Autoři popisují některé komplikace sekundárního lymfedému po onkologické léčbě u žen a jejich léčbu. Existují časté komplikace: infekční (erysipel, herpes zoster), progrese primárního nádoru a metastázy, hand-foot syndrom jako vedlejší efekt chemoterapie a relativně vzácné: duplicitní malignity (lymfangiosarkom u pacientů s lymfedémem), vícečetné malignity. Autoři zjistili autoimunitní tyreoiditidu s hypotyreózou u pacientky léčené pro postmastektomický lymfedém., The authors describe some complications of secondary lymphedema after malignant tumours treatement in women including their therapy. There are frequent complications: infections (recurrent erysipelas, herpes zoster), primary tumour progressions and metastases, hand-foot syndrome as a side-effect of chemotherapy and relatively rare complications e.g. second primary malignancy (lymphangiosarcoma in lymphedema patients) as well as multiple malignancies. The authors found autoimmune thyroiditis and decreased thyroid function in a patient treated for postmastectomy lymphedema., Věra Vítová, Hana Vítová, Drahoslava Hrubá, and Lit.: 8
Umírání představuje klinickou situaci charakterizovanou některými typickými symptomy a syndromy. Předpokladem dobré péče je správné rozpoznání, že pacient umírá, jasné stanovení cílů léčby, pravidelné hodnocení pacientova komfortu a intenzívni léčba tělesných a duševních symptomů. Důležitá je otevřená a empatická komunikace s umírajícím i jeho blízkými s respektem k jejich autonomii, ale současně k jejich velké křehkosti a zranitelnosti. Péče o umírající staré pacienty v LDN má velké nedostatky a vyžaduje zásadní zlepšení, Dying is usually characterized by some typical clinical symptoms and syndromes. The principal points of appropriate care of the dying are correct „diagnosis" of dying, clarity of goals of care, regular assessment of patient's comfort, aggressive management of physical and psychical symptoms and open communication with patient and his family respecting their autonomy but also their frailty and vulnerability. Care of the dying in Czech long term care hospitals has many shortcomings and requires wide improvement., Ondřej Sláma, Lit: 5, and Souhrn: eng
Nová právní úprava rodičovské odpovědnosti zakotvená do občanského zákoníku vycházející z Principů evropského rodinného práva ve věci rodičovské odpovědnosti vypracovanými Komisí pro evropské rodinné právo (CEFL) výslovně rozšiřuje obsah rodičovské odpovědnosti - mimo jiné - o péči o zdraví dítěte a o ochranu dítěte a zakotvuje nikoli běžné léčebné a obdobné zákroky do demonstrativního výčtu významných záležitostí, ve kterých je třeba souhlasu obou rodičů nezletilého dítěte. Tato oblast právní úpravy rodičovské odpovědnosti však není zcela bez interpretačních a aplikačních problémů. Proto je tento příspěvek věnován mnoha otázkám a odpovědím, zejména ve vazbě na možné kolize. Jeho cílem je uchopit danou problematiku v její celistvosti, tj. i v souvislosti s novou právní úpravou ochrany osobnosti v občanském zákoníku a ve vazbě na zvláštní zákony, zejména upravující zdravotnické služby, a to alespoň v rovině základního přehledu, a v neposlední řádě ve světle práv dítěte, včetně jeho práva na zdraví., The new legislation on parental responsibility enshrined in the Civil Code based on the Principles of European Family Law concerning Parental Responsibility created by the Commission on European Family Law (CEFL) explicitly extends the content of parental responsibility - among others - of the health of the child and the child protection and enshrines not common medical and similar interventions into the illustrative list of important matters which require the consent of the both parents of the minor child. This area of legal regulation of parental responsibility, however, is not entirely without interpretation and application problems. Therefore, this article is dedicated to the many questions and answers, especially in relation to possible collisions. Its aim is to take the issue in its entirety, ie. in connection with the new legislation of the protection of personality in the Civil Code and in relation to specific laws, especially on medical services, at least at the level of basic overview, and finally in the lights of the rights of the child, including the right to health., Zdeňka Králíčková, and Literatura
Cíl: Cílem práce bylo posoudit, jak všeobecné sestry pečují o své zdraví. Zda se zabývají vlastní prevencí, zmapovat výskyt zdravotních problémů, jejich řešení a odhalit postoj všeobecných sester k rizikovým faktorům ohrožujících jejich zdraví. Metodika: Metodou průzkumu bylo dotazníkové šetření provedené v období listopad 2011 - leden 2012 v Bílovecké nemocnici a. s. a v Městské nemocnici v Odrách. Nestandardizovaný dotazník obsahoval otázky zaměřené na prevenci onemocnění, výskyt zdravotních problémů a postoje všeobecných sester k rizikovým faktorům ohrožující jejich zdraví. Výzkumný soubor tvořil 100 všeobecných sester. Výsledky: Všeobecné sestry navštěvují praktického lékaře jen při subjektivních potížích, nedodržují léčebný režim u běžných respiračních onemocnění, dané onemocnění přecházejí, nevystavují si pracovní neschopnost k doléčení, zdravotní problémy konzultují na pracovišti s lékařem nebo si zvolí léčbu sami. Dlouhodobým zdravotním problémem u všeobecných sester je bolestivost pohybového aparátu, pouze čtvrtina pravidelně sportuje a upevňuje si zdraví. Pracovní výkon sester je závislý na kvalitě odpočinku a na celkové fyzické a psychické kondici. Téměř všechny všeobecné sestry se cítí fyzicky i psychicky vyčerpané, polovina sester uvažovala o změně povolání z důvodu vysoké psychické zátěže a nespokojenosti s platem. Zdravotničtí pracovníci vědí, jakým způsobem ohrožují faktory návykové a faktory životního stylu délku a kvalitu života, přesto třetina sester pravidelně kouří a trpí nadváhou. Závěr: Povolání všeobecné sestry je velmi náročné a společensky nedoceněné. Všeobecné sestry by měli využít své kvalifikace a více se angažovat v oblasti prevence, poradenství v otázkách ochrany a upevňování zdraví., Aim: One of objectives of this work is to assess how the nurses take care of their own health and whether the nurses deal with their own prevention. Also, to do the mapping of prevalence of health problems, their solution and to detect the attitude of nurses to the risk factors that may be life threatening and have an impact to their own health. Methods: The survey method supporting this work was done by questionnaire in Bílovec Hospital a.s. and Municipal hospital in Odry in period November 2011 - January 2012. Unstandardized questionnaire included questions regarding the prevention of diseases, incidents of health problems and the attitude of nurses to the threatening factors influencing their health. The experimental group was made of 100 nurses. Results: The nurses attend their doctors only in case of subjective symptoms, they do not follow the treatment regime in case of common respiratory health problems, they often pass the illness as well as they do not want to be issued the sick leave to finish the treatment properly. Often, they discuss their health problems in the work place or they decide to cure themselves. The long-term health disorder among nurses is musculoskeletal pain due to the fact that only quarter of them strengthens their health by doing a sport activity regularly. Work performance of the nurses is dependent on the quality of their relaxation and overall physical and mental condition. Almost all nurses feel physically and mentally exhausted, half of them thought of career change due to the high mental stress and pay dissatisfaction. All healthcare professionals are aware of how the addictive and lifestyle factors threaten their life, yet one third of the nurses smokes regularly and is overweight. Conclusion: The profession of general nurse is very challenging and socially undervalued. The nurses should use their skills and qualifications to engage in prevention and counceling in the issues of health protection and its strengthening., and Silvie Madziová, Eva Janíková
Článek upozorňuje na posun k normalizaci (standardy péče), v sociálních a zdravotních službách a na značný pokrok v oblasti kvality péče, ale také identifikuje slabá místa a jednostranný přístup, který což někdy nedokáže uspokojit potřeby starších osoby s polymorbiditou a dezorientačními problémy. Standardy mají riziko formalizace a prohlubování emocionální vzdálenost mezi pečovateli a staršími osobami. Systém založený na standardech má být doplněn přístupem založeným na "pečující etice" (jak jí definovali Gilligan, Noddings). Autor doporučuje větší míře zohledňovat “pečující etiku” v sociálních službách., The article notes the real shift to standardisation (standards of care) in social and health services marking progress in terms of quality of care, but it also identifies weaknesses of a unilateral approach, which sometimes fails to meet the needs of the "frail elderly" with polymorbidity and disorientation problems. Standards have an inherent risk of formalisation and deepening affective distance between caregivers and elderly. The standards-based system is to be complemented by an approach based on "ethics of care" (in the sense of the term defined by Gilligan, Noddings). The question about modalities of ethics of care in the social and health services environment is raised and some of related structural problems are discussed. The informal role of volunteers and the difficulties they encounter are highlighted. The author recommends taking greater account of ethics of care in the social services and, that the complex approaches and new forms to be researched., Pavel Habart, and Lit.: 13
On the basis of previous studies of the common dormouse Muscardinus avellanarius concentrated on deciduous woodlands in the southern counties of Great Britain, it was stated that optimal habitat for M. avellanarius should contain a high diversity of suitable shrub and tree species to provide continuous food supply through activity season and appropriate physical structure. However, both the present review of M. avellanarius habitats within its distributional range and recent dormouse studies in other parts of Great Britain indicate that M. avellanarius actually inhabits a much wider variety of habitats, and do not require specialised habitats as previously supposed. M. avellanarius habitats in Lithuania differ considerably from the optimal habitats described for this species, about 40 % of localities being situated in coniferous- dominated forests. Habitat quality may result in a very low average population density of only about one adult per hectare. However, despite of absence of optimal habitats and low population density, M. avellanarius is widespread in Lithuania, and no decline is observed in their abundance and distribution. Forest management (increasing forest cover, planting of native tree species, not too large fragmentation of forest tracts) has been favourable for M. avellanarius in Lithuania.
A comparison of the behavioural peculiarities of Ixodes persulcatus Schulze, 1930 (north-western population, Russia) and Ixodes ricinus (L., 1758) from western Russia and Denmark was determined by using two methods. Method 1 involved a sojourn of ticks on vertical plastic slicks and showed that the questing behaviour of /. ricinus nymphs was dependent on temperature and relative humidity (RH). A significantly greater number of nymphs quested at 22°C and 100% RH than at 18°C. When the humidity was reduced to 30% all of the nymphs departed. In the second method, the activity of licks on an inclined “ticksdromc” was estimated. The activity of I. ricinus adults from the Danish population was 1.2 times greater than that of ticks from Russia. Females of the species studied and specimens from all study areas were more active than all other stages of development. The locomotor activity of both adult and immature I. ricinus that were infected with Borrelia burgdorferi sensu lato was suppressed when compared with uninfected specimens. The locomotor activity of I. persulcatus females infected by borreliae with exoskeleton anomalies was 1.3 times greater (PO.05) than that of infected ticks without anomalies. Our data showed that infected females with exoskeleton anomalies could crawl faster on a human and reach uncovered parts of the body that are vulnerable for attachment and feeding. A study of locomotor aclivity and questing behaviour may be useful for comparing the risk for different tick species and populations to transmit tick-borne pathogens.
The article presents results of peculiarities of the hepatobiliary system in pregnant women with preeclampsia. It is set in the pregnant with preeclampsia of mild severity the frequency and combination of two and more complaints was reliably lower comparing to the frequency and combination of complaints in the pregnant with preeclampsia of mean severity. It must be mentioned that the received laboratory data positively correlated with the clinical manifestations of hepatobiliary dysfunction and the level of severity of preeclampsia that makes the further scientific researches necessary in future. Among the ultrasound signs of the dysfunction of the hepatobiliary system the following were detected: hepatomegaly, diffuse changes in the liver, increasing the density of the gallbladder against the decrease in contractility of the formation of sludge. and Vasily Vasilievich Simrok, Tatyana Fyodorovna Koryavaya
Films of aliphatic polyurethane-silica nanocomposite containing up to 27.3 mol. % of silica were obtained by the parallel synthesis of both composite components in one common process. This method permits to obtain the nanocomposite materials with the uniform distribution of nanoparticles in the polymer matrix volume. The rise of the silica concentration in the nanocomposite film was shown to lead from one hand to the progressive fall of both the Young’s modulus and yield stress and from another hand to the rise of the ultimate deformation and thermal expansion coefficient values. These effects were ascribed to the formation of the excessive free volume in the material along with the raise of silica concentration., Josif V. Gofman and Ivan V. Abalov., and Obsahuje bibliografii