BACKGROUND: The integration of robotic technology into surgical procedures has gained considerable attention for its promise to enhance a variety of clinical outcomes. Robotic deep inferior epigastric perforator (DIEP) flap harvest has emerged as a novel approach for autologous breast reconstruction. This systematic review aims to provide a comprehensive overview of the current techniques, outcomes, and complications of robotic DIEP flap surgery. METHODS: A systematic literature search was conducted after PRISMA 2020 guidelines across databases including PubMed, Embase, Google Scholar, and Web of Science from 2000 to 2023. Articles exploring robotic DIEP flap harvest for breast reconstruction were assessed to compare operative techniques, clinical outcomes, and complications. The risk of bias was evaluated using ROBINS-I and the Newcastle-Ottawa scale. RESULTS: Fourteen studies involving 108 patients were included. Three studies used a totally extraperitoneal (TEP) technique, whereas 11 studies used a transabdominal preperitoneal (TAPP) approach. Preoperative planning utilized computed tomography angiography and magnetic resonance angiography imaging. The mean robotic operative time was 64 minutes, with total operative times averaging 574 minutes for TAPP and 497 minutes for TEP. The mean length of stay was 5 days, and the mean fascial incision length was 3 cm. Overall complication rate was 14.9%, with no significant difference compared with conventional DIEP flap procedures. CONCLUSION: Robotic DIEP flap harvest is a promising technique that may reduce postoperative pain and limiting abdominal donor site morbidity. Potential limitations include longer operative times, variable hospital stays, and increased costs.
- MeSH
- arteriae epigastricae * transplantace MeSH
- délka operace * MeSH
- délka pobytu MeSH
- lidé MeSH
- mamoplastika * metody MeSH
- odběr tkání a orgánů metody MeSH
- perforátorový lalok * krevní zásobení MeSH
- pooperační komplikace prevence a kontrola MeSH
- roboticky asistované výkony * metody MeSH
- Check Tag
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- systematický přehled MeSH
BACKGROUND: This study examines the perspectives of individuals with coronary heart disease (CHD) on a nurse-led eHealth cardiac rehabilitation (NeCR) program, which included a website, tele-monitoring device, and social media chatroom. METHODS: Using a descriptive qualitative approach, semi-structured interviews were conducted with 18 participants to capture their feedback and experiences with the NeCR program. RESULTS: Participants found the NeCR program valuable in addressing gaps in cardiac rehabilitation services in China, empowering them to make behavioral changes and enhancing their social motivation. However, they also highlighted the need for a more user-friendly website, better symptom management during exercise, and stronger privacy protections in the peer networking chatroom. The study concludes that the NeCR program is feasible in providing accessible rehabilitative services at home post-discharge. Recommendations include improving the self-monitoring platform for ease of use, incorporating immediate symptom management guidance during exercise, and ensuring a secure environment for online peer support. CONCLUSIONS: These findings offer crucial insights for developing patient-centered eHealth cardiac rehabilitation services, emphasizing the importance of user-friendly design, effective symptom management features, and privacy protection in promoting participant engagement with e-platforms. TRIAL REGISTRATION: ChiCTR1800020411 (http://www.chictr.org.cn/showprojen.aspx?proj=33906).
- Klíčová slova
- behavioral change, cardiac rehabilitation, coronary heart disease, eHealth, patient‐centered care,
- MeSH
- dospělí MeSH
- kardiovaskulární rehabilitace * metody MeSH
- koronární nemoc rehabilitace ošetřování MeSH
- kvalitativní výzkum * MeSH
- lidé středního věku MeSH
- lidé MeSH
- rozhovory jako téma MeSH
- senioři MeSH
- telemedicína * MeSH
- zpětná vazba 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
- Čína MeSH
BACKGROUND: Venous thromboembolism (VTE) is a frequent complication in critically ill patients, who often have multiple risk factors. Pharmacological thromboprophylaxis is widely applied to lower this risk, but guidelines lack dosing recommendations. OBJECTIVE: This survey aims to assess current thromboprophylaxis preferences and willingness to participate in future randomized clinical trials (RCTs) on this topic. METHOD: We conducted an international online survey between February and May 2023 among intensive care unit (ICU) physicians, including 16 questions about preferences in relation to thromboprophylaxis and preferences on topics for a future RCT. The survey was distributed through the network of the Collaboration for Research in Intensive Care. RESULTS: A total of 715 physicians from 170 ICUs in 23 countries contributed information, with a mean response rate of 36%. In most ICUs, both pharmacological (n = 166, 98%) and mechanical thromboprophylaxis (n = 143, 84%) were applied. A total of 36 pharmacological thromboprophylaxis regimens were reported. Use of low-molecular-weight heparin (LMWH) was most common (n = 149 ICUs, 87%), followed by subcutaneous unfractionated heparin (n = 44 ICUs, 26%). Seventy-five percent of physicians indicated that they used enoxaparin 40 mg (4000 IU), dalteparin 5000 IU, or tinzaparin 4500 IU once daily, whereas 25% reported the use of 16 other LMWH type and dose combinations. Dose adjustment according to weight was common (78 ICUs, 46%). Participants perceived high variation in the application of thromboprophylaxis and were willing to consider an alternative LMWH type (n = 542, 76%) or dose (n = 538, 75%) in the context of an RCT. CONCLUSION: LMWH was the preferred agent for thromboprophylaxis in critically ill patients. There was considerable variation in the application of LMWH for prophylaxis, reflected by the use of different types, doses, and dosing strategies. Most physicians would be willing to participate in an RCT on thromboprophylaxis. EDITORIAL COMMENT: This survey demonstrates current patterns in implementation preferences for critically ill patients. While there is one approach and drug that is commonly preferred, these findings show that there is some variation in practice.
- Klíčová slova
- ICU, survey, thromboprophylaxis,
- MeSH
- antikoagulancia * terapeutické užití aplikace a dávkování MeSH
- heparin nízkomolekulární * terapeutické užití aplikace a dávkování MeSH
- internacionalita MeSH
- jednotky intenzivní péče * MeSH
- kritický stav MeSH
- lékaři MeSH
- lidé MeSH
- péče o pacienty v kritickém stavu metody MeSH
- průzkumy a dotazníky MeSH
- žilní tromboembolie * prevence a kontrola MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- antikoagulancia * MeSH
- heparin nízkomolekulární * MeSH
BACKGROUND: The enhanced application of imaging techniques is resulting in the diagnosis of more patients with asymptomatic metastatic esophagogastric cancer (mEGC). We conducted a Delphi study to gather insights from European experts on the optimal timing for initiating palliative systemic therapy for these patients. METHODS: An online survey featured 14 scenarios where physicians chose their preferred timing for initiating systemic therapy: immediate(<3 weeks) or deferred. The standard scenario was a 65-year-old male, WHO/ECOG 0 with asymptomatic mEGC, 2 metastases in each lung, HER2 -, PDL1-CPS 2. In every subsequent case, one characteristic was modified. To investigate the fortitude of the physicians' preference for an immediate start, scenarios also included a patient who was motivated to start but preferred to defer if the physician deemed it judicious. Consensus was defined as ≥ 75 % agreement; scenarios without consensus were re-evaluated in Delphi round 2. RESULTS: Thirty-nine physicians participated in the first round, and 33 in the second round. Consensus to start treatment immediately was reached in 12 (86 %) scenarios. When patients preferred to defer, the consensus was to still advise to start palliative systemic treatment immediately in half (n = 7) of the scenarios. Only 2 scenarios (pre-existent WHO/ECOG 2 or 78 years old) reached the consensus that treatment could be deferred. CONCLUSIONS: In asymptomatic mEGC, immediate start of treatment is preferred by European experts. Consensus was established that treatment can be deferred for patients who prefer deferral and either have a pre-existent WHO/ECOG performance status of 2 or are of advanced age.
- Klíčová slova
- Chemotherapy, Delphi Technique, Esophageal cancer, Gastric cancer, Metastasis, Palliative medicine,
- MeSH
- asymptomatické nemoci terapie MeSH
- čas zasáhnout při rozvinutí nemoci MeSH
- časové faktory MeSH
- delfská metoda * MeSH
- konsensus MeSH
- lidé středního věku MeSH
- lidé MeSH
- nádory jícnu * patologie farmakoterapie MeSH
- nádory žaludku * farmakoterapie patologie MeSH
- paliativní péče * metody MeSH
- senioři MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Evropa MeSH
Community-acquired respiratory viral infections (CARV) significantly impact patients with hematological malignancies (HM), leading to high morbidity and mortality. However, large-scale, real-world data on CARV in these patients is limited. This study analyzed data from the EPICOVIDEHA-EPIFLUEHA registry, focusing on patients with HM diagnosed with CARV during the 2023-2024 autumn-winter season. The study assessed epidemiology, clinical characteristics, risk factors, and outcomes. The study examined 1312 patients with HM diagnosed with CARV during the 2023-2024 autumn-winter season. Of these, 59.5% required hospitalization, with 13.5% needing ICU admission. The overall mortality rate was 10.6%, varying by virus: parainfluenza (21.3%), influenza (8.8%), metapneumovirus (7.1%), RSV (5.9%), or SARS-CoV-2 (5.0%). Poor outcomes were significantly associated with smoking history, severe lymphopenia, secondary bacterial infections, and ICU admission. This study highlights the severe risk CARV poses to patients with HM, especially those undergoing active treatment. The high rates of hospitalization and mortality stress the need for better prevention, early diagnosis, and targeted therapies. Given the severe outcomes with certain viruses like parainfluenza, tailored strategies are crucial to improving patient outcomes in future CARV seasons.
- Klíčová slova
- antiviral therapy, community‐acquired respiratory viral infection, hematological malignancy, secondary infection, vaccine coverage,
- MeSH
- chřipka lidská epidemiologie mortalita komplikace MeSH
- COVID-19 * epidemiologie mortalita komplikace MeSH
- dospělí MeSH
- hematologické nádory * mortalita epidemiologie MeSH
- hospitalizace MeSH
- infekce dýchací soustavy * epidemiologie virologie MeSH
- infekce respiračními syncytiálními viry epidemiologie mortalita komplikace MeSH
- infekce získané v komunitě epidemiologie mortalita MeSH
- lidé středního věku MeSH
- lidé MeSH
- Metapneumovirus izolace a purifikace MeSH
- registrace MeSH
- rizikové faktory MeSH
- roční období * MeSH
- SARS-CoV-2 MeSH
- senioři nad 80 let MeSH
- senioři 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
This scoping review summarizes evidence regarding the impact of civic and community engagement of young people during the COVID-19 pandemic. Recognizing that the global pandemic not only brought challenges but also new opportunities to take a stance and to actively engage in communities and society, this review assesses the impact of the COVID-19 pandemic on young people's civic engagement across different cultural contexts and identifies key factors and processes that enable young people to engage with their community or society at large. We summarize evidence from 27 original research papers, one thought piece, and four reports conducted by global organizations such as the United Nations and OECD. Relevant research was conducted in the United States, Europe, China, Southeast Asia, South Africa, and New Zealand, addressing the development of leadership skills, civic responsibility, critical consciousness, civic and community engagement, as well as social integration. Key factors that facilitated civic engagement include national investments in online learning facilities, support for basic needs (such as education, health, and employment), and promotion and encouragement of local initiatives. The studies differed in their focus depending on the socio-cultural context encountered and future research needs to consider cultural variations and different demands on young people to inform effective practices for supporting young people's active engagement in society.
- Klíčová slova
- COVID‐19, civic engagement, positive youth development, scoping review,
- MeSH
- COVID-19 * epidemiologie psychologie MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- pandemie MeSH
- SARS-CoV-2 * MeSH
- sociální odpovědnost MeSH
- účast komunity MeSH
- vůdcovství MeSH
- Check Tag
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
Pharmaceutical care for patients with sore throat not requiring medical attention Counsultancy in self-treatment of mild health problems is one of the dominant aspects of providing pharmaceutical care, especially in pharmacy practice. A sore throat is one of the most common reasons for visiting a pharmacy. According to current knowledge, the biggest pitfall of sore throat management is the systematic and reliable classification of patients into uncomplicated and potentially complicated cases, which should ideally take place at the level of pre-medical care, i.e. in a pharmacy. For this purpose, the practical use of the self-treatment algorithm in the therapy of sore throat was presented in the article. The introduction of a systematic algorithm into pharmacy practice could contribute to higher efficacy of the provided care and reduce the risk of overlooking warning symptoms (red flags). The article also provides an overview of over the counter therapeutic options for sore throat.
- Klíčová slova
- Pharyngitis, pharmaceutical care., self-treatment algorithm, sore throat,
- MeSH
- algoritmy MeSH
- farmaceutické služby MeSH
- faryngitida * farmakoterapie terapie MeSH
- léky bez předpisu terapeutické užití MeSH
- lidé MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
- Názvy látek
- léky bez předpisu MeSH
BACKGROUND: Inflammation is associated with adverse cardiovascular events. Data from recent trials suggest that colchicine reduces the risk of cardiovascular events. METHODS: In this multicenter trial with a 2-by-2 factorial design, we randomly assigned patients who had myocardial infarction to receive either colchicine or placebo and either spironolactone or placebo. The results of the colchicine trial are reported here. The primary efficacy outcome was a composite of death from cardiovascular causes, recurrent myocardial infarction, stroke, or unplanned ischemia-driven coronary revascularization, evaluated in a time-to-event analysis. C-reactive protein was measured at 3 months in a subgroup of patients, and safety was also assessed. RESULTS: A total of 7062 patients at 104 centers in 14 countries underwent randomization; at the time of analysis, the vital status was unknown for 45 patients (0.6%), and this information was most likely missing at random. A primary-outcome event occurred in 322 of 3528 patients (9.1%) in the colchicine group and 327 of 3534 patients (9.3%) in the placebo group over a median follow-up period of 3 years (hazard ratio, 0.99; 95% confidence interval [CI], 0.85 to 1.16; P = 0.93). The incidence of individual components of the primary outcome appeared to be similar in the two groups. The least-squares mean difference in C-reactive protein levels between the colchicine group and the placebo group at 3 months, adjusted according to the baseline values, was -1.28 mg per liter (95% CI, -1.81 to -0.75). Diarrhea occurred in a higher percentage of patients with colchicine than with placebo (10.2% vs. 6.6%; P<0.001), but the incidence of serious infections did not differ between groups. CONCLUSIONS: Among patients who had myocardial infarction, treatment with colchicine, when started soon after myocardial infarction and continued for a median of 3 years, did not reduce the incidence of the composite primary outcome (death from cardiovascular causes, recurrent myocardial infarction, stroke, or unplanned ischemia-driven coronary revascularization). (Funded by the Canadian Institutes of Health Research and others; CLEAR ClinicalTrials.gov number, NCT03048825.).
- MeSH
- C-reaktivní protein * analýza MeSH
- cévní mozková příhoda prevence a kontrola MeSH
- dvojitá slepá metoda MeSH
- infarkt myokardu * prevence a kontrola mortalita MeSH
- Kaplanův-Meierův odhad MeSH
- kolchicin * terapeutické užití škodlivé účinky MeSH
- lidé středního věku MeSH
- lidé MeSH
- recidiva MeSH
- sekundární prevence MeSH
- senioři MeSH
- spironolakton terapeutické užití škodlivé účinky MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- randomizované kontrolované studie MeSH
- Názvy látek
- C-reaktivní protein * MeSH
- kolchicin * MeSH
- spironolakton MeSH
Acute intoxications with medications in children and the role of pharmacist in the National toxicological information center National Toxicological Information Center (NTIC) provides 24 hours telephone consultation service in acute intoxications for physicians, health care providers and general public. More than half of all consulted intoxications provided by NTIC belong to the group of children younger than 18 years old. Children 3 years old and younger were the main group of consulted intoxications in all children. Intoxications in children with the age up to 5 years old are often accidental intoxications without any or only mild symptoms. Older children and adolescents are more often consulted due to the suicidal attempt with moderate or severe symptoms. Chemicals, medications and plants were the most often consulted in children aged up to 18-years old during period 2018-2022. Pharmacist has complex knowledge of various scientific disciplines. Pharmacist is valuable health care provider in NTIC as well as in various sectors of health care in society.
- Klíčová slova
- child, diet, intoxication, medication, pharmacist.,
- MeSH
- dítě MeSH
- farmaceuti * MeSH
- informační střediska MeSH
- kojenec MeSH
- lidé MeSH
- mladiství MeSH
- otrava * MeSH
- předškolní dítě MeSH
- role odborníka MeSH
- toxikologická centra * statistika a číselné údaje MeSH
- Check Tag
- dítě MeSH
- kojenec MeSH
- lidé MeSH
- mladiství MeSH
- předškolní dítě MeSH
- Publikační typ
- časopisecké články MeSH
Available diagnostic tests in the pharmacy and the role of the pharmacist The topic of in vitro diagnostic tests is a relatively robust area of medical devices. It includes tests used in the providing of healthcare, i.e., intended for healthcare professionals, and a group of tests intended directly for consumers (Direct-To-Consumer tests). The subject of the following article is diagnostic tests intended for home in vitro self-testing of patients in the Czech Republic. The aim is to present a basic overview of the available tests, to present the principle of diagnostic tests and in selected groups of tests to summarise the most important information for the correct performance of tests that should be part of pharmaceutical care.
- Klíčová slova
- Pharmaceutical Care, diagnostic device, self-testing.,
- MeSH
- diagnostické testy rutinní * MeSH
- farmaceuti * MeSH
- farmaceutické služby MeSH
- lidé MeSH
- role odborníka * MeSH
- samotestování MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
- Geografické názvy
- Česká republika MeSH