INTRODUCTION: Natalizumab has proved to be more effective than fingolimod in reducing disease activity in relapsing-remitting multiple sclerosis (RRMS). Whether this association is universal for all patient groups remains to be determined. OBJECTIVE: The aim of this study was to compare the relative effectiveness of natalizumab and fingolimod in RRMS subgroups defined by the baseline demographic and clinical characteristics of interest. METHODS: Patients with RRMS who were given natalizumab or fingolimod were identified in a merged cohort from three international registries. Efficacy outcomes were compared across subgroups based on patients' sex, age, disease duration, Expanded Disability Status Scale (EDSS) score, and disease and magnetic resonance imaging (MRI) activity 12 months prior to treatment initiation. Study endpoints were number of relapses (analyzed with weighted negative binomial generalized linear model) and 6-month confirmed disability worsening and improvement events (weighted Cox proportional hazards model), recorded during study therapy. Each patient was weighted using inverse probability of treatment weighting based on propensity score. RESULTS: A total of 5148 patients (natalizumab 1989; fingolimod 3159) were included, with a mean ± standard deviation age at baseline of 38 ± 10 years, and the majority (72%) were women. The median on-treatment follow-up was 25 (quartiles 15-41) months. Natalizumab was associated with fewer relapses than fingolimod (incidence rate ratio [IRR]; 95% confidence interval [CI]) in women (0.76; 0.65-0.88); in those aged ≤ 38 years (0.64; 0.54-0.76); in those with disease duration ≤ 7 years (0.63; 0.53-0.76); in those with EDSS score < 4 (0.75; 0.64-0.88), < 6 (0.80; 0.70-0.91), and ≥ 6 (0.52; 0.31-0.86); and in patients with pre-baseline relapses (0.74; 0.64-0.86). A higher probability of confirmed disability improvement on natalizumab versus fingolimod (hazard ratio [HR]; 95% CI) was observed among women (1.36; 1.10-1.66); those aged > 38 years (1.34; 1.04-1.73); those with disease duration > 7 years (1.33; 1.01-1.74); those with EDSS score < 6 (1.21; 1.01-1.46) and ≥ 6 (1.93; 1.11-3.34); and patients with no new MRI lesion (1.73; 1.19-2.51). CONCLUSIONS: Overall, in women, younger patients, those with shorter disease durations, and patients with pre-treatment relapses, natalizumab was associated with a lower frequency of multiple sclerosis relapses than fingolimod. It was also associated with an increased chance of recovery from disability among most patients, particularly women and those with no recent MRI activity.

• MeSH
• Adult MeSH
• Fingolimod Hydrochloride therapeutic use   MeSH
• Immunologic Factors therapeutic use   MeSH
• Immunosuppressive Agents therapeutic use   MeSH
• Internationality * MeSH
• Cohort Studies MeSH
• Middle Aged MeSH
• Humans MeSH
• Longitudinal Studies MeSH
• Follow-Up Studies MeSH
• Natalizumab therapeutic use   MeSH
• Registries * MeSH
• Multiple Sclerosis, Relapsing-Remitting diagnosis   drug therapy   epidemiology   MeSH
• Secondary Prevention MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Observational Study MeSH
• Research Support, Non-U.S. Gov't MeSH
• Comparative Study MeSH

Multiple sclerosis (MS) is the most common cause of nontraumatic neurological disability in Europe and North America. Growth factor expression could participate in the repair process of the demyelinating disease. Among growth factors, brain derived neurotrophic factors (BDNF) has been demonstrated to play an important role in neuronal and axonal survival. In the central nervous system (CNS ), neurons are the main source of BDNF. Another potential source are activated astrocytes, which are present in inflamed areas in the CNS as shown in MS. In this study, total protein concentration (TPC) and BDNF levels in the cerebrospinal fluid (CS F) samples from the patients with MS (n = 48) and control subjects (n = 53) were measured using a Bio-Rad protein assay and enzyme linked immunosorbent assay (ELISA). No significant change in the CS F TPC of patients with MS was seen as compared to normal CS F. The presence of BDNF in the CS F samples was shown by Western blot. Using ELISA , it was shown that the level of BDNF in the MS CS F is higher than in normal CS F. It is concluded that BDNF is a constant component of human CS F. Moreover, it could be implicated in the pathophysiology of MS.

• MeSH
• Adult MeSH
• Humans MeSH
• Brain-Derived Neurotrophic Factor MeSH
• Multiple Sclerosis MeSH
• Check Tag
• Adult MeSH
• Humans MeSH
• Male MeSH
• Female MeSH

• MeSH
• Hematology MeSH
• Multiple Myeloma MeSH
• Paraproteinemias MeSH
• Publication type
• Handbook MeSH

• NML Fields
• hematologie a transfuzní lékařství
• onkologie

Cíl studie: Těhotenství je doprovázeno četnými změnami hemostatického a fibrinolytického systému. Dochází k významným vzestupům hladin koagulačních faktorů, zejména fibrinogenu a faktoru VIII. Vysoká hladina koagulačního faktoru VIII bývá dávána do souvislosti se vznikem trombotických komplikací během těhotenství a šestinedělí. Cílem naší studie bylo posoudit změny hladiny faktoru VIII v časném šestinedělí ve srovnání s ženami netěhotnými. Pracoviště: Porodnicko-gynekologická klinika FN a LF UP, Olomouc. Metodika: Jednalo se prospektivní studii, do které bylo zařazeno 197 zdravých rodiček. Soubor tvořily prvorodičky nebo vícerodičky, jejichž předcházející těhotenství nebylo komplikováno trombotickými příhodami. Věkové rozmezí souboru činilo 18–41 let. Všechny zařazené pacientky porodily spontánně, vaginálně. Krevní testy byly provedeny 24–72 hodin po porodu. Fyziologická hladina faktoru VIII je 70–150 %. Ženy, u kterých jsme zjistili hladinu faktoru VIII vyšší než 150 %, byly pozvány ke kontrolním odběrům po šestinedělí. Faktor VIII:C byl vyšetřován jednostupňovou koagulační metodou. Statistické vyhodnocení bylo provedeno programem Statsoft, Inc. (2001) Statistika Cz (Softwarový systém na analýzu dat), verze 6. Výsledky: Těhotenství a šestinedělí je spojeno s významným zvýšením hladiny faktoru VIII:C. Průměrná hodnota činila 194,09 %. U 119 pacientek, tzn. u 60,4 %, byla zjištěna hladina faktoru VIII:C vyšší než 150 %. Hodnoty kontrolních odběrů u 59 žen odebraných po šestinedělí se již nelišily od publikovaných výsledků věkově srovnatelných souborů netěhotných žen. Průměr činil 139,76 %. Závěr: Fyziologické těhotenství a šestinedělí je spojeno se zvýšenými hladinami faktoru VIII, avšak není doprovázeno zvýšeným výskytem porodnických komplikací. Nejvyšší hodnoty jsme zjistili u pacientek s krevní skupinou A. Po šestinedělí dochází k výraznému poklesu faktoru VIII, v případě přetrvávání vyšších hladin je potřeba vyloučit trombofilní stav.

Objective: Pregnancy is accompanied by changes in the coagulation and fibrinolytic systems. There is a marked increase in some of the coagulation factors, particularly fibrinogen and factor VIII. A high plasma levels of coagulation factor VIII is an important risk factor for thrombotic complications during pregnancy and puerperium. The aim of the study was to determine changes of the VIII:C in the early postpartum period. Setting: Dept. of Obstetrics and Gynaecology, Medical Faculty of Palacký University, Olomouc. Design: A longitudinal prospective study of 197 healthy women. Primi or multigravidas whose pervious pregnancies had been uncomplicated, aged 18–41 years. All of the deliveries were spontaneous and vaginal. First samples were taken between 24–72 hours postpartum. Women whose factor VIII plasma levels were higher than 150 (percentage of standard) were tested again after 6 weeks. Factor VIII:C was investigated by the one-step coagulation method. Statistical evaluation was done by Statsoft, Inc. (2001) Statistika Cz (Software system data analysis), version 6. Results: Pregnancy is associated with increased levels of VIII:C. Mean value was 194.09 percentage of standards. 119 (60.4 %) of the tested women had VIII:C higher than 150%. The post-puerperal tests were done in 59 women and showed values similar to those from formerly published data in age-matched non-pregnant group. Mean value was 139.76%. Conclusion: Normal pregnancy is connected with increased levels of factor VIII. However elevated plasma levels of VIII:C is not associated with poor pregnancy outcome. The highest level of the clotting factor VIII was associated with patient’s blood group A. Post-puerperal data showed distinct decrease of factor VIII. There is a necessity to rule out thrombophilia, in the case of the outlasting elevation of the factor VIII.

• MeSH
• Adult MeSH
• Factor VIII analysis   MeSH
• Research Support as Topic MeSH
• Blood Coagulation Factors analysis   MeSH
• Humans MeSH
• Postpartum Period MeSH
• Statistics as Topic MeSH
• Pregnancy MeSH
• Venous Thrombosis diagnosis   pathology   MeSH
• Check Tag
• Adult MeSH
• Humans MeSH
• Pregnancy MeSH
• Female MeSH

Data in physical educational research often have a multilevel structure, with observations on individuals nested within groups. Such data have been commonly analyzed at the individual level, whereas the group level variation has been ignored. The purpose of this article is to illustrate the use of multilevel confirmatory factor analysis via a didactic example of a two-level (students nested within classes) analysis of six items test battery artificial data. The results of this analysis indicate that a two-factor model adequately described within-class (individuals) differences in tests results. By contrast, at the between-class level (groups), a general factor of battery was sufficient to capture class differences in test results. In addition, two approaches to estimating population between- and within-class covariance matrices are discussed here. Present article demonstrated the merit of using multilevel techniques in researches, where data have multilevel components. Finally, several software programs appropriate for multilevel confirmatory factor analysis are recommended here.

• MeSH
• Factor Analysis, Statistical MeSH
• Financing, Organized MeSH
• Humans MeSH
• Computing Methodologies MeSH
• Schools MeSH
• Software standards   statistics & numerical data   MeSH
• Statistics as Topic MeSH
• Physical Education and Training methods   statistics & numerical data   MeSH
• Multilevel Analysis methods   standards   MeSH
• Educational Measurement methods   standards   statistics & numerical data   MeSH
• Check Tag
• Humans MeSH

Cíl studie: Vyhodnotit těhotenství po IVF + ET a rizikové faktory pro vznik a vývoj vícečetnéhotěhotenství.Typ studie: Retrospektivní analýza za období 1992-2000.Název a sídlo pracoviště: Gynekologicko-porodnická klinika FN a LF Univerzity Palackého, Olomouc.Metodika: Byl hodnocen soubor 343 těhotenství rozdělený do 4 skupin podle věku ženy: < 29 let(n=150), 30-34 let (n=122), 35-39 let (n=66), >40 let (n=5). Byl porovnán počet přenášených embryía četnost těhotenství v závislosti na věku ženy a porovnána frekvence vícečetných těhotenstvía spontánních potratů. U porodů (n=276) byla hodnocena závislost předčasných porodů, hmotnostiplodu a operativního vedení porodu na četnosti těhotenství. Statistické hodnocení bylo provedeno χ2 testem a jednofaktorovou analýzou rozptylu dle Sheffeho, metodou porovnání středních hodnot.Výsledky: Byl potvrzen vztah mezi počtem přenášených embryí a vznikem vícečetného těhotenství,v našem souboru bez ohledu na věk ženy. Procento zachycených vícečetných těhotenství je nejvyššípo přenosu 3 a 4 embryí (37,6 % vs 42,4 %) (P<0,01). Statisticky významná závislost byla potvrzena mezi četností a délkou těhotenství (P<0,05), způsobem vedení porodu (P<0,01) a hmotností plodu (P<0,05). Závěr: Vícečetná těhotenství jsou významnou komplikací metod AR. Mezi nejvýznamnejší faktory, které četnost ovlivňují, patří počet a kvalita transferovaných embrií. Vyšší četnost těhotenství negativně ovlivňuje délku těhotenství, hmotnost novorozence a způsob vedení porodu.

Objective: To evaluate the history of pregnancies after IVF-ET, to define multiple pregnancy riskfactors.Design: A retrospective analysis of the period of 1992-2000.Setting: Department of Gynecology and Obstetrics, University Hospital, Palacký University, Olomouc.Methods: 343 pregnancies were evaluated, divided into 4 groups according to the patients' ages:40 yrs. (n=5). The number of transferredembryos and frequency of pregnancies in relation to the patient' ages were compared as well as themultiple pregnancy and spontaneous abortion rates. The dependence of pretermlabour rate, foetusweight and the incidence of operative delivery on the frequency of pregnancies were evaluated(n=276). The data were analysed using the χ2 and Sheffe tests.Results: Three or four transferred embryos markedly increase the number of multiple pregnancies(P<0.01).No relation to the patient s ages was found.An increased incidence of operative deliveries (P<0.01) as well as preterm deliveries (P<0.05) in multiple pregnancies was found. Conclusions: The number of transferred embryos is the most important risk factor for multiple pregnancy development. It is recommended to decrease the number of transferred embryous to two or one per ET.

• MeSH
• Adult MeSH
• Fertilization in Vitro MeSH
• Research Support as Topic MeSH
• Gravidity MeSH
• Humans MeSH
• Birth Weight MeSH
• Embryo Transfer MeSH
• Abortion, Spontaneous MeSH
• Pregnancy, Multiple MeSH
• Pregnancy MeSH
• Delivery, Obstetric MeSH
• Check Tag
• Adult MeSH
• Humans MeSH
• Pregnancy MeSH
• Female MeSH
• Publication type
• Review MeSH
• Comparative Study MeSH

• Keywords
• ANOVA,
• MeSH
• Analysis of Variance MeSH
• Factor Analysis, Statistical MeSH
• Models, Statistical MeSH
• Statistics as Topic MeSH
• Publication type
• Handbook MeSH

• Conspectus
• Statistika
• NML Fields
• statistika, zdravotnická statistika

Autologní transplantace krvetvorných buněk (ASCT) hraje důležitou roli v terapii symptomatických pacientů s mnohočetným myelomem (MM). Cílem práce bylo retrospektivně analyzovat výsledky transplantační léčby u 495 pacientů s MM z 6 transplantačních center na základě dat z Národního registru transplantací krvetvorných buněk České republiky se zaměřením na identifikaci parametrů významných pro dobu do progrese (PFS) a celkové přežití (OS) pacientů po transplantaci. Pacienti byli transplantováni v období 1994–2005, medián věku byl 56 let, zastoupení klinických stadií dle Durie-Salmona bylo následující: I – 8 %, II – 29 %, III – 63 %. Celkem 411 pacientů (83 %) mělo ASCT do 1 roku od stanovení diagnózy. Medián doby sledování po transplantaci byl 33,3 měsíce. Peritransplační mortalita do dne +100 byla 1 %, medián přihojení štěpu byl 12 dní. Léčebné odpovědi po transplantaci dle kritérií EBMT byly uvedeny u 149 pacientů (30 %), z toho bylo u 94 pacientů dosaženo kompletní remise. Medián PFS od transplantace byl 27,5 měsíce a medián OS 62,3 měsíce. Faktory asociované s významně kratší dobou do progrese a kratším celkovým přežitím v analyzovaném souboru 495 pacientů byly následující: přítomnost paraproteinu IgA, vstupní přítomnost renální insuficience, klinické stadium III dle Durie-Salmona, nedosažení kompletní remise po transplantaci. Věk a léčebné odpovědi před transplantací neovlivnily významně dobu do progrese a celkové přežití. Autologní transplantace u mnohočetného myelomu je bezpečná a efektivní léčebná metoda s nízkou toxicitou. Nejvýznamnější prognostické faktory pro delší přežití nemocných po transplantaci jsou nepřítomnost renální insuficience a dosažení kompletní remise po transplantaci (p < 0,001).

Autologous stem cell transplantation (ASCT) has an important role in the treatment of symptomatic multiple myeloma (MM) patients. The aim of our study was to analyse retrospectively the results of ASCT in 495 MM patients from the Czech National Registry of Hematopoietic Stem Cell Transplantation. The data from 6 transplant centres were evaluated in order to identify significant variables associated with progression free survival (PFS) and overall survival (OS). Patients were transplanted between 1994 and 2005, the median age was 56 years, clinical stages according Durie-Salmon were as follows: stage I – 8 %, stage II – 29 %, stage III – 63 %. Transplantation was performed during the first year from diagnosis in 411 patients (83 %). The median follow-up from ASCT was 33.3 months. Transplant-related mortality to day +100 was 1 %, the median time to neutrophil engraftment was 12 days. The treatment responses after ASCT according to EBMT criteria were recorded in 149 patients (30 %), the complete response (CR) was achieved in 94 patients. Median PFS and OS from transplantation were 27.5 and 62.3 months, respectively. The significant prognostic parameters for both poor PFS and OS were as follows: IgA type of monoclonal immunoglobulin, renal impairment at diagnosis, clinical stage III according to Durie-Salmon and failure to achieve CR after ASCT. The status of disease before transplantation and the age did not significantly affect PFS and OS after ASCT. ASCT in multiple myeloma is a safe and an effective treatment method with a low toxicity. The most significant prognostic factors for longer survival after transplant ASCT are lack of the renal impairment and achievement of CR after transplantation ASCT (p < 0.001).

• MeSH
• Transplantation, Autologous statistics & numerical data   utilization   MeSH
• Research Support as Topic MeSH
• Remission Induction methods   MeSH
• Humans MeSH
• Multiple Myeloma therapy   MeSH
• Prognosis MeSH
• Registries statistics & numerical data   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Comparative Study MeSH
• Geographicals
• Czech Republic MeSH

BACKGROUND: Female sex hormones are known to have immunomodulatory effects. Therefore, reproductive factors and exogenous hormone use could influence the risk of multiple myeloma in women. However, the role of hormonal factors in multiple myeloma etiology remains unclear because previous investigations were underpowered to detect modest associations. METHODS: We conducted a pooled analysis of seven case-control studies included in the International Multiple Myeloma Consortium, with individual data on reproductive factors and exogenous hormone use from 1,072 female cases and 3,541 female controls. Study-specific odds ratios and corresponding 95% confidence intervals (CI) were estimated using logistic regression and pooled analyses were conducted using random effects meta-analyses. RESULTS: Multiple myeloma was not associated with reproductive factors, including ever parous [OR = 0.92; 95% confidence interval (CI), 0.68-1.25], or with hormonal contraception use (OR = 1.04; 95% CI, 0.80-1.36). Postmenopausal hormone therapy users had nonsignificantly reduced risks of multiple myeloma compared with never users, but this association differed across centers (OR = 0.65; 95% CI, 0.37-1.15, I(2) = 76.0%, Pheterogeneity = 0.01). CONCLUSIONS: These data do not support a role for reproductive factors or exogenous hormones in myelomagenesis. IMPACT: Incidence rates of multiple myeloma are higher in men than in women, and sex hormones could influence this pattern. Associations with reproductive factors and exogenous hormone use were inconclusive despite our large sample size, suggesting that female sex hormones may not play a significant role in multiple myeloma etiology.

• MeSH
• Adult MeSH
• Hormone Replacement Therapy adverse effects   MeSH
• Middle Aged MeSH
• Humans MeSH
• Meta-Analysis as Topic MeSH
• Young Adult MeSH
• Multiple Myeloma etiology   MeSH
• Follow-Up Studies MeSH
• Postmenopause * MeSH
• Prognosis MeSH
• Reproductive History * MeSH
• Risk Factors MeSH
• Neoplasm Staging MeSH
• Case-Control Studies MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Young Adult MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Research Support, N.I.H., Extramural MeSH
• Research Support, N.I.H., Intramural MeSH

• MeSH
• Meta-Analysis as Topic * MeSH
• Statistics as Topic MeSH
• Publication type
• Meta-Analysis MeSH
• Handbook MeSH

• Conspectus
• Statistika
• NML Fields
• statistika, zdravotnická statistika