• MeSH
• stomatologie MeSH
• Publikační typ
• periodika MeSH

• Konspekt
• Stomatologie
• NLK Obory
• zubní lékařství

• MeSH
• lékařství MeSH
• Publikační typ
• příručky MeSH

• Konspekt
• Lékařské vědy. Lékařství
• NLK Obory
• lékařství

OBJECTIVE: The aim of this study was to evaluate whether a previously identified modification of Viennese method of perineal protection remains most effective for reduction of perineal tension in cases with substantially smaller or larger fetal heads. METHODS: A previously designed finite element model was used to compare perineal tension of different modifications of the Viennese method of perineal protection to "hands-off" technique for three different sizes of the fetal head. Quantity and extent of tension throughout the perineal body during vaginal delivery at the time when the suboccipito-bregmatic circumference passes between the fourchette and the lower margin of the pubis was determined. RESULTS: The order of effectiveness of different modifications of manual perineal protection was similar for all three sizes of fetal head. The reduction of perineal tension was most significant in delivery simulations with larger heads. The final position of fingers 2cm anteriorly from the fourchette (y = +2) consistently remains most effective in reducing the tension. The extent of finger movement along the anterior-posterior (y-axis) contributes to the effectiveness of manual perineal protection. CONCLUSION: Appropriately performed Viennese manual perineal protection seems to reduce the perineal tension regardless of the fetal head size, and thus the method seems to be applicable to reduce risk of perineal trauma for all parturients.

• MeSH
• analýza metodou konečných prvků MeSH
• hlava anatomie a histologie   MeSH
• komplikace porodu prevence a kontrola   MeSH
• lidé MeSH
• perineum zranění   MeSH
• plod anatomie a histologie   MeSH
• těhotenství MeSH
• vedení porodu škodlivé účinky   metody   MeSH
• Check Tag
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

Although percussion of the abdomen was already known to the Greek physician Galenos (2nd century A. D.) who used it to distinguish between ascites and meteorism, the Viennese physician Leopold Auenbrugger (1722-1809) started to use, the percussion of the chest as a diagnostic tool. In 1761 he published his experience in a treatise called "New Method for Detecting Hidden Ailments of the Chest by Percussion of the Thorax" (Inventum novum ex percussione thoracis hummani ut signo abstruso interni pectoris morbos detergendi). However, this method was introduced into practice only 50 years later by Jean Nicolas Corvisart, who translated Auenbrugger's book in 1808 into French. The famous Vinnese internist of Czech origin Joseph Skoda (1805-1881) set the teaching about percussion and auscultation on a firm physical basis. Skoda confronted the physical findings with dissection materials in close cooperation with the renowned Vinnese pathologist Karl Rokitansky (1804-1878), who was born in Hradec Králové. The Medical School in Prague became famous for its excellent command of methods based on physical examination and surpassed even the Viennese School.

• MeSH
• dějiny 15. století MeSH
• dějiny 16. století MeSH
• dějiny 17. století MeSH
• dějiny 18. století MeSH
• dějiny 19. století MeSH
• dějiny starověku MeSH
• dějiny středověku MeSH
• hrudník * MeSH
• lidé MeSH
• perkuse dějiny   MeSH
• Check Tag
• dějiny 15. století MeSH
• dějiny 16. století MeSH
• dějiny 17. století MeSH
• dějiny 18. století MeSH
• dějiny 19. století MeSH
• dějiny starověku MeSH
• dějiny středověku MeSH
• lidé MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH
• historické články MeSH

Poklep břicha byl znám již řeckému lékaři Galenovi (2 stol. po Kr.), který používal poklepu k odlišení ascitu od meteorismu. Perkusi hrudníku však jako diagnostickou metodu začal používat vídeňský lékař Leopold Auenbrugger (1722-1809). V roce 1761 publikoval své zkušenosti v pojednání „Nový způsob jak poklepáním hrudníku možno v něm objevit skryté choroby" (Inventum novum ex percussione thoracis humani ut signo obstruso interni pectoris morbos detergendi). Do praxe však byla metoda zavedena až o 50 let později J. N. Corvisartem, který přeložil Auenbruggerovu knihu v roce 1808 do francouzštiny. Vynikající vídeňský internista českého původu Josef Škoda (1805-1881) postavil nauku o perkusi a auskultaci na pevný fyzikální základ. Škoda srovnával fyzikalní nálezy při sekci v úzké kooperaci s proslulým vídeňským patologem Karlem Rokitanským (1804-1878), královéhradeckým rodákem. Pražská lékařská škola stala se známou dokonalým zvládnutím metod založených na fyzikálním vyšetření a dokonce předčila i školu vídeňskou.

Although percussion of the abdomen was already known to the Greak physician Galenos (2nd century A. D.) who used it to distinguish between ascites and meteorism. The Viennese physician Leopold Auenbrugger (1722-1809) started to use the percussion of tiie chest as a diagnostic tool. In 1761 he published his experience in a treatese called „New Method for Detecting Hidden Ailments of the Chest by Percussion of the Thorax"(Inventum novum ex percussione thoracis humani ut signo abstruso interni pectoris morbos detergendi). However, this method was introduced into practice only 50 years later by Jean Nicolas Corvisart, who translated Auenbrugger's book in 1808 into French. The famous Virmese internist of Czech origine Joseph Škoda (1805-1881) set the teaching about percussion and auscultation on a firm physical basis. Škoda confronted the physical findings with dissection materials in close cooperation with the renowned Vinnese pathologist Karl Rokitansky (1804-1878), who was born in Hradec Králové. The Medical School in Prague becam famous for its excellent command of methods based on physical examination and surpassed even the Viennese School.

• MeSH
• fyzikální vyšetření MeSH
• hrudník MeSH
• perkuse dějiny   metody   využití   MeSH
• Publikační typ
• přehledy MeSH

INTRODUCTION AND HYPOTHESIS: We compared hands-on manual perineal protection (MPP) and hands-off delivery techniques using the basic principles of mechanics and assessed the tension of perineal structures using a novel biomechanical model of the perineum. We also measured the effect of the thumb and index finger of the accoucheur's dominant-posterior hand on perineal tissue tension when a modified Viennese method of MPP is performed. METHODS: Hands-off and two variations of hands-on manual perineal protection during vaginal delivery were simulated using a biomechanical model, with the main outcome measure being strain/tension throughout the perineal body during vaginal delivery. RESULTS: Stress distribution with the hands-on model shows that when using MPP, the value of highest stress was decreased by 39 % (model B) and by 30 % (model C) compared with the hands-off model A. On the cross section there is a significant decrease in areas of equal tension throughout the perineal body in both hands-on models. Simulation of the modified Viennese MPP significantly reduces the maximum tension on the inner surface of the perineum measured at intervals of 2 mm from the posterior fourchette. CONCLUSIONS: In a biomechanical assessment with a finite element model of vaginal delivery, appropriate application of the thumb and index finger of the accoucheur's dominant-posterior hand to the surface of the perineum during the second stage of delivery significantly reduces tissue tension throughout the entire thickness of the perineum; thus, this intervention might help reduce obstetric perineal trauma.

• MeSH
• biologické modely * MeSH
• lidé MeSH
• mechanický stres MeSH
• perineum fyziologie   MeSH
• těhotenství MeSH
• vedení porodu metody   MeSH
• Check Tag
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

INTRODUCTION AND HYPOTHESIS: Comparison of the modifications of the Viennese method of manual perineal protection (VMPP) and hands-off delivery techniques by applying basic principles of mechanics with assessments of tensions within perineal structures using a novel biomechanical model of the perineum. Evaluation of the role of the precise placements of the accoucheur's posterior (dominant) thumb and index finger in perineal tissue tension when performing a modified Viennese method of MPP. METHODS: We carried out an experimental study on a biomechanical model of the perineum at NTIS (New Technologies for Information Society, Pilsen, Czech Republic). Hands-off and 38 variations of VMPP were simulated during vaginal delivery with the finite element model imitating a clinical lithotomy position. RESULTS: The main outcome measures were quantity and extent of strain/tension throughout the perineal body during vaginal delivery. Stress distribution between modifications of VMPP showed a wide variation in peak perineal tension from 72 to 102 % compared with 100 % for the "hands-off" technique. Extent of reduction depended on the extent of finger movement across a horizontal, transverse x-axis, and on final finger position on a vertical, antero-posterior y-axis. The most effective modification of VMPP was initial position of fingers 12 cm apart (x = ±6) on the x-axis, 2 cm anteriorly from the posterior fourchette (y = +2) on the y-axis with 1cm movement of both finger and thumb toward the midline on the x-axis (Δx = 1) with no movement on the y-axis (Δy = 0). CONCLUSIONS: In a biomechanical assessment with simulation of vaginal delivery, exact placement of fingertips on the perineal skin, together with their co-ordinated movement, plays an important role in the extent of reduction of perineal tension.

• MeSH
• biologické modely MeSH
• biomechanika MeSH
• lidé MeSH
• perineum zranění   MeSH
• počítačová simulace MeSH
• porod MeSH
• prsty ruky * MeSH
• rány a poranění prevence a kontrola   MeSH
• vedení porodu metody   MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

Záchranná služba v Olomouci "Freiwillige Rettungsgesellschaft Olmütz" byla ustanovena 4. října 1910 jako dobrovolnický spolek zabývající se poskytováním první pomoci a transportem nemocných a raněných. Vzorem byla vídeňská ochranná společnost. Po roce 1925 byla činnost olomouckého "Freiwillige Rettungsgesellschaft" omezena, městem byl dále preferován český záchranný sbor "První pomoc v Olomouci". Stanice záchranné služby s ambulančním vozem a s podobiznami zakladatelů, Dr. Aloisem Karschulinem a notářem Richardem Maderem, je vyobrazena na střeleckém terči z roku 1911 (depozitář Vlastivědného muzea v Olomouci).

The Emergency Service in Olomouc "Freiwillige Rettungsgesellschaft Olmütz" was established on October 4, 1910 as a volunteer association dealing with providing first aid and transportation of the sick and wounded. The Viennese Protective Society was a model example for them. The activities of the Olomouc "Freiwillige Rettungsgesellschaft" were limited after 1925, and after that the Czech rescue service"First Aid in Olomouc" was preferred by the City Council. The emergency service station with an ambulance car and portraits of the founders, Dr. Alois Karschulin and notary Richard Mader, is on display on a shooting target board from 1911 (placed in the Regional Museum’s depository in Olomouc).

• Klíčová slova
• zdravotnická záchranná služba Olomouc,
• MeSH
• dějiny 20. století MeSH
• dějiny lékařství MeSH
• lidé MeSH
• urgentní zdravotnické služby * dějiny   MeSH
• Check Tag
• dějiny 20. století MeSH
• lidé MeSH
• Publikační typ
• historické články MeSH
• Geografické názvy
• Česká republika MeSH

Manual perineal protection is an obstetric intervention to mitigate the risk of perineal trauma. There are two effective techniques (Finnish and Viennese) with minor but distinctive differences in between them. The main aim of this study was to explore clinicians' knowledge about the manual perineal protection technique they use. The study took place in three maternity units that support manual perineal protection policy in three European countries (Czech Republic, Slovenia and the UK). Our study demonstrated that the majority of participants are aware of the concept of manual perineal protection. However, there were significant differences between staff responses regarding their views and experience with manual perineal protection in general. Less than 6% of respondents were able to provide an accurate account of the actual maneuvers they perform when manually protecting the perineum. Although this is not necessarily synonymous with suboptimal performance, it highlights the potential need to give more attention to the theory that underpins the technical skill in manual perineal protection training programs.

• MeSH
• babictví * metody   MeSH
• klinické kompetence MeSH
• komplikace těhotenství prevence a kontrola   MeSH
• lacerace prevence a kontrola   MeSH
• lékařská praxe - způsoby provádění * MeSH
• lidé MeSH
• perineum zranění   MeSH
• porod MeSH
• průzkumy a dotazníky MeSH
• těhotenství MeSH
• zdraví - znalosti, postoje, praxe * MeSH
• Check Tag
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika MeSH
• Slovinsko MeSH
• Spojené království MeSH

• MeSH
• intratracheální intubace * MeSH
• Publikační typ
• periodika MeSH

• Konspekt
• Lékařské vědy. Lékařství
• NLK Obory
• anesteziologie a intenzivní lékařství
• urgentní lékařství