Casopis lekaru ceskych最新文献

Lipedema, a chronic disease characterized by excessive fatty tissue deposition in the hips, buttocks, and lower legs, significantly negatively impacts the quality of life of those affected. This disease, which almost exclusively affects women, is often underdiagnosed, and confused with obesity. Diagnosis of lipedema is crucial for initial treatment and improvement of the patient's quality of life. Hormonal changes, inflammation, and tissue fibrosis play an essential role in the pathogenesis of lipedema. This article presents nutritional strategies that may bring relief to patients with lipedema. Nutritional intervention for lipedema patients could be an adjunct to traditional treatment, improving quality of life and reducing pain. However, these findings must be subjected to further research and clinical trials. The exact mechanism by which diet affects lipedema remains incompletely understood and, therefore, requires further study. However, this work provides hope and direction for future therapeutic approaches and research in treating lipedema.

Healthcare data held by state-run organisations is a valuable intangible asset for society. Its use should be a priority for its administrators and the state. A completely paternalistic approach by administrators and the state is undesirable, however much it aims to protect the privacy rights of persons registered in databases. In line with European policies and the global trend, these measures should not outweigh the social benefit that arises from the analysis of these data if the technical possibilities exist to sufficiently protect the privacy rights of individuals. Czech society is having an intense discussion on the topic, but according to the authors, it is insufficiently based on facts and lacks clearly articulated opinions of the expert public. The aim of this article is to fill these gaps. Data anonymization techniques provide a solution to protect individuals' privacy rights while preserving the scientific value of the data. The risk of identifying individuals in anonymised data sets is scalable and can be minimised depending on the type and content of the data and its use by the specific applicant. Finding the optimal form and scope of deidentified data requires competence and knowledge on the part of both the applicant and the administrator. It is in the interest of the applicant, the administrator, as well as the protected persons in the databases that both parties show willingness and have the ability and expertise to communicate during the application and its processing.

Hepatocellular carcinoma (HCC) is the most common primary liver cancer and a frequent fatal complication of chronic liver diseases in the stage of liver cirrhosis. HCC develops at a higher rate in patients with type 2 diabetes mellitus (DM2). DM2 is associated with an increased risk of developing malignant tumors. The term multiple primary neoplasia (MPN) is used to describe the occurrence of multiple primary tumors of different organs in the same individual. To the best of the authors knowledge, the topic of the association between HCC and MPN and DM2 has not been addressed in the Czech literature. Here we present the outcomes of retrospective statistical analysis of a cohort of patients with HCC who were dispensed at the Internal Medicine Clinic of the 1st Faculty of Medicine of the Charles University in the period 2011-2021 and the impact of DM2 and MPN on overall survival (OS). MPNs are relatively common in patients with HCC. The occurrence of MPNs in our cohort was associated with DM2 in half of the cases. Median OS in HCC patients was not significantly affected by the coincidence of DM2 and/or MPNs.

The use of drains in surgery has a rich history. Since ancient times, drainage has experienced a long progress, and its development has continued all the way to the present era. Both the indications for drainage and the material of surgical drains have changed over the last 2500 years. Indeed, drainage as we know today, was not always a practice so common or generally so well accepted, as it is today. The current concept of surgical drainage has witnessed not only periods of success, but also dead ends and mistakes of both science and medicine.

Vlastimil Dostálek was born on January 18th, 1910, in the village of Včelary. Within his university studies in Brno, he was interested in otorhinolaryngology and subsequent the graduating from the medical faculty of Masaryk University, dr. Dostálek began to devote himself entirely to this field. He worked in various ENT departments led by important protagonists of his time. After the end of the Second World War, he was entrusted with building the ENT department in Nový Jičín, which he succeeded and led this department for over three decades until 1976 when he was dismantled for political reasons. Vlastimil Dostálek contributed to the development of the field in the entire district and educated many expert doctors, making him one of the prominent personalities of the Nový Jičín region. He died in 1988 at the age of 78.

Although pneumonia presents a relatively common diagnosis, it does not always present with classic clinical symptoms, nor does it follow a regular course without complications. The presented case describes a rare case of aspiration necrotizing pneumonia, which despite intensive therapy, progressed to lung gangrene and required a lung lobectomy. Another peculiarity is that the correct diagnosis was established only after the onset of abdominal pain, surprisingly by a trauma surgeon. This case emphasizes the necessity of a thorough general examination and draws attention to a rare, but conservatively intractable necrotizing pneumonia complicated by lung gangrene.

Castleman disease (CD) is a heterogeneous group of diseases characterized by lymphadenopathy and systemic inflammatory manifestations. CD can be divided into uni- (UCD) and multicentric form (MCD) according to the disease extent. MCD is usually accompanied by the features of a systemic inflammatory response including fever, weight loss, hepatosplenomegaly, ascites, and edema. In these patients, we can also observe elevation of inflammatory parameters and anemia within the laboratory assessment. Based on etiological nature, the CD can be further divided into human herpesvirus-8-associated (HHV8-associated) and idiopathic form. Interleukin 6 (IL-6) plays a central role in the disease pathogenesis. Inhibition of IL-6 has been shown to be an effective treatment modality. Currently, siltuximab, a chimeric monoclonal antibody targeting IL-6, is the only approved treatment for MCD. Its short-term and long-term efficacy and safety have been demonstrated in a few clinical studies.

Hormone replacement therapy is still the most effective treatment for acute climacteric syndrome and prevention of osteoporosis. When starting treatment within 10 years of menopause, i.e., before the onset of irreversible changes in the vessel wall and nervous tissues, it is a window of opportunity to prevent atherosclerosis and dementia. At a later start, on the contrary, it worsens these processes. To increase the safety of the treatment, especially in affecting the breast tissue, we choose the lowest effective dose of estrogen and give preference to gestagens structurally close to progesterone. For women who, for objective or subjective reasons, prefer non-hormonal treatment, they can choose from an extensive range of complementary and alternative medicines. Unfortunately, it does not always reliable documentation of efficacy and safety from well-performed studies. However, the data for fermented soybean extract DT56a, pollen extract PI82/GC Fem, and some traditional Chinese medicine procedures offer an interesting opportunity. Physical activity cannot be forgotten in a comprehensive approach.

Assisted reproduction is an integral part of infertility treatment. The basic method is in vitro fertilisation (IVF), and intracytoplasmic sperm injection into the oocyte, cryopreservation of sperm, oocytes and embryos is also commonly used. The proportion of embryos tested with preimplantation genetic testing (PGT) for chromosomal aneuploidy or defects in specific genes is increasing. The use of donated oocytes is also significant, particularly because of the depletion of ovarian reserve in women over 40 years of age. The effectiveness of treatment is always very fundamentally dependent on the age of the woman. Assisted reproductive treatment is very well available in the Czech Republic, as is fertility preservation by sperm/oocyte freezing.

Sezónní a týdenní výkyvy v užívání alkoholu patří mezi doposud neanalyzované aspekty epidemiologického výzkumu užívání alkoholu českou dospělou populací. Cílem studie je nabídnout deskriptivní a analytický pohled na sezónní a týdenní vzorce užívání alkoholu u české dospělé populace. Výzkum byl realizován na reprezentativním vzorku 809 osob v rámci on-line šetření v prostředí Českého národního panelu. Sledovanými proměnnými jsou užívání alkoholu, sezónní užívání a užívání alkoholu v rámci dní v týdnu. Výsledky ukazují, že nejčastější je konzumace v pátek, případně v sobotu, s výjimkou lidí v důchodovém věku, kteří alkohol užívání rovnoměrněji v rámci celého týdne. Z hlediska měsíců v roce je nejvyšší spotřeba uváděna v létě (červen, červenec, srpen) a v prosinci. Respondenti s vyšším skóre dotazníku AUDIT užívají alkohol více v letních měsících než v prosinci. Výsledky výzkumu mohou přispět k lepšímu časovému zacílení preventivních i klinických aktivit.