1. elektronické vydání 1 online zdroj (128 stran)
Publikace se snaží o poznání podstaty politické moci a způsoby jejího fungování. Dívá se na ně nejen z hlediska vývoje, ale i náhledu názorů, které se objevují u člověka. Z různých úhlů si klade otázku, co se ve společnosti skutečně děje, jak to vnímáme a jak se to odráží v našem myšlení. Jedná se nejen o vzpomínky na některé činy, které provázely život, ale i motivy, které k nim vedly. Subjektivní uchopení toho, co je vydáváno za skutečnost, se snaží porovnávat s vytvářeným obrazem o ní a s faktickým stavem. Jejím cílem není něco tvrdit, ale přemýšlet o problému. Závěry mohou být sice různé, ale neměly by svazovat aktivitu člověka a kultivaci jeho humanismu.; Český spisovatel vzpomíná nejen na své mládí, které prožil v období komunistického režimu, ale zaobírá se rovněž různými politickými problémy.
1. elektronické vydání 1 online zdroj (128 stran)
Předchozí epocha skončila a provázena řadou bolestí se rodí nová. Většina lidí tuto změnu nepostřehla nebo ji z různých důvodů nepřikládá takový význam, aby ji podpořila či jen akceptovala, ani nečiní kroky, aby nenastala. Jinými slovy řečeno, perspektiva a volba budoucnosti lidstva značně pokulhávají za probíhajícími procesy.Jak se ukazuje, příroda je dosud mocnější než člověk a neustále nás překvapuje. Přetrvání lidského rodu však není založeno na pouhé reakci, ale na zkoumání alternativ budoucí existence. A ty má jenom skutečně svobodný člověk. Zaměňování technických a technologických prostředků za volbu a rozhodování lidí pravděpodobně nevytvoří možnost trvání dalších pokolení. Někomu se to bude zdát jako vzdálená a předčasná úvaha, ale pandemie nás mimo jiné poučila, že dnešní rozhodnutí se projeví už zítra.; Předchozí epocha skončila a provázena řadou bolestí se rodí nová. Většina lidí tuto změnu nepostřehla nebo ji z různých důvodů nepřikládá takový význam, aby ji podpořila či jen akceptovala, ani nečiní kroky, aby nenastala. Jinými slovy řečeno, perspektiva a volba budoucnosti lidstva značně pokulhávají za probíhajícími procesy. Jak se ukazuje, příroda je dosud mocnější než člověk a neustále nás překvapuje. Přetrvání lidského rodu však není založeno na pouhé reakci, ale na zkoumání alternativ budoucí existence. A ty má jenom skutečně svobodný člověk. Zaměňování technických a technologických prostředků za volbu a rozhodování lidí pravděpodobně nevytvoří možnost trvání dalších pokolení. Někomu se to bude zdát jako vzdálená a předčasná úvaha, ale pandemie nás mimo jiné poučila, že dnešní rozhodnutí se projeví už zítra.
- MeSH
- akutní myeloidní leukemie * epidemiologie terapie MeSH
- lidé MeSH
- registrace MeSH
- retrospektivní studie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- dopisy MeSH
Research objective was to detail COVID-19's natural trajectory in relation to the Czech population's viral load. Our prospective detailed daily questionnaire-based telemonitoring study evaluated COVID-19's impact among 105 outpatients. In accordance with government quarantine requirements, outpatients were divided into a cohort with two negative tests at the end of the disease (40 patients) and a cohort with a new algorithm (65 patients) following a 14-day quarantine. Median follow-up differed significantly between the 2 groups (23 days vs. 16 days). Only 6% of patients were asymptomatic during the entire telemonitoring period. Another 13% of patients were diagnosed asymptomatic, as suspected contacts, yet later developed symptoms, while the remaining 81% were diagnosed as symptomatic on average 6 days following symptom onset. Telemonitoring enabled precise symptom status chronicling. The most frequently reported complaints were fevers, respiratory issues, and anosmia. Six patients were eventually hospitalized for complications detected early after routine telemonitoring. During the extended follow-up (median 181 days), anosmia persisted in 26% of patients. 79% of patients in the new quarantine algorithm cohort reported no symptoms on day 11 compared to just 56% of patients in the two negative test cohort upon first testing negative (median-19 days). The highest viral load occurred within 0-2 days of initial symptom onset. Both the PCR viral load and two consecutive PCR negative sample realizations indicated high interindividual variability with a surprisingly fluctuating pattern among 43% of patients. No definitive COVID-19 symptoms or set of symptoms excepting anosmia (59%) and/or ageusia (47%) were identified. No preexisting medical conditions specifically foreshadowed disease trajectory in a given patient. Without a PCR negativity requirement for quarantine cessation, patients could exhibit fewer symptoms. Our study therefore highlights the urgent need for routine ambulatory patient telemedicine monitoring, early complication detection, intensive mass education connecting disease demeanor with subsequent swift diagnostics, and, notably, the need to reevaluate and modify quarantine regulations for better control of SARS-CoV-2 proliferation.
- MeSH
- ambulantní zařízení MeSH
- COVID-19 diagnóza epidemiologie terapie MeSH
- dospělí MeSH
- karanténa MeSH
- lidé středního věku MeSH
- lidé MeSH
- management nemoci MeSH
- pacienti ambulantní MeSH
- prospektivní studie MeSH
- SARS-CoV-2 izolace a purifikace MeSH
- telemedicína MeSH
- virová nálož MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- pozorovací studie MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Česká republika MeSH
Invasive fungal disease (IFD) early diagnosis improves hematological patient survival. Non-culture-based methods may reduce diagnostic time to identify IFD. As complex data on the value of 1,3-β-D-glucan (BDG) from bronchoalveolar lavage fluid (BALF) compared to serum for the most frequent invasive pulmonary aspergillosis (IPA) diagnosis are scarce, particularly including evaluation of potential factors adversely affecting BDG assay, we provided prospective single-center analysis evaluating 172 episodes of pulmonary infiltrates with BDG detection in BALF and serum samples collected in parallel among hematological patients from 2006 to 2015. Proven and probable IPA were documented in 13.4% of the episodes. Sensitivity (SEN), specificity (SPE), positive and negative predictive value (PPV; NPV), and diagnostic odds ratio (DOR) of the BDG assay using standard (80 pg/ml) cut-off for BALF were: 56.5%; 83.2%; 34.2%; 92.5%, and 6.5, respectively, and for serum were: 56.5%; 82.6%; 33.3%; 92.5%, and 6.2, respectively. The same BDG assay parameters employing a calculated optimal cut-off for BALF (39 pg/ml) were: 78.3%; 72.5%; 30.5%; 95.6%, and 9.5, respectively; and for serum (40 pg/ml) were: 73.9%; 69.1%; 27.0%; 94.5%, and 6.3, respectively. While identifying acceptable SEN, SPE, and DOR, yet low PPV of both BALF and serum BDG assay for IPA diagnosis, neither the combination of both materials nor the new optimal BDG cut-off led to significant test quality improvement. Absolute neutrophil count and aspirated BALF volume with a significant trend affected BDG assay performance. The BDG test did not outperform galactomannan assay.
- MeSH
- beta-glukany analýza krev MeSH
- biologické markery analýza krev MeSH
- bronchoalveolární lavážní tekutina chemie MeSH
- dospělí MeSH
- hematologické nádory komplikace MeSH
- invazivní plicní aspergilóza komplikace diagnóza MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- prospektivní studie MeSH
- senioři MeSH
- senzitivita a specificita MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
During the reign of the first Ptolemaic kings in Egypt, mainly in the 3rd and 2nd centuries BCE, the Egyptian cults related to the divine couple of Isis and Sarapis (i.e. the Isiac cults) spread successfully from Egypt to ports and coastal cities of the ancient Mediterranean. The discussion on the topic of the factors involved in the process of the early spread of these cults outside Egypt is still open and, so far, the research in this area has been conducted mainly by using established historiographical methods. However, these methods are limited when dealing with the interplay among different variables involved in complex historical processes. This article aims to overcome these limits by using a quantitative spatial network analysis. The results of our previous published research, which focused on a quantitative evaluation of the impact of individual factors on the early spread of the Isiac cults across the ancient Aegean Islands, suggest that the process was promoted by military and commercial activities of the Ptolemaic dynasty, and that the Ptolemaic military operations were the most influential factor. Following these results, this article focuses on the early spread of the Isiac cults on the west coast of Hellenistic Asia Minor, i.e. the region which the Ptolemies attempted to control in the 3rd and 2nd centuries BCE. The statistically significant results presented in this article support the hypothesis that the Ptolemaic political engagement in Asia Minor had a positive impact on the early spread of the Isiac cults. The results also suggest that the activities of the Seleucid dynasty, a political rival of the Ptolemies, in the area of interest could have constituted an immunological factor limiting the spread of the Isiac cults further to the eastern parts of Asia Minor.
- MeSH
- archeologie MeSH
- dějiny starověku MeSH
- doprava MeSH
- lidé MeSH
- politika * MeSH
- prostorová analýza MeSH
- Check Tag
- dějiny starověku MeSH
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- historické články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Asie MeSH
- starověký Egypt MeSH
Early in the Ptolemaic era, Egyptian cults, particularly those of Isis and Sarapis, spread successfully to ports across the ancient Aegean Sea. Leading researchers in the field claim that the spread of these cults was influenced by multiple factors, ones that were mainly economic or political in character. However, the question of which factors had more weight or impact than others in the process of the early spread of Egyptian cults has not yet been answered in academic discussion. This could be related to the fact that the issue of the spread of religious innovations in the ancient Mediterranean has been addressed mainly by established historiographical methods such as the collection and critical analysis of archaeological and literary sources. Hypotheses and conclusions derived from these methods are, however, often unable to reflect the complexity of historical processes. A possible solution can be found in supplementing this established methodological apparatus by formalized methods, e.g. the coding of relevant datasets, statistics, geospatial modeling, and network analysis. To be able to compare the possible impacts of different factors on the spread of Egyptian cults in the Aegean Sea region, we 1) constructed a model of the ancient maritime transportation network as a platform for quantitative analysis, 2) transformed selected factors of possible influence into georeferenced parameters of the network, and 3) defined a mathematical model that allowed us to determine which parameters of the network explain the spatial dissemination of archaeological evidence connected to Egyptian cults. The results suggest that the most significant correlation is between the placement of Ptolemaic garrisons and the distribution of Egyptian temples and artefacts in the early Hellenistic Aegean Sea region. The interpretation would be that Egyptian military forces potentially played a significant role in the spread of Egyptian cults.
- MeSH
- dějiny starověku MeSH
- kultura * MeSH
- lidé MeSH
- lodě MeSH
- migrace lidstva MeSH
- náboženství dějiny MeSH
- ostrovy MeSH
- ozbrojené síly MeSH
- teoretické modely MeSH
- vedení války MeSH
- vojenská zařízení dějiny MeSH
- zásobování potravinami dějiny MeSH
- Check Tag
- dějiny starověku MeSH
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- historické články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- ostrovy MeSH
- starověký Egypt MeSH
- Středozemní moře MeSH
INTRODUCTION: Although sarcoidosis is a well-known disease, sarcoidosis patient outcome and the role of prognostic markers in everyday practice have not yet been well described. Therefore, the goal of the present study was to analyse the fate of sarcoidosis patients and the factors influencing the disease's behaviour in routine practice. METHODS: The study was a retrospective analysis of 306 consecutive patients (181 females and 125 males; median age 45 years) diagnosed with sarcoidosis in the years 2003-2012. RESULTS: Through the use of uniparametric analysis, it was determined that the stage of the disease, organ involvement, CD4/CD8 ratio in the bronchoalveolar lavage fluid (BALF), serum and urine calcium levels, smoking, and pulmonary functions had a significant influence on spontaneous sarcoidosis resolution. Multiparametric analysis revealed that spontaneous resolution was significantly positively influenced by female gender, a less advanced disease stage, a higher CD4/CD8 ratio in the BALF, lymphocytosis in the BALF and normal pulmonary functions at diagnosis. During follow-up, only three patients died. The causes of death were respiratory failure with pneumonia (n = 2) and heart attack caused by sarcoidosis heart involvement (n = 1). CONCLUSION: The data show sarcoidosis as a disorder with high variability in clinical and laboratory findings but with good general prognosis.
- MeSH
- bronchoalveolární lavážní tekutina imunologie MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- poměr CD4 a CD8 lymfocytů MeSH
- prognóza MeSH
- retrospektivní studie MeSH
- sarkoidóza diagnóza imunologie metabolismus MeSH
- senioři MeSH
- sexuální faktory MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Although rituximab has seen increasing use in the treatment of immune thrombocytopenia (ITP) for many years, its therapeutic role in this disease remains unclear. We retrospectively analyzed data of all patients with ITP treated with rituximab (375 mg/m(2) once weekly for four consecutive weeks) and consecutively entered the findings into the databases of six large academic centers in the Czech Republic. A total of 114 patients were included in the analysis. All of the patients received rituximab as a second or additional line of therapy. The overall response rate (ORR) after rituximab therapy was 72 % [48 % complete response (CR), 24 % partial response (PR)] at month 6, and 69 % (45 % CR, 24 % PR) at month 12. For the group of patients with newly diagnosed (acute) ITP, the results of treatment were significantly better than for the group of patients with persistent or chronic ITP; nonetheless, this group of patients was far too small (n = 18) for our findings to be generalized. Multivariate analysis revealed that the ORR was significantly influenced primarily by the number of therapies prior to rituximab (the more previous therapies, the worse treatment response). The results of our analysis "from everyday hematological practice" confirm the high efficiency of rituximab treatment in pretreated adult patients with ITP.
- MeSH
- dítě MeSH
- dospělí MeSH
- idiopatická trombocytopenická purpura farmakoterapie MeSH
- imunologické faktory aplikace a dávkování MeSH
- kojenec MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- myší monoklonální protilátky aplikace a dávkování MeSH
- následné studie MeSH
- předškolní dítě MeSH
- retrospektivní studie MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- Check Tag
- dítě MeSH
- dospělí MeSH
- kojenec MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- předškolní dítě MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- klinické zkoušky MeSH
- multicentrická studie MeSH
- práce podpořená grantem MeSH
BACKGROUND: The current situation in the treatment of chronic myeloid leukaemia (CML) presents a new challenge for attempts to measure the therapeutic results, as the CML patients can experience multiple leukaemia-free periods during the course of their treatment. Traditional measures of treatment efficacy such as leukaemia-free survival and cumulative incidence are unable to cope with multiple events in time, e.g. disease remissions or progressions, and as such are inappropriate for the efficacy assessment of the recent CML treatment. METHODS: Standard nonparametric statistical methods are used for estimating two principal characteristics of the current CML treatment: the probability of being alive and leukaemia-free in time after CML therapy initiation, denoted as the current cumulative incidence of leukaemia-free patients; and the probability that a patient is alive and in any leukaemia-free period in time after achieving the first leukaemia-free period on the CML treatment, denoted as the current leukaemia-free survival. The validity of the proposed methods is further documented in the data of the Czech CML patients consecutively recorded between July 2003 and July 2009 as well as in simulated data. RESULTS: The results have shown a difference between the estimates of the current cumulative incidence function and the common cumulative incidence of leukaemia-free patients, as well as between the estimates of the current leukaemia-free survival and the common leukaemia-free survival. Regarding the currently available follow-up period, both differences have reached the maximum (12.8% and 20.8%, respectively) at 3 years after the start of follow-up, i.e. after the CML therapy initiation in the former case and after the first achievement of the disease remission in the latter. CONCLUSIONS: Two quantities for the evaluation of the efficacy of current CML therapy that may be estimated with standard nonparametric methods have been proposed in this paper. Both quantities reliably illustrate a patient's disease status in time because they account for the proportion of patients in the second and subsequent disease remissions. Moreover, the model is also applicable in the future, regardless of what the progress in the CML treatment will be and how many treatment options will be available, respectively.
- MeSH
- chronická myeloidní leukemie farmakoterapie epidemiologie MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- neparametrická statistika MeSH
- piperaziny terapeutické užití MeSH
- počítačová simulace MeSH
- prevalence MeSH
- přežití bez známek nemoci MeSH
- protinádorové látky terapeutické užití MeSH
- pyrimidiny terapeutické užití MeSH
- senioři MeSH
- statistické modely MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Česká republika MeSH