D Andrea, David*
Dotaz
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BACKGROUND: Using of active cardiac medical devices increases steadily. In Europe, there were 183 implants of ICD and 944 implants of PM, 119 of biventricular ICD and 41 of biventricular PM, all per million inhabitants in 2014. Healthcare environments, including radiotherapy treatment rooms, are considered challenging for these implantable devices. Exposure to radiation may cause the device to experience premature elective replacement indicator, decreased pacing amplitude or pacing inhibition, inappropriate shocks or inhibition of tachyarrhythmia therapy and loss of device function. These impacts may be temporary or permanent. The aim of this study was to evaluate the influence of linear accelerator ionizing radiation dose of 10 Gy on the activity of the biventricular cardioverter-defibrillator in different position in radiation beam. METHODS: Two identical wireless communication devices with all three leads were used for the measurement. Both systems were soused into solution saline and exposed in different position in the beam of linear accelerator per 10 Gy fractions. In comparison of usually used maximum recommended dose of 2 Gy, the radiation doses used in test were five times higher. Using the simultaneous monitoring wireless communication between device and its programmer allowed watching of the devices activities, noise occurrence or drop of biventricular pacing on the programmer screen, observed by local television loop camera. RESULTS: At any device position in radiation beam, there were no influences of the device activity at dose of 10 Gy neither a significant increase of a solution saline temperature in any of the measured positions of CRT-D systems in linear accelerator. CONCLUSIONS: The results of the study indicated, that the recommendation dose for treating the patients with implantable devices are too conservative and the risk of device failure is not so high. The systems can easily withstand the dose fractions of tens Gy, which would allow current single-dose-procedure treatment in radiation therapy. Even though the process of the random alteration of device memory and electrical components by scatter particles not allowed to specify a safe dose during ionizing radiation, this study showed that the safe limit are above the today used dose fractions.
A fresh start of higher medical education in Slovakia and Hungary is closely related to Trnava (Nagyszombat). The University of Trnava had originally been established in 1635 but the Faculty of Medicine was added only later, in 1769, when the name of the university was also changed to Royal Hungarian University of Sciences. A fresh graduate, Václav Trnka from Křovice (1739-1791), was appointed as head of the Department of Anatomy. He was not only an anatomist, but a real polymath of the second half of the eighteenth century practicing medicine as well as becoming the Dean, then the Rector of the University. He has lived and acted within several countries of Central Europe, or rather, the Austrio-Hungarian monarchy during the reign of Empress Maria Theresia, then her son Joseph II. Born in Bohemia (now Czech Republic), studied and graduated in Austria, then finally was appointed as the first Professor of Anatomy of a newly established medical faculty in Upper Hungary (now Slovakia). In 1777, the university was moved first to Buda, then to Pest (now parts of the capital of Hungary), and the Faculty of Medicine was not separated from the rest of the faculties before the end of the Second World War. Following several institutional and name changes, this Medical Faculty is considered as the foundation of the present Semmelweis University. Trnka was a proliferous author, publishing more than 20 monographs covering various branches of clinical medicine, however, no anatomical work may be connected to his activity. And as a typical intellectual of the era, he was a keen and talented musician composing several canons.
- MeSH
- akademický sbor MeSH
- anatomie výchova MeSH
- dějiny 18. století MeSH
- lidé MeSH
- studium lékařství dějiny MeSH
- univerzity dějiny MeSH
- Check Tag
- dějiny 18. století MeSH
- lidé MeSH
- Publikační typ
- biografie MeSH
- časopisecké články MeSH
- historické články MeSH
- Geografické názvy
- Maďarsko MeSH
- Slovenská republika MeSH
Adjuvantná rádioterapia prispieva k lepším výsledkom u pacientov s karcinómom prsníka po prsník zachovávajúcej operácii. Ožarovanie celého prsníka je spojené s poškodením srdca a pľúc, zvýšením kardiovaskulárných ochorení a mortality, a vývojom karcinómu pľúc, teda s rizikami, ktoré sa môžu objaviť 15–20 rokov po liečbe. Ožarovanie prsníka v pronačnej polohe pacientky je jednou z možností ako redukovať radiačne podmienenú toxicitu u pacientiek s veľkými prsníkmi podstupujúcimi adjuvantnú liečbu. V kazuistikách poukážeme na rozdiely v objeme srdca a pľúc pri oboch polohách, porovnáme dozimetrické parametre pri ožarovaní prsníka v oboch pozíciách a poukážeme na rozdiely pri ich plánovaní. Tieto techniky nie je možné kombinovať s ožiarením lymfatických uzlín, ale môžu byť použité pri liečbe obojstranných nádorov.
Adjuvant radiotherapy contributes to better outcomes in patients with breast cancer after breast conserving surgery. Whole breast irradiation is associated with damage to the heart and lungs, increased cardiovascular mortality, and the development of lung cancer, that is, with the risks that may occur 15–20 years after treatment. Breast irradiation in the prone position, is one of the way to reduce radiation toxicity in patients conditioned with large breasts undergoing adjuvant therapy. In case reports point out the differences in the volume of the heart and lungs at both locations, we compare the dosimetric parameters in breast irradiation in both positions and point out the differences in their planning. These techniques can not be combined with irradiation of the lymph nodes, but they can be used in the treatment of bilateral tumors.
- MeSH
- adjuvantní radioterapie * škodlivé účinky MeSH
- celková dávka radioterapie MeSH
- edém etiologie MeSH
- erytém etiologie MeSH
- konformní radioterapie metody škodlivé účinky MeSH
- kritické orgány účinky záření MeSH
- lidé středního věku MeSH
- lidé MeSH
- lymfatické uzliny účinky záření MeSH
- nádory prsu * radioterapie MeSH
- plánování radioterapie pomocí počítače MeSH
- plíce účinky záření MeSH
- pronační poloha * MeSH
- prsy anatomie a histologie účinky záření MeSH
- radiační poranění prevence a kontrola MeSH
- srdce účinky záření MeSH
- supinační poloha * MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
- přehledy MeSH
... Jones -- 33 Carbohydrates, 518 -- David B. ... ... Remaley, Thomas D. Dayspring, and G. ... ... Badminton, Sharon D. Whatley, Eliane Sardh, and Aasne K. ... ... Nolte -- 49 Genetics, 1025 -- Cindy L Vnencak-Jones and D. ... ... Freedman, David Halsall, William J. ...
Sixth edition xx, 1867 stran : ilustrace
- MeSH
- diagnostické techniky molekulární MeSH
- klinická chemie MeSH
- klinické chemické testy MeSH
- Publikační typ
- příručky MeSH
- Konspekt
- Chemie. Mineralogické vědy
- NLK Obory
- biologie
- biochemie
The foundation of health care management of patients with non-healing, chronic wounds needs accurate evaluation followed by the selection of an appropriate therapeutic strategy. Assessment of non-healing, chronic wounds in clinical practice in the Czech Republic is not standardised. The aim of this study was to analyse the methods being used to assess non-healing, chronic wounds in inpatient facilities in the Czech Republic. The research was carried out at 77 inpatient medical facilities (8 university/faculty hospitals, 63 hospitals and 6 long- term hospitals) across all regions of the Czech Republic. A mixed model was used for the research (participatory observation including creation of field notes and content analysis of documents for documentation and analysis of qualitative and quantitative data). The results of this research have corroborated the suspicion of inconsistencies in procedures used by general nurses for assessment of non-healing, chronic wounds. However, the situation was found to be more positive with regard to evaluation of basic/fundamental parameters of a wound (e.g. size, depth and location of a wound) compared with the evaluation of more specific parameters (e.g. exudate or signs of infection). This included not only the number of observed variables, but also the action taken. Both were significantly improved when a consultant for wound healing was present (P = 0·047). The same applied to facilities possessing a certificate of quality issued by the Czech Wound Management Association (P = 0·010). In conclusion, an effective strategy for wound management depends on the method and scope of the assessment of non-healing, chronic wounds in place in clinical practice in observed facilities; improvement may be expected following the general introduction of a 'non-healing, chronic wound assessment' algorithm.
- MeSH
- chorobopisy MeSH
- chronická nemoc MeSH
- formuláře a záznamy - kontrola a vedení MeSH
- hojení ran MeSH
- klinické protokoly MeSH
- kožní vředy diagnóza etiologie terapie MeSH
- lidé MeSH
- nemocnice * MeSH
- rány a poranění diagnóza etiologie terapie MeSH
- role ošetřovatelky MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- hodnotící studie MeSH
- Geografické názvy
- Česká republika MeSH
- MeSH
- cystektomie MeSH
- lidé MeSH
- nádory močového měchýře * chirurgie MeSH
- retrospektivní studie MeSH
- roboticky asistované výkony * MeSH
- robotika * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- dopisy MeSH
- multicentrická studie MeSH
... Bellino • Alina Olteanu • -- Ralph D. Feigin • William R. ... ... Klein and Charles D. Bluestone -- 17 Mastoiditis, 233 -- James D. Cherry • Audrey P. ... ... Cheifetz • David A. ... ... Laurens -- 118 Vibrio parahaemolyticus, 1556 -- David Y. ... ... O\'Ryan • -- David 0. ...
7 th ed. 2 sv. (3627 s.) : il., tab. ; 28 cm
- MeSH
- dítě MeSH
- infekční nemoci MeSH
- pediatrie metody MeSH
- Check Tag
- dítě MeSH
- Publikační typ
- příručky MeSH
- Konspekt
- Pediatrie
- NLK Obory
- pediatrie
- infekční lékařství
- NLK Publikační typ
- kolektivní monografie
Indolentní (= nízce agresivní) podtypy B-ne-Hodgkinových lymfomů představují heterogenní skupinu onemocnění s odlišným chováním, prognózou a odpovědí na léčbu. Skupina B-indolentních ne-Hodgkinových lymfomů zahrnuje především nejmohutněji zastoupený folikulámí lymfom (FL), který představuje zhruba 20-25 % všech ne-Hodgkinových lymfomů (NHL). Tzv. non-folikulámí lymfomy jsou: malobuněčný lymfom/chronická lymfatickáleukémie (SLL/CLL; 4-5 % všech NHL) a lymfomy marginální zóny (MZL), které jako celek tvoří 5-17 X všech NHL. MZL se dále dělí na nodální (méně než 1 % všech NHL), extranodální MZL nebo také MALT lymfomy (asi 7 % NHL) a splenický MZL (cca 2 % všech NHL). Indolentní typy B-ne-Hodgkinových lymfomů mají globálně dobrou prognózu a medián jejich přežití se pohybuje kolem l0 let. U asymptomatických nemocných se často uplatňuje strategie pečlivého sledování („watch and wait") a léčba je obvykle indikována až při zjevné progresi a symptomech choroby.
Indolent (= low grade) B-non-Hodgkin lymphomas represent heterogeneous group of disorders with different clinical behavior, prognosis and different treatment requirements. This group includes namely the most common follicular lymphoma, which accounts for 20-25 % of all NHLs. Subgroup of ,,non-follicular indolent types" of NHL are as follows: small lymphocytic lymphoma leukemia/chronic lymphocytic leukemia (SLL/CLL; 4-5 % of all NHLs) and marginal zone lymphomas (MZL) which represent about 5-17 % of all NHL in adults. MZLs consist of extranodal type called also MALT lymphoma (about 7 % of NHLs), splenic MZL (about 2 % of NHLs) and rare nodal MZL (below i % of all NHLs). Indolent types of B-non-Hodgkin' s lymphomas have a relatively good prognosis, with a median survival about lo years. In asymptomatic patients is often watch and wait strategy applied and treatment is usually started when the disease became symptomatic and evidently progresses.
- Klíčová slova
- B-ne-Hodgkinovy lymfomy, lymfomy marginální zóny,
- MeSH
- antibakteriální látky aplikace a dávkování MeSH
- B-buněčný lymfom diagnóza patologie terapie MeSH
- folikulární lymfom diagnóza patologie terapie MeSH
- infekce vyvolané Helicobacter pylori farmakoterapie MeSH
- lidé MeSH
- lymfom z B-buněk marginální zóny diagnóza patologie terapie MeSH
- monoklonální protilátky terapeutické užití MeSH
- nehodgkinský lymfom diagnóza patologie terapie MeSH
- prognóza MeSH
- protokoly protinádorové kombinované chemoterapie aplikace a dávkování MeSH
- radioterapie metody MeSH
- rituximab MeSH
- rizikové faktory MeSH
- splenektomie využití MeSH
- staging nádorů využití MeSH
- transplantace hematopoetických kmenových buněk metody využití MeSH
- vidarabin analogy a deriváty aplikace a dávkování MeSH
- Check Tag
- lidé MeSH