Cíl: Zjistit přínos 18F-fluorocholinového PET/ CT (18F-FCH PET/CT) pro cílenou biopsii prostaty u pacientů s opakovaně negativními biopsiemi a trvajícím podezřením na přítomnost karcinomu prostaty. Soubor pacientů a metoda: Od ledna 2013 do května 2015 jsme provedli 18-F-FCH PET/CT cholinové PET CT vyšetření u 30 pacientů. Indikačním kritériem bylo PSA nad 10 ng/ml a prodělání více než tři biopsií prostaty, včetně biopsie saturační. Pokud to bylo možné, pak pacienti předem prodělali šestitýdenní kůru ATB terapie Doxycyklinem 100mg 2x denně k eliminaci zánětu, a tím možným falešně pozitivním nálezům na 18F-FCH PET/CT. Poté bylo provedeno PET/CT vyšetření a následně s odstupem byla provedena cílená biopsie ložisek popsaných na 18F-FCH PET/CT. Cílená biopsie byla provedena pod sonografickou kontrolou transrektálně za pomoci kognitivní fúze PET/CT obrazu s real-time sonografickým záznamem. Byly odebírány jen vzorky z ložisek popsaných na PET/CT. Výsledky: Od ledna 2013 do května 2015 absolvovalo 18F-FCH PET/CT 30 pacientů. Průměrný věk pacientů byl 66 let v rozmezí 57–75 let. U 14 z nich jsme potvrdili karcinom prostaty, což činí 46% záchyt ve skupině rebiopsií. Všichni tito pacienti měli Gleasonovo skóre vyšší než sedm a PSA vyšší než 20 ng/ml. Závěr: V našem souboru jsme prokázali přínos 18F-FCH PET/CT u pacientů s opakovaně negativními biopsiemi a pokračující elevací PSA, u kterých nebyl karcinom prostaty standardním způsobem detekován. Ložisko vyznačené pomocí 18F-cholinufluorocholinu umožnilo cílenou biopsii pod sonografickou kontrolou. V současnosti není jednoznačné doporučení, jak postupovat u pacientů, u kterých máme opakovaně negativní biopsie prostaty a trvá podezření na přítomnost karcinomu. Využití 18F-FCH PET/CT se jeví jako jedna z mož- ností., Aim: The aim of the study was to determine the benefits of 18F-fluorocholine PET/CT in patients with repeated negative biopsies and continued suspicion of prostate carcinoma. Material and methods: 18F-fluorocholine PET/CT (18F-FCH PET/CT) was performed with 30 patients from January 2013 until May 2015. Indication criteria were PSA above 10 ng/ml and three biopsies. If possible patients underwent six weeks treatment of antibiotic therapy with Doxycyclin 100mg twice per day to eliminate inflammation and possible false findings in PET/CT. Then PET/CT was performed with following targeted biopsy of focus from 18F-FCH PET/CT. Targeted biopsy was done under the sonographic transrectal control with the help of cognitive fusion PET/CT image with real-time sonography. Only samples from centers identified with PET/CT were taken. Results: From January 2013 until May 2015 30 patients underwent 18F-FCH PET/CT. Average age of patients was 66 years (57–75 years). We confirmed prostate cancer in 14 of them which is 46 % success in rebiopsy group. All these patients had Gleason score above seven and PSA higher than 20 ng/ml. Conclusions: We have shown in our sample the benefits of 18F-cholinFCH PET/CT in patients with repeated negative biopsies and continued PSA elevation, where prostate carcinoma was not detected in standard biopsies. The use of 18F-FCH PET/CT seems promising in diagnostic of prostate cancer where 18F-fluorocholine can be found also in slow growing cells of majority of prostate carcinoma. Using this method we can diagnose also tumors, which are located outside of typical areas in the peripheral zone and therefore can be missed even in repeated biopsies., Šárka Kudláčková, Milan Král, Pavel Koranda, Vladimír Študent, and Literatura
The study aimed to investigate the role of aggression and impulsivity in smoking among male adult students. It was hypothesized that there would be significant difference between smokers and non- smokers on the traits of aggression and impulsivity. The sample of two hundred male adult students was selected from different universities of Islamabad. Two subscales of Impulsiveness and Aggression were administered to measure the personality traits of aggression and impulsivity. Descriptive statistics and t-test was calculated for analysis of data. Results showed that there is significant differences in aggression and impulsivity between smokers and non-smokers. The result can be helpful for psychologist and other professionals to plan public health therapeutic and social reengineering interventions for youth., Uzma Zaidi, and Literatura
A cutaneous horn is a general name for cornified material protruding from skin. On the other hand, polydactyly is a common congenital anomaly of the hand and foot which is characterized by extra finger or toe. A cutaneous horn might mimick polydactyly by resembling an extra toe. Hereby, we present a 72-year-old white Caucasian male with an extra toe-like projection on his fourth toe. Initially, polydactyly was suspected, however a cutaneous horn was also considered. The lesion was surgically removed. The histopathological examination of the specimen revealed hyperkeratosis, and thus confirmed the lesion to be a cutaneous horn., Funda Tamer, Mehmet Eren Yuksel, and Literatura
Nevus lipomatosus superficialis is a rare hamartomatous malformation which is composed of ectopic adipocytes in the dermis. It was first reported in 1921 by Hoffmann and Zurhelle. Two clinical forms of nevus lipomatosus superficialis have been described: classical (multiple) and solitary. Classical form of nevus lipomatosus superficialis is usually found on pelvic girdle, trunk, buttocks and thighs as soft, skin colored papules or nodules. It is usually present at birth or it appears in the first two decades of life. The solitary form of lipomatosus superficialis appears as a solitary papule or nodule on the back, scalp and arms of the patients with late onset. The lesions are usually asymptomatic, however some patients may complain about pain and itching. Malignant transformation of nevus lipomatosis superficialis has not been reported yet. Therefore, surgical intervention is only necessary for the patients who have cosmetic concerns. Recurrence after surgical removal is very rare. Perineum is an uncommon localization for nevus lipomatosus superficialis. Hereby, we report a 55-year-old Caucasian female with a 6x5,5x4 cm mass in the perineal region. The patient had cosmetic concerns, therefore she wanted the lesion to be removed surgically. The lesion was surgically removed. The histopathological evaluation of the specimen revealed nevus lipomatosus superficialis. A solitary type of giant nevus lipomatosus superficialis in the perineal region of a patient over the age of 50 is a very rare condition. Even rarely seen, nevus lipomatosus superficialis should be kept in mind in the differential diagnosis of perineal masses., Funda Tamer, Mehmet Eren Yuksel, and Literatura
Angiosarcoma is a soft tissue tumour with a dismal prognosis. We present a 74 year old male presenting with a non healing ulcer on the scalp. On histopathology a diagnosis of angiosarcoma was made. An early diagnosis and tumour size play a pivotal role in the survival of the patient., Deepal J Deshpande, Chitra S Nayak, Sunil N Mishra, and Literatura 6
Academic detailing, also known as prescriber support and education, is the service of sending trained clinicians to physicians’ offices in order to present the best available, objective scientific evidence in a given therapeutic area. We describe and review experience with academic detailing programs. We conclude that the academic detailing program could be tried in the Czech Republic, Ludwig O. Dittrich, and Literatura
In the last decade the health of young people in Ukraine as well as in many other countries of the world significantly deteriorated according to the results of screening tests. Because of this the main task of prophylactic medicine is development and introduction of new methods of early diagnostics of diseases. The aim of the work to assess the peculiarities of adaptation of students with different types of vegetative regulation. Material and methods: 415 second year students of Lugansk State Medical University were tested. The mechanisms of physiological functions of the body regulation were assessed by registration of cardiac rhythm variability (CRV). Analysis of CRV was performed by three methods: statistical, geometrical, and spectral analysis. The express method proposed by Shlyk, N.I. (2009) was later used to determine the prevailing type of vegetative regulation. To assess adaptability the method of R.M. Baevskij (1979) was used. Results: In the result of investigation 4 types of functional states of regulatory systems were determined: I type 295 (71 %) of tested, II in 14 (3 %), III in 96 (23 %) and IV only in 10 (2%). I type of functional state of regulatory systems in the wakeful state at rest was characterized by moderate prevalence of central regulation of heart rhythm (MPCR), decreased activity of autonomic regulation. It was noticed that some of the parameters of CRV (like RR, SDNN, RMSSD and pNN50) which characterize autonomic regulation, were statistically lowere (р≤0.01) compared to type III, and some (like AMo and SI) higher, in both female and male students. Summarized spectrum capacity and components of its wave structure (HF, LF, VLF) which characterize central regulation were statistically significantly lower (р≤0.01) for the I type of regulation compared to the III one which is characterized by moderate prevalence of autonomic regulation of the heart rhythm. In female students with type I autonomic regulation compared to male students such CRV parameters as RR and AМo were statistically significantly lower (р≤0.05), while the parameters of total potency (TP) and high frequency waves (HF) were higher (р≤0.05), which could point to more centralized heart rhythm regulation in male compared to female. The evaluation of regulatory systems overstress allowed to determine the state of adaptation and risk of overstress or breakdown in students with different types of autonomic regulation. Conclusions: Thus, evaluation of adaptation state in students with different types of autonomic regulation allows to characterize the current functional state and uncover the risk of disease development., Tatiana Tananakina, Natalya Lila, Anzhelika Ivasenko, Dmitrij Bolgov, Svetlana Mavrich, Yuliya Modna, and Literatura
Cíl: Průzkumné šetření zjišťovalo schopnosti spolupráce nemocných při léčbě Warfarinem a dodrţování léčebného reţimu v průběhu dlouhodobé antikoagulační terapie Warfarinem. Konkrétně byla mapována a vyhodnocena úroveň edukace sestrou, informovanost a adherence k léčbě u pacientů léčených Warfarinem. Metodika: Průzkumný soubor tvořilo 108 pacientů evidovaných v ambulantním léčení interní a kardiologické ambulance při interním oddělení Nemocnice ve Frýdku-Místku. Průzkumné šetření probíhalo v prosinci roku 2010 a lednu roku 2011. Pro sběr dat byla vyuţita metoda dotazníkového šetření. Výsledky: Výsledky průzkumného šetření ukazují, ţe naprostá většina pacientů léčených Warfarinem se aktivně podílí na léčebném procesu. Nemocným se od zdravotníků dostává poučení o léčbě, sestry se na edukaci podílejí v 75 %. Většina dotázaných dochází na pravidelné kontroly a zná zpaměti uţívanou dávku léku. Čtvrtina nemocných však není schopna uvést krvácení jako hlavní riziko léčby. Převáţná většina respondentů si je vědoma skutečnosti, ţe účinek léčby můţe být ovlivněn sloţením přijímané potravy, méně neţ polovina respondentů zná interakci Warfarinu s jinými léky či doplňky stravy. Nemocní mají na zřeteli, ţe je nutno informovat kaţdého lékaře o této léčbě, jen polovina respondentů však informuje i lékárníka. Závěr: Adherence k léčbě ze strany pacienta je základem úspěšné a bezpečné terapie Warfarinem. Cílem všech zdravotníků by měla být snaha o kvalitní a efektivní komunikaci s nemocnými, snaha o dosaţení co nejvyšší úrovně spolupráce, ochoty a schopnosti pacientů řídit se pokyny zdravotníků. Tím se výrazně zvýší úspěšnost léčby a eliminuje se riziko moţných komplikací léčby., Aim: Exploratory investigation ascertained capabilities of cooperation of patients when treated with warfarin and adherence to treatment regimen during long term anticoagulant therapy by warfarin. Specifically was mapped and assessed the level of education by nurse, foreknowledge and adherence to treatment in patients treated with warfarin. Methods: The exploratory set consisted of 108 patients, who were registered in ambulant treatment of internal and cardiac ambulance at internal department of Hospital in Frydek-Mistek. Exploratory investigation took place in December 2010 and January 2011. For data collection was used method of questionnaire survey. Results: The results of questionnaire survey show, that absolute majority of patients treated with warfarin is actively participating in the treatment process. The patients receive from the health care providers education about the treatment, nurses are participating in education in 75%. Majority of respondents have regular check ups and knows by heart the dose of the drug. A quarter of patients is not able to state bleeding as the main risk of treatment. The vast majority of respondents are aware of the fact, that the treatment effect may be influenced by the composition of the diet, less than half of the respondents know the warfarin interactions with other medication or supplements. Patients have in mind that every doctor should be informed about this treatment, only half of the respondents, however, informs as well the pharmacist. Conclusion: Adherence to treatment by the patient is the foundation of a successful and safe warfarin therapy. The goal of all health professionals should be to aim for quality and effective communication with patients, effort to achieve the highest level of cooperation, willingness and ability of patients to follow medical instructions. This greatly increases the effectiveness of treatment and eliminates the risk of potential complications of treatment., Michaela Teperová, Lucie Sikorová, and Literatura 8
Background: We have analyzed the aged population disability processes to establish specifics and regularities of the causal structure of disability among the working and nonworking aged population. Methods: In total, 1208 examination reports of the Medical & Social Expert Commission have been subjected to excerption in Almaty. Results: Persons having the second disability status prevail in the working aged contingent 4,4%, which is much higher than the ratios for the first and second disability statuses (0,4% and 0,6%, respectively). Among the nonworking population, persons having the second disability status largely prevail too 8,1% (3,1% and 1,1%, respectively). The casual structure of disability among the nonworking disabled persons includes as follows: blood circulatory system diseases (40%), malignant neoplasms (27,2%), and diseases of the eye and its appendages (10,2%). They are followed by endocrine diseases, nutritional and metabolic disturbances (7,6%), bodily injuries (3%), and urogenital system diseases with musculoskeletal system ones 2,3% each. The data collection for the working aged population contingent has found out blood circulatory system diseases (47%) and malignant neoplasms (34,4%). Alongside with that, the distinctive feature among the said aged population cohort is a substantial predominance of bodily injuries (7,4%), endocrine diseases, nutritional and metabolic disturbances (2,3%), and only 1,4% is accounted for diseases of the eye and its appendages., Akmaral K. Abikulova, Kazbek A. Tulebaev, Aikan A. Akanov, Botagoz S. Turdalieva, Sundetgali B. Kalmahanov, Mussaeva A. Bakhit, Aldamzharova K. Madina, and Literatura
Východiska: Vzhledem ke geriatrizaci ošetřovatelské péče se ageismus stává často diskutovaným tématem. Z tohoto důvodu je velmi důležité, aby nelékařští zdravotničtí pracovníci byli v tomto ohledu dostatečně vzděláváni, protože právě dostatečná informovanost a praktická zkušenost může ovlivnit míru inklinace k ageistickým postojům. Cíl: Cílem výzkumného šetření bylo zhodnotit ageistické postoje u studentů středních zdravotnických škol v závislosti na škole a ročníku, kterou respondenti navštěvovali a zjistit rozdíly ve vnímání seniorské populace. Metody: V souladu s cíli práce byl proveden kvantitativní výzkum formou dotazníkového šetření. Na základě bodového ohodnocení odpovědí v dotazníku byla zjištěna míra ageistických postojů u respondentů. Výsledky: Práce prokázala, že je statisticky významný vztah mezi ageistickými postoji u studentů a jejich příslušností ke střední škole. Stejně tak byl prokázán rozdíl mezi ageistickými postoji u studentů druhých a čtvrtých ročníků středních zdravotnických škol. Závěry: Z práce vyplývá, že ve sledovaném souboru se u většiny studentů objevuje střední inklinace k ageistickým postojům s ohledem na navštěvovanou školu. Dále pak, že k ageistickým postojům inklinují více studenti čtvrtých ročníků, kteří již absolvovali odbornou praxi u lůžka nemocného, než studenti druhých ročníků, kteří tuto praxi ještě neabsolvovali., Background: Due to geriatrization of nursing care becomes oen discussed theme. Because of this it’s very important that non-medical health staff will be enough educated. It is that sufficient awareness and practical experience that can affect the rate of inclination to ageist attitudes. Objective: e objective of this research was to evaluate ageist attitudes of nursing school students according to school which the respondents visited and find out the differences in perception of senior population among the students of second and fourth grade. Methods: Due to the aims of this work the quantitative research has been done through a questionnaire survey. e rate of ageist attitudes was observed based on scoring responses. Results: A statistically significant relationship between symptoms of ageist attitudes this work proved as well as the differences between symptoms of ageist attitudes among second and fourth grade students. Conclusions: e work shows that in the sample survey, the majority of students appearing middle inclination to the myths of old age. Furthermore, the myths of old age tend more fourth grade students who have already completed work experience at the bedside than second grade students who have not completed this practice yet., and Kristýna Šoukalová, Jana Holá, Markéta Nemšovská