INTRODUCTION: In the last decade, substantial differences in the epidemiology of, antiretroviral therapy (ART) for, cascade of care in and support to people with HIV in vulnerable populations have been observed between countries in Western Europe, Central Europe (CE) and Eastern Europe (EE). The aim of this study was to use a survey to explore whether ART availability and therapies have evolved in CE and EE according to European guidelines. METHODS: The Euroguidelines in Central and Eastern Europe (ECEE) Network Group conducted two identical multicentre cross-sectional online surveys in 2019 and 2021 concerning the availability and use of antiretroviral drugs (boosted protease inhibitors [bPIs], integrase inhibitors [INSTIs] and nucleoside reverse transcriptase inhibitors [NRTIs]), the introduction of a rapid ART start strategy and the use of two-drug regimens (2DRs) for starting or switching ART. We also investigated barriers to the implementation of these strategies in each region. RESULTS: In total, 18 centres participated in the study: four from CE, six from EE and eight from Southeastern Europe (SEE). Between those 2 years, older PIs were less frequently used and darunavir-based regimens were the main PIs (83%); bictegravir-based and tenofovir alafenamide-based regimens were introduced in CE and SEE but not in EE. The COVID-19 pandemic did not significantly interrupt delivery of ART in most centres. Two-thirds of centres adopted a rapid ART start strategy, mainly in pregnant women and to improve linkage of care in vulnerable populations. The main obstacle to rapid ART start was that national guidelines in several countries from all three regions did not support such as strategy or required laboratory tests first; an INSTI/NRTI combination was the most commonly prescribed regimen (75%) and was exclusively prescribed in SEE. 2DRs are increasingly used for starting or switching ART (58%), and an INSTI/NRTI was the preferred regimen (75%) in all regions and exclusively prescribed in SEE, whereas the use of bPIs declined. Metabolic disorders and adverse drug reactions were the main reasons for starting a 2DR; in the second survey, HIV RNA <500 000 c/ml and high cluster of differentiation (CD)-4 count emerged as additional important reasons. CONCLUSIONS: In just 2 years and in spite of the emergence of the COVID-19 pandemic, significant achievements concerning ART availability and strategies have occurred in CE, EE and SEE that facilitate the harmonization of those strategies with the European AIDS Clinical Society guidelines. Few exceptions exist, especially in EE. Continuous effort is needed to overcome various obstacles (administrative, financial, national guideline restrictions) in some countries.

• MeSH
• COVID-19 * epidemiologie   MeSH
• HIV infekce * farmakoterapie   epidemiologie   MeSH
• inhibitory proteas terapeutické užití   MeSH
• látky proti HIV * terapeutické užití   MeSH
• lidé MeSH
• pandemie MeSH
• průřezové studie MeSH
• těhotenství MeSH
• Check Tag
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Evropa MeSH

Disekce aorty (DA) je řídce se vyskytující onemocnění s incidencí přibližně 30 nemocných na milion obyvatel za rok. Přes svou relativní vzácnost patří mezi závažné, život ohrožující stavy; zvláště zůstane-li nerozpoznaná a tedy neléčená, končí velmi často fatálně. Nejčastějším symptomem DA je bolest, avšak řada nemocných přichází s jinými obtížemi, většinou vyplývajícími z postižení různých orgánových systémů. Ani fyzikální nález zpravidla neumožňuje jednoznačně stanovit diagnózu DA. Při podezření na DA je proto k potvrzení diagnózy nutné využít zobrazovacích metod, z nichž jsou v současné době nejvíce používané počítačová tomografie (CT), jícnová echokardiografie (TEE) a stále častěji také magnetická rezonance (MRI). Léčebný postup u nemocných s DA závisí na druhu a rozsahu postižení. Dnes nejčastěji používaná stand­fordská klasifikace rozděluje DA podle lokalizace na typ A a typ B. Zatímco terapeutický postup u DA typu B je primárně konzervativní, u typu A bývá nezbytná chirurgická intervence; stále častěji se v poslední době ve vybraných případech také využívají možnosti perkutánní intervenční léčby. V přehledu uvádíme současné diagnostické a léčebné možnosti u nemocných s DA.

Aortic dissection (AD) is a rare disease with the incidence of approximately 30 cases per million people per year. Although AD is uncommon, it becomes among serious, life-threatening diseases and its outcome is frequently fatal prior to diagnosis. Chest pain is the most common symptom of AD, many patients may, however, develop various other symptoms secondary to the involvement of specific organ systems. Also physical findings are usually not efficient for accurate and rapid diagnosis of AD. In suspicion for AD, imaging methods are essential for confirmation of this diagnosis; computer tomography (CT) scanning or transesophageal echocardiography (TEE), and recently also magnetic resonance imaging (MRI) are the most frequently used modalities. Therapeutic approach to the patients with AD depends on the type and extent of dissection. The most widely used Standford classification distinguishes AD type A and type B, based on its localization. While therapeutic strategy in AD type B is primary conservative, in AD type A surgery intervention is usually the treatment of choice. Recently, also endovascular therapy is being used in selected patients. We review the current diagnostic and therapeutic options in patients with AD.

• MeSH
• diagnostické zobrazování metody   MeSH
• disekce aorty MeSH
• farmakoterapie metody   MeSH
• klasifikace MeSH
• lidé MeSH
• nemoci aorty diagnóza   patologie   terapie   MeSH
• přehledová literatura jako téma MeSH
• příznaky a symptomy MeSH
• prognóza MeSH
• Check Tag
• lidé MeSH

BACKGROUND: Despite the increasing use of remote measurement technologies (RMT) such as wearables or biosensors in health care programs, challenges associated with selecting and implementing these technologies persist. Many health care programs that use RMT rely on commercially available, "off-the-shelf" devices to collect patient data. However, validation of these devices is sparse, the technology landscape is constantly changing, relative benefits between device options are often unclear, and research on patient and health care provider preferences is often lacking. OBJECTIVE: To address these common challenges, we propose a novel device selection framework extrapolated from human-centered design principles, which are commonly used in de novo digital health product design. We then present a case study in which we used the framework to identify, test, select, and implement off-the-shelf devices for the Remote Assessment of Disease and Relapse-Central Nervous System (RADAR-CNS) consortium, a research program using RMT to study central nervous system disease progression. METHODS: The RADAR-CNS device selection framework describes a human-centered approach to device selection for mobile health programs. The framework guides study designers through stakeholder engagement, technology landscaping, rapid proof of concept testing, and creative problem solving to develop device selection criteria and a robust implementation strategy. It also describes a method for considering compromises when tensions between stakeholder needs occur. RESULTS: The framework successfully guided device selection for the RADAR-CNS study on relapse in multiple sclerosis. In the initial stage, we engaged a multidisciplinary team of patients, health care professionals, researchers, and technologists to identify our primary device-related goals. We desired regular home-based measurements of gait, balance, fatigue, heart rate, and sleep over the course of the study. However, devices and measurement methods had to be user friendly, secure, and able to produce high quality data. In the second stage, we iteratively refined our strategy and selected devices based on technological and regulatory constraints, user feedback, and research goals. At several points, we used this method to devise compromises that addressed conflicting stakeholder needs. We then implemented a feedback mechanism into the study to gather lessons about devices to improve future versions of the RADAR-CNS program. CONCLUSIONS: The RADAR device selection framework provides a structured yet flexible approach to device selection for health care programs and can be used to systematically approach complex decisions that require teams to consider patient experiences alongside scientific priorities and logistical, technical, or regulatory constraints.

• MeSH
• lidé MeSH
• technologie MeSH
• telemedicína * MeSH
• zdravotnický personál MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

Molecular profiling of tumor samples has acquired importance in cancer research, but currently also plays an important role in the clinical management of cancer patients. Rapid identification of genomic aberrations improves diagnosis, prognosis and effective therapy selection. This can be attributed mainly to the development of next-generation sequencing (NGS) methods, especially targeted DNA panels. Such panels enable a relatively inexpensive and rapid analysis of various aberrations with clinical impact specific to particular diagnoses. In this review, we discuss the experimental approaches and bioinformatic strategies available for the development of an NGS panel for a reliable analysis of selected biomarkers. Compliance with defined analytical steps is crucial to ensure accurate and reproducible results. In addition, a careful validation procedure has to be performed before the application of NGS targeted assays in routine clinical practice. With more focus on bioinformatics, we emphasize the need for thorough pipeline validation and management in relation to the particular experimental setting as an integral part of the NGS method establishment. A robust and reproducible bioinformatic analysis running on powerful machines is essential for proper detection of genomic variants in clinical settings since distinguishing between experimental noise and real biological variants is fundamental. This review summarizes state-of-the-art bioinformatic solutions for careful detection of the SNV/Indels and CNVs for targeted sequencing resulting in translation of sequencing data into clinically relevant information. Finally, we share our experience with the development of a custom targeted NGS panel for an integrated analysis of biomarkers in lymphoproliferative disorders.

• Publikační typ
• časopisecké články MeSH

• MeSH
• chronická nemoc terapie   MeSH
• investice MeSH
• medicína založená na důkazech MeSH
• mezinárodní spolupráce MeSH
• veřejná politika MeSH

• Konspekt
• Veřejné zdraví a hygiena
• NLK Obory
• epidemiologie
• lékařství
• veřejné zdravotnictví
• NLK Publikační typ
• publikace WHO

Th2 immunity and allergic immune surveillance play critical roles in host responses to pathogens, parasites and allergens. Numerous studies have reported significant links between Th2 responses and cancer, including insights into the functions of IgE antibodies and associated effector cells in both antitumour immune surveillance and therapy. The interdisciplinary field of AllergoOncology was given Task Force status by the European Academy of Allergy and Clinical Immunology in 2014. Affiliated expert groups focus on the interface between allergic responses and cancer, applied to immune surveillance, immunomodulation and the functions of IgE-mediated immune responses against cancer, to derive novel insights into more effective treatments. Coincident with rapid expansion in clinical application of cancer immunotherapies, here we review the current state-of-the-art and future translational opportunities, as well as challenges in this relatively new field. Recent developments include improved understanding of Th2 antibodies, intratumoral innate allergy effector cells and mediators, IgE-mediated tumour antigen cross-presentation by dendritic cells, as well as immunotherapeutic strategies such as vaccines and recombinant antibodies, and finally, the management of allergy in daily clinical oncology. Shedding light on the crosstalk between allergic response and cancer is paving the way for new avenues of treatment.

• MeSH
• alergie imunologie   MeSH
• imunitní dozor MeSH
• imunoglobulin E imunologie   MeSH
• imunoterapie metody   trendy   MeSH
• lidé MeSH
• nádory imunologie   terapie   MeSH
• protilátky MeSH
• Th2 buňky imunologie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

• MeSH
• nádory terapie   MeSH
• nukleární lékařství MeSH
• radiofarmacie MeSH
• radiofarmaka MeSH
• radiometrie MeSH

• Konspekt
• Lékařské vědy. Lékařství
• NLK Obory
• onkologie
• radiologie, nukleární medicína a zobrazovací metody
• farmacie a farmakologie
• NLK Publikační typ
• brožury

Our recent experience of the COVID-19 pandemic has highlighted the importance of easy-to-use, quick, cheap, sensitive and selective detection of virus pathogens for the efficient monitoring and treatment of virus diseases. Early detection of viruses provides essential information about possible efficient and targeted treatments, prolongs the therapeutic window and hence reduces morbidity. Graphene is a lightweight, chemically stable and conductive material that can be successfully utilized for the detection of various virus strains. The sensitivity and selectivity of graphene can be enhanced by its functionalization or combination with other materials. Introducing suitable functional groups and/or counterparts in the hybrid structure enables tuning of the optical and electrical properties, which is particularly attractive for rapid and easy-to-use virus detection. In this review, we cover all the different types of graphene-based sensors available for virus detection, including, e.g., photoluminescence and colorimetric sensors, and surface plasmon resonance biosensors. Various strategies of electrochemical detection of viruses based on, e.g., DNA hybridization or antigen-antibody interactions, are also discussed. We summarize the current state-of-the-art applications of graphene-based systems for sensing a variety of viruses, e.g., SARS-CoV-2, influenza, dengue fever, hepatitis C virus, HIV, rotavirus and Zika virus. General principles, mechanisms of action, advantages and drawbacks are presented to provide useful information for the further development and construction of advanced virus biosensors. We highlight that the unique and tunable physicochemical properties of graphene-based nanomaterials make them ideal candidates for engineering and miniaturization of biosensors.

• MeSH
• Betacoronavirus genetika   izolace a purifikace   patogenita   MeSH
• biosenzitivní techniky * přístrojové vybavení   metody   trendy   MeSH
• design vybavení MeSH
• DNA virů analýza   genetika   MeSH
• elektrochemické techniky MeSH
• grafit * chemie   MeSH
• hybridizace nukleových kyselin MeSH
• klinické laboratorní techniky * přístrojové vybavení   metody   statistika a číselné údaje   MeSH
• kolorimetrie MeSH
• koronavirové infekce diagnóza   epidemiologie   virologie   MeSH
• kvantové tečky chemie   MeSH
• lidé MeSH
• luminiscence MeSH
• nanostruktury chemie   MeSH
• pandemie MeSH
• povrchová plasmonová rezonance MeSH
• Ramanova spektroskopie MeSH
• reakce antigenu s protilátkou MeSH
• virologie metody   MeSH
• virová pneumonie diagnóza   epidemiologie   virologie   MeSH
• viry genetika   izolace a purifikace   patogenita   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

• MeSH
• dieta MeSH
• hodnocení stavu výživy metody   MeSH
• nutriční nároky MeSH
• přijímání potravy MeSH
• směrnice jako téma MeSH

• Konspekt
• Fyziologie člověka a srovnávací fyziologie
• NLK Obory
• nutriční terapie, dietoterapie a výživa
• zemědělství a potravinářství
• NLK Publikační typ
• publikace WHO

• MeSH
• DNA genetika   MeSH
• genetické jevy MeSH
• genom MeSH
• geny fyziologie   MeSH
• proteiny genetika   MeSH
• RNA genetika   MeSH
• Publikační typ
• monografie MeSH

• Konspekt
• Obecná genetika. Obecná cytogenetika. Evoluce
• NLK Obory
• genetika, lékařská genetika