Cíl: Cílem studie je stanovit prevalenci chronického selhání ledvin u 101 pacientů s monoklonální gamapatií neurčeného významu (MGUS). Typ studie: retrospektivní studie. Materiál a metody: Porovnali jsme glomerulární filtraci odhadovanou ze sérového kreatininu a cystatinu C a hodnotili jsme korelaci mezi koncentrací volných lehkých řetězců v séru a funkcí ledvin. U všech pacientů jsme provedli elektroforézu pro - teinů séra s denzitometrickou kvantifikací monoklonálního imunoglobulinu a změřili jsme koncentraci kreatininu, cystatinu C, volných lehkých řetězců kappa a lambda, β 2 mikroglobulinu. Výsledky: Chronické selhání ledvin jsme nalezli u 38,6 % pacientů na základě odhadu ze sérového cystatinu C a u 34,6 % pacientů na základě odhadu ze sérového kreatininu. B2mikroglobulin má největší počet významných korelací; cystatin C (0,90), CysC GFR (-0,69), Kreatinin (0,70), MDRD GFR (-0,60), MIg koncentrace (0,24), κ FLC (0,22) λ FLC (0,34) a věk (0,40). Tento velký počet korelací lze vysvětlit tím, že β 2mikroglobulin odráží jak zátěž organismu maligními buňkami, tak pokles glomerulární filtrace. Závěr: Chronické selhání ledvin jsme nalezli u 38,6 % pacientů při odhadu glomerulární filtrace z cystatinu C a u 34,6 % při odhadu ze sérového kreatininu. Třída monoklonálního imunoglobulinu může mít vliv na výsledky odhadu glomerulární filtrace ze sérového cystatinu C, odhad glomerulární filtrace ze sérového kreatininu není ovlivněn třídou imunoglobulinu. Diabetici neměli statisticky signifikantně nižší glomerulární filtraci než pacienti bez diabetu mellitu., Background: Renal function is more frequently decreased in patients with monoclonal gammopathy. 10 % of patients with multiple myeloma present with acute renal failure and renal function is included in CRAB criteria for the diagnosis of multiple myeloma. Aim: The aim of this study is to determine the prevalence of chronic renal failure (CRF), defined as a glomerular filtration rate (GFR) below 1.0 ml/s/1.73m 2 , in 101 patients with monoclonal gammopathy of undetermined significance (MGUS). Design: retrospective study Material and methods: We compared GFR estimates from serum creatinine (MDRD GFR) and serum cystatin C (CysC GFR) and looked at the correlation between free light chains (FLC) concentration and renal markers. We performed serum protein electrophoresis (SPE) with quantification of monoclonal intact immunoglobulin (MIg) and measured serum creatinine, cysta - tin C, κ and λ FLC and β 2microglobulin in all patients. Results: We found CRF in 38.6% patients using estimation from serum cystatin C and 34.6 % using estimation from serum creatinine. B2microglobulin has the highest number of significant correlations; cystatin C (0.90), CysC GFR (-0.69), crea - tinine (0.70), MDRD GFR (-0.60), MIg concentration (0.24), κ FLC (0.22) λ FLC (0.34) and age (0.40). The best correlation results may be explained by the fact that β 2microglobulin reflects both malignant cells burden and renal function. Conclusions: We found CRF in 38.6 % MGUS patients using estimation from serum cystatin C and in 34.6 % using estima - tion from serum creatinine. The class of monoclonal immunoglobulin may influence results of glomerular filtration estimated from cystatin C but it does not influence GFR estimated from creatinine. Diabetic patients had not significantly lower GFR than patients without diabetes mellitus., Šálek T., Moravčíková D., Humpolíček P., Tichý M., Palička V., and Literatura
The aim of this study was to determine the prevalence of musculoskeletal problems among Czech dentists and to analyze the factors that affect these disorders. Information was gathered through questionnaire completed by 581 physicians. The questionnaire ascertained general information about physicians including their work habits and the characteristics of their work environment along with the occurrence of musculoskeletal problems as well as their intensity. In the past year the occurrence of at least mild difficulties associated with the locomotive system was reported by 96.9% of dentists surveyed (n = 557), with 66.3% of respondents (n = 381) reporting difficulties ofa moderate or major nature. Most respondents of both sexes indicated neck pain. A statistically significant correlation with the occurrence of musculoskeletal complaints of medium and major intensity was demonstrated for the following factors: sex, age, running a private practice, past injury or musculoskeletal diseases, and the perception of work as psychologically demanding. Musculoskeletal disorders in dentists in Czech Republic are relatively frequent and serious health problem. The causes of these diseases must be identified and appropriate preventive interventions undertaken that will contribute to a reduction in the incidence of these problems. and Z. Sustová, L. Hodacová, M. Kapitán
The Purpose of this study is to demonstrate the effectiveness of combined treatment for III AB stage of nonsmallcell lung cancer. Nonsmallcell lung cancer spread form treatment is disputable. Operation is not final solution. The combined treatment is being tested (in clinical trials) in this study. This article argues that a combination of treatment is a better option than that of a specific treatment. However, there is a need to find new effective options for combined treatment., Akhat Bukenov, Elena Gizbrekht, Ergaly Shauenov, Bekzhan Orazbayev, Kalmurat Razzakov, and Literatura
Objective: to analyze main clinical-statistical indices of spine and spinal cord injuries (SCI) and system of organization of medical aid to the victims. We conducted a cohort retrospective study of materials of medical institutions of Tashkent city. Medical records of patients and records of forensic examinations were analyzed. 242 cases of spinal cord injuries were studied. Over the last 10 years in Tashkent the frequency of SCI have been tend to increase, males and working-age people are dominated. In 60.9% of cases the injury was associated, in 36.2% - isolated, and in 2.9% - combined. Fallings from height and road traffic accidents were the main reasons for getting SCI. Lesions at cervical level registered in 45% of cases, thoracic level - 27.3%, at lumbar level - 27.7%, respectively. According to ASIA/IMSOP, full injuries were noted in 40.1% of cases, incomplete injures were in 59.9%. Overall mortality from SCI was 68.6%. study allowed to get in detail the clinical and statistical indicators of SCI in the region., Rukhulla Zabikhullaevich Khikmatullaev, Alisher Iskandarovich Iskandarov, Dildora Zabikhullaevna Khakimova, and Literatura
Cíl práce: Lipoperoxidace je dávána do příčinné souvislosti s rozvojem nejdůležitějších rizikových faktorů kardiovaskulárních onemocnění. Lipoperoxidační procesy jsou důsledkem reakcí lipidů s volnými radikály bez ohledu na jejich původ. Vztah mezi triacylglyceroly (TAG) a volnými radikály (VR) není zcela jasný. Může se dokonce stát, že hypertriacylglycerolémie je doprovázena nízkými koncentracemi VR a naopak. Jedno z možných vysvětlení spočívá ve vztahu lipoperoxidace a složení mastných kyselin v molekulách TAG. Cílem této studie bylo analyzovat vztah složení mastných kyselin v TAG a produkci VR u pacientů trpících diabetes mellitus 2. typu. Typ studie: observační s kontrolní skupinou Materiál a metody: Studie zahrnovala 18 normotriacylglycerolemických (NTG) jedinců (M/F 12/6) a 24 hypertriacylglycerolemických (HTG) jedinců (M/F 16/8). Pacienti v obou skupinách byli diabetici 2. typu. Analýzu mastných kyselin v triacylglycerolech plazmy jsme provedli kapilární plynovou chromatografií a koncentrace volných radikálů byly změřeny přímou spektrofotometrií. Statistické analýzy (parametrické i neparametrické) byly provedeny pomocí statistického software STATISTICA pro Windows. Výsledky: Ve skupině HTG jsme pozorovali nižší zastoupení kyseliny myristové (14:0) (1.62 [1.23-2.07] vs. 1.90 [1.72-2.79], p = 0.022, [medián (1.-3. kvartil]) a vyšší poměr alfa-linolenové kyseliny (18:3n-3) (1.51 [1.21-1.86] vs 1.16 [1.02-1.42], p = 0.021). Poměr kyselin arachidonové/eikosapentaenové byl ve skupině HTG nižší (5.54 [3.62-7.98] vs 7.25 [5.98-15.12], p = 0.027). Když jsme HTG skupinu dále rozdělili podle koncentrací VR na tercily, prokázali jsme nižší hodnoty poměru kyseliny arachidonová/eikosapentaenová ve druhém tercilu (4.05 [2.66-4.67] vs 7.64 [5.83-11.00], 1. tercil, a 6.21 [3.20-8.31], 3. tercil p = 0.019). V spojených HTG+NTG skupinách jsme zaznamenali negativní korelaci mezi MA a TAG (r = -0.3153, p = 0.045). V triaclylglycerolech jsme prokázali pozitivní korelace VR a kyseliny stearové (p < 0.001) spolu s negativní korelací některých n-6 vícenenasycených mastných kyselin (18:3n-6, p < 0.05, 22:5n-6, p < 0.01). Závěr: Zastoupení mastných kyselin v molekulách TAG je spojeno s tvorbou VR. Nicméně do tohoto vztahu vstupují i jiné faktory., Objective: The lipoperoxidation plays a causal role in the development of most important risk factors of cardiovascular disease. The lipoperoxidation results from the reaction of lipid molecules with free radicals, regardless of their origin. The relationship between triacylglycerols (TAG) and the free radicals (FR) amount is not clear. Thus, it can turn up that the hypertriacylglyceridaemia is accompanied with the low values of FR, or vice versa. One possible explanation of this phenomenon is that the degree of lipoperoxidation of TAG is dependent on the composition of fatty acids (FA) in their molecule. Therefore, the aim of this study was to analyze FA composition in TAG and its relationship to FR production in type 2 diabetes mellitus. Design: observational study with internal control group Material and Methods: 18 normotriacylglycerolemic (NTG) individuals (12M/6F) and 24 hypertriacylglycerolemic (HTG) patients (16M/8F). Patients in both groups were persons, suffering from type 2 diabetes mellitus. Fatty acid analysis of plasma triacylglycerols was performed by gas chromatography and free radicals were determined by direct spectrophotometric method. Statistical analyses (both parametric and non-parametric) were performed with the statistical software STATISTICA for Windows. Results: We found lower content of myristic acid (14:0) (1.62 [1.23-2.07] vs. 1.90 [1.72-2.79], p = 0.022, [median (1st-3rd quartile)]) and higher content of alpha-linolenic acid (18:3n-3) (1.51 [1.21-1.86] vs. 1.16 [1.02-1.42], p = 0.021) in HTG group. The ratio of arachidonic/eicosapentaenoic acid was in HTG group lower (5.54 [3.62-7.98] vs. 7.25 [5.98-15.12], p = 0.027). When the HTG group was stratified into the tertiles by the FR concentrations, we observed lower values in the second tertile for ratios based on arachidonic acid (20:4n-6) and eicosapentaenoic acid (20:5n-3) (4.05 [2.66-4.67] vs. 7.64 [5.83-11.00], 1st tertile, and 6.21 [3.20-8.31], 3rd tertile, p = 0.019). In pooled groups, we proved negative correlation between MA and TAG (r = -0.3153, p = 0.045) and the link between FR and FA composition of TAG expressed as positive relationship of FR with content of stearic acid (p < 0.001) and negative correlation with some n-6 polyunsaturated fatty acids (18:3n-6, p < 0.05, 22:5n-6, p < 0.01). Conclusion: The composition of FA in TAG molecules has undoubtedly some relationship to the FR generation. However, the other factors seem to play a role, since the relationship is not straightforward within entire FR range., and Vecka M., Tvrzická E., Votruba M.
Wound healing is a complex physiological process important for tissue homeostasis. An acute injury initiates massive cell migration, proliferation and differentiation, synthesis of extracellular matrix components, scar formation and remodelling. Blood flow and tissue oxygenation are parts of the complex regulation of healing. Higher organisms utilize molecular oxygen as a terminal oxidant. This way of gaining energy for vital processes such as healing leads to the production of a number of oxygen compounds that may have a defensive or informatory role. They may be harmful when present in high concentrations. Both the lack and the excess of reactive oxygen species may influence healing negatively., Jiří Kanta, and Literatura 6
Aim of investigation: to study immediate and remote results of standard and extended lymphodissection in patients with rectal cancer. Material and methods: 132 patients with rectal cancer were performed radical surgery with lymphodissection in D2 and D3 volume according to a height of tumor location. In immediate postoperated period there were noted complications in 4 patients that made up 3,03%. Observation time was 5 years. Tumor recurrence was reported in 5 patients (3,8%). In remote period metastases were revealed in 8 patients (6,6%). 5year total survival rate was 78,5±4,2% at stage II. 5year total survival rate was 56,4±3,7% at stage III. Comparing the results of standard and extended lymphodissection it was noted statistically authentic increase of 5 year survival rate in patients at stage III. Obtained data allow to come to the conclusion about reasonability of performance of different variants of lymphodissection for patients with rectal cancer at stages II and III., Navruzov S. N., Abdujapparov S. B., Akbarov E. T., Navruzov B. S., Islamov H. D., and Literatura
The management of chronic diseases shall be considered a priority in the work of the global international institutions, which are related to health policies. In the search for effective and efficient solutions for the treatment of chronic diseases, scientists are developing different programs. In Bulgaria the continuous monitoring of chronically ill people is defined with the term dispensarization. The objective of the research is to analyze the place and the role of patients in the monitoring of their chronic diseases and how the concept of quality of life relates to this process. Method The research in focus groups is planned within a research project on the monitoring of chronic diseases. Five group discussions were held. The number of participants in all focus groups was sixty. Results The two discussed directions - the active role of the patient and the focus on the results are weak links in the current organization of the care for the chronically ill people. The topic of creating and adopting an Act of the patient was also presented, in which to be paid attention to the evaluation of the quality of life. In general was brought the need for a clear delineation of the roles and the competencies of everyone involved in the monitoring process of chronic diseases. The chronic disease cannot be defined only as a medical problem, as there are economic and social, including political consequences. Conclusions The management of the chronic disease requires coordination of doctor-patient interaction, a model of partnership and trust in the relations, self-management of the condition by the patients and their inclusion in the health team. The most important step to achieve this goal is the education of the patients, increasing their knowledge and motivation, psycho-emotional support, instilling hope and faith in the capacity of the patients., Teodora Dimcheva, Gergana Foreva, Radost Аsenova, Nonka Маteva, Todor Stoev, Rosica Dimova, and Literatura
Cíl studie: Cílem studie bylo zjištění vztahů mezi manifestací tinnitu, nálezem na sluchových evokovaných potenciálech a genetickým pozadím u receptoru pro gamaaminomáselnou kyselinu typu A (GABA(A) receptor), podporující desinhibiční hypotézu vzniku tinnitu. Soubor a metodika: Bylo vyšetřeno 131 pacientů z hlediska sluchové ztráty, provedena kvantifikace tinnitu, sluchové evokované potenciály střední latence (MLR) a kmenové sluchové evokované potenciály (BAEP) a dále stanovení genotypu (CA)n repetitivní sekvence pro beta‑3 podjednotku GABA(A) receptoru. Následně byly hledány vztahy mezi jednotlivými výsledky a manifestací tinnitu. Výsledky: Byla nalezena korelace tinnitus skóre s amplitudovým poměrem vln V/III v BAEP (R = 0,22, p < 0,001) a s průměrným sluchovým prahem (R = 0,22, p = 0,17). Rovněž byla nalezena korelace tinnitus skóre s amplitudou vlny PA v MLR (R = 0,31–0,37; p < 0,001). Výsledky MLR neukázaly žádný vztah k průměrnému sluchovému prahu. U skupiny s kratší anamnézou tinnitu (méně než devět měsíců) byl prokázán rozdíl v manifestaci tinnitu na genotypu pro (CA)n repetitivní sekvenci genu pro beta‑3 podjednotku GABA(A) receptoru (p = 0,002). Tento výsledek byl rovněž konzistentní s rozložením amplitudy vlny PA v dané subpopulaci. Závěr: Tyto výsledky svědčí o existenci dvou hlavních regulačních mechanizmů vzniku tinnitu: první, který je závislý na velikosti sluchové ztráty, je na úrovni mozkového kmene, zatímco druhý je na úrovni korové s možnou souvislostí s genotypem (CA)n repetitivní sekvence pro beta‑3 podjednotku GABA(A) receptoru., Study aim:Study objective was to explore associations between manifestation of tinnitus, auditory evoked potentials and genetic background of gamma‑aminobutyric acid type A (GABA(A) receptors) to support the disinhibited feedback hypothesis of tinnitus generation. Materials and methods: A population of 131 patients was assessed for severity of hearing loss, quantification of tinnitus, mid‑latency responses (MLR) and brainstem auditory evoked potentials (BAEP), and (CA)n tandem repeat polymorphism in GABA(A) Beta‑3 subunit gene to establish any correlation with manifestation of tinnitus. Results: It was observed that tinnitus score correlates with V/III amplitude ratio in BAEP (R = 0.22, p < 0.001) and with mean pure tone audiometry (PTA) threshold (R = 0.22, p = 0.017). Analysis of the MLR results showed a significant correlation between the PA wave amplitude and the tinnitus score (R = 0.31–0.37; p < 0.001). MLR result analysis showed no statistically significant correlation between the wave amplitudes and the mean auditory threshold. An analysis of a subgroup with shorter clinical history (less than nine months) revealed a statistically significant difference in the tinnitus score in relation to the genotype of (CA)n tandem repeat of the GABRß3 receptor subunit gene (p = 0.002). This result was also consistent with the distribution of the PA wave amplitude in the given subpopulation. Conclusion: Our findings indicate existence of two main regulatory mechanisms of tinnitus generation: first, the brainstem mechanism is dependent on the severity of the hearing loss; second, the cortical mechanism is likely to be dependent on the genotype of (CA)n tandem repeat in GABA(A) beta‑3 subunit gene., and J. Rottenberg, M. Zallmann, R. Kostrica, M. Jurajda, T. Talach
To improve the results of radiotherapy for cervical cancer used local and systemic radiomodification drugs. Materials and methods: 1984 patients with locally advanced cervical cancer (2b 3a stage), which at one stage of complex treatment by a course indoarterial of regional longterm polychemotherapy (EARDPHT) mode: methotrexate 50 mg/m2, the first 12 hours, fluorouracil 1000 mg/m2, over the next 12 hours and cisplatin 100 mg/m2, for 48 hours, 2 stage surgical treatment in the volume expanding hysterectomy 3 type (modification of Wertheim Meigs). Results: The results of treatment of locally cervical cancer using VADRPHT, depending on the unilateral and bilateral tumor invasion in parametrial tissue showed that under unilateral lesion of parametrium results of treatment were higher than for the bilateral involvement of parametrium. Medical pathomorphosis in tumors of different severity was observed in 86.9% of patients, metastasis to regional lymph nodes were detected in 36% of operated patients, and also studied the degree of therapeutic pathomorphosis in lymph nodes. There was revealed that the complete regression of tumors, 5 year survival rate is 98%, whereas in tumor regression of more than 50% of the original volume 78.5%, with stabilization of tumor no more than 58.4%. Conclusion: The study of molecularbiological parameters of the tumor cells show the effectiveness of conducted neoadvent indoarterial chemotherapy and play an important role in further treatment and prediction of disease., Navruzova V. S., Yuldasheva N. Sh., and Literatura