1. Release of growth factors after mechanical and chemical pleurodesis for treatment of malignant pleural effusion : a randomized control studyAljaž Hojski, Maja Leitgeb, Anton Crnjac, 2015, original scientific article Abstract: Growth factors are key inducers of fibrosis but can also mediate inflammatory responses resulting in increasing pleural effusion and acute respiratory distress syndrome. The primary aim of the study was to analyse growth factors release after performing chemical and mechanical pleurodesis in the first 48 hours at the patients with malignant pleural effusion. The secondary endpoints were to evaluate the effectiveness of the both pleurodeses, symptoms release and the quality of life of patients after the treatment. Patients and methods. A prospective randomized study included 36 consecutive female patients with breast carcinoma and malignant pleural effusion in an intention-to-treat analysis. We treated 18 patients by means of thoracoscopic mechanical pleurodesis and 18 patients by chemical pleurodesis with talcum applied over a chest tube. We gathered the pleural fluid and serum samples in the following 48 hours under a dedicated protocol and tested them for growth factors levels. A quality of life and visual analogue pain score surveys were also performed. Results. Median measured serum vascular endothelial growth factor (VEGF) level after chemical pleurodesis was 930.68 pg/ml (95% CI: 388.22-4656.65) and after mechanical pleurodesis 808.54 pg/ml. (95% CI: 463.20-1235.13) (p = 0.103). Median pleural levels of transforming growth factor (TGF) ß1 were higher after performing mechanical pleurodesis (4814.00 pg/ml [95% CI: 2726.51-7292.94]) when compared to those after performing chemical pleurodesis (1976.50 pg/ml [95% CI: 1659.82-5136.26]) (p = 0.078). We observed similar results for fibroblast growth factor (FGF) ß; the serum level was higher after mechanical pleurodesis (30.45 pg/ml [95% CI: 20.40-59.42]), compared to those after chemical pleurodesis (13.39 pg/ml [95% CI: 5.04-74.60]) (p = 0.076). Mechanical pleurodesis was equally effective as chemical pleurodesis in terms of hospital stay, pleural effusion re-accumulation, requiring of additional thoracentesis, median overall survival, but, it shortened the mean thoracic drainage duration (p = 0.030) and resulted in a higher symptoms release and in a better quality of life (p = 0.047). Conclusions. We recorded an increase in serum VEGF levels after chemical pleurodesis, however on the contrary, an increase in the pleural fluid level of TGF%1 and FGF%] after mechanical pleurodesis with respect to compared group. Although the differences did not reach statistical significance, VEGF, TGFß1 and FGFß remain the most interesting parameters for future research. Considering the mechanisms of growth factors action, we conclude that in our study group mechanical pleurodesis might be more efficient in terms of growth factors release, thoracic drainage duration and resulted in a higher symptoms release and in a better quality of life than chemical pleurodesis.
Keywords: malignant pleural effusion, pleurodesis, growth factors, quality of life
Published in DiRROS: 23.04.2024; Views: 32; Downloads: 10
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2. Olfaction and gustation abilities after a total laryngectomyGordana Mumović, Irena Hočevar-Boltežar, 2014, original scientific article Abstract: Background A laryngectomy affects many of a patient's functions. Besides speech and respiratory-tract problems, olfaction and gustation problems can also have an influence on the quality of life. The aim of this study was to find out how often various nasal problems and decreased gustation appear after a laryngectomy. Patients and methods. One hundred and five laryngectomized patients (9 women, 96 men, aged 45-88 years), treated in two tertiary centers, were included in the study. They completed a questionnaire about various nasal problems, olfactory and gustatory capabilities, possible allergies and irritants in their environment, and the impact of the nasal and gustation problems on their quality of life. Results Olfaction was impaired in 51.4%, and was even not possible in 30.5%, of patients. Decreased gustation abilities were reported in 26.7%, and dysgeusia in 11.4%, of patients. Almost 21% of patients were bothered by an impaired gustatory ability and 50.5% of patients were affected by their loss of olfaction. Frequent nasal discharge was reported in 20%, frequent sneezing in 58.1%, and nasal itching in 33.3% of the laryngectomized patients. There were no correlations between the age and the olfaction and gustation abilities and between the allergy and the nasal symptoms, whereas the correlation between olfaction and gustation appeared significant (p=0.025). Conclusions Various nasal and gustatory problems were reported in more than 80% of laryngectomized patients. The olfaction and gustation abilities are connected and have a substantial impact on the quality of life. Like in the case of speech, the rehabilitation of olfaction is also necessary in all laryngectomized patients and must take place soon after the completion of the treatment.
Keywords: laryngectomy, olfaction, gustation, questionnaire, quality of life
Published in DiRROS: 11.04.2024; Views: 74; Downloads: 30
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3. Fire safety assessment of sprinkler systems for car parks using the J-value methodologyMalika Alimzhanova, Michael Spearpoint, Grunde Jomaas, 2022, original scientific article Abstract: A J-value assessment was carried out to quantify the costs and benefits of sprinkler system installation in car parks, both with respect to life safety and property protection. Nine scenarios were established based on collected input data. All car park types were considered for the USA, England, Scotland, Wales and the UK nations collectively, while separate considerations were made for multi-storey car parks (MSCPs) in the UK and for MSCPs, underground and other parking types in England.
Even when assuming 100% sprinkler effectiveness, the J-values for the nine scenarios were all larger than unity (ranging from 5 to 555), thus indicating that the installation of sprinklers is not a cost-effective investment for car parks from a societal point of view. The analysis showed that different car park types must be treated separately, due to specifics of structure and fire statistics. The lowest J-values were obtained for MSCPs and underground car parks. Sprinkler installation mainly provides property protection benefits, because of property loss savings substantially outweigh those associated with life safety.
Even though sprinklers were not cost-effective for car parks in the current analysis, the scarcity of data and new emerging technologies suggests that further investigation is needed.
Keywords: cost-benefit analysis, J-value, life quality index, Car parks, Sprinkler systems
Published in DiRROS: 09.01.2024; Views: 168; Downloads: 54
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4. Does an active lifestyle matter? : a longitudinal study of physical activity and health-related determinants in older adultsKaja Teraž, Saša Pišot, Boštjan Šimunič, Rado Pišot, 2022, original scientific article Abstract: Introduction: It is well-known that regular physical activity, and thus an active lifestyle, has positive eects on aging and general wellbeing. However, the question remains as to whether regular or increased physical activity can improve self-perception of health status and quality of life in older adults. Methods: We conducted a longitudinal study on a group of active older adults between 2013 and 2021. At baseline, i.e., the 1st measurements (baseline), 147 participants were enrolled (mean age 68.4 ± 5.6). After 8 years, in 2021 (follow up), 52 older adults (mean age 75.9 ± 5.3 years) were measured. For the purpose of this study, we included 52 older adults participated at both time-points. For both measurements, participants reported their physical activity and sedentary behavior using the Global physical activity questionnaire (GPAQ), socio-demographic and environmental determinants, recording their self-perception in terms of overall wellbeing. Furthermore, we conducted a qualitative study using semi-structured interviews to obtain subjective data on the changes and events that may have aected physical abilities and general health over an 8-year period. Results: At the follow up, participants reported lower physical activity and sedentary behavior compared to baseline, but still met health-enhancing physical activity (HEPA) standards for total self-reported physical activity (>3,000 METmin/week). In addition, they rated their overall health (p < 0.001), physical fitness (p < 0.001), psychological wellbeing (p < 0.001) and overall quality of life (p < 0.001) as better. The qualitative data confirmed that the 8-year period involved changes in physical activity. Specifically, they have continued to carry out physical work (gardening, working in the vineyards, olive groves), but previously organized physical activities were replaced by walks in nature, which probably also influenced the reduction of sedentary behavior. Conclusion: After 8 years, as expected, participants reported a decrease in physical activity and a lower level of sedentary behavior. It appears from the interview that healthy older adults filled their days with daily tasks and found more time for walking. Individuals who were more active in the past 8 years also reported better overall health and wellbeing. Selected variables correlated with an active lifestyle and better perceptions of quality of life.
Keywords: older adults, aging, physical activity, wellbeing, quality of life, leisure time
Published in DiRROS: 30.08.2022; Views: 461; Downloads: 405
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