[Pilot register of acute myocardial infarction--a 5-year evaluation of quality of care in non-PCI hospitals]. / Pilotní registr akutního infarktu myokardu--hodnocení kvality péce v non-PCI nemocnicích v prubehu 5 let.

INTRODUCTION: The aim of this research was to describe (demographic data and cardiovascular disease risk factors) a non-selected patient population with acute myocardial infarction and to evaluate the applied diagnostic and therapeutic approaches. PATIENTS AND METHODS: Data on 3,184 cases of acute myocardial infarction from non-PCI hospitals in Cáslav, Chrudim, Jindrichuv Hradec, Kutná Hora, Písek and Znojmo were entered in a pilot register between 2003 and 2007. RESULTS: ST elevation myocardial infarctions represented 28.5% of registered cases; primary reperfusion was indicated in 68.3% of these cases. Coronarography was indicated in 43.8% of patients in the non-ST elevation myocardial infarction subgroup. When evaluating pharmacotherapy administered during the first 24 hours following admission, a statistically significant increase in pharmacotherapy administration over the 5 years of register existence was observed (the most apparent for clopidrogel--increase from 24.6% to 63.3%). Analysis of medication recommended for use at discharge also revealed significant increase in administration of the recommended medication over the 5 years in all evaluated drug groups--the most significant, once again, for thienopyridines (increase from 34.9% to 49.6%). In-hospital mortality decreased over the 5 years from 15.2% in 2003 to 8.0% in 2007. CONCLUSION: The 5-year evaluation of diagnostic and therapeutic approaches applied in patients with acute myocardial infarction in non-PCI hospitals confirmed improvement in care provided, specifically improved adherence to pharmacotherapy as well as interventional treatment guidelines pertinent to this patient group. Together with increased quality of care, we observed a decline in in-hospital mortality of patients with acute myocardial infarction.

[The application of the autologous serum eye drops results in significant improvement of the conjunctival status in patients with the dry eye syndrome]. / Aplikace autologního séra-ocních kapek vede ke statisticky významnému zlepsení stavu spojivky pacientu se syndromem suchého oka--pilotní studie.

AIM: To detect the changes on the conjunctiva surface before and after the application of the autologous serum (AS) eye drops in patients with dry eye syndrome, using both clinical and laboratory approaches, supplemented with subjective assessing the discomfort status. MATERIALS AND METHODS: The AS eye drops were applied during the period of 3 months in 8 patients with dry eye syndrome (Schirmer test < 5 mm and break-up time < 5 seconds), with the highest (maximum) frequency 8 times a day. The clinical (Schirmer test, break-up time, rose Bengal staining, examination of the tear meniscus, detritus and superficial punctate keratitis) and laboratory examinations (morphological assessment of the conjunctiva, detection of apoptotic cells) were performed at the start and at the end of the 3 months treatment period. Each day, patients reported their ocular status (dryness, discomfort, foreign body sensation, light sensitivity). RESULTS: The AS eye drops application improved significantly the values of the Schirmer test, detritus and superficial punctate keratitis as well. The goblet cells density on the conjunctival surface increased and the number of apoptotic cells decreased. The intensity of unpleasant feelings reported by the patients decreased significantly in all of the assessed categories. CONCLUSION: Because the application of AS eye drops caused the improvement of conjunctival status as well as the decrease of the severity of difficulties reported by the patients, the AS eye drops application should become common therapeutic practice in patients with dry eye syndrome.