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Pain is a common feature of most rheumatic diseases and it is often the main reason for the patient to seek for a clinical appointment. Chronic pain has a major impact on patient's quality of life, being frequently associated with functional incapacity, sleep and mood disorders. This leads to absenteeism and heavy consumption of health resources, both representing huge burdens on national economy. Managing musculoskeletal pain is pivotal but can be challenging. The use of the available pharmaceutical armamentarium should be parsimonious. Opioids are strong analgesic drugs that mostly act through their agonist action on m-receptors in the central nervous system. Opioid-related side effects are not negligible and are mediated through both central and peripheral opioid receptors. The use of opioids is well established in the treatment of oncologic pain but their role in the management of musculoskeletal pain is still controversial. Inflammatory rheumatic diseases, osteoarthritis, osteoporotic fractures, chronic low back pain and fibromyalgia represent diverse major rheumatic conditions that frequently lead to chronic pain. In order to standardize and optimize management of muscuclinical loskeletal chronic pain in these prevalent diseases, the Portuguese Rheumatology Society elaborated this position paper. The objectives were: a) to define the importance of pain assessment and classification; b) to guide patient selection, appropriate choice of opioids, their management, and raise awareness of their adverse effects; c) to review the existent data on possible indications of opioid therapy on rheumatic diseases. [ABSTRACT FROM AUTHOR]

This is the first report of a cutaneous infection in an immunocompromised domestic cat caused by Setosphaeria turcica. The investigation encompasses an assessment of its virulence factors and susceptibility to antifungal drugs. The isolated strain originated from a domestic cat displaying cutaneous lesions that tested positive for feline leukemia virus (FeLV) infection. Identification procedures employed both microscopic and molecular techniques, with molecular identification relying on ITS DNA sequencing. Enzymatic assays targeting lipase, phospholipase, protease, and keratinase yielded negative results, suggesting the prevalence of alternative virulence mechanisms. Successful treatment of the infection was achieved with itraconazole, and susceptibility testing confirmed its sensitivity to azoles and polyene antifungal drugs., (Copyright © 2024 The Authors. Publicado por Elsevier España, S.L.U. All rights reserved.)