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Hurt K, Krajcová A, Zikán M. Occurrence of acute retrobulbar hemorrhage during birth. Ceska Gynekol 2024; 89:30-33. [PMID: 38418250 DOI: 10.48095/cccg202430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/01/2024]
Abstract
OBJECTIVE Presentation of acute retrobulbar subperiostal hemorrhage (hematoma) in the course of delivery. The occurrence, possible threats and recommended methods of treatment are described. Introduction: Acute retrobulbar hemorrhage is always a serious condition. Even if not connected with other ocular trauma, it could cause permanent blindness. The reason is based on constriction of the eye, decreasing of the blood supply and thus disruption of the oxygen supply to sensitive retinal tissues. After a short time, these tissues start to deteriorate and lose their natural function. This event is often connected with exophthalmia and diplopia. The primary diagnostic procedure is to measure intraocular pressure (IOP). Even if the ideal diagnostic tools are not accessible, performing a lateral canthotomy (event. with inferior cantholysis) is recommended to relieve IOP in acute situations. Normal intraocular pressure is considered to be 8-21 mmHg. Case report: Our 29-year-old female patient was in the second stage of delivery and suddenly got retrobulbar hemorrhage, resulting in exophthalmia and diplopia. Her baby was delivered shortly after the event. The following delivery course was normal, including her perineum repair and puerperium. Our patient was fortunate because her visual acuity and IOP were normal. Therefore, we chose an observational treatment strategy. After 5 weeks, we noted successful disintegration of the hematoma and decreased exophthalmia and diplopia without other consequences. Conclusion: We described retrobulbar subperiostal bleeding in our patient in the course of delivery. We depicted possible threats that could result in blindness and described recommended methods of treatment. Even if such a situation is extremely rarely, we believe that knowledge of these guidelines could help medical professionals broaden their treatment options. This particularly occurs when a trained eye surgeon is not available.
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Huang CS, Toi M, Im YH, Iwata H, Sohn J, Wang HC, Masuda N, Im SA, Lu Y, Haddad N, Sakaguchi S, Hurt K, Neven P, Llombart-Cussac A, Sledge G. 45O Abemaciclib plus fulvestrant in East Asian women with HR+, HER2- advanced breast cancer: Overall survival from MONARCH 2. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.10.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Krajcová A, Hurt K, Kufa R, Molitor M. Breast implant rupture: A sports trauma report. Ceska Gynekol 2020; 85:116-119. [PMID: 32527105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
OBJECTIVE Breast augmentation is one of the most commonly performed plastic surgery procedures worldwide. Because of the quality of the implant material, implant rupture may first occur about 10 years after implantation. Ruptured breast implants caused by competitive sport events are rare but should be considered in women athletes as a potential risk factor. The authors report a noteworthy case of this kind. DESIGN Literature overview and case report. SETTING Department of Plastic and Obstetrics and Gynaecology 1st faculty of Charls University, Bulovka hospital, Prague. METHODS Evaluation of the literature and an observational study. CONCLUSION Breast implant ruptures are generally at high risk in competitive contact sports. We do not recommend the use of breast implants in women competing in contact sports such as boxing.
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Sledge G, Toi M, Neven P, Sohn J, Inoue K, Pivot X, Burdaeva O, Okera M, Masuda N, Kaufman P, Koh H, Grischke EM, Conte P, Lu Y, Barriga S, Hurt K, Frenzel M, Johnston S, Llombart-Cussac A. MONARCH 2: Overall survival of abemaciclib plus fulvestrant in patients with HR+, HER2- advanced breast cancer. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz394.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Racková J, Driák D, Neumannová H, Hurt K, Sehnal B, Halaška M. [Use of methotrexate in the ectopic pregnancy and pregnancy of unknown location]. Ceska Gynekol 2016; 81:140-146. [PMID: 27457397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVE There are only a few gynaecological departments in the Czech Republic that use medical treatment of the ectopic pregnancy (EP) or persistent pregnancy of unknown location (PUL). We have started using this method in 2008 at our clinic. The aim of this study was to assess the success rate of conservative medical treatment with methotrexate (MTX) in the dose of 1 mg/kg intramuscularly in patients with ectopic pregnancy or persistent pregnancy of unknown location and to compare the results of clinical history, clinical finding and laboratory results in a group of successful and a group of unsuccessful treatment. TYPE OF STUDY Retrospective analysis. SETTING Charles University in Prague, 1st Medical Faculty and Hospital Bulovka, Department of Obstetrics and Gynaecology, Prague. METHODS Patients diagnosed with EP or persistent PUL diagnosed at the outpatient of our clinic in 01/2008 - 08/2014 who were hemodynamically stable and fulfilled the indication for medical treatment were enrolled in the study. Treatment success was decrease of free subunit of β-hCG (β-hCG) < 5 IU/L independent of the number of methotrexate doses administered. RESULTS Two hundred and eleven patients were diagnosed with EP or PUL, sixty-three were eligible for our study and fulfilled the criteria for methotrexate treatment, fifty six women were finally analysed. From this number forty eight (86%) had clinically and laboratory diagnosed EP and eight (14%) were diagnosed with persistent PUL. Forty one patients (73%) had a successfull treatment (Group I) with the β-hCG level decrease <5 IU/L in a mean time of 27 days. When comparing the data of successful and unsuccessful treatment (Group II) we found a difference in the non-significant initial β-hCG level. In Group I there was a median β-hCG 538 IU/L (100-3852 IU/l), whereas in the unsuccessful Group II it was 1100 IU/L (300-3240 IU/l). Group I included more nuliparous women and more women with clinical histories of EP. Group II included more heavy smokers. The mean hematosalpinx diameter for group II, measured by transvaginal ultrasound, was larger. There were also more patients with endometriosis or deep infiltrating endometriosis in Group II, subsequently verified during laparoscopy, compared to Group I. There was no tubal rupture in these patients. CONCLUSION The results of our study are comparable with foreign literature publications. We consider the pharmacological treatment of ectopic preganancy or persistent pregnancy of unknown location as effective and relatively safe for patients, with similar impact on a woman's fertility as laparoscopic salpingectomy.
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Hurt K, Hansell D, Nair A, Sheard S, Hodson M, Kalsi H, Bilton D, Usmani O. WS13.5 Structural correlation of multiple breath washout indices derived from alveolar slope analysis in adult cystic fibrosis. J Cyst Fibros 2013. [DOI: 10.1016/s1569-1993(13)60081-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Hurt K, Nair A, Sheard S, Hansell D, Hodson M, Usmani O, Bilton D. 191 Resistance and reactance measured by impulse oscillometry: Structural functional correlation in adult cystic fibrosis. J Cyst Fibros 2013. [DOI: 10.1016/s1569-1993(13)60332-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Jones A, Perrin F, Hurt K, Cowman S, Alshafi K, Gyi K, Loebinger M, Simmonds N, Bilton D. WS1.6 Successful treatment of Mycobacterium abscessus infection in cystic fibrosis patients using a novel regimen. J Cyst Fibros 2013. [DOI: 10.1016/s1569-1993(13)60007-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Abstract
Haemoptysis is a common complication in cystic fibrosis (CF), occurring in approximately 9% of the population. Massive haemoptysis is associated with older patients, more severe disease and carries a high mortality rate. Despite this there are few robust published studies of effective treatments and knowledge of the precise pathogenesis is limited. Current guidelines for treatment from the Cystic Fibrosis Foundation (CFF) are based on consensus opinion of experts. Patients with massive haemoptysis who do not respond to initial medical treatments should undergo bronchial artery embolization. This will control the bleeding in the majority of cases but recurrence rates are high and there are little data to support long-term improved outcomes. Surgery is a last resort in patients with CF.
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Affiliation(s)
- K Hurt
- Department of Respiratory Medicine, Kings College Hospital, Denmark Hill, London, SE5 9RS.
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Hurt K, Bilton D. Haemoptysis: diagnosis and treatment. Acute Med 2012; 11:39-45. [PMID: 22423349] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Haemoptysis is a common symptom in clinical practice, which requires further investigation. Fortunately, massive haemoptysis only accounts for a small proportion of these episodes. It is a medical emergency that carries a high mortality rate. There are no agreed management guidelines. This review discusses proposed methods of resuscitation as well as outlining a diagnostic algorithm and discusses treatments including bronchial artery embolization, endobronchial therapy, surgery and medical therapies.
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Affiliation(s)
- K Hurt
- Department of Cystic Fibrosis, Royal Brompton Hospital, Sydney Street, London.
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Wiechno PJ, Chlosta P, Smok-Kalwat J, Pikilel J, Henry DH, Christianson DF, Somer BG, Mellado B, Duran I, Castellano DE, Callies S, Andre V, Hurt K, Lahn MMF, Stöckle M, Reuter C, Heinrich B. Interim results of a randomized phase II study with window-design to evaluate antitumor activity of the survivin antisense oligonucleotide (ASO) LY2181308 in combination with docetaxel for first-line treatment of castrate-resistant prostate cancer (CRPC). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.4592] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Weiss G, Donehower R, Westin E, Bence A, Hynes S, Hurt K. 516 A phase 1 dose-escalation study to examine the safety and tolerability of LY2603618 administered 1 day after pemetrexed 500 mg/m2 every 21 days in patients with cancer. EJC Suppl 2010. [DOI: 10.1016/s1359-6349(10)72223-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Hurt K, Bilton D, Gyi K, Hodson M. The importance of looking at small airways function in patients with cystic fibrosis (CF) not responding to routine therapy. J Cyst Fibros 2010. [DOI: 10.1016/s1569-1993(10)60229-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Sottner O, Halaska M, Maxová K, Vlácil J, Kolarík D, Chaloupecký J, Hurt K, Záhumenský J, Zmrhalová B, Vojtech J. [New Single-Incision Sling System MiniArc in treatment of the female stress urinary incontinence]. Ceska Gynekol 2010; 75:101-104. [PMID: 20518261] [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: 05/29/2023]
Abstract
OBJECTIVE The aim of this paper is to introduce the new Single-Incision Sling System MiniArc in treatment of the female stress urinary incontinence. SUBJECT Prospective follow up. SETTING Department of Obstetrics and Gynaecology, The First Faculty of Medicine, Charles University in Prague. SUBJECT AND METHOD Prospective follow up of the first set of 38 patients treated with the new method MiniArc. CONCLUSION We performed initial 38 cases of MiniArc under the local anesthesia. There was neither the complication during procedure, nor during the early postoperative period. No patient required urine derivation. Late postoperative period showed neither obstruction, nor ,,de novo urgency". One asymptomatic sub-urethral tape protrusion into the vagina was found. No late postoperative pain occurred. Subjective cure rate was investigated in 33 ladies with follow up from 6 weeks through 19 months. 23 females declared full dryness (i.e., 76.7%), 6 patients were very satisfied and declared improvement of more than 70% (i. e. 20.0%); thus we obtained efficacy in 29 cases of 30 (i. e. 96.7%). We have not seen any vanishing of the sling effect. Based on our initial experience we judge the new single incision tape as very promising.
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Affiliation(s)
- O Sottner
- Gynekologicko-porodnická klinika 1. LF UK a FN Na Bulovce, Praha
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Záhumenský J, Zmrhalová B, Maxová K, Hurt K, Stejskal D, Kulovaný E, Dvorák M, Sehnal B, Kolarík D, Sottner O, Driák D, Halaska M. [Abortion induction in IInd trimester]. Ceska Gynekol 2008; 73:118-122. [PMID: 18567433] [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: 05/26/2023]
Abstract
STUDY AIM Analysis of the set of women that underwent the termination of pregnancy in IInd trimester at the OBGYN clinic, Teaching Hospital Na Bulovce at interval of years 2006-2007. We appreciated the effect of method and compared with references in the literature. TYPE STUDY: Retrospective descriptive study. SEATTING: OBGYN clinic of the 1st faculty of Charles University, teaching hospital Na Bulovce, Prague. METHOD Retrospective analysis of the set of women that underwent termination of pregnancy in the IInd trimester. Data are obtained from medical documentation and statistically processed. The analysis treats with 50 cases, in all of them, cervix was prepared with hydrophile dilators. In 37 cases were subsequently handed up prostaglandins intraamnially, in two cases generally intravenously, in two cases vaginally and 9 pregnancies were finished directly by dilatation and curettage without endeavour about expulsion. RESULTS From 37 women after intraamnial administration of prostaglandins, 35 (94.6%) aborted successfully. Average time from amniocentesis to expulsion was 13 hours 45 minutes, 23 women aborted to 24 hours (62.2%). Undesirable effects were present in 12 cases (32.4%). CONCLUSION Our record of local intraamnial administration of prostaglandins appears to be effective method. On the other hand, other methods are described in recent literature, which appear to be more efficient and have smaller occurrence of adverse effects.
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Affiliation(s)
- J Záhumenský
- Gynekologicko-porodnická klinika 1. LF UK, FNB, Praha
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Záhumenský J, Zmrhalová B, Jilich D, Driák D, Rozsypal H, Machala L, Stanková M, Krcmár M, Hurt K, Tomecek J, Maxová K, Halaska M. [Analysis of a group of HIV positive women who gave birth in the Czech Republic]. Ceska Gynekol 2007; 72:228-232. [PMID: 17966602] [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: 05/25/2023]
Abstract
OBJECTIVE An analysis of HIV positive women who gave birth between 1st January 1985 to 31st December 2006 in the Czech Republic. SUBJECT A retrospective descriptive analysis. SETTING Teaching Hospital Bulovka, 1st Faculty of Medicine, Charles University, Prague. SUBJECT AND METHODS The study included HIV positive women that gave birth between 1st January 1985 to 31st December 2006 at Bulovka hospital. The group of 62 HIV positive women (including 7 secundiparae) gave birth to 71 new-borns (twice twins). The deliveries were performed by C-section. We interrupted breast-feeding by all these women. RESULTS All new-borns were born alive, no one had Apgar score less than 7 at five minutes. No congenital disorders were found. Three new-borns were transfered to Intensive care unit for new-born babies, two due to dysmaturity and one due to abstinence syndrome. 3 new-borns out of total 71 new-borns were HIV positive (4.2%). CONCLUSION Routine prenatal screening for HIV and high-quality cooperation between obstetricians and infection control doctors are the basic condition of low rate of vertical trasmission HIV infection in the Czech Republic.
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Affiliation(s)
- J Záhumenský
- Gynekologicko-porodnická klinika 1. LF UK, FN na Bulovce, Praha
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Hurt K, Sottner O, Záhumenský J, Halaska M, Krcmár M, Driák D, Zmrhalová B, Rakovicová I. [Choroid plexus cysts and risk of trisomy 18. Modifications regarding maternal age and markers]. Ceska Gynekol 2007; 72:49-52. [PMID: 17357350] [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: 05/14/2023]
Abstract
OBJECTIVE Our aim was to evaluate the risk of chromosomal abnormalities esp. trisomy 18, associated with isolated choroid plexus cyst(s) in pregnant women undergoing second-trimester ultrasonographic examination. DESIGN A review article. SETTING OBGYN clinic of the 1st faculty of medicine, Prague, Teaching hospital Bulovka. SUBJECT Choroid plexus cyst(s) (CPC) are more common in fetuses with chromosomal aneuploidies, particularly trisomy 18. Although it is accepted that the risk of karyotypic abnormality justifies amniocentesis in the case of other associated abnormalities are present, disagreement continues as to the risk of trisomy 18 in a fetus with an isolated choroid plexus cyst. We evaluated additional consideration of maternal age and multiple-marker screening for chromosomal aneuploidy in the assessment of risk. CASE REPORT We report a trisomy 18 case that was diagnosed on the basis of CPC detection by ultrasound, NMR, and further amniocentesis. CONCLUSION It is well accepted that choroid plexus cyst(s) in association with other congenital anomalies warrant amniocentesis to determine fetal karyotype. The presence of isolated CPC varies around 1% in general population, but around 30% in fetuses with trisomy 18 where the prevalence is 3 per 10,000 pregnancies. Metaanalyses reported incidence of trisomy 18 of 1 in 374 in fetuses with isolated CPC. These risks do not exceed the 1:200 risk of pregnancy loss after amniocentesis and also the 1:270 risk of Down syndrome (DS) in a 35-year-old woman, but exceeds the risk for DS of a 37-year-old woman. Thus these findings suggest that amniocentesis should not be offered to pregnant women in the presence of isolated fetal choroid plexus cyst(s), but in the absence of other pathologies. Amniocentesis is then justified only in the patient with advanced maternal age.
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Affiliation(s)
- K Hurt
- Gynekologicko-porodnická klinika 1. LF UK, Praha, Nemocnice na Bulovce
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Hurt K, Sottner J, Záhumenský J, Halaska M, Krcmár M, Krajcová A. [Hormonal contraception interactions]. Ceska Gynekol 2006; 71:499-501. [PMID: 17236412] [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: 05/13/2023]
Abstract
OBJECTIVE The purpose of this article is to discuss the probable ways of interactions between some drugs or remedies and steroid contraceptives. DESIGN A review article. SETTING OBGYN Clinic of the 1t Faculty of Medicine, Prague, Teaching Hospital Bulovka. SUBJECT Low dose oral contraceptives are very popular these days. Some drugs and remedies could negatively influence the levels of ethinyl estradiol (EE) and/or progestins and thus increase the possibility of their failure. These drugs mostly implicate as an inducer of the CYP450 system (liver) and as an inducer of P-glycoprotein transport system (transmembrane drug pump in the intestines). We wanted to describe briefly the mechanism and the principles of their impact.
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Affiliation(s)
- K Hurt
- OBGYN Clinic of the 1st Faculty of Medicine, Prague, Teaching Hospital, Bulovka
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Záhumenský J, Sottner O, Rozsypal H, Sehnal B, Kremár M, Dvorská M, Zmrhalová B, Driák D, Hurt K, Halaska M. [Methods of assisted reproduction in HIV positive patients]. Ceska Gynekol 2006; 71:479-83. [PMID: 17236408] [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: 05/13/2023]
Abstract
AIM OF THE STUDY Analysis of treatment possibilities of infertility in HIV positive patients and solution of child desire in discordant pairs. Authors also present their own case. TYPE OF STUDY Literature review and two case report. NAME AND SETTING OF DEPARTMENT: Department of Obstetrics and Gynaecology, The First Medical Faculty of Charles University in Prague. MATERIALS AND METHODS Review of papers published on risk of HIV transmission during sexual intercourse, fertility of HIV positive patients and possible solution of their child desire. Summary of papers published on safety and effectivity of artificial insemination and IVF ET in HIV discordant pairp. Analysis of our own cases of artificial insemination in pairs of HIV negative female and HIV positive male. CONCLUSION Artificial insemination seems to be safe, relatively cheap and effective solution of child desire in HIV discordant pair.
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Affiliation(s)
- J Záhumenský
- Department of Obstetrics and Gynaecology, The First Medical Faculty of Charles University, Prague
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Hurt K. [Research design strategy in medical and biostatistical studies]. Ceska Gynekol 2004; 69:71-5. [PMID: 15112392] [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: 04/29/2023]
Abstract
OBJECTIVE The purpose of this review is to discuss basic methods of the biostatistical study design and analysis. DESIGN A review article. SETTING OBGYN clinic, 1st Medical Faculty, Charles University, Teaching Hospital Bulovka, Prague. SUBJECT The medical research requires the complexity of special skills, including medical practice, biological understanding and biostatistical expertise. The following article discusses methods of the biostatistical study design and analysis using synoptical clinical and health examples.
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Affiliation(s)
- K Hurt
- Gynekologicko-porodnická klinika, 1. LF UK a Nemocnice na Bulovce, Praha
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Buechler CM, Blostein PA, Koestner A, Hurt K, Schaars M, McKernan J. Variation among trauma centers' calculation of Glasgow Coma Scale score: results of a national survey. J Trauma 1998; 45:429-32. [PMID: 9751530 DOI: 10.1097/00005373-199809000-00001] [Citation(s) in RCA: 60] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Glasgow Coma Scale (GCS) scoring is enigmatic in intubated patients. To determine if there is consensus among Level I trauma centers, a national telephone survey was conducted. METHODS Trauma registrars at state-verified or American College of Surgeons-verified Level I trauma centers were questioned about GCS scoring, recording, and reporting in patients who are intubated or intubated and pharmacologically paralyzed. RESULTS Seventy-three centers were contacted. Seventy-one use initial GCS scores for registry recording. Intubated patients are given 1 point for verbal component plus eye and motor scores at 26% of centers and a total GCS score of 3 at 23%; GCS score is estimated with "T" given for verbal component at 16%, scored as unknown at 10%, always scored as 15 at 10%, and the method of scoring is unknown at 15%. Pharmacologically paralyzed intubated patients are given a total GCS score of 3 at 34%, GCS score is estimated with "T" given for verbal component at 18%, patients are given 1 point for verbal component plus eye and motor scores at 12%, scored as unknown at 11%, always scored as 15 at 8%, and the method of scoring is unknown at 16%. CONCLUSION Wide variation in GCS scoring among Level I trauma centers was identified. Because GCS scores are used in treatment algorithms, trauma scoring, and outcome prediction (Trauma and Injury Severity Score), uniform scoring is essential and should be pursued. Use of state and national databases and outcome research may be adversely affected by the lack of consistent GCS scoring.
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Affiliation(s)
- C M Buechler
- Bronson Methodist Hospital, Kalamazoo, MI 49007, USA
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Subrt O, Tichy M, Vladyka V, Hurt K. Grafting of fetal dopamine neurons in Parkinson's disease. The Czech experience with severe akinetic patients. Acta Neurochir Suppl (Wien) 1991; 52:51-3. [PMID: 1792967 DOI: 10.1007/978-3-7091-9160-6_15] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Preliminary results in three patients with Parkinson's disease, who had transplantation of human embryonic mesencephalic tissue into the caput nuclei caudati, are reported. Some improvement was achieved.
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Affiliation(s)
- O Subrt
- Department of Neurosurgery, Charles University Medical School, Prague, Czech
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Sváb J, Base J, Hurt K. [Nephrolithiasis as a complication of sponge kidney]. Rozhl Chir 1978; 57:786-91. [PMID: 734533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Hlava A, Sládková N, Hurt K. [Healing of nephritic carbuncle in the angiographic picture]. Cesk Radiol 1972; 26:33-7. [PMID: 5013323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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