Genetic basis for individual variation in pain perception among endodontic patients

Catechol-O-methyltransferase (COMT), Cyclooxygenase (COX) 1 and 2 are enzymes that have been implicated in the modulation of pain. Previous studies have shown that human genetic variants coding for low COMT activity are correlated with increased experimental pain sensitivity and risk of developing chronic pain disorders. The present study extends this work by examining the potential contribution of three enzymes to acute pain perception. Ninety-four patients treated by endodontic residents at University of North Carolina School of Dentistry were enrolled into a prospective cohort study. Nonsurgical root canal therapy was performed. Participants recorded pain levels for five days following treatment and completed psychological questionnaires to quantify anxiety, depression and somatization disorders. Potential predictors of postoperative pain were collected and all patients submitted saliva samples for genetic analysis. In this study, 63% of patients experienced at least mild pain after root canal therapy and 24% experienced mild to severe pain. Patient age, gender, pulpal and periapical diagnosis were not associated with postoperative pain (p>0.05). Presence of pretreatment pain was significantly correlated with higher postoperative pain (p = 0.01). Diastolic blood pressure (p = 0.024), heart rate (p = 0.02) and trait anxiety score (p = 0.036) were also correlated with postoperative pain. While no association was found between postoperative pain and COMT or COX-1 genetic variants, there is evidence of an association between COX-2 haplotype and acute postoperative pain following endodontic treatment (p = 0.025). Understanding the genetic basis of endodontic pain perception will advance our pharmacologic management of postoperative pain

Ohio's Aging Network Efforts to Enhance Nursing Home Diversion and Transition

This brief report provides preliminary results from an evaluation of Ohio's diversion and transition demonstration program

Right Place, Right Time, Right Care: An Evaluation of Ohio's Nursing Home Diversion and Transition Initiative

In 2010 the Ohio General Assembly asked the Ohio Department of Aging to develop and implement a nursing home diversion and transition initiative. This report describes the evaluation of that initiative. Results showed that 3800 Ohioans were diverted or transitioned during the project period and the majority were residing in the community six months later

Right Place, Right Time, Right Care: An Evaluation of Ohio's Nursing Home Diversion and Transition Initiative--Research Brief

In 2010 the Ohio General Assembly asked the Ohio Department of Aging to develop and implement a nursing home diversion and transition initiative. This research brief summarizes the results from an evaluation of that initiative. Results showed that 3800 Ohioans were diverted or transitioned durng the project period and the majority were residing in the community six months later

Genetic Variants in Cyclooxygenase-2 Contribute to Post-treatment Pain among Endodontic Patients

Non-steroidal anti-inflammatory drugs (NSAIDs) have a well-established analgesic efficacy for inflammatory pain. These drugs exert their effect by inhibiting the enzyme cyclooxygenase (COX) and are commonly used for the management of pain following endodontic treatment. There are two distinct isoforms of COX: COX-1, which is constitutively expressed; and COX-2, which is primarily induced by inflammation. Previous studies have shown that functional human genetic variants of the COX-2 gene may explain individual variations in acute pain. The present study extends this work by examining the potential contribution of the two COX isoforms to pain after endodontic treatment