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Atlas, který se zaměřuje na anatomii lidského mozku, zobrazenou mikroskopicky, makroskopicky a pomocí magnetické rezonance. Určeno odborné veřejnosti.; Učebnice Řezy mozkem – nepostradatelný průvodce anatomickými detaily a diagnostickými metodami – spojuje makroskopické, mikroskopické a MRI řezy mozku do jednoho uceleného a systematického celku. Poskytuje jasné vizuální pochopení toho, jak mozek vypadá a jak jej lze interpretovat prostřednictvím moderních diagnostických metod, jejichž neustálý vývoj vyžaduje od studentů a lékařů, aby se orientovali nejen v zevní anatomii mozku, ale i v řezech. Vyšetření magnetickou rezonancí a výpočetní tomografií patří dnes mezi běžné metody a jednoznačným předpokladem k jejich interpretaci je znalost anatomie. Nejsrozumitelnější přístup k anatomii mozku – bohatá obrazová dokumentace umožňuje vidět mozek při pitvě nebo ve špičkově vybavené laboratoři. Ať už jde o frontální, transverzální nebo sagitální roviny, vše je zachyceno a doplněno přesnými schématy, která pomáhají pochopit polohu a orientaci jednotlivých řezů. Zdařilá kombinace teorie a praxe – text poskytuje vše, co je třeba pro interpretaci snímků z MRI nebo CT vyšetření, od makroskopické stavby až po mikroskopické detaily. Exkluzivní mikroskopické řezy – unikátní soubor mikroskopických řezů umožňuje porozumět hlavním strukturám, což pomáhá identifikaci jak pod mikroskopem, tak na diagnostických snímcích. Přehledná orientace díky současné anatomické nomenklatuře. Předpokladem k účelnému využití této publikace je základní znalost anatomie CNS, neboť atlas se soustředí výhradně na obrazovou dokumentaci. Kniha je určena studentům lékařství, neurologům, neuroradiologům, ale i dalším odborníkům, které fascinuje mozek a chtějí si rozšířit znalosti o jeho stavbě.
- MeSH
- Magnetic Resonance Imaging MeSH
- Microscopy MeSH
- Brain anatomy & histology diagnostic imaging MeSH
- Neuroanatomy MeSH
- Publication type
- Atlas MeSH
BACKGROUND AND HYPOTHESIS: Cognitive impairments are a core feature of psychosis that are often evident before illness onset and have substantial impact on both clinical and real-world functional outcomes. Therefore, these are an excellent target for stratification and early detection in order to facilitate early intervention. While many studies have aimed to characterize the effects of cognition at the group level and others have aimed to detect individual differences by referencing subjects against existing norms, these studies have limited generalizability across clinical populations, demographic backgrounds, and instruments and do not fully account for the interindividual heterogeneity inherent in psychosis. STUDY DESIGN: Here, we outline the rationale, design, and analysis plan for the PRECOGNITION project, which aims to address these challenges. STUDY RESULTS: This project is a collaboration between partners in 5 European countries. The project will not generate any primary data, but by leveraging existing datasets and combining these with novel analytic methods, it will produce multiple contributions including: (i) translating normative modeling approaches pioneered in brain imaging to psychosis data, to yield "cognitive growth charts" for longitudinal tracking and individual prediction; (ii) developing machine learning models for harmonizing and stratifying cohorts on the basis of these models; and (iii) providing integrated next-generation norms, having broad sociodemographic coverage including different languages and distinct norms for individuals with psychosis and unaffected individuals. CONCLUSIONS: This study will enable precision stratification of psychosis cohorts and furnish predictions for a broad range of functional outcome measures. It will be guided throughout by lived experience experts.
- Publication type
- Journal Article MeSH
Background: The accurate measurement of the distances within the airways during bronchoscopy is necessary for diagnostic purposes; however, a reliable and simple device does not exist. Methods: The LJ system, consisting of a probe, a box with a display, an encoder, and a microcontroller, has been developed, and its prototype has been tested in vitro and validated in clinical practice in suitable procedures of interventional bronchoscopy. Results: In vitro, the device measurements showed a good correlation with the control performed with a digital caliper. Subsequently, ten patients were included in a pilot study evaluating this novel prototype of a measurement device. The device was used on four patients with tracheal stenosis indicated for Y-stent placement, four patients indicated for open surgery, and two cases of tracheoesophageal fistula. The measurements have been validated using computed tomography imaging or by direct inspection and measurement during open surgical procedures. Conclusions: The first experience and pilot study evaluating this novel instrument for distance measurements during interventional bronchology procedures showed that the LJ device can provide precise readings of the distance from the vocal cords, the lengths of tracheal stenoses, or the size of tumorous and other lesions. Its use might be widened to other endoscopic indications.
- Publication type
- Journal Article MeSH
BACKGROUND: FosA10-producing Enterobacterales have an extremely low incidence in Europe. PATIENTS AND METHODS: In March 2024, an 83-year-old woman, hospitalized in the Modena Province, developed an infection with fosfomycin-resistant Escherichia coli. The patient was treated with piperacillin/tazobactam and, after 10 days, the clinical picture was resolved. Fosfomycin MIC was evaluated with the reference agar dilution method and the production of FosA enzymes by phenotypic testing. Genomic characterization was assessed using long-read sequencing technology on the Sequel I platform. RESULTS: An E. coli isolate (FO_2) was collected from both blood and urine samples and showed high-level resistance to fosfomycin (MIC > 128 mg/L). The resistance to fosfomycin was ascribed to the production of FosA-like enzymes by phenotypic testing. The genomic analysis pointed to a FosA10-producing E. coli ST69. The fosA10 gene was carried by a highly conjugative IncB/O/K/Z plasmid that showed relevant similarities with other globally circulating plasmids. CONCLUSIONS: The acquisition of rare fosA-like genes in clinically relevant clones is concerning and the dissemination of FosA-producing E. coli should be continuously monitored.
- Publication type
- Journal Article MeSH
BACKGROUND: Soccer is a dynamic sport that involves high-intensity running, changes of direction, jumping and contact. Therefore, a proper warm-up duration is of great importance to optimize players'performance and minimize the risk of injury. METHODS: This study examined the responses of amateur young 16 players (age = 17.00 ± 0.81 years; height = 177.38 ± 5.50 cm; weight = 64.50 ± 5.45 kg) 25 min (min), 15 min and 8 min warm-up duration in 4 v 4 small-sided games (SSGs) with mini-goal formats. Participants are assessed using the Participant Classification Framework, they are categorized under Tier 2: Trained/Developmental. The SSG interventions were randomly assigned to three training intervention groups. The features of SSG are determined as size; 25 × 32 m, bout; 4 × 4 min, resting; 4 min. Before the SSG, same protocol was applied at different times in all warm-ups. Warm-up protocols consisted of 13 sections. The intervention time in each section decreased parallel to the total 25 min, 15 min and 8 min warm-up times. The rating of perceived exertion (RPE), heart rate (HR) responses, distance covered and technical activities were consistently recorded during all SSG sessions. A one-way repeated-measures ANOVA was used to assess significant differences in performance among the different warm-up duration. RESULTS: After the interventions, HR, total player load (TPL), successful passes (SP), unsuccessful passes (USP), interceptions and lost ball results demonstrated significant difference between the 25-min, 15-min and 8-min warm-up durations (p < 0.05). Total distance, velocity, RPE and enjoyment results showed no significant difference between the 25-min, 15-min and 8-min warm-up duration (p > 0.05). Results indicate that a 15-min warm-up duration provides an optimal balance between physiological and technical preparation, leading to improved HR responses, SP and interceptions compared to the 25-min and 8-min warm-ups. The 25-min warm-up decreased USP and lost ball occurrences compared to the 15-min and 8-min warm-ups. The 8-min warm-up resulted in a lower TPL, indicating reduced physiological demands. CONCLUSIONS: The 15-min warm-up duration emerged as an optimal protocol, offering a time-efficient approach that enhances both technical performance and physiological readiness while avoiding unnecessary fatigue. This finding provides practical implications for coaches and practitioners in designing warm-up routines that maximize match readiness without overexertion.
- Publication type
- Journal Article MeSH
OBJECTIVES: To analyse characteristics of Clostridioides difficile PCR ribotype 176 clinical isolates from Poland, the Czech Republic and Slovakia with regard to the differences in its epidemiology. METHODS: Antimicrobial susceptibility testing and whole genome sequencing were performed on a selected group of 22 clonally related isolates as determined by multilocus variable-number tandem repeat analysis (n = 509). Heterologous expression and functional analysis of the newly identified methyltransferase were performed. RESULTS: Core genome multilocus sequence typing found 10-37 allele differences. All isolates were resistant to fluoroquinolones (gyrA_p. T82I), aminoglycosides with aac(6')-Ie-aph(2'')-Ia in six isolates. Erythromycin resistance was detected in 21/22 isolates and 15 were also resistant to clindamycin with ermB gene. Fourteen isolates were resistant to rifampicin with rpoB_p. R505K or p. R505K/H502N, and five to imipenem with pbp1_p. P491L and pbp3_p. N537K. PnimBG together with nimB_p. L155I were detected in all isolates but only five were resistant to metronidazole on chocolate agar. The cfrE, vanZ1 and cat-like genes were not associated with linezolid, teicoplanin and chloramphenicol resistance, respectively. The genome comparison identified six transposons carrying antimicrobial resistance genes. The ermB gene was carried by new Tn7808, Tn6189 and Tn6218-like. The aac(6')-Ie-aph(2'')-Ia were carried by Tn6218-like and new Tn7806 together with cfrE gene. New Tn7807 carried a cat-like gene. Tn6110 and new Tn7806 contained an RlmN-type 23S rRNA methyltransferase, designated MrmA, associated with high-level macrolide resistance in isolates without ermB gene. CONCLUSIONS: Multidrug-resistant C. difficile PCR ribotype 176 isolates carry already described and unique transposons. A novel mechanism for erythromycin resistance in C. difficile was identified.
- MeSH
- Anti-Bacterial Agents * pharmacology MeSH
- Drug Resistance, Bacterial * MeSH
- Bacterial Proteins genetics MeSH
- Clostridioides difficile * genetics drug effects isolation & purification classification MeSH
- Genomic Islands * MeSH
- Clostridium Infections * microbiology epidemiology MeSH
- Humans MeSH
- Methyltransferases genetics MeSH
- Microbial Sensitivity Tests MeSH
- Drug Resistance, Multiple, Bacterial * genetics MeSH
- Multilocus Sequence Typing MeSH
- Ribotyping MeSH
- Whole Genome Sequencing MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Geographicals
- Czech Republic MeSH
- Poland MeSH
Peroral endoscopic myotomy (POEM) is an advanced endoscopic procedure that has become a first-line treatment for esophageal achalasia and other esophageal spastic disorders. Structured training is essential to optimize the outcomes of this technique. The European Society of Gastrointestinal Endoscopy (ESGE) has recognized the need to formalize and enhance training in POEM. This Position Statement presents the results of a systematic review of the literature and a formal Delphi process, providing recommendations for an optimal training program in POEM that aims to produce endoscopists competent in this procedure. In a separate document (POEM curriculum Part II), we provide technical guidance on how to perform the POEM procedure based on the best available evidence. 1: POEM trainees should acquire a comprehensive theoretical knowledge of achalasia and other esophageal motility disorders that encompasses pathophysiology, diagnostic tool proficiency, clinical outcome assessment, potential adverse events, and periprocedural management. 2: Experience in advanced endoscopic procedures (endoscopic mucosal resection and/or endoscopic submucosal dissection [ESD]) is encouraged as a beneficial prerequisite for POEM training. 3: ESGE suggests that POEM trainees without ESD experience should perform an indicative minimum number of 20 cases on ex vivo or animal models before advancing to human POEM cases with an experienced trainer. 4: ESGE recommends that the trainee should observe an indicative minimum number of 20 live cases at expert centers before starting to perform POEM in humans. 5: The trainee should undertake an indicative minimum number of 10 cases under expert supervision for the initial human POEM procedures, ensuring that trainees can complete all POEM steps independently. 6: ESGE recommends avoiding complex POEM cases during the early training phase. 7: POEM competence should reflect the technical success rate, both the short- and long-term clinical success rates, and the rate of true adverse events. 8: A POEM center should maintain a prospective registry of all procedures performed, including patient work-up and outcomes, procedural techniques, and adverse events.
- MeSH
- Esophageal Achalasia * surgery MeSH
- Delphi Technique MeSH
- Natural Orifice Endoscopic Surgery * education MeSH
- Endoscopy, Gastrointestinal * education MeSH
- Clinical Competence MeSH
- Curriculum * MeSH
- Humans MeSH
- Myotomy * education methods MeSH
- Pyloromyotomy * education MeSH
- Societies, Medical MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Consensus Development Conference MeSH
- Systematic Review MeSH
- Geographicals
- Europe MeSH
Membrane contact sites harbor a distinct set of proteins with varying biological functions, thereby emerging as hubs for localized signaling nanodomains underlying adequate cell function. Here, we will focus on mitochondria-associated endoplasmic reticulum membranes (MAMs), which serve as hotspots for Ca2+ signaling, redox regulation, lipid exchange, mitochondrial quality and unfolded protein response pathway. A network of MAM-resident proteins contributes to the structural integrity and adequate function of MAMs. Beyond endoplasmic reticulum (ER)-mitochondrial tethering proteins, MAMs contain several multi-protein complexes that mediate the transfer of or are influenced by Ca2+, reactive oxygen species and lipids. Particularly, IP3 receptors, intracellular Ca2+-release channels, and Sigma-1 receptors (S1Rs), ligand-operated chaperones, serve as important platforms that recruit different accessory proteins and intersect with these local signaling processes. Furthermore, many of these proteins are directly implicated in pathophysiological conditions, where their dysregulation or mutation is not only causing diseases such as cancer and neurodegeneration, but also rare genetic diseases, for example familial Parkinson's disease (PINK1, Parkin, DJ-1), familial Amyotrophic lateral sclerosis (TDP43), Wolfram syndrome1/2 (WFS1 and CISD2), Harel-Yoon syndrome (ATAD3A). In this review, we will discuss the current state-of-the-art regarding the molecular components, protein platforms and signaling networks underlying MAM integrity and function in cell function and how their dysregulation impacts MAMs, thereby driving pathogenesis and/or impacting disease burden. We will highlight how these insights can generate novel, potentially therapeutically relevant, strategies to tackle disease outcomes by improving the integrity of MAMs and the signaling processes occurring at these membrane contact sites.
- MeSH
- Endoplasmic Reticulum * metabolism pathology MeSH
- Intracellular Membranes * metabolism MeSH
- Humans MeSH
- Mitochondrial Membranes metabolism MeSH
- Mitochondria * metabolism pathology MeSH
- Neoplasms * metabolism pathology therapy genetics MeSH
- Neurodegenerative Diseases * metabolism pathology therapy genetics MeSH
- Sigma-1 Receptor MeSH
- Receptors, sigma metabolism MeSH
- Unfolded Protein Response MeSH
- Calcium Signaling MeSH
- Animals MeSH
- Check Tag
- Humans MeSH
- Animals MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Review MeSH
BACKGROUND: Variations of inferior vena cava (IVC) area and collapsibility serve as early markers of congestion and predict risk for heart failure (HF) events. OBJECTIVES: The aim of this first-in-human study (FUTURE-HF [First in Human Clinical Investigation of the FIRE1 System in Heart Failure Patients]) was to evaluate the safety and feasibility of a novel implantable IVC sensor for remote management in patients with HF. This paper is the final report on primary (3-month) and exploratory (6-month) endpoints. METHODS: Patients with HF hospitalizations within the previous year, with elevated natriuretic peptide levels, and on optimal HF treatment were included. The primary safety endpoints were procedural success without device- or procedure-related complications at 3 months. The primary technical endpoint was signal acquisition following implantation and at a clinic visit within 3 months. Sensor-derived IVC area was compared with computed tomography (CT)-based IVC dimensions. Patient adherence to daily readings and exploratory clinical findings at 6 months were assessed. RESULTS: Fifty patients underwent successful implantation (mean age 65 ± 9 years, 14% women, 72% in NYHA functional class III), with 49 contributing to the primary safety and technical endpoints at 3 months. Sensor-derived IVC area demonstrated excellent agreement with CT measurement (mean absolute error 13.53 mm2 [3.55%] R2 = 0.98). Median adherence was 96% at 6-month follow-up. Exploratory analyses of clinical outcomes suggested improvements in N-terminal pro-B-type natriuretic peptide, NYHA functional class, and quality of life and reduced HF events. CONCLUSIONS: This first-in-human experience demonstrated that the implantation of an IVC sensor was safe and feasible. Sensor-derived IVC area demonstrated excellent correlation with CT-derived IVC area, and exploratory clinical outcomes suggest that this may serve as a novel tool for ambulatory management of congestion to facilitate remote care in HF. (First in Human Clinical Investigation of the FIRE1 System in Heart Failure Patients [FUTURE-HF]; NCT04203576).
- MeSH
- Middle Aged MeSH
- Humans MeSH
- Tomography, X-Ray Computed MeSH
- Aged MeSH
- Heart Failure * therapy physiopathology diagnosis MeSH
- Feasibility Studies MeSH
- Vena Cava, Inferior * diagnostic imaging MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Clinical Trial MeSH
- Multicenter Study MeSH
BACKGROUND: Temporal interference stimulation (TIS) is a novel noninvasive electrical stimulation technique to focally modulate deep brain regions; a minimum of two high-frequency signals (f1 and f2 > 1 kHz) interfere to create an envelope-modulated signal at a deep brain target with the frequency of modulation equal to the difference frequency: Δf = |f2 - f1|. OBJECTIVE: The goals of this study were to verify the capability of TIS to modulate the subthalamic nucleus (STN) with Δf and to compare the effect of TIS and conventional deep brain stimulation (DBS) on the STN beta oscillations in patients with Parkinson's disease (PD). METHODS: DBS leads remained externalized after implantation, allowing local field potentials (LFPs) recordings in eight patients with PD. TIS was performed initially by two pairs (f1 = 9.00 kHz; f2 = 9.13 kHz, 4 mA peak-peak per pair maximum) of scalp electrodes placed in temporoparietal regions to focus the envelope signal maximum (Δf = 130 Hz) at the motor part of the STN target. RESULTS: The comparison between the baseline LFPs and recordings after TIS and conventional DBS sessions showed substantial suppression of high beta power peak after both types of stimulation in all patients. CONCLUSIONS: TIS has the potential to effectively modulate the STN and reduce the beta oscillatory activity in a completely noninvasive manner, as is traditionally possible only with intracranial DBS. Future studies should confirm the clinical effectiveness of TIS and determine whether TIS could be used to identify optimal DBS candidates and individualize DBS targets. © 2025 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
- MeSH
- Beta Rhythm * physiology MeSH
- Deep Brain Stimulation * methods MeSH
- Middle Aged MeSH
- Humans MeSH
- Subthalamic Nucleus * physiopathology MeSH
- Parkinson Disease * therapy physiopathology MeSH
- Aged MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH