Článek předkládá adaptovaný klinický doporučený postup (KDP) v zavádění a ošetřování periferních žilních vstupů u novorozenců a kojenců, který vznikal podobně (podle ADAPTE protokolu) jako doporučený postup v péči o kůži novorozenců (uvedený v Pediatrii pro praxi č. 4/2015), v zavádění a ověřování gastrické sondy (č. 1/2016) a odsávání novorozenců a kojenců (č. 4/2017). Na základě rešerše byly vyhledány již existující klinické doporučené postupy a jiná doporučení, která byla podrobena metodologické analýze, a poté byl vytvořen návrh nového adaptovaného doporučeného postupu. Ten byl předložen celkem 463 sestrám z 11 perinatologických center v České republice a na základě jejich připomínek byl vypracován konečný KDP, jehož účelem je poskytnout kompetentním zdravotnickým pracovníkům praktické informace, týkající se výběru jehly, kanyly nebo katétru, volby místa vstupu, použití turniketu, transiluminátoru nebo infračerveného světla, vlastního postupu zavádění jehly/kanyly/katétru, volby dezinfekce a způsobu tišení bolesti. Zmíněno je také ošetřování periferních žilních vstupů, možné komplikace a jejich prevence a dokumentace celého procesu.
The article presents an adapted clinical practice guideline (CPG) in inserting and taking care of the peripheral venous access inneonates and infants. It was developed in a similar way (using the ADAPTE protocol) as the clinical practice guideline in neonatalskin care (published in Pediatrie pro praxi No. 4/2015), in gastric tube insertion and verification (No. 1/2016) and in suctioning ofneonates and infants (No. 4/2017).On the basis of a literature search the existing clinical practice guidelines and other recommendations were identified and analyzedmethodologically and then a draft of a new, adapted clinical practice guideline was developed. It was presented to 463 nursesfrom 11 perinatology centres in the Czech Republic and the final CPG was created on the basis of their comments. The purposeof the guideline is to provide the competent health care workers with practical information concerning selection of a needle,cannula or catheter, choice of the insertion site, use of a tourniquet, transilluminator or infrared light, the actual procedure of theinsertion of a needle/cannula/catheter, choice of disinfection and the way of pain control. Also mentioned is taking care of theperipheral venous access, as well as possible complications and their prevention and the documentation of the whole procedure.
- MeSH
- Vascular Access Devices MeSH
- Disinfection MeSH
- Catheterization MeSH
- Catheters MeSH
- Infant MeSH
- Humans MeSH
- Infant, Newborn MeSH
- Nursing Care MeSH
- Practice Patterns, Nurses' MeSH
- Catheterization, Peripheral * methods nursing adverse effects MeSH
- Practice Guidelines as Topic MeSH
- Transillumination utilization MeSH
- Check Tag
- Infant MeSH
- Humans MeSH
- Infant, Newborn MeSH
- MeSH
- Adult MeSH
- Fluorescence MeSH
- Physical Examination statistics & numerical data MeSH
- Radiography, Bitewing statistics & numerical data MeSH
- Middle Aged MeSH
- Humans MeSH
- Radiography, Dental methods statistics & numerical data MeSH
- Sensitivity and Specificity MeSH
- Transillumination statistics & numerical data MeSH
- Dental Restoration, Permanent methods nursing MeSH
- Dental Caries * diagnostic imaging MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Research Support, Non-U.S. Gov't MeSH
This study is focused on the vascular anatomy of the stomach in relation to the gastric pull-up construction. The vascular anatomy was studied on forty-one human specimens. We find out the differences in blood supplement between anterior and posterior wall. It was maked an review of the main trunk arteries of the stomach. To display the vessels of the stomach we used diaphanoscopy, digital shooting in special mode and micro preparation of the vessels. We find out that left gastric artery gives more branches to the posterior wall and right gastroepiploic artery (RGEA) gives more branches to the anterior wall. But brunches of RGEA are longer on the posterior wall than on the anterior. Also we are offering the new classification of the RGEA related to gastric pull-up construction. This classification based not only on the anatomical shapes of RGEA but on the properties of the flow dynamics through the artery.
- MeSH
- Anatomic Variation MeSH
- Gastroepiploic Artery anatomy & histology MeSH
- Gastroplasty methods MeSH
- Middle Aged MeSH
- Humans MeSH
- Cadaver MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Transillumination MeSH
- Stomach blood supply diagnostic imaging MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
Pial artery adjustments to changes in blood pressure (BP) may last only seconds in humans. Using a novel method called near-infrared transillumination backscattering sounding (NIR-T/BSS) that allows for the non-invasive measurement of pial artery pulsation (cc-TQ) in humans, we aimed to assess the relationship between spontaneous oscillations in BP and cc-TQ at frequencies between 0.5 Hz and 5 Hz. We hypothesized that analysis of very short data segments would enable the estimation of changes in the cardiac contribution to the BP vs. cc-TQ relationship during very rapid pial artery adjustments to external stimuli. BP and pial artery oscillations during baseline (70s and 10s signals) and the response to maximal breath-hold apnea were studied in eighteen healthy subjects. The cc-TQ was measured using NIR-T/BSS; cerebral blood flow velocity, the pulsatility index and the resistive index were measured using Doppler ultrasound of the left internal carotid artery; heart rate and beat-to-beat systolic and diastolic blood pressure were recorded using a Finometer; end-tidal CO2 was measured using a medical gas analyzer. Wavelet transform analysis was used to assess the relationship between BP and cc-TQ oscillations. The recordings lasting 10s and representing 10 cycles with a frequency of ~1 Hz provided sufficient accuracy with respect to wavelet coherence and wavelet phase coherence values and yielded similar results to those obtained from approximately 70cycles (70s). A slight but significant decrease in wavelet coherence between augmented BP and cc-TQ oscillations was observed by the end of apnea. Wavelet transform analysis can be used to assess the relationship between BP and cc-TQ oscillations at cardiac frequency using signals intervals as short as 10s. Apnea slightly decreases the contribution of cardiac activity to BP and cc-TQ oscillations.
- MeSH
- Apnea pathology MeSH
- Carotid Artery, Internal pathology MeSH
- Arteries pathology MeSH
- Adult MeSH
- Electrocardiography MeSH
- Blood Pressure MeSH
- Humans MeSH
- Young Adult MeSH
- Cerebrovascular Circulation MeSH
- Oscillometry methods MeSH
- Pia Mater blood supply MeSH
- Blood Flow Velocity physiology MeSH
- Heart Rate MeSH
- Transillumination methods MeSH
- Ultrasonography, Doppler, Transcranial MeSH
- Wavelet Analysis * MeSH
- Breath Holding MeSH
- Healthy Volunteers MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Young Adult MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- MeSH
- Early Diagnosis MeSH
- Humans MeSH
- Dental Equipment MeSH
- Transillumination * instrumentation MeSH
- Dental Caries * diagnosis MeSH
- Check Tag
- Humans MeSH
- Publication type
- Research Support, Non-U.S. Gov't MeSH
- MeSH
- Child MeSH
- Phlebotomy methods instrumentation MeSH
- Humans MeSH
- Transillumination utilization MeSH
- Check Tag
- Child MeSH
- Humans MeSH
Tuberkulóza je infekční onemocnění, jehož incidence na území České republiky postupně klesá. Přes optimistické předpoklady v průběhu minulého století, ale nikdy nepřestalo být celosvětovým problémem. Důvodem je nejen vyšší mobilita obyvatel rozvojových zemí s vysokou incidencí tuberkulózy, ale i rostoucí počty rezistentních kmenů. Proto musí být zachována účinná a organizačně zvládnutá opatření k vyhledávání tuberkulózou zasažených jedinců. Tento text se snaží o krátké shrnutí principů diagnostiky a léčby tuberkulózy v epidemiologicky stabilizované populaci.
Tuberculosis is an infectious disease the incidence of which is decreasing step-by-step in the Czech Republic. Despite optimistic presumptions in the course of the last century, it never ceased to be a global problem. The reason for that is not only the higher mobility of the inhabitants from developing countries with the high incidence of tuberculosis but also an increasing number of resistent species. Therefore, the efficient and managable measures of detection of individuals affected by tuberculosis should be maintained. This text aims at brief summarizing the principles of diagnostics and treatment of tuberculosis in the epidemiologically stabilized population.
- MeSH
- Antitubercular Agents adverse effects therapeutic use MeSH
- Diagnostic Techniques and Procedures MeSH
- Drug Therapy methods MeSH
- Drug Therapy, Combination MeSH
- Humans MeSH
- Microbiological Techniques MeSH
- Mycobacterium Infections MeSH
- Primary Prevention MeSH
- Transillumination MeSH
- Tuberculosis diagnosis epidemiology physiopathology MeSH
- Check Tag
- Humans MeSH
