PURPOSE: The appropriate treatment of pulseless pink supracondylar humerus fractures (SCHF) remains controversial. In this study, the outcomes of two treatment approaches (with and without vascular surgery) were compared. MATERIAL AND METHODS: This was a retrospective multicenter study of patients with pulseless pink SCHFs treated in ten pediatric surgery, trauma, or orthopedics departments in the Czech and Slovak Republic between 2014 and 2018. RESULTS: Of the total 3608 cases of displaced SCHF, 125 had the pulseless pink SCHF. Of those, 91% (114/125) did not undergo vascular surgery and 9% (11/125) underwent vascular surgery. The patients who did undergo vascular surgery had radial artery pulsation restored more frequently in the operating room (73% vs. 36%; p = 0.02), within 6 h (91% vs. 45%; p = 0.004), and within 24 h of surgery (91% vs. 57%; p = 0.05). However, 72 h after surgery, there was no significant difference in palpable radial artery pulsation between the vascular surgery and the non-vascular surgery groups (91% vs. 74%; p = 0.24). Additionally, no significant differences in long-term neurological (9% vs. 22%; p = 0.46) or circulatory (9% vs. 7%; p = 0.57) deficits were found between the two groups. CONCLUSION: While vascular surgery in patients with pulseless pink SCHFs is associated with a more prompt restoration of radial artery pulsation, no statistical significant differences in terms of the restoration of neurological deficits or the risks of long-term neurological or circulatory deficits were found between patients with and without vascular surgery.

• Klíčová slova
• Children, Pink, Pulseless, Supracondylar humerus fracture, Vascular surgery,
• MeSH
• arteria brachialis * zranění   chirurgie   MeSH
• dítě MeSH
• fraktury humeru * komplikace   MeSH
• humerus MeSH
• lidé MeSH
• pulz MeSH
• retrospektivní studie MeSH
• ruka krevní zásobení   MeSH
• výsledek terapie MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH

BACKGROUND: The minimum duration of pulselessness required before organ donation after circulatory determination of death has not been well studied. METHODS: We conducted a prospective observational study of the incidence and timing of resumption of cardiac electrical and pulsatile activity in adults who died after planned withdrawal of life-sustaining measures in 20 intensive care units in three countries. Patients were intended to be monitored for 30 minutes after determination of death. Clinicians at the bedside reported resumption of cardiac activity prospectively. Continuous blood-pressure and electrocardiographic (ECG) waveforms were recorded and reviewed retrospectively to confirm bedside observations and to determine whether there were additional instances of resumption of cardiac activity. RESULTS: A total of 1999 patients were screened, and 631 were included in the study. Clinically reported resumption of cardiac activity, respiratory movement, or both that was confirmed by waveform analysis occurred in 5 patients (1%). Retrospective analysis of ECG and blood-pressure waveforms from 480 patients identified 67 instances (14%) with resumption of cardiac activity after a period of pulselessness, including the 5 reported by bedside clinicians. The longest duration after pulselessness before resumption of cardiac activity was 4 minutes 20 seconds. The last QRS complex coincided with the last arterial pulse in 19% of the patients. CONCLUSIONS: After withdrawal of life-sustaining measures, transient resumption of at least one cycle of cardiac activity after pulselessness occurred in 14% of patients according to retrospective analysis of waveforms; only 1% of such resumptions were identified at the bedside. These events occurred within 4 minutes 20 seconds after a period of pulselessness. (Funded by the Canadian Institutes for Health Research and others.).

• MeSH
• dospělí MeSH
• elektrokardiografie MeSH
• extubace MeSH
• funkční vyšetření srdce MeSH
• krevní tlak fyziologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• nenasazení léčby * MeSH
• prospektivní studie MeSH
• pulz * MeSH
• resuscitační péče MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• smrt MeSH
• srdce fyziologie   MeSH
• srdeční zástava * MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• pozorovací studie MeSH
• práce podpořená grantem MeSH

INTRODUCTION: Long-term use of continuous-flow left ventricular assist devices may have negative consequences for autonomic, cardiovascular and gastrointestinal function. It has thus been suggested that non-invasive monitoring of arterial pulsatility in patients with a left ventricular assist device is highly important for ensuring patient safety and longevity. We have developed a novel, semi-automated frequency-domain-based index of arterial pulsatility that is obtained during suprasystolic occlusions of the upper arm: the 'cuff pulsatility index'. PURPOSE: The purpose of this study was to evaluate the relationship between the cuff pulsatility index and invasively determined arterial pulsatility in patients with a left ventricular assist device. METHODS: Twenty-three patients with a left ventricular assist device with end-stage heart failure (six females: age = 65 ± 9 years; body mass index = 30.5 ± 3.7 kg m-2) were recruited for this study. Suprasystolic occlusions were performed on the upper arm of the patient's dominant side, from which the cuff pressure waveform was obtained. Arterial blood pressure was obtained from the radial artery on the contralateral arm. Measurements were obtained in triplicate. The relationship between the cuff pressure and arterial blood pressure waveforms was assessed in the frequency-domain using coherence analysis. A mixed-effects approach was used to assess the relationship between cuff pulsatility index and invasively determined arterial pulsatility (i.e. pulse pressure). RESULTS: The cuff pressure and arterial blood pressure waveforms demonstrated a high coherence up to the fifth harmonic of the cardiac frequency (heart rate). The cuff pulsatility index accurately tracked changes in arterial pulse pressure within a given patient across repeated measurements. CONCLUSIONS: The cuff pulsatility index shows promise as a non-invasive index for monitoring residual arterial pulsatility in patients with a left ventricular assist device across time.

• Klíčová slova
• Left ventricular assist device, non-invasive, pulsatility index,
• MeSH
• arterie patofyziologie   MeSH
• asistovaná cirkulace přístrojové vybavení   metody   MeSH
• diagnostické techniky kardiovaskulární MeSH
• krevní tlak fyziologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• podpůrné srdeční systémy * MeSH
• pulz metody   MeSH
• pulzatilní průtok fyziologie   MeSH
• reprodukovatelnost výsledků MeSH
• senioři MeSH
• srdeční selhání * patofyziologie   terapie   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

Structural studies on living cells by conventional methods are limited to low resolution because radiation damage kills cells long before the necessary dose for high resolution can be delivered. X-ray free-electron lasers circumvent this problem by outrunning key damage processes with an ultra-short and extremely bright coherent X-ray pulse. Diffraction-before-destruction experiments provide high-resolution data from cells that are alive when the femtosecond X-ray pulse traverses the sample. This paper presents two data sets from micron-sized cyanobacteria obtained at the Linac Coherent Light Source, containing a total of 199,000 diffraction patterns. Utilizing this type of diffraction data will require the development of new analysis methods and algorithms for studying structure and structural variability in large populations of cells and to create abstract models. Such studies will allow us to understand living cells and populations of cells in new ways. New X-ray lasers, like the European XFEL, will produce billions of pulses per day, and could open new areas in structural sciences.

• MeSH
• buňky MeSH
• časové faktory MeSH
• difrakce rentgenového záření * MeSH
• elektrony MeSH
• krystalografie rentgenová MeSH
• lasery * MeSH
• molekulární modely MeSH
• nanočástice MeSH
• proteiny MeSH
• pulz MeSH
• rentgenové záření MeSH
• sinice MeSH
• teoretické modely MeSH
• Publikační typ
• časopisecké články MeSH
• komentáře MeSH
• práce podpořená grantem MeSH
• Research Support, U.S. Gov't, Non-P.H.S. MeSH
• Názvy látek
• proteiny MeSH

BACKGROUND AND AIM: The objective of this research was to determine whether invasively measured central pulse pressure (PP) in patients indicated for coronarography is associated with two common polymorphisms in the ACE2 region (rs4646156 and rs4646174). METHODS: A total of 307 patients were enrolled in the study. The genotyping of both SNPs from peripheral blood samples was carried out using 5'exonuclease (Taqman®) chemistry on the ABI Prism® 7000 system (Applied Biosystems, Foster City, CA, USA). RESULTS: In both polymorphisms, the associations with central PP were found to be highly significant when all five possible genotypes in the population had been compared (p = 0.0001). In men, there was a higher incidence of previous myocardial infarction in G0 genotype carriers of rs54646174 (OR ratio = 7; p = 0.005). The AA genotype of rs4646156 had a 7.81× higher risk of severe angina pectoris in women (OR = 7.81, p = 0.05). A significant difference in allelic frequency of ACE2rs4646174 was found between women with and without significant stenoses of the circumflex branch of the left coronary artery. CONCLUSION: More research into the role of ACE2 genetic variability in PP regulations is necessary for more detailed physiological and pathophysiological comprehension of PP regulation.

• Klíčová slova
• ACE2, polymorphism, pulse pressure, severity,
• MeSH
• angiotensin konvertující enzym genetika   MeSH
• angiotensin-konvertující enzym 2 MeSH
• demografie MeSH
• dospělí MeSH
• genetická predispozice k nemoci MeSH
• jednonukleotidový polymorfismus genetika   MeSH
• kardiovaskulární nemoci diagnostické zobrazování   enzymologie   genetika   patofyziologie   MeSH
• koronární angiografie * MeSH
• krevní tlak * MeSH
• lidé středního věku MeSH
• lidé MeSH
• multivariační analýza MeSH
• pulz MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• ACE2 protein, human MeSH Prohlížeč
• angiotensin konvertující enzym MeSH
• angiotensin-konvertující enzym 2 MeSH

BACKGROUND: Ephedrine is used in treatment of hypotension during anesthesia. We investigated its effects on the psychomotor recovery and its potential adverse reactions on cardiorespiratory functions in rhesus monkeys. METHODS: The monkeys received 50 μg/kg medetomidine, 2.0 mg/kg S-ketamine with 150 IU hyaluronidase i.m. Pulse rate, blood pressure and saturation of haemoglobin were monitored for 20 minutes. Thereafter, 1 mg/kg of ephedrine or a placebo was administered i.m. and behavioural changes, pulse rate, blood pressure and saturation of haemoglobin were monitored every 5 minutes. RESULTS: Ephedrine shortened recovery from anaesthesia from 80.4 ± 25.8 to 14.83 ± 13.70 minutes. Ephedrine also increased oxygen saturation of haemoglobin and systolic blood pressure and caused significant decrease in pulse rate 5 minutes after its administration. CONCLUSIONS: Ephedrine can be successfully used to accelerate psychomotor recovery after the use of common anesthetic protocols combining dissociative anesthetic agent and alpha 2-adrenoceptor agonist in primates.

• MeSH
• adrenergní látky farmakologie   MeSH
• anestetika disociativní MeSH
• efedrin farmakologie   MeSH
• hypnotika a sedativa MeSH
• ketamin MeSH
• krevní tlak účinky léků   MeSH
• Macaca mulatta MeSH
• medetomidin MeSH
• probouzení z anestezie * MeSH
• psychomotorický výkon účinky léků   MeSH
• pulz MeSH
• zvířata MeSH
• Check Tag
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• adrenergní látky MeSH
• anestetika disociativní MeSH
• efedrin MeSH
• hypnotika a sedativa MeSH
• ketamin MeSH
• medetomidin MeSH

PURPOSE: Proper identification of the cardiac cycle is essential for gated SPECT myocardial perfusion imaging. We have developed an alternate method of ECG for gating, that is, using the peripheral pulse wave (PW) as the triggering signal for gated SPECT acquisition. The aim of this study is to compare the use of this method of gating with the standard ECG trigger. METHODS: We tested the PW triggering by comparing it with the ECG trigger. We evaluated 33 patients (25 males, 8 females), average age of 61 years (39-80) referred for stress myocardial perfusion imaging. Data from all patients were acquired twice and were processed by CEqual and QGS software. We compared the left ventricular ejection fraction (LVEF), end-diastolic and end-systolic volumes (EDV, ESV). Paired t test and Pearson correlation coefficient were used for comparison. RESULTS: The mean LVEF, EDV, and ESV calculated with the ECG trigger were 0.52, 120, and 64, respectively, those with the pulse-wave trigger were 0.48, 126, and 71, respectively. Mean paired difference for LVEF was -0.034 (P<0.001), for EDV 5.9 (P=0.012), and for ESV 7.9 (P<0.001). Pearson correlation coefficient for LVEF was 0.955, for EDV 0.987, and for ESV 0.991 (P<0.001 for all correlations). CONCLUSION: Triggering of gated-data acquisition by the PW is feasible. Quantitative parameters of cardiac function correlate highly with those obtained from the ECG trigger and the absolute differences are not clinically significant across a wide range of values.

• MeSH
• elektrokardiografie MeSH
• funkce levé komory srdeční MeSH
• jednofotonová emisní výpočetní tomografie metody   MeSH
• lidé středního věku MeSH
• lidé MeSH
• počítačové zpracování signálu * MeSH
• pulz metody   MeSH
• srdeční akcí synchronizované zobrazovací metody metody   MeSH
• tepový objem MeSH
• zobrazování myokardiální perfuze metody   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

INTRODUCTION: The incidence of subclinical organ damage is higher in patients with hypertension (HT) and metabolic syndrome (MS). Increased aortic pulse wave velocity (PWV) is one the markers reflecting subclinical arterial damage. Treatment with sartans leads not only to a reduction of blood pressure but may also bring regression of the subclinical damage. Long-acting sartans (telmisartan) may be more effective than sartans with medium duration of action (losartan); the aim of this research was to compare the impact of hypertension therapy with losartan and telmisartan on aortic pulse wave velocity (Ao-PWV). METHODS: We examined 32 patients with HT and MS, 15 patients were treated with losartan 50 mg (group A) and 17 patients were treated with telmisartan 80 mg (group B). At the beginning and the end of the study, PWV was measured using the Complior method and 24-hour BP monitoring and biochemistry testing were carried out. RESULTS: Treatment with sartans led to a reduction in BP in both groups, daytime BPs/BPd declined by 11.5/9.0 mm Hg in group A and by 13.8/8.1 mm Hg in group B, respectively, and night time BP declined by 5.7/5.1 mm Hg in group A compared to 7.4/3.89 mm Hg in group B. Aortal pulse wave velocity declined by 1.94 m/s in group A (p < 0.001) and by 0.46 m/s in group B (p < 0.001), respectively. CONCLUSION: Treatment with losartan as well as telmisartan resulted in reduced values of BP and Ao-PWV. We did not prove a more significant effect of a long-acting sartan (telmisartan) compared to a sartan with a medium duration of action (losartan) on Ao-PWV reduction after 1 year of treatment.

• MeSH
• aorta * MeSH
• blokátory receptorů AT1 pro angiotensin II terapeutické užití   MeSH
• hypertenze farmakoterapie   patofyziologie   MeSH
• krevní tlak MeSH
• lidé středního věku MeSH
• lidé MeSH
• metabolický syndrom farmakoterapie   patofyziologie   MeSH
• pulz * MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• blokátory receptorů AT1 pro angiotensin II MeSH

The aim of the study was to evaluate arterial stiffness and its modulating factors measured by carotid-femoral pulse wave velocity (PWV) and central augmentation index (AI) in patients with pheochromocytoma (PHEO) before and after surgery. Forty-five patients with PHEO and 45 healthy controls were investigated using an applanation tonometer (SphygmoCor, AtCor Medical). The gender, age, BMI and lipid profiles were comparable among both groups. The main difference in basic characteristic was as expected for fasting plasma glucose (P<0.001) and all blood pressure modalities. PWV in PHEO was significantly higher than in controls (7.2+/-1.4 vs. 5.8+/-0.5 ms(-1); P<0.001). Between-group difference in PWV remained significant even after the adjustment for age, heart rate, fasting plasma glucose and each of brachial (P<0.001) and 24 h blood pressure parameters (P<0.01). The difference in AI between groups did not reach the statistical significance (19+/-14 vs. 16+/-13%; NS). In multiple regression analysis, age (P<0.001), mean blood pressure (P=0.002), high-sensitive C-reactive protein (hs-CRP) (P=0.007) and 24 h urine norepinephrine (P=0.007) were independently associated with PWV in PHEO. In addition, 27 patients with PHEO were studied 1 year after tumor removal. Successful tumor removal led to a significant decrease in PWV (7.0+/-1.2 vs. 6.0+/-1.1 ms(-1); P<0.001). In conclusion, patients with PHEO have an increase in PWV, which is reversed by the successful tumor removal. Age, mean blood pressure, hs-CRP and norepinephrine levels are independent predictors of PWV.

• MeSH
• adrenalektomie * MeSH
• arterie patofyziologie   MeSH
• cévní rezistence fyziologie   MeSH
• dospělí MeSH
• feochromocytom patofyziologie   chirurgie   MeSH
• index tělesné hmotnosti MeSH
• krevní glukóza MeSH
• krevní tlak fyziologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• nádory nadledvin patofyziologie   chirurgie   MeSH
• neparametrická statistika MeSH
• pulz MeSH
• pulzatilní průtok fyziologie   MeSH
• rychlost toku krve fyziologie   MeSH
• senioři MeSH
• srdeční frekvence fyziologie   MeSH
• věkové faktory MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• krevní glukóza MeSH

BACKGROUND: Problems concerning treatment of patients with haemophilia are long-term and exist even in the present days. Thanks to interdisciplinary complex therapy the results of treatment are constantly better than many years ago. AIM: The goal of this study is to analyse the current state of management of haemophilia and to suggest a comprehensive concept of rational and effective rehabilitation of children with haemophilia. METHOD: In the clinical study, two different measurements were used (goniometry and functional step test) and a special questionnaire. Four different groups of participants were created for the clinical measurements (a set of patients and a control group) and for the questionnaire (a set of patients and a control group). RESULTS: This study concluded that there were no significant differences in the outcomes of the goniometry and the step test, and in the restriction of movement activities between the patients and healthy individuals. CONCLUSIONS: The concept of physiotherapy in patients with coagulopathies in the Czech Republic is comparable with rehabilitation concepts in other European and non-European countries. Current rehabilitation care is of good quality and necessary for effective lifelong therapy of haemophilia, however, it is used insufficiently.

• MeSH
• dítě MeSH
• hemofilie A patofyziologie   rehabilitace   MeSH
• lidé MeSH
• mladiství MeSH
• pulz MeSH
• rozsah kloubních pohybů * MeSH
• tělesná výkonnost * MeSH
• zátěžový test MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• mladiství MeSH
• Publikační typ
• časopisecké články MeSH