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Neuropathic pain management

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https://www.readbyqxmd.com/read/28323403/discovery-of-potent-antiallodynic-agents-for-neuropathic-pain-targeting-p2x3-receptors
#1
Young-Hwan Jung, Yong-Chul Kim, Yeo Ok Kim, Hai Lin, Joong-Heui Cho, Jin-Hee Park, So-Deok Lee, Jinsu Bae, Koon Mook Kang, Yoon Gyoon Kim, Ae Nim Pae, Hyojin Ko, Chul-Seung Park, Myung Ha Yoon
Antagonism of the P2X3 receptor is one of the potential therapeutic strategies for the management of neuropathic pain because P2X3 receptors are predominantly localized on small to medium diameter C- and Aδ-fiber primary afferent neurons, which are related to the pain-sensing system. In this study, 5-hydroxy pyridine derivatives were designed, synthesized, and evaluated for their in vitro biological activities by two-electrode voltage clamp assay at hP2X3 receptors. Among the novel hP2X3 receptor antagonists, intrathecal treatment of compound 29 showed parallel efficacy with pregabalin (calcium channel modulator) and higher efficacy than AF353 (P2X3 receptor antagonist) in the evaluation of its antiallodynic effects in spinal nerve ligation rats...
March 21, 2017: ACS Chemical Neuroscience
https://www.readbyqxmd.com/read/28319508/exercise-combined-with-ultrasound-attenuates-neuropathic-pain-in-rats-associated-with-downregulation-of-il-6-and-tnf-%C3%AE-but-with-upregulation-of-il-10
#2
Po-Ching Huang, Kun-Ling Tsai, Yu-Wen Chen, Heng-Teng Lin, Ching-Hsia Hung
BACKGROUND: Although there are several evidences that suggest efficacies of therapeutic ultrasound (TU) or treadmill exercise (TE) to alleviate nerve injury-associated pain, molecular mechanisms are less clear. We aimed to investigate the impact of TU and/or TE on neuropathic pain induced by chronic constriction injury (CCI) of the sciatic nerve and their roles of proinflammatory and anti-inflammatory cytokines. METHODS: Rats were randomly divided into (n = 10 per group) sham operation (sham), CCI procedure followed by false application of TU (CCI + TU0), CCI procedure followed by false application of TU and TE (CCI + TU0 + TE), CCI, and CCI procedure followed by TU alone (CCI + TU), TE alone (CCI + TE), or both TU and TE (CCI + TU + TE) groups...
March 17, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28314949/tolerance-and-cross-tolerance-to-the-antinociceptive-effects-of-oxycodone-and-the-imidazoline-i2-receptor-agonist-phenyzoline-in-adult-male-rats
#3
David A Thorn, Yanan Zhang, Jun-Xu Li
RATIONALE: Emerging evidence suggests the potential utility of combining opioids with imidazoline I2 receptor agonists for chronic pain. However, chronic pain management requires prolonged pharmacotherapy, and the consequence of such combination therapy remains unclear. OBJECTIVE: This study examined the anti-hyperalgesic effect of the opioid oxycodone, the selective I2 receptor agonist phenyzoline, alone and in combination, during prolonged treatment. METHODS: Von Frey filament test was used to examine the anti-hyperalgesic effect of drugs in complete Freund's adjuvant (CFA)-induced inflammatory pain or chronic constriction injury (CCI)-induced neuropathic pain in rats...
March 17, 2017: Psychopharmacology
https://www.readbyqxmd.com/read/28306581/spinal-cord-stimulation-treatment-for-persistent-pain-after-a-burn-injury-a-case-report
#4
Takeshi Kubota, Yuuhei Ishikawa, Rie Ishikawa
Spinal cord stimulation (SCS) is used to treat neuropathic pain, but there are no published studies on its use to treat burn pain. We used SCS to treat a 67-year-old man suffering from burn pain that could not be managed with high-dose opioids or adjuvant neuropathic analgesics. A trial of SCS markedly reduced the visual analog scale score for pain in the left lateral abdominal and gluteal regions. He underwent permanent implantation of a SCS and achieved an opioid-free state. This case suggests that SCS treatment is a therapeutic option for burn pain refractory to conventional therapy...
March 16, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28294508/transversus-abdominis-plane-block-for-the-diagnosis-and-treatment-of-chronic-abdominal-wall-pain-following-surgery-a-case-series
#5
Marco Baciarello, Greta Migliavacca, Maurizio Marchesini, Adriana Valente, Massimo Allegri, Guido Fanelli
OBJECTIVE: The transversus abdominis plane (TAP) block is a relatively simple regional anesthesia technique which entails the injection of local anesthetics (LA) into the interfascial plane between the internal oblique and transversus abdominis muscles, where nerves supplying the anterolateral abdominal wall course. It is widely used for acute pain management following abdominal surgical procedures. We describe a series of cases in which TAP blocks were used to aid in the diagnosis and treatment of chronic abdominal wall pain (CAWP)...
March 14, 2017: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/28291863/report-of-neuropathic-pain-after-dental-implant-placement-a-case-series
#6
Constantinus Politis, Jimoh Agbaje, Jeroen Van Hevele, Laura Nicolielo, Antoon De Laat, Ivo Lambrichts, Reinhilde Jacobs
PURPOSE: To report on a cohort of patients referred to a tertiary center because of neuropathic pain after dental implant placement. MATERIALS AND METHODS: This retrospective study of pain after dental implant placement involved a minimum follow-up of 12 months after the initial diagnosis of neuropathic pain or persistent, uncontrolled postoperative pain at the Department of Oral and Maxillofacial Surgery, Leuven University, Leuven, Belgium, from January 2013 to June 2014...
March 2017: International Journal of Oral & Maxillofacial Implants
https://www.readbyqxmd.com/read/28280384/tapentadol-extended-release-for-the-management-of-chronic-neck-pain
#7
Domenico Billeci, Flaminia Coluzzi
BACKGROUND: The role of opioids in the management of chronic neck pain is still poorly investigated. No data are available on tapentadol extended release (ER). In this article, we present 54 patients with moderate-to-severe chronic neck pain treated with tapentadol ER. PATIENTS AND METHODS: Patients received tapentadol ER 100 mg/day; dosage was then adjusted according to clinical needs. The following parameters were recorded: pain; Douleur Neuropathique 4 score; Neck Disability Index score; range of motion; pain-associated sleep interference; quality of life (Short Form [36] Health Survey); Patient Global Impression of Change (PGIC); Clinician GIC; opioid-related adverse effects; and need for other analgesics...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28277866/treatment-for-chronic-low-back-pain-the-focus-should-change-to-multimodal-management-that-reflects-the-underlying-pain-mechanisms
#8
Gerhard Müller-Schwefe, Bart Morlion, Karsten Ahlbeck, Eli Alon, Stefano Coaccioli, Flaminia Coluzzi, Frank Huygen, Wolfgang Jaksch, Eija Kalso, Magdalena Kocot-Kępska, Hans-Georg Kress, Ana Cristina Mangas, Cesar Margarit Ferri, Philippe Mavrocordatos, Andrew Nicolaou, Concepción Pérez Hernández, Joseph Pergolizzi, Michael Schaefer, Patrick Sichère
Chronic pain is the most common cause for people to utilize healthcare resources and has a considerable impact upon patients' lives. The most prevalent chronic pain condition is chronic low back pain (CLBP). CLBP may be nociceptive or neuropathic, or may incorporate both components. The presence of a neuropathic component is associated with more intense pain of longer duration, and a higher prevalence of co-morbidities. However, many physicians' knowledge of chronic pain mechanisms is currently limited and there are no universally accepted treatment guidelines, so the condition is not particularly well managed...
February 22, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28271659/effects-of-electroacupuncture-at-2-and-100-hz-on-rat-type-2-diabetic-neuropathic-pain-and-hyperalgesia-related-protein-expression-in-the-dorsal-root-ganglion
#9
Xiao-Fen He, Jun-Jun Wei, Sheng-Yun Shou, Jian-Qiao Fang, Yong-Liang Jiang
OBJECTIVE: To investigate the analgesic effects of electroacupuncture (EA) at 2 and 100 Hz on type 2 diabetic neuropathic pain (DNP) and on the expressions of the P2X3 receptor and calcitonin gene-related peptide (CGRP) in the dorsal root ganglion (DRG). METHODS: Rat type 2 DNP was induced by a high calorie and high sugar diet fed for 7 weeks, plus a single intraperitoneal injection of streptozotocin (STZ) after 5 weeks. EA at 2 and 100 Hz was carried out once every day after 7 weeks for 7 consecutive days...
2017: Journal of Zhejiang University. Science. B
https://www.readbyqxmd.com/read/28267064/nerve-injury-induced-epigenetic-silencing-of-opioid-receptors-controlled-by-dnmt3a-in-primary-afferent-neurons
#10
Linlin Sun, Jian-Yuan Zhao, Xiyao Gu, Lingli Liang, Shaogen Wu, Kai Mo, Jian Feng, Weixiang Guo, Jun Zhang, Alex Bekker, Xinyu Zhao, Eric J Nestler, Yuan-Xiang Tao
Opioids are the gold standard for pharmacological treatment of neuropathic pain, but their analgesic effects are unsatisfactory in part due to nerve injury-induced downregulation of opioid receptors in dorsal root ganglia (DRG) neurons. How nerve injury drives such downregulation remains elusive. DNA methyltransferase-(DNMT-) triggered DNA methylation represses gene expression. We show here that blocking the nerve injury-induced increase in DRG DNMT3a (a de novo DNMT) rescued the expression of Oprm1 and Oprk1 mRNAs and their respective encoding mu opioid receptor (MOR) and kappa opioid receptor (KOR) proteins in the injured DRG...
March 4, 2017: Pain
https://www.readbyqxmd.com/read/28258733/-perioperative-gabapentin-and-pregabalin-in-cardiac-surgery-a-systematic-review-and-meta-analysis
#11
Souvik Maitra, Dalim K Baidya, Sulagna Bhattacharjee, Anirban Som
OBJECTIVES: Sternotomy for cardiac surgeries causes significant postoperative pain and when not properly managed may cause significant morbidity. As neuropathic pain is a significant component here, gabapentin and pregabalin may be effective in these patients and may reduce postoperative opioid consumption. The purpose of this systematic review was to find out efficacy of gabapentin and pregabalin in acute postoperative pain after cardiac surgery. METHODS: Published prospective human randomized clinical trials, which compared preoperative and/or postoperative gabapentin/pregabalin with placebo or no treatment for postoperative pain management after cardiac surgery has been included in this review...
March 1, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28257897/ezh2-regulates-spinal-neuroinflammation-in-rats-with-neuropathic-pain
#12
Ruchi Yadav, Han-Rong Weng
Alteration in gene expression along the pain signaling pathway is a key mechanism contributing to the genesis of neuropathic pain. Accumulating studies have shown that epigenetic regulation plays a crucial role in nociceptive process in the spinal dorsal horn. In this present study, we investigated the role of enhancer of zeste homolog-2 (EZH2), a subunit of the polycomb repressive complex 2, in the spinal dorsal horn in the genesis of neuropathic pain in rats induced by partial sciatic nerve ligation. EZH2 is a histone methyltransferase, which catalyzes the methylation of histone H3 on K27 (H3K27), resulting in gene silencing...
February 28, 2017: Neuroscience
https://www.readbyqxmd.com/read/28257351/the-experience-of-intense-pain-nursing-management-and-interventions
#13
Norma Kiser-Larson
Personal stories of illness give depth to otherwise clinical descriptions of diagnoses. This article offers an autobiographical narrative of complications after total knee replacement surgery. Diagnosis and nursing management of acute compartment syndrome, nociceptive and neuropathic origins of pain, pharmacologic and nursing interventions for pain, the use of prayer in illness, and compassionate caring from a Christian perspective are discussed.
April 2017: Journal of Christian Nursing: a Quarterly Publication of Nurses Christian Fellowship
https://www.readbyqxmd.com/read/28251660/neuronal-and-microglial-mechanisms-for-neuropathic-pain-in-the-spinal-dorsal-horn-and-anterior-cingulate-cortex
#14
REVIEW
Makoto Tsuda, Kohei Koga, Tao Chen, Min Zhuo
Neuropathic pain is a debilitating chronic pain condition occurring after damage in the nervous system and is refractory to the currently available treatments. Major challenges include elucidating its mechanisms and developing new medications to treat it. Nerve injury-induced pain hypersensitivity involves aberrant excitability in spinal dorsal horn (SDH) neurons as a consequence of dysfunction of inhibitory interneurons and of hyperactivity of glial cells, especially microglia, the immune cells of the central nervous system...
March 2, 2017: Journal of Neurochemistry
https://www.readbyqxmd.com/read/28251523/atypical-facial-pain-a-comprehensive-evidence-based-review
#15
REVIEW
Austin L Weiss, Ken P Ehrhardt, Reda Tolba
PURPOSE OF REVIEW: The purpose of this article is to focus on an excruciating disorder of the face, named atypical facial pain or persistent idiopathic facial pain (PIFP). It is considered an underdiagnosed condition with limited treatment options. Facial pain can be a debilitating disorder that affects patients' quality of life. Up to 26% of the general population has suffered from facial pain at some point in their lives. It is important to highlight the different types of facial pain to be able to properly manage this condition accordingly...
February 2017: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/28244943/mixed-pain-can-be-discerned-in-the-primary-care-and-orthopedics-settings-in-spain-a-large-cross-sectional-study
#16
Pedro J Ibor, Isabel Sánchez-Magro, Jesús Villoria, Ana Leal, Ana Esquivias
OBJECTIVES: To assess the value of the concept of mixed pain by investigating its acceptance and interpretation by health care professionals and the differential characteristics in patients with mixed pain. MATERIALS AND METHODS: Data from 5024 patients suffering pain from 551 sites in Primary Care and Orthopedics settings were analyzed in this cross-sectional study. Pain characteristics, other factors influencing pain, health care-related data and health-related quality of life were summarized and compared among 3 groups of patients according to the type of pain (nociceptive, neuropathic, or mixed), as assigned by the investigators after considering the pathophysiological mechanisms involved...
February 27, 2017: Clinical Journal of Pain
https://www.readbyqxmd.com/read/28244180/a-spinal-cord-stimulation-service-review-from-a-single-centre-using-a-single-manufacturer-over-a-7-5-year-follow-up-period
#17
Simon J Thomson, Dmitry Kruglov, Rui V Duarte
BACKGROUND: Spinal cord stimulation (SCS) is a recognized management option for patients with refractory neuropathic pain. Despite randomized controlled trials reporting the effectiveness of SCS, there is a lack of long-term data reflecting usual SCS practice. The aim of this study is to present the long-term outcomes of a cohort of patients from a single centre undertaking SCS with devices from a single manufacturer. METHODS: Data were collected between January 2008 and July 2015 on 321 patients who had an SCS trial...
February 27, 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/28241331/gabapentin-induced-bullous-pemphigoid
#18
Avram Flamm, Sarina Sachdev, Francois Dufresne
Bullous pemphigoid is an autoimmune blistering dermatosis with separation of the epidermis from the dermis. This disease process is common among elderly patients and manifests with subepidermal vesicles and tense bullae. Patients with bullous pemphigoid are more likely to have also received a previous diagnosis of a neurologic disorder. Gabapentin is an antiepileptic that is used to manage neuropathic pain. The authors describe, to their knowledge, the first report of gabapentin-induced bullous pemphigoid in an elderly man with no history of rashes or reactions to other medications...
March 1, 2017: Journal of the American Osteopathic Association
https://www.readbyqxmd.com/read/28235509/management-of-isolated-infraorbital-neuralgia-by-ultrasound-guided-infraorbital-nerve-block-with-combination-of-steroid-and-local-anesthetic
#19
Oya Y Cok, Sinan Deniz, H Evren Eker, Levent Oguzkurt, Anis Aribogan
Patients with isolated peripheral branch neuralgia of trigeminal nerve usually receive traditional treatment such as medical therapy and interventional procedures targeting the entire trigeminal nerve or related ganglions. However, if the intractable pain is limited to a certain branch, the patient may also benefit from a peripheral and nerve-targeted interventional approach. Here, we report the management of a patient with isolated infraorbital neuralgia by ultrasound-guided infraorbital nerve block with steroid and local anesthetic combination...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28222994/palliative-care-and-palliative-radiation-therapy-education-in-radiation-oncology-a-survey-of-us-radiation-oncology-program-directors
#20
Randy L Wei, Lauren E Colbert, Joshua Jones, Margarita Racsa, Gabrielle Kane, Steve Lutz, Neha Vapiwala, Kavita V Dharmarajan
PURPOSE: The purpose of this study was to assess the state of palliative and supportive care (PSC) and palliative radiation therapy (RT) educational curricula in radiation oncology residency programs in the United States. METHODS AND MATERIALS: We surveyed 87 program directors of radiation oncology residency programs in the United States between September 2015 and November 2015. An electronic survey on PSC and palliative RT education during residency was sent to all program directors...
December 1, 2016: Practical Radiation Oncology
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