Brain Abscess and MR Spectroscopy

Cíl Cílem práce je vyhodnocení vlivu podávání antibiotik na MR spektroskopický nález u pacientů léčených pro mozkový absces a současně i identifikace rizikových a prognostických markerů tohoto závažného onemocnění. Metodika Prospektivní monocentrická studie u všech pacientů léčených pro mozkový absces neurochirurgickém oddělení FNO v letech 2012-2017. V rámci předoperační přípravy byla pacientům provedena magnetická rezonance včetně difuzně váženého obrazu a jednoobjemové protonové spektroskopie se středním relaxačním časem. Byl vyhodnocen počet dní podávání antibiotik, charakter MR a spektrálního nálezu a výsledek kultivačního vyšetření. Stanovena mortalita a morbidita souboru včetně zhodnocení rizikové faktorů (pyocefalus, imunosuprese, epilepsie, zánětlivé markery). Výsledky Charakteristický MRS nález pro mozkový absces (minimálně byl detekován jeden z metabolitů - AA, acetát, alanin, sukcinát) mělo 20 pacientů ve skupině s podáním antibiotik do 72 hodin včetně (median 7 hodin; IQR 30 hodin), delší podávání antibiotik u 19 pacientů (median 336 hodin, IQR 284 hodin) je spojeno pouze s detekcí nespecifického laktátu a/nebo lipidů a neprokázalo metabolity specifické pro absces (p<0,0005). Výsledky jsem dále statisticky srovnali s výsledky kultivačního vyšetření peroperačně odebraného hnisu a prokázali...Background This work aims to determine how antibiotic therapy influences MR spectroscopic findings in patients undergoing treatment for pyogenic brain abscess and to comprehensively evaluate this naturally dreaded complication from a purely medical perspective by using an evidence- based approach and comparison with available literature which mostly comprises case reports. Methods This prospective, single center study included all patients who received treatment for brain abscesses at the Neurosurgery Department of University Hospital Ostrava between 2012- 2017. Pre-operative MR imaging was carried out on all patients including diffusion-weighted imaging and in vivo single-voxel proton spectroscopy with intermediate echo time. The following factors were evaluated: duration of antibiotic therapy, characteristics of MR imaging and spectra findings and culture results. Particular consideration was given to the effect of pyocefalus on morbidity and mortality rates and C-reactive protein levels, as well as the identification of risk factors and its possible therapeutic influence. Patients were followed up for 6 months. Results MR spectroscopy findings characteristic of brain abscesses, i.e. the resonances of at least one of the metabolites concerned (amino acids, acetate, alanine and succinate), were observed in...Katedra chirurgieAcademic Department of SurgeryLékařská fakulta v Hradci KrálovéFaculty of Medicine in Hradec Králov

Brain abscess and pyocephalus: our experience with treatment

Introduction. Pyocephalus always presents serious complications in the treatment of brain abscesses, and is associated with high rates of mortality and morbidity. This study aimed to comprehensively evaluate this understandably feared complication from a purely medical perspective by using an evidence-based approach and drawing comparisons from the available literature, which mostly comprises case reports. Methods. This was a prospective monocentric study of all patients treated for brain abscesses at the Neurosurgery Clinic of the University Hospital Ostrava between 2012 and 2017. The cohort was divided into two groups for statistical comparison; one group comprised those in which pyocephalus occurred before or during treatment, while the other group comprised patients without this complication. Particular consideration was given to the effect of pyocephalus on morbidity and mortality rates and C-reactive protein levels, as well as to the identification of risk factors, and to its possible therapeutic influence. Patients were followed up for six months. Results. A total of 43 patients were treated for a brain abscess. An unequivocal diagnosis of pyocephalus was established via CT and MRI brain scans in five cases (11.6%). In the cohort as a whole, mortality and morbidity rates were 23.3% and 48.8% respectively. Among patients with pyocephalus the incidence of mortality and morbidity was 40% and 66.6% respectively. The presence of pyocephalus is not a significant predictor of either morbidity (p 0.575) or mortality (p 0.664). In patients with pyocephalus, we determined elevated CRP levels on the day of surgery (p 0.038). The occurrence of epileptic seizures in the acute phase of the disease is associated with a poor outcome (p 0.039). Conclusions. Pyocephalus will continue to be a serious complication in the treatment of brain abscesses, although we were unable to determine its utility as a prognostic factor. Patients with this complication have elevated CRP levels on the day of operation

Mechatronický víceprocesorový systém se sběrnicí LIN Bus

Import 20/04/2006Prezenční výpůjčkaVŠB - Technická univerzita Ostrava. Fakulta elektrotechniky a informatiky. Katedra (454) elektroniky a telekomunikační technik

Nasycení dřeva pryskyřicí a vliv na mechanické vlastnosti

The subject of the thesis is to clarify the influence of saturation of wood with resin on its mechanical properties. The selected tree species is beech. From the samples of beech I've created three groups, of which two groups were saturated with resin and one was unsaturated. Groups saturated with resins are further subdivided into saturated with synthetic and natural resins. The groups were compared with each other. The samples of all groups were subjected to experimental tests, which involve determining the compression across the fibers. The obtained data were subjected to statistical analysis

Návrh podnikatelského záměru s vazbou na odvětví dřevozpracujícího průmyslu

The aim of this thesis is to develop a business plan for funding new enterprise in joinery and carpentry. The thesis is divided into two parts. In the first part there are mentioned the theoretical basis of the work, which contain and explain the concepts of business, entrepreneur, enterprise, financing of a business and business plan including its structure, evaluation of business plan effectiveness. In the second part of the thesis, the theoretical basis is applied in practice to a specific business plan. The business plan is created for the emerging business entity. Because it is a new business, it must consider carefully the financing of the business. The business plan also includes an assessment of its effectiveness by indicators of profitability and payback period

Brain Abscess and MR Spectroscopy

Background This work aims to determine how antibiotic therapy influences MR spectroscopic findings in patients undergoing treatment for pyogenic brain abscess and to comprehensively evaluate this naturally dreaded complication from a purely medical perspective by using an evidence- based approach and comparison with available literature which mostly comprises case reports. Methods This prospective, single center study included all patients who received treatment for brain abscesses at the Neurosurgery Department of University Hospital Ostrava between 2012- 2017. Pre-operative MR imaging was carried out on all patients including diffusion-weighted imaging and in vivo single-voxel proton spectroscopy with intermediate echo time. The following factors were evaluated: duration of antibiotic therapy, characteristics of MR imaging and spectra findings and culture results. Particular consideration was given to the effect of pyocefalus on morbidity and mortality rates and C-reactive protein levels, as well as the identification of risk factors and its possible therapeutic influence. Patients were followed up for 6 months. Results MR spectroscopy findings characteristic of brain abscesses, i.e. the resonances of at least one of the metabolites concerned (amino acids, acetate, alanine and succinate), were observed in..

Methodology for application of essential oils and their components for creation of fungistatic effect in repositories of paper artifacts endangered by microbiol attack caused by increased relative humidity

Cílem metodiky je na základě získaných vědomostí, tj. empirických poznatků i teoretických znalostí o jevech souvisejících s interakcemi papírová hmota - páry esenciálních olejů, shrnout zásady a vypracovat postupy, jak tyto látky nebo jejich uměle připravené analogy používat, aby jejich aplikace pro zabránění mikrobiologického rozkladu papírových artefaktů byla maximálně efektivní s minimálními negativními dopady na papírové artefakty

The role of third ventricle bowing in the success of endoscopic third ventriculostomy in pediatric and adult patients

Objective: Preoperative third ventricle deformation (known as 'bowing') is associated with higher endoscopic third ventriculostomy (ETV) success. In children, the effect of bowing has not to date been systematically studied. Aim of of this study is to determine the effect of bowing on ETV success in adult and child patients. Patients and methods: In this retrospective, monocentric study were included 135 (70 adults and 65 children) of 157 patients who underwent ETV between 2008-2016, with mean follow-up 4.3 years. Presence and extent of bowing and its impact on ETV outcome were evaluated. Third ventricular anatomy was assessed on pre- and postoperative MR imaging. Results: In patients > 6 months old, the ETV success rate was 91% in bowing-positive cases and 47.6% in bowing-negative cases. Among patients < 6 months old, ETV was successful in 37% of those with bowing and 36.4% of those without. Presence of bowing strongly indicates ETV success in patients older than 6 months (p < 0.000 5), including children of 7 months and older (p 0.001). This relationship was not confirmed in pediatric patients up to 6 months old (p 1.000). The extent of bowing does not influence ETV success (p 0.559). Bowing correction strongly correlates with ETV success (p < 0.000 5). Conclusion: We confirmed significant correlation between bowing and ETV success in patients over 6 months old. This relationship was not determined in those younger than 6 months and therefore we do not recommend bowing in ETV indication criteria for this patient cohort.Web of Science187art. no. UNSP 10555

Comparing endoscopic and open decompression of the ulnar nerve in cubital tunnel syndrome: a prospective randomized study

Background Prospective randomized data is currently lacking which compares endoscopically assisted surgery with open surgical techniques in the treatment of cubital tunnel syndrome (CUTS). The aim of this study is to compare patient outcome in both techniques. Method This prospective study comprised of 45 patients who, between October 2014 and February 2017, were randomly assigned to undergo either endoscopic or open surgery (22 and 23 patients respectively) for decompression of the ulnar nerve. Patients were followed up at 3 and 12 months postoperation. McGowan classification was used to determine the severity of symptoms. Surgical outcome was evaluated by Bishop classification. Pain levels were monitored according to gender from 0 to 10 days postoperation. Other factors investigated were chronic scar pain, working status, operation duration, and patient satisfaction regarding postoperative scarring and the procedure itself. Results Both methods are equally effective in the treatment of CUTS (Bishop score excellent or good 90% vs 96%). Postoperative pain is significant particularly in the first few days following surgery, but with no significant difference depending on procedure. In the open group, postoperative pain was significantly higher in women than in men; pain did not differ between the sexes in the endoscopic group. The tendency to lower levels of pain among endoscopically operated women in comparison with women in the open group was not statistically notable. Patients who underwent open decompression experienced notably higher levels of postoperative chronic scar pain. Although working status and satisfaction with the surgical outcome were the same in both groups, satisfaction with scarring was higher in the endoscopy group. Operation time was significantly longer by endoscopy. Conclusions Both studied methods produced equal satisfactory outcomes in the treatment of CUTS. Endoscopy has the potential to minimize chronic scar pain and improve scarring esthetics, at the expense of longer operating time. Clinical trial registration number Supported by Ministry of Health, Czech Republic—conceptual development of research organization (FNOs/2014, project number 20).Web of Science160102017201

Hydrocephalus caused by primary fourth ventricle outlet obstruction: Our experience and literature review

OBJECTIVE: Primary fourth ventricle outlet obstruction (PFVOO) is a rare cause of hydrocephalus with an unclear etiopathogenesis, and thus, consensus regarding the recommended treatment protocol is lacking. This study aims to summarize current knowledge of this condition in the light of our own treatment experience. METHODS: Retrospective analysis was carried out of all patients treated for noncommunicating tetraventricular hydrocephalus between 2006 and 2019, from which a subgroup of patients with PFVOO was created. A literature review of PFVOO cases was also carried out. RESULTS: A total of 62 patients with PFVOO were discovered, of whom 8 were treated at our institution, representing 3.8% of our patients with noncommunicating hydrocephalus. Patients most commonly presented with headaches, gait disturbance, or symptoms of intracranial hypertension. The mean follow-up duration was 75.4 months among our patients and 29.9 months in the literature. Most patients (54.8%) were treated by endoscopic third ventriculostomy (ETV), with the remainder undergoing suboccipital craniotomy alone (17.7%) or in combination with shunt surgery (9.7%), or endoscopic magendieplasty (12.9%). Treatment failure was noted in 28.6% of ETVs and 9% of craniotomies. No failures were recorded after endoscopic magendieplasty. The risk of treatment failure was found to be significantly higher with ETV compared with other treatment modalities (P < 0.0005). CONCLUSIONS: Despite the fact that PFVOO can be defined as an obstructive hydrocephalus, there seems to be a higher risk of ETV failure in such cases. The alternative treatment modalities presented are still recommended. Confirmation of these findings requires a larger multicenter study.Web of Science148E435E42