Hypertrophic cardiomyopathy can be accompanied by dynamic obstruction in the left ventricular outflow tract and acute apical ballooning, which are among the very rare causes of cardiogenic shock. This condition requires a specific treatment approach that in many ways differs from the treatment of other causes of cardiogenic shock. We present a case and our treatment strategy (including extracorporeal life support) for refractory cardiogenic shock in a patient with previously undiagnosed hypertrophic cardiomyopathy.

• Klíčová slova
• Cardiogenic shock, Takotsubo syndrome, acute heart failure, case report, extracorporeal membrane oxygenation, hypertrophic cardiomyopathy, left ventricular outflow tract obstruction, mechanical circulatory support,
• MeSH
• echokardiografie MeSH
• elektrokardiografie MeSH
• hypertrofická kardiomyopatie * komplikace   diagnóza   terapie   MeSH
• kardiogenní šok * terapie   etiologie   diagnóza   MeSH
• lidé středního věku MeSH
• lidé MeSH
• takotsubo kardiomyopatie komplikace   diagnóza   terapie   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

In many scientific fields, sparseness and indirectness of empirical evidence pose fundamental challenges to theory development. Theories of the evolution of human cognition provide a guiding example, where the targets of study are evolutionary processes that occurred in the ancestors of present-day humans. In many cases, the evidence is both very sparse and very indirect (e.g., archaeological findings regarding anatomical changes that might be related to the evolution of language capabilities); in other cases, the evidence is less sparse but still very indirect (e.g., data on cultural transmission in groups of contemporary humans and non-human primates). From examples of theoretical and empirical work in this domain, we distill five virtuous practices that scientists could aim to satisfy when evidence is sparse or indirect: (i) making assumptions explicit, (ii) making alternative theories explicit, (iii) pursuing computational and formal modelling, (iv) seeking external consistency with theories of related phenomena, and (v) triangulating across different forms and sources of evidence. Thus, rather than inhibiting theory development, sparseness or indirectness of evidence can catalyze it. To the extent that there are continua of sparseness and indirectness that vary across domains and that the principles identified here always apply to some degree, the solutions and advantages proposed here may generalise to other scientific domains.

• Klíčová slova
• Cognitive science, Evidence, Explanation, Theoretical virtues, Theory development, Underdetermination,
• Publikační typ
• časopisecké články MeSH

BACKGROUND: Neurovascular conflict between the oculomotor nerve and a posterior circulation cerebral artery is a relatively frequent radiologic finding; however, it manifests minimally clinically (by slower photoreaction on the ipsilateral side). Sustained paresis of the oculomotor nerve that arose directly due to neurovascular conflict between the superior cerebral artery (SCA) and the oculomotor nerve, and resolved after microvascular decompression, is extremely rare and has not yet been published. METHODS: A 34-year-old female patient presented with an advancing ptosis and downward gaze on one side. Differential diagnostics ruled out all other causes of the oculomotor paresis. Magnetic resonance imaging showed significant compression of the oculomotor nerve by an aberrant SCA on the ipsilateral side. Neurovascular decompression performed microsurgically resulted in near complete resolution of the symptoms. RESULTS: This case report aims to present a case of a rare clinical condition caused by a generally common anatomical variation. This variation proved to be the only cause of the patient's symptoms, which resolved after microsurgical restoration of the neuroanatomy. CONCLUSIONS: Oculomotor nerve paresis caused directly by neurovascular conflict is an extremely rare diagnosis. Microvascular decompression should be considered in these cases, if other causes have been excluded.

• Publikační typ
• časopisecké články MeSH

OBJECTIVES: Despite growing interest, the cost-effectiveness of eHealth interventions for supporting quality of life of people with dementia and their caregivers remains unclear. This study evaluated the cost-effectiveness of the FindMyApps intervention, compared to digital care-as-usual. FindMyApps aims to help people with dementia and their caregivers find and learn to use tablet apps that may support social participation and self-management of people with dementia and sense of competence of caregivers. METHOD: A randomised controlled trial (Netherlands Trial Register NL8157) was conducted, including people with mild cognitive impairment (MCI) or mild dementia and their informal caregivers (FindMyApps n = 76, digital care-as-usual n = 74). Outcomes for people with MCI/dementia were Quality-Adjusted Life-Years (QALYs), calculated from EQ-5D-5L data and the Dutch tariff for utility scores, social participation (Maastricht Social Participation Profile) and quality of life (Adult Social Care Outcomes Toolkit), and for caregivers, QALYs and sense of competence (Short Sense of Competence Questionnaire). Societal costs were calculated using data collected with the RUD-lite instrument and the Dutch costing guideline. Multiple imputation was employed to fill in missing cost and effect data. Bootstrapped multilevel models were used to estimate incremental total societal costs and incremental effects between groups which were then used to calculate Incremental Cost-Effectiveness Ratios (ICERs). Cost-effectiveness acceptability curves were estimated. RESULTS: In the FindMyApps group, caregiver SSCQ scores were significantly higher compared to care-as-usual, n = 150, mean difference = 0.75, 95% CI [0.14, 1.38]. Other outcomes did not significantly differ between groups. Total societal costs for people with dementia were not significantly different, n = 150, mean difference = €-774, 95%CI [-2.643, .,079]. Total societal costs for caregivers were significantly lower in the FindMyApps group compared to care-as-usual, n = 150, mean difference = € -392, 95% CI [-1.254, -26], largely due to lower supportive care costs, mean difference = €-252, 95% CI [-1.009, 42]. For all outcomes, the probability that FindMyApps was cost-effective at a willingness-to-pay threshold of €0 per point of improvement was 0.72 for people with dementia and 0.93 for caregivers. CONCLUSION: FindMyApps is a cost-effective intervention for supporting caregivers' sense of competence. Further implementation of FindMyApps is warranted.

• Klíčová slova
• Dementia, cost-analysis, cost-effectiveness, eHealth, psychosocial interventions, quality of life, randomised controlled trial,
• MeSH
• analýza nákladů a výnosů * MeSH
• demence * terapie   ekonomika   MeSH
• kognitivní dysfunkce terapie   ekonomika   MeSH
• kvalita života * MeSH
• kvalitativně upravené roky života MeSH
• lidé středního věku MeSH
• lidé MeSH
• mobilní aplikace ekonomika   MeSH
• osoby pečující o pacienty * psychologie   ekonomika   MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• telemedicína * ekonomika   MeSH
• zapojení do společnosti MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• randomizované kontrolované studie MeSH
• Geografické názvy
• Nizozemsko MeSH

Astrocytes are responsible for maintaining homoeostasis and cognitive functions through calcium signalling, a process that is altered in brain diseases. Current bioelectronic tools are designed to study neurons and are not suitable for controlling calcium signals in astrocytes. Here, we show that electrical stimulation of astrocytes using electrodes coated with graphene oxide and reduced graphene oxide induces respectively a slow response to calcium, mediated by external calcium influx, and a sharp one, exclusively due to calcium release from intracellular stores. Our results suggest that the different conductivities of the substrate influence the electric field at the cell-electrolyte or cell-material interfaces, favouring different signalling events in vitro and ex vivo. Patch-clamp, voltage-sensitive dye and calcium imaging data support the proposed model. In summary, we provide evidence of a simple tool to selectively control distinct calcium signals in brain astrocytes for straightforward investigations in neuroscience and bioelectronic medicine.

• MeSH
• astrocyty * metabolismus   cytologie   MeSH
• elektrická stimulace * MeSH
• elektrody * MeSH
• grafit * chemie   farmakologie   MeSH
• krysa rodu Rattus MeSH
• kultivované buňky MeSH
• mozek * metabolismus   cytologie   MeSH
• myši MeSH
• vápník metabolismus   MeSH
• vápníková signalizace * MeSH
• zvířata MeSH
• Check Tag
• krysa rodu Rattus MeSH
• myši MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• grafit * MeSH
• graphene oxide MeSH Prohlížeč
• vápník MeSH

• Publikační typ
• tisková chyba MeSH

Diabetic foot (DF) can develop in diabetic patients after organ transplantation (Tx) due to several factors including peripheral arterial disease (PAD), diabetic neuropathy and inappropriate DF prevention. Aim: To assess the occurrence of DF and associated risk factors in transplant patients. Methods: Fifty-seven diabetic patients were enrolled as part of this prospective study. All patients underwent organ Tx (01/2013-12/2015) and were followed up for minimum of 12 months up to a maximum of 50 months. Over the study period we evaluated DF incidence and identified a number of factors likely to influence DF development, including organ function, presence of late complications, PAD, history of DF, levels of physical activity before and after Tx, patient education and standards of DF prevention. Results: Active DF developed in 31.6% (18/57) of patients after organ Tx within 11 months on average (10.7 ± 8 months). The following factors significantly correlated with DF development: diabetes control (p = .0065), PAD (p<0.0001), transcutaneous oxygen pressure (TcPO2;p = .01), history of DF (p = .0031), deformities (p = .0021) and increased leisure-time physical activity (LTPA) before Tx (p = .037). However, based on logistic stepwise regression analysis, the only factors significantly associated with DF during the post-transplant period were: PAD, deformities and increased LTPA. Education was provided to patients periodically (2.6 ± 2.5 times) during the observation period. Although 94.7% of patients regularly inspected their feet (4.5 ± 2.9 times/week), only 26.3% of transplant patients used appropriate footwear. Conclusions: Incidence of DF was relatively high, affecting almost 1/3 of pancreas and kidney/pancreas recipients. The predominant risk factors were: presence of PAD, foot deformities and higher LTPA before Tx. Therefore, we recommend a programme involving more detailed vascular and physical examinations and more intensive education focusing on physical activity and DF prevention in at-risk patients before transplantation.

• Klíčová slova
• diabetes mellitus, diabetic foot, education, exercise, transplantation,
• MeSH
• cvičení fyziologie   MeSH
• diabetická noha * epidemiologie   prevence a kontrola   etiologie   MeSH
• dospělí MeSH
• hodnocení rizik metody   MeSH
• incidence MeSH
• lidé středního věku MeSH
• lidé MeSH
• pooperační komplikace epidemiologie   prevence a kontrola   etiologie   MeSH
• prospektivní studie MeSH
• rizikové faktory MeSH
• transplantace ledvin * škodlivé účinky   metody   MeSH
• transplantace slinivky břišní * škodlivé účinky   metody   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

• MeSH
• bcr-abl fúzové proteiny genetika   MeSH
• blastická krize * genetika   farmakoterapie   patologie   MeSH
• chronická myeloidní leukemie * farmakoterapie   genetika   patologie   MeSH
• imidazoly * terapeutické užití   aplikace a dávkování   MeSH
• inhibitory proteinkinas terapeutické užití   farmakologie   MeSH
• lidé MeSH
• mutace * MeSH
• myši MeSH
• niacinamid analogy a deriváty   MeSH
• protokoly antitumorózní kombinované chemoterapie terapeutické užití   MeSH
• pyrazoly MeSH
• pyridaziny * terapeutické užití   aplikace a dávkování   MeSH
• zvířata MeSH
• Check Tag
• lidé MeSH
• myši MeSH
• zvířata MeSH
• Publikační typ
• dopisy MeSH
• Názvy látek
• asciminib MeSH Prohlížeč
• bcr-abl fúzové proteiny MeSH
• imidazoly * MeSH
• inhibitory proteinkinas MeSH
• niacinamid MeSH
• ponatinib MeSH Prohlížeč
• pyrazoly MeSH
• pyridaziny * MeSH

Diabetes mellitus is a chronic disease affecting glucose metabolism. The pathophysiological reactions underpinning the disease can lead to the development of late diabetes complications. The gut microbiota plays important roles in weight regulation and the maintenance of a healthy digestive system. Obesity, diabetes mellitus, diabetic retinopathy, diabetic nephropathy and diabetic neuropathy are all associated with a microbial imbalance in the gut. Modern technical equipment and advanced diagnostic procedures, including xmolecular methods, are commonly used to detect both quantitative and qualitative changes in the gut microbiota. This review summarises collective knowledge on the role of the gut microbiota in both types of diabetes mellitus and their late complications, with a particular focus on diabetic foot syndrome.

• Klíčová slova
• Antibiotic, Complication, Diabetes mellitus, Diabetic foot, Gut microbiota,
• MeSH
• diabetes mellitus * MeSH
• diabetická noha * MeSH
• diabetická retinopatie * MeSH
• diabetické nefropatie * etiologie   MeSH
• lidé MeSH
• obezita MeSH
• střevní mikroflóra * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

Healthcare workers (HCWs) were at increased risk for mental health problems during the COVID-19 pandemic, with prior data suggesting women may be particularly vulnerable. Our global mental health study aimed to examine factors associated with gender differences in psychological distress and depressive symptoms among HCWs during COVID-19. Across 22 countries in South America, Europe, Asia and Africa, 32,410 HCWs participated in the COVID-19 HEalth caRe wOrkErS (HEROES) study between March 2020 and February 2021. They completed the General Health Questionnaire-12, the Patient Health Questionnaire-9 and questions about pandemic-relevant exposures. Consistently across countries, women reported elevated mental health problems compared to men. Women also reported increased COVID-19-relevant stressors, including insufficient personal protective equipment and less support from colleagues, while men reported increased contact with COVID-19 patients. At the country level, HCWs in countries with higher gender inequality reported less mental health problems. Higher COVID-19 mortality rates were associated with increased psychological distress merely among women. Our findings suggest that among HCWs, women may have been disproportionately exposed to COVID-19-relevant stressors at the individual and country level. This highlights the importance of considering gender in emergency response efforts to safeguard women's well-being and ensure healthcare system preparedness during future public health crises.

• Klíčová slova
• COVID-19, cross-country, gender differences, healthcare disparities, healthcare workers, mental health,
• Publikační typ
• časopisecké články MeSH