In light of recently published international guidelines concerning the diagnosis, treatment, and aftercare of urethral strictures and stenoses, the objective of this study was to synthesize an overview of guideline recommendations provided by the American Urological Association (AUA, 2023), the Société Internationale d'Urologie (SIU, 2010), and the European Association of Urology (EAU, 2023). The recommendations offered by these three associations, as well as the guidelines addressing urethral trauma from the EAU, AUA, and the Urological Society of India (USI), were assessed in terms of their guidance on posterior urethral stenosis. On the whole, the recommendations from the various guidelines exhibit considerable alignment. However, SIU and EAU place a stronger emphasis on the role of repeated endoscopic treatment compared to AUA. The preferred approach for managing radiation-induced bulbomembranous stenosis remains a subject of debate. Furthermore, endoscopic treatments enhanced with intralesional therapies may potentially serve as a significant treatment modality for addressing even fully obliterated stenoses.

• MeSH
• Endoscopy MeSH
• Humans MeSH
• Constriction, Pathologic diagnosis   MeSH
• Urethral Stricture * diagnosis   MeSH
• Urethra injuries   MeSH
• Urology * MeSH
• Check Tag
• Humans MeSH
• Publication type
• English Abstract MeSH
• Journal Article MeSH
• Review MeSH
• Geographicals
• United States MeSH

BACKGROUND: Parental involvement in the decision-making processes about medical treatment for children with life-limiting conditions is recognised as good practice. Previous research highlighted factors affecting the decision-making process, but little is known about how parents experience their participation. AIM: To explore how parents experience their participation in the process of decision-making about treatment and future care for their children with life-limiting conditions. DESIGN: A systematically constructed review using narrative synthesis. The PRISMA guidelines were followed to report the findings. Databases Medline, EMBASE, SCOPUS, CINAHL and PsycINFO were searched up to December 2023. The study protocol was registered at PROSPERO (RN CRD42021215863). RESULTS: From the initial 2512 citations identified, 28 papers met the inclusion criteria and were included in the review. A wide range of medical decisions was identified; stopping general or life-sustaining treatment was most frequent. Narrative synthesis revealed six themes: (1) Temporal aspects affecting the experience with decision-making; (2) Losing control of the situation; (3) Transferring the power to decide to doctors; (4) To be a 'good' parent and protect the child; (5) The emotional state of parents and (6) Sources of support to alleviate the parental experience. CONCLUSIONS: Parental experiences with decision-making are complex and multifactorial. Parents' ability to effectively participate in the process is limited, as they are not empowered to do so and the circumstances in which the decisions are taking place are challenging. Healthcare professionals need to support parental involvement in an effective way instead of just formally asking them to participate.

• MeSH
• Child MeSH
• Clinical Decision-Making MeSH
• Humans MeSH
• Parents * psychology   MeSH
• Decision Making * MeSH
• Narration MeSH
• Health Personnel psychology   MeSH
• Check Tag
• Child MeSH
• Humans MeSH
• Publication type
• Journal Article MeSH
• Review MeSH
• Systematic Review MeSH

PURPOSE: Clinical guidelines call for the inclusion of exercise interventions in every patient's dialysis session, but these recommendations are rarely adopted. Healthcare providers play a key role in this. Therefore, the aim of this study was to explore how healthcare providers perceive the benefits, risks and barriers of intradialytic exercise (IDE). METHODS: We conducted 21 individual, semi-structured interviews with 11 nurses, 5 nephrologists, 3 training assistants and 2 managers from two dialysis centres in Slovakia. Verbatim transcripts of digitally recorded interviews were thematically analysed using MAXQDA®. RESULTS: Participants reported the benefits of IDE as improvements in patients' physical and psychosocial functioning, independence and self-efficacy, clinical profile and quality of therapy. As risks of IDE, they most frequently reported exercise-related damage to vascular access, insufficient individualization of training and musculoskeletal injuries. The presence of psychological problems among patients was reported as a major barrier for initiating and maintaining patients' exercise. Other reported barriers included limitations in financial and personnel resources of haemodialysis care. CONCLUSIONS: Safe and sustainable implementation of IDE, which might improve a patient's well-being, need to be prescribed in alignment with the patient's clinical profile, be delivered individually according to the patient's characteristics and requires adjustments in the available resources.

• MeSH
• Exercise * psychology   MeSH
• Renal Dialysis * MeSH
• Humans MeSH
• Attitude of Health Personnel MeSH
• Self Efficacy MeSH
• Health Personnel MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH

AIMS: Retinoids participate in multiple key processes in the human body e.g., vision, cell differentiation and embryonic development. There is growing evidence of the relationship between retinol, its active metabolite- all-trans retinoic acid (ATRA) - and several pancreatic disorders. Although low levels of ATRA in pancreatic ductal adenocarcinoma (PDAC) tissue have been reported, data on serum levels of ATRA in PDAC is still limited. The aim of our work was to determine serum concentrations of retinol and ATRA in patients with PDAC, type-2 diabetes mellitus (T2DM), chronic pancreatitis (CHP) and healthy controls. METHODS: High performance liquid chromatography with UV detection (HPLC) was used to measure serum levels of retinol and ATRA in 246 patients with different stages of PDAC, T2DM, CHP and healthy controls. RESULTS: We found a significant decrease in the retinol concentration in PDAC (0.44+/-0.18 mg/L) compared to T2DM (0.65+/-0.19 mg/L, P<0.001), CHP (0.60+/-0.18 mg/L, P< 0.001) and healthy controls (0.61+/-0.15 mg/L, P<0.001), significant decrease of ATRA levels in PDAC (1.14+/-0.49 ug/L) compared to T2DM (1.37+/-0.56 ug/L, P<0.001) and healthy controls(1.43+/-0.55 ug/L, P<0.001). Differences between early stages (I+II) of PDAC and non-carcinoma groups were not significant. We describe correlations between retinol, prealbumin and transferrin, and correlation of ATRA and IGFBP-2. CONCLUSION: Significant decrease in retinol and ATRA levels in PDAC compared to T2DM, healthy individuals and/or CHP supports existing evidence of the role of retinoids in PDAC. However, neither ATRA nor retinol are suitable for detection of early PDAC. Correlation of ATRA levels and IGFBP-2 provides new information about a possible IGF and retinol relationship.

• MeSH
• Pancreatitis, Chronic * metabolism   blood   MeSH
• Diabetes Mellitus, Type 2 * metabolism   MeSH
• Adult MeSH
• Carcinoma, Pancreatic Ductal metabolism   MeSH
• Middle Aged MeSH
• Humans MeSH
• Pancreatic Neoplasms * metabolism   blood   MeSH
• Aged MeSH
• Case-Control Studies MeSH
• Tretinoin * metabolism   blood   MeSH
• Vitamin A * blood   metabolism   MeSH
• Chromatography, High Pressure Liquid MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH

The nematode Spinitectus notopteri Karve et Naik, 1951 was collected from two species of freshwater fish belonging to the family Notopteridae, namely Chitala ornata (Gray) and Notopterus notopterus (Pallas), at Khun Thale Swamp in Surat Thani province of southern Thailand. The overall prevalence of the parasite was found to be 88% (94 fish infected/106 fish examined). A higher prevalence was found in C. ornata (96%), while a higher intensity was noted for N. notopterus (117 parasites/fish). The most important morphological characters were the presence of cephalic and cuticular structures, precloacal ridges, and genital papillae. Specimens were genetically characterised using cox1 mtDNA. Morphological characteristics were most similar to Spinitectus petterae Boomker, 1993 from Clarias gariepinus (Burchell) in Africa, while the genetic data were dissimilar to all available data for the genus. Therefore, the identification of nematode specimens using a combination of morphological and molecular techniques is stressed. This study also presents the first molecular analysis of S. notopteri infecting Thai freshwater fish and a new geographical record for S. notopteri.

• MeSH
• Phylogeny MeSH
• Nematoda classification   anatomy & histology   genetics   isolation & purification   MeSH
• Spirurida Infections veterinary   parasitology   epidemiology   MeSH
• Fish Diseases * parasitology   epidemiology   MeSH
• Fishes parasitology   MeSH
• Fresh Water * MeSH
• Animals MeSH
• Check Tag
• Animals MeSH
• Publication type
• Journal Article MeSH
• Geographicals
• Thailand MeSH

BACKGROUND: Risk-reducing mastectomy (RRM) significantly lowers breast cancer risk as a preventive surgery. While racial disparities in breast cancer treatment are well-documented, research on racial differences in the utilization and outcomes of RRM is limited. METHODS: We retrospectively analyzed the American College of Surgeons National Surgical Quality Improvement Program (2008-2022) to identify women who underwent RRM. Patient demographics, comorbidities, surgical characteristics, and 30-day postoperative outcomes were compared between White and racial minority patients, including Black/African American women. RESULTS: Among 1,285 patients, 88% (n = 1,126) self-identified as White and 12.4% (n = 159) as racial minorities, including 5.8% (n = 74) Black. Minority patients were younger than White patients (50.7±11.4 years vs. 52.6±12.6 years; P = .66). Black patients had a significantly higher mean BMI than White patients (33.6±8.4 kg/m2 vs. 30.6±8.0 kg/m2; P = .03), and higher prevalence of obesity (65%, n = 48 vs. 47%, n = 524; P = .03) and hypertension (51%, n = 38 vs. 30%, n = 342; P = .007). Racial minority patients were more likely to undergo outpatient surgery (81%, n = 129 vs. 57%, n = 645; P < .001) and had shorter hospital stays than White patients (0.8±1.3 days vs. 1±2 days; P = .001). Black patients experienced higher rates of superficial incisional infections (9.5%, n = 7 vs. 2.9%, n = 33; P = .18) and overall complications (18%, n = 13 vs. 10%, n = 113; P = .48) CONCLUSION: This multi-institutional study reveals racial disparities in RRM, with minority patients significantly more likely to present with comorbidities and experience higher complication rates. These findings underscore the need for targeted strategies to ensure equitable access to RRM and improve outcomes for minority patients, advancing health equity in breast cancer prevention.

• Publication type
• Journal Article MeSH

Publikace se zaměřuje na možnosti farmakoterapie autoimunitních nemocí. Určeno odborné veřejnosti.; Třetí vydání mimořádně úspěšné publikace, která se stala v mnoha oborech moderní medicíny vodítkem praktického provádění léčby chronických, většinou dosti závažných chorob postihujících v různé míře a v nejrůznějších kombinacích prakticky všechny orgány těla. Léčba autoimunitních chorob prožívá v posledních dvou dekádách dramatický vývoj v důsledku rozvoje biologické a cílené terapie. Kniha je farmakoterapeutickým průvodcem, u každé nozologické jednotky je čtenář zasvěcenými radami veden od volby prvního léku až po léčbu komplikovaných klinických stavů. Autorský kolektiv je tvořen předními českými odborníky v oblasti léčby chronických autoimunitních onemocnění. Publikace je určena především lékařům interních oborů (revmatologie, nefrologie, gastroenterologie, endokrinologie aj.), dále pak neurologům a dermatologům, užitečnou pomůckou je však také v dalších lékařských oborech.

• MeSH
• Autoimmune Diseases MeSH
• Immunologic Factors MeSH
• Immunotherapy MeSH

• Conspectus
• Farmacie. Farmakologie
• NML Fields
• farmakoterapie
• alergologie a imunologie
• NML Publication type
• kolektivní monografie

PURPOSE: Pediatric sarcomas are bone and soft tissue tumors that often exhibit high metastatic potential and refractory stem-like phenotypes, resulting in poor outcomes. Aggressive sarcomas frequently harbor a disrupted p53 pathway. However, whether pediatric sarcoma stemness is associated with abrogated p53 function and might be attenuated via p53 reactivation remains unclear. METHODS: We utilized a unique panel of pediatric sarcoma models and tumor tissue cohorts to investigate the correlation between the expression of stemness-related transcription factors, p53 pathway dysregulations, tumorigenicity in vivo, and clinicopathological features. TP53 mutation status was assessed by next-generation sequencing. Major findings were validated via shRNA-mediated silencing and functional assays. The p53 pathway-targeting drugs were used to explore the effects and selectivity of p53 reactivation against sarcoma cells with stem-like traits. RESULTS: We found that highly tumorigenic stem-like sarcoma cells exhibit dysregulated p53, making them vulnerable to drugs that restore wild-type p53 activity. Immunohistochemistry of mouse xenografts and human tumor tissues revealed that p53 dysregulations, together with enhanced expression of the stemness-related transcription factors SOX2 or KLF4, are crucial features in pediatric osteosarcoma, rhabdomyosarcoma, and Ewing's sarcoma development. p53 dysregulation appears to be an important step for sarcoma cells to acquire a fully stem-like phenotype, and p53-positive pediatric sarcomas exhibit a high frequency of early metastasis. Importantly, reactivating p53 signaling via MDM2/MDMX inhibition selectively induces apoptosis in aggressive, stem-like Ewing's sarcoma cells while sparing healthy fibroblasts. CONCLUSIONS: Our results indicate that restoring canonical p53 activity provides a promising strategy for developing improved therapies for pediatric sarcomas with unfavorable stem-like traits.

• MeSH
• Child MeSH
• Kruppel-Like Factor 4 * MeSH
• Humans MeSH
• Adolescent MeSH
• Mice MeSH
• Cell Line, Tumor MeSH
• Neoplastic Stem Cells * metabolism   pathology   MeSH
• Tumor Suppressor Protein p53 * metabolism   genetics   MeSH
• Child, Preschool MeSH
• Gene Expression Regulation, Neoplastic MeSH
• Sarcoma * genetics   pathology   metabolism   MeSH
• Signal Transduction MeSH
• Xenograft Model Antitumor Assays MeSH
• Animals MeSH
• Check Tag
• Child MeSH
• Humans MeSH
• Adolescent MeSH
• Male MeSH
• Mice MeSH
• Child, Preschool MeSH
• Female MeSH
• Animals MeSH
• Publication type
• Journal Article MeSH