Revue médicale suisse
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Revue médicale suisse · Jun 2015
Review[The use of transdermal opioids in patients in oncological remission suffering from chronic pain].
Today, oncological patients in remission are becoming more numerous and about a third have chronic pain from various etiologies. In the objective of a comprehensive management plan for chronic pain in these patients, therapeutic goals, conditions and terms of prescription of opioids in the long-term should be discussed. ⋯ It provides increased comfort in selected patients in whom oral administration is difficult or a polypharmacy troublesome. Risks/benefits of a prescription of opioids in the treatment of chronic pain in patients in oncological remission should be re-evaluated and included in a multimodal support.
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Revue médicale suisse · Jun 2015
[Chronic noncancer pain and patient education: a place for e-learning?].
Chronic non cancerous pain considerably limits the patients' quality of life. Yet, chronic non cancerous pain has a prevalence as high as 25% to 35%, Therapeutic education allows to work on the knowledge and know-how about the disease, the treatment, the management of health resources and health behaviors. ⋯ The level of proof of its efficacy is weak, mainly because of methodological limitations. Some good quality studies are promising, with a positive effect of e-learning programs on pain intensity, disability, autonomy and medication misuse.
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Revue médicale suisse · Jun 2015
[PIPAC--Pressurized intraperitoneal aerosol chemotherapy. A novel treatment for peritoneal carcinomatosis].
Peritoneal carcinomatosis remains a diagnostic challenge with sparse treatment options. The effect of systemic chemotherapy remains limited inside the peritoneum due to low penetration and a relative resistance of peritoneal nodules. Heated IntraPeritoneal Chemotherapy (HIPEC) improves survival in selected patients but entails a high incidence of complications. ⋯ Distribution and tissue penetration of chemotherapy by PIPAC are superior to HIPEC and systemic chemotherapy despite of lower doses. Systemic side effects are uncommon and surgical trauma is limited. Histological and clinical response rates in platinum-resistant patients approach 70% and survival data appear to be favorable compared with standard therapy.