INTRODUCTION AND OBJECTIVES: With increases in obesity and metabolic syndrome because of lifestyle-related factors, the prevalence of non-alcoholic fatty liver disease (NAFLD) also is increasing worldwide. In a subset of patients with NAFLD, an inflammatory process arises in the steatotic liver, known as non-alcoholic steatohepatitis, that leads to liver fibrosis and liver cirrhosis. In selected patients with obesity, bariatric surgery, and bariatric endoscopy are important therapeutic options. MATERIALS AND METHODS: This prospective interventional pilot study was conducted to investigate two types of intragastric balloons (IGB). The IGBs were the Orbera and the Spatz3. Liver fibrosis changes were monitored non-invasively using point and 2D shear wave ultrasound elastography (SWE) and transient elastography that allowed for quantification of liver steatosis using the controlled attenuation parameter (CAP). Patients were followed for 12 months. RESULTS: Of 34 patients implanted with an IGB, 30 completed follow-up at month 12; results for one patient were excluded because of initiation of obesity pharmacotherapy. Fifteen patients received the Orbera IGB, and nineteen patients received the Spatz3 type. In month 12, total and excess weight loss was 7.88 % and 30.13 %. Elastography values decreased from baseline (3.88 kPa) to 3.61 kPa at month 12 (p 0.024). 2D SWE values decreased from baseline (5.42 kPa) to a value of 4.91 kPa at month twelve (p 0.135). Transient elastography values decreased from baseline (5.62 kPa) to a value of 4.17 kPa at month twelve (p 0.009). CONCLUSIONS: Bariatric endoscopy in the form of IGB implantation leads to weight reduction and improvement of liver fibrosis and steatosis. GOV REGISTRATION: NCT04895943.

• MeSH
• bariatrická chirurgie * MeSH
• časové faktory MeSH
• design vybavení MeSH
• dospělí MeSH
• elastografie MeSH
• hmotnostní úbytek MeSH
• jaterní cirhóza * etiologie   diagnostické zobrazování   diagnóza   MeSH
• lidé středního věku MeSH
• lidé MeSH
• nealkoholová steatóza jater * diagnostické zobrazování   diagnóza   etiologie   MeSH
• obezita * komplikace   chirurgie   diagnóza   MeSH
• pilotní projekty MeSH
• prospektivní studie MeSH
• výsledek terapie MeSH
• žaludeční balónek * MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• klinické zkoušky MeSH

BACKGROUND: Patients with severe aortic stenosis present frequently (∼50%) with concomitant obstructive coronary artery disease. Current guidelines recommend combined surgical aortic valve replacement (SAVR) and coronary artery bypass grafting (CABG) as the preferred treatment. Transcatheter aortic valve implantation (TAVI) and fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) represent a valid treatment alternative. We aimed to test the non-inferiority of FFR-guided PCI plus TAVI versus SAVR plus CABG in patients with severe aortic stenosis and complex coronary artery disease. METHODS: This international, multicentre, prospective, open-label, non-inferiority, randomised controlled trial was conducted at 18 tertiary medical centres across Europe. Patients (aged ≥70 years) with severe aortic stenosis and complex coronary artery disease, deemed feasible for percutaneous or surgical treatment according to the on-site Heart Team, were randomly assigned (1:1) to FFR-guided PCI plus TAVI or SAVR plus CABG according to a computer-generated sequence with random permuted blocks sizes stratified by site. The primary endpoint was a composite of all-cause mortality, myocardial infarction, disabling stroke, clinically driven target-vessel revascularisation, valve reintervention, and life-threatening or disabling bleeding at 1 year post-treatment. The trial was powered for non-inferiority (with a margin of 15%) and if met, for superiority. The primary and safety analyses were done per an intention-to-treat principle. This trial is registered with ClinicalTrials.gov (NCT03424941) and is closed. FINDINGS: Between May 31, 2018, and June 30, 2023, 172 patients were enrolled, of whom 91 were assigned to the FFR-guided PCI plus TAVI group and 81 to the SAVR plus CABG group. The mean age of patients was 76·5 years (SD 3·9). 118 (69%) of 172 patients were male and 54 (31%) patients were female. FFR-guided PCI plus TAVI resulted in favourable outcomes for the primary endpoint (four [4%] of 91 patients) versus SAVR plus CABG (17 [23%] of 77 patients; risk difference -18·5 [90% CI -27·8 to -9·7]), which was below the 15% prespecified non-inferiority margin (pnon-inferiority<0·001). FFR-guided PCI plus TAVI was superior to SAVR plus CABG (hazard ratio 0·17 [95% CI 0·06-0·51]; psuperiority<0·001), which was driven mainly by all-cause mortality (none [0%] of 91 patients vs seven (10%) of 77 patients; p=0·0025) and life-threatening bleeding (two [2%] vs nine [12%]; p=0·010). INTERPRETATION: The TCW trial is the first trial to compare percutaneous treatment versus surgical treatment in patients with severe aortic stenosis and complex coronary artery disease, showing favourable primary endpoint and mortality outcomes with percutaneous treatment. FUNDING: Isala Heart Centre and Medtronic.

• MeSH
• aortální stenóza * chirurgie   komplikace   MeSH
• chirurgická náhrada chlopně metody   MeSH
• frakční průtoková rezerva myokardu * MeSH
• koronární angioplastika * metody   MeSH
• koronární bypass * metody   MeSH
• lidé MeSH
• nemoci koronárních tepen * chirurgie   komplikace   terapie   MeSH
• prospektivní studie MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• transkatetrální implantace aortální chlopně * metody   MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• hodnocení ekvivalence MeSH
• multicentrická studie MeSH
• srovnávací studie MeSH

Autologous hematopoietic cell transplants (auto-HCTs) remain the standard of care for transplant-eligible MM patients. The general practice has been to undergo upfront apheresis following induction to collect sufficient number of CD34+ cells to facilitate two auto-HCTs. However, 5-30% of MM patients do not initially mobilise a sufficient number of hematopoietic stem cells and are classified as poor mobilizers (PM). We compared the baseline characteristics and outcomes of 61 PMs and 816 non-PM patients who underwent a second auto-HCT and who were enrolled in the non-interventional CALM study (NCT01362972). Only patients who collected CD34+ prior to auto-HCT1 were included. Auto-HCT2 comprised both tandem and salvage transplants. PMs were re-mobilized with plerixafor (n = 24, 39.3%) or non-plerixafor-based regimens (n = 37, 60.7%). There were no significant differences in engraftment, progression-free survival (PFS) or overall survival (OS) after the second auto-HCT between PM and non-PM patients. There was a trend to shorter PFS in PM patients undergoing salvage auto-HCT (median 9.6 vs. 12.9 months; p = 0.08) but no significant difference in OS. The median OS was 41.1 months for PM and 41.2 months for non-PM patients (p = 0.86). These data suggest that salvage mobilization is effective and does not affect overall outcomes after a second auto-HCT.

• MeSH
• autologní transplantace * metody   MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mnohočetný myelom * terapie   mortalita   MeSH
• mobilizace hematopoetických kmenových buněk * metody   MeSH
• retrospektivní studie MeSH
• senioři MeSH
• transplantace hematopoetických kmenových buněk * metody   MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH

OBJECTIVES: Pseudomonas aeruginosa (PA) is a common causative pathogen of pneumonia acquired in the intensive care unit (ICU). The aim of this study was to determine the incidence of PA ICU pneumonia (PAIP) and to quantify its independent association with PA colonization at different body sites. METHODS: Adult patients on mechanical ventilation at ICU admission were prospectively enrolled across 30 European ICUs. PA colonization in the perianal area and in the lower respiratory tract was assessed within 72 hours after ICU admission and twice weekly until ICU discharge. PAIP development was evaluated daily. Competing risk models with colonization as a time-varying exposure and ICU death and discharge as competing events were fitted and adjusted for confounders to investigate the association between PA carriage and PAIP. RESULTS: A total of 1971 subjects were enrolled. The colonization prevalence with PA in the first 72 hours of ICU admission was 10.4% (179 perianal and 51 respiratory), whereas the acquisition incidence during the ICU stay was 7.0% (158 perianal and 47 respiratory). Of the 43 (1.8%) patients who developed PAIP, 11 (25.6%) were PA colonized on admission and 9 (20.9%) acquired colonization before PAIP onset. Both perianal (adjusted subdistribution hazard ratio, 4.4; 95% CI, 1.7-11.6) and respiratory colonization (adjusted subdistribution hazard ratio: 4.6, 95% CI, 1.9-11.1) were independently associated with PAIP development. DISCUSSION: PAIP incidence was higher in PA colonized vs. non-colonized patients. Colonization of both the rectum and of the respiratory tract was associated with development of PAIP. The increased risk of PA colonization for subsequent infection provides an opportunity for targeted preventive interventions.

• MeSH
• dospělí MeSH
• incidence MeSH
• infekce spojené se zdravotní péčí epidemiologie   mikrobiologie   MeSH
• jednotky intenzivní péče * statistika a číselné údaje   MeSH
• lidé středního věku MeSH
• lidé MeSH
• přenašečství epidemiologie   mikrobiologie   MeSH
• prevalence MeSH
• prospektivní studie MeSH
• pseudomonádové infekce * epidemiologie   mikrobiologie   MeSH
• Pseudomonas aeruginosa * izolace a purifikace   MeSH
• senioři MeSH
• ventilátorová pneumonie epidemiologie   mikrobiologie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• Geografické názvy
• Evropa 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
• agrese fyziologie   MeSH
• dospělí MeSH
• feces * mikrobiologie   chemie   MeSH
• impulzivní chování * fyziologie   MeSH
• kyseliny mastné těkavé analýza   metabolismus   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• střevní mikroflóra * fyziologie   MeSH
• tryptofan krev   metabolismus   MeSH
• zločinci MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

AIM: Percutaneous transthoracic needle biopsy (PTNB), an alternative to bronchoscopic confirmation of lung lesions, is today being associated with a risk of pneumothorax and hemorrhage. Further, there are no data on the possible risk of malignant disease spreading to the pleura at the site of the PTNB. Previous studies have dealt with this risk in stage I non-small cell lung cancer only. The aim of this study was thus to assess the risk of pleural recurrence for all types of lung lesions. Secondary objectives included assessment of diagnostic yield and safety with respect to the incidence of pneumothorax and hemorrhage. METHODS: Clinical data of all patients from the University Hospital in Pilsen who had undergone PTNB of lung lesions between 1.1.2018 and 31.12.2022 were included in this retrospective study. RESULTS: Following PTNB, ipsilateral pleural effusion occurred in 4.8% of patients without prior pleural infiltration. The effusion was confirmed as malignant in one patient (0.7%). Diagnostic yield of the method was 86.6%. We recorded pneumothorax or hemorrhage in the lung parenchyma or pleural space requiring medical intervention in 3.4% and 1.1% of patients, respectively. CONCLUSION: In our study, percutaneous transthoracic needle biopsy of lung lesions showed high sensitivity and low degree of acute complications requiring an invasive solution. The risk of pleural recurrence after a biopsy was very low. Consequently, we continue to consider this method to be an alternative to bronchoscopy biopsies.

• MeSH
• dospělí MeSH
• jehlová biopsie škodlivé účinky   metody   MeSH
• krvácení etiologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• nádory plic * patologie   MeSH
• pleurální výpotek etiologie   patologie   MeSH
• plíce patologie   MeSH
• pneumotorax * etiologie   MeSH
• retrospektivní studie MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

Úvod: Současný demografický vývoj zvyšuje potřebu hledání efektivních způsobů podpory starší populace, zejména v oblasti duševního zdraví, životní pohody a soběstačnosti. V ordinacích praktických lékařů se stále častěji objevují pacienti, jejichž potřeby přesahují rámec farmakologické léčby. Jedním z možných přístupů jak s touto tendencí pracovat je tzv. „social prescribing“ – doporučování nefarmakologických a komunitních intervencí jako součást komplexní zdravotní péče. Přehled konceptu: Social prescribing je inovativní mezioborový přístup, který propojuje zdravotní a sociální profesionální péči s neformální podporou a dostupnými komunitními zdroji. Jeho cílem je poskytovat individualizovanou podporu přizpůsobenou potřebám jednotlivce i charakteru komunity, ve které žije, a zároveň odlehčit systému profesionální zdravotní péče. Důraz je kladen na aktivní zapojení člověka do života v komunitě s ohledem na jeho zdravotní, sociální, emocionální i praktické potřeby ovlivňující jeho zdraví. Příklad z praxe: Článek dále představuje mezinárodní studii RECETAS, která zkoumá potenciál social prescribing aktivit v přírodním prostředí při snižování osamělosti a zlepšování kvality života u seniorů žijících ve městech. Studie se zaměřuje na možnosti propojení zdravotní péče s komunitními programy podporujícími duševní zdraví a jedním z míst, kde studie probíhá je Praha. Závěr: Social prescribing představuje perspektivní doplněk klasické profesionální péče, který může obohatit praxi i v českém prostředí. Podporuje aktivní stárnutí, duševní pohodu a propojení formální a neformální péče o seniory. Pro jeho širší využití je však klíčová další odborná diskuse, výzkumné ověření a institucionální ukotvení v systému zdravotní a sociální péče.

Novotná B, Bártová A, Šlemarová G, Macháčová K, Holmerová I. Beyond medications: Social prescribing for older persons Introduction: Current demographic trends are increasing the need to develop effective approaches to support the growing older population, particularly in areas such as mental health, well-being, and self-sufficiency. General practitioners are increasingly encountering patients whose needs extend beyond pharmacological treatment. One emerging approach is known as social prescribing – the recommendation of non-pharmacological and community-based interventions as part of comprehensive care. Conceptual Framework: Social prescribing is an innovative, interdisciplinary approach that integrates professional healthcare and social services with informal support and locally available community resources while also reducing the burden on the health care system. Its primary aim is to provide individualized care tailored to the needs of each person and their community context. The emphasis is on encouraging meaningful participation and active engagement in community life, considering the individual’s health, social, emotional, and practical needs. Research-Based example: The article also presents the international RECETAS study, which investigates the potential of nature-based social prescribing interventions to reduce loneliness and enhance the quality of life among older adults living in urban environments. The study explores how healthcare can be meaningfully linked to community programs that support mental health and social inclusion. Conclusion: Social prescribing offers a promising complement to traditional care and has the potential to enrich clinical practice in the Czech Republic. It promotes active aging, mental well-being, and the integration of formal and informal support systems for older people. However, broader implementation requires further expert discussion, empirical validation, and institutional integration into the health and social care systems.

BackgroundDuring the COVID-19 pandemic, non-pharmaceutical interventions (NPIs) such as social distancing, lockdowns and enhanced hygiene led to a decrease in respiratory pathogens. However, as NPIs were relaxed, a resurgence in several respiratory pathogens was observed including one local Chlamydia pneumoniae outbreak in Switzerland, prompting the need for a better understanding of C. pneumoniae epidemiology.AimTo assess temporal and geographical variations in C. pneumoniae detection before, during and after the COVID-19 pandemic.MethodsData on C. pneumoniae PCR detection ratios (number of positive tests/ total number of tests) across pre-pandemic (2018-2019), pandemic (2020-2022) and post-pandemic (2023) periods were collected via a global survey disseminated through various professional networks.ResultsC. pneumoniae detection ratios were analysed across 28 sites (27 in Europe, one in Taiwan) in 2023 (Dataset A, n = 172,223 tests) and 20 sites from 2018 to 2023 (Dataset B, n = 693,106 tests). Twenty-seven sites were laboratories (hospital or clinical) and one a surveillance system (Denmark). A significant decrease in detection ratios was observed during the pandemic period (from 1.05% to 0.23%, p < 0.001). In 2023, detection ratios increased to 0.28% (p < 0.002). Notable regional variations were found, with statistically significant increases in detection ratios at six sites located in Switzerland and Slovenia, where ratios ranged from 0.52% to 3.25%.DiscussionThe study highlights how NPIs influenced C. pneumoniae epidemiology, with reduced detection during the pandemic and partial resurgence afterwards. Regional variations suggest differing NPI impacts and underscore the need for continued surveillance.

• MeSH
• Chlamydophila pneumoniae * izolace a purifikace   genetika   MeSH
• COVID-19 * epidemiologie   MeSH
• infekce bakteriemi rodu Chlamydophila * epidemiologie   diagnóza   MeSH
• lidé MeSH
• pandemie MeSH
• polymerázová řetězová reakce MeSH
• SARS-CoV-2 MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Evropa MeSH
• Taiwan MeSH

Nárast obezity a problémy pri jej liečbe, motivácia a snaha ľudí o redukciu a kontrolu telesnej hmotnosti, ako aj intenzívny marketing, vytvárajú priaznivé podhubie pre hľadanie a používanie rôznych spôsobov ako dosiahnuť a udržať žiadanú telesnú hmotnosť. Práve výživové doplnky, prezentované ako prípravky na podporu chudnutia, si získali veľkú priazeň u spotrebiteľov, a to častokrát len na základe ľahkej dostupnosti a zjednodušenej interpretácie priaznivého pôsobenia látok, ktoré obsahujú. V klinickej praxi a pre odborníkov pretrváva nedostatok robustných randomizovaných, placebom kontrolovaných štúdií, ktoré by poskytli jednoznačné vedecké dôkazy o účinnosti a bezpečnosti týchto prípravkov. Napriek intenzívnemu a aj sľubnému výskumu biologicky aktívnych látok vo výživových doplnkoch, nedostatočné a nejednoznačné dôkazy neumožňujú ich zahrnutie do štandardných odporúčaní pre komplexný manažment (pre)obezity v klinickej praxi. Odborníci aj laická verejnosť by mali jednoznačne vnímať rozdiel medzi EBM (Evidence-Based Medicine) potvrdenými farmakologickými aj nefarmakologickými intervenciami pri redukcii telesnej hmotnosti a užívaním výživových doplnkov. Článok predkladá sumárne závery publikovaných prehľadových prác zaoberajúcich sa účinnosťou a bezpečnosťou výživových doplnkov pri redukcii telesnej hmotnosti.

The rise of obesity and the difficulties in its treatment, people’s motivation and desire to reduce and control weight, and intensive marketing, have created a favorable climate for finding and using different ways to achieve and maintain a desirable body weight. In particular, dietary supplements, presented as weight-loss products, have gained a great deal of favor with consumers, often on the basis of their easy availability and simplistic interpretation of the beneficial effects of the substances they contain. In clinical practice and for practitioners, there remains a lack of robust randomized, placebo-controlled trials that provide clear scientific evidence on the efficacy and safety of these products. Despite intensive and even promising research on biologically active substances in dietary supplements, insufficient and equivocal evidence does not allow their inclusion in standard recommendations for the comprehensive management of overweight and obesity in clinical practice. Both professionals and the public should clearly perceive the difference between EBM (Evidence-Based Medicine) validated pharmacological and non-pharmacological interventions for weight reduction and the use of dietary supplements. This article presents a summary of the findings of published reviews addressing the efficacy and safety of dietary supplements in weight reduction.

• MeSH
• bezpečnost MeSH
• hmotnostní úbytek MeSH
• klinická studie jako téma MeSH
• lidé MeSH
• metaanalýza jako téma MeSH
• obezita * terapie   MeSH
• potravní doplňky * MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• přehledy MeSH

Cíl: Přehled možností využití nelékařského zdravotnického oboru ergoterapie v onkogynekologii, popis role ergoterapeuta v prehabilitaci, zhodnocení dat z pilotní studie. Soubor a metodika: Do studie probíhající od listopadu 2023 do října 2024 bylo zařazeno celkem 18 pacientek, prospektivní studie probíhala po dobu 9 měsíců. Jednalo se o pacientky přijaté k 3týdenní intenzivní multimodální prehabilitaci v režimu 4/7 před plánovaným operačním výkonem pro primární nebo recidivující maligní nádor ovaria, endometria nebo děložního hrdla. Pacientkám se v rámci prehabilitace věnoval kromě lékařů i fyzioterapeut, psycholog, nutriční specialista a ergoterapeut. Klinická práce ergoterapeuta byla změřena na vyšetření a následnou terapii v oblasti kognitivních funkcí, jemné motoriky horních končetin, soběstačnosti a kvality života. Ergoterapeut aplikoval vybrané funkční testy a dotazníky (MKF klasifikace, Hand grip test, MoCA test, 5× Sit-to-Stand test, WHODAS 2.0) pro zjištění efektu rehabilitační intervence. Výsledky a závěry: Důležitými sledovanými ukazateli byly vybrané funkční schopnosti, které mají významný dopad na kvalitu života pacientek. Výsledky funkčních testů prokázaly významné zlepšení klíčových parametrů vlivem intenzivní prehabilitace, což potvrzuje zásadní roli intervence ergoterapeuta v onkogynekologické prehabilitaci.

Objective: Overview of the possibilities of using non-medical occupational therapy in oncogynecology, description of the role of an occupational therapist in prehabilitation, and evaluation of data from a pilot study. Methods: The study cohort consisted of 18 patients enrolled between November 2023 and October 2024. The prospective study was conducted over a period of nine months. Patients were admitted for a 3-week intensive multimodal prehabilitation program scheduled on a 4/7 basis prior to elective surgery for primary or recurrent malignant ovarian, endometrial, or cervical cancer. In addition to the physicians, patients received prehabilitation by a physiotherapist, psychologist, nutritionist, and occupational therapist. Clinical work of the occupational therapist was measured upon examination and subsequent therapy in the areas of cognitive function, fine motor skills of the upper limbs, self-sufficiency, and quality of life. The occupational therapist applied selected functional tests and questionnaires (MKF classification, Hand grip test, MoCA test, 5× Sit-to-Stand test, WHODAS 2.0) to determine the effect of the rehabilitation intervention. Results and conclusions: Important indicators were selected functional abilities that have a significant impact on the quality of life of patients. The results of functional tests showed a significant improvement of key parameters due to intensive prehabilitation, confirming the essential role of occupational therapist intervention in oncogynecological prehabilitation.

• MeSH
• ergoterapie * metody   statistika a číselné údaje   MeSH
• fyzioterapie v předoperační přípravě MeSH
• hodnocení výsledků péče pacientem MeSH
• kvalita života MeSH
• lidé MeSH
• nádory ženských pohlavních orgánů * rehabilitace   MeSH
• pilotní projekty MeSH
• prospektivní studie MeSH
• průzkumy a dotazníky MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• práce podpořená grantem MeSH