Diagnosis and treatment of cancer breakthrough pain in opinions of physicians working in Outpatients’ Palliative Care Units and Pain Clinics

Breakthrough pain (BtP) is common among patients suffering from cancer pain. The experience, knowledge and education of palliative care physicians or pain management specialists seem to be essential for proper diagnosis and treatment of breakthrough pain. The purpose of this study was to determine the scope and assess the knowledge of physicians regarding BtP and its management. 135 physicians have participated in the study and completed special questionnaires for the period from April to July 2010. The vast majority of surveyed physicians (133 out of 135) declared that they diagnosed the BtP in their patients, usually 2 to 3 episodes a day. The time for the pain to become maximal, in the opinion of 73% of physicians, was usually between 5 to 30 minutes, the average duration of the breakthrough pain episode approximately was 15– –30 minutes. The vast majority of respondents prescribed pharmacological treatment to manage the BtP episodes, most commonly morphine, non-steroidal anti-inflammatory drugs, acetaminophen and tramadol.Breakthrough pain (BtP) is common among patients suffering from cancer pain. The experience, knowledge and education of palliative care physicians or pain management specialists seem to be essential for proper diagnosis and treatment of breakthrough pain. The purpose of this study was to determine the scope and assess the knowledge of physicians regarding BtP and its management. 135 physicians have participated in the study and completed special questionnaires for the period from April to July 2010. The vast majority of surveyed physicians (133 out of 135) declared that they diagnosed the BtP in their patients, usually 2 to 3 episodes a day. The time for the pain to become maximal, in the opinion of 73% of physicians, was usually between 5 to 30 minutes, the average duration of the breakthrough pain episode approximately was 15– –30 minutes. The vast majority of respondents prescribed pharmacological treatment to manage the BtP episodes, most commonly morphine, non-steroidal anti-inflammatory drugs, acetaminophen and tramadol

Breakthrough pain in patients with chronic cancer pain followed by palliative care and pain clinic physicians — an observational study

Background. Breakthrough pain (BtP) is common among patients suffering from cancer pain. The experience, knowledge and education of palliative care physicians or pain clinicans seems to be essential for proper diagnosis and treatment of breakthrough pain. Another key point is knowledge and behavior of patients suffering the breakthrough pain episodes. The aim of this study was to determine, whether patients suffering the cancer chronic pain are being informed by physicians working in palliative care outpatients and pain clinics about BtP occurrence and treatment, as well as how patients are utilizing the rescue medications. Material and methods. Six hundred seventy eight patients participated in the study. The common demographic (age, sex), disease-related, background pain (including mode and effectiveness of treatment) data were collected. The information about breakthrough pain occurrence, number of episodes, BtP management, frequency of rescue medications dosing and effectiveness of these medications were also collected. Results. Over 75% of them had been prescribed strong opioid and almost 25% of the patients — weak opioid. 58% had uncontrolled background pain. BtP was reported by 69,3% of these patients, most commonly one or two episodes per day. Only 3% of patients experienced more than 4 episodes a day. As a rescue medication patients usually used morphine, followed by nonsteroidal antiinflamatory drugs and paracetamol, but statistically not every time they experienced the BtP. Conclusion. This study confirmed that patients followed by palliative care outpatients and pain clinics receive information about background and breakthrough pain, and are well orientated in pain medications. The problem emerges in proper utilization of rescue medications, most commonly prescribed as oral. Adv. Pall. Med. 2011; 10, 1: 29–34Background. Breakthrough pain (BtP) is common among patients suffering from cancer pain. The experience, knowledge and education of palliative care physicians or pain clinicans seems to be essential for proper diagnosis and treatment of breakthrough pain. Another key point is knowledge and behavior of patients suffering the breakthrough pain episodes. The aim of this study was to determine, whether patients suffering the cancer chronic pain are being informed by physicians working in palliative care outpatients and pain clinics about BtP occurrence and treatment, as well as how patients are utilizing the rescue medications. Material and methods. Six hundred seventy eight patients participated in the study. The common demographic (age, sex), disease-related, background pain (including mode and effectiveness of treatment) data were collected. The information about breakthrough pain occurrence, number of episodes, BtP management, frequency of rescue medications dosing and effectiveness of these medications were also collected. Results. Over 75% of them had been prescribed strong opioid and almost 25% of the patients — weak opioid. 58% had uncontrolled background pain. BtP was reported by 69,3% of these patients, most commonly one or two episodes per day. Only 3% of patients experienced more than 4 episodes a day. As a rescue medication patients usually used morphine, followed by nonsteroidal antiinflamatory drugs and paracetamol, but statistically not every time they experienced the BtP. Conclusion. This study confirmed that patients followed by palliative care outpatients and pain clinics receive information about background and breakthrough pain, and are well orientated in pain medications. The problem emerges in proper utilization of rescue medications, most commonly prescribed as oral. Adv. Pall. Med. 2011; 10, 1: 29–3

Derivování vzorkovaných signálů použitím frekvenčně korigované diference

The work discusses the methodology of designing finite impulse response differential filters. The filters require combining a difference quotient term of a proper order with a low-pass correction term responsible for the correction of the difference quotient term characteristic and elimination of measurement and quantization noise. The filters well approximate the characteristic of ideal differentiating elements in the low frequency range. All calculations were executed in “Mathematica”.Práce popisuje metodologii návrhu číslicových filtrů s konečnou odezvou pro derivaci. Filtry požadují propojení rozdílového členu vlastního řádu s dolnopropustným korekčním členem plnící funkci eliminace měřicího a kvantizačního šumu. Filtry dobře aproximují charakteristiku ideálního diferenčního členu v nízkofrekvenčním rozsahu.Všechny výpočty byly provedeny v programu “Mathematica”

Neuropsychiatric disorders in patient with end-of-life stage of cancer disease — a case report

Advanced cancer disease often results in many unpleasant physical and psychological symptoms. They may have an important impact on the patients’ quality of life. Acute psychotic disorders like cognitive failure, and delirium in particular, are quite common in patients referred to oncologists and palliative care units. Here we describe the case of a man, 63 years of age, with squamous cell lung cancer, treated for severe pain due to bone metastases, who developed cognitive failure and delirium. We discuss delirium, its diagnosis and treatment which may help the clinician to improve their skills. Adv. Pall. Med. 2010; 9, 1: 17–20Advanced cancer disease often results in many unpleasant physical and psychological symptoms. They may have an important impact on the patients’ quality of life. Acute psychotic disorders like cognitive failure, and delirium in particular, are quite common in patients referred to oncologists and palliative care units. Here we describe the case of a man, 63 years of age, with squamous cell lung cancer, treated for severe pain due to bone metastases, who developed cognitive failure and delirium. We discuss delirium, its diagnosis and treatment which may help the clinician to improve their skills. Adv. Pall. Med. 2010; 9, 1: 17–2

Biology and metabolism of Glyptonotus antarcticus(Eights)(Crustacea: Isopoda) from Admiralty Bay, King George Island, Antarctica

The Glyptonotus antarcticus population of Admiralty Bay is characterised by the wider range of body sizes than that from the Signy Island region. The sex ratio is similar in both populations. Females of all development stages were captured in Admiralty Bay between March and November, which confirms the lack of seasonal variation in the developmental cycle of this species. Eggs were found in marsupia of females measuring 75mm and more. The relationship between the wet weight(Ww) and the total body length(TL) is similar for immature females and males, equalling Ww=0.0154TL^ and Ww=0.0054TL^, respectively. In the annual cycle, the basic metabolism ratio(a=R/Ww^) of G. antarcticus is lowest in September and does not change significantly during the daily cycle. Two-, four- and six-week long starvation reduces the metabolism level by 30%, 51% and 71%, respectively. Glutamic acid at the concentration of 10mmol increases the metabolism by half, both in animals starved for 2 weeks and in freshly captured individuals. Exposure to kynurenic acid at the concentration 0.1mmol blocks further reactions to the glutamic acid

Schulpartnerschaften in Niedersachsen am Beispiel GLOBO:LOG. Globaler Dialog in regionalen Netzwerken

Der Artikel informiert über ein Netzwerk-Kooperations-Projekt anhand von drei konkreten Beispielen. (DIPF/Orig.)The article informs the reader about a network-cooperation-project by means of three examples. (DIPF/Orig.

Versatile Synthesis of 4-Methylidenepyrazolidin-3-ones Using a Horner–Wadsworth–Emmons Approach

A new, versatile method for the synthesis of, so far unknown, variously substituted 4-methylidenepyrazolidin-3-ones as potential cytotoxic agents is described. Target compounds were synthesized from the corresponding 4-diethoxyphosphorylpyrazolidin-3-ones which were used as Horner–Wadsworth–Emmons ­reagents for the olefination of formaldehyde. 4-Phosphorylpyrazolidin-3-ones were, in turn, obtained starting from the sodium salt of ethyl 2-diethoxyphosphoryl-3-hydroxy-2-propenoate, ethyl 2-acyl-2-diethoxyphosphorylacetates, or 3-methoxy-2-diethoxyphosphorylacrylate and monosubstituted or 1,2-disubstituted hydrazines

Kinetics of vinyl acetate biodegradation by Pseudomonas fluorescens PCM 2123

The microbial degradation of vinyl acetate (VA) by Pseudomonas fluorescens PCM 2123 strain was studied in both batch and continuous modes. The purpose of the experiments was to determine the kinetic model of the cell growth and biodegradation rate of vinyl acetate (VA), which was the sole carbon and energy source for tested microorganisms. The experiments, carried out in a batch reactor for several initial concentrations of growth substrate in the liquid phase ranging from 18.6 to 373 gsubstrate·m–3 (gs·m–3) made it possible to choose the kinetic model and to estimate its constants. The Haldane inhibitory model with the values of constants: μm = 0.1202 h–1, KS = 17.195 gs·m–3, Ki = 166.88 gs·m–3 predicted the experimental data with the best accuracy. To set the parameters of maintenance metabolism it was necessary to carry out a series of continuous cultures at different dilution rates (0.05 to 0.072 h–1) and concentrations of VA in the liquid supplied to the chemostat ranging from 30.9 to 123.6 gs·m–3. The obtained data-base enabled to determine the coefficient for maintenance metabolism (me = 0.0251 gsubstrate·gcell dry weight –1·h–1 (gs·gcdw –1·h–1)) as well as the maximal and observed values of yield coefficients, Yxs M = 0.463 gcdw·gs –1 and (Yxs)obs = 0.411 gcdw·gs –1, respectively. The developed kinetics was verified by comparison of the computed and obtained in batch experiments profiles of changes in biomass and growth substrate concentrations

Przegląd narzędzi służących do oceny bólu neuropatycznego

Diagnoza i ocena bólu neuropatycznego u chorych na nowotwory powinna się opierać na szczegółowo zebranym wywiadzie, badaniu przedmiotowym, rysunku bólu, słownym opisie charakteru dolegliwości, kwestionariuszach/skalach oceny bólu, przeglądzie funkcji somatosensorycznych. W celu określenia pewności rozpoznania bólu neuropatycznego zaleca się stosowanie specyficznego, czterostopniowego systemu klasyfikacyjnego, w którym ocenia się obecność i neuroanatomiczną dystrybucję bólu oraz wiarygodnie potwierdza patologię układu nerwowego. Ostatnio opracowano kilka prostych narzędzi do szybkiej przesiewowej diagnostyki bólu neuropatycznego, a część z tych krótkich testów może być bardzo przydatna w przypadku pacjentów objętych opieką paliatywną. Właściwe rozpoznawanie i leczenie bólu neuropatycznego u chorych z nowotworami ciągle pozostaje ogromnym wyzwaniem. Może się to wiązać z kompleksowością zjawiska bólu u tych chorych, a także ciągle zbyt rzadko stosowanymi lekami adjuwantowymi do leczenia bólu neuropatycznego

Business uncertainty during the Covid-19 pandemic : assessment based on the pandemic fear index and economic surveys

PURPOSE: The article presents an assessment of the situation of business enterprises during the COVID-19 pandemic.DESIGN/METHODOLOGY/APPROACH: The analysis uses the Pandemic Fear Index (PFI) and more detailed analyses based on Business Tendency Surveys (BTS). The proposed PFI considers critical factors in a pandemic, such as reported cases of illness and death and government actions that restrict business operations.FINDINGS: The study indicates a clear differentiation of the situation among businesses depending on the nature of the business activity. The changes in the PFI index turned out to be like the changes observed in the BTS in individual sectors of the economy. An exceptionally high correlation was found between the indicator and the results of the “pandemic module” of the BTS.PRACTICAL IMPLICATIONS: The analysis uses data from the Polish economy, but the proposed methodology of identifying and assessing the impact of a pandemic on the economy may be used in other countries, depending on data availability. A broader application of the presented approaches considering pandemic shock may be one of the directions for further research in the future.ORIGINALITY/VALUE: The PFI, specially designed for the pandemic period, is a proxy for assessing business uncertainty during a pandemic. The advantage of the indicator is the ability to observe the daily changes of its value along with any incoming information. The added value of applying the proposed methods is the possibility of a detailed analysis of the occurrence of subsequent pandemic waves and the emerging discrepancies in the shaping of uncertainties that appear during the pandemic in individual sectors of the economy.peer-reviewe