Despite lower virulence, the omicron variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that causes coronavirus disease 2019 (COVID-19) still poses a relevant threat for immunocompromised patients. A retrospective multicentric study was conducted to evaluate the efficacy of pre-exposure prophylaxis with tixagevimab/cilgavimab (Evusheld) with a 6-month follow-up for preventing severe COVID-19 in adult patients with hematology malignancy. Among the 606 patients in the cohort, 96 (16%) contracted COVID-19 with a median of 98.5 days after Evusheld administration. A total of 75% of patients had asymptomatic or mild severity of COVID-19, while just 25% of patients with SARS-CoV-2 positivity had to be hospitalized. Two patients (2%) died directly, and one patient (1%) in association with COVID-19. Eight patients (1.3%) of every cohort experienced adverse events related to Evusheld, mostly grade 1 and of reversible character. It was found that complete vaccination status or positive seroconversion was not associated with lower risk of COVID-19 infection. Previous treatment with an anti-CD20 monoclonal antibody was associated with higher rates of COVID-19, while previous treatment with anti-CD38 monoclonal antibody was not, as was the case for recipients of hematopoietic stem cell transplantation or CAR-T cell therapy. Presence of other comorbidities was not associated with more severe COVID-19. The results support the growing evidence for Evusheld's efficacy against severe COVID-19 in patients with hematology malignancies.

• MeSH
• COVID-19 * MeSH
• dospělí MeSH
• hematologické nádory * komplikace   farmakoterapie   epidemiologie   MeSH
• lidé MeSH
• monoklonální protilátky MeSH
• preexpoziční profylaxe * MeSH
• retrospektivní studie MeSH
• SARS-CoV-2 MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• Geografické názvy
• Česká republika MeSH

BACKGROUND AND OBJECTIVES: Given the paucity of high-quality safety/efficacy data on acute stroke therapies in patients with premorbid disability, they risk being routinely excluded from such therapies. We examined utilization of endovascular thrombectomy (EVT), associated workflow, and poststroke outcomes among patients with vs without premorbid disability. METHODS: We used national registry data on thrombolysis/EVT for the Czech Republic from 1 January 2016 to 31 December 2020. Premorbid disability was defined as prestroke modified Rankin Scale score (mRS) ≥3. We compared proportions of patients with vs without premorbid disability who received EVT and examined workflow times. We compared ΔmRS-change in mRS from prestroke to 3 months-in patients with vs without premorbid disability, in addition to intracerebral hemorrhage (ICH), mortality, and discharge NIHSS (National Institutes of Health Stroke Scale score), adjusting for age, sex, baseline NIHSS, and comorbidities, and verified using propensity score weighting (PSW) and matching for differences in treatment assignment. We stratified by age group (<65, 65-74, 75-84, ≥85 years) to explore outcome heterogeneity with vs without premorbid disability. RESULTS: Among 22,405 patients with ischemic stroke who received thrombolysis/EVT/both, 1,712 (7.6%) had prestroke mRS ≥ 3. Patients with prestroke disability were less likely to receive EVT vs those without (10.1% vs 20.7%, aOR: 0.30, 95% CI 0.24-0.36). When treated, they had longer door-to-arterial puncture times (median: 75 minutes, IQR: 58-100 vs 54, IQR: 27-77, adjusted difference: 12.5, 95% CI 2.68-22.3). Patients with prestroke disability receiving thrombolysis/EVT/both had worse ΔmRS (adjusted rate ratio, aIRR on PSW: 1.57, 95% CI 1.43-1.72), rates of 3-month mRS 5-6, discharge NIHSS, and mortality (aOR-PSW [mortality]: 2.54, 95% CI 1.92-3.34), while ICH did not significantly differ. 32.1% of patients with prestroke disability receiving thrombolysis/EVT/both successfully returned to prestroke state, but this proportion ranged from 19.6% for those older than 85 years to 66.0% for those younger than 65 years. Regardless of premorbid disability, EVT was associated with better outcomes including lower ΔmRS (aIRR-PSW: 0.87, 95% CI 0.83-0.91) and mortality, with no interaction of treatment effect by premorbid disability status (e.g., mortality pinteraction = 0.73). EVT recipients with premorbid disability did not differ significantly for several outcomes including ΔmRS (aIRR: 0.99, 95% CI 0.84-1.17) but were more likely to have 3-month mRS 5-6 (70.1% vs 39.5% without premorbid disability, aOR: 1.85, 95% CI 1.12-3.04). DISCUSSION: Patients with premorbid disability were less likely to receive EVT, had slower treatment times, and had worse outcomes compared with patients without premorbid disability. However, regardless of premorbid disability, patients fared better with EVT vs medical management and one-third with prestroke disability returned to their prestroke status.

• Publikační typ
• časopisecké články MeSH

BACKGROUND AND OBJECTIVE: Intracerebral hemorrhage (ICH) is a serious medical condition with high mortality. However, factors leading to long-term mortality after ICH are largely unclear. The aim of this community-based study is to assess predictors of long-term mortality after spontaneous ICH. METHODS: We identified all patients admitted with spontaneous ICH to hospitals with a certified stroke unit in Brno, the second largest city in the Czech Republic (CR), in 2011, the year of the Czech Population and Housing Census. We reviewed their medical records for risk factors, radiographic parameters, and measures of post-stroke neurological deficit [National Institutes of Health Stroke Scale (NIHSS)]. Using the dates of death from the Czech National Mortality Register, we calculated mortality at 30 days, six months, one year, and three years after the ICH. Multivariate analysis with forward stepwise logistic regression was performed to determine independent predictors of mortality (p < 0.05). RESULTS: In 2011, 1086 patients with stroke were admitted to the four stroke-certified hospitals in Brno, CR. Of these, 134 had spontaneous ICH, with complete data available in 93 of them entering the final analysis. The mortality at 30 days, 6 months, 1 year, and 3 years post-ICH was 34%, 47%, 51%, and 63%, respectively. The mortality was highest in the first few days post-event, with 50% of patients dying in 255 days and average survival being 884 ± 90 days. Both NIHSS and modified ICH (MICH) score showed to be strong and reliable predictors of short- as well as long-term mortality; the risk of death post-ICH increased with older age and size of ICH. Other risk factors contributing to higher, primarily shorter-term mortality included history of cardiac failure, myocardial infarction, or atrial fibrillation. CONCLUSIONS: In our community-based study, we found that severity of neurological deficit at admission (NIHSS), combined with age and size of ICH, well predicted short- as well as long-term mortality after spontaneous ICH. A history of cardiac failure, myocardial infarction, or atrial fibrillation at presentation were also predictors of mortality, underscoring the need for optimal cardiac management in patients with ICH.

• MeSH
• cerebrální krvácení * mortalita   MeSH
• lidé středního věku MeSH
• lidé MeSH
• retrospektivní studie MeSH
• rizikové faktory MeSH
• senioři nad 80 let MeSH
• senioři 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
• Geografické názvy
• Česká republika MeSH

PURPOSE: To investigate the safety and efficacy of baseline antiplatelet treatment in patients with acute ischemic stroke (AIS) undergoing mechanical thrombectomy (MT). MATERIALS AND METHODS: Baseline use of antiplatelet medication before MT for (AIS) may provide benefit on reperfusion and clinical outcome but could also carry an increased risk of intracranial hemorrhage (ICH). All consecutive patients with AIS and treated with MT with and without intravenous thrombolysis (IVT) between January 2012 and December 2019 in all centers performing MT nationwide were reviewed. Data were prospectively collected in national registries (eg, SITS-TBY and RES-Q). Primary outcome was functional independence (modified Rankin Scale 0-2) at 3 months; secondary outcome was ICH. RESULTS: Of the 4,351 patients who underwent MT, 1,750 (40%) and 666 (15%) were excluded owing to missing data from the functional independence and ICH outcome cohorts, respectively. In the functional independence cohort (n = 2,601), 771 (30%) patients received antiplatelets before MT. Favorable outcome did not differ in any antiplatelet, aspirin, and clopidogrel groups when compared with that in the no-antiplatelet group: odds ratio (OR), 1.00 (95% CI, 0.84-1.20); OR, 1.05 (95% CI, 0.86-1.27); and OR, 0.88 (95% CI, 0.55-1.41), respectively. In the ICH cohort (n = 3,685), 1095 (30%) patients received antiplatelets before MT. The rates of ICH did not increase in any treatment options (any antiplatelet, aspirin, clopidogrel, and dual antiplatelet groups) when compared with those in the no-antiplatelet group: OR, 1.03 (95% CI, 0.87-1.21); OR, 0.99 (95% CI, 0.83-1.18); OR, 1.10 (95% CI, 0.82-1.47); and OR, 1.43 (95% CI, 0.87-2.33), respectively. CONCLUSIONS: Antiplatelet monotherapy before MT did not improve functional independence or increase the risk of ICH.

• MeSH
• Aspirin škodlivé účinky   MeSH
• cévní mozková příhoda * diagnostické zobrazování   terapie   MeSH
• intrakraniální krvácení chemicky indukované   MeSH
• ischemická cévní mozková příhoda * diagnostické zobrazování   terapie   MeSH
• ischemie mozku * diagnostické zobrazování   terapie   MeSH
• klopidogrel škodlivé účinky   MeSH
• lidé MeSH
• mechanická trombolýza * škodlivé účinky   MeSH
• trombektomie škodlivé účinky   MeSH
• trombolytická terapie škodlivé účinky   MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

• Publikační typ
• abstrakt z konference MeSH

Although the link between microbial infections and Alzheimer's disease (AD) has been demonstrated in multiple studies, the involvement of pathogens in the development of AD remains unclear. Here, we investigated the frequency of the 10 most commonly cited viral (HSV-1, EBV, HHV-6, HHV-7, and CMV) and bacterial (Chlamydia pneumoniae, Helicobacter pylori, Borrelia burgdorferi, Porphyromonas gingivalis, and Treponema spp.) pathogens in serum, cerebrospinal fluid (CSF) and brain tissues of AD patients. We have used an in-house multiplex PCR kit for simultaneous detection of five bacterial and five viral pathogens in serum and CSF samples from 50 AD patients and 53 healthy controls (CTRL). We observed a significantly higher frequency rate of AD patients who tested positive for Treponema spp. compared to controls (AD: 62.2 %; CTRL: 30.3 %; p-value = 0.007). Furthermore, we confirmed a significantly higher occurrence of cases with two or more simultaneous infections in AD patients compared to controls (AD: 24 %; CTRL 7.5 %; p-value = 0.029). The studied pathogens were detected with comparable frequency in serum and CSF. In contrast, Borrelia burgdorferi, human herpesvirus 7, and human cytomegalovirus were not detected in any of the studied samples. This study provides further evidence of the association between microbial infections and AD and shows that paralleled analysis of multiple sample specimens provides complementary information and is advisable for future studies.

• MeSH
• Alzheimerova nemoc * epidemiologie   mikrobiologie   MeSH
• infekce bakteriemi rodu Treponema * epidemiologie   MeSH
• lidé MeSH
• lidský herpesvirus 6 MeSH
• studie případů a kontrol MeSH
• Treponema * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

• MeSH
• bradykinin analogy a deriváty   terapeutické užití   MeSH
• hereditární angioedémy * diagnóza   farmakoterapie   MeSH
• inhibiční protein komplementu C1 genetika   terapeutické užití   MeSH
• lidé MeSH
• registrace MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• dopisy MeSH

BACKGROUND: Parkinson's disease is a progressive neurodegenerative disease which causes health problem that affects more patients in the past few years. To be able to offer appropriate care, epidemiological analyses are crucial at the national level and its comparison with the international situation. AIM: The demographic description of reported patients with parkinsonism (including Parkinson's disease and atypical parkinsonian syndromes) according to the International Classification of Diseases (ICD-10) from the national health registries. METHODS: Retrospective analysis of data available from the National Health Information System-NHIS and the National Registry of Reimbursed Health Services (NRRHS). Analyzed epidemiological data are intending to determine the regional and specific prevalence of Parkinsonism in the Czech Republic. The International Classification of Diseases diagnoses (ICD-10) of G20 (Parkinson's disease-PD) and G23.1, G23.2, G23.3 (other degenerative disorders of basal ganglia), and G31.8 (another degenerative disease of basal ganglia) from the period of 2012 to 2018 were included into the analysis. RESULTS: We identified 78 453 unique patients from national registries in the period 2012 to 2018. Diagnoses of G20, G23.1, G23.2, and G31.8 were registered as the principal diagnoses in 76.6% of all individual patients. CONCLUSION: We have found a growing number of patients coded with ICD-10 of dg. G20, G23.1, G23.2, G23.3, or G31.8 (N = 27 891 in 2012, and N = 30 612 in 2018). We have proven regional differences in the prevalence of Parkinson´s diagnoses. Therefore we assume most likely also differences in the care of patients with PD based on the availability of specialty care centers.

• MeSH
• lidé středního věku MeSH
• lidé MeSH
• neurodegenerativní nemoci epidemiologie   MeSH
• Parkinsonova nemoc diagnóza   epidemiologie   MeSH
• parkinsonské poruchy diagnóza   epidemiologie   MeSH
• prevalence MeSH
• registrace MeSH
• retrospektivní studie MeSH
• senioři MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH

Cíl: Parkinsonova nemoc (PN) je neurodegenerativní onemocnění, které se projevuje triádou hypokineticko-rigidního syndromu, posturální instability a klidového tremoru. Důsledkem stárnutí populace se incidence a prevalence PN zvyšuje a s postupujícím stavem onemocnění se zvyšují motorické a autonomní příznaky a neuropsychiatrické komplikace. Cílem studie byl demografický popis populace s cílem zhodnotit vykázané hospitalizační důvody a možné komorbidity u vybraného souboru pacientů s hlavními dia­gnózami dle Mezinárodní klasifikace nemocí (MKN-10): G20 (Parkinsonova nemoc), G23.1, G23.2, G23.3 (Jiné degenerativní nemoci bazálních ganglií) a G31.8 (Jiné určené degenerativní nemoci nervové soustavy). Metodika: Retrospektivní analýza dat s využitím dat z Národního zdravotnického informačního systému (NZIS) a Národního registru hrazených zdravotních služeb (NRHZS). Analýza epidemiologických dat s cílem určit hospitalizační důvody a možné komorbidity u vybraného souboru pacientů se stanovenými dia­gnózami. Výsledky: Z národních registrů bylo v letech 2012–2018 identifikováno celkem 78 453 případů. Ze všech hospitalizací pacientů se sledovanými dia­gnózami byla u většiny (58,1 %) v roce 2017 důvodem jejich hlavní neurologická dia­gnóza. Z jiných opakujících se vykazovaných hospitalizačních dia­gnóz při příjmu pacienta to byla nejčastěji Jiná onemocnění močové soustavy (N39) u 2,1 % pacientů. V letech 2012–2018 zemřelo na hlavní sledované dia­gnózy celkem 39,5 % pacientů (n = 30 974) a u pacientů s PN byla nejčastěji vykazovanou příčinou úmrtí ischemická choroba srdeční (20,4 %). Závěr: Dle dostupných dat z NZIS byly identifikovány hospitalizační důvody a příčiny úmrtí vykázané dle MKN-10 u pacientů s Parkinsonovu nemocí. Nejvíce (58,1 %) pacientů bylo v roce 2017 přijato s vykázanou hlavní neurologickou dia­gnózou. U pacientů s PN byla v letech 2012–2018 nejčastěji vykazovanou příčinou úmrtí ischemická choroba srdeční (20,4 %).

Aim: Parkinson's disease (PD) is a neurodegenerative disease manifested by the triad of hypokinetic-rigid syndrome, postural instability and resting tremor. As a consequence of the aging of population, the incidence and prevalence of PD are increasing, and as the disease progresses, motor and autonomic symptoms and neuropsychiatric complications are increasing. Demographic description of the population in order to evaluate the reported hospitalization reasons and possible co-morbidities in a selected group of patients with the main diagnoses according to the International Classification of Diseases (ICD-10): G20 (Parkinson's disease), G23.1, G23.2, G23.3 (Other degenerative diseases of basal ganglia) and G31.8 (Other specified degenerative diseases of the nervous system) was the aim of this study. Methods: Retrospective data analysis using data from the National Health Information System (NZIS) and the National Register of Reimbursed Health Services (NRHZS). Analysis of epidemiological data to determine hospitalization reasons and possible co-morbidities in a selected group of patients with established diagnoses. Results: A total of 78,453 cases were identified from the national registers in 2012–2018. From all hospitalizations of patients with follow-up diagnoses, the majority (58.1%) in 2017 were due to their main neurological diagnosis. From the other recurrent hospital admissions diagnosed upon admission, the most common were Other urinary tract diseases (N39) in 2.1% of patients. In 2012–2018, 39.5% of patients (N = 30,974) died because of the main follow-up diagnoses and, coronary heart disease was the most frequently reported cause of death in PD patients (20.4%). Conclusion: According to available data from the NZIS register, hospitalization reasons and causes of death reported according to ICD-10 in patients with Parkinson's disease were identified. In 2017, most (58.1%) patients were admitted with a major neurological diagnosis. The most frequently reported cause of death between 2012 and 2018 in patients with PD was coronary heart disease (20.4%).

• Klíčová slova
• atypické parkinsonské syndromy,
• MeSH
• epidemiologické studie MeSH
• hospitalizace MeSH
• incidence MeSH
• lidé MeSH
• Parkinsonova nemoc * mortalita   MeSH
• prevalence MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• práce podpořená grantem MeSH

Národní registr kardiovaskulárních intervencí (NRKI) je prospektivní multicentrický registr, který shromažďujeme data o všech provedených perkutánních koronárních intervencích (PCI) ze všech PCI center v České republice, a to prospektivně od roku 2005. V období let 2005-2017 je patrný mírný (cca 14%) nárůst počtu ošetřených nemocných a počtu provedených PCI. Podíl mužů a žen se zásadně nemění (70 : 30), stoupá průměrný vět nemocných, a to více u mužů nežli u žen. Podíl PCI pro AKS je dlouhodobě kolem 50 %, přičemž primární PCI v akutní fázi STEMI podstupuje ročně kolem 6 000 nemocných - ani počet těchto výkonů do roku 2018 neklesá. Nejčastěji intervenovanou tepnou je RIA a poté ACD, narůstá počet intervencí kmene levé věnčité tepny. Potěšitelným faktem je dominantní podíl transradiálního přístupu k PCI (75 %) a zcela dominující podíl lékových stentů (nad 95 % v roce 2018). Objektivizována jsou data o celkové mortalitě nemocných (30denní a 1roční), přičemž dominantní roli hraje klinická manifestace onemocnění (STEMI vs. NSTE-AKS vs. chronická ICHS) a věk nemocných.

he National Registry of Cardiovascular Interventions (NRKI) is a prospective multicentre registry that collects data on all percutaneous coronary interventions (PCIs) performed from all PCI centers in the Czech Republic, prospectively since 2005. In the period 2005-2017, it is noticeable (approx. 14 %) an increase in the number of patients treated and PCIs performed. The proportion of men and women does not change substantially (70 : 30), the average age of patients is increasing, more for men than for women. PCI for ACS has been around 50 % in the long term, with primary PCI in the acute phase of STEMI around 6,000 patients annually - even the number of these procedures has not decreased by 2018. The most frequently intervened artery is LAD and then RCA, increasing is the number of interventions of the left main coronary artery. A gratifying fact is dominant transradial access to PCI (75 %) and usage of drug - eluting stents (over 95 % in 2018). The data on the overall mortality of patients (30 day and 1-year) are objectivized, with clinical manifestation of the disease (STEMI vs NSTE-AKS vs chronic CHD) and age of the patients playing the dominant role.

• Klíčová slova
• Národní registr kardiovaskulárních intervencí,
• MeSH
• akutní koronární syndrom terapie   MeSH
• koronární angioplastika * statistika a číselné údaje   MeSH
• lidé MeSH
• registrace MeSH
• Check Tag
• lidé MeSH
• Geografické názvy
• Česká republika MeSH