Bakalauro darbe analizuojamas pedagogų požiūris į privalomuosius sveikatos patikrinimus ir mokymus. Tyrime dalyvavo 60 pedagogų, po 20 iš „Ringuvos“ specialiosios mokyklos, „Vijolių“ vidurinės mokyklos ir „Medelyno“ pagrindinės mokyklos. Tyrimas atliktas 2012 m. balandžio mėnesį. Anketinės apklausos metodu tirtos nuostatos į imunoprofilaktiką ir traumų profilaktiką, požiūris į profilaktinę sveikatos patikrą ir į privalomą profilaktinę saugą. / Bachelor work analyzes the educators attitude towards the mandatory health examinations and training. The investigation involved 60 pedagogues. Twenty of the "Ringuvos" special schools "Vijolių" secondary school and "Medelyno" basic school. The research was conducted on April in 2012. By using the method of the questionnaire the propertys towards vaccination and prevention of injuries were investigated. The attitudes of maintenance check-up health examinations and mandatory maintenance check-up safety was analyzed.

Ursache des klinisch durch die Amsterdam-Kriterien definierten HNPCC sind hochpenetrante Keimbahnmutationen in den DNAMismatchrepair( MMR)-Genen MLH1, MSH2, seltener in MSH6 und PMS2. Mutationsträger in diesen MMR-Genen haben ein hohes kumulatives Risiko (52–92%) für die Entwicklung kolorektaler – einschließlich syn- und metachroner – Karzinome, die sich meist in früheren Lebensjahren als bei sporadischen Fällen entwickeln. Darüber hinaus findet sich bei diesen Mutationsträgern ein deutlich erhöhtes Risiko für extrakolonische Karzinome, insbesondere des Endometriums, seltener der Ovarien, des Magens, der ableitenden Harnwege und des Dünndarms. Aus dieser Risikokonstellation erwächst die Frage nach einem spezifischen, individualisierten Therapiekonzept bei HNPCC-Patienten bzw. Mutationsträgern. Prinzipiell könnten drei Möglichkeiten des chirurgischen Vorgehens bezüglich des Kolorektums in Frage kommen: 1. prophylaktische Resektion bei gesunden Mutationsträgern 2. onkologische Resektion bei Karzinommanifestation 3. erweiterte Resektion mit zusätzlich prophylaktischer Intention bei Manifestation des ersten Kolon- oder Rektumkarzinoms. Die erste Möglichkeit kann nach kritischer Evaluation verschiedener Argumente als Option der Prävention nicht empfohlen werden. Zur Zeit kann sicherlich auch keine endgültige Empfehlung abgegeben werden, ob die zweite oder dritte Option des operativen Vorgehens favorisiert werden sollte. Die Indikation zur prophylaktischen Hysterektomie und Oophorektomie sollte nach ausführlicher genetischer, chirurgischer und gynäkologischer Beratung bei postmenopausalen Patientinnen, die die Amsterdam-Kriterien erfüllen oder Trägerinnen einer pathogenen Keimbahnmutation in einem MMR-Gen sind und bei denen dieser Eingriff mit einer anderweitig indizierten Operation kombiniert werden kann, erwogen werden. Eine exakte Prädiktion des individuellen Risikos und Erkrankungsalters auf Grundlage der Analyse von Interaktionen zwischen endogenen und exogenen, modifizierenden Faktoren ist Voraussetzung für individuelle Empfehlungen für «maßgeschneiderte»Vorsorgeprogramme oder prophylaktische chirurgische Maßnahmen. / Hereditary nonpolyposis colorectal cancer (HNPCC), clinically defined by the Amsterdam criteria, is caused by highly penetrant germ line mutations in DNA mismatch repair (MMR) genes, mostly in MLH1 and MSH2, infrequently in MSH6 und PMS2. Mutation carriers are at high cumulative risk (52-92%) for developing colorectal cancer (CRC), including syn- and metachronous colorectal carcinomas, with a younger age of onset compared with sporadic CRC. In addition, there is a remarkably increased risk in these mutation carriers for extracolonic carcinomas, especially for endometrial and ovarian carcinomas but also for gastric, ureter and renal pelvis and small bowel cancer. Therefore, the question arises if an individually tailored conception of treatment should be applied to HNPCC patients and mutation carriers. On principle, there are three options of surgical approach conceivable concerning the colorectum: i) prophylactic resection in healthy mutation carriers ii) oncological resection in the case of CRC iii) extended resection with an additional prophylactic intent in the case of first CRC. After critical evaluation of various arguments, the first option cannot be recommended for CRC prevention. However, a final recommendation neither for the second nor the third option of surgical approach can be given at the moment. The indication for a prophylactic hysterectomy and oophorectomy should be weighted in the following postmenopausal patients after intensive genetic, surgical and gynecologic counselling: patients fulfilling the Amsterdam II criteria or who have been identified as mutation carriers of a disease causing germ line mutation in one of the MMR genes and who have to be operated on due to another cause. A precise prediction of the individual risk and age of onset on the basis of the analysis of interactions between endogenous and exogenous modifying factors is the precondition for recommendations concerning individually tailored surveillance or prophylactic surgery. / Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.

Chemical warfare agents can be currently considered a high risk to humans. Group of nerve agents, is considered the most dangerous. These highly toxic substances have a rapid onset of action, the organism will receive all the entry gates, therapy intoxication is always difficult and death occurs often. The body's resistance to the effects of nerve agents at the expected intoxication increases not only prophylactic administration of antidotes , eg. when working in a contaminated environment after a terrorist attack, but also potentiates the subsequent antidotal therapy after exposure. This thesis is dedicated to gain in depth understanding of nerve agents with aspect of pharmacological prophylaxis. The introduction presents combat toxic substances in general, differentiation due to its effect on human with possible damage to the organism and brief characteristics of every basic type of nerve agents with examples included. Further on the theoretical part focuses on issues of nerve agents. The history of their development and well-known applicationsis breifly mentioned, respectively, abuse in the world. The thesis mentions of the Conventions on the prohibition of chemical weapons in connection with the misuse. Thesis continues dividing type nerve agents, describing the mechanism of action, acute toxicity and its symptoms, diagnosis and therapy of poisoning. Degree, extent and rate of damage to the body caused by nerve agents depends on many factors. A major factor which influences the ultimate toxic effect are taken input. Body damage can be caused, for example. Inhalation administration, contamination of broken or intact skin, ingestion, or hitting the conjunctiva. Since they have nerve agent toxicity and high speed action, protective and preventive measures are an important element to prevent the penetration of substances into the body. The Army of the Czech Republic ensures the protection of personal protective equipment, decontamination of affected skin and pharmacological prophylaxis. Another part of this work is the term prophylaxis and related topics, especially pharmacological prophylaxis. Directions pharmaceutical prophylaxis currently can be divided into three directions - protection against acetylcholinesterase inhibition, administration of antidotes and normal use Scavengers called. "Scavengers". The body's resistance to the effects of nerve agents at the expected intoxication not only increases prophylactic administration of antidotes, but also potentiates the subsequent antidotal therapy after exposure. Prophylactics PANPAL and TRANSANT are in equipment of Czech Army, in the work is devoted more attention to them. Both of these products were developed in the Czech Republic. There are also presented antidotal remedies of first aid, which are available for the Army of the Czech Republic. The practical part of this thesis aims to compare the prophylactic antidotes in the Czech Republic and in selected countries of NATO from four perspectives - onset, prophylactic activities, application forms, and adverse effects. An analysis of the available Czech and foreign professional articles, publications and studies and the subsequent comparative analysis of the various aspects and evaluate various selected countries is used to achieve this goal. These resulting data then point to the position of the Czech Republic in the field of prevention against intoxication by nerve agents - The Army of Czech Republic that has put in service two prophylactic antidotes that achieve the best results investigational products. It may therefore be said that the Army of the Czech Republic currently has a combination of prophylactic best in the world, which is relatively free of side effects has easy application and an unnecessarily long duration of action. This result is even answer the research question - Prophylactic antidotes in the Czech Republic are comparable according to the given parameters with antidotes in selected countries.

abstract: Cancer is one of the most serious global diseases. We have focused on cancer immunoprevention. My thesis projects include developing a prophylactic primary and metastatic cancer vaccines, early cancer detection and investigation of genes involved in tumor development. These studies were focused on frame-shift (FS) antigens. The FS antigens are generated by genomic mutations or abnormal RNA processing, which cause a portion of a normal protein to be translated out of frame. The concept of the prophylactic cancer vaccine is to develop a general cancer vaccine that could prevent healthy people from developing different types of cancer. We have discovered a set of cancer specific FS antigens. One of the FS candidates, structural maintenance of chromosomes protein 1A (SMC1A) FS, could start to accumulate at early stages of tumor and be specifically exposed to the immune system by tumor cells. Prophylactic immunization with SMC1A-FS could significantly inhibit primary tumor development in different murine tumor models and also has the potential to inhibit tumor metastasis. The SMC1A-FS transcript was detected in the plasma of the 4T1/BALB/c mouse tumor model. The tumor size was correlated with the transcript ratio of the SMC1A-FS verses the WT in plasma, which could be measured by regular RT-PCR. This unique cancer biomarker has a practical potential for a large population cancer screen, as well as clinical tumor monitoring. With a set of mimotope peptides, antibodies against SMC1A-FS peptide were detected in different cancer patients, including breast cancer, pancreas cancer and lung cancer with a 53.8%, 56.5% and 12.5% positive rate respectively. This suggested that the FS antibody could be a biomarker for early cancer detection. The characterization of SMC1A suggested that: First, the deficiency of the SMC1A is common in different tumors and able to promote tumor initiation and development; second, the FS truncated protein may have nucleolus function in normal cells. Mis-control of this protein may promote tumor development. In summary, we developed a systematic general cancer prevention strategy through the variety immunological and molecular methods. The results gathered suggest the SMC1A-FS may be useful for the detection and prevention of cancer. / Dissertation/Thesis / Ph.D. Molecular and Cellular Biology 2012

Cervical Cancer is a preventable disease. Sadly it is a cause morbidity and mortality of women in poor socio-economic settings worldwide, largely due to avoidable factors. This amounts to a gross violation of the rights to life and access to healthcare of vulnerable populations of women. Awareness, sensitisation and mobilisation of the civil society could be crucial in influencing change in political will and healthcare policies to address the needs of HIV infected women, in particular, given their susceptibility to the development of cervical cancer. This work advocates for the South African government to further commit resources towards the prevention of cervical cancer, including hysterectomy in women at high risk of developing cervical cancer before it ensues. / Mini Dissertation (MPhil)--University of Pretoria, 2019. / Public Law / MPhil / Unrestricted

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Bakgrund: Profylaktisk mastektomi är en behandling där brösten avlägsnas kirurgiskt i förebyggande syfte. Det finns olika indikationer till att profylaktisk mastektomi övervägs. Begreppet beslutsfattande kräver förståelse för att kunna beskriva kvinnors beslut vid profylaktisk kirurgi med anledning av att den individuella osäkerheten kring behandlingsval ska minska. Information och stöd är viktiga aspekter för en sjuksköterska att ge för att främja patientens integritet, självbestämmande och delaktighet. Syftet med litteraturstudien var att beskriva faktorer relaterade till beslutsfattandet hos kvinnor vid profylaktisk mastektomi. Metoden som användes var en allmän litteraturstudie med induktiv ansats där tio vetenskapliga artiklar med anknytning till aktuellt syfte valdes ut för att utforma ett resultat. Resultatet utmynnade i tre olika kategorier varav en med två underkategorier och en med tre underkategorier. Oro, föräldraskap, genmutation och upplevelse av information visade sig influera beslutsfattandet. Få skillnader i beslutsfattandet påvisades mellan kvinnor som var bärare och ickebärare av genmutation. Konklusion: Kvinnor som stod inför ett beslutsfattande vid profylaktisk mastektomi var alla egna individer och hade därmed olika preferenser i avseende behov av stöd, delaktighet i beslutsfattandet, mottagandet av information samt vad som influerat beslutet. Vårdprofessionella ska presentera adekvat, evidensbaserad samt enhällig information för att underlätta kvinnors beslutfattande. / Background: Prophylactic mastectomy is a treatment where the breasts are surgically removed for preventive purposes. There are various indications why prophylactic mastectomy is being considered. Understanding the concept of decision making is required to describe women’s decision about prophylactic surgery in order to reduce individual uncertainty about treatment choices. Information and support are important aspects for a nurse to provide in order to encourage patient integrity, self-determination and participation. The aim of this literature study was to describe factors related to decision making among women regarding prophylactic mastectomy. The method was a literature study with an inductive approach. Ten scientific articles related to the current purpose were selected to form a result. The result emerged in to three different categories, one with two subcategories and one with three subcategories. Concerns, parenting, gene mutation and experience of information were found to influence the decision making. Few differences in decision making were detected between women who were carriers and non-carriers of gene mutation. Conclusion: Women who faced a decision making in prophylactic mastectomy were all individuals and there for had different preferences regarding need for support, participation in decision making, receiving information and what influenced the decision. Health care professionals should present adequat, evidence based and unanimous information to ease women’s decision making.

No description available.

The rate at which women choose mastectomy has grown dramatically, and of particular note is the increase in contralateral prophylactic mastectomy (CPM). For women with no history of breast cancer or genetic risk, CPM represents a treatment decision that does not offer better long-term outcomes than the decision not to remove a healthy breast and may be associated with increased surgical risk and interventions, increased cost to the healthcare system, and potential adverse psycho-social outcomes. To better understand the decision making process regarding the election of CPM among women with early stage unilateral breast cancer, with no family history or genetic risk, a three-phase exploratory study was conducted. Qualitative in-depth interviews were conducted with healthcare providers who have close interaction with women during the decision making process (N=3) and patients who made a surgical decision about breast cancer treatment within the past three years (N=11). These two phases informed the design of the quantitative internet survey, conducted among women diagnosed with early stage breast cancer in the process of making a surgical decision (N=336). The survey design was also guided by an existing model for treatment decision making which uses a social ecological framework (Revenson & Pranikoff, 2005). In addition to descriptive analyses, perceptual mapping was utilized to understand patients’ conceptualizations of the relative importance of factors considered during the decision making process, and AdSAM® was used to gauge emotional response. Results suggest that women more likely to elect CPM demonstrate an emotional response to a generalized fear of cancer, along with the need to take control of their situation. In addition, retrospective interviews emphasized somewhat different reasons for electing CPM, highlighting the importance of prospective research in studying the decision making process. / Public Health

Papilomavírus humanos (HPVs) são vírus de DNA que infectam células epiteliais, podendo ser responsáveis pelo aparecimento de lesões benignas e malignas. Dentre os mais de 120 tipos identificados, o HPV -16 constitui o principal agente etiológico do câncer cervical, que é uma das maiores causas de morte por câncer em mulheres no mundo. Sendo assim, infecções associadas ao HPV devem ser prevenidas por vacinas indutoras de resposta imune vírus-específicas. A proteína L1 do capsídio viral é capaz de arranjar-se em partículas morfologicamente e antigenicamente semelhantes ao vírus, denominadas \"virus-like particles\" (VLPs), que induzem altos títulos de anticorpos neutralizantes. Neste trabalho, foram clonados os genes L1 selvagem e otimizado de HPV -16 em vetores de expressão de leveduras metilotróficas como Hansenula polymorpha e Pichia pastoris. Foi observada uma expressão consistente da proteína recombinante apenas em P. pastoris, com o gene L1 otimizado. Foram realizadas diversas tentativas de purificação da proteína heteróloga, empregando técnicas de cromatografia e ultracentrifugação em gradiente descontínuo de sacarose. A correta montagem das VLPs foi confirmada por microscopia eletrônica. Problemas de agregação, heterogeneidade e adsorção a superfícies apresentados pela proteína L1 foram resolvidos após utilização de surfactante não-iônico e de um procedimento de desmontagem e remontagem das partículas, gerando preparações mais homogêneas. Ensaios de hemaglutinação e inibição da hemaglutinação comprovaram a apresentação de epítopos conformacionais na superfície das VLPs. Este trabalho demonstrou pela primeira vez a expressão da proteína L1 de HPV -16 em P. pastoris, visando ao desenvolvimento de uma vacina profilática de baixo custo para o sistema público de saúde. / Human papillomaviruses (HPVs) are DNA viruses that infect epithelial cells and can cause both benign and malignant lesions. From over 120 types catalogued so far, HPV-16 is the main etiologic agent of cervical cancer, which is the one of the most common causes of cancer deaths among women worldwide. Thus, HPV -associated infections might be prevented by vaccine inducing virus-specific immune responses. The L1 major capsid protein can self assemble into virus-like particles (VLPs), which are morphologically and antigenically indistinguishable from native viruses and induce high titers of neutralizing antibodies. In this work, we have cloned wild-type and codon-optimized L1 genes from HPV-16 in expression vectors of the methylotrophic yeasts Hansenula polymorpha and Pichia pastoris. Consistent L1 expression was only observed in P. pastoris transformed with the construction containing the codon-optimized gene. Many attempts to purify the heterologous protein were made, including chromatography and ultracentrifugation in sucrose density gradients. The correct assembly of VLPs was confirmed by electron microscopy. Some problems presented by recombinant L1 like aggregation, surface adsorption and heterogeneity were solved by using non-ionic surfactants and a procedure of disassembly and reassembly of the particles. Hemagglutination and hemagglutination inhibition assays corroborated the display of surface conformational epitopes by VLPs. This work showed for the first time the expression of the HPV-16 L1 protein in P. pastoris, aiming the development of a prophylactic vaccine free of charge for the public health system in Brazil.