13 sv.
- MeSH
- Drug and Narcotic Control statistics & numerical data MeSH
- Blood Banks economics statistics & numerical data MeSH
- Drug Utilization economics MeSH
- Equipment and Supplies economics statistics & numerical data MeSH
- Publication type
- Periodical MeSH
- Conspectus
- Demografie. Populace
- NML Fields
- ekonomie, ekonomika, ekonomika zdravotnictví
- management, organizace a řízení zdravotnictví
- NML Publication type
- ročenky
BACKGROUND: Klebsiella pneumoniae belongs to important nosocomial pathogens causing mainly hospital-acquired infections. Beta-lactam antibiotics are frequently used in the treatment of infections caused by K. pneumoniae, but by their selection pressure the bacteria become resistant. Excessive use of third-generation cephalosporins is a risk factor for the occurrence and spread of ESBL-producing bacterial strains. The goal of this study was to describe the utilization of third-generation cephalosporins and to analyse their selection pressure on K. pneumoniae in the University Hospital in Olomouc. METHODS: Data on the utilization of antibiotics in the hospital were obtained for the period 1997-2005 from the computerized database and expressed in defined daily doses per 100 bed-days (DBD). The data were processed according to the ATC/DDD system. Klebsiella pneumoniae strains were isolated from clinical material obtained from hospitalized patients. RESULTS: Consumption of third-generation cephalosporins, which was 1.79 DBD in 1997, decreased to 0.93 in 1999, remained stable until 2002, and then increased to 2.40 DBD in 2005. During the 9-year period analysed, a total of 9564 strains of K. pneumoniae were isolated. The ESBL-positive K. pneumoniae strains frequency increased from 8% to 18%. CONCLUSIONS: Increasing utilization of third-generation cephalosporins was associated with a statistically and clinically significant increased incidence of ESBL-positive K. pneumoniae strains.
- MeSH
- beta-Lactamases analysis metabolism MeSH
- beta-Lactam Resistance MeSH
- Cephalosporins administration & dosage therapeutic use MeSH
- Databases, Factual MeSH
- Financing, Organized MeSH
- Drug Utilization Review MeSH
- Klebsiella Infections drug therapy microbiology MeSH
- Cross Infection microbiology MeSH
- Klebsiella pneumoniae drug effects MeSH
- Humans MeSH
- Microbial Sensitivity Tests MeSH
- Hospitals, University MeSH
- Retrospective Studies MeSH
- Check Tag
- Humans MeSH
- Geographicals
- Czech Republic MeSH
OBJECTIVE: Oral lichen planus (OLP) is one of the commonest diseases of the oral mucosa. The etiology of the disease is unknown. Our goal was to determine frequencies of functionally important alleles which determine the metabolic rate (phenotype) of individuals with OLP and to compare drug utilization, with focus on CYP2D6, with that of a control group. MATERIAL AND METHODS: The study population consisted of 46 patients with OLP, 60 sex- and age-matched control subjects for drug utilization evaluation and 223 healthy non-medicated controls for genotype comparison. DNA analysis was done using polymerase chain reaction and restriction fragment length polymorphism. The gene CYP2D6 was analyzed for the alleles CYP2D6*3,*4,*5,*6 and gene duplication. Drug utilization was evaluated according to Anatomical Therapeutic Chemical code, liver drug metabolism pathway and mono- or polytherapy. RESULTS: Intake of drugs was significantly higher in the group of OLP patients in comparison with control subjects. The use of CYP2D6 substrates, inhibitors or inducers did not differ between OLP patients and controls. Predicted phenotype frequencies in OLP patients and healthy controls, respectively were as follows: ultrarapid metabolizers 2% and 5.8%, extensive metabolizers 52% and 49.8%, intermediate metabolizers 39% and 37.7% and poor metabolizers 7% and 6.7%. CONCLUSIONS: We did not find a statistically significant difference in the frequency of CYP2D6 alleles between OLP patients and healthy controls. OLP patients used more medication than age- and sex-matched controls.
- MeSH
- Alleles MeSH
- Cytochrome P-450 CYP2D6 genetics metabolism MeSH
- Gene Duplication MeSH
- Liver enzymology MeSH
- Lichen Planus, Oral enzymology genetics pathology MeSH
- Humans MeSH
- Polymerase Chain Reaction MeSH
- Polymorphism, Restriction Fragment Length MeSH
- Polypharmacy MeSH
- Aged MeSH
- Drug Utilization MeSH
- Case-Control Studies MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
Infertility is a relevant late-effect following cancer treatment; yet, a large proportion of survivors cannot recall having been informed of this risk. In an intervention study, we examined if and how supportive patient information material on fertility/fertility-preserving measures influences utilization of cryopreservation in adolescent cancer patients. The control group, recruited 03/2014-01/2016, received the usual patient education at initial diagnosis. The intervention group, recruited 04/2016-10/2017, received patient education supported by a fertility flyer and brochure. Patients and parents were each asked questions on utilization of cryopreservation in a questionnaire 3 and 6 months after initial diagnosis. Patient core and therapy data were obtained from medical records. Overall, cryopreservation rates showed no significant difference between the control (32.7%, n = 37/113) and intervention group (36.6%, n = 37/101). In the control group, cryopreservation was associated with gender (OR 0.100, CI 0.023-0.427), age (OR 1.559, CI 1.077-2.258) and recalling information on fertility protection (OR 33.663, CI 2.100-539.574); in the intervention group, cryopreservation was related to gender (OR 0.093, CI 0.026-0.330) and the estimated infertility risk (OR 43.665, CI 2.157-883.974).Conclusion: Cryopreservation rates did not overall increase following the intervention; however, the individual risk seemed to be brought into attention more: Those at risk, including younger patients, cryopreserved at higher rates.What is Known:•Infertility is a relevant late-effect following adolescent cancer.•Guidelines recommend to offer fertility protection before cancer treatment.•A relevant proportion of adolescents with cancer are not aware of this risk.•Fertility protection seems under-used in cancer patients at risk for infertility.What is New:•Information material on fertility and protection in adolescents did not increase overall rates of cryopreservation.•Cryopreservation rates were improved according to individual risk for infertility.•Our flyers and brochures on fertility in cancer patients are available in various languages.
- MeSH
- Outcome Assessment, Health Care MeSH
- Cryopreservation * statistics & numerical data MeSH
- Humans MeSH
- Adolescent MeSH
- Young Adult MeSH
- Neoplasms psychology therapy MeSH
- Follow-Up Studies MeSH
- Patient Acceptance of Health Care * psychology statistics & numerical data MeSH
- Risk MeSH
- Patient Education as Topic methods MeSH
- Fertility Preservation * psychology statistics & numerical data MeSH
- Germ Cells * MeSH
- Check Tag
- Humans MeSH
- Adolescent MeSH
- Young Adult MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Clinical Trial MeSH
- Geographicals
- Europe MeSH
Cíl studie: Přezkoumání prediktivní role vaginální ultrasonografie v diagnostice karcinomu děložního těla porovnáním vaginálního sonografického nálezu (prostřednictvím EMI – endometrium/myometrium index) s příslušným histopatologickým nálezem. Typ studie: Klinická prospektivní studie. Název a sídlo: Gynekologicko-porodnická klinika, LF MU a FN Brno. Metodika: Do studie bylo zařazeno 200 pacientek – první skupinu tvořily pacientky symptomatické (nepravidelné krvácení v pre- a perimenopauze, postmenopauzální krvácení), druhou skupinou byly pacientky asymptomatické, ale se suspektním ultrasonografickým nálezem (tj. suspektní nebo pozitivní hodnotou EMI). Každá pacientka podstoupila ultrasonografické vyšetření se stanovením EMI a následně separovanou abrazi nebo diagnostickou hysteroskopii s cíleným odběrem materiálu. Stanovenou hodnotu EMI jsme pak srovnávali s výsledkem histopatologického vyšetření. Výsledky: Na základě výsledků naší studie jsme potvrdili využitelnost vaginální ultrasonografie jako prebioptické metody v diagnostice karcinomu endometria prostřednictvím EMI. Senzitivitu metody však snižují další patologie dělohy (zejména přítomnost myomatózy), která způsobuje falešnou negativitu EMI v souvislosti se zvětšením celkové tloušťky dělohy v oblasti těla dělohy. Závěr: Vysokou senzitivitu výše uvedeného indexu lze očekávat u pacientek s patologiemi endometria, u nichž je současně při ultrasonografii verifikována hladce konturovaná děloha bez přítomnosti myomatózy. Zvláštního významu nabývá toto vyšetření jako prebioptická a současně preventivní metoda včasného záchytu onemocnění u asymptomatických pacientek, u kterých jsou přítomny jeden nebo více rizikových faktorů pro vznik karcinomu děložního těla.
Objective: The verification of the predicive part of the vaginal ultrasonography in diagnostics of cancer of endometrium with the help of comparison of vaginal sonography finding (through the mediation EMI – endometrium/myometrium index) with relevant histological results. Design: Clinical prospective study. Setting: Department of Gynaecology and Obstetrics, Faculty of Medicine, Masaryk University and Faculty Hospital, Brno. Methods: In this work we included 200 patients – on one hand the patients with the symptoms (pre- and perimenopauzal irregular bleeding and postmenopauzal bleeding), on the other hand the patients without symptoms, but with the suspicious ultrasonography find (suspicious or positive EMI). Each of the patients included in this study underwent the ultrasonography examination witch determined EMI and then the endometrial biopsy or the diagnostic hysteroscopy with sampling the material. The determined value EMI was compared with the histological result. Results: On the basis of the results of this work we found out the possibility utilization of the vaginal ultrasonography as the prebioptic method in diagnostics cancer of endometrium through the mediation of determined EMI. The sensitivity of the method, however, is lowered by the next diseases of uterus (especially uterine myoma) that cause wrong negativity of EMI with connection with increased thickness of uterus in the region body of uterus. Conclusion: We can expect a high sensitivity of EMI in patients with diseases of endometrium, if there is by ultrasonography examination verified uterus with smooth border without uterine myoma. This examination acquires a special significance as the pre-bioptic and along with the preventive method the timely catch first of all in patients without symptoms, but with one or more risk factors for rise to cancer of endometrium.
Pseudomonas aeruginosa is one of the most frequent and dangerous pathogens involved in the etiology of severe nosocomial infections. A retrospective observational study was conducted at all intensive care units of the University Hospital in Olomouc, Czech Republic (155 ICU beds). Complete antibiotic utilization data of the ICUs in the period of 1999 to 2008 were processed according to ATC/DDD system and expressed in defined daily doses per 100 bed-days (DBD). Utilization of meropenem, imipenem, ciprofloxacin, ofloxacin, pefloxacin, gentamicin, amikacin, ceftazidime, cefoperazone, cefoperazone/sulbactam and piperacillin/tazobactam was measured. Pseudomonas aeruginosa strains were isolated from clinical material obtained from patients hospitalized in ICUs. During the ten-year period, utilization of the entire group of antibiotics monitored grew. It increased from 23.52 DBD in 1999 to 27.48 DBD in 2008 with a peak of 33.04 DBD in 2007. P. aeruginosa accounted for as much as 42% of pneumonias and 23% of surgical wound infections. Our results show that P. aeruginosa strains became gradually resistant to all antibiotics used in the treatment of the infections caused by them, with the exception of amikacin and piperacillin/tazobactam.
- MeSH
- Amikacin pharmacology MeSH
- Anti-Bacterial Agents pharmacology MeSH
- Cefoperazone pharmacology MeSH
- Ceftazidime pharmacology MeSH
- Ciprofloxacin pharmacology MeSH
- Gentamicins pharmacology MeSH
- Intensive Care Units MeSH
- Penicillanic Acid analogs & derivatives pharmacology MeSH
- Microbial Sensitivity Tests MeSH
- Drug Resistance, Multiple, Bacterial MeSH
- Piperacillin pharmacology MeSH
- Pseudomonas aeruginosa drug effects MeSH
- Sulbactam pharmacology MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Geographicals
- Czech Republic MeSH
The article presents a review of current situation in the the production of vegetable oils (triacylglycerols) and their use for food products and as a raw material in chemical industry. Most vegetable oils are used as edible oil and margarine) and only a small part (ca. 14 %) are used in the chemical industry (e.g. for production methyl esters), surfactants and a very small part in cosmetics and pharmaceuticals. Other possibilities of using vegetable oils are their hydrogenation and hydrogenolysis to alkanes or pyrolysis to low alkenes (ethylene) and aromatics.
