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Biomedical subjects

J Zivný

Publications and source records attributed to J Zivný.

At least 19 recordsLinked to original sources
PubMed2001

The distribution of major lymphocyte subsets in cord blood is associated with its pH.

OBJECTIVES: To assess in venous cord blood the distribution of major lymphocyte subsets according to pH and medications used during labor. DESIGN AND METHODS: Venous cord blood was sampled immediately after labor from 70 newborns (35 males and 35 females) delivered vaginally. Lymphocytes were immunophenotyped by flow cytometry and pH was measured using the AVL 900 automated blood gas analysis system. Data on birth weight, gestational age at delivery, length of labor, presence of stained amniotic fluid, medications used during labor, maternal risk factors, age and parity were collected. RESULTS: The percentage of T lymphocytes decreased while the percentage of NK lymphocytes increased with decreasing pH over the whole range of pH values. The proportions of T and NK lymphocytes were associated with the administration of neuroplegics, spasmolytics or dihydroergotoxin in the first stage of labor. CONCLUSIONS: Cord blood pH and labor-associated variables should be taken into account to adequately interpret the profile of major lymphocyte subsets as a marker of the effect of different prenatal factors on the immune system of neonates.

Adolescent↗
PubMed2001

Changes in markers of anemia and iron metabolism and how they are influenced by antianemics in postpartum period.

BACKGROUND: The object of this study was to examine the occurrence of iron deficiency anemia in women after spontaneous delivery, changes in clinical and laboratory indicators of anemia in postpartum period and their possible control by administration of peroral antianemics. METHODS: Ninety pregnant women at 35th to 39th week of gestation were randomly divided into three groups and extensively examined in a laboratory. After delivery, the mothers were examined four times at monthly intervals until the end of the third postpartum month. At the same time, they were examined for their subjective feeling of health, with some focus on typical anemic symptoms. Women in the first group were treated with 80 mg of elemental iron a day for the first two months after childbirth. Women in the second group were treated with 80 mg of elemental iron+0.35 mg of folic acid a day for the same period of time. Women in the control group did not use any medication. McNamara test was used to evaluate the portion of anemic and sideropenic women and for comparison between individual groups. RESULTS: Findings of the study have shown a faster adjustment of laboratory and clinical indicators of postpartum anemia in women treated with iron. We did not observe the only, sovereign marker of iron deficiency (sideropenic) anemia in the early postpartum period. CONCLUSIONS: We recommend flat administration of iron to all women after spontaneous delivery. Postpartum substitution with iron should last at least three months because of long-lasting sideropenia. Adding folic acid to iron does not have any significant impact during the postpartum period.

Adult↗
PubMed2001

[Changes in serum levels of C-reactive protein and the soluble adhesion molecules, sE-selectin and sICAM-1, after transdermal 17-beta estradiol replacement].

OBJECTIVE: Increases in serum concentrations of C-reactive protein (CRP) and soluble adhesion molecules sE-selectin and sICAM-1 are regarded as risk factors of atherosclerosis now. We aimed to analyse an effect of estrogen replacement therapy (ERT) by transdermal 17-beta estrogen on the variables. DESIGN: A clinical study. SETTING: Division of Gynaecology and Obstetrics, Hospital, Jicín and Department of Gynaecology and Obstetrics, 1st Faculty of Medicine, Charles University, Prague, Czech Republic. METHODS: Serum concentrations of CRP (by immunoturbidimetry) and sE-selectin and sICAM-1 (both by ELISA test) were examined in 19 women (median age 50.0 years) after hysterectomy with both side adnexectomy before and after 4 months of continuous transdermal substitution by 17-beta estradiol (ERT) in 1.5 mg dose daily. Data were compared by paired t-test or by Wilcoxon test. P = 0.05, or below was taken as significant. RESULTS: Serum concentration of C-reactive protein was decreased in treated women after 4 months of ERT (before ERT 1.82 +/- 2.20 mg/l, after 4 months of ERT 0.28 +/- 0.55 mg/l; p = 0.006) as well as both soluble adhesion molecules: sE-selectin (before ERT 45.13 +/- 17.3 micrograms/l, after 4 months of ERT 31.39 +/- 9.03 micrograms/l; p = 0.027) and sICAM-1 (before ERT 271.84 +/- 62.30 micrograms/l, after 4 months of ERT 242.86 +/- 62.32 micrograms/l; p = 0.026). CONCLUSION: Transdermal substitution with 17-beta estradiol may reduce one of risk factor of atherogenesis in treated women after hysterectomy with both side adnexectomy.

Administration, Cutaneous↗
PubMed2001

[Does bedrest after embryo transfer cause a worse outcome in in vitro fertilization?].

OBJECTIVE: To evaluate the effect of bed rest following embryotransfer (ET) on the results of an in vitro fertilization (IVF) program. DESIGN: A prospective randomized study. SETTING: Gyn.-Obst. Department--Assisted Reproduction Centre, 1st Medical Faculty of Charles University Prague and General Hospital, Prague. METHODS: After randomisation of patients on two groups (N--no bed rest, L--bed rest), embryo transfer (ET) was performed and all patients stand-up 20 minutes later. Group N went home, group L continued bed rest in the hospital overnight. We compared results of IVF in both groups. RESULTS: Both groups (N = 20 patients, L = 18 patients) were comparable in the age, number of previous IVF attempts, stimulation protocol, person performing ET, number of transferred embryos, percentage of ICSI, percentage of diagnosis "tubal infertility" and age of embryos in the day of ET. Results for group N (no bed rest) were in all parameters better than for group L: implantation rate (IR) (22.5% versus 14.5%), IR of high quality embryos (25.8% versus 16.7%), pregnancy rate (50% versus 22.2%, p = 0.08), Take-home baby rate (40% versus 11%, p = 0.07). No of results reached clear statistical significance as the study was finished for ethical reasons (worse results of more difficult therapy in group L). CONCLUSION: The overnight bed rest in the hospital following ET did not ameliorate results of IVF. There is a strong tendency to negative effect of bed rest. Similar results may be found on other authors, but they did not extend the sense of their studies to the question of negative effects of the bed rest after ET, being satisfied with the result of "no worse results after no bed rest".

Adult↗
PubMed2001

[Contraception with depot gestagens].

OBJECTIVE: Summary of contraceptive implants and injectable contraceptives. DESIGN: Review of the literature. SETTING: Department of Gynaecology and Obstetrics, 1st Faculty of Medicine, Charles University, Prague. RESULTS: Contraceptive implants and injectable contraceptives are systems based on continuous release of small dose of progestogen in the circulation. Active substances are depo-medroxyprogesterone acetate in the Depo-Provera injections and levonogestrel in Norplant implants. Mechanisms of action are: inhibition of ovulation, impermeability of cervical mucus and synchronisation of maturation of endometrial stroma and glands. Efficacy of both of the methods is very high. Recovery of fertility is immediately in after Norplant removal and in few months after discontinuation of Depo-Provera. Progesterone only contraception has only very few contraindications which are only relative. It is possible to use her by the women with contraindications of combined oral contraception. The main side effect is altered menstrual bleeding pattern.

Contraceptive Agents, Female↗
PubMed2001

[Effect of psychological factors on success of in vitro fertilization].

OBJECTIVE: To examine the influence of psychological factors on outcome of in vitro fertilisation (IVF). DESIGN: Prospective clinical study. SETTING: Department of Gynaecology and Obstetrics, Charles University School of Medicine and General University Hospital Prague. METHODS: Sixty-six couples undergoing IVF treatment were administered psychometric tests: State-Trait Anxiety Inventory, Beck's Depression Inventory, Interpersonal Check List and Dusin Frustration Test. Results of pregnant and non-pregnant group were compared. RESULTS: We found statistically significant differences only in women. Women from the pregnant group had significantly lower scores of trait anxiety then women from the non-pregnant group (P < 0.05). Pregnant women evaluated themselves (P < 0.01) and their partners (P < 0.01) as more hostile then the non-pregnant women in the ICL. In the scores of trait anxiety, depression and frustration were not any differences. In the non-pregnant group were the women significantly more anxious (state anxiety P < 0.02, trait anxiety P < 0.01) and depressed (P < 0.05) then their partners. We didn't find these differences in the pregnant group. CONCLUSION: Women from the pregnant group had significantly lower scores of trait anxiety then women from the non-pregnant group. Those women react in IVF treatment with higher stress and this stress response decreases their chance of conception. They were not any differences between the two groups of man. We found significant differences in the interpersonal interaction. In the non-pregnant group had the women significantly higher scores of depression and both state and trait anxiety. In the ICL evaluated themselves and their partners as more affiliate then the women in the pregnant group. According our opinion adequate hostility protects the women for depression and anxiety and is better coping style.

Adult↗
PubMed2001

[Characteristics of a population of drug dependent pregnant women in the Czech Republic].

OBJECTIVE: The aim of the study was to characterise the population of drug abused pregnant women in Czech republic and chart their socioeconomic situation. DESIGN: Prospective study. SETTING: The Department of Gynaecology and Obstetrics of the General Teaching Hospital and the 1st Medical Faculty of Charles University in Prague. METHODS: This prospective study coursed since January 1998 till the end of the year 2000. This study covered a group of pregnant women addict on illegal drugs (heroin, pervitin). The group was set in close cooperation with Prague's contact anti-drugs centers (DROP-IN, K-centrum, Sanopin), Dependence therapy department and Department for genetics Teaching hospital Prague and of course in cooperation with the district gynaecologists. During 3 years we succeeded in gathering 41 addict women for prenatal care. Twenty of them were heroin and 18 pervitin addict. The control groups were selected by method of accidental choice. We compared each group with its control and both groups of addicted mutually. We focused mainly on characteristics which could have a negative impact on the course of pregnancy, labour and lying-in period and the health condition of the foetus and the neonate (age, status, employment, parity, length of drug abuse, mode of application, attempt of therapy or abstinence, STD, hepatitis B and C, quality of prenatal care). RESULTS: We proved, that drug abused pregnant women are statistically significantly younger than pregnant women from control groups (by equal parity), mostly single and unemployed. The majority of them prefer intravenous way of drug application. The heroin--addict choose this type of application statistically significantly more often (94.4%) and also more often they report efforts at abstinence or therapy. A big part of drug abused pregnant women has insufficient prenatal care. 33% of heroin-addict and 25% of pervitin-addict never attended the obstetrician during their pregnancy. We revealed a significantly higher incidence of HBsAg a mainly anti HCV and active hepatitis C among women from both "drugs" groups compared to their controls. We did not encounter any HIV positive case among the Czech addict pregnant. CONCLUSION: The population of drugs-addict pregnant women may be characterised as a high risk group from the view of prenatal care. The pregnancy is not a sufficient impulse for the majority of drugs-addict women to change their life stereotypes.

Adult↗
PubMed2000

[Paracervical anesthesia in hysteroscopy and transcervical surgery].

OBJECTIVE: To evaluate the efficacity of local-paracervical anaesthesia in hysteroscopy and transcervical surgery. DESIGN: Prospective study. SETTING: Department of Obstetrics and Gynaecology, 1st medical Faculty, Charles University, Prague. METHODS: In 1998 we performed 144 hysteroscopic procedures under local anaesthesia--paracervical block. In 47 (32.6%) cases we performed transcervical surgery. As anaesthetic agent we used bupivacain (0.25%, Marcain, Astra) combined with an intravenous sedative--midazolam (Dormicum, Hoffman-LaRoche). RESULTS: In 130 (90.2%) cases patients evaluated the procedure as comfortable, in 7 (4.86%) cases the procedure caused discomfort and in 7 (4.86%) cases we used general anaesthesia. CONCLUSION: Paracervical anaesthesia is a safe method for hysteroscopy and transcervical surgery due to its minimal invasivity.

Anesthesia, Local↗
PubMed2000

[Results from the Registry of Complications in Users of Hormonal Contraception in 1998].

OBJECTIVE: To collect data on the use of hormonal contraception in the Czech Republic in 1998. SETTING: Department of Gynaecology and Obstetrics, Charles University School of Medicine and General University Hospital Prague. METHODS: A total of 2,134 questionnaires were sent to Czech gynaecologists in spring 1999. A total of 418 answers were processed. RESULTS: The estimated number of users presenting in gynaecologist's offices participating in our project was 237,099 women. The most often prescribed contraceptives were monophasic products (54.38%) containing 30-35 micrograms of ethinyl-estradiol (55.21%) with new progestins (53.8%) (norgestimate, gestoden, desogestrel). Regular follow-up of hormonal contraceptive users included the following examinations/tests: blood count in 8.5% offices, ultrasound examination in 8.0% offices, lipid spectrum in 49.8% offices, blood pressure in 74% offices, colposcopy in 97.6% offices, oncological cytology in 98.4% offices and liver tests in 77.1% gynecologist's offices. Only 10.85% of the gynaecologists did not perform lipid tests, almost 20% gynaecologists measured blood pressure only selectively in some users. 80 cases of cardiovascular disease were diagnosed, a figure consistent with an 0.0325% incidence of users. The most frequent complication was deep venous thrombosis (58 cases). The subgroup of women experiencing a cardiovascular event was not characterized by older age, higher body weight, more frequent smoking, or use of products with a higher oestrogen contents. CONCLUSION: There were major differences among gynaecologists in the follow-up of hormonal contraception users. The pattern of the products used varied markedly by regions. The number of diagnosed cardiovascular diseases was very low. Users with a previous a cardiovascular event were only exceptionally carriers of a risk factor.

Cardiovascular Diseases↗
PubMed2000

[Personal experience with thermoablation of the endometrium with the Thermachoice balloon catheter].

OBJECTIVE: To evaluate our first experience with thermal balloon therapy of abnormal uterine bleeding. DESIGN: Prospective study. SETTING: Department of Obstetrics and Gynaecology, 1st Medical Faculty, Charles University, Prague. METHODS: Ten procedures of balloon thermal endometrial ablations were performed between November 1998 and February 1999. From ten patients with abnormal uterine bleeding, 4 patients with concomitant polymorbidity (sclerosis multiplex, hypertension, hepatopathia, pyelonephritis) where more invasive intervention was not recommended or was contraindicated. Treatment entailed controlled heating of intrauterine balloon. Local anaesthesia-paracervical block with analgosedation was employed in 50% of procedures and general anaesthesia was employed in 50% of cases. Follow up after 3, 6, 12, 24 months is required. Success was defined as the reduction of menses to eumenorrhoea or less. RESULTS: Preliminary results after 6 months follow up are successful in 100%; in 5 (50%) cases we recorded amenorrhoea, in 2 (20%) cases hypomenorrhoea and in 3 (30%) cases eumenorrhoea. CONCLUSION: Thermal balloon endometrial ablation appears to be safe due to its minimal invasivity especially in patients with abnormal uterine bleeding with concomitant polymorbidity.

Adult↗
PubMed2000

[Premature ovarian failure syndrome].

OBJECTIVE: A review of the premature ovarian failure syndrome. DESIGN: Review article. SETTING: Department of Obstetrics and Gynaecology, Charles University, Prague, Czech Republic. SUMMARY: The incidence of premature ovarian failure (POF) is reported to vary between 0.9% and 3%. Most often, the syndrome is manifested by amenorrhoea followed by typical postmenopausal symptoms caused by oestrogen deficiency. The only diagnostic criteria of the syndrome are FSH levels > 40 IU/L obtained twice at least one month apart in women below 40 years of age. The cause of the disease remains obscure in most women. The most often identifiable cause is an autoimmune disorder of the follicular apparatus with a genetic cause established less frequently. All POF women should be examined for other possible autoimmune diseases and women below 30 years of age should have their karyotype identified. Despite the possibility of preserved follicular activity, the probability of pregnancy is very low in those women. Induction of ovulation is virtually ineffective. The diagnosis of POF is a clear indication for long-term oestrogen-progestagen replacement therapy even in the absence of symptoms of oestrogen deficiency.

Adult↗
PubMed2000

[Granulosa cell tumor--clinical group and literature review].

OBJECTIVE: To present a review of literature and to analyse a clinical retrospective series of patients with granulosa cell tumor. DESIGN: Retrospective study and review. SETTING: Department of Obstetrics and Gynaecology, First Faculty of Medicine, Prague, Czech Republic. METHODS: Retrospective analysis of age, stage, surgery, radiotherapy and chemotherapy, survival curve, number of recurrences and time to recurrence. Literature and information database (Medline 1997-1999) review. RESULTS: In a group of 43 patients the median of age was 53.5 years. 83.7% of cases were in a stage I. There were two duplicate tumors in a series. Conservative surgery was performed in 9/43 cases, 5 of them were reoperated on. The most frequent chemotherapy regimens were platinum-cyclophoshamide and BEP (bleomycin, etoposide, platinum). The 5-year overall survival was 86% and specific survival 90.7%. There were 3/43 recurrences, median time to recurrence was 22 months. CONCLUSION: A good prognosis of a patient with granulosa cell tumor requires a precise histopathologic examination, an adequate surgery and a comprehensive clinical analysis of a case to evaluate an indication of adjuvant therapy. Concentration of patients in oncogynaecological centres is advisable. A careful follow-up because of a risk of late recurrences is necessary.

Female↗
PubMed2000

[Gynecologic operations in patients after kidney and liver transplantation--case report].

OBJECTIVE: To give an overview of the complications associated with the post-transplantation period which thus presents an increased risk for subsequent gynecological surgery and also for the postoperative period. To determine the criteria and conditions under which these operations may be performed with relative safety. TYPE OF STUDY: Case report. SUBJECT OF STUDY: Described surgical treatment of gynecological diseases in three patients after liver and kidney transplantation. CONCLUSION: A summary of the principles/basics of patient care after surgery for gynecological indications with a prior organ transplant in ther patient's history. These patients should undergo surgery in hospitals with a high quality of professional care as well as high quality equipment and cooperation among the specialists from the various medical fields involved.

Adult↗
PubMed2000

[Initial experience with the Versapoint bipolar electrode in hysteroscopic tissue vaporization].

OBJECTIVE: To evaluate our first experience with bipolar electrode (Verspoint, Johnson&Johnson) for transcervical surgery. DESIGN: Prospective study. SETTING: Department of Obstetrics and Gynecology, 1st medical Faculty, Charles University, Prague. METHODS: Twenty procedures with bipolar electrode in normal saline as distension fluid were performed between September and November 1999. All 20 patients underwent office diagnostic hysteroscopy with biopsy sampling which demonstrated benign histological finding. We used Olympus operative 7 mm hysteroscope, Versapoint system with bipolar electrodes (twizle, spring, ball). In 13 cases we vaporized intrauterine polyps, in 4 cases we vaporized intrauterine submucous myoma (grade I-ESH), in 1 case we dissected intrauterine septum and in 2 cases we performed intrauterine adhesiolysis. Local anesthesia-paracervical block was employed in 50% of procedures and general anesthesia was employed in 50% of cases. RESULTS: The surgeon evaluated the degree of difficulty during the procedure as comfortable and easy to use in case of intrauterine polyp, intrauterine septum and intrauterine adhesions vaporisation, as mild difficulty in submucous myoma to 2 cm and moderate/severe difficulty in case of myoma vaporisation of more than 2 cm size. No complications were registered during or post procedure, we did not registered no sign of hyponatremia, no complains regarding pain or discomfort from patients. CONCLUSION: The advantage of Versapoint bipolar system for intrauterine operative hysteroscopy is the use of normal saline as distention fluid, which decreases pre and postoperative complications. We evaluated the vaporisation of pedunculate intrauterine pathologies up to 2 cm as comfortable and easy to use. Combined to local anesthesia it appears to be a useful system for office hysteroscopy and transcervical surgery.

Adult↗