X-linked agammaglobulinemia (XLA) was one of the first inborn errors of immunity to be described. It is caused by pathogenic variants in the gene for Bruton tyrosine kinase (BTK), which has important functions in B cell development and maturation. Recurrent bacterial infections in the first two years of life and hypogammaglobulinemia with absent B cells in male patients are the most common symptoms. A four-month-old male patient underwent surgical removal of urachus persistens complicated with recurrent scar abscesses. Hypogammaglobulinemia (IgG, IgA, and IgM), low phagocytic activity, mild neutropenia, and a normal percentage of B cells were observed in the patient's immune laboratory profile. Over time, he suffered recurrent respiratory infections (otitis media and rhinosinusitis) and developed B cell depletion, but interestingly, this was with a normalisation of IgG and IgA levels along with undetectable IgM. Molecular-genetic testing confirmed the presence of the pathogenic variant c.1843C>T in the BTK gene, which is associated with a milder phenotype of XLA. Molecular-genetic testing uncovers the variability of clinical and laboratory features of apparently well-known inherited disorders. Patients with mild "leaky" XLA may have normal levels of non-functional or oligoclonal immunoglobulins.
- Klíčová slova
- BTK gene, Inborn error of immunity, X-linked agammaglobulinemia, atypical leaky phenotype, molecular-genetic testing,
- MeSH
- agamaglobulinemie * genetika diagnóza MeSH
- genetické nemoci vázané na chromozom X * genetika diagnóza MeSH
- genetické testování * MeSH
- kojenec MeSH
- lidé MeSH
- proteinkinasa BTK * genetika MeSH
- Check Tag
- kojenec MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
- Názvy látek
- BTK protein, human MeSH Prohlížeč
- proteinkinasa BTK * 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
Chronic diarrhea is a significant challenge in clinical practice because of its high prevalence and various causes. Comprehensive clinical assessment and stepwise laboratory approach are crucial for an accurate diagnosis. This report presents a case of an adult woman who experienced chronic watery diarrhea, complicated by renal impairment and multiple electrolyte imbalances, including hypokalemia, hypophosphatemia, and metabolic acidosis. The diagnosis of a vasoactive intestinal polypeptide-secreting tumor (VIPoma) with liver metastases was confirmed by elevated serum levels of a vasoactive intestinal polypeptide (VIP) and imaging findings of a pancreatic mass with multiple hepatic lesions. Preoperative management, including fluid rehydration, electrolyte correction, and somatostatin analog therapy, significantly improved her clinical symptoms. Subsequent surgical tumor removal and radiofrequency ablation of the hepatic lesions resulted in complete resolution of symptoms and normalized VIP levels. This case emphasizes the importance of early recognition of this rare tumor in patients with chronic diarrhea to improve clinical outcomes.
- Klíčová slova
- VIPoma, WDHA syndrome, chronic watery diarrhea, functional neuroendocrine tumor, vasoactive intestinal polypeptide,
- MeSH
- chronická nemoc MeSH
- diareogenní nádor * komplikace diagnóza MeSH
- lidé středního věku MeSH
- lidé MeSH
- nádory jater sekundární komplikace MeSH
- nádory slinivky břišní * komplikace MeSH
- průjem * etiologie MeSH
- vazoaktivní intestinální peptid krev MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
- Názvy látek
- vazoaktivní intestinální peptid MeSH
Zirconia ceramics have become popular among other dental ceramics thanks to their biological, mechanical, optical, and aesthetic properties. CAD/CAM (computer-aided design/ computer-aided manufacturing) technology improvement has played a vital role in the increased popularity of zirconia ceramics; easy computer manipulation significantly expanded the possibility of using different types of restorations. Zirconia ceramics have a broad spectrum of indications in prosthetic dentistry, from simple restorations to complex structures supported by dental implants. A good orientation in the classification, features, and manipulation of zirconia ceramics is the main key to success.
- Klíčová slova
- adhesion, production of zirconia, zirconia ceramics, biocompatibility,
- MeSH
- design s pomocí počítače * MeSH
- keramika * MeSH
- lidé MeSH
- zirkonium * MeSH
- zubní materiály MeSH
- zubní protéza - design metody MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
- Názvy látek
- zirconium oxide MeSH Prohlížeč
- zirkonium * MeSH
- zubní materiály MeSH
The study aimed to establish the impact of age on the predictive capability of ferritin, ferritin-hemoglobin ratio (FHR), IL-6, and sIL-2R in COVID-19 patients. Compared to patients with moderate condition, patients with severe condition had higher ferritin level (441.0 [188.0-829.8] ng/mL vs 281.0 [172.0-388.0] ng/mL, p = 0.002), sIL-2R level (6.0 [4.7-9.0] pg/mL vs 5.3 [3.7-6.9] pg/mL, p = 0.020), FHR (38.4 [15.1-63.4] vs 22.0 [12.1-32.1], p = 0.002). The area under the curves (AUC) for discriminative capabilities of the following biomarkers for severe condition were assessed in patients aged <65 years and patients aged ≥65 years: ferritin (AUC = 0.585, p = 0.309 vs AUC = 0.683, p = 0.002), FHR (AUC = 0.589, p = 0.302 vs AUC = 0.688, p = 0.002), IL-6 (AUC = 0.503, p = 0.972 vs AUC = 0.647, p = 0.019), and sIL-2R (AUC = 0.549, p = 0.552 vs AUC = 0.646, p = 0.017). Also AUCs for discriminative capabilities for in-hospital mortality were compared in patients aged <65 years and ≥65 years: ferritin (AUC = 0.607, p = 0.628 vs AUC = 0.661, p = 0.105), FHR (AUC = 0.612, p = 0.621 vs AUC = 0.688, p = 0.002), IL-6 (AUC = 0.580, p = 0.724 vs AUC = 0.695, p = 0.016), and sIL-2R (AUC = 0.620, p = 0.491 vs AUC = 0.695, p = 0.029). Thus, ferritin, FHR, IL-6, and sIL-2R didn't show acceptable predictive value for severe condition and lethal outcome in patients aged <65 years but had high predictive value for lethal outcome in patients aged ≥65 years.
- Klíčová slova
- COVID-19, IL-6, age, ferritin, mortality, prediction, severity, soluble IL-2 receptors,
- MeSH
- biologické markery * krev MeSH
- COVID-19 * mortalita krev MeSH
- ferritin * krev MeSH
- hemoglobiny analýza metabolismus MeSH
- interleukin-6 * krev MeSH
- lidé středního věku MeSH
- lidé MeSH
- prediktivní hodnota testů MeSH
- receptory interleukinu-2 krev MeSH
- SARS-CoV-2 MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- stupeň závažnosti nemoci * MeSH
- věkové faktory 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
- Názvy látek
- biologické markery * MeSH
- ferritin * MeSH
- hemoglobiny MeSH
- interleukin-6 * MeSH
- receptory interleukinu-2 MeSH
Despite advances in neonatal care, neonatal jaundice remains a common problem in maternity wards. The present retrospective epidemiological study collected data on a sample of 710 newborns and compared the incidence of neonatal jaundice in infants born to Rh (D) negative and 0 Rh (D) positive mothers. The primary aim was to determine whether the higher incidence of maternal alloimmunisation in newborns was causally related to a potentially higher incidence of neonatal jaundice in newborns of 0 Rh (D) positive mothers. To the end, we investigated a possible association between the incidence of neonatal jaundice in 0 Rh (D) positive mothers and the neonatal blood group. The incidence of neonatal jaundice was not found to differ between maternal blood groups. We discuss new preventive measures that may reduce the incidence of neonatal jaundice and thereby reduce the length of hospital stay.
- Klíčová slova
- AB0 and Rh (D) alloimmunisation, haemolytic disease of the foetus and newborn, neonatal jaundice,
- MeSH
- incidence MeSH
- krevní skupiny - systém Rh-Hr MeSH
- lidé MeSH
- novorozenec MeSH
- novorozenecká žloutenka * epidemiologie etiologie MeSH
- retrospektivní studie MeSH
- Rh izoimunizace epidemiologie MeSH
- těhotenství MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- novorozenec MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- krevní skupiny - systém Rh-Hr MeSH
BACKGROUND: The cranial nerve (CN) V and adjacent neurovascular structures are crucial landmarks in microvascular decompression (MVD). MVD of CN V is the most effective treatment for patients with drug-resistant trigeminal neuralgia (TN) diagnosis. The endoscope-assisted retrosigmoid approach (RSA) provides better exposure and less cerebellar retraction in the corridor towards the cerebellopontine angle (CPA). METHODS: Five adult cadaver heads (10 sides) underwent dissection of the MVD in park bench position. MVD was simulated using microsurgical RSA, and the anatomical landmarks were defined. Microsurgical dissections were additionally performed along the endoscopic surgical path. Additionally, we present an illustrative case with TN caused by anterior inferior cerebellar artery (AICA) compression. The CN V and its close relationships were demonstrated. Endoscopic and microscopic three-dimensional pictures were obtained. RESULTS: This study increases the anatomical and surgical orientation for CN V and surrounding structures. The CN V arises from the lateral part of the pons and runs obliquely upward toward the petrous apex. It has motor roots that leave from pons antero-supero-medial direction to the sensory root. The endoscopic instruments provide perfect visualization with minimal cerebellar retraction during MVD. CONCLUSION: MVD surgically targets the offending vessel(s) leading to TN and aims to create a disconnected area. The combination of preoperative radiographic assessment with and anatomical correlation provides safe and effective application while facilitating selection of the most appropriate approach. The RSA allows satisfactory visualization for CN V. Endoscope-assisted microsurgery through the CPA is a challenge, it should be performed with advanced anatomical knowledge.
- Klíčová slova
- anatomy, endoscopic, microvascular decompression, neurovascular, trigeminal,
- MeSH
- endoskopie metody MeSH
- lidé MeSH
- mikrovaskulární dekomprese (chirurgie) * metody MeSH
- neuralgie trigeminu * chirurgie MeSH
- senioři MeSH
- Check Tag
- lidé MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
Recent advancements in digital technologies have transformed clinical workflows in dentistry, ensuring precise restorations. Custom-made crowns and fixed partial dentures (FPDs) now rely on virtual articulation. The digital facebow provides individualized data for CAD settings, streamlining the fabrication via digital workflow. For the purpose of demonstrating the differences observed during fabrication, we present a case report involving a 68-year-old patient seeking a replacement for missing teeth 24, 25, 26, and 27. The treatment plan involved the fabrication of an implant-supported FPD using monolithic zirconia (ZrO2). However, technical hurdles emerged during the planning phase, primarily due to spatial limitations posing a risk of mechanical failure over time. Consequently, we pivoted approach towards a porcelain fused to metal (PFM) FPD. For the PFM FPD, individual values from the digital facebow adjusted both virtual and conventional articulators. For comparison, two ZrO2 FPDs were milled-individual settings and average settings. All restorations underwent assessment for occlusion in maximal intercuspal position and eccentric mandible movements. In conclusion, the case report showed that individualized PFM FPD required minimal adjustments compared to milled ZrO2 restorations, whether using individual or average values. Utilizing individual values from the digital facebow reduced operator working time and minimized the intraoral adjustments.
- Klíčová slova
- CAD/CAM, digital, facebow, implant-supported crowns,
- MeSH
- design s pomocí počítače * MeSH
- lidé MeSH
- průběh práce MeSH
- senioři MeSH
- zirkonium MeSH
- zubní korunky * MeSH
- zubní náhrada ve spojení s implantáty * metody MeSH
- zubní náhrady částečné fixní MeSH
- zubní protéza - design metody MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
- Názvy látek
- zirconium oxide MeSH Prohlížeč
- zirkonium MeSH
The advent and dominance of social media in our daily lives is not a matter of discussion, and very few minimalistic individuals have tried to decrease this technological dependency, which can become toxic and noxious for the development of an autonomous personality and free thinking. Academic faculties claim a depauperation in terms of their freedom but are also not free from duties, responsibilities, and obligations. Here, duties, responsibilities, obligations, and freedom are addressed in historical terms as the university as an institution developed over the centuries after its founding in the 11th century is currently under attack. We premonish that these concepts must still be reiterated and divulgated to students and fellows in academia. Galilei's "Eppur si muove" ("and yet it moves") are the words pronounced by the Italian mathematician, physicist, and philosopher Galileo Galilei that should resonate in censorship bodies now and in the future.
- Klíčová slova
- academic freedom boundaries, obligations, responsibilities,
- MeSH
- dějiny 20. století MeSH
- lidé MeSH
- svoboda * MeSH
- univerzity dějiny MeSH
- Check Tag
- dějiny 20. století MeSH
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- historické články MeSH
INTRODUCTION: The sex ratio at birth (male/total births, M/T) is expected to approximate 0.515. M/T is influenced by many factors including stress. Both World Wars have been implicated as influencing birth rates and M/T. This study was carried out to analyse the effects of two World Wars on Belgium vis-à-vis missing births as well as M/T changes. METHODS: Belgian male and female births were available for 1830-2019 and annual population was available from Statista. ARIMA models were used to estimate and project birth losses. The effect of wars was assumed to begin in the years following the commencement of each war and extend to the year after cessation of hostilities i.e., 1915-1919 and 1940-1946 for the First and Second World Wars respectively. RESULTS: This study included 27,346,178 live births for 1830-2019, M/T 0.5124. There was a decreasing trend in births for 1830-2019, significant for 1950-2019. There were dips in births in association with both Wars resulting in over 440,000 missing births, 3.80% of the Belgian population for the First World War and 1.91% for the Second World War. M/T rose non-significantly for the First World War and significantly for the Second World War. DISCUSSION: The declining birth rate and M/T in developed countries is a recognised phenomenon. The missing births in relation to wars are of demographic importance but are often overlooked with emphasis usually on casualties and deaths. M/T may rise in wars, possibly due to increased coital activity as well as other factors.
- Klíčová slova
- Belgium, World War I., World War II., humans, live birth, sex ratio,
- MeSH
- 1. světová válka * MeSH
- 2. světová válka * MeSH
- dějiny 19. století MeSH
- dějiny 20. století MeSH
- lidé MeSH
- novorozenec MeSH
- poměr pohlaví * MeSH
- porodnost * trendy MeSH
- Check Tag
- dějiny 19. století MeSH
- dějiny 20. století MeSH
- lidé MeSH
- mužské pohlaví MeSH
- novorozenec MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- historické články MeSH
- Geografické názvy
- Belgie epidemiologie MeSH