Funding Announcements

Ellison Medical Foundation Invites Letters of Intent for Neuroscience Scholar Awards

The Ellison Medical Foundation (EMF) is accepting Letters of Intent for its 2013 EMF Neuroscience Scholar Awards, a program designed to provide researchers with the support and resources they need to gain insight into the fundamental molecular and cellular mechanisms that underlie normal biological function and, when dysfunctional, lead to illness.

Up to five new scholars and five senior scholars will be awarded grants to stimulate and nurture research that seeks to gain an understanding of the neurobiological basis of aggression and related behaviors, and of the environmental and genetic factors that contribute to violence and antisocial disorders.

Each new scholar will receive a grant of up to $100,000 per year, total costs, for a 4-year period. Senior scholar awards will be made for up to $150,000, direct costs, per year, plus full indirect costs at the institution’s NIH-negotiated rate, for up to 4 years. Funding for year 2, year 3, and year 4 is contingent on submission of an acceptable progress report. Visit the New Scholar and Senior Scholar Awards in Neuroscience page for more details on eligibility and application guidelines.

Education

Call for 2014 Symposia

APS will hold its 33rd Annual Scientific Meeting April 30–May 3, 2014, in Tampa, FL. The APS Scientific Program Committee invites the submission of proposals for symposia for presentation during the Tampa meeting.

The Scientific Program Committee requests that all proposals be multidisciplinary and interdisciplinary and therefore include speakers representing varied areas of pain research and treatment. The committee will be looking for proposals that include perspectives from physicians, nurses, physical therapists, psychologists, basic scientists, pharmacists, dentists, etc. Moderators should seek participation from a varied group of faculty (the maximum number of participants per proposal is 1 moderator and up to 3 additional speakers), and several disciplines and facilities/institutions should be represented on each proposal. Translational proposals that include both basic and clinical science are encouraged.

Submission
The submission system will remain open May 7–July 15, 2013. The system will close at 11:59 pm PST on July 15, and additional submissions will not be accepted.

Notification
Moderators and faculty will be notified in October 2013 regarding selection of their proposals. All presenters will receive complimentary conference registration. Other terms of participation will be communicated to speakers upon acceptance of the proposal.

Please visit the Call for Symposia page on the APS website for detailed instructions and a link to the submission forms.

Call for Applications for Mayday Pain & Society Fellowship: A Media and Policy Initiative

The Mayday Fund, a New York City-based foundation dedicated to alleviating the incidence, degree, and consequence of human physical pain, is interested in providing new leaders in the pain field with tools that will enable them to reach the broader public.

In 2004, Mayday established the Mayday Pain & Society Fellowship: A Media and Policy Initiative, a fellowship program to train physicians; nurses; pharmacists; social workers; basic, translational, and clinical scientists; policy experts; and legal scholars in the pain management community to go beyond their own professional pursuits to become leaders and advocates for change in the pain field in the United States and Canada. The fellowship seeks those applicants who have the capacity, time, and passion to become active advocates in the field and who foresee significant impact from their efforts to improve the lives of people in pain.

The Mayday Pain & Society Fellowship began accepting applications on Friday, March 15. The deadline for applying for the 2013 program is Monday, July 1. You must submit the following:

1. Your completed application
   
2. A letter approving your participation in the program from your immediate supervisor or chairperson. The letter should include confirmation that you can devote 10% of your time to the fellowship and provide supporting background about your candidacy for the Mayday Pain & Society Fellowship.

Finalists will be involved in a phone interview with members of the Mayday Fellowship Advisory Committee. The committee will select fellows by late August 2013. Chosen fellows will be required to participate in training October 20–23.

For questions about the Mayday fellowship program, please visit the FAQ page. The Mayday fellows advocate on behalf of themselves and not on behalf of The Mayday Fund.

ASM Attendees, Receive Your CE Credit

APS encourages all meeting attendees to complete the evaluation regardless of whether credit is being sought. Certificates of continuing education credit will be issued upon completion of the online meeting evaluation form. Please visit the evaluations page to access the meeting evaluation.

You will need to enter your username (which can be found on the second ticket of your name badge) and your password. If you are not a member of APS, did not register online for the annual meeting, or otherwise have not established a username and password, you will need to do so to access your evaluation form. Please contact APS Member Services at 847.375.4715 to activate your online profile.

If you attended the “Risk Evaluation and Mitigation Strategies (REMS) for Extended-Release and Long-Acting Opioids: Achieving Safe Use While Improving Patient Care” course on Saturday, May 11, you will have access to the evaluation form for the course upon logging into the meeting evaluation system.

Members

Member Spotlight

Gregory W. Terman, MD PhD
Professor, Anesthesiology and the Graduate Program in Neurobiology and Behavior
University of Washington
Seattle, WA

Please give us a brief description of your current area of specialty. What sparked your interest in your field?
My interests in pain started as an undergraduate psychology major at the College of William and Mary in Virginia in the late 1970s. Endorphins had just been discovered and the role of these chemicals in modulating pain was an exciting topic of discussion in my Physiological Psychology class. I did some rudimentary studies of conditioned analgesia in rats with a faculty sponsor in those undergraduate days before having the opportunity to go to University of California, Los Angeles, for graduate study in the laboratory of Dr. John Liebeskind. There we studied the anatomy, chemistry, and activating stimuli of endogenous pain inhibitory systems in the rodent brain and spinal cord. After receiving my PhD in behavioral neuroscience, I headed to the University of Miami for medical school hoping to learn more about pain. It was in medical school that I fell in love with anesthesiology, a field comprised mostly of applied pharmacology and physiology with every surgical case being a pain management problem. With my interests, it was pretty easy to choose the University of Washington in Seattle for residency with its long history of pain innovation led by John Bonica, John Loeser, and others. After residency, a pain fellowship, and a research fellowship, I joined the faculty and over the years have enjoyed my diverse activities as an anesthesiologist, pain physician, and researcher.

Why is APS important in your field?
My first American Pain Society meeting was in Chicago in 1983. My PhD mentor, Dr. John Liebeskind, pushed me to go and I have missed only a handful of annual meetings since. I particularly enjoyed meeting many of the senior scientists in the pain world that Dr. Liebeskind introduced me to. It was an excellent meeting for a trainee, and I believe that it still is. Subsequently, it has been the APS’s interdisciplinary approach to pain that has become the major attraction for me of the annual meetings specifically and of the society in general. Yes, I admit that I too end up attending mostly symposia that are in my own field during the annual meetings, but it is frequently the talks outside my particular research interests that teach me the most including the plenary lectures that always seem to give me perspectives that expand my view of pain research and treatment. This is no small matter as the dire results of mono-therapeutic approaches to pain have become more and more obvious during the past several years. Whether the therapy is an intervention or a new or ancient drug treatment, the idea of simply “fixing” a patient’s pain with a magic bullet is no more tenable today than it was as I listened at my first APS meeting.

What is your vision for APS during your tenure, and where do you see APS in 4 years?
In some ways my vision for APS has more to do with more effective communication of what we already are doing than in a major change in direction for the society. Although there are many societies out there worldwide one could join, in this country, only APS has facilitating pain research and treatment as its primary goal. Both basic scientists who may never have seen a living animal of any species in pain and clinicians who may never have seen a basic scientist benefit from APS’s work through our clinical guidelines, in-person educational opportunities, NIH and FDA advocacy activities, and research funding programs. I am hopeful that in the next 4 years we will be more successful in having our efforts recognized both by researchers who write applications for grants that might not exist without our advocacy and primary care clinicians who rely on our guidelines for treating the most difficult patients in their practice. If we are successful in these efforts I feel certain that our society will continue to grow and thereby facilitate translational efforts to bring innovative treatments to people in pain.

As president-elect, what do you think will be most challenging?
I suspect that the most challenging part of being president-elect will be similar to the most challenging parts of every other leadership position I have held—finding time and mechanisms to listen to those one is leading. It is difficult for a society to be all things to all people. As an interdisciplinary individual myself I know that I am often conflicted about how best to use my time and resources—whether providing patient care, teaching, or research. It is only by keeping the communication lines open and our eyes on our mission and goals that, as diverse and successful a group of members as we have, APS can continue to grow individually and collectively. It must be remembered that APS is all about “us” rather than “them.”

What do you hope to gain and achieve during your next year as president-elect?
Well, I hope in the next year to learn how to become a decent president for one thing—such that when my time comes, I’ll be ready. I have been fortunate in the past 30 years of APS membership to know many APS Presidents, and I have worked closely with the last four or five. Each president brought his or her own unique perspective to the job—one that I would not even attempt to copy. However, the most successful presidents I have known listened more than they talked and relied heavily on their board of directors and the APS staff to move APS forward. I hope in the next year to become better acquainted with the current APS Board and staff to help me serve members better during my presidency.

APS Member Needs Assessment Survey Coming Soon to Your Inbox

APS will be conducting a member needs assessment study. Your input is critical to ensuring that APS has the most accurate and current information regarding your professional interests, challenges, and needs.

Please watch your e-mail this month for an invitation to participate in the survey from Avenue M Group, LLC, an independent market research firm and our partner for this study.

Your participation will help APS better understand your needs and how APS can improve the products and services provided to you as a member.

Member Benefit

Journal of Pain: Benefits to APS Members and the Field of Pain
The Journal of Pain (JOP) has been APS’s flagship journal for more than 13 years. Its founding editor, Gerald F. Gebhart, PhD, worked to develop and nurture the journal from the start, quickly ensuring that it was indexed in PubMed. He provided encouragement and support to the best researchers to ensure a steady stream of articles and developed a network of reviewers who would ensure that only the most important and impactful articles would be accepted for publication. In 2010, Mark Jensen, PhD, assumed editorship of the journal. Over the years, JOP’s importance and impact has increased, and it is now considered a top-tier outlet for ground-breaking discoveries and knowledge about pain and pain relief.

JOP provides at least two critical benefits to APS members. First and foremost, it provides our multidisciplinary members with a broad range of the most cutting-edge findings in the field of pain. From pain genetics to cognitions, molecules to behavior, the readers—who are primarily APS members—can learn first-hand about critical discoveries that will influence their understanding and treatment of pain. The wide range of topics covered is an important strength and helps our members keep abreast of the entire field of pain.

JOP also provides an important outlet for the discoveries of pain researchers and scientists who are APS members. The editorial board works hard to ensure a rapid decision on articles submitted, which is among the most important author services of any journal in a rapidly evolving field. We are proud that APS members are commonly represented in the list of authors who publish in the journal. All indications are that JOP will continue to grow and thrive. We are looking forward to continuing to serve APS and APS members in the years and decades ahead.

Summaries

Journal of Pain Highlights

The following highlights summarize selected articles from June 2013 (Volume 14, Number 6).

Assessing Chronic Pain Treatment Practices and Evaluating Adherence to Chronic Pain Guidelines in Outpatient Practices in the United States
Rafia S. Rasu, Rose Sohrab, Lindsay Cunningham, and Maureen Knel; University of Missouri Kansas City School of Pharmacy; University Health System, San Antonio; and Children’s Mercy Hospital

In 2011, the Institute of Medicine reported that an estimated 100 million Americans have chronic pain, a larger population than those with heart disease, cancer, and diabetes combined. To help physicians treat chronic pain, several prominent organizations, such as the Institute for Clinical Systems Improvement, Wisconsin Medical Society, American Society of Interventional Pain Physicians, APS, and American Academy of Pain Medicine, have formulated clinical practice guidelines to improve treatment success for people with non-malignant chronic pain (NMCP). The guidelines are similar in their recommendations and cover chronic pain conditions in general rather than pain related to specific diseases.

This study was undertaken to identify the factors, variations, and current treatment practices in the management of NMCP and determine if these practices are consistent with the various clinical practice guidelines. The researchers utilized data from more than 690,000 patient visits to physician offices compiled for the National Ambulatory Medical Care Survey from 2000 to 2007. The sample included patients 18 and older with common nonmalignant chronic pain.

The authors found than chronic pain related physician office visits comprised 13 percent of total national ambulatory care visits, of which 45 percent involved primary-care physicians. Only 0.12 percent of the visits involved pain specialists. The authors noted this disparity shows that the demand for pain services far exceeds availability due to the limited number of pain specialists practicing in the United States.

With regard to pain medicine prescribing practices, the authors reported that, in compliance with published guidelines, non-steroidal anti-inflammatory drugs were with most common medication class prescribed as a first-line option. However, NSAID use was surprisingly high with rates of 97 to 99 percent in all chronic pain types studied. Also, acetaminophen use was very low at 4 percent. The authors surmised that many chronic pain patients have not achieved sufficient pain relief from acetaminophen by the time they decide to see a doctor. No other medication class was used in 26 percent or more of the study population, and there was a lower than anticipated utilization of opioid analgesics. They were prescribed for only 10.5 percent of the general pain group. The clinical practice guidelines agree that opioids are an appropriate option when other therapies fail to provide relief.

The authors concluded that their findings showed an underutilization of several guideline-recommended chronic pain therapies and support the need to increase awareness among primary care physicians about the use and value of NMCP management guidelines.

Clinicians’ Attitudes and Beliefs about Opioids Survey (CAOS): Instrument Development and Results of a National Physician Survey
Hilary D. Wilson, Elizabeth J. Danise, Myoung S. Kim, Bruce L. Moskovitz, Wing Chow, and Dennis C. Turk; United Bioscience Corp.; University of Washington, Seattle; and Janssen Scientific Affairs

The authors of this study sought to develop a reliable and valid measure to assess current and evolving beliefs about opioids and their use in patients with chronic pain, and also survey the attitudes and beliefs about opioids in a representative sample of physician specialties.

In 1994, Dennis C. Turk, PhD, and colleagues conducted a survey of physician attitudes about prescribing opioids for chronic non-cancer pain. They identified significant differences in attitudes and beliefs throughout the country and by medical specialty. The current study was intended to assess how physician beliefs about opioids have evolved over time and coincide with changes in regulations, increasing drug misuse, and negative public opinions about narcotic pain medications.

In Phase One of the study, a 38-item questionnaire was developed and it probed attitudes on impediments and concerns regarding opioid prescribing, perceived efficacy, medical education, and benefits of tamper resistant formulations (TRFs). Phases Two and Three involved pilot testing and the formal survey of 1,535 physicians.

More than 70 percent of the respondents reported that they use opioids in fewer than 30 percent of their patients with chronic non-cancer pain. However, physicians who see higher volumes of pain patients were more likely to prescribe opioids and said they are less concerned with impediments surrounding opioids, are not concerned with or avoidant of prescribing Schedule II vs. Schedule III drugs, believe in the benefits of TRFs, and know they were adequately trained to treat chronic pain. These results are consistent with other studies showing that physician uneasiness with prescribing long-term opioids is linked with inexperience in using the medications.

Overall, orthopedists expressed the most negative views of opioids and showed the lowest level of confidence in drug efficacy. They also had the highest mean levels of concern about opioid addiction, tolerance, and dependence.

There were no differences shown in overall physician attitudes about opioids in various areas of the country.

The authors concluded that the survey results show that negative physician attitudes about opioids are closely associated with lower rates of prescribing and more favorable attitudes are linked with higher prescribing levels.

Analgesic Effect of a Single Preoperative Dose of the Antibiotic Ceftriaxone in Humans
Angela Macaluso, Matteo Bernabucci, Angela Trabucco, Ludovico Ciolli, Fabiana Troisi, Rossella Baldini, Roberto Gradini, Giuseppe Battaglia, Ferdinando Nicoletti, and Saul Collini; University Sapienza Departments of Medical and Surgical Sciences and Translational Medicine, Physiology and Pharmacology, Human Anatomy, and Experimental Medicine, Roma, Italy; and I.R.C.C.S. Neuromed, Pozzilli, Italy

Previous studies have shown that drugs with a mode of action to enhance glutamate clearance might be effective in the treatment of chronic pain. In animals, repeated does of the antibiotic ceftriaxone have reduced both visceral and neuropathic pain. The drug induces activation of the GLT-1 gene. This is the first study to explore the analgesic activity of ceftriaxone in humans.

Italian researchers analyzed whether a single dose of ceftriaxone given for antimicrobial prophylaxis prior to surgery could enhance patient pain thresholds after surgery. For a negative control, a similar cephalosporin antibiotic, cefazolin, was used because it has never been shown to induce GLT-1 expression or produce analgesia.

Forty-five patients undergoing surgery for carpal tunnel syndrome or ulner nerve compression disease participated in the study. They were randomized in three treatment groups: IV doses of saline, saline with ceftriaxone, and saline with cefazolin. Injections were administered one hour prior to surgery, and mechanical pain thresholds were measured 10 minutes before the injections and 4 to 6 hours following surgery. No analgesic drugs were allowed in the first 6 hours after surgery.

Concurrently, animal studies were carried out to determine whether a single dose of ceftriaxone was sufficient for the induction of analgesia and whether the analgesic effect was addictive or synergistic to analgesia produced by the mGlu5 receptor antagonists MPEP and MTEP.

Results in the human subjects showed that those treated with saline and cefazolin showed no change in mechanical pain thresholds 6–7 hours after surgery, but pain thresholds in patients given a single preoperative does of ceftriaxone increased significantly. Mice given ceftriaxone showed a lowered reduction in pain thresholds compared to mice treated with saline or cefazolin. The authors concluded that a single injection of ceftriaxone is sufficient to cause analgesia in mouse models of inflammatory and postsurgical pain.

This is the first study showing analgesia resulted from administration of an antibiotic in humans. The study concluded that ceftriaxone should be the drug of choice for surgical prophylaxis in situations when pain does not rapidly resolve following surgery or when strong pain is expected to occur after surgery.

Pain Medicine Highlights

The following highlights summarize selected articles from May 2013 (Volume 14, Number 5).

Individual Modulation of Pain Sensitivity Under Stress
Tatyana Reinhardt, MD, Nikolaus Kleindienst, MD, Rolf-Detlef Treede, PhD, Martin Bohus, MD, and Christian Schmahl, PhD; Central Institute of Mental Health Department of Psychosomatic Medicine and Psychotherapy, Mannheim, Germany; and Ruprecht Karls-University Center for Biomedicine and Medical Technology Department of Neurophysiology, Heidelberg, Mannheim, Germany

This study investigated the effect of stress on individual pain sensitivity in a sample of 80 healthy women ages 18–35. Researchers also examined whether pain sensitivity under nonstress conditions predicts the valence of the individually predisposed shift of pain sensitivity under stress conditions. Pain thresholds and temporal summation of pain were assessed before and after inducing stress. Stress was induced by a standardized stress protocol, the Mannheim Multicomponent Stress Test.

The findings of this study provide further evidence of individual differences in the effect of stress conditions on pain sensitivity (no effect, decrease, or increase). Based on Jacobson’s criteria for reliable change, both decreased and increased pain sensitivities were observed, indicating that stress can have divergent effects on pain sensitivity.

Although the stressor induced a significant level of objective and subjective stress, the majority of subjects did not demonstrate significant changes of pain sensitivity after stress induction. These findings support the hypothesis that the character of change in pain sensitivity under stress conditions is individually predisposed and reflects interindividual variability in responsivity to stressors.

Future studies should investigate a possible dichotomy of the effects of stress on pain in larger samples of healthy people and in those who have stress-related disorders with altered pain sensitivity.

Risk Stratification of Opioid Misuse Among Patients with Cancer Pain Using the SOAPP-SF
Eduardo Bruera, MD, Carrie Aigner, PhD, Harun Nusrat, PhD, Larry Driver, MD, and Diane Novy, PhD; The University of Texas MD Anderson Cancer Departments of Pain Medicine, Palliative Care and Rehabilitation Medicine, Behavioral Science, and Biostatistics, Houston, TX

Safe and effective opioid prescribing is enhanced by correct stratification of risk and the integration of risk data into a patient’s treatment plan. Although opioid therapy has an important place in cancer pain management, there is an increasing awareness of the need to identify those at increased risk of for opioid misuse. The Screener and Opioid Assessment for Patients with Pain-Short Form (SOAPP-SF) is a brief screening tool that has been used in noncancer clinical settings to identify at-risk patients. However, this tool has not yet been well researched or validated for use with patients with cancer.

In this study, investigators reviewed 522 charts of patients who were seen in a pain center at The University of Texas MD Anderson Cancer Center between January 1, 2009, and June 30, 2009, for risk stratification of opioid misuse and demographic and clinical factors using the SOAPP-SF. Group differences based on high and low SOAPP-SF scores were evaluated at the initial visit, follow-up within 1 month, and at 6–9 months.

The study examined the ways in which personal characteristics known to be associated with opioid abuse risk (such as age, morphine equivalent daily dose [MEDD] score, and psychological symptoms) relate to SOAPP-SF scores in patients with cancer.

Patients classified as high risk by the SOAPP-SF were found to have increased pain intensity at all study points and higher MEDD at consult than patients classified as low risk by the SOAPP-SF. These findings are consistent with previous research that has found that people at higher risk for abusing opioids experience more pain and take more opioid medications.

SOAPP-SF scores correlated with age. Younger patients were more likely to score in the high-risk range on the SOAPP-SF. Higher SOAPP-SF scores also correlated with larger symptom burden across many dimensions on the Edmonton Symptom Assessment Scale, including depression, anxiety, poor appetite, and fatigue.

PAIN Highlights

The following highlights summarize selected articles from June 2013 (Volume 154, Number 6).

Altered Gray Matter Volume in the Frontal Pain Modulation Network in Patients with Cluster Headache
Fu-Chi Yang, Kun-Hsien Chou, Jong-Ling Fuh, Chu-Chung Huang, Jiing-Feng Lirng, Yung-Yang Lin, Ching-Po Lin, and Shuu-Jiun Wang; National Yang-Ming University Institute of Brain Science, Institute of Neuroscience, Department of Neurology, Department of Biomedical Imaging and Radiological Sciences, Department of Radiology, and Brain Research Center, Taiwan; National Defense Medical Center Tri-Service General Hospital Departments of Neurology, Taiwan; and Taipei Veterans General Hospital Department of Neurology and Department of Radiology, Taiwan

Several studies have used T1 voxel-based morphometry (VBM) to investigate structural abnormalities in patients with cluster headache (CH), but it has not been known if metabolic changes during the bout period are inherent to structural changes in these patients. In this study, investigators used the T1-VBM approach to determine whether structural changes in patients with CH during the bout period are restricted to the hypothalamus or if they tend to be distributed, potentially belonging to the descending pain modulation areas. They also examined whether structural brain abnormalities varied between the ‘‘in bout’’ and ‘‘out of bout’’ (remission) periods. An exploratory examination of possible correlations between gray matter volume (GMV) changes and clinical variables was also conducted.

Forty-nine patients with episodic CH (38 men, 11 women; mean age 35.7 years; age range 20–55 years) were recruited consecutively from the Headache Clinic, Neurology Department of Taipei Veterans General Hospital, Taiwan. Using the T1-VBM approach to measure brain volume, structural differences were observed between ‘‘in bout’’ patients with CH and healthy controls. In ‘‘in bout’’ CH patients, these structural abnormalities affected the bilateral middle frontal gyri (MFG), the left superior, and medial frontal gyri. In a follow-up study, patients during the bout period demonstrated an increased GMV in the left anterior cingulate, insula, and fusiform gyrus compared to their experiences during the ‘‘out of bout’’ period. Additionally, ‘‘out of bout’’ patients showed a tendency toward a reduced GMV in the left MFG. Collectively, these results suggest that the descending pain modulation system is impaired in patients with CH during the bout period, which may in turn be one possible component in a complex pathophysiology that makes these patients more susceptible to the emergence of the bout period and headache attacks.

In the follow-up study, the ‘‘in bout’’ scans were associated with an increased GMV in the anterior cingulate cortex and insula. These areas are thought to play major roles in the central descending pain control system, and, although the GMV is increased during the bout period, it seems that the increased GMV is not sufficient to prevent the bout state. These structural findings may explain the altered metabolism in frontal pain-modulating circuits in these patients, and researchers suspect an insufficient top-down pain-modulating capacity in patients with CH.

Efficacy of Melatonin in the Treatment of Endometriosis: A Phase II, Randomized, Double-Blind, Placebo-Controlled Trial
André Schwertner, Claudia C. Conceição dos Santos, Gislene Dalferth Costa, Alícia Deitos, Andressa de Souza, Izabel Cristina Custodio de Souza, Iraci L.S. Torres, João Sabino L. da Cunha Filho, and Wolnei Caumo; Laboratory of Pain & Neuromodulation at Hospital de Clínicas de Porto Alegre (HCPA), School of Medicine Post Graduate Program in Medical Sciences, Instituto de Ciências Básicas da Saúde Pharmacology Department, and Pain and Palliative Care Service at the HCPA, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil

Chronic pelvic pain (CPP) is defined as a nonmalignant pain perceived in the structures related to the pelvis that is constant or recurring over a period of 6 months. A population study demonstrated a 3.8% occurrence rate; however, in infertility populations, this rate can be as high as 40%. Endometriosis is strongly associated with CPP; lesions produce pain by compressing or infiltrating the nerves near the lesions. The presence of nerve growth factors in lesions is correlated with hyperalgesia. Although the full pathophysiology of CPP remains unknown, cumulative evidence suggests that peripheral and central sensitization result in an amplification of sensory impulses.

Endometriosis-associated chronic pelvic pain (EACPP) presents with an intense inflammatory reaction. Melatonin has emerged as an important analgesic, antioxidant, and anti-inflammatory agent. This trial investigates the effects of melatonin compared with a placebo on EACPP, brain-derived neurotrophic factor (BDNF) level, and sleep quality.

Forty women ages 18–45 were randomized into the placebo (n = 20) or melatonin (10 mg; n = 20) treatment groups for a period of 8 weeks. There was a significant interaction (time versus group) regarding the main outcomes of the pain scores, as indexed by the visual analog scale on daily pain, dysmenorrhea, dysuria, and dyschezia (analysis of variance, P < 0.01 for all analyses).

Post hoc analysis showed that compared with placebo, the treatment reduced daily pain scores by 39.8%, and dysmenorrhea by 38.01%. Melatonin improved sleep quality, reduced need for using an analgesic by 80%, and reduced BNDF levels independently of its effect on pain. This study provides additional evidence regarding the analgesic effects of melatonin on EACPP and melatonin’s ability to improve sleep quality. Additionally, the study revealed that melatonin modulates the secretion of BDNF and pain through distinct mechanisms.

Research

APS 2013 Future Leaders in Pain Research Grant Program—Now Open!

The call for applications for the 2013 Future Leaders in Pain Research Grant Program is open. This year APS will again award at least two grants in the amount of $20,000 each to pain research proposals demonstrating the greatest merit and potential for success.

The Future Leaders in Pain Research Grant Program was established in 2005 to fund pain research projects of doctoral-prepared investigators who have not yet attained National Institutes of Health RO1 level funding. The purpose of this grant is to encourage research in pain that will add to the existing body of knowledge, and to allow investigators to develop pilot data that will aid them in securing additional major grant funding for continued pain research.

Application submission is open through midnight on July 12.

For more information regarding deadlines, eligibility, topics, and more, please visit Future Leaders in Pain Research Grant on the APS website.

Society

Call for APS Award Nominations Now Open!

Every year at its Annual Scientific Meeting, APS rewards excellence in the field of pain management and research by presenting awards for career achievement, pain scholarship, education and public service, advocacy on behalf of children, outstanding service to APS, and early-career achievements.

Applications for the 2014 APS annual achievement awards open June 10 and close at midnight on August 1. Award winners will be announced in September 2013 and will be honored at the President’s Recognition Reception at the 33rd Annual Scientific Meeting April 30–May 3, 2014, in Tampa, FL.

To make one or more award nominations, please visit the APS website and complete the electronic nomination form. Please be sure to include all of the requested information. All nominations should be completed online by August 1. Please contact Amanda Pairitz at the APS office at apairitz@americanpainsociety.org with any questions.

Save the Date for APS's 2014 Annual Scientific Meeting

APS 33rd Annual Scientific Meeting
April 30–May 3, 2014
Tampa Convention Center
Tampa, FL

Attend APS’s 33rd Annual Scientific Meeting to

• discover the latest in basic science and clinical research
  
• experience a unique multidisciplinary forum for sharing advances and standards in evidence-based pain research and treatment
  
• discuss new trends, techniques, therapies, and diagnostic procedures.

For more information visit www.apsscientificmeeting.org.

APS Continues to Establish a Presence at PAINWeek

For the second year in a row, several APS members will be present at PAINWeek and share their expertise. Held in Las Vegas each September, with approximately 2,000 attendees, PAINWeek is the largest U.S. pain conference for the primary care clinician.

As we did last year, APS will host an exhibit meant to inform this audience of our work and foundational principles of science-grounded, evidence-based, interdisciplinary pain care. Those staffing the exhibit will distribute informational facts about APS, the Journal of Pain, an Annual Scientific Meeting announcement, clinical practice guideline references, and membership information.

Under the direction of Roger Fillingim, PhD, another APS Track will be held; the track last year was very well received. The 2013 track is titled “New Developments in Evidence-Based Pain Assessment and Treatment” and includes the following sessions and speakers:

• Using Quantitative Sensory Testing for Mechanism-Based Pain Assessment by Roger Fillingim, PhD
  
• Brain Imaging as an Objective Biomarker for Pain by Sean Mackey, MD PhD
  
• How to Assess and Manage Sleep Disturbances in Patients with Pain by Michael Smith, PhD
  
• Does Exercise Increase or Decrease Pain? by Kathleen Sluka, PT PhD.

Charles Argoff, MD, will lead a multidisciplinary panel through the Opioid Risk Evaluation and Mitigation Strategy (REMS) course, similar to the special session held at the 2013 Annual Scientific Meeting. This course, REMS for ER/LA Opioids: Achieving Safe Use While Improving Patient Care, is a 3-hour session aimed at completing the entire Food and Drug Administration Opioid REMS blueprint and will target PAINWeek attendees and Las Vegas–area primary care prescribers. Argoff will be joined by Katherine Galluzzi of both the American Osteopathic Association and APS, Sandra Keavey of the American Academy of Physician Assistants, and Barbara St. Marie of the Nurse Practitioner Healthcare Foundation.

APS is pleased to announce our SIG Chairs for 2013–2014

Advancing the Science of Quality—Debra Gordon, DNP RN FAAN, and Julie Sorensen Franklin, MD MPH

Basic Science—David Seminowicz, PhD, and Benedict Kolber, PhD

Clinical Trials—Neil Kumar Singla, MD

Complementary and Alternative Medicine—Arian Nachant, MD ABEM ABHPM, and Norman Kettner, BS DC DACBR FICC

Ethics—Beth Darnall, PhD

Genetics and Pain—Andrea Nackley, PhD, and Feng Dai, PhD

Geriatric Pain—Timothy Platts-Mills, PhD, and Todd Monroe, PhD RN-BC

Measurement of Pain and Its Impact—John Farrar, MD PhD, and Misha-Miroslav Backonja, MD

Nursing Issues—Maureen Cooney, BSN RN NP

Pain and Disparities—Salimah Meghani, PhD MBE RN FAAN

Pain Education—Paul Arnstein, PhD RN FAAN, and Larry Driver, MD

Pain in Infants, Children, and Adolescents—Deirdre Logan, PhD

Pain Rehabilitation—Tomer Anbar, PhD

Palliative Care—Michael Weinberger, MD

Pharmacotherapy—James Ray, PhD CPE, and Sean Ustic, PhD

Psychosocial Research—Zina Trost, PhD, and Adam Hirsh, PhD

Pain in Sickle Cell Disease—Carlton Dampier, MD

APS permits the establishment of multidisciplinary special interest groups (SIGs), which are a forum for interested members to meet and discuss a field or topic of common interest. APS SIGs are open to participation by any APS member.

SIGs meet annually at the APS Annual Scientific Meeting.

To receive more information about a SIG you may contact the volunteers listed.

To join a SIG, contact the APS national office at list@americanpainsociety.org.

In the Media

Make Sure You’re Getting Your Pain News from APS
SmartBrief

In previous issues of APS e-news, you have been able to rely on In the News for links to articles related to the field of pain sourced from various media. APS recently launched its inaugural issue of APS SmartBrief, a free digital digest of easy-to-read summaries specifically designed to bring you the most important and timely news stories on pain research, science, treatment, policy, and trends.

APS SmartBrief is available to you with the option to share and forward to your colleagues. We hope you find this new member benefit valuable and subscribe today.

Call for Submissions

Do you have a topic that is relevant to APS members? Is there a member who is doing work that APS should spotlight? Is there a funding opportunity APS members need to know about? Please submit stories, events, and more to enews@americanpainsociety.org for consideration.