Přehled současného využití robotického systému ve světě. Tříleté zkušenosti s 42 robotickými operacemi provedenými od roku 2008 do roku 2011 na gynekologickém oddělení v Ústí nad Labem. Operace provedené převážně pro karcinomy cervixu a endometria; 29 operací s lymfadenektomií., The article gives a survey of the utilisation of robotic surgery in the world. It presents three years of experience from 42 robotic operations performed from 2008 until 2011 in the Department of Gynaecology-Obstetrics at Masaryk Hospital in Usti nad Labem. The procedures were performed mostly following a diagnosis of endometrial and cervical cancer; 29 of the 42 operations were instances of lymfadenectomy., Ivo Blšťák, Marcel Vančo, and Literatura 8
Příspěvek nabízí pohled na tradiční pojem „psychosomatických rodin“ z hlediska jeho současné platnosti a užitečnosti. Poukazuje na výzkumné a klinické zkušenosti s častějším výskytem psychosomatických onemocnění u rodin s určitými poruchovými vlastnostmi struktury a interakce, v nichž tělesný projev nemoci plní účelnou, krátkodobě takovou rodinu ochraňující, dlouhodobě ji v její porušenosti ustalující a vývojově ji poškozující úlohu. Výsledkem má být připomenutí si vlastností takto rizikovějších rodin s výhledem na diagnostické rozpoznávání a porozumění funkci takového psychosomatického dění a zacílení terapeutické pomoci ke zdravějším způsobům zvládání rodinného stresu, než poskytuje takto probíhající patogenní „vyrovnávání účtů“ vzájemných potřeb v rodinném soužití., The paper presents a review of the traditional concept of „psychosomatic families“ from the viewpoint of its present validity and usefulness. It refers to research and clinical pieces of experience with more frequent occurrence of psychosomatic diseases in families that exhibit certain dysfunctional traits of structure and interaction, in which the somatic symptom fulfils an effective function in momentarily protecting the family from breakdown, however, in the long run, solidifying its ongoing malfunction and developmental impairment. The aim of the study is to remind of the typical characteristics of the families with such risks, with a view to diagnostic identification as well as understanding the function of such psychosomatic development, and leveling the therapeutic help to establishing more healthy ways of coping with family stress, than the ongoing pathogenic “squaring up“ of mutual needs in family cohabitation makes possible., Balcar K., and Literatura
Czech health and social services have undergone significant changes related to the reform of public administration including the transfer of certain social and health services to the competence of municipalities and regions. Regions also became legally responsible for social services ́ planning process including their registration and since 2015 financing. The findings in the article are based on a qualitative methodological approach, which was used as a combination of public policy documents analyses and primary data analysis. The empirical research was based on focus groups when respondents represented persons caring for the elderly and disabled people as well as providers of health-social services in the Central Bohemian Region. Based on the survey we can state that some types of services are underdeveloped, particularly the domiciliary services, social services for older children and adults with disabilities, respite care and other support services for caregivers. The great problem is the absence of interconnection between health and social services in the region. From the viewpoint of service providers and caregivers the level of municipalities is perceived as closer to the clients than regional level, thus service providers and caregivers aim their demands to municipalities more frequently. and Kotrusová Miriam, Dobiášová Karolína, Angelovská Olga
The review focuses on a very peculiar aspect of the application of copper containing biologically active compounds of different chemical classes as have shown at the last scientific researches in the field of Cu (II) chelates, chelates possess have a higher activity of the same sort, than their mother compounds. The presented material shows essentially important qualities of Cu (II) containing compounds in biological aspect and has an interest for chemists, biochemists and pharmacologists., Sedrak Ghazaryan, and Literatura
Aim: to improve treatment results of colorectal cancer, complicated carcinomatosis of abdominal cavity, by associated using of endolymphatic chemotherapy (ELCT) and local extremely high frequency (EHF) therapy. Igroup 21 people (33.3%) performed colostomy, then neoadjuvant systemic chemotherapy by the scheme FOLFOX4. It was held two cycles, after two cycles their were received cytoreductive surgery; II group 26 people (41,3%) received cytoreductive operations with early postoperative intraabdominal chemotherapy by oxaliplatin (200 mg/m(2) at day 1 and 5FU 650 mg/m(2) from days 1 to 4. III group 16 people (25,4%) also performed colostomy, then used 2 courses of ELCT with local EHF therapy and all patients were received cytoreductive operations. ELCT was carried out injecting oxaliplatin100 mg/m(2) a day during 12 hours and then 5 FU in doze of 600 mg/m2 a day during 72 hours by the instrumentality of the dozer and LV200 mg/m(2) (2h intravenous infusion). During ELCT patients received local EHF therapy in abdominal cavity for an hour. After chemotherapy the partial regress of tumor observed in 1st group in 4,8 % and in 3rd 37,5 %, stabilization of process noted in 28,6 and 50% cases, progressing 66,7 and 12,5% cases correspondingly to groups. Histomorphologic study of malignant foci after ELCT+EHF therapy showed reduction of specific area of parenchyma cancer cell from 57 till 39% simultaneous growth of stroma from 40 till 58% and in necrosis area from 1,8 till 2,5%. Mitotic activity of tumor cells in the 1st group decreased (average in 22 un.), but in 3rd group it decreased until 11 units. Analysis of life span showed that in 1st group of patients 2year survival rate was 66,7%. In 2nd group of patients 2year survival rate was 42,3%. ELCH+EHFtherapy has high clinic efficacy and promotes to decrease terms of progression of tumor process, increases life span from 0 till 24% and quality of life of the patients. ELCH+EHFtherapy brings to reduction of specific area of parenchyma in cancer cells from 57 till 39% with simultaneous growth of stroma area from 40 till 58% and necrosis area from 1,8 till 2,5%. ELCT+EHFtherapy lowers mitotic activity of tumor cells, activates apoptosis, hemodynamic and metabolic rates., Akbarov E.T., Navruzov S.N., Abdujapparov S.B., Islamov H.D., and Literatura
Postavení plátce ve zdravotnictví je zajímavou a často diskutovanou problematikou v mnoha zdravotních systémech. Česká republika v tomto směru není výjimkou. Již od roku 1993 se zde, méně či více bouřlivě, vedou debaty o tom, zda je, po vzoru národních služeb, lépe mít zdravotní systém s jedním plátcem či zda dát prostor vícero plátcům. Záměrem autorky je přispět do této polemiky a na základě poznatků literatury se zamyslet nad tím, jakou roli by vlastně plátci ve zdravotnictví měli plnit. Následně k tomu vymezit a diskutovat, jaké podmínky musí být splněny, aby tyto role plátci plnit skutečně mohli. Jinými slovy, cílem článku je specifikovat role plátců ve zdravotních systémech a vymezit a diskutovat podmínky vedoucí k tomu, aby tyto role plnit mohli., The role of payers in the healthcare systems is an interesting and often discussed issue in many countries. The Czech Republic is not an exception. Since 1993, there has been a debate, more or less heated, of whether it is better to have a single payer system (like NHS) or whether the pluralistic system should take place. The purpose of the author is to contribute to this polemics and based on the literature review, to think about what is/should be the role of the payer in the healthcare systems and, in accordance to this, to specify and to discuss the conditions that must be fulfilled to accomplish those roles. In other words, the aim of the contribution is to specify roles/objectives of payers in healthcare systems in general and to define and discuss conditions that must be fulfilled to attain those objectives., Zuzana Darmopilová, and Literatura
Pluralitní versus unitární systém po - jištění – tedy více či jedna jediná pojišťovna? Tyto otázky vedly autorku k identifikaci rolí, které by na základě teorie pojišťovny měly hrát a ke zjištění, že tyto role se pojišťovnám teoreticky lépe plní v systému pluralitním. Tato tvrzení otevírají prostor pro další výzkum a vybízejí k jejich aplikaci na realitu českého systému. Autorka si klade otázku, zda se český systém přibližuje „optimálně“ fungujícímu pluralitnímu systému, a zda dává pojišťovnám možnost, aby své role plnily. Následně studuje dopady tohoto stavu na zdravotní systém a jeho efektivitu., Plural versus unitary health insurance system – one or more health insurance funds? These questions led the author to the identification of roles that the health insurance funds should play and to the conclusion that those roles will be easily achieved in the plural system. These claims challenge further research of the Czech reality. The author examines to what extent the Czech system resembles to “optimal” plural system and if it enables the health insurance funds to fulfil their roles. Consecutively, the impact on the efficiency of the Czech system is studied., Zuzana Kotherová, and Literatura
Východiskem článku je situace viability. Ta je analyzována jako sémantický a medicínský koncept a jsou charakterizovány důsledky, které má klinický status extrémně nezralého novorozence (dítěte narozeného na hranici viability) pro etické uvažování a pro rozhodování o odpovídající lékařské péči, když není zohledněno pouze přežití extrémně nezralého novorozence ale rovněž různá úroveň poškození způsobeného lékařským zásahem. Článek se dále zabývá medicínskou nejistotou, jež je typická pro rozhodování o zdravotní péči o extrémně nezralé novorozence. Následně se zaměřuje na nejistotu etickou, která vyplývá z nejistoty medicínské. V závěru pojednání jsou navrženy způsoby, jak postupovat, rozhodovat a konat v situaci etických dilemat zachraňování dětí narozených na samé hranici viability., The paper departs from viability, analysing viability as semantic and medical concept and characterizing consequences that clinical status of an extremely preterm newborn (neonate born at the edge of viability) has for ethical considerations and decisions about the proper medical care – when not only survival of the extremely preterm neonate but also diverse level of medical harm to the infant are at the stake. Coming from medical uncertainty, typical for the extremely premature newborns, the paper focuses on moral uncertainty caused my medical uncertainty. Finally the paper brings some modi procedendi for ethical dilemmas of saving infants born at the edge of viability., Josef Kuře, and Literatura