Žilní tromboembolická nemoc (TEN), zahrnující žilní trombózu stejně jako plicní embolii, je časté a potencionálně fatální onemocnění. S uvedením nízkomolekulárních heparinů (LMWH) do praxe bylo prokázáno, že ambulantní léčba žilní trombózy je efektivní a bezpečná pro velkou část nemocných s TEN. Vzrůstající data o ambulantní léčbě LMWH v posledních letech ukazují, že až 50 % pacientů s klinicky stabilní plicní embolií může být léčeno doma. I přes tato fakta dosud neměla domácí léčba plicní embolie pevnou pozici v běžné praxi. Pokud bychom měli sumarizovat podmínky pro domácí léčbu, potom by bylo možné uvažovat o ambulantní léčbě u nemocných s nízkým rizikem dle pomocných kritérií, bez hemodynamické nestability (především bez šokového stavu), bez selhávání pravé komory, bez předchozího chronického srdečního či plicního onemocnění, bez závažných komorbidit (onemocnění gastrointestinálního traktu, onemocnění ledvin, krevní choroby, pokročilá nádorová onemocnění), s nízkým rizikem časné rekurence tromboembolické nemoci, bez jiných indikací pro hospitalizaci (bolest vyžadující parenterální analgetika, infekce apod), s nízkým rizikem krvácení a s garantovanou spoluprací nemocného a dobře organizovanou domácí péčí., Venous thromboembolic disease which includes both venous thrombosis and pulmonary embolism, is a frequent and potentially fatal disease. Based on the introduction of low-molecular-weight heparins (LMWH) into practice it has been proved that outpatient treatment of venous thrombosis is effective and safe for a large number of patients with VTE. The growing volume of data on LMWH outpatient treatment in recent years shows that up to 50 % of patients with clinically stable pulmonary embolism can be treated at home. In spite of these facts home treatment of pulmonary embolism has not been established as part of common practice as yet. If we were to summarize the conditions for home treatment, we would consider outpatient care for patients at low risk based on auxiliary criteria, free from hemodynamic instability (primarily without a shock state), free from right ventricular failure, prior chronic heart or lung disease, serious comorbidities (gastrointestinal tract disease, kidney disease, blood diseases, advanced cancers), at low risk of early thromboembolism recurrence, free from other indications for hospitalization (pain requiring parenteral analgesics, infections etc.), at low risk of bleeding and with guaranteed patient‘s cooperation and well-organized home care., and Radovan Malý, Jaroslav Malý
Invazivita nádorových buněk je kritickým krokem tvorby metastází. V současné době jsou známy dva hlavní způsoby buněčné invazivity. Mezenchymální invazivita závislá na degradaci mezibuněčné hmoty a nově popsaná améboidní invazivita charakterizovaná zvýšenou aktivitou Rho-kinázy. Článek diskutuje současné názory na mechanismy améboidní invazivity. and Invasivity of malignant tumour cells is a critical stage in the onset of metastases. At present two main types of invasion process in cells are known: mesenchymal invasivity based on degradation of intercellular substances and a newly described ameboid invasivity characterized by enhanced activity of the enzyme Rho-kinase. Various opinions on the mechanism of ameboid invasivity are discussed.
The abundance, diet, and prey relationships of American mink Mustela vison were studied in the Słońsk Reserve (W Poland) on two plots: shore and reservoir. Estimated mink number within the Reserve was 69 in autumn–winter 1998/1999 and 50 during spring 1999. The diet of American mink consisted mainly of mammals, birds and fish. In autumn–winter, birds formed 4–16%, whereas mammals constituted up to 56% and fish up to 62% of the biomass consumed, depending on the plot. In spring and summer, however, birds formed 45–60% of the biomass consumed in the reservoir and 35–46% of the biomass taken by mink on the shore. The European coot Fulica atra was the most frequently consumed prey. In spring, mink removed 7.8% (N=278 killed birds) of coots nesting in the Reserve, 1.8% (N=9) of breeding grebes Podiceps spp. and 11.2% of ducks (N=93 taken birds). On straw platforms only 13.6% of greylag geese Anser anser broods were successful. From 35 to 77% of the nests on straw platforms were destroyed by mink. In wooden boxes 46.4% of mallard Anas platyrhynchos and 33.3% of shelduck Tadorna tadorna nests were successful. American mink destroyed 22–40% of the nests in boxes. However, the arrival of American mink to the Słońsk Reserve has not resulted in a noteworthy decrease in waterfowl populations.
The article begins with introduction and critique of Martin Kramer’s problematic but interesting book Ivory Towers on Sand in which the author, recognized political scientist, describes „failure“ of Middle Eastern studies in USA in last 60 years. The cause of this failure is identified in several wrong theoretical paradigms. The rest of the article then deals with important questions aroused by revealing Kramer‘s conception of role of theory in studying different cultures and of social science as such.