Fakultni nemocnice Hradec Kralove

Hradec Králové, Czech Republic

Fakultni nemocnice Hradec Kralove

Hradec Králové, Czech Republic
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Rusinova K.,Charles University | Kukal J.,Czech Technical University | Simek J.,University of South Bohemia | Cerny V.,Dalhousie University | And 23 more authors.
BMC Psychiatry | Year: 2014

Background: Symptoms of anxiety and depression are common among family members of ICU patients and are culturally dependent. The aim of the study was to assess the prevalence of symptoms of anxiety and depression and associated factors in family members of ICU patients in two Central European countries.Methods: We conducted a prospective multicenter study involving 22 ICUs (250 beds) in the Czech and Slovak Republics. The Hospital Anxiety and Depression Scale (HADS) was used to assess symptoms of anxiety and depression in family members of ICU patients. Family member understanding of the patient's condition was assessed using a structured interview and a questionnaire was used to assess satisfaction with family member/ICU staff communication.Results: Twenty two intensive care units (both adult and pediatric) in academic medical centers and community hospitals participated in the study. During a 6 month period, 405 family members of 293 patients were enrolled. We found a high prevalence of anxiety and depression symptoms - 78% and 54%, respectively. Information leaflets distributed to family members did not lower incidences of anxiety/depression. Family members with symptoms of depression reported higher levels of satisfaction according to the modified Critical Care Family Needs Inventory. Extended contact between staff and family members was the only related factor associated with anxiety reduction (p = 0.001).Conclusion: Family members of ICU patients in East European countries suffer from symptoms of anxiety and depression. We identified limited family member/ICU staff communication as an important health care professional-related factor associated with a higher incidence of symptoms of anxiety. This factor is potentially amenable to improvement and may serve as a target for proactive intervention proactive intervention. © 2014 Rusinová et al.; licensee BioMed Central Ltd.

Nissen S.E.,Cleveland Clinic | Stroes E.,University of Amsterdam | Dent-Acosta R.E.,Amgen Inc. | Rosenson R.S.,Mount Sinai School of Medicine | And 63 more authors.
JAMA - Journal of the American Medical Association | Year: 2016

Importance: Muscle-related statin intolerance is reported by 5%to 20%of patients. Objective: To identify patients with muscle symptoms confirmed by statin rechallenge and compare lipid-lowering efficacy for 2 nonstatin therapies, ezetimibe and evolocumab. Design, Setting, and Participants: Two-stage randomized clinical trial including 511 adult patients with uncontrolled low-density lipoprotein cholesterol (LDL-C) levels and history of intolerance to 2 or more statins enrolled in 2013 and 2014 globally. Phase A used a 24-week crossover procedure with atorvastatin or placebo to identify patients having symptoms only with atorvastatin but not placebo. In phase B, after a 2-week washout, patients were randomized to ezetimibe or evolocumab for 24 weeks. Interventions: Phase A: atorvastatin (20mg) vs placebo. Phase B: randomization 2:1 to subcutaneous evolocumab (420mg monthly) or oral ezetimibe (10mg daily). Main Outcome and Measures: Coprimary end pointswere the mean percent change in LDL-C level from baseline to the mean ofweeks 22 and 24 levels and from baseline toweek 24 levels. Results: Of the 491 patients who entered phase A (mean age, 60.7 [SD, 10.2] years; 246 women [50.1%]; 170 with coronary heart disease [34.6%]; entry mean LDL-C level, 212.3 [SD, 67.9]mg/dL), muscle symptoms occurred in 209 of 491 (42.6%) while taking atorvastatin but not while taking placebo. Of these, 199 entered phase B, along with 19 who proceeded directly to phase B for elevated creatine kinase (N = 218, with 73 randomized to ezetimibe and 145 to evolocumab; entry mean LDL-C level, 219.9 [SD, 72]mg/dL). For the mean ofweeks 22 and 24, LDL-C level with ezetimibe was 183.0 mg/dL; mean percent LDL-C change, -16.7%(95% CI, -20.5% to -12.9%), absolute change, -31.0 mg/dL and with evolocumab was 103.6 mg/dL; mean percent change, -54.5%(95% CI, -57.2% to -51.8%); absolute change, -106.8 mg/dL (P < .001). LDL-C level at week 24 with ezetimibe was 181.5 mg/dL; mean percent change, -16.7% (95% CI, -20.8% to -12.5%); absolute change, -31.2 mg/dL and with evolocumab was 104.1 mg/dL; mean percent change, -52.8% (95% CI, -55.8% to -49.8%); absolute change, -102.9 mg/dL (P < .001). For the mean of weeks 22 and 24, between-group difference in LDL-C was -37.8%; absolute difference, -75.8mg/dL. For week 24, between-group difference in LDL-C was -36.1%; absolute difference, -71.7 mg/dL. Muscle symptomswere reported in 28.8% of ezetimibe-treated patients and 20.7% of evolocumab-treated patients (log-rank P = .17). Active study drugwas stopped for muscle symptoms in 5 of 73 ezetimibe-treated patients (6.8%) and 1 of 145 evolocumab-treated patients (0.7%). Conclusions and Relevance: Among patients with statin intolerance related to muscle-related adverse effects, the use of evolocumab compared with ezetimibe resulted in a significantly greater reduction in LDL-C levels after 24 weeks. Further studies are needed to assess long-term efficacy and safety. Copyright © 2016 American Medical Association. All rights reserved.

Marecek A.,Fakultni nemocnice Hradec Kralove | Vanaskova E.,Fakultni nemocnice Hradec Kralove | Vanaskova E.,Charles University | Vechtova B.,Fakultni nemocnice Hradec Kralove | Vechtova B.,Charles University
Rehabilitacia | Year: 2013

Extremity amputation is a treatment for disease complications, sequelae traumas congenital predispositions that brings many patients to the orthopaedic-prosthetic department of the University Hospital in Hradec Králové. The professional team in the department help patients to come to terms with their physical alteration and fully or partially return to their ordinary daily routine through prosthetic AIDS and physiotherapy.

Soukup T.,Charles University | Buchta V.,Charles University | Kriz Zanova R.,Charles University | Veleta T.,Fakultni Nemocnice Hradec Kralove | And 2 more authors.
Ceska Revmatologie | Year: 2015

Rheumatoid arthritis (RA) is a chronic inflammatory systemic disease, which in its essence and treatment leads to a higher incidence of infections. We describe a rare case of a 63-year-old male patient with many years of history of RA (treated with corticosteroids and conventional synthetic disease-modifying antirheumatic drugs), who developed subcutaneous and joint infection caused by fungus Scedosporium apiospermum (perfect stage Pseudallescheria boydii) after fifteen years of RA. Fungal agent from indolent subcutaneous lesions on his left forearm and right arm was found on microscopic and microbiological examination. The patient subsequently underwent a six-month cyclical treatment with voriconazole, which was alternated several times with itraconazole and terbinafine. After several cycles of six-month treatment, usually after about a year, a relapse occurred with repeated manifestation in the subcutaneous tissue and finally per continuitatem even in the joint. After seven years of repeated outbreaks of fungal infection the patient dies of a sudden death with a clinical picture of thrombo-embolic disease. Autopsy results did not show active infection or overt infectious focus. Scedosporium apiospermum is fibrous, saprophytic fungus with relatively low virulence that is ubiquitously present in the environment, including soil and aquatic ecosystems. It is one of the typical causes of subcutaneous mycoses, the presence of which is largely tied to the subtropical region. In case of an immunosuppressed patient, infection by S. apiospermum may develop into severe systemic infection. Clinical observation completes the set of possible infectious complications in patients with RA.

Kraliakova P.,Fakultni Nemocnice Hradec Kralove | Krejsek J.,Fakultni Nemocnice Hradec Kralove | Krcmova I.,Fakultni Nemocnice Hradec Kralove
Prakticky Lekar | Year: 2011

The incidence of cancer increased substantially during the 20th century. Cancer is the second leading cause of mortality in developed countries. Partially effective therapeutic approaches and medicamentous treatments: - irradiation, - chemotherapy, and - later biological therapy were developed in the second half of the last century to help combat this cancer epidemic. We review the efficacy of biological therapy based on cell-mediated immunity (BCG vaccination, cancer vaccination, adoptive immunotherapy). The aim of biological therapy is to optimally target the tumorigenesis process and to reverse it with minimal side effects.

Bolehovska R.,Fakultni Nemocnice Hradec Kralove | Pliskova L.,Fakultni Nemocnice Hradec Kralove | Friedecky B.,Fakultni Nemocnice Hradec Kralove | Palicka V.,Fakultni Nemocnice Hradec Kralove
Klinicka Biochemie a Metabolismus | Year: 2010

External quality control (EQC) in molecular biology of extrahuman genome is subsequently introduced and processes of standardization and sequence often fall short of possibility and needs of modern investigative procedures. However, in molecular biology there are no available reference methods and materials and that is why it is not possible to investigate with sequence of methods. Nevertheless every laboratory tries to make right and exact results. Basic aid of this endeavour is EQC, which is supported on international level by QCMD and INSTAND e.V., and within the Czech Republic some of National reference laboratories. EQC provides to laboratories the possibility of correctness and accuracy verification of results and comparison with results of other participated laboratories. Further EQC determines or verifies sensitivity of method. Every laboratory should have in detail and thoroughly reviewed the results of EQC and in case of the mistakes responds by adjustments or changes in PCR method. EQC is able to inspire the laboratory to creation of similar control systems for internal quality control. However, the part of EQC is not the verification of post-analytical phase and clinical interpretation. This phase is provided individually by each laboratory to the best of possibility and knowledge with very variable level.

Boudysova M.,Fakultni Nemocnice Hradec Kralove | Ettler K.,Fakultni Nemocnice Hradec Kralove | Podhola M.,Fakultni Nemocnice Hradec Kralove | Simkova M.,Fakultni Nemocnice Hradec Kralove
Casopis Lekaru Ceskych | Year: 2012

Sweet syndrome also termed acute febrile neutrophilic dermatosis is characterized by the abrupt onset of fever, leukocytosis and demarcated papules and nodules, which show dense neutrophilic infiltrates in histopathology. This syndrome is often associated with malignant and immunological conditions. Treatment with systemic glucocorticoids is successful. In the following we describe a case of a 66 year-old woman patient, who had skin problems after being reoperated for umbilical hernia.

Feuermannova A.,Fakultni nemocnice Hradec Kralove
Interni Medicina pro Praxi | Year: 2012

Ocular allergy is inflammatory response of anterior segment of the eye. Allergic disease includes seasonal allergic conjunctivitis (SAC), perennial allergic conjunctivitis (PAC), gigant papillary conjunctivitis (GPC) vernal keratoconjunctivitis (VKC), atopic keratoconjunctivitis (AKC) and contact allergy (CA). There is a summary of various diagnosis and possibilities of the treatment in this article.

Fever is part of the normal inflammatory response and most frequently occurs in response to infection. It is also often seen after vaccination, particularly in children following immunisation with diphtheria-tetanus- pertussis (DTP), measles and pneumococcal conjugate vaccines. Prophylactic paracetamol administered during the first 24 hours significantly reduced febrile reactions reported within 4 days of vaccination but had no effect on the occurrence of fever >39.5°C. However at same time GMCs and GMTs for a number of the vaccine antigens were reduced in the group receiving prophylactic paracetamol compared to those not receiving paracetamol. Due to a lack of clinical benefit and potential reduction in response to vaccination, prophylactic administration of antipyretics should not be routinely recommended unless medically justified.

PubMed | Fakultni nemocnice Hradec Kralove
Type: Case Reports | Journal: Casopis lekaru ceskych | Year: 2012

Sweet syndrome also termed acute febrile neutrophilic dermatosis is characterized by the abrupt onset of fever, leukocytosis and demarcated papules and nodules, which show dense neutrophilic infiltrates in histopathology. This syndrome is often associated with malignant and immunological conditions. Treatment with systemic glucocorticoids is successful. In the following we describe a case of a 66 year-old woman patient, who had skin problems after being reoperated for umbilical hernia.

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