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Vittorio Ventafridda

Publications and source records attributed to Vittorio Ventafridda.

10 recordsLinked to original sources

Survey of chronic pain in Europe: prevalence, impact on daily life, and treatment.

UNLABELLED: This large scale computer-assisted telephone survey was undertaken to explore the prevalence, severity, treatment and impact of chronic pain in 15 European countries and Israel. Screening interviews identified respondents aged 18 years with chronic pain for in-depth interviews. 19% of 46,394 respondents willing to participate (refusal rate 46%) had suffered pain for 6 months, had experienced pain in the last month and several times during the last week. Their pain intensity was 5 on a 10-point Numeric Rating Scale (NRS) (1 = no pain, 10 = worst pain imaginable) during last episode of pain. In-depth interviews with 4839 respondents with chronic pain (about 300 per country) showed: 66% had moderate pain (NRS = 5-7), 34% had severe pain (NRS = 8-10), 46% had constant pain, 54% had intermittent pain. 59% had suffered with pain for two to 15 years, 21% had been diagnosed with depression because of their pain, 61% were less able or unable to work outside the home, 19% had lost their job and 13% had changed jobs because of their pain. 60% visited their doctor about their pain 2-9 times in the last six months. Only 2% were currently treated by a pain management specialist. One-third of the chronic pain sufferers were currently not being treated. Two-thirds used non-medication treatments, e.g,. massage (30%), physical therapy (21%), acupuncture (13%). Almost half were taking non-prescription analgesics; 'over the counter' (OTC) NSAIDs (55%), paracetamol (43%), weak opioids (13%). Two-thirds were taking prescription medicines: NSAIDs (44%), weak opioids (23%), paracetamol (18%), COX-2 inhibitors (1-36%), and strong opioids (5%). Forty percent had inadequate management of their pain. Interesting differences between countries were observed, possibly reflecting differences in cultural background and local traditions in managing chronic pain. CONCLUSIONS: Chronic pain of moderate to severe intensity occurs in 19% of adult Europeans, seriously affecting the quality of their social and working lives. Very few were managed by pain specialists and nearly half received inadequate pain management. Although differences were observed between the 16 countries, we have documented that chronic pain is a major health care problem in Europe that needs to be taken more seriously.

Activities of Daily Living↗

Euthanasia.

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Advisory Committees↗

Paraplegia following coeliac plexus block.

Coeliac plexus block (CPB) is one of the few neurolytic procedures that is still considered very useful in managing chronic cancer pain. We describe what we believe to be the fifth case in the literature of paraplegia following coeliac plexus block with ethyl alcohol. Clinical and neurophysiological examination confirmed the hypothesis of an acute myelopathy probably caused by ischemia due to involvement of Adamkievicz's artery. The seriousness of this neurological complication led us to review the different pain-relieving strategies in pancreatic cancer. Several medical and surgical procedures are available for advanced pancreatic cancer, yet none of them alone can be considered the therapy of choice for all cases. Hence, only a multidisciplinary approach to pancreatic cancer pain can help in making the most appropriate choice for each patient.

Adenocarcinoma↗

Diclofenac does not modify morphine bioavailability in cancer patients.

We determined morphine plasma concentrations in 6 cancer patients before and with administration of diclofenac for 5 days. The non-steroidal anti-inflammatory drug does not modify morphine bioavailability. This observation suggests that diclofenac can be used in association with morphine during cancer pain treatment, without increasing the risk of overdosage or side effects of the opiate.

Aged↗

Studies on the effects of antidepressant drugs on the antinociceptive action of morphine and on plasma morphine in rat and man.

In the rat we studied the effect of 3 tricyclic antidepressants: chlorimipramine, amitriptyline and nortriptyline, and the atypical antidepressant trazodone on pain thresholds when administered alone or together with morphine. Moreover, we evaluated the effect of the antidepressants on free morphine plasma concentrations both in the rat and in man. We observed that chlorimipramine and amitriptyline, two tricyclic antidepressants active on the serotoninergic system, induce analgesia and potentiate morphine analgesia in a dose-related fashion. The noradrenergic tricyclic nortriptyline and trazodone did not elicit analgesia and inconsistently affected morphine analgesia. In the rat, all drugs tested increased plasma concentrations of morphine with the exception of amitriptyline. In man, only chlorimipramine and amitriptyline increased the plasma concentration of the free opiate.

Amitriptyline↗

Semantic descriptors of pain.

Eighty-five patients suffering from advanced cancer pain were asked to attribute a 'definite value' to 5 key words describing pain by rating them on a visual analogue scale (VAS). The score which the patient attributed to each key word was then correlated with 9 variables obtained through patient monitoring files (sex, age, educational background, financial situation, integrated pain score, number of concomitant symptoms, hours of sleep and standing, performance status). The visual analogue rating of pain description was not related to the variables examined. However, important correlations were found: the higher the degree of pain, the higher the concomitant symptoms, and the greater reduction in hours of sleep and standing.

Female↗