PainRelief.com Interview with: Marian Wilson, PhD, MPH, RN, PMGT-BC Associate Professor Assistant Editor, Pain Management Nursing Washington State University College of Nursing
Dr. Wilson
PainRelief.com: What is the background for this study?
Response: People with opioid use disorder often experience withdrawal symptoms that can interfere with recovery success. Our team was interested in whether noninvasive home sensors could provide accurate information to detect overnight restlessness and sleep problems that could indicate opioid withdrawal for adults prescribed methadone for opioid use disorder.
PainRelief.com Interview with: Maxwell C. K. Leung, Ph.D. Assistant Professor Systems Biology and Toxicology New College of Interdisciplinary Arts and Sciences Arizona State University, West Campus
PainRelief.com: What is the background for this study?
Response: Over 200 million Americans currently have legal access to medical cannabis, recreational cannabis, or both. Yet, cannabis remains an illicit Schedule 1 substance at the federal level. This limits the efforts of several federal agencies to regulate harmful contaminants – including pesticides, heavy metals, solvents, microbes, and fungal toxins – in cannabis.
PainRelief.com Interview with: Beth Wallace, M.D. M.Sc Associate Investigator, Center for Clinical Management Research Staff Physician, Rheumatology VA Ann Arbor Healthcare System Assistant Professor, Division of Rheumatology University of Michigan
Dr. Wallace
PainRelief.com: What is the background for this study?
Response: Arthritis and joint pain are common among older adults. We used data from the University of Michigan National Poll on Healthy Aging to understand how a national sample of older adults experiences and manages joint pain.
PainRelief.com: What are the main findings?
Response: Seventy percent of adults aged 50-80 report that they have joint pain. Three in five have a diagnosis of arthritis, including 30% who have a diagnosis of osteoarthritis (also called “wear and tear” or “bone on bone” arthritis).
Of those with joint pain, half said that it limited their usual activities, but about three in four said that they saw arthritis and joint pain as a normal part of aging that they could manage on their own.
More than half of all adults use over-the-counter pain relievers like non-steroidal anti-inflammatory drugs (Advil, Motrin, Aleve) for joint pain. One in ten used a prescription oral steroid, like prednisone. This is important because these medications can cause or worsen health conditions common in older people, such as high blood pressure and heart disease. More than a quarter of adults who used oral steroids for joint pain did not remember discussing the risks of these medications with their health care provider.
Ninety percent of those with joint pain used non-medication treatments, like exercise, massage, and splints and braces, to manage their symptoms. Most people who used these treatments found them to be very helpful.
David A. A. Baranger, PhD Department of Psychological and Brain Sciences
Dr. Brogdan
Ryan Bogdan, PhD Associate Professor of Psychological & Brain Sciences Department of Psychiatry Washington University in St Louis St Louis, Missouri
PainRelief.com: What is the background for this study? What are the main findings?
David Baranger: Prenatal cannabis use is increasing in the United States. Prior work from our group found that prenatal cannabis exposure, particularly when it occurred after mothers learned they were pregnant, was associated with worse mental health outcomes in children aged 9-10.
In this study we followed up with this same group of children, who are now as old as 12, to ask whether anything has changed. Have they improved, or gotten worse? To our surprise, we found that children with prenatal cannabis exposure still had worse mental health outcomes – things had not gotten better, nor had they gotten worse.
PainRelief.com Interview with: Shane Cronin PhD Staff scientist in the Penninger lab at IMBA Former postdoc in the Woolf lab at Harvard Medical School and F.M. Kirby Neurobiology Center, Boston Children’s Hospital
PainRelief.com: What is the background for this study?
Response: We and others have shown that the BH4 (tetrahydrobiopterin) metabolic pathway is upregulated in injured nerves and contributes to pain hypersensitivity in various rodent models of chronic pain. BH4 is a metabolite and an important cofactor for the aromatic amino acid hydroxylases for the production of dopamine and serotonin for example. it has also been previously shown to exert cofactor independent roles such as ROS scavenging and Fe3+ reduction in maintaining mitochondrial health.
Moreover, gene association studies in humans have also demonstrated a correlation between low levels of the bottleneck enzyme for BH4 biosynthesis, GCH1, and reduced severity of chronic pain (nicely reviewed here: PMID: 28667479). We believe that targeting this increase of BH4 after nerve injury is a viable strategy to reduce the ensuing pain. So, we set up a screening platform using transgenic mouse DRG neurons in which GFP is controlled by the Gch1 promoter – when Gch1 is turned on (as is in the case of nerve injury), GFP gets turned on as a proxy for BH4 activation and ‘in vitro cellular pain’.
PainRelief.com Interview with: Prof. Bernd Froessler MD, PhD, FANZCA Department of Anaesthesia Lyell McEwin Hospital Clinical Professor Discipline of Acute Care Medicine University of Adelaide
Prof. Bernd Froessler
PainRelief.com: What is the background for this study?
Response: Nitrous oxide (N2O) is commonly used in Australia for labour analgesia. Its use in labour is potentially associated with aerosol generation. During the first wave of the COVID-19 pandemic of 2020, nitrous oxide was suspended on many birthing units to reduce the risk of transmission. This 19-day sudden disruption period at our hospital provided a ‘natural experiment’ and opportunity to re-evaluate the role and need for N2O, with the aim to determine the impact of withdrawing N2O on labour analgesia use and maternal and neonatal outcomes.
PainRelief.com Interview with: Rajat Mittal Ph.D. Professor of Mechanical Engineering Professor of Medicine (Secondary Appt.) Johns Hopkins University
PainRelief.com: What is the background for this study? What are the main findings?
Response: I have worked on the biomechanics and fluid dynamics associated with many different organ systems in the past including the cardiovascular system, the larynx and cerebral hemodynamics, and there is very extensive research being done on these organ systems by research groups all over the world. However, as I was looking to initiate research in some new directions, the implications of stomach biomechanics on important conditions such as diabetes, obesity, gastroparesis, malnutrition and GI infections etc. became apparent to me.
Furthermore, it was clear that bioengineering research in this arena lags other more established areas such as cardiovascular flows by at least 25 years and there seemed to be great opportunity to do impactful work. We focused on drug dissolution for our first project because it offered “low-hanging fruit” in terms of new and impactful insights.
PainRelief.com Interview with: Elizabeth K. Rutkowski, MD MS Associate Professor of Neurology Director, Neurology Clerkship Assistant Director, Adult Neurology Residency Program Medical College of Georgia Augusta University Medical Center
PainRelief.com: What is the background for this study?
Response We are looking at the long-term neurological effects of COVID-19. 80% of our subjects reported neurological symptoms with the most commonly reported symptoms being fatigue and headache.
Joel M. Trugman, MD Associate Vice President Neuroscience Development AbbVie
PainRelief.com: What is the background for this study? What are the main findings?
Response: Migraine is a disabling chronic disease characterized by recurrent headache attacks and associated symptoms, including nausea, phonophobia, or sensitivity to sound, and photophobia, or sensitivity to light.
The ADVANCE clinical trial is a phase 3, randomized, double-blind, placebo-controlled trial and examined the safety and efficacy of atogepant, an oral, small-molecule calcitonin gene-related peptide receptor antagonist in patients with episodic migraine. The primary efficacy endpoint was the change from baseline in mean monthly migraine days (MMD) across the 12-week treatment period. This analysis that was recently published examined the efficacy of atogepant using 4 levels of mean monthly migraine day (MMD) responder rates.
This analysis found that all doses of atogepant significantly increased the proportion of participants who achieved a ≥25%, ≥50%, ≥75% and 100% reduction in mean monthly migraine days over 12 weeks of treatment.
Jason E. Goldstick, PhD Injury Prevention Center Department of Emergency Medicine University of Michigan, Ann Arbor
PainRelief.com: What is the background for this study? What are the main findings?
Response: In 2016, the CDC released the Guideline for Prescribing Opioids for Chronic Pain. A primary goal of this voluntary guideline is that individuals should receive pain management care that provides the greatest overall benefit. Among other things, this may entail beginning opioid treatment only when the clinician determines that the expected benefits outweigh the risks.
Other research has shown reductions in opioid prescribing as reduced since the guideline release; this report examines whether there were changes in nonopioid pain medication prescribing.
Our overall findings were that nonopioid prescribing increased nationally following the guideline release, above and beyond what would’ve been predicted based on the pre-guideline trends, and this finding was generally consistent across patient subpopulations (e.g., those with vs. without prior opioid exposure).
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