Leveraging the Sensitivity of Plants with Deep Learning to Recognize Human Emotions.

Recent advances in artificial intelligence combined with behavioral sciences have led to the development of cutting-edge tools for recognizing human emotions based on text, video, audio, and physiological data. However, these data sources are expensive, intrusive, and regulated, unlike plants, which have been shown to be sensitive to human steps and sounds. A methodology to use plants as human emotion detectors is proposed. Electrical signals from plants were tracked and labeled based on video data. The labeled data were then used for classification., and the MLP, biLSTM, MFCC-CNN, MFCC-ResNet, Random Forest, 1-Dimensional CNN, and biLSTM (without windowing) models were set using a grid search algorithm with cross-validation. Finally, the best-parameterized models were trained and used on the test set for classification. The performance of this methodology was measured via a case study with 54 participants who were watching an emotionally charged video; as ground truth, their facial emotions were simultaneously measured using facial emotion analysis. The Random Forest model shows the best performance, particularly in recognizing high-arousal emotions, achieving an overall weighted accuracy of 55.2% and demonstrating high weighted recall in emotions such as fear (61.0%) and happiness (60.4%). The MFCC-ResNet model offers decently balanced results, with AccuracyMFCC-ResNet=0.318 and RecallMFCC-ResNet=0.324. Regarding the MFCC-ResNet model, fear and anger were recognized with 75% and 50% recall, respectively. Thus, using plants as an emotion recognition tool seems worth investigating, addressing both cost and privacy concerns.

Effect of carboplatin when administered after dacarbazine failure: Clinical benefit of sequential therapy.

Dacarbazine chemotherapy has been the mainstay of melanoma treatment for >30 years. In the early 2000s, carboplatin (with or without other agents, such as paclitaxel) was the most commonly used second-line therapy in the UK. The aim of the present study was to report a significant response rate to second-line carboplatin in patients from three UK institutions who had been previously treated and failed to respond to dacarbazine, and investigate whether sequential therapy may be more effective compared with combination therapy. A total of 104 patients were identified, the majority of whom were treated with carboplatin (area under the curve 5-6) every 3 weeks for a maximum of 6 cycles. A total of 102 patients were evaluable for response, among whom 11 patients had an objective response (1 complete response and 10 partial responses) and 15 had stable disease, giving an overall response rate of 11% and disease control rate of 26%. The median progression-free survival was 1.8 months (range, 0.2-36+ months) and the median overall survival was 4.6 months (range, 0.2-36+ months). Surprisingly, the majority of the patients who benefited from second-line carboplatin therapy were those with visceral metastases, the survival of whom would not be expected to exceed 6 months after first-line treatment.

Maximal-Effort Cytoreductive Surgery for Ovarian Cancer Patients with a High Tumor Burden: Variations in Practice and Impact on Outcome.

BACKGROUND: This study aimed to compare the outcomes of two distinct patient populations treated within two neighboring UK cancer centers (A and B) for advanced epithelial ovarian cancer (EOC). METHODS: A retrospective analysis of all new stages 3 and 4 EOC patients treated between January 2013 and December 2014 was performed. The Mayo Clinic surgical complexity score (SCS) was applied. Cox regression analysis identified the impact of treatment methods on survival. RESULTS: The study identified 249 patients (127 at center A and 122 in centre B) without significant differences in International Federation of Gynecology and Obstetrics (FIGO) stage (FIGO 4, 29.7% at centers A and B), Eastern Cooperative Oncology Group (ECOG) performance status (ECOG < 2, 89.9% at centers A and B), or histology (serous type in 84.1% at centers A and B). The patients at center A were more likely to undergo surgery (87% vs 59.8%; p < 0.001). The types of chemotherapy and the patients receiving palliative treatment alone were equivalent between the two centers (3.6%). The median SCS was significantly higher at center A (9 vs 2; p < 0.001) with greater tumor burden (9 vs 6 abdominal fields involved; p < 0.001), longer median operation times (285 vs 155 min; p < 0.001), and longer hospital stays (9 vs 6 days; p < 0.001), but surgical morbidity and mortality were equivalent. The independent predictors of reduced overall survival (OS) were non-serous histology (hazard ratio [HR], 1.6; 95% confidence interval [CI] 1.04-2.61), ECOG higher than 2 (HR, 1.9; 95% CI 1.15-3.13), and palliation alone (HR, 3.43; 95% CI 1.51-7.81). Cytoreduction, of any timing, had an independent protective impact on OS compared with chemotherapy alone (HR, 0.31 for interval surgery and 0.39 for primary surgery), even after adjustment for other prognostic factors. CONCLUSIONS: Incorporating surgery into the initial EOC management, even for those patients with a greater tumor burden and more disseminated disease, may require more complex procedures and more resources in terms of theater time and hospital stay, but seems to be associated with a significant prolongation of the patients overall survival compared with chemotherapy alone.

Electronic Devices That Identify Individuals with Fever in Crowded Places: A Prototype.

Most epidemiological surveillance systems for severe infections with epidemic potential are based on accumulated symptomatic cases in defined geographical areas. Eventually, all cases have to be clinically verified to confirm an outbreak. These patients will present high fever at the early stages of the disease. Here, we introduce a non-invasive low-cost electronic device (bracelet) that measures and reports 24/7, year-round information on the temperature, geographical location, and identification of the subject using the device. The data receiver can be installed in a tower (ground) or a drone (air) in densely populated or remote areas. The prototype was made with low-cost electronic components, and it was tested indoors and outdoors. The prototype shows efficient ground and air connectivity. This electronic device will allow health professionals to monitor the prevalence of fever in a geographical area and to reduce the time span between the presentation of the first cases of a potential outbreak and their medical evaluation by giving an early warning. Field tests of the device, programs, and technical diagrams of the prototype are available as Supplementary Materials.

Real Time Monitoring of Children, and Adults with Mental Disabilities Using a Low-Cost Non-Invasive Electronic Device.

There are a growing number of small children-as well as adults-with mental disabilities (including elderly citizens with Alzheimer's disease or other forms of age-related dementia) that are getting lost in rural and urban areas for various reasons. Establishing their location within the first 72 h is crucial because lost people are exposed to all kinds of adverse conditions and in the case of the elderly, this is further aggravated if prescribed medication is needed. Herein we describe a non-invasive, low-cost electronic device that operates constantly, keeping track of time, the geographical location and the identification of the subject using it. The prototype was made using commercial low-cost electronic components. This electronic device shows high connectivity in open and closed areas and identifies the geographical location of a lost subject. We freely provide the software and technical diagrams of the prototypes.

Surgical Reconstruction for Talocalcaneal Coalitions With Severe Hindfoot Valgus Deformity.

INTRODUCTION: Coalition resection can restore motion, and improve pain in patients with talocalcaneal coalitions (TCCs) and an aligned foot. However, there is some debate regarding appropriate treatment of patients with associated valgus deformity. The purpose of this study was to present the outcomes and complications following surgical reconstruction, with or without coalition resection, in a series of patients with TCC and severe hindfoot valgus. METHODS: Thirteen consecutive patients (14 feet) were evaluated. Eleven patients were male. Mean age was 14 years. Mean follow-up was 43.8 months. Seven patients (8 feet) underwent simultaneous resection of the coalition and reconstruction, and 6 patients (6 feet) isolated reconstruction. The talar-first metatarsal angle, the talar-horizontal angle, and calcaneal pitch were measured preoperatively and postoperatively. Clinical evaluation was made according to the American Orthopaedic Foot and Ankle Society ankle-hindfoot score. RESULTS: All radiographic values improved significantly and were within the normal ranges postoperatively. The average American Orthopaedic Foot and Ankle Society ankle-hindfoot score had improved from 45 to 98 points (P<0.001) in the group of simultaneous resection and reconstruction, and from 60 to 92.3 points (P=0.002) in the group of isolated reconstruction. All patients were asymptomatic at the last follow-up and were satisfied with the procedure. DISCUSSION: Surgical reconstruction with or without coalition resection can achieve significant functional and radiographic improvements, and symptoms relief in selected patients with TCCs and severe valgus deformity. LEVEL OF EVIDENCE: Level IV-therapeutic study.

Eficacia predictiva de la resonancia magnética nuclear para diagnosticar el patrón de las lesiones completas del manguito rotador / Accuracy of magnetic resonance imaging to diagnose tear pattern of complete rotator cuff lesions

Introducción: la RMN ha demostrado influir significativamente en el diagnóstico del patrón de las lesiones completas del manguito rotador con una elevada sensibilidad y especificidad siendo el método complementario más utilizado. Nuestro objetivo es determinar la eficacia diagnóstica, y la variabilidad interobservador de la RMN para diagnosticar la forma de las lesiones completas del manguito rotador. Materiales y métodos: Se evaluaron 33 RMN de pacientes con rupturas completas de manguito rotador de manera prospectiva. Los patrones de lesiones analizados fueron crescéntica, L anterior, L posterior, lesión en U y masiva retraída. Dos especialistas en cirugía de hombro (O1 y O2) y el fellow de último año (O3) analizaron las RMN en días previos a la cirugía. Se utilizo el diagnostico artroscópico como gold standard y se calculó la concordancia entre las imágenes y la artroscopia con el índice kappa. Resultados: Para el diagnóstico del patrón de lesión obtuvo una concordancia excelente el O1, moderada el O3 y buena el O2. La ruptura crescéntica fue la mejor diagnosticada por los 3 observadores Conclusión: La RMN tiene una elevada sensibilidad y especificidad para el diagnóstico de los patrones de ruptura de manguito rotador teniendo relación con la experiencia de los observadores. Tipo de estudio: Prospectivo. Nivel de evidencia: I.

Introduction: MRI has been shown to have a significant influence on the diagnosis of complete rotator cuff tear pattern with an improved sensitivity and specificity being the most useful complementary method. Our purpose is to determine the accuracy and the interobserver variability of MRI to diagnose tear pattern of complete rotator cuff lesion. Methods: 33 patients MRI with complete rotator cuff tear were evaluated prospectively. The pattern lesions analyzed were crescent, anterior and posterior L shape tears, U pattern and massive tears. Two shoulder surgeons (O1 y O2) and one shoulder fellow (O3) analyzed the MRI´s days previous to surgery. The arthroscopic diagnosis was used as gold standard and the concordance between the images and arthroscopy was calculated with kappa index. Results: The concordance was excellent for observer 1, moderate for observer 3 and good for the observer 2 for the diagnosis of rotator cuff tear pattern. The crescent tear was the best diagnosed by the three observers. Conclusion: MRI has high sensitivity and specificity for the diagnosis of rotator cutt tear pattern in relation to the experience of the observers. Type of Study: Prospective. Level of Evidence: I.

Tratamiento artroscopico en condromatosis sinovial primaria de hombro y corredera bicipital. reporte de un caso / Arthroscopic treatment for synovial chondromatosis of the shoulder. case report

La condromatosis sinovial es una entidad patológica poco frecuente donde se desarrollan cuerpos de aspectos cartilaginosos a partir de la membrana sinovial de articulaciones, bursas o vainas tendinosas, generando cuerpos libres productores de la sintomatología. Presentamos un caso de 16 años que consulta con dolor de hombro derecho, progresivo sin antecedente de trauma previo, de 3 años de evolución. Se realizan estudios imagenológicos correspondientes llegando a la conclusión diagnostica de condromatosis sinovial de hombro. Se realiza el tratamiento quirúrgico definitivo por artroscopía, logrando remisión de los síntomas y evolución favorable sin recidiva hasta los 5 años de evolucion.

Synovial chondromatosis is a rare pathological entity where cartilaginous aspects develop from the synovial membrane of joints, bursae or tendinous sheaths, generating free bodies that produce symptoms. We present a 16-year-old male with 3 years of right shoulder pain, progressive with not previous trauma. Imaging studies are carried out, arriving at the diagnostic of synovial chondromatosis of the shoulder. The final surgical treatment is performed by arthroscopy, achieving remission of symptoms and favorable evolution without recurrence until 5 years of evolution.

Current controversies in the management of germ cell ovarian tumours.

PURPOSE OF REVIEW: Fewer than 70 new cases of malignant ovarian germ cell tumours (MOGCTs) are seen each year in the UK. Because of their rarity, no randomized trials have been reported and many of the advances in management have arisen from adopting practices developed for managing male germ cell tumours (GCTs). Not surprisingly, there have been few important publications related to ovarian germ cell tumuors over the past 2 years. We have therefore included some relevant male germ cell publications. The area in which there is greatest variability in practice globally is in the proportion of patients with stage 1a disease who go on surveillance rather than receiving adjuvant chemotherapy. Although there is increasing agreement about the best management of ovarian GCTs amongst those who treat more than five per year, many patients are still treated by doctors who usually manage epithelial ovarian cancer but rarely see these patients. RECENT FINDINGS: Novel biomarkers including microRNA profiles and DICER1 mutations, identify potential diagnostic and therapeutic targets in this group of tumours. The role of KIT mutation and amplification in the development of ovarian dysgerminoma and the use of Sunitinib, a receptor tyrosine kinase inhibitor with an effect on vascular endothelial growth factor, platelet-derived growth factor and KIT receptors in patients with platinum-resistant GCT, are novel promising approaches. SUMMARY: We will therefore highlight some key differences in management of epithelial and germ cell ovarian tumours.

Nonsurgical therapy of biliary tract cancer.

PURPOSE OF REVIEW: The management of biliary tract cancers (BTCs) has been challenging partly because of the lack of robust data to define a treatment standard. This in turn has been because of the difficulty in conducting large clinical studies in an uncommon cancer, as well as managing elderly and unwell patients. RECENT FINDINGS: Recent data and improvements in multidisciplinary patient management have established a standard of care and delivered insights into the natural history of this uncommon cancer. This is critical at a time when the incidence of this malignancy is increasing. This article describes the improving multidisciplinary management as well as seminal randomized data describing standard management. Current clinical trials that are likely to further impact on future management are described. SUMMARY: These large datasets provide insights into the natural history of BTCs hitherto not forthcoming from the many smaller studies which formed the historical evidence base. This increasing standardization of care will improve outcome for patients with BTCs and provide a platform for further research.

Pneumomediastinum and pneumothorax as presenting signs in severe Mycoplasma pneumoniae pneumonia.

We present a 3-year-old child with severe extensive Mycoplasma pneumoniae pneumonia complicated with pneumomediastinum and pneumothorax. Pneumothorax and pneumomediastinum have only exceptionally been described in mild cases of the disease. The radiological findings, differential diagnosis and clinical course are discussed.

[Prevalence of white-coat hypertension and masked hypertension in the general population, through home blood pressure measurement]. / Prevalencia de la hipertensión de bata blanca e hipertensión enmascarada en la población general, mediante automedición domiciliaria de la presión arterial.

OBJECTIVE: To determine the prevalence of white-coat hypertension (WCH) and masked hypertension (MH) in the general population, by means of home blood pressure measurement (HBPM). DESIGN: Cross-sectional, descriptive study. SETTING: Four primary care centres. PARTICIPANTS: A sample of 1400 individuals over 18 years old, selected from the Municipal Register of Inhabitants (Huelva, Spain) and randomised and stratified by age and gender. MAIN MEASUREMENTS: Two blood pressure (BP) measurements in clinic (CBP) and 12 measurements in a week of BP by HBPM were performed (OMRON 705-CP). Pressure was seen as normal when CBP means were <140/90 mm Hg and HBPM was <135/85 mm Hg. WCH was defined as when CBP was >140/90 mm Hg and HBPM <135/85 mm Hg, and hypertension when CBP was >140 mm Hg and HBPM >135/85 mm Hg or patients were in treatment for hypertension. MH was when CBP was <140/90 mm Hg and at home was >135 mm Hg and/or 85 mm Hg. RESULTS: A total of 1153 individuals (82.35% of the sample) with mean age of 45.4 (SD, 16.1) were included: 560 men and 593 women. The prevalence of MH was 8.9% (CI+/-1.6) in the general population and 9.8% (CI+/-3.2) in individuals with hypertension. WCH prevalence was 3.6% (CI+/-1.05) overall and 12.8% (CI+/-3.6) in hypertense patients, with its prevalence increasing steadily as age groups rose (P = .001). CONCLUSIONS: The prevalence of WCH in the general population is low, whereas the prevalence of MH is high.

Prevalencia de la hipertensión de bata blanca e hipertensión enmascarada en la población general, mediante automedición domiciliaria de la presión arterial / Prevalence of white-coat hypertension and masked hypertension in the general population, through home blood pressure measurement

Objetivo. Determinar la prevalencia de hipertensión de bata blanca (HBB) e hipertensión enmascarada (HE) en población general, mediante automedición de presión arterial (AMPA) en la consulta y el domicilio. Diseño. Estudio descriptivo, transversal, multicéntrico y aleatorizado. Emplazamiento. Cuatro centros de atención primaria. Participantes. Se seleccionó, mediante muestreo aleatorio estratificado por edad y sexo, una muestra de 1.400 individuos > 18 años del Padrón Municipal de Habitantes (Huelva). Mediciones principales. Fueron citados en sus centros de salud, realizándose 2 mediciones de presión arterial (PA) en consulta y 12 mediciones domiciliarias durante una semana mediante AMPA (OMRON 705-CP). Se consideró normotensión cuando las PA medias en consulta eran 140 y/o > 90 mmHg en la consulta y 135 y/o 85 mmHg. Resultados. Se incluyó a 1.153 individuos (82,35% de la muestra), con una edad media de 45,4 ± 16,1 años, 560 varones y 593 mujeres. La HE fue del 8,9% (IC ± 1,6%) globalmente y del 9,8% (IC ± 3,2) de los hipertensos. Había HBB en el 3,6% (IC ± 1,05) globalmente y el 12,8 % (IC ± 3,6) de los hipertensos, y su prevalencia aumentó progresivamente al incrementar los grupos de edad (p = 0,001). Conclusiones. La prevalencia de HBB en la población general es baja, mientras que la de HE es elevada

Objective. To determine the prevalence of white-coat hypertension (WCH) and masked hypertension (MH) in the general population, by means of home blood pressure measurement (HBPM). Design. Cross-sectional, descriptive study. Setting. Four primary care centres. Participants. A sample of 1400 individuals over 18 years old, selected from the Municipal Register of Inhabitants (Huelva, Spain) and randomised and stratified by age and gender. Main measurements. Two blood pressure (BP) measurements in clinic (CBP) and 12 measurements in a week of BP by HBPM were performed (OMRON 705-CP). Pressure was seen as normal when CBP means were 140/90 mm Hg and HBPM 140 mm Hg and HBPM >135/85 mm Hg or patients were in treatment for hypertension. MH was when CBP was 135 mm Hg and/or 85 mm Hg. Results. A total of 1153 individuals (82.35% of the sample) with mean age of 45.4 (SD, 16.1) were included: 560 men and 593 women. The prevalence of MH was 8.9% (CI±1.6) in the general population and 9.8% (CI±3.2) in individuals with hypertension. WCH prevalence was 3.6% (CI±1.05) overall and 12.8% (CI±3.6) in hypertense patients, with its prevalence increasing steadily as age groups rose (P=.001). Conclusions. The prevalence of WCH in the general population is low, whereas the prevalence of MH is high

Tratamiento del dolor neuropático de origen neoplásico con topiramato / Treatment of neuropathic pain of neoplastic origin with topiramte

El dolor neuropático está causado por una lesión o disfunción del sistema nervioso. La fisiopatología es muy compleja y representa el intento del sistema nervioso de reestablecer las propiedades que han sido alteradas. Existen muchas similitudes entre los fenómenos fisiopatológicos observados en algunos modelos de epilepsia y los modelos de dolor neuropático. Esto justificaría la utilización de fármacos antiepilépticos en el tratamiento sintomático del dolor neuropático. Objetivos: valorar la efectividad del topiramato en 4 pacientes con dolor neuropático de origen oncológico. Métodos: estudio prospectivo de 4 pacientes afectos de dolor neuropático de causa oncológica tratados con topiramato. Se registró la edad, sexo, diagnóstico, topografía del dolor, tiempo de duración del dolor, EVA inicial y EVA final, dosis media y efectos secundarios. Resultados: se revisaron los datos de 4 pacientes, 3 hombres y 1 mujer. La edad media fue de 68,7 años (rango 65-73). Todos estaban siendo tratados con analgésicos opioides mayores, AINE y adyuvantes (antiepilépticos, antidepresivos y corticoides). El tiempo medio con dolor fue de11 meses (rango 4-15). El diagnóstico fue de 1 paciente con neoplasia de pulmón con plexopatía braquial, 1 paciente con neoplasia de mama con plexopatía braquial, 1 paciente con neoplasia de vejiga con infiltración de plexo sacro y 1 paciente con neoplasia de recto con plexopatía sacra. La localización del dolor era perineal en 2 pacientes y extremidad superior derecha en 1 paciente y extremidad superior izquierda y cervical en 1paciente. La EVA inicial media fue de 87,5/100 (rango 70-100/100). La EVA final media fue de 17,5/100 (rango 0-40/100). En 1 paciente (25%) se observó una desaparición total del dolor, 2 pacientes (50%) mostraron una mejoría superior al 75% y 1 (25%) paciente una mejoría superior al 50%. La dosis media de topiramato fue de 200 mg/día (rango 100-300). Se observaron efectos secundarios en 2 pacientes: somnolencia en ambos que no obligó a retirar el fármaco y que fue desapareciendo progresivamente. Conclusión: el topiramato es una buena opción en el tratamiento de pacientes con dolor neuropático de origen oncológico, con una buena efectividad y efectos secundarios tolerables (AU)

Neuropathic pain is originated by a nervous system lesion or dysfunction. Pathophysiology is quite complex and it is an attempt of nervous system to restablish the altered properties. There are so many agreements between the physiopathological phenomena that have been found in some epilepsy models and the neuropathic pain models. This issue would warrant the antiepileptical drugs use in the symptomatic therapy of the neuropathic pain. Aims: to assess the topiramate efficacy in four patients with oncological origin neuropathic pain. Methods: this is a prospective study of 4 patients that suffered from oncological neuropathic pain and they were treated with topiramate. Age, gender, diagnosis, pain location, lasting of pain, baseline and final EVA score, mean drug dose and side-effects were all registered. Results: data from all 4 patients (3 men and a woman) were reviewed.The mean age was 68.7 years (range 65-73). All of them were treated with major opioid analgesics, NSAID and others (antiepileptics, antidepressants and steroids). The mean time with pain was 11 months (range 4-15). The diagnosis included 1 patient with lung cancer with brachial plexopathy, 1patient suffering from breast cancer and brachial plexopathy, 1 patien twith bladder carcinoma with sacral plexus infiltration and, finally, a patient with rectal neoplasia with sacral plexopathy. The pain location was in perineum in 2 patients, and right upper limb in 1 patient and left upper limb and cervical en the remaining one. The mean baseline EVA score was 87.5 (range 70-100/100). The mean final score was 17.5 (range 0-40/100). The pain totally disappeared in one patient, 2 patients showed an improvement higher than 75% and the remaining patient demonstrated an improvement higher than 50%. The topiramate mean dose was 200mg/day (range 100-300). Side-effects were found in two patients that presented drowsiness. However, the drug administration was not discontinued and the side-effect disappeared progressively. Conclusions: topiramate is a good option in the treatment of patients with neuropathic pain from oncological origin with a good efficacy and tolerable side-effects (AU)

Tratamiento del dolor oncológico irruptivo con citrato de fentanilo transmucosa oral / Treatment of breakthrough cancer pain with oral transmucosal fentanyl citrate

El dolor oncológico está insuficientemente tratado y su incidencia suele aumentar a medida que progresa la enfermedad, oscilando entre el75 a 80% en los pacientes con enfermedad avanzada. Se presenta como un dolor persistente que puede controlarse con una pauta analgésica establecida y un dolor irruptivo que precisa dosis de rescate de analgésicos. El citrato de fentanilo transmucosa oral es un opioide agonista puro que se presenta en forma de matriz edulcorada que se disuelve en la boca liberando su contenido con una absorción inmediata a través de la mucosa oral. Objetivos: evaluar los efectos del tratamiento con citrato de fentanilo transmucosa oral (CFTO) en 8 pacientes con dolor irruptivo oncológico. Métodos: revisión retrospectiva de 8 pacientes afectos de dolor oncológico con crisis de dolor irruptivo tratadas con CFTO. Se registraron la edad, sexo, diagnóstico, EVA basal, tratamiento opioide de base y dosis, medicación concomitante, número de crisis de dolor irruptivo durante 3 días (1 por semana), EVA inicial y final de las crisis, dosis de CFTO, tiempo de alivio del dolor, efectos secundarios, valoración del tratamiento en cuanto a efectividad y tolerabilidad por parte del paciente. Resultados: se incluyeron en el estudio 8 pacientes, 5 mujeres y 3 hombres. La edad media fue de 58,5 años (rango: 38-74). Todos estaban siendo tratados con fentanilo transdérmico de base con una dosis media de 93,75 µg/hora (rango: 50-200). La EVA basal media fue de 31/100 (rango: 20-40/100). El número total de crisis de dolor irruptivo fue de 27 con una media de 3,3 por paciente (rango: 2-5). La EVA inicial media fue de 80/100 (rango: 60-100/100). La EVA final media fue de 10/100 (rango: 0-30/100). De los 27 episodios de dolor irruptivo registrados, en 5 (18,5%) se obtuvo un alivio total del dolor, en 20 (74,07%) se obtuvo un alivio del dolor superioral 75%, y en 2 (7,4%) un alivio del dolor superior al 50%. La dosis media de CFTO fue de 325 µg (rango: 200-600). Tres pacientes presentaron efectos secundarios (somnolencia en 2 pacientes, xerostomía y estreñimiento en 1 paciente). La valoración del tratamiento en cuanto a efectividad fue: buena en 5 pacientes y excelente en 3 pacientes, y en cuanto a tolerabilidad fue: buena en 5 pacientes y excelente en 3 pacientes. Conclusión: el CFTO es un buen fármaco para el tratamiento del dolor irruptivo de origen oncológico, con una muy buena efectividad y tolerabilidad (AU)

Cancer pain is generally poorly controlled and its incidence usually increases with illness; it varies among 75-80% in patients with advanced illness. It features as a persistent pain that could be controlled with an usual analgesic therapy and an incidental pain that need a salvage analgesic treatment. The oral transmucosal fentanyl citrate is a pure opioid agonist. Its presentation is an edulcorate matrix that dissolves in mouth with an immediate absorption. Aims: to assess the effects of the therapy with oral transmucosal fentanylcitrate (OTFC) in eight patients with breakthrough cancer pain. Methods: this is a retrospective study of 8 patients with cancer pain with episodes of incidental pain treated with OTFC. Age, gender, diagnosis, baseline VAS, baseline opioid therapy and dose, number of pain episodes during 3 days (once a week during 3 weeks), VAS at onset and at the end of the episode, OTFC doses, pain relief time, side effects, self assessment of effectiveness and tolerance by the patient were registered. Results: eight patients, five women and three men, were included in study. Mean age was 58.5 years (range 38-74). All patients were treated with transdermic fentanyl with a baseline dose of 93.75 µg/hour (range 50-200). The mean baseline VAS was 31/100 (range 20-40/100). The total number of episodes of incidental pain was 27, being the mean number foreach patient 3.3 (range 2-5). Mean VAS at onset was 80/100 (range 60-100/100). Mean VAS at the end of the study was 10/100 (range 0-30/100). Total pain relief was obtained in 5 cases out of 27 episodes of incidental pain (18.5%). The relief was higher than 75% in 20 cases (74.07%) and higher than 50% in 2 cases (7.4%). The mean dose of OTFC was 325 µg(range 200-600). Three patients reported side-effects (sedation in 2patients, xerostomy and constipation in 1 patient). The self assessment for effectiveness was as follows: good for 5 patients and excellent in 3 patients. The assessment for tolerance was good for 5 patients and excellent in 3 patients (AU)