The Purpose of this study is to demonstrate the effectiveness of combined treatment for III AB stage of nonsmallcell lung cancer. Nonsmallcell lung cancer spread form treatment is disputable. Operation is not final solution. The combined treatment is being tested (in clinical trials) in this study. This article argues that a combination of treatment is a better option than that of a specific treatment. However, there is a need to find new effective options for combined treatment., Akhat Bukenov, Elena Gizbrekht, Ergaly Shauenov, Bekzhan Orazbayev, Kalmurat Razzakov, and Literatura
Objective: to analyze main clinical-statistical indices of spine and spinal cord injuries (SCI) and system of organization of medical aid to the victims. We conducted a cohort retrospective study of materials of medical institutions of Tashkent city. Medical records of patients and records of forensic examinations were analyzed. 242 cases of spinal cord injuries were studied. Over the last 10 years in Tashkent the frequency of SCI have been tend to increase, males and working-age people are dominated. In 60.9% of cases the injury was associated, in 36.2% - isolated, and in 2.9% - combined. Fallings from height and road traffic accidents were the main reasons for getting SCI. Lesions at cervical level registered in 45% of cases, thoracic level - 27.3%, at lumbar level - 27.7%, respectively. According to ASIA/IMSOP, full injuries were noted in 40.1% of cases, incomplete injures were in 59.9%. Overall mortality from SCI was 68.6%. study allowed to get in detail the clinical and statistical indicators of SCI in the region., Rukhulla Zabikhullaevich Khikmatullaev, Alisher Iskandarovich Iskandarov, Dildora Zabikhullaevna Khakimova, and Literatura
Cíl práce: Lipoperoxidace je dávána do příčinné souvislosti s rozvojem nejdůležitějších rizikových faktorů kardiovaskulárních onemocnění. Lipoperoxidační procesy jsou důsledkem reakcí lipidů s volnými radikály bez ohledu na jejich původ. Vztah mezi triacylglyceroly (TAG) a volnými radikály (VR) není zcela jasný. Může se dokonce stát, že hypertriacylglycerolémie je doprovázena nízkými koncentracemi VR a naopak. Jedno z možných vysvětlení spočívá ve vztahu lipoperoxidace a složení mastných kyselin v molekulách TAG. Cílem této studie bylo analyzovat vztah složení mastných kyselin v TAG a produkci VR u pacientů trpících diabetes mellitus 2. typu. Typ studie: observační s kontrolní skupinou Materiál a metody: Studie zahrnovala 18 normotriacylglycerolemických (NTG) jedinců (M/F 12/6) a 24 hypertriacylglycerolemických (HTG) jedinců (M/F 16/8). Pacienti v obou skupinách byli diabetici 2. typu. Analýzu mastných kyselin v triacylglycerolech plazmy jsme provedli kapilární plynovou chromatografií a koncentrace volných radikálů byly změřeny přímou spektrofotometrií. Statistické analýzy (parametrické i neparametrické) byly provedeny pomocí statistického software STATISTICA pro Windows. Výsledky: Ve skupině HTG jsme pozorovali nižší zastoupení kyseliny myristové (14:0) (1.62 [1.23-2.07] vs. 1.90 [1.72-2.79], p = 0.022, [medián (1.-3. kvartil]) a vyšší poměr alfa-linolenové kyseliny (18:3n-3) (1.51 [1.21-1.86] vs 1.16 [1.02-1.42], p = 0.021). Poměr kyselin arachidonové/eikosapentaenové byl ve skupině HTG nižší (5.54 [3.62-7.98] vs 7.25 [5.98-15.12], p = 0.027). Když jsme HTG skupinu dále rozdělili podle koncentrací VR na tercily, prokázali jsme nižší hodnoty poměru kyseliny arachidonová/eikosapentaenová ve druhém tercilu (4.05 [2.66-4.67] vs 7.64 [5.83-11.00], 1. tercil, a 6.21 [3.20-8.31], 3. tercil p = 0.019). V spojených HTG+NTG skupinách jsme zaznamenali negativní korelaci mezi MA a TAG (r = -0.3153, p = 0.045). V triaclylglycerolech jsme prokázali pozitivní korelace VR a kyseliny stearové (p < 0.001) spolu s negativní korelací některých n-6 vícenenasycených mastných kyselin (18:3n-6, p < 0.05, 22:5n-6, p < 0.01). Závěr: Zastoupení mastných kyselin v molekulách TAG je spojeno s tvorbou VR. Nicméně do tohoto vztahu vstupují i jiné faktory., Objective: The lipoperoxidation plays a causal role in the development of most important risk factors of cardiovascular disease. The lipoperoxidation results from the reaction of lipid molecules with free radicals, regardless of their origin. The relationship between triacylglycerols (TAG) and the free radicals (FR) amount is not clear. Thus, it can turn up that the hypertriacylglyceridaemia is accompanied with the low values of FR, or vice versa. One possible explanation of this phenomenon is that the degree of lipoperoxidation of TAG is dependent on the composition of fatty acids (FA) in their molecule. Therefore, the aim of this study was to analyze FA composition in TAG and its relationship to FR production in type 2 diabetes mellitus. Design: observational study with internal control group Material and Methods: 18 normotriacylglycerolemic (NTG) individuals (12M/6F) and 24 hypertriacylglycerolemic (HTG) patients (16M/8F). Patients in both groups were persons, suffering from type 2 diabetes mellitus. Fatty acid analysis of plasma triacylglycerols was performed by gas chromatography and free radicals were determined by direct spectrophotometric method. Statistical analyses (both parametric and non-parametric) were performed with the statistical software STATISTICA for Windows. Results: We found lower content of myristic acid (14:0) (1.62 [1.23-2.07] vs. 1.90 [1.72-2.79], p = 0.022, [median (1st-3rd quartile)]) and higher content of alpha-linolenic acid (18:3n-3) (1.51 [1.21-1.86] vs. 1.16 [1.02-1.42], p = 0.021) in HTG group. The ratio of arachidonic/eicosapentaenoic acid was in HTG group lower (5.54 [3.62-7.98] vs. 7.25 [5.98-15.12], p = 0.027). When the HTG group was stratified into the tertiles by the FR concentrations, we observed lower values in the second tertile for ratios based on arachidonic acid (20:4n-6) and eicosapentaenoic acid (20:5n-3) (4.05 [2.66-4.67] vs. 7.64 [5.83-11.00], 1st tertile, and 6.21 [3.20-8.31], 3rd tertile, p = 0.019). In pooled groups, we proved negative correlation between MA and TAG (r = -0.3153, p = 0.045) and the link between FR and FA composition of TAG expressed as positive relationship of FR with content of stearic acid (p < 0.001) and negative correlation with some n-6 polyunsaturated fatty acids (18:3n-6, p < 0.05, 22:5n-6, p < 0.01). Conclusion: The composition of FA in TAG molecules has undoubtedly some relationship to the FR generation. However, the other factors seem to play a role, since the relationship is not straightforward within entire FR range., and Vecka M., Tvrzická E., Votruba M.
Wound healing is a complex physiological process important for tissue homeostasis. An acute injury initiates massive cell migration, proliferation and differentiation, synthesis of extracellular matrix components, scar formation and remodelling. Blood flow and tissue oxygenation are parts of the complex regulation of healing. Higher organisms utilize molecular oxygen as a terminal oxidant. This way of gaining energy for vital processes such as healing leads to the production of a number of oxygen compounds that may have a defensive or informatory role. They may be harmful when present in high concentrations. Both the lack and the excess of reactive oxygen species may influence healing negatively., Jiří Kanta, and Literatura 6
Aim of investigation: to study immediate and remote results of standard and extended lymphodissection in patients with rectal cancer. Material and methods: 132 patients with rectal cancer were performed radical surgery with lymphodissection in D2 and D3 volume according to a height of tumor location. In immediate postoperated period there were noted complications in 4 patients that made up 3,03%. Observation time was 5 years. Tumor recurrence was reported in 5 patients (3,8%). In remote period metastases were revealed in 8 patients (6,6%). 5year total survival rate was 78,5±4,2% at stage II. 5year total survival rate was 56,4±3,7% at stage III. Comparing the results of standard and extended lymphodissection it was noted statistically authentic increase of 5 year survival rate in patients at stage III. Obtained data allow to come to the conclusion about reasonability of performance of different variants of lymphodissection for patients with rectal cancer at stages II and III., Navruzov S. N., Abdujapparov S. B., Akbarov E. T., Navruzov B. S., Islamov H. D., and Literatura
The management of chronic diseases shall be considered a priority in the work of the global international institutions, which are related to health policies. In the search for effective and efficient solutions for the treatment of chronic diseases, scientists are developing different programs. In Bulgaria the continuous monitoring of chronically ill people is defined with the term dispensarization. The objective of the research is to analyze the place and the role of patients in the monitoring of their chronic diseases and how the concept of quality of life relates to this process. Method The research in focus groups is planned within a research project on the monitoring of chronic diseases. Five group discussions were held. The number of participants in all focus groups was sixty. Results The two discussed directions - the active role of the patient and the focus on the results are weak links in the current organization of the care for the chronically ill people. The topic of creating and adopting an Act of the patient was also presented, in which to be paid attention to the evaluation of the quality of life. In general was brought the need for a clear delineation of the roles and the competencies of everyone involved in the monitoring process of chronic diseases. The chronic disease cannot be defined only as a medical problem, as there are economic and social, including political consequences. Conclusions The management of the chronic disease requires coordination of doctor-patient interaction, a model of partnership and trust in the relations, self-management of the condition by the patients and their inclusion in the health team. The most important step to achieve this goal is the education of the patients, increasing their knowledge and motivation, psycho-emotional support, instilling hope and faith in the capacity of the patients., Teodora Dimcheva, Gergana Foreva, Radost Аsenova, Nonka Маteva, Todor Stoev, Rosica Dimova, and Literatura
Cíl studie: Cílem studie bylo zjištění vztahů mezi manifestací tinnitu, nálezem na sluchových evokovaných potenciálech a genetickým pozadím u receptoru pro gamaaminomáselnou kyselinu typu A (GABA(A) receptor), podporující desinhibiční hypotézu vzniku tinnitu. Soubor a metodika: Bylo vyšetřeno 131 pacientů z hlediska sluchové ztráty, provedena kvantifikace tinnitu, sluchové evokované potenciály střední latence (MLR) a kmenové sluchové evokované potenciály (BAEP) a dále stanovení genotypu (CA)n repetitivní sekvence pro beta‑3 podjednotku GABA(A) receptoru. Následně byly hledány vztahy mezi jednotlivými výsledky a manifestací tinnitu. Výsledky: Byla nalezena korelace tinnitus skóre s amplitudovým poměrem vln V/III v BAEP (R = 0,22, p < 0,001) a s průměrným sluchovým prahem (R = 0,22, p = 0,17). Rovněž byla nalezena korelace tinnitus skóre s amplitudou vlny PA v MLR (R = 0,31–0,37; p < 0,001). Výsledky MLR neukázaly žádný vztah k průměrnému sluchovému prahu. U skupiny s kratší anamnézou tinnitu (méně než devět měsíců) byl prokázán rozdíl v manifestaci tinnitu na genotypu pro (CA)n repetitivní sekvenci genu pro beta‑3 podjednotku GABA(A) receptoru (p = 0,002). Tento výsledek byl rovněž konzistentní s rozložením amplitudy vlny PA v dané subpopulaci. Závěr: Tyto výsledky svědčí o existenci dvou hlavních regulačních mechanizmů vzniku tinnitu: první, který je závislý na velikosti sluchové ztráty, je na úrovni mozkového kmene, zatímco druhý je na úrovni korové s možnou souvislostí s genotypem (CA)n repetitivní sekvence pro beta‑3 podjednotku GABA(A) receptoru., Study aim:Study objective was to explore associations between manifestation of tinnitus, auditory evoked potentials and genetic background of gamma‑aminobutyric acid type A (GABA(A) receptors) to support the disinhibited feedback hypothesis of tinnitus generation. Materials and methods: A population of 131 patients was assessed for severity of hearing loss, quantification of tinnitus, mid‑latency responses (MLR) and brainstem auditory evoked potentials (BAEP), and (CA)n tandem repeat polymorphism in GABA(A) Beta‑3 subunit gene to establish any correlation with manifestation of tinnitus. Results: It was observed that tinnitus score correlates with V/III amplitude ratio in BAEP (R = 0.22, p < 0.001) and with mean pure tone audiometry (PTA) threshold (R = 0.22, p = 0.017). Analysis of the MLR results showed a significant correlation between the PA wave amplitude and the tinnitus score (R = 0.31–0.37; p < 0.001). MLR result analysis showed no statistically significant correlation between the wave amplitudes and the mean auditory threshold. An analysis of a subgroup with shorter clinical history (less than nine months) revealed a statistically significant difference in the tinnitus score in relation to the genotype of (CA)n tandem repeat of the GABRß3 receptor subunit gene (p = 0.002). This result was also consistent with the distribution of the PA wave amplitude in the given subpopulation. Conclusion: Our findings indicate existence of two main regulatory mechanisms of tinnitus generation: first, the brainstem mechanism is dependent on the severity of the hearing loss; second, the cortical mechanism is likely to be dependent on the genotype of (CA)n tandem repeat in GABA(A) beta‑3 subunit gene., and J. Rottenberg, M. Zallmann, R. Kostrica, M. Jurajda, T. Talach
To improve the results of radiotherapy for cervical cancer used local and systemic radiomodification drugs. Materials and methods: 1984 patients with locally advanced cervical cancer (2b 3a stage), which at one stage of complex treatment by a course indoarterial of regional longterm polychemotherapy (EARDPHT) mode: methotrexate 50 mg/m2, the first 12 hours, fluorouracil 1000 mg/m2, over the next 12 hours and cisplatin 100 mg/m2, for 48 hours, 2 stage surgical treatment in the volume expanding hysterectomy 3 type (modification of Wertheim Meigs). Results: The results of treatment of locally cervical cancer using VADRPHT, depending on the unilateral and bilateral tumor invasion in parametrial tissue showed that under unilateral lesion of parametrium results of treatment were higher than for the bilateral involvement of parametrium. Medical pathomorphosis in tumors of different severity was observed in 86.9% of patients, metastasis to regional lymph nodes were detected in 36% of operated patients, and also studied the degree of therapeutic pathomorphosis in lymph nodes. There was revealed that the complete regression of tumors, 5 year survival rate is 98%, whereas in tumor regression of more than 50% of the original volume 78.5%, with stabilization of tumor no more than 58.4%. Conclusion: The study of molecularbiological parameters of the tumor cells show the effectiveness of conducted neoadvent indoarterial chemotherapy and play an important role in further treatment and prediction of disease., Navruzova V. S., Yuldasheva N. Sh., and Literatura
BACKGROUND: The presence of several risk factors (genetic and non-genetic) has greater impact on the risk of premature coronary artery disease (CAD) than single risk factor. OBJECTIVE: The aim of the study was to establish possible relations between genotypes and alleles of 677C>T polymorphism of MTHFR gene and some traditional risk factors e.g. elevated levels of lipid parameters and smoking in development of premature CAD. METHODS: The groups comprised 152 patients with angiographically documented premature CAD (aged 42.9 +/- 5.5) and 121 age-matched blood donors (aged 42.3 +/- 6.5) were studied. The MTHFR 677C>T polymorphism was genotyped with Polymerase Chain Reaction-Restriction Fragment Length Polymorphism (PCR-RFLP) method. RESULTS: Patients with TT genotype who simultaneously smoked had increased risk of premature CAD compared to non-smoking cases with CC genotype (OR = 24.62). We also found that individuals with TT genotype and elevated LDL-cholesterol (LDL-chol.) level had significantly higher risk of CAD (OR = 9.92) than individuals with normal LDL-chol. level and CC genotype. CONCLUSIONS: The present study shows that simultaneous presence of MTHFR TT genotype and smoking or elevated levels of LDL-chol. influences the risk of premature CAD. This findings give interesting contribution to gene-environment interaction problem that may have clinical implications in the future. and B. Sarecka-Hujar, I. Zak, J. Krauze
Východiska: Implementace mezinárodní klasifikace NIC v podmínkách intenzivní péče v ČR. Cíl: Identifikace intervencí NIC Klasifikačního systému, které všeobecné sestry označí jako použitelné v klinické praxi intenzivní péče minimálně jednou týdně. Metody: Kvantitativní analýza četnosti intervencí NIC. Dosáhla-li konkrétní intervence NIC 75% hranice (po sečtení v kategorii denní a týdenní péče), byla identifikována jako intervence NIC, která je použitelná minimálně jednou týdně v klinické péči prostředí intenzivní péče. 386 záznamových archů, ve kterých všeobecné sestry označovaly frekvence použití vybraných 184 intervencí Klasifikačního systému NIC. Získaná data byla získána z klinické praxe intenzivní péče u 12 poskytovatelů zdravotnických služeb v České republice (ČR). Ke statistickému porovnání získaných dat z jednotlivých klinických pracovišť byl použit Pearsonův chi kvadrát, na hladině významnosti 5 % (p ≤ 0,05). Výsledky: 46 intervencí z vybraných intervencí NIC, bylo identifikováno jako intervence, použitelné minimálně jednou týdně v klinické péči prostředí intenzivní péče ČR. U 14 intervencí NIC nebyly shledány signifikantní rozdíly v označení použitelnosti jednou týdně na pracovištích ARO a JIP interního a chirurgického typu. U 32 intervencí NIC byly shledány signifikantní rozdíly v označení použitelnosti jednou týdně v klinické praxi mezi výše uvedenými pracovišti. Použitelnost těchto intervencí NIC minimálně jednou týdně častěji označily všeobecné sestry na pracovišti ARO. Závěry: Ze 184 mapovaných intervencí Klasifikačního systému NIC bylo identifikováno 46 intervencí, které všeobecné sestry označily, jako použitelné v klinické praxi intenzivní péče minimálně jednou týdně. Tyto intervence NIC podstoupí expertní validaci., Background: Implementation of the International Classification of NIC in conditions intensive care in the Czech Republic. Aim: The aim of this enquiry was the choice of interventions NIC of the classification system, which are marked by nurses as usable minimaxy once a week in the clinical practice of intensive care. This contribution maps the posibility of the usage of chosen interventions of classification system Nursing Interventions Classification NIC, which will be used for the future implementation in the intensive care sector. The aim of this enquiry was the choice of interventions NIC of the classification system, which are marked by nurses as usable minimaxy once a week in the clinical practice of intensive care. Methods: Reaches the specific interventions NIC 75% threshold for counting records in the category of daily and weekly care has been identified as an intervention NIC, which is applicable at least once a week in clinical care intensive care environment. The quantitative analysis of 386 records with 184 interventions NIC in the clinical practice, by 12 health service proveders in the Czech Republic. Pearson‘ s chi quadrat (p≤0,05) was used for the statistic comparison of the data from the individual clinical workplaces. Results: By the quantitative analysis was confirmed 46 interventions NIC of Classification system which possible usage in clinical intensive care minimally once a week in the CR. In comparison with the data distribution at individual clinical workplaces, there were not found any significant differences in minimal weekly usage indication at 14 NIC intervention of the classification system. There were found some differences in usage marking in 32 interventions NIC classification system by nurses at some workplaces. Higher frequency of presence was recorded by Anesthesiologic Resuscitation ward nurses. Conclusions: Analysis from 184 intervention NIC confirms the possibility 46 of serviceability of classification system NIC in our country. There are interventions, which usage in clinical care workplaces Anesthesiologic Resuscitation ward, Intensive Care Unit surgery minimally once a week. These interventions NIC undergo expert validation., and Jitka Hůsková, Petra Juřeníková