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44012. Urgentní chirurgické řešení volvulu žaludku při „upside-down stomach syndrome“
- Creator:
- Hána, Luděk, Kasalický, Mojmír, Koblihová, Eva, Suchánek, Štěpán, Horažďovský, Pavel, and Ryska, Miroslav
- Format:
- print, text, and regular print
- Type:
- model:article, article, Text, kazuistiky, práce podpořená grantem, and TEXT
- Subject:
- hiátová hernie--chirurgie, operace kýly--metody--využití, volvulus žaludku--chirurgie, ezofágus--chirurgie--zranění, laparotomie, reoperace, torakotomie, výsledek terapie, absces, obezita, lidé, mužské pohlaví, and lidé středního věku
- Language:
- Czech and English
- Description:
- „Upside-down stomach syndrome“ je sporadicky se vyskytující typ velké paraezofageální hiátové hernie vyžadující při známkách uskřinutí neodkladné chirurgické řešení. Autoři článku prezentují kazuistiku 53letého nemocného s volvulem žaludku při „upside-down stomach syndromu“. Chirurgický výkon byl komplikován poraněním abdominální části jícnu, které bylo úspěšně léčeno mimo jiné použitím samoexpandibilního metalického stentu. Přes závažný klinický pooperační průběh s nutností revize dutiny břišní, zavedení jícnového stentu, provedení torakotomie pro absces mediastina a sekundárního hojení laparotomie byl pacient po padesáti dvou dnech propuštěn do domácího léčení v uspokojivém stavu, plně realimentován a rehabilitován, se zhojenou perforací jícnu i laparotomií., Upside-down stomach syndrome is a rare type of a large paraoesophageal hiatal hernia, which requires an immediate surgical treatment in case of incarceration. The authors present a case report of a 53-year-old male patient with gastric volvulus related to the upside-down stomach syndrome. Surgical treatment was complicated by an injury to distal oesophagus, which was successfully treated using a self-expandable metallic stent among other methods. Despite the complicated postoperative course with a necessity of reoperation, insertion of an oesophageal stent, thoracotomy for a mediastinal abscess and secondary healing of the laparotomy, the patient was discharged in a good condition with healed oesophageal perforation and laparotomy after 52 days., and L. Hána, M. Kasalický, E. Koblihová, Š. Suchánek, P. Horažďovský, M. Ryska
- Rights:
- http://creativecommons.org/publicdomain/mark/1.0/ and policy:public
44013. Urgentní CT angiografie srdce, využití multiparametrického hodnocení nálezů u nemocných v ohrožení života
- Creator:
- Ferda, Jiří, Baxa, Jan, Pešek, Jan, and Bosman, Roman
- Format:
- print, text, and regular print
- Type:
- model:article, article, Text, and TEXT
- Subject:
- lidé, tomografie rentgenová počítačová--metody, péče o pacienty v kritickém stavu, diagnostické techniky kardiovaskulární, zobrazování trojrozměrné, infarkt myokardu--diagnóza--radiografie, obrazy - zpracování pomocí počítače, urgentní zdravotnické služby, nemoci koronární arterie--diagnóza--radiografie, tomografie spirální počítačová--metody, endokarditida--diagnóza--radiografie, zobrazování myokardiální perfuze--metody, nemoci srdce--diagnóza--radiografie, hodnotící studie jako téma, kritický stav, koronární angiografie--metody, and CT angiografie
- Language:
- Czech and English
- Description:
- Cíl: Zhodnotit přínos komplexního hodnocení CT srdce v urgentních stavech. Metodika: V období 6 měsíců byla provedena analýza akutních vyšetření srdce pomocí dvouzdrojového CT, provedených v komplexu Emergency. Vyšetření byla provedena na dvouzdrojovém CT první generace (Somatom Definition DSCT, Siemens Healthcare, Forcheim, Německo), při posuzování nálezů byla provedena evaluace CT angiografie zahrnující VRT, multiplanání rekonstrukce, kalkulace srdečních objemů z multifázové rekonstrukce CT dat a hodnocení first pass perfuzní analýzy myokardu. Výsledky: V období 6 měsíců bylo provedeno 339 vyšetření srdce, z tohoto počtu bylo provedeno 26 urgentních vyšetření - v deseti případech nemocní bez anamnézy onemocnění srdce s podezřením na non STEMI akutní infarkt myokardu, v sedmi potvrzen; v šesti případech šlo o nemocné s nově vzniklými bolestmi na hrudi po revaskularizaci myokardu, akutní infarkt byl prokázán ve čtyřech případech; ve třech případech šlo o nemocné s podezřením na komplikace po kardiochirurgické operaci. U sedmi nemocných byly zobrazovány koronární tepny před urgentní kardiochirurgickou operací disekce aorty nebo aortální endokarditidy. Závěr: Urgentní CT angiografie pomocí dvouzdrojového CT je efektivním zobrazení včetně nemocných v urgentním ohrožení života, poskytuje validní informace, které vedou ke zkrácení doby do zahájení cílené terapie. Klíčová slova: CTA srdce, koronární tepny, perfuze myokardu, kriticky nemocný pacient, endokarditida, Aim: To evaluate the value of the complex cardiac CT imaging in emergent situations. Method: During 6 months, the analysis was performed in acutely performed cardiac CT using first generation of dualsource system (Somatom Definition DSCT, Siemens HealthCare, Forchheim, Germany). In the assessment of the findings was used evaluation of coronary CTA using VT and multiplanar reconstructions, calculation of the cardiac volumes based by the multiphase CT data reconstruction and the evaluation of first-pass enhancement perfusion maps. Results: During 6 months, 339 cardiac CTs were performed, including 26 urgent examination in critically ill patients, in 10 the acute non-STEMI myocardial infarction, 7 infarctions were confirmed. In 6 patients, the acute chest pain occurred after revascularization by bypass grafting; in 3 cases the acute complication after cardiosurgery were present. In 7 patients, the cardiac imaging was performed as an initial imaging before treatment of aortic dissections or surgery due to the acute aortic endocarditis. Conclusion: Emergent cardiac CT using dualsource CT is an effective imaging tool including patients in emerging situations, it can provide a valid information leading to the shortening of needed time to initiation of tailored therapy. Key words: cardiac CT coronary arteries, myocardial perfusion, critically ill patient, endokarditis, Ferda J., Baxa J., Pešek J., Bosman R., and Literatura
- Rights:
- http://creativecommons.org/publicdomain/mark/1.0/ and policy:public
44014. Urgentní indikace k vyšetření magnetickou rezonancí v neuroradiologii - přehled literatury a návrh základních indikací dle současných znalostí a zavedené praxe („Good practice“)
- Creator:
- Neuwirth, Jiří and Eliáš, Pavel
- Type:
- model:article, article, Text, přehledy, kongresy, and TEXT
- Subject:
- urgentní lékařství--metody--přístrojové vybavení--trendy, diagnostické techniky neurologické--využití, magnetická rezonanční tomografie--metody--využití, tomografie rentgenová počítačová--metody--využití, nemoci centrálního nervového systému--diagnóza, poranění nervového systému--diagnóza, hlava--patologie, nemoci míchy--diagnóza, nemoci páteře--diagnóza, urgentní lékařství založené na důkazech--trendy, směrnice pro lékařskou praxi jako téma, and lidé
- Language:
- Czech and English
- Description:
- Jiří Neuwirth, Pavel Eliáš and Lit.: 13
- Rights:
- http://creativecommons.org/publicdomain/mark/1.0/ and policy:public
44015. Uric acid contributes greatly to hepatic antioxidant capacity besides protein
- Creator:
- Mikami, T. and Sorimachi, M.
- Type:
- article, model:article, and TEXT
- Subject:
- uric acid, antioxidant, total-radical trapping antioxidant parameter, and allantoin
- Language:
- English
- Description:
- Uric acid is the end-product of purine nucleotide metabolism and an increase in uric acid concentration in the body results in hyperuricemia, ultimately leading to gout. However, uric acid is a potent antioxidant and interacts with reactive oxygen species (ROS) to be non-enzymatically converted to allantoin. Uric acid accounts for approximately 60 % of antioxidant capacity in the plasma; however, its contribution to tissue antioxidant capacity is unknown. In this study, the contribution of uric acid to tissue antioxidant capacity and its conversion to allantoin by scavenging ROS in tissue were examined. The results showed that a decrease in hepatic uric acid content via allopurinol administration significantly reduced hepatic total-radical trapping antioxidant parameter (TRAP) content in protein-free cytosol. Additionally, treating protein-free cytosol with uricase led to a further reduction of hepatic TRAP content. Allantoin was also detected in the solution containing protein-free cytosol that reacted with ROS. These findings suggest that in the absence of protein, uric acid contributes greatly to antioxidant capacity in the liver, where uric acid is converted to allantoin by scavenging ROS.
- Rights:
- http://creativecommons.org/publicdomain/mark/1.0/ and policy:public
44016. Uric acid levelis positively associated with NT-proBNP concentration in Slovak heart failure patients
- Creator:
- Sabaka, P., Dukat, A., Gajdosik, J., Caprnda, M., Bendzala, M., and Simko, F.
- Format:
- bez média and svazek
- Type:
- model:article and TEXT
- Subject:
- uric acid, heart failure, NT-proBNP, confounding factors, and biochemical marker
- Language:
- English
- Description:
- Increased concentration of uric acid (UA) is positively associated with the clinical severity but negatively associated with the prognosis of heart failure (HF). However, data related to the association between UA concentration and N-terminal pro brain natriuretic peptide (NT-proBNP) are still lacking. The aim of the study was to analyze the relationships between UA, NT-proBNP, clearance of creatinine and NYHA function class and echocardiographic variables in the Slovak population of primary care patients diagnosed with HF. The association between UA and NT-proBNP was assessed by multivariate analysis. 848 patients (402 men, 446 women) with HF were included in the study. NT-proBNP correlated with UA in both men and women after adjustment based on age, BMI and glomerular filtration rate (r=0.263, p<0.0001; r=0.293, p<0.0001). UA concentration rose with the severity of the NYHA class and was significantly higher in patients with moderate and severe systolic dysfunctions as well as with diastolic dysfunction in the multivariate analysis. In conclusion, our study in Slovak population with HF has revealed a positive correlation between the concentration of UA and NT-proBNP, and the independency of this association on confounding factors. The results support the role of UA as a biochemical marker of HF severity and prognosis.
- Rights:
- http://creativecommons.org/publicdomain/mark/1.0/ and policy:public
44017. Uridine - an indicator of post-exercise uric acid concentration and blood pressure
- Creator:
- Dudzinska, W., Lubkowska, A., Dolegowska, B., Suska, M., and Janiak, M.
- Format:
- print, bez média, and svazek
- Type:
- article, články, model:article, and TEXT
- Subject:
- Fyziologie člověka a srovnávací fyziologie, kyselina močová, krevní tlak, tělesná cvičení, uric acid, blood pressure, exercises, uridine, 14, and 612
- Language:
- English
- Description:
- Studies have shown that uridine concentration in plasma may be an indicator of uric acid production in patients with gout. It has been also postulated that uridine takes part in blood pressure regulation. Since physical exercise is an effective tool in treatment and prevention of cardio-vascular diseases that are often accompanied by hyperuricemia and hypertension, it seemed advisable to attempt to evaluate the relationship between oxypurine concentrations (Hyp, Xan and UA) and that of Urd and BP after physical exercise in healthy subjects. Sixty healthy men (17.2±1.71 years, BMI 23.2±2.31 kg m-2, VO2max 54.7±6.48 ml kg-1 min-1) took part in the study. The subjects performed a single maximal physical exercise on a bicycle ergometer. Blood for analyses was sampled three times: immediately before exercise, immediately after exercise, and in the 30th min of rest. Concentrations of uridine and hypoxanthine, xanthine and uric acid were determined in whole blood using high-performance liquid chromatography. We have shown in this study that the maximal exercise-induced increase of uridine concentration correlates with the post-exercise increase of uric acid concentration and systolic blood pressure. The results of our study show a relationship between uridine concentration in blood and uric acid concentration and blood pressure. We have been the first to demonstrate that a maximal exercise-induced increase in uridine concentration is correlated with the post-exercise and recovery-continued increase of uric acid concentration in healthy subjects. Thus, it appears that uridine may be an indicator of post-exercise hyperuricemia and blood pressure., W. Dudzinska, A. Lubkowska, B. Dolegowska, M. Suska, M. Janiak., and Obsahuje bibliografii
- Rights:
- http://creativecommons.org/licenses/by-nc-sa/4.0/ and policy:public
44018. Urinary lipocalins in Mastomys coucha
- Creator:
- Daniszová, Kristina, Janotová, Kateřina, Jedelský, Petr L., Stopka, Pavel, and Dvořáková-Hortová, Kateřina
- Type:
- article and TEXT
- Subject:
- Major Urinary Protein and chemical communication
- Language:
- English
- Description:
- The presence of large amounts of proteins in mammal urine is usually associated with a pathological condition and indicates serious renal lesions. However, there are few species with obligate proteinuria indicating that they must derive some benefit from this condition. Urinary proteins have been most extensively studied in the house mouse and the rat, and findings to date indicate that their function in intraspecific communication is complex and not yet fully understood. Other proteins of the same protein family as MUPs have been also found in urine of some other rodent species, and still less is known about these. In this study we demonstrate the existence of urinary lipocalins in Mastomys coucha for the first time. Our results support the hypothesis that urinary proteins may play an important role in chemical communication, and level of polymorphism of these proteins in different rodents may help us to understand their specific function.
- Rights:
- http://creativecommons.org/licenses/by-nc-sa/4.0/
44019. Urinary urea nitrogen excretion during the hyperinsulinemic euglycemic clamp in type 1 diabetic patients and healthy subjects
- Creator:
- Pavel Wohl, Eva Krušinová, Marta Klementová, Petr Wohl, Simona Kratochvílová, and Terezie Pelikánová
- Format:
- print, bez média, and svazek
- Type:
- article, články, model:article, and TEXT
- Subject:
- Fyziologie člověka a srovnávací fyziologie, diabetologie, inzulín, kalorimetrie, diabetology, insulin, calorimetry, substrate utilization, urinary urea nitrogen excretion, glycemic clamp, indirect calorimetry, 14, and 612
- Language:
- English
- Description:
- The hyperinsulinemic euglycemic clamp (HEC) combined with indirect calorimetry (IC) is used for estimation of insulin-stimulated substrate utilization. Calculations are based on urinary urea nitrogen excretion (UE), which is influenced by correct urine collection. The aims of our study were to improve the timing of urine collection during the clamp and to test the effect of insulin on UE in patients with type 1 diabetes (DM1; n=11) and healthy subjects (C; n=11). Urine samples were collected (a) over 24 h divided into 3-h periods and (b) before and during two-step clamp (1 and 10 mIU.kg-1.min-1; period 1 and period 2) combined with IC. The UE during the clamp was corrected for changes in urea pool size (UEc). There were no significant differences in 24-h UE between C and DM1 and no circadian variation in UE in either group. During the clamp, serum urea decreased significantly in both groups (p<0.01). Therefore, UEc was significantly lower as compared to UE not adjusted for changes in urea pool size both in C (p<0.001) and DM1 (p<0.001). While UE did not change during the clamp, UEc decreased significantly in both groups (p<0.01). UEc during the clamp was significantly higher in DM1 compared to C both in period 1 (p<0.05) and period 2 (p<0.01). The UE over 24 h and UEc during the clamp were statistically different in both C and DM1. We conclude that urine collection performed during the clamp with UE adjusted for changes in urea pool size is the most suitable technique for measuring substrate utilization during the clamp both in DM1 and C. Urine collections during the clamp cannot be replaced either by 24-h sampling (periods I-VII) or by a single 24-h urine collection. Attenuated insulin-induced decrease in UEc in DM1 implicates the impaired insulin effect on proteolysis. and Obsahuje bibliografii a bibliografické odkazy
- Rights:
- http://creativecommons.org/licenses/by-nc-sa/4.0/ and policy:public
44020. Urine composition in pigs is regulated in both the ureter and the bladder
- Creator:
- Kaasgaard Jakobsen, L., Andersson, K.-E., Nørregaard, R., and Henning Olsen , L.
- Format:
- bez média and svazek
- Type:
- model:article and TEXT
- Subject:
- urine composition and animal model
- Language:
- English
- Description:
- The former perception of the urothelium as an impermeable barrier has been revised during the last decade, as increasing evidence of changes in urine composition during its passage of the urinary tract has been presented. Since differences in urothelial permeability between upper and lower urinary tract have been found, our aim is to demonstrate whether changes in urine composition occur during passage through the ureter. We studied consecutive urine samples from both renal pelvises in six pigs and compared them to samples from the bladder and distal ureter. We further sampled urine during storage in the bladder at a fixed volume. All samples were analysed by measuring osmolality and pH, along with the concentration of the following parameters: Na+, K+, Cl- , creatinine, urea. Urine alkalinity increased significantly during passage of the ureter. Creatinine concentration, pH and K+ increased significantly during the passage from pelvis to the bladder. All other parameters increased non-significantly during the passage to the bladder. The increase in concentration was more pronounced at low concentrations in the pelvis. During storage in the bladder, there was a significant increase in urea concentration. Changes in the composition of urine occur during its passage from the renal pelvis to the bladder and during storage in the bladder. Despite the brief transit time, significant changes in alkalinity were found already during passage through the ureter.
- Rights:
- http://creativecommons.org/publicdomain/mark/1.0/ and policy:public