Hetastarch induced volume changes of starving adenoma and suggested mechanism of action.

Submucosal injection is often required step during endoscopic mucosal resection (EMR). In clinical practice we have observed that the EMR injection solution containing hetastarch (HES) lead to selective increase of the neoplasms volume, facilitating their resection. The aim of this study was to explore the possible mechanisms of such behaviour, which was not reported elsewhere. The HCT116 cell line of human colon cancer was exposed to the same EMR solution in vitro. The significant volume increase of HCT116 cells was observed, but only for starving cell culture, suggesting that the starving is essential for the neoplasms-specific volume change. We suggest, that for the iso-oncotic composition of the EMR submucosa injection solution the HES component is crucial, as it can be subject of the starch hydrolysis followed by facilitated transport of resulting monosaccharides from the submucosa into the neoplastic tissue.

Patterns in anticoagulant utilization in the Czech Republic during 2007-2017.

Direct oral anticoagulants (DOACs) have gradually entered the Czech market as alternatives to vitamin K antagonists and parenteral anticoagulants since 2008. Considering the eventual changes, the aim was to evaluate drug use and expenditure patterns on anticoagulants in the Czech Republic. A retrospective utilization study was conducted retrieving data from the State Institute for Drug Control database, including reports on drug supplies from distributors with anatomical therapeutic chemical classification (ATC) codes B01AA, B01AB, B01AE, B01AF, and B01AX. The utilization on national level was expressed as the ratio of the number of defined daily doses per 1000 inhabitants per day (DDD/TID). Expenditures on all anticoagulants were also assessed. Data was analyzed using PASW (version 18.0). Between January 2007 and December 2017, the national anticoagulant utilization rate increased continuously from 14.15 to 27.67 DDD/TID. The use of DOACs was 0.002 DDD/TID in 2008, increased to 6.04 DDD/TID in 2017. Warfarin utilization, after a small decrease in 2008, has shown nearly stable levels in the recent years (70.9% of all anticoagulants; mean 11.55 DDD/TID over the last 5 years), while its increase was halted by the spread of DOACs utilization (p < 0.05). In 2017, over half of the expenditures (51.1%) were due to oral anticoagulants, whereof 47.6% was related to DOACs. The results reflected a growing utilization and increasing costs of all anticoagulants, especially in DOACs at the expense of warfarin. Still, additional information regarding patient persistence and prescribing patterns is needed for a better understanding of oral anticoagulant utilization.

Structure of amorphous Ag/Ge/S alloys: experimentally constrained density functional study.

Density functional/molecular dynamics simulations have been performed to determine structural and other properties of amorphous Ag/Ge/S and Ge/S alloys. In the former, the calculations have been combined with experimental data (x-ray and neutron diffraction, extended x-ray absorption fine structure). Ag/Ge/As alloys have high ionic conductivity and are among the most promising candidates for future memristor technology. We find excellent agreement between the experimental results and large-scale (500 atoms) simulations in Ag/Ge/S, and we compare and contrast the structures of Ge/S and Ag/Ge/S. The calculated electronic structures, vibrational densities of states, ionic mobilities, and cavity distributions of the amorphous materials are discussed and compared with data on crystalline phases where available. The high mobility of Ag in solid state electrolyte applications is related to the presence of cavities and can occur via jumps to a neighbouring vacant site.

Compressive syndrome of internal jugular veins in multiple sclerosis: does it matter?

OBJECTIVES: Condition known as chronic cerebrospinal venous insufficiency (CCSVI) is characterized by insufficient cerebral vein drainage in patients with multiple sclerosis (MS) and internal jugular vein (IJV), vertebral and/or azygos veins stenoses. However, external compression on the IJV was not clearly described as a potential cause of CCSVI. We aim to present a case of CCSVI in a patient with MS caused by bilateral IJV inverted valves combined with IJV external compression by carotid bulb. METHODS: A 31-year-old female patient was admitted to our institute for IJV and vertebral veins morphological and haemodynamical assessment after being treated for MS for the last 14 years. Colour Doppler ultrasonography showed right IJV prestenotic dilation and inverted valves in both IJV. Computerized tomography angiography showed bilateral IJV compression by carotid bulb. Haemodynamical Doppler parameters showed that external IJV compression significantly contributed to CCSVI occurrence. RESULTS: Bilateral IJV confluence percutaneous angioplasty (PTA) was done, and the patient was discharged for further neurological examination. Partial carbon dioxide pressure was significantly lower in the distal part of both IJV following PTA and oxygen saturation increased. CONCLUSION: In the case presented, PTA of the IJV confluence resulted in haemodynamic improvement despite the presence of IJV external compression.

Silver environment and covalent network rearrangement in GeS3-Ag glasses.

The structure of Ag-doped GeS3 glasses (0, 15, 20, 25 at.% Ag) was investigated by diffraction techniques and extended x-ray absorption fine structure measurements. Structural models were obtained by fitting the experimental datasets simultaneously by the reverse Monte Carlo simulation technique. It is observed that Ge has mostly S neighbours in GeS3, but Ge-Ge bonds appear already at 15% Ag content. Sulfur has ~2 S/Ge neighbours over the whole concentration range, while the S-Ag coordination number increases with increasing Ag content. Ag-Ag pairs can already be found at 15% Ag. The Ag-S mean coordination number changes from 2.17 ± 0.2 to 2.86 ± 0.2 between 15% and 25% Ag content. Unlike the As-S network in AsS2-25Ag glass, the Ge-S network is not fragmented upon Ag-doping of GeS3 glass.

Morphological and haemodynamic abnormalities in the jugular veins of patients with multiple sclerosis.

OBJECTIVES: Multiple areas of stenosis and different levels of obstruction of internal jugular and azygous veins (a condition known as cronic cerebrospinal venous insufficiency) recently emerged as an additional theory to the well-known autoimmune concept, explaining etiology of multiple sclerosis (MS). The aim of our study was to evaluate internal jugular vein (IJV) morphology and haemodynamic characteristics in patients with MS and compare it with well-matched healthy individuals and to evaluate the prevalence of venous flow abnormalities in both groups. METHODS: Sixty-four patients with clinically proven MS and 37 healthy individuals were included in our study. In all patients, IJV morphology and haemodynamic characteristics were evaluated by colour Doppler sonography as well as venous flow disorder. The patients were classified into four groups according to MS clinical form presentation. The prevalence of morphological and haemodynamic abnormalities in the IJV were assessed. RESULTS: The presence of stenosing lesion, mostly intraluminal defects like abnormal IJV valves, were observed in 28 patients (43%) in the MS group, and in 17 patients (45.9%) in the control group (P = NS). By adding haemodynamic Doppler information in the IJV venous outflow was significantly different in 42% of MS patients showing flow abnormalities (27/64), as compared with 8.1% of the controls (3/37), P < 0.001. CONCLUSION: In our group of patients, patients suffering from MS had significantly more IJV morphological changes and haemodynamic abnormalities when compared with healthy individuals not suffering from MS. These findings can be well demonstrated by non-invasive and cost-effective Doppler ultrasound.

Internal jugular vein duplication: a further truncular malformation in a patient with multiple sclerosis.

Different internal jugular vein (IJV) abnormalities can be found in patients with multiple sclerosis (MS): stenoses, complete occlusion, distortions and intraluminal structures, such as membranes, webs and inverted valves. IJV duplication is a very rare phenomenon. We report a case of right IJV duplication as an incidental finding during IJV morphological and haemodynamic assessment in a patient with MS. A 55-year-old female patient was admitted to our Institute for IJV and vertebral veins morphological and haemodynamic assessment. During the last seven years she had been treated for MS. Colour Doppler ultrasonography in our patient did not reveal IJV or vertebral veins stenoses or abnormal valves, but instead right IJV duplication. This finding was confirmed using multislice computed tomography angiography and by selective phlebography. In conclusion, to our knowledge, a case of IJV duplication in a patient with MS has not been described yet. This further venous malformation can be assessed by the means of Doppler ultrasounds.

Use of genetic algorithms with multivariate regression for determination of gelatine in historic papers based on FT-IR and NIR spectral data.

Quantitative non-destructive analysis of individual constituents of historic rag paper is crucial for its effective preservation. In this work, we examine the potentials of mid- and near-infrared spectroscopy, however, in order to fully utilise the selectivity inherent to spectroscopic multivariate measurements, genetic algorithms were used to select spectral data derived from information-rich FT-IR or UV-vis-NIR measurements to build multivariate calibration models based on partial least squares regression, relating spectra to gelatine content in paper. A selective but laborious chromatographic method for the quantification of hydroxyproline (HYP) has been developed to provide the reference data on gelatine content. We used 9-fluorenylmethyl chloroformate (FMOC) to derivatise HYP, which was subsequently determined using reverse-phase liquid chromatographic separation and fluorimetric detection. In this process, the sample is consumed, which is why the method can only be used as a reference method. The sampling flexibility afforded by small-size field-portable spectroscopic instrumentation combined with chemometric data analysis, represents an attractive addition to existing analytical techniques for cultural heritage materials.

[Overcooling during mild hypothermia in cardiac arrest survivors--phenomenon we should keep in mind]. / Nadmerné othlazení behem mírné hypotermie po srdecní zástave--fenomén zasluhující pozornost.

BACKGROUND: Mild hypothermia (MH) in cardiac arrest survivors has became a routine part of early postresuscitative support. Overcooling is a frequent phenomenon with the unknown outcome. AIM OF THE STUDY: To analyze the incidence and outcome ofovercooling below body core temperature (BT) of 32 degrees C. MATERIAL AND METHODS: We performed retrospective analysis of all 56 consecutive cardiac arrest survivors treated by MH who reached therapeutic BT in the 2nd Department of Internal Medicine, General Teaching Hospital, Prague. MH was initiated as soon as possible after the return of spontaneous circulation to reach BT of 33 degrees C followed by maintainance of BT 32-34 degrees C for 12 hours. Patients were cooled by surface cooling via ice-packs and by interavenous infusion of cold crystaloids. RESULTS: Overcooling below BT of 32 degrees C was observed in 23 patients (41%). This group of patients had more frequently asystole as the initial rhythm (34.8 vs 9.1%), more frequently were cooled by combinatory cooling approach (56.5 vs 27.3%), more frequently had lower baseline BT (35.3 +/- 1.3 vs 36.2 +/- 1.2 degrees C), higher cooling rate (the interval required for a decrease of BT by 1 degrees C 61.5 +/- 53.1 vs 90.1 +/- 50.0 min) (all p < 0.05) than patients with proper profile of BT during MH. Overcooling was independent negative predictor of discharge favourable neurological outcome (OR 0.16, 0.022-0.77, p = 0.037). CONCLUSION: Induction of MH by conventional cooling approach is burdened by high risk of overcooling. This phenomenon is probably associated with worse outcome.

[Standard prescriptions for the formulation of medicinal preparations in pharmacies. I. Suspensions for dermal administration]. / Standardní receptura pro prípravu lécivých prípravku v lékárnách. I. Suspenze k aplikaci na kuzi.

The paper summarizes the present state of standard prescriptions for the formulation of suspensions for dermal administration in the Czech Republic and compares it with the NRF (Neues Rezeptur-Formularium in Deuscher Arzneimittel-Codex) standard prescriptions. The analysis of medical prescriptions for suspensions for dermal administration dispensed in the pharmacies of the Czech Republic has revealed that 18.8 % of the prescriptions were for 50% suspension of zinc(II) oxide in sunflower oil. This preparation should therefore become a candidate for standardization as a monograph in the national part of the Czech Pharmacopoeia.

Induction of mild hypothermia in cardiac arrest survivors presenting with cardiogenic shock syndrome.

BACKGROUND: Induction of mild hypothermia (MH) in patients resuscitated from cardiac arrest improves their outcome. However, benefits and risks of MH in patients who remain in cardiogenic shock after the return of spontaneous circulation (ROSC) are unclear. We analysed all cardiac arrest survivors who were treated with MH in our intensive coronary care unit (CCU) and compared the outcome of patients with cardiogenic shock syndrome (CSS) with those who were circulatory stable. METHODS: We performed retrospective analysis of all consecutive cardiac arrest survivors treated by MH in our CCU from November 2002 to August 2006. They were classified into two groups, according to whether they met the criteria for cardiogenic shock or not before MH initiation. RESULTS: Out of 56 consecutive patients, 28 fulfilled criteria of cardiogenic shock before MH initiation (group A) and 28 were relatively stable (group B). In-hospital mortality was 57.1% in group A and 21.4% in group B patients (P=0.013). Favourable neurological outcome anytime during hospitalization was found in 67.9% of group A patients and in 82.1% of group B subjects (P=0.355). Favourable discharge neurological outcome was reached in 39.3% in group A and in 71.4% in group B (P=0.031). The complication rate in both groups did not differ. CONCLUSION: While in-hospital mortality in cardiac arrest survivors treated by MH was expectably higher in those with cardiogenic shock than in stable patients, the favourable neurological outcome during hospitalization was comparable in both groups. Therefore, induction of MH should be considered in cardiac arrest survivors with CSS after ROSC.

[Prescription of hypolipidemic agents in 2001-2004]. / Preskripce hypolipidemik v letech 2001-2004.

The paper analyzes the development of the prescription and consumption of hypolipidemic agents from 2000 to 2004. The principal database consisted of dispensed medical prescriptions and the consumption of hypolipidemic agents was expressed in DDD, DID, financially, and in the form of proportional representation. In the year 2004 hypolipidemic agents represented 11.8% of the total costs for medicaments (statins, 8.9%, and 75.6%, respectively, fibrates, 2.9% and 24.4%, respectively), in DDD statins, 69.0%, fibrates, 31.0%. The most frequently prescribed preparation was simvastatin, 57.8% DDD and 60.3% in financial units.

[University courses in pharmacy in the Czech Republic]. / Studium farmacie v Ceské Republice.

The paper analyzes and compares the interest of applicants for the admission to the university courses in Pharmacy in the Czech Republic from the viewpoint of their number, sex, and other indices. It also characterizes the courses and discusses the requirements for pharmacists (dispensing chemists) and their possible professional careers.

[Continuous education of pharmacists in the Czech Republic. 2nd cycle 2002-2005]. / Kontinuální vzdelávání lékárníku v Ceské Republice. 2. Cyklus 2002-2005.

The paper deals with continuous education of pharmacists in the Czech Republic in 2002-2005 (2nd cycle). It surveys the seminars organized within the framework of continuous education, their number, topics, and lecturers. A total number of 232 professional seminars took place, which included 339 lectures, mainly on pharmacology (76.1%).

[Contemporary programme of pharmaceutical studies in Germany]. / Soucasný program farmaceutického studia v nemecku.

In the year 2002, both the Czech and Slovak Faculties of Pharmacy celebrated the fiftieth anniversary of the existence of four-year and later five-year university courses of pharmaceutical studies, the contents of which were being continuously modified in order to comply with principal trends in the field of pharmacy. A new programme of pharmaceutical studies which has just started at German universities can serve us as a certain example and provide comparison, or inspiration.

[Dispensation during pharmaceutical emergency service]. / Poskytování lékárenské péce behem pohotovostních sluzeb.

The paper deals with the analysis of 24 694 medical prescriptions dispensed during pharmaceutical stand-by duty service within 12 months. 8072 medical prescriptions (32.7 %) were issued by first-aid medical service. 72.2 % of requirements for pharmaceutical stand-by duty service took place between 19.00 to 22.00. Patients under 20 requiring pharmaceutical stand-by duty service represented 37.8 %. One medical prescription issued by medical first-aid service included 1.8 packages of pharmaceutical preparations. Medical prescriptions issued by medical first-aid service to adults included altogether 529 different sorts of medicinal preparations, those issued to children, 269 sorts.

A model of animal-human brucellosis transmission in Mongolia.

We developed a dynamic model of livestock-to-human brucellosis transmission in Mongolia. The compartmental model considers transmission within sheep and cattle populations and the transmission to humans as additive components. The model was fitted to demographic and seroprevalence data (Rose Bengal test) from livestock and annually reported new human brucellosis cases in Mongolia for 1991-1999 prior to the onset of a mass livestock-vaccination campaign (S19 Brucella abortus for cattle and Rev 1 Brucella melitensis for sheep and goat). The vaccination effect was fitted to livestock- and human-brucellosis data from the first 3 years of the vaccination campaign (2000-2002). Parameters were optimized on the basis of the goodness-of-fit (assessed by the deviance). The simultaneously fitted sheep-human and cattle-human contact rates show that 90% of human brucellosis was small-ruminant derived. Average effective reproductive ratios for the year 1999 were 1.2 for sheep and 1.7 for cattle.

[Prescription and structure of formulation of medicinal preparations in a pharmacy. II]. / Preskripce a struktura prípravy lécivých prípravku v lékárne II.

The paper is concerned with the analysis of all medicinal preparations prepared extemporaneously in a pharmacy within 12 months (July 2002 through June 2003). The set under study comprised 5 260 preparations. Preparations were prescribed primarily by dermatologists, their share being 31.3 %. The expiratory period of the largest number of preparations (61.8 %) was one month. Of the total number of medicinal preparations, 76.1% were prepared on medical prescriptions, 3.5 % on orders, and 20.4 % were sold over the counter. The average annual share of preparations in the total turnover was 2.3 %.

[Unit dose systems prepared for geriatric patients. I]. / Jednodávkové systémy léciv pripravované geriatrickým pacientum I.

The project was carried out to facilitate and improve the quality of the use of drugs by geriatric patients aiming at the observation of the therapeutic regimen and the improvement of their compliance. The group under study comprised 15 clients living in a selected old people's home in the city of Brno, for whom the pharmacist prepared drugs into one-week blister dispensers on the basis of their health dossiers for a period of 6 months (February - July 2002). Polypharmacy occured in all patients included into a unit-dose preparation for drugs; they took on average 16 drugs in a week. The most frequently administered drugs belonged to the ATC groups of psycholeptics, anti-inflammatory and antirheumatic agents, peripheral vasodilators, antianaemic agents, cardiac therapy, diuretics, and vasoprotectives and venopharmaceuticals. The dimensions of the dispensers used and the size of individual blisters in them proved to be sufficient with an average number of 11 drugs dispensed weekly. The preparation of one-week drug dispensers was also evaluated from the standpoint of time consumption. The average time of preperation of dispensers by the pharmacist was 16 minutes 20 seconds. Time consumption was connected not only with the total number of drugs dispensed, but also with the frequency of drug dosing, splitting (halving, quartering) of drugs, and frequent changes in medication.