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Journal Article 2014; 35(Suppl 1): 34-39 PubMed PMID: 25433352 Citation  Keywords:  Cardiac Resynchronization Therapy:methods, Electrodes, Implanted, Heart Failure:surgery, Heart Ventricles:surgery, Humans, Pericardium:surgery,.   

: Cardiac resynchronization therapy is now recognized as an effective and safe therapeutic modality in heart failure patients and leads to a reduction in mortality and morbidity. Today, transvenous implantation is considered to be the gold standard for lead placement. However, transvenous LV lead implantation fails in 2-10% of patients undergoing the implantation procedure. In these cases surgical LV lead implantation is preferred. The present article reviews LV pacing lead implantation strategies in cases where standard transvenous implantation failed....

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Journal Article 2014; 35(Suppl 1): 26-33 PubMed PMID: 25433351 Citation  Keywords:  Adult, Community Health Nursing:methods, Community Medicine:methods, Czech Republic, Female, Humans, Male, Middle Aged, Nurse's Role, Nursing Staff, Physicians, Preventive Health Services:methods, Preventive Medicine:methods,.   

<p>OBJECTIVES: According to published reports from the WHO, health care is undergoing a transformation that reflects the increasing importance of community care based on social, group, and individual needs. Community health care is provided by multidisciplinary teams, with nurses occupying irreplaceable positions. Nurse competencies constitute significant potential in the area of community based preventive care as well as the more traditional roles in treatment and recovery.

METHODS: Data was obtained from health care professionals and the public through a structured interview. The study population included 1,007 physicians, 1,005 nurses and 2,022 laypersons. Respondents were selected randomly with the aid of quotas. The parameters for the selection of health care workers (nurses and physicians) were constructed based on registration data from the Institute of Health Information and Statistics. Layperson selection was based on data from the Czech Statistical Office. The Statistical Analysis of Social Data program (version 1.4.4) was used to process the data, which was in the form of 1st and 2nd degree contingency tables. The dependence level was determined based on χ2 and other testing criteria (according to the character of the signs).

RESULTS: The results show that respondents perceive the concept of a "community nurse" as a nurse working independently in local neighborhoods and communities. Results also showed that work in senior care, followed by home care, and care for chronically ill patients were the most preferred. A role for nurses in health care education centers was only supported by 13.1% of physicians, 13.8% of nurses, and 6.8% of laypersons. The results also reveal that community nursing is perceived by both health care professionals and laypersons as fieldwork (i.e. work not based in a hospital or clinic environment), yet, at the same time, it was perceived as work that dealt with people needing health care. The results also reflect the opinion that the establishment of an independent nurse in the workplace (in the form of preventive care) could lead to an increase in the quality of care for employees (65.7% of physicians and 70.8% of nurses), an improvement in workplace health education (33% of physicians and 34.7% of nurses) and would provide support for healthy work environments (31.4% of physicians and 30.4% of nurses).

CONCLUSION: Our results lead us to conclude that the health care system in the Czech Republic needs to better utilize the potential of trained nurses in the field of community health care. Additionally, steps need to be taken to increase job opportunities and staffing for nurses wanting to work in community health and preventive care.p>...

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Journal Article 2014; 35(Suppl 1): 19-25 PubMed PMID: 25433350 Citation  Keywords:  Activities of Daily Living:psychology, Adolescent, Adult, Crohn Disease:nursing, Czech Republic, Female, Humans, Male, Nursing Staff:standards, Patient Satisfaction, Quality of Life:psychology, Social Support, Surveys and Questionnaires, Young Adult,.   

OBJECTIVES:&nbsp;To determine the quality of life of patients with Crohn's disease and to determine if this is reflected by the quality of nursing care.

METHODS:&nbsp;For the purpose of this research, we used a generic standardized questionnaire of the quality of life, published by the World Health Organization (WHOQOL-100). The questionnaire was distributed among 100 patients with Crohn's disease and among 1456 and members of healthy population. To analyze the results, we used the SPSS program and appropriate statistical methods.

RESULTS:&nbsp;The comparison of the domain scores of population standards in the Czech Republic and the respondents with Crohn's disease revealed a difference in the domain "physical condition", where the mean value was at the limit of the lower interval of the standard, and in the domain of "independence".

CONCLUSION:&nbsp;The results given in this study define the possibilities of nurses and their functioning associated with altered quality of life. An evaluation of the most affected areas allows nurses to determine an appropriate intervention. Providing nursing care, in accordance with the latest knowledge, must be based on the quality of life. This newly incorporated area offers healthcare professionals a new dimension for assessing and determining subsequent interventions....

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Journal Article 2014; 35(Suppl 1): 11-18 PubMed PMID: 25433349 Citation  Keywords:  Activities of Daily Living, Adult, Arthritis, Rheumatoid:physiopathology, Chronic Disease, Crohn Disease:physiopathology, Czech Republic, Female, Health Surveys, Humans, Male, Middle Aged, Peripheral Arterial Disease:physiopathology, Pulmonary Disease, Ch.   

OBJECTIVES:&nbsp;A quality of life assessment is of great importance for patients with chronic diseases, because problems caused by specific diseases impact specific areas of their lives. The goal of this work was to determine, in which areas select diseases (rheumatoid arthritis, Crohn's disease, ischemic disease of the lower extremities and chronic obstructive pulmonary disease) affect patients' quality of life.

METHODS:&nbsp;The Czech version of the WHOQOL-100 instrument and specific standardized questionnaires for individual diseases: EuroQol, EQ-5D-5L, IBDQ, PAQ were used to assess quality of life. This paper presents the results of the WHOQOL-100 questionnaire. In total, 5 research samples were put together. The first sample consisted of 200 respondents with rheumatoid arthritis (RA); the second sample included 100 respondents with inflammatory bowel disease (IBD); the third sample was comprised of 404 respondents with ischemic disease of the lower extremities (IDLE); the fourth sample consisted of 449 respondents with chronic obstructive pulmonary disease (COPD); and the fifth sample was represented by 1,456 healthy respondents. The acquired data were then statistically analyzed. A statistical data analysis was performed in two steps. In the first step descriptive statistical analyses were performed in the SASD program (absolute and relative frequencies of respondents' answers, median values and variability characteristics). In the second step differences in means of the subjectively-perceived quality of life in patients with individual diseases and in control group were tested using the Mann-Whitney U test and the non-parametric Wilcoxon pair test. These analyses were computed in the SPSS (Statistical Package for the Social Sciences) program.

RESULTS:&nbsp;The results show that a statistically significant difference in average domain score values was found between the healthy population and patients diagnosed with RA in the domains of "physical health", "level of independence", "environment", and "spirituality/religion/personal beliefs". A statistically significant difference was found in all domains for patients with IDLE and COPD. A statistically significant difference was found in four domains for patients with IBD, namely those of "physical health", "level of independence", "social relationships" and "spirituality/religion/personal beliefs".

CONCLUSION:&nbsp;All therapeutic and nursing interventions that can contribute to improving QoL in poorly performing domains should be utilized....

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Journal Article 2014; 35(Suppl 1): 5-10 PubMed PMID: 25433348 Citation  Keywords:  Adolescent, Adult, Cross Infection:prevention & control, Czech Republic, Data Collection, Female, Health Knowledge, Attitudes, Practice, Hospitalization, Humans, Inpatients:psychology, Interviews as Topic, Male, Middle Aged, Patient Participation:psycholo.   

<p>OBJECTIVES: The study examined the extent to which patients in the Czech Republic are involved in decisions regarding their treatment and whether they are interested in ensuring safety during hospitalization.

METHODS: Patients were interviewed to determine their perspectives regarding the previously stated objectives. The sample consisted of 514 patients who had been admitted to hospital for a minimum of three days.

RESULTS: It is clear that patients in the Czech Republic are unaware of safety issues associated with provided care, but 52.2% of respondents expressed a desire to be more involved in decisions pertaining to their treatment. Widowed patients, as well as those hospitalized for more than six days, expressed less of a desire for such involvement. Half of the patients enrolled in the study stated that health care professionals had encouraged them to ask questions about their treatment. With regard to errors associated with surgical reversals, 58.3% of respondents stated that nursing staff had performed checkups to avoid confusion in surgery. Another patient safety issue is nosocomial infection acquired through improper hand-washing techniques of medical personnel. 73.5% of patients said they would not have the courage to ask medical staff (doctors or nurses) whether they had washed their hands prior to examination.

CONCLUSION: Patients in the Czech Republic are unaware of the safety issues associated with provided care, but more than half expressed a desire to be more involved in decisions that pertain their treatment.p>...

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Journal Article 2014; 35(5): 373-379 PubMed PMID: 25275268 Citation  Keywords:  Abdominal Fat:metabolism, Adiponectin:blood, Adult, Blood Glucose:metabolism, Diet, Reducing, Exercise:physiology, Female, Homeostasis:physiology, Humans, Insulin:blood, Obesity:diet therapy, Oxygen Consumption:physiology,.   

OBJECTIVE:&nbsp;We investigate the effect of 6 months aerobic training alone or in combination with diet on adiponectin in circulation and in adipose abdominal tissue (AT) in obese women.

METHODS:&nbsp;Twenty obese subjects were randomized into a 24 weeks intervention: 1) training (TR) and 2) training and diet (TRD). Blood samples were collected at baseline, after 12 wk and 24 wk. AT biopsies were obtained only at baseline and after 24 wk.

RESULTS:&nbsp;In the TRD group the fat loss was after 12 wk -13.74% (p<0.01) and after 24 wk -21.82% (p<0.01) with no changes in the TR group. After 12 and 24 wk, VO2max was increased by 21.81-39.54% (p<0.05) in the TRD group and 18.09-40.95% in the TR group (p<0.05). After 12 wk, plasma adiponectin was raised only in the TRD group (55.8%, p<0.05). After 24 weeks, circulating adiponectin was elevated by 110.4% (p<0.01) in the TRD group and by 27% (p<0.05) in the TR group. In AT biopsies, subjects in the TRD and TR groups exhibited a significant increase in adiponectin (p<0.05 and p<0.01, respectively). The two indices HOMA-IR and HOMA-AD for assessing insulin resistance were strongly affected by protocols. HOMA-IR decreased (p<0.05) only after 24 wk in the TRD group. HOMA-AD increased in both groups after 12 (p<0.05) and 24 wk (p<0.01).

CONCLUSION:&nbsp;Six months chronic aerobic exercise alone or combined with diet result in a significant increase in circulating and adipose tissue adiponectin levels in obese women independent of changes in body composition and/or in HOMA-IR....

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Case Reports 2014; 35(5): 352-354 PubMed PMID: 25275267 Citation  Keywords:  Empty Sella Syndrome:complications, Female, Heart Arrest:blood, Humans, Hypoglycemia:blood, Hypopituitarism:complications, Magnetic Resonance Imaging, Middle Aged, Potassium:blood,.   

:&nbsp;A 62-year-old woman was admitted to our hospital because of unconsciousness and hypoglycaemia. She had a history of weakness and fatigue after postpartum haemorrhage in 1983. Unfortunately, she was not diagnosed with Sheehan's syndrome and did not receive sufficient professional treatment due to the limited medical resources in her hometown. A laboratory examination at the local hospital revealed severe hypoglycaemia (1.8 mmol/L) with relatively low serum potassium (2.9 mmol/L). The woman appeared twice in the hospital with cardiac arrest, and her medical history, and the later laboratory investigations were consistent with Sheehan's syndrome. Empty sella was also found by magnetic resonance imaging (MRI). We conclude that Sheehan's syndrome may lead to cardiac arrest with the complication of hypokalaemia and deserves the vigilance of clinicians....

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Journal Article 2014; 35(5): 359-366 PubMed PMID: 25275266 Citation  Keywords:  Alzheimer Disease:diagnosis, Genetic Predisposition to Disease:genetics, Genetic Testing:standards, Humans, Reproducibility of Results,.   

:&nbsp;Alzheimer disease (AD) represents a group of multifactorial disorders characterized by a progressive decline of mental faculties eventually leading to dementia and death. Aging of human populations is behind the rapid worldwide increase in the prevalence of AD in recent decades. AD prevention critically depends on reliable AD-predictive genetic testing but its further development is delicately poised at present. New DNA-analyzing technologies such as the Next Generation Sequencing (NGS) have allowed rapid and comprehensive analysis of the genome and might have aided the research into the genetics of AD. However, discoveries of epigenetic mechanisms and non-coding forms of DNA and RNA - while helping to explain complexities of AD etiologies - have imposed additional challenges onto the AD diagnostics based on DNA analyses. Environmental factors can, via epigenetic mechanisms, modify both coding and non-coding DNA and this has to be respected in DNA testing, including NGS. Risk calculations based on the known odds and risk ratios for selected DNA polymorphisms are viable options at present, while the applications of neural network methodology seems the most promising way forward in the development of predictive AD tests in future....

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