2^nd International Conference and Exhibition on Pain Medicine August 04-05, 2016 New Orleans, Louisiana, USA

Biography:

Abraham Flores Vargas has completed his medical studies from Universidad Autonoma de Estado de México and recently stared residency in anesthesiology from Hospital General de México “Dr. Eduardo Liceaga “ at Mexico city and signed up in the medical program of the Universidad Nacional Autonoma de México. He has done his research social service last year publishing a review article named OCD in animal models using quinpirole as dopaminergic inductor of perseverative behavior at the “Revista medica del Hospital General de México” last year now-a-days working in the continuation of the second article related with quinpirole. He is with total willingness to continue investigating and bringing in issues related to anesthesiology.

Abstract:

In the reviewed articles, quinpirole is used as a dopamine D2 and D3 receptor agonist to induce persistent behavior in animal models. Dopamine has been related to perseverative behavior also has been related with the perseption of pain and relief. The perseverative behavior was observed in an open field with objects of different shapes and sizes. The main structures studied with this methodology are the orbitofrontal cortex, striatum, thalamus, basolateral amygdala and nucleus accumbens. The animal models studied comply with the face, predictive and construct validity. We think this topic is important because the content of the article shows the right structure and methodology also how to evaluate and compare the information in different articles this method can be applied at any topic; we have focused in the face, predictive and construct validity. It is important to mention that this reviewed article had and extensive search in the website of Pubmed although there were only a few information of the topic which it is a reason for us to continue investigating and providing new information related.

Biography:

Marucia Chacur has completed her PhD from University of Sao Paulo and Post-doctoral studies from University of Heidelberg, Germany. In recent year, her studies were focused on scientific issues regarding inflammation and pain modulation (hyperalgesia and allodynia) induced by chronic and acute injuries. She has published more than 15 papers in reputed journals and has been serving as an Editorial Board Member of repute.

Abstract:

Therapeutic alternatives for the treatment of neuropathic pain are necessary, since this type of pain does not respond satisfactorily to any conventional intervention as surgery and/or medication. Physical therapy has demonstrated through neural mobilization techniques and laser therapy to be effective for improving the quality of life of patients with this kind of pain. This study becomes important because of the lack of studies demonstrating the molecular effects of Neural Mobilization and laser therapy techniques, as these techniques are able to decrease pain sensitivity in animals with chronic pain (these results, are based on work published by our group).

Biography:

Donna Urquhart is a National Health and Medical Research Fellow in the Monash University Department of Epidemiology and Preventive Medicine and a physiotherapist with over 15 years of experience in the management of chronic pain. She has published more than 70 peer-review papers and has been awarded 5 prestigious national grants (2 as CIA). She has authored an invited book chapter in an international text and has been awarded an international investigator award for her novel work on body composition and pain. She is on the International Editorial Board for Journal of Physiotherapy and a reviewer for international/national treatment guidelines, grants and conferences.

Abstract:

Population-based studies suggest that pain in the lower body is common and that pain at multiple sites is more prevalent than single-site pain. Obesity is a risk factor for multisite musculoskeletal pain, but there are limited data on the role of body composition. Therefore, we sought to determine whether body composition is associated with multisite musculoskeletal pain involving the low back, knee, and foot. A total of 133 participants were recruited for a study examining the relationship between obesity and musculoskeletal disease. Participants completed validated questionnaires that examined levels of pain at the low back, knee, and foot. Body composition was assessed using dual-energy X-ray absorptiometry. Multisite pain was common, with 26.3% of participants reporting pain at 2 sites and 31.6% at 3 sites, and only 20% were pain free. The low back was the most common site of pain (63%). Greater fat mass and fat mass index, but not fat-free mass, were associated with pain at a greater number of sites, independent of age, gender, and fat-free mass (P<0.01). Understanding the mechanism by which increased fat mass is associated with pain may provide important insights into therapeutic strategies for the prevention of pain.

Biography:

Hee-Jeong Im Sampen is an internationally recognized orthopedic-related research scientist with over 100 peer-reviewed publications and is a Professor with a primary appointment in the Department of Biochemistry and joint appointments in the Departments of Internal Medicine (Rheumatology Section) and Orthopedic Surgery. She also holds an appointment at the Jesse Brown Veterans Affairs (VA) Medical Center as well as at the Department of Bioengineering, University of Illinois at Chicago (UIC). He is a recipient of various awards and honors such as the ANRF Scholar Award, OARSI Investigator Award, and Kappa Delta Elizabeth Winston Lanier Award from the Orthopedic Research Society (ORS).

Abstract:

Clinical management of chronic joint pain evoked by osteoarthritis is a real challenge due to our limited understanding of the cellular mechanisms that initiate and develop chronic pain. It has been increasingly recognized that glial cells, such as microglia and astrocytes in the central nervous system play an important role in the development and maintenance of chronic pain. Notably, astrocytes make very close contacts with synapses and astrocyte reaction after nerve injury, arthritis, and tumor growth is more persistent than microglial reaction and displays a better correlation with chronic pain behaviors. The transcription factor nuclear factor kappa B (NF-B) is a key regulator of inflammatory processes in reactive glial cells. The objectives were to determine whether inactivation of astroglial NF-B leads to a reduction in pain behavior and inflammation after induction of knee joint osteoarthritis (OA), and joint pathology in an experimental OA model. We utilized a transgenic mouse model (GFAP-IB-dn in C57BL/6 genetic background) where the classical NF-B pathway is inactivated by overexpression of a dominant negative (dn) form of the inhibitor of kappa B (IB) in glial fibrillary acidic protein (GFAP) expressing cells, which include astrocytes, schwann cells, and satellite cells of the dorsal root ganglion (DRG). Young adult mice (Tg and WT) were subjected to surgical OA induction by partial medial menisectomy (PMM). Weekly behavioral pain responses were recorded, and glial activation, NF-B and joint pathology were analyzed in DRGs and dorsal horns by histology and immunohistochemistry followed by quantification. Our data suggest that the inhibition of NF-kB signaling in astrocytes as a promising target for the development of therapeutic strategies for OA pain.

Biography:

Rachael Pillay is a surgical registrar in Brisbane, Australia with an interest in oncology and reconstructive surgery. She is currently completing a Masters of Philosophy with the University of Queensland looking at the development of patient derived xenograft models of squamous cell carcinoma.

Abstract:

Venous insufficiency occurs in 4% of flaps raised on the Deep Inferior Epigastric System (DIES), typically in perforator flaps. Computed Tomography Angiogram (CTA) has become a routine part of pre-operative assessment of vascular anatomy and design in these flaps. We aim to identify CTA signs that predict venous congestion. This is a retrospective cohort study of flaps raised on the DIES at our institution where a CTA was performed pre-operatively. 98 consecutive patients had 124 DIES flaps raised of which four (3.2%) developed venous congestion. In these flaps, predictors of venous congestion included a type I pedicle (75 vs. 64.2%, p=0.22), a Superficial Inferior Epigastric Vein (SIEV) that did not connect to the depp. system perforations and was larger at origin (5.2 vs. 3.5mm, p=0.007) and less likely to arborise (0 vs. 96.7%, p<0.001), the perforators of congested flaps were less likely to connect to the superficial system (38.1 vs. 88.8%, p<0.001) and an SIEV that was larger in diameter that the DIEV at origin had a correlation coefficient with congestion of 1, suggesting that that a SIEV>DIEV at origin is highly predictive of congestion. We concluded that a CTA is an important pre-operative study for the identification of risk factors for venous compromise. These findings should prompt a robust discussion of the risk of flap failure with patients and contingency planning to augment venous drainage with the superficial system if required.

Biography:

Niclas Stensson has MSc in Chemistry from Linköping’s University (Sweden) and is at present pursuing PhD studies at Pain and Rehabilitation Center on the University hospital in Linköping. He has been a co-writer to three publications and also had several abstract/poster contributions at international conferences.

Abstract:

Chronic widespread musculoskeletal pain (CWP) is a significant health problem. The molecular mechanisms involved in developing and maintaining CWP are poorly understood. Central sensitization mechanisms maintained by stimuli from peripheral tissues such as muscle has been suggested. Lipid mediators with anti-inflammatory characteristics such as endogenous ligands of peroxisome proliferator activating receptor-α, oleoylethanolamide (OEA) and palmitoylethanolamide (PEA) are suggested to be regulators of the transmission of nociception from PNS on route towards CNS. In a previous microdialysis (MD) study we reported about levels of PEA and stearoylethanolamide (SEA) in microdialysate collected at 140 min and 180 min after MD probe insertion. In that study no significant difference of lipid concentrations between woman with CWP (N=17) and female healthy controls (CON) (N=19) was observed. The aim of the present study was to investigate the levels of PEA, SEA and OEA in MD samples collected during the first 120 min after probe insertion and explore the association of these levels with different pain characteristics. During sampling of dialysate, pain ratings were conducted using a numeric rating scale (NRS). Pain thresholds were registered from upper and lower parts of the body. OEA and SEA levels were significantly higher in CWP at all time points during the tissue trauma period. NRS correlated with the level of SEA in CWP. The higher levels of the lipid mediators could reflect altered tissue reactivity in response to MD probe insertion or a habitually higher concentration in CWP.

Biography:

Husham A. Razzaq is chief director of Pain Management Dept. at Al Hussein Teaching Hospital, Al Muthanna Province, Iraq. He is the fellow of World Institute of Pain and had Active participation in international fellowship program in Interventional Pain Management held by Seoul National University Hospital (SNUH).

Abstract:

Trigeminal neuralgia involves nerves supplying head, face, teeth and jaws. Although the aetiology is not always well known, different treatment modalities are being practiced including medical, interventional, and surgical. The main modalities being practiced in my country is medical as there are very few interventional pain clinics available and the surgical modalities are almost never done due to either lack of experience or instruments. TENS acupuncture may be considered a promising adjuvant therapy which helps to decrease or completely stops the medicines used for treatment of TGN. The study was designed to study the efficacy of TENS acupuncture in management of trigeminal neuralgia as a sole or adjuvant therapy.

Biography:

Ilker Ilhanli has graduated from Ondokuz Mayis University School of Medicine in 2004 and has joined the Giresun University (Turkey) in 2011 and established the Department of Physical Medicine and Rehabilitation. He has authored/co-authored more than 50 scientific publications and has been part of many program committees and organization bodies (journals and conferences). He has international books about cultural adaptation studies and vibration at workplace. There are many citations for his research works. He is the vice president of Internal Medicine Sciences, vice director of Traditional and Complementary Medicine Research Center, and Institute of Health Sciences.

Abstract:

The cultural adaptations of questionnaires are important for easy use. Michigan Hand Outcomes Questionnaire (MHQ) is a questionnaire evaluating the hand disorders in different diseases. In this study, we aimed to assess the reliability and the validity of the Turkish version of MHQ in a single homogeneous group of patients with Carpal Tunnel Syndrome (CTS). The MHQ was translated to Turkish for cultural adaptation. A prior study was performed with a small group of patients (N=10) and healthy participants (N=10) for cognitive debriefing. After the prior study last version of the Turkish MHQ was prepared and used for reliability and validity study. For test-retest reliability, the Turkish MHQ and the ‘‘Disabilities of Arm, Shoulder and Hand’’ questionnaire (DASH) which was validated previously were answered by 100 patients with CTS and 50 healthy participants, and were repeated a week later. For internal consistency, the Cronbach’s alpha test was used. For validity, correlations between the subscales of the MHQ and the DASH were measured. Intraclass correlations of the subscales of the MHQ were high for test-retest reliability. The Cronbach’s alphas were found to be high in all subscales. We found significant differences between the patients and controls regarding all subscales of the MHQ. Correlations between subscales of the MHQ and the DASH were significant. This study showed that the Turkish version of the “Michigan Hand Outcomes Questionnaire” is reliable and valid and can be used in the Turkish patients with the Carpal Tunnel Syndrome because it is comprehensible and practicable.

Biography:

Not Available

Abstract:

Background: Postoperative immobilization is associated with a higher risk of heart and lung complications, loss of muscle mass and prolonged stay in hospital. To reduce these risks, the fast track surgery concept has been introduced. It is well documented that early mobilization after surgery, as well as an increased time out of bed each day, reduce the patient's risk of postoperative complications and improves their well-being. However, early mobilization may be a challenge to the patient. Symptoms such as nausea, vomiting, pain, dizziness, and fainting may hinder early mobilization. In many hospitals patients are mobilized postoperatively only after several hours in the general ward.

Aim: The aim of this randomized pilot study was to investigate whether it was feasible and safe to mobilize patients shortly after lumbar disc surgery with the objective of reducing postoperative complications and allowing shorter hospitalization.

Methods: The patients were randomized into two groups. Those in the intervention group used a walking frame to walk, with a porter and a nurse, from the post-anesthesia care unit to the general ward. Patients in the control group were transported in their beds. The Bournemouth Questionnaire was used to define the well-being of the patients. 22 patients were included, 11 in each group. Due to the limited number of patients statistical comparisons were not performed. However, patients in the walking group were mobilized earlier than the controls and needed fewer painkillers and less oxygen supplement during the first postoperative day.

Results: The length of stay and the number of postoperative complications were similar in the two groups as tested during the three weeks after surgery.

Conclusion: In conclusion we found that it might be feasible and safe to mobilize patients shortly after lumbar disc surgery. The need for opioid consumption and oxygen supplementation was reduced, and might improve the patient´s well-being. There were no indications of an increased number of postoperative complications.

Biography:

Abstract:

Aim : To find the effectiveness of the "Churna" as an alternative treatment to any invasion in joints for the Pain relief of Osteoarthritis, Rheumatoid arthritis and / or any kind of Joint Pain.

Methodology : A study was carried out where 889 patients of Osteoarthritis, Rheumatoid Arthritis, Ankylosing Spodylosis, Chronic Spodylitis & Frozen Shoulder of age group between 29 to 94 yrs were given 10gms of sachets of the "Churna" two times a day for 12-15 month period.

Mechanism of Action: This "Churna" containing 9 natural phytonutrients exerting synergistic activities on body, reducing inflammation and pain by inhibiting prostaglandin synthesis, suppressing cyclooxygenase-1, cyclooxygenase 2, 5-lipoxygenase and cytokines and neutralizing leukocyte elastase and free radicals by inhibiting lipid peroxidation and raising levels of Vitamin C. This "Chuma" promotes healing of joints by stimulating peripheral and collateral circulation, inhibiting platelets aggregation, reducing synovial fluid leucocyte count and lowering elevated serum transarninase levels and erythrocyte sedimentation rates, and supplying lysine to help maintain nitrogen balance in body.

Results : Eleven out of 889 patients had partial pain relief around 30-50% with the "Churna" as they left the treatment in the middle of treatment period. Total 98.76 percentage of the patient who completed stydy period of 12-15 months exhibited complete pain relief on use of the "Churna" without any noticeable side effects.

Conclusion: For painful joint treatments, Ozone treatment, LAHC injections, Prolotherapy requires invasion of joint, and long term NSAID use has known systemic side effects. Here, simple oral intake of the "Churna" to relieve joint pain without any kind of joint invasion or visible systemic side effects was achieved successfully in 878 out of 889 patients proving its effectiveness.

Biography:

De la Cruz has completed her PhD from University Pablo de Olavide, Seville, Spain. She has a Masters in Physical Activity and Sport Sciences from University of Granada (Spain) and a Bachelor in Physical Therapy from University of Seville (Spain). She has published more than 10 papers in reputed journals and has been serving as a reviewer of reputed journals. She is coordinator of Sport Physiotherapy Group of SAMEDE.

Abstract:

Introduction: There is a growing prevalence of biomechanical alterations in the lower limbs in school-age children. The aim of this study was to assess the effectiveness of a therapeutic exercise program (TEP) in child athletes with lower limb overpronation during gait.

Method: Relevant databases (PubMed and SCOPUS) were used. A total of 123 young athletes (aged 9–12 years) were evaluated, of which 20 had lower limb overpronation (n=40 lowers extremities). All subjects underwent biomechanical analysis including all relevant angles, as follows: the Helbing angle, the tibiofemoral angle, and the Fick angle in both limbs. The sample was randomly allocated to: a control group (CG=10 subjets) whose no had treatment for three months; and an experimental group (EG10 subjects) whose the children participated in a TEP intervention program for three further months.

Results: At the beginning, a CG had tibiofemoral angle169.34±0.87º, helbing angle 10.08±4.02º and fick angle 6.93±3.00º; and EG had tibiofemoral angle168.80±1.98º, helbing angle 10.65±4.17º and fick angle 5.35±3.00º. After the intervention, a CG had tibiofemoral angle 168.92±1.73º, helbing angle 9.25±3.16º and fick angle 8.95±3.49º; and EG had tibiofemoral angle 172.75±2.45º, helbing angle 5.05±1.36º and fick angle 11.58±1.50º. In EC, all biomechanical parameters significantly improved (p<0.001 for three angles), and all subjects in the case group adopted a nearly normal gait pattern.

Conclusions: Our three-month TEP-based intervention was efficient in making young athletes with a pathological gait pattern adopt a normal gait pattern.

Biography:

Agnieszka Tymecka-Woszczerowicz obtained Master of Pharmacy Degree at the Medical University of Gdansk, Poland. Her researches were carried in collaboration with Universita Degli Studi di Perugia, Italy. She has finished Ph.D. studies at Pharmacoeconomics Department, Faculty of Pharmacy, Medical University of Warsaw, Poland. She works as Clinical Research Coordinator in Clinical Research Trials in Neurology.

Abstract:

Back pain is a major health problem affecting performance at work and general well-being worldwide. It generates work absenteeism and disablement and leads to a high economic burden to society. The Global Burden of Disease (GBD) Study 2010 showed that out of 291 conditions evaluated, low back pain ranked highest in terms of years lived with disability and sixth in disability-adjusted life years (DALYS). The most common method to estimate the burden of a specific disease on a society is a cost-of-illness (COI) study. Cost-of–illness studies aim to identify and measure all the costs of a disease: direct, indirect and intangible costs. Many studies focus only on direct costs of an illness and payers perspective, like e.g. costs of hospital services, physician services, medical devices, rehabilitation, drugs, and diagnostic tests. Indirect costs represent the other portion of estimated costs as a result of broader perspective – social perspective. These include mortality costs, morbidity costs due to absenteeism and presenteeism, informal care costs. For many diseases, indirect costs are substantial and can be significantly greater than the direct costs. International literature on studies which included indirect costs of back pain has been reviewed to determine the amount of indirect costs among total costs. The data in reviewed studies referred to USA, Netherlands, Sweden, Australia, Germany, UK and Switzerland. Results showed that indirect costs compose a significant part of the total costs of back pain (from 27.4% to 95%) and should be taken into consideration in cost-of-illness analysis. Differences in obtained results are caused by various methodology used to assess the indirect costs which means there is a need to elaborate uniform and generally accepted methodology for indirect costs assessment. With expanding and aging populations in many countries, the enormous burden from back pain will grow significantly over coming decades. To prioritize prevention efforts appropriately world-wide, information on the burden caused by back pain would be useful.

Biography:

Abstract:

Biography:

Not available.

Abstract:

Nitromedicine is a new medical specialty, focused on modulating Nitro-Redox Sensitive Biochemical Pathways to managing Oxidative Stress Related Diseases (OSRDs) and enhance Stem Cell Therapy. It has been known since the discovery of the biological role of NO in the 1980s, that supplying NO donors such can have many beneficial effects in different conditions by stimulating stem cells and modulating the immune response, however, there also exists a substantial risk of side-effects with long-term use. Excess NO can inhibit mitochondrial metabolism by binding to cytochrome c oxidase (CCO) and can also produce reactive nitrogen species (Peroxynitrite) by interacting with reactive oxygen species (ROS). To avoid these potential damaging side-effects we propose to combine the use of NO donors with four additional components. Initially, we believe that the addition of antioxidants such as Thiols, Polyphenols and Vitamins can neutralize ROS and RNS. Secondly, we believe that application of appropriate wavelengths and dosages of light (blue, red or near infrared depending on the exact condition being treated) will dissociate NO from CCO (and other storage sites) thus restoring mitochondrial ATP production and stimulating healing in many situations. Thirdly, we think detoxification will remove the pathological free radical generators and increases the nitric oxide bioavailability. Lastly, by delivering electrons to the body through electrotherapy, we might help to saturate the free radicals with electrons, thus eliminating underlying oxidative stress, stabilizing mitochondria, preventing further formation of pathological free radicals and increasing the nitric oxide bioavailability. This combination therapy may be applied to treat and prevent large variety of oxidative stressed related diseases such as degenerative diseases, immunological diseases, chronic infectious diseases, cancers and a broad range of unmet medical needs involving chronic inflammation with an emphasis on pain management.

Biography:

Kalpesh Vakharia is an Assistant Professor of Facial Plastic and Reconstructive Surgery in the Department of Otorhinolaryngology – Head and Neck Surgery at the University of Maryland, School of Medicine. He is double boarded in Otolaryngology – Head and Neck Surgery as well as in Facial Plastic and Reconstructive Surgery. He received his Medical degree from University of California, San Francisco. He completed a five year residency in Otolaryngology- Head and Neck Surgery at Harvard Medical School followed by an AAFPRS Facial Plastic and Reconstructive Surgery Fellowship at the Cleveland Clinic Foundation. He is an accomplished clinician, teacher and researcher. He has several publications in the field of Facial Plastic and Reconstructive Surgery and has presented his research at many national meetings. His clinical interests include treating facial nerve disorders, facial reconstruction and reanimation, as well as aging face rejuvenation.

Abstract:

Bell's palsy is unilateral, acute onset facial paralysis that is a common condition. One in every 65 people experiences Bell's palsy in the course of their lifetime. The majority of patients afflicted with this idiopathic disorder recover facial function. Initial treatment involves oral corticosteroids, possible antiviral drugs, and protection of the eye from desiccation. A small subset of patients may be left with incomplete recovery, synkinesis, facial contracture, or hemifacial spasm. A combination of medical and surgical treatment options exist to treat the long-term sequelae of Bell's palsy. Bell’s palsy is a clinical diagnosis and is largely one of exclusion. Patients present with a sudden onset of facial weakness that tends to be unilateral and rapidly progressive. The facial weakness tends to reach its peak within 72 hours. Patients may also have accompanied hyperacusis, change in facial sensation, neck or periauricular pain, or dysgeusia.

Biography:

Samina Ismail holds the position of a Professor at the Department of Anesthesiology and Intensive Care, Aga Khan University, Karachi. Her main research interests are obstetric anesthesia, regional anesthesia and pain management. She has contributed number of scientific publication and book chapters. She is a reviewer of number of national and international journals and had served as the Editor of the journal ‘Anesthesia, Pain and Intensive Care”. She is the Director of Anesthesia Obstetric Services at her University. She has started obstetric anesthesia fellowship program at Aga Khan University and is the Director of the fellowship program. She is also Director of Anesthesia Research Cell at her university and heading the research activity in her department.

Abstract:

Caesarean section (CS) commonly induces moderate to severe pain for 48 hrs. The aims of postoperative pain treatment are to provide subjective comfort, inhibit nociceptive impulses and blunt the neuro-endocrine response to pain thus enhancing the restoration of function. Opioids are used both by systemic and neuraxial route for postoperative analgesia. Patient controlled intravenous analgesia (IV-PCA) has shown to be superior to conventional IM opioids for women having had a caesarean Pain, pruritus, nausea/vomiting, sedation and respiratory depression are concerning issues that complicate postoperative opioid usage. These limitations have led to the introduction of multimodal analgesia in the form of co-analgesic/ adjuvant drugs and nerve block and wound infilteration. The NICE guidelines for cesarean sections suggest that wound infiltration and/or ilioinguinal nerve block are viable alternatives to systemic analgesia. TAP block can be a better option for patients not receiving long acting neuraxial opioids. Women having CS presents a unique set of problems to the anesthetist and requires optimal pain management. We need to explore the possibility to establish standard pain relief methods, the choice should be determined by drug availability, resource limitations and financial consideration.