BACKGROUND AND OBJECTIVE: Monitoring of renal function in cystic fibrosis (CF) patients is essential. The dosage regimen of amikacin is regularly modified according to the patient's glomerular filtration rate (GFR). The aim of the study was to evaluate the use of cystatin C (CyC) for monitoring amikacin therapy along with other markers of renal tubular and glomerular function, and damage [N-acetyl-beta-d glucosaminidase (NAG), creatinine level and creatinine clearance]. METHODS: We compared the GFR, estimated from the serum concentrations of creatinine (Cockcroft-Gault formula) and CyC (Grubb's formula). Seventy-one patients (mean age 12 years; range 4-28 years) with CF were treated by intermittent intravenous infusion of amikacin. Tubular nephrotoxicity was investigated by measurement of urine NAG/urine creatinine ratio (U-NAG/U-creatinine). Concentrations of all markers were measured before starting amikacin therapy and at days 3, 5, 7, 10 and 12. Fluorescence polarization analysis, turbidimetry, enzymatic phototometric creatinine deaminase method and fluorimetry were used for determination of serum amikacin, serum CyC, creatinine and urine NAG activity. Receiver operating characteristic (ROC) analysis was performed to assess the influence of GFR estimated from serum creatinine and serum CyC for the prediction of amikacin clearance during aminoglycoside therapy. RESULTS: Significant differences in the rate of U-NAG/U-creatinine were noted before and after treatment with amikacin (P < 0.001). Serum creatinine levels and creatinine clearance at the end of amikacin therapy (12th day) did not show any significant differences in comparison with the levels measured before the start of therapy (0th day). At days 5, 7, 10 and 12, serum CyC levels showed a significant elevation (P < 0.001), and CyC clearance showed a significant decrease (P < 0.001) in comparison with the levels measured at day 0. The ratio of amikacin clearance/creatinine clearance decreased with therapy whereas the amikacin clearance/CyC and amikacin clearance/CyC clearance increased. CONCLUSION: We showed that the rate of U-NAG/U-creatinine is a suitable marker for monitoring tubular nephrotoxicity in CF patients. Serum creatinine and estimated creatinine clearance are modest predictors of GFR in CF patients. CyC appears to be a better marker of GFR than serum creatinine concentration or creatinine clearance in our study. Serum CyC levels and CyC clearance showed greater ability to predict amikacin clearance during therapy than creatinine clearance.

• MeSH
• acetylglukosaminidasa moč   MeSH
• amikacin aplikace a dávkování   farmakokinetika   farmakologie   MeSH
• antibakteriální látky aplikace a dávkování   farmakokinetika   farmakologie   MeSH
• biologické markery krev   MeSH
• časové faktory MeSH
• cystatin C MeSH
• cystatiny krev   MeSH
• cystická fibróza krev   farmakoterapie   MeSH
• dítě MeSH
• dospělí MeSH
• hodnoty glomerulární filtrace * MeSH
• intravenózní infuze MeSH
• kreatinin krev   moč   MeSH
• ledviny účinky léků   patologie   MeSH
• lidé MeSH
• mladiství MeSH
• monitorování léčiv MeSH
• předškolní dítě MeSH
• ROC křivka MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• předškolní dítě MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• klinické zkoušky MeSH
• srovnávací studie MeSH
• Názvy látek
• acetylglukosaminidasa MeSH
• amikacin MeSH
• antibakteriální látky MeSH
• biologické markery MeSH
• CST3 protein, human MeSH Prohlížeč
• cystatin C MeSH
• cystatiny MeSH
• kreatinin MeSH

BACKGROUND: Hyperchloremia produces renal vasoconstriction and fall in glomerular filtration rate. In 90% of brain-dead organ donors, diabetes insipidus develops, characterized by inappropriate diuresis, hyperosmolality, and hyperchloremia. The aim of this study was to determine the relationship between the serum concentration of chlorides of the donor and the onset of the function of the kidney allograft in the recipient. METHODS: We retrospectively studied 213 donors and kidney allograft recipients. Serum creatinine concentrations and glomerular filtration rates on the 1st, 7th, and 30th days after transplantation of the recipients from hyperchloremic donors were compared with the recipients from normochloremic donors, as well as the incidences of acute tubular necrosis and delayed graft function. RESULTS: On the 1st day, serum creatinine concentrations of the recipients from hyperchloremic and normochloremic donors, respectively, were 448.2 ± 212.1 μmol/L and 502.2 ± 197.8 μmol/L (P = .1), on the 7th day, 168.6 ± 102.6 μmol/L and 196.9 ± 120.6 μmol/L (P = .13), and on the 30th day, 129.4 ± 43.3 μmol/L and 131.8 ± 43.6 μmol/L (P = .73). The differences were statistically significant. The groups also did not differ significantly in glomerular filtration rates and incidences of acute tubular necrosis and delayed graft function. CONCLUSIONS: In this study, no significant correlation between serum chloride concentrations of the organ donors and the onset of the function of kidney allografts in the recipients was found.

• MeSH
• acidóza komplikace   patofyziologie   MeSH
• akutní tubulární nekróza krev   epidemiologie   etiologie   MeSH
• alografty patofyziologie   MeSH
• chloridy krev   fyziologie   MeSH
• dárci tkání * MeSH
• dospělí MeSH
• hodnoty glomerulární filtrace MeSH
• incidence MeSH
• kreatinin krev   MeSH
• ledviny patofyziologie   MeSH
• lidé MeSH
• mozková smrt patofyziologie   MeSH
• opožděný nástup funkce štěpu krev   epidemiologie   etiologie   MeSH
• pooperační komplikace krev   epidemiologie   etiologie   MeSH
• retrospektivní studie MeSH
• transplantace ledvin * MeSH
• vyšetření funkce ledvin MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• chloridy MeSH
• kreatinin MeSH

OBJECTIVE AND DESIGN: Hightone external muscle stimulation (HTEMS) ameliorates pain and discomfort of patients with polyneuropathy. Since some patients reported about an urge to urinate during these treatments, the potential effects of HTEMS application on renal function were investigated. For this purpose in healthy subjects, we analyzed in the current study the acute effects of electrotherapy on parameters of renal function. INTERVENTIONS: 24 healthy volunteers (14 women and 10 men), mean age 26 ± 4 years, were enrolled. The protocol was composed of a run-in period, a pre-treatment period, the active HTEMS treatment period of both lower extremities and the post-treatment period. The duration of each period was 60 min. Urine collection and blood samples were taken at the beginning and end of each period. To achieve a sufficient diuresis, the fluid intake was adapted to the amount of diuresis. Parameters of renal function included diuresis, glomerular filtration rate (endogenous creatinine clearance) and absolute and fractional sodium excretion. Moreover blood pressure and heart rate were monitored. RESULTS: HTEMS led to a significant increase of creatinine clearance and fractional sodium excretion which was limited to the active treatment period. CONCLUSION: These findings show for the first time that HTEMS can transiently increase glomerular filtration rate associated with a decreased tubular sodium reabsorption. The underlying mechanisms are to be elucidated.

• MeSH
• diuréza fyziologie   MeSH
• dospělí MeSH
• elektrostimulační terapie metody   MeSH
• hodnoty glomerulární filtrace fyziologie   MeSH
• kosterní svaly inervace   fyziologie   MeSH
• krevní tlak fyziologie   MeSH
• ledviny fyziologie   MeSH
• lidé MeSH
• mladý dospělý MeSH
• močení fyziologie   MeSH
• pilotní projekty MeSH
• prospektivní studie MeSH
• referenční hodnoty MeSH
• sodík moč   MeSH
• srdeční frekvence fyziologie   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• klinické zkoušky MeSH
• Názvy látek
• sodík MeSH

End-stage kidney disease is preferably treated by kidney transplantation. The suboptimal function of the allograft often results in misbalances in kidney-controlled processes and requires long-term monitoring of allograft function and viability. As the kidneys are organs with a very high metabolomic rate, a metabolomics approach is suitable to describe systematic changes in post-transplant patients and has great potential for monitoring allograft function, which has not been described yet. In this study, we used blood plasma samples from 55 patients after primary kidney transplantation identically treated with immunosuppressants with follow-up 50 months in the mean after surgery and evaluated relative levels of basal plasma metabolites detectable by NMR spectroscopy. We were looking for the correlations between circulating metabolites levels and allograft performance and allograft rejection features. Our results imply a quantitative relationship between restricted renal function, insufficient hydroxylation of phenylalanine to tyrosine, lowered renal glutamine utilization, shifted nitrogen balance, and other alterations that are not related exclusively to the metabolism of the kidney. No link between allograft function and energy metabolism can be concluded, as no changes were found for glucose, glycolytic intermediates, and 3-hydroxybutyrate as a ketone body representative. The observed changes are to be seen as a superposition of changes in the comprehensive inter-organ metabolic exchange, when the restricted function of one organ may induce compensatory effects or cause secondary alterations. Particular differences in plasma metabolite levels in patients with acute cellular and antibody-mediated allograft rejection were considered rather to be related to the loss of kidney function than to the molecular mechanism of graft rejection since they largely follow the alterations observed by restricted allograft function. In the end, we showed using a simple mathematical model, multilinear regression, that the basal plasmatic metabolites correlated with allograft function expressed by the level of glomerular filtration rate (with creatinine: p-value = 4.0 × 10-26 and r = 0.94, without creatinine: p-value = 3.2 × 10-22 and r = 0.91) make the noninvasive estimation of the allograft function feasible.

• Klíčová slova
• NMR plasma metabolomics, allograft function, kidney transplantation,
• Publikační typ
• časopisecké články MeSH

BACKGROUND: The number of older people with cognitive impairment is increasing worldwide. Impaired lung function might be associated with cognitive decline in older age; however, results from large longitudinal studies are lacking. In this study, we examined the longitudinal associations between pulmonary function and the trajectories of cognitive decline using prospective population-based SHARE data from 14 countries. METHODS: The analytic sample included N = 32,049 older adults (Mean age at baseline = 64.76 years). The dependent variable was cognitive performance, measured repeatedly across six waves in three domains: verbal fluency, memory, and numeracy. The main predictor of interest was peak expiratory flow (PEF). The data were analyzed in a multilevel accelerated longitudinal design, with models adjusted for a variety of covariates. RESULTS: A lower PEF score was associated with lower cognitive performance for each domain as well as a lower global cognitive score. These associations remained statistically significant after adjusting for all covariates Q4 vs Q1 verbal fluency: unstandardized coefficient B = -3.15; numeracy: B = -0.52; memory: B = -0.64; global cognitive score B = -2.65, all p < .001). However, the PEF score was not found to be associated with the rate of decline for either of the cognitive outcomes. CONCLUSIONS: In this large multi-national longitudinal study, the PEF score was independently associated with lower levels of cognitive functions, but it did not predict a future decline. The results suggest that pre-existing differences in lung functions are responsible for variability in cognitive functions and that these differences remained stable across aging.

• Klíčová slova
• Cognitive decline, Cross-cultural, Longitudinal, Peak expiratory flow, Pulmonary function,
• MeSH
• kognice MeSH
• kognitivní dysfunkce * epidemiologie   MeSH
• lidé MeSH
• longitudinální studie MeSH
• plíce MeSH
• prospektivní studie MeSH
• senioři MeSH
• stárnutí * psychologie   MeSH
• Check Tag
• lidé MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH

Spirometric parameters were measured in 49 patients with reduced renal function. The patients were divided according to their glomerular filtration rate (GFR) into two groups: (A) GFR < 0.2 ml s-1-end stage renal failure; (B) GFR > or = 0.2 ml s-1. FEV1 and FEF25-75 were significantly lower in the end-stage renal failure group of patients. 80% of the patients with GFR < 0.2 ml s-1 and 31% of the patients with GFR > or = 0.2 ml s-1 had spirometric evidence of small airways dysfunction. In multiple stepwise regression analysis with ventilatory parameters as dependent variables and renal function, total protein, urea, creatinine, sodium, and hemoglobin levels, proteinuria, diuresis, and history of left ventricular failure as independent variables only GFR and total protein correlated significantly with FEV1 and FEF25. In conclusion, our study demonstrates that impairment of spirometric function in patients with renal insufficiency is continual, with reduction of GFR, and thus small airways dysfunction may be expected not only in patients with end-stage renal failure, but also in those with moderate GFR reduction.

• MeSH
• chronické selhání ledvin patofyziologie   MeSH
• dospělí MeSH
• hodnoty glomerulární filtrace fyziologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• měření objemu plic MeSH
• plíce patofyziologie   MeSH
• respirační insuficience patofyziologie   MeSH
• senioři MeSH
• spirometrie * MeSH
• vyšetření funkce ledvin MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

OBJECTIVE: To investigate sexual function and subjective attitudes towards surgery in adult women after feminizing genitoplasty (FG) for congenital adrenal hyperplasia (CAH). MATERIALS AND METHODS: We retrospectively reviewed the medical files of patients who underwent FG from 1996 to 2018. Of those, patients older than 16 years of age were asked to answer non-standardized questions aiming at the awareness of genital surgery and standardized questionnaire evaluating sexual function (GRISS). The anonymized answers were compared to a control group of 50 healthy females. Student's t-test, Pearson's χ2 test, Fisher's exact test and Spearman's rank correlation coefficient were performed. A P-value less than 0.05 was considered significant. RESULTS: Out of 106 patients who underwent FG, 64 were included, 55 successfully contacted and 32, aged 17-40 years (median 25.5), answered the questionnaires (58% response rate). In all, 11 patients underwent historical clitorectomy in early childhood by a pediatric gynecologist before 1996 and pull-through vaginoplasty at puberty. A total of 21 patients underwent modern one- or two-staged FG. There were statistically significant differences between the CAH group and controls as to the proportion living in committed partnerships (28% and 84%, respectively; p = 0.0000), having sexual intercourse (41% and 92%, respectively; p = 0.0000) and having their own children (13% and 36%, respectively; p = 0.0369). The median overall GRISS score was 4 (range 1-7) in the CAH group compared to 1 (range 1-9) in the control group, with infrequency and vaginismus representing the least favorable subscales (median 5). In all, 81% of the women operated on for CAH would recommend such an operation to any other individual with CAH and 66% of them suggested the surgery should be performed in early childhood. DISCUSSION: By this study we have contributed to the debate over suggestions that FG may cause adverse effects on sexual life of the patients in adulthood, beside already published effects on their mental well-being and LUTS. Despite possible selection bias due to only 58% response rate the comparison with control group shows only a moderate sexual dysfunction and more significant impact on long-term partnership that might be caused by other factors related to CAH beside FG itself. CONCLUSIONS: Partnership, offspring, sexual frequency and function were impaired in adult females with CAH after FG. However, the median GRISS score was below the pathological level of 5.

• Klíčová slova
• Adrenal hyperplasia, Congenital, Feminizing genitoplasty, Sexual function,
• MeSH
• dítě MeSH
• dospělí MeSH
• gynekologické chirurgické výkony MeSH
• kongenitální adrenální hyperplazie * chirurgie   MeSH
• lidé MeSH
• mladiství MeSH
• předškolní dítě MeSH
• retrospektivní studie MeSH
• sexuální chování MeSH
• urogenitální chirurgické výkony MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• lidé MeSH
• mladiství MeSH
• předškolní dítě MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

OBJECTIVES: Information on renal function required before specified radiological examinations with contrast agents is usually obtained through prediction equations using serum creatinine and anthropometric data. The aim of our study was to demonstrate discrepancy between poor prediction and good diagnostic accuracy of glomerular filtration rate (GFR) estimated by prediction equations. METHODS: In 50 patients, reference GFR was measured as plasma clearance of 51-chromium labeled ethylene-diamine-tetraacetic-acid (51Cr-EDTA) and compared with GFR assayed by creatinine clearance (CC) and estimated by Cockcroft-Gault prediction equation (CG). For comparisons, CC and CG were considered as continuous, categorical, and binary variables. Accuracy of the reference GFR prediction was expressed in terms of prediction errors and diagnostic accuracy indices. RESULTS: As continuous variable, CG estimated individual values of GFR with large prediction error exceeding that of CC. As categorical variable, it classified the patient stage of chronic kidney disease (CKD) with medium diagnostic accuracy of 74% (CKD 3) and 62% (CKD 4). As binary variable, CG classified individual patient's GFR below 30 and 60 ml/min/1.73 m2 with good diagnostic accuracy of 80 and 94%, respectively. Performance of other prediction equations did not significantly differ from CG. CONCLUSIONS: Despite large variance and poor prediction accuracy of individual GFR estimates, most of them correctly classified individual patient's GFR below specified level. Results of prediction equations thus should be used and reported exclusively as binary variables, while numerical values of GFR, if required, should be measured by more accurate radionuclide or laboratory methods. KEY POINTS: • Radiological guidelines on contrast media require estimation of glomerular filtration rate to assess kidney function before specified contrast examinations. • Estimated glomerular filtration rate is obtained through prediction equations using serum creatinine and anthropometric data as predictors. • While numerical estimates of glomerular filtration rate are inaccurate (their prediction accuracy is poor), diagnostic accuracy of binary estimates (ability to classify patient's glomerular filtration rate below or above a specified level) is very good.

• Klíčová slova
• Contrast media, Creatinine, Glomerular filtration rate, Kidney function tests,
• MeSH
• chronická renální insuficience krev   diagnóza   patofyziologie   MeSH
• dospělí MeSH
• hodnoty glomerulární filtrace fyziologie   MeSH
• injekce intravenózní MeSH
• kontrastní látky aplikace a dávkování   MeSH
• kreatinin krev   MeSH
• ledviny diagnostické zobrazování   metabolismus   patofyziologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• radiografie metody   MeSH
• reprodukovatelnost výsledků MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• kontrastní látky MeSH
• kreatinin MeSH

In some taxa, males perform multiple ejaculations, which may function in sperm competition or in maintaining a baseline density of spermatozoa in the female reproductive tract to ensure fertilization, a process that has been termed 'topping up'. We investigated the function of multiple ejaculations in two species of bitterling, the European bitterling (Rhodeus amarus) and Chinese rose bitterling (Rhodeus ocellatus). Bitterling oviposit in living freshwater mussels, with fertilization taking place within the mussel gill cavity. Thus, although fertilization is external, the mussel is analogous to the female reproductive tract in an internally fertilizing species. We measured the frequency of ejaculations and mussel inspections by individual males of two bitterling species in 28 replicated mesocosms and examined focal male responses to rival ejaculations and the presence of females in spawning condition. We used a model of ejaculatory behaviour to simulate the temporal abundance of spermatozoa in mussels. Male R. amarus exhibited high rates of ejaculation and inspection of the siphons of mussels and increased their ejaculation rate in response to the presence of females in spawning condition. Rhodeus ocellatus showed lower overall rates of ejaculation, but significantly elevated ejaculation rate in response to rival ejaculations. The ejaculatory strategy of R. amarus is one that maintains a minimum level of spermatozoa in mussels, which is elevated when the probability of oviposition increases. In contrast, R. ocellatus engages more directly in sperm competition with rivals. We discuss these results in the context of the function of multiple ejaculations and male mating tactics.

• Klíčová slova
• Acheilognathinae, alternative mating tactics, fertilization, mating system, sneaking, sperm competition, territoriality,
• MeSH
• biologické modely MeSH
• Cyprinidae fyziologie   MeSH
• ejakulace fyziologie   MeSH
• kladení vajíček MeSH
• sexuální chování zvířat fyziologie   MeSH
• spermie fyziologie   MeSH
• zvířata MeSH
• Check Tag
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

The article presents a method of developing a mathematical model of the arc surfacing process performed using the self-shielded flux-cored filler metal wire with the chromium cast iron (Fe15) weld deposit. A three-level design (static, determined, and complete) was used to determine the function of the test object, thus enabling the simulation of deposition rate in relation to wire feed speed and electrode extension. The deposition rate for the specified set of surfacing parameters amounted to between 4.31 kg/h and 11.25 kg/h. The study was also concerned with identifying the effect of the significance level of test factors and interactions between them on the resultant factor, as well as an assessment of the adequacy of the test object function. In relation to significance level α = 0.01, regression coefficients b0, b1, b2, and b11 significantly affected the deposition rate of the surfacing process. Coefficient b22 was significant at a level of 0.40, whereas coefficient b12 was significant at a level of 0.15. The mathematical model presenting the effect of wire feed speed and electrode extension, as well as interactions between them on the deposition rate of the surfacing process, was adequate for the adopted level of significance α = 0.05.

• Klíčová slova
• deposition rate, flux-cored wire, mathematical model, surfacing, three-level design,
• Publikační typ
• časopisecké články MeSH