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1

Mycophenolate mofetil for treatment of idiopathic nephrotic syndrome – a single center experience (preliminary study)

100%

Tomczyk D., Jander A., Mihailescu J., Tkaczyk M.

Progress in Health Sciences

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2014

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vol. 4

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issue 1

61-67

XX

Introduction: Mycophenolate mofetil (MMF) is used in treatment of idiopathic nephrotic syndrome in children (INS). Purpose: To evaluate clinical results of MMF treatment in steroid-dependent (SD) and steroid-resistant (SR) nephrotic syndrome. Materials and methods: A retrospective analysis of 26 patients (19 boys, 7 girls) with SDINS and SRINS treated with MMF during the years 2003–2013 was made. The remission length of INS and number of relapses per year before the introduction of MMF and after 12 months was calculated. An analysis of the side effects was made. Results: The median age of INS diagnosis was 26.5 months (IQRs 24-36 months). Nineteen of the patients (73%) suffered from SDINS whereas the remaining 7 (27%) had SRINS. Twenty three (88.5%) patients underwent renal biopsy: minimal change disease (MCD) in 69.6% (n=16), focal segmental glomerulosclerosis (FSGS) in 17.4% (n=4), membranoproliferative glomerulonephritis (MPGN) in 8.7% (n=2) and mesangial cell proliferation in one case. The median MMF dosage was 956.0 mg/m2/24h (IQRs 768.1-1059.7 mg/m2/24h). Eleven patients (42.3%) were taking MMF together with cyclosporine A (CsA). In patients suffering from SDINS, there was a trend to lower the recurrence rate during MMF treatment [2.0/year (IQRs 0.25-2.0 per year) vs 2.0/year (IQRs 1.0-2.75 per year), p=0.09]. Remission without proteinuria was significantly longer in patients treated with MMF; remission median was 8.5 month (IQRs 6.25-11.0 month) vs 4.5 month (IQRs 4.0-7.5 month), (p=0.014), similarly the average length of remission without corticosteroids was 6.0 months (IQRs 0.25-8.5 months) vs 3.0 months (IQRs 0.0-7.25) months (p=0.028). In children SRINS, 4/7 children MMF treatment was clinically ineffective. Side effects of the treatment were: leucopenia (n =10), hyperbilirubinemia (n = 3), gastrointestinal disorders (n = 1) and anemia (n = 1). Conclusion: This study confirmed the efficacy of the treatment with MMF in SDINR in comparison with previously used drugs, with a small number of side effects.

2

Textgrammatika in einer Beschwerdeschrift Johann Geilers von Kaysersberg: Zur religiösen Identität und zum juridischen Selbstverständnis im späten Mittelalter

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Seyferth S.

Studia Linguistica

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2014

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issue 33

123 - 134

EN

The article deals with textual phenomena such as isotopy, recurrence or contiguity within a late medieval text, the so-called 21 articles from 1501 written by Johann Geiler von Kaysersberg. The famous preacher argues against heretic judicial instructions initiated by Strasbourg’s city council. Lexically, Geiler focuses on a certain “judgmental concept” in which he accuses, warns, japes, moderates or constructively proposes his point of view. To sum up, he frequently uses rhetorical features in order to write intelligibly.

3

Work stress and the risk of recurrent coronary heart disease events: A systematic review and meta-analysis

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Li J., Zhang M., Loerbroks A., Angerer P., Siegrist J.

International Journal of Occupational Medicine and Environmental Health

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2015

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vol. 28

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issue 1

8-19

EN

Though much evidence indicates that work stress increases the risk of incident of coronary heart disease (CHD), little is known about the role of work stress in the development of recurrent CHD events. The objective of this study was to review and synthesize the existing epidemiological evidence on whether work stress increases the risk of recurrent CHD events in patients with the first CHD. A systematic literature search in the PubMed database (January 1990 – December 2013) for prospective studies was performed. Inclusion criteria included: peer-reviewed English papers with original data, studies with substantial follow-up (> 3 years), end points defined as cardiac death or nonfatal myocardial infarction, as well as work stress assessed with reliable and valid instruments. Meta-analysis using random-effects modeling was conducted in order to synthesize the observed effects across the studies. Five papers derived from 4 prospective studies conducted in Sweden and Canada were included in this systematic review. The measurement of work stress was based on the Demand- Control model (4 papers) or the Effort-Reward Imbalance model (1 paper). According to the estimation by meta-analysis based on 4 papers, a significant effect of work stress on the risk of recurrent CHD events (hazard ratio: 1.65, 95% confidence interval: 1.23–2.22) was observed. Our findings suggest that, in patients with the first CHD, work stress is associated with an increased relative risk of recurrent CHD events by 65%. Due to the limited literature, more well-designed prospective research is needed to examine this association, in particular, from other than western regions of the world.

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Choroba Związana z Clostridium difficile u pacjentów hospitalizowanych w Centrum Medycznym w Łańcucie – badanie retrospektywne

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Musz-Kawecka M., Hawro M., Golec K.

Medical Review

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2013

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issue 3

342–355

PL

W związku z bardzo znacznym wzrostem zakażeń o etiologii C. difficile, w tym przede wszystkim zakażeń szpitalnych, zwiększa się zainteresowanie powyższym zagadnieniem oraz profilaktyką, diagnostyką i terapią Choroby Związanej z Clostridium difficile (CZCD) (1). Zakażenia związane z opieką zdrowotną stanowią dominującą część wszystkich zakażeń o etiologii C. difficile, co wynika zarówno z badań zewnętrznych (2) jak i z badań objętych tą pracą. Zakażenia szpitalne zależą od hospitalizacji i środowiska szpitalnego (3), dlatego ważne jest rozpoznanie sytuacji epidemiologicznej o etiologii C. difficile lokalnie w polskich szpitalach. Niniejsza praca analizuje zachorowalność na Chorobę Związaną z Clostridium difficile z zawężeniem do danych pochodzących z hospitalizacji w Centrum Medycznym w Łańcucie w latach 2009–2011. Przeprowadzane w ramach pracy badania wykazały, że badana populacja i środowisko odzwierciedla wyniki badań głównych ośrodków na świecie. Potwierdzono m.in. generalny wzrost zachorowalności wśród osób hospitalizowanych, zbieżność występowania czynników ryzyka, w tym związanych z wiekiem i antybiotykoterapią oraz częstość występowania przypadków nawrotów CZCD. Ponadto, zaobserwowano prawidłowości, wskazujące zakażenia C. difficile jako jedną z głównych przyczyn występowania biegunki u pacjentów hospitalizowanych. O istotności problemu zakażeń C. difficile świadczy również coraz częstsza liczba występowania przypadków CZCD w populacji pozaszpitalnej.

EN

Introduction: Due to a substantial increase in infections caused by Clostridium difficile, in particular hospital-acquired infections, an interest in this issue, as well as prevention, diagnosis and therapy of Clostridium difficile – associated Disease (CDAD) is increasing worldwide (1). Health-careassociated Clostridium difficile infections are prevalent among infections caused by Clostridium difficile, which results both from external study (2) and the research carried out and included in this work. Healthcare associated infections depend on hospitalization and hospital environment (3) so it is important to identify the epidemiological situation caused by Clostridium difficile in Polish hospitals. Aim: This work examines the incidence of Clostridium difficile – associated Disease, narrowing down the data to the ones obtained from the Medical Center in Łańcut in 2009–2011. Results: The research carried out shows that the studied population and the environment reflect the findings of the main world centers. A general increase in the incidence among hospitalized patients, the convergence of risk factors, including those age-related and connected with antibiotic therapy, and the incidence of recurrence have been confirmed. Furthermore, a certain regularity was observed, indicating that Clostridium difficile is one of the major causes of diarrhea in hospitalized patients. The significance of the problem of Clostridium difficile infection is also indicated by a growing number of CDAD incidence in a non-hospital population.

5

Triple thyroglossal duct cysts in an adult: a rare case report and review of literature

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Abhishek Bhardwaj A., Kartikesh Gupta K., Manu Malhotra M., Madhu Priya M., Mamta Verma M.

European Journal of Clinical and Experimental Medicine

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2020

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issue 2

121-126

EN

Introduction. Thyroglossal duct cyst (TDC) is the most common cause of congenital neck mass. These can present anywhere from foramen caecum to mediastinum. Usually presents as a solitary cyst, the double thyroglossal cyst is very rare and a triple thyroglossal cyst has never been reported. Aim. Herein, we report an atypical case of triple thyroglossal cyst, at levels of hyoid, thyrohyoid membrane and thyroid isthmus managed surgically without any complication. Description of the case. We are presenting case of a 48-year-old female who presented to us with the complaint of anterior neck swelling since birth. On work up it was diagnosed as a case of the thyroglossal duct cyst and was intraoperatively found to have 3 distinct cystic swellings connected to a common stalk lying beneath the hyoid. It was successfully treated by modified Sistrunk’s procedure. There was no evidence of recurrence on follow up for 6 months. Considering atypical presentations, there are 9 cases reported with the double thyroglossal duct cyst, TDC within the thyroid gland and sublingual TDC. Such presentations make the diagnosis more challenging, leading to improper treatment. Conclusion. We are presenting this case as there is no case reported in English literature with a triple thyroglossal duct cyst. An awareness that thyroglossal cyst can present as multiple cysts is important for clinician in order to perform correct surgical management and to avoid the most feared complication of recurrence.

6

"Věčnost je to pravé opakování.": Nietzsche, Kierkegaard a jejich repetitivní věčnosti

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Matějčková T.

Filosofický časopis (Philosophical Journal)

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2023

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vol. 71

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issue 2

293-306

EN

We have found a particular, fundamental and, to this point in time, little-explored concordance between Kierkegaard and Nietzsche, essentially the two founders of modern continental philosophy. Both, that is to say, link eternity with recurrence. They also both emphasize that the will is central to this type of eternity – one must correctly want – while at the same time linking recurrence with the core of reality itself, with the core of the world. This union of eternity and recurrence is, moreover, linked in both cases with the rejection of existing metaphysics. The author of the study queries the connection between these thusly-conceived “repetitive eternities.” At the same time she makes reference to the interpretation of Friedrich Nietzsche that was put forth by Pavel Kouba, the interpreter who emphasized that the very heart of eternal return is recurrence.

CS

U dvou takřka zakladatelů moderní kontinentální filosofie nacházíme zvláštní, zásadní a dosud málo probádanou shodu. Kierkegaard i Nietzsche spojují věčnost s opakováním. Oba přitom zdůrazňují, že pro tento typ věčnosti je stěžejní vůle – člověk musí správně chtít –, ale zároveň spojují opakování se samým nitrem skutečnosti, s nitrem světa. Sepětí věčnosti a opakování se kromě toho v obou případech pojí s odmítnutím dosavadní metafyziky. Autorka studie se táže po souvislosti takto pojatých „repetitivních věčností“. Navazuje přitom na interpretaci Friedricha Nietzscheho, tak jak ji předložil Pavel Kouba. Právě tento interpret zdůraznil, že samým jádrem věčného návratu je opakování.

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Strategie dlouhodobé léčby psychofarmaky a jejich vysazování

51%

Drozdová K.

E-psychologie (E-psychology)

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2022

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vol. 16

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issue 2

56-67

EN

Pharmacological treatment of psychiatric disorders is part of the complex care of patients with mental health problems, in addition to psychotherapy and counselling, behavioral activation and psychosocial rehabilitation. The choice of psychiatric medication and the strategy for its administration should be individualized to the needs of the patient. The strategy for the administration of psychiatric medication should include from the outset considerations about the duration of administration and the possibility of discontinuation. In addition to possible side effects, patients themselves ask when the medication will be discontinued at the first consultation. This neglected topic is coming to the fore with the changing concepts of treatment, cure, and recovery in psychiatry. It is appropriate that the psychiatrist, and not the patient, should be the one who discontinues the medication. Well-conducted, long-term studies are the basis for responsible decisions about when and how to discontinue medication.

CS

Farmakologická léčba psychiatrických poruch je součástí komplexní péče o nemocné s psychickými potížemi, vedle psychoterapie a poradenství, aktivizace a psychosociální rehabilitace. Volba psychofarmaka a strategie jeho podávání by měla být individualizována pro potřeby pacienta. Strategie podávání psychofarmak by měla od počátku zahrnovat i úvahy o délce podávání a možnosti jejího vysazování. Sami pacienti se kromě možných nežádoucích účinků již při první konzultaci ptají, kdy bude medikace vysazená. Toto opomíjené téma se s proměňujícím pojetím léčby, vyléčení a úzdravy v psychiatrii dostává do popředí. Je vhodné, aby tím, kdo vysazuje léky, byl psychiatr, a ne pacient sám. Základem zodpovědného rozhodnutí, kdy a jak vysadit medikaci, jsou dobře vedené, dlouhodobé studie.

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Mycophenolate mofetil for treatment of idiopathic nephrotic syndrome – a single center experience (preliminary study)

Textgrammatika in einer Beschwerdeschrift Johann Geilers von Kaysersberg: Zur religiösen Identität und zum juridischen Selbstverständnis im späten Mittelalter

Work stress and the risk of recurrent coronary heart disease events: A systematic review and meta-analysis

Choroba Związana z Clostridium difficile u pacjentów hospitalizowanych w Centrum Medycznym w Łańcucie – badanie retrospektywne

Triple thyroglossal duct cysts in an adult: a rare case report and review of literature

"Věčnost je to pravé opakování.": Nietzsche, Kierkegaard a jejich repetitivní věčnosti

Strategie dlouhodobé léčby psychofarmaky a jejich vysazování