Outcome
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Cíl: Seznámit se studií European Cataract Outcome Study a zveřejnit výsledky Oční kliniky FN v Hradci Králové z její pětileté účasti. Metodika, soubory: European Cataract Outcome Study je mezinárodní multicentrická studie sledující kvalitu operací katarakty na jednotlivých pracovištích v rámci evropských zemí. Jejímcílemje sledování vývoje nových trendů a pomocí výsledků napomoci při tvorbě standardů. Hodnotí výsledky všech operací v průběhu jednoho celého měsíce. Naše pracoviště se do ní zapojilo v letech 1998 až 2002. V první fázi se sledovaly základní demografické údaje a průběhy operací, ve druhé fázi výsledky vyšetření do půl roku po operaci. Výsledky: Operace jsou prováděny v naprosté většině fakoemulzifikací v lokální anestezii (subkonjunktivální a parabulbární), hospitalizace kolísá v jednotlivých letech od 35,1%do 56 %, každoročně stoupá podíl implantovanýchměkkých čoček, v roce 2002 až na 61,5 % (78,2 % průměr celé studie v roce 2002). Podíl výskytu ruptury zadního pouzdra při operaci na našem pracovišti během pěti let klesá (rozmezí do 3,7 % do 1,2 %). Soubory obsahovaly 40,4-50,5 % očí s vedlejším očním onemocněním. Po operaci dosáhlo nejlepší korigovaný vizus do 0,6 v jednotlivých letech v 64-78 % očí, odchylka od plánované refrakce se pohybuje v rozmezí od 0,69 do 0,88D. Indukovaný pooperační astigmatismus kolísal ve sledovaných obdobích od 0,49 do 0,62 D. Závěr: Z výsledků studie vyplývá, že kvalita prováděných operací na klinice je na vysoké úrovni a je plně srovnatelná se současným evropským standardem.
Goal: To inform about European Cataract Outcome Study and to publish results from the Department of Ophthalmology, Faculty Hospital in Hradec Králové achieved during the five years' participation. Method, groups: European Cataract Outcome Study is an international multicentric study pursuing quality of cataract surgery in individual departments of European countries. Its goal is to monitor the development of new trends and to behelpful in setting standardsusingthecollecteddata.TheStudyevaluates results of all surgeries performed during one month. Our department participated in it in the years 1998 – 2002. In the first part of the trial the basic demographic data as well as the course of the surgeries were followed, in the second part results of examination during the first six months after the surgery were collected. Results: Operations are mostly performed by means of the facoemulsification method in local anesthesia (subconjunctival or parabulbar), the stay in hospital varies in individual years between 35.1 % and 56 %, the percentage of implanted foldable (soft) intraocular lenses rises every year, in 2002 up to 61.5 % (average of the whole study was 78.2 % in 2002), the percentage of posterior lens capsule rupture during the procedure during the five year period in our department descends (range 3.7 % to 1.2 %). In the referred groups, 40.4 % to 50.5 % of eyes suffered from still another disease. The best corrected visual acuity 0.6 or better after the surgery achieved in individual years 64 % to 78 %. The deviation from planed refraction is between 0.69 to 0.88 diopters. The induced postoperative astigmatism varied in followed periods from 0.49 to 0.69 cylindrical diopters. Conclusion: The results of the study shows that the quality of surgeries performed in the department is on the high level and is fully comparable with contemporary European standard.
- MeSH
- extrakce katarakty MeSH
- lidé MeSH
- řízení kvality MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- multicentrická studie MeSH
Efforts to obtain an objective view of the working and living conditions of European women and in particular the influence of these conditions on the course of pregnancy were the reason why in 1994 within research activities of the EC a project EUROPOP (European Programme of Occupational Risk and Pregnancy Outcome) was adopted and started. Seventeen countries incl. the Czech Republic were asked to participate. The research proper was conducted in 57 maternity institutions. In the Czech Republic the Olomouc region was selected with the Gynaecological and Obstetric Clinic in Olomouc as the coordinating centre. All 13 gynaecological and obstetric departments of the Olomouc catchment area were included in the trial.
As continuation of the previous paper ther authors submit the second part of the results of the European programme EUROPOP which evaluates the relationship between work, living conditions of pregnant women, prenatal care and medical data on the outcome of pregnancy. The authors compare gproups of women, who had premature deliveries (22nd - 36 week of gestation) with control groups 1/10 deliveries in term (≥ 37 weeks). Groups of abortions in the second trimester which were investigated were relatively small (Czech Republic 49 and all-European study 229). To keep the paper within reasonable limits the tables are not presented. The project was part of the PECO programme supported by a Grant of the Ministry od Education No. OK 125.
- MeSH
- komplikace těhotenství MeSH
- lidé MeSH
- předčasný porod etiologie MeSH
- programy národního zdraví MeSH
- rizikové faktory MeSH
- sociální prostředí MeSH
- těhotenství MeSH
- Check Tag
- lidé MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Geografické názvy
- Česká republika MeSH
- Evropa MeSH
As continuation of their previous paper the authors submit the results of the European study EXJROPOP pertaining to the effect of occupation on the course and outcome of pregnancy. The paper contains the first part of results where the authors compare groups of women with premature deliveries (22nd - 36th week of pregnancy) with control groups 1/10 deliveries in term (≥ 37 weeks). The groups of abortions in the second trimester which were studied by the authors were relatively small (Czech Republic 49 and in the all-European study 229). To keep the study within a reasonable limits the tables are not presented. Comparison of results describing home work, living conditions of pregnant women, prenatal care and medical problems as well as data on the outcome of pregnancy are presented in part III. The project was part of the PECO programme supported by a Grant of the Ministry of Education No. OK 125.
- MeSH
- komplikace těhotenství MeSH
- lidé MeSH
- práce škodlivé účinky MeSH
- programy národního zdraví MeSH
- průzkumy a dotazníky MeSH
- rizikové faktory MeSH
- těhotenství MeSH
- Check Tag
- lidé MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Geografické názvy
- Česká republika MeSH
- Evropa MeSH
PURPOSE: The initiation of enzyme-replacement therapy prior to the occurrence of substantial and irreversible organ damage in patients with Fabry disease is of critical importance. The Fabry Outcome Survey is an international disease registry of patients with a confirmed diagnosis of Fabry disease. In this study, data from the Fabry Outcome Survey were used for the assessment of the risks for cardiovascular and renal events in patients who received agalsidase alfa treatment. METHODS: Eligible patients were males and females aged ≥18 years with Fabry disease treated with agalsidase alfa. Cardiovascular events included myocardial infarction, left ventricular hypertrophy (LVH), heart failure, arrhythmia, conduction abnormality, and cardiac surgery. Renal events included dialysis, transplantation, and renal failure. Kaplan-Meier curves and log-rank tests were used for comparing event-free probabilities and time to first cardiovascular or renal event, from agalsidase alfa initiation to a maximum of 120 months, in patients with LVH versus normal left ventricular mass index (LVMI; ≤50 g/m2.7 in males and ≤48 g/m2.7 in females) at treatment initiation (baseline), and in patients with a low estimated glomerular filtration rate (eGFR; <90 mL/min/1.73 m2) versus normal eGFR at baseline. Multivariate Cox regression analysis was used for examining the association between key study variables and the risks for cardiovascular and renal events. FINDINGS: Among the 560 patients (269 males; 291 females) with available LVMI data, 306 (55%) had LVH and 254 (45%) had normal LVMI at baseline. The risk for a cardiovascular event was higher in the subgroup with LVH versus normal LVMI at baseline (hazard ratio [HR] = 1.57; 95% CI, 1.21-2.05; P < 0.001), but the risk for a renal event was similar between the 2 subgroups (HR = 1.90; 95% CI, 0.94-3.85; P = 0.074). Among the 1093 patients (551 males; 542 females) with available eGFR data, 433 (40%) had a low eGFR and 660 (60%) had a normal eGFR at baseline. The subgroup with a low eGFR at baseline had a significantly higher risk for a cardiovascular event (HR = 1.33; 95% CI, 1.04-1.70; P = 0.021) or a renal event (HR = 5.88; 95% CI, 2.73-12.68; P < 0.001) compared with patients with a normal eGFR at baseline. IMPLICATIONS: In the present study, the presence of LVH and/or reduced renal function at agalsidase alfa initiation was associated with a significantly higher risk for a cardiovascular or renal event, indicating that cardiovascular and renal pathologies in Fabry disease may be inter-related. Early initiation of agalsidase alfa treatment prior to the onset of severe organ damage may improve outcomes. ClinicalTrials.gov identifier: NCT03289065.
- MeSH
- alfa-galaktosidasa terapeutické užití MeSH
- dialýza ledvin MeSH
- dospělí MeSH
- enzymová substituční terapie MeSH
- Fabryho nemoc komplikace patofyziologie terapie MeSH
- hodnoty glomerulární filtrace MeSH
- izoenzymy terapeutické užití MeSH
- ledviny patofyziologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- nemoci srdce komplikace patofyziologie terapie MeSH
- rekombinantní proteiny terapeutické užití MeSH
- renální insuficience komplikace patofyziologie terapie MeSH
- senioři MeSH
- transplantace ledvin MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- pozorovací studie MeSH
- práce podpořená grantem MeSH
- Klíčová slova
- kombinované testy,
- MeSH
- lidé MeSH
- prenatální diagnóza MeSH
- těhotenství MeSH
- trimestry těhotenství MeSH
- výsledek těhotenství MeSH
- Check Tag
- lidé MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- abstrakt z konference MeSH
elektronický časopis
BACKGROUND: Spasticity is a common feature in patients with disruptions in corticospinal pathways. However, the term is used ambiguously. Here, spasticity is defined as enhanced velocity-dependent stretch reflexes and placed within the context of deforming spastic paresis encompassing other forms of muscle overactivity. OBJECTIVE: This scoping review aims at evaluating the clinimetric quality of clinical outcome assessments (COAs) for spasticity across different pathologies and to make recommendations for their use. METHODS: A literature search was conducted to identify COAs used to assess spasticity. An international expert panel evaluated the measurement properties in the included COAs. Recommendations were based on the MDS-COA program methodology based on three criteria: if the COA was (1) applied to patients with spastic paresis, (2) used by others beyond the developers, and (3) determined to be reliable, valid, and sensitive to change in patients with spasticity. RESULTS: We identified 72 COAs of which 17 clinician-reported outcomes (ClinROs) and 6 patient-reported outcomes (PROs) were reviewed. The Tardieu Scale was the only ClinRO recommended for assessing spasticity. One ClinRO-Composite Spasticity Index-and two PROs-Spasticity 0-10 Numeric Rating Scale and 88-Item Multiple Sclerosis Spasticity Scale-were recommended with caveats. The Ashworth-derived COAs were excluded after evaluation due to their focus on muscle tone rather than spasticity, as defined in this review. CONCLUSIONS: The Tardieu Scale is recommended for assessing spasticity, and two PROs are recommended with caveats. Consistent terminology about the various types of muscle overactivity is necessary to facilitate their assessment and treatment. © 2024 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
- MeSH
- hodnocení výsledků zdravotní péče * normy MeSH
- lidé MeSH
- svalová spasticita * patofyziologie diagnóza etiologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
- MeSH
- bronchiální astma MeSH
- dítě MeSH
- dospělí MeSH
- lidé MeSH
- prognóza MeSH
- průzkumy a dotazníky MeSH
- Check Tag
- dítě MeSH
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- srovnávací studie MeSH
