Biomedical subjects
E Brenne
Publications and source records attributed to E Brenne.
[Medullary compression in metastatic cancer].
Cancer patients with spinal cord compression may develop irreversible neurological deficit. The clinical picture implies back pain and subsequent neurological deficit. There is always a danger of rapid deterioration of the patient's condition. If spinal cord compression is suspected, the case is an emergency. MRI should be preferred in the diagnostic work-up, and corticosteroids be administered promptly. Radiation therapy or surgical treatment should be started as soon as possible. Patient outcome is related to the degree of neurological deficit at the start of treatment.
Fatigue. Measures and relation to pain.
Fatigue describes reduced capacity to sustain force or power output, reduced capacity to perform multiple tasks over time and simply a subjective experience of feeling exhausted, tired, weak or having lack of energy. Pain and fatigue have several components in common, such as being subjective, prevalent in most patients with cancer and caused by multiple factors of both a physical and psychological nature. In order to explore the relationship between fatigue and pain, data from five studies were used: two random samples from the Norwegian population (n=2323 and n=1965), Hodgkin's disease survivors (n=459), palliative care patients (n=434) and patients with bone metastases (n=94). All patients had completed one or more of the following instruments: EORTC QLQ-C30, SF-36 and/or Fatigue Questionnaire. The level of fatigue was much higher in the two palliative care populations (54.4 and 63.2) as compared to the normal population samples (25.0). Patients with bone metastases had significantly more pain (72.0) than the patients in the palliative care trial (47.4) and norms (20.5). In the two palliative care and bone metastases populations fatigue was almost unchanged over time, while pain was reduced. In the palliative care population a high level of fatigue (80.3) and pain (57.8) was reported 0-1 month before death. The relationship between pain, fatigue and the health-related quality of life domains should be explored in more detail, especially in follow-up studies in order to assess possible changes over time. In addition, the validity of the existing instruments measuring fatigue should be investigated for use in patients with advanced disease and short life expectancy.
[Treatment chronic pain with amitriptyline. A double-blind dosage study with determination of serum levels].
The aim of this study was to find an optimal analgesic dose of amitriptyline, and at the same time examine whether a therapeutic window existed for this analgesic effect. 85 patients with chronic, non-malignant pain were included in a double-blind treatment regime with four doses of amitriptyline (10, 25, 50 or 100 mg). A blood sample was taken at steady state. The results showed 25 mg amitriptyline to have a good analgesic and sleep regulatory effect. The four different doses of amitriptyline did not show any significant difference in efficacy. No therapeutic window was found, but one cannot exclude that it exists. Low-dose amitriptyline, as a non-addictive drug, is a good alternative in the treatment of chronic pain, independent of co-morbid depression.