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1.
Ann Agric Environ Med ; 31(2): 255-263, 2024 Jun 27.
Artículo en Inglés | MEDLINE | ID: mdl-38940110

RESUMEN

INTRODUCTION AND OBJECTIVE: Women in pathological pregnancy are a group of patients especially exposed to the risk of occurrence of psychological complications. The aim of the study was assessment of the risk of depressive and anxiety disorders, and the relationship between the intensity of symptoms and social support. MATERIAL AND METHODS: The study group were 300 patients hospitalized in the Department of Pathology of Pregnancy. The study was conducted using the State-Trait Anxiety Inventory (STAI), the Hospital Anxiety and Depression Scale (HADS), the Inventory of Socially Supportive Behaviours (ISSB), and an author-constructed socio-demographic questionnaire. RESULTS: The level of State Anxiety (STAI) was higher in respondents from the study group, compared to the control group. The level of anxiety (HADS-A) was higher in the control group than in women from the study group. The level of social informational support was higher in those from the control group, compared to those from the study group. The level of emotional support was lower in respondents from the study group, compared to those from the control group. Instrumental support negatively correlated with the symptoms of depression among women in physiological pregnancy. The lack of evaluative support statistically significantly correlated with anxiety among women hospitalized before labour. CONCLUSIONS: The results obtained suggest the necessity for the substantive preparation of medical and psychological staff employed in departments of pathology of pregnancy to provide proper emotional and informational support for hospitalized women.


Asunto(s)
Ansiedad , Depresión , Complicaciones del Embarazo , Apoyo Social , Humanos , Femenino , Embarazo , Adulto , Depresión/psicología , Depresión/epidemiología , Ansiedad/epidemiología , Ansiedad/psicología , Estudios Transversales , Adulto Joven , Complicaciones del Embarazo/psicología , Encuestas y Cuestionarios
2.
Ann Agric Environ Med ; 30(4): 581-586, 2023 Dec 22.
Artículo en Inglés | MEDLINE | ID: mdl-38153057

RESUMEN

INTRODUCTION AND OBJECTIVE: The aim of the study was to review the current state of knowledge regarding the treatment of emotional consequences of infertility using psychosocial interventions and their effectiveness. REVIEW METHODS: The review was based on data obtained from scientific articles published in the Pub Med, Science Direct, the Cochrane Database of Systematic Reviews, Embase, Scopus, Ovid MEDLINE, Ovid EMbase, and The Cochrane Library between 1997-2022. BRIEF DESCRIPTION OF THE STATE OF KNOWLEDGE: Assistance offered to persons afflicted by the problem of infertility may take various forms, depending not only on the needs of those interested and the stage of treatment, but also on the capabilities of the staff (type and level of education). Commonly available, well-developed and researched methods of therapy are most frequently applied, often expanded by such elements as education concerning fertility and life style, and information about diagnosis and treatment. Modified methods of psychological intervention specially adjusted to persons struggling with infertility are also used. The indicators of the effectiveness of these methods are: reduction of stress, better coping with difficulties, decrease in the rates of psychological disorders, as well as an improvement of sperm parameters in men, and an increase in pregnancy and live birth rates. SUMMARY: The most frequently recommended methods of psychosocial intervention are these based on cognitive behavioural therapy and variants of stress reduction techniques. It is recommended that patients with infertility are provided with psychological care throughout the treatment period, and that the medical staff is equipped with standardized methods of assessing their mental state.


Asunto(s)
Infertilidad , Trastornos Mentales , Embarazo , Femenino , Humanos , Masculino , Semen , Revisiones Sistemáticas como Asunto , Trastornos Mentales/terapia , Infertilidad/terapia , Infertilidad/psicología
3.
Medicina (Kaunas) ; 59(9)2023 Sep 15.
Artículo en Inglés | MEDLINE | ID: mdl-37763788

RESUMEN

Background and Objectives: The consequences of stroke have a significant impact on self-sufficiency and health-related quality of life (HRQoL). Virtual reality (VR)-based rehabilitation has the potential to impact these modalities, but information on timing, volume, and intensity is not yet available. The aim of this randomized controlled trial (1:1) was to evaluate the impact of conventional rehabilitation combined with VR on self-care and domains of HRQoL in patients ≤6 months post-stroke. Materials and Methods: The intervention group completed a total of 270 min of conventional VR + rehabilitation sessions. The control group underwent conventional rehabilitation only. Primary assessments with the WHO disability assessment schedule 2.0 (WHODAS 2) questionnaire were conducted before rehabilitation (T0), after completion of the intervention (T1), and at the 4-week follow-up (T2); secondary outcomes included self-sufficiency and balance assessments. Results: Fifty patients completed the study (mean age 61.2 ± 9.0 years, time since stroke 114.3 ± 39.4 days). There were no statistically significant differences between the groups in WHODAS 2, self-sufficiency, and balance scores (p > 0.05). Conclusions: In the experimental group, there was a statistically significant difference in WHODAS 2, assessment of self-sufficiency, and balance scores before and after therapy (p < 0.05). VR appears to be a suitable tool to supplement and modify rehabilitation in patients after stroke.


Asunto(s)
Accidente Cerebrovascular , Terapia de Exposición Mediante Realidad Virtual , Humanos , Persona de Mediana Edad , Anciano , Calidad de Vida , Autocuidado , Suplementos Dietéticos , Pacientes , Accidente Cerebrovascular/complicaciones , Accidente Cerebrovascular/terapia
4.
Artículo en Inglés | MEDLINE | ID: mdl-35270642

RESUMEN

The aim of this study was to assess the quality of life (QoL) of men treated for infertility in Poland. This cross-sectional study was conducted using the Abbreviated World Health Organization Quality of Life questionnaire (WHOQoL-BREF), Fertility Quality of Life tool (FertiQoL) and an author-constructed questionnaire. The study included 1200 men treated for infertility without the use of assisted reproductive technology (non-ART), intrauterine insemination (IUI) and in vitro fertilization (IVF). The control group consisted of 100 healthy men with confirmed fertility. The quality of life assessed by the WHOQoL-BREF questionnaire was significantly lower in study groups in the Environmental domain, compared to the control group (p = 0.009). Statistically significant differences were found in the case of FertiQoL subscales: Emotional, Mind-Body, Relational, and Treatment Environment, depending on applied treatment. Men whose partners were treated without the use of ART assessed their QoL significantly more negatively than those treated with IUI. Reproductive problems and type of their treatment influenced the quality of life of the affected men. Non-ART treatment, rural place of residence, and increased BMI were associated with lower QoL.


Asunto(s)
Infertilidad , Calidad de Vida , Estudios Transversales , Fertilización In Vitro , Humanos , Masculino , Polonia
5.
Artículo en Inglés | MEDLINE | ID: mdl-34886025

RESUMEN

Vaginal bleeding and abdominal pain are symptoms indicative of a threat to pregnancy that prompt women to seek assistance from health care professionals. The purpose of the study was to present the characteristics of Emergency Medical Services (EMS) team interventions in cases of suspected miscarriage. The study involved a retrospective analysis of EMS team interventions in cases of suspected miscarriage carried out between January 2018 and December 2019 in Poland. Data obtained from Poland's National Monitoring Center of Emergency Medical Services included emergency medical procedure records and EMS team dispatch records in electronic format. The mean patient age was 30.53 years. Most were primiparous (48.90%) and up to the 13th gestational week (76.65%). The most commonly reported symptom was vaginal bleeding (80.71%). EMS teams were most commonly dispatched in the winter (27.03%), between 7 A.M. and 6:59 P.M. (51.87%), in urban areas (69.23%), with urgency code 2 (55.60%), and in most cases, they transferred the patient to a hospital (97.53%). The present study addresses very important issues concerning the characteristics of Polish suspected miscarriage cases handled by different EMS team types, in different locations (urban vs. rural areas), and concerning patients in a different obstetric situation (gestational week, gravidity, parity). Our findings suggest a need for further studies in this field and for gestational health promotion activities to be implemented, specifically including actions to reduce the risk of vaginal bleeding during pregnancy.


Asunto(s)
Aborto Espontáneo , Asesoramiento de Urgencias Médicas , Servicios Médicos de Urgencia , Aborto Espontáneo/epidemiología , Adulto , Femenino , Humanos , Paridad , Embarazo , Estudios Retrospectivos
6.
Artículo en Inglés | MEDLINE | ID: mdl-34769544

RESUMEN

Endometriosis is a common disease, affecting up to 60-80% of women, with pelvic pain or/and infertility. Despite years of studies, its pathogenesis still remains enigmatic. Genetic, hormonal, environmental, and lifestyle-related factors may be involved in its pathogenesis. Thus, the design of the review was to discuss the possible role of environmental factors in the development of endometriosis. The results of individual studies greatly differ, making it very difficult to draw any definite conclusions. There is no reasonable consistency in the role of environmental factors in endometriosis etiopathogenesis.


Asunto(s)
Endometriosis , Infertilidad Femenina , Endometriosis/epidemiología , Endometriosis/etiología , Femenino , Humanos , Infertilidad Femenina/epidemiología , Infertilidad Femenina/etiología , Dolor Pélvico
7.
World Neurosurg ; 154: e641-e648, 2021 10.
Artículo en Inglés | MEDLINE | ID: mdl-34332153

RESUMEN

BACKGROUND: Midline lumbar fusion (MIDLF) is one promising new surgical technique that has been developed to minimize perioperative damage to the paravertebral stabilizing musculotendinous system. The aim of this study was to assess long-term clinical and radiological effects of MIDLF. METHODS: This prospective cohort study evaluated patients who underwent MIDLF for degenerative spinal instability. Clinical and radiological examinations were performed before and after surgery. Perioperative and postoperative complications were recorded. Follow-up was 2 years. P ≤ 0.05 was considered statistically significant. RESULTS: The study included 64 patients (mean age 58.9 ± 10.7 years; 41 women [64.1%]). The most frequent indication for MIDLF was degenerative spondylolisthesis grade I (28 cases [43.8%]); the prevalent spinal segment to be fused was L4-L5 (35 cases [54.7%]). Mean duration of surgery was 148.2 ± 28.9 minutes. Relief of low back pain and leg pain was significant and stable in the postoperative period as assessed by visual analog scale (P < 0.001). Of patients, 86.9% reported fair, good, or excellent outcomes in terms of pain relief based on MacNab score 2 years after surgery. Patients' level of function in activities of daily living improved significantly based on Oswestry Disability Index score: from 66.8 ± 9.8 before surgery to 33.9 ± 16.5 2 years after surgery (P < 0.001). X-rays and computed tomography at 12 months showed interbody fusion in 46 cases (73.4%), inconclusive results in 13 cases (20.3%), and no fusion in 4 cases (6.3%). No damage to neural or vascular structures and no failure of hardware or screw loosening were recorded. CONCLUSIONS: MIDLF is a safe, efficient method for surgical treatment of lumbar spine instability. Its limited invasiveness contributes to better preservation of paravertebral muscles and enhanced postoperative spinal stability.


Asunto(s)
Degeneración del Disco Intervertebral/cirugía , Vértebras Lumbares/cirugía , Fusión Vertebral , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Degeneración del Disco Intervertebral/diagnóstico por imagen , Degeneración del Disco Intervertebral/patología , Vértebras Lumbares/diagnóstico por imagen , Vértebras Lumbares/patología , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Resultado del Tratamiento
8.
Ann Agric Environ Med ; 26(4): 606-616, 2019 Dec 19.
Artículo en Inglés | MEDLINE | ID: mdl-31885235

RESUMEN

INTRODUCTION AND OBJECTIVE: The tendency towards postponement of maternity implies a greater exposure of female germ cells to damaging environmental effects, including ionizing radiation (IR). Progress in paediatric oncology, based on the use of radiotherapy, also implies the occurrence of gonadal dysfunctions and subsequent female fertility disorders. Therefore, it seems justifiable to systematize the state of knowledge concerning the effect of IR on the female reproductive system. BRIEF DESCRIPTION OF THE STATE OF KNOWLEDGE: A considerable part of studies concerning the effect of IR on female germ cells have been conducted on animals. Their extrapolation to humans is hindered because in animal studies high acute exposures are applied, which do not reflect human environmental exposures characterized by chronic low dose exposure. Studies on animals provide a heterogenous image, which hinders the formulation of unequivocal conclusions and indicates that radiosensitivity depends, i.a. on IR dose, stage of development of oocytes, the applied marker of the effects of IR, or on the species. LD50 of human oocytes is estimated to be below 2 Gy. The effect of IR depends, i.a. on the dose fractionation and the age (older women are more radiosensitive). In females, the effective sterilizing dose is: at birth 20.3 Gy, at 10 years 18.4 Gy, at 20 years 16.5 Gy, whereas at 30 years 14.3 Gy, which is associated with the available pool of ovarian follicles. CONCLUSIONS: Within the range of low doses received as a result of environmental exposure to IR, there is no evidence for the occurrence of either adverse pregnancy outcomes, nor fertility disorders in females. These effects may be related to the cancer radiotherapy, or exposure to high IR doses during nuclear accidents.


Asunto(s)
Exposición a la Radiación/efectos adversos , Traumatismos por Radiación/fisiopatología , Reproducción/efectos de la radiación , Animales , Femenino , Humanos , Óvulo/efectos de la radiación , Traumatismos por Radiación/etiología , Radiación Ionizante
9.
Folia Microbiol (Praha) ; 64(3): 383-388, 2019 May.
Artículo en Inglés | MEDLINE | ID: mdl-30368648

RESUMEN

Cerebral abscesses caused by dark-pigmented Fonsecaea fungi are rare, especially in otherwise healthy individuals. In this case report, we present a 61-year-old man from Moldova, living in the Czech Republic, who had worked as a locksmith on oil platforms in Turkmenistan, Kazakhstan, Sudan, and Iraq since 1999, and was admitted to a neurology ward for a sudden motion disorder of the right leg, dysarthria, and hypomimia. Imaging revealed presence of expansive focus around the left lateral ventricle of the brain and a pronounced peripheral edema. The intracranial infectious focus was excised under intraoperative SonoWand guidance. Tissue samples were histologically positive for dark-pigmented hyphae, suggesting dematiaceous fungi. Therefore, liposomal amphotericin B therapy was initiated immediately. Fonsecaea monophora was provisionally identified using ITS rDNA region sequencing directly from brain tissue. The identification was subsequently confirmed by cultivation and DNA sequencing from culture. The strain exhibited in vitro sensitive to voriconazole (MIC = 0.016 µg/mL) and resistance to amphotericin B (MIC = 4 µg/mL); therefore, the amphotericin B was replaced with voriconazole. Postoperatively, a significant clinical improvement was observed and no additional surgery was required. Based on the literature review, this is the third documented case of cerebral infection due to this pathogen in patients without underlying conditions and the first such case in Europe.


Asunto(s)
Ascomicetos/aislamiento & purificación , Absceso Encefálico/microbiología , Absceso Encefálico/cirugía , Micosis/diagnóstico , Anfotericina B/uso terapéutico , Antifúngicos/farmacología , Antifúngicos/uso terapéutico , Ascomicetos/efectos de los fármacos , Ascomicetos/genética , Absceso Encefálico/diagnóstico por imagen , República Checa , ADN Ribosómico/genética , Humanos , Inmunocompetencia , Masculino , Persona de Mediana Edad , Micosis/diagnóstico por imagen , Resultado del Tratamiento
10.
Mol Clin Oncol ; 5(1): 161-164, 2016 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-27330791

RESUMEN

The present study reports a case of a 44-year-old female patient with a large frontal lobe tumor who underwent surgery using a modern navigation system SonoWand that combines the advantages of a non-frame navigation system with intraoperative real-time ultrasound imaging. The right frontal lobe tumor consisted of two morphologically different sections. A diffuse astrocytoma grade II and a glioblastoma grade IV were identified. These tumors were relatively substantially separated. A 17 p deletion, including TP53, was detected in a diffuse astrocytoma but not in a glioblastoma. EGFR and MDM2 amplifications were detected only in a glioblastoma. Detection of these amplifications is typical for primary glioblastomas. These findings support our assumption of two independent tumors. The KRAS, BRAF and EGFR gene mutations were also detected in a glioblastoma. Such an accumulation of molecular mutations is rare in one tumor. Following oncological treatment the patient was cared for in the oncological center and survived for 15 months after the surgery without any signs of a disease. This is an unusual case, and to the best of our knowledge, is not frequently published in literature.

11.
Neurol Neurochir Pol ; 50(1): 16-23, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-26851685

RESUMEN

BACKGROUND: The mini-invasive open posterior lumbar fusion procedure (mini PLIF) procedure is an alternative to standard open procedure (open PLIF) and is intended to reduce surgery-related trauma. The measuring of suitable biochemical factors enables objective comparison of the invasiveness of spinal surgery procedures. METHODS: Prospectively collected data on myoglobin, creatine kinase, interleukin-6, C-reactive protein levels and intensity of low back pain and radicular pain in one-level mini PLIF and open PLIF procedures were analysed. The mini PLIF and the open PLIF groups included 27 and 23 patients, respectively. The collection of blood samples and clinical data were performed preoperatively and on postoperative days 1, 3 and 7. The non-paired t-test was used for statistical evaluation. RESULTS: We did not found any statistically significant differences of myoglobin and creatine kinase levels between the groups. In the open PLIF group the IL-6 levels were significantly higher than in the mini PLIF group on postoperative day 3. CRP levels showed significant lower stress response in favour of the mini PLIF group on postoperative days 3 and 7. Levels of post-op low back pain on day 3 were significantly lower in mini PLIF group. Also intensity of radicular pain on day 1 and 3 were lower also mini PLIF group. CONCLUSION: The extent of myonecrosis was comparable in both techniques. The analysis of the IL-6 and CRP levels showed significantly lower systemic inflammatory response in mini PLIF technique. The mini PLIF technique provides transiently lower postoperative pain levels.


Asunto(s)
Creatina Quinasa/sangre , Interleucina-6/sangre , Dolor de la Región Lumbar/sangre , Procedimientos Quirúrgicos Mínimamente Invasivos/métodos , Mioglobina/sangre , Evaluación de Resultado en la Atención de Salud , Complicaciones Posoperatorias/sangre , Fusión Vertebral/métodos , Proteína C-Reactiva , Femenino , Humanos , Dolor de la Región Lumbar/fisiopatología , Vértebras Lumbares/cirugía , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/fisiopatología
12.
J Neurol Surg A Cent Eur Neurosurg ; 76(5): 384-91, 2015 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-26024471

RESUMEN

BACKGROUND: One of the methods to compare the invasiveness of different surgical techniques objectively is to measure the levels of biochemical markers of systemic inflammatory response and muscle damage. METHODS: A total of 120 patients undergoing surgery for symptomatic disc herniation at L4-L5 and L5-S1 were enrolled in the study. Patients were operated on using open discectomy (OD), microsurgical discectomy (MD), or microsurgical discectomy with tubular retractor (MD-TUB). Myoglobin (MYO) and creatine kinase (CK) levels were used as indicators of muscle damage, and interleukin-6 (IL-6) and C-reactive protein (CRP) levels were used as indicators of systemic inflammatory response. Sampling and analysis of samples were performed preoperatively and on postoperative days 1, 3, and 7. Levels of postoperative low back pain and radicular pain were recorded on a 10-grade visual analog scale. Statistical evaluation was performed using the analysis of variance test. RESULTS: MYO concentrations in the MD-TUB group on postoperative day 1 were significantly lower than in the MD and OD groups. CK values on postoperative day 1 were significantly lower in microsurgical techniques (MD and MD-TUB) than in the OD group. The lowest IL-6 levels were found in the MD-TUB group, followed by the MD and OD groups. Differences in the IL-6 levels were significant between the groups on postoperative day 1. On all postoperative days that were monitored, values of CRP in the MD-TUB group were significantly lower compared with the MD and OD groups. Lower values in the MD group versus OD group were not statistically significant. CONCLUSION: All studied techniques showed similar efficacy in reducing radicular pain. The microsurgical diskectomy using a retractor in comparison with MD and OD is friendlier toward the paraspinal muscles, but the difference is significant only for the MYO levels. The total stress inflammatory response exhibited by patients undergoing the MD-TUB technique is significantly lower compared with the MD and OD techniques.


Asunto(s)
Biomarcadores/sangre , Discectomía/métodos , Inflamación/sangre , Desplazamiento del Disco Intervertebral/cirugía , Microcirugia/métodos , Músculo Esquelético/lesiones , Evaluación de Resultado en la Atención de Salud , Complicaciones Posoperatorias/sangre , Adulto , Proteína C-Reactiva/análisis , Creatina Quinasa/sangre , Discectomía/efectos adversos , Discectomía/instrumentación , Femenino , Humanos , Interleucina-6/sangre , Vértebras Lumbares , Masculino , Microcirugia/efectos adversos , Persona de Mediana Edad , Mioglobina/sangre , Sacro
13.
Acta Neurochir Suppl ; 118: 265-7, 2013.
Artículo en Inglés | MEDLINE | ID: mdl-23564145

RESUMEN

Transcranial color-coded sonography (TCCS) monitoring of severe brain injury patients may reveal various pathological hemodynamic changes. According to changes in flow velocities in basal brain arteries, the presence of brain hyperemia, vasospasms, and oligemia can be detected. The study included a group of 20 patients with severe brain injury. TCCS measured flow velocities and ICP values were monitored on a daily basis in the course of a week after injury. In nearly 50 % of patients significant hemodynamic changes occurred. The most frequent pathological finding was hyperemia (31.8 %), followed by vasospasm (10.9 %) and oligemia (9.1 %). In 42.7 % of patients increased flow velocities were registered and only 9.1 % of records were within the normal range of values. The most substantial elevation in time-averaged mean velocity occurred from the second to the sixth day after injury. In a subgroup of patients with raised intracranial pressure 41.6 % of flow velocity (FV) measuring met the TCCS criteria for hyperemia compared with 26 % in a subgroup of patients without intracranial pressure (ICP) elevation. The study showed that hemodynamic changes after severe brain injury are relatively common findings and that TCCS is a useful bed-side tool for the monitoring of intracranial hemodynamic changes.


Asunto(s)
Lesiones Encefálicas/diagnóstico por imagen , Ultrasonografía Doppler Transcraneal , Velocidad del Flujo Sanguíneo , Lesiones Encefálicas/complicaciones , Circulación Cerebrovascular , Codificación Clínica , Femenino , Estudios de Seguimiento , Humanos , Presión Intracraneal , Masculino , Factores de Tiempo , Vasoespasmo Intracraneal/etiología
14.
Am J Emerg Med ; 30(6): 961-5, 2012 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-21795006

RESUMEN

BACKGROUND: The transmission of medical images and other data over mobile phone networks may facilitate remote medical consultations between neurosurgeons and regional hospitals treating spinal injury patients. The aim of this study was to compare the efficacy of mobile phone consultations with standard hospital workstation consultations in spinal injury patients. METHODS: The images were exported over the Internet from surrounding local hospitals through the Picture Archiving and Communication System, in DICOM III format, to the central hospital server. The xVision browser was used to view the acquired images on a standard workstation. The data were also exported to the secured hospital Web server IIS60 and converted to JPEG format to enable remote physician access and consultation. The remote consulting physician connected to this server by mobile phone using the phone's Internet browser. A second physician, blind to the mobile phone results, evaluated the same images at a workstation in the hospital. The results of the mobile phone consultations were compared with the results from standard workstation consultations. RESULTS: There was no difference in the quality of spinal computed tomographic/magnetic resonance images viewed on the phone screen compared with on the workstation. More importantly, the final diagnoses made by mobile phone did not differ from those made by workstation consultations. A transfer to the department of neurosurgery was required after consultation in 11 patients. CONCLUSION: Mobile phone consultations for patients with spinal injuries was as effective as workstation consultations. Mobile phone consultations can increase the expertise available to regional hospitals, which are often the first responders to medical emergencies.


Asunto(s)
Teléfono Celular , Traumatismos Vertebrales/diagnóstico por imagen , Telerradiología/métodos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Radiografía , Traumatismos Vertebrales/diagnóstico
15.
J Ultrasound Med ; 30(8): 1069-75, 2011 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-21795482

RESUMEN

OBJECTIVES: The aim of this retrospective study was to compare intracranial arterial stenosis in patients with stroke using 3 different methods: transcranial color-coded duplex sonography, computed tomographic (CT) angiography, and digital subtraction angiography in a common clinical practice. METHODS: Sixty-seven patients (47 male and 20 female; age range, 23-79 years; mean age ± SD, 62.0 ± 9.5 years) were enrolled in this study over 40 months. All patients underwent examinations of the intracranial arteries using transcranial color-coded sonography, CT angiography, and digital subtraction angiography. Findings were divided into 4 groups: normal, mild stenosis (<50%), severe stenosis (50%-99%), and occlusion. RESULTS: Because of technical reasons or an insufficient bone window, 465 of 536 arterial segments in 67 patients were evaluated; 12 stenotic and 15 occluded segments were detected using digital subtraction angiography. The sensitivity, specificity, positive predictive value, and negative predictive value of transcranial color-coded sonography and CT angiography in comparison with digital subtraction angiography as a reference standard were 88.9%, 94.8%, 51.1%, and 99.3% and 81.5%, 98.7%, 78.6%, and 98.6%, respectively. The agreement between transcranial color-coded sonography and CT angiography was 93.8% (κ = 0.559); between transcranial color-coded sonography and digital subtraction angiography, it was 93.9% (κ = 0.588); and between CT angiography and digital subtraction angiography, it was 96.6% (κ = 0.697). CONCLUSIONS: Moderate agreement was found between CT angiography, transcranial color-coded sonography, and digital subtraction angiography in the evaluation of intracranial stenosis. Computed tomographic angiography and digital subtraction angiography are sufficient for assessment of the diagnosis.


Asunto(s)
Angiografía de Substracción Digital/métodos , Arteriopatías Oclusivas/diagnóstico por imagen , Angiografía Cerebral/métodos , Circulación Cerebrovascular , Accidente Cerebrovascular/diagnóstico por imagen , Tomografía Computarizada por Rayos X/métodos , Ultrasonografía Doppler Transcraneal/métodos , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Estudios Retrospectivos , Sensibilidad y Especificidad , Ultrasonografía Doppler en Color
16.
J Neurol ; 258(9): 1689-94, 2011 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-21431893

RESUMEN

Decompressive surgery <48 h from stroke onset reduces the prevalence of mortality and morbidity from malignant supratentorial infarction. We investigated if utilization of decompressive surgery changed in the Czech Republic (CZ) after the release of new guidelines regarding treatment of malignant brain infarction. The volume of decompressive surgery in 2009 in all centers in the CZ was assessed using the same methodology as in 2006. All neurosurgery departments in the CZ were asked to complete a questionnaire and asked to identify all cases of decompressive surgery for malignant brain infarction through a combination of discharge codes for "brain infarction" and "decompressive surgery" from electronic hospital charts. Data for 56 patients were obtained from 15 of the 16 neurosurgery departments in the CZ. The average age was 53 ± 13; number of males 20; median time to surgery was 48 h (range 24-62); median NIHSS score was 25 (IQR, 20-30); median infarct volume was 300 cm(3) [interquartile (IQR, 250-350)]; mean shift on CT was 10.6 ± 3.6 mm and size of hemicraniectomy was 125 cm(2) (IQR, 110-154). A favorable outcome was achieved in 45% of the patients. The number of procedures increased from 39 in 2,006 to 2,056 in 2009. Based on data from one stroke center, 10% suffered from malignant supratentorial infarction and 2.3% met the criteria for decompressive surgery. In 2009, as compared to 2006, the volume of decompressive surgery carried out moderately increased. However, procedures remained underutilized because only ~10% of those who needed decompressive surgery underwent surgery.


Asunto(s)
Infarto Encefálico/cirugía , Descompresión Quirúrgica/estadística & datos numéricos , Adhesión a Directriz , Procedimientos Neuroquirúrgicos/estadística & datos numéricos , Procedimientos Quirúrgicos Vasculares/estadística & datos numéricos , Adulto , Anciano , Infarto Encefálico/epidemiología , Infarto Encefálico/patología , República Checa/epidemiología , Descompresión Quirúrgica/tendencias , Femenino , Adhesión a Directriz/tendencias , Humanos , Masculino , Persona de Mediana Edad , Procedimientos Neuroquirúrgicos/tendencias , Guías de Práctica Clínica como Asunto/normas , Prevalencia , Procedimientos Quirúrgicos Vasculares/tendencias
17.
Chir Narzadow Ruchu Ortop Pol ; 75(2): 131-5, 2010.
Artículo en Inglés | MEDLINE | ID: mdl-20695188

RESUMEN

Between 2007-2008 forty two patients neurosurgery department of the KNTB (Regional Hospital of T. Bat'a) Zlin underwent surgery using the bioactive replacement Implaspin. The group of 21 patient of the total of number of 42 patients was operated first time for diagnosis degenerative instability or spondylolisthesis gr I-II. In this group was the follow-up period of 18 months, the mean baseline Oswestry score was 57%. A value of 37% was achieved after 18 months during the evaluation of the clinical status using the Oswestry questionnaire. This result represented a improvement of the condition. No change of the position of the instruments occurred during the X-ray and CT, MRI controls. Therefore, the Implaspin replacement appeared to be a perfect alternative to other lumbar spine replacements combining the osteoconductive properties of the bioactive material with the rigidity of titanium.


Asunto(s)
Materiales Biocompatibles/uso terapéutico , Placas Óseas , Vértebras Cervicales/cirugía , Fusión Vertebral/métodos , Titanio , Adulto , Anciano , Vértebras Cervicales/diagnóstico por imagen , República Checa , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Radiografía , Recuperación de la Función , Enfermedades de la Columna Vertebral/cirugía , Fusión Vertebral/instrumentación
18.
Chir Narzadow Ruchu Ortop Pol ; 75(1): 69-73, 2010.
Artículo en Inglés | MEDLINE | ID: mdl-20496781

RESUMEN

The authors present results of surgical treatment of cervical spine degenerative disease via Implaspin biotitanium replacement. Surgery was indicated for a group of 24 patients with symptoms of cervical spondylogenic myelopathy or the irritation decay root syndrome non-reacting to conservative treatment. Pre-surgery X-ray and MRI examinations showed spinal canal stenosis caused by the intervertebral disk osteochondrosis combined with prolapse or dorsal osteophytes. Clinical problems of the group of patients were evaluated through the JOA classification before surgery and during the 2nd, the 6th and month 12th after surgery. The surgery rate of success was evaluated in percentages during post-surgery examinations that took place in the 12th month. Based on the JOA classification, that rate of success falls into the good surgery results zone. The post-surgery X-ray examinations showed two sank replacements by 1/3 of its height into the surrounding vertebral bodies. In these cases we performed the control MRI. No signs of the new spinal compression were found and the spinal canal was free in the operated site. Based on our short-term experiences, the Implaspin bioactive replacement seems to be a suitable alternative to the other types of replacements designed for intervertebral fusion in the lower cervical spine area.


Asunto(s)
Materiales Biocompatibles/uso terapéutico , Placas Óseas , Vértebras Cervicales/cirugía , Fusión Vertebral/métodos , Titanio , Vértebras Cervicales/diagnóstico por imagen , Estudios de Seguimiento , Humanos , Radiografía , Recuperación de la Función , Enfermedades de la Columna Vertebral/cirugía , Fusión Vertebral/instrumentación , Resultado del Tratamiento
19.
Pol J Radiol ; 75(4): 30-3, 2010 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-22802801

RESUMEN

Transmission of visual documentation between a neurosurgery center and a regional hospital, with a mobile phone, significantly improves consultation on a craniocerebral injury. This is one of the methods of fast consultation on image documentation (CT). We reported on one year of experience (September 2007 to September 2008) of our department with this method of image transmission in 16 patients with craniocerebral injury. The images were exported, via the Internet, from local hospitals through the PACS system [Picture Archiving and Communication System], in DICOM III format, to the server of the Regional Hospital of T. Ba̕a, (KNTB). Browsing of the acquired image documentation at particular stations was possible with the xVision browser. The data were exported to a secure hospital Web server, IIS60, to enable consultation on the images, which were changed to JPEG format. The consulting physician was connected to this server with his/her mobile phone by means of the Internet browser. After establishing the connection, it downloads and gradually displays the images on the screen of the mobile phone. The whole process takes approximately 10 minutes. After comparing the images on the screen of the mobile phone and on the workstation using the xVision browser, we verified that there was no difference in the quality of imaging of the pathological lesions recorded with CT.

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