Syphilis is a multistage sexually transmitted disease caused by Treponema pallidum ssp. pallidum (TPA). This study analyzed clinical samples collected from patients with a diagnosed syphilis infection from 2004-2022, isolated in the Czech Republic. Mucocutaneous swab samples (n = 543) from 543 patients were analyzed, and from these samples, 80.11 % (n = 435) were PCR positive, and 19.89 % (n = 108) were PCR negative for TPA DNA. Swabs were more often positive when collected from syphilis patients in the primary and secondary stages, compared to the latent or unknown stage. There was no significant difference in PCR positivity between the primary and secondary stages (p = 0.099). In IgM-positive patients, a statistically significant association with PCR-positivity was found in samples from seropositive (p = 0.033) and serodiscrepant (RPR negative) patients (p = 0.0006). When assessing our laboratory-defined cases of syphilis, the RPR, IgM, and PCR tests were similarly effective (within the range of 80.1-86.1 %). However, parallel testing with these methods was even more effective, i.e., RPR + PCR was 96.1 % effective and RPR + IgM + PCR was 97.8 % effective. A combination of RPR + PCR, or a combination of all three tests (RPR, IgM, and PCR) can therefore be used to reliably detect active syphilis cases, including reinfections. Our findings show that the reverse algorithm for detecting syphilis could be substantially improved by adding IgM and PCR testing.

• MeSH
• DNA bakterií genetika   MeSH
• dospělí MeSH
• imunoglobulin M * krev   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• polymerázová řetězová reakce * metody   MeSH
• protilátky bakteriální krev   MeSH
• senzitivita a specificita MeSH
• sérologická diagnostika syfilis metody   MeSH
• syfilis * diagnóza   mikrobiologie   MeSH
• Treponema pallidum * genetika   izolace a purifikace   imunologie   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
• Geografické názvy
• Česká republika MeSH

In this multicentric real-world observational retrospective study, we evaluated the efficacy and safety of dupilumab for atopic dermatitis in children <6 years of age who underwent a minimum of 16 weeks of therapy. The analysis focused on EASI (Eczema Area and Severity Index), CDLQI (Children's Dermatology Life Quality Index), and Itch NRS (Numeric Rating Scale) changes from baseline to 4, 16, 24, 48, 72, and 96 weeks of follow-up (when available). Overall 24 children were included, with a mean age of 4.4 years. The baseline mean EASI among these patients was 26.7 (range 11.2-42.5). Since week 16 of therapy, all patients achieved and sustained at least 50% (EASI-50) atopic dermatitis improvement from baseline for the remainder of the follow-up period. At week 16, the mean EASI was 4.6 (0.8-13.1), EASI-75 reached 75% and EASI-90 38% of the patients. Within the initial 16 weeks of dupilumab treatment, 50% of patients experienced at least one adverse event, none of which were deemed severe. Conjunctivitis was among the most common adverse events (8.3%). In conclusion, dupilumab exhibited favorable tolerability, efficacy, and safety in children diagnosed with atopic dermatitis who were below the age of 6.

• MeSH
• atopická dermatitida * farmakoterapie   MeSH
• dítě MeSH
• humanizované monoklonální protilátky * škodlivé účinky   terapeutické užití   MeSH
• kojenec MeSH
• kvalita života MeSH
• lidé MeSH
• předškolní dítě MeSH
• retrospektivní studie MeSH
• stupeň závažnosti nemoci * MeSH
• výsledek terapie MeSH
• Check Tag
• dítě MeSH
• kojenec MeSH
• lidé MeSH
• mužské pohlaví MeSH
• předškolní dítě MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• pozorovací studie MeSH

OBJECTIVES: To evaluate the efficacy and tolerability of a single dose of oral cefixime 800 mg plus oral doxycycline 100 mg twice a day for 7 days, compared with a recommended single dose of ceftriaxone plus single dose of oral azithromycin, for treatment of uncomplicated urogenital, rectal, or pharyngeal gonorrhoea. METHODS: A noninferiority, open-label, multicentre randomized controlled trial was conducted in Prague, Czech Republic. Some 161 patients, 18-65 years of age diagnosed with uncomplicated urogenital, rectal, or pharyngeal gonorrhoea by nucleic acid amplification test (NAAT) were randomized to treatment with single dose of cefixime 800 mg plus doxycycline 100 mg twice a day for 1 week or a single dose of ceftriaxone 1 g intramuscularly plus single dose of azithromycin 2 g. The primary outcome was the number of participants with negative culture and NAAT at 1 week and 3 weeks, respectively, after treatment initiation. RESULTS: In all, 161 patients were randomized and 152 were included in per-protocol analyses. All 76 (100%; 95% CI, 0.95-1.00) patients treated with ceftriaxone plus azithromycin achieved negative cultures and NAAT after treatment. In the cefixime plus doxycycline arm at week 1, culture was negative in all 76 (100%) patients; at week 3, culture was negative in 70 of the 76 patients (92%; 95% CI, 0.84-0.97) and NAAT negative in 66 of the 76 patients (87%; 95% CI, 0.77-0.94). At week 3, culture and NAAT were negative in 65 of the 76 patients (86%; 95% CI, 0.76-0.93). Per-protocol risk difference was 14.5%; 95% CI, 6.56-22.38. All treatment failures observed in the cefixime arm were pharyngeal gonorrhoea cases. DISCUSSION: The combination of cefixime and doxycycline did not achieve noninferiority to ceftriaxone and azithromycin for treatment of gonorrhoea when including pharyngeal gonorrhoea. It did, however, show high efficacy for urogenital and rectal gonorrhoea.

• MeSH
• antibakteriální látky terapeutické užití   MeSH
• azithromycin terapeutické užití   MeSH
• cefixim terapeutické užití   MeSH
• ceftriaxon * MeSH
• dospělí MeSH
• doxycyklin terapeutické užití   MeSH
• gonorea * farmakoterapie   mikrobiologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• Neisseria gonorrhoeae MeSH
• senioři MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH
• hodnocení ekvivalence MeSH
• multicentrická studie MeSH
• randomizované kontrolované studie MeSH

• Klíčová slova
• baricitinib,
• MeSH
• alopecia areata farmakoterapie   psychologie   MeSH
• atopická dermatitida * farmakoterapie   psychologie   MeSH
• cyklosporin aplikace a dávkování   MeSH
• dospělí MeSH
• inhibitory Janus kinas * aplikace a dávkování   MeSH
• lidé MeSH
• progrese nemoci MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• kazuistiky MeSH

Syphilis is a multistage sexually transmitted disease caused by Treponema pallidum ssp. pallidum. In the Czech Republic, there are around 700-800 new syphilis cases annually, continuously increasing since 2012. This study analyzed a total of 1228 samples from 2004 to 2022. Of the PCR-positive typeable samples (n = 415), 68.7% were fully-typed (FT), and 31.3% were partially-typed. Most of the identified isolates belonged to the SS14-clade and only 6.3% were the Nichols-like cluster. While in the beginning of sample collection isolates have been macrolide-susceptible, recent isolates are completely resistant to macrolides. Among the FT samples, 34 different allelic profiles (APs) were found. Most of the profiles (n = 27) appeared just once in the Czech population, while seven profiles were detected more than twice. The most frequent APs belonged to two separate groups of SS14-like isolates, including group of 1.3.1 (ST 1) and 1.26.1 (ST 25) profiles, and the second group containing 1.1.8 (ST 3), 1.1.1 (ST 2), and 1.1.3 (ST 11) (representing 57.5%, and 25.3% of all detected APs, respectively). Both groups consistently differed in 6 nucleotide positions in five genes (TP0150, TP0324, TP0515, TP0548, and TP0691) coding amino-acid replacements suggesting that one or more of these differences could be involved in the higher success of the first group.

• MeSH
• alely * MeSH
• dospělí MeSH
• genotyp MeSH
• lidé středního věku MeSH
• lidé MeSH
• makrolidy farmakologie   MeSH
• multilokusová sekvenční typizace * MeSH
• syfilis * mikrobiologie   epidemiologie   genetika   MeSH
• Treponema pallidum * genetika   izolace a purifikace   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH

• MeSH
• celulitida * farmakoterapie   prevence a kontrola   MeSH
• erysipel * farmakoterapie   prevence a kontrola   MeSH
• flavonoidy terapeutické užití   MeSH
• hmotnostní úbytek MeSH
• kardiovaskulární látky terapeutické užití   MeSH
• klindamycin farmakologie   terapeutické užití   MeSH
• komplikace diabetu MeSH
• lidé MeSH
• penicilin G farmakologie   terapeutické užití   MeSH
• rizikové faktory * MeSH
• tinea pedis komplikace   MeSH
• žilní insuficience farmakoterapie   komplikace   MeSH
• Check Tag
• lidé MeSH

• MeSH
• biologická terapie metody   MeSH
• dermatologie * trendy   MeSH
• venerologie * trendy   MeSH
• Publikační typ
• rozhovory MeSH

• MeSH
• humanizované monoklonální protilátky farmakologie   terapeutické užití   MeSH
• idiopatické střevní záněty etiologie   MeSH
• interleukin-17 antagonisté a inhibitory   škodlivé účinky   terapeutické užití   MeSH
• interleukin-23 antagonisté a inhibitory   škodlivé účinky   terapeutické užití   MeSH
• klinická studie jako téma MeSH
• lidé MeSH
• mykózy etiologie   MeSH
• psoriatická artritida farmakoterapie   MeSH
• psoriáza * farmakoterapie   MeSH
• Check Tag
• lidé MeSH

Upadacitinib je selektivní inhibitor JAK1, který je stále jednou z nejnovějších terapií atopické dermatitidy. V současné době již máme k dispozici téměř tříletá data o účinnosti a bezpečnosti dlouhodobé léčby atopického ekzému upadacitinibem a rovněž první soubory pacientů léčených upadacitinibem v reálné praxi. Všechny tyto výsledky potvrzují dobrou účinnost i bezpečnost upadacitinibu, který nevykazuje nové bezpečnostní signály či nárůst nežádoucích účinků v průběhu dlouhodobé terapie.

Upadacitinib is a selective JAK1 inhibitor that is still one of the newest therapies available for atopic dermatitis. Currently, we already have almost three-year data on the efficacy and safety of long-term treatment of atopic eczema with upadacitinib, as well as the first studies of patients from real practice. All these results confirm the good efficacy and safety of upadacitinib, which does not show any new safety signals or an increase in adverse effects during long-term therapy.

• Klíčová slova
• upadacitinib,
• MeSH
• atopická dermatitida * farmakoterapie   imunologie   MeSH
• biologická terapie MeSH
• hodnocení výsledků zdravotní péče * MeSH
• inhibitory Janus kinas farmakologie   terapeutické užití   MeSH
• Janus kinasa 1 antagonisté a inhibitory   MeSH
• klinické zkoušky jako téma MeSH
• lidé MeSH
• metaanalýza jako téma MeSH
• Check Tag
• lidé MeSH