Biomedical subjects

M Procházka

Publications and source records attributed to M Procházka.

At least 19 recordsLinked to original sources

PubMed2006

Analysis of intracellular nucleotides by capillary electrophoresis-mass spectrometry.

A pilot study using capillary electrophoresis with mass spectrometry for the analysis of nucleotides in human erythrocytes is presented. Erythrocytes were incubated with 5-amino-4-imidazolecarboxamide riboside in order to mimic situation in defect of purine metabolism--AICA-ribosiduria. Characteristic AICA-ribotides together with normal nucleotides were separated by capillary electrophoresis in acetate buffer (20 mmol/L, pH 4.4) and identified on line by mass spectrometry.

Aminoimidazole Carboxamide↗

PubMed2006

[Analysis of free foetal DNA in maternal plasma using STR loci].

BACKGROUND: Problems of maternal and foetal genotype differentiation of maternal plasma in pregnant women are solved generally by real-time systems. In this case the specific probes are used to distinguish particular genotype. Mostly gonosomal sequences are utilised to recognise the male foetus. This work describes possibilities in free foetal DNA detection and quantification by STR. METHODS AND RESULTS: Artificial genotype mixtures ranging from 0,2 % to 100 % to simulate maternal and paternal genotypes and 27 DNA samples from pregnant women in different stage of pregnancy were used for DNA quantification and detection. Foetal genotype was confirmed by biological father genotyping. The detection was performed in STR from 21st chromosome Down syndrome (DS) responsible region by innovated (I) QF PCR which allows to reveal and quantify even very rare DNA mosaics. The STR quantification was assessed in artificial mixtures of genotypes and discriminability of particular genotypes was on the level of few percent. Foetal DNA was detected in 74 % of tested samples. CONCLUSIONS: The IQF PCR application in quantification and differentiation between maternal and foetal genotypes by STR loci could have importance in non-invasive prenatal diagnostics as another possible marker for DS risk assessment.

DNA↗

PubMed2006

[Development of incidence of post-dural puncture headache in patients undergoing caesarean section in spinal anaesthesia at the Department of Obstetrics and Gynecology in Olomouc during 2003-2004].

BACKGROUND: Paper gives the analyse of the incidence of post-dural puncture headache in patients undergoing caesarean section in spinal anaesthesia at the Department of Obstetrics and Gynecology in Olomouc in 2003-2004. METHODS AND RESULTS: Post-dural puncture headache following caesarean section in spinal anaesthesia in 2003 was retrospectively analysed. Subsequently, measures to reduce the incidence of this complication (use of Whitacre and Atra ucan needles) were implemented. 2004 patients were followed prospectively. 54 caesarean sections - 16.3% (54/331) were performed in spinal anaesthesia in 2003. Following needles were used to establish spinal blockade: Quincke 22G - 35.2% (19/54), Quincke 25G - 50% (27/54), Atraucan 26G - 14.8% (8/54). Post-dural puncture headache occurred in 9 cases - 16.6% (9/54) (22G - 7x, 25G - 2x), the onset of symptoms occurred after 24 to 65 hours after the spinal blockade (mean 41.7). It was necessary to perform epidural blood patch (EBP) in 7 cases - 77% (7/9) - 12.9% (7/54) (22G - 5x, 25G - 2x). Epidural blood patch (EBP) was performed after 7 to 45 hours after the onset of symptoms (median 28.4). The age of patients at the time of delivery ranged between 22 to 43 years (median 34.5). 36 caesarean sections - 8.4% (36/426) were performed in spinal anaesthesia in 2004. Following needles were used to establish spinal blockade: Whitacre 27G - 63,9% (23/36), Atraucan 26G - 13,9% (5/3), Quincke 25G - 11,1 (4/36), Quincke 22G - 11,1% (4/36). Post-dural puncture headache (PDPH) occurred in 3 cases - 8.3 (3/36) (25G - 1x, 22G - 2x), the onset of symptoms occurred after 24 to 54 hours after spinal blockade (median 36.0). It was not necessary to perform epidural blood patch. The age of patients at the time of delivery ranged between 22 to 39 years (median 28.5). CONCLUSIONS: Incidence of post-dural puncture headache (PDPH) is significantly higher in pregnant women and in puerperal period compared to general population. The use of appropriate needles for spinal blockade and adequate level of anaesthesiologist's skills lead to lower incidence of post-dural puncture headache (PDPH) after caesarean section performed in spinal anaesthesia.

Adult↗

PubMed2006

[Discrepancy of ultrasound biometric parameters of the head (HC--head circumference, BPD--biparietal diameter) and femur length in relation to sex of the fetus and duration of pregnancy].

OBJECTIVE: To compare female and male fetuses in terms of intrauterine ultrasound growth measurements (HC--head circumference, BPD--biparietal diameter, FL--femur lenght) depending on gestational age. DESIGN: A prospective study. SETTING: Department of Obstetrics and Gynecology, Department of Medical Genetics and Fetal Medicine, Department of Preventive Medicine, University Hospital, Olomouc. METHODS: All ultrasound biometric measurements were performed according to the methodology published with the reference charts. Risk pregnancies, multiple pregnancies and breech presentations were excluded. RESULTS: Fetal HC, BPD and FL were measured in 427 ultrasound examinations at 16-38 weeks. Male fetuses had significantly larger HC and BPD measurements compared to female fetuses and these differences increased with advancing gestation. In the 16-21 week scans estimated difference was (HC + 3.9 days, 3.0% and BPD + 4.1, 3.2%), during the 21-30 week scans (HC + 6.8 days, 4.3% and BPD + 6.9, 4.4%) and in the 31-38 week scans (HC + 12.3 days, 5.6% and BPD + 12.9, 5.9%) for males. Male fetuses had significantly larger HC compared to FL measurements. In the 16-21 week scans, estimated difference was + 2.1 days (95%CI 1.7-2.6, P < 0.001), during the 21-30 week scans + 3.4 days (95%CI 2.5-4.2, P < 0.001) and in the 31-38 week scans + 9.7 days (95%CI 7.3-12.1, P < 0.001). CONCLUSION: This study suggests that male fetuses have significantly larger head circumference (HC) and biparietal diameter (BPD) measurements compared to female fetuses. These prenatal sex-related differences are established by as early as 16 weeks of gestation and tend to increase with advancing gestational age. In the case of discrepancy finding between head (HC, BPD) and femur lenght (FL) measurements the fetal gender should be taken into account.

Anthropometry↗

PubMed2006

[Prevention of Rh (D) alloimmunization in Rh (D) negative women in pregnancy and after birth of Rh (D) positive infant].

OBJECTIVE: The objective of this review was to assess the effects of antenatal anti-D immunoglobulin on the incidence of Rhesus D alloimmunization when given to Rh-negative women without anti-D antibodies and assess the effects of giving anti-D to Rhesus negative women, with no anti-D antibodies, who had given birth to a Rhesus positive infant. DESIGN: A review article. SETTING: Department of Obstetrics and Gynecology, Department of Medical Genetics and Fetal Medicine, University Hospital, Olomouc, Ministry of Health, Czech Republic. SUBJECT AND METHOD: We searched the Cochrane Pregnancy and Childbirth Group trials register, refence lists of relevant articles and bibliographies. CONCLUSION: The risk of Rhesus D alloimmunization during or immediately after a first pregnancy is about 1%. Administration of 100 microg (500 IU) anti-D to women in their first pregnancy can reduce this risk to about 0.2% without, to date, any adverse effects. Anti-D, given within 72 hours after childbirth, reduces the risk of RhD alloimmunization in Rhesus negative women who have given birth to a Rhesus positive infant. However the evidence on the optimal dose is limited.

Female↗

PubMed2006

[Actual management of pregnancies at risk for fetal anemia].

OBJECTIVE: To evaluate the utilisation measurements of peak systolic velocities in the middle cerebral artery (MCA-PSV) to predict the degree of fetal anemia and to find out whether implementation of MCA-PSV into management of pregnancies at risk for fetal anemia enable to reduce the number of invasive procedures. DESIGN: A prospective study. SETTING: Department of Obstetrics and Gynecology, Department of Medical Genetics and Fetal Medicine, Neonatology Department, University Hospital, Olomouc. METHODS: In 81 pregnancies at risk for fetal anemia MCA-PSV had been assessed and fetal blood sampling for measurement of hemoglobin concentration was obtained subsequently, either by cordocentesis or at delivery. The values of MCA-PSV and hemoglobin concentration were expressed as multiples of median (MoM). Anemia was defined as mild (hemoglobin <0.84 MoM) for a given gestational age, moderate (hemoglobin <0.65 MoM), and severe (hemoglobin <0.55 MoM). The number of cordocenteses performed in previous conventional management of pregnacies at risk for fetal anemia was compared with management by Doppler measurement of MCA-PSV. RESULTS: 313 examinations were performed at 17-38 week's gestation. An MCA-PSV >1.5 MoM detected 100% of severly anemic fetuses with a hemoglobin concentration <0,65 MoM that required invasive intervention. In 27 cases a cordocentesis was performed and intrauterine blood transfusion was given alternatively. Remaining fetuses did not require invasive intrauterine intervention and no or mild hemolytic anemia and hyperbilirubinemia were diagnosed after delivery. Overall sensitivity to detect moderate to severe anemia (hemoglobin <0.65 MoM for a given gestational age) was 100%. Specificity was 92%, positive predictive value was 60% and negative predictive value was 100%. One false positive case was identified after 35 weeks. In 2002 at least one cordocentesis was performed in all pregnancies at risk for fetal anemia 100%, in 2003 78%, in 2004 20% and in 2005 20%. At least one cordocentesis with intrauterine blood transfusion was required by only 24% of all fetuses at risk for fetal anemia. The other fetuses 76% (34/45) didn't require intrauterine transfusion. CONCLUSION: Middle cerebral artery peak systolic velocity is a highly sensitive non-invasive means for determining the degree of fetal anemia and implementation of MCA-PSV into management of pregnancies at risk for fetal anemia enable to reduce the number of invasive procedures. This parameter should not yet be considered the global standard of care for diagnosis of fetal anemia because incorrect use by an unexperienced operator may cause more harm than good. However, if there is a reasonably close medical center with sonographers tranined to assess the MCA-PSV, patients at risk for fetal anemia should be reffered to this center.

Anemia↗

PubMed2006

[Preoperative assessment of myometrial invasion in endometrial cancer patients by ultrasonography and magnetic resonance imaging (MRI)].

OBJECTIVE: To compare the accuracy of transvaginal sonography and magnetic rezonance imaging (MRI) in determining the depth of myometrial invasion in proven cases of endometrial cancer. DESIGN: A prospective study. SETTING: Department of Obstetrics and Gynecology, Department of Medical Genetics and Fetal Medicine, Department of Radiology, University Hospital, Olomouc. METHODS: Fifty five patients diagnosed as having FIGO stage I endometrial carcinoma were evaluated preoperatively by transvaginal ultrasound; 44 cases of the same group were also evaluated by magnetic resonance imaging (MRI). The degree of invasion evaluated by transvaginal sonography and by MRI was compared to the pathological specimens. RESULTS: Transvaginal sonography was successful in evaluating myometrial invasion in 44 of 55 cases (accuracy 80%, sensitivity 80%, specificity 88%, positive predictive value 77%, negative predictive value 87%). Evaluation with MRI was accurate in 37 of 44 cases (accuracy 84%, sensitivity 84%, specificity 91%, positive predictive value 81%, negative predictive value 91%). CONCLUSION: Although MRI is superior to transvaginal sonography in evaluating myometrial invasion, it is expensive and time consuming, and would not be suitable as a screening test for depth of invasion. On the other hand, transvaginal sonography is relatively low-cost technique, which can be easily performed and repeated. However, it requires more operator experience than MRI in order to achieve high accuracy.

Carcinoma↗

PubMed2005

[Contribution of Doppler examination in pregnancy at risk of alloimune fetus anemia].

OBJECTIVE: To evaluate the utilisation measurements of peak systolic velocities in the middle cerebral artery (MCA-PSV) to predict fetal anemia in pregnancies complicated by alloimmune antibodies known to cause immunological hydrops. DESIGN: A prospective study. SETTING: Department of Obstetrics and Gynecology, University Hospital, Olomouc. METHODS: In 38 pregnancies at risk for fetal anemia due to maternal red-cell alloimmunization MCA-PSV had been assessed and fetal blood sampling for measurement of hemoglobin concentration was obtained subsequently, either by cordocentesis or at delivery. RESULTS: 66 examinations were performed at 19-37 week's gestation. An MCA-PSV >1.5 MoM detected 100% of severely anemic fetuses with a hemoglobin concentration <0.65 MoM that required invasive intervention. In 18 cases a cordocentesis was performed and intrauterine blood transfusion was given alternatively. Remaining fetuses did not require invasive intrauterine intervention and no or mild hemolytic anemia and hyperbilirubinemia were diagnosed after delivery. No false positive case was identified (enregistered). The median maternal age at the term of delivery was 29.1 (range, 19-41) years. CONCLUSION: Middle cerebral artery peak systolic velocity is a highly sensitive non-invasive means for determining the degree of anemia. A Doppler interval of seven days is recommended.

Anemia↗

PubMed2005

[Coagulation factor VIII in the early postpartum period].

OBJECTIVE: Pregnancy is accompanied by changes in the coagulation and fibrinolytic systems. There is a marked increase in some of the coagulation factors, particularly fibrinogen and factor VIII. A high plasma levels of coagulation factor VIII is an important risk factor for thrombotic complications during pregnancy and puerperium. The aim of the study was to determine changes of the VIII:C in the early postpartum period. SETTING: Dept. of Obstetrics and Gynaecology, Medical Faculty of Palacký University, Olomouc. DESIGN: A longitudinal prospective study of 197 healthy women. Primi or multigravidas whose pervious pregnancies had been uncomplicated, aged 18-41 years. All of the deliveries were spontaneous and vaginal. First samples were taken between 24-72 hours postpartum. Women whose factor VIII plasma levels were higher than 150 (percentage of standard) were tested again after 6 weeks. Factor VIII:C was investigated by the one-step coagulation method. Statistical evaluation was done by Statsoft, Inc. (2001) Statistika Cz (Software system data analysis), version 6. RESULTS: Pregnancy is associated with increased levels of VIII:C. Mean value was 194.09 percentage of standards. 119 (60.4 %) of the tested women had VIII:C higher than 150%. The post-puerperal tests were done in 59 women and showed values similar to those from formerly published data in age-matched non-pregnant group. Mean value was 139.76%. CONCLUSION: Normal pregnancy is connected with increased levels of factor VIII. However elevated plasma levels of VIII:C is not associated with poor pregnancy outcome. The highest level of the clotting factor VIII was associated with patient's blood group A. Post-puerperal data showed distinct decrease of factor VIII. There is a necessity to rule out thrombophilia, in the case of the outlasting elevation of the factor VIII.

Factor VIII↗

PubMed2005

[Premature separation of the placenta--etiology and risk factors].

OBJECTIVE: Placental abruption complicates approximately 1% of all pregnancies and remains a significant cause of both maternal and fetal morbidity and mortality. Several risk factors are associated with this complications, but a clear causal relation is diffucult to establish. THE AIM OF THE STUDY: The aim of the study was to determine and identify risk factors for placental abruption. DESIGN: Retrospective cohort study. SETTING: Dept. of Obstetrics and Gynaecology, Medical Faculty of Palacký University, Olomouc. SUBJECT AND METHOD: Retrospectively gathered cohort of 180 women was compared to 198 healthy women. We have focused on anthropometric, sociodemographic, behavioral, obstetric and fetal parameters. Statistical evaluation was done by Statsoft, Inc. (2001) Statistika CZ (Software system data analysis), version 6. RESULTS: The incidence of the placental abruption was 0.89%. We have confirmed the following risk factors as statistically significant (p values are given): Low-degree education (0.00002), prepregnancy weight of the mother (0.00), weight gain in pregnancy (0.00), higher parity (0.0272), smoking (0.03847), preeclampsia (0.00889), chorioamnionitis (0.00), premature rupture of membranes (0.00), recurrent spontaneous abortions (0.00), positive family history of deep venous thrombosis (0.0007) and intrauterine growth retardation (0.0386). CONCLUSION: Placental abruption has a large number of potential risk factors. The true biological cause and its etiopathogenic role is still to be elucidated.

Abruptio Placentae↗

PubMed2005

[Changes of coagulation parameters during stimulation in the IVF programme and in ovarian hyperstimulation syndrome].

OBJECTIVE: Evaluation of changes in hemostasis system during the ovarian stimulation in IVF programme and in patients with severe form of ovarian hyperstimulation syndrome. DESIGN: Review article. SETTING: Unica, Institute for Reproductive Medicine, Brno. METHODS: Survey and discussion based on literature review. CONCLUSION: Activation of coagulation system during the ovarian stimulation and in the development of ovarian hyperstimulation syndrome is mentioned. The risk of thrombosis is increased if the patient is carrier of thrombophilic status.

Blood Coagulation↗

PubMed2005

[Prevalence of thrombophilia in patients with severe ovarian hyperstimulation syndrome].

OBJECTIVE: To determine the prevalence of markers of thrombophilia in patients with severe form of ovarian hyperstimulation syndrome DESIGN: Retrospective case - control study SETTING: Unica, Institute for Reproductive Medicine, Brno METHODS: Blood samples to test for markers of thrombophilia were obtained from 30 patients who were hospitalised for severe OHSS. Results were compared with two control groups. RESULTS: None of the patients with severe OHSS had antithrombin, protein C or protein S deficiencies. We also did not observe increased prothrombin level. Six patients had factor V Leiden mutation (heterozygotes) which is statistically significant compared to control group (p = 0.01, OR 4.65) and 12 patients had mutation of MTHFR 677 (heterozygotes). None had prothrombin G20210A mutation. CONCLUSION: We found a statistically significant increase in the prevalence of factor V Leiden mutation (heterozygot) in Czech infertile women with severe OHSS. These findings suggest the increased risk of development of OHSS in these patients.

Adult↗

PubMed2005

[Prenatal parvovirus B19 infection in fetus].

OBJECTIVE: To analyse 3 cases of parvovirus B19 infection in a pregnant woman followed by transplacental transmission to the fetus. DESIGN: A reprospective study. SETTING: Department of Obstetrics and Gynecology, University Hospital, Olomouc. METHOD: Parvovirus B19 vertical transmission from a pregnant woman to the fetus was diagnosed in 3 cases. Serologic testing of IgG and IgM antibodies against parvovirus B19, cytological bone marrow examination and parvovirus B19 DNA analysis by PCR methods were performed. The fetal anemia was predicted by measurements of peak systolic velocities in the middle cerebral artery (MCA-PSV). RESULTS: There were three pregnancies in all (1st - single, 2nd and 3rd - dizygotic twins). In the 1st and 2nd pregnancy the diagnosis of parvovirus B19 infection was set on the basis of erythroblastopenia diagnosed in the neonatal period or early infancy. In the 2nd pregnancy (dizygotic twins) intrauterine death of one twin occured. In the 3rd case (dizygotic twins) the diagnosis was already set in the 20th week of pregnancy. Subsequently the fetal anemia was predicted by doppler examination. The fetuses did not require invasive intrauterine intervention and mild anemia was diagnosed after delivery. Progressive intrauterine growth retardation of one twin was observed. Neither cardiomegaly nor fetal hydrops did not occur. All mothers were asymptomatic during the whole pregnancy. CONCLUSION: Parvovirus B19 infection should be excluded in all cases of nonimmune fetal hydrops, severe fetal anemia, cardiomegaly, intrauterine growth retardation (IUGR) and chronic erythroblastopenia diagnosed in the neonatal period or early infancy. The presence of IgM and IgG antibodies against parvovirus B19 is highly specific but their negativity is insufficient for the exclusion of a parvovirus B19 infection. Viral DNA testing by PCR method is the only reliable method available.

Adult↗

PubMed2005

[SHBG--new possibilities of diagnostic use in obstetrics and gynecology].

Recent literature review is suggesting the need to renew the traditional concept of SHBG as only a transport protein. The new role of SHBG relates to the evidence of its specific receptor on the cell membrane and an alternative signal pathway for sexual steroids. This review points to the importance of simultaneous measurements of SHBG along with determinations of the total sexual steroid concentration and informs of some new areas where SHBG can be used in laboratory diagnostics. In obstetrics the low levels of SHBG in the first half of pregnancy were reported as a promising early risk marker of the later development of preeclampsia.

Biomarkers↗

PubMed2004

[Hysterectomy at the Olomouc Clinic 1989-2002: evolution in the indication spectrum and surgical approach].

OBJECTIVE: Analysis of representation in surgical approaches and techniques to hysterectomy (abdominal hysterectomy, vaginal hysterectomy, laparoscopically assisted vaginal hysterectomy) in our clinic. The evolution of indications, diagnosis and operating approaches from 1989 to 2002 were analysed. DESIGN: Retrospective study. SETTING: Department of Obstetric and Gynecology, University Hospital, Olomouc. METHODS: Retrospective analysis of medical documentation (operating protocols). RESULTS: 3079 hysterectomies were performed in years 1989-2002. Type of hysterectomy in years 1989-1993: abdominal approach 97% (diagnosis: uterine leiomyomas 57%, malignant tumors 28%), vaginal hysterectomy 3% (diagnosis: descensus uteri only). Type of hysterectomy in years 1989-1993: abdominal approach 42% (diagnosis: malignant tumors 65%, uterine leiomyomas 28%), vaginal hysterectomy 48% (diagnosis: uterine leiomyomas 56%, descensus uteri 25%), Laparoscopically assisted vaginal hysterectomy (LAVH) 10%. CONCLUSION: Decreased number of abdominal hysterectomies in women with non oncological diagnosis since 1989 to 2002 and increase of vaginal hysterectomies and LAVH was noted. This complies with the contemporary trends of minimally invasive surgery.

Czech Republic↗

PubMed2004

[The effectiveness and complications of ovarian transposition in young women with cervical cancer].

OBJECTIVE: To discuss the indications, effectiveness, and complications of ovarian transposition before pelvic irradiation for cervical cancer. DESIGN: A review article. SETTING: Department of Obstetric and Gynecology, University Hospital, Olomouc. SUBJECT AND METHOD: A review from literature and bibliographic databases. CONCLUSION: Ovarian transposition gives an option for preserving ovarian function in patients treated by radiosurgical combination. In young women preservation of ovarian function by means of ovarian transposition brings them some positive benefits compared to conventional HRT. The main risk of ovarian transposition--a possibility of ovarian or distant metastasis--increases particularly depending on clinical stage and histopathological type of the tumor. However the risk of ovarian metastasis is very low for patients with squamosus cell carcinoma of the cervix in stages IA-B.

Adult↗

PubMed2004

[Doppler blood flow velocity in the evaluation of fetal anemia].

OBJECTIVE: To review (summarize), in maternal red blood cell alloimmunization, the diagnostic value of Doppler blood flow velocity in the evaluation and prediction of fetal anemia. DESIGN: A review article. SETTING: Department of Obstetric and Gynecology, University Hospital, Olomouc. SUBJECT AND METHOD: A review from literature and bibliographic databases. CONCLUSION: Invasive techniques such as amniocentesis and cordocentesis traditionally are used for diagnosis and treatment in fetuses at risk for anemia due to maternal red-cell alloimmunization. Middle cerebral artery peak systolic velocity is a highly sensitive non-invasive means for determining the degree of anemia. The interval of seven days between two Doppler tests is recommended. The widespread use of the Doppler method will minimize fetal complications associated with amniocentesis and fetal blood sampling and may significantly lower health care cost.

Anemia↗

PubMed2003

[Celiac disease and fertility disorders in women].

OBJECTIVE: To determine incidence of subclinical forms of celiac disease in women with decreased fertility. DESIGN: Screening test. SETTING: Department of Gynecology and Obstetrics, University Hospital, Palacký University, Olomouc. METHODS: 137 patients with fertility problems were included to the study. There were divided into two groups, patients with infertility and patients with repeated pregnancy loss. Screening test for celiac disease, serum level of antibodies tissue transglutaminase (tTGA) were performed in all of them. Positive test was confirmed by serological level of anti endomysium antibodies (EmA) and final diagnosis of silent celiac disease was done by enterobiopsy. RESULTS: Celiac disease was found in two infertile patients (1.67%). In one patient the silent form was diagnosed by enterobiopsy. The second disease was latent form. In patients with repeated pregnancy loss we did not observe positive screening test. CONCLUSION: We confirmed higher incidence of celiac disease in women with impaired fertility.

Celiac Disease↗