The WAA registry has been active since 2002. It allows bed side registration of safety and efficacy data. The data each center enters is accessible for its own use but also used for merged analysis. Most types of procedures are represented. Treatments of many severe diseases as well as the collection of autologous and donor cells for therapeutic use especially in oncologic diseases are recorded. Previous reports have shown a successive reduction in adverse events (AE) over the years. The aim of the present report is to update data of the risk for AE during the years from 2013 to Oct 2024. Contributions of 44 centers from 20 countries were analysed. Over these years, more than 169,000 apheresis procedures have been registered in more than 26,000 patients. During the study period the mean incidence of AE, merged for all types of procedures, was 1.6 /100 procedures for mild, 2.0/100 for moderate and 0.20/100 for severe AE, and reduced since 2013. Since 2002, death due to apheresis could not be excluded in one patient. There was an increased risk of hypotension during apheresis in patients with neurological diagnoses (ICD-10 chapter G) versus those with diseases of the musculoskeletal or connective tissue (ICD-10 chapter M) and vice versa for urticaria and tingling. In conclusion, the present data show the risk for various degrees of AE in apheresis procedures. Many patients suffer from severe illness and apheresis is often offered as a rescue therapy. Although the risk of death due to the apheresis procedure is extremely rare the concomitant severe disease itself poses a risk for severe events.

• MeSH
• lidé MeSH
• registrace * MeSH
• separace krevních složek * škodlivé účinky   metody   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

Prostate cancer (PCa) and Type 2 diabetes (T2D) often co-occur, yet their relationship remains elusive. While some studies suggest that T2D lowers PCa risk, others report conflicting data. This study investigates the effects of peroxisome proliferator-activated receptor (PPAR) agonists Bezafibrate, Tesaglitazar, and Pioglitazone on PCa tumorigenesis. Analysis of patient datasets revealed that high PPARG expression correlates with advanced PCa and poor survival. The PPARγ agonists Pioglitazone and Tesaglitazar notably reduced cell proliferation and PPARγ protein levels in primary and metastatic PCa-derived cells. Proteomic analysis identified intrinsic differences in mTORC1 and mitochondrial fatty acid oxidation (FAO) pathways between primary and metastatic PCa cells, which were further disrupted by Tesaglitazar and Pioglitazone. Moreover, metabolomics, Seahorse Assay-based metabolic profiling, and radiotracer uptake assays revealed that Pioglitazone shifted primary PCa cells' metabolism towards glycolysis and increased FAO in metastatic cells, reducing mitochondrial ATP production. Furthermore, Pioglitazone suppressed cell migration in primary and metastatic PCa cells and induced the epithelial marker E-Cadherin in primary PCa cells. In vivo, Pioglitazone reduced tumor growth in a metastatic PC3 xenograft model, increased phosho AMPKα and decreased phospho mTOR levels. In addition, diabetic PCa patients treated with PPAR agonists post-radical prostatectomy implied no biochemical recurrence over five to ten years compared to non-diabetic PCa patients. Our findings suggest that Pioglitazone reduces PCa cell proliferation and induces metabolic and epithelial changes, highlighting the potential of repurposing metabolic drugs for PCa therapy.

• MeSH
• hypoglykemika * farmakologie   MeSH
• lidé MeSH
• metabolické přeprogramování MeSH
• mitochondrie metabolismus   účinky léků   MeSH
• myši MeSH
• nádorové buněčné linie MeSH
• nádory prostaty * metabolismus   farmakoterapie   patologie   MeSH
• pioglitazon * farmakologie   MeSH
• pohyb buněk účinky léků   MeSH
• PPAR gama * agonisté   metabolismus   MeSH
• proliferace buněk účinky léků   MeSH
• xenogenní modely - testy protinádorové aktivity MeSH
• zvířata MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• myši MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH

The ABCB1 gene, encoding the ATP-dependent translocase ABCB1, plays a crucial role in the clearance of amyloid-beta (Aβ) peptides and the transport of cholesterol, implicating it in the pathogenesis of Alzheimer's disease. The study aims to investigate the association between polymorphisms in the ABCB1 gene and cognitive decline in individuals with mild cognitive impairment (MCI), particularly focusing on language function. A longitudinal cohort study involving 1 005 participants from the Czech Brain Aging Study was conducted. Participants included individuals with Alzheimer's disease, amnestic MCI, non-amnestic MCI, subjective cognitive decline, and healthy controls. Next-generation sequencing was utilized to analyze the entire ABCB1 gene. Cognitive performance was assessed using a comprehensive battery of neuropsychological tests, including the Boston Naming Test and the semantic verbal fluency test. Ten ABCB1 polymorphisms (rs55912869, rs56243536, rs10225473, rs10274587, rs2235040, rs12720067, rs12334183, rs10260862, rs201620488, and rs28718458) were significantly associated with cognitive performance, particularly in language decline among amnestic MCI patients. In silico analyses revealed that some of these polymorphisms may affect the binding sites for transcription factors (HNF-3alpha, C/EBPβ, GR-alpha) and the generation of novel exonic splicing enhancers. Additionally, polymorphism rs55912869 was identified as a potential binding site for the microRNA hsa-mir-3163. Our findings highlight the significant role of ABCB1 polymorphisms in cognitive decline, particularly in language function, among individuals with amnestic MCI. These polymorphisms may influence gene expression and function through interactions with miRNAs, transcription factors, and alternative splicing mechanisms.

• MeSH
• Alzheimerova nemoc genetika   MeSH
• jednonukleotidový polymorfismus * MeSH
• kognitivní dysfunkce * genetika   MeSH
• lidé MeSH
• longitudinální studie MeSH
• neuropsychologické testy MeSH
• P-glykoproteiny genetika   MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• vysoce účinné nukleotidové sekvenování MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH

Atrial fibrillation (AF) is the most common arrhythmia experienced by critically ill patients. It has been associated with adverse short-and long-term outcomes, including an increased risk of thromboembolic events, heart failure, and death. Due to complex and multifactorial pathophysiology, a heterogenous patient population, and a lack of clinical tools for risk stratification validated in this population, AF in critical illness is challenging to predict, prevent, and manage. Personalized management strategies that consider patient factors such as underlying cardiac structure and function, potentially reversible arrhythmogenic triggers, and risk for complications of AF are needed. Furthermore, evaluation of the effects of these interventions on long-term outcomes is warranted. Critical illness survivors who have had AF represent a unique population who require systematic follow-up after discharge. However, the frequency, type, and intensity of follow-up is unknown. This state-of-the-art review aims to summarize the evidence, contextualize the current guidelines within the setting of critical illness, and highlight gaps in knowledge and research opportunities to further our understanding of this arrhythmia and improve patient outcomes.

• MeSH
• fibrilace síní * terapie   patofyziologie   komplikace   MeSH
• hodnocení rizik MeSH
• kritický stav * terapie   MeSH
• lidé MeSH
• rizikové faktory MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

Purpose: Monkeypox, an orthopoxvirus with zoonotic origins, has emerged as a global health concern due to recent outbreaks outside of endemic regions. Pregnant and lactating individuals are particularly vulnerable to potential complications, emphasizing the need for targeted prevention and management approaches. Methods: This review explores the clinical presentation, impact, diagnostic methods, and treatment options for monkeypox in pregnant and lactating populations, with a focus on safety, effectiveness, and prevention strategies. Results: The review synthesizes current literature on monkeypox, specifically addressing supportive care, antiviral therapy, natural remedies, vaccination, and infection control practices. Special considerations for maternal and fetal health are discussed, along with preventive guidelines to minimize transmission risks. Supportive care is the primary management approach, with antivirals like Tecovirimat and Brincidofovir considered in severe cases. Conclusion: While vaccination offers preventive protection, strict hygiene and protective measures are crucial in healthcare and community settings. For lactating mothers, expressed milk and alternative feeding methods can mitigate transmission risks. Effective management of monkeypox in pregnant and lactating individuals requires a balanced approach that prioritizes maternal and infant safety. Further targeted research is needed to identify the specific impact of the virus on pregnancy outcomes and breastfeeding practices.

Kritériá mozgovej smrti sú medicínsky a legislatívne akceptované vo svete už viac ako polstoročie. Cieľom predkladaného článku je definovať legislatívny rámec diagnostiky smrti mozgu a postup diagnostiky v Slovenskej a Českej republike. V diskusii na základe súčasných vedeckých poznatkov bližšie rozoberáme predpoklady a kontraindikácie diagnostiky smrti mozgu.

The criteria for brain death have been medically and legally accepted worldwide for more than half a century. The aim of the presented article is to describe the legal framework for brain death diagnostics and the diagnostic procedure in the Slovak and Czech Republics. In the discussion, based on current scientific knowledge, we further analyze the preconditions and contraindications for brain death diagnostics.

• MeSH
• kontraindikace MeSH
• lidé MeSH
• mozková smrt * diagnóza   zákonodárství a právo   MeSH
• neurologické vyšetření MeSH
• zákonodárství jako téma MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• přehledy MeSH
• Geografické názvy
• Česká republika MeSH
• Slovenská republika MeSH

Smrt mozku definujeme jako stav po katastrofálním poškození mozku s trvalou nevratnou ztrátou všech funkcí celého mozku, včetně kmene. Stanovení diagnózy je založeno na klinickém vyšetření, kdy je zcela nepřípustná falešná negativita jednotlivých testů, které podporují ireverzibilní postižení mozkového kmene od mesencefala (fotoreakce) přes pons Varoli (korneální, okulocefalický reflex a algické podráždění v obličeji) až po prodlouženou míchu (dávivý a kašlací reflex). V současné době není jasně stanovena metodika provedení jednotlivých vyšetření. Tento článek pojednává o základním klinickém vyšetření při stanovení smrti mozku a apnoickém testu. Součástí publikace je rovněž soubor videí, která ukazují pozitivní nález při stanovení smrti mozku (čili areflexii) a nález, který není kompatibilní se smrtí mozku (přítomnost normální odpovědi).

We define brain death as a condition following catastrophic brain injury with permanent irreversible loss of all functions of the entire brain, including the brain stem. Diagnosis is based on clinical examination, where are completely unacceptable false negative individual tests that support irreversible brainstem involvement from the mesencephalon (photoreaction) to the pons Varoli (corneal, oculocephalic reflex and facial alginic irritation) to the medulla oblongata (gag and cough reflex). At present, the methodology for performing each exa­mination is not clearly established. This article discusses the basic clinical examination in the determination of brain death and the apnea test. The publication also includes a set of videos that show a positive finding in the determination of brain death (absence of reflex) and a finding that is not compatible with brain death (presence of a normal response).

• Klíčová slova
• apnoický test, funkce mozkového kmene, reflexy mozkového kmene,
• MeSH
• diagnostické techniky neurologické MeSH
• lidé MeSH
• mozková smrt * diagnóza   MeSH
• mozkový kmen MeSH
• neurologické vyšetření MeSH
• reflex MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• přehledy MeSH

Povinnost i podmínky potvrzujících vyšetření smrti mozku jsou dány legislativou příslušné země. Potvrzující vyšetření nepřipouští eventualitu falešné pozitivity (potvrzení smrti u žijícího jedince). Je žádoucí, aby metodika vyšetření i hodnocení byla jasná, přesná a jednotná. Metodika sluchových evokovaných odpovědí (BAEP) vychází z oficiálních mezinárodních doporučení a je přizpůsobena pro podmínky jednotek intenzivní péče. Vyšetření BAEP před rozvojem kraniokaudální deteriorace nebo rozšíření o somatosenzorické evokované odpovědi n. medianus zvyšují spolehlivost (senzitivitu) potvrzujícího vyšetření provedeného po splnění všech klinických podmínek diagnózy smrti mozku dle neurologických kritérií "brain death / death by neurological criteria".

The obligation and conditions of confirmatory brain death examinations are determined by the legislation of the respective country. Ancillary examinations do not allow for the possibility of a false positive (confirmation of death in a living individual). It is desirable that the methodology of examination and evaluation is clear, precise and uniform. The methodology of auditory evoked responses (BAEP) is based on official international recommendations and is adapted to intensive care unit (ICU) conditions. BAEP examination before the development of craniocaudal deterioration or augmentation with median nerve somatosensory evoked responses (SEP) increases the reliability (sensitivity) of ancillary testing performed after all clinical conditions for a diagnosis of brain death according to neurological criteria (BD/DNC) have been met.

• Klíčová slova
• potvrzující vyšetření,
• MeSH
• elektrodiagnostika metody   MeSH
• evokované potenciály MeSH
• lidé MeSH
• mozková smrt * diagnóza   MeSH
• sluchové kmenové evokované potenciály MeSH
• somatosenzorické evokované potenciály MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• přehledy MeSH

Smrť mozgu zostáva klinickou diagnózou, vo väčšine prípadov založenou na klinickej diagnostike. Doplnkové testy vrátane zobrazovacích vyšetrení sa používajú na potvrdenie absencie cerebrálnej perfúzie, keď sú klinické nálezy nejednoznačné. Zobrazovacie metódy ako DSA, perfúzna scintigrafia a transkraniálny Doppler môžu poskytnúť kľúčové, zákonom vyžadované údaje na podporu diagnózy. Napriek prebiehajúcim snahám neexistuje celosvetový konsenzus o optimálnom doplnkovom teste a prax sa líši podľa regiónov. Moderné vyšetrenia ako CT angiografia (CTA), MR techniky, CT perfúzia a časovo invariantná CTA ponúkajú stále presnejšie výstupy. Je však potrebná ich ďalšia validácia, zvlášť v prípade pediatrických pacientov. Včasná diagnóza smrti mozgu minimalizuje zbytočné výkony a umožňuje následný efektívny transplantačný program.

Brain death remains a clinical diagnosis, based mainly on clinical criteria. Ancillary tests, including diagnostic imaging, are used to confirm the absence of cerebral perfusion when clinical findings are inconclusive. Imaging methods like DSA, perfusion scintigraphy and transcranial Doppler can provide critical, legally required data to support the diagnosis. Despite ongoing efforts, there is no global consensus on the optimal ancillary test, with practices varying by the region. Modern techniques like CT angiography (CTA), MR imaging, CT perfusion and time-invariant CTA, offer increasingly accurate outcomes. However, further validation is needed, particularly for pediatric patients. Early brain death diagnosis is crucial to avoid unnecessary interventions and to support timely organ transplantation.

• MeSH
• diagnostické zobrazování metody   MeSH
• lidé MeSH
• mozková smrt * diagnostické zobrazování   MeSH
• neurozobrazování metody   MeSH
• radioisotopová scintigrafie metody   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• přehledy MeSH

Generalizovaná myasténia gravis (gMG) predstavuje závažné ochorenie, ktoré pri chýbajúcej liečbe môže viesť k bezprostrednému ohrozeniu života a/alebo zníženiu kvality života. K narušeniu kvality života pacienta môže prostredníctvom nepríjemných a/alebo závažných nežiaducich účinkov (NÚ) viesť aj samotná liečba i pri výbornom liečebnom efekte. V súčasnosti v najnovších odporúčaniach pre liečbu gMG je očividná veľmi markantná snaha o identifikáciu pacientov s vysokoaktívnou gMG, u ktorých je potrebná včasná eskalácia liečby s cieľom navodiť rýchlu kontrolu príznakov gMG a skoré zlepšenie kvality života, pokiaľ možno s čo najnižšou frekvenciou a intenzitou NÚ liečby.

Generalized myasthenia gravis (gMG) is a severe disease leading to risk of immediate life threatening and/or quality of life reduction in case of missing treatment. Even with an excellent therapeutic effect of conventional treatment, the treatment itself can lead to patient's quality of life worsening through unpleasant and/or serious adverse effects (AEs). Currently, in the latest recommendations for the gMG treatment, there is a very striking effort to identify patients with highly active gMG in whom early treatment escalation is needed in order to induce rapid gMG symptoms control and quality of life improvement, preferably with as little frequency and intensity of AEs as possible.

• Klíčová slova
• generalized highly active myasthenia gravis, refractory MG, control of MG symptoms, generalizovaná vysokoaktívna myasténia gravis, refraktérna MG, kontrola príznakov MG,
• MeSH
• lidé MeSH
• management nemoci MeSH
• myasthenia gravis * klasifikace   terapie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• přehledy MeSH