BACKGROUND: The definition of minor ischemic stroke (MIS) is a topic of debate, however, the most accepted definition is a stroke with National Institutes of Health Stroke Scale (NIHSS) ≤ 5. Intravenous thrombolysis (IVT) is a crucial treatment option for acute ischemic stroke (AIS) including: alteplase, recombinant human tissue-type plasminogen activator (r-tPA), and the recently approved tenecteplase. However, there is a debate regarding its safety and efficacy. Therefore, our objective was to determine the safety and efficacy of IVT in treating minor stroke patients (NIHSS ≤ 5). METHODS: Using the search strategy assigned which was based on three keywords: "mild" or "minor", "stroke", and "intravenous thrombolysis", we searched for eligible articles on PubMed, Web of Science, Embase, and Scopus from inception till 10th January 2024. We conducted this meta-analysis using the random effect model to account for the heterogeneity among the studies. For the dichotomous variables, we calculated the odds ratio (OR) from the event and total of these variables. While for the continuous variables, we calculated the mean difference (MD) of these variables. Pooling of OR for the occurrence of events was also conducted. RESULTS: A total of 21 articles with 93,057 patients with MIS were included. The mean age of the participants ranged from 62.3 to 79.6. Most of the included patients had comorbidities such as hypertension, diabetes, previous stroke, smoking, atrial fibrillation, and hyperlipidemia. Of these, 10,850 received IVT while 82,207 did not. The use of IVT was statistically significant associated with 90-day modified Rankin score (mRs) 0-1 when compared with control with OR of 1.67 (95%CI: 1.46, 1.91, p < 0.00001) and was statistically significantly associated with improvement of NIHSS on discharge with OR of 2.19 (95%CI: 1.56, 3.08, p < 0.00001). In terms of safety outcomes, IVT has proven a safe profile, as there was no significant difference in intracranial hemorrhage (ICH) and mortality rates between the IVT and control groups with OR of 1.75 (95CI: 0.95, 3.23, p = 0.07) and 0.93 (95%CI: 0.77, 1.11, p = 0.41), respectively. CONCLUSION: Although some studies have not found any benefits of IVT in MIS patients, a substantial body of literature strongly endorses IVT as an effective and safe treatment for MIS. IVT has been shown to improve the mRs and NIHSS scores at the 90-day mark without an increased risk of ICH or mortality.

• Klíčová slova
• Acute ischemic stroke, Efficacy, Intracranial hemorrhage, Safety, Tissue Plasminogen Activator,
• MeSH
• cévní mozková příhoda farmakoterapie   MeSH
• fibrinolytika * aplikace a dávkování   terapeutické užití   MeSH
• intravenózní podání MeSH
• ischemická cévní mozková příhoda farmakoterapie   MeSH
• lidé MeSH
• tkáňový aktivátor plazminogenu aplikace a dávkování   terapeutické užití   škodlivé účinky   MeSH
• trombolytická terapie * metody   MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• metaanalýza MeSH
• systematický přehled MeSH
• Názvy látek
• fibrinolytika * MeSH
• tkáňový aktivátor plazminogenu MeSH

BACKGROUND/ AIM: Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease affecting upper and lower motor neurons, causing progressive atrophy of muscles, hypertonia, and paralysis. This study aimed to evaluate the current evidence and effectiveness of ultrasound in investigating nerve cross-sectional area (CSA) of peripheral nerves, vagus and cervical roots in those with ALS compared with healthy controls and to pool the CSA measurements. METHODS: A systematic search was conducted on Cochrane, Clarivate Web of Science, PubMed, Scopus, and Embase for the mesh terms nerve, ultrasonography, and amyotrophic lateral sclerosis. A quality assessment was performed using the New-Ottawa scale. In addition, a double-arm meta-analysis using Review Manager 5 software version 5.4 was performed. RESULTS: From the seventeen studies included in this review, the overall mean difference showed that individuals with ALS had a significantly smaller CSA in comparison to healthy controls for median, ulnar, C6 root, and phrenic nerves. However, no significant difference in the CSA was found in radial, vagal, sural, and tibial nerves. DISCUSSION: This study confirmed results of some of the included studies regards the anatomic sites, where nerve atrophy in ALS could be detected to potentially support the diagnosis of ALS. However, we recommend further large, prospective studies to assess the diagnostic value of these anatomical sites for the diagnosis of ALS. CONCLUSIONS: Our findings confirmed specific anatomic sites to differentiate ALS patients from healthy controls through ultrasound. However, these findings cannot be used to confirm the ALS diagnosis, but rather assist in differentiating it from other diagnoses. TRIAL REGISTRATION: Retrospectively registered on July 30th 2024 in PROSPERO (PROSPERO (york.ac.uk)) with ID574702.

• Publikační typ
• časopisecké články MeSH

BACKGROUND: Here, we conducted a scoping review to (i) establish which machine learning (ML) methods have been applied to hematological malignancy imaging; (ii) establish how ML is being applied to hematological cancer radiology; and (iii) identify addressable research gaps. METHODS: The review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews guidelines. The inclusion criteria were (i) pediatric and adult patients with suspected or confirmed hematological malignancy undergoing imaging (population); (ii) any study using ML techniques to derive models using radiological images to apply to the clinical management of these patients (concept); and (iii) original research articles conducted in any setting globally (context). Quality Assessment of Diagnostic Accuracy Studies 2 criteria were used to assess diagnostic and segmentation studies, while the Newcastle-Ottawa scale was used to assess the quality of observational studies. RESULTS: Of 53 eligible studies, 33 applied diverse ML techniques to diagnose hematological malignancies or to differentiate them from other diseases, especially discriminating gliomas from primary central nervous system lymphomas (n=18); 11 applied ML to segmentation tasks, while 9 applied ML to prognostication or predicting therapeutic responses, especially for diffuse large B-cell lymphoma. All studies reported discrimination statistics, but no study calculated calibration statistics. Every diagnostic/segmentation study had a high risk of bias due to their case-control design; many studies failed to provide adequate details of the reference standard; and only a few studies used independent validation. CONCLUSION: To deliver validated ML-based models to radiologists managing hematological malignancies, future studies should (i) adhere to standardized, high-quality reporting guidelines such as the Checklist for Artificial Intelligence in Medical Imaging; (ii) validate models in independent cohorts; (ii) standardize volume segmentation methods for segmentation tasks; (iv) establish comprehensive prospective studies that include different tumor grades, comparisons with radiologists, optimal imaging modalities, sequences, and planes; (v) include side-by-side comparisons of different methods; and (vi) include low- and middle-income countries in multicentric studies to enhance generalizability and reduce inequity.

• Klíčová slova
• artificial intelligence, hematological malignancy, machine learning, radiology, scoping review,
• Publikační typ
• časopisecké články MeSH
• scoping review MeSH

PURPOSE: Androgen-regulated enzymes such as the angiotensin-converting enzyme 2 (ACE2) and the transmembrane serine protease 2 (TMPRSS2) are involved in the SARS-CoV-2 infection process. The expression of TMPRSS2 and its fusion gene, which are increased in the epithelium of the human prostate gland during prostate carcinogenesis, are regulated by androgens. Our goal was to assess the risk of the SARS-CoV-2 infection and the severity of the disease in PCa patients treated with androgen deprivation therapy (ADT). METHODS: We conducted a systematic review and meta-analysis according to PRISMA guidelines. We queried PubMed and Web of Science databases on 1 July 2021. We used random- and/or fixed-effects meta-analytic models in the presence or absence of heterogeneity according to Cochrane's Q test and I2 statistic, respectively. RESULTS: Six retrospective studies (n = 50,220 patients) were selected after considering inclusion and exclusion criteria for qualitative evidence synthesis. Four retrospective studies were included to assess the SARS-CoV-2 infection risk in PCa patients under ADT vs. no ADT and the summarized risk ratio (RR) was 0.8 (95% confidence intervals (CI) 0.44-1.47). Five retrospective studies were included to assess the severity of coronavirus disease 2019 (COVID-19) in PCa patients under ADT versus no ADT and the summarized RR was 1.23 (95% CI 0.9-1.68). CONCLUSION: We found a non-significant association between the risk of SARS-CoV-2 infection and COVID-19 severity in PCa patients treated with ADT. However, our results suggest that during the COVID-19 pandemic PCa patients can safely undergo ADT as a cancer therapy without worsening COVID-19 risk and trajectory.

• Klíčová slova
• ADT, Androgen deprivation therapy, COVID-19, Disease severity, Infection risk, Prostate cancer, SARS-CoV-2,
• MeSH
• androgeny MeSH
• antagonisté androgenů terapeutické užití   MeSH
• COVID-19 * MeSH
• lidé MeSH
• nádory prostaty * farmakoterapie   epidemiologie   MeSH
• pandemie MeSH
• retrospektivní studie MeSH
• rizikové faktory MeSH
• SARS-CoV-2 MeSH
• stupeň závažnosti nemoci MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• metaanalýza MeSH
• systematický přehled MeSH
• Názvy látek
• androgeny MeSH
• antagonisté androgenů MeSH

OBJECTIVE: To present an update of the available literature on external beam radiation therapy (EBRT) with or without brachytherapy (BT) compared to radical prostatectomy (RP) for patients with high-risk localised prostate cancer (PCa). METHODS: We conducted a systematic review and meta-analysis of the literature assessing the survival outcomes in patients with high-risk PCa who received EBRT with or without BT compared to RP as the first-line therapy with curative intent. We queried PubMed and Web of Science database in January 2021. Moreover, we used random or fixed-effects meta-analytical models in the presence or absence of heterogeneity per the I2 statistic, respectively. We performed six meta-analyses for overall survival (OS) and cancer-specific survival (CSS). RESULTS: A total of 27 studies were selected with 23 studies being eligible for both OS and CSS. EBRT alone had a significantly worse OS and CSS compared to RP (hazard ratio [HR] 1.38, 95% confidence interval [CI] 1.16-1.65; and HR 1.55, 95% CI 1.25-1.93). However, there was no difference in OS (HR 1.1, 95% CI 0.76-1.34) and CSS (HR 0.69, 95% CI 0.45-1.06) between EBRT plus BT compared to RP. CONCLUSION: While cancer control affected by EBRT alone seems inferior to RP in patients with high-risk PCa, BT additive to EBRT was not different from RP. These data support the need for BT in addition to EBRT as part of multimodal RT for high-risk PCa.Abbreviations: ADT: androgen-deprivation therapy; BT: brachytherapy; CSS: cancer-specific survival; HR: hazard ratio; MFS, metastatic-free survival; MOOSE: Meta-analyses of Observational Studies in Epidemiology; OR: odds ratio; OS: overall survival; PCa: prostate cancer; RR: relative risk; RP: radical prostatectomy; RCT: randomised controlled trials; (EB)RT: (external beam) radiation therapy.

• Klíčová slova
• Brachytherapy, androgen-deprivation therapy, external beam radiation therapy, high-risk prostate cancer, radiation therapy, radical prostatectomy,
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

Recent epidemiological studies have explored the association between organic food consumption and the risk of obesity, but the results remain controversial. A systematic review and meta-analysis were conducted to determine the association between organic food consumption and the risk of obesity. Rigorous methods for a comprehensive search were employed to search for literature in PubMed/MEDLINE, Web of Science, and Embase for relevant articles published until 30 November 2021. Pooled odds ratio (OR) with 95% confidence intervals (Cis) were calculated using a DerSimonian and Laird random-effects model to understand the risk of obesity based on exposure to organic food. Four studies, comprising 104,488 healthy subjects and 39,425 adults who consumed organic food, reported 1625 incident cases of obesity. Compared with the unexposed group, organic food consumption was associated with a lower probability of obesity (OR: 0.89, 95% CI: 0.80-0.97, p < 0.001). Subgroup analysis showed that this association was higher in the cohort (OR: 0.78, 95% CI: 0.63-0.92) than cross-sectional studies (OR: 0.95, 95% CI: 0.91-1.00), respectively. Overall, organic food consumption had a modest reduction (11%) in the risk of obesity and can be an appropriate strategy to prevent obesity.

• Klíčová slova
• behavior, diet, food, lifestyle, nutrition, obesity, overweight,
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

BACKGROUND: Patients undergoing intestinal urinary diversion (IUD) may have a higher risk of osteoporosis and risk of fractures due to metabolic acidosis and decrease of intestinal absorption surface. OBJECTIVE: We performed a systematic review of the available literature on the impact of IUD on bone demineralization. METHODS: We systematically searched PubMed®, for original articles published before April 2020. Primary end points were the risk of fracture and loss of bone density. Secondary outcomes were the metabolic changes in biochemical and urine parameters related to calcium metabolism and histological changes. RESULTS: Our electronic search identified a total of 2417 articles. After a detailed review, we selected 11 studies that addressed the impact of IUD on bone health in 10369 patients. The risk of bone fracture was studied in 3 articles, showing a higher risk in the IUD population. Of the 9 articles evaluating the relation between intestinal urinary diversion and bone density, 5 did find a positive association. One article evaluated the bone metabolism at a cellular level after IUD showing a decrease in bone turnover in this population. Three of the eight studies reporting data on serum parameters related to calcium and phosphate metabolism showed differences. Finally, a correlation between concentration of pyridolines in urine and loss of bone density was found in two of the three studies. CONCLUSIONS: Although published data on BMD are contradictory, patients undergoing IUD seem to be at higher risk of bone fractures. Our finding support the need to implement accessible strategies on osteoporosis screening and prevention in IUD patients.

• Klíčová slova
• Urinary Bladder Neoplasms, acidosis, bone fracture, cystectomy, metabolic diseases, osteoporosis, urinary diversion,
• Publikační typ
• časopisecké články MeSH
• systematický přehled MeSH

Meta-analyses of cross-sectional studies suggest that patients with psychosis have higher circulating levels of C-reactive protein (CRP) compared with healthy controls; however, cause and effect is unclear. We examined the prospective association between CRP levels and subsequent risk of developing a psychotic disorder by conducting a systematic review and meta-analysis of population-based cohort studies. Databases were searched for prospective studies of CRP and psychosis. We obtained unpublished results, including adjustment for age, sex, body mass index, smoking, alcohol use, and socioeconomic status and suspected infection (CRP > 10 mg/L). Based on random effect meta-analysis of 89,792 participants (494 incident cases of psychosis at follow-up), the pooled odds ratio (OR) for psychosis for participants with high (>3 mg/L), as compared to low (≤3 mg/L) CRP levels at baseline was 1.50 (95% confidence interval [CI], 1.09-2.07). Evidence for this association remained after adjusting for potential confounders (adjusted OR [aOR] = 1.31; 95% CI, 1.03-1.66). After excluding participants with suspected infection, the OR for psychosis was 1.36 (95% CI, 1.06-1.74), but the association attenuated after controlling for confounders (aOR = 1.23; 95% CI, 0.95-1.60). Using CRP as a continuous variable, the pooled OR for psychosis per standard deviation increase in log(CRP) was 1.11 (95% CI, 0.93-1.34), and this association further attenuated after controlling for confounders (aOR = 1.07; 95% CI, 0.90-1.27) and excluding participants with suspected infection (aOR = 1.07; 95% CI, 0.92-1.24). There was no association using CRP as a categorical variable (low, medium or high). While we provide some evidence of a longitudinal association between high CRP (>3 mg/L) and psychosis, larger studies are required to enable definitive conclusions.

• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

To evaluate oncological outcomes of primary versus secondary muscle-invasive bladder cancer treated with radical cystectomy. Medline, Embase, Scopus and Cochrane Library were searched for eligible studies. Hazard ratios for overall survival (OS), cancer specific survival (CSS) and progression free survival (PFS) were calculated using survival data extracted from Kaplan-Meier curves. A total of 16 studies with 5270 patients were included. Pooled analysis showed similar 5-year and 10-year OS (HR 1, p = 0.96 and HR 1, p = 0.14) and CSS (HR 1.02, p = 0.85 and HR 0.99, p = 0.93) between primMIBC and secMIBC. Subgroup analyses according to starting point of follow-up and second-look transurethral resection revealed similar results. Subgroup analyses of studies in which neoadjuvant chemotherapy was administered demonstrated significantly worse 5-year CSS (HR 1.5, p = 0.04) but not 10-year CSS (HR 1.36, p = 0.13) in patients with secMIBC. Patients with secMIBC had significantly worse PFS at 5-year (HR 1.41, p = 0.002) but not at 10-year follow-up (HR 1.25, p = 0.34). This review found comparable oncologic outcomes between primMIBC and secMIBC patients treated with RC regarding OS and CSS. Subgroup analysis showed worse 5-year CSS but not 10-year CSS for neoadjuvant chemotherapy in the secMIBC group. Prospective clinical trials incorporating molecular markers, that allow precise risk stratification of secMIBC and further research uncovering underlying molecular and clinical drivers of the heterogeneous group of secMIBC is needed.

• Klíčová slova
• CSS, OS, PFS, neoadjuvant chemotherapy, outcome, primary MIBC, secondary MIBC,
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

OBJECTIVES: To evaluate recurrence and progression risk after simultaneous endoscopic surgery of bladder cancer and benign prostatic hyperplasia (BPH), as simultaneous surgery is not an unusual scenario and theoretically simultaneous transurethral resection of bladder tumour (TURBT) and transurethral resection of the prostate (TURP) can lead to an increased risk of recurrence in the bladder neck and prostatic urethra (BN/PU). METHODS: We conducted a systematic review and meta-analysis to assess the risk of recurrence (i.e. whole bladder and/or BN/PU) and tumour progression as outcomes after a simultaneous endoscopic surgery of bladder tumour and BPH, as compared to TURBT alone. We queried PubMed and Web of Science database on 1 January 2020. We used random- and/or fixed-effects meta-analytic models in the presence or absence of heterogeneity according to the I2 statistic, respectively. RESULTS: Nine retrospective and three clinical trial studies were selected after considering inclusion and exclusion criteria. We conducted the meta-analysis on retrospective and randomised controlled trials (RCTs) separately. Eight retrospective and three RCT studies were included to assess the BN/PU recurrence risk and the summarised risk ratio (RR) was 1.02 (95% confidence interval [CI] 0.74-1.41) and 0.93 (95% CI 0.47-1.84), respectively. Five retrospective and two RCT studies were included to assess the progression risk and the summarised RR was 0.91 (95% CI 0.56-1.48) and 1.16 (95% CI 0.30-4.51), respectively. Eight retrospective and three RCT studies were included to assess the whole bladder recurrence risk and the summarised RR was 0.87 (95% CI 0.78-0.97) and 0.89 (95% CI 0.65-1.21), respectively. CONCLUSION: We did not observe any increased risk of total bladder recurrence, BN/PU recurrence, or progression after a simultaneous endoscopic surgery of bladder tumour and BPH, as compared to TURBT alone.

• Klíčová slova
• #BladderCancer, #blcsm, TURBT, TURP, benign prostatic hyperplasia, bladder cancer, endoscopic surgery, simultaneous surgery,
• MeSH
• cystektomie škodlivé účinky   MeSH
• hyperplazie prostaty diagnóza   chirurgie   MeSH
• lidé MeSH
• lokální recidiva nádoru diagnóza   MeSH
• močový měchýř diagnostické zobrazování   MeSH
• nádory močového měchýře diagnóza   chirurgie   MeSH
• transuretrální resekce prostaty škodlivé účinky   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• metaanalýza MeSH
• systematický přehled MeSH