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Pain Management R8185_1 Pain Man_Cov01.qxd 11/1/07 17:34 Page 2 VOLUME 1 NUMBER 1 2007 Advances in PAIN MANAGEMENT EDITOR-IN-CHIEF Russell Portenoy, New York, NY, USA Breakthrough Pain in Cancer Patients Giovambattista Zeppetella Mechanisms of Neuropathic Pain Nanna Finnerup and Troels Jensen Pamidronates for Non-Cancer Pain Marco Pappagallo www.advancesinpainmanagement.com This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the University of Kentucky College of Medicine and Remedica. The University of Kentucky College of Medicine is accredited by the ACCME to provide continuing medical education for physicians. The University of Kentucky is an equal This journal is supported by an opportunity university. educational grant from Cephalon R8185_1 Pain Man_Cov01.qxd 11/1/07 17:34 Page 4 ADVANCES IN PAIN MANAGEMENT Advances in Pain Management is supported by an educational grant from Cephalon Reader Survey – Let Us Know What You Think! Please take a few moments to complete this survey. We would value your opinion. EDITOR-IN-CHIEF ASSOCIATE EDITOR Please photocopy this page, complete the survey below, and fax it back to Remedica on Russell K Portenoy Ricardo A Cruciani +44 (0)20 7759 2951. Or you can visit ADVANCES IN PAIN MANAGEMENT website and complete Chairman and Gerald J and Dorothy R Friedman Chair Vice-Chairman and Director, Research Division, the survey online (registration online is FREE): in Pain Medicine and Palliative Care, Department of Department of Pain Medicine and Palliative Care, Pain Medicine and Palliative Care, Beth Israel Medical Beth Israel Medical Center, New York, NY, USA www.advancesinpainmanagement.com Center, Professor of Neurology and Anesthesiology Albert Einstein College of Medicine, Chief Medical 1. We are aiming to provide practical information for Pain specialists, including anesthesiologists, neurologists, oncologists, Officer Continuum Hospice Care, New York, NY, USA general physicians, and primary care physicians. How would you rate the information presented in this issue? EDITORS Strongly agree Strongly disagree Lara Dhingra Helena Knotkova a) The technical quality of information included in Research Psychologist, Department of Pain Medicine Research Scientist, Research Division, Department ADVANCES IN PAIN MANAGEMENT was acceptable: 12345 and Palliative Care, Beth Israel Medical Center, of Pain Medicine and Palliative Care, Beth Israel New York, NY, USA Medical Center, New York, NY, USA b) The information was relevant to my practice: 12345 c) The information was presented clearly: 12345 EDITORIAL ADVISORY BOARD d) The leading articles provided new information regarding Miroslav Backonja Howard Heit the understanding and treatment of pain management: 12345 Professor of Neurology, Anesthesiology and Chronic Pain Specialist, Assistant Clinical Professor, Orthopedics & RehabilitationDirector of Research Georgetown University, Washington, DC, USA e) The clinical review section was helpful and and Education of the UW-Pain Treatment and I would like to see analyses in future issues: 12345 Frank Keefe Research Center, Medical School, the University of Professor of Psychiatry and Behavioral Sciences, 2. Did you learn anything through the CME activity Wisconsin, Madison, WI, USA ■ ■ Duke University, Durham, NC, USA ADVANCES IN PAIN MANAGEMENT that will change the way you practice medicine? Yes No Peggy Compton Jianren Mao If so, what? ........................................................................................................................................................................................ Associate Professor, School of Nursing, Acute Care Associate Professor, Director, MGH Center for Section, University of California Los Angeles, Translational Pain Research, Division of Pain 3. Is there anything you learned from the CME activity ADVANCES IN PAIN MANAGEMENT Los Angeles, CA, USA Medicine, Department of Anesthesia and Critical that prompts you to seek further information that may influence the way you practice medicine in the future? ■ Yes ■ No Robert Dworkin Care, Massachusetts General Hospital, Professor of Anesthesiology, Neurology, Oncology, Harvard Medical School, Boston, MA, USA If so, what? ........................................................................................................................................................................................ and Psychiatry, Director, Anesthesiology Clinical Judith A Paice Research Center, University of Rochester School 4. Would you like to recommend ADVANCES IN PAIN MANAGEMENT to a colleague? ■ Yes ■ No Director, Cancer Pain Program, Division of of Medicine and Dentistry, Rochester, NY, USA Hematology-Oncology, Northwestern University; My colleague’s email is: ...................................................................................................................................................................... Doug Gourlay Feinberg School of Medicine, Chicago, IL, USA Medical Consultant, Pain and Chemical Dependency 5. What specific topics do you think should be covered in future issues? Steven D Passik Division, The Wasser Pain Management Centre, Associate Attending Psychologist, Memorial Sloan Mount Sinai Hospital, The Centre for Addiction ........................................................................................................................................................................................................... Kettering Cancer Center, Associate Professor of and Mental Health, Toronto, ONT, Canada Psychiatry, Weill College of Cornell Medical Center, Name ...... ............................................................................ Job title .......................................................................................... Martin Grabois New York, NY, USA Professor and Chairman, Physical Medicine and Neal Slatkin Institution .......................................................................................................................................................................................... Rehabilitation, Professor, Anesthesiology, Baylor Director, Department of Supportive Care, Pain and College of Medicine, Professor, Physical Medicine Address ... .......................................................................................................................................................................................... Palliative Medicine, Professor, Division of Medicine, and Rehabilitation, University of Texas Health Departments of Supportive Care, Pain and Palliative Country .. .............................................................................. Post/zip code ................................................................................. Science Center-Houston, Houston, TX, USA Medicine and Neurology, City of Hope National Medical Center, Duarte, CA, USA Email ....... .......................................................................................................................................................................................... R8185_1 Pain_1_04 17/1/07 10:08 Page 1 Dear Colleagues, Welcome to the first issue of Advances in Pain Management. Contents Advances in Pain Management, a new CME accredited Editorial journal, has been founded to identify and highlight the Pain Management in Transition important developments in the assessment and treatment of Russell Portenoy and Ricardo A Cruciani 2 pain. The journal will appear quarterly and will provide access to a critical and clinically relevant review of information regarding pain management, providing up-to-date and clinically important information as it pertains to the appropriate Leading Articles diagnosis, treatment, and management of chronic pain. Breakthrough Pain in Cancer Patients Giovambattista Zeppetella 5 Each issue will include major review articles authored by leading specialists. These manuscripts are peer-reviewed for Mechanisms of Neuropathic Pain quality and CME accredited to provide an ongoing Nanna B Finnerup and Troels S Jensen 12 educational resource. In addition, summaries and analyses of recent papers, chosen for their impact upon the field, are provided for the reader together with highlights from recent Bisphosphonate Therapy for Non-Cancer Pain international conferences. Marco Pappagallo 19 Drs Portenoy and Cruciani (Beth Israel Medical Center, New York, NY, USA) lead us into this first issue with an editorial Clinical Reviews highlighting the challenges facing pain physicians in terms of Novel Therapies 24 the immensity of the problem and the many difficulties in the research and treatment of this condition. Opioids 26 This first issue contains three articles. Dr Zeppetella (St Clare Hospice, Hastingwood, Essex, UK) discusses breakthrough Post-operative Pain 29 pain (BTP) in cancer patients, emphasizing the importance of distinguishing BTP from background pain, and implementing Palliative Care 30 a specific strategy for its management. Involving a number of pharmacological and non-pharmacological treatment modalities, along with thorough patient assessment Neuropathic Pain 31 and reassurance of the individual and carer, can help ease this burden. Miscellaneous 34 In the second article, Drs Finnerup and Jensen (Aarhus University, Aarhus, Denmark) provide an overview of neuropathic pain, discussing its clinical characteristics and the mechanisms involved. After summarising
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