Breakthrough pain characteristics and syndromes in patients with cancer pain. An international survey.

Breakthrough pain (BKP) is a transitory flare of pain that occurs on a background of relatively well controlled baseline pain. Previous surveys have found that BKP is highly prevalent among patients with cancer pain and predicts more severe pain, pain-related distress and functional impairment, and relatively poor quality of life. An international group of investigators assembled by a task force of the International Association for the Study of Pain (IASP) evaluated the prevalence and characteristics of BKP as part of a prospective, cross-sectional survey of cancer pain.

[Staphylococcus nasal carriage and infection of central venous ports in oncology].

Objective: To assess the risk of infection of either subcutaneously implanted central venous access devices or percutaneous central venous catheters inserted via a subcutaneous tunnel in cancer patients with a positive staphylococcal nasal carriage.

Study Design: Prospective study.

Patients: The study included 266 patients undergoing cancer chemotherapy.

[Factor VII deficiency and surgery].

Factor VII deficiency is a rare disorder (1/500,000), with manifestations similar to those experienced by patients with haemophilia. Excessive bleeding during surgical procedure is prevented by factor VII administration. We report two cases of patients presenting a factor VII deficiency who were treated for oncological surgery.

Energy expenditure during allogeneic and autologous bone marrow transplantation.

Resting energy expenditure (REE) was measured by indirect calorimetry during allogeneic and autologous bone marrow transplantation in order to evaluate the evolution in allogeneic and autologous recipient patients. REE values obtained with indirect calorimetry and compared with values using the Harris-Benedict formula were different. Evolution of REE during aplasia were significantly different in autologous and allogeneic recipients with an increase 11.

[Morphine therapy: evaluation of patient information].

Pain is frequent in the course of cancer and can have negative consequences on patients quality of life. The great majority of patients can be helped by simple treatments. The prescription of morphine (M) must be preceded by some explanations.

[Peripheral venous catheter embolism].

The accidental embolization of peripheral venous catheter fragments seems to be a rare event. Removal of the catheter embolus is usually recommended, because of the high morbidity and mortality rates from sepsis, perforation, thrombosis and arrhythmias. We report a case, in which the diagnosis was made 17 years after the embolization by the means of a systematic chest X-ray.

Amphotericin B intralipid formulation: stability and particle size.

Amphotericin B remains the drug of choice for treating systemic fungal infections, although toxicity limits its clinical use. Some studies reported the use of Intralipid deoxycholate amphotericin B as an alternative delivery system. An in-vitro study was performed to assess the compatibility of deoxycholate amphotericin B in Intralipid.

Postoperative infections in immunocompromised patients after oncological surgery.

Immunodeficiency secondary to cancer chemotherapy (chemotherapy for less than 3 months, or intensive chemotherapy with bone marrow transplant) may be responsible for postoperative infections. To estimate the value of this hypothesis, a prospective study was done over a period of 18 months in patients who had undergone pulmonary surgery. Antibiotic prophylaxis was by pefloxacin, one tablet (400 mg) 1 h before surgery then 11 h after.

Clinical evaluation of the CORDIS vascular access port systems: a multicenter study.

Two non-metallic vascular access port systems, the Multipurpose Access Port (MPAP) and Miniport, developed by CORDIS S.A., France, have been evaluated clinically in 78 cancer patients.

A comparative study of controlled-release morphine (CRM) suspension and CRM tablets in chronic cancer pain.

This study compared the efficacy and the adverse effects of controlled-release morphine (CRM) suspension (SAR 213) and CRM tablets (Moscontin) in the treatment of cancer pain. This multicenter, randomized, double-blind, double-dummy, crossover study was carried out on 52 patients. Each patient received both study treatments given at an equivalent dosage of morphine during each of two 7-day periods.

Phase I trial of recombinant interleukin-2 followed by recombinant tumor necrosis factor in patients with metastatic cancer.

In this Phase I trial, the feasibility of sequential administration of continuous intravenous recombinant interleukin-2 (rIL-2) at 18 x 10(6) IU/m2/day for 6 days, followed by three daily bolus intravenous recombinant tumor necrosis factor (rTNF) infusions at doses escalating between 10 and 120 micrograms/m2/day, was investigated in 31 patients with metastatic malignancies. Prophylactic use of indomethacin prior to and during rTNF administration was found to significantly reduce toxicity. However, despite prophylactic indomethacin, a maximum tolerated dose of rTNF of 120 micrograms/m2 was reached.

[Perforation of the esophagus during attempted endotracheal intubation].

A case is reported of oesophageal perforation which occurred during an attempt to carry out endotracheal intubation. A 54-year-old female patient was scheduled for mastectomy. She had no clinical features likely to predict a difficult endotracheal intubation.

[Electromagnetic location of central venous catheters].

A new technique, the Cath Finder (Pharmacia Deltec) system, for locating central venous catheters is described. It was initially designed to facilitate the insertion of the PAS Port (Pharmacia Deltec), a long central venous catheter with an implantable chamber. It is based on a low intensity high frequency electromagnetic field generated by a locator wand.

[Adverse effects of interleukin 2].

Interleukin 2, has frequent and important side effects. Toxic effects observed are systemic (fever, chills, malaise), hemodynamic (capillary leak syndrome, hypotension), cardiac (arrhythmia, infarction), renal (renal dysfunction), infectious (septicemia), cutaneous, hematologic, gastrointestinal, endocrinologic and metabolic. Side effects are dose-dependent, generally reversible, with a mortality from 1 to 3%.

Intravenous interleukin-2 just after high dose BCNU and autologous bone marrow transplantation. Report of a multicentric French pilot study.

This multicentric pilot study was conducted in order to evaluate the feasibility of early interleukin-2 (IL2) after high dose chemotherapy requiring autologous bone marrow transplantation (ABMT). BCNU at 800 mg/m2 was followed, 3 days later, by the reinjection of the bone marrow cells. At day 4, IL2 at 18 x 10(6) i.

Alteration of the inner surface of venous catheters by antineoplastic drugs.

Septic complications and thrombosis are frequent causes of long-term venous catheter implantation failure and tend to occur more frequently in oncology than in patients using catheters for hyperalimentation only. The purpose of this in vitro study was to study extensively the inner surface behaviour and the possible changes in their mechanical properties of various silicone and polyurethane catheters after exposure to a flow of the most common antineoplastic drugs. Silicone catheters appeared to be the best choice for cytostatic drug infusions because of their chemical stability, but the addition of an opacifier imposes a protective inner and outer layer to improve their surface properties for biocompatibility.

[Hemodilution and peroperative autotransfusion during harvest for bone marrow graft].

In order to avoid the infectious and immunological complications of homologous blood given to autologous bone marrow graft recipients, intraoperative haemodilution together with delayed salvage of the red blood cells contaminating the marrow graft were used prospectively over a period of 6 months. This was carried out in 74 patients, i.e.

Using the costal muscle flap with latissimus dorsi muscle to repair full-thickness anterior chest wall defects.

Musculoosseous flaps with latissimus dorsi muscle are used for reconstruction of full-thickness anterior chest wall defects. The 11th and 12th ribs and the posterior parietal pleura are elevated with the latissimus dorsi muscle. The blood supply of the compound flap comes from the thoracodorsal pedicle and from perforating segmental vessels.