Karcinomska bol i terapija

Cancer pain is not a homogenous and clearly understood pathological process. The best treatment is a combination of drug and non-drug measures. Pain is divided into visceral, bone or neuropathic pain and has characteristics of continuous or intermittent pain. Cancer bone pain therapy remains centered on strong opioid, radiotherapy and bisphosphonates. Invasive procedures are aimed to improve neurological function, ambulation and pain relief. Solid tumors often demand surgery. Treatment of acute postoperative pain is crucial for the prevention of chronic pain. Chemotherapy and radiation sometimes also cause pain. The management of cancer pain has improved because of rapid diagnosis and treatment, understanding of analgesics and the cooperation of patients and their family. The presence of special pain centers in hospitals also raise standard of cancer pain management. Drug therapy with non-opioid, opioid and adjuvant drugs is the base of such management. The side effects must be monitored and timely treated. Methods of regional nerve blockade in pain control are numerous. Placement of epidural, intrathecal and subcutaneous catheters, conductive nerve blocks with continuous delivery of mixed local anesthetics are very successful for selected patients. Conventional physical therapy involving lymphatic drainage is useful. Acupuncture, psychotherapy and similar methods are also applicable.Karcinomska bol nije homogen i potpuno razjašnjen patološki proces. Najbolja terapija je kombinacija medikamentozne terapije i nemedikametoznih postupaka. Možemo je podijeliti na visceralnu, koštanu i neuropatsku bol i ima karakteristike kontinuirane ili povremene boli. Terapija koštane boli fokusirana je na jake opioide, radioterapiju i bifosfonate. Cilj invazivnih metoda liječenja boli je poboljšati neurološku funkciju, pokretljivost i olakšanje boli. Solidni tumori često zahtjevaju operaciju. Liječenje akutne poslijeoperacijske boli je od iznimne važnosti u prevenciji nastanka kronične boli. Kemoterapija i radioterapija ponekad također uzrokuju bol. Liječenje karcinomske boli je poboljšano bržom dijagnostikom i terapijom, boljim poznavanjem analgetika i suradnjom s pacijentom i njegovom obitelji. Postojanje specijaliziranih centara za bol u bolnicama također je podiglo standard u liječenju boli. Liječenje boli medikamentozno neopioidima, opioidima i drugim pomoćnim lijekovima je osnova liječenja boli. Nuspojave lijekova moraju se neprestano pratiti i na vrijeme liječiti. Metode regionalne nervne blokade u liječenju boli su brojne. Plasiranje epiduralnih, intratekalnih i supkutanih katetera s kontinuiranom isporukom mješavine lokalnih anestetika veoma su uspješne kod određenih bolesnika. Fizikalna terapija s limfnom drenažom je korisna. Akupunktura, psihoterapija i slične metode su također primjenjive

Važnost pravovremene i redovite procjene boli nakon operacije raka dojke

Breast cancer is one of the most prevalent cancers in the world amongst women. Incidence of breast cancer in Croatia, in 2012 was 2227. The crude incidence rat for Croatia was 100,4 (on 100 000 persons) and standardized incidence rate for the world population was 53,7 (1,2). As a consequence of advancements in available diagnostic procedures and treatments, the rate of survival is increasing, hence it is expected that the population susceptible to pain as a complication would also increase (3). The persistent pain causes a negative physical and psyhosocial impact on patient’s life (3,4). Early identifi cation and accurate assessment of pain after breast cancer surgery includes: physicians and nurses in the ICU, surgical and oncological departments, general practitioners, psychiatrists, neurologists, palliative care teams and family members (5). In this review we presented results of early and regular assessment of pain intensity and detection of factors involved in the emergence and spread of pain that occurs after breast cancer surgery (6,7). Herein, a modified questionnaire about pain is described as used in our clinical practice, based on which a combination of analgesic therapy is applied and a more satisfactory response in patients treated for breast cancer is obtained.Rak dojke je jedan od najčešćih oblika raka u svijetu među ženama. Incidencija raka dojke u Hrvatskoj, u 2012. godini, je 2227 slučaja. Stopa učestalosti za Hrvatsku iznosila je 100,4 (na 100 000 osoba), a standardizirana učestalost za svjetsku populaciju je 53,7 (1,2). Kao posljedica napretka u dostupnoj dijagnostici i liječenju, stopa preživljavanja oboljelih je u porastu te se očekuje porast broja stanovništva s komplikacijama boli (3). Stalna bol ima negativne fizičke i psihosocijalne učinke na život oboljelih (3,4). Rano prepoznavanje i točna procjena boli, nakon operacije raka dojke, uključuje: liječnike i medicinske sestre u intenzivnim jedinicama, kirurškim i onkološkim odjelima; liječnika obiteljske medicine, psihijatra, neurologa, tim palijativne skrbi i članove obitelji (5). U ovom preglednom članku želimo prikazati važnost rane i redovite procjene kvalitete i jačine boli kao i otkrivanje čimbenika odgovornih za nastanak i širenje boli koja nastaje nakon operacije raka dojke (6,7). Također smo prikazali primjer modificiranog upitnika o boli koji smo koristili u našoj kliničkoj praksi, prema kojemu smo primjenili kombinaciju analgetske terapije i dobili zadovoljavajući odgovor u bolesnica operiranih od karcinoma dojk

Važnost pravovremene i redovite procjene boli nakon operacije raka dojke

Breast cancer is one of the most prevalent cancers in the world amongst women. Incidence of breast cancer in Croatia, in 2012 was 2227. The crude incidence rat for Croatia was 100,4 (on 100 000 persons) and standardized incidence rate for the world population was 53,7 (1,2). As a consequence of advancements in available diagnostic procedures and treatments, the rate of survival is increasing, hence it is expected that the population susceptible to pain as a complication would also increase (3). The persistent pain causes a negative physical and psyhosocial impact on patient’s life (3,4). Early identifi cation and accurate assessment of pain after breast cancer surgery includes: physicians and nurses in the ICU, surgical and oncological departments, general practitioners, psychiatrists, neurologists, palliative care teams and family members (5). In this review we presented results of early and regular assessment of pain intensity and detection of factors involved in the emergence and spread of pain that occurs after breast cancer surgery (6,7). Herein, a modified questionnaire about pain is described as used in our clinical practice, based on which a combination of analgesic therapy is applied and a more satisfactory response in patients treated for breast cancer is obtained.Rak dojke je jedan od najčešćih oblika raka u svijetu među ženama. Incidencija raka dojke u Hrvatskoj, u 2012. godini, je 2227 slučaja. Stopa učestalosti za Hrvatsku iznosila je 100,4 (na 100 000 osoba), a standardizirana učestalost za svjetsku populaciju je 53,7 (1,2). Kao posljedica napretka u dostupnoj dijagnostici i liječenju, stopa preživljavanja oboljelih je u porastu te se očekuje porast broja stanovništva s komplikacijama boli (3). Stalna bol ima negativne fizičke i psihosocijalne učinke na život oboljelih (3,4). Rano prepoznavanje i točna procjena boli, nakon operacije raka dojke, uključuje: liječnike i medicinske sestre u intenzivnim jedinicama, kirurškim i onkološkim odjelima; liječnika obiteljske medicine, psihijatra, neurologa, tim palijativne skrbi i članove obitelji (5). U ovom preglednom članku želimo prikazati važnost rane i redovite procjene kvalitete i jačine boli kao i otkrivanje čimbenika odgovornih za nastanak i širenje boli koja nastaje nakon operacije raka dojke (6,7). Također smo prikazali primjer modificiranog upitnika o boli koji smo koristili u našoj kliničkoj praksi, prema kojemu smo primjenili kombinaciju analgetske terapije i dobili zadovoljavajući odgovor u bolesnica operiranih od karcinoma dojk

Macedonian Speech Synthesis for Assistive Technology Applications

Speech technology is becoming ever more ubiquitous with the advance of speech enabled devices and services. The use of speech synthesis in Augmentative and Alternative Communication tools, has facilitated inclusion of individuals with speech impediments allowing them to communicate with their surroundings using speech. Although there are numerous speech synthesis systems for the most spoken world languages, there is still a limited offer for smaller languages. We propose and compare three models built using parametric and deep learning techniques for Macedonian trained on a newly recorded corpus. We target low-resource edge deployment for Augmentative and Alternative Communication and assistive technologies, such as communication boards and screen readers. The listening test results show that parametric speech synthesis is as performant compared to the more advanced deep learning models. Since it also requires less resources, and offers full speech rate and pitch control, it is the preferred choice for building a Macedonian TTS system for this application scenario.Comment: 5 pages, 1 figure, EUSIPCO conference 202

Neurodegenerative changes caused by inhalation anesthetics

Mozak je ciljni organ djelovanja inhalacijskih anestetika. Osjetljivost mozga na oksidacijski stres povezana je sa njegovom izraženom metaboličkom aktivnošću, proizvodnjom ROSa (engl. reactive oxygen species, ROS), velikim brojem mitohondrija i smanjenom enzimskom antioksidativnom aktivnošću. Inhalacijski anestetici, poput Isoflurana i Sevoflurana, utječu na jačanje osjetljivosti mozga na oštećenja oksidativnim stresom te na povećanje aktivnost beta-sekretaze (BACE), enzima koji formira beta-amiloidne plakove i izaziva beta-amiloidnu ovisnu apoptozu živčanih stanica. Nadalje, beta-amiloidni plakovi, kao patološki produkt amiloidnog prekursorskog proteina (APP), predstavljaju važnu značajku za razvoj neurodegenerativnih promjena povezanih sa nastankom Alzheimerove bolesti. Istraživanje prooksidativnih, upalnih i neurotoksičnih učinaka inhalacijskih anestetika, te praćenje razine oksidativnog stresa u moždanom tkivu i nastalih patohistoloških promjena na mozgu štakora vezanih za neurodegenerativna oštećenja i upalu možemo povezati sa dugotrajnim izlaganjem inhalacijskim anesteticima, narušavanjem oksidacijsko/antioksidacijske homeostaze i stvaranje beta-amiloidnih plakova. Razumijevanjem povezanosti izloženosti inhalacijskim anesteticima i nastanku ireverzibilnih neurodegenerativnih promjena sugeriralo bi se poštednijim korištenjem inhalacijskih anestetika utjecati na ograničavanje neurodegenerativnihpromjena vezanih za nastanak Alzheimerove bolesti.Main target of inhalation anesthetics is the brain. The sensitivity of the brain to oxidative stress is associated with its pronounced metabolic activity, production of ROS (reactive oxygen species), large number of mitochondria and reduced enzymatic antioxidant activity. Inhaled anesthetics, such as Isoflurane and Sevoflurane, increase the sensitivity of the brain to oxidative stress damage and increase the activity of beta-secretase (BACE), an enzyme that forms beta-amyloid plaques and causes beta-amyloid-dependent apoptosis of nerve cells. Furthermore, beta-amyloid plaques, pathological product of amyloid precursor protein (APP), represent an important feature for the development of neurodegenerative changes associated with the development of Alzheimer’s disease. By investigation of prooxidative, inflammatory and neurotoxic effects of inhaled anesthetics and analyzing the parameters of oxidative stress levels in brain tissue and pathohistological changes in rat brain related to neurodegenerative damage and inflammation, connection with long-term exposure to inhaled anesthetics disruption of oxidative/antioxidant homeostasis and formation of beta amyloid plaques can be made. By understanding the relationship between exposure to inhaled anesthetics and the occurrence of irreversible neurodegenerative changes it could be suggested to reduce using inhaled anesthetics to limit the neurodegenerative changes associated with the development of Alzheimer’s disease

NOTIONES - iNteracting netwOrk of inTelligence and securIty practitiOners with iNdustry and acadEmia actorS

With cyberattacks becoming more and more dangerous in the current, connected digital landscape, it is necessary to develop methods and technologies to tackle them. The EU funded NOTIONES project will address the danger by building a network of practitioners from security and intelligence services. It will bring together 30 partners, practitioners from military, civil, financial, judiciary, local, national and international security and intelligence services from 9 EU Member States and 6 Associated Countries. Together they will monitor the results of academic research and industrial innovation and suggest actions. NOTIONES will organise and participate in workshops and conferences to present its findings to the broad intelligence community