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Aims. This study aimed to investigate the relationship between sleep parameters and tear film hydration assessed by tear meniscus height (TMH), and to evaluate the usability of a mobile application for remote behavioral and physiological data collection. Methods. Eighteen healthy adults (mean age 29.6 ± 6.4 years) completed five consecutive days of linked measurements combining objective sleep tracking (using Fitbit Charge 4) and slit-lamp imaging of TMH under standardized conditions. Behavioral data on stress, caffeine intake, and smartphone use were collected via a custom mobile application, whose usability was assessed by the System Usability Scale (SUS). Results. Ninety valid daily records were analyzed. TMH correlated positively with total sleep time (r=0.31, P=0.0033), REM sleep duration (r=0.28, P=0.0066), and sleep quality (r=0.32, P=0.0024). Each additional 30 min of REM sleep increased TMH by approximately 0.014 mm. Short sleepers (<6 h) showed significantly lower TMH (0.121 mm) than normal sleepers (≥6 h; 0.153 mm; P=0.0023). Stress and evening smartphone use were associated with reduced sleep quality and lower TMH. The mobile application achieved excellent usability (SUS = 87 ± 6). Conclusions. Our data indicate that sleep duration and architecture play essential roles in maintaining tear film stability. Behavioral habits that impair sleep continuity may thus directly affect ocular surface physiology. The combined use of wearable sensors and mobile self-reporting represents a practical approach to studying the interaction between sleep and ocular physiology.

There are currently no laboratory markers available to diagnose Fibromyalgia (FM). The aim in this study was to investigate biochemical markers that would support the pathogenesis and diagnosis of FM. To the best of the knowledge of the authors, this is the first study to evaluate CRP/prealbumin and prealbumin values in patients with Fibromyalgia. The results suggest that the CRP, CRP/prealbumin, lymphocyte and platelet levels increase in the disease and the prealbumin level decreases, which may indicate the role of inflammation in the pathogenesis. It was concluded that the inflammatory markers identified in this study may be useful in facilitating early diagnosis and treatment of patients with FM. The study was presented to contribute to the literature on FM.

This study aspired to provide comprehensive real-world data on a population with heart failure in the Moravian region of the Czech Republic. The authors compared local clinically relevant data with those from the ground-breaking Paradigm-HF trial and they found that local patients had a more advanced state of heart failure. The high prevalence of implantable cardioverter-defibrillators (ICD) and cardiac resynchronization therapy (CRT) confirms access to advanced and financially demanding treatment options in this region.

An observational study evaluating the safety and efficacy of thoracoscopic ablation of atrial fibrillation in the single-center experience. The cohort consisted of 81 patients suffering from some form of atrial fibrillation, undergoing thoracoscopic ablation either as a single method of treatment or as a part of the hybrid protocol where catheter ablation was suplemented later.

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.

Background and Aim. Vitamin D deficiency is linked to increased cancer risk and death but the effect of vitamin D substitution on the prognosis of patients with malignant disease is debatable. We aimed to investigate the value of serum vitamin D3 levels in patients with a history of malignancy and confirmed lung metastases. Materials and Method. Serum Vitamin D2 (25-hydroxyergokalciferol) and D3 (25‑hydroxycholekalciferol) levels were measured in 38 patients (28 with and 10 without lung metastases) using high performance liquid chromatography (HPLC). Serum Vitamin D2 + D3 levels of patients with lung metastases were analysed with respect to season, number of metastases, number of malignancies in the history, value according to the ASA (The American Society of Anaesthesiologists) physical status classification, and compared to patients with a history of malignancy without confirmed lung metastasis. Results. Overall, mean serum vitamin D3 levels were significantly higher in summer (summer vs. winter; 85.06 nmol/L vs. 61.01 nmol/L; P=0.013). There was no significant difference in vitamin D3 levels in summer or winter between patients with or without lung metastases. There was also no significant difference in vitamin D3 levels in the summer months between patients with a history of one malignancy versus those with two or more. In winter however, patients with a history of one malignancy had significantly higher vitamin D3 levels (mean, 75.25 nmol/L) than those with two or more malignancies (mean 44.6 nmol/L) (P=0.027). The differences between vitamin D3 levels in patients with ASA 2 and 3 were not statistically significant. Conclusion. Vitamin D supplementation may be advisable for patients with a history of multiple malignancies, particularly during the winter months. However, confirmation in a clinical trial with a larger patient cohort is warranted before firm recommendations can be made.

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.

The Measles-Rubella-Zoster (MRZ) reaction is a test for the intrathecal synthesis of IgG antibodies against measles, rubella and varicella zoster viruses. Since the 1990s, it has been used as an adjunctive test to support the diagnosis of multiple sclerosis (MS), although it has no formal role in current McDonald diagnostic criteria and its clinical relevance remains debated. While early studies considered a single elevated antibody index (M, R or Z) as a positive result, the practice today requires at least two elevated antibody indices (M+R, M+Z, or R+Z), referred to as a polyspecific MRZ reaction (MRZ-2). MRZ-2 is the most specific laboratory marker for MS, with reported specificity exceeding 90%. However, sensitivity varies widely across studies, ranging from approximately 30% to over 70%. In the Czech adult MS population, MRZ-2 sensitivity was recently reported at 32%, markedly lower than the 67% pooled sensitivity reported in a meta-analysis of predominantly German cohorts. Broadening the panel of anti-viral antibodies (MRZ+) has been proposed to improve sensitivity, with parvovirus B19 and mumps virus being the most promising candidates. Further studies are required to determine whether an extended panel can increase sensitivity while maintaining high diagnostic specificity.

There is a current need to better stratify patient prognosis following histological evaluation for prostate cancer in order to optimise therapy decisions. In this article, the authors provide an overview of some recently discussed putative prognostic markers. These include the immunohistochemical stains PSA, PSMA, Ki67, PD-L1, CDK19, PTPN12, EZH2 and E-cadherin and the genes TMPRSS2:ERG, SPOP, IDH-1, PTEN, TP53, RB1, CHD1 and SPINK1, the androgen receptor, BRCA1 and BRCA2, ATM, MYC and CCND1. The results are not easy to interpret due to wide variations in a number of key variables. Overall, the Gleason score is still the most widely used and most validated of the prognostic markers. Ki67 and PTEN are the most promising.

The aim of the study was to evaluate the association of cardiac biomarkers levels with the parameters of cardiac structure and function in the patients with arterial hypertension. Patients with arterial hypertension, normal left ventricular ejection fraction and absence of signs of heart failure were included in the study. Biomarker of cardiac remodeling (NT-proBNP) correlated with the parameters of left ventricular diastolic function and biomarkers involved in myocardial fibrosis (sST2) correlated with parameters of cardiac structure and were associated with left ventricular hypertrophy (sST2 and TIMP-1).

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.

Lung cancer is a leading cause of cancer deaths. Although the most affected age group is in the 6th decade occasionally we meet very young patients with the disease. The authors looked at a group of young patients under 40 years with this diagnosis, its characteristics, the diversity of the group and the potential pathogenesis of lung cancer at such a young age. Data of 17 individuals diagnosed during 2011–2020 at the Department of Respiratory Diseases, University Hospital Brno, Czech Republic, were analysed. From 8 valid samples, we detected actionable mutation in 75% patients.

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.

The use of epidural analgesia in neonates raises concerns due to possible drug cumulation and toxicity. In general, studying PK and modelling using plasma concentrations of the used local anaesthetic (LA) in neonates is applicable in daily clinical practice because the intravenous blood volume is small, and the number of samples does not have to be large. To the best of their knowledge, this is the first case report of the pharmacokinetic profile of levobupivacaine (LA) achieving pharmacotherapy goals during epidural use in preterm neonates. A special adjustment of the laboratory method reduced the blood samples to 0.2-0.5 mL each. Although elimination of levobupivacaine was prolonged, no accumulation occurred and concentrations of total and free levobupivacaine were well below the toxicity threshold. Epidural analgesia at this age should be monitored and used with caution.

XGJZ-containing serum was obtained from obese rats treated with the XGJZ formula. The authors confirmed that XGJZ-containing serum can inhibit the differentiation of 3T3-L1 adipocytes, reduce the expression of lipogenic transcription factors, lipid accumulation, and lipid metabolism-related enzyme activity in differentiated 3T3-L1 adipocytes, thereby improving the risk of obesity and obesity-related diseases. It provides evidence for the mechanism of obesity

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.

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.

Postdischarge nausea and vomiting (PDNV) is the main cause of patient´s discomfort, worsens postoperative morbidity and put the child at risk of dehydrataion, dehiscence of surgical wound, bleeding and hospital readmission in the most serious cases. This paper reviews currently available data on the incidence, risk factors and management of postdischarge nausea and vomiting (PDNV) in pediatric patients. This narrative review is extended by an observational study of the incidence of PDNV.

Six multiple sclerosis (MS) patients with a rapid progression of disability underwent immunoablative therapy followed by autologous hematopoietic stem cell transplantation (AHSCT) as the first-line disease-modifying therapy, between 2018 and 2021. Four out of six patients showed disability progression after AHSCT, so the rapid progression of MS was just slowed down by AHSCT. One patient developed activity on magnetic resonance imaging and two patients experienced mild relapses after AHSCT. None of the patients developed grade 4 non-hematological toxicity.

Glioblastoma pseudoprogession is dependent, by definition, on the location within the RT high dose field, however, there is lack of routine reporting of RT isodoses to radiologists during glioma follow up. Using blinded contouring and a number of different indices, we found poor awareness among routine clinical radiologists of per-protocol constructed target volumes for adjuvant glioblastoma RT, thus, automatic tools for exporting of RT target volumes would be very useful for routine clinical practice.

Aims: Brittle cornea syndrome (BCS) is a rare autosomal recessive disorder. The aim of this study was to review ZNF469 mutations associated with BCS type 1 to date and to describe an additional case of Czech/Polish background. Methods: Whole genome sequencing was undertaken to identify the molecular genetic cause of disease in the proband. Sequence variants in ZNF469 previously reported as BCS type 1-causing were searched in the literature, manually curated and aligned to the reference sequence NM_001127464.2. Results: The proband has been reviewed since childhood with progressive myopia and hearing loss. Aged 13 years had been diagnosed with Stickler syndrome. Aged 16.5 years, he developed acute hydrops in the left eye managed by corneal transplantation. At the age of 26, he experienced right corneal rupture after blunt trauma, also managed by grafting. He had a number of secondary complications and despite regular follow-up and timely management, the right eye became totally blind and the left eye had light perception at the last follow-up visit, aged 42. He was found to be a compound heterozygote for two novel mutations c.1705C>T; p.(Gln569*) and c.1402_1411del; p.(Pro468Alafs*31) in ZNF469. In total 22 disease-causing variants in ZNF469 have been identified, mainly in consanguineous families or endogamous populations. Only four probands, including the case described in the current study, harboured compound heterozygous mutations. Conclusion: BCS occurs very rarely in outbred populations which may cause diagnostic errors due to poor awareness of the disease. Investigation into the underlying molecular genetic cause in patients with connective tissue disorders may lead to a re-evaluation of their clinical diagnosis.

This case report describes the management of treatment of HCL in a 53-year-old woman who developed a rare lung condition as part of the activity of the hematological disease. The authors present the differential diagnosis of pulmonary disease in patients with HCL and the treatment approach in these patients.

Antiphosphatidylethanolamine antibodies (aPE) may be related to venous thromboembolism and be part of the repertoire of aPL in immunologically-mediated diseases. aPE IgG may have various avidities and their avidities differ from those of anticardiolipin antibodies IgG.

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Visual field defects persist after antibiotic treatment in one third of patients with syphilitic uveitis. The observation supports adjacent systemic corticosteroid treatment for severe forms of syphilitic uveitis and/or neuritis.

Various studies have examined the therapeutic value of periradicular infiltration using treatments consisting of local anesthetic and corticosteroids or ozone application for radicular pain but this is to our knowledge the first study that statistically compares the treatment effect of different types of corticosteroids and ozone.

This 10-year follow-up indicates that B-TUERP is a safe and highly effective treatment for symptomatic BPH with lower reoperation rates. UDS value plays an important role in the preoperative judgment of surgical indications and the prediction of postoperative effect. Age, OABSS, PSA, MCC and DO may be critical predictors for urge incontinence after B-TUERP.

Inflammatory periodontal diseases are related to dental plaque formation and are influenced by its microbial composition and the host immune system. The dry socket (alveolar osteitis), which may occur as an inflammatory complication after third molar extraction, is similar in many ways. For this reason, efforts are currently underway to formulate preparations that inhibit dental plaque formation and suppress inflammation. The results of this pilot study show that the combination of the phenolic fraction of Lonicera caerulea fruit and Macleaya cordata alkaloids has beneficial effects on antioxidant imbalance and inflammation both in vitro and in a clinical study.

This is an analysis of post-acute COVID symptoms and the pulmonary function test (PFT) results in patients surviving the native strain of the virus (Wuhan variant). There were 785 subjects (345 male) mean age 53.8 (SD 14.6); PFT results showed a decrease with disease severity; anosmia during the acute phase was associated with mild course of the disease, persisting dyspnoea was more frequent in the more severe disease groups; female sex was identified as a possible risk factor for persisting symptoms in the post-acute phase.