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Svancer P, Capek V, Skoch A, Kopecek M, Vochoskova K, Fialova M, Furstova P, Jakob L, Bakstein E, Kolenic M, Hlinka J, Knytl P, Spaniel F. Longitudinal assessment of ventricular volume trajectories in early-stage schizophrenia: evidence of both enlargement and shrinkage. BMC Psychiatry 2024; 24:309. [PMID: 38658884 PMCID: PMC11040899 DOI: 10.1186/s12888-024-05749-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 04/08/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND Lateral ventricular enlargement represents a canonical morphometric finding in chronic patients with schizophrenia; however, longitudinal studies elucidating complex dynamic trajectories of ventricular volume change during critical early disease stages are sparse. METHODS We measured lateral ventricular volumes in 113 first-episode schizophrenia patients (FES) at baseline visit (11.7 months after illness onset, SD = 12.3) and 128 age- and sex-matched healthy controls (HC) using 3T MRI. MRI was then repeated in both FES and HC one year later. RESULTS Compared to controls, ventricular enlargement was identified in 18.6% of patients with FES (14.1% annual ventricular volume (VV) increase; 95%CI: 5.4; 33.1). The ventricular expansion correlated with the severity of PANSS-negative symptoms at one-year follow-up (p = 0.0078). Nevertheless, 16.8% of FES showed an opposite pattern of statistically significant ventricular shrinkage during ≈ one-year follow-up (-9.5% annual VV decrease; 95%CI: -23.7; -2.4). There were no differences in sex, illness duration, age of onset, duration of untreated psychosis, body mass index, the incidence of Schneiderian symptoms, or cumulative antipsychotic dose among the patient groups exhibiting ventricular enlargement, shrinkage, or no change in VV. CONCLUSION Both enlargement and ventricular shrinkage are equally present in the early stages of schizophrenia. The newly discovered early reduction of VV in a subgroup of patients emphasizes the need for further research to understand its mechanisms.
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Affiliation(s)
- Patrik Svancer
- National Institute of Mental Health, Topolova 748, 250 67, Klecany, Czech Republic
- Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Vaclav Capek
- National Institute of Mental Health, Topolova 748, 250 67, Klecany, Czech Republic
| | - Antonin Skoch
- National Institute of Mental Health, Topolova 748, 250 67, Klecany, Czech Republic
- Department of Diagnostic and Interventional Radiology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Miloslav Kopecek
- National Institute of Mental Health, Topolova 748, 250 67, Klecany, Czech Republic
- Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Kristyna Vochoskova
- National Institute of Mental Health, Topolova 748, 250 67, Klecany, Czech Republic
- Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Marketa Fialova
- National Institute of Mental Health, Topolova 748, 250 67, Klecany, Czech Republic
- Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Petra Furstova
- National Institute of Mental Health, Topolova 748, 250 67, Klecany, Czech Republic
| | - Lea Jakob
- National Institute of Mental Health, Topolova 748, 250 67, Klecany, Czech Republic
- Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Eduard Bakstein
- National Institute of Mental Health, Topolova 748, 250 67, Klecany, Czech Republic
- Department of Cybernetics, Faculty of Electrical Engineering, Czech Technical University in Prague, Prague, Czech Republic
| | - Marian Kolenic
- National Institute of Mental Health, Topolova 748, 250 67, Klecany, Czech Republic
- Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Jaroslav Hlinka
- National Institute of Mental Health, Topolova 748, 250 67, Klecany, Czech Republic
| | - Pavel Knytl
- National Institute of Mental Health, Topolova 748, 250 67, Klecany, Czech Republic
- Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Filip Spaniel
- National Institute of Mental Health, Topolova 748, 250 67, Klecany, Czech Republic.
- Third Faculty of Medicine, Charles University, Prague, Czech Republic.
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Varenyiova Z, Rojas-Hernandez LS, Spano J, Capek V, Rosenberg-Hasson Y, Holmes T, Milla C. Azithromycin promotes proliferation, and inhibits inflammation in nasal epithelial cells in primary ciliary dyskinesia. Sci Rep 2023; 13:14453. [PMID: 37660113 PMCID: PMC10475097 DOI: 10.1038/s41598-023-41577-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 08/29/2023] [Indexed: 09/04/2023] Open
Abstract
Primary ciliary dyskinesia (PCD) is a genetic disorder associated with recurrent and chronic respiratory infections due to functional defects of motile cilia. In this study, we aimed to elucidate inflammatory and proliferative responses in PCD respiratory epithelium and evaluate the effect of Azithromycin (AZT) on these responses. Airway basal cells (BCs) were isolated from nasal samples of Wild-type (WT) epitope of healthy donors and PCD donors with bi-allelic mutations in DNAH5, DNAH11 and CCDC39. Cells were expanded in vitro and stimulated with either Lipopolysaccharide (LPS) or vehicle control. Post stimulation, cells were treated with either Azithromycin (AZT) or vehicle control. Cell proliferation was imaged in real-time. Separately, BCs from the same donors were expanded and grown at an air-liquid interface (ALI) to generate a multi-ciliated epithelium (MCE). Once fully mature, cells were stimulated with LPS, AZT, LPS + AZT or vehicle control. Inflammatory profiling was performed on collected media by cytokine Luminex assay. At baseline, there was a significantly higher mean production of pro-inflammatory cytokines by CCDC39 BCs and MCEs when compared to WT, DNAH11 and DNAH5 cells. AZT inhibited production of cytokines induced by LPS in PCD cells. Differences in cell proliferation were noted in PCD and this was also corrected with AZT treatment.
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Affiliation(s)
- Zofia Varenyiova
- Department of Pediatrics, 2nd Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic.
| | | | - Jacquelyn Spano
- Center for Excellence in Pulmonary Biology, Stanford University, Palo Alto, CA, USA
| | - Vaclav Capek
- Department of Pediatrics, 2nd Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | | | - Tyson Holmes
- Human Immune Monitoring Center, Stanford University, Stanford, CA, USA
| | - Carlos Milla
- Center for Excellence in Pulmonary Biology, Stanford University, Palo Alto, CA, USA
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Plankaova A, Brajerova M, Capek V, Novotna GB, Kinross P, Skalova J, Soltesova A, Drevinek P, Krutova M. Clostridioides difficile infections were predominantly driven by fluoroquinolone-resistant C. difficile ribotypes 176 and 001 in Slovakia in 2018-2019. Int J Antimicrob Agents 2023; 62:106824. [PMID: 37116667 DOI: 10.1016/j.ijantimicag.2023.106824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 04/12/2023] [Accepted: 04/17/2023] [Indexed: 04/30/2023]
Abstract
AIMS We aimed to investigate Clostridioides difficile (CDI) epidemiology in Slovakian hospitals after the emergence of ribotype 176 (027-like) in 2016. METHODS Between 2018 and 2019, the ECDC CDI surveillance protocol v2.3 was applied to 14 hospitals, with additional data collected on recent antimicrobial use and the characterisation of C. difficile isolates. RESULTS The hospital mean CDI incidence of 4.1 cases per 10,000 patient bed-days. An in-hospital fatal outcome was reported in 27.6% (n=105) of the 381 cases. Antimicrobial treatment within the previous 4 weeks was recorded in 90.5% (333/368). Ribotype (RT)176 was detected in 50% (n=185/370; 14 hospitals) and RT001 in 34.6% (n=128/370;13/14 hospitals) cases with RT data. A total of 86% (n=318/370) of isolates were moxifloxacin-resistant by Thr82Ile in GyrA (99.7%). Multilocus Variable Tandem Repeat Analysis showed clonal relatedness of predominant RTs within and between hospitals. Seven of 14 sequenced RT176 isolates and 5 of 13 RT001 isolates showed only 0-3 allele differences by wgMLST. The majority of sequenced isolates (24/27) carried the erm(B) gene and 16/27 also carried aac(6')-aph(2'') gene with the corresponding antimicrobial susceptibility phenotypes. Nine RT176 strains carried the cfr(E)gene and one RT001 strain carried the cfr(C) gene, but without a linezolid resistance. CONCLUSIONS The newly-predominant RT176 and endemic RT001 drive CDI epidemiology in Slovakia. In addition to fluoroquinolones, the use of macrolide-lincosamide-streptogramin B group of antibiotics can represent another driving force for the spread of these epidemic lineages. In C. difficile, linezolid resistance should be confirmed phenotypically in strains with detected cfr-gene(s).
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Affiliation(s)
- Adriana Plankaova
- Department of Clinical Microbiology, Unilabs Inc., Roznava, Slovakia
| | - Marie Brajerova
- Department of Medical Microbiology, 2nd Faculty of Medicine, Charles University and Motol University Hospital, Czech Republic
| | - Vaclav Capek
- Bioinformatics centre, 2nd Faculty of Medicine, Charles University, Czech Republic
| | | | - Pete Kinross
- Department of Medical Microbiology, 2nd Faculty of Medicine, Charles University and Motol University Hospital, Czech Republic
| | - Jana Skalova
- Department of Clinical Microbiology, Unilabs Inc., Roznava, Slovakia
| | - Anna Soltesova
- Department of Clinical Microbiology, Unilabs Inc., Roznava, Slovakia
| | - Pavel Drevinek
- Department of Medical Microbiology, 2nd Faculty of Medicine, Charles University and Motol University Hospital, Czech Republic
| | - Marcela Krutova
- Department of Medical Microbiology, 2nd Faculty of Medicine, Charles University and Motol University Hospital, Czech Republic.
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Vetrovsky T, Kral N, Pfeiferova M, Kuhnova J, Novak J, Wahlich C, Jaklova A, Jurkova K, Janek M, Omcirk D, Capek V, Maes I, Steffl M, Ussher M, Tufano JJ, Elavsky S, Van Dyck D, Cimler R, Yates T, Harris T, Seifert B. mHealth intervention delivered in general practice to increase physical activity and reduce sedentary behaviour of patients with prediabetes and type 2 diabetes (ENERGISED): rationale and study protocol for a pragmatic randomised controlled trial. BMC Public Health 2023; 23:613. [PMID: 36997936 PMCID: PMC10064755 DOI: 10.1186/s12889-023-15513-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 03/23/2023] [Indexed: 04/01/2023] Open
Abstract
BACKGROUND The growing number of patients with type 2 diabetes and prediabetes is a major public health concern. Physical activity is a cornerstone of diabetes management and may prevent its onset in prediabetes patients. Despite this, many patients with (pre)diabetes remain physically inactive. Primary care physicians are well-situated to deliver interventions to increase their patients' physical activity levels. However, effective and sustainable physical activity interventions for (pre)diabetes patients that can be translated into routine primary care are lacking. METHODS We describe the rationale and protocol for a 12-month pragmatic, multicentre, randomised, controlled trial assessing the effectiveness of an mHealth intervention delivered in general practice to increase physical activity and reduce sedentary behaviour of patients with prediabetes and type 2 diabetes (ENERGISED). Twenty-one general practices will recruit 340 patients with (pre)diabetes during routine health check-ups. Patients allocated to the active control arm will receive a Fitbit activity tracker to self-monitor their daily steps and try to achieve the recommended step goal. Patients allocated to the intervention arm will additionally receive the mHealth intervention, including the delivery of several text messages per week, with some of them delivered just in time, based on data continuously collected by the Fitbit tracker. The trial consists of two phases, each lasting six months: the lead-in phase, when the mHealth intervention will be supported with human phone counselling, and the maintenance phase, when the intervention will be fully automated. The primary outcome, average ambulatory activity (steps/day) measured by a wrist-worn accelerometer, will be assessed at the end of the maintenance phase at 12 months. DISCUSSION The trial has several strengths, such as the choice of active control to isolate the net effect of the intervention beyond simple self-monitoring with an activity tracker, broad eligibility criteria allowing for the inclusion of patients without a smartphone, procedures to minimise selection bias, and involvement of a relatively large number of general practices. These design choices contribute to the trial's pragmatic character and ensure that the intervention, if effective, can be translated into routine primary care practice, allowing important public health benefits. TRIAL REGISTRATION ClinicalTrials.gov (NCT05351359, 28/04/2022).
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Affiliation(s)
- Tomas Vetrovsky
- Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic.
| | - Norbert Kral
- Institute of General Practice, 1st Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Marketa Pfeiferova
- Institute of General Practice, 1st Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Jitka Kuhnova
- Faculty of Science, University of Hradec Kralove, Hradec Kralove, Czech Republic
| | - Jan Novak
- Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic
| | - Charlotte Wahlich
- Population Health Research Institute, St George's University of London, London, UK
| | - Andrea Jaklova
- 2nd Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Katerina Jurkova
- Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic
| | - Michael Janek
- Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic
| | - Dan Omcirk
- Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic
| | - Vaclav Capek
- 2nd Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Iris Maes
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Michal Steffl
- Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic
| | - Michael Ussher
- Population Health Research Institute, St George's University of London, London, UK
- Institute for Social Marketing and Health, University of Stirling, Stirling, UK
| | - James J Tufano
- Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic
| | - Steriani Elavsky
- Department of Human Movement Studies, University of Ostrava, Ostrava, Czech Republic
| | - Delfien Van Dyck
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Richard Cimler
- Faculty of Science, University of Hradec Kralove, Hradec Kralove, Czech Republic
| | - Tom Yates
- Diabetes Research Centre, University of Leicester, Leicester, UK
- National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust and the University of Leicester, Leicester, UK
| | - Tess Harris
- Population Health Research Institute, St George's University of London, London, UK
| | - Bohumil Seifert
- Institute of General Practice, 1st Faculty of Medicine, Charles University, Prague, Czech Republic
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Potockova V, Mala S, Hoskovcova L, Capek V, Nedelka T, Riedlbauchova L, Baumgartner D, Mensova L, Mazanec R. Thermal quantitative sensory testing as a screening tool for cardiac autonomic neuropathy in patients with diabetes mellitus. Brain Behav 2022; 12:e2506. [PMID: 35212197 PMCID: PMC8933758 DOI: 10.1002/brb3.2506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 11/14/2021] [Accepted: 01/02/2022] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION Electrophysiological diagnosis of cardiac autonomic neuropathy (CAN) is based on the evaluation of cardiovascular autonomic reflex tests (CARTs). CARTs are relatively time consuming and must be performed under standardized conditions. This study aimed to determine whether thermal quantitative sensory testing (TQST) can be used as a screening tool to identify patients with diabetes at a higher risk of CAN. METHODS Eighty-five patients with diabetes and 49 healthy controls were included in the study. Neurological examination, CARTs, TQST, biochemical analyses, and neuropathy symptom questionnaires were performed. RESULTS CAN was diagnosed in 46 patients with diabetes (54%). CAN-positive patients with diabetes had significantly higher warm detection thresholds (WDT) and significantly lower cold detection thresholds (CDT) in all tested regions (thenar, tibia, and the dorsum of the foot). CDT on the dorsum < 21.8°C in combination with CDT on the tibia < 23.15°C showed the best diagnostic ability in CAN prediction, with 97.4 % specificity, 60.9% sensitivity, 96.6% positive predictive value, and 67.3% negative predictive value. CONCLUSION TQST can be used as a screening tool for CAN before CART.
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Affiliation(s)
- Veronika Potockova
- Second Faculty of Medicine, Department of Neurology, Motol University Hospital, Charles University, Prague, Czech Republic
| | - Sarka Mala
- Second Faculty of Medicine, Department of Internal Medicine, Motol University Hospital, Charles University, Prague, Czech Republic
| | - Lucie Hoskovcova
- Second Faculty of Medicine, Department of Internal Medicine, Motol University Hospital, Charles University, Prague, Czech Republic
| | - Vaclav Capek
- Second Faculty of Medicine, Department of Neurology, Motol University Hospital, Charles University, Prague, Czech Republic
| | - Tomas Nedelka
- Second Faculty of Medicine, Department of Neurology, Motol University Hospital, Charles University, Prague, Czech Republic.,Faculty of Biomedical Engineering, Czech Technical University in Prague, Prague, Czech Republic
| | - Lucie Riedlbauchova
- Second Faculty of Medicine, Department of Cardiology, Motol University Hospital, Charles University, Prague, Czech Republic
| | - Daniel Baumgartner
- Second Faculty of Medicine, Department of Neurology, Motol University Hospital, Charles University, Prague, Czech Republic
| | - Livie Mensova
- Second Faculty of Medicine, Department of Neurology, Motol University Hospital, Charles University, Prague, Czech Republic
| | - Radim Mazanec
- Second Faculty of Medicine, Department of Neurology, Motol University Hospital, Charles University, Prague, Czech Republic
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Uher T, Kubala Havrdova E, Vodehnalova K, Krasensky J, Capek V, Vaneckova M, Horakova D. Pregnancy-induced brain MRI changes in women with multiple sclerosis. Eur J Neurol 2022; 29:1446-1456. [PMID: 35015921 DOI: 10.1111/ene.15245] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 11/30/2021] [Accepted: 12/23/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND The effect of pregnancy on brain changes and radiological disease activity in women with multiple sclerosis (MS) is not well understood. AIMS To describe the dynamic of lesion activity and brain volume changes during the pregnancy and postpartum periods. METHODS This observational study of 62 women with relapsing-remitting MS included MRI (221 scans) as well as clinical visits at baseline (<24 and >6 months before), prepregnancy (<6 months before), postpartum (<3 months after), and the follow-up (>12 and <24 months after delivery) period. RESULTS The majority of women had a mild disability and a short disease duration (median 5.5 years). Eighteen (29.0%) women had a relapse during the year preceding pregnancy onset, 9 (14.5%) during pregnancy, and 20 (32.3%) in the year following delivery. Disability status remained unchanged during follow-up. Women in the postpartum period (n=62) had higher T2 lesion volume (median: 0.94 ml vs. 1.18 ml), greater annualized T2 lesion volume increase (0.0 ml vs. 0.23 ml), lower brain parenchymal fraction (86.4% vs. 85.6%) and greater annualized brain volume loss (-0.16% vs. -1.74%) compared with the prepregnancy period (all p<0.001). At 12-24 months after delivery women (n=41) had higher T2 lesion volume (1.0 ml vs. 1.16 ml) and lower brain parenchymal fraction (86.5% vs. 86.0%) compared to the prepregnancy period (both p<0.001). CONCLUSIONS The postpartum period was associated with an increase in T2 lesion volume and accelerated brain volume loss in a considerable proportion of women. This should be considered in treatment decision-making and designing clinical trials.
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Affiliation(s)
- Tomas Uher
- Department of Neurology and Center of Clinical Neuroscience, Charles University in Prague, 1st Faculty of Medicine and General University Hospital, Prague, Czech Republic
| | - Eva Kubala Havrdova
- Department of Neurology and Center of Clinical Neuroscience, Charles University in Prague, 1st Faculty of Medicine and General University Hospital, Prague, Czech Republic
| | - Karolina Vodehnalova
- Department of Neurology and Center of Clinical Neuroscience, Charles University in Prague, 1st Faculty of Medicine and General University Hospital, Prague, Czech Republic
| | - Jan Krasensky
- Department of Radiology, Charles University in Prague, First Faculty of Medicine and General University Hospital in Prague, Czech Republic
| | - Vaclav Capek
- Department of Neurology and Center of Clinical Neuroscience, Charles University in Prague, 1st Faculty of Medicine and General University Hospital, Prague, Czech Republic
| | - Manuela Vaneckova
- Department of Radiology, Charles University in Prague, First Faculty of Medicine and General University Hospital in Prague, Czech Republic
| | - Dana Horakova
- Department of Neurology and Center of Clinical Neuroscience, Charles University in Prague, 1st Faculty of Medicine and General University Hospital, Prague, Czech Republic
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Mares T, Albrecht J, Buday J, Podgorna G, Le TH, Magyarova E, Poshor K, Halik J, Buna J, Capek V, Kostylkova L, Klasova J, Fabian V, Anders M. Long-term effect of transcranial direct current stimulation in the treatment of chronic tinnitus: A randomized, placebo-controlled trial. Front Psychiatry 2022; 13:969800. [PMID: 36311525 PMCID: PMC9606613 DOI: 10.3389/fpsyt.2022.969800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 09/20/2022] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Tinnitus is an intrusive and chronic illness affecting a significant portion of the population, decreasing affected individuals' quality of life and socioeconomic functioning. Transcranial Direct Current Stimulation (tDCS) is a non-invasive neuromodulatory method utilizing weak electrical currents to elicit short and long-term central nervous system changes. Several studies have proven its effect on tinnitus. We aimed to broaden the knowledge and provide data on the effect and its retention. METHODS In the randomized, double-blinded, sham-controlled trial, 39 patients (active n = 19, sham n = 20) underwent bifrontal tDCS (anode over right dorsolateral prefrontal cortex (DLPFC), cathode left DLPFC, current of 1.5 mA, 20 min, 6 sessions in 2 weeks). Tinnitus Functional Index (TFI), Iowa Tinnitus Handicap Questionnaire (ITHQ), Beck Anxiety Inventory (BAI), Zung Self-Rating Depression Scale (SDS), and WHO-Quality of Life-BREF were employed in 4 evaluation points, including the follow-ups of 6 weeks and 6 months. RESULTS We reached a delayed, significant long-term improvement (p < 0.05) in auditory difficulties associated with tinnitus and noticed it even after 6 months compared to placebo. We also reached a short-term, negative effect in the psychological domain of WHO-Quality of Life-BREF (p < 0.05). Not all subdomains of TFI and ITHQ reached statistical significance during the data analysis, even though specific positive trends were noticed. CONCLUSION We proved partial, positive, long-term effects of tDCS on tinnitus and short-term, negative, transient effect on a specific aspect of the general quality of life. We expanded upon the results of previous trials and provided data concerning the longevity and the precise effect of multiple sessions, bifrontal DLPFC tDCS. Our sample size (n = 39) was limited, which might have contributed to the lesser statistical power of the analyzed items. CLINICAL TRIAL REGISTRATION [www.ClinicalTrials.gov], identifier [NCT05437185].
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Affiliation(s)
- Tadeas Mares
- Department of Psychiatry, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czechia.,First Faculty of Medicine, Charles University, Prague, Czechia
| | - Jakub Albrecht
- Department of Psychiatry, Krajska zdravotni a.s. - Most Hospital, Most, Czechia
| | - Jozef Buday
- Department of Psychiatry, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czechia.,First Faculty of Medicine, Charles University, Prague, Czechia
| | - Gabriela Podgorna
- Department of Psychiatry, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czechia.,First Faculty of Medicine, Charles University, Prague, Czechia
| | - Thai Hong Le
- Department of Psychiatry, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czechia.,First Faculty of Medicine, Charles University, Prague, Czechia
| | - Eva Magyarova
- Department of Psychiatry, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czechia.,First Faculty of Medicine, Charles University, Prague, Czechia
| | - Katerina Poshor
- Department of Psychiatry, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czechia
| | - Jakub Halik
- Department of Psychiatry, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czechia
| | - Jan Buna
- Department of Psychiatry, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czechia
| | - Vaclav Capek
- Department of Psychiatry, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czechia.,First Faculty of Medicine, Charles University, Prague, Czechia
| | - Lenka Kostylkova
- National Institute of Mental Health, Klecany, Czechia.,Third Faculty of Medicine, Charles University, Prague, Czechia
| | - Johana Klasova
- Department of Internal Medicine, First Faculty of Medicine, Charles University and Military University Hospital, Prague, Czechia
| | - Vratislav Fabian
- Department of Physics, Faculty of Electrical Engineering, Czech Technical University in Prague, Prague, Czechia
| | - Martin Anders
- Department of Psychiatry, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czechia.,First Faculty of Medicine, Charles University, Prague, Czechia
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8
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Tkadlec J, Capek V, Brajerova M, Smelikova E, Melter O, Bergerova T, Polivkova S, Balejova M, Hanslianova M, Fackova D, Neradova K, Tejkalova R, Vagnerova I, Bartonikova N, Chmelarova E, Drevinek P, Krutova M. The molecular epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) in the Czech Republic. J Antimicrob Chemother 2021; 76:55-64. [PMID: 33118033 DOI: 10.1093/jac/dkaa404] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 08/30/2020] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES To gain data on the current molecular epidemiology and resistance of MRSA in the Czech Republic. METHODS Between September 2017 and January 2018, a total of 441 single-patient MRSA isolates were collected from 11 Czech hospitals and analysed by spa typing, SCCmec typing, antibiotic susceptibility testing, detection of the PVL toxin and the arcA gene. RESULTS Of all MRSA isolates, 81.41% (n = 359) belonged to the CC5-MRSA clone represented by the spa types t003 (n = 136), t586 (n = 92), t014 (n = 81), t002 (n = 20) and other spa types (n = 30); a majority of the CC5 isolates (n = 348, 96.94%) carried SCCmec type II. The occurrence of CC5-MRSA was more likely in older inpatients and associated with a healthcare origin (P < 0.001). The CC5-MRSA isolates were resistant to more antimicrobial drugs compared with the other MRSAs (P < 0.001). Interestingly, t586 was detected in blood samples more often than the other spa types and, contrary to other spa types belonging to CC5-MRSA, t586 was not associated with patients of advanced age. Other frequently found lineages were CC8 (n = 17), CC398 (n = 11) and CC59 (n = 10). The presence of the PVL was detected in 8.62% (n = 38) of the MRSA isolates. CONCLUSIONS The healthcare-associated CC5-MRSA-II lineage (t003, t586, t014) was found to be predominant in the Czech Republic. t586 is a newly emerging spa type in the Czech Republic, yet reported rarely in other countries. Our observations stress the need for MRSA surveillance in the Czech Republic in order to monitor changes in MRSA epidemiology.
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Affiliation(s)
- Jan Tkadlec
- Department of Medical Microbiology, Charles University, 2nd Faculty of Medicine and Motol University Hospital, Prague, Czech Republic
| | - Vaclav Capek
- Bioinformatics Centre, Charles University, 2nd Faculty of Medicine, Prague, Czech Republic
| | - Marie Brajerova
- Department of Medical Microbiology, Charles University, 2nd Faculty of Medicine and Motol University Hospital, Prague, Czech Republic
| | - Eva Smelikova
- Department of Medical Microbiology, Charles University, 2nd Faculty of Medicine and Motol University Hospital, Prague, Czech Republic
| | - Oto Melter
- Department of Medical Microbiology, Charles University, 2nd Faculty of Medicine and Motol University Hospital, Prague, Czech Republic
| | - Tamara Bergerova
- Department of Microbiology, Faculty of Medicine and University Hospital Plzen, Charles University in Prague, Plzen, Czech Republic
| | - Sylvia Polivkova
- Department of Infectious Diseases, Charles University, 3rd Faculty of Medicine and Bulovka Teaching Hospital, Prague, Czech Republic
| | - Magda Balejova
- Department of Medical Microbiology, Hospital Ceske Budejovice, Czech Republic
| | - Marketa Hanslianova
- Department of Medical Microbiology, University Hospital Brno, Czech Republic
| | - Daniela Fackova
- Department of Medical Microbiology and Immunology, Hospital Liberec, Czech Republic
| | - Katerina Neradova
- Department of Clinical Microbiology, University Hospital Hradec Kralove, Czech Republic
| | - Renata Tejkalova
- Department of Medical Microbiology, Faculty of Medicine, Masaryk University and St Anne's University Hospital, Brno, Czech Republic
| | - Iva Vagnerova
- Department of Microbiology, Faculty of Medicine and Dentistry, Palacky University Olomouc, University Hospital Olomouc, Czech Republic
| | - Natasa Bartonikova
- Department of Medical Microbiology, Tomas Bata's Hospital Zlin, Czech Republic
| | - Eva Chmelarova
- Department of Microbiology, Agel Laboratories a.s., Ostrava-Vitkovice, Czech Republic
| | - Pavel Drevinek
- Department of Medical Microbiology, Charles University, 2nd Faculty of Medicine and Motol University Hospital, Prague, Czech Republic
| | - Marcela Krutova
- Department of Medical Microbiology, Charles University, 2nd Faculty of Medicine and Motol University Hospital, Prague, Czech Republic
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Kruseova J, Kovacova AS, Zapotocky M, Sumerauer D, Pernikova I, Starkova D, Misove A, Zichova A, Capek V, Langer T, am Zehnhoff-Dinnesen A, Eckschlager T, Kyncl M. Older age is a protective factor for academic achievements irrespective of treatment modalities for posterior fossa brain tumours in children. PLoS One 2020; 15:e0243998. [PMID: 33326475 PMCID: PMC7743944 DOI: 10.1371/journal.pone.0243998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Accepted: 12/01/2020] [Indexed: 11/18/2022] Open
Abstract
The treatment of children with posterior fossa brain tumours (PFBT) impacts their long term functional and imaging outcomes. This study aimed to evaluate academic achievement correlated with long-term sequelae after different PFBT treatment modalities. The study cohort consisted of 110 survivors (median age at diagnosis 10.1 years and median time of follow up 13.2 years) who completed hearing questionnaires, neurological assessment and MRI of the brain ≥5 years after the end of treatment. There were three treatment groups. A cisplatin group which underwent cisplatin chemotherapy, radiotherapy and surgery (medulloblastoma N = 40), a radiotherapy group which underwent radiotherapy and surgery (astrocytoma/ependymoma N = 30), and a surgery group (astrocytoma N = 40). Academic achievement was correlated to the age at diagnosis, ototoxicity, Karnofsky score (KS), and MRI findings (Fazekas Score (FS)- treatment related parenchymal changes). For a modelled age at diagnosis of five years, the cisplatin group had lower academic achievements compared to the radiotherapy (p = 0.028) and surgery (p = 0.014) groups. Academic achievements evaluated at a modelled age of 10 years at diagnosis did not significantly differ among the treatment groups. The cisplatin group exhibited a higher occurrence of ototoxicity than the radiotherapy (p<0.019) and surgery groups (p<0.001); however, there was no correlation between ototoxicity and academic achievements (p = 0.722) in older age at diagnosis. The radiotherapy group exhibited lower KS than the surgery group (p<0.001). KS significantly influenced academic achievements in all groups (p<0.000). The cisplatin group exhibited higher FS than the surgery group (p<0.001) while FS did not correlate with academic achievement (p = 0.399). Older age is a protective factor for academic achievements irrespective of a treatment modality.
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Affiliation(s)
- Jarmila Kruseova
- Department of Paediatric Haematology and Oncology, Charles University, 2 Faculty of Medicine and University Hospital Motol, Prague, Czech Republic
- * E-mail:
| | - Anna Sarah Kovacova
- Department of Radiology, Charles University, 2 Faculty of Medicine and University Hospital Motol, Prague, Czech Republic
| | - Michal Zapotocky
- Department of Paediatric Haematology and Oncology, Charles University, 2 Faculty of Medicine and University Hospital Motol, Prague, Czech Republic
| | - David Sumerauer
- Department of Paediatric Haematology and Oncology, Charles University, 2 Faculty of Medicine and University Hospital Motol, Prague, Czech Republic
| | - Ivana Pernikova
- Department of Paediatric Neurology, Charles University, 2 Faculty of Medicine and University Hospital Motol, Prague, Czech Republic
| | - Darja Starkova
- Department of Radiology, Charles University, 2 Faculty of Medicine and University Hospital Motol, Prague, Czech Republic
| | - Adela Misove
- Department of Paediatric Haematology and Oncology, Charles University, 2 Faculty of Medicine and University Hospital Motol, Prague, Czech Republic
| | - Andrea Zichova
- Department of Paediatric Haematology and Oncology, Charles University, 2 Faculty of Medicine and University Hospital Motol, Prague, Czech Republic
| | - Vaclav Capek
- Bioinformatics Centre, Charles University, 2 Faculty of Medicine and University Hospital Motol, Prague, Czech Republic
| | - Thorsten Langer
- Pediatric Oncology and Hematology, University Hospital for Children and Adolescents, Lübeck, Germany
| | | | - Tomas Eckschlager
- Department of Paediatric Haematology and Oncology, Charles University, 2 Faculty of Medicine and University Hospital Motol, Prague, Czech Republic
| | - Martin Kyncl
- Department of Radiology, Charles University, 2 Faculty of Medicine and University Hospital Motol, Prague, Czech Republic
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Marel M, Padr R, Fila L, Rakita D, Casas Mendez F, Capkova L, Capek V, Pavlik R. Biopsy of lung lesions under CT control. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2020; 165:390-394. [PMID: 32955039 DOI: 10.5507/bp.2020.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 09/08/2020] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES With the increasing number of detected lung nodules and the need for morphological verification, the number of CT- controlled biopsies is increasing. The aim of this study was to assess the risks and benefits of these biopsies. METHODS This is a prospective and observational study. We evaluated 101 punctures performed on a group of 90 consecutive patients in the Department of Radiology. RESULTS In patients with a mean age of 66 years, with mostly accidentally detected lung nodules, we observed complications 38 times. The most common were minor pneumothoraxes or insignificant bleedings. In 6 patients, the complications were more serious, 5 times the pneumothoraxes required chest drainage, once massive hemoptysis was recorded. The lesions were successfully biopsied 78 times, the target was missed 23 times. The diagnosis of lung cancer (LC) was confirmed in 60 patients, 49 LCs were verified by puncture under CT control. 42% (25/60) of patients with LC were diagnosed in TNM stages I and II. 23% (14/60) of patients with LC were treated surgically. The remaining 30 patients most often suffered from lung metastazes (13/30), in 8 of them an inflammatory lung disease was diagnosed. 69 patients underwent bronchoscopy, in only 19% (13/69) it contributed to the diagnosis. In a model "screening like" group of 49 patients with only randomly detected lung deposits, we diagnosed LC in 76% (37/49). 49% (18/37) were in TNM stage I and II, 11 were treated surgically. CONCLUSIONS CT-controlled biopsy of lung lesions is an effective and safe diagnostic method.
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Affiliation(s)
- Miloslav Marel
- Department of Pulmonology, University Hospital Motol and 2nd Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Radek Padr
- Department of Radiology, University Hospital Motol, and 2nd Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Libor Fila
- Department of Pulmonology, University Hospital Motol and 2nd Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Dmitry Rakita
- Department of Pulmonology, University Hospital Motol and 2nd Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Fernando Casas Mendez
- Department of Pulmonology, University Hospital Motol and 2nd Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Linda Capkova
- Department of Pathology and Molecular Medicine, University Hospital Motol, and 2nd Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Vaclav Capek
- Bioinformatics Centre, University Hospital Motol, and 2nd Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Radim Pavlik
- Department of Radiology, University Hospital Motol, and 2nd Faculty of Medicine, Charles University, Prague, Czech Republic
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11
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Krutova M, Capek V, Nycova E, Vojackova S, Balejova M, Geigerova L, Tejkalova R, Havlinova L, Vagnerova I, Cermak P, Ryskova L, Jezek P, Zamazalova D, Vesela D, Kucharova A, Nemcova D, Curdova M, Nyc O, Drevinek P. The association of a reduced susceptibility to moxifloxacin in causative Clostridium (Clostridioides) difficile strain with the clinical outcome of patients. Antimicrob Resist Infect Control 2020; 9:98. [PMID: 32605598 PMCID: PMC7325081 DOI: 10.1186/s13756-020-00765-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 06/23/2020] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES To investigate the relationship between Clostridium (Clostridioides) difficile strain characteristics and C. difficile infection (CDI) outcome. METHODS Between October and December 2017, 16 hospitals collected epidemiological data according to the European Centre for Disease Prevention and Control (ECDC) surveillance protocol for CDI. C. difficile isolates were characterized by ribotyping, toxin genes detection and antibiotic susceptibility testing to metronidazole, vancomycin and moxifloxacin. RESULTS The overall mean CDI incidence density was 4.5 [95% CI 3.6-5.3] cases per 10,000 patient-days. From the 433 CDI cases, 330 (76.2%) were healthcare-associated, 52 (12.0%) cases were community-associated or of unknown origin and 51 (11.8%) CDI cases recurrent; a complicated course of CDI was reported in 65 cases (15.0%). Eighty-eight (20.3%) of patients died and 59 of them within 30 days after the CDI diagnosis. From the 379 C. difficile isolates, the most prevalent PCR ribotypes were 001 (n = 127, 33.5%) and 176 (n = 44, 11.6%). A total of 186 (49.1%) isolates showed a reduced susceptibility to moxifloxacin (> 4 mg/L) and 96.4% of them had Thr82Ile in the GyrA. Nineteen isolates revealed reduced susceptibility to metronidazole and two isolates to vancomycin (> 2 mg/L). A fatal outcome was associated with a reduced susceptibility to moxifloxacin, the advanced age of the patients and a complicated course of CDI (p<0.05). No association between ribotype, binary toxin and a reduced susceptibility to moxifloxacin and complicated course or recurrent CDI was found. CONCLUSIONS A reduced susceptibility to moxifloxacin, in causative C. difficile strains was associated with fatal outcome of the patients, therefore it is an important marker in surveillance of CDI.
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Affiliation(s)
- Marcela Krutova
- Department of Medical Microbiology, Charles University, 2nd Faculty of Medicine and Motol University Hospital, Prague, Czech Republic.
| | - Vaclav Capek
- Bioinformatics centre, 2nd Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Elka Nycova
- Department of Medical Microbiology, Hospital Bulovka, Prague, Czech Republic
| | - Sabina Vojackova
- Department of Medical Microbiology, University Hospital Brno, Brno, Czech Republic
| | - Magda Balejova
- Department of Medical Microbiology, Hospital Ceske Budejovice, Ceske Budejovice, Czech Republic
| | - Lenka Geigerova
- Department of Medical Microbiology, Faculty of Medicine, Charles University and University Hospital Plzen, Plzen, Czech Republic
| | - Renata Tejkalova
- Department of Medical Microbiology, Faculty of Medicine, Masaryk University and St. Anne's University Hospital, Brno, Czech Republic
| | - Lenka Havlinova
- Department of Medical Microbiology and Immunology, Hospital Liberec, Liberec, Czech Republic
| | - Iva Vagnerova
- Department of Microbiology, Faculty of Medicine and Dentistry, Palacky University Hospital, Olomouc, Czech Republic
| | - Pavel Cermak
- Department of Medical Microbiology, Thomayer's Hospital, Prague, Czech Republic
| | - Lenka Ryskova
- Department of Clinical Microbiology, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
| | - Petr Jezek
- Department of Clinical Microbiology and Parasitology, Hospital Pribram, Pribram, Czech Republic
| | - Dana Zamazalova
- Department of Clinical Microbiology, Hospital Nove Mesto na Morave, Nove Mesto na Morave, Czech Republic
| | - Denisa Vesela
- Department of Medical Microbiology, Hospital Jindrichuv Hradec, Jindrichuv Hradec, Czech Republic
| | - Alice Kucharova
- Department of Medical Microbiology, Hospital Tabor, Tabor, Czech Republic
| | - Dana Nemcova
- Department of Clinical Microbiology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Martina Curdova
- Department of Clinical Microbiology, Military University Hospital, Prague, Czech Republic
| | - Otakar Nyc
- Department of Medical Microbiology, Charles University, 2nd Faculty of Medicine and Motol University Hospital, Prague, Czech Republic
| | - Pavel Drevinek
- Department of Medical Microbiology, Charles University, 2nd Faculty of Medicine and Motol University Hospital, Prague, Czech Republic
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Vetrovsky T, Siranec M, Marencakova J, Tufano JJ, Capek V, Bunc V, Belohlavek J. Validity of six consumer-level activity monitors for measuring steps in patients with chronic heart failure. PLoS One 2019; 14:e0222569. [PMID: 31518367 PMCID: PMC6743766 DOI: 10.1371/journal.pone.0222569] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Accepted: 09/03/2019] [Indexed: 12/28/2022] Open
Abstract
INTRODUCTION Although numerous activity trackers have been validated in healthy populations, validation is lacking in chronic heart failure patients who normally walk at a slower pace, making it difficult for researchers and clinicians to implement activity monitors during physical activity interventions. METHODS Six consumer-level activity monitors were validated in a 3-day field study in patients with chronic heart failure and healthy individuals under free living conditions. Furthermore, the same devices were evaluated in a lab-based study during treadmill walking at speeds of 2.4, 3.0, 3.6, and 4.2 km·h-1. Concordance correlation coefficients (CCC) were used to evaluate the agreement between the activity monitors and the criterion, and mean absolute percentage errors (MAPE) were calculated to assess differences between each device and the criterion (MAPE <10% was considered as a threshold for validity). RESULTS In the field study of healthy individuals, all but one of the activity monitors showed a substantial correlation (CCC ≥0.95) with the criterion device and MAPE <10%. In patients with heart failure, the correlation of only two activity monitors (Garmin vívofit 3 and Withings Go) was classified as at least moderate (CCC ≥0.90) and none of the devices had MAPE <10%. In the lab-based study at speeds 4.2 and 3.6 km·h-1, all activity monitors showed substantial to almost perfect correlations (CCC ≥0.95) with the criterion and MAPE in the range 1%-3%. However, at slower speeds of 3.0 and 2.4 km·h-1, the accuracy of all devices substantially deteriorated: their correlation with the criterion decreased below 90% and their MAPE increased to 4-8% and 10-45%, respectively. CONCLUSIONS Even though none of the tested activity monitors fall within arbitrary thresholds for validity, most of them perform reasonably well enough to be useful tools that clinicians can use to simply motivate chronic heart failure patients to walk more.
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Affiliation(s)
- Tomas Vetrovsky
- Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic
- * E-mail:
| | - Michal Siranec
- 2nd Department of Medicine – Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Jitka Marencakova
- Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic
| | - James J. Tufano
- Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic
| | - Vaclav Capek
- Second Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Vaclav Bunc
- Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic
| | - Jan Belohlavek
- 2nd Department of Medicine – Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
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13
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Liba Z, Nohejlova H, Capek V, Krsek P, Sediva A, Kayserova J. Utility of chemokines CCL2, CXCL8, 10 and 13 and interleukin 6 in the pediatric cohort for the recognition of neuroinflammation and in the context of traditional cerebrospinal fluid neuroinflammatory biomarkers. PLoS One 2019; 14:e0219987. [PMID: 31356620 PMCID: PMC6663008 DOI: 10.1371/journal.pone.0219987] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Accepted: 07/05/2019] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The recognition of active inflammation in the central nervous system (CNS) in the absence of infectious agents is challenging. The present study aimed to determine the diagnostic relevance of five selected chemo/cytokines in the recognition of CNS inflammation and in the context of traditional cerebrospinal fluid (CSF) biomarkers (white blood cell [WBC] counts, oligoclonal bands, protein levels, CSF/serum albumin ratios) and clinical diagnoses. METHODS C-C and C-X-C motif ligands (CCL2, CXCL8, 10 and 13) and interleukin (IL) 6 levels in the CSF and serum from 37 control and 87 symptomatic children with ten different (mostly noninfectious) inflammatory CNS disorders (16 of which had follow-up samples after recovery) were determined using Luminex multiple bead technology and software. Nonparametric tests were used; p < 0.05 was considered statistically significant. Receiver operating characteristic curves were constructed to analyze controls and 1) all symptomatic samples or 2) symptomatic samples without CSF pleocytosis. RESULTS Compared with the control CSF samples, levels of all investigated chemo/cytokines were increased in symptomatic CSF samples, and only IL-6 remained elevated in recovery samples (p ≤ 0.001). CSF CXCL-13 levels (> 10.9 pg/mL) were the best individual discriminatory criterion to differentiate neuroinflammation (specificity/sensitivity: 97/72% and 97/61% for samples without pleocytosis), followed by CSF WBC counts (specificity/sensitivity: 97/62%). The clinical utility of the remaining CSF chemo/cytokine levels was determined in descending order of sensitivities corresponding to thresholds that ensured 97% specificity for neuroinflammation in samples without pleocytosis (pg/mL; sensitivity %): IL-6 (3.8; 34), CXCL8 (32; 26), CXCL10 (317; 24) and CCL2 (387; 10). Different diagnosis-related patterns of CSF chemo/cytokines were observed. CONCLUSIONS The increased CSF level of CXCL13 was the marker with the greatest predictive utility for the general recognition of neuroinflammation among all of the individually investigated biomarkers. The potential clinical utility of chemo/cytokines in the differential diagnosis of neuroinflammatory diseases was identified.
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Affiliation(s)
- Zuzana Liba
- Department of Pediatric Neurology, 2nd Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
- * E-mail:
| | - Hana Nohejlova
- Department of Pediatric Neurology, 2nd Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
- Department of Neurology, 2nd Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | - Vaclav Capek
- Bioinformatics Centre, 2nd Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | - Pavel Krsek
- Department of Pediatric Neurology, 2nd Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | - Anna Sediva
- Department of Immunology, 2 Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | - Jana Kayserova
- Department of Immunology, 2 Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
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14
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Cepelova M, Kruseova J, Luks A, Capek V, Cepela P, Potockova J, Kraml P. Accelerated atherosclerosis, hyperlipoproteinemia and insulin resistance in long-term survivors of Hodgkin lymphoma during childhood and adolescence. Neoplasma 2019; 66:978-987. [PMID: 31305124 DOI: 10.4149/neo_2019_190115n45] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 04/10/2019] [Indexed: 11/08/2022]
Abstract
Long-term survivors of Hodgkin lymphoma during childhood or adolescence (HL survivors) are at high risk of developing treatment-related late cardiovascular sequelae. In our study we evaluated the presence of modifiable cardiovascular risk factors (hypertension, hyperlipoproteinemia, hyperinsulinemia, obesity), endothelial and inflammatory markers (E-selectin, PAI-1, hs-CRP) and atherosclerotic changes in the common carotid arteries. Assessment was performed in 80 young adult Hodgkin lymphoma long-term survivors at more than 10 years after the potentially cardiovascular toxic anticancer treatment (median age at evaluation 34.7 years; range 24.1-40.9 years). The HL survivors were compared with 83 age- and gender-matched healthy volunteers. The HL survivors showed unfavorable lipid profiles compared to those of healthy controls: triglycerides (p=0.01), total cholesterol (p=0.0004), low density lipoprotein cholesterol (p=0.005). In HL survivors, we found a higher prevalence of hypertension (p=0.004) and insulin resistance - HOMA-IR (p=0.0002). Ultrasonographic examination of both common carotid arteries revealed a higher prevalence of atherosclerotic plaques (p=0.0009) and higher carotid intima-media thickness (p<0.0001) in HL survivors. Markers of oxidative stress (advanced oxidation protein products, oxidized low-density lipoprotein), inflammation (hs-CRP) and endothelial dysfunction (E-selectin, PAI-1) were also higher in HL survivors (p<0.0001, p=0.0002, p=0.0031, p=0.0087, p=0.004, respectively). Adult survivors of Hodgkin lymphoma during childhood and adolescence need closer follow-up with screening of metabolic syndrome components, unfavorable lifestyle factors and early management of these risk factors.
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Affiliation(s)
- M Cepelova
- Department of Pediatric Hematology and Oncology, 2nd Medical Faculty Charles University and University Hospital in Motol, Charles University, Prague, Czech Republic
| | - J Kruseova
- Department of Pediatric Hematology and Oncology, 2nd Medical Faculty Charles University and University Hospital in Motol, Charles University, Prague, Czech Republic
| | - A Luks
- Department of Pediatric Hematology and Oncology, 2nd Medical Faculty Charles University and University Hospital in Motol, Charles University, Prague, Czech Republic
| | - V Capek
- Department of Pediatric Hematology and Oncology, 2nd Medical Faculty Charles University and University Hospital in Motol, Charles University, Prague, Czech Republic
| | - P Cepela
- 2nd Internal Clinic, 3rd Medical Faculty Charles University and Kralovske Vinohrady University Hospital, Charles University, Prague, Czech Republic
| | - J Potockova
- 2nd Internal Clinic, 3rd Medical Faculty Charles University and Kralovske Vinohrady University Hospital, Charles University, Prague, Czech Republic
| | - P Kraml
- 2nd Internal Clinic, 3rd Medical Faculty Charles University and Kralovske Vinohrady University Hospital, Charles University, Prague, Czech Republic
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15
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Vetrovsky T, Cupka J, Dudek M, Kuthanova B, Vetrovska K, Capek V, Bunc V. A pedometer-based walking intervention with and without email counseling in general practice: a pilot randomized controlled trial. BMC Public Health 2018; 18:635. [PMID: 29769107 PMCID: PMC5956962 DOI: 10.1186/s12889-018-5520-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Accepted: 04/26/2018] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND General practitioners play a fundamental role in combatting the current epidemic of physical inactivity, and pedometer-based walking interventions are able to increase physical activity levels of their patients. Supplementing these interventions with email counseling driven by feedback from the pedometer has the potential to further improve their effectiveness but it has to be yet confirmed in clinical trials. Therefore, the aim of our pilot randomized controlled trial is to evaluate the feasibility and potential efficacy of future trials designed to assess the additional benefit of email counseling added to a pedometer-based intervention in a primary care setting. METHODS Physically inactive patients were opportunistically recruited from four general practices and randomized to a 12-week pedometer-based intervention with or without email counseling. To explore the feasibility of future trials, we assessed the speed and efficiency of recruitment, adherence to wearing the pedometer, and engagement with email counseling. To evaluate the potential efficacy, daily step-count was the primary outcome and blood pressure, waist and hip circumference, and body mass were the secondary outcomes. Additionally, we conducted a qualitative analysis of structured interviews with the participating general practitioners. RESULTS The opportunistic recruitment has been shown to be feasible and acceptable, but relatively slow and inefficient; moreover, general practitioners selectively recruited overweight and obese patients. Patients manifested high adherence, wearing the pedometer on 83% (± 20) of days. All patients from the counseling group actively participated in email communication and responded to 46% (± 22) of the emails they received. Both groups significantly increased their daily step-count (pedometer-plus-email, + 2119, p = 0.002; pedometer-alone, + 1336, p = 0.03), but the difference between groups was not significant (p = 0.18). When analyzing both groups combined, there was a significant decrease in body mass (- 0.68 kg, p = 0.04), waist circumference (- 1.73 cm, p = 0.03), and systolic blood pressure (- 3.48 mmHg, p = 0.045). CONCLUSIONS This study demonstrates that adding email counseling to a pedometer-based intervention in a primary care setting is feasible and might have the potential to increase the efficacy of such an intervention in increasing physical activity levels. TRIAL REGISTRATION The trial was retrospectively registered at ClinicalTrials.gov (ID: NCT03135561 , date: April 26, 2017).
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Affiliation(s)
- Tomas Vetrovsky
- Faculty of Physical Education and Sport, Charles University, Jose Martiho 31, 162 52, Prague 6, Czech Republic.
| | - Jozef Cupka
- Mediciman s.r.o, Maxovska 1019/6, 155 00, Prague 5, Czech Republic
| | - Martin Dudek
- Laureus s.r.o, Palackeho 541, 252 29, Dobrichovice, Czech Republic
| | - Blanka Kuthanova
- Praktici Praha 6, s.r.o, Vitezne namesti 817/9, 160 00, Prague 6, Czech Republic
| | | | - Vaclav Capek
- Second Faculty of Medicine, Charles University, V Uvalu 84, 150 06, Prague 5, Czech Republic
| | - Vaclav Bunc
- Faculty of Physical Education and Sport, Charles University, Jose Martiho 31, 162 52, Prague 6, Czech Republic
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Nunvar J, Capek V, Fiser K, Fila L, Drevinek P. What matters in chronic Burkholderia cenocepacia infection in cystic fibrosis: Insights from comparative genomics. PLoS Pathog 2017; 13:e1006762. [PMID: 29228063 PMCID: PMC5739508 DOI: 10.1371/journal.ppat.1006762] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Revised: 12/21/2017] [Accepted: 11/19/2017] [Indexed: 01/29/2023] Open
Abstract
Burkholderia cenocepacia causes severe pulmonary infections in cystic fibrosis (CF) patients. Since the bacterium is virtually untreatable by antibiotics, chronic infections persist for years and might develop into fatal septic pneumonia (cepacia syndrome, CS). To devise new strategies to combat chronic B. cenocepacia infections, it is essential to obtain comprehensive knowledge about their pathogenesis. We conducted a comparative genomic analysis of 32 Czech isolates of epidemic clone B. cenocepacia ST32 isolated from various stages of chronic infection in 8 CF patients. High numbers of large-scale deletions were found to occur during chronic infection, affecting preferentially genomic islands and nonessential replicons. Recombination between insertion sequences (IS) was inferred as the mechanism behind deletion formation; the most numerous IS group was specific for the ST32 clone and has undergone transposition burst since its divergence. Genes functionally related to transition metal metabolism were identified as hotspots for deletions and IS insertions. This functional category was also represented among genes where nonsynonymous point mutations and indels occurred parallelly among patients. Another category exhibiting parallel mutations was oxidative stress protection; mutations in catalase KatG resulted in impaired detoxification of hydrogen peroxide. Deep sequencing revealed substantial polymorphism in genes of both categories within the sputum B. cenocepacia ST32 populations, indicating extensive adaptive evolution. Neither oxidative stress response nor transition metal metabolism genes were previously reported to undergo parallel evolution during chronic CF infection. Mutations in katG and copper metabolism genes were overrepresented in patients where chronic infection developed into CS. Among professional phagocytes, macrophages use both hydrogen peroxide and copper for their bactericidal activity; our results thus tentatively point to macrophages as suspects in pathogenesis towards the fatal CS. The large Burkholderia cenocepacia populations which persist in cystic fibrosis lungs during many years of chronic infections have an inherent potential for adaptive evolution. The results provided by comparative genomics are key in understanding the processes involved. Mutational events which have taken place allow us to deductively reconstruct the history of chronic infection and to identify driving forces acting upon the bacteria. Beyond the conventional point mutation analysis of next generation sequencing data, we observed interesting phenomena such as large deletions and transposable element movement which represent another facet of adaptive evolution of B. cenocepacia during chronic infection. We also found, unexpectedly, that adaptive evolution in B. cenocepacia strain ST32 affects a set of genes conspicuously different from related species B. dolosa; these appear to be linked to host immune response. Our study provides clues to the complex puzzle of chronic B. cenocepacia infection establishment, persistence and outcome in cystic fibrosis.
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Affiliation(s)
- Jaroslav Nunvar
- Department of Medical Microbiology, 2nd Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | - Vaclav Capek
- Bioinformatics Centre, 2nd Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Karel Fiser
- Department of Paediatric Haematology and Oncology, 2nd Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | - Libor Fila
- Department of Pneumology, 2nd Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | - Pavel Drevinek
- Department of Medical Microbiology, 2nd Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
- * E-mail:
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Fecikova A, Cejka V, Capek V, Urgosik D, Jech R. O19 Abnormal interaction between somatosensory and the motor cortex in dystonia not responding to pallidal stimulation. Clin Neurophysiol 2017. [DOI: 10.1016/j.clinph.2017.07.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Fecikova A, Cejka V, Capek V, Ruzicka F, Bocek V, Stastna D, Stetkarova I, Urgosik D, Jech R. P065 Abnormally low intracortical inhibition in dystonia with poor response to pallidal stimulation. Clin Neurophysiol 2017. [DOI: 10.1016/j.clinph.2016.10.190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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19
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Dezortova M, Jiru F, Skoch A, Capek V, Ryznarova Z, Vik V, Hajek M. The aging effect on prostate metabolite concentrations measured by 1H MR spectroscopy. MAGMA 2016; 30:65-74. [PMID: 27522359 DOI: 10.1007/s10334-016-0584-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Revised: 07/29/2016] [Accepted: 08/02/2016] [Indexed: 12/15/2022]
Abstract
OBJECTIVE The effects of aging, magnetic field and the voxel localization on measured concentrations of citrate (Cit), creatine (Cr), cholines (Cho) and polyamines (PA) in a healthy prostate were evaluated. MATERIALS AND METHODS 36 examinations at both 1.5T and 3T imagers of 52 healthy subjects aged 19-71 years were performed with PRESS 3D-CSI sequences (TE = 120 and 145 ms). Concentrations in laboratory units and their ratios to citrate were calculated using the LCModel technique. Absolute concentrations were also obtained after the application of correction coefficients. Statistical analysis was performed using a robust linear mixed effects model. RESULTS Significant effects of aging, the magnetic field strength and the voxel position in central (CZ) or peripheral (PZ) zones on all measured metabolites were found. The concentrations (mmol/kg wet tissue) including prediction intervals in a range of 20-70 years were found: Cit: 7.9-17.2; Cho: 1.4-1.7; Cr: 2.8-2.5; PA (as spermine): 0.6-2.1 at 3T in CZ. In PZ, the concentrations were higher by about 10 % as compared to CZ. CONCLUSION Increasing citrate and spermine concentrations with age are significant and correlate well with a recently described increase of zinc in the prostate. These findings should be considered in decision-making if the values obtained from a subject are in the range of control values.
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Affiliation(s)
- Monika Dezortova
- MR-Unit, Department of Diagnostic and Interventional Medicine, Institute for Clinical and Experimental Medicine, Videnska 1958/9, 14021, Prague 4, Czech Republic.
| | - Filip Jiru
- MR-Unit, Department of Diagnostic and Interventional Medicine, Institute for Clinical and Experimental Medicine, Videnska 1958/9, 14021, Prague 4, Czech Republic
| | - Antonin Skoch
- MR-Unit, Department of Diagnostic and Interventional Medicine, Institute for Clinical and Experimental Medicine, Videnska 1958/9, 14021, Prague 4, Czech Republic
| | - Vaclav Capek
- MR-Unit, Department of Diagnostic and Interventional Medicine, Institute for Clinical and Experimental Medicine, Videnska 1958/9, 14021, Prague 4, Czech Republic
| | - Zuzana Ryznarova
- MR-Unit, Department of Diagnostic and Interventional Medicine, Institute for Clinical and Experimental Medicine, Videnska 1958/9, 14021, Prague 4, Czech Republic
| | - Viktor Vik
- Department of Urology, Thomayer Hospital, Videnska 800, 14000, Prague 4, Czech Republic
| | - Milan Hajek
- MR-Unit, Department of Diagnostic and Interventional Medicine, Institute for Clinical and Experimental Medicine, Videnska 1958/9, 14021, Prague 4, Czech Republic
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Capek V. Unified approach to the DC and AC conductivity and optical absorption of amorphous semiconductors below the fundamental edge. ACTA ACUST UNITED AC 2001. [DOI: 10.1088/0022-3719/8/4/016] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Abstract
Three patients with primary lung cancer had perirenal metastases detected with CT. In two cases a symptomatic perirenal mass was the first evidence of metastatic spread and CT-guided biopsy of the perirenal lesion confirmed the diagnosis of metastatic lung cancer. The perirenal space is an unusual but potentially significant site of metastasis from lung cancer as well as other tumors such as malignant melanoma. It is suggested that connections between perirenal and intrathoracic lymphatics are the most probable mechanism of this pattern of spread by lung cancers.
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Affiliation(s)
- A C Wilbur
- Department of Radiology, University of Illinois College of Medicine, Chicago
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Abstract
The rational treatment of thyroid diseases requires an understanding of the thyroid function and an accurate evaluation of its functional (endocrine), as well as it morphological alteration. There are several different imaging techniques which are available and are in use in the evaluation of thyroid diseases. In this article we present a protocol for the use of diagnostic imaging to evaluate a focal thyroid mass, a diffusely enlarged gland, regional, and distant metastatic disease. The current diagnostic applications of radionuclide scanning, ultrasound, computed tomography, and magnetic resonance imaging (MRI) will be discussed.
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Affiliation(s)
- M F Mafee
- Department of Radiology, University of Illinois, Chicago
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Abstract
To evaluate the usefulness of magnetic resonance (MR) imagining in the evaluation of choroidal pathologic conditions, the authors studied 15 patients with either choroidal hematoma or choroidal effusion with a 1.5-T MR imager. These two lesions were reliably distinguished from each other on the basis of MR findings. Choroidal hematomas appeared as lenticular-shaped masses in the wall of the eyeball, and signal intensity depended on the age of the hematoma. Choroidal effusions appeared as crescentic or ring-shaped areas of increased signal on both T1- and T2-weighted images in an anatomic distribution corresponding to the choroidal and suprachoroidal spaces.
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Affiliation(s)
- M F Mafee
- Department of Radiology, University of Illinois, Chicago, IL 60612
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Abstract
The human temporal bone is an extremely complex structure. Direct axial and coronal CT sections are quite satisfactory for imaging the anatomy of the temporal bone; however, many relationships of the normal and pathologic anatomic detail of the temporal bone are better seen with direct sagittal CT sections. The sagittal projection is of interest to surgeons, as it has the advantage of following the plane of surgical approach. This article describes the advantages of using direct sagittal sections for studying various diseases of the temporal bone. The CT sections were obtained with the aid of a new head holder added to our GE CT 9800 scanner. The direct sagittal projection was found to be extremely useful for evaluating diseases involving the vertical segment of the facial nerve canal, vestibular aqueduct, tegmen tympani, sigmoid sinus plate, sinodural angle, carotid canal, jugular fossa, external auditory canal, middle ear cavity, infra- and supralabyrinthine air cells, and temporomandibular joint.
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Affiliation(s)
- M F Mafee
- Department of Radiology, University of Illinois College of Medicine, Chicago 60612
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Mafee MF, Putterman A, Valvassori GE, Campos M, Capek V. Orbital space-occupying lesions: role of computed tomography and magnetic resonance imaging. An analysis of 145 cases. Radiol Clin North Am 1987; 25:529-59. [PMID: 3575688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
CT and MRI of the orbit have significantly enhanced the diagnosis of orbital lesions. Because of these techniques, disorders of the globe, structures within the bony orbit, surrounding structures of the eye, and optic pathways can now be diagnosed with much more certainty than before.
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Mafee MF, Peyman GA, Grisolano JE, Fletcher ME, Spigos DG, Wehrli FW, Rasouli F, Capek V. Malignant uveal melanoma and simulating lesions: MR imaging evaluation. Radiology 1986; 160:773-80. [PMID: 3737917 DOI: 10.1148/radiology.160.3.3737917] [Citation(s) in RCA: 81] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Twenty-one patients with intraocular disease were studied by magnetic resonance (MR) imaging and computed tomography (CT). In 13 cases, malignant uveal melanoma was considered the likely diagnosis. Both imaging methods were accurate in determining the location and size of uveal melanomas. MR imaging was superior for the assessment of possible associated retinal detachment, for assessment of vitreous change, and for differentiating uveal melanoma from choroidal hemangioma and choroidal detachment. A case of retinal gliosis could not be differentiated from uveal melanoma by either technique. Uveal melanomas appeared as hyperintense lesions on T1-weighted images and as hypointense lesions on T2-weighted images. High signal intensity of the vitreous was observed in patients with vitritis and in those who were thought to have protein leaking into the vitreous as a result of impairment of the retinal-blood barrier.
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Mafee MF, Rasouli F, Spigos DG, Valvassori GE, Friedman M, Capek V. Magnetic resonance imaging in the diagnosis of nonsquamous tumors of the head and neck. Otolaryngol Clin North Am 1986; 19:523-36. [PMID: 3748581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Nonsquamous cell tumors of the head and neck can be reliably evaluated by MRI. In certain pathologic entities, it appears that MRI can provide more information than CT scan.
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Abstract
Inflammation of the middle ear cleft is a disease of great interest from both clinical and radiologic points of view. The attic floor (tympanic diaphragm), the tympanic isthmus, and the aditus ad antrum play important roles in inflammatory processes of the middle ear cleft. The anatomy of the temporal bone at this level was examined by studying microdissections of 250 fresh temporal bones and reviewing over 1,000 high-resolution computed tomography (CT) scans of the temporal bones. The pertinent anatomy is described, and the role of the tympanic diaphragm and isthmus in determining the degree to which middle ear disease may progress is stressed. The appearances on CT scans of chronic otomastoiditis, tympanosclerosis, cholesterol granuloma, attic retraction pocket, and acquired cholesteatoma are reviewed and illustrated.
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Mafee MF, Pruzansky S, Corrales MM, Phatak MG, Valvassori GE, Dobben GD, Capek V. CT in the evaluation of the orbit and the bony interorbital distance. AJNR Am J Neuroradiol 1986; 7:265-9. [PMID: 3082161 PMCID: PMC8332686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The distance between the orbits and their individual dimensions are important in the diagnosis of craniofacial anomalies. Most observers rely on standard radiographs for measuring the bony interorbital distance. Tomography of the skull base and orbital computed tomography (CT) can also be used. This article describes the normal range of the bony interorbital distance and other useful orbital linear and angular measurements as determined from a series of CT scans of the orbits in 400 adults who had CT for other purposes. The normal interorbital distance measured at the posterior border of the frontal processes of the maxilla on nonrotated scans, in the plane of the optic nerve, ranges from 2.29 to 3.21 cm (average, 2.67 cm) in men and 2.29 to 3.20 cm (average, 2.56 cm) in women. The widest interorbital distance lies behind the posterior poles of the globes. This ranges from 3.16 to 4.10 cm (average, 3.37 cm) in men and 2.93 to 3.67 cm (average, 3.20 cm) in women.
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Abstract
Otosclerosis (otospongiosis) occurs when the hard endochondral bone of the otic capsule is replaced by spongy vascular foci of haversian bone. Using computed tomography (CT), we studied the ears of 32 selected patients with mixed or sensorineural hearing loss (one patient had normal hearing); 24 were suspected of having otosclerosis. CT proved valuable in detecting cochlear otosclerosis, foci of demineralization, and changes in bony texture and enables the easy recognition of subtle radiographic findings. Our paper also reports the CT findings of temporal bones in osteogenesis imperfecta and Paget disease.
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Mafee MF, Schild JA, Michael AS, Choi KH, Capek V. Cartilage involvement in laryngeal carcinoma: correlation of CT and pathologic macrosection studies. J Comput Assist Tomogr 1984; 8:969-73. [PMID: 6470268 DOI: 10.1097/00004728-198410000-00031] [Citation(s) in RCA: 27] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Fifteen patients with laryngeal epidermoid carcinoma underwent CT of the larynx prior to surgery. Whole mount sections of the extirpated larynx cut in the horizontal plane were compared with the corresponding level of the preoperative CT sections. This study in particular was designed to evaluate the accuracy of diagnosing cartilage involvement by CT and to correlate CT findings with histologic involvement. Our results indicate that CT correlates well with anatomic location of gross cartilage involvement by the tumor; however, small macroscopic invasion of the laryngeal cartilages may be difficult to diagnose with CT. Microscopic involvement of the cartilages cannot be diagnosed with CT. Decisions regarding conservation surgery cannot be based on CT evaluation alone.
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Mafee MF, Kumar A, Valvassori GE, Dobben GD, Potter GD, Capek V. CT in the evaluation of the vestibulocochlear nerves and their central pathways. Evaluation of neurotologic disorders. Radiol Clin North Am 1984; 22:45-66. [PMID: 6324278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
CT has evolved to become an important technique for the diagnosis of neurotologic disorders. By obtaining thin sections, the central pathway of the vestibulocochlear nerve can be rather properly evaluated with satisfactory clinical correlation when pathology exists. The validity of central vestibular and audiometric signs can be best substantiated with CT. The functional neuroanatomy of the vestibulocochlear and vestibulo-oculomotor systems is discussed. Results of the assessment of endocranial lesions involving the vestibulocochlear system are presented.
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Abstract
The ears of 47 selected patients with congenital sensorineural hearing loss were examined with complex-motion tomography. The patients were divided into 3 general categories: those with a recognized syndrome, those with sensorineural hearing loss unrelated to any known syndrome, and those with microtia. A great variety of inner ear anomalies was detected, but rarely were these characteristic of a particular clinical entity. The most common finding was the Mondini malformation or one of its variants. Isolated dysplasia of the internal auditory canal or the vestibular aqueduct may be responsible for sensorineural hearing loss in some patients. Patients with microtia may also have severe inner ear abnormalities despite the fact that the outer and inner ears develop embryologically from completely separate systems.
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36
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Mantravadi RV, Spigos DG, Karesh SM, Pavel DG, Grady EG, Capek V. Work in progress: intra-arterial P-32 chromic phosphate for prevention of postoperative liver metastases in high-risk colorectal cancer patients. Radiology 1983; 148:555-9. [PMID: 6867356 DOI: 10.1148/radiology.148.2.6867356] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Eight patients with locally extensive colorectal cancer were treated with colloidal P-32 chromic phosphate via the superior mesenteric artery following resection to prevent development of liver metastases. Less than 2% of the injected dose was found in the right atrial blood following the first pass through the liver and less than 1% in the urine. Therapy was tolerated well by all patients, with no acute complications. Long-term follow-up is needed to determine the effect of P-32 on the liver and the frequency of hepatic metastases.
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37
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Mafee MF, Schild JA, Valvassori GE, Capek V. Computed tomography of the larynx: correlation with anatomic and pathologic studies in cases of laryngeal carcinoma. Radiology 1983; 147:123-8. [PMID: 6828716 DOI: 10.1148/radiology.147.1.6828716] [Citation(s) in RCA: 45] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Seven patients with known carcinoma of the larynx underwent computed tomography (CT) of the larynx prior to surgery. Whole-mount sections of the extirpated larynx cut in the horizontal plane were compared with the corresponding level of the preoperative CT sections to demonstrate the validity of CT scanning in the evaluation of tumors of the larynx. The results indicate that CT scanning accurately demonstrates the anatomic location and gross size of laryngeal tumor, although early invasion of the laryngeal cartilages may be difficult to diagnose with CT. It is concluded that preoperative CT scanning of the larynx is the radiologic procedure of choice for evaluating carcinoma of the larynx.
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38
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Tan WS, Spigos DG, Khine N, Capek V. Computed air myelography of the lumbosacral spine. AJNR Am J Neuroradiol 1983; 4:609-10. [PMID: 6410811 PMCID: PMC8334993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Plain computed tomography (CT) of the lumbosacral spine may be a reliable method for diagnosing herniated disk when abundant epidural fat is present. When epidural fat is not sufficient, CT after the administration of nonionic contrast medium (170 mg I/ml) and/or regular metrizamide myelography have been used. Ten patients were studied by CT enhanced with air injected as a negative contrast agent. The findings were correlated with plain and contrast-enhanced (metrizamide) CT as well as conventional myelography. The technique is described and advantages and disadvantages of the method are discussed. Air-contrast CT is useful in the evaluation of herniated disk in cases with equivocal findings on plain CT and in patients with a history of allergic reaction to iodinated contrast media.
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Mafee MF, Goldberg MF, Valvassori GE, Capek V. Computed tomography in the evaluation of patients with persistent hyperplastic primary vitreous (PHPV). Radiology 1982; 145:713-7. [PMID: 7146401 DOI: 10.1148/radiology.145.3.7146401] [Citation(s) in RCA: 45] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
The computed tomographic (CT) findings in 5 patients with proven persistent hyperplastic primary vitreous (PHPV) are described. PHPV arises when the embryonic hyaloid vascular system fails to regress normally. Clinically, this condition usually manifests as unilateral or bilateral leukokoria and is one of the more important and frequent conditions mimicking retinoblastoma. The spectrum of CT findings include: (a) soft-tissue replacement (infiltration) of the vitreous body; (b) retrolental soft tissue along the Cloquet canal; (c) absence of abnormal calcification within the orbit; (d) microphthalmus; (e) retrohyaloid layered blood; and (f) hypervascularity of the vitreous humor.
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Nabawi P, Mafee M, Phillips J, Capek V. The success rate of metrizamide CT cisternography in the evaluation of cerebrospinal fluid (CSF) rhinorrhea. Comput Radiol 1982; 6:343-54. [PMID: 7166032 DOI: 10.1016/0730-4862(82)90005-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Lalyre Y, Wilson DE, Kidao J, Hall CH, Capek V. Comparison of intravenous and intramuscular sincalide (C-terminal octapeptide of cholecystokinin) on gallbladder contraction in man. Dig Dis Sci 1981; 26:214-7. [PMID: 6263565 DOI: 10.1007/bf01391632] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
The effects of intramuscular and intravenous sincalide on gallbladder contraction and visualization of the bile ducts were compared in a group of 37 subjects referred for oral cholecystography. The maximum reduction in gallbladder size observed after sincalide 400 ng/kg intramuscular, 54.7 +/- 7.2% (mean +/- SEM), occurred 25 min after injection and was significantly greater than that observed after sincalide 20 ng/kg intravenous, 26.5 +/- 8.2%. Maximum reduction after sincalide 100 ng/kg intramuscular was 47.3 +/- 8.2%. The common bile duct was visualized in 60 and 45% of subjects after intramuscular and intravenous sincalide, respectively. The use of intramuscular sincalide 400 ng/kg intramuscular is an effective and convenient adjunct to oral cholecystography when significant gallbladder contraction and visualization of the common bile duct is desired.
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Abstract
A series of in vitro and animal experiments were performed to determine ultrasonic features of blood during stasis and coagulation. Liquid whole blood became echogenic within a few seconds to 3 minutes following the onset of stasis. This occurred in citrated human blood allowed to stand and in occluded segments of vena cava and aorta of dogs. Mechanical agitation of the blood in stasis caused a disappearance of echoes. This echogenicity occurred with gray-scale and real-time ultrasonography using 7.5-mHz transducers, but was not observed with 3.5-mHz transducer used in real-time scanning. Whole blood clot was echogenic both with 7.5- and 3.5-mHz scanning. Fibrin clot was sonolucent. Echogenicity with stasis did not occur with plasma, serum, or packed erythrocytes. The development of echogenicity required the presence of fibrinogen or its products plus erythrocytes. The echogenicity of blood during stasis detectable by high-frequency ultrasonography probably was related to physical layering of blood products. The disappearance of reflective echoes following agitation suggested that the layering could be readily disrupted.
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Abstract
High resolution real-time B-mode ultrasound scanning using a sterile 7.5 MHz transducer was performed during operations on the biliary tract. Ultrasound is useful for locating the common bile duct in the presence of acute inflammation and other abnormal anatomy, detecting small calculi in the gallbladder with a thickened wall, measuring the caliber of the common bile duct, and identifying calculi in the common bile duct. Intraoperative ultrasonography can permit earlier and more precise appraisal of operative findings and, thereby, decrease operative time.
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46
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Abstract
Transcatheter embolization of the spleen has been associated with serious complications, such as splenic abscess, rupture of the spleen, pneumonia, and septicemia. These complications, with their grave consequences, have prevented the use of this procedure as an alternative to operative splenectomy in selected cases. A detailed description of our method, which consists of partial splenic embolization, antibiotic prophylaxis, adequate pain control, and careful pre- and postembolization, is reported. Thirteen patients with hypersplenism were successfully treated with transcatheter partial embolization of their spleen.
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Abstract
Urine extravasation in the early postoperative period after renal transplantation is a serious complication requiring expedient surgical intervention. Whereas clinical and laboratory findings are inconclusive, radiologic diagnostic studies have definite value. Routine ultrasound and radioisotope studies were performed on 111 renal transplant patients. In the eight who developed urine extravasation, ultrasound and/or radioisotope studies identified the extravasation in seven cases. Four of the eight were studied by intravenous pyelography and another two were studied by cystography. All results were positive. We recommend use of radioisotope and ultrasound studies for routine postoperative screening with invasive techniques reserved for inconclusive cases.
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48
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Abstract
The transplanted kidney is an ideal organ for study by ultrasonic methods because it is located superficially in the iliac fossa and it is free of superimposed echoes from the intestines. Therefore, it is possible to localize the transplant accurately, measure the distance from the skin to the surface of the kidney and determine with precision the angle of the intended pathway of the needle.
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Abstract
Skin necrosis is an unusual complication following venography of the legs. The authors have found only four cases in the English literature. Two cases of skin necrosis following extravasation of contrast medium are reported. Their pathogenesis, clinical course, and treatment are discussed along with methods of prevention.
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50
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Thoen CO, Beluhan FZ, Himes EM, Capek V, Bennett T. Mycobacterium bovis infection in baboons (Papio papio). Arch Pathol Lab Med 1977; 101:291-3. [PMID: 324436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Two tuberculin-positive baboons in a primate colony were found to have grossly visible tuberculous lesions in the liver, spleen, lung, and mediastinal lymph nodes on necropsy. Results of histopathologic examination of the tissues showed granulomas with Langhans giant cells. An acid-fast organism was isolated from tissues of each baboon; the isolates were identified as Mycobacterium bovis by being negative for niacin production and nitrate reduction and by their susceptibility to thiophen-2-carbosylic acid hydrazide and to 5% glycerol.
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