Anti-cancer therapy faces major challenges, particularly in terms of specificity of treatment. The ideal therapy would eradicate tumor cells selectively with minimum side effects on normal tissue. Gene or cell therapies have emerged as realistic prospects for the treatment of cancer, and involve the delivery of genetic information to a tumor to facilitate the production of therapeutic proteins. However, there is still much to be done before an efficient and safe gene medicine is achieved, primarily developing the means of targeting genes to tumors safely and efficiently. An emerging family of vectors involves bacteria of various genera. It has been shown that bacteria are naturally capable of homing to tumors when systemically administered resulting in high levels of replication locally. Furthermore, invasive species can deliver heterologous genes intra-cellularly for tumor cell expression. Here, we review the use of bacteria as vehicles for gene therapy of cancer, detailing the mechanisms of action and successes at preclinical and clinical levels.

162Purpose: In this prospective randomized study, a comparison was made between the efficacy of 20 mg tenoxicam, administered either, 30 min preoperatively or at induction of anesthesia, for the relief of postoperative pain in patients undergoing ambulatory breast biopsy.Methods. Seventy-three patients were recruited and all received a standard anesthetic consisting of induction with 2 mg·kg -1 propofol followed by 5 µg·kg -1 alfentanyl. No premedication was administered and at the end of the procedure the wounds were infiltrated with 10 ml of bupivacaine (0.5 %). Patients were randomized to receive 20 mg tenoxicam intraveneously either 30 min before surgery or at induction of anesthesia.Results: Demographic criteria were similar in both groups. There were differences in pain scores at 30, 60, 120 and 240 min postoperatively (VAS at 30 min 3.2 ± 1.2 vs 5.5 ± 1.8; P < 0.001: VAS at 60 min 1.8 ± 1.2 vs 3.7 ± 1.9; P < 0.001: VAS at 120 min 0.9 ± 0.9 vs 1.7 ± 1.0; P = 0. 003: VAS at 240 min 0.5 ± 0.5 vs 1.1 ± 0.8; P < 0.001: Expressed as mean ± SD). There was a difference in the number of patients requiring additional analgesia, in the first four hours postoperatively (12 (33%) vs 27 (73%); P = 0.001) and a difference in the time to additional analgesia in these patients (87.5 ± 32.5 vs 55.0 ± 26.8 min; P = 0.002). Conclusion:Early administration of pre-emptive tenoxicam 30 min before induction of anesthesia improves postoperative analgesia in patients undergoing ambulatory breast biopsy.Objectif : Notre étude porte sur la comparaison de l'efficacité de 20 mg de ténoxicam, administrés 30 min avant l'opération ou à l'induction de l'anesthésie pour le soulagement de la douleur postopératoire de patientes qui subissent une biopsie du sein en chirurgie ambulatoire.Méthode : Nous avons recruté 73 patientes qui ont toutes reçu un régime anesthésique normal constitué d'une induction avec 2 mg·kg -1 de propofol suivi de 5µg·kg -1 d'alfentanil. Aucune prémédication n'a été administrée et, à la fin de l'intervention, 10 ml de bupivacaïne (0,5 %) ont été infiltrés dans la plaie chirurgicale. Les patientes, réparties de façon aléatoire, ont reçu 20 mg de ténoxicam intraveineux, soit 30 min avant l'opération, soit à l'induction de l'anesthésie.Résultats : Les informations personnelles étaient similaires dans les deux groupes. Les scores de douleur ont été différents pour les mesures réalisées 30, 60, 120 et 240 min après l'opération (selon l'EVA à 30 min 3,2 ± 1,2 vs 5,5 ± 1,8; P < 0,001: EVA à 60 min 1,8 ± 1,2 vs 3,7 ± 1,9; P < 0,001: EVA à 120 min 0,9 ± 0,9 vs 1,7 ± 1,0; P = 0,003: EVA à 240 min 0,5 ± 0,5 vs 1,1 ± 0,8; P < 0,001: moyenne ± écart type). Un nombre différent de patientes a demandé de l'analgésie supplémentaire, pendant les quatre premières heures postopéra-toires (12 (33 %) vs 27 (73 %); P = 0,001). Le temps écoulé avant cette demande d'analgésie diffère également (87,5 ± 32,5 vs 55,0 ± 26,8 min; P = 0,002).Conclusion : L'administration précoce de ténoxicam préventif, 30 min avant l'induction de l'anesthésie, amé...

SummaryIn this prospective randomised study, pruritus and pain were evaluated in patients undergoing abdominal surgery in which intrathecal morphine was administered. Each patient received intrathecal morphine 0.3 mg prior to induction, followed by a standard anaesthetic. The patients were randomly allocated to one of two groups. One group received 100 mg of rectal diclofenac immediately post-induction. Patients receiving diclofenac had signi®cantly lower pruritus scores at 30 min (p 0.0076), 2, 4, 8 and 24 h postoperatively, as well as signi®cantly reduced pain scores at each time point (p < 0.0001 at each study interval). Morphine consumption in the ®rst 24 h was also signi®cantly lower in this group. In conclusion, rectal administration of diclofenac signi®cantly reduces the incidence and severity of postoperative pruritus. It also signi®cantly reduces pain and further analgesic requirements postoperatively.

Intra-articular tenoxicam improves postoperative analgesia in knee arthroscopyPurpose: Non Steroidal Anti-Inflammatory drugs have a well documented benef~ in the relief of postoperative pain. This study was designed to compare the analgesic effect of intra-articular tenoxicam 20 mg with intravenous tenoxicam on postoperative pain in 88 patients undergoing day case knee arthroscopy. Methods: A prospective, double blind, randomized trial was performed. All patients received a standard general anesthetic. Patients in group A received 20 mg tenoxicam made up to 40 ml with normal saline intra-articularly (io) and 2 ml normal saline iv. Patients in group B received 40 ml normal saline intra-articularly and 2 ml, 20 mg of tenoxicam, iv. Results: Both groups of patients were similar with respect to age, weight, sex and tourniquet inflation time. Patients receiving in tenoxicam had lower pain scores (at rest and upon movement) at 30, 60, 120 and 180 min postoperatively (0.8 _ 0.2 vs 2.5 _ 0.2 at rest and 1.24 _+ 0.2 vs 3.4 _+ 0.2 at movement at 60 min; P < 0.000 I). Fewer patients required additional analgesia in the first four hours postoperatively (33% vs 84%; P < 0.0000 I) and the time to first analgesia (23.7 + I 1.2 vs 9.4 _+ 0.6; P < 0.02) was longer in those receiving in tenoxicam. Conclusion: Intra-articular tenoxicam provides superior postoperative analgesia and reduces postoperative analgesic requirements compared with iv tenoxicam in patients undergoing day case knee arthroscopy.Objcctif: Les anti-inflammatoires non st&oi'diens sont des mddicaments bien reconnus pour le soulagement de la douleur postop&atoire. La pr&ente ~tude avait pour but de comparer reffet analg&ique de 20 mg de t6noxi-cam intra-articulaire ~ du t~noxicam intraveineux sur la douleur postop&atoire chez 88 patients admis en chirurgie ambulatoire pour une arthroscopie du genou. M&hode : On a proc6d~ ~ un essai prospectif, randomis6 et ~ double insu. Tous les patients ont re~u un anesth&ique g~n&al standard. Les patients du groupe A ont re~u une injection intra-articulaire (io) compos& de 20 mg de t~noxicam compl6t~ ~ 40 ml par une solution salve et 2 ml de solution sal& iv. Les patients du groupe B ont re~u 40 ml de solution sal& en injection intra-articulaire et 2 ml, 20 mg de t~noxicam, iv. R~sultats : Les deux groupes pr6sentaient des caract&istiques semblables quant ~ I'~ge, le poids, le sexe et le temps de gonflement du garrot. Les patients qui ont re~u du tfinoxicam io ont eu des scores de douleur plus bas (au repos et en mouvement) ~ 30, 60, 120 et 180 min apr~s I'intervention (0,8 + 0,2 vs 2,5 -0,2 au repos et 1,24 _+ 0,2 vs 3,4 _+ 0,2 en mouvement ~ 60 min; P < 0,0001). Moins de patients ont eu besoin d'analg&ie suppl~mentaire pendant les quatre premi&es heures postop&atoires (33 % vs 84 %; P < 0,0000 I) et le temps &oul~ avant la premi&e analg&ie (23,7 _+ I 1,2 vs 9,4 _+ 0,6 P < 0,02) a ~t~ plus long pour les patients qui ont re~u du t~noxicam in. Conclusion : Le t6noxicam intra-articulaire, compar~ au t~noxicam iv, fournit une anal...

Pre-operatively administered tenoxicam provides superior post-operative analgesia than tenoxicam administered after surgical incision in patients undergoing breast biopsy.