OBJECTIVES: Structural chromosomal aberrations in blood lymphocytes represent a biomarker for cellular damage caused by genotoxic carcinogens and are an indicator of increased cancer risk. We evaluated the association between frequencies of total chromosomal aberrations, chromatid- and chromosome-type aberrations, and occupational exposures to volatile anesthetics, antineoplastic agents, and formaldehyde among 601 medical professionals. METHODS: Chromosomal damage among exposed individuals and unexposed controls was determined by conventional cytogenetic analysis. We used binary logistic regression to evaluate the effects of workplace exposures and major confounders on chromosomal damage. RESULTS: Significantly higher frequencies of total chromosomal, chromatid-type and chromosome-type aberrations were observed among subjects occupationally exposed to volatile anesthetics, antineoplastic agents, and formaldehyde compared to age- and sex-matched controls (P<0.0001). The risk of an increased frequency of chromosomal aberrations was associated with exposure to anesthetics [odds ratio (OR) 3.9, 95% confidence interval (95% CI) 2.7-5.8], cytostatics (OR 2.7, 95% CI 1.9-3.9), and formaldehyde (OR 1.7, 95% CI 1.1-2.7). No other covariate contributed significantly to the model. Chromatid- and chromosome-type aberrations were associated with exposure to anesthetics and cytostatics without any contribution of other variables. Stratified data analysis showed the risk of increased chromosomal aberrations among non-smoking female nurses and physicians exposed to anesthetics, cytostatics and, partially, formaldehyde. Chromatid and chromosome exchanges were significantly higher in the exposed groups than among controls. CONCLUSION: Our findings indicate that the presence of genotoxic compounds in operating rooms, oncological units, and pathological departments results in a significant increase of chromosomal damage (impair of chromosomal integrity) among medical workers employed in these facilities.
- MeSH
- anestetika inhalační toxicita MeSH
- antitumorózní látky toxicita MeSH
- chromozomální aberace * MeSH
- dospělí MeSH
- formaldehyd toxicita MeSH
- lidé středního věku MeSH
- lidé MeSH
- mutageny toxicita MeSH
- pracovní expozice * MeSH
- studie případů a kontrol MeSH
- volatilizace MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Slovenská republika MeSH
This paper provides a summary of up-to-date information and experience with the combined treatment of patients suffering from peripheral arterial disease (PAD) with endovascular and open surgery, performed simultaneously and in a single operating room. Hybrid intervention is reported to have good results in well-indicated groups of patients with acute and chronic limb ischemia, even with older, high-risk patients. The indications for the use of this technique remain unclear with inconsistent opinions among vascular surgeons. The indications for treatment were divided into three main groups: 1) Patients with chronic limb ischemia, 2) acute limb ischemia, and 3) occlusion of a previous vascular reconstruction. The operating techniques for the most commonly used combinations are described. In conclusion, hybrid operating techniques are often useful when treating complex problems and multilevel disease in patients with chronic or acute lower limb ischemia. Modern vascular surgeons need to master both open and endovascular techniques, and to combine them in a creative fashion to the benefit of our patients.
- MeSH
- akutní nemoc MeSH
- chronická nemoc MeSH
- endovaskulární výkony metody MeSH
- lidé MeSH
- onemocnění periferních arterií chirurgie MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
National Medical Library (NML) operates MEDVIK system, a centralized library management system for medical libraries in Czech Republic. MEDVIK system environment with its strong technological infrastructure and WWW portal (www.medvik.cz) have created extensive opportunities to innovate NML provided information services. This paper describes key issues that have been implemented or NML has been working on. MEDVIK shared database serves either as the union catalogue of periodicals (UCP). The flexible database structures have been modified to enable new model of collaboration with participating libraries - online update of UCP holdings data via MEDVIK Portal sub-module. This effort led to important data consolidation which now allows precise searching for titles or owner library by available years. NML plan to implement new e-resources management system in first quarter 2008, which is intended to interoperate with MEDVIK as closely as possible to serve our users with accurate availability information and access to both traditional and electronic resources. ERM system interface will be incorporated into MEDVIK Portal. NML produces Czech National Medical Bibliography (BMC), a bibliographic database of Czech medical literature. Current production has been already processed in MEDVIK system and there are several backfiles that will be converted by the end of this year. Total number of BMC records approximates 500 thousands and there will be more older records added retrospectively back to 1946. BMC records have been indexed with MeSH descriptors. Abstracts and links to fulltext have been added where available. BMC will be made accessible through MEDVIK Portal. Recently, efforts have been made to promote cooperation with Czech journal publishers to find ways how to provide persistent linking, fulltext archiving and possibly to automate basic metadata input into BMC database. NML is going to conduct a review of available digital archiving tools and to implement a digital repository. The intention is that the repository shall serve as Czech health information archive for published documents and non-published materials as well. NML plan to gradually digitize older endangered journal volumes to be stored in the repository. NML believes that MEDVIK Portal providing access to BMC linked with consistent union catalogue holdings and ERM, backed up with the digital repository of journal articles and other important content shall become the unique discovery resource for all interested medical information users.
The authors presents procedures of problem solving at searching of answers to the question what is value of Library Information Services (LIS) in the Czech medical libraries (library and information services for the hospital and academic health science centre). Working group (Steering Committee) of the National Medical Library of the Czech republic in cooperation with the National Library of the Czech Republic pay attention to the solution of the Project “Benchmarking of libraries”. Identification, determination and collection of most suitable indicators detailing activities in comparable type of library enable to decide on change of existing processes (services) and thereby to improve the quality of provided service. The authors inform about the results of analysis of medical libraries activities according to the statistical returns for 2007 and about proposal of optimization of these activities by method of benchmarking. Statistical investigation must be evaluated with respect to categories of users of provided services. The categorization of user groups according to different types of health facilities where libraries act is necessary condition for assessment of LIS value.
BACKGROUND AND AIMS: At present, revision surgery of a total hip replacement is a major problem that must be dealt with by all orthopedic facilities. Aseptic loosening of the acetabular component is often associated with destruction of the original spherical shape of the acetabulum and the formation of bone defects. An orthopedist faces the challenge of acetabular revision and stable fixation of the new acetabular component in an effort to re-establish the functioning of the hip replacement. MATERIAL AND METHODS: The authors evaluated a group of 74 patients in whom they implanted an oblong revision cup due to aseptic loosening of the acetabular component from August 2000 until December 2003. The mean duration of the follow-up period was 63 months (ranging from 38 to 78 months). RESULTS AND CONCLUSIONS: The authors reported very good results from the use of this implant, where osteointegration and good functional outcome evaluated according to the Harris Hip Score (HHS) were achieved in 95% of cases. The long-term outcome should be the subject of further investigation.
- MeSH
- artróza kyčelních kloubů chirurgie MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- náhrada kyčelního kloubu škodlivé účinky MeSH
- následné studie MeSH
- nekróza hlavice femuru etiologie chirurgie radiografie MeSH
- protézy - design MeSH
- protézy a implantáty MeSH
- reoperace přístrojové vybavení MeSH
- retrospektivní studie MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
OBJECTIVES: A wide range of low-molecular-weight agents can cause occupational asthma. The chemical industry is an environment in which numerous hazardous substances are used. Lasamide (2,4-dichloro-5-sulfamoylbenzoic acid) is one of them (along with its precursors). METHODS: Five patients from a lasamide production line with suspected occupational asthma and rhinitis were examined. During the first visit, skin prick tests, total immunoglobulin E (IgE), a nonspecific bronchoprovocation test, and specific bronchoprovocation tests using occupational agents were performed to confirm the diagnosis of allergic diseases. During the follow-up visit (1-3 years after removal from exposure), all of the tests (except the specific bronchoprovocation test) were performed again. RESULTS: At the first hospitalization, the total IgE levels were increased in three patients. In addition, skin prick tests and the nonspecific bronchoprovocation test were positive for three patients. After the specific bronchoprovocation test, serious bronchoconstriction occurred in three patients; symptoms of rhinitis were present in all five patients. Several years after removal from exposure to the occupational agents, normalization (with respect to the parameters followed) was not yet complete for all of the patients. CONCLUSIONS: The process of lasamide production seems to be hazardous and is likely to cause allergic respiratory disease. The prognosis of allergic diseases caused by these products is not very favorable. Allergic symptoms (despite the removal from occupational allergen exposure) persisted even after several years.
- MeSH
- benzoáty škodlivé účinky MeSH
- bronchiální astma chemicky indukované MeSH
- bronchoprovokační testy MeSH
- celoroční alergická rýma chemicky indukované MeSH
- dospělí MeSH
- financování organizované MeSH
- imunoglobulin E krev MeSH
- kožní testy MeSH
- lidé středního věku MeSH
- lidé MeSH
- nemoci z povolání chemicky indukované MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
OBJECTIVES: The aim of the study was to estimate the numbers of workers exposed to carcinogens in Estonia, Latvia, Lithuania, and the Czech Republic. METHODS: CAREX is an international information system on occupational exposure to 139 known and suspected carcinogens. It provides exposure data and estimates of the numbers of exposed workers by country, carcinogen, and industry. The CAREX method, which has been previously applied in the member states of the European Union, was applied in the present study to the exposure situation in Estonia, Latvia, Lithuania, and the Czech Republic in 1997. The preliminary estimates generated by CAREX were reviewed and revised by national experts mainly for asbestos, benzene, and lead, which were of special interest for this project. RESULTS: The numbers of workers exposed to carcinogens covered by CAREX in 1997 were about 180,000 (29% of employed persons) in Estonia, 260,000 (28% of employed persons) in Latvia, 470,000 (28% of employed persons) in Lithuania, and 1,400,000 (28% of employed persons) in the Czech Republic. The most common exposures were solar radiation (7-13% exposed at least 75% of the worktime), environmental tobacco smoke (4-5% exposed at least 75% of the worktime), wood dust (3-5% exposed), crystalline silica (2-3% exposed), diesel exhaust (2-3% exposed), radon and its decay products (2% exposed), benzene (0.9-1.7% exposed), and lead and inorganic lead compounds (0.8-1.4% exposed). Exposure to asbestos was slightly less prevalent (0.3-1.1% exposed). CONCLUSIONS: These preliminary results indicate that a substantial proportion of the workers in the studied countries were exposed to carcinogens.
- MeSH
- časové faktory MeSH
- hodnocení rizik MeSH
- karcinogeny životního prostředí * MeSH
- lidé MeSH
- nádory prevence a kontrola MeSH
- nemoci z povolání prevence a kontrola MeSH
- pracovní expozice statistika a číselné údaje MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Česká republika MeSH
- Estonsko MeSH
- Litva MeSH
- Lotyšsko MeSH
