If a vaccine against COVID-19 was available, would you like to be vaccinated? And are you vaccinated against flu and other diseases? A survey among university students during state of emergency.

AIM: Achieving sufficient vaccination rate (and herd immunity respectively) is considered to be the most promising strategy for prevention of outbreaks of novel coronavirus disease in future. The main aim of this work was to compare willingness of university students to receive vaccine against COVID-19 with vaccines for adults against other well-known diseases. Another aim was to assess students´ opinion on growing trend of parents refusing to vaccinate children. METHODS: The online questionnaire shared with students consisted of 12 questions. It was distributed via university bulk emails and social media. RESULTS: 3,133 students responded to our questionnaire. Overall university response rate was 15.9%. Students of our university showed significantly much stronger interest in receiving vaccine against COVID-19 than vaccine against other diseases (p < 0.0001). Students also showed strong pro-vaccination attitude to vaccination of children. CONCLUSION: The study showed very well sudden change of attitude of university students to vaccination of adults at the time of strong restrictive regulations. Most of university students had pro-vaccination attitude to vaccination of children.

Acceptance of a vaccine against COVID-19 - a systematic review of surveys conducted worldwide.

OBJECTIVES: The most promising strategy for managing COVID-19 pandemic is achieving sufficient vaccination rate worldwide. The question is how many people will be willing to get vaccinated. STUDY DESIGN: We systematically reviewed peer-reviewed manuscripts monitoring people´s intention to receive a vaccine against COVID-19. METHODS: Up to December 28, 2020 we identified 62 relevant peer-reviewed articles in PubMed, Web of Science, Scopus and GoogleScholar. RESULTS: Total sample size was 118 855 respondents with overall average COVID-19 vaccine acceptance rate of 72.5% which is "just" the level estimated to be sufficient for reaching herd immunity threshold. Surprisingly, healthcare workers showed smaller interest in receiving the vaccine when compared to general adult population and university students. On the other hand, their attitude to vaccination did not change over time. In case of general adult population, the longer the pandemic lasts, the smaller proportion of population wants to get vaccinated. Vaccination intentions were independent of gross domestic product and human development index. CONCLUSION: Willingness of population to receive COVID-19 is just at the herd immunity threshold and it is decreasing over time (Tab. 2, Fig. 3, Ref. 110).  Keywords: vaccination, survey, COVID-19, pandemic, review.

Echogenic foci in fetal heart from a pediatric cardiologists point of view.

OBJECTIVES: To evaluate the occurrence and the significance of echogenic foci in the fetal heart and to assess the prognosis of the fetus and child. SETTING: Department of Pediatrics and Prenatal Cardiology, Department of Pediatrics, University Hospital, Faculty of Medicine, Ostrava. DESIGN: Original article. METHODS: A retrospective study was conducted between 2008-2017. Fetal echocardiography was performed in the second trimester of pregnancy in the study population. The identification of echogenic heart foci, and their follow up during and after the pregnancy were performed by a pediatric cardiologist. RESULTS: In the monitored period, a total of 27,633 fetuses were examined. Isolated cardiac hyperechogenic foci were detected in 3% (829/27,633) of the fetuses. The foci was found in 93%, 5%, and 2% in the left ventricle, mainly in valvular apparatus of the mitral valve, in the both ventricles, and in the right ventricle, respectively. In 1% (11/829) of the fetuses with cardiac echogenic foci, the others concomitant pathologies (tricuspid regurgitation, extrasystoles, renal pathology) were found. No genetic abnormalities were detected in the fetuses with cardiac hyperechogenic foci. CONCLUSION: The echogenic focus in fetal heart is a relatively common, mostly insignificant finding, with any serious consequences for the fetus and the child.

[Development of prenatal diagnostics of congenital heart defects, profit of standardized scanning planes]. / Vývoj prenatální diagnostiky vrozených srdecních vad, zisk z jednotlivých ultrazvukových projekcí.

OBJECTIVE: To audit the development and success rate of prenatal detection of congenital heart defects (CHDs), and to evaluate the effectiveness of diagnostics performed in standardized scanning planes. SETTING: Department of Pediatrics, University Hospital Ostrava. DESIGN: Retrospective study. METHODS: Ultrasound examination of fetal heart (fetal echocardiography) was performed in the second trimester pregnancy. The observed region was the Moravian-Silesian region; the assessment was performed in the retrospective study performed between 2000- 2016. The knowledge of all significant heart defects in the region, processing of data from genetic reporting, further examination of all prenatal pathologies by a pediatric cardiologist, presence of a pediatric cardiologist at all autopsies, with a precise description of the defect, birth of a pathological new-born at a specialized centre. Analysis of detected CHDs was performed in relation to the ultrasound scans used. RESULTS: During the monitored 17-year period, a total of 748 (3.8 cases per 1,000 foetuses) of prenatally identified and postnatally significant CHDs were observed in the total population of 198,300 foetuses. There were 53% (393/748) CHDs detected prenatally and 47% (355/748) of cases were not prenatally recognized. The effectiveness of CHD screening has improved progressively, from the initial 10% up to the current 74%. The best results were obtained using the basic four-chamber (4CH) scan; the results in practice gradually decreased, from the basic 4CH projection to the aortic arch. CONCLUSION: The effectiveness of prenatal detection of congenital heart defects gradually improves, namely in cases of hypoplasia and significant ventricular anomalies, with up to 100% prenatally detected cases in the past three years. The level of detection statistically decreases, from the four-chamber projection to out-flow tracts, great arteries and the aortic arch. Congenital heart defect is generally well detectable prenatally, and is usually observed as an isolated anomaly. The most important factors include a precise diagnosis, overall examination of the pregnancy and correct counselling provided for the affected family.

Triple pregnancy with mixed chorionicity following in vitro fertilization: is fetal reduction neccesary?

OBJECTIVE: The increasing incidence and management of monozygotic twinning in patients undergoing in vitro fertilization (IVF) has been the subject of much debate. Here, we describe the management and outcome of two triple pregnancies with mixed chorionicity with a monochorionic-diamniotic twin pair and a singleton following the transfer of two embryos during IVF treatment. DESIGN: Case report. SETTING: Department of Obstetrics and Gynaecology, Palacký University Hospital, Olomouc, Czech Republic. METHODS: This study involved Patient A (30 years of age; 0 para) and Patient B (32 years of age; I Para), both with triplets of mixed chorionicity following the transfer of two embryos during IVF treatment, and treated in The Fetal Medicine Centre, Palacky University Olomouc. Detailed counselling led to the deployment of different management strategies for each case. RESULTS: The monochorionic twin component of Patient A was terminated by fetal reduction in the 15th week of gestation, while the remaining single pregnancy was delivered at term without complication. Patient B opted for expectant management. However, the pregnancy was complicated by severe maternal morbidity and was terminated in the 28th week of gestation following the death of one fetus. CONCLUSION: Fetal reduction should be offered as a management tool to patients carrying triplets in order to improve perinatal survival. In triplets with mixed chorionicity, the reduction of monochorionic twins is particularly advisable in preventing the additional risk posed by a shared placenta.

[Aspiration of functional ovarian cyst]. / Ambulantní miniinvazivní lécba funkcních cyst ovaria.

OBJECTIVE: The study was designed to prove the safety of simple cyst aspiration instead of the current treatment by laparoscopy. DESIGN: Retrospective analysis. SETTING: Fertimed Olomouc, Infertility Center. METHODS: We are presenting our experience with the aspiration of follicles (group A) and a functional cyst (group B, C). We are evaluating a number of complications in all groups, anaesthesia versus analgesia in group B, C and the cytological examination of fluid from the function cyst in group C. RESULTS: In 2,744 aspirations we detected 0.0004% small complications (vaginal wall bleeding) and 0.0004% major complications (laparoscopy, cystoscopy). No single cytological examination was suspect in the simple ovarian function cyst. CONCLUSION: Aspiration of a simple functional cyst is the first step of the treatment. It is a simple procedure. For patients it is comfortable and safe. In a simple cyst, we do not find suspect cells.

Low-level 45,X/46,XX mosaicism is not associated with congenital heart disease and thoracic aorta dilatation:prospective magnetic resonance imaging and ultrasound study.

OBJECTIVE: To establish the prevalence of risk factors for aortic dissection, such as bicuspid aortic valve, aortic coarctation and ascending aorta dilatation, in women with low-level 45,X/46,XX mosaicism undergoing an in-vitro fertilization (IVF) procedure. METHODS: The study group comprised 25 women with low-level 45,X/46,XX mosaicism (ranging from 3.3% to 10.0%) who were referred to two reproductive medicine units between 2009 and 2013 because of infertility and who underwent subsequent karyotyping. In accordance with the recommendation of the Practice Committee of the American Society for Reproductive Medicine for patients with Turner syndrome (TS), prior to the IVF procedure, all women underwent careful cardiovascular screening for congenital heart disease and thoracic aorta dilatation, including standard cardiac examination, echocardiography and non-contrast cardiac magnetic resonance imaging. Aortic size index (ASI, diameter of the ascending aorta normalized to body surface area) and the prevalence of coarctation of the aorta and of bicuspid aortic valve were compared with findings previously reported in women with TS and the general population. RESULTS: Bicuspid aortic valve without any stenosis or regurgitation was found in one woman in the study group with low-level 45,X/46,XX mosaicism, a statistically significantly lower prevalence of bicuspid aortic valve than that reported in women with TS. Aortic coarctation was not identified in any individual. The ASI was below the 95th percentile in all cases and the mean value was significantly lower than the mean reference values for both the general population and women with TS. CONCLUSION: Compared with the general population, the prevalence of risk factors for aortic dissection was not found to be higher in women with low-level 45,X/46,XX mosaicism without any noticeable features except infertility.

[Exercise cardiorespiratory parameters in children motivated to physical activity after treatment for acute lymphoblastic leukemia]. / Zátezové kardiorespiracní parametry u detí motivovaných k pohybové aktivite po prelécené akutní lymfoblastické leukémii.

BACKGROUND: Children treated for acute lymphoblastic leukemia (ALL) with anthracycline antibiotic agents must be followed up for the danger of late cardiotoxic effects of the treatment. Another threat represents the consequence of the protective upbringing and inactive lifestyle. The aim of present study was to assess the exercise cardiorespiratory indexes and anthropometric variables in previously treated children without clinical, ECG and echocardiographic signs of cardiotoxicity, who had been motivated to physical activity. METHODS AND RESULTS: 29 children (12.3 +/- 2.7 years old) previously treated for ALL with anthracyclines were examined. The cumulative dosis of anthracyclines was 224 +/- 39.4 mg/m2. The treatment was finished before 4.8 +/- 2.1 years and after this period no signs of the late cardiotoxicity were detectable. Both children and their parents were encouraged to the regular physical activity of submaximal intensity. 29 age- and sex-matched control subjects were healthy children, never limited in their activities, but without special physical training. As soon as the basic anthropometric data had been verified, both groups completed a progressive exercise test with the assessment of submaximal and maximal spiroergometric indexes. In all parameters followed we failed to prove any significant differences between the two groups. The treated children exhibited only slightly lower body height, higher body weight and higher percentage of body fat. They reached lower respiratory exchange ratio (R), with higher oxygen uptake on both submaximal and maximal load levels. CONCLUSIONS: When sufficiently motivated, children surviving five years after the treatment with anthracycline for ALL, who have no signs of cardiotoxic effects, have their functional cardiorespiratory capacity approximately comparable to that of healthy children.