Fulltext search in archive

The proposed system of assessment enables fast screening of the actual health risk levels in situations of chemical threat. The system could facilitate and accelerate emergency management concerning application of protective devices, implementation of emergency precautions or total evacuation. The system includes analytical, physical and toxicological modules. The analytical module collects information about a form of chemical emergency event, actual air levels of selected dangerous compounds in the site of emergency event and actual atmospheric conditions. The physical module calculates the total concentration zones (the total zones of health risk) and records the zones into the map. The toxicological module enables continual assessment of actual health risk in the emergency team workplace. The system includes more than 80 dangerous chemical compounds and is still under development, with a target number of about 100 substances. After the final completion, the system could be a part of the integrated rescue system.

The authors present the problems of psychological and psychosocial intervention in oncological patients, their importance and position in global antitumorous therapy.

In this paper we compare two methods for detection of nephropathy - determination of microalbuminuria (Ma) and examination of human protein spectrum in urine with two-dimensional gel high-resolution electrophoresis (TGHE) caused by nephrotoxic effect of cyclophosphamide.Microalbuminuria was examined in 11 patients (6 men and 5 women) with basic hematooncologic disease (acute leukemia and multiple myeloma) indicated to cytostatic treatment. Five patients were treated for acute leukemia (2 men and 3 women) and 6 patients for multiple myeloma (4 men and 2 women). All patients were given cyclophosphamide in a 3-hour infusion at a mean dose of 3200 mg.m-2. Simultaneously with Ma, urine of all patients was examined with TGHE. In our group of patients, prior examination did not show any presence of kidney affection. In all patients, diuresis (at least 3 l/24 h) was secured by suitable hydration during application of cytostatics, however, in most of them it was much higher. Ma was examined before cytostatic application and day 1 and 10 after its end. An analysis revealed diversified and polymorphic changes. They were individual, i.e. different in each patient. However, at the present state of knowledge and insufficient experience with the method, their analysis and interpretation cannot yet be done. Therefore, just as an example, reference maps of excreted proteins only in 1 female patient with multiple myeloma were made up: prior to cytostatic therapy and 1 and 10 days after its completion.We found out that kidney function was changed in a certain way, and the use of the cytostatic drug and sub-sequent polyuria influenced the character of proteinuria.

Methods to analyze toxic scheduled chemicals (TSC) and their decomposition products in environmental samples have been developed and are widely used. However, methods for such analyses in biological samples have only recently been developed. Retrospective detection of exposure to TSC can be useful for various reasons. First of all, such analytical methods can be used to establish firmly whether casualties have indeed been exposed to these chemicals, whereas dosimetry of the exposure will be a starting point for medical treatment of the intoxication. Second, these methods will be useful for verification of alleged non-adherence to the Chemical Weapons Convention. Moreover, these methods can be used for health surveillance of workers in destruction facilities of chemical warfare agents and in forensic analyses in case of suspected terrorist activities. In this presentation an overview is given of the methods currently available for detection of exposure to sulfur mustard, nerve agents, lewisite and phosgene. In this report an overview is presented of the methods currently available for detection of exposure to sulfur mustard, nerve agents, lewisite and phosgene.

Cardiac toxicity is one of the possible adverse events of oncology treatment. Various methods have been recommended for diagnostics of cardiac toxicity. In our conditions, electrocardiography and echocardiography are routinely used. The article gives a review of the potential of electrocardiography in diagnostics of cardiac toxicity of oncology treatment and contains the authors' own experience with this problem.

The acute cardiac toxicity of anthracyclines is one of possible side effects of anthracyclines. The study is focused on applicability of the continuous 24-hours monitoring of electrocardiogram in patients treated with anthracyclines. There were 19 patients, who had a newly diagnosed acute leukemia and were treated with chemotherapy containing anthracyclines, participating in the study. Two standard 24-hours Holter ECG records were made in each patient, the first before the onset of administration of anthracyclines and the other during and after the administration of anthracyclines. During and after the administration of anthracyclines the length of the PQ, QRS and QTc interval increased, whereas the heart rate decreased. The count of the supraventricular as well as ventricular premature beats didn't increase. The occurrence as well as the severity of arrhythmias showed mesoscale or strong dependence on the occurrence and the severity of arrhythmias before the treatment. There were 6 (31.6 %) patients with R on T type ventricular premature beats associated with prolonged QTc interval in our group. In these patients, the biggest benefit from monitoring of the electrocardiogram during therapy containing anthracyclines may be suspected.

Infections caused by intracellular bacterial pathogens are generally considered as a serious problem for health care services. The vaccination strategy is missing in most of these infections due to the absence of vaccines licensed for human use. The information from newly performed studies revealed the possibility of utilizing the polyclonal or monoclonal antibodies alone, or in combination with cytokines as a tool for passive immunoprophylaxis of these serious infections.

Introduction: Lately eliminative methods have developed which enable an effective treatment of patients with acute liver failure (ALF) waiting for liver transplantation or spontaneous liver parenchyma regeneration.Aim of the study: To evaluate the effectiveness of non-biological method FPSA (Fractionated plasma separation and adsorption) in the treatment of experimental ALF on a big laboratory animal.Methods: Surgical model of ALF with liver devascularization in pigs weighting 25-40 kg was provided following monitoring of ALF markers (AST, ALT, bilirubin, ammonia, glycaemia, INR) including intracranial pressure (ICP). A control group without treatment of ALF was performed. 14 pigs weighting 35 kg (35 ± 5 kg) with the identical ALF were treated by Prométheus (FPSA). Results were compared with the control group and statistically worked on by the T-test and Mann-Whitney non-parametric test using tabulator EXCEL and QUATRO.Results: The level of bilirubin serum in the experimental group comparing with the control group was significantly lower (p < 0.05) within 6th hour 12.81 ± 6.54 vs. 29.84 ± 9.99 within 9th hour 11.94 ± 4.14 vs. 29.95 ± 12.36 and within 12th hour 13.88 ± 6.31 vs. 26.10 ± 12.23 mmol/l. The significant difference in ammonia serum level was not founded. ICP was significantly different from 9th hour to 12th hour in favour of FPSA group (p < 0.05): 9th hour 19.1 ± 4.09 vs. 24.1 ± 2.85, 10th hour 21.9 ± 3.63 vs. 25.1 ± 2.19, 11th hour 22.5 ± 3.98 vs. 26.3 ± 3.50 and 12th hour 24.0 ± 4.66 vs. 29.8 ± 5.88 mm Hg.Conclusion: Using the FPSA method (Prométheus) the significant decrease of bilirubin and ICP was proved by the authors on a surgical devascularization model of acute liver failure in the experiment on a big laboratory animal. The method is suitable for a supportive therapy of the acute liver failure in ROLE 3.

The Czech Republic as a member of NATO supports missions in several places of the world, which results from its membership. The Medical Service members of the Czech Army participated actively in foreign missions in the last few years. One of the destinations where missions take place in 2006-2007 is also Afghanistan where our soldiers work in provincial reconstruction teams. These missions are The Enduring Freedom and ISAF mission (International Security Assistance Force) in Kabul. The authors decided to present the recent epidemiological situation of this Asian country from the viewpoint of sending the Czech Army soldiers to Afghanistan. The report is based on the author's personal experience: she took care of local patients during the mission ISAF 2002 where she worked as a general practitioner in the 11th Field Hospital.

Aim: The study analyses the influence of selected aspects on the global quality of life in patients with multiple myeloma and malignant lymphoma after the hematopoietic stem cell transplantation at the Department of Clinical Hematology of the Second Internal Clinic of the University Hospital and Medical Faculty of Charles University in Hradec Králové from 2001 to 2003. Patients and Methods: The total number of respondents after the transplantation was 80 and the return rate of questionnaire was 70% (56 respondents - 32 with multiple myeloma - average age was 60 years and 24 with malignant lymphoma - average age was 46,5 years). The Czech version of the international generic European Quality of Life Questionnaire - Version EQ-5D was used. The influence of monitored aspects (the type of transplantation - autologous, allogenous, age, sex, education, marital status, religion, nicotinism, the type of disease and the time-gap from the transplantation) on the global quality of life in patients was performed by means of analysis of variance. Results: The above-mentioned aspects proved statistically significant dependence of EQ-5D index and EQ-5D VAS on the age (in both cases p < 0,01) and on the type of disease (in both cases p < 0,01) in both groups of patients and on nicotinism in patients with multiple myeloma (in both cases p < 0,05). EQ-5D index and EQ-5D VAS significantly decrease with increasing age and type of disease in both groups and nicotinism in patients with multiple myeloma. The influence of other factors on EQ-5D index and EQ-5D VAS was not proven as statistically significant. Conclusion: The global quality of life in patients with multiple myeloma after the hematopoietic stem cell transplantation is lower than in patients with malignant lymphoma after the transplantation performed at our department, what show us the average values of EQ-5D index (68,9 % in patients with multiple myeloma and 82,7 % in patients with malignant lymphoma) and the average values of EQ-5D VAS (66,6 % in patients with multiple myeloma and 76,7 % in patients with malignant lymphoma).

Aim: The study analyses the quality of life (QoL) in patients with multiple myeloma (MM) and acute myeloid leukaemia (AML) undergoing autologous haematopoietic stem cell transplantation (HSCT). Patients and Methods: The total number of respondents with AML was 12 (7 male, 5 female). The total number of respondents with MM was 32 (18 male, 14 female). The average age of patients with AML was 47.5 years and average age of patients with MM was 60 years. The Czech version of an international generic European Quality of Life Questionnaire - Version EQ-5D was used. The effect of selected psychosocial, health and demographic aspects on QoL in patients was determined by means of variance analysis. The descriptive analysis was used for evaluation of QoL questionnaires. Results: The above-mentioned aspects proved a statistically significant dependence of QoL (EQ-5D score and EQ-5D VAS) on age in both cohorts (p<0,01), religion in AML cohort (p<0,05), smoking abuse in both cohorts (p<0,01), level of education in AML cohort (p<0,05), increasing number of associated diseases in both cohorts (p<0,05) and type of disease (p<0,05). Conclusion: The global QoL in patients with AML is at a higher level than in patients with MM treated by means of autologous PSCT.

Conditions and directions of possible development of new chemical compounds usable for military purposes are characterized and focused on the groups of toxic agents in question. Non-lethal chemical weapons are also mentioned.

This review deals with the smokeless tobacco products, their use, composition, systemic and oral diseases associated with it. It is evident that smokeless tobacco is carcinogenic to human and causes various systemic and oral diseases. One of the major cancers caused by smokeless tobacco use is oral cancer and other oral diseases like leucoplakia, dental caries, smokeless keratosis, and other negative influences of smokeless tobacco on oral cavity including staining of teeth, bad breath, mouth sores, attrition and abrasion. This review also tries to describe the possible tobacco cessation intervention in dental office.

One of the parametres of the electrical heart stability is also the QT interval (electrical systole) duration. It depends on the heart rate, during tachycardia it is being shortened during bradycardia it is being prolonged. However, its limits on the ECG are not very exactly defined, especially the end of T wave. For QT interval duration the ventricular cells of type M are mainly important and they have the very long action potentials. Plenty of equations were proposed, linear or nonlinear. QT duration and the mathematic formula of regression equation depend on several factors - gender, age, exercise, diseases, pharmacological agents. QT duration in healthy women at the same heart rate is approximately by 10-20 ms longer than in healthy men, in elderly persons is longer than in younger ones. The slowed repolarization of ventricular cells in women is the cause of the difference. Many cardiovascular, cerebral, other diseases and some drugs are able to prolong QT interval. Change of the dependence of QT duration on the heart rate means a change of autonomic nervous system activity. Relation between QT and RR intervals is highly individual and specific in every person.

Excavation of a mass grave of Napoleon's soldiers in Vilnius showed their massive infestation with body lice and evidence for a severe typhus epidemic which contributed essentially to Napoleon's crushing defeat in Russia 1812.

The haematopoietic stem cell transplantation is a specific therapy used not only in the therapy of haemato-oncological disease and in the therapy of solid tumors but also in the therapy of non-malignant diseases. As other currative methods, the haematopoetic stem cell transplantation has an influence on the course of disease and consequently on the quality of life. The authors explore the global quality of life in 12 adult patients with acute myeloid leukemia after haematopoietic stem cell transplantation at the Department of Clinical Haematology of the 2nd Department of Internal Medicine, University Hospital and the Faculty of Medicine of Charles University in Hradec Králové. The EuroQol methodology (European Quality of Life Questionnaire EQ-5D) was used in evaluating the effects of selected aspects on the global quality of life (age, sex, level of education, religion, smoking abuse, polymorbidity, marital status, type of transplantation (autologous or allogeneic) and the lapse time from transplantation. The results show that the global quality of life is significantly related with the age, level of education, smoking abuse, religion and polymorbidity. The effect of other factors on the global quality of life has not been proved. The global quality of life in adult patients wih acute myeloid leukemia after the haematopoietic stem cell transplantation at the Department of Clinical Haematology of the 2nd Department of Internal Medicine, University Hospital and the Faculty of Medicine of Charles University in Hradec Králové is on a greatly good level (mean EQ-5D score was 75,1% and mean EQ-5D VAS was 67,5%).

The influence of the dissociative anaesthetic ketamine and its combination with the alpha 2 agonist medetomidine administered nasaly and by inhalation on behaviour and neurologicalfunctions was demonstrated in experiments in rats. Animals inhaled the drugs in two whole-body glass chambers, each having a volume of 410 ml. The anaesthetic aerosol was generated by a nebuliser based on a mobile form of the Henderson apparatus. The particle volume concentration of the aerosol generated was measured by a Royco 225 particle counter. The theoretical ketamine concentration during two and ten minute exposures was 3.57 mg/l of inhaled air. During the ketamine and medetomidine mixture’s exposure, the ketamine concentration was 1.78 mg/l and the medetomidine concentration was 17.8 μg/l of inhaled air In case of I00% ketamine absorption, the received dose of 4.6 mg/kg should be after a two minutes exposure and the received dose of 23 mg/kg should be after a 10 minute exposure. In fact the inhaled doses were of course lower. The development of first symptoms was very rapid. The first behavioural changes — ataxia, easier catching of the animals as well as easier animal handling appeared as early as two minute. The first evidences of analgesia were manifested. Very serious psychomotoric coordination changes were found after a ten minute exposure. The applied ketamine doses are much lower than for the intramuscular or intraperitoneal routes of administration. In the mixture of ketamine and medetomidine the ketamine doses could be reduced to 50%. This drug combination potentiated some eflects on position reflex, pain perception, muscle relaxation and behaviour.
Ketamine alone or in combination with medetomidine could be used in indolent analgosedation in children or in disaster medicine.

Strychnine is a poisonous indole alkaloid which was first identified in plants of the Strychnos genus and Loganiaceae family. It is an extremely toxic compound. Strychnine is rapidly absorbedfrom the gastrointestinal and respiratory tracts and causes failure of the central nervous system and induces seizures. The principal symptom is strong convulsions, sometimes beginning within a few minutes of ingestion and it may be fatal. Any sound or movement may elicit seizure activity. Other symptoms include: muscular cramps (especially in the neck and back), joint stiffness, muscle twitching, restlessness, headache, severe blood-oxygen deficiency in body tissues and cyanosis. Kidney failure may occur as a secondary effect of central nervous system toxicity. Death often occurs due to respiratory arrest. Strychnine is a substantial component of arrow curare poison.

The antitumorous treatment has a lot of side effects. One of them is also cardiac toxicity. The study focuses on using electrocardiography in monitoring of acute cardiac toxicity induced by anthracyclines. There were 15 patients with newly diagnosed acute leukemia or myelodysplastic syndrome participating in the study. The patients were treated by induction chemotherapy containing anthracyclines (idarubicin, daunorubicin or mitoxantron). The study shows the suitability of using electrocardiography to monitor acute cardiac toxicity of anthracyclines, particularly important is the prolongation of QTc interval, which can cause ventricular arrhythmias severely threatening the patient. In our group, the significant QTc interval prolongation (above 440 ms) was seen in 3 (20 %) patients.

Coffee is a widely consumed beverage, usually served hot, prepared from roasted seeds of a coffee plant. In terms of money, coffee is the second most traded commodity in the world, that is outclassed only by petroleum. Even though substances in coffee have relatively small health effects they are widely discussed by the public. Coffee is one of mankind's main sources of caffeine, compound with a stimulating effect. Caffeine is the most widely consumed psychoactive "drug" in the world and probably one of the most commonly used stimulants in sports. Its potential benefits and hazards have been, and continue to be, widely studied and discussed. For example it is supposed that caffeine in coffee increases the risk of hypertension. The aim of this paper is to present a view of toxicologist of drinking of coffee.

The authors desribe a problem of the bone marrow and blood stem cell transplantation. They desribe separate types of indications to the bone marrow transplantation and the transplantation ilself.

This study defines the term “bystander effect of ionizing radiation“, discusses the usefulness of various scientific methods for bystander effect evaluation. Next, it briefly introduces a relatively new technology, the microbeam facility, from the radiobiologic and other branch points of view. The microbeam facility is able to irradiate defined subcellular compartments with the exact number of particles and with the requested energy.

Since 1972 the former Institute for Immunology of Purkyne Military Medical Academy has been engaged in the study of pathogenesis of severe viral, rickettsial and bacterial infections. In the late eighties this Institute built laboratory for the analysis of complex protein mixtures originating from prokaryotic and eukaryotic cells that was based on the application of high-resolution two-dimensional gel electrophoresis (2-DE). Furthermore, the complete proteome "technology including computer-assisted 2-DE gel evaluation and MALDI-TOF MS for protein identification, was successfully implemented in 1999. In the year 2000 the Institute launched the tight cooperation with Faculty of Medicine of Charles University in Hradec Kralove and Masaryk Memorial Cancer Institute in Brno in order to perform the complex analysis of host-bacteria interactions on tissue, cellular; protein, and nucleic acid levels....

Genomic and proteomic analysis bring to biomedical labs qualitatively new technologies, which enable the complex look to genes and gene-related products — proteins. In contrary to genes, which number is definitive for given living system, the number of protein species varied substantially according the immediate living conditions of the system studied. Moreover, most of the proteins have the function associated with the tertiary structure of their molecule, e.g. with the space orientation so called folding and intracellular compartment where are they located. In in vitro systems the process of folding is inefficient and only minority of synthesized molecules have correct shape. In vivo most molecules mustrapidly fold to proper tertiary conformation, otherwise unfolded and misfolded proteins would be degraded. The promotion of protein folding is most probably the chaperones and chaperonins role. These molecules create a family of conserved proteins found in all compartments of prokaryotic and eukaryotic cells. Moreover, in in vivo systems synthesized and folded proteins must occupy the proper intracellular niche to express their function.

This study analyzes possibilities of the use of biodosimetric methods in military practice. It also mentions information concerning limited use of these methods. Subsequently it contains a summary of the most important facts concerning radiation-induced mechanisms at the molecular level, in paticular those concerning p53 activation, induction of G2/M cell cycle arrest and related activation of the MAP kinase pathway at the molecular level.

Vojenske Zdravotnické Listy, the Czech .Military Medical Review, has celebrated its 70^th anniversary in 1996 by the publication of a special bilingual issue; all the articles were written in full in Czech and in English. This special occasion deserves a sincere congratulation from all partner medical reviews, and particularly from the Netherlands Military Medical Review - in Dutch Nederlands Militair Geneeskundig Tijdschrift or NMGT.....