INTRODUCTION: The exposures to hazardous antineoplastic drugs (AD) represent serious risks for health care personnel but the exposure limits are not commonly established because of the no-threshold effects (genotoxic action, carcinogenicity) of many ADs. In this study, we discussed and derived practically applicable technical guidance values (TGV) suitable for management of AD risks. METHODS: The long-term monitoring of surface contamination by eight ADs was performed in pharmacies and hospitals in the Czech Republic and Slovak Republic in 2008-2021; in total 2,223 unique samples were collected repeatedly in 48 facilities. AD contamination was studied by LC-MS/MS for cyclophosphamide, ifosfamide, methotrexate, irinotecan, paclitaxel, 5-fluorouracil and gemcitabine and by ICP-MS for total Pt as a marker of platinum-based ADs. RESULTS: The study highlighted importance of exposure biomarkers like 5-fluorouracil and especially carcinogenic and persistent cyclophosphamide, which should be by default included in monitoring along with other ADs. Highly contaminated spots like interiors of laminar biological safety cabinets represent a specific issue, where monitoring of contamination does not bring much added value, and prevention of staff and separated cleaning procedures should be priority. Rooms and surfaces in health care facilities that should be virtually free of ADs (e.g., offices, kitchenettes, daily rooms) were contaminated with lower frequency and concentrations but any contamination in these areas should be carefully examined. DISCUSSION AND CONCLUSIONS: For all other working places, i.e., majority of areas in pharmacies and hospitals, where ADs are being prepared, packaged, stored, transported, or administered to patients, the study proposes a generic TGV of 100 pg/cm2. The analysis of long-term monitoring data of multiple ADs showed that the exceedance of one TGV can serve as an indicator and trigger for improvement of working practices contributing thus to minimizing of unintended exposures and creating a safe work environment.

• MeSH
• chromatografie kapalinová MeSH
• cyklofosfamid analýza   MeSH
• fluoruracil analýza   MeSH
• lékárny * MeSH
• lidé MeSH
• nemocnice MeSH
• pracovní expozice * analýza   MeSH
• protinádorové látky * MeSH
• tandemová hmotnostní spektrometrie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika MeSH
• Slovenská republika MeSH

• MeSH
• Betacoronavirus MeSH
• COVID-19 MeSH
• epidemický výskyt choroby MeSH
• osobní ochranné prostředky MeSH

• Konspekt
• Veřejné zdraví a hygiena
• NLK Obory
• veřejné zdravotnictví
• infekční lékařství
• NLK Publikační typ
• publikace WHO

• MeSH
• indukovaný potrat prevence a kontrola   komplikace   MeSH
• mateřská mortalita MeSH

• Konspekt
• Gynekologie. Porodnictví
• NLK Obory
• gynekologie a porodnictví
• gynekologie a porodnictví
• NLK Publikační typ
• publikace WHO

Úvod: Standardní kefalometrické hodnoty jsou z hlediska kefalometrické analýzy telerentgenových snímků využívány při diagnostice ortodontických anomálií, k porovnávání stavu stomatognátního systému pacientů před a po ortodontické terapii a jsou jedním z několika hledisek evaluace úspěšnosti ortodontické či ortodonticko-chirurgické léčby. Termín standardní kefalometrická hodnota vyjadřuje průměrnou hodnotu kefalometrických měření s vypočítanou směrodatnou odchylkou. Nejedná se o absolutní číslo, ale vždy o rozmezí hodnot, jež jsou získány proměřením definovaného vzorku populační skupiny. Materiál a metoda: Vzorek populační skupiny do naší studie byl vybrán z pacientů Dětské stomatologické kliniky FN Motol a Ortodontického oddělení FN Motol. Kritéria pro zařazení do studie byla I. třída podle Anglea, rovnovážný profil obličeje, žádná předchozí ortodontická léčba, absence zubních protetických náhrad včetně dentálních implantátů a z hlediska homogenity studovaného vzorku museli probandi být narozeni na území ČR a spadat do kavkazské populační skupiny. Měření bylo provedeno u celkového počtu 91 probandů, jejichž věkové rozpětí bylo od 18 do 45 let, v počítačovém programu Dolphin Imaging za použití McLaughlinovy kefalometrické analýzy. Soubor byl rozdělen na dvě skupiny podle pohlaví, tzn. 21 mužů a 70 žen. Výsledky a závěr: Z výsledků vyplývá, že kefalometrické hodnoty u populace definované rovnovážným profilem obličeje, I. třídou podle Anglea, neporušenými opěrnými zónami a narozené na našem území mají v parametrech předních zubů dle McLaughlinovy analýzy tendenci ke kompenzačním mechanismům, které pozorujeme u pacientů s II. třídou podle Anglea. Toto podporuje hypotézu, že se v takto definované populační skupině může jednat o variaci zdravé okluze.

Objective: Term standard cephalometric values mean average value of cephalometric measurements which includes standard deviation. This is not an absolute number but the range of values, which were obtained by measuring the defined sample of the population. Material and Methods: The sample of the population in our study group was selected from patients of Charles University, 2nd Medical Faculty, and Department of Orthodontics. Selection criteria were: Class I occlusion, balanced facial profile, no previous orthodontic treatment, absence of denture, including dental implants. From the homogeneity point of view the probands were born in Czech Republic and belong to Caucasian population. 91 patients were evaluated (age range was from 18 to 45 years; 21 men and 70 women) in computer program – Dolphin imaging using McLaughlin cephalometric analysis. Results: The results showed that our patients are in Class I but position of lower frontal teeth is similar to compensatory mechanisms of Class II patients.

• Klíčová slova
• ortodontie, standardní kefalometrická hodnota, kavkazská populace,
• MeSH
• běloši MeSH
• dospělí MeSH
• financování organizované MeSH
• interpretace statistických dat MeSH
• kefalometrie metody   normy   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• ortodoncie MeSH
• populace MeSH
• referenční hodnoty MeSH
• referenční standardy MeSH
• statistika jako téma MeSH
• stomatologie MeSH
• zubní okluze MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH

Cíl práce Studie se zabývá hodnocením výsledků primární chirurgické rekonstrukce rtu a patra u předškolních dětí s celkovým jednostranným rozštěpem. Úspěšnost péče je hodnocena u pětiletých pacientů s celkovým jednestranným rozštepenm v rozštěpovém centru FNKV Praha zhodnocením vztahu zubních oblouků a tzv. „5-letým indexem", jehož výsledky jsou porovnány s jinými rozštěpovými pracovišti. Materiál a metodika: íBylo analyzováno 30 sádrových diagnostických modelů pětiletých pacientů s celkovým jeddnostranným rozštěpem léčených na našem pracovišti a dle vztahu zubních oblouků byl každý pacient zařazen do jedné z pěti kategorií uvedeného indexu. Výsledky: Průměrná hodnota 5-letého indexu byla 3,3. Porovnáním výsledků 5-letého indexu s jinými rozštěpovými centry a zeměmi se rozštěpové pracoviště FNKV řadí na žebříčku úspěšnosti výsledků primární rekonstrukce rtu a patra do spodní třeXiny tabulky. U sledovaného souboru měla časná primární rekonstnjkce rtu do tří měsíců věku větší negativní vliv na vývoj horní čelisti než klasická primární rekonstnjkci rtu provedená později. Ve vyšetřovaném souboru nebyl prokázán negativní vliv chirurgické faryngofixace na vývoj horní čelisti. Celkově větší postižení a růstový deficit horní čelisti lze očekávat, vyskytuje-li se v chmpu větší hloubka skusu a závažnější postižení strany bez rozštěpu. U vyšetřovaného souboru pacieritů byl častý výskyt III. tříd dle Baumea, obrácený skus ve frontálním úseku chrupu a výskyt zkříženého skusu u dočasných špičáků na straně rozštěpu. Závěr: Je důležité kontinuálně pokračovat ve sledování výsledků úspěšnosti nejen primární chirurgické rekonstrukce rtu a patra u pacientů s celkovým jednostranným rozštěpem, ale i dalších operací a ortodontické léčby a hodncotit vztah zubních oblouků u sledovaných souborů pacientů také v dalších letech a jejich pozdějším věku. Dlouhodobé výsledky představují podklady pro úpravy léčebného protokolu specializovaného pracoviště a pro volbu optimálálních pracovních postupů.

Aims: The study evaluates the results of primary surgery of lip and palate in preschool children with complete unilateral cleft lip and palate (UCLP). Success rate is evaluated in five-year old patients with UCLP treated at the centiter of cleft defects University Hospital Královské Vinohrady, Prague by means of assessing the dental arches relationship and the so-called ,,5-year index". The results are compared with those obtained in other cleft centers. Material and methods: We analyzed 30 study models of five-year old patients with complete ULCP treated at our department. According to the dental arches relationship each patient was ranked into one of the five categories of the given index. Results: The mean value of 5-year index was 3.3. In the list of the best results of primary surgery of lip and palate, the comparison of the 5-year index results with other cleft centers and countries put the cleft defects department off FNKV into the lowerthird of the chart. In our sample of patients, the early primary surgery of lip - until 3 months of age - showed greater negative impact on the maxilla development than the classic primary surgery of lip made later. In our sample of patients the negative impact of surgical pharyngofixation on the maxilla development was not proved. More significant defect and maxilla growth deficiency may be expected in case there is deeper bite and more severe impairment of the side without cleft. In the sample of our patients there was frequently Class III according to Baume, reversed bite in the anterior segment of dentition, and crossbite in deciduous canines on the cleft side. Conclusion; It is important to continue monitoring of the success rate not only in primary surgery of lip and palate of patients with UCLP, but in the following inten/entions and orthodontic treatment, and to evaluate the relationship of dental arches in the sample of patients observed in the following years as well as in their older age. Long-term results sen/e as the basis for modifications of the treatment protocol of a specialized department, and they help to choose optimum approaches.

• Klíčová slova
• 5-letý index, celkový jednostranný rozštěp,
• MeSH
• časové faktory MeSH
• čelisti patologie   MeSH
• dítě MeSH
• hodnotící studie jako téma MeSH
• kojenec MeSH
• lidé MeSH
• předškolní dítě MeSH
• rozštěp patra * diagnóza   etiologie   chirurgie   klasifikace   terapie   MeSH
• rozštěp rtu * diagnóza   etiologie   chirurgie   terapie   MeSH
• růst a vývoj fyziologie   MeSH
• statistika jako téma MeSH
• zubní oblouk růst a vývoj   MeSH
• zubní okluze MeSH
• zuby růst a vývoj   MeSH
• Check Tag
• dítě MeSH
• kojenec MeSH
• lidé MeSH
• předškolní dítě MeSH

A comprehensive guide to all practical procedures and technical measures required to ensure the safety of drinking-water supplies in small communities and periurban areas of developing countries. Now in its second edition, the book has been vastly expanded in line with broadened appreciation for the many factors that influence water quality and determine its impact on health. Revisions and additions also reflect considerable new knowledge about the specific technical and social interventions that have the greatest chance of success in situations where resources are scarce and logistic problems are formidable. Since quality controls may be especially difficult to implement in small communities, the book concentrates on the most essential requirements, emphasizing the crucial need to ensure microbiological safety. Details range from advice on how to design simple pictorial reporting forms for sanitary inspections, to guidance on setting priorities for remedial action, from a comparison of different methods for the analysis of coliform bacteria, to drawings of measures for protecting water sources. Throughout numerous checklists, charts, diagrams, and model forms are used to enhance the volume\'s practical value. The book has eight chapters, organized to reflect the key stages in the development of surveillance. Chapter one explains how the basic principles of surveillance and control apply to small-community supplies and alerts readers to several unique problems that need to be overcome. Planning and implementation are discussed in the second chapter, which gives particular attention to the distinct yet complementary responsibilities of the water supply agency and the public health protection agency. Subsequent chapters offer advice on the nature, scope and timing of sanitary inspections, describe the most appropriate methods for sampling water and assessing its hygienic quality, and explain how the resulting data can be used to improve the quality, coverage, quantity, cost, and continuity of the water supply. The most extensive chapter describes and illustrates numerous technical interventions for preventing or correcting hazards associated with water from different sources, procedures for water treatment, and methods used to treat and store water in households. Additional strategies for improvement are covered in the remaining chapters, which outline methods of hygiene education in communities and discuss the important role of legislation and regulation. Further practical guidance is provided in a series of annexes, which give examples of sanitary inspection and hazard scoring forms for 11 different types of water supply, list responsibilities for different categories of surveillance staff, and provide illustrated step-by-step instructions for several sampling methods and analytical tests for use in laboratories and the field.

• MeSH
• mikrobiologie vody MeSH
• monitorování životního prostředí MeSH
• programy národního zdraví MeSH
• rozvojové země MeSH
• zásobování vodou MeSH
• znečištění vody prevence a kontrola   MeSH

• Konspekt
• Veřejné zdraví a hygiena
• NLK Obory
• environmentální vědy
• environmentální vědy
• environmentální vědy
• NLK Publikační typ
• publikace WHO

Intraductal carcinoma of the prostate (IDC-P) has been recently recognized by the World Health Organization classification of prostatic tumors as a distinct entity, most often occurring concurrently with invasive prostatic adenocarcinoma (PCa). Whether documented admixed with PCa or in its rare pure form, numerous studies associate this entity with clinical aggressiveness. Despite increasing clinical experience and requirement of IDC-P documentation in protocols for synoptic reporting, the specifics of its potential contribution to assessment of grade group (GG) and cancer quantitation of PCa in both needle biopsies (NBx) and radical prostatectomy (RP) specimens remain unclear. Moreover, there are no standard guidelines for incorporating basal cell marker immunohistochemistry (IHC) in the diagnosis of IDC-P, either alone or as part of a cocktail with AMACR/racemase. An online survey containing 26 questions regarding diagnosis, reporting practices, and IHC resource utilization, focusing on IDC-P, was undertaken by 42 genitourinary subspecialists from 9 countries. The degree of agreement or disagreement regarding approaches to individual questions was classified as significant majority (>75%), majority (51% to 75%), minority (26% to 50%) and significant minority (≤25%). IDC-P with or without invasive cancer is considered a contraindication for active surveillance by the significant majority (95%) of respondents, although a majority (66%) also agreed that the clinical significance/behavior of IDC-P on NBx or RP with PCa required further study. The majority do not upgrade PCa based on comedonecrosis seen only in the intraductal component in NBx (62%) or RP (69%) specimens. Similarly, recognizable IDC-P with GG1 PCa was not a factor in upgrading in NBx (78%) or RP (71%) specimens. The majority (60%) of respondents include readily recognizable IDC-P in assessment of linear extent of PCa at NBx. A significant majority (78%) would use IHC to confirm or exclude intraductal carcinoma if other biopsies showed no PCa, while 60% would use it to confirm IDC-P with invasive PCa in NBx if it would change the overall GG assignment. Nearly half (48%, a minority) would use IHC to confirm IDC-P for accurate Gleason pattern 4 quantitation. A majority (57%) report the percentage of IDC-P when present, in RP specimens. When obvious Gleason pattern 4 or 5 PCa is present in RP or NBx, IHC is rarely to almost never used to confirm the presence of IDC-P by the significant majority (88% and 90%, respectively). Most genitourinary pathologists consider IDC-P to be an adverse prognostic feature independent of the PCa grade, although recommendations for standardization are needed to guide reporting of IDC-P vis a vis tumor quantitation and final GG assessment. The use of IHC varies widely and is performed for a multitude of indications, although it is used most frequently in scenarios where confirmation of IDC-P would impact the GG assigned. Further study and best practices recommendations are needed to provide guidance with regards to the most appropriate indications for IHC use in scenarios regarding IDC-P.

• MeSH
• biopsie dutou jehlou trendy   MeSH
• duktální karcinom chemie   patologie   terapie   MeSH
• imunohistochemie trendy   MeSH
• lékařská praxe - způsoby provádění trendy   MeSH
• lidé MeSH
• nádorové biomarkery analýza   MeSH
• nádory prostaty chemie   patologie   terapie   MeSH
• prediktivní hodnota testů MeSH
• průzkumy zdravotní péče MeSH
• reprodukovatelnost výsledků MeSH
• specializace trendy   MeSH
• stupeň nádoru MeSH
• zdravotnické zdroje trendy   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH

• MeSH
• bioetika MeSH
• zdraví MeSH

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

Very low or very high concentrations of calcium (Ca) and magnesium (Mg) or total hardness in drinking water have been empirically recognized as the cause of the problems with corrosion, scaling, or taste of water. A large body of scientific evidence over the last 60 years has also attributed health problems to both extremes of these minerals in water. For example, drinking water low in Mg significantly increases the likelihood of cardiovascular mortality. This knowledge is not properly considered in the drinking water quality regulations, especially as more and more water is now produced by desalination disturbing its natural mineral composition. Although the current EU Drinking Water Directive does not include limits for hardness, Ca or Mg, most member states regulate these parameters either through law (12 countries) or technical guidance (7 countries), and several countries have issued educational information for the public. However, the regulations in most countries are not based on current research and not comparable because some provide a recommended range while others provide mandatory minimum or maximum limit values. This summary of the situation in 28 European Union countries is intended to provide information that can contribute to the implementation of the revised EU Directive.

• MeSH
• Evropská unie * MeSH
• hořčík analýza   MeSH
• lidé MeSH
• pitná voda chemie   MeSH
• vápník analýza   MeSH
• zásobování vodou MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

OBJECTIVE: Analysis of the effect of technical factors, i.e. the type of stone targeting and shock wave generator, on ESWL efficacy. Evaluation of secondary outcomes to determine an optimal strategy for performing the procedure. PATIENTS AND METHOD: In the period from 01/2016 to 07/2021, we analyzed data from patients indicated for ESWL for nephrolithiasis and proximal or distal ureterolithiasis. This was a tricenter retrospective study to evaluate stone-free rates (SFR) while taking into account the number of ESWL sessions in four selected groups of patients with comparable characteristics. A patient is considered stone-free in the absence of residual lithiasis or with an asymptomatic residue of up to 2 mm. The real-time ultrasound-guided (USG) arm consisted of a group of 120 patients on the electromagnetic STORZ SLK lithotripter in the period from 02/2017 to 02/2020. A total of three comparison arms with x-ray guidance were created: A: 68 patients between 01/2016 and 03/2017 on the Medilit 7 electrohydraulic lithotripter. B: 72 patients from 04/2017 to 10/2017 on the Sonolith i-sys electroconductive lithotripter (EDAP). C: 120 patients from 03/2018 to 07/2021 on the STORZ SLK electromagnetic lithotripter. By comparing the US and x-ray guidance using the STORZ SLK lithotripter, the effect of targeting when using an identical device (electromagnetic generator) was evaluated. By comparing the arms A, B, and C, the efficacy in different types of generators - electromagnetic, electroconductive, electrohydraulic - was assessed when the same type of targeting (fluoroscopy) was used. The secondary parameters that were monitored included: the rate of use of auxiliary techniques in stone management; radiation exposure for the patient and/or operator; analgesic consumption; and the time required to perform the procedure. RESULTS: When US versus x-ray guidance was compared in an electromagnetic lithotripter, SFRs of 90% vs. 85% (P=0.329), i.e. statistically comparable results, were obtained. By comparing electromagnetic, electroconductive, and electrohydraulic generators with fluoroscopy, SFRs of 85%, 88.9%, and 88.2% were obtained, respectively (P=0.727). When the degree of need for intraoperative analgesic administration was assessed, the electromagnetic generator was found to have a significantly lower consumption (20.8% vs. 30.6% vs. 48.5%) (P=0.0005). Values less than 1095 HU and 108.5 mm were shown to be optimal cut-off values for stone density and skin-to-stone distance, respectively. CONCLUSION: Based on our comparative analysis, the noninferiority of US stone targeting was demonstrated compared to fluoroscopic targeting. No significant differences in ESWL efficacy were found using electrohydraulic, electroconductive or electromagnetic shock wave generators. With the electromagnetic lithotripter, there was a significantly lower analgesic consumption than with the electrohydraulic type.

• MeSH
• analgetika MeSH
• ledvinové kameny * terapie   MeSH
• lidé MeSH
• litotripse * metody   MeSH
• retrospektivní studie MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH