The puzzling clinical presentation of fluoropyrimidines cardiotoxicity.

The cardiotoxicity of fluoropyrimidines (FP) [5-Fluorouracil and Capecitabine] is often reported as acute cardiac ischemia with rest typical angina, signs of ischemia at electrocardiogram (ECG), and ventricular kinetics abnormalities. However, silent ischemia, effort-related toxicity, and ventricular arrhythmias (VA) have been also described. The aim of this study is to report a consecutive series of 115 patients with FP cardiotoxicity observed in a single center both within clinical prospective studies and during the clinical routine.

Cardiotoxicity from Capecitabine Chemotherapy: Prospective Study of Incidence at Rest and During Physical Exercise.

Background: Physical activity may increase the risk of cardiotoxicity (myocardial ischemia, major arrhythmias) of 5-Fluorouracil, but this risk has never been investigated for its prodrug capecitabine.

Patients And Methods: One hundred and ninety-two consecutive patients undergoing capecitabine chemotherapy from December 1, 2010 through July 31, 2016 were prospectively evaluated. The baseline evaluation included electrocardiography (ECG) and echocardiography (2DE); a follow-up evaluation, including ECG and exercise stress testing (2DE in case of ECG abnormalities), was done after ≥10 days of treatment.

What Is the Medication Iatrogenic Risk in Elderly Outpatients for Chronic Pain?

Purpose: Medication iatrogeny is a major public health problem that increases as the population ages. Therapeutic escalation to control pain and associated disorders could increase polypharmacy and iatrogeny. This study aimed to characterize the medication iatrogenic risk of elderly outpatients with chronic pain.

eDOL mHealth App and Web Platform for Self-monitoring and Medical Follow-up of Patients With Chronic Pain: Observational Feasibility Study.

Background: Chronic pain affects approximately 30% of the general population, severely degrades quality of life (especially in older adults) and professional life (inability or reduction in the ability to work and loss of employment), and leads to billions in additional health care costs. Moreover, available painkillers are old, with limited efficacy and can cause significant adverse effects. Thus, there is a need for innovation in the management of chronic pain.

Efficacy of Auricular Acupuncture in Chemotherapy-Induced Peripheral Neuropathy: A Case Series of 73 Cases.

Chemotherapy-induced peripheral neuropathy (CIPN) can adversely affect completion of systemic anticancer treatment and cause long-term morbidity. To date, its physiopathology remains unclear, and treatments are rare and poorly performed. Auricular acupuncture has already offered interesting results in several symptoms.

Treatment Impact on Patient-Reported Outcomes in Peripheral Neuropathic Pain: Comparing Single Intervention With Topical High-Concentration Capsaicin to Daily Oral Pregabalin.

Background: Peripheral neuropathic pain (PNP) is a complex, subjective experience affecting both physical and psychological aspects of functioning. Assessing patient-reported outcomes (PROs) beyond pain relief is important and aligns with the recommendations of IMMPACT (Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials). Moreover, PRO data are key to clinical decision-making when evaluating treatment options.

Characterisation of pragmatic postoperative PAin Trajectories over seven days and their association with CHronicity after 3 months: a prospective, pilot cohort study (PATCH study).

Background: Reliable outcome measurement providing information both on early and late postoperative pain outcomes are still lacking. The purpose of this study was: 1) to characterise postoperative pain trajectories according to an innovative pragmatic concept: ideal pain trajectory (rapid and sustained pain relief) vs non-ideal pain trajectories (late, transient, or no pain relief); and 2) to assess the incidence of persistent post-surgical pain (PPSP) and the potential association between non-ideal pain trajectories and PPSP.

Methods: This prospective observational pilot cohort study was performed from March until June 2016.

Drugs and driving prior to cannabis legalization: A 5-year review from DECP (DRE) cases in the province of Quebec, Canada.

Objectives: To examine alleged drug-impaired driving in the province of Quebec (Canada), including drug use profile amongst suspected impaired drivers, prior to recreational cannabis legalization and major modifications to the legislation regarding driving under the influence of drugs (DUID).

Methods: The Laboratoire de sciences judiciaires et de médecine légale (LSJML) performs toxicological analyses on all biological samples collected during a Drug Evaluation and Classification Program (DECP) evaluation by a Drug Recognition Expert (DRE). A targeted analysis of 137 drugs and metabolites by liquid chromatography - tandem mass spectrometry (LC-MS/MS) is systematically carried out, enhanced by gas chromatography - mass spectrometry (GC-MS) general unknown screening if deemed necessary.

Safety and efficacy of an equimolar mixture of oxygen and nitrous oxide: a randomized controlled trial in patients with peripheral neuropathic pain.

Nitrous oxide (N2O) is an odorless and colorless gas routinely used as an adjuvant of anesthesia and for short-duration analgesia in various clinical settings mostly in the form of an N2O/O2 50%-50% equimolar mixture (EMONO). Experimental studies have suggested that EMONO could also induce long-lasting analgesic effects related to the blockade of N-methyl-D-aspartate receptors. We designed the first international multicenter proof of concept randomized, placebo-controlled study to assess the efficacy and safety of a 1-hour administration of EMONO or placebo (medical air) on 3 consecutive days up to 1 month after the last administration in patients with chronic peripheral neuropathic pain.

Fluoropyrimidine-Associated Cardiotoxicity: Probably Not So Rare As It Seems.

This letter to the editor focuses on a recent report of a retrospective case‐control study of fluoropyrimidine‐associated cardiotoxicity in cancer patients.

Quality of palliative care in identified palliative care beds.

Background: Dedicated identified palliative care beds (IPCB) are unique to France.

Aims: This study aimed to assess their use and advantages in a medical oncology department of a private provincial hospital.

Findings: Of the last 100 patients who died in the medical oncology department, 57 had an IPCB.

[The approach to gender violence from the perspective of communities in northern Córdoba Province, Argentina].

Gender violence is a human rights violation and a serious public health problem that should be addressed with an inter-sector and interdisciplinary focus. Collaboration and coordination between sectors, including the health sector, is essential for guaranteeing such approach. The study aimed to learn which actors address gender violence in the communities and to study the communities' opinions concerning the public health system's role in (and approach to) this problem.

Fractal properties in sensorimotor variability unveil internal adaptations of the organism before symptomatic functional decline.

If health can be defined as adaptability, then measures of adaptability are crucial. Convergent findings across clinical areas established the notion that fractal properties in bio-behavioural variability characterize the healthy condition of the organism, and its adaptive capacities in general. However, ambiguities remain as to the significance of fractal properties: the literature mainly discriminated between healthy vs.

Management of neuropathic pain induced by surgery: Review of the literature by a group of experts specialized in pain management, anesthesia and surgery.

Chronic postsurgical neuropathic pain (CPSNP) is frequent. While prevalence varies considerably according to type of operation and means of evaluation, it can reach 37% following breast surgery. Identification of risk factors related to the procedure and to the patient and taking into account the development of new, minimally invasive surgical techniques is increasingly nerve-sparing and reduces the likelihood of injury.

French clinical guidelines for peripheral motor nerve blocks in a PRM setting.

Introduction: Motor nerve blocks with anesthetic drug for local anesthesia are commonly used in physical and rehabilitation medicine (PRM), especially in the field of spasticity. Guidelines in this context are currently lacking.

Method: Eighteen experts selected on the basis of their recognized experience by the scientific committees of the French PRM (SOFMER) and Anesthesia and Intensive care (SFAR) societies were invited to work and propose guidelines for the use of loco-regional anesthetic drug for motor nerve blocks in PRM setting.

[Drug management of cancer-related peripheral neuropathic pain: A systematic review of the literature].

The objective of the present systematic literature review was to provide an update on medical treatment of neuropathic pain in cancer patients. The number of cancer patients is steadily increasing. Pain is frequent in cancer patients.

Successfully treatment by eribulin in visceral crisis: a case of lymphangitic carcinomatosis from metastatic breast cancer.

Background: Metastatic breast cancer (MBC) rest an incurably disease associated with bad prognosis and a median overall survival of 23-31 months. There are several treatment options including chemotherapy and sometimes endocrine therapy. Currently, there is no standard treatment for patients with MBC who have already benefited from anthracyclines and taxanes therapy.

SK3 Gene Polymorphism Is Associated with Taxane Neurotoxicity and Cell Calcium Homeostasis.

Taxane-induced peripheral neuropathy is a common side effect induced by anticancer agents, and no drug capable of preventing its occurrence or ameliorating its long-term course has been identified. The physiology of taxane neuropathy is not clear, and diverse mechanisms have been suggested, with ion channels regulating Ca homeostasis appearing good candidates. The calcium-activated potassium channel SK3 is encoded by the gene, which is characterized by a length polymorphism due to variable number of CAG repeats.

Peripheral human CD4CD8 T lymphocytes exhibit a memory phenotype and enhanced responses to IL-2, IL-7 and IL-15.

CD4CD8 T lymphocytes account for 1-2% of circulating human T lymphocytes, but their frequency is augmented in several diseases. The phenotypic and functional properties of these T lymphocytes are still ill-defined. We performed an ex vivo characterization of CD4CD8 T lymphocytes from the blood of healthy individuals.

Nonpegylated liposomal doxorubicin combination regimen in patients with diffuse large B-cell lymphoma and cardiac comorbidity. Results of the HEART01 phase II trial conducted by the Fondazione Italiana Linfomi.

The purpose of this phase 2, multicenter study was to determine the activity and safety of nonpegylated liposomal doxorubicin as part of "R-COMP" combination in patients with diffuse large B-cell lymphoma and coexisting cardiac disorders. The study was conducted using a Bayesian continuing assessment method using complete remission rate and rate of cardiac events as study endpoints. Between November 2009 and October 2011, 50 evaluable patients were enrolled (median age, 76 years).

Parecoxib, propacetamol, and their combination for analgesia after total hip arthroplasty: a randomized non-inferiority trial.

Background: This study assessed non-inferiority of parecoxib vs. combination parecoxib+propacetamol and compared the opioid-sparing effects of parecoxib, propacetamol, and parecoxib+propacetamol vs. placebo after total hip arthroplasty.

Efficiency of auricular acupuncture in climacteric symptoms after cancer treatments.

Objectives: This paper aims to highlight the efficiency of auriculotherapy in the treatment of hot flushes, especially in cancer-related menopausal transition.

Methods: We used systematically collected data from patients in 2014 in a medical oncology practice. The treatment was made according to the guidelines of The Inter-University Diploma and the cartography of the World Health Organization; data on satisfaction were collected orally.

Anthracycline-free neoadjuvant therapy induces pathological complete responses by exploiting immune proficiency in HER2+ breast cancer patients.

Background: Neoadjuvant Chemotherapy (NC) including trastuzumab induces a high rate of pathological Complete Responses (pCR) in patients with locally advanced HER2-overexpressing Breast Cancer (BC), but is penalized by a severe cardiotoxicity when combined with anthracyclines. A phase II study was designed to assess whether an anthracycline-free NC regimen based on the early addition of trastuzumab to paclitaxel may increase the pCR rate without inducing severe cardiotoxicity in patients with locally advanced HER2-overexpressing BC. Immunomonitoring was performed to assess the contribution of patients' immunological background to the induction of clinical responses.

Prolonged complete response after treatment withdrawal in HER2-overexpressed, hormone receptor-negative breast cancer with liver metastases: the prospect of disappearance of an incurable disease.

Background: Metastatic breast cancer has consistently been viewed as a non-curable disease. Specific palliative treatments such as chemotherapy and hormone therapy have resulted in a mean overall survival of approximately 30 months. While cases of prolonged complete response have been reported with hormone or trastuzumab monotherapy, rendering metastatic breast cancer a chronic disease, any treatment withdrawal has ineluctably led to relapse.

Effort myocardial ischemia during chemotherapy with 5-fluorouracil: an underestimated risk.

Background: Effort-induced myocardial ischemia (EMI) has been seldom described. Aims of our study were (A) to evaluate the prevalence of EMI during long-lasting 5-FU infusion; (B) to identify possible risk factors of EMI during 5-FU infusion.

Patients And Methods: For the purpose (A), we prospectively evaluated a group of patients undergoing in-hospital continuous infusion (c.