Cíl: Mezinárodní asociace medicínské informatiky (IMIA) se dohodla na revizi stávajících mezinárodních doporucení týkajících se vzdelávání ve zdravotnické informatice/ medicínské informatice. Tato doporucení by mela pomoci ustavit kurzy, zkušební okruhy nebo dokonce kompletní programy v této oblasti, dále rozvinout existující vzdelávací aktivity v ruzných státech a podporit mezinárodní aktivity týkající se vzdelávání v biomedicínské a zdravotnické informatice (BMZI), zejména mezinárodní aktivity ve vzdelávání odborníku v BMZI a mela by pomoci sdílet výukový software. Metoda: Pracovní skupina IMIA, která byla navržena v roce 2006, pracovala na aktualizaci první verze Doporucení. Tyto aktualizace byly široce diskutovány a vylepšeny cleny národních spolecností IMIA, cleny akademických institucí IMIA a cleny pracovní skupiny IMIA zamerené na vzdelávání ve zdravotnické a medicínské informatice. Výsledky a závery: Doporucení IMIA se soustredují na vzdelávací potreby odborníku ve zdravotnictví, aby získali znalosti a dovednosti ve zpracovávání informací a v informacních a komunikacních technologiích. Vzdelávací potreby jsou popsány v trídimenzionálním rámci.

Objective: The International Medical Informatics Association (IMIA) agreed on revising the existing international recommendations in health informatics /medical informatics education. These should help to establish courses, course tracks or even complete programs in this field, to further develop existing educational activities in the various nations and to support international initiatives concerning education in biomedical and health informatics (BMHI), particularly international activities in educating BMHI specialists and the sharing of courseware. Method: An IMIA task force, nominated in 2006, worked on updating the recommendations’ first version. These updates have been broadly discussed and refined by members of IMIA’s National Member Societies, IMIA’s Academic Institutional Members and by members of IMIA’s Working Group on Health and Medical Informatics Education. Results and Conclusions: The IMIA recommendations center on educational needs for health care professionals to acquire knowledge and skills in information processing and information and communication technology. The educational needs are described as a threedimensional framework. The dimensions are: 1) professionals in health care (e.g. physicians, nurses, BMHI professionals), 2) type of specialization in BMHI (IT users, BMHI specialists), and 3) stage of career progression (bachelor, master, doctorate). Learning outcomes are defined in terms of knowledge and practical skills for health care professionals in their role a) as IT user and b) as BMHI specialist. Recommendations are given for courses /course tracks in BMHI as part of educational programs in medicine, nursing, health care management, dentistry, pharmacy, public health, health record administration, and informatics /computer science as well as for dedicated programs in BMHI (with bachelor, master or doctor degree). To support education in BMHI, IMIA offers to award a certificate for high-quality BMHI education. It supports information exchange on programs and courses in BMHI through its Working Group on Health and Medical Informatics Education.

• Keywords
• medicínská informatika, doporučení,
• MeSH
• Financing, Organized MeSH
• Education, Medical, Continuing methods   standards   MeSH
• Medical Informatics methods   standards   MeSH
• Humans MeSH
• Guidelines as Topic MeSH
• Education methods   standards   MeSH
• Computational Biology methods   standards   education   MeSH
• Check Tag
• Humans MeSH

• MeSH
• Medical Informatics MeSH
• Medicine MeSH
• Computational Biology MeSH
• Publication type
• Meeting Abstract MeSH
• Collected Work MeSH

• Conspectus
• Lékařské vědy. Lékařství
• NML Fields
• lékařská informatika

Objective: The need for health and social care for community-dwelling elderly is on the rise as the population ages. Through the provision of comprehensive services by multiple professionals in local communities, elderly people can receive continual care in a non-medical setting, which is favorable for early detection and intervention of potential problems. However, the lack of digitalization in primary care affects the effectiveness of the services and precludes full exploitation of the data. This study proposed an information system dedicated to caring for community-dwelling elderly people and investigated its acceptance and usability. Methods: An information system was designed for elderly care centers in the community, where data generated during care delivery, involving socio-demographic data, bio-measurements and health assessments and questionnaires, were digitized and stored for information management and exchange. A study was conducted to evaluate the acceptance and usability of the system after routine use of 6 months. The users of the system at an elderly care center were recruited to respond to a technology acceptance questionnaire and a system usability questionnaire. Results: The mean scores of the acceptance and usability questionnaires reached 5.1 out of the highest possible score of 7. The constructs of the acceptance questionnaire had good reliability. The social influence and facilitating conditions constructs had a significant correlation with the behavioral intention construct. Conclusions: The proposed information system demonstrated good acceptance and usability, which supported the feasibility of implementing it in community care centers for older adults. Further research will be conducted to address the limitation of sample size by extending the system to other elderly care centers, forming a large user base for a more in-depth and comprehensive performance evaluation.

• Publication type
• Journal Article MeSH

• MeSH
• Medical Records Systems, Computerized MeSH
• Knowledge Management MeSH
• Decision Support Techniques MeSH
• Intersectoral Collaboration MeSH
• Image Processing, Computer-Assisted MeSH
• Signal Processing, Computer-Assisted MeSH
• Health Services Administration MeSH
• Education, Medical MeSH
• Health Information Systems MeSH
• Publication type
• Collected Work MeSH

• Conspectus
• Lékařské vědy. Lékařství
• NML Fields
• lékařská informatika
• NML Publication type
• ročenky

• MeSH
• Medical Informatics methods   trends   MeSH
• International Cooperation MeSH
• Medical Informatics Applications MeSH
• Publication type
• Abstracts MeSH
• Congress MeSH
• Collected Work MeSH
• Geographicals
• Romania MeSH

• Conspectus
• Lékařské vědy. Lékařství
• NML Fields
• lékařská informatika

Background: ADHD syndrome is still at the forefront of discussed diagnoses in children, and is a continuing phenomenon even into adulthood. At the same time, the development of substance and non-substance addictions at an early age is a constant problem. The phenomenon of behavioral disorders, hyperactivity, impulsivity, and inattention, resulting from the immature development of brain centers in children, often brings with it persecution from pedagogues and educators. For both children and adults, there is no suggested therapeutic procedure, except for medication, although it is possible to work with the given disorder with an appropriate bio-psycho-social approach. Subsequently, the developmental deficit persists into adulthood.Objective: The main objective of the work was to reduce the stigmatization of addicted persons and to point out all developmental factors leading to addictive behavior, one of which is ADHD and its manifestations. One of the other goals is to draw attention to the importance of therapy for people with ADHD and to reduce medication to a minimum, if this can be achieved, and at the same time to emphasize this developmental deficit in the recruitment of professional soldiers.Methods: It was a retrospective collection and analysis of anamnestic data from medical records, and further data was obtained through a questionnaire survey. The data was evaluated based on established scales. The method of surveying the analyzed data by the coefficient in the maximum value. The resulting values were obtained by summing the points within the individual risk factors.Results: The highest score in the evaluation of the answers, and therefore the highest influence on the later use of addictive substances, had a psychiatric illness in childhood (point evaluation 351), in second place with a number of 295 points was a serious illness in childhood as a significant risk factor, followed by learning disabilities (277 points) and a low level of sports skills.Conclusion: The information obtained should initiate an increase in attention in the framework of preventive examinations in children, to the expansion of screening in the framework of gross motor skills, movement skills, and the implementation of therapeutic methods through frequent training in connection with the development of brain centers. At the same time, attention should be focused on the treatment of children with ADHD by amphetamine-containing substances, which should have a decreasing tendency and expand efforts to implement therapeutic methods and knowledge of preventive medicine, such as sufficient exercise, healthy diet, and calm family background, which will lead to improved relationships in families to achieve a reduction in anxiety states in children.

• MeSH
• Mental Disorders complications   MeSH
• Attention Deficit Disorder with Hyperactivity complications   MeSH
• Humans MeSH
• Behavior, Addictive etiology   MeSH
• Military Personnel psychology   MeSH
• Substance-Related Disorders * etiology   MeSH
• Surveys and Questionnaires MeSH
• Risk Factors MeSH
• Check Tag
• Humans MeSH
• Male MeSH
• Female MeSH

Malignity žlučových cest zahrnují intra- a extrahepatální cholangiokarcinomy, karcinom žlučníku a karcinom Vaterské papily. Jsou to vzácné nádory s celkově špatnou prognózou. Incidence dosahuje 12,5/ 100 tis. obyvatel a mortalita 9,5/ 100 tis. obyvatel, obojí byly v posledních 30 letech pozoruhodně stabilní. Celkové přežití pacientů s těmito nádory je žalostné, většinou do 12 měsíců. Diagnostika má různá úskalí a velmi často přichází pozdě. Většina případů je při diagnóze neoperabilních, proto je zde hlavní modalitou paliativní léčba. Ta je však stále problematická, nové postupy mnoho nepřinesly. Chybí standardy paliativní péče a hodnocení kvality života je překvapivě velmi málo časté. I z nečetných dat se zdá být zřejmý pozitivní efekt multimodální individualizované léčby na přežití a kvalitu života pacientů. Ve specializovaných centrech zahrnují léčebné možnosti metody chirurgické, intervenční radiologii, klinickou onkologii a metody kvalitní podpůrné péče. Tyto metody jsou rozebírány v článku podrobněji. Zlepšení lze očekávat od nových diagnostických metod a nových postupů v chirurgii a intervenční radiologii. Také lepší poznání bio logie nádorů na molekulární úrovni snad přinese více vyléčených pacientů. V paliativní léčbě lze zlepšení očekávat v nalezení nových cílových struktur a vývoji nových léčiv. Malé počty pacientů jsou limitující pro jakýkoli pokrok v tomto odvětví. Lze doufat, že nový volnější design mezinárodních randomizovaných multicentrických studií s pružným sdílením dat tento hlavní problém překlene. Nezbytným dalším krokem je defi nice standardů paliativní péče a hodnocení kvality života přinese pohled na skutečný přínos paliativní léčby pro pacienty.

Bile duct malignancies include intrahepatic cholangiocarcinoma (ICC), extrahepatic cholangiocarcinoma (ECC), gall bladder carcinoma (GC) and carcinoma of Vater's ampulla (ampulloma). Bile duct neoplasms are rare tumours with overall poor prognosis. The overall incidence aff ects up to 12.5 per 100,000 persons in the Czech Republic. The mortality rate has risen recently to 9.5 per 100,000 persons. The incidence and mortality have been remarkably stable over the past 3 decades. The survival rate of patients with these tumours is poor, usually not exceeding 12 months. The diagnostic process is complex, uneasy and usually late. Most cases are diagnosed when unresectable, and palliative treatment is the main approach of medical care for these tumours. The treatment remains very challenging. New approaches have not brought much improvement in this fi eld. Standards of palliative care are lacking and quality of life assessments are surprisingly not common. From the scarce data it seems, however, that multimodal individually tailored treatment can prolong patients' survival and improve the health-related quality of life. The care in specialized centres off ers methods of surgery, interventional radiology, clinical oncology and high quality supportive care. These methods are discussed in the article in greater detail. Improvements in this fi eld can be sought in new diagnostic methods and new procedures in surgery and interventional radiology. Understanding the tumour bio logy on the molecular level could shift the strategy to a more successful one, resulting in more cured patients. Further improvements in palliative care can be sought by defi ning new targets and new drug development. The lack of patients with bile duct neoplasms has been the limiting factor for any improvements. A new design of larger randomized international multicentric clinical trials with prompt data sharing could help to overcome this major problem. Defi ning standards of palliative care is a necessity. Addressing health-related quality of life could help to assess the real benefi t of palliative treatment.

• Keywords
• paliativní terapie,
• MeSH
• Cholangiocarcinoma diagnosis   epidemiology   therapy   MeSH
• Financing, Organized MeSH
• Humans MeSH
• Common Bile Duct Neoplasms diagnosis   therapy   MeSH
• Gallbladder Neoplasms diagnosis   therapy   MeSH
• Bile Duct Neoplasms diagnosis   epidemiology   therapy   MeSH
• Prognosis MeSH
• Check Tag
• Humans MeSH
• Publication type
• Review MeSH

Cíl práce: Kryokonzervace spermatu před gonadotoxickou léčbou je základní a nejúčinnější metodou zachování reprodukce, která může být využita i v období adolescence. Sdělení shrnuje 26 let zkušeností provozu onkologické spermabanky, uvádí analýzy spermiogramů onkologických pacientů, posouzení vztahu patologie spermatu s diagnózou, stanovení počtu zemřelých a využití zamrazeného spermatu. Metodika: Za dobu existence CAR 01 (centrum asistované reprodukce) bylo provedeno více než 50 000 spermiogramů. V rámci spermabanky od ledna 1995 do prosince 2020 bylo vyšetřeno 24 729 mužů, z toho 1 448 (5,9 %) mělo onkologickou diagnózu. Spermiogramy byly vyhodnoceny podle aktuálních manuálů Světové zdravotnické organizace (WHO – World Health Organization). Kryokonzervace spermatu prošla zásadním vývojem. Pravidla pro skladování zamražených buněk jsou od roku 2008 stanoveny zákonem č. 296/2008 Sb. V roce 2019 byla aktualizována metodika "Kryokonzervace reprodukčních buněk a tkání u pacientů před onkologickou léčbou". Ve všech případech byla použita standardní technika rozmrazení. Spermie byly zpracovány metodou swim-up. V rámci léčby metodami asistované reprodukce byly oocyty oplozovány mikromanipulační technikou ICSI (intracytoplazmatická injekce spermie). Výsledky: Z 1 448 vyšetřených spermiogramů u mužů s onkologickou diagnózou byl zhoubný nádor varlete u 43,7 % pacientů, maligní onemocnění mízní a krvetvorné tkáně v 24,1 %, z toho Hodgkinův lymfom 70,1 %, non-Hodgkinův lymfom 29,9 %. Leukemie byla zjištěna u 7,9 %, zhoubné nádory kostí a chrupavek u 6,8 % pacientů. Věk klientů celého souboru byl od 13 do 64 let (27,2 ± 6,8 let). Normozoospermii mělo 38,3 % mužů, 54,2 % spermiogramů vykázalo patologický nález v 1–3 hodnocených parametrech a azoospermii mělo 7,5 % pacientů. Těžká astenozoospermie (pohyblivost ≤ 10 %) byla prokázána u 57,2 % mužů a těžká oligozoospermie (koncentrace ≤ 1 × 106 mm3) u 22,3 % pacientů. Nejnižší hodnoty spermiogramu byly zjištěny u mužů s tumorem varlete, nejlepší hodnoty byly u nádorových onemocnění centrální nervové soustavy (CNS). Kryokonzervace spermatu byla provedena v 1 340 případech (92,5 %). Zamrazené sperma dosud celkem využilo 160 mužů (11,9 %), z toho 83 u nás (6,2 %). V těchto 83 případech byla vždy použita technika ICSI, bylo dosaženo 38 klinických těhotenství (45,8 %) a 32 porodů. Máme evidováno 424 ukončených skladování spermatu (31,6 %), z toho 148 z důvodu úmrtí, tzn. u 11,0 % všech onkologických pacientů, ostatní na vlastní žádost. Specifickou otázkou je využití spermatu zemřelých. Závěr: U onkologických pacientů jsou ve vysokém procentu těžké patologie spermatu. Nejnižší hodnoty spermiogramu byly prokázány u mužů se zhoubným nádorem varlete. Je nutné počítat s dlouhodobým skladováním a oplozením mikromanipulačními metodami. Počet mužů, kteří zemřou, je výrazně vyšší než těch, kteří sperma využijí pro léčbu neplodnosti. Kryokonzervace spermatu by měla být nabídnuta každému pacientovi před terapií vedoucí k destrukci spermatogeneze.

Objective: Sperm cryopreservation before gonadotoxic treatment is the basic and most effective method of preserving reproduction, which can be used during adolescence. The communication summarizes 26 years of experience in the operation of an oncological sperm bank, analyzes spermiograms of oncological patients, assesses the relationship between sperm pathology and diagnosis, and determines the number of deaths and the use of frozen sperm. Methods: During the existence of CAR 01 (assisted reproduction center), more than 50,000 spermiograms were performed. From January 1995 to December 2020, a total of 24,729 men were examined within the sperm bank, of which 1,448 (5.9%) had an oncological dia­gnosis. The spermiograms were evaluated according to current WHO (World Health Organization) manuals. Cryopreservation of sperm has undergone a major development. The rules for the storage of frozen cells have been laid down by Act No. 296/2008 Coll. since 2008. In 2019, the methodology "Cryopreservation of reproductive cells and tissues in patients before cancer treatment" was updated. In all cases, the standard thawing technique was used. The sperms were processed by the swim-up method. As part of the treatment with assisted reproduction methods, oocytes were fertilized by the ICSI (intracytoplasmatic sperm injection) micromanipulation technique. Results: Out of 1,448 examined spermiograms in men with oncological dia­gnoses, testicular cancer was present in 43.7% of patients and malignant diseases of lymphatic and hematopoietic tissue were found in 24.1%, of which 70,1% included Hodgkin‘s lymphomas and 29,9% were non-Hodgkin‘s lymphomas. Leukemia was found in 7.9%, bone and cartilage cancers in 6.8%. The age of the clients of the whole group ranged from 13 to 64 years (27.2 ± 6.8 years). A total of 38.3% of men had normozoospermia, 54.2% of spermiograms showed pathological findings in 1 to 3 evaluated parameters and 7.5% of patients had azoospermia. Severe asthenozoospermia (mobility ≤ 10%) was detected in 57.2% of men and severe oligozoospermia (concentration ≤ 1 × 106 mm3) in 22.3% of patients. The lowest values of the spermiogram were found in men with testicular cancer; the best values were seen in CNS (central nervous system) cancers. The cryopreservation of sperm was performed in 1,340 cases (92.5%). So far, a total of 160 men (11.9%) have used frozen sperm, of which 6.2% in our center. In these 83 cases, the ICSI technique was always used, 38 clinical pregnancies (45.8%) and 32 births were achieved. We have registered 424 completed storages of semen (31.6%), of which 148 (11.0% of all oncology patients) were made due to death and the others at patients’ request. Using the sperm of the dead is a specific issue. Conclusion: In cancer patients, sperm pathologies occur in high percentage. The lowest spermiogram values were found in men with testicular cancer. It is necessary to take into account long-term storage and fertilization by micromanipulation methods. The number of men who die is significantly higher than the number of those who use sperm to treat infertility. Cryopreservation of sperm should be offered to each patient prior to the therapy leading to the destruction of spermatogenesis. Publication ethics: The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for bio medical papers. Conflict of interests: The authors declare they have no potential conflicts of interest concerning the drugs, products or services used in the study. Dedication: The work was supported by the Ministry of Health of the Czech Republic – RVO (FNBr: 65269705), IGA No. NR/ 8469-3, AZV MZ ČR No. NV18-01-00544 and NV-18-08-00291.

• MeSH
• Reproductive Techniques, Assisted * MeSH
• Cryopreservation methods   MeSH
• Humans MeSH
• Retrospective Studies MeSH
• Sperm Banks * MeSH
• Spermatozoa MeSH
• Pregnancy MeSH
• Testicular Neoplasms therapy   MeSH
• Semen Preservation MeSH
• Check Tag
• Humans MeSH
• Male MeSH
• Pregnancy MeSH
• Female MeSH