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The authors compared the efficiency, safety and tolerance of two types of vaginal micronized progesterone for luteal phase support in a randomized prospective study. The efficacy of Utrogestan and Crinone 8% for luteal support was evaluated by fertilization, implantation, pregnancy and take-home baby rate. The safety of the medicaments was compared through the results of vaginal findings and vaginal inflammation markers before and after the treatment.

This study expands current knowledge about extrapulmonary sarcoidosis and affected organs in Czech patients. It compares laboratory and clinical data for patients with sarcoidosis limited to the lungs and those with accompanying extrapulmonary involvement.

This article summarises pilot animal experiments with our novel micro-catheter technology for endovascular magnetically guided interventions in the central nervous system. By using the external magnetic field generated by the NIOBE Stereotaxis technology, the micro-catheter can be safely and easily navigated into targeted areas in the brain vasculature, including areas with extremely high tortuosity of arterial or venous systems. Further, the micro-catheter technology is capable of endovascular sensing of EEG signal in the targeted area. To the best of our knowledge, this is the first micro-catheter technology developed so far for magnetically guided interventions in the central nervous system, opening new opportunities for interventional treatment of stroke, epilepsy and several others CNS disorders.

Aim: To evaluate the anticancer effect of alpha-tomatine (i.p.) either alone or in combination with doxorubicin (i.v.) in a mouse tumour model. Methods: We studied the effect of repeated alpha-tomatine (0.1 - 9 mg/kg) and/or doxorubicin (2 mg/kg) on the growth and mitotic activity of the solid Ehrlich tumour in vivo, as well as on the survival of the tumour-bearing mice. Results: Monotherapy with alpha-tomatine had a significant dose-dependent anticancer effect which peaked at 1 mg/kg. This was shown by both slowed tumour growth and reduced tumour cell proliferation. We also provide the first evidence that the combination alpha-tomatine (1 mg/kg) and doxorubicin (2 mg/kg) had a synergistic effect and significantly prolonged the survival of the mice. Neither alpha-tomatine nor doxorubicin influenced the infiltration of tumours with CD3+ lymphocytes; nor were we able to find an in vivo modulation of the key molecules of two regulatory pathways reported in vitro as the principal anti-cancer mechanisms of alpha-tomatine, i.e. iNOS and phosphorylated ERK2. However, alpha-tomatine still led to intracellular DNA inhibition and protein synthesis in Ehrlich tumour cells in a short-term culture ex vivo with IC₅₀ values of 8.7 and 6.6 µM. Conclusions: The results suggest that ΤΟΜ, especially in combination with doxorubicin, may be a promising agent for the treatment of malignant solid tumours. Despite growing knowledge of the mechanisms of ΤΟΜ action in cancer cells, most aspects remain unclear. Parallel organ toxicity, especially potential liver effects, requires careful attention when performing in vivo studies in the future.

Background: Experimental, epidemiological and clinical data substantiate the beneficial role of n-3 polyunsaturated fatty acids (PUFAs) in preventing inflammation and cancer of the colon. This review covers the unsaturated docosahexaenoic fatty acid (DHA), describes some of its important cellular and molecular mechanisms, its interaction with another dietary lipid, butyrate and with endogenous apoptotic regulators of the tumour necrosis factor (TNF) family. We also discuss the clinical impact of this knowledge and the use of these lipids in colon cancer prevention and treatment. Results: From the literature, DHA has been shown to suppress the growth, induce apoptosis in colon cancer cells in vitro and decrease the incidence and growth of experimental tumours in vivo. Based on these data and our own experimental results, we describe and discuss the possible mechanisms of DHA anticancer effects at various levels of cell organization. We show that DHA can sensitize colon cancer cells to other chemotherapeutic/chemopreventive agents and affect the action of physiological apoptotic regulators of the TNF family. Conclusion: Use of n-3 PUFAs could be a relatively non-toxic form of supportive therapy for improving colon cancer treatment and slowing down or preventing its recurrence. However, it is necessary to use them with caution, based on solid scientific evidence of their mechanisms of action from the molecular to the cellular and organism levels.

Backround. Acute kidney injury (AKI) is a common serious complication of severe acute pancreatitis (SAP) and an important marker of morbidity and mortality in critically ill septic patients. AKI due to severe acute pancreatitis can be the result of hypoxemia, release of pancreatic amylase from the injured pancreas with impairment of renal microcirculation, decrease in renal perfusion pressure due to abdominal compartment syndrome, intraabdominal hypertension or hypovolemia. Endotoxins and reactive oxygen species (ROS) also play an important role in the pathophysiology of SAP and AKI. Knowledge of the pathophysiology and diagnosis of AKI following SAP might improve the therapeutic outcome of critically ill patients. Methods and Results: An overview of the pathophysiology, diagnosis and potential treatment options based on a literature search of clinical human and experimental studies from 1987 to 2013. Conclusions: Early recognition of AKI and SAP in order to prevent severe complication like septic shock, intraabdominal hypertension or abdominal compartment syndrome leading to multiple organ dysfunction syndrome is a crucial tool of therapeutic measures in intensive care.

Aims: At specific time periods following ischemic stroke (IS), acute coronary syndrome as ischemic heart disease (IHD) represents a higher risk of death than IS. Not all IS patients can undergo specific examination for IHD detection. The aim of this study was to assess exclusive risk factors (RFs) associated with IHD occurrence in IS patients. Knowledge of these RFs should help in stratifying IS patients for IHD detection. Materials and methods: This was a hospital-based, retrospective, single centre study. The sample consisted of 192 consecutive IS patients, divided into two subgroups - Subgroup 1 (54 patients without IHD; 55.6% males; 63.1 ± 11.8 years) and Subgroup 2 (138 patients with IHD; 39.1% males; 76.3 ± 9.6 years). The following factors were identified: age; sex; presence of arterial hypertension, atrial fibrillation, diabetes mellitus; plasma levels of total cholesterol, triglycerides, low-density cholesterol, high-density cholesterol; body mass index; presence of carotid plaques. Logistic regression analysis was used for statistical evaluation. Results: Of all identified risk factors only age (OR=1.109; 95% CI: 1.069 - 1.150, P=0.001) and the presence of arterial hypertension (OR=6.298; 95% CI: 2.215 - 17.905, P=0.003) were exclusively and significantly associated with the presence of IHD in IS patients. Conclusions: Age and arterial hypertension may be exclusive risk factors associated with IHD in IS patients.

Background: Diffuse large B-cell lymphoma (DLBCL) accounts for up to 40% of all non-Hodgkin's lymphomas diagnosed in the western hemisphere. Determination of the gene expression profile has confirmed the physiological heterogeneity of the disease and defined three molecular prognostic subgroups - germinal center B-cell-like (GCB), activated B-cell-like (ABC) and primary mediastinal B-cell lymphoma (PMBL) - with different gene expression and prognosis. Methods and Results: This review covers current knowledge on the most frequent recurrent cytogenetic and molecular cytogenetic aberrations in molecular DLBCL subgroups. Conclusions: Cytogenetic and molecular cytogenetic techniques used to determine nonrandom chromosomal aberrations in patients with DLBCL have revealed the incidence of frequent cytogenetic aberrations in the subgroups reported, suggesting their potential use for more accurate prognostic stratification of DLBCL, contributing to personalized selection of the most effective therapy.

To the best of our knowledge, this is the first report in the study of the impact of modifier gene in the occurrence of osteonecrosis in sickle cell anemia in Tunisian patients. Significant associations with osteonecrosis were found with 2 SNPs namely: rs267196 and rs267201 of BMP6 gene.

Background: Psychoeducation programs have been shown in the last two decades to significantly improve the post-hospital discharge care of individuals with schizophrenia by demonstrated effects on rehospitalization rates, compliance with medication and knowledge. The benefits of psychoeducation can be sustained for up to seven years although most studies have not shown such enduring benefit. Psychoeducation is a type of psychotherapeutic support that aims to provide broad and adequate information on psychotic disorders for both patients and their families. Method: The purpose of the group psychoeducational program at the Psychiatric clinic in Olomouc is to familiarize patients with the core of the disorder, explain the part played by pharmacotherapy, teach recognition of the warning signs of relapse, to advise on communication problems within families, and finally the training of social skills. Results: Patients perceive the program as meaningful and helpful in better understanding their lives.

This review summarizes recent knowledge about autoimmune pancreatitis as a unique clinical entity within putative IgG4 diseases.

This paper confirms the superiority of currently used imaging techniques, low-dose computed tomography (LD-CT) and whole-body magnetic resonance imaging (WB-MRI) over conventional radiography (CR) in assessment of myeloma bone disease (MBD) in a prospectively designed study. The authors conclude that either WB-MRI or LD-CT should be used as preferred imaging techniques in the place of CR in order to detect correctly skeletal involvement in multiple myeloma (MM). Relying solely on CR may underestimate the extent of MBD or even fail to diagnose active MM requiring treatment in a substantial number of patients.

The accuracy of postnatal CT was compared with histopathological findings in 24 children with bronchopulmonary malformation (BPM). Chest CT with intravenous contrast agent administration in patients with BPM is accurate for the detailed evaluation of the morphologic substrate of congenital lung pathology.

The current chromatographic and mass spectrometric methods used in therapeutic drug monitoring of major antidepressants and antipsychotic drugs in body fluids and tissues are summarized for the period 2006-2015. The article provides the reader with a comprehensive overview of sample preparation procedures, analyte stability, analytical (validation) parameters achieved by various methods as well as description and comparison of different methods.

This is an investigation on the development of a multilocus calibration material for analysis of somatostatin (SSTR1-5), estrogen (ER1), and dopamine (D2R) receptors in pituitary adenomas. Using this calibrator the authors were able to align all calibration functions, including assays for the transcripts whose expression in the pituitary was very low (SSTR4 and SSTR5). As a result the authors investigated a large group of 206 pituitary tumors with various histo-pathological classification, and defined individual expression profile for postoperative pharmacological treatment with somatostatin analogues and dopamine agonists. The numbers of D2R, ER1, and SSTR1 transcripts were highest in patients with Cushing disease and prolactinomas. SSTR2 expression was significantly higher in acromegaly and thyrotroph adenomas. Significantly more SSTR3 transcripts were found in clinically non-functioning adenomas and acromegaly, and higher levels of SSTR5 were found in patients with acromegaly and prolactinomas.

The authors newly describe the presence of Streptococcus milleri group (SMG) in the respiratory tract of patients suffering from chronic obstructive pulmonary disease (COPD). They document 3 cases of acute exacerbations of COPD, where (i) SMG were present in the respiratory tract, (ii) no other bacterial pathogen was detected, (iii) increased CRP levels indicated bacterial infection and (iv) patients recovered during empirical antibiotic treatment. The data indicate that SMG may act as an opportunist respiratory pathogens capable of exacerbating COPD.

Four week cranberry fruit powder intake before prostatectomy in men modulates serum PSA.

The estimation of serum drug levels enables diagnosis of non-adherence to recommended therapy. The data suggest that non-adherence is a common problem among patients presenting with acute decompensation of chronic heart failure.

This is a review on delirium tremens, the most severe complication of alcohol withdarawal and focused on pathogenesis, clinical symptoms, complications and proper, current management.

The study focused on the incidence of radial artery injuries after first and repeated transradial coronary catheterizations. The results show a low occurrence of injuries and no differences between the first and follow-up procedure. One of the reasons for the results seems to be the use of short radial sheats for arterial access.

Cytokines and adhesion molecules are important in the microenvironment of malignant diseases. The authors found that leukocyte count and levels of some cytokines correlate with levels of adhesion molecules and are affected by the FLT3-ITD mutation found in acute myeloid leukemia (AML), possibly linked to endothelial cell activation. Disruption of these interactions may suggest novel approaches to overcoming the high resistance of AML to treatment.

The authors describe long-term follow-up of a large, selected and homogenous cohort of patients from a single centre reflecting the course of heart failure with severe left ventricular systolic dysfunction barely modified by comorbidities. Short-term prognosis of heart failure patients could be estimated based on simple parameters available on out-patient examination. Patients presenting with these parameters should be referred to a tertiary centre to be considered for advanced heart failure therapy.

The authors report on the development and preliminary validation of a new prognostic scale (the COPD Prognostic Score - CPS) using a retrospective analysis of the National Emphysema Treatment Trial cohort. The CPS included: the age mMRC dyspnea scale, post-bronchodilator FEV1 (% predicted), hemoglobin level, respiratory emergency admission rate and daily activity. The CPS ranged from 0 to 16, with 16 indicating the poorest prognosis. A one-point increase in the CPS was associated with an increase,in all-cause death (with a HR of 1.28). The preliminary validation suggests that the CPS (new prognostic scale) had a slightly better prognostic ability than the BODE index and the ADO index. Future validation in a prospective cohort is anticipated.

This is a comparison of postoperative distress related to selected surgical techniques: conventional open surgery (OS) and transoral robotic surgery (TORS) used in the treatment of base of tongue and supraglottis malignant tumours. There were statistically significant deviations in two main areas: blood loss and somatic problems. The study confirms that there are significant differences between the use of TORS and conventional open surgery for the removal of malignant carcinomas located in the tongue base or supraglottis.

This paper is an overview of the impact of the human gut microbiota on the metabolism of drugs in the intestinal lumen, on the pharmacokinetics of orally administered drugs and the links between xenobiotics and the composition of the gut microbiota leading to variations in response to medication.

This study is the only one demonstrating the absence (using both polymerase chain reaction and electron microscopy) of Borrelia burgdorferi in the myocardium of subjects with normal left ventricular systolic function and no history of Lyme disease or myocarditis. The absence of B. burgdorferi in these individuals supports the idea of its pathogenicity in the development of dilated cardiomyopathy.

Aims: To assess the impact of autologous serum eye drops on the level of ocular surface apoptosis in patients with bilateral severe dry eye disease. Methods: This prospective study was conducted on 10 patients with severe dry eye due to graft versus host disease (group 1) and 6 patients with severe dry eye due to primary Sjögren's syndrome (group 2). Impression cytology specimens from the bulbar conjunctiva were obtained before and after a three-month treatment with 20% autologous serum eye drops applied a maximum of 12 times a day together with regular therapy with artificial tears. The percentage of apoptotic epithelial cells was evaluated immunochemically using anti-active caspase 3 antibody. Results: In group 1, the mean percentage of apoptotic cells was 3.6% before the treatment. The three-month treatment led to a significant decrease to a mean percentage of 1.8% (P = 0.028). The mean percentage of apoptotic conjunctival cells decreased from 5.4% before the treatment to 3.8% in group 2; however, these results did not reach the level of significance. Conclusion: Three-month autologous serum treatment led to the improvement of ocular surface apoptosis, especially in the group of patients with severe dry eye due to graft versus host disease. This result supports the very positive effect of autologous serum on the ocular surface in patients suffering from severe dry eye.

This paper is a concise review of the available data on the potential importance of MDR1/P-gp in respiratory disease pathogenesis and treatment. The literature includes references to experimental in vitro and in vivo investigations, and clinical results on MDR1 genetic polymorphisms and P-gp expression levels which aim to elucidate their influence on chronic obstructive pulmonary disease and different types of lung tumor pathogenesis and treatment.

Ureterocele in duplex kidney leads to more serious damage of upper pole kidney parenchyma than ectopic ureter. Upper pole function 3% or less in the case of ureterocele and 2% or less in the case of ectopic ureter indicates irreversible parenchymal damage. Ultrasound examination of duplex kidney is not able to predict the severity of histological lesions of upper pole parenchyma.

This was a prospective study comparing the degree of posterior capsule opacification (PCO) after AquaLase and NeoSoniX phacoemulsification methods during an 8-year follow-up. There was minimal PCO difference between these 2 approaches, AquaLase and NeoSoniX. Neither AquaLase nor NeoSoniX technique was able to prevent a natural progression of PCO.