Acta medica (Hradec Kralove)最新文献

{"title":"Refractory Form of Chronic Idiopathic Demyelinating Polyneuropathy with Rituximab Effect: A Case Report.","authors":"Edvard Ehler, Tomáš Jurka, Ivana Štětkářová","doi":"10.14712/18059694.2026.22","DOIUrl":"10.14712/18059694.2026.22","url":null,"abstract":"<p><p>The basic characteristic of chronic idiopathic demyelinating polyneuropathy (CIDP) is demyelination of peripheral nerves of autoimmune origin. Antibodies against various myelin sheath proteins play an important role in the pathogenesis of the disease. Cell-mediated immunity, characterised by T-cell and macrophage infiltration in peripheral nerves and spinal roots, is also significantly involved (1). Treatment of CIDP is aimed at suppressing inflammation, but also at removing autoantibodies, cytokines and other pro-inflammatory molecules from the blood. Treatment options include corticosteroids, (intravenous or subcutaneous) immunoglobulins, and plasma exchange (plasmapheresis). If a patient with CIDP does not show an adequate clinical response to these three treatment modalities, it is then refractory CIDP. Based on various studies, this affects up to 10% of patients. We present here a patient with CIDP whose condition gradually stopped improving after all three commonly used treatment modalities (corticosteroids, immunoglobulins, and plasmapheresis). His neurological findings were very severe. The case was ultimately diagnosed as a refractory form of CIDP, which is discussed here in the light of current knowledge of this issue.</p>","PeriodicalId":101400,"journal":{"name":"Acta medica (Hradec Kralove)","volume":"69 2","pages":"75-80"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148709069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"80 Years of the Faculty of Medicine in Hradec Králové.","authors":"Jiří Manďák","doi":"10.14712/18059694.2026.9","DOIUrl":"10.14712/18059694.2026.9","url":null,"abstract":"&lt;p&gt;&lt;p&gt;Last year marked 80 years since Edvard Beneš, President of the Czechoslovak Republic, signed a decree establishing the medical faculty in Hradec Králové as a branch of the Faculty of Medicine at Charles University in Prague. This was the beginning of medical education in the city and the wider East Bohemian region.The decision to establish the faculty here was no coincidence.For centuries, Hradec Králové was an important fortified town in the Austrian Empire, and all aspects of life in the town and its surroundings were subordinated to this fact. This situation lasted until the end of the 19th century, when the fortress was dismantled. It was only after this that the town and region underwent rapid development, a process that continued during the First Republic.The region's development led to a sharp increase in population, creating a need for better, more accessible healthcare. Thanks to the significant support and efforts of city officials, one of the largest and most modern hospitals in what was then Czechoslovakia was built. This hospital employed a number of leading experts who, in addition to their high level of professional expertise and medical experience, were also actively involved in lecturing, publishing and social activities.The region therefore possessed a high level of personnel, professional and material readiness to support a medical faculty. Its possible establishment was therefore discussed throughout the interwar period as part of the efforts to establish a university in Hradec Králové - or rather, a regional university in East Bohemia. However, this process was halted for six long years by a significant historical event: the occupation of the republic and its subjugation as the Protectorate as part of the German Reich.The desperate shortage of doctors after the liberation in 1945 increased the urgency to open a medical faculty as soon as possible. The closure of universities during the occupation, violent deaths on the battlefield, in concentration and labour camps, the post-war displacement of the German population and waves of emigration all contributed to the critical shortage of physicians. Given these circumstances, it was only logical that the city of Hradec Králové was chosen to establish a medical faculty shortly after the war ended. Thanks to the extraordinary efforts of the government, the Ministry, the district and municipal authorities, representatives of higher education and leading physicians at the Hradec Králové hospital, the city became a university town 80 years ago when a branch of the Medical Faculty of Charles University was established there.However, the beginnings were not easy. Besides having access to the state-of-the-art hospital, the school also needed adequate facilities for teaching basic theoretical subjects and high-quality teaching materials. The need for teaching facilities was resolved thanks to the opportunity to use a modern building on Šimkova Street. Built just before the war for th","PeriodicalId":101400,"journal":{"name":"Acta medica (Hradec Kralove)","volume":"69 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148038449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison between the Prognosis of Temporomandibular Disorders with and without Accompanying Otologic Symptoms after Non-Invasive Non-Pharmacological Treatment: Controlled Clinical Trial.","authors":"Samer Al Akkad, Mohammad Y Hajeer, Marwan Al Akkad","doi":"10.14712/18059694.2026.13","DOIUrl":"10.14712/18059694.2026.13","url":null,"abstract":"<p><strong>Background: </strong>Otologic symptoms are commonly reported by patients with temporomandibular disorders.</p><p><strong>Objective: </strong>This study aims to investigate the likely outcome or progression of temporomandibular disorders with and without accompanying otologic symptoms when treated in the dental clinic.</p><p><strong>Methods: </strong>The study is registered under the International Standard Randomised Controlled Trial Number: ISRCTN49976724, DOI: 10.1186/ISRCTN49976724. Forty patients with temporomandibular disorders were included and allocated into two groups: Control group (n=20): isolated temporomandibular disorders symptoms, and Experimental group (n=20): temporomandibular disorders symptoms with otologic symptoms (confirmed by otorhinolaryngological evaluation to exclude primary ear pathology). All participants underwent non-invasive, non-pharmacological treatment. The treatment contained physiotherapy and custom-made occlusal splints. Outcomes (full/partial/no recovery) were assessed at 3 months by a single maxillofacial surgeon, with follow-up every 3 weeks. Statistical analysis included Fisher's exact test and odds ratios.</p><p><strong>Results: </strong>Fisher's exact test revealed a statistically significant association between group allocation and recovery outcomes (χ2=5.979, p=0.041). The odds ratio was 5.33.</p><p><strong>Conclusion: </strong>The presence of otological symptoms accompanying temporomandibular disorders might predict a better prognosis after non-invasive, non-pharmacological treatment, perhaps not as a direct predictor per se but as a confounding factor.</p>","PeriodicalId":101400,"journal":{"name":"Acta medica (Hradec Kralove)","volume":"69 1","pages":"26-31"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148038457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current and Emerging Approaches to Osseointegration Assessment in Dental Implantology: Limitations, Clinical Utility, and Future Directions.","authors":"Panagiotis Kafas, Theodoros Lillis, Nikolaos Dabarakis","doi":"10.14712/18059694.2026.11","DOIUrl":"10.14712/18059694.2026.11","url":null,"abstract":"<p><p>This review evaluates existing methods for the measurement of osseointegration, which is the biological mechanism that assures long-term stability of dental implants. Invasive techniques, such as histology and pull-out torque measures, provide direct objective evaluation; however, they cannot be employed clinically due to their invasive nature. Non-invasive methods such as radiographic imaging, resonance frequency analysis, Periotest, and newer methods utilizing ultrasound have been used clinically. These are mainly based on indirect measurements or incomplete measures regarding bone-to-implant contact. Clinical measures of implant osseointegration are often subjective and vary significantly. Research into biochemical blood markers, biochemical markers in peri-implant fluids, and the use of digital technologies associated with decision-making shows promise for generating more personalized assessment outcomes and possibly predictive capacity. Many factors, including implant design, bone density, surgical technique, systemic disease, and others, influence the accuracy of measurement. Future research assessment will likely be based upon the usage of a multimodal protocol (involving mechanical, radiographic, biological, and computational data) so that the oral surgeon will consider all available data to assist decision-making, evaluation, and enhance long-term assessment of implants.</p>","PeriodicalId":101400,"journal":{"name":"Acta medica (Hradec Kralove)","volume":"69 1","pages":"11-18"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148038441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Eyelid Radiotherapy-Treated Basal and Squamous Cell Carcinomas: A Case Series.","authors":"Ioannis Athanasiadis, Aristeidis Konstantinidis, Eirini-Kanella Panagiotopoulou, Minas Bakirtzis, Michael Koukourakis, Georgios Labiris","doi":"10.14712/18059694.2025.20","DOIUrl":"10.14712/18059694.2025.20","url":null,"abstract":"<p><strong>Introduction: </strong>This case report aims to showcase the successful application of electron hypofractionated radiotherapy in the treatment of eyelid basal cell carcinoma (BCC) and squamous cell carcinoma (SCC).</p><p><strong>Cases presentation: </strong>Two cases are presented involving a 91-year-old Greek female with nodular BCC and an 88-year-old Greek male with ulcerative SCC. Both cases were treated with electron 10MeV irradiation using an ELEKTA 5-15MV linear accelerator. In the first case, a patient with advanced dementia presented with left-upper-eyelid nodular BCC. Following confirmation through biopsy and imaging, hypofractionated electron-beam radiotherapy was chosen, leading to gradual recession of the lesion and no recurrence at the one-year follow-up. In the second case, an elderly male with comorbidities had right-upper-eyelid ulcerative SCC. After systemic evaluation ruled out metastasis, the patient underwent hypofractionated radiotherapy, resulting in unexpected lesion shrinkage, resolution, and absence of recurrence at the 6-month and one-year follow-ups.</p><p><strong>Conclusions: </strong>Hypofractionated electron-beam radiotherapy emerges as an effective and well-tolerated alternative for eyelid tumors, particularly in cases where surgical excision is challenging or contraindicated.</p>","PeriodicalId":101400,"journal":{"name":"Acta medica (Hradec Kralove)","volume":"68 2","pages":"58-62"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145254337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Two Hurt More Than One: Severe Hyponatraemia and Rhabdomyolysis as Presenting Features of Addison's Disease.","authors":"Luca Foppiani, Christian Cascio, Paola Pesce, Giancarlo Antonucci","doi":"10.14712/18059694.2025.16","DOIUrl":"10.14712/18059694.2025.16","url":null,"abstract":"<p><p>Addison's disease (AD) is characterized by non-specific symptoms and electrolyte disorders, namely hyponatraemia and hyperkalaemia; rhabdomyolysis is uncommon. AD may manifest at onset with a life-threatening adrenal crisis which is triggered by stressful events. We describe the case of a young man who was hospitalized for severe myalgia and fatigue. Severe hypotonic hyponatraemia, rhabdomyolysis and hypotension were found; hormonal assessment unexpectedly revealed primary adrenal insufficiency. Saline infusion and intravenous hydrocortisone significantly improved the patient's condition and normalized sodium and muscle enzyme levels; thereafter, he was switched to oral steroid therapy. The autoimmune origin of AD was ascertained by the positivity of adrenal cortex autoantibodies and 21b-hydroxylase autoantibodies. The association of hyponatraemia and rhabdomyolysis may be the initial finding of an as yet unknown AD, which requires proper investigation and treatment.</p>","PeriodicalId":101400,"journal":{"name":"Acta medica (Hradec Kralove)","volume":"68 1","pages":"31-36"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144304219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond the Headlines: Why Henipaviruses Warrant Our Attention.","authors":"Biplab Adhikari","doi":"10.14712/18059694.2025.11","DOIUrl":"10.14712/18059694.2025.11","url":null,"abstract":"<p><p>Henipaviruses, including Hendra and Nipah viruses, represent significant zoonotic threats with higher mortality rates. Due to limited therapeutic interventions, poses substantial challenges. These bat-borne pathogens were first identified in Australia (Hendra, 1994) and Malaysia (Nipah, 1998-1999), with subsequent multiple outbreaks. The recent discovery of Camp Hill virus in North American shrews, suggest broader geographic distribution than previously recognized. Transmission occurs primarily through contact with reservoir hosts, though human-to-human spread has been documented in Nipah outbreaks. Initial non-specific febrile symptoms can progress to fatal encephalitis with distinctive pathological findings including syncytia formation and vasculitis. A concerning feature is the potential for relapsing encephalitis months or years after initial infection. Management remains predominantly supportive, highlighting the urgent need for effective antivirals, vaccines, and enhanced surveillance. Expanded research into therapeutic countermeasures is essential to address this emerging global public health threat.</p>","PeriodicalId":101400,"journal":{"name":"Acta medica (Hradec Kralove)","volume":"68 1","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144304294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intra-Operative and Post-Operative Impact of Body Weight on Total Hip Arthroplasty: Are We Approaching It Correctly?","authors":"Edoardo Ipponi, Sara Barderi, Elena Bechini, Belinda Misso, Luca Orsetti, Lorenzo Andreani, Nicola Piolanti, Enrico Bonicoli, Paolo Domenico Parchi","doi":"10.14712/18059694.2025.15","DOIUrl":"https://doi.org/10.14712/18059694.2025.15","url":null,"abstract":"<p><strong>Background: </strong>To this date, the impact of body weight on total hip arthroplasty is still debated. The literature lacks evidence on the impact of body weight on surgical times and complications.</p><p><strong>Methods: </strong>We retrospectively evaluated all the patients who underwent primary total hip arthroplasty (THA), collecting patients' pre-operative BMI before surgery. We recorded the surgical approach performed (anterior or posterolateral), and their duration. All the major complications were recorded.</p><p><strong>Results: </strong>Seven-hundred-thirty-two cases were included (627 posterolateral and 105 anterior approach). The mean BMI was 27.3. The mean surgical time was 90.8 minutes (104.9 for anterior and 88.5 for posterolateral approach). We found a significant positive relationship between BMI and surgical times for both cases treated with a posterolateral approach, and (even more remarked) in case anterior approach. Thirty-nine cases (5.3%) had major complications; 27 of them (69.2%) were overweight or obese. The surgical times of those who had complications were significantly higher compared to others.</p><p><strong>Conclusions: </strong>Patients' body weight, and in particular their Body Mass index, has a direct impact on the duration of THA surgical procedures, particularly if performed using an anterior approach, and an indirect effect on complication rates.</p>","PeriodicalId":101400,"journal":{"name":"Acta medica (Hradec Kralove)","volume":"68 1","pages":"26-30"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144304296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of Chondral Defect of the Knee Joint - Current Methods, Possibilities of Using Cultured Mesenchymal Stem Cells.","authors":"Libor Prokeš, Tomáš Kučera","doi":"10.14712/18059694.2025.12","DOIUrl":"https://doi.org/10.14712/18059694.2025.12","url":null,"abstract":"<p><p>Cartilage damage is caused by degenerative process and also by trauma, microtrauma or as a consequence of avascular necrosis. The damage may be focal or diffuse over a larger area. Because of the limited healing potential, treatment of articular cartilage injuries is problematic. The choice of surgical treatment depends on several factors: the size, depth and location of the defect, the age of the patient, the desired activity, associated changes and the possibility of postoperative rehabilitation. Finding an appropriate method of treatment for chondral defects with a reliable long-term outcome is difficult. The most common, clinically proven and used surgical techniques include abrasive chondroplasty, marrow stimulating techniques, transplantation procedures or a combination of methods. The possibility of introducing new methods in the form of the application of cultured mesenchymal stem cells represents a significant advance in the field of regenerative medicine. Their use is safe and effective.</p>","PeriodicalId":101400,"journal":{"name":"Acta medica (Hradec Kralove)","volume":"68 1","pages":"8-13"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144304298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Are We Moving Toward Curative Approaches in Chronic Lymphocytic Leukemia?","authors":"Martin Šimkovič, Eva Vejražková, Dominika Écsiová, Pavel Vodárek","doi":"10.14712/18059694.2026.1","DOIUrl":"10.14712/18059694.2026.1","url":null,"abstract":"<p><p>Over the past decade, chronic lymphocytic leukemia (CLL) management has undergone a fundamental transformation driven by the introduction of oral targeted inhibitors. Continuous Bruton tyrosine kinase (BTK) inhibition and time-limited BCL-2-based therapy has replaced chemoimmunotherapy as the standard of care, improving survival and quality of life. Ibrutinib and its next-generation analogues, acalabrutinib and zanubrutinib, provide durable disease control with improved safety. At the same time, venetoclax combined with anti-CD20 antibodies enables deep and measurable residual disease (MRD)-negative remissions within fixed-duration regimens. Recent trials have demonstrated the feasibility of MRD-guided treatment cessation and the potential benefit of combining BTK and BCL-2 inhibition to achieve durable, chemotherapy-free responses. Ongoing research focuses on optimizing treatment sequencing, overcoming acquired resistance through non-covalent BTK inhibitors, and integrating immunotherapeutic modalities such as bispecific antibodies and CAR-T cells. The current paradigm emphasizes individualized, biomarker- and comorbidity-driven therapy based primarily on TP53 and IGHV status, with treatment selection tailored to patient fitness, tolerance, and long-term safety. This review summarizes contemporary evidence, clinical practice recommendations, and future directions in the targeted management of CLL.</p>","PeriodicalId":101400,"journal":{"name":"Acta medica (Hradec Kralove)","volume":"68 4","pages":"113-122"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147505808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}