Pomocí molekulárně genetických metod lze prokázat infekční organismy virového, bakteriálního a houbového původu, stejně jako protozoa a parazitické červy. Molekulární metody detekují specifické úseky v sekvencích nukleových kyselin infekčních agens, a není tedy nutné zachování viability hledaných mikroorganismů. Proto je možné použít tyto metody i pro přímý průkaz infekčního agens z fixované tkáně, nejčastějšího dostupného materiálu v patologii. Tento krátký přehledový článek vychází z více než dvacetiletého fungování molekulárně mikrobiologického úseku v rámci patologie a naším cílem je přiblížit možnosti molekulárně genetické detekce infekčních organismů pro patologickou diagnostiku.
Using molecular methods, infectious organisms of viral, bacterial and fungal origin, as well as protozoa and helminths, can be detected. Molecular methods detect specific segments in the nucleic acid sequences of infectious agents and therefore do not require the maintenance of viability of the microorganisms of interest. Therefore, these methods can also be used for direct detection of infectious agents from fixed tissue, the most commonly available material in pathology. This short review article is based on more than 20 years of molecular microbiology within pathology and our aim is to present the possibilities of molecular detection of infectious organisms for pathological diagnosis.
BACKGROUND: Job satisfaction is a key factor for the successful transition of newly graduated nurses (NGNs) and for retaining NGNs in their workplaces. However, there is limited evidence of the relationship between satisfaction regarding the nursing education program and NGNs' job satisfaction in the first year after graduation. Therefore, this study aims to examine the association of the nursing education related factors and NGNs' job satisfaction. METHODS: A cross-sectional study design with the utilization of data collected from the same respondents one year earlier as educational factors was applied. The data were collected from NGNs (n = 557) in 10 European countries using an electronic survey between February 2019 and September 2020, and analyzed in detail for four countries (n = 417). Job satisfaction was measured with three questions: satisfaction with current job, quality of care in the workplace, and nursing profession. Nursing education related factors were satisfaction with nursing education program, level of study achievements, nursing as the 1st study choice, intention to stay in nursing, and generic nursing competence. The data were analyzed statistically using logistic regression. RESULTS: Most of the NGNs in the 10 countries were satisfied with their current job (88.3%), the quality of care (86.4%) and nursing profession (83.8%). Finnish, German, Lithuanian and Spanish NGNs' satisfaction with the nursing education program at graduation was statistically significantly associated with their job satisfaction, i.e., satisfaction with their current job, the quality of care, and the nursing profession. Moreover, NGNs who had fairly often or very often intention to stay in nursing at graduation were more satisfied with their current job, with the quality of care, and with the nursing profession compared with NGNs who had never or fairly seldom intention to stay in nursing at graduation. CONCLUSIONS: Nursing education plays a significant role in NGNs' job satisfaction one year after graduation, indicating the importance to start career planning already during nursing education. Both nursing education providers and healthcare organizations could plan in close collaboration a transition program for NGNs to ease the transition phase and thus increase the NGNs' job satisfaction and ultimately the high-quality care of the patients.
- Publikační typ
- časopisecké články MeSH
Metylační umlčení některých buněčných genů je známkou progrese karcinogeneze a proto testy, které metylaci detekují, by mohly být využívány v diagnostice či „stagingu“ maligních onemocnění. V diagnostice dlaždicobuněčných karcinomů děložního hrdla (DH), které jsou téměř ve 100 % způsobeny dlouhodobou infekcí vysoce rizikovými lidskými papilomaviry (HR-HPV), je metylační umlčení určitých buněčných genů vysoce specifickým markerem pokročilé dysplastické léze a zřejmě vzniká důsledkem aberantní aktivace metyltransferázy DNMT1 virovými onkoproteiny E6 a E7. Metylační test provedený ze vzorku cervikovaginální cytologie umožňuje zvýšit výpovědní hodnotu tohoto neinvazivního vyšetření a selektovat pacientky s biologicky závažnou dlaždicobuněčnou lézí pro následné vyšetření. Pomocí cytologického vyšetření lze odhalit také méně časté anogenitální malignity, které jsou indukované HR-HPV v nižší míře – žlázové léze různého původu, nejčastěji adenokarcinomy DH a endometria a anální karcinom. Cílem naší pilotní studie bylo ohodnotit přínos metylačního testu pro diagnostiku těchto malignit na souboru 50 tekutých cervikovaginálních cytologií s nálezem žlázové léze a 74 tekutých análních cytologií HIV-pozitivních homosexuálů, kteří jsou ve vysokém riziku vzniku karcinomu anu.
Methylation silencing of certain cellular genes is a sign of carcinogenesis progression and therefore tests that detect methylation could be used in the diagnosis or staging of malignant diseases. In the diagnosis of squamous cell carcinomas of the cervix which are almost 100% caused by long-term infection with highrisk human papillomavirus (HR-HPV), methylation silencing of certain cellular genes is a highly specific marker of advanced dysplastic lesions and appears to result from aberrant activation of the methyltransferase DNMT1 by viral oncoproteins E6 and E7. A methylation test performed on a cervicovaginal cytology specimen allows to increase the diagnostic value of this non-invasive test and to select patients with severe squamous cell lesions for follow-up. Other less frequent anogenital malignancies that are induced by HR-HPV to a lesser extent can also be detected by cytological examination - glandular lesions of various origins, most commonly cervical and endometrial adenocarcinomas and anal carcinoma. The aim of our pilot study was to evaluate the utility of a methylation test for the diagnosis of these malignancies in a cohort of 50 liquid-based cervicovaginal cytologies with glandular lesion and 74 liquid-based anal cytologies from HIV-positive men having sex with men who are at high risk for anal cancer development.
- MeSH
- cytodiagnostika metody MeSH
- HIV séropozitivita komplikace MeSH
- infekce papilomavirem diagnóza komplikace patologie MeSH
- lidé MeSH
- metylace DNA * MeSH
- nádory anu diagnóza patologie prevence a kontrola MeSH
- nádory děložního čípku diagnóza patologie prevence a kontrola MeSH
- onkogenní proteiny virové genetika MeSH
- pilotní projekty MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
SIGNIFICANCE STATEMENT: Although cytomegalovirus (CMV) infection is an important factor in the pathogenesis of kidney allograft rejection, previous studies have not determined the optimal CMV prevention strategy to avoid indirect effects of the virus. In this randomized trial involving 140 kidney transplant recipients, incidence of acute rejection at 12 months was not lower with valganciclovir prophylaxis (for at least 3 months) compared with preemptive therapy initiated after detection of CMV DNA in whole blood. However, prophylaxis was associated with a lower risk of subclinical rejection at 3 months. Although both regimens were effective in preventing CMV disease, the incidence of CMV DNAemia (including episodes with higher viral loads) was significantly higher with preemptive therapy. Further research with long-term follow-up is warranted to better compare the two approaches. BACKGROUND: The optimal regimen for preventing cytomegalovirus (CMV) infection in kidney transplant recipients, primarily in reducing indirect CMV effects, has not been defined. METHODS: This open-label, single-center, randomized clinical trial of valganciclovir prophylaxis versus preemptive therapy included kidney transplant recipients recruited between June 2013 and May 2018. After excluding CMV-seronegative recipients with transplants from seronegative donors, we randomized 140 participants 1:1 to receive valganciclovir prophylaxis (900 mg, daily for 3 or 6 months for CMV-seronegative recipients who received a kidney from a CMV-seropositive donor) or preemptive therapy (valganciclovir, 900 mg, twice daily) that was initiated after detection of CMV DNA in whole blood (≥1000 IU/ml) and stopped after two consecutive negative tests (preemptive therapy patients received weekly CMV PCR tests for 4 months). The primary outcome was the incidence of biopsy-confirmed acute rejection at 12 months. Key secondary outcomes included subclinical rejection, CMV disease and DNAemia, and neutropenia. RESULTS: The incidence of acute rejection was lower with valganciclovir prophylaxis than with preemptive therapy (13%, 9/70 versus 23%, 16/70), but the difference was not statistically significant. Subclinical rejection at 3 months was lower in the prophylaxis group (13% versus 29%, P = 0.027). Both regimens prevented CMV disease (in 4% of patients in both groups). Compared with prophylaxis, preemptive therapy resulted in significantly higher rates of CMV DNAemia (44% versus 75%, P < 0.001) and a higher proportion of patients experiencing episodes with higher viral load (≥2000 IU/ml), but significantly lower valganciclovir exposure and neutropenia. CONCLUSION: Among kidney transplant recipients, the use of valganciclovir prophylaxis did not result in a significantly lower incidence of acute rejection compared with the use of preemptive therapy. CLINICAL TRIAL REGISTRY NAME AND REGISTRATION NUMBER: Optimizing Valganciclovir Efficacy in Renal Transplantation (OVERT Study), ACTRN12613000554763 .
- MeSH
- antivirové látky škodlivé účinky MeSH
- cytomegalovirové infekce * epidemiologie MeSH
- Cytomegalovirus genetika MeSH
- lidé MeSH
- neutropenie * chemicky indukované komplikace MeSH
- příjemce transplantátu MeSH
- transplantace ledvin * škodlivé účinky MeSH
- valganciklovir škodlivé účinky MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- randomizované kontrolované studie MeSH
BACKGROUND: HIV-positive men who have sex with men (MSM) are more likely to experience human papillomavirus (HPV) infection. The persistent HPV infection is the major factor in the development of anal and oropharyngeal neoplasms. Data on the prevalence of anal and oral HPV in MSM are almost absent from the countries of Central and Eastern Europe. We conducted a cross-sectional study focused on the prevalence of oral and anal HPV infections and the relationship between current anal and oral HPV intrapersonal infection in a Czech population of predominantly HIV-positive MSM. METHODS: Oral gargle and anal swab samples from 205 predominantly HIV-positive MSM from the Czech Republic were analysed for HPV infection using PCR. Selected sociodemographic and clinical data were correlated with HPV detection using generalized linear models and multivariate analysis. RESULTS: HPV infection was detected in 183 (96.8%) anal and 48 (23.6%) oral samples. The most common type of HR-HPV was HPV16 in both anal (25.4%) and oral (2.5%) samples. Multiple anal HPV infections and the presence of vaccine-targeted HR-HPV types were significantly correlated with abnormal anal cytology and HIV status. CONCLUSION: The prevalence of anal HPV infection in Czech predominantly HIV-positive MSM ranks among the highest reported, while oral HPV prevalence is consistent with MSM populations. Minimal overlap of oral and anal HPV types within a patient was observed.
- MeSH
- anální kanál MeSH
- HIV infekce * komplikace epidemiologie diagnóza MeSH
- HIV séropozitivita * epidemiologie MeSH
- homosexualita mužská MeSH
- infekce papilomavirem * diagnóza MeSH
- lidé MeSH
- Papillomaviridae genetika MeSH
- prevalence MeSH
- průřezové studie MeSH
- rizikové faktory MeSH
- sexuální a genderové menšiny * MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Česká republika MeSH
Anální karcinom je nádor s nízkou prevalencí, ale vysokou morbiditou. Díky vzácnosti tohoto nádoru proto nebylo donedávna ani uvažováno o jeho screeningu. V posledních dekádách však dochází k nárůstu počtu případů hlavně v populaci HIV pozitivních mužů majících sex s muži. Vzhledem k tomu, že většina případů análního karcinomu jsou dlaždicobuněčné karcinomy asociované s infekcí lidskými papilomaviry (HPV), máme obdobně jako v případě karcinomu děložního hrdla i v případě análního karcinomu možnost sekundární prevence pomocí vhodného screeningu. Základem současných screeningových vyšetření je digitální anorektální vyšetření, cytologické vyšetření a anoskopie. Včasné zachycení léčitelných forem je důležité i vzhledem k tomu, že díky kulturním změnám a prevalenci rizikových faktorů lze v budoucnu předpokládat nadále zvyšování incidence tohoto nádoru. Ke zvýšení efektivity screeningu je však nutná taktéž edukace a motivace rizikových skupin pacientů, hlavně rozšiřováním povědomí o análním karcinomu a roli rizikového sexuálního chování a HPV infekce.
Anal cancer is a tumour with a low prevalence but high morbidity. Due to the rarity of this tumour, therefore, its screening has not been considered until recently. However, in recent decades there has been an increase in the number of cases, especially in the population of HIV-positive men having sex with men. Since the most cases of anal cancer are squamous cell carcinomas associated with human papillomavirus (HPV) infection, as in the case of cervical cancer, there is the possibility of secondary prevention through appropriate screening. The basis of current screening examinations are digital anorectal examination, cytological examination and anoscopy. Early detection of treatable forms is important, also based on the fact that due to cultural changes and the prevalence of risk factors, an increase in the incidence of this tumour can be expected. However, education and motivation of at-risk groups of patients are necessary to increase the effectiveness of the screening, mainly by raising awareness of anal cancer and the role of risky sexual behavior and HPV infection.
- MeSH
- časná detekce nádoru metody MeSH
- karcinom diagnóza terapie MeSH
- lidé MeSH
- nádory anu * diagnóza klasifikace terapie MeSH
- rizikové faktory MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- práce podpořená grantem MeSH
- přehledy MeSH
New nurses are needed in healthcare. To meet the role expectations of a registered nurse, nursing students must feel empowered at graduation. However, there are only a few studies focusing on nursing students' empowerment. This study aims to describe and analyze graduating nursing students' level of empowerment in six European countries and potential related factors. A comparative and cross-sectional study was performed in the Czech Republic, Finland, Italy, Portugal, Slovakia, and Spain with graduating nursing students (n = 1746) using the Essential Elements of Nurse Empowerment scale. Potentially related factors included age, gender, a previous degree in health care, work experience in health care, graduation to first-choice profession, intention to leave the nursing profession, level of study achievements, satisfaction with the current nursing programme, clinical practicums, theoretical education, and generic competence measured with the Nurse Competence Scale. The data were analysed statistically. Graduating nursing students' self-assessed level of empowerment was moderate, with statistical differences between countries. Those with high empowerment had no intention to leave the nursing profession, had a higher level of study achievements, and a higher self-assessed generic competence level. The results suggest that empowerment needs to be enhanced during nursing education. Further research is needed to understand the development of empowerment during the early years of a nursing career.
- Publikační typ
- časopisecké články MeSH
AIM: To describe nursing students' level of self-directed learning abilities and identify possible factors related to it at graduation in six European countries. DESIGN: A cross-sectional comparative design across the countries. METHODS: The study was conducted from February 2018 to September 2019. Nursing students (N = 4,135) from the Czech Republic, Finland, Italy, Portugal, Slovakia and Spain were invited to respond to the research instruments (the Self-Rating Scale of Self-Directed Learning and the Nurse Competence Scale) at graduation. The data were analysed using the chi-square test, Pearson correlation coefficient and the linear model. RESULTS: The nursing students' (N = 1,746) overall self-directed learning abilities were at high level in all countries. Statistically significant differences occurred between countries. Spanish nursing students reported the highest level of self-directed learning abilities while students from the Czech Republic reported the lowest. Higher level of self-directed learning abilities was related to several factors, particularly with the self-assessed level of competence and country.
- MeSH
- inteligence MeSH
- lidé MeSH
- průřezové studie MeSH
- studenti ošetřovatelství * MeSH
- učení MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Evropa MeSH
AIM: To analyse graduating nursing students' self-assessed competence level in Europe at graduation, at the beginning of nursing career. DESIGN: An international cross-sectional evaluative design. METHODS: Data were collected in February 2018-July 2019 from graduating nursing students in 10 European countries. Competence was assessed with a validated instrument, the Nurse Competence Scale (NCS). The sample comprised 3,490 students (response rate 45%), and data were analysed statistically. RESULTS: In all countries, graduating nursing students assessed their competence as good (range 50.0-69.1; VAS 0-100), albeit with statistically significant differences between countries. The assessments were highest in Iceland and lowest in Lithuania. Older students, those with working experience in health care, satisfied with their current degree programme, with excellent or good study achievements, graduating to 1st study choice and having a nursing career plan for future assessed their competence higher.
- MeSH
- lidé MeSH
- průřezové studie MeSH
- studenti ošetřovatelství * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Evropa MeSH
- Island MeSH
- Litva MeSH
Popisujeme prípad 50-ročnej imunokompetentnej ženy, ktorá bola hospitalizovaná s poruchou vedomia. Stav progredoval do bezvedomia s kvadruparézou, pričom ani laboratórne vyšetrenia ani opakované vyšetrenia likvoru z lumbálnej punkcie nezistili pôvodcu klinického stavu. Pacientka zomrela po osemdňovej hospitalizácii. Mikroskopicky a kultivačne bol po pitve ako etiologický agens zistený Cryptococcus, ktorý počas života viedol k ťažkej kryptokokovej meningoencefalitíde, ktorá bola príčinou smrti. Histologicky boli v tkanive mozgu prítomné nakopenia kryptokokov, ktoré vo farbení hematoxylínom-eozínom verne napodobovali erytrocyty a rozsiahle krvácania. Multifokálna obliterácia cievneho riečiska mozgu kvasinkami bola sprevádzaná rozvojom hypoxicko-ischemických zmien imitujúcich úrazové difúzne axonálne poškodenie mozgu.
In this article, we report the autopsy findings of a 50-year-old immunocompetent woman, who was hospitalized with an altered state of consciousness. Examinations, including cerebrospinal fluid analysis, carried out during hospitalization failed to identify the infectious agent causing progressive loss of consciousness and quadriparesis. The patient died within 8 days of admission to the hospital. Post-mortem microscopic and culture examination revealed Cryptococcus species. Death was attributed to cryptococcal meningoencephalitis. Histologic examination revealed accumulation of cryptococcus mimicking erythrocytes and extensive hemorrhage in hematoxylin and eosin-stained sections of the brain. Multifocal obliteration of the vascular bed by yeast was accompanied by hypoxic-ischemic brain injury mimicking traumatic diffuse axonal injury.
