Roboticky asistovaná radikální prostatektomie je standardní metodou léčby lokalizovaného karcinomu prostaty. Přesto zůstávají pozdní funkční komplikace jako stresová inkontinence moči, erektilní dysfunkce a striktury hrdla močového měchýře zásadními faktory ovlivňujícími kvalitu života pacientů. Tento článek se zabývá možnostmi prevence těchto komplikací prostřednictvím optimalizace chirurgických technik a individualizované rehabilitační péče. Důraz je kladen na šetrné operační postupy, zachování klíčových anatomických struktur a důslednou pooperační péči a fyzioterapii. Výsledky studií ukazují, že kombinace těchto přístupů může významně přispět ke zlepšení pooperačních výsledků a urychlit návrat pacientů k běžnému životu. Komplexní přístup zahrnující precizní chirurgické metody, systematickou rehabilitaci a edukaci pacientů je nezbytný pro minimalizaci nežádoucích účinků a maximalizaci kvality života po operaci.
Robot-assisted radical prostatectomy is the standard treatment for localized prostate cancer. However, late functional complications such as stress urinary incontinence, erectile dysfunction, and bladder neck strictures continue to be critical factors affecting patients' quality of life. This article explores strategies to prevent these complications through optimized surgical techniques and individualized rehabilitation care. Emphasis is placed on minimally invasive surgical approaches, preservation of key anatomical structures, and comprehensive postoperative management, including physiotherapy, pharmacological support, and technical aids. Studies indicate that combining these approaches can significantly improve postoperative outcomes and accelerate patients' return to daily life. A comprehensive approach integrating precise surgical methods, systematic rehabilitation, and patient education is essential to minimizing adverse effects and maximizing quality of life after surgery.
- MeSH
- Erectile Dysfunction etiology prevention & control MeSH
- Humans MeSH
- Postoperative Complications prevention & control MeSH
- Prostatectomy * methods adverse effects MeSH
- Robotic Surgical Procedures MeSH
- Urinary Incontinence, Stress etiology prevention & control MeSH
- Urethral Stricture etiology prevention & control MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Publication type
- Review MeSH
U vybraných pacientů s karcinomem prostaty (KP) nízkého rizika představuje aktivní sledování (AS) metodu volby, jejímž cílem je oddálit nebo se vyhnout radikální léčbě. Může však u nich vyvolávat úzkost a nejistotu. Pacienti také často dostávají nedostatečné, matoucí a obtížně srozumitelné informace, což vede k úzkosti a stresu. Psychosociální podpora a intervence zaměřené na zlepšení životního stylu mohou hrát klíčovou roli ve zvládání nejistoty a zlepšení důvěry pacientů k AS. Vzdělávání pacientů a jejich rodin je důležité, protože také vede ke snížení stresu a lepší spolupráci. Podpůrné skupiny a psychoterapeutické intervence mohou být užitečné pro pacienty, kteří se potýkají s psychickou zátěží spojenou s AS. Tento přehledový článek se zaměřuje na psychosociální aspekty AS a intervence ovlivňující psychosociální zátěž.
For selected patients with low-risk prostate cancer (PC), active surveillance (AS) represents the method of choice aimed at delaying or avoiding radical treatment. However, AS can cause anxiety and uncertainty. Patients also often receive insufficient, confusing, and difficult-to-understand information, leading to anxiety and stress. Psychosocial support and interventions focused on lifestyle improvement can play a key role in managing uncertainty and enhancing patients' confidence in AS. Patient and family education is essential, as it also reduces stress and improves cooperation. Patient support groups and psychotherapeutic interventions may be beneficial for patients experiencing psychological distress related to AS. This review article focuses on the psychosocial aspects of AS and interventions affecting psychosocial burden.
- MeSH
- Humans MeSH
- Prostatic Neoplasms * psychology MeSH
- Family Support MeSH
- Watchful Waiting MeSH
- Psychosocial Support Systems MeSH
- Social Support MeSH
- Life Style MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Publication type
- Review MeSH
Tento článek zpracovává téma nových trendů a technologií v urologii, a to konkrétně v oblasti telemedicíny a umělé inteligence. Nejprve stručně pojednává o přínosech telemedicíny a jak mění pohled na vztah mezi lékařem a pacientem. Podrobněji se pak text věnuje především umělé inteligenci, jež se v současnosti dostává do popředí zájmu laické i odborné veřejnosti. Její potenciál v urologii je testován v mnoha studiích, především se zaměřením na uroonkologii, v menší míře pak také v oblasti benigních urologických onemocnění. Článek se snaží identifikovat nejvýznamnější pokroky v této rychle se rozvíjející oblasti, a zároveň předkládá současné limity jejího zapojení do klinické praxe.
This article explores the emerging trends and technologies in urology, focusing on telemedicine and artificial intelligence. It provides a brief overview of the benefits of telemedicine and its impact on the patient-physician interactions. The article subsequently explores in detail the use of artificial intelligence, which is currently gaining considerable interest from both general public and medical professionals. Its potential in urology has been tested in a number of clinical studies, particularly in the field of uro-oncology and, to a lesser extent, in benign urological diseases. The aim of this article is to identify the key advances in this rapidly evolving field, while also highlighting the current limitations of its implementation into clinical practice.
- MeSH
- Deep Learning MeSH
- Humans MeSH
- Robotic Surgical Procedures MeSH
- Machine Learning MeSH
- Telemedicine MeSH
- Artificial Intelligence MeSH
- Urologic Neoplasms diagnosis therapy MeSH
- Urology * trends MeSH
- Check Tag
- Humans MeSH
- Publication type
- Review MeSH
Článek pojednává o stresu a syndromu vyhoření obecně, o výsledcích výzkumu syndromu vyhoření českých lékařů a dále a způsobech, jak je možné tomuto čelit. Specificky se zaměřuje na vysvětlení fungování balintovských skupin jako možnosti psychohygieny lékařů a jako prostředku vedoucímu k lepšímu porozumění vztahu lékař - pacient.
The article addresses stress and burnout syndrome in general, the results of research on burnout syndrome among Czech doctors, and approaches to coping with these challenges. It specifically focuses on explaining the functioning of Balint groups as a form of psychological hygiene for doctors and as a mens leading to a better understanding of the doctor-patient relationship.
- Keywords
- balintovská skupina,
- MeSH
- Burnout, Psychological * prevention & control MeSH
- Physicians MeSH
- Humans MeSH
- Occupational Stress prevention & control MeSH
- Surveys and Questionnaires MeSH
- Psychotherapy, Group methods MeSH
- Physician-Patient Relations MeSH
- Check Tag
- Humans MeSH
- Publication type
- Review MeSH
Stručný souhrn současných poznatků a praktických doporučených postupů týkajících se nezhoubného zvětšení předstojné žlázy.
Short summary of the current knowledge and practical guidelines on benign prostatic hyperplasia.
S recidivujícími infekcemi močových cest se v klinickém praxi setkáváme velmi často. Intravezikální aplikace kyseliny hyaluronové napomáhá k obnovení ochranné glykosaminoglykanové vrstvy na povrchu urotelu a přispívá ke snížení počtu recidiv. Tato léčba představuje účinnou možnost zejména u pacientek, u kterých režimová opatření v kombinaci s non-antimikrobiální či antimikrobiální profylaxí nemají dostatečný efekt.
Recurrent urinary tract infections are very common in clinical practice. Endovesical installation of hyaluronic acid helps to restore the protective glycosaminoglycan layer on the surface of bladder urothelium and reduces the frequency of recidives. This treatment represents an effective option especially for patients in whom regime measures in combination with non-antimicrobial or antimicrobial prophylaxis has been unsuccessful.
PURPOSE: Minimally invasive surgery (MIS) in neonates and infants presents technical challenges and is still unfamiliar to many paediatrics surgeons. This study aims to identify currently available simulators for neonatal/infant MIS training, to assess their validity, level of evidence, and related recommendations. METHODS: The review followed PRISMA guidelines and was registered in PROSPERO (CRD420250581050). Electronic search limited to English articles was performed through PubMed/MEDLINE, SCOPUS, Web of Science and Cochrane Database from January 2010 to June 2024. RESULTS: Out of 1084 identified records, 72 studies met the inclusion criteria and were analysed across general, gastrointestinal, thoracic, and urological MIS specialties. Recent efforts have led to the development of 3D-printed, animal-based, and hybrid models several of which showed high fidelity, skill differentiation, and educational value. Despite promising results, no universal MIS training model exists for neonate/infant patients, highlighting the need for structured, proficiency-based curricula. Overall, studies demonstrated moderate levels of evidence and recommendation, supporting integration of cost-effective simulation into paediatrics MIS training CONCLUSION: This systematic review highlights the need for validated, standardized simulation models and proficiency-based curricula to optimize neonate and infant MIS training and guide future research toward improving model fidelity, accessibility, and long-term educational outcomes.
- MeSH
- Clinical Competence MeSH
- Infant MeSH
- Humans MeSH
- Minimally Invasive Surgical Procedures * education MeSH
- Infant, Newborn MeSH
- Pediatrics * education MeSH
- Simulation Training * methods MeSH
- Check Tag
- Infant MeSH
- Humans MeSH
- Infant, Newborn MeSH
- Publication type
- Journal Article MeSH
- Systematic Review MeSH
Objective.Accurate localization of the epileptogenic zone (EZ) is crucial for epilepsy surgery, but the class imbalance of epileptogenic vs. non-epileptogenic electrode contacts in intracranial electroencephalography (iEEG) data poses significant challenges for automatic localization methods. This review evaluates methodologies for handling the class imbalance in EZ localization studies that use machine learning (ML).Approach.We systematically reviewed studies employing ML to localize the EZ from iEEG data, focusing on strategies for addressing class imbalance in data handling, algorithm design, and evaluation.Results.Out of 2,128 screened studies, 35 fulfilled the inclusion criteria. Across the studies, the iEEG contacts annotated as epileptogenic prior to automatic localization constituted a median of 18.34% of all contacts. However, many of these studies did not adequately address the class imbalance problem. Techniques such as data resampling and cost-sensitive learning were used to mitigate the class imbalance problem, but the chosen evaluation metrics often failed to account for it.Significance.Class imbalance significantly impacts the reliability of EZ localization models. More comprehensive management and innovative approaches are needed to enhance the robustness and clinical utility of these models. Addressing class imbalance in ML models for EZ localization will improve both the predictive performance and reliability of these models.
Primary sclerosing cholangitis (PSC) is a chronic cholestatic liver disease often associated with underlying inflammatory bowel disease (IBD). This study investigates how PSC predisposes individuals to altered inflammatory immune responses compared with IBD alone. A case-control study was conducted with a cohort of 75 patients, including 16 with PSC (14 with concomitant IBD), 39 with IBD alone, and 20 controls. Serum bile acid profile, proteomic analysis, and immune-related gene expression in the colon tissue were examined. Colonic tissue from PSC patients exhibited up-regulation of immune regulation and inflammatory signaling mRNA markers, including LGR5, IL-8, CCL2, COX2, TWIST1, and SNAIL. Additionally, PSC patients displayed a distinct proinflammatory serum proteomic signature and moderate elevation of some bile acids, such as glycochenodeoxycholic acid (GCDCA). Co-incubation of human-derived monocytes with GCDCA partially replicated the inflammatory profile observed in PSC. These findings suggest that circulating bile acids modulate the peripheral immune system proinflammatory response, contributing to the unique PSC phenotype.
- MeSH
- Adult MeSH
- Inflammatory Bowel Diseases * immunology complications blood genetics MeSH
- Colon metabolism immunology MeSH
- Middle Aged MeSH
- Humans MeSH
- Monocytes immunology metabolism MeSH
- Proteomics methods MeSH
- Cholangitis, Sclerosing * immunology blood complications genetics MeSH
- Case-Control Studies MeSH
- Bile Acids and Salts * blood immunology MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
