The aim of this prospective study was the validation of the risk stratification of thyroid nodules using ultrasonography with the American College of Radiology Thyroid Imaging, Reporting and Data System (ACR TI-RADS) and partly in comparison to American Thyroid Association (ATA) guidelines in a secondary referral center. Fine needle aspiration biopsy (FNA) (n=605) and histological examinations (n=63) were the reference standards for the statistical analysis. ACR TI-RADS cut-off value: TR4 with sensitivity 85.7 %, specificity 54.1 %, PPV 58.5 %, accuracy 67.7 % (AUC 0.738; p<0.001). ATA cut-off value: “high suspicion” with sensitivity 80 %, specificity 83.3 %, PPV 80 %, accuracy 81.8 % (AUC 0.800; p=0.0025). 18.4 % nodules (3 malignant) could not be assigned to a proper ATA US pattern group (p<0.0001). Both ACR TI-RADS and ATA have allowed fair selection of nodules requiring FNA with superiority of ACR TI-RADS according to classification of all thyroid nodules to the proper group. According to ACR TI-RADS almost one third of the patients were incorrectly classified with 17.9 % missed thyroid carcinomas, exclusively micropapillary carcinomas, even though, the amount of FNA would be reduced to 48 %., Tereza Grimmichová, Petra Pačesová, Libuše Srbová, Jana Vrbíková, Terezia Havrdová, Martin Hill., and Obsahuje bibliografii
It is well known that the training level of a muscle belongs to the parameters that affect the H-reflex response amplitude. The aim of this study was to investigate the effects of training type on H- and T-reflex response parameters. For this purpose, 20 long-distance athletes (group I, test group), 18 short-distance athletes (group II, test group) and 20 non-trained subjects (group III, control group) were involved in this study in which the H- and T-reflex amplitude and latency values were measured. The H-reflex amplitude and latency values found in groups I, II and III were 3.64±0.28 mV and 26.88±1.45 ms, 3.17±0.26 mV and 26.19±1.89 ms, and 6.07±0.34 mV and 26.77±1.32 ms, respectively. The T-reflex amplitude and latency values of the groups I, II and III were 3.30±0.18 mV and 32.01±1.02 ms, 3.11±0.20 mV and 31.47±1.16 ms, 4.24±0.21 mV and 31.47±1.16 ms, respectively. There was no statistically significant difference between the groups with respect to latencies of H- and T-reflexes (p>0.05). In both test groups, the amplitudes of the H-reflex and T-reflex were significantly smaller than the control group (p<0.05). The results of this study suggest that training of muscles affect the H- and T-reflex response parameters., R. Ozmerdivenli, S. Bulut, T. Urat, A. Ayar., and Obsahuje bibliografii
Risk factors (RF) of cardiovascular diseases associated with modern lifestyle, such as stress, chronically increased blood pressure, hyperglycemia and dyslipidemia have a negative impact on the heart exposed to ischemia: their may facilitate its lethal injury (myocardial infarction) and occurrence of sudden death due to ventricular arrhythmias. On the other hand, some stressful stimuli related to RF including reactive oxygen species, transient episodes of ischemia (hypoxia), high glucose and other may play a dual role in the pathogenesis of ischemia/reperfusion (I/R) injury (IRI). Besides their deleterious effects, these factors may trigger adaptive processes in the heart resulting in greater resistance against IRI, which is also a characteristic feature of the female myocardium. However, sensitivity to ischemia is increasing with age in both genders. Current research indicates that comorbidity related to lifestyle may impair the cardiac response to acute ischemia not only by interference with pathophysiological mechanisms of IRI per se, but via suppression of intrinsic protective mechanisms in the heart and its ability to tolerate the ischemic challenges, although the role of RF has not been unequivocally proven. Moreover, even pathologically altered myocardium need not completely lose its adaptive potential. In addition, increased ischemic tolerance can be induced by the pleiotropic (independent of the primary) effects of some hypolipidemic and antidiabetic drugs, even in the diseased myocardium. This review addresses the issue of the impact of RF on cellular cardioprotective mechanisms and the possibilities to restore adaptive potential in subjects challenged with several RF. Reactivation of adaptive processes in the myocardium taking into consideration gender and age can contribute to optimalization of antiischemic therapy., T. Ravingerová, ... [et al.]., and Obsahuje seznam literatury
Cytokines are widely known mediators of inflammation accompanying many neurodegenerative disorders including normal pressure hydrocephalus (NPH). NPH is caused by impaired cerebrospinal fluid (CSF) reabsorption and treated by surgical shunt insertion. The diagnostics is still complicated and the shunt effect is not durable; after several years, dementia may develop. In the clinical practice, biomarkers support the diagnostics as well as the further time course of many neurodegenerative diseases. Until recently, no reliable biomarker for NPH was evaluated. The attempt of this review was to make a survey concerning cytokines as possible NPH markers. Among all reviewed cytokines, the most promising are CSF IL-10 and IL-33, enabling to follow-up the disease progression and monitoring the effectiveness of the shunt insertion., L. Sosvorova, M. Mohapl, J. Vcelak, M. Hill, J. Vitku, R. Hampl., and Obsahuje bibliografii
Previous studies of physiological responses to music and noise showed the effect on the autonomic nervous system. The heart rate variability (HRV) has been used to assess the activation of the sympathetic and the parasympathetic nervous systems. The present study was aimed to examine HRV with exposure to four sine-wave pure tones (20 Hz, 50 Hz, 2 kHz and 15 kHz) in an environment where the sound intensity exceeded level 65 dB (A-weighted). The participants (20 adolescent girls) were lying in supine position during exposure protocol divided into 6 periods, the first time with generated sounds and the second time without sounds. In the protocol without sound exposure, the low frequency band of the HRV spectrum was increased compared to the basal state before examination (period_1: 6.05±0.29 ms2 compared to period_5: 6.56±0.20 ms2, p<0.05). The significant increase of root Mean Square of the Successive Differences (rMSSD, period_1: 4.09±0.16 s compared to period_6: 4.33±0.12 s, p<0.05) and prolongation of R to R peak (RR) interval (period_1: 889±30 ms compared to period_5: 973±30 ms, p<0.001) were observed in the protocol without sound exposure comparing to the protocol with sound exposure where only bradycardia was observed. Contrary to rather polemical data in literature our pilot study suggests that sounds (under given frequencies) have no impact on the heart rate variability and cardiac autonomic regulation., M. Veternik, I. Tonhajzerova, J. Misek, V. Jakusova, H. Hudeckova, J. Jakus., and Obsahuje bibliografii
C-reactive protein (CRP) is a marker of arterial inflammation while lipoprotein-associated phospholipase A2 (Lp-PLA2) is related to plaque instability. The aim of this study was to evaluate the correlation between the risk of unstable plaque presenting as acute coronary syndrome (ACS) and Lp-PLA2, and to assess the influence of statins on interpretation of Lp-PLA2. A total of 362 consecutive patients presenting to the emergency department (ED) with acute chest pain suggestive of ACS were evaluated by cardiologists as STEMI, NSTEMI, or unstable angina, and non- ACS. Serum biomarkers measured on admission: troponin I, Creactive protein (Abbott), and Lp-PLA2 (DiaDexus). Four groups were defined according to the final diagnos-; non- ACS/statin+. Lp-PLA2 was highest in ACS/statin- group; statins decreased Lp-PLA2 both in ACS and non-ACS of about 20 %. Lp- PLA2 was higher in ACS patients in comparison with non-ACS patients group without respect to statin therapy (p<0.001). Lp- PLA2 predicted worse outcome (in terms of acute coronary syndrome) effectively in patients up to 62 years; limited prediction was found in older patients. C-reactive protein (CRP) failed to discriminate four groups of patients. Statin therapy and age should be taken into consideration while interpreting Lp-PLA2 concentrations and lower cut-off values should be used for statintreated persons., J. Franeková, J. Kettner, Z. Kubíček, A. Jabor., and Obsahuje bibliografii
Catecholaminergic system plays an important role in hypertension development. The available results on mRNA expression of catecholaminergic system genes in spontaneously hypertensive rats (SHR) are often contradictory. One of the possible causes might be the use of various reference genes as internal controls. In the present study, we searched for suitable reference genes in adrenal medulla or sympathetic ganglia of SHR and Wistar-Kyoto (WKY) rats, which would enable reliable comparison of mRNA expression between these two strains. The mRNA expression was measured by quantitative real-time PCR in adrenal medulla and superior cervical ganglia of 4-week-old or 24-week-old SHR and WKY rats. We evaluated 12 reference genes by three software tools (Normfinder, BestKeeper, geNorm) and compared them for the standardization of mRNA expression. Combination of reference genes Hprt1 and Ywhaz in adrenal medulla and Gapdh and 18S in sympathetic ganglia were chosen as the best ones. 18S was found as applicable reference gene in both tissues. We found many alterations in expression of catecholaminergic system genes in adrenal medulla and sympathetic ganglia of SHR. The usage of the most or the least stable reference gene as internal control changed results moderately in sympathetic ganglia but seriously in adrenal medulla. For example, tyrosine hydroxylase (Th) gene was underexpressed in adrenal medulla of adult SHR using the appropriate reference gene but unchanged after the standardization to the least stable reference gene. Our results indicate the importance of appropriate internal control. The suitability of reference genes should be checked again in the case of change in experimental conditions., A. Vavřínová, M. Behuliak, J. Zicha., and Obsahuje bibliografii
Adenine-induced model of chronic kidney disease (CKD) is a widely used model especially in studies testing novel nephroprotective agents. We investigated the effects of adenineinduced CKD in rats on the activities of some xenobiotic metabolizing enzymes in liver and kidneys, and on some in vivo indicators of drug metabolism (viz pentobarbitone sleeping time, and plasma concentration of theophylline 90 min post administration). CKD was induced by orally feeding adenine (0.25 % w/w) for 35 days. Adenine induced all the characteristics of CKD, which was confirmed by biochemical and histological findings. Glutathione concentration and activities of some enzymes involved in its metabolism were reduced in kidneys and livers of rats with CKD. Renal CYP450 1A1 activity was significantly inhibited by adenine, but other measured isoenzymes (1A2, 3A4 and 2E1) were not significantly affected. Adenine significantly prolonged pentobarbitone-sleeping time and increased plasma theophylline concentration 90 min post administration. Adenine also induced a moderate degree of hepatic damages as indicated histologically and by significant elevations in some plasma enzymes. The results suggest that adenine-induced CKD is associated with significant in vivo inhibitory activities on some drug-metabolizing enzymes, with most of the effect on the kidneys rather than the liver., M. Al Za’abi, A. Shalaby, P. Manoj, B. H. Ali., and Obsahuje bibliografii
Common alimentary obesity frequently occurs on a polygenic basis as a typical lifestyle disorder in the developed countries. It is associated with characteristic complex metabolic changes, which are the cornerstones for future metabolic syndrome development. The aims of our study were 1) to determine the incidence of metabolic syndrome (based on the diagnostic criteria defined by the International Diabetes Federation for children and adolescents) in Czech obese children, 2) to evaluate the incidence of insulin resistance according to HOMA-IR and QUICKI homeostatic indexes in obese children with and without metabolic syndrome, and 3) to consider the diagnostic value of these indexes for the early detection of metabolic syndrome in obese children. We therefore performed anthropometric and laboratory examinations to determine the incidence of metabolic syndrome and insulin resistance in the group of 274 children with obesity (128 boys and 146 girls) aged 9-17 years. Metabolic syndrome was found in 102 subjects (37 %). On the other hand, the presence of insulin resistance according to QUICKI <0.357 was identified in 86 % and according to HOMA-IR >3.16 in 53 % of obese subjects. This HOMA-IR limit was exceeded by 70 % children in the MS(+) group, but only by 43 % children in the MS(–) group (p<0.0001). However, a relatively high incidence of insulin resistance in obese children without metabolic syndrome raises a question whether the existing diagnostic criteria do not falsely exclude some cases of metabolic syndrome. On the basis of our results we suggest to pay a preventive attention also to obese children with insulin resistance even if they do not fulfill the actual diagnostic criteria for metabolic syndrome., D. Pastucha, ... [et al.]., and Obsahuje seznam literatury