Acute appendicitis in pregnancy — do we treat correctly, or do we delay unnecessarily?

Objectives: Acute appendicitis is the most common non-gynaecological indication for surgical intervention during pregnancy. The aim of this study was to compare perioperative and postoperative results of surgical treatment of acute appendicitis in the early and late stage of pregnancy. Material and methods: This is a retrospective study focused on the evaluation of perioperative and postoperative results of appendectomy in pregnancy. The study included all pregnant patients who underwent laparoscopic or open appendectomy at the University Hospital Ostrava during the observed 10-year period (January 2012–December 2021). The patients were divided into two subgroups according to the stage of pregnancy in relation to the expected viability of the foetus (the viability limit was defined as the 23rd week of pregnancy). Results: In the monitored 10-year period, a total of 25 pregnant patients underwent appendectomy. Comparing the two subgroups of patients, there were no statistically significant differences in any of the admission parameters. Laparoscopy was performed in 100% of the patients in the lower stage of pregnancy (< 23 g.w.) and in 61% of the subgroup of patients with more advanced pregnancy (> 23 g.w.); this difference was statistically significant (p = 0.039). Differences in subgroups regarding duration of surgery, risk of revision and 30-day postoperative morbidity were not statistically significant. In the subgroup of patients < 23 g.w., uncomplicated forms of appendicitis predominated (66%), whereas in the subgroup > 23 g.w., complicated forms predominated (69%); this difference was statistically significant (p = 0.026). When comparing the two subgroups of patients, there was a statistically significant difference in the length of hospitalization (p = 0.006). The mortality rate of the group was zero. Conclusions: The results of the study confirm the fact that advanced pregnancy may be related to complicated forms of appendicitis. Therefore, early appendectomy is still the method of choice. In accordance with the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) recommendations, laparoscopic approach is preferred in pregnant patients, even in advanced pregnancy

Obesity in cases undergoing the surgical procedure of lung lobectomy: risk or benefit?

OBJECTIVE: The aim of the study was to evaluate the effect of body mass index on patients’ short-term results following lung lobectomy. METHODS: In this retrospective study, we compared the perioperative and short-term postoperative results of obese (BMI≥30 kg/m2) versus nonobese patients (BMI<30 kg/m2) who underwent anatomical lung resection for cancer. The two groups had the same distribution of input risk factors and the same ratio of surgical approaches (thoracoscopy vs. thoracotomy). RESULTS: The study included a total of 144 patients: 48 obese and 96 non-obese patients. Both groups had the same ratio of thoracoscopic vs. thoracotomy approach (50/50%), and were comparable in terms of demographics and clinical data. The g roups did not significantly differ in the frequency of perioperative or postoperative complications. Postoperative morbidity was higher among non-obese patients (34.4 vs. 27.1%), but this difference was not statistically significant (p=0.053). Hospital stay was similar in both study groups (p=0.100). Surgery time was significantly longer among obese patients (p=0.133). Postoperative mortality was comparable between the study groups (p=0.167). CONCLUSIONS: Obesity does not increase the frequency of perioperative and postoperative complications in patients after lung lobectomy. The slightly better results in obese patients suggest that obesity may have some protective role. © 2022 Associacao Medica Brasileira. All rights reserved.MZ ČR – RVO-FNOs/201

A novel labeling modality of intra-abdominal lesions with Magseed magnetic marker and extirpation by Sentimag probe navigation

OBJECTIVE: This study aimed to evaluate our experience with the use of Magseed, the magnetic metallic marker, as a localization technique followed by Sentimag probe detection in patients with solitary intra-abdominal local metastases with subsequent resection of the lesions. METHODS: Five patients underwent resection after the lesion was marked with the Magseed magnetic marker. Prior to the surgery, a computed tomography scan of the chest and abdomen and/or positron emission tomography was performed to rule out the dissemination of the disease. The indication for surgery was evaluated in a meeting of a multidisciplinary team, and the placement of the magnetic marker under computed tomography control had been performed the day before the planned procedure. RESULTS: The present preliminary outcomes have revealed that Magseed might be a promising technique that is feasible and safe, particularly when the postsurgical anatomic conditions in the abdominal cavity are altered and the lesions are not visible or palpable. Surgical extirpation of lesions occurred without complications in each case. In all the cases, the resection was complete and curative, and one wound infection in all (20%), without any major complications, had occurred. The mean hospital stay was 6.6 days. CONCLUSION: Magseed utilization, as a localization technique, followed by Sentimag probe detection in intra-abdominal tumors has not been reported before. Improving the visualization and, consequently, the precise marking of the lesion with subsequent radical removal can prevent insufficient or excessive removal of healthy tissue, leading to a faster diagnosis and better overall clinical outcomes

Revitalization of Primary School

Import 04/02/2014Diplomová práce na téma „Revitalizace základní školy“ se zaměřuje na kompletní řešení pavilonu ´A´ s ohledem na stavebně – energetickou přestavbu v rozsahu projektové dokumentace pro provádění stavby. V druhé části se diplomová práce zabývá stavební tepelnou techniku. V této části jsou posuzovány vybrané detaily v programu Area (posuzován původní stav a nově navrhovaný stav). Dále je zpracován průkaz energetické náročnosti budovy, který poukazuje na celkovou energetickou náročnost pavilonu A. Třetí část práce je zaměřena na návrh vzduchotechnické soustavy s rekuperací. Návrh má dvě variantní řešení v důsledku ekonomického zhodnocení navržených variant. Čtvrtá část diplomové práce je zaměřena na posouzení denního osvětlení pobytových místností (učebny a kabinety). Posouzení je zpracováno v programu WDLS a to pro stávající stav a pro nově navrhovaný stav. V poslední části práce jsou posuzovány akustické vlastnosti vybraných stavebních konstrukcí.The final thesis " Primary School Revitalization" focuses on entiredesign of 'A' pavilion, and construction - enegetic alteration according to the project documents is included. The first part of this paper deals with the site heat engineering. In this part the sample details in Area programme are explored (the present and future, newly designed condition). Then the energy intensity document of the building which shows the complete energy intensity of 'A' pavilion is processed. The second part is engaged in the air conditiong system with the waste heat recovery design. This design shows two possible lay-outs according to the cost-effective evaluation of the proposed options. The third part of the paper targets the examination of rooms' daylight (classrooms and teachres' rooms). The examination is processed in WDLS programme for the current and future condition of the building. The acoustic qualities of chosen engineering constructions are assessed in the final part.Prezenční229 - Katedra prostředí staveb a TZBvelmi dobř