OBJECTIVES: This study quantified blood bicarbonate (HCO3-) kinetics and gastrointestinal upset to determine the gender-related ergogenic potential of sodium bicarbonate (0.15-, 0.25- and 0.35 gSB·kgFat-free mass (FFM)-1) in high intensity functional training. DESIGN: Double-blind randomized placebo-controlled crossover. METHODS: Thirty female and male athletes performed two bouts of the Wingate Anaerobic Test (WAnTPRE-HIFT and WAnTPOST-HIFT) interspaced with two 3-min bouts of Wall Balls and Burpees 120 min after ingestion of three sodium bicarbonate doses. Blood HCO3- was determined pre-ingestion, after supplementation and before/post exercise. Gastrointestinal upset was evaluated 120 min post-ingestion. Control (CTRL) measurements were performed. RESULTS: There were significant gender × treatment interactions for: changes in blood HCO3- at 60 min post-ingestion (p = 0.014; η2p = 0.104; at 0.15 gSB·kgFFM-1 males experienced higher increase than females); peak power (p = 0.015; η2p = 0.103) and average power (p = 0.005; η2p = 0.124) during WAnTPOST-HIFT, and changes in peak power between the Wingate Anaerobic Test bouts (p = 0.049; η2p = 0.081). Sodium bicarbonate compared to PLA had no significant impact on Wall Balls and Burpees performance. The dose of 0.35 gSB·kgFFM-1 resulted in higher less severe gastrointestinal symptoms compared to CTRL and 0.15 gSB·kgFFM-1 (p = 0.001; W = 0.178); and higher total gastrointestinal upset compared to CTRL, PLA and 0.15 gSB·kgFFM-1 (p < 0.001; W = 0.323). CONCLUSIONS: There were dose- and gender-related differences in extracellular buffering capacity and ergogenic potential of sodium bicarbonate. The study suggested a detrimental impact of gastrointestinal upset on performance.

• MeSH
• dospělí MeSH
• dvojitá slepá metoda MeSH
• hydrogenuhličitan sodný * aplikace a dávkování   farmakologie   krev   MeSH
• klinické křížové studie * MeSH
• látky zvyšující výkon aplikace a dávkování   farmakologie   MeSH
• lidé MeSH
• mladý dospělý MeSH
• sexuální faktory MeSH
• zátěžový test MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• randomizované kontrolované studie MeSH

Každý operačný výkon predstavuje u pacienta určité riziko a možnosť vzniku pooperačných komplikácii, hoci ide o bežne vykonávanú operáciu. Najčastejšie sa komplikácie vyskytujú u obéznych pacientov, kedy aj z banálnej operácie môže pacient skončiť na oddelení poskytujúcom intenzívnu starostlivosť a bojovať tak o svoj život. U obéznych pacientov je poskytovanie intenzívnej starostlivosti náročnejšie, nakoľko je potrebné u nich saturovať všetky základné potreby od prijímania potravy cez hygienu až po vyprázdňovanie. Cieľom príspevku je predstaviť a opísať priebeh liečby a ošetrovateľskej starostlivosti u extrémne obéznej pacientky po cholecystektómii, ktorej stav si vyžadoval intenzívnu starostlivosť z dôvodu rozvíjajúcej sa sepsy v oblasti operačnej rany, kde bolo potrebné využitie inovatívnych liečebných postupov a metód pri jej hojení. Metodika: Pomocou kvalitatívneho výskumu formou kazuistiky, opisujeme zaujímavý prípad pacientky, ktorá si vyžadovala 95 dňovú hospitalizáciu na intenzívnom oddelení s ťažkou sepsou, kardiovaskulárnym zlyhávaním, nutnosťou umelej pľúcnej ventilácie (UVP), s využitím VAC systému (vacuum assisted closure) na hojenie rany, dekubitmi rôznych stupňov, infekčnou hnačkou a syndrómom závislosti od UVP. Výsledky: Pacientka preložená z chirurgickej jednotky intenzívnej starostlivosti (JIS) v poruche vedomia, s potrebou zabezpečenia dýchacích ciest, napojenia na UVP, potrebou vazopresorickej podpory, septickým stavom, rozpadom operačnej rany a potrebou korekcie glykémie inzulínom v lineárnom dávkovači. Po cirkulačnej stabilizácii pacientky na 13. deň hospitalizácie bol naložený chirurgom do operačnej rany VAC systém, ktorý sa v pravidelných intervaloch menil. Počas hospitalizácie stav pacientky komplikovaný vznikom dekubitov a Clostridioides difficile infection (CDI). U pacientky postupne vznikol syndróm závislosti na UVP, preto extubovaná až na 91. deň. Na 95. deň pacientka v stabilizovanom stave so zhojenými dekubitmi, preliečenou CDI infekciou a s VAC systémom preložená na oddelenie dlhodobo chorých. Aj banálna operácia môže skončiť bojom o život. U extrémne obéznych pacientov je riziko komplikácii vyššie, nakoľko trpia viacerými ochoreniami, ktoré spomaľujú proces hojenia rán a zároveň zvyšujú nároky na poskytovanú ošetrovateľskú starostlivosť vo všetkých oblastiach. Zachránený život však prevyšuje všetky nároky a je najväčšou odmenou pre celý personál oddelenia.

Every surgical procedure represents a certain risk and possibility of developing a patient. postoperative complications, although it is a commonly performed operation. Most often, complications occur in obese patients, when even a banal operation can cause a end up in an intensive care unit and fight for their lives. In obese patients, the provision of intensive care is more difficult, as it is necessary to restoreall basic needs from foodintake to hygiene to defecation. The aim of the paper is to present and describe the course of treatment and nursing care in an extremely obese cholecystectomy patient who secondition required intensive care for developing sepsis in the area of the surgical wound, as a result of which the wound It fell apart and it was necessary to use innovative treatments and methods to heal it. Methodology: Using qualitative research in the form of a case report, we describe an interesting the case of a patient who required 95 days of hospitalization in an intensive care unit with severe sepsis, cardiovascular failure, the need for artificial pulmonary ventilation (APV), using the VAC system (vacuum assisted closure) wound healing, pressure ulcers of varying degrees, infectious diarrhea and addictionsyndrome UVP. Results: Patient transferred from the surgical intensive care unit (ICU) in a disorder of consciousness, with a need securing the respiratory tract, connection to UVP, the need for vasopressor support, septic condition, disintegration of the surgical wound and the need for glucose correction with insulin in lineardispenser. After circulatory stabilization of the patient on the 13th day of hospitalization, loaded by the surgeoninto the surgical wound of the VAC system, which at regular intervals Changed. During hospitalization, the patient’s condition is complicated by the development of pressure ulcers and Clostridioides difficile infection (CDI). The patient gradually developed UVP dependence syndrome, so shewasextubated on day 91. At the 95. day a patient in a stablecondition with healed pressure ulcers, retreated CDI infection and with the VAC system transferred to the long-term care unit. Even a banal operation can end in a fight for life. In extremely obese patients, it is the risk of complications is higher, as they suffer from several diseases that slowdown the process of wound healing and at the sametimeincrease the demands on the nursing care provided in the allareas. However, a life saved exceed sall claims and is the grea test reward for the entire staff of the department.

• MeSH
• Clostridioides difficile MeSH
• dehiscence operační rány ošetřování   terapie   MeSH
• dekubity ošetřování   terapie   MeSH
• hojení ran MeSH
• obezita komplikace   MeSH
• ošetřovatelská péče o pacienty v kritickém stavu MeSH
• péče o pacienty v kritickém stavu MeSH
• plicní ventilace MeSH
• pooperační komplikace ošetřování   terapie   MeSH
• sepse MeSH
• terapie ran pomocí řízeného podtlaku MeSH
• výsledek terapie MeSH
• Publikační typ
• kazuistiky MeSH

Autorka v príspevku uvádza kazuistiku pacienta s pokročilou granulomatózou s polyangitídou, ktorý bol privezený po úspešnej kardiopulmonálnej resuscitácii v rámci infarktu myokardu v ťažkom kardiogénnom šoku a vyžadoval umelú pľúcnu ventiláciu. Autorka sa snaží poukázať na závažnosť základného ochorenia, s ktorým sa v súčasnej dobe stretávame čoraz častejšie. Zároveň vyzdvihuje dôležitosť primárnej zdravotnej starostlivosti, ktorá prispieva k správnej diagnostike a liečbe ochorenia.

The author presents a case study of a patient with advanced granulomatosis with polyangiitis, who was admitted after successful cardiopulmonary resuscitation due to myocardial infarction in severe cardiogenic shock and required mechanical ventilation. The author aims to high light the severity of the underlying disease, which is being encountered increasingly often in contemporary practice. At the same time, the author emphasizes the importance of primary healthcare in contributing to the accurate diagnosis and treatment of the disease

• MeSH
• granulomatóza s polyangiitidou diagnostické zobrazování   etiologie   klasifikace   patofyziologie   terapie   MeSH
• infarkt myokardu ošetřování   terapie   MeSH
• kardiogenní šok MeSH
• ošetřovatelská péče o pacienty v kritickém stavu MeSH
• péče o pacienty v kritickém stavu MeSH
• plicní ventilace MeSH
• výsledek terapie MeSH
• Publikační typ
• kazuistiky MeSH

• Klíčová slova
• bariérová ošetřovatelská péče,
• MeSH
• antisepse MeSH
• dekontaminace MeSH
• dezinfekce rukou MeSH
• dezinfekce MeSH
• hygiena rukou MeSH
• hygiena MeSH
• infekce spojené se zdravotní péčí prevence a kontrola   MeSH
• mechanické ventilátory mikrobiologie   MeSH
• ochranné prostředky MeSH
• ošetřovatelská péče o pacienty v kritickém stavu MeSH
• plicní ventilace MeSH
• polohování pacienta MeSH
• sanitace MeSH
• sterilizace MeSH
• ventilátorová pneumonie prevence a kontrola   MeSH

• MeSH
• jednotky intenzivní péče MeSH
• morbidní obezita MeSH
• ošetřovatelská péče o pacienty v kritickém stavu MeSH
• plicní ventilace MeSH
• terapie ran pomocí řízeného podtlaku MeSH
• umělé dýchání MeSH

BACKGROUND: Interstitial lung disease is rarer in children than adults, but, with increasing diagnostic awareness, more cases are being discovered. The prognosis of childhood interstitial lung disease is often poor, but increasing numbers are now surviving into adulthood. AIM: To characterise childhood interstitial lung disease survivors and identify their impact on adult interstitial lung disease centres. METHODS: This was a European study (34 adult and childhood interstitial lung disease centres) reporting incident/prevalent cases of childhood interstitial lung disease survivors from January to July 2023. Epidemiological, clinical, physiological and genetic data were collected. RESULTS: 244 patients were identified with a median (interquartile range) age at diagnosis of 12.5 years (6-16 years) and age at study inclusion of 25 years (22-33 years), with 51% male, 86% nonsmokers and a median (interquartile range) % predicted forced vital capacity of 70% (47-89%) and diffusing capacity of the lungs for carbon monoxide of 48% (32-75%). 32% were prescribed long-term oxygen and 227 (93%) were followed up in adult centres whereas 17 (7%) never transitioned. The commonest diagnoses (82%) were childhood interstitial lung disease category B1 (sarcoidosis, hemosiderosis, connective tissue disorders, vasculitis) at 35%, A4 (surfactant-related) at 21%, B2 (bronchiolitis obliterans, hypersensitivity pneumonitis) at 14% and Bz (unclassified interstitial lung disease) at 13%. Bz patients had the worst functional status. 60% of all patients were still being prescribed corticosteroids. Re-specification of diagnosis and treatment were made after transition for 9.8% and 16% of patients, respectively. Not all childhood interstitial lung disease diagnoses were recognised in adult interstitial lung disease classifications. CONCLUSION: Childhood interstitial lung disease survivors are seen in most adult interstitial lung disease centres and only a minority continue follow-up in paediatric centres. Survivors have a significant loss of lung function. The heterogeneity of their aetiologies and therapeutic requirements has a real impact on adult interstitial lung disease centres. Re-specification of diagnosis and treatment may contribute to precision and personalisation of management.

• MeSH
• dítě MeSH
• dospělí MeSH
• intersticiální plicní nemoci * diagnóza   patofyziologie   epidemiologie   MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• přežívající * statistika a číselné údaje   MeSH
• prognóza MeSH
• vitální kapacita MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• Geografické názvy
• Evropa MeSH

AIMS: To evaluate the prevalence, long-term mortality, and clinical characteristics in total cavopulmonary connection patients with excellent functional outcomes. METHODS AND RESULTS: A retrospective study of cardiopulmonary exercise test results in 288 patients after total cavopulmonary connection from a single-centre nationwide database. A subgroup of 88 (30.6%) patients (45 women; 51.1%), at a median age 13.0 [interquartile range 11.0; 18.0] years achieved ≥80% of predicted VO2peak value (Super-Fontan phenotype). Survival free from death or heart transplantation 20 years after surgery was 100.0% in the Super-Fontan group versus 94.0% in the rest of the cohort (p = 0.04). Super-Fontan patients were younger, had lower body mass index, lower regurgitant fraction on atrioventricular valve, and larger preoperative McGoon ratio than the rest of the cohort (p = 0.002, p < 0.0001, p = 0.004, and p = 0.04, respectively). Females and tricuspid atresia patients were significantly more prevalent in the Super-Fontan group than in the rest of the cohort (p = 0.02 for both). There was no difference regarding systemic ventricle morphology, fenestration presence, or ejection fraction of systemic ventricle between the Super-Fontan group and the rest of the total cavopulmonary connection cohort (p = 0.06, p = 0.09, and p = 0.64, respectively). CONCLUSIONS: The subgroup of Super-Fontan patients has unique clinical characteristics when compared to the rest of the total cavopulmonary connection nationwide cohort. Besides superior VO2peak results, Super-Fontan patients tend to have lower long-term mortality, body mass index, and atrioventricular valve, greater preoperative pulmonary dimensions, and a higher prevalence of females and tricuspid atresia patients. There was no variance in morphology of the systemic ventricle, or presence of fenestration.

• MeSH
• dítě MeSH
• Fontanova operace * MeSH
• lidé MeSH
• míra přežití trendy   MeSH
• mladiství MeSH
• prevalence MeSH
• retrospektivní studie MeSH
• rizikové faktory MeSH
• trikuspidální atrézie chirurgie   mortalita   MeSH
• vrozené srdeční vady * chirurgie   mortalita   MeSH
• zátěžový test * MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

Recent reviews have highlighted conflicting findings regarding the validity of finger flexor strength and endurance tests in sport climbers, often due to small sample sizes and low ecological validity of the tests used. To address these gaps, 185 male and 122 female climbers underwent maximal finger flexor strength, intermittent and continuous finger flexor endurance, and the finger hang tests in a sport-specific setting to determine the predictive and concurrent validity of these tests. The finger hang test showed the strongest relationship to climbing ability for both sexes (R ≈ 0.75). However, despite its widespread use as an endurance test, the finger hang was found to be primarily determined by finger strength, explaining 65% and 80% of the variance in males and females, respectively. Finger strength emerged as the dominant factor, explaining the majority of variance in climbing ability (males 68%; females 64%), followed by intermittent endurance (males 28%; females 34%). These findings emphasize finger strength as the primary predictor of climbing ability and highlight the importance of intermittent endurance testing for assessing climbing-specific endurance of the finger flexors. No significant differences were found between male and female climbers in finger flexor strength and endurance when normalized to body mass.

• MeSH
• dospělí MeSH
• fyzická vytrvalost * fyziologie   MeSH
• horolezectví * fyziologie   MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• prsty ruky * fyziologie   MeSH
• reprodukovatelnost výsledků MeSH
• sexuální faktory MeSH
• síla ruky fyziologie   MeSH
• svalová síla fyziologie   MeSH
• zátěžový test metody   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• validační studie MeSH

BACKGROUND: Large vessel carotid stenosis is a significant cause of ischaemic stroke. Indications for surgical revascularisation depend on the severity of the stenosis and clinical symptoms. However, mild symptoms such as TIA (Transient ischaemic attack), amaurosis fugax or minor stroke precede large strokes in only 15% of cases. AIM: The aim of this prospective study is to evaluate whether retinal perfusion is impacted in significant carotid stenosis. Automated retinal oximetry will be used to better assess perfusion in the post-stenotic basin. We presume the more stenotic the blood vessel, the more reduced the retinal perfusion is, resulting in adaptive changes such as greater arteriovenous saturation difference due to greater oxygen extraction. This could broaden the indication spectrum for revascularisation for carotid stenosis. METHODS: We plan to enroll yearly 50 patients with significant carotid stenosis and cross-examine them with retinal oximetry. The study group will provide stenotic vessels and, non-stenotic vessels will form the control group. Patients with significant carotid stenosis will undergo an MRI (Magnetic Resonnance imaging) examination to determine the presence of asymptomatic recent ischaemic lesions in the stenotic basin, and the correlation to oximetry parameters. STATISTICS: The stenosis severity and retinal oximetry parameters will be compared for study and control groups with a threshold of 70%, respectively 80% and 90% stenosis. Results will be then reevaluated with emphasis on MRI findings in the carotid basin. CONCLUSION: This prospective case control study protocol will be used to launch a multicentre trial assessing the relationship between significant carotid stenosis and retinal perfusion measured with automated retinal oximetry. Despite these differences, the findings indicate the potential of retinal oximetry for noninvasive real-time measurements of oxyhaemoglobin saturation in central nervous system vessels. Following calibration upgrade and technological improvement, verification retinal oximetry may potentially be applied to critically ill and anaesthesia care patients. The study on combined scanning laser ophthalmoscope and retinal oximetry supports the feasibility of the technique for oximetry analysis in newly born babies. TRIAL REGISTRATION: ClinicalTrials.gov, ID: NCT06085612.

• MeSH
• lidé středního věku MeSH
• lidé MeSH
• oxymetrie * metody   MeSH
• prospektivní studie MeSH
• retina diagnostické zobrazování   patofyziologie   MeSH
• retinální cévy diagnostické zobrazování   patofyziologie   MeSH
• senioři MeSH
• stenóza arteria carotis * patofyziologie   chirurgie   komplikace   MeSH
• studie případů a kontrol MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• protokol klinické studie MeSH

• MeSH
• infekce respiračními syncytiálními viry * diagnóza   epidemiologie   farmakoterapie   MeSH
• kazuistiky jako téma MeSH
• lidé MeSH
• novorozenci extrémně nezralí * MeSH
• novorozenec MeSH
• palivizumab farmakologie   terapeutické užití   MeSH
• plicní ventilace MeSH
• preexpoziční profylaxe klasifikace   metody   MeSH
• ribavirin farmakokinetika   terapeutické užití   MeSH
• Check Tag
• lidé MeSH
• novorozenec MeSH
• ženské pohlaví MeSH
• Publikační typ
• přehledy MeSH