Výskum v medicíne a etika

 Eva Ďurovcová - Mária Mareková 

The presented textbook is intended for students of general medicine and should support their knowledge about indication and interpretation of basic biochemical tests. Clinical biochemistry continues to be one of the most rapidly advancing areas of laboratory medicine, which in line with using of modern technology more and more emphasizes the evidence-based medicine in order to improve diagnosis and monitoring of patients. Selected topics have an ambition to outline and explain the most common issues of biochemical diagnosis of in internal medicine. Individual chapters are devoted to disorders of water, electrolyte and acid-base balance, kidney and liver disease, diabetes mellitus, and biomarkers used in the diagnosis of cardiac necrosis and heart failure. Given the limited range, the textbook merely summarizes the basic knowledge that students have obtained during the study of other subjects, such as medical biochemistry, pathophysiology and internal medicine, and emphasis is given to laboratory diagnosis in accordance with the newer guidelines of professional societies. We hope that the textbook will be helpful in the study of clinical subjects and encourage students' interest in laboratory medicine.

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Peter Berek

University scripts “Visceral pathology of vascular origin“analyze one of the most challenging vascular regions, the aorta and the visceral aortic branches, from the surgical perspective. The diagnostic and the treatment aneurysms of the abdominal aorta are dedicated to the first chapter. Early diagnostic and operative treatment is crucial in the treatment of ruptured aneurysms of the abdominal aorta. Shortening of the interval between the patient’s arrival with ruptured aneurysm of the abdominal aorta into the hospital and the beginning of the operation decreased the perioperative mortality. This shortening, together with the use of the cell savers, led to the dropping of perioperative mortality from 50% to 20%. The diagnostics and surgical treatment of the acute and chronic occlusion of the aorta and iliac arteries are analyzed in the second chapter. In this chapter, the focus is given to the aortobifemoral bypass as “the gold standard“ of the surgical therapy of aortoiliac atherosclerosis. The management of acute mesenteric ischemia is the content of the third chapter. Acute mesenteric ischemia is a severe condition with high mortality. The problem of acute mesenterial ischemia is a delayed diagnostic that is the reason for poor therapeutical outcomes of the disease. The possible imagine studies and operations used in treating acute mesenteric ischemia are brought in this chapter. Chronic mesenteric ischemia leads to cachexia. The diagnosis of chronic mesenterial ischemia is one of the most demanding, and surgical therapy used in the treatment of chronic mesenterial ischemia also belongs to the most challenging operations. Left-sided colon ischemia belongs to the severe complications of the aortoiliac reconstructions. Left-sided colon ischemia has a high mortality. In the prevention of the left-sided colon, ischemia is preserving at least one internal iliac artery. The complex diagnostics treatment of intraabdominal compressive syndromes as Dunbar syndróme, „Nutcracker“ syndróme a Wilkie syndróme, analyzed in the last chapter.

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Tatiana Kimáková - Vladimír Pavlík

The scientific monograph focuses on the characteristics of free radicals, reactive oxygen and nitrogen species, oxidative stress, and its impact on various diseases. A significant portion is dedicated to antioxidants, their classification based on multiple criteria, the characteristics of selected antioxidants in terms of their functions, manifestations of their deficiency and excess, and the overall antioxidant capacity of the body.

A special section is devoted to enzyme-based antioxidants, natural sources of antioxidants in the form of vitamins, trace elements, flavonoids, polyphenols, and coenzyme Q10. To provide a clearer understanding of antioxidants and their influence on population health, the monograph presents results from a research project included in the program "Research Support for Enhancing the Defense Capabilities of the Czech Republic in NATO Structures."

The research was conducted between 2010 and 2012 as part of preventive rehabilitation programs for professional soldiers with a sports component. The study involved 218 professional soldiers, including 180 men and 38 women, with an average age of 33.3 years. The current health status and dietary habits of the soldiers were assessed using questionnaires.

The study described the saturation of the observed group with antioxidant vitamins and statistically evaluated the relationship between their levels and the risk indicators for the development of cardiovascular diseases. Individual analyses were performed using the Reflotron device calibrated with Reflotron Precinorm control serum. Following blood collection, all participants underwent anthropometric examinations (body weight, height, waist circumference), blood pressure measurements, heart rate monitoring, and physical fitness assessments through simple functional tests.

This scientific monograph is suitable for the scientific community, students of medical, veterinary, and natural sciences, as well as public health students at all levels of university education. It is also intended for informed members of the public.

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Jozef Kafka

Význam vedomia pre každého človeka ale aj pre pozná­vanie je taký rozhodujúci, že by bolo nesprávne hovoriť o ňom iba pri psychických procesoch, lebo je jadrom ľudskej individuality a práve vedomím sa človek odlišuje od ostat­ných živých tvorov.

Je potešujúce, že nová oblasť poznávania označovaná ako veda o mysli začína sa vedomím zaoberať podrobnejšie a vylučuje tvrdenia, že vedomie nejestvuje hoci zatiaľ hovorí podľa mojej mienky iba o bazálnom vedomí a jej inter­pretácie prekračujú zistené fakty.

V svojej odbornej činnosti a aj v učebniciach som rozlišoval dve cesty poznávania vedomia a  iba postupne som si uvedomil, že mám pred sebou dva úrovne vedomia. V tejto práci  rozlišujem tieto dve úrovne:

• bazálne vedomie,
• rozvinuté vedomie.

Ak bazálne vedomie vyjadruje bdenie a spánok, tiež po­zornosť a gnostické rozpoznávanie, teda  idiognózia a somatognózia, rozvinuté vedomie predpokladá reč a vytvára také prejavy, ktoré označujeme ako duševné, teda identita, sebareali­záciu, čo vyjadruje schopnosť uvedomovania si seba, okolia, spoločnosti ale aj všetkého čo sme schopní poznať.

Také chápanie je blízke výkladu fyziológa Pavlova o dvoch signálnych sústavách a chápaniu Poppera o treťom sve­te ale aj ďalšie náhľady, nikto však neurobil určitejšie závery a nedošiel k náhľadu, že naše vedomie má dvojvrstevnú podobu, dve úrovne.

Napriek rozsiahlej a takmer neprehľadnej literatúre vieme o vedomí málo, okrem toho, že je to schopnosť uvedomo­vania, teda schopnosť uvedomiť si, že jestvujem, že som, že jest­vujú aj iní ľudia, že jestvuje niečo čo označujeme ako svet ako nepredstaviteľný vesmír. Uvedomujem si, že som individua­litou jedinečnou, ale limitovanou narodením a smrťou a že mám aj zmysel svojho bytia. Toto uvedomovanie, akokoľvek spo­chybňované je pre človeka prítomné v jeho poznávaní, hoci nemáme zmysly, ktorými by sme vedeli lokalizovať jeho prí­tomnosť v mozgu, ale svojou charakteristikou s dynamikou a integráciou má však duševný charakter, odlišný od    ostatných preja­vov mozgovej činnosti.

Práca sa pokúša v deviatich kapitolách osvetliť, čo sa chápe pojmom bazálne a rozvinuté vedomie    a možno ju rozdeliť do troch okruhov:

V prvých šiestich kapitolách diela hovorí o vedomí ako o doméne bytia človeka, podáva sa preto výklad vedomia a jeho rozlíšenie, potom sa hovorí o kolobehu života a rozvoji ve­domia, kladie sa otázka vedomia u stavovcov, potom náhľady filozofické a metodológia skúmania vedomia. Nasledujú ďalšie kapitoly, ktoré analyzujú podrobnejšie dve formy, úrovne vedomia, sú to kapitoly 7-9, začínajú ana­lýzou individuality človeka, lebo to je báza vedomia aj je­ho foriem, ďalej kapitoly o bazálnom vedomí a rozvinu­tom vedomí, čo považujem za jadro predkladanej práce. Napokon sa opisujú niektoré poruchy vedomia, ktoré dokladajú realitu vedomia v podobe  jej porúch ale aj možnosti rozlí­šenia dvoch úrovní, ktoré sa dajú zistiť pri starostlivom štúdiu a pri práci s chorými.