DN4 questionnaire as a useful tool for evaluating the pharmacotherapeutic response to opioid pharmacotherapy in malignant neuropathy.

Objective: Tapentadol is a drug of choice for neuropathic cancer pain. DN4 questionnaire quickly determines neuropathic pain component. The aim of this study is to determine the correlation between neuropathic malignant pain component by applying tapentadol antidolorose pharmacotherapy in combination with palliative radiotherapy of osseous neuropathic metastatic changes in breast cancer patients before and after palliative radiotherapy. Methods: The first patients group comprised 30 patients with primary breast cancer and proved painful bone secondary deposits with neuropathy for which tapentadol was prescribed, and they underwent palliative radiotherapy. The second group comprised 30 patients with primary breast cancer and proved painful bone metastases with neuropathy treated only with palliative antidolorose radiotherapy. Key findings : After two-months-follow up, tapentadol group patients had lower DN4 score values (Z=2,021; p=0.043). Significantly lower number of tapentadol group patients was without neuropathic pain after a three-month-follow up (χ ²=5,711; p=0.017). Significantly greater number of tapentadol group patients had best ECOG score 0 ( χ² =7,486; p=0.023). There was statistically significant positive correlation between tapentadol dose and DN4 score in patients after a month (ρ=0,471; p=0.009) and three months after the radiotherapy completion (ρ=0,610; p<0.001). Tapentadol is an opioid analgesic efficient for neuropathy relief in these patients and DN4 questionnaire is an efficient pharmacotherapy tool.

Associations between neighbourhood street pattern, neighbourhood socioeconomic status and sleep in adults.

Sleep duration is a risk factor for poor health and all-cause mortality. Evidence suggests that neighbourhood characteristics such as built environment and socioeconomic status (SES) may affect sleep duration in adults. This study examined the relationship between neighbourhood built environment (i.e., measured via the street pattern) and SES with sleep duration in adults (n = 797) from 12 neighbourhoods in Calgary (Canada). Covariate adjusted linear and multinomial logistic regression models estimated the associations between street pattern (grid, warped-grid, curvilinear), SES and sleep duration. We also tested if the interaction between street pattern and SES was associated with sleep duration. Although neighbourhood street pattern and neighbourhood SES were not independently associated with sleep, the interaction between street pattern and neighbourhood SES, was associated with mean sleep duration. Individuals living in curvilinear low SES neighbourhoods had the shortest sleep duration (6.93 h per day; 95% CI 6.68, 7.18), while those living in curvilinear high SES neighbourhoods slept the longest (7.43 h per day; 95% CI 7.29, 7.57). Neighbourhood street pattern and SES, as well as their interaction, were not associated with the odds of sleeping shorter or longer than 7 to 8 h per day. Our findings suggest that the combined effect of the neighbourhood built environment and SES is potentially important for influencing sleep duration. More research is needed to understand the complex interrelationships between the built environment, SES, and sleep.

Choriocarcinoma--postdisease ultrasonographic findings.

This is a case report of consequences that malignant gestational trophoblastic disease (GTD) can cause on reproductive health protruding into uterine wall and damaging uterine tissue. Transvaginal Doppler ultrasound examination can be of great value in detecting molar tissue, protrusion of malignant trophoblast in uterine wall, and neovasularization in malignant tissue. It is expected to measure a low resistance index in a field of neovascularization, because neovascularization in malignancy is not rare and those vessels do not have muscular stratum. This case is an example of possible irreversible serious and large damages that can be seen after successful treatment of GTD. They are warning on possible high degree of malignancy in GTD as well as on possible serious impact on reproductive health.