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PURPOSE OF THE STUDY Axial deformities of the lower limbs of various aetiologies are relatively common orthopaedic diagnoses in paediatric population. Fixed deformity is an indication for correction in order to reduce the pain and to delay the early osteoarthrosis of adjacent joints and pain. Temporary hemiepiphysiodesis is technically a fairly simple method for modulating growth at the level of the growth plate and thus correcting the skeletal axis. MATERIAL AND METHODS 59 patients who underwent axial deformity correction of lower limbs at KDCHOT FN Brno were retrospectively analysed. Group 1 consisted of 21 patients with Blount staples implantation, Group 2 consisted of 38 patients to whom eight-figure plates had been applied. Anthropometric parameters (BMI, age, gender, intermalleolar distance (IMD)), duration of therapy, X-ray parameters (anatomical lateral distal femoral angle (aLDFA), anatomical medial proximal tibial angle (aMPTA)) and complications were recorded. The rate of correction was evaluated as the difference in X-ray parameters before and after surgery with respect to the time interval of the therapy. RESULTS The groups were comparable in terms of anthropometric parameters (BMI (p=0.800), IMD (p=0.334), gender (p=0.87)). The only statistically significant difference was found when comparing the mean age of the groups (p=0.005), with Group 1 (12.7±0.7) containing patients with a higher mean age than Group 2 (11.6±1.5). The groups were also comparable in terms of the average rate of correction over a one-month interval (aLDFA p=0.393; aMPTA p=0.831). The mean correction rate for Group 1 was: aLDFA 0.52±0.20/month, aMPTA 0.12±0.08/month; for Group 2: aLDFA 0.56±0.28/month, aMPTA 0.12±0.20/month. Individual implants differed in the type of complications, but no significant statistical difference in the incidence of complications was found between the analysed groups (p=0.526). DISCUSSION Recently, the system of eight-figure plates has been adopted as a standard method for correction of axial deformities of limbs. Although the benefits of this system are indisputable, when comparing the average monthly correction rate, no significant difference was found between the system of eight-figure plates and Blount staples in our study. Another monitored parameter was the occurrence of complications, which was evaluated fairly strictly. Even in this case, no statistically significant difference was found. We believe that the issue of using eight-figure plates is still open, as evidenced by studies, which often produce different results and conclusions. Therefore, a precise evaluation of the indication for correction, including individual characteristics of patients, is needed. CONCLUSIONS Based on the results, it can be concluded that the use of eight-figure plates in comparison with Blount staples provides neither faster correction of axial deformities nor lesser occurrence of complications. It can therefore be argued that the Blount staples still have their place in the indication of correction of axial deformities. The use of eight-figure plates represents a suitable solution for children of younger age to whom anchoring of the screws of eight-figure plates is a suitable solution in the cartilaginous epiphysis of long bones of younger children. Key words: temporary hemiepiphysiodesis, growth plate, Blount staples, eight-figure plates.
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Geno Valgo , Placas Ósseas , Criança , Epífises , Geno Valgo/cirurgia , Humanos , Dor , Estudos Retrospectivos , Tíbia/cirurgiaRESUMO
PURPOSE OF THE STUDY Radial head fractures in paediatric patients account for 5-19% of all elbow injuries and approximately 1% of all fractures in children. Non-displaced fractures are treated with plaster cast fixation. If the fracture is displaced, we proceed to closed reduction, or to osteosynthesis in case of unstable fragments. If closed reduction fails, we opt for open reduction and osteosynthesis. The prospective randomised clinical study aims to compare the two methods of minimally invasive osteosynthesis using the pre-bent Kirschner wire or Prévot nail and to identify differences between them. MATERIAL AND METHODS The prospective randomised clinical study was conducted in 2015-2019. The final cohort included 32 patients who met the inclusion criteria. The patients in whom other osteosynthesis implants had been used or in whom open reduction had to be performed were excluded from the study. Also excluded were the patients with serious concomitant injuries of elbow. For patients included in the cohort, demographic data, precise evaluation of the displacement and location of the fracture as well as the duration of plaster cast fixation and osteosynthesis implants used were recorded. In the clinical part, the methods were compared based on the achievement of full range of motion in dependence on the degree of original displacement, use of osteosynthesis implant, and occurrence of early and delayed complications. Clinical and radiological outcomes were compared. In both types of minimally invasive osteosynthesis, Métaizeau surgical technique was used. RESULTS Based on the clinical trial criteria, 26 (81%) excellent, 4 (13%) good and 2 (6%) acceptable outcomes were achieved. In 3 cases the loss of rotation was up to 20°, in 1 case the loss of flexion was up to 10°. In one patient the loss of flexion was 15° and rotation up to 30°. In another patient the loss of rotation was up to 40°. The radiological assessment showed 14 (44%) excellent outcomes, 15 good (47%) and 3 (9%) acceptable outcomes. The statistical analysis of both the groups of the cohort using non-parametric tests revealed no statistically significant differences in individual demographic parameters. The comparisons of both types of osteosynthesis in dependence on the degree of displacement by non-parametric Fisher's exact test showed no statistically significant difference in the radiologic or clinical results. The only statistically significant difference was observed in the duration of metal implant placement. DISCUSSION Comparable studies report excellent or good clinical outcomes in 80-95% of cases (1,13,16). In our cohort, excellent or good clinical outcomes were achieved in 30 patients (94%). In two patients, in whom Prévot nail was used, the outcomes were acceptable. Nonetheless, this fact did not result in any statistical significance when comparing the two methods separately or in comparisons based on the degree of displacement. CONCLUSIONS The comparison of the two methods of minimally invasive osteosynthesis revealed no statistically significant difference, namely not even when both the methods were compared based on the degree of displacement. When Kirschner wire is used, the possibility to remove the metal implant in the outpatient setting is considered to be an advantage. The drawback consists in potential penetration of the sharp Kirschner wire in the radiocapitellar joint, which we did not encounter when the second technique of osteosynthesis was used. The advantage of Prévot nail includes a lower risk of pin-tract infection. Key words: minimally invasive osteosynthesis, radial head, fracture, child.
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Fixação Interna de Fraturas , Fraturas do Rádio , Fios Ortopédicos , Criança , Fixação Interna de Fraturas/métodos , Humanos , Estudos Prospectivos , Rádio (Anatomia)/lesões , Fraturas do Rádio/diagnóstico por imagem , Fraturas do Rádio/etiologia , Fraturas do Rádio/cirurgia , Resultado do TratamentoRESUMO
INTRODUCTION: An increased incidence rate of cases of complicated pneumonia, reaching up to the stage of necrotizing pneumonia was observed at University Hospital Brno in the past period. The aim of this study was to perform a single-center retrospective analysis of patients with acquired inflammatory lung disease requiring surgical treatment, comprising a long-term follow-up group. METHODS: Patients hospitalized for community-acquired pneumonia and surgically treated in the years 2015-2019 were analyzed. The rates of necessary chest drainages, decortications and lung resections in relation to the whole group and individual years were monitored. Clinical and X-ray examinations were performed one year after hospitalization and the prognosis was determined for individual types of required treatments. The age, gender and etiological agents were also monitored. RESULTS: A total of 688 patients were included in the study with the incidence rising until 2018 and decreasing slightly in 2019. A statistically significantly higher number of community-acquired pneumonias and complications was recorded between 2017 and 2018 (p.
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Pneumonia Necrosante , Criança , Hospitalização , Humanos , Pneumonia Necrosante/complicações , Pneumonia Necrosante/epidemiologia , Pneumonia Necrosante/cirurgia , Prognóstico , Radiografia , Estudos RetrospectivosRESUMO
INTRODUCTION The clubfoot ranks among the most frequent paediatric structural deformities of the lower extremity. Currently, the Ponseti method is considered the gold standard for the treatment. To evaluate the degree and severity of the deformity, clinical classification systems have been developed, commonly used in clinical practice. This study aims to verify whether the Pirani and Dimeglio clinical scoring systems can be used to predict the results of treatment by the Ponseti method. MATERIAL AND METHODS The study included 31 patients. The patients had been referred from the neonatal departments to the Department of Paediatric Surgery, Orthopaedics and Traumatology in Brno with the diagnosed clubfoot deformity, where they were treated by an erudite orthopaedist experienced in this field according to the Ponseti treatment standards. The Pirani and Dimeglio clinical scoring of the deformity were performed always before the commencement of the therapy and after the second plaster cast fixation. The number of plaster cast fixations, the necessity to carry out achillotomy and the relapse rate were set as the parameters of treatment results. In the first stage of statistical analysis, the respective clinical systems were correlated with the treatment results, in the second part of the study the patients were based on the clinical evaluation divided into 3 groups depending on the severity of the deformity, and these groups were subsequently compared. RESULTS 22 patients from the group (71%) underwent percutaneous achillotomy and in 3 patients (9.7%) a relapse occurred. To correct deformities 7.1 corrective casts were used on average. The correlation between the number of plaster cast fixations and classification systems was significant in all the cases, with the strongest dependency shown by the correlation with the Pirani score after the second corrective cast (r = 0.594, p < 0.001). Positive correlation was found also between the necessity to perform achillotomy and both the classification systems. In this case the strongest correlation was established in the case of the Pirani clinical scoring after the second plaster cast fixation (r = 0.488, p = 0.003). Conversely, significant correlation was not established between the relapse rate and the used classification systems, not even in a single case (p ≥ 0.05). In the second stage of the statistical analysis, in the case of the Pirani scoring before the therapy no difference was found between the individual groups with diverse severity of clubfoot deformity during the evaluation of the aforementioned parameters of treatment results. In the Pirani classification after the second plaster cast fixation, a statistically significant difference was established in the number of plaster cast fixations (p = 0.003) and the necessity to perform achillotomy (p = 0.012). When the Dimeglio scoring was applied before the therapy, a statistically significant difference between the groups was found in the number of plaster cast fixations (p = 0.031) and after the second plaster cast fixation in the relapse rate (p = 0.035). DISCUSSION Although the clinical scoring systems belong to key indicators of severity of the deformity and are commonly used in clinical practice, the current literature provides only an inconsistent picture of their application in predicting the course and the results of treatment. Concurrently, the authors opinions on this issue differ. The scoring in later stages of treatment shows a better predictive value than the scoring at the beginning of the treatment, which was confirmed also by the results of our study. CONCLUSIONS Even though the clinical scoring systems show a certain dependency on the parameters of the treatment results, in practice their predictive function can be used to a limited degree only. The complexity of the evaluation of the deformity itself and subsequently of the results of treatment requires also the use of other parameters than the clinical classifications only so that the prediction of the course and results of the treatment of clubfoot according to Ponseti shows a higher degree of reliability. Key words:clubfoot, Ponseti, Pirani classification, Dimeglio classification.
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Pé Torto Equinovaro/classificação , Pé Torto Equinovaro/cirurgia , Projetos de Pesquisa/normas , Moldes Cirúrgicos/normas , Pé Torto Equinovaro/diagnóstico por imagem , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Valor Preditivo dos Testes , Recidiva , Reprodutibilidade dos Testes , Índice de Gravidade de Doença , Tenotomia/métodos , Resultado do TratamentoRESUMO
PURPOSE OF THE STUDY Olecranon fractures in skeletally immature patients are rather rare and represent up to 7% of elbow skeletal injuries. Although the majority of olecranon fractures is constituted by undisplaced fractures treated conservatively with good outcomes, a few of them require surgery. The aim of the study was to compare two different approaches of surgical treatment - the open reduction with tension band wiring - cerclage (ORCe) and the closed reduction and percutaneous pinning (CRPP). MATERIAL AND METHODS 37 patients (28 boys, 9 girls) were included in the retrospective multicentric study. The patients were treated at two different institutions (the Clinic of Paediatric Surgery, Orthopaedics and Traumatology, the University Hospital Brno and the Department of Paediatric Surgery and Traumatology, the University Hospital Hradec Králové, Czech Republic). 17 patients underwent the ORCe procedure, while 20 patients were treated using the CRPP method. Different parameters were statistically compared in the groups (demographic data, data concerning the course of the therapy, outcome of the therapy in terms of movements' restrictions and complications such as osteosynthesis failure and infection). RESULTS Both the groups were comparable in terms of demographic data because no statistically significant difference was observed in terms of the age (p = 0.082), the affected site (p = 1.000) and the gender (p = 0.462). Statistically significant difference between these two groups was found in the interval between the implementation and the removal of the osteosynthetic material (p < 0.001) and in the length of cast immobilisation (p = 0.047). The number of patients with movement restriction up to 10° was statistically significantly higher in patients who underwent the CRPP procedure (p = 0.040), but no statistically significant difference was seen between these two groups in terms of movement restriction more than 10° (p = 0.609). One revision surgery was performed in the CRPP group, however with no statistical significance (p = 0.350). DISCUSSION The multicentric study included 37 children, who underwent surgical treatment of a displaced olecranon fracture. Compared to the studies dealing with this topic the number of patients included in this study is relatively high. It advocates the possibility of using the CRPP method as a good alternative to the gold-standard ORCe technique because no difference in terms of the number of revision surgeries and the clinically important movement restriction of more than 10° were seen. It also brings along advantages such as a simple surgical technique, good functional and cosmetic effects, reducing the risk of ischemic insult of growth plate and the possibility of osteosynthetic material removal at an outpatient department with no need for general anaesthesia. The risk of a higher radiation exposure of both the patient and the surgical team should be considered as a disadvantage of the closed method. CONCLUSIONS The mini-invasive CRPP appears to be a good alternative option to the ORCe method for the treatment of isolated olecranon fractures in children offering the advantages such as avoiding extensive open procedure and simple implants removal. Key words:children, olecranon, fracture, tension band wiring - cerclage, percutaneous pinning, elbow.
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Redução Fechada , Lesões no Cotovelo , Articulação do Cotovelo , Fraturas do Úmero/cirurgia , Olécrano , Redução Aberta , Fatores Etários , Fios Ortopédicos , Criança , Redução Fechada/efeitos adversos , Redução Fechada/métodos , Pesquisa Comparativa da Efetividade , Articulação do Cotovelo/diagnóstico por imagem , Articulação do Cotovelo/cirurgia , Feminino , Humanos , Fraturas do Úmero/diagnóstico , Masculino , Olécrano/diagnóstico por imagem , Olécrano/lesões , Olécrano/cirurgia , Redução Aberta/efeitos adversos , Redução Aberta/instrumentação , Redução Aberta/métodos , Avaliação de Resultados em Cuidados de Saúde , Seleção de Pacientes , Radiografia/métodosRESUMO
PURPOSE OF THE STUDY The presented study was construed as a retrospective multicentric clinical study focused on paediatric skeletal injuries of the proximal radius. As a general rule, the Type I displaced fractures (Judet classification) are treated conservatively, with no reduction. In the case of Type II-IV displacement, the fracture necessitates reduction or is also transfixed by a Kirschner wire (K-wire) or a Prevot nail (P-nail) where subsequent fragment instability occurs. The comparison aimed to ascertain whether there is a statistically significant difference between the two methods. No difference was expected by the authors, therefore a null hypothesis was set. MATERIAL AND METHODS The patients were treated at the Clinic of Paediatric Surgery, Orthopaedics and Traumatology (CPSOT) of the Faculty of Medicine of the Masaryk University and at the Clinic of Orthopaedics and Traumatology of the Musculoskeletal System of the University Hospital in Pilsen in the period from 2006 to 2015. Two methods of closed reduction and minimally- invasive osteosynthesis were evaluated. The first method was the elastic stable intramedullary nailing (ESIN) with a P-nail, the second method was an osteosynthesis using a K-wire. In the clinical part of the study, comparisons were made based on the monitoring of the same parameters - final restriction of movement, time to full weight bearing of the extremity and incidence of serious complications. RESULTS The final group comprised a total of 31 patients, of whom 7 boys and 24 girls aged 3-16 years with the median of 9-10 years. Some restriction of movement following the treatment occurred in a total of seven patients (44%) with the K-wire and in four patients (27%) with the P-nail. When comparing the movement at 5% level of significance using the Chi-Square tests, no significant difference was found (p = 0.446). When evaluating the serious complications at 5% level of significance using the Chi-Square tests, the difference between the two methods of treatment was again insignificant (p = 0.365). When the full weight bearing was compared (median K-wire 8 weeks, median P-nail 10 weeks), a statistically significant difference was obtained at 5% level of significance using the Fischer exact test (p = 0.003). DISCUSSION In these fractures, usually the metaphysis or the physis are involved in the injury, in which case the fractures are classified according to Salter and Harris, with the most frequent occurrence of SHII epiphyseal separation and rare SHIII and SHIV epiphyseal fractures. The radial head fractures are mostly caused by valgus force. Therefore, the individuals with a higher elbow valgosity are more prone to injuries. The girls strongly prevail (77%) also in our study. In general, our results as well as the literature have proven that as the displacement increases, the necessity of closed reduction and osteosynthesis grows. The post-treatment complications in our group were observed in 35.5% of patients, namely most often in the form of limited movement. The literature refers to complications in 26.5-53% of patients. CONCLUSIONS The clinical results clearly show that when comparing the complications after the radial head fracture in children there is no statistically significant difference between the methods of osteosynthesis. This study shall serve as a starting point for the currently ongoing prospective multicentric study evaluating the modified ESIN technique using a pre-bent Kirschner wire. Key words:children, fracture, radius, proximal, osteosynthesis.
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Pinos Ortopédicos , Tratamento Conservador , Fixação Intramedular de Fraturas , Complicações Pós-Operatórias , Fraturas do Rádio , Rádio (Anatomia) , Adolescente , Fios Ortopédicos , Criança , Pré-Escolar , Tratamento Conservador/efeitos adversos , Tratamento Conservador/métodos , Feminino , Fixação Intramedular de Fraturas/efeitos adversos , Fixação Intramedular de Fraturas/instrumentação , Fixação Intramedular de Fraturas/métodos , Humanos , Masculino , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/etiologia , Rádio (Anatomia)/diagnóstico por imagem , Rádio (Anatomia)/lesões , Rádio (Anatomia)/cirurgia , Fraturas do Rádio/diagnóstico , Fraturas do Rádio/cirurgia , Amplitude de Movimento Articular , Resultado do TratamentoRESUMO
Ionic and nutrient compositions of throughfall, tributaries and lake outlet were analysed in the Plesné catchment-lake system (an unmanaged mountain forest in Central Europe) from 1997 to 2016. The aim was to evaluate changes in surface water chemistry after natural forest dieback. In the 2004-2008, 93% of the Norway spruce trees were killed by bark beetle outbreak, and all dead biomass remained in the catchment. Forest dieback changed the chemistry of all water fluxes, and the magnitude, timing, and duration of these changes differed for individual water constituents. The most pronounced decreases in throughfall concentrations occurred for K+, dissolved organic carbon (DOC), Ca2+ and Mg2+, i.e. elements mostly originating from canopy leaching, while concentrations of NH4+ and soluble reactive phosphorus (SRP) remained almost unaffected. In tributaries, the most rapid changes were increases in NO3-, K+, H+ and ionic aluminium (Ali) concentrations, while terrestrial export of DOC and P forms started more slowly. Immediately after the forest dieback, increase in NO3- concentrations was delayed by elevated DOC availability in soils. NO3- became the dominant anion, with maximum concentrations up to 346µeqL-1 within 5-7years after the bark beetle outbreak, and then started to decrease. Terrestrial exports of Ali, K+, H+, Mg2+, and Ca2+ accompanied NO3- leaching, but their trends differed due to their different sources. Elevated losses of SRP, DOC, and dissolved organic nitrogen continued until the end of the study. In the lake, microbial processes significantly decreased concentrations of NO3-, organic acid anions, H+ and Ali, and confounded the chemical trends observed in tributaries. Our results suggest that terrestrial losses of elements and the deterioration of waters after forest dieback are less pronounced in unmanaged than managed (clear-cut) catchments.
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Florestas , Água/química , Carbono/análise , Europa (Continente) , Lagos/química , Lagos/microbiologia , Nitrogênio/análise , Árvores , Microbiologia da ÁguaAssuntos
Oxigenação por Membrana Extracorpórea , Olho , Coração Artificial , Pulso Arterial , HumanosRESUMO
Two ethylene-bridged methylaluminium amidinates and one aluminium amidinate containing three terminal trimethylstannyl-ethynyl groups interconnected by π-coordinated potassium ions were prepared in situ. The re-oxidation of the ethylene-bridged compound by iodine followed by further reduction using the same activation procedure demonstrated the versatility of the approach. The reactivity of an ethylene-bridged methylaluminum amidinate towards HCl was examined to demonstrate the building block concept. DFT calculations were performed to gain insight into the mechanism of the in situ activation of diphenylacetylene.
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Juvenile wild and hatchery-reared European grayling Thymallus thymallus were tagged with radio-transmitters and tracked in the Blanice River, River Elbe catchment, Czech Republic, to study their behavioural response to stocking and environmental variation. Both wild and hatchery-reared T. thymallus increased their diel movements and home range with increasing light intensity, flow, temperature and turbidity, but the characteristics of their responses differed. Environmental variables influenced the movement of wild T. thymallus up to a specific threshold, whereas no such threshold was observed in hatchery-reared T. thymallus. Hatchery-reared fish displayed greater total migration distance over the study period (total migration) than did wild fish, which was caused mainly by their dispersal in the downstream direction.
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Biodynamic imaging (BDI) is a novel phenotypic cancer profiling technology which optically characterizes changes in subcellular motion within living tumor tissue samples in response to ex vivo treatment with cancer chemotherapy drugs. The purpose of this preliminary study was to assess the ability of ex vivo BDI to predict in vivo clinical response to chemotherapy in ten dogs with naturally-occurring non-Hodgkin's lymphomas. Pre-treatment tumor biopsy samples were obtained from all dogs and treated ex vivo with doxorubicin (10 µM). BDI measured six dynamic biomarkers of subcellular motion from all biopsy samples at baseline and at regular intervals for 9 h following drug application. All dogs subsequently received doxorubicin to treat their lymphomas. Best overall response to and progression-free survival time following chemotherapy were recorded for all dogs. Receiver operating characteristic (ROC) curves were used to determine accuracy and identify possible cut-off values for the BDI-measured biomarkers which could accurately predict those dogs' cancers that would and would not respond to doxorubicin chemotherapy. One biomarker (designated 'MEM') showed 100% discriminative capability for predicting clinical response to doxorubicin (area under the ROC curve = 1.00, 95% CI 0.692-1.000), while other biomarkers also showed promising predictive capability. These preliminary findings suggest that ex vivo BDI can accurately predict treatment outcome following doxorubicin chemotherapy in a spontaneous animal cancer model, and is worthy of further investigation as a technology for personalized cancer medicine.
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Cancer cells form three-dimensional (3D) multicellular aggregates (or spheroids) under non-adherent culture conditions. In ovarian cancer (OC), spheroids serve as a vehicle for cancer cell dissemination in the peritoneal cavity, protecting cells from environmental stress-induced anoikis. To identify new targetable molecules in OC spheroids, we investigated gene expression profiles and networks upregulated in 3D vs traditional monolayer culture conditions. We identified ALDH1A1, a cancer stem cell marker as being overexpressed in OC spheroids and directly connected to key elements of the ß-catenin pathway. ß-Catenin function and ALDH1A1 expression were increased in OC spheroids vs monolayers and in successive spheroid generations, suggesting that 3D aggregates are enriched in cells with stem cell characteristics. ß-Catenin knockdown decreased ALDH1A1 expression levels and ß-catenin co-immunoprecipitated with the ALDH1A1 promoter, suggesting that ALDH1A1 is a direct ß-catenin target. Both short interfering RNA-mediated ß-catenin knockdown and A37 ((ethyl-2-((4-oxo-3-(3-(pryrrolidin-1-yl)propyl)-3,4-dihydrobenzo [4,5]thioeno [3,2-d]pyrimidin-2-yl)thio)acetate)), a novel ALDH1A1 small-molecule enzymatic inhibitor described here for the first time, disrupted OC spheroid formation and cell viability (P<0.001). ß-Catenin knockdown blocked tumor growth and peritoneal metastasis in an OC xenograft model. These data strongly support the role of ß-catenin-regulated ALDH1A1 in the maintenance of OC spheroids and propose new ALDH1A1 inhibitors targeting this cell population.
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Aldeído Desidrogenase/metabolismo , Técnicas de Cultura de Células/métodos , Neoplasias Ovarianas/patologia , Esferoides Celulares/metabolismo , beta Catenina/metabolismo , Aldeído Desidrogenase/genética , Família Aldeído Desidrogenase 1 , Animais , Linhagem Celular Tumoral , Inibidores Enzimáticos/química , Inibidores Enzimáticos/farmacologia , Feminino , Regulação Neoplásica da Expressão Gênica , Humanos , Camundongos , Transplante de Neoplasias , Neoplasias Ovarianas/tratamento farmacológico , Neoplasias Ovarianas/metabolismo , Neoplasias Peritoneais/tratamento farmacológico , Neoplasias Peritoneais/metabolismo , RNA Interferente Pequeno/farmacologia , Retinal Desidrogenase , Esferoides Celulares/efeitos dos fármacos , Via de Sinalização Wnt/efeitos dos fármacos , beta Catenina/genéticaRESUMO
OBJECTIVE: The aim of this study was to compare the oral health status of women with normal pregnancies and those with high-risk pregnancies. METHOD: A total of 142 women in the third trimester of pregnancy were randomly selected for this study. The pregnant women were divided into two groups: a normal pregnancy group (group F, n = 61) and a high-risk pregnancy group (group R, n = 81). The following variables were recorded for each woman: age, general health status, DMF index, CPITN index, PBI index, amounts of Streptococcus mutans in the saliva and dental treatment needs. The data obtained were analysed statistically. The Mann-Whitney test, Kruskal-Wallis test and chi square test were used, and p-values less than 0.05 were considered statistically significant. The two-sided t-test was used to compare the two cohorts. RESULTS: Women with high-risk pregnancies showed increased values in all measured indices and tests, but there were no statistically significant differences between the two groups in the DMF index, CPITN index and amounts of Streptococcus mutans present in the saliva. Statistically significant differences were detected between the two groups for the PBI index and dental treatment needs. In group F, the maximum PBI index value was 2.9 in group F and 3.8 in group R. Significant differences were found also in mean PBI values. Out of the entire study cohort, 94 women (66.2%) required dental treatment, including 52% (n = 32) of the women with normal pregnancies and 77% (n = 62) of the women with high-risk pregnancies. CONCLUSIONS: This study found that women with complications during pregnancy had severe gingivitis and needed more frequent dental treatment than women with normal pregnancies.
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Índice CPO , Saúde Bucal , Gravidez de Alto Risco/fisiologia , Adulto , Feminino , Humanos , GravidezRESUMO
The growth, and dispersal of stocked European grayling Thymallus thymallus, reared in a hatchery (fed dry food pellets) or in a pond (fed natural food), compared with their wild conspecifics was assessed from the recapture of individually tagged fish 168 days after their release into the Blanice River, Czech Republic. Recapture rates and site fidelity were higher for wild T. thymallus than for artificially reared fish. Specific growth rate and upstream or downstream dispersal did not significantly differ between any of the groups of fish. An influence of rearing conditions (pond v. hatchery) on the overall performance of stocked fish was not demonstrated. Initially, lower condition factors of reared T. thymallus were equal to wild fish after recapture, suggesting adaptation of artificially reared fish that remained in the sections studied.
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Comportamento Animal , Salmonidae/crescimento & desenvolvimento , Animais , República Tcheca , Pesqueiros , Modelos Lineares , Rios , Salmonidae/fisiologiaRESUMO
Photorefractive materials are dynamic holographic storage media that are highly sensitive to coherent light fields and relatively insensitive to a uniform light background. This can be exploited to effectively separate ballistic light from multiply-scattered light when imaging through turbid media. We developed a highly sensitive photorefractive polymer composite and incorporated it into a holographic optical coherence imaging system. This approach combines the advantages of coherence-domain imaging with the benefits of holography to form a high-speed wide-field imaging technique. By using coherence-gated holography, image-bearing ballistic light can be captured in real-time without computed tomography. We analyzed the implications of Fourier-domain and image-domain holography on the field of view and image resolution for a transmission recording geometry, and demonstrate holographic depth-resolved imaging of tumor spheroids with 12 microm axial and 10 microm lateral resolution, achieving a data acquisition speed of 8 x 10(5) voxels/s.
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Diagnóstico por Imagem/instrumentação , Holografia/métodos , Imageamento Tridimensional/instrumentação , Animais , Biópsia/instrumentação , Biópsia/métodos , Diagnóstico por Imagem/métodos , Desenho de Equipamento , Análise de Fourier , Holografia/instrumentação , Processamento de Imagem Assistida por Computador/métodos , Imageamento Tridimensional/métodos , Luz , Óptica e Fotônica , Osteossarcoma/patologia , Polímeros/química , Ratos , Tomografia de Coerência Óptica/instrumentação , Tomografia de Coerência Óptica/métodosRESUMO
THE AIM: To study serum antibodies against annexin V and against other phospholipids in women with fertility failure. DESIGN: Prospective study. SETTING: Department of Gynecology and Obstetrics, Institute of Imunology and Alergology, Institute of Forensic Medicine, Charles University and Faculty Hospital, Pilsen, Czech Republic. PATIENTS AND METHODS: We investigated sera from a total of 1550 women aged 26-41 years who attended the Division for Infertility and Reproductive imunology, in the Department of Obstetrics and Gynecology, Charles University, and Faculty Hospital, Pilsen, Czech Republic. ELISA was used for detection of antibodies against annexin V, phosphatidic (ph)-acid, ph-ethanolamine, D-L glycerol, ph-inositol, L-serine, cardiolipine, beta-glycoprotein, and prothrombine), antibodies against zona pellucida by passive hemmagglutination. Antibodies against annexin V in ovulatory cervical mucus were studied only in 47, and in follicular fluid in 168 women. Eighty-four fertile healthy women were included in the control group. RESULTS: Antibodies against annexin V were found in 13% (in 170 infertile women). Anamnestic data showed two or more unexplained pregnancy losses in 48 (28.2%), 108 (63.5%) patients had two or more unsuccessfull in vitro fertilization, polycystic ovaries (PCO) was diagnosed in 3 (1.7%), and endometriosis in 11 (6.6%) of them. The increased levels of antibodies against ph-inositole (28.8%), and L-serine (19.4%) were detected. 353% of patients had positive levels against zona pellucida. In ovulatory cervical mucus only in six (6/47) antibodies against annexin V were detected, in 5.55% in follicular fluid (6/108). CONCLUSION: Our study also demonstrated serum positivity against annexin V as a significant risk factor mainly in patiens with repeated reproductive failure.
Assuntos
Anexina A5/imunologia , Anticorpos Antifosfolipídeos/sangue , Autoanticorpos/sangue , Infertilidade Feminina/imunologia , Aborto Habitual/imunologia , Adulto , Anexina A5/análise , Autoanticorpos/análise , Muco do Colo Uterino/imunologia , Feminino , Humanos , Infertilidade Feminina/etiologia , GravidezRESUMO
OBJECTIVE: Evaluation of mutual relationship between the perineal length, vaginal delivery and perineal injury. DESIGN: Prospective study. SETTING: Department of Gynaecology and Obstetrics, Charles University and Faculty Hospital Pilsen. METHODS: 318 women (92%) entered the study after their first vaginal delivery having given their consent. Instrumental vaginal deliveries were excluded. According to the perineal length, the women were divided into three study groups: short perineum (less or equal 30 mm), normal perineum (> 30 mm and < 60 mm), long perineum (equal to 60 mm and longer). Parameters evaluated: incidence of episiotomy, length of episiotomy, angle of episiotomy of the midline, shortest distance between episiotomy and anus, episiotomy and perineum length ratio. If episiotomy was not performed, the perineal tear has been evaluated in grades. RESULTS: The total proportion of episiotomy makes up 75%. The proportion of episiotomy and its angle has not reached statistical significance amongst the study groups. The length of episiotomy has been statistically significant amongst all study groups--the shortest being in the group of short perineum and the longest in the group of long perineum (p = 0.001). However the shortest distance between episiotomy and anus was statistically significant in the group of short perineum compared to normal perineum (p = 0.026) and long perineum (p = 0.005). If episiotomy was not performed, the total average perineal tear (in grades) was minimum in the group of short perineum and maximum in the group of long perineum (p = 0.018). SUMMARY: The short perineum does not appear to be the risk factor in the higher rate of episiotomy and perineal tears in this study. However if episiotomy was performed, the part of perineum which was not injured was found significantly shorter than in the other study groups. This could subsequently lead to postpartum anal incontinence. In this group the use of episiotomy as a prevention of perineal injury seems unjust. The group of long perineum has a significantly longer episiotomy and grade of perineal tear. This could contribute to the development of dyspareunia.
Assuntos
Episiotomia , Períneo/anatomia & histologia , Adulto , Feminino , Humanos , Complicações do Trabalho de Parto/prevenção & controle , Paridade , Períneo/lesões , Gravidez , Fatores de RiscoRESUMO
OBJECTIVE: Summary of the mutual relationship between vaginal delivery and anal incontinence. DESIGN: Retrospective case-control study. SETTING: Department of Gynaecology and Obstetrics, Charles University and Faculty Hospital Pilsen, Czech Republic. METHODS: 9600 vaginal deliveries between January 1997 and March 2004 were evaluated. The aim of the study was to observe the incidence of the 3rd degree tear and identification of the risk factors. The recognition of the perineal injury was open to the individual interpretation and assessment of the doctors involved. RESULTS: The incidence of the 3rd degree tear was 0.84%. The diagnostics of the 3rd degree tear was significantly more frequent if the evaluation of the perineal injury was performed by the urogynaecologists (p<0.001). Statistically significant risk factors of the 3rd degree tear in the univariate and multivariate analysis were: forceps, shoulder dystocia, the length of the 2nd stage of labour and maternal cooperation at the final phase of delivery. Parturity (primiparity), birth weight and episiotomy (when all types of episiotomy were included) were statistically significant only in the univariate analysis. Mediolateral episiotomy was not proved to be either the risk or the protective significant factor. SUMMARY: The diagnostics of the 3rd degree tear demands a detailed knowledge of the structure and anatomy of the pelvic floor. A sufficient amount of experience and erudition are the requirements for the prevention, diagnostics and subsequent treatment of this injury.
Assuntos
Complicações do Trabalho de Parto , Períneo/lesões , Adulto , Feminino , Humanos , Gravidez , Fatores de Risco , RupturaRESUMO
OBJECTIVE: Summary of the mutual relationship between obstetric operations, instrumental vaginal delivery and the third degree tear and anal incontinence. DESIGN: Review. SETTING: Department of Gynaecology and Obstetrics, Charles University and Faculty Hospital Plzen, Czech Republic. SUMMARY: Review of the current international literature covering the given problem. Midline episiotomy is a recognized risk factor. The role of mediolateral episiotomy is not quite clear. This could be a preventive factor in 20-30% of all deliveries (particularly at the first delivery). The use of forceps is the most significant risk factor of the third degree tear and anal incontinence. Vacuumextraction should be preferred when possible. There is a paucity of literature addressing the problem of fundal pressure and perineal trauma. In the largest study the relative risk of fundal pressure of the third degree was 1.27. Elective Caesarean is considered to be a prevention of pelvic floor injury and the development of urine and anal incontinence for a certain length of time. Its protective effect seems to die down and ultimately cease over a period 6 years. Endoanal sonography is a reliable method of anal sphincter defect detection. Primary and secondary prevention of anal incontinence is outlined.
Assuntos
Parto Obstétrico/efeitos adversos , Incontinência Fecal/etiologia , Períneo/lesões , Cesárea/efeitos adversos , Episiotomia , Extração Obstétrica/efeitos adversos , Feminino , Humanos , Gravidez , Incontinência Urinária/etiologiaRESUMO
Holographic optical coherence imaging acquires en face images from successive depths inside scattering tissue. In a study of multicellular tumor spheroids the holographic features recorded from a fixed depth are observed to be time dependent, and they may be classified as variable or persistent. The ratio of variable to persistent features, as well as speckle correlation times, provides quantitative measures of the health of the tissue. Studies of rat osteogenic sarcoma tumor spheroids that have been subjected to metabolic and cross-polymerizing poisons provide quantitative differentiation among healthy, necrotic, and poisoned tissue. Organelle motility in healthy tissue appears as super-Brownian laser speckle, whereas chemically fixed tissue exhibits static speckle.