Chronic pancreatitis is a scarring condition of the pancreas that often results in debilitating pain. When pancreatic duct drainage appears to be impaired by the presence of a blocking stone or scar tissue, pancreatic endotherapy (procedures performed through the mouth using a lighted tube with special instruments to enter the pancreatic duct) is often offered in clinical practice. The rationale for this study is that while pancreatic endotherapy is logical, there are limited studies to suggest it helps patients with their pain. Furthermore, these procedures are costly and have potential risks. This is a preliminary study to perform the first sham (like a placebo) study of pancreatic endotherapy in patients with chronic pancreatitis and evidence of impaired pancreatic duct drainage by radiology scans.
The objectives of this study are to: 1) determine the feasibility of a sham-controlled pancreatic endotherapy trial, and 2) optimize enrollment criteria and outcome measures for a subsequent, definitive study.
Under this study, we would like to collect specimens from CP patients who will undergo pancreatic resection at the VA Hospital for in vitro experiments. In these experiments, we will determine whether immune cells from CP patients are different from cells from healthy donors purchased from ATCC or other commercial sources. We will then assess whether pre-culture of immune cells from CP patients with MSCs can shift them to less pro-inflammatory phenotypes that won't induce inflammation in neuronal cells. All studies will be done in vitro in the cell culture system. Exploring mechanisms that contribute to chronic pain is vital for veterans' health and VA healthcare.
The purpose of this study is to find out whether a web-based intervention using a mobile device is helpful for teens learning to care for and manage symptoms of their sickle cell disease. The intervention lasts 12 weeks with a 3-month follow up period, and uses a smartphone or a tablet. For more information, please contact Shannon at 843-792-9379.
This study seeks to identify the impact of structured communication between Registered nurses (RNs) and Unlicensed Assistive Personnel (UAP) to decrease the fall rate and number of injurious falls on a Medical-Surgical unit. A seven item tool addressing fall risks (pocket card) will be utilized to communicate fall risks on admission, at hand off of care, and every 4 hrs.
Pain control after tonsillectomy is imperative but often difficult. Current post-operative pain medication regimens include opioid analgesics and are often still inadequate. Though not standard of care, it is our practice to prescribe a single dose of oral steroid medication on the third day after surgery, when pain and swelling are at their peak, in order to assist with pain control and reduce opioid consumption. Though this practice has a rational theoretical basis, there is no prospective data supporting or discounting it. We aim to compare pain control, opioid consumption, and complication rates in children receiving post-operative steroids versus those who do not.
The purpose of this study is to gain knowledge from 10-15 minute key informant interviews (pre- and post-transplant recipients) in regards to their experience with pain and pain management. We will interview key informants on their attitudes and perceptions towards using mobile technology to track pain and pain management after surgery and providing educational resources for appropriate pain management.
Sickle cell disease (SCD) is a group of inherited blood disorders associated with recurrent pain, which may evolve into a chronic state over time. Acute and chronic pain approaches in SCD frequently involve the use of opioid medications. The purpose of this study is to understand opioid knowledge and perceptions of the benefits and risks of opioid medication in patients with SCD (all ages) and their caregivers (in the case of pediatric patients).
Chronic pain is a serious public health problem with estimates as high as nearly half of the adult population experiencing some form of pain that lasts for more than 6 months. This issue negatively impacts quality of life, is financially burdensome, and has contributed to the opioid crisis in the United States. Therefore, a non-pharmacologic, non-invasive approach for alleviating chronic pain like prefrontal repetitive transcranial magnetic stimulation (rTMS) is an appealing avenue for research into chronic pain management. While rTMS has already been approved for use in treating depression, it has shown promise in treating chronic pain as well. However, there is a debate about which coil designs are most effective and which regions of the brain respond best to rTMS therapy. This study will examine the use of two novel coil designs the H1 coil which is designed to increase activity of the dorsolateral prefrontal cortex and the H7 coil which is designed to decrease activity of the medial prefrontal cortex. To evaluate the efficacy of the two treatment strategies, patients will undergo thermal pain testing before and after the rTMS interventions. The relative efficacy of these two treatment strategies will be useful for establishing rTMS as an effective strategy for chronic pain management and determining the direction for future rTMS research.
The purpose of this study is to develop transcranial magnetic stimulation (TMS) as a novel, non-pharmacologic approach to decreasing pain in individuals with chronic pain. This study will test whether rTMS over the prefrontal cortex can produce a reduction in your perception of pain, your desire to use opiates, and your brain's response to opiate cues. The results of this study will be used to design and develop a large clinical trial of rTMS as an innovative, new treatment option for chronic lower back pain in individuals that may have used chronic opiates.
The overall goal of this feasibility study is to test an individualized, nurse-led behavioral health program that leverages home telehealth technology to directly teach low and fixed income older adults residing in the community to reduce their pain and fatigue by improving mobility through strength and balance training in the context of a complementary mental health intervention to address motivation and social support. Specifically, the integrated intervention includes components to address (1) balance and fall prevention (Otago), (2) strengthening and mindfulness (Yoga), and importantly, (3) affective state and social support which are crucial to maintaining motivation (Behavioral Activation). Moreover, these 3 best practices interventions will be enhanced by integrating physical activity data tracking to complement self-report measures, the former of which will be available in real time for patient and provider review, with parameter violations (eg, non-activity during scheduled activity time; overall activity level lower for a set period of time) triggering brief telehealth sessions to address any problems. Finally, participant qualitative feedback will be captured through voice/video recorded diaries focusing on experienced pain, fatigue, sleep, personal reactions to the project and physical activity as well as technology issues they may encounter.