Casopís lékar̆ů c̆eských
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Fibromyalgia is a chronic syndrome characterized by dysfunction of pain processing and regulation. Although the definite etiology has not been recognized yet, the key role in the pathogenesis of this syndrome probably plays the central sensitization process with the development of chronic (central) pain and other associated symptoms (fatigue, stiffness, sleep disorders, cognitive and vegetative disturbance). ⋯ New drugs introduced to the therapy in the recent years can have positive effect on symptom reduction and improvement of patients quality of life. Key words: fibromyalgia, chronic pain, fatigue, central sensitization.
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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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The goal of this work was to acquire data concerning characteristics, ways of assessing presented documentation, publishing attitudes and other related activities of ethics committees established according to the Act No. 378/2007 Coll., on Pharmaceuticals, and to use evaluated data subsequently for mapping actual state of assessing clinical trial projects with emphasis to observance of legislation, as well as description of differences between individual ethics committees. ⋯ Being able to focus only on a formal part of ethics committees' activity, it is possible to say that individual ethics committees differ from each other particularly in the general characteristics, conditions made for their work and in some trial aspect, but it doesn't automatically mean serious law breach and the immediate need of rectification. It seems that not all members of ethics committees realize adequately the seriousness of their actions from the ethical point of view at current research done with human subjects.
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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.