Since mammographic screening programmes were initiated, the spectrum of breast cancer has changed in terms of impalpable tumours, thus causing the development of new localisation methods, including magnetic markers. We offer herein an up-to-date review focused on two magnetic markers (Magseed, MaMaLoc) currently used in breast cancer surgery for the localisation of breast tumours or pathological axillary nodes.<br /> Magnetic marker localisation presents a safe and reliable method for breast tumour marking. Four currently available prospective studies demonstrate that the Magseed system has a negative margin rate and a successful localisation rate, both of which are comparable to standard marking systems used in breast cancer surgery. The main benefits of magnetic markers are that they require no radiation safety measures, and they offer the possibility of longer deployment times, thus simplifying surgery scheduling. The most important drawbacks are cost of the system, depth limitation and need for frequent probe recalibration.

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a,b , Ales Foltys a,b , Anton Pelikan a,b,c,d , Jan Roman a,bBackground. Non-alcoholic fatty liver disease (NAFLD), often associated with obesity and metabolic syndrome, manifests itself as steatosis, hepatic fibrosis, cirrhosis, or even end-stage liver disease. NAFLD causes inflammation, insulin resistance and cardiovascular complications. The current study aimed to evaluate the beneficial effects of bariatric surgery on biochemical parameters of hepatic functions in obese patients by comparing them before and one-year after the surgery. Methods. A total of 72 morbidly obese patients underwent bariatric surgery between 2016 and 2018. The incidence of diabetes mellitus in this group was 29%, median body weight was 124.5 kg (109.0-140.0) and mean body mass index (BMI) was 44.38 ± 6.770 kg/m 2 . The used surgical procedures included gastric bypass, sleeve gastrectomy, laparoscopic gastric plication, and single anastomosis duodeno-ileal bypass-sleeve gastrectomy. Biochemical parameters including ALT/AST ratio (AAR), NAFLD fibrosis score (NFS), hepatic fibrosis index (FIB-4) and Fatty Liver Index (FLI) were evaluated in all patients at the time of surgery and one year after the intervention. Results. Significant improvement after the intervention was observed in 64 patients. A significant reduction in body weight (P<0.0001), waist circumference (P<0.0001), and body mass index (P<0.0001) were observed. NAFLD liver fibrosis index changed significantly (P<0.0001), suggesting a trend of improvement from advanced fibrosis towards stages 0-2. The FIB-4 fibrosis index indicated significant improvement (P=0.0136). Besides, a significant decline in hepatic steatosis (P<0.0001) was observed after bariatric surgery as compared to the pre-surgery fatty liver conditions. Conclusion. Among the strategies to overcome NAFLD-associated impediments, bariatric surgery can be considered effective in reducing obesity and metabolic co-morbidities. Trial Registration: ClinicalTrials.gov (NCT04569396)

Incidence zhoubných novotvarů v populaci stále narůstá a odhaduje se že, každý třetí člověk onemocní nějakou formou rakoviny. S narůstajícím věkem populace přibývá malignit mezi seniory, což s sebou přináší nové výzvy, zvláště s ohledem na vyšší incidence kardiovaskulárních onemocnění (KVO) u této populace pacientů. Zároveň se zlepšují léčebné možnosti a prodlužuje se celkové přežívání pacientů a rakovina se stává v mnoha případech chronickým onemocněním. Častěji se budeme setkávat s pacienty, u kterých v důsledku protinádorové léčby dochází k rozvoji nového KVO nebo ke zhoršení stávajícího onemocnění. Mezi kardiovaskulární komplikace samotných nádorů můžeme řadit lokální mechanické působení nádorů v mediastinu (útlak, výpotky), zvýšené riziko tromboembolické nemoci (TEN), arytmie či např. tzv. karcinoidové srdce. Kardiotoxicita medikamentózní léčby nádorů se projevuje velmi rozmanitě. Nejobávanějším projevem je rozvoj chronického srdečního selhání (CHSS), ať již přímým vlivem antracyklinů či antiHER2 terapie, nebo jako důsledek jiných negativních vlivů terapie na kardiovaskulární aparát. Mezi významné rizikové faktory kardiotoxicity patří léčbou indukovaná či akcelerovaná arteriální hypertenze (AH). Mezi léky, které mohou vést k rozvoji/akceleraci AH, patří inhibitory angiogeneze (bevacizumab, aflibercept, ramucirumab, multikinázové inhibitory) i klasická cytostatika (alkylační cytostatika, cisplatina). Dále negativně působí kortikoidy a některá analgetika. Mezi další rizikové faktory CHSS patří fibrilace síní (AF) jako projev nejčastější arytmie u onkologických pacientů. K rozvoji AF přispívá sekundární ischemie myokardu při anémii, metabolické odchylky způsobené vlastním onemocněním či léčbou, tromboembolická nemoc a uplatňuje se i přímé kardiotoxické působení onkologické léčby (cisplatina, ifosfamid, taxany, gemcitabin, 5-fluorouracil, etoposid). V neposlední řadě se na rozvoji CHSS podílí i ischemická choroba srdce, která je závažnou pozdní komplikací týkající se zvláště dlouhodobě přežívajících pacientů s nádory typickými pro mladší věk (nádory varlat, nádory dětského věku, hematologické malignity) nebo i pacientek po léčbě karcinomu prsu. K rozvoji ICHS přispívá i radioterapie nebo rozvoj dyslipidemie u pacientek na terapii inhibitory aromatáz nebo alkylačními cytostatiky navozená endotelová dysfunkce. Pacienti dlouhodobě přežívající onkologické onemocnění jsou významnou rizikovou skupinou pro rozvoj kardiovaskulárních onemocnění. Je třeba myslet na to, že k rozvoji "typických" KVO může docházet ve výrazně mladším věku ve srovnání s normální populací a u vysoce rizikových pacientů je nutné KVO aktivně vyhledávat. Klíčová slova: antracykliny -fibrilace síní -ICHS -kardiotoxicita -srdeční selhání -TEN Cardiovascular complications of cancers and anti-cancer therapy SummaryIn our aging population the incidence of cancer is increasing in the elderly. We are thus facing a new challenge especially considering incidence of cardiovascular diseases (CVD) in this patients' population. Overall survival of cancer patie...

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The authors report on the treatment of lower-pole caliceal nephrolithiasis with extracorporeal shockwave lithotripsy (SWL) using the Czech-made Medilit M-5 lithotripter. In 310 patients, they have performed 452 treatments and evaluated the results 3 months after the last session using plain radiographs and ultrasound examination. The effectiveness of treatment and the success rate of SWL decreased with increasing size of stones: with stones >20 mm, it declined to 30%. This poor success rate was attributable not only to the size of the concrement, but also to its location in a lower calix, which is unfavorable for the passage of fragments. For big lower-pole caliceal stones (>20 mm in the longest diameter), the authors recommend percutaneous nephrolithotomy as the primary management method, the effectiveness of which does not depend on the size of the stone. The success rate achieved in treating the lower-pole caliceal lithiasis using the Medilit M-5 machine was 61.3%, similar to that achieved with other lithotripters.

Introduction: The aim of this pilot retrospective study is to evaluate the complication rate in patients after axillary dissection comparing preparation with harmonic scalpel vs traditional ligation technique, and to analyse risk factors for complications occurrence. Methods: 144 patients with 148 axillary dissections operated in a single centre between January 2014 and 2019 were included into the study. Axillary dissection was performed using harmonic scalpel in 73 and absorbable ligations in 70 cases. Results: Seroma formation was observed in 41 patients (56.2%) in the harmonic scalpel group and in 21 patients (30.0%) in the ligations group (p=0.003). The mean period from the surgery to drain removal was 4.0 days in the harmonic scalpel group and 3.0 days in the ligations group (p<0.001). The mean amount of the drained fluid after mastectomy was 300.9 ml in the harmonic scalpel group and 168.7 ml in the ligations group (p=0.005); after breast conserving surgery, it was 241.9 ml and 107.4 ml, respectively (p =0.023). Conclusion: In comparison with traditional ligations with absorbable material, axillary dissection using harmonic scalpel significantly increases the risk of postoperative seroma formation, prolongs the time from the surgery to drain removal, and increases the amount of drained fluid.ut any suspicion of nodal involvement, hemithyroidectomy is considered to be a sufficient procedure or the method of choice, respectively.

Background: In 2016, more than 1.9 billion adult populations were overweight, 650 million of them were obese, which represents around 13% of the world's adult population. Liver steatosis has become the most common chronic liver disease in developed countries. In most cases, non-alcoholic fatty liver disease (NAFLD) is a benign and reversible liver disorder. Under certain circumstances, the disease may result through the image of non-alcoholic steatohepatitis (NASH) and hepatic fibrosis to liver cirrhosis with all known negative consequences, until formation of hepatocellular carcinoma (HCC). Methods: We searched from the Pubmed, Google Scholar and Research gate database and looked for keywords NAFLD, steatohepatitis, steatohepatitic variant of HCC. Results: The pathogenesis of NAFLD and metabolic syndrome seems to have common pathophysiological mechanisms. Although liver biopsy remains the gold standard for NAFLD diagnosis, it seems that new diagnostic procedures and scoring systems are emerging that could non-invasively distinguish simple steatosis from NASH. Conclusion: A higher number of metabolic syndrome risk factors have been registered in patients with steatohepatitic HCC variant. HCC patients with clinical symptoms have a very poor prognosis (median 5-year overall survival is between 0-10%); on the other hand, patients with asymptomatic HCC detected by screening show a higher survival rate, with a total 5-year survival of more than 50 % due to radical treatment. Simple and unassuming diagnostic methods can be used in a wide range of patients, thus systematically preventing the development of diseases and related disorders. Early diagnosis and risk stratification are essential for effective treatment management. We searched from the Pubmed, Google Scholar and Research gate database and looked for keywords NAFLD, steatohepatitis, steatohepatitic variant of HCC. Search strategy and selection criteria The global prevalence of obesity nearly tripled between 1975 and 2016. As the incidence of obesity in the population increases, the number of patients with liver steatosis also increases.