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
Here we report the case of a 31-year-old man admitted to our hospital with echocardiografic and Cardiac Magnetic Resonance signs of myocarditis complicated by ventricular tachycardia, initially resolved with direct current shock. After the recurrence of ventricular tachycardia the patient was submitted to electrophysiological study revealing a re-entrant circuit at the level of the medium segment of interventricular septum, successfully treated with transcatheter ablation. This case highlights how the presence of recurrent ventricular arrhythmias at the onset of acute myocarditis, suspected or proven, could be associated with a pre-existing arrhythmogenic substrate, therefore these patients should be submitted to electrophysiological study in order to rule out the presence of arrhythmogenic focuses that can be treated with transcatheter ablation., Emanuele Cecchi, Serena Fatucchi, Elena Crudeli, Cristina Giglioli, and Literatura 15
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
Cíl: Srovnání senzitivity peroperační ultrasonografie (IOUS), CT, MR a PET/CT při detekci jaterních metastáz kolorektálního karcinomu. Metodika: Retrospektivně jsme hodnotili soubor pacientů operovaných pro metastázy kolorektálního karcinomu v letech 2009-2014 na chirurgické klinice v Plzni a srovnávali jsme výsledky předoperačních diagnostických metod (CT, MR či PET/CT) s nálezem IOUS, kterou bereme za zlatý standard. Zjišťovali jsme počet dodatečných lézí objevených až během operačního zákroku prostřednictvím IOUS a vypočítali jsme senzitivitu a specificitu uvedených metod. Výsledky: Naše výsledky ukazují, že předoperační diagnostické metody mají ve srovnání s IOUS senzitivitu/specificitu: CT 82,2 %/93,1 %, MR 89,3 %/100 %, PET/CT 82,0 %/96,1 % a relativně nízkou negativní prediktivní hodnotu CT 54,9 %, MR 66, 6 %, PET/ CT 52,0 %. Peroperačně bylo nalezeno 18 % dodatečných lézí oproti předoperačnímu CT či PET/CT a 10 % oproti MR. Závěr: IOUS je metodou poskytující aktuální pohled na játra v okamžiku operace a dokáže s vysokou přesností zhodnotit lokalizaci a velikost řešeného nádoru. Zároveň je nejsenzitivnější v detekci drobných lézí, které nemusí být předoperační zobrazovací metodou zachyceny., Aim: Comparison of the sensitivity of intraoperative ultrasonography, CT, MRI and PET/CT in the detection of colorectal cancer metastases. Method: In cohort of patients which were operated for liver metastases of colorectal carcinoma were retrospectively corelated results of preoperative imaging (CT, MRI and PET/CT) with intraoperative ultrasound. We searched for additional lesions that were invisible in CT, MRI or PET/CT. Sensitivity and specificity of CT, PET/CT and MRI was calculated. Results: Our results show that preoperative diagnostic methods are compared with the IOUS lower sensitivity/specificity: CT 82.2%/93.1%, MR 89.3%/100%, PET/CT 82.0%/96.1% and low negative predictive value CT 54.9%, MR 66.6%, PET/CT 52.0%. Intraoperatively we found 18% additional lesions compared to preoperative CT or PET/ CT and 10% compared to preoperative MRI. Conclusion: IOUS is a method that provides synoptic view of the liver at the time of the surgery and it is able to show accurately size and location of operated tumor. It is considered as the most sensitive method in detection of small lesions that maybe missed in preoperative imaging., Eva Korčáková, Hynek Mírka, Tomáš Skalický, Vladislav Třeška, Václav Liška, Jan Baxa, Eva Ferdová, Martina Nováková, Václav Skála, 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
Autoři na základě zkušenosti, literárního review a doporučení mezinárodních společností podávají evidence based přehled této problematiky., Based on their experience, literature review and recommendations of international organizations, the authors provide an evidencebased review of this issue., Pavel Lovas, Zuzana Lovasová, Jana Garčicová, and Lit.: 33
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