Pancreatic cancer is a malignant tumour with very poor prognosis and a chance for 5-year survival is approximately 6%. One of the main symptoms of this neoplasm is pain, mostly of neuropathic origin, which significantly decreases the quality of life and impairs the functional activity of patients. The most common treatment of pain in pancreatic cancer is conservative therapy which is based on analgesic ladder rules established by the World Health Organization. Unfortunately, it is not always effective and it has many side effects that also can diminish patients' quality of life. Invasive treatment of pain in pancreatic cancer includes mainly coeliac plexus block and sympathectomy, and both of them significantly reduce levels of pain and help to improve the quality of life. It is postulated that the place of those two invasive methods should not be at the final stage of treatment, but they can provide significantly better improvement of pain once instituted earlier (such as the first or second step of analgesic World Health Organization's ladder). The aim of this article is to review and assess the conservative as well as the invasive therapy in the management of pain in pancreatic cancer. It also presents brief insight into non-medical methods of pain reduction, which can be supplementary to conservative and/or invasive treatment.

Routine laboratory lipid assays include simple measurements of total cholesterol, triacylglycerols and HDL. However, lipids are a large group of compounds involved in many metabolic pathways, and their alterations may have serious health consequences. In this study, we used 1H NMR to analyze lipids extracted from sera of 16 obese patients prior to and after bariatric surgeries. We observed a post-surgery decrease in serum concentrations of lipids from various groups. The hereby presented findings imply that 1H NMR is suitable for rapid, simple and non-invasive detection of lipids from 30 structural groups, among them triacylglycerols, phosphatidylcholine, phosphatidylethanolamine, sphingomyelin, total phospholipids, total, free and esterified cholesterol, total and unsaturated fatty acids. NMR-based analysis of serum lipids may contribute to a substantial increase in the number of routinely determined markers from this group; therefore, it may find application in clinical assessment of obese subjects prior to and after bariatric surgeries, as well as in the examination of patients with other metabolic diseases.

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IntroductionPrimary hyperhidrosis (PHH) is a disease that is mainly characterized by increased palmar and plantar sweating that significantly affects the everyday functioning. It is not clear to what extent this surgical intervention has an effect on one's further emotional functioning.AimTo evaluate the impact of endoscopic thoracic sympathectomy (ETS) on crying tendency in PHH patients.Material and methodsEighty-six patients qualified for ETS due to PHH took part in the study. All patients completed the Adult Crying Inventory (ACI) and the Functional Assessment of Chronic Illness Therapy (FACIT) questionnaires before and 3 months after sympathectomy. The ACI questionnaire was additionally completed by a group of 60 volunteers.ResultsIn females, the number of crying episodes increased after ETS, though it was still lower than the number observed in the control group (1.19 vs. 2.36 vs. 3.83; p < 0.05). In males the number of crying episodes dropped insignificantly to the number observed in the control group (0.87 vs. 0.27 vs. 0.14; p = NS). The tendency to cry in females decreased compared to the level prior to surgery, but it was lower than the level observed in the control group (respectively, 4.5 vs. 3.5 vs. 5.63; p < 0.05). In males the differences were not statistically significant (1.03 vs. 1.5 vs. 1.77; p = NS). There was no impact of emotional status on crying, either before or after the treatment.ConclusionsEndoscopic thoracic sympathectomy decreases the subjective tendency to cry though it increases the number of crying episodes in women, but does not change crying behaviours in men.