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The contraindications include a large goiter, previous neck surgery, history of thyroiditis, lymphadenopathy of the neck, advanced thyroid cancer. Relative contraindications include previous radiotherapy to the throat, Grave´s disease, and obese patients with a short neck. Intraoperative findings may result in a modification of the procedure. TOETVA is an excellent choice for selected patients who want to avoid a neck incision. This method provides the benefit of using standard endoscopic instruments and techniques. It is a safe and effective procedure that provides a good cosmetic result and considerable comfort in terms of clarity of the operating field by zooming in with an endoscopic camera. Longer operating times become shorter due to the learning curve effect.

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.

144 patients with 148 axillary dissections operated in asingle 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.

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).

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.

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.

Differentiated thyroid cancer (DTC) has agood prognosis and low mortality despite its growing incidence, which is particularly the case of microcarcinomas (T1a – up to 10 mm).

Retrospective analysis of overall survival of patients in the group of thyroid gland surgeries for differentiated forms of microcarcinoma in the period of 2006-2015 up to the present. An overview of contemporary therapeutic methods is included.

Thyroid cancer was detected in 144 cases out of the total of 1820 patients with thyreopathy undergoing surgery (8%); DTC microcarcinoma was detected in 65 cases (45.1%) of all carcinomas. The papillary form was diagnosed in 59 cases (51.8% of all papillary cases), and the follicular form was found in 6 cases (37.5% of all follicular cases). Two cases of Hürthle cells cancer were found, both in astage higher than T1. Overall 10-year survival of carcinomas &gt;T1 was 86%, reaching 90% in the microcarcinoma group (Gehan Wilcoxon test p=0.10675).

Differentiated microcarcinoma shows avery good overall survival. Provided that other criteria are satisfied, particularly unifocal occurrence without spreading through the gland casing and without any suspicion of nodal involvement, hemithyroidectomy is considered to be asufficient procedure or the method of choice, respectively.

Differentiated microcarcinoma shows a very good overall survival. Provided that other criteria are satisfied, particularly unifocal occurrence without spreading through the gland casing and without any suspicion of nodal involvement, hemithyroidectomy is considered to be a sufficient procedure or the method of choice, respectively.

Retrosternal goiter is an enlarged thyroid mass of which more than 50% is located in the mediastinum. MAPK inhibitor Indications for surgery of retrosternal goiter include ineffective pharmacological treatment, mechanical syndrome, suspicion of malignancy and thyrotoxicosis. Computed tomography is the gold standard in the diagnosis of retrosternal goiter. The surgery can be performed from acervical incision, using sternotomy or thoracotomy.

The aim of our study was to evaluate our own group of retrosternal goiters. In 2011-2019, 1739 thyroid surgeries were performed at the 3rd Department of Surgery, University Hospital Motol, Prague. We retrospectively followed the age, gender, retrosternal spreading, postoperative complications (especially hypocalcemia, bleeding and dysphonia) and the definitive histological finding.

Retrosternal goiters were presented in 202 (19.2%) of the total of 1739 thyroid surgery patients. Sternotomy was performed in 31 patients. Women (61%) predominated over men (39%). The mean operating timeality, higher blood loss and longer hospital stay; nevertheless, it does not increase the risk of long-term postoperative complications. Procedures requiring sternotomy or thoracotomy should be done at centers experienced in these types of procedures.

Papillary thyroid cancer (PTC), especially micropapillary variant (MPTC), is the most common thyroid malignancy. Biological behavior is not aggressive and the patientsprognosis is satisfactory. The objective of our comparative retrospective study was to evaluate whether the incidence is rising in the Region of Zlín and if less extensive approach was adopted by Czech endocrinologists.

We compared 2 groups from years 2005-2008 and 2014-2018. The incidence of thyroid cancer, the PTC and the MPTC, the extent of the surgery and the lymphadenectomy, number of removed lymph nodes and the number of positive lymph nodes were observed.

We gathered 1353 patients in group 1. We found 220 malignancies (16.3%), 180 (81.8%) were PTC with MPTC variant in 44.4% (80 patients). All patients underwent atotal thyroidectomy. We made 18 central and 10 lateral lymphadenectomies, 280 lymph nodes were collected with meta-stasis in 29,3%. In group 2 with 1569 patients we found 318 (20.3%) carcinomas, PTC in 302 (94.6%) cases. The MPTC accounted for 215 (67.4%) cases. 10 patients with MPTC underwent hemithyroidectomy only. Numbers of central and lateral lymphadenectomies rose to 52 and 24 respectively. We gathered 376 lymph nodes with proven metastasis in 44.4% of these nodes.

Both, the incidence and the frequency of PTC and MPTC are rising in our region. However, the number of less invasive procedures is not increasing significantly despite representing asufficient way of treatment. We need wider adoption of these evidence-based recommendations by indicating endocrinologists in the Czech Republic.

Both, the incidence and the frequency of PTC and MPTC are rising in our region. However, the number of less invasive procedures is not increasing significantly despite representing a sufficient way of treatment. We need wider adoption of these evidence-based recommendations by indicating endocrinologists in the Czech Republic.Thyroid cancer is the most common endocrine malignancy, the treatment is multidisciplinary and multimodal. Thyroid tumors are heterogeneous in origin, morphology, biological behavior and therapeutic options. Substantial advances in diagnostic methods for thyroid cancer have led to detection of earlier stages of the disease that have the possibility of targeted therapeutic treatment and improved patient prognosis. In addition to surgical treatment, hormonal suppression and radioiodine therapy, targeted molecular therapy, which requires genetic testing, has come to the fore in recent decades. In the summary, we present an overview of current knowledge on the genetic background of individual types of thyroid carcinomas and the possibilities of therapeuticintervention.The authors present an outline of the development of thyroid surgery from the ancient times to the beginning of the 20th century, when the defini-tive surgical technique have been developed and the physiologic and pathopfysiologic consequences of thyroid resections have been described. The key representatives, as well as the contribution of the most influential czech surgeons are mentioned.MAIT cells are a separate cell population differentiating in the thymus. They are mostly present in the peripheral blood, liver, intestine, and lungs, less often in other tissues, and infrequently in the lymph nodes. The presentation molecules for MAIT cells are MR1 proteins. They are evolutionarily conserved and non-polymorphic, resemble class I HLA molecules, and are expressed by all cell types. They present bacterial and yeast vitamin metabolites which arise during the synthesis of vitamin B2. The effector functions of MAIT cells are promoted through cytokine synthesis. They also act cytotoxically, directly killing infected or tumour cells. MAIT cells may also play a role in pathological processes. Their involvement in the development of rheumatoid arthritis, systemic lupus erythematosus, autoimmune diabetes mellitus, Crohn’s disease, and bronchial asthma has been demonstrated. In practical terms, MAIT cells are very sensitive to therapeutic doses of glucocorticoids. Treatment of patients with BA or chronic obstructive pulmonary disease with glucocorticoids increases their susceptibility to pneumonia, especially when caused by Streptococcus pneumoniae.Despite health literacy being an important assumption for maintaining a healthy population, there are not many studies focusing on health literacy concerning HIV infection among adolescents in the Czech Republic and among Czech authors. In contrast, there are plenty of scientific papers and researches focused on awareness and susceptibility of adolescents in most affected regions of the world, Sub-Saharan Africa and India particularly. Adolescents belong to a high-risk group of the population. Education is one of the most important factors that influence the level of risk of HIV infection. However, increasing health literacy is only implemented in some types of secondary schools in the Czech Republic. The goal of this study is to verify health literacy concerning HIV infection among adolescents in two types of Czech secondary schools (grammar school and vocational school) in two Czech regional cities (Plzeň and České Budějovice). To determine the level of health literacy of HIV infection, a que

Pharmacotherapy in geriatric patients is challenging due to frequent multimorbidity, polypharmacy, increased risk of adverse drug effects, and altered pharmacokinetics and pharmacodynamics associated with aging. Therapeutic drug monitoring (TDM) is a dosing individualisation strategy that helps to minimise toxicity whilst maximising the efficacy of the agent. Routine TDM of vancomycin is recommended in clinical practice in order to optimise drug exposure. Guidelines by Rybak et al. from 2009 on vancomycin TDM promote monitoring of trough concentrations only, with higher target ranges for dosage adjustment. The aim of the study was to evaluate the practice of vancomycin TDM in geriatric (aged 65 ys) and non-geriatric patients, compare two methods of dosing adjustment (trough-based vs. AUC-based approach), and finally determine covariates enabling to choose an appropriate initial vancomycin maintenance dosing regimen in geriatric patients. Methods A retrospective analysis of all vancomycin plasma concentrations determined during a five year period in patients treated with IV vancomycin in the University Hospital Olomouc was performed.