Evaluation of the scientific impact of the Ebola epidemic: a systematic review.

OBJECTIVES: The Ebola outbreak prompted an extensive number of scientific publications, but little attention has been paid to the involvement of local scientists, distribution of research funding and related publications. We sought to systematically review publicly available information on the scientific impact of the Ebola epidemic. METHODS: A systematic review of literature on the Ebola outbreak was performed. Extracted information included origins of the authors, type and distribution of funding, and impact factors (IF) of related publications between 6 December 2013, and 22 December 2015. RESULTS: We identified 460 relevant articles out of 3281 references, which were mostly authored by American (46.6%) and European (28.4%) institutions; only 13.4% of authors were affiliated with African institutions. Most IF can be attributed to the Americas and Europe, with 43% (25 030.8 IF) and 34.5% (20 074.2 IF), respectively, compared with 17.9% (10 436.5 IF) in Africa. Funds were provided mainly by the Americas (31.8% of all funded studies) and Europe (17%). American and European funds were also distributed back, mainly to American (77.8%) and European (85.2%) institutions, respectively. CONCLUSIONS: The Ebola outbreak had a significant scientific impact and resulted in numerous publications in high IF journals. The main impact could be measured in the Americas and Europe, and was directly related to funding. African researchers were only marginally involved in the scientific processing (86.6% of all researchers were not African), probably because major research centres are located in America and Europe. Our results suggest the importance of promoting closer cooperation between regions.

Use of accuracy profile procedure to validate a real-time PCR method to quantify bacteria in feces.

This study describes a novel validation procedure of real-time PCR based on accuracy profile to estimate bacterial concentrations in fecal samples. To assess the performance of the method, measurements of axenic fecal samples spiked with a measured quantity of known bacterial species (Bacteroides fragilis, Bifidobacterium adolescentis, Enterococcus faecium, and Escherichia coli) were performed under repeatability and intermediate precision conditions. Data collected were used to compute a tolerance interval that was compared to a defined acceptance interval. It is concluded that the method is valid and relevant for the studied validation range of 8.20-10.24 and 7.43-9.47 log10 CFU/g of feces to ensure proper measurement of B. fragilis and E. coli, respectively. The LOQ is 8.20 and 7.43 log10 CFU/g of feces. In contrast, the method is not valid for the quantification of E. faecium and B. adolescentis, but by applying a correction factor of +0.63 log10 CFU/g, it can be considered valid for E. faecium. This correction is included in the final results. In conclusion, the accuracy profile is a statistical tool that is easy to use and totally adapted to validate real-time PCR.

Diagnosis and surgical therapy of plasma cell neoplasia of the spine.

Presented is a retrospective analysis of 27 patients with plasma cell neoplasms of the spine treated by surgery. Multiple myeloma was confirmed in 22 (81%) and solitary plasmacytoma in 5 patients (19%), assessed at the time of surgery. Nineteen patients (70%) with the preliminary diagnosis of malignancy of unknown etiology were admitted for surgery. In 23 patients (85%) the essential symptom was back pain, which preceded surgery by an average of 4 months. Thirteen patients (48%) were bedridden due to tumor spinal cord compression, on average for 7 days before undergoing surgery. Only 5 out of 13 bedridden patients (38%) regained the ability to walk after surgery and 8 patients (62%) remained bedridden despite successful surgical decompression of the spinal cord. The difference of survival of the patients between bedridden and able to walk prior to surgery was statistically significant (Cox's F-Test = 0.005). Key words: plasma cell neoplasia, spinal cord compression, late diagnosis, outcome.

[Present view on the spinal haemangioma]. / Soucasný pohled na problematiku páterního hemangiomu.

Ethiopathogenesis, diagnostic and treatment of spinal haemangioma remains suggestive topic not only for surgeons. The development of diagnostic imaging methods allows more precise evaluation of the pathology and optimal therapeutic planning. We have many therapeutic modalities: selective embolisation, radiotherapy, vertebroplasty, alcohol ablation and surgery. It depends on radiologic findings and clinical status which of them is used. The treatment of emergent compression is still the domain of surgeon. In the therapy of haemangiomas causing local pain, we prefer less invasive procedures. The interdisciplinary cooperation is required for the successful treatment.

[Role of percutaneous vertebroplasty and kyphoplasty in the treatment of oncology disorders of the spine]. / Postavení perkutánní vertebroplastiky a kyfoplastiky v lécbe onkologického onemocnení pátere.

BACKGROUND: The aim of the study is to present results of a prospective uncontrolled clinical study. Percutaneous vertebroplasty or kyphoplasty are minimally invasive methods based on polymethylmethacrylate (PMMA) bone cement application into the damaged vertebra. This leads to decrease of the pain and vertebral body stabilisation. Oncology disorders of the spine are relatively common, having a wide alternative of various methods of treatment. Patients, according to their findings and indication criteria, are treated surgically or conservatively, oncological treatment is usually based on radiotherapy. Authors discuss the role of these invasive procedures in the treating algorithm of patients with spinal metasthases and multiple myeloma. METHODS AND RESULTS: From September 2003 to December 2005, 21 percutaneous vertebroplasties in 14 patients, mean age 68.7 (47-80) year, were performed in our department. During one treatment session 1-2 vertebrae (total of 21 vertebrae) in level Th9 - L5 were treated. Vertebroplasties and kyphoplasty were performed under fluoroscopy guidance. Transpedicular acces was used. Totally, 3 asymptomatic complications were proved. As first, a bone cement leaked paravertebrally during L5 body treatment, as second, a bone cement leaked into paravertebral veins, and as third, a bone cement leaked into the intervertebral space. Visual analog scale (VAS) was 8.9 points before procedure, 1.9 point 3 months after procedure and 2.6 points 6 months after procedure. We did not prove a symptomatic or total complication. CONCLUSIONS: According to our experience, percutaneous vertebroplasty is an effective alternative treatment of painful oncologic spine disease.

[Percutaneous sacroplasty in sacral insufficiency fracture treatment]. / Perkutánní sakroplastika v lécbe insuficientní fraktury krizové kosti.

Stress (insufficient) sacral bone fracture is a seriously painful disease with discussed and disunited therapy. Older women sufferig from osteoporosis create the main group in which this fracture occurs. Clinically, serious pain in sacral area is the most common symptome. This pain may last for a long time when treated conservatively and it can lead to pacient's immobilization with related comorbidity. In 2% of patients, neurological complications can be observed. Authors present summary of published studies and demonstrate an own case treated using percutaneous sacroplasty.

[Percutaneous vertebroplasty]. / Perkutánní vertebroplastiky.

Percutaneous vertebroplasty is a therapeutic, interventional radiologic procedure originally developed in France by Galibert, Deramond et al. (1987). The technique consists of the percutaneous puncture of the affected vertebral body, followed by injection of bone cement into a vertebral body for the relief of pain, and the strengthening of the bone. The procedure was used initially to treat aggressive hemangiomas, but it then was extended to the treatment of osteolytic metastases, multiple myeloma and osteoporotic compression fractures refractory to medical therapy. In this article we review the current techniques, indications for this procedure, preoperative and postoperative evaluations.

Vascular access monitoring evaluated from automated recirculation measurement.

Vascular access quality monitoring by means of vascular access blood flow (QVA) evaluated from automated thermodilutional measurement of recirculation with reverse needle position is described. This method provides significant advantages over conventional methods based on simple monitoring of pressures in the extracorporeal circuit and/or measurement of recirculation with normal needle position. AQVA evaluation protocol was developed and introduced into the system of primary nursing. The QVA values were found independent of the extracorporeal blood flow used during the recirculation measurement. QVA values from below 200 ml/min to over 2 l/min were seen. In general, lower values were found in diabetics compared to non-diabetics and in females compared to males. While blood flow below 600 ml/min is considered risky for synthetic vascular grafts, native AV-fistulae seem to remain stable and patent at a flow of 400 ml/min or even below. The method is able to detect erroneous needle placement in looped grafts, stenosis between needles, and is also well suited for effective evaluation of success/failure of interventions on access.

[Long-term results after surgical treatment of head injuries]. / Dlouhodobé výsledky po chirurgicky resených poraneních hlavy.

It outflows from a survey of 174 cases operated during five years for skull injuries that the resulting state depends of preoperative level of consciousness. In injuries with the loss of consciousness, there is a close correlation between the type of motor-topain response and the resulting state. It was stated from the delay for up to 5 years after surgery that the independence from the day life has been achieved in 65% of injured patients which experienced preoperatively a mild loss of consciousness as they localized the pain stimulus or produced unintelligible sounds in response to pain. The similar condition has been achieved in only 14% cases of preoperatively deep loss of consciousness, which responded to pain or not with decerebrative extension, or unconsciously flexion of extremities. The resulting state is less dependent of operative diagnosis. Epidural hematomas show better results, where the independence of the day life has been achieved in 62% of cases. The majority of them was able to perform their previous working activities later on. In contrast, the worst results were achieved in association with brain contusions, where only 18% of injured patients sustained the independence of environs with no return to the previous work. Prognostically, the factor of age is the most important. In the age group over than 60 years, the mortality represented 58%, whereas in 20-40 years of age it was only 24%.