K běžnému bio-psycho-sociálnímu modelu zdraví a nem oci, přidává autor ve své úvaze filosofický aspekt. Klade si otázku, proč vlastně k ritizujeme Descarta za neřešitelnou karteziánskou podvojnost těla a duše, když jde skut ečně o dvě odlišné úrovně lidského žití? K plnému porozumění člověka, jenž je charakte rizován autopoezou a svobodnou volbou, patří i pochopení a smysl, čemuž odpovídají konotativní teorie. Zde se hodí k poznání vnitřního světa a chování druhého empatie, příběhy, obrazy, přirovnání a metafory, tak je třeba chápat i psychoanalytické te orie a interpretace., The author, in his essay, adds a philosophical asp ect to the current bio-psycho-social model of health and illness. The question “Why is D escartes criticized for intractable Cartesian duality of body and soul when it is reall y two different levels of human life?” is being raised. Both understanding and sense are i nvolved in full understanding of a human being, who is characterized by autopoiesis an d free choice, with which connotative theories correspond. Empathy, stories, images, similes and metaphors suit to the knowledge of the inner world and the behavio ur of the others. It is to be even understood psychoanalytic theories and interpretati ons., Poněšický J., and Literatura
Cíl: Cílem příspěvku je literární analýza dosavadních nejvíce využívaných nefarmakologických metod tlumících bolest u novorozencůpro nejlepší praxi založenou na důkazech. Metodika: Pro získání dat za období 2000–2012 byly použity elektronické licencované a volně přístupné databáze. Hodnocení nalezených důkazů bylo realizováno dle metodiky Fineout-Overholt, Johnstona (2005), kteří řadí studie dle specifi ckých kritérií do sedmi kategorií. Do výběru předkládaného příspěvku byly zařazeny důkazy úrovně I, II, III. Zvolená kritéria splňovalo 42 studií (4 meta-analýzy, 6 systematických přehledů, 1 multicentrická studie a 31 randomizovaných kontrolovaných studií). Výsledky: Nefarmakologické metody využívané k tlumení bolesti u novorozenců jsou mnohem více efektivní, pokud jsou použity v kombinaci s dalšími nefarmakologickými metodami, jako jsou muzikoterapie, zavinutí, usnadněné zasunutí, multisenzorická stimulace, klokánkování a non-nutritivní a nutritivní sání. Závěr: Nefarmakologické postupy jsou účinné a vedou k efektivnímu zmírnění bolesti především při drobných procedurálních výkonech jako je odběr krve z patičky pomocí lancety, venepunkce, apod. Léčba bolesti a řízení její prevence by měla být nezbytnou součástí standardní i intenzivní zdravotní péče o novorozence., Aim: The aim of study is a literary analysis of the current most used non-pharmacological methods of relieving pain in neonates for the best evidence-based practice. Methods: For obtain data for the period 2000–2012 were used e-licensed and freely accessible database. Evaluation of the evidence found was carried out according to the methodology Fineout-Overholt, Johnston (2005), who put the study according to specifi c criteria in seven categories. The selection of the present study were classifi ed evidence level I, II, III. Selected criteria met the 42 studies (4 meta-analyzes, 6 systematic reviews, 1 multicenter study and 31 randomized controlled study). Results: Non-pharmacological methods used to control pain in neonates are much more eff ective when used in combination with other non-pharmacological methods, such as swaddling, facilitated tucking, multisensory stimulation, kangaroo care and non-nutritive and nutritive sucking. Conclusion: Non-pharmacological methods are eff ective and lead to eff ective pain relief especially when minor procedural performance as the heel lanceting, venipuncture, etc. Treatment of pain and management prevention should be an essential part of the standard and intensive care of the newborn., Jana Chromá, Lucie Sikorová, and Literatura
Cieľ: Cieľom štúdie bolo posúdiť bolesť, funkčný stav, úzkosť, depresiu, sociálne aktivity a sociálnu oporu u seniorov s reumatoidnou artritídou (RA) a ich vzájomné vzťahy, posúdiť možné rozdiely vzhľadom na pohlavie, rodinný stav, vek, trvanie ochorenia a komorbiditu. Metódy: U 60 seniorov s RA bola posudzovaná intenzita bolesti vizuálnou analógovou škálou (VAS), funkčná disabilita Stanfordským dotazníkom hodnotiacim zdravie indexom disability (HAQ-DI), úzkosť Beckovým inventárom úzkosti (BAI), depresia Zungovým sebahodnotiacim dotazníkom depresie (SDS) a sociálna interakcia škálou sociálnych aktivít (SA) a sociálnej opory (SO) nástroja Škály merania vplyvu chorôb kĺbov 2 (AIMS2). Výsledky: U seniorov s RA bolo zistené pociťovanie priemerne silnej bolesti, stredná až ťažká funkčná disabilita, prežívanie stredne silnej úzkosti a depresie, obmedzovanie v spoločenských aktivitách. Vo vnímaní sociálnej opory bolo zistené najlepšie skóre. Medzi sledovanými premennými boli Pearsonovou koreláciou zistené väčšinou signifikantné (P ≤ 0,05) kladné slabé až silné vzťahy. Medzi pohlaviami neboli zaznamenané rozdiely. Horšie skóre (P ≤ 0,05) bolo zistené v oblasti prežívania úzkosti a vo vnímanej sociálnej opore u osamelo žijúcich seniorov oproti seniorom žijúcim v manželskom zväzku. Štatisticky významný pozitívny vzťah (P ≤ 0,05) sa potvrdil medzi vekom a prežívaním úzkosti, medzi trvaním ochorenia a depresiou, medzi komorbiditou a funkčným stavom a depresiou. Záver: Ako naznačujú výsledky, prioritou v starostlivosti o túto skupinu seniorov by nemalo byť iba zmierňovanie bolesti a zlepšovanie/udržiavanie funkčných schopností, ale aj redukcia úzkosti a depresie, a to o to viac, čím sú seniori starší, čím u nich trvá ochorenie dlhšie, s komorbiditou a tiež u osamelo žijúcich., Aim: The aim of this study was to assess pain, functional status, anxiety, depression, social activity, and social support and their interactions in older adults with rheumatoid arthritis (RA), and to assess possible differences by gender, marital status, age, duration of disease, and co-morbidity. Methods: Pain intensity was assessed by the Visual Analogue Scale (VAS), functional disability by the Stanford Health Assessment Questionnaire – Disability Index (HAQ-DI), anxiety by the Beck Anxiety Inventory (BAI), depression by the Zung Self-rating Depression Scale (SDS), social activity by the Arthritis Impact Measurement Scales 2 (AIMS2) with scale of Social Activity (SA), and social support (SO) by AIMS2 with scale Support from family and friend in 60 elderly with RA. Results: There were found average strong pain, moderate to severe functional disability, moderate anxiety and moderate-to-marked depression, and limitation in social activity in elderly with RA. The best score was found in scale of social support. Significant (p ≤ 0.05) mild to severe relations were confirmed between explored objectives by Pearson’s correlations. Between genders no significant differences were recorded. Worse score (p ≤ 0.05) was detected in anxiety and social support in elderly living alone compared to married elderly. Between age and anxiety, duration of disease and depression, co-morbidity and functional disability, and depression were confirmed significant (p ≤ 0.05) positive relationships. Conclusion: According to results, not only pain reduction and improving/maintaining of functional status is the priority of care in elderly with RA, but also reduction of anxiety and depression is important, mainly in older, with longer duration of disease, co-morbidity and also for elderly living alone., Mária Sováriová Soósová, Renáta Suchanová, Libuša Tirpáková, and Literatura
The problem of prophylaxis of incompetence of bronchial stump and bronchial fistula is many sided. Notwithstanding the development of new technologies, perfection of surgical technique, its frequency still remains on high level that persistently requests the search of new ways for resolving this problem, which preserved its topicality till nowadays. We have found that: The most efficiency of BFS is achieved during treatment of bronchial fistulas with diameter up to 3 mm and with effectiveness at 83.2% patients after rightside PE and at 92.3% patients after leftside PE. In case of BPF with diameter more than 3 mm the number of satisfactory results of BFS reaches only 33.3%. but, it is necessary to mention that among patients with BPF sized over 3 mm after leftside PE the effectiveness of BFS significantly exceeds as general index (50.0% against 33.3%) so after rightside PE (50.0% against 25.0%)., F. G. Nazyrov, V. A. Porkhanov, Sh. N. Khudaybergenov, О. Т. Irisov, and Literatura
CD200/CD200R are highly conserved type I paired membrane glycoproteins that belong to the Ig superfamily containing a two immunoglobulin‑like domain (V, C). CD200 is broadly distributed in a variety of cell types, whereas CD200R is primarily expressed in myeloid and lymphoid cells. They fulfill multiple functions in regulating inflammation. The interaction between CD200/CD200R results in activation of the intracellular inhibitory pathway with RasGAP recruitment and thus contributes to effector cell inhibition. It was confirmed that the CD200R activation stimulates the differentiation of T cells to the Treg subset, upregulates indoleamine 2,3‑dioxygenase activity, modulates cytokine environment from a Th1 to a Th2 pattern, and facilitates an antiinflammatory IL‑10 and TGF‑β synthesis. CD200/CD200R are required for maintaining self‑tolerance. Many studies have demonstrated the importance of CD200 in controlling autoimmunity, inflammation, the development and spread of cancer, hypersensitivity, and spontaneous fetal loss., Drahomíra Holmannová, Martina Koláčková, Kateřina Kondělková, Pavel Kuneš, Jan Krejsek, Ctirad Andrýs, and Literatura 46
Cíl studie: zhodnocení efektivity cerkláže dle McDonalda ve Fakultní nemocnici Ostrava v období 1/2007 – 3/2014. Typ studie: retrospektivní studie Název a sídlo pracoviště: Porodnicko–gynekologická klinika, Fakultní nemocnice Ostrava Metodika: retrospektivní analýza provedených cerkláží ve Fakultní nemocnici Ostrava a rozbor výsledků takto ošetřených gravidit. Kritériem úspěšnosti byl stanoven porod po ukončeném 34. týdnu gravidity. Závěr: ve sledovaném období bylo indikováno devět cerkláží – 7 terapeutických a 2 záchranné. Výkony byly provedeny mezi 18. a 25. týdnem gravidity. Tři pacientky již měly v minulosti cerkláž provedenu. 57 % takto ošetřených těhotných porodilo po ukončeném 34. týdnu gravidity. Pouze v jednom případě (11,1 %) byla cerkláž neúspěšná a těhotenství skončilo potratem. Průměrná doba mezi provedením cerkláže a porodem činila 69 dnů., Objective: To evaluate the efficacy of cerclage according to McDonald at the University Hospital Ostrava in the period 1/2007 - 3/2014. Design: A retrospective study Obstetrics and Gynecology: Obstetrics - Gynecology, University Hospital Ostrava Methods: A retrospective analysis of cerclage performed at the University Hospital Ostrava and analysis of the results thus treated pregnancies. The criterion for success was determined after childbirth completed 34 weeks of preg - nancy. Conclusion: In the reporting period, nine indicated cerclage - 7 of therapeutic and 2 emergency. The procedures were performed between the 18th and 25th week of pregnancy. Three patients have had in the past cerclage performed. 57% of the treated pregnant women gave birth after 34 completed weeks of gestation. Only in one case (11.1 %) cerclage was unsuccessful and the pregnancy ended in a miscarriage. The average time between performing cerclage and delivery was 69 days., Petr Vašek, Igor Michalec, and Literatura
The subject of work is the development of Czech health care law in the past 20 years in the context of (1) Czechoslovak and Czech social change, (2) the development of international human rights interpretations related to health. The goal is evaluation of the Czech health care law in the individual developmental stages and their compliance with human rights related to health. Running away from the Czech health care law framework of human rights and its substitution by a positive concept of patients‘ rights is accompanied by efforts to reduce human rights protection mechanisms at the Constitutional Court („euroamendment“ of the Czech Constitution in 2001). Major changes in medical law in relation to human rights brings the current changes in health care reform (2011 - Health Reform I and II. Phase)., Petr Háva, Pavla Mašková, Tereza Teršová, and Literatura
The subject of work is the development of Czech health care law in the past 20 years in the context of (1) Czechoslovak and Czech social change, (2) the development of international human rights interpretations related to health. The goal is evaluation of the Czech health care law in the individual developmental stages and their compliance with human rights related to health. Running away from the Czech health care law framework of human rights and its substitution by a positive concept of patients‘ rights is accompanied by efforts to reduce human rights protection mechanisms at the Constitutional Court („euroamendment“ of the Czech Constitution in 2001). Major changes in medical law in relation to human rights brings the current changes in health care reform (2011 - Health Reform I and II. Phase). and Petr Háva, Pavla Mašková, Tereza Teršová