Canadian Journal of Pain-Revue Canadienne de la Douleur最新文献

{"title":"Response to \"Winner of the Ronald Melzack - <i>Canadian Journal of Pain 2021</i> Paper of the Year Award\".","authors":"Jason W Busse,&nbsp;David Juurlink,&nbsp;D Norman Buckley","doi":"10.1080/24740527.2022.2108775","DOIUrl":"https://doi.org/10.1080/24740527.2022.2108775","url":null,"abstract":"","PeriodicalId":53214,"journal":{"name":"Canadian Journal of Pain-Revue Canadienne de la Douleur","volume":" ","pages":"171-172"},"PeriodicalIF":2.4,"publicationDate":"2022-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9481076/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40367430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic pain in children and adolescents in Manitoba: A retrospective chart review to inform the development of a provincial service for pediatric chronic pain.","authors":"Anna Liu,&nbsp;Polina Anang,&nbsp;Danielle Harling,&nbsp;Kristy Wittmeier,&nbsp;Kerstin Gerhold","doi":"10.1080/24740527.2022.2094228","DOIUrl":"https://doi.org/10.1080/24740527.2022.2094228","url":null,"abstract":"ABSTRACT Background In the absence of an interdisciplinary service for pediatric chronic pain in Manitoba, pain management has been offered through a single provider outpatient setting with consultative services from physiotherapy, occupational therapy, and psychiatry since October 2015. Aims The aim of this study was to characterize the patient population of this clinic to understand needs and inform future service development for pediatric chronic pain. Methods Demographics and disease characteristics of all patients seen in this clinic between October 1, 2015, and February 28, 2019, were analyzed retrospectively from electronic medical records. Results A total of 157 patients, mean age 13.1 (sd ±3.0) years, 75.2% female, with a median duration of pain of 20.5 (interquartile range [IQR] = 10.0–45.8) months at their first visit were included in the study. At baseline, 74.0% of patients experienced insomnia, 76.6% fatigue, 86.5% symptoms of anxiety, and 58.69% symptoms of depression; 80.1% showed withdrawal from physical activity, 67.1% missed school, and 10.2% reported opioid usage. Throughout their care in clinic, 83.4% of patients received physiotherapy, 17.8% occupational therapy, 49.7% mental health support, and 51.6% care from multiple services. The clinic experienced a significant increase in median referrals from 1.0 to 5.0 (IQR = 2.0–9.0) per month and wait time from 35.0 to 97.0 (IQR = 88.0–251.0) days during the observation period. Conclusions Developing an interdisciplinary service for pediatric chronic pain will provide an opportunity to improve access, coordination, and comprehensiveness of care and to employ culturally sensitive services to improve care for children and youth living with chronic pain in Manitoba and possibly other jurisdictions with similar demographics and needs.","PeriodicalId":53214,"journal":{"name":"Canadian Journal of Pain-Revue Canadienne de la Douleur","volume":" ","pages":"124-134"},"PeriodicalIF":2.4,"publicationDate":"2022-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9389926/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40413647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful conversion from butorphanol nasal spray to buprenorphine/naloxone using a low-dose regimen to assist with opioid tapering in the setting of chronic pain and migraine management in an older adult patient: A case report.","authors":"Joshua MacAusland-Berg,&nbsp;Amy Wiebe,&nbsp;Radhika Marwah,&nbsp;Katelyn Halpape","doi":"10.1080/24740527.2022.2090911","DOIUrl":"https://doi.org/10.1080/24740527.2022.2090911","url":null,"abstract":"<p><strong>Background: </strong>Butorphanol is marketed as a treatment for migraines; however, evidence suggests that the harms of its use exceed the benefits. The short half-life of butorphanol places patients at high risk for opioid dependence and makes tapering a challenge. Buprenorphine/naloxone has unique pharmacological properties that are beneficial in chronic pain treatment. At this time there is limited published data on the use of micro-dosing initiation regimens in patients with chronic pain, especially in older adult patients.</p><p><strong>Aims: </strong>This article presents the case of an older adult patient for whom a buprenorphine/naloxone micro-dosing regimen was successfully utilized to aid discontinuation of butorphanol nasal spray, assist with opioid tapering, and manage chronic pain.</p><p><strong>Methods: </strong>This case took place in an outpatient setting while the patient was receiving care from an interprofessional chronic pain service. The electronic medical record was reviewed to obtain a summary of the case data. Informed patient consent was obtained.</p><p><strong>Results: </strong>We present a case of an older adult patient who had been using butorphanol nasal spray for migraine and general pain management for over 20 years. The risks of ongoing use of butorphanol (i.e., inter-dose-related pain, opioid dependence, possible opioid-induced hyperalgesia, and fall risk) no longer exceeded any perceived benefit. The patient was successfully transitioned onto sublingual buprenorphine/naloxone using a micro-dosing regimen.</p><p><strong>Conclusions: </strong>This case provides an example of the potential benefit buprenorphine/naloxone can have for patients with chronic pain and previous opioid exposure, especially older adults at risk of central adverse effects of opioids.</p>","PeriodicalId":53214,"journal":{"name":"Canadian Journal of Pain-Revue Canadienne de la Douleur","volume":" ","pages":"135-141"},"PeriodicalIF":2.4,"publicationDate":"2022-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9397438/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33438176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Innovation Poster Abstracts","authors":"D. Anghelescu, Heidi Meeks, Michael J Frett, Latika Puri, N. Alberts, M. Bordeleau, J. Vollert, M. Backonja, Serge Marchand","doi":"10.1080/24740527.2022.2088026","DOIUrl":"https://doi.org/10.1080/24740527.2022.2088026","url":null,"abstract":"St. Jude Children’s Research Hospital, Pediatric Medicine, Memphis, Tennessee, United States; St. Jude Children’s Research Hospital, Pediatric Medicine, Memphis, Tennessee, United States; St. Jude Children’s Research Hospital, Pediatric Medicine, Memphis, Tennessee, United States; Loma Linda University, Pediatrics, Loma Linda, California, USA; Concordia University, Psychology, Montreal, Quebec, Canada","PeriodicalId":53214,"journal":{"name":"Canadian Journal of Pain-Revue Canadienne de la Douleur","volume":"6 1","pages":"A45 - A59"},"PeriodicalIF":2.4,"publicationDate":"2022-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46486177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Research Poster Abstracts","authors":"","doi":"10.1080/24740527.2022.2088027","DOIUrl":"https://doi.org/10.1080/24740527.2022.2088027","url":null,"abstract":"","PeriodicalId":53214,"journal":{"name":"Canadian Journal of Pain-Revue Canadienne de la Douleur","volume":"6 1","pages":"A60 - A180"},"PeriodicalIF":2.4,"publicationDate":"2022-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41526137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Symposia Abstracts","authors":"Nader Ghasemlou, Bradley Kerr, Vivianne Tawfik","doi":"10.1080/24740527.2022.2088025","DOIUrl":"https://doi.org/10.1080/24740527.2022.2088025","url":null,"abstract":"Symposium Abstract: Females are disproportionately affected by chronic pain compared to males, with a higher prevalence of pain conditions including arthritis, migraine and fibromyalgia, among others. Seminal work from various laboratories has shown that differing inflammatory responses underlie some of the sexual dimorphism observed in the regulation of pain. While it is now clear that interactions between the nervous and immune systems are critical mediators of both acute and chronic pain responses, the underlying molecular and cellular mechanisms controlling these differences remain poorly understood. We will present evidence from our respective laboratories showing how sexually dimorphic responses in neuroimmunity help control pain using models of multiple sclerosis (Dr. Bradley Kerr), complex regional pain syndrome (Dr. Vivianne Tawfik), and in the baseline control of nociception (Dr. Nader Ghasemlou). Abstract Activated myeloid-lineage cells, macrophages peripherally and microglia centrally, contribute to the acute-to-chronic pain transition, however, the details on the timing and possible sex-specificity of such involvement remains a matter of debate. For example, there is evidence that CNS microglia may contribute to chronic pain only in males. In this talk I will discuss data from my laboratory using complementary pharma-cologic and transgenic approaches in mice to more specifically manipulate myeloid-lineage cells using a model of the pain condition, complex regional pain syndrome. I will discuss a novel spatiotemporal transgenic mouse line, Cx3CR1-Cre ERT2 -eYFP;TLR4 fl/fl (TLR4 cKO) that we used to specifically knock out toll-like receptor 4 (TLR4), only in microglia and no other myeloid-lineage cells. Using this transgenic mouse, we find that early TLR4 cKO results in profound improvement in chronic, but not acute, allodynia in males, with a significant but less robust effect in females. In contrast, late TLR4 cKO results in partial improvement in allodynia in both sexes, suggesting that downstream cellular or molecular TLR4-independent events may have already been triggered. I will further discuss new data using a transgenic mouse that allows for microglia-specific depletion, Cx3CR1-Cre ERT2 -eYFP;iDTR lox-STOP-lox (microglia cKO). We performed microglial depletion at multiple time points after peripheral injury and see the most striking decrease in mechanical allodynia in males and females when depletion is performed several weeks after injury. Overall, Symposium Abstract: Observing the pain of brings about a cascade of biological and psychological in the self For caregivers and loved ones of individuals in pain, the ability to adaptively manage these reactions is closely related to the ability to provide appropriate pain assessment and pain management behaviours. This three-part symposium examines the psychological, physiological, and neural responses of individuals observing their loved ones as they undergo a range of painful exp","PeriodicalId":53214,"journal":{"name":"Canadian Journal of Pain-Revue Canadienne de la Douleur","volume":"6 1","pages":"A4 - A44"},"PeriodicalIF":2.4,"publicationDate":"2022-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60130137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Plenary Abstracts","authors":"","doi":"10.1080/24740527.2022.2088024","DOIUrl":"https://doi.org/10.1080/24740527.2022.2088024","url":null,"abstract":"This presentation will focus upon our understanding of how pain is processed in the developing spinal cord and brain. The neurobiological, mechanistic approach provides (i) pre-dictive and testable theories of early life pain from age-appropriate animal models using new technologies and (ii) a scientific framework for better measurement & treatment of pain in infants and children. Pain is learned in infancy – and so discoveries in this area are relevant to us all.","PeriodicalId":53214,"journal":{"name":"Canadian Journal of Pain-Revue Canadienne de la Douleur","volume":"6 1","pages":"A1 - A3"},"PeriodicalIF":2.4,"publicationDate":"2022-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60130128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic pain-related consultations to the emergency department of children with complex pain conditions: A retrospective analysis of healthcare utilization and costs.","authors":"Michelle Stoopler,&nbsp;Manon Choinière,&nbsp;Annabelle Nam,&nbsp;André Guigui,&nbsp;Laurel Walfish,&nbsp;Nada Mohamed,&nbsp;Marie Vigouroux,&nbsp;Victor-Hugo González-Cárdenas,&nbsp;Pablo Ingelmo","doi":"10.1080/24740527.2022.2070840","DOIUrl":"https://doi.org/10.1080/24740527.2022.2070840","url":null,"abstract":"<p><strong>Background: </strong>There is limited information regarding the effects of pediatric chronic pain management on the number and cost of chronic pain-related emergency department (ED) consultations.</p><p><strong>Aim: </strong>This retrospective study aimed to evaluate the number and costs of chronic pain-related ED consultations of children and adolescents with chronic pain conditions at the Montreal Children's Hospital (MCH).</p><p><strong>Methods: </strong>Charts of patients followed by the Edwards Family Interdisciplinary Center for Complex Pain (CCP) of the MCH between April 2017 and December 2018 were reviewed. ED consultations, specialist consultations, medication prescriptions, hospital admissions, and outpatient consultation referrals were assessed for the period of 1 year before and after the patients' first consultation with the CCP. Associated costs were also calculated.</p><p><strong>Results: </strong>One-hundred sixty-eight patients were included in the analysis. Fifty-one percent consulted the ED and had 151 chronic pain-related ED consultations within 1 year before their initial CCP consultation. In the year following their first CCP consultation, 52 patients (31%) consulted the ED, of which 24 consultations were chronic pain-related (84% reduction). There was an 81% reduction in the costs associated with chronic pain-related ED consultations within 1 year after CCP management. In addition, there was a significant reduction in ED interventions within 1 year after CCP management, though there was no change in medication prescriptions, hospital admissions, or subspecialist consultations.</p><p><strong>Conclusion: </strong>Children and adolescents with chronic pain conditions had fewer chronic pain-related ED consultations within 1 year after the first evaluation by an interdisciplinary center for complex pain, contributing to reduced ED costs.</p>","PeriodicalId":53214,"journal":{"name":"Canadian Journal of Pain-Revue Canadienne de la Douleur","volume":" ","pages":"86-94"},"PeriodicalIF":2.4,"publicationDate":"2022-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9225287/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40398361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The development of a stakeholder-endorsed national strategic plan for advancing pain education across Canadian physiotherapy programs.","authors":"Timothy H Wideman, Geoffrey Bostick, Jordan Miller, Aliki Thomas, André Bussières, David Walton, Yannick Tousignant-Laflamme, Lisa Carlesso, Judith Hunter, Kadija Perreault, Barbara Shay","doi":"10.1080/24740527.2022.2056006","DOIUrl":"10.1080/24740527.2022.2056006","url":null,"abstract":"<p><strong>Background: </strong>The Canadian Pain Task Force recently advanced an action plan calling for improved entry-level health professional pain education. However, there is little research to inform the collaboration and coordination across stakeholders that is needed for its implementation.</p><p><strong>Aims: </strong>This article reports on the development of a stakeholder-generated strategic plan to improve pain education across all Canadian physiotherapy (PT) programs.</p><p><strong>Methods: </strong>Participants included representatives from the following stakeholder groups: people living with pain (<i>n</i> = 1), PT students and recent graduates (<i>n</i> = 2), educators and directors from every Canadian PT program (<i>n</i> = 24), and leaders of Canada's national PT professional association (<i>n</i> = 2). Strategic priorities were developed through three steps: (1) stakeholder-generated data were collected and analyzed, (2) a draft strategic plan was developed and refined, and (3) stakeholder endorsement of the final plan was assessed. The project was primarily implemented online between 2016 and 2018.</p><p><strong>Results: </strong>The plan was developed through five iterative versions. Stakeholders unanimously endorsed a plan that included five priorities focusing on uptake of best evidence across (1) national PT governance groups and (2) within individual PT programs; (3) partnering with people living with pain in pain education; (4) advocacy for the PT role in pain management; and (5) advancing pain education research.</p><p><strong>Conclusion: </strong>This plan is expected to help Canadian stakeholders work toward national improvements in PT pain education and to serve as a useful template for informing collaboration on entry-level pain education within other professions and across different geographic regions.</p>","PeriodicalId":53214,"journal":{"name":"Canadian Journal of Pain-Revue Canadienne de la Douleur","volume":"6 1","pages":"21-32"},"PeriodicalIF":2.0,"publicationDate":"2022-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ec/ad/UCJP_6_2056006.PMC9176229.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10380948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Painful reminders: Involvement of the autobiographical memory system in pediatric postsurgical pain and the transition to chronicity.","authors":"Anna Waisman, Maria Pavlova, Melanie Noel, Joel Katz","doi":"10.1080/24740527.2022.2058474","DOIUrl":"10.1080/24740527.2022.2058474","url":null,"abstract":"<p><p>Memory biases for previous pain experiences are known to be strong predictors of postsurgical pain outcomes in children. Until recently, much research on the subject in youth has assessed the sensory and affective components of recall using single-item self-report pain ratings. However, a newly emerging focus in the field has been on the episodic specificity of autobiographical pain memories. Still in its infancy, cross-sectional work has identified the presence of various memory biases in adults living with chronic pain, one of which concerns the lack of spatiotemporal specificity. Moreover, a recent prospective longitudinal study found that adults scheduled for major surgery who produced fewer specific pain memories before surgery were at greater risk of developing chronic postsurgical pain up to 12 months later. The present review draws on this research to highlight the timely need for a similar line of investigation into autobiographical pain memories in pediatric surgical populations. We (1) provide an overview of the literature on children's pain memories and underscore the need for further research pertaining to memory specificity and related neurobiological factors in chronic pain and an overview of the (2) important role of parent (and sibling) psychosocial characteristics in influencing children's pain development, (3) cognitive mechanisms underlying overgeneral memory, and (4) interplay between memory and other psychological factors in its contributions to chronic pain and (5) conclude with a discussion of the implications this research has for novel interventions that target memory biases to attenuate, and possibly eliminate, the risk that acute pain after pediatric surgery becomes chronic.</p>","PeriodicalId":53214,"journal":{"name":"Canadian Journal of Pain-Revue Canadienne de la Douleur","volume":"6 1","pages":"121-141"},"PeriodicalIF":2.0,"publicationDate":"2022-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9176239/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43566183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}