Tick-borne encephalitis (TBE) virus (TBEV) is transmitted to humans via tick bites. Infection is benign in >90% of the cases but can cause mild (<5%), moderate (<4%), or severe (<1%) encephalitis. We show here that ∼10% of patients hospitalized for severe TBE in cohorts from Austria, Czech Republic, and France carry auto-Abs neutralizing IFN-α2, -β, and/or -ω at the onset of disease, contrasting with only ∼1% of patients with moderate and mild TBE. These auto-Abs were found in two of eight patients who died and none of 13 with silent infection. The odds ratios (OR) for severe TBE in individuals with these auto-Abs relative to those without them in the general population were 4.9 (95% CI: 1.5-15.9, P < 0.0001) for the neutralization of only 100 pg/ml IFN-α2 and/or -ω, and 20.8 (95% CI: 4.5-97.4, P < 0.0001) for the neutralization of 10 ng/ml IFN-α2 and -ω. Auto-Abs neutralizing type I IFNs accounted for ∼10% of severe TBE cases in these three European cohorts.
- MeSH
- autoprotilátky * imunologie MeSH
- dospělí MeSH
- interferon typ I * imunologie MeSH
- klíšťová encefalitida * imunologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- neutralizující protilátky * imunologie MeSH
- senioři MeSH
- viry klíšťové encefalitidy imunologie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
- Rakousko MeSH
BACKGROUND AND OBJECTIVES: Endovascular treatment of cerebral aneurysms has tremendously advanced over the past decades. Nevertheless, aneurysm residual and recurrence remain challenges after embolization. The objective of this study was to elucidate the portion of embolized aneurysms requiring open surgery and evaluate whether newer endovascular treatments have changed the need for open surgery after failed embolization. METHODS: All 15 cerebrovascular centers in Austria and the Czech Republic provided overall aneurysm treatment frequency data and retrospectively reviewed consecutive cerebral aneurysms treated with open surgical treatment after failure of embolization from 2000 to 2022. All endovascular modalities were included. RESULTS: On average, 1362 aneurysms were treated annually in the 2 countries. The incidence increased from 0.006% in 2005 to 0.008% in 2020 in the overall population. Open surgery after failed endovascular intervention was necessary in 128 aneurysms (0.8%), a proportion that remained constant over time. Subarachnoid hemorrhage was the initial presentation in 70.3% of aneurysms. The most common location was the anterior communicating artery region (40.6%), followed by the middle cerebral artery (25.0%). The median diameter was 6 mm (2-32). Initial endovascular treatment included coiling (107 aneurysms), balloon-assist (10), stent-assist (4), intrasaccular device (3), flow diversion (2), and others (2). Complete occlusion after initial embolization was recorded in 40.6%. Seventy-one percent of aneurysms were operated within 3 years after embolization. In 7%, the indication for surgery was (re-)rupture and, in 88.3%, reperfusion. Device removal was performed in 16.4%. Symptomatic intraoperative and postoperative complications occurred in 10.2%. Complete aneurysm occlusion after open surgery was achieved in 94%. CONCLUSION: Open surgery remains a rare indication for cerebral aneurysms after failed endovascular embolization even in the age of novel endovascular technology, such as flow diverters and intrasaccular devices. Regardless, it is mostly performed for ruptured aneurysms initially treated with primary coiling that are in the anterior circulation.
- MeSH
- dospělí MeSH
- endovaskulární výkony * metody MeSH
- intrakraniální aneurysma * chirurgie epidemiologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- mikrochirurgie metody MeSH
- neurochirurgické výkony metody MeSH
- retrospektivní studie MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- terapeutická embolizace * metody MeSH
- terapie neúspěšná MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- Geografické názvy
- Česká republika MeSH
- Rakousko MeSH
An international joint statement about the use of hyperthermic intraperitoneal chemotherapy (HIPEC) in ovarian cancer was published in 2016, warning about the uncritical use of HIPEC outside controlled studies. This statement has now been updated after the most recent literature was reviewed by the participating study groups and societies. HIPEC became a treatment option in patients with advanced colon cancer after positive results of a randomized trial comparing surgery and HIPEC versus palliative treatment alone. Although this trial did not compare the added value of HIPEC to surgery alone, HIPEC for the treatment of peritoneal metastases was in the subsequent years generalized to many other cancer types associated with peritoneal carcinomatosis including epithelial ovarian cancer (EOC). In the meantime, new evidence from prospective randomized trials specifically for EOC-patients emerged, with however contradicting results and several quality aspects that made the interpretation of their findings critical. Moreover, three additional trials in colorectal cancer failed to confirm the previously presumed survival benefit through the implementation of HIPEC in peritoneally disseminated colorectal cancers. Based on a still unclear and inconsistent landscape, the authors conclude that HIPEC should remain within the remit of clinical trials for EOC-patients. Available evidence is not yet sufficient to justify its broad endorsement into the routine clinical practice.
- MeSH
- epiteliální ovariální karcinom patologie MeSH
- hypertermická intraperitoneální peroperační chemoterapie MeSH
- indukovaná hypertermie * metody MeSH
- kombinovaná terapie MeSH
- lidé MeSH
- nádory vaječníků * farmakoterapie patologie MeSH
- prospektivní studie MeSH
- protokoly antitumorózní kombinované chemoterapie terapeutické užití MeSH
- Check Tag
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
- Geografické názvy
- Rakousko MeSH
- Švýcarsko MeSH
PURPOSE: Determining the frequency and distribution of pathogenic germline variants (PGVs) in Austrian prostate cancer (PCa) patients and to assess the accuracy of different clinical risk scores to correctly predict PGVs. METHODS: This cross-sectional study included 313 men with advanced PCa. A comprehensive personal and family history was obtained based on predefined questionnaires. Germline DNA sequencing was performed between 2019 and 2021 irrespective of family history, metastatic or castration status or age at diagnosis. Clinical risk scores for hereditary cancer syndromes were evaluated and a PCa-specific score was developed to assess the presence of PGVs. RESULTS: PGV presence was associated with metastasis (p = 0.047) and castration resistance (p = 0.011), but not with personal cancer history or with relatives with any type of cancer. Clinical risk scores (Manchester score, PREMM5 score, Amsterdam II criteria or Johns Hopkins criteria) showed low sensitivities (3.3-20%) for assessing the probability of PGV presence. A score specifically designed for PCa patients stratifying patients into low- or high-risk regarding PGV probability, correctly classified all PGV carriers as high-risk, whereas a third of PCa patients without PGVs was classified as low risk of the presence of PGVs. CONCLUSION: Application of common clinical risk scores based on family history are not suitable to identify PCa patients with high PGV probabilities. A PCa-specific score stratified PCa patients into low- or high-risk of PGV presence with sufficient accuracy, and germline DNA sequencing may be omitted in patients with a low score. Further studies are needed to evaluate the score.
- MeSH
- genetická predispozice k nemoci MeSH
- lidé MeSH
- nádory prostaty * genetika patologie MeSH
- průřezové studie MeSH
- rizikové faktory MeSH
- zárodečné buňky patologie MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Rakousko MeSH
The incidence and mortality of traumatic brain injuries (TBI) among non-residents to countries where they occur remains unknown, warranting epidemiological research. Epidemiological data are key to inform prevention and public health policies related to TBI, as well as to help promote safe travelling practice. The aim of this study was to analyse the epidemiological patterns of TBI-related deaths among residents and non-residents in 30 European countries in 2015 using standardised European level data on causes of death. A large-scale cross-sectional study analysing TBI-related deaths in 30 European countries in 2015 among residents and non-residents to the country of occurrence of the death was conducted. Data from death certificates collected on European level by Eurostat were used to calculate the numbers of TBI-related deaths and estimate crude and age-standardised mortality rates. Rates were stratified by country, sex, age-group and by resident status. External causes of the injury were determined using the provided ICD-10 codes. 40,087 TBI-related deaths were identified; overall about 3% occurred among non-residents with highest proportions in Turkey (11%), Luxembourg (9%) and Cyprus (5%). Taking into account tourism intensity in the countries, Bulgaria, Greece and Austria showed highest rates of TBI-related deaths in non-residents: 0.7,0.5 and 0.5 per million overnight stays, respectively. The pooled age-standardised TBI-related mortality in non-residents was 0.2 (95% CI 0.1-0.3), among residents 10.4 (95% CI 9.4-11.5) per 100,000. In non-residents, TBI-related deaths were shifted to younger populations (86% in < 35 years); in non-residents 78% were 15-64 years old. Falls were predominant among residents (47%), and traffic accidents among non-residents (36%). Male:female ratio was higher among non-residents (3.9), compared to residents (2.1). Extrapolating our findings, we estimate that annually 1022 TBI-related deaths would occur to non-residents in the EU-27 + UK and 1488 in Europe as a continent. We conclude, that the primary populations at risk of TBI-related deaths in European countries differ in several characteristics between residents and non-residents to the country of the occurrence of death, which warrants for different approaches in prevention and safety promotion. Our findings suggest that TBI occurring in European countries among non-residents present a problem worthy of attention from public health and travel medicine professionals and should be further studied.
- MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- průřezové studie MeSH
- traumatické poranění mozku * etiologie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Kypr MeSH
- Rakousko MeSH
- Řecko MeSH
- MeSH
- lidé MeSH
- soukromá zařízení MeSH
- studium stomatologie * organizace a řízení MeSH
- studium vysokoškolské MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- zprávy MeSH
- Geografické názvy
- Rakousko MeSH
- MeSH
- dějiny 18. století MeSH
- diagnóza * MeSH
- epidurální hematom dějiny MeSH
- fraktury lebky dějiny MeSH
- kraniocerebrální traumata dějiny MeSH
- lidé MeSH
- náhodná zranění dějiny MeSH
- příčina smrti MeSH
- tělesné pozůstatky * MeSH
- významné osobnosti MeSH
- Check Tag
- dějiny 18. století MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Geografické názvy
- Rakousko MeSH
- MeSH
- asistovaná reprodukce * ekonomika statistika a číselné údaje trendy MeSH
- fertilizace in vitro statistika a číselné údaje zákonodárství a právo MeSH
- kryoprezervace statistika a číselné údaje MeSH
- náhradní matky zákonodárství a právo MeSH
- odběr spermií statistika a číselné údaje zákonodárství a právo MeSH
- preimplantační diagnóza statistika a číselné údaje MeSH
- přenos embrya statistika a číselné údaje MeSH
- redukce mnohoplodového těhotenství statistika a číselné údaje zákonodárství a právo MeSH
- všeobecné zdravotní pojištění normy MeSH
- výzkum plodu etika zákonodárství a právo MeSH
- Geografické názvy
- Česká republika MeSH
- Německo MeSH
- Rakousko MeSH
Cíl: Cílem studie byla evaluace a srovnání výsledků pacientů vyšetřených tzv. CT polytraumatickým protokolem ve Fakultní nemocnici Olomouc a v Zemské nemocnici v Rakouském Hornu v letech 2018 a 2019. Zvláštní pozornost byla věnována odlišnostem v postupech a výsledcích nemocnic obou států. Metodika: Do této retrospektivní, observační studie byli zahrnuti pacienti vyšetření standardizovaným polytraumatickým CT protokolem. Kromě sběru obvyklých dat, jako jsou věk pacienta, pohlaví, datum a čas vyšetření, zde byly dále zahrnuty i údaje jako například, zda bylo vyšetření provedeno ve službě a případné požití alkoholu nebo drog. Důraz při sběru a analýze dat byl kladen mimo jiné na mechanismus úrazu, stejně jako délku hospitalizace. Poranění byla klasifikována podle zasažených tělesných regionů a závažnosti zranění pomocí tzv. Abbreviated Injury Scale (AIS) a tzv. Injury Severity Score (ISS). Výsledky: Z celkem 486 pacientů převažovali muži, v Olomouci ze 75 % a v Hornu z 68 %. Signifikantně vyšší věk měli pacienti rakouské nemocnice (52,5 let) než v české (48 let). Ukázala se korelace zranění hlavy při pádu ze stoje, dále hrudníku u sebevrahů a cyklistů a poranění dolních končetin u motocyklistů. Závažnost úrazů statisticky významně stoupala s věkem. Hospitalizováni byli pacienti s podobným ISS, ale propuštění pacienti z rakouské nemocnice měli ISS podstatně vyšší (4,5) než z FN Olomouc (1). Závěr: Co do profilu pacientů a nemocniční péče nebyly prokázány u většiny parametrů podstatné rozdíly mezi oběma nemocnicemi. K výjimkám náleží vyšší věk pacientů v rakouské nemocnici, stejně jako vyšší průměrná hodnota ISS u pacientů propouštěných domů bez hospitalizace tamtéž.
Purpose: Purpose of our study was to evaluate and compare data of patients examined by standardized CT protocol in FN Olomouc (the Czech Republic) and in hospital in Horn (Austria) in years 2018 and 2019. Special attention was paid to the differences in procedures and results at these two hospitals in both states. Methods: In this retrospective observational study were involved patients examined with CT standardized protocol. Apart to the usual data such as age, sex, date and time of examination, we also collected data of consumption of drugs or alcohol as well as a fact weather was the examination done during a shift. Furthermore, the mechanism of injury and the length of hospitalization were marked. Injuries were classified according to affected body regions and severity of the injury with Abbreviated Injury Scale (AIS) and Injury Severity Score (ISS). Results: From total of 486 patients were more frequent male, in Olomouc they comprised 75% and in Horn 68%. Patients of the Austrian hospital had significantly higher age (52.5 years) than in the Czech one (48 years). Correlation of a head injury and a fall from upright position, correlation of thorax injury and suicides and cycling as well as correlation of lower extremity injury and motorcycle accidents was found. The severity of injury had statistically significant growth with age. Patients at both hospitals were hospitalized with similar ISS, but patients discharged from Horn had ISS significantly higher (4.5) compared to FN Olomouc (1). Conclusions: In the profile of patients and hospital care were no relevant differences in majority of the parameters between both hospitals. Exceptions were higher age of the patients in Horn, as well as the higher average value of ISS in patients discharged home without hospitalization.
- MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- nemocnice statistika a číselné údaje MeSH
- počítačová rentgenová tomografie * MeSH
- polytrauma * diagnostické zobrazování epidemiologie MeSH
- senioři MeSH
- ukazatel závažnosti úrazu MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- práce podpořená grantem MeSH
- srovnávací studie MeSH
- Geografické názvy
- Česká republika MeSH
- Rakousko MeSH
