Od začátku války na Ukrajině přijala Česká republika více než 360 000 uprchlíků (United Nations High Council for Refugees, 2023), z nichž velkou část tvořily děti, včetně dětí s diabetem 1. typu (T1D). Celkem jsme v devíti centrech léčby dětského diabetu od února 2022 do června 2023 registrovali 124 dětí s T1D z Ukrajiny, které jsme následně sledovali ve tříměsíčních intervalech. Během prvního roku jejich pobytu v ČR došlo k významnému zlepšení průměrného HbA1c o 2,2 mmol/mol za ambulantní návštěvu (p=0,01, CI [-3,2; -1,1]). Největší pokles HbA1c jsme pozorovali u skupiny, u které byly nově nasazeny kontinuální monitory glykemie (CGM) (průměrný pokles o 2,9 mmol/mol za ambulantní návštěvu). Naše výsledky ukazují na nezastupitelnou roli CGM v managementu diabetu 1. typu.
Czechia has received over 360 000 refugees since the beginning of the war on Ukraine (United Nations High Council for Refugees, 2023). A majority of those refugees were women and children including children with type 1 diabetes (T1D). Throughout the duration of our study (February 2022 - June 2023) a total of 124 Ukrainian children with T1D presented into one of the 9 participating centers for pediatric diabetes. We followed up these children every 3 months for HbA1c, CGM values, therapy type and anthropologic measures. During the first year of their stay in Czechia, the HbA1c of these children decreased significantly by 2,2 mmol/mol per visit (p=0.01, CI [-3.2; -1.1]). HbA1c decreased the most in children who newly received CGM in Czechia with average decrease of 2,9 mmol/mol per visit. Our results show further underline the importance of CGM use in T1D management.
AIM: Our study aimed to assess expression of L1 cell adhesion molecule (L1CAM) in early-stage cervical squamous-cell cancer as a prognostic factor. PATIENTS AND METHODS: This retrospective, single-institution study included 154 patients who underwent radical hysterectomy for early-stage squamous cell cervical cancer between 2007 and 2017. Tumor samples from 154 patients were available for L1CAM analysis by immunohistochemistry. Among all patients, radical abdominal hysterectomy was performed in 144 cases. RESULTS: L1CAM expression was positive in 24 tumors (15.6%) of the whole group. In relation to the grade of differentiation and the presence of lymphovascular invasion, L1CAM expression did not show an association (p=0.154 and p=0.306, respectively). The disease-free interval and overall survival also did not significantly differ between L1CAM-positive and L1CAM-negative cases (p=0.427 and p=0.240, respectively). For histopathological characteristics, L1CAM-positive cases had a significantly higher median tumor size (p=0.015). Even in the selected group of 115 cases without nodal infiltration, L1CAM status had no effect on the relapse rate during follow-up. CONCLUSION: Our study did not confirm the results of previous studies showing L1CAM expression to be a negative prognostic factor in cervical cancer. In our study, increased L1CAM expression in early-stage squamous-cell cervical cancer was not associated with adverse prognosis regarding disease recurrence, disease-free survival, nor overall survival. L1CAM expression was correlated only with the size of the tumor.
- Publikační typ
- časopisecké články MeSH
AIMS/HYPOTHESIS: We previously detected indications that beta cell function is protected by gluten-free diet (GFD) introduced shortly after the onset of childhood type 1 diabetes. The present aim was to assess whether GFD was associated with changes in the gut bacteriome composition and in its functional capacity, and whether such changes mediated the observed effects of GFD on beta cell function. METHODS: Forty-five children (aged 10.2 ± 3.3 years) were recruited into a self-selected intervention trial primarily focused on determining the role of GFD on beta cell preservation ( ClinicalTrials.gov NCT02867436). Stool samples were collected prior to the dietary intervention and then at 3-month intervals. A total of 128 samples from the GFD group and 112 from the control group were analysed for bacteriome 16S rDNA community profiles, the bacteriome functional capacity was predicted using PICRUSt2 and actual gut metabolome profiles measured using NMR. Intestinal permeability was assessed using serum zonulin concentrations at 1, 6 and 12 months and lactulose/mannitol tests at the end of intervention. Dietary questionnaires were used to ensure that the dietary intervention did not result in differences in energy or nutrient intake. RESULTS: The bacteriome community composition changed during the intervention with GFD: of abundant genera, a 3.3-fold decrease was noted for Bifidobacterium genus (adjusted p=1.4 × 10-4 in a DESeq2 model, p=0.026 in generalised estimating equations model), whereas a 2.4-fold increase was observed in Roseburia (adjusted p=0.02 in DESeq2 model, p=0.002 in generalised estimating equations model). The within-sample (alpha) diversity did not change, and there was no statistically significant clustering of GFD samples in the ordination graphs of beta diversity. Neither of the genera changes upon GFD intervention showed any association with the pace of beta cell loss (p>0.50), but of the remaining taxa, several genera of Bacteroidaceae family yielded suggestive signals. The faecal metabolome profile ordination correlated with that of bacteriomes but did not associate with GFD or categories of beta cell preservation. There was no indication of changes in gut permeability. CONCLUSIONS/INTERPRETATION: The bacteriome reacted to GFD, but the changes were unrelated to the pace of beta cell capacity loss. The previously observed moderately protective effect of GFD is therefore mediated through other pathways.
- Publikační typ
- abstrakt z konference MeSH
- MeSH
- bolest etiologie MeSH
- Burkittův lymfom diagnóza komplikace MeSH
- diferenciální diagnóza MeSH
- fatální výsledek MeSH
- hematemeze * etiologie terapie MeSH
- hydrolasy analýza MeSH
- inhibitory protonové pumpy terapeutické užití MeSH
- lidé MeSH
- metastázy nádorů diagnostické zobrazování MeSH
- mladiství MeSH
- nádory trávicího systému * diagnostické zobrazování patologie MeSH
- progrese nemoci MeSH
- Check Tag
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
- MeSH
- antibakteriální látky terapeutické užití MeSH
- hospitalizace MeSH
- lidé MeSH
- předškolní dítě MeSH
- tularemie diagnóza etiologie terapie MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- předškolní dítě MeSH
- Publikační typ
- kazuistiky MeSH
- Publikační typ
- abstrakt z konference MeSH
Úvod: Hodnotenie kvality života u pacientov po prekonaní cievnej mozgovej príhody (CMP) je nevyhnutnou súčasťou liečby. Kvalitu života predikujú nielen telesné postihnutie po CMP, ale aj psychosociálny stav pacienta. Cieľom štúdie je zistiť vzťah medzi depresiou, úzkosťou a kvalitou života v akútnej fáze po prekonaní CMP. Metódy: Výskum bol realizovaný ako prierezová deskriptívna štúdia. Výskumnú vzorku tvorilo 79 pacientov po CMP (Mvek = 67,9 ± 12,3). Depresia a úzkosť boli merané prostredníctvom dotazníka Hospital Anxiety and Depression Scale a kvalita života dotazníkom Stroke Specific Quality of Life Scale . Dáta boli analyzované jednoduchou a viacnásobnou lineárnou regresiou. Výsledky: Depresia a úzkosť predikujú celkovú kvalitu života pacientov po CMP štatisticky významne. Fyzický aspekt kvality života a celkovú kvalitu života viac predikuje depresia, naopak psychosociálny aspekt kvality života viac súvisí s úzkosťou pacientov po prekonaní CMP. Vyššia depresia aj úzkosť sa prejavujú v zhoršenej kvalite života, obdobne vo fyzickom aj psychosociálnom aspekte. Závažnú mieru depresie a úzkosti vykazovalo približne 20 % pacientov. Záver: Na kvalitu života pacienta po prekonaní CMP má vplyv nielen jeho funkčný stav, ale aj psychosociálny distres. Včasná diagnostika psychosociálneho distresu by mala byť dôležitou súčasťou starostlivosti a liečby pacientov po CMP.
Introduction: Evaluating quality of life in stroke patients is an essential part of treatment. Quality of life can be predicted not only by the physical disability after a stroke, but also by the patient's psychosocial state. The aim of the present study is to examine the relationship between depression, anxiety, and quality of life in the acute phase after strokes. Methods: A cross-sectional descriptive type of study was carried out. The research sample consisted of 79 patients after a stroke (Mage = 67.9 ± 12.3). Depression and anxiety were measured using the Hospital Anxiety and Depression Scale, and quality of life using the Stroke Specific Quality of Life Scale. Simple and multiple linear regression analyses were used for data analysis. Results: Depression and anxiety predicted overall quality of life in patients after a stroke. The physical aspect of quality of life and overall quality of life were strongly predicted by depression, while the psychosocial aspect of quality of life was strongly related to anxiety in stroke patients. Higher depression and anxiety are manifested in a worsened quality of life, and it is similar in the physical and psychosocial aspects. Approximately 20% of patients had severe depression and anxiety. Conclusions: A patient's quality of life after a stroke is affected not only by their functional condition, but also by psychosocial distress. Early diagnostics of psychosocial distress should be an important part of the care and treatment of stroke patients.
- MeSH
- cévní mozková příhoda * terapie MeSH
- deprese komplikace MeSH
- kvalita života MeSH
- lidé MeSH
- úzkost komplikace MeSH
- Check Tag
- lidé MeSH
AIMS/HYPOTHESIS: The proportion of children with type 1 diabetes (T1D) who have experience with low-carbohydrate diet (LCD) is unknown. Our goal was to map the frequency of LCD among children with T1D and to describe their clinical and laboratory data. METHODS: Caregivers of 1040 children with T1D from three centers were addressed with a structured questionnaire regarding the children's carbohydrate intake and experience with LCD (daily energy intake from carbohydrates below 26% of age-recommended values). The subjects currently on LCD were compared to a group of non-LCD respondents matched to age, T1D duration, sex, type and center of treatment. RESULTS: A total of 624/1040 (60%) of the subjects completed the survey. A total of 242/624 (39%) subjects reported experience with voluntary carbohydrate restriction with 36/624 (5.8%) subjects currently following the LCD. The LCD group had similar HbA1c (45 vs. 49.5, p = 0.11), lower average glycemia (7.0 vs. 7.9, p = 0.02), higher time in range (74 vs. 67%, p = 0.02), lower time in hyperglycemia >10 mmol/L (17 vs. 20%, p = 0.04), tendency to more time in hypoglycemia <3.9 mmol/L(8 vs. 5%, p = 0.05) and lower systolic blood pressure percentile (43 vs. 74, p = 0.03). The groups did not differ in their lipid profile nor in current body height, weight or BMI. The LCD was mostly initiated by the parents or the subjects themselves and only 39% of the families consulted their decision with the diabetologist. CONCLUSIONS/INTERPRETATION: Low carbohydrate diet is not scarce in children with T1D and is associated with modestly better disease control. At the same time, caution should be applied as it showed a tendency toward more frequent hypoglycemia.
- MeSH
- diabetes mellitus 1. typu dietoterapie metabolismus MeSH
- dieta s omezením sacharidů * škodlivé účinky statistika a číselné údaje MeSH
- dítě MeSH
- glykovaný hemoglobin analýza MeSH
- index tělesné hmotnosti MeSH
- krevní glukóza analýza MeSH
- lidé MeSH
- lipidy krev MeSH
- průzkumy a dotazníky MeSH
- tělesná hmotnost MeSH
- tělesná výška MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- Publikační typ
- abstrakt z konference MeSH
