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PURPOSE OF REVIEW: Men face distinctive health-related challenges as a result of biological, behavioral, and sociocultural factors. In addition, the modern healthcare system does not offer men equal opportunities and options to ensure sex-specific access and delivery to health services. Men's health concerns are, indeed, often not addressed or even forgotten. In this review, we wanted to assess the impact of biology and sociocultural effects on sex-specific life-expectancy. RECENT FINDINGS: Globally, men have a shorter life expectancy than women. With a 5.8 years gender gap in the USA and 5.4 in the EU-27 (both in 2022). Cardiovascular disease, cancer, and accidents continue to represent the primary causes of mortality for both genders with all having disproportional preponderance in men. In recent years, there has been a notable decline in age-adjusted mortality rates related to cancer, while there has been an increase in deaths from accidental and intentional self-harm. Moreover, in the United States, men are more likely than women to develop and die from nonsex-specific cancers. As a result, men's poor health affects productivity, absenteeism, and employment. SUMMARY: The status of men in healthcare is complex. It is rooted in history, culture, and institutions. To address disparities, we need a comprehensive approach that includes policy reforms, sociocultural changes, and a fair and equitable public discourse. Grassroots and top-down strategies are needed to ensure a value-based societal healthcare system acknowledging the unique health needs of men.
- MeSH
- disparity zdravotní péče statistika a číselné údaje MeSH
- disparity zdravotního stavu MeSH
- dostupnost zdravotnických služeb statistika a číselné údaje MeSH
- lidé MeSH
- naděje dožití * MeSH
- poskytování zdravotní péče statistika a číselné údaje MeSH
- rovnost ve zdraví MeSH
- sexuální faktory MeSH
- zdraví mužů * MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
- Geografické názvy
- Spojené státy americké MeSH
Goals: This research aims to clarify the relationships between healthcare use and availability, preparation for active ageing and ageing, and involvement in the care of one's health among people aged 65 and over. Methods: Qualitative research (grounded theory) was used to achieve the goal. This study was conducted from the beginning of February to the end of April 2024. The informants were people aged 65 and over who lived in South Bohemia. Semi-structured interviews were used. Results: Health was the central category. Other categories were care availability, GP services, active ageing, alternative medicine, and hospitalisation. The connections found show that health is the key to fulfilling the idea of healthy ageing and is closely related to self-sufficiency. Self-sufficiency is essential from the point of view of active ageing. They pay attention to maintaining it from the point of view of planning the future. On the other hand, illness is a factor influencing thoughts about the future, the availability of care, and the need for information. Communication becomes an essential element, which is intertwined with the entire concept of successful ageing. Conclusion: The results suggest that paying more attention to examining the expectations of patients and healthcare professionals regarding care aimed at maintaining and restoring health, or possibly implementing changes, is going to be necessary.
- MeSH
- dostupnost zdravotnických služeb MeSH
- komunikace MeSH
- kvalitativní výzkum MeSH
- lidé MeSH
- nemoc psychologie MeSH
- poskytování zdravotní péče MeSH
- praktičtí lékaři MeSH
- rozhovory jako téma MeSH
- senioři MeSH
- zdravé stárnutí * psychologie MeSH
- zpráva o sobě MeSH
- Check Tag
- lidé MeSH
- senioři MeSH
- Publikační typ
- práce podpořená grantem MeSH
We analyzed mucormycosis data from the Zygomyco.net registry (2009-2022), encompassing cases from 16 countries. India, Russia and the Czech Republic provided the largest contributions. India reported the highest case number, consistent with its substantially higher incidence compared to that of high-income countries. Among the 382 patients with mucormycosis, 236 (61.8%) were male (male-to-female ratio 1.6). The median age was 48 years [interquartile range (IQR) 32-60]. There were 59 pediatric patients (median age ranging from < 1 month to 19 years). Diabetes mellitus type 2 was the most common underlying condition (39%), with significant geographic variation (> 70% of cases in India and Iran but only 6.9% in Europe). Hematologic malignancies (HM, 31.4%), the second most common underlying condition, were absent in India and Iran. The primary clinical presentations were rhino-orbito-cerebral mucormycosis (ROCM, 36.6%), pulmonary (33.2%) and cutaneous mucormycosis (17.5%). Patients with diabetes mellitus typically developed ROCM (55.9%), while pulmonary infections were more common in those with HM or hematopoietic cell transplantation (HCT) (47.5%, p < 0.001). Rhizopus was the leading fungal genus (58%), followed by Lichtheimia (13.7%) and Mucor (7%), with regional variations. Pulmonary infections in HM patients were linked to L. corymbifera and R. microsporus, while Apophysomyces spp. and Saksenaea spp. were more frequent in Indian healthcare-associated cutaneous cases. Concomitant infections were observed in 8.7% of patients with HM, complicating diagnosis and treatment. In most of them (57.1%), Aspergillus spp. was involved. Improved diagnostic practices, including direct microscopy and cultures, showed higher positivity rates, although PCR remained underutilized. Antifungal therapy, primarily with an amphotericin B formulation, combined with surgery, was the most common therapeutic approach. Overall mortality was high (47.8%), particularly in disseminated or advanced ROCM cases. Multivariable analysis identified older age, advanced ROCM, and HM/HCT as independent mortality risk factors (p < 0.05); whereas localized sinusitis and combined medical and surgical therapy were independently associated with improved outcomes (p < 0.006). This study underscores regional disparities in the mucormycosis epidemiology and species distribution. Improved early detection is needed, particularly in immunocompromised populations with HM. Enhanced surveillance and tailored public health strategies are crucial to address this ongoing global health threat.
- MeSH
- celosvětové zdraví MeSH
- dítě MeSH
- dospělí MeSH
- incidence MeSH
- kojenec MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mukormykóza * epidemiologie mikrobiologie farmakoterapie MeSH
- novorozenec MeSH
- předškolní dítě MeSH
- registrace * MeSH
- Check Tag
- dítě MeSH
- dospělí MeSH
- kojenec MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- novorozenec MeSH
- předškolní dítě MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Evropa MeSH
Toscana virus (TOSV) is an emerging but neglected human pathogen currently circulating around the Mediterranean basin including North Africa. Human illness ranges from asymptomatic or mild flu-like syndromes to severe neurological diseases such as meningitis or meningoencephalitis. Despite its significant impact, understanding of TOSV transmission and epidemiology remains limited. Sand flies (Diptera: Phlebotominae), specifically Phlebotomus perniciosus and Phlebotomus perfiliewi, are believed to be the primary vectors of TOSV. However, the spread of TOSV to new geographical areas and its detection in other sand fly species suggest that additional species play a role in the circulation and transmission of this virus. This study investigated the vector competence of four sand fly species - P. tobbi, P. sergenti, P. papatasi, and Sergentomyia schwetzi - for two TOSV strains: 1500590 (TOSV A lineage) and MRS20104319501 (TOSV B lineage). Sand flies were orally challenged with TOSV via bloodmeals. None of the tested species showed susceptibility to the TOSV A strain. However, for TOSV B strain, P. tobbi demonstrated a high potential as a new vector, exhibiting high infection and dissemination rates. P. sergenti also showed some susceptibility to TOSV B, with the virus dissemination observed in all infected females. These finding suggests that P. tobbi and P. sergenti are new potential vectors for TOSV B. Given that P. tobbi and P. sergenti are the primary vectors of human leishmaniases in the Balkans, Turkey and Middle East, their susceptibility to TOSV could have significant epidemiological consequences. On the other hand, P. papatasi and S. schwetzi appeared refractory to TOSV B infection. Refractoriness of P. papatasi, a highly anthropophilic species distributed from the Mediterranean to the Middle East and India, suggests that this species does not contribute to TOSV circulation.
Úvod: Shigelóza je vysoce nakažlivé průjmové onemocnění s potenciálně velmi závažným průběhem. I s ohledem na třetinový nárůst případů v roce 2023 ve srovnání s rokem předchozím jsme si stanovili za cíl podat přehled aktuálních informací o onemocnění a analyzovat data nahlášených případů shigelózy v České republice (ČR). Metody: Zpracovali jsme narativní rešerši odborné literatury v českém a anglickém jazyce, zejména cílenou na evropské studie od roku 2018. Dále jsme provedli analýzu dat hlášených pod kódem diagnózy A03 v národním systému pro hlášení infekčních nemocí (ISIN) v letech 2018–2023. Soustředili jsme se na hlavní epidemiologické ukazatele, zejména pohlaví, věk, geografickou distribuci, sezonnost a hospitalizace. Použity byly programy Excel (verze 2016), STATA (verze 17) a Datawrapper GmbH. Výsledky: Celkem bylo nahlášeno 681 případů onemocnění shigelózou s průměrnou roční incidencí 1/100 000 obyvatel: do roku 2021 byla incidence mírně vyšší u žen, od roku 2022 evidujeme trend opačný. V pandemických letech byl zaznamenán významný pokles případů. V letech 2022 a 2023 byl počet případů mírně vyšší než v období před pandemií. Nejvíce případů evidujeme v ČR každoročně v měsících srpen až prosinec. Ze všech sérotypů shigel byla nejčastěji detekována S. sonnei (80 %), následovaná S. flexneri (15 %). Incidence na 100 000 obyvatel byla nejvyšší u osob ve věku 5–9 let: 2,6 (chlapci 2,4 a dívky 2,8), dále 1–4 roky: 2,4 (chlapci 2,2, dívky 2,6) a osob ve věku 25–34 let: 1,8 (muži 1,8 a ženy 1,7). Podle krajů byla průměrná roční specifická incidence nejvyšší v krajích Moravskoslezském, Olomouckém a v hlavním městě Praze. Hospitalizováno bylo 27 % případů, nejvíce ve věkových skupinách 25–34 a 5–9 let (shodně 17,9 %). Proporce hospitalizovaných případů v rámci jednotlivých věkových skupin byla nejvyšší ve věkové skupině 75+ let (69 %), dále věkových skupinách 1–4 roky, 5–9 let a 65–74let (32–37 %). V souvislosti s onemocněním bylo vykázáno jedno úmrtí muže ve věku 52 let. V rámci epidemického výskytu bylo nahlášeno 11 % případů. Importováno bylo 39 % nahlášených případů. Závěr: V ČR je shigelóza spíše málo zastoupeným gastrointestinálním onemocněním, přičemž téměř 40 % případů tvoří importované nákazy. V současnosti je hrozbou pro veřejné zdraví především globální šíření multirezistentních kmenů podpořené narůstajícím cestovním ruchem a volnými sexuálními praktikami. Rizikovými skupinami zůstávají děti, imunokompromitované osoby (včetně seniorů) a muži mající sex s muži. Očkování není v Evropě dostupné. Stěžejním je nadále dodržování základních hygienických pravidel, zejména v kolektivech a při práci s potravinami. Důraz by měl být dále kladen na zdravotní edukaci osob, včetně poučení před vycestováním do zahraničí. Důkladná anamnéza, včasné trasování, dohled a racionální volba eventuální antibiotické terapie jsou zásadní. V ČR musí být všechny suspektní kmeny zaslány do NRL ke konfirmaci. Celogenomovou sekvenaci a testy citlivosti na antibiotika je vhodné provádět u všech izolátů.
Introduction: Shigellosis is a highly contagious diarrheal disease, which could potentially be very serious. Considering the onethird increase in cases in 2023 compared to the previous year, we aimed to provide an update on the disease and to analyse data on reported cases of shigellosis in the Czech Republic (CZ). Methods: We conducted a narrative search of the literature in Czech and English, particularly targeting European studies from 2018 onwards. We also analysed data reported under the diagnosis code A03 to the National Infectious Disease Reporting System (ISIN) in 2018–2023. We focused on the main epidemiological indicators, i.e. gender, age, geographical distribution, seasonality, and hospitalizations. Excel (version 2016), STATA (version 17), and Datawrapper GmbH were used. Results: A total of 681 shigellosis cases were reported with an average annual incidence of 1/100,000 population: until 2021, the incidence was slightly higher in women, while from 2022 onwards, the trend was reversed. A significant decrease in cases was recorded in the pandemic years. In 2022 and 2023, the number of cases was slightly higher than in the pre-pandemic period. Most cases were detected in CZ in August and December each year. Of all shigella serotypes, S. sonnei was the most frequently detected (80%), followed by S. flexneri (15%). The incidence per 100.000 population was highest among children aged 5–9 years: 2.6 (boys 2.4 and girls 2.8), followed by 1–4-year-olds: 2.4 (2.2 and 2.6, respectively) and persons aged 25–34 years: 1.8 (males 1.8 and females 1.7). Within individual age group, the average annual specific incidence rates were highest in the Moravian-Silesian and Olomouc regions and the capital city Prague. Hospitalizations accounted for 27% of cases, with the highest numbers in the 25–34 and 5–9 age groups (both 17.9%). The proportion of hospitalized cases was highest in the age groups 75+ (69%), 1–4, 5–9, and 65–74 (32–37%). A 52-year-old man was reported to have die in relation to the disease. Eleven percent of cases were reported in outbreak settings. Thirty-nine percent of reported cases were imported. Conclusions: In CZ, shigellosis is a relatively rare gastrointestinal disease, with nearly 40% of cases being imported. At present, the threat to public health is posed mainly by the global spread of multi-resistant strains linked to increasing tourism and free sexual practices. Children, immunocompromised persons (including the elderly), and men who have sex with men remain risk groups. Vaccination is not available in Europe. Compliance with basic hygiene rules, especially in collectives and when working with food, is still a key concern. Emphasis should also be placed on the health education, including instructions before traveling abroad. A thorough medical history, early tracing, surveillance, and rational choice of antibiotic therapy if appropriate are essential. In CZ, all suspected strains shall be sent to the NRL for confirmation. Whole genome sequencing and antibiotic susceptibility testing should be performed on all isolates.
Russia's invasion and war in Ukraine have caused a major humanitarian crisis among Ukrainian citizens, but also specifically affected diagnosis and provision of HIV care. As Ukraine remains the country with the second highest (after Russia) HIV incidence in Europe, the forced migration resulting from the war has required urgent and targeted responses to allow for uninterrupted access to medical care and antiretroviral drug supply in neighboring countries and beyond. Response and integration of people with HIV (PWH) has been swift across European countries, but several challenges remain. Key challenges relate to the expansion of unstigmatized HIV testing to tackle late diagnoses, development of legal frameworks allowing for access to medication not registered or under patent protection in other European countries, diagnosis and treatment of key comorbidities including tuberculosis (TB) and hepatitis C virus (HCV), vaccination programs, and continued surveillance for drug resistance and changes in molecular epidemiology.
- MeSH
- antiretrovirové látky terapeutické užití zásobování a distribuce MeSH
- dostupnost zdravotnických služeb * MeSH
- HIV infekce * farmakoterapie diagnóza epidemiologie MeSH
- lidé MeSH
- osoby s přechodným pobytem a migranti * statistika a číselné údaje MeSH
- ozbrojené konflikty MeSH
- poskytování zdravotní péče * organizace a řízení MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
- Geografické názvy
- Ukrajina MeSH
Phlebotomine sand flies (Diptera: Psychodidae: Phlebotominae) are the principal vectors of Leishmania spp. (Kinetoplastida: Trypanosomatidae) worldwide. The subgenus Adlerius is taxonomically challenging and currently comprises about 20 species with a wide geographic distribution from eastern Asia to southeastern Europe. Some species are confirmed or suspected vectors of Leishmania donovani/infantum, L. major, and L. tropica, and are thus of high medical and veterinary relevance. A single record of Phlebotomus (Adlerius) simici in Austria from 2018 marks its sporadic northernmost and westernmost occurrence, with the origin of its appearance remaining unclear. To better understand Adlerius diversification and particularly post-glacial spread of Ph. simici to northern parts of Europe, we combined phylogenetic analyses with climatic suitability modelling. Divergence time estimates well supported the currently observed geographic distribution of the studied species and revealed several taxonomic challenges in the subgenus. We clearly delineated three distinct genetic and geographic Ph. simici lineages and phylogeographically assessed diversification that were well supported by climatic models. This study provides a comprehensive phylogenetic analysis of the subgenus Adlerius, enhancing our understanding of the diversification in relation to changing climate of this understudied group, and we present new insights into the post-glacial spread of Ph. simici, a suspected vector of L. infantum.
- MeSH
- fylogeneze * MeSH
- fylogeografie * MeSH
- hmyz - vektory genetika klasifikace MeSH
- Phlebotomus * klasifikace genetika MeSH
- podnebí MeSH
- zvířata MeSH
- Check Tag
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Evropa MeSH
Ticks are important vectors of various microorganisms, including bacteria. In this study, we examined Hyalomma aegyptium ticks collected from 240 spur-thighed tortoises Testudo graeca at 42 localities in the Mediterranean and Middle East and analysed them for the presence of bacteria of the genera Anaplasma, Borrelia, Coxiella, and Rickettsia. Altogether, 576 out of 928 analysed ticks (62.1%) were positive for at least one of the tested bacteria. The highest prevalence in individual ticks was found for Borrelia turcica (43.6%), followed by Rickettsia (12.3%) and Anaplasma (6.1%). No sample was positive for Coxiella burnetii. Among Rickettsia, we detected two species, Rickettsia africae and Rickettsia aeschlimannii, and also other unspecified Rickettsia. Anaplasma (100% identity with A. phagocytophilum) was detected at 15 (35%) out of 42 studied localities, any of Rickettsia at 28 (67%), and B. turcica at 32 (76%) localities. The geographic distribution of the studied microorganisms varied, with none of them detected in Syria, and only Rickettsia spp. detected in Morocco. Sequence analysis revealed substantial genetic variability in all detected agents, with the most variable (36 new haplotypes) being glpQ gene used as a marker for B. turcica. We also analysed the prevalence of various co-infections among studied ticks, with the mean number of co-infected ticks per tortoise increased with the number of ticks per tortoise. However, the frequencies of co-infected ticks do not indicate the presence of antagonistic or synergistic facilitative interactions between the agents. According to our data, we could expect that the eco-epidemiological importance of H. aegyptium does not stem from their tortoise hosts but rather from the low host specificity of its larvae and nymphs, feeding on a wider spectrum of reptilian, avian, and mammalian hosts.
- MeSH
- Anaplasma * izolace a purifikace MeSH
- Borrelia izolace a purifikace MeSH
- Coxiella izolace a purifikace genetika MeSH
- infestace klíšťaty veterinární epidemiologie parazitologie MeSH
- Ixodidae * mikrobiologie růst a vývoj MeSH
- Rickettsia * izolace a purifikace MeSH
- želvy * mikrobiologie MeSH
- zvířata MeSH
- Check Tag
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Střední východ MeSH
- Středomoří MeSH
- MeSH
- časná detekce nádoru MeSH
- dostupnost zdravotnických služeb MeSH
- elektronické zdravotní záznamy MeSH
- kvalita zdravotní péče MeSH
- lékařské předpisy normy MeSH
- lidé MeSH
- náklady na zdravotní péči MeSH
- poskytování zdravotní péče * organizace a řízení MeSH
- úhradový mechanismus MeSH
- výdaje na zdravotnictví MeSH
- zdravotní pojištění organizace a řízení zákonodárství a právo MeSH
- zdravotničtí pracovníci MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- novinové články MeSH
- Geografické názvy
- Česká republika MeSH
- MeSH
- dávkové mechanismy MeSH
- dostupnost zdravotnických služeb * MeSH
- lékárny MeSH
- lidé MeSH
- úhrada zdravotního pojištění MeSH
- veřejné lékárenské služby ekonomika organizace a řízení MeSH
- zdravotní pojištění MeSH
- zdravotnické služby pro venkov MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- novinové články MeSH