Science and research

Scientific outputs

VFN has been among the largest research organizations managed by the Ministry of Health of the Czech Republic for many years. Every year, our scientific teams publish hundreds of scientific papers in international high-impact journals. Below we will present the most interesting scientific outputs.

Gynecology and Obstetrics

: International guidelines for the diagnosis and treatment of cervical cancer are updated every 5 years. An international group of experts from many fields participated in their preparation, nominated by 3 professional European societies, led by prof. MD David Cibula, CSc. and with the contribution of prof. MD Daniela Fischerová, Ph.D., both from VFN.

The publication was published simultaneously in the professional journals of all 3 societies, and at this year's European Society of Gynecologic Oncology (ESGO) congress, it will receive the 2023 IJGC Editors' Choice Award as the article with the highest number of downloads this year.

Link to the article: https://doi.org/10.1136/ijgc-2023-004429

IF 9.6, Q1
: The publication presents the results of the RUBY study, which after several decades is changing the clinical standard in the primary treatment of advanced and metastatic stages of endometrial cancer. The VFN representative (Prof. David Cibula, MUDr., CSc) is only a co-author of the study, but he participated in the preparation of the study design from the beginning and represents not only the workplace but the entire CEEGOG (Central and Eastern European Gynecologic Oncology Group) collaborative group in the author's collective. which originated in VFN and today coordinates 65 centers from 13 countries (www.ceegog.eu).

Link to the article: https://doi.org/10.1056/nejmoa2216334

IF 158.5, Q1, D1
: The publication presents the conclusions of a retrospective observational study evaluating oncological outcomes in patients with early-stage cervical cancer after fertility-preserving surgical treatment. The study was coordinated from the Department of Gynecology, Obstetrics and Neonatology of the 1st Faculty of Medicine of the UK and VFN, and 44 centers from 13 European countries contributed to it. It represents the largest published set of patients who underwent fertility-sparing treatment for early-stage cervical cancer. In addition, the conclusions of the study have already been taken into account in the creation of new European recommended procedures for the treatment of cervical cancer.

Link to the article: https://doi.org/10.1016/j.ajog.2022.11.1295

IF 9.8, Q1, D1
: The work of our urogynecology group defines simple ultrasound parameters to easily evaluate the result of stress urinary incontinence treatment using the so-called tape. Since the incidence of recurrent incontinence is not negligible and its solution is complex and errors are numerous, it is crucial to describe the mechanism of tape treatment failure. We managed to define the values of the ultrasound parameter describing the functionality of the so-called sling-pubis gap tape, which mean that the effect of the tape is a priori insufficient. Subsequently, it is not a failure of the operation as such, but only of its technique, which is much easier to correct.

Link to the article: https://doi.org/10.1002/uog.26142

IF 8.678, Q1, D1
: The publication presents the conclusions of a prospective study of our center evaluating perinatal and neonatal outcomes in patients with moderate to severe Asherman's syndrome, for which the patients underwent hysteroscopic treatment. Our study represents the largest published set of these patients to date, which was the first to reveal the main risk factors associated with the treatment of Asherman's syndrome related to the development of severe perinatal morbidity in patients. At the same time, the study revealed that although a history of Asherman's syndrome significantly increases the risk of developing serious complications in the mother, it has no impact on newborn outcomes.

Link to the article: https://doi.org/10.1093/humrep/dead092

IF 9.8, Q1, D1
: The cardionephrology team of the 3rd Internal Clinic is the only one in the Czech Republic dedicated to the problem of concurrent chronic kidney disease and heart disease. One of the areas that he has been working on for a long time is the hemodynamic effects of arteriovenous dialysis shunt. Clinical data show that a high-flow dialysis shunt can put patients at risk of overloading the heart and worsening blood flow to organs, including the brain. Therefore, in cooperation with the Institute of Physiology of the 1st Faculty of Medicine of the UK, a GAČR grant was solved, which studied this issue on an experimental biomodel. The results show that arteriovenous shunt significantly affects circulation and blood supply to organs even in critical situations.

Link to the article: https://doi.org/10.3389/fphys.2023.1109524

IF 4.0, Q2
: The cardionephrology team of the 3rd Internal Clinic is the only one in the Czech Republic dedicated to the problem of concurrent chronic kidney disease and heart disease. One of the areas that he has been working on for a long time is the hemodynamic effects of arteriovenous dialysis shunt. Clinical data show that a high-flow dialysis shunt can put patients at risk of overloading the heart and worsening blood flow to organs, including the brain. Therefore, in cooperation with the Institute of Physiology of the 1st Faculty of Medicine of the UK, a GAČR grant was solved, which studied this issue on an experimental biomodel. The results show that arteriovenous shunt significantly affects circulation and blood supply to organs even in critical situations.

Link to the article: https://doi.org/10.3389fphys.2023.1180224

IF 4.0, Q2
: The thesis describes the importance of catheterization treatment of some heart rhythm disorders in patients with pulmonary hypertension. Catheterization treatment achieves the best results in patients who have so-called atrial tachycardia, i.e. an orderly but rapid arrhythmia in the heart's atria. The procedures are demanding and long, and it turns out that to treat patients it is enough to remove only the present arrhythmia and it is not necessary to carry out extensive preventive procedures. The work was supported by a grant from the Agency for Health Research and was proposed for an award from the Minister of Health.

Link to the article: https://doi.org/10.1093/europace/euad131

IF 6.1, Q1
: The type of entry rhythm in out-of-hospital circulatory arrest is of great importance for the fate of patients. In general, a rapid ventricular arrhythmia may be present during circulatory arrest, or, on the contrary, the absence of any cardiac activity, or the heart is unable to pump despite the presence of electrical activity. Of all the possibilities, rapid ventricular arrhythmias are precisely the disorder that has the greatest chance of returning the patient to a full life. The work is a supplementary analysis to the important study of Prague OHCA by prof. Jana Bělohlávka, who tested the effect of an invasive treatment strategy (early transport to the hospital, invasive diagnostics and introduction of extracorporeal circulatory support) in refractory out-of-hospital circulatory arrest.

Link to the article: https://doi.org/10.1016/j.resuscitation.2022.10.006

IF 6.5, Q1, D1
: Among patients who have a permanent pacemaker, it is possible to detect some gene mutations that are responsible for the development of Fabry disease. However, the clinical significance of these mutations is currently unclear. Fabry disease is a rare disease affecting multiple organ systems. It is a disorder of the breakdown of certain molecules, which then accumulate in cells and damage their proper function.

Link to the article: https://doi.org/10.1016/j.ijcard.2022.11.062

IF 3.5, Q2
: Refractory out-of-hospital circulatory arrest has a number of causes. One of these causes is pulmonary embolism. Additional analysis of the Prague OHCA study by professor Bělohlávek shows that patients with pulmonary embolism who experience refractory out-of-hospital circulatory arrest have a worse prognosis than patients with other diagnoses. Manifestations of pulmonary embolism in circulatory arrests can be diverse.

Link to the article: https://doi.org/10.1093/ehjacc/zuad052

IF 4.1, Q2
: Fabry disease is a rare disease affecting many organ systems, including the heart. It is a disorder of the breakdown of certain molecules, which then accumulate in cells and damage their proper function. Three-dimensional echocardiographic examination methods are able to estimate the severity of heart failure and the long-term prognosis of the disease in patients with Fabry disease.

Link to the article: https://doi.org/10.1093/ehjci/jead121

IF 6.2, Q1
: During circulatory arrest, the body suffers from a lack of oxygen and generates lactic acid. The behavior of lactic acid levels after circulatory arrest, when it was not possible to achieve effective blood circulation before admission to the hospital, is an indicator of the fate of these patients. The work is a supplementary analysis to the important study of Prague OHCA by prof. Jana Bělohlávka, who tested the effect of an invasive treatment strategy (early transport to hospital, invasive diagnostics and introduction of extracorporeal circulatory support) in refractory out-of-hospital circulatory arrest.

Link to the article: https://doi.org/10.1016/j.resuscitation.2023.109935

IF 6.5, Q1, D1
: Circulatory arrest that occurs outside a medical facility has a very serious prognosis, especially if it is refractory. From the data of two studies, one of which was conducted at II. internal clinic, it follows that an invasive approach - mechanical resuscitation, early connection to an extracorporeal circuit and early intensive and invasive diagnostics increases the chance of survival of patients with a good neurological outcome.

Link to the article: https://doi.org/10.1016/j.eclinm.2023.101988

IF 15.1 Q1, D1
: Letter to editor: A reanalysis of the Prague OHCA study using modern statistical approaches showed that patients with refractory out-of-hospital circulatory arrest treated with an invasive approach (early transport to the hospital, early interventional diagnosis and connection to cardiopulmonary bypass) have a better prognosis than patients treated with the standard usual approach.

Link to the article: https://doi.org/10.1016/j.chest.2023.07.030

IF 9.6 Q1
: Scientists have succeeded in describing the significance of hundreds of congenital mutations in the CHEK2 gene in the development of breast cancer. The research team was led by Zdeněk Kleibl from the 1st Faculty of Medicine of Charles University and Libor Macůrek from the Institute of Molecular Genetics of the Academy of Sciences of the Czech Republic. The CHEK2 gene has been in the sights of clinical geneticists for a long time. This is the third most frequently affected gene related to the medium risk of breast cancer in the Czech Republic. Some of its hereditary mutations expose carriers to almost a 30% lifetime risk of the disease.

Link to the article: https://doi.org/10.1158/1078-0432.ccr-23-0212

IF 11.5, D1
: Ovarian carcinomas are the 5th most common cause of cancer in women in the Czech Republic. One possible predictor of response to immunotherapy in these tumors is microsatellite instability, which is a sign of a malfunction in one of the DNA repair mechanisms. Microsatellite instability can also be a clue for detecting patients with the so-called Lynch syndrome, a hereditary disease predisposing to the development of various tumors. In our work, we tested microsatellite instability in selected types of a total of 400 epithelial ovarian tumors. We compared all available methods for the analysis of this marker, including immunohistochemical analysis, PCR analysis and NGS analysis. Based on our analysis, we proposed an optimal approach for testing. In addition, we analyzed the tumors also with regard to the possible association with Lynch syndrome, which we demonstrated in several cases.

This work was presented at the 24th Student Scientific Conference of the 1st Faculty of Arts, UK, and the author won 2nd place in the postgraduate lecture category.

Link to the article: https://doi.org/10.1016/j.trsl.2023.05.004

IF 7.8, D1
: A total of 169 patients with prostate cancer underwent radical surgery in 2013-2016. Before the procedure, blood was taken for analysis of the Serum Thymidine Kinase 1 (STK1) enzyme level. The results were related to a control group of men without a detected tumor. We found significant differences in STK1 levels in tumor patients, increasing with tumor aggressiveness. The determination of the STK1 level also specified the recommendation for possible additional radiation after surgery

Link to the article: hhttps://doi.org/10.21873/anticanres.16319

IF 2.0, Q4
: In our article, we present the case of a 15-year-old boy with a six-month history of a palpable mass on the glans penis. By palpation, we discovered a well-defined solid whitish deposit with a diameter of about one centimeter. To clarify the position and rule out other deposits in the entire penis, we performed an ultrasound examination and magnetic resonance imaging. In the case of this boy, we finally removed the mass, the definitive report from the VFN Institute of Pathology described the mass as a myointimoma, which is an absolutely rare finding in children and adolescents. In the article, we further summarize the existing publications on this disease. It is a benign tumor, careful removal and a special histological examination are recommended to rule out other more aggressive tumors.

Link to the article: https://doi.org/10.1186/s12894-022-01131-3

IF 2.0, Q3
: In this article, we present our results of a total of 336 operations in patients aged 7-21 years (operated within the last 21 years) who underwent surgery for varicocele (enlarged veins in the scrotum). We chose the laparoscopic method, it is a so-called mini-invasive operation that uses access through very short cuts into the abdominal cavity, operated with the help of a camera. During the operation, we severed only the diseased veins draining blood from the testicle, we preserved the arteries and lymph vessels. We found persistent varicocele after surgery in 15 cases (4.2%), testicular damage never occurred as a result of surgery. It is the largest set in the world literature describing experiences with this type of performance.

Link to the article: https://doi.org/10.1016/j.jpurol.2022.01.020

IF 2.0, Q3
: In this study, boys with asymptomatic unilateral undescended testis aged 2.5-3.5 months were examined. The presence of an undescended testis was confirmed by palpation or ultrasound, and we randomly divided the boys into groups with or without pretreatment with the hormone gonadorelin. We included a total of 36 boys (21 in the study group and 15 in the control group). The operation (retraction of the testicle into the scrotum) was performed before 12 months of age. We recorded penile size, testicular volume, and laboratory values of various hormones at three months of age and at the time of surgery. From the first examination to the operation, there was an increase in the size of the penis without difference in both groups. We also found no difference in laboratory values between groups. This finding is important to confirm the safety of hormonal pretreatment with gonadorelin.

Link to the article: https://doi.org/10.1016/j.jpurol.2022.05.010

IF 2.0, Q3