Nádory tenkého čreva patria medzi zriedkavé

Napísal TS OZ Zriedkavé choroby 30. apríl 2020

Tretia časť osvetového videoseriálu o TOP slovenských pracoviskách pre zriedkavé choroby predstavuje Oddelenie klinickej onkológie E, ktoré patrí pod II. Onkologickú kliniku LFUK a NOÚ. Viac ako 20 rokov sa venuje liečbe nádorov tráviaceho traktu, malígneho melanómu a tiež pľúc a hrudníka.

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Aj keď sa oddelenie, kde ročne hospitalizujú vyše 1 100 pacientov z celého Slovenska, primárne zameriava na liečbu nádorov zažívacieho ústrojenstva, ktoré patria v onkológii k najčastejším, i tu sa stretávajú s raritnejšími diagnózami. „Ide najmä o karcinómy pažeráka, tenkého čreva, análneho kanála, vzácne formy rakoviny pečene, nádory pohrudnice, melanómy oka, ale tiež neuroendokrinné nádory, ktoré môžu postihnúť akýkoľvek orgán. Kľúčom k ich diagnostike sú moderné genetické vyšetrenia, ktoré prispeli k účelnejšej klasifikácii nádorov a tým aj k cielenejšej liečbe,“ hovorí primár oddelenia MUDr. Jozef Dolinský.

Kým štatistiky nádorových ochorení tráviacej sústavy neslávne vedie hrubé črevo, a to ako na Slovensku tak i v Európe, susediace tenké črevo, kde prebieha najdôležitejšia časť trávenia, je na tom z pohľadu výskytu opačne. Nádory tenkého čreva patria k zriedkavým, predstavujú zhruba 1 až 2% všetkých nádorov zažívacieho traktu. Ročne je v NOÚ diagnostikovaných približne 60 pacientov.

V súčasnosti veľmi významne stúpa aj výskyt nádorov pankreasu, ktoré patria k mimoriadne zákerným ochoreniam, aj kvôli tomu, že z dôvodu dlhej bezpríznakovosti sa často diagnostikujú až v pokročilých štádiách. K zriedkavým diagnózam tu patria neuroendokrinné nádory, ktoré v porovnaní so štandardnými adenokarcinómami pankreasu majú ale oveľa priaznivejšiu prognózu. „Mali sme tu napríklad pacienta diagnostikovaného v 54. roku života, ktorý v súčasnosti prežíva s diagnózou neuroendokrinného nádoru pankreasu 14-ty rok,“ vysvetľuje klinická onkologička z oddelenia, MUDr. Silvia Jurišová.

O charaktere nádoru pankreasu ako žľazy s vonkajším - exokrinným a vnútorným - endokrinným vylučovaním rozhoduje typ buniek, z ktorého je zhubný nádor tvorený. Neuroendokrinné nádory vznikajú z endokrinných buniek, ktoré majú na starosti produkciu hormónov ako napríklad inzulín ovplyvňujúci hladinu cukru v krvi. Štandardné adenokarcinómy (zhubné nádory buniek výstelkového tkaniva) pankreasu vznikajú z exokrinnej časti, ktorá tvorí 95% pankreasu a je zodpovedná za tvorbu pankreatickej šťavy napomáhajúcej tráveniu.

Pre akýkoľvek typ nádoru, pri zriedkavých diagnózach o to viac, je kľúčová diagnostika. Na pomoc jej v posledných rokoch okrem patológie prichádzajú moderné genetické metódy, ktoré zásadným spôsobom menia klasifikáciu nádorov. Inak povedané, kým sa jednotlivé nádory kedysi definovali podľa časti tela, orgánu alebo neskôr bunky, z ktorej vychádzali, moderná genetická diagnostika ide hlbšie do vnútra bunky, až na úroveň génov. Výsledkom je zacielenie liečby na časť DNA, ktorá spustila nádorové bujnenie a to v kontexte liečby posúva medicínu o výrazný krok ďalej.

Pozrite si tretiu časť videoseriálu TOP pracoviská pre zriedkavé choroby, ktoré pripravuje OZ Zriedkavé choroby. V seriáli sú postupne predstavované slovenské pracoviská a špičkoví odborníci. https://www.zriedkavechoroby.sk/kde-hladat-pomoc/videoserial-top-pracoviska/

Seriál je prístupný aj na YouTube kanáli OZ Zriedkavé choroby:


 Kto je OZ Zriedkavé choroby:

Občianske združenie Zriedkavé choroby odštartovalo svoju činnosť v roku 2018. Špecializuje sa na zriedkavé choroby, ktorými môže na Slovensku trpieť až 300-tisíc Slovákov. Na svojom portáli www.zriedkavechoroby.sk ponúka komplexné informácie, aktuality, zoznamy odborníkov a špecializovaných pracovísk, odborných zahraničných zdrojov a platforiem. Na portáli sa nachádza pravidelne aktualizovaná podstránka skutočných pacientskych príbehov, s opismi príznakov chorôb. Združenie poskytuje pacientom a ich blízkym poradenstvo, pomoc a tiež služby krízovej intervencie.

12 komentárov

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    In different words, it’s not a great idea to wear operating
    sneakers when you’ll be specializing in energy training—instead, go for one of the flatter pairs below.
    For athletes that just wish to keep their physique in form yet don’t have curiosity in additional advanced exercises,
    you’re fantastic with forgoing this gear choice.
    The Inov-8 FastLift Energy G 380s is usually a great alternative to lugging your kicks across the gym thanks to their light-weight make-up at
    simply thirteen.4 ounces. I also recognize the ripstop upper
    that’s best for sustaining the scuffs and stressors of figuring out yet still has the flexibility to maintain your ft cool throughout training.
    For powerlifters that don’t need to change between footwear for each massive carry (bench, squat, deadlift), the Powerlift 5s from Adidas can be a superb option for
    a variety of causes.
    GORUCK is well-known for their rucking gear, and these sneakers were
    designed with that in thoughts. Out Of Doors fanatics will love these sneakers for
    their durability and efficiency. Nevertheless, the dual strap
    system is a good feature, especially at this value level.
    The general support and construction of those footwear is quite good,
    making them a contender for many lifting kinds. This shoe has a comfortable,
    sustainably-made ripstop upper that breathes properly and breaks in quickly.
    Nevertheless, the flexibility doesn’t give me
    as a lot safety through the midfoot as others, even with the strap.
    Subsequently, I use it solely for squats, squat variations, and some accessories.

    Lastly, while not as extensive because the TYR L-1 Lifters, the Legacy Lifter 3’s are wider than the Romaleos and Adipowers.
    This mannequin has steadily grown on me relating to its efficiency and I assume
    it’s a decent possibility for flatter ft. Footwear can play
    a role in lifting mechanics and performance outcomes, so spend a little bit of
    time researching what you want to use and what you need to use to
    get essentially the most bang for your buck. Nonetheless, in certain contexts, they might help help and increase
    performance when we are understanding what they’re going to do for our lifting mechanics.

    We have a decently well-made heel cup again here, not the thickest
    materials, however it does have additional leather-based padding.
    The type of footwear you choose to put on is fairly particular about
    the type of workout that you’re doing. That being mentioned, if you’re
    nearer to a newbie a much less expensive option with a stable sole just like the Nike Savaleos or the Adidas Powerlift 5 could additionally be a
    greater starter possibility.
    A lace and strap system combine for a more contoured hug of the mid foot, which means
    added stability. The Inov-8 is considered more of an entry-level Weightlifting shoe,
    and the decrease heel makes it more versatile than most different models.

    At the same time, they are comfortable and designed as multipurpose footwear for
    all types of training. A fast look on the toe box
    shape of the Adipowers is adequate to perceive how narrow they're.

    They really feel as though they’ll also final a while so lengthy as you’re taking excellent care
    of them. For squats, machine work, and leisure lifting, I really benefit from the
    Inov-8 Fastlift Power G 380’s efficiency.
    I think if you’re investing in this shoe for recreational lifting, you’ll get so much out of this mannequin and you’ll get pleasure from their efficiency.
    Over the earlier few years, Inov-8 has continued to innovate and roll out sneakers that includes Graphene of their construction.
    Personally, I discover the worth level to be a little excessive for the Reebok Legacy Lifter III
    and I think that’s because of it receiving updates that haven’t essentially
    drastically improved this shoe’s efficiency.
    Since this shoe has the next worth point, it’s a good suggestion to verify they carry
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    As a complete, I assume the Reebok Legacy Lifter III
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    It’s just like the Legacy Lifter II in many ways so from a stability viewpoint this
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    "I can literally feel the ground by way of the shoe, which is extremely essential for feeling stable while you’re throwing weights around," she says.
    Nevertheless, it isn’t very flexible and is stiff,
    so that you won’t feel an excellent toe-to-ground connection compared to the Lululemon Strongfeel.
    Not solely does the Powerlift 5 run slim, however it also (in my opinion)
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    a way to at all times dimension up. "They additionally strike the perfect balance of feeling cosy and supportive without limiting or slicing off circulation, which is a standard sneaker drawback I deal with,"
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    however passing on them in case you have
    wide feet.
    It delivers some commonality to the Legacy Lifter II which is
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    they’re price it. Basically, I wish this mannequin gave
    you more relating to its updates because it has a $20 USD value improve.
    This is why I additionally advocate looking for coupons to knock down the worth of this
    shoe should you plan to put money into them. If you've low-volume ft, then I
    might see this characteristic being extra helpful on your security wants.
    The strap of this shoe can run a tiny bit lengthy for
    low-volume feet, so the pump can be actually useful for these instances.

    They even have a wider toe box for toe placement, so by
    method of weight lifting particularly, where you need a lot of room to display those toes and grip
    the ground. For example, for the back squat, what is going to
    usually end up taking place when sporting a weightlifting
    shoe is we’re able to achieve greater ranges of motion whereas sustaining more upright torso positioning.

    This can then assist with our performance output and our
    stability whereas shifting varied hundreds. Mainly, whenever you're coaching
    with the intent to create carryover to how you
    carry out your competitors lifts, you’ll need to wear the shoes you compete in. This will let you create familiarity along with your powerlifting gear and the way
    it interprets to your efficiency. Whether you’re squatting, deadlifting, or even benching, you’ll need shoes that have a
    good quantity of stability that doesn’t compress easily underneath heavy
    weight. Powerlifting may be extremely fun, and I assume each lifter
    ought to attempt it no much less than once of their coaching
    career.
    If you use the three construction traits above to guide your shoe choice, then you definitely can’t go mistaken along
    with your choice. The TYR CXT-1 Trainer is taking my top choose as the best cross-training shoe for squats.
    I like the TYR CXT-1 Trainer for squats particularly for two
    key squat-related causes. There’s just
    one method to test the best shoes for squats — and that’s with a ton of
    squatting.
    I just like the Reebok Nano the most on this class, however it's admittedly been some time since
    I was in something aside from a barefoot shoe or an Olympic lifter.

    Rogue Health (not affiliated) usually has the most effective selection and availability, but it's price checking different websites for
    deals. Kat Ellis, a Denver-based private coach, prefers Nobull
    as her go-to weightlifting shoe model. "They have a flat, sturdy sole that lets you properly sense your toes whereas lifting," she
    says. It Is wonderful for squatting and deadlifting, particularly if you’re
    somebody who prefers to stabilize via the toes rather than letting your shoe do
    the work.
    I'm not new to the fitness center, but desirous to get one thing extra solid underfoot than my Nike revolutions.
    Second, the Converse Chuck Taylor All-Star typically offers greater
    than enough stability for beginner powerlifters. These sneakers are
    constructed with a dense rubber sole that usually doesn’t compress underneath heavy squats and deadlifts.
    "Avoiding stress and pressure to the lower again is essential when lifting, and flat shoes help with that by preventing pelvic tilt", Perkins says.
    On the other hand, whenever you're weightlifting in running shoes, your ankle is doing the other.
    The cushioned sole supplies a less secure base, forcing
    the toes to point as much as preserve stability.
    For one, the decrease heel-to-toe drop may be glorious for beginners however could go away taller athletes wanting
    the next setup for improved ankle mobility. Additionally, this is doubtless considered one of the most slender profiles I’ve worn in training, so I would advocate
    sizing as a lot as achieve a extra snug really feel.
    For that coin, I’d count on a more well-to-do silhouette that fits
    all my wants. Fortunately, though, the higher development,
    environment friendly outsole and leather-based components might help keep this weightlifting shoe in your
    rotation longer, which helps lessen the sting of the higher
    value.
    One of the important thing distinguishing features of this shoe is that it has a 1.2-inch
    heel, which is way higher than the other shoes.
    However, they've a more conservative heel elevation of solely 0.fifty
    nine inches, which is roughly a 25% reduction in heel top
    in comparability with the Nike Romaleos four. The current and most up to date mannequin comes with two straps
    and a hard plastic base similar to the old Nike Romaleos 2
    heel base. Given their stiffer development, I discovered these footwear
    wanted an extended break-in period than most.
    The simple higher design minimizes fail factors, and I like the texture and
    general breathability. I additionally like the general look of
    these footwear, especially the white and black colorways.

    Third and lastly, this model’s toe box has much more maneuverability compared
    to other weightlifting sneakers. This is an enormous cause why this model is taking my
    prime decide right here because blocky and stiff toe boxes
    can feel tough throughout CrossFit workouts. This shoe’s ripstop higher development does a good job with durability and
    it delivers one of the better-looking appearances
    of weightlifting sneakers. I’m going to offer context per what
    I advocate to lots of the beginner lifters and athletes that I work with who ask
    this question. In my teaching opinion, novices can wear weightlifting sneakers particularly when they
    assist athletes improve their kind. Without creating confusion here, when lifters say "squat shoes" and "lifting shoes" they
    imply weightlifting sneakers.
    The Nike Metcon 9, the latest mannequin from the Metcon line, takes the spot as the best general weightlifting
    shoe for its attention to detail and functionality for heavy lifts.

    An upgrade from the Metcon eight, the Metcon 9 has an improved and enlarged
    Hyperlift plate that helps to displace weight down and
    outward throughout lifts for firmer grounding. It’s additionally constructed with
    upgraded know-how called EasyOn—a versatile heel that collapses and
    snaps again for hands-free slip on and off. The sturdy Nike Romaleo four is one other splurge-worthy shoe if performance is top-of-mind for you.
    It has attained fan-favorite standing amongst dedicated lifters for its wide range of movement and exceedingly steady base.
    I really feel extraordinarily secure, like I’m
    stepping on a platform," one Nike reviewer wrote. Nevertheless, like other stiff, lifted options in our roundup, it isn’t one of the best shoe for CrossFit or cardio workouts.
    (They're not disposable like running shoes, thank God.) There are also loads of older fashions and frivolously used pairs obtainable on locations like eBay. Running shoes, and other comfortable sneaker-like footwear, are inclined to have squishy soles. You will not have as solid a connection to the ground, and if your weight shifts slightly, you could end up wobbling a bit.
    For people with swag who take kettlebell lifting critically, you possibly can't do higher than a completely customized shoe constructed by Honored Grasp of Sport Arseny Zhernakov at Laboratory of Champions. These dangerous boys are primarily based on traditional Russian power lifting shoe design but tailor-made for kettlebell sport lifting. They can be custom-made to your coronary heart's want, and most of the high lifters on the planet carry in these. Be positive to take cautious measurements of your foot and communicate any distinctive wants earlier than placing your order because the custom shoes can't be returned.
    I personally didn't notice any distinction a method or one other and the general feel was "lifted" but not clunky. The cool thing is that when you find you do need a taller heel lift, you'll find a way to all the time take these to a cobbler and have them add to the heel since it's made from wood. ➡️ What makes a great weightlifting shoe is the shoe that matches you the most effective and provides construction options that assist your lifting type and can also be wholesome for your ft. The mixture of both of these development traits offers you a nice "anchored" feeling when squatting. The base of the heel is as wide as any other weightlifting shoe, however narrows immediately around the heel cup and then widens once more the place it meets the actual shoe creating this sort of stability beam impact. Related to the premium weightlifting sneakers, the Nike Romaleos 3 comes with a large price ticket of $ + USD so the justification here for a lot of must be giant. The Nike Romaleos 3 is the third iteration of the popular Nike Romaleos weightlifting shoe line.
    In addition, this model could additionally be useful for lifters and athletes who need to start using heel elevation for squatting. The Romaleos 3 could also be an excellent weightlifting shoe for athletes who wish to finally compete in strength sports and need sneakers to accompany their objectives. Nicotera likes weightlifting footwear due to the soundness that they offer, particularly during heavy lifting.
    This way, it is possible for you to to perform all actions without having to change footwear. I incessantly have difficulty with tiny toe bins, which is why I’ve at all times returned to my Romaleo 2s. I usually suggest individuals purchase costlier sneakers, however the Do-Wins on a sale are value it. The soles are manufactured from a thin rubber layer with a diamond-carved design to forestall slipping on the platform. I’ve been a Nationwide stage competitive Weightlifter, and my spouse is an International medalist, having competed in Olympic Weightlifting on the elite degree for 20 years. Though it doesn't have a heel collar pull tab, you can typically accidentally fold the again of the shoe’s heel.
    The ripstop higher is durable yet tremendous breathable, and the inside reinforcement of the forefoot is designed for lateral assist in each step. Some lifters like utilizing flat footwear for better stability and make contact with with the ground, whereas different lifters prefer an elevated heel to get extra vary of motion on certain lifts like squats. Moreover, some like a low high versus a excessive high shoe for ankle stability. Converses can be good for powerlifting as they provide a flat base of assist with minimal foot elevation. Converses are also good for basic strength training but aren’t good for Olympic weightlifting since they aren’t supportive enough for heavy, dynamic lifts just like the snatch and clean and jerk. They aren't as frequent as the opposite big brand shoes but supply much worth for money.
    While you’ll still benefit from the improved positioning, the efficiency may not be nearly as good depending in your lifting fashion. That said, I discover decrease heels more versatile, making them a fantastic all-purpose choice. My favorite characteristic of these footwear is the 22mm TPU heel, which is my most popular top for squats. I love the assist the Adipowers provide for squatting and discover the midsole very efficient.

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    helping them feel awake and well-rested. Its well-balanced formulation supports muscle recovery,
    enhances exercise performance, and offers clean, sustained energy
    without excessive stimulants. I haven’t but taken a 6 scoop serving as
    a pre-workout, but I do begin to really feel the energy
    ramp up after 2-3 scoops. I doubt this would be equivalent
    to an actual pre-workout complement, but I even have no doubts this will increase your vitality level within the fitness center.
    CLA is a remarkable dietary complement derived from sources like safflower and sunflower oil, and located naturally in grass fed meats and
    dairy as nicely as the yolk of an egg.
    Clients like the amino acid content of the nutritional supplement.
    They say it supplies all important amino acids and is a great addition to their line
    of amino energies. The blend of amino acids and
    green tea extract helps them get their aminos and minimize power drinks out.
    Clients recognize the amino acid content material of the nutritional
    supplement. They say it supplies important amino acids they do not get elsewhere, with an entire 9-amino acid profile.


    However, some customers mention that the amino mix will increase BP, which isn't
    good for any time however particularly around or
    throughout exercise. Prospects respect the nutritional complement's style,
    power level, and quality. They discover it refreshing and never as sweet as fruit fusion. Many say it helps
    present good power and focus with out jitters. The product accommodates more than 10 important amino acids that the
    body needs to perform correctly.
    Optimum Nutrition Amino Vitality is out there in a extensive range of flavors,
    corresponding to fruit fusion, blue raspberry, grape, watermelon, and lemon lime.
    Customers have combined opinions about the style of Optimum
    Diet Amino Energy. Some users love the taste and find
    it refreshing, scrumptious, and simple to drink. They benefit from the
    fruity and sweet flavors and the sleek and lightweight texture.
    They also like that the product mixes well with water or other beverages, with
    out leaving any clumps or residue. With 5
    grams of amino acids and 100 mg of caffeine per serving, it features as a
    flexible pre-workout, intra-workout, or noon power booster.
    Clients enjoy the vitality boost from the nutritional complement.

    However, it also means that Optimum Vitamin Amino Energy
    does not present any important quantity of protein,
    which is crucial for muscle progress and recovery.
    Due To This Fact, you could must supplement your food
    regimen with different protein sources, similar
    to whey, casein, or plant-based proteins. Whether you should
    switch on and perform within the health club, or boost energy levels and focus all through the
    day, Amin.O. Energy gives you every thing you have to perform at your peak wherever, anytime.

    Research means that BCAA supplementation may help cut back exercise-induced muscle damage, decrease muscle soreness, and enhance restoration time.
    BCAAs may also assist cut back fatigue throughout prolonged train by serving in its place vitality source for
    muscular tissues. Clients appreciate the dietary supplement's jitter-free effects.

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