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https://www.readbyqxmd.com/read/29154979/small-fiber-neuropathy-diagnosis-causes-and-treatment
#1
Damien Sène
Small fiber neuropathy, which affects the sensory A≏ and C fibers, is now a major diagnostic and therapeutic challenge. Nearly 7% of the general population have chronic neuropathic pain responsible for severe quality-of-life impairments. Awareness must therefore be raised among clinicians of the somatosensory and autonomic symptoms that can reveal small fiber neuropathy, appropriate diagnostic investigations, most common causes, and best treatment options for each patient profile. To help achieve this goal, the present review article discusses the clinical presentation of neuropathic pain and paresthesia and/or autonomic dysfunction due to involvement of nerves supplying exocrine glands and smooth muscle; normal findings from standard electrophysiological investigations; most informative diagnostic tests (epidermal nerve fiber density in a skin biopsy, laser-evoked potentials, heat- and cold-detection thresholds, electrochemical skin conductance); main causes, which consist chiefly of metabolic diseases (diabetes mellitus, glucose intolerance), dysimmunity syndromes (Sjögren's syndrome, sarcoidosis, monoclonal gammopathy), and genetic abnormalities (familial amyloidosis due to a transthyretin mutation, Fabry disease, sodium channel diseases); and the available symptomatic and etiological treatments...
November 15, 2017: Joint, Bone, Spine: Revue du Rhumatisme
https://www.readbyqxmd.com/read/29154689/peripheral-vagal-nerve-stimulation-modulates-the-nociceptive-withdrawal-reflex-in-healthy-subjects-a-randomized-cross-over-sham-controlled-study
#2
Roberto De Icco, Daniele Martinelli, Vito Bitetto, Mauro Fresia, Eric Liebler, Giorgio Sandrini, Cristina Tassorelli
Introduction The mechanism of action of non-invasive vagal nerve stimulation in the treatment of migraine is elusive. We studied its effect in a human model of pain, the nociceptive withdrawal reflex. Methods We enrolled 10 healthy subjects who underwent active non-invasive vagal nerve stimulation and sham treatment in a randomized, cross-over, sham-controlled study. Non-invasive vagal nerve stimulation was delivered with gammaCore®. The assessment of the nociceptive withdrawal reflex was performed at baseline (T0) and at 5 (T5) and 30 (T30) minutes after stimulation...
January 1, 2017: Cephalalgia: An International Journal of Headache
https://www.readbyqxmd.com/read/29154261/electrical-impedance-of-the-torso-is-associated-with-the-pressure-pain-threshold-on-myofascial-trigger-points-in-patients-with-chronic-neck-pain-a-cross-sectional-study
#3
Almir Vieira Dibai-Filho, Marília Artese Barros, Alessandra Kelly de Oliveira, Rinaldo Roberto de Jesus Guirro
BACKGROUND: Myofascial trigger points are dysfunctional structures present in skeletal muscles and are related to sensory, motor, and autonomic changes. Despite scientific advances in recent decades in the measurement of musculoskeletal pain, evaluation of this clinical phenomenon is supported with instruments that, although valid and reliable, have a considerable degree of subjectivity. OBJECTIVE: To correlate electrical impedance of the upper limbs and torso with pain intensity, functional capacity, catastrophizing, pressure pain threshold, and skin temperature on myofascial trigger points in the upper trapezius muscle of patients with neck pain...
November 10, 2017: Journal of Back and Musculoskeletal Rehabilitation
https://www.readbyqxmd.com/read/29154057/far-infrared-ray-patches-relieve-pain-and-improve-skin-sensitivity-in-myofascial-pain-syndrome-a-double-blind-randomized-controlled-study
#4
Yen-Ting Lai, Hsiang-Lin Chan, Shu-Huan Lin, Chih-Ching Lin, Szu-Yuan Li, Chih-Kuang Liu, Hao-Wei Teng, Wen-Sheng Liu
OBJECTIVE: Myofascial pain syndrome (MPS) is a common disorder characterized by muscle pain if myofascial trigger points (MTrP) are stimulated. This study evaluated the effectiveness of far-infrared ray (FIR) patches in reducing the severity of pain in patients with MPS. METHODS: A double-blind, randomized controlled study involving 125 patients with MPS and 201 MTrPs located in the trapezius muscle. A FIR patch was applied to 98 MTrPs for 24h in the intervention group (61 patients) and a placebo patch was applied to 91 MTrPs in the control group (57 patients) at the end...
December 2017: Complementary Therapies in Medicine
https://www.readbyqxmd.com/read/29153332/sensorimotor-performance-and-function-in-people-with-osteoarthritis-of-the-hand-a-case-control-comparison
#5
Nicoló Edoardo Magni, Peter John McNair, David Andrew Rice
OBJECTIVES: To determine whether hand left/right judgements, tactile acuity, and body perception are impaired in people with hand OA. To examine the relationships between left right judgements, tactile acuity and hand pain. To explore the relationships between sensorimotor measures (left/right judgements and tactile acuity) and measures of hand function in people with hand OA. METHODS: Twenty patients with symptomatic hand OA and 19 healthy pain-free controls undertook a hand left/right judgment task, a control left/right judgement task, two-point discrimination (TPD) threshold testing (assessing tactile acuity), a neglect-like symptoms questionnaire (assessing body perception) and several established measures of hand function...
September 25, 2017: Seminars in Arthritis and Rheumatism
https://www.readbyqxmd.com/read/29149236/mutations-affecting-glycinergic-neurotransmission-in-hyperekplexia-increase-pain-sensitivity
#6
Pascal Henri Vuilleumier, Raphael Fritsche, Jürg Schliessbach, Bernhard Schmitt, Lars Arendt-Nielsen, Hanns Ulrich Zeilhofer, Michele Curatolo
Inhibitory interneurons in the spinal cord use glycine and GABA for fast inhibitory neurotransmission. While there is abundant research on these inhibitory pain pathways in animal models, their relevance in humans remains unclear, largely due to the limited possibility to manipulate selectively these pathways in humans. Hyperekplexia is a rare human disease that is caused by loss-of-function mutations in genes encoding for glycine receptors and glycine transporters. In the present study, we tested whether hyperekplexia patients display altered pain perception or central pain modulation compared with healthy subjects...
November 15, 2017: Brain: a Journal of Neurology
https://www.readbyqxmd.com/read/29148911/report-from-enhanced-safety-surveillance-of-two-influenza-vaccines-vaxigrip-and-intanza-15%C3%AE-g-in-two-european-countries-during-influenza-season-2016-17-and-comparison-with-2015-16-season
#7
Anne Laure Chabanon, Hélène Bricout, Céline Ballandras, Audrey Souverain, Timothy David Caroe, Karina M Butler
Passive enhanced safety surveillance (ESS) was implemented in the United Kingdom and in the Republic of Ireland for Vaxigrip and Intanza 15µg influenza vaccines during the 2016/17 influenza season. Lessons learned during 2015/16 ESS implementation were integrated and applied towards the current ESS. The primary objective was to estimate the reporting rates of suspected adverse reactions (ARs) occurring within 7 days of vaccination with Vaxigrip or Intanza 15µg. For Vaxigrip (N = 962), 17 vaccinees (1.8%) reported 59 suspected ARs (6...
November 17, 2017: Human Vaccines & Immunotherapeutics
https://www.readbyqxmd.com/read/29144720/cost-effectiveness-of-gammacore-non-invasive-vagus-nerve-stimulation-for-acute-treatment-of-episodic-cluster-headache
#8
Mkaya Mwamburi, Eric J Liebler, Andrew T Tenaglia
Cluster headache is a debilitating disease characterized by excruciatingly painful attacks that affects 0.15% to 0.4% of the US population. Episodic cluster headache manifests as circadian and circannual seasonal bouts of attacks, each lasting 15 to 180 minutes, with periods of remission. In chronic cluster headache, the attacks occur throughout the year with no periods of remission. While existing treatments are effective for some patients, many patients continue to suffer. There are only 2 FDA-approved medications for episodic cluster headache in the United States, while others, such as high-flow oxygen, are used off-label...
November 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/29143247/using-circulating-tumor-cells-to-evaluate-the-efficacy-of-irreversible-electroporation-for-unresectasble-pancreatic-cancer
#9
Mao Lin, Mohammed Alnaggar, Shu-Zhen Liang, Jian Shi, Li-Zhi Niu, Ji-Bing Chen, Ke-Cheng Xu
We used circulating tumor cells (CTCs) as biomarkers to evaluate the efficacy of pre-irreversible electroporation (IRE) and post-IRE for unresectable pancreatic cancer (PC). Real-time qPCR was used to detect potential biomarker genes in CTCs, and magnetic-activated cell sorting (MACS) and fluorescence-activated cell sorting (FACS) were performed on 43 patients with PC who underwent IRE. Some patients experienced adverse reactions within 30 days of the operation, including arrhythmia (6.9%), intraoperative transient change of blood pressure (25...
November 15, 2017: Immunologic Research
https://www.readbyqxmd.com/read/29140929/tactile-acuity-dys-function-in-acute-nociceptive-low-back-pain-a-doubleblind-experiment
#10
Wacław M Adamczyk, Oskar Saulicz, Edward Saulicz, Kerstin Luedtke
Research shows that chronic pain is related to cortical alterations that can be reflected in reduced tactile acuity, but whether acute pain perception influences tactile acuity has not been tested. Considering the biological role of nociception, it was hypothesized that nociceptive pain will lead to a rapid improvement in tactile acuity and that this effect is correlated with pain intensity and pain distribution. In this randomised double-blind controlled experiment (trial no. NCT03021278), healthy participants were exposed to one of three experimental conditions: acute, nociceptive low back pain induced by saline injection, a sham-injection (without piercing the skin) potentially inducing nocebo pain, or no intervention...
November 13, 2017: Pain
https://www.readbyqxmd.com/read/29138049/pain-neurophysiology-education-and-therapeutic-exercise-for-patients-with-chronic-low-back-pain-a-single-blind-randomized-controlled-trial
#11
Bodes Pardo Gema, Lluch Girbés Enrique, Roussel Nathalie A, Gallego Izquierdo Tomás, Jiménez Penick Virginia, Pecos Martín Daniel
AIM: To assess the effect of a pain neurophysiology education program plus therapeutic exercise for patients with chronic low back pain (CLBP). DESIGN: Single-blind randomized controlled trial. SETTING: Private clinic (Clínica Bonn) and Alcalá de Henares University, Madrid, Spain. PARTICIPANTS: 56 patients with CLBP for 6 months or more. INTERVENTION: Participants were randomized to receive either a therapeutic exercise (TE) program consisting of motor control, stretching, and aerobic exercises (TE group, n=28) or the same therapeutic exercise program in addition to a pain neurophysiology education program (PNE+TE group, n=28), conducted in two 30 to 50 minute sessions in groups of 4 to 6 participants...
November 11, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/29137644/functional-resonance-magnetic-imaging-fmri-in-adolescents-with-idiopathic-musculoskeletal-pain-a-paradigm-of-experimental-pain
#12
Juliana Molina, Edson Amaro, Liana Guerra Sanches da Rocha, Liliana Jorge, Flavia Heloisa Santos, Claudio A Len
BACKGROUND: Studies on functional magnetic resonance imaging (fMRI) have shown that adults with musculoskeletal pain syndromes tolerate smaller amount of pressure (pain) as well as differences in brain activation patterns in areas related to pain.The objective of this study was to evaluate, through fMRI, the brain activation in adolescents with idiopathic musculoskeletal pain (IMP) while performing an experimental paradigm of pain. METHODS: The study included 10 consecutive adolescents with idiopathic musculoskeletal pain (average age 16...
November 14, 2017: Pediatric Rheumatology Online Journal
https://www.readbyqxmd.com/read/29135586/increased-hyperalgesia-and-proinflammatory-cytokines-in-the-spinal-cord-and-dorsal-root-ganglion-after-surgery-and-or-fentanyl-administration-in-rats
#13
Lu Chang, Fang Ye, Quehua Luo, Yuanxiang Tao, Haihua Shu
BACKGROUND: Perioperative fentanyl has been reported to induce hyperalgesia and increase postoperative pain. In this study, we tried to investigate behavioral hyperalgesia, the expression of proinflammatory cytokines, such as interleukin-1β (IL-1β), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α), and the activation of microglia in the spinal cord and dorsal root ganglion (DRG) in a rat model of surgical plantar incision with or without perioperative fentanyl. METHODS: Four groups of rats (n = 32 for each group) were subcutaneously injected with fentanyl at 60 μg/kg or normal saline for 4 times with 15-minute intervals...
November 10, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29135458/immediate-effects-of-osteopathic-treatment-versus-therapeutic-exercise-on-patients-with-chronic-cervical-pain
#14
Xabier Galindez-Ibarbengoetxea, Igor Setuain, Robinson Ramírez-Velez, Lars L Andersen, Miriam González-Izal, Andoni Jauregi, Mikel Izquierdo
Context • Alternatives to medication for immediate pain relief are needed because long-term use of pain medication has been associated with adverse effects. High-velocity, low-amplitude (HVLA) manipulation techniques (MTs) and craniocervical flexion (CCF) exercises have been frequently used in the management of chronic cervical pain. Objective • The study intended to compare the immediate effects on pain of a treatment using HVLA manipulation versus one using a CCF exercise protocol. Design • The research team designed a single-blinded, randomized clinical trial...
November 14, 2017: Alternative Therapies in Health and Medicine
https://www.readbyqxmd.com/read/29131477/a-risk-assessment-score-and-initial-high-sensitivity-troponin-combine-to-identify-low-risk-of-acute-myocardial-infarction-in-the-emergency-department
#15
John W Pickering, Dylan Flaws, Stephen W Smith, Jaimi Greenslade, Louise Cullen, William Parsonage, Edward Carlton, A Mark Richards, Richard Troughton, Christopher Pemberton, Peter M George, Martin P Than
OBJECTIVES: Early discharge of patients with presentations triggering assessment for possible acute coronary syndrome is safe when clinical assessment indicates low-risk, biomarkers are negative, and electrocardiograms (ECGs) are non-ischemic. We hypothesized that the Emergency Department Assessment of Chest Pain Score (EDACS) combined with a single measurement of high-sensitivity cardiac troponin (hs-cTn) could allow early discharge of a clinically meaningful proportion of patients. METHODS: We pooled data from 4 patient cohorts from New Zealand and Australia presenting to an ED with symptoms suggestive of ACS...
November 13, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29131461/somatosensory-profile-of-patients-with-haemophilia
#16
S Krüger, M K Boettger, T Hilberg
INTRODUCTION: Patients with haemophilia (PwH) suffer from an enhanced pain sensitivity due to repetitive joint bleedings. A comprehensive, quantitative examination of the somatosensory system has not been performed in this population to date. MATERIAL AND METHODS: Thirty patients with moderate or severe haemophilia A or B and 30 healthy controls were examined by means of Quantitative Sensory Testing to assess the function of the somatosensory system. Detection (DT) and pain thresholds (PT) were determined, amounting to a total of 13 parameters...
November 13, 2017: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/29128111/nocturnal-phantom-shock-cessation-with-zolpidem
#17
L McLean House, Rachel E McKay, John Thomas Eagan, Zachary L McCormick
A 77 year old man with a biventricular ICD-pacemaker complained of painful, electric jolts disturbing him nightly from sleep. Extensive work-up including device interrogation revealed no defibrillations or arrhythmia, and he was subsequently diagnosed with phantom shocks (PS). His nightly PS symptoms terminated after starting zolpidem 10 mg each night. To date, literature review reveals fifteen articles reporting 163 phantom shock (PS) cases. PS affects 5-9% of ICD recipients. Risk factors include psychiatric disease, atrial fibrillation, NYHA functional status III or greater, prior shock storm, and intraoperative awareness during ICD placement, with defibrillation threshold testing...
November 8, 2017: Heart & Lung: the Journal of Critical Care
https://www.readbyqxmd.com/read/29127072/no-effect-of-a-pulsed-magnetic-field-on-induced-ischemic-muscle-pain-a-double-blind-randomized-placebo-controlled-trial
#18
Renáta Szemerszky, Zsuzsanna Szabolcs, Tamás Bogdány, Gábor Jánossy, György Thuróczy, Ferenc Köteles
Empirical evidence supporting the effectiveness of pulsed (electro)magnetic field (PEMF) therapy on chronic and acute pain is equivocal. In the current randomized, double-blind, placebo-controlled experiment, impact of a commercially available whole-body PEMF mat on acute ischemic muscle pain induced in the forearm was studied with the participation of 70 healthy volunteers. The device emitted a pulsed magnetic field with a repetition frequency of 2.05Hz and a maximum flux density of 25.3μT (rms). The highest dB/dt was 48mT/s...
November 7, 2017: Physiology & Behavior
https://www.readbyqxmd.com/read/29126222/lumbar-disc-herniation-the-association-between-quantitative-sensorial-test-and-magnetic-resonance-imaging-findings
#19
Serpil Canan Erbüyün, Gülgün Yilmaz Ovali, Beyhan Özyurt, E Alp Yentür
Objective: Quantitative sensorial tests (QST) are used for evaluating specific sensorial nerve function. In this study, QST and magnetic resonance imaging (MRI) findings are compared in lumbar disc herniation patients, and the accuracy of QST data was investigated. Material and Methods: Sixty-four patients between 18 and 70 years of age suffering from radicular pain with positive Lasegue's test were included in this study. Specific criteria included complaints due to L5 discopathy...
November 6, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29123982/decreased-grip-strength-muscle-pain-and-atrophy-occur-in-rats-following-long-term-exposure-to-excessive-repetitive-motion
#20
Mitsuhiro Fujiwara, Masahiro Iwata, Takayuki Inoue, Yosuke Aizawa, Natsumi Yoshito, Kazuhiro Hayashi, Shigeyuki Suzuki
Work-related musculoskeletal disorders (WMSD) are caused by the overuse of muscles in the workplace. Performing repetitive tasks is a primary risk factor for the development of WMSD. Many workers in highly repetitive jobs exhibit muscle pain and decline in handgrip strength, yet the mechanisms underlying these dysfunctions are poorly understood. In our study, rats performed voluntary repetitive reaching and grasping tasks (Task group), while Control group rats did not perform these activities. In the Task group, grip strength and forearm flexor withdrawal threshold declined significantly from week 2 to week 6, compared with these values at week 0 (P < 0...
November 2017: FEBS Open Bio
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