BACKGROUND AND AIMS: Overweight and obesity are modifiable risk factors for atherosclerotic cardiovascular disease (ASCVD) in the general population, but their prevalence in individuals with heterozygous familial hypercholesterolaemia (HeFH) and whether they confer additional risk of ASCVD independent of LDL cholesterol (LDL-C) remains unclear. METHODS: Cross-sectional analysis was conducted in 35 540 patients with HeFH across 50 countries, in the EAS FH Studies Collaboration registry. Prevalence of World Health Organization-defined body mass index categories was investigated in adults (n = 29 265) and children/adolescents (n = 6275); and their association with prevalent ASCVD. RESULTS: Globally, 52% of adults and 27% of children with HeFH were overweight or obese, with the highest prevalence noted in Northern Africa/Western Asia. A higher overweight/obesity prevalence was found in non-high-income vs. high-income countries. Median age at familial hypercholesterolaemia diagnosis in adults with obesity was 9 years older than in normal weight adults. Obesity was associated with a more atherogenic lipid profile independent of lipid-lowering medication. Prevalence of coronary artery disease increased progressively across body mass index categories in both children and adults. Compared with normal weight, obesity was associated with higher odds of coronary artery disease in children (odds ratio 9.28, 95% confidence interval 1.77-48.77, adjusted for age, sex, lipids, and lipid-lowering medication) and coronary artery disease and stroke in adults (odds ratio 2.35, 95% confidence interval 2.10-2.63 and odds ratio 1.65, 95% confidence interval 1.27-2.14, respectively), but less consistently with peripheral artery disease. Adjusting for diabetes, hypertension and smoking modestly attenuated the associations. CONCLUSIONS: Overweight and obesity are common in patients with HeFH and contribute to ASCVD risk from childhood, independent of LDL-C and lipid-lowering medication. Sustained body weight management is needed to reduce the risk of ASCVD in HeFH.

• MeSH
• Child MeSH
• Adult MeSH
• Heterozygote MeSH
• Hyperlipoproteinemia Type II * epidemiology   complications   MeSH
• Body Mass Index MeSH
• Cardiovascular Diseases epidemiology   etiology   MeSH
• Cholesterol, LDL blood   metabolism   MeSH
• Middle Aged MeSH
• Humans MeSH
• Adolescent MeSH
• Young Adult MeSH
• Overweight * epidemiology   complications   MeSH
• Obesity * complications   epidemiology   MeSH
• Prevalence MeSH
• Cross-Sectional Studies MeSH
• Registries * MeSH
• Risk Factors MeSH
• Check Tag
• Child MeSH
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Adolescent MeSH
• Young Adult MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Multicenter Study MeSH

Defekty pánevního dna u žen jsou velmi rozšířeným problémem. Odhaduje se, že až 11 % žen potřebuje řešit nějakou formu prolapsu pánevních orgánů (POP, Pelvic Organ Prolapse). Jen stěží lze předpokládat, že se bude tento statistický údaj výrazněji měnit. Operační postupy stále procházejí zákonitým vývojem. V minulosti prováděné samostatné kolporafie v dnešní době již nejsou aktuální a kolpokleiza je indikována výjimečně. Významný počet neuspokojivých výsledků po klasických operacích byl příčinou hledání nových chirurgických technologií v této oblasti. Prevalence reoperací v zemích, kde probíhají relevantní klinické studie, je vysoká. Olsen a kol. ve své studii uvádí 29,2% výskyt recidiv, Whiteside v prospektivní studii prezentuje dokonce 58 % recidiv po vaginálních operacích pro POP (1, 2). Zavedení síťkových implantátů do operativy pánevních prolapsů znamenalo zásadní zvrat v této problematice. Síťkové implantáty začaly být užívány při operacích pánevních prolapsů po dobrých zkušenostech se síťkami při řešení břišních kýl a také po přelomových zkušenostech při řešení stresové inkontinence (SI) implantacemi tahuprostých suburetrálních pásek. Přinesly do operativy POP jeden zásadní prvek - schopnost přemostit i velké plošné defekty pojivové tkáně vzniklé porodním traumatem nebo pánevní operací. Jejich použití při operaci POP je však daleko náročnější než při operacích břišních kýl, protože POP je specifickou kýlou v dynamicky náročném prostoru. Při těchto operacích zasahujeme do velmi citlivých funkcí, jakými jsou močení, defekace a sexuální funkce. Jejich zavedení do chirurgické praxe lze jednoznačně považovat za pokrok, přesto že klinické výsledky při jejich používání byly někdy rozpačité. Především se objevily zcela nové typy komplikací, s jejichž řešením nebyly žádné zkušenosti. Přes řadu komplikací při zavádění pánevních implantátů vývoj dosáhl takové úrovně, kdy lze dosahovat prakticky anatomických rekonstrukcí pánevního dna s vynikajícími funkčními výsledky. Pánevní implantáty lze zavádět transvaginálně nebo transabdominálně. U transabdominálního přístupu je aktuální miniinvazivní laparoskopická nebo roboticky asistovaná technologie implantace. Kvalitní rekonstrukci pánevního dna bez použití síťkových implantátů v současné době není možné provést.

Pelvic floor disorders in women are a very common issue. It is estimated that up to 11% of women are experiencing some form of pelvic organ prolapse (POP). It can hardly be assumed that this statistic will change significantly. Operating technologies are still evolving. Separate colporrhaphys performed in the past are no longer relevant and colpocleisis are indicated rarely. A high rate of unsatisfactory outcomes following conventional surgeries has driven the search for new surgical technologies in this area. Reoperation rates are notably high in countries where relevant clinical trials are ongoing. Olsen et al. report a 29.2% incidence of recurrences, while Whiteside et al. present even 58% of recurrences after vaginal surgery for POP in a prospective study (1, 2). The introduction of mesh implants into pelvic prolapse surgery meant a significant turning point in the treatment of this condition. Mesh implants began to be used in pelvic prolapse surgeries following successful experience with meshes in the treatment of abdominal hernias and also after groundbreaking experience in dealing with stress incontinence (SI) through tension-free suburethral tape implantation. They brought one essential element to POP operations - the ability to bridge even large surface defects of connective tissue caused by childbirth trauma or previous pelvic surgeries. However, their use in POP surgery is far more demanding than in abdominal hernia surgery, because POP is a specific type of hernia in a dynamically demanding space. These operations interfere with very sensitive functions such as urination, defecation and sexual function. While their introduction into surgical practice can clearly be considered a progress, the clinical results of their use have sometimes been less satisfactory. New types of complications emerged, and there was initially no experience in managing them. Despite these challenges, the development of pelvic implant technology has progressed to the point where it is possible to achieve practically anatomical reconstructions of the pelvic floor with excellent functional results. Pelvic implants can be inserted transvaginally or transabdominally. In the transabdominal approach, minimally invasive laparoscopic or robot-assisted implantation technology is currently available. A high-quality pelvic floor reconstruction is not possible without the use of mesh implants.

• Publication type
• Published Erratum MeSH

Příručka, která se zaměřuje na miniinvazivní roboticky a video asistované torakoskopické chirurgické výkony, zejména na onkologické plicní operace. Určeno odborné veřejnosti.; Resekce plic patří v současné medicíně mezi nejčastější a současně nejnáročnější operační výkony. Bohatě ilustrovaná publikace vychází z autorových dlouholetých operačních zkušeností, přičemž zohledňuje i nejnovější pokroky v oblasti torakoskopických a robotických technik. Práce není kompilací aktuálních literárních pohledů na problematiku, ale je primárně zaměřena zejména na praktický popis jednotlivých operačních technik a konkrétních chirurgických postupů. Největší devizou knihy je velmi obsáhlá obrazová dokumentace zachycující detailně jednotlivé kroky chirurgických výkonů. Fotografie operačních postupů jsou vždy doplněny překreslením do ilustrace. Díky tomu je i pro začátečníka snadné orientovat se v složitých operačních anatomických situacích. Kniha je bez nadsázky originální postgraduální učebnicí a operačním atlasem v jednom. Je určena chirurgům, kteří v hrudní chirurgii začínají a rovněž i pokročilým chirurgům, kteří si jen chtějí konfrontovat své vlastní postupy.

• MeSH
• Surgical Oncology MeSH
• Pulmonary Surgical Procedures MeSH
• Thoracic Surgery, Video-Assisted MeSH
• Minimally Invasive Surgical Procedures MeSH
• Lung Neoplasms surgery   MeSH
• Robotic Surgical Procedures MeSH
• Publication type
• Handbook MeSH

• Conspectus
• Ortopedie. Chirurgie. Oftalmologie
• NML Fields
• chirurgie
• pneumologie a ftizeologie

Sborník prací přednesených na sympoziu, které se zaměřilo na léčbu hematologických nádorů. Určeno odborné veřejnosti.

• Keywords
• zanubrutinib,
• MeSH
• Receptors, Chimeric Antigen MeSH
• Hematologic Neoplasms MeSH
• Protein Kinase Inhibitors MeSH
• Leukemia, Lymphoid MeSH
• Lymphoma, Mantle-Cell MeSH
• Multiple Myeloma MeSH
• Agammaglobulinaemia Tyrosine Kinase MeSH
• Antineoplastic Agents MeSH
• Publication type
• Congress MeSH
• Collected Work MeSH
• News MeSH

• Conspectus
• Patologie. Klinická medicína
• NML Fields
• hematologie a transfuzní lékařství
• onkologie

Routine outcome monitoring (ROM) has become an increasingly utilized tool in therapeutic practice that has the potential to improve therapy outcomes. This study aimed to synthesize the findings of existing qualitative studies investigating how clinicians use ROM in their work with clients. A systematic search of qualitative studies on clinicians' experience with the use of ROM in mental health services was conducted via PsycInfo, PsycArticles, Medline, Web of Science, and Scopus databases. Qualitative meta-analysis was used to synthesize the finding of the primary studies. Forty-seven studies met the inclusion criteria. The analysis resulted in 21 meta-categories organized into six clusters, namely (1) obtaining clinically relevant information, (2) adapting treatment, (3) facilitating communication, (4) enhancing the therapeutic relationship, (5) facilitating change in clients, and (6) personalized usage of ROM. The meta-analysis revealed that clinicians utilized ROM in diverse ways, including both informational and communicational functions. From the clinicians' perspective, ROM was an element that, on the one hand, introduced additional structure and standardization in treatment and, on the other hand, allowed for greater flexibility and tailoring of treatment.

• MeSH
• Mental Disorders therapy   MeSH
• Outcome Assessment, Health Care MeSH
• Communication MeSH
• Qualitative Research MeSH
• Humans MeSH
• Attitude of Health Personnel MeSH
• Psychotherapists * MeSH
• Psychotherapy * organization & administration   standards   MeSH
• Mental Health Services organization & administration   standards   MeSH
• Professional-Patient Relations MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Meta-Analysis MeSH

The effects of a large arteriovenous fistula (AVF) on pulmonary perfusion remains to be elucidated. We aimed to study, for the first time, the real-time acute effects of a large AVF on regional distribution of pulmonary perfusion in a novel porcine model. Ten healthy swine under general anesthesia were studied. AVF was created by the connection of femoral artery and femoral vein using high-diameter perfusion cannulas. The AVF was closed and after 30 min of stabilization the first values were recorded. The fistula was then opened, and new data were collected after reaching stable state. Continuous hemodynamic monitoring was performed throughout the protocol. The following functional images were analyzed by electrical impedance tomography (EIT): perfusion and ventilation distributions. We found an increased cardiac output and right ventricular work, which was strongly correlated to an increased pulmonary artery mean pressure (r=0.878, P=0.001). The ventral/dorsal ratio of pulmonary perfusion decreased from 1.9+/-1.0 to 1.5+/-0.7 (P=0.025). The percentage of total pulmonary blood flow through the dorsal lung region increased from 38.6+/-11.7 to 42.2+/-10.4 (P=0.016). In conclusion, we have used EIT for the first time for studying the acute effects of a large AVF on regional distribution of pulmonary perfusion in a novel porcine model. In this new experimental model of hyperkinetic circulation caused by AVF, we documented an increased percentage of total pulmonary blood flow through the dorsal lung region and a more homogeneous perfusion distribution. Key words Arteriovenous fistula, Hyperkinetic circulation, Tissue perfusion, Animal model, Pulmonary blood flow.

• MeSH
• Pulmonary Artery diagnostic imaging   physiopathology   MeSH
• Arteriovenous Fistula physiopathology   diagnostic imaging   MeSH
• Arteriovenous Shunt, Surgical MeSH
• Lung blood supply   diagnostic imaging   MeSH
• Pulmonary Circulation * physiology   MeSH
• Swine MeSH
• Femoral Vein diagnostic imaging   MeSH
• Animals MeSH
• Check Tag
• Female MeSH
• Animals MeSH
• Publication type
• Journal Article MeSH

BACKGROUND: Rheumatoid arthritis (RA) and axial spondyloarthritis (axSpA) are autoimmune illnesses characterised by chronic inflammation demonstrating differential associations with psychiatric conditions. OBJECTIVE: In this matched-cohort study, we aimed to investigate whether the associations between these inflammatory illnesses and mental disorders are predominantly the consequence of the burden of the former or whether common causes might underpin the susceptibility to both. METHODS: Using Czech national inpatient care data, we identified individuals with RA or axSpA during the years 1999-2012. We investigated the occurrence of psychiatric outcomes up to 2017 using stratified Cox proportional hazards models. In evidence triangulation, we assessed the potential moderation by age at inflammatory illness, the associations relative to counterparts with other similarly burdensome chronic illnesses and the temporal ordering of conditions. FINDINGS: Both RA and axSpA were associated with mood and anxiety disorders and behavioural syndromes. In evidence triangulation, the associations with depression showed a decreasing age-at-inflammatory-illness gradient in RA; the association between RA and depression was stronger than that between other chronic illnesses and depression; and excluding prevalent depression attenuated the RA-depression association. RA showed consistent inverse associations with schizophrenia and Alzheimer's disease. CONCLUSIONS: Common aetiologies might be involved in increasing the risk of developing both RA and depression. The consistent inverse associations between RA and schizophrenia and between RA and Alzheimer's disease suggest that at least part of these associations might also be a consequence of shared aetiologies as well as potential medication effects. CLINICAL IMPLICATIONS: People with autoimmune arthritides are more likely to experience mood and anxiety disorders, even relative to counterparts with other similarly burdensome chronic illnesses.

• MeSH
• Adult MeSH
• Mental Disorders * epidemiology   immunology   MeSH
• Cohort Studies MeSH
• Middle Aged MeSH
• Humans MeSH
• Arthritis, Rheumatoid * epidemiology   immunology   psychology   complications   MeSH
• Aged MeSH
• Spondylarthritis immunology   epidemiology   psychology   MeSH
• Inflammation epidemiology   immunology   MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Geographicals
• Czech Republic MeSH

Hydrogen sulfide (H2S) is a gas neurotransmitter that is synthesized in various mammalian tissues including vascular tissues and regulates vascular tone. The aim of this study is to investigate whether the endogenous L-cysteine/H2S pathway is impaired due to aging and endothelial denudation in mouse isolated thoracic aorta. For this purpose, young (3-4 months) and old (23-25 months) mice were used in the experiments. The effects of aging and endothelium on endogenous and exogenous H2S-induced vasorelaxation were investigated by cumulative L-cysteine-(1 microM-10 mM) and NaHS-(1 microM-3 mM) induced vasorelaxations, respectively. The L-cysteine-induced relaxations were reduced in old mice aorta compared to the young mice. Also, vasorelaxant responses to L-cysteine (1 microM-10 mM) were reduced on aorta rings with denuded-endothelium of young and old mice. However, the relaxation responses to NaHS were not altered by age or endothelium denudation. The loss of staining of CSE in the endothelial layer was observed in old thoracic aorta. Ach-induced (1-30 microM) relaxation almost abolished in endothelium-denuded rings from both mice group. Also, relaxation Ach reduced in intact endothelium tissue of old mice aorta. In conclusion, the vasorelaxant responses to L-cysteine but not NaHS decreased and the protein expression of CSE reduced in old thoracic aorta rings consistent with a decrease in H2S concentration with aging and endothelium damage, suggesting that aging may be lead to decrease in enzyme expression and H2S signaling system due to endothelium damage in mouse thoracic aorta. Key words Aging, Hydrogen sulfide, L-cysteine, Endothelium, Thoracic aorta.

• MeSH
• Aorta, Thoracic * drug effects   metabolism   physiology   MeSH
• Endothelium, Vascular * metabolism   drug effects   MeSH
• Cysteine metabolism   pharmacology   MeSH
• Mice, Inbred C57BL MeSH
• Mice MeSH
• Signal Transduction MeSH
• Aging * metabolism   MeSH
• Hydrogen Sulfide * metabolism   MeSH
• Vasodilation * drug effects   physiology   MeSH
• Animals MeSH
• Check Tag
• Male MeSH
• Mice MeSH
• Animals MeSH
• Publication type
• Journal Article MeSH

Polycystic ovary syndrome (PCOS) is a common endocrine disorder affecting women of reproductive age, characterized by a spectrum of reproductive, endocrine, and metabolic disturbances. The etiology of PCOS encompasses a complex interplay of genetic, metabolic, inflammatory, and oxidative factors, though the precise pathological mechanisms remain inadequately understood. Despite considerable variability in the clinical characteristics and biochemical profiles among individuals with PCOS, abnormalities in follicular development are a hallmark of the condition. Granulosa cells, integral to follicular development, play a pivotal role in follicle maturation. Recent studies have established a strong correlation between granulosa cell programmed cell death and follicular atresia in PCOS. This review provides a comprehensive analysis of the current understanding of granulosa cell programmed cell death and its contribution to follicular atresia within the pathophysiology of PCOS, providing a foundation for future research endeavors. Key words Follicular atresia, Hyperandrogenism, Insulin resistance, Polycystic ovary syndrome, Programmed cell death of granulosa cells.

• MeSH
• Apoptosis * MeSH
• Follicular Atresia * metabolism   MeSH
• Granulosa Cells * metabolism   pathology   MeSH
• Humans MeSH
• Ovarian Follicle metabolism   pathology   MeSH
• Polycystic Ovary Syndrome * pathology   metabolism   MeSH
• Animals MeSH
• Check Tag
• Humans MeSH
• Female MeSH
• Animals MeSH
• Publication type
• Journal Article MeSH
• Review MeSH