To evaluate the clinical performance and safety of the ONIRY system for obstetric anal sphincter injuries (OASI) detection versus three-dimensional endoanal ultrasound (EAUS). A prospective, comparative, multicentre, international study. Poland, Czechia, Slovakia, and Spain. 152 women between the first moments up to 8 weeks after vaginal delivery. Participants underwent EAUS and were allocated to groups based on OASIS classification: A (no perineal tear), B (1st or 2nd degree tear), or C (3rd or 4th degree, anal sphincters affected). Electric impedance was measured in the anal canal using the ONIRY system. The primary endpoint was the diagnostic outcome of impedance spectroscopy versus EAUS. Adverse events were collected. Part II involved in silico modelling and 10-time 10-fold cross-validation for automated analysis. Accuracy, sensitivity, and specificity. 30 women were allocated to group A, 61 to group B, and 61 to group C. The diagnostic outcome was determined for 147 participants. The accuracy, sensitivity, and specificity of the ML-assisted impedance spectroscopy were 87.0 ± 0.5%, 90.6 ± 2.0%, and 84.6 ± 1.9%, respectively, compared with EAUS. After data cleaning, the performance metrics of the proposed final ML model for ONIRY were: 90.0 ± 0.4%, 90.0 ± 1.2%, and 90.0 ± 0.7%, respectively. No adverse device effects or deficiencies were observed. By enabling early identification of sphincter injuries, ML-assisted impedance spectroscopy facilitates timely diagnosis and intervention, potentially reducing long-term complications such as faecal incontinence. Its rapid, bedside application in obstetric settings supports immediate postpartum care, complementing digital rectal examination and optimizing clinical decision-making.

• MeSH
• anální kanál * zranění   diagnostické zobrazování   MeSH
• dospělí MeSH
• impedanční spektroskopie * metody   MeSH
• komplikace porodu diagnóza   diagnostické zobrazování   MeSH
• lidé MeSH
• prospektivní studie MeSH
• strojové učení * MeSH
• těhotenství MeSH
• vedení porodu * škodlivé účinky   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• srovnávací studie MeSH

• Publikační typ
• tisková chyba MeSH

OBJECTIVE: To assess the prevalence of pelvic floor and anal sphincter trauma in women after assisted vaginal delivery. METHODS: Retrospective study on 201 primiparous women after assisted vaginal delivery, control group 43 women after normal vaginal delivery. 4D translabial ultrasound examination of the levator ani and the anal sphincter was performed according to standard methodology at least 3 months postpartum. Ultrasound classification of trauma was performed by two independent evaluators blinded to clinical data. A third evaluator was asked to confirm findings in case of discrepancy. RESULTS: The LAM avulsion rate for normal delivery was 20.9%, for forceps 60%, for vacuum extraction 21.7% Odds ratio for forceps vs. NVD was 4.32 (1.69, 11.01), for vacuum vs. NVD 0.98 (0.409, 2.327). Ultrasound OASI rate was 33.3% for Forceps and 30.50% for Vacuum. This equated to an OR of 1.78 (0.85 - 3.10) for Forceps and 1.62 (0.85-3.10) for Vacuum relative to NVD. CONCLUSIONS: Our data confirm forceps as the major risk factor for levator avulsion. Forceps also implies a non-significantly higher risk of OASI compared to NVD.

• MeSH
• anální kanál * zranění   diagnostické zobrazování   MeSH
• dospělí MeSH
• extrakce porodnická škodlivé účinky   MeSH
• lidé MeSH
• mladý dospělý MeSH
• pánevní dno * diagnostické zobrazování   zranění   MeSH
• porodnické kleště škodlivé účinky   MeSH
• retrospektivní studie MeSH
• těhotenství MeSH
• ultrasonografie * metody   MeSH
• vakuová extrakce porodnická * škodlivé účinky   MeSH
• vedení porodu škodlivé účinky   metody   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mladý dospělý MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

INTRODUCTION: Home parenteral nutrition (HPN) is the primary treatment modality for patients with chronic intestinal failure, one of the least common organ failures. This article provides a retrospective analysis of the data collected on HPN patients in the Czech Republic over the past 30 years. METHODS: National registry data were collected using a standardised online form based on the OASIS registry (Oley - A.S.P.E.N. Information System) across all centres providing HPN in the Czech Republic. Data collected prospectively from adult patients in the HPN program were analysed in the following categories: epidemiology, demographics, underlying syndrome, diagnosis, complications, and teduglutide therapy prevalence. RESULTS: The registry identified a total of 1,838 adult patient records, reflecting almost 1.5 million individual catheter days. The prevalence of HPN has risen considerably over the last few decades, currently reaching 5.5 per 100,000 population. The majority of patients have short bowel syndrome and GI obstruction, with cancer being the most prevalent underlying disease. Catheter-related bloodstream infections have been the most prevalent acute complication. However, the incidence in 2022 was only 0.15 per 1,000 catheter days. The study also observed an increase in the prevalence of patients on palliative HPN over the last decade. CONCLUSION: This study presents a thorough analysis of data from the Czech REgistr Domaci NUtricni Podpory (REDNUP) registry. It shows an increasing prevalence of HPN, namely, in the palliative patient group. The sharing of national data can improve understanding of this rare condition and facilitate the development of international guidelines.

• MeSH
• dospělí MeSH
• katétrové infekce epidemiologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• parenterální výživa doma * statistika a číselné údaje   MeSH
• peptidy aplikace a dávkování   MeSH
• prevalence MeSH
• registrace * MeSH
• retrospektivní studie MeSH
• selhání střeva terapie   epidemiologie   MeSH
• senioři MeSH
• syndrom krátkého střeva terapie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH

Byla zavedena a validována jednoduchá metoda s použitím kapalinové chromatografie a tandemové hmotnostní spektrometrie (LC-MS/MS) pro stanovení kolistinu A a kolistinu B v plazmě. Extrakce proteinů z plazmy byla provedena pomocí 1 ml kazet Oasis HLB a chromatografická separace byla provedena na koloně Arion® Polar C18 (250 × 4,6 mm; 5 mm) při 35 °C. Mobilní fáze se skládala z vody obsahující 0,1 % kyseliny mravenčí a methanolu obsahujícího 0,1 % kyseliny mravenčí v poměru 40 : 60 (v/v), při průtoku 0,8 ml/minutu. Eluent byl detekován v režimu pozitivních iontů pomocí ionizace elektrosprejem s následujícími iontovými přechody m/z: kolistin A 585,55 → 101,05; kolistin B 578,5 → 101,15; a IS 602,4 → 101,1; 120,15; 86,15. Byly provedeny testy krátkodobé stability kolistinu a CMS, a to při pokojové teplotě a 37 °C, kdy se stabilita obou složek se zvyšující se teplotou snižuje. Předložený příspěvek je součástí studie Pharmacokinetics of Colistin in Critically Ill Patients With Extracorporeal Membrane Oxygenation (COL-ECMO2022), v níž budou prezentovány další výsledky.

A simple liquid chromatography tandem mass spectrometry (LC-MS/MS) assay for the determination of colistin A and colistin B in human plasma was developed and validated. Plasma extraction was performed using Oasis HLB 1 ml cartridges, analysis was performed using Arion® Polar C18 (250×4,6mm; 5mm) column at 35°C. Mobile phases consisted of water containing 0,1% formic acid and methanol containing 0,1% formic acid (40:60, v/v) delivered at a flow rate of 0,8 ml/minute. Eluent was detected in the positive ion mode using electrospray ionization at the following transitions of mass to charge (m/z): colistin A 585,55 → 101,05; colistin B 578,5 → 101,15; and IS 602,4 → 101,1; 120,15; 86,15. Short-term stability tests of colistin and CMS were performed, at room temperature and 37°C, where the stability of both components decreases with increasing temperature. The presented paper is part of the Pharmacokinetics of Colistin in Critically Ill Patients With Extracorporeal Membrane Oxygenation (COL-ECMO2022) study in which further results will be presented.

• MeSH
• chemické techniky analytické * metody   přístrojové vybavení   MeSH
• chromatografie kapalinová metody   přístrojové vybavení   MeSH
• hydrolýza MeSH
• kolistin * krev   MeSH
• lidé MeSH
• methansulfonáty krev   MeSH
• stabilita proteinů MeSH
• statistika jako téma MeSH
• tandemová hmotnostní spektrometrie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• klinická studie MeSH
• práce podpořená grantem MeSH

BACKGROUND: This study examined the impact of anxiety and depression symptoms during the first stage of the COVID-19 pandemic on the behavioral, cognitive, and emotional changes of the Czech population. METHODS: The research sample (n = 2363; 48.83 ± 16.53 years; 50.15% men) was obtained using an online survey. Depression and anxiety symptoms were measured using the Overall Depression Severity and Impairment Scale (ODSIS) and the Overall Anxiety Severity and Impairment Scale (OASIS) and associations were adjusted for age, gender, and economic status. RESULTS: The results showed that increased symptoms of anxiety and depression were significantly linked to feelings of loneliness, helplessness, reduced quality of relationship with a partner, higher probabilities of alcohol abuse, food consumption, and contemplation of existential questions. Higher symptoms of anxiety were associated with feelings of being threatened. Higher symptoms of depression symptoms increased tobacco abuse. CONCLUSION: During the first stage of the COVID-19 pandemic, higher symptoms of anxiety and depression among Czech citizens were associated with behavioral, cognitive, and emotional changes.

• Publikační typ
• časopisecké články MeSH

BACKGROUND: The Overall Anxiety Severity and Impairment Scale (OASIS) is a transdiagnostic measure that assesses severity and impairment associated with anxiety disorders. However, its psychometric properties were primarily examined in English-speaking or western countries. Therefore, this study aims to examine its psychometric parameters in the Czech Republic. METHODS: A large representative sample (n = 1738), a clinical sample (n = 57) and a retest sample (n = 20) were used. In addition to the OASIS, conventional measures of anxiety, depression, personality traits, self-esteem, life satisfaction, and other scales were also administered. Moreover, we examined the latent structure, reliability, validity, and the cut-off score for the Reliable Change Index (RCI) and the Clinically Significant Change Index (CSI). RESULTS: Higher anxiety was found in females, religious non-church members, and students. The Confirmatory Factor Analysis supported the adequate fit of the unidimensional solution: x2(4) = 3.20; p < 0.525; CFI = 1.000; TLI = 1.000;RMSEA = 0, SRMR = 0. The measurement equivalence examination indicated that the OASIS measures anxiety invariantly between males and females. The validity of the OASIS was supported by positive associations with neuroticism, depression, perceived stress, guilt, shame, and the established anxiety measures. The internal consistency was excellent (Cronbach's alpha = 0.96, McDonald's omega = 0.96). The test-retest reliability was acceptable (r = 0.66). The cut-off for the CSI is 6 and the RCI is 5.32. CONCLUSIONS: The OASIS represents a reliable and valid instrument for assessing anxiety in adults. Due to its shortness, excellent psychometric properties, and percentile norms, it is especially useful for short and accurate screening of anxiety and mapping therapeutic changes in clinical practice.

• MeSH
• dospělí MeSH
• lidé MeSH
• průzkumy a dotazníky MeSH
• psychiatrické posuzovací škály MeSH
• psychometrie metody   MeSH
• referenční standardy MeSH
• reprodukovatelnost výsledků MeSH
• úzkost * diagnóza   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika MeSH

OBJECTIVES: Obstetrical anal sphincter injuries (OASIS) are complications of vaginal delivery. Unrepaired anal sphincter after delivery increases the risk of anal incontinence. The aim of our study is to search for residual defect after OASI repair by 4D introital ultrasound (US). We hypothesised that imaging prior to hospital discharge would show the same number of defects as assessment at 3 months. STUDY DESIGN: This is a retrospective analysis of 138 patients with immediate repair after OASIS. Since 2009, we have been routinely inviting all our patients with OASIS to the perineal clinic for postoperative follow-up. We scheduled the first visit before discharge from hospital and followed up with a second visit after three months. During both visits, patients underwent transperineal 4D ultrasound examination. We provided examination while at rest and during contraction; volumes were saved for further evaluation. RESULTS: Eighty-one patients (58.7%) completed both exams and were included in the analysis. Residual external anal sphincter defect was found in 17.3% at the first visit versus 13.6% at the second (delayed) visit. We were not able to assess the sphincter in 9.9% at early versus none in the delayed examination. In 9.9%, the residual defect was not confirmed by the second examination, and in 4.9% the residual defect was missed by the first examination. CONCLUSIONS: In conclusion, we have found that a 3 month scan yields a smaller number of defects than a scan before discharge.

• MeSH
• anální kanál diagnostické zobrazování   zranění   MeSH
• fekální inkontinence * diagnostické zobrazování   etiologie   MeSH
• komplikace porodu * MeSH
• lidé MeSH
• perineum zranění   MeSH
• retrospektivní studie MeSH
• těhotenství MeSH
• ultrasonografie metody   MeSH
• vedení porodu škodlivé účinky   MeSH
• Check Tag
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

Short and effective tools for measuring depression, anxiety and their resulting impairments are lacking in the Czech language. The abbreviated versions of the Overall Anxiety Severity and Impairment Scale (OASIS) and the Overall Depression Severity and Impairment Scale (ODSIS) show very good psychometric properties in English and other languages, and can be used in different settings for research or clinical purposes. The aim of this study was the psychometric evaluation and validation of the Czech versions of the abbreviated forms of both tools in the general population. A nationally representative sample of 2912 participants (age = 48.88, SD = 15.56; 55% female) was used. The non-parametric testing of the differences between sociodemographic groups revealed a higher level of anxiety and depression in students, females and religious respondents. Confirmatory Factor Analysis suggested a good fit for the unidimensional model of the OASIS: x2(4) = 38.28; p < 0.001; TLI = 0.999; CFI = 0.997; RMSEA = 0.078; SRMR = 0.027 and the ODSIS: x2(4) = 36.54; p < 0.001; TLI = 0.999; CFI = 0.999; RMSEA = 0.076; SRMR = 0.021 with the data. Both scales had an excellent internal consistency (OASIS: Cronbach's alpha = 0.95, McDonald's omega = 0.95 and ODSIS: Cronbach's alpha = 0.95, McDonald's omega = 0.95). A clinical cut-off of 15 was identified for the OASIS and a cut-off of 12 for the ODSIS. The study showed good validity for both scales. The Czech versions of the abbreviated OASIS and ODSIS were short and valid instruments for measuring anxiety and depression.

• MeSH
• deprese * diagnóza   epidemiologie   MeSH
• faktorová analýza statistická MeSH
• jazyk (prostředek komunikace) * MeSH
• lidé středního věku MeSH
• lidé MeSH
• průzkumy a dotazníky MeSH
• psychometrie MeSH
• reprodukovatelnost výsledků MeSH
• úzkost diagnóza   epidemiologie   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika MeSH