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Special Issue "Pain and Rheumatology"

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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Anesthesiology".

Deadline for manuscript submissions: 31 December 2023 | Viewed by 11008

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Special Issue Editors

Prof. Dr. Giustino Varrassi

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Guest Editor

Paolo Procacci Foundation, Roma, Italy
Interests: pain medicine; anesthesiology
Special Issues, Collections and Topics in MDPI journals

Prof. Dr. Piercarlo Sarzi-Puttini

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Guest Editor

1. School of Medicine, University of Milano, Milan, Italy
2. Rheumatology Unit, Internal Medicine Department, ASST Fatebenefratelli Sacco, Milan, Italy
Interests: pain medicine; pain assessment; pain management; acute pain; chronic pain; pain research; comorbidity; anesthesiology

Prof. Dr. Stefano Coaccioli

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Guest Editor

Department of Internal Medicine, School of Medicine, Perugia University, Terni, Italy
Interests: pain medicine; rheumatology; clinical immunology; internal medicine

Special Issue Information

Dear Colleagues,

It is our pleasure to present a new “Special Issue” in this journal, whose aim it is to make clear the strong relationship between “Pain” and “Rheumatology”. It would be useless to discuss the epidemiological aspects of this important correlation, which affects a huge quantity of patients all over the world. This Special Issue seeks a new scientific vision on the pathophysiologic aspects of this topic. However, proposals involving basic science and research on the many different aspects of this terrible enemy of humankind are also encouraged. Pain and rheumatology are strictly connected; even the most modern therapies for rheumatic pathologies, which have changed the prognosis of these diseases, are not completely able to prevent or cure the pain they inflict.

This “Special Issue” aims to provide an up-to-date overview of modern discoveries of the inflammatory processes linked to rheumatic diseases, from the molecular scale to the consequences of inflammation. It also hopes to reveal the genetic predispositions for a group of pathologies affecting a large part of the population. Correlations between rheumatic pathologies and other organs/systems (e.g., nervous, cardiovascular, renal, etc.) and their relationship to pain should be highlighted through reports on the last discoveries. The importance of rehabilitation and non-pharmacological treatments, as elucidated by relevant results from scientists around the world, should also be emphasized. This includes any potential interventional treatments for the management of pain in rheumatic diseases. Lastly, submissions should provide a modern vision of pharmacologic therapy, which remains a cornerstone for the wellbeing of the patients affected by rheumatic diseases.

We look forward to receiving your submissions.

Prof. Dr. Giustino Varrassi
Prof. Dr. Piercarlo Sarzi-Puttini
Prof. Dr. Stefano Coaccioli
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Published Papers (4 papers)

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Research

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Open AccessArticle

New Perspectives on the Adverse Effects of NSAIDs in Cancer Pain: An Italian Delphi Study from the Rational Use of Analgesics (RUA) Group

Vittorio Andrea Guardamagna

Filomena Puntillo

and

Giovanni Sotgiu

J. Clin. Med. 2022, 11(24), 7451; https://doi.org/10.3390/jcm11247451 - 15 Dec 2022

Cited by 2 | Viewed by 1062

Abstract

Non-steroidal anti-inflammatory drugs (NSAIDs) are among the most frequently prescribed drugs for cancer pain. We used the Delphi methodology to evaluate the opinions of clinicians on NSAIDs and paracetamol, with a specific focus on their safety profile. Consensus was reached on seven statements. A high level of consensus was reached regarding the use of NSAIDs and gastrointestinal, cardiovascular, and renal risk in patients taking low-dose aspirin and assessment of liver function during long-term treatment with paracetamol. Consensus was also reached that assessment and monitoring of eGFR are important in the elderly being administered NSAIDs. It was further agreed that NSAIDs can often play a key role in association with opioids in the treatment of cancer pain and that paracetamol is the analgesic of first choice for patients with mild chronic pain. When NSAIDs are administered in combination with steroids, it was agreed that the risk of gastrointestinal damage is increased since steroids delay the healing of ulcers and that paracetamol can be used during pregnancy and does not affect the health of the fetus. This Delphi study highlights that there is poor agreement on how these drugs are routinely prescribed. However, a consensus was reached for seven key statements and may represent a valid contribution to daily practice. Full article

(This article belongs to the Special Issue Pain and Rheumatology)

Review

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Open AccessReview

Bone Cement and Its Anesthetic Complications: A Narrative Review

and

J. Clin. Med. 2023, 12(6), 2105; https://doi.org/10.3390/jcm12062105 - 07 Mar 2023

Cited by 1 | Viewed by 3384

Abstract

The concept of bone cement implantation syndrome (BCIS) is not yet fully understood. In patients undergoing cemented hip arthroplasty, it is a significant factor in intraoperative mortality and morbidity. It may also manifest in a milder form postoperatively, resulting in hypoxia and confusion. In the older population, hip replacement surgery is becoming more prevalent. The risks of elderly patients suffering BCIS may be increased due to co-existing conditions. In this article, we present a narrative review of BCIS including its definition, incidence, risk factors, etiology, pathophysiology, clinical features, prevention, and management, all from an anesthetic point of view. Full article

(This article belongs to the Special Issue Pain and Rheumatology)

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Open AccessReview

Radiation Exposure during Fluoroscopy-Guided Ozone Chemonucleolysis for Lumbar Disc Herniation

Matteo Luigi Giuseppe Leoni

and

J. Clin. Med. 2022, 11(24), 7424; https://doi.org/10.3390/jcm11247424 - 14 Dec 2022

Cited by 1 | Viewed by 918

Abstract

Introduction: Radiation exposure is a frequent drawback of spinal surgery, even if X-ray guidance plays a pivotal role in improving the accuracy and safety of spinal procedures. Consequently, radiation protection is essential to reduce potential negative biological effects. The aim of this study was to evaluate patients’ radiation exposure, the radiation dose emission during fluoroscopy-guided ozone chemonucleolysis (OCN), and the potential role of patient characteristics. Methods: The radiation dose emission reports were retrospectively evaluated in patients who underwent single-level OCN for lumbar disc herniation. A generalized linear model (GLM) with a gamma distribution and log link function was used to assess the association between radiation emission and patients’ characteristics such as age, sex, BMI, level of disc herniation, disc height, and site of disc herniation. Results: Two hundred and forty OCN cases were analyzed. A safe and low level of radiation exposure was registered during OCN. The median fluoroscopy time for OCN was 26.3 (19.4–35.9) seconds, the median radiation emission dose was 19.3 (13.2–27.3) mGy, and he median kerma area product (KAP) was 0.46 (0.33–0.68) mGy ⋅ m². The resulting KAP values were highly dependent on patient variables. In particular, sex, obesity, and residual disc height < 50% significantly increased the measured KAP, while levels of disc herniations other than L5-S1 reduced the KAP values. Conclusions: The radiation exposure during OCN is low and quite similar to a simple discography. However, patient characteristics are significantly related to radiation exposure and should be carefully evaluated before planning OCN. Full article

(This article belongs to the Special Issue Pain and Rheumatology)

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Open AccessReview

Osteoarthritis: New Insight on Its Pathophysiology

Stefano Coaccioli

Piercarlo Sarzi-Puttini

Panagiotis Zis

Giuseppe Rinonapoli

and

Giustino Varrassi

J. Clin. Med. 2022, 11(20), 6013; https://doi.org/10.3390/jcm11206013 - 12 Oct 2022

Cited by 16 | Viewed by 4963

Abstract

Understanding of the basis of osteoarthritis (OA) has seen some interesting advancements in recent years. It has been observed that cartilage degeneration is preceded by subchondral bone lesions, suggesting a key role of this mechanism within the pathogenesis and progression of OA, as well as the formation of ectopic bone and osteophytes. Moreover, low-grade, chronic inflammation of the synovial lining has gained a central role in the definition of OA physiopathology, and central immunological mechanisms, innate but also adaptive, are now considered crucial in driving inflammation and tissue destruction. In addition, the role of neuroinflammation and central sensitization mechanisms as underlying causes of pain chronicity has been characterized. This has led to a renewed definition of OA, which is now intended as a complex multifactorial joint pathology caused by inflammatory and metabolic factors underlying joint damage. Since this evidence can directly affect the definition of the correct therapeutic approach to OA, an improved understanding of these pathophysiological mechanisms is fundamental. To this aim, this review provides an overview of the most updated evidence on OA pathogenesis; it presents the most recent insights on the pathophysiology of OA, describing the interplay between immunological and biochemical mechanisms proposed to drive inflammation and tissue destruction, as well as central sensitization mechanisms. Moreover, although the therapeutic implications consequent to the renewed definition of OA are beyond this review scope, some suggestions for intervention have been addressed. Full article

(This article belongs to the Special Issue Pain and Rheumatology)

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