Polypragmazie a jak jí předcházet.

Polypharmacy is currently a serious problem that causes decrease in adherence and increased number of hospitalizations and mortality. WHO addresses polypharmacy in the Medication Without Harm campaign. Other initiatives that deal with polypharmacy are the International Group for Reducing Inappropriate Medication Use & Polypharmacy (IGRIMUP) and Choosing Wisely campaign.

A novel dosing approach for rituximab in glomerular diseases based on a population pharmacokinetic analysis.

Objectives: Rituximab is being increasingly prescribed for the treatment of autoimmune glomerular diseases. While it is highly effective for some diseases, the response is less predictable for others, which may be due to differing requirements in terms of the dosing according to the disease type and variations concerning exposure to the drug.

Methods: We compiled novel rituximab dosing schedules according to pharmacokinetic analysis of data gathered from rituximab treated patients in a tertiary referral nephrology centre between May 2020 and June 2023.

Ivacaftor pharmacokinetics and lymphatic transport after enteral administration in rats.

Ivacaftor is a modern drug used in the treatment of cystic fibrosis. It is highly lipophilic and exhibits a strong positive food effect. These characteristics can be potentially connected to a pronounced lymphatic transport after oral administration.

Elimination and penetration of amikacin into urine in patients with decreased glomerular filtration rate.

Background: Amikacin monotherapy is recommended for urinary tract infection (UTI) treatment with multi-resistant pathogens. Even though amikacin efficacy in the treatment of UTIs is dependent on its urinary concentration, there are no robust data proving that sufficiently high urinary concentration is reached in patients with reduced glomerular filtration rate (GFR).

Methods: A prospective study to monitor amikacin penetration into urine of 70 patients [40 males, median (interquartile range) age 70 (65-79) years] with different levels of glomerular filtration decline, including patients treated by dialysis, was conducted.

USE OF NON-STEROIDAL ANTI-INFLAMMATORY DRUGS IN PATIENTS WITH ADVANCED ACTIVE RHEUMATOID ARTHRITIS.

This study aimed to determine whether patients with active rheumatoid arthritis (RA) regularly take non-steroidal anti-inflammatory drugs (NSAIDs) and to clarify whether their decision to take NSAIDs depends on disease activity, intensity of pain, or functional status. The study also aimed to identify the risk factors for gastrointestinal side effects. Over 6 months, we conducted a cross-sectional single-center study of consecutively hospitalized patients with confirmed RA.

Psychometric properties and observational data for COVID-19 Yorkshire Rehabilitation Scale (C19-YRSm) for post-COVID-19 syndrome.

Background: The recently developed modified COVID-19 (coronavirus of 2019) Yorkshire Rehabilitation Scale (C19-YRSm) captures comprehensive biopsychosocial components of WHO's International Classification of Functioning, Disability, and Health related to the Long Covid or post-COVID syndrome. The scale response categories on C19-YRSm were done post hoc on data collected from the original version of C19-YRS.

Aim: To evaluate the C19-YRSm scale using reliability and validity measures.

Factors Affecting the Metabolic Conversion of Ciprofloxacin and Exposure to Its Main Active Metabolites in Critically Ill Patients: Population Pharmacokinetic Analysis of Desethylene Ciprofloxacin.

The objective of this prospective study was to examine the exposure to the main active metabolites of ciprofloxacin in critically ill patients and to examine the factors (demographic, laboratory and genetic) that could potentially affect the drug metabolic conversion of ciprofloxacin. The secondary aim was to develop a population pharmacokinetic model for the metabolite showing the most associations with the abovementioned factors. A total of 29 patients were treated with intravenous infusion of ciprofloxacin and enrolled on this trial.

Serum S100A12 levels in children with childhood-onset systemic lupus erythematosus, systemic juvenile arthritis, and systemic undefined recurrent fevers.

Background: We compared serum levels of S100A12, a proinflammatory protein predominantly secreted by neutrophils, in children with newly diagnosed childhood-onset systemic lupus erythematosus (cSLE), systemic juvenile arthritis (sJIA), and systemic undefined recurrent fevers (SURFS) to examine its role as a diagnostic and discriminative marker of inflammation and to indirectly point out the importance of neutrophils and innate immunity in the pathogenesis of these diseases.

Materials And Methods: In a cross-sectional study, the serum levels of S100A12 protein of 68 children (19 with cSLE, 18 with sJIA, 7 with SURFS, and 24 controls) were determined by enzyme-linked immunosorbent assay and compared between groups and with clinical and laboratory findings.

Results: The median serum S100A12 levels were 469 ng/mL in the cSLE group, 6103 ng/mL in the sJIA group, 480 ng/mL in the SURFS group, and 44 ng/mL in the control group.

Effects of Yoga in Daily Life program in rheumatoid arthritis: A randomized controlled trial.

Objectives: To explore the feasibility and effectiveness of a yoga program in improving health-related quality of life (HQOL), physical and psychological functioning in rheumatoid arthritis (RA) patients.

Design: Single-centre parallel-arms randomized controlled trial comparing yoga (n = 30) and education control group (n = 27).

Setting: Tertiary care University hospital.

Anti-neutrophil cytoplasmic antibody positivity in five children with systemic lupus erythematosus--what is the importance of this finding?

Juvenile systemic lupus erythematosus (JSLE) is a systemic autoimmune chronic disease that can affect any part of the body. It is characterized by the formation of antibodies against nuclear antigens. Vasculitis may be found in SLE, but it scarcely complies with anti-neutrophil cytoplasmic antibodies (ANCA)-associated vasculitis (AAV) criteria.

The presence of high mobility group box-1 and soluble receptor for advanced glycation end-products in juvenile idiopathic arthritis and juvenile systemic lupus erythematosus.

Background: The involvement of high mobility group box-1 (HMGB1) in various inflammatory and autoimmune diseases has been documented but clinical trials on the contribution of this pro-inflammatory alarmin in children with juvenile idiopathic arthritis (JIA) and systemic lupus erythematosus (SLE) are basically absent. To address the presence of HMGB1 and a soluble receptor for advanced glycation end products (sRAGE) in different subtypes of JIA and additionally in children with SLE, we enrolled a consecutive sample of children harvested peripheral blood as well as synovial fluids (SF) at diagnosis and correlated it with ordinary acute-phase reactants and clinical markers.

Methods: Serum and synovial fluids levels of HMGB1 and sRAGE in total of 144 children (97 with JIA, 19 with SLE and 27 healthy controls) were determined by ELISA.

[The significance of innate immunity in juvenile idiopathic arthritis].

For years it was thought that the disorder of adaptive immunity is critical in the pathogenesis of juvenile idiopathic arthritis (JIA). However, the results of recent studies emphasize the importance of innate immunity and especially the role of alarmins, a group of multifunctional proteins that are released into the intercellular space during tissue injury or inflammation, mobilizing and activating the cells of innate immunity. These data indicate that inflammation triggered by alarmins plays a role in the pathogenesis of JIA.

Vitamin D serum level, disease activity and functional ability in different rheumatic patients.

Background: The aim of the study was to determine the serum vitamin D levels in patients with psoriatic arthritis (PsA) and compare it with patients with rheumatoid arthritis (RA) and with osteoarthritis (OA), as well as to explore the relationship of the vitamin D level with indices of disease activity and functional ability in a real-life setting in a South-European country.

Methods: In a cross-sectional study, 120 adult patients with established diagnosis of PsA, RA and OA were consecutively enrolled. Serum 25-hydroxyvitamin D and intact parathyroid hormone were determined.

Key role for CD4 T cells during mixed antibody-mediated rejection of renal allografts.

We utilized mouse models to elucidate the immunologic mechanisms of functional graft loss during mixed antibody-mediated rejection of renal allografts (mixed AMR), in which humoral and cellular responses to the graft occur concomitantly. Although the majority of T cells in the graft at the time of rejection were CD8 T cells with only a minor population of CD4 T cells, depletion of CD4 but not CD8 cells prevented acute graft loss during mixed AMR. CD4 depletion eliminated antidonor alloantibodies and conferred protection from destruction of renal allografts.

A nonthoracotomy myocardial infarction model in an ovine using autologous platelets.

Objective: There is a paucity of a biological large animal model of myocardial infarction (MI). We hypothesized that, using autologous-aggregated platelets, we could create an ovine model that was reproducible and more closely mimicked the pathophysiology of MI.

Methods: Mepacrine stained autologous platelets from male sheep (n = 7) were used to create a myocardial infarction via catheter injection into the mid-left anterior descending (LAD) coronary artery.

[Scoring of disease activity using BASDAI and ASDAS method in ankylosing spondylitis].

Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) is the most frequently used ankylosing spondylitis activity assesment by which through 6 questions 5 basic diseases symptoms (fatigue, back pain, joint pain/swelling, enthesitic points, intensity and duration of morning stiffness) are being evaluated. In distinction from mentioned, Ankylosing Spondylitis Disease Activity Score (ASDAS) is the first validated index for the AS activity assessment with the patient's assessments of the disease symptoms (back pain, duration of the morning stiffess, activity of the disease, pains and swelling of the peripheral joints) includes the acute phase reactants (SE or CRP). We compared BASDAI and ASDAS indexes to the group of patients with the AS, in order to evaluate their congruence and to evaluate the inluence of SE, fatigue and back pain at obtained values.

[The cervical spine involvement in patients with psoriatic arthritis].

Unlabelled: Psoriatic arthritis (PsA) is a systemic disease and cervical spine can be affected. The data regarding cervical spondylitis are very rare and diverse in literarture. The aim of study was to assess the prevalence of cervical spine involvement in patients with PsA.

[The presence of CD30 on lymphocytes in the inflammatory infiltrate of acute atopic dermatitis].

Atopic dermatitis (AD) has cellular immunohistochemical features similar to those of allergic contact dermatitis (ACD). There is plenty of evidence for T-cell activation in this disease such us the presence of T-lymphocytes which carry CD30, CD3, CD4, CD45RO markers. The aim of this study was to show the presence of lymphocyte-surface antigens including CD30, CD3, CD4, CD45RO in patients with acute AD and to compare the presence of the same molecules in patients with acute ACD (nickel-induced) because of the possible morphologic difference of these two entities.

The presence of surface CD30 on T cells in atopic dermatitis.

Atopic dermatitis (AD) has cellular immunohistochemical features similar to those of allergic contact dermatitis (ACD) and there is plenty of evidence for T-cell activation in this disease. The involvement of CD30+ T cells in acute stages of atopic dermatitis might establish CD30 as a helpful marker in differentiating those two diseases. Tissue sections from the skin of 12 patients with active atopic dermatitis and 13 with allergic contact (nickel-induced) dermatitis were immunohistochemically analyzed for cell-surface antigens, including CD30, CD3, CD4, and CD45RO.

Individual and ecological assets and positive developmental trajectories among gang and community-based organization youth.

The Search Institute framework for conceptualizing developmental assets was used in a longitudinal study of African American male youth involved in gangs or in community-based organizations (CBOs) serving youth. Analyses of intraindividual change indicated that individual and ecological assets are linked to positive developmental trajectories among these youth.

Stability of attributes of positive functioning and of developmental assets among African American adolescent male gang and community-based organization members.

An analysis is presented of the longitudinal stability over the course of a year of characteristics of positive functioning and of individual and ecological developmental assets, among African American male youth involved in gangs or in community-based organizations (CBOs) serving youth. Evidence is provided for the potential of positive youth development among both groups of adolescents.