Casopis lekaru ceskych最新文献

In 2024, the multidisciplinary team of the Department of Pulmonology, 2nd Faculty of Medicine, Charles University and Motol University Hospital discussed 454 cases of patients with lung cancer; There were 70 (16%) operated on that year. Patients with adenocarcinoma (52%) in TNM stages I to IIIB prevailed among the operated patients. We administered immunochemotherapy as neoadjuvant treatment to 18 of the operated patients, and 61% of them experienced complete pathological regression. Lobectomies (86%) were significantly more prevalent among surgical procedures, only once the procedure ended with exploratory thoracotomy. We have achieved a 55% agreement between cTNM and pTNM. No one died within 30 days after the operation. We compared the current results of lung cancer surgery with similar groups of patients from outpatient and clinical departments from the last 45 years. During this time, the number of indications for resection treatment did not increase. The proportion of morphological types of lung carcinoma has changed (increase in adenocarcinomas), procedures performed in patients (lobectomies clearly predominate today) and the number of patients operated on in stages IIIA and IIIB has increased slightly. The agreement between the clinically evaluated extent of the tumor and its actual size determined by the pathologist remains at a very good level, as in the past, and is comparable to the results of the most advanced centers in the world. The number of indications for resection depends on the timeliness of diagnosis. At present, less than 20% of patients with lung cancer are diagnosed in TNM stages I and II. We see a possible improvement in the increase in the number of participants in lung cancer screening using low-dose CT, which is well organized and available to all interested parties from 2022. The results of this screening known so far confirm a 57% representation of stages I and II of TNM in patients detected in this way.

A multidisciplinary medical team from several Czech hospitals participated in a mission to a hospital in the Ukrainian town of Vynnyky as part of the MEDEVAC project. Civilian patients were provided with specialized surgical care in cooperation with plastic surgeons for injuries related to combat operations and without it. A case of a complex open fracture of the forearm bones with extensive defect of soft tissues and skeleton in a 32-year-old civilian patient is briefly described.

The aim of genomic data sharing is to enable secure access to this data, primarily for research, personalized healthcare and health policy-making. Data sharing has the potential to accelerate research and bring about significant advances in the understanding of health and disease, but it faces legal and ethical issues related to the protection of privacy and confidentiality of information. In addition to the often counterintuitive European legislation leading to different legal interpretations, there are other national rules in individual European Union countries that can further specify the handling of genomic data. This diversity complicates international cooperation and data sharing, not only in genetics but also in other areas of biomedical research. This thesis analyzes the basic legal framework and its application enabling the sharing of genomic data and clarifies the concepts of further processing, secondary use and purpose of data processing. Furthermore, it stresses the importance of data subjects' consent and specific exceptions to the general ban on processing sensitive data. For effective sharing of genomic data, it is essential to comply with European and national legislation, including a clear definition of the purpose and legal basis of processing. International cooperation requires regulatory harmonization and robust data management. This paper analyzes the fundamental dynamics and legality of data sharing in the field of genomic research.

Communicative health literacy is essential for effective interaction between patients and healthcare professionals. Its limitations may contribute to health inequalities. Ukrainian war refugees face significant barriers in accessing healthcare, primarily due to language and cultural differences. This study analyses their level of communicative health literacy and compares it with the Czech population. A quantitative study was conducted using the standardized HLS19-COM-P questionnaire. In November 2023, 1,182 Ukrainian refugees were surveyed using the CAWI method. Data analysis was performed using IBM SPSS Statistics software version 28. The communicative health literacy of refugees was significantly lower than that of the Czech population. The most significant barriers included difficulties in expressing health problems (40%), asking questions to physicians (50%), and participating in shared decision-making (55%). A low level of communicative health literacy was associated with poorer utilization of healthcare services. To reduce health inequalities, it is necessary to strengthen language support for refugees, increase the availability of intercultural mediators, and implement educational programs aimed at improving communicative health literacy.

Male infertility is a multifactorial condition influenced by hormonal, anatomical, genetic, and lifestyle factors. Although the male factor contributes to up to 40% of infertility cases, the exact etiology often remains unknown (so-called idiopathic infertility). Current diagnostic approaches include detailed clinical evaluation, semen analysis, hormonal assessment, genetic testing, and imaging techniques. Significant progress has been achieved in sperm DNA fragmentation testing and oxidative stress evaluation, offering a broader insight into sperm quality. Treatment strategies vary depending on the underlying cause, ranging from pharmacological therapy and surgical interventions to assisted reproductive technologies. Rapid advances in regenerative medicine and gene therapy show promise for novel therapeutic options. A healthy lifestyle and risk factor management are integral to both prevention and treatment.

Surrogate motherhood is one of the possible procedures to become a parent, However, it is not legally regulated. Practice shows that there are several problematic or controversial aspects that should be regulated in the interest of all participants, but especially the well-being of the child. The legislation should mainly concern the altruistic principle, the medical indications of the intended and surrogate mother, their medical examinations and approval by the court.

Amiodarone-induced thyroid dysfunction represents a serious complication of treatment with amiodarone, a frequently used potent antiarrhythmic drug. In clinical practice, there are two main forms: hypothyroidism and hyperthyroidism. Amiodarone-induced thyrotoxicosis is further divided into type 1 and type 2 with different pathogenesis, diagnostic findings and, most importantly for the patient, therapeutic approach. Due to frequent diagnostic overlap, a mixed form of amiodarone-induced thyrotoxicosis is also recognized, requiring a combination of both distinct treatment strategies, antithyroid drugs and glucocorticoids. Amiodarone-induced type 1 thyrotoxicosis necessitates prospective discontinuation of amiodarone therapy; in type 2 this step is usually not warranted. In hypothyroidism, substitution therapy with levothyroxine is sufficient without the need to stop antiarrhythmic treatment with amiodarone. Amiodarone-induced thyrotoxicosis may significantly increase the incidence of cardiovascular complications. If amiodarone treatment is discontinued solely for cardiological indications, patients without a history of thyroid disease usually experience restoration of normal thyroid function. However, in predisposed individuals, dysfunction may persist or recur following repeated iodine exposure.

The autopsy performed by Ján Jesenský in 1600 is often perceived as the first autopsy in the history of Czech medicine. However, when examining historical sources and previously published articles, it turns out that several autopsies had been performed in our territory earlier. The article presents these events chronologically and with available details.