The androgens dehydroepiandrosterone sulfate, dehydroepiandrosterone, androstenedione and testosterone are routinely assessed in women, and circulating levels of these androgens reflect their production. These androgens are measured in most laboratories using various immuno-analytical methods. Recently, however, androgen assays have begun to be performed using gas or liquid chromatography combined with mass spectrometry. To better understand the difficulties and issues of androgen laboratory diagnostics, it is important to assess each of the methods used, how and why they were introduced into practice, and their advantages, limits, historic milestones and current status. It is also necessary to understand how reference ranges are determined and specifics arising from the physiology of individual androgens. Here we present a summary and discussion of these issues., M. Dušková, L. Kolátorová, L. Stárka., and Obsahuje bibliografii
Anemia frequently complicates chronic kidney disease (CKD). We investigated here the effect of adenine-induced CKD in rats on erythrocyte count (EC), hematocrit (PCV) and hemoglobin (Hb) concentration, as well as on the activity of L-γ-glutamyl transferase (GGT) and the concentrations of iron (Fe), transferrin (Tf), ferritin (F), total iron binding capacity (TIBC) / unsaturated iron binding capacity (UIBC) and hepcidin (Hp) in serum and erythropoietin (Epo) in renal tissue. Renal damage was assessed histopathologically, and also by measuring the serum concentrations of the uremic toxin indoxyl sulfate (IS), creatinine, and urea, and by creatinine clearance. We also assessed the influence of concomitant treatment with gum acacia (GA) on the above analytes. Adenine feeding induced CKD, accompanied by significant decreases (P<0.05) in EC, PCV, and Hb, and in the serum concentrations of Fe, Tf, TIBC, UIBC and Epo. It also increased Hp and F levels. GA significantly ameliorated these changes in rats with CKD. A general improvement in the renal status of rats with CKD after GA is shown due to its antiinflammatory and anti-oxidant actions, and reduction of the uremic toxin IS, which is known to suppress Epo production, and this may be a reason for its ameliorative actions on the indices of anemia studied., B. H. Ali, M. Al Za'Abi, A. Ramkumar, J. Yasin, A. Nemmar., and Obsahuje bibliografii
Anémie patří mezi nejčastější onemocnění vůbec. Celosvětově postihuje až 25 % populace. Anémie z nedostatku železa (Fe) pak patří mezi vedoucí. Není také překvapením, že sideropenická anémie postihuje především ženy. Anémie patří obecně mezi významné problémy na každém interním oddělení. Tento článek si nedělá ambici na podání komplexního přehledu o významu, diagnostice a léčbě anémie. Jeho cílem je upozornit na jedné straně na zdánlivě běžná (ale právě proto někdy opomíjená) fakta z každodenní praxe na interním oddělení, a na druhé straně poukázat na novinky v léčbě především parenterálním Fe. Význam anémie na interním oddělení. Už v úvodu je zmíněno, že anémie je na interně častá. Je to především anémie z nedostatku Fe a anémie chronických onemocnění. Anémií trpí především starší, polymorbidní nemocní (často s jedním dominujícím, někdy kryptogenním onemocněním). Jako určitý problém vidím fakt, že anémie je často vnímána především jako signál dalšího onemocnění sama o sobě, a pak tedy není cílem ani diagnostického ani léčebného snažení. Diagnostika a léčba. Nemocného má v péči obvykle kmenový lékař interního oddělení, pokud je ale anémie závažnější, vstupuje do procesu diagnostiky a léčby hematolog jako konziliář. Základní vyšetření představuje vyšetření Fe, ferritinu, transferinu, cirkulujících transferinových receptorů, případně dalších parametrů. Samozřejmě, že zejména u sideropenické anémie se soustředí pozornost na pátrání po příčině možných ztrát nebo v případě anémie chronických onemocnění po prvotní chorobě. Poznámky k léčbě Fe. Pokud je u nemocného prokázán deficit železa, je často (po zjištění příčiny) indikována terapie Fe. Železo se podává ve většině případů perorálně. Existuje však několik situací, v nichž je parenterální podání Fe nejen výhodnější, ale dokonce představuje jedinou možnost léčby. V současné době je nejvíce důkazů pro pozitivní účinky parenterálně podávaného Fe pro železitou karboxymaltózu, přípravek Ferinject. Parenterální podávání Fe v gastroenterologii. Gastroenterologie představuje v zásadě typickou oblast pro využití podávání Fe. Je to proto, že ztráty do GIT jsou časté, ale některá onemocnění GIT jsou navíc i příčinou poruchy vstřebávání Fe. Typickým příkladem mohou být nespecifické střevní záněty, zejména potom Crohnova choroba. Nejen kazuistická sdělení prokazují pozitivní působení železité karboxymaltózy u Crohnovy choroby. Parenterální podávání Fe v kardiologii. Nedávno publikovaná práce (kontrolovaná, dvojitě slepá, multicentrická, dostatečně statisticky silná) CONFIRM HF prokázala, že podání železité karboxymaltózy u nemocných se srdečním selháním zlepšila jejich funkční zdatnost, změnila k lepšímu klasifikaci podle NYHA a ne na poledním míst zlepšila kvalitu života. Nebyla to přitom studie této indikaci první. Pilotní studie u srdečního selhání dopadla rovněž pozitivně CONFIRM HF jen potvrdila její výsledky. Kvalita života – opomíjený parametr. Již při popisu výsledků studie CONFIRM HF je uvedena, jako jeden z výsledků, zlepšená kvalita života. Je bohužel pravdou, že je to parametr (jistě subjektivní a obtížně objektivizovatelný), kterému není dáván zdaleka takový význam jako „tvrdým endpointům“, cílovým ukazatelům intervenčních studií. Přitom je prokázáno, že léčba anémie má významný vliv na kvalitu života u chronické únavy (především u žen). Zlepšení příznaků vyčerpanosti bylo prokázáno po podání 1 000 mg železité karboxymaltózy. Kvalitu života zlepšuje terapie Fe také anemickým nemocným s nádorovým onemocněním., Anaemia is one of the most common diseases. Worldwide affects up to 25% of the population. Anaemia with iron deficiency (Fe) is the leading one. It is not surprising that iron deficiency mainly affects women. Generally, anaemia is one of the major problems in every department of internal medicine. There is no ambition to provide a comprehensive review of the diagnosis and treatment of anaemia. The aim is to point out the common (but sometimes neglected) facts from daily practice in internal department and on the other hand, to highlight the news in the treatment focusing on parenteral Fe. The importance of anaemia at the department of internal medicine. Mentioned above, anaemia is very frequent in internal medicine. Especially, it is anaemia of Fe deficiency and anaemia of chronic disease. Mostly elderly and polymorbid patients (often with one dominant, sometimes cryptogenic disease) suffer from anaemia. I am concern about the fact that anaemia is often seen only as a sign of other disease and usually is not the target of diagnostic and therapeutic efforts. Diagnosis and treatment. The internal department physician is responsible for patient care, but cooperates with haematologist in case of severe anaemia in diagnostic and therapeutic process. Basic examination contains analysis of Fe, ferritin, transferrin, circulating serum transferrin receptors or other parameters. Of course, the focus in iron deficiency anaemia is on its possible loss or in case of chronic disease anaemia on primary disease. Notes to Fe treatment. If the patient has iron deficiency the Fe treatment is often indicated (after finding the cause). Iron is administered orally in most cases. There are several situations when parenteral Fe is not only preferable, but also represents the only therapeutic option. Currently, the best evidence for the positive effects is observed in parenterally administered Fe ferric carboxymaltose, Ferinject. Parenteral administration of Fe in gastroenterology. Gastorenterology is a common field for the use of Fe administration. The losses in the GIT are frequent as well as malabsorption of Fe in several gastrointestinal diseases. A typical example may be inflammatory bowel disease, especially Crohn´s disease. Not only case reports demonstrate the positive effect of ferric carboxymaltose in Crohn´s disease. Parenteral administration of Fe in cardiology. Recently published work (multicentric randomized controlled double-blinde trial) CONFIRM HF have proved that administration of ferric carboxymaltose in heart failure patients have improved their functional ability, NYHA stratification and quality of life. The pilot studies performed before resulted positively and CONFIRM HF only confirmed their conclusions. Quality of life – neglected parameter. Conclusions of CONFIRM HF introduce the improved quality of life as one of the main result. Unfortunately, it is a parameter (subjective, difficult to objectify) which doesn´t have such importance as endpoint – indicator of intervention trials. It is shown that treatment of anaemia is important in chronic fatigue (especially women) and affects quality of life. Improvement in symptoms of fatigue has been demonstrated after administration of 1000 mg of ferric carboxymaltose. Fe treatment improves quality of life in anaemic oncology patients as well., and Richard Češka
Anémie je poměrně časté onemocnění zejména u žen a to v těhotenství i mimo ně. Protože její příznaky mají široké spektrum – mohou zhoršovat kvalitu života až být život ohrožující, je třeba na tento zdravotní problém myslet a vyšetřovat ženy, aby se vyloučila přítomnost anémie, a pokud se potvrdí, že je pacientka anemická, adekvátně ji léčit. Klíčová slova: anémie – gynekologie – těhotenství – perinatologie, Anaemia is a common disease in pregnancy, even in non-pregnant women. Symptoms have a wide spectrum – may reduce the quality of life or even life-threatening directly. That is why it is necessary to examine and adequately treated. Key words: anaemia – gynecology – pregnancy – perinatology, and Hana Vráblíková, Michal Koucký
Hemolytic uremic syndrome (HUS) is a type of thrombotic microangiopathy, in the course of which some patients may develop chronic kidney disease (CKD). It is clinically important to investigate the markers of a poor prognosis. The levels of angiotensinogen (AGT) and interleukin-18 (IL-18) in serum and urine were evaluated. Study was conducted in 29 children with a history of HUS. Serum and urine AGT concentration was significantly higher in children after HUS as compared to the control group. No differences depending on the type of HUS and gender were noted. The serum concentration of IL-18 in children after HUS was significantly lower, whereas in urine did not differ significantly between the sick and healthy children. A negative correlation between the concentration of AGT in serum and albuminuria in patients after HUS was detected. The results indicate that the concentration of AGT in serum and urine in children after HUS increases, which may indicate the activation of the intrarenal renin-angiotensin-aldosterone system. The statement, that AGT may be a good biomarker of CKD after acute kidney injury due to HUS requires prospective studies with follow-up from the acute phase of the disease on a larger group of patients. Reduced IL-18 serum concentration in children after HUS with no difference in its urine concentration may indicate a loss of the protective effects of this cytokine on renal function due to previously occurred HUS., K. Lipiec, P. Adamczyk, E. Świętochowska, K. Ziora, M. Szczepańska., and Obsahuje bibliografii
This review compiles information on the taxonomy, identification, geographical distribution, life cycles, host ranges, occurrence, development and growth in both intermediate and final hosts, pathogenicity, and control measures of AnguilUcola crassus and A. globiceps, swimbladder nematodes of farmed and wild populations of two species of eels, Anguilla japonica and A. anguilla, in East Asia. Anguillicola crassus is distributed in Japan, Korea, Taiwan, and China, while A. globiceps is reported only in Japan and China. These nematodes use cyclopoid copepods as intermediate hosts. Known intermediate hosts are Eucyclops serrulatus (Japan) and Therirwcyclops hyalinus (Korea) for A. crassus, and Mesocyclops leuckarti, T. hyalinus, T. taihokuensis, E. serrulatus, Acanthocyclops viridis, and Cyclops slrenuus (China) for A. globiceps. Anguillicola crassus shows a seasonal occurrence in T. hyalinus with high prevalence in summer, Paratenic hosts are yet unknown in East Asia. Anguillicola crassus is relatively common in farmed and wild populations of Anguilla japonica in East Asia, but A. globiceps is usually found in wild populations of A. japonica in Japan and China. In culture ponds, A. crassus is more prevalent and abundant in A. anguilla than in A. japonica. Although A. globiceps induces only the thickening of the host’s swimbladder wall, A. crassus gives severe pathological effects in A. anguilla and heavy infection leads to host mortality. Prevalence of A. crassus in A. japonica cultured in Japan and Korea is relatively low in winter, whereas prevalence of A. globiceps in wild populations of A. japonica from Japan is high in winter.
The orientation of the Earth is defined by Earth orientation parameters that are measured by space geodetic techniques. The results provided by these techniques differ from each other. The method presented here combines these results in order to get a representative solution of the Earth orientation parameters. Other products of the method are improved coordinates and velocities of collocations stations distributed on six major and two minor tectonic plates. The fact that the stations lie on their plates gives us possibility to describe movements of these plates during our data interval. All new results are compared with the ones published by ITRF 2005 and presented hereafter., Vojtěch Štefka., and Obsahuje bibliografii
Exercise training-induced cardiac hypertrophy occurs following a program of aerobic endurance exercise training and it is considered as a physiologically beneficial adaptation. To investigate the underlying biology of physiological hypertrophy, we rely on robust experimental models of exercise training in laboratory animals that mimic the training response in humans. A number of experimental strategies have been established, such as treadmill and voluntary wheel running and swim training models that all associate with cardiac growth. These approaches have been applied to numerous animal models with various backgrounds. However, important differences exist between these experimental approaches, which may affect the interpretation of the results. Here, we review the various approaches that have been used to experimentally study exercise training-induced cardiac hypertrophy; including the advantages and disadvantages of the various models., Y. Wang, U. Wisloff, O. J. Kemi., and Obsahuje bibliografii a bibliografické odkazy
Fractures commonly existing in rocks flow on their elastic properties and hence on velocity of seismic waves propagating in the rock mass. This relation allows to use seismic methods to determine the fracture density and the orientation of fracture sets. This paper presents results of the research which concern directional changes of dynamic elastic moduli in sedimentary and igneous rocks from south part of Poland. These moduli depend on density of the rock matrix as well as density and orientation of cracks and flow on seismic wave velocity. The seismic equipment Terraloc MK6 (ABEM) was used for the measurements of seismic wave velocity in the surface layers of rock mass. The research was made along precise oriented radial seismic profiles. P-waves and S-waves ve locities were established from recorded seism ograms. The values of P and S waves velocity allowed to calculate values of dynamic elastic moduli for all profiles. The results were presented on diagrams of azimuth distribution of elastic moduli, and diagrams of dynamic elastic moduli versus P - wave velocity. The diagrams showed an anisotropy of elastic properties of the investigated rocks. The maximal values of moduli agree with maximal values of velocity and also with orientation of main crack sets or potential directions of weakening of rock mass. Obtained results point that the seismic methods allow to assign the directions of weakening of rocks what can be for example use during preliminary designing, constructing and exploitation of tunnels., Iwona Stan - Kleczek and Adam F. Idziak., and Obsahuje bibliografické odkazy