SOCIODEMOGRAPHIC CHARACTERISTICS INFLUENCE PAIN PERCEPTION IN NON-SMALL CELL LUNG CANCER PATIENTS.

BACKGROUND: Lung cancer is the most common malignant disease in men and the third most common in women worldwide. Pain in these patients is a leading and debilitating symptom, among others. OBJECTIVES: The aim of this research was to determine the relationship between the sociodemographic characteristics and pain perception, as measured by visual analogue scale for pain, in patients with non-small cell lung cancer. METHODS: This observational, single centre study included both a cross-sectional and prospective cohort design. RESULTS: Forty-one patients with a median age of 61 years (range 56-68) were included. This study showed that subjective perception of pain is related to age and place of residence. Younger patients ( ≤ 60 years old, p=0.026) and those residing in cities (p=0.03 1) reported feeling worse pain. Age was independently and statistically associated with the relative relief of pain after analgesic therapy (Wald=5.914; ss=1; p=0.015). CONCLUSION: Age, lifestyle, place of residence, and mentality should be considered when evaluating pain percep- tion in patients suffering from chronic pain related to malignant disease in order to provide the best possible medical treat- ment with the goal of improving quality of life.

Smoking behaviors and lung cancer epidemiology: a cohort study.

BACKGROUND: Lung cancer is the most common cancer in the world. According to the latest available data, in the year 2012 Croatia was among 20 countries with the highest incidence of lung cancer. Although tobacco smoking is a proven cause of lung cancer, recent data show that more than one quarter of adult inhabitants of Croatia are everyday smokers. The purpose of this study was to present epidemiology and treatment modalities of lung cancer in the Department for mediastinal tumors, Clinic for lung diseases Jordanovac, and to make a comparison between the available data from Croatia and the rest of the world. SUBJECTS AND METHODS: The study cohort included 212 newly diagnosed lung cancer patients who had referred to our Department from January 2012 until December 2012. Features such as age, gender, cytology and histology of the tumor, stage at diagnosis and applied therapy were evaluated respectively. RESULTS: Approximately two-thirds of all newly diagnosed lung cancers occurred in men. Out of the study cohort, 12.3% were diagnosed with small cell lung cancer (SCLC) and 87.7% were diagnosed with non-small cell lung cancer (NSCLC). The majority of the patients diagnosed with NSCLC had adenocarcinoma (47.9%), followed by squamous cell carcinoma (33.9%) and large cell carcinoma (15%). Only a small number of patients diagnosed and treated for lung cancer in our Department had never smoked tobacco. The majority of those patients were women and the most common histological type found was adenocarcinoma. CONCLUSION: The number of patients who had potentially operable disease at presentation was around 10%. That is why, in most cases, therapeutic options were confined to palliative chemotherapy or radiotherapy. Attention should be directed to an early detection of lung cancer patients, which could provide better treatment options and improve overall survival.

Tracheal complications of mechanical ventilation for COVID-19: a plot twist for survivors.

Tracheal complications should be suspected in mechanically ventilated COVID-19 survivors with respiratory symptoms. Treatment requires a multimodal approach of interventional bronchoscopy and surgery with tight follow-up due to a high rate of restenosis. https://bit.ly/3iw05xQ.

Tranexamic Acid vs Adrenaline for Controlling Iatrogenic Bleeding During Flexible Bronchoscopy: A Double-Blind Randomized Controlled Trial.

BACKGROUND: The most commonly used topical hemostatic agents during flexible bronchoscopy (FB) are cold saline and adrenaline. Data on use of other agents such as tranexamic acid (TXA) for this purpose are limited. RESEARCH QUESTION: Is TXA effective and safe in controlling iatrogenic bleeding during FB compared with adrenaline? STUDY DESIGN AND METHODS: We conducted a cluster-randomized, double-blind, single-center trial in a tertiary teaching hospital. Patients were randomized in weekly clusters to receive up to three applications of TXA (100 mg, 2 mL) or adrenaline (0.2 mg, 2 mL, 1:10000) after hemostasis failure after three applications of cold saline (4 ° C, 5 mL). Crossover was allowed (for up to three further applications) before proceeding with other interventions. Bleeding severity was graded by the bronchoscopist using a visual analog scale (VAS; 1 = very mild, 10 = severe). RESULTS: A total of 2,033 FBs were performed and 130 patients were randomized successfully to adrenaline (n = 65) or TXA (n = 65), whereas 12 patients had to be excluded for protocol violations (two patients from the adrenaline arm and 10 patients from TXA arm). Bleeding was stopped in 83.1% of patients (54/65) in both groups (P = 1). The severity of bleeding and number of applications needed for bleeding control were similar in both groups (adrenaline: mean VAS score, 4.9 ± 1.3 [n = 1.8 ± 0.8]; TXA: mean VAS score, 5.3 ± 1.4 [n = 1.8 ± 0.8]). Both adrenaline and TXA were more successful in controlling moderate bleeding (86.7% and 88.7%, respectively) than severe bleeding (40% and 58.3%, respectively; P = .008 and P = .012, respectively) and required more applications for severe bleeding (3.0 ± 0 and 2.4 ± 0.5, respectively) than moderate bleeding (1.7 ± 0.8 and 1.7 ± 0.8, respectively) control (P = .006 and P = .002, respectively). We observed no drug-related adverse events in either group. INTERPRETATION: We found no significant difference between adrenaline and TXA for controlling noncatastrophic iatrogenic endobronchial bleeding after cold saline failure, adding to the body of evidence that TXA can be used safely and effectively during FB. TRIAL REGISTRY: ClinicalTrials.gov; No.: NCT04771923; URL: www. CLINICALTRIALS: gov.

Pressure-Induced Formation and Mechanical Properties of 2D Diamond Boron Nitride.

Understanding phase transformations in 2D materials can unlock unprecedented developments in nanotechnology, since their unique properties can be dramatically modified by external fields that control the phase change. Here, experiments and simulations are used to investigate the mechanical properties of a 2D diamond boron nitride (BN) phase induced by applying local pressure on atomically thin h-BN on a SiO2 substrate, at room temperature, and without chemical functionalization. Molecular dynamics (MD) simulations show a metastable local rearrangement of the h-BN atoms into diamond crystal clusters when increasing the indentation pressure. Raman spectroscopy experiments confirm the presence of a pressure-induced cubic BN phase, and its metastability upon release of pressure. Å-indentation experiments and simulations show that at pressures of 2-4 GPa, the indentation stiffness of monolayer h-BN on SiO2 is the same of bare SiO2, whereas for two- and three-layer-thick h-BN on SiO2 the stiffness increases of up to 50% compared to bare SiO2, and then it decreases when increasing the number of layers. Up to 4 GPa, the reduced strain in the layers closer to the substrate decreases the probability of the sp2-to-sp3 phase transition, explaining the lower stiffness observed in thicker h-BN.