DESCARTES Dotaz Zobrazit nápovědu
Cílem našeho referátu je vysvětlení zaprvé, proč se univerzálně lidské přesvědčení o dualismu duše a těla stále tak neodbytně vtírá do lidských myslí, zadruhé jak navzdory Descartově snaze i ty nejabstraktnější mentální procesy (pojmové a jazykové) předpokládají jako svoji nutnou podmínku tělesnou strukturaci lidské zkušenosti. V tomto kontextu a rovněž klíčovém bodě referátu se jako podpory pro naši argumentaci budeme odvolávat zejména na teorii metafor kognitivního lingvisty George Lakoffa a na koncepci pocitů jakožto tělesných map neurovědce Antonia Damasia.
It is safe to say that even our paleolithic ancestors had an intuitive hypothesis about the fundamental differences between human mind and body. This intuition was given a precise expression at the beginning of the Modern Age in Descartes' discrimination between mental and bodily states which results in notion of Cartesian dualism. But for the scientific approach of the 20th and 21st century that kind of dualism is unacceptable. The aim of our article is to explain why we are to the present day prone to believe in ontological difference between mind and body. Secondly, how despite Descartes' effort even those the most abstract mental operations are necessarily bound and mediated with the representations of bodily states. In this context, as a support for our argumentation we will invoke on the cognitive linguist George Lakoff's metaphor theory and on the neuroscientist Antonio Damasio's theory of feelings as bodily mapings.
Transplantation medicine is a rapidly evolving field. Keeping afloat of the published literature to offer the best clinical care to our patients is a daunting task. As part of its educational mission, the Descartes advisory board identified seven topics in kidney transplantation where there has been substantial progresses over the last years: kidney allocation within Eurotransplant; kidney exchange strategies; kidney machine perfusion strategies; the changing landscape of anti-human leukocyte antigen (HLA) antibodies; the new immunosuppressive drugs in the pipeline; strategies for immunosuppression minimization; and the continuous enigma of focal segmental glomerular sclerosis recurrence after transplantation. Here, we have summarized the main knowledge and the main challenges of these seven topics with the aim to provide transplant professionals at large with key bullet points to successfully understand these new concepts.
- MeSH
- alokace zdrojů * MeSH
- chronické selhání ledvin terapie MeSH
- fokálně segmentální glomeruloskleróza prevence a kontrola MeSH
- imunosupresiva terapeutické užití MeSH
- lidé MeSH
- transplantace ledvin metody MeSH
- výběr pacientů * MeSH
- získávání tkání a orgánů normy MeSH
- zvířata MeSH
- Check Tag
- lidé MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
Two recent matched cohort studies from the USA and Norway published in 2014 have raised some concerns related to the long-term safety of kidney living donation. Further studies on the long-term risks of living donation have since been published. In this position paper, Developing Education Science and Care for Renal Transplantation in European States (DESCARTES) board members critically review the literature in an effort to summarize the current knowledge concerning long-term risks of kidney living donation to help physicians for decision-making purposes and for providing information to the prospective live donors. Long-term risk of end-stage renal disease (ESRD) can be partially foreseen by trying to identify donors at risk of developing ‘de novo’ kidney diseases during life post-donation and by predicting lifetime ESRD risk. However, lifetime risk may be difficult to assess in young donors, especially in those having first-degree relatives with ESRD. The study from Norway also found an increased risk of death after living donor nephrectomy, which became visible only after >15 years of post-donation follow-up. However, these findings are likely to be largely the result of an overestimation due to the confounding effect related to a family history of renal disease. DESCARTES board members emphasize the importance of optimal risk–benefit assessment and proper information to the prospective donor, which should also include recommendations on health-promoting behaviour post-donation.
- MeSH
- autistická porucha * MeSH
- dítě MeSH
- lidé MeSH
- psychoanalytická teorie MeSH
- vývojová psychologie MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
BACKGROUND: Kidney recipients maintaining a prolonged allograft survival in the absence of immunosuppressive drugs and without evidence of rejection are supposed to be exceptional. The ERA-EDTA-DESCARTES working group together with Nantes University launched a European-wide survey to identify new patients, describe them and estimate their frequency for the first time. METHODS: Seventeen coordinators distributed a questionnaire in 256 transplant centres and 28 countries in order to report as many 'operationally tolerant' patients (TOL; defined as having a serum creatinine <1.7 mg/dL and proteinuria <1 g/day or g/g creatinine despite at least 1 year without any immunosuppressive drug) and 'almost tolerant' patients (minimally immunosuppressed patients (MIS) receiving low-dose steroids) as possible. We reported their number and the total number of kidney transplants performed at each centre to calculate their frequency. RESULTS: One hundred and forty-seven questionnaires were returned and we identified 66 TOL (61 with complete data) and 34 MIS patients. Of the 61 TOL patients, 26 were previously described by the Nantes group and 35 new patients are presented here. Most of them were noncompliant patients. At data collection, 31/35 patients were alive and 22/31 still operationally tolerant. For the remaining 9/31, 2 were restarted on immunosuppressive drugs and 7 had rising creatinine of whom 3 resumed dialysis. Considering all patients, 10-year death-censored graft survival post-immunosuppression weaning reached 85% in TOL patients and 100% in MIS patients. With 218 913 kidney recipients surveyed, cumulative incidences of operational tolerance and almost tolerance were estimated at 3 and 1.5 per 10 000 kidney recipients, respectively. CONCLUSIONS: In kidney transplantation, operational tolerance and almost tolerance are infrequent findings associated with excellent long-term death-censored graft survival.
- MeSH
- dospělí MeSH
- homologní transplantace MeSH
- imunologická tolerance imunologie MeSH
- imunosupresivní léčba metody MeSH
- incidence MeSH
- lidé MeSH
- míra přežití trendy MeSH
- přežívání štěpu imunologie MeSH
- příjemce transplantátu * MeSH
- průzkumy a dotazníky MeSH
- rejekce štěpu epidemiologie imunologie prevence a kontrola MeSH
- transplantace ledvin * MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- Geografické názvy
- Evropa epidemiologie MeSH
BACKGROUND: Existing guidelines on the evaluation and preparation of recipients for kidney transplantation target the entire spectrum of patients with end-stage renal disease. Within the ERA-EDTA Developing Education Science and Care for Renal Transplantation in European States (DESCARTES) Working Group, it was proposed that in a subset of relatively young patients (<40 years) without significant comorbidities (such as diabetes or cardiovascular disease), the work-up for transplantation could be restricted to a small set of tests. METHODS: Aiming for agreement between transplant centres across Europe, we surveyed the opinion of 80 transplant professionals from 11 European states on the composition of a minimal work-up. RESULTS: We show that there is a wide agreement among European experts that the work-up for kidney transplantation of the low-risk candidate, as opposed to the standard risk candidate, could include a limited number of investigations. However, there is some disagreement regarding the small number of diagnostic procedures, which is related to geographical location within Europe and the professional background of respondents. CONCLUSIONS: Based on the results of the survey, published guidelines and expert meetings by the DESCARTES Working Group, we have formulated a proposal for the work-up of low-risk kidney transplant candidates.
- MeSH
- chronické selhání ledvin diagnóza chirurgie MeSH
- dospělí MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- předoperační péče * MeSH
- průzkumy zdravotní péče MeSH
- směrnice pro lékařskou praxi jako téma normy MeSH
- transplantace ledvin výchova normy MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Evropa MeSH
