- Publikační typ
- abstrakt z konference MeSH
BACKGROUND: Atherosclerosis and coronary artery disease (CAD) are a common condition and cause of death in the elderly population. There are difficulties with risk assessment in the elderly as the objectification of their symptomatic status can be challenging due to neuromuscular weakness, physical deconditioning or neurological, orthopaedic, peripheral vascular, or respiratory limitations. Non-invasive coronary artery velocity assessment by Doppler method at rest could be helpful in the elderly population. To evaluate the prognostic role of coronary artery ultrasound assessment in a non-selected elderly population in everyday clinical practice. METHODS: One hundred forty-five patients, aged ≥75years (99 women; 80 ± 4 years), formed the study group. Left coronary artery flows were scanned in addition to conventional echocardiography. During a median follow-up of 26 months, 16 deaths and 2 non-fatal MI occurred. RESULTS: In multivariable analysis, maximal coronary velocity was the only independent predictor for mortality (heart rate [HR]: 1.02, 95%, CI: 1.01-1.04, p < .0005) and for mortality/MI (HR: 1.02, 95%, CI: 1.01-1.03, p < .0001). The value of 110 cm/s maximal coronary flow velocity (CFL) in the proximal segments of left arteries was the best predictor for death, sensitivity 50%, specificity 90%, p < .005. The annual mortality rate was 16.6% persons/year for patients with elevated CFL ≥110 cm/s. The value 81 cm/s was the best predictor for death/MI, sensitivity 61%, specificity 80%, p < .0005; annual mortality rate was 11.2% persons/year for patients with elevated CFL ≥81 cm/s (p < .0001). CONCLUSION: Doppler CFL scanning during routine echocardiography is a feasible and valuable tool for assessment of short-term prognosis in elderly patients.
- MeSH
- dopplerovská echokardiografie * metody MeSH
- echokardiografie MeSH
- koronární cirkulace fyziologie MeSH
- lidé MeSH
- nemoci koronárních tepen * MeSH
- prognóza MeSH
- rychlost toku krve fyziologie MeSH
- senioři MeSH
- Check Tag
- lidé MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Publikační typ
- abstrakt z konference MeSH
BACKGROUND: Prostate cancer (PCa) is the second most commonly diagnosed cancer in men. To date, the role of the combined application of long non-coding RNAs (PCA3, DLX1, HOXC6, TMPRSS2:ERG) for obtaining the most accurate method of detection of PCa has not yet been comprehensively investigated. METHODS: In total 240 persons were included in the retrospective study. Among them were 150 patients with confirmed PCa, 30 patients with benign prostatic hyperplasia, 30 patients with active chronic prostatitis and 30 healthy volunteers. In all patients, the urine samples were collected prior to biopsy or treatment. Polymerase chain reaction with reverse transcription was performed to detect the expression level of PCA3, HOXC6, DLX1 and the presence of the TMPRSS2:ERG transcript. RESULTS: PCA3 was detected in urine samples in all cases. Using a PCA3 score of 56 allowed the differentiation between PCa and all other cases with a sensitivity of 61% and specificity of 96% (p < 0.001) while a PCA3 score threshold value of 50 resulted in a differentiation between clinically significant PCa (ISUP grades 2-5) and all other cases with a sensitivity of 93% and specificity of 93% (p < 0.001). The TMPRSS2:ERG expression in urine was detected exclusively in the group of patients with PCa and only in 16% of all cases. CONCLUSIONS: PCA3 score detected in urine demonstrated moderate sensitivity and good specificity in differentiation between PCa and non-PCa and high sensitivity and specificity in differentiation between clinically significant PCa and non-PCa.
- MeSH
- antigeny nádorové * genetika MeSH
- fúzní onkogenní proteiny genetika moč MeSH
- homeodoménové proteiny genetika MeSH
- lidé MeSH
- nádorové biomarkery moč MeSH
- nádory prostaty * diagnóza genetika MeSH
- prostata patologie MeSH
- prostatický specifický antigen MeSH
- retrospektivní studie MeSH
- serinové endopeptidasy genetika MeSH
- transkripční regulátor ERG MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Metabolic reprogramming of cancer cells is a common hallmark of malignant transformation. The preference for aerobic glycolysis over oxidative phosphorylation in tumors is a well-studied phenomenon known as the Warburg effect. Importantly, metabolic transformation of cancer cells also involves alterations in signaling cascades contributing to lipid metabolism, amino acid flux and synthesis, and utilization of ketone bodies. Also, redox regulation interacts with metabolic reprogramming during malignant transformation. Flavonoids, widely distributed phytochemicals in plants, exert various beneficial effects on human health through modulating molecular cascades altered in the pathological cancer phenotype. Recent evidence has identified numerous flavonoids as modulators of critical components of cancer metabolism and associated pathways interacting with metabolic cascades such as redox balance. Flavonoids affect lipid metabolism by regulating fatty acid synthase, redox balance by modulating nuclear factor-erythroid factor 2-related factor 2 (Nrf2) activity, or amino acid flux and synthesis by phosphoglycerate mutase 1. Here, we discuss recent preclinical evidence evaluating the impact of flavonoids on cancer metabolism, focusing on lipid and amino acid metabolic cascades, redox balance, and ketone bodies.
- MeSH
- aminokyseliny * MeSH
- faktor 2 související s NF-E2 metabolismus MeSH
- flavonoidy farmakologie MeSH
- ketolátky metabolismus MeSH
- lidé MeSH
- metabolismus lipidů MeSH
- nádorová transformace buněk metabolismus MeSH
- nádory * farmakoterapie metabolismus MeSH
- oxidace-redukce MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
BACKGROUND: There is a lack of information about the prognostic value of high velocity in coronary arteries during echocardiography. The present study was aimed at investigating the three-year prognostic value of coronary velocity assessment in all patients who were referred for echocardiography examination. METHODS: The prospective study comprises 747 consecutive patients. Death, myocardial infarction (MI), acute coronary syndrome (ACS), and/or revascularisation were defined as major adverse cardiac events (MACE). Routine echocardiography was added with coronary velocity assessment in the left main, anterior descending, or circumflex coronary arteries by the Doppler method. RESULTS: During a median follow-up of 36 months, 192 patients experienced MACE. Deaths occurred more frequently in patients with high local velocity in proximal left-sided segments vs. in middle left-sided segments vs. patients without high coronary velocity (9 vs. 3 vs. 1%, p < 0.0001). Death/MI/ACS occurred in 17 vs. 7 vs. 1%, p < 0.0001, respectively. Age (HR 1.04, 95% CI 1.00; 1.06; p < 0.04), a velocity more than 65 cm/s in any proximal segments of the arteries (HR 4.7, 95% CI 1.9; 11.9; p < 0.002), ejection fraction (HR 0.97, 95% CI 0.94; 0.99; p < 0.007) were strong independent prognostic predictors of death/MI/ACS. The maximal velocity of coronary flow velocity had a significant additive prognostic value to ejection fraction. CONCLUSIONS: The coronary velocity parameters give long-term prognostic information that can be used to identify persons with a high risk of MACE in consecutive non-selected patients.
Všeobecné lekárstvo predstavuje odbor primárnej zdravotnej starostlivosti, ktorého fungovanie významne ovplyvňuje poskytovanie zdravotnej starostlivosti ako takej. Zabezpečenie kompetentných všeobecných lekárov si vyžaduje ich kvalitné vzdelávania. Na dosiahnutie tohto cieľa je vhodné začať už počas vysokoškolského pregraduálneho vzdelávania medikov a následne v rámci špecializačného štúdia v špecializačnom odbore všeobecné lekárstvo. Posledné roky vzdelávanie všeobecných lekárov na Slovensku prešlo viacerými pozitívnymi zmenami, ktorých cieľom je doplnenie kvalitných, kompetentných a erudovaných všeobecných lekárov do praxe. K 31. júlu 2022 bolo na Slovenskej zdravotníckej univerzite v Bratislave (SZU) do odboru všeobecné lekárstvo zaradených 433 lekárov, z toho do tzv. klasickej formy 316 a rezidentského štúdia 117 lekárov (z toho 38 malo prerušené špecializačné štúdium z dôvodu materskej alebo rodičovskej dovolenky). V klasickej forme bolo z celkového počtu 316 lekárov 22 zaradených do doplnkovej odbornej prípravy na získanie špecializácie v odbore všeobecné lekárstvo pre lekárov so získanou špecializáciou v odboroch vnútorného lekárstva (DOP-INT) a 25 v odbore anesteziológia a intenzívna medicína (DOP-AIM). Za posledných 10 rokov na SZU absolvovali špecializačné štúdium v špecializačnom odbore všeobecné lekárstvo 375 lekári, z toho 261 v tzv. klasickej forme, vrátane 18 v DOP-INT, traja v DOP-AIM a 114 rezidenti. Nakoľko všeobecné lekárstvo je veľmi dynamickým odborom medicíny, aj vzdelávanie musí reflektovať jeho potreby.
General medicine represents a field of primary health care, the functioning of which significantly affects the provision of subsequent health care as well. Ensuring competent general practitioners requires their quality education. To achieve this goal, it is advisable to start already during the undergraduate medical education and then as part of a specialized study in the specialized field of General Medicine. In recent years, the education of general practitioners in Slovakia has undergone several positive changes, the aim of which is to add high-quality, competent and knowledgeable general practitioners to practice. As of the date 31. 7. 2022, 433 doctors were enrolled in the education of general medicine at Slovak Medical University in Bratislava, (SMU) of which the so-called of the classical form 316 and residency study 117. In the classical form, out of the total number of 316 doctors, 22 were enrolled in additional training to obtain a specialization in the field of general medicine for doctors with a specialization in the field of internal medicine (AT-INT) and 25 in the field of anesthesiology and intensive care medicine (AT-AICM). Over the past 10 years at SMU, 375 doctors have completed specialized studies in the specialized field of general medicine, of which 261 in the so-called classical form, including 18 in AT-INT, 3 in AT-AICM and 114 residents. Since general medicine is a very dynamic field of medicine, education must also reflect its needs.
- MeSH
- kontinuální vzdělávání lékařů * MeSH
- lidé MeSH
- praktické lékařství MeSH
- studium lékařství specializační postgraduální MeSH
- Check Tag
- lidé MeSH
- Geografické názvy
- Slovenská republika MeSH
A lot of people with coronary artery disease do not have specific symptoms, and myocardial infarction or death are the first manifestation of the disease. New accurate, non-invasive and safe screening methods are required that can assess the prognosis of patients during routine examinations performed on millions of people. The aim of this review was to discuss the current literature regarding the utility of non-invasive ultrasound imaging of the coronary artery in assessing a patient's prognosis in daily practice. Assessment of coronary artery flow during common stress echocardiography or echocardiography can provide additive incremental prognostic information without the burden of radiation. Exercise or pharmacologic stress echocardiography tests combined with coronary flow velocity reserve assessment has advantages over stress tests based only on regional wall motion abnormalities. Scanning of main coronary arteries as an addition to routine echocardiography can reveal patients at high risk of adverse cardiac events in the near future.
- MeSH
- echokardiografie MeSH
- koronární cévy * diagnostické zobrazování MeSH
- koronární cirkulace MeSH
- lidé MeSH
- nemoci koronárních tepen * diagnostické zobrazování MeSH
- prognóza MeSH
- rychlost toku krve MeSH
- zátěžová echokardiografie metody MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
Domáca parenterálna výživa je náhradnou cestou a formou výživy u pacientov s ireverzibilným zlyhaním intestinálnych funkcií, u ktorých enterálna výživa nie je možná, resp. dlhodobo nedostačujúca s prehlbujúcim sa energetickým deficitom. Zahájením parenterálnej výživy v domácom prostredí sa zlepšuje kvalita života pacientov, a tým aj priebeh základného ochorenia s optimalizáciou klinických prejavov malnutrície. K najčastejším indikáciám domácej parenterálnej výživy patria rozsiahle redukcie absorbčnej plochy pri intestinálnych resekciách (pri chirurgických komplikáciách morbus Crohn, pri ischemickej nekróze tenkého čreva v dôsledku trombózy vo vena mesenterica superior, resp. embólii alebo aterosklerotickom uzávere arteria mesenterica superior, ale tiež funkčné zlyhanie čreva rôznej etiológie a nádorové ochorenia s dostatočnou utilizáciou základných živín).
Home parenteral nutrition is an alternative route and form of nutrition in patients with irreversible intestinal failure in whom enteral nutrition is not possible or is insufficient in the long run with an increasing energy deficit. Starting parenteral nutrition at home improves the quality of patients' life and consequently also the course of the underlying disease, with optimization of clinical manifestations of malnutrition. The most common indications for home parenteral nutrition include large reductions of the absorption area due to intestinal resections (Crohn's disease surgical complications, ischemic small bowel necrosis due to thrombosis in the superior mesenteric vein or embolism or atherosclerotic occlusion of the superior mesenteric artery, but also intestinal failures of different aetiology and cancer with sufficient utilization of essential nutrients).
- MeSH
- lidé MeSH
- parenterální výživa doma * metody MeSH
- syndrom krátkého střeva * komplikace patofyziologie terapie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
