BACKGROUND: An in-depth study of neurological symptoms and complications of influenza in elderly patients. This population group is more susceptible to complications of the disease and these complications are more likely to end in death. METHODS: A retrospective analysis of patient data was performed. All patients aged 65 years and older were included in the study. The study period was from the 1st of January , 2018 to 31st of December, 2021. All symptoms and complications of influenza were analyzed. Especially neurological and general symptoms were analyzed. Data were extracted from the complete medical records of the patients. RESULTS: The most common symptoms of influenza in the elderly were fever in 218 cases (83.52%), cough in 189 patients (72.41%), general weakness in 182 (69.73%) and fatigue in 166 patients (63.6%). Myalgias were experienced by 106 patients (40.61%) and arthralgias by 101 patients (38.7%). Headache occurred in only 21 patients (8.06%). Encephalopathy was observed in 7 elderly patients (2.68%) during hospitalization. Influenza encephalitis was noted in 2 cases. CONCLUSION: The most common neurological symptoms of influenza in more than half of the elderly are general weakness and increased fatigue. Myalgias are common, headache less often. Nausea is not uncommon. Of the complications, encephalopathy is the most common. Cases of influenza encephalitis have also been reported. We have not encountered a stroke. Concerning other complications, bacterial pneumonia was the most common.

• MeSH
• bolesti hlavy etiologie   epidemiologie   MeSH
• chřipka lidská * komplikace   epidemiologie   MeSH
• horečka etiologie   MeSH
• kašel etiologie   MeSH
• lidé MeSH
• myalgie etiologie   epidemiologie   MeSH
• nemoci nervového systému epidemiologie   etiologie   MeSH
• retrospektivní studie MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• svalová slabost etiologie   epidemiologie   MeSH
• únava etiologie   epidemiologie   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

Edema of the psoas major muscle can indicate various pathologies, such as infection, malignancy, and trauma, but it can also result from benign causes like delayed-onset muscle soreness (DOMS). This article presents the case of a 44-year-old female patient who developed DOMS in the psoas major after participating in an intense abdominal workout. The patient reported hip pain that began a day after the workout, which was confirmed by magnetic resonance imaging (MRI) revealing significant edema in the psoas major muscles, particularly on the right side. Conservative treatment with rest and analgesics led to full recovery within two weeks. DOMS, typically associated with eccentric exercises, can be mistaken for more serious conditions, but its recognition is crucial to avoid unnecessary investigations and interventions. This case highlights the importance of clinical history and imaging findings in distinguishing DOMS from other causes of muscle edema, emphasizing the need for accurate diagnosis to ensure appropriate management.

• Klíčová slova
• delayed-onset muscle soreness, magnetic resonance imaging, psoas muscles,
• MeSH
• bederní svaly * diagnostické zobrazování   MeSH
• dospělí MeSH
• edém etiologie   MeSH
• lidé MeSH
• magnetická rezonanční tomografie * MeSH
• myalgie * etiologie   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

INTRODUCTION: Protracted febrile myalgia syndrome (PFMS) is a rare manifestation of familial Mediterranean fever (FMF), characterized by myalgia, fever and elevated inflammatory markers lasting several weeks. As the hallmark of FMF are short episodes of disease symptoms, the long duration of PFMS may lead to a delayed diagnosis and treatment. OBJECTIVES: 1. To perform a review of literature and rheumatology textbooks focused on clinical features and treatment of PFMS in children. 2. To present our own case. METHODS: All articles in Pub Med generated using the keywords "protracted febrile myalgia" and information on PFMS in seven rheumatology textbooks were collected. The systematic review was supplemented with our own case presentation. RESULTS: In total, 18 articles with 78 pediatric patients (including our own) were retrieved. More than half of the patients presented with PFMS as the first manifestation of FMF. All complained of myalgia, 65% of abdominal pain and 26% had a rash. Corticosteroids (CS) were effective in 77%. In all CS-refractory cases, anakinra was shown efficient. MRI was used in 5 patients and showed myositis in all of them. The scrutiny of seven rheumatology textbooks showed that PFMS presenting with myalgia was mentioned in six. Possible accompanying symptoms were described only once, the long duration of symptoms twice, the efficacy of corticosteroids three times and anakinra only once. The presented 6 year old patient manifested with fever, myalgia, abdominal pain and petechial rash lasting 6 weeks. She had undergone multiple diagnostic procedures before her parents mentioned a positive family history for FMF. The subsequent genetic testing confirmed a homozygosity for M694V pathogenic variant in the MEFV gene. CONCLUSION: The long duration of PFMS may be misleading to clinicians especially if PFMS occurs at manifestation of FMF. The fact that more than half of the reported patients experienced PFMS as the presenting symptom of FMF is one of the key findings of our study. Our case presentation demonstrates the importance of genetic testing early in suspected autoinflammatory diseases. Furthermore, MRI may be an important diagnostic tool showing myositis in PFMS.

• Klíčová slova
• Clinical features, Diagnostic role of MRI, Protracted febrile myalgia syndrome, Treatment,
• MeSH
• dítě MeSH
• familiární středomořská horečka * komplikace   diagnóza   MeSH
• horečka * diagnóza   etiologie   MeSH
• lidé MeSH
• magnetická rezonanční tomografie metody   MeSH
• myalgie * diagnóza   etiologie   MeSH
• syndrom MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH
• systematický přehled MeSH

Controlling the pandemic is primarily achieved through vaccination against COVID-19. Although various COVID-19 vaccines are used worldwide, little is known about their safety and side effects. As a result, the objectives of this research are to identify the shortterm side effects of the different COVID-19 vaccines used in Iraq. Furthermore, exploring the association between experienced side effects and the brand of vaccine received. The current study evaluated the shortterm side effects of Pfizer, Sinopharm and AstraZeneca vaccines among healthcare workers in Iraq. The study used a questionnaire that consisted of dedicated sections to collect demographic data, the brand of COVID-19 vaccine received, the short-term side effects, and the willingness to receive a third booster dose. Regarding the post-vaccination side effects, the studied COVID-19 vaccines showed a comparable range of side effects, such as headaches, fever, muscle pain, joint pain, malaise, tenderness, redness, as well as pain at the site of vaccination. However, the Pfizer vaccine showed a higher incidence of pain and tenderness at the site of injection and fever compared to AstraZeneca and Sinopharm, respectively. On the other hand, the Sinopharm vaccine was associated with a higher occurrence of headaches, muscle pain, joint pain, and malaise in comparison to the Pfizer and AstraZeneca vaccines, respectively. In summary, the short-term side effects of the three vaccines were comparable; however, the AstraZeneca vaccine was associated with a lower risk of side effects.

• Klíčová slova
• AstraZeneca, COVID-19, Pfizer, Sinopharm, Sputnik V, side effect, side effects, vaccine,
• MeSH
• artralgie MeSH
• bolesti hlavy MeSH
• COVID-19 * MeSH
• lidé MeSH
• myalgie MeSH
• nežádoucí účinky léčiv * MeSH
• vakcíny proti COVID-19 MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• vakcíny proti COVID-19 MeSH

Botek, M, Krejčí, J, McKune, A, Valenta, M, and Sládečková, B. Hydrogen rich water consumption positively affects muscle performance, lactate response, and alleviates delayed onset of muscle soreness after resistance training. J Strength Cond Res 36(10): 2792-2799, 2022-Positive outcomes of hydrogen rich water (HRW) supplementation on endurance performance have been shown, but the effects of HRW in resistance training are unclear. The aim of this study was to assess the effects of 1,260 ml of HRW intake on physiological, perceptual, and performance responses to a resistance training and after 24 hours of recovery. This randomized, double-blinded placebo-controlled cross-over study included 12 men aged 23.8 ± 1.9 years. Subjects performed a half squat, knee flexion, and extension exercises with the load set at 70% of 1 repetition maximum for 3 sets (10 reps/set). Lunges were performed with a load of 30% of body mass for 3 sets (20 reps/set). Time of each set, lactate, and ratings of perceived exertion were assessed mid-way through exercise and immediately after the exercise. Creatine kinase, muscle soreness visual analog scale ratings, countermovement jump, and heart rate variability were evaluated before the training and at 30 minutes, 6, and 24 hours of recovery. Lunges were performed faster with HRW compared with placebo ( p < 0.001). Hydrogen rich water reduced lactate at mid-way and immediately after the exercise (HRW: 5.3 ± 2.1 and 5.1 ± 2.2, placebo: 6.5 ± 1.8 and 6.3 ± 2.2 mmol·L -1 , p ≤ 0.008). Visual analog scale ratings were significantly lower with HRW (26 ± 11 vs. 41 ± 20 mm, p = 0.002) after 24 hours of recovery. In conclusion, an acute intermittent HRW hydration improved muscle function, reduced the lactate response, and alleviated delayed onset of muscle soreness.

• MeSH
• klinické křížové studie MeSH
• kosterní svaly fyziologie   MeSH
• kreatinkinasa, forma MM MeSH
• kyselina mléčná MeSH
• lidé MeSH
• myalgie prevence a kontrola   MeSH
• odporový trénink * MeSH
• pití MeSH
• svalová síla fyziologie   MeSH
• svaly MeSH
• voda MeSH
• vodík MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• randomizované kontrolované studie MeSH
• Názvy látek
• kreatinkinasa, forma MM MeSH
• kyselina mléčná MeSH
• voda MeSH
• vodík MeSH

BACKGROUND: In December 2019, a new coronavirus, SARS-CoV-2, appeared in Wuhan, China. This virus is the cause of the COVID-19 disease. This infection later spread to the whole world. The goal of this article is to present the clinical and laboratory characteristics of patients with COVID-19 treated in the Faculty Hospital Pilsen. METHODS: In this monocentric, retrospective study, clinical and biochemical data of 89 adult patients with COVID-19 was analyzed. These patients were in the care of the Faculty Hospital Pilsen between March 14 and April 7. RESULTS: In this cohort, made up of 89 patients, 63 were treated as outpatients and 26 were hospitalized. 10 patients required intensive care. The most common symptoms among patients were cough and fever. Dyspnea was present in 29 patients. A CT scan showed bilateral pneumonia in 23 of the admitted patients. Fever and bilateral pneumonia were significantly more common in patients ≥ 60 years old (p=0.047, and p=0.001, respectively). Of lab results, the patients in intensive care had significantly higher values of C-reactive protein, procalcitonin, lactate dehydrogenase, interleukin 6, myoglobin and ferritin. CONCLUSION: The most common symptoms of COVID-19 are fever and cough. These two symptoms are simultaneously present in more than half the cases. Approximately 1/10th of patients requires intensive care. Higher values of lactate dehydrogenase, myoglobin and ferritin on patient admission appear to be a strong predictive factor of the patient's status progressing into requiring ICU attention.

• MeSH
• ambulantní péče statistika a číselné údaje   MeSH
• artralgie patofyziologie   MeSH
• bolesti hlavy patofyziologie   MeSH
• C-reaktivní protein metabolismus   MeSH
• COVID-19 krev   epidemiologie   patofyziologie   MeSH
• diabetes mellitus epidemiologie   MeSH
• dospělí MeSH
• dyspnoe patofyziologie   MeSH
• ferritiny krev   MeSH
• horečka patofyziologie   MeSH
• hospitalizace statistika a číselné údaje   MeSH
• hypertenze epidemiologie   MeSH
• interleukin-6 krev   MeSH
• jednotky intenzivní péče MeSH
• kašel patofyziologie   MeSH
• komorbidita MeSH
• L-laktátdehydrogenasa krev   MeSH
• lidé středního věku MeSH
• lidé MeSH
• myalgie patofyziologie   MeSH
• myoglobin krev   MeSH
• obezita epidemiologie   MeSH
• počítačová rentgenová tomografie MeSH
• prokalcitonin krev   MeSH
• SARS-CoV-2 MeSH
• senioři MeSH
• věkové faktory MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH
• Názvy látek
• C-reaktivní protein MeSH
• ferritiny MeSH
• interleukin-6 MeSH
• L-laktátdehydrogenasa MeSH
• myoglobin MeSH
• prokalcitonin MeSH

BACKGROUND: The clinical presentation of European patients with mild-to-moderate COVID-19 infection is still unknown. OBJECTIVE: To study the clinical presentation of COVID-19 in Europe. METHODS: Patients with positive diagnosis of COVID-19 were recruited from 18 European hospitals. Epidemiological and clinical data were obtained through a standardized questionnaire. Bayesian analysis was used for analysing the relationship between outcomes. RESULTS: A total of 1,420 patients completed the study (962 females, 30.7% of healthcare workers). The mean age of patients was 39.17 ± 12.09 years. The most common symptoms were headache (70.3%), loss of smell (70.2%), nasal obstruction (67.8%), cough (63.2%), asthenia (63.3%), myalgia (62.5%), rhinorrhea (60.1%), gustatory dysfunction (54.2%) and sore throat (52.9%). Fever was reported by 45.4%. The mean duration of COVID-19 symptoms of mild-to-moderate cured patients was 11.5 ± 5.7 days. The prevalence of symptoms significantly varied according to age and sex. Young patients more frequently had ear, nose and throat complaints, whereas elderly individuals often presented fever, fatigue and loss of appetite. Loss of smell, headache, nasal obstruction and fatigue were more prevalent in female patients. The loss of smell was a key symptom of mild-to-moderate COVID-19 patients and was not associated with nasal obstruction and rhinorrhea. Loss of smell persisted at least 7 days after the disease in 37.5% of cured patients. CONCLUSION: The clinical presentation of mild-to-moderate COVID-19 substantially varies according to the age and the sex characteristics of patients. Olfactory dysfunction seems to be an important underestimated symptom of mild-to-moderate COVID-19 that needs to be recognized as such by the WHO.

• Klíčová slova
• COVID-19, Europe, clinical, coronavirus, epidemiological, medicine, patients, symptoms,
• MeSH
• Bayesova věta MeSH
• Betacoronavirus * MeSH
• bolesti hlavy epidemiologie   MeSH
• COVID-19 MeSH
• dospělí MeSH
• koronavirové infekce komplikace   diagnóza   enzymologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• myalgie epidemiologie   MeSH
• pandemie MeSH
• poruchy chuti epidemiologie   MeSH
• poruchy čichu epidemiologie   MeSH
• prevalence MeSH
• SARS-CoV-2 MeSH
• sexuální faktory MeSH
• určení symptomu MeSH
• věkové faktory MeSH
• virová pneumonie komplikace   diagnóza   enzymologie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Evropa MeSH

Poor neuromuscular control and fatigue have been proposed as a risk factor for non-contact injuries especially around peak height velocity (PHV). This study explored the effects of competitive soccer match-play on neuromuscular performance and muscle damage in male youth soccer players. 24 youth players aged 13-16y were split into a PHV group (-0.5 to 0.5y) and post PHV group (1.0-2.5y) based on maturity off-set. Leg stiffness, reactive strength index (RSI), muscle activation, creatine kinase (CK), and muscle soreness were determined pre and post a competitive soccer match. Paired t-tests were used to explore differences pre and post competitive match play and independent sample t-tests for between groups differences for all outcome measures. There was no significant fatigue-related change in absolute and relative leg stiffness or muscle activation in both groups, except for the gastrocnemius in the post PHV group. RSI, CK and perceived muscle soreness were significantly different after soccer match-play in both groups with small to large effects observed (ES:0.41-2.82). There were no significant differences between the groups pre match-play except for absolute and relative leg stiffness (P < 0.001; ES = 1.16 and 0.63 respectively). No significant differences were observed in the fatigue related responses to competitive match play between groups except for perceived muscle soreness. The influence of competitive match-play on neuromuscular function and muscle damage is similar in male youth around the time of PHV and those post-PHV indicating that other factors must contribute to the heightened injury risk around PHV.

• Klíčová slova
• Youth, maturation, muscle damage, neuromuscular, soccer, stretch-shortening cycle,
• MeSH
• fotbal * MeSH
• kompetitivní chování MeSH
• kosterní svaly patofyziologie   MeSH
• kreatinkinasa krev   MeSH
• lidé MeSH
• mladiství MeSH
• myalgie patofyziologie   MeSH
• sport pro děti a mládež MeSH
• sportovní výkon * MeSH
• svalová únava * MeSH
• věkové faktory MeSH
• Check Tag
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• kreatinkinasa MeSH

INTRODUCTION: Effective management of seasonal and pandemic influenza is a high priority internationally. Guidelines in many countries recommend antiviral treatment for older people and individuals with comorbidity at increased risk of complications. However, antivirals are not often prescribed in primary care in Europe, partly because its clinical and cost effectiveness has been insufficiently demonstrated by non-industry funded and pragmatic studies. METHODS AND ANALYSIS: Antivirals for influenza-Like Illness? An rCt of Clinical and Cost effectiveness in primary CarE is a European multinational, multicentre, open-labelled, non-industry funded, pragmatic, adaptive-platform, randomised controlled trial. Initial trial arms will be best usual primary care and best usual primary care plus treatment with oseltamivir for 5 days. We aim to recruit at least 2500 participants ≥1 year presenting with influenza-like illness (ILI), with symptom duration ≤72 hours in primary care over three consecutive periods of confirmed high influenza incidence. Participant outcomes will be followed up to 28 days by diary and telephone. The primary objective is to determine whether adding antiviral treatment to best usual primary care is effective in reducing time to return to usual daily activity with fever, headache and muscle ache reduced to minor severity or less. Secondary objectives include estimating cost-effectiveness, benefits in subgroups according to age (<12, 12-64 and >64 years), severity of symptoms at presentation (low, medium and high), comorbidity (yes/no), duration of symptoms (≤48 hours/>48-72 hours), complications (hospital admission and pneumonia), use of additional prescribed medication including antibiotics, use of over-the-counter medicines and self-management of ILI symptoms. ETHICS AND DISSEMINATION: Research ethics committee (REC) approval was granted by the NRES Committee South Central (Oxford B) and Clinical Trial Authority (CTA) approval by The Medicines and Healthcare products Regulatory Agency. All participating countries gained national REC and CTA approval as required. Dissemination of results will be through peer-reviewed scientific journals and conference presentations. TRIAL REGISTRATION NUMBER: ISRCTN27908921; Pre-results.

• Klíčová slova
• adaptive clinical trial, cost-benefit analysis, influenza, oseltamivir, primary healthcare,
• MeSH
• adaptivní klinické zkoušky jako téma MeSH
• analýza nákladů a výnosů MeSH
• antivirové látky ekonomika   terapeutické užití   MeSH
• bolesti hlavy virologie   MeSH
• časové faktory MeSH
• chřipka lidská komplikace   farmakoterapie   prevence a kontrola   MeSH
• činnosti denního života MeSH
• horečka virologie   MeSH
• hospitalizace MeSH
• léky bez předpisu terapeutické užití   MeSH
• léky na předpis terapeutické užití   MeSH
• lidé MeSH
• multicentrické studie jako téma MeSH
• myalgie virologie   MeSH
• oseltamivir ekonomika   terapeutické užití   MeSH
• péče o sebe MeSH
• pneumonie virologie   MeSH
• pragmatické klinické studie jako téma * MeSH
• určení symptomu MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• protokol klinické studie MeSH
• Názvy látek
• antivirové látky MeSH
• léky bez předpisu MeSH
• léky na předpis MeSH
• oseltamivir MeSH

Although statin therapy has proven to be the cornerstone for prevention and treatment of cardiovascular disease (CVD), there are many patients for whom long-term therapy remains suboptimal. The aims of this article are to review the current complex issues associated with statin use and to explore when novel treatment approaches should be considered. Statin discontinuation as well as adherence to statin therapy remain two of the greatest challenges for lipidologists. Evidence suggests that between 40 and 75% of patients discontinue their statin therapy within one year after initiation. Furthermore, whilst the reasons for persistence with statin therapy are complex, evidence shows that low-adherence to statins negatively impacts clinical outcomes and residual CV risk remains a major concern. Non-adherence or lack of persistence with long-term statin therapy in real-life may be the main cause of inadequate low density lipoprotein cholesterol lowering with statins. There is a large need for the improvement of the use of statins, which have good safety profiles and are inexpensive. On the other hand, in a non-cost-constrained environment, proprotein convertase subtilisin/kexin type 9 inhibitors should arguably be used more often in those patients in whom treatment with statins remains unsatisfactory.

• Klíčová slova
• Cardiovascular risk, Discontinuation, HDL-C, Non-adherence, PCSK9, Statin, Statin-associated muscle symptoms,
• MeSH
• adherence k farmakoterapii * MeSH
• HDL-cholesterol antagonisté a inhibitory   krev   MeSH
• hypercholesterolemie krev   farmakoterapie   MeSH
• kardiovaskulární nemoci krev   farmakoterapie   MeSH
• lidé MeSH
• myalgie chemicky indukované   MeSH
• PCSK9 inhibitory MeSH
• poruchy spánku a bdění chemicky indukované   MeSH
• randomizované kontrolované studie jako téma metody   MeSH
• rizikové faktory MeSH
• statiny škodlivé účinky   terapeutické užití   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Názvy látek
• HDL-cholesterol MeSH
• PCSK9 inhibitory MeSH
• PCSK9 protein, human MeSH Prohlížeč
• statiny MeSH