Glioblastoma is the commonest primary malignant brain tumor, with a very poor prognosis and short overall survival. It is characterized by its high intra- and intertumoral heterogeneity, in terms of both the level of single-nucleotide variants, copy number alterations, and aneuploidy. Therefore, routine diagnosis can be challenging in some cases. We present a complicated case of glioblastoma, which was characterized with five cytogenomic methods: interphase fluorescence in situ hybridization, multiplex ligation-dependent probe amplification, comparative genomic hybridization array and single-nucleotide polymorphism, targeted gene panel, and whole-genome sequencing. These cytogenomic methods revealed classical findings associated with glioblastoma, such as a lack of IDH and TERT mutations, gain of chromosome 7, and loss of chromosome 10. At least three pathological clones were identified, including one with whole-genome duplication, and one with loss of 1p and suspected loss of 19q. Deletion and mutation of the TP53 gene were detected with numerous breakends on 17p and 20q. Based on these findings, we recommend a combined approach to the diagnosis of glioblastoma involving the detection of copy number alterations, mutations, and aneuploidy. The choice of the best combination of methods is based on cost, time required, staff expertise, and laboratory equipment. This integrated strategy could contribute directly to tangible improvements in the diagnosis, prognosis, and prediction of the therapeutic responses of patients with brain tumors.

• MeSH
• glioblastom * genetika   patologie   diagnóza   MeSH
• hybridizace in situ fluorescenční metody   MeSH
• jednonukleotidový polymorfismus MeSH
• lidé středního věku MeSH
• lidé MeSH
• mutace MeSH
• nádorové biomarkery genetika   MeSH
• nádory mozku * genetika   patologie   diagnóza   MeSH
• prognóza MeSH
• srovnávací genomová hybridizace metody   MeSH
• variabilita počtu kopií segmentů DNA MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

There are two key sources of data that contribute to biomedicine research: surveillance and questionnaires and interviews. The Centers for Disease Control and Prevention (CDC, Atlanta, GA, USA) defines surveillance as the ongoing systematic collection, analysis, and interpretation of health data, essential to the planning, implementation, and evaluation of public health practice, closely integrated with the timely dissemination to those who need to know. The three things to keep in mind about surveillance systems are that they are ongoing (collecting information only once is not a surveillance system), the data collected are used (analyzed and interpreted) and finally, surveillance data is disseminated. There are several tangible applications of surveillance as a tool. For example, surveillance data can be used to establish public health priorities, aid in determining resource allocation and assess or evaluate public health programs. Surveillance data originate from many sources; therefore, standardization of surveillance practices is an ongoing challenge.For epidemiologists specifically, surveillance data can be used to determine a baseline for the detection of epidemics or for early detection of epidemics. This is clearly the positive meaning and impact of this system collecting sensitive population data. However, expression surveillance means in effect, supervision or control. The subsequent resulting regulations are the subject of reflection in this article.

• MeSH
• COVID-19 epidemiologie   MeSH
• epidemiologické monitorování * MeSH
• lékařská informatika metody   MeSH
• lidé MeSH
• paternalismus MeSH
• umělá inteligence * MeSH
• vědecká epidemiologie MeSH
• vláda MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• přehledy MeSH
• Geografické názvy
• Čína MeSH

This review aims to explore the role of professional diagnostic rapid testing of acute respiratory infections (ARIs), especially COVID-19 and influenza, ensuring proper disease management and treatment in Europe, and particularly in Czech Republic, Poland, and Romania. The paper was constructed based on a review of scientific evidence and national and international policies and recommendations, as well as a process of validation by four experts. The development of new testing technologies, treatment options, and increased awareness of the negative multidimensional impact of ARI profiles transformed differential diagnosis into a tangible and desirable reality. This review covers the following topics: (1) the multidimensional impact of ARIs, (2) ARI rapid diagnostic testing platforms and their value, (3) the policy landscape, (4) challenges and barriers to implementation, and (5) a set of recommendations illustrating a path forward. The findings indicate that rapid diagnostic testing, including at the point of care (POC), can have a positive impact on case management, antimicrobial and antibiotic stewardship, epidemiological surveillance, and decision making. Integrating this strategy will require the commitment of governments and the international and academic communities, especially as we identified room for improvement in the access and expansion of POC rapid testing in the focus countries and the inclusion of rapid testing in relevant policies.

• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

This article emphasizes the critical role of self-care in the professional lives of cognitive behavioural therapy (CBT) therapists and supervisors. It delves into the importance of self-care, elucidating its significance in maintaining therapists' mental health and effectiveness. The article presents a range of practical strategies that promote self-care, providing therapists and supervisors with specific steps to incorporate self-care into their daily routines. Moreover, the article explores common challenges and barriers to self-care, such as a lack of time, feelings of guilt associated with prioritizing one's needs, and a lack of available resources for self-care. The article aims to deepen our understanding of the complexities of practising self-care by shedding light on possible obstacles. In addition, the article includes case vignettes that demonstrate tangible examples of the positive impact of self-care on therapists' mental health and effectiveness. The overarching goal of this article is to encourage ongoing discussion and research on self-care. It advocates a greater emphasis on self-care in CBT and CBT supervision (CBTS), intending to promote the health and well-being of those who dedicate their lives to caring for others. The insights and strategies presented in this article serve as a resource for therapists and supervisors striving to achieve a balanced lifestyle while effectively catering to the needs of their clients.

• MeSH
• duševní zdraví MeSH
• emoce MeSH
• kognitivně behaviorální terapie * MeSH
• lidé MeSH
• péče o sebe * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

Gynaecological malignancies affect women in low and middle income countries (LMICs) at disproportionately higher rates compared with high income countries (HICs) with little known about variations in access, quality, and outcomes in global cancer care. Our study aims to evaluate international variation in post-operative morbidity and mortality following gynaecological oncology surgery between HIC and LMIC settings. Study design consisted of a multicentre, international prospective cohort study of women undergoing surgery for gynaecological malignancies (NCT04579861). Multilevel logistic regression determined relationships within three-level nested-models of patients within hospitals/countries. We enrolled 1820 patients from 73 hospitals in 27 countries. Minor morbidity (Clavien-Dindo I-II) was 26.5% (178/672) and 26.5% (267/1009), whilst major morbidity (Clavien-Dindo III-V) was 8.2% (55/672) and 7% (71/1009) for LMICs/HICs, respectively. Higher minor morbidity was associated with pre-operative mechanical bowel preparation (OR = 1.474, 95%CI = 1.054-2.061, p = 0.023), longer surgeries (OR = 1.253, 95%CI = 1.066-1.472, p = 0.006), greater blood loss (OR = 1.274, 95%CI = 1.081-1.502, p = 0.004). Higher major morbidity was associated with longer surgeries (OR = 1.37, 95%CI = 1.128-1.664, p = 0.002), greater blood loss (OR = 1.398, 95%CI = 1.175-1.664, p ≤ 0.001), and seniority of lead surgeon, with junior surgeons three times more likely to have a major complication (OR = 2.982, 95%CI = 1.509-5.894, p = 0.002). Of all surgeries, 50% versus 25% were performed by junior surgeons in LMICs/HICs, respectively. We conclude that LMICs and HICs were associated with similar post-operative major morbidity. Capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention.

• Publikační typ
• časopisecké články MeSH

Our study intends to specify the impact of the singular pandemic stressors on the population and also quantify the contribution of different predictors of depression; some of them are stronger than others, and this research shows how the whole effect is divided into single items. This research included a structured online survey using data from 11,340 respondents from six European countries during the first months of the pandemic. The statistical analysis focused on how behavioural patterns appear in different groups of the population and how they mark the psychological wellbeing of these groups with regard to various factors. We targeted social media's role and analyzed the impact of its consumption on symptoms of depression in different groups divided by age and other characteristics. The analysis creates a mosaic of lifestyle choices and other characteristics that manifest different effects on depression inside selected groups whereas several groups generated by the cluster analysis are less vulnerable to their effect than others. Regarding our findings, the perceived reality through information sources and the manner of their processing seems to be more significant than the tangible reality (poor self-reported health correlated with depression more strongly than intrinsic health limitations).

• Publikační typ
• časopisecké články MeSH

Legumes are ubiquitous, low-cost meals that are abundant in protein, vitamins, minerals, and calories. Several biotic constraints are to blame for the global output of legumes not meeting expectations. Fungi, in particular, are substantial restrictions that not only hinder production but also pose a serious health risk to both human and livestock consumption. Athelia rolfsii (Syn. Sclerotium rolfsii) is a dangerous pathogenic fungus that attacks most crops, causing massive yield losses. Legumes are no longer immune to this dreadful fungus, which can potentially result in a 100% yield loss. The initial disease symptoms based on the formation of brown color lesions at the point of infection and further development of mycelia, followed by yellowing and wilting of the whole plant. To tackle such situation, various strategies, i.e., management in cultural practices, disease-free plant growth, genetic changes, crop hybridization and in vitro culture techniques have been undertaken. This present review encapsulates the entire situation, from sclerotial dissemination through infection development and control in legume crops, with the goal of developing a tangible understanding of sustainable legume production improvements. Further study in this area might be led in an integrated manner as a result of this information, which could contribute to a better understanding of the processes of disease incidence, resistance mechanism, and its control, and fostering greater inventiveness in the production of legumes.

• MeSH
• Ascomycota * MeSH
• Basidiomycota * genetika   MeSH
• Fabaceae * MeSH
• lidé MeSH
• půda MeSH
• zelenina MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

Koncept farmaceutické péče (FP) existuje jako profesní filozofie již více než 30 let, nicméně po dlouhou dobu bylo pro jeho začlenění do běžné praxe poskytování zdravotní péče učiněno jen málo. Pandemie COVID-19 a s ní spojený zvýšený příliv pacientů do veřejných lékáren (VL) podnítily zkoumání a zavádění nových zdravotnických služeb poskytovaných v rámci VL. Přesto jsou tyto služby lékárenské péče stále nové a pro rozšíření současné role komunitních lékárníků v primární zdravotní péči lze udělat více. Toho lze dosáhnout zlepšením a rozšířením nově zavedených služeb a zároveň začleněním nových služeb ve prospěch veřejného zdraví a snížení výdajů na zdravotní péči, kterým se lze vyhnout. Přestože farmaceutická péče (FP) existuje jako profesní filozofie od roku 1990, pro její začlenění do běžné praxe poskytování zdravotní péče bylo učiněno jen málo. Tento článek přináší přehled informací o přínosech této služby, pokud jde o zdraví pacientů a snížení finančních výdajů souvisejících s nežádoucími účinky léčivých přípravků v prostředí VL. Nežádoucí účinky jsou příčinou značných výdajů na zdravotní péči a potíží pacientů v důsledku příslušných symptomů, návštěv lékaře na pohotovosti a zvýšené míry hospitalizace. Několik studií provedených v mezinárodním měřítku zkoumalo pozitivní dopad farmaceutické péče, kterou vykonávají lékárníci ve VL. Navzdory výsledkům, které někdy vykazují nesouvislý průběh, má FP uplatňovaná za specifických podmínek hmatatelné pozitivní výsledky. U pacientů s městnavým srdečním selháním a diabetes mellitus 2. typu bylo zaznamenáno méně hospitalizací, lepší kontrola symptomů a vyšší adherence ve srovnání s kontrolními skupinami, zatímco studie na pacientech s astmatem odhalila zlepšení inhalačních technik. Všechny intervenční skupiny uváděly zlepšení psychického stavu a lepší porozumění léčbě. Zvláštní zmínka je věnována významu této služby pro pacienty podstupující protinádorovou léčbu a skutečnosti, že lékárníci ve VL mohou hrát klíčovou roli při navrhování, monitorování a změně návrhu těchto léčebných schémat, jejichž složitost a související nežádoucí účinky léčivých přípravků negativně ovlivňují adherenci pacientů. Úloha komunitních lékárníků byla během pandemie velmi důležitá, zejména pro primární péči, a to jak pro pacienty, tak pro systémy zdravotní péče, a zdá se, že bude rozhodující i v období po skončení pandemie. Zvýšená složitost terapie a polyfarmacie vytváří potřebu organizované a aktivní účasti lékárníků na poskytování zdravotní péče tak, aby mohli využívat své znalosti a dovednosti při kontinuální spolupráci s ostatními zdravotnickými pracovníky, a poskytovat tak koordinované služby ve prospěch pacienta.

The concept of pharmaceutical care (PC) has existed as a professional philosophy for more than 30 years. However, for a long period of time, little had been done for its integration into the regular practice of healthcare provision. The COVID-19 pandemic and the resulting increase in patient influx in the community pharmacies (CP) encouraged the exploration and establishment of new healthcare services provided within the CP. Nevertheless, these services of PC are still novel, and more can be done to expand the community pharmacists’ current role in primary healthcare. This can be achieved by improving and expanding the newly established services, all while incorporating new ones, for the benefit of public health and the reduction of avoidable healthcare expenditures. This article reviews information about the benefits of this service regarding patient health and the reduction of financial expenses pertinent to adverse drug events within the setting of the CP. Adverse drug events account for significant healthcare expenses and patient distress due to relevant symptoms, emergency doctor visits, and increased hospitalization rates. Several studies conducted internationally have investigated the positive impact of PC practiced by community pharmacists. In spite of results sometimes presenting a non-continuous pattern, PC applied under specific conditions has tangible positive outcomes. Congestive heart failure and type 2 diabetes mellitus patients presented fewer hospital admissions, better symptom control, and higher adherence in comparison to control groups, while a study on asthma patients revealed improved inhalation techniques. All intervention groups reported psychological improvement and a better understanding of their treatment. Special reference is made to the importance of this service for patients receiving anti-cancer treatment and how community pharmacists can have a crucial role in designing, monitoring, and re-designing these therapeutic schemes whose complexity and related adverse drug events negatively affect patient adherence. The role of community pharmacists was very important, especially for primary care, for both patients and healthcare systems during the pandemic, and it seems that it will remain decisive in the post-COVID era as well. The increased complexity of therapy and polypharmacy creates the need for organized, active participation of pharmacists in healthcare provision so that they can use their knowledge and skills under continuous cooperation with other healthcare professionals, thus providing coordinated services for the benefit of the patient.

• MeSH
• lidé MeSH
• management farmakoterapie MeSH
• nežádoucí účinky léčiv MeSH
• veřejné lékárenské služby * MeSH
• Check Tag
• lidé MeSH

Napriek hmatateľným pokrokom v liečbe covidu- 19 ide stále o quoad vitam vysoko rizikové ochorenie, najmä pre seniorov. Najsilnejšou garanciou minimalizácie rizík pandémie ostáva vakcinácia. Na Slovensku sme doteraz nedosiahli zaočkovanosť proti covidu-19, ktorá by bola garanciou zásadného zníženia hrozby covidu-19 aj z pohľadu verejného zdravia. V retrospektívnej observačnej štúdii sme analyzovali zaočkovanosť hospitalizovaných seniorov (87 pacientov, priemerne 80,3-roční), keď už vakcinácia bola dobre dostupná. Nevakcinovaných bolo napriek tomu 72,6 % hospitalizovaných. Nezistili sme žiadny vzťah nezaočkovanosti a veku, bola kvantitatívne výrazná tendencia k vyššej nezaočkovanosti žien (80,9 vs. 62,5 % u mužov; ns), signifikantne častejšie boli vakcinovaní žijúci v domovoch sociálnych služieb než doma (50,0 vs. 23,3 %; p = 0,04) a vysokoškolsky vzdelaní než ostatní (58,3 vs. 22,7 %; p = 0,01). Príčiny nezaočkovanosti sa v 73 % nepodarilo zistiť, kategoricky sa proti vakcinácii profilovalo len 3,2 % pacientov, vo vakcínu neverilo alebo sa jej bálo 9,5 % pacientov. Jeden hospitalizovaný nevakcinovaný pacient pripadal približne na 374 nevakcinovaných 65-ročných a starších obyvateľov regiónu (obyvateľ), jeden hospitalizovaný vakcinovaný len na 3953 vakcinovaných obyvateľov. Nevakcinovaní pacienti trpeli značnou polymorbiditou: okrem covidu-19 mali priemerne 14,2 ochorení (z toho 12,5 chronických) spomedzi 59 sledovaných. Nemocničná úmrtnosť bola veľmi vysoká (48,3 %). Hoci sa nezaočkovaní a očkovaní významnejšie nelíšili v základných charakteristikách (vek, sumárna komorbidita, saturácia krvi kyslíkom pred prijatím, dĺžka hospitalizácie), rozdiel v úmrtnosti bol zrejmý v prospech očkovaných (33,3 vs. 54,0 %; ns). Sme si istí, že aj nami zistené skutočnosti potvrdzujú zásadný význam vakcinácie proti covidu-19.

Despite tangible advances in the treatment of COVID-19, it is still a high-risk disease quoad vitam, especially for the elderly. Vaccination remains the strongest guarantee to minimize the risks of the pandemic. In Slovakia, we have not yet achieved vaccination level against COVID-19, which would ensure a substantial reduction in the COVID-19 threat from the public health standpoint. In a retrospective observational study, we analysed the vaccination coverage of hospitalized seniors (87 patients, average age 80.3 years) when vaccination was already readily available. Nevertheless, 72.6% of hospitalized were not vaccinated. We did not find any relationship between the absence of vaccination and age, there was a quantitatively significant tendency for non-vaccination among women (80.9 vs. 62.5% in men; ns), people living in social care facilities were significantly more frequently vaccinated than those living at home (50.0 vs. 23.3%; p = 0.04), vaccinated patients were significantly more likely to have a university degree than the others (58.3 vs. 22.7%; p = 0.01). The reasons for non-vaccination were not identified in 73%, only 3.2% of patients were categorically against the vaccination and 9.5% of patients did not believe in the vaccine or were afraid of it. One hospitalized unvaccinated patient corresponded approximately to 374 unvaccinated people aged 65 and older in their region, one hospitalized vaccinated patient corresponded only to 3,953 vaccinated people in their region. Unvaccinated patients suffered from significant polymorbidity: in addition to COVID-19, they had on average of 14.2 diseases (of which 12.5 were chronic) out of 59 analysed diseases. In-hospital mortality was very high (48.3%). Although unvaccinated and vaccinated did not differ significantly in baseline characteristics (age, overall comorbidity, blood oxygen saturation before admission, length of hospital stay), the difference in mortality was evident in favour of the vaccinated (33.3 vs. 54.0% in the unvaccinated; ns). We are sure that our findings confirm the crucial importance of vaccination against the COVID-19.

• MeSH
• COVID-19 * mortalita   prevence a kontrola   MeSH
• hospitalizace MeSH
• lidé MeSH
• retrospektivní studie MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• vakcinace statistika a číselné údaje   MeSH
• Check Tag
• lidé MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• Geografické názvy
• Slovenská republika MeSH

BACKGROUND: Changes in public attitudes toward "authorities" in general, as well as shifts in medical practice toward participative models of diagnosis and treatment, imply fundamental transformations in the patient-doctor relationship. However, consistency in reciprocal role expectations cannot be assumed, and this study reveals significant discrepancies in attitudes and behaviors in primary health consultations. METHODS: We conducted a study in the tri-lingual northeastern Italian region of South Tyrol to determine whether perceptions of the patient's role were congruent or differed. In a mixed method approach, the quantitative research part consisted of a survey with 34 identical questions for general practitioners (n = 109) and adult primary care patients (n = 506) on verbal communication, self-initiative and health literacy, interpersonal and social qualities of the patient-physician relationship, and formal aspects of the consultation. Patients were interviewed via telephone, and general practitioners responded online. In the qualitative part, 26 semi-structured in-depth interviews were conducted with the patients and analyzed. RESULTS: General practitioners considered patients' communicative efforts (p < 0.001), self-initiative (p < 0.001), compliance (p = 0.0026), and openness regarding psychosocial issues (p < 0.001) to be significantly more important, whereas patients showed a tendency to give increased importance to formal aspects such as politeness and hygiene (p < 0.001). Perception of the patient's role differed significantly between the Italian and German linguistic groups. CONCLUSIONS: Patients and general practitioners differ in their understanding of patients' roles. These data suggest that a considerable proportion of the population lacks a clear and tangible idea of the active role they could play in consultations. Targeted information on the identified aspects of patient-provider communication may facilitate participatory behavior and positively impact the longitudinal quality of the patient-general practitioner relationship.

• Publikační typ
• časopisecké články MeSH