INTRODUCTION AND OBJECTIVES: With increases in obesity and metabolic syndrome because of lifestyle-related factors, the prevalence of non-alcoholic fatty liver disease (NAFLD) also is increasing worldwide. In a subset of patients with NAFLD, an inflammatory process arises in the steatotic liver, known as non-alcoholic steatohepatitis, that leads to liver fibrosis and liver cirrhosis. In selected patients with obesity, bariatric surgery, and bariatric endoscopy are important therapeutic options. MATERIALS AND METHODS: This prospective interventional pilot study was conducted to investigate two types of intragastric balloons (IGB). The IGBs were the Orbera and the Spatz3. Liver fibrosis changes were monitored non-invasively using point and 2D shear wave ultrasound elastography (SWE) and transient elastography that allowed for quantification of liver steatosis using the controlled attenuation parameter (CAP). Patients were followed for 12 months. RESULTS: Of 34 patients implanted with an IGB, 30 completed follow-up at month 12; results for one patient were excluded because of initiation of obesity pharmacotherapy. Fifteen patients received the Orbera IGB, and nineteen patients received the Spatz3 type. In month 12, total and excess weight loss was 7.88 % and 30.13 %. Elastography values decreased from baseline (3.88 kPa) to 3.61 kPa at month 12 (p 0.024). 2D SWE values decreased from baseline (5.42 kPa) to a value of 4.91 kPa at month twelve (p 0.135). Transient elastography values decreased from baseline (5.62 kPa) to a value of 4.17 kPa at month twelve (p 0.009). CONCLUSIONS: Bariatric endoscopy in the form of IGB implantation leads to weight reduction and improvement of liver fibrosis and steatosis. GOV REGISTRATION: NCT04895943.
- MeSH
- bariatrická chirurgie * MeSH
- časové faktory MeSH
- design vybavení MeSH
- dospělí MeSH
- elastografie MeSH
- hmotnostní úbytek MeSH
- jaterní cirhóza * etiologie diagnostické zobrazování diagnóza MeSH
- lidé středního věku MeSH
- lidé MeSH
- nealkoholová steatóza jater * diagnostické zobrazování diagnóza etiologie MeSH
- obezita * komplikace chirurgie diagnóza MeSH
- pilotní projekty MeSH
- prospektivní studie MeSH
- výsledek terapie MeSH
- žaludeční balónek * MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- klinické zkoušky MeSH
PURPOSE: The International Study of Movement Behaviors in the Early Years (SUNRISE) was conducted in Tunisia to assess the proportion of preschoolers who met the World Health Organization guidelines for physical activity, sedentary behavior, and sleep. The study also evaluated the feasibility of the methods for the SUNRISE study. METHODS: Five kindergartens were recruited from urban and rural areas in Tunisia. Physical activity and sleep duration were assessed using a waist-worn ActiGraph. Screen time and sleep quality were assessed via an interview-administered parent questionnaire. The NIH Toolbox was used. RESULTS: A total of 112 preschoolers were assessed (50 boys, age = 4.1 [0.58]). Only 18% of children met all recommendations of the World Health Organization guidelines, while 53% met the sedentary screen time (in minutes per day), and 41% met physical activity recommendation (in minutes per day). Eighty-one percent of children met the sleep duration recommendation (in minutes per day). There was good compliance with the ActiGraph protocol. CONCLUSIONS: This pilot study provided important insights into the feasibility of the study and the movement behaviors of Tunisian preschool children. The results suggest there is a need to promote healthy levels of physical activity and sedentary screen time in children, which should be a priority in public health initiatives, including preschool curricula, in Tunisia.
- MeSH
- aktigrafie MeSH
- čas strávený před obrazovkou MeSH
- cvičení * MeSH
- lidé MeSH
- pilotní projekty MeSH
- předškolní dítě MeSH
- průzkumy a dotazníky MeSH
- sedavý životní styl * MeSH
- spánek * MeSH
- studie proveditelnosti MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- předškolní dítě MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Tunisko MeSH
Bisoprolol is a second-generation, highly selective beta-1 adrenergic receptor antagonist with various beneficial effects in patients with heart failure. Interindividual variability in response to bisoprolol is known, and finding the optimal dose for individual patients with heart failure is still challenging. This pilot study included patients treated with bisoprolol for chronic heart failure with reduced ejection fraction. Between November 2022 and November 2023, one to six blood samples were collected from these patients to determine the trough serum concentration of bisoprolol. At the same time, the values of selected clinical variables were recorded. Bisoprolol concentrations ranged from 1.1 to 65.0 μg/L and correlated with both the daily dose and the dose per kilogram of body weight. However, wide variability in measured serum concentrations of bisoprolol was observed at the same daily dose and in apparent weight-adjusted clearance. Patients classified as NYHA III-IV received a 33% higher dose per kilogram of body weight than patients in NYHA I-II but achieved 165% higher serum concentrations of bisoprolol. An inverse correlation was found between diastolic blood pressure and dose per kilogram of body weight, and a positive correlation between N-terminal pro-B-type natriuretic peptide and both dose per kilogram of body weight and serum bisoprolol concentration. A wide variability in patients' serum concentrations of bisoprolol achieved after taking the same dose has been observed. A significantly higher concentration-to-dose ratio and a significantly lower weight-adjusted apparent clearance were demonstrated in patients with reduced cardiac function, reduced renal function, and taking the combination with amiodarone. These patients may be more prone to overdose with bisoprolol.
- MeSH
- antagonisté beta-1-adrenergních receptorů * krev aplikace a dávkování farmakokinetika terapeutické užití MeSH
- bisoprolol * krev aplikace a dávkování farmakokinetika terapeutické užití MeSH
- lidé středního věku MeSH
- lidé MeSH
- monitorování léčiv MeSH
- pilotní projekty MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- srdeční selhání * farmakoterapie krev patofyziologie MeSH
- tepový objem účinky léků MeSH
- vztah mezi dávkou a účinkem léčiva MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
BACKGROUND: Severe combined immunodeficiency (SCID) is a fatal but treatable inborn error of immunity (IEI). Newborn screening (NBS) using T-cell receptor excision circles (TREC) has been adopted globally, with very few countries incorporating kappa recombination excision circles (KREC) to also detect early B-cell development disorders, such as X-linked agammaglobulinemia (XLA). OBJECTIVE: To evaluate the effectiveness of a 2-year pilot SCID NBS program in the Czech Republic, emphasising the utility of combined TREC/KREC screening. METHODS: Between January 2022 and December 2023, a dual TREC/KREC NBS pilot was conducted across the Czech Republic, alongside spinal muscular atrophy (SMA) screening. Approximately 200,000 newborns were screened using quantitative real-time PCR on dried blood spots collected 48-72 h after birth. RESULTS: The pilot referred 58 newborns, identifying 21 cases of IEI, including two SCID cases, with an overall incidence of TREC/KREC screenable IEI of 10.5/100,000 newborns. SCID incidence was 1/100,000. KREC screening proved invaluable, detecting 10 cases of congenital agammaglobulinemia including novel non-XLA forms, which increased the estimated incidence of agammaglobulinemia in the Czech Republic sixfold. Over one-third of low KREC results were linked to maternal immunosuppression. CONCLUSION: The Czech pilot demonstrated the effectiveness of integrated TREC/KREC NBS in detecting both T- and B-cell immunodeficiencies. As of 2024, SCID and SMA screening are included in the nationwide NBS, with KREC screening significantly improving early detection of B-cell disorders.
- MeSH
- agamaglobulinemie diagnóza MeSH
- B-lymfocyty imunologie MeSH
- genetické nemoci vázané na chromozom X MeSH
- lidé MeSH
- novorozenec MeSH
- novorozenecký screening * metody MeSH
- pilotní projekty MeSH
- receptory antigenů T-buněk * genetika MeSH
- těžká kombinovaná imunodeficience * diagnóza genetika epidemiologie MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- novorozenec MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
BACKGROUND: Emerging evidence suggests that tumour morphological heterogeneity may influence mutational profiles relevant to therapy response. In this pilot study, we aimed to assess whether mutations identified within specific morphological patterns or at the invasion front correlate with shorter time to progression after anti-EGFR therapy, as compared to whole-tissue analysis. METHODS: We investigated genetic mutations in 142 samples from primary tumours of 39 KRAS wild-type metastatic colorectal cancer (CRC) patients receiving anti-EGFR therapy. Deep next-generation sequencing was performed on whole-tumour sections and six morphology-defined tumour regions. RESULTS: Mutations in genes linked to anti-EGFR therapy response (KRAS, BRAF, NRAS, PTEN and PI3KCA) were found uniquely in the non-responder group, with substantial variability across morphological sub-regions. BRAF mutations were aligned with serrated and mucinous morphologies, while KRAS mutations (p.Lys147Glu and p.Ala146Thr) were associated with mucinous and desmoplastic morphologies. In all cases, the cumulative mutational profile from sub-regions provided more details than that of the whole-tumour profile. CONCLUSION: Our findings highlight that comprehensive analysis, considering morphological heterogeneity, is crucial for personalised CRC treatment strategies.
- MeSH
- chemorezistence * genetika MeSH
- dospělí MeSH
- erbB receptory antagonisté a inhibitory MeSH
- fosfohydroláza PTEN genetika MeSH
- GTP-fosfohydrolasy genetika MeSH
- inhibitory proteinkinas * terapeutické užití MeSH
- kolorektální nádory * genetika farmakoterapie patologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- mutace * MeSH
- mutační analýza DNA MeSH
- pilotní projekty MeSH
- protinádorové látky * terapeutické užití MeSH
- protoonkogenní proteiny B-Raf genetika MeSH
- protoonkogenní proteiny p21(ras) genetika MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- vysoce účinné nukleotidové sekvenování MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
BACKGROUND: Regular evaluation of foot posture should be performed to determine whether foot-level interventions are necessary because changes in foot posture may contribute to lower-limb overuse injuries. This pilot study aims to test the level of pronation in judokas. METHODS: A total of 61 judokas from Slovakia and the Czech Republic participated in the study, including 36 members of the youth team. Based on sex, the sample was composed of 42 males and 19 females with a mean ± SD age of 16.82 ± 2.41 years. Pronation was measured by the navicular drop test on the foot. RESULTS: According to the data, the mean ± SD pronation in males was 0.86 ± 0.34 cm on the right foot and 0.89 ± 0.34 cm on the left foot. The mean ± SD navicular drop measurement for the right foot was 0.874 ± 0.20 cm and 0.878 ± 0.23 for the left foot. No correlation between pronation and age (r = 0.29), height (r = 0.04), body mass index (r = 0.02), or years of judo training (r = 0.22) was found. CONCLUSIONS: This study of judoka pronation values is the first of its kind, providing novel insights into the biomechanics of judo athletes. The findings indicate that sex and age do not significantly influence pronation, suggesting that training and technique may play a more critical role in movement patterns.
- MeSH
- biomechanika MeSH
- bojové sporty * fyziologie MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- noha (od hlezna dolů) * fyziologie MeSH
- pilotní projekty MeSH
- pronace * fyziologie MeSH
- Check Tag
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
- Slovenská republika MeSH
BACKGROUND: Effective end-of-life care requires transitioning pharmacotherapy from chronic disease management to symptom relief. Patients in pre-terminal and terminal palliative care may be at risk of receiving potentially inappropriate drugs regarding indication, dosage, route of administration, and polypharmacy, which can increase the risk of deteriorating quality of life. However, data on this process in Home Hospice Care (HHC) is limited. This pilot retrospective study evaluated the pharmacotherapy of 50 patients during their final days under HHC, focusing on changes in treatment and preferred administration routes to optimize symptomatic care. METHODS: Anonymised medical records data were analysed retrospectively to assess the shift from chronic disease pharmacotherapy to symptom and quality-of-life-focused treatment. Statistical methods were applied to identify trends in drug utilisation and administration routes. RESULTS: The study group qualified the most common drugs associated with potential drug-related problems: antidepressants (26%), sedatives/hypnotics (32%), gastroprotection (34%), antihypertensives (46%), coanalgesics (50%), and analgesics (84%). On the final day, the mean was 2.64 systemic medication (standard deviation 1.27), with a minimum number of drugs and a maximum of 6. The most common symptom addressed was pain, which occurred in 28 patients in the group (56%). Therefore, terminal analgosedation was mapped in more detail when, at the end of life, 26 patients (52%) were terminally transferred to continuous medication administered subcutaneously. Continuous subcutaneous linear driver for analgosedation containing two components was used in 12 patients (46.2%) or three components in 14 patients (53.8%). CONCLUSIONS: This retrospective study highlights the importance of targeted pharmacotherapy adjustments in terminal care, including multidisciplinary HHC teams. Pharmacotherapy is simplified and targeted to prevalent symptoms, using the widely used subcutaneous drug administration.
- MeSH
- kvalita života MeSH
- lidé středního věku MeSH
- lidé MeSH
- paliativní péče * MeSH
- péče o umírající * metody MeSH
- péče v hospici * metody MeSH
- pilotní projekty MeSH
- polypharmacy MeSH
- retrospektivní studie MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- služby domácí péče * MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Oral microorganisms are closely related to oral health, the occurrence of some oral diseases is associated with changes in the oral microbiota, and many studies have demonstrated that traditional smoking can affect the oral microbial community. However, due to the short time since the emergence of e-cigarettes, fewer studies are comparing oral microorganisms for users of e-cigarettes versus cigarettes. We collected saliva from 40 non-smokers (NS), 46 traditional cigarette smokers (TS), and 27 e-cigarette consumers (EC), aged between 18 and 35 years. We performed 16S rRNA gene sequencing on the saliva samples collected to study the effects of e-cigarettes versus traditional cigarettes on the oral microbiome. The results showed that compared with the NS group, the alpha diversity of oral flora in saliva was altered in the TS group, with no significant change in the e-cigarette group. Compared with the NS and EC groups, the relative abundance of Actinomyces and Prevotella was increased in the TS group. However, compared with the NS and TS groups, the relative abundance of Veillonella was increased, and the relative abundance of Porphyromonas and Peptostreptococcus was decreased in the EC group. These results showed that both e-cigarettes and traditional cigarettes could alter the structure and composition of oral microbiota. The use of traditional cigarettes promotes the growth of some anaerobic bacteria, which may contribute to dental decay and bad breath over time. E-cigarettes have a different effect on the structure and composition of the oral microbial community compared to conventional cigarettes. In order to better understand the effects of e-cigarettes and traditional cigarettes on users' mouths, future studies will investigate the relationship between diseases such as dental caries and periodontitis and changes in oral microbial species levels.
- MeSH
- Bacteria * klasifikace izolace a purifikace genetika MeSH
- dospělí MeSH
- kuřáci * MeSH
- lidé MeSH
- mikrobiota * MeSH
- mladiství MeSH
- mladý dospělý MeSH
- pilotní projekty MeSH
- RNA ribozomální 16S * genetika MeSH
- sliny * mikrobiologie MeSH
- systémy dodávající nikotin elektronicky MeSH
- tabákové výrobky škodlivé účinky MeSH
- ústa * mikrobiologie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- srovnávací studie MeSH
Background: Individuals with intellectual disabilities experience inequalities in healthcare. Aim: In this cross-sectional study, we aimed to analyse the perceived professional competencies of nursing students from two countries: the Czech Republic and Poland in relation to providing medical care for patients with intellectual disabilities. Methods: Two closed self-report questionnaires were used to examine the relationships between students' competency, their attitudes toward keeping a social distance from individuals with intellectual disabilities in healthcare, and their participation in training related to this issue. The sample consisted of 208 nursing students from two countries: the Czech Republic and Poland. Results: Relationships were observed between students' self-assessed competencies and their social distance. Additionally, training in the field of care and treatment of individuals with intellectual disabilities played a differing role. Conclusion: The findings highlight the complexity of developing nursing competencies in providing medical care for patients with intellectual disabilities. They suggest the need for tailored, context-sensitive training programs, ongoing research to uncover additional influencing factors, and a supportive educational environment that encourages honest dialogue and self-assessment.
- MeSH
- lidé MeSH
- mentální retardace ošetřování terapie MeSH
- odborná způsobilost MeSH
- osoby s mentálním postižením * MeSH
- pilotní projekty MeSH
- postoj MeSH
- psychologický odstup MeSH
- statistika jako téma MeSH
- studenti ošetřovatelství * psychologie MeSH
- zpráva o sobě MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- srovnávací studie MeSH
- Geografické názvy
- Česká republika MeSH
- Polsko MeSH
Background: COVID is described as having not only medical but also wider social consequences for society. Individuals may experience persistent health problems after infection. We aimed to find out whether people with chronic neurodegenerative disease (multiple sclerosis - MS) still perceive any complications after this infection. And the secondary aim was to offer them a physiotherapy. Methods: In this single-centre study, people with MS who experienced COVID-19 between January and March 2022 were contacted and structurally asked about the occurrence of any post-COVID symptoms. Results: In March 2023, 251 (75 men) people responded to the survey. The mean age of these people was 43.8 years (SD 8.9), and the mean disease duration 14.1 years (SD 8.3). A total of 76 people (22%) suffered from post-COVID symptoms lasting 12 weeks or longer. Most common symptoms included fatigue (55%), dyspnoe (26%), neurological deterioration (20%), and joint and muscle pain (18%).A total of 6 people participated in a pilot physiotherapy program. Conclusion: Based on subjective reports, a considerable number of people with MS can suffer from post-COVID symptoms Our experience from a small pilot study showed that individual physiotherapy could probably relieve some of these difficulties. However, this would need to be verified in a larger sample. Knowledge of any persistent post-COVID difficulties can also help other health and social care professionals.
- MeSH
- COVID-19 komplikace MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- pilotní projekty MeSH
- postakutní syndrom COVID-19 * epidemiologie komplikace patologie rehabilitace MeSH
- rozhovory jako téma MeSH
- roztroušená skleróza * komplikace MeSH
- techniky fyzikální terapie MeSH
- zpráva o sobě MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- práce podpořená grantem MeSH