We report the case of a patient who developed myoclonus and hyperalgesia following administration of high-dose subarachnoid morphine. This complication occurred with 40-80 mg/day continuous infusion. The pathophysiology of these side effects is discussed.

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Neurologic dysfunction associated with IFN therapy was mild. Psychiatric symptoms and neuropsychologic impairment were not found. Levels of fatigue and anxiety were increased in the IFN group but without a sizable impact on quality of life measures.

To clarify the range of potential etiologies that may contribute to organic brain syndrome in patients receiving systemic opioids for cancer pain, we describe 15 patients who presented this complication. In 11 cases, concomitant conditions were found that could contribute to the onset of organic brain syndrome. These data illustrate that multiple causes often play a role in the development of mental status changes in advanced cancer. Opioids are seldom the only causal factor implicated.

Summary and conclusionsA standardised form was developed to review the daily problems suffered by patients with arthritis of the hip and provide clinicians with information for planning treatment and in judging subsequent progress. The reports made by various patients in a preliminary study provided 81 statements on pain, restricted movements, and restricted activities that were then tested to identify the most reliable. The responses of 32 patients waiting for hip replacements and 66 patients who had undergone operation were compared with independent assessments of pain and physical limitations. The 33 statements eventually selected were chosen mainly on the basis of their sensitivity to differences between preoperative and postoperative patients and their correlation with the independent assessments.The final questionnaire provides a valid and concise summary of a patient's disabilities and is simple enough for the patient to complete while waiting to see the doctor.

We evaluated the local and systemic tolerability of ketorolac administered through continuous subcutaneous infusion in ten cancer patients. The patients were monitored daily for the severity and duration of pain, and the development of other symptoms. The duration of injection site varied from 1 to more than 7 days. No patients complained of local discomfort or pain. Mild local bleeding at the site of drug injection was observed in seven cases. No increase in the intensity of symptoms was observed during the infusion of ketorolac.

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