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painful diabetic neuropathy

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https://www.readbyqxmd.com/read/27926760/epidermal-nerve-fiber-quantification-in-patients-with-erythromelalgia
#1
William G Mantyh, P James B Dyck, Peter J Dyck, Janean K Engelstad, William J Litchy, Paola Sandroni, Mark D P Davis
Importance: Erythromelalgia is a clinical diagnosis based on intermittent warmth, erythema, and pain in the distal extremities. One problem facing physicians is how to objectively test for this disease. Given that other painful conditions of the distal extremities (ie, neuropathy related to human immunodeficiency virus, diabetes, or Fabry disease) can be evaluated with a skin biopsy to visualize pathologically decreased densities of the small nerve fibers that innervate the epidermis, one hypothesis is that erythromelalgia could similarly be associated with a loss of epidermal nerve fiber density (ENFD)...
December 7, 2016: JAMA Dermatology
https://www.readbyqxmd.com/read/27922760/nervecheck-for-the-detection-of-sensory-loss-and-neuropathic-pain-in-diabetes
#2
Georgios Ponirakis, Maria N Odriozola, Samantha Odriozola, Ioannis N Petropoulos, Shazli Azmi, Maryam Ferdousi, Hassan Fadavi, Uazman Alam, Andrew Marshall, Maria Jeziorska, Anthony Miro, Ahmad Kheyami, Mitra Tavakoli, Ahmed Al-Ahmar, Maria B Odriozola, Ariel Odriozola, Rayaz A Malik
BACKGROUND: Accurate and economic detection of nerve damage in diabetes is key to more widespread diagnosis of patients with diabetic peripheral neuropathy (DPN) and painful diabetic neuropathy. This study examined the diagnostic performance of NerveCheck, an inexpensive ($500) quantitative sensory testing (QST) device. METHODS: One hundred forty-four subjects (74 with and 70 without diabetes) underwent assessment with NerveCheck, neuropathy disability score (NDS), nerve conduction studies (NCS), intraepidermal and corneal nerve fiber density (IENFD and CNFD), and McGill questionnaire for neuropathic pain...
December 6, 2016: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/27919222/capsaicin-8-patch-repeat-treatment-plus-standard-of-care-soc-versus-soc-alone-in-painful-diabetic-peripheral-neuropathy-a-randomised-52-week-open-label-safety-study
#3
Aaron I Vinik, Serge Perrot, Etta J Vinik, Ladislav Pazdera, Hélène Jacobs, Malcolm Stoker, Stephen K Long, Robert J Snijder, Marjolijne van der Stoep, Enrique Ortega, Nathaniel Katz
BACKGROUND: This 52-week study evaluated the long-term safety and tolerability of capsaicin 8% w/w (179 mg) patch repeat treatment plus standard of care (SOC) versus SOC alone in painful diabetic peripheral neuropathy (PDPN). METHODS: Phase 3, multinational, open-label, randomised, controlled, 52-week safety study, conducted in Europe. Patients were randomised to capsaicin 8% patch repeat treatment (30 or 60 min; 1-7 treatments with ≥ 8-week intervals) to painful areas of the feet plus SOC, or SOC alone...
December 6, 2016: BMC Neurology
https://www.readbyqxmd.com/read/27917764/diabetic-cachectic-neuropathy-an-uncommon-neurological-complication-of-diabetes
#4
A Iyagba, A Onwuchekwa
A 40-year-old female patient with diabetes of 12 years' duration, with poor drug compliance, presented with a 4-month history of rapid progressive weight loss, burning sensations in the feet, abdominal swelling, and constipation with occasional episodes of epigastric pain. On examination, she was chronically ill-looking with a body mass index of 17.1 kg/m2, grossly distended abdomen (initially mistaken for gravid abdomen). Blood pressure measurements in the supine and standing positions were 200/130 mmHg and 180/100 mmHg, respectively...
December 1, 2016: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/27901334/differential-efficacy-of-methylcobalamin-and-alpha-lipoic-acid-treatment-on-negative-and-positive-symptoms-of-type-2-diabetic-peripheral-neuropathy
#5
Yajuan Han, Min Wang, Jie Shen, Zhen Zhang, Min Zhao, Jing Huang, Youming Chen, Zhi Chen, Yulan Hu, Yubing Wang
BACKGROUND: Diabetic hyperglycemia damages peripheral nerves by triggering ischemia, oxidative stress, and inflammation. Alpha-lipoic acid (ALA) and methylcobalamin (MC) are known to improve signs of diabetic peripheral neuropathy (DPN), possibly by enhancing neural and vascular endothelial cell metabolism and antioxidant capacity. We evaluated differences in efficacy following short-term MC or ALA treatment on DPN symptoms to guide clinical drug selection. METHODS: Forty DPN patients were randomly divided into MC and ALA treatment groups (n=20/20) and assessed by the Toronto Clinical Neuropathy Scoring System (TCSS), total symptom score (TSS), visual analog scale (VAS) of positive symptoms, and easy sensory test (EST) for negative symptoms before and after 2 weeks of treatment...
November 30, 2016: Minerva Endocrinologica
https://www.readbyqxmd.com/read/27898216/characterization-of-prostacyclin-associated-leg-pain-in-patients-with-pulmonary-arterial-hypertension
#6
Gabriel L Pagani-Estévez, Keith M Swetz, Michael D McGoon, Robert P Frantz, Susan K Tointon, Ann M Karnyski, Louise A Durst, James C Watson
RATIONALE: Prostacyclin-associated leg pain is a potentially debilitating adverse effect of prostacyclin therapy for patients with pulmonary arterial hypertension (PAH). However, to our knowledge, this entity has not been systematically studied. OBJECTIVE: To characterize the clinical features and metabolic risk factors for prostacyclinassociated leg pain. METHODS: At one academic medical center we assembled and analyzed a case series of patients with PAH and prostacyclin-associated leg pain...
November 29, 2016: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/27891351/evaluation-of-effect-of-nishamalaki-on-stz-and-hfhf-diet-induced-diabetic-neuropathy-in-wistar-rats
#7
Jayshree Shriram Dawane, Vijaya Anil Pandit, Madhura Shirish Kumar Bhosale, Pallawi Shashank Khatavkar
INTRODUCTION: Diabetic neuropathy is one of the most common complications affecting 50% of diabetic patients. Neuropathic pain is the most difficult types of pain to treat. There is no specific treatment for neuropathy. Nishamalaki (NA), combination of Curcuma longa and Emblica officinalis used to treat Diabetes Mellitus (DM). So, efforts were made to test whether NA is useful in prevention of diabetic neuropathy. AIM: To evaluate the effect of NA on diabetic neuropathy in type 2 diabetic wistar rats...
October 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27889175/inhibition-of-adenylyl-cyclase-in-the-spinal-cord-alleviates-painful-diabetic-neuropathy-in-zucker-diabetic-fatty-rats
#8
Hao Feng, Guodong Lu, Qingsong Li, Zhonghao Liu
OBJECTIVES: Diabetic neuropathy is the most common complication of both type 1 and type 2 diabetes. In this study, we tested the hypotheses that impaired Gi protein expression/function in the spinal cord is associated with the development of painful neuropathy in people with type 2 diabetes and that reduction of cyclic adenosine monophosphate (cAMP) production by inhibiting adenylyl cyclase in the spinal cord can alleviate diabetic neuropathy. METHODS: To this end, we examined the levels of cAMP, cAMP-dependent protein kinase (PKA) and cAMP response element-binding protein (CREB) in the spinal cord after the development of neuropathic pain in Zucker diabetic fatty (ZDF) rats with type 2 diabetes...
November 23, 2016: Canadian Journal of Diabetes
https://www.readbyqxmd.com/read/27861415/decompressive-surgery-for-diabetic-neuropathy-waiting-for-incontrovertible-proof
#9
Martijn R Tannemaat, Mirjam Datema, J Gert van Dijk, Rajiv Midha, Martijn J A Malessy
: : Triple decompression surgery has been advocated as a treatment for diabetic peripheral neuropathy (DPN). A practice advisory published in 2006 by the American Academy of Neurology concluded that "this treatment alternative should be considered unproven." Since then, multiple cohort studies involving several thousands of patients and 1 nonblind, randomized, controlled trial have been published, suggesting that surgical treatment of DPN has become commonplace in many centers globally...
December 2016: Neurosurgery
https://www.readbyqxmd.com/read/27857760/galanin-and-its-receptor-system-promote-the-repair-of-injured-sciatic-nerves-in-diabetic-rats
#10
Xiao-Feng Xu, Dan-Dan Zhang, Jin-Chi Liao, Li Xiao, Qing Wang, Wei Qiu
Various studies have reported that galanin can promote axonal regeneration of dorsal root ganglion neurons in vitro and inhibit neuropathic pain. However, little is known about its effects on diabetic peripheral neuropathy, and in vivo experimental data are lacking. We hypothesized that repeated applications of exogenous galanin over an extended time frame may also repair nerve damage in diabetic peripheral neuropathy, and relieve pain in vivo. We found that neuropathic pain occurred in streptozotocin-induced diabetic rats and was more severe after sciatic nerve pinch injury at 14 and 28 days than in diabetic sham-operated rats...
September 2016: Neural Regeneration Research
https://www.readbyqxmd.com/read/27851902/therapeutic-potential-of-mesenchymal-stem-cells-for-the-treatment-of-diabetic-peripheral-neuropathy
#11
Marianna Monfrini, Elisabetta Donzelli, Virginia Rodriguez-Menendez, Elisa Ballarini, Valentina Alda Carozzi, Alessia Chiorazzi, Cristina Meregalli, Annalisa Canta, Norberto Oggioni, Luca Crippa, Federica Avezza, Sara Silvani, Barbara Bonandrini, Marina Figliuzzi, Andrea Remuzzi, Carla Porretta-Serapiglia, Roberto Bianchi, Giuseppe Lauria, Giovanni Tredici, Guido Cavaletti, Arianna Scuteri
Type-1 Diabetes is generally treated with exogenous insulin administration. Despite treatment, a very common long term consequence of diabetes is the development of a disabling and painful peripheral neuropathy. The transplantation of pancreatic islets is an advanced alternative therapeutic approach, but its clinical application is still very limited, mainly because of the great number of islets required to complete the procedure and of their short-term survival. An intriguing method to improve the performance of pancreatic islets transplantation is the co-transplantation of Mesenchymal Stem Cells (MSCs), adult stem cells already known to support the survival of different cellular populations...
November 13, 2016: Experimental Neurology
https://www.readbyqxmd.com/read/27836326/diabetes-mellitus-influences-the-expression-of-npy-and-vegf-in-neurons-of-rat-trigeminal-ganglion
#12
Milka Jerić, Katarina Vukojević, Ana Vuica, Natalija Filipović
BACKGROUND: Diabetes mellitus (DM) influences the trigeminal nerve function by changing the pain response and transduction of the orofacial sensory pathways. It affects the inflammatory response via neuropeptide Y (NPY) and vascular endothelial growth factor (VEGF), which could potentially have a relevant role in the pathophysiology of diabetic neuropathy. The aim was to investigate expression of VEGF and NPY in subpopulations of trigeminal ganglion (TG) neurons in rat models of early DM1 and DM2...
November 3, 2016: Neuropeptides
https://www.readbyqxmd.com/read/27822619/the-5-lidocaine-medicated-plaster-its-inclusion-in-international-treatment-guidelines-for-treating-localized-neuropathic-pain-and-clinical-evidence-supporting-its-use
#13
REVIEW
Ralf Baron, Massimo Allegri, Gerardo Correa-Illanes, Guy Hans, Michael Serpell, Gerard Mick, Victor Mayoral
When peripheral neuropathic pain affects a specific, clearly demarcated area of the body, it may be described as localized neuropathic pain (LNP). Examples include postherpetic neuralgia and painful diabetic neuropathy, as well as post-surgical and post-traumatic pain. These conditions may respond to topical treatment, i.e., pharmaceutical agents acting locally on the peripheral nervous system, and the topical route offers advantages over systemic administration. Notably, only a small fraction of the dose reaches the systemic circulation, thereby reducing the risk of systemic adverse effects, drug-drug interactions and overdose...
December 2016: Pain and Therapy
https://www.readbyqxmd.com/read/27813425/emerging-drugs-for-diabetic-peripheral-neuropathy-and-neuropathic-pain
#14
Nikolaos Papanas, Dan Ziegler
Diabetic sensorimotor polyneuropathy (DSPN) is a common complication of diabetes. Areas covered: In this review, the authors discuss the emerging drugs for DSPN, which aim either at improving alleviation of neuropathic pain or addressing the putative mechanisms underlying diabetic neuropathy. Expert Opinion: Current treatment does not address the sensory deficits and pathogenesis underlying DSPN, so there is an unmet need for treatment options targeting the natural history of the condition. Some of these pathogenetic therapies have demonstrated clinically relevant improvements in neuropathic endpoints in recent randomised controlled trials...
November 18, 2016: Expert Opinion on Emerging Drugs
https://www.readbyqxmd.com/read/27802497/association-between-metabolic-syndrome-components-and-polyneuropathy-in-an-obese-population
#15
Brian C Callaghan, Rong Xia, Evan Reynolds, Mousumi Banerjee, Amy E Rothberg, Charles F Burant, Emily Villegas-Umana, Rodica Pop-Busui, Eva L Feldman
Importance: Past studies have shown an association between metabolic syndrome and polyneuropathy, but the precise components that drive this association remain unclear. Objectives: To determine the prevalence of polyneuropathy stratified by glycemic status in well-characterized obese and lean participants and investigate the association of specific components of metabolic syndrome with polyneuropathy. Design, Setting, and Participants: We performed a cross-sectional, observational study from November 1, 2010, to December 31, 2014, in obese participants (body mass index [calculated as weight in kilograms divided by height in meters squared] of 35 or more with no comorbid conditions or 32 or more with at least 1 comorbid condition) from a weight management program and lean controls from a research website...
October 31, 2016: JAMA Neurology
https://www.readbyqxmd.com/read/27787711/delta-opioid-receptor-dor-ligands-and-pharmacology-development-of-indolo-and-quinolinomorphinan-derivatives-based-on-the-message-address-concept
#16
Akiyoshi Saitoh, Hiroshi Nagase
The pharmacology of the delta opioid receptor (DOR) has lagged, mainly due to the lack of an agonist with high potency and selectivity in vivo. The DOR is now receiving increasing attention, and there has been progress in the synthesis of better novel ligands. The discovery of a selective receptor DOR antagonist, naltrindole (NTI), stimulated the design and synthesis of (±)TAN-67, which was designed based on the message-address concept and the accessory site theory. Intensive studies using (±)TAN-67 determined the DOR-mediated various pharmacological effects, such as antinociceptive effects for painful diabetic neuropathy and cardiovascular protective effects...
October 28, 2016: Handbook of Experimental Pharmacology
https://www.readbyqxmd.com/read/27785092/improvement-in-pain-severity-category-in-clinical-trials-of-pregabalin
#17
Bruce Parsons, Charles E Argoff, Andrew Clair, Birol Emir
BACKGROUND: Pregabalin is approved by the US Food and Drug Administration for the treatment of fibromyalgia (FM), diabetic peripheral neuropathy (DPN), postherpetic neuralgia (PHN), and neuropathic pain due to spinal cord injury (SCI). Approval was based on clinical trial data demonstrating statistically significant differences in pain scores versus placebo. However, statistically significant pain relief may not always equate to clinically meaningful pain relief. To further characterize the clinical benefit of pregabalin, this analysis examined shifts in pain severity categories in patients with FM, DPN/PHN (pooled in this analysis), and SCI treated with pregabalin...
2016: Journal of Pain Research
https://www.readbyqxmd.com/read/27769219/advanced-practice-pharmacists-a-retrospective-evaluation-of-the-efficacy-and-cost-of-clinical-pharmacist-practitioners-managing-ambulatory-medicare-patients-in-north-carolina-apple-nc
#18
Michèle M Kislan, Adam T Bernstein, Loretta R Fearrington, Timothy J Ives
BACKGROUND: Clinical Pharmacist Practitioners are advanced practicing pharmacists in North Carolina that provide disease-specific management. The purpose of this retrospective cohort study was to compare the efficacy and charges from referrals to a Clinical Pharmacist Practitioner by the primary care provider, to those managed by a primary care provider alone. METHODS: Patients were separated into cohorts depending if they had at least two appointments with a Clinical Pharmacist Practitioner from November 2008 to November 2011...
October 21, 2016: BMC Health Services Research
https://www.readbyqxmd.com/read/27764759/6-methoxyflavanone-attenuates-mechanical-allodynia-and-vulvodynia-in-the-streptozotocin-induced-diabetic-neuropathic-pain
#19
Shehla Akbar, Fazal Subhan, Nasiara Karim, Muhammad Shahid, Nisar Ahmad, Gowhar Ali, Wajahat Mahmood, Khwaja Fawad
BACKGROUND: Diabetic neuropathy is the most prevalent, persistent and debilitating complication of diabetes mellitus often coupled with vulvodynia that may present as an isolated symptom or as a part of constellation of other neuropathic abnormalities. OBJECTIVE: Flavonoids have selective affinity for GABA receptors and 6-methoxyflavanone (6-MeOF) is a positive allosteric modulator of GABA responses at human recombinant GABAA receptors. GABAergic and opioidergic system inhibition have been shown to facilitate neuropathic pain...
October 17, 2016: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
https://www.readbyqxmd.com/read/27764706/management-of-postoperative-pain-after-lumbar-surgery-pregabalin-for-one-day-and-14-days-a-randomized-triple-blinded-placebo-controlled-study
#20
Mohammad Zarei, Arvin Najafi, Pejman Mansouri, Sadaf Sadeghi-Yazdankhah, Houshang Saberi, Mehran Moradi, Mahmoud Farzan
OBJECTIVES: Despite the progress in understanding acute pain physiology during recent decade, eighty percent of patients still suffer from post-operative discomfort. Pregabalin is an anticonvulsant agent that is approved for painful neuropathies in diabetic patients and post herpetic neuralgia. The main objective of the present study was to compare the improvement in post-operative pain management and patient lifestyle in 3 groups, as first group received placebo, second who received Pregabalin for one day and the last group those who received it for 14 days...
December 2016: Clinical Neurology and Neurosurgery
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