The prevalence of centenarians, people who lived 100 years and longer, is steadily growing in the last decades. This exceptional longevity is based on multifaceted processes influenced by a combination of intrinsic and extrinsic factors such as sex, (epi-)genetic factors, gut microbiota, cellular metabolism, exposure to oxidative stress, immune status, cardiovascular risk factors, environmental factors, and lifestyle behavior. Epidemiologically, the incidence rate of cardiovascular diseases is reduced in healthy centenarians along with late onset of age-related diseases compared with the general aged population. Understanding the mechanisms that affect vascular ageing in centenarians and the underlying factors could offer valuable insights for developing strategies to improve overall healthy life span in the elderly. This review discusses these key factors influencing vascular ageing and how their modulation could foster healthy longevity.
- MeSH
- Longevity * physiology MeSH
- Cardiovascular Diseases physiopathology epidemiology MeSH
- Humans MeSH
- Oxidative Stress physiology MeSH
- Risk Factors MeSH
- Aged, 80 and over MeSH
- Aging * physiology MeSH
- Gastrointestinal Microbiome physiology MeSH
- Healthy Aging physiology MeSH
- Life Style MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Aged, 80 and over MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Review MeSH
The tumor microenvironment (TME) is a complex, highly structured, and dynamic ecosystem that plays a pivotal role in the progression of both primary and metastatic tumors. Precise assessment of the dynamic spatiotemporal features of the TME is crucial for understanding cancer evolution and designing effective therapeutic strategies. Cancer is increasingly recognized as a systemic disease, influenced not only by the TME, but also by a multitude of systemic factors, including whole-body metabolism, gut microbiome, endocrine signaling, and circadian rhythm. In this review, we summarize the intrinsic, extrinsic, and systemic factors contributing to the formation of 'cold' tumors within the framework of the cancer-immunity cycle. Correspondingly, we discuss potential strategies for converting 'cold' tumors into 'hot' ones to enhance therapeutic efficacy.
- MeSH
- Circadian Rhythm MeSH
- Humans MeSH
- Tumor Microenvironment * immunology MeSH
- Neoplasms * pathology therapy MeSH
- Gastrointestinal Microbiome MeSH
- Animals MeSH
- Check Tag
- Humans MeSH
- Animals MeSH
- Publication type
- Journal Article MeSH
- Review MeSH
Necrotizing enterocolitis (NEC) is one of the most devastating intestinal diseases observed in preterm in the first days of life. Researchers have recently focused on potential predictive biomarkers for early and concomitant diagnoses. Thus, we inquired about the linkage of intestinal dysbiosis, one of the most important factors in NEC development to the gut microbiota. In this study, the systematic differences in the bacterial composition between neonates affected by NEC and healthy newborns were highlighted by metagenomic analysis. The next-generation sequencing of the V3-V4 variable region of the 16S rRNA gene and gene-specific qPCR analyzed the untargeted gut microbiota. Total bacteria, total and fecal coliform loads in stool samples with NEC were higher than control. OTU-level relative abundances of NEC infant was characterized by Firmicutes and Bacteroidetes at phylum levels. At the genus level, NEC stool was identified by the lack of Klebsiella and the presence of Roseburia, Blautia, and Parasutterella. Finally, Clostridium fessum was the predominant species of Clostridium genus in disease and healthy specimens at the species level, whereas Clostridium jeddahitimonense was at NEC diagnosis. Despite a strong relationship between pathophysiology and characterization of gut microbiota at a clinical diagnosis of NEC, our results emphasize the broad difficulty in identifying potential biomarkers.
- MeSH
- Bacteria * classification genetics isolation & purification MeSH
- DNA, Bacterial genetics MeSH
- Dysbiosis microbiology MeSH
- Feces * microbiology MeSH
- Humans MeSH
- Metagenomics MeSH
- Enterocolitis, Necrotizing * microbiology MeSH
- Infant, Premature MeSH
- Infant, Newborn MeSH
- RNA, Ribosomal, 16S * genetics MeSH
- Gastrointestinal Microbiome * MeSH
- High-Throughput Nucleotide Sequencing MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Infant, Newborn MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
BACKGROUND: Robot-assisted minimally invasive esophagectomy (RAMIE) is increasingly adopted in centers worldwide, with ongoing refinements to enhance results. This study aims to assess the current state of RAMIE worldwide and to identify potential areas for improvement. METHODS: This descriptive study analyzed prospective data from esophageal cancer patients who underwent transthoracic RAMIE in Upper GI International Robotic Association (UGIRA) centers. Main endpoints included textbook outcome rate, surgical techniques, and perioperative outcomes. Analyses were performed separately for intrathoracic (Ivor-Lewis) and cervical anastomosis (McKeown), divided into three time cohorts (2016-2018, 2019-2020, 2021-2023). A sensitivity analysis was conducted with cases after the learning curve (> 70 cases). RESULTS: Across 28 UGIRA centers, 2012 Ivor-Lewis and 1180 McKeown procedures were performed. Over the time cohorts, textbook outcome rates were 39%, 48%, and 49% for Ivor-Lewis, and 49%, 63%, and 61% for McKeown procedures, respectively. Fully robotic procedures accounted for 66%, 51%, and 60% of Ivor-Lewis procedures, and 53%, 81%, and 66% of McKeown procedures. Lymph node yield showed 27, 30, and 30 nodes in Ivor-Lewis procedures, and 26, 26, and 34 nodes in McKeown procedures. Furthermore, high mediastinal lymphadenectomy was performed in 65%, 43%, and 37%, and 70%, 48%, and 64% of Ivor-Lewis and McKeown procedures, respectively. Anastomotic leakage rates were 22%, 22%, and 16% in Ivor-Lewis cases, and 14%, 12%, and 11% in McKeown cases. Hospital stay was 13, 14, and 13 days for Ivor-Lewis procedures, and 12, 9, and 11 days for McKeown procedures. In Ivor-Lewis and McKeown, respectively, the sensitivity analysis revealed textbook outcome rates of 43%, 54%, and 51%, and 47%, 64%, and 64%; anastomotic leakage rates of 28%, 18%, and 15%, and 13%, 11%, and 10%; and hospital stay of 11, 12, and 12 days, and 10, 9, and 9 days. CONCLUSIONS: This study demonstrates favorable outcomes over time in achieving textbook outcome after RAMIE. Areas for improvement include a reduction of anastomotic leakage and shortening of hospital stay.
- MeSH
- Esophagectomy * methods MeSH
- Middle Aged MeSH
- Humans MeSH
- Minimally Invasive Surgical Procedures methods MeSH
- Esophageal Neoplasms * surgery pathology MeSH
- Follow-Up Studies MeSH
- Postoperative Complications epidemiology MeSH
- Prognosis MeSH
- Prospective Studies MeSH
- Registries * MeSH
- Robotic Surgical Procedures * methods MeSH
- Aged MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
INTRODUCTION: Impulsivity and aggression are often interlinked behavioral traits that have major implications for our society. Therefore, the study of this phenomenon and derivative interventions that could lead to better control of impulsive aggression are of interest. METHODS: We analyzed the composition and diversity of the gut bacterial microbiome of 33 impulsively violent female convicts with dissocial personality disorder and 20 non-impulsive age-matched women. Further, levels of assorted neurotransmitters and short-chain fatty acids (SCFAs) were analyzed in serum and stool samples. We also assessed all participants using a battery of psychological questionnaires and tested possible correlations between the collected clinical data and the composition and diversity of their microbiomes and metabolites. RESULTS: We identified four bacterial amplicon sequencing variants that were differentially abundant in non-impulsive versus impulsive women - the genera Bacteroides, Barnesiella, and the order Rhodospirillales were more abundant in impulsive women. In contrast, the genus Catenisphaera was more abundant in non-impulsive women. Fecal tryptophan levels were significantly higher in impulsive women. Association analysis revealed a strong positive intercorrelation between most fecal SCFAs in the entire dataset. CONCLUSIONS: Our study demonstrated possible associations between gut microbiomes and their metabolites and impulsive behavior in a unique cohort of prisoners convicted of violent assaults and a matched group of non-impulsive women from the same prison. Genus Bacteroides, which was differentially abundant in the two groups, encoded enzymes that affect serotonin pathways and could contribute to this maladaptive behavior. Similarly, increased fecal tryptophan levels in impulsive individuals could affect neuronal circuits in the brain. INTRODUCTION: Impulsivity and aggression are often interlinked behavioral traits that have major implications for our society. Therefore, the study of this phenomenon and derivative interventions that could lead to better control of impulsive aggression are of interest. METHODS: We analyzed the composition and diversity of the gut bacterial microbiome of 33 impulsively violent female convicts with dissocial personality disorder and 20 non-impulsive age-matched women. Further, levels of assorted neurotransmitters and short-chain fatty acids (SCFAs) were analyzed in serum and stool samples. We also assessed all participants using a battery of psychological questionnaires and tested possible correlations between the collected clinical data and the composition and diversity of their microbiomes and metabolites. RESULTS: We identified four bacterial amplicon sequencing variants that were differentially abundant in non-impulsive versus impulsive women - the genera Bacteroides, Barnesiella, and the order Rhodospirillales were more abundant in impulsive women. In contrast, the genus Catenisphaera was more abundant in non-impulsive women. Fecal tryptophan levels were significantly higher in impulsive women. Association analysis revealed a strong positive intercorrelation between most fecal SCFAs in the entire dataset. CONCLUSIONS: Our study demonstrated possible associations between gut microbiomes and their metabolites and impulsive behavior in a unique cohort of prisoners convicted of violent assaults and a matched group of non-impulsive women from the same prison. Genus Bacteroides, which was differentially abundant in the two groups, encoded enzymes that affect serotonin pathways and could contribute to this maladaptive behavior. Similarly, increased fecal tryptophan levels in impulsive individuals could affect neuronal circuits in the brain.
- MeSH
- Aggression physiology MeSH
- Adult MeSH
- Feces * microbiology chemistry MeSH
- Impulsive Behavior * physiology MeSH
- Fatty Acids, Volatile analysis metabolism MeSH
- Middle Aged MeSH
- Humans MeSH
- Young Adult MeSH
- Gastrointestinal Microbiome * physiology MeSH
- Tryptophan blood metabolism MeSH
- Criminals MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Young Adult MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
BACKGROUND AND AIMS: Neurodegenerative disorders affecting the brain and spinal cord are caused by a large number of factors. More recently, imbalances in gut microbiota are found to be one factor linked directly to neurological dysfunction. Probiotics prevent cognitive decline. For the first time, the effect of probiotics was assessed by monitoring the concentrations of the neurodegeneration biomarker neurofilament light chains (NfL) in a well-defined group of community-dwelling individuals. The aim of this study was to determine whether administration of our new probiotics could reduce NfL concentrations. METHODS: The serum NfL concentrations were measured in total of 190 serum samples of 85 older community-dwelling individuals. The participants were randomly divided into two groups: the PROPLA group and the PLAPRO group. Individuals in the PROPLA group started with a three-month use of probiotics and continued with a three-month use of placebo while the order was reversed in the PLAPRO group. The participants underwent detailed examinations at three time points: at baseline, in three and six months. The serum NfL concentrations were determined using ultrasensitive single-molecule array (SIMOA) assay. RESULTS: Longitudinal comparisons of NfL concentrations between samplings at different time points in the PROPLA and PLAPRO groups showed no statistically significant differences. Baseline NfL concentrations at the beginning of the study and in the succeeding samplings were not significantly different for the two groups in cross-sectional comparisons. CONCLUSIONS: Serum NfL concentrations were not influenced by the three-month use of probiotics.
- MeSH
- Biomarkers blood MeSH
- Double-Blind Method MeSH
- Middle Aged MeSH
- Humans MeSH
- Neurofilament Proteins * blood MeSH
- Probiotics * therapeutic use MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Gastrointestinal Microbiome MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Multicenter Study MeSH
- Randomized Controlled Trial MeSH
Východiska: Krvácení do horní části gastrointestinálního traktu je relativně častou, ale potenciálně fatální náhlou příhodou břišní. Na diagnostice a léčbě tohoto onemocnění se podílí řada odborností, ale nemocní jsou obvykle primárně hospitalizováni na lůžkách chirurgických oddělení. Ošetřující lékař, tj. chirurg je tedy zodpovědný za léčbu pacienta a indikaci konzilií spolupracujících specialistů. Operace může být také ultimum refugium postupem při selhání méně invazivních léčebných postupů. Cíl: Cílem práce je přehled současných postupů a metod užívaných v léčbě pacientů s krvácením do horní části trávicího traktu na základě literární rešerše i vlastních zkušeností s léčbou těchto nemocných. Závěr: Krvácení do horní části gastrointestinalniho traktu je relativně častou náhlou příhodou. Jde o krvácení, jehož zdroj je proximálně od Treitzova ligamenta. Diagnostika a léčba vyžaduje multioborovou spolupráci více oborů. Klíčovou roli v diagnostice a terapii dnes představuje endoskopie. Správné načasování jednotlivých kroků je zásadní pro přežití pacienta. Článek v přehledné formě shrnuje současné doporučené postupy od iniciální resuscitace, tekutinové léčby, podání krevních náhrad přes úpravu koagulačních parametrů u pacientů s antikoagulační a antitrombotickou léčbou, možnosti endoskopické diagnostiky a terapie a také postupy při recidivě krvácení, vč. angiointervenční a chirurgické léčby s hlavním zaměřením na nevariceální krvácení.
Background: Upper gastrointestinal bleeding is a relatively common but potentially fatal medical emergency. Many medical disciplines are involved in the diagnosis and treatment of this condition. The patients are usually admitted primarily to surgical wards and the attending surgeon is responsible for management of the patients. Surgery may also be an ultimatum refugium when less invasive treatments fail. Objective: The aim of this study is to review the current practice in the management of patients with upper gastrointestinal bleeding based on a literature review and our own experience in the management of these patients. Conclusions: Upper gastrointestinal bleeding is a relatively common emergency. It is a hemorrhage whose the source is proximal to the ligament of Treitz. The diagnosis and treatment require a multidisciplinary approach. Today, endoscopy plays a key role in the diagnosis and treatment. The correct timing of each step is essential for patient survival. This article provides a clear summary of the current recommended procedures from initial resuscitation, fluid therapy, administration of blood substitutes, adjustment of coagulation parameters in patients on anticoagulant and antithrombotic therapy, endoscopic diagnostic and therapeutic options, and procedures for recurrent bleeding, including angiointervention and surgical treatment, with a main focus on nonvariceal bleeding.
- MeSH
- Anticoagulants adverse effects therapeutic use MeSH
- Endoscopy, Digestive System MeSH
- Gastrointestinal Hemorrhage * diagnosis etiology therapy MeSH
- Upper Gastrointestinal Tract * surgery pathology drug effects MeSH
- Humans MeSH
- Practice Guidelines as Topic MeSH
- Check Tag
- Humans MeSH
- Publication type
- Review MeSH
Blastocystis je jednobuněčný anaerobní mikroorganismus, osídlující lidský i zvířecí gastrointestinální trakt (GIT). Je nejhojnějším zástupcem eukaryot nalézaných v lidské stolici a osídluje asi miliardu lidí po celém světě. I přes četný výskyt není jasná jeho přímá patogenita a jeho postavení mezi jinými významnějšími parazity GIT. Nález Blastocystis bývá spojován s různými nespecifickými soubory příznaků, jako jsou průjem, bolesti břicha, plynatost, nevolnost, tento mikroorganismus bývá často diagnostikován u pacientů se syndromem dráždivého tračníku, ulcerózní kolitidou či kopřivkou. Kontroverze přetrvávají zejména z důvodu přítomnosti Blastocystis i u asymptomatických pacientů a pro nejasný mechanismus potenciální patogenity. Rovněž léčba nemá jasně dané doporučené postupy z výše uvedených důvodů.
Blastocystis is a unicellular anaerobic microorganism inhabiting the human and animal gastrointestinal tract (GIT). It is the most abundant representative of eukaryotes reported in human feces and found in approx. a billion people worldwide. Despite the common occurrence, its direct pathogenicity and status among other, more significant, GIT parasites remain unclear. Blastocystis colonization is associated with various non-specific clusters of symptoms, such as diarrhea, abdominal pain, flatulence, or nausea and is often diagnosed in patients with irritable bowel syndrome, ulcerative colitis, or urticaria. Controversy persists mainly because of the detection of Blastocystis even in asymptomatic patients and the unclear mechanism of its potential pathogenicity. Also, for the reasons mentioned above, no treatment guidelines are available.
- MeSH
- Asymptomatic Infections MeSH
- Blastocystis * pathogenicity MeSH
- Blastocystis Infections diagnosis therapy MeSH
- Abdominal Pain etiology MeSH
- Flatulence etiology MeSH
- Gastrointestinal Tract microbiology MeSH
- Humans MeSH
- Nausea etiology MeSH
- Diarrhea etiology MeSH
- Irritable Bowel Syndrome microbiology MeSH
- Colitis, Ulcerative microbiology MeSH
- Urticaria microbiology MeSH
- Treatment Outcome MeSH
- Check Tag
- Humans MeSH
Úvod: PEUGIC (post-endoscopy upper gastrointestinal cancer) je definován jako karcinom v horní části gastrointestinálního traktu (GIT), kterému v době diagnózy předcházela v posledních 3 letech horní endoskopie, která tento karcinom neprokázala. Dle doporučení České gastroenterologické společnosti je míra PEUGIC důležitým parametrem kvality endoskopie a neměla by přesahovat 10 %. Cílem této práce bylo zhodnotit výskyt a rizikové faktory PEUGIC v Nemocnici ve Frýdku-Místku v období 2013–2023. Metodika: Jedná se o retrospektivní analýzu všech pacientů s diagnostikovaným nádorem horního zažívacího traktu od ledna 2013 do prosince 2023. Sledovanými údaji byl výskyt rodinné anamnézy (RA) nádoru horního GIT, indikace prováděné gastroskopie, poloha a histologický typ nádoru a terapie. K výpočtu rizikových faktorů PEUGIC byl použit chí-kvadrát test a Fisherův exaktní test: p < 0,05 bylo považováno za signifikantní. Výsledky: Za sledované období zde bylo provedeno celkem 22 727 gastroskopií a bylo diagnostikováno 122 pacientů s nádorem horního GIT (88 mužů a 34 žen), z toho 35 nádorů jícnu, 80 žaludku a 7 duodena. Rodinnou anamnézu tumoru horního GIT udávalo deset pacientů. Jako PEUGIC bylo hodnoceno dvanáct pacientů (9,84 %; 9 mužů a 3 ženy, průměrný věk 69,25 let), z toho šest v jícnu, pět v žaludku a jeden v duodenu. U dvou pacientů se jednalo o záchyt v rámci adekvátní dispenzarizace (Barrettův jícen, sledování po polypektomii). Jako reálné PEUGIC můžeme tedy hodnotit deset pacientů (8,2 %). Ani lokalizace tumoru, histologie, mužské pohlaví nebo RA tumoru horního GIT nebyly hodnoceny jako statisticky významné rizikové faktory nálezu PEUGIC. Závěr: Celková míra PEUGIC byla na našem pracovišti za sledované období 11 let 9,86 %, bez časných záchytů v rámci adekvátní dispenzarizace to bylo 8,2 %. Od reálných přehlédnutých PEUGIC, které jsou ukazatelem horší kvality endoskopie, je třeba odlišit časný záchyt karcinomu v rámci adekvátní surveillance.
Background: Post-endoscopy upper gastrointestinal cancer (PEUGIC) is defined as carcinoma in the upper gastrointestinal (GI) tract, which was preceded by negative upper endoscopy in the past 3 years. According to current knowledge, the rate of PEUGIC is an important parameter of endoscopic quality and should not exceed 10%. The aim of this study was to evaluate the occurrence and risk factors of PEUGIC at a non-university hospital in Frýdek-Místek between 2013 and 2023. Methodology: This is a retrospective analysis of the patients diagnosed with upper GI cancer from January 2013 to December 2023. The data analyzed included family history of upper GI cancer, indications of the examination, therapy, tumor location, and histological type. Risk factors for PEUGIC were calculated using the Chi-squared test and Fisher‘s exact test, with P < 0.05 considered significant. Results: During the study period, a total of 22,727 gastroscopies were performed in total, and 122 patients were diagnosed with upper GI cancer (88 men and 34 women), including 35 esophageal tumors, 80 gastric tumors, and 7 duodenal tumors. Family history of upper GI tumors was reported in 10 patients. PEUGIC was identified in 12 patients (9.84%, 9 men and 3 women, mean age 69.25 years), including 6 in the esophagus, 5 in the stomach, and 1 in the duodenum. Two patients had early detection as part of adequate surveillance (Barrett‘s esophagus, post-polypectomy). Thus, we can evaluate 10 patients as true PEUGIC (8.20%). Tumor location, histology, male gender, or family history of upper GI tumors were not statistically significant risk factors for detecting PEUGIC. Conclusion: The overall rate of PEUGIC at our institution over the 11-year study period was 9.86%, and without early detected lesions as part of adequate surveillance, it was 8.20%. Early detection of PEUGIC indicated poorer endoscopy quality that needs to be distinguished from early detection of carcinoma with adequate surveillance.
