Supportive and Palliative Care in Cancer Therapies—Path from Tumor-Driven Therapies to Patient-Driven Ones

Cancer patients frequently report a set of symptoms including fatigue, pain, and physiological and social distress. Families and other personal lay relations give proposals to take supportive drugs and supplemental nutrients, without professional knowledge about their actions. Internet search engines and social networks serve up most of the treatment proposals, opening wide possibilities for quackeries and predatory money-making practices. Medical professionals have a responsibility to clear this field and concentrate on patients’ well-being and personal needs. According to our approach, the integration of supportive and palliative care with conventional therapies needs a change of paradigm from tumour-driven to patient-driven treatment actions. Supportive/palliative care includes a broad spectrum of applied methods, including medications, nourishments, electrical effects, and psycho and social supports. Our goal is to discuss the possibilities for combining conventional oncotherapies with additional supportive/palliative care and to give suggestions on a professional basis.

The impact of diabetes and hypertension on renal allograft survival-A single center study

Background:To determine the impact of pre-transplant diabetes mellitus(DM)and post-transplant hypertension(HT)at 1 year on renal allograft survival in all adult first kidney-only(FKO)transplant recipients at a single transplant center in Johannesburg,South Africa.Materials and methods:A retrospective review was conducted of all adult FKO transplant procedures at the Charlotte Maxeke Johannesburg Academic Hospital transplant unit between 1966 and 2013.Results:During the stipulated timeframe,1685 adult FKO transplant procedures were performed.Of these,84.1%were from deceased donors(n=1413/1685).The prevalence of pre-transplant DM transplant recipients with no missing or incomplete records was 6.5%(n=107/1625).Of the total cohort of 1685 adult FKO transplant recipients,63.6%of those with no missing data survived to 1 year(n=1072/1685).The prevalence of HT at 1-year post-transplant was 53.6%(n=503/1072).HT at 1-year post-transplant,even after adjusted survival analysis,proved a significant risk factor for renal allograft loss(hazard ratio,1.63;95%confidence interval,1.37-1.94)(p<0.0001).Similarly,after adjusted survival analysis,the risk of renal allograft loss within the pre-transplant DM group was significantly higher(p=0.043;hazard ratio,1.26;95%confidence interval,1.01-1.58).Conclusions:This study identified pre-transplantation diabetes mellitus and post-transplantation HT as significant risk factors for graft loss within the population assessed in this region of the world.These factors could potentially be used as independent predictors of renal graft survival.