Roger B. FiLLiNGiM PhD
Colleen M. FiTZGERALD MD, MS
Michael R. CLARK MD, MPH, MBA
A prominent psychiatrist and pain educator discusses the challenge of managing patients with chronic pain who also suffer with borderline personality disorder and depression, including the special difficulties associated with demanding, noncompliant, and high-utilizer patients. Dr. Clark is Vice Chair of Clinical Affairs, Johns Hopkins University School of Medicine, the Director of the Adolf Meyer […]
John J. BURKE
- New Technique Improves Early Detection of Endometriosis
In a report published online in the journal Endocrinology, researchers at UC San Francisco write that they have identified patterns of genetic activity that can be used to diagnose endometriosis and its severity. The finding may offer millions of women an alternative to currently-used surgical investigation, through a simple noninvasive procedure for diagnosis. Endometriosis, an often painful condition that occurs when tissue normally lining the inside of the uterus grows outside the uterus, is estimated to affect approximately 10% of reproductive age women. Frequently caused by retrograde menstruation, it can result in inflammation, scarring, and pain and may lead to infertility. The newly developed molecular diagnostic approach monitors gene expressions in the uterine lining, and enabled identification of the condition with an accuracy of 90% to 100%. Read more about the findings here.
- Running Beats Walking for Geriatric Health and Mobility
A new study, published online last week in the journal PLOS ONE, highlights an unexpected benefit of jogging in older adults. Researchers at Humboldt State University and the University of Colorado, Boulder report that adults over age 65 who run at least 30 minutes 3 times a week were less likely to experience age-related physical decline in walking efficiency than those who simply walked. The study found that participation in high aerobic activity by this population results in a lower metabolic cost of walking, as compared with sedentary study subjects. Metabolic cost is the amount of energy needed to move, and it increases naturally increases with age. High metabolic cost contributes to making walking more difficult and tiring. Decline in walking ability is a key predictor of morbidity in older adults. The researchers hypothesize that vigorous exercise results in healthier mitochondria in their muscles, and plan to investigate other forms of high-aerobic activity such as swimming and cycling for evidence of similar benefit. A news story about the research may be read here.
- Product Expands Arsenal of Treatment Options for Chronic Pain
In a press release last week, Purdue Pharma L.P. announced that the US Food and Drug Administration (FDA) approved Hysingla ER (hydrocodone bitartrate) extended-release tablets CII, a once-daily, single-entity medication formulated using Purdue’s proprietary extended-release solid oral platform, RESISTEC™. According to the release, it is the first and only hydrocodone product to be recognized by the FDA as having abuse-deterrent properties that are expected to deter misuse and abuse via chewing, snorting, and injection. The company notes that the newly approved medication does not contain acetaminophen, the overuse of which has been reported to be a leading cause of acute liver failure in the United States. Prescription products containing hydrocodone and acetaminophen are both the most prescribed and among the most widely abused (nonmedical use) medications in the US. The release further notes that potential for abuse of Hysingla ER by the intravenous, intranasal, and oral routes still exists. Read the press release from Purdue Pharma, including commentary from PAINWeek senior faculty member Charles Argoff, MD, here.
- The Impact of Maternal Caregiving on Infant Pain and Brain Development
A poster presentation given this week at the American Society for Neuroscience meeting reports that in a study of rats, a mother’s attention and care can both ameliorate infant pain as well as impact early brain development by altering gene activity in a part of the brain involved in emotions. The research was undertaken by neurobiologists from NYU Langone Medical Center, and is believed to be the first to show the short-term effects of maternal caregiving in a distressed infant pup’s brain. The findings may also shed light into the long-term consequences of differences in how mammals, including humans, are nurtured from birth. The study analyzed the genes present and active in rat infants experiencing pain and found that the number of these was reduced when the mothers were present. The authors report that the mother comforting her infant in pain does not just elicit a behavioral response, but that the comforting itself modifies—for better or worse—critical neural circuitry during early brain development. The findings may assist in the development of nonpharmacological, less dangerous treatment strategies for human infant pain as well. Read more about the research here.
Department of Public Health and Community Medicine
Tufts Medical Center