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Kafka P.,Charles University | Kafka P.,Kralovske Vinohrady University Hospital | Vajnerova O.,Charles University | Hampl V.,Charles University
Bratislava Medical Journal | Year: 2016

Background: Chronic hypoxia elevates vascular resistance on the fetal side of the placenta. However, when a low-viscosity perfusate is used, the increase in resistance caused by chronic hypoxia is relatively small (12 mmHg). In the present study, we tested the hypothesis that perfusion with more viscous fluid (blood) will reveal more substantial effect of chronic hypoxia. Methods: Using an isolated, dually perfused rat placenta perfused at a constant flow rate with homologous blood, perfusion pressure on the fetal side was measured. Then, the relationship between perfusion pressure and flow (P/Q) was determined. Results: Fetoplacental vascular resistance was increased by chronic hypoxia (10 % O2) during the last third of gestation. This was observed when the placentas were perfused with a low viscosity Krebs solution and more enhanced when perfused with blood. Nevertheless, we found no clear advantage for using blood instead of Krebs solution to study the effects of hypoxia on the fetoplacental vasculature. The elevation of fetoplacental vascular resistance caused by chronic hypoxia was at least partly resistant to acute reoxygenation. Conclusion: Using blood for the perfusion of the isolated rat placenta does not confer any clear methodological advantage over using Krebs solution.


Sadilkova L.,Thomayer University Hospital | Paluch Z.,Thomayer University Hospital | Mottlova J.,Thomayer University Hospital | Bednar F.,Kralovske Vinohrady University Hospital | Alusik S.,Thomayer University Hospital
Clinical Laboratory | Year: 2012

Background: Thromboxane B 2 (TxB 2) and particularly 11-dehydrothromboxane B 2 (H-dTxB 2) are widely used as prognostic risk markers of platelet activation in cardiovascular diseases. The main errors in TxB 2 and H-dTxB 2 determination include either low concentrations of circulating TxB 2 (1-2 pg/mL) and H-dTxB 2 (0.9-4.3 pg/mL) or rather high transiency (mean TxB 2 half-life is approximately 5 minutes) as well as an incorrect pre-analytical phase set up. The aim of this study was to investigate the impact of a widely used purification step on the results of enzyme immunosorbent assay (EIA) - based measurement of the two selected thromboxanes. Methods: For the purpose of this study, 20 plasma samples (10 healthy donors, 10 patients under treatment with acetylsalicylic acid) were screened for TxB 2 and H-dTxB 2 concentrations using commercial competitive EIA kits (Cayman Chemicals™, Tallinn, Estonia; Neogen™, Lexington, KY, USA) with or without the introduction of the purification procedure. Results: The purification step does not significantly affect the results of EIA measurements of the two of TxA 2 metabolites (TxB 2, 11-dTxB 2) in human plasma. The levels of TxB 2 and 11-dTxB 2 determined in the plasma samples were not significantly changed (p<0.05) when the purification step was omitted compared to the purified samples. Conclusions: This study establishes a protocol allowing for reliable and reproducible plasma TxB 2 and 11-dTxB 2 EIA measurement for routine basic screening of platelet function.


Hork E.,Kralovske Vinohrady University Hospital | Beneov S.,Kralovske Vinohrady University Hospital
Journal of Pain and Palliative Care Pharmacotherapy | Year: 2010

A Case of complex regional pain syndrome is presented from the perspectives of pain specialists from the Czech Republic. Clinical presentation, goals of therapy, epidural analgesia, radiofrequency ablation, and nerve block, opioids and spinal cord stimulation are discussed. Commentaries on this case are provided by pain specialists from Israel and Sweden. © 2010 Informa Healthcare USA, Inc.


Raudenska J.,Charles University | Javurkova A.,Kralovske Vinohrady University Hospital | Kozak J.,Motol University Hospital
Neuroendocrinology Letters | Year: 2013

Pain-related fear may pose a serious barrier in the management of patients with chronic musculoskeletal pain, resulting in severe functional impairment in many cases. The paper describes the cognitive-behavioural therapy of a patient with a specific phobia (fear of pain and movement). The principal objective of the therapy was to educate the patient in strategies and skills to manage his fear and to verify the effect of the therapy. Both group and individual therapy was used. Group multimodal therapy of pain was provided by an interdisciplinary team of health care providers, specialising in pain management (psychotherapist, doctors and physiotherapists). The programme was based on operant therapy principles and included pacing and graded exercising and walking, relaxation, group education about ergonomics, and fear and pain relapse prevention. Reduction in the fear of pain and movement was achieved, and social bonds and physical and social activities improved after the psychotherapy, while the results were stable for two years. © 2013 Neuroendocrinology Letters.


Plistil L.,Charles University | Plistil L.,Kralovske Vinohrady University Hospital | Henke P.,Charles University | Kubat P.,J. Heyrovsky Institute of Physical Chemistry | And 2 more authors.
Photochemical and Photobiological Sciences | Year: 2014

Anion exchange polystyrene nanofiber materials (AE) were prepared by electrospinning followed by two-step functionalization of the nanofiber surface by chlorosulfonic acid and ethylendiamine. The photoactive character of these materials was introduced through adsorption of the tetra-anionic 5,10,15,20-tetrakis-(4-sulfonatophenyl)porphyrin photosensitizer (TPPS-AE) on the nanofiber surface or by encapsulation of the nonpolar 5,10,15,20- tetraphenylporphyrin photosensitizer (AE(TPP)) into the nanofibers. Anion exchange nanofiber materials with porphyrins are characterized by a high ion-exchange capacity, photogeneration of singlet oxygen O2( 1Δg), and singlet oxygen-sensitized delayed fluorescence. Due to the photogeneration of cytotoxic O2( 1Δg), the nanofibers exhibited oxidation of the external substrates in aqueous solution and an efficient antibacterial effect when activated by simulated daylight. Adsorption of both TPPS and I- on the surface of AE led to the formation of more efficient I-TPPS-AE materials. Rapid photooxidation of I- by O2(1Δ g), and the formation of another cytotoxic species, I 3 -, on the surface of the nanofibers were responsible for the increased antibacterial properties of I-TPPS-AE and the prolonged antibacterial effect in the dark. © the Partner Organisations 2014.


Bednar F.,Kralovske Vinohrady University Hospital | Tencer T.,Homolka Hospital | Plasil P.,Homolka Hospital | Paluch Z.,Thomayer Faculty Hospital | And 3 more authors.
Journal of Cardiothoracic and Vascular Anesthesia | Year: 2012

Objective: Aspirin therapy decreases mortality and ischemic complication rates after coronary artery bypass grafting (CABG). However, platelet inhibition after oral aspirin seems to be insufficient in the early postoperative period. There are incomplete data reporting aspirin efficacy early after CABG. The aim of this study was to assess the pharmacologic effect of aspirin on platelets in the first postoperative days using the most specific laboratory tests for the evaluation of aspirin efficacy. Design: A prospective study. Setting: A clinical study in one cardiac surgery center and measurements in two pharmacologic institutions. Participants: Thirty patients. Interventions: Postoperative aspirin efficacy (200 mg/d) was assessed by the suppression of serum thromboxane B2 (TxB2) and by arachidonic acid-induced aggregometry using the MULTIPLATE analyzer. Samples were collected before surgery and on postoperative days 1-5. Methods and Main Results: The median baseline value (range) of serum TxB2 was 1.6 ng/mL (1.4-1.9). The median TxB 2 inhibition >90% (the value required for full platelet inhibition) was not achieved until day 5 (-91%, 0.13 ng/mL [0.08-0.22], p < 0.001) and in only 55% of patients. The median baseline ASPI value was 805 (640-975) aggregation units (AU)*min. A significant decrease in aspirin insufficiency was not seen before postoperative day 5 (390 [243-621], p < 0.003) and only 34% of patients reached an effective platelet inhibition on day 5 (cutoff < 300 AU*min). Conclusions: The effect of aspirin on inhibition of TxB2 production and arachidonic acid-induced platelet aggregation is impaired during the first postoperative days after CABG. A more effective antiplatelet strategy presumably could increase early graft patency and improve clinical outcomes after CABG. © 2012 Elsevier Inc.


Sadilkova L.,Thomayer Hospital | Paluch Z.,Thomayer Hospital | Mottlova J.,Thomayer Hospital | Bednar F.,Kralovske Vinohrady University Hospital | Alusik S.,Thomayer Hospital
International Journal of Laboratory Hematology | Year: 2013

Aims: Platelet function testing is often affected by the existence of different pre-analytical variables that can cause platelet activation. The aim of this study was to assess the effect of such variables that are present when samples are taken (different anticoagulants, incubation temperature, and storage conditions) to select those which enable to reach optimal range of measured plasma concentrations of the two stable thromboxane A2 metabolites, that is, thromboxane B2 (TxB2) and 11-dehydrothromboxane B2 (11-dTxB2). Materials and Methods: For the purpose of this study, whole blood samples obtained from 20 volunteers were screened for TxB2 and 11-dTxB2 concentrations using commercial EIA kits (Cayman Chemicals™; Neogen™) in relation to the effect of different anticoagulants, using different incubation temperatures and storage conditions. Results: Trisodium citrate has been shown not to be affecting the TxB2 and 11-dTxB2 concentrations compared with the values measured in the serum. Incubation of the samples for 1 h at 37 °C and freezing at -20 °C or -80 °C give the most suitable concentration range of both thromboxanes in the used EIA measurement. Conclusion: This study describes the setup of such pre-analytical phase conditions that enable the screening of platelet function in terms of the plasma concentrations of TxB2 and 11-dTxB2 in selected EIA measurement. © 2012 Blackwell Publishing Ltd.


PubMed | Anglia, Aristotle University of Thessaloniki, Kralovske Vinohrady University Hospital, Vilnius University and 19 more.
Type: | Journal: Clinical nutrition (Edinburgh, Scotland) | Year: 2015

Malnutrition represents a serious health care threat, as it increases morbidity, mortality and health care cost. The effective screening and treatment with enteral (EN) or parenteral (PN) nutrition are the key elements of the policy called Optimal Nutrition Care for All (ONCA). The study tried to analyze the impact of the states economy on the implementation of EN and PN to define its role in ONCA.an international survey in twenty two European countries was performed between January and December 2014. An electronic questionnaire was distributed to 22 representatives of clinical nutrition (PEN) societies. The questionnaire comprised questions regarding country economy, reimbursement, education and the use EN and PN. Return rate was 90.1% (n=20).EN and PN were used in all countries surveyed (100%), but to different extent. The countrys income significantly influenced the reimbursement for EN and PN (p<0.05). It was also associated with the overall use of tube feeding and PN (p=0.05), but not with the use of oral nutritional supplements (p=0.165). The use of both, EN and PN at hospitals was not depended on the economy (p>0.05). Education was actively carried out in all countries, however the teaching at the pre-graduate level was the least widespread, and also correlated with the country income (p=0.042).Results indicated that economic situation influences all aspects of ONCA, including education and treatment. The reimbursement for EN and PN seemed to be the key factor of effective campaign against malnutrition.


PubMed | Kralovske Vinohrady University Hospital and Charles University
Type: Case Reports | Journal: Neuro endocrinology letters | Year: 2014

Pain-related fear may pose a serious barrier in the management of patients with chronic musculoskeletal pain, resulting in severe functional impairment in many cases. The paper describes the cognitive-behavioural therapy of a patient with a specific phobia (fear of pain and movement). The principal objective of the therapy was to educate the patient in strategies and skills to manage his fear and to verify the effect of the therapy. Both group and individual therapy was used. Group multimodal therapy of pain was provided by an interdisciplinary team of health care providers, specialising in pain management (psychotherapist, doctors and physiotherapists). The programme was based on operant therapy principles and included pacing and graded exercising and walking, relaxation, group education about ergonomics, and fear and pain relapse prevention. Reduction in the fear of pain and movement was achieved, and social bonds and physical and social activities improved after the psychotherapy, while the results were stable for two years.


PubMed | Kralovske Vinohrady University Hospital and Charles University
Type: | Journal: Critical care (London, England) | Year: 2015

Mitochondrial damage occurs in the acute phase of critical illness, followed by activation of mitochondrial biogenesis in survivors. It has been hypothesized that bioenergetics failure of skeletal muscle may contribute to the development of ICU-acquired weakness. The aim of the present study was to determine whether mitochondrial dysfunction persists until protracted phase of critical illness.In this single-centre controlled-cohort ex vivo proof-of-concept pilot study, we obtained vastus lateralis biopsies from ventilated patients with ICU-acquired weakness (n = 8) and from age and sex-matched metabolically healthy controls (n = 8). Mitochondrial functional indices were measured in cytosolic context by high-resolution respirometry in tissue homogenates, activities of respiratory complexes by spectrophotometry and individual functional capacities were correlated with concentrations of electron transport chain key subunits from respiratory complexes II, III, IV and V measured by western blot.The ability of aerobic ATP synthesis (OXPHOS) was reduced to ~54% in ICU patients (p<0.01), in correlation with the depletion of complexes III (~38% of control, p = 0.02) and IV (~26% of controls, p<0.01) and without signs of mitochondrial uncoupling. When mitochondrial functional indices were adjusted to citrate synthase activity, OXPHOS and the activity of complexes I and IV were not different, whilst the activities of complexes II and III were increased in ICU patients 3-fold (p<0.01) respectively 2-fold (p<0.01).Compared to healthy controls, in ICU patients we have demonstrated a ~50% reduction of the ability of skeletal muscle to synthetize ATP in mitochondria. We found a depletion of complex III and IV concentrations and relative increases in functional capacities of complex II and glycerol-3-phosphate dehydrogenase/complex III.

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