Brucellosis is a zoonosis with non-specific clinical symptoms involving multiple systems and organs. Its prevalence is low in most of EU countries, which can lead to the difficulties in laboratory and clinical diagnostic. Due to its relationship to the Ochrobactrum spp., it may be misclassified in rapid identification systems. We present a case of a 13-year-old immunocompetent girl who was examined several times for fever, fatigue, night sweats and weight loss; laboratory results showed mildly elevated C-reactive protein, anaemia and leukopenia. Four weeks before the onset of symptoms, she had been on a family holiday in Egypt. Given her symptoms, a haemato-oncological or autoimmune disease was considered more likely. The diagnosis of Brucella spondylitis was made after 4 months. The main reasons for this delay were as follows: low specificity of clinical symptoms, delay in completing the travel history, inconclusive initial serological results and misidentification of the blood culture isolate as Ochrobactrum sp. Even in countries with a low incidence of brucellosis, it is essential to educate healthcare professionals about the disease. Low specificity of symptoms and limited experience of laboratory staff may lead to late diagnosis with risk of complications and poor outcome. If Ochrobactrum spp. is detected in clinical specimens by rapid identification, careful re-evaluation must follow and all measures to prevent laboratory-acquired infections must be taken until Brucella spp. is unequivocally excluded.

• MeSH
• bakteriemie * diagnóza   mikrobiologie   MeSH
• Brucella izolace a purifikace   klasifikace   MeSH
• brucelóza * diagnóza   mikrobiologie   MeSH
• chybná diagnóza * MeSH
• gramnegativní bakteriální infekce diagnóza   mikrobiologie   MeSH
• horečka * mikrobiologie   etiologie   MeSH
• lidé MeSH
• mladiství MeSH
• Ochrobactrum * genetika   izolace a purifikace   MeSH
• spondylitida mikrobiologie   diagnóza   MeSH
• Check Tag
• lidé MeSH
• mladiství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH
• Geografické názvy
• Egypt MeSH

Hand and foot osteosarcoma represents ~1% of all diagnosed cases of osteosarcoma. The rarity of osteosarcoma of the hand and foot leads to frequent misdiagnosis, delayed diagnosis or incorrect treatments, which can lead to fatal consequences. Typically, salvaging the affected limb is the treatment of choice, and with the use of chemotherapy, 60-65% of patients with osteosarcoma can be treated without amputation. Due to its rarity, misdiagnosis and treatment delays are common, yet detailed reviews and analyses of such cases are limited. The present retrospective cohort study aimed to review and analyze cases of osteosarcoma located in the hand and foot. From January 2007 to January 2019, 11 patients were treated at the Masaryk Memorial Cancer Institute Sarcoma Center (Brno, Czechia), 5 cases affected the hand and 6 affected the foot. A total of 6 male patients and 5 female patients, with a mean age of 30.9±16.74 years, were diagnosed with hand or foot osteosarcoma. The mean follow-up period was 90.36±66.14 months. The mean tumor size detected during diagnosis was 4.29±1.81 cm. Osteoblastic osteosarcoma was the most common histopathological type, accounting for 4 cases (33.4%). A majority of the osteosarcomas were identified as high grade (81.8%). A total of 5 patients experienced misdiagnoses following their initial biopsy, with 2 patients initially receiving treatment outside the Masaryk Memorial Cancer Institute Sarcoma Center. The most frequently encountered misdiagnosis was giant-cell tumor of the bone. A total of 3 patients underwent limb amputation and 2 patients developed lung metastasis and succumbed to the disease. The disease-free survival period and overall survival rate were calculated using Kaplan-Meier survival analysis. The mean disease-free survival period was 82.83±60.05 months, while the overall survival rate was 72%, with a mean survival time of 90.36±56.73 months. In summary, an examination of a case series involving 11 patients diagnosed with osteosarcoma of the hand and foot was conducted. The treatment approach, clinical characteristics and patient outcomes were described. A total of four case studies of patients with osteosarcoma in the hand or foot were presented. Misdiagnosis of this disease may result in the inappropriate treatment being administered to patients, therefore, the correct and rapid diagnosis of disease is necessary for effective treatment of hand and foot osteosarcomas.

• Publikační typ
• časopisecké články MeSH

The rapid evolution and spread of multidrug resistance among bacterial pathogens has significantly outpaced the development of new antibiotics, underscoring the urgent need for alternative therapies. Antimicrobial photodynamic therapy and antimicrobial sonodynamic therapy have emerged as promising treatments. Antimicrobial photodynamic therapy relies on the interaction between light and a photosensitizer to produce reactive oxygen species, which are highly cytotoxic to microorganisms, leading to their destruction without fostering resistance. Antimicrobial sonodynamic therapy, a novel variation, substitutes ultrasound for light to activate the sonosensitizers, expanding the therapeutic reach. To increase the efficiency of antimicrobial photodynamic therapy and antimicrobial sonodynamic therapy, the combination of these two methods, known as antimicrobial photo-sonodynamic therapy, is currently being explored and considered a promising approach. Recent advances, particularly in the application of nanomaterials, have further enhanced the efficacy of these therapies. Nanosensitizers, due to their improved reactive oxygen species generation and targeted delivery, offer significant advantages in overcoming the limitations of conventional sensitizers. These breakthroughs provide new avenues for treating bacterial infections, especially multidrug-resistant strains and biofilm-associated infections. Continued research, including comprehensive clinical studies, is crucial to optimizing nanomaterial-based antimicrobial photo-sonodynamic therapy for clinical use, ensuring their effectiveness in real-world applications.

• MeSH
• antibakteriální látky * farmakologie   MeSH
• Bacteria účinky léků   MeSH
• bakteriální infekce * farmakoterapie   mikrobiologie   terapie   MeSH
• biofilmy účinky léků   MeSH
• fotochemoterapie * metody   MeSH
• fotosenzibilizující látky * farmakologie   MeSH
• lidé MeSH
• nanočástice chemie   MeSH
• nanostruktury chemie   MeSH
• reaktivní formy kyslíku metabolismus   MeSH
• ultrazvuková terapie MeSH
• zvířata MeSH
• Check Tag
• lidé MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

Foodborne diseases triggered by various infectious micro-organisms are contributing significantly to the global disease burden as well as to increasing mortality rates. Salmonella enterica belongs to the most prevalent form of bacteria accountable for significant burden of foodborne illness across the globe. The conventional therapeutic approach to cater to Salmonella enterica-based infections relies on antibiotic therapy, but the rapid emergence of the antibiotic resistance strains of Salmonella sp. necessitates the development of alternative treatment and prevention strategies. In light of this growing concern, the scientific community is rigorously exploring novel phytochemicals harnessed from medicinally important plants as a promising approach to curb Salmonella enterica infections. A variety of phytochemicals belonging to alkaloids, phenols, flavonoid, and terpene classes are reported to exhibit their inhibitory activity against bacterial cell communication, membrane proteins, efflux pumps, and biofilm formation among drug resistant Salmonella strains. The present review article delves to discuss the emergence of antibiotic resistance among Salmonella enterica strains, various plant sources, identification of phytochemicals, and the current state of research on the use of phytochemicals as antimicrobial agents against Salmonella enterica, shedding light on the promising potential of phytochemicals in the fight against this pathogen.

• MeSH
• antibakteriální látky * farmakologie   MeSH
• bakteriální léková rezistence MeSH
• fytonutrienty * farmakologie   chemie   MeSH
• lidé MeSH
• nemoci přenášené potravou mikrobiologie   prevence a kontrola   farmakoterapie   MeSH
• Salmonella enterica * účinky léků   MeSH
• salmonelóza * mikrobiologie   farmakoterapie   MeSH
• zvířata MeSH
• Check Tag
• lidé MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

Pancreas is a vital gland of gastrointestinal system with exocrine and endocrine secretory functions, interweaved into essential metabolic circuitries of the human body. Pancreatic ductal adenocarcinoma (PDAC) represents one of the most lethal malignancies, with a 5-year survival rate of 11%. This poor prognosis is primarily attributed to the absence of early symptoms, rapid metastatic dissemination, and the limited efficacy of current therapeutic interventions. Despite recent advancements in understanding the etiopathogenesis and treatment of PDAC, there remains a pressing need for improved individualized models, identification of novel molecular targets, and development of unbiased predictors of disease progression. Here we aim to explore the concept of precision medicine utilizing 3-dimensional, patient-specific cellular models of pancreatic tumors and discuss their potential applications in uncovering novel druggable molecular targets and predicting clinical parameters for individual patients.

• MeSH
• duktální karcinom slinivky břišní * patologie   genetika   metabolismus   MeSH
• individualizovaná medicína * metody   MeSH
• lidé MeSH
• nádory slinivky břišní * patologie   genetika   MeSH
• techniky 3D buněčné kultury metody   MeSH
• zvířata MeSH
• Check Tag
• lidé MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

Existence syndromu časného normoglykemického zhoršení byla dlouhou dobu předmětem sporů. V současné době je tento syndrom široce akceptován pod zkratkou EWDR. Jeho podstatou je rychlá kompenzace subkompenzovaného až dekompenzovaného diabetu, která vede k progresi diabetické retinopatie. Významnou roli v jeho patogenezi hrají vysoké hladiny růstového faktoru. V kazuistice upozorňujeme na současný přístup v prevenci této závažné komplikace.

The existence of normoglycaemic re-entry phenomenon has long been a matter of controversy. Currently, this syndrome is widely accepted under the acronym EWDR. Its essence is rapid compensation of subcompensated to decompensated diabetes, which leads to progression of diabetic retinopathy. High levels of growth factor play a significant role in its pathogenesis. In the case report, we draw attention to the current approach to the prevention of this serious complication.

INTRODUCTION: Ventilatory efficiency (V'E/V'CO2 ) has been shown to predict postoperative pulmonary complications (PPCs) in lung resection candidates. V'E/V'CO2 is determined by arterial partial pressure of carbon dioxide (PaCO2 ) and by dead space to tidal volume ratio (VD/VT). We hypothesised PaCO2 and VD/VT contribute equally to the increase in V'E/V'CO2 in lung resection patients. METHODS: Consecutive lung resection candidates from two prior prospective studies were included in this post hoc analysis. All subjects underwent preoperative spirometry, cardiopulmonary exercise testing and arterial blood gas analysis at rest and peak exercise. PPCs were prospectively assessed during the first 30 postoperative days, or hospital stay. A t-test, Mann-Whitney U-test and two-tailed Fisher's exact test were used to compare patients with and without PPCs. p-values <0.05 were considered statistically significant. RESULTS: Of 398 patients, PPC developed in 64 (16%). Patients with PPCs more frequently underwent lobectomy by open thoracotomy, had longer hospital and ICU length of stay and higher 30- and 90-day mortality. Moreover, patients with PPCs exhibited a higher V'E/V'CO2 ratio both at rest and peak exercise. Both ratios were independently associated with PPCs. At rest, the contribution of PaCO2 and VD/VT to the increase in V'E/V'CO2 ratio in patients with PPCs was 45% and 55%, respectively. At peak exercise, the contribution of PaCO2 and VD/VT to the increase in V'E/V'CO2 ratio was 16% and 84%, respectively. CONCLUSIONS: VD/VT (V'/Q' mismatch and/or rapid shallow breathing pattern) is the dominant contributor to the increase in V'E/V'CO2 in lung resection candidates who develop PPCs.

• Publikační typ
• časopisecké články MeSH

Background: A 69-year-old man with multiple myeloma and left-sided heart failure presented to the hospital with a two-month fever. Method: A transjugular liver biopsy was performed due to the rapid progression of liver failure. The procedure was complicated by an intraperitoneal hemorrhage. The bleeding was managed expectantly. Result: Significantly elevated serum bilirubin levels occurred on the 13th day after liver biopsy. Increasing serum bilirubin levels were observed until the patient's death due to a biliovenous fistula at the liver biopsy site. Simultaneously, his slightly elevated liver enzymes returned to normal. The patient died 23 days after liver biopsy due to acute respiratory distress syndrome. Fistulous communication between the biliary tree and the hepatic venous system with subsequent bile leakage into the venous system (bilhemia) can lead to bile deposition in the lungs. Bile deposition in the lungs may potentiate and accelerate the development of diffuse alveolar damage with hyaline membranes. Conclusions: Lambda and kappa light chain deposition in the pulmonary alveoli in patients with multiple myeloma can mimic typical hyaline membranes.

• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

Many small molecules require derivatization to increase their volatility and to be amenable to gas chromatographic (GC) separation. Derivatization is usually time-consuming, and typical batch-wise procedures increase sample variability. Sequential automation of derivatization via robotic liquid handling enables the overlapping of sample preparation and analysis, maximizing time efficiency and minimizing variability. Herein, a protocol for the fully automated, two-stage derivatization of human blood-based samples in line with GC-[Orbitrap] mass spectrometry (MS)-based metabolomics is described. The protocol delivers a sample-to-sample runtime of 31 min, being suitable for better throughput routine metabolomic analysis. Key features • Direct and rapid methoximation on vial followed by silylation of metabolites in various blood matrices. • Measure ~40 samples per 24 h, identifying > 70 metabolites. • Quantitative reproducibility of routinely measured metabolites with coefficients of variation (CVs) < 30%. • Requires a Thermo ScientificTM TriPlusTM RSH (or comparable) autosampler equipped with incubator/agitator, cooled drawer, and automatic tool change (ATC) station equipped with liquid handling tools. Graphical overview Workflow for profiling metabolites in human blood using automated derivatization.

• Publikační typ
• časopisecké články MeSH

Context: Paroxysmální supraventrikulární tachykardie (PSVt) je běžnou formou arytmie, která se často projevuje symptomy připomínajícími akutní koronární syndrom (AKS). Popis případu: Popisujeme případ 58letého muže s PSVt doprovázenou bolestí na hrudi a zvýšenými hodnotami troponinu naměřenými vysoce senzitivní metodou (high-sensitivity troponin, hs-tn). Koronarografické vyšetření prokázalo pomalý průtok krve koronárními tepnami v nepřítomnosti obstrukčního postižení. Pacientovy symptomy vymizely spontánně a echokardiografické parametry měly při jeho propouštění normální hodnoty. Závěry: Popisovaný případ ukazuje diagnostickou náročnost rozpoznávání AKS a upozorňuje na přechodné zvýšení hodnot troponinu při PSVt, možná v důsledku ischemie myokardu na podkladě rychlé srdeční frekvence. Při rozhodování o léčbě, zvláště v nepřítomnosti významné ischemické choroby, je nezbytné opřít se o klinické korelace a použít doplňkové diagnostické metody.

Background: Paroxysmal supraventricular tachycardia (PSVT) is a common arrhythmia often presenting with symptoms mimicking acute coronary syndrome (ACS). Case presentation: We present a case of a 58-year-old man with PSVT accompanied by chest pain and elevated high-sensitivity troponin (hs-Tn) levels. Coronary angiography revealed slow coronary flow in absence of obstructive disease. The patient's symptoms resolved spontaneously, and echocardiographic findings normalized upon discharge. Conclusions: This case underscores the diagnostic challenge of individuating ACS and highlights the transient troponin elevation seen in PSVT, potentially due to myocardial ischemia secondary to rapid heart rates. Clinical correlation and adjunctive diagnostic modalities are crucial in guiding management decisions, especially in the absence of significant coronary artery disease.