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This rare complication proved lethal in one out of two of the cases described in this paper. An imminent and adequate reaction is necessary when the first signs of haemorrhage appear.

The aim of this study was to evaluate the results of surgical treatment of intrahepatic cholangiocarcinoma (IHCHCA) in terms of overall survival and disease-free survival, and to analyse and find potential prognostic factors affecting overall survival and disease-free survival.

Retrospective evaluation was performed of consecutively enrolled patients operated for IHCHCA from January 2005 to January 2022 (17 years) had undergone surgery. During the monitored period, 38 surgical procedures were performed, of which liver resection was done in 25 cases (65.8%).

The 5-year survival in the radically resected group was 44%, and the 5-year disease-free survival was 32%. Based on univariate and multivariate analysis, radicality of surgery (p=0.01116) and lymph node involvement (p=0.00576) were assessed as negative prognostic factors for overall survival. Radicality of surgery (p=0.018) and administration of adjuvant chemotherapy (p=0.044) were significant negative prognostic factors affecting disease-free survival. However, they lost their significance in the multivariate analysis.

Radical surgical resection of the liver remains an essential treatment option for intrahepatic cholangiocarcinoma aimed at achieving a radical procedure with microscopically negative margins.

cholangiocarcinoma, resection, recurrence, survival.

cholangiocarcinoma, resection, recurrence, survival.

The prognosis of extrahepatic cholangiocarcinoma is dismal and the only way to achieve long-term survival is surgical resection. While pancreatoduodenectomy (PD) is the standard procedure for distal cholangiocarcinoma (distal bile duct cancer; DBDC), bile duct segmental resection (BDR) can be used as an alternative approach for middle bile duct cholangiocarcinoma (middle bile duct cancer; MBDC). The aim of the study was to calculate the short-term and long-term outcomes of curative-intent surgery in distal bile duct cholangiocarcinoma patients.

A retrospective cohort study of consecutive patients treated for MBDC and DBDC with PD or BDR between 1/2009-12/2019. The patients were divided according to the type of surgical resection (PD and BDR group). Demographic, clinicopathological and histopathological data and overall survival (OS) were evaluated in both groups. OS was estimated using the Kaplan-Meier analysis.

The study comprised a total of 62 patients - 45 patients (72.6%) in the PD group and 17 (27.e BDR group (N=10/17; 58.8%). Median age was higher in the BDR group (p=0.048). Serious morbidity (Clavien-Dindo III-V) (33.3% vs 11.8%), 30-day and 90-day mortality (4.4% vs 0.0% and 8.9% vs 5.9%, respectively) predominated in the PD group although the differences were not statistically significant, as well as a longer hospital stay (16.0 days vs 11.0 days; p=0.002). Pathological assessments revealed comparable numbers of positive lymph nodes in both groups, but a significantly higher number of total resected lymph nodes in the PD group (p.

Biliary tract malignancies belong to very aggressive malignancies of the gastrointestinal tract. The only radical treatment is surgical resection which is possible only in a limited number of cases due to late diagnosis. The aim of this report was to present the experience of our own department with the diagnosis and treatment of these tumours.

In the years 2005-2021 radical (R0) resection was performed in 27 (28.4%) patients, the same number were managed only symptomatically and in 41 (43.2%) patients we used biliary stenting and external-internal drainage as the definitive procedure. Adjuvant oncological treatment was indicated in 16 (59.3%) of the radically operated and 49 (72.1%) of the non-operated patients.

Median overall survival and median progression-free survival in the operated patients were 19.9 months and 15.7 months, respectively. Overall survival in the operated patients was significantly better (p.

Median overall survival and median progression-free survival in the operated patients were 19.9 months and 15.7 months, respectively. Overall survival in the operated patients was significantly better (p.Iatrogenic bile duct injury still represents a serious complication mostly connected with minimally invasive cholecystectomy. This complication has an important impact both on short- and long-term morbidity and is associated with non-negligible mortality. The objective of our study was to provide a comprehensive summary of information based on the most recent guidelines with recommendations for how to prevent a bile duct injury, how to reach an early diagnosis and finally, how to proceed should they occur in order to minimize further damage. We also present ATOM, a new classification of bile duct injuries that provides clear information not only about the extent of anatomical damage, but also about the time and mechanism of its occurrence.Extrahepatic cholangiocarcinoma is a rare disease with poor prognosis, requiring comprehensive multidisciplinary management. Only radical resection gives hope for long-term survival. Most patients have either an unresectable disease or their condition does not allow for radical surgery. The method of choice for resectable perihilar cholangiocarcinoma is en-block liver resection including the extrahepatic bile duct, or pancreatoduodenectomy for distal cholangiocarcinoma. Hepatopancreatoduodenectomy can be performed in selected patients if the entire hepato-choledochus is affected. Liver transplantation after neoadjuvant treatment can be also considered in highly selected patients with unresectable perihilar cholangiocarcinoma. These procedures are technically demanding, are associated with high morbidity and relevant mortality, and must be concentrated in tertiary hepatobiliary centers. Preoperative optimization (bile duct drainage, nutrition, portal venous embolization, etc.) plays a crucial role in reducing postoperative morbidity and mortality.Malaria is one of the worlds most important infectious diseases, occurring in many tropical and subtropical countries. The causative agent is a parasitic protozoan of the genus Plasmodium, transmitted to humans by infected mosquitoes. More than 200 million people get malaria every year worldwide, and hundreds of thousands of them, mostly children under 5 years of age, die of it. Thanks to prevention programmes implemented by various organisations headed by the World Health Organisation (WHO) with the aim of eliminating malaria, cases have been declining in recent years. However, particularly in African countries, malaria continues to be a health and economic issue.This study describes a cohort of 223 patients who received anti-S protein monoclonal antibody (mAb) treatment for COVID-19 after having met the indication criteria set by the national guidelines in the Czech Republic at the time. The authors compare the vaccinated and unvaccinated subpopulations of this cohort. The results show that most of the patients (73.5%) already had significant circulating levels of anti-S antibodies detectable at the time of treatment. The authors confirm a positive correlation between number of vaccine doses and S-protein antibody levels. The data show, that vaccinated patients are overall less likely to be hospitalized than unvaccinated ones. The authors recommend a change in the national guidelines for mAb treatment in the Czech Republic.

To report on a unique combination of cerebral toxoplasmosis and ocular toxoplasmosis in an HIV-positive patient in Slovakia.

A 35-year-old heterosexual patient who presented with headache and major seizures underwent computed tomography (CT) and magnetic resonance imaging (MRI). Based on clinical findings, serological tests for toxoplasmosis were performed on serum and ocular fluid specimens. PCR was also used to detect Toxoplasma gondii and cytomegalovirus DNA. Goldmann and Witmer coefficient calculation was applied to demonstrate the synthesis of intraocular IgG antibodies.

CT and MRI revealed cystic lesions suspected of metastasis in the occipital and temporal regions, and we searched for the primary tumor. After vision loss in the left eye, which rapidly progressed to complete blindness, an eye examination detected macular edema. Anti-edema treatment was initiated. HIV positivity with a very low CD4 T-cell count (20/μL) was found, and the viral load was 100 400 HIV-RNA copies/ml. The serum reatment initiation was 16 days, which assumedly caused irreversible blindness in the patient.

CT and MRI scans offered no clue as to Toxoplasma etiology of the brain and eye involvement in an HIV-positive patient, which was only confirmed by laboratory tests. Due to the delay in the diagnosis of toxoplasmosis, time from the epileptic seizure to treatment initiation was 16 days, which assumedly caused irreversible blindness in the patient.Vibrio spp. are Gram-negative rod-shaped bacteria commonly present in marine, estuarine and natural freshwater environments. A few members of this genus are associated with human diseases. Here we present the study of Vibrio spp. isolations from 20 artificial recreational pools in Slovakia. Water samples were collected from artificial pools filled with mineralized thermal water in eight recreational areas in Slovakia in 2019 and 2020. Ninety six out of 176 samples were positive for Vibrio spp. Totally 118 different strains of Vibrio spp. were isolated, from which 77 belonged to potentially pathogenic species - V. cholerae (34 isolates), V. vulnificus (4 isolates), V. furnissii (3 isolates), V. fluvialis (25 isolates), V. buy LBH589 alginolyticus (10 isolates) and V. mimicus (1 isolate). To our knowledge this is the first study demonstrating the presence of pathogenic or potentially pathogenic Vibrio spp. in artificial pools filled with thermal mineralized waters even disinfected with chlorine compounds.

An analysis is presented of epidemiological and molecular data from invasive meningococcal disease (IMD) surveillance in the Czech Republic (CR) for 1993-2020, comparing trends in four seven-year periods 1993-1999, 2000-2006, 2007-2013, and 2014-2020.

IMD surveillance data are generated by linking National Reference Laboratory for Meningococcal Diseases data and epidemiological data routinely reported to the infectious diseases information systems, with duplicate data removal. Whole genome sequencing (WGS) was used for analysis of selected isolates from IMD cases. In this study, WGS data are analysed on 323 isolates recovered from IMD cases in the Czech Republic between 1993-2020.

Over the entire study period 1993-2020, 2,674 cases were recorded in the IMD surveillance programme, of which 272 were fatal. In the first seven-year period, the highest incidence rate of 2.2/100,000 population was reported in 1995, a gradual decline from 0.8 to 0.6/100,000 was observed in the third period, and in the last pery currently used in the Czech Republic, i.e., vaccination of young children and adolescents with a combination of MenB vaccine and quadrivalent conjugate ACWY vaccine, appears to be the most appropriate in the context of the long-term epidemiological situation of IMD in the CR.