INTRODUCTION: It is hypothesized that systemically administered antibiotics penetrate wound sites more effectively during negative pressure wound therapy (NPWT). However, there is a lack of clinical data from patients who receive NPWT for deep sternal wound infection (DSWI) after open-heart surgery. Here, we evaluated vancomycin penetration into exudate in this patient group. PATIENTS AND METHODS: For this prospective observational study, we enrolled 10 consecutive patients treated with NPWT for post-sternotomy DSWI. On the first sampling day, serum and exudate samples were synchronously collected at 0 (pre-dose), 0.5, 1, 2, 3 and 6 h after vancomycin administration. On the following three consecutive days, additional samples were collected, only before vancomycin administration. RESULTS: The ratio of average vancomycin concentration in wound exudate to in serum was higher for free (unbound) (1.51 ± 0.53) than for total (bound + unbound) (0.91 ± 0.29) concentration (p = 0.049). The percentage of free vancomycin was higher in wound exudate than serum (0.79 ± 0.19 vs. 0.46 ± 0.16; p = 0.04). Good vancomycin wound penetration was maintained on the following three days (vancomycin trough exudate-to-serum concentration ratio > 1). The total hospital stay was significantly longer in patients with DSWI (46 ± 11.6 days) versus without DSWI (14 ± 11.7 days) (p < 0.001). There was no in-hospital or 90-day mortality. Two patients experienced late DSWI recurrence. All-cause mortality was 4.8% during a median follow-up of 2.5 years. CONCLUSION: Vancomycin effectively penetrates wound exudate in patients receiving NPWT for DSWI after open-heart surgery.The protocol for this study was registered at ClinicalTrials.gov on July 16, 2024 (NCT06506032).

Vancomycin effectively penetrates into wound exudate in patients receiving NPWT to treat post-sternotomy DSWI after open-heart surgery.NPWT promotes the penetration of vancomycin into the infection site.

• Klíčová slova
• Deep sternal wound infection, exudate, negative pressure wound therapy, open-heart surgery, vancomycin, wound penetration,
• MeSH
• antibakteriální látky * farmakokinetika   aplikace a dávkování   MeSH
• exsudáty a transsudáty metabolismus   mikrobiologie   MeSH
• infekce chirurgické rány * MeSH
• kardiochirurgické výkony * škodlivé účinky   MeSH
• lidé středního věku MeSH
• lidé MeSH
• prospektivní studie MeSH
• senioři MeSH
• sternotomie * škodlivé účinky   MeSH
• sternum chirurgie   MeSH
• terapie ran pomocí řízeného podtlaku * metody   MeSH
• vankomycin * aplikace a dávkování   farmakokinetika   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• pozorovací studie MeSH
• Názvy látek
• antibakteriální látky * MeSH
• vankomycin * MeSH

Meta-analyses of observational and clinical studies conducted in recent years have raised serious doubts about the validity of the low-fat dietary recommendations introduced in the late 1970s/early 1980s, due to the absence of any convincing link between saturated fat and the risk of cardiovascular diseases. At the same time, long-term food supply statistics from the FAOSTAT database show that these recommendations were at the root of fundamental dietary changes in Western countries, which resulted in a lower consumption of eggs and red meat, a higher consumption of cereals and poultry, a decline in average protein quality and, overall, in a higher glycemic load of the diet. Because current views on human nutrition are based primarily on highly unreliable questionnaire data from observational studies, the purpose of this commentary is to provide an alternative ecological (country-level) perspective and to trace the consequences of these nutritional changes using the FAOSTAT database in combination with available anthropological and health statistics. This comparison shows a close connection between the decline in protein quality and the sudden reversal of the positive height trend in some Western countries, after ∼150 years of continuous growth, which points to suboptimal levels of child nutrition. The sharp increase in the prevalence of obesity and type 2 diabetes is strongly correlated with the increasing consumption of high-glycemic carbohydrates and sweeteners, and is also interconnected with the decrease in body height, because a high-quality, growth-stimulating diet during adolescence is inversely related to obesity. Given the long-term association between height and phenotypic IQ, the lower quality of nutrients in children's diet may also seriously affect intellectual potential and future civilizational development. In light of these findings, current nutritional strategies should be seriously reconsidered and recommended protein intakes for children must be urgently reevaluated.

• Klíčová slova
• Child health, flynn effect, nutrition, obesity, physical growth,
• MeSH
• diabetes mellitus 2. typu epidemiologie   MeSH
• dieta * trendy   MeSH
• dítě MeSH
• lidé MeSH
• mladiství MeSH
• obezita * epidemiologie   MeSH
• tělesná výška * MeSH
• zásobování potravinami * statistika a číselné údaje   MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• mladiství MeSH
• Publikační typ
• časopisecké články MeSH

From tumorigenesis to the establishment of local or metastatic high-grade tumours, an integral part of the cellular lifespan relies on various signalling pathways. Particular pathways that allow cells to proliferate by creating a network of new blood vessels have been documented, whereas other pathways are primarily involved with a migration to distant body parts, partially through the process of epithelial-mesenchymal transition (EMT). This review will discuss the different signalling pathways, such as TGF-β, Cripto-1, Wnt pathways, Hedgehog, Notch and NF-κB pathways, and how they promote tumour initiation and progression by influencing diverse cellular processes and EMT in general and in benign and malignant prostate tumours. This review will discuss only the critical pathways. Therefore, many other types of signalling pathways which are related to prostate cancer will not be discussed. Possibilities for further investigation will be mentioned, as many underlying mechanisms involved in these pathways have potential as targets in future tumour therapy. This review will also introduce some novel clinical trials relating to the inhibition of signalling pathways and their clinical outcomes.

• Klíčová slova
• EMT, Hedgehog, NF-κB, Notch, Prostate cancer, TGF, WNT/β-catenin, castration resistance, signalling pathways, therapeutic target, β,
• MeSH
• epitelo-mezenchymální tranzice fyziologie   MeSH
• lidé MeSH
• nádory prostaty * patologie   metabolismus   terapie   farmakoterapie   MeSH
• NF-kappa B metabolismus   MeSH
• proteiny hedgehog metabolismus   MeSH
• signální transdukce * fyziologie   MeSH
• transformující růstový faktor beta metabolismus   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Názvy látek
• NF-kappa B MeSH
• proteiny hedgehog MeSH
• transformující růstový faktor beta MeSH

PURPOSE: To assess motor performance among Czech paediatric off therapy patients of acute lymphoblastic leukaemia (ALL) and to compare their data with normative data. METHODS: Thirty-nine off therapy patients (21 girls, 18 boys; aged 4-21 years) were evaluated using the Complete Form of the Bruininks-Oseretsky Test Second Edition (BOT-2 CF) approximately 1.5 years post-therapy cessation. Gross and fine motor skills were assessed. Normative data from BOT-2 CF served as the basis for comparison. RESULTS: The total motor composite (p = .381, Cohen's d = 0.14) and overall fine (p = .743; Cohen's d = 0.05) and gross (p=.312; Cohen's d = 0.16) motor performance were similar to the normative data. Motor deficits in manual coordination (p = .018; Cohen's d = 0.45), strength and agility (p = .012; Cohen's d = 0.51), manual dexterity (p < .001; Cohen's d = 0.59) and running speed and agility (p < .001; Cohen's d = 0.97) were identified, along with performance better than the established norms on fine motor integration (p = .048; Cohen's d = 0.33) and bilateral coordination (p = .018; Cohen's d = 0.47). CONCLUSION: The findings suggest nuanced motor skill outcomes in ALL off therapy patients, with both deficits and strengths observed. Comprehensive assessments are vital for tailoring rehabilitation strategies to address the varied impacts of ALL and its treatment on motor skills.

• Klíčová slova
• Bruininks-Oseretsky test of motor proficiency (BOT-2 CF), Paediatric acute lymphoblastic leukaemia (ALL), motor performance deficits, motor skills assessment, rehabilitation in paediatric oncology,
• MeSH
• akutní lymfatická leukemie * patofyziologie   komplikace   farmakoterapie   MeSH
• dítě MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• motorické dovednosti * fyziologie   MeSH
• poruchy motorických dovedností * diagnóza   etiologie   MeSH
• předškolní dítě MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• předškolní dítě MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH

BACKGROUND: The current negative trend in the physical behavior and lifestyle of the population therefore requires adequate changes in the professional training of physiotherapists. OBJECTIVES: This study aimed to determine the structure and differences in the weekly physical activity (PA) of Czech physiotherapy students, the use of wearables in physiotherapy professional training, and the attitude of physiotherapy students toward PA and the use of wearables in physiotherapy practice. METHODS: Between 2013 and 2022, 412 physiotherapy students participated in a PA-monitoring study using questonnaires International Physical Activity Questionnaire-long form, Motives for Physical Activity Measure-Revise, pedometers, Garmin Vívofit and Axivity AX3 accelerometers. RESULTS: A retrospective analysis of physiotherapy students PA drew attention to insufficient weekly PA and insufficient achievement of the PA recommendation of at least 60 min five times a week (55% of men and 41% of women). Instrumental PA monitoring allowed analyzing individual daily PA and structure of weekly PA. Highest PA indicated men (14,102 steps/day) and women (12,724 steps/day) of the 1st study year on Tuesday. The lowest PA (9,488 steps/day for men and 8,815 steps/day for women), were observed in the 4th study year on Sundays. The recommended target of 11,000 steps per day was achieved by 40% of the men and 46% of the women. Wearables enhanced participants PA motivation (51%). CONCLUSIONS: The inclusion of weekly PA monitoring in the professional training of physiotherapists ensured a deeper insight into the possibilities of PA monitoring in physiotherapy practice . Students are prepared to use wearables more widely to improve physical therapy practice.

The study demonstrated the need for greater support for physical activity (PA) of physiotherapy students during their studies.Incorporating comprehensive weekly PA monitoring into physiotherapy education is essential, especially with the rapid development of wearable technology.Monitoring PA using different methods enabled students to better assess the possibilities of using wearables in physiotherapy practice.

• Klíčová slova
• Physical activity, lifestyle, monitoring, professional education, wearables,
• MeSH
• cvičení * fyziologie   MeSH
• dospělí MeSH
• fyzioterapeuti * výchova   MeSH
• lidé MeSH
• mladý dospělý MeSH
• motivace MeSH
• postoj zdravotnického personálu MeSH
• průzkumy a dotazníky MeSH
• retrospektivní studie MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH

BACKGROUND: Inflammatory bowel diseases (IBD), comprising ulcerative colitis and Crohn's disease, have a profound impact on people's lives. This study aims to investigate the perceived impact of IBD on sexual life and family planning to enhance understanding of the interplay between IBD, sexuality, intimacy and family planning to foster a better quality of life for those living with the condition. MATERIALS AND METHODS: The study used the qualitative DIPEx method (Database of Personal Experiences of Health and Illness) developed by the Health Experiences Research Group at the University of Oxford, standardized for the Czech Republic. Semi-structured interviews with 36 participants (19 with Crohn's disease, 17 with ulcerative colitis) were conducted, employing open coding and thematic analysis. The maximum variation sampling was utilized, considering various factors, such as disease stage, medications, treatments, age, age at diagnosis and sociodemographic characteristics. RESULTS: Five main topics emerged: sexual activity, body image and discomfort, partner relationships, family planning, and the role of gastroenterologists in family planning decisions. Participants' perceptions of sexuality varied, with some experiencing reduced sexual activity during acute phases of the disease. IBD had contrasting effects on partner relationships, and family planning was an important concern, with women valuing support and collaboration with their gastroenterologists in making pregnancy decisions. Information dissemination and open communication from professionals are highly needed. CONCLUSIONS: This is the first study concerning the sexuality and family planning of people with IBD in the Czech Republic. It highlights the need for information and open communication from professionals.

Intimacy and Family Planning in Inflammatory Bowel Diseases. This study focuses on understanding how Inflammatory Bowel Diseases (IBD) like ulcerative colitis and Crohn’s disease affect personal aspects of life such as sexual activity, relationships, and decisions about starting a family. Through interviews with 36 individuals living with IBD, researchers found that these conditions can significantly impact one’s sex life, how they see themselves, their comfort with their bodies, and their relationships with partners. It also explored how people with IBD make decisions about having children, often needing more guidance and open conversations with their doctors. The findings emphasize the importance of clear communication and support from healthcare professionals to improve the quality of life for those with IBD. This research is a first of its kind in the Czech Republic.

• Klíčová slova
• Crohn’s disease, IBD, family planning, sexuality, ulcerative colitis,
• MeSH
• Crohnova nemoc * psychologie   MeSH
• dospělí MeSH
• idiopatické střevní záněty psychologie   MeSH
• kvalita života * MeSH
• kvalitativní výzkum * MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• představa o vlastním těle psychologie   MeSH
• senioři MeSH
• sexualita psychologie   MeSH
• sexuální chování * psychologie   MeSH
• sexuální partneři psychologie   MeSH
• služby plánování rodičovství * MeSH
• ulcerózní kolitida * psychologie   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
• Geografické názvy
• Česká republika MeSH

INTRODUCTION: Previous research has raised concerns about high prevalence of drug-related problems, polypharmacy and inappropriate benzodiazepine prescribing in nursing homes (NHs) and confirmed lack of studies from Central and South-Eastern Europe. The aim of our study was to determine the prevalence and characteristics of polypharmacy, hyperpolypharmacy and inappropriate benzodiazepine prescribing in NH residents in Croatia. METHODS: Data from 226 older NH residents from five Croatian NHs were collected using the InterRAI Long-Term Care Facilities assessment form. The prevalence and determinants of polypharmacy/hyperpolypharmacy and patterns of inappropriate benzodiazepine prescribing were documented. RESULTS: The prevalence of polypharmacy (49.6%) and hyperpolypharmacy (25.7%) among NH residents was high. In our study, 72.1% of NH residents were prescribed at least one psychotropic agent, 36.7% used 2-3 psychotropics and 6.6% used 4+ psychotropics. Among benzodiazepine users (55.8%), 28% of residents were prescribed benzodiazepines in higher than recommended geriatric doses, 75% used them for the long term and 48% were prescribed concomitant interacting medications. The odds of being prescribed polypharmacy/hyperpolypharmacy were significantly higher for older patients with polymorbidity (6+ disorders, proportional odds ratio (POR) = 19.8), type II diabetes (POR = 5.2), ischemic heart disease (POR = 4.6), higher frailty (Clinical Frailty Scale (CFS ≥5); POR = 4.3) and gastrointestinal problems (POR = 4.8). CONCLUSIONS: Our research underscores the persistent challenge of inappropriate medication use and drug-related harms among older NH residents, despite existing evidence and professional campaigns. Effective regulatory and policy interventions, including the implementation of geriatrician and clinical pharmacy services, are essential to address this critical issue and ensure optimal medication management for vulnerable NH populations.

• Klíčová slova
• Nursing home residents, geriatric deprescribing, inappropriate benzodiazepine prescribing, polypharmacy/hyperpolypharmacy, psychiatric polypharmacy/hyperpolypharmacy,
• MeSH
• benzodiazepiny * terapeutické užití   škodlivé účinky   aplikace a dávkování   MeSH
• domovy pro seniory statistika a číselné údaje   MeSH
• lékařská praxe - způsoby provádění statistika a číselné údaje   normy   MeSH
• lidé MeSH
• nevhodné předepisování * statistika a číselné údaje   MeSH
• pečovatelské domovy * statistika a číselné údaje   MeSH
• polypharmacy * MeSH
• prevalence MeSH
• psychotropní léky terapeutické užití   škodlivé účinky   MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Chorvatsko epidemiologie   MeSH
• Názvy látek
• benzodiazepiny * MeSH
• psychotropní léky MeSH

BACKGROUND: In the last three decades, both medical and sports science professionals have recognized the considerable potential of digital-based interventions (DBI) to enhance the health-related outcomes of their practitioners. OBJECTIVES: This study aimed to investigate the effectiveness and potential moderators of DBI on measures of muscular strength. METHODS: Six databases (PubMed/MEDLINE, Web of Science, SportDiscus, Embase, Cochrane Register of Controlled Trials and Google Scholar) were searched for eligible studies up to June 2022. The GRADE, PEDRO, and TIDieR checklists were used to assess the quality of evidence, methodology, and completeness of intervention descriptions, respectively. RESULTS: A total of 56 studies were included in the meta-analysis (n = 2346), and participants were classified as healthy (n = 918), stroke survivors (n = 572), diagnosed with other neurological disorders (n = 683), and frail (n = 173). The DBI showed a small effect (standardized mean difference [SMD] = 0.28, 95% CI 0.21 to 0.31; p < 0.001) on strength, regardless of the type of intervention, control group, or tested body part. More specifically, while splitting the studies into different subgroups, a meta-analysis of 19 studies (n = 918) showed a small effect (SMD = 0.38, 95% CI 0.12 to 0.63; p = 0.003) on strength in the asymptomatic population. Similarly, small but positive effects of DBI were observed for stroke survivors (SMD = 0.34, 95% CI 0.13 to 0.56; p = 0.002), patients diagnosed with other neurological disorders (SMD = 0.17, 95% CI 0.03 to 0.32; p = 0.021), and the frail population (SMD = 0.25, 95% CI 0.0 to 0.5; p = 0.051). Sub-group analysis and meta-regression revealed that neither variable modified the effects of the DBI on measures of strength. CONCLUSIONS: Overall, DBI may serve as an effective method to improve measures of strength in adults, regardless of their health status as well as the type of digital device, the presence of human-computer interaction, and the age of participants. In addition, the DBI was found to be more effective than traditional training or rehabilitation methods.KEY MESSAGESDigital-based intervention (DBI) is effective in improving measures of muscular strength in adults regardless of participants' health statusDBIs were equally effective for strength improvements in lower and upper limbsAlthough, DBIs were found to be effective in improving muscular strength, most studies did not follow strength training guidelines when prescribing the interventions.

• Klíčová slova
• (registration number: CRD42022337043), Cognitive training, frailty, neurodegenerative disorders, older adults, physical function, strength,
• MeSH
• cévní mozková příhoda * MeSH
• dospělí MeSH
• lidé MeSH
• randomizované kontrolované studie jako téma MeSH
• rehabilitace po cévní mozkové příhodě * metody   MeSH
• svalová síla MeSH
• zdravotní stav MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• metaanalýza MeSH
• práce podpořená grantem MeSH
• systematický přehled MeSH

BACKGROUND: Patient safety strategies highlight patients' own active involvement in ensuring medication safety. A prerequisite for involving patients in their medication therapy is having tools that can assist them in ensuring safe medicine use. Older home-dwelling adults with multiple medications are at high risk for medication-related problems, yet only a few age-specific patient self-administered medication risk screening tools exist. This study aimed to develop, validate, and assess the feasibility of a self-administered medication risk checklist for home-dwelling older adults ≥65 years. MATERIALS AND METHODS: The draft checklist was formed based on a validated practical nurse-administered Drug Related Problem Risk Assessment Tool supplemented with findings from two systematic literature reviews. The content validity of the draft checklist was determined by a three-round Delphi survey with a panel of 19 experts in geriatric care and pharmacotherapy. An agreement of ≥80% was required. A feasibility assessment (i.e. understandability of the items, fill-out time of the checklist) of the content-validated checklist was conducted among older adults ≥65 years (n = 87) visiting community pharmacies (n = 4). Data were analysed using qualitative content analysis. RESULTS: The final validated and feasibility-tested Medication Risk Checklist (LOTTA) for home-dwelling older adults consists of eight items screening the highest priority systemic risks (three items), potentially drug-induced symptoms (one item), adherence, and self-management problems (four items). The checklist proved feasible for self-administration, the mean fill-out time being 6.1 min. CONCLUSIONS: A wide range of potential medication risks related to the medication use process can be identified by patient self-assessment. Screening tools such as LOTTA can enhance early detection of potential medication risks and risk communication between older adults and their healthcare providers. A wider and more integrated use of the checklist could be facilitated by making it electronically available as part of the patient information systems.

Patient safety strategies highlight patients’ own active involvement in ensuring medication safety, which in turn, requires easy-to-use tools to self-assess potential medication risks and communicate them with healthcare providers.This study produced a short, age-specific eight item Medication Risk Checklist (LOTTA) to be self-administered by home-dwelling older adults to identify major systemic risks, potential drug-induced symptoms, adherence, and self-management problems related to medication taking.To facilitate the use of the checklist in early detection of potential medication risks, future studies should focus on converting the LOTTA list into electronic form and pilot its use as an integrated part of the electronic patient information system.

• Klíčová slova
• Medication therapy, older adults, patient safety, primary care, risk screening, self-management,
• MeSH
• bezpečnost pacientů MeSH
• kontrolní seznam * MeSH
• lidé MeSH
• sebezhodnocení (psychologie) * MeSH
• senioři MeSH
• zdravotnický personál MeSH
• Check Tag
• lidé MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

Introduction: The six-minute walk test (6MWT) is a well-established tool for assessing submaximal functional capacity for cardiac patients, but space limitations challenge its implementation. Treadmill-based (TR) 6MWT is a promising alternative, but it requires patients to complete a familiarization test to adapt treadmill speed regulation. With the advancement of sensors, it is possible to automatically control speed for individual patients and thus overcome the space limitation or the speed control difficulty on the treadmill for each patient.Methods: This study investigated the validity and interchangeability of automated speed TR6MWT and standard hallway (HL) 6MWT. Eighteen patients were assessed at baseline of the 12-week cardiac rehabilitation program. Fourteen of them were assessed after rehabilitation. All patients performed three TR6MWTs and three HL6MWTs at baseline and one of each test after the program.Results: Patients well tolerated the TR6MWT. There was a strong correlation between both test methods (r = 0.79). However, patients performed significantly better in HL6MWT (514.8m ± 59.7m) than in TR6MWT (447.2 ± 79.1m) with 95% CI, 40.4-94.6m, p < 0.05. Both tests showed high test-retest reliability (intraclass correlation coefficient of 0.86). The TR6MWT showed a valuable comparison of the effect of the cardiac rehabilitation program (20% increase, effect size 1.1) even though it is not interchangeable with the HL6MWT.Conclusion: The automated speed TR6MWT appears to be an acceptable tool with adequate validity, reliability, and responsiveness for assessing functional capacity in patients utilizing cardiac rehabilitation programs.

• Klíčová slova
• Six minute walk test, automatized treadmill, cardiac rehabilitation, functional capacity, technology-assisted assessment,
• MeSH
• chůze fyziologie   MeSH
• kardiovaskulární rehabilitace * MeSH
• lidé MeSH
• reprodukovatelnost výsledků MeSH
• test chůzí MeSH
• zátěžový test metody   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH