A hybrid approach to elephant trunk technique for treatment of thoracic aortic aneurysms combines a conventional surgical and endovascular therapy. Compared to surgery alone, there is a presumption that mortality and morbidity is reduced. We present a case report of a 42-year-old man with a giant aneurysm of the entire thoracic aorta, significant aortic and tricuspid regurgitation and ventricular septum defect. The patient underwent multiple consecutive operations and interventions having, among others, finally replaced the entire thoracic aorta with the use of the hybrid elephant trunk technique. and T. Holubec, J. Raupach, J. Dominik, J. Vojácek
In view of the high anti-oxidative potential oftocotrienol, the role of the tocotrienol-rich fraction (TRF) of palm oil in preventing pregnancy induced hypertension (PIH) was explored in a randomized double-blind placebo-controlled clinical trial in an urban teaching hospital. Healthy primigravidae were randomized to receive either oral TRF 100 mg daily or placebo, from early second trimester until delivery. Out of 299 women, 151 were randomized into the TRF arm and 148 into the placebo arm. A total of 15 (5.0%) developed PIH. Although there was no statistically significant difference in the incidence of PIH (4/151 or 2.6% in the TRF arm vs. 11/148 or 7.4% in the placebo arm, p = 0.058) between the two arms, there was a tendency towards a lower incidence of PIH in the TRF arm compared to the placebo arm. With TRF supplementation, the relative risk (RR) of PIH was 0.36 (95% CI 0.12-1.09). In conclusion, although TRF from palm oil does not statistically significantly reduce the risk of development of PIH in the population studied, the 64% reduction in incidence of PIH is substantial. The findings warrant further clinical trials, particularly in high risk populations. and ZA. Mahdy, HH. Siraj, H. Khaza'ai, MS. Mutalib, MH. Azwar, MA. Wahab, AZ. Dali, R. Jaafar, NA. Ismail, MA. Jamil, N. Adeeb
INTRODUCTION: Autologous stem cell transplantation (ASCT) became standard of care for patients with multiple myeloma (MM) under the age of 65 years. We routinely perform ASCT for newly diagnosed MM since 1996 in our department. PATIENTS AND METHODS: We retrospectively analyzed all 285 transplants in 185 patients done for MM from January 1996 till December 2010. We analyzed overall survival (OS) and progression-free survival (PFS) regarding conditioning, stage, complete or very good partial remission (CR, VGPR) achievement, renal impairment, single vs. double transplant. RESULTS: Estimated 10-years survival of the whole set of patients is 39% (median survival 95 months). Patients with renal impairment show same OS as those without (p = 0.22). Patients show similar overall survival and event free survival regardless of type of transplant. We observed better outcome in terms of overall survival in patients treated with new drugs (p = 0.0014). Reaching CR or VGPR was not translated into better OS (p = 0.30) and EFS (p = 0.10). Also stage of the disease and whether single or double transplant was used did not make any significant difference in the outcome. CONCLUSION: Stem cell transplantation greatly improved outcome of patients with MM. Poor outcome of allogeneic transplantation in our group of patients is related to high transplant related mortality (20% vs. 0%) and unexpected high relapse rate. There is a trend towards better survival, when new drugs are incorporated at any time in the course of the disease. This fact supports hypothesis that use of these drugs with ASCT should translate into better long-term outcome. and J. Radocha, V. Maisnar, A. Zavrelová, M. Cermanová, M. Lánská, M. Kmonícek, L. Jebavý, M. Bláha, J. Malý, P. Zák
There are various complications of prosthetic valvular surgeries. Among them, leaflet perforation should be emphasized and brought to mind when there have been eccentric valvular regurgitation. In this report, we presented 2 cases of iatrogenic aortic and mitral valve leaflet perforation after prosthetic valve surgeries. and M. Dogan, S. Acikel, U. Arslantas, T. Cimen, E. Yeter
We assessed the intensive care unit (ICU) patients for Invasive aspergillosis (IA) with culture and non-culture based diagnostic methods from Iran. Thirty-six ICU patients with underlying predisposing conditions for IA were enrolled in the study. Sixty eight Bronchoalveolar lavage (BAL) samples were collected by bronchoscope twice a weekly. BAL samples were analyzed by microscopic examination, fungal culture and galactomannan (GM) detection. The Platelia Aspergillus GM EIA was used to quantify GM indices. Samples with a BAL GM index > or = 1 were considered as positive for GM. Patients were classified as having probable or possible IA. Out of 36 suspected patients to IA, 36.1% of cases showed IA which were categorized as: 4 cases of possible IA and 9 of probable IA. 76.2% of BAL samples were positive for GM. From 13 patients with IA, 11 (84.6%) had at least one positive BAL GM index. Of these patients, 9 (81.8%) showed probable IA. The main underlying predisposing conditions were neutropenia (53.8%) and COPD (30.8%). Our study has indicated that COPD must be considered as one of the main predisposing condition for occurrence of aspergillosis in ICU patients. Our data have also revealed that GM detection in BAL samples play a significant role to IA diagnosis. and MT. Hedayati, S. Khodavaisy, M. Alialy, SM. Omran, MR. Habibi
UNLABELLED: Aim of our study was to evaluate the importance of atopy patch testing with aeroallergens as a diagnostic method in patients suffering from atopic dermatitis. METHOD: The complet dermatological and allergological examinations were performed in 29 patients; 10 men, 19 women with the average age of 27.8 years, min. 17, max. 57 years; with the median SCORAD 24.2 points, s.d. 13.3 points. Wormwood, grass, dog dander, cat dander, dermatophagoides pharinae, dermatophagoides pteronyssinus and birch pollen were examined in diagnostic procedures. Skin prick tests, specific IgE were examined; the atopy patch tests were performed with aeroallergens for skin prick tests in concentration 1 x skin prick tests. RESULTS: Specific IgE and skin prick tests to one or more tested aeroallergens were positive altogether in 27 patients; atopy patch tests were positive only in one of these patients. CONCLUSION: For atopy patch testing with aeroallergens the concentration of 1 x skin prick tests is low to confirme the eczematic reaction in patients suffering from allergy to inhallant allergens. and J. Celakovská, K. Ettlerová, K. Ettler, J. Vanecková
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
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
The pilot study deals with the clinical results of the regenerative therapeutical method in intraosseous periodontal defects done by surgical augmentation procedure using a material of a new generation prepared on the basis of a bioactive glass. A group of 10 individuals were treated properly for chronic periodontitis. Some of treated infraalveolar periodontal lesions, both periodontal pockets and interradicular defects, persisted or recurred in posterior teeth. In order to eliminate them they were indicated for advanced periodontal surgery or regenerative surgical therapy stimulating healing processes of supportive tissues, mostly alveolar bone around treated teeth. Relevant clinical parameters, i. e. values of the pocket depth, gingival recession, and loss of attachment were evaluated before and after the periodontal surgery and compared with each other. The therapy led to significant improvement of clinical parameters in terms of the reduction of pocket depth and loss of attachment values. and R. Slezák, V. Paulusová