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Endovaskulární léčba aneurysmatu abdominální aorty je zatím stále ještě limitovaná morfologií vlastního aneurysmatu a ilia-kálního řečiště, i když morfologická kritéria se mění spolu s vývojem endovaskulárních technik a technologií. Se současně dostupnými stentgrafty je anatomicky vhodných k endovaskulární léčbě asi 60-80 % výdutí, u zbylých 20-40 % je nejčasněj-ší limitací nevhodná morfologie proximálního krčku. Limitací pro klasickou endovaskulární léčbu aneurysmatu břišní aorty je nepřítomnost vhodného krčku až šíření aneurysmatu supra-renálně, nevhodný tvar krčku, rozsáhlý trombus nebo jeho výrazná angulace. Některé tyto limitace lze překonat implan-tací fenestrovaných a větvených stentgraftů. Nicméně i přes veškeré pokroky v endovaskulární léčbě je vhodná morfologie aneurysmatu abdominální aorty stále zásadní podmínkou pro standardní endovaskulární léčbu. Podle instrukcí pro použití stentgraftů by měl být prox'mální krček délky 15 a více mm, resp. 10 mm a více, průměru do 32 mm, neměl by být konický a kalcifikovaný a s nástěnným trombem. Angulace subrenální břišní aorty by měla být do 60°. Nevhodný prox'mální krček, jako je krček krátký, angulovaný a široký, pak patříjednoznačně k prediktívním faktorům pro pozdní komplikace a reintervence po implantaci stentgraftu a je spojen nejen s vyšším výskytem endoleaku typu Ia, a to časným i pozdním, který je rizikový z hlediska ruptury. S délkou sledování je pak výskyt pozdních komplikací jednoznačně vyšší. Vzhledem k pokračující degeneraci aortální stěny a pokračující dilataci krčku se setkáváme s komplikacemi v proximální kotvící zóně i u pacientů, kteří sice splňovali kritéria instrukcí pro použití stentgraftu, nicméně kritéria byla splněna hraničně jak co do délky, tak kvality krčku. Standardní endovaskulární léčba tedy může být provedena i u nemocných s hraničními parametry proximálního krčku, ale s významně vyšším výskytem proximálního endoleaku. U krčků mimo rámec instrukcí pro použití stentgraftu nebo krčků splňujících hraničně podmínky sice po implantaci stentgraftu proximální anastomóza bezprostředně po výkonu těsní, ale sebemenší migrace a časový odstup od výkonu znamená riziko pozdního proximálního endoleaku. Navíc je známo, že v současné době je asi 44 % endovaskulární léčby prováděno mimo instrukce pro použití pro daný typ stentgraftu. Tyto výkony by měly být pak prováděny s vědomím vyššího rizika komplikací. Dodržování a možná i zpřísnění morfologických kritérií je tedy zásadní z hlediska snížení rizika komplikací po standardní endovaskulární léčbě aneurysmatu břišní aorty a její dlouhodobou stabilitu. I přes stále nové konstrukční prvky stentgraftů při snaze zlepšit jeho kotvící vlastnosti je nejdůležitější vlastní morfologie výduti. V tomto světle lze do budoucna předpokládat spíše rozšíření indikací pro fenestrované stentgrafty. [ABSTRACT FROM AUTHOR]

Copyright of Czech Radiology / Ceska Radiologie is the property of Czech Medical Association of JE Purkyne and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Česká a Slovenská Neurologie a Neurochirurgie is the property of Czech Medical Association of JE Purkyne and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Due to the severity of the consequences, the diagnosis of postural disorders at a younger school age is the focus of parents, pediatricians, physiotherapists and teachers or coaches of sports teams. Significant signs of insufficiency of the so-called posture, in addition to risky asymmetric manifestations, are insufficient scapulo thoracical fixation, described as scapula alata. and flat foot. Methods: The aim was to find statistical correlations between the finding of a) scapula alata and age, sex and the occurrence of hypermobility, shortened muscles (mm. trapezii pars descendens and mm. pectorales minores) and impaired trunk stabilization functions b) flat foot and age, sex and the occurrence of hypermobility, lumbar spine hyperlordosis, shortened hamstrings and overweight. Results: 298 children aged 6-12 years were examined. Significant relationships between the occurrence of scapula alata (in 67 % of children) were described, with which the finding of hypermobility and shortening of mm. trapezii pars descendens has the greatest statistical relationship. The likelihood of finding scapula alata at a younger school age increases gender (girls have a 40 % lower risk of finding scapula alata), the incidence of hypermobility (the risk of finding scapula alata is 2.4 higher in hypermobile children) and shortened muscles (the likelihood of finding scapula alata is in children with shortened trapezius pars descendens increases 2.27x). The occurrence of a flat foot has the greatest and at the same time significant association with gender, the finding of hypermobility, shortened hamstrings, lumbar spine hyperlordosis and overweight. The probability of finding a flat foot was increased in boys (boys have a 56 % higher risk of finding a flat foot, overweight - in overweight children there was even a 10.1 times higher risk of flat foot) and hypermobility (children with hypermobility are 2.3 times more likely occurrence of a flat foot). Conclusion: Although the occurrences of some observed parameters are only a manifestation of the child's growth dynamics, it is necessary to be aware of possible risks and consequences for further movement of the child, if these manifestations of insufficiency are not diagnosed and at least controlled to prevent their fixation in further movement behavior of the child or adolescent. [ABSTRACT FROM AUTHOR]

Copyright of Česká a Slovenská Neurologie a Neurochirurgie is the property of Czech Medical Association of JE Purkyne and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Plzensky Lekarsky Sbornik is the property of Charles University Prague, Karolinum Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aims Islet cell autoantibodies are associated with autoimmune insulitis and belong to the diagnostic criteria of Type 1 diabetes mellitus. However, growing evidence suggests that autoantibodies are present in other types of diabetes. Here, we focus on the autoantibody incidence in Czech patients with maturity-onset diabetes of the young and analyse their functional relevance in terms of diabetes onset and control. Methods Autoantibodies against glutamic acid decarboxylase ( GAD) 65 and protein tyrosine phosphatase islet antigen 2 ( IA-2) were measured in a cohort of 28 Czech patients with maturity-onset diabetes of the young, all confirmed by genetic testing. Selected clinical data were correlated to the status and kinetics of autoantibodies. Results One quarter of patients with maturity-onset diabetes of the young examined (7/28; 25%) was positive for GAD or IA-2 autoantibodies. GAD autoantibodies were more prevalent (7/7) than IA-2 autoantibodies (1/7). The incidence of autoantibodies did not correlate with human leukocyte antigen status. The patients who were positive for the autoantibodies developed diabetes later than those who were autoantibody-negative, but had worse glycaemic control (increased HbA1c). Expression of autoantibodies decreased with any improvement of diabetes compensation. Only one patient did not correspond to the above and displayed signs of combined signs of maturity-onset diabetes of the young and Type 1 diabetes. Conclusions The data suggest transient but highly prevalent islet cell autoantibody expression in Czech patients with maturity-onset diabetes of the young. The autoantibodies were found in patients with delayed diabetes onset, and in times of insufficient diabetes control. As improvement of glycaemic control was associated with a decrease in levels of autoantibodies, their presence may reflect the kinetics of β-cell destruction induced by causes other than autoimmune ones. [ABSTRACT FROM AUTHOR]

Copyright of General Practitioner / Praktický Lékař is the property of Czech Medical Association of JE Purkyne and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)