Despite the rising global burden of stroke and its socio-economic implications, the neuroimaging predictors of subsequent cognitive impairment are still poorly understood. We address this issue by studying the relationship of white matter integrity assessed within ten days after stroke and patients' cognitive status one year after the attack. Using diffusion-weighted imaging, we apply the Tract-Based Spatial Statistics analysis and construct individual structural connectivity matrices by employing deterministic tractography. We further quantify the graph-theoretical properties of individual networks. The Tract-Based Spatial Statistic did identify lower fractional anisotropy as a predictor of cognitive status, although this effect was mostly attributable to the age-related white matter integrity decline. We further observed the effect of age propagating into other levels of analysis. Specifically, in the structural connectivity approach we identified pairs of regions significantly correlated with clinical scales, namely memory, attention, and visuospatial functions. However, none of them persisted after the age correction. Finally, the graph-theoretical measures appeared to be more robust towards the effect of age, but still were not sensitive enough to capture a relationship with clinical scales. In conclusion, the effect of age is a dominant confounder especially in older cohorts, and unless appropriately addressed, may falsely drive the results of the predictive modelling.

• MeSH
• bílá hmota * diagnostické zobrazování   MeSH
• cévní mozková příhoda * komplikace   diagnostické zobrazování   MeSH
• difuzní magnetická rezonance MeSH
• kognitivní dysfunkce * diagnostické zobrazování   etiologie   psychologie   MeSH
• lidé MeSH
• senioři MeSH
• stárnutí MeSH
• zobrazování difuzních tenzorů metody   MeSH
• Check Tag
• lidé MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

Purpose: The aim of this study was to analyze factors affecting spatio-temporal gait parameters in elderly people of both genders and different ages with different risks of fall, fall history, and medications. Patients and Methods: A total of 210 community-dwelling older adults (156 females, 54 males; mean age 72.84±6.26 years) participated in this study. To assess the risk of falls, the Downton Fall Risk Index was used. An additional question about medication intake (all prescribed drugs) was asked. To assess the spatio-temporal gait parameters, the Zebris FDM platform was used. Gait parameters and Downton Fall Risk Index, stratified by participants' history of falls, multiple medication use (0/1/2+), gender, age, and medication categories, were statistically analyzed using the Mann-Whitney U-test and Kruskal-Wallis test. Results: When comparing different medication categories, a Downton Fall Risk Index score indicating a high risk of falls was observed in the psychotropic medication category (3.56±1.67). A gait velocity suggesting a higher risk of falls (≤3.60 km/h) was observed in the psychotropic (2.85±1.09 km/h) and diabetes (2.80±0.81 km/h) medication categories, in the age groups 70-79 years (3.30±0.89 km/h) and 80+ years (2.67±0.88 km/h), and in participants using two or more medications (3.04±0.93 km/h). Conclusion: The results of this study confirm previous observations and show that higher age and multiple medication negatively affect the gait, and that the higher risk of falls is associated with psychotropic and diabetes medication use. These results provide important information for future fall preventive programs for the elderly that would be especially beneficial for elderly people taking psychotropic and diabetes medication.

• MeSH
• chůze (způsob) * MeSH
• lidé MeSH
• psychotropní léky MeSH
• rizikové faktory MeSH
• samostatný způsob života * MeSH
• senioři MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

Primární angiosarkom prsu představuje vzácnou malignitu, která obvykle postihuje mladé ženy mezi třetí a čtvrtou dekádou. Manifestuje se jako hmatná, rychle rostoucí rezistence v prsu u žen bez předešlé expozice ionizujícímu záření. Hlavní léčebnou modalitu představuje chirurgický výkon, role radioterapie a chemoterapie zůstává nejasná pro nedostatek randomizovaných klinických studií. Prognóza primárního angiosarkomu je nepříznivá, typická je vysoká míra lokální rekurence a časná hematogenní diseminace zejména do plic.

Primary angiosarcoma of the breast is a rare malignancy, usually affecting young women between the third and fourth decades of life. It is manifested as a palpable, rapidly growing mass in the breast of women with no history of exposure to ionizing radiation. Surgery is the main treatment modality, with the role of radiotherapy and chemotherapy remaining unclear due to a lack of randomized clinical trials. The prognosis of primary angiosarcoma is unfavourable, with a high rate of local recurrence and early haematogenous dissemination, particularly to the lungs, being typical.

• MeSH
• adjuvantní chemoterapie MeSH
• dospělí MeSH
• hemangiosarkom * diagnóza   terapie   MeSH
• lidé MeSH
• nádory prsu * diagnóza   terapie   MeSH
• progrese nemoci MeSH
• radioterapie MeSH
• recidiva MeSH
• rozsev nádorových buněk MeSH
• vzácné nemoci MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• kazuistiky MeSH

Background: Dance is a complex activity combining physical exercise with cognitive, social, and artistic stimulation. Objectives: We aimed to assess the effects of dance intervention (DI) on intra and inter-network resting-state functional connectivity (rs-FC) and its association to cognitive changes in a group of non-demented elderly participants. Methods: Participants were randomly assigned into two groups: DI and life as usual (LAU). Six-month-long DI consisted of supervised 60 min lessons three times per week. Resting-state fMRI data were processed using independent component analysis to evaluate the intra and inter-network connectivity of large-scale brain networks. Interaction between group (DI, LAU) and visit (baseline, follow-up) was assessed using ANOVA, and DI-induced changes in rs-FC were correlated with cognitive outcomes. Results: Data were analyzed in 68 participants (DI; n = 36 and LAU; n = 32). A significant behavioral effect was found in the attention domain, with Z scores increasing in the DI group and decreasing in the LAU group (p = 0.017). The DI as compared to LAU led to a significant rs-FC increase of the default mode network (DMN) and specific inter-network pairings, including insulo-opercular and right frontoparietal/frontoparietal control networks (p = 0.019 and p = 0.023), visual and language/DMN networks (p = 0.012 and p = 0.015), and cerebellar and visual/language networks (p = 0.015 and p = 0.003). The crosstalk of the insulo-opercular and right frontoparietal networks were associated with attention/executive domain Z-scores (R = 0.401, p = 0.015, and R = 0.412, p = 0.012). Conclusion: The DI led to intervention-specific complex brain plasticity changes that were of cognitive relevance.

• Publikační typ
• časopisecké články MeSH

• Klíčová slova
• Orphanet,
• MeSH
• databáze faktografické MeSH
• lidé MeSH
• vzácné nemoci * MeSH
• zdravotnické informační systémy MeSH
• Check Tag
• lidé MeSH

V léčbě hormonálně pozitivního HER2-negativního metastatického karcinomu prsu dochází v posledních le- tech k výraznému pokroku. Pochopení úlohy fostatidylino- sitol-3-kinázy (PI3K) v patologicky aktivované signální dráze PI3K/AKT/mTOR nádorové buňky vedlo k vývoji inhibitorů PI3K. Mutace genu PIK3CA se vyskytuje přibližně u 40 % pacientek s hormonálně pozitivním HER2-negativním karci- nomem prsu. Specifický inhibitor PI3K alpelisib prokázal protinádorovou aktivitu v klinických studiích. Na základě výsledku registrační studie SOLAR-1 byl zařazen do léčby nemocných s hormonálně pozitivním HER2-negativním metastatickým karcinomem prsu s mutací genu PIK3CA.

Recently, there has been much advancement in the treatment of hormone receptor positive HER2-negative metastatic breast cancer. Understanding of the role of phosphatidylinositol-3-kinase (PI3K) in the pathologically activated PI3K/AKT/mTOR pathway has led to the development of PI3K inhibitors. PIK3CA mutations occur in approximately 40% of patients with hormone receptor positive HER2-negative breast cancer. The PI3K specific inhibitor alpelisib has shown antitumor activity in clinical trials and based on the results of the SOLAR-1 registration study, it was included in the treatment of hormone receptor positive HER2-negative metastatic breast cancer with PI3KCA mutation.

• Klíčová slova
• pertuzumab,
• MeSH
• humanizované monoklonální protilátky aplikace a dávkování   terapeutické užití   MeSH
• klinické zkoušky, fáze III jako téma MeSH
• kombinovaná farmakoterapie MeSH
• lidé MeSH
• nádory prsu * farmakoterapie   genetika   MeSH
• protinádorové látky imunologicky aktivní aplikace a dávkování   terapeutické užití   MeSH
• protokoly antitumorózní kombinované chemoterapie MeSH
• receptor erbB-2 * antagonisté a inhibitory   MeSH
• trastuzumab aplikace a dávkování   škodlivé účinky   terapeutické užití   MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH

OBJECTIVE: Epilepsy surgery fails in > 30% of patients with focal cortical dysplasia (FCD). The seizure persistence after surgery can be attributed to the inability to precisely localize the tissue with an endogenous potential to generate seizures. In this study, we aimed to identify the critical components of the epileptic network that were actively involved in seizure genesis. METHODS: The directed transfer function was applied to intracranial EEG recordings and the effective connectivity was determined with a high temporal and frequency resolution. Pre-ictal network properties were compared with ictal epochs to identify regions actively generating ictal activity and discriminate them from the areas of propagation. RESULTS: Analysis of 276 seizures from 30 patients revealed the existence of a seizure-related network reconfiguration in the gamma-band (25-170 Hz; p < 0.005) - ictogenic nodes. Unlike seizure onset zone, resecting the majority of ictogenic nodes correlated with favorable outcomes (p < 0.012). CONCLUSION: The prerequisite to successful epilepsy surgery is the accurate identification of brain areas from which seizures arise. We show that in FCD-related epilepsy, gamma-band network markers can reliably identify and distinguish ictogenic areas in macroelectrode recordings, improve intracranial EEG interpretation and better delineate the epileptogenic zone. SIGNIFICANCE: Ictogenic nodes localize the critical parts of the epileptogenic tissue and increase the diagnostic yield of intracranial evaluation.

• MeSH
• dítě MeSH
• dospělí MeSH
• gama rytmus EEG fyziologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• malformace mozkové kůry diagnostické zobrazování   patofyziologie   chirurgie   MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mozková kůra diagnostické zobrazování   patofyziologie   chirurgie   MeSH
• následné studie MeSH
• nervová síť diagnostické zobrazování   patofyziologie   chirurgie   MeSH
• refrakterní epilepsie diagnostické zobrazování   patofyziologie   chirurgie   MeSH
• retrospektivní studie MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

Loss of muscle strength characterizes the period before total hip arthroplasty (THA). Little is known about whether muscle strength imbalances caused by muscle strength decline could be considered another clinical predictor for THA. This study aimed to determine whether muscle imbalances may be used as a clinical predictor for THA surgery. Thirty-six participants were enrolled in the study. Eighteen patients had THA (THA group), while 18 were healthy elders (CON group). Ipsilateral (H/Q) and bilateral (% Def) muscle imbalances of the knee were assessed. THA patients showed impairment of the extensors on the affected extremity compared to those unaffected. A comparison between the groups proved there were weakened flexors in the THA group on both extremities. A comparison of the imbalances revealed a significant bilateral imbalance of the extensors and ipsilateral imbalance of both extremities in the THA group. We computed two logistic regressions using bilateral and ipsilateral imbalance as the predictors of THA surgery. We found that bilateral extensor imbalance may be used as a predictor for THA (Nagelkerke R2 = 0.22). A decrease of the bilateral extensors imbalance by 8% decreases the probability of THA by 8%. The most interesting finding is that the evaluation of the bilateral extensor imbalance may be used as another clinical predictor for THA.

• MeSH
• koleno MeSH
• lidé MeSH
• náhrada kyčelního kloubu * MeSH
• senioři MeSH
• svalová síla MeSH
• Check Tag
• lidé MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

BACKGROUNDː The COVID-19 outbreak forced many states to introduce public health and social measures (PHSM), which may pose an obstacle to performing physical activity (PA). METHODS: This study investigated PA levels and their changes and perceived stress in a sample of 193 participants (aged 71.21 ± 4.87 years) engaged in exercise lessons prior to PSHM. Data were collected via an online survey distributed directly to the participants. The survey included two instruments: the International Physical Activity Questionnaire and the Perceived Stress Scale. RESULTS: The results indicate that sports habits may be a protective factor in staying active and meting PA recommendations. Nevertheless, there were no associations between the number of exercise lessons in the pre-COVID-19 period and PA level or the perceived change in PA during PSHM. Ability to replace the cancelled exercise lesson with PA of similar duration and intensity was negatively associated with PA levels and its change. The PSS-10 score suggests that the sample did not experience a significant increase in perceived stress, but the relationship of this outcome to PA is unclear. CONCLUSIONS: The promotion of alternative PA that could be performed during PHSM and building long-term exercise habits in older adults should be considered.