63P Ocena skuteczności paliatywnej brachyterapii HDR w leczeniu raka przełyku

Celem pracy jest ocena skuteczności paliatywnej brachyterapii w leczeniu zaawansowanego raka przełyku. Poddano analizie wpływ wcześniejszej teleradioterapii na efekt paliacji oraz dokonano oceny przydatności powtórnej brachyterapii w leczeniu nawrotu dysfagii.Materiał i metodyW latach 1991–1997 w Instytucie Onkologii w Gliwicach leczono brachyterapią HDR 35 chorych na zaawansowanego raka przełyku. 23 chorych tej grupy było uprzednio leczonych z zastosowaniem zewnętrznych źródeł promieniowania, dla 12 brachyterapia była jedyną metodą leczenia. U 9 chorych tej grupy zastosowano ponownie brachyterapię w leczeniu nawrotu dysfagii. Skuteczność paliatywnej brachyterapii oceniono na podstawie analizy pięciu czynników:•subiektywnego odczucia poprawy•stopnia dysfagii po leczeniu•bólu przy przełykaniu•wzrostu wagi•regresji radiologicznej zmianyW celu analizy wpływu teleradioterapii na skuteczność paliatywnej brachyterapii chorzy zostali podzieleni na dwie grupy A i B. Do grupy A zaliczono chorych leczonych uprzednio teleradioterapią, do grupy B zaliczono chorych leczonych wyłącznie brzchyterapią.WynikiSubiektywną poprawę po leczeniu zgłaszało 28 (80%) chorych. U 31 chorych nastąpiło zmniejszenie dysfagii. Spośród 14(40%) chorych cierpiących z powodu bólu u 6 (42%) chorych stwierdzono zmniejszenie nasilenia tego objawu. Ból nie był częstym objawem w badanej grupie. 21 (60%) chorych nie odczuwało bólu zarówno przed jak i po leczeniu. U 14 (40%) chorych stwierdzono wzrost wagi po leczeniu, a u 20 (57%) chorych waga utrzymywała się na stałym poziomie. W skopii przełyku z kontrastem stwierdzono regresję zmiany u 29 (83%) chorych. Czas trwania regresji objawów wahał się od kilkunastu dni do półtora roku; średnio wynosił 2,5 miesiąca. Ciężkie powikłania po leczeniu zaobserwowano u 6 (17%) chorych. W grupach A i B stwierdzono porównywalny efekt paliatywny, ciężkie powikłania zaobserwowano jednak tylko u chorych zaliczonych do grupy A.Spośród 9 chorych leczonych z powodu nawrotu dysfagii powtórna brachyterapia przyniosła efekt u 5 (56%) chorych. powikłania po powtórnej brachyterapii zaobserwowano u 3chorych; wszyscy byli uprzednio leczeni teradioterapią.WnioskiBrachyterapia HDR jest skuteczną metodą paliatywnego leczenia raka przełyku i wydaje się być wystarczająca jako jedyna metoda paliacji przy tym rozpoznaniu. W badanej grupie powtórne zastosowanie brachyterapii okazało się skuteczna metodą w przypadku nawrotu dysfagii u chorych nie poddanych wcześniej teleradioterapii

Gearing motion in cogwheel pairs of molecular rotors: weak-coupling limit

Variable-​temp. (VT) crystal structures, VT 1H spin-​lattice relaxation in static crystals, and DFT modeling of the rotational barriers of BCP rotators in cryst. arrays of a rod-​like mol. contg. two 1,​3-​bis(ethynyl)​bicyclo[1.1.1]​pentane (BCP) units demonstrate that a correlated gearing motion occurs in the limit of a weak coupling between two rotors in a pair

Associations between fruit and vegetable intake, leisure-time physical activity, sitting time and self-rated health among older adults : cross-sectional data from the WELL study

BackgroundLifestyle behaviours, such as healthy diet, physical activity and sedentary behaviour, are key elements of healthy ageing and important modifiable risk factors in the prevention of chronic diseases. Little is known about the relationship between these behaviours in older adults. The purpose of this study was to explore the relationship between fruit and vegetable (F&V) intake, leisure-time physical activity (LTPA) and sitting time (ST), and their association with self-rated health in older adults.MethodsThis cross-sectional study comprised 3,644 older adults (48% men) aged 55-65 years, who participated in the Wellbeing, Eating and Exercise for a Long Life ("WELL") study. Respondents completed a postal survey about their health and their eating and physical activity behaviours in 2010 (38% response rate). Spearman\u27s coefficient (rho) was used to evaluate the relationship between F&V intake, LTPA and ST. Their individual and shared associations with self-rated health were examined using ordinal logistic regression models, stratified by sex and adjusted for confounders (BMI, smoking, long-term illness and socio-demographic characteristics).ResultsThe correlations between F&V intake, LTPA and ST were low. F&V intake and LTPA were positively associated with self-rated health. Each additional serving of F&V or MET-hour of LTPA were associated with approximately 10% higher likelihood of reporting health as good or better among women and men. The association between ST and self-rated health was not significant in the multivariate analysis. A significant interaction was found (ST*F&V intake). The effect of F&V intake on self-rated health increased with increasing ST in women, whereas the effect decreased with increasing ST in men.ConclusionThis study contributes to the scarce literature related to lifestyle behaviours and their association with health indicators among older adults. The findings suggest that a modest increase in F&V intake, or LTPA could have a marked effect on the health of older adults. Further research is needed to fully understand the correlates and determinants of lifestyle behaviours, particularly sitting time, in this age group

Major Depressive Disorder (MDD) and Antidepressant Medication Are Overrepresented in High-Dose Statin Treatment

Objective: To examine the dose-dependent relationship of different types of statins with the occurrence of major depressive disorder (MDD) and prescription of antidepressant medication. Methods: This cross-sectional study used medical claims data for the general Austrian population (n = 7,481,168) to identify all statin-treated patients. We analyzed all patients with MDD undergoing statin treatment and calculated the average defined daily dose for six different types of statins. In a sub-analysis conducted independently of inpatient care, we investigated all patients on antidepressant medication (statin-treated patients: n = 98,913; non-statin-treated patients: n = 789,683). Multivariate logistic regression analyses were conducted to calculate the risk of diagnosed MDD and prescription of antidepressant medication in patients treated with different types of statins and dosages compared to non-statin-treated patients. Results: In this study, there was an overrepresentation of MDD in statin-treated patients when compared to non-statin-treated patients (OR: 1.22, 95% CI: 1.20–1.25). However, there was a dose dependent relationship between statins and diagnosis of MDD. Compared to controls, the ORs of MDD were lower for low-dose statin-treated patients (simvastatin>0– 0– 0– 40– 60–80 mg:OR: 5.27, 95% CI: 4.21–6.60; atorvastatin>40– 60– 20– < =40 mg:OR: 2.09, 95% CI: 1.31–3.34). The results were confirmed in a sex-specific analysis and in a cohort of patients taking antidepressants, prescribed independently of inpatient care. Conclusions: This study shows that it is important to carefully re-investigate the relationship between statins and MDD. High-dose statin treatment was related to an overrepresentation, low-dose statin treatment to an underrepresentation of MDD

How are "teaching the teachers" courses in evidence based medicine evaluated? A systematic review

Background Teaching of evidence-based medicine (EBM) has become widespread in medical education. Teaching the teachers (TTT) courses address the increased teaching demand and the need to improve effectiveness of EBM teaching. We conducted a systematic review of assessment tools for EBM TTT courses. To summarise and appraise existing assessment methods for teaching the teachers courses in EBM by a systematic review. Methods We searched PubMed, BioMed, EmBase, Cochrane and Eric databases without language restrictions and included articles that assessed its participants. Study selection and data extraction were conducted independently by two reviewers. Results Of 1230 potentially relevant studies, five papers met the selection criteria. There were no specific assessment tools for evaluating effectiveness of EBM TTT courses. Some of the material available might be useful in initiating the development of such an assessment tool. Conclusion There is a need for the development of educationally sound assessment tools for teaching the teachers courses in EBM, without which it would be impossible to ascertain if such courses have the desired effect

The Role of Law Enforcement Agencies and the Use of IT Tools for a Coordinate Response in Pandemic Crisis Management: The STAMINA project

Copyright © the author(s) and CEPOL. Pandemic crises are disruptive events that imply a threat to the health of citizens, and also to public safety. In order to provide an adequate response, Law Enforcement Agencies (LEAs) organizations up to now had to adapt their structures, staffing conditions and competencies to the exceptional circumstances. At the same time, pandemics, such as COVID-19 that is currently a real scenario, require from LEAs to test their capabilities and thus to further identify their own gaps and get to know themselves better. The complexity of this kind of phenomena requires a coordinated and multidisciplinary response through Information Technology (IT) tools to mitigate the effects of pandemics. In this sense, our participation in the European H2020 STAMINA project: “Demonstration of intelligent decision support for pandemic crisis prediction and management within and across European borders” brings added value to our daily work as LEAs. The project implements a set of tools whose goal is twofold: improvement of management of information in all phases of the pandemic as well as improvement of response and coordination among all first responders involved in a pandemic. STAMINA attempts to achieve this through the combination of a number of IT tools ranging from Predictive models and Early Warning systems to Real-time Social Media Analytics and a Common Operational Picture (COP) platform that acts as the main interface for real-time situation assessment and coordinated responses of the involved LEAs.European Union Horizon 2020 innovation action programme grant agreement No 883441, STAMINA project (https://cordis.europa.eu/project/id/883441); European Union Horizon 2020 research and innovation programme grant agreement No 824115, HiDALGO project (https://cordis.europa.eu/project/id/824115).https://bulletin.cepol.europa.eu/index.php/bulletin/article/view/46