• MeSH
• adjuvantní chemoterapie MeSH
• kombinovaná farmakoterapie MeSH
• nádory prsu terapie   MeSH
• protinádorové látky MeSH

• Konspekt
• Patologie. Klinická medicína
• NLK Obory
• onkologie

• MeSH
• estrogeny aplikace a dávkování   fyziologie   MeSH
• ethinylestradiol aplikace a dávkování   MeSH
• kontraceptiva orální hormonální MeSH
• kosti a kostní tkáň účinky záření   MeSH
• kostní denzita fyziologie   účinky léků   MeSH
• lidé MeSH
• menstruační cyklus MeSH
• mladiství MeSH
• vývoj kostí MeSH
• Check Tag
• lidé MeSH
• mladiství MeSH
• ženské pohlaví MeSH

• MeSH
• fotochemie MeSH
• fotometrie MeSH
• matematické výpočty počítačové MeSH
• radiografie MeSH
• zuby radiografie   MeSH

• Konspekt
• Fyzioterapie. Psychoterapie. Alternativní lékařství
• NLK Obory
• radiologie, nukleární medicína a zobrazovací metody

The aim of the study was to compare the bone mineral density (BMD) and body composition between ambulatory male MS patients and control subjects and to evaluate the relationships among body composition, motor disability, glucocorticoids (GC) use, and bone health. Body composition and BMD were measured by dual-energy X-ray absorptiometry in 104 ambulatory men with MS (mean age: 45.2 years) chronically treated with low-dose GC and in 54 healthy age-matched men. Compared to age-matched controls, MS patients had a significantly lower total body bone mineral content (TBBMC) and BMD at all measured sites except for the radius. Sixty five male MS patients (62.5 %) met the criteria for osteopenia and twenty six of them (25 %) for osteoporosis. The multivariate analysis showed a consistent dependence of bone measures (except whole body BMD) on BMI. The total leg lean mass % was as an independent predictor of TBBMC. The Expanded Disability Status Scale (EDSS), cumulative GC dose and age were independent determinants for BMD of the proximal femur. We conclude that decreasing mobility in male MS patients is associated with an increasing degree of osteoporosis and muscle wasting in the lower extremities. The chronic low-dose GC treatment further contributes to bone loss.

• MeSH
• dospělí MeSH
• glukokortikoidy terapeutické užití   MeSH
• kostní denzita fyziologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• roztroušená skleróza farmakoterapie   metabolismus   MeSH
• složení těla fyziologie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

OBJECTIVE: The endpoint of this prospective study is to evaluate response rate, survival and toxicity of high-dose density neoadjuvant chemotherapy (NAC) in bulky IB cervical cancer. MATERIAL AND METHODS: Between January 1998 and December 2009, 154 women were enrolled into study. Three patients were withdrawn. Of the 151 women, 119 had stage IB2 cervical cancer (78.8%) and 32 had stage IB1 cancer (21.2%) infiltrating the whole cervical stroma. Women received 3-4cycle cisplatin-75mg/m(2) and ifosfamide-2g/m(2) in cases of squamous-cell cancer or cisplatin-75mg/m(2) and doxorubicin-35mg/m(2) in adenocarcinoma every 10days and then underwent radical hysterectomy type III. Patients who had non-resectable disease underwent chemoradiotherapy. RESULTS: The overall response rate (reduction of tumor volume more than 50%) was 78.8%. Reduction of tumor volume less than 50% was seen in 15.2%. Tumor progression during chemotherapy occurred in nine patients (6.0%). There were positive lymph-nodes in 26 patients (18.3%) of the 142 that underwent surgery. 38 women underwent adjuvant radiotherapy (26.7%). There were 26 recurrences (17.2%). After surgery 20 women recurred from 142 (14.1%) and after primary radiotherapy 6 from 9 women recurred (66.7%). 25 of 151 women died from disease (16.5%). At the time of the study, surgery was performed in 118 women 5 or more years ago, 19 of them died of disease. Five-year specific survival is 83.6%. Grade 3-4 neutropenia was found in only 7.3% of the women, and grade 3-4 thrombocytopenia were found in 1.3%. CONCLUSION: High-dose density NAC appears to be feasible in the treatment IB bulky cervical cancer and toxicity is acceptable. Adjuvant radiotherapy was used only in 26.7%.

• MeSH
• adjuvantní chemoterapie MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• lokální recidiva nádoru MeSH
• nádory děložního čípku farmakoterapie   mortalita   patologie   MeSH
• přežití bez známek nemoci MeSH
• prospektivní studie MeSH
• senioři MeSH
• staging nádorů MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• klinické zkoušky MeSH
• práce podpořená grantem MeSH

We report five patients with early-stage cervical cancer who do not fulfill criteria of fertility-sparing surgery (tumor more than 2 cm in the biggest diameter or infiltrating more than half of stroma). Five patients received three cycles of dose density neoadjuvant chemotherapy (NAC) at a 10-day interval: cisplatin plus ifosfamide in squamous cell cancer or plus doxorubicin in adenocarcinoma with good tolerance. After NAC, they underwent laparoscopic pelvic lymphadenectomy and vaginal simple trachelectomy. Two patients had no residual tumor, two had only microscopic residual disease, and one had macroscopic residual disease. Two women became pregnant 5 and 8 months after surgery, one delivered in term healthy baby and one is now in the second trimester of pregnancy without any complications. NAC followed by fertility-sparing surgery seems to be feasible treatment for women with tumor bigger than 2 cm or infiltrated more than half of the stroma.

• MeSH
• cervix uteri chirurgie   MeSH
• dospělí MeSH
• financování organizované MeSH
• lidé MeSH
• nádory děložního čípku farmakoterapie   chirurgie   patologie   MeSH
• protinádorové látky terapeutické užití   MeSH
• těhotenství MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH

BACKGROUND: The aim was to evaluate changes of bone mineral density (BMD) and markers of bone turnover in healthy adolescents, and in adolescent users of combined oral contraceptives (COCs) with different ethinylestradiol (EE) contents. METHODS: In this prospective crossover study, 56 healthy females (15-19.5 years) with desire to use hormonal contraception were randomized to COC with either 30 or 15 μg of EE in crossover design of 9-month intervention each in reverse order. Nonusers of the same age (n=28) served as controls. BMD at lumbar spine (LS), total femur, femoral neck, distal radius, and total body, and serum markers (N-propeptide of type I procollagen, and type I collagen C-telopeptide) were measured at baseline and after 9 and 18 months. RESULTS: In COC nonusers, BMD significantly increased at LS and radius, while markers decreased. In COC users, BMD did not increase, with the exception of LS BMD in the 30 μg COC group (P<0.05). In the crossover design, a difference between the low- and very low-dose COC users was found in LS BMD changes (P<0.05), where increase in BMD was more impaired in the 15 μg COC users. The skeletal effects of COC remained significant after adjustments for age and smoking status. Markers declined faster in COC users during the first period, while they remained stable or even increased during the second 9 months. CONCLUSION: Physiological acquisition of LS BMD during adolescent age may be prevented by use of COC, especially those containing very low dose of EE.

• MeSH
• analýza rozptylu MeSH
• bederní obratle metabolismus   MeSH
• biologické markery krev   metabolismus   MeSH
• časové faktory MeSH
• denzitometrie MeSH
• elektrochemie MeSH
• ethinylestradiol aplikace a dávkování   škodlivé účinky   MeSH
• faktory vyvracející (epidemiologie) MeSH
• femur metabolismus   MeSH
• imunoanalýza metody   MeSH
• klinické křížové studie MeSH
• kolagen typu I krev   MeSH
• kontraceptiva orální kombinovaná aplikace a dávkování   škodlivé účinky   MeSH
• kosti a kostní tkáň účinky léků   metabolismus   MeSH
• kostní denzita účinky léků   fyziologie   MeSH
• krček femuru metabolismus   MeSH
• lidé MeSH
• luminiscence MeSH
• mladiství MeSH
• mladý dospělý MeSH
• peptidové fragmenty krev   MeSH
• peptidy krev   MeSH
• prokolagen krev   MeSH
• prospektivní studie MeSH
• radius metabolismus   MeSH
• remodelace kosti účinky léků   fyziologie   MeSH
• rozvrh dávkování léků MeSH
• vitamin D analogy a deriváty   krev   MeSH
• výzkumný projekt MeSH
• Check Tag
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• randomizované kontrolované studie MeSH

Progression-free survival (PFS) of patients with lower-risk myelodysplastic syndromes (MDS) treated with red blood cell transfusions is usually reduced, but it is unclear whether transfusion dose density is an independent prognostic factor. The European MDS Registry collects prospective data at 6-monthly intervals from newly diagnosed lower-risk myelodysplastic syndromes patients in 16 European countries and Israel. Data on the transfusion dose density - the cumulative dose received at the end of each interval divided by the time since the beginning of the interval in which the first transfusion was received - were analyzed using proportional hazards regression with time-varying co-variates, with death and progression to higher-risk MDS/acute myeloid leukemia as events. Of the 1,267 patients included in the analyses, 317 died without progression; in 162 patients the disease had progressed. PFS was significantly associated with age, EQ-5D index, baseline World Health Organization classification, bone marrow blast count, cytogenetic risk category, number of cytopenias, and country. Transfusion dose density was inversely associated with PFS (P<1×10-4): dose density had an increasing effect on hazard until a dose density of 3 units/16 weeks. The transfusion dose density effect continued to increase beyond 8 units/16 weeks after correction for the impact of treatment with erythropoiesis-stimulating agents, lenalidomide and/or iron chelators. In conclusion, the negative effect of transfusion treatment on PFS already occurs at transfusion densities below 3 units/16 weeks. This indicates that transfusion dependency, even at relatively low dose densities, may be considered as an indicator of inferior PFS. This trial was registered at www.clinicaltrials.gov as #NCT00600860.

• MeSH
• doba přežití bez progrese choroby MeSH
• lidé MeSH
• myelodysplastické syndromy * terapie   MeSH
• prospektivní studie MeSH
• transfuze erytrocytů škodlivé účinky   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Evropa MeSH
• Izrael MeSH

Only 50% of patients with relapsed Hodgkin lymphoma (HL) can be cured with intensive induction chemotherapy, followed by high-dose chemotherapy (HDCT) and autologous stem cell transplant (ASCT). Based on the results of the HDR2 trial two courses of DHAP and subsequent HDCT/ASCT are the current standard of care in relapsed HL. In order to assess the prognostic relevance of DHAP dose density, we performed a retrospective multivariate analysis of the HDR2 trial (N=266). In addition to four risk factors (early or multiple relapse, stage IV disease or anemia at relapse, and grade IV hematotoxicity during the first cycle of DHAP) a delayed start of the second cycle of DHAP>day 22 predicted a significantly poorer progression-free survival (PFS, p=0.0356) and overall survival (OS, p=0.0025). In conclusion, our analysis strongly suggests that dose density of DHAP has a relevant impact on the outcome of relapsed HL patients.

• MeSH
• adjuvantní radioterapie MeSH
• cisplatina škodlivé účinky   terapeutické užití   MeSH
• cytarabin škodlivé účinky   terapeutické užití   MeSH
• dexamethason škodlivé účinky   terapeutické užití   MeSH
• dospělí MeSH
• Hodgkinova nemoc farmakoterapie   mortalita   patologie   MeSH
• kombinovaná terapie MeSH
• lidé středního věku MeSH
• lidé MeSH
• opakovaná terapie MeSH
• prognóza MeSH
• proporcionální rizikové modely MeSH
• protokoly protinádorové kombinované chemoterapie škodlivé účinky   terapeutické užití   MeSH
• recidiva MeSH
• staging nádorů MeSH
• transplantace hematopoetických kmenových buněk MeSH
• výsledek terapie MeSH
• záchranná terapie MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• klinické zkoušky, fáze III MeSH
• multicentrická studie MeSH
• práce podpořená grantem MeSH
• randomizované kontrolované studie MeSH
• Geografické názvy
• Německo MeSH

• MeSH
• dichlormethylendifosfonát MeSH
• kostní denzita MeSH
• mnohočetný myelom MeSH
• osteolýza MeSH
• počítačová rentgenová tomografie MeSH
• rozvrh dávkování léků MeSH
• vztah mezi dávkou a účinkem léčiva MeSH