Review
Anesthesiology
Thomas Cheriyan, Mohamed Gaber, Taylor Glenn, John Latremouille, Kayla L. Loy, Jerry Cheriyan, Anterpeet Dua, Paramvir Singh, Vikas Kumar, Mohamed Ben Omran
Summary: This meta-analysis compares the efficacy of intraoperative methadone with other opioids on postoperative outcomes. The results show that there is no significant reduction in opioid consumption postoperatively between the groups. However, pain scores within 24 hours were significantly lower in the methadone group. There was no difference in secondary outcomes such as extubation time, nausea, vomiting, and respiratory depression.
Article
Anesthesiology
Feliciano C. N. Duarte, Leonardo H. D. C. Ferraro, Alessandra Ferreira, Rioko K. Sakata
Summary: The study aimed to evaluate whether the combination of a low dose of methadone with morphine could reduce opioid consumption and provide faster pain relief. The results showed that the combination provided faster pain control compared to morphine alone, with no significant difference in adverse effects between the groups.
CLINICAL JOURNAL OF PAIN
(2021)
Review
Pharmacology & Pharmacy
Sebastiano Mercadante
Summary: Managing cancer pain is challenging, and opioid therapy remains the cornerstone. Individual characteristics should guide the choice of opioids, and optimizing therapy allows for personalized treatment based on patient characteristics and pain syndromes. Adjuvants and interventional procedures are options in specific circumstances.
Review
Pharmacology & Pharmacy
Sebastiano Mercadante
Summary: Intravenous methadone is a valuable option for both acute and chronic pain management due to its unique characteristics. Studies have shown that it can effectively reduce postoperative pain and opioid consumption, with potential benefits in preventing persistent postoperative pain. Limited studies have also indicated promising activities of intravenous methadone in cancer pain management. More research is needed, particularly in patients with cancer pain.
Article
Neurosciences
Erik Nylander, Sofia Zelleroth, Fred Nyberg, Alfhild Gronbladh, Mathias Hallberg
Summary: Opioids like methadone and fentanyl have negative effects on mitochondrial morphology, potentially leading to neuronal cell death.
BRAIN RESEARCH BULLETIN
(2021)
Review
Medicine, General & Internal
Mia Elena Koponen, Patrice Forget
Summary: This study aimed to investigate pharmacological interventions for opioid-induced hyperalgesia caused by different opioids. The majority of interventions were studied in only one trial, with the most common mechanism being the inhibition of N-methyl-D-aspartate (NMDA) receptors.
JOURNAL OF CLINICAL MEDICINE
(2022)
Review
Pharmacology & Pharmacy
Camila Vantini Capasso Palamim, Matheus Negri Boschiero, Alethea Guimaraes Faria, Felipe Eduardo Valencise, Fernando Augusto Lima Marson
Summary: The use of opioids during the COVID-19 pandemic has both positive and negative aspects. Positively, opioids can be used for pain relief, chronic pain management, and as a supplement in the management of acute pain. However, they may exacerbate respiratory depression, lead to opioid tolerance, and result in increased adverse effects at higher doses.
FRONTIERS IN PHARMACOLOGY
(2022)
Article
Oncology
Judith A. Paice, Kari Bohlke, Debra Barton, David S. Craig, Areej El-Jawahri, Dawn L. Hershman, Lynn R. Kong, Geana P. Kurita, Thomas W. LeBlanc, Sebastiano Mercadante, Kristina L. M. Novick, Ramy Sedhom, Carole Seigel, Joanna Stimmel, Eduardo Bruera
Summary: The purpose of this article is to provide guidance on the use of opioids for managing cancer-related pain in adults. The authors conducted a systematic review of the literature and identified the efficacy and safety of opioid analgesics, approaches to opioid initiation and titration, and strategies for preventing and managing opioid adverse events. The findings indicate that opioids effectively reduce pain in patients with moderate-to-severe cancer pain, but there is limited evidence for some questions of interest, leading to consensus-based recommendations or the absence of recommendations.
JOURNAL OF CLINICAL ONCOLOGY
(2023)
Article
Multidisciplinary Sciences
Saeyeon Kim, In-Ae Song, Boram Lee, Tak Kyu Oh
Summary: This study investigated the risk factors for discontinuing intravenous patient-controlled analgesia (IV PCA) due to side effects after general surgery. The findings indicate that female sex, hepato-pancreatic-biliary surgery, and background infusion of PCA are associated with an increased likelihood of discontinuing PCA, while preoperative opioid use is linked to a decreased likelihood of discontinuation. Individualized pain management, considering patient characteristics and surgical procedures, is crucial.
SCIENTIFIC REPORTS
(2023)
Review
Biochemistry & Molecular Biology
Ana Catarina Matos, Ines Alexandra Marques, Ana Salome Pires, Ana Valentim, Ana Margarida Abrantes, Maria Filomena Botelho
Summary: Breast cancer is a common and deadly disease in women. This systematic review examines the effects of analgesics and local anesthetics on breast cancer cells and animal models. The results show that local anesthetics have anti-tumorigenic properties, while morphine appears to promote tumor growth. More research is needed to understand the controversial effects of each drug and their implications for breast cancer treatment outcomes and prognosis.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2022)
Article
Pharmacology & Pharmacy
Sebastiano Mercadante, Russell K. Portenoy
Summary: Breakthrough cancer pain (BTcP) is a complex phenomenon that varies between individuals and may change over time. Personalized management requires appropriate assessment of BTcP patterns. The use of opioids, specifically fentanyl products with rapid onset and offset, is recommended. The optimal opioid dose remains a controversial topic, with conflicting recommendations regarding dosing strategies.
Article
Oncology
Sebastiano Mercadante, Claudio Adile, Patrizia Ferrera, Maria Caterina Pallotti, Marianna Ricci, Giuseppe Bonanno, Alessandra Casuccio
Summary: This study aimed to evaluate the efficacy and adverse effects of methadone as a first-line therapy in patients receiving low doses of opioids or none. Results showed that methadone provided good analgesia with limited adverse effects and minimal opioid-induced tolerance.
Article
Medicine, General & Internal
Mihai O. Botea, Diana Lungeanu, Alina Petrica, Mircea I. Sandor, Anca C. Huniadi, Claudiu Barsac, Adina M. Marza, Ramona C. Moisa, Laura Maghiar, Raluca M. Botea, Codruta I. Macovei, Erika Bimbo-Szuhai
Summary: Perioperative analgesia for cesarean section is crucial for the comfort, success, and recovery of mothers. Adding morphine to bupivacaine significantly improves pain management and satisfaction levels but also increases the risk of adverse reactions. Further research is needed to determine appropriate dosages.
JOURNAL OF CLINICAL MEDICINE
(2023)
Review
Medicine, General & Internal
Josephine L. Feliciano, Julie M. Waldfogel, Ritu Sharma, Allen Zhang, Arjun Gupta, Ramy Sedhom, Jeff Day, Eric B. Bass, Sydney M. Dy
Summary: This systematic review and meta-analysis included 19 studies evaluating pharmacologic interventions for breathlessness in patients with advanced cancer. The evidence did not support the association of opioids or other pharmacologic interventions with improved breathlessness. While pharmacologic interventions demonstrated some harms compared with usual care, dropout attributable to adverse events was minimal in these short-term studies.
Article
Clinical Neurology
Alan Villavicencio, Hash Brown Taha, Sigita Burneikiene
Summary: Intrathecal morphine (ITM) has been effective in improving postoperative outcomes, but may cause respiratory depression. This study compared the use of ITM alone or with fentanyl in patients undergoing lumbar interbody fusions. Both ITM and ITM + fentanyl groups had lower pain scores and opioid intake on postoperative day 1 compared to the control group. The addition of fentanyl predicted a decrease in opioid intake, but there were no differences in opioid-related side effects.
NEUROSURGICAL REVIEW
(2023)
Article
Biology
Davide Vacca, Antonino Fiannaca, Fabio Tramuto, Valeria Cancila, Laura La Paglia, Walter Mazzucco, Alessandro Gulino, Massimo La Rosa, Carmelo Massimo Maida, Gaia Morello, Beatrice Belmonte, Alessandra Casuccio, Rosario Maugeri, Gerardo Iacopino, Carmela Rita Balistreri, Francesco Vitale, Claudio Tripodo, Alfonso Urso
Summary: In this study, direct RNA sequencing technology was used to directly identify SARS-CoV-2 sequences from samples of patients infected with the virus in Sicily, Italy. Mutations were found in the nucleocapsid gene, and the technique used offers the advantages of true native RNA sequencing without amplification steps that could introduce errors. This study provides novel information relevant to next-generation sequencing strategies for SARS-CoV-2.
Article
Environmental Sciences
Giuseppa Minutolo, Palmira Immordino, Alessia Dolce, Mario Valenza, Emanuele Amodio, Walter Mazzucco, Alessandra Casuccio, Vincenzo Restivo
Summary: This study investigated the adherence to colorectal cancer screening in the Palermo province of Italy and found that the population had lower adherence to colonoscopy. The results indicated that perceived benefits of colonoscopy were significantly associated with adherence.
INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH
(2022)
Article
Environmental Sciences
Palmira Immordino, Dario Genovese, Fatima Morales, Alessandra Casuccio, Emanuele Amodio
Summary: Undocumented migrants in Italy, particularly those in Sicily, have experienced worse health outcomes during the COVID-19 pandemic, with higher hospitalization rates and more severe clinical outcomes compared to Italian nationals.
INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH
(2022)
Article
Immunology
Emanuele Amodio, Giuseppe Vella, Vincenzo Restivo, Alessandra Casuccio, Francesco Vitale
Summary: This retrospective cohort study in Sicily aimed to estimate the effectiveness of mRNA COVID-19 vaccines. The results showed high effectiveness in the first two months after vaccination, but a decrease over time, suggesting the need for booster vaccination campaigns.
Article
Immunology
Emanuele Amodio, Giuseppa Minutolo, Alessandra Casuccio, Claudio Costantino, Giorgio Graziano, Walter Mazzucco, Alessia Pieri, Francesco Vitale, Maurizio Zarcone, Vincenzo Restivo
Summary: Coronavirus disease (COVID-19) has caused high morbidity and mortality globally. BNT162b2, the only authorized vaccine in Italy, can lead to adverse reactions. An active surveillance system using instant messaging was implemented to monitor vaccine recipients, revealing a higher prevalence of adverse reactions after the second dose compared to the first dose. Younger individuals and females were at higher risk for adverse reactions. This active surveillance system appears to be more effective in detecting adverse reactions compared to passive surveillance.
Review
Nutrition & Dietetics
Pasquale Mansueto, Aurelio Seidita, Marta Chiavetta, Dario Genovese, Alessandra Giuliano, Walter Priano, Antonio Carroccio, Alessandra Casuccio, Emanuele Amodio
Summary: This narrative review analyzed the correlation between diet and clinical outcomes of familial Mediterranean fever (FMF). Conflicting results were found regarding the association between high-fat and high-salt food intake and FMF attack recurrence. Wheat was suggested to potentially play a role in FMF. A diet rich in antioxidants and anti-inflammatory supplements may partly reduce symptoms and improve the well-being of FMF patients. However, further studies are needed to clarify the impact of diet on FMF symptom triggering.
Article
Health Care Sciences & Services
Sebastiano Mercadante, Yasmine Grassi, Alessio Lo Cascio, Vincenzo Restivo, Alessandra Casuccio
Summary: This study explored the characteristics of patients who had never received anticancer treatments at admission to an acute supportive palliative care unit. The results showed that these treatment-naive patients were mainly admitted to the unit due to low Karnofsky status and high symptom burden. Compared to patients who had received treatment, these patients were older, more frequently male, had more comorbidities, and had higher symptom burden that was less responsive to palliative treatment. They also had a higher mortality rate within three months.
JOURNAL OF PAIN AND SYMPTOM MANAGEMENT
(2023)
Article
Health Care Sciences & Services
Sebastiano Mercadante, Alessio Lo Cascio, Alessandra Casuccio
Summary: This study assessed the outcome of switching patients from oral opioids to intravenous methadone (IV-ME), and evaluated the conversion ratio from IV-ME to oral methadone at hospital discharge. The results showed that titrated IV-ME dose infusion allowed rapid pain control in patients with severe pain not responsive to previous opioids. Conversion to oral methadone was successful and facilitated discharge. Further studies are needed to confirm these findings.
JOURNAL OF PAIN AND SYMPTOM MANAGEMENT
(2023)
Article
Oncology
Vincenzo Restivo, Giuseppa Minutolo, Marianna Maranto, Antonio Maiorana, Francesco Vitale, Alessandra Casuccio, Emanuele Amodio
Summary: This study aims to assess the effectiveness of preventive strategies in Italian HPV-related hospital admissions. From 2008 to 2018, all HPV-related diseases showed a decrease. The increase in cervical cancer screening adherence and HPV vaccine coverage led to a decrease in invasive cervical cancer and in situ cervical cancer. The study highlights the need to improve acceptance of preventive strategies and provide consistent information by healthcare workers.
Article
Immunology
Vincenzo Restivo, Alessandra Fallucca, Federica Trapani, Palmira Immordino, Giuseppe Calamusa, Alessandra Casuccio
Summary: Suboptimal levels of measles vaccination coverage in Italy have led to endemic virus circulation and nosocomial outbreaks among hospitalized patients and healthcare workers. A study conducted in the University Hospital of Palermo found that almost half of the healthcare workers were not immunized against measles, with factors such as female sex, non-physician status, high perception of barriers to vaccination, and lack of immunization for other exanthematous diseases being associated with non-immunization. Effective strategies are needed to increase immunization coverage among healthcare workers and prevent further nosocomial measles outbreaks.
Article
Immunology
Marianna Maranto, Giuseppe Gullo, Alessandra Bruno, Giuseppa Minutolo, Gaspare Cucinella, Antonio Maiorana, Alessandra Casuccio, Vincenzo Restivo
Summary: Pregnant women are at higher risk of severe COVID-19 complications. The exclusion of pregnant women from vaccine trials has led to a lack of conclusive data on vaccine safety and efficacy for this vulnerable population. Factors associated with vaccine acceptance among high-risk pregnant women were identified through a cross-sectional study. The results showed that a high educational level, low perception of barriers to vaccination, and gynecologist's advice were associated with vaccine acceptance. Vaccine hesitancy among pregnant women highlights the need to address conflicting information and develop effective vaccination strategies.
Article
Pediatrics
Anna Maria Caruso, Denisia Bommarito, Vincenza Girgenti, Glenda Amato, Ugo Calabrese, Adele Figuccia, Fabio Baldanza, Francesco Grasso, Emanuela Giglione, Alessandra Casuccio, Mario Pietro Marcello Milazzo, Maria Rita Di Pace
Summary: This study analyzed anal sphincter activity in patients with anorectal malformation (ARM) using Three-Dimensional High Resolution Anorectal Manometry (3D-HRAM). The results revealed a correlation between manometric parameters and clinical outcomes, highlighting spinal malformations and ARM type as important prognostic risk factors for a bad outcome. Specific sphincteric defects can be explored with manometry, enabling tailored bowel management strategies.
Article
Gastroenterology & Hepatology
Giuseppe Miceli, Vincenza Calvaruso, Alessandra Casuccio, Grazia Pennisi, Massimo Licata, Chiara Pintus, Maria G. Basso, Mariachiara Velardo, Mario Daidone, Emanuele Amodio, Salvatore Petta, Fabio Simone, Giuseppe Cabibbo, Domenico Di Raimondo, Antonio Craxi, Antonio Pinto, Antonino Tuttolomondo
Summary: This study investigated the correlation between HRV parameters and the degree of portal hypertension in patients with cirrhosis. The results showed that liver dysfunction was positively correlated with HRV parameters, while the presence of ascites was negatively correlated. Drug treatment also had an impact on HRV parameters. These findings suggest a role of the autonomic nervous system in hepatic decompensation.
HEPATOLOGY COMMUNICATIONS
(2023)
Article
Immunology
Vincenzo Restivo, Alessandra Bruno, Giuseppa Minutolo, Alessia Pieri, Luca Riggio, Maurizio Zarcone, Stefania Candiloro, Rosalia Caldarella, Palmira Immordino, Emanuele Amodio, Alessandra Casuccio
Summary: The study aimed to evaluate the effectiveness of an online intervention among adolescents during the COVID-19 pandemic in increasing knowledge and positive attitudes toward vaccinations. The results showed a significant increase in perception of disease severity among adolescents after the intervention. The educational intervention was found to be more effective in schools with lower dropout rates. It is crucial to tailor interventions for adolescents to reduce their concerns about adverse effects and improve vaccination coverage.
Article
Immunology
Palmira Immordino, Vincenzo Pisciotta, Emanuele Amodio, Celestino Bonura, Floriana Bonura, Federica Cacioppo, Giuseppe Calamusa, Giuseppina Capra, Alessandra Casuccio, Simona De Grazia, Dario Genovese, Davide Graci, Guido Lacca, Giuseppa Luisa Sanfilippo, Maria Gabriella Verso, Giovanni Maurizio Giammanco, Donatella Ferraro
Summary: The study compared neutralizing antibody titers against SARS-CoV-2 variants in recovered and vaccinated healthcare workers. Higher titers were observed in vaccinated individuals compared to recovered patients, indicating better efficacy of artificial immunization. This emphasizes the importance of vaccination even in individuals with previous infections.