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https://www.readbyqxmd.com/read/29336009/gefitinib-for-advanced-non-small-cell-lung-cancer
#1
REVIEW
Esther Ha Sim, Ian A Yang, Richard Wood-Baker, Rayleen V Bowman, Kwun M Fong
BACKGROUND: The role of gefitinib for the treatment of advanced non-small cell lung cancer (NSCLC) is evolving. We undertook a systematic review to evaluate the available evidence from all randomised trials. OBJECTIVES: To determine the effectiveness and safety of gefitinib as first-line, second-line or maintenance treatment for advanced NSCLC. SEARCH METHODS: We performed searches in CENTRAL, MEDLINE and Embase from inception to 17 February 2017...
January 16, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29306933/mechanisms-and-treatment-of-painful-neuromas
#2
Changfeng Lu, Xun Sun, Chong Wang, Yu Wang, Jiang Peng
A painful neuroma is a common complication of a peripheral nerve injury or amputation, and it can cause tremendous pain that is resistant to most analgesics. Furthermore, painful neuromas have a high postoperative recurrence rate. Painful neuromas are often accompanied by functional disorders, drastically reducing the patient's quality of life. Several pathophysiological mechanisms have been proposed to explain this type of neuropathic pain, including peripheral and central sensitisation and the involvement of nerve growth factor, α-smooth muscle actin, the cannabinoid CB2 receptor and structural changes in neuroma fibres...
January 8, 2018: Reviews in the Neurosciences
https://www.readbyqxmd.com/read/29221427/validity-of-the-dutch-modified-paindetect-questionnaire-for-patients-with-hip-or-knee-osteoarthritis
#3
Wietske Rienstra, Tim Blikman, Baukje Dijkstra, Jos van Raay, Geranda Slager, Sjoerd Bulstra, Martin Stevens, Inge van den Akker-Scheek
BACKGROUND: The modified painDETECT questionnaire (PDQ) is a self-reported questionnaire to discriminate between nociceptive and neuropathic-like pain in patients with knee/hip osteoarthritis (OA). This study aims to assess the structural and construct validity of this questionnaire. METHODS: Confirmatory factor analysis and hypothesis-testing was used. For 168 patients, predefined hypotheses were formulated on the correlation between the modified painDETECT and several other questionnaires, and in a subsample of 46 with pain pressure thresholds (PPTs)...
December 8, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/29220355/adults-with-patellofemoral-pain-do-not-exhibit-manifestations-of-peripheral-and-central-sensitization-when-compared-to-healthy-pain-free-age-and-sex-matched-controls-an-assessor-blinded-cross-sectional-study
#4
Michael Skovdal Rathleff, Camilla Rams Rathleff, Aoife Stephenson, Rebecca Mellor, Mark Matthews, Kay Crossley, Bill Vicenzino
Patellofemoral Pain (PFP) is highly prevalent among adults and adolescents. Localized mechanical hyperalgesia around the knee and tibialis anterior have been observed in people with PFP, but limited knowledge of potential manifestations of central sensitisation exists. The aims of this study were to study conditioned pain modulation (CPM) and wide-spread hyperalgesia in adults with PFP. This assessor-blinded cross-sectional study design compared CPM and mechanical pressure pain thresholds (PPT) between 33 adults (23 females) diagnosed with PFP and 32 age and sex matched pain-free controls...
2017: PloS One
https://www.readbyqxmd.com/read/29197071/peroxisome-proliferator-activated-receptor-gamma-agonists-for-preventing-recurrent-stroke-and-other-vascular-events-in-people-with-stroke-or-transient-ischaemic-attack
#5
REVIEW
Jia Liu, Lu-Ning Wang
BACKGROUND: Peroxisome proliferator-activated receptor gamma (PPAR-γ) agonists are insulin-sensitising drugs used for the treatment of insulin resistance. In addition to lowering glucose in diabetes, these drugs may also protect against hyperlipidaemia and arteriosclerosis, which are risk factors for stroke. This is an update of a review first published in January 2014 and subsequently updated in October 2015. OBJECTIVES: To assess the efficacy and safety of PPAR-γ agonists in the secondary prevention of stroke and related vascular events for people with stroke or transient ischaemic attack (TIA)...
December 2, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29183107/insulin-sensitising-drugs-metformin-rosiglitazone-pioglitazone-d-chiro-inositol-for-women-with-polycystic-ovary-syndrome-oligo-amenorrhoea-and-subfertility
#6
REVIEW
Lara C Morley, Thomas Tang, Ephia Yasmin, Robert J Norman, Adam H Balen
BACKGROUND: Polycystic ovary syndrome (PCOS) is characterised by infrequent or absent ovulation, and high levels of androgens and insulin (hyperinsulinaemia). Hyperinsulinaemia occurs secondary to insulin resistance and is associated with increased risk of cardiovascular disease and diabetes mellitus. Insulin-sensitising agents such as metformin may be effective in treating PCOS-related anovulation. OBJECTIVES: To evaluate the effectiveness and safety of insulin-sensitising drugs in improving reproductive and metabolic outcomes for women with PCOS undergoing ovulation induction...
November 29, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29149168/airway-expression-of-transient-receptor-potential-trp-vanniloid-1-and-ankyrin-1-channels-is-not-increased-in-patients-with-idiopathic-pulmonary-fibrosis
#7
Nicola-Xan Hutchinson, Allen Gibbs, Amanda Tonks, Benjamin D Hope-Gill
Dry cough is a common symptom described in patients with Idiopathic Pulmonary Fibrosis (IPF) and impairs quality of life. The exact mechanisms causing cough in IPF remain unclear, however evidence suggests altered cough neurophysiology and sensitisation plays a role; IPF patients have an enhanced cough reflex sensitivity to inhaled capsaicin. The Transient Receptor Potential Vanniloid-1 channel (TRPV-1) has a role in the cough reflex and airway expression is increased in patients with chronic cough. The Ankyrin-1 receptor (TRPA-1) is often co-expressed...
2017: PloS One
https://www.readbyqxmd.com/read/29105941/assessment-and-manifestation-of-central-sensitisation-across-different-chronic-pain-conditions
#8
L Arendt-Nielsen, B Morlion, S Perrot, A Dahan, A Dickenson, H G Kress, C Wells, D Bouhassira, A Mohr Drewes
Different neuroplastic processes can occur along the nociceptive pathways and may be important in the transition from acute to chronic pain and for diagnosis and development of optimal management strategies. The neuroplastic processes may result in gain (sensitisation) or loss (desensitisation) of function in relation to the incoming nociceptive signals. Such processes play important roles in chronic pain, and although the clinical manifestations differ across condition processes, they share some common mechanistic features...
November 5, 2017: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/29079893/characterisation-of-pain-in-people-with-hereditary-neuropathy-with-liability-to-pressure-palsy
#9
Darren Beales, Robyn Fary, Cameron Little, Shruti Nambiar, Hakon Sveinall, Yen Leng Yee, Brigitte Tampin, Tim Mitchell
Hereditary neuropathy with liability to pressure palsy (HNPP) has historically been considered a pain-free condition, though some people with HNPP also complain of pain. This study characterised persistent pain in people with HNPP. Participants provided cross-sectional demographic data, information on the presence of neurological and persistent pain symptoms, and the degree to which these interfered with daily life. The painDETECT and Central Sensitization Inventory questionnaires were used to indicate potential neuropathic, central sensitisation and musculoskeletal (nociceptive) pain mechanisms...
December 2017: Journal of Neurology
https://www.readbyqxmd.com/read/29071071/environmental-triggers-of-copd-symptoms-a-case-cross-over-study
#10
Susan R Sama, David Kriebel, Rebecca J Gore, Rebecca DeVries, Richard Rosiello
INTRODUCTION: This study investigated the hypothesis that common environmental chemical exposures with known irritant or sensitising properties trigger exacerbations for patients with chronic obstructive pulmonary disease (COPD). METHODS: We conducted a case cross-over study in 168 patients with COPD who were members of a disease management group in central Massachusetts. Participants completed a baseline health survey and several short exposure surveys. Exposure surveys were administered by a nurse when a participant telephoned to report an exacerbation (case periods) and at a maximum of three randomly identified control periods when they were not experiencing an exacerbation...
2017: BMJ Open Respiratory Research
https://www.readbyqxmd.com/read/29029859/intensive-insulin-therapy-insulin-sensitisers-and-insulin-secretagogues-for-burns-a-systematic-review-of-effectiveness-and-safety
#11
REVIEW
Jared M Campbell, Natalia Adanichkin, Rochelle Kurmis, Zachary Munn
This systematic review investigated the effectiveness and safety of intensive insulin therapy (IIT), insulin secretagogues and sensitisers in burn patients. PubMed, Embase, clinicaltrials.gov and Cochrane central were searched from 1990 to 2016. Title/abstract screening, full-text review, critical appraisal and data extraction were carried out by two independent reviewers. Inclusion criteria were hospitalised burn patients, IIT, insulin sensitisers or secretagogues and the outcomes mortality, length of stay, resting energy expenditure, blood glucose, catabolism, or complications...
October 10, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28967373/an-overview-of-pathways-encoding-nociception
#12
REVIEW
Sarah A Woller, Kelly A Eddinger, Maripat Corr, Tony L Yaksh
The nervous system detects and interprets a variety of chemical, mechanical, and thermal stimuli. In the face of tissue injury, local inflammatory products perpetuate ongoing activity and sensitisation of the peripheral nerve termini. This ongoing activity evokes a state of robust spinal facilitation mediated by a number of local circuits, the net effect yielding an enhanced message of nociception to higher centres. This messaging typically wanes with the resolution of inflammation or wound healing. However, there are situations in which peripheral and central components of the pain transmission pathway extend and enhance the pain state, leading to a persistent hypersensitivity, e...
September 2017: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/28967365/hypermobility-the-ehlers-danlos-syndromes-and-chronic-pain
#13
REVIEW
Delfien Syx, Inge De Wandele, Lies Rombaut, Fransiska Malfait
Chronic widespread pain is a common complaint among individuals affected by generalised joint hypermobility. In the absence of other conditions that cause chronic pain, these individuals are usually diagnosed with joint hypermobility syndrome (JHS). JHS is a multifactorial trait with a strong genetic basis, but no specific genetic markers. Clinical overlap of JHS is seen with heritable connective tissue disorders, particularly with the Ehlers-Danlos syndrome, hypermobile type (hEDS). The Ehlers-Danlos syndromes (EDS) comprise a heterogeneous group of rare monogenic conditions that are characterised by joint hypermobility, skin and vascular fragility and generalised connective tissue friability, and are caused by genetic defects in an array of extracellular matrix genes...
September 2017: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/28967357/in-the-spine-or-in-the-brain-recent-advances-in-pain-neuroscience-applied-in-the-intervention-for-low-back-pain
#14
REVIEW
Jo Nijs, Jacqui Clark, Anneleen Malfliet, Kelly Ickmans, Lennard Voogt, Sanneke Don, Hester den Bandt, Dorien Goubert, Jeroen Kregel, Iris Coppieters, Wim Dankaerts
Conservative, surgical and pharmacological strategies for chronic low back pain (CLBP) management offer at best modest effect sizes in reducing pain and related disability, indicating a need for improvement. Such improvement may be derived from applying contemporary pain neuroscience to the management of CLBP. Current interventions for people with CLBP are often based entirely on a "biomedical" or "psychological" model without consideration of information concerning underlying pain mechanisms and contemporary pain neuroscience...
September 2017: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/28967356/pain-sensitisation-in-osteoarthritis
#15
REVIEW
Lars Arendt-Nielsen
Treating chronic musculoskeletal pain, and chronic joint pain (osteoarthritis (OA)) in particular, is challenging as the peripheral and central pain mechanisms are not fully discovered, and safe and as efficient analgesic drugs are not available. In general, the preclinical models of OA are limited to provide fundamental understanding of the pain mechanisms involved in patients with chronic joint pain (1). The pain associated with joint discomfort is highly variable, often underestimated by clinicians, and shows only modest association with crude radiological scorings...
September 2017: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/28967354/pain-mechanisms-in-rheumatoid-arthritis
#16
REVIEW
Daniel F McWilliams, David A Walsh
Understanding of the causes and underlying mechanisms of pain in people with RA is rapidly changing. With the advent of more effective disease modifying drugs, joint inflammation is becoming a more treatable cause of pain, and joint damage can often be prevented. However, the long-term prognosis for pain still is often unfavourable, even after inflammation is suppressed. Pain is associated with fatigue and psychological distress, and RA pain qualities often share characteristics with neuropathic pain. Each of these characteristics suggests key roles for central neuronal processing in RA pain...
September 2017: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/28893757/effectiveness-and-cost-effectiveness-of-duloxetine-added-to-usual-care-for-patients-with-chronic-pain-due-to-hip-or-knee-osteoarthritis-protocol-of-a-pragmatic-open-label-cluster-randomised-trial-the-duo-trial
#17
Jacoline J van den Driest, Dieuwke Schiphof, Pim A J Luijsterburg, Aafke R Koffeman, Marc A Koopmanschap, Patrick J E Bindels, Sita M A Bierma-Zeinstra
INTRODUCTION: Osteoarthritis (OA) is a highly prevalent painful condition of the musculoskeletal system. The effectiveness of current analgesic options has proven to be limited and improved analgesic treatment is needed. Several randomised placebo-controlled trials have now demonstrated the efficacy of duloxetine, an antidepressant with a centrally acting effect, in the treatment of OA pain. The aim of the current study is to investigate if duloxetine is effective and cost-effective as a third-choice analgesic added to usual care for treating chronic pain compared with usual care alone in general practice...
September 11, 2017: BMJ Open
https://www.readbyqxmd.com/read/28813645/lat-is-essential-for-the-mast-cell-stabilising-effect-of-thga-in-ige-mediated-mast-cell-activation
#18
Ji Wei Tan, Daud Ahmad Israf, Nur Fariesha Md Hashim, Yoke Kqueen Cheah, Hanis Hazeera Harith, Khozirah Shaari, Chau Ling Tham
Mast cells play a central role in the pathogenesis of allergic reaction. Activation of mast cells by antigens is strictly dependent on the influx of extracellular calcium that involves a complex interaction between signalling molecules located within the cells. We have previously reported that tHGA, an active compound originally isolated from a local shrub known as Melicope ptelefolia, prevented IgE-mediated mast cell activation and passive systemic anaphylaxis by suppressing the release of interleukin-4 (IL-4) and tumour necrosis factor (TNF)-α from activated rat basophilic leukaemia (RBL)-2H3 cells...
November 15, 2017: Biochemical Pharmacology
https://www.readbyqxmd.com/read/28770972/prophylactic-levosimendan-for-the-prevention-of-low-cardiac-output-syndrome-and-mortality-in-paediatric-patients-undergoing-surgery-for-congenital-heart-disease
#19
REVIEW
Johanna Hummel, Gerta Rücker, Brigitte Stiller
BACKGROUND: Low cardiac output syndrome remains a serious complication, and accounts for substantial morbidity and mortality in the postoperative course of paediatric patients undergoing surgery for congenital heart disease. Standard prophylactic and therapeutic strategies for low cardiac output syndrome are based mainly on catecholamines, which are effective drugs, but have considerable side effects. Levosimendan, a calcium sensitiser, enhances the myocardial function by generating more energy-efficient myocardial contractility than achieved via adrenergic stimulation with catecholamines...
August 2, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28698330/clinical-characteristics-of-importance-to-outcome-in-patients-with-axial-spondyloarthritis-protocol-for-a-prospective-descriptive-and-exploratory-cohort-study
#20
Rikke Asmussen Andreasen, Lars Erik Kristensen, Torkell Ellingsen, Robin Christensen, Xenofon Baraliakos, Jimmi Wied, Claus Aalykke, Thomas Ulstrup, Berit Schiøttz-Christensen, Hans Christian Horn, Amir Emamifar, Bent Duerlund, Lars Fischer, Inger Marie Jensen Hansen
INTRODUCTION: Spondyloarthritis (SpA) is a heterogeneous spectrum of rheumatic diseases with either predominantly axial inflammatory symptoms of the spine and sacroiliac joints or predominantly peripheral arthritis. The two main entities of axial SpA (axSpA) are ankylosing spondylitis or non-radiographic axSpA (nr-axSpA). Tumour necrosis factor-α inhibitors have revolutionised the treatment of patients with axSpA who failed to respond to non-steroidal anti-inflammatory drugs and physical therapy...
July 10, 2017: BMJ Open
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