Casopís lékar̆ů c̆eských
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Casopís lékar̆ů c̆eských · Jan 2012
[Present concept for management of severely injured patients in Trauma Centre Faculty Hospital Královské Vinohrady].
The implementation of standardized protocols for management of polytrauma, multiple injuries and complicated monotrauma has led to improvement in trauma care with decrease in posttraumatic morbidity and mortality. The introduction of algorithm "Definitive Surgical Trauma Care" (DSTC) with concept of "damage control" surgery assumed the principal role in care of polytrauma patients. It can be accomplished only in the trauma- centre with implementation of care system for severely injured patients. Analysis of severely injured patients treated in Trauma Centre Faculty Hospital Královské Vinohrady was performed in a retrospective study. ⋯ The implementation of trauma care system in severely injured patients brings increased numbers of primary trauma admissions to trauma centres. Polytraumas and craniocerebral injuries were the most frequently admitted patients to emergency unit. Implementation of standardized protocols with interdisciplinary cooperation in trauma management represents improvements of trauma care. Early indication and performance of urgent operations with control of bleeding and prevention of subsequent contamination belongs to principal steps in the management of severely injured patients. Definitive management with reoperation in polytrauma patients can be indicated after the stabilisation. ISS > 40 was connected with high mortality rate (65%).
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Casopís lékar̆ů c̆eských · Jan 2012
[Determination of needs of terminally ill patients in the hospice care].
The aim of palliative care is the solution of bio-psycho-social and spiritual problems of patients and achievement of the highest possible quality of life. This is related to a need of understanding the patient and his needs. The aim of our research was to determine bio-psychosocial-spiritual needs of patients in hospice care in conjunction with the quality of life and rate of their saturation. Further then to determine, whether the needs vary depending on length of stay in hospice, gender, age and religion. ⋯ During the stay in hospice patients' satisfaction with saturation of some needs and overall assessment of quality of life increased.
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The article describes the situation of the Czechoslovak exile, especially the exile of physicians to Sweden. Many of Czechoslovak physicians decided to emigrate due to their political attitudes. Majority of them left Czechoslovakia after the invasion of Warsaw Pact armies in 1968. ⋯ After one year of service in northern part of Sweden, where there was a lack of physicians, they could choose hospital, where they wanted to work. Czechoslovak physicians were very successful in the Swedish medical system and also well accepted in the Swedish society as other exulants from Czechoslovakia. Key words: Czechoslovak exile to Sweden, political asylum 1968-1968.
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Electronic cigarette (e-cigarettes) belongs to the "ENDS (Electronic Nicotine Delivery Systems), ie systems that deliver nicotine electronically. Extract of tobacco does not burn, just warm. Vapors may or may not contain nicotine. ⋯ Moreover, lately it was shown that they can really contribute to smoking quitting. The legislative framework varies considerably, from the prohibition on sales to the recommended assistance in quitting. In the CR they are included according to the Act 379/2005 in 2009 among the tobacco products.
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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.