2., upr. vyd. 47 s. : il. ; 30 cm
Krátké intervence jsou stále více oceňovanou formou léčby osob s rizikovým a škodlivým pitím. Manuál vznikl s cílem pomoci pracovníkům primární péče - lékařům, zdravotním sestrám, komunitním zdravotním pracovníkům ad. - při práci s osobami, u nichž se konzumace alkoholu stala nebezpečnou nebo škodlivou pro jejich zdraví.
- MeSH
- alkoholismus MeSH
- návykové chování MeSH
- odvykací prostředky alkoholu MeSH
- pití alkoholu MeSH
- primární zdravotní péče MeSH
- Publikační typ
- příručky MeSH
- Konspekt
- Hygiena. Lidské zdraví
- NLK Obory
- adiktologie
- MeSH
- adherence pacienta psychologie statistika a číselné údaje MeSH
- adjuvantní chemoterapie * MeSH
- anastrozol farmakokinetika farmakologie škodlivé účinky terapeutické užití MeSH
- inhibitory aromatasy škodlivé účinky terapeutické užití MeSH
- klinické zhoršení MeSH
- lidé středního věku MeSH
- lidé MeSH
- nádory prsu farmakoterapie MeSH
- návaly chemicky indukované epidemiologie MeSH
- postmenopauza MeSH
- postmenopauzální osteoporóza chemicky indukované epidemiologie MeSH
- tamoxifen farmakokinetika farmakologie škodlivé účinky terapeutické užití MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- ženské pohlaví MeSH
- MeSH
- adjuvantní chemoterapie MeSH
- inhibitory aromatasy škodlivé účinky terapeutické užití MeSH
- klinický obraz nemoci MeSH
- lidé středního věku MeSH
- lidé MeSH
- nádory prsu * farmakoterapie MeSH
- návaly chemicky indukované epidemiologie MeSH
- nežádoucí účinky léčiv psychologie MeSH
- postmenopauzální osteoporóza chemicky indukované epidemiologie MeSH
- tamoxifen škodlivé účinky terapeutické užití MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- ženské pohlaví MeSH
Most cancers occur with the same characteristic pattern of incidence. The simplicity of this pattern is in contrast to the perceived complexity of carcinogenesis. Therefore, age-onset statistics represent a tempting set of data and have provoked many bold but often misguided conclusions concerning the physiopathological mechanisms of cancer. Half a century has passed since the original multistage theory of Armitage and Doll. Although their basic notion of a healthy cell becoming malignant in several rate-limiting steps is still accepted, prevailing wisdom about the nature and number of these steps has never settled into a consensus. Why have we been unable to elucidate the quantitative dependence of cancer incidence on the molecular processes that feature in its aetiology? In this review we aim to provide answers for this question.
- MeSH
- dějiny 20. století MeSH
- dějiny 21. století MeSH
- fluorodeoxyglukosa F18 dějiny diagnostické užití MeSH
- lidé MeSH
- nádory mozku dějiny MeSH
- nemoci mozku dějiny MeSH
- pozitronová emisní tomografie MeSH
- radiofarmaka dějiny diagnostické užití MeSH
- Check Tag
- dějiny 20. století MeSH
- dějiny 21. století MeSH
- lidé MeSH
- Geografické názvy
- Spojené království MeSH
Debilitating hot flushes and sleep dysfunction often affect survivors of breast cancer, most notably in those taking anti-oestrogen medications. Conventional treatments have been only partially effective in diminishing these issues, and some have serious risks. We did a pilot study to investigate our hypothesis that stellate-ganglion block can be a safe and effective treatment for hot flushes and sleep dysfunction in this patient population. METHODS: 13 survivors of breast cancer (in remission) with severe hot flushes and night awakenings were treated with stellate-ganglion block at the anterolateral aspect of the C6 vertebra on the right side under fluoroscopy. Patients recorded hot flushes in a daily diary by use of the Hot-Flash Score, devised by Sloan and colleagues, and night awakenings by use of the Pittsburgh Sleep Quality Index. Both instruments were used 1 week before the procedure [A40] and then weekly after the procedure for 12 weeks. We used the generalised-estimating-equations method to analyse the longitudinal measurements of the number of hot flushes and night awakenings over time. This method is a popular approach to analysing datasets that have repeated measures from the same person, and is robust because it does not need the complete distribution of the outcomes to be specified. This trial is registered on the International Standard Randomised Controlled Trial Number register (ISRCTN14318565). FINDINGS: There were no adverse events resulting from the stellate-ganglion block, although patients had temporary Horner's syndrome indicating the effectiveness of the block. Five patients had only one stellate-ganglion block and eight had two stellate-ganglion blocks. The total number of hot flushes decreased from a mean of 79.4 (SD 37.4) per week before the procedure to a mean of 49.9 (SD 39.9) per week during the first 2 weeks after the procedure (p=0.0002). The total number of hot flushes continued to decrease over the remaining follow-up period (weeks 3-12), and stabilised at a mean of 8.1 (SD 5.6) per week (p<0.0001). The number of very severe hot flushes was decreased to near zero by the end of the follow-up period (week 12; p<0.0001). Night awakenings decreased from a mean of 19.5 (SD 14.8) per week before the procedure to a mean of 7.3 (SD 7.1) per week during the first 2 weeks after the procedure (p<0.0001). The total number of night awakenings continued to decrease over the remaining follow-up period (weeks 3-12) and stabilised at a mean of 1.4 (SD 1.2) per week (p<0.0001). INTERPRETATION: The findings of this study suggest that stellate-ganglion block can provide survivors of breast cancer with relief from hot flushes and sleep dysfunction with few or no side-effects. Long-term relief of symptoms has the potential to improve overall quality of life and increase compliance with anti-oestrogen medications for breast cancer.
- MeSH
- adherence pacienta MeSH
- anestetika lokální aplikace a dávkování MeSH
- bdění účinky léků MeSH
- blokáda autonomních nervů MeSH
- bupivakain aplikace a dávkování MeSH
- dospělí MeSH
- financování organizované MeSH
- ganglion stellatum účinky léků MeSH
- hormonální protinádorové látky škodlivé účinky MeSH
- kvalita života MeSH
- lidé středního věku MeSH
- lidé MeSH
- modulátory estrogenních receptorů škodlivé účinky MeSH
- nádory prsu farmakoterapie MeSH
- návaly MeSH
- pilotní projekty MeSH
- poruchy spánku a bdění etiologie patofyziologie prevence a kontrola MeSH
- přežívající MeSH
- průzkumy a dotazníky MeSH
- senioři MeSH
- stupeň závažnosti nemoci MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- randomizované kontrolované studie MeSH
As our understanding of stem-cell behaviour rapidly increases, more and more reports suggest that use of stem-cell therapy will extend well beyond regenerative medicine in the near future. Due to their inherent tumoritropic migratory properties, stem cells can serve as vehicles for the delivery of effective, targeted treatment to isolated tumours and to metastatic disease. In vitro, stem cells can readily be engineered by inserting specifically tailored transgenes with antitumour effects to create tumour-seeking therapeutic vehicles. Transgene effects include direct tumour-cell killing, promotion of local immune responses, oncolytic virus production, and prodrug activation schemes. Many of these strategies have been validated in a wide range of studies assessing treatment feasibility or efficacy and establishing methods for real-time monitoring of stem-cell migration and fate in vivo. New insights into avenues for stem-cell sourcing have shortened the probable time to realisation of such treatments for patients. In this Review, we provide an outline of the rationale and status of stem-cell-based treatments for tumours, and we discuss prospects for clinical implementation and the factors crucial for maintaining momentum towards this goal.
- MeSH
- analýza přežití MeSH
- embryonální kmenové buňky MeSH
- hematopoetické kmenové buňky MeSH
- hodnocení rizik MeSH
- lidé MeSH
- mezenchymální kmenové buňky MeSH
- nádory chirurgie mortalita patologie MeSH
- předpověď MeSH
- regenerativní lékařství normy trendy MeSH
- transplantace kmenových buněk normy trendy MeSH
- výsledek terapie MeSH
- zvířata MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- zvířata MeSH
