidemiologie etiologie patofyziologie terapie MeSH
- zdravotní výchova MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
BACKGROUND AND AIMS: Delirium is an acute brain dysfunction and a frequent complication in critically ill patients. When present it significantly worsens the prognosis of patients. The aim of this study was to evaluate the incidence of delirium and risk factors for delirium in a mixed group of trauma, medical and surgical ICU patients. METHODS: A prospective observational study was conducted in one of the six-bed Intensive Care Units of the University Hospital Ostrava in the Czech Republic during a 12-month period. We evaluated the incidence of delirium and its predisposing and precipitating risk factors. All patients were assessed daily using the Confusion Assessment Method for the ICU (CAM-ICU). RESULTS AND CONCLUSIONS: Of the total of 332 patients with a median APACHE II (the Acute Physiology and Chronic Health Evaluation) score of 12, who were evaluated for delirium, 48 could not be assessed using CAM-ICU (47 due to prolonged coma, 1 due to language barriers). The incidence of delirium was 26.1%, with trauma and medical patients being more likely to develop delirium than surgical patients. Risk of delirium was significantly associated with age ≥ 65 years, and alcohol abuse in their anamnesis, with APACHE II score on admission, and with the use of sedatives and/or vasopressors. Delirious patients who remained in the ICU for a prolonged period showed a greater need for ventilator support and had a greater ICU-mortality.
- MeSH
- APACHE MeSH
- delirium epidemiologie etiologie ošetřování MeSH
- incidence MeSH
- jednotky intenzivní péče statistika a číselné údaje MeSH
- kritický stav terapie MeSH
- lidé středního věku MeSH
- lidé MeSH
- prospektivní studie MeSH
- rizikové faktory MeSH
- senioři MeSH
- umělé dýchání škodlivé účinky statistika a číselné údaje MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- pozorovací studie MeSH
- Geografické názvy
- Česká republika MeSH
Východiska: Karcinom pankreatu je závažnou a rychle progredující diagnózou. Méně je známo o úloze výživy v etiologii karcinomu pankreatu. Studie se zaměřila na roli vybraných výživových zvyklostí u karcinomu pankreatu. Materiál a metody: Studie případů a kontrol probíhala v České republice ve třech centrech (Olomouc, Ostrava, České Budějovice) v letech 2006–2009. Soubor tvořilo celkem 530 osob (310 případů karcinomu pankreatu a 220 kontrolních osob). Údaje byly získávány od subjektů přímo formou rozhovoru se školeným tazatelem a zaznamenány do standardizovaného dotazníku. Data byla vyhodnocena pomocí hrubého odds ratio (OR) a multivariabilní logistické regrese na 95% CI. Statistická analýza byla provedena za použití softwaru STATA v. 10. Výsledky: Velmi silný protektivní efekt byl nalezen u nakládaného zelí (OR 0,32; 95% CI 0,19–0,55), brokolice (OR 0,37; 95% CI 0,25–0,53), vařené cibule (OR 0,14; 95% CI 0,08–0,27), rajčat (OR 0,28; 95% CI 0,13–0,60), syrové mrkve (OR 0,33; 95% CI 0,20–0,56), vařené mrkve (OR 0,35; 95% CI 0,19–0,62). V modelu logistické regrese byl nalezen statisticky významný protektivní vliv u konzumace tří a více porcí vařené zeleniny týdně (OR 0,16; 95% CI 0,05–0,55) a vysoké konzumace citrusového ovoce (OR 0,46; 95% CI 0,23–0,90). Závěr: Studie nalezla signifikantní protektivní vliv konzumace tří a více porcí vařené zeleniny týdně a vysoké konzumace citrusového ovoce u karcinomu pankreatu.
Background: Pancreatic cancer is serious and rapidly progressing condition. Little is known about the role of diet in etiology of pancreatic cancer. The study focused on the role of selected dietary factors related to pancreatic cancer. Material and Methods: The case-control study was performed in the Czech Republic in 2006–2009, involving three centers in Olomouc, Ostrava and Ceske Budejovice. It comprised a total of 530 persons, of whom 310 had pancreatic cancer and 220 were controls. Data were obtained directly from each participant in an interview with a trained interviewer and entered into a standardized questionnaire. The data were analyzed using a crude odds ratio (OR) and multivariate logistic regression with an adjusted OR and 95% CI. The statistical analysis was performed with the STATA v. 10 software. Results: A very strong protective effect was found in pickled cabbage (OR 0.32; 95% CI 0.19–0.55), broccoli (OR 0.37; 95% CI 0.25–0.53), cooked onion (OR 0.14; 95% CI 0.08–0.27), tomatoes (OR 0.28; 95% CI 0.13–0.60), raw carrot (OR 0.33; 95% CI 0.20–0.56), cooked carrot (OR 0.35; 95% CI 0.19–0.62). In logistic regression model, statistically significant protective associations were found in consumption of more than three portions of cooked vegetables per week (OR 0.16; 95% CI 0.05–0.55) and high consumption of citrus fruit (OR 0.46; 95% CI 0.23–0.90). Conclusion: The study found statistically significant protective effect of consumption of more than three portions of cooked vegetables per week and high consumption of citrus fruit.
Dementias of old age, in particular Alzheimer's disease (AD), pose a growing threat to the longevity and quality of life of individuals as well as whole societies world-wide. The risk factors are both genetic and environmental (life-style) and there is an overlap with similar factors predisposing to cardiovascular diseases (CVD). Using a case-control genetic approach, we have identified a SNP (rs10507391) in ALOX5 gene, previously associated with an increased risk of stroke, as a novel genetic risk factor for AD. ALOX5 gene encodes a 5'-lipoxygenase (5'-LO) activating protein (FLAP), a crucial component of the arachidonic acid/leukotriene inflammatory cascade. A-allele of rs4769874 polymorphism increases the risk of AD 1.41-fold (p<0.0001), while AA genotype does so 1.79-fold (p<0.0001). In addition, GG genotype of rs4769874 polymorphism is associated with a modest increase in body mass index (BMI). We discuss potential biochemical mechanisms linking the SNP to AD and suggest possible preventive pharmacotherapies some of which are based on commonly available natural products. Finally, we set the newly identified AD risk factors into a broader context of similar CVD risk factors to generate a more comprehensive picture of interacting genetics and life-style habits potentially leading to the deteriorating mental health in the old age.
- MeSH
- Alzheimerova nemoc genetika patofyziologie psychologie MeSH
- arachidonát-5-lipoxygenasa genetika MeSH
- genetické asociační studie MeSH
- genotyp MeSH
- index tělesné hmotnosti * MeSH
- jednonukleotidový polymorfismus genetika MeSH
- lidé MeSH
- průzkumy a dotazníky MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- tělesná hmotnost genetika MeSH
- životní styl MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Česká republika MeSH
