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This paper is focused on the transient thermal model of the Permanent Magnet Synchronous Motor (PMSM) and the airflow cooling model through the ribs in the stator lamination. The stator lamination has a new specialized designed shape. This type of lamination does not need a frame, and the lamination is directly cooled. It has reduced the thermal resistance between the cooling medium and stator lamination. The thermal model is loaded with variable Power, and the airflow speed of cooling air is variable. Thermal models are solved by software ANSYS CFX and Mechanical. The thermal model of PMSM is based on the traction motor. This machine is designed as enclosed. The modelled PMSM is used in the electric racing formula.

In 1984, we started using therapeutic plasmapheresis (plasma exchange) as a method of extracorporeal lipoprotein elimination for the treatment of hypercholesterolemic patients. We evaluated the results of long-term therapy in 14 patients, 8 men and 6 women. The average age was 55.6±13.2 (range 28-70), median 59.5 years. 14 patients were diagnosed with familial hypercholesterolemia (FH): 5 homozygous, 9 heterozygous. Ten patients in the group were treated using immunoadsorption lipoprotein apheresis and 4 using hemorheopheresis. Immunoapheretic interventions decreased LDL-cholesterol (82±1 %), ApoB (73±13 %) and even Lp(a) by 82±19 %, respectively. Selected non-invasive methods are important for long-term and repeated follow-up. Carotid intima-media thickness showed improvement or stagnation in 75 % of the patients. Biomarkers of endothelial dysfunction such as endoglin (in the control group: 3.85±1.25 μg/l, in lipoprotein apheresis-treated hypercholesterolemic individuals 5.74±1.47 μg/l), CD40 ligand (before lipoprotein apheresis: 6498±2529 ng/l, after lipoprotein apheresis: 4057±2560 ng/l) and neopterin (before lipoprotein apheresis: 5.7±1.1 nmol/l, after lipoprotein apheresis: 5.5±1.3 nmol/l) related to the course of atherosclerosis, but did not reflect the actual activity of the disease nor facilitate the prediction or planning of therapy. Hemorheopheresis may improve blood flow in microcirculation in familial hypercholesterolemia and also in some other microcirculation disorders via significantly decreased activity of thrombomodulin (p

The main goal of this work is in the qualification of temperature changes due to design modifications of the medium-sized turbo generator with the output power 40 MW, ie the temperature distribution of the active parts. The work summarizes of designing a number of changes in the cooling system of a 40 MW synchronous machine. The work is based on ventilation and thermal calculations to verify the change in flow rates, respectively, the flow rate of cooling air in the machine. Individual changes are first analyzed separately and then compared with the original state. Temperature trends and their comparison with the original solution are used to evaluate the impacts of design changes.

INTRODUCTION Poverty is associated with higher cancer rates, cancer risk factors such as tobacco use and obesity, and lack of access to cancer screening and treatment. This analysis examined differences in cancer outcomes and associated factors among the poorest counties and the most affluent counties in Ohio. METHODS We compared cancer incidence and mortality rates and prevalence of selected cancer risk factors between the 12 poorest counties in Ohio and the 10 most affluent counties in Ohio from January 1, 2011, through December 31, 2015. We also compared stage at diagnosis of selected cancers and the health insurance and treatment status of people with cancer. RESULTS The mortality rate for all cancers combined was 19% higher in the poorest counties (192.2 per 100,000) than in the most affluent counties (161.9 per 100,000). Cervical cancer and other smoking-related cancers had higher rates in the poorest counties, where they were more likely to be diagnosed at a late stage. The prevalence was significantly higher in Ohio's poorest counties for current tobacco smoking (25.6% vs 17.1%), obesity (32.7% vs 28.3%), and physical inactivity (29.7% vs 23.0%). Among people with cancer, a smaller percentage had private health insurance (42.9% vs 33.0%) and a greater percentage had no treatment (8.9% vs 10.4%) in the poorest counties. CONCLUSION This study demonstrates disparities in cancer incidence, mortality, and stage, and differences in cancer risk factors, health insurance, and treatment status between Ohio's poorest and most affluent counties. This information may help to target public health interventions for the prevention, early detection, and control of cancer.

Objective: The incidence of esophageal adenocarcinoma, one of the most lethal gastroenterological diseases, has been increasing since the 1960s. Prevention of esophageal adenocarcinoma is important because no early detection screening programs have been shown to reduce mortality. Obesity, gastroesophageal reflux disease, and tobacco smoking are risk factors for esophageal adenocarcinoma. Due to the high prevalence in Ohio of obesity (32.6%) and cigarette smoking (21.0%), this study sought to identify trends and patterns of these risk factors and esophageal adenocarcinoma in Ohio as compared with the United States. Methods: Data from the Ohio Cancer Incidence Surveillance System, Surveillance Epidemiology and End Results Program (SEER), and Behavioral Risk Factor Surveillance System were used. Incidence rates overall, by demographics and by county, as well as trends in incidence of esophageal adenocarcinoma and the percent of esophageal adenocarcinoma among esophageal cancers were examined. Trends in obesity and cigarette smoking in Ohio, and the prevalence of each by county, were reported. Results: There was an increasing trend in esophageal adenocarcinoma incidence in Ohio. Ohio’s average annual esophageal adenocarcinoma incidence rate was higher than the SEER rate overall and for each sex, race, and age group in 2009 to 2013. There was also an increasing prevalence of obesity in Ohio. Although the prevalence of cigarette smoking has been stable, it was high in Ohio compared with the United States. Conclusions: Health care providers and researchers should be aware of the esophageal adenocarcinoma incidence rates and risk factor patterns and tailor interventions for areas and populations at higher risk.

Oxidative stress is thought to play an important role in the pathogenesis of disorders associated with atherosclerosis. Alpha-tocopherol is considered to be an effective lipophilic antioxidant, which protects lipid membranes against peroxidation and thus prevents cell damage by reaction with free radicals. However, measurement of alpha-tocopherol concentration in serum does not reflect the content of α-tocopherol in membranes whereas erythrocyte alpha-tocopherol may be good indicator of antioxidative status. Therefore a simple isocratic reversed phase HPLC method has been developed and validated for the determination of alpha-tocopherol in human erythrocytes in a clinical setting. The content of alpha-tocopherol in human erythrocyte membrane and lipoperoxidation were studied in patients with severe hypercholesterolemia treated by lipoprotein apheresis. The group of hypercholesterolemic patients (n = 14) treated by lipoprotein apheresis was compared to healthy adult normolipidemic controls. After lipoprotein apheresis, the content of in membrane alpha-tocopherol did not change significantly despite decreased tocopherol in serum and lipoprotein fractions. We observed significantly decreased lipoperoxidation as revealed by serum TBARS, representing end products of lipid peroxidation, which increased from third day afterwards and remained significantly higher in comparison to controls until the next LDL-apheresis. We conclude that aggressive lipid lowering procedure with lipoprotein apheresis was associated with favorable transient decrease of lipoperoxidation. Simultaneously the cell membrane bound antioxidative defense mechanisms as reflected by the content of alpha-tocopherol in human erythrocyte membrane where not depressed in spite of its decreased plasma lipid carrier. Another variables involved remain to be investigated.

Genetic testing has grown dramatically in the past decade and is becoming an integral part of health care. Genetic nondiscrimination laws have been passed in many states, and the Genetic Information Nondiscrimination Act (GINA) was passed at the federal level in 2008. These laws generally protect individuals from discrimination by health insurers or employers based on genetic information, including test results. In 2010, Connecticut, Michigan, Ohio, and Oregon added four questions to their Behavioral Risk Factor Surveillance System (BRFSS) survey to assess interest in genetic testing, awareness of genetic nondiscrimination laws, concern about genetic discrimination in determining life insurance eligibility and cost, and perceived importance of genetic nondiscrimination laws that address life insurance. Survey results showed that awareness of genetic nondiscrimination laws was low (less than 20 % of the adult population), while perceived importance of these types of laws was high (over 80 % of respondents rated them as very or somewhat important). Over two-thirds of respondents indicated they were very or somewhat concerned about life insurance companies using genetic test results to determine life insurance coverage and costs. Results indicate a need for more public education to raise awareness of protections provided through current genetic nondiscrimination laws. The high rate of concern about life insurance discrimination indicates an additional need for continued dialogue regarding the extent of legal protections in genetic nondiscrimination laws.

Delivered by Jenelle L. Sobotka, PharmD, FAPhA, incoming President of the American Pharmacists Association, at APhA2012, the Association’s Annual Meeting and Exposition, March 11, 2012, New Orleans, LA. Good morning! I am delighted to be here and excited to serve as our Association’s next president. As Marialice affirmed yesterday, the state of our Association and profession are strong and getting stronger. I am looking forward to the next year and continuing to work with a great team of board members, our CEO Tom Menighan, and his incredible staff. I also want to acknowledge the outstanding year of leadership that President Marialice Bennett has provided. It has been a privilege to “be her shadow” this past year. Over the past year, Marialice has been a constant reminder to us to remain focused on the opportunities being placed before us with the Affordable Care Act and other activities. It is up to us to focus on the transforming health care system and continue to build recognition and demand for pharmacists’ roles in the system. This job is our responsibility and the goal of my presidency. I know that our Association is up to the task of driving connections and transforming patient care.

Summary Background. Hyaluronan (HA) plays an important role in the repair of damaged skin and has been used for the treatment of wounds. Iodine is a mild topical antiseptic. Aim. A mixture of high molecular weight HA with the iodine complex KI3 (hyiodine) was reported to accelerate wound healing in patients with diabetes and patients after surgery. We investigated how this mixture affects wound contraction, granulation tissue (GT) and wound edges in excision skin wounds in rats. Methods. Hyiodine was applied to full-thickness wounds made on the back of rats. The areas of the contracting wounds were calculated from digital photographs. The moving edges of the wound were studied by histological methods. The properties of GT were studied in wounds in which contraction was prevented by the insertion of plastic rings. The effects of hyiodine were compared with those of high molecular weight (1200 kDa) HA, low molecular weight (11 kDa) HA and KI3 solution. Results. Hyiodine accelerated wound contraction significantly in the first 5 days of healing. On day 3, hyiodine-treated wounds had reduced to 63% of the original area, whereas the wound area in saline-treated animals was 75% of the original size. The proliferating epidermis was thicker in hyiodine-treated animals on day 7. In the wounds with inserted rings, hyiodine caused little change in GT, but the weight of the crust/exudate formed on the top of the wound was increased by 351% compared with only minor changes caused by the hyiodine components alone. Conclusions. Hyiodine supports wound healing by stimulating wound contraction and epidermal proliferation and by keeping the wound moist through increased exudation.

Nutritional intake is often compromised in elderly, multimorbid patients. Enteral nutrition (EN) by means of oral nutritional supplements (ONS) and tube feeding (TF) offers the possibility to increase or to insure nutrient intake in case of insufficient oral food intake. The present guideline is intended to give evidence-based recommendations for the use of ONS and TF in geriatric patients. It was developed by an interdisciplinary expert group in accordance with officially accepted standards and is based on all relevant publications since 1985. The guideline was discussed and accepted in a consensus conference. EN by means of ONS is recommended for geriatric patients at nutritional risk, in case of multimorbidity and frailty, and following orthopaedic-surgical procedures. In elderly people at risk of undernutrition ONS improve nutritional status and reduce mortality. After orthopaedic-surgery ONS reduce unfavourable outcome. TF is clearly indicated in patients with neurologic dysphagia. In contrast, TF is not indicated in final disease states, including final dementia, and in order to facilitate patient care. Altogether, it is strongly recommended not to wait until severe undernutrition has developed, but to start EN therapy early, as soon as a nutritional risk becomes apparent.

1. Alzheimer's disease (AD) is a degenerative disease of the central nervous system and its progression is often connected with a development of severe malnutrition. However, sufficient data on nutritional state and intervention regarding the progression of AD are not yet available. The aim of the present study was to assess the relationship between nutritional support and the improvement, or the maintenance, of patients' health. 2. One hundred AD patients were included in a 2 year study. Voluntary food intake was measured during the first year, following which patients were randomized into one of two groups. The study group received a 600 kcal supplement to their regular diet, whereas the control group continued on the standard diet. Nutritional parameters, voluntary food intake and mental state were monitored every 2nd month of the study period. 3. Patients with Alzheimer's dementia who died had been suffering from severe malnutrition during the last 3 months of their lives. A significant decline in mental functions was discovered in AD patients also suffering from malnutrition. Nutritional support significantly slowed the deterioration of the mental function of AD patients. 4. The present study shows that patients with AD are undernourished despite normal voluntary energy intake. Nutritional intervention significantly decreased the progression of deterioration of the mental function of AD patients, as well as other complications. It is concluded that dietary counselling and nutritional support in patients with AD are clinically important and reduce the impairment of mental function.

Home parenteral nutrition is the only option to provide nutrition in a number of patients. Care of venous entry, its management and treatment of complications resulting from its use importantly affect patient survival. Appropriate care of the catheter and the use of current knowledge may prolong the lifespan of the catheter, reduce patient morbidity and mortality and thus increase quality of life of patients who are dependent on home parenteral nutrition. The present paper summarizes recommendations for the care of long-term venous catheters.

All diabetic patients with acute pancreatitis should be intensively treated and monitored in spite of the fact that 75-80% have mild-to-moderate disease. This is due to difficult diagnosis and problems with standard monitoring due to diabetes and its complications. Especially intensive rehydration and subsequent fluid mobilisation can be difficult. Also glucose control and impaired gut motility can cause difficulties in diabetic patients with acute pancreatitis. Nutrition support should be implemented according to severity of disease and insulin infused to control glycaemia.

Skin defects and wounds are rather frequent in diabetic population. They most frequently occur on lower limbs and their origins are often multifaceted. If vascular perfusion is not damaged, it is important to secure perfect drainage with sufficient incision and to use local treatment modalities such as hyaluronan-iodine complex, now well-established at our clinic. It is always essential to save the vascular system if this is damaged. Careful examination by an angiologist is normally followed by angioplasty or vascular bypass. Amputation is an extreme solution that, nevertheless, may save the limb functionality if done in a patient with ischemic damage that cannot be resolved.

In type I diabetes insulin must be administered during nutritional support. The method of insulin administration is dependent on the clinical situation, presence of inflammation, method of nutrition delivery (enteral or parenteral) and other conditions. In type II diabetic patients oral drug treatment should be stopped in stress conditions. Obese type II diabetic patients often profit from hypocaloric nutrition but only when they are stable and any acute inflammatory illness has passed. This may improve their condition before elective procedures. However, strict monitoring of these patients is necessary in both types of diabetes mellitus.

Malnutrition is a major problem in chronically ill patients. The combination of diabetes and renal insufficiency increases the risk of malnutrition, also due to dietary interventions associated with the two diseases. Resulting malnutrition intensifies inflammatory activity and further compromises nutrition intake. This results in a vicious circle which significantly reduces the quality of life of the affected patients and increases their mortality. Proper nutritional care for such patients is an integral part of their treatment.

Early case reports of fatal hematologic effects attributed to carbamazepine (CBZ) resulted in extensive monitoring recommendations by the manufacturer. The rarity of blood dyscrasias led many authors to question the manufacturer's guidelines. Thus the manufacturer removed specific monitoring guidelines, allowing physicians to monitor CBZ using their clinical judgment. This article reviews case reports and studies of CBZ's hematologic effects. Due to their rapid onset, daily laboratory checks would be necessary to monitor for aplastic anemia, agranulocytosis, and thrombocytopenia. These adverse effects are best monitored by informing patients and physicians to carefully watch for signs and symptoms. Leukopenia develops more slowly, occurring in approximately 12 percent of children and 7 percent of adults. Its onset is typically within the first three months of treatment, with patients at risk having a low or low-normal pretreatment white blood cell (WBC) count. Leukopenia often reverses, even if CBZ is continued. Based upon our review of the literature, we recommend monitoring of those high-risk patients during the first three months of treatment with the frequency being determined by results of each laboratory value. WBC counts 3or neutrophil counts below 1000/mm3warrant a decrease in dose with frequent monitoring or CBZ discontinuation, if necessary.

The number of patients with chronic renal failure is on the rise; these patients have a 10 to 20 times higher risk of development and progression of cardiovascular diseases. Higher cardiovascular risk in such patients cannot be satisfactorily explained by traditional risk factors defined in the Framingham study. On the contrary, a concept of reverse epidemiology has been brought forward, designating a situation in which the incidence of obesity and hyperlipoproteinemia is associated with a higher survival rate of the patients concerned. Higher risk is today explained by the "MIAC (malnutrition, inflammation, atherosclerosis, calcification) syndrome", which is present in patients with chronic kidney disease. New evidence has been recently obtained of different circulating molecules associated with atherosclerosis, the plasmatic levels of which are decreased or increased in such patients and which are in a way linked with the MIAC syndrome and the progression of atherosclerosis. Clinical management of the syndrome could increase survival in the future, and reduce morbidity and the number of hospitalisations. Circulating molecules could serve as markers evidencing the presence of the syndrome and its severity, as well as the success of treatment.

Complicated diabetic defects are difficult to heal and frequently result in leg amputation. We have developed a new and unique system for wound treatment, which is based on combination of high molecular weight sodium hyaluronate with an iodine complex--Hyiodine. The aim of our study was to assess the effect of this new method of wound dressing on infected diabetic defects healing.The effect of Hyiodine was studied on 22 patients suffering from complicated foot diabetic wounds. Hyiodine was either spread directly over the wound, or (more frequently) gauze was immersed in Hyiodine and then put on/into the wound. Then several layers of dry gauze covered the wound.Within 2-6 weeks after the onset of treatment all but two defects were filled with granulation tissue. Complete healing was evident in 18 patients within 6-20 weeks after the start of treatment, depending on the wound character, localization and extent. Two patients are still treated by Hyiodine, and significant improvement is apparent on their wound. Treatment was not successful in two subjects with ischemic defects due to simultaneous arterial occlusion.We can conclude that the hyaluronan-iodine complex Hyiodine is efficient method for treatment of difficult to heal diabetic defects without complete arterial occlusion.

We describe the results of detailed 3-D Monte Carlo simulations of a "CZT calorimeter" that can be used to detect photons in the keV to several MeV range. Several astrophysics applications require the detection of photons in the energy range of keV up to several MeV with good position and energy resolution. For certain applications Cadmium Zinc Telluride (CZT) detectors might be the detector option of choice. Up to now, CZT detectors have mainly been used in the energy range between a few keV to ~1 MeV, we describe the results of detailed 3-D Monte Carlo simulations of a "CZT calorimeter" that can be used to detect photons in the keV to several MeV range. The main objective of these studies is to evaluate the feasibility of CZT calorimeters, to study their performance and detect and understand performance limiting factors. Such a calorimeter consists of many layers of closely packed pixellated CZT detector units. Our simulations of single detector units reproduce experimental results, indicating that our simulations capture the main factors that limit the performance of a detector unit. Overall the conclusion of our simulation study is that between 1 cm and 1.5 cm thick detector units can be used to build a calorimeter with good performance over the energy range from ~20 keV to ~10 MeV., Accepted for publication in Astroparticle Physics, 20 pages, 14 figures

The authors describe the administration of different types of artificial nutrition depending on the clinical condition of patients with acute pancreatitis. They summarize contemporary findings on the pathophysiology of the disease, evaluation of everity according to Ranson's criteria and the tactics of nutritional support in acute pancreatitis.

Teachers of pharmacy self-care courses have met annually since 1998 at the Nonprescription Medicines Academy (NMA) held in Cincinnati, Ohio. During these meetings, self-care faculty members discuss methods of enhancing the teaching of self-care in US colleges and schools of pharmacy. Self-care courses are taught using a variety of methods and content is woven into pharmacy curricula in many different ways. This manuscript sets forth the current state of self-care instruction in pharmacy curricula including the recommended core curriculum, instructional methodologies, course mechanics, existing standards, and assessment and curricular placement, and makes recommendations for the future.

Several astrophysics and nuclear physics applications require the detection of MeV photons with good position and energy resolution. For certain applications cadmium zinc telluride (CZT) detectors might be the detector option of choice: they achieve better position and energy resolution than scintillation detectors and can be built more compact and more economically than Ge detectors. In this contribution, we briefly describe astrophysics and nuclear physics applications in which we are interested. Subsequently, we describe the results of Monte Carlo simulations of an "MeV Calorimeter": a 10 cm to 30 cm thick detector made of closely packed 1.5times1.5times1 cm3 large pixellated CZT detector units, each pixel being read out individually. Our simulation shows that the spatial extent of the energy deposition inside the CZT together with the electronic properties of present-day CZT substrates limits the theoretically achievable performance of such a calorimeter. The conclusion holds even if one considers detector modules with very small pixels and assumes correction of the anode signals with electron drift times. Finally, we discuss crucial detector issues that need to be addressed to improve the performance of CZT calorimeters

In a group of 126 obese subjects hospitalized at the obesitological unit of the Gerontological and Metabolic Clinic, Faculty Hospital Hradec Králové the authors confirmed the effect of short-term modified fasting and a low energy diet on the body weight and body mass index They also proved the influence of weight reduction on normalization of cholesterol and LDL-cholesterol and triacylglycerols. They did not prove however the influence of short-term modified fasting and a low energy diet on the concentration of some coagulation pareameters (fibrinogen, D-dimers, antithrombin). In the patients a decline of the fibrinolytic activity was observed and an increase of the fibrinolytic capacity. The authors found a close correlation between the decline of the inhibitor of plasminogen-1 activator, an indicator of the fibrinolytic activity, and body weight and lipid changes. The authors proved a close negative correlation between the rise of fibrnolytic capacity and changes of body weight and lipids. In conjunction with the presented results and based on data from the lierature it may be stated that a decline of body weight in obese subjects reduces the risk of the syndrome of insulin resistance. Activation of fibrinolysis in insulin resistance depends directly on the amount of visceral fat and changes of te fibrinolytic properties of blood in obese subsjects depend on the production of PAI-1 by adipocytes of visceral fat.

An acute operation was made on a 56-year woman for inflammatory perforation of colon. A series of repeated operations followed due to relapsing iatrogenic intestinal fistula and peritonitis. From the day 70 the patient was treated at the Intensive Metabolic Care Unit of the Gerontological and Metabolic Clinic of Faculty Hospital in Hradec Králové. Having cured the septic shock the authors prepared the patient to a reconstruction operation on alimentary tract by administering parenteral nutrition, treating the wounds and by motion rehabilitation. From day 150 on the patient was treated with low doses of enteral nutrition into the segment of intestine between the fistulas, in connection with the subsequent decrease of two-month lasting hyperbilirubinemia of 200-260 mumol/l. A successful reconstruction of the alimentary tract was performed on the day 205 of the treatment with the time lapse of 146 days after the last surgical intervention. A three-fold anastomosis on small intestine and a resection of the fistula on the transversal colon was made. The post-operation fistula was healed-up conservatively, while the parenteral nutrition continued, as verified on day 246 by enteroclysis. The paper draws attention to the importance of conservative metabolic care in the therapy of dishiscences of intestinal anastomoses not treated by acute surgery in time. A favourable additive effect of enteral nutrition on the persisting cholestasis during parenteral nutrition is discussed.

The diet of diabetic women should not differ fundamentally from an ordinary healthy diet. The intake of the basic energy providing nutrients and of microelements should be balanced and if possible should be supplied in natural food products. This ensues among others from the fact that the relations between some micronutrients are not yet quite clear. During pregnancy it is however necessary to ensure in diabetic women 400 micrograms folic acid; increased attention must be paid to magnesium intake and during the menopause the vitamin D and calcium intake must be followed up.

Development of amino acid solutions for i.v. use proceeds worldwide, the main stimulus being the expanding physiological and pathophysiological findings of specific effects of some amino acids and their metabolism and the need to improve intensive metabolic care. New Czech preparations in this respect are the series of NEONUTRINS 5%, 10% and 15% (Infusia Ltd. Horátev). They are modern preparations which meet the pretentious criteria of contemporary amino acid solutions (balanced ratio of all essential, semiessential and assisting amino acids, a high content of essential and branched-chain amino acids, amino acids with specific pharmacodynamic effects). In a multicentre open clinical study the authors assessed the tolerance, safety and efficacy of NEONUTRIN 15% in 82 patients requiring total parenteral nutrition on account of catabolic states of different etiology. The preparation was administered repeatedly in an all-in-one mixture (together with glucose and lipid emulsions) by means of a central venous catheter. A total of 801 doses was administered. The trial provided evidence of very good tolerance and safety of the preparation with a practically zero incidence of undesirable effects. The follow-up of basic indicators of nitrogen metabolism confirmed also the efficacy of NEONUTRIN 15% in comprehensive treatment of patients (stabilization of nitrogen balance in the acute stage of a disease, normalization of the plasmatic aminogram).

Assessment of the effect of short term modified low calorie diet on body weight and body mass index (BMI). Assessment of the effect of modified low calorie diet on blood lipids and some biochemical parameters.Before and after diet: body weight, BMI, whole blood count, platelet count, serum cholesterol, triglycerides and HDL cholesterol, serum creatinine, uric acid, urea, bilirubin, AST, ALT, pH of urine and atherogenic index (CHOL-HDL/HDL).11 male, mean age 52 years and 19 female, mean age 53.3 years.Modified diet 14 days, 3.3 MJ daily, vitamins and minerals.No significant difference was observed in platelet count, serum creatinine, urea, bilirubin, AST, ALT, pH of urine, HDL cholesterol and atherogenic index before and after modified low calorie diet. Significant loss of body weight and decrease of BMI, cholesterol and triglycerides occurred after modified diet. Serum uric acid significantly increased after weight loss.The present result's shows that a drop of serum cholesterol and triglycerides follows a significant loss of body weight after modified diet. Our result's shows a significant increase of uric acid levels after weight loss. There was no effect of body weight loss on other biochemical parameters.

Electroretinographic examinations performed according to the international standard were used in two patients with alimentary hypovitaminosis A. In one instance a mentally caused long-term deficiency of dietary vitamin A intake was involved, in the second instance a fistula from the proximal jejunum into the transverse colon. In both instances night blindness was reported. The initial vitamin A values were 1.0 and 0.6 micromol/l resp. and after substitution therapy they rose to 2 micromol/l. While the rod and maximal ERG responses improved gradually, the oscillation potentials remained pathological as regards amplitudes and latencies. We consider them therefore a sensitive indicator of the electric sensitivity of the retina also in other cases of confirmed or suspected vitamin A deficiency. The existence and orientation of our metabolic and gerontological clinic provides adequate opportunities for these investigations.

Early case reports of fatal hematologic effects associated with carbamazepine (CBZ) resulted in manufacturer recommendations for extensive laboratory monitoring. Several alternative monitoring protocols have been published, indicating disagreement with those recommendations. The manufacturer has removed specific monitoring guidelines allowing physicians to monitor CBZ during treatment based on their clinical judgment. This study was designed to determine the frequency of CBZ hematologic monitoring in one academic setting. Data on complete blood counts (CBCs) were retrospectively obtained and were compared with 1975–88 Physicians' Desk Reference recommendations for weekly CBCs during the first three months of treatment. Eighty-three patients were identified: 32 psychiatry, 37 neurology, and 14 from other clinics. Only one patient met guidelines for monitoring during the entire first three months of treatment. Comparisons between clinics demonstrated no statistically significant differences in monitoring rates. Prospective studies in academic and private practice settings are needed to provide more information on actual monitoring practices. Due to the removal of specific manufacturer recommendations, a standard approach is needed to establish consistent and adequate monitoring and to provide legal support to prescribers.

To standardize studies on the utilization and consumption of drugs, the World Health Organization recommends the use of the Anatomical Therapeutic Chemical (ATC) classification system, using the defined daily dose (DDD value) as a technical unit of measurement of drug consumption. DDD values of total parenteral nutrition have not been established yet. In our descriptive study the methodology by E. Frankfort et al. (1993) is used. This methodology allows the calculation of both the total number of DDD values for TPN and the number of DDD values for the individual substances. Suggested DDD values and consumption of total parenteral nutrition by E. Frankfort et al. (1994) were compared with the values at the Teaching Hospital in Hradec Králové. During 3 months 142 patients administered only TPN were included in the study. The following data from every patient were collected: sex, age, the main diagnosis, composition of TPN each day and duration of this administration. The mean PDD value for carbohydrates was 200 +/- 41 g, for fat emulsion 77 +/- 27 g and for amino acids 93 +/- 16 g. The difference between our and Frankfort's results were found.

The authors review indications and principles for providing home enteral nutrition. It is a method of nutritional support in ambulatory patients, which is effective, easy to administer and financially feasible.