Lymfadenopatie je obecný název pro patologické změny ve velikosti a konzistenci lymfatické uzliny. Postižení lymfatické uzliny způsobené zánětlivým procesem je označováno pojmem lymfadenitida. Etiologie lymfadenitid je nejčastěji bakteriální nebo virová. Cesta infekce může být lymfogenním šířením, přímým mikrobiálním postižením uzliny, nebo se jedná o reaktivní změny. Mezi typické projevy onemocnění patří zvětšení uzliny, palpační citlivost, otok, někdy erytém okolní kůže nebo hnisavá sekrece. První diagnostika zahrnuje klinickou úvahu na základě anamnézy a fyzikálního vyšetření. Při potřebě jsou využívány laboratorní testy k potvrzení charakteru zánětu a k detekci infekčního agens. Na klinické vyšetření s hodnocením počtu a lokalizace lymfatických uzlin, jejich velikosti, pohyblivosti a palpační citlivosti navazuje ze zobrazovacích metod na prvním místě ultrasonografie, která slouží k přesnějšímu zhodnocení rozměrů, struktury a vaskularizace uzliny. Pouze při komplikovaných nálezech nebo diagnostických rozpacích užíváme v indikovaných případech i vyšetření počítačovou tomografií (CT) nebo magnetickou rezonancí (MR). Terapie lymfadenitid je primárně konzervativní. Při kolikvaci uzliny je nutná chirurgická intervence. U lymfadenitid chronických, rezistentních k terapii nebo je-li podezření na jinou etiologii lymfadenopatie, indikujeme podle klinické rozvahy punkční biopsii či exstirpaci.

Lymphadenopathy is the general name for pathological changes in the size and consistency of a lymph node. Lymph node involvement caused by an inflammatory process is termed lymphadenitis. The etiology of lymphadenitis is most often bacterial or viral. The route of infection may be by lymphogenous spread, direct microbial involvement of the lymph node, or reactive changes. Typical manifestations of the disease include lymph node enlargement, palpation tenderness, swelling, sometimes erythema of the surrounding skin or purulent secretion. Initial diagnosis involves clinical consideration based on history and physical examination. When necessary, laboratory tests are used to confirm the nature of the inflammation and to detect the infectious agent. The clinical examination with assessment of the number and location of lymph nodes, their size, mobility and palpation sensitivity is followed by ultrasonography, which is the first imaging modality used to more accurately assess the size, structure and vascularity of the lymph node. Only in the case of complicated findings or diagnostic confusion a computed tomography (CT) or magnetic resonance imaging (MRI) could be used when indicated. Therapy of lymphadenitis is primarily conservative. Surgical intervention is necessary in case of nodal colicvation. In chronic lymphadenitis, resistant to therapy or if another etiology of lymphadenopathy is suspected, puncture biopsy or extirpation is indicated according to clinical judgment.

• MeSH
• Diagnosis, Differential MeSH
• Child MeSH
• Communicable Diseases diagnosis   classification   microbiology   MeSH
• Neck * pathology   MeSH
• Humans MeSH
• Lymphadenitis * diagnostic imaging   diagnosis   etiology   drug therapy   classification   MeSH
• Lymphadenopathy diagnostic imaging   diagnosis   etiology   MeSH
• Lymph Nodes pathology   MeSH
• Check Tag
• Child MeSH
• Humans MeSH
• Publication type
• Research Support, Non-U.S. Gov't MeSH
• Review MeSH

Výživa hraje významnou roli v léčbě chronického onemocnění ledvin (CHOL). Jedním z hlavních cílů nutriční terapie CHOL je umožnění správného vývoje a růstu dětí. Vhodná výživa je zásadní pro terapii komplikací CHOL, obzvláště metabolické kostní nemoci. Zdravá, čerstvá a pestrá strava by měla být základem jídelníčku, příjem zpracovaných potravin by měly děti s CHOL významně omezit. Tento přehledový článek vychází z recentně publikovaných mezinárodních doporučení a shrnuje současný přístup k výživě dětí s CHOL.

Nutrition plays an important role in the management of chronic kidney disease (CKD). One of the main nutritional goals in children is to achieve normal growth and develop­ment. Adequate nutrition is crucial for proper management of CKD complications, especially metabolic bone disease. A healthy, fresh, and varied diet should form the basis of the meal plan, patients should significantly limit their intake of processed foods. This review is based on recently published international guidelines and summarizes the current approach to nutrition of children with CKD.

• MeSH
• Renal Insufficiency, Chronic * diagnosis   MeSH
• Child MeSH
• Potassium blood   MeSH
• Phosphorus blood   MeSH
• Nutrition Assessment MeSH
• Infant MeSH
• Humans MeSH
• Nutrition Therapy methods   MeSH
• Child, Preschool MeSH
• Diet, Food, and Nutrition MeSH
• Calcium blood   MeSH
• Recommended Dietary Allowances MeSH
• Check Tag
• Child MeSH
• Infant MeSH
• Humans MeSH
• Child, Preschool MeSH
• Publication type
• Review MeSH

Numulární ekzém je v pediatrické praxi relativně častý. Diagnostika a diferenciální diagnostika mohou být náročné. Předpokladem úspěchu je nejen správně zvolená a prováděná léčba, ale rovněž vhodná a pravidelná péče o kůži. Základními léky pro obnovení a udržení funkce kožní bariéry jsou emoliencia. Hlavními protizánětlivými léky jsou středně silné lokální kortikoidy s dobrým terapeutickým indexem. Způsob používání těchto extern je pro výsledek léčby stejně důležitý jako správná volba léku, proto jsou pro praxi krátce rozebrány strategie a režimy této léčby.

Nummular eczema is quite frequent in paediatric practice. Diagnostics and differential diagnostics can be challenging. Differential diagnosis is presented in a tabular overview. Right chosen and properly done treatment as well as appropriate and regular skin care are prerequisites for treatment success. Emollients are the basic drugs for restoring and maintaining skin barrier function. Topical corticosteroids of moderate strenght with good therapeutic index are the main anti-inflammatory drugs. The way, how these topicals are used, is for the result of therapy as important as the correct choice of drug, therefore the strategies and regimens of their use in practice are briefly discussed.

• Keywords
• nummular eczema in children,
• MeSH
• Dermatitis, Atopic diagnosis   etiology   drug therapy   MeSH
• Diagnosis, Differential MeSH
• Child MeSH
• Eczema * diagnosis   etiology   drug therapy   classification   MeSH
• Emollients administration & dosage   pharmacology   therapeutic use   MeSH
• Adrenal Cortex Hormones pharmacology   therapeutic use   MeSH
• Humans MeSH
• Disease Management MeSH
• Tinea diagnosis   etiology   drug therapy   MeSH
• Check Tag
• Child MeSH
• Humans MeSH
• Publication type
• Review MeSH

Výskyt průduškového astmatu (asthma bronchiale, dále jen astma) v dětském věku trvale v posledních dekádách v ekonomicky vyspělých zemích, kam se řadí i Česká republika, narůstá. Astma je nejčastější chronickou respirační chorobou dětského věku. Pokud je diagnóza stanovena včas a je včas zahájena účinná farmakoterapie, jejímž základem jsou inhalačními kortikosteroidy, a to bez ohledu na věk či fenotypy astmatu, je ve většině dosaženo plné kontroly astmatu. V podávání antiastmatik je preferována inhalační cesta, která je účinná, bezpečná, ale náročná na výběr správného inhalačního systému, nácvik správné inhalační techniky a na monitorování správné inhalační techniky.

The incidence of asthma in childhood has been steadily increasing in recent decades in economically developed countries, including the Czech Republic. Asthma is the most common chronic respiratory disease of childhood. If the diagnosis is made early and effective pharmacotherapy based on inhaled corticosteroids is initiated on time, regardless of age or asthma phenotypes, full asthma control is achieved in most cases. The inhalation route is preferred in the administration of antiasthmatic, which is effective, safe, but demanding in terms of choosing the right inhalation system, training the correct inhalation technique and monitoring the correct inhalation technique.

• MeSH
• Asthma * diagnosis   epidemiology   drug therapy   MeSH
• Bronchial Hyperreactivity diagnosis   drug therapy   physiopathology   MeSH
• Respiratory Therapy methods   MeSH
• Diagnosis, Differential MeSH
• Child MeSH
• Humans MeSH
• Disease Management MeSH
• Adolescent MeSH
• Respiratory Tract Diseases diagnosis   epidemiology   drug therapy   MeSH
• Respiratory Function Tests methods   MeSH
• Check Tag
• Child MeSH
• Humans MeSH
• Adolescent MeSH
• Publication type
• Review MeSH
• Geographicals
• Czech Republic MeSH

BACKGROUND: Liver glycogen storage disorders (GSDs) are rare inherited disorders of carbohydrate metabolism that are clinically characterized by hepatomegaly and fasting intolerance. This group of disorders comprises GSD Ia and Ib as well as the so-called ketotic GSDs including GSD III, VI, IX, XI and 0a. Although clinical practice guidelines exist for most GSD subtypes, diagnostics, treatment and monitoring differ significantly among metabolic centres. The aim of this study was to gain insight into current clinical practice for liver GSDs. METHODS: An international web-based survey was performed among health care professionals involved in the care of individuals with liver GSDs. RESULTS: Sixty-seven respondents from 28 different countries caring for approximately 2650 liver GSD patients completed the survey. While the diagnostic approach was generally consistent, significant differences among metabolic centres are still observed with respect to monitoring parameters and treatment approaches. Reasons for these differences are local availability of management tools and treatment options, the rarity of the different GSD subtypes, the experiences of health care professionals, and the existence of extreme phenotypes. CONCLUSION: The development of a standard set of outcomes for patients with liver GSDs is warranted as a reference for both daily care and the evaluation of safety and efficacy of future therapies. For various parameters that serve as valuable outcome measures, tools and target values should be better defined.

• MeSH
• Glycogen Storage Disease * therapy   diagnosis   MeSH
• Liver metabolism   pathology   MeSH
• Humans MeSH
• Disease Management MeSH
• Liver Diseases * therapy   diagnosis   MeSH
• Surveys and Questionnaires MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH

BACKGROUND: Patient safety in undergraduate nursing studies is an indispensable component of the curriculum. The process of experiential learning from practice is of high value not only in terms of personal development but also enables students to identify and address critical areas of patient safety that require improvement. AIM: To explore Czech undergraduate nursing students' perceptions of patient safety culture during clinical practice through a mixed-method sequential study. METHODS: Data were collected between 2021 and 2024 using a mixed-method approach. The quantitative phase utilised the hospital survey on patient safety culture for nursing students. Four hundred and eighty-two undergraduate nursing students from 16 faculties across the Czech Republic participated. The subsequent qualitative phase employed semi-structured interviews with 12 undergraduate nursing students from one faculty in the Czech Republic. Descriptive and inferential statistical methods were used to analyse quantitative results, complemented by a reflective thematic analysis of qualitative data. RESULTS: The most negatively rated survey dimensions were 'Frequency of events reported' (37.0%) and 'Nonpunitive responses to errors' (42.4%). Predictors for reporting adverse events in clinical practice were 'Indicators of good practice' (p ≤ 0.05). Based on the quantitative phase, the interpretive journey of nursing students' experiences from Exposure to adverse events, through Feeling disconnected and Cognitive dissonance, to the necessity of Speaking up for patient safety culture was captured in the qualitative phase. CONCLUSIONS: Nursing students struggle to engage in a patient safety culture, particularly in reporting adverse events during clinical practice. Strengthening education on reporting and standards is essential for students, along with professional development for clinical staff to align practices and cultures.

• MeSH
• Patient Safety * standards   MeSH
• Adult MeSH
• Qualitative Research MeSH
• Humans MeSH
• Young Adult MeSH
• Attitude of Health Personnel * MeSH
• Surveys and Questionnaires MeSH
• Students, Nursing * psychology   MeSH
• Education, Nursing, Baccalaureate MeSH
• Check Tag
• Adult MeSH
• Humans MeSH
• Young Adult MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Geographicals
• Czech Republic MeSH

T-cell engagers represent a transformative approach to cancer immunotherapy leveraging bispecific and multispecific antibody constructs to redirect T-cell cytotoxicity toward malignant cells. These molecules bridge T cells and tumor cells by simultaneously binding CD3 on T cells and tumor-associated antigens on cancer cells, thereby enabling precise immune targeting even in immunologically "cold" tumors. Recent advancements include conditional T-cell engagers activated by tumor microenvironment proteases to minimize off-tumor toxicity as well as T-cell receptor-based engagers targeting intracellular antigens via MHC presentation. Clinical successes, such as Kimmtrak in metastatic uveal melanoma, underscore good potential of these modalities, while challenges persist in the management of cytokine release syndrome, neurotoxicity, and tumor resistance. Emerging multispecific engagers are aimed at enhancing efficacy via incorporation of costimulatory signals, thus offering a promising trajectory for next-generation immunotherapies. T-cell engagers are also gaining attention in the treatment of autoimmune disorders, where they can be designed to selectively modulate pathogenic immune responses. By targeting autoreactive T or B cells, T-cell engagers hold promise for restoring immune tolerance in such conditions as HLA-B*27-associated autoimmunity subtypes, multiple sclerosis, rheumatoid arthritis, and type 1 diabetes mellitus. Engineering strategies that incorporate inhibitory receptors or tissue-specific antigens may further refine T-cell engagers' therapeutic potential in autoimmunity, by minimizing systemic immunosuppression while preserving immune homeostasis.

• MeSH
• Immunotherapy * methods   MeSH
• Humans MeSH
• Tumor Microenvironment immunology   MeSH
• Neoplasms * immunology   therapy   MeSH
• Antibodies, Bispecific therapeutic use   immunology   MeSH
• Receptors, Antigen, T-Cell immunology   metabolism   MeSH
• T-Lymphocytes * immunology   metabolism   MeSH
• Animals MeSH
• Check Tag
• Humans MeSH
• Animals MeSH
• Publication type
• Journal Article MeSH
• Review MeSH

INTRODUCTION: Studies indicate that chronic treatment with mucoactive drugs may reduce COPD exacerbation rates. This real-world, multicenter, prospective, observational study aimed to determine the effect of long-term mucoactive treatment on exacerbations in patients with COPD in the Czech Republic. METHODS: 452 adult patients on the Czech Multicenter Research Database of COPD with post-bronchodilator FEV1 ≤ 60% of predicted value received standard of care and were followed up for 5 years. For the first 24 months, 81 patients received regular thiol-based mucoactive drugs (77 erdosteine, 4 N-acetylcysteine) at the discretion of the treating physician and 371 patients had no mucoactive treatment (control group). Erdosteine was fully reimbursed, and NAC was partially reimbursed for COPD patients. The annual number/rate of COPD exacerbations over 5 years was monitored. RESULTS: Patients receiving mucoactive treatment for 24 months had a significantly larger reduction from baseline in all exacerbations compared to the control group (- 0.61 vs - 0.18, p = 0.026; - 0.54 vs - 0.09, p = 0.007; - 0.55 vs 0.04, p = 0.005; - 0.67 vs 0.13, p = 0.002; - 0.53 vs 0.10, p = 0.019 in the first to fifth year, respectively). The reduction in moderate exacerbations was also significantly larger in those receiving mucoactive treatment versus no mucoactive treatment. The exacerbation rate was reduced to a greater extent in the subgroups with cough or with stage 3‒4 COPD who received mucoactive treatment but was independent of the use of inhaled corticosteroids (ICS). CONCLUSION: Mucoactive treatment for two years reduced the number of COPD exacerbations (all, moderate) over five years of follow-up. The reduction in exacerbations was more pronounced in patients with cough or with stage 3‒4 COPD but was independent of the use of ICS.

• MeSH
• Acetylcysteine * therapeutic use   MeSH
• Time Factors MeSH
• Pulmonary Disease, Chronic Obstructive * drug therapy   physiopathology   diagnosis   MeSH
• Expectorants * therapeutic use   MeSH
• Middle Aged MeSH
• Humans MeSH
• Follow-Up Studies MeSH
• Disease Progression MeSH
• Prospective Studies MeSH
• Aged MeSH
• Forced Expiratory Volume MeSH
• Treatment Outcome MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Multicenter Study MeSH
• Observational Study MeSH
• Geographicals
• Czech Republic MeSH

JBI has long held the view that an inclusive approach to the conceptualization of what counts as evidence is important to the evidence-based movement. JBI's approach for appraising textual evidence had encompassed all forms of text (narrative, opinion, and policy), with one general tool used to guide critical appraisal. The proliferation of textual evidence and increase in textual evidence reviews demonstrate the need to reconceptualize JBI's methodological approach to critically appraising textual evidence. The objective of this paper is to outline the updated methodological approach to systematic reviews of textual evidence, especially in relation to the development of 3 separate critical appraisal tools for narrative, expert opinion, and policy text. Using an adapted Delphi approach, the JBI Textual Evidence Methodology Group convened over several rounds of meetings and discussions with international experts to reach consensus on the reconceptualization of critical appraisal tools for textual evidence sources. Strategies to effectively interrogate the legitimacy and authenticity of sources were found to be dependent upon the type of textual evidence under review. Therefore, 3 separate critical appraisal tools for narrative, expert opinion, and policy text were developed. This paper provides an overview of the development of 3 separate critical appraisal tools, highlighting the complex nature of textual evidence data sources.

• MeSH
• Delphi Technique MeSH
• Humans MeSH
• Evidence-Based Medicine * methods   MeSH
• Periodicals as Topic MeSH
• Review Literature as Topic MeSH
• Editorial Policies MeSH
• Systematic Reviews as Topic MeSH
• Narration MeSH
• Research Design MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH

Publikace obsahuje práci přednesenou na kongresu, který se zaměřil na roli biomarkerů u Alzheimerovy nemoci. Určeno odborné veřejnosti.

• MeSH
• Alzheimer Disease MeSH
• Biomarkers MeSH
• Publication type
• Congress MeSH
• News MeSH

• Conspectus
• Patologie. Klinická medicína
• NML Fields
• neurologie