Cystic lymphangioma (CL) is a rare benign tumour that arises from the lymphatic vessels. The most common site of presentation is the posterior triangle of the neck. 90% of the lesions are diagnosed before the age of two years old and only a small number is reported in adults. In this paper, we describe the diagnostic and treatment approach of a cervical CL in an adult male.

• Klíčová slova
• adult patient, cystic lymphangioma, neck, treatment,
• MeSH
• dospělí MeSH
• krk MeSH
• lidé MeSH
• lymfangiom cystický * diagnostické zobrazování   chirurgie   MeSH
• předškolní dítě MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• předškolní dítě MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

In this study, the question of health literacy in adult patient population in the Czech Republic is explored in the context of healthcare, particularly in the South Bohemian Region. The study is based on the analysis of qualitative data which were collected during the first half of 2016. The study included 34 adult participants at the age range between 18 and 64 years. The study is focused on the involvement of adult patients in the process of decision making concerning the healthcare provided. The views of this sort of problems were recorded by the technique of semi-structured dialogues. The study results have suggested that adult individuals accept the healthcare provided by doctors or nurses prevailingly with trust. In addition, they have shown that in the sphere of health education, the adults lack the knowledge of the right for information about the individual's health condition and information about the service provided by the health insurance agency. It is regarded as desirable to deal with the topic of health literacy of adult population, particularly in the area of internet counselling and telemedicine, and to develop the space for information sharing between the doctor and nurse on one side and the patient on the other.

• MeSH
• dospělí MeSH
• kvalitativní výzkum MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• pacientův souhlas se zdravotní péčí statistika a číselné údaje   MeSH
• zapojení pacienta statistika a číselné údaje   MeSH
• zdravotní gramotnost statistika a číselné údaje   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH

Overweight and obesity prevalence in middle aged subjects in the Czech Republic is more than 50 per cent, obesity is found in around 26 per cent of population. Obesity management is a long-term and time-consuming process. Early start of the treatment can prevent continuous weight gain and development of co-morbidities. General practitioners see obese patients usually as the first and they represent the first point of contact for adults with obesity. The basis of obesity management is a change of the lifestyle with added pharmacotherapy and/or bariatric/metabolic surgery. The paper presents overview of methods in obesity diagnostics and management and possibilities of their use in GPs daily practice.

• Klíčová slova
• bariatric/metabolic surgery, diet, obesity diagnostics, pharmacotherapy,
• MeSH
• dospělí MeSH
• hmotnostní přírůstek MeSH
• lidé středního věku MeSH
• lidé MeSH
• nadváha * MeSH
• obezita * komplikace   diagnóza   epidemiologie   MeSH
• primární zdravotní péče MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH

OBJECTIVES: Adult growth hormone deficiency (AGHD) is a rare disease characterised by abnormal body composition, reduced strength and exercise capacity and impaired psychological wellbeing. An advisory board of leading Central and Eastern European (CEE) endocrinologists was assembled to gain insights into the status of AGHD care in the CEE region. Topics of discussion included the position of adult hypopituitarism/AGHD in health system priorities, availability and affordability of treatments, awareness of AGHD, practice guidelines used in CEE countries and provisions for long-term care of patients. DESIGN: Prior to the meeting, the advisors were asked to summarise, using an itemised survey questionnaire, the usual standards of care for patients with AGHD in their country. At the meeting, the panel of experts discussed the findings and thereby elucidated similarities and differences among CEE countries; these were compared with international guideline-recommended practices for AGHD. RESULTS: All CEE countries involved reported having some type of infrastructure in place for care of patients with GHD transitioning from adolescence to adulthood. Most countries reported having at least one specialist centre for patients with AGHD. The main variations across the region included initial entry into healthcare systems, tests required to confirm AGHD diagnosis and medication reimbursement by health authorities. Most CEE countries relied on international society-led guidelines, while some countries have developed national guidelines. CONCLUSION: The CEE Adult Endocrinology Advisory Board meeting recognised considerable diversity in the care and patient pathways for AGHD across CEE countries. Additional work is needed to optimise care of patients with AGHD in the CEE region.

• Klíčová slova
• Adult growth hormone deficiency (AGHD), CEE adult endocrinology advisory board, Central and Eastern Europe (CEE), Growth hormone replacement therapy (GHRT), Practice guidelines, Recombinant human growth hormone (rhGH),
• MeSH
• dospělí MeSH
• hypofyzární nanismus diagnóza   genetika   terapie   MeSH
• hypopituitarismus diagnóza   genetika   terapie   MeSH
• kritické cesty * MeSH
• lidé MeSH
• lidský růstový hormon nedostatek   MeSH
• směrnice pro lékařskou praxi jako téma normy   MeSH
• standardní péče * MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• přehledy MeSH
• Názvy látek
• lidský růstový hormon MeSH

• MeSH
• dirofilarióza diagnóza   MeSH
• dospělí MeSH
• lidé MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH
• Geografické názvy
• Izrael MeSH

Mucopolysaccharidosis type VII (MPS VII) is a rare autosomal recessive lysosomal storage disorder. MPS VII is caused by mutations in the GUSB gene that encodes β-glucuronidase. Adult MPS VII patients present with musculoskeletal abnormalities, coarse features, and corneal clouding. Cardiac and valvular impairment are common; however, severe valvular disease necessitating surgery has not yet been reported. We present a 32-year-old male MPS VII patient admitted to our hospital with decompensated heart failure. We identified aortic valve disease with severe stenosis (valve area 0.69 cm2) and moderate regurgitation. Severe mitral valve stenosis (valve area 1 cm2) with moderate to severe regurgitation was also found in the patient. In addition, an occlusion of the right coronary artery (RCA) was documented. The patient underwent surgical replacement of the mitral and aortic valves with mechanical prostheses and implantation of a venous bypass graft to his RCA. The surgery led to a significant improvement of his clinical symptoms. Six months after the procedure, both mechanical valves function normally. Histopathological assessment identified chronic inflammatory infiltrates, fibrosis and calcifications in both resected valves. Foamy cytoplasmic transformation was most evident in the valvular interstitial cells. The ultrastructural vacuolar abnormality seen in these cells corresponded to storage changes observed in other MPSs. In conclusion, we describe clinical findings and valvular pathology in an MPS VII patient with the first-reported successful combined surgical valve replacement and myocardial revascularization. The histological and ultrastructural analyses revealed that the lysosomal storage predominantly affected the valvular interstitial cells.

• Klíčová slova
• Sly syndrome, cardiac surgery, cardiomyopathy, coronary artery disease, mucopolysaccharidosis type VII, valve replacement, valvular disease,
• MeSH
• aortální insuficience diagnostické zobrazování   etiologie   chirurgie   MeSH
• aortální stenóza diagnostické zobrazování   etiologie   chirurgie   MeSH
• chirurgická náhrada chlopně * MeSH
• dospělí MeSH
• koronární bypass * MeSH
• koronární okluze diagnostické zobrazování   etiologie   chirurgie   MeSH
• lidé MeSH
• mitrální insuficience diagnostické zobrazování   etiologie   chirurgie   MeSH
• mitrální stenóza diagnostické zobrazování   etiologie   chirurgie   MeSH
• mukopolysacharidóza VII komplikace   diagnóza   MeSH
• stupeň závažnosti nemoci MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

PURPOSE: Amblyopia is one of the most common childhood disease. The average prevalence of amblyopia in children is estimated at 2-5 %. It arises during the child development until the age of six, if not treated then, it persist throught adulthood. The aim of our work is to retrospectively analyze the results of treatment of anisometropic amblyopia using dichoptical training in virtual reality in adult amblyopic patients. MATERIALS AND METHODS: Our group consisted of 84 amblyopic patients with anisometropic amblyopia with an average age of 33.8 ± 9.4 years. Patients played a video game twice a week in the Oculus Rift 3D virtual reality. Together they completed 8 visual trainings, with one training lasting 60 minutes. Before and after the training we evaluated the best corrected visual acuity (BCVA). DISCUSSION: Throughout the group, we observed an improvement of 0.1 BCVA from 0.48 to 0.58 Sloan table (p.

• Klíčová slova
• adult patient, anisometropic amblyopia, pleoptics, video games, virtual reality, visual training,
• MeSH
• amblyopie * terapie   MeSH
• dítě MeSH
• dospělí MeSH
• lidé MeSH
• mladý dospělý MeSH
• retrospektivní studie MeSH
• virtuální realita * MeSH
• výsledek terapie MeSH
• zraková ostrost MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• lidé MeSH
• mladý dospělý MeSH
• Publikační typ
• časopisecké články MeSH

BACKGROUND: The Near Visual Acuity Questionnaire Presbyopia (NAVQ-P) is a patient-reported outcome (PRO) measure that was developed in a phakic presbyopia population to assess near vision function impacts. The study refined and explored the psychometric properties and score interpretability of the NAVQ-P and additional PRO items assessing near vision correction independence (NVCI), near vision satisfaction (NVS), and near vision correction preference (NVCP). METHODS: This was a psychometric validation study conducted using PRO data collected as part of a Phase IIb clinical trial (CUN8R44 A2202) consisting of 235 randomized adults with presbyopia from the US, Japan, Australia, and Canada. Data collected at baseline, week 2, and months 1, 2, and 3 during the 3-month trial treatment period were included in the analyses to assess item (question) properties, NAVQ-P dimensionality and scoring, reliability, validity, and score interpretation. RESULTS: Item responses were distributed across the full response scale for most NAVQ-P and additional PRO items. Confirmatory factor analysis supported the pre-defined unidimensional structure and calculation of a NAVQ-P total score as a measure of near vision function. Item deletion informed by item response distributions, dimensionality analyses, item response theory, and previous qualitative findings, including clinical input, supported retention of 14 NAVQ-P items. The 14-item NAVQ-P total score had excellent internal consistency (α = 0.979) and high test-retest reliability (Intraclass Correlation Coefficients > = 0.898). There was good evidence of construct-related validity for all PROs supported by strong correlations with concurrent measures. Excellent results for known-groups validity and ability to detect change analyses were also demonstrated. Anchor-based and distribution-based methods supported interpretation of scores through generation of group-level and within-individual estimates of meaningful change thresholds. A meaningful within-patient change in the range of 8-15-point improvement on the NAVQ-P total score (score range 0-42) was recommended, including a more specific responder definition of 10-point improvement. CONCLUSIONS: The NAVQ-P, NVCI, and NVS are valid and reliable instruments which have the ability to detect change over time. Findings strongly support the use of these measures as outcome assessments in clinical/research studies and in clinical practice in the presbyopia population.

• Klíčová slova
• Clinical outcome assessment, Near vision function, Patient-reported outcome, Presbyopia, Psychometric validation,
• MeSH
• dospělí MeSH
• hodnocení výsledků péče pacientem MeSH
• lidé MeSH
• myopie * MeSH
• presbyopie * diagnóza   MeSH
• psychometrie MeSH
• reprodukovatelnost výsledků MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Austrálie MeSH

INTRODUCTION: Lymphangiomas belong to the group of benign vascular tumors that originate in the lymphatic tissue. Up to 90% of cases manifest in children before the second year of life. In adults, their presence is very rare. In most cases, they are located in the head, neck and axilla. Intra-abdominal lymphangiomas are very rare and represent less than 1% of all cases. CASE REPORT: The authors present the case of a 64-year-old female patient diagnosed with an intra-abdominal cystic lesion following a routine examination. A CT scan of the abdomen confirmed a cystic lesion located in the lesser omentum between the left lobe of the liver and the lesser curvature of the stomach. The patient was scheduled for laparoscopic exstirpation of the lesion. Histological examination confirmed the clinical diagnosis of cystic lymphangioma of the lesser omentum. CONCLUSION: The etiopathogenesis of lymphangiomas remains unclear. Despite the fact that they are benign tumors, lymphangiomas tend to have an infiltrative pattern of growth, invading surrounding structures. The majority of cases are asymptomatic and the diagnosis is incidental. The gold standard in treatment remains complete surgical extirpation with microscopically negative margins.

• Klíčová slova
• cystic lymphangioma, intra-abdominal cysts, lesser omentum, podoplanin,
• MeSH
• lidé středního věku MeSH
• lidé MeSH
• lymfangiom cystický * chirurgie   patologie   diagnóza   diagnostické zobrazování   MeSH
• omentum * patologie   chirurgie   MeSH
• peritoneální nádory * patologie   chirurgie   diagnostické zobrazování   diagnóza   MeSH
• počítačová rentgenová tomografie MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

The article reports the case of a patient with bronchopulmonary sequestration complicated by destructive actinomycotic inflammation leading to life-threatening hemoptysis. It was an adult patient with the history of repeated right-sided pneumonia the cause of which had not been investigated in detail in the past. Only hemoptysis, which appeared as a complication, led to a closer investigation of the background of repeated right-sided pneumonia. CT scan of the chest revealed a lesion of the middle lobe of the right lung with anomalous vascularization - compatible with intralobar sequestration. Initially, conservative antibiotic treatment of pneumonia was provided at a local clinic. Embolization of the afferent vessels of the sequestrum was indicated due to persistent hemoptysis; this led to a reduction of its blood supply, proven by a follow-up CT examination of the chest. Clinically, the hemoptysis subsided. Three weeks later, the hemoptysis reocurred. The patient was acutely hospitalized at a specialized thoracic surgery department where shortly after admission, hemoptysis progressed to life-threatening hemoptea. Urgent middle lobectomy of the right lung was approached via thoracotomy to treat the source of bleeding. The case describes unrecognized bronchopulmonary sequestration as a possible cause of recurrent ipsilateral pneumonia in adulthood; additionally, it emphasizes the possible risks associated with a pathologically altered tissue microenvironment of pulmonary sequestration, and the need for surgical removal in all indicated cases.

• Klíčová slova
• Pneumonia, bronchopulmonary sequestration, hemoptea, hemoptysis, pneumonia,
• MeSH
• bronchopulmonální sekvestrace * komplikace   diagnóza   chirurgie   MeSH
• dospělí MeSH
• hemoptýza diagnóza   etiologie   chirurgie   MeSH
• krvácení MeSH
• lidé MeSH
• plíce chirurgie   MeSH
• pneumonie * komplikace   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH