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https://www.readbyqxmd.com/read/27854104/new-practical-approaches-to-chemotherapy-induced-neuropathic-pain-prevention-assessment-and-treatment
#1
REVIEW
Neil Majithia, Charles L Loprinzi, Thomas J Smith
Chemotherapy-induced peripheral neuropathy (CIPN) is one of the most disabling and demoralizing problems that arise for cancer survivors. When investigating symptoms of numbness, tingling, or pain in the extremities, it is critical to determine whether the problem is neuropathic, somatic, or mixed. If the diagnosis is CIPN, it is important to weigh the potential benefits and harms of possible treatment options, and to devise an evidence-based multimodality treatment program. Such programs may include mixtures of opioid and nonopioid adjunctive medications, based on evidence from CIPN trials, and also extrapolation from trials in patients with other neuropathic pain syndromes-although such extrapolating must be done with caution, since other syndromes sometimes respond to agents that CIPN does not respond to...
November 15, 2016: Oncology (Williston Park, NY)
https://www.readbyqxmd.com/read/27843610/survey-of-the-management-of-chemotherapy-induced-peripheral-neuropathy-in-japan-japanese-society-of-medical-oncology
#2
Yasuo Hirayama, Jiichiro Sasaki, Hirotoshi Dosaka-Akita, Kunihiko Ishitani
BACKGROUND: Various drugs are administered for the management of chemotherapy-induced peripheral neuropathy (CIPN) in Japan. However, there have been no surveys undertaken to identify these drugs or their frequency of prescription. Therefore, we administered a questionnaire survey to the diplomates of the Subspecialty Board of Japanese Society of Medical Oncology (JSMO) to investigate the frequency of administration of different drugs for the management of CIPN in Japan. METHODS: We investigated the use of vitamin B12, antiepileptic agents such as pregabalin, duloxetine, antidepressants other than duloxetine, non-steroidal anti-inflammatory drugs (NSAIDs), opioids and the Kampo compound goshajinkigan in a questionnaire employing a three-step scale wherein A implies routine or prophylactic administration, B implies occasional administration and C implies infrequent administration...
2016: ESMO Open
https://www.readbyqxmd.com/read/27831985/randomized-double-blind-placebo-controlled-phase-iii-trial-of-duloxetine-monotherapy-in-japanese-patients-with-chronic-low-back-pain
#3
Shinichi Konno, Natsuko Oda, Toshimitsu Ochiai, Levent Alev
STUDY DESIGN: A 14-week, randomized, double-blind, multicenter, placebo-controlled study of Japanese patients with chronic low back pain (CLBP) who were randomized to either duloxetine 60 mg once daily or placebo. OBJECTIVE: This study aimed to assess the efficacy and safety of duloxetine monotherapy in Japanese patients with CLBP. SUMMARY OF BACKGROUND DATA: In Japan, duloxetine is approved for the treatment of depression, diabetic neuropathic pain, and pain associated with fibromyalgia; however, no clinical study of duloxetine has been conducted for CLBP...
November 15, 2016: Spine
https://www.readbyqxmd.com/read/27799181/mitovite-a-mitochondria-targeted-antioxidant-limits-paclitaxel-induced-oxidative-stress-and-mitochondrial-damage-in-vitro-and-paclitaxel-induced-mechanical-hypersensitivity-in-a-rat-pain-model
#4
B McCormick, D A Lowes, L Colvin, C Torsney, H F Galley
BACKGROUND: Neuropathic pain is a common side-effect of chemotherapy. Although precise mechanisms are unclear, oxidative stress and mitochondrial damage are involved. We investigated whether the mitochondria targeted antioxidant, MitoVitE, provided better protection against paclitaxel-induced mitochondrial damage in rat dorsal root ganglion (DRG) cells, than a non-targeted form of vitamin E, Trolox. We also determined whether MitoVitE, compared with duloxetine, could limit paclitaxel-induced mechanical hypersensitivity in rats...
November 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/27796152/an-open-label-long-term-phase-iii-extension-trial-of-duloxetine-in-japanese-patients-with-fibromyalgia
#5
Masato Murakami, Kenichi Osada, Hisao Ichibayashi, Hiromichi Mizuno, Toshimitsu Ochiai, Mitsuhiro Ishida, Levent Alev, Kusuki Nishioka
OBJECTIVES: We aimed to evaluate the long-term safety and efficacy of duloxetine 60 mg in Japanese patients with fibromyalgia enrolled from a preceding randomized, placebo-controlled, phase III duloxetine trial. METHODS: This was a long-term, open-label extension study. Patients received oral duloxetine once daily at a dose of 20 mg for 1 week, followed by 40 mg for 1 week, and then 60 mg for 48 weeks. The primary outcome was the frequency of adverse events (AEs) and adverse drug reactions (ADRs) of duloxetine...
October 31, 2016: Modern Rheumatology
https://www.readbyqxmd.com/read/27788130/brain-connectivity-predicts-placebo-response-across-chronic-pain-clinical-trials
#6
Pascal Tétreault, Ali Mansour, Etienne Vachon-Presseau, Thomas J Schnitzer, A Vania Apkarian, Marwan N Baliki
Placebo response in the clinical trial setting is poorly understood and alleged to be driven by statistical confounds, and its biological underpinnings are questioned. Here we identified and validated that clinical placebo response is predictable from resting-state functional magnetic-resonance-imaging (fMRI) brain connectivity. This also led to discovering a brain region predicting active drug response and demonstrating the adverse effect of active drug interfering with placebo analgesia. Chronic knee osteoarthritis (OA) pain patients (n = 56) underwent pretreatment brain scans in two clinical trials...
October 2016: PLoS Biology
https://www.readbyqxmd.com/read/27768754/duloxetine-inhibits-microglial-p2x4-receptor-function-and-alleviates-neuropathic-pain-after-peripheral-nerve-injury
#7
Tomohiro Yamashita, Shota Yamamoto, Jiaming Zhang, Miho Kometani, Daisuke Tomiyama, Keita Kohno, Hidetoshi Tozaki-Saitoh, Kazuhide Inoue, Makoto Tsuda
P2X4 receptors (P2X4R) are a family of ATP-gated non-selective cation channels. We previously demonstrated that activation of P2X4R in spinal microglia is crucial for neuropathic pain, a highly debilitating chronic pain condition, suggesting that P2X4R is a potential therapeutic target for treating neuropathic pain. Thus, the identification of a compound that has a potent inhibitory effect on P2X4R is an important clinical challenge. In the present study, we screened a chemical library of clinically approved drugs and show for the first time that duloxetine, a serotonin and noradrenaline reuptake inhibitor, has an inhibitory effect on rodent and human P2X4R...
2016: PloS One
https://www.readbyqxmd.com/read/27755218/an-open-label-pilot-study-of-duloxetine-in-patients-with-irritable-bowel-syndrome-and-comorbid-major-depressive-disorder
#8
Roberto Lewis-Fernández, Peter Lam, Susan Lucak, Hanga Galfalvy, Elizabeth Jackson, Jane Fried, Melissa Rosario, Ana Alicia de la Cruz, Arturo Sánchez-Lacay, Samantha Díaz, Franklin Schneier
Major depressive disorder (MDD) and irritable bowel syndrome (IBS) frequently co-occur, yet treating their comorbid presentation is challenging. Low-dose tricyclic antidepressants are efficacious for IBS, but higher doses to treat depressive symptoms present tolerability problems, whereas selective serotonin reuptake inhibitors are more tolerable but show inconsistent efficacy for IBS. If efficacious, serotonin-norepinephrine reuptake inhibitors like duloxetine would provide a useful alternative. We explored efficacy, tolerability, and time to onset of action of duloxetine in comorbid IBS-MDD in an open-label, 12-week trial...
October 17, 2016: Journal of Clinical Psychopharmacology
https://www.readbyqxmd.com/read/27747105/restoring-spinal-noradrenergic-inhibitory-tone-attenuates-pain-hypersensitivity-in-a-rat-model-of-parkinson-s-disease
#9
Lei-Fang Cao, Xiao-Yan Peng, Ya Huang, Bing Wang, Feng-Ming Zhou, Ruo-Xiao Cheng, Li-Hua Chen, Wei-Feng Luo, Tong Liu
In the present study, we investigated whether restoring descending noradrenergic inhibitory tone can attenuate pain in a PD rat model, which was established by stereotaxic infusion of 6-hydroxydopamine (6-OHDA) into the bilateral striatum (CPu). PD rats developed thermal and mechanical hypersensitivity at the 4th week after surgery. HPLC analysis showed that NE content, but not dopamine or 5-HT, significantly decreased in lumbar spinal cord in PD rats. Additional noradrenergic depletion by injection of N-(2-chloroethyl)-N-ethyl-2-bromobenzylamine (DSP-4) aggravated pain hypersensitivity in PD rats...
2016: Neural Plasticity
https://www.readbyqxmd.com/read/27742549/knowledge-on-fibromyalgia-among-general-practitioners-from-chiclayo-peru-2016
#10
Fátima Evelin Acuña Ortiz, Victoria Alejandra Capitán de la Cruz, Franco Ernesto León Jiménez
OBJECTIVE: Knowledge about fibromyalgia in general practitioners in the province of Chiclayo, Peru, 2016. MATERIALS AND METHODS: Cross sectional descriptive study. Non-probability sampling, census type. In all, 145 physicians were evaluated through a questionnaire of 14 questions, validated by experts and a pilot. The analysis was performed using STATA v. 13. RESULTS: Accuracy in questions involving diagnosis was 41.1% and in questions about treatment: 65%; 75...
October 11, 2016: Reumatología Clinica
https://www.readbyqxmd.com/read/27738505/depression-masquerading-as-chest-pain-in-a-patient-with-wolff-parkinson-white-syndrome
#11
Rajashree Madabushi, Anil Agarwal, Saipriya Tewari, Sujeet K S Gautam, Sandeep Khuba
Wolff Parkinson White (WPW) syndrome is a condition in which there is an aberrant conduction pathway between the atria and ventricles, resulting in tachycardia. A 42-year-old patient, who was treated for WPW syndrome previously, presented with chronic somatic pain. With her cardiac condition in mind, she was thoroughly worked up for a recurrence of disease. As part of routine screening of all patients at our pain clinic, she was found to have severe depression as per the Patient Health Questionnaire-9 (PHQ-9) criteria...
October 2016: Korean Journal of Pain
https://www.readbyqxmd.com/read/27704502/neuropathic-pain
#12
Janne Gierthmühlen, Ralf Baron
Diagnosing neuropathic pain and distinguishing it from nociceptive pain can be challenging, but is essential because both forms of pain require different treatment strategies. The diagnosis of neuropathic pain is primarily based on clinical findings. Therefore, a careful, focused history and an examination of the signs characteristic of neuropathic pain are crucial. Imaging techniques and electrophysiological examinations, as well as punch skin biopsy can support the clinical diagnosis. Ideally, treatment should be individualized using a mechanism-based approach...
October 2016: Seminars in Neurology
https://www.readbyqxmd.com/read/27685982/the-noradrenergic-locus-coeruleus-as-a-chronic-pain-generator
#13
Bradley K Taylor, Karin N Westlund
Central noradrenergic centers such as the locus coeruleus (LC) are traditionally viewed as pain inhibitory; however, complex interactions among brainstem pathways and their receptors modulate both inhibition and facilitation of pain. In addition to the well-described role of descending pontospinal pathways that inhibit spinal nociceptive transmission, an emerging body of research now indicates that noradrenergic neurons in the LC and their terminals in the dorsal reticular nucleus (DRt), medial prefrontal cortex (mPFC), spinal dorsal horn, and spinal trigeminal nucleus caudalis participate in the development and maintenance of allodynia and hyperalgesia after nerve injury...
September 29, 2016: Journal of Neuroscience Research
https://www.readbyqxmd.com/read/27684492/pregabalin-for-pain-in-fibromyalgia-in-adults
#14
Sheena Derry, Malene Cording, Philip J Wiffen, Simon Law, Tudor Phillips, R Andrew Moore
BACKGROUND: This review updates part of an earlier Cochrane review on 'Pregabalin for acute and chronic pain in adults' (Moore 2009), and considers only fibromyalgia pain.Antiepileptic drugs have been used in pain management since the 1960s. Pregabalin is an antiepileptic drug also used in management of chronic pain conditions, including fibromyalgia. Pain response with pregabalin is associated with major benefits for other symptoms, and improved quality of life and function in people with chronic painful conditions...
September 29, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27663827/treatment-of-depression-in-patients-with-osteoarthritis-the-importance-of-an-early-diagnosis-and-the-role-of-duloxetine
#15
Cátia Jesus, Inês Jesus, Mark Agius
BACKGROUND: Osteoarthritis (OA) also called degenerative joint disease is the most common chronic condition of the joints that just in 2004, caused moderate to severe disability in 43.4 million of people. OA in Western populations is one of the most frequent causes of joint pain, loss of function and disability in adults. In the U.S. it is the second most common cause of work disability in men over 50 years of age, following ischaemic heart disease, and accounts for a higher number of hospitalizations when compared with rheumatoid arthritis (RA) each year...
September 2016: Psychiatria Danubina
https://www.readbyqxmd.com/read/27660061/small-fiber-neuropathy-in-children-two-case-reports-illustrating-the-importance-of-recognition
#16
Janneke G J Hoeijmakers, Catharina G Faber, Carien J Miedema, Ingemar S J Merkies, Johan S H Vles
Small fiber neuropathy (SFN) is a debilitating condition that often leads to pain and autonomic dysfunction. In the last few decades, SFN has been gaining more attention, particularly in adults. However, literature about SFN in children remains limited. The present article reports the cases of 2 adolescent girls diagnosed with SFN. The first patient (14 years of age) complained about painful itch and tingling in her legs, as well as dysautonomia symptoms for years. She also reported a red/purple-type discoloration of her legs aggravated by warmth and standing, compatible with erythromelalgia...
September 22, 2016: Pediatrics
https://www.readbyqxmd.com/read/27541383/single-versus-multiple-drug-pharmacotherapy-in-the-management-of-diabetic-painful-neuropathy
#17
Kuan-Ling Kuo, Diana Brixner, Arthur G Lipman, Michael Goodman, Man Hung, Gary M Oderda
This study compared patient characteristics and health care costs between newly treated diabetic painful neuropathy (DPN) patients receiving mono- pharmacotherapy and those receiving combination pharmacotherapy. A retrospective cohort was developed through Inovalon's Medical Outcomes Research for Effectiveness and Economics Registry (MORE2) database. Patients included were ≥18 years on the date of first DPN prescription: tricyclic antidepressant, opioids, duloxetine, gabapentin, pregabalin, or lidocaine. The authors conducted a simple proportional hazards model comparing times to discontinuation, switch, or addon...
September 2016: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/27484440/a-study-on-comparative-efficacy-and-cost-effectiveness-of-pregabalin-and-duloxetine-used-in-diabetic-neuropathic-pain
#18
Midhun K Roy, Abaedha Susan Kuriakose, Sujith K Varma, Lejo A Jacob, N Jeena Beegum
AIM: The study was designed for comparing the efficacy and cost effectiveness of Pregabalin and Duloxetine used in Diabetic Neuropathic Pain. METHODS: The prospective interventional 6 month study was conducted in a diabetic clinic of a 500 bedded tertiary care hospital in South India. The subjects having diagnosed with diabetic neuropathy and not treated with Pregabalin and Duloxetine or any other drugs of its class were selected. The data were collected using NPS and Neuro QoL questionnaires...
July 27, 2016: Diabetes & Metabolic Syndrome
https://www.readbyqxmd.com/read/27479625/treating-painful-diabetic-peripheral-neuropathy-an-update
#19
Matthew J Snyder, Lawrence M Gibbs, Tammy J Lindsay
Painful diabetic peripheral neuropathy occurs in approximately 25% of patients with diabetes mellitus who are treated in the office setting and significantly affects quality of life. It typically causes burning pain, paresthesias, and numbness in a stocking-glove pattern that progresses proximally from the feet and hands. Clinicians should carefully consider the patient's goals and functional status and potential adverse effects of medication when choosing a treatment for painful diabetic peripheral neuropathy...
August 1, 2016: American Family Physician
https://www.readbyqxmd.com/read/27475515/medication-treatment-efficacy-and-chronic-orofacial-pain
#20
REVIEW
Glenn T Clark, Mariela Padilla, Raymond Dionne
Chronic pain in the orofacial region has always been a vexing problem for dentists to diagnose and treat effectively. For trigeminal neuropathic pain, there are 3 medications (gabapentinoids, tricyclic antidepressants, and serotonin-norepinephrine reuptake inhibitors) to use plus topical anesthetics that have therapeutic efficacy. For chronic daily headaches (often migraine in origin), 3 prophylactic medications have reasonable therapeutic efficacy (β-blockers, tricyclic antidepressants, and antiepileptic drugs)...
August 2016: Oral and Maxillofacial Surgery Clinics of North America
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