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Sborník sloupků publikovaných v novinách Seznam Zprávy, které se zaměřují na aktuální politické a společenské dění, zejména v Česku, a představují názory autora. Určeno široké veřejnosti.; Už vás někdy napadlo, proč se ve společnosti opakují stále stejné chyby? Proč ti, kteří zpívali hymny o svobodě, dnes sedí v pohodlí funkcí a moci? Tato kniha vám nabízí odpovědi – a zároveň vás donutí přemýšlet nad vaší vlastní rolí v tomto příběhu. Kritické diagnózy nejsou čtením pro slabé povahy. Přinutí vás vidět svět jinak, opustit komfortní zónu a podívat se pravdě do očí. Ať už jste student, profesionál, rodič nebo politik, kniha inspiruje k otázce: Co mohu já udělat, aby byla naše společnost lepší? Autor přesvědčivě ukazuje, kde jsme jako národ uspěli, a kde selhali. Sloupky jsou břitké, přesné a často nepohodlné – pro každého. Právě proto jsou tak důležité. Odhalují to, co se skrývá pod povrchem každodenního dění. Čtenář může nahlédnout do zákulisí mocenských her, osobních selhání, ale také do nadějí a možností, kam bychom mohli směřovat. Josef Veselka není politik ani novinář s agendou. Je lékař, který roky vedl prestižní kardiologickou kliniku, a zároveň člověk, jenž se čtenářům rozhodl nabídnout svůj pohled na českou společnost. Tato dvojí zkušenost – odborná i lidská – činí jeho texty mimořádně autentickými a důvěryhodnými. Autorův pronikavý pohled do nedávné historie – od revolučních nadějí po současné rozčarování – je varováním i lekcí. Ukazuje, jak snadno může být ztracena svoboda, jak hluboko může zakořenit pokrytectví a jak důležitá je morálka. Každý sloupek je doplněn stručným vysvětlením kontextu, ve kterém vznikal. Kniha tedy není jen aktuální výpovědí, ale i záznamem pro budoucí generace. Je jako víno – čím déle zraje, tím více chutí a vrstev objevíte. Kritické diagnózy: 100 sloupků, které rozkrývají společenské paradoxy dnešního Česka.
- MeSH
- History, 21st Century MeSH
- Politics MeSH
- Delivery of Health Care MeSH
- Attitude MeSH
- Sociological Factors MeSH
- Check Tag
- History, 21st Century MeSH
- Publication type
- Newspaper Article MeSH
- Popular Work MeSH
- Collected Work MeSH
- Geographicals
- Czech Republic MeSH
- Conspectus
- Vnitropolitický vývoj, politický život
- NML Fields
- politologie, politika, zdravotní politika
- sociologie
- About
- Seznam.cz (firma) Authority
BACKGROUND: Peptic ulcer perforation (PUP) is a surgical emergency and life-threatening complication affecting 2-10% of peptic ulcer disease (PUD) patients. Delayed diagnosis and surgical management are associated with significant morbidity and mortality. This study assessed the magnitude and outcome of PUP among patients operated on at two public hospitals in Jigjig town, Ethiopia. METHODS: A 3-year hospital-based retrospective cross-sectional study was conducted on 130 patients operated for PUP at the study hospitals in Jigjig from April 1st, 2018, to July 30th, 2021. Data were collected from medical records. Bivariate analysis identified key factors impacting outcomes in PUP patients. RESULTS: The cohort had a male-to-female ratio of 8.7:1, and a mean age of 38 ± 13.3 years, with 48.8% smokers and 56.6% chat chewers. Duodenal perforations accounted for 93.7% of cases, with post-operative complications in 29.1% and an in-hospital mortality rate of 5.5%. Significant predictors of morbidity and mortality included advanced age (AOR 23.88), comorbidities (AOR 26.80), pre-operative hypotension (AOR 32.33), and delayed hospital presentation (AOR 30.10). CONCLUSIONS: Male predominance, younger age, high smoking and chat chewing rates, and primarily duodenal perforations are common in perforated peptic ulcer cases. Advanced age, comorbidities, pre-operative hypotension, and delayed hospital presentation significantly increase postoperative complications and mortality, emphasizing the need for timely intervention and targeted public health measures to improve patient outcomes. Early intervention and careful management of comorbidities are crucial to improve survival and reduce complications in patients with PUP.
- MeSH
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Adolescent MeSH
- Hospital Mortality trends MeSH
- Peptic Ulcer Perforation * mortality surgery epidemiology MeSH
- Cross-Sectional Studies MeSH
- Retrospective Studies MeSH
- Risk Factors MeSH
- Aged MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Adolescent MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Geographicals
- Ethiopia MeSH
OBJECTIVE: From 1995, the European Association of Hospital Pharmacists (EAHP) has regularly investigated the progress of the hospital pharmacy profession in Europe, and identified key barriers and drivers of this. The most recent 'Investigation of the Hospital Pharmacy Profession in Europe' was conducted from November 2022 to March 2023. METHODS: The online questionnaire was sent to all hospital pharmacies in EAHP member countries. The investigation was drafted using the same questions as the 2015 baseline survey. Where possible and relevant, responses were compared with the data from previous surveys that monitored the implementation of the EAHP statements. Keele University, Centre for Medicines Optimisation, School of Pharmacy and Bioengineering, UK analysed the data. RESULTS: The overall number of responses was 653, with a better response rate of 19% compared with 14% in 2018 statements survey. The findings indicated that participating hospital pharmacies have similar characteristics to previous surveys. Section 1 (Introductory statements and governance), section 2 (Selection, procurement and distribution), section 3 (Production and compounding), section 5 (Patient safety and quality assurance) questions were generally answered positively, with results ranging from 52% to 90%. However, results for section 4 (Clinical pharmacy services) returned lower levels of positivity, with responses from 8 of the 15 questions being less than 60%. When asked what is preventing hospital pharmacists from achieving implementation of these activities, most answers were limited capacity, not considered to be a priority by managers, or other healthcare professionals do this. The last section focused on self-assessment and action planning, with fewer than 50% of positive responses; COVID-19 preparedness and vaccines with mixed positive and negative responses. Furthermore, implementation of the falsified medicines directive impacted the medication handling processes in 50% or more of the answers. Regarding sustainability, the majority (59%) of respondents felt a greater focus should be on sustainability from an organisational or management perspective. CONCLUSION: Results offer valuable insights into the hospital pharmacy profession throughout Europe. While there have been improvements in certain areas, challenges remain, particularly in implementing clinical pharmacy services. The findings provide a foundation for further dialogue, advocacy, and strategic planning to advance the role of hospital pharmacists and enhance patient care in Europe's healthcare systems.
- MeSH
- COVID-19 epidemiology MeSH
- Pharmacists * trends MeSH
- Humans MeSH
- Pharmacy Service, Hospital * trends organization & administration statistics & numerical data standards MeSH
- Surveys and Questionnaires MeSH
- Professional Role * MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Geographicals
- Europe MeSH
BACKGROUND: In women with severe aortic stenosis, there are limited data regarding outcome differences following transcatheter (TAVR) vs surgical aortic valve replacement (SAVR). OBJECTIVES: The authors sought to examine outcomes of TAVR vs SAVR in a patient-level pooled analysis of women in the RHEIA and PARTNER 3 trials. METHODS: Patients in both trials were randomly allocated to a balloon-expandable SAPIEN 3/Ultra valve or to surgical bioprostheses. Individual patient data of female participants in the 2 trials were pooled. The primary endpoint was all-cause mortality, all stroke, or rehospitalization at 1 year. RESULTS: A total of 376 women were randomized to TAVR and 336 to SAVR. The mean age was ∼73 years, and the mean Society of Thoracic Surgeons (STS) score was 2.1%. Kaplan-Meier estimates of event rates at 1 year with TAVR vs SAVR were 8.5% vs 16.8% for the composite of all-cause mortality, all stroke, or rehospitalization (absolute difference -8.2%; 95% CI: -13.1% to -3.3%; P < 0.001), 1.1% vs 2.1% (P = 0.27) for all-cause mortality, 2.7% vs 3.9% (P = 0.35) for all stroke, and 5.4% vs 11.9% (P = 0.002) for rehospitalization. The composite endpoint of all-cause death or stroke was similar between the 2 treatment groups: 3.5% vs 5.4% (absolute difference -1.9%; 95% CI: -5.0% to 1.1%; P = 0.21). CONCLUSIONS: Among women with symptomatic severe aortic stenosis, TAVR led to a reduction in the rate of the combined endpoint of all-cause mortality, stroke, or rehospitalization at 1-year follow-up, largely due to a significant reduction in the rate of rehospitalization.
- MeSH
- Aortic Valve * surgery physiopathology diagnostic imaging MeSH
- Aortic Valve Stenosis * mortality surgery physiopathology diagnostic imaging MeSH
- Bioprosthesis MeSH
- Time Factors MeSH
- Stroke mortality etiology therapy MeSH
- Heart Valve Prosthesis Implantation * adverse effects mortality instrumentation MeSH
- Risk Assessment MeSH
- Humans MeSH
- Prosthesis Design MeSH
- Randomized Controlled Trials as Topic MeSH
- Risk Factors MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Sex Factors MeSH
- Heart Valve Prosthesis MeSH
- Severity of Illness Index MeSH
- Transcatheter Aortic Valve Replacement * adverse effects mortality instrumentation MeSH
- Treatment Outcome MeSH
- Patient Readmission MeSH
- Check Tag
- Humans MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Comparative Study MeSH
INTRODUCTION: Heart surgery is associated with a sternotomy in most patients. Low serum calcidiol level below 80 nmol/l carries the risk of bone loss as a risk factor in sternotomy healing. OBJECTIVES: The primary objective was to compare postoperative complications of sternotomy healing in two groups of patients treated with cholecalciferol or placebo. Secondary objectives were focused on the degree of sternal healing, length of hospitalization, number of days spent in ICU and mechanical ventilation, and number of repeated hospitalizations for sternotomy complications. METHODOLOGY: Monocentric, randomized, double-blind, placebo-controlled, prospective study was conducted from September 2016 to December 2020 at Na Homolce Hospital. Of the 216 originally recruited and randomized subjects, 141 completed the study. Seventy-two subjects were enrolled in the cholecalciferol arm, and sixty-nine subjects in the placebo arm. The detailed methodology has been published previously. The results are presented as a comparison between two groups: calcidiol above 80 nmol/l (saturated subjects) and the calcidiol lower or equal to 80 nmol/l (unsaturated subjects). RESULTS: Statistics include 141 subjects. After a 6-month follow-up, CT imaging and calcidiol levels were performed. PRIMARY OBJECTIVE: postoperative complications in sternotomy were not among the population under or above 80 nmol/l statistical difference (p = 0.907). SECONDARY OBJECTIVES: monitored parameters did not differ between individual arms. But the key was the state of saturation with calcidiol (> 80 nmol/l), which was associated with a significantly lower risk of complete non-healed sternotomy (p = 0.008). CONCLUSION: Optimal calcidiol level (> 80 nmol/l) indicates a positive trend towards greater sternal healing. Cholecalciferol oral administration can be considered as a safe method how to achieve the required calcidiol concentration. TRIAL REGISTRATION: EU Clinical Trials Register, EUDRA CT No: 2016-002606-39.
- MeSH
- Time Factors MeSH
- Cholecalciferol * administration & dosage MeSH
- Double-Blind Method MeSH
- Wound Healing * drug effects MeSH
- Calcifediol * blood MeSH
- Cardiac Surgical Procedures * adverse effects MeSH
- Middle Aged MeSH
- Humans MeSH
- Postoperative Complications etiology MeSH
- Prospective Studies MeSH
- Aged MeSH
- Sternotomy * adverse effects MeSH
- Sternum * diagnostic imaging surgery MeSH
- Treatment Outcome MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Randomized Controlled Trial MeSH
The abnormalities in blood coagulation in patients with diabetes can lead to a prothrombotic state and requirement for the administration of direct anticoagulants. However, no comparative studies have been conducted on the effects of different direct anticoagulants. A head-to-head investigation of the impact of anticoagulants in 50 patients of type 1 diabetes mellitus (DMT1) was performed, and the data were compared to 50 generally healthy individuals. Prothrombin time (PT) and activated partial thromboplastin time (aPTT) were measured in plasma treated with vehicle, heparin, or four direct anticoagulants at 1 μM. In addition to common biochemical parameters, novel inflammatory markers (neopterin, kynurenine/tryptophan ratio) and major vitamin K forms were measured. Heparin and dabigatran treatments resulted in prolonged coagulation in DMT1 patients compared to healthy individuals in both tests (both p < 0.001). The same phenomenon was observed for rivaroxaban and apixaban-treated samples in PT (p < 0.001). Interestingly, healthy volunteers had higher total vitamin K levels than DMT1. Further analysis suggested that observed coagulation differences were not caused by differences in glycemia but were rather associated with an unexpected, better lipid profile of our DMT1 group. There were also correlations between prolongation of coagulation brought about by the most active anticoagulants and inflammatory markers, and hence inflammatory state probably also contributed to the differences, as well as the mentioned differences in vitamin K levels. Conclusively, this paper suggests the suitability for controlling the effects of direct anticoagulants in DMT1 patients.
- MeSH
- Anticoagulants * pharmacology therapeutic use MeSH
- Dabigatran pharmacology MeSH
- Diabetes Mellitus, Type 1 * blood drug therapy MeSH
- Adult MeSH
- Blood Coagulation drug effects MeSH
- Heparin pharmacology MeSH
- Middle Aged MeSH
- Humans MeSH
- Young Adult MeSH
- Partial Thromboplastin Time MeSH
- Prothrombin Time MeSH
- Rivaroxaban pharmacology MeSH
- Case-Control Studies MeSH
- Vitamin K * blood MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Young Adult MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
The circadian clock in choroid plexus (ChP) controls processes involved in its physiological functions, but the signals that synchronize the clock have been sparsely studied. We found that the ChP clock in the fourthventricle (4V) is more robust than that in the lateral ventricle (LV) and investigated whether both clocks use information about mealtime as a signal to synchronize with the current activity state. Exposure of mPer2Luc mice to a 10-day reverse restricted feeding (rRF) protocol, in which food was provided for 6 h during daytime, advanced the phase of the ChP clock in 4V and LV, as evidenced by shifted (1) PER2-driven bioluminescence rhythms of ChP explants ex vivo and (2) daily profiles in clock gene expression in both ChP tissues in vivo. In contrast, clocks in other brain regions (DMH, ARC, LHb) of the same mice did not shift. The 4V ChP responded more strongly than the LV ChP to rRF by modulating the expression of genes to ensure a decrease in resistance to cerebrospinal fluid drainage and increase the secretory capacity of ChP cells. Mechanistically, rRF affects the ChP clock through food-induced increases in insulin, glucose and temperature levels, as in vitro all three signals significantly shifted the clocks in both ChP tissues, similar to rRF. The effect of glucose was partially blocked by OSMI-1, suggesting involvement of O-linked N-acetylglucosamine posttranslational modification. We identified mechanisms that can signal to the brain the time of feeding and the associated activity state via resetting of the ChP clock.
- MeSH
- Circadian Clocks * physiology genetics MeSH
- Period Circadian Proteins metabolism genetics MeSH
- Circadian Rhythm physiology MeSH
- Mice, Inbred C57BL MeSH
- Mice, Transgenic MeSH
- Mice MeSH
- Choroid Plexus * metabolism physiology MeSH
- Gene Expression Regulation MeSH
- Feeding Behavior * physiology MeSH
- Lateral Ventricles metabolism physiology MeSH
- Animals MeSH
- Check Tag
- Male MeSH
- Mice MeSH
- Animals MeSH
- Publication type
- Journal Article MeSH