Infectious Diseases Society of America.

http://academic.oup.com/milmed/article-pdf/146/7/506/24126715/milmed-146-7-506.pdf

Goodman and Gilman's The Pharmacological Basis of Therapeutics

This USPSTF recommendation on screening for prostate cancer considers evidence on the benefits and harms of prostate-specific antigen (PSA)–based screening for prostate cancer, as well as those of ...

/pdf/screening-for-prostate-cancer-u-s-preventive-services-task-1mzp6sktrg.pdf

Screening for Prostate Cancer: U.S. Preventive Services Task Force Recommendation Statement

https://behandelaar.pijnbijkanker.nl/sites/behandelaar.pijnbijkanker.nl/files/publicaties/van%20den%20Beuken%20et%20al.%20Prevalence%20cancer%20pain.%20Ann%20Oncol%202007.pdf

Prevalence of pain in patients with cancer: a systematic review of the past 40 years

Neuropathic pain is triggered by lesions to the somatosensory nervous system that alter its structure and function so that pain occurs spontaneously and responses to noxious and innocuous stimuli are pathologically amplified. The pain is an expression of maladaptive plasticity within the nociceptive system, a series of changes that constitute a neural disease state. Multiple alterations distributed widely across the nervous system contribute to complex pain phenotypes. These alterations include ectopic generation of action potentials, facilitation and disinhibition of synaptic transmission, loss of synaptic connectivity and formation of new synaptic circuits, and neuroimmune interactions. Although neural lesions are necessary, they are not sufficient to generate neuropathic pain; genetic polymorphisms, gender, and age all influence the risk of developing persistent pain. Treatment needs to move from merely suppressing symptoms to a disease-modifying strategy aimed at both preventing maladaptive plasticity and reducing intrinsic risk.

/pdf/neuropathic-pain-a-maladaptive-response-of-the-nervous-4p6rq7623l.pdf

Neuropathic Pain: A Maladaptive Response of the Nervous System to Damage

Until recently, research on the results of hernia surgery has focused mainly on recurrences. However, with the introduction of mesh techniques and presumably an increased awareness of the importance of systematic quality control, the recurrence rate has decreased dramatically.1 Hence, now that recurrences are no longer a pressing clinical problem, there has been a recent upsurge in interest in chronic pain as an adverse outcome. But the level of quantification of pain has often been limited in studies addressing the risk of long-term pain, and pain has sometimes been treated merely as a dichotomous (yes/no) phenomenon.2 As a result, the clinical and public health significance of reported prevalence rates of residual pain (ranging between 0% and 37%) remains uncertain.3

With the main purpose of evaluating long-term pain as an alternative endpoint in research on the outcome of hernia surgery, we used a validated pain questionnaire to investigate pain behavior rather than imaginary descriptors of pain intensity in an essentially population-based series of patients operated on 59 hospitals.

Risk Factors for Long-term Pain After Hernia Surgery

OBJECTIVE: To describe the characteristics of femoral hernias and outcome of femoral repairs, with special emphasis on emergency operations. BACKGROUND: Femoral hernias account for 2% to 4% of all ...

Emergency femoral hernia repair: a study based on a national register.

Objective To assess whether screening for prostate cancer reduces prostate cancer specific mortality. Design Population based randomised controlled trial. Setting Department of Urology, Norrkoping, and the South-East Region Prostate Cancer Register. Participants All men aged 50-69 in the city of Norrkoping, Sweden, identified in 1987 in the National Population Register (n=9026). Intervention From the study population, 1494 men were randomly allocated to be screened by including every sixth man from a list of dates of birth. These men were invited to be screened every third year from 1987 to 1996. On the first two occasions screening was done by digital rectal examination only. From 1993, this was combined with prostate specific antigen testing, with 4 µg/L as cut off. On the fourth occasion (1996), only men aged 69 or under at the time of the investigation were invited. Main outcome measures Data on tumour stage, grade, and treatment from the South East Region Prostate Cancer Register. Prostate cancer specific mortality up to 31 December 2008. Results In the four screenings from 1987 to 1996 attendance was 1161/1492 (78%), 957/1363 (70%), 895/1210 (74%), and 446/606 (74%), respectively. There were 85 cases (5.7%) of prostate cancer diagnosed in the screened group and 292 (3.9%) in the control group. The risk ratio for death from prostate cancer in the screening group was 1.16 (95% confidence interval 0.78 to 1.73). In a Cox proportional hazard analysis comparing prostate cancer specific survival in the control group with that in the screened group, the hazard ratio for death from prostate cancer was 1.23 (0.94 to 1.62; P=0.13). After adjustment for age at start of the study, the hazard ratio was 1.58 (1.06 to 2.36; P=0.024). Conclusions After 20 years of follow-up the rate of death from prostate cancer did not differ significantly between men in the screening group and those in the control group. Trial registration Current Controlled Trials, ISRCTN06342431.

https://www.bmj.com/content/bmj/342/bmj.d1539.full.pdf

Randomised prostate cancer screening trial: 20 year follow-up

BACKGROUND: Long-term pain is an important outcome after inguinal hernia repair. The aim of this study was to test the validity and reliability of a specific Inguinal Pain Questionnaire (IPQ). METHODS: The study recruited patients aged between 15 and 85 years who had undergone primary inguinal or femoral hernia repair. To test the validity of the questionnaire, 100 patients received the IPQ and the Brief Pain Inventory (BPI) 1 and 4 weeks after surgery (group 1). To test reliability and internal consistency, 100 patients received the IPQ on two occasions 1 month apart, 3 years after surgery (group 2). Non-surgery-related pain was analysed in group 3 (2853 patients). RESULTS: A significant decrease in IPQ-rated pain intensity was observed in the first 4 weeks after surgery (P < 0.001). Significant correlations with corresponding BPI pain intensity items corroborated the criterion validity (P < 0.050). Logical incoherence did not exceed 5.5 per cent for any item. Values for kappa in the test-retest in group 2 were higher than 0.5 for all but three items. Cronbach's alpha was 0.83 for questions on pain intensity and 0.74 for interference with daily activities. CONCLUSION: This study found good validity and reliability for the IPQ, making it a useful instrument for assessing pain following groin hernia repair.

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Validation of an Inguinal Pain Questionnaire for assessment of chronic pain after groin hernia repair

BackgroundDifficulties in obtaining and analysing outcome measures in hernia surgery may be an obstacle to necessary progress in non-specialized hospitals. Against this background a voluntary regis ...

Gabriel Sandblom

Papers

Risk Factors for Long-term Pain After Hernia Surgery

Emergency femoral hernia repair: a study based on a national register.

Randomised prostate cancer screening trial: 20 year follow-up

Validation of an Inguinal Pain Questionnaire for assessment of chronic pain after groin hernia repair

Methods of repair and risk for reoperation in Swedish hernia surgery from 1992 to 1996