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rk properties and that the temporal gyrus, frontal gyrus, hippocampus, and cerebellar regions may play key roles in such mechanisms. These findings have important implications for our understandings of ECT and depression. However, this study is limited by a relatively small sample size and the results should be confirmed in larger samples.The professionalization of hospice and palliative medicine has been well documented, as has its associated rise to specialty status. The movement to formalize hospice and palliative medicine in the United States included ten sponsoring boards for initial certification through a practice pathway. Thus, it began with the potential for subspecialty interests, advocacy, and training. This review will examine the emergence of surgical palliative care as a field within hospice and palliative medicine as well as its unique place within the specialty of surgery, where it is sometimes hailed as an inherent, historically present body of knowledge and skill, and just as often, remarked upon as an ahistorical oxymoron. The phases of formation, early adoption, popularization, and normalization will be described and illustrated by the benchmarks of formal education requirements, board eligibility and certification, and professional relationships fostered by medical societies and online communities. Community building in palliative care must acknowledge the diversity of its constituents and the differences in subspecialty identity formation and sources of professional credibility and legitimacy. Metaphors for practitioners of surgical palliative care range from the rarity of the unicorn to the swarm intelligence principles of the beehive. check details Future directions include facing the questions about the role of specialty training and practice in surgical palliative care compared to renewed emphasis on palliative principles in general surgical training and practice.
Regional analgesia, such as intercostal nerve blockade (INB), is a viable modality for postoperative pain control in thoracic surgery patients. Asian patients have historically been underrepresented in studies of pain responses and pain medication requirements based on race. In this study, we examined the postoperative opioid medications used by Asian and Caucasian patients undergoing video-assisted thoracoscopic surgery (VATS) lobectomy who received different bupivacaine-based INB.
We retrospectively reviewed patients undergoing VATS lobectomy who received standard bupivacaine (SB), liposomal bupivacaine (LB), or liposomal bupivacaine mixed with standard bupivacaine (MIX). Length of stay (LOS), postoperative pain scores, postoperative opioid use (in intravenous morphine equivalents) were evaluated. The Chi-square test was used to compare categorical variables; Student's t-test for normally distributed variables; and the Wilcoxon rank-sum test for non-normally distributed variables. Multivariable linear r01).
INB with LB or liposomal-standard bupivacaine mix resulted in statistically significant decreased postoperative pain scores and opioid use in Asians compared to Caucasians. There was no difference in LOS between the LB/MIX and SB groups.
INB with LB or liposomal-standard bupivacaine mix resulted in statistically significant decreased postoperative pain scores and opioid use in Asians compared to Caucasians. There was no difference in LOS between the LB/MIX and SB groups.Carcinosarcoma of the pancreas is a rare malignancy with high mortality. Diagnosis is based on pathologic demonstration of adjacent malignant epithelial and mesenchymal tissue. Due to inherent limitations of biopsy sampling, tumor heterogeneity is rarely recognized until definitive surgical resection. A 52-year-old woman presented to the emergency department with diarrhea. Abdominal CT imaging showed a 4.1×4.5 cm mass in the head of the pancreas with intrahepatic and extrahepatic ductal dilation. Endoscopic ultrasound (EUS) confirmed the mass with evidence of superior mesenteric vein involvement. Fine-needle aspiration (FNA) showed adenocarcinoma. After multi-disciplinary tumor board discussion, the patient was treated with four cycles of neoadjuvant of oxaliplatin, irinotecan, fluorouracil, and leucovorin (FOLFIRINOX) followed by 50-55 Gray (Gy) photon radiation with concurrent capecitabine. Pancreaticoduodenectomy was performed after 6 months of neoadjuvant therapy. Pathologic examination revealed carcinosarcoma of the pancreas, with pathological partial response in the resected tumor. Patient has been disease-free for 15 months. Carcinosarcoma of pancreas is a rare clinical entity. There is no established systemic therapy and only two patients, inclusive of this case, have been treated with neoadjuvant chemotherapy. Here we report a case of pancreatic carcinosarcoma treated with neoadjuvant FOLFIRINOX followed by chemoradiation with pathological partial response. Modern treatment approaches for pancreatic ductal adenocarcinoma (PDAC) could be applied to this rare pathology.A case report is presented of a patient with suspected septicaemia from whose blood culture a new strain of Corynebacterium sp. was isolated. Until now, no report of this strain isolated from human clinical materials has been available in the literature. In addition to a brief clinical description of the case, the article also features morphological, biochemical properties as well as antibiogram of the bacterium. It describes also methods used for the identification of this isolate. The aim of the work was to highlight a novel and rare coryneform strain.The clinical course of the SARS-CoV-2 virus infection (COVID-19 disease) in paediatric patients is predominantly mild. However, in a small percentage of paediatric patients, the COVID-19 could lead to the development of with the Paediatric Inflammatory Multisystem Syndrome (PIMS) presenting as high fever, gastrointestinal symptoms, neurological symptomatology and even as multiorgan dysfunction. These three cases represent the first published report of critically ill paediatric patients with PIMS in the Czech Republic.B cells play a vital role in the defence of the body against infectious agents. Apart from their ability to present antigen to T cells, B cells are mainly producers of antibodies. These play a crucial role in the effective elimination of infection and are also involved in the regulation of the immune response. The analysis of peripheral blood B cell subpopulations that makes it possible to monitor the development of B cells to the stage of antibody producing plasmablasts provides a valuable laboratory parameter which is important for both the study of the pathogenesis and diagnosis of some diseases. Laboratory analysis of B cell subpopulations is now a routinely available laboratory option thanks to the development of multicolour flow cytometry. This article summarizes the core knowledge which is currently applied to the analysis of B cell subpopulations in immunological laboratories.Mumps is an infectious viral disease transmitted by droplets. It is vaccine preventable and thanks to the start of compulsory vaccination in 1987, there has been a significant reduction in cases. Nevertheless, over the years, occasional local outbreaks have occurred in the Czech Republic, especially in adolescents, while in Slovakia, since the beginning of vaccination, the situation has been kept under somewhat better control. This may be explained by the differences in the vaccination schedules between the countries and the consequent secondary vaccine failure, the so-called waning of immunity in Czech older children, adolescents, and young adults. The article summarizes current knowledge about mumps and data on its incidence in the Czech Republic and Slovakia.
The aim of the study was to determine the prevalence of arterial hypertension and its awareness rate and control rate among diabetes mellitus (DM) patients in the Czech Republic between 25-64 years of age and to compare the results with those in age-matched non-diabetic patients.
Blood pressure measurement data of 1 170 respondents (467 men and 703 women) obtained during the EHES study in 2014 were analysed. DM was diagnosed in 95 (8.2%) respondents (44 men and 51 women).
Mean systolic blood pressure in DM patients was 130.7 ± 18.3 vs. 123.2 ± 16.8 mmHg in non-DM subjects (p < 0.001). The difference in diastolic blood pressure was on the borderline of statistical significance (82.2 ± 9.4 mmHg in DM vs. 80.0 ± 10.6 mmHg in non-DM subjects, p = 0.051). Among the study population, 69.5% of DM and 34.2% of non-DM subjects suffered from arterial hypertension (p < 0.001). The hypertension awareness rates were 87.9% in the DM group and 66.8 % in the non-DM group. (p = 0.001). The percentage of trients (< 130/80 mmHg) are not always reached in clinical practice.
The study has shown the prevalence of arterial hypertension to be twice as high in DM patients aged 25-64 compared to the age-matched non-DM subjects in the Czech Republic. The adequate blood pressure control rate is significantly lower in DM patients than in the non-diabetic population. The study results indicate that the blood pressure targets recommended for diabetic patients (< 130/80 mmHg) are not always reached in clinical practice.
The monitoring of influenza virus resistance is a routine part of influenza virus surveillance conducted by the National Reference Laboratory for Influenza and Non-Influenza Respiratory Viral Diseases (NRL/INI) at the National Institute of Public Health (NIPH). The aim is to detect neuraminidase inhibitor (oseltamivir) resistance in patients diagnosed with influenza.
A total of 326 influenza virus isolates from tissue culture were included in the study. They were obtained from inpatient and outpatient nasopharyngeal swabs which were referred to the NRL/INI during the seasons 2013/2014 to 2019/2020 and turned out to be RTPCR (reverse transcription polymerase chain reaction) positive for RNA (ribonucleic acid) of influenza virus A or B. The MDCK (Madin-Darby canine kidney) tissue culture cells were used for virus isolation from nasopharyngeal swabs. Oseltamivir resistance was tested using the NA-Star Influenza Neuraminidase Inhibitor Resistance Detection Kit (Applied Biosystems, Foster City, CA).
Nine of est the emergence and/or spread of antiviral drug resistance in the population.
Noroviruses are members of the Caliciviridae family and are currently segregated into at least 10 genogroups. The distribution of these viruses in the Czech Republic has not yet been investigated in detail. A pilot study was performed to contribute to the overall knowledge and understanding of norovirus circulation in the population. Clinical specimens from patients diagnosed with norovirus infection during their hospitalization at the Pilsen University Hospital were genotyped.
A total of 118 patients were diagnosed with norovirus infection between July 2017 and March 2020. Stool samples from patients presenting with gastroenteritis were routinely screened by the RIDA®QUICK Norovirus Test (R-Biopharm AG), a rapid chromatographic immunoassay for the qualitative detection of Norovirus genogroups I and II, according to the manufacturers instructions. Norovirus positive samples were subsequently analysed by molecular biological methods. Stool suspensions (10%) were prepared with phosphate-buffered saline, and nucleic acid was extracted using the QIAamp Viral RNA kit (Qiagen) according to the manufacturers instructions.
