• MeSH
• arsen metabolismus   MeSH
• dieta MeSH
• izotopové značení MeSH
• metabolická clearance MeSH
• myši MeSH
• Check Tag
• myši MeSH

• MeSH
• incidence MeSH
• lacerace etiologie   chirurgie   MeSH
• lidé MeSH
• perineum * zranění   chirurgie   MeSH
• pooperační komplikace * etiologie   epidemiologie   MeSH
• prospektivní studie MeSH
• retence moči * etiologie   epidemiologie   MeSH
• rizikové faktory MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• dopisy MeSH
• komentáře MeSH
• Geografické názvy
• Uganda MeSH

PURPOSE OF THE STUDY Revision surgery with implant retention and exchange of mobile prosthetic parts is considered to be the method of first choice in acute periprosthetic infections with a stable endoprosthesis and good condition of soft tissues, where the symptoms did not last longer than 3 weeks. The aim of the study was to evaluate the long-term outcomes and to identify the factors affecting the success rate of this procedure. MATERIAL AND METHODS This unicentric retrospective study evaluated the results of 18 surgeries with implant retention performed at the Department of Orthopaedics of České Budějovice Hospital in the period 2009-2016. The failure of the procedure was defined as the presence of at least one of the following criteria: removal or replacement of endoprosthesis within 2 years after the DAIR procedure, detection of the same pathogen during the DAIR procedure and in the later performed revision surgery, necessity of chronic suppressive antibiotic therapy, death related to periprosthetic infection. The cured patients were invited for a clinical check-up. The postoperative condition was assessed using the Knee Society Score and the Harris Hip Score. RESULTS The overall success rate of the procedure reached 61.1%. Hematogenic dissemination was the cause of periprosthetic infection in 13 followed-up cases (72.2%), with the average time after the implantation of 153.2 weeks. Treatment through the DAIR procedure was successful in 53.8%. Early postoperative complications were observed in 5 cases (27.8%), in 4 of which, i.e. 80%, they were successfully managed by a surgery with implant retention. The most frequently identified etiological agents were Staphylococcus aureus and Staphylococcus epidermidis strains. In primo-implanted endoprostheses the success rate reached 90.9% (in case of early postoperative infections even 100%), whereas surgeries in repeatedly operated joints were successful in 14.3% only. The mean value of the Knee Society Score in patients after a successful knee joint surgery was 81.2 of the maximum score of 100 (σ= 8.5), the Function Knee Society Score was 70 of 100 (σ= 34.6). In the case of the Harris Hip Score in patients after the hip replacement, the mean hip function score was 89.8 of the maximum of 100 (σ= 7.3). The patients with knee and hip joint endoprosthesis after the performed DAIR procedure were satisfied on average to the level of 82.5% and 90%, respectively, while 28.6% of patients experienced certain functional decline during daily activities. Postoperatively, 25% of patients reported continuing stronger pain as compared to the past medical history. No patient experienced any change in terms of a limited range of motion or decreased joint stability. DISCUSSION The overall success rate of the DAIR procedure of 61.1% corresponds with the values stated in the literature. A significantly higher success rate was achieved in early postoperative complications. This can be explained by a lower specificity in determining the actual pathogenesis of late periprosthetic infections and potentially longer lasting colonisation of endoprosthesis. The medical history of previous surgeries performed on the affected joints for septic arthritis or with a surgical instrument retention was identified as an important risk factor of failure of the subsequently performed DAIR procedure. Significant effects of pathogenicity of the detected agent or systemic comorbidities on the success rate of the procedure were not confirmed in our group. Successful performance of the DAIR procedure results in maintaining a very good function of endoprosthesis as well as subjective satisfaction of patients. CONCLUSIONS The DAIR technique is an ideal solution in correctly and early diagnosed acute periprosthetic infections. The results suggest that it is particularly appropriate in early postoperative infections of primary total joint replacements. Its indication in late periprosthetic infections, especially of repeatedly operated joints, shall be carefully considered. Key words:acute periprosthetic joint infections, PJI, DAIR, implant retention, risk factors, success rate.

• MeSH
• akutní nemoc MeSH
• antibakteriální látky terapeutické užití   MeSH
• debridement MeSH
• infekce spojené s protézou mikrobiologie   terapie   MeSH
• lidé MeSH
• odstranění implantátu MeSH
• retrospektivní studie MeSH
• rizikové faktory MeSH
• selhání protézy MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

Introduction: This systematic review and meta-analysis aimed to investigate adherence and retention rates to home-based video exercise programs and identify key factors associated with these rates in older adults to understand the effectiveness of home-based video exercise interventions. Methods: We searched PubMed, Web of Science, and Scopus for articles addressing adherence to and retention of home-based video exercise programs. The study was conducted following PRISMA recommendations. Results: A total of 26 articles, including 1,292 participants older than 65, were included in the final qualitative and quantitative syntheses. The weighted mean of the retention rate was 91.1, and of the attendance rate was 85.0, with low I2 = 3.5, not significant p = 0.409 heterogeneity. The generalized regression models showed a positive effect of session duration on the attendance rate (%), where the possible change from <20 min to >60 min duration could decrease the attendance rate (%) B = -24.390 (p <0.001). The delivery method had a significant effect, where the absence of live contact with the coach in web-based or DVD-delivered interventions could decrease the attendance rate (%) compared to the online sessions B = -11.482 (p = 0.010). The lockdown during the COVID-19 pandemic had a positive effect on both the attendance rate (%) B = 10.321 (p = 0.019) and retention rate (%) B = 9.577 (p = 0.032). Conclusions: This systematic review and meta-analysis indicate that supervised home-based video exercise programs lasting less than 60 min might be a suitable and sustainable exercise mode to keep older adults active, especially in times resembling feelings of confinement.

• MeSH
• adherence pacienta * statistika a číselné údaje   MeSH
• COVID-19 epidemiologie   prevence a kontrola   MeSH
• lidé MeSH
• senioři MeSH
• služby domácí péče organizace a řízení   MeSH
• terapie cvičením * metody   MeSH
• Check Tag
• lidé MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH
• metaanalýza MeSH
• přehledy MeSH
• systematický přehled MeSH

OBJECTIVE: To investigate TNF inhibitor (TNFi) retention and response rates in European biologic-naïve patients with PsA. METHODS: Prospectively collected data on PsA patients in routine care from 12 European registries were pooled. Heterogeneity in baseline characteristics between registries were explored (analysis of variance and pairwise comparison). Retention rates (Kaplan-Meier), clinical remission [28-joint count DAS (DAS28) <2.6; 28 joint Disease Activity index for Psoriatic Arthritis ⩽4] and ACR criteria for 20% improvement (ACR20)/ACR50/ACR70 were calculated, including LUNDEX adjustment. RESULTS: Overall, 14 261 patients with PsA initiated a first TNFi. Considerable heterogeneity of baseline characteristics between registries was observed. The median 12-month retention rate (95% CI) was 77% (76, 78%), ranging from 68 to 90% across registries. Overall, DAS28/28 joint Disease Activity index for Psoriatic Arthritis remission rates at 6 months were 56%/27% (LUNDEX: 45%/22%). Six-month ACR20/50/70 responses were 53%/38%/22%, respectively. In patients initiating a first TNFi after 2009 with registered fulfilment of ClASsification for Psoriatic ARthritis (CASPAR) criteria (n = 1980) or registered one or more swollen joint at baseline (n = 5803), the retention rates and response rates were similar to those found overall. CONCLUSION: Approximately half of >14 000 patients with PsA who initiated first TNFi treatment in routine care were in DAS28 remission after 6 months, and three-quarters were still on the drug after 1 year. Considerable heterogeneity in baseline characteristics and outcomes across registries was observed. The feasibility of creating a large European database of PsA patients treated in routine care was demonstrated, offering unique opportunities for research with real-world data.

• MeSH
• antirevmatika terapeutické užití   MeSH
• databáze faktografické MeSH
• dospělí MeSH
• inhibitory TNF terapeutické užití   MeSH
• lidé středního věku MeSH
• lidé MeSH
• pacientův souhlas se zdravotní péčí * MeSH
• prospektivní studie MeSH
• psoriatická artritida farmakoterapie   MeSH
• registrace MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

Cíl studie: Zhodnocení bezpečnosti a efektivity operace pomocí volně uložené pásky pod uretrou – Uretex – pro léčbu ženské stresové močové inkontinence. Typ studie: Retrospektivní multicentrická klinická studie. Název a sídlo pracoviště: Gynekologicko-porodnická klinika 2. LF UK a FN Motol, Praha. Metodika: Studie 145 pacientek se stresovou inkontinencí, které podstoupily operaci pomocí volně uložené pásky pod uretrou Uretex. Operace byly provedeny vaginální retropubickou cestou. Pacientky byly operovány na jednom urologickém a pěti gynekologických pracovištích v České republice. Předoperační hodnocení zahrnovalo kompletní urogynekologické vyšetření, věk, paritu, index tělesné hmotnosti, anamnézu předchozích pánevních operací a hormonální stav. Úspěšnost a komplikace operace byly hodnoceny v krátkodobém sledování. Výsledky: Průměrný věk souboru byl 56 let (25-80), průměrná parita byla 2,25 (1-4), 113 (78 %) pacientek bylo v pásmu mírné nadváhy (BMI 25-30 kg/m2) a ostatní měly normální hmotnost (BMI 20-25 kg/m2). Vyléčení stresové inkontinence nastalo po operaci u 90,3 % (131 z 145) žen. Komplikace se objevily ve 22 (15,2 %) případech. U dvou pacientek (1,4 %) došlo k perforaci močového měchýře. U dvou žen (1,4 %) bylo pooperačně zjištěno neperforující poranění stěny měchýře. U dvou žen (1,4 %) se objevil retropubický hematom. 16 (11 %) pacientek mělo lehké časné pooperační komplikace (8krát krátkodobá retence moči, 6krát infekce dolního močového ústrojí, 2krát urgentní symptomatologie). Pooperačně se neobjevila žádná eroze pásky do pochvy. Všechny komplikace byly vyřešeny a pacientky byly při kontrole do 6 měsíců po operaci bez negativních pooperačních příznaků. Závěr: Studie prokázala, že operace pomocí volně uložené pásky pod uretrou Uretex je efektivní a bezpečnou minimálně invazivní metodou chirurgické léčby stresové inkontinence.

Objective: To evaluate the safety and efficacy of the Uretex tension-free vaginal tape procedure in the treatment of female stress urinary incontinence. Design: Retrospective multicenter clinical trial. Setting: Obstetrics and Gynecology Department, The Charles University 2nd Medical School and Teaching Hospital Motol, Prague. Methods: A group of 145 patients with stress urinary incontinence who underwent Uretex tension-free vaginal tape procedure was studied. Procedures were performed from vaginal retropubic route. Patients were operated on in one urological and five gynecological departments in Czech Republic. Preoperative evaluation consisted of complete urogynecological examination, age, parity, body mass index, history of previous pelvic surgery and hormonal status. The cure rate and complications were determined in shortterm postoperative follow-up. Results: The mean age was 56 (25-80) years, the median parity was 2.25 (1-4), 113 (78%) patients were slightly overweight (BMI 25-30 kg/m2) and others had normal weight (BMI 20-25 kg/m2). The cure rate after surgery was 90.3% (131 women). Complications occured in 22 (15.2%) cases. In two (1.4%) patients perforation of the urinary bladder wall occurred. In two (1.4%) women nonperforated injury of bladder wall was postoperatively diagnosed. Retropubic haematoma occurred in another two patients (1.4%). 16 (11%) patients had mild early postoperative complications (eight times short-term urinary retention, six lower urinary tract infections, two urgent symptomatology). Erosion of vaginal wall did not occur postoperatively. All complications were resolved and the patients were free of negative postoperative symptoms 6 month after the procedure. Conclusion: This study shows that Uretex tension-free vaginal tape procedure is an effective and safe minimally invasive surgical procedure in the treatment of stress urinary incontinence.

• MeSH
• finanční podpora výzkumu jako téma MeSH
• lidé MeSH
• miniinvazivní chirurgické výkony škodlivé účinky   trendy   využití   MeSH
• pooperační komplikace chirurgie   terapie   MeSH
• retrospektivní studie MeSH
• stresová inkontinence moči chirurgie   terapie   MeSH
• uretra chirurgie   patologie   MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH

OBJECTIVE: There is a lack of real-life studies on interleukin-17 (IL-17) inhibition in psoriatic arthritis (PsA). We assessed real-life 6- and 12-month effectiveness (i.e., retention, remission, low disease activity [LDA], and response rates) of the IL-17 inhibitor secukinumab in PsA patients overall and across 1) number of prior biologic/targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs), 2) years since diagnosis, and 3) European registries. METHODS: Thirteen quality registries in rheumatology participating in the European Spondyloarthritis Research Collaboration Network provided longitudinal, observational data collected as part of routine care for secondary use. Data were pooled and analyzed with Kaplan-Meier plots, log rank tests, Cox regression, and multiple linear and logistic regression analyses. RESULTS: A total of 2,017 PsA patients started treatment with secukinumab between 2015 and 2018. Overall secukinumab retention rates were 86% and 76% after 6 and 12 months, respectively. Crude (LUNDEX adjusted) 6-month remission/LDA (LDA including remission) rates for the 28-joint Disease Activity Index for Psoriatic Arthritis, the Disease Activity Score in 28 joints using the C-reactive protein level, and the Simplified Disease Activity Index (SDAI) were 13%/46% (11%/39%), 36%/55% (30%/46%), and 13%/56% (11%/47%), and 12-month rates were 11%/46% (7%/31%), 39%/56% (26%/38%), and 16%/62% (10%/41%), respectively. Clinical Disease Activity Index remission/LDA rates were similar to the SDAI rates. Six-month American College of Rheumatology 20%/50%/70% improvement criteria responses were 34%/19%/11% (29%/16%/9%); 12-month rates were 37%/21%/11% (24%/14%/7%). Secukinumab effectiveness was significantly better for b/tsDMARD-naive patients, similar across time since diagnosis (<2/2-4/>4 years), and varied significantly across the European registries. CONCLUSION: In this large real-world study on secukinumab treatment in PsA, 6- and 12-month effectiveness was comparable to that in previous observational studies of tumor necrosis factor inhibitors. Retention, remission, LDA, and response rates were significantly better for b/tsDMARD-naive patients, were independent of time since diagnosis, and varied significantly across the European countries.

• MeSH
• antirevmatika * terapeutické užití   MeSH
• humanizované monoklonální protilátky * terapeutické užití   MeSH
• interleukin-17 antagonisté a inhibitory   MeSH
• lidé MeSH
• psoriatická artritida * diagnóza   farmakoterapie   MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• pozorovací studie MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Evropa MeSH

INTRODUCTION AND HYPOTHESIS: Our purpose was to verify whether extensive dissection toward the sacrospinous ligament (SSL) needed for mesh fixation during anterior compartment repair increases the risk of postoperative voiding difficulties. METHODS: A total of 124 patients after anterior compartment mesh repair without simultaneous suburethral sling placement operated on in the period 2005-2012 were enrolled in this retrospective observational study. Patients with previous anti-incontinence surgery with normal urodynamics were not excluded; 30 patients with incomplete data, severe perioperative complications, and urinary retention before and after the surgery were excluded. Urinary retention was defined as post-void residual over 150 ml more than 48 h after permanent catheter removal. The rate of urinary retention after anterior compartment repair by mesh anchored to the SSL from an anterior approach (SSLS group) was compared to that following transobturator mesh repair often combined with SSL fixation from the posterior approach (TOT group). RESULTS: Of the 94 patients considered for statistical analysis, 62 were from the SLSS group and 32 from the TOT group. The groups were comparable in age (mean 65.5 vs 66.3), body mass index (24.8 vs 25.9), and parity (2.4 vs 2.9). Patients from the SSLS group had higher rates of prior vaginal reconstructive (27 vs 19 %) and anti-incontinence surgery (26 vs 19 %). Postoperative urinary retention was statistically significantly more frequent in the SSLS group compared to the TOT group [(17 (27 %) vs 2 (6.25 %), odds ratio 5.7, 95 % confidence interval 1.2-26.3, p = 0.027]. Hospital discharge with self-catheterization was statistically insignificantly more frequent in the SSLS group [8 % (5) vs 3 % (1)]. CONCLUSIONS: Extensive dissection needed for SSL suspension from an anterior approach may lead to more frequent postoperative voiding difficulties. This phenomenon could be explained by more considerable injury to pelvic splanchnic nerves during the dissection. A large prospective study is needed for validation of our results.

• MeSH
• chirurgické síťky škodlivé účinky   MeSH
• cystokéla chirurgie   MeSH
• gynekologické chirurgické výkony škodlivé účinky   MeSH
• incidence MeSH
• lidé středního věku MeSH
• lidé MeSH
• ligamenta chirurgie   MeSH
• poruchy močení epidemiologie   MeSH
• retence moči epidemiologie   MeSH
• retrospektivní studie MeSH
• rizikové faktory MeSH
• senioři MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• pozorovací studie MeSH
• práce podpořená grantem MeSH

Cíl: Metabolická acidóza je téměř konstantním projevem renální insuficience. Při konvenčním hodnocení acidobazické rovnováhy na základě Hendersonovy-Hasselbalchovy rovnice nejsme schopni definovat příčinu metabolických poruch, neboť sérová koncentrace HCO3 může být pouze odrazem změn celkového spektra plazmatických iontů. Použili jsme proto Stewartovu-Fenclovu teorii, vycházející z podrobnější fyzikálně-chemické analýzy, ze které je patrné, že změna sérové koncentrace HCO3 úzce souvisí s veličinami, ve spojitosti s acidobazickou rovnováhou běžně nesledovanými. Soubor pacientů a metodika: U 69 nedialyzovaných nemocných s glomerulární filtrací pohybující se mezi 0,04 a 0,88 ml/s/1,73m2 dle MDRD jsme jednorázově změřili pH a pCO2 arteriální či kapilární krve, sérovou koncentraci HCO3 jsme standardně dopočítali z Hendersonovy-Hasselbalchovy rovnice, z venózní krve jsme určili sérové koncentrace albuminu a iontů: Na+, K+, Cl-, Pi, dále sérové koncentrace kreatininu a urey. Výsledky: U 47 nemocných byla přítomna metabolická acidóza ([S-HCO3-] < 22 mmol/l), s průměrnou hodnotou [S-HCO3-] celého souboru 19,6 mmol/l. Prokázali jsme statisticky signifikantní korelaci mezi [S-HCO3-] a [SID] (p < 0,001), dále mezi [S-HCO3-] a jednotlivými faktory determinujícími [SID]: [Na+-Cl-], [UA-], [Pi-], [K+] (p < 0,01). Závěr: U nedialyzovaných pacientů s poklesem glomerulární filtrace je snížení [S-HCO3-] asociováno majoritně s poklesem [Na+-Cl-] diference, jejíž kvantitativní příspěvek k metabolické acidóze je významnější než retence silných kyselin. Na snížení [Na+-Cl-] diference se kromě zvýšení [S-Cl-] významně uplatňuje i pokles [S-Na+].

AIM: Metabolic acidosis is a regular sign of renal insufficiency. Conventional assessment of acid-base balance using Henderson-Hasselbalch equation does not make identification of the cause of metabolic disorders possible as the serum HCO3- concentration might only reflect changes to the overall plasma ion spectrum. Therefore, we used the Stewart-Fencl approach that is based on a more detailed physical and chemical analysis and that showed that changes to serum HCO3- concentration are closely related to parameters not usually monitored in connection to acid-base balance. PATIENT GROUP AND METHODOLOGY: We performed a single measurement of arterial or capillary blood pH and pCO2 in 69 non-dialysed patients with glomerular filtration rate ranging from 0.04 to 0.88 ml/s/1.73 m2 according to MDRD, standard calculation of serum HCO3- concentration using Henderson-Hasselbalch equation was carried out, and serum albumin and ion concentrations (Na+, K+, Cl, Pi) plus creatinine and urea concentrations were determined from venous blood. RESULTS: Metabolic acidosis was present in 47 patients ([S-HCO3-] < 22 mmol/l) with the mean [S-HCO3-] value of 19.6 mmol/l for the entire group. We proved a statistically significant correlation between [S-HCO3-] and [SID] (p < 0.001), and between [S-HCO3-] and the individual [SID] determining factors: [Na+-Cl-], [UA- ], [Pi-], [K+] (p < 0.01). CONCLUSION: Reduction in [S-HCO3-] in non-dialysed patients with reduced glomerular filtration is predominantly associated with a decrease in [Na+-Cl-] difference, the quantitative contribution of which to metabolic acidosis is more significant than the strong acids retention. In addition to [S-Cl-] increase, [S-Na+] reduction too has a major role in reducing the [Na+-Cl-] difference.

• MeSH
• acidobazická rovnováha MeSH
• acidóza metabolismus   MeSH
• dospělí MeSH
• hodnoty glomerulární filtrace MeSH
• hydrogenuhličitany krev   MeSH
• koncentrace vodíkových iontů MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• renální insuficience komplikace   metabolismus   patofyziologie   MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• sérový albumin analýza   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH

INTRODUCTION: The aims of this study were to survey current retention procedures applied by Dutch orthodontists and to examine their acquaintance with "unintentionally active retainers." METHODS: A questionnaire was sent to all 306 Dutch orthodontists involved in patient treatment. Questions were clustered in 4 parts: (1) general information, (2) retention procedures, (3) characteristics of wire materials for bonded retainers, and (4) acquaintance with "unintentionally active retainers." RESULTS: The response rate was 98%. The most applied retention modality in the maxillary arch was a combination of a removable and a bonded retainer (54%); in the mandibular arch, mainly a bonded retainer without a removable retainer was used (83%). Bonded retention was aimed to be lifelong for the maxillary arch (90%) and the mandibular arch (92%). Mean removable retention duration was 2 years. Vacuum-formed retainers were used more frequently and Hawley-type retainers less frequently. The wire materials used for bonded retainers were diverse. All orthodontists were familiar with unintentionally active retainers; 44% believed this phenomenon is caused by the properties of round multistrand wires. The opinion that unwanted changes in tooth position can arise due to the properties of round multistrand wire material was associated with changing the wire material (P <0.005). CONCLUSIONS: Lifelong retention with bonded retainers continues to increase. All orthodontists were acquainted with unintentionally active retainers and their impact. There is a need to identify all causative factors of inadvertent tooth movement in relation to bonded retainers and to prevent the onset of unintentionally active retainers.

• MeSH
• epidemiologické studie * MeSH
• lidé MeSH
• malokluze terapie   MeSH
• mandibula MeSH
• maxila MeSH
• ortodoncie korekční metody   statistika a číselné údaje   MeSH
• ortodontické dráty MeSH
• ortodontické přístroje - design MeSH
• ortodontické retainery * statistika a číselné údaje   MeSH
• ortodontisté MeSH
• postupy ortodontického kotvení přístrojové vybavení   metody   statistika a číselné údaje   MeSH
• průzkumy a dotazníky MeSH
• vazba zubní MeSH
• vzorové postupy ve stomatologii statistika a číselné údaje   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH