Casopis lekaru ceskych最新文献

The number of pediatric solid organ transplantations is growing. This therapy leads often to better quality of life but also brings some specific complications. Our review summarizes practical recommendations for long-time care of the children after kidney and liver transplantation. The knowledge of the issues related to transplantation is essential for the first contact physicians, whose cooperation with transplant centre contributes highly to adequate management of these children.

The current significant development of human genome/exome sequencing in biomedical research is one of the important paths leading to personalized medicine. However, sequencing of human genetic information generates potentially sensitive and exploitable data, which leads to ethical, legal, and security issues. For this reason, it is necessary to follow several measures when working with these data, applying to their entire life cycle - i.e., acquisition, storage, processing, usage, sharing, archiving, and reuse. In addition, importance of good practice during the whole data life cycle is emphasized by current European trends towards open science and digital transformation. Therefore, the following recommendations have been developed, establishing principles for work with the whole human genome sequences or parts of it in research context. The recommendations are based on two documents published by the Global Alliance for Genomics and Health (GA4GH) and on foreign literature, thus summarizing recent relevant guidance on most aspects of working with human genomic data.

This review summarizes the issue of acute hypercapnic respiratory failure. Acute respiratory failure is a condition in which the respiratory system is unable to fulfill its basic function, i.e. enriching the blood with oxygen and excreting carbon dioxide. Chronologically, we divide it into acute and chronic, and according to the manifestation into hypoxemic or hypoxemic with hypercapnia. Multiple factors, such as reduced ventilation and increased dead space, contribute to the development of hypoxemic-hypercapnic (global) respiratory failure. Both the patient's clinical presentation and laboratory examination of blood gases and acid-base balance (preferably from arterial blood) are used for diagnosis. In the absence of contraindications, non-invasive ventilation is used to establish normocapnia.

In medicine, there are two main methods of improving the healthcare provided: perfecting (optimizing) the existing ones and seeking new treatment procedures. Despite of tremendous development in the central nervous system research, current treatment of severe mental illnesses, such as schizophrenia and depressive disorder, is suboptimal. Nowadays, optimization of treatment in psychiatry includes therapeutic drug monitoring (TDM) and pharmacogenomic testing, which examines genetic variation involved in medication metabolism and drug action. The TDM enables to determine drug concentrations in blood and adjust the dose accordingly if clinical effects correlate better with drug blood levels than drug doses. The first international guidelines for TDM in neuropsychopharmacology were published in 2004 and regularly updated. The recent update provides therapeutic reference ranges for a majority of commonly prescribed psychiatric medications and gives example of patients regularly treated in clinical practice profiting from TDM (using antipsychotics and changing their smoking habits). TDM in psychiatry is an underused tool, given its ability to optimize treatment, as well as to improve treatment effectiveness.

World Health Organization (WHO) Europe organizes Childhood Obesity Surveillance Initiative (COSI), in which the Czech Republic participates since the beginning. The aim of this project is to monitor the prevalence of overweight and obesity of 7-year-old children in the Czech Republic. Data were obtained from 2349 children examined by 72 pediatricians across the Czech Republic. Anthropometric parameters were measured and subjects filled questionnaire. The prevalence of obesity and overweight did not change significantly between 2008 and 2019. Although in the fifth round in 2019, the prevalence of obesity increased and the prevalence of overweight slightly decreased in both sexes. In 2019 6.09 % of boys and 7.12 % of girl had overweight. The prevalence of obesity in the fifth round was 9.26 % in boys and 8.64 % in girls (assessed according to the Czech reference values). Already in the first round we noticed a relatively high prevalence of severe obesity (3.21 % for boys and 0.8 % for girls), which did not differ significantly between rounds. Even if the prevalence of overweight has not significantly increased until 2019, preventive and treatment programs are very important, because it is an important part of the prevention and early detection of obesity in children.

The aim of the review article was to analyze studies dealing with the implementation of nutritional intervention with vitamin D content and nutritional intervention including vitamin D in combination with resistance exercise. All these interventions are being investigated in patients with and without sarcopenia. PubMed, CINAHL and MEDLINE databases were used to search for studies. Studies from 2017-2022, in Czech and English, were searched for. All studies had to be freely accessible in fulltext and had to focus on patients older than 65 years. Only meta-analyses and randomized controlled trials (RCTs) were included in the review. A total of 5 RCTs were included in the review. These can be thematically divided into studies devoted to nutritional intervention (1) and studies devoted to nutritional intervention in combination with resistance exercise (4), where the results were most reliable. It can be concluded that the administration of nutritional intervention enriched with vitamin D, with is combined with resistance exercise, can improve vitamin D values, muscle strength and physical fitness in seniors over 65 years of age.

Idiopathic pulmonary fibrosis (IPF) is a severe progressive fibrotic disease of the lung. Its etiology is not yet completely clear. The affected population is exclusively older than 40 years with maximum incidence in the age categories of 60 to 70 years. Its worldwide prevalence varies from 2 to 29/100 000 people (in the Czech Republic 5-6/100 000). Annual incidence is constantly rising, mainly thanks to the ever-improving diagnostic possibilities. Untreated IPF disease causes rapid structural and functional devastation of the lungs with development of respiratory insufficiency and death of the patient within 2 to 3 years after diagnosis, prognosis with IPF is therefore fully (without any exaggeration) comparable to untreated bronchogenic carcinoma. In recent years, the prognosis and quality of life of patients have significantly improved thanks to available specific antifibrotic treatment, which can substantially slow down the disease progression and thus prolong survival. However, a necessary condition for the timely treatment initiation is a quick and accurate diagnosis. The following case report describes a protracted journey to the correct diagnosis in a patient with atypical radiological findings, so that the definitive diagnosis was established only as a result of a surgical lung biopsy.

Over the last 5 years, around 75 heart transplantations a year have been performed in the Czech Republic. According to these data and longer survival of these patients, it is obvious that non-cardiac surgical procedures in this particular group of patients are not rare. In the patients after heart transplantation, there is a significantly higher risk of undergoing elective and emergency surgical procedures due to various reasons. Appropriate anaesthesia and perioperative care are fundamentally affected by the knowledge of pathophysiological and pharmacological differences of transplanted heart. An equally important aspect is a lifetime immunosuppressive therapy in these patients.

Liver function tests are among the most determined biochemical parameters, and it is essential that their interpretation is always performed correctly. The presence of liver disease is indicated not only by the well-known basic panel of liver function tests (bilirubin, ALT, AST, GGT and ALP), but also by other biochemical parameters, especially albumin, INR and platelet count. The latter analytes are often overlooked, as is the fact that normal values in the baseline liver test panel do not yet rule out advanced chronic liver disease - liver fibrosis or cirrhosis. In contrast, high levels of liver function tests do not automatically indicate liver failure. Considering the increasing incidence of liver disease as well as the rising mortality from liver causes in many European countries, it is desirable to update the diagnostic algorithm when pathological liver function tests are detected.

Horizon Europe is the 9th framework programme of European Union (EU) funding research and innovation with the biggest budget ever of €95.5 billion. The main aims of the programme are to boost competitiveness and growth of European Union, to achieve EU sustainable development and to tackle climate change. The programme facilitates collaboration between member states and strengthens the impact of research and innovations. The structure of HEU is similar as in Horizon 2020 based on three pillars: Excellent Science, Global Challenges and European Industrial Competitiveness, and Innovative Europe. Horizon Europe brings several novelties as missions, European partnerships, open science, and gender issues. There are five mission areas and the first one of them is Cancer Mission. European partnership is a new form of objective-driven collaborations bringing together private and/or public partners together to address some of Europe´s most important challenges through concerted research and innovation initiatives. Open science policy is mandatory and refers to the open access to publications and open science principles. In the frame of gender equality strategy, the EU has established a well-established regulatory framework on gender equality, including binding directives, which apply widely across the labour market including the research sector.