In dementia care, psychosocial interventions can increase people's quality of life with dementia and their caregivers. Despite their effectiveness, their translation into practice lacks the desirable systematicity. Systematic educational programs on psychosocial interventions in dementia will improve this translation, as it prepares professionals to face the complexity of dementia care. This study aimed to systematically map out the extent to which higher education programs in Europe include teaching activities about psychosocial care of dementia. We collected quantitative and qualitative data about 303 higher education teaching activities on psychosocial care in dementia across Europe. The analysis revealed that the number of teaching activities focusing on psychosocial care in dementia was relative. Although the results reflected UNESCO indications, the teaching activities on psychosocial care in dementia appeared less systematized than optimal. As world health agencies recommend, international higher education systems should consider more psychosocial care topics because they can prepare professionals to respond timely and effectively to dementia patients and caregivers' needs.
- MeSH
- demence * terapie MeSH
- kvalita života MeSH
- lidé MeSH
- osoby pečující o pacienty MeSH
- psychiatrická rehabilitace * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Evropa MeSH
BACKGROUND/AIM: The study aimed to evaluate differences in the overall survival of HER2+ breast cancer patients treated with regard to their hormone receptors negativity or positivity. We evaluated a cohort of patients treated with trastuzumab in the Czech Republic. PATIENTS AND METHODS: The present study is a retrospective analysis of patients whose data were recorded in a nationwide non-interventional, post-authorisation database BREAST. After propensity score matching of data, the cohort included 4,532 patients. RESULTS: A significant difference in overall survival (OS) of the entire cohort was found between patients with and without hormone dependence. The OS was significantly higher in the group of patients with hormone receptor-positive (HR+) tumours in the following cohorts: patients treated with neoadjuvant therapy, patients with advanced disease, G2 tumours, stage III and IV and in patients with stage II and III of G2 tumours. CONCLUSION: Increased OS rates were found in several subgroups of patients with HR+/HER2+ tumours compared to those with HR-/HER2+ tumours. Better outcomes of HR+/HER2+ patients were only observed in the first four/five years of follow-up, and the differences disappeared over time.
- MeSH
- adjuvantní chemoterapie MeSH
- hormony MeSH
- lidé MeSH
- nádory prsu * farmakoterapie genetika MeSH
- neoadjuvantní terapie MeSH
- prognóza MeSH
- protokoly protinádorové kombinované chemoterapie MeSH
- receptor erbB-2 genetika MeSH
- retrospektivní studie MeSH
- Check Tag
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
OBJECTIVE: This article reviews the published studies dealing with the influence of cigarette smoking on metabolic changes and effectiveness of drugs used in the systemic chemotherapy of the lung cancer. METHODS: The literature search of interactions between cigarette smoking and drugs used for lung cancer was carried out. The abstracted data mostly involved some induction of key drug-metabolizing enzymes of cytochrome CYP1A1/2, CYP2D6, CYP3A4 and isoforms of UDP-glucuronosyltransferase. RESULTS: Metabolic changes are important both in the non-chemotherapy and for the drugs used in the chemotherapy. They can change pharmacokinetic and pharmacodynamic effects of drugs. Primarily, we addressed potential differences in drug effects on smokers and non-smokers. The increased clearance of erlotinib and irinotecan may have impact on effectiveness of the lung cancer therapy. The effects of taxanes and gemcitabine are more complex. CONCLUSION: The evaluated studies show that continued smoking after lung cancer diagnosis is related to poor prognosis, reduced survival, risk of second primary malignancies, and increased cancer recurrence. Of particular importance is the deterioration in the quality of life and an increased incidence of the adverse drug reactions in smokers. The patient's cigarette smoking history should be considered carefully and smoking cessation must be taken into account.
- MeSH
- kouření metabolismus MeSH
- lidé MeSH
- nádory plic farmakoterapie MeSH
- protinádorové látky farmakokinetika terapeutické užití MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
Breast cancer with high expression of human epidermal growth factor receptor (HER)-2 represents a biologically and clinically heterogeneous group of neoplastic disorders. Importantly, hormone receptor expression has an effect on biological properties and affects the selection of therapies. On the basis of molecular genetics, four principal subtypes, including luminal A, luminal B, HER2-enriched (HER-2-E), and basal-like can be distinguished. Breast tumors characterized by HER-2 positivity and simultaneous expression of hormone receptors, triple positive breast cancers (TPBC) are of increasing interest owing to the unique biological characteristics associated with complex interactions between HER-2 and hormone receptor signaling pathways. Interactions between hormone receptors and HER-2 explain the decreased efficacy of hormonal therapy in comparison with HER-2-negative patients. The expression of estrogen receptors in HER-2 positive tumors may also be associated with resistance to anti-HER-2 treatment. Multiple available therapeutic options, including hormonal therapy, anti-HER-2 agents and cytotoxic drugs explain favorable prognosis of TPBC. Escalation and de-escalation therapeutic strategies that could result in lower toxicities are being investigated as well as combinations of anti-HER-2 agents with hormonal therapy, immunotherapy, cyclin dependent kinase 4/6 and phosphatidyl inositol-3-kinase inhibitors. Distinction between subtypes of HER-2-positive breast cancer and treatment diversification may result in improved outcomes in TPBC. A response to neoadjuvant therapy may serve in the tailoring of therapy management.
- MeSH
- adjuvantní chemoterapie MeSH
- analýza přežití MeSH
- chinoliny terapeutické užití MeSH
- dospělí MeSH
- hodnocení rizik MeSH
- hormonální protinádorové látky aplikace a dávkování MeSH
- invazivní růst nádoru patologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- mastektomie metody MeSH
- nádory prsu genetika mortalita patologie terapie MeSH
- přežití bez známek nemoci MeSH
- prognóza MeSH
- protinádorové látky imunologicky aktivní MeSH
- randomizované kontrolované studie jako téma MeSH
- receptor erbB-2 genetika MeSH
- regulace genové exprese u nádorů MeSH
- staging nádorů MeSH
- trastuzumab terapeutické užití MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
- srovnávací studie MeSH
The authors trace the history of metformin and its clinical use to the present day. Recent insights into its mode of action and latest data from experimental and clinical medicine have unraveled novel properties of metformin, which may be particularly useful in the treatment of conditions other than diabetes. Results of ongoing clinical trials will show whether or not the hypoglycemic effect of metformin will become only one of the many to be employed in clinical practice.
- MeSH
- aplikace orální MeSH
- diabetes mellitus 2. typu farmakoterapie MeSH
- hmotnostní úbytek účinky léků MeSH
- hodnocení rizik MeSH
- hypoglykemika aplikace a dávkování škodlivé účinky terapeutické užití MeSH
- klinické zkoušky jako téma MeSH
- lidé MeSH
- medicína založená na důkazech MeSH
- metformin aplikace a dávkování škodlivé účinky terapeutické užití MeSH
- randomizované kontrolované studie jako téma MeSH
- rizikové faktory MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
- Publikační typ
- abstrakt z konference MeSH
The incidence of diabetes mellitus is rising worldwide. The aim of this prospective epidemiological study was to compare the effects of natural and surgical menopause on parameters of glucose metabolism. In a group of 587 repeatedly examined women, with a baseline age of 45-55 years, the following subgroups of women were separated: those after bilateral oophorectomy (BO, n=37) and those in natural menopause (NAT, n=380) including women menopausal already at baseline (POST, n=89). The study parameters including glycemia, insulinemia, HOMA-IR and beta-cell function using HOMA-beta were determined at baseline and 6 years later. Over the study period, there was a marked rise in prediabetic and diabetic values of fasting glycemia; the percentage of women with diabetic values increased in the NAT (from 0.8 % to 3.9 %) and POST (from 2.2 % to 9.0 %) subgroups, with the highest prevalence in the BO subgroup (from 8.1 % to 10.8 %). While, among women with non-diabetic fasting glycemia, an increase in fasting glycemia was observed in all study subgroups, it was more marked in the BO subgroup than in the NAT and POST ones (p=0.02 both). This difference between NAT and BO was also found in the long-term trend of development of glycemia in non-diabetic women (p=0.014). Compared with natural menopause, bilateral oophorectomy may have an adverse effect on glucose metabolism.
- MeSH
- krevní glukóza metabolismus MeSH
- lidé středního věku MeSH
- lidé MeSH
- menopauza krev MeSH
- ovarektomie škodlivé účinky MeSH
- prospektivní studie MeSH
- surveillance populace * metody MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- srovnávací studie MeSH
The authors presents procedures of problem solving at searching of answers to the question what is value of Library Information Services (LIS) in the Czech medical libraries (library and information services for the hospital and academic health science centre). Working group (Steering Committee) of the National Medical Library of the Czech republic in cooperation with the National Library of the Czech Republic pay attention to the solution of the Project “Benchmarking of libraries”. Identification, determination and collection of most suitable indicators detailing activities in comparable type of library enable to decide on change of existing processes (services) and thereby to improve the quality of provided service. The authors inform about the results of analysis of medical libraries activities according to the statistical returns for 2007 and about proposal of optimization of these activities by method of benchmarking. Statistical investigation must be evaluated with respect to categories of users of provided services. The categorization of user groups according to different types of health facilities where libraries act is necessary condition for assessment of LIS value.
