Neuropathic pain in cancer Fallon, M.T.
British journal of anaesthesia,
07/2013, Letnik:
111, Številka:
1
Journal Article
Recenzirano
Odprti dostop
Cancer-related neuropathic pain is common; it can be disease related or related to the acute or chronic effects of cancer treatment. For example, chemotherapy-induced peripheral neuropathy occurs in ...90% of patients receiving neurotoxic chemotherapy. Cancer treatments have become more effective; patients are living longer with cancer and there are more cancer survivors. However, side-effects (particularly neuropathy) have become more problematic. The key to management of cancer-related neuropathy is a considered assessment, remembering not to miss the opportunity of reversing the cause of the pain with appropriate oncological management. An increasing range of oncological therapies are available, including radiotherapy, chemotherapy, hormonal therapy, or one of the evolving approaches (e.g. immune therapies).
Patients are often elderly and with comorbidities; therefore, all treatment decisions have to be made carefully and reviewed appropriately. Cancer pain is often of mixed aetiology or, if purely neuropathic, may be one of several pains experienced by a patient. For these reasons, opioids are used more frequently in patients with cancer-related neuropathic pain. Standard guidelines for the use of anticonvulsants (e.g. pregabalin and gabapentin), antidepressants (e.g. duloxetine and tricyclics), and topical treatments (e.g. capsaicin and lidocaine) may be applicable, but there is a lack of good-quality clinical trials in cancer-related neuropathic pain. Choice is dictated not just by age, drug interactions, and comorbidities, but also by the coexistence of many symptoms in patients with cancer. Treating more than one symptom with a particular neuropathic pain agent can avoid polypharmacy.
A series of “double-cable” conjugated polymers were developed for application in efficient single-component polymer solar cells, in which high quantum efficiencies could be achieved due to the ...optimized nanophase separation between donor and acceptor parts. The new double-cable polymers contain electron-donating poly(benzodithiophene) (BDT) as linear conjugated backbone for hole transport and pendant electron-deficient perylene bisimide (PBI) units for electron transport, connected via a dodecyl linker. Sulfur and fluorine substituents were introduced to tune the energy levels and crystallinity of the conjugated polymers. The double-cable polymers adopt a “face-on” orientation in which the conjugated BDT backbone and the pendant PBI units have a preferential π–π stacking direction perpendicular to the substrate, favorable for interchain charge transport normal to the plane. The linear conjugated backbone acts as a scaffold for the crystallization of the PBI groups, to provide a double-cable nanophase separation of donor and acceptor phases. The optimized nanophase separation enables efficient exciton dissociation as well as charge transport as evidenced from the highup to 80%internal quantum efficiency for photon-to-electron conversion. In single-component organic solar cells, the double-cable polymers provide power conversion efficiency up to 4.18%. This is one of the highest performances in single-component organic solar cells. The nanophase-separated design can likely be used to achieve high-performance single-component organic solar cells.
The majority of organic semiconductors have a low relative dielectric constant (
ε
r
< 6), which is an important limitation for organic solar cells (OSCs). A high dielectric constant would reduce the ...exciton binding energy, reduce charge carrier recombination losses, and thereby enhance the overall device performance of OSCs. However, the development of organic/polymeric semiconductors with higher relative dielectric constants (
ε
r
> 6) has attracted a very limited attention. Moreover, high performance OSCs based on high dielectric constant photovoltaic materials are still in their infancy. Herein, we report an oligoethylene oxide side chain-containing non-fullerene acceptor (ITIC-OE) with a high relative dielectric constant of
ε
r
≈ 9.4, which is two times larger than that of its alkyl chain-containing counterpart ITIC. Encouragingly, the OSCs based on ITIC-OE show a high power conversion efficiency of 8.5%, which is the highest value for OSCs that employ high dielectric constant materials. Nevertheless, this value is lower than those of ITIC-based control devices. The less phase-separated morphology in blend films due to the reduced crystallinity of ITIC-OE and the too good miscibility between PBDB-T and ITIC-OE are responsible for the lower device performance. This work suggests additional prerequisites to make high dielectric constants play a significant role in OSCs.
Four hexachlorosubphthalocyanines SubPcCl6‐X bearing different axial substituents (X) have been synthesized for use as novel electron acceptors in solution‐processed bulk‐heterojunction organic solar ...cells. Subphthalocyanines are aromatic chromophoric molecules with cone‐shaped structure, good solution processability, intense optical absorption in the visible spectral region, appropriate electron mobilities, and tunable energy levels. Solar cells with subphthalocyanines as the electron acceptor and PTB7‐Th as the electron donor exhibit a power conversion efficiency up to 4 % and an external quantum efficiency approaching 60 % due to significant contributions from both the electron donor and the electron acceptor to the photocurrent, indicating a promising prospect of non‐fullerene acceptors based on subphthalocyanines and structurally related systems.
A promising prospect: Subphthalocyanines SubPcCl6‐X bearing different axial substituents (X) are presented as novel electron acceptors in bulk‐heterojunction organic solar cells. Power conversion efficiencies up to 4 % were achieved due to photocurrent contribution from both electron donor and electron acceptor, which makes non‐fullerene acceptors based on SubPcs and structurally related systems a promising synthesis goal.
In the past decade, significant advances in chemistry and manufacturing have enabled the development of increasingly complex and controllable biomaterials. A key innovation is the design of dynamic ...biomaterials that allow for user‐specified, reversible, temporal control over material properties. In this review, we provide an overview of recent advancements in reversible biomaterials, including control of stiffness, chemistry, ligand presentation, and topography. These systems have wide‐ranging applications within biomedical engineering, including in vitro disease models and tissue‐engineered scaffolds to guide multistep biological processes.
High-dose-rate (HDR) brachytherapy was originally used with external beam radiation therapy (EBRT) to increase the dose to the prostate without injuring the bladder or rectum. Numerous studies have ...reported HDR brachytherapy is safe and effective. We adapted it for use without EBRT for cases not requiring lymph node treatment.
We entered the patient demographics, disease characteristics, and treatment parameters into a prospective registry and serially added follow-up data for 448 men with low-risk (n=288) and intermediate-risk (n=160) prostate cancer treated from 1996 to 2009. Their median age was 64 years (range 42-90). The median prostate-specific antigen (PSA) level was 6.0 ng/mL (range 0.2-18.2). The Gleason score was ≤6 in 76% and 7 in 24%. The median dose was 43.5 Gy in 6 fractions. The clinical and biochemical disease control and survival rates were calculated. Adverse events were graded according to the Common Toxicity Criteria of Adverse Events.
The median follow-up period was 6.5 years (range 0.3-15.3). The actuarial 6- and 10-year PSA progression-free survival was 98.6% (95% confidence interval CI 96.9%-99.4%) and 97.8% (95% CI 95.5%-98.9%). Overall survival at 10 years was 76.7% (95% CI 69.9%-82.2%). The local control, distant metastasis-free survival, and cause-specific survival were 99.7% (95% CI 97.9%-99.9%), 98.9% (95% CI 96.3%-99.7%), and 99.1% (95% CI 95.8%-99.8%). T stage, initial PSA level, Gleason score, National Comprehensive Cancer Network risk group, patient age, and androgen deprivation therapy did not significantly correlate with disease control or survival. No late grade 3 to 4 rectal toxicities developed. Late grade 3 to 4 genitourinary toxicity occurred in 4.9% (grade 3 in 4.7%).
HDR monotherapy is a safe and highly effective treatment of low- and intermediate-risk prostate cancer.
The obligate intracellular microbe, Wolbachia pipientis (Rickettsiales; Anaplasmataceae), is a Gram-negative member of the alpha proteobacteria that infects arthropods and filarial worms. Although ...closely related to the genera Anaplasma and Ehrlichia, which include pathogens of humans, Wolbachia is uniquely associated with invertebrate hosts in the clade Ecdysozoa. Originally described in Culex pipiens mosquitoes, Wolbachia is currently represented by 17 supergroups and is believed to occur in half of all insect species. In mosquitoes, Wolbachia acts as a gene drive agent, with the potential to modify vector populations; in filarial worms, Wolbachia functions as a symbiont, and is a target for drug therapy. A small number of Wolbachia strains from supergroups A, B, and F have been maintained in insect cell lines, which are thought to provide a more permissive environment than the natural host. When transferred back to an insect host, Wolbachia produced in cultured cells are infectious and retain reproductive phenotypes. Here, I review applications of insect cell lines in Wolbachia research and describe conditions that facilitate Wolbachia infection and replication in naive host cells. Progress in manipulation of Wolbachia in vitro will enable genetic and biochemical advances that will facilitate eventual genetic engineering of this important biological control agent.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
PDF
