Obezita je v poslední době vnímána většinou zdravotníků jako onemocnění se závažnými zdravotními a socioekonomickými následky. Přesto, podle několika šetření prováděných napříč světem, je léčba obezity jako chronické nemoci s opakovanými relapsy podceňována jak lékaři, tak ostatními zdravotníky. Článek shrnuje hlavní překážky v patřičné léčbě pacientů s obezitou. Nedostatečné znalosti o obezitě u zdravotníků představují významnou zábranu v implementaci sofistikovaných principů v její léčbě. Proto jsou zde představeny zkušenosti s postgraduálním vzděláváním v obezitologii v České republice a v zahraničí. Autoři rovněž popisují různé přístupy při vzdělávání a certifikaci obezitologů jako lékařů, kteří dosáhli způsobilosti v péči o pacienty s obezitou. Obezitologové by měli sehrávat významnou úlohu nejen v komplexní multidisciplinární léčbě obezity, ale i při vzdělávání ostatních zdravotníků v obezitologii. To se jeví významné zejména dnes, kdy lze očekávat častou indikaci k dlouhodobé léčbě novými účinnými antiobezitiky a méně invazivními bariatrickými operacemi.

Obesity has recently been recognized as a disease with serious health and socioeconomic consequences by most health professionals. However, according to several surveys conducted across the world, comprehensive management of chronic relapsing disease such obesity continues to be underestimated by both physicians and other healthcare providers. The paper highlights the main obstacles to the appropriate treatment of patients with obesity. One key barrier is the insufficient knowledge about obesity among healthcare providers, which hinders the implementation of advanced principles in obesity management. This paper also explores experiences in postgraduate education on obesity both in the Czech Republic and abroad. The authors further describe different attitudes toward educating and certifying obesity specialists, i.e. physicians who achieved a competency in obesity care. Obesity specialists should play an important role not only in comprehensive multidisciplinary treatment of obesity but also in educating other health professionals about obesity medicine. This role is increasingly significant nowadays as the demand for long-term treatment with new, efficient anti-obesity drugs and less invasive bariatric surgery grows.

• Klíčová slova
• obezitologie,
• MeSH
• endokrinologie MeSH
• kontinuální vzdělávání lékařů * MeSH
• lidé MeSH
• obezita * MeSH
• odborná způsobilost MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• práce podpořená grantem MeSH

INTRODUCTION: The rapid advancement of artificial intelligence and big data analytics, including descriptive, diagnostic, predictive, and prescriptive analytics, has the potential to revolutionize many areas of medicine, including nephrology and dialysis. Artificial intelligence and big data analytics can be used to analyze large amounts of patient medical records, including laboratory results and imaging studies, to improve the accuracy of diagnosis, enhance early detection, identify patterns and trends, and personalize treatment plans for patients with kidney disease. Additionally, artificial intelligence and big data analytics can be used to identify patients' treatment who are not receiving adequate care, highlighting care inefficiencies in the dialysis provider, optimizing patient outcomes, reducing healthcare costs, and consequently creating values for all the involved stakeholders. OBJECTIVES: We present the results of a comprehensive survey aimed at exploring the attitudes of European physicians from eight countries working within a major hemodialysis network (Fresenius Medical Care NephroCare) toward the application of artificial intelligence in clinical practice. METHODS: An electronic survey on the implementation of artificial intelligence in hemodialysis clinics was distributed to 1,067 physicians. Of the 1,067 individuals invited to participate in the study, 404 (37.9%) professionals agreed to participate in the survey. RESULTS: The survey showed that a substantial proportion of respondents believe that artificial intelligence has the potential to support physicians in reducing medical malpractice or mistakes. CONCLUSION: While artificial intelligence's potential benefits are recognized in reducing medical errors and improving decision-making, concerns about treatment plan consistency, personalization, privacy, and the human aspects of patient care persist. Addressing these concerns will be crucial for successfully integrating artificial intelligence solutions in nephrology practice.

• MeSH
• dialýza ledvin MeSH
• lidé MeSH
• nefrologie * MeSH
• nefrologové MeSH
• průzkumy a dotazníky MeSH
• umělá inteligence * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

• MeSH
• diabetes mellitus MeSH
• lidé MeSH
• nemocnice krajské * dějiny   organizace a řízení   MeSH
• vnitřní lékařství MeSH
• výstavba, architektura a design nemocnic MeSH
• Check Tag
• lidé MeSH
• Geografické názvy
• Česká republika MeSH

• O autorovi
• Baťova krajská nemocnice (Zlín, Česko) Autorita

• MeSH
• kardiologie * MeSH
• osobní vzpomínky jako téma MeSH
• Publikační typ
• zprávy MeSH

• O autorovi
• Piťha, Jan, 1964- Autorita
• Blaha, Vladimír, 1964- Autorita

• MeSH
• kardiologie * MeSH
• lidé MeSH
• neurologie * MeSH
• Check Tag
• lidé MeSH

Vysokoškolská učebnica, ktorá sa zameriava na imunológiu a endokrinológiu.

• MeSH
• alergologie a imunologie MeSH
• endokrinologie MeSH

• Konspekt
• Patologie. Klinická medicína
• Učební osnovy. Vyučovací předměty. Učebnice
• NLK Obory
• alergologie a imunologie
• endokrinologie
• NLK Publikační typ
• učebnice vysokých škol

OBJECTIVES: To re-evaluate cut-offs for disease activity states according to the Axial Spondyloarthritis Disease Activity Score (ASDAS), and study the impact of sex, age, calendar time, disease and symptom duration on ASDAS and ASDAS cut-offs in a large contemporary cohort. METHODS: Data from 2939 patients with axial spondyloarthritis (axSpA) starting their first tumour necrosis factor inhibitor in nine European registries were pooled and analysed. Receiver operating characteristic analyses were performed to identify cut-offs against external criteria. Six-month data including patient and physician global assessments, both ≤1 (0-10 integer scale), and Assessment of SpondyloArthritis International Society partial remission were used for separation of inactive disease (ID) from low disease activity (LDA), while patient and physician global ≤3 were applied as external criteria to separate LDA from high disease activity (HDA). Patient and physician global ≥6 were applied to separate HDA from very high disease activity in baseline data. RESULTS: The three ASDAS cut-offs identified to separate the four disease activity states in the overall patient population were <1.3, <2.0 and >3.5. Cut-offs for ID and LDA in women were higher (<1.5 and <2.0, respectively) than in men (<1.3 and <1.9), as were cut-offs in patients ≥45 years (<1.5 and <2.2) versus ≤34 years (<1.2 and <1.9) and 35-44 years (<1.3 and <1.8). Cut-offs were independent of calendar time and disease duration. CONCLUSIONS: Re-evaluation of ASDAS cut-offs for disease activity states in a large multi-national axSpA cohort resulted in cut-offs similar to those currently endorsed. Differences in cut-offs between sex and age groups for ID and LDA were observed, but the differences were minor.

• MeSH
• axiální spondyloartritida * diagnóza   epidemiologie   MeSH
• dospělí MeSH
• inhibitory TNF terapeutické užití   MeSH
• lidé středního věku MeSH
• lidé MeSH
• registrace * MeSH
• revmatologie normy   MeSH
• ROC křivka MeSH
• sexuální faktory MeSH
• stupeň závažnosti nemoci * MeSH
• věkové faktory MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Evropa MeSH

INTRODUCTION: Advance care planning (ACP) ensures that patients receive medical care aligned with their values, goals, and preferences, especially regarding end-of-life decisions in serious chronic illnesses. OBJECTIVE: This project aimed to introduce and promote evidence-based ACP in oncology and palliative care at a midsized hospital near Berlin, Germany, during the COVID-19 pandemic. METHODS: This project was guided by the JBI Evidence Implementation Framework and used a mixed methods audit cycle. A baseline audit was conducted using qualitative interviews and workshops with representatives from all the health care disciplines involved in oncology and palliative care at the hospital. The findings were compared with eight best practice recommendations. Targeted strategies aimed at the key stakeholders involved in ACP practice were then implemented. Finally, a semi-quantitative questionnaire was used in a follow-up audit with the same participants as in the baseline audit. RESULTS: The baseline audit revealed a high level of familiarity with the concept of ACP. However, there was a lack of a uniformly accepted definition and understanding of ACP among the health care professionals, leading to a lack of coordination in task distribution. The follow-up audit revealed improvements with regard to education and training in ACP (Criterion 1: 50% to 100%) and organizational support to facilitate ACP conversations (Criterion 3: 87.5% to 100%). Other audit criteria compliance rates remained unchanged. CONCLUSION: Clinical education and team-based process analysis can facilitate ACP implementation across disciplines in oncology and palliative care facilities. However, the project did not succeed in implementing lasting changes in clinical processes and best practice ACP due to the COVID-19 pandemic. Such an endeavor would demand considerable resources and time, both of which were constrained during the pandemic. SPANISH ABSTRACT: http://links.lww.com/IJEBH/A236.

• MeSH
• COVID-19 * epidemiologie   MeSH
• lékařská onkologie * MeSH
• lékařská praxe založená na důkazech MeSH
• lidé MeSH
• paliativní péče * organizace a řízení   MeSH
• pandemie MeSH
• předběžné plánování péče * MeSH
• SARS-CoV-2 MeSH
• směrnice pro lékařskou praxi jako téma MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Německo MeSH

• MeSH
• hematologie MeSH
• lékařská onkologie MeSH
• Publikační typ
• biografie MeSH

• MeSH
• endokrinologie MeSH
• kardiologie * MeSH
• Publikační typ
• biografie MeSH

• O autorovi
• Petrášek, Jan, 1929- Autorita