Editorial – Musculoskeletal pain: Which role for tapentadol?

Chronic pain is defined as pain persisting after healing of an underlying pathology or as persisting pain in the absence of tissue damage. In the last decade, the understanding of mechanisms involved in chronic pain led to an improved approach to patient management, with the aim to reduce discomfort, improve quality of life (QoL) and enhance functional recovery. Chronic musculoskeletal pain, which is frequently encountered in clinical practice, can affect patients of all ages and is particularly common in older patients. Indeed, low back pain is the most frequent chronic pain condition worldwide, with a lifetime prevalence of >70% in western countries1,2. Neck pain is also a common disabling disease, with a prevalence of 23%, and is associated with high costs for medical visits and physiotherapy. Both low back pain and neck pain involve nociceptive and neuropathic pain mechanism

Raising Awareness on the Clinical and Social Relevance of Adequate Chronic Pain Care

Appropriate pain care should be regarded as a right and effectively guaranteed to people with chronic pain (CP). Law 38, enacted in Italy in 2010, establishes the citizen’s right not to suffer. Twelve years later, such right appears still disregarded in Italy and the current access to adequate pain care reveals significant shortcomings. In addition, a mismatch between CP-associated burden and the available healthcare resources in the framework of our national health system has been observed. This article gathers the perspectives of a Board of Italian anesthesiologists on the state of the art of CP management in Italy and aims at strengthening the scientific rationale and clinical relevance of pursuing the enforceability of the right not to suffer and at promoting widespread multidisciplinary care of patients with CP

Life in the Atacama — Year 2: Geologic reconnaissance through long-range roving and implications on the search for life

The Life in the Atacama-2004 project, which included geological, morphological, and mineralogical mapping through combined satellite, field-based, and microscopic perspectives and long-range roving, led to the localization of potential habitats

Cost-of-illness analysis reveals potential healthcare savings with reductions in type 2 diabetes and cardiovascular disease following recommended intakes of dietary fiber in Canada

Background: Consumption of fibre-rich diets is associated with favourable impacts on type 2 diabetes (T2D) and cardiovascular disease (CVD), two of the most costly ailments worldwide, however the economic value of altered fibre intakes remains poorly understood. Methods: A cost-of-illness analysis was conducted to identify the percentage of adults expected to consume fibre-rich diets in Canada, estimate fibre intakes in relation to T2D and CVD reductions, and assess the potential annual savings in healthcare costs with reductions in rates of these two epidemics. Results: Non-trivial healthcare and related savings of CAD$35.9-$718.8 million in T2D costs and CAD$64.8-$1,295.7 million in CVD costs were calculated under a scenario where cereal fibre was used to increase current intakes of dietary fibre to the recommended levels of 38 g per day for men and 25 g per day for women. Each 1 g per day increase in fibre consumption resulted in annual CAD$2.6-$51.1 and $4.6-$92.1 million savings for T2D and CVD, respectively. Conclusions: Strategies to increase consumers’ knowledge of the recommended dietary fibre intakes, as part of healthy diet, and to facilitate stakeholder synergy are warranted to enable better management of costs associated with T2D and CVD in Canada

Spectroscopic results from the Life in the Atacama (LITA) project 2004 field season

Analysis of spectroscopy datasets from rover field tests in the Atacama Desert (Chile), focusing on the composition of the surface and identification of potential habitats for life

Pretratamientos de la cáscara de semilla de girasol para su utilización como sustrato de plantas

La cáscara de semilla de girasol es un residuo agro-industrial de impacto medioambiental negativo que suele estar contaminado con Sclerotinia sclerotiorum, lo que imposibilita su uso como enmienda orgánica o sustrato para plantas en macetas. El objetivo de este estudio fue evaluar si el tratamiento de ureólisis o los pretratamientos previos a la fermentación fúngica en estado sólido, i.e. solarización, pasteurización, compostado y desinfección química de la cáscara con clorito de sodio o Dazomet, podrían controlar el desarrollo de la enfermedad. Además se evaluó en co-cultivo el comportamiento de dos hongos lignocelulolíticos usados para fermentación en estado sólido frente a S. sclerotiorum. Excepto el pre-tratamiento con clorito de sodio, los demás fueron efectivos en la eliminación de la viabilidad de los esclerocios, considerándose la pasteurización el más sencillo. El G. lucidum inhibió, tanto el crecimiento del micelio de S. sclerotiorum como la germinación de los esclerocios. La ureólisis fue eficaz en varios de los tratamientos, siendo óptima la realizada en presencia de 3% de urea y 35% de humedad, y el compostado pudo eliminar la viabilidad de los esclerocios al primer mes y desintegrarlos completamente al segundo. Ambos se consideran efectivos para obtener un producto de aplicación como sustrato o enmienda

Prospective study on prevalence, intensity, type, and therapy of acute pain in a second-level urban emergency department

Aim: Pain represents the most frequent cause for patient admission to emergency departments (EDs). Oligoanalgesia is a common problem in this field. The aims of this study were to assess prevalence and intensity of pain in patients who visited a second-level urban ED and to evaluate the efficacy of pharmacological treatment administered subsequent to variations in pain intensity. Methods: A 4-week prospective observational study was carried out on 2,838 patients who visited a second-level urban ED. Pain intensity was evaluated using the Numeric Rating Scale at the moment of triage. The efficacy of prescribed analgesic therapy was evaluated at 30 and 60 minutes, and at discharge. Data concerning pain intensity were classified as absent, slight, mild, or severe. Pain was evaluated in relation to the prescribed therapy. Results: Pain prevalence was 70.7%. Traumatic events were the primary cause in most cases (40.44%), followed by pain linked to urologic problems (13.52%), abdominal pain (13.39%), and nontraumatic musculoskeletal pain (7.10%). Only 32.46% of patients were given pharmacological therapy. Of these, 76% reported severe pain, 19% moderate, and 5% slight, and 66% received nonsteroidal anti-inflammatory drugs or paracetamol, 4% opioids, and 30% other therapies. A difference of at least 2 points on the Numerical Rating Scale was observed in 84% of patients on reevaluation following initial analgesic therapy. Conclusion: Pain represents one of the primary reasons for visits to EDs. Although a notable reduction in pain intensity has been highlighted in patients who received painkillers, results show that inadequate treatment of pain in ED continues to be a problem

Searching for life with rovers: exploration methods and science results from the 2004 field campaign of the “Life in the Atacama” project and applications to future Mars Missions

LITA develops and field tests a long-range automated rover and a science payload to search for microbial life in the Atacama. The Atacama's evolution provides a unique training ground for designing and testing exploration strategies and life detection methods for the search for life on Mars