1,721,050 research outputs found
The Afterlife of Dante’s Vita Nova in the Anglophone World: Interdisciplinary Perspectives on Translation and Reception History
No full textThis volume provides the first systematic study of the translation and reception of Dante’s Vita Nova in the Anglophone world, reconstructing for the first time the contexts and genesis of its English-language afterlife from the early nineteenth century to the present day.
Dante is one of the foremost authors of the Western canon, and his Vita Nova has been repeatedly translated into English over the past two centuries. However, there exists no comprehensive account of the critical, scholarly, and creative English-language reception of Dante’s work. This collection brings together scholars from Dante studies, translation studies, English studies, and book history to examine the translation and reception of the Vita Nova among modern English-speaking publics, in both academic and non-academic contexts, and thus represents a major contribution to Dante studies.
The Afterlife of Dante’s Vita Nova in the Anglophone World will be an essential reference point for scholars and students in English and Italian studies, literary and cultural studies, and translation and reception studies in the UK, Ireland, the USA, and Italy, where Dante is taught and researched
Intraoperative nociception. “If you can’t measure it, you can’t manage it”
Full text linkIn clinical practice, analgesia is still empirically monitored by using variation of heart rate, blood pressure, and sweating, as the result of the sympathetic activation, or movements. The challenge of monitoring analgesia in anesthetized patients is related to the interference of hypnosis and cardiovascular drugs used during general anesthesia, and to the rapid changes of the sympathetic system activation observed during surgery. Clinical studies showed that the ANI, the SPI, and pupillary dilatation were superior to clinical signs in detecting changes in the antinociception nociception balance in patients undergoing total general anesthesia. The role of currently available devices for intraoperative nociception monitoring is still unclear, but, for adequate analgesia management during surgery, the need for an objective measurement as an alternative to the current clinical standard of care is imminent
The potential role of dual mechanistic opioids in combating opioid misuse
No full textPurpose: In the last years, the consumption of opioid analgesics in western countries, particularly in USA, has dramatically increased, and this rise has been paralleled by a proportional number of opioid-related deaths. To response to this health crisis, opioid guidelines have been developed to reduce the risk of harm related to opioid prescribing. Many activities have been suggested to face opioid epidemic. Clinicians should find a proper balance that meets the patient’s need for pain relief while minimizing abuse. The aim of this review was to examine the value of so-called dual opioids in this context Recent Findings: Many activities have been suggested to face opioid epidemic. Clinicians should find a proper balance that meets the patient’s need for pain relief while minimizing abuse. Dual mechanistic opioids, including tramadol and tapentadol, could be less appealing for opioid abusers, because of the reduced mu-load. Significant differences have been observed in post-marketing surveillance between tramadol and tapentadol, in favor of the latter. Summary: Further investigations are warranted for clarifying the role of innovative molecules for preventing opioid abuse
Tapentadol in the management of cancer pain: current evidence and future perspectives
Full text linkHans G Kress,1 Flaminia Coluzzi2 1Department of Special Anesthesia and Pain Medicine, Medical University, Vienna General Hospital, Vienna, Austria; 2Department of Medical and Surgical Sciences and Biotechnologies, Unit of Anesthesia, Intensive Care and Pain Medicine, Sapienza University of Rome, Polo Pontino, Latina, Italy Abstract: Thanks to the progress in early diagnosis and treatment of cancer, the life expectancy of cancer patients has now increased. Patients are, therefore, more likely to experience their individual cancer pain as a chronic pain. As a consequence, long-term treatment of cancer-related pain and oncological therapy-related pain are a major need for all patients and a challenge to all healthcare professionals. Tapentadol is a centrally acting analgesic drug characterized by two synergistic mechanisms of action, since it acts at the µ-opioid receptor (MOR) and inhibits noradrenalin re-uptake (NRI). Therefore, tapentadol has been considered the first of a new class of drugs, MOR-NRI. Tapentadol has been tested in different populations of cancer patients (opioid-naive and -pretreated), such as those with pain of mixed etiology, patients with pain from hematological malignancies and patients experiencing pain conditions due to anticancer treatment. According to available evidence, tapentadol prolonged release was well tolerated and effective in cancer pain patients. In randomized, double-blind and active-controlled trials it proved non-inferior to standard opioids like morphine or oxycodone in the management of moderate-to-severe cancer pain, both in opioid-naive and in opioid-pretreated patients. The good analgesic efficacy may be partly due to the action of tapentadol on neuropathic pain components. Together with the low rate of gastrointestinal adverse effects and the overall favorable safety profile, tapentadol can be considered a good option in cancer pain patients, who can suffer frequently from nausea, vomiting, constipation or other events that further reduce their quality of life. Keywords: cancer pain, tapentadol, neuropathic pai
The anglophone Vita Nova: translators and readers
No full textThis chapter sets out the rationale for this volume. Despite some significant studies on the English reception of the Vita Nova, there is no comprehensive book that systematically examines significant and representative translations, drawing on a number of different fields, from Dante Studies and English Studies to Translation Studies and Book History Studies. The chapter presents the structure of the book, which is articulated in three parts, roughly corresponding to the nineteenth century; the first half of the twentieth century; and postwar to the present. It, furthermore, summarizes key issues treated in the 12 chapters of the volume, and contextualizes the English-language translations within global translations of the Vita Nova
Managing chronic pain patients at the time of covid-19 pandemic
Full text linkCOVID-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
The effect of opiates on bone formation and bone healing
No full textPurpose of Review: Opioids have been shown to be associated with an increased risk of fracture. The purpose of this paper is to review recent research into the effects of opioids on bone formation and bone healing in animal models and in human studies. Recent Findings: Most opioids, such as morphine and fentanyl, negatively affected bone remodeling and bone healing in animal models. Conversely, remifentanil has been recently shown to promote in vitro osteoblast differentiation and to inhibit differentiation and maturation of osteoclasts, therefore reducing bone resorption. According to the possible negative role of opioids in bone healing, opioid antagonists have been shown to enhance bone mineralization, suggesting a possible therapeutic role in the future for osteoporosis. Other neuropeptides, such as the vasoactive intestinal peptide (VIP) and the neuropeptide Y (NPY), have been proved to promote osteogenesis. The increased risk of fractures among opioid users may be related to their central nervous system side effects or to the reduced bone density, partly due to their endocrine effects, and partly to their direct activity on bone cells. Clinical data strongly suggested a potential negative effect of opioids in bone healing. The risk of nonunion fracture is significantly increased in opioid users, and bone mass density was reduced in patients under long-term opioid treatment. Summary: The direct effects of opioids on bone remodeling appears evident from these reports. Not all opioids have the same potential for negatively impacting bone healing. Opioid antagonists may increase bone density and could represent a possible future treatment for low bone mass density pathologies. However, further trials are warranted to clarify the clinical relevance of these emerging findings from animal studies
Naldemedine. A new option for OIBD
Full text linkOpioid-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. We will herein review its underlying pathophysiological mechanisms and the available treatments. In the last years, pharmaceutical research has focused on the opportunity of targeting peripheral mu-opioid receptors without affecting their analgesic activity in the central nervous system, and several peripherally acting mu-opioid receptors antagonists (PAMORAs) drugs have been approved. We will mainly focus on naldemedine, discussing its pharmacological properties, its clinical efficacy and side effects. Head-to-head comparisons between naldemedine and the other PAMORAs are not available yet, but some considerations will be discussed based on the pharmacological and clinical data. As a whole, the available data suggest that naldeme-dine is a valid treatment option for OIBD, as it is a well-tolerated drug that alleviates constipation without affecting analgesia or causing symptoms of opioid withdrawal
Using opioid therapy for pain in clinically challenging situations. Questions for clinicians
Full text linkHealthcare 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. The authors have formulated ten questions to address in order to provide adequate analgesia for such patients. These questions demand a highly individualized approach to analgesia. These ten questions involve understanding the painful condition (presumed trajectory, duration, type of pain), using validated metrics such as risk assessment tools, guidelines, protocols, and safeguards within the system, selection of the optimal analgesic product(s) or combination therapy, and never starting opioid therapy without clear treatment objectives and a definitive exit plan. It is tempting but inaccurate to label these individuals as “inappropriate patients,” rather they are high-risk individuals in very challenging clinical situations. The challenge is that both options — being in pain or being treated with opioids to control pain — expose the patient to a risk of rekindling an addiction. The question is how do we, as clinicians, adequately respond to these very perplexing clinical challenges
Chronic pain management in pregnancy and lactation.
No full textDuring pregnancy most of women will experience some kind of pain, either as a result of a pre-existing condition (low back pain, headache, fibromyalgia, and rheumatoid arthritis) or as a direct consequence of pregnancy (weight gain, postural changes, pelvic floor dysfunction, hormonal factors). However, chronic pain management during pregnancy and lactation remains a challenge for clinicians and pregnant women are at risk of undertreatment for painful conditions, because of fear about use of drugs during pregnancy. Few analgesic drugs have been demonstrated to be absolutely contraindicated during pregnancy and breastfeeding, but studies in pregnant women are not available for most of pain medications. The aim of this paper is to review the safety profile in pregnancy or lactation of the commonly prescribed pain medications and non-pharmacological treatments. In addition to the conventional classifications from the Food and Drug Administration and the American Academy of Paediatrics, authors analyzed the currently available clinical data from literatur
- …
