BACKGROUND: The increasing urgency to address rising loneliness among adolescents has become a critical issue, underscoring the need for further studies on its association with mental and physical health. The objective was to examine the changes in loneliness and its relation to mental and physical health issues in three adolescent age groups. METHODS: A total sample of 14,588 Czech pupils (50.7% boys, mean age 13.6 ± 1.7 years) in grades 5, 7 and 9 was used from a representative dataset of the Health Behaviour in School-aged Children (HBSC) study. The network analysis based on undirected graphical models was used as an exploratory technique to assess and test the structure of the data. RESULTS: The association between loneliness and health decreased with age. There was a significant positive association between loneliness, feeling low, and irritability. No significant direct association between loneliness and physical health complaints was found. CONCLUSION: Further studies, preferably of longitudinal character, are needed to confirm the changes in associations between loneliness and mental and physical health outcomes.
- Publikační typ
- časopisecké články MeSH
OBJECTIVES: The Short Form-8 (SF-8) is a widely used 8-item tool for health-related quality of life assessment. This study aimed to evaluate the psychometric properties of the Slovak version of the SF-8 in a population sample. METHODS: A cross-sectional survey on a Slovak representative sample (n = 1018; mean age 46.24 ± 16.56 years; 51.3% women) monitoring health and well-being was performed in 2019. Exploratory network analysis and confirmatory factor analysis were used to assess the construct validity of the scale. Reliability and sociodemographic differences were evaluated. RESULTS: A 2-factor model had an adequate fit to the data [χ2(19) = 186.2, P < .001, comparative fit index = 0.998, Tucker-Lewis index = 0.997, root mean square error of approximation = 0.093, standardized root mean of residuals = 0.039], with high reliability (α = 0.93, ω = 0.95). The physical component score and mental component score (MCS) were negatively associated with the presence of chronic health conditions. Lower physical component score and MCS were associated with higher age (P < .001), and lower MCS were associated with female gender (P < .001). CONCLUSIONS: The Slovak version of the SF-8 represents a valuable tool for measuring health-related quality of life in the Slovak population in both practice and research.
- MeSH
- dospělí MeSH
- kvalita života * psychologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- průřezové studie MeSH
- průzkumy a dotazníky MeSH
- psychometrie * metody přístrojové vybavení normy MeSH
- reprodukovatelnost výsledků MeSH
- senioři MeSH
- zdravotní stav MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- validační studie MeSH
- Geografické názvy
- Slovenská republika MeSH
BACKGROUND: Partial nephrectomy (PN) has become the dominant treatment modality for cT1 renal tumor lesions. Tumors suspected of malignant potential are indicated for surgery, but some are histologically classified as benign lesions after surgery. This study aims to analyze the number of benign findings after PN according to definitive histology and to evaluate whether there is an association between malignant tumor findings and individual factors. METHODS: The retrospective study included 555 patients who underwent open or robotic-assisted PN for a tumor in our clinic from January 2013 to December 2020. The cohort was divided into groups according to definitive tumor histology (malignant tumors vs. benign lesions). The association of factors (age, sex, tumor size, R.E.N.A.L.) with the malignant potential of the tumor was further evaluated. RESULTS: In total, 462 tumors were malignant (83%) and 93 benign (17%). Of the malignant tumors, 66% were clear-cell RCC (renal cell carcinoma), 12% papillary RCC, and 6% chromophobe RCC. The most common benign tumor was oncocytoma in 10% of patients, angiomyolipoma in 2%, and papillary adenoma in 1%. In univariate analysis, there was a higher risk of malignant tumor in males (OR 2.13, 95% CI 1.36-3.36, p = 0.001), a higher risk of malignancy in tumors larger than 20 mm (OR 2.32, 95% CI 1.43-3.74, p < 0.001), and a higher risk of malignancy in tumors evaluated by R.E.N.A.L. as tumors of intermediate or high complexity (OR 2.8, 95% CI 1.76-4.47, p < 0.001). In contrast, there was no association between older age and the risk of malignant renal tumor (p = 0.878). CONCLUSIONS: In this group, 17% of tumors had benign histology. Male sex, tumor size greater than 20 mm, and intermediate or high R.E.N.A.L. complexity were statistically significant predictors of malignant tumor findings.
- MeSH
- angiomyolipom patologie chirurgie MeSH
- dospělí MeSH
- karcinom z renálních buněk chirurgie patologie epidemiologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- nádory ledvin * chirurgie patologie MeSH
- nefrektomie * metody MeSH
- oxyfilní adenom patologie chirurgie MeSH
- předoperační období MeSH
- retrospektivní studie MeSH
- senioři 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: Secretoneurin (SN) is a neuropeptide with potential utility as a biomarker of cardiovascular episodes. The main effect of SN is mediated through its inhibition of calmodulin-dependent kinase II (CaMKII), which influences calcium handling. We aimed to associate the levels of SN in plasma with different causes of heart failure. METHODS: We prospectively enrolled consecutive patients with ischaemic (ICM) and dilated (DCM) cardiomyopathy from the outpatient heart failure clinic and healthy individuals. SN was analysed from venous blood by use of the ELISA method. SN plasma levels were compared in DCM, ICM and healthy individuals with non-parametric tests. RESULTS: A total of 53 patients (81.1% male, 18.9% female; mean age 67.9 ± 12.6 years) and 34 healthy individuals (38% male, 62% female) were included in the analysis. Plasma SN levels were significantly higher in the dilated cardiomyopathy (38.8 ± 27 pmol/L) as compared with the ischaemic cardiomyopathy (19.7 ± 22.6 pmol/L) group (P = 0.006). There was no significant difference between females vs. males (27.1 ± 23 vs. 25.5 ± 26.2 pmol/L, P = NS). Plasma SN levels allowed DCM and ICM to be differentiated with 88% sensitivity and 61% specificity (P = 0.007), the cut of value is 13.3 pmol/L. Plasma SN levels differed significantly between healthy volunteers and both ICM (P < 0.0001) and DCM (P = 0.049). Plasma SN levels did not differ according to age and were not associated with comorbidities, left ventricular ejection fraction, heart failure medication, troponin, creatinine, or natriuretic peptide plasma levels. CONCLUSION: Plasma secretoneurin levels differed significantly in DCM vs. ICM, being higher in the former. Based on plasma SN levels, discrimination between DCM and ICM might be possible. Healthy individuals produce higher SN plasma levels than stable HFrEF patients.
- Publikační typ
- časopisecké články MeSH
BACKGROUND: Symptomatic lymphoceles present the most common complication of robot-assisted radical prostatectomy (RARP) with extended pelvic lymph node dissection (ePLND). No surgical technique has so far shown success in reducing the incidence rate, but several retrospective studies have shown the beneficial effect of the fixation of the peritoneum. OBJECTIVE: To introduce a modification in the technique of fixing the peritoneum to the pubic bone and to confirm whether this intervention reduces the incidence of lymphoceles. DESIGN, SETTING, AND PARTICIPANTS: A prospective randomized (1:1) single-center one-sided blind study was conducted in patients with localized prostate cancer (cT1-2cN0M0) indicated for RARP with ePLND operated between December 2019 and June 2021. In the intervention group, the free flap of the peritoneum was fixed to the pubic bone. In the control group, the peritoneal flap was left free without fixation. SURGICAL PROCEDURE: In the intervention group, the free flap of the peritoneum was fixed to the pubic bone (PerFix) so that lateral holes were left, allowing drainage of lymph from the pelvis into the abdominal cavity, where it would be resorbed. The iliac vessels and obturator fossa remained uncovered by the peritoneum and the bladder. MEASUREMENTS: The primary objective was to evaluate the frequency of symptomatic lymphoceles during follow-up. The secondary endpoints were the radiological presence of lymphoceles on computed tomography of the pelvis carried out 6 wk after surgery, the volume of the lymphoceles, and the degree of severe (Clavien-Dindo ≥3) complications. RESULTS AND LIMITATIONS: Of the 260 randomized patients, 245 were evaluated in the final analysis-123 in the intervention and 122 in the control group. The median follow-up was 595 d. There were no differences between the groups regarding clinical and pathological variables. The median of 17 nodes removed was the same in both groups (p = 0.961). Symptomatic lymphoceles occurred in 17 patients (6.9%), while in the intervention group these were found in three (2.4%) versus 14 (11.5%) in the control group (p = 0.011). The number of radiologically detected asymptomatic lymphoceles did not differ (p = 0.095). There was no significant difference in lymphocele volume between the two groups (p = 0.118). The rate of serious complications (Clavien 3a and 3b) was 4.8% in the intervention group and 9.1% in the control group (p = 0.587). A multivariate logistic regression model of symptomatic lymphocele occurrence was created with significant factors: body mass index (odds ratio [OR] = 1.1, 95% confidence interval [CI] = [1.03, 1.26], p = 0.012) and intervention (OR = 4.6, 95% CI = [1.28, 16.82], p = 0.02). CONCLUSIONS: Fixation of the peritoneum (PerFix) reduced the incidence of symptomatic lymphoceles in RARP with ePLND. We found no difference in the frequency of asymptomatic lymphocele development. The volume of the detected lymphoceles was similar. PATIENT SUMMARY: In this study, we compared the rate of development of postoperative complications using the peritoneal fixation technique with that of a nonfixation control group for robot-assisted radical prostatectomy with extended pelvic lymphadenectomy. Fixation of the peritoneum should obviate the development of severe complications in the postoperative period.
- MeSH
- lidé MeSH
- lymfadenektomie škodlivé účinky metody MeSH
- lymfokela * etiologie prevence a kontrola MeSH
- nádory prostaty * patologie MeSH
- pánev patologie MeSH
- peritoneum patologie chirurgie MeSH
- prospektivní studie MeSH
- prostatektomie škodlivé účinky metody MeSH
- retrospektivní studie MeSH
- roboticky asistované výkony * škodlivé účinky metody MeSH
- robotika * MeSH
- volné tkáňové laloky * patologie MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- randomizované kontrolované studie MeSH
Background: The aim of the present study was to examine the efficacy of carboplatin in combination with paclitaxel in patients with metastatic castration-resistant prostate cancer pretreated with multiple regimens including docetaxel and androgen receptor-targeted agents. Methods: Clinical data from patients treated with carboplatin plus paclitaxel were collected retrospectively from a single institution. Results: 43 patients with metastatic castration-resistant prostate cancer were identified. Median number of cycles was ten (range: 1 to 23), prostate-specific antigen response was observed in 18 (42%) patients, median progression-free survival was 115 days and median overall survival was 8.1 months. Conclusion: Combination chemotherapy using taxane with carboplatin is an effective and well-tolerated therapy in heavily pretreated patients with metastatic castration-resistant prostate cancer.
- MeSH
- docetaxel terapeutické užití MeSH
- karboplatina terapeutické užití MeSH
- lidé MeSH
- nádory prostaty rezistentní na kastraci * patologie MeSH
- paclitaxel * terapeutické užití MeSH
- prostatický specifický antigen terapeutické užití MeSH
- protokoly protinádorové kombinované chemoterapie škodlivé účinky MeSH
- retrospektivní studie MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Radikální prostatektomie (RP) s rozšířenou pánevní lymfadenektomií (ePLND) představuje standardní terapii středně a vysoce rizikového lokalizovaného karcinomu prostaty (PCa). Využití ePLND v poslední době narůstá díky provádění většího množství RP u agresivnějších nádorů. Jednou z častých komplikací této operace je vznik symptomatických lymfokél, který se udává až u 10 % operovaných. Dosud, i přes rozsáhlý výzkum, nebyla nalezena vhodná strategie, jak předejít této komplikaci. Jednou z potenciálně úspěšných intervencí se zdá být fixace volného listu peritonea při provádění transperitoneální RP. Několik retrospektivních klinických studií prokázalo snížení výskytu symptomatických lymfokél při fixování peritonea k měchýři nebo stěně pánve, čímž je ponechána mezera v peritoneu, která vytvoří cestu pro volný pohyb lymfy z pánevní oblasti do peritoneální dutiny a její následnou resorpci. Jediná dosud publikovaná randomizovaná studie však tuto hypotézu nepotvrdila. Cílem tohoto článku je představit přehled dosud publikovaných klinických studií zabývajících se fixací peritonea.
Radical prostatectomy (RP) with extended pelvic lymph node dissection (ePLND) is currently a standard of care of intermediate and high-risk localized prostate cancer (PCa). The utilization of ePLND is increasing due to stage migration towards more aggressive cancer. Symptomatic lymphoceles, with incidence ranging up to 10 %, are one of the most frequent complications of ePLND. No successful strategy on how to prevent their occurrence has been found so far. One of the promising interventions could be peritoneal flap fixation during transperitoneal RP. Several retrospective studies have shown a reduction in the incidence of symptomatic lymphocele. The peritoneum can be fixed to the urinary bladder or to the pelvic wall leaving a window in the peritoneum that presents a pathway that directs the lymphatic fluid out of the pelvis into the peritoneal cavity where it can be absorbed. The only randomized trial published so far, however, did not show any benefit. This article aims to present an overview of published clinical studies on the fixation of the peritoneum.
- Klíčová slova
- fixace peritonea,
- MeSH
- lidé MeSH
- lymfadenektomie * metody škodlivé účinky MeSH
- lymfokela * etiologie prevence a kontrola MeSH
- nádory prostaty chirurgie MeSH
- prostatektomie metody škodlivé účinky MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- práce podpořená grantem MeSH
- přehledy MeSH
Pánevní lymfadenektomie (PLND) představuje standardní součást stagingu u lokalizovaného karcinomu prostaty (PCa). V současné době je dle doporučení indikována u středně a vysoce rizikového PCa. Využití PLND v poslední době narůstá díky provádění většího množství RP u agresivnějších nádorů. Onkologický význam PLND zůstává nejasný, někteří pacienti po radikální prostatektomii (RP) a PLND s nálezem pozitivních uzlin (pN1) zůstávají dlouhodobě v onkologické remisi, většina ale vyžaduje další adjuvantní nebo salvage léčbu. Přínos PLND musí být vyvážený k riziku perioperační morbidity. Komplikace zahrnují vážné stavy jako symptomatickou lymfokélu, hlubokou žilní trombózu (HŽT), plicní embolii, poranění obturatorního nervu a poranění velkých cév. Cílem tohoto článku je popsat současný pohled guidelines na PLND, doporučení týkající se rozsahu PLND, dále jaké komplikace se vyskytují při provedení PLND, které nomogramy lze použít při vypočítání rizika postižení uzlin a také současný pohled na biopsii sentinelové uzliny a salvage lymfadenektomii.
Pelvic lymph node dissection (PLND) represents an integral part of staging in prostate cancer (PCa). Guidelines recommend PLND in intermediate and high-risk PCa. The use of PLND has increased recently due to stage migration towards more aggressive PCa. The oncological significance of PLND remains unclear. Some patients after radical prostatectomy (RP) with PLND, remain in oncological remission for a long time, but most of those patients with positive nodes (pN1) require additional adjuvant or salvage treatment. The benefit of PLND must be balanced against the risk of perioperative morbidity. Complications include conditions such as symptomatic lymphocele, deep vein thrombosis (DVT), pulmonary embolism, obturator nerve injury, and large vessel injury. The aim of this article is to describe the current view of the guidelines on PLND, recommendations regarding the extent of PLND, what complications occur when performing PLND, which nomograms can be used to calculate the risk of nodal involvement and what is the role of sentinel node biopsy and salvage lymph node dissection.
- Klíčová slova
- salvage lymfadenektomie, pánevní lymfadenektomie,
- MeSH
- lidé MeSH
- lymfadenektomie metody MeSH
- nádory prostaty * chirurgie MeSH
- prostatektomie MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- přehledy MeSH
