Cíl studie: Cílem naší práce bylo posouzení variability terapie hypotenze po úvodu do celkové anestezie (GAIH). Typ studie: Multicentrická dotazníková studie. Typ pracovišť: Osm anesteziologických pracovišť různé velikosti z České a Slovenské republiky. Materiál a metoda: Respondenti odpovídali na tři identifikační otázky (pracoviště, délka praxe, specializovaná způsobilost) a deset zjišťovacích otázek týkajících se managementu GAIH v online dotazníku. Byla použita jednoduchá popisná statistika hodnotící zastoupení odpovědí respondentů v absolutních a relativních četnostech. Normalizovaná entropie (H) byla použita k posouzení variability odpovědí. Výsledky: Plně vyplněný dotazník jsme získali od 172 respondentů. Největší míra variability byla pozorována u otázky č. 1.: „Za referenční hodnotu tlaku krve, se kterou porovnávám další hodnoty..., považuji…“ (H = 0,966). Nejnižší míra variability odpovědí byla zaznamenána u otázky č. 4.: „Za hypotenzi považuji pokles…“ (H = 0,070). Závěr: Výsledky práce ukazují vysokou variabilitu názorů na terapii GAIH..
Objective: The aim of our study was to assess the management of hypotension after general anaesthesia induction (GAIH). Design: Multicenter questionnaire study. Setting: Eight different size anaesthesiology departments located in the Czech or Slovak Republics. Materials and methods: The respondents responded to three identification questions (workplace, length of practice, specialized competence) and ten GAIH management questions in our online questionnaire. Simple descriptive statistics describing the representation of the respondents' answers in absolute and relative terms were used. Normalized entropy (H) was used to assess the variability of responses. Results: A fully completed questionnaire was obtained from 172 respondents. The highest rate of variability was observed in question 1.: “As the baseline blood pressure value (BP), to which I compare other BP values, I consider…” H = 0.966. The lowest response variability rate was observed in question 4.: “As hypotension, I consider the decrease of BP…” H = 0.07). Conclusion: Our results indicate high variability of GAIH management among anaesthetists.
BACKGROUND: The aim of this paper was to design a finite element model for a hinged PROSPON oncological knee endoprosthesis and to verify the model by comparison with ankle flexion angle using knee-bending experimental data obtained previously. METHOD: Visible Human Project CT scans were used to create a general lower extremity bones model and to compose a 3D CAD knee joint model to which muscles and ligaments were added. Into the assembly the designed finite element PROSPON prosthesis model was integrated and an analysis focused on the PEEK-OPTIMA hinge pin bushing stress state was carried out. To confirm the stress state analysis results, contact pressure was investigated. The analysis was performed in the knee-bending position within 15.4-69.4° hip joint flexion range. RESULTS: The results showed that the maximum stress achieved during the analysis (46.6 MPa) did not exceed the yield strength of the material (90 MPa); the condition of plastic stability was therefore met. The stress state analysis results were confirmed by the distribution of contact pressure during knee-bending. CONCLUSION: The applicability of our designed finite element model for the real implant behaviour prediction was proven on the basis of good correlation of the analytical and experimental ankle flexion angle data.
- MeSH
- algoritmy MeSH
- analýza metodou konečných prvků MeSH
- analýza selhání vybavení MeSH
- biologické modely * MeSH
- design s pomocí počítače MeSH
- kolenní kloub patofyziologie MeSH
- kosterní svaly patofyziologie MeSH
- lidé MeSH
- mechanický stres MeSH
- modul pružnosti MeSH
- nádory kostí patofyziologie chirurgie MeSH
- pevnost v tahu MeSH
- pevnost v tlaku MeSH
- počítačová simulace MeSH
- protetické vybavení metody MeSH
- protézy - design MeSH
- protézy kolene * MeSH
- šlachy patofyziologie MeSH
- software MeSH
- svalová kontrakce MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- validační studie MeSH
Interpretation of cardiotocogram (CTG) is a difficult task since its evaluation is complicated by a great inter- and intra-individual variability. Previous studies have predominantly analyzed clinicians' agreement on CTG evaluation based on quantitative measures (e.g. kappa coefficient) that do not offer any insight into clinical decision making. In this paper we aim to examine the agreement on evaluation in detail and provide data-driven analysis of clinical evaluation. For this study, nine obstetricians provided clinical evaluation of 634 CTG recordings (each ca. 60min long). We studied the agreement on evaluation and its dependence on the increasing number of clinicians involved in the final decision. We showed that despite of large number of clinicians the agreement on CTG evaluations is difficult to reach. The main reason is inherent inter- and intra-observer variability of CTG evaluation. Latent class model provides better and more natural way to aggregate the CTG evaluation than the majority voting especially for larger number of clinicians. Significant improvement was reached in particular for the pathological evaluation - giving a new insight into the process of CTG evaluation. Further, the analysis of latent class model revealed that clinicians unconsciously use four classes when evaluating CTG recordings, despite the fact that the clinical evaluation was based on FIGO guidelines where three classes are defined.
- MeSH
- kardiotokografie statistika a číselné údaje MeSH
- lidé MeSH
- metody pro podporu rozhodování * MeSH
- odchylka pozorovatele MeSH
- porodnictví statistika a číselné údaje MeSH
- reprodukovatelnost výsledků MeSH
- rozpoznávání automatizované metody MeSH
- senzitivita a specificita MeSH
- systémy pro podporu klinického rozhodování * MeSH
- umělá inteligence * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- MeSH
- analýza metodou konečných prvků * MeSH
- kolenní kloub anatomie a histologie fyziologie MeSH
- lidé MeSH
- modely anatomické MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
This paper deals with a knee joint endoprosthesis finite element analysis. Based on a three dimensional geometric model of a lower extremity, a mechanical axis of the limb was designed. This axis is important for several reasons. Firstly, the endoprosthesis was positioned due to its direction, secondly, boundary conditions was defined on its proximal and distal end and finally, the axis enabled reasonable simplification of the model which led to the time saving analysis while preserving principal features of the model like the natural boundary conditions or knee joint's degrees of freedom . Having this, one leg stance was simulated. Results of the analysis were encouraging for future models. Especially the choice of the mechanical axis was suitable and enabled a better distribution of contact pressures and stress on both femoral and tibial component compared to our former models. Also their magnitudes correspond better the manufacturer's experience and our findings. The stresses did not exceeded 30MPa for the UHMWPE tibial plateau and 100MPa for the femoral component. The contact pressures were lower than 40MPa.
- MeSH
- biologické modely MeSH
- femur anatomie a histologie patofyziologie MeSH
- financování organizované MeSH
- kolenní kloub anatomie a histologie patofyziologie MeSH
- lidé MeSH
- mechanický stres MeSH
- protézy kolene MeSH
- rozsah kloubních pohybů MeSH
- tibie anatomie a histologie patofyziologie MeSH
- tlak MeSH
- zatížení muskuloskeletálního systému MeSH
- Check Tag
- lidé MeSH
