Our results show feasibility of PS in HC and HS and suggest setting differences in rates, indications, and practice of PS, possibly related to patients' selection or care organization.

Serum lipid, lipoprotein and apoprotein parameters were evaluated in 15 patients (7 males and 8 females) with Friedreich’s ataxia. Serum lipid levels in patients showed no significant differences compared to controls. Small reduction in serum phospholipid and in total HDL and HDL₃ cholesterol levels were observed, and the female patients presented a slight reduced total cholesterol level; among the serum apoproteins, apo B was reduced only in the males. The most interesting findings concerned the lipoproteins, since both lipid and protein masses of the VLDL, LDL and HDL₂ fractions were reduced. In reference to lipoprotein composition, however, HDL₂ was the most modified fraction, showing an important protein reduction. From this point of view, this lipoprotein seems the most responsible for the changes observed in our patients. The meaning of this modified lipoprotein pattern in the pathophysiology of Friedreich’s ataxia is not clear.

Objective:To investigate the possible role and tolerability of high-dose (Ͼ160 mg/day) oxycodone controlled release (CR) for the treatment of cancer and non-cancer pain. Design: 227 patients with cancer or non-cancer pain were enrolled in an open-label, multi-center, Italian study in order to assess the adequacy of their existing pain management (using a numerical rating scale [NRS]) and the possible benefi t high-dose oxycodone CR may offer patients experiencing uncontrolled pain. Results: Pain was poorly controlled at baseline, with only 18.1% of patients reporting adequate pain relief (NRS Ͻ3.5). All other patients reported uncontrolled pain, with an average NRS of 7.81. At baseline assessment, 47.89% of patients had been in pain for up to 3 months, 32.82% for 3-6 months, and 19.19% for more than 6 months. After baseline assessment, patients were switched to oxycodone CR monotherapy. The starting dose was individualized to each patient and titrated up over a 3-to 4-day period until effective pain management was achieved. Treatment was continued for an average of 37.24 days during the study. Pain control (fi nal mean NRS of 2.85) was attained with an average dose of oxycodone CR 221.84 mg/day. Standard adverse events (including constipations, nausea, and vomiting) were recorded in 39.64% of patients receiving high-dose oxycodone CR monotherapy. Side-effects tended to subside after the initial week of treatment and did not result in any participants leaving the study. Conclusion: High-dose oxycodone CR can achieve rapid and effective management of moderate to severe cancer and non-cancer pain with minimum side-effects.

SummaryGranulocyte colony-stimulating factor (G-CSF) and granulocyte-macrophage colony-stimulating factor (GM-CSF) sensitise nerves to mechanical stimuli experimentally and may induce bone and muscle pain when used as supportive drugs. G-CSF and GM-CSF produced endogenously by tumour cells can cause paraneoplastic leucocytosis. Whether paraneoplastic leucocytosis is associated with changes in pain sensitivity is not yet clear. We report on a patient with advanced-stage thyroid cancer who developed extreme leucocytosis within a period of 4 weeks (103 000 white blood cells/mm 3 ), composed mostly of neutrophils and eosinophils. Parallel to this leukemoid reaction, allodynia and hyperalgesia developed in the absence of tissue inflammation. The course of disease of an elderly male with advanced stage metastatic thyroid cancer with new onset neuropathic pain followed by the development of extreme leucocytosis in a leukemoid reaction suggests paraneoplastic release of myeloid CSFs. The coincidence of pain sensitisation and extreme leucocytosis suggests a causal contribution of G-CSF and GM-CSF. BACKGROUND

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