BACKGROUND Whole-body magnetic resonance imaging(wbMRI)allows general assessment of systemic cancers including lymphomas without radiation burden.AIM To evaluate the diagnostic performance of wbMRI in the staging of d...BACKGROUND Whole-body magnetic resonance imaging(wbMRI)allows general assessment of systemic cancers including lymphomas without radiation burden.AIM To evaluate the diagnostic performance of wbMRI in the staging of diffuse large B-cell lymphoma(DLBCL),determine the value of individual MRI sequences,and assess patients’concerns with wbMRI.METHODS In this single-center prospective study,adult patients newly diagnosed with systemic DLBCL underwent wbMRI on a 3T scanner[diffusion weighted images with background suppression(DWIBS),T2,short tau inversion recovery(STIR),contrast-enhanced T1]and fluorodeoxyglucose(18F-FDG)positron emission tomo-graphy/computed tomography(PET/CT)(reference standard).The involvement of 12 nodal regions and extranodal sites was evaluated on wbMRI and PET/CT.The utility of wbMRI sequences was rated on a five-point scale(0=not useful,4=very useful).Patients received a questionnaire regarding wbMRI.RESULTS Of 60 eligible patients,14(23%)were enrolled and completed the study.The sensitivity of wbMRI in the nodal involvement(182 nodal sites)was 0.84,with 0.99 specificity,positive predictive value of 0.96,negative predictive value of 0.97,and 0.97 accuracy.PET/CT and wbMRI were concordant both in extranodal involvement(13 instances)and staging(κ=1.0).The mean scores of the utility of MRI sequences were 3.71±0.73 for DWIBS,2.64±0.84 for T1,2.14±0.77 for STIR,and 1.29±0.73 for T2(P<0.0001).Patients were mostly concerned about the enclosed environment and duration of the MRI examination(27%of patients).CONCLUSION The wbMRI exhibited excellent sensitivity and specificity in staging DLBCL.DWIBS and contrast-enhanced T1 were rated as the most useful sequences.Patients were less willing to undergo wbMRI as a second examination parallel to PET/CT,especially owing to the long duration and the enclosed environment.展开更多
Magnesium is an excellent material in terms of biocompatibility and its corrosion products can serve as an active source for new bone formation.However,localized corrosion and H_(2)generation limit the potential of Mg...Magnesium is an excellent material in terms of biocompatibility and its corrosion products can serve as an active source for new bone formation.However,localized corrosion and H_(2)generation limit the potential of Mg-based implants.Utilizing low-alloyed Mg-Zn wires can strongly reduce problems with large H_(2)bubbles and improve the mechanical properties considerably while maintaining excellent long-term biocompatibility.Acidic pickling and a polymer coating can be effectively used to lower the rate of in vivo degradation.In this work,microstructural,mechanical,and in vitro characterization of 250μm and 300μm extruded wires made from ultra-pure Mg,commercially pure Mg,Mg-0.15Zn,Mg-0.4Zn and Mg-1Zn was performed.Additionally,Mg-0.4Zn wires together with a variant coated with a copolymer of L-lactide andε-caprolactone were tested in vivo on artificially damaged Wistar rat femurs.Based on the observed Mg-induced osteogenesis,polymer-coated Mg wires with a small addition of Zn are a perspective material for bone-support applications,such as cerclage and fixation wires.展开更多
We are entering an exciting epoch in livestock biotechnology during which the fundamental approaches(such as transgenesis, spermatozoa cryopreservation and artificial insemination) will be enhanced based on the modern...We are entering an exciting epoch in livestock biotechnology during which the fundamental approaches(such as transgenesis, spermatozoa cryopreservation and artificial insemination) will be enhanced based on the modern understanding of the biology of spermatogonial stem cells(SSCs) combined with the outstanding recent advances in genomic editing technologies and in vitro cell culture systems. The general aim of this review is to outline comprehensively the promising applications of SSC manipulation that could in the nearest future find practical application in livestock breeding. Here, we will focus on 1) the basics of mammalian SSC biology;2) the approaches for SSC isolation and purification;3) the available in vitro systems for the stable expansion of isolated SSCs;4) a discussion of how the manipulation of SSCs can accelerate livestock transgenesis;5) a thorough overview of the techniques of SSC transplantation in livestock species(including the preparation of recipients for SSC transplantation,the ultrasonographic-guided SSC transplantation technique in large farm animals, and the perspectives to improve further the SSC transplantation efficiency), and finally, 6) why SSC transplantation is valuable to extend the techniques of spermatozoa cryopreservation and/or artificial insemination. For situations where no reliable data have yet been obtained for a particular livestock species, we will rely on the data obtained from studies conducted in rodents because the knowledge gained from rodent research is translatable to livestock species to a great extent. On the other hand, we will draw special attention to situations where such translation is not possible.展开更多
AIM:To study possible decrease in prevalence of Helicobacter pylori(H.pylori) infection in the Czech Republic within a 10-year period.METHODS:A total of 22 centres entered the study.The catchment areas of these centre...AIM:To study possible decrease in prevalence of Helicobacter pylori(H.pylori) infection in the Czech Republic within a 10-year period.METHODS:A total of 22 centres entered the study.The catchment areas of these centres covered cities and towns with more than 20 000 inhabitants,smaller towns(≤ 20 000 inhabitants) with surrounding villages and rural areas,and were spread over the whole country,corresponding well to the geographical distribution of the Czech population.A total of 1 837 subjects(aged 5-98 years) took part in the study,randomly selected out of 38 147 people from the general population.H.pylori infection was investigated by means of a 13 C-urea breath test.Breath samples in duplicates were analysed using isotope ratio mass spectrometry.The cut-off point was 3.5.Social and demographic characteristics were based on data from self-completed questionnaires.RESULTS:The overall prevalence of H.pylori infection was 23.5%(430/1826),and 4.8%(20/420) in children aged 15 or less.There was no statistically significant difference in prevalence between males(24.3%;208/857) and females(22.9%,222/969,P = 0.494).H.pylori infection was strongly associated with higher age,among subjects aged 55+ years,prevalence of H.pylori infection was 39.8%(252/633,P < 0.001).The highest prevalence of H.pylori infection was found among persons aged 55-64 years(43.9%,97/221) and 75+ years(37.9%,58/153).Among study subjects aged 15+ years,prevalence of H.pylori infection was significantly increased in those with lowest education(odds risk 3.19,95% CI 1.87-5.47).Compared to never married(14.1%),the prevalence of H.pylori infection was statistically significantly higher among married(35.4%,246/694,P < 0.001),divorced(36.8%,49/133,P < 0.001) and widowed study subjects(40.2%,45/112,P < 0.001),both in minimally and fully adjusted analysis.There was no significant difference in the prevalence of H.pylori infection between married and widowed subjects(35.4%,246/694 vs 40.2%,45/112,P = 0.389).There was little variation in smoking prevalence across categories of smoking and there was no evidence of an increased risk ofH.pylori infection among current or past smokers in our data(odds risk 1.04 with 95% CI 0.78-1.40 for current smokers;odds ratio 0.83 with 95% CI 0.60-1.16 for former smokers).The current prevalence of H.pylori in 2011 was significantly lower compared to the prevalence reported from identical geographical areas in 2001(23.5%vs 41.7%,P < 0.001).CONCLUSION:The overall prevalence of H.pylori infection in the general population has fallen substantially in the Czech Republic over the past 10 years.展开更多
Crohn’s disease affects more than 500000 individuals in the United States, and about 25% of cases are diagnosed during the pediatric period. Imaging of the bowel has undergone dramatic changes in the past ...Crohn’s disease affects more than 500000 individuals in the United States, and about 25% of cases are diagnosed during the pediatric period. Imaging of the bowel has undergone dramatic changes in the past two decades. The endoscopy with biopsy is generally considered the diagnostic reference standard, this combination can evaluates only the mucosa, not inflammation or fibrosis in the mucosa. Actually, the only modalities that can visualize submucosal tissues throughout the small bowel are the computed tomography (CT) enterography (CTE) with the magnetic resonance enterography (MRE). CT generally is highly utilized, but there is growing concern over ionizing radiation and cancer risk; it is a very important aspect to keep in consideration in pediatric patients. In contrast to CTE, MRE does not subject patients to ionizing radiation and can be used to detect detailed morphologic information and functional data of bowel disease, to monitor the effects of medical therapy more accurately, to detect residual active disease even in patients showing apparent clinical resolution and to guide treatment more accurately.展开更多
Global food security is a major development challenge dictated by state stability, resilience to geopolitical and economic shocks and is linked to health security. Fragile and failed nation-states are at risk of extre...Global food security is a major development challenge dictated by state stability, resilience to geopolitical and economic shocks and is linked to health security. Fragile and failed nation-states are at risk of extreme poverty and lead to war and conflict. Fragile states experience, corrupt financial regimes and are influenced by skewed global market systems and reduced equitable market access that decrease food and health security. This qualitative review describes the critical cross sections of food security, the influence of global market systems and state stability and institutions that form the nexus of global health security. We outline how the manipulation of free market systems and decreased state capacity not only decrease food and health security but also contribute to state fragility and failure. Improved public health policy mechanisms, decreased dependence on foreign financial structures and extractive mechanisms are crucial to improving food and health security at present, and to further increase state stability in the future.展开更多
Individuals with unipolar depressive disorder(UDD)are having an increased risk of death and development of dementia in later life.It is widely expected that in a near future UDD would be the leading cause of death;the...Individuals with unipolar depressive disorder(UDD)are having an increased risk of death and development of dementia in later life.It is widely expected that in a near future UDD would be the leading cause of death;therefore,a primary inexpensive prevention of UDD will be of a great importance to the society.Several studies provide evidences supporting the positive effect of Mediterranean diet on a reduced risk for development of depression.展开更多
Patients presenting to emergency and urgent care centers with calf pain after long and short-haul flights are a common presentation throughout Europe. Patients fitting an epidemiological risk profile for cholelithiasi...Patients presenting to emergency and urgent care centers with calf pain after long and short-haul flights are a common presentation throughout Europe. Patients fitting an epidemiological risk profile for cholelithiasis and presenting with right upper quadrant abdominal pain can also be a common presentation fitting of a specific patient profile. However, pulmonary hypertension can present in a nuanced and possible missed chronic and acute presentation. The patient case we present profiles a mildly obese 54-year-old Caucasian woman and recent holiday maker with unilateral calf pain and shortness of breath after traveling on a long-haul flight with tertiary symptoms of indigestion and epigastric discomfort indicative of gastroenteritis. This case highlights the required diligence for emergency physicians to maintain a high index of suspicion and broad differential diagnosis in the undifferentiated patient with seemingly common or classic presentations. We find that a serendipitous definitive diagnosis is made by following a systematic and organized approach.展开更多
This patient case report describes a 40-year-old African woman presenting with a classic acute presentation of carbon monoxide poisoning from an unlikely source responding to conventional treatment. This case highligh...This patient case report describes a 40-year-old African woman presenting with a classic acute presentation of carbon monoxide poisoning from an unlikely source responding to conventional treatment. This case highlights the classic presenting features of carbon monoxide poisoning and the requirement to maintain a high index of suspicion and immediate use of rapid empirical treatment in the undifferentiated patient, sometimes before diagnostics and definitive diagnosis can be determined. The definitive diagnosis and cause of poisoning are also discussed to educate the emergency physician to new and foreign cultural habits and encourage best medical practices within multicultural societies.展开更多
Src regulates cell adhesion, invasiveness, motility and growth in cancer cells. In melanoma, accumulating data show that Src inhibition can be effective and may enhance the effects of other agents. Increased Src expre...Src regulates cell adhesion, invasiveness, motility and growth in cancer cells. In melanoma, accumulating data show that Src inhibition can be effective and may enhance the effects of other agents. Increased Src expression and activity thus has recently become a target for drug therapy. Several melanoma cell lines were exposed to inhibitors of Src activity despite their broad specificity. To examine the particular activity of Src in human melanoma cells, we used SU6656, the selective inhibitor of Src family protein kinases. The activity of Src and cell proliferation were suppressed in HBL human cells, wild type melanoma cells and in SK-MEL-5 human melanoma cells harboring mutant BRAF V600E, upon their treatment with SU6656. The suppression of Src kinase activity had not inhibitory effects on Akt/PKB activity in SK-MEL-5 cells, which we have previously found in HBL cells. This may indicate that changes of Src involvement in the control of Akt/PKB activity and its downstream signaling could be induced by BRAF V600E mutation in SK-MEL-5 cells.展开更多
AIM: To investigate the feasibility of separation and cultivation of circulating tumor cells (CTCs) in pancreatic cancer (PaC) using a filtration device.
To evaluate vital signs and body indices in Helicobacter pylori (H. pylori) positive and negative persons. A total of 22 centres entered the study. They were spread over the whole country, corresponding well to the ge...To evaluate vital signs and body indices in Helicobacter pylori (H. pylori) positive and negative persons. A total of 22 centres entered the study. They were spread over the whole country, corresponding well to the geographical distribution of the Czech population. A total of 1818 subjects (aged 5-98 years) took part in the study, randomly selected out of 38147 subjects. H. pylori infection was investigated by means of a 13C-urea breath test. Data on height, weight, systolic and diastolic blood pressure and heart rate were collected at the clinics of general practitioners. The overall prevalence of H. pylori infection was 30.4% (402/1321) in adults (≥ 18 year-old) and 5.2% (26/497) in children and adolescents (≤ 17 year-old). Once adjusted for age and gender, only a difference in body mass index remained statistically significant with H. pylori positive adults showing an increase of 0.6 kg/m<sup>2</sup> in body mass index. Once adjusted for age and gender, we found a difference in height between H. pylori positive and H. pylori negative children and adolescents. On further adjustment for place of residence, this difference became statistically significant, with H. pylori positive children and adolescents being on average 3.5 cm shorter. H. pylori positive adults were significantly older compared to H. pylori negative subjects. Once adjusted for age and gender, H. pylori infection had no impact on body weight, body mass index and vital signs either in adults or children and adolescents. Chronic H. pylori infection appeared to be associated with short stature in children. H. pylori infection did not influence blood pressure, body weight and body mass index either in adults or children and adolescents.展开更多
Distribution and activity of mitochondda are key factors in neuronal development, synaptic plasticity and axogenesis. The majority of energy sources, necessary for cellular functions, originate from oxidative phosphor...Distribution and activity of mitochondda are key factors in neuronal development, synaptic plasticity and axogenesis. The majority of energy sources, necessary for cellular functions, originate from oxidative phosphorylation located in the inner mitochondrial membrane. The adenosine-5＇- triphosphate production is regulated by many control mechanism-firstly by oxygen, substrate level, adenosine-5＇-diphosphate level, mitochondrial membrane potential, and rate of coupling and proton leak. Recently, these mechanisms have been implemented by ＂second control mechanisms,＂ such as reversible phosphorylation of the tricarboxylic acid cycle enzymes and electron transport chain complexes, aUosteric inhibition of cytochrome c oxidase, thyroid hormones, effects of fatty acids and uncoupling proteins. Impaired function of mitochondria is implicated in many diseases ranging from mitochondrial myopathies to bipolar disorder and schizophrenia. Mitochondrial dysfunctions are usually related to the ability of mitochondria to generate adenosine-5＇-triphosphate in response to energy demands. Large amounts of reactive oxygen species are released by defective mitochondria similarly, decline of antioxidative enzyme activities （e.g. in the elderly） enhances reactive oxygen species production. We reviewed data concerning neuroplasticity, physiology, and control of mitochondrial oxidative phosphorylation and reactive oxygen species production.展开更多
Hyperbilirubinemia has been presumed to prevent the process of atherogenesis and cancerogenesis mainly by decreasing oxidative stress.Dubin-Johnson syndrome is a rare,autosomal recessive,inherited disorder characteriz...Hyperbilirubinemia has been presumed to prevent the process of atherogenesis and cancerogenesis mainly by decreasing oxidative stress.Dubin-Johnson syndrome is a rare,autosomal recessive,inherited disorder characterized by biphasic,predominantly conjugatedhyperbilirubinemia with no progression to end-stage liver disease.The molecular basis in Dubin-Johnson syndrome is absence or deficiency of human canalicular multispecific organic anion transporter MRP2/cMOAT caused by homozygous or compound heterozygous mutation(s) in ABCC2 located on chromosome 10q24.Clinical onset of the syndrome is most often seen in the late teens or early adulthood.In this report,we describe a case of previously unrecognized Dubin-Johnson syndrome caused by two novel pathogenic mutations (c.2360_2366delCCCTGTC and c.3258+1G>A),coinciding with cholestatic liver disease in an 82-year-old male patient.The patient,suffering from advanced atherosclerosis with serious involvement of coronary arteries,developed colorectal cancer with nodal metastases.The subsequent findings do not support the protective role of Dubin-Johnson type hyperbilirubinemia.展开更多
Despite advanced therapies,the mortality of patients with myocardial infarction(MI)complicated by cardiogenic shock(CS)remains around 50%.Mechanical complications of MI are rare nowadays but associated with high morta...Despite advanced therapies,the mortality of patients with myocardial infarction(MI)complicated by cardiogenic shock(CS)remains around 50%.Mechanical complications of MI are rare nowadays but associated with high mortality in patients who present with CS.Different treatment strategies and mechanical circulatory support(MCS)devices have been increasingly used to improve the grim prognosis of refractory CS.This article discusses current evidence regarding the use of MCS in MI complicated by CS,ventricular septal rupture,free wall rupture and acute mitral regurgitation.Device selection should be tailored according to the cause and severity of CS.Early MCS initiation and multidisciplinary team cooperation is mandatory for good results.MCS associated bleeding remains a major complication and an obstacle to better outcomes.Ongoing prospective randomized trials will improve current knowledge regarding MCS indications,timing,and patient selection in the coming years.展开更多
Schizophrenia is a severe psychiatric disorder characterized by emotional,behavioral and cognitive disturbances, and the treatment of schizophrenia is oftencomplicated by noncompliance and pharmacoresistance. The sear...Schizophrenia is a severe psychiatric disorder characterized by emotional,behavioral and cognitive disturbances, and the treatment of schizophrenia is oftencomplicated by noncompliance and pharmacoresistance. The search for thepathophysiological mechanisms underlying schizophrenia has resulted in theproposal of several hypotheses to explain the impacts of environmental, genetic,neurodevelopmental, immune and inflammatory factors on disease onset andprogression. This review discusses the newest insights into the pathophysiologyof and risk factors for schizophrenia and notes novel approaches in antipsychotictreatment and potential diagnostic and theranostic biomarkers. The currenthypotheses focusing on neuromediators (dopamine, glutamate, and serotonin),neuroinflammation, the cannabinoid hypothesis, the gut-brain axis model, andoxidative stress are summarized. Key genetic features, including small nucleotidepolymorphisms, copy number variations, microdeletions, mutations andepigenetic changes, are highlighted. Current pharmacotherapy of schizophreniarelies mostly on dopaminergic and serotonergic antagonists/partial agonists, butnew findings in the pathophysiology of schizophrenia have allowed theexpansion of novel approaches in pharmacotherapy and the establishment ofmore reliable biomarkers. Substances with promising results in preclinical andclinical studies include lumateperone, pimavanserin, xanomeline, roluperidone,agonists of trace amine-associated receptor 1, inhibitors of glycine transporters,AMPA allosteric modulators, mGLUR2-3 agonists, D-amino acid oxidase inhibitorsand cannabidiol. The use of anti-inflammatory agents as an add-on therapy ismentioned.展开更多
BACKGROUND Acute appendicitis in a solid organ transplant recipient is a rare occurrence, and experience remains limited. Appendicitis in uterine transplant recipients has never been reported. Immunocompromised patien...BACKGROUND Acute appendicitis in a solid organ transplant recipient is a rare occurrence, and experience remains limited. Appendicitis in uterine transplant recipients has never been reported. Immunocompromised patients with acute abdomen often present late and with attenuated symptoms. The differential diagnosis in a transplanted patient is broad and challenging due to possible existing complications associated with the graft, effects of immunosuppression, and altered anatomical relations.CASE SUMMARY A 26-year-old woman suffering from absolute uterine factor infertility received a uterus transplant. In the post-transplant period, she suffered from leukopenia and recurrent acute cellular rejection. Her compliance was suboptimal. She travelled to an exotic destination despite the physician's recommendation not to do so. Following her vacation, she presented with abdominal discomfort, nausea and diarrhoea. There was no sign of acute abdomen;the abdominal ultrasound was negative on day 0. Clostridium difficile colitis was verified and treated with perorally administered vancomycin. On day 4, the discomfort changed to pain;the ultrasound scan revealed a finding suggestive of appendicitis. Surgical exploration revealed perforated appendicitis, and appendectomy was performed.From a surgical point of view, the patient's follow-up was uneventful. The patient underwent a successful embryo transfer 6 months after the appendectomy. The patient gave birth to a healthy boy at the 35 th week of gestation.CONCLUSION A high index of suspicion of an atypical course and symptomatology of acute abdomen should be maintained in immunosuppressed patients.展开更多
A retrospective,multicenter study of 180 children with cytochrome c oxidase (COX) deficiency analyzed the clinical features,prognosis,and molecular bases of the COX deficiency. Clinical symptoms including failure to t...A retrospective,multicenter study of 180 children with cytochrome c oxidase (COX) deficiency analyzed the clinical features,prognosis,and molecular bases of the COX deficiency. Clinical symptoms including failure to thrive,encephalopathy,hypotony,Leigh syndrome,cardiac involvement,and hepatopathy appeared in most patients early after birth or in early childhood. Two thirds of all children died. Biochemical examination revealed an isolated COX deficiency in 101 children and COX deficiency combined with disturbances of other respiratory chain complexes in 79 children. Blood and cerebrospinal fluid lactate increased in 85%and 81%of examined cases,respectively. Pathogenic mutations in mitochondrial or nuclear DNA were established in 75 patients. Mutations in surfeit locus protein 1 gene (SURF1) were found in 47 children with Leigh syndrome; 2bp deletion 845-846 delCT was found in 89%of independent alleles. Mutations in a mitochondrial copper-binding protein (SCO2) gene were found in nine children with encephalomyopathy and/or cardiomyopathy; all of them were homozygotes or heterozygotes for 1541G>A mutation. Different mitochondrial DNA (mtDNA) deletion or depletion were found in nine children,mtDNA mutation 3243A>G in six,mtDNA mutation 8363G>A in two children with Leigh syndrome and mtDNA mutations 8344A>G,and 9205-9206delTA in one child each. COX deficiency represents a heterogeneous group of diseases with unfavorable prognosis. Marked prevalence of two nuclear DNA mutations (845-846 delCT in the SURF1 gene and 1541G>A in the SCO2 gene) associated with COX deficiency in a Slavonic population suggests the existence of regional differences in the genetic basis of COX deficiency.展开更多
AIM:To investigate the contribution of ABCB4 mutations to pediatric idiopathic gallstone disease and the potential of hormonal contraceptives to prompt clinical manifestations of multidrug resistance protein 3 deficie...AIM:To investigate the contribution of ABCB4 mutations to pediatric idiopathic gallstone disease and the potential of hormonal contraceptives to prompt clinical manifestations of multidrug resistance protein 3 deficiency.METHODS:Mutational analysis of ABCB4,screening for copy number variations by multiplex ligation-dependent probe amplification,genotyping for low expression allele c.1331T>C of ABCB11 and genotyping for variation c.55G>C in ABCG8 previously associated with cholesterol gallstones in adults was performed in 35 pediatric subjects with idiopathic gallstones who fulfilled the clinical criteria for low phospholipid-associated cholelithiasis syndrome(LPAC,OMIM#600803)and in 5young females with suspected LPAC and their families(5 probands,15 additional family members).The probands came to medical attention for contraceptiveassociated intrahepatic cholestasis.RESULTS:A possibly pathogenic variant of ABCB4was found only in one of the 35 pediatric subjects with idiopathic cholesterol gallstones whereas 15 members of the studied 5 LPAC kindreds were confirmed and another one was highly suspected to carry predictably pathogenic mutations in ABCB4.Among these 16,however,none developed gallstones in childhood.In 5index patients,all young females carrying at least one pathogenic mutation in one allele of ABCB4,manifestation of LPAC as intrahepatic cholestasis with elevated serum activity of gamma-glutamyltransferase was induced by hormonal contraceptives.Variants ABCB11c.1331T>C and ABCG8 c.55G>C were not significantly overrepresented in the 35 examined patients with suspect LPAC.CONCLUSION:Clinical criteria for LPAC syndrome caused by mutations in ABCB4 cannot be applied topediatric patients with idiopathic gallstones.Sexual immaturity even prevents manifestation of LPAC.展开更多
When evaluating environmental risk and its perception, psychosocial and psychosomatic factors may be of fundamental importance for public health programming and the promotion of quality of life. This is the case in pa...When evaluating environmental risk and its perception, psychosocial and psychosomatic factors may be of fundamental importance for public health programming and the promotion of quality of life. This is the case in particular where knowledge of the true health consequences of environmental exposure to given risk factors are incomplete or its action is within the range of values where we do not anticipate the measurable biological effect. This applies not only in the case of the indoor environment related complaints but also to that of non-ionizing electromagnetic radiation and electroionic microclimate, among many others. A serious consequence found in the syndrome of mass hysteria is the fact that due to differently motivated information and disinformation, part of the population can suffer from psychosomatic symptoms and deterioration quality of life for those affected.展开更多
基金Supported by the Czech Ministry of Health,General University Hospital in Prague,No.VFN00064165。
文摘BACKGROUND Whole-body magnetic resonance imaging(wbMRI)allows general assessment of systemic cancers including lymphomas without radiation burden.AIM To evaluate the diagnostic performance of wbMRI in the staging of diffuse large B-cell lymphoma(DLBCL),determine the value of individual MRI sequences,and assess patients’concerns with wbMRI.METHODS In this single-center prospective study,adult patients newly diagnosed with systemic DLBCL underwent wbMRI on a 3T scanner[diffusion weighted images with background suppression(DWIBS),T2,short tau inversion recovery(STIR),contrast-enhanced T1]and fluorodeoxyglucose(18F-FDG)positron emission tomo-graphy/computed tomography(PET/CT)(reference standard).The involvement of 12 nodal regions and extranodal sites was evaluated on wbMRI and PET/CT.The utility of wbMRI sequences was rated on a five-point scale(0=not useful,4=very useful).Patients received a questionnaire regarding wbMRI.RESULTS Of 60 eligible patients,14(23%)were enrolled and completed the study.The sensitivity of wbMRI in the nodal involvement(182 nodal sites)was 0.84,with 0.99 specificity,positive predictive value of 0.96,negative predictive value of 0.97,and 0.97 accuracy.PET/CT and wbMRI were concordant both in extranodal involvement(13 instances)and staging(κ=1.0).The mean scores of the utility of MRI sequences were 3.71±0.73 for DWIBS,2.64±0.84 for T1,2.14±0.77 for STIR,and 1.29±0.73 for T2(P<0.0001).Patients were mostly concerned about the enclosed environment and duration of the MRI examination(27%of patients).CONCLUSION The wbMRI exhibited excellent sensitivity and specificity in staging DLBCL.DWIBS and contrast-enhanced T1 were rated as the most useful sequences.Patients were less willing to undergo wbMRI as a second examination parallel to PET/CT,especially owing to the long duration and the enclosed environment.
基金the project Ferr Mion of the Ministry of Education,Youth and Sports,Czech Republic,co-funded by the European Union(CZ.02.01.01/00/22_008/0004591)the support of The Charles University Grant Agency in the frame of the project No.121724 and the project Cooperatio No.207030 Dental Medicine/LF1 of the Charles University+4 种基金financial support from the Ministry of Education,Youth and Sport of the Czech Republic under the grant No.RVO 14000supported by the Ministry of Health of the Czech Republic-RVO project VFN64165the support of the project GAMA 2 of the Technology Agency of the Czech Republic No.TP01010055the project of the Czech Academy of Sciences,Czech Republic(Praemium Academiae grant No.AP2202)the support of the Ministry of Health of the Czech Republic,grant project No.NU20-08-00150。
文摘Magnesium is an excellent material in terms of biocompatibility and its corrosion products can serve as an active source for new bone formation.However,localized corrosion and H_(2)generation limit the potential of Mg-based implants.Utilizing low-alloyed Mg-Zn wires can strongly reduce problems with large H_(2)bubbles and improve the mechanical properties considerably while maintaining excellent long-term biocompatibility.Acidic pickling and a polymer coating can be effectively used to lower the rate of in vivo degradation.In this work,microstructural,mechanical,and in vitro characterization of 250μm and 300μm extruded wires made from ultra-pure Mg,commercially pure Mg,Mg-0.15Zn,Mg-0.4Zn and Mg-1Zn was performed.Additionally,Mg-0.4Zn wires together with a variant coated with a copolymer of L-lactide andε-caprolactone were tested in vivo on artificially damaged Wistar rat femurs.Based on the observed Mg-induced osteogenesis,polymer-coated Mg wires with a small addition of Zn are a perspective material for bone-support applications,such as cerclage and fixation wires.
基金supported by the S grant of the Ministry of Education,Youth and Sport(MEYS)of Czech Republicsupported by the Primus Research Programme PRIMUS/17/MED/16 of the Charles University
文摘We are entering an exciting epoch in livestock biotechnology during which the fundamental approaches(such as transgenesis, spermatozoa cryopreservation and artificial insemination) will be enhanced based on the modern understanding of the biology of spermatogonial stem cells(SSCs) combined with the outstanding recent advances in genomic editing technologies and in vitro cell culture systems. The general aim of this review is to outline comprehensively the promising applications of SSC manipulation that could in the nearest future find practical application in livestock breeding. Here, we will focus on 1) the basics of mammalian SSC biology;2) the approaches for SSC isolation and purification;3) the available in vitro systems for the stable expansion of isolated SSCs;4) a discussion of how the manipulation of SSCs can accelerate livestock transgenesis;5) a thorough overview of the techniques of SSC transplantation in livestock species(including the preparation of recipients for SSC transplantation,the ultrasonographic-guided SSC transplantation technique in large farm animals, and the perspectives to improve further the SSC transplantation efficiency), and finally, 6) why SSC transplantation is valuable to extend the techniques of spermatozoa cryopreservation and/or artificial insemination. For situations where no reliable data have yet been obtained for a particular livestock species, we will rely on the data obtained from studies conducted in rodents because the knowledge gained from rodent research is translatable to livestock species to a great extent. On the other hand, we will draw special attention to situations where such translation is not possible.
基金Supported by Research Project PRVOUK P37-08 from Faculty of Medicine at Hradec Králové,Charles University in Praha,Czech Republic
文摘AIM:To study possible decrease in prevalence of Helicobacter pylori(H.pylori) infection in the Czech Republic within a 10-year period.METHODS:A total of 22 centres entered the study.The catchment areas of these centres covered cities and towns with more than 20 000 inhabitants,smaller towns(≤ 20 000 inhabitants) with surrounding villages and rural areas,and were spread over the whole country,corresponding well to the geographical distribution of the Czech population.A total of 1 837 subjects(aged 5-98 years) took part in the study,randomly selected out of 38 147 people from the general population.H.pylori infection was investigated by means of a 13 C-urea breath test.Breath samples in duplicates were analysed using isotope ratio mass spectrometry.The cut-off point was 3.5.Social and demographic characteristics were based on data from self-completed questionnaires.RESULTS:The overall prevalence of H.pylori infection was 23.5%(430/1826),and 4.8%(20/420) in children aged 15 or less.There was no statistically significant difference in prevalence between males(24.3%;208/857) and females(22.9%,222/969,P = 0.494).H.pylori infection was strongly associated with higher age,among subjects aged 55+ years,prevalence of H.pylori infection was 39.8%(252/633,P < 0.001).The highest prevalence of H.pylori infection was found among persons aged 55-64 years(43.9%,97/221) and 75+ years(37.9%,58/153).Among study subjects aged 15+ years,prevalence of H.pylori infection was significantly increased in those with lowest education(odds risk 3.19,95% CI 1.87-5.47).Compared to never married(14.1%),the prevalence of H.pylori infection was statistically significantly higher among married(35.4%,246/694,P < 0.001),divorced(36.8%,49/133,P < 0.001) and widowed study subjects(40.2%,45/112,P < 0.001),both in minimally and fully adjusted analysis.There was no significant difference in the prevalence of H.pylori infection between married and widowed subjects(35.4%,246/694 vs 40.2%,45/112,P = 0.389).There was little variation in smoking prevalence across categories of smoking and there was no evidence of an increased risk ofH.pylori infection among current or past smokers in our data(odds risk 1.04 with 95% CI 0.78-1.40 for current smokers;odds ratio 0.83 with 95% CI 0.60-1.16 for former smokers).The current prevalence of H.pylori in 2011 was significantly lower compared to the prevalence reported from identical geographical areas in 2001(23.5%vs 41.7%,P < 0.001).CONCLUSION:The overall prevalence of H.pylori infection in the general population has fallen substantially in the Czech Republic over the past 10 years.
文摘Crohn’s disease affects more than 500000 individuals in the United States, and about 25% of cases are diagnosed during the pediatric period. Imaging of the bowel has undergone dramatic changes in the past two decades. The endoscopy with biopsy is generally considered the diagnostic reference standard, this combination can evaluates only the mucosa, not inflammation or fibrosis in the mucosa. Actually, the only modalities that can visualize submucosal tissues throughout the small bowel are the computed tomography (CT) enterography (CTE) with the magnetic resonance enterography (MRE). CT generally is highly utilized, but there is growing concern over ionizing radiation and cancer risk; it is a very important aspect to keep in consideration in pediatric patients. In contrast to CTE, MRE does not subject patients to ionizing radiation and can be used to detect detailed morphologic information and functional data of bowel disease, to monitor the effects of medical therapy more accurately, to detect residual active disease even in patients showing apparent clinical resolution and to guide treatment more accurately.
文摘Global food security is a major development challenge dictated by state stability, resilience to geopolitical and economic shocks and is linked to health security. Fragile and failed nation-states are at risk of extreme poverty and lead to war and conflict. Fragile states experience, corrupt financial regimes and are influenced by skewed global market systems and reduced equitable market access that decrease food and health security. This qualitative review describes the critical cross sections of food security, the influence of global market systems and state stability and institutions that form the nexus of global health security. We outline how the manipulation of free market systems and decreased state capacity not only decrease food and health security but also contribute to state fragility and failure. Improved public health policy mechanisms, decreased dependence on foreign financial structures and extractive mechanisms are crucial to improving food and health security at present, and to further increase state stability in the future.
文摘Individuals with unipolar depressive disorder(UDD)are having an increased risk of death and development of dementia in later life.It is widely expected that in a near future UDD would be the leading cause of death;therefore,a primary inexpensive prevention of UDD will be of a great importance to the society.Several studies provide evidences supporting the positive effect of Mediterranean diet on a reduced risk for development of depression.
文摘Patients presenting to emergency and urgent care centers with calf pain after long and short-haul flights are a common presentation throughout Europe. Patients fitting an epidemiological risk profile for cholelithiasis and presenting with right upper quadrant abdominal pain can also be a common presentation fitting of a specific patient profile. However, pulmonary hypertension can present in a nuanced and possible missed chronic and acute presentation. The patient case we present profiles a mildly obese 54-year-old Caucasian woman and recent holiday maker with unilateral calf pain and shortness of breath after traveling on a long-haul flight with tertiary symptoms of indigestion and epigastric discomfort indicative of gastroenteritis. This case highlights the required diligence for emergency physicians to maintain a high index of suspicion and broad differential diagnosis in the undifferentiated patient with seemingly common or classic presentations. We find that a serendipitous definitive diagnosis is made by following a systematic and organized approach.
文摘This patient case report describes a 40-year-old African woman presenting with a classic acute presentation of carbon monoxide poisoning from an unlikely source responding to conventional treatment. This case highlights the classic presenting features of carbon monoxide poisoning and the requirement to maintain a high index of suspicion and immediate use of rapid empirical treatment in the undifferentiated patient, sometimes before diagnostics and definitive diagnosis can be determined. The definitive diagnosis and cause of poisoning are also discussed to educate the emergency physician to new and foreign cultural habits and encourage best medical practices within multicultural societies.
基金supported by grant NT11231-3/2010 from the Ministry of Health of the Czech Republic
文摘Src regulates cell adhesion, invasiveness, motility and growth in cancer cells. In melanoma, accumulating data show that Src inhibition can be effective and may enhance the effects of other agents. Increased Src expression and activity thus has recently become a target for drug therapy. Several melanoma cell lines were exposed to inhibitors of Src activity despite their broad specificity. To examine the particular activity of Src in human melanoma cells, we used SU6656, the selective inhibitor of Src family protein kinases. The activity of Src and cell proliferation were suppressed in HBL human cells, wild type melanoma cells and in SK-MEL-5 human melanoma cells harboring mutant BRAF V600E, upon their treatment with SU6656. The suppression of Src kinase activity had not inhibitory effects on Akt/PKB activity in SK-MEL-5 cells, which we have previously found in HBL cells. This may indicate that changes of Src involvement in the control of Akt/PKB activity and its downstream signaling could be induced by BRAF V600E mutation in SK-MEL-5 cells.
基金Supported by Research project"CTC in gastrointestinal cancer"awarded by League Against Cancer Prague,Czech Republic and grant of the Czech Ministry of Health,No.IGA NT14439-3/2013the projects by Ministry of Helath Czech Republic,conceptual development of research organization,University Hospital Motol,Prague Czech Republic,No.000 64203
文摘AIM: To investigate the feasibility of separation and cultivation of circulating tumor cells (CTCs) in pancreatic cancer (PaC) using a filtration device.
基金Supported by Research project PRVOUK P37-08(from Charles University in Praha,Faculty of Medicine at Hradec Kralove,Czech Republic)
文摘To evaluate vital signs and body indices in Helicobacter pylori (H. pylori) positive and negative persons. A total of 22 centres entered the study. They were spread over the whole country, corresponding well to the geographical distribution of the Czech population. A total of 1818 subjects (aged 5-98 years) took part in the study, randomly selected out of 38147 subjects. H. pylori infection was investigated by means of a 13C-urea breath test. Data on height, weight, systolic and diastolic blood pressure and heart rate were collected at the clinics of general practitioners. The overall prevalence of H. pylori infection was 30.4% (402/1321) in adults (≥ 18 year-old) and 5.2% (26/497) in children and adolescents (≤ 17 year-old). Once adjusted for age and gender, only a difference in body mass index remained statistically significant with H. pylori positive adults showing an increase of 0.6 kg/m<sup>2</sup> in body mass index. Once adjusted for age and gender, we found a difference in height between H. pylori positive and H. pylori negative children and adolescents. On further adjustment for place of residence, this difference became statistically significant, with H. pylori positive children and adolescents being on average 3.5 cm shorter. H. pylori positive adults were significantly older compared to H. pylori negative subjects. Once adjusted for age and gender, H. pylori infection had no impact on body weight, body mass index and vital signs either in adults or children and adolescents. Chronic H. pylori infection appeared to be associated with short stature in children. H. pylori infection did not influence blood pressure, body weight and body mass index either in adults or children and adolescents.
基金supported by grant NoMSM0021620849 given by the Ministry of Education,Youth and Sports of the Czech Republicby project PRVOUK-P26/LF1/4given by Charles University in Prague+1 种基金by grant No. SVV-2012-264514 from Charles University in Pragueby grant No.41310 given by the Grant Agency of Charles University in Prague,Czech Republic
文摘Distribution and activity of mitochondda are key factors in neuronal development, synaptic plasticity and axogenesis. The majority of energy sources, necessary for cellular functions, originate from oxidative phosphorylation located in the inner mitochondrial membrane. The adenosine-5＇- triphosphate production is regulated by many control mechanism-firstly by oxygen, substrate level, adenosine-5＇-diphosphate level, mitochondrial membrane potential, and rate of coupling and proton leak. Recently, these mechanisms have been implemented by ＂second control mechanisms,＂ such as reversible phosphorylation of the tricarboxylic acid cycle enzymes and electron transport chain complexes, aUosteric inhibition of cytochrome c oxidase, thyroid hormones, effects of fatty acids and uncoupling proteins. Impaired function of mitochondria is implicated in many diseases ranging from mitochondrial myopathies to bipolar disorder and schizophrenia. Mitochondrial dysfunctions are usually related to the ability of mitochondria to generate adenosine-5＇-triphosphate in response to energy demands. Large amounts of reactive oxygen species are released by defective mitochondria similarly, decline of antioxidative enzyme activities （e.g. in the elderly） enhances reactive oxygen species production. We reviewed data concerning neuroplasticity, physiology, and control of mitochondrial oxidative phosphorylation and reactive oxygen species production.
基金Supported by The Project(Ministry of Health,Czech Republic)for Development of Research Organization00023001(IKEM,Prague,Czech Republic)-Institutional supportthe grant SVV-2012-264502
文摘Hyperbilirubinemia has been presumed to prevent the process of atherogenesis and cancerogenesis mainly by decreasing oxidative stress.Dubin-Johnson syndrome is a rare,autosomal recessive,inherited disorder characterized by biphasic,predominantly conjugatedhyperbilirubinemia with no progression to end-stage liver disease.The molecular basis in Dubin-Johnson syndrome is absence or deficiency of human canalicular multispecific organic anion transporter MRP2/cMOAT caused by homozygous or compound heterozygous mutation(s) in ABCC2 located on chromosome 10q24.Clinical onset of the syndrome is most often seen in the late teens or early adulthood.In this report,we describe a case of previously unrecognized Dubin-Johnson syndrome caused by two novel pathogenic mutations (c.2360_2366delCCCTGTC and c.3258+1G>A),coinciding with cholestatic liver disease in an 82-year-old male patient.The patient,suffering from advanced atherosclerosis with serious involvement of coronary arteries,developed colorectal cancer with nodal metastases.The subsequent findings do not support the protective role of Dubin-Johnson type hyperbilirubinemia.
基金supported by the Agency for the Czech Republic Health Research(No.15-27994A)。
文摘Despite advanced therapies,the mortality of patients with myocardial infarction(MI)complicated by cardiogenic shock(CS)remains around 50%.Mechanical complications of MI are rare nowadays but associated with high mortality in patients who present with CS.Different treatment strategies and mechanical circulatory support(MCS)devices have been increasingly used to improve the grim prognosis of refractory CS.This article discusses current evidence regarding the use of MCS in MI complicated by CS,ventricular septal rupture,free wall rupture and acute mitral regurgitation.Device selection should be tailored according to the cause and severity of CS.Early MCS initiation and multidisciplinary team cooperation is mandatory for good results.MCS associated bleeding remains a major complication and an obstacle to better outcomes.Ongoing prospective randomized trials will improve current knowledge regarding MCS indications,timing,and patient selection in the coming years.
基金Supported by the Projects Progres of Charles University,No. Q25/LF1 and No. Q27/LF1the Grant Agency of Charles University+1 种基金Czech Republic,No. 34119the Project Ministry of Health,Czech Republic for Conceptual Development of Research Organization,No. 64165.
文摘Schizophrenia is a severe psychiatric disorder characterized by emotional,behavioral and cognitive disturbances, and the treatment of schizophrenia is oftencomplicated by noncompliance and pharmacoresistance. The search for thepathophysiological mechanisms underlying schizophrenia has resulted in theproposal of several hypotheses to explain the impacts of environmental, genetic,neurodevelopmental, immune and inflammatory factors on disease onset andprogression. This review discusses the newest insights into the pathophysiologyof and risk factors for schizophrenia and notes novel approaches in antipsychotictreatment and potential diagnostic and theranostic biomarkers. The currenthypotheses focusing on neuromediators (dopamine, glutamate, and serotonin),neuroinflammation, the cannabinoid hypothesis, the gut-brain axis model, andoxidative stress are summarized. Key genetic features, including small nucleotidepolymorphisms, copy number variations, microdeletions, mutations andepigenetic changes, are highlighted. Current pharmacotherapy of schizophreniarelies mostly on dopaminergic and serotonergic antagonists/partial agonists, butnew findings in the pathophysiology of schizophrenia have allowed theexpansion of novel approaches in pharmacotherapy and the establishment ofmore reliable biomarkers. Substances with promising results in preclinical andclinical studies include lumateperone, pimavanserin, xanomeline, roluperidone,agonists of trace amine-associated receptor 1, inhibitors of glycine transporters,AMPA allosteric modulators, mGLUR2-3 agonists, D-amino acid oxidase inhibitorsand cannabidiol. The use of anti-inflammatory agents as an add-on therapy ismentioned.
文摘BACKGROUND Acute appendicitis in a solid organ transplant recipient is a rare occurrence, and experience remains limited. Appendicitis in uterine transplant recipients has never been reported. Immunocompromised patients with acute abdomen often present late and with attenuated symptoms. The differential diagnosis in a transplanted patient is broad and challenging due to possible existing complications associated with the graft, effects of immunosuppression, and altered anatomical relations.CASE SUMMARY A 26-year-old woman suffering from absolute uterine factor infertility received a uterus transplant. In the post-transplant period, she suffered from leukopenia and recurrent acute cellular rejection. Her compliance was suboptimal. She travelled to an exotic destination despite the physician's recommendation not to do so. Following her vacation, she presented with abdominal discomfort, nausea and diarrhoea. There was no sign of acute abdomen;the abdominal ultrasound was negative on day 0. Clostridium difficile colitis was verified and treated with perorally administered vancomycin. On day 4, the discomfort changed to pain;the ultrasound scan revealed a finding suggestive of appendicitis. Surgical exploration revealed perforated appendicitis, and appendectomy was performed.From a surgical point of view, the patient's follow-up was uneventful. The patient underwent a successful embryo transfer 6 months after the appendectomy. The patient gave birth to a healthy boy at the 35 th week of gestation.CONCLUSION A high index of suspicion of an atypical course and symptomatology of acute abdomen should be maintained in immunosuppressed patients.
文摘A retrospective,multicenter study of 180 children with cytochrome c oxidase (COX) deficiency analyzed the clinical features,prognosis,and molecular bases of the COX deficiency. Clinical symptoms including failure to thrive,encephalopathy,hypotony,Leigh syndrome,cardiac involvement,and hepatopathy appeared in most patients early after birth or in early childhood. Two thirds of all children died. Biochemical examination revealed an isolated COX deficiency in 101 children and COX deficiency combined with disturbances of other respiratory chain complexes in 79 children. Blood and cerebrospinal fluid lactate increased in 85%and 81%of examined cases,respectively. Pathogenic mutations in mitochondrial or nuclear DNA were established in 75 patients. Mutations in surfeit locus protein 1 gene (SURF1) were found in 47 children with Leigh syndrome; 2bp deletion 845-846 delCT was found in 89%of independent alleles. Mutations in a mitochondrial copper-binding protein (SCO2) gene were found in nine children with encephalomyopathy and/or cardiomyopathy; all of them were homozygotes or heterozygotes for 1541G>A mutation. Different mitochondrial DNA (mtDNA) deletion or depletion were found in nine children,mtDNA mutation 3243A>G in six,mtDNA mutation 8363G>A in two children with Leigh syndrome and mtDNA mutations 8344A>G,and 9205-9206delTA in one child each. COX deficiency represents a heterogeneous group of diseases with unfavorable prognosis. Marked prevalence of two nuclear DNA mutations (845-846 delCT in the SURF1 gene and 1541G>A in the SCO2 gene) associated with COX deficiency in a Slavonic population suggests the existence of regional differences in the genetic basis of COX deficiency.
基金The project (Ministry of Health,Czech Republic) for development of research organization 00023001 (IKEM,Prague,Czech Republic) - Institutional support PRVOUK-P24/LF1/3 and MH CZ - DRO VFN64165 to Dvorakova L and Hrebicek M
文摘AIM:To investigate the contribution of ABCB4 mutations to pediatric idiopathic gallstone disease and the potential of hormonal contraceptives to prompt clinical manifestations of multidrug resistance protein 3 deficiency.METHODS:Mutational analysis of ABCB4,screening for copy number variations by multiplex ligation-dependent probe amplification,genotyping for low expression allele c.1331T>C of ABCB11 and genotyping for variation c.55G>C in ABCG8 previously associated with cholesterol gallstones in adults was performed in 35 pediatric subjects with idiopathic gallstones who fulfilled the clinical criteria for low phospholipid-associated cholelithiasis syndrome(LPAC,OMIM#600803)and in 5young females with suspected LPAC and their families(5 probands,15 additional family members).The probands came to medical attention for contraceptiveassociated intrahepatic cholestasis.RESULTS:A possibly pathogenic variant of ABCB4was found only in one of the 35 pediatric subjects with idiopathic cholesterol gallstones whereas 15 members of the studied 5 LPAC kindreds were confirmed and another one was highly suspected to carry predictably pathogenic mutations in ABCB4.Among these 16,however,none developed gallstones in childhood.In 5index patients,all young females carrying at least one pathogenic mutation in one allele of ABCB4,manifestation of LPAC as intrahepatic cholestasis with elevated serum activity of gamma-glutamyltransferase was induced by hormonal contraceptives.Variants ABCB11c.1331T>C and ABCG8 c.55G>C were not significantly overrepresented in the 35 examined patients with suspect LPAC.CONCLUSION:Clinical criteria for LPAC syndrome caused by mutations in ABCB4 cannot be applied topediatric patients with idiopathic gallstones.Sexual immaturity even prevents manifestation of LPAC.
文摘When evaluating environmental risk and its perception, psychosocial and psychosomatic factors may be of fundamental importance for public health programming and the promotion of quality of life. This is the case in particular where knowledge of the true health consequences of environmental exposure to given risk factors are incomplete or its action is within the range of values where we do not anticipate the measurable biological effect. This applies not only in the case of the indoor environment related complaints but also to that of non-ionizing electromagnetic radiation and electroionic microclimate, among many others. A serious consequence found in the syndrome of mass hysteria is the fact that due to differently motivated information and disinformation, part of the population can suffer from psychosomatic symptoms and deterioration quality of life for those affected.
