Obesity is a strong cardiometabolic (CM) risk factor in children. We tested potential CM risk in obese/overweight children and the effect of an intensive lifestyle intervention using newer CM markers: atherogenic index of plasma AIP [Log(TG/HDL-C)], apoB/apoAI ratio and a marker of insulin resistance HOMA-IR. The participants (194 girls, 115 boys, average age 13) were enrolled in an intensive, one-month, inpatient weight reduction program. The program consisted of individualised dietary changes and the exercise program comprised aerobic and resistance training. Anthropometrical and biochemical parameters in plasma and CM risk biomarkers - (AIP, apoB/apoAI ratio and HOMA-IR) were examined before and after the intervention. AIP and HOMA-IR significantly correlated with BMI while apoB/apoAI ratio did not. Only AIP and HOMA-IR showed systematic increases according to the level of obesity by BMI quartiles. Lifestyle intervention significantly improved anthropometrical and biochemical values and the biomarkers too. The response of lipid parameters to the intervention was considerably higher in boys than in girls. The children were stratified into three risk categories according to AIP, where 13.8 % of boys and 5.3 % of girls fell into high risk category. The monitored biomarkers may complement each other in the prognosis of CM risk. AIP was strongly related to obesity and to lipid and glycid metabolism, while the relationship of the apoB/apoAI ratio to obesity and glycid metabolism was not significant. The obese children benefited from the intensive lifestyle intervention which improved the anthropometrical and biochemical parameters and CM risk biomarkers., M. Vrablík, M. Dobiášová, L. Zlatohlávek, Z. Urbanová, R. Češka., and Obsahuje bibliografii
Primary graft dysfunction (PGD) is a life-threatening complication among heart transplant recipients and a major cause of early mortality. Although the pathogenesis of PGD is still unclear, ischemia/reperfusion injury has been identified as a predominant factor. Both necrosis and apoptosis contribute to the loss of cardiomyocytes during ischemia/reperfusion injury, and this loss of cells can ultimately lead to PGD. The aim of our prospective study was to find out whether cell death, necrosis and apoptosis markers present in the donor myocardium can predict PGD. The prospective study involved 64 consecutive patients who underwent orthotopic heart transplantation at our institute between September 2010 and January 2013. High-sensitive cardiac troponin T (hs-cTnT) as a marker of minor myocardial necrosis was detected from arterial blood samples before the donor’s pericardium was opened. Apoptosis (caspase-3, active + pro-caspase-3, bcl-2, TUNEL) was assessed from bioptic samples taken from the right ventricle prior graft harvesting. In our study, 14 % of transplant recipients developed PGD classified according to the standardized definition proposed by the ISHLT Working Group. We did not find differences between the groups in regard to hs-cTnT serum levels. The mean hs-cTnT value for the PGD group was 57.4±22.9 ng/l, compared to 68.4±10.8 ng/l in the group without PGD. The presence and severity of apoptosis in grafted hearts did not differ between grafts without PGD and hearts that subsequently developed PGD. In conclusion, our findings did not demonstrate any association between measured myocardial cell death, necrosis or apoptosis markers in donor myocardium and PGD in allograft recipients. More detailed investigations of cell death signaling pathways in transplanted hearts are required., O. Szarszoi, J. Besik, M. Smetana, J. Maly, M. Urban, J. Maluskova, A. Lodererova, L. Hoskova, Z. Tucanova, J. Pirk, I. Netuka., and Obsahuje bibliografii
Pneumatic tourniquets are widely used in pediatric extremity surgery to provide a bloodless field and facilitate dissection. This prospective study was carried out to examine possible effect of different anesthesia techniques on oxidative stress and endothelial dysfunction connected with ischemia-reperfusion injury during extremity operations at children's age. Patients were randomized into three groups of 15 patients each: general inhalational anesthesia with sevoflurane (group S), total intravenous anesthesia with propofol (group T) and regional anesthesia (group R). Venous blood samples for determination of the malondialdehyde in plasma and erythrocytes, protein carbonyl groups concentration as well as plasma nitrites and nitrates level and xanthine oxidase activity were obtained at four time points: be fore peripheral nerve block and induction of general anesthesia (baseline), 1 min before tourniquet release, 5 and 20 min after tourniquet release. This study demonstrates that total intravenous anesthesia with propofol and regional anesthesia techniques provide better antioxidant defense and reduce endothelial dysfunct ion than general inhalational anesthesia with sevoflurane during tourniquet application in pediatric extremity surgery., I. Budic ... [et al.]., and Obsahuje bibliografii a bibliografické odkazy
Hospitalized patients in internal medicine have an increased risk of low physical reserve which further declines during the hospital stay. The diagnosis requires bed-side testing of functional domains or more complex investigations of the muscle mass. Clinically useful biomarkers of functional status are needed, thus we aimed to explore the potential of microRNAs. Among hospitalized patients, we recorded the basic demographics, anthropometrics, nutritional status, and physical function domains: hand-grip strength (HGS, abnormal values M<30 kg, W<20 kg), balance (<30 s), chair-stands speed (CHSS<0.5/s) and gait speed (GS<0.8 m/s). A panel of five micro-RNAs (miRNA 1, miRNA 133a, miRNA 133b, miRNA 29a, miRNA 29b) and basic blood biochemistry and vitamin D values were recorded. We enrolled 80 patients (M40, W40), with a mean age of 68.8± 8.4 years. Obesity was observed in 27.5 % and 30 %, low HGS and low CHSS in 65.0, 77.5 %, and 80, 90 % of men and women respectively. The median hospital stay was 6.5 days. MiRNA29a and miRNA29b have the strongest correlation with the triceps skinfold (miRNA 29b, r=0.377, p=0.0006) and CHSS (miRNA 29a, r=0.262, p=0.02). MiRNA 29a, miRNA 29b and 133a levels were significantly higher in patients with CHSS<0.5/s. Other anthropometric parameters, mobility domains, or vitamin D did not correlate. All miRNAs except of miRNA 1, could predict low CHSS (miRNA29b, AUROC=0.736 CI 0.56-0.91, p=0.01), particularly in patients with low HGS (miRNA 29b, AUROC=0.928 CI 0.83-0.98). Among hospitalized patients in internal medicine, low functional status was frequent. MicroRNAs were fair biomarkers of the antigravity domain, but not other domains. Larger studies with clinical endpoints are needed., Petra Vrbová, Simona Valášková, Andrea Gažová, Juraj Smaha, Martin Kužma, Ján Kyselovič, Juraj Payer, Tomáš Koller., and Obsahuje bibliografii
Roztroušená skleróza je chronické onemocnění centrálního nervového systému neznámé etiologie s projevy autoimunitního zánětu a neurodegenerace. Onemocnění je heterogenní s nepředvídatelnou prognózou. Průběh choroby lze monitorovat klinickými parametry a sledováním vývoje patologických změn na magnetické rezonanci. I když máme znalosti o efektu nově zaváděných léků na základě klinických studií, není možné předvídat jejich účinnost u konkrétního pacienta. Proto se v posledních letech prosazuje snaha najít takové laboratorní markery, které by co možná nejspolehlivěji odpověděly na otázky spojené se subklinickou aktivitou onemocnění, jeho progresí a usnadnily terapeutické rozhodnutí na základě personifikované medicíny., Multiple sclerosis is a chronic disease of the central nervous system of unknown etiology with manifestations of autoimmune inflammation and neurodegeneration. The disease is heterogeneous with an unpredictable outcome. The course of the disease can be monitored with clinical parameters as well as pathological changes on magnetic resonance imaging. Even though the effects of newly introduced drugs are known from clinical trials, it is not possible to predict their efficacy in a specific patient. Therefore, efforts have intensified over the recent years to identify laboratory markers that would as reliably as possible answer questions on subclinical disease activity, its progression and would facilitate therapeutic decisions based personalized medicine. Key words. multiple sclerosis – therapy – biomarkers The author declare he has no potential conflicts of interest concerning drugs, products, or services used in the study. The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers., and J. Piťha
The safety of pedestrians and cyclists in traffic is justified especially in terms of prevention. This paper deals with the biomechanical analysis of load exerted on the child pedestrian and cyclist. In the case of cyclists, the impact configurations were chosen with respect to the statistical outputs (sudden enter the road or the case of non-giving way; the car front vs. the left side of the cyclists). Two tests were performed in the same configuration and nominal collision speed, the first one with a bicycle helmet and the second one without the helmet. The initial position of pedestrian was chosen with respect to the dummy degrees of freedom. Using the accelerometers in the head, chest, pelvis and knee of the dummy acceleration fields were detected, which are the child pedestrian and cyclist exposed during the primary and secondary collision. In addition, prediction diagnostics method implementation was discussed such as one possible solution of vulnerable road users harm reduction. In conclusion, the results are interpreted by values of biomechanical load and severity of potential injuries including kinematic and dynamic comparison.
The present article introduces a novel method of characterizing the macromechanical cartilage properties based on dynamic testing. The proposed approach of instrumented impact testing shows the possibility of more detailed investigation of the acting dynamic forces and corresponding deformations within the wide range of strain rates and loads, including the unloading part of stress-strain curves and hysteresis loops. The presented results of the unconfined compression testing of both the native joint cartilage tissues and potential substitute materials outlined the opportunity to measure the dissipation energy and thus to identify the initial mechanical deterioration symptoms and to introduce a better definition of material damage. Based on the analysis of measured specimen deformation, the intact and pathologically changed cartilage tissue can be distinguished and the differences revealed., F. Varga, M. Držík, M. Handl, J. Chlpík, P. Kos, E. Filová, M. Rampichová, A. Nečas, T. Trč, E. Amler., and Obsahuje bibliografii
Biomechanics has widely expanded in the last decades. The last development of computers provides new possibilities in this field. Problems can be solved faster and can be more extensive. One of these problems is the biomechanical model of human body. Its realisaton is practically impossible without using computers, because it is necessary to solve systems of thousands of equations.
There are several software packages that enable human body modeling. One of them is the PAM environment [15] developed by the ESI Group International. This computational system is based on the Finite Element Method and is one of the mostly used systems for crash test simulations.
Various human body models for various purposes are developed. Pregnant female model serve to optimize safety systems in cars to be more friendly to pregnant abdomen. and Obsahuje seznam literatury
The presented work is focused on the biomechanical study of the dental disk implant. The first part of the study deals with the strain analysis of the affected bone tissue and the dental implant loaded in the coronoapical direction by force 190 N. The study includes three types of implant anchorge, four degrees (stages) of osseointegration and nine degrees describing the quality of the cancellous bone. Two types of the disk implant were researched: single-disk and double-disk implant. Biomechanical study of the implant was focused on a stress-strain analysis of the affected bone rissue. The highest influence on the stresses in the bone tissue was primarily an implant anchorage. By the application of correlation relationships between Young modulus and the apparent density of the bone tissue - which is measurable in patients - we achieved the variable presented in this study. and Obsahuje seznam literatury
The presented work follows the first part [1], which is focused on the analysis of bone tissue in terms of dependence of bone tissue 'quality' and its subsequent behaviour based on the stress around the disk implant when biting.
This second part is focused on the stress-strain analysis (and tolerability) of disk implants as loaded during the masticating process.
The study includes two types of disk implants (single-disk and double-disk), three types of anchorage, four degrees (stages) of osseointegration in three quality degrees of the cancellous bone. The study, as expected, has shown that the problematic area of he implants is a transition between the implant body and the disk component, where the equivalent stress in the analyzed implants reaches 700 MPa. and Obsahuje seznam literatury