INTRODUCTION: It has been shown that general intensive care nurses are able to perform an examination of the deep venous system of the lower extremities for the diagnosis of proximal deep vein thrombosis (DVT) using a compression ultrasound test with a high degree of reliability. (Skulec et al. in Eur J Intern Med 76:130-131, 2020) Another challenge for the use of vascular point-of-care ultrasound in intensive care is the diagnosis of central venous catheter-related thrombosis. It is a common problem that is often underdiagnosed. Due to the simplicity of the examination and the possible link with nursing care of inserted central venous catheters, this may be another potential diagnostic competency for critical care nurses. METHODOLOGY: Before the start of the study, each nurse participating in the study completed a two-hour training in duplex ultrasonography and examined 5 patients under supervision. Then patients in the intensive care unit (ICU) included in the study, underwent a duplex ultrasound performed by a nurse. Within 24 h, the examination was repeated by the ICU doctor. In the case of catheter insertion into the internal jugular vein (VJI) or the subclavian vein (VSC), the jugular vein, subclavian vein, and axillary vein (VA) were examined bilaterally. When the catheter was inserted into the femoral vein (VF), the patients were subjected to a duplex ultrasound of the femoral vein and the popliteal vein (VP) of both lower limbs. The examination results of each patient were blinded until both tests were performed. Calculations were used to evaluate the reliability of the test. RESULT: A total of 160 patients aged 62.9 ± 12.3 years were included. In our sample, the prevalence of CRT was found to be 41%. The overall sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of examinations performed by general intensive care nurses were 90.8%, 97.1%, 91.8%, 96.8%, and 95.5%, respectively. CONCLUSION: The results of our study suggest that general ICU nurses are able to perform inpatient CRT duplex ultrasound with excellent specificity but only moderate sensitivity after a short, predefined training.

• MeSH
• dospělí MeSH
• duplexní dopplerovská ultrasonografie * metody   MeSH
• jednotky intenzivní péče MeSH
• katetrizace centrálních vén * škodlivé účinky   MeSH
• klinické kompetence MeSH
• lidé středního věku MeSH
• lidé MeSH
• ošetřovatelská péče o pacienty v kritickém stavu * MeSH
• reprodukovatelnost výsledků MeSH
• senioři MeSH
• vena subclavia diagnostické zobrazování   MeSH
• venae jugulares diagnostické zobrazování   MeSH
• žilní trombóza * diagnostické zobrazování   etiologie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

Antibiotic resistance is one of the biggest threats to global health. Fungal endophytes are important sources of active natural products with antimicrobial potential. The purpose of this study was to characterize the endophytes coexisting with Helichrysum oocephalum, evaluate their antimicrobial activities, and annotate the endophytes metabolites. Six fungal species, including Fusarium avenaceum and Fusarium tricinctum, were identified. Endophytes were cultured, and their metabolites were extracted. The antimicrobial effects of the extracts were tested against Staphylococcus aureus, Bacillus cereus, Staphylococcus epidermidis, Pseudomonas aeruginosa, Escherichia coli, and Candida albicans. In addition, anti-biofilm effects of the extracts were examined against P. aeruginosa and S. epidermidis. The metabolites in the most active extract were annotated on the basis of the LC-ESI-QToF-MS/MS data. In anti-biofilm studies, F. avenaceum extract was effective in destroying and inhibiting the biofilm formation of S. epidermidis. LC-MS analysis showed that most of the identified compounds in the active extracts were enniatins (cyclic hexadepsipeptides). However, apicidin derivatives were also annotated. Our results revealed that these endophytes, especially Fusarium species, have antimicrobial activity against S. aureus, B. cereus, and C. albicans and anti-biofilm activity against S. epidermidis. According to the literature, the observed antimicrobial activity can be attributed to the enniatins. However, further phytochemical and pharmacological studies are necessary in this regard.

• MeSH
• antibakteriální látky * farmakologie   izolace a purifikace   chemie   MeSH
• antifungální látky * farmakologie   izolace a purifikace   chemie   MeSH
• antiinfekční látky * farmakologie   izolace a purifikace   chemie   MeSH
• Bacillus cereus účinky léků   MeSH
• biofilmy účinky léků   MeSH
• Candida albicans účinky léků   MeSH
• endofyty * chemie   metabolismus   izolace a purifikace   MeSH
• Escherichia coli účinky léků   MeSH
• Fusarium * chemie   metabolismus   MeSH
• mikrobiální testy citlivosti MeSH
• Pseudomonas aeruginosa účinky léků   MeSH
• Staphylococcus aureus účinky léků   MeSH
• Staphylococcus epidermidis účinky léků   MeSH
• tandemová hmotnostní spektrometrie MeSH
• Publikační typ
• časopisecké články MeSH

BACKGROUND: Avoiding conization may reduce the risk of pre-term labor in future pregnancies, making conservative treatment of high-grade cervical dysplasia an increasingly discussed approach, especially for younger patients. However, data on the integration of individual predictive factors into routine clinical practice remain limited. PRIMARY OBJECTIVE: The primary objective of the Regression of High-Grade Squamous Intraepithelial Cervical Lesions and Associated Risk Factors (RECER) study is to assess the rate of spontaneous regression in high-grade cervical squamous dysplasia (cervical intraepithelial neoplasia [CIN] 2 and 3) and identify associated predictive factors within clinical practice, without necessitating conization. STUDY HYPOTHESIS: We hypothesize that the characterization of cervical lesions, including colposcopic findings and patient-specific factors, along with a sufficient rate of spontaneous regression, will aid in identifying a subgroup of patients who may derive the greatest benefit from conservative management of high-grade cervical lesions. TRIAL DESIGN: The RECER trial is a multi-center prospective cohort study. Patients with histologically confirmed high-grade squamous intraepithelial lesions (CIN 2 or 3) undergo colposcopic assessments every 4 months. Colposcopic images are compared to evaluate lesion dynamics. In case of progression, conization is indicated, whereas in case of regression, documentation of a biopsy with low-grade dysplasia (CIN 1) or no dysplasia is required. Patients with stable disease are further followed up. MAJOR INCLUSION/EXCLUSION CRITERIA: Patients aged 18 to 40 years with bioptically confirmed high-grade lesion (CIN 2 or 3), a fully visible squamo-columnar junction, and a willingness to undergo conservative management can be included. Excluded are patients with unsatisfactory colposcopy, pregnancy, glandular lesions, invasive disease, or a history of treatment for severe cervical dysplasia. PRIMARY ENDPOINT: The primary end point is the regression rate of high-grade cervical dysplasia. SAMPLE SIZE: 300 patients ESTIMATED DATES FOR COMPLETING ACCRUAL AND PRESENTING RESULTS: As of October 2024, a total of 127 patients have been recruited from 4 participating sites across 3 countries. Estimated date of last patient enrollment: September 2026; estimated date for results presentation: January 2028. TRIAL REGISTRATION: Clinicaltrials.gov: NCT06147388.

• MeSH
• dlaždicová intraepiteliální léze cervixu * diagnóza   patologie   MeSH
• dospělí MeSH
• dysplazie děložního hrdla * diagnóza   patologie   MeSH
• kolposkopie MeSH
• konizace děložního čípku škodlivé účinky   MeSH
• lidé MeSH
• mladý dospělý MeSH
• multicentrické studie jako téma MeSH
• nádory děložního čípku * diagnóza   patologie   prevence a kontrola   MeSH
• pozorovací studie jako téma MeSH
• prospektivní studie MeSH
• rizikové faktory MeSH
• spontánní remise * MeSH
• stupeň nádoru MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mladý dospělý MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• protokol klinické studie MeSH

BACKGROUND: Breast reconstruction following prophylactic mastectomy in women with ptotic or hypertrophic breasts often poses challenges. We describe a combined technique of large-volume fat grafting (>100 mL) and an inferior dermal flap, aiming to improve aesthetic outcomes and patient satisfaction. METHODS: We conducted a retrospective analysis of 21 patients undergoing immediate breast reconstruction with the described technique. All patients were asked to complete the BREAST-Q questionnaire preoperatively and at least 12 months postoperatively (median interval: 20 months). Statistical analysis (Wilcoxon signed-rank test) was used to assess changes in satisfaction and well-being; aesthetic outcomes were scored by an independent, multidisciplinary team. RESULTS: Among 13 patients with complete BREAST-Q data, satisfaction with the breasts increased significantly from a median score of 38-85 (p = 0.002), psychosocial well-being from 57-70 (p = 0.045), and physical well-being (chest) from 68 to 81 (p = 0.045). Sexual well-being rose from 47-63 (p = 0.023). Aesthetic evaluation by an independent panel showed notable improvements in breast symmetry, shape, and overall appearance. Minimal and asymptomatic fat necroses or oil liponecrotic pseudocysts were observed. CONCLUSIONS: Combining large-volume fat grafting with an inferior dermal flap appears promising for women with ptotic breasts, yielding high satisfaction and low complication rates. Despite requiring multiple operative stages, this autologous reconstruction technique may offer a less invasive alternative for high-risk patients seeking natural outcomes without implants.

• MeSH
• chirurgické laloky * MeSH
• dospělí MeSH
• estetika MeSH
• kohortové studie MeSH
• lidé středního věku MeSH
• lidé MeSH
• mamoplastika * metody   MeSH
• nádory prsu * prevence a kontrola   chirurgie   MeSH
• profylaktická mastektomie * MeSH
• prsy chirurgie   patologie   MeSH
• průzkumy a dotazníky MeSH
• retrospektivní studie MeSH
• senioři MeSH
• spokojenost pacientů MeSH
• tuková tkáň * transplantace   MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

INTRODUCTION: Photon-counting detector (PCD) CT represents a major advancement in CT imaging, offering improved image quality and reduced radiation dose compared to traditional energy-integrating detector (EID) CT. This study compared image quality and radiation dose using a self-controlled approach, while evaluating the impact of patient positioning. METHODS: This retrospective study analyzed data from 200 patients who underwent abdominal CT scans on both EID (Somatom Definition Flash) and PCD (Naeotom Alpha) scanners. After applying inclusion criteria for proper positioning (within ±20 mm) and stable anatomical conditions, 119 patients were included. Radiation doses were assessed using CTDIvol, and image quality was evaluated via CT numbers, noise levels, signal-to-noise ratio (SNR), SNR to dose (SNRD), and contrast-to-noise ratio to dose (CNRD). RESULTS: The study found a median radiation dose reduction of 37 % with PCD CT compared to EID CT (p < 0.05). Image quality assessments revealed significant improvements with PCD CT, including reduced noise levels (up to 31 % in contrast-enhanced organs) and enhanced SNRD (33-51 % increase). CNRD improved by 60-76 %, indicating superior imaging performance of PCD CT. However, 36 % of patients on EID were positioned outside the ±20 mm range, which could adversely affect image quality and radiation dose, underscoring the need for more precise patient positioning. CONCLUSION: This study confirms that PCD CT achieves substantial reductions in radiation dose while enhancing image quality. However, accurate patient positioning is crucial to fully optimize these benefits. Automated tools that ensure proper positioning may be necessary to consistently maintain image quality and reduce radiation exposure. IMPLICATIONS FOR PRACTICE: PCD CT offers improved patient safety and diagnostic imaging. Automated positioning tools are essential to optimize and consistently maintain image quality and minimize radiation exposure.

• MeSH
• dávka záření * MeSH
• dospělí MeSH
• fotony MeSH
• lidé středního věku MeSH
• lidé MeSH
• počítačová rentgenová tomografie * metody   MeSH
• polohování pacienta * metody   MeSH
• poměr signál - šum MeSH
• rentgendiagnostika břicha * metody   MeSH
• retrospektivní studie MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• srovnávací studie MeSH

PDGFRA is crucial to tumorigenesis and frequently genomically altered in high-grade glioma (HGG). In a comprehensive dataset of pediatric HGG (n = 261), we detect PDGFRA mutations and/or amplifications in 15% of cases, suggesting PDGFRA as a therapeutic target. We reveal that the PDGFRA/KIT inhibitor avapritinib shows (1) selectivity for PDGFRA inhibition, (2) distinct patterns of subcellular effects, (3) in vitro and in vivo activity in patient-derived HGG models, and (4) effective blood-brain barrier penetration in mice and humans. Furthermore, we report preliminary clinical real-world experience using avapritinib in pediatric and young adult patients with predominantly recurrent/refractory PDGFRA-altered HGG (n = 8). Our early data demonstrate that avapritinib is well tolerated and results in radiographic response in 3/7 cases, suggesting a potential role for avapritinib in the treatment of HGG with specific PDGFRA alterations. Overall, these translational results underscore the therapeutic potential of PDGFRA inhibition with avapritinib in HGG.

• MeSH
• dítě MeSH
• dospělí MeSH
• gliom * farmakoterapie   genetika   patologie   MeSH
• hematoencefalická bariéra metabolismus   MeSH
• inhibitory proteinkinas * farmakologie   terapeutické užití   MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mutace MeSH
• myši MeSH
• nádorové buněčné linie MeSH
• nádory mozku * farmakoterapie   genetika   patologie   MeSH
• předškolní dítě MeSH
• protinádorové látky * farmakologie   terapeutické užití   MeSH
• pyrazoly * farmakologie   terapeutické užití   MeSH
• pyrroly MeSH
• růstový faktor odvozený z trombocytů - receptor alfa * genetika   antagonisté a inhibitory   metabolismus   MeSH
• stupeň nádoru MeSH
• triaziny MeSH
• xenogenní modely - testy protinádorové aktivity MeSH
• zvířata MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• myši MeSH
• předškolní dítě MeSH
• ženské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH

Corneal dystrophies are a group of predominantly rare inherited disorders. They are by definition bilateral, relatively symmetrical, and without systemic involvement, affecting corneal transparency and/or refraction. Traditional classification of corneal dystrophies is based on slit-lamp appearance, affected corneal layer and histological features. Molecular genetics has provided ultimate proof for the existence of distinct corneal dystrophies and discarded duplicates in their terminology. Currently, there are at least 16 genes with identified pathogenic variants implicated in corneal dystrophies. Herein, we summarise contemporary knowledge on genotype-phenotype correlations of corneal dystrophies, including a critical review of some reported variants, along with the understanding of the underlying pathogenic dystrophic process; essential knowledge for the development of targeted therapies.

• MeSH
• dědičné dystrofie rohovky * genetika   terapie   MeSH
• fenotyp MeSH
• genetické asociační studie * MeSH
• genotyp MeSH
• lidé MeSH
• molekulární biologie MeSH
• mutace * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

The utilization of 3D printing- digital light processing (DLP) technique, for the direct fabrication of microneedles encounters the problem of drug solubility in printing resin, especially if it is predominantly composed of water. The possible solution how to ensure ideal belonging of drug and water-based printing resin is its pre-formulation in nanosuspension such as nanocrystals. This study investigates the feasibility of this approach on a resin containing nanocrystals of imiquimod (IMQ), an active used in (pre)cancerous skin conditions, well known for its problematic solubility and bioavailability. The resin blend of polyethylene glycol diacrylate and N-vinylpyrrolidone, and lithium phenyl-2,4,6-trimethylbenzoylphosphinate as a photoinitiator, was used, mixed with IMQ nanocrystals in water. The final microneedle-patches had 36 cylindrical microneedles arranged in a square grid, measuring approximately 600 μm in height and 500 μm in diameter. They contained 5wt% IMQ, which is equivalent to a commercially available cream. The homogeneity of IMQ distribution in the matrix was higher for nanocrystals compared to usual crystalline form. The release of IMQ from the patches was determined ex vivo in natural skin and revealed a 48% increase in efficacy for nanocrystal formulations compared to the crystalline form of IMQ.

• MeSH
• 3D tisk * MeSH
• aplikace kožní MeSH
• imichimod * chemie   aplikace a dávkování   MeSH
• jehly * MeSH
• kožní absorpce MeSH
• kůže metabolismus   MeSH
• lékové transportní systémy přístrojové vybavení   MeSH
• mikroinjekce přístrojové vybavení   MeSH
• nanočástice * chemie   aplikace a dávkování   MeSH
• polyethylenglykoly chemie   aplikace a dávkování   MeSH
• povidon chemie   MeSH
• rozpustnost * MeSH
• uvolňování léčiv MeSH
• zvířata MeSH
• Check Tag
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH

Leták obsahující směrnice, které se zaměřují na zástavu peripartálního krvácení. Určeno odborné veřejnosti.

• MeSH
• farmakoterapie MeSH
• hemostatika MeSH
• hemostáza chirurgická MeSH
• peripartální období MeSH
• poporodní krvácení MeSH
• Check Tag
• ženské pohlaví MeSH
• Publikační typ
• letáky MeSH
• směrnice pro lékařskou praxi MeSH

• Konspekt
• Patologie. Klinická medicína
• NLK Obory
• hematologie a transfuzní lékařství
• gynekologie a porodnictví

Publikace se zaměřuje na vnitřní lékařství. Určeno odborníkům v praxi i studentům lékařství.; Toto vydání zahrnuje 1. a 2. díl. Kniha je rozdělena do dvou dílů a rozřazena do 20 kapitol, v nichž se kromě základních oborů vnitřního lékařství (kardiologie, pneumologie, gastroenterologie, nefrologie, onkologie, hematologie, revmatologie, endokrinologie a metabolismu, geriatrie) dotýká i oborů blízkých, jako jsou neurologie, psychiatrie, medicína akutních stavů, otravy, bolest, infekční nemoci, výživa, imunologie, genetika. Je zde zařazena i kapitola o zdraví a nemoci a nově kapitola zabývající se paliativní medicínou a multimorbiditou ve vnitřním lékařství, které stále více ovlivňují naši klinickou praxi. K napsání druhého vydání publikace vedl především obrovský pokrok v diagnostice a léčbě v jednotlivých podoborech vnitřního lékařství, nahromadění nových poznatků, ale také zájem lékařů o původní učebnici. První i druhý díl publikace poskytují informace nejen integrálním oborům interní medicíny, ale i oborům, které s ní úzce souvisejí.

• MeSH
• vnitřní lékařství MeSH

• Konspekt
• Patologie. Klinická medicína
• Učební osnovy. Vyučovací předměty. Učebnice
• NLK Obory
• vnitřní lékařství
• NLK Publikační typ
• kolektivní monografie
• učebnice vysokých škol