Older individuals experience cardiovascular dysfunction during extended bedridden hospital or care home stays. Bed rest is also used as a model to simulate accelerated vascular deconditioning occurring during spaceflight. This study investigates changes in retinal microcirculation during a ten-day bed rest protocol. Ten healthy young males (22.9 ± 4.7 years; body mass index: 23.6 ± 2.5 kg·m-2) participated in a strictly controlled repeated-measures bed rest study lasting ten days. High-resolution images were obtained using a hand-held fundus camera at baseline, daily during the 10 days of bed rest, and 1 day after re-ambulation. Retinal vessel analysis was performed using a semi-automated software system to obtain metrics for retinal arteriolar and venular diameters, central retinal artery equivalent and central retinal vein equivalent, respectively. Data analysis employed a mixed linear model. At the end of the bed rest period, a significant decrease in retinal venular diameter was observed, indicated by a significantly lower central retinal vein equivalent (from 226.1 μm, CI 8.90, to 211.4 μm, CI 8.28, p = .026), while no significant changes in central retinal artery equivalent were noted. Prolonged bed rest confinement resulted in a significant (up to 6.5%) reduction in retinal venular diameter. These findings suggest that the changes in retinal venular diameter during bedrest may be attributed to plasma volume losses and reflect overall (cardio)-vascular deconditioning.

• MeSH
• arteria centralis retinae * diagnostické zobrazování   MeSH
• fluoresceinová angiografie MeSH
• klid na lůžku škodlivé účinky   MeSH
• lidé MeSH
• retinální cévy diagnostické zobrazování   MeSH
• vena centralis retinae * diagnostické zobrazování   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

Numerous countermeasures have been proposed to minimize microgravity-induced physical deconditioning, but their benefits are limited. The present study aimed to investigate whether personalized aerobic exercise based on artificial gravity (AG) mitigates multisystem physical deconditioning. Fourteen men were assigned to the control group (n=6) and the countermeasure group (CM, n=8). Subjects in the CM group were exposed to AG (2 Gz at foot level) for 30 min twice daily, during which time cycling exercise of 80-95 % anaerobic threshold (AT) intensity was undertaken. Orthostatic tolerance (OT), exercise tests, and blood assays were determined before and after 4 days head-down bed rest (HDBR). Cardiac systolic function was measured every day. After HDBR, OT decreased to 50.9 % and 77.5 % of pre-HDBR values in control and CM groups, respectively. Exercise endurance, maximal oxygen consumption, and AT decreased to 96.5 %, 91.5 % and 91.8 % of pre-HDBR values, respectively, in the control group. Nevertheless, there were slight changes in the CM group. HDBR increased heart rate, sympathetic activity, and the pre-ejection period, but decreased plasma volume, parasympathetic activity and left-ventricular ejection time in the control group, whereas these effects were eliminated in the CM group. Aldosterone had no change in the control group but increased significantly in the CM group. Our study shows that 80-95 % AT aerobic exercise based on 2 Gz of AG preserves OT and exercise endurance, and affects body fluid regulation during short-term HDBR. The underlying mechanisms might involve maintained cardiac systolic function, preserved plasma volume, and improved sympathetic responses to orthostatic stress.

• MeSH
• časové faktory MeSH
• cvičení fyziologie   MeSH
• dospělí MeSH
• gravitace změněná * MeSH
• klid na lůžku metody   MeSH
• krevní tlak fyziologie   MeSH
• lidé MeSH
• mladý dospělý MeSH
• ortostatická intolerance diagnóza   patofyziologie   MeSH
• simulace stavu beztíže metody   MeSH
• spotřeba kyslíku fyziologie   MeSH
• srdeční frekvence fyziologie   MeSH
• Trendelenburgova poloha fyziologie   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

Objective: Conduct and evaluate system-level evidence-based practice intervention for deep vein thrombosis (DVT) prevention. Design: One group post-intervention survey evaluation. Setting: A mother-baby unit in a tertiary hospital. Interventions/me­asurement: Educating nurses, implementing an evidence-based deep vein thrombosis (DVT) prevention guideline in the mother-baby unit, and recommending policy changes. Outcomes were measured using Omaha System Knowledge, Behavior, and Status scales (1 = lowest – 5 = highest) for nurse DVT knowledge and practice behavior, and implementation of policy recommendations. Results: Twenty nurses (80%) completed the evaluation survey. The nurses reported that their knowledge increased significantly (3.70 vs. 4.40; p < 0.001). Behavior was variable in DVT guideline adherence. After training, most nurses (65%) usually or always assessed women for DVT risk, and some (35%) usually or always applied compression boots for DVT. The majority of nurses (70%) reported that women refused compression boots. Nurses who did not usually or always assess patients were statistically less likely to apply boots (p = 0.022). The nurses who reported discomfort with the procedure (30%) were statistically less likely to apply stockings (p = 0.028). Policy implementation to support evidence-based DVT prevention increased significantly (p = 0.008). Conclusion: Comprehensive evidence-based interventions resulted in practice and system change to prevent DVT. Nurses‘ knowledge about DVT prevention increased and some nurses consistently assessed for DVT and applied compression boots. The facility supported the implementation of the guideline and implemented unit/facility policy changes.

• Klíčová slova
• edukace pacienta, intervence sestry, praxe založná na důkazech,
• MeSH
• klid na lůžku MeSH
• komplikace těhotenství MeSH
• kompresivní punčochy MeSH
• medicína založená na důkazech MeSH
• těhotenství MeSH
• vzdělávání pacientů jako téma MeSH
• žilní trombóza ošetřování   prevence a kontrola   terapie   MeSH
• Check Tag
• těhotenství MeSH

Objective: Conduct and evaluate system-level evidence-based practice intervention for deep vein thrombosis (DVT) prevention. Design: One group post-intervention survey evaluation. Setting: A mother-baby unit in a tertiary hospital. Interventions/me­asurement: Educating nurses, implementing an evidence-based deep vein thrombosis (DVT) prevention guideline in the mother-baby unit, and recommending policy changes. Outcomes were measured using Omaha System Knowledge, Behavior, and Status scales (1 = lowest – 5 = highest) for nurse DVT knowledge and practice behavior, and implementation of policy recommendations. Results: Twenty nurses (80%) completed the evaluation survey. The nurses reported that their knowledge increased significantly (3.70 vs. 4.40; p < 0.001). Behavior was variable in DVT guideline adherence. After training, most nurses (65%) usually or always assessed women for DVT risk, and some (35%) usually or always applied compression boots for DVT. The majority of nurses (70%) reported that women refused compression boots. Nurses who did not usually or always assess patients were statistically less likely to apply boots (p = 0.022). The nurses who reported discomfort with the procedure (30%) were statistically less likely to apply stockings (p = 0.028). Policy implementation to support evidence-based DVT prevention increased significantly (p = 0.008). Conclusion: Comprehensive evidence-based interventions resulted in practice and system change to prevent DVT. Nurses‘ knowledge about DVT prevention increased and some nurses consistently assessed for DVT and applied compression boots. The facility supported the implementation of the guideline and implemented unit/facility policy changes.

• MeSH
• klid na lůžku * ošetřování   škodlivé účinky   MeSH
• komplikace těhotenství MeSH
• lidé MeSH
• ošetřovatelství založené na důkazech MeSH
• role ošetřovatelky MeSH
• těhotenství MeSH
• zdravotní výchova metody   MeSH
• žilní trombóza prevence a kontrola   MeSH
• Check Tag
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Geografické názvy
• Spojené státy americké MeSH

• Klíčová slova
• Bioparox (fusangin - fusarium),
• MeSH
• antibakteriální látky aplikace a dávkování   terapeutické užití   MeSH
• chřipka lidská diagnóza   etiologie   terapie   MeSH
• dospělí MeSH
• farmakoterapie * MeSH
• Fusarium MeSH
• Haemophilus influenzae MeSH
• imunita fyziologie   imunologie   MeSH
• infekce dýchací soustavy diagnóza   etiologie   terapie   MeSH
• klid na lůžku MeSH
• kyselina askorbová terapeutické užití   MeSH
• lidé MeSH
• Moraxella catarrhalis izolace a purifikace   účinky léků   MeSH
• nachlazení * diagnóza   etiologie   terapie   MeSH
• příznaky a symptomy ústrojí dýchacího * MeSH
• Streptococcus pneumoniae izolace a purifikace   účinky léků   MeSH
• tekutinová terapie MeSH
• viry imunologie   izolace a purifikace   patogenita   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• kazuistiky MeSH

INTRODUCTION AND HYPOTHESIS: Pelvic organ prolapse (POP) in pregnancy is a rare condition with decreasing incidence and improved management and outcome world-wide recently. Systematic review of the literature for cases of POP in pregnancy published since 1990 was carried out to identify common factors in presentation, management and outcomes. One case from our own practice was added to the analysis. METHODS: An extensive search of the Pubmed/Medline, Scopus and Google Scholar databases was performed to identify all cases of POP in pregnancy since 1990. Published case reports of POP in pregnancy were reviewed and summarized in tables to find similarities in history, course, management and outcome of the pregnancies. RESULTS: Of the 43 cases and one case series, 41 case studies were eligible for analysis. Two types of POP in pregnancy were identified: preexisting is less common (14 vs 27 cases), often resolves during pregnancy (5 out of 14) and always recurs after delivery (14 out of 14); acute onset of POP in pregnancy rarely resolves in pregnancy (2 out of 27), but often resolves after delivery (18 out of 27). Most patients were managed with bed rest (20 out of 41), pessary (15 out of 41), manual reduction (6 out of 41) and local treatment (6 out of 41). The most common complications reported include preterm labour (14 out of 41), cervical ulcerations (9 out of 41), infection (3 out of 41) and obstructed labour (4 out of 41). About a half of the women delivered vaginally (22 out of 41), caesarean section due to prolapse was required in 15 cases. CONCLUSIONS: Two distinct entities were identified based on similarities regarding onset, course and outcome of POP in pregnancy. Concise recommendations for practice were derived from the analysis of case studies published since 1990.

• MeSH
• císařský řez MeSH
• dystokie etiologie   MeSH
• infekční komplikace v těhotenství etiologie   MeSH
• klid na lůžku MeSH
• komplikace těhotenství etiologie   MeSH
• lidé MeSH
• pesary MeSH
• předčasná porodní činnost etiologie   MeSH
• prolaps pánevních orgánů komplikace   diagnóza   terapie   MeSH
• těhotenství MeSH
• Check Tag
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• přehledy MeSH

• MeSH
• antibakteriální látky aplikace a dávkování   farmakologie   terapeutické užití   MeSH
• chronická nemoc MeSH
• diferenciální diagnóza * MeSH
• epiglotitida * diagnóza   etiologie   terapie   MeSH
• faryngitida * diagnóza   etiologie   terapie   MeSH
• hospitalizace * MeSH
• infekce dýchací soustavy * MeSH
• klid na lůžku MeSH
• lidé MeSH
• nazofaryngitida * diagnóza   etiologie   terapie   MeSH
• Streptococcus pyogenes účinky léků   MeSH
• tonzilitida * diagnóza   dietoterapie   etiologie   terapie   MeSH
• Check Tag
• lidé MeSH

• MeSH
• časové faktory MeSH
• dospělí MeSH
• klid na lůžku škodlivé účinky   MeSH
• kosmický let MeSH
• kosti a kostní tkáň fyziologie   metabolismus   MeSH
• lidé středního věku MeSH
• lidé MeSH
• pohlavní steroidní hormony analýza   krev   metabolismus   moč   MeSH
• stav beztíže MeSH
• testosteron analýza   krev   metabolismus   moč   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• souhrny MeSH

Hltan představuje místo prvního styku organizmu s okolím, a proto zde probíhá řada zánětů. Jsou-li záněty lokalizovány především na oblast mandlí, mluvíme o angínách. Záněty hltanu jsou nejčastěji virové etiologie, z bakteriálních agens jsou záněty způsobeny nejčastěji pyogenním streptokokem sk. A. Diagnostika onemocnění je založena na klinickém vyšetření, dle potřeby i laboratorním (CRP, mikrobiologické vyšetření a další). Virové záněty jsou obvykle méně závažné a jsou léčeny symptomaticky, bakteriální záněty pak antibiotiky. Lékem volby u streptokokových infekcí je penicilin, který je třeba užívat 10 dní. Penicilin naopak není vhodný u recidivujících zánětů, u kterých jsou indikována antibiotika širokospektrá. Tonzilektomii lze zvážit při recidivách zánětů mandlí a je indikována, opakují-li se záněty mandlí 7× po dobu 1 roku, 5×/2 roky či 3×/3 roky. Při rozhodování o tonzilektomii je ale vždy třeba postupovat individuálně v závislosti na potížích, věku a dalších faktorech.

The pharynx is the site of first contact of the body with the environment; therefore, a lot of inflammatory processes occur here. If an inflammation is mainly confined to the area of the tonsils, it is referred to as tonsillitis. Pharyngitides are most frequently of viral etiology, with group A Streptococcus pyogenes being the most common bacterial agent. They are diagnosed based on clinical examination and, if necessary, laboratory investigations (CRP, microbiological examination, etc.). Non-serious inflammatory processes are treated symptomatically and those caused by bacteria with antibiotics. Penicillin is the drug of choice in streptococcal infections and has to be taken for ten days. By contrast, penicillin is not suitable in recurrent inflammations in which broad-spectrum antibiotics are indicated. Tonsillectomy may be considered in recurrent tonsillitis and is indicated if there are seven episodes of tonsillitis in one year, five episodes for two consecutive years, or three episodes per year for three consecutive years. When considering tonsillectomy, however, an individual approach is always required depending on the complaints, age, and other factors.

• Klíčová slova
• angína, léčba,
• MeSH
• antibakteriální látky MeSH
• dítě MeSH
• epidemiologie MeSH
• faryngitida MeSH
• klid na lůžku MeSH
• lidé MeSH
• mikrobiologie MeSH
• mladiství MeSH
• nemoci dýchací soustavy MeSH
• pediatrie MeSH
• předškolní dítě MeSH
• příznaky a symptomy MeSH
• recidiva MeSH
• streptokokové infekce MeSH
• tekutinová terapie MeSH
• tonzilektomie MeSH
• tonzilitida * diagnóza   klasifikace   terapie   MeSH
• virové nemoci MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• mladiství MeSH
• předškolní dítě MeSH

S rozvojem moderních technologií se v monitorování fyziologických pohybů uplatňuje řada nových metod, ne vždy však lékaři požadují složitá zařízení omezující pohyb pacienta na lůžku či připojení dalších zařízení k pacientovi. Nová, námi navržená, metoda je určená k monitorování jemných pohybů pacienta v horizontální poloze na lůžku během léčby či (krátkodobého) lékařského vyšetření. Metoda je založena na využití snímačů, detekujících poměrné deformace od napětí v konstrukčních částech lůžka, které je způsobeno momenty sil. Momenty sil jsou způsobeny jemnými pohyby pacienta na lůžku. Systém poskytuje informace o poloze a pohybech pacienta na lůžku a o jemných fyziologických pohybech pacienta, konkrétně se jedná o frekvenci dýchání a frekvenci stahů srdce. Nový způsob monitorování založený na tenzometrických snímačích umožňuje nahradit stávající systémy identifikace polohy a pohybů pacienta, včetně monitorování fyziologických veličin jako je frekvence dýchání, srdečních stahů a chvění těla. Metoda byla testována na souboru dobrovolníků/ studentů FBMI ČVUT v počtu osmi s cílem ověřit potenciální využitelnost nové metody v klinické praxi. U všech subjektů byly identifikovány fyziologické pohyby.

Currently, new methods are applied to monitor the involuntary movement and other physiological movements, but physicians do not always require complex equipment or they do not accept to use the devices connected to the patient. We designed the new method which is suitable to monitor the small movements of the patient in a horizontal position on the bed or monitor the movements during short term medical examination. The method is based on the use of strain gauge sensors to detect deformation of construction of the popular commercially mass-produced Eleganza bed (LINET Ltd.). Strain gauge sensors are implemented into the construction of the bed and detect bending of the elements of the bed. The designed method provides information about the patient’s physiological movements, namely it is the breathing rate and heart rate. The method was tested on a set of volunteers / students in order to verify the new method and design for the application in clinical practice. The average magnitude of change in the strain caused by movements from the heart is 1.7 μm/m and average magnitude of change in the strain caused by movements from the breathing is 3.3 μm/m. Much more significant change is the change in the strain caused by movements from the rolling, the magnitude of change in the strain is 246 μm/m. The primary advantage of our system used in a modified popular mass-produced bed is non-invasive i.e. non-contact measurement. The system is not even in the space normally used for other medical devices. The proposed method allows continuous monitoring of the patient 24 hours a day and increases the safety of the patient in bed. The proposed method could also evaluate the patient’s weight and its changes over time. This is possible if the measurement system is calibrated. The accurate calibration and its verification can be another research direction. Commercially available beds equipped with our proposed system can find application in anesthesiology, resuscitation and intensive care, long-term care and retirement homes.

• Klíčová slova
• balistografie, inteligentní lůžko, fyziologické pohyby, monitorování,
• MeSH
• balistokardiografie metody   přístrojové vybavení   MeSH
• financování organizované MeSH
• klid na lůžku MeSH
• lidé MeSH
• lůžka MeSH
• monitorování fyziologických funkcí MeSH
• pacienti hospitalizovaní MeSH
• pohyb fyziologie   MeSH
• Check Tag
• lidé MeSH