early detection
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INTRODUCTION: The use of signal dogs for cancer detection is not yet routinely performed,but dogs and their powerful olfactory system have proven to be a unique and valuable tool for many lineages and are beginning to be incorporated into medical practice. This method has great advantages; the dog can detect a tumour in the human body already in preclinical stages, when the patient has no symptoms yet. The identification of cancer biomarkers to enable early diagnosis is a need for many types of cancer, whose prognosis is strongly dependent on the stage of the disease. However, this method also has its various pitfalls that must be taken into account. AIM: The aim of the study was to identify and highlight the factors that affect the level of detection accuracy, but also the conditions associated with olfactometric diagnosis. METHODS: The study included 48 dogs and 48 handlers, that were part of the training between 2016 and 2023.All those who started olfactometry training and remained in training for at least one year were included in the study. The dogs ranged in age from 8 months to 12 years and were of different races and sexes. After long-term observation, a qualitative analysis was performed and factors that may play a role in the early detection of the disease were listed. RESULTS: The results of the search for the different factors have been compiled into two groups, focussing on the actual handling of the patient biological sample from collection, processing, storage until transport, preparation of the sample,and detection. Focus on the actual work and behaviour of the dog and handler. CONCLUSION: There are many factors; however, it is worth addressing them because the canine sense of smell is one of the possible uses as a diagnostic method.
- Publikační typ
- časopisecké články MeSH
PURPOSE: High-dose intravenous glucocorticoids are the standard first-line treatment in active, moderate to severe and severe thyroid eye disease (TED). We evaluate the usefulness of clinical activity score (CAS) and thyroid-stimulating immunoglobulin (TSI) as predictors and/or post-treatment markers of corticoresistance in patients with TED and the effect of rituximab in second-line treatment. METHODS: We enrolled 236 patients with an active TED into this retrospective single-tertiary-center cohort study. All patients were initially treated with high-dose systemic glucocorticoids. Rituximab was later administered to 29 of 42 corticoresistant patients. RESULTS: The CAS of the corticoresistant patients was significantly higher both before (p = 0.0001) and after (p = <0.0001) first-line treatment compared to the corticosensitive group. ROC analysis established the cut-point value as CAS ≥ 2.5 with a sensitivity of 96.3%, specificity of 57.5% and area under the curve of 82.8%. In 22 patients treated with rituximab, CAS gradually decreased to zero values without reactivation during extended follow-up. There was no difference in the TSI of corticosensitive and corticoresistant patients before or after first-line therapy. CONCLUSION: CAS ≥ 2, after first-line treatment, could be used as a corticoresistance marker. Corticoresistant patients should be subject to long-term follow-up for early detection of reactivation to reduce the delay to second-line treatment. Rituximab is a well-tolerated choice of second-line treatment and has a long-lasting effect on disease activity. Although TSI is a valuable biomarker of Graves' disease and TED activity, according to our results, TSI cannot be used as a marker of corticoresistance.
- MeSH
- dospělí MeSH
- glukokortikoidy terapeutické užití MeSH
- Gravesova oftalmopatie * farmakoterapie krev MeSH
- imunoglobuliny stimulující tyreoideu krev MeSH
- imunologické faktory terapeutické užití MeSH
- léková rezistence * MeSH
- lidé středního věku MeSH
- lidé MeSH
- retrospektivní studie MeSH
- rituximab * terapeutické užití MeSH
- senioři MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Poly(ɛ-caprolactone) (PCL) is a biocompatible, biodegradable, and highly mechanically resilient FDA-approved material (for specific biomedical applications, e.g. as drug delivery devices, in sutures, or as an adhesion barrier), rendering it a promising candidate to serve bone tissue engineering. However, in vivo monitoring of PCL-based implants, as well as biodegradable implants in general, and their degradation profiles pose a significant challenge, hindering further development in the tissue engineering field and subsequent clinical adoption. To address this, photo-cross-linkable mechanically resilient PCL networks are developed and functionalized with a radiopaque monomer, 5-acrylamido-2,4,6-triiodoisophthalic acid (AATIPA), to enable non-destructive in vivo monitoring of PCL-based implants. The covalent incorporation of AATIPA into the crosslinked PCL networks does not significantly affect their crosslinking kinetics, mechanical properties, or thermal properties, but it increases their hydrolysis rate and radiopacity. Complex and porous 3D designs of radiopaque PCL networks can be effectively monitored in vivo. This work paves the way toward non-invasive monitoring of in vivo degradation profiles and early detection of potential implant malfunctions.
- MeSH
- biokompatibilní materiály chemie MeSH
- myši MeSH
- polyestery * chemie MeSH
- poréznost MeSH
- testování materiálů MeSH
- tkáňové inženýrství metody MeSH
- tkáňové podpůrné struktury * chemie MeSH
- vstřebatelné implantáty MeSH
- zvířata MeSH
- Check Tag
- myši MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
Acute kidney injury (AKI) due to gentamicin nephrotoxicity is a significant concern in clinical medicine, particularly in patients receiving prolonged or high-dose gentamicin therapy. Gentamicin is an aminoglycoside antibiotic frequently used in the treatment of a range of bacterial infections. However, its use is associated with nephrotoxicity which can manifest as AKI. Due to this, it is crucial to diagnose promptly and manage treatment effectively. Ongoing studies are therefore focusing on non-protein-coding RNAs as potential biomarkers for AKI. Numerous microRNAs (miRNAs) have been implicated in gentamicin-induced nephrotoxicity and AKI. They participate in pathways associated with inflammation, cell death, and oxidative stress and each of these factors play critical roles in the development of gentamicin-induced kidney injury. Research studies have demonstrated changes in the expression levels of these miRNAs in response to gentamicin exposure both in vitro and in in vivo models, as well as in human clinical trials involving patients receiving gentamicin therapy. The dysregulation of these miRNAs correlates with the severity of kidney injury and may serve as sensitive biomarkers for early detection and monitoring of AKI induced by gentamicin.
Minimal residual disease (MRD) is one of the most important prognostic factors in multiple myeloma (MM) and a valid surrogate for progression-free survival (PFS) and overall survival (OS). Recently, MRD negativity was approved as an early clinical endpoint for accelerated drug approval in MM. Nevertheless, there is limited evidence of MRD utility in real-world setting. In this retrospective multicenter study, we report outcomes of 331 newly diagnosed MM patients with MRD evaluation at Day+100 after autologous stem cell transplantation using flow cytometry with a median limit of detection of 0.001%. MRD negativity was reached in 47% of patients and was associated with significantly prolonged median PFS (49.2 months vs. 18.4 months; hazard ratios (HR) = 0.37; p < 0.001) and OS (not reached vs. 74.9 months; HR = 0.50; p = 0.007). Achieving MRD negativity was associated with PFS improvements regardless of age, International Staging System (ISS) stage, lactate dedydrogenase (LDH) level, or cytogenetic risk. Importantly, MRD positive patients benefited from lenalidomide maintenance versus no maintenance (18-months PFS: 81% vs. 46%; HR = 0.24; p = 0.002) while in MRD negative patients such benefit was not observed (p = 0.747). The outcomes of our real-world study recapitulate results from clinical trials including meta-analyses and support the idea that MRD positive patients profit more from lenalidomide maintenance than MRD negative ones.
- MeSH
- autologní transplantace MeSH
- dospělí MeSH
- lenalidomid aplikace a dávkování terapeutické užití MeSH
- lidé středního věku MeSH
- lidé MeSH
- mnohočetný myelom * diagnóza mortalita terapie patologie MeSH
- prognóza MeSH
- průtoková cytometrie * metody MeSH
- retrospektivní studie MeSH
- reziduální nádor * diagnóza MeSH
- senioři MeSH
- staging nádorů MeSH
- transplantace hematopoetických kmenových buněk metody MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
BACKGROUND AND OBJECTIVE: While prostate cancer (PCa) incidence and mortality rates continue to rise, early detection of PCa remains highly controversial, and the research landscape is rapidly evolving. Existing systematic reviews (SRs) and meta-analyses (MAs) provide valuable insights, but often focus on single aspects of early detection, hindering a comprehensive understanding of the topic. We aim to fill this gap by providing a comprehensive SR of contemporary SRs covering different aspects of early detection of PCa in the European Union (EU) and the UK. METHODS: On June 1, 2023, we searched four databases (Medline ALL via Ovid, Embase, Web of Science, and Cochrane Central Register of Controlled Trials) and Google Scholar. To avoid repetition of previous studies, only SRs (qualitative, quantitative, and/or MAs) were considered eligible. In the data, common themes were identified to present the evidence systematically. KEY FINDINGS AND LIMITATIONS: We identified 1358 citations, resulting in 26 SRs eligible for inclusion. Six themes were identified: (1) invitation: men at general risk should be invited at >50 yr of age, and testing should be discontinued at >70 yr or with <10 yr of life expectancy; (2) decision-making: most health authorities discourage population-based screening and instead recommend a shared decision-making (SDM) approach, but implementation of SDM in clinical practice varies widely; decision aids help men make more informed and value-consistent screening decisions and decrease men's intention to attempt screening, but these do not affect screening uptake; (3) acceptance: facilitators for men considering screening include social prompting by partners and clinician recommendations, while barriers include a lack of knowledge, low-risk perception, and masculinity attributes; (4) screening test and algorithm: prostate-specific antigen-based screening reduces PCa-specific mortality and metastatic disease in men aged 55-69 yr at randomisation if screened at least twice; (5) harms and benefits: these benefits come at the cost of unnecessary biopsies, overdiagnosis, and subsequent overtreatment; and (6) future of screening: risk-adapted screening including (prebiopsy) risk calculators, magnetic resonance imaging, and blood- and urine-based biomarkers could reduce these harms. To enable a comprehensive overview, we focused on SRs. These do not include the most recent prospective studies, which were therefore incorporated in the discussion. CONCLUSIONS AND CLINICAL IMPLICATIONS: By identifying consistent and conflicting evidence, this review highlights the evidence-based foundations that can be built upon, as well as areas requiring further research and improvement to reduce the burden of PCa in the EU and UK. PATIENT SUMMARY: This review of 26 reviews covers various aspects of prostate cancer screening such as invitation, decision-making, screening tests, harms, and benefits. This review provides insights into existing evidence, highlighting the areas of consensus and discrepancies, to guide future research and improve prostate cancer screening strategies in Europe.
- MeSH
- časná detekce nádoru * MeSH
- Evropská unie * MeSH
- lidé MeSH
- nádory prostaty * diagnóza MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
- Geografické názvy
- Spojené království MeSH
Hypoparatyreóza s hypokalcemií je jednou z nejčastějších komplikací operací štítné žlázy. Od roku 2022 využíváme ve Vojenské nemocnici v Brně peroperační vizualizaci příštítných tělísek (PT) pomocí autofluorescenčního systému Fluoptics, Fluobeam® LX (FF®). Cílem práce je prezentovat princip této metody a zhodnotit přínos pro operatéry a pacienty. Materiál a metody: Během každé operace štítné žlázy používáme systém FF®, který na podkladě fluorescenčních vlastností příštítných tělísek umožňuje jejich časnou peroperační detekci. Retrospektivní analýzou posuzujeme přínos této metody pro naše pracoviště. Sledujeme vliv zapojení systému FF® během tyreoidálních výkonů na snížení incidence neúmyslného odstranění PT, pokles výskytu pooperační hypokalcemie a vliv použití FF® na délku operace. Výsledky: Bylo hodnoceno celkem 309 pacientů. Soubor operovaných bez využití FF® zahrnoval 163 pacientů, soubor s použitím FF® 146 pacientů. PT bylo v souboru bez FF® neúmyslně odstraněno v 16,6 %, v souboru s FF® v 4,1 % případů. Pokles hladiny sérového vápníku < 2,00 mmol/l v pooperačním období jsme zaznamenali v souboru bez FF® v 18,4 %, v souboru s FF® ve 13,7 %. Pokles hladiny vápníku s nutnou dlouhodobou substitucí byl v souboru bez FF® 5,5 %, v souboru s FF® 0,7 %. Průměrná doba trvání totální tyreoidektomie s použitím FF® se prodloužila o 10,9 min, doba trvání hemityreoidektomie se prodloužila o 2,4 min. Závěr: Dosavadní zkušenosti s peroperačním fluorescenčním zobrazením příštítných tělísek na našem pracovišti prokazují významný pokles incidence nechtěného odstranění PT. Snížení výskytu dočasné i trvalé hypokalcemie nebylo statisticky významné. Celková doba operace se prodloužila v řádu jednotek minut.
Hypoparathyroidism with hypocalcemia is one of the most common complications of thyroid surgery. Since 2022, at the Military Hospital Brno, we have been using intraoperative visualization of the parathyroid glands (PG) with Fluoptics, Fluobeam® LX (FF®) autofluorescence system. We would like to present the principle of this method and evaluate the benefits for surgeons and patients. Materials and methods: During thyroid surgery, we use the FF® system, which based on the fluorescent properties of PG, enables early intraoperative detection. Through a retrospective analysis, we assess the benefit of this method-especially the effect of using the FF® system during thyroid procedures on the reduction of the incidence of inadvertent resection of PG, the decrease in the incidence of postoperative hypocalcemia, and the effect of the use of FF® for the duration of the operation. Results: A total of 309 patients were evaluated. The group of patients operated without using FF® included 163 patients, and the group using FF® included 146 patients. PG was unintentionally removed in 16.6% of cases in the group without using FF®, and in 4.1% of cases in the group using FF®. A drop in the serum calcium level below 2.00 mmol/ l was registered during the postoperative period in 18.4% in the group without using FF® and 13.7% in the group using FF®. Long-term calcium substitution was necessary in 5.5% cases in the group without using FF®, and 0.7% in the group using FF®. The average duration of total thyroidectomy using FF® increased by 10.9 minutes, and the duration of hemithyroidectomy increased by 2.4 minutes. Conclusion: According to our experience, intraoperative fluorescence imaging confi rms a decrease in the incidence of inadvertent resection of PG. Reduction in the incidence of temporary and permanent hypocalcemia was not significant. The mean operative time was extended in units of minutes.
Úvod: Onkologické skríningy sú kľúčové pre včasné odhalenie rakoviny a zvýšenie šancí na úspešnú liečbu. Sestry hrajú dôležitú rolu v edukácii pacientov a verejnosti o prevencii onkologických ochorení. Cieľ: Cieľom prieskumu bolo zistiť úroveň vedomostí študentov ošetrovateľstva o onkologických skríningových programoch na Slovensku. Metodika: Prieskum sa uskutočnil na Fakulte ošetrovateľstva a zdravotníckych odborných štúdií Slovenskej zdravotníckej univerzity v Bratislave od novembra 2023 do februára 2024. Prieskumná vzorka zahŕňala denných študentov bakalárskeho štúdia ošetrovateľstva, ktorí vyplnili dotazník zameraný na onkologické skríningové programy na Slovensku. Dotazník obsahoval 4 sociodemografické, 14 vedomostných a 2 osobnostné otázky. Prieskum bol dobrovoľný, anonymný a vyžadoval súhlas študenta. Výsledky boli vyhodnotené v absolútnych a relatívnych číslach. Výsledky: Prieskumu sa zúčastnilo 129 študentov (100 %), z toho 124 (96,12 %) žien a 5 (3,88 %) mužov. Najväčšiu skupinu tvorili študenti 1. ročníka v počte 58 (44,97 %). Priemerný počet získaných bodov bol 9,7 z maximálnych 14 bodov (min. 2, max. 14, SD: 3,4), čo predstavuje 69,73% úspešnosť vo vedomostných otázkach. Najvyššiu úspešnosť dosiahli študenti 3. ročníka (74 %). Najlepšie výsledky dosiahli študenti v odpovediach týkajúcich sa rakoviny krčka maternice (61 – 85 % správnych odpovedí), zatiaľ čo najnižšie výsledky pri otázkach o rakovine prsníka (24 – 65 % správnych odpovedí). Až 97,67 % študentov vyjadrilo záujem dozvedieť sa viac o prevencii v onkológii, pričom 62,79 % študentov sa domnieva, že by nedokázali edukovať pacienta v oblasti onkologickej prevencie. Záver: Vzhľadom na rastúcu incidenciu onkologických ochorení je dôležité zamerať sa na vzdelávanie študentov ošetrovateľstva v oblasti prevencie v onkológii, aby boli pripravení vykonávať edukačné intervencie a zvyšovať zdravotnú gramotnosť pacientov a širokej verejnosti.
Introduction: Cancer screenings are essential for the early detection of cancer and increasing the chances of successful treatment. Nurses play a crucial role in educating patients and the public about cancer prevention. Aim: The aim of the survey was to assess nursing students’ knowledge of cancer screening programs in Slovakia. Methodology: The survey was conducted at the Faculty of Nursing and Professional Health Studies of the Slovak Medical University in Bratislava from November 2023 to February 2024. The survey sample included full-time bachelor’s nursing students who completed a questionnaire focused on cancer screening programs in Slovakia. The questionnaire consisted of 4 sociodemographic, 14 knowledgebased, and 2 personal questions. Knowledge-based questions were evaluated, for which students could earn a maximum of 14 points. The student received 1 point for each correct answer, and for an incorrect answer or no answer, they received 0 points. Participation in the survey was voluntary, anonymous, and required the student’s consent. The results were evaluated in absolute and relative numbers. Results: A total of 129 students (100%) participated in the survey, including 124 women (96.12%) and 5 men (3.88%). The largest group consisted of first-year students, with 58 participants (44.97%). The average number of points obtained was 9.7 out of a maximum of 14 (min:. 2, max. 14, SD: 3.4), representing a 69.73% success rate in knowledge-based questions. The highest success rate was achieved by third-year students (74%). The best results were obtained in questions related to cervical cancer (61–85% correct answers), while the lowest results were observed in questions about breast cancer (24–65% correct answers). As many as 97.67% of students expressed interest in learning more about cancer prevention, while 62.79% believed they would not be able to educate a patient about cancer prevention. Conclusion: Given the increasing incidence of cancer diseases, it is crucial to focus on educating nursing students in cancer prevention to prepare them for providing educational interventions and enhancing the health literacy of patients and the general public.
- MeSH
- dospělí MeSH
- lidé MeSH
- mladiství MeSH
- nádory prevence a kontrola MeSH
- plošný screening MeSH
- průzkumy a dotazníky MeSH
- studenti ošetřovatelství * MeSH
- studium ošetřovatelství MeSH
- znalosti * MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Geografické názvy
- Slovenská republika MeSH
... Diethyldithiocarbamate-copper complex ignites the tumor microenvironment trough NKG2D-NKG2DL axis -- Quality of life in early ... ... partial-breast irradiation (APBI) in randomized trial -- Biomarkers, omics and artificial intelligence for early ... ... detection of pancreatic cancer ...
OBJECTIVE: The aim of the study was the assessment of adherence to antiretroviral (ARV) treatment in a population of people living with HIV (PWH), improving the awareness of PWH, drawing attention to the risk of developing HIV drug resistance and subsequent treatment failure. METHODS: The basic cohort consisted of PWH followed up long-term at the HIV centre of the University Hospital Pilsen. Adherence to treatment was assessed by ARV levels. Nucleoside analogs were determined in urine by high pressure liquid chromatography (HPLC), in relation to clinical data, viral load (HIV RNA), and absolute CD4 and CD8 T cell counts. To assess mental and physical state of the patients, a modified SF-36 questionnaire was used to measure social relationships, education and ability to relax. RESULTS: From a group of 131 PWH, 18 (13.7%) with zero levels and 113 (86.3%) with any detectable ARV levels were followed for 6-12 months. A statistically significant lower viral load was demonstrated in patients who adhered to the treatment at the time of the test as indicated by ARV levels in the urine. CD4 T lymphocyte values in adherent patients were, as expected, statistically significantly higher. A significant difference for CD8 T lymphocyte was not demonstrated. A survey assessed subjective factors influencing the degree of adherence. PWH consider important: quality care enabling trust, low risk of developing opportunistic infections, self-sufficiency, quality of sleep, managing leisure activities, and good family relationships. Quality of life evaluation and satisfaction in the monitored areas were similar in both groups of PWH. CONCLUSIONS: Non-adherence leads to deterioration of CD4 and viral load levels and may be the cause of the development of HIV drug resistance and treatment failure on the part of the patient. PWH with zero or low urinary nucleoside levels were repeatedly instructed about the need for regular and sustained medication use. Regular checks with a laboratory examination service are needed to detect early emergence of resistance and side effects of the treatment, which are initially only detectable in the laboratory.
- MeSH
- adherence k farmakoterapii * psychologie MeSH
- dospělí MeSH
- HIV infekce * farmakoterapie psychologie MeSH
- kohortové studie MeSH
- kvalita života * MeSH
- látky proti HIV * terapeutické užití moč MeSH
- lidé středního věku MeSH
- lidé MeSH
- počet CD4 lymfocytů MeSH
- virová nálož MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH