|
|
Risk factors of malignant melanoma, its possibilities of prevention and early diagnosis
Kulichová, Daniela ; Čelko, Alexander (advisor) ; Rosina, Jozef (referee) ; Dohnal, Karel (referee)
Background Ultraviolet radiation is one of the most important environmental risk factors for cutaneous melanoma. Nonetheless, information concerning ultraviolet exposure in many populations, including the central European population, is lacking. Objectives The aim of our study was to investigate risk factors for malignant melanoma, particularly those related to ultraviolet exposure behavior in two European neighboring countries, Germany and the Czech Republic. Methods We conducted a hospital-based case-control study. 224 consecutive patients were diagnosed with melanoma in two dermatological clinics (Prague and Munich). Controls were 268 patients with other conditions from the same hospitals. All subjects completed a questionnaire on socio-demographic data and factors related to ultraviolet exposure. Associations between melanoma, ultraviolet exposure and other variables were assessed by multivariate logistic regression. Results Patients with red hair had higher risk of developing melanoma than those with other hair color (odds ratio 3.597, 95% confidence interval 1.341-9.646). A similar trend was seen when comparing phototypes; subjects with phototype I and II had a higher likelihood of melanoma than those with phototype III (OR 4.028 and 4.837, 95%CI 1.929-8.411 and 2.574- 9.086). Frequent...
|
|
|
A comparison of various systems of urgent care and their future directions
Pokorný, Jiří ; Čelko, Alexander (advisor) ; Kalvach, Pavel (referee) ; Špunda, Jan (referee)
While a relatively young field of medicine, emergency care (EC) has recently witnessed dramatic advances which will definitely continue. At present, there are 2 main systems of EC provision, the Anglo-American and the Franco-German ones. Both systems have their indisputable advantages; however, they are also fraught with major drawbacks. Given my long-term personal experience with emergency medical service as well as my appointments in hospital resuscitation wards, emergency departments, and operating theaters, I am convinced there is still considerable room for improvement in the organization of pre- and in-hospital EC in our country. To develop this thesis, I have collected as much as possible information about the organization of EC in various countries of the world and in the CR. Based on my knowledge and data from the above sources and, also, using my long-standing experience, I have evaluated and compared individual EC systems assessing both their advantages and disadvantages. The analysis has shown that the system of EC should meet both the geopolitical and economic status of the country involved, and the standard of currently available therapeutic options. The outcome of my study is a proposal to modify the system of EC in the CR. It should be an adaptable system, with its main advantage being it...
|
|
| |
|
| |
|
| |
|
|
Factors with negative impact on functional outcome and mortality in elderly pati ens treated surgically for proximal femoral fracture: their identification and r elevance for prevention
Kopp, Lubomír ; Čelko, Alexander (advisor) ; Janout, Vladimír (referee) ; Jahoda, David (referee)
AIM: Increase in one-year mortality following proximal femoral fractures in elderly patients was seen in many studies. Identification of factors increasing the risk of mortality is decisive for prognosis of these patients. Our aim was to identify significance of single factors on shortening of survival time and worsening of functional outcome. We have dominantly concentrated on influence of pressure sores and impairment of cognitive functions. METHODS: In a prospective consecutive manner, we have observed 275 patients treated in our department in period from January 2003 to June 2005. We have observed altogether 25 prehospitalisation, hospitalisation and posthospitalisation factors. Using statistical tests (log-rank, Mann-Whitney, logistic regression), we have analysed relationship between length of survival and different observed factors on a 5 % level of significance. RESULTS: In our study, we have identified factors significantly shortening survival time. These were: age, male sex, comorbidities, decreased mobility before injury, acute general complications, development of pressure sores after surgery, insufficiency of osteosynthesis requiring revision surgery, deep wound infection and low ADL and MMSE scores. CONCLUSION: Our study has identified simple predictors of poor functional outcome and...
|
|
|
New Surgical Techniques to Prevent Serious Permanent Disability of Proximal Hume ral Fractures
Edelmann, Karel ; Čelko, Alexander (advisor) ; Janout, Vladimír (referee) ; Landor, Ivan (referee)
NEW SURGICAL TECHNIQUES TO PREVENT SERIOUS PERMANENT DISABILITY OF PROXIMAL HUMERAL FRACTURES AIM: Fractures of the proximal humerus are the third most common fracture in adults. In the treatment of displaced three-and four-part fractures in the last decade we have witnessed the advent of new angular stable implants, which have better biomechanical stability in osteoporotic bone in these patients very frequent. The purpose of this study was to determine whether these new implants are a better prevention of severe permanent disability, compared with the earlier technique of percutaneous pinning with K wires. METHOD: The detailed analysis for publishing rich area of research literature on treatment history, epidemiology and prevention of proximal humerus fractures was accomplished. Medium-term results were evaluated in a prospective randomized study of 55 patients treated with angular stable implants with an average age of 62.1 years (Targon PH nail 32 patients, Philos plate 23 patients). For comparison was used a group of 9 patients treated with percutaneous K wire fixation, combined monitored prospectively and retrospectively. With a minimal follow up of 12 months in all patients was determined the final individual relative Constant score and DASH score. For patients in the sample were obtained...
|
|
| |
|
|
Trends of distribution of tick-borne encephatlits in period 2000 - 2010 in district Pardubice
Macounová, Dana ; Dáňová, Jana (advisor) ; Čelko, Alexander (referee)
- Summary The bachelor thesis deals with the tick-borne encephalitis transmitted to humans by a tick and its distribution in the Czech Republic and the Pardubice region in the period 2000 - 2010. The work is divided into two parts. First - the theoretical part of thesis summarizes the general knowledge on tick-borne encephalitis, its characteristics, occurrence, history, prevention, diagnosis as well as treatment of various forms of disability according to the development of disease. At the same time there is also described the tick as the vector of the disease, its development cycle and method of attachment to humans as the host. For the purposes of prevention of tick-borne encephalitis, this section also describes the conditions of increased tick activity, there are given recommendations of prevention and protection, and the correct procedure for removing the parasite. The second - the practical part of the thesis includes the analysis and interpretation of epidemiological data on tick-borne encephalitis in the years 2000 - 2010 obtained from the system EPIDAT (countrywide information and monitoring system of infectious diseases). The obtained data were evaluated, focusing on the comparison of incidence of tick-borne encephalitis in the Czech Republic and in the Pardubice region and its...
|
|
| |
guest ::
RSS feed.