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Impact of chlamidia trachomatis infection on chronic pelvic pain
Kříž, Jaroslav Thierry ; Košťál, Milan (advisor) ; Kudela, Milan (referee) ; Bouda, Jiří (referee)
Summary: Impact of Chlamydia trachomatis infection on chronic pelvic pain. The aim of the study was to determine whether women with chronic pelvic pain and Chlamydia infection differ from women with chronic pelvic pain without Chlamydia infection in respect of findings on laparoscopy and sexual behaviour. In a study conducted from April 2006 to December 2009, we monitored a group of 129 female patients suffering from chronic pelvic pain of more than 6 months duration. All monitored patients underwent laparoscopy, and during the procedure, swabs were taken from their Fallopian tubes and cervix, which were immunofluorescensed for the presence of Chlamydia trachomatis antigen. The patients were divided into two groups (Chlamydia positive and Chlamydia negative) according to the presence of Chlamydia antigen. The patients completed questionnaires covering the age at first sexual intercourse, number of lifetime and current sexual partners, frequency of sexual intercourse and the method of contraception. The differences in findings on laparoscopy and questionnaire results of women with positive and negative proof of Chlamydia infection were studied. Fisher's exact test was used for data description and group differences analysis. We observed that 30,2% (n=39) of a cohort of 129 women with chronic pelvic pain were...
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The effects of mid-urethral tape on symptoms of overactive bladder
Hensel, Germund ; Košťál, Milan (advisor) ; Huvar, Ivan (referee) ; Krhut, Jan (referee)
Background: Mid-urethral tape implantation is at present a common procedure for stress urinary incontinence. It is greatly successful with a low degree of complications. A large part of patients suffering from stress urinary incontinence has co-existing symptoms of overactive bladder (OAB), which can improve in a certain manner after placing of the mid-urethral tape. Data in literature about risk factors for persistence of OAB symptoms are not unanimous. Objectives: To determine the influence of mid-urethral tape implantation on the different symptoms of OAB, to determine risk factors for persistence of OAB symptoms after mid- urethral tape implantation. Methods: The study included 111 female patients suffering at the same time from stress urinary incontinence and symptoms of OAB. All of them underwent implantation of mid- urethral transobturator tape. Using micturition diary and two specific questionnaires (ICIQ- OAB and ICIQ-OABqol) we compared the intenzity of OAB symptoms before and after tape implantation. To determine risk factors for persistence of OAB symptoms we used univariate logistic regression, followed by multivariate regression analysis for selected factors. Results: All the four symptoms of OAB - urgency, frequency, nocturia and urgency incontinence - improved statistically...
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Risk factors influencing incidence and seriousness of infection complications after cesarean section
Gregor, Miroslav ; Košťál, Milan (advisor) ; Procházka, Martin (referee) ; Záhumenský, Jozef (referee)
Objective: The aim of this study was to evaluate the incidence of post-cesarean infections at the Department of Gynaecology and Obstetrics at the University Hospital in Hradec Kralove, including spectrum and seriousness of infections. And to identify independent risk factors for infections. In Czech republic, no study have been conducted on post-cesarean infections. Methods: Prospective descriptive clinical study. 357 consecutive women had cesarean section from January to June 2013 (32%). 13 women with the presence of any infection before an operation, and 45 lost women were excluded from the study. A total of 299 women were included in the study. Prophylactic antibiotics were given to all women. Cases of post- cesarean infections were verified by chart review using the definitions from the Center for Disease Control, Atlanta, USA, as an infection occurring within 30 days after a surgical procedure. Comparisons between groups were obtained by Fisher's exact test. Significant association was defined as a p-value of less than 0.05. Results are reported with 95% confidence interval. Results: Of 299 women having cesarean section, 10 women (3,3%) had a post-cesarean infections. Nine women had a surgical site infection and one woman had an urinary tract infection. The incidence of surgical site...
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The effects of mid-urethral tape on symptoms of overactive bladder
Hensel, Germund ; Košťál, Milan (advisor) ; Huvar, Ivan (referee) ; Krhut, Jan (referee)
Background: Mid-urethral tape implantation is at present a common procedure for stress urinary incontinence. It is greatly successful with a low degree of complications. A large part of patients suffering from stress urinary incontinence has co-existing symptoms of overactive bladder (OAB), which can improve in a certain manner after placing of the mid-urethral tape. Data in literature about risk factors for persistence of OAB symptoms are not unanimous. Objectives: To determine the influence of mid-urethral tape implantation on the different symptoms of OAB, to determine risk factors for persistence of OAB symptoms after mid- urethral tape implantation. Methods: The study included 111 female patients suffering at the same time from stress urinary incontinence and symptoms of OAB. All of them underwent implantation of mid- urethral transobturator tape. Using micturition diary and two specific questionnaires (ICIQ- OAB and ICIQ-OABqol) we compared the intenzity of OAB symptoms before and after tape implantation. To determine risk factors for persistence of OAB symptoms we used univariate logistic regression, followed by multivariate regression analysis for selected factors. Results: All the four symptoms of OAB - urgency, frequency, nocturia and urgency incontinence - improved statistically...
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Cerebral venous thrombosis risk factors and JAK2 mutation
Košťál, Milan ; Dulíček, Petr (advisor) ; Doubek, Michael (referee) ; Krčová, Věra (referee)
Cerebral venous thrombosis risk factors and JAK2 mutation Cerebral venous thrombosis is a rare type of cerebrovascular disease. The widespread use of neuroimaging has aided early diagnosis of CVT and its parenchymal complications. Etiology and natural history of CVT differs from DVT mainly due to different pathophysiologic conditions of sinuses. The main objective of this study was to find out prevalence of genetic and acquired thrombophilic factors and prevalence of JAK2 V617F mutation (typical for myeloproliferative diseases) in CVT patients and discover their relation to prognosis and treatment. Next target of our survey was to identify typical symptoms of CVT and to verify significance of clinical indicators (time to diagnosis, type of therapy, recurrence, recanalization, etc.) and laboratory tests (D-dimers, blood count). Minority of the data were collected as retrospective (5 patients from a hospital in Pardubice, 18 patients from the University hospital in Hradec Králové). Majority of study was prospective; all patients with CVT prior to the starting point of survey were re-evaluated in outpatient department during the study. Healthy controls were recruited from Transfusion department of the University hospital in Hradec Králové We enrolled 64 patients and 70 healthy controls. JAK2 mutation was more...
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Changes of lipid metabolism caused by pregnancy
Kokrdová, Zuzana ; Košťál, Milan (advisor) ; Měchurová, Alena (referee) ; Pařízek, Antonín (referee)
As evidenced by recent literature, adverse pregnancy outcomes such as pre-eclampsia, gestational diabetes, preterm delivery, and intrauterine growth restriction are risk factors for maternal metabolic and vascular diseases in later life. The second half of a normal pregnancy is accompanied by glucose intolerance, hyperlipidaemia and an increase in coagulation factors. This physiological response to pregnancy represents a transient excursion into a metabolic syndrome. Approximately 3-4% of all pregnant women are diagnosed with gestational diabetes that usually reverts to normal after delivery. However, gestational diabetes may predict the development of type 2 diabetes later in life. It is not yet known if changes similar to carbohydrate metabolism occur in the lipid metabolism and weather a certain degree of hyperlipidaemia in the last trimester could predict the appearance of an overt non-gestational hyperlipidaemia in the future. Our study describes antepartum and postpartum changes of lipoprotein lipids in 26 healthy pregnant women, 11 women with gestational diabetes, 10 women with type 1 diabetes, and in 9 women with metabolic syndrome in gestation weeks 12, 32 - 34 and 6 and 24 months postpartum. The results are compared to measurements in 30 nonpregnant controls not taking oral contraceptives,...
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Impact of chlamidia trachomatis infection on chronic pelvic pain
Kříž, Jaroslav Thierry ; Košťál, Milan (advisor) ; Kudela, Milan (referee) ; Bouda, Jiří (referee)
Summary: Impact of Chlamydia trachomatis infection on chronic pelvic pain. The aim of the study was to determine whether women with chronic pelvic pain and Chlamydia infection differ from women with chronic pelvic pain without Chlamydia infection in respect of findings on laparoscopy and sexual behaviour. In a study conducted from April 2006 to December 2009, we monitored a group of 129 female patients suffering from chronic pelvic pain of more than 6 months duration. All monitored patients underwent laparoscopy, and during the procedure, swabs were taken from their Fallopian tubes and cervix, which were immunofluorescensed for the presence of Chlamydia trachomatis antigen. The patients were divided into two groups (Chlamydia positive and Chlamydia negative) according to the presence of Chlamydia antigen. The patients completed questionnaires covering the age at first sexual intercourse, number of lifetime and current sexual partners, frequency of sexual intercourse and the method of contraception. The differences in findings on laparoscopy and questionnaire results of women with positive and negative proof of Chlamydia infection were studied. Fisher's exact test was used for data description and group differences analysis. We observed that 30,2% (n=39) of a cohort of 129 women with chronic pelvic pain were...
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