Current medical research and opinion
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The different operational definitions of breakthrough cancer pain (BTcP) has generated unclear epidemiological data. ⋯ Patients having good pain control after optimization of the analgesic regimen may have a decrease in number, intensity, and duration of BTcP, although the general prevalence of BTcP remains unchanged.
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Meta Analysis Comparative Study
The predictive role of phosphatase and tensin homolog (PTEN) loss, phosphoinositol-3 (PI3) kinase (PIK3CA) mutation, and PI3K pathway activation in sensitivity to trastuzumab in HER2-positive breast cancer: a meta-analysis.
Phosphatase and tensin homolog (PTEN) loss or activating mutations of phosphoinositol-3 (PI3) kinase (PIK3CA) may be related to trastuzumab resistance in in vitro studies; however, this issue in clinical studies is controversial. Therefore, we conducted a meta-analysis to assess the association between PTEN loss, PIK3CA mutation and the efficacy of trastuzumab-based treatment in HER2-positive breast cancer patients. ⋯ In HER2-positive recurrent or metastatic breast cancer patients PTEN loss might indicate resistance to trastuzumab-based salvage treatment. Due to the small sample size and the considerable heterogeneity in the chemotherapy treatment regimens, further research is needed to clarify the association between PTEN loss, PIK3CA mutation and the efficacy of trastuzumab-based treatment in neoadjuvant and adjuvant settings.
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Multicenter Study
Semiological evaluation of pain according to its origin: a prospective, observational, and national study of current French medical practice.
To determine how the origin of acute pain influences its semiological characteristics, and to evaluate the efficacy and safety of two Level 2 analgesic combinations in general practice. ⋯ Acute pain should not be understood as a single entity but as multiple entities with specific characteristics related to its underlying origin. Furthermore, our data suggest that, as already demonstrated in clinical trials, Level 2 analgesia provides effective relief of acute pain in 'real life' conditions.
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As part of the CHANGE PAIN international health campaign to improve pain management, patient surveys are being undertaken to explore how patients perceive their noncancer chronic pain and how they deal with it. ⋯ Chronic noncancer pain management is poor. The uncoupling of VRS and NRS pain ratings reveals the high subjectivity of the pain experience, whilst the wide variation in treatment choices indicates that an optimal management strategy remains to be defined. Advances might be attained by boosting communication to tailor treatments to individual patients' perceptions.
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Reversible defunctionalisation of nociceptors by the TRPV1 agonist capsaicin in high concentration is an emerging new concept for the treatment of peripheral neuropathic pain. ⋯ The study did not include a control group; therefore, a comparison of the results with that of therapeutic alternatives is not justified.