The Institute for Safe Medication Practices and the American Society of Health-System Pharmacists have advocated for removing all injectable promethazine from inpatient and outpatient settings; however, this drug is still being used despite the risk for tissue necrosis, gangrene, and possible amputation when it inadvertently is given by the subcutaneous or intra-arterial route. This article describes alternative injectable medications that can be selected based on patient comorbidities, indications, and clinician experience.

• MeSH
• injekce subkutánní MeSH
• injekce MeSH
• lidé MeSH
• promethazin * aplikace a dávkování   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

Syphilis, known as "the great mimicker," is caused by the spirochete Treponema pallidum and is characterized by a diverse array of clinical and histopathologic presentations. In secondary cutaneous syphilis, the most consistent morphological features include a superficial and deep perivascular infiltrate containing plasma cells, varying degrees of endothelial swelling, irregular acanthosis, elongation of rete ridges, a vacuolated pattern, and the presence of plasma cells. Although serologic tests are essential for definitive diagnosis, spirochetes can sometimes be directly identified in silver-stained tissue slides or through immunohistochemistry. Granuloma annulare is a relatively common, benign, self-limiting condition with 3 main variants: conventional, subcutaneous, and interstitial, each with distinct characteristics. In this study, we report 2 cases of cutaneous secondary syphilis with a striking granulomatous reaction pattern that closely mimics the interstitial variant of granuloma annulare. Owing to the severity of the tertiary stage of syphilis, distinguishing between these 2 entities is crucial.

• MeSH
• anulární granulom * patologie   diagnóza   mikrobiologie   MeSH
• diferenciální diagnóza MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• syfilis kožní patologie   diagnóza   mikrobiologie   MeSH
• syfilis * diagnóza   patologie   mikrobiologie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

Angioedémy jsou přechodné lokalizované otoky podkoží a sliznic, způsobené dočasně zvýšenou cévní permeabilitou. Při ošetření a další péči o pacienta s touto diagnózou je nutné především odlišit, zda se jedná o otoky vyvolané mediátory žírných buněk nebo způsobené bradykininem. V prvním případě zpravidla uspějeme s použitím antihistaminik a kortikosteroidů, ve druhém případě je nutné volit léčbu, která specificky ovlivňuje kaskádu kalikrein-kininy.

Angioedemas are transient localized swellings of the subcutaneous tissue and mucous membranes caused by temporarily increased vascular permeability. When treating and providing further care for a patient with this diagnosis, it is crucial to distinguish whether the swellings are triggered by mast cell mediators or caused by bradykinin. In the first case, treatment with antihistamines and corticosteroids is usually successful, while in the second case, specific treatment that specifically affects the kallikrein-kinin cascade is required.

The global rise in obesity has emerged as a significant health concern, amplifying susceptibility to various diseases, including asthma. Epidemiological evidence demonstrates a higher prevalence of asthma among obese individuals, with obesity exacerbating asthma severity and control. This review aims to explore the interplay between asthma and obesity assessed by objective imaging methods and discusses the consistency between anthropometric and imaging methods. A literature search was conducted with the main keywords "asthma", "obesity", and "imaging techniques" using databases such as PubMed, Web of Sciences, and Scopus for the relevant articles published up to January 2024. The consistency between Body Mass Index (BMI), Waist Circumference (WC), and results from imaging techniques is uncertain. Unlike anthropometric methods, imaging methods provide us with the exact location of adipose tissue as well as fat and lean mass distinction, which can be further correlated with different airway parameters and respiratory system functions and dysfunctions. Studies indicate that the relationship between lung functions and obesity is more complex in females. Abdominal visceral fat is supposed to be the major asthma predictor already in the pediatric population. The connection between obesity and asthma is already evident in children and adolescents. Imaging methods can measure visceral and subcutaneous fat mass and both contribute to the association between obesity and lung functions. These methods are more accurate and reproducible but require more time and expertise. Key words Asthma, Obesity, Magnetic resonance imaging, Dual-energy, X-ray absorptiometry, Bioimpedance analysis.

• MeSH
• bronchiální astma * diagnostické zobrazování   epidemiologie   patofyziologie   MeSH
• index tělesné hmotnosti MeSH
• lidé MeSH
• magnetická rezonanční tomografie metody   MeSH
• obezita * diagnostické zobrazování   komplikace   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

BACKGROUND: Pulmonary hernia is a rare condition characterized by the protrusion of lung tissue through a chest wall defect. Trauma and thoracic surgery are the most common causes of acquired lung hernias. We present an unusual case of (sequential) bilateral lung herniation with parenchymal infarction after bilateral lobar lung transplantation. CASE PRESENTATION: A 50-year-old female, wait-listed as high-urgency candidate, with a body mass index (BMI) of 29 kg/m2 underwent a bilateral lobar lung transplantation for pulmonary fibrosis through a clamshell thoracotomy approach. Due to a size mismatch, stapler resection of the segment 3 and the middle lobe of the right lung, as well as an upper left lobectomy was required. The chest was closed with 3 braided non-absorbable pericostal sutures on each side. Sternal osteosynthesis was performed with a titanium sternal splint along with 7 self-tapping screws with a length of 18 mm. On the posttransplant day (PTD) 18, patient's clinical condition deteriorated. Physical examination didn't reveal any palpable subcutaneous chest resistance. However, a computed tomography (CT) scan showed a herniation of the segment 6 of the right lung. During acute surgical revision, perioperative finding revealed posterior pericostal suture failure. Therefore, a stapler resection was performed due to the infarction of the herniated segment. On the PTD 36, herniation of the left lung parenchyma was detected by acute CT scan. The protruding vital parenchyma was surgically repositioned without necessity of resection. Two posterior pericostal sutures were broken, and distal part of sternal splint detached. Thoracotomy was closed using 5 braided non-absorbable sutures. Sternum was re-osteosynthesized with the STRATOSTM system. After 3 months of intensive postoperative care, the patient was transferred to the rehabilitation department. She was discharged on the PTD 99. After 20 months of follow-up, lung function remains stable without the need for oxygen support. CONCLUSION: Clamshell incision remains ultimate approach in thoracic surgery. However, pulmonary herniation after clamshell thoracotomy is a rare complication and may manifest as acute respiratory distress syndrome with an inflammatory response. In these cases, CT scan should be always considered, even if no palpable pathology of chest is present.

• MeSH
• hernie * etiologie   MeSH
• infarkt etiologie   chirurgie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• operace kýly metody   škodlivé účinky   MeSH
• plíce diagnostické zobrazování   MeSH
• plicní nemoci chirurgie   etiologie   MeSH
• počítačová rentgenová tomografie MeSH
• pooperační komplikace chirurgie   MeSH
• torakotomie * metody   MeSH
• transplantace plic * škodlivé účinky   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

Methoxphenidine (MXP) is classified as a new psychoactive substance that has recently emerged on the illicit drug market. Understanding the pharmacological and behavioural profiles of newly emerging drugs is essential for a better understanding of their psychotropic effects and potential toxicity. Therefore, in this study, we investigated a broad range of effects of acute MXP administration: pharmacokinetics in the brain and serum; behaviour (open field and prepulse inhibition), systemic toxicity (lethal dose; LD 50), and histopathology changes in parenchymal organs of Wistar rats. MXP rapidly crossed the blood-brain barrier, reaching peak median concentrations in both serum and brain 30 min post-administration, followed by an elimination phase with a half-life of 2.15 h. Locomotor activity in the open field test displayed a dose-response effect at low to moderate doses (10-20 mg/kg MXP). At higher doses (40 mg/kg), locomotor activity decreased. All doses of MXP significantly disrupted prepulse inhibition and the effect was present during the onset of its action as well as 60 min after treatment. Additionally, MXP demonstrated moderate acute toxicity, with an estimated LD50 of 500 mg/kg when administered subcutaneously. In summary, MXP exhibited a profile similar to typical dissociative anesthetics, producing stimulant and anxiogenic effects at lower doses, sedative effects at higher doses, and disrupting sensorimotor gating. The accumulation of MXP in brain tissue is likely to contribute to acute intoxication in humans, potentially leading to negative experiences. Our findings highlight the potentially dangerous effects of recreational MXP use and underscore the risks of inducing serious adverse health outcomes.

• MeSH
• chování zvířat účinky léků   MeSH
• krysa rodu rattus MeSH
• LD50 MeSH
• mozek účinky léků   metabolismus   MeSH
• piperidiny farmakokinetika   farmakologie   MeSH
• pohybová aktivita účinky léků   MeSH
• potkani Wistar * MeSH
• prepulsní inhibice účinky léků   MeSH
• test otevřeného pole účinky léků   MeSH
• vztah mezi dávkou a účinkem léčiva * MeSH
• zvířata MeSH
• Check Tag
• krysa rodu rattus MeSH
• mužské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH

Kongenitální hemangiomy (KH) se zakládají in utero a patří do skupiny benigních cévních nádorů, které dosahují svého růstového vrcholu při narození a dále již neprogredují. Od infantilních hemangiomů (IH) se liší nejen svým klinickým, radiologickým a histologickým obrazem, ale také odlišným chováním a léčebným přístupem. Autoři popisují případ novorozené dívky s KH krku o velikosti 30 × 20 × 30 mm. Ultrasonografické vyšetření v barevném mapování prokázalo zvýšeně echogenní formaci v podkoží s mírně zvýšeným prokrvením. Ke kompletní spontánní regresi KH došlo ve věku 12 měsíců.

Congenital hemangiomas (CH) are established in utero and belong to the group of benign vascular tumors that reach their growth peak at birth and do not progress further. They differ from infantile hemangiomas (IH) not only in their clinical, radiological and histological picture, but also in their behaviour and therapeutic approach. The authors describe a case of a newborn boy with a neck KH of 30 × 20 × 30 mm. Ultrasonographic examination in color mapping showed an increased echogenic formation in the subcutaneous tissue with slightly increased blood supply. Complete spontaneous regression of KH occurred at the age of 12 months.

• MeSH
• hemangiom * diagnóza   patofyziologie   terapie   MeSH
• krk patologie   MeSH
• lidé MeSH
• magnetická rezonanční tomografie metody   MeSH
• novorozenec MeSH
• Check Tag
• lidé MeSH
• novorozenec MeSH
• ženské pohlaví MeSH
• Publikační typ
• kazuistiky MeSH

Uveální melanom je vzácnou malignitou, nicméně nejčastější nitrooční malignitou u dospělých. Má velmi vysoké riziko metastazování, především do jater, dále do plic, skeletu a kůže a podkoží, s rizikem rozvoje metastazujícího onemocnění u 25 % pacientů do 5 let a u 50 % pacientů do 15 let od diagnózy onemocnění. Biologické charakteristiky a mutační nálož uveálního melanomu jsou odlišné od standardního kožního melanomu s důsledkem omezeného využití imunoterapie checkpoint inhibitory u metastazujícího onemocnění. Jako zásadní molekula v léčbě pro vybrané pacienty s metastazujícím onemocněním se jeví tebentafusp.

Uveal melanoma is a rare malignancy, but the most common intraocular malignancy in adults. It has a very high risk of metastasis, mainly to the liver, lung, skeleton and skin and subcutaneous tissue, with a risk of metastatic disease in 25% of patients within 5 years and in 50% of patients within 15 years of diagnosis. The biological characteristics and mutational load of uveal melanoma are different from standard cutaneous melanoma, with the consequence of limited use of checkpoint inhibitor immunotherapy in metastatic disease. Tebentafusp appears to be an essential molecule in the treatment for selected patients with metastatic disease.

• Klíčová slova
• tebentafusp,
• MeSH
• inhibitory kontrolních bodů farmakologie   terapeutické užití   MeSH
• lidé MeSH
• melanom * diagnóza   farmakoterapie   genetika   klasifikace   MeSH
• metastázy nádorů diagnóza   farmakoterapie   MeSH
• nádory uvey * diagnóza   farmakoterapie   genetika   klasifikace   MeSH
• prognóza MeSH
• protilátky bispecifické farmakologie   klasifikace   terapeutické užití   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• přehledy MeSH

OBJECTIVE: The aim of the present study was to illustrate the (potential) diagnostic role of high resolution US images in assessing the elementary lesions of dactylitis. METHODS: Using high-frequency US machines/probes, we matched the micro-anatomical cadaveric architecture of the digit with multiple sonographic findings of dactylitis. High-sensitive color/power Doppler assessments have also been performed to evaluate the digital microvasculature. DISCUSSION: Modern US equipment/features guarantee prompt and in-depth B-mode and color/power Doppler imaging of tiny anatomical structures of the digit which are usually not properly visible with standard US machines. More specifically, hypervascularization of the digital subcutaneous tissue, fibrous pulleys of flexor tendons, dorsal synovial pads as well as pathological changes of the distal entheseal anchorage network can be accurately detected. CONCLUSION: In clinical practice, high-end US equipment can be used to accurately assess the digits in patients with dactylitis. This way, simple and convenient sonographic diagnosis of different elementary lesions can be timely established.

• MeSH
• kloub prstu ruky diagnostické zobrazování   MeSH
• lidé MeSH
• mrtvola MeSH
• prsty ruky * diagnostické zobrazování   krevní zásobení   MeSH
• ultrasonografie dopplerovská barevná metody   MeSH
• ultrasonografie metody   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

• MeSH
• klasifikace MeSH
• nádory diagnóza   MeSH
• Publikační typ
• monografie MeSH

• Konspekt
• Patologie. Klinická medicína
• NLK Obory
• patologie
• onkologie