1
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Khurana A, Mahdi L, Wie C, Strand NH. Age and pain: are pain management clinicians keeping up with the increasing Medicare population? Reg Anesth Pain Med 2024:rapm-2023-104556. [PMID: 38599787 DOI: 10.1136/rapm-2023-104556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 03/07/2024] [Indexed: 04/12/2024]
Affiliation(s)
| | - Layth Mahdi
- NewYork-Presbyterian Brooklyn Methodist Hospital, Brooklyn, Arizona, USA
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2
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Glenn B, Tieppo Francio V, Westerhaus BD, Goree J, Strand NH, Sparks D, Petersen E. Accessibility and Ease of Use in Neuromodulation Devices. Neuromodulation 2024; 27:584-588. [PMID: 37045647 DOI: 10.1016/j.neurom.2023.03.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 02/20/2023] [Accepted: 03/08/2023] [Indexed: 04/14/2023]
Abstract
BACKGROUND The utilization of neuromodulation therapy continues to grow as therapeutic indications expand. These conditions often present with comorbid physical, visual, and auditory impairments. Patients with disabilities in these categories may have difficulty operating their devices. Thus, reviewing the accessibility and inclusive design of neuromodulation devices is imperative to ensure equal access for patients of all ability levels. To date, the literature provides little insight into this topic. MATERIALS AND METHODS Manufacturers of Food and Drug Administration-approved neuromodulation devices in the United States completed our electronic survey to assess neuromodulation device features, universal/inclusive design guidelines, and methods used to make the device accessible to patients with disabilities. RESULTS We assessed 11 devices from seven manufacturers. Of those, there were six spinal cord, two peripheral nerve, and three deep brain stimulators. Of all respondents, 91% used universal inclusive design guidelines. Of the studied devices, 91% have an interface that uses visual feedback, and 82% have an interface that uses auditory feedback. All surveyed devices were reported to have an interface that requires physical handling. DISCUSSION Our study found that most devices incorporate auditory signals, buttons with raised indentations, speech commands, or other useful features to assist those with visual disabilities. Visual interfaces may be sufficient for a patient with hearing impairment to use all the surveyed devices. However, dual sensory impairment presents a significant limitation in all devices surveyed. Furthermore, the biggest barrier to using neuromodulation devices was physical impairment because all surveyed devices require physical handling. CONCLUSIONS Manufacturers have awareness of universal inclusive design principles. However, our study was unable to find a device that is accessible to all users regardless of ability. As such, it is critical to involve universal design principles to ensure that inclusive devices are available to improve patient adherence, treatment efficacy, and outcomes.
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Affiliation(s)
- Brett Glenn
- College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
| | - Vinicius Tieppo Francio
- Department of Physical Medicine and Rehabilitation, University of Kansas Medical Center, Kansas City, KS, USA; Department of Anesthesiology and Pain Medicine, University of Kansas Medical Center, Kansas City, KS, USA
| | - Benjamin D Westerhaus
- Cantor Spine Center at The Paley Orthopedics & Spine Institute, West Palm Beach, FL, USA
| | - Johnathan Goree
- Department of Anesthesiology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | | | | | - Erika Petersen
- Department of Neurosurgery, University of Arkansas for Medical Sciences, Little Rock, AR, USA
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3
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Sowder T, Sayed D, Concannon T, Pew SH, Strand NH, Abd-Elsayed A, Wie CS, Gomez Ramos DE, Raslan AM, Deer TR. The American Society of Pain and Neuroscience (ASPN) Guidelines for Radiofrequency Ablative Procedures in Patients with Implanted Devices. J Pain Res 2023; 16:3693-3706. [PMID: 37942223 PMCID: PMC10629507 DOI: 10.2147/jpr.s419594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 10/26/2023] [Indexed: 11/10/2023] Open
Abstract
Radiofrequency ablation (RFA) is a treatment modality used in interventional pain management to treat several conditions including chronic neck or back pain, sacroiliac joint pain, major joint pain, and pain from sites that can be isolated to a sensory nerve amenable to RFA. The goals of such procedures are to reduce pain, improve function, delay need for surgical intervention, and reduce pain medication consumption. As applications for RFA expand through novel techniques and nerve targets, there is concern with how RFA may impact patients with implanted medical devices. Specifically, the electrical currents used in RFA produce electromagnetic interference, which can result in unintentional energy transfer to implanted devices. This may also interfere with device function or cause damage to the device itself. As the number of patients with implanted devices increases, it is imperative to establish guidelines for the management of implanted devices during RFA procedures. This review aims to establish guidelines to assist physicians in the preoperative, intraoperative, and postoperative management of implanted devices in patients undergoing procedures using radiofrequency energy. Here, we provide physicians with background knowledge and a summary of current evidence to allow safe utilization of RFA treatment in patients with implanted devices such as cardiac implantable electronic devices, spinal cord stimulators, intrathecal pumps, and deep brain stimulators. While these guidelines are intended to be comprehensive, each patient should be assessed on an individual basis to optimize outcomes.
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Affiliation(s)
- Timothy Sowder
- Department of Anesthesiology, University of Kansas Medical Center, Kansas City, KS, USA
| | - Dawood Sayed
- Department of Anesthesiology, University of Kansas Medical Center, Kansas City, KS, USA
| | - Tyler Concannon
- Department of Anesthesiology, University of Kansas Medical Center, Kansas City, KS, USA
| | - Scott H Pew
- Department of Anesthesiology, Mayo Clinic, Phoenix, AZ, USA
| | | | - Alaa Abd-Elsayed
- Department of Anesthesiology, University of Wisconsin, Madison, WI, USA
| | | | | | - Ahmed M Raslan
- Department of Neurological Surgery, Oregon Health and Science University, Portland, OR, USA
| | - Timothy R Deer
- The Spine and Nerve Center of the Virginias, Charleston, WV, USA
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4
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Pritzlaff SG, Goree JH, Hagedorn JM, Lee DW, Chapman KB, Christiansen S, Dudas A, Escobar A, Gilligan CJ, Guirguis M, Gulati A, Jameson J, Mallard CJ, Murphy MZ, Patel KV, Patel RG, Sheth SJ, Vanterpool S, Singh V, Smith G, Strand NH, Vu CM, Suvar T, Chakravarthy K, Kapural L, Leong MS, Lubenow TR, Abd-Elsayed A, Pope JE, Sayed D, Deer TR. Pain Education and Knowledge (PEAK) Consensus Guidelines for Neuromodulation: A Proposal for Standardization in Fellowship and Training Programs. J Pain Res 2023; 16:3101-3117. [PMID: 37727682 PMCID: PMC10505612 DOI: 10.2147/jpr.s424589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 08/23/2023] [Indexed: 09/21/2023] Open
Abstract
The need to be competent in neuromodulation is and should be a prerequisite prior to completing a fellowship in interventional pain medicine. Unfortunately, many programs lack acceptable candidates for these advanced therapies, and fellows may not receive adequate exposure to neuromodulation procedures. The American Society of Pain and Neuroscience (ASPN) desires to create a consensus of experts to set a minimum standard of competence for neurostimulation procedures, including spinal cord stimulation (SCS), dorsal root ganglion stimulation (DRG-S), and peripheral nerve stimulation (PNS). The executive board of ASPN accepted nominations for colleagues with excellence in the subject matter of neuromodulation and physician education. This diverse group used peer-reviewed literature and, based on grading of evidence and expert opinion, developed critical consensus guides for training that all accredited fellowship programs should adopt. For each consensus point, transparency and recusal were used to eliminate bias, and an author was nominated for evidence grading oversight and bias control. Pain Education and Knowledge (PEAK) Consensus Guidelines for Neuromodulation sets a standard for neuromodulation training in pain fellowship training programs. The consensus panel has determined several recommendations to improve care in the United States for patients undergoing neuromodulation. As neuromodulation training in the United States has evolved dramatically, these therapies have become ubiquitous in pain medicine. Unfortunately, fellowship programs and the Accreditation Council for Graduate Medical Education (ACGME) pain program requirements have not progressed training to match the demands of modern advancements. PEAK sets a new standard for fellowship training and presents thirteen practice areas vital for physician competence in neuromodulation.
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Affiliation(s)
- Scott G Pritzlaff
- Department of Anesthesiology and Pain Medicine, University of California, Davis, Sacramento, CA, USA
| | - Johnathan H Goree
- Department of Anesthesiology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Jonathan M Hagedorn
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Mayo Clinic, Rochester, MN, USA
| | - David W Lee
- Fullerton Orthopedic Surgery Medical Group, Fullerton, CA, USA
| | | | - Sandy Christiansen
- Department of Anesthesiology and Perioperative Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Andrew Dudas
- Mays & Schnapp Neurospine and Pain, Memphis, TN, USA
| | | | - Christopher J Gilligan
- Division of Pain Medicine, Brigham and Women’s Hospital Harvard Medical School, Boston, MA, USA
| | - Maged Guirguis
- Division of Pain Management, Ochsner Health, New Orleans, LA, USA
| | - Amitabh Gulati
- Department of Anesthesiology and Critical Care, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | | | | | - Kiran V Patel
- Department of Anesthesiology and Pain Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health, Hempstead, NY, USA
| | | | - Samir J Sheth
- Interventional Pain Management, Sutter Health, Roseville, CA, USA
| | | | - Vinita Singh
- Department of Anesthesiology, Emory University, Atlanta, GA, USA
| | - Gregory Smith
- Department of Anesthesiology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Natalie H Strand
- Interventional Pain Management, Mayo Clinic, Scottsdale, AZ, USA
| | - Chau M Vu
- Evolve Restorative Center, Santa Rosa, CA, USA
| | - Tolga Suvar
- Department of Anesthesiology and Pain Medicine, Rush University Medical Center, Chicago, IL, USA
| | | | | | - Michael S Leong
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University, Stanford, CA, USA
| | - Timothy R Lubenow
- Department of Anesthesiology and Pain Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Alaa Abd-Elsayed
- Department of Anesthesiology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | | | - Dawood Sayed
- Department of Anesthesiology, Pain and Perioperative Medicine, University of Kansas, Kansas City, KS, USA
| | - Timothy R Deer
- The Spine and Nerve Center of the Virginias, Charleston, WV, USA
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5
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Staats PS, Hagedorn JM, Reece DE, Strand NH, Poree L. Percutaneous image-guided lumbar decompression and interspinous spacers for the treatment of lumbar spinal stenosis: A 2-year Medicare Claims Benchmark Study. Pain Pract 2023; 23:776-784. [PMID: 37254613 DOI: 10.1111/papr.13256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Revised: 03/07/2023] [Accepted: 05/12/2023] [Indexed: 06/01/2023]
Abstract
OBJECTIVE This prospective longitudinal study compares outcomes between Medicare beneficiaries receiving percutaneous image-guided lumbar decompression (PILD) using the mild® procedure and a control group of patients receiving interspinous spacers for the treatment of lumbar spinal stenosis (LSS) with neurogenic claudication (NC). METHODS Patients diagnosed with LSS with NC and treated with either the mild procedure or a spacer were identified in the Medicare claims database. The incidence of harms, the rate of subsequent interventions, and the overall combined rate of harms and subsequent interventions during 2-year follow-up after the index procedure were compared between the two groups and assessed for statistical significance with p = 0.05. RESULTS The study included 2229 patients in the mild group and 3401 patients who were implanted with interspinous spacers. The rate of harms for those treated with the mild procedure was less than half that of patients implanted with a spacer (5.6% vs. 12.1%, respectively; p < 0.0001) during 2-year follow-up. The rate of subsequent interventions was not significantly different between the two groups (24.9% and 26.1% for the mild and spacer groups, respectively; p = 0.7679). The total rate of harms and subsequent interventions for mild was found to be noninferior to spacers (p < 0.0001). CONCLUSIONS This comprehensive study of real-world Medicare claims data demonstrated a significantly lower rate of harms for the mild procedure compared to interspinous spacers for patients diagnosed with LSS with NC, and a similar rate of subsequent interventions during 2-year follow-up.
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Affiliation(s)
- Peter S Staats
- National Spine and Pain Centers, Atlantic Beach, Florida, USA
| | | | - David E Reece
- Walter Reed National Military Medical Center, Bethesda, Maryland, USA
| | | | - Lawrence Poree
- Department of Anesthesia and Perioperative Care, UCSF Pain Management Center, University of California at San Francisco, San Francisco, California, USA
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6
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Strand NH, Maloney J, Kraus M, Wie C, Turkiewicz M, Gomez DA, Adeleye O, Harbell MW. Cannabis for the Treatment of Fibromyalgia: A Systematic Review. Biomedicines 2023; 11:1621. [PMID: 37371716 DOI: 10.3390/biomedicines11061621] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 05/09/2023] [Accepted: 05/25/2023] [Indexed: 06/29/2023] Open
Abstract
Fibromyalgia is a common disease syndrome characterized by chronic pain and fatigue in conjunction with cognitive dysfunction such as memory difficulties. Patients currently face a difficult prognosis with limited treatment options and a diminished quality of life. Given its widespread use and potential efficacy in treating other types of pain, cannabis may prove to be an effective treatment for fibromyalgia. This review aims to examine and discuss current clinical evidence regarding the use of cannabis for the treatment of fibromyalgia. An electronic search was conducted on MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Scopus using Medical Subject Heading (MeSH) terms on all literature published up to October 2022. A follow-up manual search included a complete verification of relevant studies. The results of four randomized controlled trials (RCTs) and five observational studies (a total of 564 patients) that investigated the effects of cannabis on fibromyalgia symptoms were included in this review. Of the RCTs, only one demonstrated that cannabinoids did not have a different effect than placebo on pain responses. Overall, this analysis shows low-quality evidence supporting short-term pain reduction in people with fibromyalgia treated with cannabinoid therapeutics. Although current evidence is limited, medical cannabis appears to be a safe alternative for treating fibromyalgia.
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Affiliation(s)
- Natalie H Strand
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Phoenix, AZ 85050, USA
| | - Jillian Maloney
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Phoenix, AZ 85050, USA
| | - Molly Kraus
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Phoenix, AZ 85050, USA
| | - Christopher Wie
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Phoenix, AZ 85050, USA
| | | | - Diego A Gomez
- Mayo Clinic Alix School of Medicine, Phoenix, AZ 85050, USA
| | | | - Monica W Harbell
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Phoenix, AZ 85050, USA
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7
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Maloney JA, D’Souza RS, Buckner Petty SA, Turkiewicz MJ, Sinha D, Patel A, Strand NH. Job Satisfaction Among Pain Medicine Physicians in the US. J Pain Res 2023; 16:1867-1876. [PMID: 37284326 PMCID: PMC10239623 DOI: 10.2147/jpr.s406701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 05/30/2023] [Indexed: 06/08/2023] Open
Abstract
Purpose Data are lacking on the factors that contribute to job satisfaction among pain medicine physicians. We sought to determine how sociodemographic and professional characteristics relate to job satisfaction among pain medicine physicians. Methods In this nationwide, multicenter, cross-sectional observational study, an electronic questionnaire related to job satisfaction was emailed in 2021 to pain medicine physicians who were members of the American Society of Anesthesiologists or the American Society of Pain and Neuroscience. The 28-item questionnaire asked physicians about sociodemographic and professional factors. Eight questions related to job satisfaction were based on a 10-point Likert scale, and 1 question was a binary (yes/no) variable. Differences in responses based on sociodemographic and professional factors were assessed with the Kruskal-Wallis rank sum test for Likert scale questions and with the Pearson χ2 test for yes/no questions. Results We determined that several variables, including gender, parental status, geographic location, specialty, years of practice, and volume of patients, are associated with pain medicine physicians' outlook on job satisfaction. Overall, 74.9% of respondents surveyed would choose pain medicine as a specialty again. Conclusion High rates of poor job satisfaction persist among pain medicine physicians. This survey study identified several sociodemographic and professional factors that are associated with job satisfaction among pain medicine physicians. By identifying physicians at high risk for poor job satisfaction, healthcare leadership and occupational health agencies can aim to protect physicians' well-being, enhance working conditions, and raise awareness about burnout.
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Affiliation(s)
- Jillian A Maloney
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Phoenix, AZ, USA
| | - Ryan S D’Souza
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA
| | | | | | - Debarshi Sinha
- Mayo Clinic Alix School of Medicine, Scottsdale, AZ, USA
| | - Ajay Patel
- Department of Rehabilitation & Regenerative Medicine (Patel), New York-Presbyterian Hospital-University Hospital of Columbia and Cornell, New York, NY, USA
| | - Natalie H Strand
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Phoenix, AZ, USA
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Peck J, Zeien J, Patel M, Cornett EM, Berger AA, Hasoon J, Kassem H, Jung JW, Ramírez GF, Fugueroa PC, Singhal NR, Song J, Kaye AM, Kaye AD, Koushik SS, Strand NH, Ganti L. Review of Interventional Therapies for Refractory Pediatric Migraine. Health Psychol Res 2023; 10:67853. [PMID: 36726476 PMCID: PMC9886171 DOI: 10.52965/001c.67853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
This is a review of the latest and seminal evidence in pediatric migraine. It covers the etiology and pathophysiology known today, and then will review treatment options, efficacy and safety, quality of data and indications. Though migraine is usually regarded as an infliction in adults, it is not uncommon in the pediatric population and affects up to 8% of children. Children may experience migraine differently than adults, and present not only with headache but also frequent gastrointestinal symptoms. They are frequently shorter in duration than in adults. Traditional migraine treatment in adults is less effective in children. In this population, adjunct therapies - such as interventional techniques - should be considered when traditional treatment fails, including Botulinum Toxin A (BTA) injections, peripheral nerve and ganglion blocks. BTA injections are FDA approved for migraine prophylaxis in adults, but currently not in children; however, recent evidence shows efficacy and safety in pediatric migraine management. Nerve blocks stop nociceptive afferent fibers through injection of local anesthetics, and it may be associated with the local injection of corticosteroids. Although more common in adults, recent data suggests they are safe and effective in children and adolescents. Blocking the sphenopalatine ganglion can be achieved through nasal approach, and achieves a similar action by blocking the entire ganglion. Interventional techniques may provide a key component in the alleviation of this otherwise debilitating chronic migraine pain. Though most studies have been performed in adults, new studies provide encouraging results for treatment in children.
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Affiliation(s)
| | - Justin Zeien
- Department of AnesthesiologyUniversity of Arizona College of Medicine-Phoenix
| | - Megha Patel
- Department of AnesthesiologyUniversity of Arizona College of Medicine-Phoenix
| | - Elyse M. Cornett
- Department of AnesthesiologyLouisiana State University Shreveport
| | | | - Jamal Hasoon
- Department AnesthesiologyMount Sinai Medical Center
| | - Hisham Kassem
- Department AnesthesiologyCritical Care, and Pain Medicine, Beth Israel Deaconess Medical Center
| | | | | | - Paola Colon Fugueroa
- NeurologyHCA Florida Osceola Hospital & University of Central Florida College if Medicine
| | - Neil R. Singhal
- Valley Anesthesiology and Pain Consultants – Envision Physician Services
| | | | - Adam M. Kaye
- Department of Pharmacy PracticeThomas J. Long School of Pharmacy and Health Sciences, University of the Pacific
| | - Alan D. Kaye
- Department of AnesthesiologyLouisiana State University Shreveport
| | - Sarang S. Koushik
- Valleywise Health Medical Center, Creighton University School of Medicine
| | - Natalie H. Strand
- Department of Anesthesiology and Perioperative MedicineMayo Clinic Phoenix
| | - Latha Ganti
- Neurology and Emergency MedicineUniversity of Central Florida College of Medicine
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9
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Petersen EA, Deer TR, Bojanic S, Sankary LR, Strand NH, Al Kaisy A, Huygen F, Sayed D, Steegers M, Verrills P, Schatman ME. Best Practices from the American Society of Pain and Neuroscience (ASPN) for Clinical Research During a Pandemic or Emergency. J Pain Res 2023; 16:327-339. [PMID: 36744112 PMCID: PMC9895883 DOI: 10.2147/jpr.s393539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 01/19/2023] [Indexed: 02/05/2023] Open
Abstract
The COVID-19 pandemic caught many areas of medicine in a state of unpreparedness for conducting research and completing ongoing projects during a global crisis, including the field of pain medicine. Waves of infection led to a disjointed ability to provide care and conduct clinical research. The American Society of Pain and Neuroscience (ASPN) Research Group has created guidance for pragmatic and ethical considerations for research during future emergency or disaster situations. This analysis uses governmental guidance, scientific best practices, and expert opinion to address procedure-based or device-based clinical trials during such times. Current literature offers limited recommendations on this important issue, and the findings of this group fill a void for protocols to improve patient safety and efficacy, especially as we anticipate the impact of future disasters and spreading global infectious diseases. We recommend local adaptations to best practices and innovations to enable continued research while respecting the stressors to the research subjects, investigator teams, health-care systems, and to local infrastructure.
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Affiliation(s)
- Erika A Petersen
- Department of Neurosurgery, University of Arkansas for Medical Sciences, Little Rock, AR, USA,Correspondence: Erika A Petersen, Department of Neurosurgery, University of Arkansas for Medical Science, 4301 West Markham Slot #507, Little Rock, AR, 72205, USA, Tel +15016865270, Email
| | - Timothy R Deer
- Spine and Nerve Center of the Virginias, Charleston, WV, USA
| | - Stana Bojanic
- Department of Neurosurgery, John Radcliffe University Hospitals NHS Trust, Oxford, UK
| | | | | | - Adnan Al Kaisy
- The Pain Management and Neuromodulation Centre, Guy’s & St. Thomas’ NHS Foundation Trust, London, UK
| | - Frank Huygen
- Department of Anesthesiology, Center of Pain Medicine, Erasmus MC, Rotterdam, the Netherlands
| | - Dawood Sayed
- Department of Anesthesiology and Pain Medicine, The University of Kansas Medical Center, Kansas City, KS, USA
| | - Monique Steegers
- Departments of Anesthesiology and Pain and Palliative Medicine, Amsterdam UMC, Amsterdam, the Netherlands
| | - Paul Verrills
- Pain Medicine, Metro Pain Clinic, Melbourne, Australia
| | - Michael E Schatman
- Department of Anesthesiology, Perioperative Care, and Pain Medicine, NYU Grossman School of Medicine, New York, NY, USA,Department of Population Health – Division of Medical Ethics, NYU Grossman School of Medicine, New York, NY, USA
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10
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Keim AA, Pelkey MN, Broadfoot JE, Folley TA, Kraus MB, Maloney JA, Strand NH, Misra L. Women Authorship Trends in the Highest-Impact Anesthesiology Journals from 2005 to 2021. J Womens Health (Larchmt) 2023; 32:592-597. [PMID: 36637854 DOI: 10.1089/jwh.2022.0532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Background: Although women and men have matriculated into medical schools in similar proportions since the 1980s, recent data indicate that anesthesiology is lagging in gender equity, especially in academic leadership roles.1,2 As promotion in academic medicine is strongly influenced by publications, understanding whether a lack of women authorship is contributing to this gender gap is crucial.3,4 This article aims to assess how woman authorship trends have changed in the last 16 years, including during the COVID-19 pandemic. Methods: The five highest impact journals in anesthesia were identified as Journal of Clinical Anesthesia, British Journal of Anaesthesia, Anesthesiology, PAIN, and Regional Anesthesia & Pain Medicine. Number of total authors, including women, men, and unknown gender authors as well as incidence of woman first and/or last author, was documented from articles published in 2005, 2010, 2015, 2020, and 2021. Results: This analysis shows that women are gaining representation in anesthesia publications. Overall, there was a statistically significant increase in the total number of women authors and women first and last authorship. However, as of 2021, women still only represented ∼40% of total and first authors and ∼24% of last authors. In addition, increase in first/last woman authorship was not present in all journals when stratified. Conclusion: These journal differences may suggest the editorial evaluation process as a potential source of gender bias. There was a statistically significant relationship between women senior authors and articles with 50% or more women authors, indicating that woman mentorship is contributing to closing equity gap. These data present a starting point for further investigations into gender disparities within anesthesia to continue the forward progression for women in academic medicine.
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Affiliation(s)
- Audrey A Keim
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic Alix School of Medicine, Scottsdale, Arizona, USA
| | - Melissa N Pelkey
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic Alix School of Medicine, Scottsdale, Arizona, USA
| | - Jourdan E Broadfoot
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Phoenix, Arizona, USA
| | - Tarrah A Folley
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Phoenix, Arizona, USA
| | - Molly B Kraus
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Phoenix, Arizona, USA
| | - Jillian A Maloney
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Phoenix, Arizona, USA
| | - Natalie H Strand
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Phoenix, Arizona, USA
| | - Lopa Misra
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Phoenix, Arizona, USA
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11
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Sayed D, Naidu RK, Patel KV, Strand NH, Mehta P, Lam CM, Tieppo Francio V, Sheth S, Giuffrida A, Durkin B, Khatri N, Vodapally S, James CO, Westerhaus BD, Rupp A, Abdullah NM, Amirdelfan K, Petersen EA, Beall DP, Deer TR. Best Practice Guidelines on the Diagnosis and Treatment of Vertebrogenic Pain with Basivertebral Nerve Ablation from the American Society of Pain and Neuroscience. J Pain Res 2022; 15:2801-2819. [PMID: 36128549 PMCID: PMC9482788 DOI: 10.2147/jpr.s378544] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 08/26/2022] [Indexed: 12/05/2022] Open
Abstract
Chronic low back pain is a worldwide leading cause of pain and disability. Degenerative disc disease has been the presumptive etiology in the majority of cases of chronic low back pain (CLBP). More recent study and treatments have discovered that the vertebral endplates play a large role in CLBP in a term defined as vertebrogenic back pain. As the vertebral endplates are highly innervated via the basivertebral nerve (BVN), this has resulted in a reliable target in treating patients suffering from vertebrogenic low back pain (VLBP). The application of BVN ablation for patients suffering from VLBP is still in its early stages of adoption and integration into spine care pathways. BVN ablation is grounded in a solid foundation of both pre-clinical and clinical evidence. With the emergence of this therapeutic option, the American Society of Pain and Neuroscience (ASPN) identified the need for formal evidence-based guidelines for the proper identification and selection of patients for BVN ablation in patients with VLBP. ASPN formed a multidisciplinary work group tasked to examine the available literature and form best practice guidelines on this subject. Based on the United States Preventative Task Force (USPSTF) criteria for grading evidence, gives BVN ablation Level A grade evidence with high certainty that the net benefit is substantial in appropriately selected individuals.
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Affiliation(s)
- Dawood Sayed
- Department of Anesthesiology and Pain Medicine, The University of Kansas Medical Center, Kansas City, KS, USA
| | - Ramana K Naidu
- Anesthesiology, California Orthopedics & Spine, Marin, CA, USA.,Pain Management, MarinHealth Medical Center, Marin, CA, USA
| | - Kiran V Patel
- Interventional Pain Management/ Anesthesiology, The Spine & Pain Institute of New York, New York City, NY, USA
| | - Natalie H Strand
- Interventional Pain Management, Mayo Clinic, Scottsdale, AZ, USA
| | - Pankaj Mehta
- Clinical Research, Pain Specialists of Austin, Austin, TX, USA
| | - Christopher M Lam
- Department of Anesthesiology and Pain Medicine, The University of Kansas Medical Center, Kansas City, KS, USA
| | - Vinicius Tieppo Francio
- Department of Rehabilitation Medicine, University of Kansas Medical Center, Kansas City, KS, USA
| | - Samir Sheth
- Interventional Pain Management, Sutter Health, Roseville, CA, USA
| | - Anthony Giuffrida
- Cantor Spine Center, Paley Orthopedic and Spine Institute, Fort Lauderdale, FL, USA
| | - Brian Durkin
- Pain Institute of Long Island, Port Jefferson, NY, USA
| | - Nasir Khatri
- Interventional Pain Medicine, Novant Health, Charlotte, NC, USA
| | - Shashank Vodapally
- Physical Medicine and Rehabilitation, Michigan State University, East Lansing, MI, USA
| | - Christopher O James
- Department of Physical Medicine and Rehabilitation, University of Kentucky, Lexington, KY, USA
| | | | - Adam Rupp
- Department of Rehabilitation Medicine, University of Kansas Medical Center, Kansas City, KS, USA
| | - Newaj M Abdullah
- Pain Medicine and Anesthesiology, University of Utah, Salt Lake City, UT, USA
| | - Kasra Amirdelfan
- Clinical Research, IPM Medical Group, Inc, Walnut Creek, CA, USA
| | - Erika A Petersen
- Department of Neurosurgery, University of Arkansas for Medical Science, Little Rock, AR, USA
| | | | - Timothy R Deer
- The Spine and Nerve Center of the Virginias, Charleston, WV, USA
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12
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Buchanan P, Lee DW, Comer A, Hussaini Z, Grillo C, Vodapally S, Strand NH, Sayed D, Deer TR. Best Practices for Postoperative Management of Posterior Sacroiliac Joint Fusion. J Pain Res 2022; 15:1149-1162. [PMID: 35469250 PMCID: PMC9034860 DOI: 10.2147/jpr.s357123] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 03/28/2022] [Indexed: 11/23/2022] Open
Abstract
Sacroiliac joint (SIJ) pain is a common cause of low back pain. Traditionally, treatment for SIJ joint pain and dysfunction has consisted of physical therapy, medication management, SIJ injections, and SIJ ablations. Improved recognition of the SIJ as an etiology for back pain has led to advances in treatment options. Radiofrequency of the lateral sacral branches has been shown to be effective, though evidence is fraught with inconsistent patient selection, study design and procedural technique. It also does not directly address the mechanical dysfunction of the SIJ. In order to create a more enduring approach SIJ fusion has become an attractive option to reduce pain and to improve function. This method of SI joint treatment requires guidance in the perioperative phase of care from both the physicians and advanced practice providers (APP). In order to improve care and outcomes of those undergoing posterior SI joint fusion the American Society of Pain and Neuroscience appointed an expert panel of physicians and advanced practice providers to create a best practice for the post operative care of this approach. As with any best practice, the panel considered current peer reviewed literature and clinical expertise to create guidance today. This is intended to be a living document with modifications as additional evidence comes to light in data publication. The goals of this paper are to focus on (1) wound care, (2) medication use, (3) physical activity and (4) therapeutic exercises.
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Affiliation(s)
- Patrick Buchanan
- Department of Pain Medicine, Spanish Hills Interventional Pain Specialists, Camarillo, CA, USA
| | - David W Lee
- Department of Pain Medicine, Fullerton Orthopedic Surgery Medical Group, Fullerton, CA, USA
| | - Ashley Comer
- Department of Pain Medicine, The Spine and Nerve Center of the Virginias, Charleston, WV, USA
| | - Zohra Hussaini
- Department of Anesthesiology, Division of Pain Medicine, The University of Kansas Medical Center, Kansas City, KS, USA
| | - Casey Grillo
- Department of Pain Medicine, The Spine & Pain Institute of New York, New York, NY, USA
| | - Shashank Vodapally
- Department of Physical Medicine and Rehabilitation, Michigan State University, East Lansing, MI, USA
| | - Natalie H Strand
- Department of Anesthesiology, Division of Pain Medicine, Mayo Clinic, Phoenix, AZ, USA
| | - Dawood Sayed
- Department of Anesthesiology, Division of Pain Medicine, The University of Kansas Medical Center, Kansas City, KS, USA
| | - Timothy R Deer
- Department of Pain Medicine, The Spine and Nerve Center of the Virginias, Charleston, WV, USA
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13
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Francio VT, Wie CS, Murphy MT, Neal MT, Lyons MK, Gibbs WN, Strand NH. Multispecialty perspective on intradural disc herniation: diagnosis and management - A case report -. Anesth Pain Med (Seoul) 2022; 17:221-227. [PMID: 35378571 PMCID: PMC9091668 DOI: 10.17085/apm.21100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 02/04/2022] [Indexed: 11/17/2022] Open
Abstract
Background Intradural disc herniation (IDH) is a very rare and challenging diagnosis, with an estimated incidence of less than 1.5%. The pathogenesis of IDH remains uncertain. Definitive management remains surgical; however, some cases may initially be managed non-surgically. Case A middle-aged male with presented with acute right-sided lumbar radiculopathy following heavy lifting. History was significant for prior lumbar disc herniation managed non-surgically. Lumbar MRI demonstrated a large disc herniation. The patient was initially treated non-surgically with epidural steroid injections. At 4-months, he re-injured and follow-up images demonstrated the herniated disc penetrating the dura and the diagnosis of intradural disc herniation. Conclusions The present case is rare because the IDH occurred at the L3-4 level and resulted in unilateral radiculopathy without cauda-equina symptoms and occurred in the absence of prior surgery. This patient was initially treated non-surgically with satisfactory relief, however, reinjury led to progression of IDH with new neurological deficits necessitating surgery.
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Affiliation(s)
- Vinicius Tieppo Francio
- Department of Rehabilitation Medicine, The University of Kansas Medical Center, Kansas City, KS, USA
| | - Christopher S. Wie
- Department of Anesthesiology, Mayo Clinic, Phoenix, AZ, USA
- Corresponding author: Christopher S. Wie, M.D. Department of Anesthesiology, Mayo Clinic, 5777 E Mayo Blvd, Phoenix, AZ 85054, USA Tel: 1-480-301-8000, Fax: 1-480-342-2986, E-mail:
| | - Micheal T. Murphy
- Department of Rehabilitation Medicine, The University of Kansas Medical Center, Kansas City, KS, USA
| | - Matthew T. Neal
- Department of Neurological Surgery, Mayo Clinic, Phoenix, AZ, USA
| | - Mark K. Lyons
- Department of Neurological Surgery, Mayo Clinic, Phoenix, AZ, USA
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Abstract
BACKGROUND Neuropathies, the most common complication of diabetes, manifest in various forms, including entrapments, mononeuropathies or, most frequently, a distal symmetric polyneuropathy. Painful diabetic neuropathy (PDN) in the classic "stocking" distribution is a disease of increasing prevalence worldwide and a condition for which standard medical treatment only provides modest relief. Neuromodulation offers a potential alternative to pharmacotherapies given its demonstrated efficacy in other refractory chronic neuropathic pain syndromes. High-quality evidence from randomized controlled trials (RCTs) is available in these other settings for two approaches to spinal cord stimulation (SCS): (1) conventional low-frequency SCS (LF-SCS), which modulates axonal activity in the dorsal column and is paresthesia-dependent, and (2) high-frequency SCS delivered at 10 kilohertz (10 kHz SCS), which targets neurons in the superficial dorsal horn and is paresthesia-independent. METHOD This review examines the evidence for SCS from published RCTs as well as prospective studies exploring the safety and effectiveness of treating PDN with neuromodulation. RESULTS Two RCTs enrolling 60 and 36 participants with PDN showed treatment with LF-SCS reduced daytime pain by 45% to 55% for up to two years. An RCT testing 10 kHz SCS versus conventional medical management (CMM) in 216 participants with PDN revealed 76% mean pain relief after six months of stimulation. None of the studies revealed unexpected safety issues in the use of neuromodulation in this patient population. CONCLUSION These well-designed RCTs address the unmet need for improved PDN therapies and provide data on the safety, effectiveness, and durability of SCS therapy.
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Affiliation(s)
- Natalie H. Strand
- Division of Pain Medicine, Department
of Anesthesiology, Mayo Clinic Arizona, Phoenix, AZ, USA
- Natalie H. Strand, MD, Division of Pain
Medicine, Department of Anesthesiology, Mayo Clinic Arizona, 5777 E. Mayo Blvd,
Phoenix, AZ 85054, USA.
| | - Adam R. Burkey
- Chair of Pain Section, American Academy
of Neurology, Minneapolis, MI, USA
- Anesis Spine & Pain Care, Renton,
WA, USA
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15
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Kraus MB, Reynolds EG, Maloney JA, Buckner-Petty SA, Files JA, Hayes SN, Stonnington CM, Vallow LA, Strand NH. Correction to: Parental leave policy information during residency interviews. BMC Med Educ 2022; 22:57. [PMID: 35078464 PMCID: PMC8790905 DOI: 10.1186/s12909-022-03114-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
- Molly B Kraus
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, 5777 E Mayo Blvd, Phoenix, AZ, 85054, USA.
| | - Emily G Reynolds
- Mayo Clinic Alix School of Medicine, Mayo Clinic, 13400 E Shea Blvd, Scottsdale, AZ, 85259, USA
| | - Jillian A Maloney
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, 5777 E Mayo Blvd, Phoenix, AZ, 85054, USA
| | - Skye A Buckner-Petty
- Department of Quantitative Health Sciences, Mayo Clinic, 13400 E Shea Blvd, Scottsdale, AZ, 85259, USA
| | - Julia A Files
- Department of Internal Medicine, Mayo Clinic, 13400 E Shea Blvd, Scottsdale, AZ, 85259, USA
| | - Sharonne N Hayes
- Department of Cardiovascular Medicine, Mayo Clinic, 200 1st St SW, Rochester, MN, 55905, USA
| | - Cynthia M Stonnington
- Department of Psychiatry and Psychology, Mayo Clinic, 13400 E Shea Blvd, Scottsdale, AZ, 85259, USA
| | - Laura A Vallow
- Department of Radiation Oncology, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | - Natalie H Strand
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, 5777 E Mayo Blvd, Phoenix, AZ, 85054, USA
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16
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Kraus MB, Reynolds EG, Maloney JA, Buckner-Petty SA, Files JA, Hayes SN, Stonnington CM, Vallow LA, Strand NH. Parental leave policy information during residency interviews. BMC Med Educ 2021; 21:623. [PMID: 34922524 PMCID: PMC8684616 DOI: 10.1186/s12909-021-03067-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 11/22/2021] [Indexed: 05/27/2023]
Abstract
BACKGROUND During interviews, medical students may feel uncomfortable asking questions that might be important to them, such as parental leave. Parental leave policies may be difficult for applicants to access without asking the program director or other interviewers. The goal of this study is to evaluate whether parental leave information is presented to prospective residents and whether medical students want this information. METHODS Fifty-two program directors (PD's) at 3 sites of a single institution received a survey in 2019 to identify whether parental leave information is presented at residency interviews. Medical students received a separate survey in 2020 to identify their preferences. Fisher exact tests, Pearson χ2 tests and Cochran-Armitage tests were used where appropriate to assess for differences in responses. RESULTS Of the 52 PD's, 27 responded (52%) and 19 (70%) indicated that information on parental leave was not provided to candidates. The most common reason cited was the belief that the information was not relevant (n = 7; 37%). Of the 373 medical students, 179 responded (48%). Most respondents (92%) wanted parental leave information formally presented, and many anticipated they would feel extremely or somewhat uncomfortable (68%) asking about parental leave. The majority (61%) felt that these policies would impact ranking of programs "somewhat" or "very much." CONCLUSIONS Parental leave policies may not be readily available to interviewees despite strong interest and their impact on ranking of programs by prospective residents.
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Affiliation(s)
- Molly B Kraus
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, 5777 E Mayo Blvd, Phoenix, AZ, 85054, USA.
| | - Emily G Reynolds
- Mayo Clinic Alix School of Medicine, Mayo Clinic, 13400 E Shea Blvd, Scottsdale, AZ, 85259, USA
| | - Jillian A Maloney
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, 5777 E Mayo Blvd, Phoenix, AZ, 85054, USA
| | - Skye A Buckner-Petty
- Department of Quantitative Health Sciences, Mayo Clinic, 13400 E Shea Blvd, Scottsdale, AZ, 85259, USA
| | - Julia A Files
- Department of Internal Medicine, Mayo Clinic, 13400 E Shea Blvd, Scottsdale, AZ, 85259, USA
| | - Sharonne N Hayes
- Department of Cardiovascular Medicine, Mayo Clinic, 200 1st St SW, Rochester, MN, 55905, USA
| | - Cynthia M Stonnington
- Department of Psychiatry and Psychology, Mayo Clinic, 13400 E Shea Blvd, Scottsdale, AZ, 85259, USA
| | - Laura A Vallow
- Department of Radiation Oncology, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | - Natalie H Strand
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, 5777 E Mayo Blvd, Phoenix, AZ, 85054, USA
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17
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Strand NH, Maloney J, Hunt CL. Regenerative medicine therapies for sacroiliac joint disease. Sacroiliac Joint Pain 2021:95-114. [DOI: 10.1093/med/9780197607947.003.0009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
The sacroiliac joint is a common cause of low back pain, and techniques to reduce pain and improve function are of utmost interest to the pain medicine practitioner. As regenerative medicine continues to expand, a thorough understanding of the types of therapies that make up the regenerative medicine toolkit is imperative. This chapter reviews prolotherapy and injections of mesenchymal stem cells, platelet-rich plasma, autologous whole blood, and hyaluronic acid for the treatment of sacroiliac joint–mediated pain. Information on background, mechanisms of action, pharmacology, safety and efficacy, possible side effects, and preparation and administration is provided for each of these regenerative injectants, along with a brief review of clinical trials and published data.
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18
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Strand NH, Mariano ER, Goree JH, Narouze S, Doshi TL, Freeman JA, Pearson ACS. Racism in Pain Medicine: We Can and Should Do More. Mayo Clin Proc 2021; 96:1394-1400. [PMID: 34088411 DOI: 10.1016/j.mayocp.2021.02.030] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 01/25/2021] [Accepted: 02/22/2021] [Indexed: 12/12/2022]
Affiliation(s)
- Natalie H Strand
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic Hospital, Phoenix, AZ.
| | - Edward R Mariano
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University, Stanford, CA; Anesthesiology and Perioperative Care Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA
| | - Johnathan H Goree
- Department of Anesthesiology, University of Arkansas for Medical Sciences, Little Rock
| | - Samer Narouze
- Center for Pain Medicine, Western Reserve Hospital, Cuyahoga Falls, OH
| | - Tina L Doshi
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University, Baltimore, MD
| | - John A Freeman
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic Hospital, Phoenix, AZ
| | - Amy C S Pearson
- Department of Anesthesia, University of Iowa, Iowa City, Iowa
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19
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Strand NH, Abd-Elsayed A, Shumsky PM, Freeman JA, Kukulski ML, Wie CS. Epidural Blood Patch Procedure in Patients with Lymphoma or Leukemia: Is There a Risk of Cancer Seeding? Pain Med 2021; 22:1236-1237. [PMID: 32918480 DOI: 10.1093/pm/pnaa285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Natalie H Strand
- Division of Pain Medicine, Mayo Clinic Hospital, Phoenix, Arizona, USA
| | - Alaa Abd-Elsayed
- Department of Anesthesiology, University of Wisconsin, Madison, Wisconsin, USA
| | - Philip M Shumsky
- Division of Pain Medicine, Mayo Clinic Hospital, Phoenix, Arizona, USA
| | - John A Freeman
- Division of Pain Medicine, Mayo Clinic Hospital, Phoenix, Arizona, USA
| | | | - Christopher S Wie
- Division of Pain Medicine, Mayo Clinic Hospital, Phoenix, Arizona, USA
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20
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Eshraghi Y, Chakravarthy K, Strand NH, Shirvalkar P, Schuster NM, Abdallah RT, Vallejo R, Sayed D, Kim D, Kim C, Meacham K, Deer T. The American Society of Pain and Neuroscience (ASPN) Practical Guidelines to Study Design and Scientific Manuscript Preparation in Neuromodulation. J Pain Res 2021; 14:1027-1041. [PMID: 33889019 PMCID: PMC8057952 DOI: 10.2147/jpr.s295502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 03/09/2021] [Indexed: 11/28/2022] Open
Abstract
Background Healthcare clinical and even policy decisions are progressively made based on research-based evidence. The process by which the appropriate trials are developed and well-written manuscripts by means of evidence-based medicine recommendations has resulted in unprecedented necessity in evidence-based medicine in neuromodulation. Methods The essential considerations in the planning of neuromodulation research are discussed in the light of available scientific literature as well as the authors’ scientific expertise regarding research study design and scientific manuscript preparation. Conclusion This article should enable the reader to understand how to appropriately design a clinical research study and prepare scientific manuscripts. The high-quality and well-designed studies, when performed and reported effectively, support evidence-based medicine and foster improved patient outcomes.
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Affiliation(s)
- Yashar Eshraghi
- Department of Anesthesia, Interventional Pain Management, Ochsner Health System, New Orleans, LA, USA.,University of Queensland Ochsner Clinical School. Academics Department, Ochsner Health System, New Orleans, LA, USA.,Louisiana State University School of Medicine, New Orleans, LA, USA
| | - Krishnan Chakravarthy
- Division of Pain Medicine, Department of Anesthesiology, University of California San Diego, San Diego, CA, USA.,VA San Diego Health Care, San Diego, CA, USA
| | - Natalie H Strand
- Division of Pain Medicine, Department of Anesthesiology, Mayo Clinic, Phoenix, Arizona, USA
| | - Prasad Shirvalkar
- Department of Anesthesiology (Pain Management), Department of Neurology, UCSF School of Medicine, San Francisco, CA, USA
| | - Nathaniel M Schuster
- Division of Pain Medicine, Department of Anesthesiology, University of California San Diego, San Diego, CA, USA
| | - Rany T Abdallah
- Center for Interventional Pain and Spine, Wilmington, DE, USA
| | - Ricardo Vallejo
- National Spine and Pain Center, Bloomington, IL, USA.,Psychology Department, Illinois Wesleyan University, Bloomington, IL, USA
| | - Dawood Sayed
- University of Kansas Medical Center, Kansas City, KS, USA
| | - David Kim
- University of Kansas Medical Center, Kansas City, KS, USA
| | - Chong Kim
- Departments of Physical Medicine and Rehabilitation and Anesthesiology, Case Western Reserve University/MetroHealth, Cleveland, OH, USA
| | - Kathleen Meacham
- Division of Pain Management, Department of Anesthesiology, Washington University School of Medicine, St Louis, MO
| | - Timothy Deer
- The Spine and Nerve Center of the Virginias, Charleston, WV, USA.,West Virginia University, School of Medicine, Charleston, WV, USA
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21
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Hwang AS, Kraus MB, Maloney JA, Lanyu M, Strand NH. Trends in Opioid Prescribing: Have We Reduced Opioid Prescriptions or Merely Shifted to New Prescribers? Pain Med 2021; 22:3096-3097. [PMID: 33620475 DOI: 10.1093/pm/pnab075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
| | | | | | - Mi Lanyu
- Mayo Clinic Division of Health Sciences Research
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22
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Acquaviva KD, Mugele J, Abadilla N, Adamson T, Bernstein SL, Bhayani RK, Büchi AE, Burbage D, Carroll CL, Davis SP, Dhawan N, Eaton A, English K, Grier JT, Gurney MK, Hahn ES, Haq H, Huang B, Jain S, Jun J, Kerr WT, Keyes T, Kirby AR, Leary M, Marr M, Major A, Meisel JV, Petersen EA, Raguan B, Rhodes A, Rupert DD, Sam-Agudu NA, Saul N, Shah JR, Sheldon LK, Sinclair CT, Spencer K, Strand NH, Streed CG, Trudell AM. Correction: Documenting Social Media Engagement as Scholarship: A New Model for Assessing Academic Accomplishment for the Health Professions. J Med Internet Res 2020; 22:e26225. [PMID: 33315581 PMCID: PMC7769691 DOI: 10.2196/26225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 12/08/2020] [Indexed: 11/13/2022] Open
Affiliation(s)
| | - Josh Mugele
- Northeast Georgia Medical Center, Gainesville, GA, United States
| | - Natasha Abadilla
- School of Medicine, Stanford University, Stanford, CA, United States
| | - Tyler Adamson
- Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD, United States
| | - Samantha L Bernstein
- College of Nursing, Medical University of South Carolina, Charleston, SC, United States
| | - Rakhee K Bhayani
- School of Medicine, Washington University, St. Louis, MO, United States
| | - Annina Elisabeth Büchi
- Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Darcy Burbage
- Oncology Nursing Consultant, Newark, DE, United States
| | | | - Samantha P Davis
- Department of Respiratory Care, Boise State University, Boise, ID, United States
| | - Natasha Dhawan
- Hematology/Oncology Section, Dartmouth-Hitchcock Medical Center, Lebanon, NH, United States
| | - Alice Eaton
- Swansea University Medical School, Swansea, United Kingdom
| | - Kim English
- Trent/Fleming School of Nursing, Peterborough, ON, Canada
| | - Jennifer T Grier
- Department of Biomedical Sciences, University of South Carolina School of Medicine Greenville, Greenville, SC, United States
| | - Mary K Gurney
- College of Pharmacy, Glendale Campus, Midwestern University, Glendale, AZ, United States
| | - Emily S Hahn
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Heather Haq
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, United States
| | - Brendan Huang
- Department of Neurology and Neurosurgery, Tulane University, New Orleans, LA, United States
| | - Shikha Jain
- Division of Hematology and Oncology, University of Illinois Chicago, Chicago, IL, United States
| | - Jin Jun
- College of Nursing, Ohio State University, Columbus, OH, United States
| | - Wesley T Kerr
- Department of Neurology, University of California Los Angeles, Los Angeles, CA, United States
| | - Timothy Keyes
- School of Medicine, Stanford University, Stanford, CA, United States
| | - Amelia R Kirby
- School of Nursing, University of Virginia, Charlottesville, VA, United States
| | - Marion Leary
- School of Nursing, University of Pennsylvania, Philadelphia, PA, United States
| | - Mollie Marr
- School of Medicine, Oregon Health & Science University, Portland, OR, United States
| | - Ajay Major
- Section of Hematology and Oncology, University of Chicago, Chicago, IL, United States
| | - Jason V Meisel
- Hunter School of Nursing, City University of New York, New York, NY, United States
| | - Erika A Petersen
- University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | | | - Allison Rhodes
- School of Medicine, Tufts University, Boston, MA, United States
| | - Deborah D Rupert
- Cold Spring Harbor Laboratory, Cold Spring Harbor, NY, United States.,State of New York-Stony Brook University, Stony Brook, NY, United States
| | - Nadia A Sam-Agudu
- Institute of Human Virology and Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD, United States.,International Research Center of Excellence, Institute of Human Virology Nigeria, Abuja, Nigeria
| | - Naledi Saul
- Office of Career and Professional Development, University of California San Francisco, San Francisco, CA, United States
| | - Jarna R Shah
- University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | | | | | - Kerry Spencer
- Department of Mathematics and Physics, Stevenson University, Owings Mills, MD, United States
| | - Natalie H Strand
- Department of Anesthesiology, Mayo Clinic, Phoenix, AZ, United States
| | - Carl G Streed
- Department of Medicine, School of Medicine, Boston University, Boston, MA, United States
| | - Avery M Trudell
- McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States
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23
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Acquaviva KD, Mugele J, Abadilla N, Adamson T, Bernstein SL, Bhayani RK, Büchi AE, Burbage D, Carroll CL, Davis SP, Dhawan N, Eaton A, English K, Grier JT, Gurney MK, Hahn ES, Haq H, Huang B, Jain S, Jun J, Kerr WT, Keyes T, Kirby AR, Leary M, Marr M, Major A, Meisel JV, Petersen EA, Raguan B, Rhodes A, Rupert DD, Sam-Agudu NA, Saul N, Shah JR, Sheldon LK, Sinclair CT, Spencer K, Strand NH, Streed CG, Trudell AM. Documenting Social Media Engagement as Scholarship: A New Model for Assessing Academic Accomplishment for the Health Professions. J Med Internet Res 2020; 22:e25070. [PMID: 33263554 PMCID: PMC7744266 DOI: 10.2196/25070] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 11/11/2020] [Accepted: 11/16/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The traditional model of promotion and tenure in the health professions relies heavily on formal scholarship through teaching, research, and service. Institutions consider how much weight to give activities in each of these areas and determine a threshold for advancement. With the emergence of social media, scholars can engage wider audiences in creative ways and have a broader impact. Conventional metrics like the h-index do not account for social media impact. Social media engagement is poorly represented in most curricula vitae (CV) and therefore is undervalued in promotion and tenure reviews. OBJECTIVE The objective was to develop crowdsourced guidelines for documenting social media scholarship. These guidelines aimed to provide a structure for documenting a scholar's general impact on social media, as well as methods of documenting individual social media contributions exemplifying innovation, education, mentorship, advocacy, and dissemination. METHODS To create unifying guidelines, we created a crowdsourced process that capitalized on the strengths of social media and generated a case example of successful use of the medium for academic collaboration. The primary author created a draft of the guidelines and then sought input from users on Twitter via a publicly accessible Google Document. There was no limitation on who could provide input and the work was done in a democratic, collaborative fashion. Contributors edited the draft over a period of 1 week (September 12-18, 2020). The primary and secondary authors then revised the draft to make it more concise. The guidelines and manuscript were then distributed to the contributors for edits and adopted by the group. All contributors were given the opportunity to serve as coauthors on the publication and were told upfront that authorship would depend on whether they were able to document the ways in which they met the 4 International Committee of Medical Journal Editors authorship criteria. RESULTS We developed 2 sets of guidelines: Guidelines for Listing All Social Media Scholarship Under Public Scholarship (in Research/Scholarship Section of CV) and Guidelines for Listing Social Media Scholarship Under Research, Teaching, and Service Sections of CV. Institutions can choose which set fits their existing CV format. CONCLUSIONS With more uniformity, scholars can better represent the full scope and impact of their work. These guidelines are not intended to dictate how individual institutions should weigh social media contributions within promotion and tenure cases. Instead, by providing an initial set of guidelines, we hope to provide scholars and their institutions with a common format and language to document social media scholarship.
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Affiliation(s)
| | - Josh Mugele
- Northeast Georgia Medical Center, Gainesville, GA, United States
| | - Natasha Abadilla
- School of Medicine, Stanford University, Stanford, CA, United States
| | - Tyler Adamson
- Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD, United States
| | - Samantha L Bernstein
- College of Nursing, Medical University of South Carolina, Charleston, SC, United States
| | - Rakhee K Bhayani
- School of Medicine, Washington University, St. Louis, MO, United States
| | - Annina Elisabeth Büchi
- Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Darcy Burbage
- Oncology Nursing Consultant, Newark, DE, United States
| | | | - Samantha P Davis
- Department of Respiratory Care, Boise State University, Boise, ID, United States
| | - Natasha Dhawan
- Hematology/Oncology Section, Dartmouth-Hitchcock Medical Center, Lebanon, NH, United States
| | - Alice Eaton
- Swansea University Medical School, Swansea, United Kingdom
| | - Kim English
- Trent/Fleming School of Nursing, Peterborough, ON, Canada
| | - Jennifer T Grier
- Department of Biomedical Sciences, University of South Carolina School of Medicine Greenville, Greenville, SC, United States
| | - Mary K Gurney
- College of Pharmacy, Glendale Campus, Midwestern University, Glendale, AZ, United States
| | - Emily S Hahn
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Heather Haq
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, United States
| | - Brendan Huang
- Department of Neurology and Neurosurgery, Tulane University, New Orleans, LA, United States
| | - Shikha Jain
- Division of Hematology and Oncology, University of Illinois Chicago, Chicago, IL, United States
| | - Jin Jun
- College of Nursing, Ohio State University, Columbus, OH, United States
| | - Wesley T Kerr
- Department of Neurology, University of California Los Angeles, Los Angeles, CA, United States
| | - Timothy Keyes
- School of Medicine, Stanford University, Stanford, CA, United States
| | - Amelia R Kirby
- School of Nursing, University of Virginia, Charlottesville, VA, United States
| | - Marion Leary
- School of Nursing, University of Pennsylvania, Philadelphia, PA, United States
| | - Mollie Marr
- School of Medicine, Oregon Health & Science University, Portland, OR, United States
| | - Ajay Major
- Section of Hematology and Oncology, University of Chicago, Chicago, IL, United States
| | - Jason V Meisel
- Hunter School of Nursing, City University of New York, New York, NY, United States
| | - Erika A Petersen
- University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | | | - Allison Rhodes
- School of Medicine, Tufts University, Boston, MA, United States
| | - Deborah D Rupert
- Cold Spring Harbor Laboratory, Cold Spring Harbor, NY, United States.,State of New York-Stony Brook University, Stony Brook, NY, United States
| | - Nadia A Sam-Agudu
- Institute of Human Virology and Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD, United States.,International Research Center of Excellence, Institute of Human Virology Nigeria, Abuja, Nigeria
| | - Naledi Saul
- Office of Career and Professional Development, University of California San Francisco, San Francisco, CA, United States
| | - Jarna R Shah
- University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | | | | | - Kerry Spencer
- Department of Mathematics and Physics, Stevenson University, Owings Mills, MD, United States
| | - Natalie H Strand
- Department of Anesthesiology, Mayo Clinic, Phoenix, AZ, United States
| | - Carl G Streed
- Department of Medicine, School of Medicine, Boston University, Boston, MA, United States
| | - Avery M Trudell
- McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States
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24
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Strand NH, Maloney JA, Mariano ER, Rosenow JM, Moeschler SM, Narouze S, Petersen EA. Analysis of the gender distribution of industry- and society-sponsored webinar faculty during the COVID-19 pandemic. J Clin Anesth 2020; 67:110040. [PMID: 32979612 DOI: 10.1016/j.jclinane.2020.110040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 09/08/2020] [Indexed: 10/23/2022]
Affiliation(s)
- Natalie H Strand
- Division of Pain Medicine, Mayo Clinic Hospital, Phoenix, AZ, United States of America.
| | - Jillian A Maloney
- Division of Pain Medicine, Mayo Clinic Hospital, Phoenix, AZ, United States of America
| | - Edward R Mariano
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford, CA, United States of America
| | - Joshua M Rosenow
- Department of Neurosurgery, Feinburg School of Medicine, Northwestern University, Chicago, IL, United States of America
| | - Susan M Moeschler
- Division of Pain Medicine, Mayo Clinic, Rochester, MN, United States of America
| | - Samer Narouze
- Center for Pain Medicine, Western Reserve Hospital, Cuyahoga Falls, OH, United States of America
| | - Erika A Petersen
- Department of Neurosurgery, University of Arkansas for Medical Sciences, Little Rock, AR, United States of America
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25
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Shanthanna H, Strand NH, Provenzano DA, Lobo CA, Eldabe S, Bhatia A, Wegener J, Curtis K, Cohen SP, Narouze S. Caring for patients with pain during the COVID-19 pandemic: consensus recommendations from an international expert panel. Anaesthesia 2020; 75:935-944. [PMID: 32259288 PMCID: PMC7262200 DOI: 10.1111/anae.15076] [Citation(s) in RCA: 162] [Impact Index Per Article: 40.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2020] [Indexed: 12/17/2022]
Abstract
Chronic pain causes significant suffering, limitation of daily activities and reduced quality of life. Infection from COVID-19 is responsible for an ongoing pandemic that causes severe acute respiratory syndrome, leading to systemic complications and death. Led by the World Health Organization, healthcare systems across the world are engaged in limiting the spread of infection. As a result, all elective surgical procedures, outpatient procedures and patient visits, including pain management services, have been postponed or cancelled. This has affected the care of chronic pain patients. Most are elderly with multiple comorbidities, which puts them at risk of COVID-19 infection. Important considerations that need to be recognised during this pandemic for chronic pain patients include: ensuring continuity of care and pain medications, especially opioids; use of telemedicine; maintaining biopsychosocial management; use of anti-inflammatory drugs; use of steroids; and prioritising necessary procedural visits. There are no guidelines to inform physicians and healthcare providers engaged in caring for patients with pain during this period of crisis. We assembled an expert panel of pain physicians, psychologists and researchers from North America and Europe to formulate recommendations to guide practice. As the COVID-19 situation continues to evolve rapidly, these recommendations are based on the best available evidence and expert opinion at this present time and may need adapting to local workplace policies.
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Affiliation(s)
- H Shanthanna
- Department of Anesthesia, McMaster University, ON, Canada
| | - N H Strand
- Division of Pain Medicine, Mayo Clinic Alix School of Medicine, Phoenix, AZ, USA
| | - D A Provenzano
- Pain Diagnostics and Interventional Care, Sewickley, PA, USA
| | - C A Lobo
- Department of Anaesthesiology, Hospital das Forças Armadas, Pólo Porto, Portugal
| | - S Eldabe
- Department of Pain Medicine, James Cook University Hospital, Middlesbrough, UK
| | - A Bhatia
- Comprehensive Integrated Pain Program-Interventional Pain Service, Department of Anesthesia and Pain Medicine, University of Toronto and Toronto Western Hospital, Toronto, ON, Canada
| | - J Wegener
- Department of Anesthesiology, Sint Maartenskliniek, Nijmegen, The Netherlands
| | - K Curtis
- Comprehensive Integrated Pain Program-Interventional Pain Service, Department of Anesthesia and Pain Medicine, Toronto Western Hospital, Toronto, ON, Canada
| | - S P Cohen
- Department of Anesthesiology and Critical Care Medicine, Neurology and Physical Medicine and Rehabilitation, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - S Narouze
- Northeast Ohio Medical University and Chairman, Center for Pain Medicine, Western Reserve Hospital, Cuyahoga Falls, OH, USA
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26
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Strand NH, Trentman TL, Vargas BB, Dodick DW. Occipital nerve stimulation with the Bion® microstimulator for the treatment of medically refractory chronic cluster headache. Pain Physician 2011; 14:435-440. [PMID: 21927047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND Chronic cluster headache is a severely disabling neurological disorder. Evidence from open-label case series suggest that occipital nerve stimulation may be effective for the treatment of chronic cluster headache. OBJECTIVE To evaluate the effectiveness of a microstimulator for chronic cluster headache. STUDY DESIGN Prospective, observational feasibility study plus medical record review. SETTINGS Academic medical center. METHODS Four patients with medically refractory chronic cluster headache underwent implantation of a unilateral bion microstimulator. In-person follow-up was conducted for 12 months after implantation, and a prospective follow-up chart review was carried out to assess long term outcome. RESULTS Three of the participants returned their headache diaries for evaluation. The mean duration of chronic cluster headache was 14.3 years (range 3 to 29 years). Pain was predominantly or exclusively retroocular/periocular. One participant demonstrated a positive response (> 50% reduction in cluster headache frequency) at 3 months post-implant, while there were 2 responders at 6 months. At least one of the participants continued to show > 60% reduction in headache frequency at 12 months. A chart review showed that at 58-67 months post-implant, all 3 participants reported continued use and benefit from stimulation. No side-shift in attacks was noted in any participant. Adverse events were limited to 2 participants with neck pain and/or cramping with stimulation at high amplitudes; one required revision for a faulty battery. LIMITATIONS Small patient population without control group. Not blinded or randomized. CONCLUSION Unilateral occipital nerve stimulation, using a minimally invasive microstimulator, may be effective for the treatment of medically refractory chronic cluster headache. This benefit may occur immediately after implantation, remain sustained up to 5 years after implantation, and occur despite the anterior location of the pain. Prospective, randomized controlled trials of occipital nerve stimulation in chronic cluster headache should proceed.
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Affiliation(s)
- Natalie H Strand
- Newport Beach Headache and Pain and Departments of Anesthesiology and Neurology, Mayo Clinic, Phoenix, AZ, USA
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