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Prague, Czech Republic

Background: An imbalance between pro- and anti-inflammatory cytokine activities favors the induction of autoimmunity, chronic inflammation and joint damage in patients with rheumatoid arthritis (RA). Adipokines are bioactive proteins that are important regulators of inflammation. IL-35 is a new cytokine involved in the inflammatory processes in mouse models and is of unknown function in humans. The aim of the work was to study the levels and role of several adipokines and IL-35 in the joint and blood compartment and the association with the disease activity in patients with RA or other rheumatic diseases. Results: We found increased levels of adiponectin in serum of patients with erosive osteoarthritis (OA) of the hand, differential regulation of new adipokines vaspin and omentin in synovial fluid of patients with RA compared with OA and the effect of therapy using TNFa inhibitor on the expression profile of adipokines in subcutaneous adipose tissue of RA patients. B cell depletion therapy in RA resulted in decrease of serum levels of visfatin that correlated with following change of disease activity. The levels of IL-35 in synovial fluid are significantly higher in RA than in OA and correlate with the disease activity and functional status. IL-35 subunits p35 and EBI3 are overexpressed in RA synovial tissue than that in OA. IL-35 is increased at transcriptional and protein levels after stimulation with proinflammatory cytokine TNFa in RA synovial fibroblasts and peripheral blood mononuclear cells (PBMC). IL-35 induces release of some inflammatory mediators in PBMC. Conclusion: Our results show the role of adipokines and IL-35 in inflammation in patients with rheumatic diseases and the association with disease activity in RA. Thus, the discovery of new therapeutic targets would be beneficial for patient resistant to current therapy.

A role of Helicobacter pylori infection in the etiopathogenesis of immune thrombocytopenic purpura is still investigated and discussed. The infection of Helicobacter pylori in 58-years old female with severe thrombocytopenia and the clinical manifestation of cholecystitis was confirmed by antigen detection in stool. The regression of cholecystitis as well as the normalization of platelets count were achieved with standard eradication therapy. Presented case report is an example of immune thrombocytopenia induced by Helicobacter pylori infection with dominating extragastric manifestation.

Introduction: Systemic sclerosis (SSc) is a generalized connective tissue disease affecting the skin and internal organs. The pathogenesis of SSc is characterized by inflammation, vasculopathy and fibrosis. To date, none of the tested drugs have demonstrated convincing efficacy in the treatment of SSc. S100A4 is involved in the regulation of cell motility, proliferation, apoptosis, angiogenesis and remodeling of the extracellular matrix. It was originally described as a promoter of metastasis in tumors, however, its pro-inflammatory properties have recently been demonstrated in inflammatory rheumatic diseases. The aim of this study was to assess the role of S100A4 in pathological activation of fibroblasts in SSc and in experimental models of dermal fibrosis. Results: The expression of S100A4 was increased in the skin of SSc patients, in SSc fibroblasts and in experimental fibrosis in a TGF-β / Smad dependent manner. Overexpression of S100A4 or stimulation with recombinant S100A4 induced an activated phenotype in resting normal fibroblasts. In contrast, inhibition of S100A4 or its complete deficit abrogated the pro-fibrotic effects of TGF-β and decreased the release of collagen. S100A4 knock-out mice (S100A4-/-) were protected from bleomycin-induced skin fibrosis with reduced dermal thickening, decreased hydroxyproline content and lower counts of activated fibroblasts, so called myofibroblasts. Similarly, deficiency of S100A4 also ameliorated fibrosis in the Tight skin-1 (Tsk-1) mouse model. Anti-fibrotic effects of the inactivation of S100A4 in both experimental models of dermal fibrosis were mediated by inhibition of TGF-β / Smad signaling. Conclusion: Our results characterize S100A4 as a positive regulator of the stimmulatory effects of TGF-β on fibroblasts in SSc. S100A4 is induced by TGF-β and in turn amplifies the stimulatory effects of canonical TGF-β / Smad signaling on collagen synthesis by SSc fibroblasts and on induction of fibrosis. Since S100A4 is essentially required for the pro-fibrotic effects of TGF-β and neutralizing antibodies against S100A4 are currently evaluated in tumors, S100A4 might become a candidate molecule for novel anti-fibrotic therapies.

The article deals with the psychological aspects of the medical examiner during the execution of his examination praxis. He comes often into conflict with the doctor in charge, with the examined person, as well as by the dealing with the medical reports for the purposes of the judicial proceeding and by the control of the superiors. The medical assessor has to be aware of his own personality to be able to constructively handle the chronic stress and the pressure from several sides. He must to be at home in the psychology basics; person's attributes, act empathetically and assertively, in the communication and must avoid self-manipulation. He has to be fit in the medicine and legislative field. The author deals with the conflict solving situations with the aim of achieving a compromise, which would bring positive changes in the social security of seriously ill patients.

Kimakova T.,Lekarska Fakulta | Hrnkova L.,Farmaceuticka Fakulta | Kobliskova Z.,Farmaceuticka Fakulta
Klinicka Farmakologie a Farmacie | Year: 2015

Objective of study: The purpose of the study was to evaluate the use of dietary supplements by general public in Slovakia, to identify their attitudes and knowledges towards these products. Methods: A questionnaire survey of 256 respondents was conducted in the time span of October to December 2014 by on-line collection. The use of dietary supplements and knowledges of respondents as their agreement with general, safety and efficacy claims regarding to dietary supplements were evaluated. The results were processed using descriptive Microsoft Excel. Results: Up to 64.5% of the respondents use dietary supplements sometimes (49.8%). Pharmacy was the most frequent place for their pur- chase (55.8%). The main reason for their use is prevention of disease (30.0%) and particular it concerns to supplements containing vitamins. 57.0% of respondents reported enough information about dietary supplements, the main informative source was identified internet (23.8%), pharmacists (18.6%) and physicians (14.6%). Only 21.5% of respondents use dietary supplements by the recommendation of a physician and 11.5% by the recommendation of the pharmacist. As areas with higher level of knowledge of respondents were identified the perception of difference between dietary supplement and medicine (78.1%), knowledge that dietary supplement is available without a prescription (72.0%) and that its use is appropriate to consult with a specialist (71.3%). 58.5% of respondents knew that a dietary supplement is not a medicine, but only 25.3% of them knew that dietary supplement belongs to food for special nutritional purposes. 34.0% of respondents considered dietary supplements as completely safe and 19.6% thought that they are effective as medicines. Conclusion: The study found that the use of dietary supplements by the general public in Slovakia is comparable with other countries. The evaluation of knowledges showed perceptions and attitudes of the general public towards the efficacy, safety and general characteristics of dietary supplements. Responsible and safe use of dietary supplements, however, requires greater involvement of health professionals. © 2015, SOLEN s.r.o. All rights reserved.

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