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This study aimed to investigate changes in fundus autofluorescence in patients taking daily lutein oral supplements and to develop image processing methods for follow-up evaluations of the images. Dual wavelength fundus autofluorescence is a valuable technique for macular pigment evaluation in follow-up examinations, utilizing software image post-processing with commonly available hardware.

Background. Proinflammatory cytokines are a pivotal factor in cancer initiation and progression. The paracrine and autocrine secretions of such inflammatory cytokines are reported in different cancer types. Recently, C-C motif ligand (CCL) 5 (CCL5), CCL22, granulocyte-colony stimulating factor (G-CSF), and interleukin-1 receptor antagonist (IL-1 RA) have been detected in basal secretions of breast cancer (BC) cells and linked to BC pathogenesis. While Vitamin D has been found to have anti-inflammatory effects, its modulation on cytokine expression is rarely studied in relation to cancer. Aims. In this study, we evaluated whether vitamin D could modulate cytokine basal levels in BC. Materials and Methods. This in vitro study was conducted on BC cell lines, MCF-7 and MDA-MB-231. Cells were treated with vitamin D (10 and 100 nM), and cytokine levels were measured using the Enzyme-Linked Immunosorbent Assay (ELISA). Results. There was a significant reduction in CCL5 total levels in MCF-7 cells at both concentrations (P≤0.01) and in MDA-MB-231 at 100 nM (P≤0.05). Both concentrations reduced CCL22 levels significantly in MCF-7 (P≤0.05) and MDA-MB-231 (P≤0.01). Regarding G-CSF, a significant reduction was found in MCF-7 at both concentrations (P≤0.05) and at 100 nM in MDA-MB-231 (P≤0.01). In comparison, IL-1 RA levels were significantly elevated in MCF-7 (100 nM (P≤0.01)) and MDA-MB-231 (10 nM (P≤0.05) and 100 nM (P≤0.01)). Conclusion. Vitamin D down-regulated the pro-inflammatory and up-regulated the anti-inflammatory cytokines. This indicates that vitamin D can modulate the expression of inflammatory mediators, particularly in a cancer setting. The results support the potential use of vitamin D as an anti-cancer agent with anti-inflammatory properties.

Introduction. Intraoperative neurophysiological monitoring is a standard in surgeries with an increased risk of iatrogenic neurological injury development. The gold standard for this monitoring modality is propofol-based total intravenous anaesthesia (TIVA). Although there seems to be no clinically significant complication for propofol administration in patients with soy, egg, or peanut allergies, a whole range of recommendations still prohibit propofol administration in patients with these allergies. Remimazolam is a new, ultra-short-acting benzodiazepine that can potentially be an alternative in cases of propofol contraindications in need of TIVA. Case reports. We report two cases of a 19-year-old girl and a 17-year-old boy undergoing scoliosis surgery with transcranial motor evoked potentials monitoring (TcMEP). We chose remimazolam-based total intravenous anaesthesia due to the severe peanut and soy allergy, respectively. Total intravenous anaesthesia was maintained with remimazolam at a dose of 1.5-2 mg/kg/h and remifentanil at a dose of 0.5-0.8 µg/kg/min. Depth of anaesthesia was controlled using frontal EEG monitoring. TcMEP remained stable and showed no significant alterations throughout the surgeries. No new neurological deficits were detected after the surgeries. Conclusion. Our results show that remimazolam-based anaesthesia may be a safe alternative to propofol-based anaesthesia for surgeries with an intraoperative neurophysiological monitoring, or patients with propofol contraindications but more data are needed.

Cervical cancer remains a major contributor to cancer-related mortality among women worldwide, despite substantial progress in prevention and treatment strategies. While established prognostic factors such as tumor size, lymphovascular space invasion, and nodal status guide clinical decision-making, they lack sufficient specificity for individualized risk stratification. Consequently, there remains an unmet need for robust biomarkers capable of reliably predicting recurrence and treatment response. L1 cell adhesion molecule (L1CAM), a neural adhesion protein implicated in epithelial-mesenchymal transition (EMT), tumor invasion, and metastasis, has emerged as a candidate prognostic marker in several solid tumors, including gynecologic malignancies. Its role in cervical cancer, however, remains insufficiently defined. This narrative review synthesizes preclinical evidence and clinical studies evaluating L1CAM expression in cervical cancer, with an emphasis on its biological rationale, methodological challenges, and prognostic significance across different disease contexts. Data from early-stage and from locally advanced disease were critically appraised. Most early-stage studies have not demonstrated an independent prognostic effect of L1CAM, although associations with adverse histopathological features have been reported. In contrast, recent multicenter evidence suggests that high-level L1CAM expression (≥50%) may predict inferior pelvic control in patients undergoing chemoradiotherapy, underscoring a potential context-dependent prognostic role. Current evidence emphasizes the need for standardized immunohistochemistry protocols, prespecified positivity thresholds, and integration of L1CAM assessment with other. Prospective, adequately powered studies are essential to validate L1CAM as a clinically actionable biomarker and to determine whether its incorporation into prognostic models can enhance treatment personalization in cervical cancer.

Patients with atrial fibrillation (AF) may experience other supraventricular tachycardias (SVT) that can trigger AF and cause similar symptoms. This study aimed to analyse the safety and efficacy of inducing SVT in patients undergoing catheter ablation (CA) for AF. The authors enrolled 61 patients with paroxysmal AF who underwent CA between January 2022 and March 2023. This electrophysiological study was performed after pulmonary vein isolation (PVI) to induce SVT. Induced arrhythmias were mapped and ablated. All patients were followed at 3, 6 and 12 months after the procedure and seven-day ECG Holter monitoring was carried out after 6 and 12 months from the procedure. SVT inducibility after successful pulmonary vein isolation was 39%. Age differed significantly in patients with arrhythmia inducibility compared to those without (64.5± 7.6 and 58.2±10.5, P=0.04). There were no significant differences in procedure time (P=0.408) or fluoroscopy dose (P=0.458) between patients with inducible arrhythmia and those without. None of the echocardiographic parameters showed any significant differences between groups. The conclusion of the study is that ablation of induced non-clinical arrhythmia is safe and does not prolong the total procedure or fluoroscopy time.

Introduction. Ovarian tumours represent a highly malignant disease that is often diagnosed at an advanced stage and is associated with a poor prognosis. The most common histological type is high-grade serous carcinoma, characterized by significant genomic instability and homologous recombination defects, particularly due to pathogenic variants in the BRCA1 and BRCA2 genes. The introduction of high throughput sequencing methods has enabled the identification of a broader spectrum of predisposing genes and further emphasised the importance of genetic testing for targeted prevention and individualised treatment. Methods. The aim of our study was to determine the frequency of germline mutations in 117 unrelated patients diagnosed with ovarian, tubal, or primary peritoneal cancer. We also assessed epidemiological and tumor pathogenesis data. The patients were examined with the "CZECANCA" gene panel sequenced by next-generation sequencing (NGS) on an Illumina platform. Results. Pathogenic variants were found in 29% of patients, most commonly mutations in the BRCA1 and BRCA2 genes. The median age of patients with high-grade serous ovarian cancer was 61 years. The median age of BRCA1/2-positive women was 54 years, and all had a positive family history of cancer. Conclusion. Identifying carriers of pathogenic variants enables targeted prevention, earlier detection, and personalized therapy. Despite significant advances in treatment, early diagnosis and screening of at-risk individuals remain a major challenge.

Chronic nonbacterial prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a prevalent urological disorder with a significant impact on quality-of-life. The administration of cannabidiol/hyaluronic acid based suppositories demonstrated potential symptom relief in CP/CPPS with a favourable tolerability profile.

Background. To investigate the association between atopic dermatitis (AD) and keratoconus (KC) in atopic dermatitis patients with no prior ophthalmologic diagnosis. Methods. Thirty eyes of 30 patients with moderate to severe AD were included in this pilot study and compared to healthy controls (n=20) and patients with forme fruste KC (n=28). In the AD group, diagnosis of KC was based on clinical signs and corneal topography criteria such as inferior steepening (inferior-superior difference>1.45 D) and elevated maximum keratometry values (>47 D). Subclinical KC was defined by the presence of specific sensitive indices from corneal topography, tomography, or biomechanical assessments. Risk factors analyzed for ectasia development were the onset and severity of AD, sensitization to aeroallergens, systemic therapy, concomitant atopic diseases, eyelid eczema, and total IgE. Results. We identified two manifest KC (6.7%), and six subclinical KC (20%) cases in patients with AD but with no previous diagnosis of KC. No overall differences were found in corneal tomography and biomechanics indices between control and AD patients. However, eye rubbing was not identified as a risk factor for developing ectasia in the AD group. Conclusion. Dermatologists should be aware that patients with moderate or severe AD may have a higher risk for developing corneal ectasia, particularly when eyelid eczema is present. The estimated prevalence of KC in patients with AD appears to be higher than that in the general population but more studies are needed.

In this review, the authors comprehensively evaluate the unique challenges associated with assessing stroke risk and determining the need for anticoagulation therapy in patients with device-detected atrial fibrillation. This condition poses diagnostic and therapeutic dilemmas, given its often subclinical nature and variability in atrial fibrillation burden. The analysis places particular emphasis on findings from recently published clinical trials, which provide valuable insights into the management strategies for this patient population. Additionally, the authors explore the emerging evidence on the interplay between device-detected atrial fibrillation and heart failure.

A prosthetic arteriovenous graft (AVG) represents a type of vascular access for haemodialysis (HD), employing a synthetic conduit that replaces a native vessel and permits repeated cannulation. Due to their associated complications, particularly thrombosis and infection, arteriovenous grafts (AVGs) have long been regarded as a secondary option. Current recommendations advocate an individualized approach to vascular access planning based on patient´s anatomy, life expectancy, anticipated dialysis duration, and personal preferences, leading to a broader and more flexible use of AVGs. Their key advantage is the potential for early initiation of HD, while minimizing the need for central venous catheters. However, a major disadvantage of AVGs is their tendency to develop stenotic lesions, predominantly at the venous anastomosis, which adversely affects graft patency. If left untreated, this may lead to graft thrombosis. Regular evaluation of AVG function is essential for early detection of stenosis and maintenance of graft patency. Despite its widespread use in clinical practice, the role of AVG surveillance in vascular access management remains a subject of considerable debate, as current evidence regarding its effectiveness in preventing thrombosis and prolonging graft patency is inconclusive.

Ceramides are a heterogeneous group of bioactive membrane sphingolipids. Evidence suggests that specific ceramide species are potential biomarkers and mediators of cardiovascular disease. The aim of the study was to develop two prediction models for carotid intima-media thickness (CIMT) using readily available variables. One model included conventional biomarkers (total cholesterol, triglycerides, hypolipidemics) in addition to gender and age, while the other included blood concentrations of selected ceramides. Cer(d18:1/18:0) was inversely related to CIMT, while Cer(d18:1/24:1) was positively correlated. Given that the study is cross-sectional, the findings should be interpreted as associations and do not support any causal inference.

Motor imagery techniques, such as motor imagery, mirror therapy, and graded motor imagery, have the capacity to activate brain regions that overlap with those involved in actual movement execution. In individuals with chronic pain, these areas may undergo structural and functional changes due to persistent nociceptive input. Engaging in motor imagery can stimulate brain activity and potentially contribute to the restoration of more typical neural patterns. This scoping review of randomized controlled trials demonstrates that patients with chronic musculoskeletal pain may benefit from these techniques. Compared to control groups, participants receiving MI-based interventions experienced reductions in pain both immediately after therapeutic sessions and during follow-up assessments conducted up to several months post-intervention.

Integrin alpha-6 (α6ITG, CD49f) has long been considered one of the most reliable markers of stemness, yet emerging evidence challenges this view by revealing its broader role in niche accessibility and survival. As a laminin receptor, α6ITG mediates cellular interactions and participates in signal transduction pathways that help maintain cellular phenotype. Its expression allows for the identification and purification of stem cells from heterogeneous populations. Because α6ITG expression is highly sensitive to environmental cues, it also serves as a sensor of culture conditions and cryopreservation stress, with potential use in biobanking and regenerative medicine. This marker holds significant potential; it may be one of the few markers consistently expressed in all stem cells, potentially qualifying it as a common "stemness" marker. Additionally, the therapeutic implications of α6ITG knockdown using antibodies may greatly influence future cancer treatments. Elevated expression in cancer correlates with growth, invasion, and poor prognosis. The aim of this review is to explore the biological and translational importance of α6ITG in stem cell and cancer biology.

Background and Aims. Suicide represents a major public health issue influenced by a complex interplay of individual, social, and environmental factors. While suicidological research traditionally focuses on psychological and clinical aspects, spatial dimensions of suicidal behavior remain less explored, particularly in Central Europe. This study presents a geospatial analysis of completed suicides in the Olomouc and Zlín Regions of the Czech Republic between 2018 and 2022, using a unique dataset derived from forensic autopsy records. The primary goal was to demonstrate the potential of spatial processing and interdisciplinary collaboration between forensic medicine and geoinformatics in identifying contextual patterns of suicidal behavior. Methods. A dataset of 585 completed suicides was compiled from forensic autopsy reports, including detailed individual-level characteristics and geolocation data. Spatial analyses were conducted using GIS software, integrating additional layers such as land use, demographic and socioeconomic indicators, and quality of life indices. Both point-level and aggregated data (municipality and administrative district levels) were used to explore correlations and spatial variability. Results. The study confirmed known trends - such as male predominance and the role of alcohol - and identified new spatial relationships, including a negative correlation between blood alcohol concentration and latitude, and between age and distance from residence to suicide location. Spatial analyses were conducted at multiple levels of aggregation and combined with selected socioeconomic and environmental indicators, including quality of life, urban-rural context, and foreclosure (enforcement) rates. The results demonstrate that spatial patterns and correlations between suicide rates and area-based characteristics vary depending on the spatial scale of analysis. Conclusion. The findings illustrate the potential of interdisciplinary collaboration between forensic medicine and geoinformatics and provide an exploratory basis for further research and more context-sensitive suicide prevention approaches.

This randomized controlled multicentric pilot study evaluated a home-based telerehabilitation system aimed at improving balance and cognitive function in older adults. The results show it is safe, user-friendly, and effective as traditional therapy, with added benefits from cognitive stimulation.

The study aimed to determine the preoperative clinical and molecular genetic risks of malignancy in indeterminate nodules (Bethesda III and IV) and their influence on the surgical treatment strategy of hemi/total thyroidectomy. Molecular tests were focused on the occurrence of pathogenic variants of somatic genes BRAF, RAS, TERT and rearrangements of RET/PTC, PAX8/PPARγ associated with thyroid oncogenesis. The incidence of clinical risk factors for malignancy was evaluated. The presence of at least one of these led to a significantly higher incidence of malignancy than in cases of their absence. From the experience of the authors so far, molecular genetic testing is one of the many decision-making factors in elective surgical procedures.

The possibility of using deep-frozen corneal stromal lenticules could significantly help in the treatment of corneal ulcers or even perforations, which is currently difficult due to the relative unavailability of corneal tissue donors, especially in developing countries.

Heart failure is one of the critical and most costly medical challenges of the 21st century. It is a chronic debilitating condition and adherence to medication, a precondition for successful treatment is often poor. There are various interventions for improving adherence. Depending on the goal of the intervention, these are roughly patient centric, healthcare provider centric and system centric. The authors provide an overview of these interventions with a focus on effectiveness and appropriateness in different clinical situations. Their use can lead to improved patient outcomes and reduced economic burden of the disease.

This is a retrospective one tertiary centre study which investigated the humoral and cellular immunity reconstitution and clinical impact of chemotherapeutic protocols that included a single rituximab dose in children and adolescents treated for non-Hodgkin Lymphoma. The proportion of IgG, IgM, and IgA hypogammaglobulinemia decreased over the follow-up period. The median for B cell reconstitution was 3 months after the end of lymphoma treatment. Transitional B lymphocyte subsets dominated at the time of B cell subset reconstitution. No secondary antibody deficiency needing immunoglobulin replacement therapy was found.

During the COVID-19 pandemic, patients often died abruptly under the picture of circulatory and respiratory failure. The cause of this sudden deterioration remained hidden even after their death due to initial low number of the autopsies of COVID-19 positive patients. Fat embolism is a commonly overlooked cause of circulatory and respiratory failure, but it does not normally accompany viral infections and is therefore not standardly considered in their treatment. The authors present one of the first studies to relate these mechanisms based on microscopic examination with special staining of the specimens, shedding new light on the treatment of severe conditions of SARS-CoV-2 infection.

Detection of drug or its metabolite in a blood sample without evaluation of serum concentration does not fully enable uncovering instances of improper drug use or white-coat adherence. Considering pharmacokinetic properties of the drug helps us to recognize if measured concentration refers to steady state, i. e. regular use, or is markedly reduced and therefore originates from irregular or single dose ingestion before sampling. Application of pharmacokinetic principles in the interpretation of serum concentrations of antihypertensive drugs leads to a more precise evaluation of a patient's behaviour.

This work evaluates the effect of carteolol and latanoprost on vessel density in the peripapillary area of the optic nerve head. These drugs were chosen for two reasons: latanoprost is recommended by the European Glaucoma Society as the first-line drug for glaucoma. Carteolol works on a different principle but should not have any ischemic effect on the vascular system of the eye. In a previous study, during a 5-year follow-up of patients receiving beta-blockers (carteolol) and prostaglandins (latanoprost), the authors demonstrated a greater progression of visual field changes with prostaglandins than with beta-blockers. This led them, with the introduction of OCT angiography, to investigate whether they could detect changes in the vessels of the posterior pole of the eye in early-stage and newly diagnosed cases of primary open-angle glaucoma. The results showed that only patients treated with carteolol experienced a statistically significant improvement in vessel density.

This study evaluates the results of surgical transnasal procedures in patients with functioning pituitary adenomas. The cohort consisted of 58 patients. Microadenoma was diagnosed in 58.6% and macroadenoma in 41.4%. In the group with excessive production of ACTH, complete remission was achieved after the first surgery in 78.6% of cases; in the group with excessive GH production in 51.4%. In the group with excessive production of PRL, it was 57.1%. Surgical therapy in the cohort described led to the normalisation of excessive hormone production in 58.6% of cases.

High levels of oxidative stress, E-selectin, and microparticles are detected in HIV patients with and without ART. These abnormalities predisposed to the diseases associated with aging. There were no correlations between these biomarkers and viral suppression that is detected in peripheral blood. These results support the hypothesis that residual viremia in cellular reservoirs of various tissues is the key factor related to the premature aging of the immune system.

This case report presents a unique instance of primary ventriculitis in a 53-year-old patient with no predisposing factors, caused by the rare pathogen Streptococcus intermedius. Despite early and targeted antibiotic therapy, the patient's condition did not improve, highlighting the challenges in managing such infections. Imaging studies and cerebrospinal fluid analysis were crucial for diagnosis, revealing significant inflammation and ventricular debris. This case emphasizes the need for further research into the treatment of primary ventriculitis, as standard therapeutic approaches may not always be effective. The findings underscore the importance of early detection and the complexity of managing central nervous system infections.

The aim of this study was to determine whether there is a difference in the efficacy of palliative treatment depending on the use of ­cisplatin or carboplatin in combination with etoposide in patients with ES-SCLC in real-world practice in the Czech Republic. The authors performed a retrospective analysis of a cohort of 348 patients from the LUCAS project with ESSCLC. 79 patients were treated with etoposide plus cisplatin and 265 were treated with etoposide plus carboplatin. No statistically significant difference in mOS or mPFS was found depending on the use of carboplatin or cisplatin in combination with etoposide. In the subgroup analysis according to age and performance status (PS), no statistically significant difference in mOS was found either.

Multiple sclerosis (MS) is a chronic autoimmune disease affecting the central nervous system with a greater frequency in young adults. It has been speculated for some time, that an altered intestinal barrier is may be involved in the ethiopathogenesis of this disease, too. In our study we observed that the function of the intestinal epithelium can be impaired by increased permeability in patients with CIS and CDMS, however, no significant intestinal damage has been found. Based on the results CLDN-3 may play a role as potential biomarker of intestinal barrier disruption in patients with multiple sclerosis, mainly with treatment, but further contribution of CLDN3 from other compartments needs to be elucidated, e.g., the blood-cerebrospinal fluid barrier.

This review explores novel insights into the use of biomarkers for traumatic brain injury (TBI) prognosis and management. By examining emerging evidence on neuronal injury, inflammation, extracellular vesicles and non-coding RNAs, it underscores their potential in predicting clinical outcomes such as recovery and cognitive impairment. The work bridges a critical gap between basic research and clinical application, offering a comprehensive perspective on advancing diagnostic and therapeutic approaches for TBI.

In this paper, the authors show that simple physical and cognitive training after mild traumatic brain injury (mTBI) can be positive for the brain and its functions and help in the prevention of post-concussion syndrome. This can lead to the decreased economic burden of mTBI, and individual training can be performed without professional supervision.

In this prospective, unicentric, observational study, the prevalence and predictors of left ventricular thrombus (LVT) formation after acute myocardial infarction (AMI) were investigated. The study aimed to assess the role of transthoracic echocardiography, cardiovascular magnetic resonance and cardiac markers in predicting LVT and to determine the risk of systemic embolization to the central nervous system using brain MRA. In a cohort of seventy patients, the prevalence of LVT detected by TTE was 15.9% and by DE-CMR was 16.7%. LVT prevalence was particularly high in patients with anterior STEMI. However, there was no significant association between LVT detection and the occurrence of cardioembolic events. These findings provide valuable insights into the diagnosis, prediction, and potential risk factors of LVT following AMI.