INTRODUCTION: Cellulitis remains a very serious disease even today. Mortality, which varied between 10-40%, has been reduced owing to the standard securing of airway patency and use of an appropriate surgical treatment approach. MATERIALS AND METHODS: A total of 195 patients were hospitalised for cellulitis at the University Hospital in Hradec Králové during 2007-2011. The following parameters were evaluated: age, gender, dependence of incidence of the disease on the season of the year, frequency of attacks of the particular areas and their clinical characteristics, aetiology of the inflammation, types of patient complaints, prevalence of current systemic diseases, results of microbiological and selected laboratory analyses, socio-economic status of the patients, and duration of patient stay at the hospital. Statistical analysis was performed by using Pearson's correlation coefficient, the statistical significance level was p < 0.05. RESULTS: The mean age of the patients was 39.8 years. The group of 195 patients included 108 (55%) males and 87 (45%) females. The mean time between the first symptoms of the disease and admission to the Department was 5 days. From among the 195 patients, 116 (59.5%) were working persons, 79 (40.5%) were non-working (children, students, unemployed persons, women on maternity leave, retired people). The odontogenic origin of the disease was verified in 173 (88.7%) patients. In total, 65 (33.3%) patients had no coinciding complicating systemic disease, 22 (11.3%) patients had diabetes mellitus. The most frequent symptom of cellulitis was painful swelling, found in 194 (99.5%) patients, followed by jaw contracture, found in 153 (78.5%) patients. CONCLUSION: The results are largely very similar to those of previous studies performed in other countries, except that we found no correlation between the prevalence of cellulitis and the socio-economic status, nor have we confirmed Klebsiella pneumoniae sp. as the cause of cellulitis in patients with diabetes mellitus. and H. Doležalová, J. Zemek, L. Tuček
BACKGROUND: Human immunodeficiency virus (HIV) continues to be a serious health issue and one of the world most devastating epidemics. An estimated 1.5 million people died from AIDS-related illnesses in 2013, and an estimated 37 million people with AIDS have died worldwide since the epidemic has begun. HIV infection is known for its oral manifestations which causes discomfort and pain for infected individuals. The objective of this study was to document oral conditions of HIV positive patients and the pattern and frequency of oral and dental lesions. METHODS: All patients with confirmed HIV infection who were treated at the Department of Dentistry, University Hospital in Hradec Králové, were examined. RESULTS: During the study period, 29 HIV positive patients were examined and treated--19 men, 10 women, with mean age of 32.9 years (range 22-58 years). 72.41% patients received ART. In total, all patients underwent 186 visits. The most frequent treatments were associated with teeth and periodontal lesions (71.80%), oral mucosal lesions were diagnosed and treated only in 3.96% cases. CONCLUSION: Since the introduction of ART, the frequency of oral mucosal lesions is minimal in patients with HIV infection. and M. Šembera, V. Radochová, R. Slezák
Typ studie: retrospektivní. Cíl: Cílem studie bylo zjistit úspěšnost porodů u žen s císařským řezem v anamnéze na našem pracovišti. Rovněž bylo cílem určit rizikové faktory pro úspěšnost porodu po předchozím císařském řezu a míru rizika, kterou tyto pacientky podstupují. Metodika: Výzkumný soubor tvořilo 1 060 porodů, které na našem pracovišti proběhly ve sledovaném období. Z toho 103 žen mělo císařský řez v anamnéze a 70 z nich se pokusilo porodit vaginálně. Výsledky: Z 1 060 porodů bylo 19,2 % sekcí, ze 70 TOLAC (trial of labour after caesarean – pokus o spontánní porod po císařském řezu) bylo 54,3 % úspěšných (porodily vaginálně), ze 13 indukcí po sekci bylo úspěšných 23,1 %. Jako prediktivní faktor pro úspěšný TOLAC byl prokázán vaginální porod v anamnéze (p = 0,00), BMI < 35 (p = 0,04) a trend naznačil věk rodičky < 25 let (p = 0,05). Byl prokázán signifikantní rozdíl v krevní ztrátě (měřené odhadem) mezi pokusem o vaginální porod po sekci a bez sekce v anamnéze (p = 0,000), pokusem o vaginální porod po sekci a primární sekcí po sekci (p = 0,000) a mezi úspěšným a neúspěšným pokusem o vaginální porod po sekci (p = 0,000). Byl rovněž prokázán signifikantní rozdíl Apgar(ové) skóre v 1. a 5. minutě u dětí z úspěšných a neúspěšných pokusů o vaginální porod po sekci. Tyto výsledky byly dány do kontextu s doporučenými postupy z USA, Kanady, Spojeného království, Německa, Rakouska a Austrálie a Nového Zélandu. Závěr: Studie poskytla informace, se kterými je možné seznámit pacientku plánující pokus o vaginální porod po sekci na našem pracovišti. Klíčová slova: císařský řez – pokus o spontánní porod po císařském řezu – TOLAC – trial of labour after caesarean, Study type: retrospective Aim: The aim of this study was to determine the success rate of births in patients with caesarean section in medical history in our clinic. We also wanted to determine the predictive factors for successful vaginal birth and the amount of risk which the vaginal birth after caesarean brings to the patient. Metodics: There were 1,060 births in our study, that took place in our clinic at the specified time. Out of this set there were 103 women, who had caesarean delivery in medical history and 70 of those tried to deliver vaginally. Results: Out of 1,060 births there were 19.2 % caesarean sections, from 70 patients who tried to give birth vaginally after caesaren (TOLAC – trial of labour after caesarean) 54.3 % succeeded (the rest gave birth per sectionem caesaream), out of 13 induced labours after caesarean there were only 23.1 % successful. We determined following predictive factors for successful TOLAC: at least one vaginal birth in medical history (p = 0.00), BMI under 35 (p = 0.04) at the time of birth and age under 25 (p = 0.05). We found significant difference in the blood loss between following groups: TOLAC vs deliveries without caesarean in medical history (p = 0.000), TOLAC vs. elective repeat sections (p = 0.000) and successful vs. unsuccessful TOLAC (p = 0.000). We also found significant difference in Apgar score in first and fifth minute between the group of successful TOLAC and unsucessful TOLAC. These results were compared with the current guidelines in UK, USA, Canada, Australia and New Zealand, Germany and Austria. Conclusion: This study has brought us data, that should be provided to the patients who think about giving birth in our clinic and who have already caesarean section in medical history. Key words: cesarean section – TOLAC – trial of labour after caesarean, and MUDr. Lukáš Dostálek
Selen, který tvoří významnou komponentu řady enzymů, je pro lidský organizmus esenciálním prvkem. Jeho nedostatečný přívod má vliv na funkčnost prakticky všech tkání. Cílem naší práce bylo stanovit distribuci obvyklého přívodu selenu stravou, porovnat zjištěné hodnoty s výživovými doporučeními a stanovit nejvýznamnější expoziční zdroje selenu v české dietě. K tomuto účelu byla využita aktuální data o obsahu selenu v potravinách (2010/2011), která byla čerpána z výsledků projektu sledování dietární expozice realizovaného v rámci programu Monitoringu zdraví a životního prostředí. Údaje o spotřebě potravin byly pořízeny v národní Studii individuální spotřeby potravin (SISP 04) uskutečněné v letech 2003–2004 na reprezentativním vzorku populace České republiky (2590 mužů a žen ve věku 4–90 let). Pro každou osobu ve výběru byl vypočten aktuální přívod selenu a následně byla určena distribuce obvyklého přívodu v definovaných skupinách populace. Z výsledků vyplynulo, že ve skupinách dětí (4–14 let), dospívajících a dospělých mužů (15–59 let) se jeví přívod selenu stravou u většiny osob jako dostatečný. Naopak nejvíce rizikovými skupinami z hlediska nízkého přívodu selenu byly dospívající dívky (15–17 let), dospělé ženy (≥18 let) a starší muži (věk 60 let a více). Přibližně u 60 % dospívajících žen a 75 % dospělých žen neodpovídal zjištěný přívod selenu doporučeným hodnotám. Dietární zdroje selenu se lišily v závislosti na věku a pohlaví, obecně však převažovaly zdroje živočišné, které tvořily přibližně 70 % z celkového přívodu. Vyšší přívod selenu běžnou stravou by bylo možné zajistit především vyšší konzumací mořských ryb a rybích výrobků, které představují bohatý a v naší populaci stále v nízké míře přijímaný zdroj selenu., Selenium is an essential element and component of many enzymes in the human organism. Deficiency can affect the function of virtually all tissues. The main objective of this article is to present the distribution of usual selenium intake in the Czech population, to compare the obtained values with available dietary recommendations and to determine the most important dietary sources of selenium. For this purpose current analytical data (2010/2011) on the selenium content in foodstuffs from the project of Environmental health monitoring in the Czech Republic and data on food consumption originated from the national survey SISP 04 (Study of individual food consumption) were used. SISP 04 was carried out between 2003–2004 on a representative sample of the Czech population (2,590 men and women aged 4–90 years). Actual intake of selenium was calculated for each subject in the sample and subsequently usual intake distributions were estimated in defined population subgroups. The results indicated that selenium intake appears to be sufficient in groups of children (4–14 years) and young and adult men (15–59 years). Population groups with increased risk of low selenium intake were identified as teenage girls (15–17 years), adult women (≥18 years) and elderly men (60 years and over). Approximately 60% of teenage girls and 75% of adult women did not meet the intake recommendations for selenium. Dietary sources of selenium varied depending on age and gender, but generally animal sources prevailed, accounting for approximately 70% of the total intake. Higher consumption of fish and fish products, as a rich source of selenium, can be recommended to increase selenium intake from natural sources, especially when its consumption in our population is still very low., Zlata Kapounová, Jitka Blahová, Marcela Dofková, Jiří Ruprich, Irena Řehůřková, and Literatura
Vysoce rizikové typy lidských papilomavirů (HR-HPV) jsou kauzálně spojeny s karcinomem děložního hrdla (KDH) a částí dalších malignit. Současně dostupné HPV-vakcíny obsahují antigeny dvou HR HPV – HPV16 a HPV18 zodpovědných v ČR za více než 70% KDH. Cílem studie bylo sledování výskytu znaků HPV-infekce ve vakcinované populaci, detekce předchozí, současné a přetrvávající HPV-infekce a sledování vlivu vakcinace na následnou HPV-infekci a vznik atypických nálezů na děložním hrdle. Zde prezentujeme výsledky prevalence znaků HPV-infekce při vstupu do studie. Celkem jsme nalezli 37,4 % HPV-DNA-pozitivních jedinců, polovinu séropozitivních žen proti některému z testovaných antigenů a téměř čtvrtinu s protilátkami proti typům HPV16/18. Současnou/přetrvávající/předchozí infekci typy HPV16/18 jsme nalezli u 4,7 %/6,7 %/15,4 % žen. Snížením účinnosti vakcín proti HPV16/18 je v naší studii ohroženo 11,4 % sledovaných, s nejvyšším rizikem ve věkové skupině 24–26 let (22,6 %)., High-risk human papillomaviruses (HR HPV) are causally linked to cervical cancer (CC) and some other malignancies. The currently available HPV vaccines contain antigens of two HR HPV types, HPV16 and HPV18 that account for more than 70% of CC in the Czech Republic. The study objective was to monitor the prevalence of HPV infection markers in the vaccinated population, to detect past, present, and persistent HPV infection, and to assess the effect of vaccination on subsequent HPV infection and development of atypical cervical lesions. Here we present the baseline prevalence data on the of HPV infection markers at enrolment. Overall, 37.4% of the study cohort were HPV DNA positive, half of the females were seropositive to at least one of the antigens tested, and nearly one quarter had antibodies against HPV16/18 types. Present/persistent/past infection with HPV16/18 types was detected in 4.7%/6.7%/15.4% of the females, respectively. Altogether 11.4% of the study cohort are at risk for reduced vaccine efficacy against HPV16/18, with the risk being highest in the age group 24–26 years (22.6%)., and Eva Hamšíková, Jana Šmahelová, Viera Ludvíková, Martina Saláková, Jana Rychlá, Jana Skřenková, Lukáš Rob, Ruth Tachezy
INTRODUCTION: Annually more than 27,000 persons die of cancer in the Czech Republic and the overall incidence of malignancies is still increasing. These data shows the need for affordable and good follow-up care especially for patients without any cancer treatment due to irreversible progression of tumor. Currently the outpatient palliative cancer care gets more into the forefront. Prerequisite for a well working outpatient palliative care is cooperation with general practitioners and home health care agencies. The purpose of the so called program of palliative cancer care is to guide a patient in palliative cancer care and to improve the cooperation among health care providers. METHODS: During the period from January 2008 to October 2010 we evaluated in patient without any oncology treatment due to irreversible progression of tumor. RESULTS: In palliative outpatient clinic we treated 446 patients, 119 of them received home care services with average length of 27.8 days. 77 patients died at home, 51 in health facilities and 41 in inpatient hospice care. CONCLUSION: We present pilot study focusing on outpatient palliative cancer care which shows the real benefit from early indication of palliative cancer care. This type of care allows patients to stay as long as possible at home among their close relatives. and I. Slánská, J. Kopecký, S. Filip
Aim: The principal aim was to establish reference paediatric data for the serum homocysteine levels in Czech children and adolescents. Methods and Results: 144 children either healthy or not sufferig from acute or chronic inflammation, autoimmune disorders including rheumatic diseases, inflammatory musculoskeletal disorders, inflammatory bowel disease, diabetes mellitus, hypercholesterolemia, epilepsy, chronic renal failure, aged 0–19.9 years (0–6.9 years, n = 40; 7–10.9 y, n = 28; 11–15.9 y, n = 45; 16–19.9 y, n = 31) had their blood samples collected and the serum homocysteine level (S-homocysteine) was evaluated by chemiluminescence. A significant age dependence of the S-homocysteine levels was observed (R = 0.35, p < 0.01); with highest values of upper reference range in the 11–15.9 and 16–19.9 years’ group, respectively. Conclusion: The establishment of S-homocysteine reference Czech pediatric values is a potentially useful tool for proper evaluation of elevated homocysteine levels and corresponding risks in childhood., Vladimír Němec, Eva Bočkayová, Štěpán Kutílek, and Literatura 30
Úvod: Observační, prospektivní a neintervenční projekt SOLOSTAR měl za cíl získat informace z klinické praxe v České republice o spokojenosti pacientů s používáním předplněného inzulinového pera SoloStar. Metodika: 1 805 pacientů s diabetem 1. nebo 2. typu bylo po zahájení používání pera SoloStar sledováno 3–4 měsíce. Spokojenost pacientů s perem SoloStar a s jeho jednotlivými parametry byla posuzována ve skupině všech pacientů a v podskupinách rozdělených dle demografických parametrů včetně zdravotního omezení. Pacienti také porovnávali pero SoloStar s pery používanými před vstupem do projektu. Výsledky: 98,3 % pacientů ohodnotilo celkovou spokojenost s perem SoloStar jako „výbornou“ a „dobrou“ (nejlepší a druhé nejlepší hodnocení na 5stupňové škále). Na celkovou spokojenost s perem SoloStar nemělo statisticky významný vliv žádné z demografických kritérií, a to ani zrakový handicap či omezení manuální zručnosti. Parametry pera SoloStar byly u více než 90 % pacientů hodnoceny jako „výborné“ a „dobré“. Lépe byly některé parametry hodnoceny zejména pacienty bez předchozí zkušenosti s aplikací inzulinu. Pacienti, kteří používali jiný typ aplikátoru před zařazením do projektu, byli více spokojeni s perem SoloStar než s předchozím aplikátorem a většina z nich ohodnotila používání pera SoloStar (93,1 %) a aplikaci inzulinu perem SoloStar (83,5 %) v porovnání s původním perem jako „mnohem jednodušší“ a „jednodušší“ (nejlepší a druhé nejlepší hodnocení na 5stupňové škále). Závěr: Používání pera SoloStar je v běžné klinické praxi v České republice spojeno s vysokou spokojeností pacientů, a to včetně pacientů se zdravotním omezením. Pacienti navíc pero SoloStar upřednostňovali před inzulinovými pery používanými před vstupem do projektu. Klíčová slova: diabetes mellitus – inzulinové pero – spokojenost pacientů, Introduction: The aim of the observational, prospective and non-interventional survey SOLOSTAR was to obtain, in a clinical practice setting in the Czech Republic, information about patient satisfaction with the use of the pre-filled insulin pen SoloStar. Methodology: 1 805 patients suffering from type 1 or 2 diabetes who began using the pen SoloStar were observed for 3 to 4 months. Satisfaction of patients with SoloStar and with its particular features was evaluated in the group of all patients and in subgroups defined by demographic parameters including the type of handicap. Patients also compared SoloStar with the pens used before the entry into the survey. Results: 98.3 % of patients rated overall satisfaction with the pen SoloStar as “excellent” and “good” (the highest and second highest rating on a 5-point scale). Demographic criteria, including visual handicap and manual dexterity handicap, did not have any statistically significant effect on the rating of the overall satisfaction with SoloStar. Features of SoloStar were rated as “excellent” and “good” by more than 90% of patients. Higher rating of some of the features of SoloStar was awarded mostly by patients without prior experience with insulin application. Patients who used other insulin applicators before entering into the survey were more satisfied with the pen SoloStar than with the previously used applicator and most of them rated the use of SoloStar (93.1 %) and insulin application with SoloStar (83.5 %) as “much easier” and “easier” (the highest and second highest rating on a 5-point scale) in comparison with the previously used pen. Conclusion: The use of the pen SoloStar in a clinical practice setting in the Czech Republic is associated with high levels of satisfaction of patients, including handicapped patients. In addition, patients preferred SoloStar over insulin pens used before the entry into the survey. Key words: diabetes mellitus – insulin pen – patient satisfaction, and Tomáš Edelsberger, Michal Policar, Dita Pospíšilová, Jana Psottová, Jana Houdová, Denisa Janíčková Žďarská
The aim of this study was to determine the prevalence of musculoskeletal problems among Czech dentists and to analyze the factors that affect these disorders. Information was gathered through questionnaire completed by 581 physicians. The questionnaire ascertained general information about physicians including their work habits and the characteristics of their work environment along with the occurrence of musculoskeletal problems as well as their intensity. In the past year the occurrence of at least mild difficulties associated with the locomotive system was reported by 96.9% of dentists surveyed (n = 557), with 66.3% of respondents (n = 381) reporting difficulties ofa moderate or major nature. Most respondents of both sexes indicated neck pain. A statistically significant correlation with the occurrence of musculoskeletal complaints of medium and major intensity was demonstrated for the following factors: sex, age, running a private practice, past injury or musculoskeletal diseases, and the perception of work as psychologically demanding. Musculoskeletal disorders in dentists in Czech Republic are relatively frequent and serious health problem. The causes of these diseases must be identified and appropriate preventive interventions undertaken that will contribute to a reduction in the incidence of these problems. and Z. Sustová, L. Hodacová, M. Kapitán