- Klíčová slova
- sysadoa,
- MeSH
- antiflogistika nesteroidní aplikace a dávkování škodlivé účinky terapeutické užití MeSH
- hormony kůry nadledvin aplikace a dávkování škodlivé účinky terapeutické užití MeSH
- kolagen aplikace a dávkování terapeutické užití MeSH
- konzervativní terapie MeSH
- kyselina hyaluronová aplikace a dávkování terapeutické užití MeSH
- lidé MeSH
- osteoartróza * diagnóza patofyziologie terapie MeSH
- plazma bohatá na destičky MeSH
- rehabilitace MeSH
- viskosuplementace MeSH
- Check Tag
- lidé MeSH
BACKGROUND: Thrombosis is linked to neutrophil release of neutrophil extracellular traps (NETs). NETs are proposed as a mechanism of resistance to thrombolysis. This study intends to analyze the composition of thrombi retrieved after mechanical thrombectomy, estimate the age and organization of thrombi, and evaluate associations with the use of thrombolysis, antiplatelets, and heparin. METHODS: This retrospective observational study involved 72 samples (44 from cerebral and 28 coronary arteries), which were stained with hematoxylin and eosin, anti-NE (neutrophil elastase) antibody, and anti-histone H2B (histone H2B) antibody, representing different components in NET formation, all detectable during the later stages of NETosis, for histochemical and digital quantification of NET content. The histological and morphological evaluations of the specimens were correlated, through univariate and mediation analyses, with clinical information and therapy administered before intervention. RESULTS: The results demonstrated that the composition of cerebral and coronary thrombi differs, and there were significantly more lytic cerebral thrombi than coronary thrombi (66% versus 14%; P=0.005). There was a considerably higher expression of NETs in the cerebral thrombi as testified by the higher expression of H2B (P=0.031). Thrombolysis was remarkably associated with higher NE positivity (average marginal effect, 6.461 [95% CI, 0.7901-12.13]; P=0.02555), regardless of the origin of thrombi. There was no notable association between the administration of antiaggregant therapy/heparin and H2B/NE amount when adjusted for the thrombus location. Importantly, the age of the thrombus was the only independent predictor of NET content without any mediation of the thrombolytic treatment (P=0.014). CONCLUSIONS: The age of the thrombus is the driving force for NET content, which correlates with impaired clinical outcomes. The therapy that is currently administered does not modify NET content. This study supports the need to investigate new pharmacological approaches added to thrombolysis to prevent NET formation or enhance their disruption, such as recombinant human DNase I (deoxyribonuclease I).
Background and Aim: Osteoarthritis is a degenerative chronic disease that affects the joints, it is strongly associated with age and affects the quality of life and fatigue in addition to its associated pain, stiffness, and loss of mobility. This study aimed to evaluate the daily fatigue score among patients with osteoarthritis. Methods: A cross-sectional descriptive study was conducted among patients with osteoarthritis who were invited from three Rheumatology clinics. The fatigue scale (FACIT version) was used in addition to biochemical data collected from patients' records.Result: A total of 370 patients were included in the final data analysis and a negative significant relationship between fatigue score with age, BMI, duration of the disease, and ESR (P<.0.05) were found. Significant differences in the fatigue scores were also found between groups of gender, glucosamine previous use, and former steroid injection.Conclusion: The severity of fatigue among osteoarthritis patients was higher in females than males. The medication used either analgesics or supplements for the patients with OA was not significant to improve the severity of fatigue. The severity of fatigue was more common in groups of patients that had one co-morbid than the patients who had more than one co-morbid.
Rationale: Definitive guidelines for anticoagulation management during veno-venous extracorporeal membrane oxygenation (VV ECMO) are lacking, whereas bleeding complications continue to pose major challenges. Objectives: To describe anticoagulation modalities and bleeding events in adults receiving VV ECMO. Methods: This was an international prospective observational study in 41 centers, from December 2018 to February 2021. Anticoagulation was recorded daily in terms of type, dosage, and monitoring strategy. Bleeding events were reported according to site, severity, and impact on mortality. Measurements and Main Results: The study cohort included 652 patients, and 8,471 days on ECMO were analyzed. Unfractionated heparin was the initial anticoagulant in 77% of patients, and the most frequently used anticoagulant during the ECMO course (6,221 d; 73%). Activated partial thromboplastin time (aPTT) was the most common test for monitoring coagulation (86% of days): the median value was 52 seconds (interquartile range, 39 to 61 s) but dropped by 5.3 seconds after the first bleeding event (95% confidence interval, -7.4 to -3.2; P < 0.01). Bleeding occurred on 1,202 days (16.5%). Overall, 342 patients (52.5%) experienced at least one bleeding event (one episode every 215 h on ECMO), of which 10 (1.6%) were fatal. In a multiple penalized Cox proportional hazard model, higher aPTT was a potentially modifiable risk factor for the first episode of bleeding (for 20-s increase; hazard ratio, 1.07). Conclusions: Anticoagulation during VV ECMO was a dynamic process, with frequent stopping in cases of bleeding and restart according to the clinical picture. Future studies might explore lower aPTT targets to reduce the risk of bleeding.
- MeSH
- antikoagulancia škodlivé účinky MeSH
- dospělí MeSH
- hemokoagulace MeSH
- heparin * škodlivé účinky MeSH
- krvácení chemicky indukované terapie MeSH
- lidé MeSH
- mimotělní membránová oxygenace * škodlivé účinky MeSH
- retrospektivní studie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- pozorovací studie MeSH
In an increasingly aging society, there is a growing demand for the development of technology related to tissue regeneration. It involves the development of the appropriate biomaterials whose properties will allow the desired biological response to be obtained. Bioactivity is strongly affected by the proper selection of active ingredients. The aim of this study was to produce bioactive hydrogel materials based on hyaluronic acid and collagen modified by the addition of placenta. These materials were intended for use as dressings, and their physicochemical properties were investigated under simulated biological environmental conditions. The materials were incubated in vitro in different fluids simulating the environment of the human body (e.g., simulated body fluid) and then stored at a temperature close to body temperature. Using an FT-IR spectrophotometer, the functional groups present in the composites were identified. The materials with the added placenta showed an increase in the swelling factor of more than 300%. The results obtained confirmed the potential of using this material as an absorbent dressing. This was indicated by pH and conductometric measurements, sorption, degradation, and surface analysis under an optical microscope. The results of the in vitro biological evaluation confirmed the cytosafety of the tested biomaterials. The tested composites activate monocytes, which may indicate their beneficial properties in the first phases of wound healing. The material proved to be nontoxic and has potential for medical use.
- MeSH
- biokompatibilní materiály farmakologie MeSH
- hojení ran MeSH
- hydrogely * farmakologie chemie MeSH
- kolagen farmakologie chemie MeSH
- kyselina hyaluronová * farmakologie chemie MeSH
- lidé MeSH
- ovce MeSH
- spektroskopie infračervená s Fourierovou transformací MeSH
- zvířata MeSH
- Check Tag
- lidé MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
Kyselina hyaluronová (KH) je lineární, přirozeně se vyskytující polysacharid o vysoké molekulové hmotnosti. Je součástí řady bio logických procesů, zejména regulačních, protizánětlivých, imunosupresivních nebo antiproliferativních. Významně váže vodu a podílí se na udržování viskoelasticity tkání, na supramolekulárním prostorovém uspořádání proteoglykanů v extracelulární matrix a na regulaci osmotického tlaku, což významně ovliňuje homogenitu tkáně a její homeostatickou integritu. Díky těmto vlastnostem lze neimunogenní KH použít v mnoha klinických aplikacích. V otorinolaryngologii jsou možnosti jejího využití široké zejména v otologii, laryngologii, rinologii nebo při léčbě zánětlivý stavů a keloidních jizev. Ně kte ré potenciální oblasti využití jsou stále ve stadiu experimentu (genová terapie).
Hyaluronic acid (HA) is a linear, naturally occurring polysaccharide of high molecular weight. It is part of a number of bio logical processes, especially regulatory, anti-inflammatory, immunosuppressive or antiproliferative. It significantly binds water and participates in the maintenance of tissue viscoelasticity, in the supramolecular spatial arrangement of proteoglycans in the extracellular matrix and in the regulation of osmotic pressure, which significantly affects tissue homogeneity and its homeostatic integrity. Due to these properties, non-immunogenic HA can be used in many clinical applications. In otorhinolaryngology, the possibilities of its use are wide, especially in otology, laryngology, rhinology or in the treatment of inflammatory conditions and keloid scars. Some potential areas of use are still in the experimental stage (gene therapy).
Antikoagulační terapie zabraňuje různými mechanismy genezi trombinu a následné přeměny fibrinogenu na fibrin. Heparin je parenterálně aplikované antikoagulancium, které po aktivaci antitrombinu nepřímo blokuje trombotický účinek trombinu. Mezi injekčně podávaná antikoagulancia patří dále nízkomolekulární hepariny (LMWH) a fondaparinux, které nepřímo, za účasti antitrombinu, inhibují aktivovaný F Xa. Mezi perorální antikoagulancia (OAC) řadíme warfarin, který potlačuje tvorbu funkčních prokoagulačních faktorů závislých na vitaminu K (protrombinu, F VII, F IX a F X), a tzv. přímá perorální antikoagulancia (DOAC), která vyvolávají buď přímou inhibici trombinu (dabigatran etexilát), nebo přímou inhibici aktivovaného F Xa (apixaban, edoxaban, rivaroxaban).
Anticoagulation therapy prevents the generation of thrombin and the subsequent conversion of fibrinogen to fibrin by various mechanisms. Heparin is a parenterally administered anticoagulant that indirectly blocks the thrombotic effect of thrombin after activation of antithrombin. Injectable anticoagulants also include low-molecular-weight heparins (LMWH) and fondaparinux, which indirectly, with the participation of antithrombin, inhibit activated F Xa. Oral anticoagulants (OACs) include warfarin, which suppresses the formation of functional procoagulation factors dependent on vitamin K (prothrombin, F VII, F IX, and F X), and so-called direct oral anticoagulants (DOACs), which cause either direct inhibition of thrombin (dabigatran etexilate) or direct inhibition of activated F Xa (apixaban, edoxaban, rivaroxaban).
- Klíčová slova
- přímá orální antikoagulancia (DOAC),
- MeSH
- antikoagulancia * aplikace a dávkování klasifikace terapeutické užití MeSH
- aplikace orální MeSH
- heparin nízkomolekulární aplikace a dávkování terapeutické užití MeSH
- lidé MeSH
- náklady na léky MeSH
- tromboembolie prevence a kontrola MeSH
- warfarin aplikace a dávkování farmakologie terapeutické užití MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- práce podpořená grantem MeSH
- přehledy MeSH
- MeSH
- fibrinolytika aplikace a dávkování terapeutické užití MeSH
- heparin nízkomolekulární aplikace a dávkování terapeutické užití MeSH
- lidé MeSH
- mnohočetný myelom * farmakoterapie komplikace MeSH
- tromboembolie * chemicky indukované prevence a kontrola MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- směrnice pro lékařskou praxi MeSH
Spinocelulární karcinom anu představuje vzácné onemocnění gastrointestinálního traktu. Díky přítomnosti časných příznaků, mezi které patří krvácení, bolestivost a pocit rezistence v konečníku, bývá toto onemocnění diagnostikováno v časných stadiích. V současné době je standardním léčebným postupem multimodální přístup, který kombinuje radioterapii a chemoterapii na bázi 5-fluorouracilu s mytomicinem nebo cisplatinou. Prognóza je u většiny pacientů s onemocněním lokalizovaným pouze na anus velmi příznivá, přesto je léčba spjata s jistými riziky. Tato kazuistika popisuje managment širokého spektra komplikací včetně kardiotoxicity spojené s 5-fluorouracilem, rozvoje heparinem indukované trombocytopenie a trombotických komplikací u jinak standardně léčené pacientky pro spinocelulární karcinom anu.
Squamous cell carcinoma of the anus is a rare gastrointestinal tract disease. Due to the early presence of symptoms, which include bleeding, soreness and a feeling of resistance in the anus, this disease is usually diagnosed in its initial stages. The standard treatment consists of a multimodal approach combining radiotherapy and 5-fluorouracil-based chemotherapy with mitomycin or cisplatin. The prognosis is very favorable for most patients with the disease localized only to the anus, yet there are some risks associated with the treatment. This case report describes the management of a wide range of complications, including 5-fluorouracil-associated cardiotoxicity, development of heparin-induced thrombocytopenia, and thrombotic complications in a patient otherwise standardly treated for squamous cell carcinoma of the anus.
- MeSH
- antitumorózní látky aplikace a dávkování škodlivé účinky MeSH
- fluorouracil škodlivé účinky terapeutické užití MeSH
- heparin nízkomolekulární aplikace a dávkování škodlivé účinky MeSH
- kardiotoxicita patofyziologie patologie terapie MeSH
- lidé MeSH
- nádory anu * komplikace terapie MeSH
- nežádoucí účinky léčiv * patofyziologie patologie terapie MeSH
- riziko MeSH
- senioři MeSH
- trombocytopenie chemicky indukované patofyziologie terapie MeSH
- Check Tag
- lidé MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
- MeSH
- COVID-19 * diagnóza patofyziologie terapie MeSH
- heparin aplikace a dávkování terapeutické užití MeSH
- intravenózní imunoglobuliny aplikace a dávkování terapeutické užití MeSH
- lidé MeSH
- methylprednisolon aplikace a dávkování terapeutické užití MeSH
- syndrom systémové zánětlivé reakce * etiologie farmakoterapie patofyziologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
