BACKGROUND AND GOALS OF THE STUDY: Adherence to lung-protective ventilation leads to a lower incidence of perioperative pulmonary complications. However, adherence is reported to be only approximately 15% worldwide. Therefore, we conducted a prospective interventional clinical pre-post study to assess the impact of a standardized operating procedure (SOP) enhanced with a mandatory educational programme on adherence to intraoperative lung protective ventilation (IOLPV). MATERIALS AND METHODS: First, we assessed the current level of adherence to the IOLPV concept (Group A - before SOP). Thereafter, we implemented the SOP enhanced with a mandatory educational programme. When the program finished, our team assessed the new adherence level to the LPV concept (Group B - after SOP). We compared the number of cases that abided by each IOLPV recommendation and the number of cases that abided by the whole IOLPV bundle between the groups. RESULTS: A total of 164 patients were enrolled (Group A 82, Group B 82) in the study. The number of procedures with adherence to the whole IOLPV bundle was significantly greater in Group B (Group A, 4%; Group B, 24%; p < 0.001). Similarly, the total number of recruitment manoeuvres performed was significantly greater in Group B than in Group A (Group A 11, Group B 35, p < 0.001). The mean positive end-expiratory pressure (PEEP) was likewise significantly greater in Group B than in Group A (Group A, 6.6 ± 1.88 mbar; Group B, 7.8 ± 2.10 mbar; p < 0.001), leading to significantly more cases with an abiding level of PEEP, as recommended in Group B, than in Group A (Group A, 22; Group B, 49; p < 0.001). There was no significant difference between the groups in terms of the number of cases that abided by the plateau, the driving pressure, the tidal volume, or the breathing frequency. CONCLUSIONS: The SOP enhanced with a mandatory educational program focused on IOLPV may be an effective tool for increasing adherence to IOLPV in daily practice. TRIAL REGISTRATION: The study has been preregistered in registry clinicaltrials.gov and assigned the study registration number NCT05831683 with the brief title "Standard Operating Procedure as a Valuable Tool to Increase Adherence to Lung Protective Ventilation among Anaesthesiologists". Initial release on 3.4.2023 accessible on link https://clinicaltrials.gov/study/NCT05831683 .

• Klíčová slova
• Education, General anaesthesia, Lung protective ventilation, Perioperative pulmonary complications, Standard operating procedure,
• MeSH
• anestezie * metody   MeSH
• anesteziologie * výchova   MeSH
• dodržování směrnic * MeSH
• lidé středního věku MeSH
• lidé MeSH
• prospektivní studie MeSH
• senioři MeSH
• umělé dýchání * metody   normy   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

OBJECTIVE: The Airway Section of the Spanish Society of Anaesthesiology, Resuscitation, and Pain Therapy (SEDAR), the Spanish Society of Emergency Medicine (SEMES), the Latin American Federation of Emergency Medicine (FLAME) and an international group of airway experts (IAG) aimed to establish multidisciplinary recommendations advocating for the universal use of videolaryngoscopy (VL) in both emergency and planned care settings. DESIGN: A committee of experts from the two national scientific societies and an international group of airway experts was convened. Relevant research questions aligning with the document's objective were identified. A rapid systematic review of the evidence was performed, and the quality of evidence was assessed. Recommendations were formulated using the GRADE methodology (Grading of Recommendations Assessment, Development, and Evaluation) The entire process was conducted independently of industry funding. METHODS: Six domains were defined pertaining to VL: Clinical Benefits; Infrastructure and Accessibility; Clinical Guidelines and Protocols; Teaching and Clinical Training; Dissemination and Promotion of Clinical Benefits; Innovation, Sustainability, and Research. For each domain, specific questions were developed using the PICO model (Population, Intervention, Comparison, and Outcomes). A literature search was conducted following PRISMA-R guidelines and analysed using the GRADE methodology. RESULTS: The synthesis process resulted in 12 recommendations. Due to the low quality of available evidence, most recommendations were formulated based on expert opinion. CONCLUSION: The experts achieved strong consensus, formulating 12 recommendations to support strategies aimed at universalising the use of videolaryngoscopy.

• MeSH
• audiovizuální záznam * normy   metody   MeSH
• intratracheální intubace * normy   metody   MeSH
• laryngoskopie * normy   metody   MeSH
• lidé MeSH
• zajištění dýchacích cest * normy   metody   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• směrnice pro lékařskou praxi MeSH
• systematický přehled MeSH

Therapeutic oligonucleotides are an emerging class of drugs designed for gene expression modulation. The increasing number of clinical trials and currently expanding market is facilitating further integration and accessibility of these therapeutics. A crucial step in drug development involves reliable analytical tools for characterization and quality control. For clinical applications, oligonucleotides must be separated and purified to ensure regulatory compliance. However, their analysis represents a complex bioanalytical challenge, grounded in their complex impurity profiles. Chemical stability and binding affinity of oligonucleotide-based therapeutics are enhanced during synthesis by extensive modifications, inducing formation of various synthesis failures or truncated sequences. Furthermore, meeting current guidelines or addressing manufacturing scale-up strategies remains challenging as each oligonucleotide typically necessitates a custom analytical protocol. Here, we provide an overview of the most recent advances in separation methods, including various chromatography methods and capillary electrophoresis for nucleic acid-based therapeutics.

Therapeutic oligonucleotides are an emerging class of drugs with the potential to treat diseases previously viewed as untreatable or lethal. Although mainly synthetically prepared, they mimic and interact with substances naturally produced in bodies. As promising drugs, therapeutic oligonucleotides are thoroughly researched. Part of this research goes to analytical methods that help verify, purify, or characterize them. This review describes various analytical methods capable to do so. Principles of these methods just as their advantages and disadvantages for oligonucleotide analysis are discussed, as well as methodological advances that can move oligonucleotide research forward.

• Klíčová slova
• Therapeutic oligonucleotides, capillary electrophoresis, liquid chromatography, separation techniques, structural modification,
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

INTRODUCTION: Ultrasonography is a non-invasive and safe method for assessing muscle morphology. Among its parameters, echo intensity (EI), derived from grayscale image analysis, has emerged as a promising indicator of muscle quality and intramuscular fat infiltration. This study aims to validate EI as a marker for evaluating muscle quality in a population of Czech children, through integration with gold-standard assessments of muscle strength and body composition. The primary aim of this study is to assess the reliability and construct validity of quadriceps muscle EI using ultrasound as a proxy measure of morphological muscle quality in children aged 10-14 years. METHODS AND ANALYSIS: Children aged 10-14 years will undergo ultrasound assessment of the quadriceps femoris (QF). EI will be derived from longitudinal scans of each QF head and the cross-sectional area (CSAQF) from panoramic mid-thigh images. Muscle function will be assessed as maximal voluntary contraction (MVC) of isometric knee extension with muscle quality expressed as MVC/CSAQF. A 30 s sit-to-stand test (30STS) will be used as an additional functional measure. EI reliability (intra-rater, inter-rater and test-retest) will be evaluated with intraclass correlation coefficients (ICC), Bland-Altman plots and complementary indices. Exploratory known-groups validity will be tested by comparing EI between weight-status groups. Control variables include dual-energy X-ray absorptiometry (DXA)-derived body composition, skeletal age (as determined by DXA hand scans) and physical activity (assessed using 7-day accelerometry).This study will include 200 children (100 girls and 100 boys) aged 10-14 years using an a priori power analysis based on the primary objective of assessing construct validity through multiple linear regression, assuming an alpha level of 0.05 and 80% power. Participants will be recruited from paediatric outpatients of the Paediatric Obesity Clinic and individuals reached through a recruitment campaign. Inclusion criteria require general good health, while exclusion criteria include a history or symptoms of cardiovascular, pulmonary, metabolic or neurological disease, as well as the use of over-the-counter or prescribed medications. Informed consent and assent will be obtained from all participants.Reliability of ultrasound-derived EI will be assessed for intra-rater, inter-rater and test-retest agreement using ICC coefficients, Bland-Altman plots and complementary indices such as SE of measurement, coefficient of variation and minimal detectable change at 95% CI, following Consensus-based Standards for the selection of health Measurement Instruments guidelines. Construct validity will be examined by modelling associations between EI and functional muscle quality (MVC/CSAQF), with 30STS as an additional functional measure. Known-groups validity will be tested by comparing EI across weight groups, using generalised linear regression models adjusted for skeletal age, body composition and physical activity. All validity analyses will be conducted separately for girls and boys. Ultrasound-derived EI of the QF is expected to show high reliability (ICC≥0.80) and acceptable test-retest reproducibility. Construct validity should be supported by moderate associations with functional muscle quality (MVC/CSAQF), while known-groups validity is expected to reveal higher EI values in children with obesity and/or insufficient physical activity. ETHICS AND DISSEMINATION: The study will be conducted in accordance with the Declaration of Helsinki and was approved by the Ethics Committee of the Faculty of Physical Education and Sport, Charles University (EK 101/2024). Written parental consent and verbal assent from children will be obtained, with all data handled confidentially and anonymised. Results will be disseminated transparently to participants and their families in line with ethical principles of respect, beneficence and justice. TRIAL REGISTRATION NUMBER: NCT06792279.

• Klíčová slova
• Child, Obesity, Ultrasound,
• MeSH
• čtyřhlavý sval stehenní * diagnostické zobrazování   fyziologie   MeSH
• dítě MeSH
• lidé MeSH
• mladiství MeSH
• pozorovací studie jako téma MeSH
• průřezové studie MeSH
• reprodukovatelnost výsledků MeSH
• složení těla MeSH
• svalová síla * fyziologie   MeSH
• ultrasonografie metody   MeSH
• validační studie jako téma MeSH
• výzkumný projekt MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• protokol klinické studie MeSH
• Geografické názvy
• Česká republika MeSH

AIMS: The PRACTICE survey aimed to characterize vascular access device (VAD) practices for systemic anti-cancer therapy (SACT) across Europe, addressing gaps in clinician decision-making, training, and complication management. METHODS: Conducted as a cross-sectional survey from May to October 2024, the study engaged healthcare professionals (HCPs) from 18 European countries, with 403 completing demographic questions and 166 responding to procedural and training-related queries. RESULTS: Results revealed significant variability in VAD selection, influenced by institutional protocols, geographic location, and the presence of vascular access teams (VATs). Oncologists were identified as primary decision-makers (36 %), though nursing staff played a pivotal role in daily management. Peripheral intravenous catheters (PIVCs) dominated in Ireland and Finland (43-49 %), while tunnelled implantable devices (TIVADs) were preferred in Belgium (65 %). Barriers to optimal VAD selection included insufficient training (80 % sought further education) and inconsistent guideline adoption (51 % reported institutional protocols). CONCLUSION: The study underscores the need for standardised practices, interdisciplinary collaboration, and enhanced training. Findings highlight opportunities for integrating VAD selection into cancer care certification metrics and fostering partnerships between oncology and vascular access societies.

• Klíčová slova
• Antineoplastic Agents, Professional Practice, Vascular Access Devices,
• Publikační typ
• časopisecké články MeSH

Classic psychedelics are increasingly studied as potential treatments for different psychiatric disorders. Current research protocols often require patients to discontinue antidepressants (ADs) for at least 2 weeks before psychedelic administration to decrease the risk of serotonin syndrome and limit their effect on efficacy and the acute subjective effects of psychedelics. Moreover, the discontinuation of ADs represents a significant burden to patients that could also worsen their depression status and increase suicidal ideation. Together, this suggests that the general recommendation for AD discontinuation might be unnecessary and even detrimental to the therapeutic efficacy of psychedelics. In this scoping review, we summarise the existing literature on the concomitant use of conventional ADs with classic psychedelics in humans with the aims to assess safety, tolerability, efficacy, and subjective effects. Following PRISMA-ScR guidelines, we searched MEDLINE, Embase, and Scopus databases to retrieve relevant literature from inception to March 3, 2025. Data were systematically charted from included studies. We included 18 studies and found that the concomitant use of ADs and classic psychedelics is generally safe and tolerable, with no increased risk of serotonin syndrome, particularly for psilocybin. Some studies reported significant improvements in depression and other mental health symptoms. While some evidence indicates a potential attenuation of acute subjective psychedelic effects, this was not observed in all studies. Accordingly, we conclude that the use of ADs can be maintained to enhance patient access to psychedelic treatments and avoid the risk of AD discontinuation syndrome. Finally, this review highlights limitations and several knowledge gaps in the current literature that need to be addressed in future randomized double-blind, placebo-controlled trials.

• Klíčová slova
• antidepressants, classic psychedelics, safety, subjective effects, treatment efficacy,
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

UNLABELLED: Viral infectious diseases have caused millions of deaths worldwide. Antiviral agents are critical for controlling these infections; however, an open-access database dedicated specifically to antiviral agents remains unavailable. Here, we present AntiviralDB (https://www.antiviraldb.com/), an expert-curated resource that compiles both approved and experimental antiviral agents with laboratory-confirmed in vitro activity against a broad spectrum of human viruses. These include the human immunodeficiency virus, coronaviruses, hepatitis viruses, influenza virus, respiratory syncytial virus, herpes simplex virus, varicella-zoster virus, human cytomegalovirus, human papillomavirus, dengue virus, Zika virus, Ebola virus, mpox virus, norovirus, chikungunya virus, and 16 other common or life-threatening pathogens. Each antiviral agent in the database is annotated with key information, including its molecular target, in vitro antiviral activity (IC50, EC50, and CC50 across specific viral strains and cell lines), mechanism of action, and relevant pharmacokinetic and pharmacodynamic parameters. AntiviralDB also provides clinical efficacy and safety data derived from randomized clinical trials. Unlike existing drug databases, AntiviralDB offers two distinctive features: (i) standardized laboratory protocols for antiviral drug screening under appropriate biosafety conditions and (ii) clinical guidelines for the therapeutic use of antiviral agents against viral infections. By serving as a comprehensive repository of antiviral agents and their clinical applications, AntiviralDB aims to advance antiviral drug discovery and support the effective clinical management of viral infectious diseases. IMPORTANCE: Over the past decade, viral infectious diseases have caused significant morbidity and mortality worldwide, underscoring the urgent need for effective antiviral therapies. However, there is a lack of an open-access database that consolidates detailed information on antiviral agents, clinical guidelines, and laboratory protocols. To address this need, AntiviralDB was developed to integrate extensive data on antiviral agents-including clinical efficacy, safety profiles, pharmacokinetic parameters, and in vitro and in vivo activities-together with standardized experimental protocols and clinical treatment guidelines. This resource empowers researchers and clinicians to (i) identify promising antiviral candidates for controlling infectious diseases, (ii) accelerate the discovery and development of novel therapeutics, (iii) optimize the clinical use of existing antiviral drugs, and (iv) enhance a quick response to emerging viral outbreaks.

• Klíčová slova
• antiviral agents, antiviral targets, clinical guidelines, protocols,
• Publikační typ
• časopisecké články MeSH

PURPOSE: To investigate the current practice patterns in image-guided proton therapy (IGPT) for extremities. METHODS: A multi-institutional survey was distributed to European particle therapy centres to analyse the current practice of IGPT for tumours of the extremities. A Delphi consensus analysis was developed to define minimum requirements and optimal workflow for clinical practice within eight centres participating in the European Particle Therapy Network (EPTN). RESULTS: Eight centres participated in the survey. Patient immobilization methods varied, with supine position being optimal for selected tumor locations in most of the centres and prone position being optional in some centres. Multimodal imaging, in particular magnetic resonance imaging (MRI), was routinely used for across all centres, especially for delineation. Setup verification involved 2D imaging predominantly, with a few centres employing 3D imaging. Imaging for treatment evaluation varied, with differing intervals between treatment and first control computer tomography (CT) scans. Current limitations highlighted the need for improved software tools, streamlined workflow processes, and more comprehensive guidelines. Five centres participated in the Delphi consensus analysis. The full consensus was reached on the use of specific imaging modalities, adaptive techniques, and dedicated protocols for paediatric patients, with a need for standardization and guidelines. CONCLUSION: There are differences in extremity IGPT clinical practice among European particle therapy centres. The optimal workflow identified by the expert consensus has not yet been reached, partly due to the small number of patients treated annually. To standardize clinical practice and improve IGPT quality for extremity tumours, consensus guidelines are strongly needed.

• Klíčová slova
• Extremities, Image guided proton therapy, Immobilization, Positioning, Proton therapy,
• MeSH
• delfská metoda MeSH
• končetiny * diagnostické zobrazování   MeSH
• lidé MeSH
• magnetická rezonanční tomografie MeSH
• nádory * radioterapie   diagnostické zobrazování   MeSH
• protonová terapie * metody   MeSH
• průzkumy a dotazníky MeSH
• radioterapie řízená obrazem * metody   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• Geografické názvy
• Evropa MeSH

INTRODUCTION: Social prescribing (SP) is an innovative model that connects individuals to non-clinical community resources. However, its uptake and evaluation have been hindered by inconsistent role definitions for key stakeholders. Although recent studies have refined SP definitions, outside the UK, the responsibilities, educational backgrounds and training requirements of social prescribing link workers (SPLWs) remain poorly defined. Additionally, it is essential to identify which patient populations will benefit most from SP, establish specific methodologies, and standardize assessment tools and referral pathways. MATERIAL AND METHODS: We will employ a 3-round Delphi protocol with an international expert panel to establish consensus on SP definitions. Approximately 60 participants from diverse disciplines and regions will be recruited to complete multiple survey rounds, providing insights into the roles of SPLWs, beneficiary populations, methodologies, and assessment tools. Consensus will be defined as at least 80% agreement on a 5-point Likert scale. Data collection and analysis will follow rigorous protocols to ensure validity, reliability and transparency, in accordance with the Guidance on Conducting and REporting DElphi Studies (CREDES) guidelines. OBJECTIVES: The aim of this research is to unify the fragmented understanding of SP and the role of SPLWs, thereby establishing a foundation for integrating SPLWs into healthcare systems where appropriate. The Delphi technique offers key strengths - namely, participant anonymity and structured iterative feedback - to enable robust consensus building. While we acknowledge limitations such as potential participant attrition and the resource-intensive nature of the methodology, these will be mitigated through targeted engagement strategies and strict adherence to established best practices. CONCLUSION: This study addresses critical gaps in SP engagement, conceptual understanding and implementation. The anticipated outcomes will reinforce SP's role in community-based, integrated care to reduce health inequalities and foster social cohesion across Europe and beyond. Ultimately, this work aims to enhance the uptake and adoption of SP in primary care.

• Klíčová slova
• community health services, integrated care, link workers, primary health care, social prescribing,
• MeSH
• delfská metoda MeSH
• konsensus MeSH
• lidé MeSH
• primární zdravotní péče * MeSH
• sociální preskripce MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Evropa MeSH

As part of its mission to improve the quality of care for women with gynecological cancers across Europe, the European Society of Gynecological Oncology (ESGO) organized 3 international consensus meetings with leading experts in the field to define protocols and to provide guidance for pregnant patients and healthcare providers on the management of gynecological cancers in pregnancy. Following the third consensus meeting, the guidelines published in 2019 were updated by incorporating new evidence on this field and covering new topics to provide comprehensive evidence-based guidelines on all relevant issues within a multidisciplinary setting. ESGO appointed 21 experts from relevant disciplines and 2 cancer survivors to serve on the international development group. Members of the International Network on Cancer, Infertility and Pregnancy involved in the 3 international consensus meetings were included. To ensure that the guidelines were evidence-based, data identified from a systematic search were reviewed and critically appraised. In the absence of robust scientific evidence, the guidelines were based on the consensus of the international development group. Prior to publication, the guidelines were reviewed by 100 independent international practitioners in cancer care delivery from Asia, Europe, Africa, and North and South Americas, and 3 patient representatives to ensure a global perspective. These ESGO/International Network on Cancer, Infertility and Pregnancy guidelines address all relevant aspects of imaging, pathology, surgery, medical oncology, obstetrics, radiation therapy, psychology, patient perspectives and pediatric follow-up in a multidisciplinary setting for patients with tubo-ovarian, cervical, and vulvar cancers during pregnancy. Treatment algorithms for each tumor type are also defined.

• Klíčová slova
• Cervical Cancer, Guidelines, Pregnancy, Tubo-Ovarian Cancer, Vulvar Cancer,
• MeSH
• lidé MeSH
• nádorové komplikace v těhotenství * terapie   MeSH
• nádory ženských pohlavních orgánů * terapie   MeSH
• těhotenství MeSH
• Check Tag
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• směrnice pro lékařskou praxi MeSH