Therapeutic challenge: severe dyspnea in a patient with metastatic breast cancer and lymphangitis carcinomatosis syndrome

Introduction. Dyspnea, regardless of etiology (pulmonary, neuromuscular or caused by other factors),remains a significant challenge. There is still a lack of effective methods of the treatment of severe dyspneaassociated with intensifying anxiety which is the most common indication for intensification of causativeand symptomatic treatment or palliative sedation.Case report. A 48 year-old woman diagnosed with relapsed breast cancer with bone, pleural, hepaticand pulmonary metastases with lymphangitis carcinomatosis syndrome confirmed by lung biopsy. In 2011the patient underwent breast conserving surgery followed by teletherapy, brachytherapy and tamoxifenhormone therapy for 5 years. Comorbidities included chronic obstructive pulmonary disease, diabetesmellitus type 2, depression and nicotine addiction.The patient was urgently admitted to the Department of Oncology and Radiotherapy from ClinicalEmergency Department due to rapidly aggravating dyspnea and respiratory failure. Chest X-ray showedmassive bilateral pleural effusion and threatening cardiac tamponade. Treatment involved thoracentesisand pericardiocentesis with concurrent symptomatic management. After temporary stabilization of thepatient and due to rapid progression of the disease salvage, paclitaxel chemotherapy was started. Despitethe features of potential chemosensitivity (chemotherapy–naïve, rapid progression, visceral metastases)the applied treatment was ineffective. After careful evaluation of clinical situation and possible treatmentstrategies, and after obtaining patient’s consent, sedation with midazolam and morphine was applied.Conclusions. This case demonstrated ineffective salvage chemotherapy used in the patient with severe dyspnea inducedby a rapid progression of metastatic breast cancer and difficulties in obtaining effective symptomatic treatment. Palliat Med Pract 2019; 13, 3: 156–16

Report on the 1st Nationwide Students' Conference on Palliative Medicine

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Role language as a tool for creating fictional characters- analysis of various yakuwarigo types in Japanese manga

Celem pracy jest przybliżenie tematyki języka roli oraz języka postaci w kontekście stylizacji językowej w japońskich komiksach manga. Wyjaśnione zostają także mechanizmy powstawania odmian języka roli, metody ich klasyfikacji oraz charakterystyka tych najpopularniejszych. Na zakończenie poddane analizie zostają przykłady zastosowania języka roli w stylizacji językowej japońskich komiksów manga.The main aim of this paper is to introduce the subject of role language and character language in the context of linguistic stylization in Japanese manga comics. The formation mechanisms of role language varieties, the methods of their classification and the characteristics of the most popular ones are elaborated on as well. Finally, the examples of the use of role language in the linguistic stylization of Japanese manga comics are investigated and analyzed extensively

Remote education and student online safety

The COVID-19 pandemic has had a significant impact on the higher education sector. The transfer of teaching activities to the web has seriously increased the likelihood of successful cyber-attacks on the student user group of the Internet. This paper explores the relationship between remote teaching and online student safety. 622 students from three Polish universities participated in the study. It was found that: (1) during remote teaching, students’ main activities were browsing content posted by lecturers and participating in teaching activities. (2) Students primarily communicated via Facebook (93.09%), (3) The most common cyber threats encountered by students were spam, online auction scams and communication fraud. (4) Students’ cybersecurity knowledge and security level in cyberspace is at an average level. (5) Students change their account passwords not at all (25.88%) or less often than once a year (39.87%), and use antivirus software to a greater extent (69.61% of respondents). The correlation analysis between demographic variables and the frequency of changing passwords showed a statistically significant relationship in the case of the form of education and the level of study. On the other hand, taking into account the selected variables and the software used, a statistically significant relationship was only found in the case of the gender of the students and the form of study, while in the case of the other variables, there was no statistically significant relationship. Three of the parameters which was the question of interest in cyber security training at the university is statistically significant in the case of gender, age and level of study.Pandemia COVID-19 wpłynęła w istotny sposób na sektor szkolnictwa wyższego. Przeniesienie aktywności dydaktycznej do sieci poważnie zwiększyło prawdopodobieństwo udanych cyberataków na grupę użytkowników Internetu, jaką są studenci. W niniejszym artykule zbadano zależność pomiędzy zdalnym nauczaniem a bezpieczeństwem studentów w sieci. W badaniu wzięło udział 622 studentów trzech polskich uczelni wyższych. Stwierdzono, że: (1) w trakcie zdalnego nauczania główną aktywnością studentów było przeglądanie zamieszczanych przez wykładowców treści oraz udział w zajęciach dydaktycznych; (2) studenci komunikowali się przede wszystkim za pomocą Facebooka (93,09%); (3) najczęściej spotykanymi przez studentów cyberzagrożeniami był spam, oszustwa na aukcjach internetowych oraz oszustwa komunikacyjne; (4) wiedza na temat cyberbezpieczeństwa oraz poziom bezpieczeństwa studentów w cyberprzestrzeni jest na średnim poziomie; (5) studenci wcale (25,88%) lub rzadziej iż raz do roku (39,87%) zmieniają hasła zabezpieczające konta, w większym zakresie wykorzystują oprogramowania antywirusowe (69,61% badanych). Przeprowadzona analiza korelacji pomiędzy wybranymi zmiennymi a częstotliwością zmiany haseł wykazała zależność istotną statystycznie w przypadku formy kształcenia i poziomu studiów. Z kolei uwzględniając zmienne demograficzne i wykorzystywane oprogramowanie, należy stwierdzić, iż zależność statystycznie istota występuje tylko w przypadku płci studentów i formy kształcenia, w przypadku pozostałych zmiennych brak zależności statystycznie istotnej. Zainteresowanie szkoleniami na uczelni z zakresu cyberbezpieczeństwa, jest statystycznie istotne w przypadku płci, wieku i poziomu studiów

Hypofractionated radiotherapy for renal cell carcinoma with inferior vena cava tumour thrombus

Renal cell carcinoma (RCC) constitutes about 3% of all malignant neoplasms in adults. Clear cell carcinoma is the most frequent type, accounting for about 65% of cases. It tends to invade the veins and form tumour thrombi in inferior vena cava (IVC-TT), occasionally reaching the right atrium. Nephrectomy and thrombectomy are standard therapeutic procedures performed in RCC-IVC-TT. Despite proven effectiveness of surgery, this entity in IVC-TT is associated with poor outcome. The role of palliative radiotherapy in this entity is undetermined. We present a case of a 43-year-old female patient after right-sided nephrectomy due to advanced RCC which invaded the IVC, hepatic veins, and right atrium. The patient has been treated with postoperative, hypofractionated radiotherapy on the residual disease

Hierarchic genetic strategy with maturing as a generic tool for multiobjective optimization

In this paper we introduce the Multiobjective Optimization Hierarchic Genetic Strategy with maturing (MO-mHGS), a meta-algorithm that performs evolutionary optimization in a hierarchy of populations. The maturing mechanism improves growth and reduces redundancy. The performance of MO-mHGS with selected state-of-the-art multiobjective evolutionary algorithms as internal algorithms is analysed on benchmark problems and their modifications for which single fitness evaluation time depends on the solution accuracy. We compare the proposed algorithm with the Island Model Genetic Algorithm as well as with single-deme methods, and discuss the impact of internal algorithms on the MO-mHGS meta-algorithm. © 2016 Elsevier B.V