Lékové formy s elektronickým prvkem je možné zařadit mezi jedny z nejmodernějších a nejinovativnějších lékových systémů posledních několika dekád. Inkorporace elektronického/digitálního prvku nabízí řadu výhod, jako např. možnost přesného načasování uvolnění léčivé látky v požadované lokaci gastrointestinálního traktu, sběr biometrických dat, či nezpochybnitelný průkaz adherence pacienta k terapii. V současné době je možné pozorovat vývoj oboru do dvou hlavních směrů. Tím prvním je využití těchto systémů ve spojení s řízeným uvolňováním při absorpčních a obecně farmakokinetických studiích nových látek. Druhým směrem je pak digitální monitoring adherence k léčbě. Tento stručný přehled pojednává krátce o historii problematiky, přináší informace o obou zmíněných odvětvích a zmiňuje zásadní zástupce obou skupin a jejich využití.

Delivery systems with an electronic element can be classified as one of the last few decades' most modern and innovative pharmaceutical systems. Incorporating an electronic/digital element offers several advantages, such as the possibility of the precise timing of the drug released in the desired location of the gastrointestinal tract, collection of biometric data, or indisputable proof of the patient's adherence to therapy. Currently, it is possible to observe the development of the field in two main directions. The first one is using these systems in conjunction with the controlled release principle in absorption and general pharmacokinetic studies of new substances. The second direction is digital monitoring of therapy adherence. This brief overview briefly mentions the field's history, brings information about the two main branches, and states the essential systems of both branches and their use.

• MeSH
• chytré materiály farmakokinetika   terapeutické užití   MeSH
• digitální technologie * metody   MeSH
• kapslové endoskopy ekonomika   MeSH
• lékové formy * MeSH
• uvolňování léčiv MeSH
• Publikační typ
• přehledy MeSH

Bronchoezofageálne a bronchogastrické fistuly sú zriedkavou komplikáciou chirurgických zákrokov v hrudnej dutine, ako ezofagektómia, malígnych ochorení, dlhodobej endotracheálnej intubácie alebo infekčných ochorení. I keď nie sú časté, dosahujú vysokú morbiditu a mortalitu. Liečba týchto fistúl je náročná a často zdĺhavá s obmedzenou úspešnosťou. V rámci terapie môžeme u niektorých typov fistúl zvoliť endoskopické riešenie, ktorého úspešnosť, napriek veľkému množstvu rôznych metód, je nižšia s malým množstvom konzistentných dôkazov o účinnosti. Súčasne sa objavujú nové zariadenia a technológie s potenciálom na riešenie týchto stavov. Jednou z týchto metód je aj endobronchiálny bloker – Watanabeho spigot, ktorý sa iniciálne používal v pneumológii v terapii perzistentného pneumotoraxu, resp. pyotoraxu s bronchiálnou fistulou. V prezentovaných kazuistikách uvádzame použitie Watanabeho spigotu v kombinácii s over-the-scope klipmi v rámci terapie bronchoezofageálnych fistúl po ezofagektómii. V teoretickej časti článku uvádzame tiež prehľad endoskopických možností terapie uvedených fistúl v kontexte najnovších poznatkov a osobitne diskutujeme dostupné dáta o možnostiach využitia Watanabeho spigotov v liečbe bronchoezofageálnych fistúl.

Bronchoesophageal and bronchogastric fistulas are rare complications of thoracic surgery as esophagectomy, malignancy or prolonged endotracheal intubation. Although uncommon, their morbidity and mortality is substantial. Treatment of these fistulas is challenging and often lengthy with limited success rates. Endoscopic treatment may be the treatment of choice for some types of fistulas, but despite a variety of methods available, the success rate is relatively low with little consistent data about its effectiveness. At the same time, new technologies and devices have become available with a potential to address these complicated conditions. One of them are Watanabe spigots, initially used in pneumology for the treatment of persistent pneumothorax and pyothorax with bronchial fistula. In the presented case reports Watanabe spigots are used in combination with over-the-scope clips in two of our patients with bronchoesophageal fistulas fol lowing esophagectomy with promising results. We also present an overview of endoscopic methods of therapy in the context of and separately discuss available evidence about the possibilities of the use of Watanabeho spigots in the treatment of bronchoesophageal fistulas.

• MeSH
• bronchiální píštěl * chirurgie   diagnóza   MeSH
• diagnostické zobrazování MeSH
• dospělí MeSH
• endoskopy gastrointestinální MeSH
• ezofagektomie metody   MeSH
• lidé MeSH
• nádory jícnu chirurgie   farmakoterapie   MeSH
• pooperační komplikace etiologie   terapie   MeSH
• senioři MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• kazuistiky MeSH

PURPOSE: Endoscopic ear surgery has become a popular operative approach to treat middle ear diseases. Surgeons use either 0° or 30° endoscopes worldwide. The main aim of the work was to compare the properties of these two types of endoscopes. MATERIAL AND METHODS: Since this type of evaluation is hard to perform in vivo during the actual surgery, we designed 3D printed temporal bone models with different levels of complexity. The evaluation of endoscopes was based on image analysis or visibility of anatomical structures. RESULTS: The results show that a 30° endoscope offers a view of lateral walls from 4 mm distance, contrary to a 0° endoscope which cannot see lateral walls from this distance at all. On the other hand, visible area of the anterior wall is up to 40 % larger using 0° endoscope, compared to 30° endoscope. Angled endoscope distorts the picture and leads to the deterioration of the image. At commonly used distances above 5 mm from middle ear structures, resolution and image distortion is comparable between both endoscopes. CONCLUSIONS: Our results do not offer a definitive opinion on which endoscope is better for ear surgery. Both types of endoscopes have advantages and disadvantages, and the choice depends on the surgeon's personal preference and on the type of planned procedure.

• MeSH
• 3D tisk * MeSH
• anatomické modely * MeSH
• design vybavení MeSH
• endoskopie * metody   MeSH
• endoskopy * MeSH
• lidé MeSH
• otologické chirurgické výkony * metody   přístrojové vybavení   MeSH
• spánková kost chirurgie   MeSH
• střední ucho * chirurgie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• srovnávací studie MeSH

• MeSH
• intratracheální intubace metody   MeSH
• laryngoskopie metody   MeSH
• laryngoskopy * MeSH
• lidé MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• dopisy MeSH

• MeSH
• artroskopie * přístrojové vybavení   MeSH
• artroskopy MeSH
• lidé MeSH
• nemocnice zásobování a distribuce   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• novinové články MeSH
• zprávy MeSH
• Geografické názvy
• Česká republika MeSH

While foreign body aspiration remains a frequent and preventable cause of morbidity and mortality in children, recommendations on the appropriate removal technique do often not match the lived practice and expertise of the performing examiners. As there is a scarcity of data regarding success and complication rates of the procedure, the aim of this study was to set up a classification system for procedure-related complications, prospectively record and analyze them. Specialists in the field of foreign body removal contributed cases anonymously. Information regarding procedural details of the bronchoscopy, type, and severity of complications as well as patient characteristics were classified and recorded. Correlations were calculated using Pearson's Chi Square test. A total of 314 rigid and 178 flexible bronchoscopies were compared. Complications were categorized and their severity was defined by the anesthesiologist's assessment of whether to interrupt or terminate the procedure. The overall complication rate was similar in rigid vs. flexible bronchoscopy (19.1% vs. 24.2%, p = 0.232), while respiratory complications occurred significantly less frequent during rigid bronchoscopy (9.2% vs. 16.3%, p = 0.025). This is the largest pediatric case collection recording and comparing complications between rigid and flexible foreign body removal. The higher rate of respiratory complications in flexible bronchoscopy has been shown for the first time and validates some of the concerns about its use for foreign body removal. Flexible bronchoscopy is a safe procedure when extended respiratory monitoring and the possibility of an immediate switch to a secured airway are assured.

• MeSH
• aspirace do dýchacích cest MeSH
• bronchoskopie metody   MeSH
• bronchy MeSH
• cizí tělesa * MeSH
• dítě MeSH
• dýchací soustava MeSH
• endoskopy MeSH
• lidé MeSH
• retrospektivní studie MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

Migrace pankreatobiliarního stentu není častá komplikace, většinou bez závažných následků, ale někdy způsobující perforace střeva. Autoři popisují migraci DB stentu do sigmoidea s následnou zcela asymptomatickou perforací stěny střeva. Vzhledem ke klinickému stavu a věku pacientky byla perforace úspěšně řešena endoskopicky.

Pancreatobiliary stent migration is not a common complication, mostly without serious consequences, but sometimes causing intestinal perforation. The authors describe migration of the DB stent into the sigmoid with subsequent completely asymptomatic perforation of the bowel wall. Due to the patient’s clinical condition and age, the perforation was successfully treated endoscopically.

• Klíčová slova
• biliarní stent,
• MeSH
• cholangiopankreatografie endoskopická retrográdní * škodlivé účinky   MeSH
• cholangitida terapie   MeSH
• endoskopy gastrointestinální MeSH
• lidé MeSH
• perforace střeva chirurgie   etiologie   MeSH
• senioři nad 80 let MeSH
• stenty škodlivé účinky   MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• senioři nad 80 let MeSH
• ženské pohlaví MeSH
• Publikační typ
• kazuistiky MeSH

The aims of the study were to compare the change in the Wisconsin Stone Quality of Life (WISQOL) score in patients who underwent retrograde intrarenal surgery (RIRS) single-use ureteroscope or extracorporeal shock wave lithotripsy (ESWL) with a calculation of quality-adjusted life-years (QALYs). 158 patients treated with urinary stone disease were randomly divided into 80 patients in the validation and 78 patients in the intervention arm. Patients in the intervention arm were randomly divided into the RIRS or the ESWL group. Linguistic validation of the WISQOL into the Slovak language was performed using a standardised multistep process. Discriminant validity was assessed by comparing stone-forming patients to an additional 34 healthy individuals. Patients were asked to fill in the WISQOL before and in the 24th week after the intervention. The QALYs were calculated by the formula QALY = weight factor (WF) x time period after intervention. The Cronbach's α of the WISQOL was 0.94, the Pearson's coefficient for test-retest reliability was 0.91, and the discriminant validity confirmed a higher score for healthy individuals (p < 0.001). The median WISQOL score changed from 45.5 to 95.5 vs. 33.9 to 87.1 in the RIRS and ESWL groups, respectively (p < 0.001). Patients from the RIRS group had a good possibility of reaching 19.727 QALYs gained during life expectancy compared to 15.780 for the ESWL group (p < 0.001). RIRS single-use ureteroscope is significantly superior to ESWL in reaching more QALYs gained during life expectancy. The WISQOL Slovak version is valid, reliable and strictly specific for stone-forming patients.

• MeSH
• kvalita života * MeSH
• kvalitativně upravené roky života MeSH
• lidé středního věku MeSH
• lidé MeSH
• litotripse statistika a číselné údaje   MeSH
• močové kameny komplikace   psychologie   chirurgie   MeSH
• překládání MeSH
• prospektivní studie MeSH
• průzkumy a dotazníky statistika a číselné údaje   MeSH
• psychometrie metody   MeSH
• reprodukovatelnost výsledků MeSH
• senioři MeSH
• ureteroskopie přístrojové vybavení   statistika a číselné údaje   MeSH
• ureteroskopy MeSH
• výsledek terapie MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• randomizované kontrolované studie MeSH
• validační studie MeSH

BACKGROUND: The indirect visualisation of the glottic area with a videolaryngoscope could improve intubation conditions which may possibly lead to a higher success rate of the first intubation attempt. OBJECTIVE: Comparison of videolaryngoscopy and direct laryngoscopy for elective airway management in paediatric patients. DESIGN: Prospective randomised controlled trial. SETTINGS: Operating room. PARTICIPANTS: 535 paediatric patients undergoing elective anaesthesia with tracheal intubation. 501 patients were included in the final analysis. INTERVENTIONS: Patients were randomly allocated to the videolaryngoscopy group (n = 265) and to the direct laryngoscopy group (n = 269) for the primary airway management. MAIN OUTCOME MEASURES: The first attempt intubation success rate was assessed as the primary outcome. The secondary outcomes were defined as: the time to successful intubation (time to the first EtCO2 wave), the overall intubation success rate, the number of intubation attempts, the incidence of complications, and the impact of the length of the operator's clinical practice. RESULTS: The study was terminated after the planned interim analysis for futility. There were no significant demographic differences between the two groups. The first attempt intubation success rate was lower in the videolaryngoscopy group; 86.8% (n = 211) vs. 92.6% (n = 239), P = 0.046. The mean time to the first EtCO2 wave was longer in the videolaryngoscopy group at 39.0 s ± 36.7 compared to the direct laryngoscopy group, 23.6 s ± 24.7 (P < 0.001). There was no difference in the overall intubation success rate, in the incidence of complications nor significant difference based on the length of the clinical practice of the operator. CONCLUSIONS: The first attempt intubation success rate was lower in the videolaryngoscopy group in comparison to the direct laryngoscopy group. The time needed for successful intubation with videolaryngoscopy was longer compared with direct laryngoscopy. TRIAL REGISTRATION: Clinicaltrials.gov identifier: NCT03747250.

• MeSH
• anestezie * MeSH
• audiovizuální záznam MeSH
• dítě MeSH
• intratracheální intubace škodlivé účinky   MeSH
• laryngoskopie MeSH
• laryngoskopy * MeSH
• lidé MeSH
• prospektivní studie MeSH
• zajištění dýchacích cest MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• randomizované kontrolované studie MeSH

INTRODUCTION: The TROPHY registry has been established to conduct an international multicenter prospective data collection on the surgical management of neonatal intraventricular hemorrhage (IVH)-related hydrocephalus to possibly contribute to future guidelines. The registry allows comparing the techniques established to treat hydrocephalus, such as external ventricular drainage (EVD), ventricular access device (VAD), ventricular subgaleal shunt (VSGS), and neuroendoscopic lavage (NEL). This first status report of the registry presents the results of the standard of care survey of participating centers assessed upon online registration. METHODS: On the standard of treatment forms, each center indicated the institutional protocol of interventions performed for neonatal post-hemorrhagic hydrocephalus (nPHH) for a time period of 2 years (Y1 and Y2) before starting the active participation in the registry. In addition, the amount of patients enrolled so far and allocated to a treatment approach are reported. RESULTS: According to the standard of treatment forms completed by 56 registered centers, fewer EVDs (Y1 55% Y2 46%) were used while more centers have implemented NEL (Y1 39%; Y2 52%) to treat nPHH. VAD (Y1 66%; Y2 66%) and VSGS (Y1 42%; Y2 41%) were used at a consistent rate during the 2 years. The majority of the centers used at least two different techniques to treat nPHH (43%), while 27% used only one technique, 21% used three, and 7% used even four different techniques. Patient data of 110 infants treated surgically between 9/2018 and 2/2021 (13% EVD, 15% VAD, 30% VSGS, and 43% NEL) were contributed by 29 centers. CONCLUSIONS: Our results emphasize the varying strategies used for the treatment of nPHH. The international TROPHY registry has entered into a phase of growing patient recruitment. Further evaluation will be performed and published according to the registry protocol.

• MeSH
• cerebrální krvácení epidemiologie   chirurgie   MeSH
• hydrocefalus * epidemiologie   chirurgie   MeSH
• kojenec MeSH
• lidé MeSH
• neuroendoskopie * MeSH
• neuroendoskopy MeSH
• novorozenec MeSH
• registrace MeSH
• Check Tag
• kojenec MeSH
• lidé MeSH
• novorozenec MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• práce podpořená grantem MeSH