Sbornik lekarsky最新文献

The authors described anomalous development of maxillary lateral incisor non-yet published in stomatologic literature. Diagnostics and clinical findings of the anomaly and the prognosis of the affected tooth they based on the description of six longitudinal observed patients. The principal symptom of the anomaly is the disturbance of time-plan of the tooth development. Terms of the tooth mineralization, the time of eruption and root completion cannot be included either in deciduous or in permanent dentition. The tooth is the only product of the dental lamina; it has no predecessor or successor. Frequent disturbances of the eruption pathway result often in anomalous position of the tooth. Taking into consideration the fact that the anomaly appeared always in connection with hypodontia syndrome, it is possible to consider it to be the symptom of hypodontia syndrome. This fact is more significant as it enables to establish the diagnosis of hypodontia syndrome already in early deciduous dentition.

A method for ABO genotyping originally designed by Lee and Chang [3] and further developed by Akane et al. [7] has been even more simplified and improved. We obtained a rapid, robust, sensitive and low cost method for detection of sequence polymorphism of ABO glycosyltransferase gene by changing the MaeII restriction enzyme for its isoschizomer TaiI and by optimization of the condition during digestion and electrophoretic separation.

Sleep related breathing disorders (especially sleep apnea syndrome--SAS) limit the patient through deteriorated nocturnal sleep, insufficient wakefulness, daytime inefficiency and tiredness including a cognitive impairment, through higher rate of road accidents, higher co morbidity, through impaired quality of life and higher mortality. The society pays for the SAS patient higher medical costs and other expenses related to the accidents, co morbidity and lower professional productivity.

Recent epidemiologic studies indicate that approximately 40 to 50% of stable patients with congestive heart failure (CHF) suffer from either obstructive sleep apnea (SA) or Cheyne-Stokes respiration with central SA. In either type of sleep apnea, several mechanisms contribute to significant mechanical and adrenergic stresses upon the failing myocardium. These include hypoxemia, reductions in intrathoracic pressure, rises in systemic arterial pressure, increases in left ventricular afterload, and arousals from sleep worsening the sleep architecture. Consequently, sympathetic activation and parasympathetic withdrawal are the hallmark of sleep-related sleeping disorders that contribute to the progression of heart failure and may adversely affect its prognosis. On the other hand, recent studies indicate that successful treatment of either type of SA with continuous positive airway pressure in patients with CHF results in objective and subjective improvement in the severity of heart failure increases in left ventricular ejection fraction, and reductions in sympathetic nervous system activity. Therefore, the early diagnosis and specific treatment of either obstructive or central SA in patients with CHF is highly warranted.

Lifestyle is one of the most important determinants of health. The authors are interested in the characteristics of medical students' life and they used the anonymous questionnaire study. The sample was 152 persons and this study is continuing. The article presents some information about nutrition, negative events (smoking, alcohol, and drugs), sports activities and sleep. The investigated data are indicators of using knowledge by medical students in their extra-school activities (healthy lifestyle). From the current data there is the fact that nutrition habits and day regime are not so ideal. The fact about consumption of drugs, alcohol, smoking habit and sleeping time is nearly satisfied.

Unlabelled: The dynamic changes in levels of procalcitonin (PCT), as well as other cytokines and acute phase proteins (APP) in post-operative stages reflect the systemic immune response, integrating perioperative infectious and non-infectious stimuli. This study evaluates PCT in context of 16 other inflammatory parameters in patients with different types of infectious post-operative complications. It analyses the specificity and sensitivity of PCT, cytokines and APP and their relationships during systemic inflammatory response.

Subjects and methods: The study involved the following groups of patients: those with confirmed bacterial sepsis, fulfilling the SIRS criteria (N = 28), those with limited infectious site at the wound (N = 16), those with post-operative pneumonia (N = 15) and a control group of N = 25. In 24-hour interval we assessed plasma levels of: PCT, TNF-alpha, IL-1 beta, IL-1ra, IL-6, IL-8, sIL-2R and a spectrum of APP.

Results: PCT in patients with wound infection (1.4 +/- 0.31 ng/ml) and in those with pneumonia (0.7 +/- 0.30 ng/ml) does not rise above levels expected in uncomplicated post-op course (1.7 +/- 0.04 ng/ml), but it differs significantly in comparison to healthy controls (0.2 +/- 0.07 ng/ml). Initial levels of PCT as well as their maximum levels were significantly different in septic patients compared to other groups (p < 0.001). According to specificity and sensitivity tests PCT is the most significant marker for diagnosis of sepsis as opposed to uncomplicated post-operative course (AUC 0.91, CI 0.82-1.0).

Conclusion: Individual inflammatory parameters vary in sensitivity and specificity to causative stimulus. PCT when compared to major cytokines and APP reacts sensitively mainly to systemic stimuli accompanying bacterial infection, notably endotoxin. It is characterized by markedly lower sensitivity to non-bacterial stimuli (trauma of surgery) or localized bacterial inflammations. It is this behaviour that makes it a useful diagnostic tool in post-op courses. Unlike other parameters, PCT allows with sufficient sensitivity and specificity single-test diagnosis of initial sepsis.

Unlabelled: Ambulatory blood pressure monitoring (ABPM) and heart rate variability measurement are frequently used by general practitioners for diagnostic of various cardiovascular diseases. Coincidence of hypertension, heart failure and sleep related breathing disorders are very common. Therefore we proposed to use ambulatory blood pressure monitoring device (ABPM), as a tool, for selection of proper patients for polysomnographic examination in sleep laboratory.

Methods: Power spectral analysis of heart rate (HR) monitored together with blood pressure (BP), was performed using a ABPM device (Cardiotens 01, Meditech Budapest) in 24 adults patients. Low frequency/high frequency ratio (LF/HF), which reflects the sympatho-vagal balance, was calculated for the period of sleep versus wakefulness (S/W). Our aim was to detect changes in sympatho-vagal tone during sleep in the following groups of patients: obstructive sleep apnea syndrome (OSAS, respiratory disturbance index RDI = 43.8, arousal index ArI = 17.1), upper airway resistance syndrome (UARS-RDI = 7.4, ArI = 18.3), CPAP treated group (RDI = 6.4, ArI = 8.1) and controls.

Results: S/W ratio reflecting sympathetic activation, was lower in controls (0.59), than in patients with OSAS (0.9; p < 0.025) or UARS (2.16, p < 0.01). S/W ratio in patients treated with CPAP (0.68) was similar to controls (p = 0.38). S/W ratio correlated moderately with arousal index (r = 0.94 in group of patients with OSAS).

Conclusion: S/W ratio reflecting sympathetic activation upon arousal can be used for screening of patient with sleep related breathing disorders, as well as for assessment of CPAP treatment. ABPM with measurement of heart rate variability can detect also effectiveness of antihypertensive treatment with drugs influencing the autonomous nervous system.

Introduction: Imbalance between energy intake and energy expenditure, influenced as well as by eating pattern, contributes to the development of obesity. The aim of retrospective "case-control" study was to compare dietary pattern of 246 obese women (O, BMI = 36.2 +/- 7.4 kg/m2) with 108 control, normal weight, women (C, BMI = 22.8 +/- 3.3 kg/m2). The examined groups were randomly selected according Body Mass Index from non dieting population.

Methods: The administration of Food frequency questionnaire [1] was used, evaluating three months period before administration. The eating patterns in the form of relative representation of the main food commodities, based on intake frequencies (RRFCI), were calculated using special mathematical procedure and were compared using the non-pair two sides' t-test.

Results: O performed significantly lower absolute number of intake of non-drink food per month (p = 0.01). RRFCI in the eating patterns of O and C is summarized in the next table: [table: see text]

Conclusion: Obese women showed significantly higher relative number of frequencies of intake of meat and dairy products and lower proportion of frequencies of intake of cereals, free fat, sweets in their eating patterns in comparison to normal weight women.

Two cases of venous thromboembolism (VTE) (26th week and 35th week of pregnancy) are described. The standard anticoagulation therapy (Fraxiparine) with vena cava (IVC) filter insertion was applied with successful result and uneventful post partial period. The indications of IVC filters (permanent x retrievable x temporary) and timing of insertion and/or extraction are discussed. IVC filters are an effective and safe method in the prophylaxis and therapy of VTE in pregnancy. This method is justified to be used for a defined group of high-risk patients where benefit predominates potential complications.