Birth weight rather than birth length is associated with childhood behavioural problems in a Czech ELSPAC cohort

Many physical and psychological characteristics are influenced by prenatal development. Some studies have located links between low birth parameters and behavioural problems, with the latter in turn associated with educational progress, career success, overall health, and subsequent life events. However, few studies have investigated whether this association also applies to children in the normal birth growth range. This study thus investigates the relationship between normal-range birth length, weight, and behavioural problems at the age of seven. We use data from the Czech part of the European Longitudinal Study of Pregnancy and Childhood (ELSPAC) cohort, which provides comprehensive insight into a post-communist country undergoing a period of economic transition. Childhood behavioural problems were measured in 1,796 children using the Strengths and Difficulties Questionnaire. Associations were modelled using weighted logistic regression. Birth weight was found to be linked to the total difficulties score, hyperactivity, and peer relationship problems subscales in a fully adjusted model while birth length was not significantly associated with any subscale in the fully adjusted model. We thus conclude that normal-range birth weight is associated with behavioural problems. It can therefore be assumed that the odds of behavioural problems and their consequences can be mitigated by preventive programs targeting pregnant women and children with lower but still normal weight

Socioeconomic characteristics, family structure and trajectories of children's psychosocial problems in a period of social transition

Data from the Czech part of the European Longitudinal Study of Pregnancy and Childhood offer a unique opportunity to examine a period of changing socioeconomic structure of the country. Our aim was to analyse the association between socioeconomic status, family structure and children's psychosocial problems at the age of 7, 11, 15 and 18 years in 3,261 subjects and compare our results with findings from western settings. The Strengths and Difficulties Questionnaire (SDQ) and its five subscales were used to assess individual problem areas (emotional symptoms, peer problems, hyperactivity, conduct problems) and prosocial behaviour. Socioeconomic status was represented by maternal education and three forms of family structure were identified: nuclear family, new partner family and single parent family. The SDQ subscale score over time was modelled as a quadratic growth curve using a linear mixed-effects model. Maternal university education was associated with a faster decline in problems over time for all five SDQ subscales. Problems in children from nuclear families were found to be significantly lower than in children from single parent families for all SDQ subscales with the exception of peer problems. Compared to nuclear families, children from new partner families scored significantly higher in hyperactivity and conduct problems subscales. The nuclear family structure and higher maternal education have been identified as protective factors for children's psychosocial problems, in agreement with findings from western settings. Adopting a longitudinal perspective was shown as essential for providing a more complex view of children's psychosocial problems over time

Comparison of biochemical response between the minimally invasive and standard open posterior lumbar interbody fusion

Background The mini-invasive open posterior lumbar fusion procedure (mini PLIF) procedure is an alternative to standard open procedure (open PLIF) and is intended to reduce surgery-related trauma. The measuring of suitable biochemical factors enables objective comparison of the invasiveness of spinal surgery procedures. Methods Prospectively collected data on myoglobin, creatine kinase, interleukin-6, C-reactive protein levels and intensity of low back pain and radicular pain in one-level mini PLIF and open PLIF procedures were analysed. The mini PLIF and the open PLIF groups included 27 and 23 patients, respectively. The collection of blood samples and clinical data were performed preoperatively and on postoperative days 1, 3 and 7. The non-paired t-test was used for statistical evaluation. Results We did not found any statistically significant differences of myoglobin and creatine kinase levels between the groups. In the open PLIF group the IL-6 levels were significantly higher than in the mini PLIF group on postoperative day 3. CRP levels showed significant lower stress response in favour of the mini PLIF group on postoperative days 3 and 7. Levels of post-op low back pain on day 3 were significantly lower in mini PLIF group. Also intensity of radicular pain on day 1 and 3 were lower also mini PLIF group. Conclusion The extent of myonecrosis was comparable in both techniques. The analysis of the IL-6 and CRP levels showed significantly lower systemic inflammatory response in mini PLIF technique. The mini PLIF technique provides transiently lower postoperative pain levels

Prognostic Factors of Early Morphological Response to Treatment with Ranibizumab in Patients with Wet Age-Related Macular Degeneration

Aim. To assess the significance of age, gender, baseline best corrected visual acuity, baseline macula thickness, and type and size of choroidal neovascularization in early morphological therapeutic response to ranibizumab treatment in patients with the wet form of age related macular degeneration. Methods. From 09/2008 to 06/2013 we evaluated 1153 newly diagnosed, treatment naive patients treated with ranibizumab. Based on the morphological findings in the macula following the initial 3 injections of ranibizumab, the patients were divided into two groups based on active and inactive choroidal neovascularization. Results. After the initial 3 injections of ranibizumab, we examined the sample of 841 eyes with active CNV and 312 eyes with inactive CNV. In the inactive group, we found a statistically higher proportion of occult CNV (P less than 0.001) and lower incidence of CNV greater than 5DA (P less than 0.001) compared with the active group. We found no statistically significant difference in age, gender, baseline best corrected visual acuity, or baseline macula thickness between the inactive and active groups. Conclusion. Occult CNV and CNV smaller than 5DA are optimistic factors for a better morphological therapeutic response at the beginning of ranibizumab treatment.Cíl. Zjistit vliv věku, pohlaví, zrakové ostrosti a tloušťky makuly na počátku léčby, typu a velikosti choroidální neovaskularizace na časnou morfologickou odpověď u pacientů s vlhkou věkem podmíněnou makulární degenerací. Metodika. Od 09/2008 do 06/2013 jsme zhodnotili výsledky léčby ranibizumabem u 1153 nově diagnostikovaných, předtím neléčených pacientů. Na základě morfologické odpovědi v makule po 3 injekcích ranibizumabu byli pacienti rozděleni do dvou skupin na základě aktivity nebo inaktivity choroidální neovaskularizace. Výsledky. Po 3 úvodních injekcích ranibizumabu jsme vyšetřili skupinu 841 očí s aktivní CNV a 312 očí s inaktivní CNV. V inaktivní skupině jsme našli statisticky vyšší počet okultních CNV (P less than 0.001) a nižší incidenci okultních CNV menších než 5DA (P less than 0.001) v porovnání s aktivní skupinou. Nenašli jsme statisticky signifikantní rozdíl u věku, pohlaví, zrakové ostrosti a tloušťky makuly na počátku léčby mezi inaktivní a aktivní skupinou. Závěr. Okultní CNV a CNV menší než 5DA je jsou faktory prognosticky prognosticky příznivější morfologické a terapeutické odpovědi na počátku léčby ranibizumabem.Aim. To assess the significance of age, gender, baseline best corrected visual acuity, baseline macula thickness, and type and size of choroidal neovascularization in early morphological therapeutic response to ranibizumab treatment in patients with the wet form of age related macular degeneration. Methods. From 09/2008 to 06/2013 we evaluated 1153 newly diagnosed, treatment naive patients treated with ranibizumab. Based on the morphological findings in the macula following the initial 3 injections of ranibizumab, the patients were divided into two groups based on active and inactive choroidal neovascularization. Results. After the initial 3 injections of ranibizumab, we examined the sample of 841 eyes with active CNV and 312 eyes with inactive CNV. In the inactive group, we found a statistically higher proportion of occult CNV (P less than 0.001) and lower incidence of CNV greater than 5DA (P less than 0.001) compared with the active group. We found no statistically significant difference in age, gender, baseline best corrected visual acuity, or baseline macula thickness between the inactive and active groups. Conclusion. Occult CNV and CNV smaller than 5DA are optimistic factors for a better morphological therapeutic response at the beginning of ranibizumab treatment

Cartilage tympanoplasty for retraction pocket of the tympanic membrane in children

BackgroundRetraction pocket (RP) of the tympanic membrane (TM) is a common pathology in children that can cause ossicular chain erosion, cholesteatoma formation, and potentially life-threatening complications of cholesteatoma. This study assessed the functional and anatomical results of cartilage grafting in children with severe RP of the TM.MethodsThis was a retrospective review of 212 children from a tertiary referral center.ResultsWe identified significant differences in hearing results, indication criteria, and location of TM fixation between stages II and III of RP (according to Charachon). We observed a significantly higher incidence of RP in boys than in girls.ConclusionsCartilage tympanoplasty for retraction pocket of the tympanic membrane in children is a safe procedure with good anatomical and hearing results

Hyperinvasive approach to out-of hospital cardiac arrest using mechanical chest compression device, prehospital intraarrest cooling, extracorporeal life support and early invasive assessment compared to standard of care. A randomized parallel groups ...

Out of hospital cardiac arrest (OHCA) has a poor outcome. Recent non-randomized studies of ECLS (extracorporeal life support) in OHCA suggested further prospective multicenter studies to define population that would benefit from ECLS. We aim to perform a prospective randomized study comparing prehospital intraarrest hypothermia combined with mechanical chest compression device, intrahospital ECLS and early invasive investigation and treatment in all patients with OHCA of presumed cardiac origin compared to a standard of care. Methods This paper describes methodology and design of the proposed trial. Patients with witnessed OHCA without ROSC (return of spontaneous circulation) after a minimum of 5 minutes of ACLS (advanced cardiac life support) by emergency medical service (EMS) team and after performance of all initial procedures (defibrillation, airway management, intravenous access establishment) will be randomized to standard vs. hyperinvasive arm. In hyperinvasive arm, mechanical compression device together with intranasal evaporative cooling will be instituted and patients will be transferred directly to cardiac center under ongoing CPR (cardiopulmonary resuscitation). After admission, ECLS inclusion/exclusion criteria will be evaluated and if achieved, veno-arterial ECLS will be started. Invasive investigation and standard post resuscitation care will follow. Patients in standard arm will be managed on scene. When ROSC achieved, they will be transferred to cardiac center and further treated as per recent guidelines. Primary outcome 6 months survival with good neurological outcome (Cerebral Performance Category 1–2). Secondary outcomes will include 30 day neurological and cardiac recovery. Discussion Authors introduce and offer a protocol of a proposed randomized study comparing a combined “hyper invasive approach” to a standard of care in refractory OHCA. The protocol is opened for sharing by other cardiac centers with available ECLS and cathlab teams trained to admit patients with refractory cardiac arrest under ongoing CPR. A prove of concept study will be started soon. The aim of the authors is to establish a net of centers for a multicenter trial initiation in future

Accelular nanofbrous bilayer scafold intrapenetrated with polydopamine network and implemented into a full-thickness wound of a white-pig model afects infammation and healing process

Treatment of complete loss of skin thickness requires expensive cellular materials and limited skin grafts used as temporary coverage. This paper presents an acellular bilayer scaffold modified with polydopamine (PDA), which is designed to mimic a missing dermis and a basement membrane (BM). The alternate dermis is made from freeze-dried collagen and chitosan (Coll/Chit) or collagen and a calcium salt of oxidized cellulose (Coll/CaOC). Alternate BM is made from electrospun gelatin (Gel), polycaprolactone (PCL), and CaOC. Morphological and mechanical analyzes have shown that PDA significantly improved the elasticity and strength of collagen microfibrils, which favorably affected swelling capacity and porosity. PDA significantly supported and maintained metabolic activity, proliferation, and viability of the murine fibroblast cell lines. The in vivo experiment carried out in a domestic Large white pig model resulted in the expression of pro-inflammatory cytokines in the first 1-2 weeks, giving the idea that PDA and/or CaOC trigger the early stages of inflammation. Otherwise, in later stages, PDA caused a reduction in inflammation with the expression of the anti-inflammatory molecule IL10 and the transforming growth factor beta (TGF beta 1), which could support the formation of fibroblasts. Similarities in treatment with native porcine skin suggested that the bilayer can be used as an implant for full-thickness skin wounds and thus eliminate the use of skin grafts

Propagation of very low frequency radio waves in the Earth-ionosphere waveguide

Bleskové výboje jsou zdrojem silného elektromagnetického (EM) záření, především v oblasti velmi nízkých frekvencí (VLF) 3-30 kHz. Toto záření se vlnovodem mezi Zemí a spodní vrstvou ionosféry dokáže došířit až do vzdálenosti tisíců kilometrů od zdrojového blesku. Pomocí měření vhodných komponent EM pole je možné určit směr, odkud EM vlna vy- volaná bleskem přišla. Výsledkem této práce je algoritmus, který daný výpočet provede, otestovaný na datech z měřící stanice umístěné v jižní Francii. Algoritmus byl testován jednak na jednotlivé bleskové výboje se známými polohami a jednak na signál z vysílačů určených ke komunikaci s ponorkami, neboť tyto vysílají ve stejném pásmu a jsou též vhodné pro aplikaci nově vyvinutého algoritmu.