The study deals with expectations of patients - future consumers of health care services provided in hospitals. Authors of this study propose about how the fulfilled or unfilled expectations can influence the patient’s satisfaction with provided health care. There is also suggested to what categories those expectations most often belong and to what extent is possible in common conditions of Czech hospitals the patient’s expectations comply, Kalábová L., Křečková Tůmová N., Zlámal J., and Literatura
Objective: To determine risk factors in different pathogenic subtypes of ischemic stroke in Tashkent hospital registry and to compare with the data of other stroke registers. Design: Prospective observational study. Participants: 300 adults aged 18 years or over who suffered first-ever acute ischemic stroke, of them, the data of 100 patients with atherothrombotic, lacunar and cardioembolic strokes were analyzed. Main outcome measures: Mathematically significant differences and not significant differences but interesting from other point of view. Categorical variables are expressed as frequencies and percentages. Differences were regarded as statistically significant when the P value was less than 0.05 (P<0.05). Results: Of 100 patients with acute first-ever ischemic stroke at the median age of 62.63±4.68 (interquartile range 25-92) years, 57% were men and 43% were women. Depending on aetiology and stroke subtype, all the patients were divided into three groups: 42 patients with atherothrombotic stroke, 41 – with lacunar stroke, and 17 patients with cardioembolic stroke. Atherothrombotic stroke developed often in people over 60 years old, while lacunar stroke prevailed at the younger age. Stroke cases increased in people over 51 years old. Although men were more likely to suffer strokes than women, stroke incidence was equal in both sexes with increasing of age (over 60 years old), especially in atherothrombotic stroke, testifying to that women live longer. Combination of cerebral atherosclerosis and hypertension was the most significant risk factor for stroke. Atherosclerosis was the main aetiological factor for ischemic stroke, independently of its pathogenic heterogeneity. Diabetes mellitus was an independent risk factor for all stroke subtypes, which in most cases worsened the European Medical, Health and Pharmaceutical Journal ISSN 1804-5804 course and outcome of stroke. Hypertension was the leader aetiological factor for lacunar stroke. In these patients, we Cardioembolic stroke developed mainly because of cardiac thrombosis and valve pathology, which were often associated with chronic diseases of other organs, worsening the course and outcome of stroke. Despite of high prevalence of myocardial infarction in men, women were more likely to develop cardioembolic stroke. Conclusions: This study found simultaneous influence of many risk factors (multifactorial disease) in the development of ischemic stroke. The more course and influence of the underlying disease and risk factor, the higher stroke risk and severity, especially in the absence or inadequate previous therapy of underlying disease before the stroke index. We have noted a high prevalence of under-diagnosis of vascular risk factors at levels of primary and secondary care. We recommend for improved public awareness of vascular risk factors and better diagnostic and treatment facilities aimed at addressing those factors at levels of primary and secondary healthcare. Larger population-based studies may provide additional data on stroke incidence and outcome among Uzbeks., Khurshidakhon Abduboriyevna Rasulova, and Literatura
The Purpose of this study is to demonstrate the effectiveness of combined treatment for III AB stage of nonsmallcell lung cancer. Nonsmallcell lung cancer spread form treatment is disputable. Operation is not final solution. The combined treatment is being tested (in clinical trials) in this study. This article argues that a combination of treatment is a better option than that of a specific treatment. However, there is a need to find new effective options for combined treatment., Akhat Bukenov, Elena Gizbrekht, Ergaly Shauenov, Bekzhan Orazbayev, Kalmurat Razzakov, and Literatura
Objective: to analyze main clinical-statistical indices of spine and spinal cord injuries (SCI) and system of organization of medical aid to the victims. We conducted a cohort retrospective study of materials of medical institutions of Tashkent city. Medical records of patients and records of forensic examinations were analyzed. 242 cases of spinal cord injuries were studied. Over the last 10 years in Tashkent the frequency of SCI have been tend to increase, males and working-age people are dominated. In 60.9% of cases the injury was associated, in 36.2% - isolated, and in 2.9% - combined. Fallings from height and road traffic accidents were the main reasons for getting SCI. Lesions at cervical level registered in 45% of cases, thoracic level - 27.3%, at lumbar level - 27.7%, respectively. According to ASIA/IMSOP, full injuries were noted in 40.1% of cases, incomplete injures were in 59.9%. Overall mortality from SCI was 68.6%. study allowed to get in detail the clinical and statistical indicators of SCI in the region., Rukhulla Zabikhullaevich Khikmatullaev, Alisher Iskandarovich Iskandarov, Dildora Zabikhullaevna Khakimova, and Literatura
Východiska: Pohybový projev zdravého organismu je charakterizován vysokou mírou variability provedení pohybového úkonu. Za situace vzniklé poruchy řízení, zejména v důsledku neurologických onemocnění, dochází v různé míře k fixnímu pohybového projevu, projevujícímu se omezením schopnosti pružné reakce na změnu zevních či vnitřních podmínek, působících v průběhu provádění cíleně zaměřené pohybové akce. Cíl: Zjistit rozdíly ve svalové aktivitě a variabilitě svalových souher akrálních a proximálních svalů během dosahu a úchopu u zdravých jedinců a u pacientů s hemiparézou. Metody: Experimentální soubor tvořilo 24 probandů po prodělané ischemické cévní mozkové příhodě (iktu) s pravostrannou hemiparézou. Kontrolní soubor tvořilo 30 zdravých probandů. Svalová aktivita byla zaznamenána pomocí povrchové elektromyografie v průběhu dosahu, úchopu a oddálení válcového a kulového předmětu. Rozdíly v hodnotách plochy pod křivkou záznamu jednotlivých svalů mezi experimentálním a kontrolním souborem byly statisticky vyhodnoceny pomocí T-testu pro nezávislé skupiny. Vztah mezi aktivitou svalů předloktí a svalů pletence ramenního byl hodnocen pomocí Spearmanova korelačního koeficientu pro neparametrické hodnoty. Výsledky: Byly zjištěny významné rozdíly v míře a počtu statisticky významných korelací akrálních a pletencových svalů. U souboru probandů s hemiparézou byla zjištěna statisticky významně nižší aktivita m. pectoralis major a naopak vyšší aktivita m. trapezius. Současně převažovala vysoká korelace m. pectoralis major a extenzorů zápěstí a prstů, na rozdíl od souboru zdravých probandů, kdy se vzájemné korelace akrálních a proximálních svalových skupin objevovaly nahodile, v menší míře a četnosti. Závěry: Výsledky ukazují na snížení variability svalové aktivity u pacientů s hemiparézou v průběhu úchopové funkce. Náhradou nedostatečné funkčnosti akrálních svalových skupin se stává relativně fixní „ko-aktivace“ s vybranými proximálními svalovými skupinami., Background: Movement of a healthy organism is characterized by a high degree of variability performance of a movement task. In a situation of a motor control lesion, mainly due to neurological disease, occurs in varying degrees to a fixed musculoskeletal manifestation. ere are manifesting in a limiting responsiveness to changing external or internal conditions during the task oriented physical action. Objective: To determine differences in muscle activity and variability between a muscle synergy of acral and proximal muscles during reach and grip in healthy subjects and stroke patients. Methods: e experimental group consisted of 24 probands aer ischemic stroke (ictus) with right-sided hemiparesis. e control group consisted of 30 healthy subjects. Muscle activity was recorded using surface electromyography during the performation of selected types of grips of cylindric and spheric objects. e differences in the area under the curve record of individual muscles between the experimental and control group were statistically evaluated using the t-test for independent groups. e relationship between the activity of the muscles of the forearm and shoulder girdle muscles was assessed using Spearman‘s correlation coefficient for non-parametric values . Results: ere were the significant differences in the size and number of statistically significant correlations distal and proximal arm muscles. In stroke group was found significantly lower activity m. pectoralis major and higher activity m. trapezius. At the same time the prevailing high correlation m. pectoralis major and extensor wrist and fingers, unlike the group of healthy subjectss, when the correlation distal and proximal muscle groups appeared at random, in a lesser extent and frequency. Conclusions: e results indicate a reduction in variability of muscle activity during grasp function of stroke patients. To compensate the lack of activity of acral muscles becomes relatively fixed „co-activation“ with selected proximal muscles., and Petra Bastlová, Ivana Barbora Frgalová, Barbora Kolářová, Milan Elfmark, Alois Krobot