This study provides the first evidence that co-administration of prolonged-release oxycodone and existing gabapentin therapy has a clinically meaningful effect in painful diabetic neuropathy.

7-day buprenorphine patches plus oral paracetamol were non-inferior to co-codamol tablets with respect to analgesic efficacy in older adults with OA pain in the hip/knee.

BackgroundOpioids provide effective analgesia for moderate-to-severe, chronic pain. Transdermal buprenorphine (TDB) is available in the UK as weekly, lower-dose (5–20 μg/h) patches and twice-weekly, higher dose (35–70 μg/h) patches. This prospective, observational, multicenter study of patients with various chronic pain conditions assessed the safety, perceptions, and discontinuation of treatment with TDB in a real-world, non-interventional setting (ClinicalTrials.gov study ID: NCT01225861).MethodsPatients aged ≥18 years who were already receiving or initiating treatment with TDB were recruited in the UK during routine clinical visits and were followed for 6 visits or 9 months (whichever came first). Self-reported treatment adherence, patient satisfaction, and safety data were collected at each study visit.ResultsOf 465 patients, 272 were already receiving 7-day TDB at the study start (TDB experienced), 146 were TDB naïve, and 47 were prescribed twice-weekly TDB. Most patients were female (72.9 %) and overweight/obese (body mass index ≥25: 75.3 %). The median age was 67 years, and the mean duration of pain was 11.1 years. Arthritis/other musculoskeletal disorders (39.6 %) were the most common causes of pain. Mild adverse events were commonly reported. Skin irritations, which were most frequent in 7-day TDB-experienced patients (45.6 %), rarely resulted in treatment discontinuation (8.8 %). Nearly all patients used TDB in accordance with treatment recommendations. Most patients reported that TDB was ‘effective’/‘very effective’ at relieving pain and were ‘satisfied’/‘very satisfied’ with TDB therapy.ConclusionIn everyday clinical practice, TDB was well tolerated and patients were satisfied with their therapy. Self-reported adherence to TDB was very high, and adverse events rarely resulted in treatment discontinuation. Opportunities were identified to limit common adverse events associated with TDB.Electronic supplementary materialThe online version of this article (doi:10.1007/s40271-015-0151-y) contains supplementary material, which is available to authorized users.

AIM: Due to movement complexity and the use of interdisciplinary styles, all theatrical dance genres require dancers to have excellent balance skills to meet choreographic demands. The aim of this systematic review was to evaluate the experimental evidence for the relationship between balance and dance performance, including balance testing, balance training, and balance performance. The key focus was on balance and theatrical styles of dance, involving adult participants who were either in full-time dance training or professional dancers. METHODS: The databases MEDLINE, PubMed, Cumulative Index to Nursing & Allied Health (CINAHL), SPORTDiscus, Cochrane, ScienceDirect, and Google Scholar were searched using MeSH terms “postural balance,” “balance, postural,” “musculoskeletal equilibrium,” and “postural equilibrium,” and used in combination with “dance,” between 1980 and 2016. PRISMA recommendations were applied in modifications to the search terms. RESULTS: The initial search revealed 1,140 published articles. After applying inclusion and exclusion criteria, 47 articles were judged to be relevant for further assessment using the GRADE system. Results revealed only 1 randomized controlled trial (RCT); the remaining articles were experimental without randomisation or pre-experimental, thus achieving low scores. A total of 39 articles focused on balance ability, including postural sway and control; 5 were related to multi-joint coordination; and 3 investigated laterality and balance. Female ballet dancers were the most studied population, while a wide range of measurement tools and balance tasks were employed. CONCLUSION: The available material on balance and dance performance is of rather low quality. There is a need for more RCTs and intervention balance studies.

The majority of older people live active lives and more are retaining their teeth. These people rely for their dental care on general dental practitioners. However, many find that the service they are offered falls short of their desires, and this study examined this problem from the points of view of the public and the dentists. Qualitative group discussions were conducted among 61 middle-aged and elderly people and 20 dentists, followed by a quantitative study involving 20 dentists and 57 of their patients. The aim was to discover what, if any, differences there may have been between their expectations of dental treatment. There were no significant differences between middle-aged and older peoples' views on barriers to the receipt of dental care. However, dentists assumed that their older patients would have significantly greater negative dental attitudes than their middle-aged patients. Dentists considered that ability to pay would be a significantly greater barrier for their working-class rather than their middle-class patients. However, among the patients themselves there was no significant difference. The comparison of dentists' and patients' views on barriers to treatment showed that dentists significantly overestimated their older patients' reluctance to receive dental treatment.

Aim We aim to compare machine learning with neural network performance in predicting R0 resection (R0), length of stay > 14 days (LOS), major complication rates at 30 days postoperatively (COMP) and survival greater than 1 year (SURV) for patients having pelvic exenteration for locally advanced and recurrent rectal cancer. Method A deep learning computer was built and the programming environment was established. The PelvEx Collaborative database was used which contains anonymized data on patients who underwent pelvic exenteration for locally advanced or locally recurrent colorectal cancer between 2004 and 2014. Logistic regression, a support vector machine and an artificial neural network (ANN) were trained. Twenty per cent of the data were used as a test set for calculating prediction accuracy for R0, LOS, COMP and SURV. Model performance was measured by plotting receiver operating characteristic (ROC) curves and calculating the area under the ROC curve (AUROC). Results Machine learning models and ANNs were trained on 1147 cases. The AUROC for all outcome predictions ranged from 0.608 to 0.793 indicating modest to moderate predictive ability. The models performed best at predicting LOS > 14 days with an AUROC of 0.793 using preoperative and operative data. Visualized logistic regression model weights indicate a varying impact of variables on the outcome in question. Conclusion This paper highlights the potential for predictive modelling of large international databases. Current data allow moderate predictive ability of both complex ANNs and more classic methods.

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