Acute to Chronic painTransition– ACTION program
 
The Acute to Chronic Pain Transition (ACTION) Program was initiated by Dr. Ana M. Velly (D.D.S., M.Sc, Ph.D), Associate Professor, McGill University, from the Department of Dentistry, Jewish General Hospital to elucidate strategies to promote the prevention and the treatment of acute and chronic pain.

More specifically, the aims of this program include:
• Identifying the risk and prognostic factors related to acute and chronic pain;
• Identifying risk factors related to the transition from acute to chronic pain;
• Determining the relationship between chronic pain and comorbid conditions;
• Determining prognostic factors related to unsuccessful pain treatment;
• Evaluating the best strategies for the management of acute and chronic pain;
• Identifying the adverse events related to pharmaceutics used in the management of pain.
• Identifying biomarkers associated with acute and chronic pain.
 
We invite you to complete a survey regarding the transition from acute to chronic Temporomandibular Disorder (or TMD), a type of facial pain. Based on your responses, you may be contacted to participate in the study or for further information. We are interested in understanding what may predict well-being associated with facial pain. The survey will ask you a few questions about your health in relation to your temporomandibular joint (TMJ) disorder. Completing the questionnaire takes an average of 5 minutes. To continue with the survey, please click on the following link: https://www.surveymonkey.com/r/J2ZNLL2
 
 
 
Top row (Dr. Khurram Khan, Dr. Omar Sabsoob, Dr. Gurveen Gill, Dr. Harsimrat Kaur, Shrisha Mohit,
Dr. Marcelo Weber). Bottom row (Dr. SherifElseraj, Dr. Ana Velly, Dr. Mervyn Gornitsky).
 
 
Current projects in the ACTION program:
 
Transition from Acute to Chronic Painful Temporomandibular Disorders (TMD), and the persistence of Chronic painful TMD
 
This study is conducted in Montreal and Ottawa, with funding received from the RSBO-QPRN in 2016. The aims are: (i) to assess factors that contribute to the onset of chronic painful TMD, (ii) to evaluate risk factors implicated in the persistence of painful TMD, and (iii) to identify salivary biomarkers related to painful TMD.

The research team include: Dr. A. M. Velly and Dr. R. Hovey as Principal Investigators (PIs), and co-investigators from the Lady Davis Institute and Jewish General Hospital/McGill University (Dr. M. Gornitsky, and Dr. H. Schipper), McGill University (Dr. Z. Der Khatchadourian, Dr. P.Schweinhardt, and Dr. J. Zhang), and from the University of Minnesota (Dr. J. Fricton and Dr. E. Schiffman).

Students implicated in this study are:Dr. Omar Sabsoob, Dr. SherifElsaraj and Dr. Mohamed Ahmed

Funding Sources: RSBO-QPRN Structuring projects
 
Poster presentation:
Factors Associated with Acute and Chronic Painful Temporomandibular Disorders: Preliminary results

Presenter: Sabsoob O.*, Elsaraj S., Der Khatchadourian Z., Gornitsky M., Velly A.

Awards: 1- The RSBO poster award (First place)
2- The QPRN poster award (First place)

Summary: This poster showed factors that differentiate between acute and chronic TMD pain as well as the clinically and non-clinically significant TMD pain.
 1st Place Award Winner QPRN 2016 – Dr. Omar Sabsoob
Oral presentation:
Factors Associated with Acute and Chronic Painful Temporomandibular Disorders: Preliminary results

Presenter: Elsaraj S.*,Sabsoob O., Der Khatchadourian Z., Gornitsk yM., Velly A.

Summary: The presentation compared baseline factors that associate with acute and chronic TMD pain as well as clinically and non-clinically significant pain.
McGill Research Day 2016 - Dr. Sherif Elsaraj

Painful temporomandibular disorders and comorbidities among adolescents
 
The goal of this project is to estimate the prevalence of painful TMD among adolescents in Montreal; Canada, Nice; France, and Brazil. We also seek to assess other health conditions related to painful TMD among adolescents.

The research team include: Dr. A. M. Velly as PI and co-investigators from the Lady Davis Institute and Jewish General Hospital/McGill University (Dr. M. Gornitsky), University of Sao Paulo, Brazil (Dr. S.Guimares), and from the University of Nice Sophia-Antipolis, France (Dr. Michelle Muller-Bolla).

Students implicated in this study are:Dr. Khurram Khan, Dr. Oscar Anacleto and Dr. Sabbah R.

Funding Sources: RSBO- Fonds de la Recherche en Santé du Québec (FRSQ)
 
Oral presentation:
Painful temporomandibular disorders and comorbidities among adolescents
in Montreal: Preliminary results.

Presenter: Khan K*, Gornitsky M., Velly A.
Awards: 1) NCOHR Conference (3rd place in “elevator pitch” competition)
2) Graduate Excellence Award for VP Academics (MDGSS) (1st Prize)

Summary: The presentation identified the association between painful
TMD and comorbidities among adolescents in Montreal.
 
1st Place Award Winner, McGill Pain Day 2016 ( left to right),
Dr. Khurram Khan and Dr. Marc McKee
 

Assessing the management of TMJD pain patients in the Network - The National Dental Patient-Based Research Network (NDPBRN)

The main aims of this NIH study granted in 2014 are to: (i) assess treatment recommendations for patients with painful TMD in the NDPRN, (ii) identify risk factors implicated on patients’ adherence to treatments, (iii) evaluate factors influencing treatments indication, and (iv) identify contributors for pain intensity and disability within a one-year follow-up.

The research team includes: Dr. E. Schiffman (University of Minnesota) and G. Gilbert (University of Alabama at Birmingham) as PIs, and Dr. Ana M. Velly as the co-investigator from the Lady Davis Institute, and Jewish General Hospital/McGill University.

Funding Sources: Foundation for the National Institutes of Health (FNIH). National Institute of Dental and Craniofacial Research (NIDCR) Funding Mechanism:U19-DE-22516
 
 
Transition from Acute to Chronic Pain after Breast Cancer Surgery
 
We are interested in investigating factors related to patients’ well-being following breast cancer surgery. More specifically, the aim of this study is to evaluate if initial health conditions, psychological factors, cancer characteristics and salivary biomarkers influence the risk of acute and chronic post-surgical pain. Furthermore, we are also assessing the salivary cytokines implicated in the persistence of acute and severe pain after breast cancer surgery.

The research team include: Dr. A. M. Velly as PI, and co-investigators;Dr. M. Basik, Dr. H.Sigman, Dr. D. Hickey, Dr. F.Boileau, Dr. M. Gornitsky, and Dr. H. Schipper, from the Jewish General Hospital/McGill University, andDr. R. Hovey from McGill University.

Funding Sources: Salivary study was granted by Alpha Omega Foundation of Canada (Willowdale, ON) in 2015 and 2016
 
Poster presentation:
1) Risk factors associated with severe acute pain after breast cancer
surgery at McGill pain day 2016 and RSBO scientific day 2016
2) To conduct a systematic review to identify the potential risk factors related to chronic pain after breast cancer surgery (CPBCS) at McGill research day 2016

Presenter:
Gill G.*, Kau rH, Basik M.,Sigman H, Hickey D.,Boilea uF., Gornitsky M., Schipper H., Velly A.
McGill Pain Day 2016 (left to right) Dr. Harsimrat Kaur,
Dr. A. M. Velly, Dr. Gurveen Gill
 
 
Opioids and risk of pneumonia
 
In 2014, we received a Canadian Institutes of Health Research (CIHR) operating grant for the study on the Risk of Community-Acquired Pneumonia (CAP) among opioid users. Our goal is to determine whether opioid analgesics increase the risk of CAP among a large number of adults from two large UK electronic databases; the Clinical Practice Research Datalink and the Hospital Episode Statistics. This study will provide useful clinical information on the type, dosage, and long-term effects of opioids in clinical practices, as related to the risk of CAP.

The research team include: A. M. Velly as PI and co-investigators at the Lady Davis Institute and Jewish General Hospital/McGill University (Dr. R. Steele, and Dr. L. Azoulay), McGill University (Dr. J. Leandry), University of Western Ontario (Dr. D. Moulin and Dr. I. Karp), University of Montreal (Dr F. Moldovan), and from the University of Dundee, UK (Dr. D. Morales). Research assistant (Yejin Han).

Funding Sources: CIHR Operating Grant 2014
 
Opioids and cancer incidence

This study is being carried out with investigators from Jewish General Hospital/McGill University, Montreal Canada, and the University of Iceland to assess the risk of cancer among users of opioids and hypnotics.

The research team include: Drs. A. M. Velly and L. Gudmundsson from the Faculty of Pharmaceutical Sciences at the University of Iceland as PIs. Research assistant (Yejin Han).

Funding source: University of Iceland, Faculty of Pharmaceutical Sciences, School of Health Sciences


Opioids and cancer recurrence

This study is being carried out with investigators from McGill University, assessing the relationship between opioid prescriptions and the recurrence of cancers.

The research team include: Drs. A. M. Velly and T. Schricke ras PIs and co-investigators Dr. A. Moore and Dr. R. Hatzakorzian from McGill University. Research assistant (Yejin Han).
 
Assessing the management of TMJD pain patients in Japan

The goal is to investigate the management of painful TMD in Japan.

The research team include: Dr. Naoki Kakudate as the PI from the University of Tokyo and co-investigators from Jewish General Hospital/McGill University (Dr. A. M. Velly), University of Alabama (Dr. G. Gilbert), University of Florida (Dr. V. Gordan), University of Minnesota (E. Schiffman), and University of Tokyo (Dr. Y. Matsumoto).

Salivary biomarkers
 
The overall goal of this project is to identify salivary biomarkers associated with specific health conditions (e.g. scleroderma, diabetes). The PIs are Drs. M. Gornitsky and H. Schipper. All processed saliva are kept in the Saliva Biobank, co-directed by Dr. M. Gornitsky and Dr. H. Schipper, at the Lady Davis Institute/Jewish General Hospital. As of March 2016, the Biobank holds saliva samples from over 250 pain patients recruited at the JGH (ongoing) and 300 patients from Minnesota, USA, for the ACTION program.

Orofacial pain and temperature
 
The goal is to investigate the association of painful TMD and muscle temperature.

Presenter: Weber M*, Velly A., Arita E.S.

Summary:
This project illustrate the relationship between muscle pain and muscle temperature.
 
Dr. Marcelo Weber & Dr. Sherif Elsaraj RSBO 2016
 

Up-to-date information on all aspects of orofacial pain biomarkers. Discusses biomarkers for various types of orofacial
painIdentifies future directions and new challenges.
 
This book provides up-to-date information on all aspects of orofacial pain biomarkers.
It opens by presenting background information on clinical phenotypes and the
neurobiological substrates underlying chronic orofacial pain and by explaining the
potential role of biomarkers in the diagnosis, prognostic evaluation, and treatment of
orofacial pain. The main section of the book examines the contribution of human and
animal studies to the field of biomarkers for orofacial pain and discusses biomarkers for
masticatory muscle pain, temporomandibular joint pain, neuropathic face pain, and
autonomic nervous system involvement in trigeminal facial pain. The potential impacts
of the immune system on orofacial pain biomarkers and candidate gene phenotypes with
possible links to chronic orofacial pain conditions are also addressed, and differences and
similarities between saliva and serum biomarkers for pain are explained as well. The final
section covers research-related issues in assessment methods and statistical analyses used
in evaluating biomarkers, identifies future challenges and suggests new directions in the
field.
Support research at the Lady Davis Institute - Jewish General Hospital