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PURPOSE OF THE STUDY This article presents the evidence and the rationale for the recommendations for surgical treatment of degenerative lumbar stenosis (DLS) and spondylolisthesis that were recently developed as a part of the Czech Clinical Practice Guideline (CPG) “The Surgical Treatment of the Degenerative Diseases of the Spine”. MATERIAL AND METHODS The Guideline was drawn up in line with the Czech National Methodology of the CPG Development, which is based on the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. We used an innovative GRADE-adolopment method that combines adoption and adaptation of the existing guidelines with de novo development of recommendations. In this paper, we present three adapted recommendations on DLS and a recommendation on spondy-lolisthesis developed de novo by the Czech team. RESULTS Open surgical decompression in DLS patients has been evaluated in three randomized controlled trials (RCTs). A recommendation in favour of decompression was made based on a statistically significant and clinically evident improvement in the Oswestry Disability Index (ODI) and leg pain. Decompression may be recommended for patients with symptoms of DLS in the event of correlation of significant physical limitation and the finding obtained via imaging. The authors of a systematic review of observational studies and one RCT conclude that fusion has a negligible role in the case of a simple DLS. Thus, spondylodesis should only be chosen as an adjunct to decompression in selected DLS patients. Two RCTs compared supervised rehabilitation with home or no exercise, showing no statistically significant difference between the procedures. The guideline group considers the post-surgery physical activity beneficial and suggests supervised rehabilitation in patients who have undergone surgery for DLS for the beneficial effects of exercise in the absence of known adverse effects. Four RCTs were found comparing simple decompression and decompression with fusion in patients with degenerative lumbar spondylolisthesis. None of the outcomes showed clinically significant improvement or deterioration in favour of either intervention. The guideline group concluded that for stable spondylolisthesis the results of both methods are comparable and, when other parameters are considered (balance of benefits and risks, or costs), point in favour of simple decompression. Due to the lack of scientific evidence, no recommendation has been formulated regarding unstable spondylolisthesis. The certainty of the evidence was rated as low for all recommendations. DISCUSSION Despite the unclear definition of stable/unstable slip, the inclusion of apparently unstable cases of DS in stable studies limits the conclusions of the studies. Based on the available literature, however, it can be summarized that in simple degenerative lumbar stenosis and static spondylolisthesis, fusion of the given segment is not justified. However, its use in the case of unstable (dynamic) vertebral slip is undisputable for the time being. CONCLUSIONS The guideline development group suggests decompression in patients with DLS in whom previous conservative treatment did not lead to improvement, spondylodesis only in selected patients, and post-surgical supervised rehabilitation. In patients with degenerative lumbar stenosis and spondylolisthesis with no signs of instability, the guideline development group suggests simple decompression (without fusion). [ABSTRACT FROM AUTHOR]

The semi-smooth Newton method for solving discretized contact problems with Tresca friction in three-dimensional space is analysed. The slanting function is approximated to get symmetric inner linear systems. The primal–dual algorithm is transformed into the dual one so that the conjugate gradient method can be used. The R-linear convergence rate is proved for an inexact globally convergent variant of the method. Numerical experiments conclude the paper. [ABSTRACT FROM AUTHOR]

Background: To compare four automated immunoassays for the measurement of 25(OH)-vitamin D (25-OHD) and to assess the impact on the results obtained from a healthy population. Methods: We analysed 100 serum samples on Unicel DxI 800 (Beckman Coulter), Architect i1000 (Abbott), Cobas e411 (Roche) and Liaison XL (DiaSorin). Passing-Bablok regression and Bland-Altman plots were used for method comparison. In order to categorise the obtained values, results were categorised into the following groups: 0-25 nmol/L, 25-50 nmol/L, 50-75 nmol/L and above 75 nmol/L and compared. The percentage of samples below 75 nmol/L, and below 50 nmol/L was then calculated for every method. Results: According to paired comparisons, each method differs from others (p

Unlike the Navier boundary condition, this paper deals with the case when the slip of a fluid along the wall may occur only when the shear stress attains certain bound which is given a priori and does not depend on the solution itself. The mathematical model of the velocity-pressure formulation with this type of threshold slip boundary condition is given by the so-called variational inequality of the second kind. For its discretization, we use Pl-bubble/Pl mixed finite elements. The resulting algebraic problem leads to the minimization of a nondifferentiable energy function subject to linear equality constraints representing the discrete impermeability and incompressibility condition. To release the former one and to regularize the nonsmooth term characterizing the stick-slip behavior of the algebraic formulation, two additional vectors of Lagrange multipliers are introduced. Further, the velocity vector is eliminated, and the resulting minimization problem for a quadratic function depending on the dual variables (the discrete pressure and the normal and shear stress) is solved by the interior point type method which is briefly described. To justify the threshold model and to illustrate the efficiency of the proposed approach, three physically realistic problems are solved and the results are compared with the ones solving the Stokes problem with the Navier boundary condition. [ABSTRACT FROM AUTHOR]

Signaling pathway of IGF1 (insulin-like growth factor 1) belongs to the most important growth pathways in the organism. This pathway has been studied for many years in connection with the growth and survival of cells and in recent years also in connection with the cancer development. Over time, the step from IGF1 serum levels to the mapping of the occurrence of IGF1 in tissues was done, further, we observed that the effect is mediated by a specific receptor, which is located on the cell surface. Finally, we found location of genes which encoded IGF1, its binding protein and its receptor. The entire way of IGF1 in human body was described, from its synthesis, transport in serum and receptor binding. Also the individual components of cellular signaling pathways were identified starting IGF1 receptor till the individual effectors within the cell. These findings allow us to give an idea about the functioning of IGF1 and its role in the growth, differentiation and cell surviving. IGF1 depends on age and gender, which must be respected when reference ranges are established. [ABSTRACT FROM AUTHOR]

The influence of IGF1 (insulin-like growth factor 1) and its binding proteins to the cancer incidence and development have been discussed recently. Since the early 80's of the last century, many experiments and studies were carried out on this topic. These findings allow us to give an idea about the functioning of IGF1 and its role in the growth, differentiation and cell surviving. Our knowledge ultimately resulted in the development of the latest generation of oncological drugs. Despite of major achievements in research of IGF1, its place in tumor diagnosis is currently not so clear. [ABSTRACT FROM AUTHOR]

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Objective: Monitoring and evaluation of benefit of the soluble cytokeratin fragments determination for the liver metastases diagnostics. Design: Combined retrospective and prospective study. Material and Methods: In the period from January 2010 to December 2014 was in the Laboratory of immunoanalysis examined 1616 serum samples of patients from lung and surgery clinic. Patients were divided into groups according to the diagnoses. C34 consisted of the patients with lung cancer in stage I, II and III. C787 group consisted of patients with metastatic liver disease without distinguishing of origin of these metastases. The control group consisted of patients treated for inflammatory lung diseases and then from patients who were treated for thyroid disorders or metabolic disorders. At the time of sample collection all the patients were in the compensated status. MonoTotal, CYFRA 21-1 and CEA were determined in each sample. MonoTotal was determined using an immunoradiometric kit MonoTotal IRMA (IDL Biotech, Sweden), CYFRA 21-1 using immunoradiometric CYFRA 21-1 IRMA kit (Cisbio Bioassays, France) and CEA was determined using chemiluminescent kit and the measurement was performed using the Architect i1000 instrument (Abbott Laboratories, USA) . Statistical software (StatSoft, Inc., USA) was used for all statistical calculations. Results: For liver metastases, we found significantly higher levels of all studied markers than for the primary lung tumor and non-tumor diagnoses (both p-value <0.0001). ROC curves show that the ability of assessed markers to distinguish between the tumor group (C34 + C787) and the control is not too strong. Calculated AUC values confirm this fact: Mono- Total=0.6924, CYFRA 21-1=0.6398 and CEA=0.5955. When evaluating the cancer groups separately according to the diagnose ROC curves clearly show that the ability to distinguish hepatic metastases from control group using the evaluated markers is significantly higher than the distinguishing of pulmonary tumor. AUC calculated for liver metastases are: Mono- Total=0.9497, CYFRA 21-1=0.8758 and CEA=0.7514. Conclusion: For liver metastases are the levels of all monitored markers significantly higher than in the patients with the primary lung tumors and in the patients with non-tumor diagnoses. ROC curve and AUC clearly show that cytokeratin markers MonoTotal and CYFRA 21-1are highly sensitive markers of liver metastases. CEA, which was used as a marker of metastatic process in the past, did not match so good results as both cytokeratins did. Cytokeratin markers allow for earlier detection of liver metastases and the use of modern oncology and surgical treatments allow prolonged survival and improved quality of life of patients. [ABSTRACT FROM AUTHOR]

The paper deals with a variant of the interior-point method for the minimization of strictly quadratic objective function subject to simple bounds and separable quadratic inequality constraints. Such minimizations arise from the finite element approximation of contact problems of linear elasticity with friction in three space dimensions. The main goal of the paper is the convergence analysis of the algorithm and its implementation. The optimal preconditioners for solving ill-conditioned inner linear systems are proposed. Numerical experiments illustrate the computational efficiency for large-scale problems. [ABSTRACT FROM AUTHOR]

SUMMARY This paper deals with the role of the generalized inverses in solving saddle-point systems arising naturally in the solution of many scientific and engineering problems when finite-element tearing and interconnecting based domain decomposition methods are used to the numerical solution. It was shown that the Moore-Penrose inverse may be obtained in this case at negligible cost by projecting an arbitrary generalized inverse using orthogonal projectors. Applying an eigenvalue analysis based on the Moore-Penrose inverse, we proved that for simple model problems, the number of conjugate gradient iterations required for the solution of associate dual systems does not depend on discretization norms. The theoretical results were confirmed by numerical experiments with linear elasticity problems. Copyright © 2011 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]