BACKGROUND: Skeletal muscle alterations are associated with higher mortality and morbidity in patients with liver cirrhosis. Assessing these changes seems to be a promising method for identifying patients at a high risk of poor outcomes following liver transplantation (LT). This is particularly important given the current global shortage of organ donors. However, evidence of the impact of these alterations on the prognosis of patients undergoing LT is inconclusive. The aim of our prospective study was to evaluate the impact of skeletal muscle changes, reflected in sarcopenia, myosteatosis and metabolic changes in the calf muscles, on perioperative outcomes and long-term survival after LT. We also sought to determine the posttransplant evolution of the resting muscle metabolism. METHODS: We examined 134 adult LT candidates. Of these, 105 underwent LT. Sarcopenia and myosteatosis were diagnosed by measuring the skeletal muscle index and mean psoas muscle radiation attenuation, respectively, which were obtained from computed tomography (CT) scans taken during pretransplant assessment. Additionally, patients underwent 31P MR spectroscopy (MRS) of the calf muscles at rest before LT and 6, 12 and 24 months thereafter. The median follow-up was 6 years. RESULTS: Patients with abnormal 31P MRS results and CT-diagnosed myosteatosis prior to LT had significantly worse long-term survival after LT (hazard ratio (HR), 3.36; 95% confidence interval (CI), 1.48-7.60; p = 0.0021 and HR, 2.58; 95% CI, 1.06-6.29; p = 0.03, respectively). Multivariable analysis showed that abnormal 31P MR spectra (HR, 3.40; 95% CI, 1.50-7.71; p = 0.003) were a better predictor of worse long-term survival after LT than myosteatosis (HR, 2.78; 95% CI, 1.14-6.78; p = 0.025). Patients with abnormal 31P MR spectra had higher blood loss during LT (p = 0.038), required a higher number of red blood cell transfusions (p = 0.006) and stayed longer in ICU (p = 0.041) and hospital (p = 0.007). Myosteatosis was associated with more revision surgeries following LT (p = 0.038) and a higher number of received red blood cell transfusion units (p = 0.002). Sarcopenia had no significant effect on posttransplant patient survival. An improvement in the resting metabolism of the calf muscles was observed at 12 and 24 months after LT. CONCLUSIONS: Abnormal 31P MRS results of calf muscles were superior to CT-based diagnosis of myosteatosis and sarcopenia in predicting perioperative complications and long-term survival after LT. Resting muscle metabolism normalized 1 year after LT in most recipients.

• MeSH
• dospělí MeSH
• kosterní svaly * diagnostické zobrazování   metabolismus   MeSH
• lidé středního věku MeSH
• lidé MeSH
• magnetická rezonanční spektroskopie * metody   MeSH
• počítačová rentgenová tomografie * metody   MeSH
• prognóza MeSH
• prospektivní studie MeSH
• sarkopenie etiologie   metabolismus   MeSH
• senioři MeSH
• transplantace jater * MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

BACKGROUND AND OBJECTIVES: The relevance of the use of intra-aortic balloon pump (IABP) in cardiogenic shock (CS) has been discussed over the past years. The aim of this study is to describe a single-centre 10-year experience with IABP and analyse the risk factors for 30-day mortality. METHODS: The data for this single-centre, observational, retrospective study were drawn from records dated from January 2012 to May 2022 pertaining to patients presenting with CS, treated with IABP and hospitalised at the Department of Acute Cardiology, Institute for Clinical and Experimental Medicine, Prague. RESULTS: Among the patients included in the study, 87% patients presented with newly developed heart failure. The leading cause of CS was acute myocardial infarction accounting for 86% of cases. Hospital mortality was recorded at 39% and the 30-day mortality reached 43%. Upon multi-variable analysis, only the vasoactive inotropic score on day 5 emerged as a statistically significant predictor for 30-day mortality (p=0.0055). Cox regression analysis revealed that the presence of mechanical complications was the only variable identified as yielding a statistically significant impact on the 30-day survival (Log-rank p=0.014, HR 2.19, 95% CI: 1.15‒4.15). There was no statistically significant difference in the 30-day mortality across the SCAI classes. CONCLUSION: The main cause of CS was a newly developed acute heart failure secondary to acute myocardial infarction. Despite the implementation of mechanical circulatory support, both in-hospital and 30-day mortality rates remained high. Increased vasoactive inotropic score and presence of mechanical complications were identified as significant predictors the 30-day survival (Tab. 6, Fig. 1, Ref. 36). Text in PDF www.elis.sk Keywords: cardiogenic shock, IABP, risk factors, mortality, Czech Republic, AMICS.

• MeSH
• infarkt myokardu komplikace   mortalita   MeSH
• intraaortální balónková pumpa * MeSH
• kardiogenní šok * mortalita   terapie   etiologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mortalita v nemocnicích * MeSH
• retrospektivní studie MeSH
• rizikové faktory MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• srdeční selhání mortalita   terapie   komplikace   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
• pozorovací studie MeSH
• Geografické názvy
• Česká republika MeSH

Multiple sclerosis (MS) is an autoimmune disease characterized by central nervous system demyelination and axonal loss. The diagnosis of optic neuritis (ON) is based on clinical symptoms and signs and paraclinical findings. Current diagnostic procedures provide insufficient data on patient prognosis, and the pathophysiological processes in ON remain partly unknown. Patients with ON and sex- and age-matched healthy controls will be included and undergo neurological and ophthalmological examination, visual evoked potentials, retinal oximetry, optic coherence tomography (OCT), neurosonology and magnetic resonance imaging (MRI) with functional MRI. Patients will undergo follow-up visits 3 and 6 months after the first visit. We hypothesize that changes in retinal blood oxygen saturation level in ON will be associated with the clinical outcome and with activation changes in the medial and lateral occipital cortices in fMRI, and with subsequent structural changes in the optic pathways assessed by MRI and OCT.

Roztroušená skléróza (RS) je autoimunitní onemocnění centrálního nervového systému vedoucí k demyelinizaci a neurodegeneraci. Diagnóza retrobulbární neuritidy (RN) je založena na klinickém obrazu a výsledcích pomocných vyšetření. Současné diagnostické metody poskytují nedostatečnou informaci o prognóze pacienta, přičemž nejsou zcela známy všechny patofyziologické procesy, které se při RN uplatňují. Do studie budou zařazeni pacienti s RN a zdravé věkem a pohlavím vázané kontroly, kteří podstoupí neurologické a oční vyšetření, zrakové evokované potenciály (VEP), retinální oxymetrii, optickou koherentní tomografii (OCT), neurosonologické vyšetření a magnetickou rezonanci (MR) včetně funkční magnetické rezonance (fMRI). Pacienti absolvují vyšetření 3krát (vstupně, 3 a 6 měsíců od prvního vyšetření). Očekáváme, že během RN dochází ke změnám retinální kyslíkové saturace, které by měly korelovat s klinickým vývojem a se změnami aktivace mediálního a laterálního okcipitálního kortexu při vyšetření fMRI, a s následnými strukturálními změnami zrakové dráhy měřenými pomocí MR a OCT.

• Klíčová slova
• roztroušená skleróza, multiple sclerosis, optická koherentní tomografie, zrakové evokované potenciály, visual evoked potentials, retrobulbární neuritida, automatická retinální oxymetrie, funkční magnetická rezonance, optic neuritis, automatic retinal oximetry, functional magnetic resonance, optical coherent tomography,

• NLK Publikační typ
• závěrečné zprávy o řešení grantu AZV MZ ČR

BACKGROUND: Cladribine, a selective immune reconstitution therapy, is approved for the treatment of adult patients with highly active multiple sclerosis (MS). OBJECTIVES: Provide experience with cladribine therapy in a real-world setting. METHODS: This is a registry-based retrospective observational cohort study. First, using data from the Czech nationwide registry ReMuS, we analysed patients who initiated cladribine from September 1, 2018 to December 31, 2021. Second, we analysed a subgroup of patients who initiated cladribine between September 1, 2018 to June 30, 2020, thus possessing a follow-up period of at least 2 years. We evaluated demographic and MS characteristics including disease-modifying therapies (DMTs) before and after cladribine administration, relapses, Expanded Disability Status Scale (EDSS), and adherence. RESULTS: In total, 617 patients (335 with follow-up of at least 2 years) started cladribine therapy in the study period (mean age 37.0, mean disease duration 8.4 years, 74.1% females). In most cases, cladribine was administered as a second-line drug, a total of 80.7% had been escalated from a platform DMT. During 2 years before cladribine initiation, the average annualised relapse rate (ARR) was .67. Following cladribine initiation, the ARR decreased to .28 in the first year and .22 in the second year. Overall, across the entire two-year treatment period, 69.0% of patients were relapse-free and the average ARR was .25. As for EDSS development, the median baseline EDSS was 2.5 and remained stable even after 24 months. The adherence to treatment ranged of around 90%. CONCLUSION: This nationwide study confirms the efficacy of cladribine in real-world settings, especially in patients who are not treatment-naïve. In addition, the study shows an exceptionally high adherence rate, a finding that underscores the invaluable role of cladribine, but also the value of registry-based studies in capturing real-world clinical practice.

• Publikační typ
• časopisecké články MeSH

Crocosphaera watsonii is a unicellular N2-fixing (diazotrophic) cyanobacterium observed in tropical and subtropical oligotrophic oceans. As a diazotroph, it can be a source of bioavailable nitrogen (N) to the microbial community in N-limited environments, and this may fuel primary production in the regions where it occurs. Crocosphaera watsonii has been the subject of intense study, both in culture and in field populations. Here, we summarize the current understanding of the phylogenetic and physiological diversity of C. watsonii, its distribution, and its ecological niche. Analysis of the relationships among the individual Crocosphaera species and related free-living and symbiotic lineages of diazotrophs based on the nifH gene have shown that the C. watsonii group holds a basal position and that its sequence is more similar to Rippkaea and Zehria than to other Crocosphaera species. This finding warrants further scrutiny to determine if the placement is related to a horizontal gene transfer event. Here, the nifH UCYN-B gene copy number from a recent synthesis effort was used as a proxy for relative C. watsonii abundance to examine patterns of C. watsonii distribution as a function of environmental factors, like iron and phosphorus concentration, and complimented with a synthesis of C. watsonii physiology. Furthermore, we have summarized the current knowledge of C. watsonii with regards to N2 fixation, photosynthesis, and quantitative modeling of physiology. Because N availability can limit primary production, C. watsonii is widely recognized for its importance to carbon and N cycling in ocean ecosystems, and we conclude this review by highlighting important topics for further research on this important species.

• MeSH
• fixace dusíku * MeSH
• fylogeneze * MeSH
• sinice * genetika   metabolismus   fyziologie   MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

U onemocnění RS má MR nezastupitelnou roli. Pro maximální využití potenciálu této metody, tedy pro časnou a přesnou diagnostiku s určením prognostických markerů, časný signál neefektivity terapie či bezpečnostního problému, ale i pro dostupnost adekvátní péče pro všechny pacienty, je klíčová unifikace managementu MR napříč jednotlivými pracovišti. Zároveň je podstatná komunikace mezi radiologem a neurologem a s tím související standardizace jak žádanky, tak popisu MR. Jednotná forma dat z MR by vedle zkvalitnění péče o individuálního pacienta vedla i k možnosti sběru dat na národní úrovni. Tím by umožnila získat strukturované informace pro výzkum a také využití dat z MR při jednáních s plátci zdravotní péče. Za tímto účelem vznikl pod záštitou Sekce klinické neuroimunologie a likvorologie České neurologické společnosti tento konsenzus českého expertního radiologicko-neurologického panelu vycházející z mezinárodních doporučení Magnetic Resonance Imaging in Multiple Sclerosis (MAGNIMS). Přichází s návrhem doporučení základního a rozšířeného diagnostického, monitoračního a bezpečnostního protokolu MR, stanovuje frekvenci jednotlivých vyšetření, nutné informace na žádance na MR a představuje normovaný popis diagnostické i monitorační MR u pacientů s podezřením či stanovenou diagnózou RS.

In MS, MRI has an irreplaceable role. The unification of MRI management across different institutions is crucial for maximal use of the potential of this method, i.e., for early and accurate diagnosis with the determination of prognostic markers, early signal of ineffectiveness of therapy or safety problem, but also for availability of adequate care for all patients. At the same time, communication between the radiologist and neurologist and the associated standardization of both the referral form and MRI description are essential. In addition to improving the quality of care for the individual patient, a uniform MRI data format would also lead to the possibility of national data collection. This would allow for structured information for research as well as the use of MRI data in negotiations with healthcare providers. For this purpose under the patronage of the Section of Clinical Neuroimmunology and Liquorology of the Czech Neurological Society, this consensus of the Czech Expert Radiology-Neurology Panel is published based on the international Magnetic Resonance Imaging in Multiple Sclerosis (MAGNIMS) recommendations. It proposes recommendations for a basic and extended diagnostic, monitoring and safety MRI protocol, specifies the frequency of individual examinations, the necessary information on the MRI referral form and presents a standardized description of diagnostic and monitoring MRI in patients with suspected or confirmed diagnosis of MS.

• Klíčová slova
• diagnostická kritéria, žádanka, diagnostický protokol, monitorační protokol,
• MeSH
• klinické protokoly MeSH
• lidé MeSH
• magnetická rezonanční tomografie * normy   MeSH
• roztroušená skleróza * diagnostické zobrazování   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• směrnice pro lékařskou praxi MeSH

The initial phase of multiple sclerosis (MS), often known as clinically isolated syndrome (CIS), is a critical period for identifying individuals at high risk of progressing to full-blown MS and initiating timely treatment. In this study, we aimed to evaluate the prognostic value of C-X-C motif chemokine ligand 13 (CXCL13) and interleukin-8 (IL-8) as potential markers for CIS patients' conversion to MS. Our study encompassed patients with CIS, those with relapsing-remitting MS (RRMS), and control subjects, with sample analysis conducted on both cerebrospinal fluid (CSF) and serum. Patients were categorized into four groups: CIS-CIS (no MS development within 2 years), CIS-RRMS (conversion to RRMS within 2 years), RRMS (already diagnosed), and a control group (CG) with noninflammatory central nervous system disorders. Results showed significantly elevated levels of CXCL13 in CSF across all patient groups compared with the CG (p < 0.0001, Kruskal-Wallis test). Although CXCL13 concentrations were slightly higher in the CIS-RRMS group, statistical significance was not reached. Similarly, significantly higher levels of IL-8 were detected in CSF samples from all patient groups compared with the CG (p < 0.0001, Kruskal-Wallis test). Receiver operating characteristic analysis in the CIS-RRMS group identified both CXCL13 (area under receiver operating characteristic curve = .959) and IL-8 (area under receiver operating characteristic curve = .939) in CSF as significant predictors of CIS to RRMS conversion. In conclusion, our study suggests a trend towards elevated CSF IL-8 and CSF CXCL13 levels in CIS patients progressing to RRMS. These findings emphasize the importance of identifying prognostic markers to guide appropriate treatment strategies for individuals in the early stages of MS.

• MeSH
• biologické markery mozkomíšní mok   krev   MeSH
• chemokin CXCL13 * mozkomíšní mok   krev   MeSH
• demyelinizační nemoci mozkomíšní mok   MeSH
• dospělí MeSH
• interleukin-8 * mozkomíšní mok   krev   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• prognóza MeSH
• progrese nemoci * MeSH
• relabující-remitující roztroušená skleróza * mozkomíšní mok   krev   diagnóza   MeSH
• roztroušená skleróza mozkomíšní mok   krev   diagnóza   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

Borrelia burgdorferi sensu lato is a species complex of pleomorphic spirochetes, including species that cause Lyme disease (LD) in humans. In addition to classic spiral forms, these bacteria are capable of creating morphological forms referred to as round bodies and aggregates. The subject of discussion is their possible contribution to the persistence of infection or post-infection symptoms in LD. This study investigates the immunological properties of these forms by monitoring reactivity with early (n = 30) and late stage (n = 30) LD patient sera and evaluating the immune response induced by vaccination of mice. In patient sera, we found a quantitative difference in reactivity with individual morphotypes, when aggregates were recognized most intensively, but the difference was statistically significant in only half of the tested strains. In post-vaccination mouse sera, we observed a statistically significant higher reactivity with antigens p83 and p25 (OspC) in mice vaccinated with aggregates compared to mice vaccinated with spiral forms. The importance of the particulate nature of the antigen for the induction of a Th1-directed response has also been demonstrated. In any of morphological forms, the possibility of inducing antibodies cross-reacting with human nuclear and myositis specific/associated autoantigens was not confirmed by vaccination of mice.

• MeSH
• antigeny bakteriální MeSH
• Borrelia burgdorferi komplex * MeSH
• Borrelia burgdorferi * MeSH
• lidé MeSH
• lymeská nemoc * mikrobiologie   MeSH
• myši MeSH
• zvířata MeSH
• Check Tag
• lidé MeSH
• myši MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH

In gait stability analysis, patients suffering from dysfunction problems are impacted by shifts in their dynamic balance. Monitoring the patients' progress is important for allowing physicians and patients to observe the rehabilitation process accurately. In this study, we designed a new methodology for classifying gait disorders to quantify patients' progress. The dataset in this study includes 84 measurements of 37 patients based on a physician's opinion. In this study, the system, which includes a Kinect camera to observe and store the frames of patients walking down a hallway, a key-point detector to detect the skeletal key points, and an encoder transformer classifier network integrated with generator-discriminator networks (ET-GD), is designed to evaluate the classification of gait dysfunction. The detector extracts the skeletal key points of patients. After feature engineering, the selected high-level features are fed into the proposed neural network to analyse patient movement and perform the final evaluation of gait dysfunction. The proposed network is inspired by the 1D encoder transformer, which is integrated with two main networks: a network for classification and a network to generate fake output data similar to the input data. Furthermore, we used a discriminator structure to distinguish between the actual data (input) and fake data (generated data). Due to the multi-structural networks in the proposed method, multi-loss functions need to be optimised; this increases the accuracy of the encoder transformer classifier.

• MeSH
• analýza chůze MeSH
• chůze (způsob) * MeSH
• chůze MeSH
• lidé MeSH
• neuronové sítě (počítačové) MeSH
• pohybové poruchy * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

BACKGROUND: Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disorder characterized by progressive deterioration of upper and lower motor neurons. A definitive diagnostic test or biomarker for ALS is currently unavailable, leading to a diagnostic delay following the onset of initial symptoms. Our study focused on cerebrospinal fluid (CSF) concentrations of clusterin, tau protein, phosphorylated tau protein, and beta-amyloid1-42 in ALS patients and a control group. METHODS: Our study involved 54 ALS patients and 58 control subjects. Among the ALS patients, 14 presented with bulbar-onset ALS, and 40 with limb-onset ALS. We quantified biomarker levels using enzyme-linked immunosorbent assay (ELISA) and compared the results using the Mann-Whitney U-test. RESULTS: Significant elevations in neurodegenerative markers, including tau protein (p < 0.0001), phosphorylated tau protein (p < 0.0001), and clusterin (p = 0.038), were observed in ALS patients compared to controls. Elevated levels of tau protein and phosphorylated tau protein were also noted in both bulbar and limb-onset ALS patients. However, no significant difference was observed for beta-amyloid1-42. ROC analysis identified tau protein (AUC = 0.767) and p-tau protein (AUC = 0.719) as statistically significant predictors for ALS. CONCLUSION: Our study demonstrates that neurodegenerative marker levels indicate an ongoing neurodegenerative process in ALS. Nonetheless, the progression of ALS cannot be predicted solely based on these markers. The discovery of a specific biomarker could potentially complement existing diagnostic criteria for ALS.

• MeSH
• amyotrofická laterální skleróza * diagnóza   MeSH
• biologické markery MeSH
• klusterin MeSH
• lidé MeSH
• opožděná diagnóza MeSH
• proteiny tau MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH