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Abstract: Background: There is a concern that terminally ill cancer patients may be aggressively treated due to the rapidly growing possibilities of anticancer treatment. The aim of this study was to evaluate the use of anticancer treatment at the end of life (EoL). Materials and methods: This retrospective study included adult patients with advanced solid cancers who were treated at the Institute of Oncology Ljubljana and died of cancer between January 2015 and December 2019. A multiple logistic regression model was used to assess an association between the aggressiveness of anticancer treatment (i.e. systemic therapy, radiotherapy and surgery) in the last 2 weeks of life and year of death, age at death, sex, prognosis of cancer and enrolment into the specialist palliative care (SPC). Results: We included 1736 patients in our analysis. Overall, 13.7% of patients were enrolled into the SPC and 14.4% received anticancer treatment in the last 2 weeks of life. The odds of receiving anticancer treatment significantly increased over time [odds ratio (OR) 1.15, 95% confidence interval (CI) 1.04-1.27]. There was an increased use of novel systemic therapy (e.g. small-molecule targeted therapy and immunotherapy) at the EoL. Older patients had significantly lower odds to receive anticancer treatment in the last 2 weeks of life as compared to younger patients (OR 0.96, 95% CI 0.95-0.98). As compared to patients receiving only a standard oncology care, those also enrolled into the SPC had significantly lower odds for anticancer treatment in the last 2 weeks of life (OR 0.22, 95% CI 0.12-0.43). Conclusions: Terminally ill cancer patients have increased odds for receiving anticancer treatment, especially novel systemic therapies, in the last 2 weeks of life. Younger patients and those not enrolled into the SPC are at particular risk for anticancer treatment at the EoL
Keywords: systemic therapy, aggressive treatment, anticancer drugs, palliative care
Published in DiRROS: 18.04.2024; Views: 71; Downloads: 48
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Abstract: Na 12 izbranih lokacijah v Mežiški dolini smo spomladi leta 2022 opravili popis epifitskih lišajev z uporabo slovenske metode SI in nemške metode VDI. Z obema metodama se ocenjuje kakovost zraka na podlagi obstoječih rastnih tipov steljk in vrst epifitskih lišajev, na katere vplivajo predvsem plinasta onesnažila v zraku. Dodatno smo določali tudi indekse toksitolerance. Skupaj smo na prostostoječem drevju evidentirali 34 vrst epifitskih lišajev; 25 v Zgornji Mežiški dolini in 27 vrst epifitskih lišajev v Spodnji Mežiški dolini. Na podlagi izračuna povprečnega indeksa toksitolerance za posamezno lokacijo smo ugotovili, da na vseh lokacijah prevladujejo vrste, ki so manj občutljive za onesnaževanje. Največji indeks zračne čistosti, določen po metodi VDI, je bil izračunan za lokacijo Lom, sledita lokaciji Žerjav in Tolsti vrh, kjer smo evidentirali tudi največje število vrst lišajev. Stanje lišajske vegetacije na vseh obravnavanih lokacijah je primerljivo in kaže, da so lokacije srednje obremenjene s plinastimi onesnažili. V ospredje lahko postavimo lokaciji Dolgo Brdo in Preški vrh, kjer je izpostavljenost plinastim onesnažilom velika do zmerna; na lokaciji Dolgo Brdo pa je bila tudi obrast lišajev revna. Izračunani indeksi zračne čistosti so sicer pokazali, da je kakovost zraka v Zgornji Mežiški dolini nekoliko boljša kot v Spodnji Mežiški dolini, vendar razlike niso statistično značilne.
Keywords: epifitski lišaji, kartiranje, bioindikatorji, onesnažen zrak, Mežiška dolina
Published in DiRROS: 25.01.2024; Views: 659; Downloads: 190
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Abstract: Izhodišča: V procesih sežiga in sosežiga odpadkov ter proizvodnje cementa se v okolje sproščajo izpusti, ki vsebujejo različna onesnaževala. Z namenom oceniti povezanost med rakom pri poklicno izpostavljenih in okoliških prebivalcih ter izpostavljenostjo okoljskim onesnaževalom iz sežigalnic, naprav za sosežig in cementarn smo si za cilj zadali izdelavo krovnega pregleda literature. Metode: V krovni pregled literature so bile vključene metaanalize in sistematični pregledi literature v angleščini v obdobju od leta 1980 do leta 2023. Iskanje je bilo izvedeno v štirih podatkovnih zbirkah (PubMed, Scopus, Web of Science, Cochrane Reviews). Kakovost je bila ocenjena z orodjema AMSTAR-2 (metodologija) in GRADE (dokazi). Rezultati: Izmed 7.701 opredeljenih dokumentov jih je bilo v končno analizo vključenih 14 (pet metaanaliz, devet sistematičnih pregledov). Obstajajo nizki do zmerni dokazi o povezanosti med sarkomom mehkih tkiv in ne-Hodgkinovim limfomom z izpostavljenostjo dioksinom v okolici sežigalnic I. generacije, česar študije niso dokazale za sežigalnice naslednjih generacij. Zaenkrat ne razpolagamo z dokazi za sosežig. Pri delavcih v cementarnah I. do II. generacije obstaja nekaj zmernih dokazov o povezanosti med incidenco vseh rakov, pljučnega raka, raka ustne votline in žrela, prostate in želodca z izpostavljenostjo šestvalentnemu kromu. Velika večina dokazov je omejenih zaradi mešanih rezultatov, razlik v tehniki vprašanj, heterogenosti in potencialni pristranosti. Zaključek: Obstajajo omejeni dokazi o povezanosti med rakom in izpostavljenostjo onesnaževalom iz sežigalnic I. in cementarn I. do II. generacije. Za oceno morebitne povezanosti med rakom in onesnaževali iz najsodobnejših naprav za sosežig je smiselno načrtovati ciljane epidemiološke študije in študije notranje izpostavljenosti z uporabo humanega biomonitoringa.
Keywords: rak, odpadki, sežig, sosežig, cementarna, onesnaževala
Published in DiRROS: 08.01.2024; Views: 216; Downloads: 84
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Abstract: The purpose of this study was to identify the ostracod assemblage from a 43 m thick section of the Bizeljsko Formation, which constitutes the middle part of the Upper Miocene Posavje Group. The succession comprises sandstone, siltstone, and marlstone, deposited in a delta front environment. The determined ostracods belong to the families Cyprididae, Cytheridae, Darwinulidae, and Loxoconchidae. In total, 30 species were identified. Additionally, 8 morphotypes were determined at the genus level. The most common genera are Candona, Hemicytheria, and Cyprideis. The assemblage belongs to the Caspiocypris labiata subzone from the upper Pannonian. The ostracod assemblage from the Krško Basin is similar in species composition to Pannonian ostracod assemblages from Croatia and Serbia.
Keywords: Lake Pannon, Bizeljsko Formation, Pannonian, biostratigraphy, palaeoenvironment
Published in DiRROS: 27.07.2023; Views: 295; Downloads: 149
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Abstract: In the southernmost outcrops of the Slovenian Basin the Middle Jurassic coarse-grained limestone breccia (mega)beds are interstratified within a succession that is otherwise dominated by hemipelagites and distal turbidites. In this paper, these beds are described as the Ponikve Breccia Member of the Tolmin Formation. We provide descriptions of the studied sections with detailed geological maps and analysis of the breccia lithoclasts. From the latter, a non-outcropping margin of the Dinaric Carbonate Platform is reconstructed. In the Late Triassic the platform margin was characterized by a Dachstein-type marginal reef. After the end-Triassic extinction event, the platform architecture remained, but the reefs were replaced by sand shoals characterized by ooids. In the late Early Jurassic and/or early Middle Jurassic a slope area might have been dissected by normal faults and a step-like paleotopography was formed. In the Bajocian, during a period of major regional geodynamic perturbations, extensional or transtensional tectonic activity intensified and triggered the large-scale collapses of the Dinaric Carbonate Platform margin producing the limestone breccias described herein. This may in turn have caused a backstepping of the platform margin, as is evident from the occurrence of Late Jurassic marginal reefs that are installed directly above the Upper Triassic and Lower Jurassic inner platform successions.
Keywords: Slovenian Basin, Dinaric Carbonate Platform, Middle Jurassic, limestone breccia, debris-flow, stratigraphy, Ponikve breccia
Published in DiRROS: 18.01.2023; Views: 520; Downloads: 412
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