Přibližně třetina starších lidí trpí aspoň občas nespavostí. Často se pod stížností na nespavost skrývá somatické onemocnění vedoucí k bolestem (kloubní nemoci, vředová choroba trávicího systému), dusnost (onemocnění srdce a cév, chronické onemocnění průdušek a plic), svěděni (kožní nemoci, diabetes) a snad nejčastěji starosti, strach a úzkost. Spánek narušuje častě noční nutkání na močení při hypertrofii prostaty u muže a gynekologická onemocnění u ženy. K poruchám spánku patří také chrápání spojené s episodami apnoe časté zvláště u lidí obézních s hypertensí (Pickwickův syndrom). Specifickou léčbu dopaminergnímí léky vyžaduje syndrom neklidných nohou (restless legs). U starých lidí bývá nespavost signálem narušení cyklu bdění a spánku, který je součástí důležitých biologických rytmů, na jejichž regulaci se podílejí geny, hormony a neurotransmitéry. Typickou poruchou je oplošténi amplitudy rytmu bdění a spánku: starý člověk je během dne málo bdělý a už proto je spánek povrchní a přerušovaný. Kvalita spánku bývá zrcadlovým obrazem kvality bdělosti. Oploštění rytmu je vážným risikovým faktorem vzniku poruch paměti a rychlejší progrese Alzheimerovy nemoci. Vyšší psychická a fyzická aktivita ve dne a zlepšení oxidativního a glukózového metabolismu mozku nootropními léky (napr. piracetamem) podávanými ráno a v poledne zlepší předpoklady pro zdravý spánek v noci. Při volbě hypnotik dáváme zvláště u starších osob přednost takovým, která nejméně narušují architekturu spánkových rytmů (střídání REM a non-REM episod na EEC), poněvadž jejich narušení vede k poruchám paměti. K těmto hypnotikům patří především zopiclon,. zolpidem a zaleplon., Approximately one third of the population suffer at lest sometimes from insomnia. The complaint of insomnia covers often somatic conditions connected with pain (arthralgia, ulcers of the digestive systém), dyspnea (cardiovascular and obstructive bronchopulmonal diseases), itch (skin disorders, diabetes) and perhaps most frequently sorrow, fear and anxiety. Sleep is disturbed also by the necessity of frequent nocturnal urination (prostate hyper tropy in man, gynaecological abnormities in woman). Snoring is also a sleep disturbance agravated by apnoe and becomes serious risk factor in obese hypertensive patiens (Pickwick" s syndrome) The syndrome of resdess legs requires a specific dopaminergic drug treatment. Insomnia in the old is a signal of a disturbance of the diurnal cycle of vigilance and sleep which is part of biogical rythms regulated by genes, hormones and neurotransmitters. Flattened ampUtude of the cycle is typical for many old people: vigilance is insufficient during the day and sleep is superficial during the night. The quality of sleep might mirror the quai¬ ity of vigilance. The flatness of the diurnal cycle is a serious risk factor for memory disorders and may accelerate the progress of Alzheimer s disease. Higher mental and physical activity during the day and improvement )f oxidative and glucose metaboUsm induced by nootropic drugs (e.g. piracetam) used in the morning and at noon ameliorate the sleep during the night. When choosing a hypnotic for an old person, drugs have to be prefered which do not disturb the physiological EEG architecture of the sequence of REM and non-REM episoCodes. Zopiclone, Zolpidem and zaleplon represent drugs of preference in this respect., Oldřich Vinař, Lit: 5, and Souhrn: eng
Úvod a cíl: U mladých pacientů bývá velmi často příčina ischemické cévní mozkové příhody (iCMP) kryptogenní. Ve starší populaci jsou za možnou příčinu považovány nedetekované poruchy srdečního rytmu. Cílem této prospektivní studie bylo stanovit výskyt srdečních arytmií u mladých pacientů s kryptogenním iktem pomocí dlouhodobého EKG‑Holter monitoringu a podkožně implantovaného srdečního monitoru. Soubor a metodika: Soubor tvoří konsekutivní pacienti s akutní iCMP do 50 let zařazení do prospektivní studie HISTORY (Heart and Ischemic STrOke Relationship studY). Kryptogenní iCMP byla definována dle TOAST kritérií. U všech pacientů byla mozková ischemie potvrzena na CT/MR, provedeno vstupní EKG, vyšetření sérových kardiomarkerů, trombofilní skríning vč. genetického vyšetření, neurosonologie, jícnová echokardiografie (TEE), 24hod EKG‑Holter a třítýdenní holterovský EKG monitoring. Vybraným pacientům s negativním třítýdenním EKG‑Holterem byl následně implantován podkožní srdeční monitor. Výsledky: Z 838 pacientů zařazených do studie HISTORY mělo 123 pacientů méně než 50 let. Z nich bylo 102 (83 %) identifikováno jako kryptogenní iCMP (56 mužů, průměrný věk 39 ? 8,5 let). Srdeční arytmie byla zachycena celkem u 12 (12 %) pacientů (devět mužů, průměrný věk 43 ? 4,2 let). V devíti (75 %) případech se jednalo o fibrilaci síní. U tří pacientů byla arytmie zaznamenána během 24hod EKG‑Holteru a u zbývajících devíti pak během třítýdenního monitoringu. Podkožní monitor byl implantován 12 pacientům, u žádného ale nedošlo k záchytu arytmie během sledovaného období (medián 122 dní). Závěr: Arytmie byla detekována u 12 % mladých pacientů s kryptogenní iCMP. Prodloužení holterovského EKG monitoringu významně zvýšilo jejich záchyt. Clinical Trial Registration: http://www.clinicaltrials.gov. Unique identifier: NCT01541163., Background and aim: The cause of ischemic stroke (IS) in young patients remains often cryptogenic. In elderly population, undetected heart arrhythmias with a risk of embolization are considered the cause of cryptogenic IS (CIS). The aim of this prospective study was to assess the presence of heart arrhythmias in young CIS patients using a long-term ECG-Holter monitoring and implantable subcutaneous heart monitor. Patients and methods: Study set consisted of acute IS patients < 50 years enrolled in the HISTORY (Heart and Ischemic STrOke Relationship studY) study. CIS was defined according to the TOAST criteria. In all patients, brain ischemia was confirmed on CT/MRI. Admission ECG, serum levels of cardio-markers, markers of thrombophilia including genetic screening, neurosonology, transoesophageal echocardiography, 24-hour and 3-week ECG-Holter monitoring were performed in all patients. In selected patients with negative 3-week Holter, subcutaneous heart monitor was implanted. Results: Out of 838 patients enrolled in the HISTORY study, 123 patients were < 50 years and 102 (83%) of them were identified as cryptogenic (56 males, mean age 39 ? 8.5 years). Cardiac arrhythmia was detected in 12 (12%) patients (nine males, mean age 43 ? 4.2 years). In nine (75%) patients, atrial fibrillation was presented. In three patients, the arrhythmia was detected during 24-h ECG-Holter and during 3-week monitoring in the remaining nine patients. The subcutaneous monitor was implanted in 12 patients, but no arrhythmia was detected during study period (median 122 days). Conclusion: Heart arrhythmia was detected in 12% of young CIS patients. Prolongation of ECG-Holter monitoring increased the detection rate significantly. Clinical Trial Registration: http://www.clinicaltrials.gov. Unique identifier: NCT01541163. Key words: cryptogenic ischemic stroke – cardiac arrhythmias – atrial fibrillation – ECG-Holter monitoring The authors declare they have 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 D. Šaňák, M. Hutyra, M. Král
In decision processes some objects may not be comparable with respect to a preference relation, especially if several criteria are considered. To provide a model for such cases a poset valued preference relation is introduced as a fuzzy relation on a set of alternatives with membership values in a partially ordered set. We analyze its properties and prove the representation theorem in terms of particular order reversing involution on the co-domain poset. We prove that for every set of alternatives there is a poset valued preference whose cut relations are all relations on this domain. We also deal with particular transitivity of such preferences.
In this paper we follow our previous research in the field of positioned agents in the eco-grammar systems and pure grammars. We extend model of the positioned eco-grammar systems by boundary markers and we introduce bordered positioned eco-grammar systems (BPEG systems, for short) and that way we show one of the possible answers to the question stated in \cite{jou}. Namely we compare generative power of the BPEG systems with three types of pure regulated grammars with appearance checking.
It is known that chromosomes occupy non-random positions in the cell nucleus. However, it is not clear to what extent their nuclear positions, together with their neighborhood, are conserved in daughter cells. To address specific aspects of this problem, we used the model of the chromosomes carrying ribosomal genes that are organized in clusters termed Nucleolus Organizer Regions (NORs). We compared the association of chosen NOR-bearing chromosomes (NOR-chromosomes) with nucleoli, as well as the numbers of nucleoli, in the pairs of daughter cells, and established how frequently the daughter cells had equal numbers of the homologs of certain NOR-chromosomes associated with individual nucleoli. The daughter cells typically had different numbers of nucleoli. At the same time, using immuno-FISH with probes for chromosomes 14 and 15 in HeLa cells, we found that the cell pairs with identical combinations appeared significantly more frequently than predicted by the random model. Thus, although the total number of chromosomes associated with nucleoli is variable, our data indicate that the position of the NOR-bearing chromosomes in relation to nucleoli is partly conserved through mitosis., M. Kalmárová, E. Smirnov, L. Kováčik, A. Popov, I. Raška., and Obsahuje bibliografii a bibliografické odkazy
The social consequence of gating have been generally characterized as negative, particularly in regards to raising issues of social injustice such as the privatization of space, estrangement, and segregation. Some authors have found positive social consequences of gating particularly in regard to reducing the scale of segregation and promoting social interdependency as a form of social integration as well as encouraging neighbourhood cohesion and maintaining social capital. The following is a critical review of the positive consequences of gating within the overall trend of commodification of community in new residential developments.
The activation of metabotropic glutamate receptors subtype 4 (mGluR4) potentiates models of absence seizures in adult rats. These seizures are age-dependent, but data concerning the role of mGluR4 in immature brain is insufficient. N-phenyl-7- (hydroxyimino)cyclopropa[b]chromen-1acarboxamide (PHCCC), which is a positive allosteric modulator of these receptors, was used in three different models of seizures in immature rats: 1) convulsions induced by high doses of pentetrazol (PTZ; a model of generalised tonic-clonic seizures); 2) rhythmic electroencephalographic (EEG) activity induced by low doses of PTZ (a model of absence seizures); and 3) electrically elicited cortical afterdischarges (ADs, a model of myoclonic seizures). We administered four doses of PHCCC (1, 3, 10 and 20 mg/kg) in PTZ-induced convulsions and two doses (3 and 10 mg/kg) in the two electrophysiological models of freely moving rats with implanted electrodes. Every dose and age group consisted from 8 to 10 rats. PTZ-elicited convulsions were not significantly influenced by PHCCC. In contrast, PHCCC potentiated the effect of a subconvulsant dose (60 mg/kg) of PTZ. The 10-mg/kg dose of PHCCC significantly prolonged the duration of PTZ-induced rhythmic activity episodes and shortened the intervals between individual episodes in 25-day-old rats (P25). In contrast, this potentiation was not seen in P18 rats. Cortical ADs were significantly prolonged with repeated stimulations by both doses of PHCCC in P12 and P18 animals. P25 rats exhibited only slightly longer AD durations. In conclusion, we did not find any anticonvulsant effect of PHCCC. On the contrary, proconvulsant action was demonstrated in all three models in immature rats., E. Szczurowska, P. Mareš., and Obsahuje seznam literatury
The effect of oral supplementation with glycosaminoglycans (GAG) and radical scavengers (vitamin E/selenium) on the regeneration of osteochondral defects was investigated in rabbits. After introduction of defined osteochondral defects in the knee joint, groups of ten animals were given a GAG/vitamin E/selenium mixture or a placebo (milk sugar) for 6 weeks. Following sacrifice, histological and histochemical analysis was performed. The amount of synovial fluid was increased in the placebo group, while the viscosity of the synovial fluid was significantly enhanced in the GAG group. The amount of sulfated GAG in the osteochondral regenerates (8.8±3.6 % vs. 6.0±5.6 %; p<0.03) was significantly higher in the GAG group. In both groups, the GAG amount in the cartilage of the operated knee was significantly higher than in the non-involved knee (p<0.05). Histological analysis of the regenerates in the GAG group was superior in comparison with the placebo group. For the first time, a biological effect following oral supplementation with GAG was demonstrated in healing of osteochondral defects in vivo. These findings support the known positive clinical results., M. Handl, E. Amler, K. Bräun, J. Holzheu, T. Trč, A. B. Imhoff, A. Lytvynets, E. Filová, H. Kolářová, A. Kotyk, V. Martínek., and Obsahuje bibliografii a bibliografické odkazy