testata-attegge 38/2010; dolore oncologico

L’informazione e l’aggiornamento delle diverse competenze coinvolte nella gestione del dolore, attraverso la ricerca scientifica continua, la redazione di pubblicazioni e il dibattito tra medici, operatori sanitari e cittadini è un processo fondamentale per una sempre più corretta e completa applicazione della Legge 38/2010.


Di seguito alcuni dei trial clinici tra i più significativi pubblicati in rete sul dolore.

Per segnalarci studi clinici o articoli scientifici scrivi a : impactproactive@plsconsulenze.com


– Little is known about the moderators and mediators of change in online pain interventions based on cognitive-behavior therapy (CBT) VISUALIZZA


– Ketamine is a well-known anesthetic with its use trailing back to the 1960s VISUALIZZA


Despite the prevalence and the functional, psychological, and economic impact of chronic pain, few intervention studies of treatment of chronic pain in veterans have been performed VISUALIZZA


New drug treatments, clinical trials, and  standards of quality for assessment of evidence justify an update of  evidence-based recommendations for the pharmacological treatment of  neuropathic pain VISUALIZZA


 – Total hip replacement (THR) involves the replacement of a damaged hip joint with an artificial hip prosthesis. Resurfacing arthroplasty (RS) involves replacement of the joint surface of the femoral head with a metal surface covering. VISUALIZZA


 – Chronic pain management in the obese patient a focused review of key challenges and potential exercise solutions VISUALIZZA

   Commento: questa articolo risulta particolarmente degno di nota in quanto fornisce un riesame estremamente importante dell’intersezione sempre più diffusa tra le malattie del dolore cronico e obesità .


 – Reanalysis of morphine consumption from two randomized controlled trials of gabapentin using longitudinal statistical methods VISUALIZZA


 –  Rolling and Flexing to Massage Away Pain and Stress  – A Class in the MELT Method of Body Work   from “The New York Times”  Visualizza


  – Tramadol is a weak opioid analgesic whose use has increased rapidly, and it has been associated with adverse events of hypoglycemia

OBJECTIVE: to assess whether tramadol use, when compared with codeine use, is associated with an increased risk of hospitalization for hypoglycemia. Visualizza

DESIGN, SETTING AND PARTICIPANTS: A nested case-control analysis was conducted within the United Kingdom Clinical Practice Research Datalink linked to the Hospital Episodes Statistics database of all patients newly treated with tramadol or codeine for noncancer pain between 1998 and 2012. Cohort and case-crossover analyses were also conducted to assess consistency of the results. Main Outcomes and Measures: Cases of hospitalization for hypoglycemia were matched with up to 10 controls on age, sex, and duration of follow-up. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated comparing use of tramadol with codeine. A cohort analysis, with high-dimensional propensity score-adjusted hazard ratios (HRs) and 95% CIs, was performed comparing tramadol with codeine in the first 30 days after treatment initiation. Finally, a case-crossover analysis was also performed, in which exposure to tramadol in a 30-day risk period immediately before the hospitalization for hypoglycemia was compared with 11 consecutive 30-day control periods. Odds ratios and 95% CIs were estimated using conditional logistic regression analysis.

RESULTS: The cohort included 334 034 patients, of whom 1105 were hospitalized for hypoglycemia during follow-up (incidence, 0.7 per 1000 per year) and matched to 11 019 controls. Compared with codeine, tramadol use was associated with an increased risk of hospitalization for hypoglycemia (OR, 1.52 [95% CI, 1.09-2.10]), particularly elevated in the first 30 days of use (OR, 2.61 [95% CI, 1.61-4.23]). This 30-day increased risk was confirmed in the cohort (HR, 3.60 [95% CI, 1.56-8.34]) and case-crossover analyses (OR, 3.80 [95% CI, 2.64-5.47]). Conclusions and Relevance: The initiation of tramadol therapy is associated with an increased risk of hypoglycemia requiring hospitalization. Additional studies are needed to confirm this rare but potentially fatal adverse event.


 –  Progetto ASCO  – Fibromyalgia A Clinical Review

JAMA April 16, 2014 Volume 311, Number 15 – Visualizza


 – Acupuncture for chronic knee pain: a randomized clinical trial

JAMA. 2014 Oct, Abstract – Visualizza


 –  Interpreting the Clinical Importance of Treatment Outcomes in Chronic Pain Clinical Trials: IMPACT Recommendations

The Journal of Pain, Vol 9, No 2 (February), 2008: pp 105-121 – Visualizza


  –  Pain education to prevent chronic low back pain: a study protocol for a randomised controlled trial

BMJ Open 2014;4:e005505 doi:10.1136/bmjopen-2014-005505 – Visualizza


 Neuropathic pain: mechanisms and their clinical implications

BMJ 2014; 348 doi: http://dx.doi.org/10.1136/bmj.f7656 (Published 05 February 2014) Cite this as: BMJ 2014;348:f7656 – Visualizza


 – Neuropathic pain in the general population: a systematic review of epidemiological studies.

Pain. 2014 Apr;155(4):654-62 – Visualizza


 – Pain palliation measurement in cancer clinical trials: the US Food and Drug Administration perspective.

Cancer. 2014 Mar 1;120(5):761-7 – Visualizza


 – IASP (International Association for the Study of Pain) CLINICAL UPDATES

1.Medical Cannabis and Pain – October 2014 (Volume 22, Issue 3) – Mark Ware and Julie Desroches –Visualizza

2. Integrative Pain Medicine: A Holistic Model of Care May 2014 (Volume 22, Issue 2) – Heather Tick – Visualizza


 – Practice guidelines for chronic pain management: an updated report by the American Society of Anesthesiologists Task Force on Chronic Pain Management and the American Society of Regional Anesthesia and Pain Medicine.

Anesthesiology 2010; 112:1–1 – Visualizza


 –  Clinical importance of changes in chronic pain intensity measured on an 11-point numerical pain rating scale

Pain 94 (2001) 149–158 – Visualizza