Intraperitonealna aerosolna kemoterapija pod povišanim pritiskom

Patients with peritoneal carcinomatosis have a poor prognosis despite multimodal treatment with surgery and chemotherapy. Cytoreductive surgery is the only curative option for the treatment of carcinomatosis but only minority of patients are eligible for surgical treatment. For non-resectable peritoneal carcinomatosis, chemotherapy is the only possible option with limited effect on the peritoneal metastases due to poor vascularization and low penetration of the drug. Pressurized IntraPeritoneal Aerosol Chemotherapy (PIPAC) is a new minimally invasive method using laparoscopy to deliver chemotherapy in the form of pressurized aerosol into the abdomen allowing better distribution of the drug in the abdominal cavity and deeper penetration of the drug. PIPAC is technically feasible and safe procedure useful as a treatment option for isolated peritoneal carcinomatosis of various origins. Promising results have been published in the treatment of the peritoneal metastases of all origin with PIPAC. Many prospective clinical trials are ongoing evaluating oncological efficacy of PIPAC in multiple indications with various drugs.Bolniki s peritonealnimi metastazami imajo kljub multimodalnemu zdravljenju s kirurgijo in kemoterapijo slabo prognozo. Samo citoreduktivna kirurgija  je lahko kurativna pri zdravljenju peritonealne karcinoze, toda le manjši delež bolnikov je primeren za kirurško zdravljenje. Pri neresektabilni peritonealni karcinozi je kemoterapija edina možna terapija z omejenim učinkom na peritonealne metastaze zaradi slabe vaskularizacije in nizke penetracije zdravila. Intraperitonealna aerosolna kemoterapija pod pritiskom (PIPAC) je nova minimalno invazivna metoda, ki s pomočjo  laparoskopije omogoča aplikacijo citostatika v abdomen v obliki aerosolov pod povišanim pritiskom, kar omogoča boljšo razporeditev zdravila v abdominalni votlini in globjo penetracijo zdravila. PIPAC je tehnično varen postopek, ki omogoča zdravljenje izolirane peritonealne karcinoze različnih vrst tumorjev. Objavljeni rezultati zdravljenja peritonealnih metastaz različnih vrst tumorjev s PIPAC so obetavni. Trenutno potekajo številne prospektivne študije, ki analizirajo terapevtsko učinkovitost PIPAC-a pri različnih indikacijah z različnimi zdravili

PlantACT! – how to tackle the climate crisis

International audienceGreenhouse gas (GHG) emissions have created a global climate crisis which requires immediate interventions to mitigate the negative effects on all aspects of life on this planet. As current agriculture and land use contributes up to 25% of total GHG emissions, plant scientists take center stage in finding possible solutions for a transition to sustainable agriculture and land use. In this article, the PlantACT! (Plants for climate ACTion!) initiative of plant scientists lays out a road map of how and in which areas plant scientists can contribute to finding immediate, mid-term, and long-term solutions, and what changes are necessary to implement these solutions at the personal, institutional, and funding levels

Prosafe: a european endeavor to improve quality of critical care medicine in seven countries

BACKGROUND: long-lasting shared research databases are an important source of epidemiological information and can promote comparison between different healthcare services. Here we present ProsaFe, an advanced international research network in intensive care medicine, with the focus on assessing and improving the quality of care. the project involved 343 icUs in seven countries. all patients admitted to the icU were eligible for data collection. MetHoDs: the ProsaFe network collected data using the same electronic case report form translated into the corresponding languages. a complex, multidimensional validation system was implemented to ensure maximum data quality. individual and aggregate reports by country, region, and icU type were prepared annually. a web-based data-sharing system allowed participants to autonomously perform different analyses on both own data and the entire database. RESULTS: The final analysis was restricted to 262 general ICUs and 432,223 adult patients, mostly admitted to Italian units, where a research network had been active since 1991. organization of critical care medicine in the seven countries was relatively similar, in terms of staffing, case mix and procedures, suggesting a common understanding of the role of critical care medicine. conversely, icU equipment differed, and patient outcomes showed wide variations among countries. coNclUsioNs: ProsaFe is a permanent, stable, open access, multilingual database for clinical benchmarking, icU self-evaluation and research within and across countries, which offers a unique opportunity to improve the quality of critical care. its entry into routine clinical practice on a voluntary basis is testimony to the success and viability of the endeavor