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BACKGROUND: Perioperative neurocognitive disorders are often neglected and undiagnosed. There are known risk factors for these disorders (e.g., higher levels of frailty, cognitive decline before surgery). However, these factors are usually not assessed in the daily clinical setting. One of the main reasons for this lack of examination is the absence of a suitable cognitive function test that can be used in acute clinical settings. The primary aim of this study was to determine correlations between preoperative and postoperative scores on three cognitive tests (the Mini Mental State Exam (MMSE), the Clock Drawing Test (CDT) and the Test of Gestures (TEGEST). METHODS: This was a prospective, monocentric, observational study that included one cohort of patients aged 65 years and older. Patients underwent acute or elective surgical operations. Preanaesthesia tests were administered. After the operation, the patients completed the same tests between the 2nd postoperative day and discharge. Preoperative and postoperative cognitive test scores were assessed. RESULTS: This study included 164 patients. The arithmetic mean age was 74.5 years. The strongest correlations were observed between MMSE scores and TEGEST scores (r = 0.830 before and 0.786 after surgery, P < 0.001). To compare the MMSE and the TEGEST, the MMSE was divided into 2 categories-normal and impaired-and good agreement was found among 76.2% of the participants (κ = 0.515). If the TEGEST scoring system was changed so that scores of 4-6 indicated normal cognition and scores of 0-3 indicated cognitive impairment, the level of agreement would be 90.8%, κ = 0.817. Only 5.5% of the patients had impaired MMSE scores and normal TEGEST scores, whereas 3.7% of the respondents normal MMSE scores and impaired TEGEST scores. CONCLUSION: According to our results, the TEGEST is a suitable option for assessing cognitive functioning before surgery among patients who are at risk of developing perioperative neurocognitive disorders. This study revealed that it is necessary to change the rating scale for the TEGEST so that scores of 4-6 indicate normal cognition and scores of 0-3 indicate cognitive impairment. In clinical practice, the use of the TEGEST may help to identify patients at risk of perioperative neurocognitive disorders.
- MeSH
- hodnocení rizik metody MeSH
- kognitivní dysfunkce diagnóza psychologie etiologie MeSH
- lidé MeSH
- neurokognitivní poruchy * diagnóza psychologie MeSH
- neuropsychologické testy MeSH
- perioperační období MeSH
- pooperační komplikace diagnóza psychologie etiologie MeSH
- prospektivní studie MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- testy pro posouzení mentálních funkcí a demence MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- pozorovací studie MeSH
Objectives. This article reports on the adaptation procedure of the MacArthur-Bates Communicative Development Inventory (MB-CDI): Words & Gestures into Czech. The parental-report questionnaire screens communicative development in infants aged 8 to 18 months and focuses on general communicative skills, active and passive vocabulary, and communicative gestures. The content of the Czech adaptation needs to reflect the communicative practices specific to the Czech language and cultural environment. Methods. The final item list for the questionnaire was developed by combining a variety of methods including translations, parental diaries from 44 caregivers, an expert focus group, and a corpus survey. The preliminary questionnaire was piloted in two rounds, altogether in 95 Czech caregivers and 100 children. Preliminary content was drawn from translations and parental diaries. These items were reduced based on assessment of child-development experts and frequency in four Czech-language corpora. Item analysis was conducted after each of the pilot rounds to remove from the final content words or gestures which were infrequently checked. Conclusions. This process assured that the Czech CDI screens communicative development on items relevant to the Czech linguistic and social landscape. As such, Dovyko I offers a powerful tool to measure communicative development in local children and may also find use in research of children with different developmental and linguistic characteristics. Limitations. The questionnaire is designed as a complement to other existing methods of communicative screening. The tool thus does not serve for final diagnosis but may help indicate an area problematic for the child or motivate further medical, cognitive, or linguistic assessment. The norming, validity, and reliability studies, which have been completed with Czech-speaking families, are not described in this article but separately in the tool’s manual.
Ataxie‐telangiektázie (AT) je autozomálně recesivně děděné onemocnění charakterizované pomalu progredující mozečkovou ataxií, telangiektáziemi a zvýšenou citlivostí k ionizačnímu záření. Často se vyvíjí imunodeficit projevující se opakujícími respiračními infekcemi. Dalšími klinickými projevy může být okulomotorická apraxie nebo extrapyramidové projevy. Pacienti jsou predisponováni ke vzniku hematologických malignit i solidních nádorů. AT je nejčastější příčinou progresivní ataxie u dětí mladších 10 let. Cílem tohoto článku je upozornit na toto onemocnění a poukázat na diagnostiku a možnosti symptomatické terapie. Jako příklad uvádím dvě kazuistiky z našeho oddělení.
Ataxia-telangiectasia (AT) is an autosomal recessively disorder characterized by slowly progressive cerebellar ataxia, telangiectasia and heightended sensitivity to ionizing radiation. The condition often leads to immunodeficiency, presenting as recurrent respiratory infections. Other clinical manifestations may include oculomotor apraxia or extrapyramidal symptoms. Furthermore, patients are predisposed to hematological malignancies and solid tumors. In children under the age of 10, AT represents the most prevalent cause of progressive ataxia. This article aims to raise awareness of AT, providing an overview of its diagnosis and available options for symptomatic therapy. To illustrate these aspects, I present two case reports from our department.
- MeSH
- alfa-fetoproteiny analýza MeSH
- apraxie diagnóza etiologie klasifikace MeSH
- diferenciální diagnóza MeSH
- dítě MeSH
- kazuistiky jako téma MeSH
- lidé MeSH
- mezioborová komunikace MeSH
- motorické poruchy diagnóza etiologie MeSH
- předškolní dítě MeSH
- teleangiektatická ataxie * diagnóza farmakoterapie genetika MeSH
- teleangiektazie diagnóza klasifikace MeSH
- těžká kombinovaná imunodeficience diagnóza etiologie MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- mužské pohlaví MeSH
- předškolní dítě MeSH
- Publikační typ
- přehledy MeSH
Augmentace hlasivek je miniinvazivní fonochirurgický výkon, který se využívá ke zlepšení uzávěru hlasivek při fonaci při fonační insuficienci do 3 mm. Fonační insuficience vzniká nejčastěji při obrně zvratného nervu nebo jako následek úbytku hmoty hlasivky ve vyšším věku (presbyfonie). V článku je prezentována kazuistika pacientky s presbyfonií, u které byla provedena augmentace hlasivek autologním tukem. Cílem je zdůraznit možnost využití augmentace autologním tukem u pacientů s presbyfonií při neúspěšné konzervativní léčbě.
Lipoinjection of vocal cords is a minimally invasive phonosurgical treatment, which is used to increase the volume of vocal cords if the glottal gap is less than 3 mm. Glottic gap is usually caused by paresis of the recurrent laryngeal nerve or as a result of vocal cord muscle atrophy in the elderly (presbyphonia). In this article, a case report of a patient with presbyphonia who underwent lipoinjection of the vocal cords is presented. The aim of this case report is to highlight the use of lipoinjetion of vocal cords in elderly patients with presbyphonia in case of unsuccessful conservative treatment.
- Klíčová slova
- presbyfonie, augmentace hlasivek,
- MeSH
- apraxie diagnóza klasifikace terapie MeSH
- autologní štěp klasifikace transplantace MeSH
- fonace * MeSH
- glottis * chirurgie patologie MeSH
- hlasové řasy chirurgie patologie MeSH
- lidé MeSH
- nervus laryngeus recurrens patologie MeSH
- ochrnutí hlasivek diagnóza klasifikace terapie MeSH
- senioři MeSH
- Check Tag
- lidé MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
- práce podpořená grantem MeSH
Touretteův syndrom (TS) je jednou z nejčastějších neuropsychiatrických poruch dětského věku. Obvyklý věk vzniku příznaků je mezi 5. a 6. rokem věku a naprostá většina případů vznikne do 12 let, až čtyřikrát častěji u chlapců než u dívek. Průběh onemocnění je charakteristicky měnlivý v čase, s exacerbacemi, remisemi a změnami rázu tiků. V dospívání se obvykle tiky zmírňují a výrazné pozdní exacerbace se vyskytují zřídka. Od roku 2020 však prudce vzrostl počet nově vzniklých případů tikové poruchy u adolescentních dívek. Jejich projevy jsou inkongruentní s klasickým obrazem TS a svědčí pro funkční (psychogenní) původ, přičemž vykazují nápadně shodné rysy s videozáznamy šířenými na sociálních sítích. Na případech několika našich pacientek ukazujeme typické projevy onemocnění. Uvádíme koncept masové sociogenní nemoci, popisujeme roli sociálních médií při jejím šíření a uvádíme paralely s historickými hromadnými psychickými jevy.
Tourette syndrome (TS) is one of the most common neuropsychiatric disorders of childhood. The usual age of symptom onset is between the ages of 5 and 6 years, and the vast majority of cases emerge by age 12, up to four times more often in boys than in girls. The course of the disease characteristically varies over time, with exacerbations, remissions, and changes in the tic pattern. In adolescence, the tics usually diminish and marked late exacerbations are rare. However, since 2020, the number of new cases of tic disorder has increased sharply in adolescent girls. Their manifestations are incongruent with the classical presentation of TS and are suggestive of a functional (psychogenic) origin. They show strikingly similar features to videos circulated on social media. We present the typical manifestations of the disease in several of our patients. Using the concept of mass sociogenic illness, we describe the role of social media in its spread and draw parallels with historical mass psychiatric phenomena.
- Klíčová slova
- masová sociogenní nemoc,
- MeSH
- diferenciální diagnóza MeSH
- dítě MeSH
- lidé MeSH
- mladiství MeSH
- pacienti bez organického nálezu MeSH
- sociální média MeSH
- tikové poruchy * diagnóza epidemiologie etiologie prevence a kontrola MeSH
- tiky diagnóza etiologie klasifikace MeSH
- Tourettův syndrom diagnóza epidemiologie etiologie MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- mladiství MeSH
- ženské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
Touretteův syndrom (TS) je jednou z nejčastějších neuropsychiatrických poruch dětského věku. Obvyklý věk vzniku příznaků je mezi 5. a 6. rokem věku a naprostá většina případů vznikne do 12 let, až čtyřikrát častěji u chlapců než u dívek. Průběh onemocnění je charakteristicky měnlivý v čase, s exacerbacemi, remisemi a změnami rázu tiků. V dospívání se obvykle tiky zmírňují a výrazné pozdní exacerbace se vyskytují zřídka. Od roku 2020 však prudce vzrostl počet nově vzniklých případů tikové poruchy u adolescentních dívek. Jejich projevy jsou inkongruentní s klasickým obrazem TS a svědčí pro funkční (psychogenní) původ, přičemž vykazují nápadně shodné rysy s videozáznamy šířenými na sociálních sítích. Na případech několika našich pacientek ukazujeme typické projevy onemocnění. Uvádíme koncept masové sociogenní nemoci, popisujeme roli sociálních médií při jejím šíření a uvádíme paralely s historickými hromadnými psychickými jevy.
Tourette syndrome (TS) is one of the most common neuropsychiatric disorders of childhood. The usual age of symptom onset is between the ages of 5 and 6 years, and the vast majority of cases emerge by age 12, up to four times more often in boys than in girls. The course of the disease characteristically varies over time, with exacerbations, remissions, and changes in the tic pattern. In adolescence, the tics usually diminish and marked late exacerbations are rare. However, since 2020, the number of new cases of tic disorder has increased sharply in adolescent girls. Their manifestations are incongruent with the classical presentation of TS and are suggestive of a functional (psychogenic) origin. They show strikingly similar features to videos circulated on social media. We present the typical manifestations of the disease in several of our patients. Using the concept of mass sociogenic illness, we describe the role of social media in its spread and draw parallels with historical mass psychiatric phenomena.
- MeSH
- antidepresiva terapeutické užití MeSH
- antipsychotika terapeutické užití MeSH
- deprese farmakoterapie MeSH
- lidé MeSH
- mladiství MeSH
- neurologické vyšetření MeSH
- randomizované kontrolované studie jako téma MeSH
- sebepoškozování MeSH
- sociální sítě MeSH
- tikové poruchy * diagnóza etiologie terapie MeSH
- tiky MeSH
- Tourettův syndrom diagnóza etiologie terapie MeSH
- Check Tag
- lidé MeSH
- mladiství MeSH
- ženské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
Fair play as a phenomenon of sporting life is present even if only in the form of small acts or gestures in most competitions; its absence is present in cases of foul play. The daily press comments its presence or absence every day in, and not only in the sports sections. Both the public and experts discuss acts from so called grey zone (forms of gamesmanship). Deciding unequivocally on the moral quality of a diverse range of actions, attitudes or statements requires clarity about the values underpinning fair play. Our aim is therefore to find the constitutive values of fair play by examining a set of values from the field of sport, rel¬evant offerings from fundamental ethics, using Abraham Maslow’s meta-value system and selection from the fundamental values of fair play considered so far. Organizing the selected values into a meaningful system is the final aim. We used a hermeneutic method to interpret the role of values within fair play. We identify five values and five meta-values as constitutive of fair play, the meta-values of goodness, truth, and transcendence as the basis of the entire system. We identify character (of athletes) and ethos (of sports communities) as both initiators of activities within the system and recipients of benefits.
- MeSH
- afázie * psychologie MeSH
- gesta MeSH
- klinická logopedie MeSH
- komunikace MeSH
- lidé MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- recenze MeSH
BACKGROUND: Cogan ́s syndrome is a rare, presumed autoimmune vasculitis of various vessels characterized by interstitial keratitis and vestibular impairment accompanied by sensorineural hearing loss. Due to the rarity of Cogan ́s syndrome in children, therapeutic decision making may be challenging. Therefore, a literature search was performed to collect all published paediatric Cogan ́s syndrome cases with their clinical characteristics, disease course, treatment modalities used and their outcome. The cohort was supplemented with our own patient. MAIN TEXT: Altogether, 55 paediatric Cogan ́s syndrome patients aged median 12 years have been reported so far. These were identified in PubMed with the keywords "Cogan ́s syndrome" and "children" or "childhood". All patients suffered from inflammatory ocular and vestibulo-auditory symptoms. In addition, 32/55 (58%) manifested systemic symptoms with musculoskeletal involvement being the most common with a prevalence of 45%, followed by neurological and skin manifestations. Aortitis was detected in 9/55 (16%). Regarding prognosis, remission in ocular symptoms was attained in 69%, whereas only 32% achieved a significant improvement in auditory function. Mortality was 2/55. Our patient was an 8 year old girl who presented with bilateral uveitis and a history of long standing hearing deficit. She also complained of intermittent vertigo, subfebrile temperatures, abdominal pain with diarrhoea, fatigue and recurrent epistaxis. The diagnosis was supported by bilateral labyrinthitis seen on contrast-enhanced magnetic resonance imaging. Treatment with topical and systemic steroids was started immediately. As the effect on auditory function was only transient, infliximab was added early in the disease course. This led to a remission of ocular and systemic symptoms and a normalization of hearing in the right ear. Her left ear remained deaf and the girl is currently evaluated for a unilateral cochlear implantation. CONCLUSIONS: This study presents an analysis of the largest cohort of paediatric Cogan ́s syndrome patients. Based on the collected data, the first practical guide to a diagnostic work-up and treatment in children with Cogan ́s syndrome is provided.
- MeSH
- apraxie * vrozené MeSH
- Coganův syndrom * komplikace diagnóza terapie MeSH
- dítě MeSH
- keratitida * diagnóza terapie komplikace MeSH
- lidé MeSH
- percepční nedoslýchavost * diagnóza etiologie terapie MeSH
- prognóza MeSH
- progrese nemoci MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
- přehledy MeSH