INTRODUCTION: Lumbar hernia in the pediatric population is an extremely rare diagnosis and therefore requires specific diagnostic and therapeutic approaches. This case report describes the first published case of a pediatric lumbar hernia in the Czech Republic. CASE DESCRIPTION: A 22-month-old boy was examined at a pediatric surgical clinic due to a soft reducible mass in the right lumbar region, which, according to his mother, has been present from birth. An ultrasound scan confirmed a defect in the anatomical localization of the superior lumbar triangle (the triangle of Grynfeltt-Lesshaft) measur-ing 17 × 11 mm with a bowel loop herniation. The patient underwent a skeletal X-ray and an abdominal ultrasound in order to rule out associated malformations, following which he was scheduled for an open hernioplasty. Given the small size of the defect, a primary closure without mesh hernioplasty was performed. The postoperative course was uneventful and at clinical follow-ups the patient showed no signs of hernia recurrence or growth asymmetry. CONCLUSION: Lumbar hernia in children is congenital and frequently occurs with other associated malformations, which must be ruled out. The type of operation depends on the size of the defect and its purpose is to provide a tension-free closure.

• Klíčová slova
• associated anomalies, congenital lumbar hernia, mesh repair, surgical technique,
• MeSH
• abdominální hernie * vrozené   chirurgie   MeSH
• hernie * vrozené   MeSH
• kojenec MeSH
• lidé MeSH
• lumbosakrální krajina * MeSH
• operace kýly MeSH
• Check Tag
• kojenec MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

OBJECTIVE: Description of rare diagnosis of patent urachus. DESIGN: Case report. SETTING: Department of Obstetrics and Gynecology, 2nd Faculty of Medicine and Faculty Hospital Motol Prague. CASE REPORT: Patent urachus is a rare diagnosis, which in this case was detected prenatally by ultrasound. Involution of the urachus is not fully completed upon birth, therefore in cases of small persisting communication between the urinary bladder and the umbilicus conservative approach and waiting for spontaneous closure is usually chosen. In our case surgery treatment has chosen as a prevention of urinary infection because of patent urachus manifested as a wide communication. CONCLUSION: This congenital defect usually manifests itself early after birth as a visible structural anomaly of the umbilicus and/or as urine leakage in the umbilicus opening area. It is important to keep in mind that urachus irregularities may be accompanied by other urinary system defects. Every child presenting with such an anomaly should therefore be thoroughly examined. If the procedure is performed by an experienced surgical team postoperative complications are uncommon and overall long-term prognosis for patients is excellent.

• Klíčová slova
• patent urachus, umbilical cord cyst,
• MeSH
• cysta urachu diagnostické zobrazování   chirurgie   MeSH
• dítě MeSH
• lidé MeSH
• močový měchýř MeSH
• pupečník diagnostické zobrazování   MeSH
• těhotenství MeSH
• ultrasonografie prenatální metody   MeSH
• urachus abnormality   diagnostické zobrazování   MeSH
• vzácné nemoci MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

BACKGROUND: Describe risk factors for relapsing and severe Clostridium difficile infection (CDI) in a set of patients hospitalized at the Clinic of infectious diseases the University Hospital Brno. MATERIAL AND METHODS: A retrospective study observing epidemiological, clinical and laboratory data of 281 patients with proven diagnosis of Clostridium difficile infection hospitalized in the period from 1. 1. 2007 to 31. 12. 2010. RESULTS: In the first part of the evaluation were enrolled 233 patients, 87 (37.3 %) patients had a record of relapsing CDI and 146 (62.7 %) patients had nonrelapsing CDI. Factors associated with relaps included 2 or more comorbidities, previous hospitalization during the 4 weeks before CDI, the use of proton pump inhibitors. In the second part of the evaluation were enrolled all 281 patients, severe CDI during any episode of the disease was observed in 181 (64.4 %) patients, while the remaining 100 (35.6 %) patients had mild or moderate CDI. The risk factors associated with severe CDI were age older than 65 years, history of coronary heart disease, chronic renal insufficiency, a combination of 2 or more comorbidities, previous hospitalization in a period of 4 weeks. CONCLUSIONS: Age older than 65 years is the risk for severe CDI. Patients with 2 or more comorbidities or with history of previous hospitalization are in a risk for both, relapsing and severe CDI. Use of proton pump inhibitors may lead to recurrence, probably on the basis of re-infection Clostridium difficile spores.

• MeSH
• Clostridioides difficile * MeSH
• klostridiové infekce etiologie   MeSH
• kolitida etiologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• nekrotizující enterokolitida etiologie   MeSH
• recidiva MeSH
• rizikové faktory MeSH
• senioři MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

The authors present a case report of a patient with febrile pancytopenia, hepatosplenomegaly and weight loss as main symptoms of visceral leishmaniasis. Standard treatment regimen with amphothericin B led to relapse of the disease after several weeks. The definitive cure of the disease was achieved with cytostatic miltefosin (Impavido©), which is not registered in the Czech Republic. The aim of this article is to point out this imported protozoan infection and its basic clinical and laboratory features.

• MeSH
• dospělí MeSH
• hepatomegalie komplikace   MeSH
• horečka komplikace   MeSH
• leishmanióza viscerální komplikace   diagnóza   farmakoterapie   MeSH
• lidé MeSH
• pancytopenie komplikace   MeSH
• splenomegalie komplikace   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH
• kazuistiky MeSH

It was demonstrated that estrogen deficiency and consuming high fat (HF) diet enhanced orexigenic activity of ghrelin. Therefore, we hypothesized that antagonizing of ghrelin action would attenuate food intake and body weight in mice obese both from ovariectomy (OVX) and feeding a HF diet. Ghrelin receptor antagonist [D-Lys(3)]GHRP-6 after seven days of subcutaneous treatment markedly decreased food intake in OVX mice fed both HF and standard diets; furthermore, it reduced body weight and blood glucose, insulin and leptin, and increased β-hydroxybutyrate level and uncoupling-protein-1 mRNA in brown adipose tissue. Pair-feeding revealed that effect of [D-Lys(3)]GHRP-6 was primary anorexigenic. Estrogen supplementation reduced anorexigenic effects of [D-Lys(3)]GHRP-6. OVX [D-Lys(3)]GHRP-6 treatment in mice on HF diet resulted in markedly increased circulating level and liver expression of a major metabolic regulator, fibroblast growth factor 21. Our data suggest that ghrelin antagonists could be especially beneficial in individuals with common obesity combined with estrogen deficiency.

• MeSH
• adipozita účinky léků   MeSH
• chování zvířat účinky léků   MeSH
• dieta s vysokým obsahem tuků * MeSH
• estrogeny aplikace a dávkování   nedostatek   MeSH
• ghrelin metabolismus   MeSH
• hnědá tuková tkáň metabolismus   MeSH
• iontové kanály genetika   metabolismus   MeSH
• lidé MeSH
• mitochondriální proteiny genetika   metabolismus   MeSH
• modely u zvířat * MeSH
• myši inbrední C57BL MeSH
• myši MeSH
• obezita patofyziologie   MeSH
• oligopeptidy farmakologie   MeSH
• ovarektomie MeSH
• pohybová aktivita účinky léků   MeSH
• postmenopauza metabolismus   MeSH
• PPAR alfa genetika   metabolismus   MeSH
• přenašeč glukosy typ 1 genetika   metabolismus   MeSH
• přijímání potravy účinky léků   MeSH
• receptory ghrelinu antagonisté a inhibitory   genetika   metabolismus   MeSH
• tělesná hmotnost účinky léků   MeSH
• uncoupling protein 1 MeSH
• zvířata MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• myši MeSH
• ženské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• estrogeny MeSH
• ghrelin MeSH
• growth hormone releasing hexapeptide MeSH Prohlížeč
• iontové kanály MeSH
• mitochondriální proteiny MeSH
• oligopeptidy MeSH
• PPAR alfa MeSH
• přenašeč glukosy typ 1 MeSH
• receptory ghrelinu MeSH
• UCP1 protein, human MeSH Prohlížeč
• Ucp1 protein, mouse MeSH Prohlížeč
• uncoupling protein 1 MeSH