rome and Opioid-Related-Disorders

The incidence of post-surgical chronic pain ranges between 20% and 40% in Europe. Osteoarthritis pain after prosthesis implantation is one of the most severe secondary syndromes, depending not only on surgery but also on organic changes before and after joints replacement. No data are available about risk factors. An excessive inflammatory response plays a central role but a best therapy is not defined yet. It is not clear whether opioid administration could influence post-surgical pain and lead to tolerance or addiction. Interestingly, the immune system, together with the nervous and peptidergic ones, is involved in hypersensibility. The connection across the three biological systems lies in the presence of opioid receptors on immune cells surface. Here, we show a method to analyze whether opioids could modulate lymphocytes, by proposing opioid receptors as biological markers to prevent chronic pain and opioid tolerance or addiction after hip surgery.. After institutional independent ethics committee approval, 60 patients, in pain and undergoing hip surgery, will be enrolled in a single-blind, randomized, phase IV, pilot study. Pain treatment will be selected inside a class of non-steroidal anti-inflammatory drugs (NAISDs) or paracetamol or a class of opioids, into three medication arms: 25 mg tapentadol twice daily; 75 mg tapentadol twice daily; NSAIDs or paracetamol in accordance with surgeon's custom. For each group, we will collect blood samples before, during and after surgery, to apply molecular analysis. We will perform lymphocyte opioid receptors genes and proteins expression and functional analysis. Data will be statistically analyzed.. This project has the potential to obtain a personalized diagnostic kit, by considering lymphocyte opioid receptors as biological markers. Starting from a simple blood sample, it will be possible to decide the best therapy for a single patient. Using a noninvasive approach, we expect to fix a daily standard dose and timing, before and after surgery, to bypass hip chronic pain and the insurgence of tolerance or addiction. The analysis of opioid receptors sensitivity will help to identify the best drug administration in each specific case (tailored therapy).. ISRCTN, ISRCTN12559751 . Retrospectively registered on 23 May 2017.

Topics: Analgesics, Opioid; Arthralgia; Arthroplasty, Replacement, Hip; Biomarkers; Chronic Pain; Clinical Protocols; Drug Tolerance; Humans; Lymphocytes; Opioid-Related Disorders; Osteoarthritis, Hip; Pain Measurement; Pain, Postoperative; Pilot Projects; Receptors, Opioid; Research Design; Risk Assessment; Risk Factors; Risk Management; Rome; Single-Blind Method; Time Factors; Treatment Outcome

Besides fertility, poppies have been used to symbolize sleep, night, and death. Consistent with the agrarian origin of their ritual use, poppies also became a symbol of reincarnation. Several literary and iconographic sources, in particular of the early Roman imperial age, are here interpreted as evidence that poppy derivatives were ingested during mystery rites. The reversible narcotic effects of poppy derivatives should have allowed a "realistic" representation of death and reincarnation, as intended by the Orphic belief of the transmigration of souls.

Topics: Funeral Rites; History, Ancient; Humans; Opioid-Related Disorders; Opium; Papaver; Plants, Medicinal; Rome

Topics: Europe; History, 18th Century; History, 19th Century; History, 20th Century; History, Ancient; History, Medieval; Humans; Opioid-Related Disorders; Opium; Rome; United States

Zipeprol is a non-opioid cough suppressor agent recently abused in Italy. Clinical reports from 30 street abusers show that the drug in high doses has a definite abuse liability and dependence potential. Many of its effects were identical to those induced by opiates, although specific dysperceptive symptoms were commonly reported by patients. Spontaneous withdrawal symptoms were similar to those of opiates. Withdrawal could be also precipitated by naloxone. It is concluded that zipeprol can induce dependence with a mechanism which may be mediated by some types of opioid receptors.

Topics: Adolescent; Adult; Antitussive Agents; Female; Hallucinations; Humans; Male; Opioid-Related Disorders; Piperazines; Rome; Substance Withdrawal Syndrome; Substance-Related Disorders

Topics: Epidemiologic Methods; Hepatitis; Hospitals, Military; Humans; Opioid-Related Disorders; Prisons; Rome; Seasons