Categorization systems for tick-borne encephalitis virus (TBEV) infection lack consistency in classifying disease severity. To evaluate the need for a standard, consensus-based categorisation system for TBEV infection across subtypes, we gathered an expert panel of clinicians and scientists with diverse expertise in TBEV infection. Consensus was sought using the Delphi technique, which consisted of 2 web-based survey questionnaires and a final, virtual, consensus-building exercise. Ten panellists representing 8 European countries participated in the Delphi exercise, with specialities in neurology, infectious disease, paediatrics, immunology, virology, and epidemiology. Panellists reached unanimous consensus on the need for a standardised, international categorisation system to capture both clinical presentation and severity of TBEV infection. Ideally, such a system should be feasible for use at bedside, be clear and easy to understand, and capture both the acute and follow-up phases of TBEV infection. Areas requiring further discussion were (1) the timepoints at which assessments should be made and (2) whether there should be a separate system for children. This Delphi panel study found that a critical gap persists in the absence of a feasible and practical classification system for TBEV infection. Specifically, the findings of our Delphi exercise highlight the need for the development of a user-friendly classification system that captures the acute and follow-up (i.e., outcome) phases of TBEV infection and optimally reflects both clinical presentation and severity. Development of a clinical categorisation system will enhance patient care and foster comparability among studies, thereby supporting treatment development, refining vaccine strategies, and fortifying public health surveillance.
- MeSH
- Delphi Technique * MeSH
- Encephalitis, Tick-Borne * epidemiology virology diagnosis MeSH
- Consensus MeSH
- Humans MeSH
- Encephalitis Viruses, Tick-Borne * classification MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
BACKGROUND AND OBJECTIVES: Enhanced Recovery After Surgery (ERAS) guidelines for Radical Cystectomy (RC) were published over ten years ago. Aim of this systematic review is to update ERAS recommendations for patients undergoing RC and to give an expert opinion on the relevance of each single ERAS item. METHODS: A systematic review was performed to identify the impact of each single ERAS item on RC outcomes. Embase and Medline (through Pubmed) were searched systematically. Relevant articles were selected and graded. For each ERAS item, a level of evidence was determined. An e-Delphi consensus was then performed amongst an international panel with renowned experience in RC to provide recommendations based on expert opinion. KEY FINDINGS AND LIMITATIONS: Preoperative medical optimization and avoiding bowel preparation are highly recommended. Robotic-assisted RC with intracorporeal urinary diversion is moderately recommended and can help in applying other ERAS items, such as early mobilization. Medical thromboprophylaxis should be administered and nasogastric tube should be removed at the end of surgery. Perioperative fluid restriction as well as opioid-sparing anesthesia protocols should be implemented. Generally, consensus was reached on most ERAS items, with the exception of epidural anesthesia (no consensus), resection site drainage (consensus against), and type of urinary drainage. Limitations include the lack of a multidisciplinary approach to the present consensus, giving however a highly specialized surgical opinion on ERAS. CONCLUSIONS: and clinical implications: The current study updates ERAS recommendations for patients undergoing RC and suggests application of ERAS by a panel of experts in the field.
- MeSH
- Early Ambulation MeSH
- Surgeons MeSH
- Cystectomy * methods MeSH
- Urinary Diversion methods MeSH
- Humans MeSH
- Urinary Bladder Neoplasms surgery MeSH
- Robotic Surgical Procedures MeSH
- Practice Guidelines as Topic MeSH
- Enhanced Recovery After Surgery * MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Review MeSH
- Systematic Review MeSH
The European Renal Association (ERA) Registry collects data on kidney replacement therapy (KRT) in patients with end-stage kidney disease (ESKD). This paper summarizes the ERA Registry Annual Report 2022, with a special focus on comparisons by sex. The supplement of this paper contains the complete ERA Registry Annual Report 2022. Data was collected from 53 national and regional KRT registries from 35 countries. Using this data, incidence, and prevalence of KRT, kidney transplantation rates, survival probabilities, and expected remaining lifetimes were calculated. In 2022, 530 million people of the European general population were covered by the ERA Registry. The incidence of KRT was 152 per million population (pmp). In incident patients, 54% were 65 years or older, 64% were male, and the most common primary renal disease (PRD) was diabetes mellitus (22%). At KRT initiation, 83% of patients received haemodialysis, 12% received peritoneal dialysis, and 5% underwent pre-emptive kidney transplantation. On 31 December 2022, the prevalence of KRT was 1074 pmp. In prevalent patients, 48% were 65 years or older, 62% were male, the most common PRD was of miscellaneous origin (18%), 56% of patients received haemodialysis, 5% received peritoneal dialysis, and 39% were living with a functioning graft. In 2022, the kidney transplantation rate was 40 pmp, with most kidneys coming from deceased donors (66%). For patients starting KRT between 2013 to 2017, 5-year survival probability was 52%. Compared with the general population, the expected remaining lifetime was 66% and 68% shorter for males and females, respectively, receiving dialysis, and 46% and 49% shorter for males and females, respectively, living with a functioning graft.
- Publication type
- Journal Article MeSH
- Review MeSH
The alveolar-capillary interface is the key functional element of gas exchange in the human lung, and disruptions to this interface can lead to significant medical complications. However, it is currently challenging to adequately model this interface in vitro, as it requires not only the co-culture of human alveolar epithelial and endothelial cells but mainly the preparation of a biocompatible scaffold that mimics the basement membrane. This scaffold should support cell seeding from both sides, and maintain optimal cell adhesion, growth, and differentiation conditions. Our study investigates the use of polycaprolactone (PCL) nanofibers as a versatile substrate for such cell cultures, aiming to model the alveolar-capillary interface more accurately. We optimized nanofiber production parameters, utilized polyamide mesh UHELON as a mechanical support for scaffold handling, and created 3D-printed inserts for specialized co-cultures. Our findings confirm that PCL nanofibrous scaffolds are manageable and support the co-culture of diverse cell types, effectively enabling cell attachment, proliferation, and differentiation. Our research establishes a proof-of-concept model for the alveolar-capillary interface, offering significant potential for enhancing cell-based testing and advancing tissue-engineering applications that require specific nanofibrous matrices.
Úvod. Adolescencia ako obdobie náhlych a intenzívnych zmien predstavuje dôležitú výskumnú oblasť. Autori čoraz zriedkavejšie skúmajú adolescentov zo špeciálnych výchovných zariadení, u ktorých by zistenia o ich sociálnych kompetenciách a črtách temnej triády mohli prispieť do menej prebádanej oblasti. Vo výskumnej štúdii sa venujeme vzťahom sociálnych kompetencií a čŕt temnej triády u adolescentov zo špeciálnych výchovných zariadení. Skúmame tiež rozdiely medzi adolescentami zo špeciálnych výchovných zariadení a referenčnou skupinou. Metódy. Dáta sme zbierali dotazníkovou formou osobne v štyroch špeciálnych výchovných zariadeniach. Do výskumu sa zapojilo 40 adolescentov. Referenčnú skupinu tvorilo 45 adolescentov. Účasť bola anonymná a výskum bol schválený etickou komisiou Paneurópskej vysokej školy. Výsledky. Pozitívne vzťahy sme zistili medzi dimenziou narcizmu a sebaprezentácie (rs = 0,529), extraverzie (rs = 0,324); psychopatie a extraverzie (rs = 0,358). Negatívnu koreláciu sme zistili medzi narcizmom a počúvaním (rs = -0,409), ako aj machiavelizmom a počúvaním (rs = –0,305). Zistili sme rozdiely v dimenzii prevzatia perspektívy (d = 0,453) v prospech adolescentov z referenčnej skupiny a extraverzie (d = 0,707) v prospech adolescentov zo špeciálnych výchovných zariadení. Závery. Dátami sme podporili empirické zistenia vzťahov machiavelizmu a počúvania; narcizmu a extraverzie, sebaprezentácie a počúvania; psychopatie a extraverzie, ktoré sú v súlade s predošlými výsledkami iných autorov. Nepodporili sme empirické východiská výskumu pri vzťahoch machiavelizmu a prevzatia perspektívy, sebakontroly, emocionálnej stability a sebaprezentácie, ako aj pri vzťahoch psychopatie a prevzatia perspektívy, počúvania a sebakontroly. V článku sa venujeme možným alternatívnym vysvetleniam týchto zistení.
Introduction. Adolescence, as a period of sudden and intense changes, represents an important area of research. Researchers are less likely to study adolescents from special educational institutions, despite the fact that findings regarding their social competencies and dark triad traits could contribute to a less explored domain. In this study, we examine the relationships between social competencies and dark triad traits in adolescents from special educational institutions. We also investigate differences between adolescents from these institutions and a reference group. Methods. Data were collected through questionnaires administered in person at four special educational institutions. A total of 40 adolescents participated in the study. The reference group consisted of 45 adolescents. Participation was anonymous, and the research was approved by the Ethics Committee of the Pan-European University. Results. We found positive relationships between the dimension of narcissism and self-presentation (rs = 0,529), extraversion (rs = 0,324); and between psychopathy and extraversion (rs = 0,358). A negative correlation was found between narcissism and listening (rs = -0,409), as well as between Machiavellianism and listening (rs = -0,305). We identified differences in the dimension of perspective-taking (d = 0,453) in favor of adolescents from the reference group and in extraversion (d = 0,707) in favor of adolescents from special educational institutions. Conclusion. Our data supported the empirical findings regarding the relationships between Machiavellianism and listening; narcissism and extraversion; self-presentation and listening; psychopathy and extraversion, which are in line with previous results by other authors. We did not support the empirical foundations of the research in the relationships between Machiavellianism and perspective-taking, self-control, emotional stability, and self-presentation, as well as in the relationships between psychopathy and perspective-taking, listening, and self-control. In the article, we discuss possible alternative explanations for these findings.
Special education practice and theory show us that the number of pupils with specific learning disabilities has been continuously increasing for the last 5 years. Therefore, our investigation in the whole Czech Republic focused on the state of the issue among pupils with severe visual impairment. The topic is difficult to elaborate, mainly because very few authors have addressed it to date, despite the fact that special education practice sees this need. The following article summarises data collected through both quantitative and qualitative methods, thanks to the IGA project – The phenomenon of specific learning disabilities in pupils with visual impairment.
Úvod. Populace stárne, což zvyšuje potřebu komplexní péče seniorů v zařízeních dlouhodobé péče. Psychologická podpora představuje důležitou součást této služby, avšak v České republice není legislativně zakotvena. Cílem této studie bylo zmapovat dostupnost psychologické péče v domovech pro seniory a domovech se zvláštním režimem, analyzovat formy a rozsah spolupráce s psychologickými službami a odhalit překážky, které brání jejímu poskytování. Metody. Online dotazníky byly rozeslány do 471 zařízení dlouhodobé péče v České republice. Bylo získáno 205 odpovědí (44 %), které byly analyzovány pomocí deskriptivní statistiky a tematické analýzy otevřených otázek. Data byla sbírána anonymně a na základě provedené kontroly nepředpokládáme, že by z jednoho zařízení pocházelo více odpovědí. Dotazník se zaměřil na přítomnost psychologů, formy a rozsah spolupráce a důvody absence psychologické péče. Výsledky. 33 % (67 z 205), uvedlo, že nad tím ani neuvažovali. 28 % (58 z 205) uvedlo, že zajišťuje psychologickou péči a 7 % přiznává, že přítomnost psychologa nepokrývá veškerou poptávku. Nejčastější formou spolupráce byla externí činnost (OSVČ) nebo dohody o pracovní činnosti, dvě zařízení zaměstnávají psychologa na hlavní pracovní poměr. Tematická analýza odhalila pět hlavních překážek: systémové překážky; finanční důvody; limity v dostupnosti psychologů; nepotřebnost a nepochopení role psychologa; nahrazování jinými rolemi. Závěr. Přechod do pobytového zařízení je pro mnoho seniorů významným stresorem spojeným se ztrátou autonomie, sociálních vazeb a změnou prostředí, což může vést k psychické nepohodě či zhoršení duševního zdraví. Právě proto je nezbytné, aby psychologická péče byla součástí multidisciplinárního přístupu v každém zařízení dlouhodobé péče. Výsledky této studie však naznačují, že přítomnost psychologů v zařízeních dlouhodobé péče není běžně zajišťována. Je nezbytné legislativně ukotvit pozici psychologa v těchto zařízeních a zlepšit vzdělávání psychologů v oblasti stáří a stárnutí Zapojení psychologů do týmu poskytujícího péči je klíčové pro zajištění komplexní podpory odpovídající potřebám stárnoucí populace.
Introduction. The aging population increases the demand for comprehensive care in long-term care facilities for older adults. Psychological support is a crucial component of this care; however, it is not legislatively established in Czechia. This study aimed to assess the availability of psychological services in nursing homes and special regime homes, analyze forms and scope of collaboration with psychological services, and identify barriers to their provision. Methods. Online questionnaires were distributed to 471 long-term care facilities in Czechia. A total of 205 responses (44%) were collected and analyzed using descriptive statistics and thematic analysis of open-ended questions. Data were collected anonymously, and based on the conducted verification, we do not expect multiple responses from a single device. The questionnaire focused on the presence of psychologists, forms, the scope of collaboration, and reasons for the absence of psychological care. Results. A total of 33% (67 of 205) respondents reported they had not considered providing psychological care. Psychological care was provided by 28% (58 of 205) of facilities, while 7% acknowledged that the presence of a psychologist did not fully meet the demand. The most common form of collaboration was external contractors (self-employed professionals) or agreements for work outside standard employment contracts. Only two facilities employed psychologists on a full-time basis. Thematic analysis revealed five main barriers: systemic challenges, financial constraints, limited availability of psychologists, perceived lack of necessity or understanding of the psychologist's role, and substitution by other professionals. Conclusion. The transition to a residential care facility is a significant stressor for many older adults, associated with loss of autonomy, social connections, and environmental change, which can lead to psychological distress or deterioration of mental health. For this reason, psychological care must be part of a multidisciplinary approach in every long-term care facility. However, the findings of this study suggest that the presence of psychologists in long-term care facilities is not commonly ensured. It is necessary to establish the role of psychologists in these facilities through legislation and to improve the training of psychologists in the fields of aging and old age. Integrating psychologists into care teams is crucial for providing comprehensive support that meets the needs of the aging population.
Fifth English edition, fourth at Karolinum Press 165 stran : ilustrace ; 24 cm
- Keywords
- čeština,
- MeSH
- Medicine MeSH
- Terminology as Topic MeSH
- Conspectus
- Učební osnovy. Vyučovací předměty. Učebnice
- Čeština
- NML Fields
- lingvistika, lékařská terminologie
- NML Publication type
- učebnice vysokých škol
Endometrial carcinomas (EC) of no special molecular profile (NSMP) represent the largest molecular category of EC, comprising a mixture of tumors with different histology and molecular profiles. These facts likely point to different tumor biology, clinical outcomes, and targeted therapy responses within this molecular category. The PIK3CA is currently the only targetable kinase oncoprotein directly implicated in EC carcinogenesis. Investigating a unique single-institution cohort, we attempted to stratify NSMP ECs based on the presence of the PIK3CA pathogenic mutation. Those cases were further analyzed for other well-established-associated oncogenic driver gene mutations. Histological and clinical variables were also correlated in each case. Altogether, 175 ECs were prospectively tested by a limited custom NGS panel containing ARID1A, BCOR, BRCA1, BRCA2, CTNNB1, KRAS, MLH1, MSH2, MSH6, NRAS, PIK3CA, PMS2, POLD1, POLE, PTEN,and TP53 genes. We identified 24 PIK3CA mutated cases in the group of 80 NSMP ECs, with another co-occurring mutation in at least one oncogenic driver gene (CTNNB1, PTEN, ARID1A, KRAS, BCOR, PMS2) in 19 cases. In conclusion, a limited NGS panel can effectively test EC tissue for specific pathogenetically relevant oncogene mutations. The NSMP EC category contains 30% of the PIK3CA mutated cases. Of those, 21% contain the PIK3CA mutation as a sole EC-associated oncogene mutation, while 79% harbor at least one more mutated gene. These findings may inform future healthcare planning and improve the effectiveness of EC patient selection for the PIK3CA-targeted therapy.
- MeSH
- Molecular Targeted Therapy MeSH
- Adult MeSH
- Class I Phosphatidylinositol 3-Kinases * genetics antagonists & inhibitors MeSH
- Middle Aged MeSH
- Humans MeSH
- Mutation MeSH
- DNA Mutational Analysis MeSH
- Biomarkers, Tumor * genetics MeSH
- Endometrial Neoplasms * genetics pathology drug therapy MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Patient Selection MeSH
- High-Throughput Nucleotide Sequencing * methods MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
