Autoři předkládají první zkušenosti s novým ošetřovacím dnem následné komplexní intenzivní léčebně rehabilitační péče dětských pacientů s diagnózou dětské mozkové obrny, která má přidělený kód Ministerstvem zdravotnictví 0035. Tato péče je tedy hrazena z prostředků veřejného zdravotního pojištění. Efekt terapie je hodnocen standardizovaným GMFM-88 (gross motor function measure) testem. V souboru bylo hodnoceno celkem 32 dětí s průměrným věkem 8,4 let. Převažovaly děti s III. stupněm psychomotorického postižení dle GMFCS (gross motor function classification system). Efekt terapie probíhající 2× ročně s délkou rehabilitačního pobytu vždy 1 měsíc je statisticky významný nejen v celkovém skóre, ale také v jednotlivých položkách GMFM testu. Zlepšení se týká pohybových dovedností ve všech posturálních polohách. Děti profitují nejen v rovině pohybové, ale i na úrovni rozvoje kognitivních funkcí a v celkovém vývojovém trendu.
The authors present the first experience with the new treatment method – comprehensive intensive medical rehabilitation for children with cerebral palsy which the Ministry of Health designates with the code 00035.This care is therefore covered by public health insurance funds. The effect of the therapy is assessed by the standardized GMFM-88 (gross motor function measure) test. A total of 32 children with an average age of 8.4 years were evaluated in the group. Children with degree III of psychomotor disability according to the GMFCS (gross motor function classification system) predominated. The effect of therapy taking place twice a year with a rehabilitation stay of 1 month is statistically significant, not only in the total score, but also in the individual items of the GMFM test. The improvement therefore concerns movement skills in all postural positions. Children benefit not only on the level of movement, but also on the level of development of cognitive functions and in the overall development trend.
- Klíčová slova
- sanatorium Klimkovice,
- MeSH
- dítě MeSH
- hodnocení výsledků pacienta MeSH
- lidé MeSH
- mladiství MeSH
- mozková obrna * rehabilitace MeSH
- neurorehabilitace metody MeSH
- výsledek terapie MeSH
- zdravotnická zařízení MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- mladiství MeSH
Úvod: Plicní resekce může zapříčinit změny ve funkčním stavu a z toho důvodu také v kvalitě života pacientů, kteří ji podstupují. Aby bylo plánování péče o tyto pacienty efektivní, je potřeba identifikovat oblasti, které si vyžadují zvláštní pozornost. Cíl: Cílem této prospektivní studie bylo porovnat kvalitu života a disabilitu před plicní resekcí a tři měsíce po ní. Metodika: Kvalita života a disabilita byly hodnoceny pomocí standardizovaných nástrojů: Short Form-12 verze 2 a WHO Disability Assessment Schedule 2. Výsledky: Výzkumný vzorek zahrnoval 44 pacientů indikovaných k plicní resekci. Průměrný věk v souboru byl 65,7 let (min. 37, max. 79), 56,8 % představovali muži. Tři měsíce po resekci bylo zjištěno zhoršení kvality života v doménách Fyzické zdraví (p = 0,016) a Bolest (p = 0.044). Došlo také k signifikantní změně celkové úrovně disability (p < 0.001). Signifikantní změny disability byly zjištěny také v doménách Mobilita (p < 0.001), Životní aktivity (p < 0.001) a Účast ve společnosti (p = 0.037). Závěr: Tři měsíce po resekci plic bylo zjištěno statisticky významné zhoršení kvality života a disability ve více doménách. Fyzické zdraví, Bolest, Mobilita, Životní aktivity a Účast ve společnosti byly identifikovány jako oblasti, které při plánování pooperační péče o tyto pacienty vyžadují zvláštní pozornost.
Background: Lung resection can cause changes in patients' functional status, potentially affecting their quality of life. For effective care planning after resection, it is necessary to identify areas of quality of life that require special attention. Objectives: This prospective study aimed to compare the quality of life, health, and disability before lung resection and three months after it. Methods: Quality of life, health, and disability were assessed using standardized tools: Short Form-12 version 2, and WHO Disability Assessment Schedule 2. Results: The research group included 44 patients with a mean age of 65.7 years (min. 37, max. 79) referred for lung resection. Men were more represented in the study group (56.8%) than women. Three months after the surgery, statistically significant deterioration in the quality of life was observed in the domains of Physical functioning (p = 0.016) and Bodily pain (p = 0.044). Where disability was concerned, the overall score also deteriorated (p < 0.001). This was driven predominantly by the domains of Mobility (p < 0.001), Life activities (p < 0.001), and Participation (p = 0.037). Conclusion: The deterioration in the quality of life in multiple domains three months after lung resection is highly significant. The deterioration in the domains Physical functioning and Bodily pain in the quality of life field, and of Mobility, Life activities, and Participation in the health and disability score identifies these areas as those that need special attention when planning post-surgery care for these patients.
- MeSH
- kvalita života * MeSH
- lidé MeSH
- pneumektomie * MeSH
- prospektivní studie MeSH
- Check Tag
- lidé MeSH
OBJECTIVE: This study purposed to evaluate preoperative two tumor markers, namely, carcinoembryonic antigen and carbohydrate antigen (CA)19-9, in colorectal cancer for anatomotopographic location with disease stage and to assess their utility for diagnostic staging purposes. METHODS: The study retrospectively incorporated patients who had undergone surgery for colorectal cancer at our department in 2015-2018 and in whom carcinoembryonic antigen and CA19-9 tumor markers had been preoperatively analyzed. The obtained data were then statistically processed using R-project. RESULTS: A total of 155 patients had been incorporated, of whom 96 (62%) were men and 59 (38%) were women. Rectum was the most common location (74 patients, 48%), and the least represented stage was IV (18, 12%). The marker carcinoembryonic antigen was obtained in all 155 cases, while CA19-9 was in 105. The median carcinoembryonic antigen was 3 (0.34-1104.25), and the median CA19-9 was 12 (0.18-840.00). A significance was recognized between median carcinoembryonic antigen and disease stage (p-value=0.016), with stages I, II, and III (medians 2, 3, and 2) different from stage IV (median 13), while no significance for CA19-9 was recognized (p-value=0.343). No significance between either marker and location (carcinoembryonic antigen: p=0.276; CA19-9: p=0.505) was detected. The testing was performed at a significance level of alpha=0.05. CONCLUSION: This study revealed a significance between the marker carcinoembryonic antigen, but not CA19-9, and the disease stage, while no relationship of either of these markers with tumor location was found. Herewith, the study confirmed that higher carcinoembryonic antigen values may suggest the finding of more advanced forms of colorectal cancer and thus a worse prognosis of this malignant phenomenon.
Background and Objectives: The consequences of stroke have a significant impact on self-sufficiency and health-related quality of life (HRQoL). Virtual reality (VR)-based rehabilitation has the potential to impact these modalities, but information on timing, volume, and intensity is not yet available. The aim of this randomized controlled trial (1:1) was to evaluate the impact of conventional rehabilitation combined with VR on self-care and domains of HRQoL in patients ≤6 months post-stroke. Materials and Methods: The intervention group completed a total of 270 min of conventional VR + rehabilitation sessions. The control group underwent conventional rehabilitation only. Primary assessments with the WHO disability assessment schedule 2.0 (WHODAS 2) questionnaire were conducted before rehabilitation (T0), after completion of the intervention (T1), and at the 4-week follow-up (T2); secondary outcomes included self-sufficiency and balance assessments. Results: Fifty patients completed the study (mean age 61.2 ± 9.0 years, time since stroke 114.3 ± 39.4 days). There were no statistically significant differences between the groups in WHODAS 2, self-sufficiency, and balance scores (p > 0.05). Conclusions: In the experimental group, there was a statistically significant difference in WHODAS 2, assessment of self-sufficiency, and balance scores before and after therapy (p < 0.05). VR appears to be a suitable tool to supplement and modify rehabilitation in patients after stroke.
- MeSH
- cévní mozková příhoda * komplikace terapie MeSH
- kvalita života MeSH
- lidé středního věku MeSH
- lidé MeSH
- pacienti MeSH
- péče o sebe MeSH
- potravní doplňky MeSH
- senioři MeSH
- terapie pomocí virtuální reality * MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- senioři MeSH
- Publikační typ
- časopisecké články MeSH
- randomizované kontrolované studie MeSH
Úvod: Turnerův syndrom (TS) je spojen s řadou jasně definovaných kardiovaskulárních rizik v podobě vrozených srdečních vad a získaných kardiovaskulárních onemocnění. Nejednotné jsou údaje o arytmogenním potenciálu u nositelek TS, především ve výskytu maligních komorových arytmií na podkladě dlouhého intervalu QT. Cílem této práce bylo zhodnocení výskytu abnormalit EKG u pacientek s tímto syndromem. Metodika: Do studie bylo zařazeno 61 dívek a žen s TS, u kterých bylo provedeno kompletní kardiologické vyšetření včetně EKG a holterovské monitorace EKG. Na 12svodovém EKG byla hodnocena délka intervalu PR a QT, při holterovské monitoraci EKG průměrná tepová frekvence (TF) včetně z-score, přítomnost síňové/komorové extrasystolie a jiných arytmií. Interval QT byl korigován dle Bazetta a Hodgese a tyto hodnoty byly porovnány. Analyzována byla závislost parametrů na jednotlivých karyotypech. Výsledky: Medián intervalu PR byl 120 ms (průměr 118,4 ms), krátký interval PR byl identifikován u 13 % (8/61), žádná z pacientek neměla delta vlnu jako obraz preexcitace komor. Absolutní hodnota QT byla v mediánu 340 ms (průměr 336 ms). Interval QTc prodloužený nad 440 ms mělo 5 % (3/61) pacientek při užití korekce dle Bazetta a 3 % (2/61) při korekci dle Hodgese. Hodnota QTc dle Bazetta se významně lišila od QTc dle Hodgese (medián 410 ms, průměr 405 ms vs. medián 390 ms, průměr 390 ms; p < 0,001). Z holterovské monitorace byla TF za 24 hodin v mediánu 92/min (průměr 93,3/min). TF nad +2 z-score se potvrdila u 6,5 % (4/61) případů. U 48 % (29/61) pacientek byla zachycena síňová a u 25 % (15/61) komorová extrasystolie, četnější výskyt byl u monosomie 45,X na rozdíl od ostatních skupin karyotypů. Závažné arytmie nebyly identifikovány. Závěr: EKG změny jsou u nositelek TS srovnatelně četné jako v obecné populaci a jsou klinicky nevýznamné. Riziko maligních arytmií nebylo v této studii prokázáno. Pro hodnocení intervalu QTc u pacientek s TS je pravděpodobně vhodnější metoda dle Hodgese než běžně používaná Bazettova formule.
Introduction: Turner syndrome (TS) is associated with a range of distinct cardiovascular risks such as congenital heart disease and acquired cardiovascular disease. Data on arrhythmogenic potential in TS carriers are inconsistent, especially regarding the occurrence of malignant ventricular arrhythmias due to long QT interval. The aim of this study was to evaluate the prevalence of ECG abnormalities in patients with TS. Methods: 61 girls and women with TS syndrome were included in the study and underwent a cardiac examination including ECG and 24-hour ECG Holter monitoring. The 12-lead ECG was used to assess the length of PR and QT interval, the mean heart rate (HR) including z-score, presence of atrial/ventricular premature beats and other arrhythmias. QT interval was corrected according to Bazett and Hodges formulas, and both values were statistically compared. The relationship of parameters to individual karyotypes was analyzed. Results: Median PR interval was 120 ms (mean 118.4 ms), short PR interval was identified in 13% (8/61), none of the patients had delta wave as a manifestation of ventricular pre-excitation. Median of absolute QT values was 340 ms (mean 336 ms). QTc interval prolonged above 440 ms was observed in 5% (3/61) of patients using Bazett, and 3% (2/61) using Hodges formula. The QTc value according to Bazett significantly differed from the QTc according to Hodges (median 410 ms, mean 405 ms vs. median 390 ms, mean 390 ms; p <0.001). Regarding Holter monitoring, the median 24-hour HR was 92/min (mean 93.3/min). HR above +2 z-score was confirmed in 6.5% (4/61) of cases. Atrial and ventricular premature beats were detected in 48% (29/61) and 25% (15/61) of patients, respectively, with the highest frequency in monosomy 45.X. No clinically relevant arrhythmias were identified. Conclusions: ECG changes in TS individuals are as frequent as in the general population and are clinically insignificant. The increased risk of malignant arrhythmias was not demonstrated in this study. The Hodges formula seems to be more appropriate than the widely used Bazett formula for the evaluation of the QTc interval in TS patients.
- MeSH
- diagnostické techniky kardiovaskulární MeSH
- elektrokardiografie ambulantní metody MeSH
- klinická studie jako téma MeSH
- lidé MeSH
- srdeční arytmie * etiologie MeSH
- syndrom dlouhého QT etiologie etiologie MeSH
- Turnerův syndrom * genetika komplikace patologie MeSH
- vrozené srdeční vady etiologie genetika MeSH
- Check Tag
- lidé MeSH
- ženské pohlaví MeSH
BACKGROUND: Lung carcinoma is one of the most common malignancies worldwide. At present, unfortunately, there are no markers that would allow early identification of this tumor in the preclinical or early clinical stage. The use of sniffer dogs has been reported to show some promise in early diagnosis of this type of cancer Aim: This study aimed to evaluate the possibility of utilizing changes in the heart rate of sniffer dogs (which increases when finding a positive sample) in tumor detection. METHODS: This double-blinded pilot study included two sniffer dogs. A chest strap was fastened on the dog's chests for heart rate monitoring while they were examining samples and heart rate was recorded. Test parameters (sensitivity, specificity, positive and negative predictive values) were then calculated, evaluating performances based on (i) the dog's indications according to their training and (ii) the changes in their heart rates. RESULTS: Calculation according to the dog's indications revealed an overall sensitivity of 95.2% accompanied by a specificity of 81.8%, a PPV of 93.7%, and an NPV of 85.7%, respectively. These results were not significantly different from those evaluated by heart rate; heart rate monitoring was, however, burdened with a relatively high proportion of invalid experiments in which heart rate measurement failed. When the method of calculation was changed from rounds to individual samples, the test parameters further increased. CONCLUSIONS: This pilot study confirmed the hypothesis that heart rate increases in trained sniffer dogs when encountering samples from tumor-positive patients but remains unchanged when only negative samples are present. The reliability of results based on heart rate increase is similar to that obtained by a dog's indications and, if the limitation represented by technical issues is overcome, it could serve as a valuable verification method.
- Publikační typ
- časopisecké články MeSH
- Publikační typ
- abstrakt z konference MeSH
- Publikační typ
- abstrakt z konference MeSH
- Publikační typ
- abstrakt z konference MeSH
- Publikační typ
- abstrakt z konference MeSH
