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Hrabovsky V, Skrobankova M, Lys Z, Vrtkova A, Spacilova V, Vaclavik J. Point-of-care ultrasound (POCUS) in acute hospitalized older patients focused on hydration. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2023. [PMID: 37799003 DOI: 10.5507/bp.2023.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND Acutely ill older patients frequently suffer not only from their acute disease, but also polymorbidity and frailty. Dehydration is another typical symptom, usually occurring in its both forms: low-intake dehydration and volume depletion. POCUS is goal-directed bedside ultrasound examination and several studies refer to its positive impact on hydration assessment. The aim of our study was to determine whether POCUS might influence (de)hydration diagnostics and/or treatments in older patients with acute illness. METHODS We randomized 120 acutely ill patients, aged ≥65 years, into POCUS and non-POCUS groups. All participants underwent routine laboratory tests, including haematocrit, serum and urine osmolality, blood urea nitrogen (BUN), creatinine, BUN/creatinine ratio, and C-reactive protein (CRP). POCUS was performed twice during the first two days to determine chest and abdominal status, with inferior vena cava (IVC) measurements. Length of hospital stay (HL) and consumption of infused fluids (CIF) was evaluated too. Data were analysed with exploratory methods and appropriate statistics. RESULTS Among all participants, the serum osmolality significantly correlated with age, BUN, creatinine and CIF. HL correlated with CRP and CIF. No significant correlations between IVC and other followed parameters were found. The POCUS group consumed significantly less infused fluids than the non-POCUS group, what could be influenced by POCUS examination of defined body compartments. CONCLUSION Dehydration is a common feature in older individuals and its diagnostics is rather complicated. The role of POCUS in assessing hydration status remains unclear. However, our study showed, that ultrasound assessment provides next important information for comprehensive understanding of clinical status in older patients and can be beneficial for optimizing the treatment strategy, including fluid management decisions.
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Affiliation(s)
- Vladimir Hrabovsky
- Department of Internal Medicine, University Hospital Ostrava, Czech Republic
- Faculty of Medicine, University of Ostrava, Czech Republic
| | - Martina Skrobankova
- Department of Internal Medicine, University Hospital Ostrava, Czech Republic
- Faculty of Medicine, University of Ostrava, Czech Republic
| | - Zdenek Lys
- Department of Internal Medicine, University Hospital Ostrava, Czech Republic
- Faculty of Medicine, University of Ostrava, Czech Republic
| | - Adela Vrtkova
- Department of Deputy Director of Science and Research, University Hospital Ostrava, Ostrava, Czech Republic
- Department of Applied Mathematics, Faculty of Electrical Engineering and Computer Science, VSB - Technical University of Ostrava, Czech Republic
| | - Veronika Spacilova
- Department of Internal Medicine, University Hospital Ostrava, Czech Republic
- Faculty of Medicine, University of Ostrava, Czech Republic
| | - Jan Vaclavik
- Department of Internal Medicine, University Hospital Ostrava, Czech Republic
- Faculty of Medicine, University of Ostrava, Czech Republic
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Rysankova K, Hanzlikova P, Zidlik V, Vrtkova A, Slisarenko M, Skarda J, Grepl M, Krhut J. Is high accuracy of Vesical Imaging-Reporting and Data System (VI-RADS) sufficient for its implementation in the urological practice? Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2023; 167:85-90. [PMID: 36628563 DOI: 10.5507/bp.2022.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 12/14/2022] [Indexed: 01/12/2023] Open
Abstract
AIMS Currently, the only method used to differentiate between MIBC and NMIBC is transurethral resection of the bladder tumour (TURBT). Magnetic resonance and Vesical Imaging-Reporting and Data System (VI-RADS) would allow for discrimination between NMIBC and MIBC. We evaluate the sensitivity and specificity of VI-RADS in the diagnosis of muscle-invasive bladder cancer and discuss its value in everyday urological practice. METHODS 64 patients with bladder cancer (BC) were enrolled into this prospective study. Multiparametric magnetic resonance imaging (mpMRI) was performed before transurethral resection of the bladder tumour (TURBT) and evaluated using the VI-RADS score. Score were compared to histopathology results. We evaluated the sensitivity, specificity, positive and negative predictive value of this system using both cut-off VI-RADS ≥ 3 and ≥ 4. RESULTS Sensitivity of 92.3% (95%CI: 64.0; 99.8), specificity of 81.4% (95%CI: 69.1; 90.3), positive predictive value of 52.2% (95%CI: 30.6; 73.2) and negative predictive value of 98.0% (95%CI: 89.1; 99.9) was determined using cut off VI-RADS ≥ 3, while sensitivity of 76.9% (95%CI: 46.2; 95.0), specificity of 91.5% (95%CI: 81.3; 97.2), positive predictive value of 66.7% (95%CI: 38.4; 88.2), and negative predictive value of 94.7% (95%CI: 85.4; 98.9) was determined using cut-off VI-RADS ≥ 4. Based on our results, we consider the optimal cut-off point to be VI-RADS ≥ 3 with the overall prediction accuracy of 83.3% (95%CI: 72.7; 91.1). CONCLUSIONS We acknowledge that mpMRI provides valuable information with regard to BC staging, however, despite its high overall accuracy, we do not consider the VI-RADS could replace TURBT in discrimination between non-muscle invasive and MIBC.
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Affiliation(s)
- Katerina Rysankova
- Department of Urology, University Hospital Ostrava, Czech Republic.,Department of Surgical Studies, Faculty of Medicine, University of Ostrava, Czech Republic
| | - Pavla Hanzlikova
- Department of Radiology, University Hospital Ostrava, Czech Republic.,Department of Imaging Methods, Faculty of Medicine, University of Ostrava, Czech Republic
| | - Vladimir Zidlik
- Department of Pathology, University Hospital Ostrava, Czech Republic.,Department of Molecular and Clinical Pathology and Medical Genetics, Faculty of Medicine, University of Ostrava, Czech Republic
| | - Adela Vrtkova
- Department of Applied Mathematics, Faculty of Electrical Engineering and Computer Science, VSB - Technical University Ostrava, Czech Republic.,Department of Deputy Director for Science and Research, University Hospital Ostrava, Czech Republic
| | - Maryna Slisarenko
- Department of Pathology, Faculty of Medicine in Pilzen, Charles University, Pilzen, Czech Republic
| | - Jozef Skarda
- Department of Pathology, University Hospital Ostrava, Czech Republic.,Department of Molecular and Clinical Pathology and Medical Genetics, Faculty of Medicine, University of Ostrava, Czech Republic
| | - Michal Grepl
- Department of Urology, University Hospital Ostrava, Czech Republic.,Department of Surgical Studies, Faculty of Medicine, University of Ostrava, Czech Republic
| | - Jan Krhut
- Department of Urology, University Hospital Ostrava, Czech Republic.,Department of Surgical Studies, Faculty of Medicine, University of Ostrava, Czech Republic
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Harach T, Simonik P, Vrtkova A, Mrovec T, Klein T, Ligori JJ, Koreny M. Novel Method for Determining Internal Combustion Engine Dysfunctions on Platform as a Service. Sensors (Basel) 2023; 23:477. [PMID: 36617078 PMCID: PMC9824704 DOI: 10.3390/s23010477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 12/23/2022] [Accepted: 12/27/2022] [Indexed: 06/17/2023]
Abstract
This article deals with a unique, new powertrain diagnostics platform at the level of a large number of EU25 inspection stations. Implemented method uses emission measurement data and additional data from significant sample of vehicles. An original technique using machine learning that uses 9 static testing points (defined by constant engine load and constant engine speed), volume of engine combustion chamber, EURO emission standard category, engine condition state coefficient and actual mileage is applied. An example for dysfunction detection using exhaust emission analyses is described in detail. The test setup is also described, along with the procedure for data collection using a Mindsphere cloud data processing platform. Mindsphere is a core of the new Platform as a Service (Paas) for data processing from multiple testing facilities. An evaluation on a fleet level which used quantile regression method is implemented. In this phase of the research, real data was used, as well as data defined on the basis of knowledge of the manifestation of internal combustion engine defects. As a result of the application of the platform and the evaluation method, it is possible to classify combustion engine dysfunctions. These are defects that cannot be detected by self-diagnostic procedures for cars up to the EURO 6 level.
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Affiliation(s)
- Tomas Harach
- Department of Electronics, Faculty of Electrical Engineering and Computer Science, VSB–Technical University of Ostrava, 17. listopadu 15/2172, 708 00 Ostrava-Poruba, Czech Republic
| | - Petr Simonik
- Department of Electronics, Faculty of Electrical Engineering and Computer Science, VSB–Technical University of Ostrava, 17. listopadu 15/2172, 708 00 Ostrava-Poruba, Czech Republic
| | - Adela Vrtkova
- Department of Applied Mathematics, Faculty of Electrical Engineering and Computer Science, VSB–Technical University of Ostrava, 17. listopadu 15/2172, 708 00 Ostrava-Poruba, Czech Republic
| | - Tomas Mrovec
- Department of Electronics, Faculty of Electrical Engineering and Computer Science, VSB–Technical University of Ostrava, 17. listopadu 15/2172, 708 00 Ostrava-Poruba, Czech Republic
| | - Tomas Klein
- Department of Electronics, Faculty of Electrical Engineering and Computer Science, VSB–Technical University of Ostrava, 17. listopadu 15/2172, 708 00 Ostrava-Poruba, Czech Republic
| | - Joy Jason Ligori
- Department of Electronics, Faculty of Electrical Engineering and Computer Science, VSB–Technical University of Ostrava, 17. listopadu 15/2172, 708 00 Ostrava-Poruba, Czech Republic
| | - Martin Koreny
- Development Rear Lighting Electronics, HELLA AUTOTECHNIK NOVA, s.r.o., Druzstevni 338/16, 789 85 Mohelnice, Czech Republic
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Rysankova K, Vrtkova A, Viktoria MG, Vesela A, Krhut J. Risk of genitourinary malignancy in patients that receive anticoagulant or antiplatelet therapy. BRATISL MED J 2023; 124:738-741. [PMID: 37789788 DOI: 10.4149/bll_2023_112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
OBJECTIVES Haematuria is a common indication for a urology evaluation. In many cases, its cause is not determined unequivocally, but it does not pose any threat to the patient. However, it can represent the first symptom of urinary tract cancer. BACKGROUND The present study aimed to compare the risk of urological malignancies in patients with haematuria who received antiplatelet or anticoagulant therapy versus those who did not. METHODS This prospective study included 562 patients with haematuria during the period of 2018‒2021. Among these, 129 patients had macroscopic haematuria. All patients underwent a urinary tract ultrasound, CT with urography, and cystoscopy. Patients with suspected malignancy underwent an appropriate surgical procedure with a pathology examination. Data were analysed with univariate and multiple logistic regression. RESULTS The incidence rates of malignancies were 21.5 % overall, and 44.2 % and 14.8 % among patients with macroscopic and microscopic haematuria, respectively. Univariate regression showed that the odds of malignancy was significantly higher among patients with antiplatelet therapy compared to patients without antiplatelet therapy (OR: 1.88, 95% CI: 1.14‒3.05). In contrast, anticoagulation therapy did not significantly increase the odds of malignancy compared to no anticoagulation therapy (OR: 1.45, 95% CI: 0.74‒2.69). However, a multiple logistic regression model that included other known risk factors (e.g., sex or age) showed similar odds of malignancy among these patient groups. CONCLUSIONS Malignancy risk for patients who received anticoagulant or antiplatelet therapy was similar to the risk observed in the general population. Antiplatelet and anticoagulant therapy were not significant risk factors of urological malignancy in patients with haematuria. The results from the present study will be used in a power analysis for an upcoming multicentre study (Tab. 4, Ref. 17). Text in PDF www.elis.sk Keywords: anticoagulation therapy, antiplatelet therapy, cancer, haematuria, risk factor.
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Demel J, Planka L, Stichhauer R, Vrtkova A, Bajor G, Havlicek M, Pleva L. 5th Metatarsal Jones Fracture - To Treat Conservatively, or Surgically Using Headless Double-Threaded Herbert Screw? Acta Chir Orthop Traumatol Cech 2023; 90:53-58. [PMID: 36907584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/14/2023]
Abstract
PURPOSE OF THE STUDY Fifth metatarsal fractures, in particular so-called Jones fractures, are relatively common injuries both in the general population and athletes. Although discussions about whether the surgical or conservative solution should be preferred are ongoing for decades, there is no clear consensus. Here, we aimed to prospectively compare the results of osteosynthesis using the Herbert screw with the conservative solution in patients from our department. MATERIAL AND METHODS Patients 18-50 years presenting to our department with Jones fracture and meeting further inclusion/exclusion criteria were offered participation in the study. Those willing to participate signed informed consent and were randomized by flipping the coin into surgically and conservatively treated groups. After six and twelve weeks, X-ray was performed in each patient and AOFAS score was determined. Conservatively treated patients who showed no signs of healing and whose AOFAS was below 80 after six weeks were offered surgery again. RESULTS Of 24 patients in total, 15 were assigned to the surgically treated group and nine were treated conservatively. After six weeks, AOFAS score of all but two patients (86%) in the surgically treated group ranged between 97 and 100, while this score exceeded 90 points only in three patients (33%) from the conservatively treated group. On X-ray, successful healing after six weeks was observed in seven patients (47%) from the surgically treated group but in none of the patients from the conservatively treated group. Three out of five patients in the conservative group whose AOFAS was below 80 after six weeks opted for surgery at that time and all improved significantly by the twelfth week. DISCUSSION Although studies on surgical treatment of Jones fracture using various screws or plates are not rare, we present an uncommon method of surgical treatment of this injury - the use of the Herbert screw. The results of this method are excellent and even on a relatively small sample yielded statistically significantly better results than conservative treatment. Moreover, the surgical treatment facilitated early loading of the injured limb, which allows an earlier return of the patients to normal life. CONCLUSIONS Osteosynthesis using Herbert screw in Jones fracture yielded significantly better results than conservative treatment. Key words: Jones fracture, AOFAS, Herbert screw, 5th metatarsal fracture, surgical treatment.
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Affiliation(s)
- J Demel
- Department of Trauma Surgery, University Hospital Ostrava, Czech Republic
- Department of Disaster Medicine, Faculty of Medicine, University of Ostrava, Czech Republic
- Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - L Planka
- Department of Pediatric Surgery, Orthopedics and Trauma Surgery, University Hospital Brno Czech Republic
| | - R Stichhauer
- Department of Pediatric Surgery and Trauma Surgery, University Hospital Hradec Králové Czech Republic
| | - A Vrtkova
- Department of Applied Mathematics, Faculty of Electrical Engineering and Computer Science, VSB - Technical University of Ostrava, Ostrava, Czech Republic
- University Hospital Ostrava, Department of the Deputy Director for Science, Research and Education, Ostrava, Czech Republic
| | - G Bajor
- Department of Human Anatomy, Faculty of Medical Science in Katowice, Medical University in Katowice, Katowice, Poland
- Department of Anatomy, Faculty of Medicine, University of Ostrava, Czech Republic
| | - M Havlicek
- MEDIN, a.s., Nové Město na Moravě, Czech Republic
| | - L Pleva
- Department of Trauma Surgery, University Hospital Ostrava, Czech Republic
- Department of Disaster Medicine, Faculty of Medicine, University of Ostrava, Czech Republic
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Cubík J, Kepak S, Wiedermannova H, Vrtkova A, Burckova H, Zarubova P, Fernandez C, Pavlicek J, Jargus J, Vasinek V. Measuring respiratory and heart rate using a fiber optic interferometer: A pilot study in a neonate model. Front Pediatr 2022; 10:957835. [PMID: 36545663 PMCID: PMC9760927 DOI: 10.3389/fped.2022.957835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 11/07/2022] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION The study aim was to test the safety and efficacy of a pad with optic fibers developed for monitoring newborn respiratory rate (RR) and heart rate (HR). METHODS Thirty New Zealand White rabbits were included, divided by weight into three groups. RR and HR were measured using two methods for each rabbit: ECG electrodes as the reference method and a newly developed pad with an experimental fiber optic system (EFOS) as the experimental method. RESULTS Analysis was performed on data for 29 rabbits (10 female, 34%; 19 male, 66%). EFOS performed better at measuring RR compared with HR. RR values did not differ significantly between the methods for the whole group (p = 0.151) or within each sex (female: p > 0.999; male: p = 0.075). Values for HR, however, did differ between methods for the whole group of animals (p < 0.001) and also within groups by sex (female: p < 0.001; male: p = 0.006). CONCLUSION The results of this preclinical study demonstrate the potential of this non-invasive method using a fiber optic pad to measure HR and RR.
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Affiliation(s)
- Jakub Cubík
- Department of Telecommunications, Faculty of Electrical Engineering and Computer Science, VSB-Technical University of Ostrava, Ostrava, Czech Republic
| | - Stanislav Kepak
- Department of Telecommunications, Faculty of Electrical Engineering and Computer Science, VSB-Technical University of Ostrava, Ostrava, Czech Republic
| | - Hana Wiedermannova
- Department of Neonatology, University Hospital Ostrava, Ostrava, Czech Republic.,Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
| | - Adela Vrtkova
- Department of Applied Mathematics, Faculty of Electrical Engineering and Computer Science, VSB-Technical University of Ostrava, Ostrava, Czech Republic.,Department of the Deputy Director for Science, Research, and Education, University Hospital Ostrava, Ostrava, Czech Republic
| | - Hana Burckova
- Department of Neonatology, University Hospital Ostrava, Ostrava, Czech Republic
| | - Pavla Zarubova
- Department of Neonatology, University Hospital Ostrava, Ostrava, Czech Republic
| | - Carlos Fernandez
- Centre for Cardiovascular Research and Development, American Heart Poland Inc, Kostkowice, Poland
| | - Jan Pavlicek
- Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic.,Department of Pediatrics and Prenatal Cardiology, University Hospital Ostrava, Ostrava, Czech Republic.,Biomedical Research Center, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
| | - Jan Jargus
- Department of Telecommunications, Faculty of Electrical Engineering and Computer Science, VSB-Technical University of Ostrava, Ostrava, Czech Republic
| | - Vladimir Vasinek
- Department of Telecommunications, Faculty of Electrical Engineering and Computer Science, VSB-Technical University of Ostrava, Ostrava, Czech Republic
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Machaczka O, Jirik V, Brezinova V, Vrtkova A, Miturova H, Riedlova P, Dalecka A, Hermanova B, Slachtova H, Siemiatkowski G, Osrodka L, Sram RJ. Evaluation of Fine and Ultrafine Particles Proportion in Airborne Dust in an Industrial Area. Int J Environ Res Public Health 2021; 18:ijerph18178915. [PMID: 34501505 PMCID: PMC8431044 DOI: 10.3390/ijerph18178915] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 08/16/2021] [Accepted: 08/20/2021] [Indexed: 11/16/2022]
Abstract
The health impacts of suspended particulate matter (SPM) are significantly associated with size-the smaller the aerosol particles, the stronger the biological effect. Quantitative evaluation of fine and ultrafine particles (FP and UFP) is, therefore, an integral part of ongoing epidemiological studies. The mass concentrations of SPM fractions (especially PM2.5, PM1.0, PM0.25) were measured in an industrial area using cascade personal samplers and a gravimetric method, and their mass ratio was determined. The results of PM2.5, PM1.0 were also compared with the reference measurement at stationary stations. The mean ratios PM2.5/SPM, PM1.0/SPM, and PM1.0/PM2.5 were 0.76, 0.65, and 0.86, respectively. Surprisingly, a mass dominance of UFP with an aerodynamic diameter <0.25 μm (PM0.25) was found with mean ratios of 0.43, 0.57, 0.67 in SPM, PM2.5 and PM1.0. The method used showed satisfactory agreement in comparison with reference measurements. The respirable fraction may consist predominantly of UFP. Despite the measures currently being taken to improve air quality, the most biologically efficient UFP can escape and remain in the air. UFP are currently determined primarily as particle number as opposed to the mass concentration used for conventional fractions. This complicates their mutual comparison and determination of individual fraction ratios.
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Affiliation(s)
- Ondrej Machaczka
- Centre for Epidemiological Research, Faculty of Medicine, University of Ostrava, 703 00 Ostrava, Czech Republic; (O.M.); (V.B.); (A.V.); (P.R.); (A.D.); (B.H.); (H.S.); (R.J.S.)
- Department of Epidemiology and Public Health, Faculty of Medicine, University of Ostrava, 703 00 Ostrava, Czech Republic
| | - Vitezslav Jirik
- Centre for Epidemiological Research, Faculty of Medicine, University of Ostrava, 703 00 Ostrava, Czech Republic; (O.M.); (V.B.); (A.V.); (P.R.); (A.D.); (B.H.); (H.S.); (R.J.S.)
- Department of Epidemiology and Public Health, Faculty of Medicine, University of Ostrava, 703 00 Ostrava, Czech Republic
- Correspondence: ; Tel.: +420-553-46-1796
| | - Viera Brezinova
- Centre for Epidemiological Research, Faculty of Medicine, University of Ostrava, 703 00 Ostrava, Czech Republic; (O.M.); (V.B.); (A.V.); (P.R.); (A.D.); (B.H.); (H.S.); (R.J.S.)
| | - Adela Vrtkova
- Centre for Epidemiological Research, Faculty of Medicine, University of Ostrava, 703 00 Ostrava, Czech Republic; (O.M.); (V.B.); (A.V.); (P.R.); (A.D.); (B.H.); (H.S.); (R.J.S.)
- Department of Applied Mathematics, Faculty of Electrical Engineering and Computer Science, VSB—Technical University of Ostrava, 708 00 Ostrava, Czech Republic
| | - Hana Miturova
- Institute of Public Health in Ostrava, 702 000 Ostrava, Czech Republic;
| | - Petra Riedlova
- Centre for Epidemiological Research, Faculty of Medicine, University of Ostrava, 703 00 Ostrava, Czech Republic; (O.M.); (V.B.); (A.V.); (P.R.); (A.D.); (B.H.); (H.S.); (R.J.S.)
- Department of Epidemiology and Public Health, Faculty of Medicine, University of Ostrava, 703 00 Ostrava, Czech Republic
| | - Andrea Dalecka
- Centre for Epidemiological Research, Faculty of Medicine, University of Ostrava, 703 00 Ostrava, Czech Republic; (O.M.); (V.B.); (A.V.); (P.R.); (A.D.); (B.H.); (H.S.); (R.J.S.)
- Department of Epidemiology and Public Health, Faculty of Medicine, University of Ostrava, 703 00 Ostrava, Czech Republic
| | - Barbara Hermanova
- Centre for Epidemiological Research, Faculty of Medicine, University of Ostrava, 703 00 Ostrava, Czech Republic; (O.M.); (V.B.); (A.V.); (P.R.); (A.D.); (B.H.); (H.S.); (R.J.S.)
- Department of Epidemiology and Public Health, Faculty of Medicine, University of Ostrava, 703 00 Ostrava, Czech Republic
| | - Hana Slachtova
- Centre for Epidemiological Research, Faculty of Medicine, University of Ostrava, 703 00 Ostrava, Czech Republic; (O.M.); (V.B.); (A.V.); (P.R.); (A.D.); (B.H.); (H.S.); (R.J.S.)
- Department of Epidemiology and Public Health, Faculty of Medicine, University of Ostrava, 703 00 Ostrava, Czech Republic
| | - Grzegorz Siemiatkowski
- Lukasiewicz Research Network—Institute of Ceramics and Building Materials, 31-983 Cracow, Poland;
| | - Leszek Osrodka
- Institute of Meteorology and Water Management National Research Institute, 01-673 Warsaw, Poland;
| | - Radim J. Sram
- Centre for Epidemiological Research, Faculty of Medicine, University of Ostrava, 703 00 Ostrava, Czech Republic; (O.M.); (V.B.); (A.V.); (P.R.); (A.D.); (B.H.); (H.S.); (R.J.S.)
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Jonszta T, Czerny D, Prochazka V, Vrtkova A, Chovanec V, Krajina A. Computed Tomography (CT)-Navigated Translumbar Hemodialysis Catheters: A 10-Year Single-Center Experience. Med Sci Monit 2020; 26:e927723. [PMID: 33318464 PMCID: PMC7749525 DOI: 10.12659/msm.927723] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 09/17/2020] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND In dialysis patients with exhausted usual central venous access sites, the translumbar hemodialysis catheter (TLC) provides a viable option for dialysis access. The technical success of catheter insertion, associated complications, and long-term patency of TLC were evaluated in this study. MATERIAL AND METHODS This retrospective study included 37 patients with occluded central thoracic veins in whom 39 TLC implantation procedures were performed and 196 patients with internal jugular vein hemodialysis catheters (JVC). TLC implantation was performed as a hybrid procedure with computed tomography (CT)-navigated translumbar inferior vena cava cannulation and subsequent fluoroscopy-guided hemodialysis catheter placement. RESULTS The rates of technical success of the implantations and minor periprocedural complications were 97.4% and 10.3% in the TLC group and 98.6% and 4.2% in the JVC group, respectively. The median follow-up in the TLC and JVC groups was 673 days and 310 days, respectively. The primary-assisted patency at the 1-year and 3-year follow-up was 88.7% and 72.0% in the TLC group and 81.6% and 67.0% in the JVC group, respectively, with no statistically significant difference between the 2 groups. The incidence rate of infection-related and patency-related complications calculated for 1000 catheter-days was 0.15 and 0.11 in the TLC group and 0.33 and 0.25 in the JVC group, respectively. CONCLUSIONS The CT-guided implantation of the TLC is a useful option to create dialysis access with a low complication rate and satisfactory long-term patency in patients without usual venous access.
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Affiliation(s)
- Tomas Jonszta
- Department of Radiology, University Hospital Ostrava, Ostrava, Czech Republic
- Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
| | - Daniel Czerny
- Department of Radiology, University Hospital Ostrava, Ostrava, Czech Republic
- Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
| | - Vaclav Prochazka
- Department of Radiology, University Hospital Ostrava, Ostrava, Czech Republic
- Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
| | - Adela Vrtkova
- Department of Applied Mathematics, Faculty of Electrical Engineering and Computer Science, VSB – Technical University of Ostrava, Ostrava, Czech Republic
| | - Vendelin Chovanec
- Department of Radiology, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
- Charles University, Faculty of Medicine in Hradec Kralove, Hradec Kralove, Czech Republic
| | - Antonin Krajina
- Department of Radiology, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
- Charles University, Faculty of Medicine in Hradec Kralove, Hradec Kralove, Czech Republic
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Procházka V, Jonszta T, Czerny D, Krajca J, Roubec M, Hurtikova E, Urbanec R, Streitová D, Pavliska L, Vrtkova A. Comparison of Mechanical Thrombectomy with Contact Aspiration, Stent Retriever, and Combined Procedures in Patients with Large-Vessel Occlusion in Acute Ischemic Stroke. Med Sci Monit 2018; 24:9342-9353. [PMID: 30578729 PMCID: PMC6320656 DOI: 10.12659/msm.913458] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background We investigated the properties and effects of 5 mechanical thrombectomy procedures in patients with acute ischemic stroke. The relationships between the type of procedure, the time required, the success of recanalization, and the clinical outcome were analyzed. Material/Methods This prospective comparative analysis included 500 patients with acute ischemic stroke and large-vessel occlusion. We compared contact aspiration thrombectomy (ADAPT, n=100), stent retriever first line (SRFL, n=196), the Solumbra technique (n=64), mechanical thrombectomy plus stent implantation (n=81), and a combined procedure (n=59). Results ADAPT provided shorter procedure (P<0.001) and recanalization times (P<0.001) than the other techniques. Better clinical outcome was achieved for ischemia in the anterior circulation than ischemia in the posterior fossa (P<0.001). Compared to the other techniques, patients treated with ADAPT procedure had increased odds of achieving better mTICI scores (P=0.002) and clinical outcome (NIHSS) after 7 days (P=0.003); patients treated with SRFL had increased odds of achieving better long-term clinical status (3M-mRS=0–2; P=0.040). Patients with SRFL and intravenous thrombolysis (IVT) had increased odds of better clinical status (3M-mRS=0–2; P=0.031) and decreased odds of death (P=0.005) compared to patients with SRFL without IVT. The other treatment approaches had no additional effect of IVT. Patients with SRFL with a mothership transfer had increased odds of achieving favorable clinical outcome (3M-mRS) compared to SRFL with the drip-and-ship transfer paradigm (P=0.015). Conclusions Our results showed that ADAPT and SRFL provided significantly better outcomes compared to the other examined techniques. A mothership transfer and IVT administration contributed to the success of the SRFL approach.
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Affiliation(s)
- Václav Procházka
- Department of Radiology, University Hospital Ostrava, Ostrava, Czech Republic
| | - Tomas Jonszta
- Department of Radiology, University Hospital Ostrava, Ostrava, Czech Republic
| | - Daniel Czerny
- Department of Radiology, University Hospital Ostrava, Ostrava, Czech Republic
| | - Jan Krajca
- Department of Radiology, University Hospital Ostrava, Ostrava, Czech Republic
| | - Martin Roubec
- Department of Neurology, University Hospital Ostrava, Ostrava, Czech Republic
| | - Eva Hurtikova
- Department of Neurology, University Hospital Ostrava, Ostrava, Czech Republic
| | - Rene Urbanec
- Clinic of Anesthesiology, Resuscitation and Intensive Medicine, University Hospital Ostrava, Ostrava, Czech Republic
| | - Dana Streitová
- Clinic of Anesthesiology, Resuscitation and Intensive Medicine, University Hospital Ostrava, Ostrava, Czech Republic.,St. Elizabeth University of Health and Social Work, Bratislava, Slovakia
| | - Lubomir Pavliska
- IT Department, University Hospital Ostrava, Ostrava, Czech Republic
| | - Adela Vrtkova
- Department of Applied Mathematics, VŠB-Technical University of Ostrava, Ostrava, Czech Republic.,Department of Deputy Director of Science and Research, University Hospital Ostrava, Ostrava, Czech Republic
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Prochazka V, Jonszta T, Czerny D, Krajca J, Roubec M, Macak J, Kovar P, Kovarova P, Pulcer M, Zoubkova R, Lochman I, Svachova V, Pavliska L, Vrtkova A, Kasprak D, Gumulec J, Weisel JW. The Role of von Willebrand Factor, ADAMTS13, and Cerebral Artery Thrombus Composition in Patient Outcome Following Mechanical Thrombectomy for Acute Ischemic Stroke. Med Sci Monit 2018; 24:3929-3945. [PMID: 29887594 PMCID: PMC6029516 DOI: 10.12659/msm.908441] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Background The aim of the study was to investigate the role of von Willebrand factor (vWF), the vWF-cleaving protease, ADAMTS13, the composition of thrombus, and patient outcome following mechanical cerebral artery thrombectomy in patients with acute ischemic stroke. Material/Methods A prospective cohort study included 131 patients with ischemic stroke (<6 hours) with or without intravenous thrombolysis. Interventional procedure parameters, hemocoagulation markers, vWF, ADAMTS13, and histological examination of the extracted thrombi were performed. The National Institutes of Health Stroke Scale (NIHSS) score was used on hospital admission, after 24 hours, at day 7; the three-month modified Rankin Scale score was used. Results Mechanical thrombectomy resulted in a Treatment in Cerebral Ischemia (TICI) score of 2–3, with recanalization in 89% of patients. Intravenous thrombolysis was used in 101 (78%). Patients with and without intravenous thrombolysis therapy had a good clinical outcome (score 0–2) in 47% of cases (P=0.459) using the three-month modified Rankin Scale. Patients with a National Institutes of Health Stroke Scale (NIHSS) score ≥15 had significantly increased vWF levels (P=0.003), and a significantly increased vWF: ADAMTS13 ratio (P=0.038) on hospital admission. Significant correlation coefficients were found for plasma vWF and thrombo-embolus vWF (r=0.32), platelet (r=0.24), and fibrin (r=0.26) levels. In the removed thrombus, vWF levels were significantly correlated with platelet count (r=0.53), CD31-positive cells (r=0.38), and fibrin (r=0.48). Conclusions In patients with acute ischemic stroke, mechanical cerebral artery thrombectomy resulted in a good clinical outcome in 47% of cases, with and without intravenous thrombolysis therapy.
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Affiliation(s)
- Vaclav Prochazka
- Department of Radiology, University Hospital Ostrava, Ostrava, Czech Republic
| | - Tomas Jonszta
- Department of Radiology, University Hospital Ostrava, Ostrava, Czech Republic
| | - Daniel Czerny
- Department of Radiology, University Hospital Ostrava, Ostrava, Czech Republic
| | - Jan Krajca
- Department of Radiology, University Hospital Ostrava, Ostrava, Czech Republic
| | - Martin Roubec
- Department of Neurology, University Hospital Ostrava, Ostrava, Czech Republic
| | - Jirka Macak
- Department of Pathology, University Hospital Ostrava, Ostrava, Czech Republic
| | - Petr Kovar
- Department of Pathology, University Hospital Ostrava, Ostrava, Czech Republic
| | - Petra Kovarova
- Blood Centre, University Hospital Ostrava, Ostrava, Czech Republic
| | - Martin Pulcer
- Department of Clinical Hematology, University Hospital Ostrava, Ostrava, Czech Republic
| | - Renata Zoubkova
- Department of Anesthesiology, Resuscitation and Intensive Medicine Clinic, University Hospital Ostrava, Ostrava, Czech Republic
| | | | | | - Lubomir Pavliska
- Department of Deputy Director of Science and Research, University Hospital Ostrava, Ostrava, Czech Republic
| | - Adela Vrtkova
- Department of Applied Mathematics , VŠB-Technical University of Ostrava, Ostrava, Czech Republic
| | - David Kasprak
- Department of Hematooncology, University Hospital Ostrava, Ostrava, Czech Republic
| | - Jaromir Gumulec
- Department of Hematooncology, University Hospital Ostrava, Ostrava, Czech Republic
| | - John W Weisel
- Department of Cell and Developmental Biology, University of Pensylvania School of Medicine, Philadelphia, PA, USA
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