INTRODUCTION: Multidisciplinary teams (MDTs) have become a standard part of treating oncological patients. Based on the available data, they have lead to significantly higher survival rates in the treatment of colorectal cancer (CRC). Reported negatives include potentially longer times between diagnoses and the start of appropriate treatment, and the lack of quality controls over the MTDs actions. This report aims to assess the benefits of MDTs using our own data set for 2017. METHODS: Year 2010 saw the institution of an MDT at the Central Military University Hospital in Prague, with the obligation to refer CRC patients to the MDT before the start of treatment. Having standardized the registration, we have implemented a simple procedure to track the quality of our MDTs involvement and its patient benefits: number of patients, number of referrals with proposed diagnostic and therapeutic procedure, frequency and reason of changes to original strategies, and the frequency of variations from the MDTs conclusions. RESULTS: 405 CRC patients were referred to the MDT in 2017; we have found 499 referrals in this group. The data set was formed predominantly by men (61%), with the mean age of 63 (21-91), and the median age of 64.5 years. Surgical treatment was the most commonly proposed procedure (59%), followed by systemic treatment or, as the case may be, radiotherapy. In 24% of the cases, the conclusion did not match the originally proposed procedure. The decision not to go through with the proposed surgical treatment was the most common change (66 %). We have found a difference in the quality of referral in patients examined specifically by the referring doctor, as opposed to patients whose medical records have just been sent in. We have found therapeutic variation in the MTDs conclusions in less than 5% of patients. CONCLUSION: Having analyzed our data for CRC patients referred to the MDT in 2017, we have found out that in 24% of the patients, the MDT referral leads to a change in the originally proposed diagnostic and therapeutic procedure. Consensus among the MDTs members on the CRC patients treatment guarantees an optimum procedure. What is fundamental is that the referring doctor knows the patient. Constant tracking of the MDTs outputs forms a condition for sustaining the quality of its work and a base for assessing its benefits to the patients.

• Klíčová slova
• multidisciplinary team, colorectal cancer, colorectal liver metastases,
• MeSH
• dospělí MeSH
• klinické rozhodování MeSH
• kolorektální nádory diagnóza   mortalita   terapie   MeSH
• kvalita zdravotní péče * MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• týmová péče o pacienty normy   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

BACKGROUND: Huntington's disease is a complex neurodegenerative hereditary disease with symptoms in all domains of a person's functioning. It begins after a healthy start in life and leads through the relentless progression over many years to complete care dependency and finally death. To date, the disease is incurable. The long progressive complex nature of the disease demands multiple disciplines for treatment and care of patient and family. These health care providers need inter- and multidisciplinary collaboration to persevere and be efficacious in this devastating disease trajectory. DISCUSSION: The position paper outlines current knowledge and experience alongside the experience and consensus of a recognised group of HD multidisciplinary experts. Additionally the patient's voice is clear and calls for health care providers with a holistic view on patient and family. Building long-term trust is a cornerstone of the network around the patient. This paper describes a managed care network comprising all the needed professionals and services. In the health care system, the role of a central coordinator or case manager is of key importance but lacks an appropriate guideline. Other disciplines currently without guidelines are general practitioners, nurses, psychologists, and social workers. Guidelines for neurologists, psychiatrists, geneticists, occupational therapists, speech and language therapists, physiotherapists, dieticians, and dentists are being discussed. Apart from all these profession-specific guidelines, distinctive inter- and multidisciplinary collaboration requirements must be met. CONCLUSIONS AND RECOMMENDATIONS: The complex nature of Huntington's disease demands multidisciplinary treatment and care endorsed by international regulations and the lay association. Available guidelines as reviewed in this paper should be used, made available by a central body, and updated every 3-5 years. Time needs to be invested in developing missing guidelines but the lack of this 'proof' should not prevent the 'doing' of good care.

• Klíčová slova
• Care, Case manager, Guidelines, Huntington’s disease, Interdisciplinary team, Managed care network, Multidisciplinary treatment, Position paper,
• MeSH
• Huntingtonova nemoc * terapie   MeSH
• konsensus MeSH
• lidé MeSH
• poskytování zdravotní péče MeSH
• zdravotnický personál MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

Cleft lip and cleft palate are among the most common congenital defects of the head. The treatment of clefts is centralized, multidisciplinary, and involves a plastic surgeon, orthodontist, anesthesiologist, clinical speech therapist, and other specialists. While the incidence of cleft lip and cleft palate remains approximately unchanged, the approach to their treatment is evolving. Modern treatment methods increasingly include 3D printing and the associated therapeutic and educational possibilities.

• Klíčová slova
• cleft lip and palate, anesthesia in children, 3D printing, 3D models,
• MeSH
• lidé MeSH
• rozštěp patra * terapie   chirurgie   MeSH
• rozštěp rtu * terapie   chirurgie   MeSH
• týmová péče o pacienty MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

• MeSH
• idiopatická plicní fibróza diagnóza   MeSH
• lidé MeSH
• reprodukovatelnost výsledků MeSH
• směrnice pro lékařskou praxi jako téma MeSH
• týmová péče o pacienty * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

INTRODUCTION: The Royal College of Physicians (RCP) and the Royal College of Nursing (RCN) in the United Kingdom advocate the use of structured multidisciplinary team (MDT) ward rounds since they can enable safe, effective, improved care and enhanced staff satisfaction. OBJECTIVES: This project sought to implement best practices for MDT ward rounds in a male medical ward in a hospital in Malawi. METHODS: The project was conducted in line with the JBI Evidence Implementation Framework. A baseline audit of MDT ward rounds was conducted with six staff members. Audit criteria consisted of ten best practices, as recommended by JBI, the RCP, and the RCN. Stakeholder meetings were held to review the baseline audit results and highlight areas of non-compliance. JBI's Getting Research into Practice (GRiP) tool was used to identify barriers to compliance with best practices, and a follow-up audit was conducted to determine changes in practice. RESULTS: The results only showed improvement for one criterion, which rose from 33% to 100% (n=6) where nurses attended the ward round. CONCLUSIONS: This study demonstrated some challenges in evidence implementation projects and how these can, in part, be overcome. While the results only demonstrated improvement for one criterion, this paper shows how audits can be used to promote best practice, which in this case resulted in nurses being more involved in ward rounds, improvements in MDT communication, enhanced nurse inclusion in decision-making and, consequently, patient care. SPANISH ABSTRACT: http://links.lww.com/IJEBH/A233.

• MeSH
• lékařská praxe založená na důkazech * MeSH
• lidé MeSH
• studentská vizita * organizace a řízení   MeSH
• týmová péče o pacienty * organizace a řízení   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Malawi MeSH

Electrical burns are not ranked among the most frequent type of injuries, but they have the most devastating potential of all thermal injuries and often cause lifelong stigmatization. Those primarily affected are young males: work injuries predominate. An electrical burn is a specific nosological unit that has multiple acute and chronic abnormal manifestations. In this study we describe the case of a young man who suffered an electrical injury after contact with a high-voltage line (22,000 volts) while paragliding. This contact was followed by a 10 m fall. In our work we present the need for multidisciplinary cooperation along with the opportunities, problems and risks that accompany the treatment of this type of injury.

• MeSH
• dospělí MeSH
• lidé MeSH
• nehody letecké * MeSH
• poranění elektrickým proudem etiologie   patologie   terapie   MeSH
• týmová péče o pacienty organizace a řízení   MeSH
• zdroje elektrické energie škodlivé účinky   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

Nowadays, selection of appropriate therapy in patients with lung cancer is based on comprehensive molecular characteristics of their tumors. On molecular level, lung cancer is one of the best described solid tumors. Currently, there are already methods in routine clinical practice that enable a relatively quick, accurate and cost-effective analysis of dozens of genes and thus make it possible to determine a complex molecular characteristic of a tumor. This creates new possibilities to tailor the treatment to the patients to achieve long-term survival with a good quality of life. New technologies bring more and more information and to transform it into the best clinical benefit for the patient can be challenging. This is a place for the multidisciplinary approach in the form of a molecular tumor board. Its role is to try to indicate appropriate therapy based on the identified genetic alteration. Today, dozens of targeted drugs are available and new treatment options are emerging even for genetic alterations, which until now seemed to be undruggable.

• Klíčová slova
• comprehensive molecular profiling, lung cancer, molecular tumor board, precision oncology, targeted therapy,
• MeSH
• individualizovaná medicína * MeSH
• kvalita života * MeSH
• lidé MeSH
• mezioborová komunikace * MeSH
• nádory plic terapie   MeSH
• týmová péče o pacienty organizace a řízení   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

OBJECTIVES: Multidisciplinary teams in cancer care are increasingly using information and communication technology (ICT), hospital health information system (HIS) functionalities and ICT-driven care components. We aimed to explore the use of these tools in multidisciplinary team meetings (MTMs) and to identify the critical challenges posed by their adoption based on the perspective of professionals representatives from European scientific societies. DESIGN: This qualitative study used discussion of cases and focus group technique to generate data. Thematic analysis was applied. SETTING: Healthcare professionals working in a multidisciplinary cancer care environment. PARTICIPANTS: Selection of informants was carried out by European scientific societies in accordance with professionals' degree of experience in adopting the implementation of ICT and from different health systems. RESULTS: Professionals representatives of 9 European scientific societies were involved. Up to 10 ICTs, HIS functionalities and care components are embedded in the informational and decision-making processes along three stages of MTMs. ICTs play a key role in opening MTMs to other institutions (eg, by means of molecular tumour boards) and information types (eg, patient-reported outcome measures), and in contributing to the internal efficiency of teams. While ICTs and care components have their own challenges, the information technology context is characterised by the massive generation of unstructured data, the lack of interoperability between systems from different hospitals and HIS that are conceived to store and classify information rather than to work with it. CONCLUSIONS: The emergence of an MTM model that is better integrated in the wider health system context and incorporates inputs from patients and support systems make traditional meetings more dynamic and interconnected. Although these changes signal a second transition in the development process of multidisciplinary teams, they occur in a context marked by clear gaps between the information and management needs of MTMs and the adequacy of current HIS.

• Klíčová slova
• health services administration & management, information technology, oncology, telemedicine,
• MeSH
• informační technologie * MeSH
• komunikace MeSH
• lidé MeSH
• nádory * terapie   MeSH
• poskytování zdravotní péče MeSH
• týmová péče o pacienty MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

A biosimilar is an officially regulated and approved copy of an originator biologic therapy. Improved affordability and consequent wider patient access compared with biologics are a significant appeal of biosimilars. Regulatory guidelines for biosimilar development and approval are rigorous and undergoing constant refinement. The process of licensing approval for all biosimilars requires demonstration of comparability in quality, efficacy, and safety between the biosimilar and reference (originator) product, which is undertaken in a stepwise procedure of nonclinical and clinical evaluation. The approval of >20 biosimilars in Europe in several drug classes, including the first monoclonal antibody biosimilar, bears testimony to the increasing regulatory acceptance of these agents. In contrast, the clinical application of biosimilars remains underrecognized by physicians across therapy areas. Therefore, this article aims to provide a comprehensive review of the biosimilar development process and to provide multidisciplinary guidance on the potential therapeutic utility of biosimilars in clinical practice. Specifically, experts discuss clinical developments in the introduction of biosimilars across the disciplines of gastroenterology, nephrology, oncology, and rheumatology, and from a payer perspective, and also highlight a common need for ongoing pharmacovigilance, robust head-to-head clinical studies, and real-world data to establish the long-term risk-benefit profile of biosimilars. In conclusion, significant potential exists for biosimilars to revolutionize biologic therapy by widening patient access across therapy areas.

• Klíčová slova
• Inflammatory Bowl Disease (IBD), Nephrology, arthritis, biosimilars, pharmacovigilance, safety,
• MeSH
• biosimilární léčivé přípravky terapeutické užití   MeSH
• farmakovigilance * MeSH
• hodnocení rizik MeSH
• lidé MeSH
• monoklonální protilátky terapeutické užití   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Evropa MeSH
• Názvy látek
• biosimilární léčivé přípravky MeSH
• monoklonální protilátky MeSH

The goal of an IVF cycle is the birth of at least one baby per intention to treat. However, IVF cannot confer competence on an embryo, but only can provide each couple with a safe treatment to meet a predetermined chance of success. This commentary highlights how clinical, financial and patient-centred perspectives should be included in the definition of success in IVF. The primary outcome, which is the cumulative live birth delivery rate per intention to treat, must always be complemented by analyses of risks, costs and time invested, as well as by measures of patient satisfaction. Finally, it is essential, whenever clinical conditions exist, to limit treatment discontinuation after failed attempts. Constant monitoring of the data is pivotal and must be adjusted for patient characteristics and compared with national and international registers. The authors aimed to review all these aspects and highlight the points that are still open for discussion. Is it time for a consensus?

• Klíčová slova
• Cost-effectiveness, Cumulative live birth rate, IVF success, Patient-centeredness, Time to pregnancy,
• MeSH
• analýza nákladů a výnosů MeSH
• fertilizace in vitro * ekonomika   psychologie   MeSH
• konsensus * MeSH
• lidé MeSH
• mezioborová komunikace * MeSH
• narození živého dítěte MeSH
• poradenství MeSH
• rizikové faktory MeSH
• spokojenost pacientů MeSH
• těhotenství MeSH
• výsledek terapie * MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH