Casopis lekaru ceskych最新文献_第4页

Diabetic foot attack. 糖尿病足发作

Casopis lekaru ceskych Pub Date : 2024-01-01

Milan Flekač

引用次数: 0

Roma people in the Czech Republic and cultural differences in health and health care. 捷克共和国的罗姆人与健康和医疗保健方面的文化差异。

Casopis lekaru ceskych Pub Date : 2024-01-01

Helena Hnilicová

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Renal impairment in monoclonal gammopathies and multiple myeloma. 单克隆丙种球蛋白病和多发性骨髓瘤的肾功能损害。

Casopis lekaru ceskych Pub Date : 2024-01-01

Romana Ryšavá

{"title":"Renal impairment in monoclonal gammopathies and multiple myeloma.","authors":"Romana Ryšavá","doi":"","DOIUrl":"","url":null,"abstract":"The incidence of monoclonal gammopathy (MG) increases with age. In individuals over 80 years of age, we can diagnose the presence of monoclonal immunoglobulin (MIg) in up to 10 % of cases. Not only malignant diseases such as multiple myeloma (MM), but also benign forms such as MGUS (monoclonal gammopathy of undetermined significance) can lead to renal involvement. The light chains of immunoglobulins (LC) are the most damaging to the kidneys, as they are freely filtered into the urine due to their molecular weight. Detection of MIg relies mainly on a combination of immunofixation electrophoresis of serum (IELFO) and urine and determination of free light chains (FLC) of kappa and lambda and their ratio (κ/λ) in serum. The combination of these tests will detect the presence of MIg with 99 % sensitivity. Renal damage in MG may be caused by direct deposition of MIg in the glomeruli (e.g. AL amyloidosis, LC deposition disease) or tubules (in the distal tubule as a myeloma kidney or in the proximal tubule as Fanconi syndrome or proximal tubulopathy). Typical urinary findings in these diseases are moderate or severe proteinuria or nephrotic syndrome. Acute kidney injury (AKI) can be expected especially when serum FLC is >500 mg/l. Renal biopsy is crucial to establish an accurate diagnosis and thus initiate the correct treatment. Treatment of these types of renal damage involves the same treatment regimens used in the treatment of MM, including proteasome inhibitors or daratumumab.","PeriodicalId":9645,"journal":{"name":"Casopis lekaru ceskych","volume":"163 3","pages":"98-105"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141562767","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}

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Artificial intelligence in medicine and healthcare: Opportunity and/or threat. 人工智能在医疗和保健领域的应用：机遇和/或威胁。

Casopis lekaru ceskych Pub Date : 2024-01-01

Lenka Lhotská

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COVID-19: to vaccinate or not to vaccinate - that is the question. COVID-19：接种还是不接种--这是一个问题。

Casopis lekaru ceskych Pub Date : 2024-01-01

Jiří Městecký, Milan Raška

{"title":"COVID-19: to vaccinate or not to vaccinate - that is the question.","authors":"Jiří Městecký, Milan Raška","doi":"","DOIUrl":"","url":null,"abstract":"SARS-CoV-2 is a virus which infects the respiratory tract and may cause severe, occasionally life-threatening disease COVID-19. In more than 5% of symptomatic patients the infection is associated with post-acute symptoms. The initial contact of the virus with the immune system of the nasopharynx and oropharynx induces a mucosal immune response manifested by the production of secretory IgA (sIgA) antibodies which may contribute to the restriction of the infection to the upper respiratory tract and an asymptomatic or clinically mild disease. The current systemically administered vaccines protected against the severe COVID-19 infection and its post-acute sequelae. However, they do not induce antibodies in mucosal secretions in SARS-CoV-2-naive individuals. In contrast, in those who previously experienced mucosal infection, systemically administered vaccines may stimulate sIgA production. The clinical benefit of systemic vaccination convincingly documented in tens of millions of individuals overshadows the rare, sometimes controversial reports of complications encountered after vaccination. The inability of current SARS-CoV-2 vaccines to induce mucosal immune responses and to prevent the spreading of the virus by external secretions demonstrates the mutual independence of mucosal and systemic compartments of the immune system, and thus emphasizes need for the development of vaccines inducing protective immune responses in both compartments.","PeriodicalId":9645,"journal":{"name":"Casopis lekaru ceskych","volume":"163 4","pages":"131-136"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142280712","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}

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Je obezita a malnutrice u geriatrických pacientů problémem z hlediska dávkování analgetik? 老年病人的肥胖和营养不良是否会影响镇痛剂的剂量？

Casopis lekaru ceskych Pub Date : 2024-01-01

Eliška Dvořáčková

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Polypragmazie a jak jí předcházet. 多发性瘫痪和如何预防多发性瘫痪。

Casopis lekaru ceskych Pub Date : 2024-01-01

Jan Miroslav Hartinger, Daniel Laurus Bobek

{"title":"Polypragmazie a jak jí předcházet.","authors":"Jan Miroslav Hartinger, Daniel Laurus Bobek","doi":"","DOIUrl":"","url":null,"abstract":"Polypharmacy is currently a serious problem that causes decrease in adherence and increased number of hospitalizations and mortality. WHO addresses polypharmacy in the Medication Without Harm campaign. Other initiatives that deal with polypharmacy are the International Group for Reducing Inappropriate Medication Use & Polypharmacy (IGRIMUP) and Choosing Wisely campaign. The correct approach to address polypharmacy consists of its prevention, i.e. not prescribing inappropriate or unnecessary medication and providing clear timeframe for medication that should not be continued life-long. Further on we should actively seek patients suffering from polypharmacy and intervene it by deprescription. Correctly provided deprescription can be done by means of various tools beginning from simple lists of inappropriate drugs (Beers criteria, STOPP/START) to more comprehensive approaches that evaluate the importance of each particular drug in patient's medication list and help to identify the least important ones that are candidates for deprescription (Medication Appropriateness Index, Good Palliative Geriatric Practice Algorithm and others). When evaluating the appropriateness of pharmacotherapy, we always check if the treatment aim is achieved, if the indication persists, appropriateness of dosing and if the patient understands the pharmacotherapeutical regimen. By this approach we try to eliminate the pharmacotherapy with very low or no benefit for particular patient. Clinical pharmacologist or pharmacist can significantly help with this time-consuming process.","PeriodicalId":9645,"journal":{"name":"Casopis lekaru ceskych","volume":"163 1","pages":"3-8"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142709315","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}

引用次数: 0

Large language models are changing landscape of academic publications. A positive transformation? 大型语言模型正在改变学术出版物的格局。积极的转变？

Casopis lekaru ceskych Pub Date : 2024-01-01

Martin Májovský, Martin Černý, David Netuka

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Artificial intelligence's contribution to early pulmonary lesion detection in chest X-rays: insights from two retrospective studies on a Czech population. 人工智能对胸部 X 射线早期肺部病变检测的贡献：两项针对捷克人群的回顾性研究的启示。

Casopis lekaru ceskych Pub Date : 2024-01-01

Martin Černý, Daniel Kvak, Daniel Schwarz, Hynek Mírka, Jakub Dandár

{"title":"Artificial intelligence's contribution to early pulmonary lesion detection in chest X-rays: insights from two retrospective studies on a Czech population.","authors":"Martin Černý, Daniel Kvak, Daniel Schwarz, Hynek Mírka, Jakub Dandár","doi":"","DOIUrl":"","url":null,"abstract":"In recent years healthcare is undergoing significant changes due to technological innovations, with Artificial Intelligence (AI) being a key trend. Particularly in radiodiagnostics, according to studies, AI has the potential to enhance accuracy and efficiency. We focus on AI's role in diagnosing pulmonary lesions, which could indicate lung cancer, based on chest X-rays. Despite lower sensitivity in comparison to other methods like chest CT, due to its routine use, X-rays often provide the first detection of lung lesions. We present our deep learning-based solution aimed at improving lung lesion detection, especially during early-stage of illness. We then share results from our previous studies validating this model in two different clinical settings: a general hospital with low prevalence findings and a specialized oncology center. Based on a quantitative comparison with the conclusions of radiologists of different levels of experience, our model achieves high sensitivity, but lower specificity than comparing radiologists. In the context of clinical requirements and AI-assisted diagnostics, the experience and clinical reasoning of the doctor play a crucial role, therefore we currently lean more towards models with higher sensitivity over specificity. Even unlikely suspicions are presented to the doctor. Based on these results, it can be expected that in the future artificial intelligence will play a key role in the field of radiology as a supporting tool for evaluating specialists. To achieve this, it is necessary to solve not only technical but also medical and regulatory aspects. It is crucial to have access to quality and reliable information not only about the benefits but also about the limitations of machine learning and AI in medicine.","PeriodicalId":9645,"journal":{"name":"Casopis lekaru ceskych","volume":"162 7-8","pages":"283-289"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141562755","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}

引用次数: 0

Risk factors for postoperative pneumonia in patients after lung resection for non-small cell lung cancer - results of a cohort study. 非小细胞肺癌肺切除术后患者术后肺炎的风险因素--一项队列研究的结果。

Casopis lekaru ceskych Pub Date : 2024-01-01

Markéta Kepičová, Lubomír Tulinský, Adéla Kondé, Čestmír Neoral, Lubomír Martínek

{"title":"Risk factors for postoperative pneumonia in patients after lung resection for non-small cell lung cancer - results of a cohort study.","authors":"Markéta Kepičová, Lubomír Tulinský, Adéla Kondé, Čestmír Neoral, Lubomír Martínek","doi":"","DOIUrl":"","url":null,"abstract":"Postoperative pneumonia is the most common complication in patients after lung resection for non-small cell lung cancer (NSCLC). The tolerable incidence of this complication ranges from 5 to 8 %. The aim of this study was to evaluate the influence of initial risk factors on the incidence of postoperative pneumonia in patients undergoing lung resection for NSCLC. A retrospective cohort study was conducted at the University Hospital Ostrava between January 1, 2016, and December 31, 2022. All adult patients who underwent pulmonary lobectomy for primary NSCLC during the study period were included in the study. A total of 350 patients were included in the study. The incidence of postoperative pneumonia was 10.9%. Analysis of baseline risk factors did not show a statistically significant association with the incidence of this complication. The only statistically significant finding was a longer hospital stay in patients with postoperative pneumonia. The risk of postoperative pneumonia in patients undergoing lung resection for non-small cell lung cancer cannot be clearly explained by the initial risk factors examined alone. The complex nature of this risk also requires a comprehensive approach to prevention, including both patient-centred measures and improved postoperative care.","PeriodicalId":9645,"journal":{"name":"Casopis lekaru ceskych","volume":"163 3","pages":"94-97"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141562768","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}

引用次数: 0