The prevalence of episodic pain in cancer: a survey of hospice patients on admission.

Pain that varies with time, referred to here as episodic pain, is a commonly encountered but under-investigated clinical problem. Previous studies of cancer patients have found that a significant proportion of their pains are episodic. To establish the prevalence and characteristics of episodic pains in hospice in-patients we assessed 245 consecutive admissions to four hospices in Yorkshire. The admitting doctor completed a questionnaire, detailing the characteristics of all pains experienced by the patient in the previous 24 h. Two hundred and forty-two questionnaires were entered into the study. One hundred and thirty-two patients reported pain in the preceding 24 h, of these 93% had at least one episodic pain. In total, 228 pains were described, of which 211 were episodic with a wide variation in their temporal characteristics, intensities and limitation. One hundred and fifty-two episodic pains had a precipitating factor; movement and weight bearing being the most frequent precipitants. One hundred and sixty-eight episodic pains had a relieving factor, medication improving 54%. Ninety-five pains were related to the malignancy and 47 to concurrent illness. The study confirms that episodic pain is extremely common in cancer patients referred for in-patient hospice care and highlights the need for further evaluation of its management.

Macroscopic ionic currents within the human leg.

Recent research on developing and healing tissues suggests that small quasi-DC ionic currents (of magnitude 10-20 microA) may play a controlling role in the initiation and organisation of growing tissues, but the difficulties of measuring such small currents have led to confusing results. Sensitive magnetometry provides a method of demonstrating and, to some extent, locating such currents. A SQUID magnetometer system has been built and used to investigate the magnetic fields around the uninjured human leg. Analysis of the magnetic fields reveals the presence of slowly changing macroscopic current loops (of magnitude up to 12 microA) within the leg. These currents are broadly similar in all subjects, and show day-to-day reproducibility in individuals. They change predictably with time of muscle relaxation (over an hour), and revert to the original form on muscular exertion. These currents are of significance when considering the therapeutic use of injected current for the healing of non-union in bone.