UNLABELLED: The study aimed to analyze the entomological material collected during 13 autopsies performed on the unidentified cadavers revealed at different stages of decay in the Upper Silesia Region (Poland) over 2016-2022. During the preparation of human tissues for genetic identification, we revealed larvae, puparia, and adult insects in previously undescribed locations: costal cartilage, femur nutrient canals (foramen nutrients), and tooth cavities. The taxonomical assessment was done using morphological examination or DNA barcoding, where necessary. Based on our observations, we conclude that the apical constriction, foramen, and cavities may serve as migration paths inside teeth, and the femur nutrient canals to the bone marrow. The study also revealed that the beetle Necrobia ruficollis (Fabricius, 1775) and the moth family Pyralidae Latreille, 1802 (Phycitinae) moths can form pupal chambers inside the costal cartilage, indicating that these insects can complete their life cycle inside this cache. We believe that the newly reported locations of carrion insects in human remains may be relevant to forensic entomology, as they provide new opportunities to collect insect evidence. KEY POINTS: Costal cartilage may serve as an occasional cache for adults and immatures of carrion insects.Tooth cavities and apical foramen may serve as entryways for necrophilous insect larvae.Insect larvae use nutrient canals as migratory pathways to the bone marrow.
- Klíčová slova
- DNA barcoding, costal cartilage, foramen nutrients, forensic entomology, forensic sciences, nutrient canal, tooth cavity,
- Publikační typ
- časopisecké články MeSH
This study aims to review the current literature on methods of preoperative prediction of pituitary adenoma consistency. Pituitary adenoma consistency may be a limiting factor for successful surgical removal of tumors. Efforts have been made to investigate the possibility of an accurate assessment of the preoperative consistency to allow for safer and more effective surgery planning. We searched major scientific databases and systematically analyzed the results. A total of 54 relevant articles were identified and selected for inclusion. These studies evaluated methods based on either MRI intensity, enhancement, radiomics, MR elastometry, or CT evaluation. The results of these studies varied widely. Most studies used the average intensity of either T2WI or ADC maps. Firm tumors appeared hyperintense on T2WI, although only 55% of the studies reported statistically significant results. There are mixed reports on ADC values in firm tumors with findings of increased values (28%), decreased values (22%), or no correlation (50%). Multiple contrast enhancement-based methods showed good results in distinguishing between soft and firm tumors. There were mixed reports on the utility of MR elastography. Attempts to develop radiomics and machine learning-based models have achieved high accuracy and AUC values; however, they are prone to overfitting and need further validation. Multiple methods of preoperative consistency assessment have been studied. None demonstrated sufficient accuracy and reliability in clinical use. Further efforts are needed to enable reliable surgical planning.
- Klíčová slova
- Pituitary adenoma, Preoperative prediction, Tumor consistency,
- MeSH
- lidé MeSH
- nádory hypofýzy * diagnostické zobrazování chirurgie MeSH
- reprodukovatelnost výsledků MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
- systematický přehled MeSH
BACKGROUND: Experience of early-life socioeconomic deprivation (ELSD) may increase the risk of mental disorders in young adulthood. This association may be mediated by structural and functional alterations of the hippocampus. METHODS: We conducted a prospective cohort study on 122 participants of the European Longitudinal Study of Pregnancy and Childhood. Information about ELSD was collected via questionnaire from mothers during the first 18 months of participants' lives. At age 23-24, participants underwent examination by structural magnetic resonance imaging, resting-state functional connectivity and assessment of depressive symptoms (Mood and Feelings Questionnaire) and anxiety (Spielberger State-Trait Anxiety Inventory). The association of ELSD with brain outcomes in young adulthood was assessed with correlations, linear regression (adjusting for sex, socioeconomic position and mother's mental health) and moderated mediation analysis. RESULTS: Higher ELSD was associated with greater depressive symptoms (B = 0.22; p = 0.001), trait anxiety (B = 0.07; p = 0.02) and lower global connectivity of the right hippocampus (B = -0.01; p = 0.02). These associations persisted when adjusted for covariates. In women, lower global connectivity of the right hippocampus was associated with stronger trait anxiety (B = -4.14; p = 0.01). Global connectivity of the right hippocampus as well as connectivity between the right hippocampus and the left middle temporal gyrus mediated the association between ELSD and trait anxiety in women. Higher ELSD correlated with a lower volume of the right hippocampus in men, but the volume of the right hippocampus was not related to mental health. CONCLUSIONS: Early preventive strategies targeted at children from socioeconomically deprived families may yield long-lasting benefits for the mental health of the population.
- Klíčová slova
- anxiety, depression, fMRI, sex differences,
- MeSH
- deprese * MeSH
- dítě MeSH
- dospělí MeSH
- hipokampus MeSH
- lidé MeSH
- longitudinální studie MeSH
- magnetická rezonanční tomografie MeSH
- mladý dospělý MeSH
- prospektivní studie MeSH
- socioekonomické faktory MeSH
- těhotenství MeSH
- úzkost * MeSH
- Check Tag
- dítě MeSH
- dospělí MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
We collected a multi-centric retrospective dataset of patients (N = 213) who were admitted to ten hospitals in Czech Republic and tested positive for SARS-CoV-2 during the early phases of the pandemic in March-October 2020. The dataset contains baseline patient characteristics, breathing support required, pharmacological treatment received and multiple markers on daily resolution. Patients in the dataset were treated with hydroxychloroquine (N = 108), azithromycin (N = 72), favipiravir (N = 9), convalescent plasma (N = 7), dexamethasone (N = 4) and remdesivir (N = 3), often in combination. To explore association between treatments and patient outcomes we performed multiverse analysis, observing how the conclusions change between defensible choices of statistical model, predictors included in the model and other analytical degrees of freedom. Weak evidence to constrain the potential efficacy of azithromycin and favipiravir can be extracted from the data. Additionally, we performed external validation of several proposed prognostic models for Covid-19 severity showing that they mostly perform unsatisfactorily on our dataset.
- MeSH
- adenosinmonofosfát analogy a deriváty terapeutické užití MeSH
- alanin analogy a deriváty MeSH
- amidy terapeutické užití MeSH
- antivirové látky terapeutické užití MeSH
- azithromycin terapeutické užití MeSH
- COVID-19 * epidemiologie MeSH
- dexamethason terapeutické užití MeSH
- dospělí MeSH
- farmakoterapie COVID-19 * MeSH
- hospitalizace MeSH
- hydroxychlorochin terapeutické užití MeSH
- lidé středního věku MeSH
- lidé MeSH
- progrese nemoci * MeSH
- retrospektivní studie MeSH
- SARS-CoV-2 * izolace a purifikace MeSH
- senioři MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- Geografické názvy
- Česká republika epidemiologie MeSH
- Názvy látek
- adenosinmonofosfát MeSH
- alanin MeSH
- amidy MeSH
- antivirové látky MeSH
- azithromycin MeSH
- dexamethason MeSH
- hydroxychlorochin MeSH
- remdesivir MeSH Prohlížeč
PURPOSE: We aimed to study the association of educational attainment with occurrence of mental disorders in the Czech Republic. METHODS: Data were derived from the CZEch Mental health Study (CZEMS), a cross-sectional study of community-dwelling individuals. Mental disorders were assessed with Mini International Neuropsychiatric Interview (M.I.N.I.), and information on completed education was acquired as a part of a paper and pencil interview. Logistic regression was used to estimate odds ratio (OR) with 95% confidence intervals (CI) for the association of educational attainment with all mental disorders as well as with specific groups (affective, anxiety, alcohol use and substance use disorders), stepwise adjusting for socio-demographic, social and health-related characteristics. RESULTS: We studied 3175 individuals (average age 50 years, range 18-96 years; 54% women). Compared to individuals with higher education, those educated below high school graduation had higher odds of mental disorders (OR 2.07; 95% CI 1.58-1.71), even after adjustment for all covariates (OR 1.64; 95% CI 1.21-2.23). Education showed the strongest association with alcohol use disorders, even when covariates were adjusted for, but was not related to anxiety disorders. The association of education with affective as well as substance use disorders was explained by covariates. CONCLUSIONS: Interventions aimed at reducing the burden of mental disorders should target individuals with low education. Strategies to improve population mental health need to go hand in hand with policies to enhance education as well as reduce alcohol consumption in the Czech Republic.
- Klíčová slova
- Education, Inequality, Mental disorder, Population,
- MeSH
- alkoholismus * MeSH
- dospělí MeSH
- duševní poruchy * epidemiologie MeSH
- duševní zdraví MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- průřezové studie MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- stupeň vzdělání MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika epidemiologie MeSH
Functional endoscopic sinus surgery (FESS) is a treatment of choice for fungal sinus ball (mycetoma), which is considered safe with a very low major complication rate. We present an unusual case of a 12-year-old female, who underwent FESS for a sphenoid sinus mycetoma and which was complicated by an acute, compressive epidural fluid collection. This presumably resulted from sinus irrigation in the setting of an under-appreciated skull base and mucosal defects causing a ball-valve effect. Our patient had a temporary neurologic deficit with complete recovery, however, similar complications can have fatal consequences.
- Klíčová slova
- Complication, Epidural, FESS, Fungal ball, Mycetoma,
- MeSH
- baze lební MeSH
- dítě MeSH
- endoskopie MeSH
- lidé MeSH
- mycetom * MeSH
- paranazální dutiny * MeSH
- sinus sphenoidalis MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
BACKGROUND: Increasing educational attainment (EA) could decrease the occurrence of depression. We investigated the relationship between EA and depressive symptoms in older individuals across four European regions. METHODS: We studied 108,315 Europeans (54% women, median age 63 years old) from the Survey on Health, Ageing and Retirement in Europe assessing EA (seven educational levels based on International Standard Classification of Education [ISCED] classification) and depressive symptoms (≥4 points on EURO-D scale). Logistic regression estimated the association between EA and depressive symptoms, adjusting for sociodemographic and health-related factors, testing for sex/age/region and education interactions. RESULTS: Higher EA was associated with lower odds of depressive symptoms, independent of sociodemographic and health-related factors. A threshold of the lowest odds of depressive symptoms was detected at the first stage of tertiary education (OR 0.60; 95% confidence interval [CI] 0.55-0.65; p < 0.001; relative to no education). Central and Eastern Europe showed the strongest association (OR for high vs. low education 0.37; 95% CI 0.33-0.40; p < 0.001) and Scandinavia the weakest (OR for high vs. low education 0.69; 95% CI 0.60-0.80; p < 0.001). The association was strongest among younger individuals. There was a sex and education interaction only within Central and Eastern Europe. CONCLUSIONS: Level of EA is reflected in later-life depressive symptoms, suggesting that supporting individuals in achieving EA, and considering those with lower EA at increased risk for depression, could lead to decreased burden of depression across the life course. Further educational support in Central and Eastern Europe may decrease the higher burden of depressive symptoms in women.
- Klíčová slova
- Depression, Europe, education, epidemiology,
- MeSH
- deprese epidemiologie MeSH
- důchod MeSH
- lidé středního věku MeSH
- lidé MeSH
- logistické modely MeSH
- senioři MeSH
- sociální determinanty zdraví statistika a číselné údaje MeSH
- stárnutí MeSH
- stupeň vzdělání * MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Research Support, N.I.H., Extramural MeSH
- Geografické názvy
- Evropa epidemiologie MeSH
- východní Evropa MeSH
AIM: To compare survival outcomes in patients with non-small cell lung cancer (NSCLC) treated with modern-era drugs (antifolates, antiangiogenics, tyrosine kinase and anaplastic lymphoma kinase inhibitors, immunotherapy) with treatment initiation in 2011-12 and 2015-16, respectively. PATIENTS AND METHODS: Prospective data from Czech TULUNG Registry (960 patients from 2011-12 and 512 patients from 2015-16) were analyzed. Kaplan-Meier analysis was used to estimate overall survival (OS) and progression-free survival (PFS); Cox proportional hazards model to assess factors associated with 2-year survival. RESULTS: Survival at 2 years was more frequent in cohort 2015-16 compared to cohort 2011-12 (43.2% vs. 24% for adenocarcinoma; p<0.001 and 28.7% vs. 11.8% for squamous-cell lung carcinoma; p=0.002). Assignment to cohort 2015-16 and treatment multilinearity (two or more lines in sequence) were associated with higher probability of 2-year survival (hazard ratio=0.666 and hazard ratio=0.597; p<0.001). Comparison of 2-year survivors from both cohorts showed no differences. CONCLUSION: Survival at 2 years probability in stage IIIB-IV NSCLC doubled between 2011-12 and 2015-16; advanced-stage NSCLC may be considered a chronic disease in a large proportion of patients.
- Klíčová slova
- 2-year survival, Non-small cell lung cancer, chronic disease, modern-era treatment, personalized treatment,
- MeSH
- adenokarcinom plic epidemiologie mortalita patologie terapie MeSH
- chronická nemoc MeSH
- dospělí MeSH
- kohortové studie MeSH
- kombinovaná terapie MeSH
- lidé středního věku MeSH
- lidé MeSH
- míra přežití MeSH
- nádory plic epidemiologie mortalita patologie terapie MeSH
- následné studie MeSH
- nemalobuněčný karcinom plic epidemiologie mortalita patologie terapie MeSH
- prognóza MeSH
- registrace statistika a číselné údaje MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- spinocelulární karcinom epidemiologie mortalita patologie terapie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika epidemiologie MeSH
BACKGROUND: Facing an increasing prevalence of dementia, the Czech Republic is developing a new nationwide strategy for the management and prevention of dementia. Lack of evidence about characteristics of individuals with dementia in the country is a major obstacle. OBJECTIVE: The study aimed to 1) characterize individuals with dementia, 2) compare their mortality with the general population, and 3) analyze differences in survival between different dementia disorders. METHODS: The study capitalizes on two nationwide registers in the Czech Republic, from which information about individuals who were hospitalized with dementia or died from it between 1994 and 2014 was retrieved. Standardized intensity of hospitalizations was calculated for each year, mortality was studied using standardized mortality ratio, life-tables, Kaplan-Mayer curves, and Cox proportional hazard models. RESULTS: Standardized intensity of hospitalizations for dementia increased more than 3 times from 1994 to 2014. Standardized mortality ratio was 3.03 (95% confidence interval 2.97-3.08). One-year survival rate was 45% and five-year survival rate 16%. Vascular dementia was the most common type of dementia disorders and was associated with higher hazard of death than Alzheimer's disease, even after adjusting for sociodemographic and clinical covariates (hazard ratio 1.04; 95% confidence interval 1.02-1.05). CONCLUSION: The study provides estimates on demographic characteristics and mortality of the Czech hospitalized dementia population, which have not been so far available and which are unique also in the context of the entire region of Central and Eastern Europe.
- Klíčová slova
- Alzheimer’s disease, Czech Republic, dementia, hospitalization, mortality, population characteristics, registries,
- MeSH
- demence epidemiologie mortalita MeSH
- hospitalizace statistika a číselné údaje MeSH
- Kaplanův-Meierův odhad MeSH
- lidé MeSH
- mortalita MeSH
- proporcionální rizikové modely MeSH
- registrace MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Česká republika epidemiologie MeSH
OBJECTIVE: To evaluate the impact of generalized quasiperiodic epileptiform discharges ("hurdles") observed in non-rapid eye movement (NREM) sleep on cognitive function in children with intractable focal epilepsy. "Hurdles" pattern does not meet the criteria of the electrical status epilepticus in slow-wave sleep (ESES). METHODS: In a retrospective analysis, 24 patients with "hurdles" and their 24 peers matched for demographic and epilepsy-related variables were compared in terms of neuropsychological domains and electroencephalography (EEG)-derived quantifiers. Both "hurdles" and controls were children between 2 and 19 years of age who had intractable focal epilepsy evaluated as candidates of resective epilepsy surgery. RESULTS: Full-scale intelligence quotient/developmental quotient (FSIQ/DQ) (P = .002) and visuoconstructional skills (P = .004) were significantly lower in children with "hurdles" compared to controls. Patients with "hurdles" presented with higher interictal spike indexes in sleep (P < .001, median difference -0.9, 95% confidence interval [CI] -1.4, -0.6) and wakefulness (P < .001, median difference -0.3, 95% CI -0.5, -1). Relative time of sleep spindles in NREM sleep was significantly reduced (P < .001, median difference 0.1, 95% CI 0.0, 0.1) in the "hurdles" group. The time proportion of sleep spindles represented a significant positive (P = .008) and spike index of generalized spikes in sleep a significant negative explanatory variable (P = .004) of FSIQ/DQ scores. The proportion of seizure-free patients 2 years after epilepsy surgery did not differ significantly between the two groups (P = .19). SIGNIFICANCE: Although the "hurdles" pattern does not fulfill the criteria of ESES, it is associated with a pronounced cognitive dysfunction. Disturbed sleep structure marked by reduced sleep spindles and generalized spiking in sleep is associated with worse cognitive performance. Despite having a generalized nature, we did not find a lower probability of postsurgical seizure freedom in patients with "hurdles" pattern.
- Klíčová slova
- ESES, cognition, epilepsy surgery, epileptic encephalopathy, non-REM sleep,
- MeSH
- bdění fyziologie MeSH
- dítě MeSH
- elektroencefalografie trendy MeSH
- epilepsie parciální diagnóza patofyziologie psychologie MeSH
- kognitivní dysfunkce diagnóza patofyziologie psychologie MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- předškolní dítě MeSH
- refrakterní epilepsie diagnóza patofyziologie psychologie MeSH
- retrospektivní studie MeSH
- spánek fyziologie MeSH
- studie případů a kontrol MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- předškolní dítě MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- pozorovací studie MeSH
- práce podpořená grantem MeSH