Current medical research and opinion
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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.
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The aim of this exploratory study was to assess the conversion ratios between tapentadol and other opioids in patients requiring an opioid switching. ⋯ Data suggest that a conversion ratio between tapentadol and other opioids, expressed in oral morphine equivalents could be 1:3.3 in both direction, particularly in patients who are switched in conditions of equianalgesia. The limited number of patients prevents a definitive conclusion to be drawn, and data should be interpreted with caution, given the exploratory nature of the study and the question of the low number of patients should be addressed in future studies.
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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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This study compared progression, progression-free survival (PFS), overall survival (OS), and treatment changes among chronic myelogenous leukemia patients in chronic phase (CML-CP) receiving nilotinib or dasatinib as second-line therapy. ⋯ Among CML-CP patients in this retrospective chart review who switched from imatinib to either nilotinib or dasatinib, nilotinib was associated with a significantly lower risk of progression and longer PFS than dasatinib. Nilotinib patients were also less likely than dasatinib patients to subsequently have treatment changes due to ineffectiveness or drug holidays due to intolerance. These findings could be subject to unobserved confounders.