Q47442384
Dotaz
Zobrazit nápovědu
Úvod: Podle dostupných pramenů trpí syndromem obstrukční spánkové apnoe (OSAS) ve čtvrté dekádě života 1-5 % ženské populace a více než 90 % žen s OSAS o svém problému neví. Přibližně 15 % obézních těhotných žen má pravděpodobně SAS (Sleep Apnoe Syndrome). Cílem práce je průzkum výskytu OSAS v populaci rizikově těhotných a průzkum souvislosti OSAS s rizikovými faktory pro těhotenství. Charakteristika souboru: Ze 480 sledovaných těhotných bylo zkoumáno 85 a do studie zařazeno 61 rizikově těhotných respondentek. Metody: Statisticky jsme zhodnotili vztah OSAS k hypertenzi, obezitě, preeklamptickým změnám placenty, nízkému pH pupečníkové krve, nízké hladině PlGF ve skupině rizikově těhotných s AHI < 5 a ve skupině s AHI ≥ 5. Výsledky: Ve studovaném souboru byla prokázána významná statistická souvislost výskytu OSAS s gestačním diabetem a obezitou u rizikově těhotných. Nebyla prokázána souvislost s výskytem hypertenze. Pro nízký záchyt respondentek s těmito potížemi nebyla statisticky přínosná hodnocení výskytu histomorfologických preeklamptických změn placenty, nízkého pH pupečníkové krve a nízké hladiny PlGF.
Introduction: According to the available data, OSAS (Obstructive Sleep Apnea Syndrome) occurs in the fourth decade in 1 to 5% of women in the total population, and over 90% of women with OSAS do not know about their problems. Approximately 15% of obese pregnant females are thought to suffer from SAS. The aim of this work is to explore OSAS incidence in high-risk pregnant women and the association of OSAS with risk factors for pregnancy. Material: 85 women of a group of 480 monitored high-risk pregnant females were examined, and 61 of these were involved in this study. Methods: We statistically evaluated the relation between OSAS and hypertension, obesity, preeclamptic placental changes, low pH values of umbilical cord blood, and low PlGF levels in the group of high-risk pregnant women with AHI < 5 and in the group with AHI ≥ 5. Results: In the monitored group there was a statistical significant coherence between OSAS and gestational diabetes and obesity in high-risk gravid women. Surprisingly, an association with hypertension was not found. From a statistical point of view, evaluations of histomorphological preeclamptic placental changes, low pH values of umbilical cord blood and low PlGF levels was not significant for a small number of respondents with these disorders.
- MeSH
- komorbidita MeSH
- obstrukční spánková apnoe * epidemiologie MeSH
- rizikové faktory MeSH
- rizikové těhotenství * MeSH
- těhotenství MeSH
- Check Tag
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- práce podpořená grantem MeSH
- Geografické názvy
- Česká republika MeSH
Introduction: Laryngeal cancer is the most frequent cancer in the head and neck area. Approximately one third of patients are treated by total laryngectomy (TL). The rate of the patient's adaptation to new conditions is crucial to the quality of his or her future life. Some patients survive tens of years after this operation. The preparation for TL is a complicated process that affects a patient's cooperation in postsurgical time. The patient is informed of the essence of the disease, treatment possibilities, the process of preoperative preparation, as well as the operation itself. Great emphasis is put on awareness of the postoperative development, the patient's good cooperation, as well as good prognosis of the disease. Losing one's voice and the cosmetic defects caused by the tracheostoma are a great problem for the patient. The aim of this study was to show the main problems that patients after total laryngectomy deal with in common life. Material: In the group, there were 102 patients who had been operated on between 2003 and 2013, 62 of which met the classification criteria. Methods: This prospective study was statistically evaluated. The frequencies of responses were processed in tables. Results: During the early postoperative period, the greatest problem of patients after total laryngectomy is their adaptation to new principles of breathing, which is subsequently followed by the adaptation to a new and different way of communication. The best option for the patient is to communicate using esophageal voice. Only 55% of operated patients use one of the verbal forms of alternative voice communication in their future lives.
143 stran : ilustrace (některé barevně) ; 21 cm
- MeSH
- histocytochemie MeSH
- Publikační typ
- abstrakty MeSH
- kongresy MeSH
- programy MeSH
- sborníky MeSH
- zprávy MeSH
- Konspekt
- Obecná biologie
- NLK Obory
- histologie
- cytologie, klinická cytologie
- biochemie
AIM: Percutaneous transthoracic needle biopsy (PTNB), an alternative to bronchoscopic confirmation of lung lesions, is today being associated with a risk of pneumothorax and hemorrhage. Further, there are no data on the possible risk of malignant disease spreading to the pleura at the site of the PTNB. Previous studies have dealt with this risk in stage I non-small cell lung cancer only. The aim of this study was thus to assess the risk of pleural recurrence for all types of lung lesions. Secondary objectives included assessment of diagnostic yield and safety with respect to the incidence of pneumothorax and hemorrhage. METHODS: Clinical data of all patients from the University Hospital in Pilsen who had undergone PTNB of lung lesions between 1.1.2018 and 31.12.2022 were included in this retrospective study. RESULTS: Following PTNB, ipsilateral pleural effusion occurred in 4.8% of patients without prior pleural infiltration. The effusion was confirmed as malignant in one patient (0.7%). Diagnostic yield of the method was 86.6%. We recorded pneumothorax or hemorrhage in the lung parenchyma or pleural space requiring medical intervention in 3.4% and 1.1% of patients, respectively. CONCLUSION: In our study, percutaneous transthoracic needle biopsy of lung lesions showed high sensitivity and low degree of acute complications requiring an invasive solution. The risk of pleural recurrence after a biopsy was very low. Consequently, we continue to consider this method to be an alternative to bronchoscopy biopsies.
- MeSH
- dospělí MeSH
- jehlová biopsie škodlivé účinky metody MeSH
- krvácení etiologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- nádory plic * patologie MeSH
- pleurální výpotek etiologie patologie MeSH
- plíce patologie MeSH
- pneumotorax * etiologie MeSH
- retrospektivní studie MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
OBJECTIVE: The aim of the study was to investigate the associations of cross-sectional area (CSA) of the median nerve measured by ultrasonography, the median to ulnar nerve ratio (MUR), the median to ulnar nerve difference (MUD) and the ratio of CSA of the median nerve to height squared (MHS) in relation to electrodiagnostic classification of moderate and severe carpal tunnel syndrome (CTS) and thus to identify patients suitable for surgical treatment. MATERIALS AND METHODS: A prospective study was conducted in patients aged ≥ 18 years who underwent both median and ulnar nerve ultrasonography and electrodiagnostic studies (EDS). 124 wrists of 62 patients were examined. The patients' characteristics were acquired through a questionnaire. CTS was diagnosed using EDS and classified according to the guidelines of the Czech Republic Association of Electrodiagnostic Medicine. The CSA of the median nerve and of the ulnar nerve were measured at the carpal tunnel inlet. RESULTS: Median nerve CSA at the tunnel inlet ≥ 12 mm2 correlates with electrodiagnostic classification of moderate to severe carpal tunnel syndrome. At this cut-off value, the sensitivity of ultrasonography is 82.4%, its specificity is 87.7%, the positive predictive value is 82.4%, the negative predictive value is 87.7%. MUD, MUR and MHS perform worse than the median nerve CSA, as shown by their lower area under the receiver operating characteristic curve. CONCLUSIONS: Ultrasound could help us indicate surgical treatment for CTS, especially in patients with clinical findings. Our results suggest a cut-off value of CSA at the tunnel inlet of ≥ 12mm2.
Úvod: Zhoubné nádory žlučových cest patří k velmi agresivním malignitám gastrointestinálního traktu. Jedinou radikální léčbou je chirurgická resekce, která je však možná jen u omezeného počtu případů vzhledem k pozdní diagnostice. Cílem sdělení bylo podat zkušenosti vlastního pracoviště s diagnostikou a léčbou těchto nádorů. Metody: V letech 2005–2021 autoři řešili celkem 95 nemocných s diagnózou zhoubného nádoru mimojaterních žlučových cest. Radikální (R0) resekcí bylo operováno 27 (28,4 %) nemocných, stejný počet byl řešen jen symptomaticky a u 41 (43,2 %) nemocných byl použit jako definitivní výkon stent žlučových cest, nebo zevně – vnitřní drenáž. Adjuvantní onkologická léčba byla indikována u 16 (59,3 %) radikálně operovaných a 49 (72,1 %) neoperovaných nemocných. Výsledky: Medián celkového přežití a přežití do progrese u operovaných nemocných byl 19,9 měsíce, resp. 15,7 měsíce. Celkové přežití u operovaných nemocných bylo významně lepší (p<0,0001) než u nemocných řešených paliativně. Medián celkového přežití u drenážní, resp. paliativní léčby byl 5,8, resp. 3,6 měsíce. V celkovém přežití nebyl rozdíl mezi symptomatickou a drenážní léčbou (p<0,3383). Závěr: Příčinou špatných výsledků léčby zhoubných nádorů mimojaterních žlučových cest je vedle jejich histopatologické agresivity především pozdní diagnostika. Léčba má být vedena multidisciplinárním týmem. V současnosti dochází k velkému rozvoji endoskopických metod, které společně s dalším rozvojem personalizované onkologické léčby může v budoucnu přinést zlepšení výsledků. Chirurgická, radikální léčba zůstává metodou volby s nejlepšími dlouhodobými výsledky.
Introduction: Biliary tract malignancies belong to very aggressive malignancies of the gastrointestinal tract. The only radical treatment is surgical resection which is possible only in a limited number of cases due to late diagnosis. The aim of this report was to present the experience of our own department with the diagnosis and treatment of these tumours. Methods: In the years 2005–2021 radical (R0) resection was performed in 27 (28.4%) patients, the same number were managed only symptomatically and in 41 (43.2%) patients we used biliary stenting and external-internal drainage as the definitive procedure. Adjuvant oncological treatment was indicated in 16 (59.3%) of the radically operated and 49 (72.1%) of the non-operated patients. Results: Median overall survival and median progression-free survival in the operated patients were 19.9 months and 15.7 months, respectively. Overall survival in the operated patients was significantly better (p<0.0001) than in patients managed palliatively. Median overall survival for drainage and palliative treatment was 5.8 and 3.6 months, respectively. Overall survival did not differ between symptomatic and drainage treatment (p<0.3383). Conclusion: In addition to their histopathological aggressiveness, late diagnosis is the main cause of poor treatment outcomes in extrahepatic biliary tract malignancies. Treatment should be guided by a multidisciplinary team. Currently, there is a great development of endoscopic methods, which, together with further development of personalized oncological treatment, may bring improved results in the future. Surgical, radical treatment remains the method of choice with the best long-term results.
OBJECTIVES: The first objective of our study was to determine the radiation exposure received by patients during tin-filtrated ultra-low-dose computed tomography (TFULDCT) of sacroiliac joints and to compare those to conventional X-ray doses. For comparison, we added a cohort examined by low-dose CT (LDCT) without tin filtration. The second objective was to compare the results of TFULDCT and X-ray in the detection of sacroiliitis. METHODS: Our retrospective study covered 45 patients, who were examined for suspected axial spondyloarthritis (AxSpA). The first group underwent TFULDCT as well as conventional radiography (CR); the second group underwent LDCT only without tin filtration. Effective doses of TFULDCT, LDCT and CR were calculated by an experienced medical physicist. TFULDCT and CR were independently evaluated by three investigators, who decided on the presence or absence of rheumatoid inflammatory bone changes. The results were statistically evaluated. RESULTS: In our cohort, the median effective dose for TFULDCT was 0.11 mSv, range (0.06-0.40 mSv), for LDCT 0.5 mSv (0.29-0.89 mSv), and for CR 0.25 mSv (0.06-1.87 mSv). We proved that TFULDCT produces a significantly lower percentage of uncertain results (23.3%; 95% CI: 11.3-41.6%) than CR (66.7%; 95% CI: 48.3-81.1%). CONCLUSIONS: Tin filtration helps to reduce CT radiation exposure to values lower than those resulting from CR. TFULDCT offers better overall diagnostic performance than CR. Our results prove that TFULDCT can replace CR in the diagnosis of sacroiliitis in the radiographical stage of AxSpA.
