Treatment of the consequences of irradiation of pelvis minor with hyperbaric oxygen

Obsevanje predstavlja pomemben del zdravljenja tumorjev male medenice. Pozne posledice se lahko razvijejo od nekaj mesecev pa do več let po končanem zdravljenju in se vhudi obliki (3. ali 4. stopnje po lestvici RTOG) pojavijo pri 5 do 15 % obsevanih bolnikov. Poleg ostalih invazivnih in neinvazivnih metod se v zadnjih letih pri zdravljenju poznih zapletov obsevanja uporablja tudi zdravljenje s hiperbaričnim kisikom. Uspešnost tovrstnega zdravljenja je bila dokaza nanajprej za zdravljenje osteonekroze čeljustnice, v zadnjih letihpa so študije potrdile tudi uspešnost zdravljenja poobsevalnega cistitisa in proktitisa s hiperbaričnim kisikom. Zdravljenje s hiperbaričnim kisikom zmanjša verjetnost nastanka posledic, zmanjša že razvite simptome in znake ter pomembno izboljša kakovost življenja. V zadnjih šestih letih se je le 7 bolnikov Onkološkega inštituta Ljubljana zdravilo s hiperbaričnim kisikom zaradi poobsevalnih poškodb, ki so nastale zaradi obsevanja medenice, čeprav bi tovrstno zdravljenje letno potrebovalo 40 do 50 bolnikov.Radiation therapy is an important part of treatment of tumours of the pelvis minor. Late effects can develop months or years after treatment, and they occur in a severe form (RTOG grades 3 or 4) in 5-15% of irradiated patients. In the last few years, besides other invasive and non-invasive methods, radiotherapy-induced late complications have also been treated with hyperbaric oxygen therapy. Such treatment first proved successful in the treatment of osteonecrosis of the jaw, while in the last few years, the studies have confirmed that hyperbaric oxygen therapy is also effective in the treatment of post-radiation cystitis and proctitis. Hyperbaric oxygen therapy minimises the likelihood of complications, reduces the already developed symptoms and signs, and significantly improves the quality of life. In the last six years, only seven patients were treated with hyperbaric oxygen therapy at the Institute of Oncology Ljubljana for post-radiation injuries developed due to pelvic irradiation, although such treatment should be provided to 40-50 patients annuall

Zdravljenje posledic obsevanja male medenice s hiperbaričnim kisikom

Radiation therapy is an important part of treatment of tumours of the pelvis minor. Late effects can develop months or years after treatment, and they occur in a severe form (RTOG grades 3 or 4) in 5-15% of irradiated patients. In the last few years, besides other invasive and non-invasive methods, radiotherapy-induced late complications have also been treated with hyperbaric oxygen therapy. Such treatment first proved successful in the treatment of osteonecrosis of the jaw, while in the last few years, the studies have confirmed that hyperbaric oxygen therapy is also effective in the treatment of post-radiation cystitis and proctitis. Hyperbaric oxygen therapy minimises the likelihood of complications, reduces the already developed symptoms and signs, and significantly improves the quality of life. In the last six years, only seven patients were treated with hyperbaric oxygen therapy at the Institute of Oncology Ljubljana for post-radiation injuries developed due to pelvic irradiation, although such treatment should be provided to 40-50 patients annually.Obsevanje predstavlja pomemben del zdravljenja tumorjev male medenice. Pozne posledice se lahko razvijejo od nekaj mesecev pa do več let po končanem zdravljenju in se vhudi obliki (3. ali 4. stopnje po lestvici RTOG) pojavijo pri 5 do 15 % obsevanih bolnikov. Poleg ostalih invazivnih in neinvazivnih metod se v zadnjih letih pri zdravljenju poznih zapletov obsevanja uporablja tudi zdravljenje s hiperbaričnim kisikom. Uspešnost tovrstnega zdravljenja je bila dokaza nanajprej za zdravljenje osteonekroze čeljustnice, v zadnjih letihpa so študije potrdile tudi uspešnost zdravljenja poobsevalnega cistitisa in proktitisa s hiperbaričnim kisikom. Zdravljenje s hiperbaričnim kisikom zmanjša verjetnost nastanka posledic, zmanjša že razvite simptome in znake ter pomembno izboljša kakovost življenja. V zadnjih šestih letih se je le 7 bolnikov Onkološkega inštituta Ljubljana zdravilo s hiperbaričnim kisikom zaradi poobsevalnih poškodb, ki so nastale zaradi obsevanja medenice, čeprav bi tovrstno zdravljenje letno potrebovalo 40 do 50 bolnikov. ; slv - slovensk

Treatment results in patients with esophageal carcinoma treated at the Institute of oncology in Ljubljana from 2006–2010

Karcinom požiralnika je relativno redka bolezen s slabo prognozo. Namen naše retrospektivne raziskave je bil oceniti različne načine in rezultate zdravljenja bolnikov z rakom požiralnika, ki so bili v obdobju od leta 2006 do 2010 obravnavani na Onkološkem inštitutu v Ljubljani (OIL). V raziskavo je bilo vključenih 151 bolnikov, od katerih jih je bilo 74 zdravljenih paliativno in 75 radikalno. Pri dveh bolnikih je bilo načrtovano radikalno zdravljenje, vendar sta zaradi zapletov s hitrim poslabšenjem splošnega stanja prejela le podporno zdravljenje. Petletno celokupno preživetje (CP) je za vse bolnike znašalo 9.5%, za zdravljene paliativno 0% in zdravljene radikalno 18.7%. Ustrezne vrednosti za petletno preživetje brez progresa bolezni (PBP) so bile za vse bolnike 22.4% in za zdravljene radikalno 29.6%. V skupini radikalno zdravljenih bolnikov je bila opravljena tudi primerjava preživetij med skupino 50 bolnikov, ki so bili zdravljeni samo z obsevanjem z ali brez sočasne kemoterapije in skupino 25 bolnikov, ki so bili pred ali po radio- in/ali kemoterapiji tudi operirani. Med podskupinama statistično pomembne razlike v CP (p=0.42) in v PBP (p=0.31) ni bilo. Rezultati zdravljenja teh bolnikov so v Sloveniji slabi, vendar ne odstopajo bistveno od prav tako slabih rezultatov iz raziskave EUROCARE-5. Odgovor na vprašanje ali bomo pri zdravljenju raka požiralnika z dosledno uporabo trimodalnega zdravljenja (pri izbranih bolnikih) in morebitno uporabo novih kemoterapevtskih shem dosegli kakršenkoli napredek, bodo lahko dale samo dobro načrtovane in izpeljane prospektivne raziskave .Esophageal carcinoma is a relatively rare disease with bad prognosis. The purpose of our retrospective study was to evaluate the methods and results of treatment of patients with esophageal cancer, who were treated at the Institute of Oncology in Ljubljana (OIL) from 2006 to 2010. The study included 151 patients, of whom 74 received palliative treatment and 75 radical treatment. In two patients radical treatment had been planned, but because of rapidly progressing complications and deteriorating general condition they only received supporting treatment. The five-year overall survival (OS) rate for all patients amounted to 9.5%, of those receiving palliative treatment 0% and those receiving radical treatment 18.7%. The corresponding values for five-year progression-free survival (PFS) rate were for all patients 22.4% and for radically treated patients 29.6%. In radically treated patients we also performed a survival comparison study between the group of 50 patients, who were treated only with radiation with or without simultaneous chemotherapy and the group of 25 patients, who had also been operated either prior or post radio and/ or chemotherapy. There were no significant differences among the subgroups in OS (p=0.42) or PFS (p=0.31). The results of treatment of these patients in Slovenia are poor, but do not substantially differ from the likely poor results from the EUROCARE-5 study. Whether consistent trimodality therapy in treating esophageal cancer (in selected patients) and potential use of new chemotherapeutic schemes can achieve any kind of progress, is a question, which only carefully planned and implemented prospective studies can answer

Tannin as steel corrosion inhibitor

Za zaščito jekel v industriji se vse bolj uveljavljajo zeleni inhibitorji korozije. V diplomski nalogi je v ta namen uporabljena galna kislina (spada med hidrolizirane tanine), da se ugotovi njena inhibicijska učinkovitost. To je bilo doseženo z diferencialno gravimetrično metodo ob spremembi mase pred izpostavitvijo korozijskim medijem in po njej ter z izračunom inhibicije in korozijske hitrosti. Delo je potekalo z vzorci iz nerjavnega jekla (številka: 1.4301), ki jih je bilo potrebno predhodno zbrusiti in očistiti. Za kisli medij so bile izbrane različne koncentracije HCl (0,1 M0,15 M0,25 M0,3 M in 0,5 M), kot inhibitor pa se je uporabila 0,5-, 0,75- in 1-% galna kislina pri izpostavitvenih časih: 4, 8 in 24 ur. Tej metodi je sledila površinska analiza vzorcev s pregledom morfologije površin vzorcev pod svetlobnim mikroskopom in ATR-FTIR (infrardeča spektroskopija s Fourierjevo transformacijo na oslabljeni totalni odboj). Rezultati so pokazali, da je inhibicijska učinkovitost galne kisline največja v 0,25 M HCl, saj pri nižjih koncentracijah ni prišlo do korozije oziroma je bila le-ta minimalna, pri višjih pa je bila inhibicija zanemarljiva, v nekaterih primerih je prišlo celo do negativnih vrednosti inhibicijske učinkovitosti, kar nakazuje na proces aktivacije. Pri izpostavljenosti 0,25 M HCl za 24 ur, je pri 0,5-% galni kislini dosežena več kot 60 % inhibicijska učinkovitost, med tem ko le-ta pri 1-% galni kislini znaša skoraj 87 %. Na podlagi tega se zaključi, da se galna kislina lahko uporabi, v razredčeni raztopini klorovodikove kisline in podobnih kislih medijih, kot uspešen zeleni inhibitor korozije na jeklu.Green corrosion inhibitors are becoming increasingly popular in industry for the protection of steel. In this thesis, gallic acid (a part of hydrolyzed tannin) was used to determine its inhibition effect. This was performed using the mass difference gravimetric method before and after exposure to corrosion media, as well as using the calculations of inhibition and corrosion rate. In the laboratory, stainless steel samples (No. 1.4301) were used, which had to be ground and cleaned beforehand. Different concentrations (0.1 M0.15 M0.25 M0.3 M and 0.5 M) of HCl were used as acidic medium and 0.5 %0.75%and 1 % gallic acid were applied as inhibitors at exposure times of 4, 8 and 24 hours. In addition, the surface of the samples was analyzed with surface morphology inspection under optical microscope and ATR-FTIR (infrared spectroscopy with Fourier transform under attenuated total internal reflection). The results showed that gallic acid in 0.25 M HCl exhibitet the highest value of inhibition efficiency, as no or minimal corrosion occurred at lower HCl concentrations, and at higher HCl concentrations the inhibition was negligible, in some cases even indicating activation processes. In 0.25 M HCl and 24 h exposure, the 0.5% gallic acid achieved an inhibition effect of more than 60 %, while at 1 % gallic acid the inhibition increased to almost 87 %. On this basis, it can be concluded that gallic acid forms a successful green corrosion inhibitor in dilute acidic medium

Photocatalytic oxidation of pollutants in wastewater using visible light and tio 2 based photocatalysts

Vse večji in naprednejši razvoj industrije ter kmetijstva vzporedno z rastjo populacije povzroča ogromno škodo okolju z izpustom škodljivih kemikalij in ostalih organskih onesnaževal. Večina teh polutantov je toksičnih, mutagenih in karcinogenih, ki so zelo obstojni ter se zlahka bioakumulirajo. V to kategorijo sodijo tudi motilci endokrinega sistema (bisfenol A) z močnim vplivom na fiziološke procese v človeškem organizmu in zaskrbljujoča nova onesnaževala (farmacevtske učinkovine) z znanimi ali domnevnimi učinki na okolje ter zdravje človeka. V odgovor ekološki zaskrbljenosti zaradi obsežnega onesnaževanja pitne vode, rek, jezer in morja, se je v zadnjih desetletjih med znanstveniki povečalo zanimanje za razvoj novih tehnologij na področju čiščenja odpadnih voda. Velik potencial pri učinkovitem odstranjevanju organskih onesnaževal iz vodnih sistemov so pokazali napredni oksidacijski procesi, ki s prilagajanjem postopkov oksidacije dosežejo neselektivno razgradnjo organskih snovi do CO2 in vode. Med temi procesi velja metoda heterogene fotokatalize z uporabo fotokatalizatorjev na osnovi TiO2 za najbolj raziskano, obetavno, enostavno in okolju prijazno. Namen magistrske naloge je bil z metodo mokre impregnacije pripraviti fotokatalizatorje na osnovi TiO2 nanodelcev, ki bodo uspešno razgradili organska onesnaževala v šaržnem reaktorju ob obsevanju z vidno svetlobo. Ker je čisti TiO2 aktiven samo v ultravijoličnem spektru svetlobe, smo na njegovo površino dopirali plazmonski žlahtni kovini (Au, Pt) in njune zlitine. S karakterističnimi metodami smo sintetiziranim katalizatorjem določili njihove optične, strukturne in površinske lastnosti ter preverili učinkovitost pri tvorjenju reaktivnih kisikovih zvrsti (HO• s kumarinom ter O2•- in e- z ABTS•+). Fotokatalitsko aktivnost pri razgradnji bisfenola A pod svetlobo v vidnem delu spektra smo ugotovili s tekočinsko kromatografijo visoke ločljivosti in z merjenjem celotnega organskega ogljika pred in po fotokatalizi določili stopnjo mineralizacije onesnaževal. Sintetizirani fotokatalizatorji so se med seboj razlikovali v optičnih in površinskih lastnostih, po učinkovitosti tvorbe reakcijskih kisikovih zvrsti ter razgradnje bisfenola A. Ugotovili smo tudi, da nanos Au, Pt in njunih zlitin na površino nosilca TiO2 ne vpliva na njegovo morfologijo. Pri razgradnji bisfenola A je bil najbolj učinkovit fotokatalizator z nanosom zlitine 0,25 % Au + 0,75 % Pt (80,7 %), sledil mu je katalizator z nanosom zlitne 0,5 % Au + 0,5 % Pt (74,5 %), še sprejemljivo razgradnjo pa je dosegel katalizator z nanosom 1 % Pt (70,9 %). Ker je katalizator z dopirano zlitino 0,5 % Au + 0,5 % Pt teoretično izkazoval potencialno veliko katalitsko aktivnost, smo ga uporabili še za preverjanje učinkovitosti razgradnje farmacevtskih učinkovin, kot so aspirin, kofein in paracetamol. Izbrani katalizator je bil najbolj uspešen pri razgradnji aspirina (97 %), naslednji je bil kofein (79 %), paracetamola pa se je razgradilo nekoliko majn (62 %). Zbrani podatki so potrdili fotokatalitski potencial katalizatorjev z dopiranimi zlitinami Au in Pt, kjer ima Pt prevladujoč ali enak deleže od Au pri razgradnji bisfenola A in farmacevtskih učinkovin (aspirin, kofein in paracetamol).Growing and developing industry and agriculture, combined with population growth, is causing significant environmental damage through the release of harmful chemicals and other organic pollutants. Most of them are toxic, mutagenic and carcinogenic and have high resistance and bioaccumulation. This category also includes substances that disrupt the endocrine system (bisfenol A) and severely affect processes in the human organism, as well as emerging compounds (pharmaceutical agents) with known and suspected effects on the environment and human health. To respond to environmental problems caused by severe pollution of drinking water, rivers, lakes, and oceans, scientists have shown increased interest in developing new technologies for wastewater treatment. Greater potential for effective removal of organic pollutants from aquatic ecosystems has been achieved through advanced oxidation processes that enable non-selective degradation of organics to CO2 and water by adjusting oxidation processes. Among these processes, heterogeneous photocatalysis using TiO2-based photocatalysts is considered the most researched, promising, simple and environmentally friendly. The aim of this master thesis was to prepare TiO2 nanoparticle-based photocatalysts by wet impregnation, which can successfully degrade organic pollutants with visible light in a batch reactor. Since TiO2 is active only in the ultraviolet spectral region, plasmonic noble metals (Au, Pt) and their alloys were doped onto its surface. We specified the optical, structural and surface properties of the catalysts synthesised by characteristic methods and checked their efficiency in the formation of reactive oxigen species (HO - with coumarin, O2-- and e- with ABTS-+). The photocatalytic activity in the decomposition of bisfenol A under visible light was determined by high-resolution liquid surface chromatography, and the degree of contaminant mineralization was determined by measurements of total organic carbon before and after photocatalysis. The synthesised photocatalysts differed in their optical and surface properties, reactive oxygen species formation efficiency, and bisfenol A degradation. We also found that the use of Au, Pt and their alloys on the TiO2 support did not affect its morphology. For the degradation of BPA, the photocatalyst with alloy 0.25% Au + 0.75% Pt (80.7%) was the most efficient, followed by a catalyst with alloy 0.5% Au + 0.5% Pt (74.5%), although degradation was also possible with a catalyst with 1% Pt (70.9%). Since the catalyst with 0.5% Au + 0.5% Pt theoretically has potentially high catalytic activity, we additionally used it to test the decomposition efficiency of pharmaceutical agents such as aspirin, caffeine, and acetaminophen. The selected catalyst was most successful in decomposing aspirin (97%), followed by caffeine (79%) and a slightly lower decomposition of paracetamol (62%). The data collected confirm the catalytic potential of doped Au and Pt alloys, with Pt playing a dominant role in the decomposition of bisfenol A and pharmaceutical agents (aspirin, caffeine, paracetamol), or just ahead of Au

Kazalniki kakovosti v radioterapiji

Zagotovitev kakovosti v zdravstvu postaja pomembnejša dejavnost plačnikov in ponudnikov zdravstvenih storitev, prav tako mednarodne organizacije uspešno akreditacijo pogojujejo z izvajanjem programov nadzora kakovosti. Za analizo pomanjkljivosti v zagotavljanju storitev se uporabljajo kazalniki kakovosti, ki analizirajo strukture, procese in izide v zdravstvenem sistemu in s tem omogočijo načrtovanje in izvedbo izboljšav zdravstvenih storitev. V radioterapiji je tradicija nadzora kakovosti, ki se razvija vzporedno s tehnološkimi in metodološkimi spremembami na tem področju. Pri analizi izidov zdravljenja, ki so najbolj poveden kazalnik kakovosti onkoloških zdravstvenih storitev, se velikokrat srečujemo z nezanesljivostjo podatkov oz. zapletenim dostopom do njih, kar zmanjšuje ažurnost in verodostojnost rezultatov. Namen tega članka je pregled kazalnikov kakovosti v radioterapiji in onkologiji