Tag: eusja

  • Forum in Valencia

    By Agnes Kittel

    This year Valencia (Spain)  was the host city of the present conference of a biennial series organized by the European Pain Association (EFIC).  The conference was held in the FIRA Center between  September 4-7, 2019 and visited by 3500 participants .

    This series of conferences is a special one. The audience could listen to not only the results presented by researchers, but also to the experiences of clinicians. This year as a new initiative,  a group of invited patients also could enjoy the lectures presented by renowned plenary speakers.

    Some form of pain, this very complex sensation is familiar to all people.  However, while we have a theory for the development of acute or short-term pain, and in most cases we can alleviate it, the situation is different in the case of  chronic pain. Chronic pain lasts for more than six weeks, often for the whole life of the patient, and affects one fifth of humanity!

    Even if we can discover the cause of chronic pain, its alleviation  is one of the greatest challenges in medicine. Due to the aging societies the number of patients in need is increasing however, it is not the only thing to make the task more difficult.

    Pain experience is fundamentally influenced by the patient’s past experience and current emotional state, so the treatment should be personalized and has to select a painkiller for long-term use without serious side effects. It is a huge task. Unfortunately, the opium derivatives, which have been used for thousands of years by mankind and have been used in medical practice for so many years for pain management, are not only effective pain relievers but also cause addiction. Nowadays, especially in the case of the United States, we can read a lot about the opioid crisis. We know about cases  where the death can be attributed to the dependence or overdose of synthetic opiates prescribed by doctors. At this conference we also learnt about the side effects of these medications which can make the everyday life a misery. It was heartbreaking to read the patients’ statements that they would have never started taking these type of painkillers, or rather reduced the dose and endured the pain, just to get rid of the side effects. / Perhaps the most troublesome side effect of opiates, is chronic constipation.

    And what else could we learn? Actually, a lot.

    Let’s see only two examples!

    “Neuromodulation – Where Are We Going To?” It was the title of a lecture presented by Belgian neurosurgeon Dirk De Ridder, which introduced the initial steps of (brain-nerve) stimulation therapies and led us to an amazing future.

    Dirk de Ridder, who is professor of neurosurgery at the Neurological Foundation at the University of Otago in Dunedin, New Zealand, shares his time between New Zeeland and Belgium, where he is working on setting up a neuromodulation clinic and collect patients for his research. He investigates a variety of diseases and disorders such as phantom perceptions – e.g. understanding and treating common mechanisms of phantom pain, tinnitus – Parkinson’s disease, depression, slow-wave epilepsy, addiction, obsessive-compulsive disorder, different personality disorders – and tries to find their common root.

    As treatment he  uses non-invasive neuromodulation (for experts in the field: TMS, tDCS, tACS, tRNA, tPNA, neurofeedback) and invasive neuromodulation techniques such as brain implants.

    According to Professor Dirk De Ridder, combining brain stimulation and artificial intelligence (AI) can open up new avenues for treating not only pain but also many other illnesses. By means of a variety of software, treatments can be truly patient-specific, perfectly adapting to the given condition.

    “Initially, we sent a single pulse to the brain during neurostimulation. The new device we are developing already sends pulse sequences that the brain has to “respond to.” So today we can treat conditions like phantom sounds (tinnitus) or phantom pain, depression, OCD, Parkinson’s and various addictions. It is still quite primitive, but our goal is to follow the way in which the human brain communicates with itself. The different brain circuits,  just like radio,  use different frequencies. Today,  we are already able to create this by non-invasive techniques.

    As a further step, we want to incorporate AI, which is constantly being used on our smart phones, into the nervous system stimulators. In fact, the neurostimulation hardware is already in place, but the software is not yet available. And artificial intelligence can be this software. If this is accomplished in 10 to 20 years, AI software itself will act as a “small brain” that first recognizes abnormal patterns in the brain – e.g. when a person experiences a certain amount of pain or stress – AI automatically adjusts the stimulation at the right time and under the right conditions to modulate brain signals to relieve discomfort while also triggering a deep learning process. ”

    Professor Ridder added, that while pharmaceutical companies are not interested in the method, many organizations have already invested huge sums of money in research of neurostimulation, including opportunities such as electronic interfaces between the human brain and the Internet. It was almost a terrifying experience to hear that “we are already able to read the memories of some animals and to pass on those memories to other animals. The next big thing is when such a connection can be made over the Internet. E.g. a  husband or wife would be able to send good-night kiss to the other from thousands of miles away so that the other can feel it.The realization of this is not so far off. ”

    The audience was wondering how much we wanted this “brave new world” . . .

    Professor Lorimer Moseley’s presentation focused more on the tasks to be accomplished today. The purpose of his presentation was to convince everyone, that if someone has been succeeded in understanding how pain actually works, this one  can achieve fantastic pain relief.

    About two-thirds of the 3,500 conference attendees listened to the presentation, which certainly changed their views on chronic pain. According to Professor Moseley, this change would also be needed by many clinicians because, even if they know how dynamically our pain sensitivity can change, and, that long-term pain can increase its sensitivity is a well-known fact for them, many clinicians are sceptical  that the patients can be taught to take control of their lives. Many of physicians cannot belive that their patients would cope with difficulties  and they would not be trapped by catastrophic thinking.

    “All patients need to be aware that pain is not bad in itself, that it has a protective function, and that your body, your entire sensory system, is not working against you but for you … if people learn how pain works and how the body and brain do, then you can achieve great results in reducing pain, ”said the professor.

    With his books and lectures, he does his best to make this opportunity to be known to all sufferers. He suggested that health care professionals should be provided with modern pain science education so that patients can have the knowledge that can effectively improve their quality of life.

    Hopefully  this conference, where also decision-makers were invited, was the best place for his proposal to be not only listened but accepted, too.

    Agnes Kittel thanks for the support of EFIC and EUSJA and for the great work of  Dennis Landsbert-Noon to help science journalists.

    Photos: credit Agnes Kittel.

    Agnes Kittel is science journalist and researcher based in Budapest.

     

     

     

  • European Health Forum Gastein 2019

    By Agnes Kittel

    Austria has many places famous about their natural beauty and it is for sure that Bad Hofgastein is among the best ones. The mountains with or without snow on their top, surround the little town, which new and older but evenly nicely decorated houses, villas and hotels, everything reveals richness and peacefulness and altogether it looks ideal place for an international conference.

    For me it was the second time to attend an EHFG meeting.

    When I say, this second one was much better, it does not mean, I was not satisfied with the quality of the first one. It was also very good, very well organized, too, however, this year it was special.

    The title of the  22nd edition of the European Health Forum Gastein  was “A healthy dose of disruption? Transformative change for health and societal well-being” .

    Reading this title, I was a bit confused at first. There are too many valuable things disruptured today, however, later I had to accept, that if something wrong, instead of mending, the best thing we can do is to disrupt/distroy it and build something new.

    But what to disrupt and how to build a new system?

    Naturally, a conference, even if it is an excellent one, organized and  lead by outstanding people, it cannot answer and solve every problem. However,  finding the root of the problems, grabbing the good questions, to give guiding and  support – it can be a good start for a common, coordinated work.

    By now  it has became clear that the whole world has to cope with unavoidable and undeniable challenges, the  climate changes, and  the time we have is getting less. The health system is one of the main factors of CO2 emission and we have to act immediately.

    Besides excellent lecturers given  by  main executives  of national and international organizations /e.g.WHO / we could listened to   representatives of NGOs  – e.g. about the treatments and care of HIV patiens, health care for immigrants, unemployments, sexworkers –  but we could hear the opinion of patients about questions under heated debates /e.g. use of medical marihuna, care of obesity/

    We have to rethink a lot among our previous solutions and the effective solution demands that we have to work together.

    Fortunately, the excecutives of the world leading and , and especially the representatives of the NGOs spoke about not only plans but facts and tried hard to answer questions and not  to repeat only something said before.

    Finally I have  to mention the exeptional possibility of science journalists to meet the European Commissioner for Health and Food Safety Vytenis Andriukaitis.  His passion for this work and his example will last much longer than his term as Commissioner which lasts only till November.

    I  thank you the EHFG, EUSJA and Viola Egikova for the support to participate, and a big thank for the help obtained from the members of EHFG Press Office.

    Photos: credit Agnes Kittel.

    Agnes Kittel is science journalist and researcher based in Budapest.

  • The importance to combat climate change and environmental pollution to protect human health in Europe

    By Bartolomeo Buscema

    Healthcare in Europe is provided through a wide range of different systems run at individual national levels. There is a need to harmonize all national systems in order to achieve best practices together with economical results. In this scenery, about six hundred  of  European health policy experts , member of civil society, academia and business  from across Europe met at the annual 2019 European Health Forum Gastein (2-4 October 2019, Austria) explored disruptive proposals  to enhance  health  level  based mainly on artificial intelligence,  economy  strategies  concerning well-being  and to combat  climate change  to limit its effect on  citizens.

    Many topics  have been deal with, among them: data for safer care ( digital solutions and surveillance systems for patient safety),toward economy of well-being, vaccine ecosystem health check, obesity  and cancer  guidelines in Europe. Besides, ministers and high-level representatives from EU Member States, experts of  the European Commission joined the discussions  outlining  their  near term  visions  for the future of health. Other topics were the power of digital technologies, developing effective vaccines campaigns to decrease vaccine hesitancy and harmful effects of climate change on health. In this article , we  focus on the latter  topic  underlining  the undeniable effect on people’s health, which is rapidly becoming a public health emergency.

    As the fifth-highest emitter of pollution, the healthcare sector is responsible for 4.7% of carbon emissions, which underscores the need for significant measures to achieve zero carbon emissions in Europe. Hospitals, healthcare professionals, industry, and patients must all take radical steps to reduce their carbon footprint. Moreover, the effects of climate change on public health are significant and far-reaching, with increased risks of infectious diseases, allergies, and heat-related illnesses, particularly affecting older and poorer people. Such effects also have consequences on the labor market, as annual working hours decrease. In this regard, it is worth noting that Douglaston urgent care and other healthcare facilities in Europe are better equipped to manage the impacts of climate change, especially among vulnerable populations. However, the same cannot be said for other regions such as Africa, where the effects of climate change are more severe and disproportionately affect poorer people. To address this, the European Union must take on a more active role and assume responsibility for helping people in other parts of the world by promoting and implementing best practices and adaptation measures to mitigate the disruptive effects of the rapid increase in global temperatures.

    In recent years our understanding of climate-health relationships has increased rapidly and  consequently our understanding of how the disruption of biophysical and ecological systems due to climate change might affect the longer-term wellbeing and health of populations. It is worthwhile to underline that Climate change can affect human health directly (e.g., impacts of thermal stress, death/injury in floods and storms) and indirectly through changes in the ranges of disease vectors (e.g., mosquitoes), water-borne pathogens, water quality, air quality, and food availability and quality. For this scope, it is crucial to cut  greenhouse emissions sufficiently to keep temperature increase below 1,5°C above pre-industrial level   going toward  to decarbonising the economy as a result of reduced air pollution. Solutions ,of course,  must be implemented taking into account  present knowledge and in this respect the scientific community  should be played an important role in  countering misinformation on the health effects of climate change and in wide spreading  the best solutions adaptation and mitigation strategies. This should be done, in close collaboration with decision makers and politicians. Starting from the Paris Climate Agreement, which also is the most important public health agreement of this century, we need to decrease emissions from fossil fuel combustion and consequently reduce air pollution, which causes 600.000 deaths in European region every year. During the forum it has been stated that if member States would honor the commitments of the Paris Climate Agreement, we would prevent 180.000 yearly deaths in the region.

    Photos: credit Bartolomeo Buscema

     Bartolomeo Buscema is science journalist and science writer, UGIS, Italy

  • Pain, just a symptom or a disease on its right?

    By Merce Piqueras

    When I told a friend of mine, who is a nurse, that I was to attend a meeting on pain, she asked me: “Is it an anaesthesiology meeting?” My friend, like other professionals of health, assumes that pain is the province of anaesthesiologists, the specialists whose main task is to prevent pain during and after surgery. However, pain medicine is much more than anaesthesiology; it is a multi-disciplinary, complex branch of medicine. The meeting I attended through EUSJA was the 11th Congress of the European Pain Federation EFIC, which was held in Valencia, Spain on September 4-7 this year, which gathered around 3,500 healthcare professionals from different fields of pain medicine. Pain has been usually considered only a symptom. However, in many pathological conditions in which pain starts as a symptom, it turns into a disease on its right, with its own biology and own biological consequences.

    Pain is a subjective experience that cannot be quantified like temperature and blood pressure. Research has shown that around half of our pain sensitivity is determined by our genetics. At the Allan Edwards Centre for Research on Pain in Montreal, Canada, Luda Diatchenko is investigating the cellular and molecular events that lead to chronic pain. In a recent talk in Valencia, Diatchenko explained how the results of genetic studies are being used to create new drugs for pain management, including personalized pain diagnoses and treatments. Additionally, with a growing body of research supporting its use, many people with chronic pain are turning to marijuana for chronic pain relief as a means of improving their quality of life. To explore more cannabis products for medical and leisure purposes, you may visit the online shop of indacloud.

    The fact that pain is invisible, an emotion, makes it difficult for the physicians to assess the severity of the patient’s condition and the effectivity of treatments. By now, providing evidence of chronic pain at the best walk-in clinic for insurance and legal purposes has been very difficult, if not impossible. Nevertheless, this could change in the near future. At the EFIC Congress, Rolf-Detlef Trede, from the Centre for Biomedicine and Medical Technology of Manheim, Germany, presented a project he leads that aims to identify biomarkers such as proteins and hormones with the capability of objectively measuring pain. These are just two of the many topics discussed at the EFIC Congress.

    The International Association of the Study of Pain (IASP) declared 2019 “Global Year Against Pain in the Most Vulnerable” with the aim to improve the assessment and treatment of pain in the most vulnerable populations: infants and young children, the elderly (including old people suffering dementia), individuals with cognitive impairments (non-dementia related) or psychiatric disorders, and survivors of torture. If you have an elderly relative in an assisted living facility because of dementia, you need to make sure that they are properly taken care of. There are reports of residents being verbally and physically abused. If you suspect that your loved one is being abused in their nursing home, you may need to contact a Milwaukee nursing home abuse lawyer.

    The EFIC Congress took into account the 2019 celebration and various sessions focused on topics related to the most vulnerable populations. Miriam Kunz, co-chair of the 2019 Global Year Against Pain in the Most Vulnerable, has used her advanced understanding of patient’s facial expressions and other non-verbal cues to attract attention towards the usually inadequate treatments of pain in vulnerable patients Communication of pain by patients from these groups tends to be difficult and the health professionals must interpret body language and other non-verbal communication of patients.

    The Societal Impact of Pain (SIP) platform, which was created as a joint initiative of the European Pain Federation EFIC and the pharmaceutical company Grünenthal GmbH, was also present at the Congress. Currently, SIP comprises eight SIP national platforms (Belgium, Finland, France, Ireland, Malta, Netherlands, Portugal Spain), whose representatives presented their experiences and achievements at different sessions.

    In an informal talk with science journalists, Bart Morlion, EFIC past President, highlighted that, in the 2017 Congress, the foundations for a new EFIC direction were laid. They do not want ‘dinosaurs’ leading the organization, and young people can bring fresh ideas such as the increasing use of digital tools. This is why the motto of the 2019 Congress was “Bringing the Future to the Present”. Another change in EFIC, whose core work focuses on education, research and advocacy, is that the Federation has, for the first time, a female President: Brona Fullen, who is also the first non-physician President—she is Associate Professor in the School of Public Health, Physiotherapy and Sports Science of University College Dublin. Morlion described some novelties in the Congress including the active participation of patients and the introduction of new formats of workshops to give room to young talented researchers. Out of modesty, Morlion did not mention what was to be the highlight of the last day of the Congress: the innovative session on antinociceptive cooking led by Morlion himself, assisted by Víctor Mayoral, Secretary of the Spanish Pain Society (and by Miguel, a professional cook, just in case…).

    Brona Fullen evoked David Niv (1950-2007), a former EFIC President (1999-2002) whose patients used to call him the “pain doctor”, and remembered a phrase he had liked: “Few die of pain, but many die of pain, even more live in pain”. In fact, in Europe, more than 150 million people suffer from chronic pain—persistent, episodic o variable—an amount higher than French and German populations together. The clinical and socio-economic impact of chronic pain, which often leads to distress and disability, is of great relevance and it costs the European Union more than 441 billion euros per year. However, in the current EU 8th Framework Programme (FP8/Horizon 2020), pain has been mentioned in one call for proposal on Novel patient-centred approaches for survivorship, palliation and/or end-of-life care, with a funding which does not reach 1% of health research funding in the Horizon 2020. SIP and other organizations involved in the management of pain, have requested to the European Commission, to its member states and to the Civil society that they unite to reduce the impact of pain in the European Union. The Congresses of the  European Pain Federation EFIC provide the right framework for stakeholders to gather and discuss all issues related to pain.

    Photo: Merce Piqueras

    Merce Piqueras is science journalist based in Bacelona. Freelance collaborator of ARA (Catalan newspaper, print and online) and various digital media in Catalan, Spanish and English. Science writer and science journalist mostly on biology and health topics. Author of “Walks around the Scientific World of Barcelona” (Catalan, Spanish and English eds.). Former President of ACCC.

  • EFIC 2019 : networking for fighting pain

    By Cinzia Bolschiero,

    science journalist (UGIS, Italy)

     Ten EUSJA journalists attended  recently one of the biggest European congresses. And here is the first blog that has been sent by our members to EUSJA web page.

                 The Congress, EFIC 2019 held between 4 – 7 September in Valencia, Spain, is the largest scientific congress on pain in 2019, bringing together the most recognised experts in the field of pain medicine to exchange knowledge, ideas and the latest advances in the field. Several journalists attended it and ten were from EUSJA, its member associations in Croatina, Hungary, Italy, Finland, Romania, Spain,

    The highlights at the European Congress EFIC 2019 included presentations on the latest advances in neurostimulation; the relation between gender and migraines; how pain is experienced differently between different age-groups; how the evolution of digital health care will impact pain treatment; and whether there is an opioid crisis in Europe, but not only this.  New European research into objective measurement of pain could be a ‘game-changer’ for patients.Until now, a patient’s experience of pain has always been subjective, relying upon their personal feeling and their communication of the experience. However, a research project by the international consortium IMI-Pain Care is aiming to identify biomarkers for pain. Biomarkers, such as proteins or hormones, can enable objective measurement of a particular disease state. Biomarkers for pain would be a complete game-changer, potentially providing us with an objective measurement of pain for the first time, allowing us to compare the severity of conditions and the efficacy of treatments and services. The experts moreover explained also how the multi-modal pain treatment for cancer patients, as well as continuous assessment and understanding the risk factors for opioid misuse, will reduce the potential harm of opioids in cancer care.

    In EFIC 2019 there were over 3500 delegates from 37 States. The European Pain Federation’s biennialCongress in Valencia contributed to give evidence to the importance of networking. Many european projects and trials were presented. The European Pain Federation (EFIC) is a multidisciplinary professional organisation in the field of pain research and medicine. Established in 1993, EFIC constituent chapters represent Pain Societies from 37 European countries and close to 20,000 physicians, basic researchers, nurses, physiotherapists, psychologists and other health care professionals across Europe, who are involved in pain management and pain research. It has been said also how linking brain stimulation to artificial intelligence (AI) can open up a world of new possibilities in the treatment of pain and many other conditions. In the future, 10-20 years ahead, the AI software will act as a ‘small brain’ in itself, so it can first recognise abnormal patterns in the brain (ie identifying that a person is feeling a certain level of pain, or stress – or perhaps is suffering alcohol cravings because they are passing a bar – then the AI will automatically adjust the stimulation design atprecisely the right time and in the right circumstances to modulate the brain signals, alleviate the discomforts and also create deep learning in the brain.

    In EFIC 2019 doctors and researchers also gave some new data about migraines: it affects around 15% of the general population (around 1.2 bn people globally) and the disorder is three times more prevalent in women than in men.

    Photo: copy right Cinzia Bolsciero