Efficacy and safety of 5% lidocaine-medicated plasters in localized pain with neuropathic and/or inflammatory characteristics: an observational, real-world study.

OBJECTIVE: Based on clinical study results, 5% lidocaine-medicated plaster (5% LMP) is currently recommended for the treatment of localized peripheral neuropathic pain, such as post-herpetic neuralgia (PHN). However, its effective action, as well as the high safety, have indeed led to its use in clinical practice for pain conditions with similar pathophysiological mechanisms. In this study, the efficacy and safety of 5% LMP were investigated in patients with localized pain with neuropathic and/or inflammatory characteristics, such as PHN, post-traumatic/surgical or musculoskeletal pain. PATIENTS AND METHODS: 503 patients with localized pain treated with 5% LMP were evaluated at baseline (T0), after 30 days (T30) and after 60 days (T60). The primary endpoint was number and proportion of 30% responders at T60, whereas secondary endpoints included number and proportion of 30% responders at T30, mean pain intensity, mean extension of the painful area, dynamic mechanical allodynia and quality of sleep. Evaluations were assessed in all patients and subgroups based on different clinical entities. Concomitant treatments and adverse reactions were also recorded. RESULTS: 72% and 90% of all patients responded to 5% LMP treatment at T30 and T60, respectively. Comparable results were also obtained in subgroups such as PHN patients (72% and 68% at T30 and T60, respectively), and musculoskeletal pain (73% and 83% at T30 and T60, respectively). The mean pain intensity, as well as the extension of the painful area, significantly decreased during the study, in all patients and each subgroup. In addition, secondary endpoints significantly improved at each time-point compared with baseline, in all groups. CONCLUSIONS: The effectiveness and safety of 5% LMP were shown in localized pain conditions such as neuropathic and, importantly, in musculoskeletal pain, a condition never investigated with this product. This field-practice study suggests that topical pain-reducing strategies such as 5% LMP could be effective in neuropathic and/or inflammatory, localized pain conditions.

TSF, RBP and TBPA as nutritional indices in surgical patients with gynecological cancer.

The Authors investigated the usefulness of some biochemical markers of visceral protein synthesis (TSF, TBPA and RBP) in 24 patients affected with gynecological cancer and treated with Total Parenteral Nutrition in the perioperative period. The absence of an improving TSF and TBPA is related to increased morbidity and mortality.

[Post-traumatic constrictive pericarditis with fast course]. / Péricardite constrictive posttraumatique à évolution rapide.

A case is reported of a 46-year-old male patient who sustained a blunt thoracic injury with an anterior flail chest, and right haemopneumothorax. He was intubated and ventilated because of acute respiratory failure. There were initially no signs suggesting any myocardial injury. It was not before day 20 that the electrocardiogram showed a QS wave in leads V2 and V3. The hypothesis of an antero-septal myocardial infarct was not confirmed by echocardiography, which only revealed slight thickening of the posterior pericardium. From day 50 on, the patient had tachycardia, raised jugular venous pressure, and effort dyspnoea. Echocardiography (day 59) showed an anterior and posterior pericardial effusion (about 500 ml), marked pericardial thickening, and inferior vena caval collapse during inspiration, with normal myocardial wall movements. Drainage pericardiocentesis was therefore carried out, followed by, four days later, a pericardiectomy. A small ecchymosis was found on the anterior aspect of the right ventricle. The pericardium was thickened, fibrous, hyperhaemic, Case is y stuck to the epicardium. Eight months later, echocardiography showed that the posterior pericardium remained thickened, and there was a very small residual effusion. Movements of the septum had returned to normal.