Background and Objectives: Postoperative pneumonia and complications significantly impact outcomes in thoracic surgery, particularly for patients undergoing lobectomy for non-small cell lung cancer (NSCLC). This study evaluates whether preoperative premedication influences the risk of postoperative pneumonia and overall complications. Materials and Methods: This retrospective study included 346 patients who underwent lobectomy for NSCLC at the University Hospital Ostrava between 2015 and 2021. Data on demographic variables, tumour staging, surgical approach, and premedication (anticholinergics, benzodiazepines, antihistamines, and analgesics) were analysed. Postoperative outcomes included pneumonia and complications classified by the modified Clavien-Dindo system. Results: Premedication was not significantly associated with postoperative pneumonia (10.7%) or overall complications (26.0%). Tumour size was the only factor significantly associated with complications, with larger tumours increasing the odds (OR: 1.16, p = 0.032). Other factors, including age, ASA classification, BMI, and surgical approach, did not demonstrate significant associations with postoperative outcomes. Conclusions: Premedication does not appear to significantly influence the risk of postoperative pneumonia or overall complications in patients undergoing lobectomy for NSCLC. Similarly, other clinical variables, such as age, ASA classification, BMI, and surgical approach, also did not show significant associations with these outcomes. These findings suggest that premedication can be individualised without increasing postoperative risks. However, tumour size emerged as a significant factor associated with complications, highlighting the need for careful preoperative assessment and planning, particularly in patients with larger tumours.

• Klíčová slova
• lobectomy, lung cancer, postoperative complication, postoperative pneumonia, premedication, risk factors, thoracic surgery,
• MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• nádory plic * chirurgie   MeSH
• nemalobuněčný karcinom plic * chirurgie   MeSH
• pneumektomie * škodlivé účinky   metody   MeSH
• pneumonie etiologie   epidemiologie   prevence a kontrola   MeSH
• pooperační komplikace * prevence a kontrola   etiologie   epidemiologie   MeSH
• premedikace * metody   MeSH
• retrospektivní studie MeSH
• rizikové faktory 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

Postoperative pneumonia is the most common complication in patients after lung resection for non-small cell lung cancer (NSCLC). The tolerable incidence of this complication ranges from 5 to 8 %. The aim of this study was to evaluate the influence of initial risk factors on the incidence of postoperative pneumonia in patients undergoing lung resection for NSCLC. A retrospective cohort study was conducted at the University Hospital Ostrava between January 1, 2016, and December 31, 2022. All adult patients who underwent pulmonary lobectomy for primary NSCLC during the study period were included in the study. A total of 350 patients were included in the study. The incidence of postoperative pneumonia was 10.9%. Analysis of baseline risk factors did not show a statistically significant association with the incidence of this complication. The only statistically significant finding was a longer hospital stay in patients with postoperative pneumonia. The risk of postoperative pneumonia in patients undergoing lung resection for non-small cell lung cancer cannot be clearly explained by the initial risk factors examined alone. The complex nature of this risk also requires a comprehensive approach to prevention, including both patient-centred measures and improved postoperative care.

• Klíčová slova
• non-small cell lung carcinoma, postoperative pneumonia, lung resection, risk factors, incidence,
• MeSH
• délka pobytu MeSH
• incidence MeSH
• kohortové studie MeSH
• lidé středního věku MeSH
• lidé MeSH
• nádory plic * chirurgie   MeSH
• nemalobuněčný karcinom plic * chirurgie   MeSH
• pneumektomie * škodlivé účinky   MeSH
• pneumonie * etiologie   epidemiologie   MeSH
• pooperační komplikace * etiologie   MeSH
• retrospektivní studie MeSH
• rizikové faktory MeSH
• senioři MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

The ability to predict invasive fungal infections (IFI) in patients with hematological malignancies is fundamental for successful therapy. Although gut dysbiosis is known to occur in hematological patients, whether airway dysbiosis also contributes to the risk of IFI has not been investigated. Nasal and oropharyngeal swabs were collected for functional microbiota characterization in 173 patients with hematological malignancies recruited in a multicenter, prospective, observational study and stratified according to the risk of developing IFI. A lower microbial richness and evenness were found in the pharyngeal microbiota of high-risk patients that were associated with a distinct taxonomic and metabolic profile. A murine model of IFI provided biologic plausibility for the finding that loss of protective anaerobes, such as Clostridiales and Bacteroidetes, along with an apparent restricted availability of tryptophan, is causally linked to the risk of IFI in hematologic patients and indicates avenues for antimicrobial stewardship and metabolic reequilibrium in IFI.

• Klíčová slova
• airway microbiome, antibiotics, hematological malignancies, indole-3-aldehyde, invasive fungal infection, metabolomics, tryptophan,
• MeSH
• antifungální látky farmakologie   terapeutické užití   MeSH
• farynx mikrobiologie   MeSH
• hematologické nádory komplikace   MeSH
• hodnocení rizik MeSH
• krevní nemoci komplikace   MeSH
• lidé MeSH
• metagenom MeSH
• metagenomika metody   MeSH
• mikrobiota * MeSH
• modely nemocí na zvířatech MeSH
• mykózy diagnóza   farmakoterapie   etiologie   MeSH
• myši MeSH
• pneumonie diagnóza   farmakoterapie   etiologie   MeSH
• rizikové faktory MeSH
• zvířata MeSH
• Check Tag
• lidé MeSH
• myši MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• práce podpořená grantem MeSH
• Názvy látek
• antifungální látky MeSH

BACKGROUND: Older patients with acute myeloid leukemia (AML) have a dismal prognosis, even after treatment with a hypomethylating agent. Azacitidine added to venetoclax had promising efficacy in a previous phase 1b study. METHODS: We randomly assigned previously untreated patients with confirmed AML who were ineligible for standard induction therapy because of coexisting conditions, because they were 75 years of age or older, or both to azacitidine plus either venetoclax or placebo. All patients received a standard dose of azacitidine (75 mg per square meter of body-surface area subcutaneously or intravenously on days 1 through 7 every 28-day cycle); venetoclax (target dose, 400 mg) or matching placebo was administered orally, once daily, in 28-day cycles. The primary end point was overall survival. RESULTS: The intention-to-treat population included 431 patients (286 in the azacitidine-venetoclax group and 145 in the azacitidine-placebo [control] group). The median age was 76 years in both groups (range, 49 to 91). At a median follow-up of 20.5 months, the median overall survival was 14.7 months in the azacitidine-venetoclax group and 9.6 months in the control group (hazard ratio for death, 0.66; 95% confidence interval, 0.52 to 0.85; P<0.001). The incidence of complete remission was higher with azacitidine-venetoclax than with the control regimen (36.7% vs. 17.9%; P<0.001), as was the composite complete remission (complete remission or complete remission with incomplete hematologic recovery) (66.4% vs. 28.3%; P<0.001). Key adverse events included nausea of any grade (in 44% of the patients in the azacitidine-venetoclax group and 35% of those in the control group) and grade 3 or higher thrombocytopenia (in 45% and 38%, respectively), neutropenia (in 42% and 28%), and febrile neutropenia (in 42% and 19%). Infections of any grade occurred in 85% of the patients in the azacitidine-venetoclax group and 67% of those in the control group, and serious adverse events occurred in 83% and 73%, respectively. CONCLUSIONS: In previously untreated patients who were ineligible for intensive chemotherapy, overall survival was longer and the incidence of remission was higher among patients who received azacitidine plus venetoclax than among those who received azacitidine alone. The incidence of febrile neutropenia was higher in the venetoclax-azacitidine group than in the control group. (Funded by AbbVie and Genentech; VIALE-A ClinicalTrials.gov number, NCT02993523.).

• MeSH
• akutní myeloidní leukemie farmakoterapie   mortalita   MeSH
• analýza podle původního léčebného záměru MeSH
• azacytidin aplikace a dávkování   škodlivé účinky   MeSH
• bicyklické sloučeniny heterocyklické aplikace a dávkování   škodlivé účinky   MeSH
• dvojitá slepá metoda MeSH
• indukce remise MeSH
• Kaplanův-Meierův odhad MeSH
• leukopenie chemicky indukované   MeSH
• lidé středního věku MeSH
• lidé MeSH
• následné studie MeSH
• pneumonie etiologie   MeSH
• protokoly protinádorové kombinované chemoterapie terapeutické užití   MeSH
• recidiva MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• sulfonamidy aplikace a dávkování   škodlivé účinky   MeSH
• trombocytopenie chemicky indukované   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
• klinické zkoušky, fáze III MeSH
• multicentrická studie MeSH
• práce podpořená grantem MeSH
• randomizované kontrolované studie MeSH
• srovnávací studie MeSH
• Názvy látek
• azacytidin MeSH
• bicyklické sloučeniny heterocyklické MeSH
• sulfonamidy MeSH
• venetoclax MeSH Prohlížeč

BACKGROUND: There is no universally accepted opinion on the use of granulocyte transfusions collected using apheresis (GTA) in neutropenic patients and severe infection. PATIENTS AND METHODS: The efficacy and safety of GTAs transfused at a single center over 10 years were analyzed retrospectively. GTAs were harvested from voluntary unrelated donors after priming with methylprednisolone using continuous apheresis and hydroxyethylstarch as sedimentation agent. RESULTS: 41 patients with neutropenia and hematologic malignancy (15 females and 26 males aged 22-69 (median 45.5)) were given a median 3.5 GTAs per patient (range: 1-17) containing a median 1.39×1010 granulocyte/GTA (range: 0.65-2.81). The indications for GTA use were soft tissue inflammation, sepsis, and pneumonia in 30, 22, and 14 cases, respectively. After GTA complete (30 patients: 73.2%) or partial (6 patients: 14.6%) healing of the infection was achieved. The success rate was 91.7% in soft tissue infections, 66.7% in invasive fungal infections, and 68% in sepsis. Septic shock (documented in 12 cases) was associated with a poor response (P<0.03; Chi-square test). Clinical worsening was observed in six cases (14.6%); four patients died. No significant short-term side effects of GTA treatment were recorded. CONCLUSIONS: In our study GTAs collected after steroid priming and used for the treatment of infection during severe neutropenia have shown comparable efficacy with several previously reported trials. However retrospective fashion of our study and inhomogeneous group of patients do not allow any firm conclusions. Prospective studies (including patients' registries) are needed for the better clarification of the role and the dose of GTAs necessary for the successful infection management during neutropenia.

• Klíčová slova
• Granulocyte from apheresis, Granulocytes de l’aphérèse, Infection sévère, Neutropénie sévère prolongée, Prolonged severe neutropenia, Severe infection,
• MeSH
• antiinfekční látky terapeutické užití   MeSH
• deriváty hydroxyethylového škrobu farmakologie   MeSH
• dospělí MeSH
• febrilní neutropenie komplikace   MeSH
• granulocyty transplantace   MeSH
• hematologické nádory komplikace   terapie   MeSH
• infekce měkkých tkání farmakoterapie   etiologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• methylprednisolon farmakologie   terapeutické užití   MeSH
• mladý dospělý MeSH
• mykózy farmakoterapie   etiologie   MeSH
• pneumonie farmakoterapie   etiologie   MeSH
• převod jednotlivých krevních složek * MeSH
• retrospektivní studie MeSH
• senioři MeSH
• separace krevních složek MeSH
• sepse farmakoterapie   etiologie   MeSH
• transplantace hematopoetických kmenových buněk * MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• antiinfekční látky MeSH
• deriváty hydroxyethylového škrobu MeSH
• methylprednisolon MeSH

Nosocomial infections are a common complication of hospital care. Hospital-acquired (HAP) pneumonia is one of the most common nosocomial infections and it is the most dangerous in terms of mortality. The problem is mainly selected hospital bacterial strains with rising antibiotic resistance. Diagnosis of the cause of pneumonia is difficult and often does not lead to a positive result. Management is complex and is based on timely and appropriate empirical antibiotic treatment. Local and extrapulmonary complications are relatively common and they increase morbidity and mortality. Prognosis of the HAP is often unfavorable, especially in the elderly and polymorbid individuals.Key words: complications - etiology - hospital-acquired pneumonia - management.

• MeSH
• antibakteriální látky terapeutické užití   MeSH
• infekce spojené se zdravotní péčí diagnóza   farmakoterapie   MeSH
• lidé MeSH
• pneumonie diagnóza   farmakoterapie   etiologie   MeSH
• senioři MeSH
• Check Tag
• lidé MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Názvy látek
• antibakteriální látky MeSH

BACKGROUND: Adalimumab therapy has an established record of high efficacy in psoriasis treatment. However, only a limited number of studies have investigated long-term results in clinical practice. OBJECTIVES: To evaluate the effectiveness and safety of adalimumab in a center for biological therapy in the Czech Republic. METHODS: Retrospectively, we analyzed 90 patients with moderate to severe psoriasis who were treated with adalimumab between 2008 and 2016. The proportion of patients achieving PASI75, 90, and 100 after 3, 6, 12, 18, 24, 30, and 36 months was determined. RESULTS: The mean period of treatment was 4.4 years (maximum duration reached was 8.6 years). PASI75 was observed in 85.6% of patients after 3 months, PASI90 in 50%, and PASI100 in 23.3%. Throughout the 3-year analysis, PASI90 was persistent in 91.4% and PASI100 in 51.7%. The majority of patients who reached PASI100 showed a trend to maintain the response in the long-term follow-up. No safety issues were identified. CONCLUSIONS: Adalimumab is effective and safe in the long-term treatment of psoriatic patients in daily clinical practice. Once patients achieved PASI100, they tended to remain stable in treatment.

• Klíčová slova
• Psoriasis, adalimumab, long-term efficacy,
• MeSH
• adalimumab škodlivé účinky   terapeutické užití   MeSH
• antiflogistika škodlivé účinky   terapeutické užití   MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• následné studie MeSH
• pneumonie etiologie   MeSH
• psoriáza farmakoterapie   patologie   MeSH
• retrospektivní studie MeSH
• rozvrh dávkování léků MeSH
• stupeň závažnosti nemoci MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH
• Názvy látek
• adalimumab MeSH
• antiflogistika MeSH

UNLABELLED: The objective of this study was to determine the prevalence of infectious complications in burn patients requiring intensive care in a one-day multicenter study encompassing burn centers in various European countries. MATERIAL AND METHODS: The European Burns Association database identified 87 centers in Western and Eastern Europe, 27 of which agreed to cooperate. American Burn Association recommendations were used for diagnosis of various infectious complications in patients with thermal trauma. RESULTS: From those centers, we randomly assigned 134 patients (44 women) to the analysis. Mean age of the group was 40.39 ± 22.17(SD) years. Mean abbreviated burn severity index was 7.5±2.54, mean size of burned area was 30.49 ± 20.14% of total body surface area. Mean length of hospitalization to date was 24.32 ± 30.64 days. Infectious complications were observed in 92 patients (68.7%), 76 (56.7%) of whom met the criteria for infection of the burned area, 26 patients (19.4%) for bloodstream infection, 21 (15.7%) for pneumonia, and 13 (9.7%) for urinary system infection. Multifocal infections were found in 29 patients (21.6%). Gram-positive bacterial strains as potentially pathogenic microorganisms were identified in 67 patients (50.0%), Gram-negative bacterial strains in 73 (54.5%), and yeasts in 18 (13.4%) patients. Filamentous fungi were not isolated from any patient in the group. CONCLUSION: Cornerstone future standards in individual burn centers should be to monitor the occurrence of infectious complications in burn patients, prevent the spread of these complications, and report resistant pathogens. This work constitutes an important project in this area.

• Klíčová slova
• burns - infectious complications - bacteria - inhalation injury - Europe.,
• MeSH
• délka pobytu MeSH
• dítě MeSH
• dospělí MeSH
• infekce močového ústrojí epidemiologie   etiologie   MeSH
• infekce v ráně epidemiologie   mikrobiologie   MeSH
• katétrové infekce epidemiologie   etiologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• náhodné rozdělení MeSH
• péče o pacienty v kritickém stavu MeSH
• pneumonie epidemiologie   etiologie   MeSH
• popálení komplikace   epidemiologie   mikrobiologie   MeSH
• popáleninové jednotky MeSH
• prevalence MeSH
• rizikové faktory MeSH
• senioři MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• Geografické názvy
• Evropa epidemiologie   MeSH

Common variable immunodeficiency disorder belongs to the most common primary human immunodeficiencies and it is characterized by primary defective immunoglobulin production. Hypogammaglobulinemia manifests in every age, usually in adult people. There is no gender predisposition. The prevalence is 1 : 25 000-1 : 50 000. The ethiopathogenesis of the majority of CVIDs is unknown. The main clinical respiratory symptoms include recurrent respiratory infects, especially bacterial etiology, sinusitis, bronchitis, pneumonia, leading to bronchiectasis and lung fibrosis. Interstitial lung fibrosis and granulomatosis often manifest at diagnosis of CVID and they are negative prognostic factors of the disease.

• MeSH
• agamaglobulinemie etiologie   MeSH
• běžná variabilní imunodeficience komplikace   diagnóza   epidemiologie   MeSH
• bronchiektazie etiologie   MeSH
• dospělí MeSH
• intersticiální plicní nemoci etiologie   MeSH
• lidé MeSH
• pneumonie etiologie   MeSH
• prevalence MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

AIMS AND OBJECTIVES: To establish the availability of High Efficiency Particulate Air (HEPA)- and nonHEPA-filtered rooms in eastern European transplant centres and to investigate the impact on incidence of pneumonia and mortality after haematopoietic stem cell transplantation (HSCT). BACKGROUND: Barrier nursing in HEPA-filtered rooms is generally recommended for patients undergoing HSCT. There are only limited data on the availability of HEPA-filtered rooms and the impact on incidence of pneumonia and mortality. DESIGN: A prospective, observational, international study. METHODS: Monitoring cards were distributed within the East Forum EBMT-Nurses Group cooperating centres, and 689 consecutive patients were registered in 1/2010-6/2012. Patients were monitored for 100 days post-transplant. RESULTS: In patients undergoing autologous HSCT, pneumonia developed in 14/400 (3·5%) and was the cause of death in 2/14 (14%) of patients. There was no significant difference in mortality between HEPA-filtered and nonHEPA-filtered groups (4·5% vs. 4·9%, respectively). 239/400 (59%) transplantations were performed in single-bed rooms [190/239 (79%) HEPA-filtered] and 161 (41%) in two-bed rooms [28/161 (17%) HEPA-filtered]. In allogeneic transplantation, pneumonia developed in 24/289 (8·3%) and was the cause of death in 11/24 (45%) of patients. There was no significant difference in mortality between HEPA-filtered and non-HEPA-filtered groups (14% vs. 17%, respectively). 281/289 (97%) of allogeneic transplantations were performed in single-bed rooms [254/281 (90%) HEPA-filtered], and pneumonia was more frequent in patients on corticosteroids and in rooms without HEPA. CONCLUSION: The incidence of pneumonia in the autologous transplantation setting is low. More pneumonia was observed in the allogeneic HSCT group, especially in patients on corticosteroids. There was a trend towards a lower incidence of pneumonia in allogeneic HSCT patients treated in HEPA-filtered rooms. RELEVANCE TO CLINICAL PRACTICE: Autologous HSCT transplantation may safely be performed without HEPA filtration. HEPA filtration might be preferable in patients undergoing allogeneic transplantation.

• Klíčová slova
• HEPA, barrier nursing, isolation, nursing, pneumonia, protection, stem cell, transplantation,
• MeSH
• dospělí MeSH
• incidence MeSH
• izolace pacientů * MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• pneumonie epidemiologie   etiologie   ošetřování   prevence a kontrola   MeSH
• pokoje pro pacienty * MeSH
• prospektivní studie MeSH
• senioři MeSH
• transplantace hematopoetických kmenových buněk * MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• pozorovací studie MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Evropa epidemiologie   MeSH