Incidence of emergence delirium in the pediatric PACU: Prospective observational trial

Emergence delirium (ED) is a postoperative complication in pediatric anesthesia characterized by perception and psychomotor disorder and has a negative impact on morbidity in the form of maladaptive behavior, which can last weeks after anesthesia. Patients with developed ED present with psychomotor anxiety, agitation, and are at higher risk of unintentional extraction of an intravenous cannula, self-harm and nausea and vomiting. The described incidence of ED varies between 25-80%, with a higher prevalence among children younger than 6 years of age. We aimed to determine the incidence of ED in pediatric patients (>1 month) after general anesthesia in the post-anesthesia care unit (PACU), using Paediatric Anaesthesia Emergence Delirium (PAED) score, Watcha score and Richmond agitation and sedation scale (RASS). The incidence of ED was the highest in the PAED score with cutoff >= 10 points (89.0%, n = 1088). When using PAED score >12 points, ED incidence was 19.3% (n = 236). The lowest incidence was described by Watcha and RASS scores, 18.8% (n = 230) vs. 18.1% (n = 221), respectively. The threshold for PAED >= 10 points seems to give false-positive results, whereas the threshold >12 points is more accurate. RASS scale, although intended primarily for estimation of the depth of sedation, seems to have a good predictive value for ED.Web of Science910art. no. 159

The efficiency of insulin production and its content in insulin-expressing model β-cells correlate with their Zn 2+ levels : Zn 2+ levels in β-cells

Insulin is produced and stored inside the pancreatic β-cell secretory granules, where it is assumed to form Zn 2+ -stabilized oligomers. However, the actual storage forms of this hormone and the impact of zinc ions on insulin production in vivo are not known. Our initial X-ray fluorescence experiment on granules from native Langerhans islets and insulinoma-derived INS-1E cells revealed a considerable difference in the zinc content. This led our further investigation to evaluate the impact of the intra-granular Zn 2+ levels on the production and storage of insulin in different model β-cells. Here, we systematically compared zinc and insulin contents in the permanent INS-1E and BRIN-BD11 β-cells and in the native rat pancreatic islets by flow cytometry, confocal microscopy, immunoblotting, specific messenger RNA (mRNA) and total insulin analysis. These studies revealed an impaired insulin production in the permanent β-cell lines with the diminished intracellular zinc content. The drop in insulin and Zn 2+ levels was paralleled by a lower expression of ZnT8 zinc transporter mRNA and hampered proinsulin processing/folding in both permanent cell lines. To summarize, we showed that the disruption of zinc homeostasis in the model β-cells correlated with their impaired insulin and ZnT8 production. This indicates a need for in-depth fundamental research about the role of zinc in insulin production and storage

Educational Prevention Programs for Children and Youths in Broumov Region

Práce se zabývá preventivně výchovnými programy na Broumovsku. Definuje pojmy prevence, výchova, charakterizuje kdo je dítě a mladistvý a jakou úlohu zde sehrává rodina. Cílem je zmapovat instituce zabývající se preventivně výchovnou činností v regionu Broumovsko. Pozornost je zaměřena na SVP Varianta Police nad Metují, které je zásadní institucí v této oblasti.The main focus of this work is put on the prevention education programmes launched in the Broumov region. The thesis attempts to define the terms "prevention" and "education". Furthermore it explains the difference between the term "child" and "youth" and analyses the role of the family within those programmes. Considerable attention is also devoted to the prevention education programmes carried out within the Czech Republic and the aim of the analysis is to provide a list of institutions following those strategies within the Broumov region. The author cooperates with SVP Varianta Police nad Metují - the major institution within this region.Katedra věd o výchov

Quality of life of a womans with breast cancer

Author: Martina Kosinová Institution: Institute of Social Medicine, Charles University in Hradec Králové Department of Nursing Title: The quality of life of women with breast cancer Supervisor: Mgr. Eva Vachková, Ph.D. Number of pages: 110 Number of attachments: 3 Year of defense: 2018 Keywords: quality of life, cancer, breast cancer The bachelor thesis deals with breast cancer and its influence on the quality of life of the sick woman. The theoretical part focuses on breast anatomy, breast cancer division, epidemiology, etiology, prevention, disease manifestations, disease diagnosis, treatment and nursing care. It clarifies the concept of "quality of life". The empirical part examines the quality of life of women with breast cancer using a questionnaire survey.Autor: Martina Kosinová Instituce: Ústav sociálního lékařství LF UK v Hradci Králové Oddělení Ošetřovatelství Název práce: Kvalita života žen s nádorovým onemocněním prsu Vedoucí práce: Mgr. Eva Vachková, Ph.D. Počet stran: 110 Počet příloh: 3 Rok obhajoby: 2018 Klíčová slova: kvalita života, nádorové onemocnění, karcinom prsu Bakalářská práce se zabývá nádorovým onemocněním prsu a jeho vlivem na kvalitu života nemocné ženy. Teoretická část se zaměřuje na anatomii prsu, dělení nádorů prsu, epidemiologii, etiologii, prevenci, projevy nemoci, diagnostiku onemocnění, léčbu a ošetřovatelskou péči. Objasňuje pojem "kvalita života". Empirická část zkoumá pomocí dotazníkového šetření kvalitu života žen s nádorovým onemocněním prsu.Ústav sociálního lékařstvíDepartment of Social MedicineFaculty of Medicine in Hradec KrálovéLékařská fakulta v Hradci Králov

Quality of life of a womans with breast cancer

Author: Martina Kosinová Institution: Institute of Social Medicine, Charles University in Hradec Králové Department of Nursing Title: The quality of life of women with breast cancer Supervisor: Mgr. Eva Vachková, Ph.D. Number of pages: 110 Number of attachments: 3 Year of defense: 2018 Keywords: quality of life, cancer, breast cancer The bachelor thesis deals with breast cancer and its influence on the quality of life of the sick woman. The theoretical part focuses on breast anatomy, breast cancer division, epidemiology, etiology, prevention, disease manifestations, disease diagnosis, treatment and nursing care. It clarifies the concept of "quality of life". The empirical part examines the quality of life of women with breast cancer using a questionnaire survey

Controversies in Pediatric Perioperative Airways

Pediatric airway management is a challenge in routine anesthesia practice. Any airway-related complication due to improper procedure can have catastrophic consequences in pediatric patients. The authors reviewed the current relevant literature using the following data bases: Google Scholar, PubMed, Medline (OVID SP), and Dynamed, and the following keywords: Airway/s, Children, Pediatric, Difficult Airways, and Controversies. From a summary of the data, we identified several controversies: difficult airway prediction, difficult airway management, cuffed versus uncuffed endotracheal tubes for securing pediatric airways, rapid sequence induction (RSI), laryngeal mask versus endotracheal tube, and extubation timing. The data show that pediatric anesthesia practice in perioperative airway management is currently lacking the strong evidence-based medicine (EBM) data that is available for adult subpopulations. A number of procedural steps in airway management are derived only from adult populations. However, the objective is the same irrespective of patient age: proper securing of the airway and oxygenation of the patient

Critically Ill Pediatric Patient and SARS-CoV-2 Infection

In December 2019 SARS-CoV-2 initiated a worldwide COVID-19 pandemic, which is still ongoing in 2022. Although adult elderly patients with chronic preexisting diseases had been identified as the most vulnerable group, COVID-19 has also had a significant impact on pediatric intensive care. Early in 2020, a new disease presentation, multisystemic inflammatory syndrome, was described in children. Despite the vaccination that is available for all age categories, due to its selection process, new viral mutations and highly variable vaccination rate, COVID-19 remains a significant clinical challenge in adult and pediatric intensive care in 2022