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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,.   

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.

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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: 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: 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: 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: 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: 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: 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: 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: 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.   

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.

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Case Reports 2014; 35(5): 335-341 PubMed PMID: 25275265 Citation  Keywords:  Adolescent, Antithyroid Agents:administration & dosage, Autoantibodies:immunology, Child, Child, Preschool, Female, Graves Disease:drug therapy, Hashimoto Disease:drug therapy, Humans, Hypothyroidism:chemically induced, Male, Methimazole:administration & .   

BACKGROUND: The main clinical manifestations of autoimmune thyroid diseases are Graves' disease (GD) and Hashimoto's thyroiditis (HT). Graves' disease is the cause of most cases of hyperthyroidism in childhood. Indications for radical therapy (surgery or 131I treatment) in children are still a matter of discussion, as sustained (sometimes very long) remission of GD is possible, while the radical therapy almost always leads to hypothyroidism. Spontaneous evolution from GD with hyperthyroidism to HT with hypothyroidism may also be observed.

OBJECTIVE: The aim of the study was to analyze the clinical course of 6 cases of hyperthyroid girls with GD in whom a normalization of previously increased autoantibodies against thyrotropin (TSH) receptor (anti-TSHR) was observed together with a significant increase in autoantibodies against thyroid peroxidase (anti-TPO) and thyroglobulin (anti-Tg), with concomitant hypo- or euthyroidism but no recurrence of hyperthyroidism.

SUBJECTS: Patients' age at diagnosis ranged from 5.0 to 16.5 years. Two (2) patients had Turner syndrome, another one (1), diabetic, was on insulin therapy.

RESULTS: In all the girls, antithyroid drugs were administered and euthyroid state was achieved during the first 2.0-3.5 months of the treatment. Mild side effects were observed in only one case. The therapy was continued up to 1.5-4.0 years. Relapses during the therapy were observed in 2 cases. Up to now, no relapses have been observed for 0.5-7.5 years since the therapy withdrawal in 5 patients (1 patient was lost to follow-up), 2 patients are currently treated with levothyroxine due to hypothyroidism.

CONCLUSIONS: It seems that the prolonged pharmacotherapy with antithyroid drugs, followed by observation after remission of hyperthyroidism, may be an appropriate therapeutic option at least in some children with GD as they can be cured without radical therapy and the potential risks of such treatment....

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Journal Article 2014; 35(5): 393-397 PubMed PMID: 25275264 Citation  Keywords:  Adrenal Cortex Hormones:therapeutic use, Arthralgia:diagnostic imaging, Combined Modality Therapy, Denervation:methods, Female, High-Energy Shock Waves:therapeutic use, Humans, Low Back Pain:diagnostic imaging, Lumbar Vertebrae:diagnostic imaging, Male, M.   

OBJECTIVE: Lumbar facet joints (FJ) is a common source of low back pain and contributes approximmately on one third of chronic low back pain. Medial branch radiofrequency neurotomy is considered as a gold standard in the treatment of facet joint pain. Corticosteroid injections have also presented effect in FJ pain. As an interventional procedures, they carry not-negligible risk of possible complications including infection, damage to nerve root or medial branch structures. Shockwave therapy (SWT) is a non-invasive method for treatment of various musculoskeletal disorders. Its effect is based on transduction of mechanical energy, transferred to cascade of various biochemical processes in target tissue. Its efficacy was proved in the treatment of different painful conditions. The efficacy of SWT was not yet studied in FJ pain. Aim of our work was to compare the efficacy of SWT against interventional treatment procedures - radiofrequency neurotomy and corticosteroid FJ injections.

METHODS: A retrospective study was done on 62 selected patients with unilateral chronic lumbar facet pain. There were 32 women and 30 men, divided into SWT group, corticosteroid injections group radiofrequency group. Nociceptive and neuropathic pain intensity and severity of pain were measured.

RESULTS: Shockwave therapy had shown better longterm results compared to FJ injections group and little inferior efficacy compared to RMBN. We did not observe any adverse effects and complications in SWT group. Moreover, in SWT and RMBN groups, significant longterm improvement in daily activities limitation, was observed.

CONCLUSIONS: SWT appears to be a safe and perspective option in the treatment of FJ pain with negligible side effects....

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Journal Article 2014; 35(5): 405-410 PubMed PMID: 25275263 Citation  Keywords:  Adult, Algorithms, Circadian Rhythm:physiology, Disorders of Excessive Somnolence:diagnosis, Electroencephalography, Epilepsy:complications, Female, Humans, Male, Medical History Taking, Middle Aged, Polysomnography, Prospective Studies, Sleep Stages:phys.   

OBJECTIVES: Authors evaluated quality of sleep and daytime vigilance in patients with nocturnal epilepsy and compared it to those with daytime epilepsy.

BACKGROUND: Nocturnal seizures are an important type of epilepsy. They can result in morbidity due to disruption of sleep architecture. Daytime sleepiness, as a serious consequence of nocturnal seizures, has negative influence on quality of life in patients with epilepsy.

METHODS: Authors examined 100 patients with epilepsy. The occurrence of epileptic seizures in circadian rhythm, type of epilepsy and epileptic seizures, as well as aetiology of epilepsy were evaluated. Patients were divided in two groups, 17 patients with nocturnal epilepsy and 83 patients with epileptic seizures not related to sleep. All of them underwent overnight video-EEG-polysomnography and they filled in the Epworth Sleepiness Scale questionnaire (ESS) as well as The Pittsburgh Sleep Quality Index questionnaire (PSQI).

RESULTS: Overnight video-EEG-polysomnography detected significant changes in the sleep architecture in patients with nocturnal epilepsy. Significant decrease of N3 stage of NREM sleep (14.31%±8.07 in the group of nocturnal epilepsy vs. 20.12%±9.24 in the group of daytime epilepsy, p=0.01). Concurrently, significantly poorer sleep quality according to PSQI (18.52±7.51 in the group of nocturnal epilepsy vs. 6.21±3.62 in the group of daytime epilepsy, p=0.01) and tendency to increased daytime sleepiness according to ESS was revealed in these patients.

CONCLUSION: Remarkable changes in sleep architecture associated with poor quality of sleep and increased daytime sleepiness were detected in patients with nocturnal epilepsy. In conclusion, we emphasize the importance of sleep history taking in patients with epilepsy and their further evaluation in sleep laboratory....

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