Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 2.345
Filtrar
2.
Cesk Slov Oftalmol ; 1(Ahead of print): 1-15, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33086847

RESUMO

Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease in children and uveitis is its most important extra-articular manifestation. Evidence-based recommendations are available only to a limited extent and therefore JIA associated uveitis management is mostly based on physicians experience. Consequently, treatment practices differ widely, both nationally and internationally. Therefore, an effort to optimize and publish recommendations for the care of children and young adults with rheumatic diseases was launched in 2012 as part of the international project SHARE (Single Hub and Access Point for Pediatric Rheumatology in Europe) to facilitate clinical practice for paediatricians and (paediatric) rheumatologists. The aim of this work was to translate published international SHARE recommendations for the diagnosis and treatment of JIA associated uveitis and to adapt them for use in the Czech and Slovak Republics. International recommendations were developed according to the standard methodology of the European League against Rheumatism (EULAR) by a group of nine experienced paediatric rheumatologists and three experts in ophthalmology. It was based on a systematic literature review and evaluated in the form of an online survey and subsequently discussed using a nominal group technique. Recommendations were accepted if > 80% agreement was reached (including all three ophthalmologists). A total of 22 SHARE recommendations were accepted: 3 on diagnosis, 5 on disease activity assessment, 12 on treatment and 2 on future recommendations. Translation of the original text was updated and modified with data specific to the czech and slovak health care systems and supplemented with a proposal for a protocol of ophthalmological dispensarization of paediatric JIA patients and a treatment algorithm for JIA associated uveitis. Conclusion: The aim of the SHARE initiative is to improve and standardize care for paediatric patients with rheumatic diseases across Europe. Therefore, recommendations for the diagnosis and treatment of JIA-associated uveitis have been formulated based on the evidence and agreement of leading European experts in this field.


Assuntos
Artrite Juvenil , Uveíte , Artrite Juvenil/complicações , Artrite Juvenil/diagnóstico , Artrite Juvenil/terapia , Criança , República Tcheca/epidemiologia , Europa (Continente) , Humanos , Eslováquia/epidemiologia , Uveíte/diagnóstico , Uveíte/epidemiologia , Uveíte/etiologia , Adulto Jovem
3.
Cent Eur J Public Health ; 28 Suppl: S06-S11, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33069174

RESUMO

OBJECTIVES: The authors evaluate situation in the field of musculoskeletal disorders (MSDs) and working risk factors in the Czech Republic. METHODS: Analysis of selected data from the Czech National Registry of Occupational Diseases during 2008-2018, description of criteria for recognition of occupational MSDs and risk factors associated with MSDs. RESULTS: 6,152 cases of 6 selected recognized occupational musculoskeletal diseases represent 47% of all recognized occupational diseases. The main proportion formed diseases of peripheral nerves in the extremities in terms of compressive neuropathies due to long-term and stereotyped overload, diseases of tendons, tendon capsules or insertions of muscles or joints in the extremities due to long-term and stereotyped overload and diseases of peripheral nerves in the upper extremities in terms of ischaemic and compressive neuropathies due to work with vibrating tools and devices. The authors discussed decreasing trend of the exposure time in three main diagnoses and association of the incidence of MSDs with the risky work related to overload of the musculoskeletal system of the upper extremities. CONCLUSIONS: Important factors for the prevention of MSDs are directly related to the technical provision of production, the organization of work and the regime of work and rest, the length of working hours and the setting of production standards, and generally to the work related stress.


Assuntos
Doenças Musculoesqueléticas , Doenças Profissionais , República Tcheca/epidemiologia , Humanos , Incidência , Doenças Musculoesqueléticas/epidemiologia , Doenças Profissionais/epidemiologia , Fatores de Risco
4.
Cent Eur J Public Health ; 28 Suppl: S37-S42, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33069179

RESUMO

OBJECTIVES: Asbestos-related diseases are still a current problem worldwide. What is their occurrence in the Czech Republic? The answer is the subject of this study, which aims to provide a general and regional overview of the situation over the last 20 years with a more detailed focus on mesothelioma, the development of which is highly associated with asbestos exposure and the issue of their recognition as an occupational disease. METHODS: In its retrospective reviews, the study is based on analyses of data from the Institute of Health Information and Statistics of the Czech Republic and data from the Czech National Cancer Registry, which also interconnects. RESULTS: In the last 20 years, 512 new cases of occupational diseases from asbestos have been reported, namely 228 cases of pleural thickening, 133 mesotheliomas, 92 asbestoses, and 59 cases of lung cancer. In the last 5 years, mesotheliomas (n = 39) predominated among the reported diseases with a 45% proportion in the total number of 86 cases. The trend in their incidence, as the only one among asbestos-related diseases, is not declining. There was a significant difference in the overall incidence of mesothelioma in a general population and the incidence of occupational mesotheliomas. At the national level, occupational aetiology was acknowledged in only 11.3% of cases of mesothelioma on average. The highest proportion of occupational mesotheliomas and the highest incidence of all asbestos-related diseases were found in regions where the largest asbestos processing plants were located. CONCLUSION: The authors emphasize the importance of work history for the diagnostic process of asbestos-related diseases and also the need to perform follow-up examinations for their early detection.


Assuntos
Asbestos , Mesotelioma , Doenças Profissionais , Asbestos/toxicidade , República Tcheca/epidemiologia , Humanos , Mesotelioma/induzido quimicamente , Mesotelioma/epidemiologia , Doenças Profissionais/epidemiologia , Estudos Retrospectivos
5.
Cent Eur J Public Health ; 28 Suppl: S47-S52, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33069181

RESUMO

OBJECTIVES: The aim of this work is to compare the current prevalence of selected risk factors in cardiovascular diseases in the Czech general population in a particular region with a selected population of Czech soldiers in a particular military unit. METHODS: Within medical preventive examinations, data from 684 civilians aged between 30-60 years were obtained (405 men and 279 women). Within compulsory medical preventive examinations, data from 659 soldiers from a particular military unit aged between 30-60 years were obtained (576 men and 83 women). Anthropometric parameters such as height and body weight were monitored and then used to calculate the values of Body Mass Index (BMI) and waist circumference. From biochemical parameters the following values were monitored: glycaemia, uric acid, total cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides, ALT, and GGT. As for the demographic data, age and gender were processed. In the cohort of male soldiers a questionnaire was used to find the extent of cigarette smoking, frequency of using alcoholic drinks and performance of regular physical activities such as aerobic exercises. RESULTS: As for cardiovascular risk, assessed anthropometric parameters in monitored female age categories are statistically significantly lower (p < 0.05) in women in the Army of the Czech Republic (ACR) compared to the female civilian population. Most of the biochemical parameters also display values that indicate the female military population is healthier than the civilian in these parameters. On the other hand, assessed anthropometric parameters in monitored male age categories are statistically significantly lower (p < 0.001) in civilian men compared to the male military population. Most of the assessed biochemical parameters show statistically significant health-indicative values in the male civilian population as well. CONCLUSION: This work revealed differences in anthropometric and biochemical parameters between the examined civilian and military populations. As for cardiovascular risk, the main findings are significantly worse anthropometric and biochemical parameters in the selected male military cohort compared to the male civilian cohort.


Assuntos
Doenças Cardiovasculares , Adulto , Antropometria/métodos , Índice de Massa Corporal , Doenças Cardiovasculares/epidemiologia , República Tcheca/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco
6.
Vnitr Lek ; 66(5): 69-71, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32942873

RESUMO

Prevalence of type 2 diabetes in the Czech Republic can be estimated from data reported by health care providers either to the statistical office or to health insurers. The latter include both diagnosis and prescribed drugs. Patient classification to a certain chronic condition based on consumption of drugs (Pharmacy-based Cost Groups classification) has been used in the Czech Republic for the purpose of redistribution of collected funds among health insurers since the beginning of 2018. This article compares prevalence of diabetes estimated from statistical data and from data reported to health insurers, and discusses current and future advantages and disadvantages of all methodologies. Diagnoses reporting in outpatient care are considered to be inaccurate, on the other hand peroral antidiabetics do not seem to be prescribed to all indicated patients. The appropriate approach to prevalence estimation from data reported to health insurers is becoming even more important after the creation of National Diabetes Register based on insurance data and the related abatement of direct reporting to the statistical office.


Assuntos
Diabetes Mellitus Tipo 2 , Assistência Ambulatorial , República Tcheca/epidemiologia , Diabetes Mellitus Tipo 2/epidemiologia , Humanos , Hipoglicemiantes/uso terapêutico , Prevalência
7.
Cent Eur J Public Health ; 28(3): 230-236, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32997480

RESUMO

OBJECTIVE: This study aimed to analyze the complications of planned home births treated at healthcare facilities in the Czech Republic. METHODS: This prospective cohort observational study is based on analysis of women hospitalized with complications related to planned home deliveries in the Czech Republic between 2016 and 2017. The data were collected using an online form made accessible to the directors of all maternity hospitals in the Czech Republic. The results were statistically evaluated. RESULTS: We identified 45 complications during planned home deliveries. Complications occurred most often among women living in largely populated cities with higher levels of education. Overall, 40% of patients did not receive routine antenatal care, and 38% of women gave birth after the 41st week of pregnancy. In 60% of cases, no professionals attended the birth. Hospital transfer frequencies were 42% after delivery, 36% at third-stage labour, 11% first-stage labour, 9% second-stage labour, and 2% before delivery. We recorded four neonatal deaths and one severe newborn morbidity. There was one maternal death unrelated to the home-birthing process and six cases of severe maternal haemorrhagic shock requiring intensive care. CONCLUSION: Complications of planned home births occurred more frequently in women living in largely populated cities and with higher education levels. Planned home births were also observed among women who were at a higher risk of complications. Risk factors included nulliparity, postdate pregnancy, and lack of prenatal care. Hospital transfers occurred most often in the third stage of labour and postpartum.


Assuntos
Parto Domiciliar/efeitos adversos , Complicações na Gravidez/epidemiologia , República Tcheca/epidemiologia , Feminino , Humanos , Recém-Nascido , Gravidez , Estudos Prospectivos , Fatores de Risco
8.
Ann Agric Environ Med ; 27(3): 356-360, 2020 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-32955214

RESUMO

OBJECTIVES: The aim of this study is to evaluate the seroprevalence of antibodies of Borrelia burgdorferi sensu lato (Bbsl) and Leptospira interrogans sensu lato (Lisl) and their possible concurrence in domestic cats living in variable conditions in South Moravia in the district of Brno and its environs. Additional objectives were to discover possible differences in seroprevalence between groups of cats living in different living conditions, and to determine the spectrum of Leptospira serogroups in cats in the same places. MATERIAL AND METHODS: A total of 360 blood sera from domestic cats of 3 different sets were collected during the period 2013-2015. All samples were examined using ELISA for the detection of IgM and IgG antibodies against Bbsl, and the microscopic agglutination test (MAT) for the detection of antibodies against 8 serogroups of Lisl. RESULTS: The ELISA method determined 15.8%, 4.8% and 10.3% IgM anti-Borrelia antibodies in the patient group, shelter cats and street cats, respectively. IgG anti-Borrelia antibodies were found in 6.2%, 9.5%, 5.2%, respectively. Antibodies specific for 5 Leptospira serogroups were detected by the use of MAT in 8.8%, 9.5% and 10.3% of cats from the investigated groups. The total positivity of all examined cats for anti-Borrelia antibodies was 18.0% and for anti-Leptospira - 9.2%. CONCLUSIONS: Cats can be infected with both Bbsl and Lisl. The obtained results are exclusive to the city of Brno and its environs, and are comparable to the limited previous studies. There is a need for further studies of clinical signs of both infections and the possible transmission of Leptospira by ticks.


Assuntos
Grupo Borrelia Burgdorferi/isolamento & purificação , Doenças do Gato/epidemiologia , Leptospira interrogans/isolamento & purificação , Leptospirose/veterinária , Doença de Lyme/veterinária , Animais , Anticorpos Antibacterianos/sangue , Doenças do Gato/microbiologia , Gatos , República Tcheca/epidemiologia , Leptospirose/epidemiologia , Leptospirose/microbiologia , Doença de Lyme/epidemiologia , Doença de Lyme/microbiologia , Prevalência , Estudos Soroepidemiológicos
9.
Epidemiol Psychiatr Sci ; 29: e173, 2020 Sep 29.
Artigo em Inglês | MEDLINE | ID: mdl-32988427

RESUMO

AIMS: The United Nations warned of COVID-19-related mental health crisis; however, it is unknown whether there is an increase in the prevalence of mental disorders as existing studies lack a reliable baseline analysis or they did not use a diagnostic measure. We aimed to analyse trends in the prevalence of mental disorders prior to and during the COVID-19 pandemic. METHODS: We analysed data from repeated cross-sectional surveys on a representative sample of non-institutionalised Czech adults (18+ years) from both November 2017 (n = 3306; 54% females) and May 2020 (n = 3021; 52% females). We used Mini International Neuropsychiatric Interview (MINI) as the main screening instrument. We calculated descriptive statistics and compared the prevalence of current mood and anxiety disorders, suicide risk and alcohol-related disorders at baseline and right after the first peak of COVID-19 when related lockdown was still in place in CZ. In addition, using logistic regression, we assessed the association between COVID-19-related worries and the presence of mental disorders. RESULTS: The prevalence of those experiencing symptoms of at least one current mental disorder rose from a baseline of 20.02 (95% CI = 18.64; 21.39) in 2017 to 29.63 (95% CI = 27.9; 31.37) in 2020 during the COVID-19 pandemic. The prevalence of both major depressive disorder (3.96, 95% CI = 3.28; 4.62 v. 11.77, 95% CI = 10.56; 12.99); and suicide risk (3.88, 95% CI = 3.21; 4.52 v. 11.88, 95% CI = 10.64; 13.07) tripled and current anxiety disorders almost doubled (7.79, 95% CI = 6.87; 8.7 v. 12.84, 95% CI = 11.6; 14.05). The prevalence of alcohol use disorders in 2020 was approximately the same as in 2017 (10.84, 95% CI = 9.78; 11.89 v. 9.88, 95% CI = 8.74; 10.98); however, there was a significant increase in weekly binge drinking behaviours (4.07% v. 6.39%). Strong worries about both, health or economic consequences of COVID-19, were associated with an increased odds of having a mental disorder (1.63, 95% CI = 1.4; 1.89 and 1.42, 95% CI = 1.23; 1.63 respectively). CONCLUSIONS: This study provides evidence matching concerns that COVID-19-related mental health problems pose a major threat to populations, particularly considering the barriers in service provision posed during lockdown. This finding emphasises an urgent need to scale up mental health promotion and prevention globally.


Assuntos
Infecções por Coronavirus/psicologia , Transtornos Mentais/epidemiologia , Saúde Mental/estatística & dados numéricos , Pneumonia Viral/psicologia , Adulto , Transtornos Relacionados ao Uso de Álcool/epidemiologia , Transtornos Relacionados ao Uso de Álcool/etiologia , Transtornos de Ansiedade/epidemiologia , Transtornos de Ansiedade/etiologia , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Estudos Transversais , República Tcheca/epidemiologia , Transtorno Depressivo Maior/epidemiologia , Transtorno Depressivo Maior/etiologia , Feminino , Humanos , Masculino , Transtornos Mentais/etiologia , Pessoa de Meia-Idade , Transtornos do Humor/epidemiologia , Transtornos do Humor/etiologia , Pandemias , Pneumonia Viral/epidemiologia , Prevalência , Escalas de Graduação Psiquiátrica , Suicídio/estatística & dados numéricos , Inquéritos e Questionários
10.
Int J Behav Nutr Phys Act ; 17(1): 104, 2020 08 14.
Artigo em Inglês | MEDLINE | ID: mdl-32795287

RESUMO

BACKGROUND: To examine compositional associations between short sleep duration and sedentary behavior (SB), light physical activity (LPA) and moderate-to-vigorous physical activity (MVPA) among children and adolescents. METHODS: Multi-day 24-h data on sleep, SB, LPA and MVPA were collected using accelerometers among 343 children (8-13 years old) and 316 adolescents (14-18 years old). Children and adolescents with sleep duration of < 9 and < 8 h, respectively, were classified as short sleepers. Robust compositional regression analysis was used to examine the associations between short sleep duration and the waking-time composition. RESULTS: Seventy-one percent of children and 75.3% of adolescents were classified as short sleepers. In children, being a short sleeper was associated with higher SB by 95 min/day (p < 0.001) and lower MVPA by 16 min/day (p = 0.002). Specifically, it was associated with a higher amount of time spent in long sedentary bouts (ßilr1 = 0.46, 95% confidence interval [CI] = 0.29 to 0.62) and lower amounts of time spent in sporadic SB (ßilr1 = - 0.17, 95% CI = -0.24 to - 0.10), sporadic LPA (ßilr1 = - 0.09, 95% CI = -0.14 to - 0.04) and sporadic MVPA (ßilr1 = - 0.17, 95% CI = -0.25 to - 0.10, p < 0.001 for all), relative to the remaining behaviours. In adolescents, being a short sleeper was associated with a higher amount of time spent in SB by 67 min/day (p = 0.001) and lower LPA by 2 min/day (p = 0.035). Specifically, it was associated with more time spent in sedentary bouts of 1-9 min (ßilr1 = 0.08, 95% CI = 0.02 to 0.14, p = 0.007) and 10-29 min (ßilr1 = 0.10, 95% CI = 0.02 to 0.18, p = 0.015), relative to the remaining behaviours. CONCLUSIONS: Among children and adolescents, short sleep duration seems to be highly prevalent and associated with less healthy waking time. Public health interventions and strategies to tackle the high prevalence of short sleep duration among children and adolescents are warranted.


Assuntos
Exercício Físico , Comportamento Sedentário , Sono , Acelerometria , Adolescente , Criança , República Tcheca/epidemiologia , Análise de Dados , Feminino , Humanos , Masculino
11.
Sci Total Environ ; 746: 141033, 2020 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-32750577

RESUMO

Although impacts of extremely cold temperatures on human health have been widely studied, adverse effects of other extreme weather phenomena have so far received much less attention. We employed a high-quality long-term mortality time series (1982-2017) to evaluate impacts of extreme winter weather in the Czech Republic. We aimed to clarify whether compound events of extreme weather cause larger impacts on mortality than do each type of extreme if evaluated individually. Using daily data from the E-OBS and ERA5 datasets, we analyzed 9 types of extreme events: extreme wind gust, precipitation, snowfall, and sudden temperature and pressure changes. Relative mortality deviations from the adjusted baseline were used to estimate the immediate effect of the selected extreme events on excess mortality. The impact was adjusted for the effect of extreme cold. Extreme events associated with sudden rise of minimum temperature and pressure drops had generally significant impact on excess mortality (3.7% and 1.4% increase). The impacts were even more pronounced if these events occurred simultaneously or were compounded with other types of extremes, such as heavy precipitation, snowfall, maximum temperature rise, and their combinations (increase as great as 14.4%). Effects of some compound events were significant even for combinations of extremes having no significant impact on mortality when evaluated separately. On the other hand, a "protective" effect of pressure increases reduced the risk for its compound events. Meteorological patterns during extreme events linked to excess mortality indicate passage of a low-pressure system northerly from the study domain. We identified extreme winter weather events other than cold temperatures with significant impact on excess mortality. Our results suggest that occurrence of compound extreme events strengthen the impacts on mortality and therefore analysis of multiple meteorological parameters is a useful approach in defining adverse weather conditions.


Assuntos
Temperatura Baixa , Tempo (Meteorologia) , República Tcheca/epidemiologia , Humanos , Mortalidade , Estações do Ano , Temperatura
12.
Artigo em Inglês | MEDLINE | ID: mdl-32751749

RESUMO

The virus SARS-CoV-2, which has caused the recent COVID-19 pandemic, may be present in the stools of COVID-19 patients. Therefore, we aimed to detect SARS-CoV-2 in wastewater for surveillance of SARS-CoV-2 in the population. Samples of untreated wastewater were collected from 33 wastewater treatment plants (WWTPs) of different sizes within the Czech Republic. SARS-CoV-2 RNA was concentrated from wastewater and viral RNA was determined using real-time reverse transcription polymerase chain reaction (RT-qPCR). SARS-CoV-2 RNA was detected in 11.6% of samples and more than 27.3% of WWTPs; in some of them, SARS-CoV-2 was detected repeatedly. Our preliminary results indicate that an epidemiology approach that focuses on the determination of SARS-CoV-2 in wastewater could be suitable for SARS-CoV-2 surveillance in the population.


Assuntos
Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/virologia , Pneumonia Viral/virologia , Águas Residuárias/virologia , Infecções por Coronavirus/epidemiologia , República Tcheca/epidemiologia , Fezes/virologia , Humanos , Pandemias , Pneumonia Viral/epidemiologia , RNA Viral , Reação em Cadeia da Polimerase em Tempo Real
13.
Rozhl Chir ; 99(6): 271-276, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32736482

RESUMO

INTRODUCTION: Prevalence of obesity is 30 % in the Czech Republic and is expected to increase further in the future. This disease complicates surgical procedures but also the postoperative period. The aim of our paper is to present the surgical technique called hand-assisted laparoscopic nephrectomy (HALS), used in surgical management of kidney cancer in morbid obese patients with BMI >40 kg/m2. METHODS: The basic cohort of seven patients with BMI >40 undergoing HALS nephrectomy was retrospectively evaluated. Demographic data were ana-lyzed (age, gender, body weight, height, BMI and comorbidities). The perioperative course (surgery time, blood loss, ICU time, hospital stay and early complications), tumor characteristics (histology, TNM classification, tumor size, removed kidney size) and postoperative follow-up were evaluated. RESULTS: The patient age was 3867 years; the cohort included 2 females and 5 males, the body weight was 117155 kg and the BMI was 40.3501 kg/m2. Surgery time was 7398 minutes, blood loss was 20450 ml, and hospital stay was 57 days; incisional hernia occurred in one patient. Kidney cancer was confirmed in all cases, 48-110 mm in diameter, and the largest removed specimen size was 210×140×130 mm. One patient died just 9 months after the surgery because of metastatic disease; the tumor-free period in the other patients currently varies between 1 and 5 years.  Conclusion: HALS nephrectomy seems to be a suitable and safe surgical technique in complicated patients like these morbid obese patients. HALS nephrectomy provides acceptable surgical and oncological results.


Assuntos
Laparoscopia Assistida com a Mão , Laparoscopia , Obesidade Mórbida/cirurgia , República Tcheca/epidemiologia , Feminino , Humanos , Masculino , Nefrectomia , Complicações Pós-Operatórias , Estudos Retrospectivos , Resultado do Tratamento
14.
Artigo em Inglês | MEDLINE | ID: mdl-32630556

RESUMO

BACKGROUND: People exposed to childhood trauma show insecure attachment patterns and are more prone to chronic and pain-related conditions, including migraine. The aim of this study was to explore the mediating role of attachment in the association between childhood trauma and adulthood chronic health conditions, with a focus on migraine. METHODS: Respondents from a representative sample of citizens of the Czech Republic (n = 1800, mean age: 46.6 years, 48.7% male) were asked to report various chronic and pain-related conditions, childhood trauma (The Childhood Trauma Questionnaire, CTQ), and attachment anxiety and avoidance (The Experience in Close Relationships Revised, ECR-R) in a cross-sectional, questionnaire-based survey conducted in 2016. Structural equation models (SEM) adjusted for sociodemographic variables were used to assess the relationship between childhood trauma, adulthood attachment, and adulthood chronic health conditions (migraine, other pain-related conditions, chronic health conditions other than pain, no chronic health complaints). RESULTS: After adjusting for sociodemographic variables, SEM confirmed a significant mediation of the relationship between childhood trauma and migraine through adulthood attachment. There was no mediation effect of adulthood attachment found in other health complaints. CONCLUSION: This study highlights the mediation effect of attachment in the link between childhood trauma and migraine. Attachment-based therapeutic interventions can be useful in the treatment of patients with migraine.


Assuntos
Sobreviventes Adultos de Maus-Tratos Infantis , Transtornos de Enxaqueca , Apego ao Objeto , Adulto , Transtornos de Ansiedade/epidemiologia , Estudos Transversais , República Tcheca/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos de Enxaqueca/epidemiologia
15.
Public Health ; 185: 153-158, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32634606

RESUMO

OBJECTIVES: Colorectal cancer (CRC) remains a major health burden. Although screening is recommended and considered beneficial, further data on its positive effects are needed for worldwide implementation. STUDY DESIGN: The aim of our national multicentre prospective observational study was to reveal and document clinicopathological differences in CRC diagnosed by screening and presented by disease symptoms as well as assess the efficiency of the screening programme in the Czech Republic. METHODS: Between March 2013 and September 2015, a total of 265 patients were enrolled in 12 gastroenterology centres across the Czech Republic. Patients were divided into screening and symptomatic groups and compared for pathology status and clinical characteristics. Screening was defined as a primary screening colonoscopy or a colonoscopy after a positive faecal occult blood test in an average-risk population. RESULTS: The distribution of CRC stages was significantly (statistically and clinically) favourable in the screening group (predominance of stages 0, I and II) compared with the non-screening group (P < 0.001). The presence of distant and local metastases was significantly less frequent in the screening group than in the symptomatic group (P < 0.001). Patients in the screening group had a higher probability of radical surgery (R0) than those diagnosed based on symptoms (P < 0.001). Systemic palliative treatment was indicated in two patients in the screening group compared with 23 patients in the non-screening group (P = 0.018). CONCLUSION: CRC diagnosed by screening disclosed less advanced clinicopathological characteristics and results in patients with a higher probability of radical surgery (R0) than diagnoses established based on symptoms, with subsequent management differing accordingly between both groups. These results advocate the implementation of a suitable worldwide screening programme.


Assuntos
Neoplasias Colorretais/epidemiologia , Detecção Precoce de Câncer , Programas de Rastreamento/métodos , Idoso , Colonoscopia , Neoplasias Colorretais/diagnóstico , República Tcheca/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Sangue Oculto , Estudos Prospectivos , Fatores de Risco , Índice de Gravidade de Doença
16.
Cent Eur J Public Health ; 28(2): 161-162, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32592550

RESUMO

The mandatory face mask wearing was implemented in the Czech Republic and Slovakia shortly after the COVID-19 outbreak in Central Europe. So far, the number of COVID-19-associated deaths per 100,000 individuals is far lower in these countries as compared with other neighbouring or close countries. The use of face masks in public may not protect the general public from contracting the virus, however, presumptively decreases the viral load and contributes to a favourable clinical outcome in COVID-19 disease. A certain time is required for antigen-specific T cells and B cells to fully develop. Obligatory face mask wearing in public favours the virus transmission through oral mucosa and/or conjunctival epithelium, which enables the adaptive immune responses to evolve. In the case of inhalation of high loads of SARS-CoV-2, the time for the development of fully protective adaptive immune responses seems to be insufficient. Then, a less specific and more damaging innate immune response prevails.


Assuntos
Infecções por Coronavirus/prevenção & controle , Máscaras , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , República Tcheca/epidemiologia , Humanos , Equipamento de Proteção Individual , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Roupa de Proteção , Eslováquia/epidemiologia , Carga Viral
17.
Cent Eur J Public Health ; 28(2): 114-119, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32592555

RESUMO

OBJECTIVE: The aim of this analysis was to analyze the presence of the most important cardiovascular (CV) risk factors and to discuss patterns of LDL cholesterol management in the population studied. METHODS: We enrolled 961 males, average age of 42.9 ± 4.7, and 851 females, average age of 51.2 ± 3.6. Data on personal, pharmacological and family history, and laboratory examinations were collected. Cardiovascular (CV) risk was calculated using the Systematic Coronary Risk Evaluation (SCORE) algorithm with modifications according to the guidelines. RESULTS: The distribution of CV risk in the observed cohort was as follows: 24% of the subjects had low, 51% moderate, 17% high and 8% very high risk. The percentage of patients who reached target values of LDL cholesterol was dramatically lower in the groups with very high (1%) and high (3%) risk than in the groups with moderate (14%) or low risk (59%). Dyslipidemia was newly identified in 20% of both sexes. Arterial hypertension was newly diagnosed in 8% of males and 5% of females, and type 2 diabetes mellitus was newly diagnosed in 3% of both the males and females. Dyslipidemia was present in 39% of males and 41% of females; arterial hypertension in 43% of males and 45% of females, and type 2 diabetes mellitus was diagnosed in 11% of the subjects of both sexes. 49% of males and 31% of females were overweight and 32% of both genders were obese. There were 36% of male smokers and 22% of female smokers. 48% of the participants were pharmacologically treated. Non-pharmacological treatment was recommended to 62% of male and to 65% of female participants. Pharmacological intervention was started in 53% of males and 51% of females. In both gender antihypertensive treatment with angiotensin-converting enzyme (ACE) inhibitors (29% of males and 27% of females) and lipid lowering therapy with a statin (28% of males, 27% of females) were the most commonly initiated treatments. In the subgroup of the 101 patients with LDL cholesterol levels > 5 mmol/L 56% were not treated with a statin. The analysis of relationship between the positive family history of any of the followed CV risks showed significant increases of the risk for arterial hypertension, type 2 diabetes mellitus and dyslipidemia. CONCLUSION: European guidelines suggest general screening for risk factors, including analysis of lipid profiles in the population of 40-year-old males and 50-year-old or postmenopausal women. Our study documents high prevalence and incidence of CV risk factors together with insufficient control of the risk factors in Czech patients of this age range. This finding suggests that preventive examinations should be undertaken earlier (e.g., in 30-year-old males and 40-year-old women). Exact timing of the preventive check-ups to yield the best cost-benefit ratio needs to be verified.


Assuntos
Doenças Cardiovasculares/epidemiologia , Diabetes Mellitus Tipo 2/epidemiologia , Dislipidemias/epidemiologia , Hipertensão/epidemiologia , Obesidade/epidemiologia , Adulto , Idoso , Inibidores da Enzima Conversora de Angiotensina/uso terapêutico , Anti-Hipertensivos/uso terapêutico , Doenças Cardiovasculares/tratamento farmacológico , República Tcheca/epidemiologia , Diabetes Mellitus Tipo 2/tratamento farmacológico , Dislipidemias/tratamento farmacológico , Feminino , Humanos , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Hipertensão/tratamento farmacológico , Incidência , Masculino , Pessoa de Meia-Idade , Obesidade/tratamento farmacológico , Prevalência , Fatores de Risco , Inquéritos e Questionários
18.
Ann Hematol ; 99(7): 1583-1594, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32506244

RESUMO

Relapsing diffuse large B cell lymphomas (rDLBCL) represent a heterogeneous disease. This heterogeneity should be recognized and reflected, because it can deform the interpretation of clinical trial results. DLBCL patients with the first relapse and without CNS involvement were identified in the Czech Lymphoma Study Group (CLSG) database. Interval-to-therapy (ITT) was defined as the time between the first manifestation of rDLBCL and the start of any treatment. The overall survival (OS) of different ITT cohorts (< 7 vs. 7-21 vs. > 21 days) was compared. In total, 587 rDLBCLs (51.8% males) progressed with a median of 12.8 months (range 1.6 to 152.3) since the initial diagnosis (2000-2017). At the time of relapse, the median age was 67 years (range 22-95). First-line therapy was administered in 99.3% of the patients; CHOP and anti-CD20 were given to 69.2% and 84.7% of the patients, respectively. The salvage immune/chemotherapy was administered in 88.1% of the patients (39.2% platinum-based regimen). The median ITT was 20 days (range 1-851), but 23.2% of patients initiated therapy within 7 days. The 5-year OS was 17.4% (range 10-24.5%) vs. 20.5% (range 13.5-27.4%) vs. 42.2% (range 35.5-48.8%) for ITT < 7 vs. 7-21 vs. > 21 days (p < 0.001). ITT was associated with B symptoms (p 0.004), ECOG (p < 0.001), stage (p 0.002), bulky disease (p 0.005), elevated LDH (p < 0.001), and IPI (p < 0.001). The ITT mirrors the real clinical behavior of rDLBCL. There are patients (ITT < 7 days) with aggressive disease and a poor outcome. Conversely, there are rDLBCLs with ITT ≥ 21 days who survive for a long time.


Assuntos
Linfoma Difuso de Grandes Células B/diagnóstico , Linfoma Difuso de Grandes Células B/terapia , Tempo para o Tratamento , Adulto , Idoso , Idoso de 80 Anos ou mais , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Estudos de Coortes , Ciclofosfamida/uso terapêutico , República Tcheca/epidemiologia , Bases de Dados Factuais , Progressão da Doença , Doxorrubicina/uso terapêutico , Feminino , Humanos , Linfoma Difuso de Grandes Células B/epidemiologia , Linfoma Difuso de Grandes Células B/patologia , Masculino , Pessoa de Meia-Idade , Terapia Neoadjuvante/métodos , Terapia Neoadjuvante/estatística & dados numéricos , Prednisona/uso terapêutico , Prognóstico , Recidiva , Estudos Retrospectivos , Rituximab/administração & dosagem , Tempo para o Tratamento/estatística & dados numéricos , Resultado do Tratamento , Vincristina/uso terapêutico , Adulto Jovem
19.
Soud Lek ; 65(2): 22-26, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32493019

RESUMO

From the National Registry of autopsies and toxicology examinations, we selected the deceased for 2015, 2016, 2017 and January 2018 active road accident participants, i.e. pedestrians, cyclists and motor vehicle drivers. From these, we further selected those who were tested for THC presence. Of the 836 deceased active road accident participants, only 251 (i.e. 30%) were tested for cannabinoids, most often passenger car drivers, 46 percent. Of the 251 people tested, THC was demonstrated in 12 (4.8%), most commonly motorcycle drivers (7.8%) and passenger car drivers (3.4%). Of the 12 positive people, 7 were found to have a possible effect of THC ingestion on the road accident, but only one participant was found to have overdosed on THC, and 2 were reported by the dissecting physician to have had no effect on the accident. In the Czech Republic, when driving under the influence of addictive substances, there is no uniform procedure for qualification, whether it is an offence or an offence, and thus in the award of punishment. While somewhere there is an effort to divide this wrongdoing into offences and crimes, elsewhere it practically always only constitutes an offense. This situation seeks to resolve the instruction of the Attorney-at-chief 1 SL 732/2018 of 29 December 4.2019, which, however, arose without any discussion with the professional public, which is heavily criticized especially for the absurly high limits, which in particular in morphine and cocaine are practically unachievable. At the time of this writing, the impact of this guideline on practice is not clear.


Assuntos
Acidentes de Trânsito , Condução de Veículo , Acidentes de Trânsito/mortalidade , República Tcheca/epidemiologia , Dronabinol , Humanos , Motocicletas
20.
J Med Internet Res ; 22(5): e19367, 2020 05 27.
Artigo em Inglês | MEDLINE | ID: covidwho-268536

RESUMO

BACKGROUND: The beginning of the coronavirus disease (COVID-19) epidemic dates back to December 31, 2019, when the first cases were reported in the People's Republic of China. In the Czech Republic, the first three cases of infection with the novel coronavirus were confirmed on March 1, 2020. The joint effort of state authorities and researchers gave rise to a unique team, which combines methodical knowledge of real-world processes with the know-how needed for effective processing, analysis, and online visualization of data. OBJECTIVE: Due to an urgent need for a tool that presents important reports based on valid data sources, a team of government experts and researchers focused on the design and development of a web app intended to provide a regularly updated overview of COVID-19 epidemiology in the Czech Republic to the general population. METHODS: The cross-industry standard process for data mining model was chosen for the complex solution of analytical processing and visualization of data that provides validated information on the COVID-19 epidemic across the Czech Republic. Great emphasis was put on the understanding and a correct implementation of all six steps (business understanding, data understanding, data preparation, modelling, evaluation, and deployment) needed in the process, including the infrastructure of a nationwide information system; the methodological setting of communication channels between all involved stakeholders; and data collection, processing, analysis, validation, and visualization. RESULTS: The web-based overview of the current spread of COVID-19 in the Czech Republic has been developed as an online platform providing a set of outputs in the form of tables, graphs, and maps intended for the general public. On March 12, 2020, the first version of the web portal, containing fourteen overviews divided into five topical sections, was released. The web portal's primary objective is to publish a well-arranged visualization and clear explanation of basic information consisting of the overall numbers of performed tests, confirmed cases of COVID-19, COVID-19-related deaths, the daily and cumulative overviews of people with a positive COVID-19 case, performed tests, location and country of infection of people with a positive COVID-19 case, hospitalizations of patients with COVID-19, and distribution of personal protective equipment. CONCLUSIONS: The online interactive overview of the current spread of COVID-19 in the Czech Republic was launched on March 11, 2020, and has immediately become the primary communication channel employed by the health care sector to present the current situation regarding the COVID-19 epidemic. This complex reporting of the COVID-19 epidemic in the Czech Republic also shows an effective way to interconnect knowledge held by various specialists, such as regional and national methodology experts (who report positive cases of the disease on a daily basis), with knowledge held by developers of central registries, analysts, developers of web apps, and leaders in the health care sector.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , República Tcheca/epidemiologia , Mineração de Dados , Humanos , Internet , Pandemias , Software
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA