Casopís lékar̆ů c̆eských
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Sepsis is a serious high mortality disease. As regards pathophysiology, it is a systemic inflammatory response to infection. Its timely diagnosis strongly influences mortality. ⋯ The most frequently used sepsis markers in routine clinical diagnostics are C-reactive protein and procalcitonin. The detection of selected cytokines, mediators, and surface markers in immunocompetent cells gives us further chance for improvement of this diagnostics. The methods of calculating gene expression represent a technology with a potential for the discovery of new biomarkers which would improve both diagnostics and therapy in the sense of personalized medicine.
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Neurogenic pulmonary oedema is a complication of severe central nervous system injury. The centre of neurogenic pulmonary oedema is assumed to be a group of dorsal ventrolateral medulla nuclei, which are activated by a combination of afferent pathway hyperactivity and a sudden increase of intracranial pressure. The sympathetic system plays a crucial role in the pathogenesis of neurogenic pulmonary oedema by activating a rapid cascade of processes, leading to interstitial and intraalveolar oedema, together with important haemorrhage. ⋯ There are several experimental models that can be used for studying the etiopathogenesis or treatment of neurogenic pulmonary oedema. The main goal of experimental studies is to elucidate a preventive and therapeutic approach that is able to prevent or treat neurogenic pulmonary oedema. In this context, the most promising agent is atropine.
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Pelvic ring injuries occur at any age. Most injuries to the pelvis are due to high-energy trauma, these injuries are therefore associated with abdominal, thoracic and head injuries. Unstable disruption of the pelvic ring has been often coupled with massive or life-threatening haemorrhage. ⋯ In the acute period minimally invasive internal fixation with closed reduction should be used (transiliacal internal fixator, iliosacral screws). The open reduction with internal fixation can be performed after stabilization of the general state of health (after about 5 days), pelvic plates and spinopelvic fixation are appropriate for this approach. To recover the patient into normal life, bed rest and rehabilitation follows after surgical treatment.
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Casopís lékar̆ů c̆eských · Jan 2011
[Deep brain stimulation in movement disorders: a Prague-center experience].
Deep brain stimulation (DBS) in the basal ganglia plays an irreplaceable role in the treatment of Parkinson's disease (PD), essential tremor (ET), and some types of dystonia. Electrodes are typically inserted into the subthalamic nucleus (STN), the internal globus pallidus (GPi) and the ventral intermediate nucleus of the thalamus (VIM). Stimulation of the STN is the main objective in PD, GPi in the treatment of dystonia and PD, and VIM stimulation is effective against tremor. ⋯ Intraoperatively we have succeeded in eliminating rigidity in 95% of cases of PD, and tremor in 93% of cases of ET. The positive effect of stimulation on dystonia appeared in 95% with a latency of weeks. Transitory intraoperative morbidity occurred in 8%, intracranial hemorrhage in 1%, infectious complications in 6%, and problems with hardware in 7%.
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Casopís lékar̆ů c̆eských · Jan 2011
[Conflict of interest: the World Medical Association statement].
This article presents a translation of the World Medical Association Statement on Conflict of Interest (2009) and Statement concerning the Relationship between Physicians and Commercial Enterprises (2009). The introduction illuminates the objectives of this recommendation in the context of healthcare in the Czech Republic.