Author Interviews, Lancet, Pain Research, Surgical Research / 14.08.2015

Dr Martin Hirsch Clinical Research Fellow Women’s Health Research Unit Queen Mary University of LondoMedicalResearch.com Interview with: Dr Martin Hirsch Clinical Research Fellow Women’s Health Research Unit Queen Mary University of London and Dr Jenny Hole Foundation Year 1 Doctor Kettering University Hospital Dr Jenny Hole Foundation Year 1 Doctor Kettering University Hospital   MedicalResearch: What is the background for this study? What are the main findings? Response: As doctors we see medicines being prescribed on a daily basis and the benefit but also harm that they can cause. We wanted to assess the role of non pharmaceutical interventions which can benefit patients with a low or minimal potential for harm. We all have an interest in music of different genres and we agreed that we didn’t know anybody who did not like music of one sort or another. On the basis that we all have gained pleasure from music, we wanted to see if this pleasurable experience at the time of a difficult and painful stimulus could reduce the problems encountered as people recover from surgery. We searched all published medical literature and found 73 of the highest quality studies (randomised controlled trials) to compare and combine their findings in a meta-analysis. This technique aims to strengthen the validity by producing a combined result. We found that using music before during or after surgery reduced pain, reduced the requirement for pain killers, reduced anxiety, and improved satisfaction. (more…)
Author Interviews, NIH, Pain Research / 14.08.2015

Richard L. Nahin, Ph.D., M.P.H National Center for Complementary and Integrative Health National Institutes of Health, Bethesda, MarylandMedicalResearch.com Interview with: Richard L. Nahin, Ph.D., M.P.H National Center for Complementary and Integrative Health National Institutes of Health, Bethesda, Maryland Medical Research: What is the background for this study? Dr. Nahin: In 2011 the Institute of Medicine published a blueprint for transforming pain care in the United States.  In this report the IOM noted the lack of a comprehensive picture of pain’s prevalence and severity in the U.S., and especially noted that lack of data examining racial and ethnic groups. The current analysis of data from the 2012 National Health Interview survey is a step toward addressing these deficiencies.  Medical Research: What are the main findings? Dr. Nahin: The analyses found that an estimated 25.3 million adults (11.2 percent) had pain every day for the preceding 3 months. Nearly 40 million adults (17.6 percent) experience severe levels of pain.  Those with severe pain are also likely to have worse health status.  There were associations between pain severity and race, ethnicity, language preference, gender, and age. Women, older individuals, and non-Hispanics were more likely to report any pain, while Asians were less likely.  Minorities who did not choose to be interviewed in English are markedly less likely to report pain. (more…)
Author Interviews, Pain Research / 07.08.2015

MedicalResearch.com Interview with: Jane Marjoribanks Obstetrics and Gynaecology University of Auckland, National Women's Hospital, Auckland, New Zealand MedicalResearch: What is the background for this study? Response: This study is a systematic review of all randomised evidence published up to January 2015 on the effectiveness and safety of non-steroidal inflamatory drugs (NSAIDs) used to treat primary dysmenorrhoea (period pain). It includes 80 randomised controlled trials (total 5820 participants), which compare 20 different NSAIDs versus placebo, other NSAIDs or paracetamol. The review was prepared by researchers from the Cochrane Collaboration, which is a global independent network of contributors (37,000 from more than 130 countries) who gather and summarize the best evidence from research to produce credible, accessible health information that is free from commercial sponsorship and other conflicts of interest. (more…)
Annals Internal Medicine, Author Interviews, Pain Research, Rheumatology / 30.07.2015

MedicalResearch.com Interview with: Raveendhara R Bannuru MD, PhD, FAGE Director, Center for Treatment Comparison and Integrative Analysis (CTCIA) Asst Professor of Medicine, Tufts University School of Medicine Special & Scientific Staff, Center for Arthritis and Rheumatic Diseases Tufts Medical Center Boston, MA Medical Research: What is the background for this study? Dr. Bannuru: Placebos are used to determine the efficacy of a wide variety of treatments for medical conditions such as osteoarthritis. A sound understanding of potential differences among placebos is essential for determining the relative efficacy of such treatments. Medical Research: What are the main findings? Dr. Bannuru: Our results indicate that different types of placebos do in fact differ in efficacy. Placebo injections and topical placebos were both found to be more effective than orally administered placebos for reducing knee osteoarthritis pain. (more…)
Author Interviews, Cannabis, Pain Research / 23.07.2015

Mark S. Wallace MD Department of Anesthesiology School of Medicine University of California, San Diego, CaliforniaMedicalResearch.com Interview with: Mark S. Wallace MD Department of Anesthesiology School of Medicine University of California, San Diego, California Medical Research: What is the background for this study? What are the main findings? Dr. Wallace: The study was funded by the center for medicinal cannabis research at the University of California San Diego. The center was funded by the state of California. The center was the first to fund a series of double-blind randomized controlled trials with inhaled cannabis for neuropathic pain. My trial is the first in diabetic peripheral neuropathy pain which is one of the most prevalent pain syndromes in our society with limited treatments. We found a dose dependent reduction in pain. However there was also a dose dependent increase in euphoria and sedation which may limit clinical use. Effects on neurocognitive functioning were minimal. (more…)
Author Interviews, BMJ, Emergency Care, Pain Research / 25.06.2015

MedicalResearch.com Interview with: Prof. Jason Smith Consultant in Emergency Medicine, Derriford Hospital, Plymouth, UK Royal College of Emergency Medicine Professor Defence Professor of Emergency Medicine, Academic Department of Military Emergency Medicine, Royal Centre for Defence Medicine, UK Honorary Professor in Emergency Medicine, Plymouth University Peninsula Schools of Medicine and Dentistry, UK Medical Research: What is the background for this study? Prof. Smith: Patients commonly present to emergency departments in pain. When patients are asked about their emergency department experience, they often say that more could have been done to manage their pain. Routine care for patients in moderate or severe pain who present to emergency departments usually involves intravenous (IV) morphine, delivered by a nurse. There may be a delay when patients are admitted to a hospital ward before they are reviewed by the admitting medical team, when their pain needs are reassessed. Patient controlled analgesia (PCA) is used to good effect elsewhere in the hospital. The aim of this study was to compare PCA with routine care in patients presenting to emergency departments with either traumatic injuries or non-traumatic abdominal pain, who require admission to hospital. Medical Research: What are the main findings? Prof. Smith: We found that significant reductions in pain were possible using patient controlled analgesia in patients with abdominal pain. Patients spent significantly less time in moderate or severe pain, and were more likely to be very or perfectly satisfied with their pain management. In patients with traumatic injuries, a modest (but non-significant) reduction in pain was seen in patients allocated to the PCA group compared with the routine care group. Patients in the PCA group were more likely to be very or perfectly satisfied with their pain management. (more…)
Author Interviews, Neurological Disorders, NYU, Opiods, Pain Research, Pharmacology / 25.06.2015

Dr. Mia T. Minen, MD, MPH Director, Headache Services at NYU Langone Medical Center Assistant professor, Department of Neurology MedicalResearch.com Interview with: Dr. Mia T. Minen, MD, MPH Director, Headache Services NYU Langone Medical Center Assistant professor, Department of Neurology   Medical Research: What is the background for this study? What are the main findings? Dr. Minen: We conducted a survey on opioid and barbiturate use among patients visiting a headache center to find out which medications they were receiving for treatment. There’s limited evidence that long-term use of these medications can help treat headaches or migraines, and even short-term use in small quantities can cause medication overuse headache. It is important to determine which providers start these medications so that educational interventions can be tailored to these physician specialties to try to prevent situations such as incorrect prescribing practices and medication overuse. In this sample of patients from a specialty headache center, approximately 20 percent of patients -- or 1 in 5 -- were using opioids or barbiturates, and about half had been prescribed these medications at some point in the past for their headaches. These findings show that opioids and barbiturates are commonly prescribed to patients with headaches. While two-thirds of patients found opioids or barbiturates helpful, many did not like them, were limited by side effects or did not find them to be helpful. Emergency department physicians were reported to be the most frequent first prescribers of opioids and general neurologists were the most frequent prescribers of barbiturate-containing medications. Primary care physicians were also identified as frequent first prescribers of these medications. (more…)
Author Interviews, JAMA, Kaiser Permanente, Pain Research / 03.06.2015

Harley Goldberg, DO Physical Medicine and Rehabilitation Kaiser PermanenteMedicalResearch.com Interview with: Harley Goldberg, DO Physical Medicine and Rehabilitation Kaiser Permanente Medical Research: What is the background for this study? What are the main findings? Dr. Goldberg: This is the first large-scale randomized, double-blind, placebo-controlled clinical trial of oral steroids for acute radiculopathy, commonly called sciatica, associated with a herniated lumbar disk. Lumbar radiculopathy (or pain down the leg in a lumbar nerve root distribution) is a common source of pain and disability for many adults. It is thought that inflammation from a disk herniation is responsible for many of the symptoms, so giving a powerful anti-inflammatory, such as steroid medication, might help relieve sciatica symptoms quickly. Prior research has shown that lumbar diskectomy does not affect the one year outcome for most patients, and epidural steroid injections do not have strong support by clinical trials. If the use of epidural steroids injections is based on application of steroid anti-inflammatory to the affected nerve root(s), perhaps an oral steroid can have affect. Although oral steroids are used by many physicians and have been included in some clinical guidelines, no large-scale clinical trials of oral steroids for sciatica have been conducted before. Our study found that among patients with acute radiculopathy associated with a herniated lumbar disk, a short course of oral steroids resulted in only modest improvement in function and no significant improvement in pain. (more…)
Author Interviews, Opiods, Orthopedics, Pain Research, Surgical Research / 02.06.2015

MedicalResearch.com Interview with: Winfried Meissner, M.D. Dep. of Anesthesiology and Intensive Care Jena University Hospital University Hospital Jena, Germany Medical Research: What is the background for this study? Dr. Meissner: Post-operative pain is managed inadequately worldwide. There are probably many reasons for this, one of which may be lack of evidence about outcomes of treatment in the clinical routine. PAIN OUT was established  as a  multi-national research network and quality improvement project offering healthcare providers  validated tools to collect data about pain-related patient reported outcomes and management after surgery. Patients fill in a questionnaire asking for pain intensity, pain interference and side effects of pain management. The questionnaire has now been translated into 20 languages. Data are collected electronically and clinicians are provided with feedback about management of their own patients, compared to similar patients in other hospitals.  Furthermore, the findings are used for outcomes and comparative effectiveness research. PAIN OUT is unique in that  outcomes of postoperative pain management can be examined internationally. PAIN OUT was created in 2009 with funds from the European Commission, within the FP7 framework and  has now been implemented in hospitals in Europe, USA, Africa and SE Asia. The findings allow us to gain insights as to how pain in managed in different settings and countries. For this particular study, we compared management of pain in the US to other countries. We assessed a large group of patients who underwent different types of orthopedic surgery and compared their patient reported outcomes and management regimens. We included 1011 patients from 4 hospitals in the USA  and 28,510 patients from  45  hospitals in 14 countries (“INTERNATIONAL”). Medical Research: What are the main findings? Dr. Meissner: Postoperative pain intensity of US patients was higher than in INTERNATIONAL patients; they felt more often negatively affected by pain-associated anxiety and helplessness, and more US patients stated they wished to have received more pain treatment. However, other patient-reported outcomes like time in severe pain or the level of pain relief did not differ. We found that treatment regiments of American patients differed compared to INTERNATIONAL patients. More US patients received opioids, and their opioid doses were higher compared to INTERNATIONAL patients. In contrast, INTERNATIONAL countries use more nonopioid medications intraoperatively and postoperatively. Thus, under-supply with opioids cannot explain our findings. Mean BMI of US patients was 30.3 while for INTERNATIONAL it was 27.4. However, insufficient evidence exists that this finding might account for differences in pain intensity. Routine pain assessment was performed in almost all US patients, in contrast to about 75% in the INTERNATIONAL group. Obviously, routine pain assessment, as practiced in the United States, fails to result in lower postoperative pain. Perhaps it has the opposite effect by directing patients’ attention to the pain. (more…)
Author Interviews, Pain Research / 16.04.2015

MedicalResearch.com Interview with: Geoff Durso PhD Candidate Department of Psychology The Ohio State University Medical Research: What is the background for this study? What are the main findings? Response: Recent research has shown that acetaminophen blunts negative emotions beyond those arising from physical pain (e.g., social rejection). We hypothesized that this was the case because acetaminophen was having a broader effect on individuals' evaluative and emotional processing, given past psychological theory (e.g., differential susceptibility, personality differences in emotionality, etc) and related neurological evidence (acetaminophen affects serotonin neurotransmission in the brain, reduces inflammatory signaling in the brain, and decreases activation in the brain areas responsible for emotion, for instance--any one or combination of these effects could be responsible for the psychological outcomes that we observe on individuals' blunted negative and positive evaluations). So we conducted two double-blind studies (neither participants nor experiments were aware of participants' assignment to condition). What we found was that participants taking an acute dose of acetaminophen (compared to those taking an inert placebo control) reported diminished negative evaluations of displeasing stimuli (photographs of starving children, wartorn city blocks, disgusting toilets) as well as diminished positive evaluations of pleasing stimuli (photographs of children playing with kittens, a large pile of money, a couple in bed together). Participants taking acetaminophen also reported experiencing diminished emotional responses to the photographs overall. These findings supported our predictions that acetaminophen works to reduce pain in part because it has a broader blunting effect on individuals' evaluations and emotional experience. (more…)
Author Interviews, JAMA, Pain Research / 11.03.2015

Matthew J. Bair, MD, MS Research Service, Veterans Affairs Health Services Research and Development, Center for Health Information and Communication Richard L. Roudebush Veterans Affairs Medical Center, Department of Medicine, Indiana University School of Medicine, Health Services Research, Regenstrief Institute, Inc, Indianapolis, IndianaMedicalResearch.com Interview with: Matthew J. Bair, MD, MS Research Service, Veterans Affairs Health Services Research and Development, Center for Health Information and Communication Richard L. Roudebush Veterans Affairs Medical Center, Department of Medicine, Indiana University School of Medicine, Health Services Research, Regenstrief Institute, Inc, Indianapolis, Indiana MedicalResearch.com: What is the background for this study? Dr. Bair: Despite the prevalence and functional, psychological, and economic impact of chronic pain, there have been few intervention studies to treat chronic pain in Veterans. MedicalResearch.com: What are the main findings? Dr. Bair: A stepped-care intervention that combined analgesics, self-management strategies, and brief cognitive behavioral therapy resulted in statistically significant reductions in pain-related disability, pain interference, and pain severity in Veterans with chronic musculoskeletal pain. (more…)
Author Interviews, CMAJ, Pharmacology / 19.12.2014

MedicalResearch.com Interview with: Naveen Poonai MSc MD FAAP FRCPC Paediatric Emergency Physician Children's Hospital, London Health Sciences Center Assistant Professor Paediatrics and Internal Medicine Schulich School of Medicine and Dentistry London, Ontario, Medical Research: What is the background for this study? What are the main findings? Dr. Poonai: We found that in children discharged home with a fracture, both ibuprofen and oral morphine were effective at relieving pain. However, there were no significant differences in efficacy between the two agents and oral morphine was associated with more side effects. MedicalResearch.com: What was most surprising about the results? Dr. Poonai: The most surprising findings for us were that over 70% of children experienced pain significant enough to require analgesia once they were discharged home.  Furthermore, we were surprised to find that the anecdotally more potent agent morphine, was equivalent to ibuprofen for post-fracture pain relief in children. (more…)
Author Interviews, Pain Research, Rheumatology / 18.12.2014

Sandra Goldsmith, MA, MS, RD Director of Public and Patient Education at Hospital for Special Surgery New York City.MedicalResearch.com Interview with: Sandra Goldsmith, MA, MS, RD Director of Public and Patient Education at Hospital for Special Surgery New York City. Medical Research: What is the background for this study? What are the main findings? Response: Almost 50 million adults in the United States suffer from some form of musculoskeletal disorder, which can affect their mobility and quality of life. Osteoarthritis (OA) is the leading cause of disability in the U.S. and affects more than 70 percent of adults between the ages of 55 and 78. Research has shown that there is a connection between being physically active and maintaining joint health, pain relief and improved quality of life. This study attempts to support the efficacy of Hospital for Special Surgery’s hospital-based exercise programs in increasing physical activity and improving quality of life through pain relief and improved stiffness, fatigue and balance in the older adult community. This study found that after taking the exercise classes, fewer participants reported experiencing a high level of muscle/joint pain from their condition (56 percent before the program started vs. 47 percent after completing the program). The study also reported improved quality of life, as evidenced by statistically significant reductions in how much their pain interfered with their general activities, ability to walk, mood, sleep and enjoyment of life. In addition, 83 percent of participants indicated a reduction in stiffness; 82 percent said they felt their balance improved; and 67 percent said they experienced less fatigue as a result of taking part in the program. Health outcomes were also related to the type of exercise class participants chose, with the greatest reduction in muscle/joint pain reported by those who took t’ai chi. (more…)
Author Interviews, Pain Research, Surgical Research / 31.10.2014

Lars Peter Holst Andersen MD., Ph.d. Fellow / Læge, Ph.d. studerende Department of Surgery Herlev Hospital Gastroenheden, Herlev HospitaMedicalResearch.com Interview with: Lars Peter Holst Andersen MD., Ph.d. Fellow / Læge, Ph.d. studerende Department of Surgery Herlev Hospital Gastroenheden, Herlev Hospital Medical Research: What is the background for this study? Dr. Andersen: The sleep hormone, melatonin is diverse molecule. Several experimental animal studies have documented significant antinociceptive effects in a wide range of pain models. In perioperative medicine, administration of melatonin has demonstrated anxiolytic, analgesic and anti-oxidant effects. Optimization of the analgesic treatment in surgical patients is required due to documented inadequate analgesia and the risk of adverse effects and complications caused by commonly used NSAIDs and opioids. Our goal was to investigate if melatonin was able to reduce pain scores or analgesic use in patients undergoing laparoscopic cholecystectomy. (more…)
Author Interviews, JAMA, Orthopedics, Pain Research / 01.10.2014

MedicalResearch.com Interview with: Ben Metcalf BsC (co-author) on behalf or A/Prof Rana Hinman PhD Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia Medical Research: What are the main findings of the study? Dr. Metcalf: This study investigated whether acupuncture is an effective treatment for people aged more than 50 years with chronic knee pain. Participants in our study were randomly assigned to one of four groups; needle acupuncture, laser acupuncture, sham laser acupuncture or no treatment. The people in the treatment groups received acupuncture treatment from a family physician for 12 weeks. Participants were assessed after treatment and again after one year. There were no significant differences in knee pain or physical function between active and sham laser acupuncture at 12 weeks or at one year. Both needle and laser acupuncture resulted in modest improvements in pain compared with no treatment at 12 weeks that were not maintained at one year. Needle acupuncture improved physical function at 12 weeks compared with no treatment but was not different from sham acupuncture and was not maintained at one year. (more…)
Annals Internal Medicine, Author Interviews, Pain Research / 16.09.2014

Gert Bronfort, DC, PhD Professor, Integrative Health and Wellbeing Research Program Center for Spirituality & Healing University of MinnesotaMedicalResearch.com Interview with: Gert Bronfort, DC, PhD Professor, Integrative Health and Wellbeing Research Program Center for Spirituality & Healing University of Minnesota Medical Research: What are the main findings of the study? Were any of the findings unexpected? Dr. Bronfort: Our study found that spinal manipulative therapy  SMT coupled with home exercise and advice (HEA) appears to be helpful compared to home exercise and advice alone (especially in the short term) for patients with sub-acute and chronic back-related leg pain (BRLP). BRLP was defined as radiating pain originating from the lumbar spine, which travels into the proximal or distal lower extremity, with or without neurological signs. Patients with progressive neurological deficits, cauda equina syndrome, spinal fracture, and other potentially serious causes of BRLP (and often candidates for surgery) were EXCLUDED. There were a few things we did find to be quite interesting. First, it is notable that the spinal manipulative therapy & home exercise and advice group experienced less self-reported medication use after one year than the  home exercise and advice alone group (SMT&HEA was 2.6 times more likely to experience fewer medication days than HEA alone at 1 year). Given the growing concerns of overuse of pain medications (and the potential for adverse events and addiction), this is a finding that has important public health consequence. Another interesting and important finding is that the adverse events observed in this study were only mild to moderate and self-limiting. No serious adverse events occurred that were related to the study interventions. Mild to moderate adverse events (e.g. temporary aggravation of pain, muscle soreness, etc.) were reported by 30% of the patients in the SMT&HEA group, and 42% in the HEA group. This is important as few studies have systematically recorded the side effects and adverse events related to SMT&HEA and HEA alone; this is one of the first, larger clinical trials to do so. These findings are especially notable because SMT is often not recommended for patients with leg symptoms because of safety concerns (which might be related to the previous absence of robust scientific data to support its use). Finally, while an advantage of SMT& HEA versus HEA was found (especially in the short term), we do find the findings of the HEA alone group to also be of interest. Almost half of the HEA patients experienced a 50% reduction in leg pain symptoms in both the short (at 12 weeks) and long term (at 52 weeks). That’s an important improvement and warrants future investigation. Self-management strategies (like home exercise) that emphasize the importance of movement and fitness, restoration of normal activities, and allow patients to care for themselves embrace important principles for promoting overall health and wellbeing that could have a big impact if routinely put into practice. (more…)
Anesthesiology, Author Interviews, Pain Research, Surgical Research / 30.08.2014

Ian Gilron, MD, MSc, FRCPC Director of Clinical Pain Research Professor of Anesthesiology & Perioperative Medicine, Biomedical & Molecular Sciences, and Center for Neuroscience Studies Queen's University Kingston General Hospital, Kingston, Ontario, CanadaMedicalResearch.com Interview with: Ian Gilron, MD, MSc, FRCPC Director of Clinical Pain Research Professor of Anesthesiology & Perioperative Medicine, Biomedical & Molecular Sciences, and Center for Neuroscience Studies Queen's University Kingston General Hospital, Kingston, Ontario, Canada Medical Research: What are the main findings of the study? Dr. Gilron: Pain is the most common symptom which prevents recovery from surgery. Even with the best available treatments today, many patients still suffer from moderate to severe pain after surgery. Antidepressants - drugs used to treat depression - are also proven effective for treating chronic pain due to nerve disease and fibromyalgia. However, there has been much less research on the effects of antidepressant drugs on pain after surgery. Our group conducted a systematic review of all published clinical trials of antidepressant for post surgical pain. Slightly more than half of these studies suggested some benefit of these drugs but the details of this review led us to conclude that there is not yet enough evidence to recommend these medications for post surgical pain treatment. Given the possibility that these medications could be useful treatments for pain after surgery, we believe that future studies of higher scientific quality and which involve larger numbers of patients should be carried out in the hopes of finding safer and more effective treatments for pain after surgery. (more…)
Author Interviews, Lancet, Pain Research / 24.07.2014

MedicalResearch.com Interview with: R Chris Williams PhD Honorary Fellow, Musculoskeletal Division The George Institute for Global Health Sydney NSW 2000 Australia Medical Research: What are the main findings of the study? Dr. Williams: We found that in addition to advice and reassurance, ‘regular’ or ‘as needed’ paracetamol did not improve recovery time for people with low back pain, compared to placebo. We also found the pain intensity and a range of other relevant measures, such as patient’s physical function was not different between the treatment groups. (more…)
Author Interviews, JAMA, Pain Research / 15.07.2014

Kurt Kroenke, M.D. Professor of Medicine, Indiana University School of Medicine Research Scientist, Indiana University Center for Health Services and Outcomes Research Research Scientist, Center for Health Services Research, Regenstrief Institute, Inc. Director of Education and Training Programs, Regenstrief Institute, Inc. Core Investigator, VA HSR&D Center for Health Information and CommunicationMedicalResearch.com Interview with: Kurt Kroenke, M.D. Professor of Medicine, Indiana University School of Medicine Research Scientist, Indiana University Center for Health Services and Outcomes Research Research Scientist, Center for Health Services Research, Regenstrief Institute, Inc. Director of Education and Training Programs, Regenstrief Institute, Inc. Core Investigator, VA HSR&D Center for Health Information and Communication
Medical Research: What are the main findings of the study? Dr. Kroenke: The telecare intervention including monitoring of pain using automated phone calls or the Internet with contacts by a nurse care manager who met weekly with a physician pain specialist to discuss treatment of new patients or patients already being followed who were not improving.
  • Almost twice as many patients in the telecare group had improvement in their pain compared to the usual care control group (52% vs. 27%).
  • Moreover, nearly twice as many patients in the usual care group got worse over 12 months (36% vs. 19%).  Thus, patients with chronic pain may not only fail to improve with current treatment, they in fact can get worse over time.
  • Although one-third of these chronic pain patients were on opioids at start of study, there were very few patients in which opioids needed to be started or dose increased.
  • The intervention group was about equally divided between those who chose to do automated symptom monitoring (ASM) by IVR (51%) or internet (49%).  The majority of patients rated the monitoring as easy to do, and the telecare intervention helpful.
(more…)
Author Interviews, Dermatology, Duke, Pain Research / 26.05.2014

MedicalResearch.com Interview with: Seok-Yong Lee, Ph.D. Assistant Professor of BiochemistrySeok-Yong Lee, Ph.D. Assistant Professor of Biochemistry and Ru-Rong Ji, Ph.D. Distinguished Professor of Duke University Professor of Anesthesiology and Neurobiology Chief of Pain ResearchRu-Rong Ji, Ph.D. Distinguished Professor  of Duke University Professor of Anesthesiology  and Neurobiology Chief of Pain Research Duke University Medical Center Durham, NC 27710 MedicalResearch: What are the main findings of the study?

 Answer: We have developed an antibody that can block the pain and itching sensations in mice simultaneously with high efficacy. We would like to point out that our discovery has the potential to be applied to human once the antibody is humanized. Given the high selectivity, general safety profile, and long half-lives of monoclonal antibodies, this method we developed to raise antibodies against therapeutic targets (e.g., ion channels) can have broad applications to other diseases. (more…)
Mayo Clinic, Pain Research, Surgical Research / 05.04.2014

Dr. Juliane Bingener-Casey, M.D. Mayo Clinic in Rochester, Minn.MedicalResearch.com Interview with: Dr. Juliane Bingener-Casey, M.D. Mayo Clinic in Rochester, Minn. MedicalResearch.com:  What are the study’s main findings? Dr. Bingener-Casey:  “Patient-reported outcomes such as pain and fatigue are sensitive tools to detect how well patients recover from surgery. These patient-reported outcome results are different for men and women and for older versus younger people.” (more…)
Author Interviews, Pain Research, Rheumatology, Sleep Disorders / 14.02.2014

dr_john_mcbethMedicalResearch.com Interview: Dr. John McBeth Arthritis Research UK Primary Care Centre Keele University in Staffordshire MedicalResearch.com: What are the main findings of the study? Dr. McBeth: In this study, reporting musculoskeletal pain was common with just under half of participants reporting some pain and one quarter reporting widespread pain. Of those who were free of WP at baseline, 19% reported new onset widespread pain at three year follow up. In addition to osteoarthritis, sleep, cognitive impairment, anxiety and physical health independently predicted the onset of widespread pain and are important treatment targets. In this study non-restorative sleep was the strongest predictor of new onset widespread pain. Sleep is a modifiable target that could improve outcome in this patient group. (more…)
Author Interviews, Cancer Research, Journal Clinical Oncology, Pain Research / 01.02.2014

MedicalResearch.com Interview with: Fengmin Zhao, MS,PhD Biostatistician Department of Biostatistics & Computational Biology Dana-Farber Cancer Institute Boston, MA 02215 MedicalResearch.com: What are the main findings of the study? Dr. Zhao: We analyzed 2,761 patients in this study. We found that at initial assessment, 53.0% of patients had no pain, 23.5% had mild pain, 10.3% had moderate pain, and 13.2% had severe pain. Overall, one third of patients with initial pain had pain reduction within 1 month of follow-up, and one fifth had an increase. Inadequate pain management was significantly associated with pain deterioration in these patients, as were lower baseline pain level, younger age, and poor health status. Of the patients without pain at initial assessment, 28.4% reported pain at the follow-up assessment (8.9% of them were moderate to severe pain), and more than half of them received inadequate pain management. (more…)
Author Interviews, Pain Research / 04.12.2013

Morten Sejer Hansen Department of Anaesthesia 4231 Centre of Head and Orthopaedics, Rigshospitalet Copenhagen University Hospital, Copenhagen, DenmarkMedicalResearch.com Interview with: Dr. Morten Sejer Hansen Department of Anaesthesia 4231 Centre of Head and Orthopaedics, Rigshospitalet Copenhagen University Hospital, Copenhagen, Denmark MedicalResearch.com: What are the main findings of the study? Answer: Out-of-hospital administration of intranasal fentanyl in doses of 50 and 100 microgram appears to be safe and well tolerated, with a low incidence of side effects Secondly, intranasal fentanyl appeared effective in a wide range of patients, although no firm conclusions on analgesic efficacy can be provided due to the lack of a placebo control. (more…)
Author Interviews, CMAJ, Orthopedics, Pain Research, University of Michigan / 19.09.2013

Chad M. Brummett, M.D. Assistant Professor, University of Michigan Health System Department of Anesthesiology Division of Pain Medicine 1500 East Medical Center Drive, 1H247 UH, Box 5048 Ann Arbor, MI 48109MedicalResearch.com Interview with: Chad M. Brummett, M.D. Assistant Professor, University of Michigan Health System Department of Anesthesiology Division of Pain Medicine 1500 East Medical Center Drive, 1H247 UH, Box 5048 Ann Arbor, MI 48109 MedicalResearch.com:  What are the main findings of the study? Dr. Brummett: The study found that 42% of new patients presenting to a tertiary care pain clinic with a primary spine pain diagnosis met the American College of Rheumatology (ACR) survey criteria for fibromyalgia, which is a measure of widespread body pain and comorbid symptoms (e.g. trouble thinking, fatigue, mood symptoms, etc.).  Patients categorized as fibromyalgia-positive using the survey measure were distinctly different from those not meeting criteria.  In a multivariate regression model, independent predictors of being categorized as fibromyalgia-positive were female sex, higher neuropathic pain scores, anxiety, and lower physical function. (more…)
Author Interviews, CMAJ, Johns Hopkins, Pain Research, Pharmacology / 16.09.2013

Matthew Daubresse, MHS Research Data Analyst Center for Drug Safety and Effectiveness Johns Hopkins School of Public Health 615 N. Wolfe Street, Suite W6023 Baltimore, MD 21205 MedicalResearch.com: What are the main findings of the study? Answer: Over the past decade, prescriptions for non-opioid medications remained stable or declined among ambulatory pain visits in the United States. In visits for new-onset musculoskeletal pain, non-opioid prescribing decreased from 38% of visits in 2000 to 29% of visits in 2010. During this time, opioid prescriptions nearly doubled. Few patient, provider, and visit characteristics were associated with the likelihood of opioid receipt, suggesting increases in opioid prescribing have occurred generally across different groups of patients.  (more…)
Author Interviews, Case Western, Cleveland Clinic, Cost of Health Care, Pain Research, Surgical Research / 30.08.2013

MedicalResearch.com Interview with: Conor P. Delaney, MD MCh PhD FRCSI FACS FASCRS The Jeffrey L. Ponsky Professor of Surgical Education | Chief, Division of Colorectal Surgery | Vice-Chair, Department of Surgery | Director, CWRU Center for Skills and Simulation | Surgical Director, Digestive Health Institute | University Hospitals Case Medical Center | Case Western Reserve University | 11100 Euclid Avenue Cleveland, OH 44106-5047 MedicalResearch.com: What are the main findings of the study? Answer: Our goal was to see whether the transversus abdominis plane (TAP) block reduced complications and shortened the hospital stay of patients undergoing colorectal operations.  The TAP block is a nerve block injection given at the conclusion of the operation which reduces pain in the operative area.  Results showed that the mean hospital stay dropped to less than 2.5 days after the surgical procedure, significantly lower than the 3.7 days which the University Hospitals Case Medical Center Care pathway had already described for more than 1,000 consecutive patients. In our new study, we employed the TAP block and the Enhanced Recovery Pathway (ERP) on 100 patients.  We found that 27 patients went home the next day and another 35 went home 48 hours after their operations. That is considerably better than the five or six days patients usually stay in the hospital after laparoscopic colorectal procedures, and certainly better than nine days often seen after an open operation.  With a third of patients leaving the day after colorectal resection, we feel these results are significant. (more…)
Author Interviews, JAMA, Ophthalmology, Pain Research / 07.08.2013

MedicalResearch.com Interview with: Jelle Vehof PhD Department of Twin Research & Genetic Epidemiology King’s College London, St Thomas’ Hospital, Waterloo, London, England Department of Ophthalmology & Epidemiology University Medical Center Groningen, Groningen, the Netherlands MedicalResearch.com: What are the main findings of the study? Dr. Vehof: The current study provides the first empirical evidence that individuals with dry eye disease show altered pain sensitivity. Specifically, this study demonstrates that subjects with DED pain and discomfort complaints have lower pain threshold and pain tolerance of heat-based stimulus compared to those without. These findings support the hypothesis that a subset of persons with DED is more sensitive to pain. (more…)
Anesthesiology, Author Interviews, Duke, Pain Research / 21.07.2013

Ru-Rong Ji, PhD Professor, Chief of Pain Research Department of Anesthesiology and Neurobiology Duke University Medical Center Durham, NC 27710MedicalResearch.com Interview with: Ru-Rong Ji, PhD Professor, Chief of Pain Research Department of Anesthesiology and Neurobiology Duke University Medical Center Durham, NC 27710 Neuroprotectin/Protectin D1 protects neuropathic pain in mice after nerve trauma MedicalResearch.com: What are the main findings of the study? Answer: We found the pro-resolution lipid mediator protectin D1 (PD1), derived from the fish oil DHA, can effectively prevent nerve injury-induced neuropathic pain. This treatment can also prevent nerve injury-induced neuroinflammation in the spinal cord (such as glial activation and expression of cytokines and chemokines, e.g., IL-1b, CCL2). These cytokines and chemokines are known to elicit pain. (more…)