Brenda Golianu's research while affiliated with Stanford University and other places
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This Research Topic aims to enhance our understanding of the effects and potential mechanisms of Complementary and alternative therapy (CAT) for pain disorder management. We are particularly interested in studies focusing on:
CAT for neuropathic pain
CAT for postoperative pain
CAT for headaches/migraines
CAT for dysmenorrhea
CAT for labor pain
CAT for cancer pain
We welcome studies on these topics, as well as other acute and chronic pain disorders such as neck pain, shoulder pain, elbow pain, back pain, knee pain, pelvic pain, postoperative pain, cancer pain, and phantom limb pain.
The types of manuscripts we accept include but are not limited to, Original Research, Clinical Trial, Review.
You can learn more about the collection here: https://www.frontiersin.org/submission/submit?st=1&tid=58161&domainid=2&fieldid=54&specialtyid=2147&entitytype=2&entityid=1784
Please attention:
Abstract Deadline: 11/09/2023
Manuscript Deadline: 11/01/2024
This study aimed to investigate the research hotspots and global trends of acupuncture in the treatment of headaches from 1974 to 2022. The Web of Science core collection database and literature related to acupuncture for headache treatment were retrieved. The CiteSpace (version 5.1.R8) and VOSviewer (version 1.6.19) software perform collaborative network analysis on the information of countries, academic institutions, authors, and co-occurrence network analysis on keywords, co-cited journals, and references. A total of 841 studies were included. Overall, the number of publications has increased over the past 5 decades. We identified and analyzed the countries, institutions, authors, and journals that were most active in the domain of acupuncture treatment for headaches. The most productive countries were the United States and China. Chengdu University of Traditional Chinese Medicine was the most productive institution and Linde Klaus was the most productive author. Cephalalgia was the most productive and co-cited journal, whereas Lancet had the highest impact factor. The research hotspots mainly focus on headache, migraine, tension headache, electroacupuncture, and acupuncture. Research trends have mainly focused on acupuncture therapy and its curative effects, migraine without aura, paroxysmal migraine, and the mechanism of acupuncture treatment. The main research hotspots and frontier trends were the therapeutic effect and mechanism of acupuncture for headaches. The mechanism of acupuncture in the treatment of headache mainly focused on the neural mechanism by multimodal MRI.
Rationale:
A guideline that both evaluates current practice and provides recommendations to address sedation, pain, and delirium management with regard for neuromuscular blockade and withdrawal is not currently available.
Objective:
To develop comprehensive clinical practice guidelines for critically ill infants and children, with specific attention to seven domains of care including pain, sedation/agitation, iatrogenic withdrawal, neuromuscular blockade, delirium, PICU environment, and early mobility.
Design:
The Society of Critical Care Medicine Pediatric Pain, Agitation, Neuromuscular Blockade, and Delirium in critically ill pediatric patients with consideration of the PICU Environment and Early Mobility Guideline Taskforce was comprised of 29 national experts who collaborated from 2009 to 2021 via teleconference and/or e-mail at least monthly for planning, literature review, and guideline development, revision, and approval. The full taskforce gathered annually in-person during the Society of Critical Care Medicine Congress for progress reports and further strategizing with the final face-to-face meeting occurring in February 2020. Throughout this process, the Society of Critical Care Medicine standard operating procedures Manual for Guidelines development was adhered to.
Methods:
Taskforce content experts separated into subgroups addressing pain/analgesia, sedation, tolerance/iatrogenic withdrawal, neuromuscular blockade, delirium, PICU environment (family presence and sleep hygiene), and early mobility. Subgroups created descriptive and actionable Population, Intervention, Comparison, and Outcome questions. An experienced medical information specialist developed search strategies to identify relevant literature between January 1990 and January 2020. Subgroups reviewed literature, determined quality of evidence, and formulated recommendations classified as "strong" with "we recommend" or "conditional" with "we suggest." Good practice statements were used when indirect evidence supported benefit with no or minimal risk. Evidence gaps were noted. Initial recommendations were reviewed by each subgroup and revised as deemed necessary prior to being disseminated for voting by the full taskforce. Individuals who had an overt or potential conflict of interest abstained from relevant votes. Expert opinion alone was not used in substitution for a lack of evidence.
Results:
The Pediatric Pain, Agitation, Neuromuscular Blockade, and Delirium in critically ill pediatric patients with consideration of the PICU Environment and Early Mobility taskforce issued 44 recommendations (14 strong and 30 conditional) and five good practice statements.
Conclusions:
The current guidelines represent a comprehensive list of practical clinical recommendations for the assessment, prevention, and management of key aspects for the comprehensive critical care of infants and children. Main areas of focus included 1) need for the routine monitoring of pain, agitation, withdrawal, and delirium using validated tools, 2) enhanced use of protocolized sedation and analgesia, and 3) recognition of the importance of nonpharmacologic interventions for enhancing patient comfort and comprehensive care provision.
"Although we appreciate the thoughtful letter by Humphry and colleagues and are grateful for the opportunity to respond, we somewhat disagree with the interpretation of our findings by the authors."
Background
In the field of pain, virtual reality (VR) technology has been increasingly common in the context of procedural pain management. As an interactive technology tool, VR has the potential to be extended beyond acute pain management to chronic pain rehabilitation with a focus on increasing engagement with painful or avoided movements.
Objective
We outline the development and initial implementation of a VR program in pain rehabilitation intervention to enhance function in youth with chronic pain.
Methods
We present the development, acceptability, feasibility, and utility of an innovative VR program (Fruity Feet) for pediatric pain rehabilitation to facilitate increased upper and lower extremity engagement. The development team was an interdisciplinary group of pediatric experts, including physical therapists, occupational therapists, pain psychologists, anesthesiologists, pain researchers, and a VR software developer. We used a 4-phase iterative development process that engaged clinicians, parents, and patients via interviews and standardized questionnaires.
ResultsThis study included 17 pediatric patients (13 female, 4 male) enrolled in an intensive interdisciplinary pain treatment (IIPT) program, with mean age of 13.24 (range 7-17) years, completing a total of 63 VR sessions. Overall reports of presence were high (mean 28.98; max 40; SD 4.02), suggestive of a high level of immersion. Among those with multisession data (n=8), reports of pain (P
BACKGROUND
In the field of pain, virtual reality (VR) technology has been increasingly common in the context of procedural pain management. As an interactive technology tool, VR has the potential to be extended beyond acute pain management to chronic pain rehabilitation with a focus on increasing engagement with painful or avoided movements.
OBJECTIVE
We outline the development and initial implementation of a pain rehabilitation virtual reality (PRVR) intervention to enhance function in youth with chronic pain.
METHODS
We present the development, acceptability, feasibility and utility of an innovative PRVR program for pediatric pain rehabilitation to facilitate increased upper and lower extremity engagement, entitled Fruity Feet. The development team was an interdisciplinary group of pediatric experts, including physical therapists, occupational therapists, pain psychologists, anesthesiologists, pain researchers, and a VR software developer. We used a four-phase iterative development process that engaged clinicians, parents, and patients via interviews and standardized questionnaires.
RESULTS
The current study included 17 pediatric patients (13 female, 4 male) enrolled in an intensive interdisciplinary pain treatment (IIPT) program, with mean age 13.24 (range 7-17), completing a total of 63 VR sessions. Overall reports of presence were high, suggestive of a high level of immersion. Among those with multi-session data (n=8), reports of pain, fear, avoidance, and functional limitations significantly decreased. Qualitative analysis revealed: 1) a positive experience with VR (e.g., enjoyed VR, would like to utilize the VR program again, felt VR was a helpful tool), 2) feeling distracted from pain while engaged in VR, 3) greater perceived mobility, and 4) fewer clinician observed pain behaviors during VR. Movement data supports the targeted impact of the Fruity Feet compared to other available VR programs.
CONCLUSIONS
The iterative development process yielded a highly engaging and feasible PRVR program based on qualitative feedback, questionnaires, and movement data. We discuss next steps for the refinement, implementation, and assessment of impact of VR in chronic pain rehabilitation. Virtual reality holds great promise as a tool to facilitate therapeutic gains in chronic pain rehabilitation in a manner that is highly reinforcing and fun.
Objectives
Using multiple well-validated measures and a large sample size, the goal of this paper was to describe the immediate clinical and behavioral recovery of children following tonsillectomy with or without an adenoidectomy (T&A) during the first two weeks following surgery.
Study Design
Observational, longitudinal study.
Setting
Four major pediatric hospitals in the U.S. consisting of Children’s Hospital of Orange County, Children’s Hospital of Los Angeles, Lucile Packard Children’s Hospital, and Children’s Hospital Colorado.
Subjects
and Methods: Participants included 827 patients between 2 and 15 years of age who underwent tonsillectomy with or without adenoidectomy surgery. Baseline and demographic information were gathered prior to surgery, and measures of clinical, behavioral, and physical recovery were recorded immediately following and up through two weeks after surgery.
Results
Pain following T&A was clinically significant through the first post-operative week and nearly resolved by the end of the second week. Negative behavioral changes were highly prevalent after surgery (75.6% of children at Day 0) through the first week (63.9% at Week 1), and over 20% of children continued to evidence new onset negative behavioral changes at two weeks post-operatively. Children were rated as experiencing significant functional impairment in the immediate three days following surgery and most children returned to baseline functioning by the end of the second week.
Conclusions
Results of this study suggest that children show immediate impairment in functioning and experience clinically significant pain throughout the first week following T&A, and new onset maladaptive behavioral changes persisting even up to the two-week assessment period.
Background:
This aim of this study is to assess the effectiveness and safety of acupuncture for the treatment of patients with postoperative pain (PPP).
Methods:
We will carry out a systematic review of the published literature and will comprehensively search Cochrane Library, MEDLINE, EMBASE, CINAHL, PsycINFO, Allied and Complementary Medicine Database, Chinese Biomedical Literature Database, and China National Knowledge Infrastructure from inception to the present with no language restrictions. Randomized controlled trials comparing acupuncture with other interventions or sham acupuncture will be included. Two reviewers will independently conduct study selection, data collection, and study quality. A third reviewer will resolve any discrepancies. We will apply RevMan 5.3 software for statistical analysis.
Results:
The protocol of this study will systematically assess the effectiveness and safety of acupuncture for patients with PPP. The primary outcome is postoperative pain intensity. The secondary outcomes comprise of: analgesic consumption, postoperative recovery parameters, vital signs, quality of life, and treatment related adverse events.
Conclusion:
This study will summarize the current evidence base for the effectiveness and safety of acupuncture for patients with PPP.
Objective:
The purpose of this study is to compare postoperative pain scores between children undergoing tonsillectomy and adenoidectomy (T&A) surgery and their parents, identify potential predictors for this disagreement, and determine possible impact on analgesic administration.
Methods:
This is a prospective longitudinal study conducted with children undergoing outpatient T&A in 4 major tertiary hospitals and their parents. Children and their parents were enrolled prior to surgery and completed baseline psychological instruments assessing parental anxiety (STAI), parental coping style (MBSS), child temperament (EAS) and parental medication administration attitude questionnaire (MAQ). Postoperatively, parents and children completed at-home pain severity ratings (Faces Pain Scale-Revised, children; Numeric Rating Scale, parents) on postoperative recovery days 1, 2, and 3, reflecting an overall pain level for the past 24 h. Parents also completed a log of analgesic administration. Based on postoperative pain scores, parent-child dyads were classified as overestimators (i.e., parents rated their child's pain higher than children rated their own pain), in agreement (i.e., rating in agreement), or underestimators (i.e., parents rated their child's pain lower than children rated their own pain).
Results:
A significant proportion of parent-child pairs disagreed on pain ratings on postoperative days 1-3 (30.05%-35.95%). Of those pairs in disagreement, the majority of parents overestimated their child's pain on all three postoperative days, specifically such that a total of 24-26% parents overestimated their child's pain on postoperative days 1, 2, and 3. Repeated measures ANOVA demonstrated that parents in the overestimator group administered higher, though still within safe limits, amounts of ibuprofen and oxycodone (mg/day) than did the underestimator or agreement groups. Multiple regression models showed hospital site as the only independent predictor for postoperative pain rating disagreement between children and parents.
Conclusions:
Since parents overestimate their child's postoperative pain and may administer more analgesics to their child, it is essential to develop a standardized method of child pain assessment and a tailored recommended postoperative analgesic regimen amongst medical providers for children undergoing T&A.
Opioid therapy is the cornerstone of treatment for acute procedural and postoperative pain and is regularly prescribed for severe and debilitating chronic pain conditions. Although beneficial for many patients, opioid therapy may have side effects, limited efficacy, and potential negative outcomes. Multidisciplinary pain management treatments incorporating pharmacological and integrative non-pharmacological therapies have been shown to be effective in acute and chronic pain management for pediatric populations. A multidisciplinary approach can also benefit psychological functioning and quality of life, and may have the potential to reduce reliance on opioids. The aims of this paper are to: (1) provide a brief overview of a multidisciplinary pain management approach for pediatric patients with acute and chronic pain, (2) highlight the mechanisms of action and evidence base of commonly utilized integrative non-pharmacological therapies in pediatric multidisciplinary pain management, and (3) explore the opioid sparing effects of multidisciplinary treatment for pediatric pain.
... Several delirium assessment tools exist, such as the Pediatric Anesthesia Emergence Delirium Scale (PAED) [11], pediatric and pre-school Confusion Assessment Method for the ICU (p/psCAM-ICU) [12,13], and the Sophia Observation Withdrawal Symptoms-Pediatric Delirium (SOS-PD) [14,15]. The most commonly used delirium assessment tool is the Cornell Assessment of Pediatric Delirium (CAPD) [3,16], recommended by the European Society of Pediatric and Neonatal Intensive Care (ESPNIC) and the Society of Critical Care Medicine (SCCM) for daily use in PICUs [17,18]. The CAPD includes eight questions assessing various aspects of behavior, with a cutoff score ≥ 9 indicating delirium presence. ...
... For instance, a pilot feasibility study focusing on youth (mean age of 13.24 years) aimed at enhancing lower extremity movement reported high immersion in the virtual world (mean = 28.98, standard deviation = 4.02) which led to significant improvements in pain (p < 0.001), fear (p = 0.003), avoidance (p = 0.004), and functional limitations (p = 0.01), alongside other benefits for distraction, mobility, and reducing observed pain behaviors (Table 1) [32]. ...
... Previous studies of pain at home following tonsil surgery report that pharmacological pain management may be needed for up to three weeks postoperatively after TE and more than one week after TT [4,5,48,49]. To meet the patient's individual needs, instructions from professionals regarding pain treatment should be flexible in terms of treatment length. ...
... As a result, more and more doctors and patients seek nonpharmaceutical treatment to relieve the pain. A large number of studies have shown that electroacupuncture (EA) can significantly relieve postsurgical pain, with fewer side effects [5][6][7][8][9][10][11], but its mechanism is still unclear. ...
... Unfortunately, myths regarding pain persist, where studies suggest that patients and families believe myths and hold misconceptions about pain and pain interventions (medicine and nonmedicine), exacerbating the undertreatment of hospitalized children's pain. 8,27,32 Misconceptions and mismanagement of pediatric pain have provided the impetus for consumer-targeted educational interventions to support pain understanding and the use of safe and effective multimodal treatments. 7,22,38 Participants in this study suggested the portal could provide convenient access to trusted, evidencebased resources about pain, most notably medication information. ...
... Thus, at this point, a robust treatment plan incorporates multimodal analgesia, with the diminishing use of opioids in CPSP management due to their ineffectiveness for long-term pain relief and the escalating misuse observed among adolescents later in life. 105 In addition to higher-quality studies evaluating pharmacologic agents, the effectiveness of regional nerve blocks to treat CPSP should be further investigated in pediatrics, as they are increasingly utilized in practice for CPSP for pain that is localized to a targetable nerve or fascial plane. The use of interventional procedures was associated with return to normal function, reduction in pain intensity, and reduction in pain medications in almost three-quarters of patients included in a multidisciplinary pain treatment program. ...
... Dentro del enfoque terapéutico para el manejo de dolor, se ha descrito la neurólisis del plano del músculo erector de la espina como una alternativa para el dolor oncológico pediátrico tipo osteosarcoma (3,4) . En algunos casos, la neurólisis ha sido realizada posterior al manejo sin éxito con analgesia endovenosa con parace- tamol y buprenorfina, coadyuvada con ketamina, lidocaína y dexametasona, con estabilización del dolor basal, pero con requerimientos de rescates recurrentes con opioides por episodios de dolor irruptivo (3) . ...
... This study delves into the efficacy of stretching exercises and myofascial pain release therapy-techniques focusing on the myofascial tissues that wrap and support muscles. Utilizing the International Restless Legs Syndrome Study Group's (IRLSSG) scale for symptom severity and the Numeric Rating Pain scale for pain intensity, the research aims to provide a comparative analysis of these interventions' effectiveness in alleviating the discomforts associated with antenatal RLS (2). ...
... Through individualized strategies, the most appropriate treatment plan can be tailored for each patient, thereby improving the success rate of weaning and reducing the risk of complications [55] . ...
... It is known that an effective reduction in preoperative anxiety can improve the child's cooperation with the care team (3) , promote a better postoperative response (5) , increase parental satisfaction with the procedure and improve the quality of care (6) . In children, strategies such as the administration of anxiolytic medication, the use of videos, hospital clowns, music therapy and allowing the presence of their parents/ caregivers during anesthetic induction are some of the interventions that aim to reduce anxiety and, thus, promote a more cooperative child during anesthetic induction (7)(8)(9) . ...