BACKGROUND: Lung cancer poses a significant challenge with high mortality rates. Minimally invasive surgical approaches, including the uniportal thoracoscopic technique, offer potential benefits in terms of recovery and patient compliance. This study focuses on evaluating the radicality of mediastinal lymphadenectomy during uniportal thoracoscopic lung resection, specifically assessing the reachability of established lymphatic stations. METHODS: A comparative study was conducted at the University Hospital Ostrava from January 2015 to July 2022, focusing on the evaluation of radicality in mediastinal lymphadenectomy across three patient subgroups: uniportal thoracoscopic approach, multiportal thoracoscopic approach, and thoracotomy approach. The study implemented the routine identification and excision of 8 lymph node stations from the respective hemithorax to assess the radicality of lymph node harvesting. RESULTS: A total of 428 patients were enrolled and evaluated. No significant differences were observed in the number of lymph nodes removed between the subgroups. The mean number of lymph nodes removed was 6.50 in the left hemithorax and 6.49 in the right hemithorax. The 30-day postoperative morbidity rate for the entire patient population was 27.3%, with 17.5% experiencing minor complications and 6.5% experiencing major complications. Statistically significant differences were observed in major complications between the uniportal approach and the thoracotomy approach (3.5% vs 12.0%, p = 0.002). The overall mortality rate in the study population was 3%, with a statistically significant difference in mortality between the uniportal and multiportal approaches (1.0% vs 6.4%, p = 0.020). CONCLUSIONS: The uniportal approach demonstrated comparable accessibility and lymph node yield to multiportal and thoracotomy techniques. It is equivalent to established methods in terms of postoperative complications, with fewer major complications compared to thoracotomy. While our study indicates a potential for lower mortality following uniportal lung resection in comparison to multiportal lung resection, and demonstrates comparable outcomes to thoracotomy, it is important to approach these findings cautiously and refrain from drawing definitive conclusions.

• Klíčová slova
• Lung cancer, Lung resection, Mediastinal lymphadenectomy, Morbidity, Mortality, Uniportal thoracoscopy,
• MeSH
• hrudní chirurgie video-asistovaná metody   MeSH
• lidé MeSH
• lymfadenektomie metody   MeSH
• nádory plic * chirurgie   patologie   MeSH
• plíce patologie   MeSH
• pneumektomie škodlivé účinky   metody   MeSH
• retrospektivní studie MeSH
• torakotomie * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

INTRODUCTION: Migraine is a widespread neurological disorder, growing increasingly common. However, the pathogenesis of the disease is often unclear and the evidence for the role of various risk factors is limited. This study aimed to identify risk factors associated with migraine and to contribute towards a better understanding of this disease. METHODS: Data from 3,247 questionnaires were analyzed for associations between migraine and sex, age, BMI, degree of education, and air pollution, along with other factors such as contact with friends, physical condition, health, anxiety, and depression. A cross-sectional study was conducted with an approximately equal distribution of the sample by age, gender and two analysed regions. Data were presented using basic descriptive statistics using the chi-square test. The model output was presented using a crude odds ratio (OR) and a fully adjusted OR. Three hundred and eight-six individuals (12%) suffered from migraine. RESULTS: In an adjusted model, the presented study found associations between the prevalence of migraine and sex, age, and level of education. Individuals with migraine statistically significantly more often suffered from depression, anxiety and other selected factors. However, the assumed significant association between the occurrence of migraine and pollution in the region has not been found.

• Klíčová slova
• air pollution, anxiety, depression, migraine, risk factors,
• Publikační typ
• časopisecké články MeSH

OBJECTIVE: This study purposed to evaluate preoperative two tumor markers, namely, carcinoembryonic antigen and carbohydrate antigen (CA)19-9, in colorectal cancer for anatomotopographic location with disease stage and to assess their utility for diagnostic staging purposes. METHODS: The study retrospectively incorporated patients who had undergone surgery for colorectal cancer at our department in 2015-2018 and in whom carcinoembryonic antigen and CA19-9 tumor markers had been preoperatively analyzed. The obtained data were then statistically processed using R-project. RESULTS: A total of 155 patients had been incorporated, of whom 96 (62%) were men and 59 (38%) were women. Rectum was the most common location (74 patients, 48%), and the least represented stage was IV (18, 12%). The marker carcinoembryonic antigen was obtained in all 155 cases, while CA19-9 was in 105. The median carcinoembryonic antigen was 3 (0.34-1104.25), and the median CA19-9 was 12 (0.18-840.00). A significance was recognized between median carcinoembryonic antigen and disease stage (p-value=0.016), with stages I, II, and III (medians 2, 3, and 2) different from stage IV (median 13), while no significance for CA19-9 was recognized (p-value=0.343). No significance between either marker and location (carcinoembryonic antigen: p=0.276; CA19-9: p=0.505) was detected. The testing was performed at a significance level of alpha=0.05. CONCLUSION: This study revealed a significance between the marker carcinoembryonic antigen, but not CA19-9, and the disease stage, while no relationship of either of these markers with tumor location was found. Herewith, the study confirmed that higher carcinoembryonic antigen values may suggest the finding of more advanced forms of colorectal cancer and thus a worse prognosis of this malignant phenomenon.

• MeSH
• antigen CA-19-9 MeSH
• karcinoembryonální antigen * MeSH
• kolorektální nádory * diagnóza   MeSH
• lidé MeSH
• nádorové biomarkery MeSH
• retrospektivní studie MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• antigen CA-19-9 MeSH
• karcinoembryonální antigen * MeSH
• nádorové biomarkery MeSH

Background and Objectives: The consequences of stroke have a significant impact on self-sufficiency and health-related quality of life (HRQoL). Virtual reality (VR)-based rehabilitation has the potential to impact these modalities, but information on timing, volume, and intensity is not yet available. The aim of this randomized controlled trial (1:1) was to evaluate the impact of conventional rehabilitation combined with VR on self-care and domains of HRQoL in patients ≤6 months post-stroke. Materials and Methods: The intervention group completed a total of 270 min of conventional VR + rehabilitation sessions. The control group underwent conventional rehabilitation only. Primary assessments with the WHO disability assessment schedule 2.0 (WHODAS 2) questionnaire were conducted before rehabilitation (T0), after completion of the intervention (T1), and at the 4-week follow-up (T2); secondary outcomes included self-sufficiency and balance assessments. Results: Fifty patients completed the study (mean age 61.2 ± 9.0 years, time since stroke 114.3 ± 39.4 days). There were no statistically significant differences between the groups in WHODAS 2, self-sufficiency, and balance scores (p > 0.05). Conclusions: In the experimental group, there was a statistically significant difference in WHODAS 2, assessment of self-sufficiency, and balance scores before and after therapy (p < 0.05). VR appears to be a suitable tool to supplement and modify rehabilitation in patients after stroke.

• Klíčová slova
• activities of daily living, quality of life, stroke, virtual reality,
• MeSH
• cévní mozková příhoda * komplikace   terapie   MeSH
• kvalita života MeSH
• lidé středního věku MeSH
• lidé MeSH
• pacienti MeSH
• péče o sebe MeSH
• potravní doplňky MeSH
• senioři MeSH
• terapie pomocí virtuální reality * MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH
• randomizované kontrolované studie MeSH

OBJECTIVES: The objective of this study was to determine the incidence of neoplastic diseases and associated risk factors in the early stages of life. METHODS: Data were retrospectively assessed in 730,000 live births between 2000 and 2019. The occurrence of tumors was monitored in the neonatal, infant (1-12 months), and toddler (13-24 months) periods. Risk factors were divided into demographic, internal, and environmental factors. The control group consisted of subjects in the same age category without oncological diseases. RESULTS: A total of 452 neoplastic diseases were diagnosed in the study sample. In total, 24% (110/452) manifested during the neonatal period, 45% (203/452) in infants, and 31% (139/452) at the age of 13-24 months. Any genetic disease (OR 26.68; 95% CI 7.64-93.12) and medications used by the mother (OR 3.07; 95% CI 1.32-7.15) were identified as risk factors. Without adjustment for all factors, asphyxia in the first minute, a younger age of the mother, lower pregnancy, and the presence of a congenital defect manifested themselves as risk factors. CONCLUSIONS: The highest risk factors for the development of early childhood tumors were identified as with medications used by the mother before or during pregnancy and genetic diseases.

• Klíčová slova
• early-aged period, epidemiology, neoplastic disease, risk factors,
• MeSH
• kojenec MeSH
• leukemie * epidemiologie   etiologie   MeSH
• lidé MeSH
• matky MeSH
• nádory * epidemiologie   etiologie   MeSH
• novorozenec MeSH
• předškolní dítě MeSH
• retrospektivní studie MeSH
• rizikové faktory MeSH
• těhotenství MeSH
• Check Tag
• kojenec MeSH
• lidé MeSH
• novorozenec MeSH
• předškolní dítě MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

BACKGROUND: Lung carcinoma is one of the most common malignancies worldwide. At present, unfortunately, there are no markers that would allow early identification of this tumor in the preclinical or early clinical stage. The use of sniffer dogs has been reported to show some promise in early diagnosis of this type of cancer Aim: This study aimed to evaluate the possibility of utilizing changes in the heart rate of sniffer dogs (which increases when finding a positive sample) in tumor detection. METHODS: This double-blinded pilot study included two sniffer dogs. A chest strap was fastened on the dog's chests for heart rate monitoring while they were examining samples and heart rate was recorded. Test parameters (sensitivity, specificity, positive and negative predictive values) were then calculated, evaluating performances based on (i) the dog's indications according to their training and (ii) the changes in their heart rates. RESULTS: Calculation according to the dog's indications revealed an overall sensitivity of 95.2% accompanied by a specificity of 81.8%, a PPV of 93.7%, and an NPV of 85.7%, respectively. These results were not significantly different from those evaluated by heart rate; heart rate monitoring was, however, burdened with a relatively high proportion of invalid experiments in which heart rate measurement failed. When the method of calculation was changed from rounds to individual samples, the test parameters further increased. CONCLUSIONS: This pilot study confirmed the hypothesis that heart rate increases in trained sniffer dogs when encountering samples from tumor-positive patients but remains unchanged when only negative samples are present. The reliability of results based on heart rate increase is similar to that obtained by a dog's indications and, if the limitation represented by technical issues is overcome, it could serve as a valuable verification method.

• Klíčová slova
• detection, diagnosis, heart rate, lung cancer, sniffer dog,
• Publikační typ
• časopisecké články MeSH

AIM: The aim of the study was to evaluate fidelity in first episode psychosis (FEP) teams in Czechia and to gage the feasibility and utility of the process in a mental health system that is undergoing a transformation. METHODS: Fidelity assessment was conducted using The First Episode Psychosis Services Fidelity Scale (FEPS-FS). Fidelity assessment was based on a review of data abstracted from the health records of active clients, program documents, administrative data, and interviews with members of staff. The mean scores were compared across the teams. Feasibility and utility were assessed by program response to their fidelity results. RESULTS: Three FEP teams were involved in the fidelity assessment. Across the 35 items, the mean fidelity score ranged from 2.5 to 3.1. Across the FEP teams, the percentage of the 35 items rated as 4 or 5 (satisfactory or exemplary) ranged from 34.3% to 51.4%. CONCLUSIONS: This study provided an opportunity to implement FEPS-FS and assess fidelity in FEP teams in Czechia. The fidelity assessment also provided a baseline for measuring change.

• Klíčová slova
• early intervention in psychosis, early psychosis, evaluation, implementation, psychiatric service,
• MeSH
• lidé MeSH
• pilotní projekty MeSH
• psychotické poruchy * diagnóza   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• přehledy MeSH
• Geografické názvy
• Česká republika MeSH

In this retrospective study, we used data from the hospital information system (HIS) to evaluate the influence of the COVID-19 pandemic on rehabilitation care at the University Hospital of Ostrava (UHO). From March 2020 to December 2021, 5173 COVID-19 cases were hospitalized at UHO. Cases within individual groups and categories are shown in a flowchart. The average patient age was 64.9 ± 16.9 years. The mean BMI value was 30.6 ± 6.8 in the rehabilitated group, which was significantly higher compared to that among the non-rehabilitated cases 29.1 ± 6.9 (p < 0.001). Among the admitted patients, 16.6% required artificial pulmonary ventilation (APV), 1.8% extracorporeal membrane oxygenation (ECMO), and 11.9% high-flow oxygenation (HF). The days of rehabilitation ranged from 1-102 days. Among all rehabilitated patients, 92.0% (n = 1302) had a hospitalization duration ranging from 1-15 days and 8.0% (n = 114) longer than 15 days. Overall, rehabilitation care plays an important role in providing exercise, mobilization, and rehabilitation interventions to survivors of critical illness associated with COVID-19, enabling the early and functional return to home, and it must, therefore, be integrated into the clinical care of patients with COVID-19.

• Klíčová slova
• COVID-19, artificial pulmonary ventilation, physical activity, physical therapy, public health, rehabilitation,
• Publikační typ
• časopisecké články MeSH

Mental health policies and plans (MHPPs) are important policy instruments and powerful tools to facilitate development of mental health systems and services across the world. We aimed to map and analyse methods and tools used to assess the extent, process and impact of implementing MHPPs. We systematically searched peer-reviewed and grey literature across seven scientific databases. We extracted and analysed the data on a) the characteristics of included studies (e.g., policy areas, region of origin, income setting) and b) the methodology and evaluation tools applied to assess the extent and process of implementation. We included 48 studies in the analyses. Twenty-six of these studies employed only qualitative methods (e.g., semi-structured interviews, focus group discussions, desk review, stakeholder consultations); 12 studies used quantitative methods (e.g., trend analysis, survey) and 10 used mixed-methods approaches. Generally, methods and tools used for assessment were described poorly with less than half of the studies providing partial or full details about them. Only three studies provided assessment of full policies. There is a lack of rigorous research to assess implementation MHPPs. Assessments of the implementation of entire MHPPs are almost non-existent. Strategies to assess the implementation of MHPPs should be an integral part of MHPPs.

• Klíčová slova
• assessment tools, global mental health policy, policy making, prevention strategies,
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

We know that suicide is preventable, yet hundreds of thousands of people still die due to suicide every year. Many interventions were proven to be effective, and dozens of others showed promising results. However, translating these interventions into new settings brings several challenges. One of the crucial obstacles to success is not anticipating possible barriers to implementation nor enhancing possible benefits of factors facilitating the implementation. While we witnessed great support for suicide prevention activities globally in the past years, implementation barriers and facilitating factors are yet to be comprehensively mapped to help implementation activities worldwide. This scoping review maps current knowledge on facilitators and barriers to the implementation of suicide prevention interventions while using the Consolidated Framework for Implementation Research (CFIR) for classification. We included 64 studies. Barriers and facilitators were most commonly identified in the outer setting CFIR domain, namely in the sub-domain of patient needs and resources, which refers to the way in which these needs and resources are reflected by the reviewed interventions. The second most saturated CFIR domain for facilitators was intervention characteristics, where relative advantage, adaptability and cost of intervention sub-domains were equally represented. These sub-domains refer mostly to how the intervention is perceived by key stakeholders, to what extent it can be tailored to the implementation context and how much it costs. While intervention characteristics domain was the second most common also for barriers, the complexity sub-domain referring to high perceived difficulty of implementation was the most frequently represented. With reference to the results, we recommend adapting interventions to the needs of the target groups. Furthermore, carefully selecting the intervention to suit the target context concerning their adaptability, costs and complexity is vital for a successful implementation. Further implications for practice and research are discussed.

• Klíčová slova
• barriers, facilitators, implementation, interventions, self-harm, suicide,
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH