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J Stehlik

Publications and source records attributed to J Stehlik.

9 recordsLinked to original sources
PubMed2006

Utility of long-term surveillance endomyocardial biopsy: a multi-institutional analysis.

BACKGROUND: The utility of long-term endomyocardial biopsy surveillance in heart transplant recipients has been questioned. This study was undertaken to identify risk factors for late rejection and to examine the impact of different biopsy surveillance protocols on outcomes using the registry of the Cardiac Transplant Research Database. METHODS: The study group consisted of all adult patients who underwent heart transplantation at the 33 centers participating in this investigation between January 1, 1993 and January 1, 2002, survived past the second post-transplant year, and were followed-up by a defined surveillance biopsy protocol. RESULTS: During a follow-up that consisted of 24,137 patient-years, 1,626 late rejections occurred. Shorter time since transplant, history of rejection, younger age and African-American ethnicity of the recipient were strong risk factors for late rejection. The practice of surveillance biopsy varied among institutions. Continued surveillance increased the rate of diagnosis of late rejection (RR = 1.3, p = 0.002). There was no reduction in the incidence of hemodynamically compromising rejection and no increase in survival in patients with long-term vs intermediate-term surveillance. Short-term surveillance was associated with an increased incidence of hemodynamically compromising rejection, particularly among high-risk patients, and increased mortality in African-American patients. CONCLUSIONS: There are no apparent benefits from surveillance biopsy beyond 5 years post-transplant. Surveillance biopsy between 2 and 5 years post-transplant was found to reduce mortality in African-American recipients. Non-African-American recipients at high risk for late rejection will likely benefit from surveillance up to 5 years post-transplant.

Adult↗
PubMed2006

Minimally-invasive treatment of intra-articular fractures of the calcaneum.

We describe the results of 287 intra-articular fractures of the calcaneum in 247 patients treated by minimally-invasive reduction and K-wire fixation between 1994 and 2003. There were 210 men (85%) and 37 women (15%). The most common cause of injury was a fall from a height in 237 patients (96%). Fracture classification was based on the method described by Sanders and Essex-Lopresti. All patients were operated on within 21 days of injury and 89% (220) within 48 hours. The reduction was graded as nearly anatomical (less than 2 mm residual articular displacement and satisfactory overall alignment) in 212 (73.9%) fractures. There were 20 cases (7%) of superficial pin-track infection and five (1.7%) of deep infection. All healed at a mean of 6 weeks (3 to 19). Loss of reduction was observed in 13 fractures (4.5%) and a musculocutaneous flap was needed in three (1%). The results were evaluated in 176 patients (205 fractures) with a mean age of 44.3 years (13 to 67), available for follow-up at a mean of 43.4 months (25 to 87) using the Creighton-Nebraska Health Foundation Assessment score. The mean score was 83.9 points (63 to 100). There were 29 (16.5%) excellent, 98 (55.7%) good, 26 (14.8%) fair and 23 (13%) poor results. A total of 130 patients (73.9%) were able to return to their original occupation at a mean of 5.6 months (3.2 to 12.5) after the injury. Semi-open reduction and percutaneous fixation is an effective treatment for displaced intra-articular fractures of the calcaneum.

Adolescent↗
PubMed1997

2D and 3D finite element pre- and post-processing in orthopaedy.

The present widespread tomographic techniques based on computed tomography (CT), magnetic resonance imaging (MRI) and automatic 2D and 3D reconstructions also involve numerous new points of view for planning surgical techniques in orthopaedy. These require efficient pre- and post-processing methods. By pre-processing and post-processing is meant both the generation of a finite element mesh that numerically models human joints and the visualization of the results obtained as required by the surgeon. Since the numerical reconstructions of human joints are based on the finite element approximation of contact problems assuming linear elasticity, the main goal of pre-processing is to generate triangular (2D) and tetrahedral (3D) meshes of objects with a 'reasonable' boundary-human joints. In our paper we restrict ourselves, for the sake of simplicity, to polygonal (resp. polyhedral) objects. The idea of preprocessing is based on the modified method of Delaunay Mangulalia and on the so-called relaxation technique. After the generation of the finite element mesh and after numerical simulation of surgical problems of orthopaedy, the results obtained as stress-strain fields, temperature, etc. may be visualized in a graphical form on the computer screen as well as on other media.

Arthrography↗
PubMed1992

The technique of osteosynthesis in replantations of the upper limb.

The authors present their experience in osteosynthesis in replantations in the area of the wrist in 19 patients. For osteosynthesis they use external fixation device, type Poldi 7, which guarantees the stability not only during the microsurgical procedure but also over the whole period of healing. They point out the importance of the resection of both bones ends, i.e. the resection of the comminuted zone, as well as the importance of an extensive fasciotomy. In all patients but one healing was achieved without infection. The authors consider external fixation for the method of choice in the replantation in the wrist area.

Adolescent↗
PubMed1976

Surveillance of pertussis in the CSSR. IV. Immunological surveys of antibodies to pertussis and parapertussis in the Bohemian regions and in Slovakia in 1958 - 1971.

A comparison of the results of repeated immunological surveys with the notification of morbidity and mortality to pertussis and parapertussis revealed direct dependence and simultaneously confirmed the effectiveness of Czechoslovak vaccine. Immunological surveys should be continued in spite of the fact that morbidity of pertussis is low at present, because immunological surveys may lead to timely detection of shortcomings in the quality of vaccination and vaccine. The results after 14 years of systematic vaccination and revaccination and consequent follow-up to the state of immunity in the population and of other factors in the pertussis surveillance programme rank among the other achievements of epidemiology and hygiene in Czechoslovak health services. Contemporary immunological surveys show that the state of immunity in Czechoslovak child population is such as to exclude the occurrence of pertussis in epidemics in the nearest future. The situation is different in parapertussis where epidemic incidence is still possible and where epidemics regularly occur in children of prae-school age.

Adolescent↗