The bioimpedance spectroscopy as useful tool for measuring the fluid excess and fluid management in severe polytrauma patients.

Although the fluid therapy plays a fundamental role in the management of polytrauma patients (PP), a tool which could determine it appropriately is still lacking. The aim of this study was to evaluate the application of a bioimpedance spectroscopy (BIS) for body fluids volume and distribution monitoring in these patients. This prospective, observational study was performed on 25 severe PP and 25 healthy subjects. The body fluids composition was repeatedly assessed using BIS between days 3 to 11 of intensive care unit stay while the impact of fluid intake and balance was evaluated. Fluid intake correlated significantly with fluid excess (FE) in edemas, and their values were significantly higher in comparison with the control group. FE was strongly associated with cumulative fluid balance (p<0.0001; r=0.719). Furthermore, this parameter was associated with the entire duration of mechanical ventilation (p=0.001, r=0.791) independently of injury severity score. In conclusion, BIS measured FE could be useful in PP who already achieved negative fluid balance in prevention the risk of repeated hypovolemia through inappropriate fluid restriction. What is more, measured FE has a certain prognostic value. Further studies are required to confirm BIS as a potential instrument for the improvement of PP outcome.

Comet assay and its use for evaluating oxidative DNA damage in some pathological states.

The comet assay, or single-cell gel electrophoresis (SCGE), is a sensitive, rapid, relatively simple and inexpensive method for detecting DNA strand breaks in individual cells. It is used in a broad variety of applications and as a tool to investigate DNA damage and repair. The sensitivity and specificity of the assay are greatly enhanced if the DNA incubated with an enzyme, which recognizes a specific kind of DNA damage. This damage induced by oxidative stress plays a pivotal role in many diseases and in aging. This article is a critical review of the possible application of the comet assay in some pathological states in clinical practice. Most of the studies relate to evaluating the response of an organism to chemotherapy or radiotherapy with statistically significant evidence of DNA damage in patients. Other useful applications have been demonstrated for patients with heart or neurodegenerative diseases. Only a few studies have been published on the use of this method in critically ill patients, although its use would be appropriate. There are also other scenarios where the comet assay could prove to be very useful in the future, such as in predicting the likelihood of certain pathological conditions.

Detection of DNA crosslinks in peripheral lymphocytes isolated from patients treated with platinum derivates using modified comet assay.

Platinum-based chemotherapeutic agents induce the formation of crosslinks in DNA, which are accepted as being responsible for the cytotoxicity of these agents. In this study, we used a modification of the alkaline comet assay for detection of the presence of DNA crosslinks in vitro caused by cisplatin, and in peripheral lymphocytes of patients with non-small cell lung carcinoma undergoing chemotherapy with platinum derivatives. The comet technique modified for the detection of DNA crosslinks was calibrated in vitro by treating HeLa cells and human lymphocytes from healthy donors with different concentrations of cisplatin. A cisplatin dose-dependent formation of DNA crosslinks was observed in in vitro measurements using 10-200 µM concentrations of cisplatin. Lymphocytes from cancer patients were also assayed for the formation and repair of DNA crosslinks. Evidence of crosslink formation and repair was observed in peripheral blood lymphocytes of all cancer patients in this study, although some inter-individual differences were observed in the response to chemotherapy and in repair of DNA crosslinks. We propose that monitoring the number of DNA crosslinks in peripheral blood lymphocytes might be a quick and sensitive method for monitoring a patient's sensitivity to this agent. Modification of the method by incubation of analysed cells with styrene oxide before crosslink analysis by comet assay extends the use of the method also to laboratories which have no facilities to use ionizing irradiation for introducing DNA breaks into the cells.

[Advances in metabolism and nutrition 2011 and the route to personalized treatment]. / Pokroky v metabolizmu a výzive 2011 a cesta k personalizované lécbe.

Current model of metabolic and nutritional disorders management utilizes modern techniques that promote some of the nutritional techniques to pharmacoteherapy. This approach is demonstrated on an example of multiple organ failure and systemic inflammatory reaction managed with pharmacologically active nutritional substrates, such as arginine, glutamine, taurine, threonine and cysteine. Treatment of sarcopenia in older age is also discussed. Personalized nourishment as a component part of a wider term personalized medicine represents a new approach that requires recognition of individual differences in human genome and its expression. However, this approach also requires a change of attitude towards laboratory diagnostics and clinical practice, with patients and clinical prediction as the focal point. From this perspective, there is a need to replace current traditional laboratory tests with a new system that utilizes molecular biology and bioinformatics.

Antioxidants and vitamins in clinical conditions.

Various reactive oxygen species (ROS) may be produced from normal biochemical, essential metabolic processes or from external sources as exposure to a variety of agents presented in the environment. Lipids, proteins, carbohydrates and DNA are all capable of reacting with ROS and can be implicated in etiology of various human disorders (rheumatoid arthritis, reperfusion injury, atherosclerosis, lung diseases etc.). In the organism damage by ROS is counteracted with natural antioxidants (glutathione peroxidases, superoxide dismutases, catalase, glutathione, ubiquinol, uric acid, and essential minerals) and nutritional antioxidants from diet (i.e. vitamins E, C, carotenoids). Possible mechanisms of nutritional depletion and side effects of high intake are in the article described.

[Functional foodstuffs and diabetes--evidence and myths]. / Funkcní potraviny a diabetes--dukazy a mýty.

Functional food and nutritional supplements balance the difference between the natural nutritional requirement of man, as a slowly changing genotype, and the nutrition of today's man. This type of specifically treated food enables the nutrition of both the healthy population, where functional food eliminates certain risks and have a preventative effect (fibre, microelements), and the nutrition of the ill, which is based on the therapeutical and regulatory effect of nutrients (organ-specific nutrition).

[Antifungal effect in selected natural compounds and probiotics and their possible use in prophylaxis of vulvovaginitis]. / Antifungální ucinek u vybraných prírodních látek a probiotik, jejich mozností pouzití v profylaxi vulvovaginitidy.

OBJECTIVE: a survey of effective natural compounds and probiotics with antifungal activity and their possible use in vulvovaginitis as a prophylactic or therapeutic drug. DESIGN: review of literature. SETTING: Charles University at Prague, Pharmaceutical Faculty at Hradec Kralove. METHODS: and review of literature and publications from medical data-bases. CONCLUSIONS: certain natural compounds were proved to exert antimycotic effects. The efficiency of garlic extract under in vitro conditions against yeast of C. albicans family becomes manifest within one hour. Essential oils present in the Cayenne pepper (Capsodum frutescens) exert considerable antifungal activity against C. albicans as well. Clove exerts lower antimycotic effects. The effects of Chinese leek are similar to garlic. Propolis also possesses antifungal properties, and sensitivity of the yeast strains decreases in the following order: C. albicans > C. tropicalis > C. crusei > C. guilliermondii. Its efficiency depends on the composition and place of origin. Tea trea oil (Melalauca alternifolia) is inhibiting strains of Candida family (genus) in minimal inhibiting concentration, higher concentrations are necessary for C. crusei and C. norvengensis. In the prophylaxis of vaginal candidoses, oral administration of the strains of Lactobacilus rhamnosus GR-1 and L. fermentum RC-14, B-54 may be recommended. Moreover there are suitable strains of L. brevis CD-2, L. salivarius FV-2, L. gasseri MB 335, L. plantarum, useful in the form of gel capsules (L. plantarum) or vaginal tablets (L. gasseri). The strains of L. acidophilus CRL 1294 and L. salivarius CRL 1328 display the capacity of self aggregation and co-aggregation with Candida. It should be pointed out that the probiotic strain of Lactobacillus (especially L. casei and L. rhamnosus) may, in exceptional cases, cause bacteriemia and sepsis, especially in immunodeficient patients and those who underwent surgery of alimentary tract. No protective effect against yeast infection was detected with vitamin E, any positive effect was not unequivocally confirmed with zinc, but adjusting zinc levels to normal may be recommended.

[Deficient intake of nutrients and the resulting health complications in vegetarians in the course of pregnancy and lactation]. / Deficitní príjem nutrientu a z neho vyplývající zdravotní komplikace u vegetariánek v období gravidity a laktace.

OBJECTIVE: A survey of present results about deficient intake of nutrients and resulting health complications in vegetarians in the course of pregnancy and lactation. DESIGN: A review of literature. SETTING: Charles University, Pharmaceutical Faculty, Hradec Králové. METHODS: Review of literature and publications from medical data bases. CONCLUSIONS: Deficient intake of nutrients and associated development of pathological conditions were described in vegetarians in the course of pregnancy and lactation. Deficient intake of certain amino acids, vitamin B12, calcium, iron, zinc and iodine, n-3 polyunsaturated fatty acids and restriction of energy intake were demonstrated. The health complications included hypoproteinemia, edemas, abortion, the delivery of children of lower birth weight, megablastic and sideropenic anemia, spastic conditions, weak labor, atonic bleeding, mental retardation of the conceptus.

[Effect of hormonal contraception on levels of vitamins in the body]. / Vliv hormonální antikoncepce na hladinu vitaminu v organismu.

OBJECTIVE: To summarize the effect of hormonal contraceptive on the level of some vitamins. SUBJECTS: A literature review. SETTING: Faculty of Pharmacy, Charles University, Hradec Kralove. SUMMARY: Administration of hormonal contraceptive increase the levels of retinol and 25-hydroxyvitamin D, on the contrary it decreases plasmatic concentration of beta-carotene, transcobalamin, and vitamin E. Results of the evaluation of the level of vitamin C and its interaction with ethinylestradiol with consecutive effect are non-uniform. Some alteration of levels of nutrients was determinated in women during administration of post climacteric hormonal therapy (decreased plasmatic level of cobalamin and increased level of vitamin D). Alterations of the level of vitamins are small-scale, administration of this steroid is safe from this point of view.

[Importance of iodine intake during pregnancy--iodine supplementation and its risks]. / Význam príjmu jodu v období tehotenství--suplementace jodem a její mozná rizika.

Expressive deficiency of iodine (level of iodine in the urine is under 50 micrograms/l) is characteristic for 10% children and 20% adult. Low levels of iodine in the urine were described by women after the delivery and by newborns. In the article are described specificity physiology of the thyroid gland, consequences of low intake of iodine, importance and risk of supplementation of iodine in the pregnancy. Intake of dose 200 micrograms iodine per day for pregnant women is important as the prevention of pathophysiological changes in the pregnancy and for development of foetus.

The association between specific nutritional antioxidants and manifestation of colorectal cancer.

Determination of specific antioxidants for examination of oxidative balance and immune responses may be of value in the early diagnosis of colorectal cancer. In the present report, we investigated urinary excretion of zinc, copper, and neopterin and serum levels of vitamins A, C, and E in 30 patients (age = 64 +/- 12 y) with colorectal cancer at the time of diagnosis and in 30 control subjects (age = 61 +/- 11 y) with benign disorders not associated with a systemic inflammatory response. Urinary excretion of zinc, copper, and neopterin was significantly elevated, and serum concentration of vitamin A was decreased in patients with colorectal cancer; these changes are characteristics of systemic immune activation. These phenomena may be of use for the detection of tumor progression and immune response to neoplasm.

[The effect of Saponinum album Merck on changes in the hemolytic resistance of erythrocytes in relation to age in healthy persons]. / Menící se hemolytická rezistence erytrocytu k Saponinum album Merck v závislosti na veku u zdravých jedincu.

The authors elaborated a method for the assessment of the haemolytic resistance of erythrocytes which tests them from the aspect of resistance of their membranes against the haemolytic action of Saponinum album Merck. The physicochemical principle of this method is quite different from the routine test of osmotic resistance of red cells. By the described method red cells of healthy male and female donors aged 4 to 77 years were evaluated. By means of linear regression a significant relationship (with a confidence of 0.999) was proved between parameter M (saponin concentration producing 50% haemolysis (and age). From the evaluation it is apparent that with advancing age in man the resistance of red cell membranes against saponin action declines. From this and from known findings on the mechanism of saponin haemolysis it may be concluded that red cells of all age groups cannot be considered equal as regards the quality of membranes and that these cells undergo certain changes in the course of the lifetime of the individual.