Does higher gadolinium concentration play a role in the morphologic assessment of brain tumors? Results of a multicenter intraindividual crossover comparison of gadobutrol versus gadobenate dimeglumine (the MERIT study)
Seidl Z.,Lekarska Fakulta |
Vymazal J.,Na Homolce Hospital |
Mechl M.,University Hospital Brno |
Goyal M.,Seaman Family Center |
And 11 more authors.
American Journal of Neuroradiology | Year: 2012
BACKGROUND AND PURPOSE: Gadobenate dimeglumine has proved advantageous compared with other gadolinium-based contrast agents for contrast-enhanced brain MR imaging. Gadobutrol is a more highly concentrated agent (1.0 mol/L). This study intraindividually compared 0.1-mmol/kg doses of these agents for qualitative and quantitative evaluation of brain tumors. MATERIALS AND METHODS: Adult patients with suspected or known brain tumors underwent 2 identical MR imaging examinations at 1.5T, 1 with gadobenate dimeglumine and the other with gadobutrol, both at a dose of 0.1-mmol/kg body weight. The agents were injected in randomized order separated by 3-14 days. Imaging sequences and acquisition timing were identical for the 2 examinations. Three blinded readers evaluated images qualitatively for diagnostic information (lesion extent, delineation, morphology, enhancement, global preference) and quantitatively for CNR and LBR. RESULTS: One hundred fourteen of 123 enrolled patients successfully underwent both examinations. Final diagnoses were intra-axial tumors, metastases, extra-axial tumors, "other" tumors, and "nontumor" (49, 46, 8, 7, and 4 subjects, respectively). Readers 1, 2, and 3 demonstrated preference for gadobenate dimeglumine in 46 (40.7%), 54 (47.4%), and 49 (43.0%) patients, respectively, compared with 6, 7, and 7 patients for gadobutrol (P < .0001, all readers). Highly significant (P < .0001, all readers) preference for gadobenate dimeglumine was demonstrated for all other qualitative end points. Inter-reader agreement was good for all evaluations (κ = 0.414-0.629). Significantly superior CNR and LBR were determined for gadobenate dimeglumine (P < .019, all readers). CONCLUSIONS: Significantly greater morphologic information and lesion enhancement are achieved on brain MR imaging with 0.1-mmol/kg gadobenate dimeglumine compared with gadobutrol at an equivalent dose.
Kimakova T.,Lekarska fakulta |
Hrnkova L.,Comenius University |
Kobliskova Z.,Comenius University
Klinicka Farmakologie a Farmacie | Year: 2016
Objective of study: The purpose of the study was to evaluate the use of dietary supplements by the general public in Slovakia and to identify their attitudes and knowledge towards these products. Methods: A questionnaire survey of 256 respondents was conducted in the interval from October to December 2014 by on-line collection. The use of dietary supplements and knowledge of the respondents were evaluated based on whether they agreed with general, safety and efficacy statements regarding dietary supplements. The results were processed descriptively using Microsoft Excel. Results: Up to 64.5% of the respondents use dietary supplements sometimes (49.8%). Pharmacy was the most frequent place for their purchase (55.8%). The main reason for their use is prevention of disease (30.0%) and this particularly concerns the supplements containing vitamins. Fifty-seven percent of the respondents reported having enough information about dietary supplements, with the main information sources being identified as follows: the internet (23.8%), pharmacists (18.6%) and physicians (14.6%). Only 21.5% of the respondents use dietary supplements according to the recommendation of a physician and 11.5% according to that of the pharmacist. As areas with a higher level of knowledge of the respondents were identified the perception of difference between a dietary supplement and a medicine (78.1%), knowledge that a dietary supplement is available without a prescription (72.0 %) and the fact that it is appropriate to consult its use with a specialist (71.3%). Moreover, 58.5% of the respondents knew that a dietary supplement is not a medicine, but only 25.3% of them knew that dietary supplements belong to foods for special nutritional purposes. Thirty-four percent of the respondents considered dietary supplements as completely safe and 19.6% thought that they were effective as medicines. Conclusion: The study found that the use of dietary supplements by the general public in Slovakia is comparable with that in other countries. The evaluation of knowledge 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 care professionals. © 2016, SOLEN s.r.o. All rights reserved.
Raida L.,Lekarska Fakulta
Prakticky Lekar | Year: 2013
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.
Filkova M.,Lekarska Fakulta
Ceska Revmatologie | Year: 2013
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.
Suchankova M.,Lekarska fakulta
Lekarsky Obzor | Year: 2012
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.
Polak P.,Lekarska fakulta |
Husa P.,Lekarska fakulta
Interni Medicina pro Praxi | Year: 2014
The authors present several notices to the practical indication and evaluation of serological methods. Detailed pathophysiology neither treatment are aim of the paper; the most frequent mistakes with emphasis on actually emerging disease - lyme borreliosis are discussed.
Svetlak M.,Lekarska fakulta |
Cernik M.,Lekarska fakulta
Prakticky Lekar | Year: 2010
Recent findings show that food craving is strongly related to body weight and causes excessive eating patterns observed in obesity, binge eating and bulimia nervosa and its severity represents a good predictor of relapse. Our study aimed to validate the Czech translation of the General Food-Craving Questionnaire - Trait (G-FCQ-T) that currently represents one of the most reliable tools for food craving measurement. In order to achieve this goal we measured indices of food craving in 257 university students. The statistical analysis of the acquired data revealed that the Czech version of the G-FCQ-T has satisfactory psychometric properties and it is ready to be used in common clinical practice.
Kucova J.,Lekarska Fakulta |
Sikorova L.,Lekarska Fakulta
Rehabilitacia | Year: 2014
Basis: If the healthcare professionals should provide the care, corresponding with Family Centred Care philosophy, it is necessary to know the needs of the children patients' families. The knowledge of these needs can help in care planning, concerning not only the child, but also whole family Group: 123 parents who take care of a child with ICP aged 1 to 7 years. Methods: Data were obtained via Family Needs Survey (FNS) questionnaire. Functional abilities of children were assessed via Gross Motor Function Classification System (GMFCS). Results: Most needs (60%) were formulated by respondents in the area of information. Parents of children with mild functional abilities have statistically more needs in the financial area. Functional abilities of a child are significantly influenced by five particular needs of parents. Statistical significant difference was showed in six needs, influenced by the age of child. Conclusion: Saturated needs of parents can significantly influence the quality of interactions among family and child and subsequently improve the development of children's abilities.
The role of new pro-inflammatory and/or pro-fibrotic molecules in the pathogenesis of systemic sclerosis [Význam nových prozánětlivých a/nebo profibrotických molekul v patogenezi systémové sklerodermie]
Tomcik M.,Lekarska Fakulta
Ceska Revmatologie | Year: 2014
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.
PubMed | Lekarska Fakulta
Type: | Journal: Journal of ophthalmology | Year: 2015
Aim. To evaluate the long-term effect of rheohemapheresis (RHF) treatment of age-related macular degeneration (AMD) on photoreceptor IS/OS junction status. Methods. In our study, we followed 24 patients with dry AMD and drusenoid retinal pigment epithelium detachment (DPED) for a period of more than 2.5 years. Twelve patients (22 eyes) were treated by RHF and 12 controls (18 eyes) were randomized. The treated group underwent 8 RHF standardized procedures. We evaluated best-corrected visual acuity, IS/OS junction status (SD OCT), and macular function (multifocal electroretinography) at baseline and at 2.5-year follow-up. Results. RHF caused a decrease of whole-blood viscosity/plasma viscosity at about 15/12%. BCVA of treated patients increased insignificantly (P = 0.187) from median 74.0 letters (56.2 to 81.3 letters) to median 79.0 letters (57.3 to 83.4 letters), but it decreased significantly from 74.0 letters (25.2 to 82.6 letters) to 72.5 letters (23.4 to 83.1 letters) in the control group (P = 0.041). The mfERG responses in the region of eccentricity between 1.8 and 7 were significantly higher in treated patients (P = 0.04). Conclusions. RHF contributed to sparing of photoreceptor IS/OS junction integrity in the fovea, which is assumed to be a predictive factor for preservation of visual acuity.