Secondary prevention of lung cancer in the Czech Republic - pitfalls, risks, benefits.

Lung cancer (LC) is one of the most frequently diagnosed cancers and one of the leading causes of cancer deaths in the Czech Republic, the prevalence of which is steadily increasing. There is scientific evidence that LC screening through low-dose computed tomography (LDCT) reduces the risk of death from LC. No systematic LC screening strategy has been currently in place in the Czech Republic. Since the beginning of 2022, the methodology of early detection of LC using LDCT has been piloted to test the feasibility of the screening program. The primary purpose of the project is an early and accurate diagnosis of the disease, which, in combination with follow-up treatment, will lead to a reduction in LC mortality. The pilot data will definitely serve as a basis for an expert discussion of the acceptability of the program to the Czech population and its impact on the healthcare system. It is clear that by introducing such a screening program, we will join the countries that, based on scientific data, enable the population to profit from an actively implemented LC prevention strategy. Public awareness of the benefits of early non-invasive LC detection can contribute to higher compliance of at-risk persons and their willingness to participate in the program. The key role in the entire process is played by general practitioners and/or outpatient pulmologists who address at-risk individuals and can positively influence their involvement in the program.

COVID-19 symptom duration predicts immunoglobulin G seropositivity.

OBJECTIVES: The study focused on the relationship between routine clinical characteristics and anti-SARS-CoV-2 specific antibodies in a pilot sample of healthcare workers (HCWs) having suffered COVID-19. The aim was to investigate the existence of readily available predictors of antibodies against COVID-19. METHODS: As part of the recognition of COVID-19 as an occupational disease in 152 HCWs with the mean age of 43.2 years, personal, anthropometric and anamnestic data related to the disease as well as anti-spike immunoglobulin (Ig) levels were obtained. Through descriptive statistics, correlation and regression analyses, relationships of all variables and Ig levels, especially seropositivity of IgG, were investigated. RESULTS: The mean interval between the symptom onset and the determination of antibodies was 58 days. IgG seropositivity and IgM seropositivity were noted in 82 % and 49 % of HCWs, respectively. Symptom duration was the only statistically significant predictor of IgG seropositivity. With each day of symptom duration, the probability of IgG seropositivity increased from 1.078 to 1.092 times (p < 0.05). If symptoms lasted longer than 17 days, a majority (almost 80 %) of the subjects demonstrated seropositivity in the following months.  CONCLUSION: The presence of IgG immunity may be assumed from symptom duration. Such easy recognizing of seropositive patients may be a useful tool, e.g. in vaccination strategies (Tab. 3, Fig. 1, Ref. 28).

Epidemiology of hepatitis E virus infection.

Hepatitis E is a major concern to public health, it is estimated that 44,000 people die annually due to hepatitis E. Hepatitis E virus (HEV) is the most common cause of acute viral hepatitis in the world. HEV has been found with 7 genotypes, only 4 can infect humans. Genotypes 1 and 2 are major causes of the epidemic and endemic acute hepatitis in developing countries. In the poor hygienic conditions, these genotypes are obligate human pathogens transmitted between humans by the fecal-oral route and via contaminated water. On the contrary, in developed countries, genotypes 3 and 4 are of zoonotic origin and they are transmitted by alimentary route and via direct contact with the infected animal. Transmission by blood, blood products and tissues from infected persons or animals and even mother-to-infant transmission is also possible. Hepatitis E clinical course varies from self-limiting disease to fulminant hepatic failure, and extrahepatic manifestations have occurred. Management to control and prevent this infection is mainly hygienic measures. The provision of clean drinking water and ameliorating the sanitation of human wastes are the most effective preventive approaches as in any infection outbreak transmitted through the fecal-oral route. Nevertheless, dietary habits, distribution of different zoonotic reservoirs and the hygienic level play a crucial role in limiting and preventing the spread of hepatitis E in the developed countries. Although HEV vaccine was developed, it is still available only in China. It protects against genotype 4 with no clear evidence of protection against other genotypes.

A case of accelerated silicosis.

Silicosis, caused by inhaling dust containing free crystalline silica, typically has a chronic course, with the numbers of silicosis patients declining globally. Much rarer are the acute and subacute forms. Presented is a case of severe subacute (accelerated) silicosis. The condition resulted from ~2 years of very intense exposure without appropriate personal protective equipment while sandblasting. The patient's initial symptoms were progressive cough, dyspnoea and weight loss. Given his occupational history, typical clinical manifestations and radiological findings, an initial diagnosis of accelerated silicosis was proposed and histologically confirmed. The patient was a candidate for lung transplantation. The case demonstrates a rare but largely preventable disease with serious health effects and a poor prognosis.

Differential contributions of basal ganglia and thalamus to song initiation, tempo, and structure.

Basal ganglia-thalamocortical circuits are multistage loops critical to motor behavior, but the contributions of individual components to overall circuit function remain unclear. We addressed these issues in a songbird basal ganglia-thalamocortical circuit (the anterior forebrain pathway, AFP) specialized for singing and critical for vocal plasticity. The major known afferent to the AFP is the premotor cortical nucleus, HVC. Surprisingly, previous studies found that lesions of HVC alter song but do not eliminate the ability of the AFP to drive song production. We therefore used this AFP-driven song to investigate the role of basal ganglia and thalamus in vocal structure, tempo, and initiation. We found that lesions of the striatopallidal component (Area X) slowed song and simplified its acoustic structure. Elimination of the thalamic component (DLM) further simplified the acoustic structure of song and regularized its rhythm but also dramatically reduced song production. The acoustic structure changes imply that sequential stages of the AFP each add complexity to song, but the effects of DLM lesions on song initiation suggest that thalamus is a locus of additional inputs important to initiation. Together, our results highlight the cumulative contribution of stages of a basal ganglia-thalamocortical circuit to motor output along with distinct involvement of thalamus in song initiation or "gating."

CRYP-2/cPTPRO is a neurite inhibitory repulsive guidance cue for retinal neurons in vitro.

Receptor protein tyrosine phosphatases (RPTPs) are implicated as regulators of axon growth and guidance. Genetic deletions in the fly have shown that type III RPTPs are important in axon pathfinding, but nothing is known about their function on a cellular level. Previous experiments in our lab have identified a type III RPTP, CRYP-2/cPTPRO, specifically expressed during the period of axon outgrowth in the chick brain; cPTPRO is expressed in the axons and growth cones of retinal and tectal projection neurons. We constructed a fusion protein containing the extracellular domain of cPTPRO fused to the Fc portion of mouse immunoglobulin G-1, and used it to perform in vitro functional assays. We found that the extracellular domain of cPTPRO is an antiadhesive, neurite inhibitory molecule for retinal neurons. In addition, cPTPRO had potent growth cone collapsing activity in vitro, and locally applied gradients of cPTPRO repelled growing retinal axons. This chemorepulsive effect could be regulated by the level of cGMP in the growth cone. Immunohistochemical examination of the retina indicated that cPTPRO has at least one heterophilic binding partner in the retina. Taken together, our results indicate that cPTPRO may act as a guidance cue for retinal ganglion cells during vertebrate development.

Associations Between Homeostasis Model Assessment (HOMA) and Routinely Examined Parameters in Individuals With Metabolic Syndrome.

The aim of the study was to investigate whether routine clinical parameters, including visceral adiposity index (VAI) and atherogenic index of plasma (AIP), could become widely applicable predictors of insulin resistance (IR), evaluated using homeostasis model assessment (HOMA-IR, HOMA-ß), with regard to presence of metabolic syndrome (MS). The study comprised 188 individuals identified to meet the MS criteria during regular health examinations and an equal number of age, sex-matched controls without MS. The strongest correlations were noted between HOMA-IR and waist circumference (WC) in the MS group (r=0.57) as well as between HOMA-IR and alanine aminotransferase (ALT, r=0.57) or aspartate aminotransferase (r=0.56) in the controls, with a statistical significance of p<0.001. In a multivariate linear regression model, the predictors of HOMA-IR were WC (linear coefficient ß=0.1, p<0.001), ALT (ß=2.28, p<0.001) and systolic blood pressure (ß=0.04, p<0.001). HOMA-ß was determined by WC (ß=1.97, p=0.032) and ALT (ß=99.49, p=0.004) and inversely associated with age (ß=-1.31, p=0.004). Neither VAI nor AIP were significant predictors. The presence of MS was significantly associated with both HOMA-IR and HOMA-ß. These results indicate that WC and ALT appear to be reliable predictors of IR. Comprehensive assessment of these parameters may serve for estimating the level of IR.