The aim of the study was to establish the frequency of hypovitaminosis D in children with type 1 diabetes mellitus (T1D), its influence on biochemical and densitometric parameters and the relation to diabetic nephropathy. 58 children with T1D at the age 9–19 years were enrolled to the study. Vitamin D concentration less than 30 ng/ml was considered as insufficient. 37 children (63.79%) had vitamin D level under 30 ng/ml, from these 19 subjects (32.7%) had vitamin D level under 20 ng/ml and 2 subjects (3.44%) under 10 ng/ml. Children with vitamin D deficiency had significantly lower magnesium concentration and lower Z score of lumbar spine (−1.34 ± 1.24 vs. −0.30 ± 1.21, p = 0.01) compared to diabetics with sufficient vitamin D concentration. No significant difference was found in parameters calcium, phosphorus or glycosylated hemoglobin. Patients with diabetic nephropathy (n = 18) showed no significant difference in vitamin D, glycosylated hemoglobin or Z score of lumbar spine compared to the patients without nephropathy (n = 40). Subjects with nephropathy had significantly longer diabetes duration, significantly higher cholesterol and triacylglycerol concentration. In our cohort of patients nearly two thirds of children had insufficient vitamin D concentration what supports the need to monitor and eventually supplement vitamin D in T1D subjects., Jarmila Vojtková, Miriam Čiljaková, Lenka Vojarová, Katarína Janíková, Zuzana Michnová, Veronika Šagiová, and Literatura 35
Prezentujeme kazuistiku pacientky s iatrogenní lézí levého močovodu, u které byla diagnóza stanovena po měsíci od gynekologické operace. Hlavními příznaky, kterých si pacientka všimla, byly zvětšující se objem břicha a difuzní bolesti v bříšní oblasti. I přes provedené CT-IVU diagnóza nebyla stanovena. Až senzitivnější ascendentní ureteropyelografie prokázala lézi močovodu. Při nejasnostech je vždy vhodné provedení nejcitlivější diagnostické metody, We present a case report of a patient with an iatrogenic lesion of the left ureter diagnosed one month after gynecological surgery. The main symptoms were abdominal distension and abdominal pain. A CT-IVP was not diagnostic. Only a subsequent reterograde urogram was more sensitive and demonstrated a ureteric lesion. It is always advisable to perform the most sensitive diagnostic methods when in doubt., Jakub Szewczyk, Jan Krhut, Henryk Fikoczek, Ivana Kalusková, and Literatura
Viral hepatitis B and C is a relevant issue because of high prevalence and degree of chronicity, late diagnosis and poor prognosis. Today, protein products of numerous genes are involved in the pathogenesis of viral pathology of the liver. In this review, the authors analysed 42 literature sources on genetic basis of susceptibility to various infectious diseases. Study of the role of immunogenetic factors is of great practical importance to develop methods for predicting outcomes of viral hepatitis., Khamid Karimov, Sevara Azimova, Bakhtiyor Iriskulov, and Literatura
We report the case of a 52year old man with severe acute pancreatitis. In this case report we discuss the undesirable effects of parenteral nutrition and the importance of nutritional support at patients with severe necrotizing pancreatitis. Severe acute pancreatitis is usually accompanied by systemic inflammatory response syndrome, which results in hypermetabolism with prominent protein catabolism. Providing nutrition to these patients is of paramount importance. An adequate nutritional support is crucial in patients with severe and complicated pancreatitis. A negative energy balance has a negative impact on the nutritional status and the disease progression., Shpata Vjollca, Kuneshka Loreta, Kurti Floreta, Ohri Ilir, and Literatura
Birth rate regulation is a major problem of modern medicine. Unfortunately, frequency of artificial abortions is still high not only in developing, but also in developed countries. Abortion results in severe gynecologic and endocrine complications in the woman’s body (Alieva, 2001). Use of intrauterine devices (IUDs) is a most effective method of contraception. A great number of studies in the field of utilization and possible complications of IUDs revealed the occurrence of inflammatory diseases of small pelvis organs (IDSPO). Andizhan (Uzbekistan). Duration of patients’ follow-up ranged 40 days to 6 months. Women did not have contraindications for IUDs according to WHO medical eligibility criteria. Blood was a material for study; it was taken in 40 days, 3 and 6 months following IUD insertion. After insertion of copper IUDs to women, a cytokine cascade was studied in dynamics. in this test system made 4 pg/ml. During the study, the women of the test group showed increased proinflammatory cytokines. The further study of vaginal smears confirmed development of bacterial vaginoses in them that suggests a relation of complications due to IUDs with imbalance of the cytokine cascade. Elevated serum concentration of cytokines was revealed in women with IUDs already on the first days of their application. European Medical, Health and Pharmaceutical Journal ISSN 1804-5804 Sharp increase in IL-1 on days 40 and 90 after insertion of IUDs is associated with presence of complications in the form of expulsions and possible development of inflammatory diseases of small pelvis organs., Umida Yusupova, Farida Ayupova, and Literatura
To study efficiency of the combined treatment of advanced gastric cancer with inclusion Trastuzumab. Material: We present the intermediate analysis of the use of target therapy with Trastuzumab in patients with a HER2positive gastric cancer. Up to 01.10.2009y 118 patients have been tested for HER2 expression, and in 24 gastric cancer patients it is revealed HER2positive status of tumor. It is lead chemotherapy to all patients by the PLF regimen and Herceptin in doze 6 mg/kg once in 3 weeks (6 cycles). In control group in 26 patients it is lead only chemotherapy by the PLF regimen once in 3 weeks without addition Trastuzumab (6 cycles). Results: At the moment of the analysis of preliminary data, the median remission duration in compared groups has made 8.3 months, and 5.2 months, accordingly. Conclusion: At advanced gastric cancer with high level HER2 expression Trastuzumab increases frequency of objective effect and the median remission duration., M. D. Juraev, D. M. Egamberdiev, S. S. Khudayorov, H. N. Tuyev, and Literatura
Rozvoj v oblasti prenatální a neonatální medicíny stále častěji umožňuje dětem, které by bývaly zemřely, aby přežily a vedly zdravý život. Stejný pokrok ve vědě zároveň opakovaně vyvolává etická, sociální a právní dilemata pro ty rodiny a zdravotnické profesionály, kteří jsou postaveni před komplexní volby, které mohou mít celoživotní následky nejen pro samotné dítě, ale i pro jejich okolí. Stále znovu se objevují otázky týkající se hodnoty lidského života v různých fázích jeho vývoje, rozdílu mezi aktivním ukončením lidského života a smrtí, jež je následkem nezapočetí života zachraňující léčby nebo odstoupení od ní, a balancování mezi nejlepším zájmem dotčeného dítěte, jeho rodičů a potřeb dalších sociálních skupin. Ve Spojeném království se od počátku osmdesátých let objevují případy zabývající se otázkou, za jakých podmínek je přípustné, aby rodiče, lékaři případně soudy rozhodly, že by těžce malformovaným dětem neměla být poskytnuta život zachraňující léčba. Článek se zabývá nejen analýzou některých případů z prostředí britského soudnictví, ale také doporučením Nuffield Council on Bioethics v souvislosti s touto problematikou. Představuje nejčastější dilemata, která se objevují v praxi a to, jakým způsobem jsou řešeny v rovině právní v souladu anglickým common law., Development in fetal and neonatal medicine enabled children who previously would have died to survive and lead healthy lives. The same developments also arise ethical, social and legal dilemmas for those families and health professionals who are faced with complex decisions that may have lifelong consequences not only for the children but also for their relatives. The ethical issues concern the value of human life at different stages of development, distinction between active ending of life and death resulting from withholding or withdrawing care or balancing the interests of affected children, their families and needs of other social groups. In the United Kingdom there have been several cases since early 1980s which centred on issue as to whether there are circumstances that permit parents, doctors or the courts to take a decision that a severly malformed children should not be provided with life-saving treatment. The paper provides a brief legal analysis of several British cases and also analysis of Nuffield Council on Bioethics guidelines regarding this issue from an ethical point of view. It introduces the most common dilemmas which occure in practice and the way these dilemmas are solved under English common law., Barbora Vráblová, and Literatura
Toto zvláštní monotematické číslo časopisu se věnuje problematice infanticidy a kritických rozhodnutí na počátku života., This special issue of Journal of Medical Law and Bioethics is mono-thematic and focuses on the problems of infanticide and Critical Decisions at the Beginning of Life., and Tomáš Doležal, Adam Doležal