Viral hepatitis B and C is a relevant issue because of high prevalence and degree of chronicity, late diagnosis and poor prognosis. Today, protein products of numerous genes are involved in the pathogenesis of viral pathology of the liver. In this review, the authors analysed 42 literature sources on genetic basis of susceptibility to various infectious diseases. Study of the role of immunogenetic factors is of great practical importance to develop methods for predicting outcomes of viral hepatitis., Khamid Karimov, Sevara Azimova, Bakhtiyor Iriskulov, and Literatura
We report the case of a 52year old man with severe acute pancreatitis. In this case report we discuss the undesirable effects of parenteral nutrition and the importance of nutritional support at patients with severe necrotizing pancreatitis. Severe acute pancreatitis is usually accompanied by systemic inflammatory response syndrome, which results in hypermetabolism with prominent protein catabolism. Providing nutrition to these patients is of paramount importance. An adequate nutritional support is crucial in patients with severe and complicated pancreatitis. A negative energy balance has a negative impact on the nutritional status and the disease progression., Shpata Vjollca, Kuneshka Loreta, Kurti Floreta, Ohri Ilir, and Literatura
Birth rate regulation is a major problem of modern medicine. Unfortunately, frequency of artificial abortions is still high not only in developing, but also in developed countries. Abortion results in severe gynecologic and endocrine complications in the woman’s body (Alieva, 2001). Use of intrauterine devices (IUDs) is a most effective method of contraception. A great number of studies in the field of utilization and possible complications of IUDs revealed the occurrence of inflammatory diseases of small pelvis organs (IDSPO). Andizhan (Uzbekistan). Duration of patients’ follow-up ranged 40 days to 6 months. Women did not have contraindications for IUDs according to WHO medical eligibility criteria. Blood was a material for study; it was taken in 40 days, 3 and 6 months following IUD insertion. After insertion of copper IUDs to women, a cytokine cascade was studied in dynamics. in this test system made 4 pg/ml. During the study, the women of the test group showed increased proinflammatory cytokines. The further study of vaginal smears confirmed development of bacterial vaginoses in them that suggests a relation of complications due to IUDs with imbalance of the cytokine cascade. Elevated serum concentration of cytokines was revealed in women with IUDs already on the first days of their application. European Medical, Health and Pharmaceutical Journal ISSN 1804-5804 Sharp increase in IL-1 on days 40 and 90 after insertion of IUDs is associated with presence of complications in the form of expulsions and possible development of inflammatory diseases of small pelvis organs., Umida Yusupova, Farida Ayupova, and Literatura
To study efficiency of the combined treatment of advanced gastric cancer with inclusion Trastuzumab. Material: We present the intermediate analysis of the use of target therapy with Trastuzumab in patients with a HER2positive gastric cancer. Up to 01.10.2009y 118 patients have been tested for HER2 expression, and in 24 gastric cancer patients it is revealed HER2positive status of tumor. It is lead chemotherapy to all patients by the PLF regimen and Herceptin in doze 6 mg/kg once in 3 weeks (6 cycles). In control group in 26 patients it is lead only chemotherapy by the PLF regimen once in 3 weeks without addition Trastuzumab (6 cycles). Results: At the moment of the analysis of preliminary data, the median remission duration in compared groups has made 8.3 months, and 5.2 months, accordingly. Conclusion: At advanced gastric cancer with high level HER2 expression Trastuzumab increases frequency of objective effect and the median remission duration., M. D. Juraev, D. M. Egamberdiev, S. S. Khudayorov, H. N. Tuyev, and Literatura
Rozvoj v oblasti prenatální a neonatální medicíny stále častěji umožňuje dětem, které by bývaly zemřely, aby přežily a vedly zdravý život. Stejný pokrok ve vědě zároveň opakovaně vyvolává etická, sociální a právní dilemata pro ty rodiny a zdravotnické profesionály, kteří jsou postaveni před komplexní volby, které mohou mít celoživotní následky nejen pro samotné dítě, ale i pro jejich okolí. Stále znovu se objevují otázky týkající se hodnoty lidského života v různých fázích jeho vývoje, rozdílu mezi aktivním ukončením lidského života a smrtí, jež je následkem nezapočetí života zachraňující léčby nebo odstoupení od ní, a balancování mezi nejlepším zájmem dotčeného dítěte, jeho rodičů a potřeb dalších sociálních skupin. Ve Spojeném království se od počátku osmdesátých let objevují případy zabývající se otázkou, za jakých podmínek je přípustné, aby rodiče, lékaři případně soudy rozhodly, že by těžce malformovaným dětem neměla být poskytnuta život zachraňující léčba. Článek se zabývá nejen analýzou některých případů z prostředí britského soudnictví, ale také doporučením Nuffield Council on Bioethics v souvislosti s touto problematikou. Představuje nejčastější dilemata, která se objevují v praxi a to, jakým způsobem jsou řešeny v rovině právní v souladu anglickým common law., Development in fetal and neonatal medicine enabled children who previously would have died to survive and lead healthy lives. The same developments also arise ethical, social and legal dilemmas for those families and health professionals who are faced with complex decisions that may have lifelong consequences not only for the children but also for their relatives. The ethical issues concern the value of human life at different stages of development, distinction between active ending of life and death resulting from withholding or withdrawing care or balancing the interests of affected children, their families and needs of other social groups. In the United Kingdom there have been several cases since early 1980s which centred on issue as to whether there are circumstances that permit parents, doctors or the courts to take a decision that a severly malformed children should not be provided with life-saving treatment. The paper provides a brief legal analysis of several British cases and also analysis of Nuffield Council on Bioethics guidelines regarding this issue from an ethical point of view. It introduces the most common dilemmas which occure in practice and the way these dilemmas are solved under English common law., Barbora Vráblová, and Literatura
Toto zvláštní monotematické číslo časopisu se věnuje problematice infanticidy a kritických rozhodnutí na počátku života., This special issue of Journal of Medical Law and Bioethics is mono-thematic and focuses on the problems of infanticide and Critical Decisions at the Beginning of Life., and Tomáš Doležal, Adam Doležal
V následující kazuistice demonstrujeme 57leté- ho pacienta, který se dostavil s cystickým ložiskem pravé ledviny způsobujícím mechanický syndrom. Nález klinicky imponoval jako infikovaná cysta, diferenciálně diagnosticky nebylo možné vyloučit cysticky změněný renální karcinom, který byl po radikálním ledvinu šetřícím výkonu histologicky definitivně verifikován., We present a case report of a 57-year old male with a cystic lesion of the right kidney which caused a mechanical compression syndrome. Preliminary clinical findings suggested an infected cyst, although an altered renal cell carcinoma was suspected and later confirmed by histology after a nephron-sparing radical resection of described lesion., Jan Novák, Jiří Stejskal, Jan Mokriš, Vladimír Borovička, Viktor Vik, David Girsa, František Koukolík, Roman Zachoval, and Literatura
This research paper presents the results of ovarian reserve estimation for 125 women with the Polycystic Ovary Syndrome (PCOS) who have undergone various methods of surgical treatment resection of the ovaries, thermokauterisation and drilling by laser (HoYag). Ovarian reserve was estimated according to the amount of antral follicles, level of follitropin and Müllerian inhibiting substance (MIS), also named antiMüllerian hormone (AMH). Blood flow in ovarian tissue was also examined after various methods of surgical treatment. The study has shown that the gentlest method of surgical treatment is drilling by HoYag laser, which is least likely to injure the tissue of ovaries, and also this method is most effective in enhancing and preserving ovarian reserve., Vasiliy Simrok, Daria Simrok-Starcheva, and Literatura
Hormonálna antikoncepcia je dnes ponúkaná ako niečo prospešné pre zdravie ženy, avšak nové vedecké poznatky poukazujú aj na výskyt jej nežiaducich účinkov a rizík. Cieľom štúdie bolo zistiť úroveň informovanosti žien o nežiaducich účinkoch a rizikách antikoncepcie zo strany lekárov/ pôrodných asistentiek. Ako výskumný nástroj bol vytvorený neštandardizovaný dotazník. Celkovo bolo v gynekologických ambulanciách distribuovaných 130 dotazníkov, vrátilo sa 108 (responzibilita: 83,07 %), pričom 8 dotazníkov bolo vyradených pre nesplnenie kritérií. Výskumu sa zúčastnilo 100 respondentiek s vekovým priemerom 28,7 (±5,28) rokov, ktoré užívali hormonálnu antikoncepciu, a podpísali informovaný súhlas so zapojením do výskumnej štúdie. Najčastejšími dôvodmi užívania hormonálnej antikoncepcie u respondentiek nášho súboru boli: zamedzenie plodnosti (66%) a zdravotné dôvody (34%). Zistili sme, že 54 % respondentiek bolo informovaných zo strany lekárov/ pôrodných asistentiek o nežiaducich účinkoch hormonálnej antikoncepcie avšak 51,85 % z nich bolo informovaných nedostatočne. O rizikách zvyšujúcich nežiaduce účinky HAK bolo informovaných 64 % respondentiek. Najčastejšie nežiaduce účinky HAK u respondentiek sa zaznamenali bolesť hlavy, emočná labilita, zníženie libida. Úroveň informovanosti žien o nežiaducich účinkoch antikoncepcie zo strany lekárov/ pôrodných asistentiek môžeme hodnotiť ako neuspokojivú, preto by bolo potrebné zlepšiť a skvalitniť edukáciu žien o hormonálnej antikoncepcii ., Hormonal contraception is nowadays offered as something beneficial for the woman´s health, but the new scientific knowledge is showing us its undesirable effects as well. The objective of the study was to find out the awareness level of women about the undesirable effects and risks of hormonal contraception from the side of doctors/ midwives. As a research tool, we have created a non- standardized questionnaire. Overall we have distributed 130 questionnaires in the gynaecological centres, 108 questionnaires have been returned (recoverability: 83.07 %). 8 questionnaires have been excluded from the research due to the incomplete information. 100 respondents, with the average age of 28.7 (±5.28) years, that have used hormonal contraception have participated in this research and signed the written agreement about their participation in this research study. The most frequent reasons for using the hormonal contraception by our respondents were the following ones: fertility prevention (66 %) and healthy reasons (34 %). We have found out that 54 % of respondents were informed from the side of doctors/midwives about the undesirable effect of hormonal contraception, however 51.85 % from them have been informed insufficiently. 64 % of respondents have been informed about the risks of increased effects of hormonal contraception. The most frequent effects of hormonal contraception by our respondents were headache, emotional instability, and decrease of libido. The awareness level of women about the undesirable effects of hormonal contraception from the side of doctors/midwives has been evaluated as unsatisfactory. So it would be necessary to improve the education of women in the area of hormonal contraception., Mazúchová L., Kelčíková S., Markusová K., and Literatura
Informovaný souhlas na gerontopsychiatrických odděleních je ke škodě pacientů opomíjené téma. Obsahem článku je komentovaný výčet vybraných důležitých problémů, které se váží především k informovanému souhlasu. Je upozorněno na to, že potíže souvisí s přetrvávající stigmatizací psychiatrie a s faktem, že psychiatričtí pacienti z řad seniorů očekávají paternalistický přístup ze strany lékařů. Redukci souvisejících komplikací lze také očekávat od funkčního systému opatrovnictví., The informed consent at geriatric psychiatric wards is – to the detriment of patients – a neglected topic. This article contains a commented enumeration of selected important issues that bind primarily to the informed consent. It points out that the problems are related to the continuing stigmatization of psychiatry and at the same time, to the fact that psychiatric patients among the seniors expect a paternalistic attitude of the physicians. Reduction of associated complications can be also expected from the functional system of guardianship., Alice Holečková, and Literatura