Cévní mozkové příhody (CMP) jsou jednou z nejčastějších kardiovaskulárních komplikací, přičemž arteriální hypertenze je považována za nejvýznamnější rizikový faktor. Odhaduje se, že více než 50 % CMP je způsobeno hypertenzí a vysoký krevní tlak sám o sobě zvyšuje riziko CMP3–4×! Hypertenze je navíc samostatným rizikovým faktorem pro vznik fibrilace síní. Následující stručný souhrn se zabývá přístupy k antihypertenzní léčbě u primární a sekundární prevence cévních mozkových příhod. Adekvátní kontrola hypertenze farmakologickou léčbou vede (kromě jiných benefitů) k významnému snížení rizika jak ischemických, tak i hemorhagických CMP. Časně zahájená antihypertenzní léčba zpomaluje i rozvoj kognitivních poruch. V textu jsou stručně sumarizovány současné přístupy k farmakologické antihypertenzní intervenci. Léčba hypertenze v akutní fázi CMP závisí na vyvolávající příčině, použité léčbě a časovém odstupu od vzniku symptomů. Podrobnosti přesahují rámec tohoto textu.
Strokes are among the most common cardiovascular complications, with arterial hypertension being considered the most significant risk factor. It is estimated that more than 50% of strokes are caused by hypertension, and high blood pressure alone increases the risk of stroke by 3-4 times! Furthermore, hypertension is an independent risk factor for the development of atrial fibrillation. The following brief summary addresses approaches to antihypertensive treatment in the primary and secondary prevention of strokes. Adequate control of hypertension through pharmacological treatment leads (among other benefits) to a significant reduction in the risk of both ischemic and hemorrhagic strokes. Early initiation of antihypertensive treatment also slows the progression of cognitive disorders. This text briefly summarizes current approaches to pharmacological antihypertensive intervention. The treatment of hypertension in the acute phase of a stroke depends on the underlying cause, the treatment used, and the time elapsed since the onset of symptoms. Details are beyond the scope of this text.
- MeSH
- antihypertenziva terapeutické užití MeSH
- cévní mozková příhoda * etiologie prevence a kontrola MeSH
- hypertenze farmakoterapie komplikace prevence a kontrola MeSH
- lidé MeSH
- primární prevence metody MeSH
- rizikové faktory kardiovaskulárních chorob MeSH
- sekundární prevence metody MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
BACKGROUND: Atherosclerotic cardiovascular disease (ACVD) is worsened by chronic inflammatory diseases. Interleukin receptor antagonists (IL-RAs) and tumour necrosis factor-alpha (TNF) inhibitors have been studied to see if they can prevent cardiovascular events. OBJECTIVES: The purpose of this study was to assess the clinical benefits and harms of IL-RAs and TNF inhibitors in the primary and secondary prevention of ACVD. SEARCH METHODS: The Cochrane Heart Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL), Ovid MEDLINE (including In-Process & Other Non-Indexed Citations), Ovid Embase, EBSCO CINAHL plus, and clinical trial registries for ongoing and unpublished studies were searched in February 2024. The reference lists of relevant studies, reviews, meta-analyses and health technology reports were searched to identify additional studies. No limitations on language, date of publication or study type were set. SELECTION CRITERIA: RCTs that recruited people with and without pre-existing ACVD, comparing IL-RAs or TNF inhibitors versus placebo or usual care, were selected. The primary outcomes considered were all-cause mortality, myocardial infarction, unstable angina, and adverse events. DATA COLLECTION AND ANALYSIS: Two or more review authors, working independently at each step, selected studies, extracted data, assessed the risk of bias and used GRADE to judge the certainty of evidence. MAIN RESULTS: We included 58 RCTs (22,053 participants; 21,308 analysed), comparing medication efficacy with placebo or usual care. Thirty-four trials focused on primary prevention and 24 on secondary prevention. The interventions included IL-1 RAs (anakinra, canakinumab), IL-6 RA (tocilizumab), TNF-inhibitors (etanercept, infliximab) compared with placebo or usual care. The certainty of evidence was low to very low due to biases and imprecision; all trials had a high risk of bias. Primary prevention: IL-1 RAs The evidence is very uncertain about the effects of the intervention on all-cause mortality(RR 0.33, 95% CI 0.01 to 7.58, 1 trial), myocardial infarction (RR 0.71, 95% CI 0.04 to 12.48, I2 = 39%, 2 trials), unstable angina (RR 0.24, 95% CI 0.03 to 2.11, I2 = 0%, 2 trials), stroke (RR 2.42, 95% CI 0.12 to 50.15; 1 trial), adverse events (RR 0.85, 95% CI 0.59 to 1.22, I2 = 54%, 3 trials), or infection (rate ratio 0.84, 95% 0.55 to 1.29, I2 = 0%, 4 trials). Evidence is very uncertain about whether anakinra and cankinumab may reduce heart failure (RR 0.21, 95% CI 0.05 to 0.94, I2 = 0%, 3 trials). Peripheral vascular disease (PVD) was not reported as an outcome. IL-6 RAs The evidence is very uncertain about the effects of the intervention on all-cause mortality (RR 0.68, 95% CI 0.12 to 3.74, I2 = 30%, 3 trials), myocardial infarction (RR 0.27, 95% CI 0.04 to1.68, I2 = 0%, 3 trials), heart failure (RR 1.02, 95% CI 0.11 to 9.63, I2 = 0%, 2 trials), PVD (RR 2.94, 95% CI 0.12 to 71.47, 1 trial), stroke (RR 0.34, 95% CI 0.01 to 8.14, 1 trial), or any infection (rate ratio 1.10, 95% CI: 0.88 to 1.37, I2 = 18%, 5 trials). Adverse events may increase (RR 1.13, 95% CI 1.04 to 1.23, I2 = 33%, 5 trials). No trial assessed unstable angina. TNF inhibitors The evidence is very uncertain about the effects of the intervention on all-cause mortality (RR 1.78, 95% CI 0.63 to 4.99, I2 = 10%, 3 trials), myocardial infarction (RR 2.61, 95% CI 0.11 to 62.26, 1 trial), stroke (RR 0.46, 95% CI 0.08 to 2.80, I2 = 0%; 3 trials), heart failure (RR 0.85, 95% CI 0.06 to 12.76, 1 trial). Adverse events may increase (RR 1.13, 95% CI 1.01 to 1.25, I2 = 51%, 13 trials). No trial assessed unstable angina or PVD. Secondary prevention: IL-1 RAs The evidence is very uncertain about the effects of the intervention on all-cause mortality (RR 0.94, 95% CI 0.84 to 1.06, I2 = 0%, 8 trials), unstable angina (RR 0.88, 95% CI 0.65 to 1.19, I2 = 0%, 3 trials), PVD (RR 0.85, 95% CI 0.19 to 3.73, I2 = 38%, 3 trials), stroke (RR 0.94, 95% CI 0.74 to 1.2, I2 = 0%; 7 trials), heart failure (RR 0.91, 95% 0.5 to 1.65, I2 = 0%; 7 trials), or adverse events (RR 0.92, 95% CI 0.78 to 1.09, I2 = 3%, 4 trials). There may be little to no difference between the groups in myocardial infarction (RR 0.88, 95% CI 0.0.75 to 1.04, I2 = 0%, 6 trials). IL6-RAs The evidence is very uncertain about the effects of the intervention on all-cause mortality (RR 1.09, 95% CI 0.61 to 1.96, I2 = 0%, 2 trials), myocardial infarction (RR 0.46, 95% CI 0.07 to 3.04, I2 = 45%, 3 trials), unstable angina (RR 0.33, 95% CI 0.01 to 8.02, 1 trial), stroke (RR 1.03, 95% CI 0.07 to 16.25, 1 trial), adverse events (RR 0.89, 95% CI 0.76 to 1.05, I2 = 0%, 2 trials), or any infection (rate ratio 0.66, 95% CI 0.32 to 1.36, I2 = 0%, 4 trials). No trial assessed PVD or heart failure. TNF inhibitors The evidence is very uncertain about the effect of the intervention on all-cause mortality (RR 1.16, 95% CI 0.69 to 1.95, I2 = 47%, 5 trials), heart failure (RR 0.92, 95% 0.75 to 1.14, I2 = 0%, 4 trials), or adverse events (RR 1.15, 95% CI 0.84 to 1.56, I2 = 32%, 2 trials). No trial assessed myocardial infarction, unstable angina, PVD or stroke. Adverse events may be underestimated and benefits inflated due to inadequate reporting. AUTHORS' CONCLUSIONS: This Cochrane review assessed the benefits and harms of using interleukin-receptor antagonists and tumour necrosis factor inhibitors for primary and secondary prevention of atherosclerotic diseases compared with placebo or usual care. However, the evidence for the predetermined outcomes was deemed low or very low certainty, so there is still a need to determine whether these interventions provide clinical benefits or cause harm from this perspective. In summary, the different biases and imprecision in the included studies limit their external validity and represent a limitation to determining the effectiveness of the intervention for both primary and secondary prevention of ACVD.
- MeSH
- ateroskleróza * prevence a kontrola mortalita MeSH
- humanizované monoklonální protilátky * aplikace a dávkování škodlivé účinky MeSH
- infarkt myokardu * prevence a kontrola mortalita MeSH
- lidé MeSH
- nestabilní angina pectoris prevence a kontrola mortalita MeSH
- příčina smrti MeSH
- primární prevence * metody MeSH
- randomizované kontrolované studie jako téma MeSH
- receptory interleukinu-1 * antagonisté a inhibitory MeSH
- sekundární prevence * metody MeSH
- TNF-alfa * antagonisté a inhibitory MeSH
- zkreslení výsledků (epidemiologie) MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- metaanalýza MeSH
- systematický přehled MeSH
- MeSH
- filozofie * MeSH
- kvartérní prevence metody MeSH
- lidé MeSH
- nádory * prevence a kontrola MeSH
- plošný screening metody MeSH
- primární prevence metody MeSH
- sekundární prevence metody MeSH
- terciární prevence metody MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
Doporučené postupy klinické péče o nosiče patogenních variant v klinicky relevantních nádorových predispozičních genech definují kroky primární a sekundární prevence, která by měla být těmto osobám ve vysokém riziku vzniku dědičných nádorů v ČR poskytnuta. Tvorba doporučení byla organizována pracovní skupinou onkogenetiky Společnosti lékařské genetiky a genomiky (SLG ČLS JEP) ve spolupráci se zástupci onkologie a onkogynekologie. Doporučené postupy vycházejí z aktuálních doporučení National Comprehensive Cancer Network (NCCN), European Society of Medical Oncology (ESMO) a zohledňují kapacitní možnosti našeho zdravotnictví.
The Guidelines for Clinical Practice for carriers of pathogenic variants in clinically relevant cancer predisposition genes define the steps of primary and secondary prevention that should be provided to these individuals at high risk of developing hereditary cancer in the Czech Republic. The drafting of the guidelines was organized by the Oncogenetics Working Group of the Society for Medical Genetics and Genomics of J. E. Purkyně Czech Medical Society (SLG ČLS JEP) in cooperation with the representatives of oncology and oncogynecology. The guidelines are based on the current recommendations of the National Comprehensive Cancer Network (NCCN), European Society of Medical Oncology (ESMO) and take into account the capacity of the Czech healthcare system.
- MeSH
- ATM protein genetika MeSH
- checkpoint kinasa 2 genetika MeSH
- genetická predispozice k nemoci * MeSH
- geny BRCA1 MeSH
- geny BRCA2 MeSH
- nádory prostaty diagnóza genetika prevence a kontrola MeSH
- nádory prsu diagnóza genetika prevence a kontrola MeSH
- nádory slinivky břišní diagnóza genetika prevence a kontrola MeSH
- nádory vaječníků diagnóza genetika prevence a kontrola MeSH
- primární prevence metody MeSH
- protein FANCN genetika MeSH
- sekundární prevence metody MeSH
- směrnice pro lékařskou praxi jako téma MeSH
- zárodečné mutace MeSH
x
x
- MeSH
- chování snižující riziko MeSH
- duševní poruchy * etiologie prevence a kontrola MeSH
- lidé MeSH
- návykové chování prevence a kontrola psychologie terapie MeSH
- poruchy příjmu potravy prevence a kontrola psychologie terapie MeSH
- primární prevence metody MeSH
- rodiče MeSH
- sebepoškozování prevence a kontrola psychologie terapie MeSH
- školní zdravotnické služby MeSH
- služby v oblasti duševního zdraví komunity organizace a řízení MeSH
- výchova a vzdělávání metody MeSH
- zdravotně rizikové chování MeSH
- Check Tag
- lidé MeSH
Súčasný koncept profesie lekárnika sa výrazne mení a "tradične" poskytovaná lekárenská starostlivosť sa postupne rozširuje o lekárenské služby v oblasti klinickej farmácie, ktoré sú priamo zamerané na pacienta a na jeho individuálne potreby. Odborné kompetencie lekárnikov sa globálne rozširujú a stávajú sa prirodzenou súčasťou lekárenskej starostlivosti celosvetovo. Vzhľadom na zvýšený tlak na primárnu starostlivosť v súčasnosti je nevyhnutné, aby lekárnici plne participovali v preventívnych programoch a boli zapojení do zdravotnej starostlivosti o pacientov s chronickými ochoreniami. Kľúčovým krokom pre slovenské lekárenstvo a rozvoj klinicky orientovaných služieb vo verejných lekárňach je zostavenie štandardných postupov schválených MZ SR, ktoré by sa mali stať spoločnými základnými piliermi pre výkon prevencie rôznych chronických ochorení a manažment pacientov s podozrením na akútne ochorenia v podmienkach verejných lekární.
The current concept of the profession of pharmacist is changing and "traditionally" provided pharmaceutical care is gradually expanding to include pharmacy services such as clinical pharmacy, which are directly focused on the individual patient. The professional competencies of pharmacists are expanding globally and are becoming a casual part of pharmaceutical care worldwide. Currently, for increased pressure on primary care, it is necessary that pharmacist fully participate in prevention programs and are involved in the healthcare of patients with chronic diseases. A crucial step for Slovak pharmacy and development of clinical services in community pharmacies is the creation of standard procedures approved by the Ministry of Health of the Slovak Republic, which should become the common base for the performance of prevention programs and management of patients with suspected acute diseases in the conditions of community pharmacies.
- MeSH
- farmaceuti * zákonodárství a právo MeSH
- fyzikální vyšetření MeSH
- lékárny MeSH
- lidé MeSH
- podpora zdraví * metody MeSH
- primární prevence metody MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
- Geografické názvy
- Slovenská republika MeSH
Orální restrikci můžeme považovat za problematiku, která spadá do dikce mnoha odborností, jako např. pediatra, laktační poradkyně, stomatologa, logopeda, ortodontisty, fyzioterapeuta, ORL lékaře a dalších. Je potřeba na ni nahlížet komplexně v širším časovém horizontu. Článek shrnuje dopady orální restrikce na pacienta v průběhu jeho vývoje a poukazuje na oblasti, které by mohly být diagnostickým vodítkem k odhalení orální restrikce a jejímu řešení z pohledu multidisciplinárního týmu. Čím je pacient starší, tím více odborníků se bude na jeho léčbě podílet. Tímto příspěvkem si klademe za cíl vzbudit zájem o problematiku u různých odborníků, a předcházet tak nepříznivým dopadům na zdraví jedinců. Orální restrikce jsou sice svým rozsahem malé tkáňové struktury, ale mohou velmi negativně ovlivnit kvalitu našeho života.
Tethered oral tissues can be considered as an issue that belongs under the scope of many specialists, such as paediatricians, lactation consultants, dentists, speech therapists, orthodontists, physiotherapists, ENT doctors and others. It is necessary to look at tethered oral tissues comprehensively in a broader timeframe. The article summarises the impact of tethered oral tissues on the patient throughout their development and highlights areas that could provide diagnostic clues to detect tethered oral tissues and their management from a multidisciplinary team perspective. The older the patient, the more specialists will be involved in their treatment. With this paper, we aim to arouse interest about the issue among different professionals and to prevent adverse effects on the health of the individual. Although tethered oral tissues are short stretches of tissue, they can have a very negative impact on the quality of life.
- MeSH
- ankyloglosie komplikace MeSH
- dítě MeSH
- lidé MeSH
- malokluze MeSH
- mezioborová komunikace MeSH
- nemoci úst * diagnóza komplikace MeSH
- podjazyková uzdička patologie MeSH
- poruchy artikulace etiologie MeSH
- poruchy dýchání etiologie MeSH
- poruchy hlasu etiologie MeSH
- poruchy příjmu potravy etiologie MeSH
- primární prevence metody MeSH
- retní uzdička patologie MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
V príspevku sa budeme venovať programu InterACT – Attitude Change & Tolerance Program (Weidner, 2015) určenému pre deti predškolského a mladšieho školského veku, ako i procesu jeho adaptácie do poľského (2019) a slovenského (2019–2023) jazyka. Program nadväzuje na niekoľko výskumov, ktoré sledovali postoje detí k zajakavosti a možnosti včasného oboznámenia sa s relevantnými informáciami o zajakavosti. Výskumy potvrdili potrebu venovať sa zmene postojov k zajakavosti už v predškolskom veku. Štatisticky sa preukázalo, že program InterACT efektívne zlepšuje postoje detí k zajakavosti a učí, ako vhodne komunikovať s deťmi so zajakavosťou (Wesierska a Weidner, 2022). Program je koncepčne vytvorený tak, aby bolo možné preložiť ho do iných jazykov so zohľadnením kultúrnych podmienok. Keďže Slovensko je jazykovo, kultúrne aj historickým kontextom blízke Poľsku, kde je efektivita programu potvrdená, javí sa nám aplikovanie výsledkov z ich výskumov relevantné aj pre Slovensko ako súčasť logopedickej prevencie a efektívnej podpory procesu antistigmatizácie
In this paper we discuss the InterACT - Attitude Change & Tolerance programme (Weidner, 2015) for preschool and younger school-age children, as well as the process of its adaptation into Polish (2019) and Slovak (2019-2023) languages. The programme builds on several research studies that have investigated children's attitudes towards stuttering and the possibilities of early exposure to relevant information about stuttering. Research has confirmed the need to address changing attitudes towards stuttering already at pre-school age. Statistically, the InterACT programme has been shown to be effective in improving children's attitudes toward stuttering and teaching how to appropriately interact with children with stuttering (Wesierska and Weidner, 2022). The programme is conceptualised in a way that it can be translated into other languages, with consideration of cultural contexts. As Slovakia is close in terms of language, culture and historical context to Poland, where the effectiveness of the programme is confirmed, we find the application of the results from their research relevant for Slovakia as part of speech therapy prevention and effective support of the process of anti-stigmatisation of stuttering.
Aims: Prevention is one of the most effective methods in the fight against respiratory infections. Electronic platforms can streamline care and have positive applications in the case of infectious diseases. This study was conducted to search for and describe the current scientific knowledge on prevention and the use of electronic platforms and their impact on the application of prevention strategies.Methods: A scoping review was conducted. In January 2022, a search was performed in selected licensed and free databases (EBSCOhost, Ovid, Scopus, Web of Science) based on PCC keywords using Boolean operators.Results: A total of 1927 sources were retrieved, of which 21 were subjected to critical analysis. 8 sources were included in the final review. Vaccination, social isolation, hygienic hand disinfection and respiratory protection are described as the most common and effective preventive measures. The platforms described had a positive effect on prevention and improving the quality of care.Conclusion: The effectiveness of the use of electronic platforms in prevention has been confirmed. Future research should be directed towards the development of these platforms to enable better diagnosis and treatment. Prevention-focused platforms can facilitate, simplify and improve care and access in the prevention of respiratory diseases.
- MeSH
- klinická studie jako téma MeSH
- lidé MeSH
- morbidita MeSH
- nemoci dýchací soustavy * prevence a kontrola MeSH
- pracovní síly MeSH
- primární prevence * metody MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- práce podpořená grantem MeSH
