BACKGROUND: Advancements in artificial intelligence (AI) and machine learning (ML) have revolutionized the medical field and transformed translational medicine. These technologies enable more accurate disease trajectory models while enhancing patient-centered care. However, challenges such as heterogeneous datasets, class imbalance, and scalability remain barriers to achieving optimal predictive performance. METHODS: This study proposes a novel AI-based framework that integrates Gradient Boosting Machines (GBM) and Deep Neural Networks (DNN) to address these challenges. The framework was evaluated using two distinct datasets: MIMIC-IV, a critical care database containing clinical data of critically ill patients, and the UK Biobank, which comprises genetic, clinical, and lifestyle data from 500,000 participants. Key performance metrics, including Accuracy, Precision, Recall, F1-Score, and AUROC, were used to assess the framework against traditional and advanced ML models. RESULTS: The proposed framework demonstrated superior performance compared to classical models such as Logistic Regression, Random Forest, Support Vector Machines (SVM), and Neural Networks. For example, on the UK Biobank dataset, the model achieved an AUROC of 0.96, significantly outperforming Neural Networks (0.92). The framework was also efficient, requiring only 32.4 s for training on MIMIC-IV, with low prediction latency, making it suitable for real-time applications. CONCLUSIONS: The proposed AI-based framework effectively addresses critical challenges in translational medicine, offering superior predictive accuracy and efficiency. Its robust performance across diverse datasets highlights its potential for integration into real-time clinical decision support systems, facilitating personalized medicine and improving patient outcomes. Future research will focus on enhancing scalability and interpretability for broader clinical applications.
BACKGROUND: This intervention pilot case series assessed 40-Gy stereotactic radiosurgery (SRS) neuromodulation applied to the bilateral stellate ganglion (SG) as a bailout procedure for patients with refractory angina pectoris (RAP). MATERIALS AND METHODS: The local institutional review board approved this feasibility study. In three patients with RAP, after repeated good response, symptoms were temporarily relieved after anaesthetic blockade of the left SG under ultrasound guidance. Radiosurgical neuromodulation with a dose of 40 Gy in one fraction was used for more permanent pain control. When RAP recurred after the initial SRS, right-sided procedures were considered after a confirmed positive response to right SG anesthetic block. RESULTS: No acute or late radiation-related toxicities were observed. Two patients (67%) responded to bilateral SRS (follow-up: 60 and 48 months, respectively). From baseline to 24 months, their average prescribed nitrate package count decreased from 5.5 to 0 and remained low. Daily emergency nitrates declined from 20 to 30 to 1-2 applications, and walking distance improved from 10 to 20 m to 200-400 m and remained stable. Quality of life as measured with the EQ-5D and all domains of the Seattle Angina Questionnaire improved. The third patient received only unilateral SRS, had a temporary improvement for 6 months before a return to baseline, and died after 42 months of follow-up. CONCLUSIONS: Bilateral radiosurgical neuromodulation at 40 Gy appears to be feasible, safe, and effective as a bailout procedure for RAP.
- MeSH
- angina pectoris * terapie MeSH
- ganglion stellatum MeSH
- kvalita života MeSH
- lidé středního věku MeSH
- lidé MeSH
- pilotní projekty MeSH
- radiochirurgie * metody MeSH
- senioři MeSH
- studie proveditelnosti MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
BACKGROUND: Detrimental effects of misinformation were observed during the COVID-19 pandemic. Presently, amid Russia's military aggression in Ukraine, another wave of misinformation is spreading on the web and impacting our daily lives, with many citizens and politicians embracing Russian propaganda narratives. Despite the lack of an objective connection between these 2 societal issues, anecdotal observations suggest that supporters of misinformation regarding COVID-19 (BM-C) have also adopted misinformation about the war in Ukraine (BM-U) while sharing similar media use patterns and political attitudes. OBJECTIVE: The aim of this study was to determine whether there is a link between respondents' endorsement of the 2 sets of misinformation narratives, and whether some of the selected factors (media use, political trust, vaccine hesitancy, and belief rigidity) are associated with both BM-C and BM-U. METHODS: We conducted a survey on a nationally representative sample of 1623 individuals in the Czech Republic. Spearman correlation analysis was performed to identify the relationship between BM-C and BM-U. In addition, multiple linear regression was used to determine associations between the examined factors and both sets of misinformation. RESULTS: We discovered that BM-C and BM-U were moderately correlated (Spearman ρ=0.57; P<.001). Furthermore, increased trust in Russia and decreased trust in the local government, public media, and Western allies of the Czech Republic predicted both BM-C and BM-U. Media use indicating frustration with and avoidance of public or mainstream media, consumption of alternative information sources, and participation in web-based discussions indicative of epistemic bubbles predicted beliefs in misinformation narratives. COVID-19 vaccine refusal predicted only BM-C but not BM-U. However, vaccine refusers were overrepresented in the BM-U supporters (64/161, 39.8%) and undecided (128/505, 25.3%) individuals. Both beliefs were associated with belief rigidity. CONCLUSIONS: Our study provides empirical evidence that supporters of COVID-19 misinformation were susceptible to ideological misinformation aligning with Russian propaganda. Supporters of both sets of misinformation narratives were primarily linked by their shared trust or distrust in the same geopolitical actors and their distrust in the local government.
- MeSH
- COVID-19 * prevence a kontrola epidemiologie psychologie MeSH
- dospělí MeSH
- důvěra MeSH
- komunikace * MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- odkládání očkování psychologie MeSH
- pandemie MeSH
- politika MeSH
- průzkumy a dotazníky MeSH
- SARS-CoV-2 MeSH
- senioři MeSH
- vakcíny proti COVID-19 aplikace a dávkování MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Rusko MeSH
- Ukrajina MeSH
Infective endocarditis (IE) is a life-threatening disease, with its mortality rate varying depending on the infectious agent. Streptococci are among the most common causes of infective endocarditis. However, Streptococcus vestibularis has rarely been associated with human infections, typically affecting patients with underlying conditions such as immunosuppressive diseases, valve replacement, rheumatic heart disease, and hemodialysis. We present the case of a 26-year-old man who presented with fever, unanticipated weight loss, and fatigue. Although no typical risk factors for infective endocarditis were identified at admission, transesophageal echocardiography revealed a bicuspid aortic valve with calcification, paravalvular aortic abscess formation, and vegetations on the anterior leaflet of the mitral valve. Blood cultures grew S. vestibularis, which was initially sensitive to benzylpenicillin but developed emergent resistance on the third day of the antibiotic treatment. Subsequently, ceftriaxone therapy was initiated, and blood cultures became sterile on day 10. The patient eventually underwent aortic valve replacement. We report the first known case of native aortic and mitral valve endocarditis caused by S. vestibularis, accompanied by a paravalvular abscess around the native aortic valve, in a patient who had no typical risk factors for infective endocarditis, except for a bicuspid aortic valve.
- MeSH
- antibakteriální látky terapeutické užití MeSH
- aortální insuficience * mikrobiologie chirurgie MeSH
- bakteriální endokarditida * komplikace diagnóza farmakoterapie mikrobiologie MeSH
- bikuspidální aortální chlopeň * komplikace chirurgie MeSH
- cefalosporiny třetí generace terapeutické užití MeSH
- ceftriaxon terapeutické užití MeSH
- chirurgická náhrada chlopně MeSH
- dospělí MeSH
- lidé MeSH
- mitrální chlopeň * mikrobiologie MeSH
- penicilin G terapeutické užití MeSH
- rezistence na penicilin MeSH
- streptokokové infekce * komplikace diagnóza farmakoterapie mikrobiologie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
Temporomandibular disorders (TMDs) are conditions with multifactorial etiology and complex treatment. Among the non-invasive therapeutic possibilities for these conditions is the Front Plateau, a partial anterior plate made from colourless self-curing acrylic resin. It is a simple procedure that can be carried out in a single clinical section promoting muscle relaxation to reduce symptoms associated with TMDs. This study aims to report a prospective, consecutive, single-centric case series to evaluate the Front Plateau's effectiveness in patients with temporomandibular disorders. A questionnaire adapted from the Research Diagnostic Criteria for TMDs was used and 4 patients were treated with the Front Plateau plaque. Patients were monitored after 5 and 9 months, respectively, after starting to use the Front Plateau. Of the 4 cases listed, 2 showed significant improvement in initial signs and symptoms. Front Plateau may be a favourable treatment option for patients with TMD, if the guidelines are followed. Clinical trials on this modality should seek to minimize possible biases and limitations associated with the design of this type of research.
- MeSH
- akrylové pryskyřice terapeutické užití MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- nemoci temporomandibulárního kloubu * terapie diagnóza MeSH
- prospektivní studie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
- přehledy MeSH
Iliac crest is common site for harvesting bone grafts. Morphometry of iliac crest is of vital importance in orthopedic surgery. Measurements were done on male (n=85) and female (n=85) hip bones. Length of iliac crest, thickness of iliac crest and ilium were measured. Thickness was measured at pre-defined points on crest and ilium 2 cm apart starting from anterior superior iliac spine (ASIS). Ilium was measured at a depth of 2.5 cm from crest. Statistical analysis was done. Iliac crests were longer in male bones. Ventral iliac crest was thickest at 6 cm from ASIS in both sexes. While iliac crest bore minimum thickness at 12 cm and 10 cm from ASIS in male and female bones respectively, however at 2.5 cm below iliac crest surface ilium was thickest at 4 cm from ASIS and at ASIS in male and female bones respectively. In case of male bones, dorsal part of iliac crest was thickest at 2.15 ± 1.29 cm from posterior superior iliac spine (PSIS) while in females it was at 1.78 ± 1.31 cm from PSIS. In dorsal part of ilium, it was observed at 2.31 ± 1.47 cm and 1.9 ± 1.79 cm from PSIS for male and female bones respectively. This study provided detailed variable morphometry and significant sexual dimorphism observed in iliac crest and ilium. Thickest safe zones in both sexes are a useful guide for harvesting appropriate bone grafts.
- MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- odběr tkání a orgánů metody MeSH
- os ilium * anatomie a histologie MeSH
- senioři MeSH
- transplantace kostí * metody MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Ormond's disease is a systemic autoimmune disease with serious complications. We present our retrospective analysis of 83 patients diagnosed with and treated for idiopathic retroperitoneal fibrosis (Ormond's disease) in our department from 1997 to 2023. In this retrospective study, we analysed the diagnostic approaches, the clinical history and surgical and immunosuppressive therapies, and their subsequent effects on our patients. Patients with established disease activity were given immunosuppressive treatment, using corticosteroids alone or in combination with azathioprine, in patients with exacerbation of the disease mycophenolate mofetil. Three patients with Ormond's disease and systemic complications (IgG4-related disease) were treated with rituximab. In the entire cohort, 83 patients received immunosuppressive therapy; the next 5 patients did not receive this treatment because they did not present inflammatory activity from the disease. In these 83 patients, computed tomography showed that immunosuppressive treatment resulted in partial or complete regression of the inflammatory infiltrate. Out of the 83 patients, 10 patients experienced disease exacerbation 7 and 24 months after the immunosuppressive treatment was discontinued. The follow-up ranged from 24 months to 26 years.
- MeSH
- dospělí MeSH
- imunosupresiva * terapeutické užití MeSH
- lidé středního věku MeSH
- lidé MeSH
- retroperitoneální fibróza * diagnóza farmakoterapie MeSH
- retrospektivní studie MeSH
- senioři MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Intersticiální high-dose rate brachyterapie (HDR BRT) představuje slibnou metodu léčby časného karcinomu penisu, která v mnoha případech slouží jako alternativa k primární chirurgické léčbě. Tato technika umožňuje zachování celistvosti penisu až u 80 % pacientů, kteří by jinak museli podstoupit radikální operaci. Výsledkem je nejen lepší kvalita života pacientů, ale také výrazně nižší výskyt psychických problémů spojených s léčbou. Důležitým přínosem je rovněž možnost zachování sexuálních funkcí na úrovni srovnatelné s obdobím před zahájením léčby.
Interstitial high-dose rate brachytherapy (HDR BRT) is a promising treatment method for early-stage penile cancer, which in many cases serves as an alternative to primary surgical treatment. This technique allows for the preservation of the penis integrity in up to 80% of patients who would otherwise require radical surgery. As a result, patients experience not only a better quality of life but also significantly fewer post-treatment psychological issues. An important benefit is also the ability to maintain sexual function at a level comparable to that before the treatment.
Úvod: Pleomorfný dermálny sarkóm (PDS) je zriedkavý malígny mezenchýmový nádor kože. Klinicky aj histogeneticky zdieľa podobné črty s atypickým fibroxantómom (AFX) a predpokladá sa, že tieto dva nádory predstavujú morfologické spektrum jednej neoplázie. Kazuistika: 60-ročný muž s anamnézou karcinómu hlasivky pozoroval niekoľko mesiacov rast ulcerovaného tumoru na koži kapilícia. Odstránený bol chirurgickou excíziou. Histologicky išlo o solídne rastúci mezenchýmový nádor pozostávajúci z atypických buniek epiteloidného a histiocytoidného vzhľadu. Na spodine infiltroval podkožný tuk a zasahoval až po hlbokú fasciu. Prítomná bola krvná cieva vyplnená nádorovým trombom. Imunohistochemicky exprimoval CD68, CD10, CD163, CD99 a sčasti aj αSMA a CD31. Nález zodpovedal PDS. Pacient absolvoval PET/CT vyšetrenie s negatívnym výsledkom. Krčné lymfatické uzliny neboli zväčšené. Vykonaná bola široká reexcízia miesta jazvy bez nádorových reziduí. Pacient je ďalej sledovaný, aktuálne bez známok recidívy. Záver: PDS predstavuje pre patológov diagnostickú výzvu. Najčastejšie vzniká u starých mužov na vlasatej časti hlavy a v tejto lokalite, typickej pre nemelanómovú rakovinu kože, predstavuje významnú diferenciálnu diagnózu. Jeho odlíšenie od histogeneticky a štrukturálne príbuzného, ale klinicky omnoho priaznivejšieho AFX môže byť veľmi obtiažne, ale z hľadiska ďalšej prognózy a klinického manažmentu pacienta zásadné.
Introduction: Pleomorphic dermal sarcoma (PDS) is a rare malignant mesenchymal tumor of the skin. It clinically and histogenetically shares similar features with atypical fibroxanthoma (AFX) and they are thought to represent the morphologic spectrum of one neoplasia. Case report: A 60-year-old man with a history of vocal cord carcinoma had observed an ulcerated skin tumor in the scalp growing for several months. It was removed by surgical excision. Histology revealed a solid mesenchymal tumor consisting of atypical cells population of epithelioid and histiocytoid appearance. At the base, it infiltrated the subcutaneous fat and extended into the deep fascia. A blood vessel filled with a tumor thrombus was found. The tumor was positive for CD68, CD10, CD163, CD99 and partly reactive for αSMA and CD31. The diagnosis of PDS was established. The patient underwent PET/CT examination with a negative result. The cervical lymph nodes were not enlarged. A wide re-excision of the scar region was performed without evidence of residual tumor. The patient continues to be monitored, currently without signs of recurrence. Conclusion: PDS represents a diagnostic challenge for pathologists. It mostly occurs in old men in the capillitium and in this location, which is typical for non-melanoma skin cancer, represents an important differential diagnosis. Its differentiation from the histogenetically and structurally related but clinically much more favorable AFX can be very difficult, but essential in terms of further prognosis and clinical management of the patient.
- MeSH
- histologické techniky MeSH
- imunohistochemie MeSH
- lidé středního věku MeSH
- lidé MeSH
- nádory kůže diagnóza patologie terapie MeSH
- sarkom * diagnóza patologie terapie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
