Účelem této studie je představit a zavést do klinické praxe nový skríningový nástroj Test mince v ruce (Coin in the Hand Test) pro detekci předstírání zdravotních potíží. Cíl: Cílem této práce je zjistit maximální výkon v Testu mince v ruce a dále zjistit, v jaké míře jsou pokusné osoby schopny předstírat oslabený výkon tak, aby jejich snaha o záměrné zkreslení výsledků nebyla poznána. Soubor a metodika: Test mince v ruce byl administrován v první studii (N = 153) zdravým dobrovolníkům ke zjištění schopnosti adaptace na tři scénáře s manipulací výkonu, přičemž 1 = snaha o maximální výkon, 2 = snaha o závažnou simulaci, 3 = snaha o mírnou simulaci. V druhé studii jsme test administrovali v individualizovaném vyšetření u hospitalizovaných psychiatrických pacientů. Výsledky: Při standardní instrukci k maximálnímu výkonu byl průměrný výkon blízký maximu 10 bodů (M = 9,59; SD = 1,41; 1–10), při závažné simulaci nejnižší (M = 4,63; SD = 2,39; 0–10) a při mírné simulaci se nacházel mezi předchozími hodnotami (M = 6,78; SD = 1,74; 1–10). Porovnáním odlišného pořadí jednotlivých scénářů jsme zjistili významný vliv pořadí na výsledky v testu. Závěr: Poměrně dobrá schopnost Testu mince v ruce odlišit osoby se snahou podávat záměrně horší výkon od osob, které nejsou motivovány k vyšetření a nedostatečně se snaží podat dobrý výkon, je povzbuzením pro zařazení testu do klinické praxe.

The purpose of this study is to introduce and bring into the clinical practice new screening tool Coin in the Hand Test for detection of simulat­ing disability or weak results in psychological assessment. Aim: The goal of this study was to define the maximal performance in a general and clinical population and to determine the extent to which participants in experimental group are capable of faking weakened performance so that this fraud would not be recognized. Material and methods: The test Coin in the Hand Test was studied on a non-psychiatric group of participants (N = 153) to determine the ability to adapt to three different scenarios: 1 = the best possible performance; 2 = acquiring disability pension; 3 = prolonging sick leave. In the second study the test was administered individually to a group of hospitalized psychiatric patients. Results: The performance score for each scenario significantly differed suggesting to a good ability of experimental group to adapt to the instruction. The mean performance score for the maximal performance was close to the maximum of 10 points (M = 9,98; SD = 0,13; 9–10), while for the serious faking it was the lowest (M = 4,87; SD = 2,37; 0–10). Score for moderate faking was found in between the previous two values (M = 6,85; SD = 1,72; 1–10). The results of the individual assessment done on a group of psychiatric patients corresponded with the results of the group with a scenario for the best possible performance. Conclusion: The presented very good ability to differentiate between faking and honest individuals is an encouragement for inclusion of this test into the clinical practice.

• Klíčová slova
• test mince v ruce, test validity výkonu,
• MeSH
• diferenciální diagnóza MeSH
• dospělí MeSH
• lidé MeSH
• neuropsychologické testy * MeSH
• plnění a analýza úkolů MeSH
• psychometrie MeSH
• senzitivita a specificita MeSH
• simulování * diagnóza   psychologie   MeSH
• výkon neodpovídající schopnostem * MeSH
• výkonnost MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• práce podpořená grantem MeSH

The aim of this study is an evaluation of the results of The Manual Ability Classification System (MACS), Gross Motor Function Classification System (GMFCS), and muscle strength examination measured by dynamometer in children with cerebral palsy. We examined 51 patients with cerebral palsy in the age ranging from 8 years to 26 years (average age 17.3 ± 4.2) living in the Home for Handicapped Children and Young Adults, Kociánka, Brno. The group consisted of 28 girls and 23 boys. Maximum handgrip was measured by a hand dynamometer in both upper extremities. After the examination by a physiotherapist the patients were categorised according to their gross motor skills using the Gross Motor Function Classification System (GMFCS) and fine motor skills using the Manual Ability Classification System (MACS). Muscle strength in the better hand in the whole group ranged from 34 to 442 N (average 235.8 ± 85.9), in the other hand from 5 to 376 N (average 66.7 ± 66.2). The results show a weak correlation between the muscle strength of the handgrip and MACS, but it is statistically significant (R= 0.342; p < 0.05), correlation between the muscle strength of the handgrip and GMFCS does not exist.

• MeSH
• dítě MeSH
• dospělí MeSH
• financování organizované MeSH
• lidé MeSH
• mladiství MeSH
• motorické dovednosti klasifikace   MeSH
• mozková obrna MeSH
• pohybová aktivita MeSH
• síla ruky MeSH
• svalová síla - dynamometr MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• hodnotící studie MeSH

BACKGROUND/PURPOSE: All living organisms emit spontaneous ultra-weak photon emission as a result of cellular metabolic processes. Exposure of living organisms to exogenous factors results in oxidative processes and enhancement in ultra-weak photon emission. Here, hydrogen peroxide (H(2)O(2)), as a strongly oxidizing molecule, was used to induce oxidative processes and enhance ultra-weak photon emission in human hand skin. The presented work intends to compare both spontaneous and peroxide-induced ultra-weak photon emission from the epidermal cells on the dorsal and the palm side of the hand. METHODS: A highly sensitive photomultiplier tube and a charge-coupled device camera were used to detect ultra-weak photon emission from human hand skin. RESULTS: Spontaneous ultra-weak photon emission from the epidermal cells on the dorsal side of the hand was 4 counts/s. Topical application of 500 mM H(2)O(2) to the dorsal side of the hand caused enhancement in ultra-weak photon emission to 40 counts/s. Interestingly, both spontaneous and peroxide-induced ultra-weak photon emission from the epidermal cells on the palm side of the hand were observed to increase twice their values, i.e. 8 and 80 counts/s, respectively. Similarly, the two-dimensional image of ultra-weak photon emission observed after topical application of H(2)O(2) to human skin reveals that photon emission from the palm side exceeds the photon emission from the dorsal side of the hand. CONCLUSION: The results presented indicate that the ultra-weak photon emission originating from the epidermal cells on the dorsal and the palm side of the hand is related to the histological structure of the human hand skin. Ultra-weak photon emission is shown as a non-destructive technique for monitoring of oxidative processes in the epidermal cells of the human hand skin and as a diagnostic tool for skin diseases.

• MeSH
• epidermis účinky léků   metabolismus   MeSH
• fotony MeSH
• fyziologie kůže účinky léků   MeSH
• lidé MeSH
• oxidace-redukce MeSH
• oxidační stres účinky léků   fyziologie   MeSH
• oxidancia aplikace a dávkování   diagnostické užití   MeSH
• peroxid vodíku aplikace a dávkování   diagnostické užití   MeSH
• radiometrie MeSH
• ruka MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• klinické zkoušky MeSH
• práce podpořená grantem MeSH
• srovnávací studie MeSH

BACKGROUND: Our aim was to use functional magnetic resonance imaging (fMRI) to compare brain activation changes due to botulinum toxin A (BoNT) application between two chronic stroke patient groups with different degree of weakness treated for upper limb spasticity. METHODS: Fourteen ischemic stroke patients with hand weakness and spasticity were studied. Spasticity was scored by modified Ashworth scale (MAS). FMRI was performed 3 times: before (W0) and 4 (W4) and 11 weeks (W11) after BoNT application. Group A: 7 patients (2 males, 5 females; mean age 59.14 years) with hand plegia, who imagined moving fingers. Group B: 7 age-matched patients (6 males, 1 female; mean age 59.57 years) able to perform sequential finger movement. RESULTS: BoNT transiently lowered MAS in W4 in both groups. In group A, activation of the frontal premotor cortex dominated and persisted for all three fMRI sessions whereas the ipsilesional cerebellum and cortex bordering bilateral intraparietal sulcus activation changed over time. Between-session contrasts showed treatment-related activation decreases in the mesial occipitoparietal and lateral occipital cortex. In group B, brain activation was markedly reduced after BoNT (W4). Whereas some of these areas manifested only transient reduction and expanded again at W11, in others the reduction persisted. CONCLUSION: Study of two age-matched groups with mild and severe weakness demonstrated different effects of BoNT-lowered spasticity on sensorimotor networks. Group A performing movement imagery manifested BoNT-induced reduction of activation in structures associated with visual imagery. Group B performing movement manifested reduced activation extent and reduced activation of structures outside classical motor system, suggestive of motor network normalization.

• MeSH
• botulotoxiny typu A farmakologie   terapeutické užití   MeSH
• cévní mozková příhoda komplikace   patofyziologie   MeSH
• dospělí MeSH
• imaginace fyziologie   MeSH
• ischemie mozku komplikace   patofyziologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• magnetická rezonanční tomografie MeSH
• mozková kůra účinky léků   patofyziologie   MeSH
• nervosvalové látky farmakologie   terapeutické užití   MeSH
• paralýza farmakoterapie   etiologie   patofyziologie   MeSH
• paže patofyziologie   MeSH
• pohyb účinky léků   fyziologie   MeSH
• ruka patofyziologie   MeSH
• senioři MeSH
• svalová spasticita farmakoterapie   etiologie   patofyziologie   MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

PURPOSE OF REVIEW: Critical illness myopathy and neuropathy are common complications in the ICU, causing limb and respiratory muscle weakness. We review the most recent data concerning their presentation, diagnosis and treatment. RECENT FINDINGS: Limb muscle strength can be reliably assessed by using the Medical Research Council scale or handgrip dynamometry. A Medical Research Council sum score below 48 or mean Medical Research Council score below 4 (antigravity strength) across all testable muscle groups, and a force value of less than 11 kg-force for men and less than 7 kg-force for women at dominant-hand dynamometry identify ICU-acquired weakness in previously healthy individuals admitted to an ICU for nonneuromuscular disorder. Clinical signs, together with measurements of the maximal inspiratory and expiratory pressures and vital capacity, are important to timely diagnose respiratory muscle weakness. Electrophysiological testing is usefully implemented in unconscious patients or in awake patients who do not improve despite appropriate treatments. Early physiotherapy in the ICU can increase the proportion of patients reaching an independent functional status following their ICU stay. Critical illness myopathy and neuropathy may occur outside the ICU; however, exact estimates are lacking. SUMMARY: Systematic application of diagnostic criteria and early physiotherapy may help clinicians to timely diagnose critical illness myopathy and neuropathy and to reduce the associated morbidity.

• Klíčová slova
• fyzioterapie, myopatie kriticky nemocných, neuropatie kriticky nemocných, stupnice Medical Research Council,
• MeSH
• elektrofyziologické jevy účinky léků   MeSH
• elektrofyziologie metody   MeSH
• elektromyografie MeSH
• hyperglykemie prevence a kontrola   MeSH
• lidé MeSH
• péče o pacienty v kritickém stavu metody   metody   MeSH
• polyneuropatie diagnóza   etiologie   terapie   MeSH
• svalová slabost diagnóza   etiologie   terapie   MeSH
• techniky fyzikální terapie využití   MeSH
• Check Tag
• lidé MeSH

• Klíčová slova
• malíři skla, neuropatie,
• MeSH
• akční potenciály MeSH
• cyklofosfamid aplikace a dávkování   škodlivé účinky   MeSH
• diferenciální diagnóza MeSH
• imunoglobuliny aplikace a dávkování   MeSH
• lidé středního věku MeSH
• lidé MeSH
• methylprednisolon aplikace a dávkování   MeSH
• neurodegenerativní nemoci * diagnóza   farmakoterapie   MeSH
• ruka patologie   MeSH
• svalová slabost * etiologie   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• kazuistiky MeSH

Two-dimensional imaging of spontaneous ultra-weak photon emission was measured in the yeast cells, Arabidopsis plant and the human hand using highly sensitive charge coupled device (CCD) camera. For the first time, the detail analysis of measuring parameters such as accumulation time and binning is provided with the aim to achieve two-dimensional images of spontaneous ultra-weak photon emission of good quality. We present data showing that using a hardware binning with binning factor 4 × 4, the accumulation time decreases in the following order: yeast cells (30 min) > the human hand (20 min) > Arabidopsis plant (10 min). Analysis of measuring parameters provides a detailed description of standard condition to be used for two-dimensional spontaneous ultra-weak photon imaging in microbes, plants and animals. Thus, CCD imaging can be employed as a unique tool to examine the oxidative state of the living organism with the application in microbiological, plant and medical research.

• MeSH
• Arabidopsis fyziologie   MeSH
• časové faktory MeSH
• fotony * MeSH
• lidé MeSH
• oxidace-redukce MeSH
• ruka fyziologie   MeSH
• Saccharomyces cerevisiae fyziologie   MeSH
• zvířata MeSH
• Check Tag
• lidé MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

STUDY DESIGN: Matched pair study. INTRODUCTION: Differences in hand-muscle strength/dexterity between dominant (DH) and non-dominant (NDH) hand in Charcot-Marie-Tooth disease (CMT) are not well understood. PURPOSE OF THE STUDY: To compare muscle strength/dexterity between DH and NDH and to correlate manual dexterity, strength and sensory function. PATIENTS AND METHODS: Thirty CMT patients were studied using functional muscle testing (FMT) and strength (dynamometry), dexterity (the Nine Hole Peg Test [NHPT]), and Jebsen-Taylor Hand Function [JTT]), and sensory function (the Nottingham Sensory Assessment [NSA]). RESULTS: Scores were worse for DH than NDH on FMT (p = 0.043) and NHPT (p = 0.014) but not on JTT (p = 0.098), handgrip strength (p = 0.710) or tripod pinch (p = 0.645). NSA did not correlate significantly with any tests (p's0.05). CONCLUSIONS: In CMT disease, DH appears more impaired than NDH in terms of function and dexterity. Greater muscle weakness in DH may also emerge as CMT progresses. LEVEL OF EVIDENCE: 3b.

• MeSH
• Charcotova-Marieova-Toothova nemoc patofyziologie   MeSH
• dospělí MeSH
• funkční lateralita fyziologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• motorické dovednosti fyziologie   MeSH
• neurologické vyšetření MeSH
• senioři MeSH
• síla ruky fyziologie   MeSH
• svalová síla - dynamometr MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

INTRODUCTION: Bradykinesia is an essential diagnostic criterion for Parkinson's disease (PD) but is frequently observed in many non-parkinsonian movement disorders, complicating differential diagnosis, particularly in disorders featuring tremors. The presence of bradykinetic features in the subset of dystonic tremors (DT), either "pure" dystonic tremors or tremors associated with dystonia, remains currently unexplored. The aim of the current study was to evaluate upper limb bradykinesia in DT patients, comparing them with healthy controls (HC) and patients with PD by observing repetitive finger tapping (FT). METHODS: The protocol consisted of two main parts. Initially, the kinematic recording of repetitive FT was performed using optical hand tracking system (Leap Motion Controller). The values of amplitude, amplitude decrement, frequency, frequency decrement, speed, acceleration and number of halts of FT were calculated. Subsequently, three independent movement disorder specialists from different movement disorders centres, blinded to the diagnosis, rated the presence of FT bradykinesia based on video recordings. RESULTS: Thirty-six subjects participated in the study (12 DT, 12 HC and 12 early-stage PD). Kinematic analysis revealed no significant difference in the selected parameters of FT bradykinesia between DT patients and HC. In comparisons between DT and PD patients, PD patients exhibited bigger amplitude decrement and slower FT performance. In the blinded clinical assessment, bradykinesia was rated, on average, as being present in 41.6% of DT patients, 27.7% of HC, and 91.7% of PD patients. While overall inter-rater agreement was moderate, weak agreement was noted within the DT group. DISCUSSION: Clinical ratings indicated signs of bradykinesia in almost half of DT patients. The objective kinematic analysis confirmed comparable parameters between DT and HC individuals, with more pronounced abnormalities in PD across various kinematic parameters. Interpretation of bradykinesia signs in tremor patients with DT should be approached cautiously and objective motion analysis might complement the diagnostic process and serve as a decision support system in the choice of clinical entities.

• Publikační typ
• časopisecké články MeSH

V současnosti se mnoho zdravotnických zařízení zaměřuje na zvýšení kvality péče o pacienty. Kvalita se buduje, zavádí, kontroluje, řídí a certifikuje. Proto je pro každé zdravotnické zařízení strategicky důležité zavádění systému řízení kvality do praxe. Sestry tvoří největší skupinu zaměstnanců ve zdravotnických zařízení, a proto je nutné zdůraznit klíčovou roli sester ve vedoucích pozicích nemocnic v aplikaci programů kvality. Cílem tohoto příspěvku je definovat kvalitu zdravotní péče. Nastínit problematiku měření kvality ošetřovatelské péče pomocí indikátorů kvality, k nimž patří i výsledky ošetřovatelských auditů. Zdůraznit význam tvorby standardů, kterými se stanovuje minimální úroveň kvality, jejíž dodržování je zajištěno kontrolním systémem poskytovatele této služby. Poukázat na důležitost hygienického zabezpečení rukou ve zdravotnických zařízení. Autoři D. Pittet, RW. Haley se ve svých studiích zabývají přenosem nozokomiálních nákaz a nedostatečnou hygienou rukou u zdravotnických pracovníků. A v neposlední řadě přiblížit čtenáři metodiku a realizaci ošetřovatelského auditu „Mytí rukou“ v českobudějovické nemocnici, jehož smyslem nebylo hledání chyb jednotlivců, ale nalezení „slabých míst“ v systému a zajištění co nejrychlejší nápravy.

At present, a number of health care institutions focus on increasing the quality of care for patients. Quality is built, introduced, controlled, managed and certificated. Therefore it is strategically important for each health care institution to introduce the quality management system into practice. Nurses constitute the biggest group of employees in health care institutions, and therefore the key role of nurses in leading positions of hospitals in quality program application must be pointed out. The aim of this article is to define the health quare quality. To outline the issue of quality measuring of nursing care with the help of quality indicators, which include the results of nursing audits. To point out the significance of creation of standards that determine the minimum quality level, the observance of which is ensured by control system of the provider of this service. To point out the importance of hygienic ensuring of hands in health care institutions. The authors D. Pittet, RW. Haley address communication of nosocomial infections and insufficient hygiene of hands in health care workers in their studies. And last but not least the article should familiarize the reader with the methodology and implementation of nursing audit of „Hands washing“ in the hospital of České Budějovice, the sense of which was not to seek errors of individuals, but to find "weak points” in the system and to provide rectification as soon as possible.

• MeSH
• dezinfekce rukou metody   normy   MeSH
• infekce spojené se zdravotní péčí prevence a kontrola   MeSH
• kvalita zdravotní péče normy   trendy   MeSH
• ošetřovatelská péče statistika a číselné údaje   trendy   MeSH
• referenční standardy MeSH
• řízení kvality MeSH