Prevalence of Anxiety and Depression and Their Impact on the Quality of Life of Cancer Patients Treated with Palliative Antineoplasic Therapy - Results of the PALINT Trial.

BACKGROUND: Anxiety, depression, and psychological distress are common syndromes of advanced cancer; all have a negative impact on overall quality of life. However, these symptoms are not monitored explicitly and they are managed only by pharmacotherapy. Given the complex etiology of these symptoms, this biomedical approach is inadequate and inefficient. MATERIALS AND METHODS: Here, we present the results of a longitudinal assessment of distress, anxiety, and depression in a sample of 126 patients treated with palliative systemic therapy for advanced cancer in the PALINT trial. Symptoms and quality of life were assessed regularly using the Hospital Anxiety and Depression Scale (HADS) and The European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30), respectively. RESULTS: The baseline prevalence of significant distress, anxiety, and depression was 32,6; 35,9; and 56,5%, respectively. A decreasing trend in the prevalence of distress and anxiety occurred after 2 and months - distress (19.4 and 16.3%), anxiety (20.9 and 16.3%), and depression (46.3 and 46.9%). However, these changes did not reach statistical significance. The presence of anxiety and depression correlated negatively with overall quality of life. CONCLUSION: High rates of distress, anxiety, and depression are a strong argument for implementation of systematic screening for psychological distress, and for comprehensive psychosocial support for all patients with advanced cancer throughout the disease trajectory. The HADS questionnaire is a suitable tool for this type of screening. This work was supported by the grant of Ministry of Health AZV 15-33590A. The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study. The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers. Submitted: 3. 12. 2018 Accepted: 24. 3. 2019.

[Cost analysis of radiotherapy provided in inpatient setting -  testing potential predictors for a new prospective payment system]. / Analýza nákladu na radioterapii v luzkové péci - hledání vhodných prediktoru pro potreby nového prospektivního úhradového modelu.

BACKGROUND: As a part of the development of a new prospective payment model for radiotherapy we analyzed data on costs of care provided by three comprehensive cancer centers in the Czech Republic. Our aim was to find a combination of variables (predictors) which could be used to sort hospitalization cases into groups according to their costs, with each group having the same reimbursement rate. We tested four variables as possible predictors -  number of fractions, stage of disease, radiotherapy technique and diagnostic group. METHODS: We analyzed 7,440 hospitalization cases treated in three comprehensive cancer centers from 2007 to 2011. We acquired data from the I COP database developed by Institute of Biostatistics and Analyses of Masaryk University in cooperation with oncology centers that contains records from the National Oncological Registry along with data supplied by healthcare providers to insurance companies for the purpose of retrospective reimbursement. RESULTS: When comparing the four variables mentioned above we found that number of fractions and radiotherapy technique were much stronger predictors than the other two variables. Stage of disease did not prove to be a relevant indicator of cost distinction. There were significant differences in costs among diagnostic groups but these were mostly driven by the technique of radiotherapy and the number of fractions. Within the diagnostic groups, the distribution of costs was too heterogeneous for the purpose of the new payment model. CONCLUSION: The combination of number of fractions and radiotherapy technique appears to be the most appropriate cost predictors to be involved in the prospective payment model proposal. Further analysis is planned to test the predictive value of intention of radiotherapy in order to determine differences in costs between palliative and curative treatment.

Stereoisomerism of molecular multipropellers. 1. Static stereochemistry of bis- and tris-triaryl systems.

The static stereoisomerism of bis- and tris-triaryl systems has been analyzed by a systematic stereochemical analysis, and the resulting theoretical predictions have been experimentally confirmed by using reversed-phase HPLC and ESR and (1)H NMR spectroscopies with a family of seven distinct polychlorinated aromatic multipropellers. To analyze the static stereochemistry of these molecules, we have developed a specific procedure that uses a symmetry-adapted symbolic notation, allowing the theoretical prediction of both the number and symmetry of the isomers of the investigated molecules. Due to the steric hindrance introduced by the presence of bulky chlorine substituents, (all) conformational isomers can be characterized experimentally by several independent techniques confirming the theoretical stereochemical predictions. The different propeller moieties that constitute the molecule appear to be nearly independent of each other. Consequently, most of the observed isomers show comparable populations in solution at room temperature.

Stereoisomerism of molecular multipropellers. 2. Dynamic stereochemistry of bis- and tris-triaryl systems.

The dynamic stereochemistry of bis- and tris-triaryl systems, the most simple "molecular multipropellers", is discussed on the basis of an extension of a systematic stereochemical analysis based on a symmetry-adapted symbolic notation developed specifically for these molecules. A suitable theoretical basis for our study is provided by the classical hypotheses concerning the dynamics of simple triaryl systems as formulated by Mislow and co-workers (J. Am. Chem. Soc. 1973, 95, 1535-1547), which, once applied to molecular multipropellers, show the existence of two modes of rearrangement for each propeller. Interconversion graphs for all molecules under study, covering a wide span of structural complexity, are presented. A complete NMR study of a two- and a three-propeller molecule indicates that all experimentally observable exchange pathways are indeed predicted by theoretical analysis. Moreover, quantitative analysis of 2D-EXSY experiments affords the activation energy of the subset of pathways that give rise to observable interconversions on the NMR time scale. Assuming that two-ring flips are the threshold mechanism for individual propeller interconversion, the experimental evidence indicates a preference for the flip of the central ring and one of the outer rings over the flip of two outer rings.

[Preparation of the scrotal skin for urethroplasty: depilation technique]. / Preparación de la piel escrotal para uretroplastia: técnica de depilación.

OBJECTIVE: To describe a simple method of depilation of scrotal skin and the advantages of utilizing scrotal skin flaps for urethroplasty in the postpubertal male. METHODS: Depilation of the scrotal flap is achieved by electrocoagulating the dermal papillae with a needle specifically designed for scrotal hair. The frequency and the number of depilations are determined by the hair biological cycle. RESULTS: Scrotal hair is removed with no injury to tissue or changes in the characteristics of scrotal skin. This method of depilation is well-tolerated and no complication has been observed. CONCLUSION: The scrotal skin depilated provides excellent flaps for reconstructive surgery of complex urethral strictures, specially those extending beyond the penoscrotal angle up to the membranous and prostatic inframontanum portion.

[Extracorporeal piezogenerated shockwave lithotripsy. Our experience in 500 cases]. / Litotricia extracorpórea por ondas de choque piezogeneradas. Nuestra experiencia en 500 casos.

Between April 1987 and August 1988, 498 patients suffering renal or ureteral lithiasis, all of them with a 6 months or more follow-up period, have been treated in our Unit. Patients were treated in an ambulatory regime without need for anesthesia or analgesia. Up to 27% of the cases has surgical background for lithiasis. One hundred and twenty-six patients had a double J ureteral catheter placed prior to lithotripsy treatment. Fourty-four percent cases needed only one session, 25% two, 12% three and 18% more than three sessions. At the time of discharge 86% patients had no lithiasis or fragments less than 3 mm. Only 9% had fragments larger that 3 mm. It is our opinion than piezoelectric extracorporeal lithotripsy has been proven as a safe, effective and painless procedure in most renal lithiasis.