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1.
Vnitr Lek ; 65(7-8): 475-482, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31487990

RESUMO

INTRODUCTION: Acute pulmonary embolism, usually caused by thromboembolism is still a serious medical problem in spite of technical progress in diagnostics, as well as the enhancements in prophylactic and therapeutic options. AIM: The evaluation of characteristic, incidence, diagnostic, treatment and mortality rate of patients with pulmonary embolism hospitalized at the 1st Internal Clinic, University Hospital in Martin, within the years 1996-2017. METHODS: The authors offer retrospective analysis of 699 (359 men) patients with pulmonary embolism. Diagnosis was confirmed by angiography, perfusion scan or computed tomography. The data of patients were collected continuously and they are archived at the workplace of the authors. RESULTS: Patients with explicitly confirmed pulmonary embolism created 1.01 % of all hospitalized patients with average age 60.2. The average age of men was lower compared to women (56.6 vs 65.9). As high-risk pulmonary embolism presented 14.88 %, intermediate-risk 40.77 % and low-risk 44.34 % patients with pulmonary embolism. The source of pulmonary embolism was detected in 46.35 % and risk factors were detected in 52.79 % patients with pulmonary embolism. With thrombolytic therapy were treated 23.18 % of all patient with pulmonary embolism and intracranial bleeding occurred in 0.28 % of them. Early mortality rate was 7.58 % of all patients with pulmonary embolism. CONCLUSION: The authors detected increasing occurrence of patients with pulmonary embolism and from 2005 increasing occurrence of non-provoked pulmonary embolism. An average age in the patients with non-provoked pulmonary embolism compared to patients with provoked pulmonary was lower in men (53.5 vs 60.9) as well in women (56 vs 67.7). Patients with non-provoked pulmonary embolism compared to patients with provoked pulmonary were more frequent hospitalized because acute coronary syndrome (5.03 % vs 2.91 %) as well ischemic stroke (7.16 % vs 5.61 %) within one year after pulmonary embolism.


Assuntos
Embolia Pulmonar , Angiografia , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Embolia Pulmonar/diagnóstico , Embolia Pulmonar/etiologia , Embolia Pulmonar/terapia , Estudos Retrospectivos , Fatores de Risco , Terapia Trombolítica
2.
Vnitr Lek ; 65(1): 51-54, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30823838

RESUMO

Acromegaly is a rare disorder usually caused by a benign tumour of the pituitary gland. Long-term presence of elevated growth hormone (GH) and insulin like growth factor 1 (IGF1) levels accompanying this disease is associated with complications such as cardiomyopathy, diabetes mellitus, sleep apnoea and arthropathy. Incidence of acromegaly is 3-4 patients per million per year. Klinefelter syndrome (KS) is the most common sex chromosome disorder occuring in about 1/500 live male births. Common physical features include particularly small testes, among other symptoms are tall stature, reduced muscle tone, delayed pubertal development, lack of secondary male sex characteristics and gynecomastia. We present a 32-year-old man suffering from both acromegaly and 47, XXY Klinefelter syndrome. The patient with typical acromegalic features. Laboratory tests revealed high level of GH which was not suppressed after glucose administration, high level of IGF1, low testosterone concentration with high concentation of luteinizing hormone and follicle stimulating hormone. A magnetic resonance imaging scan revealed a 25 × 18 × 18 mm macroadenoma involving the pituitary gland. A diagnosis of acromegaly was established. After this examination trans-sphenoidal resection was performed. Histopathologic and immunohistochemical findings revealed growth hormoneproducing pituitary adenoma. The presence of infertility with clinical features such as small testes, lack of secondary male sex characteristics and laboratory findings revealed hypergonadotropic hypogonadism that could not be explained by the diagnosis of acromegaly. A chromosomal karyotyping revealed a 47, XXY, confirming the diagnosis of KS. Testosterone replacement therapy wasn´t begun because of patient disagreement Postoperatively elevated plasma concentration of GH and IGF1 levels persist. Treatment by somatostatin analogues (lanreotid) was initiated at dose 120 mg every 28 days. Control magnetic resonance imaging of the sella demonstrated a residue of pituary adenoma size 14 × 14 × 7 mm. The patient is currently undergoing endoscopic revision of the residue. acromegaly - growth hormone - IGF1 - Klinefelter syndrome - testosterone.


Assuntos
Acromegalia , Adenoma , Síndrome de Klinefelter , Neoplasias Hipofisárias , Acromegalia/complicações , Acromegalia/diagnóstico , Acromegalia/genética , Adenoma/complicações , Adenoma/diagnóstico , Adenoma/genética , Adulto , Hormônio do Crescimento Humano , Humanos , Fator de Crescimento Insulin-Like I , Síndrome de Klinefelter/complicações , Síndrome de Klinefelter/diagnóstico , Síndrome de Klinefelter/genética , Masculino , Neoplasias Hipofisárias/complicações , Neoplasias Hipofisárias/diagnóstico , Neoplasias Hipofisárias/genética
3.
Vnitr Lek ; 62(6): 442-8, 2016.
Artigo em Tcheco | MEDLINE | ID: mdl-27485841

RESUMO

BACKGROUND: Diabetes mellitus is the most common cause of end stage kidney disease in the developed countries. Chronic kidney disease-mineral and bone disorder (CKD-MBD) develops with deteriorating of the renal functions. Diabetic patients on hemodialysis are characterized by low bone turnover, higher prevalence of severe and progressive vascular calcification with increased cardiovascular morbidity and mortality. The main factor which causes vascular calcification in patients with diabetic kidney disease (DKD) is poor glycemic control. The recent trial findings describe an inverse correlation between intact parathyroid hormone (iPTH) serum levels and glycemic control in a group of diabetic patients on hemodialysis. AIM: The objective of the proposed project is to access the difference of the laboratory markers MBD in the group of patients with 3rd stage DKD depending on glycemic control. We focused on the relationship between the glycemic compensation of diabetes (HbA1c) and iPTH serum level. PATIENTS AND METHOD: Ninety one patients with 3rd stage DKD were investigated. There were 46 women (50.5 %) and 45 men (49.5 %), average age of patients was 71.2 ± 7.0 years, with creatinine level 128 ± 30 µmol/l and estimated glomerular filtration (eGF, MDRD) 0.82 ± 0.16 ml/s. There were 60 patients with better glycemic control of diabetes (HbA1c < 7 %) vs 29 patients with poorly controlled diabetes (HbA1c > 7 %). MBD markers were compared in both groups. Patients were further stratified into subgroups based on the serum level of iPTH (iPTH < 35 pg/ml vs iPTH > 35 pg/ml) and MBD markers compared. Statistical analysis was performed using and Mann-Whitney test. RESULTS: We have found the statistical significance in the serum phosphate and proteinuria levels in between groups with HbA1c < 7 % vs patients with HbA1c > 7 %. Diabetics with better glycemic control had significant reduction in serum phosphate level (1.14 ± 0.20 vs 1.23 ± 0.18 mmol/l, p = 0.038) and in 24 hrs proteinuria level (0.56 ± 1.35 vs 1.30 ± 1.61 g/day, p = 0.007). In the group of presumed low bone turnover (iPTH < 35 pg/ml) we have found the trend towards increased serum calcium level (2.49 ± 0.12 vs 2.43 ± 0.10 mmol/l, p = 0.063) and increased HbA1c value (7.5 ± 1.8 vs 6.4 ± 1.6 %, p = 0.023). CONCLUSION: Our results suggest the closer relationship between glycemic control of diabetes and mineral-bone disorder in earlier stages of DKD. KEY WORDS: diabetes mellitus type 2 (DM2T) - chronic kidney disease (CKD) - mineral and bone disorder (MBD).


Assuntos
Biomarcadores/análise , Distúrbio Mineral e Ósseo na Doença Renal Crônica/diagnóstico , Nefropatias Diabéticas/diagnóstico , Idoso , Glicemia/metabolismo , Distúrbio Mineral e Ósseo na Doença Renal Crônica/sangue , Diabetes Mellitus Tipo 2/complicações , Nefropatias Diabéticas/sangue , Feminino , Humanos , Falência Renal Crônica/diagnóstico , Masculino
4.
J Obstet Gynaecol Res ; 37(3): 215-21, 2011 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-21272145

RESUMO

AIM: The aim of this study was to assess the participation of ligand-sensitive potassium large conductance calcium-activated ion channels (BK(Ca2+) ) and adenosine triphosphate (ATP)-sensitive potassium ion channels (K(ATP) ) using its openers (NS1619 and pinacidil) in the contractility of human term pregnant myometrium in in vitro conditions. METHODS: Human myometrium tissue samples were collected from term pregnant laboring women who had to undergo cesarean section. The contractility of myometrium was induced by the application of oxytocin into the organ bath. Myometrial strips were incubated with the opener of BK(Ca2+) potassium ion channels NS1619 and its antagonist tetraethylammonium or with the opener of K(ATP) potassium ion channels pinacidil and its antagonist glibenclamide. RESULTS: K(ATP) potassium ion channel's opener pinacidil significantly decreased amplitude of myometrial contractions (P < 0.05) as well as frequency of myometrial contractions (P < 0.05) provoked by oxytocin in human term pregnant myometrium in in vitro conditions. The inhibition of the human myometrial contractions of pinacidil was significantly antagonized by its specific antagonist glibenclamide (P < 0.05). BK(Ca2+) potassium ion channel's opener NS1619 did not significantly affect the contractile activity of human term pregnant myometrium induced by the application of oxytocin in in vitro conditions. CONCLUSION: In our experimental study we found that the participation of BK(Ca2+) and K(ATP) potassium ion channels in the contractility of human term pregnant myometrium in labor is probably different.


Assuntos
Canais KATP/fisiologia , Canais de Potássio Ativados por Cálcio de Condutância Alta/fisiologia , Miométrio/fisiologia , Contração Uterina/fisiologia , Benzimidazóis/farmacologia , Feminino , Humanos , Técnicas In Vitro , Canais KATP/efeitos dos fármacos , Canais de Potássio Ativados por Cálcio de Condutância Alta/efeitos dos fármacos , Moduladores de Transporte de Membrana/farmacologia , Ocitocina , Pinacidil/farmacologia , Gravidez , Contração Uterina/efeitos dos fármacos
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