Postoperative delirium.

Postoperative delirium is a serious complication occurring mainly in patients over 65 years. This complication is common in the above mentioned age group and has been described in up to 50% of patients. Postoperative delirium has a significant impact both on postoperative morbidity and mortality. Systematic and early detection of at-risk patients is essential to reduce the risk of postoperative delirium. Targeted efforts are then developed in thus identified patients to reduce the risk factors for developing delirium. An individualized approach to anesthesia is adopted during the surgery. Procedures that contribute to reducing the risk of developing delirium are preferred in the postoperative period. If this complication does occur, it is primarily preferred to manage any potential cause of the condition using non-pharmacological procedures. Pharmacological interven- tion should be reserved only for patients with a hyperactive form of delirium. The aim of the article was to shed more light on measures that help to prevent the delirium and on the therapeutic procedures used.

[Coffee in Cancer Chemoprevention]. / Káva v chemoprevenci nádoru.

Coffee consumption is associated with a reduced risk of several diseases including cancer. Its chemopreventive effect has been studied in vitro, in animal models, and more recently in humans. Several modes of action have been proposed, namely, inhibition of oxidative stress and damage, activation of metabolizing liver enzymes involved in carcinogen detoxification processes, and anti-inflammatory effects. The antioxidant activity of coffee relies partly on its chlorogenic acid content and is increased during the roasting process. Maximum antioxidant activity is observed for medium-roasted coffee. The roasting process leads to the formation of several components, e.g., melanoidins, which have antioxidant and anti-inflammatory properties. Coffee also contains two specific diterpenes, cafestol and kahweol, which have anticarcinogenic properties. Roasted coffee is a complex mixture of various chemicals. Previous studies have reported that the chemopreventive components present in coffee induce apoptosis, inhibit growth and metastasis of tumor cells, and elicit antiangiogenic effects. A meta-analysis of epidemiological studies showed that coffee consumption is associated with a lower risk of developing various malignant tumors. This review summarizes the molecular mechanisms and the experimental and epidemiological evidence supporting the chemopreventive effect of coffee.Key words: coffee - chemoprevention - antioxidative enzyme - detoxification enzyme - anti-inflammatory effect The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study. The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers.Submitted: 11. 9. 2016Accepted: 24. 11. 2016.

[Anticancer Effect of Fish Oil - a Fable or the Truth?]. / Protinádorový efekt rybího oleje -  mýtus, nebo realita?

Omega-3 fatty acids from fish oil have several health benefits for cancer patients. Recent findings indicate that, besides their well-known anti-cachectic effect, they can act synergistically with chemotherapeutic agents and may enhance tumor radio-sensitivity. The mechanisms underlying their anti-tumor effects are complex. The following effects have been reported after administration of omega-3 fatty acids: increased lipid peroxidation during therapy; disturbed tumor receptor signal pathways; lower levels level of pro-inflammatory cytokines that induce tumor cell proliferation; promotion of apoptosis in tumor tissues; immune modulation; and changes in hormonal metabolism. Epidemiological and experimental evidence support the conjecture that fish oil has an anticancer benefit for both animals and humans. However, Western countries have a diet rich in omega-6 fatty acids, which interfere with the health benefits of omega-3 fatty acids because they compete for the same rate-limiting enzymes. For this reason, the consumption of omega-6 fatty acids in Western diet needs to be lowered to observe the anti-tumor effect of omega-3 fatty acids. Some epidemiological studies report conflicting results, which may be explained by inconsistencies in the methodologies employed.