Search

Aims. Multiple sclerosis treatment strategies are changing in the Czech Republic. According to data from 2013–2021, the proportion of patients starting high-efficacy disease-modifying therapies is increasing. In this survey, we describe the actual data trends in multiple sclerosis (MS) patients beginning their first disease-modifying therapies (DMTs) from 2013 to 2021. The secondary objective was to present the history, data collection, and scientific potential of the Czech National MS registry (ReMuS). Methods. First, using descriptive statistics, we analysed the data for patients starting their first DMTs, either platform (including dimethyl fumarate) or high-efficacy DMTs (HE-DMTs), for each successive year. Second, a detailed description of the history, data collection, completeness, quality optimising procedures, and legal policies of ReMuS is provided. Results. Based on the dataset from December 31, 2021, the total number of monitored patients with MS in ReMuS increased from 9,019 in 2013 (referred from 7 of 15 MS centres) to 12,940 in 2016 (referred from all 15 Czech MS centres) to 17,478 in 2021. In these years, the percentage of patients treated with DMTs in the registry ranged from 76 to 83%, but the proportion of patients treated with HE-DMTs changed from 16.2% in 2013 to 37.1% in 2021. During the follow-up period, a total of 8,491 treatment-naive patients received DMTs. The proportion of patients (all MS phenotypes) starting HE-DMTs increased from 2.1% in 2013 to 18.5% in 2021. Conclusion. Patient registries, including ReMuS, provide an essential quality data source, especially in light of the increasing percentage of patients on HE-DMTs. Although early initiation of HE-DMT can provide considerable benefits, it also carries greater potential risks. Consistent long-term follow-up of patients in real-world clinical practice, which only registries allow, is therefore crucial to evaluate the efficacy and safety of therapeutic strategies, for epidemiological research and to assist decision making by healthcare providers and regulatory bodies. [ABSTRACT FROM AUTHOR]

Aims. Critically ill patients undergoing aggressive fluid resuscitation and treated empirically with hydrosoluble timedependent beta-lactam antibiotics are at risk for sub-therapeutic plasma concentrations. The aim of this study was to assess the impact of two covariates . creatinine clearance (Clcr) and cumulative fluid balance (CFB) on pharmacokinetics/ pharmacodynamics (PK/PD) target attainment within a week of treatment with meropenem (ME) or piperacillin/ tazobactam (PIP/TZB). Methods. In this prospective observational pharmacokinetic (PK) study, 18 critically ill patients admitted to a surgical Intensive Care Unit (ICU) were enrolled. The primary PK/PD target was free antibiotic concentrations above MIC at 100% of the dosing interval (100%fT>MIC) to obtain maximum bactericidal activity. Drug concentration was measured using liquid chromatography-tandem mass spectrometry. Results. The treatment of both 8 septic patients with IV extended ME dosing 2 g/3 h q8 h and 10 polytraumatized patients with IV intermittent PIP/TZB dosing 4.0/0.5 g q8 h was monitored. 8/18 patients (44%) manifested augmented renal clearence (ARC) where Clcr ≥130 mL/min/1.73 m2. Maximum changes were reported on days 2.3: the median positive CFB followed by the large median volume of distribution: Vdme=70.3 L (41.9.101.5), Vdpip = 46.8 L (39.7.60.0). 100%fTme>MIC was achieved in all patients on ME (aged ≥60 years), and only in two patients (non-ARC, aged ≥65 years) out of 10 on PIP/TZB. A mixed model analysis revealed positive relationship of CFBpip with Vdpip (P=0.021). Conclusion. Assuming that the positive correlation between CFB and Vd exists for piperacillin in the setting of the pathological state, then CFB should predict Vdpip across subjects at each and every time point. [ABSTRACT FROM AUTHOR]

An abstract of the medical research "THERAPEUTIC DRUG MONITORING (TDM) OF GENTAMICIN IN CRITICALLY ILL NEONATES," by Iva Selke-Krulichova, Jirina Martinkova, Pavla Pokorna and Jiri Zahora is presented.

An abstract of the medical research "ARGININE METABOLISM IN A RAT MODEL OF BRONCHIAL ASTHMA," by Zuzana Havlinova, Jaroslav Chladek, Stanislav Micuda, Jana Prokopova and Jirina Martinkova is presented.

An abstract of the medical research "INFLUENCE OF AZITHROMYCIN ON HEPATOBILIARY AND RENAL EXCRETION OF METHOTREXATE IN RATS ," by Jolana Cermanova, Stanislav Micuda, Eva Brcakova, Leos Fuksa, Milos Hroch, Jaroslav Chladek, Jitka Hajkova, Halka Lotkova, Jirina Martinkova, Zuzana Cervinkova and Frantisek Staud is presented.

An abstract of the medical research "CHANGES IN CARDIAC TROPONIN T DURING ACUTE AND CHRONIC CHOLESTASIS IN RATS," by Stanislav Micuda, Michaela Adamcova, Eva Brcakova, Leos Fuksa, Jolana Cermanova, Jitka Hajkova, Gabriela Kolouchova, Jirina Martinkova and Frantisek Staud is presented.

An abstract of the medical research "A RANDOMIZED CROSS-OVER STUDY OF FOLIC ACID SUPPLEMENTATION DURING THE INITIAL PHASE OF PSORIASIS TREATMENT WITH METHOTREXATE," by Jaroslav Chladek, Jaroslava Vaneckova, Marie Simkova, Milos Hroch, Jirina Martinkova and Jiri Grim is presented.