INTRODUCTION: Mumps data were analysed to assess the effect of vaccination on mumps complications and hospitalisation. METHODS: The mumps cases reported to the Czech nationwide surveillance system from 2013 to 2022 were analysed using logistic regression with an odds ratio (aOR) adjusted for age, sex, year of onset and administrative region to measure the association between vaccination and complications or hospitalisation. Adjusted vaccine effectiveness (aVE) was calculated: aVE=(1-aOR)x100. RESULTS: A total of 11,913 mumps cases were reported, of which 6,885 (58%) were male. The median age of the study participants was 16 (range: 0-89 years). No complications occurred in 91% of patients. Mumps orchitis occurred in 633 (9%) male cases. A total of 946 (8%) patients required hospitalisation. The highest proportion of complications and hospitalisations was in the age group 35-44 years. Two doses of vaccine reduced statistically significantly the risk of any complications and of hospitalisation compared with unvaccinated patients: aOR 0.48 (95% CI: 0.37, 0.62), aVE of 52% (95% CI: 38, 63); and aOR 0.43 (95% CI: 0.33, 0.56), aVE of 57% (95% CI: 44, 67), respectively. Two doses showed statistically significant aVE 50% (95% CI: 32, 64) against orchitis, and 59% (95% CI: 23, 79) against meningitis. Among the two-dose recipients, the proportion of complications increased gradually with the time from the second dose. CONCLUSIONS: Our findings demonstrated a protective effect of two-dose vaccination against mumps complications and hospitalisation for mumps. We recommend continuing routine childhood mumps vaccination and maintaining high MMR coverage in Czechia.
- Publikační typ
- časopisecké články MeSH
The use of antiangiogenic and antiresorptive medications, particularly in patients with cancer or osteoporosis, can lead to osteonecrosis of the jaw following tooth extraction, trauma or arising spontaneously- A condition known as medication-related osteonecrosis of the jaw (MRONJ). In this article, we present a unique case of MRONJ in a patient with no history of antiresorptive or antiangiogenic drug use, who was instead taking the anti-interleukin 17-A (Secukinumab) medication for severe psoriasis. This association has not been previously reported in the literature.
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
Autologous cell therapy (ACT) is primarily used in diabetic patients with chronic limb-threatening ischemia (CLTI) who are not candidates for standard revascularization. According to current research, this therapy has been shown in some studies to be effective in improving ischemia parameters, decreasing the major amputation rate, and in foot ulcer healing. This review critically evaluates the efficacy of ACT in patients with no-option CLTI, discusses the use of mononuclear and mesenchymal stem cells, and compares the route of delivery of ACT. In addition to ACT, we also describe the use of new revascularization strategies, e.g., nanodiscs, microbeads, and epigenetics, that could enhance the therapeutic effect. The main aim is to summarize new findings on subcellular and molecular levels with the clinical aspects of ACT.
- MeSH
- autologní transplantace * MeSH
- buněčná a tkáňová terapie metody MeSH
- chronická kritická ischemie končetin terapie MeSH
- diabetes mellitus terapie MeSH
- ischemie terapie MeSH
- lidé MeSH
- transplantace mezenchymálních kmenových buněk metody MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
Replication forks stalled at co-transcriptional R-loops can be restarted by a mechanism involving fork cleavage-religation cycles mediated by MUS81 endonuclease and DNA ligase IV (LIG4), which presumably relieve the topological barrier generated by the transcription-replication conflict (TRC) and facilitate ELL-dependent reactivation of transcription. Here, we report that the restart of R-loop-stalled replication forks via the MUS81-LIG4-ELL pathway requires senataxin (SETX), a helicase that can unwind RNA:DNA hybrids. We found that SETX promotes replication fork progression by preventing R-loop accumulation during S-phase. Interestingly, loss of SETX helicase activity leads to nascent DNA degradation upon induction of R-loop-mediated fork stalling by hydroxyurea. This fork degradation phenotype is independent of replication fork reversal and results from DNA2-mediated resection of MUS81-cleaved replication forks that accumulate due to defective replication restart. Finally, we demonstrate that SETX acts in a common pathway with the DEAD-box helicase DDX17 to suppress R-loop-mediated replication stress in human cells. A possible cooperation between these RNA/DNA helicases in R-loop unwinding at TRC sites is discussed.
- MeSH
- "flap" endonukleasy metabolismus genetika MeSH
- DEAD-box RNA-helikasy * metabolismus genetika MeSH
- DNA vazebné proteiny * metabolismus genetika MeSH
- DNA-helikasy * metabolismus genetika MeSH
- DNA-ligasa ATP metabolismus genetika MeSH
- DNA metabolismus genetika MeSH
- endonukleasy * metabolismus genetika MeSH
- genetická transkripce MeSH
- lidé MeSH
- multifunkční enzymy * metabolismus genetika MeSH
- R-smyčka * MeSH
- replikace DNA * MeSH
- RNA-helikasy * metabolismus genetika MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
A patient who requests an amputation deemed medically unnecessary by professionals is disqualified per se from being regarded as having medical decision-making capacity. This decision is based on the assumption that there is an option to pursue something other than amputation; such an assumption in many cases overflows into therapeutic obstinacy. This is the case for individuals who have ill or damaged body parts and who wish to avoid recurrent and painful medical treatment designed to save the limb, as well as for individuals affected by body integrity dysphoria (BID). BID is a condition that is recognised by the WHO and is included in the International Classification of Diseases, 11th edition. Individuals who are affected develop an intense feeling of overcompleteness of their body configuration, which leads to the development of a strong sense of dysphoria and consequently the desire to amputate in order to remove the source of such discomfort. In the few cases in which amputation has been carried out, the results have proved successful; the individual's quality of life has improved and they have had no new amputation desires. No medical therapy, including medical amputation, is available currently for individuals affected by the condition. This situation leads many with BID to mutilate themselves. Such events create a challenging ethical dilemma for the medical world.The present paper is focused on the capacity of the individual with BID to do other than request amputation and the implications that this carries regarding moral responsibility. It is proposed that the autonomy of the patient cannot be disqualified by default based on the amputation request, despite its oddity, and that any scepticism demonstrated by the physicians is based on a false preconception of ill will or ignorance, which results in a blaming attitude towards the requesting person.
- MeSH
- amputace * psychologie MeSH
- kvalita života * MeSH
- lidé MeSH
- morální závazky MeSH
- představa o vlastním těle psychologie MeSH
- rozhodování * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
