Papers by Silvie Bělašková
Journal of Small Animal Practice, 2017
Objectives-Although difficult to clinically diagnose, presumptive meningomyelitis of unknown orig... more Objectives-Although difficult to clinically diagnose, presumptive meningomyelitis of unknown origin (MMUO) is an important differential diagnosis for dogs presenting with signs of spinal cord dysfunction. The aim of this study was to evaluate clinical presentation, diagnostic findings and long-term outcome for dogs clinically diagnosed with MMUO. Methods-Medical records were reviewed for dogs diagnosed with presumptive MMUO between 2006 and 2015. Results-Twenty-one dogs met the inclusion criteria. The majority of dogs presented with an acute (43%) or chronic (52%) onset of neurological signs. Ambulatory paresis was the most common neurological presentation (67%). Neurological examination most commonly revealed a T3-L3 myelopathy, and spinal hyperaesthesia was a common finding (71%). A spinal cord lesion was visible in 90% of cases on MR imaging. Lesions were typically extensive, ill-defined, hyperintense on T2-weighted and isointense on T1-weighted images. Eighteen lesions (86%) showed parenchymal contrast enhancement and 17 lesions (81%) showed contrast enhancement of overlying meninges. All dogs were treated with immunosuppressive doses of glucocorticosteroids, sometimes combined with cytosine arabinoside. At time of data capture, 10/21 dogs (48%) had died or been euthanized because of MMUO. Overall median survival time was 669 days. Impact-MMUO should be considered in the differential diagnosis of dogs presenting with an acute or chronic, progressive, and potentially painful myelopathy. MRI features can possible help to distinguish presumptive MMUO from other more common spinal diseases. Overall, long-term survival is guarded, approximately 50% of dogs will die or be euthanized because of MMUO regardless of immunosuppressive treatment.
medRxiv (Cold Spring Harbor Laboratory), Aug 1, 2021
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Diagnostics
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Science Translational Medicine, May 5, 2021
We report reversal of the FGFR3-related skeletal dysplasia by RNA aptamer designed to neutralize ... more We report reversal of the FGFR3-related skeletal dysplasia by RNA aptamer designed to neutralize FGFR3 ligand FGF2.
Journal of Cardiovascular Electrophysiology, Mar 2, 2020
Bipolar ablation with contact force sensing of swine ventricles shows improved acute lesion featu... more Bipolar ablation with contact force sensing of swine ventricles shows improved acute lesion features compared to sequential unipolar ablation.
Biomedical Papers of the Faculty of Medicine of Palacký University, Olomouc Czech Republic, Dec 12, 2022
Backround. The goal of assisted reproduction is for a couple treated with IVF techniques to end t... more Backround. The goal of assisted reproduction is for a couple treated with IVF techniques to end the treatment by giving birth to a healthy baby. A neccessary presumption for success is the identification of the best embryo with high implantation and developmental potential. One option is to select an euploid embryo by invasive preimplantaion genetic testing for aneuploidy (PGT-A) or it is possible to select the best embryo by non-invasive time-lapse monitoring (TLM), specifically based on morphokinetic parameters and morphological markers that are able to identify an embryo with high developmental potential. Materials and Methods. The study involved a total of 1060 embryos (585 euploid and 475 aneuploid embryos after PGT-A) with good morphology from 329 patients in the period 01/2016-10/2021. All embryos were cultured in a timelapse incubator, trophectoderm (TE) cells biopsies for PGT-A examination were performed on day 5 (D5) or day 6 (D6) of culture. During the study period, 225 frozen embryo transfers (FET) of one euploid embryo were performed. Based on the treatment outcome, the embryos were divided into 2 groups-euploid embryos, which led to the birth of a healthy child, and euploid embryos that did not show fetal heartbeat (FHB) after FET. Results. Based on the statistical analysis of the embryos without implantation and the embryos with live birth, it is clear that the morphokinetic parameters t5 (time of division into 5 cells) and tSB (time of start of blastulation) are significantly different. Conclusion. The results suggest that of the morphokinetic parameters tSB and t5 are predictive indicators for selecting an embryo with high developmental potential and with a high probability of achieving the birth of a healthy child.
Topics in Companion Animal Medicine, Aug 1, 2021
Canine non-infectious inflammatory meningoencephalomyelitis is termed meningoencephalomyelitis of... more Canine non-infectious inflammatory meningoencephalomyelitis is termed meningoencephalomyelitis of unknown origin (MUO) and may affect dogs of every breed at any age. Treatment with immunosuppressive medication, the survival time based on MRI, and cerebrospinal fluid (CSF) findings has been widely reported; however, these studies only included a small number of patients, or they are summaries from the literature. Therefore, the aim of this study was to compare the clinical presentation, diagnostic findings, treatment protocol and long-term survival time in many dogs diagnosed with MUO in one clinic with previously published studies. One hundred eighty-two dogs met the inclusion criteria. Age, sex, duration of clinical signs before diagnosis, presence of neurological signs, MRI and CSF analysis were similar to those in previous reports. Our study revealed that dogs with a brainstem lesion have a 60% lower chance of death before one year than dogs with multifocal brain lesions. A total of 55.56% of treated dogs survived for more than 1 year, and 10.55% survived for more than 5 years since diagnosis. The median survival time for all dogs was 540 days. Our findings support glucocorticosteroid monotherapy as a viable treatment option for dogs with MUO.
Physiological Research, Oct 31, 2022
Medical cannabis has recently been legalized in many countries, and it is currently prescribed wi... more Medical cannabis has recently been legalized in many countries, and it is currently prescribed with increasing frequency, particularly for treatment of chronic pain resistant to conventional therapy. The psychoactive substance delta-9-tetrahydrocannabinol (THC) contained in cannabis may affect driving abilities. Therefore, the aims of this study (open-label, monocentric, nonrandomized) were to evaluate blood and saliva concentrations of THC after oral administration of medical cannabis and to assess the time needed for THC levels to decline below a value ensuring legal driving. The study involved 20 patients with documented chronic pain using long-term medical cannabis therapy. They were divided into two groups and treated with two different doses of cannabis in the form of gelatin capsules (62.5 mg or 125 mg). In all patients, the amount of THC was assessed in saliva and in blood at pre-defined time intervals before and after administration. THC levels in saliva were detected at zero in all subjects following administration of both doses at all-time intervals after administration. Assessment of THC levels in blood, however, showed positive findings in one subject 9 h after administration of the lower dose and in one patient who had been given a higher dose 7 h after administration. Our finding suggested that for an unaffected ability to drive, at least 9-10 h should elapse from the last cannabis use.
Journal of the American College of Cardiology, Mar 1, 2022
Alzheimers & Dementia, Jul 1, 2018
and over, fifty-four participants aged 60 to over under 70 were included in the study. Subjects w... more and over, fifty-four participants aged 60 to over under 70 were included in the study. Subjects with dementia or major mental disorders were excluded. We assessed cognitive functions using the Korean version of the Consortium to Establish a Registry for Alzheimer Disease neuropsychological battery (CERAD-NP), digit span forward (DS-F), digit span backward (DS-B) and the Frontal Assessment Battery (FAB) within 24 hours after quitting. The score of 1 or more standard deviation below appropriate norms of each test was classified as impairment. Results: All participants were male, and the mean age of each group was 45.962.0 years, 54.263.1 years and 64.662.8 years. There was no difference of the daily smoking amount (mean number 1⁄4 21.668.2) and urinary cotinine levels at the beginning of smoking cessation (mean 1⁄4 3491.2 6 2743.4 ng/ml) between the age groups. Impairment of the DS-B (18.2%) and constructional recall (18.2%) were the most frequent, followed by the impairment of word list recall (12.2%), constructional praxis (11.5%), and verbal fluency (10.7%). Among them, abnormalities of constructional recall, word list recall, and constructional praxis were different according to the age group and these impairments were more frequent as the age increased. Digit backward abnormality was seen in all age group without group differences. Conclusions:The effect of varenicline on the nicotine-withdrawal cognitive impairment may vary depending on subgroups, such as age. The future research is needed to understand the underlying mechanisms and improve the nicotine withdrawal-related cognitive deficits in treatment-seeking smokers of various age groups.
European Heart Journal, Aug 1, 2018
Neurology, Apr 9, 2019
Objective: The primary objective of this study was to describe characteristics of patients diagno... more Objective: The primary objective of this study was to describe characteristics of patients diagnosed with Cluster headache (CH) at our institution and review the appropriateness of their management. Background: Cluster headache (CH) is the most common trigeminal autonomic cephalalgia, an extremely debilitating primary headache disorder that is often sub optimally treated. Patients usually present with excruciating unilateral headaches with autonomic symptoms. Design/Methods: This retrospective analysis used the Leaf research data base to analyze CH patients (using ICD 9 and ICD 10 codes) presenting to University of Washington Medical Center. We analyzed the treatments used in this group of patients based on American Headache Society and European Federation of Neurologic Societies Recommendations for Treatment of Cluster Headache. Results: Of 935 CH patients, the majority were male 519 (55%). Episodic cluster was present in 72% and chronic cluster in 28%. Only 19.3 % were older than 65 years. The most commonly prescribed drug classes for CH patients included: opioids (47.3%), triptans (5HT-1 B and 5HT-1D agonists) (28.9%), anticonvulsants (13.6%), corticosteroids (11%), verapamil (10%), antidepressants (8%), benzodiazepines (8%), melatonin (6.4%), NSAIDs (4%), lithium (0.6%), and occipital nerve blocks (0.2%). We were not able to access data on high-flow oxygen therapy use. Only 18.5 % of CH patients received recommended acute treatments prior to referral, and 22.9% of patient received preventive CH treatment. Conclusions: Evidence-based guidelines are underutilized in CH Treatment, this leads to suboptimal management. Treatment patterns indicate frequent use of opiates and unsupported CH treatments with less frequent use of recommended cluster headache treatments. This supports significant need for widespread education regarding current CH guidelines to providers likely to encounter and prescribe for this headache. Disclosure: Dr. Mannava has nothing to disclose. Dr. Wax has nothing to disclose. Dr. Krashin has nothing to disclose. Dr. Kanter has nothing to disclose. Dr. Belaskova has nothing to disclose. Dr. Murinova has nothing to disclose.
European Heart Journal, Oct 1, 2019
Aims: Despite all this technical progress, VT recurrence after unipolar ablation remains relative... more Aims: Despite all this technical progress, VT recurrence after unipolar ablation remains relatively high (12-47%). Bipolar ablation has been proposed as an appealing solution, which may overcome boundaries associated with unipolar ablation settings. Therefore, we have proposed an animal study to compare bipolar (BPA) vs sequential unipolar ablation (UPA) using a contact-force sensing technology on both catheters. Methods: 20 large white female pigs (6 months-old, 60-70kg) underwent multiple RF ablations (30W, 60s, 30ml/min irrigation) on ventricular myocardium, from epicardial and endocardial sides. After the procedure, the animal underwent euthanasia, cardioplegia and organ excision. The hearts were fixed and underwent high-resolution cardiac MRI. Each lesion was characterized primarily in terms of volume, depth, width and transmurality. Results: We evaluated 35 lesions across the intraventricular septum. No difference in volume, linear dimensions and impedance drop was observed in this area, between the two ablation settings. However, for the generation of unipolar lesions, twice the ablation time was needed. Transmurality of the lesions shows a trend in favor of BPA. We then analyzed 73 lesions from the endocardial side and 34 from the epicardial one of the ventricular free walls. Lesion transmurality was found remarkably improved in BPA (p=0.030, OR 23.73 [4.71,11.96]). Ventricular BPA lesions were significantly deeper on the epicardial side (p<0.0001) Conclusion: BPA is more likely to create transmural lesions in the ventricle, when compared to UPA. Half the time is needed for the creation of comparably deep and large lesions. BPA is specifically more effective in creating epicardial lesions.
Alzheimers & Dementia, Feb 24, 2023
The choroid plexus (ChP) produces and is bathed in the cerebrospinal fluid (CSF), which in aging ... more The choroid plexus (ChP) produces and is bathed in the cerebrospinal fluid (CSF), which in aging and Alzheimer's disease (AD) shows extensive proteomic alterations including evidence of inflammation. Considering inflammation hampers functions of the involved tissues, the CSF abnormalities reported in these conditions are suggestive of ChP injury. Indeed, several studies document ChP damage in aging and AD, which nevertheless remains to be systematically characterized. We here report that the changes elicited in the CSF by AD are consistent with a perturbed aging process and accompanied by aberrant accumulation of inflammatory signals and metabolically active proteins in the ChP. Magnetic resonance imaging (MRI) imaging shows that these molecular aberrancies correspond to significant remodeling of ChP in AD, which correlates with aging and cognitive decline. Collectively, our preliminary post‐mortem and in vivo findings reveal a repertoire of ChP pathologies indicative of its dysfunction and involvement in the pathogenesis of AD.Highlights Cerebrospinal fluid changes associated with aging are perturbed in Alzheimer's disease Paradoxically, in Alzheimer's disease, the choroid plexus exhibits increased cytokine levels without evidence of inflammatory activation or infiltrates In Alzheimer's disease, increased choroid plexus volumes correlate with age and cognitive performance
Journal of stroke and cerebrovascular diseases, Sep 1, 2020
The aim of the study was to compare the assessment of ischemic changes by expert reading and avai... more The aim of the study was to compare the assessment of ischemic changes by expert reading and available automated software for non-contrast CT (NCCT) and CT perfusion on baseline multimodal imaging and demonstrate the accuracy for the final infarct prediction. Methods: Early ischemic changes were measured by ASPECTS on the baseline neuroimaging of consecutive patients with anterior circulation ischemic stroke. The presence of early ischemic changes was assessed a) on NCCT by two experienced raters, b) on NCCT by e-ASPECTS, and c) visually on derived CT perfusion maps (CBF<30%, Tmax>10s). Accuracy was calculated by comparing presence of final ischemic changes on 24-hour follow-up for each ASPECTS region and expressed as sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). The subanalysis for patients with successful recanalization was conducted. Results: Of 263 patients, 81 fulfilled inclusion criteria. Median baseline ASPECTS was 9 for all tested modalities.
Global heart, Dec 1, 2018
Introduction: Acute rheumatic fever (ARF) is a leading disease of cardiovascular disease among ch... more Introduction: Acute rheumatic fever (ARF) is a leading disease of cardiovascular disease among children, adolescents and young people of the Kyrgyz Republic. Kyrgyz-Japanese international scientific-practical alpine expedition was held in 2014-2017. Objectives: The aimed at providing medical care to the alpine valley Alay and Aksay-Naryn regions (3600-4200 m above sea level), where carried out an in-depth survey of more than 5000 residents in the highlands aged 1 to 78 years, including 1600 children from 1year to 17 years. Methods: Rapid antigen detection test for group A streptococcus (GAS) and instrumental study (electrocardiography-ECG, 2-D echocardiography color) was made. The diagnosis of ARF was verified according to the WHO diagnostic criteria in the modification of Jones' criteria, American Heart Association (AHA, 1999) and the World Heart Federation (WHF, 2008). Results: In 86 % of the surveyed contingent revealed the presence of chronic foci of infection (oropharyngeal, nasopharyngeal): tonsillitis, pharyngitis, dental caries, sinusitis and otitis. In 49 % of surveyed adults' revealed carriage of pathogenic GAS and 44.7 % of children are positive of the total number of 1600 children tested for streptococcus. 58% of streptococcus-positive residents have articular syndrome of varying severity. The effect of various factors on the risk of developing rheumatic fever was assessed by the odds ratio (OR) with a 95% confidence interval (CI) calculation, i.e. in relation to events (i.e. presence / absence of a risk factor) in groups of patients with / without RF. The most significant increase in the risk of developing rheumatic fever was noted in the presence of the patient's dysplasia syndrome of connective tissue of the heart (SCTD). Thus, in the presence of CTD syndrome, the risk of developing ARF increased more than 7-fold (OR-7.2, 95% CI 4.32-58.4, p <0.005). A significant increase in the risk of developing RF was noted in patients with tonsillopharyngitis. As the results of our study indicate, the presence of tonsillopharyngitis was associated with increase in the risk of developing RF (OR, 5.2, 95% CI 3.22-11.23, p <0.01). Conclusion: Thus, in the patients examined by us, the clinical manifestations and course of RF were characterized by a high incidence of the latent form of the disease. At the same time, the diagnosis of RHD was verified for the first time, using EchoCG diagnostics.
Journal of stroke and cerebrovascular diseases, Feb 1, 2020
Background: It is not known if risk factors differ between ischemic stroke (IS) subtypes in Centr... more Background: It is not known if risk factors differ between ischemic stroke (IS) subtypes in Central and Eastern Europe. Aims: We performed a community-based analysis of risk factors in patients admitted with IS over a 1 year period in Brno, the second largest city in the Czech Republic (CR). Methods: Based on the National Register of Hospitalized Patients, all patients with IS admitted in Brno in 2011 were identified. Comprehensive discharge summaries from hospital admissions were collected and reviewed. IS subtype and relevant risk factors were ascertained for all patients. The age-and sex-adjusted association of risk factors with IS subtypes was determined. Results: Overall, 682 patients with IS were admitted in 2011 to Brno hospitals. The distribution of IS subtypes was: 35% cardioembolism, 28% largeartery atherosclerosis, 23% small-artery occlusion, 7% stroke of undetermined etiology, 7% stroke of other determined etiology. Several of the risk factors showed high prevalence in the overall sample À e.g. hypertension (84%) and hyperlipidemia (61%). Cardioembolism as compared to other subtypes was positively associated with a history of myocardial infarction, cardiac failure, and atrial fibrillation. Smallartery occlusion was positively associated with history of dementia. No significant association was found between IS subtypes and history of IS, hypertension, diabetes, obesity, alcohol abuse or smoking. Conclusions: We found high frequency of stroke risk factors in all IS subtypes. These findings have implications for stroke prevention strategies in the CR and across Central Europe.
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Papers by Silvie Bělašková