OBJECTIVE: The purpose of this qualitative review is to examine prodromes, precipitants, and risk factors for repeated episodes of mania and depression in bipolar disorder. METHODS: PubMed, EMBASE, and PsychInfo were searched for "bipolar disorder" in conjunction with: "prodromes", "triggers", and "life change events". RESULTS: Phenomenology and prevalence of prodromes, precipitants, and risk factors are described, and their therapeutic implications are outlined. CONCLUSIONS: Most patients with bipolar disorder are able to recognize their prodromes. This ability depends largely on insight. Psychoeducation focused on improving various aspects of insight, including treatment adherence, reduces incidence of relapses in bipolar disorder.

• MeSH
• antidepresiva terapeutické užití   MeSH
• bipolární porucha farmakoterapie   epidemiologie   prevence a kontrola   MeSH
• incidence MeSH
• lidé MeSH
• prodromální symptomy * MeSH
• rizikové faktory MeSH
• sekundární prevence MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• přehledy MeSH
• Názvy látek
• antidepresiva MeSH

PURPOSE OF THE STUDY: To evaluate, in a retrospective study, the surgical outcomes of percutaneous A1 pulley release in the treatment of trigger digits. MATERIAL: The group evaluated comprised 100 digits in 88 patients. There were 65 women and 23 men. Ten patients had surgery on two digits and one patient on three digits. The patients' average age at the time of surgery was 57.9 years. This procedure was performed on 55 thumbs and 45 fingers (4 index fingers, 19 middle fingers, 19 ring fingers, and 3 little fingers). METHODS: A bent hypodermic needle is used to release the A1 pulley, whose localization is determined as suggested by Froimson. The procedure is performed under local anaesthesia without tourniquet use. Pulley release is done with the needle tip. The finger/thumb is kept in hyperextension of the metacarpophalangeal joint to avoid injury to the nerve and vascular plexus. The extent of tendon release is checked by active motion of the treated digit that should move freely without snapping or locking. Subsequently, a compression bandage is applied for two days, with the digit being exercised immediately after surgery. RESULTS: Of the 100 digits treated, 95 procedures led to complete relief of symptoms and restoration of a full range of motion. Five digits underwent repeat surgery (three percutaneous and two open release procedures). No complaints were reported for 79.7 % and 91.1 % of the treated digits at 2 weeks and 2 months after surgery, respectively. Better results were recorded for the treatment of thumbs. Complications included early trigger finger recurrence in two cases, late recurrence was not recorded. A restricted range of motion after surgery required repeat surgery in three cases. No serious complications such as injury to the tendon, bowstring effect, nerve damage or wound infection were recorded. DISCUSSION: The results of surgery, both percutaneous and open release, in our patient group are comparable with those reported in the literature. In contrast to some authors, we carry out release on all digits. If indicated, we perform percutaneous release also at reoperations. CONCLUSIONS: Percutaneous release has been adopted as a standard method at our department. Because of its minimal invasiveness, it reduces the risk of complications associated with open procedures. It can be carried out at an outpatient department, is less painful and allows the patient to return to daily activities and work in a shorter time.

• MeSH
• lidé středního věku MeSH
• lidé MeSH
• lupavý prst chirurgie   MeSH
• miniinvazivní chirurgické výkony MeSH
• ortopedické výkony přístrojové vybavení   metody   MeSH
• pooperační komplikace MeSH
• recidiva MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH

Monitoring of minimal residual disease (MRD) after hematopoietic stem cell transplantation (HSCT) in patients with acute lymphoblastic leukemia (ALL) is vital for timely therapeutic intervention planning. However, interpreting low-positive results from the current standard method, quantitative PCR (qPCR) of immunoglobulin and T-cell receptor gene rearrangements (IG/TR), poses challenges due to the risk of false positivity caused by non-specific amplification. We aimed to improve MRD detection specificity using the next-generation amplicon sequencing (NGS) of IG/TR rearrangements for better relapse prediction. In pediatric and young adult ALL patients undergoing sequential post-HSCT MRD monitoring, we prospectively re-tested positive non-quantifiable qPCR results with NGS-MRD using the EuroClonality-NGS approach. We were able to confirm 13 out of 47 (27.7%) qPCR positive results using the more specific NGS-MRD method. Out of 10 patients with at least one MRD positivity confirmed by NGS, six relapsed (60%) 1-3.7 months after testing. Among 25 patients with all NGS-MRD results negative, two relapses occurred (8%) after 5.1 and 12.1 months. One-year RFS was 40% versus 96% and 3-year OS was 33.3% versus 94.4% for the NGS-positive and NGS-negative groups, respectively. The difference was not attributable to a varying rate of therapeutic interventions. Six patients out of 14 who had immunosuppressive treatment tapered or received donor lymphocyte infusion in response to MRD positivity developed significant graft versus host disease, leading to one fatality. This underscores the importance of enhancing the post-HSCT relapse risk prediction accuracy through NGS-MRD testing to avoid unnecessary interventions.

• Publikační typ
• časopisecké články MeSH

A novel class of anti-cancer therapeutics - polymeric conjugates of N-(2-hydroxypropyl)methacrylamide (HPMA) copolymers and doxorubicin with pH-controlled release of the drug - is highly efficient in killing tumor cells in vitro and is potent in eradicating growing tumors in vivo. Moreover, in comparison with low-molecular-weight drugs, the macromolecular therapeutics show decreased acute as well as delayed adverse side-toxicity. More importantly, the polymeric conjugates trigger the onset of specific anti-tumor immune response and this anti-tumor immunity can be transferred with splenocytes to naïve recipients. In other terms, chemotherapy based on conjugates of HPMA copolymer with doxorubicin possesses immunomodulating properties. This finding might also have wider implications for the management of relapsing tumors in human patients.

• MeSH
• akrylamidy chemická syntéza   farmakologie   MeSH
• doxorubicin analogy a deriváty   chemická syntéza   farmakologie   MeSH
• experimentální nádory imunologie   prevence a kontrola   MeSH
• galaktosamin chemická syntéza   farmakologie   MeSH
• imunoterapie adoptivní * MeSH
• inhibiční koncentrace 50 MeSH
• injekce subkutánní MeSH
• koncentrace vodíkových iontů MeSH
• kyseliny polymethakrylové chemická syntéza   farmakologie   MeSH
• léky s prodlouženým účinkem MeSH
• lidé MeSH
• myši inbrední C57BL MeSH
• myši MeSH
• nádorové buněčné linie MeSH
• proliferace buněk účinky léků   MeSH
• protinádorové látky chemická syntéza   farmakologie   MeSH
• slezina cytologie   imunologie   transplantace   MeSH
• transplantace nádorů MeSH
• zvířata MeSH
• Check Tag
• lidé MeSH
• myši MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• akrylamidy MeSH
• doxorubicin-N-(2-hydroxypropyl)methacrylamide copolymer conjugate MeSH Prohlížeč
• doxorubicin MeSH
• galaktosamin MeSH
• HPMA coploymer-doxorubicin-galactosamine MeSH Prohlížeč
• kyseliny polymethakrylové MeSH
• léky s prodlouženým účinkem MeSH
• protinádorové látky MeSH

PURPOSE: Smoking among nurses is a barrier to providing smoking cessation interventions to patients. In Central and Eastern Europe-where tobacco use is the leading cause of preventable death and disease-there is limited knowledge about nurses' attitudes toward cessation interventions. Our aim was to describe the attitudes of nurses who are former and current smokers toward providing cessation interventions to patients as well as explore barriers and facilitators to their own quit efforts. METHODS: Nine focus groups with 81 nurses (94% females) in five Central and Eastern European countries. Content analysis was used to identify major themes. RESULTS: Nurses agreed that they should set a good example by not smoking; should be involved in helping patients stop smoking; and needed additional training in tobacco control. Five common themes were identified as barriers to quitting: smoking cues in the environment; presence of smokers in the environment; relapse postpartum; stress and nicotine addiction; and misperceptions about the dangers of smoking. Former smokers reported facilitators to quitting including: seeing the health consequences of smoking among their patients; personal and family health concerns; receiving support from family; and pregnancy. CONCLUSION: There is a need to build upon nurses' positive attitudes about engaging in smoking cessation interventions with patients to ensure that cessation interventions are standard nursing practice. Future studies should focus on programs that support nurses' quit efforts by addressing barriers to smoking cessation, which will improve their health and patient care.

• Klíčová slova
• Europe, Nurses, Relapse triggers, Smoking cessation, Tobacco control,
• MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• odvykání kouření psychologie   MeSH
• personál sesterský psychologie   MeSH
• postoj ke zdraví * MeSH
• postoj zdravotnického personálu * MeSH
• prevence kouření metody   MeSH
• těhotenství MeSH
• zdravé chování * MeSH
• zjišťování skupinových postojů MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Evropa MeSH

Mutations in ATP1A3 lead to different phenotypes having in common acute neurological decompensation episodes triggered by a specific circumstance and followed by sequelae. Alongside Alternating Hemiplegia of Childhood (AHC), Rapid-onset Dystonia Parkinsonism (RDP) and Cerebellar ataxia, Areflexia, Pes cavus, Optic atrophy, Sensorineural hearing loss syndrome (CAPOS), a new Relapsing Encephalopathy with Cerebellar Ataxia (RECA) phenotype was published in 2015. We describe herein eight new pediatric cases. Most of them had no specific history when the first neurological decompensation episode occurred, before the age of 5 years, triggered by fever with severe paralytic hypotonia followed by ataxia with or without abnormal movements. Neurological sequelae with ataxia as the predominant symptom were present after the first episode in three cases and after at least one subsequent relapse in five cases. Five of the eight cases had a familial involvement with one of the two parents affected. The phenotype-genotype correlation is unequivocal with the causal substitution always located at position 756. The pathophysiology of the dysfunctions of the mutated ATPase pump, triggered by fever is unknown. Severe recurrent neurological decompensation episodes triggered by fever, without any metabolic cause, should lead to the sequencing of ATP1A3.

• Klíčová slova
• ATP1A3, Ataxia, Child, Movement disorder,
• MeSH
• cerebelární ataxie genetika   MeSH
• dítě MeSH
• fenotyp MeSH
• genetické asociační studie MeSH
• horečka komplikace   MeSH
• lidé MeSH
• mladiství MeSH
• mutace MeSH
• nemoci mozku genetika   MeSH
• recidiva MeSH
• sodíko-draslíková ATPasa genetika   MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• ATP1A3 protein, human MeSH Prohlížeč
• sodíko-draslíková ATPasa MeSH

OBJECTIVE: Bipolar affective disorder runs a natural course of frequent relapses and recurrences. Despite significant strides in the pharmacological treatment of bipolar disorder, most bipolar patients cannot be treated only by drugs. The limitations of using medication alone in symptomatic, relapse prevention, and satisfaction/quality of life terms have long prompted interest in wider forms of management. One of the promising way how to enhance remission seems to be combination of pharmacotherapy and psychoeducation. METHODS: Studies were identified through PUBMED, Web of Science and Scopus databases as well as existing reviews. The search terms included "bipolar disorder", "psychoeducation", "psychotherapy", "psychosocial treatment", "family therapy", "individual therapy", "group therapy", and "psychoeducation". The search was performed by repeated use of the words in different combinations with no language or time limitations. This article is a review with conclusions concerned with psychoeducation in bipolar disorder. CONCLUSIONS: Randomized controlled trials of cognitive behavioral therapy, interpersonal and social rhythm therapy, individual, group and family psychoeducation show that these approaches augment stabilizing effect of pharmacotherapy. Patients and their families should be educated about bipolar disorder, triggers, warning signs, mood relapse, suicidal ideation, and the effectiveness of early intervention to reduce complications. Psychosocial approaches are important therapeutic strategies for reducing relapse and rehospitalization in bipolar disorder.

• MeSH
• bipolární porucha prevence a kontrola   psychologie   terapie   MeSH
• kognitivně behaviorální terapie metody   MeSH
• lidé MeSH
• psychoterapie * metody   MeSH
• rodinná terapie metody   MeSH
• sekundární prevence MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• přehledy MeSH

Definition of reflux as a centrifugal flow within an incompetent vein connecting both poles of the ambulatory pressure gradient and causing ambulatory venous hypertension is presented. Recurrent reflux occurs also after correctly performed crossectomy and stripping. Growth of new vessels (neo-angiogenesis) or dilatation of pre-existing venous channels (vascular remodelling) has been claimed to be the main cause of recurrences in these instances. Attempts to blockade the development of recurrent reflux in the groin by inserting mechanical barriers over the ligated saphenofemoral junction failed to prevent recurrences. The synergistic effect of two hemodynamic factors - pressure difference between the femoral vein and the saphenous remnant in the thigh on one side, and the propensity to restore centrifugal flow on the other side - may play a crucial role in the development of recurrent reflux. Pressure gradient apparently triggers the event. Restoration of centrifugal flow might be the pre-programmed phenomenon that improves compromised blood supply in arterial occlusions, but evokes recurrent reflux in incompetent superficial veins. In this way, it can be explained why recurrent reflux can occur after any therapeutic procedure.

• MeSH
• hemodynamika MeSH
• lidé MeSH
• recidiva MeSH
• regionální krevní průtok MeSH
• varixy patofyziologie   chirurgie   MeSH
• venózní tlak MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

OBJECTIVE: To evaluate whether compliance with European Society of Gynaecological Oncology (ESGO) surgery quality indicators impacts disease-free survival in patients undergoing radical hysterectomy for cervical cancer. METHODS: In this retrospective cohort study, 15 ESGO quality indicators were assessed in the SUCCOR database (patients who underwent radical hysterectomy for International Federation of Gynecology and Obstetrics (FIGO) stage 2009 IB1, FIGO 2018 IB1, and IB2 cervical cancer between January 2013 and December 2014), and the final score ranged between 0 and 16 points. Centers with more than 13 points were classified as high-quality indicator compliance centers. We constructed a weighted cohort using inverse probability weighting to adjust for the variables. We compared disease-free survival and overall survival using Cox proportional hazards regression analysis in the weighted cohort. RESULTS: A total of 838 patients were included in the study. The mean number of quality indicators compliance in this cohort was 13.6 (SD 1.45). A total of 479 (57.2%) patients were operated on at high compliance centers and 359 (42.8%) patients at low compliance centers. High compliance centers performed more open surgeries (58.4% vs 36.7%, p<0.01). Women who were operated on at centers with high compliance with quality indicators had a significantly lower risk of relapse (HR=0.39; 95% CI 0.25 to 0.61; p<0.001). The association was reduced, but remained significant, after further adjustment for conization, surgical approach, and use of manipulator surgery (HR=0.48; 95% CI 0.30 to 0.75; p=0.001) and adjustment for adjuvant therapy (HR=0.47; 95% CI 0.30 to 0.74; p=0.001). Risk of death from disease was significantly lower in women operated on at centers with high adherence to quality indicators (HR=0.43; 95% CI 0.19 to 0.97; p=0.041). However, the association was not significant after adjustment for conization, surgical approach, use of manipulator surgery, and adjuvant therapy. CONCLUSIONS: Patients with early cervical cancer who underwent radical hysterectomy in centers with high compliance with ESGO quality indicators had a lower risk of recurrence and death.

• Klíčová slova
• cervical cancer, gynecologic surgical procedures, hysterectomy,
• MeSH
• hysterektomie MeSH
• lidé MeSH
• lokální recidiva nádoru chirurgie   MeSH
• nádory děložního čípku * patologie   MeSH
• retrospektivní studie MeSH
• staging nádorů MeSH
• ukazatele kvality zdravotní péče MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

BACKGROUND: a severe generalized pustular eruption occurred several months after allogeneic hematopoietic stem cell transplantation for multiple myeloma in a patient being treated with antibiotics for respiratory infection. Neither he nor his donor had a history of psoriasis. METHODS: the patient was treated with drug withdrawal and administration of cyclosporine and methylprednisolone without improvement; later, acitretin and methylprednisolone were used successfully. The eruption slowly subsided, and therapy was discontinued. Four months later, the patient experienced a recurrent severe pustular eruption associated with fever and leukocytosis, and the same treatment was used successfully again. RESULTS AND CONCLUSION: the patient has not experienced relapses in the ensuing 3 years. Acute generalized exanthematous pustulosis is a rare cutaneous adverse reaction triggered most commonly by drugs with a tendency to resolve spontaneously. The surprisingly prolonged, refractory, and relapsing course of the eruption in our patient might be due to the immune alteration and the polypharmacologic therapy after stem cell transplantation.

• MeSH
• acitretin aplikace a dávkování   MeSH
• akutní generalizovaná exantematózní pustulóza farmakoterapie   imunologie   patologie   MeSH
• antiflogistika aplikace a dávkování   MeSH
• keratolytika aplikace a dávkování   MeSH
• kombinovaná farmakoterapie MeSH
• kůže patologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• methylprednisolon aplikace a dávkování   MeSH
• mnohočetný myelom chirurgie   MeSH
• pooperační komplikace imunologie   MeSH
• recidiva MeSH
• transplantace hematopoetických kmenových buněk * MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH
• práce podpořená grantem MeSH
• Názvy látek
• acitretin MeSH
• antiflogistika MeSH
• keratolytika MeSH
• methylprednisolon MeSH