Long-term efficacy and safety of combined prolonged-release oxycodone and naloxone in the management of non-cancer chronic pain.

OBJECTIVE: The aim of this study was to assess safety and efficacy of fixed combination oxycodone prolonged release (PR)/naloxone PR in terms of both analgesia and improving opioid-induced bowel dysfunction (OIBD) and associated symptoms, such as opioid-induced constipation (OIC), in adults with chronic non-cancer pain. STUDY DESIGN: These were open-label extension studies in which patients who had previously completed a 12-week, double-blind study received oxycodone PR/naloxone PR for up to 52 weeks. The analgesia study assessed pain using the modified Brief Pain Inventory-Short Form (BPI-SF). The bowel function study assessed improvements in constipation using the Bowel Function Index (BFI). RESULTS: At open-label baseline in the analgesia study (n = 379), mean score [+/- standard deviation (SD)] for the BPI-SF item 'average pain over the last 24 h' was 3.9 +/- 1.52, and this remained low at 6 months (3.7 +/- 1.59) and 12 months (3.8 +/- 1.72). Mean scores for BPI-SF item 'sleep interference', and the BPI-SF 'pain' and 'interference with activities' subscales also remained low throughout the 52-week study. In the bowel function study (n = 258), mean BFI score (+/- SD) decreased from 35.6 +/- 27.74 at the start of the extension study to 20.6 +/- 24.01 after 12 months of treatment with oxycodone PR/naloxone PR. Pain scores also remained low and stable during this study. Adverse events in both extension phases were consistent with those associated with opioid therapy; no additional safety concerns were observed. CONCLUSION: Results from these two open-label extension studies demonstrate the long-term efficacy and tolerability of fixed combination oxycodone PR/naloxone PR in the treatment of chronic pain. Patients experienced clinically relevant improvements in OIBD while receiving effective analgesic therapy.

[Indications for right-sided and total pancreatectomy]. / Unele indicatii ale pancreatectomiei drepte si totale.

The files were studied of 362 patients hospitalized in the Surgical Clinic from Tg. Mures in the last 20 years with various primary or secondary pancreatic affections, and for whom curative, palliative or exploratory surgery was indicated. Of the total 307 had pancreatic cancers, 16 had Vater ampulomas, 23 had gastric cancers, and 5 had primary duodenal tumours. In six patients pseudotumoral chronic pancreatitis was found, 2 had retroperitoneal tumours, and 3 had pancreatic cysts, lymphoma of the spleen, and mesenteric tumour. A total of 212 palliative surgical interventions were performed, 75 radical interventions (pancreatic reactions), and in another 75 patients simple laparotomies were done. In 45 of the pancreatic resections the duodenum was also removed. The other 30 cases included 6 total resections, 6 subtotal pancreatic resections and 18 resections of the left part of the pancreas.