Alzheimerova choroba (ACH) je nejčastější forma demence. Jedná se o degenerativní, nevyléčitelné, terminální onemocnění. Postihuje až 75 % nemocných na celém světě postižených demencí. Prevalence tohoto onemocnění je vysoká, etiologie stále není známá. Je sledována řada rizikových faktorů. Pilotní studie projektu Epidemiologie a genetika Alzheimerovy choroby s 334 případy a 102 kontrolami z psychiatrických léčeben přináší následující výsledky z dotazníkového šetření a stěru z bukální sliznice. Dotazník se skládá z otázek zaměřených na základní identifikační údaje, vzdělání, životní styl, vaskulární rizikové faktory, zájmy, zaměstnání, výskyt nemoci v rodině, výsledky Minimental State Examination (MMSE). Dále jsou uvedeny výsledky analýzy polymorfizmů genu pro angiotenzinkonvertázu (ACE). Ve výsledcích je naznačeno, že u pacientů s ACH se v anamnéze častěji vyskytuje kardiovaskulární onemocnění a úraz hlavy. Výsledky analýz vztahu polymorfizmu I/D genu pro ACE k Alzheimerově chorobě odpovídají dosud publikovaným výsledkům, tzn., že genotypy II a ID mají vztah k riziku ACH, i když zatím nebyl zjištěn statisticky významný rozdíl ve sledovaných skupinách respondentů., Alzheimer's disease (AD) is the most common form of dementia. It is a degenerative incurable terminal disease. AD affects a high percentage (75%) of persons with dementia all over the world. Prevalence is very high. Etiology is still unknown. Numerous etiological factors of AD have already been discovered. Pilot evaluation of 334 cases and 102 controls from mental hospitals in project Epidemiology and Genetics of Alzheimer's Disease provided following the results from questionaires and buccal mucosa smears. The questionnaires contain questions about identification, education, lifestyle, vascular risk factors, hobbies, occupation, incidence of the disease in the family, results of Minimental State Examination (MMSE).Results of the analysis of the gene of I/D polymorphism of ACE are presented. Results suggest that persons with AD have often a cardiovascular disease and head injury in their case history. The results of analysis of the relationship between I/D polymorphism of ACE gene and Alzheimer's diseases in accordance with results published until now, even if the statistical difference between AD patients and controls is not statistically significant., Jana Povová, Hana Tomášková, Omar Šerý, Petr Ambroz, Kateřina Vařechová, Vladimír Janout, and Literatura
Se stárnutím populace se primární péče musí vypořádat s přibývajícími případy Alzheimerovy nemoci. S novou léčbou lze již udělat mnoho pro zlepšení kvality Života pacientů., As the population ages, primary care will manage more and more cases of Alzheimer's disease. With new treatments, there is now much that can be done to improve patients' quality of life., Roger Bullock, Lit: 21, and Souhrn: eng
When spectators see a baroque play staged with use of period means of expression, they often appreciate fine form, but lack emotions. Dealing with Jesuit school plays from the first half of the 18th century, whose theme is true friendship, this article illustrates that baroque drama actually combines stylized form and strong emotions. It was also the main aim of baroque theatre: to transfer the emotions through this form., Magdaléna Jacková., and Obsahuje bibliografické odkazy
Žilní tromboembolická nemoc (TEN), zahrnující žilní trombózu stejně jako plicní embolii, je časté a potencionálně fatální onemocnění. S uvedením nízkomolekulárních heparinů (LMWH) do praxe bylo prokázáno, že ambulantní léčba žilní trombózy je efektivní a bezpečná pro velkou část nemocných s TEN. Vzrůstající data o ambulantní léčbě LMWH v posledních letech ukazují, že až 50 % pacientů s klinicky stabilní plicní embolií může být léčeno doma. I přes tato fakta dosud neměla domácí léčba plicní embolie pevnou pozici v běžné praxi. Pokud bychom měli sumarizovat podmínky pro domácí léčbu, potom by bylo možné uvažovat o ambulantní léčbě u nemocných s nízkým rizikem dle pomocných kritérií, bez hemodynamické nestability (především bez šokového stavu), bez selhávání pravé komory, bez předchozího chronického srdečního či plicního onemocnění, bez závažných komorbidit (onemocnění gastrointestinálního traktu, onemocnění ledvin, krevní choroby, pokročilá nádorová onemocnění), s nízkým rizikem časné rekurence tromboembolické nemoci, bez jiných indikací pro hospitalizaci (bolest vyžadující parenterální analgetika, infekce apod), s nízkým rizikem krvácení a s garantovanou spoluprací nemocného a dobře organizovanou domácí péčí., Venous thromboembolic disease which includes both venous thrombosis and pulmonary embolism, is a frequent and potentially fatal disease. Based on the introduction of low-molecular-weight heparins (LMWH) into practice it has been proved that outpatient treatment of venous thrombosis is effective and safe for a large number of patients with VTE. The growing volume of data on LMWH outpatient treatment in recent years shows that up to 50 % of patients with clinically stable pulmonary embolism can be treated at home. In spite of these facts home treatment of pulmonary embolism has not been established as part of common practice as yet. If we were to summarize the conditions for home treatment, we would consider outpatient care for patients at low risk based on auxiliary criteria, free from hemodynamic instability (primarily without a shock state), free from right ventricular failure, prior chronic heart or lung disease, serious comorbidities (gastrointestinal tract disease, kidney disease, blood diseases, advanced cancers), at low risk of early thromboembolism recurrence, free from other indications for hospitalization (pain requiring parenteral analgesics, infections etc.), at low risk of bleeding and with guaranteed patient‘s cooperation and well-organized home care., and Radovan Malý, Jaroslav Malý
Nephrotoxicity of cisplatin (CP) involves renal oxidative stress and inflammation, and sesamin (a major liganin in many plants) has strong antioxidant and antiinflammatory actions. Therefore, we investigated here the possible mitigative action of sesamin on CP nephrotoxicity in rats. Sesamin was given orally (5 mg/kg/day, 10 days), and on the 7th day, some of the treated rats were injected intraperitoneally with either saline or CP (5 mg/kg). On the 11th day, rats were sacrificed, and blood and urine samples and kidneys were collected for biochemical estimation of several traditional and novel indices of renal damage in plasma and urine, several oxidative and nitrosative indices in kidneys, and assessment of histopathological renal damage. CP significantly and adversely altered all the physiological, biochemical and histopathological indices of renal function measured. Kidneys of CP‐treated rats had a moderate degree of necrosis. This was markedly lessened when CP was given simultaneously with sesamin. Sesamin treatment did not significantly alter the renal CP concentration. The results suggested that sesamin had ameliorated CP nephrotoxicity in rats by reversing the CP-induced oxidative stress and inflammation. Pending further pharmacological and toxicological studies sesamin may be considered a potentially useful nephroprotective agent.
In this article, the author traces how the lessons of the Munich Agreement of September 1938 (on the basis of which Czechoslovakia was forced to cede the predominantly ethnic-German Sudetenland to Nazi Germany) were projected into US foreign policy. In Part One of the essay, based on published sources and unpublished documents from American archives, the topic is covered from the late 1930s to the outbreak of the Korean War (which is discussed in Part Two, to be published in the next issue of Soudobé dějiny). The author looks at immediate American reaction to the North Korean attack on South Korea in June 1950, and then returns to autumn 1938 to test his hypothesis that behind the unusual unity of this reaction was the ingrained negative attitude of the United States to the policy of appeasement. He demonstrates that since the late 1930s the terms ‘Munich’ and ‘appeasement’ have remained forever linked in US policy and US public discourse, and he discusses the transformations of the perception of the two concepts during the Second World War, after the war, and at the beginning of the Cold War. The lessons of Munich, he argues, have drawn on the idealistic as well as the pragmatic sources of US policy, because they stem from the conviction that appeasement is immoral and does not pay. Whereas in Roosevelt’s policy the general lesson was not to allow Hitler’s expansion, Harry S. Truman, Roosevelt’s successor in the White House, had to use the lessons, despite his own self-restraint, to try to counter the steps of a wartime ally, Stalin’s Soviet Union. The Communist take-over in Czechoslovakia in February 1948 and the blockade of the western sectors of Berlin beginning in the summer of that year were important events on this path.The author further considers the infl uence of this factor on the US approach taken in the Korean War in the early 1950s. He seeks to demonstrate that the decision of the Truman Administration to substantially intervene in this confl ict was a direct consequence of the negative attitude to the policy of appeasing an aggressor. This attitude was also shared by the American public, regardless of party affi liation and political sympathies. Arguments based on the rejection of appeasement, however, soon began to be used by the Republicans as ammunition in the election campaign against the incumbent Democrats and the choice of strategy also became a matter of dispute in the choice of strategy on the Korean battlefi eld after China entered the war. Whereas the White House wished to avoid an unlimited confl ict with China, the Commander-in-Chief of the United Nation Command in Korea, General Douglas MacArthur (1880–1964), was in favour of an uncompromising approach and in fact ceased to obey President Harry S. Truman (1884-1972). After being relieved of his command by Truman, MacArthur became the chief critic of his policies and a hero of Truman’s Republican opponents. In spring 1951, the Republicans organized a special Senate committee hearing on the circumstances of MacArthur’s suspension. The author looks in detail at this exceptional clash in post-war US domestic politics, which was meant to be triumphantly used against MacArthur, but gradually changed into a debacle in consequence of, among other things, the compelling testimonies of Secretary of State Dean Acheson (1893-1971) and Secretary of Defense George C. Marshall (1880-1959). In his conclusion, the author seeks to demonstrate how other US presidents returned to the ‘lessons of Munich’, and he argues that these lessons became Truman’s lasting political legacy and as such became fi rmly rooted in American political discourse. and Přeložil: Jiří Mareš