Stosowanie środków psychostymulujących w leczeniu wspomagającym i paliatywnym pacjentów z chorobą nowotworową

Środki psychostymulujące są od dawna stosowane w leczeniu pacjentów z chorobami psychicznymi oraz somatycznymi. Potrzeba kontrolowania i przeciwdziałania różnorodnym stresującym objawom występującym w przebiegu choroby nowotworowej oraz podczas jej leczenia sprawiła, że leki te włączono do leczenia wspomagającego i paliatywnego u pacjentów z nowotworami. Badano wykorzystanie psychostymulantów w leczeniu takich objawów jak zmęczenie w przebiegu choroby nowotworowej, zaburzenia funkcji poznawczych, depresja oraz sedacja. W poniższej pracy oceniono farmakologię metylfenidatu, amfetaminy i premoliny oraz innych psychostymulantów, takich jak kofeina czy też nowy środek somnolityczny - modafinil. W pracy wykorzystano badania oceniające skutki działania tych leków u pacjentów z chorobą nowotworową

Genetic variation and cognitive dysfunction in opioid-treated patients with cancer

Background and purpose The effects of single‐nucleotide polymorphisms (SNP s) on the cognitive function of opioid‐treated patients with cancer until now have not been explored, but they could potentially be related to poor functioning. This study aimed at identifying associations between SNP s of candidate genes, high opioid dose, and cognitive dysfunction. Methods Cross‐sectional multicenter study (European Pharmacogenetic Opioid Study, 2005–2008); 1586 patients; 113 SNP s from 41 genes. Inclusion criteria: cancer, age ≥18 year, opioid treatment, and available genetic data. Cognitive assessment by Mini‐Mental State Examination (MMSE ). Analyses: SNP s were rejected if violation of Hardy–Weinberg equilibrium (P < 0.0005), or minor allele frequency <5%; patients were randomly divided into discovery sample (2/3 for screening) and validation sample (1/3 for confirmatory test); false discovery rate of 10% for determining associations (Benjamini–Hochberg method). Co‐dominant, dominant, and recessive models were analyzed by Kruskal–Wallis and Mann–Whitney tests. Results In the co‐dominant model significant associations (P < 0.05) between MMSE scores and SNP s in the HTR 3E , TACR 1 , and IL 6 were observed in the discovery sample, but the replication in the validation sample did not confirm it. Associations between MMSE scores among patients receiving ≥400 mg morphine equivalent dose/day and SNP s in TNFRSF 1B , TLR 5 , HTR 2A , and ADRA 2A were observed, but they could not be confirmed in the validation sample. After correction for multiple testing, no SNP s were significant in the discovery sample. Dominant and recessive models also did not confirm significant associations. Conclusions The findings did not support influence of those SNP s analyzed to explain cognitive dysfunction in opioid‐treated patients with cancer

Practical evaluation of polycrystalline photovoltaic module efficiency under Karaganda conditions

Nowadays, seven major projects aiming at solar power plants development with total capacity of 300 MW have been introducedin Kazakhstan, which advances the use of non-conventional renewable energy sources and develops the technologies to promotethe solar energy. The paper reports on the research focused on the design and construction of 60 MW solar power plant in the cityof Saran. An experimental solar power plant has been built at Karaganda State Technical University to study technical parametersof photovoltaic modules under operational conditions and their adjustment to climatic conditions of Karaganda located in CentralKazakhstan. The statistical analysis of data was performed, and the distribution parameters with the criteria for processing experi-mental results were evaluated. It was found out that the monitoring system and the change in the values of Azimuth and Zenithangles of solar modules will be effective for Karaganda. The results of observations have shown that the amount of electrical ener-gy produced in 2014 exceeded the amount generated in 2015 in the range of 10 %, depending on the month of the year. A temper-ature increase by 1 °C from 25 °C reduces the solar panel capacity by approximately 0.51 %

Is admittance to specialised palliative care among cancer patients related to sex, age and cancer diagnosis?:A nation-wide study from the Danish Palliative Care Database (DPD)

BACKGROUND: Specialised palliative care (SPC) takes place in specialised services for patients with complex symptoms and problems. Little is known about what determines the admission of patients to SPC and whether there are differences in relation to institution type. The aims of the study were to investigate whether cancer patients’ admittance to SPC in Denmark varied in relation to sex, age and diagnosis, and whether the patterns differed by type of institution (hospital-based palliative care team/unit, hospice, or both). METHODS: This was a register-based study of adult patients living in Denmark who died from cancer in 2010–2012. Data sources were the Danish Palliative Care Database, Danish Register of Causes of Death and Danish Cancer Registry. The associations between the explanatory variables (sex, age, diagnosis) and admittance to SPC were investigated using logistic regression. RESULTS: In the study population (N = 44,548) the overall admittance proportion to SPC was 37%. Higher odds of overall admittance to SPC were found for women (OR = 1.23; 1.17–1.28), younger patients (<40 compared with 80+ years old) (OR = 6.44; 5.19–7.99) and patients with sarcoma, pancreatic and stomach cancers, whereas the lowest were for patients with haematological malignancies. The higher admission found for women was most pronounced for hospices compared to hospital-based palliative care teams/units, whereas higher admission of younger patients was more pronounced for hospital-based palliative care teams/units. Patients with brain cancer were more often admitted to hospices, whereas patients with prostate cancer were more often admitted to hospital-based palliative care teams/units. CONCLUSION: It is unlikely that the variations in relation to sex, age and cancer diagnoses can be fully explained by differences in need. Future research should investigate whether the groups having the lowest admittance to SPC receive sufficient palliative care elsewhere

Effects of butter naturally enriched with conjugated linoleic acid and vaccenic acid on blood lipids and LDL particle size in growing pigs

<p>Abstract</p> <p>Background</p> <p>Cow milk is a natural source of the cis 9, trans 11 isomer of conjugated linoleic acid (c9,t11-CLA) and trans vaccenic acid (VA). These fatty acids may be considered as functional foods, and the concentration in milk can be increased by e.g. sunflower oil supplementation to the dairy cow feed.</p> <p>The objective of this study was to compare the effects of regular butter with a special butter naturally enriched in c9,t11-CLA and VA on plasma lipids in female growing pigs. The experimental period lasted for three weeks and the two diets provided daily either 5.0 g c9,t11-CLA plus 15.1 g VA or 1.3 g c9,t11-CLA plus 3.6 g VA.</p> <p>Results</p> <p>The serum concentrations of c9,t11-CLA, VA and alpha-linolenic acid were increased and myristic (14:0) and palmitic acid (16:0) were reduced in the pigs fed the CLA+VA-rich butter-diet compared to regular butter, but no differences in plasma concentrations of triacylglycerol, cholesterol, HDL-cholesterol, LDL-cholesterol, LDL particle size distribution or total cholesterol/HDL cholesterol were observed among the two dietary treatment groups.</p> <p>Conclusion</p> <p>Growing pigs fed diets containing butter naturally enriched in about 20 g c9,t11-CLA plus VA daily for three weeks, had increased serum concentrations of alpha-linolenic acid and decreased myristic and palmitic acid compared to pigs fed regular butter, implying a potential benefit of the CLA+VA butter on serum fatty acid composition. Butter enriched in CLA+VA does not appear to have significant effect on the plasma lipoprotein profile in pigs.</p

Natural and cultural heritage in mountain landscapes: towards an integrated valuation

Mountain areas of Europe have been managed by humans for a long time, leading to a prevalence of semi-natural habitats in mountain landscapes today. These landscapes contain both natural and cultural heritage; however, natural and cultural heritage are rarely considered together when valuing landscapes and developing management plans in protected areas. Here we present a case study of seven protected areas in the mountains of Great Britain and Norway. We take a long-term perspective on landscape and land-use change and propose an integrated model of landscape valuation on the basis of combined natural and cultural heritage. Our model plots indicators of natural and cultural heritage along a gradient of land-use intensity, allowing simultaneous assessment and highlighting how valuation depends on what type of heritage is considered. We show that while contemporary land-use changes follow similar trajectories in Norway and Britain, different land-use histories mean that the loss of heritage differs between the regions. The model presented here thus allows for the consolidation of valuation based on both cultural and natural heritage in landscapes.publishedVersio

Detailed statistical analysis plan for the Danish Palliative care trial (DanPaCT)

Acknowledgements We wish to thank the students who sent out the questionnaires, who entered and compared all data, help with data management, made material blind to the investigators, and were/will be outcome assessors of interventions given. They were: Nicla Rohde Christensen, Ellen Lundorff, Marc Klee Olsen, Charlotte Lund Rasmussen, and Nete Skjødt. This work was funded by the Tryg Foundation [journal number 7-10-0838A] and the Danish Cancer Society [journal number R16-A695]. Other than funding the trial, the funding body had no role in the design, conduct, analysis, or reporting of the present trial.Peer reviewedPublisher PD

From "Breakthrough" to "Episodic" Cancer Pain? A European Association for Palliative Care Research Network Expert Delphi Survey Towards a Common Terminology and Classification of Transient Cancer Pain Exacerbations

Context: Cancer pain can appear with spikes of higher intensity. Breakthrough cancer pain (BTCP) is the most common term for the transient exacerbations of pain, but the ability of the nomenclature to capture relevant pain variations and give treatment guidance is questionable. Objectives: To reach consensus on definitions, terminology, and sub classification of transient cancer pain exacerbations. Methods: The most frequent authors on BTCP literature were identified using the same search strategy as in a systematic review and invited to participate in a two-round Delphi survey. Topics with a low degree of consensus on BTCP classification were refined into twenty statements. The participants rated their degree of agreement with the statements on a numeric rating scale (NRS 0-10). Consensus was defined as a median NRS score of ≥ 7 and an interquartile range of ≤ 3. Results: Fifty-two authors had published three or more papers on BTCP over the past ten years. Twenty-seven responded in the first round and 24 in the second round. Consensus was reached for 13 of 20 statements. Transient cancer pain exacerbations can occur without background pain, when background pain is uncontrolled, and regardless of opioid treatment. There exist cancer pain exacerbations other than BTCP, and the phenomenon could be named “episodic pain”. Patient reported treatment satisfaction is important with respect to assessment. Sub classification according to pain pathophysiology can provide treatment guidance. Conclusion: Significant transient cancer pain exacerbations include more than just BTCP. Patient input and pain classification are important factors for tailoring treatment