J Feyereisl

Ústav pro péči o matku a dítě, Praha, Praha, Czech Republic

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Publications (71)74.64 Total impact

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    ABSTRACT: Objective: We made an analysis of number of intrauterine fetal deaths in our institute, it´s causes, risk factors and patient´s main complaints.Methods: Retrospective study of all intrauterine fetal deaths in Institute for the care of mother and child in years 2008-2012.Results: We had 60 cases of intrauterine fetal death from 2008 to 2012 which represented 2.4 of all deliveries (24884). The examination started in 45% of cases due to information about decreased fetal movements, 28.3% was diagnosed during regular visit, 13.3% came for contractions, 10% because of PPROM and 3.3% due to vaginal bleeding. In 58.3% we used induction of delivery, in 10% delivery started spontaneously and in 31.7% a caesarean section was performed. Conclusion: Decrease in fetal movements was the most frequent complaint of our patients. Spontaneously delivered 68.3% patiens, caesarean section was indicated in twins, due to maternal diseases or from vital indication. In 70% of cases we approved the cause of intrauterine fetal death. Mostly umbilical cord or placental abnormalities were present. Keywords: intrauterine fetal death, causes, risk factors.
    Ceska gynekologie / Ceska lekarska spolecnost J. Ev. Purkyne 01/2014; 79(2):120-7.
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    ABSTRACT: Nocturia is the complaint that the individual has to wake at night one or more times to void, according to the International Continence Society definition from the ICS Standardisation of Terminology Report 2002. As the nocturia definition is complicated there are also other slightly modified definitions. It is currently not absolutely clear if prevalence or incidence is more important for epidemiology evaluation of nocturia. Nocturia is a variable symptom and its presence in individuals is reversible therefore it is very difficult to obtain reliable incidence data. Nocturia prevalence varies remarkably in different studies according to evaluation methodology, nocturia definition, methods of data collection and characteristics of evaluated population. There are not enough studies, especially demographic ones, evaluating lower urinary tract symptoms and/or nocturia in males and females. There is relatively large number of comparative studies confirming strong correlation between aging and prevalence of nocturia. Prevalence of two or more voids per night in individuals in their twenties varies between 5-15 %, it progresses with age, and in the seventh decade of life ranges between 35-50 %. Prevalence evaluated by gender is higher among younger women compared to older women and older men compared to younger men. Currently there are only limited sources of data regarding nocturia incidence. Incidence of nocturia (two or more voids per night) in a population older than60 years is 213 new cases/1000 persons/1 year in two year observation. Incidence of two or more voids per night is 75 new cases/1000 male/1 year in five year observation and 126 new cases/1000 male/1year in ten year observation in male population. Incidence of nocturia rises significantly with age. Incidence of two or more voids per night increases by 2,7 % in the population of women after child birth during 5 year follow up and by 5,9 % during 12 year follow up. Incidence of nocturia newly diagnosed in a pregnancy drops down by 98% in 3 month after the child birth. The incidence data indicate that incidence of nocturia rises with age and probability of nocturia relief decreases with age. Incidence of mild nocturia is higher compared to incidence of severe nocturia and significant relief of nocturia in women after child birth is very inconsistent compared to increase of other lower urinary tract symptoms. Ethiology of nocturia might be polyuria, nocturnal polyuria or reduced bladder capacity. Nocturia and its ethiology can be determined in most cases with simple and commonly used investigative methods on the out-patients bases. The diagnostic algorithm should lead to verification of nocturia and identifying its cause because treatment of nocturia differs remarkably according to the etiology.. Keywords: nocturia - prevalence - incidence - ethiology - diagnostics.
    Ceska gynekologie / Ceska lekarska spolecnost J. Ev. Purkyne 12/2013; 78(6):566-72.
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    ABSTRACT: Nonpharmacologic and especially pharmacologic treatment options are available for nocturnal polyuria. Desmopressin represents the basis of pharmacologic treatment. Desmopressin acetate is a synthetic analogue of arginine vasopressin with high affinity to V2 receptors with antidiuretic effect. It is the only medicament currently registered for antidiuretic treatment. Desmopressin has not any relevant affinity to V1 receptors, and therefore there is no hypertensive effect in contrary to natural vasopressin. Desmopressin use before a bedtime leads to reduced production of urine during a sleep, therefore time between desires to void is prolonged and number of nocturia is reduced. Clinical effect, in a meaning of reduced urine production and increased osmolality of urine, lasts approximately 8-12 hours. In the treatment of nocturnal polyuria desmopressin is used orally one hour before a bedtime. It is essential to titrate an ideal dose, the initial dose is 60 µg of MELT formula (fast melting oral formulation) and it can be increased according to the clinical effect up to the maximal recommended daily dose 240 µg. Patients treated with desmopressin should cut down a fluid intake 1 hour before and 8 hours after the use of desmopressin. Total number of adverse events connected withdesmopressin treatment in clinical studies was higher compared to placebo but the side effects were mostly mild. The most common adverse events were headaches, nausea, diarrhoea, abdominal pain, dry mouth and hyponatremia both in the short-term and long-term clinical trials. Hyponatremia was observed mainly in patients over 65 year of age. Therefore treatment with desmopressin should not be commended in patients over 65 year of age without close monitoring of the natrium level in serum and all patients should be informed about the first symptoms of hyponatremia - headache, nausea and insomnia. According to Evidence Based Medicine, the level of evidence for treatment of nocturnal polyuria with desmopressin is 1b and the grade of recommendation for treatment is A. Keywords: nocturnal polyuria - treatment - desmopressin.
    Ceska gynekologie / Ceska lekarska spolecnost J. Ev. Purkyne 08/2013; 78(4):385-9.
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    ABSTRACT: The purpose of this study was to describe the distribution and structure of ventral tributaries leading into the inferior vena cava where right-sided paraaortic lymphadenectomy is performed. The study examined 21 retroperitoneal specimens by graphic reconstruction, statistical evaluation, and histological examination of ventral tributaries (VTs). Seventy VTs were identified. The average number per specimen was 3.33. There were 20, 40, and 40% of VTs found in Levels I, II, and III, respectively. During the preparation, we observed an unusual arrangement of the IVC wall, into which VTs were led through a preformed sleeve-like channel and anchored near the lumen. This finding is a key mechanism that explains the ease with which VTs are extracted during surgery. Knowledge of the distribution and histological structure of VTs allows proper orientation of the retroperitoneal area of the front wall of inferior vena cava, which is essential for uncomplicated right-sided paraaortic lymphadenectomy. The histological structure of the VT ostium within the wall of the inferior vena cava explains why injury is easy during the procedure.
    Journal of Anatomy 05/2013; · 2.36 Impact Factor
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    ABSTRACT: Objective: The paper addresses transfer of doctors specialty training from the national Institute of postgraduate medical education (IPVZ) to University Medical Schools (UMS) with the special focus to Obstetrics and Gynecology (OG).Methods: The National Specialty Board (NSB) has been established. NSB tasks include definition of inclusion criteria and process of specialty choice at UMS. In OG specialty there are defined mid-term and final postgraduate training courses and other requirements for final specialty exam (FSE) - in particular trainee´s scientific work and surgery done with the supervision of NTB member. The system of FSE, its content, application, reimbursement and mechanisms are described in details. Results: In the whole country in 2012 there have been done 864 FSE in all basic medical specialties, which took place at seven UMS. Autumn semester terms has been utilized significantly more than spring terms (57% vs. 43%). There have been differences in the numbers of specialties and also numbers of candidates in each specialty among different UMS. In total 94% of applicants succeed in the FSE. In 2012 within OG specialty training there has been held 56 FSE - 24 exams on five UMS in spring term and 32 (57%) exams only on two UMS in autumn term. In the spring 2013 FSE were organized on 1st LF UK in Prague with 23 applicants, from which 22 successfully passed. During autumn 2013 the FSE in OG will be held on LF UP in Olomouc with 44 applicants for final postgraduate training course and 39 candidates for FSE. Conclusion: Within OG specialty the transfer of doctors specialty training from IPVZ to UMS has been successfully managed. The NSB in OG specialty closely cooperates with past IPVZ and the Accreditation Commission of the Czech Ministry of Health. Thus continuity, quality and continuous enhancement of specialty training program in OG in Czech Republic is assured.Keywords: doctors specialty training - gynecology and obstetrics - specialty postgraduate courses - specialty certification system.
    Ceska gynekologie / Ceska lekarska spolecnost J. Ev. Purkyne 01/2013; 78(5):486-90.
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    ABSTRACT: A basic precondition for the development of preeclampsia is the presence of placental trophoblast cells in the maternal blood circulation. On the other hand, while trophoblast cells are present in the blood of all pregnant women, preeclampsia occurs in only 2-5% of them. Evidently, other factors play a crucial role. The aim of this study was to compare a set of selected immunological factors (anti-cardiolipin autoantibodies, trophoblast-induced cell-mediated immunity, C3 and C4 complement components) and biochemical factors (serum immunoglobulins IgA, IgG, IgM) among three groups of women with uncomplicated pregnancy, gestational hypertension, or preeclampsia. Blood samples were taken 2-12h before delivery. In the preeclampsia group, there was a significantly higher number of women positive for anti-cardiolipin autoantibodies, trophoblast-induced cell-mediated immunity was elevated, serum IgG was elevated and C4 complement component was reduced. We conclude that both elevated autoimmune reactivity and the higher immune reactivity to trophoblast may contribute to the onset of preeclampsia.
    Journal of Reproductive Immunology 11/2012; · 2.34 Impact Factor
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    Ultrasound in Obstetrics and Gynecology 09/2012; 40(S1). · 3.56 Impact Factor
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    Ultrasound in Obstetrics and Gynecology 09/2012; 40(S1). · 3.56 Impact Factor
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    ABSTRACT: 22 experts from the fields of gynecology and obstetrics, anesthesiology and resuscitation, intensive care, hematology and transfusion medicine has developed recommendations for diagnosis and procedure for life-threatening peripartum haemorrhage, which is still one of the most common causes of maternal mortality in childbirth. This guidelines, which is valid for the Czech Republic, supported by a total of 10 professional medical societies. There are based on new knowledge applicable at this time and is focused mainly on eliminating the most common causes of bleeding during delivery and prevention of haemorrhagic shock. Key words: childbirth - maternal bleeding - diagnosis - intensive care - hypotonia of the uterus - blood derivatives.
    Vnitr̆ní lékar̆ství 09/2012; 58(9):661-4.
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    K. Dlouha, L. Krofta, J. Vojtech, J. Feyereisl
    Ultrasound in Obstetrics and Gynecology 09/2012; 40(S1). · 3.56 Impact Factor
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    Ultrasound in Obstetrics and Gynecology 09/2012; 40(S1). · 3.56 Impact Factor
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    ABSTRACT: In the managing of labor, the obstetrician gets often to the border situations especially at the end of the second stage of labor, where only accurate diagnosis allows the make correct decisions on how to end the delivery. Since clinical vaginal examination does not always give complete informations about station and rotation of the head, the intrapartum fetal ultrasound showing the fetus inside the birth canal can refine and document the diagnosis and help us to decide.
    Ceska gynekologie / Ceska lekarska spolecnost J. Ev. Purkyne 12/2011; 76(6):453-7.
  • J Feyereisl, L Krofta
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    ABSTRACT: To demonstrate the significance of introital ultrasound of the lower urinary tract in the diagnostic algorithm in patients with lower urinary tract symptoms (LUTS) after Burch colposuspension. Twenty six women with voiding dysfunction directly associated with prior anti-incontinence surgery (Burch colposuspension) were included in the study (Group A). The control group (Group B) consisted of twenty eight women after Burch colposuspension with a good clinical result without LUTS. Introital ultrasound was performed at rest and at maximum voluntary contraction to measure the monitored parameters (angle alpha: the inclination angle of the urethra, angle beta: the posterior urethrovesical angle, angle gamma: the angle between the axis of the symphysis and the line segment connecting the region of the internal urethral orifice and the lower margin of the symphysis, distance H: the distance between the internal urethral orifice and the horizontal axis running through the bottom edge of the symphysis, distance p: the distance between the internal urethral orifice and the lower margin of the symphysis). Significant differences were found in bladder neck position and mobility between those women with LUTS and control group. At a 5% confidence interval, both groups differ in mean values of the angles alpha, beta a gamma, and in the mean values of segments p and H on straining. Ventral displacement of the bladder neck (characterized by angles alpha and gamma) at rest and during straining was present in all women in group A. The difference was statistically significant (p=0,001). Angle beta also demonstrates abnormal position and minimal mobility of the bladder neck in group A. As a result of bladder neck disclocation in the ventral direction, at rest, this parameter shows significantly lower values in comparison with group B. This difference is more apparent on Valsalva, where as a result of minimal mobility of the bladder neck. This parameter has even lower values in group A in comparison with group B. The bladder neck in patients with LUTS after Burch colposuspension shows not only ventral displacement of the bladder neck but also a significant reduction in dorsocaudal movement during straining. In women with LUTS after Burch colposuspension, atypical changes in the position and mobility of urethra can be demonstrated when compared with women who underwent successful surgery for incontinence.
    Ceska gynekologie / Ceska lekarska spolecnost J. Ev. Purkyne 12/2011; 76(6):425-38.
  • F Hron, V Hejda, J Feyereisl, P Safár, H Sochová
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    ABSTRACT: Case report. Center for trophoblastic disease in Czech Republic, Institute for care of mother and child, 3rd Faculty of Medicine of Charles University Prague. The autors present a case of quiscent trophoblastic disease diagnosed at 27 years old primipara, secundigravida after previous molar pregnancy. The patient had low levels of serum hCG present for more than 18 months after the termination of pregnancy. After this period there was a malignant transformation associated with rapid elevation of hCG levels with need for chemotherapy which was succesfully completed. Quiscent (dormant, noninvasive) trophoblastic disease is a recently described unit defined by low levels of hCG present in patients serum and urine samples without any evidence of trophoblastic tumour or other source of hCG production. Quiscent trophoblastic disease is associated with high risk of malignant transformation.
    Ceska gynekologie / Ceska lekarska spolecnost J. Ev. Purkyne 12/2011; 76(6):443-6.
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    ABSTRACT: With ongoing evolution of advanced ultrasound diagnostic in prenatal care the trend is to detect potential fetal anomalies in the first trimester if possible. Complex knowledge of normal fetal anatomy, embryology and ultrasound anatomy is important to be able to identify subtle abnormalities. In this review we demonstrate the possibilities of ultrasound imaging of fetal brain at late first trimester and describe normal central nervous system development week by week. Original images are presented.
    Ceska gynekologie / Ceska lekarska spolecnost J. Ev. Purkyne 12/2011; 76(6):446-9.
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    Ultrasound in Obstetrics and Gynecology 10/2011; 38(S1). · 3.56 Impact Factor
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    Ultrasound in Obstetrics and Gynecology 10/2011; 38(S1). · 3.56 Impact Factor
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    Ultrasound in Obstetrics and Gynecology 10/2011; 38(S1). · 3.56 Impact Factor
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    Ultrasound in Obstetrics and Gynecology 10/2011; 38(S1). · 3.56 Impact Factor
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    ABSTRACT: Clarifying the role of three-dimensional transvaginal sonography in diagnosis sterility and assisted reproduction treatment. Review. Institute for the Care of Mother and Child, Department of IVF, Charles University, Prague. Study of current literature. With arrised frequency of ovarian, uterus and another pelvic patologies remains the three-dimensional transvaginal sonography in diagnosis of sterility women very actual in the fields of reproductive medicine. Actually the assessment of ovarian reserve belong to the essentials investigations in the diagnosis of primary and secondary sterility at this time. The advance in the three-dimensional transvaginal sonography allows to assess the endometrial volume, echogenity, endometrial vascularity and endometrial receptivity. There is a significant importance of 3D power Doppler angiography by measurement of folicular and ovarian vascularity with three indices (VI, FI, VFI) and provides the calculation of ovarian vascularity from the volume. New Sono-Automatic Volume Calculation (Sono-AVC) software that identifies and quantifies hypoechoic regions within a three-dimensional dataset and provides automatic estimation of their absolute dimensions, mean diameter and volume. An unlimited number of volumes can theoretically be quantified, which makes it an ideal tool for assessment of the ovarian volume and the antral follicle count (AFC) in women undergoing controlled ovarian stimulation.
    Ceska gynekologie / Ceska lekarska spolecnost J. Ev. Purkyne 04/2011; 76(2):128-34.

Publication Stats

156 Citations
74.64 Total Impact Points

Institutions

  • 2002–2013
    • Ústav pro péči o matku a dítě
      Praha, Praha, Czech Republic
  • 2012
    • The Police Academy of the Czech Republic in Prague
      Praha, Praha, Czech Republic
  • 2007–2010
    • Charles University in Prague
      • • 3. lékařská fakulta
      • • Gynekologicko-porodnická klinika (1. LF)
      Praha, Praha, Czech Republic