Východisko. Benigní stenózy velkých dechových cest vznikají nejčastěji u osob s předchozí intubací nebo tracheostomií. Jejich incidence není známá, jsou často pozdě diagnostikované a na jejich léčbu existují ve světě různé názory. S cílem přispět ke zlepšení našich vědomostí o této závažné poruše jsme prospektivně od března 1998 sledovali všechny nemocné, kteří s touto diagnózou prošli oddělením. Metody a výsledky. V souboru 31 nemocných s benigními stenózami nenádorového původu, které jsme diagnostikovali a léčili na oddělení TRN FN Motol v letech 1998–2000, bylo 24 mužů a 7 žen, medián věku byl 52 let. Příčinou stenózy byla u 27 osob intubace, u 4 nemocných byly jiné příčiny stenózy. Po přijetí jsme u 30 nemocných prováděli elektrokauterizaci a dilataci stenózy, jeden nemocný byl odeslán na operaci přímo. Kromě dvou jsme vždy dosáhli dostatečného zprůchodnění stenózy a zvažovali jsme možnost operace. Na ni jsme odeslali 15 nemocných, 10 nemocných jsme trvale vyléčili metodami intervenční bronchoskopie včetně zavedení stentů 6 nemocným. Ze zbylých 6 osob jsou 2 připravováni k resekci stenózy, 4 nemocní jsou inoperabilní z různých důvodů. 2 nemocní zemřeli bez souvislosti se stenózou. Závěry. Na základě zkušeností soudíme, že optimálním postupem u těchto nemocných je po dilataci či odstranění stenózy vždy zvážit resekci trachey. V případě inoperability lze uplatnit metody intervenční bronchoskopie. Autoři doporučují, aby všichni nemocní po intubaci delší než 2 dny byli s odstupem 2 měsíců odesláni na bronchoskopickou kontrolu.

Background. Benign stenoses of main respiratory pathways develop usually in patients after intubation or tracheostomy. Incidence of such states is not known, they are frequently diagnosed too late, and there are different views of their treatment. In order to contribute to the improvement of our knowledge of this serious impairment we followed prospectively all patients with this diagnose at our department since March 1998. Methods andResults. The group of 31 patientswith benign stenoses of non-tumorous origin diagnosed and treated at the TRN of the Teaching Hospital Motol in years 1998 to 2000 consisted of 24 males and 7 females, age median was 52 years. Stenosis was caused in 27 patients by intubation, in 4 patients by some other causes. At admission we performed in 30 patients electrocauterization and dilatation of stenosis, one patient was immediately indicated for surgery. Beside two cases we always achieved sufficient patency of stenosis and weighted indication to surgery. We sent for surgery 15 patients, 10 patients were permanently healed using methods of interventional bronchoscopy, including introduction of stent in 6 cases. From the remaining 6 patients, two of them are planned for resection of stenosis, four are inoperable from various reasons, and two died of causes not related to stenosis. Conclusions. Based on our experience we recommend as an optimal management of such patients is the dilatation or removal of stenosis and then always to consider resection of trachea. In inoperable cases methods of interventional bronchoscopy should be used.Authors recommend sending all patients intubated longer than 2 days for bronchoscopic examination in interval of 2 months.

• MeSH
• Bronchial Diseases diagnosis   etiology   surgery   MeSH
• Bronchoscopy methods   statistics & numerical data   MeSH
• Electrocoagulation methods   statistics & numerical data   MeSH
• Research Support as Topic MeSH
• Intubation, Intratracheal adverse effects   MeSH
• Humans MeSH
• Tracheal Stenosis diagnosis   etiology   surgery   MeSH
• Tracheostomy adverse effects   MeSH
• Check Tag
• Humans MeSH
• Male MeSH
• Female MeSH

• MeSH
• Neuroanatomy MeSH

• Conspectus
• Patologie. Klinická medicína
• NML Fields
• neurovědy
• NML Publication type
• učebnice vysokých škol

Od dubna 1995 jsme na Radiodiagnostické klinice ve Fakultní nemocnici v Brné-Bohunicích zavedli u 15 nemocných s maligní, inoperabilní stenózou žlučových cest krytý Z stent. U 8 nemocných se jednalo o tumor pankreatu, ve 2 případech o tumor žlučníku, u 2 nemocných o tumor žlučových cest, ve 2 případech o tumor žaludku a v 1 případě o metastázy do jaterního hilu. Šířka lumen stentu byla 10 či 12 mm, délka stentu byla 70 - 100 mm. Ve 12 případech jsme stent zavedli po předchozí PTD drenáži. U tří nemocných jsme stent zavedli jednokrokovou technikou. Tři nemocní (20 %) zemřeli do 30 dnů po zavedení stentu. 4 nemocní (26 %) zemřeli za 6 - 31 týdnů po zavedení stentu. V současné době žije 8 nemocných (4 - 11 měsíců po zavedení stentu). Migraci stentu jsme nepozorovali ani v jednom případě. K uzavření stentu došlo u 3 nemocných.

Since April 1995 the authors inserted at the Radiodiagnostic Clinic of the Faculty Hospital in Brno-Bohunice in 15 patients with malignant inoperable stenoses of the biliary pathways a covered Z stent. Eight patients suffered from a pancreatic tumour, two from a tumour of the gallbladder, two from tumours of the biliary pathways, two from gastric tumours and one patient from a secondary in the hilus of the liver. The width of the stent lumen was 10 mm or 12 mm, the length 70 -100 mm. In 12 instances the stent was introduced after previous PTD drainage. In three patients the stent was introduced by a single step technique. Three patients (20 %) died within 30 days after insertion of the stent. Four patients (26 %) died 6 - 31 weeks after introduction of the stent. At present eight patients survive (4 -11 months after introduction of the stent). The authors did not observe migration of the stent in any of the patients. In three patients occlusion of the stent occurred.

• MeSH
• Humans MeSH
• Pancreatic Neoplasms surgery   MeSH
• Gallbladder Neoplasms surgery   MeSH
• Bile Duct Neoplasms surgery   MeSH
• Palliative Care MeSH
• Stents therapeutic use   MeSH
• Jaundice etiology   MeSH
• Bile Ducts pathology   MeSH
• Check Tag
• Humans MeSH

Care pathways are one of the tools to improve patient safety. In Slovenia, the health care system introduced care pathways in 2002. The implementation rate and number of used care pathways are today still low but steadily increasing. Introducing care pathways is a matter of the attitude and beliefs of health care staff, in other words, change clinical (organizational) behavior and culture. In 2006, we wanted to find out about the progress of the implementation of care pathways in Slovenian hospitals after their first introduction in 2002; and the reasons for their slow/fast implementation. For that purpose a survey was conducted to analyze the penetration and use of care pathways. Care pathways were for the first time introduced at the time of the World Bank project "Health Sector Management Project" in 2002. By 2004 only 4 hospitals (out of 25) were using their own care pathways for various types of patients, whereas 3 other hospitals were in the developing stage. In 2005, we found out that the number of hospitals using care pathways increased to 7 and so did the number of care pathways. Care pathways are one of the tools that provide patient safety and improvement of the quality of care in the Slovenian healthcare system. More needs to be done in terms of involving physicians and changing the clinical (organizational) culture. There is a need to introduce more tools such as workshops, regular measurement of implementation, and publication of papers on care pathways so as to help our hospitals.

• Publication type
• Abstracts MeSH

Autoři ve své práci shrnují svoje zkušenosti s léčbou téměř 100 nemocných s maligní či benigní stenózou žlučových cest perkutánně zavedeným kovovým expandibilním stentem. Srovnávají výhody jednotlivých perkutánních postupů a kriticky hodnotí indikace zavedení kovového expandibilního či samoexpandibilního stentu u nemocných s maligní a benigní stenózou žlučovodů.

The authors summarise their experience with the treatment of almost 100 patients with malignant or benign stenosis of the biliary pathways by a percutaneously inserted expansible metal stent. They compare the advantages of different percutaneous procedures and evaluate critically indication for the introduction of an expansible metal stent or self-expansible stent in patients with malignant or benign stenosis of the bile ducts.

• MeSH
• Humans MeSH
• Stents MeSH
• Bile Ducts pathology   MeSH
• Check Tag
• Humans MeSH

Introduction: Diabetes requires a high level of disease management to be executed by the patient himself in order to succeed in treatment and for improving or at least preserving his health status. Aim: The main objective of the presented project is to design and implement a web technology based application framework. It shall provide sufficient means for selfmanagement and enable patient empowerment within the treatment process. Its underlying concept will be outlined in this work. Methods: Common techniques on requirements’ engineering have been applied to derive an initial concept. It is based on a comprehensive state of the art analysis drawn from literature and web search.

• MeSH
• Diabetes Mellitus * therapy   MeSH
• Electronic Health Records MeSH
• Expert Systems * MeSH
• Humans MeSH
• Decision Support Techniques MeSH
• Software Design MeSH
• Self Care MeSH
• Pilot Projects MeSH
• Diffusion of Innovation MeSH
• Telemedicine MeSH
• Knowledge Bases MeSH
• Check Tag
• Humans MeSH
• Publication type
• Research Support, Non-U.S. Gov't MeSH
• Geographicals
• Germany MeSH
• Turkey MeSH

BACKGROUND: Understanding the dimensions of pathways of introduction of alien plants is important for regulating species invasions, but how particular pathways differ in terms of post-invasion success of species they deliver has never been rigorously tested. We asked whether invasion status, distribution and habitat range of 1,007 alien plant species introduced after 1500 A.D. to the Czech Republic differ among four basic pathways of introduction recognized for plants. PRINCIPAL FINDINGS: Pathways introducing alien species deliberately as commodities (direct release into the wild; escape from cultivation) result in easier naturalization and invasion than pathways of unintentional introduction (contaminant of a commodity; stowaway arriving without association with it). The proportion of naturalized and invasive species among all introductions delivered by a particular pathway decreases with a decreasing level of direct assistance from humans associated with that pathway, from release and escape to contaminant and stowaway. However, those species that are introduced via unintentional pathways and become invasive are as widely distributed as deliberately introduced species, and those introduced as contaminants invade an even wider range of seminatural habitats. CONCLUSIONS: Pathways associated with deliberate species introductions with commodities and pathways whereby species are unintentionally introduced are contrasting modes of introductions in terms of invasion success. However, various measures of the outcome of the invasion process, in terms of species' invasion success, need to be considered to accurately evaluate the role of and threat imposed by individual pathways. By employing various measures we show that invasions by unintentionally introduced plant species need to be considered by management as seriously as those introduced by horticulture, because they invade a wide range of seminatural habitats, hence representing even a greater threat to natural areas.

• MeSH
• Time Factors MeSH
• Species Specificity MeSH
• Ecosystem MeSH
• Quantitative Trait, Heritable MeSH
• Linear Models MeSH
• Plants MeSH
• Plant Development MeSH
• Conservation of Natural Resources MeSH
• Introduced Species MeSH
• Agriculture MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH
• Geographicals
• Czech Republic MeSH

INTRODUCTION: The presence of microbial invasion of the amniotic cavity (MIAC) and histological chorioamnionitis (HCA) is associated with adverse neonatal outcomes in pregnancies complicated by preterm prelabor rupture of membranes (pPROM). Therefore, there is an urgent need to identify new biomarkers revealing these conditions. The objective of this study is to identify possible biomarkers and their underlying biofunctions in pPROM pregnancies with and without MIAC and HCA. METHODS: A total of 72 women with pPROM were recruited. Only women with both MIAC and HCA (n = 19) and all women without these complications (n = 19) having the same range of gestational ages at sampling were included in the study. Samples of amniotic fluid were obtained by transabdominal amniocentesis, processed and analyzed using quantitative shotgun proteomics. Ingenuity pathway analysis was used to identify molecular networks that involve altered proteins. RESULTS: Network interaction identified by ingenuity pathway analysis revealed immunological disease and the inflammatory response as the top functions and disease associated with pPROM in the presence of MIAC and HCA. The proteins involved in these pathways were significantly altered between the groups with and without the presence of both MIAC and HCA. Proteins involved included histones H3, H4, H2B, cathelicidin antimicrobial peptide, myeloperoxidase, neutrophil gelatinase-associated lipocalin, matrix metalloproteinase-9, peptidoglycan recognition protein-1 and neutrophil defensin 1, all of which were found to be up-regulated in the presence of MIAC and HCA. CONCLUSION: Bioinformatic analysis of proteomics data allowed us to project likely biomolecular pathology resulting in pPROM complicated by MIAC and HCA. As inflammation is not a homogeneous phenomenon, we provide evidence for oxidative-stress-associated DNA damage and biomarkers of reactive oxygen species generation as factors associated with inflammation and proteolysis.

• MeSH
• Biomarkers metabolism   MeSH
• Chorioamnionitis immunology   metabolism   MeSH
• Adult MeSH
• Histones metabolism   MeSH
• Cohort Studies MeSH
• Humans MeSH
• Inflammation Mediators metabolism   MeSH
• Metabolic Networks and Pathways MeSH
• Young Adult MeSH
• Infant, Newborn MeSH
• Oxidative Stress MeSH
• Fetal Membranes, Premature Rupture immunology   metabolism   MeSH
• Proteomics MeSH
• Case-Control Studies MeSH
• Pregnancy MeSH
• Computational Biology MeSH
• Check Tag
• Adult MeSH
• Humans MeSH
• Young Adult MeSH
• Male MeSH
• Infant, Newborn MeSH
• Pregnancy MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH

• MeSH
• Cell Physiological Phenomena MeSH
• Genomics methods   MeSH
• Metabolism MeSH
• Systems Biology methods   MeSH
• Publication type
• Monograph MeSH

• Conspectus
• Biochemie. Molekulární biologie. Biofyzika
• NML Fields
• biochemie

INTRODUCTION: Anti-amyloid antibodies for the treatment of Alzheimer ́s disease (AD) are currently being evaluated for approval and reimbursement in Europe. An approval brings opportunities, but also challenges to health care systems across Europe. The objective of this position paper is to provide guidance from experts in the field in terms of navigating implementation. METHODS: Members of the European Alzheimer's Disease Consortium and a representative of Alzheimer Europe convened to formulate recommendations covering key areas related to the possible implementation of anti-amyloid antibodies in AD through online discussions and 2 rounds of online voting with an 80% threshold for a position to be accepted. RESULTS: In total, 24 recommendations were developed covering the research landscape and priorities within research in AD following a possible approval, potential impact on health care systems and diagnostic pathways, and communication to patients about anti-amyloid antibodies. Anti-amyloid antibodies are regarded as a substantial innovation with an important clinical impact. In addition, however, new compounds with other mechanisms of action and/or route of administration are also needed. Approval of new treatments will require changes to existing patient pathways and real-world data needs to be generated. CONCLUSION: Comprehensive guidance is provided on the potential implementation of anti-amyloid antibody therapies in Europe following possible approval. Emphasis is placed on the necessity of regularly updating recommendations as new evidence emerges in the coming years.

• MeSH
• Alzheimer Disease * drug therapy   therapy   MeSH
• Amyloid beta-Peptides * immunology   MeSH
• Humans MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Review MeSH
• Geographicals
• Europe MeSH