Background: Intrathecal pumps (ITPs) are indicated for refractory cancer pain and decrease systemic opioid requirements. While not yet indicated for cancer pain, spinal cord stimulators (SCSs) are used off-label for cancer pain, with increasing evidence of their efficacy.
Materials And Methods: A retrospective chart review was conducted of patients who underwent both ITP and at least SCS trial for cancer pain. Primary outcomes were pain numeric rating scale (NRS) and daily morphine equivalents (MEQs).
Results: Seventeen patients were identified. Both ITP and SCS were associated with significant decreases in pain ratings at the 3-month follow-up, but this decrease became nonsignificant subsequently. ITP, but not SCS, was associated with a significant decrease in MEQ.
Conclusions: ITP and SCS may both provide efficacy for cancer pain, but the opioid-sparing effects of SCS may be limited. ITP and SCS may potentially be complementary in their ability to provide relief from cancer-related pain.
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http://dx.doi.org/10.1089/pmr.2023.0089 | DOI Listing |
Nat Commun
December 2024
Department of Biochemistry, Duke University School of Medicine, Durham, NC, 27710, USA.
The current opioid crisis urgently calls for developing non-addictive pain medications. Progress has been slow, highlighting the need to uncover targets with unique mechanisms of action. Extracellular adenosine alleviates pain by activating the adenosine A1 receptor (A1R).
View Article and Find Full Text PDFArch Pharm (Weinheim)
January 2025
European Institute for Molecular Imaging (EIMI), University of Muenster, Muenster, Germany.
The P2X4 receptor (P2X4R), a ligand-gated ion channel activated by ATP, plays a critical role in neuroinflammation, chronic pain, and cancer progression, making it a promising therapeutic target. In this study, we explored the design and synthesis of piperazine-based P2X4R antagonists, building on the structural framework of paroxetine. A series of over 35 compounds were synthesized to investigate structure-activity relationships (SARs) in a Ca²⁺-flux assay for P2X4R antagonistic activity.
View Article and Find Full Text PDFFront Oncol
December 2024
Department of Oncology, Guang'anmen Hospital Jinan Hospital (Jinan Hospital of Traditional Chinese Medicine), Jinan, China.
Malignant ascites (MA), a common and serious complication of various cancers in the abdominal cavity, originates from the extensive infiltration, metastasis, and growth of cancer cells in or on the abdominal cavity, leading to abnormal accumulation of fluid in the abdominal cavity and the formation of MA. MA seriously reduces the quality of life of cancer patients, shortens their survival period, and generally has a poor prognosis. Modern medicine has developed various strategies for the treatment of MA, including targeted supportive treatment, diuretic treatment, abdominal paracentesis, surgical intervention, and intraperitoneal administration therapy.
View Article and Find Full Text PDFFront Cardiovasc Med
December 2024
Division of Hematology-Oncology, Department of Medicine, Tufts Medical Center, Boston, MA, United States.
Background: A 63-year-old Black woman presented with progressive exertional dyspnea and chronic lower back pain. The course and findings in her case are instructive.
Case Report: Family history was notable for cardiac deaths.
J Cardiothorac Surg
December 2024
Izmir Faculty of Medicine, Department of Thoracic Surgery, University of Health Sciences Turkey, Izmir, Turkey.
Background: Intrapericardial pneumonectomy is a complex procedure indicated for large lung tumors where safe dissection of major vascular structures outside the pericardium is unfeasible or when the pericardium itself is invaded. Traditionally managed via open thoracotomy, recent advancements in VATS techniques now allow for intrapericardial pneumonectomy even in cases with extensive tumors or locally advanced disease. In this article, we detail the clinical outcomes and surgical considerations of six patients with non-small cell lung cancer who underwent VATS intrapericardial pneumonectomy.
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