PurposeCancer-related fatigue (CRF) is a common and relevant symptom in patients with advanced cancer that significantly decreases their quality of life. The aim of this study was to evaluate the effect of a physiotherapy programme on CRF and other symptoms in patients diagnosed with advanced cancer.MethodsThe study was designed as a randomized controlled trial. Sixty patients diagnosed with advanced cancer receiving palliative care were randomized into two groups: the treatment group (n = 30) and the control group (n = 30). The therapy took place three times a week for 2 weeks. The 30-min physiotherapy session included active exercises, myofascial release and proprioceptive neuromuscular facilitation (PNF) techniques. The control group did not exercise. The outcomes included Brief Fatigue Inventory (BFI), Edmonton Symptom Assessment Scale (ESAS) and satisfaction scores.ResultsThe exercise programme caused a significant reduction in fatigue scores (BFI) in terms of severity of fatigue and its impact on daily functioning. In the control group, no significant changes in the BFI were observed. Moreover, the physiotherapy programme improved patients’ general well-being and reduced the intensity of coexisting symptoms such as pain, drowsiness, lack of appetite and depression. The analysis of satisfaction scores showed that it was also positively evaluated by patients.ConclusionThe physiotherapy programme, which included active exercises, myofascial release and PNF techniques, had beneficial effects on CRF and other symptoms in patients with advanced cancer who received palliative care. The results of the study suggest that physiotherapy is a safe and effective method of CRF management.

The problem of drug shortages has been reported worldwide, gaining prominence in multiple domains and several countries in recent years. The aim of the study was to analyze, characterise and assess this problem in Belgium and France, while also adopting a wider perspective from the European Union. A qualitative methodological approach was employed, including semi-structured interviews with the representatives of respective national health authorities, pharmaceutical companies and wholesalers, as well as hospital and community pharmacists. The research was conducted in early 2014. Four themes, which were identified through the interviews, were addressed in the paper, i.e. a) defining drug shortages, b) their dynamics and perception, c) their determinants, d) the role of the European and national institutions in coping with the problem. Three groups of determinants of drug shortages were identified throughout this study: manufacturing problems, distribution and supply problems, and problems related to economic aspects. Currently, the Member States of the European Union are striving to resolve the problem very much on their own, although a far more focused and dedicated collaboration may well prove instrumental in coping with drug shortages throughout Europe more effectively. To the best of the authors’ knowledge, this is the first qualitative study to investigate the characteristics, key determinants, and the problem drivers of drug shortages, focusing on this particular group of countries, while also adopting the European Union’s perspective.

We determined the effect of a long acting beta2-agonist, salmeterol, on aspirin-induced asthma (AIA) attacks and urinary release of eicosanoids in a double-blind, placebo-controlled, crossover study in 10 asthmatics sensitive to aspirin. The patients inhaled 50 microgram of salmeterol or placebo 15 min prior to a cumulative challenge with increasing doses of lysine-aspirin (L-ASA) (Part I), and before a single, predetermined dose of L-ASA that caused a 20% fall in FEV1 (PD20) (Part II). Salmeterol significantly attenuated aspirin-precipitated bronchoconstriction and the increase in urinary LTE4. Salmeterol also prevented the decrease in blood eosinophils, and abolished the correlation between the urinary levels of LTE4 and provocative doses of aspirin. In addition, PGD-M, the major urinary metabolite of PGD2, increased after L-ASA inhalation in six of nine subjects; this increase was blocked in all six by salmeterol. The protective effect of salmeterol on aspirin-induced attacks and mediator release suggests that it may be efficacious in aspirin-sensitive asthma.

Opracowanie przedstawia koncepcję przedłużenia traktu spacerowego, obejmują-cego Rynek, ulice Kościuszki i 3-go Maja oraz aleje Lubomirskich i Pod Kasztanami w Rzeszowie, w kierunku Ogrodu Miejskiego przy ul. Dąbrowskiego. Koncepcję opracowano w celu włączenia do jednolitego obszaru przestrzeni publicznej mało eksponowanych obszarów o wybitnych w skali Rzeszowa wartościach architektonicznych, historycznych i przyrodniczych. Trasę nowoprojektowanego traktu spacerowego przewiduje się poprowadzić wzdłuż ulicy Kraszewskiego, a po przekroczeniu ul. Unii Lubelskiej prostopadle do ulicy Reformackiej, i dalej prosto w kierunku Ogrodu Miejskiego. W pracy dokonano analizy Ogrodu Miejskiego oraz najbardziej znaczących obiektów położonych wzdłuż projektowanego odcinka szlaku spacerowego. Zwrócono uwagę na możliwości wykorzystania ich walorów dla realizacji istotnych funkcji przestrzeni publicznej. Przedstawiono plan niezbędnych zmian w przestrzeni architektonicznej, wraz z propozycjami konkretnych rozwiązań w tym zakresie. Przedłożono propozycję osłabienia przeszkody na trasie traktu, jaką stanowi ruchliwa ul. Lisa-Kuli, proponując przeniesienie części ruchu samochodowego do tunelu wybudowanego pod obecną jezdnią, a tym samym przywrócenie ulicy jej pierwotnej skali urbanistycznej. Wymienione propozycje zostały zaprezentowane w opracowaniach urbanistycznych oraz rysunkach wizualizacyjnych. Projekt przedłużenia traktu spacerowego w obszarze historycznego centrum, wychodzi naprzeciw potrzebom miasta Rzeszowa. W mieście występuje deficyt właściwie zagospodarowanej przestrzeni publicznej, odpowiedniej dla realizacji aktywności społecznej mieszkańców oraz kształtującej ich tożsamość i poczucie przynależności do lokalnej społeczności.

Objectives: Medicine shortages are a global phenomenon. A growing number of reports indicate the problem is increasingly affecting the European pharmaceutical market. The present study aims to investigate the characteristics, determinants, legal aspects and management of medicine shortages in Belgium, France and from the perspective of the European Union. MethOds: A review of scientific and grey literature was performed. The legal framework on European and national level was reviewed. Primary qualitative data was collected through 22 semi-structured interviews with key representatives of health care systems' stakeholders on the national and European level. Results: France reported three times more shortages than Belgium. However, the main therapy area, the major cause and the dynamics of medicine shortages were analogous between the two countries. Determinants of medicine shortages were categorised in manufacturing problems, distribution and supply issues, and economic-related challenges. Manufacturing problems were most frequently reported as the primary cause of medicine shortages. Laws and regulations related to medicine shortages are more extensive in France than Belgium. Several preventive and responsive measures were identified to address such shortages. cOnclusiOns: Although medicine shortages are country-specific, the underlying mechanisms of medicine shortages appear to be similar in Belgium and France. Economic aspects seem to play a central role in the phenomenon of medicine shortages, as it influences stakeholders' business decisions. The impact of the legal framework around medicines on the occurrence of medicine shortages may be limited. Collaboration, communication and coordination are key to any effective approach to address medicine shortages.

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The aim: A comparative analysis of the efficiency of the lumbo-pelvic-hip complex for bodybuilders and football referees. Defining factors that are related and those that are not related to their professions that can affect their efficiency of the lumbo-pelvic-hip complex. Materials and methods: 35 bodybuilders and 41 football referees were randomly selected in different assosiations in Lodz. The study was performed using a questionnaire and tests for the SFTR range of motion of hip joints and also a Shober test. Results: It occurs that statistically the extension, flexion, abduction, external and internal rotation were significant with bodybuilders and the extension and internal rotation movement with the referees. The mean values for the Shober test when moving forward were worse for the test group than man for the control group were correct. Alongside bulking within the test group and control group the range of motion in the hip joint has decreased. The biggest statistical significance has been for the flexion and internal rotation. Conclusions: In the group of bodybuilders the restriction appears to be in 5 out of 6 type of movements in the hip joint area: extension, flexion, abduction, internal and external rotation. In the second group, football referees the range of motion forward and internal rotation is restricted. The mobility of the lumbar region in both groups is within the average, but for the bodybuilders at quite low. The efficiency of lumbo-pelvic-hip complex is determined by duration of training, body mass, type of training and also any pain ailments. Bodybuilders have less efficiency of lumbo-pelvic-hip complex.