objective estimation
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Úvod: Syndrom karpálního tunelu je nejčastější úžinový syndrom. Jedná se o onemocnění přinášející výrazné zhoršení kvality života s nezanedbatelnými socioekonomickými důsledky. Léčba středně těžkého a těžkého syndromu karpálního tunelu je na prvním místě chirurgická. Metodika: Analyzovali jsme výsledky transcize karpálního vazu u 96 konsekutivních pacientů po 129 operacích. Výkon byl prováděn v lokální anestezii klasickou otevřenou metodou. Sledovali jsme objektivní i subjektivní parametry s odstupem jednoho roku od operace. Výsledky: Ani v jednom případě nedošlo k poškození nervových nebo cévních struktur. Ve 3 % případů došlo k povrchové ranné infekci bez nutnosti revize. Více než 95 % pacientů uvádí trvalé zlepšení subjektivních potíží. Závěr: Transcize karpálního vazu otevřeným přístupem je zlatý standard chirurgické léčby syndromu karpálního tunelu s vysokou úspěšností a minimem komplikací. Celková spokojenost pacientů po operaci přesahuje 97 %.
Introduction: Carpal tunnel syndrome is the most common entrapment neuropathy. It is a cause of serious decrease of quality of life with considerable socioeconomic impact. Treatment of choice in moderate and severe carpal tunnel syndrome is surgery. Methods: Surgical results of 96 consecutive patients after 129 operations were analyzed. Procedure was performed under local anaesthesia with classic open technique. Objective and subjective symptoms were examined at one-year follow-up. Results: Neither neural, nor vascular injury occurred in our series. 3% of patients had superficial wound infection with no need for revision surgery. Over 95% of patients show permanent improvement of subjective complaints. Conclusion: Open carpal tunnel release is a golden standard in surgical treatment of carpal tunnel syndrome with high success rate and minimum complications. Overall satisfaction with procedure is more than 97%.
- MeSH
- lidé středního věku MeSH
- lidé MeSH
- nervus medianus MeSH
- pooperační komplikace MeSH
- statistika jako téma MeSH
- syndrom karpálního tunelu * chirurgie MeSH
- výsledek terapie MeSH
- výsledky a postupy - zhodnocení (zdravotní péče) MeSH
- zápěstí anatomie a histologie chirurgie patofyziologie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Klíčová slova
- moderní gymnastika, změna pohybového obsahu sestav, změny v rámci olympijského cyklu,
- MeSH
- estetika * psychologie MeSH
- gymnastika * dějiny normy trendy MeSH
- krása MeSH
- lidé MeSH
- pohyb fyziologie MeSH
- sporty dějiny normy trendy MeSH
- statistika jako téma MeSH
- tělesná výchova * dějiny metody normy MeSH
- ženskost dějiny MeSH
- Check Tag
- lidé MeSH
Článek pojednává o některých posttranslačních modifikacích proteinů, které jsou, nebo by mohly být významné pro vypracování objektivních a standardních metod stanovení lidského stáří pro potřeby identifikace v soudním lékařství. Z množství posttranslačních modifikací jiných než racemizace kyseliny asparagové se jako perspektivní jeví stanovení pentosidinu – jednoho z produktů neenzymatické glykosylace proteinů. Rozšíření nabídek metod je zvlášť důležité pro kriminalistickou praxi, kdy v mnoha případech je třeba stanovit stáří mrtvoly nezjištěné totožnosti. Morfologické metody jsou často značně subjektivní a tedy zatížené chybou.
This article deals with some of posttranslational modifications of proteins which are, or could be useful to work out objective and standard methods for age estimation in forensic medicine. From many posttranslational modifications other than racemization, the evaluation of pentosidine, one of the products of nonenzymatic glycosylation, seems to be promising. The enlargement of menu of methods for age estimation is important mainly for forensic sciences when determination of the age of an unknown dead body is necessary. Morphological methods are quite often subjective and charged with errors.
BACKGROUND: The reliability of the subjective statements reports on disturbed night sleep and alertness in the daytime was assessed by their correlation to the objective indicators in patients with mild depression. METHOD: Among patients with depression, altogether 28 patients with insomnia were examined. Their answers to typical questions, as they are used during a psychiatric interview, were scored. In parallel, night sleep quality and alertness level in the daytime were objectively estimated by means of polygraphic recording. RESULTS: The subjective statements on the type of insomnia, the estimated time of falling asleep, frequent awakenings and occurrence of disturbing dreams seem to be unreliable. Similarly, the results were disappointing when the patients were asked about alertness disturbances in the daytime. An unexpected finding was the lack of any significant correlation to the scores obtained by means of Epworth's scale. Among the factors possibly influencing the patients' reports, age, sex, coffee intake and also chronic administration of sedatives or hypnotics showed a low correlation with the sleep and alertness indicators. CONCLUSION: The statistical evaluation indicated rather poor agreement between the subjective and objective items. The statistical evaluation suggested that anxiety and depression significantly influence reports on sleep quality and alertness disturbances in the daytime.
- MeSH
- arousal fyziologie MeSH
- bdění fyziologie MeSH
- cirkadiánní rytmus fyziologie MeSH
- depresivní poruchy diagnóza psychologie MeSH
- elektroencefalografie statistika a číselné údaje MeSH
- komorbidita MeSH
- lidé MeSH
- polysomnografie MeSH
- poruchy iniciace a udržování spánku diagnóza MeSH
- poruchy spánku a bdění diagnóza psychologie MeSH
- průzkumy a dotazníky MeSH
- psychiatrické posuzovací škály MeSH
- sny fyziologie MeSH
- spánek fyziologie MeSH
- úzkostné poruchy diagnóza psychologie MeSH
- zdravotní stav MeSH
- Check Tag
- lidé MeSH
Čas je v našom živote všadeprítomný. Hlavným cieľom tejto prehľadovej štúdie je preto prediskutovať tak širší historický kontext, ako aj súčasné empirické zistenia, spájajúce náš zmysel pre čas s kognitívnymi procesmi, obzvlášť exekutívnymi funkciami. V príspevku sa zameriavame na tri mnohokrát postulované jadrové exekutívne funkcie (Miyake, Friedman, Emerson, Witzki, & Howerter, 2000). Okrem toho sa pokúšame reflektovať súčasné metodologické a koncepčné limity a zdôrazniť potenciálny prínos aktuálnej rekonceptualizácie exekutívnych funkcií (Friedman & Miyake, 2017) k problematike. Spomínaná rekonceptualizácia poukazuje pri odhadoch trvania skôr na dôležitosť všeobecného faktoru exekutívnych funkcií než na jednotlivé jadrové exekutívne funkcie. Následne rozpracuvávame otázku, týkajúcu sa toho, akú úlohu môžu hrať v odhadoch trvania vedomé myšlienky v najširšom zmysle slova (Phillips, 2012). Na pozadí uvedeného sa taktiež pokúšame hľadať miesto psychológie v súčasnom interdisciplinárnom kontexte výskumu subjektívneho času.
From waiting for the web-page to load to the estimation of how long have somebody been stuck in a traffic jam, time is a profoundly ubiquitous in our daily life. However, in some instances, a striking difference between objective time and subjective perception of a time can be found. Such discrepancy is studied by a psychology of time. Despite the past decline in interest, in the present, a renaissance of attempts to corroborate this issue can be seen (Hancock & Block, 2012) with interdisciplinary overlap (Block & Zakay, 2001). In spite of the plethora of research avenues that have emerged (Block & Zakay, 2001; Block, Grondin, & Van Rijn, 2014; Grondin, 2010; Mareš, 2010), the main aim of the present review is to discuss one specific line of research - time estimation in the context of cognitive load. Therefore, the ample body of evidence connecting estimation of subjective time to the metaphorical „internal clock“ and its further relation to cognitive processes, especially, executive functions, is discussed. In the beginning, selected task dedicated for time estimation (time reproduction, time production, method of comparison and verbal estimation) and their variants; the time scale (short vs. long intervals) and related differences between time perception and time estimation; as well as paradigm of estimation - retrospective timing (estimating passing of a time from memory) and prospective timing (experiencing the passage of time) are depicted in relation to cognitive factors. Likewise, the way in which time is coded in our brain (dedicated and intrinsic models); specific neural correlates of the processing of time (e. g. prefrontal cortex; basal ganglia, cerebellum); as well as selected influential psychological models are further analyzed in the context of the broader role of cognitive factors. Specifically, variety of models are discussed (from Piéron´s approach; Francois´s corroboration; Hoagland´s & Treisman´s models; and Scalar expectancy theory to Attentional gate model and its recent modification, Executive gate model). Consequently, in the context of recently emerged body of evidence related to the role of cognitive factors in the time estimation (e.g. Bartholomew, Meck, & Cirulli, 2015; Block, Hancock, & Zakay, 2010; Brown, Collier, & Night, 2013; Brown, Johnson, Sohl, & Dumas, 2015; Fortin, Schweickert, Gaudreault, & Viau-Quesnel, 2010; Lovaš & Kačmár, 2016; Mioni, Stablum, Mcclintock, & Grondin, 2014; Ogden, Salominaite, Jones, Fisk, & Montgomery, 2011; Ogden, Wearden, & Montgomery, 2014; Radua, Pozo, Gómez, Guillen- Grima, & Ortuno, 2015; Viau-Quesnel & Fortin, 2014; Zakay & Block, 2004), the role of executive functions (Diamond, 2013) in human prospective timing is analyzed. Specifically, the role three often postulated core executive functions (Shifting, Inhibition, and Updating; Miyake, Friedman, Emerson, Witzki, & Howerter, 2000); as well as their common factor in the more recent reconceptualization of executive functions (Friedman & Miyake, 2017) are further evaluated. Crucially, our analysis points out to the prominent role of a common executive factor (Friedman & Miyake, 2017) in human prospective timing and implications that can be derived. Such pattern of results is further corroborated and a call for a reevaluation of classical internal clock models is stressed. Moreover, one reconceptualization of internal clock on the psychological level of analysis is proposed and the role of conscious thoughts in prospective time estimation, as proposed by Phillips (2012), is discussed.
- MeSH
- cirkadiánní hodiny MeSH
- cirkadiánní rytmus MeSH
- lidé MeSH
- vnímání času * MeSH
- Check Tag
- lidé MeSH
Smoking is a modifiable behaviour that may hasten the progression of chronic kidney disease (CKD). Cotinine, a nicotine metabolite, is measurable in body fluids, including urine, and can be utilized as an objective measure of smoking exposure. Its use has not been examined in the CKD population. METHODS: In this cross-sectional study, we evaluated use of 24-h urinary cotinine excretion (Ucot) as a quantitative index of smoking exposure in a CKD population. Methods of comparison included self-report and expired air carbon monoxide (eCO) as standard measures of smoking exposure. Assessments of kidney function included estimated glomerular filtration rate (eGFR) and 24-h urinary protein (Uprot) excretion. RESULTS: Sixty-one patients were enrolled, of whom 12 were excluded for incomplete urine collections. Of the remaining, 77% were active current smokers (mean cigarettes smoked: 12+/-7 per day). The mean eGFR was 47+/-25 ml/min/1.73 m2 with no significant differences among non-smokers. The mean eCO and Ucot were significantly higher in smokers vs non-smokers (12.5+/-6.9 ppm and 1.3+/-1.1 ppm and 1685.87+/-922.77 microg/d and 134.18+/-445.03 microg/d, respectively, P<0.001 for both). Ucot was weakly correlated with eGFR (R=0.40, P=0.005), but not with Uprot (R=0.09, P=0.54). In multivariate analyses, daily cigarette consumption and eCO were the only significant predictors of Ucot (P<0.05 for both). CONCLUSION: In this CKD cohort, Ucot is correlated with commonly used measures of smoking exposure and is minimally influenced by underlying renal function, demonstrating its potential utility in clinical trials examining change in smoking behaviour and effects on renal injury.
- MeSH
- chronická nemoc MeSH
- cirkadiánní rytmus MeSH
- dechové testy MeSH
- hodnoty glomerulární filtrace MeSH
- kohortové studie MeSH
- kotinin moč MeSH
- kouření MeSH
- lidé středního věku MeSH
- lidé MeSH
- multivariační analýza MeSH
- nemoci ledvin moč patofyziologie MeSH
- průřezové studie MeSH
- průzkumy a dotazníky MeSH
- senioři MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
BACKGROUND: To assign a course of secondary progressive multiple sclerosis (MS) (SPMS) may be difficult and the proportion of persons with SPMS varies between reports. An objective method for disease course classification may give a better estimation of the relative proportions of relapsing-remitting MS (RRMS) and SPMS and may identify situations where SPMS is under reported. MATERIALS AND METHODS: Data were obtained for 61,900 MS patients from MS registries in the Czech Republic, Denmark, Germany, Sweden, and the United Kingdom (UK), including date of birth, sex, SP conversion year, visits with an Expanded Disability Status Scale (EDSS) score, MS onset and diagnosis date, relapses, and disease-modifying treatment (DMT) use. We included RRMS or SPMS patients with at least one visit between January 2017 and December 2019 if ≥ 18 years of age. We applied three objective methods: A set of SPMS clinical trial inclusion criteria ("EXPAND criteria") modified for a real-world evidence setting, a modified version of the MSBase algorithm, and a decision tree-based algorithm recently published. RESULTS: The clinically assigned proportion of SPMS varied from 8.7% (Czechia) to 34.3% (UK). Objective classifiers estimated the proportion of SPMS from 15.1% (Germany by the EXPAND criteria) to 58.0% (UK by the decision tree method). Due to different requirements of number of EDSS scores, classifiers varied in the proportion they were able to classify; from 18% (UK by the MSBase algorithm) to 100% (the decision tree algorithm for all registries). Objectively classified SPMS patients were older, converted to SPMS later, had higher EDSS at index date and higher EDSS at conversion. More objectively classified SPMS were on DMTs compared to the clinically assigned. CONCLUSION: SPMS appears to be systematically underdiagnosed in MS registries. Reclassified patients were more commonly on DMTs.
- Publikační typ
- časopisecké články MeSH
In this paper, we analyse the effect of an onset of a health shock on subjective survival probability and compare it with objective survival probability and self-reported health measures. In particular, we are interested in whether expectations of people respond to health shocks and whether these follow the evolution of objective life expectations and self-reported health measures over time. Using longitudinal data from the Health and Retirement Study, we estimate fixed effects models of adaptation for the objective and subjective survival probabilities and for some self-reported health measures. The results show that after cancer diagnosis, conditional on surviving, both the objective and subjective longevity and self-reported health measures drift back to the before diagnosis trajectories. For stroke and heart attack, in spite of their persistent negative effect on survival, subjective life expectations and self-reported health measures seem to indicate only a transient effect of the health shock. The differences between the objective and subjective measures are in line with the concept of adaptation. We discuss the policy implications of our results.
- MeSH
- diagnostické sebehodnocení * MeSH
- dlouhověkost * MeSH
- lidé středního věku MeSH
- lidé MeSH
- longitudinální studie MeSH
- naděje dožití trendy MeSH
- přežívající onkologičtí pacienti statistika a číselné údaje MeSH
- průzkumy a dotazníky MeSH
- senioři MeSH
- věkové faktory MeSH
- zdravé chování * MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
Cíl studie: Autoři popisují velice dobré zkušenosti s rutinním stanovením aktivního vitaminu B12 – holotranskobalaminu (HTC) u pacientů odeslaných do metabolické ambulance Nemocnice na Homolce za posledních 5 let. Pacienti a metody: Za rok navštíví ambulanci zhruba 1000 dospělých i dětských pacientů s metabolickými poruchami, u kterých je diferenciálnědiagnosticky indikováno vyšetření HTC a stanoveno metodikou MEIA AxSym Active B-12 Assay (Abbott). Výsledky: Deficit HTC nacházíme kromě makrocytární anémie také u pacientů s nepoznanými neuropsychiatrickými, gastrointestinálními, srdečními a perikoncepčními problémy. Zřetelný deficit HTC je také prokazován při mozkových příhodách, infarktech myokardu, emboliích plícnice, trombóz, tromboembolií, typických i atypických perniciózních anémií, u mentálního opoždění a kognitivních poruch, u žen trpících dysfertilitou aj. Vybrané kazuistiky jsou stručně dokumentovány a dokazují, že správná diagnóza byla možná jen díky zavedení tohoto vyšetření do rutinního provozu laboratoře. Závěr: Autoři doporučují vyšetření HTC u shora uvedených klinických symptomů, protože spolu se stanovením metylmalonátu a homocysteinu dokáže snížená hladina HTC překvapivě objasnit vyvolávající příčinu mnoha různorodých nálezů a určit tu správnou diagnózu či pochopit neočekávané komplikace.
Objective: Authors are commenting very good experience with routinely use of holotranscobalamin (HTC) in patients attending the metabolic surgery of Hospital Homolka within last 5 yrs. Patients and Method: Among 1000 adult or children patients attending yearly the metabolic surgery the typical cases of HTC deficiency were detected in patients with unexplained neurological, psychiatric, gastroenterological, cardiologic, obstetric, nutritional and metabolic symptoms. The MEIA AxSym Active B-12 Assay (Abbott) method was introduced in routine laboratory use instead of total vitamin B-12 estimation. Results: Typical clinical cases of patients suffering from heart attacks, pulmonary embolism, typical or atypical pernicious anemias as well as in patients with deep vein thrombosis, thromboembolism, in patients with neuronal and perception disorders, in females suffering from fertility disorders are presented in details. All these patients were detected only thanks to introducing of very efficient method for HTC estimation in the routine use in clinical chemical laboratory. Conclusion: In many typical or atypical clinical cases of known or unknown origin, the estimation of active form of vitamin B-12-HTC together with methylmalonic acid and total homocysteine could be very helpful to find the reason for corresponding diagnosis or complications.
- Klíčová slova
- deficit vitaminu B12, kobalamin, aktivní vitamin B12,
- MeSH
- hyperhomocysteinemie diagnóza komplikace krev MeSH
- lidé MeSH
- nedostatek vitaminu B12 etiologie krev metabolismus MeSH
- rizikové faktory MeSH
- transkobalaminy analýza genetika metabolismus MeSH
- vitamin B 12 analogy a deriváty aplikace a dávkování metabolismus MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- kazuistiky MeSH