U pacientů s časným karcinomem hrtanu je v současnosti chirurgická léčba zachovávající funkci hrtanu preferovanou primární léčebnou modalitou. Cílem je odstranění karcinomu hrtanu s negativními okraji se současným zachováním přiměřené kvality hlasu a dýchání bez nutnosti tracheostomie. Mezi chirurgické postupy šetřící hrtan patří transorální endoskopická chirurgie, robotická mikrochirurgie hrtanu a vertikální parciální laryngektomie ze zevního přístupu (VPL). Cíl: Cílem studie bylo analyzovat faktory, které jsou zohledňovány při současných indikacích parciálních laryngektomií prováděných ze zevního přístupu pro glotický karcinom a zhodnotit chirurgické a onkologické výsledky těchto operací. Materiál a metodika: Do retrospektivní studie bylo zařazeno 18 pacientů, u nichž byla od 1. 1. 2012 do 31. 12. 2022 na Klinice otorinolaryngologie a chirurgie hlavy a krku FN u sv. Anny v Brně provedena VPL pro glotický spinocelulární karcinom. U 12 (67 %) pacientů byla předléčebná klasifikace nádoru cT1, u 6 (33 %) pacientů cT2. Nejčastěji prováděným výkonem byla laryngofi sura s rozšířenou chordektomií, která byla indikována u 17 (94 %) pacientů; frontální parciální laryngektomie byla provedena u jednoho pacienta (6 %). Nejčastější indikací k VPL byla konverze původně zvoleného endoskopického přístupu u 10 (56 %) pacientů, u 3 (17 %) pacientů se jednalo o revizní výkon po neradikálním endoskopické operaci a v 5 (28 %) případech byla VPL indikována z jiných důvodů. Výsledky: Mezi nejvýznamnější klinické rizikové faktory zohledněné při indikaci VPL patřily: omezená expozice nitra hrtanu v 11 případech, infiltrace přední komisury v 10 případech, šíření nádoru do paraglotického prostoru v 5 případech, subglotická propagace ve 4 případech, postižení processus vocalis ve 3 případech a nádorové šíření do laryngeálního ventrikulu ve 3 případech. Hodnocení resekčních okrajů prokázalo negativní resekční okraje (R0) u 8 (44 %) pacientů, blízké okraje (R0) u 6 (33 %) pacientů a pozitivní resekční okraje (R1) u 4 (22 %) pacientů. Pooperační průběh byl u většiny pacientů příznivý, přičemž u 15 (71 %) pacientů nenastaly žádné komplikace. Mírné lokální komplikace se vyskytly u 5 (24 %) pacientů, zatímco závažné komplikace nebyly zaznamenány u žádného z nich. Medián doby sledování činil 3,0 roku s interkvartilovým rozptylem 2,0 až 5,0 let. U jednoho pacienta byla dia- gnostikována recidiva karcinomu po VPL a adjuvantní radioterapii. U tohoto pacienta byla finálně indikována záchranná totální laryngektomie. Pravděpodobnost přežití byla stanovena Kaplan-Meierovou analýzou: 1 rok 90,5 %; 2 roky 85,7 %; 3 roky 85,7 %; 4 roky 77,1 %; 5 let 66,1 %. Závěr: Ačkoli jsou indikace pro zevní přístupy v současnosti velmi omezené, VPL stále představují záložní chirurgickou variantu u pacientů s omezenou expozicí vnitra hrtanu a u glotických nádorů postihujících rizikové anatomické sublokality, především přední komisuru a paraglotický prostor. I s ohledem na naše výsledky lze laryngofisuru s rozšířenou chordektomií považovat za hrtan šetřicí postup, který nabízí funkčně přijatelné a onkologicky srovnatelné výsledky léčby časného glotického karcinomu v porovnání s preferovanými endoskopickými přístupy a radioterapií.

For patients with early-stage laryngeal carcinoma, function-preserving surgical treatment is currently the preferred primary therapeutic modality. The goal is to achieve complete tumor removal with negative margins while preserving adequate voice quality and respiration without the need for a tracheostomy. Larynx-preserving surgical approaches include transoral endoscopic surgery, robotic microlaryngeal surgery, and external vertical partial laryngectomy (VPL). Objective: The aim of this study was to analyze the factors influencing current indications for open partial laryngectomies for glottic carcinoma and to evaluate the surgical and oncological outcomes of these procedures. Materials and methods: 18 patients who underwent VPL for glottic squamous cell carcinoma from 1. 1. 2012 to 31. 12. 2022 at the Department of Otorhinolaryngology and Head and Neck Surgery, St. Anne‘s Hospital in Brno were included in the retrospective study. Pre-treatment tumor classification was cT1 in 12 (67%) patients and cT2 in 6 (33%) patients. The most commonly performed procedure was laryngofissure with extended chordectomy in 17 (94%) patients; frontal partial laryngectomy was performed in one patient (6%). The most frequent indication for VPL was conversion of the initially chosen endoscopic approach in 10 (56%) patients, revision surgery following a non-radical endoscopic procedure in 3 (17%) patients, and other indications in 5 (28%) cases. Results: The most significant clinical risk factors considered in the indication for VPL included: limited exposure of the larynx in 11 cases, anterior commissure infiltration in 10 cases, tumor spread to the paraglottic space in 5 cases, subglottic extension in 4 cases, involvement of the vocal process in 3 cases, and tumor spread to the laryngeal ventricle in 3 cases. Evaluation of resection margins showed negative resection margins (R0) in 8 (44%) patients, close margins (R0) in 6 (33%) patients, and positive resection margins (R1) in 4 (22%) patients. Postoperative course was favorable in most patients, with no complications in 15 (71%) patients. Mild local complications occurred in 5 (24%) patients, while no severe complications were noted in any of them. The median follow-up period was 3.0 years, with an interquartile range of 2.0 to 5.0 years. Recurrence of carcinoma after VPL and adjuvant radiotherapy was diagnosed in one patient, who ultimately underwent salvage total laryngectomy. Survival probability was estimated using the Kaplan-Meier analysis: 1-year survival at 90.5%, 2-year survival at 85.7%, 3-year survival at 85.7%, 4-year survival at 77.1%, and 5-year survival at 66.1%. Conclusion: Although indications for external approaches are currently very limited, VPL still represents a salvage surgical option for patients with limited laryngeal exposure and for glottic tumors affecting high-risk anatomical subsites, particularly the anterior commissure and paraglottic space. Even considering our results, laryngofissure with extended cordectomy can be regarded as a larynx-preserving procedure that offers functionally acceptable and oncologically comparable treatment outcomes for early glottic carcinoma in comparison with preferred endoscopic approaches and radiotherapy.

• MeSH
• Laryngectomy * classification   methods   statistics & numerical data   MeSH
• Larynx surgery   pathology   MeSH
• Humans MeSH
• Laryngeal Neoplasms surgery   diagnosis   MeSH
• Otorhinolaryngologic Surgical Procedures methods   MeSH
• Retrospective Studies MeSH
• Carcinoma, Squamous Cell surgery   diagnosis   MeSH
• Treatment Outcome MeSH
• Check Tag
• Humans MeSH

Publikace se zaměřuje na rozdíly v Mezinárodní klasifikaci nemocí co se týče duševních poruch u dospělých. Určeno odborné veřejnosti.; Mezinárodní klasifikace nemocí (MKN) je klíčovým nástrojem pro diagnostiku a zdravotnickou dokumentaci. Přechod z MKN-10 na MKN-11 přináší zásadní změny, které budou v nadcházejících letech ovlivňovat klinickou praxi i zdravotnický výzkum. Tato publikace je systematickým, přehledným a snadno použitelným průvodcem, který pomůže rychle se zorientovat v novinkách MKN-11 a usnadní přípravu na její implementaci. Kniha je určena zejména těm, kteří aktivně pracují s MKN-10 a chtějí držet krok s vývojem a se změnami v diagnostické klasifikaci. Přináší jasný a srozumitelný výklad nejdůležitějších rozdílů, včetně podrobného rozboru hlavních změn v klíčových diagnostických oblastech.

• MeSH
• Adult MeSH
• Mental Disorders classification   MeSH
• International Classification of Diseases MeSH
• Check Tag
• Adult MeSH
• Publication type
• Monograph MeSH

• Conspectus
• Psychiatrie
• NML Fields
• psychiatrie

Flow cytometry immunophenotyping is critical for the diagnostic classification of mature/peripheral B-cell neoplasms/B-cell chronic lymphoproliferative disorders (B-CLPD). Quantitative driven classification approaches applied to multiparameter flow cytometry immunophenotypic data can be used to extract maximum information from a multidimensional space created by individual parameters (e.g., immunophenotypic markers), for highly accurate and automated classification of individual patient (sample) data. Here, we developed and compared five diagnostic classification algorithms, based on a large set of EuroFlow multicentric flow cytometry data files from a cohort 659 B-CLPD patients. These included automatic population separators based on Principal Component Analysis (PCA), Canonical Variate Analysis (CVA), Neighbourhood Component Analysis (NCA), Support Vector Machine algorithms (SVM) and a variant of the CA(Canonical Analysis) algorithm, in which the number of SDs (Standard Deviations) varied for each of the comparisons of different pairs of diseases (CA-vSD). All five classification approaches are based on direct prospective interrogation of individual B-CLPD patients against the EuroFlow flow cytometry B-CLPD database composed of tumor B-cells of 659 individual patients stained in an identical way and classified a priori by the World Health Organization (WHO) criteria into nine diagnostic categories. Each classification approach was evaluated in parallel in terms of accuracy (% properly classified cases), precision (multiple or single diagnosis/case) and coverage (% cases with a proposed diagnosis). Overall, average rates of correct diagnosis (for the nine B-CLPD diagnostic entities) of between 58.9 % and 90.6 % were obtained with the five algorithms, with variable percentages of cases being either misclassified (4.1 %-14.0 %) or unclassifiable (0.3 %-37.0 %). Automatic population separators based on CA, SVM and PCA showed a high average level of correctness (90.6 %, 86.8 %, and 86.0 %, respectively). Nevertheless, this was at the expense of proposing a considerable number of multiple diagnoses for a significant proportion of the test cases (54.5 %, 53.5 %, and 49.6 %, respectively). The CA-vSD algorithm generated the smaller average misclassification rate (4.1 %), but with 37.0 % of cases for which no diagnosis was proposed. In contrast, the NCA algorithm left only 2.7 % of cases without an associated diagnosis but misclassified 14.0 %. Among correctly classified cases (83.3 % of total), 91.2 % had a single proposed diagnosis, 8.6 % had two possible diagnoses, and 0.2 % had three. We demonstrate that the proposed AI algorithms provide an acceptable level of accuracy for the diagnostic classification of B-CLPD patients and, in general, surpass other algorithms reported in the literature.

• MeSH
• Algorithms MeSH
• B-Lymphocytes * pathology   MeSH
• Immunophenotyping * methods   MeSH
• Middle Aged MeSH
• Humans MeSH
• Lymphoproliferative Disorders * diagnosis   classification   MeSH
• Flow Cytometry * methods   MeSH
• Aged MeSH
• Support Vector Machine MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Comparative Study MeSH

Corneal dystrophies are a group of predominantly rare inherited disorders. They are by definition bilateral, relatively symmetrical, and without systemic involvement, affecting corneal transparency and/or refraction. Traditional classification of corneal dystrophies is based on slit-lamp appearance, affected corneal layer and histological features. Molecular genetics has provided ultimate proof for the existence of distinct corneal dystrophies and discarded duplicates in their terminology. Currently, there are at least 16 genes with identified pathogenic variants implicated in corneal dystrophies. Herein, we summarise contemporary knowledge on genotype-phenotype correlations of corneal dystrophies, including a critical review of some reported variants, along with the understanding of the underlying pathogenic dystrophic process; essential knowledge for the development of targeted therapies.

• MeSH
• Corneal Dystrophies, Hereditary * genetics   therapy   MeSH
• Phenotype MeSH
• Genetic Association Studies * MeSH
• Genotype MeSH
• Humans MeSH
• Molecular Biology MeSH
• Mutation * MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Review MeSH

Familiárna hypercholesterolémia (FH) je monogénové autosómovo dominantne dedičné ochorenie, ktoré je charakterizované vysokou hladinou celkového a LDL-cholesterolu a vysokým rizikom aterosklerózou podmienených kardiovaskulárnych ochorení (ASKVO). Na stanovenie klinickej diagnózy FH sa najčastejšie používa Dutch Lipid Clinic Network Score (DLNC), ktoré je na Slovensku predpokladom pre DNA-analýzu FH. Cieľom našej štúdie bolo ukázať ako koreluje klinická diagnóza FH na základe DLNC s DNA-analýzou génov pre LDL-receptory, APOB a PCSK9. Zamerali sme sa na nepríbuzných jedincov (probandov). Kompletné údaje DNA-analýzy, klinického a biochemického vyšetrenia boli u 182 probandov. Porovnávali sa pacienti s primárnou hypercholesterolémiou, ktorí mali na základe skóre DLNC istú FH (defFH) alebo pravdepodobnú (probable)/možnú (possible) FH (pFH). LDL-receptory a gény APOB a PCSK9 sa analyzovali metódou next generation sequencing. 102 probandov bolo zaradených do skupiny defFH a 89 do skupiny pFH. Pacienti s defFH boli mladší, mali štatisticky významne vyšší výskyt xantomatózy, vyššiu hladinu celkového cholesterolu a LDL-cholesterolu ako pacienti v skupine pFH (p < 0,001,resp). Nezistili sme rozdiel vo výskyte ASKVO v osobnej ani rodinnej anamnéze. 72,5 % pacientov s klinickou diagnózou defFH malo potvrdenú mutáciu v génoch pre LDL-receptory alebo APOB, kým v skupine pFH to bolo 25,8 % (p < 0,001). Tento štatisticky významný rozdiel bol spojený s významne vyššou prevalenciou mutácií v géne pre LDL-receptor (60,8 % vs 14,6 %; p < 0,001). Prevalencia mutácií v géne APOB sa medzi oboma skupinami nelíšila (11,8 % vs 10,1 %, ns). Ani u jedného pacienta sa nezistil patologický variant v géne PCSK9. Ukázali sme, že v projekte MED-PED predstavuje DLNC efektívne kritérium pre diagnózu FH. Dá sa predpokladať, že v kombinácii s univerzálnym skríningom FH u detí by sa mohol významne zlepšiť záchyt monogénovej FH, a tým aj efektívna primárna prevencia včasných kardiovaskulárnych príhod.

Familial hypercholesterolemia (FH) is a monogenic autosomal dominant disease, which is characterized by a high level of total and LDL-cholesterol and a high risk of atherosclerosis-related cardiovascular diseases (ASCVD). To determine the clinical diagnosis of FH, the Dutch Lipid Clinic Network Score (DLNC) is most often used, which is a prerequisite for DNA analysis of FH in Slovakia. The aim of our study was to show how the clinical diagnosis of FH based on DLNC correlates with DNA analysis of genes for LDL-receptors, APOB and PCSK9. We focused on unrelated individuals – probands. Complete data of DNA analysis, clinical and biochemical examination were available for 182 probands. Patients with primary hypercholesterolemia who had definite FH (defFH) or probable/possible FH (pFH) based on the DLNC score were compared. LDL-receptors, ApoB and PCSK9 genes were analyzed by the next generation sequencing. 102 probands were assigned to the defFH group and 89 to the pFH group. Patients with defFH were younger, had a statistically significantly higher incidence of xanthomatosis, higher levels of total cholesterol and LDL-cholesterol than patients in the pFH group (p < 0.001, resp.). We did not find a difference in the incidence of ASCVD in personal or family history. 72.5 % of patients with a clinical diagnosis of defFH had a confirmed mutation in the genes for LDL-receptors or APOB, while in the pFH group it was 25.8 % (p < 0.001). This statistically significant difference was associated with a significantly higher prevalence of mutations in the LDL-receptor gene (60.8 % vs 14.6 %; p < 0.001). The prevalence of mutations in the APOB gene did not differ between the two groups (11.8 % vs 10.1 %, ns). Not a single patient was found to have a pathological variant in the PCSK9 gene. We have shown that in the MED-PED project, DLNC is an effective criterion for the diagnosis of FH. It can be assumed that, in combination with universal FH screening in children, the detection of monogenic FH could be significantly improved and thus the effective primary prevention of early cardiovascular events.

• Keywords
• Dutch Lipid Clinic Network Score, DLNC,
• MeSH
• Adult MeSH
• Hyperlipidemia, Familial Combined * diagnosis   genetics   MeSH
• Genetic Techniques MeSH
• Middle Aged MeSH
• Humans MeSH
• Statistics as Topic MeSH
• Health Status Indicators * MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Female MeSH

AIMS: Benign tumours of the rete testis include mostly cystadenomas and adenomas. A subset with tubular or tubulopapillary architecture shows morphological similarities to Sertoli cell tumours; these neoplasms were previously termed "Sertoliform cystadenomas of the rete testis". In the most recent WHO classification, they have been interpreted as Sertoli cell tumours, not otherwise specified (NOS), with pure intra-rete growth, and therefore excluded as an entity. The remaining cystadenomas of the rete testis vaguely resemble tumours of Mullerian origin arising in the ovaries. In this study we analyse benign tumours of the rete testis, including a subset with Sertoliform features. METHODS AND RESULTS: Benign neoplasms of the rete testis were identified through query of consultation and institutional files. Clinicopathologic data were collected, and available slides were reviewed. Cases were assessed using IHC and three separate DNA sequencing panels. Eleven tumours from patients 32-78 years old were evaluated. Four were classified as Sertoliform adenomas/cystadenomas, displaying tubulo-papillary or tubular/trabecular architecture; all of them were PAX8-positive and lacked nuclear beta-catenin expression. The remaining seven tumours were benign cystadenomas NOS. Genomic analysis was performed successfully in 10/11 tumours (including all Sertoliform adenomas/cystadenomas) and revealed no pathogenic variants in CTNNB1, KRAS, or BRAF. CONCLUSION: Sertoliform cystadenomas of the rete testis differ from Sertoli cell tumours NOS, as evidenced by the absence of molecular markers characteristic of Sertoli cell tumours. The remaining benign cystadenomas lack molecular alterations seen in Mullerian tumors of the ovaries.

• MeSH
• Cystadenoma * pathology   genetics   MeSH
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Sertoli Cell Tumor * pathology   diagnosis   MeSH
• Biomarkers, Tumor analysis   MeSH
• Rete Testis * pathology   MeSH
• Aged MeSH
• Testicular Neoplasms * pathology   genetics   MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged MeSH
• Publication type
• Journal Article MeSH

Myelodysplastic syndromes (MDS) are clonal hematologic disorders characterized by morphologic abnormalities of myeloid cells and peripheral cytopenias. Although genetic abnormalities underlie the pathogenesis of these disorders and their heterogeneity, current classifications of MDS rely predominantly on morphology. We performed genomic profiling of 3233 patients with MDS or related disorders to delineate molecular subtypes and define their clinical implications. Gene mutations, copy-number alterations, and copy-neutral loss of heterozygosity were derived from targeted sequencing of a 152-gene panel, with abnormalities identified in 91%, 43%, and 11% of patients, respectively. We characterized 16 molecular groups, encompassing 86% of patients, using information from 21 genes, 6 cytogenetic events, and loss of heterozygosity at the TP53 and TET2 loci. Two residual groups defined by negative findings (molecularly not otherwise specified, absence of recurrent drivers) comprised 14% of patients. The groups varied in size from 0.5% to 14% of patients and were associated with distinct clinical phenotypes and outcomes. The median bone marrow (BM) blast percentage across groups ranged from 1.5% to 10%, and the median overall survival ranged from 0.9 to 8.2 years. We validated 5 well-characterized entities, added further evidence to support 3 previously reported subsets, and described 8 novel groups. The prognostic influence of BM blasts depended on the genetic subtypes. Within genetic subgroups, therapy-related MDS and myelodysplastic/myeloproliferative neoplasms had comparable clinical and outcome profiles to primary MDS. In conclusion, genetically-derived subgroups of MDS are clinically relevant and might inform future classification schemas and translational therapeutic research.

• MeSH
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Mutation MeSH
• Myelodysplastic Syndromes * genetics   classification   pathology   MeSH
• Prognosis MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• DNA Copy Number Variations MeSH
• Loss of Heterozygosity MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH

Gingivální epitéza je jednou z léčebných nechirurgických možností protetického ošetření chrupu postiženého pokročilou parodontitidou nebo gingiválními recesy klasifikace Miller III a IV s výrazným defektem měkkých tkání ve frontálním úseku postihujícími více zubů a mezizubních prostorů. Je sice snímatelným ošetřením, avšak představuje jednoduchou a bezpečnou alternativu chirurgického ošetření gingiválních recesů skýtající pro pacienty výrazný estetický efekt. Pro zuby s oslabeným parodontem je výhodou nízká hmotnost gingivální epitézy. Nasazení a vyjmutí je minimálně traumatizující. Nevýhodou gingivální epitézy jsou pigmentace materiálu, omezená životnost a snímatelná povaha této varianty ošetření.

Gingival epithesis is one of the therapeutic non-surgical modalities of prosthetic treatment of teeth affected by advanced periodontitis or gingival recessions of the Miller III or IV classification with a significant soft tissue defect in the anterior area affecting multiple teeth and interdental spaces. Although it is a removable treatment, it represents a simple and safe alternative to the surgical treatment of gingival recessions, providing patients a significant aesthetic effect. The low weight of the gingival epithesis is advantageous for teeth with a weakened periodontium. Insertion and removal is minimally traumatic. The disadvantages of gingival epithesis are the pigmentation of the material, limited durability and the removable nature of this treatment option.

• Keywords
• gingivální epitéza,
• MeSH
• Periodontal Atrophy MeSH
• Esthetics, Dental * MeSH
• Middle Aged MeSH
• Humans MeSH
• Periodontal Pocket MeSH
• Periodontitis * surgery   etiology   complications   therapy   MeSH
• Orthotic Devices MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Female MeSH
• Publication type
• Case Reports MeSH

Mutations in UBA1, which are disease-defining for VEXAS (vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic) syndrome, have been reported in patients diagnosed with myelodysplastic syndromes (MDS). Here, we define the prevalence and clinical associations of UBA1 mutations in a representative cohort of patients with MDS. Digital droplet polymerase chain reaction profiling of a selected cohort of 375 male patients lacking MDS disease-defining mutations or established World Health Organization (WHO) disease classification identified 28 patients (7%) with UBA1 p.M41T/V/L mutations. Using targeted sequencing of UBA1 in a representative MDS cohort (n = 2027), we identified an additional 27 variants in 26 patients (1%), which we classified as likely/pathogenic (n = 12) and of unknown significance (n = 15). Among the total 40 patients with likely/pathogenic variants (2%), all were male and 63% were classified by WHO 2016 criteria as MDS with multilineage dysplasia or MDS with single-lineage dysplasia. Patients had a median of 1 additional myeloid gene mutation, often in TET2 (n = 12), DNMT3A (n = 10), ASXL1 (n = 3), or SF3B1 (n = 3). Retrospective clinical review, where possible, showed that 82% (28/34) UBA1-mutant cases had VEXAS syndrome-associated diagnoses or inflammatory clinical presentation. The prevalence of UBA1 mutations in patients with MDS argues for systematic screening for UBA1 in the management of MDS.

• MeSH
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Young Adult MeSH
• Mutation * MeSH
• Myelodysplastic Syndromes * genetics   diagnosis   MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Ubiquitin-Activating Enzymes * genetics   MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Young Adult MeSH
• Male MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH

Migréna je neurologické onemocnění s opakujícími se záchvaty bolesti hlavy a významným dopadem na pacienty i společnost. Cílem tohoto souhrnu je poskytnout základní informace o této diagnóze a aktuální doporučení pro léčbu migrény. Úvodní přehled zahrnuje údaje o epidemiologii, diagnostice, klinickém obrazu, klasifikaci, etiologii a patofyziologii migrény. Novinkami ve farmakologické léčbě migrény je kontraindikace topiramátu u žen ve fertilním věku (riziko neurovývojových poruch v případě otěhotnění) a také valproátu u mužů (potenciální riziko u jejich dětí). Nově je pacientům hrazen atogepant (antagonista CGRP receptoru) za stejných podmínek jako monoklonální protilátky s anti-CGRP účinkem. Zvláštní pozornost je věnována léčebným doporučením pro ženy ve fertilním věku, v těhotenství a při kojení. Doplněny jsou také informace o nefarmakologické léčbě migrény a naznačeny jsou očekávané směry vývoje nových léčiv.

Migraine is a neurological disorder characterized by recurrent episodes of headache with significant impact on patients and society. The aim of this summary is to provide basic information about this diagnosis and current recommendations for migraine treatment. The introductory overview includes data on epidemiology, diagnosis, clinical presentation, classification, etiology and pathophysiology of migraine. Recent advancements in pharmacological treatment include contraindications of topiramate in women of childbearing age (risk of neurodevelopmental disorders in pregnancy) and also valproate in men (potential risk for their children). Atogepant (CGRP receptor antagonist) is now reimbursed to patients under the same conditions as monoclonal antibodies with anti-CGRP effect. Special attention is given to treatment recommendations for women of childbearing age, during pregnancy and breastfeeding. Additionally, information on non-pharmacological treatment of migraine is also provided and anticipated directions for the development of new drugs are indicated.

• MeSH
• Analgesics MeSH
• Calcitonin Gene-Related Peptide Receptor Antagonists pharmacology   therapeutic use   MeSH
• Antiemetics MeSH
• Anticonvulsants MeSH
• Adrenergic beta-Antagonists MeSH
• Tertiary Care Centers MeSH
• Humans MeSH
• Migraine Disorders * diagnosis   drug therapy   classification   physiopathology   MeSH
• Antibodies, Monoclonal pharmacology   therapeutic use   MeSH
• Tryptamines MeSH
• Check Tag
• Humans MeSH
• Publication type
• Practice Guideline MeSH