Casopís lékar̆ů c̆eských
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The main purpose of total hip replacement is to relieve hip pain and recover the lost mobility of the joint. The postoperative functionality of the hip endoprosthesis is closely related to proper physiotherapy. A good range of motion, sufficient pain reduction and minimum disruption to the muscle tissues are conditions allowing the patients to perform individualized muscle strengthening exercises and to exercise the newly gained mobility, following practice sessions during the early postoperative period still in hospital. The authors describe the individual fazes of the physiotherapy and summarize the principles, which lead to a successful rehabilitation of the patient and his early recovery as well as return to normal life activities.
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Whole-genome sequencing analyses revealed that the majority of the human genome is transcribed and identified thousands of protein non-coding transcripts. Non-coding RNAs (ncRNAs) are divided into two main groups: small and long ncRNAs. This review is focused on the regulatory ncRNAs mainly on microRNAs and long ncRNAs. ⋯ Due to high tissue specificity and ability to regulate multiple genes often within one signaling pathway, ncRNAs represent attractive therapeutic targets. Increasing knowledge about a wide spectrum of ncRNA actions demonstrate a pivotal role of these transcripts in expression regulation. Many aspects of the ncRNA biology are still unclear and their understanding will provide us a new perspective on the complexity of the regulatory network.
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The scarcity of organs for transplantation resulted in the increase of organ donation after circulatory death. This review describes the current practice with donors after circulatory death (DCD), recent classification of DCD and organ procurement from DCD. Then the outcome of organ transplantation from is discussed and the new strategies in DCD are presented. Despite of the fact that DCD are extended criteria donors, strict organ selection and novel technologies as machine perfusion or normothermic perfusion allows better utilization of DCD with a similar outcome as from donors after brain death.
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Two approaches have been used in clinical evaluation the acid-base status: traditional (bicarbonate-centered) is based on the Henderson-Hasselbalch equation complemented by calculation of the anion gap, and more recent quantitative approach proposed by Stewart and Fencl. The latter method defines the three independent variables, which regulate pH. These include: the difference between the sum of charges carried by strong plasma cations and anions termed the strong ion difference - SID (decrease causes acidosis, and vice versa); the total concentration of the weak non-volatile acids [Atot] (inorganic phosphate and albumin, decrease causes alkalosis and vice versa), and pCO2. ⋯ This correction brings traditional approach closer to the Stewart-Fencl method that precisely calculates unmeasured strong anions by further adjustment of the corrected anion gap according to the serum phosphate, calcium and magnesium levels. The precise calculation of unmeasured anions is important in critically ill patients with the metabolic breakdown, where the traditional approach may overlook the presence of unmeasured anions. Consideration of the sodium-chloride difference draws the attention to acid-base disturbance caused by change of the strong ion difference.
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Despite being known more than 60 years, refeeding syndrome (RS) still bears many uncertainties. For example, its definition is not clear and definite, and the attitude to it varies from the complete neglect to over-prevention. The term "refeeding syndrome" refers to electrolyte and metabolic changes occurring in malnourished patients after the readministration of nutrition. ⋯ However, even its development can lead to many complications increasing the patient's morbidity and the length of stay in the hospital. Yet the refeeding syndrome is more or less predictable and if kept in mind also preventable. The aim of this article is to get the reader to know more about this metabolic phenomenon and possible attitudes towards it.