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Purpose of review: Advances in oncological therapies have resulted in an increase in the number of patients living with and beyond cancer. The personal and societal impact of chronic pain in the survivor population represents an area of significant unmet need. Capsaicin (a TRPV1 agonist) may provide analgesia with limited systemic side effects. This review looks to summarise the most recent evidence regarding the use of capsaicin in the management of cancer pain. Recent findings: Various international guidelines have recently endorsed the use of high concentration capsaicin patches in the treatment of chronic painful chemotherapy induced peripheral neuropathy. Numerous studies support the use of capsaicin in the treatment of peripheral neuropathic pain. This promising data is predominantly yielded from pain secondary to herpes zoster and diabetic neuropathy, with an expanding but small evidence base for its utility in other neuropathic pains. Emerging data suggests that treatments are better tolerated and provide analgesia more rapidly when compared with systemic treatments. Summary: Whilst randomised controlled trial data in the treatment of cancer pain are lacking, recent large cohort studies, and international guidelines, support the use of high concentration capsaicin patches in a wide variety of neuropathic pain secondary to cancer treatments. [ABSTRACT FROM AUTHOR]

Purpose of review Advanced pain management techniques may be indicated in 5-15% of cancer patients. Despite this, a recent review identified that, over the course of 1 year in England, only 458 patients received a procedure intended to provide analgesia and only 30 patients had intrathecal drug delivery (ITDD) devices implanted. This article describes the emerging evidence for ITDD in cancer pain and provides a narrative review of other neuromodulatory techniques (including spinal cord stimulation, peripheral nerve stimulation and acupuncture), approaches that might be employed to address this area of significant unmet clinical need. Recent findings Numerous studies have been published within the last year reporting positive outcomes associated with ITDD in cancer pain management. Neuromodulation represents an important strategy in the management of persistent pain. Whilst the nonmalignant pain evidence-base is rapidly growing, it remains sparse for cancer pain management. The growing cohort of cancer survivors may significantly benefit from neuromodulatory techniques. Summary ITDD and other neuromodulatory techniques for cancer pain management appear underutilised in the UK and offer the prospect of better treatment for cancer patients with refractory pain or intolerable side-effects from systemic analgesics. [ABSTRACT FROM AUTHOR]

This project monitored the extent students demonstrated actual mastery of the role cluster associated with their academic level and recorded both the introductory experiences they had in advanced roles beyond their cluster, and field experiences in which their performance in one role accelerated their proficiency in another. (Author/MLW)

A consortia model for colleges within a short distance of each other is described. Particular attention is given to the components of consortial infrastructure: the policy board and the role of the deans, the consortium director, the campus program coordinators, and the students' departmental boards. (Author/MLW)

The Society of Thoracic Surgeons General Thoracic Surgery Database (STS GTSD) remains the most robust thoracic surgical database in the world, providing participating institutions semiannual risk-adjusted performance reports and facilitating multiple quality improvement initiatives each year. In 2018, the STS GTSD Data Collection Form was substantially revised to acquire the most important variables with the least data manager burden. In addition, a composite quality measure for all pulmonary resections for cancer was developed, and the impact that minimally invasive approaches have on the model was assessed. The 2018 database audit found that the accuracy of the database remains high, ranging from 92.5% to 98.4%. In 2019, the STS GTSD Task Force plans to focus on increasing generalizability of the database, initiating esophagectomy outcome public reporting, and creating customizable real-time dashboards. This review summarizes all national aggregate outcome, quality measurement, and improvement initiatives from the STS GTSD over the past 12 months. [ABSTRACT FROM AUTHOR]

Describes several experiments using the techniques of thermal analysis and thermometric titrimetry. Defines thermal analysis and several recent branches of the technique. Notes most of the experiments use simple equipment and standard laboratory techniques. (MVL)

Background Parameters defining attainment and maintenance of proficiency in thoracoscopic video-assisted thoracic surgery (VATS) lobectomy remain unknown. To address this knowledge gap, this study investigated the institutional performance curve for VATS lobectomy by using risk-adjusted cumulative sum (Cusum) analysis. Methods Using The Society of Thoracic Surgeons General Thoracic Surgery Database, the study investigators identified centers that had performed a total of 30 or more VATS lobectomies. Major morbidity, mortality, and blood transfusion were deemed primary outcomes, with expected incidence derived from risk-adjusted regression models. Acceptable and unacceptable failure rates for outcomes were set a priori according to clinical relevance and informed by regression model output. Results Between 2001 and 2016, 24,196 patients underwent VATS lobectomy at 159 centers with a median volume of 103 (range, 30 to 760). Overall rates of operative mortality, major morbidity, and transfusion were 1% (244 of 24,189), 17.1% (4,145 of 24,196), and 4% (975 of 24,196), respectively. Of the highest-volume centers (≥100 cases), 84% (65 of 77) and 82 % (63 of 77) (p = 0.48) were proficient by major morbidity standards by their 50th and 100th cases, respectively. Similarly, 92% (71 of 77) and 90% (69 of 77) (p = 0.41) of centers showed proficiency by transfusion standards by their 50th and 100th cases, respectively. Three performance patterns were observed: (1) initial and sustained proficiency, (2) crossing unacceptability thresholds with subsequent improved performance; and (3) crossing unacceptability thresholds without subsequent improved performance. Conclusions VATS lobectomy outcomes have improved with lower mortality and transfusion rates. The majority of high-volume centers demonstrated proficiency after 50 cases; however, maintenance of proficiency is not ensured. Cusum provides a simple yet powerful tool that can trigger internal audits and performance improvement initiatives. [ABSTRACT FROM AUTHOR]