Doporučení pro léčbu diabetu 2. typu obsahují individualizaci léčebných cílů pro pacienty s komorbiditami, u nichž hypoglykemie zvyšují riziko komplikací. Postačuje cílová hodnota HbA1c do 60 mmol/mol dle doporučení České diabetologické společnosti. S délkou trvání diabetu a progresí onemocnění se pro řadu pacientů, a to i v pokročilém věku, stává inzulinová terapie nezbytnou. Diabetes and Aging Study sledovala pacienty ≥ 60 let věku s diabetem, hypoglykemie patřily k nejčastějším vedlejším účinkům léčby a výskyt se zvyšoval s věkem. Pro pacienty je třeba volit jednoduché inzulinové režimy, které odpovídají přidruženým chorobám i osobnosti. Terapie bazálními inzulinovými analogy je spojena s nízkým rizikem hypoglykemických příhod, umožňuje kombinaci s perorálními antidiabetiky i GLP1 receptorovými agonisty. Klíčová slova: bazální inzulinová analoga – diabetes mellitus 2. typu – hypoglykemie, As recommendation for treatment of type 2 diabetes mellitus, incorporating individualization of therapeutic targets for patients with co-morbidities, for whom hypoglycemia increases the risk of complications. The sufficient target value is 60 mmol/mol of HbA1c under the guidelines of Czech Diabetesl Society. Insulin therapy becomes essential for a whole line of patients, including those of advanced age, in relation to duration of diabetes and progression of the disease. The Diabetes and Aging Study observed patients of ≥ 60 years age with diabetes, in which hypoglycemia ranked among the most frequent side effects of therapy and where incidence increased with age. It is necessary to select simple insulin regimens which are in accordance with the associated diseases and the age of the person. A therapy of basal insulin analogues, linked to a low risk rate of hypoglycemic incidence, enables combination with oral antidiabetic drugs and GLP-1 receptor agonists. Key words: basal insulin analogues – hypoglycemia – type 2 diabetes mellitus, and Alena Adamíková, Jaroslav Rybka
Cílem práce je ukázat v průběhu 18letého sledování kognitivní, emoční a behaviorální změny u pacientky s roztroušenou sklerózou mozkomíšní (RS). Předkládaná kazuistika dokumentuje maladaptaci na diagnózu RS a dlouhodobé maladaptivní zvládání, prolínání a vliv afektivních složek na inhibici kognitivních schopností a psychického stavu, vliv stresu na vznik „pseudoatak“ RS, psychosociální problematiku a kvalitu života. Diagnóza RS měla negativní vliv na pacientku a rodinu. Nepředvídatelný průběh ovlivňoval potíže v adaptaci a v plánování podpory. Vliv stresu souvisejícího s onemocněním a zároveň vedlejší negativní efekt léčby vedli k mnoha psychosociálním potížím, které snížily kvalitu života pacientky a měly negativní vliv na její spolupráci při léčbě a rehabilitaci. Součástí komprehensivní diagnostiky i léčby RS byla opakovaná neuropsychologická vyšetření a v závěru sledování, ve fázi chronicko‑progresivní RS, i kognitivně‑behaviorální terapie cílená na snížení zátěže způsobené chronicitou nemoci a zlepšení kvality života., The aim of the paper is to show cognitive, emotional and behavioural changes in a multiple sclerosis (MS) patient over eighteen years of observation. Case study documents maladaptation to MS diagnosis and prolonged maladaptive coping, diffusion and influence of affective components on inhibition of cognitive abilities and mental health status, the contribution of stress to development of „pseudo-relapses“ of MS, psychosocial problems and quality of life. The diagnosis of MS was devastating for the patient herself and her family. Its unpredictable course complicated adjustment and created difficulties in planning for support. Effects of disease-related stress as well as a negative side-effect of treatment led to many psychosocial problems that impaired the patient’s quality of life and affected compliance with treatment and rehabilitation. Repeated neuropsychological assessment was a part of a comprehensive diagnostic process and treatment of MS and, at the end of observation, in chronic-progressive phase of MS, was complemented with cognitive-behavioural therapy aimed at reducing burden of disease and improving the quality of life., and A. Javůrková, J. Amlerová, J. Raudenská
Cílem práce je ukázat v průběhu 18letého sledování kognitivní, emoční a behaviorální změny u pacientky s roztroušenou sklerózou mozkomíšní (RS). Předkládaná kazuistika dokumentuje maladaptaci na diagnózu RS a dlouhodobé maladaptivní zvládání, prolínání a vliv afektivních složek na inhibici kognitivních schopností a psychického stavu, vliv stresu na vznik „pseudoatak“ RS, psychosociální problematiku a kvalitu života. Diagnóza RS měla negativní vliv na pacientku a rodinu. Nepředvídatelný průběh ovlivňoval potíže v adaptaci a v plánování podpory. Vliv stresu souvisejícího s onemocněním a zároveň vedlejší negativní efekt léčby vedli k mnoha psychosociálním potížím, které snížily kvalitu života pacientky a měly negativní vliv na její spolupráci při léčbě a rehabilitaci. Součástí komprehensivní diagnostiky i léčby RS byla opakovaná neuropsychologická vyšetření a v závěru sledování, ve fázi chronicko‑progresivní RS, i kognitivně‑behaviorální terapie cílená na snížení zátěže způsobené chronicitou nemoci a zlepšení kvality života., The aim of the paper is to show cognitive, emotional and behavioural changes in a multiple sclerosis (MS) patient over eighteen years of observation. Case study documents maladaptation to MS diagnosis and prolonged maladaptive coping, diffusion and influence of affective components on inhibition of cognitive abilities and mental health status, the contribution of stress to development of „pseudo-relapses“ of MS, psychosocial problems and quality of life. The diagnosis of MS was devastating for the patient herself and her family. Its unpredictable course complicated adjustment and created difficulties in planning for support. Effects of disease-related stress as well as a negative side-effect of treatment led to many psychosocial problems that impaired the patient’s quality of life and affected compliance with treatment and rehabilitation. Repeated neuropsychological assessment was a part of a comprehensive diagnostic process and treatment of MS and, at the end of observation, in chronic-progressive phase of MS, was complemented with cognitive-behavioural therapy aimed at reducing burden of disease and improving the quality of life., and A. Javůrková, J. Amlerová, J. Raudenská
Dna představuje heterogenní skupinu metabolických onemocnění, pro kterou je charakteristická tvorba a ukládání depozit krystalů natriumurátů v různých tkáních. V důsledku depozice natriumurátu ve strukturách pohybového aparátu se rozvíjí dnavá artritida, manifestující se akutními dnavými záchvaty a rozvojem chronické tofózní dny. Nejvýznamnějším ovlivnitelným rizikovým faktorem pro vznik dny je hyperurikemie, tedy patologické zvýšení hladiny kyseliny močové v séru. Dna, ale i samotná hyperurikemie, představuje významný nezávislý rizikový faktor zvýšené celkové a kardiovaskulární morbidity a mortality. U významné části pacientů s hyperurikemií a dnou jsou přítomna i jiná onemocnění a rizikové faktory provázející metabolický syndrom. Nezbytnou podmínkou pro úspěšnou léčbu dny je udržení sérové hladiny kyseliny močové pod hodnotou 360 μmol/l, rozpuštění usazenin natriumurátu v tkáních a zabránění jejich tvorbě. V léčbě chronické hyperurikemie se kromě nefarmakologických opatření využívají i léky snižující sérovou hladinu kyseliny močové, zejména inhibitory enzymu xantinoxidáza nebo urikosurika. Úspěšná léčba hyperurikemie může přispět ke snížení kardiovaskulárního rizika pacientů s hyperurikemií a dnou. <p align="">Klíčová slova: dna – hyperurikemie – kardiovaskulární riziko – kyselina močová – metabolický syndrom – terapie, Gout represents a heterogeneous group of metabolic disorders characterized by production and deposition of sodium urate crystals in various tissues. The consequence of this deposition in musculoskeletal system causes gouty arthritis often presented by acute recurrent attack and development of chronic tophi. The most important risk factor is hyperuricemia which means higher level of acid uric in blood. Gout or hyperuricemia alone represents significant independent risk factor of all-cause and cardiovascular morbidity and mortality. Many patients with hyperuricemia and gout have risk factors typical for metabolic syndrome or suffer from other diseases. Maintaining the acid uric serum levels below 360 ?mol/l, dissolution of sodium urate deposits and prevention of their formation are crucial for successful treatment. In addition to the non-pharmacological approaches, medications as xanthine oxidase inhibitors or uricosuric agents are used for lowering serum uric acid levels in treatment of chronic hyperuricemia. The successful treatment may contribute to reduce cardiovascular risk in patients with hyperuricemia and gout. Key words: gout – hyperuricemia – cardiovascular risk – uric acid – metabolic syndrome – treatment, and Petr Němec
Cellular response to ionizing radiation-induced damage depends on the cell type and the ability to repair DNA damage. Some types of cells undergo apoptosis, whereas others induce a permanent cell cycle arrest and do not proliferate. Our study demonstrates two types of response of embryonic diploid fibroblasts WI-38 to ionizing radiation. In the WI-38 cells p53 is activated, protein p21 increases, but the cells are arrested in G2 phase of cell cycle. Some of the cells die by apoptosis, but in remaining viable cells p16 increases, senescence associated DNA- damage foci occur, and senescence-associated beta-galactosidase activity increases, which indicate stress-induced premature senescence., J. Cmielová ... [et al.]., and Obsahuje bibliografii a bibliografické odkazy
DNA repair is an active cellular process to respond to constant DNA damage caused by metabolic processes and environmental factors. Since the outcome of DNA damage is generally adverse and long term effects may contribute to oncogenesis, cells have developed a variety of DNA repair mechanisms, which operate depending on the type of DNA damage inflicted. At least 15 Fanconi anemia (FA) proteins interact in a common pathway involved in homologous recombination. Inherited homozygous mutations in any of these FA genes cause a rare disease, Fanconi anemia, characterized by congenit al abnormalities, progressive bone-marrow failure and cancer susceptibility. Heterozygous germline FA mutations predispose to various types of cancer. In addition, somatic FA mutations ha ve been identified in diverse cancer types. Evidence exists that cells deficient in the FA pathway become dependent on alternative pathways for survival. Additional inhibition of such alternative pathways is thus expected to result in cell death, creating a relationship of synthetic lethality. Identifying these relationships can reveal yet unknown mechanisms of DNA repair and new targets for therapy., T. Hucl, E. Gallmeier., and Obsahuje bibliografii a bibliografické odkazy
Among the semi-natural elements in agricultural landscapes, wildflower strips sown at field margins or within fields are potential habitats for the natural enemies of insect pests. As insects are sensitive to a variety of flower traits, we hypothesized that mixtures with high functional diversity attract and support a higher abundance and species richness of aphid flower visiting predators than mixtures with low functional diversity. During a field experiment, repeated over two years (2014 and 2015) in Gembloux (Belgium), aphid predators (i.e., lacewings, ladybeetles and hoverflies) were pan-trapped in five sown flower mixtures (including a control mixture, with three replicates of each mixture) of low to high functional diversity based on seven traits (i.e., flower colour, ultra-violet reflectance and pattern, start and duration of flowering, height and flower class, primarily based on corolla morphology). In both years, the species of flowering plants in the sown mixtures (i.e., sown and spontaneous flowers) were listed, and the realized functional diversity in each plot calculated. Over the two years, a high functional diversity was not associated with high abundance and richness of aphid predators. Moreover, ladybeetles, which made up the majority of the predators trapped, were more abundant in mixtures with very low or intermediate functional diversity at sowing, especially in 2014. We hypothesize that certain flowers, which were abundant in certain mixtures (and not in those exhibiting the highest functional diversity), attracted predators and were sufficiently abundant to support them. Our results present novel information that could be used for developing flower mixtures that provide effective ecosystem services, such as pest control., Séverin Hatt, Roel Uyttenbroeck, Thomas Lopes, Pierre Mouchon, Julian Chen, Julien Piqueray, Arnaud Monty, Frédéric Francis., and Obsahuje bibliografii
There are records of glands that produce sexual pheromones that are released into the environment or applied directly on sexual partners. Within Opiliones (Arachnida), several harvestmen in the suborder Laniatores have sexually dimorphic glands on legs I and IV, the mode of use of which is recorded only in two species but their function is unknown: while walking, males rub the glands against the substrate or against their body. Here we test an alternative and non-exclusive hypothesis that the glands present on the legs of male Gryne perlata (Cosmetidae) produce contact pheromones used in mating. We predicted that males would touch the females with the gland openings or with other male body parts previously rubbed by these glands. We also predicted that there are chemoreceptors on those parts of the females where males touch them. We analyzed 13 videos of G. perlata mating, a species in which the males have glands on legs I and IV of unknown function. We also analyzed 14 videos of Discocyrtus pectinifemur (Gonyleptidae) mating as a control, a species that lacks these glands. Finally, we looked for chemoreceptors on the legs of female G. perlata using a scanning electron microscope. During copulation, males of both species rubbed the legs of females with their first pair of legs, but not with the regions of these legs where the openings of the glands are. The fourth pair of legs were only used to support the body. Rubbing other body parts of the female by males with their glands was not observed during mating. Setae on the legs of the female did not have tip pores and therefore do not seem to be chemoreceptors. We therefore did not find any evidence that these sexually dimorphic glands in G. perlata release contact pheromones during mating., Jéssica M. Dias, Rodrigo H. Willemart., and Obsahuje bibliografii
Former authors claimed that, due to parasites' aggregated distribution, small samples underestimate the true population mean abundance. Here we show that this claim is false or true, depending on what is meant by 'underestimate' or, mathematically speaking, how we define 'bias'. The 'how often' and 'on average' views lead to different conclusions because sample mean abundance itself exhibits an aggregated distribution: most often it falls slightly below the true population mean, while sometimes greatly exceeds it. Since the several small negative deviations are compensated by a few greater positive ones, the average of sample means approximates the true population mean., Jenő Reiczigel, Lajos Rózsa., and Obsahuje bibliografii