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AbstractObjectives:To assess the efficacy and safety of biphasic insulin aspart 70/30 (BIAsp 30) and insulin glargine, administered once daily in subjects with type 2 diabetes inadequately controlled with oral anti-diabetic drugs.Research design and methods:In this 26-week, open-labeled, randomized, parallel-group, multinational, treat-to-target trial, 480 insulin-naïve subjects were randomized to receive either BIAsp 30 before dinner or insulin glargine at bedtime, both in combination with metformin and glimepiride.Trial registration:NCT00469092, ClinicalTrials.gov.Results:A total of 433 subjects completed the trial. Estimated mean reduction in HbA1cfrom baseline to end of treatment was −1.41 with BIAsp 30 and −1.25 with insulin glargine (BIAsp 30 – insulin glargine  −0.16, 95 CI [−0.30; −0.02], p  0.029). At the end of treatment, mean HbA1cwas 7.1 and 7.3 for BIAsp 30 and insulin glargine, respectively. Significantly lower plasma glucose levels were observed with BIAsp 30 post-dinner (BIAsp 30 – insulin glargine  −0.52 mmol/L, 95 CI [−1.02; −0.03], p  0.04) and at bedtime (BIAsp 30 – insulin glargine  −0.78 mmol/L, 95 CI [−1.25; −0.31], p < 0.01). The relative risk (RR) of experiencing a nocturnal hypoglycemic episode (00:00–06.00 a.m.) was significantly higher with BIAsp 30 than with insulin glargine (1.1 versus 0.5 episodes/year, RR  2.41, 95 CI [1.34; 4.34], p  0.003), but overall hypoglycemia rates were low. There were three major hypoglycemic episodes in each group.Conclusions:With respect to HbA1c, BIAsp 30 fulfilled the statistical criteria for non-inferiority and superiority to insulin glargine and, according to pre-defined criteria, the improvements in HbA1care considered clinically equivalent. Subjects had an increased risk of minor nocturnal hypoglycemia with BIAsp 30. There were no differences in treatment satisfaction between the two groups. [ABSTRACT FROM AUTHOR]

The small collection of terracotta and pottery finds, stored in the depository of the Náprstek Museum in Prague, comes from the ancient city of Karakorum in Mongolia. Their origin is connected with the first Czechoslovak-Mongolian expedition led by Dr. Lumír Jisi (1921-1969), whose interests were focused on Mongolian archaeology and Mongolian, Tibetan and Japanese art. In 1958 he was charged with the excavation of prince Kültegin monument in Khöshöö-tsaidam (Arkhangai aimak, Central Mongolia) and within this time he had also undertaken few study journeys round famous Mongolian sites in the valley of Orkhon. One of his surface searches pointed to also to the area of Karakorum and Erdene Zuu monastery, where he gathered some significant pottery sherds, fragments of terracotta statues and other artefacts. These were later in 1984 donated to the Náprstek Museum (inventory 1994) as a part of L. Jisl's estate, held by Mrs. Jislová. [ABSTRACT FROM AUTHOR]

Tereza Hendrychova,1 Magda Vytrisalova,1 Abdullah Alwarafi,2 Jurjen Duintjer Tebbens,3,4 Helena Vankatova,1 Sandra Leal,5 Ales Antonin Kubena,1 Alena Smahelova,6 Jiri Vlcek1 1Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University in Prague, Hradec Králové, Czech Republic; 2Faculty of Dentistry, Ibb University, Ibb, Yemen; 3Department of Biophysics and Physical Chemics, Faculty of Pharmacy in Hradec Králové, Charles University in Prague, Hradec Králové, Czech Republic; 4Institute of Computer Science, Academy of Sciences of the Czech Republic, Prague, Czech Republic; 5Department of Clinical Pharmacy, El Rio Community Health Center, Tucson, AZ, USA; 6Diabetes Center, Department of Gerontology and Metabolism, University Hospital and Faculty of Medicine in Hradec Králové, Charles University in Prague, Hradec Králové, Czech Republic Purpose: Diet and eating habits are of key importance in patients with type 2 diabetes mellitus (T2DM). The purpose of this comparative study was to analyze fat- and fiber-related behavior (FFB) in patients with T2DM from distinct cultural areas. Patients and methods: Observational study was carried out in the Czech Republic (CR) (n=200), the US (n=207), and Yemen (n=200). Patients completed the Fat- and Fiber-related Diet Behavior Questionnaire (FFBQ). Results: Differences in all aspects of FFB among countries were found (P

The human papillomavirus (HPV) integration, the critical step in viral carcinogenesis, most frequently occurs in the E2 gene, which results in its inactivation and in an increase of E6/E7 transcription. However, in a substantial number of tumors, the virus is present in an extrachromosomal form. For those tumors, the transformation mechanisms are not fully elucidated. Here we evaluated the possible mechanism of inactivating the E2 without interruption of the gene, methylation or mutation of the E2 binding sites (E2BSs) in HPV16-positive tonsillar tumors by next-generation and Sanger sequencing. Viral genome status was analyzed by the amplification of papillomavirus oncogene transcripts assay (APOT) and mRNA mapping, and expression of viral oncogenes was performed by qPCR. The methylation of E2BSs was significantly higher in tumors with an integrated, in comparison to extrachromosomal, form of the viral genome. No mutations were detected in the E2BSs. The viral oncogenes were equally expressed in samples with an integrated and extrachromosomal form of the virus. Only the nucleotide variants were identified in the E2 gene. No proposed mechanism of E2 inactivation was confirmed in tonsillar tumors with an extrachromosomal form of the HPV genome. The expression of E6/E7 genes seems to be sufficient to initiate and maintain the carcinogenic process [ABSTRACT FROM AUTHOR]

Tereza Hendrychova,1 Magda Vytrisalova,1 Jiri Vlcek,1 Alena Smahelova,2 Ales Antonin Kubena1 1Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Kralove, Charles University in Prague, Czech Republic; 2Diabetology Centre, Department of Gerontology and Metabolism, University Hospital and Faculty of Medicine in Hradec Kralove, Charles University in Prague, Czech Republic Background: Despite the efforts of health care providers, adherence of patients with type 2 diabetes to the recommended diet is poor. The aim of this study was to describe the eating habits with emphasis on fat and fiber-related behavior (FFB) as well as the relationship between FFB behavior and parameters of diabetes control in men and women with type 2 diabetes mellitus. Methods: The subjects in this observational cross-sectional study were 200 patients (54.5% male, mean age 66.2 ± 10.1 years, mean Diabetes Control and Complications Trial [DDCT] glycosylated hemoglobin [HbA1c] 7.6% ± 1.7%) recruited from diabetes outpatient clinics in the Czech Republic. The subjects filled out the Fat- and Fiber-related Diet Behavior Questionnaire. The most recent patient data on diabetes control and drug therapy were derived from patient medical records. Results: Patients tend to modify the dishes they are used to, rather than remove them completely from their diet and replace them by other types of foods. It is easier to perform healthier fat-related behaviors than fiber-related ones. Women scored significantly better than men on the fat-related diet habits summary scale (P = 0.002), as well as on "modify meat" (P = 0.001) and "substitute specially manufactured low-fat foods" (P = 0.045) subscales. A better score on the fat-related diet habits summary scale was significantly associated with higher HbA1c (ρ = -0.248; P = 0.027) and higher waist circumference (ρ = -0.254; P = 0.024) in women. Conclusion: Type 2 diabetes patients are likely to vary in their FFB behavior, and their dietary habits depend on gender. Health care professionals should pay attention to these facts when providing specific education. Emphasis should be placed on how to increase the fiber intake in diabetic patients. Keywords: Fat- and Fiber-related Diet Behavior Questionnaire, dietary fat, dietary fiber, adherence

Tereza Hendrychova,1 Magda Vytrisalova,1 Alena Smahelova,2 Jiri Vlcek,1 Ales Antonin Kubena1 1Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University in Prague, Hradec Králové, Czech Republic; 2Diabetes Center, Department of Gerontology and Metabolism, University Hospital and Faculty of Medicine in Hradec Králové, Charles University in Prague, Hradec Králové, Czech Republic Purpose: Diabetes self-care and self-monitoring adherence has a positive effect on the metabolic control of the disease. The aim of this study was to analyze the adherence to self-care recommendations and to identify its correlates in adults with type 1 diabetes mellitus. Patients and methods: One hundred and eleven patients with type 1 diabetes were enrolled in an observational cross-sectional study conducted at the Diabetes Center of the University Hospital in Hradec Králové, Czech Republic. Diabetes self-care adherence was measured by the Self Care Inventory-Revised, and treatment satisfaction by the Diabetes Treatment Satisfaction Questionnaire-status version. Additional data were collected from self-administered questionnaires and medical records. The Mann–Whitney test, Spearman correlations, and multiple linear regressions were used in the statistical analysis. Results: The mean age of patients was 42.4 years; 59.5% of them were females and 53.2% of all patients used an insulin pump. The mean glycosylated hemoglobin (HbA1c) was 66.2 ± 15.3 mmol/mol and the mean insulin dosage was 0.6 ± 0.3 IU insulin/kg/day. The number of hypoglycemic episodes (including severe) that patients had in the last month before taking the survey was 3.6 ± 3.2. Self-care adherence was associated with treatment satisfaction (0.495; P = 0.004) along with frequency of self-monitoring of before meal blood glucose (0.267; P = 0.003). It was not associated with the incidence of hypoglycemic events or any other insulin therapy-related problems or with socio-demographic or clinical characteristics. Conclusion: Treatment satisfaction is one of the key factors that need to be targeted to maximize benefits to patients. Self-care adherence in adults with type 1 diabetes did not correlate with socio-demographic and clinical characteristics, nor with adverse events. Keywords: treatment adherence, self-care inventory revised, diabetes treatment satisfaction questionnaire, self-monitoring

Background: The HPV type distribution is the most crucial parameter for estimation of the impact of cervical cancer screening and HPV vaccines on incidence of diseases etiologically linked with HPV. Objectives: Recently recta-analyses of HPV type distribution worldwide have been published but data from the Czech Republic were not included. Materials and Methods: Samples of squamose cell carcinomas from different anatomical locations (N=297) as well as samples of precancerous lesions (N=719) available in the bank of the National Reference Laboratory for Papillomaviruses in Prague were included. In this study samples of cancers from following locations were analyzed: cervix (SCC), vulva (VC). anus (AC), urinary bladder of male (BC), prostate (PC). head and neck (HNC). Samples of precancerous lesions were available from low-grade (LGL) and high-grade (HGL) cervical lesions, vulvar intraepithelial lesions (VIN) and anal adenomas (AA). HPV detection and typing was done using PCR with GP5+/6+-bio primers and reverse line blot assay. This method can detect at least 37 different HPV types and determine positivity for multiple HPV types. Results: Altogether, 94% of SCC, 34% of VC, 81% of AC, 62% of HNC, 8% of BC and no PC were HR HPV positive. Further we detected HPV in 87% of HGL, 61% of LGL samples, 87% of VIN and 40% of AA. HPV-16 was the most prevalent genotype in all types of carcinoma (63-90%). In SSC 8 other HR HPV types were detected while in other cancers only HR HPV-16, 18, 33 and 45 have been found. In cervical precancerous lesions bigger variety of HPV types was present but the same was not truth for precancerous lesions in other locations. Multiple infections were found mainly in the cervical lesions. Conclusions: The HPV type distribution in Czech women and men with diseases etiologically linked with HPV is very similar to the distribution revealed by recent worldwide studies. The proportion of lesions and carcinomas, which contain one or both vaccination HR HPV types and therefore can be prevented by vaccination, is considerable. [ABSTRACT FROM AUTHOR]

Background: Digitalisation of health services is among the top priorities of the European Union (EU), yet take-up of eHealth tools is slower in some EU countries than others. Aim: The aim of this study was to evaluate the use of information communication technology (ICT) and eHealth tools by Czech GPs, to elucidate their motivation and barriers to the adoption of eHealth technologies. Design & setting: A cross-sectional, mixed-design survey study, administered online and conducted with GPs from seven randomly selected Czech regions. Of the invited 777 GPs, 196 participants responded (25% response rate) and 153 completed the survey. Method: Quantitative (measured using, for example, the eHealth readiness scale) and qualitative (thematic analysis) methods were used. Results: Hierarchical multilinear regression (controling for age, sex, and city size) showed that ICT usage in general practice was predicted by eHealth readiness. Among GPs with their own practice, age and practice size also predicted ICT use. Analysis of barriers specific to mobile health tools identified obstacles on the side of GPs (such as low perceived usefulness), patients (such as lack of interest), and contextual barriers (such as lack of time). Conclusion: In addition to system-level change, educating Czech GPs about the benefits of eHealth tools for better patient–provider interaction and quality of care is necessary to facilitate eHealth adoption and usage in the Czech Republic.

Head and neck squamous cell carcinomas (HNSCC) can be induced by smoking or alcohol consumption, but a growing part of cases relate to a persistent high-risk papillomavirus (HPV) infection. Viral etiology has a beneficial impact on the prognosis, which may be explained by a specific immune response. Tumor associated macrophages (TAMs) represent the main immune population of the tumor microenvironment with a controversial influence on the prognosis. In this study, the level, phenotype, and spatial distribution of TAMs were evaluated, and the expression of TAM-associated markers was compared in HPV positive (HPV+) and HPV negative (HPV−) tumors. Seventy-three formalin and embedded in paraffin (FFPE) tumor specimens were examined using multispectral immunohistochemistry for the detection of TAM subpopulations in the tumor parenchyma and stroma. Moreover, the mRNA expression of TAM markers was evaluated using RT-qPCR. Results were compared with respect to tumor etiology, and the prognostic significance was evaluated. In HPV− tumors, we observed more pro-tumorigenic M2 in the stroma and a non-macrophage arginase 1 (ARG1)-expressing population in both compartments. Moreover, higher mRNA expression of M2 markers—cluster of differentiation 163 (CD163), ARG1, and prostaglandin-endoperoxide synthase 2 (PTGS2)—was detected in HPV− patients, and of M1 marker nitric oxide synthase 2 (NOS2) in HPV+ group. The expression of ARG1 mRNA was revealed as a negative prognostic factor for overall survival of HNSCC patients.

The paper starts from a consideration of two variant critiques of structuralism: in 1935, Marxistoriented historians polemicized with Mukařovský’s concept of the development of literature; in 1951, Mukařovský himself presented a critique based in the ideology of the totalitarian regime. A comparison between the state of the scholarly debate in the 1930s and the latter event allows us to develop some more general characteristics of the ingerence of power ideology into scientific discourse and its paradigm. The focus of our inquiry is the question as to what allowed Mukařovský to perform this radical turn and adopt an ideological doctrine. What we find is that a link between the topics pursued in our argument — i.e. between the structuralist theory, an ideology in the service of power and the deformation of the scholarly paradigm — is provided by the position of the individual in history, in both artistic and social discourse. The gist of the matter is that with the weakening or even elimination of the individual’s role disappears the ethical dimension of the human relating to the world, disappears individual responsibility as an essential, irreducible part of one’s identity.

The human papillomavirus (HPV) integration, the critical step in viral carcinogenesis, most frequently occurs in the E2 gene, which results in its inactivation and in an increase of E6/E7 transcription. However, in a substantial number of tumors, the virus is present in an extrachromosomal form. For those tumors, the transformation mechanisms are not fully elucidated. Here we evaluated the possible mechanism of inactivating the E2 without interruption of the gene, methylation or mutation of the E2 binding sites (E2BSs) in HPV16-positive tonsillar tumors by next-generation and Sanger sequencing. Viral genome status was analyzed by the amplification of papillomavirus oncogene transcripts assay (APOT) and mRNA mapping, and expression of viral oncogenes was performed by qPCR. The methylation of E2BSs was significantly higher in tumors with an integrated, in comparison to extrachromosomal, form of the viral genome. No mutations were detected in the E2BSs. The viral oncogenes were equally expressed in samples with an integrated and extrachromosomal form of the virus. Only the nucleotide variants were identified in the E2 gene. No proposed mechanism of E2 inactivation was confirmed in tonsillar tumors with an extrachromosomal form of the HPV genome. The expression of E6/E7 genes seems to be sufficient to initiate and maintain the carcinogenic process

The article highlights the cervical cancer screening in the Czech Republic. It states the onset of organized screening program that were announced by the Czech Ministry of Health (MH) in February 2008 which include the definition of a new screening code for cervicovaginal screening smear. It mentions the available vaccines in the country namely Silgard and Cervarix.