Ricerc@Sapienza

Pain is one of the most common symptoms among patients with end-stage renal disease (ESRD), and is often under recognized and not adequately managed in hemodialysis (HD) patients. Barriers to adequate pain management include poor awareness of the problem, insufficient medical education, fears of possible drug-related side effects, and common misconceptions about the inevitability of pain in elderly and HD patients. Caregivers working in HD should be aware of the possible consequences of inadequate pain assessment and management.

Introduction: Chronic noncancer pain has remained a challenging clinical problem. Opioid analgesics are effective, but they are known to be associated with opioid use disorder and potentially treatment-limiting side effects. Buprenorphine is a Schedule III synthetic opioid in the USA with a chemical structure similar to that of morphine but with a longer duration of action, greater potency, and other unique pharmacological attributes. Its role in treatment of chronic noncancer pain may be broader than currently thought.

Cannabinoids consistently produced antinociceptive effects in preclinical models. However, in clinical practice, evidence of their analgesic efficacy is still lacking. The possible risk of side effects and diversion should be considered. High-quality data are critically needed to define the real role of cannabis-related medications in chronic pain management

Healthcare professionals and organizations increasingly face the conundrum of treating patients with active substance use disorder, a history of personal or familial substance use disorder, or those at elevated risk for substance abuse. Such patients need compassionate care when facing painful conditions; in fact, denying them pain control makes it likely that they will seek out ways to self-medicate with illicit drugs. Yet it remains unclear how to safely and effectively treat patients in these challenging situations.

COVID-19 is imposing unprecedented stress on our healthcare system but in some cases these
changes, such as more telemedicine for pain management, may be valuable paradigm shifts that shape the future of modern medicine. Pain does not stop for the pandemic and pain care must continue as well.

Opioid-induced bowel dysfunction (OIBD) is a common complication in long-term opioid users and abusers. It is a burdensome condition, which significantly limits quality of life and is associated with increasing health costs. OIBD affects up to 60% of patients with chronic non-cancer pain and over 80% of patients suffering from cancer pain and is one of the conditions of the most common symptoms associated with opioid main-tenance. Given the continued use of opioids for chronic pain management in appropriate patients, OIBD is likely to persist in clinical practice in the coming years.

Pain is one of the most common symptoms in children suffering from leukemia, who are often misdiagnosed with other childhood painful diseases such as juvenile idiopathic arthritis. Corticosteroid-induced osteonecrosis (ON) and vincristine-induced peripheral neuropathy (VIPN) are the most common painful manifestations. Additionally, ongoing pain may continue to impact quality of life in survivorship. This narrative review focuses on the pathophysiological mechanisms of pain in childhood leukemia and current available indications for analgesic treatments.

Background: In Italy, chronic pain affects more than a quarter of the population, while the average European prevalence is 21%. This might be due to the high percentage of people who do not receive treatment, even after the passing of law 38/2010. Aims: To investigate the clinical characteristics of patients with non-cancer chronic pain. Methods: An observational, multi-center, cross-sectional study was performed and clinical records of adult chronic pain patients attending pain management clinics in the Latium Region, Italy, were retrospectively reviewed. Results.

Interdisciplinary multimodal pain therapy (IMPT) is a biopsychosocial treatment approach for patients with chronic pain that comprises at least psychological and physiotherapeutic interventions. Core Outcome Sets (COSs) are currently developed in different medical fields to standardize and improve the selection of outcome-domains, and measurement instruments in clinical trials, to make trial results meaningful, to pool trial results, and to allow indirect comparison between interventions.