Daniel B. Carr
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View article: In Memoriam: Professor Michael J. Cousins
In Memoriam: Professor Michael J. Cousins Open
The field of pain medicine mourns the passing of Professor Michael J. Cousins, a towering figure who reshaped the landscape of pain management for anesthetists and pain specialists globally. Professor Cousins was not merely a luminary in t…
View article: The psychometric strength and patient centeredness of the Defense and Veterans Pain Rating Scale
The psychometric strength and patient centeredness of the Defense and Veterans Pain Rating Scale Open
We read Costantino and colleagues article that erroneously asserts that the Defense and Veterans Pain Rating Scale (DVPRS), "falls short in terms of content validity, construct validity, and patient-centeredness", and is perceived by these…
View article: Comparison of the Impacts of Under-Treated Pain and Opioid Pain Medication on Cognitive Impairment
Comparison of the Impacts of Under-Treated Pain and Opioid Pain Medication on Cognitive Impairment Open
The published literature indicates that moderate to severe pain can impair cognitive function, and that careful use of opioid analgesics in such subjects does not necessarily worsen cognition. Although our results are insufficient to suppo…
View article: Features and methods to discriminate between mechanism-based categories of pain experienced in the musculoskeletal system: a Delphi expert consensus study
Features and methods to discriminate between mechanism-based categories of pain experienced in the musculoskeletal system: a Delphi expert consensus study Open
Classification of musculoskeletal pain based on underlying pain mechanisms (nociceptive, neuropathic, and nociplastic pain) is challenging. In the absence of a gold standard, verification of features that could aid in discrimination betwee…
View article: Scoping Review of Off-Label Topical Analgesia in Palliative, Hospice and Cancer Care: Towards Flexibility in Evidence-Based Medicine
Scoping Review of Off-Label Topical Analgesia in Palliative, Hospice and Cancer Care: Towards Flexibility in Evidence-Based Medicine Open
Patients with the greatest need for evidence to identify and guide lesser-used agents during aggressive pain management are the most difficult to enroll and follow in standardized, controlled and/or blinded clinical trials. This scoping re…
View article: Persistent Spinal Pain Syndrome: A Proposal for Failed Back Surgery Syndrome and ICD-11
Persistent Spinal Pain Syndrome: A Proposal for Failed Back Surgery Syndrome and ICD-11 Open
Objective For many medical professionals dealing with patients with persistent pain following spine surgery, the term Failed back surgery syndrome (FBSS) as a diagnostic label is inadequate, misleading, and potentially troublesome. It misr…
View article: Patient phenotyping in clinical trials of chronic pain treatments: IMMPACT recommendations
Patient phenotyping in clinical trials of chronic pain treatments: IMMPACT recommendations Open
There is tremendous interpatient variability in the response to analgesic therapy (even for efficacious treatments), which can be the source of great frustration in clinical practice. This has led to calls for “precision medicine” or perso…
View article: Prevention, Diagnosis, and Management of Opioids, Opioid Misuse, and Opioid Use Disorder in Older Adults
Prevention, Diagnosis, and Management of Opioids, Opioid Misuse, and Opioid Use Disorder in Older Adults Open
The information in this report is intended to help healthcare decision makers-patients and clinicians, health system leaders, and policymakers, among others-
View article: AAAPT Diagnostic Criteria for Acute Neuropathic Pain
AAAPT Diagnostic Criteria for Acute Neuropathic Pain Open
Objective Acute neuropathic pain is a significant diagnostic challenge, and it is closely related to our understanding of both acute pain and neuropathic pain. Diagnostic criteria for acute neuropathic pain should reflect our mechanistic u…
View article: Severe Chronic Pain Following Retroperitoneal Hemorrhage in a COVID-19 Patient: Amelioration with a Topical Pain Cream
Severe Chronic Pain Following Retroperitoneal Hemorrhage in a COVID-19 Patient: Amelioration with a Topical Pain Cream Open
\nTo the editor:\nMorbidity related to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection continues to rise and includes acute and chronic pain.1 Multiple etiologies include viral-induced myalgia, neuropathic pain, tiss…
View article: The revised International Association for the Study of Pain definition of pain: concepts, challenges, and compromises
The revised International Association for the Study of Pain definition of pain: concepts, challenges, and compromises Open
The current International Association for the Study of Pain (IASP) definition of pain as “An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage” was recommend…
View article: The ACTTION–APS–AAPM Pain Taxonomy (AAAPT) Multidimensional Approach to Classifying Acute Pain Conditions
The ACTTION–APS–AAPM Pain Taxonomy (AAAPT) Multidimensional Approach to Classifying Acute Pain Conditions Open
Objective. With the increasing societal awareness of the prevalence and impact of acute pain, there is a need to develop an acute pain classification system that both reflects contemporary mechanistic insights and helps guide future resear…
View article: Topical Ketamine with Other Adjuvants: Underutilized for Refractory Cancer Pain? A Case Series and Suggested Revision of the World Health Organization Stepladder for Cancer Pain
Topical Ketamine with Other Adjuvants: Underutilized for Refractory Cancer Pain? A Case Series and Suggested Revision of the World Health Organization Stepladder for Cancer Pain Open
Background: Uncontrolled cancer pain is a significant problem in palliative medicine. Opioids are often first-line treatment that increase risks of analgesic tolerance and hyperalgesia. Topical ketamine with other adjuvant pain medications…
View article: Tufts University School of Medicine Mary Y Lee, MD, Medical Education Day Poster Abstracts
Tufts University School of Medicine Mary Y Lee, MD, Medical Education Day Poster Abstracts Open
The following abstracts represent posters of Tufts University School of Medicine (TUSM) research and innovation projects in medical education (in progress and completed).
View article: Kyphoplasty patient-centered outcomes via questionnaire
Kyphoplasty patient-centered outcomes via questionnaire Open
Large randomized and observational evidence support the use of kyphoplasty in osteoporotic and malignant compression fractures. Based on our survey, patients believe kyphoplasty is a tolerable procedure that produces full or partial pain r…
View article: Current methods and challenges for acute pain clinical trials
Current methods and challenges for acute pain clinical trials Open
Introduction: The clinical setting of acute pain has provided some of the first approaches for the development of analgesic clinical trial methods. Objectives: This article reviews current methods and challenges and provides recommendation…
View article: Scope and Nature of Pain- and Analgesia-Related Content of the United States Medical Licensing Examination (USMLE)
Scope and Nature of Pain- and Analgesia-Related Content of the United States Medical Licensing Examination (USMLE) Open
This emphasis on assessment misses other important aspects of safe and effective pain management, including those specific to opioid safety. Our findings inform ways to improve the long-term education of our medical and other graduates, th…
View article: Pharmacokinetics of Diclofenac and Hydroxypropyl‐β‐Cyclodextrin (HPβCD) Following Administration of Injectable HPβCD‐Diclofenac in Subjects With Mild to Moderate Renal Insufficiency or Mild Hepatic Impairment
Pharmacokinetics of Diclofenac and Hydroxypropyl‐β‐Cyclodextrin (HPβCD) Following Administration of Injectable HPβCD‐Diclofenac in Subjects With Mild to Moderate Renal Insufficiency or Mild Hepatic Impairment Open
Given their established analgesic properties, nonsteroidal anti‐inflammatory drugs (NSAIDs) represent an important postoperative pain management option. This study investigated: (1) the effects of mild or moderate renal insufficiency and m…
View article: Sample-Based Models of Protein Energy Landscapes and Slow Structural Rearrangements
Sample-Based Models of Protein Energy Landscapes and Slow Structural Rearrangements Open
Proteins often undergo slow structural rearrangements that involve several angstroms and surpass the nanosecond timescale. These spatiotemporal scales challenge physics-based simulations and open the way to sample-based models of structura…
View article: Oral nonsteroidal anti-inflammatory drugs (NSAIDs) for cancer pain in adults
Oral nonsteroidal anti-inflammatory drugs (NSAIDs) for cancer pain in adults Open
There is no high-quality evidence to support or refute the use of NSAIDs alone or in combination with opioids for the three steps of the three-step WHO cancer pain ladder. There is very low-quality evidence that some people with moderate o…
View article: Oral paracetamol (acetaminophen) for cancer pain
Oral paracetamol (acetaminophen) for cancer pain Open
There is no high-quality evidence to support or refute the use of paracetamol alone or in combination with opioids for the first two steps of the three-step WHO cancer pain ladder. It is not clear whether any additional analgesic benefit o…
View article: “Are perioperative opioids obsolete?” Proceedings of an IASP Acute Pain Special Interest Group Satellite Symposium September 25, 2016 Yokohama, Japan
“Are perioperative opioids obsolete?” Proceedings of an IASP Acute Pain Special Interest Group Satellite Symposium September 25, 2016 Yokohama, Japan Open
This IASP Satellite Symposium surveyed opioid adverse effects upon patients and society, current and future drug and nondrug alternatives, and strategies to optimize postoperative outcomes through quality improvement.