Sistemsko zdravljenje melanoma (original) (raw)

Tarčno zdravljenje razsejanih gastrointestinalnih stromalnih tumorjev v Sloveniji

2008

Gastrointestinal stromal tumors (GIST) are rare mesenchymal neoplasms. They express the cell-surface transmembrane receptor KIT, a product of the c-kit proto-oncogene. Frequent mutations of KIT result in the constitutive activation of KIT signaling, which leads to uncontrolled cell proliferation and resistance to apoptosis. Until recently, surgery was the only successful treatment for localized GIST, while there was no effective treatment for metastatic disease. With the discovery of imatinib mesylate and sunitinib, selective inhibitors of certain protein tyrosine kinases, the prognosis of unresectable or metastatic GIST has substantially improved from a median survival of 6 months to almost 5 years. From 2001, we have successfully treated 51 patients with GIST at the Institute of Oncology Ljubljana. Median survival of our patients is 66 months. This treatment success can be attributed to the fact that all Slovenian metastatic GIST patients were treated by the multidisciplinary sarc...

Klinične raziskave v onkologiji

Onkologija, 2018

Klinične raziskave ali klinična preskušanja so raziskave, ki vključujejo ljudi. Na njihovih izsledkih temelji vsakodnevna obravnava bolnikov, zdravljenje, ki temelji na dokazih. Klinična preskušanja razvrščamo v več faz. V fazi I ugotavljamo predvsem toksičnost, v fazi II aktivnost zdravila pri določeni bolezni in v fazi III primerjamo učinkovitost nove oblike zdravljenja s trenutno priporočenim zdravljenjem določene bolezni. V želji po hitrejši informaciji o učinkovitosti številnih novih, predvsem tarčnih zdravil, se je razvil novi tip kliničnih raziskav, klinične raziskave tipa »košara«, »dežnik« in »prilagoditev«. Vse klinične raziskave morajo izpolnjevati stroga merila, ki zagotavljajo, da so bolniki v raziskavah zaščiteni in so rezultati pravilno ovrednoteni. Dostopnost do raziskav je pomembna za razvoj stroke, pa tudi za bolnike, saj v okviru teh lahko dobijo dodatne možnosti zdravljenja. Zato je pomembno, da zdravniki bolnike spodbujamo k sodelovanju v kliničnih raziskavah. Ključne besede: klinična raziskava, na dokazih temelječe zdravljenje, faze kliničnih raziskav, raziskava tipa košara, raziskava tipa dežnik, raziskava tipa prilagoditev ABSTRACT Clinical trials or clinical studies refer to research that is done in people. Their results are the backbone of daily clinical practice, namely evidence-based medicine. Clinical trials involve several phases. The main purpose of a phase I trial is to determine the safety of treatment, a phase II trial aims to determine if the new treatment is effective in treating a certain cancer, and a phase III trial compares the new treatment to the current standard treatment for a certain type of cancer. Aimed at providing prompt information on the effectiveness of many new agents, especially targeted drugs, new types of clinical study designs have been developed, namely basket trials, umbrella trials, and adaptive trials. All clinical trials have to meet strict criteria to ensure that patient rights are protected and that the results are properly evaluated. Accessibility to clinical trials is important for the development of oncology and for patients as well, as clinical trials may provide them with additional treatment. It is, therefore, important that doctors encourage patients to participate in clinical trials.

Tarčno zdravljenje slovenskih bolnikov z razsejanimi gastrointestinalnimi stromalnimi tumorji

Onkologija, 2013

Klasifikacija, diagnostika in zdravljenje stromalnih ter mezenhimskih neoplazem prebavil je v zadnjih 30 letih doživela obsežen napredek. Gastrointestinalni stromalni tumorji (GIST) predstavljajo manj kot 1 % vseh malignih tumorjev prebavil.Klinična slika je odvisna od mesta, velikosti in malignega potenciala GIST. Razsejani GIST predstavlja primer uspešnega zdravljenja s tarčno terapijo, saj se je z odkritjem KIT in PDGFR signalne poti ter tirozin kinaznih inhibitorjev, kot staimatinib mesilat in sunitinib, prognoza te bolezni pomembno izboljšala. Izhod zdravljenja slovenskih bolnikov z razsejanim GIST je primerljiv z izhodom zdravljenja bolnikov, ki so bili zdravljeni v pomembnih večjih mednarodnih kliničnih raziskavah, srednji čas do progresa bolezni pri naših bolnikih je 52 mesecev in srednje preživetje 72 mesecev. Uporabljali smo protokol sledenja, ki je poleg kontrastne računalniške tomografije trebuha vključeval tudi preiskavo trebuha z ultrazvokom. S tem smo ob primerljivem ...

Vpliv svetovnega spleta na zdravstvene storitve

2017

INTERNET'S INFLUENCE ON MEDICAL SERVICES This diploma is dealing with the demand of medical services on the internet. In Slovenia the number of commercial health related web pages run by volunteers is growing. The web pages are reliable and take on a big part of the public medical care system. The government is working on the reorganization and digitalization of the medical system. In this diploma we have three assumptions: the visit of the current medical related web pages is growing; patients favour web communication with the medical staff because it allows them a quicker access to quality information and the medical staff does not favour web communication with patients because their work is too extensive. We assume that because of the overload of work in the hospitals they lack time for a web based medical consult. The validation of our assumptions is checked through survey and interview. We take a look into medical web sites and the patterns of the visit they get. We focus our attention on individuals, patients. The survey's and interview's results confirm our first two assumptions and discard the third one. Web communication in medicine has a lot of advantages but there is still a lot of work to be done in the Slovenian medical system before it will work efficiently.

Nevidni učinki programa PUM

Andragoska Spoznanja, 2013

tHe invisible effect of tHe plYa programme comparison of selected results of the evaluation of the programme in 2002 and 2010-abstract It is interesting to note that key competences are becoming an important issue in adult education. Although the European Council of the European Union has created a European reference framework of key competences, the member states are expected to adapt the proposal to cultural and educational specificities of their countries. However, in various adult education programmes key competences are defined and developed in a very different way. In this paper, we focus on key competences by comparing the evaluations of the program Project Learning for Young Adults (PLYA) implemented in the years 2002 and 2010. In conclusion we consider the evaluation of different approaches to the PLYA programme, taking into account its effects on the development of key competences.

Razvoj zdravstvenega sistema v pogojih globalizacije: in kaj je z zdravstveno nego

2003

One of the consequences of the globalization for the modern health system is that medicine is losing its role of the »supreme« ruler over the processes of healing. The medical profession has to accept a more equal collaboration with other healing professions among modern health system, especially with the nursing. Nursing is focusing on the »ethic of caring« and thus presents an important alternative to the technical relationship to the patients, which is prevailing in the modern medicine. However, this quality could find its expression on condition that the nursing overcomes its traditional »assistant« role in medical treatment, and it actively intervenes in the space and market of medical services. Sure, such an activity requires many changes, from some more equal relationships between physician and nurses, changed self-image of the nurses to some more partner-like relationships between nurses and patients or the seekers of the health services.

New approaches to lung cancer treatment

Current Oncology Reports

Pljučni rak spada med pogoste rake. V Sloveniji vsako leto za njim zboli 1200, umre pa 1000 ljudi. Glavni dejavnik tveganja za nastanek pljučnega raka je kajenje. Poleg kajenja pa k njegovem nastanku pripomore tudi radon v zaprtih prostorih ter poklicna izpostavljenost škodljivim snovem. Predvsem so v nevarnosti ljudje, ki delajo v gradbeni in kovinski industriji. Vrsto let je pljučni rak veljal za raka z zelo slabo prognozo. V zadnjih letih je prišlo do napredkov tako v diagnostiki kakor tudi v zdravljenju, kar se odraža z daljšim in kvalitetnejšim preživetjem bolnikov.