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Lectures (from a clinical point of view): Upper limb Lower limb Thorax Abdomen Pelvis Head and neck Department of Anatomy ...

UPJŠ LF v Košiciach | discipline: Anatomy | keywords: upper limb, lower limb, thorax, abdomen, pelvis, head and neck | published on: 29. 3. 2022

Ortopedická klinika FN Brno-Bohunice page The most common spinal deformities scoliosis kyphosis page SCOLIOSIS page Scoliosis is three-dimensional deformity  in frontal plane - scoliosis  in sagittal plane – hypo, hyperkyphosis  in transversal plane – rotation, torsion page Scoliosis: 3-D deformity page Torsion page Elementary primary evaluation • anamnesis • clinical examination • X-ray evaluation • treatment page Anamnesis • familiar anamnesis • complex health status • development – sitting, standing, … • capture and present treatment page Clinical evaluation  trunk compensation – plumb line  shoulder height  waist asymmetry  pelvic balance  curve flexibility in bending position  prominence in bending forward  others - laxicity, sexual development, skin pigmentation, lenght of lower extremities page Žeberní prominence (APVZ) page Measurement of trunk decompensation page Measurement of paravertebral gibbus Measurement of shoul der asymmetry page Measurement of paravertebral gibbus page Sagittal balance page Shoulder height Gibbus Asymmetry of waist Trunk decompensation page Neurofibromatosis „café au lait“ page Radiological evaluation • PA and lateral X-rays in standing position (35x90 cm) • lateral bending X-rays and traction of 200 N • Special projections: Fergusson a Stagnara • wrist X-ray for bone age measurement (Greulich-Pyle 1959) • CT for measurement of apex vertebra rotation page Radiological scoliotic measurement • COBB – angle of scoliosis and sagittal balance • MOE – evaluation of vertebral rotation • RISSER sign – evaluation of bone age page Curve gravity evaluation according to COBB page page page Rotation evaluation according to MOE page RISSER´s sign  STADIUM 1 = 2 years before ending of growing period  STADIUM 3 = peak of growing spurt page FERGUSON´s projection page STAGNARA projection page Rotation - vertebra evaluation Th apical vertebra L apical vertebra double Th-L curves page Basic terms Apical vertebra Ending vertebra Neutral vertebra CSVL Stable vertebra page Characteristics of the curves Structural Non-structural page Curves terminology (according to Cobb angle) Main (weighty rotation) Adjacent (compensatory) page Curve structurality  Main – structural  Adjacent – structural, non-structural Curve structurality of adjacent curve is important to decide the fusion of adjacent curve in surgical treatment of AIS page Non-structural curve H 10° H 47° V 33° V 3° page Classification  Orientation – right or left convexity  Localisation – C,CT,T,TL,L,LS  Gravity of curves – according to Cobb angles  Etiology page Localisation of the curve according to position of the apical vertebra  Thoracic: T2- disc T11/12 Upper Th T3 – T5 Lower Th T6 – disc T11/12  Thoracolumbar: T12-L1  Lumbar: disc L1/2-L4 HH DH TL L page Scoliosis – ethiopathogenetic classification  Congenital  Idiopathic……..............4/5 80%  infantile  iuvenile  adolescent  Neuromuscular  neuropatic  myopatic  Neurofibromatosis  Secondary  Postural  Tumours  Other syndromas (Marfan, Ehlers-Danlos…… ... Imaging methods page Magnetic resonance imaging (MRI) Imaging methods page • conservative treatment • observation • casting and bracing • surgical treatment • simple bony fusion • hemiepiphyseodesis • complete posterior • combined a/p • posterior instrumentation • hemivertebrectomy • combined a/p surgery • posterior only surgery Treatment possibilities page Observation Indication: - small curves <20° - curves at low risk of progression -nonsegmented hemivertebra -bilateral defects of segmentation - curves <40°at the end of an adolescent age Follow up: - clinical examination every half year - follow-up X-ray once per year up to growth completition - FU X-ray every five years in adults Progression over 25° bracing or surgery page Bracing Indication: - curves 20°-40° - curves at low risk of progression -semisegmented hemivertebra - controling of secondary curves in growth period Progression over 40° surgery page 2 main surgical techniques used today Simple bony fusion Hemivertebrectomy with instrumentation Arrest of curve progression (without direct correction) -in small curves -in early detection Correction of scoliotic curve -in greater curves -in supposed curve progression page Simple bony fusion Indication: - hemivertebra without kyphosis - short curvature < 5 vertebrae - curvature < 50° Technique: - bilateral bone desis - unilateral bone desis – hemiepiphyseodesis (convex side) - posterior, anterior or combined Unilateral fusion growth arrest on convex side allow growth on concave side page Simple bony fusion page Postoperative care Plaster cast: first 6-12 months Bracing: till the growth ending - clinical examination every half year - follow-up X-ray once per year up to growth completition page Hemivertebrectomy using combined a/p surgical approach with instrumentation stabilization page page Associated rib cage deformities Absented ribs Fused ribs page Vertical Expandable Prosthetic Titanium Rib (VEPTR) page The main factors of quality treatment results: -early detection -good timing -choosing of adequate surgical treatment type page Neuromuscular scoliosis page Neuromuscular scoliosis the 3rd main scoliotic deformity - extensive progression (even after mature) - weighty deformities - associated with pelvic and hip deformities -high rate of associated dysfunctions - cardiopulmonal - urinary - pressure sores - osteopenia page Neuromuscular scoliosis Sitting instability Standing instability page Etiologic classification of the spinal neuromuscular deformities -affection of the upper motoric neuron -cerebral palsy -spinocerebelar degeneration (Friedreich, Charcot-Marie-Tooth, Roussy-Lévy) -syringomyelia -spinal tumours -spinal trauma -affection of the lower motor neuron -poliomyelitis -spinal muscular atrophy (Werdnig-Hoffmann) -paralytic myelomeningocele 1.neuropathic 2.myopathic -artrogryphosis -muscular dystrophy (Duchenne) page Neuromuscular scoliosis  long unilateral curve  kyphoscoliosis  lumbar hyperlordosis  pelvic and hip deformities 1.Spastic forms rigid kyphoscoliosis 2.Hypotonic forms paralytic curves page Pelvic deformities 1.structural - in spinal deformities 2.functional - in muscle imbalances page Pelvic deformities •Posterior tilt •Pelvic obliquity •Pelvic rotation •Windswept hip phenomenon •Anterior tilt page POSTERIOR TILT page Extensive pelvic posterior tilt •Hyperactivity of hip extensors •Hamstrings shortening •Weakeness of lower back extensors •Decreasing of lumbar lordosis •Lumbar spine flexion POSTERIOR TILT page ANTERIOR TILT page Extensive pelvic anterior tilt •Shortening of lower back extensors •Weakness of trunk muscles •Shortening of iliotibial tractus •Shortening of hip extensors •Increasing of lumbar lordosis ANTERIOR TILT page PELVIC OBLIQUITY page Pelvic obliquity •Unbalanced trunk •Lumbar scoliosis •Hip dislocation •Muscle imbalance: •Hip adductors imbalance •Hip abductors weakness PELVIC OBLIQUITY page PELVIC ROTATION page Pelvic rotation •Often associated with scoliosis •Dislocated hip located in posterior side of rotation PELVIC ROTATION page Wind hip deformity •1st hip: Flexion+abduction+external rotation •2nd hip Adduction+internal rotation WINDBLOW HIP DEFORMITY •Hip dislocation •Pelvic obliquity and rotation •Scoliosis •Different leg lenght page Therapy of the neuromuscular spinal deformities 1.conservative disadvantages: -low efect -poor tolerance of the orthosis -worsening of the cardiopulmonal functions -pressure sores 2.surgical indications: -collapse and instability of the spine -progressivity in cardiopulmonal dysfunctions -back pain -tendence to pressure sores page Surgical therapy - doesn´t solve the primary affection - improving the secondary dysfunctions Main aims of the surgical therapy: - prevention of the deformity progression - correction of the deformity - improving of the sitting and standing stability - compensation of the pelvic obliquity - improving of the cardiopulmonal functions page Combination of the surgical techniques LUQUE = segmental spinal sublaminar instrumentation with translation forces GALVESTON = pelvic stabilisation page Luque spinal segmental instrumentation - good and safe correction - stable instrumentation - allows the release of the orthosis - possibility of the extending to the pelvis page Galveston pelvic stabilization page GALVESTON page LUQUE + GALVESTON page Main complications in instrumentation Incorrect implantation of the rod to the pelvis Dislocation of the upper instrumentation part page Contemporary treatment - transpedicular fixation page Other scoliosis page Neurofibromatosis page Neurofibromatosis „café au lait“ page Neurofibromatosis - Sharp curves - High rate of pseudoarthrosis - Reexploration of fusion page Scoliosis in other syndromas  Osteochondrodystrofy  Ehlers – Danlos  Marfan  Morquio  O. imperfecta page Secondary curves  Postural  Inflamations  Tumours  Hysteria  Degenerative page Degenerative scoliosis page Complications of surgical therapy page  perioperative – implantation of instruments  overcorrection – mechanical (spinal cord distraction) - vascular Neurological complications page Cast syndroma – vascular duodenal compression  acute (postop., plaster)  chronical (Wilke syndroma) Duodenal compresion in third part between a. mesent. sup. and aorta with partial duodenal obstruction page page Therapy of cast syndroma  intravenous nutrition  nasogastric drain  left side body position  (side to side duodenojejunoanastomosis) page Later complications  Pseudoarthrosis (loss of correction, pain, loosening of instrumentation)  Bending of fusion during growth period  Fracture in fusion page page Infection complications  superficial  deep  punction, antibiotics  surgical revision, drainage page Possible postoperative fixations FN Brno-Bohunice, Ortopedická klinika page FN Brno-Bohunice, Ortopedická klinika 1 ...

LF MU | discipline: Surgery, Traumatology and Orthopaedics | ...: Array | published on: 13. 5. 2016

The testes and scrotum are larger Stage 5: adult page Staging of pubertal development -TANNER Girls Breast B1-5 Pubic hair (P1-5) Axillary hair (A1-5) Menarche page Staging of pubertal development in girls Stage 1: preadolescent, elevation of the papilla only Stage 2: breast bud stage, elevation of the breast and papilla as a small mound Stage 3: further enlargement and elevation of the breast and areola, with no separation of their contours Stage 4: projection of the areola and papilla above the level of the breast Stage 5: mature stage, projection of the papilla alone due to recession of the areola page Timing of puberty • the age of normal pubertal onset in boys or girls varies considerably • determined in part by genetic factors and external factors – adequacy of nutrition, occurrence and severity of chronic disease and tempered by exercise levels • over the last 100 yrs has been a slow but marked transgenerational decrease in the age of onset of puberty in both boys and girls and onset of menarche page Normal pubertal development BOYS GIRLS Age of start (yrs) 12.5 (10-14) 11.5 (9-13) First sign of puberty G2 (testicular volume  4 ml) B2 Growth velocity (cm/yr) 10.3 (Tanner III ... • Growth velocity is normal • FSH and LH levels after LH-RH are normal • Gonadal and adrenal steroid levels are normal • Pelvic and adrenal ultrasonography is normal • only observation of the signs of pubertal develepment • in a few isolated cases can premature thelarché proceeds to precocious puberty page Gynecomastia - breast enlargement in boys Physiologic • testosteron is converting to estrogens in liver • increasing sensitivity of E receptors in breast to slightly elevated E level • In 40-50% boys at the start of puberty • unilateral or bilateral Pathologic • unilateral - breast tumor (very rare) • bilateral - elevated prolactin (prolactinoma or hypothyreosis with elevated TSH) - elevate estrogen/testosteron ratio (47,XXY) page Precocious puberty-treatement • Gonadotropin-dependent PP idiopathic GnRH (LH-RH) analog (triptorelin) to block LH-RH receptor in gonadotroph of pituitary gland • Organic – tumor or cysts surgery, exlude hamartoma • Gonadotropin-independent pseudopuberty testicular, ovarian or adrenal tumors – surgery CAH – substitution of corticosteroids autonomous steroid secretion-estrogens receptor antagonists (tamoxifen) steroid synthesis inhibitors (ketoconasole) page Delayed puberty • initial physical changes of puberty are not present: by age 13 years in girls (or primary amenorhoe at age 15.5-16yrs) by age 14 years in boys • pubertal development is inappropriate the interval between first signs of puberty and menarche in girls/completition genital growth in boys is ˃ 5 yrs page GnRH or gonadotropin dependent DP • Idiopathic – sporadic or familial (associated with constitutional growth delay) • Chronic disease with bone age delay and growth retardation due to different pathophysical mechanismes (malnutrition, anemia, acidosis, hypoxia) ...anorexia nervosa, cystic fibrosis, chronic kidney disease • Psychosocial deprivation page GnRH or gonadotropin dependent DP Hypogonadotropic hypogonadism • Gonadotropin deficiency (isolated) LH only (fertile eunuch syndrome) FSH and LH - congenital: Kallman sy, Prader-Willi sy - acquired: tumors, inflamation, irradiation, trauma ...

UPJŠ LF v Košiciach | discipline: Paediatrics, Neonatology | ...: Array | published on: 27. 3. 2017

... date 2011-02-05T15:34:06Z pdf:PDFVersion 1.5 xmp:CreatorTool Microsoft® Publisher 2010 stream_content_type application/pdf pdf:hasXFA false access_permission:modify_annotations true access_permission:can_print_degraded true dc:creator JANA language cs-CZ dcterms:created 2011-02-05T15:34:06Z Last-Modified 2011-02-05T15:34:06Z dcterms:modified 2011-02-05T15:34:06Z dc:format application/pdf; version=1.5 Last-Save-Date 2011-02-05T15:34:06Z pdf:docinfo:creator_tool Microsoft® Publisher 2010 access_permission:fill_in_form true pdf:docinfo:modified 2011-02-05T15:34:06Z stream_name https://portal.lf1.cuni.cz/_down1lfMefa48s56PRTG554-89898sds/4/157-introduction-to-first-aid-pdf_4d4fd0635bc41.pdf meta:save-date 2011-02-05T15:34:06Z pdf:encrypted false modified 2011-02-05T15:34:06Z pdf:hasMarkedContent true Content-Type application/pdf stream_size 854854 pdf:docinfo:creator JANA X-Parsed-By org.apache.tika.parser.DefaultParser X-Parsed-By org.apache.tika.parser.pdf.PDFParser creator JANA dc:language cs-CZ meta:author JANA meta:creation-date 2011-02-05T15:34:06Z stream_source_info url created 2011-02-05T15:34:06Z access_permission:extract_for_accessibility true access_permission:assemble_document true xmpTPg:NPages 25 Creation-Date 2011-02-05T15:34:06Z pdf:hasXMP false access_permission:extract_content true access_permission:can_print true Author JANA producer Microsoft® Publisher 2010 access_permission:can_modify true pdf:docinfo:producer Microsoft® Publisher 2010 pdf:docinfo:created 2011-02-05T15:34:06Z page 1 Scene of an emergency  Usually very stressful situation  Improvisation is usually necessary ACTION IN AN EMERGENCY  Primary Survey (Initial assessment)  Get help  Secondary Survey (assessment)  Provide first aid  Reassess regularly  Transport to health care facility page 2 1) Primary assessment and BLS  Many injuries or illnesses do not require life-saving effort or even medical treatment but in some cases very promptly and properly applied first aid could mean difference between life and death or just temporary and permanent disability  Aim of primary assessment is to decide if any life-saving intervention usually basic life support is necessary or not  Mnemonic DRs ABC helps to remember what is necessary to assess ACTION IN AN EMERGENCY  Primary Survey (assessment)  Get help  Secondary Survey (assessment)  Provide first aid  Reassess regularly  Transport to health care facility  D  R  s  A  B  C page 3 1) Primary assessment and BLS  Dangers = Hazards  Before rescuer approaches scene of an emergency, he needs to be sure it is safe  Look for any hazards that could be dangerous to you, the victim, or bystanders (Gasoline; Fire; Vehicle obstructing traffic; Electric current; Toxic vapour; Deep water; …)  Take general precautions at first  Do not attempt heroic rescue in hazardous circumstances  Any even potentially dangerous situation could result in further injury to the victim, rescuer or the other  In some circumstances to provide proper first aid cold mean: “call emergency services and wait for them” ACTION IN AN EMERGENCY  Primary Survey (assessment)  Dangers  R  s  A  B  C page 4 1) Primary assessment and BLS  Response = Consciousness  Start with assessment while you are approaching  Moving speaking, crying victim is alert - there is no need for further assessment of respon- siveness  If the victim is not alert, to assess responsiveness, firmly squeeze the victims shoulders, gen- tly shake and ask loudly: “Are you all right? ... “  Responsive victim (alert or responds to verbal or painful stimuli)  proceed to secondary assessment as basic life support is not needed right now  Unresponsive victim continue with primary assessment ACTION IN AN EMERGENCY  Primary Survey (assessment)  Dangers  Response  s  A  B  C  Alert and aware  Responds to Verbal stimuli  Responds to Painful stimuli  Unresponsive  AVPU scale page 5 1) Primary assessment and BLS  shout for help  Try to attract attention of somebody who could help you but so not leave the victim at this point ACTION IN AN EMERGENCY  Primary Survey (assessment)  Dangers  Response  shout for help  A  B  C page 6 1) Primary assessment and BLS  Airway  clear or not? ...

1.LF UK | discipline: Health Care Sciences | ...: Array | published on: 9. 2. 2011

... date 2011-02-05T15:34:06Z pdf:PDFVersion 1.5 xmp:CreatorTool Microsoft® Publisher 2010 stream_content_type application/pdf pdf:hasXFA false access_permission:modify_annotations true access_permission:can_print_degraded true dc:creator JANA language cs-CZ dcterms:created 2011-02-05T15:34:06Z Last-Modified 2011-02-05T15:34:06Z dcterms:modified 2011-02-05T15:34:06Z dc:format application/pdf; version=1.5 Last-Save-Date 2011-02-05T15:34:06Z pdf:docinfo:creator_tool Microsoft® Publisher 2010 access_permission:fill_in_form true pdf:docinfo:modified 2011-02-05T15:34:06Z stream_name https://portal.lf1.cuni.cz/_down1lfMefa48s56PRTG554-89898sds/4/163-introduction-to-first-aid-pdf_4d73e039748d8.pdf meta:save-date 2011-02-05T15:34:06Z pdf:encrypted false modified 2011-02-05T15:34:06Z pdf:hasMarkedContent true Content-Type application/pdf stream_size 854854 pdf:docinfo:creator JANA X-Parsed-By org.apache.tika.parser.DefaultParser X-Parsed-By org.apache.tika.parser.pdf.PDFParser creator JANA dc:language cs-CZ meta:author JANA meta:creation-date 2011-02-05T15:34:06Z stream_source_info url created 2011-02-05T15:34:06Z access_permission:extract_for_accessibility true access_permission:assemble_document true xmpTPg:NPages 25 Creation-Date 2011-02-05T15:34:06Z pdf:hasXMP false access_permission:extract_content true access_permission:can_print true Author JANA producer Microsoft® Publisher 2010 access_permission:can_modify true pdf:docinfo:producer Microsoft® Publisher 2010 pdf:docinfo:created 2011-02-05T15:34:06Z page 1 Scene of an emergency  Usually very stressful situation  Improvisation is usually necessary ACTION IN AN EMERGENCY  Primary Survey (Initial assessment)  Get help  Secondary Survey (assessment)  Provide first aid  Reassess regularly  Transport to health care facility page 2 1) Primary assessment and BLS  Many injuries or illnesses do not require life-saving effort or even medical treatment but in some cases very promptly and properly applied first aid could mean difference between life and death or just temporary and permanent disability  Aim of primary assessment is to decide if any life-saving intervention usually basic life support is necessary or not  Mnemonic DRs ABC helps to remember what is necessary to assess ACTION IN AN EMERGENCY  Primary Survey (assessment)  Get help  Secondary Survey (assessment)  Provide first aid  Reassess regularly  Transport to health care facility  D  R  s  A  B  C page 3 1) Primary assessment and BLS  Dangers = Hazards  Before rescuer approaches scene of an emergency, he needs to be sure it is safe  Look for any hazards that could be dangerous to you, the victim, or bystanders (Gasoline; Fire; Vehicle obstructing traffic; Electric current; Toxic vapour; Deep water; …)  Take general precautions at first  Do not attempt heroic rescue in hazardous circumstances  Any even potentially dangerous situation could result in further injury to the victim, rescuer or the other  In some circumstances to provide proper first aid cold mean: “call emergency services and wait for them” ACTION IN AN EMERGENCY  Primary Survey (assessment)  Dangers  R  s  A  B  C page 4 1) Primary assessment and BLS  Response = Consciousness  Start with assessment while you are approaching  Moving speaking, crying victim is alert - there is no need for further assessment of respon- siveness  If the victim is not alert, to assess responsiveness, firmly squeeze the victims shoulders, gen- tly shake and ask loudly: “Are you all right? ... “  Responsive victim (alert or responds to verbal or painful stimuli)  proceed to secondary assessment as basic life support is not needed right now  Unresponsive victim continue with primary assessment ACTION IN AN EMERGENCY  Primary Survey (assessment)  Dangers  Response  s  A  B  C  Alert and aware  Responds to Verbal stimuli  Responds to Painful stimuli  Unresponsive  AVPU scale page 5 1) Primary assessment and BLS  shout for help  Try to attract attention of somebody who could help you but so not leave the victim at this point ACTION IN AN EMERGENCY  Primary Survey (assessment)  Dangers  Response  shout for help  A  B  C page 6 1) Primary assessment and BLS  Airway  clear or not? ...

1.LF UK | discipline: Health Care Sciences | ...: Array | published on: 7. 3. 2011

The critical area (to reject 𝑯𝟎) is: −∞;−𝒛 𝟏− 𝜶 𝟐 ∪ 𝒛 𝟏− 𝜶 𝟐 ;∞ or in one-tailed (one-sided) 𝑯𝟎: −∞;−𝒛𝟏−𝜶 𝒐𝒓 𝒛𝟏−𝜶;∞ TESTS OF MEAN VALUES page Hypothesis testing for a mean if the variance of the population 𝝈𝟐 is unknown and the sample group is big enough Null hypothesis: 𝑯𝟎: 𝝁 = 𝝁𝟎 Alternative hypothesis: 𝑯𝟏: 𝝁 ≠ 𝝁𝟎 𝒐𝒓 𝑯𝟏: 𝝁 > 𝝁𝟎 𝒐𝒓 𝑯𝟏: 𝝁 < 𝝁𝟎 The test statistic is: 𝒁 = ഥ𝑿 − 𝝁𝟎 𝑺 𝒏 𝝈𝟐 is estimated by sample variance 𝑺𝟐 calculated from sample group data. The critical area (to reject 𝑯𝟎) is: −∞;−𝒛 𝟏− 𝜶 𝟐 ∪ 𝒛 𝟏− 𝜶 𝟐 ;∞ or in one-tailed (one-sided) 𝑯𝟎: −∞;−𝒛𝟏−𝜶 𝒐𝒓 𝒛𝟏−𝜶;∞ TESTS OF MEAN VALUES page Hypothesis testing for a mean if the variance of the population 𝝈𝟐 is unknown and the sample group is small Null hypothesis: 𝑯𝟎: 𝝁 = 𝝁𝟎 Alternative hypothesis: 𝑯𝟏: 𝝁 ≠ 𝝁𝟎 𝒐𝒓 𝑯𝟏: 𝝁 > 𝝁𝟎 𝒐𝒓 𝑯𝟏: 𝝁 < 𝝁𝟎 The test statistic is: 𝑻 = ഥ𝑿 − 𝝁𝟎 𝑺 𝒏 has t-distribution with 𝒏 − 𝟏 degrees of freedom that will be used to determine critical values at particular significance level 𝛂 ...

UPJŠ LF v Košiciach | discipline: Medical Informatics and Information Science | ...: Array | published on: 9. 10. 2019

... kongenitálna dyserytropoetická anémia Napadnutie kostnej drene paraneoplastickým alebo neoplastickým procesom page Erytroidné progenitorové bunky sú abnormálne → ↓ citlivosť na erytropoetín spôsobená funkčnou abnormalitou receptorov erytropoetínu page  Anémia a bledosť počas prvých 3 mesiacov, 90% - pri dosiahnutí 1. roka  Počet Trc a Le→ normálny  25% → poruchy rastu a kongenitálne defekty (malý vzrast, abnormality palcov a kostry kostry, VCC, kožná riasa na krku, abnormality močového traktu a kraniofaciálny dysmorfizmus)  Bez hepatosplenomegálie  Malígny potenciál (↑ výskyt ALL, AML, hepatocelulárny karcinóm) annotation http://www.google.sk/url? ... )  Obštrukčný ikterus s ↑ priameho (konj.) bilirubínu→ aj následok cholelitiázy (dôsledok ↑ vylučovania pigmentu) page Klinické príznaky hereditárnej sferocytózy  Anémia a ikterus – závisí od stupňa hemolýzy a kompenzácie  Splenomegália  Hemolytická kríza – akcelerovaná hemolýza, ↑ ikteru  Erytroblastopenická kríza – prudký ↓hladiny Hb a a Rtc, spojený s infekciou (parvovírusom B19)  Deficit kyseliny listovej → ↑ obmena ery → superponovaná megaloblastová anémia  Cholelitiáza u 50% neliečených pacientov annotation http://www.google.sk/url? ...

UPJŠ LF v Košiciach | discipline: Paediatrics, Neonatology | ...: Array | published on: 5. 9. 2016

... page RELATIVE FREQUENCY TABLE • relative frequency is proportion of values falling within a particular class • frequency divided by the total number of values • the sum of relative frequency is 1 page CUMULATIVE RELATIVE FREQUENCY TABLE • cumulative relative frequency is the accumulation of the previous relative frequencies • the sum of the relative frequencies for all values that are less than or equal to the given value • the last entry of cumulative relative frequency column is 1 (100% of data) page HISTOGRAM • distribution of total frequency into different classes/group • can display large data sets • consists of continuous bars (boxes) • vertical axis is labeled as frequency (relative frequency) • frequency curve smoothly connects the mid-points of all bars page NUMBER OF CLASSES AND CLASS INTERVAL WIDTH Range (max - min) has to be divided into 𝒌 classes • 𝒌 is usually between 5 and 15, (can be 𝒌 ≅ 𝒏) • avoid too few or to many classes in distribution – optimal value depends on data to be processed (researcher’s knowledge) Sturges’s formula • can be used to determine number of classes and range of class intervals (width) Number of classes: 𝒌 = 𝟏 + 𝟑. 𝟑𝟐𝟐 log𝟏𝟎 𝒏 where 𝒏 is the number of values. Class interval width: 𝒄 = 𝑹𝒂𝒏𝒈𝒆 𝒌 • rounded to a whole number The classes should be evenly distributed ...

UPJŠ LF v Košiciach | discipline: Medical Informatics and Information Science | ...: Array | published on: 9. 10. 2019

Licencia Anatomy of upper extremity from orthopaedic view 14.1.2019 6.17 MB registered user – Anatomy of lower extremity from orthopaedic view 14.1.2019 5.4 MB registered user – Anatomy 1 [UA/A-GM1/14] Department of Orthopaedics and Traumatology of Locomotory Apparatus ...

UPJŠ LF v Košiciach | discipline: Anatomy | keywords: anatomy, upper extremity, lower extremity, orthopedics | published on: 14. 1. 2019

1.LF UK | discipline: Emergency Medicine | ...: Array | published on: 7. 12. 2006

Artificial bezoar control AcknowledgementAcknowledgement This work was supported by a grant No. 209071 given by the CzechThis work was supported by a grant No. 209071 given by the Czech Ministry of EducationMinistry of Education D a y s 0 1 0 2 0 3 0 4 0 5 0 6 0 7 0 Su rv iv al (% ) 0 2 0 4 0 6 0 8 0 1 0 0 FigFig. 2.. 2 ...

1.LF UK | discipline: Gastroenterology and Hepatology | ...: Array | published on: 11. 12. 2006

Licencia Renal Rescue Therapy 16.3.2020 2.2 MB anyone – – Some Invasive Procedures in Anaesthesia 16.3.2020 283.18 KB anyone – – Enteral and Parenteral Nutrition – Basic Principles of Fluid Therapy 16.3.2020 3.38 MB anyone – – Fluid Balance, Oxygentherapy, Pneumothorax 16.3.2020 3.06 MB anyone – – Metabolizmus, transport kyslíka, spotreba a dodávka kyslíka, hemodynamika 16.3.2020 2.52 MB anyone – – ACLS Review 16.3.2020 573.94 KB anyone – – 2nd Department of Anestesiology and Intensive Medicine ...

LF UK v Bratislave | discipline: Anaesthesiology and Intensive Care Medicine | keywords: Anestehsiology, ACLS | published on: 16. 3. 2020

Special projections: Fergusson a Stagnara •! wrist X-ray for bone age measurement (Greulich-Pyle 1959) •! ... complete posterior •!combined a/p •!posterior instrumentation •!hemivertebrectomy •! ...

LF MU | discipline: Surgery, Traumatology and Orthopaedics | ...: Array | published on: 15. 4. 2009

... q Scar measurement is different with every person, nevertheless there is a general rule that deeper the burn and the longer healing time is than the greater and worse influenced scars by rehabilitation arise ... page THE MAIN PHYSIOTHERAPY PRINCIPLE q Systematic (time demanding) q Specialized physiotherapist q Patient´s activation and motivation q Nursing staff co-operation q Family relatives co-operation page PHYSIOTHERAPY q Right after the injury, after the burn shock wearing off q Repositioning q Passive exercising q Active one with some help q Active exercising q Exercising against resistance q Exercising in hypermanganese bath page q Single fingers binding q Pressure massages q Soft techniques and balooning q Peripheral joints mobilization q Post isometric relaxation q Silicone patches q Elastic stalls q Phyical therapy q Occupational therapy and exercise of daily routines page PHYSIOTHERAPY CONTRAINDICATION q Transplanting period (1-5 days according to the consulting room) q Patint´s state (febrile states, cardiopulmonary decompensation.... q Thrombosis, thrombophlebitis page ACTIVE AND PASSIVE EXERCISING page EXERCISING IN HYPERMANGANESE BATH page BINDING OF EACH FINGERS page PRESSURE MASSAGES q Done a few times a day q Finger pressure on the scar area for 30s q Hypertrophic scars formation prevention page SOFT TECHNIQUES + BBALOONING q Influence the reflexive changes in the mucles and hypodermis q Put before the exercising page PERIPHERAL JOINTS MOBLIZATION page page ELASTIC STALLS q From polyurethane fibre q Made-to-measure q Worn for 23 hours everyday for one or two years page REPOSTITIONING q Redressive q Corrective q Functional page POST ISOMETRIC RELAXATION TECHNIQUE page SILICONE GELS AND PATCHES q Affect the scars likely as pressure masssages page ERGOTHERAPY AND DAILY ROUTINE EXERCISING page TRAINING: q Inform the affected person or his/her family to stick to the above metioned rules (wearing elast. stalls, press. mas,..) ...

LF MU | discipline: Surgery, Traumatology and Orthopaedics | ...: Array | published on: 26. 10. 2018

Elaborate a semester work according to study groups on the given topics ...

LF UK v Bratislave | discipline: Dentistry | keywords: oral surgery, dentistry | published on: 24. 3. 2020

Enzymes – provides introduction to enzymology, describing mechanism of enzyme action and nature of coenzymes Biologic membranes – deals with cell membranes with a focus on structure and function of plasma membrane and membranes of intracellular organelles ...

JLF UK v Martine | discipline: Medical Chemistry and Biochemistry | ...: Array | published on: 6. 12. 2013

... page COMPUTER HISTORY COMPUTER HISTORY –– ComputerComputer computers development brought va pp according to them, the computers w Zero generation all the computers developed before  first electromechanical components manually programmable using the s low reliability as well as computing  MARK I MARK II ZUSE 1 ZUSE 2 ZUMARK I, MARK II, ZUSE 1, ZUSE 2, ZU 1st generation forties and fifties of the last centuryforties and fifties of the last century starts with invention of vacuum–tub up to 1000 operation per secondup to 1000 operation per second, first computer code, high energy consumption and short g gy p ENIAC, UNIVAC I, UNIVAC II, IBM 704  generations generations arious conceptions, gg were divided into generations: forties of the last century, s (relay), switches and wires, rate, USE 3 EDVAC EDSACUSE 3, EDVAC, EDSAC … yy, be, lifetime of vacuum – tubes,, 4, IBM 650 … page COMPUTER HISTORY COMPUTER HISTORY –– ComputerComputer 2nd generation pp end of fifties and first half of sixties  vacuum–tubes replaced by transisto smaller, faster, less energy consump first magnetic disc, operating system th d f ti dthousands of operation per second, IBM 1410, MINSK, ZPA 600, SPECTRA 3rd generation3rd generation second half of sixties and seventies  starts with invention of integrated cstarts with invention of integrated c 100 000 operations per second, universal operating systems, real timp g y , first monitors and terminals end of seventies – 3.5 generation (m IBM 360, JSEP, EC 1021, RPP 16, IBM  generations generationsgg of the last century, ors, ption, higher reliability, ms, programming languages, A 70, TESLA 200 … of the last century, ircuitsircuits, me applications,pp , million ops) M 370, EC 1045 … page COMPUTER HISTORY COMPUTER HISTORY –– ComputerComputer 4th generation pp first half of eighties of the last centu transition to monolithic integrated c usage of microprocessors, semicond microcomputers IBM PC, Apple Mac Hewlett Packard SunHewlett Packard, Sun … 5th generation nineties of the last century till thesenineties of the last century till these improvements in parallel computing billion operations per second,p p , integration of communications and  massive expansion of computer netw information technologies (IT) lead to  generations generationsgg ury, circuits, ductor memories, laser technique, cintosh, minicomputers DEC (Compaq),  e yearse years, g, multimedia, works, o information society ... pp it is hard to specify whether there a only improvements of the 5th genera h d l d dthe development trends tend to use processing approach similar to the h the computers of the 6th generationthe computers of the 6 generation  the changes may occur also by usage integrated optoelectronic syste cryogenic electronics, and/or bioelectronics ...

UPJŠ LF v Košiciach | discipline: Medical Informatics and Information Science | ...: Array | published on: 25. 4. 2008

Cummulative recovery (cPDR) significantly distinguishes severe CHP (grade C3) from all other groups, mild CHP (grade A) is significantly higher compared to other groups of CHP ...

1.LF UK | discipline: Gastroenterology and Hepatology | keywords: diagnostic techniques, digestive system, pancreatic function tests, pancreatitis, breath tests, Exocrine pancreatic function, Chronic pancreatitis, Breath test, Stable isotope 13C, Mixed triglyceride, Fecal elastase, diagnostic techniques, digestive system, pancreatic function tests, pancreatitis, breath tests | published on: 19. 2. 2007

Diagnostics and operation of a cyst in maxillary sinus. Preventive aspects) ...

LF UK v Bratislave | discipline: Dentistry | keywords: Oral surgery, Cysts of hard tissue, Precancers | published on: 22. 2. 2022

Serological reactions based on the reaction between antigen and antibody can be used directly in the detection, identification and quantification of microbial antigens in a clinical sample. They are mainly used for the identification of hard-to-isolate and non-cultivable microorganisms, but also as screening methods and methods of rapid preliminary diagnosis ...

UPJŠ LF v Košiciach | discipline: Microbiology | keywords: serologic reaction, agglutination, antibody, antigen, antibody titer | published on: 28. 5. 2023

Licencia Practical lessons 1 8.2.2023 1.43 MB registered user – Practical lessons 2 8.2.2023 1.09 MB registered user – Practical lessons 3 8.2.2023 989.8 KB registered user – Practical lessons 4 8.2.2023 475.63 KB registered user – Practical lessons 5 8.2.2023 839.83 KB registered user – Practical lessons 6 8.2.2023 938.51 KB registered user – Practical lessons 7 8.2.2023 1.05 MB registered user – Practical lessons 8 8.2.2023 543.49 KB registered user – Practical lessons 9 8.2.2023 709.59 KB registered user – Practical lessons 10 8.2.2023 972.64 KB registered user – Practical lessons 11 8.2.2023 1.49 MB registered user – Practical lessons 12 8.2.2023 2.23 MB registered user – Practical lessons 13 8.2.2023 1.01 MB registered user – Practical lessons 14 8.2.2023 408.4 KB registered user – Anatomy 2 [UA/A-GM2/14] Department of Anatomy Topics for practical lessons from Anatomy 1 for students of General Medicine ...

UPJŠ LF v Košiciach | discipline: Anatomy | keywords: thoracic wall, diaphragm, breast, mediastinum, heart, respiratory system, nasal cavity, nasopharynx, abdominal wall, abdominal cavity, pelvis, thoracic wall, diaphragm, breast, mediastinum, heart, respiratory system | published on: 30. 6. 2018

... page Systemic lupus erythematosus Rheumatoid arthritis Sjogren’s syndrome Polymyositis Dermatomyositis Scleroderma (progressive systemic sclerosis) Systemic autoimmune diseases page SLE • A prototypic multi-system autoimmune and immune complex disease • Involvement of skin, kidneys, lungs, heart blood vessels • Immunoregulatory abnormalities • Many autoantibodies – ANA • ds DNA • ENA – Phospholipids page Systemic lupus erythematodes (SLE) • Systemic autoimmune disease affecting various tissues and organs ... ) • Anti-inflammatory drugs • Immunosuppressive treatment • Tolerance induction page Systemic Immunosuppression • High-dose steroids • Purine antagonists: Azathioprin • Alkylating agents: Cyclophosphamide • Anti-pholates: Methotrexate • Calcineurin antagonists: Cyclosporine A, Rapamycin, Tacrolymus • Block of purins synthesis: Mycophemolate • Monoclonal antibodies: anti-CD3, anti-CD20, anti-CD54 ...

LF MU | discipline: Immunology, Allergology | ...: Array | published on: 6. 9. 2013

... producer Microsoft® Word 2016 access_permission:can_modify true pdf:docinfo:producer Microsoft® Word 2016 pdf:docinfo:created 2023-01-24T08:07:07Z page Week 4 – Topics for practical lessons A. Repetition. B. 4th teoretical and practical test ...

UPJŠ LF v Košiciach | discipline: Anatomy | ...: Array | published on: 30. 6. 2018

... producer Microsoft® Word 2016 access_permission:can_modify true pdf:docinfo:producer Microsoft® Word 2016 pdf:docinfo:created 2023-01-24T08:11:50Z page Week 14 – Topics for practical lessons A. Repetition B. Teoretical and practical tests ...

UPJŠ LF v Košiciach | discipline: Anatomy | ...: Array | published on: 30. 6. 2018

Except of other requirements a well-designed hospital information system should be scalable and flexible to meet the specific needs of the hospital ...

UPJŠ LF v Košiciach | discipline: Medical Informatics and Information Science | keywords: information system, hospital, health record, patient record | published on: 18. 3. 2011

After completing the course, the participant should acquire the ability to understand the preparation of a comprehensive research study as well as the necessary knowledge to design their own clinical study and basic research ...

LF UK v Bratislave | discipline: Medical Informatics and Information Science | keywords: Biomedical research | published on: 22. 2. 2021

Licencia Minor (dentoalveolar) preprosthetic surgery 29.10.2025 38.61 MB anyone – – Major preprosthetic surgery on maxilla and mandible 30.10.2025 156.26 MB anyone – – Dentofacial Anomalies A 29.10.2025 117.68 MB anyone – – Dentofacial Anomalies B 29.10.2025 104.48 MB anyone – – Dentofacial Anomalies C 29.10.2025 79.11 MB anyone – – Temporomandibular Joint (TMJ) Disorders 29.10.2025 55.13 MB anyone – – Orofacial Neuralgias and Pain in H+N region 29.10.2025 80.27 MB anyone – – Palsy of Facial Nerve 29.10.2025 32.15 MB anyone – – General Bone Diseases 29.10.2025 13.52 MB anyone – – Department of Stomatology and Maxilofacial Surgery ...

LF UK v Bratislave | discipline: Dentistry | keywords: Maxillofacial Surgery, Anomalies | published on: 21. 10. 2020

The compound nevus is the most common type of conjunctival melanocytic tumors and has a benign course which does not require treatment ...

LF UK v Bratislave | discipline: Ophthalmology and Optometry | keywords: Ophthalmooncology | published on: 25. 3. 2020

A.) HELICID (OMEPRAZOL) REMESTYP (TERLIPRESIN) BLOOD TRANSFUSION FRESH FROZEN PLASMA PLATELET CONCENTRATE FIBRINOGEN NOVOSEVEN (FACTOR VII) page CAUSES OF BLEEDING INTO UPPER GIT ESOPHAGEAL VARICES PEPTIC ULCER TUMOR EROSIVE GASTRITIS REFLUX ESOPHAGITIS HEMOBILIA MALLORY-WEISS ZOLLINGER-ELLISON page AFTER INITIAL STABILISATION THERE IS PLACE FOR GASTROSCOPY ESOPHAGEAL VARICES LIGATION SCLEROTISATION page BLEEDING SUCCESFULLY STOPPED 6 HOURS LATES HEMATEMESIS AGAIN ESOPHAGEAL VARICES LIGATION SCLEROTISATION AFTER INITIAL STABILISATION THERE IS PLACE FOR GASTROSCOPY page SENGSTAKEN – BLAKEMORE (INTERIM MEASURE) page SENGSTAKEN – BLAKEMORE (INTERIM MEASURE) page SENGSTAKEN – BLAKEMORE (INTERIM MEASURE) page SENGSTAKEN – BLAKEMORE (INTERIM MEASURE) page SENGSTAKEN – BLAKEMORE (INTERIM MEASURE) page SENGSTAKEN – BLAKEMORE (INTERIM MEASURE) page OTHER TREATMENT POSSIBILITIES (EXCEPTIONALLY) TIPSS WARREN PROCEDURE ESOPHAGEAL TRANSECTION page ACUTE APPENDICITIS page VOMITING (NAUSEA) WHAT IS THE TYPICAL COURSE OF APPENDICITIS? ... COULD BE DIAGNOSED BY DOORMAN page ACUTE APPENDICITIS HALF OF APPENDICES DON‘T READ SURGERY TEXTBOOKS page ACUTE APPENDICITIS ANALGETICS CORTICOIDS ATB CAUSES OF TYPICAL COURSE: page ACUTE APPENDICITIS IT COULD BE DIFFICULT EVEN FOR A SKILLED DIAGNOSTICIAN page ACUTE APPENDICITIS WHAT COULD YOU CONFUSE APPENDICITIS WITH? ...

LF MU | discipline: Surgery, Traumatology and Orthopaedics | ...: Array | published on: 26. 10. 2018

� Člověk je orientován na budoucnost a změnu. � Životním cílem je potřeba začlenit se do společnosti a zde se uplatnit a prosadit, k tomu potřebuje povzbuzovat a naučit se kompenzovat pocity méněcennosti ... Sen má svůj účel a smysl, pomáhá pochopit současnost a připravit se na budoucnost ...

LF UP | discipline: Psychiatry, Psychology, Sexology | ...: Array | published on: 24. 2. 2009