INTRODUCTION: An increased incidence rate of cases of complicated pneumonia, reaching up to the stage of necrotizing pneumonia was observed at University Hospital Brno in the past period. The aim of this study was to perform a single-center retrospective analysis of patients with acquired inflammatory lung disease requiring surgical treatment, comprising a long-term follow-up group. METHODS: Patients hospitalized for community-acquired pneumonia and surgically treated in the years 2015-2019 were analyzed. The rates of necessary chest drainages, decortications and lung resections in relation to the whole group and individual years were monitored. Clinical and X-ray examinations were performed one year after hospitalization and the prognosis was determined for individual types of required treatments. The age, gender and etiological agents were also monitored. RESULTS: A total of 688 patients were included in the study with the incidence rising until 2018 and decreasing slightly in 2019. A statistically significantly higher number of community-acquired pneumonias and complications was recorded between 2017 and 2018 (p.

• Klíčová slova
• Streptococcus pneumoniae, child, necrotizing pneumonia, partial pneumonectomy,
• MeSH
• dítě MeSH
• hospitalizace MeSH
• lidé MeSH
• nekrotizující pneumonie * komplikace   epidemiologie   chirurgie   MeSH
• prognóza MeSH
• radiografie MeSH
• retrospektivní studie MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

Herein, we present our findings of an early appearance of the Monkeypox virus in Prague, Czech Republic. A retrospective analysis of biological samples, carried out on the 28th of April, revealed a previously unrecognized case of Monkeypox virus (MPxV) infection. Subsequent data analysis confirmed that the virus strain belongs to the ongoing outbreak. Combined with clinical and epidemiological investigations, we extended the roots of the current outbreak at least back to 16th of April, 2022.

• Klíčová slova
• infection, monkeypox virus, orthopoxvirus, outbreak, poxviridae, zoonosis,
• MeSH
• epidemický výskyt choroby MeSH
• lidé MeSH
• opičí neštovice * epidemiologie   MeSH
• retrospektivní studie MeSH
• virus opičích neštovic MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH

INTRODUCTION: The incidence of parathyroid - glandula parathyreoideae (PTG) diseases has been increasing worldwide. Unlike benign tumours, the incidence of malignant PTG tumours is rather a rare diagnosis. The morbidity of parathyroid surgery is associated with surgical removal of one or more pathologically altered parathyroid glands, particularly parathyroid adenoma associated with primary hyperparathyroidism (HPPT), but also hyperplasia associated with secondary or tertiary HPPT, and last but not least, HPPT due to parathyroid cancer. METHODS: A retrospective statistical analysis was performed in the set of patients undergoing surgery for a parathyroid disorder at the Department of Otorhinolaryngology and Maxillofacial Surgery, 3rd Faculty of Medicine, Charles University and Military University Hospital in Prague in 2013-2019 (7-year period). In this period, 127 procedures were performed. The incidences of morbidity, mortality, complications and lethality were analysed. RESULTS: Parathyroid surgery was performed in 20 male and 107 female patients. The mean age was 54.7 years, and the morbidity expressing recurrent laryngeal nerve (RLN) palsy was 0.7% of the nerves exposed during the procedure. The incidence of permanent normal postoperative calcaemia was 98.43%, demonstrated by a decrease in serum parathyroid hormone (PTH) levels. In 12 cases, this state was achieved only after a surgical revision (primary procedure for primary HPPT in 2 cases; 10 patients came for surgical revision with secondary or tertiary HPPT from other centres). Decreased PTH levels were demonstrated intraoperatively in 12.6% patients using the so-called PTH assay (a rapid serum PTH assay). Surgery for secondary or tertiary hyperparathyroidism was done in 33 patients (26% procedures). PTG surgery lethality (mortality) was divided into perioperative mortality within 24 hours from the procedure and early mortality within 120 hours. Lethality related to PTG surgery was 0.0% including patients undergoing the surgery while being in a dialysis programme and those with kidney transplant. CONCLUSIONS: Surgery is always associated with complications, with morbidity and mortality. Experience of endocrinology surgeons of all specialties is reflected in a very low incidence of RLN injuries and in sufficient oncological, or respectively, surgical radicality. This, in connection with other medical fields of endocrinology, nephrology, transplantology, nuclear medicine and oncology, allows a safe and effective treatment of all PTG disorders with a good prognosis for the patients. In those with secondary or tertiary HPPT, it not only improves their quality of life, which was not explored in our study, but in many cases it is an essential step for listing the patient for the transplant surgery. The current level of experience in the field of parathyroid carcinoma does not enable us to formulate any conclusions in terms of prognosis which should be considered as very serious in all cases.

• Klíčová slova
• complications, complications − morbidity − mortality, parathyroid glands, surgery,
• MeSH
• kvalita života * MeSH
• lidé středního věku MeSH
• lidé MeSH
• morbidita MeSH
• nádory příštítného tělíska * komplikace   chirurgie   MeSH
• paratyreoidea MeSH
• paratyreoidektomie MeSH
• retrospektivní studie MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

INTRODUCTION: Hospitals strive, over the long term, to reduce the incidence of falls of hospitalized patients. Falls are monitored, analyzed, and regularly evaluated and corrective and preventive actions are established based on the findings. To establish preventive actions, it is essential to determine the circumstances under which the patient fell and in what type of health care facility. OBJECTIVES: The goal of the study consisted in retrospectively analyzing falls in selected hospitals of the South Bohemian Region in 2014 and 2015. METHODS: Our retrospective analysis of 1101 patient falls was reported by the health care staff from 4 hospitals of the South Bohemian Region. The data from the reported incidents (i.e., falls) from individual hospitals were encoded and entered in a database using the SASD statistical program and subsequently subjected to statistical analysis. RESULTS: The highest frequency of falls was found on internal wards, 565 (51.3%) with the second highest frequency found on subsequent care wards, 267 (24.3%). The study showed that the risk of falls increases with patient age; more than 60% the hospitals, in the monitored period, involved patients over 70 years of age. Falls occurred most frequently in patient rooms and in bathrooms. Statistically significant relationships were identified between the type of ward and the time of the fall, between the type of the ward and the location of the fall, between patient age and the time of the fall, between patient age and the location of the fall, between the time of fall and the location of fall, and between the location of fall and the patient mobility before the fall. CONCLUSION: Intensive monitoring of patient falls and the circumstances under which the falls occurred are needed to fully understand the epidemiology of hospital falls.

• MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• nemocnice statistika a číselné údaje   MeSH
• retrospektivní studie MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• úrazy pádem statistika a číselné údaje   MeSH
• věkové faktory MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH

Cutaneous T-cell lymphomas (CTCL) represent rare non-Hodgkin lymphomas (NHL) with an incidence less than 1 per 100,000 inhabitants. The most common type of CTCL is mycosis fungoides (MF), which represents approximately 60% of all CTCL, followed by Sézary syndrome (SS), approximately 5%. We retrospectively analyzed the outcome of 118 patients with MF (n=96) and SS (n=22) treated between the years 1998 and 2021 at the Charles University General Hospital in Prague, Czech Republic. The ratio between men and women was 1.2:1 (62 men, and 56 women). The median age at diagnosis was 62 years (23 to 92 years). From the MF cohort 48 patients (50% out of MF cohort) presented with advanced stage disease. Ninety patients (77%) received a systemic treatment at any time from the diagnosis; the median number of therapy lines was two. At the time of database lock, the overall survival (OS) of 96 patients with MF reached 17.7 years with the median follow-up 4.0 years. With the median follow-up 2.6 years, the median OS of 22 patients with SS was 3.5 years. The most common type of systemic therapy for MF included low-dose methotrexate (61%), interferon-alpha (58%), bexarotene (28%), and chlorambucil (25%). The most common type of therapy for SS included bexarotene (64%), extracorporeal photopheresis (50%), and interferon-alpha (45%). Only the minority of patients received innovative targeted agents including brentuximab vedotin, mogamulizumab, or pembrolizumab. Besides the retrospective analysis of the CTCL cohort, current standards and future perspectives of selected innovative agents are summarized and discussed. The analyzed cohort represents the largest cohort of CTCL patients in the Czech Republic. Overall, the survival parameters of our CTCL cohort are comparable to those previously published by other groups. In conclusion, our analysis of 118 real world cohort of consecutive CTCL patients treated at the single center confirmed the efficacy of immune response modifiers and underlines the urgent need for ample implementation of innovative agents and their combinations into earlier lines of therapy.

• Klíčová slova
• cutaneous T-cell lymphoma (CTCL), mycosis fungoides (MF), real-world analysis, retrospective study, sézary syndrome (SS),
• Publikační typ
• časopisecké články MeSH

INTRODUCTION: The aim of this pilot retrospective study is to evaluate the complication rate in patients after axillary dissection comparing preparation with harmonic scalpel vs traditional ligation technique, and to analyse risk factors for complications occurrence. METHODS: 144 patients with 148 axillary dissections operated in a single centre between January 2014 and 2019 were included into the study. Axillary dissection was performed using harmonic scalpel in 73 and absorbable ligations in 70 cases. RESULTS: Seroma formation was observed in 41 patients (56.2%) in the harmonic scalpel group and in 21 patients (30.0%) in the ligations group (p=0.003). The mean period from the surgery to drain removal was 4.0 days in the harmonic scalpel group and 3.0 days in the ligations group (p<0.001). The mean amount of the drained fluid after mastectomy was 300.9 ml in the harmonic scalpel group and 168.7 ml in the ligations group (p=0.005); after breast conserving surgery, it was 241.9 ml and 107.4 ml, respectively (p =0.023). CONCLUSION: In comparison with traditional ligations with absorbable material, axillary dissection using harmonic scalpel significantly increases the risk of postoperative seroma formation, prolongs the time from the surgery to drain removal, and increases the amount of drained fluid.

• Klíčová slova
• breast cancer − axillary dissection – ligation − harmonic scalpel − seroma,
• MeSH
• axila MeSH
• disekce MeSH
• lidé MeSH
• multivariační analýza MeSH
• nádory prsu * chirurgie   MeSH
• retrospektivní studie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

INTRODUCTION: The incidence of thyroid disorders has been rising worldwide. Unlike the incidence, mortality associated with malignant thyroid cancer shows only a modest increase. Between 1979 and 2009, mortality in Czech women increased from 1.21 to 1.31 and in Czech men from 0.54 to 0.74 cases per 100,000 individuals. Methods: A retrospective statistical analysis was performed in patients undergoing thyroid surgery at the Department of Otorhinolaryngology and Head and Neck Surgery of the 1st Faculty of Medicine, Charles University and University Hospital Motol, and at the Department of Otorhinolaryngology of the Institute for Postgraduate Medical Education in Prague from 1991 to 2010 (twenty years). In this period, 11,005 procedures were done for thyroid disease. The study analysed the incidence, morbidity, mortality, surgical complications and lethality. RESULTS: The study group included surgeries in 1588 male and 9417 female patients. The male/female ratio was 1:5.93. Benign thyroid tumours - mean patient age is 54.7 years; recurrent nerve morbidity is 1.37% (calculated from exposed nerves). Hypocalcaemia incidence is low, 5.4% of permanent hypocalcaemia or hypoparathyroidism, respectively, based on decreased serum parathyroid hormone (PTH) levels. Temporary hypocalcaemia is much more frequent, occurring in almost 15% cases depending on age, season of the year, and nutritional status. Hypoparathyroidism was demonstrated based on laboratory serum PTH levels only in 0.3% patients. In total, 442 patients were operated for the mechanic syndrome (a large goitre). The mean thyroid volume was 493 ml±136 ml; however, the maximum volume was 980 ml and weight 1115 g. The incidence of recurrent nerve injury occurs in 4.5%, i.e. the morbidity is 2 times higher compared to surgeries for other diagnoses. The incidence of hypoparathyroidism is not higher compared to other surgeries. Revision surgeries were indicated more commonly in malignant thyroid diseases, particularly in papillary and follicular carcinomas. Cervical lymph nodes procedures comprise another large segment in tumour treatment. Our analysis supports selective neck dissections while preserving non-lymphatic structures. As a rule, mortality associated with thyroid surgery is divided as mortality in the perioperative period (within 24 hours after the procedure) and early postoperative mortality (within 120 hours after the procedure). Surgery-related mortality was never classified as perioperative or within 24 hours after the procedure. Despite that, we believe that perioperative mortality within 120 hours after the procedure, which occurred in 7 cases, is very important. Mortality of the group was 0.007%. CONCLUSIONS: Each surgery procedure is associated with complications, morbidity and mortality. Experience of endocrine surgeons of all disciplines leads to a very low incidence of recurrent nerve and parathyroid gland injuries while at the same time achieving sufficient radicality. This, in cooperation with other medical fields such as endocrinologists, nuclear medicine specialists and oncologists, supports a safe and effective management of all thyroid disorders, including a good prognosis of patients with most types of cancer. Key word: thyroid surgery - complications recurrent nerve - hypoparathyroidism lethality.

• Klíčová slova
• complications − recurrent nerve, hypoparathyroidism − lethality, thyroid surgery,
• MeSH
• lidé středního věku MeSH
• lidé MeSH
• morbidita MeSH
• nádory štítné žlázy * chirurgie   MeSH
• paratyreoidea MeSH
• pooperační komplikace epidemiologie   MeSH
• retrospektivní studie MeSH
• štítná žláza * MeSH
• tyreoidektomie škodlivé účinky   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

BACKGROUND: Economic data pertaining to cystic fibrosis (CF), is limited in Europe generally, and completely lacking in Central and Eastern Europe. We performed an analysis of all direct costs associated with CF relative to key disease features and laboratory examinations. METHODS: A retrospective prevalence-based cost-of-illness (COI) study was performed in a representative cohort of 242 CF patients in the Czech Republic, which represents about 65 % of all Czech CF patients. Medical records and invoices to health insurance companies for reference year 2010 were analyzed. RESULTS: The mean total health care costs were €14,486 per patient, with the majority of the costs going towards medicinal products and devices (€10,321). Medical procedures (€2676) and inpatient care (€1829) represented a much smaller percentage of costs. A generalized linear model showed that the strongest cost drivers, for all cost categories, were associated with patient age and lung disease severity (assessed using the FEV1 spirometric parameter), when compounded by chronic Pseudomonas aeruginosa airway infections. Specifically, maximum total costs are around the age 16 years; a FEV1 increase of 1 % point represented a cost decrease of: 0.9 % (medicinal products), 1.7 % (total costs), 2.8 % (procedures) and 7.0 % (inpatient care). CONCLUSIONS: COI analysis and regression modeling using the most recent data available can provide a better understanding of the overall economic CF burden. A comparison of our results with other methodologically similar studies demonstrates that although overall costs may differ, FEV1 can nonetheless be utilized as a generally transferrable indicator of the relative economic impact of CF.

• Klíčová slova
• Cost-of-illness, Cystic fibrosis, Disease severity, FEV1, Generalized linear model, Health care costs,
• MeSH
• cystická fibróza ekonomika   epidemiologie   patofyziologie   MeSH
• dítě MeSH
• dospělí MeSH
• lidé MeSH
• mladiství MeSH
• náklady na zdravotní péči statistika a číselné údaje   MeSH
• osobní újma zaviněná nemocí * MeSH
• předškolní dítě MeSH
• prevalence MeSH
• pseudomonádové infekce ekonomika   epidemiologie   MeSH
• regresní analýza MeSH
• retrospektivní studie MeSH
• spirometrie MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• předškolní dítě MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH

OBJECTIVE: To evaluate the quality of care provided to patients with febrile neutropenia (FN) hospitalized at the Depart-ment of Infectious Diseases, Military University Hospital Prague, as a foundation for improving the management of this condition. MATERIAL AND METHODS: A retrospective observational analysis of patients diagnosed with the ICD-10 code D70 from 1 January 2015 to 1 June 2023. All evaluated parameters were selected primarily to facilitate the assessment of care quality and compliance with recommended practices. RESULTS: Of 32 evaluated patients, 19 met the criteria for FN. A history of conditions or treatments predisposing to neutropenia was noted in 74 % of patients. Seventy-four percent were admitted following evaluation or referral from an emergency department or another specialist. Blood cultures (at least two sets) were initially obtained in 80 % of cases. Antibiotics were initially administered correctly to all patients. However, considering antibiotic combinations would have been appropriate in 40 % of cases. No patients received antibiotics within one hour of initial contact with a healthcare facility. Antifungals were therapeutically administered to 58% of patients, though 37 % of these had no clear indication. A hematologist was consulted in 75 % of cases, and a stimulating factor (filgrastim) was administered in 88 % of cases. All patients were treated in isolation. An infection source was identified in 74 % of cases. CONCLUSION: The analysis highlighted areas for improving the quality of care for patients with FN. Based on this study, an internal procedure is now being developed that will focus on coordination with emergency and other departments, emphasize obtaining blood cultures, and ensure the timely and correct administration of antibiotics, including their possible combinations, as well as antifungals.

• Klíčová slova
• antibiotics, antifungal agents filgrastim., blood culture, febrile neutropenia,
• MeSH
• antibakteriální látky terapeutické užití   MeSH
• antifungální látky terapeutické užití   aplikace a dávkování   MeSH
• dospělí MeSH
• febrilní neutropenie * terapie   farmakoterapie   MeSH
• hospitalizace MeSH
• kvalita zdravotní péče * MeSH
• lidé středního věku MeSH
• lidé MeSH
• retrospektivní studie MeSH
• senioři MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH
• pozorovací studie MeSH
• Názvy látek
• antibakteriální látky MeSH
• antifungální látky MeSH

Priapism is a rare condition in the newborn. The aim of this study was to investigate the demographic, etiologic and clinical features of neonatal priapism. We retrospectively analysed the data of 11 patients diagnosed with neonatal priapism in the neonatal intensive care unit between 2000 and 2019. Priapism was defined as an erection in the neonatal period, lasting more than 4 hours. Etiological examinations revealed polycythemia in one (9.09%) patient, D-dimer elevation in three patients, and heterozygous methyltetrahydrofolate 667 gene mutations in one patient. Other patients were considered idiopathic. Detumescence was achieved in all 11 (100%) patients during the follow-up period. The median hospitalization duration was 6 (IQR [4, 8]; range, 2-9) days. The median follow-up duration was 38 (IQR [30, 42]; range, 13-94) months for patients followed-up in our hospital after discharge. Neonatal priapism is a rare condition. Successful treatment results can be achieved with conservative methods. Data acquired from our study showed that diseases with a tendency to hypercoagulation belong to the etiology by damaging penile microcirculation and make the response to conservative treatment more challenging.

• Klíčová slova
• D-dimer, Neonate, Priapism,
• MeSH
• erekce penisu MeSH
• lidé MeSH
• novorozenec MeSH
• penis MeSH
• priapismus * diagnóza   etiologie   terapie   MeSH
• propuštění pacienta MeSH
• retrospektivní studie MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• novorozenec MeSH
• Publikační typ
• časopisecké články MeSH