BACKGROUND: In a previous study we compared rocuronium and suxamethonium for rapid-sequence induction of general anaesthesia for caesarean section and found no difference in maternal outcome. There was however, a significant difference in Apgar scores. As this was a secondary outcome, we extended the study to explore this finding on a larger sample. METHODS: We included 488 parturients of whom 240 were women from the original study. Women were randomly assigned to receive either rocuronium 1mg/kg (ROC n=245) or suxamethonium 1mg/kg (SUX n=243) after propofol 2mg/kg. Anaesthesia was maintained with up to 50% nitrous oxide and up to one minimum alveolar concentration of sevoflurane until the umbilical cord was clamped. We compared neonatal outcome using Apgar scores and umbilical cord blood gases. RESULTS: Data were analysed for 525 newborns (ROC n=263vs. SUX n=262). There was a statistically significant difference in the proportion of Apgar scores <7 at 1min (ROC 17.5% vs. SUX 10.3%, P=0.023) but no difference at 5min (ROC 8% vs. SUX 4.2%, P=0.1) or 10min (ROC 3.0% vs. SUX 1.9%, P=0.58). There was no difference between groups in other measured outcomes. CONCLUSION: The use of rocuronium was associated with lower Apgar scores at 1min compared with suxamethonium. The clinical significance of this is unclear and warrants further investigation.

• MeSH
• androstanoly farmakologie   MeSH
• Apgar skóre * MeSH
• celková anestezie metody   MeSH
• císařský řez MeSH
• dospělí MeSH
• lidé MeSH
• novorozenec MeSH
• porodnická anestezie metody   MeSH
• sukcinylcholin farmakologie   MeSH
• těhotenství MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• novorozenec MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• randomizované kontrolované studie MeSH
• srovnávací studie MeSH

PURPOSE: Aim of this prospective observational study was to analyze fertility status of Hodgkin lymphoma (HL) patients treated with different types of chemotherapy while receiving GnRH analogues to preserve ovarian function. METHODS: Fertility status was assessed among 108 females in reproductive age treated by curative chemotherapy for freshly diagnosed HL between 2005 and 2010 in university-based tertiary fertility and oncology center. All patients received GnRH analogues during chemotherapy to preserve their ovarian function. Their reproductive functions were assessed by follicle-stimulating hormone (FSH) measurement and pregnancy achievement. Ovarian function was determined separately in three groups with increasing gonadotoxicity of chemotherapy. RESULTS: One year following the treatment, normal ovarian function was found in 89 (82.4%) of patients. Two years after chemotherapy, 98 (90.7%) of patients retained their ovarian function, and 23 (21.3%) achieved clinical pregnancy during the follow-up period. Average FSH after chemotherapy was 11.6 ± 17.9 IU/l 1 year after the treatment resp. 9.0 ± 13.8 at the 2 years interval. There were significantly more patients with chemotherapy induced diminished ovarian reserve (chDOR) among the group receiving escalated BEACOPP chemotherapy in comparison with the other types of treatment (58.1% vs. 87.9% resp. 95.5%). CONCLUSION: The rate of chDOR is significantly higher after EB poly-chemotherapy and there is no tendency for improvement in time. The 2 + 2 chemotherapy with GnRH-a required for more advanced HL retained ovarian function significantly better after 2 years. Another important advantage of GnRH-a co-treatment is the excellent control of patient's menstrual cycle.

• MeSH
• dospělí MeSH
• folikuly stimulující hormon krev   MeSH
• Hodgkinova nemoc farmakoterapie   patofyziologie   MeSH
• hormon uvolňující gonadotropiny analogy a deriváty   MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• ovarium účinky léků   fyziologie   MeSH
• prospektivní studie MeSH
• protokoly antitumorózní kombinované chemoterapie škodlivé účinky   terapeutické užití   MeSH
• těhotenství MeSH
• zachování plodnosti metody   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• pozorovací studie MeSH
• práce podpořená grantem MeSH

BACKGROUND/AIMS: The study describes clinical management and outcomes of currently available fertility preservation techniques in a set of 154 young female cancer patients. METHODS: Patients in reproductive age with newly diagnosed cancer were offered embryo or oocyte cryopreservation, ovarian tissue cryopreservation and the administration of GnRH analogues during chemotherapy. Particular attention was given to the technical aspects and clinical application of these fertility preservation techniques. RESULTS: During the study period (2004-2009), 154 young female cancer patients were offered fertility preservation counseling. Patient's average age was 29.4 years and average parity was 0.7 children. Administration of GnRH analogues (n = 123, 79.9%) and ovarian tissue cryopreservation (n = 15, 9.7%) were the most commonly used fertility preservation strategies. In 20 cases (16.1%), the combination of several fertility preservation techniques was offered to individually selected patients. CONCLUSIONS: Combination of fertility preservation techniques gives young cancer patients the best chance for future fertility and should be concentrated in specialized centers.

• MeSH
• antitumorózní látky škodlivé účinky   terapeutické užití   MeSH
• dospělí MeSH
• hormon uvolňující gonadotropiny analogy a deriváty   terapeutické užití   MeSH
• imunoterapie škodlivé účinky   MeSH
• kryoprezervace MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• morula MeSH
• nádory farmakoterapie   MeSH
• oocyty MeSH
• ovarium MeSH
• systémový lupus erythematodes farmakoterapie   MeSH
• zachování plodnosti MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

Cardiotocography is the monitoring of fetal heart rate (FHR) and uterine contractions (TOCO), used routinely since the 1960s by obstetricians to detect fetal hypoxia. The evaluation of the FHR in clinical settings is based on an evaluation of macroscopic morphological features and so far has managed to avoid adopting any achievements from the HRV research field. In this work, most of the features utilized for FHR characterization, including FIGO, HRV, nonlinear, wavelet, and time and frequency domain features, are investigated and assessed based on their statistical significance in the task of distinguishing the FHR into three FIGO classes. We assess the features on a large data set (552 records) and unlike in other published papers we use three-class expert evaluation of the records instead of the pH values. We conclude the paper by presenting the best uncorrelated features and their individual rank of importance according to the meta-analysis of three different ranking methods. The number of accelerations and decelerations, interval index, as well as Lempel-Ziv complexity and Higuchi's fractal dimension are among the top five features.

• MeSH
• artefakty MeSH
• automatizace MeSH
• lidé MeSH
• monitorování plodu metody   MeSH
• počítačové zpracování signálu MeSH
• srdeční frekvence plodu fyziologie   MeSH
• uterus fyziologie   MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• hodnotící studie MeSH
• práce podpořená grantem MeSH

Malá a často nenápadná forma plicní žilní tromboembolie (synonyma: latentní, tichá, němá tromboembolie) se vyskytuje poměrně často a představuje, zejména pro chirurgické pacienty mnohdy fatální riziko. Samotná primoataka takové malé a nenápadné varianty embolie nebývá nebezpečná, její význam však spočívá v riziku dalšího uvolnění větších nebo menších částí trombu z místa jeho vzniku. Může dojít k nové atace embolie, někdy s vážnými až tragickými důsledky. Také se mohou postupně oddrolovat další části nestabilního „mateřského" trombu, což má za následek opakované - sukcesivní embolické příhody, které mohou vést až k sekundární plicní hypertenzi. V našem sdělení poukazujeme na některé problémy diagnózy, terapie a prevence těchto malých nenápadných plicních tromboembolií po chirurgických výkonech, zejména v ortopedii, břišní chirurgii, urologii, traumatologii, plastické chirurgii i v gynekologii a v těhotenství.

Small and often silent pulmonary tromboembolism (synonyms: latent embolism, "silent killer") is a variant of venous pulmonary tromboembolism (PTE), which is not rare at all. It often represents a serious risk for surgical patients in particular. The Hrst attack of silent PTE does not seem very dangerous for the patient, but there is a possibility that part of the originál instable thrombus may become separated, which could lead to another attack of PTE with a possible serious or even fatal outcome. Recurrent separation of little throm- bi from the "maternal" thrombus represents another risky situation. This successive form of PTE may result in secondary pulmonary hypertensive disease. In our páper we attempt to point out some problems concerning diagnosis, therapy and prevention of small forms of PTE in all branches of surgery, especially in orthopedics, abdominal surgery, traumatology, plas tic surgery, gynecology and obstetrics.

• MeSH
• diagnostické techniky a postupy MeSH
• lidé MeSH
• plicní embolie diagnóza   MeSH
• příznaky a symptomy MeSH
• tromboembolie diagnóza   MeSH
• trombofilie MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• kazuistiky MeSH