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
The management of chronic diseases shall be considered a priority in the work of the global international institutions, which are related to health policies. In the search for effective and efficient solutions for the treatment of chronic diseases, scientists are developing different programs. In Bulgaria the continuous monitoring of chronically ill people is defined with the term dispensarization. The objective of the research is to analyze the place and the role of patients in the monitoring of their chronic diseases and how the concept of quality of life relates to this process. Method The research in focus groups is planned within a research project on the monitoring of chronic diseases. Five group discussions were held. The number of participants in all focus groups was sixty. Results The two discussed directions - the active role of the patient and the focus on the results are weak links in the current organization of the care for the chronically ill people. The topic of creating and adopting an Act of the patient was also presented, in which to be paid attention to the evaluation of the quality of life. In general was brought the need for a clear delineation of the roles and the competencies of everyone involved in the monitoring process of chronic diseases. The chronic disease cannot be defined only as a medical problem, as there are economic and social, including political consequences. Conclusions The management of the chronic disease requires coordination of doctor-patient interaction, a model of partnership and trust in the relations, self-management of the condition by the patients and their inclusion in the health team. The most important step to achieve this goal is the education of the patients, increasing their knowledge and motivation, psycho-emotional support, instilling hope and faith in the capacity of the patients., Teodora Dimcheva, Gergana Foreva, Radost Аsenova, Nonka Маteva, Todor Stoev, Rosica Dimova, and Literatura
We aimed to investigate in detail the structural mutations after influence of actellic insecticide at different doses and different temperature conditions. We tested effects of single introduction of different doses of actellic: 48, 96, 192, and 384 mg/kg. Cytogenetic effect of actellic in bone marrow cells at different temperature regimens was studied. Following actellic administration, animals were being in two temperature regimes: normal (18-20°C) and high (37-38°C). After treatment with actellic, animals were kept within 1, 2, 4 and 8 hours at high temperature (37-38°C), i.e. in a thermostat (TV-80) with access of air. In experiments, the animals were divided into seven groups. The animals of the 1st group were administered actellic at a dose 384 mg/kg and kept under normal temperature until slaughtering. The animals of the 2nd group after administration of actellic were immediately placed in an environment with a temperature of 37-38°C. Animals of the 3rd, 4th, 5th, and 6th groups after treatment with actellic were transferred to conditions with high temperature, respectively, for 1, 2, 4 and 8 hours. The 7th group of mice was under normal temperature conditions without treatment with actellic. Our results have shown that in normal temperature conditions single exposure of actellic (384 mg/kg) did not affect the genetic apparatus of somatic cell, evidenced by the frequency of chromosome aberrations in bone marrow cells that were within the control levels. However, at high temperatures (37-38°C) the pesticide caused 6-fold larger number of chromosome aberrations in bone marrow cells, in comparison with normal conditions., Anvarjon Rakhmankulovich Shermuratov, and Literatura
The widespread introduction of dental implant in the dental practice will determine progress and the future of prosthetic dentistry. At the same time, like any new direction dental implantation has generated a lot of questions and unsolved problems. On many of these issues and problems can be answered only by using morphological methods. Therefore, after the development of a new construction of the dental implant one of the main issues was the question of its interaction with the jawbone and soft tissues of the oral cavity. We performed the experiment on 24 long snout dogs of both sexes, weighing 30-35 kg, with normal bite, at the age of 20-24 months. Animals were divided into 2 groups, according to samples of screw dental implants used in the experiment: basic group - 12 dogs in which were used samples of the new construction of dental implant “Implant.uz” (Uzbekistan); control group – 12 dogs in which were applied screw dental implant system “Dentium” (South Korea). Terms of derivation of animals from experiments were 1, 3, and 6 months. By using morphological techniques were studied implants “Implant.uz” from medical titanium BT-1.00 brand, their interaction with bone of alveolar ridge. “Implant.uz” did not cause pathological changes in the bone tissue of alveolar ridges of jaws and could be an alternative to known dental implants., Nigman Lukmanovich Khabilov, Tatyana Olegovna Mun, Farkhodjon Komiljonovich Usmonov, Iskander Mukhamedovich Baybekov, and Literatura
Východiska: Implementace mezinárodní klasifikace NIC v podmínkách intenzivní péče v ČR. Cíl: Identifikace intervencí NIC Klasifikačního systému, které všeobecné sestry označí jako použitelné v klinické praxi intenzivní péče minimálně jednou týdně. Metody: Kvantitativní analýza četnosti intervencí NIC. Dosáhla-li konkrétní intervence NIC 75% hranice (po sečtení v kategorii denní a týdenní péče), byla identifikována jako intervence NIC, která je použitelná minimálně jednou týdně v klinické péči prostředí intenzivní péče. 386 záznamových archů, ve kterých všeobecné sestry označovaly frekvence použití vybraných 184 intervencí Klasifikačního systému NIC. Získaná data byla získána z klinické praxe intenzivní péče u 12 poskytovatelů zdravotnických služeb v České republice (ČR). Ke statistickému porovnání získaných dat z jednotlivých klinických pracovišť byl použit Pearsonův chi kvadrát, na hladině významnosti 5 % (p ≤ 0,05). Výsledky: 46 intervencí z vybraných intervencí NIC, bylo identifikováno jako intervence, použitelné minimálně jednou týdně v klinické péči prostředí intenzivní péče ČR. U 14 intervencí NIC nebyly shledány signifikantní rozdíly v označení použitelnosti jednou týdně na pracovištích ARO a JIP interního a chirurgického typu. U 32 intervencí NIC byly shledány signifikantní rozdíly v označení použitelnosti jednou týdně v klinické praxi mezi výše uvedenými pracovišti. Použitelnost těchto intervencí NIC minimálně jednou týdně častěji označily všeobecné sestry na pracovišti ARO. Závěry: Ze 184 mapovaných intervencí Klasifikačního systému NIC bylo identifikováno 46 intervencí, které všeobecné sestry označily, jako použitelné v klinické praxi intenzivní péče minimálně jednou týdně. Tyto intervence NIC podstoupí expertní validaci., Background: Implementation of the International Classification of NIC in conditions intensive care in the Czech Republic. Aim: The aim of this enquiry was the choice of interventions NIC of the classification system, which are marked by nurses as usable minimaxy once a week in the clinical practice of intensive care. This contribution maps the posibility of the usage of chosen interventions of classification system Nursing Interventions Classification NIC, which will be used for the future implementation in the intensive care sector. The aim of this enquiry was the choice of interventions NIC of the classification system, which are marked by nurses as usable minimaxy once a week in the clinical practice of intensive care. Methods: Reaches the specific interventions NIC 75% threshold for counting records in the category of daily and weekly care has been identified as an intervention NIC, which is applicable at least once a week in clinical care intensive care environment. The quantitative analysis of 386 records with 184 interventions NIC in the clinical practice, by 12 health service proveders in the Czech Republic. Pearson‘ s chi quadrat (p≤0,05) was used for the statistic comparison of the data from the individual clinical workplaces. Results: By the quantitative analysis was confirmed 46 interventions NIC of Classification system which possible usage in clinical intensive care minimally once a week in the CR. In comparison with the data distribution at individual clinical workplaces, there were not found any significant differences in minimal weekly usage indication at 14 NIC intervention of the classification system. There were found some differences in usage marking in 32 interventions NIC classification system by nurses at some workplaces. Higher frequency of presence was recorded by Anesthesiologic Resuscitation ward nurses. Conclusions: Analysis from 184 intervention NIC confirms the possibility 46 of serviceability of classification system NIC in our country. There are interventions, which usage in clinical care workplaces Anesthesiologic Resuscitation ward, Intensive Care Unit surgery minimally once a week. These interventions NIC undergo expert validation., and Jitka Hůsková, Petra Juřeníková
V devadesátých letech minulého století dochází k rozvoji laparoskopické chirurgie. Cestu ukázali chirurgickým oborům gynekologové. Vývoj metody započal simultáně na třech místech. V USA, Francii a Německu. V roce 1989 provedl Reich v USA první LAVH. Querleu v roce 1991 první laparoskopickou lymfadenektomii a v roce 1992 kombinoval Dargeant Schautovu radikální vaginální hysterektomii s laparoskopickým přístupem. Systematická pánevní a alternativně paraortální lymfadenektomie je součástí radikálních laparoskopických výkonů. Stanovili jsme novou nomenklaturu parametrií, snažíme se šetřit autonomní inervaci. Zpočátku byli operatéři autodidakté, v poslední době jsme svědky standardizace indikací a techniky. Bezpečnost výkonu a komfort operatéra zvyšuje vyspělá technika, 3D zobrazení, vysokofrekvenční bipolární technika, konstrukce trokarů omezujících možnost cévních poranění. Postupně byl téměř na všech specializovaných pracovištích opuštěn vaginální přístup a kompletní operace je prováděna pouze laparoskopicky pod mezinárodně srozumitelným označením TRLH (totální, radikální, laparoskopická hysterektomie). Systematicky se budeme ve svém sdělení věnovat anatomickým aspektům, aplikaci trokarů, základním preparačním krokům a postupům, které omezí možné komplikace, zejména ze strany močového měchýře a ureterů. Zmíníme nutné technické vybavení, základy bezpečné práce s vysokofrekvenční koagulací. Na závěr probereme pooperační péči., In the nineties we experienced a massive development of laparoscopic surgery. Gynecologists were the first who paved the way. The method was simultaneously developed in three countries - the United States, France and Germany. From the United States the vaginal laparoscopically assisted procedures have came to Europe. The French and German schools were based on the historical knowledge of the Schauta radical hysterectomy. In 1989 Reich was the first who operated the LAVH, followed by Querleu in 1992 with lymphadenectomy and Dargeant who combined the Schauta procedure with the laparoscopic lymph node dissection. It was the laparoscopy that taught us the proper functional anatomy. A new nomenclature of the parametries was defined. Careful attention is given to the preservation of the autonomous inervation. In the beginning all laparoscopic surgeons were self-taught. Nowadays a standardized laparoscopic techniques are implemented for a radical laparoscopic operations. The safety of this method is enhanced by using advanced technologies like 3D imaging, high frequence bipolar tools, safety trocars. More often the vaginal approach is being abandoned and the whole operation is performed laparoscopically. A generally accepted term for this operation is TRLH which stands for Total Radical Laparoscopic Hysterectomy. We will systematically describe the anatomical aspects of the dissection technique regarding the save preparation of the ureters and the bladder. The technical equipment will be mentioned as well as the use of monopolar and bip, Radek Chvátal, and Literatura
Tento článek obsahuje dosavadní poznatky o tradiční amazonské medicíně v České republice. Rovněž je v něm zahrnuta klasifikace pořádaných obřadů a charakteristika jejich pořadatelů a účastníků. Terénní výzkum mezi uživateli tradiční amazonské medicíny byl realizován od listopadu 2015. Výzkumný vzorek tvoří 46 osob (23 žen a 23 mužů), které se v minulosti s tradiční amazonskou medicínou minimálně jednou zúčastnily nějakého typu rituálu. S těmito osobami byly nahrány semi-strukturované rozhovory. Cílem tohoto článku je kategorizovat jejich obsah. Za tímto účelem jsme provedli obsahovou analýzu interview metodou zakotvené teorie. V tomto článku prezentujeme výsledky analýzy prvních 15 rozhovorů. Tyto výsledky potvrzují, že v České republice je nejčastěji užívaným přípravkem z tradiční amazonské medicíny psychoaktivní odvar ayahuasca. V závěru článku jsou uvedena rizika spojená s užíváním psychoaktivních látek., This article assesses the present situation in traditional Amazonian medicine in the Czech Republic. It also classifies the types of organized rituals and characterizes their organizers and participants in the country. The fieldwork among traditional Amazonian medicine users was conducted since November 2015. A total of 46 respondents (23 women and 23 men) who had attended at least one ritual of traditional Amazonian medicine were selected for the study and we recorded with them semi-structured interviews. The aim of this article is to categorize their contents. In order to fulfill this objective, we performed a content analysis of interviews based on the Grounded Theory method. In this article we publish results of analysis of the first 15 interviews. These results confirm that in the Czech Republic a psychoactive brew ayahuasca is the most used preparation from traditional Amazonian medicine. Finally, there are risks associated with the use of psychoactive substances indicated., and Miroslav Horák, Šárka Vosáhlová
V článku předkládáme kazuistiku pacienta s traumatem podkovovité ledviny. Vzhledem ke stupni poranění jsme pacienta indikovali k akutní- mu operačnímu výkonu. Popisujeme problematiku přístupu a operačního řešení podkovovité ledviny z pohledu její atypické polohy a cévního zásobení. V našem případě jsme provedli laparotomii, provedli jsme záchovný výkon s hemostázou pomocí stehů s Hem-o-lok klipů. Pacient byl v pooperač- ním období bez závažných komplikací, následně byl propuštěn do domácí péče a je pravidelně sledován., We present a case report of a patient with injury to their horseshoe kidney. According to CT examination and grade of trauma we decided to proceed with surgery. We describe and discuss issues of kidney abnormalites from the perspective of investigation, surgical approach and treatment. In our case we proceed with exploratory laparotomy, we performed nephron sparing procedure with hemostasis by nephrorrhaphy with stitch and hem-o-lok clips. The patient recovered with no serious complication. He was discharged home early, Martin Hlavička, Marek Broul, Miroslav Štrbavý, Petr Skála, Filip Cihlář, David Škvára, Jan Schraml, and Literatura