Out-of-field dose Dotaz Zobrazit nápovědu
Stray radiation produced by ultra-high dose-rates (UHDR) proton pencil beams is characterized using ASIC-chip semiconductor pixel detectors. A proton pencil beam with an energy of 220 MeV was utilized to deliver dose rates (DR) ranging from conventional radiotherapy DRs up to 270 Gy/s. A MiniPIX Timepix3 detector equipped with a silicon sensor and integrated readout electronics was used. The chip-sensor assembly and chipboard on water-equivalent backing were detached and immersed in the water-phantom. The deposited energy, particle flux, DR, and the linear energy transfer (LET(Si)) spectra were measured in the silicon sensor at different positions both laterally, at different depths, and behind the Bragg peak. At low-intensity beams, the detector is operated in the event-by-event data-driven mode for high-resolution spectral tracking of individual particles. This technique provides precise energy loss response and LET(Si) spectra with radiation field composition resolving power. At higher beam intensities a rescaling of LET(Si) can be performed as the distribution of the LET(Si) spectra exhibits the same characteristics regardless of the delivered DR. The integrated deposited energy and the absorbed dose can be thus measured in a wide range. A linear response of measured absorbed dose was obtained by gradually increasing the delivered DR to reach UHDR beams. Particle tracking of scattered radiation in data-driven mode could be performed at DRs up to 0.27 Gy/s. In integrated mode, the saturation limits were not reached at the measured out-of-field locations up to the delivered DR of over 270 Gy/s. A good agreement was found between measured and simulated absorbed doses.
- MeSH
- křemík MeSH
- lineární přenos energie MeSH
- protonová terapie * metody MeSH
- protony MeSH
- radiometrie * metody MeSH
- voda MeSH
- Publikační typ
- časopisecké články MeSH
The lowest possible energy of proton scanning beam in cyclotron proton therapy facilities is typically between 60 and 100 MeV. Treatment of superficial lesions requires a pre-absorber to deliver doses to shallower volumes. In most of the cases a range shifter (RS) is used, but as an alternative solution, a patient-specific 3D printed proton beam compensator (BC) can be applied. A BC enables further reduction of the air gap and consequently reduction of beam scattering. Such pre-absorbers are additional sources of secondary radiation. The aim of this work was the comparison of RS and BC with respect to out-of-field doses for a simulated treatment of superficial paediatric brain tumours. EURADOS WG9 performed comparative measurements of scattered radiation in the Proteus C-235 IBA facility (Cyclotron Centre Bronowice at the Institute of Nuclear Physics, CCB IFJ PAN, Kraków, Poland) using two anthropomorphic phantoms-5 and 10 yr old-for a superficial target in the brain. Both active detectors located inside the therapy room, and passive detectors placed inside the phantoms were used. Measurements were supplemented by Monte Carlo simulation of the radiation transport. For the applied 3D printed pre-absorbers, out-of-field doses from both secondary photons and neutrons were lower than for RS. Measurements with active environmental dosimeters at five positions inside the therapy room indicated that the RS/BC ratio of the out-of-field dose was also higher than one, with a maximum of 1.7. Photon dose inside phantoms leads to higher out-of-field doses for RS than BC to almost all organs with the highest RS/BC ratio 12.5 and 13.2 for breasts for 5 and 10 yr old phantoms, respectively. For organs closest to the isocentre such as the thyroid, neutron doses were lower for BC than RS due to neutrons moderation in the target volume, but for more distant organs like bladder-conversely-lower doses for RS than BC were observed. The use of 3D printed BC as the pre-absorber placed in the near vicinity of patient in the treatment of superficial tumours does not result in the increase of secondary radiation compared to the treatment with RS, placed far from the patient.
- MeSH
- 3D tisk * MeSH
- celková dávka radioterapie MeSH
- dávka záření * MeSH
- dítě MeSH
- fantomy radiodiagnostické MeSH
- lidé MeSH
- metoda Monte Carlo MeSH
- nádory mozku radioterapie MeSH
- neutrony MeSH
- počítačová simulace MeSH
- protonová terapie přístrojové vybavení MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- srovnávací studie MeSH
PURPOSE: Craniospinal irradiation (CSI) has greatly increased survival rates for patients with a diagnosis of medulloblastoma and other primitive neuroectodermal tumors. However, as it includes exposure of a large volume of healthy tissue to unwanted doses, there is a strong concern about the complications of the treatment, especially for the children. To estimate the risk of second cancers and other unwanted effects, out-of-field dose assessment is necessary. The purpose of this study is to evaluate and compare out-of-field doses in pediatric CSI treatment using conventional and advanced photon radiotherapy (RT) and advanced proton therapy. To our knowledge, it is the first such comparison based on in-phantom measurements. Additionally, for out-of-field doses during photon RT in this and other studies, comparisons were made using analytical modeling. METHODS: In order to describe the out-of-field doses absorbed in a pediatric patient during actual clinical treatment, an anthropomorphic phantom, which mimics the 10-year-old child, was used. Photon 3D-conformal RT (3D-CRT) and two advanced, highly conformal techniques: photon volumetric-modulated arc therapy (VMAT) and active pencil beam scanning (PBS) proton RT were used for CSI treatment. Radiophotoluminescent and poly-allyl-diglycol-carbonate nuclear track detectors were used for photon and neutron dosimetry in the phantom, respectively. Out-of-field doses from neutrons were expressed in terms of dose equivalent. A two-Gaussian model was implemented for out-of-field doses during photon RT. RESULTS: The mean VMAT photon doses per target dose to all organs in this study were under 50% of the target dose (i.e., <500 mGy/Gy), while the mean 3D-CRT photon dose to oesophagus, gall bladder, and thyroid, exceeded that value. However, for 3D-CRT, better sparing was achieved for eyes and lungs. The mean PBS photon doses for all organs were up to three orders of magnitude lower compared to VMAT and 3D-CRT and exceeded 10 mGy/Gy only for the oesophagus, intestine, and lungs. The mean neutron dose equivalent during PBS for eight organs of interest (thyroid, breasts, lungs, liver, stomach, gall bladder, bladder, prostate) ranged from 1.2 mSv/Gy for bladder to 23.1 mSv/Gy for breasts. Comparison of out-of-field doses in this and other phantom studies found in the literature showed that a simple and fast two-Gaussian model for out-of-field doses as a function of distance from the field edge can be applied in a CSI using photon RT techniques. CONCLUSIONS: PBS is the most promising technique for out-of-field dose reduction in comparison to photon techniques. Among photon techniques, VMAT is a preferred choice for most of out-of-field organs and especially for the thyroid, while doses for eyes, breasts, and lungs are lower for 3D-CRT. For organs outside the field edge, a simple analytical model can be helpful for clinicians involved in treatment planning using photon RT but also for retrospective data analysis for cancer risk estimates and epidemiology in general.
- MeSH
- celková dávka radioterapie MeSH
- dítě MeSH
- konformní radioterapie * metody MeSH
- kraniospinální iradiace * škodlivé účinky metody MeSH
- kritické orgány účinky záření MeSH
- lidé MeSH
- nádory mozečku * radioterapie MeSH
- plánování radioterapie pomocí počítače metody MeSH
- protony MeSH
- radioterapie s modulovanou intenzitou * škodlivé účinky metody MeSH
- retrospektivní studie MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Since 2010, EURADOS Working Group 9 (Radiation Dosimetry in Radiotherapy) has been involved in the investigation of secondary and scattered radiation doses in X-ray and proton therapy, especially in the case of pediatric patients. The main goal of this paper is to analyze and compare out-of-field neutron and non-neutron organ doses inside 5- and 10-year-old pediatric anthropomorphic phantoms for the treatment of a 5-cm-diameter brain tumor. Proton irradiations were carried out at the Cyclotron Centre Bronowice in IFJ PAN Krakow Poland using a pencil beam scanning technique (PBS) at a gantry with a dedicated scanning nozzle (IBA Proton Therapy System, Proteus 235). Thermoluminescent and radiophotoluminescent dosimeters were used for non-neutron dose measurements while secondary neutrons were measured with track-etched detectors. Out-of-field doses measured using intensity-modulated proton therapy (IMPT) were compared with previous measurements performed within a WG9 for three different photon radiotherapy techniques: 1) intensity-modulated radiation therapy (IMRT), 2) three-dimensional conformal radiation therapy (3D CDRT) performed on a Varian Clinac 2300 linear accelerator (LINAC) in the Centre of Oncology, Krakow, Poland, and 3) Gamma Knife surgery performed on the Leksell Gamma Knife (GK) at the University Hospital Centre Zagreb, Croatia. Phantoms and detectors used in experiments as well as the target location were the same for both photon and proton modalities. The total organ dose equivalent expressed as the sum of neutron and non-neutron components in IMPT was found to be significantly lower (two to three orders of magnitude) in comparison with the different photon radiotherapy techniques for the same delivered tumor dose. For IMPT, neutron doses are lower than non-neutron doses close to the target but become larger than non-neutron doses further away from the target. Results of WG9 studies have provided out-of-field dose levels required for an extensive set of radiotherapy techniques, including proton therapy, and involving a complete description of organ doses of pediatric patients. Such studies are needed for validating mathematical models and Monte Carlo simulation tools for out-of-field dosimetry which is essential for dedicated epidemiological studies which evaluate the risk of second cancers and other late effects for pediatric patients treated with radiotherapy.
- Publikační typ
- časopisecké články MeSH
LET spectra can be measured by track-etched detectors. However, these detectors are not able to identify the type of interacting particles. Monte Carlo simulations can provide this missing information. In this work, Monte Carlo simulations based on the EURADOS Work Group 9 experiment consisting of systematic 3D mapping of out-of-field doses and LET spectra in a prototype water phantom were performed. The simulations aimed to identify the types of particles contributing to the out-of-field LET spectra. The total absorbed dose, LET and energy spectra were calculated. The calculated dose distributions and LET spectra were compared with the ones measured by radiophotoluminiscence and track-etched detectors. The out-of-field particles and their LET values were identified. No statistically significant differences between the measured and simulated spectra were revealed in the LET range of 100-2000 keV μm-1.
Objective.This work presents a method for enhanced detection, imaging, and measurement of the thermal neutron flux.Approach. Measurements were performed in a water tank, while the detector is positioned out-of-field of a 20 MeV ultra-high pulse dose rate electron beam. A semiconductor pixel detector Timepix3 with a silicon sensor partially covered by a6LiF neutron converter was used to measure the flux, spatial, and time characteristics of the neutron field. To provide absolute measurements of thermal neutron flux, the detection efficiency calibration of the detectors was performed in a reference thermal neutron field. Neutron signals are recognized and discriminated against other particles such as gamma rays and x-rays. This is achieved by the resolving power of the pixel detector using machine learning algorithms and high-resolution pattern recognition analysis of the high-energy tracks created by thermal neutron interactions in the converter.Main results. The resulting thermal neutrons equivalent dose was obtained using conversion factor (2.13(10) pSv·cm2) from thermal neutron fluence to thermal neutron equivalent dose obtained by Monte Carlo simulations. The calibrated detectors were used to characterize scattered radiation created by electron beams. The results at 12.0 cm depth in the beam axis inside of the water for a delivered dose per pulse of 1.85 Gy (pulse length of 2.4μs) at the reference depth, showed a contribution of flux of 4.07(8) × 103particles·cm-2·s-1and equivalent dose of 1.73(3) nSv per pulse, which is lower by ∼9 orders of magnitude than the delivered dose.Significance. The presented methodology for in-water measurements and identification of characteristic thermal neutrons tracks serves for the selective quantification of equivalent dose made by thermal neutrons in out-of-field particle therapy.
- MeSH
- algoritmy * MeSH
- elektrony * MeSH
- kalibrace MeSH
- neutrony MeSH
- záření gama MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
In this study of high-dose-rate brachyradiotherapy to the lumpectomy site as the sole radiation are documented a three-dimensional treatment planning and preliminary results of accelerated partial- breast irradiation. From March 2002 to July 2004 25 patients were prospectively included in this study. Six patients were excluded becuase of definitive histology of lobular carcinoma or positive margin. The median age was 63.2 years (range: 44-77 years). Median follow-up of all patients is 11 months (range: 3-25 months) with a minimum follow-up of 3 months. Radiation was delivered using the high-dose-rate remote afterloader VariSource with [192]Ir source. The patients received radiation twice a day at least 6 hours apart for a total of 10 fractions over five days with a single dose of 3.4 Gy. The total dose was 34.0 Gy prescribed as a minimum peripheral dose to match or minimally exceed the volume defined by the surgical clips as seen on CT scans. Freehand technique allows conformal placement of the catheters to the shape of the lumpectomy cavity. We use the method of geometric optimalisation which allows the calculations of dose distribution in relation to target. At a median follow-up of 11 months none of patients developed in-field breast recurrences, one patient had out-of-field recurrences. There were no regional nodal recurrences. At each patient, there was calculated target volume size in cm3 (median 91.3 cm3) dose volume histogram (DVH), dose homogenity index (DHI). Median DHI was 0.42. Median volume of breast tissue getting 100% of the prescription dose, V(100), is 87%; and V(150) 48.5%. We have noticed two treatment complications: hematoma and abscess in the place of tumorous bed after exstirpation. At last follow-up, patients rated the overall cosmetic outcome excellent. This method is suitable just for patients with histologically confirmed small tumors (<3 cm in diameter) without negative prognostic factors for local recurrence (age at least 40 years, negative surgical margins, nodal involvement - maximum three positive nodes without extracapsular extension).
- MeSH
- brachyterapie metody MeSH
- dospělí MeSH
- financování organizované MeSH
- frakcionace dávky záření MeSH
- klinické zkoušky jako téma MeSH
- konformní radioterapie metody MeSH
- lidé středního věku MeSH
- lidé MeSH
- lobulární karcinom radioterapie MeSH
- nádory prsu radioterapie MeSH
- prognóza MeSH
- prospektivní studie MeSH
- senioři MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- senioři MeSH
- ženské pohlaví MeSH
BACKGROUND: Particularly in the pediatric clinical pharmacology field, data-sharing offers the possibility of making the most of all available data. In this study, we utilize previously collected therapeutic drug monitoring (TDM) data of term and preterm newborns to develop a population pharmacokinetic model for phenobarbital. We externally validate the model using prospective phenobarbital data from an ongoing pharmacokinetic study in preterm neonates. METHODS: TDM data from 53 neonates (gestational age (GA): 37 (24-42) weeks, bodyweight: 2.7 (0.45-4.5) kg; postnatal age (PNA): 4.5 (0-22) days) contained information on dosage histories, concentration and covariate data (including birth weight, actual weight, post-natal age (PNA), postmenstrual age, GA, sex, liver and kidney function, APGAR-score). Model development was carried out using NONMEM® 7.3. After assessment of model fit, the model was validated using data of 17 neonates included in the DINO (Drug dosage Improvement in NeOnates)-study. RESULTS: Modelling of 229 plasma concentrations, ranging from 3.2 to 75.2mg/L, resulted in a one compartment model for phenobarbital. Clearance (CL) and volume (Vd) for a child with a birthweight of 2.6kg at PNA day 4.5 was 0.0091L/h (9%) and 2.38L (5%), respectively. Birthweight and PNA were the best predictors for CL maturation, increasing CL by 36.7% per kg birthweight and 5.3% per postnatal day of living, respectively. The best predictor for the increase in Vd was actual bodyweight (0.31L/kg). External validation showed that the model can adequately predict the pharmacokinetics in a prospective study. CONCLUSION: Data-sharing can help to successfully develop and validate population pharmacokinetic models in neonates. From the results it seems that both PNA and bodyweight are required to guide dosing of phenobarbital in term and preterm neonates.
- MeSH
- fenobarbital aplikace a dávkování MeSH
- kojenec MeSH
- lidé MeSH
- monitorování léčiv metody MeSH
- novorozenec nedonošený MeSH
- novorozenec MeSH
- prospektivní studie MeSH
- šíření informací metody MeSH
- vztah mezi dávkou a účinkem léčiva MeSH
- Check Tag
- kojenec MeSH
- lidé MeSH
- mužské pohlaví MeSH
- novorozenec MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Cíl: Nepravidelné dávkování inzulinu je jedním z hlavních problémů spojených s inzulinovou terapií u pacientů s diabetem 2. typu; jeho skutečný rozsah však není přesně znám. Cílem průzkumu provedeného v ČR v rámci mezinárodního projektu GAPP2TM – Globální přehled přístupů pacientů a lékařů (Global Attitudes of Patients and Physicians) proto bylo ověřit, jaký je výskyt a dopad nepravidelného užívání bazálních inzulinových analog u pacientů s diabetem 2. typu, jakým způsobem a z jakých důvodů k těmto nepravidelnostem dochází, a jakým způsobem zdravotníci o nepravidelné aplikaci inzulinu s pacienty diskutují. Metodika: Projekt GAPP2TM je mezinárodní průřezovou studií provedenou on-line formou dotazníku prostřednictvím internetu u pacientů s diabetem 2. typu léčených inzulinovými analogy a u lékařů a zdravotníků, kteří tyto pacienty ošetřují. Průzkum proběhl ve dvou vlnách v celkem 17 zemích světa; do první vlny, která byla dokončena začátkem roku 2012, bylo zahrnuto 6 zemí, do druhé, dokončené v roce 2014, pak dalších 11 zemí včetně České republiky. Průzkum měl za cíl získat data o pohledech pacientů a lékařů na některé aspekty léčby diabetu 2. typu inzulinem a o přetrvávajících problémech v této oblasti v reálné každodenní praxi. Zabýval se zejména incidencí a zvládáním lehkých hypoglykemií a nepravidelnostmi v aplikaci inzulinu. V části zaměřené na adherenci k aplikaci bazálního inzulinu byly sledovány 3 typy nepravidelností v léčbě inzulinem: vynechání dávky, časový posun dávky (? 2 hodiny oproti předepsanému času) a snížení dávky, ve všech v případech během uplynulých posledních 30 dnů před vyplněním dotazníku. Dále bylo zkoumáno chování pacientů ve vztahu k této problematice a jejich vnímání těchto problémů. Výsledky: Výsledky průzkumu ukázaly, že nepravidelné dávkování inzulinu je v České republice méně časté než v ostatních zemích, v nichž probíhal výzkum GAPP2TM. I tak se ovšem týká cca pětiny všech nemocných s DM 2. typu léčených inzulinovými analogy v režimu bazál-bolus nebo pouze bazál. Při poslední nepravidelné aplikaci bazálního inzulínu se jednalo o záměr pacienta při úplném vynechání dávky ve 13 % případů, posun aplikace byl záměrný ve 23 % a snížení dávky inzulínu v 61 % případů. Nejčastěji hlášenými důvody bylo snížení rizika hypoglykemie a dodržování doporučení zdravotníků. Obavu z vynechání dávky bazálního inzulinu má 40 % českých pacientů a 35 % by mělo pocit viny, pokud by svou dávku bazálního inzulinu vynechali (u pacientů s intenzivním inzulinovým režimem je to 47 %). Pouze 60 % pacientů si uvědomuje, že vynechávání dávek bazálního inzulinu může mít negativní dopad na jejich dlouhodobý zdravotní stav. Dotazovaní lékaři měli podezření, že během pravidelných kontrol hlásí nižší počet vynechaných dávek bazálního inzulínu nebo vynechávání zcela zatajuje přibližně třetina pacientů. Tuto skutečnost však připustilo jen 11 % pacientů užívajících bazální inzulin a 15 % pacientů léčených intenzifikovaným režimem. Čtvrtina předepisujících lékařů navíc uvádí, že se svými pacienty nepravidelné užívání bazálního inzulinu během kontrol běžně neprobírá. Závěry: Ačkoli pacienti s diabetem 2. typu dodržují v České republice předepsané schéma léčby bazálním inzulinem častěji než v jiných zemích účastnících se průzkumu GAPP2TM, vynechání, časový posun a snížení dávky inzulinu je poměrně časté a ze strany zdravotníků si zasluhuje během pravidelných kontrol více pozornosti a cílenou edukaci.
Objective: Irregular insulin dose is one of the main problems associated with insulin therapy in patients with type 2 diabetes; its extent is not known precisely. The aim of survey conducted in the Czech Republic in the international project GAPP2™ – Global Attitudes of Patients and Physicians was to determine the incidence and the impact of irregular use of basal insulin analogues in patients with type 2 diabetes, to point out the reasons for these irregularities and to focus on how physicians discuss irregular application of insulin with patients. Methods: The project GAPP2™ is an international cross-sectional study performed on-line via the Internet using a questionnaire filled by diabetic patients treated with insulin analogues and physicians who treat these patients. The survey was conducted in two steps in 17 countries; the first step included 6 countries and was completed in the beginning of 2012, the second step involved 11 other countries including the Czech Republic with termination in 2014. The survey was designed to obtain the views of patients and physicians on certain aspects of insulin treatment and persistent issues in this field in the real daily practice. Special focus was on the incidence and management of hypoglycaemia as well as on irregularities of insulin application. In the part dedicated to adherence to basal insulin application were observed three types of irregular insulin therapy: missed dose, time imprecision of dose (? 2 hours vs. the prescribed time) and dose reduction in all cases in the past 30 days before completing the questionnaire. In addition, it was investigated the attitude and relation of patients to these issues. Results: The results have shown that irregular insulin dose in the Czech Republic is less frequent than in other countries involved in the GAPP2™ research. Nevertheless, approximately one fifth of diabetic patients using insulin analogues in basal-bolus or only basal therapy regimen is related to this problem. The last irregular insulin application was due to missed dose in 13% of cases, time imprecision in 23% and reduction of dose in 61% of cases. The most commonly reported reason was risk reduction of hypoglycaemia and the recommendations of health professionals. Fear of missed dose is present in 40% Czech patients and 35% would feel guilty if their insulin dose is missed (up to 47% in patients with intensified insulin regimen). Only 60% patients are aware of negative impact on their long-term health after missed dose of basal insulin. Questioned doctors have suspected that the patients report lower number of missed doses during regular medical check because one third of patients doesn´t admit missed dose. However, this fact conceded only 11% of patients on basal insulin and 15% of patients on intensified insulin therapy. Quarter of prescribing doctors admit that they usually don´t discuss with patients irregularities in basal insulin treatment. Conclusion: Although, type 2 diabetes patients in the Czech Republic follow prescribed basal insulin therapy scheme more often than patients in other countries participating in the survey GAPP2 ™, missed dose, time imprecision and reduction of dose is quite common and it deserves more attention from medical side during regular medical check together with appropriate education of patients.
- MeSH
- adherence k farmakoterapii * statistika a číselné údaje MeSH
- diabetes mellitus 2. typu * farmakoterapie MeSH
- inzulin * aplikace a dávkování MeSH
- lidé středního věku MeSH
- lidé MeSH
- průzkumy a dotazníky MeSH
- senioři MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- práce podpořená grantem MeSH
Fricke gel dosimeters in the form of layers are suitable to reconstruct bidimensional distributions of the absorbed dose; in accordance with their chemical composition and applying suitably developed algorithms, they can provide dose images of the different radiation components in a BNCT field. After the description of the applied method, this work presents the results obtained at the epithermal column of the BNCT facility at the NRI in Rez (CZ). The measured dose distributions are shown in comparison with data taken by means of other dosimeters thermoluminescence dosimeters (TLDs) and with calculations carried out with the Monte Carlo code MCNP5. The agreement with the results obtained by means of the different techniques is satisfying.
- MeSH
- atomové reaktory statistika a číselné údaje MeSH
- fantomy radiodiagnostické statistika a číselné údaje MeSH
- lidé MeSH
- metoda Monte Carlo MeSH
- plánování radioterapie pomocí počítače statistika a číselné údaje MeSH
- prasata MeSH
- radiometrie přístrojové vybavení statistika a číselné údaje MeSH
- roztoky MeSH
- rychlé neutrony terapeutické užití MeSH
- terapie metodou neutronového záchytu (bor-10) statistika a číselné údaje MeSH
- termoluminiscenční dozimetrie statistika a číselné údaje MeSH
- voda MeSH
- želatina MeSH
- železnaté sloučeniny MeSH
- zvířata MeSH
- Check Tag
- lidé MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- hodnotící studie MeSH
- práce podpořená grantem MeSH
- srovnávací studie MeSH
- Geografické názvy
- Česká republika MeSH