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1.
Acta Chir Orthop Traumatol Cech ; 86(5): 324-329, 2019.
Artigo em Tcheco | MEDLINE | ID: mdl-31748106

RESUMO

PURPOSE OF THE STUDY In the Czech Republic a systematic neonatal hip screening has been performed for many decades. Its aim is to prevent, by means of early treatment of hip dysplasia in the newborn period, the development of hip deformities leading to the onset of degenerative hip changes during the adulthood. The study aims to prove the effects of paediatric hip care based on the data analysis of the Czech National Register of Joint Replacement. MATERIAL AND METHODS The National Register of Joint Replacement comprises information on implantation of hip arthroplasties performed over the period of last 15 years, while the screening has been carried out for almost 60 years. An analysis of the patients' data from the register was conducted; the data was sorted by the diagnosis leading to surgery in individual age categories and individual years. The obtained data was correlated with the systems of newborn hip screening at the time when the treated generations of patients were born. RESULTS According to the National Register of Joint Replacement, in the period 2003-2017 a total of 174,515 primary hip joint replacements were performed, 345 total hip arthroplasties (0.19 %) were implanted for complete hip dislocation in dysplasia, 14,139 replacements (8.10%) were performed for postdysplastic hip degeneration. By comparing the periods 2005-2007 and 2015-2017 a decrease almost to a half of the number of implanted endoprostheses for hip dislocation was identified. Moreover, only 8 of 345 dislocated hips in the Register were managed by joint replacement in patients who were born during the systematic screening period. The percentage of endoprostheses implanted for postdysplastic degeneration decreased respectively; in 2005-2007 period 2,692 of 28,525 hip endoprotheses (9.44%) were implanted, whereas in 2015-2017 period 3,285 of 46,228 hips (7.11%) were operated on. This decline is statistically significant (p < 0.001, OR 1.34). DISCUSSION The efficiency and success rate of sonography resulted in Central Europe in such a rapid expansion of neonatal ultrasound hip screening that no comparative studies were carried out to confirm this concept (as is currently requested by evidencebased-medicine). This has later become the source of misunderstanding and subject to criticism primarily in the overseas literature. Those who focus on ultrasound screening feel that conducting prospective randomised studies on (non)treatment in ultrasound detected pathologies is ethically unacceptable today. When seeking another way of confirming the efficiency of universal screening, a detailed analysis of data from the hip joint replacement registry has proven successful. CONCLUSIONS A low number of arthroplasties implanted for hip dislocation in the Czech population is recorded in the National Register of Joint Replacement. This confirms the success of the existing system of neonatal hip screening; the results show that the treatment of hip dislocation in children is successful. The ongoing decline in the share of patients in the population treated by total hip replacement in postdysplastic degeneration has been confirmed. Data evolution will be subject to further research in the upcoming decades, with a positive effect of ultrasound monitoring of treatment to be foreseen. Key words: developmental dysplasia of the hip, screening, register of joint replacements.


Assuntos
Artroplastia de Quadril/estatística & dados numéricos , Luxação Congênita de Quadril/epidemiologia , Sistema de Registros/estatística & dados numéricos , Adulto , Criança , República Tcheca/epidemiologia , Luxação Congênita de Quadril/diagnóstico , Luxação Congênita de Quadril/diagnóstico por imagem , Luxação Congênita de Quadril/cirurgia , Humanos , Recém-Nascido , Programas de Rastreamento/estatística & dados numéricos , Estudos Prospectivos , Ultrassonografia
2.
Acta Chir Orthop Traumatol Cech ; 86(5): 330-333, 2019.
Artigo em Tcheco | MEDLINE | ID: mdl-31748107

RESUMO

PURPOSE OF THE STUDY The pilot study deals with the current situation in proximal femoral fractures in culturally diverse regions, namely in Afghanistan (AFG) and in the Czech Republic (CZ). The study aimed to find out whether there are any differences in proximal femoral fractures in dependence on the selected criteria between the two culturally diverse areas. The study used the data of patients who underwent surgery for proximal femoral fracture at the Department of Orthopaedics of the 1 s t Medical Faculty of the Charles University and the Military University Hospital and at the Military Base Hospital Kabul. MATERIAL AND METHODS The study included patients aged 21 years or older who sustained a proximal femoral fracture in the period from October 2013 to February 2014. For the period concerned, the evaluation comprised 44 patients with a proximal femoral fracture from the Military Base Hospital Kabul, of whom 25 women and 19 men, and a total of 71 patients with a proximal femoral fracture from the Department of Orthopaedics of the 1st Medical Faculty of the Charles University and the Military University Hospital, of whom 43 women and 28 men. Based on the medical documentation, the following evaluation parameters were selected: age, sex, type of fracture. The data was processed using descriptive statistics, one-way and multifactorial analysis (ANOVA) and the POST-HOC test (Fisher LSD test, confidence interval = 95%) RESULTS The mean age of all the patients who suffered a fracture of proximal femur in AFG (58 years) was considerably lower (p < 0.001) than in patients in CZ (81 years). Similarly, a significant difference (p <0.001) was identified in the age of men and women treated for a proximal femoral fracture in both the countries. In AFG there was a statistically significant difference (p = 0.002) between the age of men and women, where women sustaining fractures were younger (54 years) compared to men (63 years). In CZ no significant age difference was reported (83 years vs 78 years). In AFG, the observed fractures occurred generally in their 6th and 7th decade, whereas in CZ only in their 9th decade. The incidence of proximal femoral fractures in Afghan women is the highest in their 5th and 6th decade. Pertrochanteric fractures and intracapsular fractures prevailed in both countries. The lowest age in both types of the fracture was reported in Afghan women (52 years in femoral neck fracture, p <0.001, 54 years in trochanteric fracture, p = 0.039). DISCUSSION Significant differences between the patients in AFG and CZ concern several factors. Afghanistan is a country with the lowest average life expectancy. In the Afghan population a major Vitamin D deficiency was confirmed. This is related to the conservative dress code, especially in women, when the Vitamin D synthesis is suppressed. That can cause the occurrence of osteoporosis in women at a considerably younger age than in the population in the Czech Republic, which is subsequently accompanied by an increased incidence of proximal femoral fractures. Similar results, however, were also obtained in men. One of the risk factors of osteoporosis development is also low physical activity throughout the lifetime. This risk factor is significant primarily in female population in the Muslim world. Afghanistan also faces serious malnutrition. All of that is reflected in low life expectancy in the given country, incidence of osteoporosis and injuries in this region. There is reasonable evidence that the mortality in a causal relationship with proximal femoral fracture is substantially higher in this region than in Western Europe. CONCLUSIONS The results of the pilot study showed that there are significant differences in age and frequency of fractures in dependence on sex and country. The obtained results can be considered valuable since there are virtually no scientific or professional studies on osteoporosis and fractures in the given area that would help physicians get ready for significant differences. These results may become a source of valuable information not only for medical practitioners coming to Afghanistan to help as volunteers in the framework of developmental assistance from all over the world, but also for physicians from Europe, with respect to the wave of migrants coming from this area. Key words: proximal femur, fracture, gender, age, Afghanistan, Czech Republic.


Assuntos
Fraturas do Fêmur/epidemiologia , Fraturas por Osteoporose/epidemiologia , Afeganistão/epidemiologia , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , República Tcheca/epidemiologia , Feminino , Fraturas do Fêmur/etiologia , Fraturas do Colo Femoral/epidemiologia , Fraturas do Colo Femoral/etiologia , Fraturas do Quadril/epidemiologia , Fraturas do Quadril/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Fraturas por Osteoporose/etiologia , Projetos Piloto , Fatores Sexuais
3.
Acta Chir Orthop Traumatol Cech ; 86(5): 334-341, 2019.
Artigo em Tcheco | MEDLINE | ID: mdl-31748108

RESUMO

PURPOSE OF THE STUDY The study aimed to map the use of imaging techniques and results reporting in polytrauma patients by the trauma centres in the Czech Republic. MATERIAL AND METHODS The representatives of radiology departments and units of all 12 trauma centres in the Czech Republic completed a questionnaire regarding the imaging in polytrauma patients. RESULTS The Focused Assessment with Sonography for Trauma (FAST) as an initial imaging is used by all the centres, the WholeBody CT scan (WBCT) is the dominant imaging technique everywhere and all the centres have standards in place for its performance. The WBCT examination protocol varies across the centres, just like the evaluation procedures of the CT scan and reporting of the results over to the indicating physicians. In majority of centres, there is a high percentage of WBCT with normal findings. One of the centres which uses also X-rays as a part of imaging algorithm, reports a notably higher percentage of WBCT positive findings. DISCUSSION When considering the radiation dose, data and time necessary for WBCT, work required to assess the WBCT and a large number of negative findings, it is disputable whether in a number of cases the WBCT is a suitable method for polytrauma patient examination. Similar conclusions have been drawn also by other authors who recommend that the WBCT is always used for unconscious polytrauma patients, in whom a clinical examination is virtually impossible. In the other cases, based on the clinical parameters the other imaging techniques and the focused CT (and in the indicated cases also the wholebody CT) can be safely used. CONCLUSIONS he diagnostic procedure in a polytrauma patient is not uniform in trauma centres and even the procedure for urgent reporting of crucial WBCT findings to clinical physicians has not been standardised. In a number of cases the indication for WBCT seems to be unnecessary. A more careful consideration of indications for imaging examinations based on the clinical finding may reduce the radiation exposure of patients while maintaining the diagnostic accuracy. A structured report on WBCT in polytrauma is not used even though it is recommended by the European Society of Radiology. Key words:polytrauma, diagnostic imaging, Whole-Body Computed Tomography, structured report.


Assuntos
Traumatismo Múltiplo/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Centros de Traumatologia/estatística & dados numéricos , República Tcheca/epidemiologia , Pesquisas sobre Serviços de Saúde , Humanos , Masculino , Traumatismo Múltiplo/epidemiologia , Exposição à Radiação , Estudos Retrospectivos , Tomografia Computadorizada por Raios X/estatística & dados numéricos
4.
Epidemiol Mikrobiol Imunol ; 68(2): 75-81, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31398980

RESUMO

AIM: The purpose of the surveillance performed from October to December in 2010-2017 was to monitor the trends in the susceptibility to beta-lactam and macrolide antibiotics in Streptococcus pneumoniae isolates from respiratory tract infections in the Czech Republic. MATERIAL AND METHODS: Between 42 and 55 laboratories participated in the study every year. Consecutive non-duplicate pneumococcal isolates from relevant microbiological specimens from patients with community-acquired bacterial respiratory tract infection were sequentially included in the study. Laboratories recorded qualitative results of penicillin and erythromycin susceptibility testing; susceptibility to antibiotics was determined by the disk diffusion method. Penicillin non-susceptible and/or erythromycin resistant isolates were referred to the National Reference Laboratory for Antibiotics, where the minimum inhibitory concentration of each antibiotic was tested using the broth microdilution method, and their serotyping was performed in the National Reference Laboratory for Streptococcal Infections. Twenty-six isolates from 2017 were analysed by the multilocus sequence typing method. RESULTS: In total, 7 491 pneumococcal strains were examined, of which 53.7% (4 023) were from the upper respiratory tract and 47.7% (3 573) from children under 15 years of age. Non-susceptibility to penicillin decreased from 2.6% in 2010 to 1.2% in 2017, while resistance to erythromycin increased from 7.4% to 9.7% over the same period. Penicillin non-susceptible isolates were mostly of serotypes 19A, 19F, and 15A. Macrolide resistant but penicillin susceptible isolates were predominantly represented by serotypes 19A and 3. The presence of the Taiwan19F-14 clone was confirmed in penicillin non-susceptible isolates by MLST, and the most frequently identified sequence type (ST) in macrolide resistant isolates was ST416 classified into the Netherlands15B-37 clone. CONCLUSIONS: The respiratory study of antibiotic resistance in S. pneumoniae confirmed the decreasing trend of resistance to penicillin but revealed a growing resistance to macrolide antibiotics in the Czech Republic. The results of our study confirm that antibiotic resistance in the vaccination era is associated primarily with the non-vaccine serotypes, and the clonal expansion of macrolide resistant serotype 19A was apparently supported by the growing prescription of macrolide antibiotics.


Assuntos
Antibacterianos , Farmacorresistência Bacteriana , Infecções Pneumocócicas , Streptococcus pneumoniae , Adolescente , Antibacterianos/farmacologia , Criança , República Tcheca/epidemiologia , Farmacorresistência Bacteriana Múltipla , Humanos , Testes de Sensibilidade Microbiana , Tipagem de Sequências Multilocus , Infecções Pneumocócicas/epidemiologia , Infecções Pneumocócicas/microbiologia , Sorotipagem , Streptococcus pneumoniae/efeitos dos fármacos
5.
Klin Onkol ; 32(4): 294-299, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31426646

RESUMO

BACKGROUND: Head and neck carcinomas are characterized by frequent metastases to cervical lymph nodes and locoregional recurrence. By contrast, distant metastases (M1) are seldom detected. MATERIAL AND METHODS: This study retrospectively analyzed patients with head and neck cancer who were treated at the Department of Otorhinolaryngology of F. D. Roosevelt Faculty Hospital in Banska Bystrica in 2011-2017. M1 incidence, localization, and risk factors were determined, as well as time to development of M1, methods of M1 diagnosis, and patient survival. RESULTS: M1 was diagnosed in 50 (10.5%) of 474 patients and was significantly more frequent in patients with oropharyngeal cancer, more extensive primary tumors (T3 and T4 status), nodal disease (N2 and N3 status), and poorly differentiated carcinomas. M1 was most often detected in the lungs (59%) and skeleton (47%). M1 was detected by computed tomography (CT) scans in 84% of patients and by, positron emission tomography/CT (PET/CT) in 12%. Mean patient survival was 10.4 ± 3.5 months, with two patients being in remission. CONCLUSION: M1 is detected most frequently by CT scans. PET/CT screening is indicated in patients with risk factors, including metastases to 3 lymph nodes or bilateral lymph nodes, lymph nodes >6 cm, low jugular lymph node metastases, or regional recurrence. Curative treatment is possible for patients with good performance status, solitary M1, and locoregional remission. The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study. The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers. Submitted: 22. 2. 2019 Accepted: 30. 5. 2019.


Assuntos
Neoplasias de Cabeça e Pescoço/epidemiologia , Neoplasias de Cabeça e Pescoço/patologia , República Tcheca/epidemiologia , Neoplasias de Cabeça e Pescoço/diagnóstico por imagem , Humanos , Incidência , Metástase Linfática , Recidiva Local de Neoplasia , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Estudos Retrospectivos , Fatores de Risco , Tomografia Computadorizada por Raios X
6.
Klin Mikrobiol Infekc Lek ; 25(1): 7-11, 2019 Mar.
Artigo em Tcheco | MEDLINE | ID: mdl-31266087

RESUMO

OBJECTIVES: Ventilator-associated pneumonia (VAP) is the most common nosocomial infection in intensive care patients. The aim of the study was to evaluate the effect of previous antibiotic therapy on the incidence of VAP, mortality and spectrum of bacterial pathogens. MATERIAL AND METHODS: The retrospective, observational study comprised patients over 18 years of age meeting the clinical criteria of VAP. Controls were patients requiring mechanical ventilation for more than 48 hours with no signs of VAP. Each group was divided into two arms according to previous antibiotic therapy. Tracheal aspirates and oropharyngeal swabs were taken from all patients. Cultured isolates were identified using standard microbiological techniques. Antimicrobial susceptibility testing was performed according to the European Committee on Antimicrobial Susceptibility Testing guidelines. In both groups, 28-day mortality, 90-day mortality and multidrug-resistant (MDR) bacterial pathogen frequency were evaluated. RESULTS: The study included 49 patients (32 patients with previous antibiotic therapy, 17 antimicrobial-naive patients). The proportion of individuals with previous antibiotic therapy was significantly lower in VAP patients (34%) than among controls group (66%; p = 0.02). The VAP criteria were met by 23 patients (11 with previous antibiotic therapy, 12 without the therapy). The Enterobacteriaceae including extended-spectrum beta-lactamase-producing strains and Pseudomonas aeruginosa were the most common pathogens isolated. MDR pathogens were statistically significantly more frequent in patients with previous antibiotic therapy (77% vs. 33%; p = 0.047). In patients with previous antibiotic therapy, 28-day mortality was lower (18%; n = 2) than in antimicrobial-naïve patients (33%, n = 4; p = 0.640). The difference was more pronounced in 90-day mortality, albeit with low statistical significance (18%, n = 2 vs. 58%, n = 7; p = 0.089). CONCLUSIONS: Previous antibiotic therapy was associated with a lower incidence of VAP and a higher frequency of MDR bacterial pathogens. VAP antibiotic therapy modified according to knowledge of previous antibiotic therapy and cultured isolates was correlated with lower 28-day and 90-day mortality rates.


Assuntos
Anti-Infecciosos , Pneumonia Associada à Ventilação Mecânica , Adolescente , Adulto , Anti-Infecciosos/uso terapêutico , República Tcheca/epidemiologia , Farmacorresistência Bacteriana Múltipla , Humanos , Pneumonia Associada à Ventilação Mecânica/tratamento farmacológico , Pneumonia Associada à Ventilação Mecânica/epidemiologia , Estudos Retrospectivos
7.
Vet Ital ; 55(2): 169-172, 2019 Jun 30.
Artigo em Inglês | MEDLINE | ID: mdl-31274179

RESUMO

The purpose of this study was to examine the prevalence of antimicrobial resistance among 180 Escherichia coli strains isolated from 200 wild pheasants caught in rural areas of the Czech Republic (Eastern Moravia) and Slovakia (Western Region). The isolates were also classified into phylogenetic groups by the multiplex PCR method. Our findings demonstrated that 130 strains were resistant to ampicillin (72%), 160 strains to cephalothin (89%), and 40 strains to tetracycline (22%). Ten strains were found to be resistant to chloramphenicol and sulfamethoxazole/trimethoprim (5.6%). In turn, all strains were sensitive to cefoperazone/sulbactam, ciprofloxacin, colistin, gentamicin, and piperacillin/tazobactam. Ten of the 180 isolates (5.6%) exhibited multi-resistant phenotypes, including resistances against beta-lactams, aminoglycosides, tetracyclines, sulphonamides, and chloramphenicol. As far as we know, this is the first report describing antimicrobial resistance in E. coli from pheasants.


Assuntos
Doenças das Aves/epidemiologia , Farmacorresistência Bacteriana , Infecções por Escherichia coli/veterinária , Escherichia coli/efeitos dos fármacos , Galliformes , Animais , Antibacterianos/farmacologia , Doenças das Aves/microbiologia , República Tcheca/epidemiologia , Farmacorresistência Bacteriana Múltipla , Infecções por Escherichia coli/epidemiologia , Infecções por Escherichia coli/microbiologia , Prevalência , Eslováquia/epidemiologia
8.
Parasit Vectors ; 12(1): 332, 2019 Jul 03.
Artigo em Inglês | MEDLINE | ID: mdl-31269975

RESUMO

BACKGROUND: Rodents are important reservoirs for zoonotic vector-borne agents. Thus, the distribution of rodents and their vicinity to humans and companion animals may have an important impact on human and animal health. However, the reservoir potential of some rodent genera, e.g. Microtus, has not yet been precisely examined concerning tick-borne pathogens in Central Europe. Therefore, we examined small mammals from Germany and the Czech Republic for the following vector-borne pathogens: Babesia spp., Bartonella spp., Anaplasma phagocytophilum, "Candidatus Neoehrlichia mikurensis" (CNM) and Coxiella burnetii. Spleen DNA from 321 small mammals belonging to four genera, Myodes (n = 78), Apodemus (n = 56), Microtus (n = 149), Sorex (n = 38), collected during 2014 in Germany and the Czech Republic were available for this study. DNA samples were examined for the presence of Babesia and Bartonella DNA by conventional PCR targeting the 18S rRNA gene and the 16S-23S rRNA intergenic spacer region, respectively. For the detection of CNM, A. phagocytophilum and C. burnetii real-time PCR assays were performed. RESULTS: Bartonella spp. DNA was detected in 216 specimens (67.3%) with 102/174 (58.6%) positive in Germany and 114/147 (77.6%) in the Czech Republic. The prevalence in each genus was 44.9% for Myodes, 63.2% for Sorex, 77.2% for Microtus and 75% for Apodemus. Four Bartonella species, i.e. Bartonella sp. N40, B. grahamii, B. taylorii and B. doshiae, as well as uncultured bartonellae, were detected. The Bartonella species diversity was higher in rodents than in shrews. In total, 27/321 (8.4%) small mammals were positive for CNM and 3/321 (0.9%) for A. phagocytophilum (S. coronatus and M. glareolus). All samples were negative for Babesia spp. and Coxiella spp. CONCLUSIONS: While the detected high prevalence for Bartonella in Apodemus and Myodes spp. is confirmatory with previous findings, the prevalence in Microtus spp. was unexpectedly high. This indicates that individuals belonging to this genus may be regarded as potential reservoirs. Interestingly, only Sorex spp. and M. glareolus were positive for A. phagocytophilum in the present study, suggesting a possible importance of the latter for the maintenance of certain A. phagocytophilum strains in nature.


Assuntos
Anaplasma phagocytophilum/isolamento & purificação , Anaplasmataceae/isolamento & purificação , Babesia/isolamento & purificação , Bartonella/isolamento & purificação , Coxiella burnetii/isolamento & purificação , Roedores/parasitologia , Animais , República Tcheca/epidemiologia , Reservatórios de Doenças/microbiologia , Reservatórios de Doenças/parasitologia , Prevalência , Roedores/microbiologia
9.
Int J Evid Based Healthc ; 17 Suppl 1: S43-S47, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31283581

RESUMO

Coronary heart disease, sometimes also referred to as ischemic heart disease, remains the leading condition causing most deaths and disability-adjusted life years worldwide. Acute coronary syndrome (ACS) represents a subset that is defined by sudden reduction of blood supply in the coronary arteries. ACS consists of unstable angina, non-ST-segment elevation myocardial infarction (NSTEMI), and ST-segment elevation myocardial infarction (STEMI).The current short communication aims to provide current ACS prevalence and incidence data analysis to inform development of clinical practice guidelines in the Czech Republic.The Institute of Health Information and Statistics of the Czech Republic has provided the data that are collected by the National Health Information System with the National Register of Reimbursed Health Services as a primary source providing data for the period from 2015 to 2017.There has been a slight decrease in the number of hospitalized patients for ACS in the Czech Republic from 2015 to 2017. Sex difference remains large, with majority (two thirds) of those hospitalized for unstable angina, NSTEMI, or STEMI being men. Hospitalization with STEMI is reported in younger age with no sex difference compared with NSTEMI and unstable angina.


Assuntos
Síndrome Coronariana Aguda/epidemiologia , Angina Instável/epidemiologia , Infarto do Miocárdio/epidemiologia , Fatores Etários , República Tcheca/epidemiologia , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Incidência , Masculino , Prevalência , Fatores Sexuais
10.
Int J Evid Based Healthc ; 17 Suppl 1: S48-S52, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31283582

RESUMO

The prevalence of diabetes is on the rise worldwide especially in developed countries. The aim of glucose management in all types of diabetes is to minimize chronic and acute complications associated with diabetes. All patients with type 1 diabetes mellitus (T1DM) require insulin. Main areas of technology advances in diabetes are continuous subcutaneous insulin infusion (CSII) and also continuous glucose monitoring systems for the management of patients with both types of diabetes. It is very important to analyse the epidemiological situation within each country before and during the clinical practice guidelines (CPGs) development and implementation. The analyses will allow us to monitor the effect of the CPG after its implementation.The aim of this short communication is to analyse the epidemiology of prevalence and incidence of diabetes mellitus and use of CSII to inform development of CPGs in the Czech Republic.The analysis is developed based on the data managed by Institute of Health Information and Statistics of the Czech Republic. We used the National Register of Reimbursed Health Services 2015-2017 as primary source, and the annual report type A (Ministry of Health) 1-01: for Diabetology (A MH 004) 2007-2017 was used as validation source. The presented data are related to the year 2016 because we were able to validate them based on the data from 2015 to 2017 for this cohort of patients.The number of patients with T1DM is increasing in the Czech Republic with no significant sex difference. Life expectancy is about 11 years lower in the T1DM population. The majority of the patients are in older age; however, these are not treated with CSII compared with the younger population. From 61 533 patients with T1DM, 81% were reported with acute and chronic complications in 2016. Only 5011 of these patients were reported as using CSII.


Assuntos
Diabetes Mellitus Tipo 1/tratamento farmacológico , Diabetes Mellitus Tipo 1/epidemiologia , Hipoglicemiantes/administração & dosagem , Insulina/administração & dosagem , República Tcheca/epidemiologia , Diabetes Mellitus Tipo 1/complicações , Feminino , Humanos , Hipoglicemiantes/uso terapêutico , Incidência , Insulina/uso terapêutico , Sistemas de Infusão de Insulina/estatística & dados numéricos , Expectativa de Vida , Masculino , Prevalência
11.
Int J Evid Based Healthc ; 17 Suppl 1: S53-S56, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31283583

RESUMO

Stroke is one of the leading causes of mortality and the leading cause of functional impairment and cognitive deficits worldwide. It is important that clinical practice guidelines development is based on robust statistical and epidemiological data and their analysis throughout the whole process of guidelines development and implementation. The aim of this short communication is to analyse epidemiology of prevalence and incidence of ischaemic stroke, its main causes, brain imaging using MRI, recanalization therapies, secondary prevention with antiplatelet and anticoagulants, mortality data and to inform development of stroke clinical practice guidelines in the Czech Republic. The main analysed diagnosis was I63 (cerebral infarction) and secondary diagnoses were: I48 (atrial fibrillation and flutter), I35.9 (nonspecified aortic valve disease), Q21.1 (atrial septal defect) or I33.0 (acute and subacute endocarditis). We have also analysed use of brain imaging with MRI, recanalization treatment using intravenous thrombolysis and mechanical thrombectomy, stroke secondary prevention with antiplatelet drugs and anticoagulation as well as hospital admissions and mortality. In total, 159 344 patients were diagnosed with an ischaemic stroke from 2015 to 2017. Average prevalence of ischaemic stroke in the Czech Republic is 54.9 patients per 100 000. 22.2% of patients with stroke received intravenous thrombolysis or mechanical thrombectomy in 2017.


Assuntos
Isquemia Encefálica/epidemiologia , Isquemia Encefálica/terapia , Acidente Vascular Cerebral/epidemiologia , Acidente Vascular Cerebral/terapia , Anticoagulantes/administração & dosagem , Encéfalo/diagnóstico por imagem , Isquemia Encefálica/diagnóstico por imagem , Isquemia Encefálica/etiologia , República Tcheca/epidemiologia , Feminino , Humanos , Incidência , Imagem por Ressonância Magnética , Masculino , Inibidores da Agregação de Plaquetas/administração & dosagem , Prevalência , Acidente Vascular Cerebral/diagnóstico por imagem , Acidente Vascular Cerebral/etiologia , Trombectomia/estatística & dados numéricos , Terapia Trombolítica/estatística & dados numéricos
12.
Int J Evid Based Healthc ; 17 Suppl 1: S57-S61, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31283584

RESUMO

Colorectal cancer (CRC) is the third most commonly diagnosed cancer and the fourth most common cause of cancer death worldwide. Crucial in CRC as well as for other effective diagnostics and treatment is the knowledge translation and implementation of the current best available evidence into clinical practice and public health. Clinical practice guidelines are one of the useful tools to be able to improve diagnostics and increase survival rate.The epidemiological analysis was performed based on the data of the Czech National Cancer Registry from 1977 to 2017. We have analysed incidence, prevalence, mortality and primary treatment of CRC in the Czech Republic.The incidence of CRC increased significantly from 1982 to 2002 and is higher in men compared with women based on the data from the National Health Information System in the Czech Republic. The majority of the patients with CRC were diagnosed in early stages. Women were diagnosed at slightly higher age than men. An increase in surgical therapy performed in primary treatment of early CRC was reported from 2006 to 2016. Relative time of survival increased in reported patients with CRC.This analysis reported significant changes in incidence of CRC in the last 40 years as well as in diagnostics and primary therapy in early stages of CRC in the last 12 years. The first ever evidence-based clinical practice guideline on diagnostics and therapy of early CRC in the Czech Republic was developed and disseminated.


Assuntos
Neoplasias Colorretais/epidemiologia , Neoplasias Colorretais/terapia , Neoplasias Colorretais/mortalidade , República Tcheca/epidemiologia , Feminino , Guias como Assunto , Humanos , Incidência , Masculino , Prevalência , Fatores Sexuais , Análise de Sobrevida
13.
Work ; 63(3): 457-467, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31322585

RESUMO

BACKGROUND: Given that shift work spreads across many different business sectors, studies of its adverse effects are very topical. Much research has been done on the negative impact of shift work, but many researchers have not focused on its impact in a multicultural environment. OBJECTIVE: The aim of this study was to map out how shift work is perceived by workers in two different shift regimes and two national groups. METHODS: The research was carried out on Czech manufacturing workers and Turkish airport ground personnel using a questionnaire. The impact of shift work was studied from physical, mental, social and health aspects with connection to family status and gender. For statistical evaluation, Pearson's chi-squared test of independence was used. The effect of shift work on workers' performance and scrap rate was analysed only on the sample of the manufacturing workers. RESULTS: Fifty-five Czech male workers, 49 Turkish male workers and 60 Turkish female workers participated in the survey. The dependence between sexes was confirmed for mental aspects and sleeping routines. The main difference between nationalities is in work attitude, social aspects and sleeping routines. According to the family status, the difference was confirmed in all areas except social aspects. The lowest values of productivity and the highest scrap rate were observed on night shifts and the maximum productivity and lowest scrap rates were observed on afternoon shifts. CONCLUSIONS: Some of the basic assumptions were confirmed which suggests that a multicultural environment has an influence on the perception of shift work by the nations and gende.


Assuntos
Diversidade Cultural , Jornada de Trabalho em Turnos/efeitos adversos , Adolescente , Adulto , República Tcheca/epidemiologia , República Tcheca/etnologia , Humanos , Masculino , Indústria Manufatureira/métodos , Indústria Manufatureira/normas , Pessoa de Meia-Idade , Jornada de Trabalho em Turnos/psicologia , Transtornos do Sono do Ritmo Circadiano/epidemiologia , Transtornos do Sono do Ritmo Circadiano/etnologia , Transtornos do Sono do Ritmo Circadiano/etiologia , Inquéritos e Questionários , Turquia/epidemiologia , Turquia/etnologia , Tolerância ao Trabalho Programado/psicologia , Local de Trabalho/psicologia , Local de Trabalho/normas
14.
BMC Res Notes ; 12(1): 463, 2019 Jul 29.
Artigo em Inglês | MEDLINE | ID: mdl-31358031

RESUMO

OBJECTIVES: The aim of this data paper is to provide the data set of a sub-analysis of the DEMDATA study data. In the DEMDATA study, epidemiological data on the prevalence and severity of dementia, as well as functioning, behavioral problems and other health related factors in residents living in Austrian and Czech nursing homes were collected. The DEMDATA project further provides information on relatives' perception of the life Quality of residents, care team burden as well as environmental factors. Participating nursing homes were randomly drawn and stratified. Inclusion criteria for participation were that the resident was living permanently in the institution and that he/she and/or a legal representative (where relevant) had signed an informed consent. DATA DESCRIPTION: This paper provides data of cognitive, functional and behavioral assessments as well as other health related information of 1085 residents living in Austrian and Czech nursing homes. For each resident, several measurements on his or her cognitive, functional, and behavioral status are available. Also further health-related factors such as quality of life, pain, numbers of falls and hospital stays are provided.


Assuntos
Demência/psicologia , Instituição de Longa Permanência para Idosos , Casas de Saúde , Qualidade de Vida/psicologia , Idoso , Idoso de 80 Anos ou mais , Áustria/epidemiologia , Estudos Transversais , República Tcheca/epidemiologia , Demência/epidemiologia , Feminino , Humanos , Masculino , Testes de Estado Mental e Demência/estatística & dados numéricos , Prevalência
15.
PLoS One ; 14(5): e0217611, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31150464

RESUMO

A recently introduced Multilocus Sequence Typing scheme for Treponema pallidum subsp. pallidum was applied to clinical samples collected from 2004 to 2017 from the two largest cities (Prague and Brno) in the Czech Republic. Altogether, a total of 675 samples were tested in this study and 281 of them were found PCR-positive for treponemal DNA and typeable. Most of the typed samples (n = 281) were swabs from primary or secondary syphilis lesions (n = 231), and only a minority were whole blood or tissue samples (n = 50). Swab samples from patients with rapid plasma regain (RPR) values of 1-1024 were more frequently PCR-positive (84.6%) compared to samples from patients with non-reactive RPR test (46.5%; p-value = 0.0001). Out of 281 typeable samples, 136 were fully-typed at all TP0136, TP0548, and TP0705 loci. Among the fully and partially typed samples, 25 different allelic profiles were identified. Altogether, eight novel allelic variants were found among fully (n = 5) and partially (n = 3) typed samples. The distribution of TPA allelic profiles identified in the Czech Republic from 2004 to 2017 revealed a dynamic character with allelic profiles disappearing and emerging over time. While the number of samples with the A2058G mutation was seen to increase (86.7% in 2016/2017), the number of samples harboring the A2059G mutation was found to have decreased over time (3.3% in 2016/2017). In addition, we found several allelic profile associations with macrolide resistance or susceptibility, the gender of patients, as well as patient residence.


Assuntos
Tipagem de Sequências Multilocus , Sífilis/microbiologia , Treponema pallidum/genética , Adulto , Alelos , Antibacterianos/farmacologia , República Tcheca/epidemiologia , DNA Bacteriano/genética , Farmacorresistência Bacteriana/genética , Feminino , Genótipo , Humanos , Masculino , RNA Ribossômico 23S/genética , Sífilis/genética , Sífilis/patologia , Treponema pallidum/patogenicidade , Adulto Jovem
16.
Epidemiol Mikrobiol Imunol ; 68(1): 3-8, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31181946

RESUMO

OBJECTIVES: To follow on the epidemiology of HCV, especially genotypes spreading among people who inject drugs (PWID) in Prague and surrounding Central Bohemia, Czech Republic. METHODS: 546 patients who reported past and/or recent injecting of drugs were recruited in the years 2010-2012. They were initially tested for anti-HCV. Real-time PCR was used for quantification and genotyping of hepatitis C virus. Obtained data from the years 2010-2012 were compared with historical controls from periods of 1998-2000 and 2005-2007. RESULTS: Of 546 initially recruited and tested patients were 393 (72%) anti-HCV seropositive and of them 269 (68.4%) had detectable HCV PCR RNA. The most prevalent subtype was 3a in 97 patients (36.1%), 1a was detected in 85 patients (31.6%) and 1b in 57 patients (21.2%). These three genotypes were responsible for nearly 89% of infections. CONCLUSION: Significant increase in both genotypes 1a and 3a over the 15 years was apparent and significant, followed by the decrease in genotype 1b. In the genotype 1b and genotype 3a the significance has risen with the years of data collection. Described genotypic shift reflects the evolution of HCV epidemics and corresponds with the mode of transmission.


Assuntos
Genótipo , Hepacivirus , Hepatite C , República Tcheca/epidemiologia , Hepatite C/epidemiologia , Hepatite C/genética , Humanos , Prevalência
17.
Epidemiol Mikrobiol Imunol ; 68(1): 9-14, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31181947

RESUMO

In 2017 chronic hepatitis C (CHC) seems to be a curable disease in most cases. Analysis of epidemiologic data of hepatitis C virus (HCV) infection gained from a primary care office shows how HCV is underdiagnosed in the Czech Republic (CZ). The importance of primary care in screening of HCV infection is shown, as is the necessity of spreading information about this disease between common population and healthcare workers. The aim of the study is to determine seroprevalence of HCV antibodies and HCV ribonucleic acid (RNA) positivity among registered patients with risk factors (RF) in medical history in one physician´s practice. 1620 complete follow-ups of registered clients were accomplished during a 10-month period between 2016 and 2017 in the office of one general practitioner (GP). Amongst those 627 were confirmed to have RF. Each client with RF was tested for HCV antibodies, including detection of HCV RNA via polymerase chain reaction (PCR) method in cases of HCV antibodies positivity. 19 anti HCV positive clients were found, with a prevalence of 3.03%, 5 were HCV RNA positive, with a prevalence of 0.8%.


Assuntos
Hepacivirus , Hepatite C , Adulto , Anticorpos Antivirais/sangue , República Tcheca/epidemiologia , Hepatite C/epidemiologia , Humanos , Reação em Cadeia da Polimerase , Prevalência , RNA Viral/genética , Fatores de Risco , Estudos Soroepidemiológicos
18.
Epidemiol Mikrobiol Imunol ; 68(1): 24-31, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31181949

RESUMO

Progressive multifocal leukoencephalopathy (PML) is a severe disease of the central nervous system with very high mortality. It is caused by the JC virus with high seroprevalence, at up to 80%. Development of PML is typically opportunistic, particularly in acquired immunodeficiency syndrome, and usually affects patients with profound immunodeficiency. Furthermore, as a result of highly efficient immunosuppressive and immunomodulatory treatments in recent years, the number of PML cases has increased in the general population. In this article, the authors mention virological and epidemiological relationships and characteristic manifestations of PML. Possible relationships of humoral and cellular immunity are discussed and limited treatment options including prophylaxis are mentioned.


Assuntos
Vírus JC , Leucoencefalopatia Multifocal Progressiva , Antivirais/uso terapêutico , República Tcheca/epidemiologia , Humanos , Leucoencefalopatia Multifocal Progressiva/tratamento farmacológico , Leucoencefalopatia Multifocal Progressiva/epidemiologia , Leucoencefalopatia Multifocal Progressiva/imunologia , Leucoencefalopatia Multifocal Progressiva/patologia , Fatores de Risco , Estudos Soroepidemiológicos
19.
Epidemiol Mikrobiol Imunol ; 68(1): 33-38, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31181950

RESUMO

Botulism caused by toxins of Clostridium botulinum and other neurotoxic clostridia is a rare but life-threatening disease with neurological symptoms. Food-borne botulism (food poisoning) is the most common type worldwide; rarely, wound botulism, infant botulism, or botulism of unknown etiology may also occur. Botulism is a very rare disease in the Czech Republic as well, with only nine cases reported since 2008 (EPIDAT). These were mostly sporadic cases of food-borne botulism except a small family outbreak with three cases due to the consumption of homemade pork pate (2013). This outbreak prompted the creation of a national standby supply of life-saving anti-infective drugs in Prague. This article reviews the etiology, epidemiology, clinical manifestations, diagnosis, and therapy of botulism.


Assuntos
Botulismo , Clostridium botulinum , Anti-Infecciosos/uso terapêutico , Botulismo/tratamento farmacológico , Botulismo/epidemiologia , República Tcheca/epidemiologia , Surtos de Doenças , Doenças Transmitidas por Alimentos/tratamento farmacológico , Doenças Transmitidas por Alimentos/epidemiologia , Humanos
20.
Epidemiol Mikrobiol Imunol ; 68(1): 47-50, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31181952

RESUMO

Typhoid fever is a disease caused by the highly virulent bacterium Salmonella Typhi. It is transmitted by the oral-faecal route. In the Czech Republic, 53 cases of typhoid fever were reported in 1997-2017. Only seven of these cases were autochthonous. In August 2017, an imported case of typhoid fever was recorded in a 25-year-old unvaccinated woman who participated in the Rainbow Gathering in Italy one week prior to the onset of the disease. During her stay in Italy, she slept in a tent, ate her own food, and drank unboiled water. Presenting with persisting cough, tiredness, muscle and joint pain, and fever up to 40 °C after her return, she was admitted to the Třebíč Hospital where she was diagnosed with S. Typhi. The epidemiological investigation identified six contacts. On discharge from hospital and at follow-up, the patient was tested negative. None of the contacts became ill.


Assuntos
Doença Relacionada a Viagens , Febre Tifoide , Adulto , República Tcheca/epidemiologia , Feminino , Humanos , Itália , Salmonella typhi , Febre Tifoide/diagnóstico , Febre Tifoide/epidemiologia , Febre Tifoide/patologia
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